Despite significant advances in the field of critical care medicine over the past three decades, veno-arterial extracorporeal membrane oxygenation (V-A ECMO) remains the primary temporary mechanical circulatory support modality for patients with acute severe circulatory failure. With the accumulation of clinical experience and the increasing maturity of operational techniques in V-A ECMO, its technical management—particularly hemodynamic management—has become a key factor influencing patient outcomes. To further improve patient survival, the Chinese Critical Care Ultrasound Study Group, in collaboration with the Hemodynamic Therapy of Critical Care Collaborative Group and the Critical Care Medicine Branch of the China International Exchange and Promotive Association for Medical and Health Care, organized experts in critical care medicine to develop the Consensus on Hemodynamic Management in Adult Veno-Arterial Extracorporeal Membrane Oxygenation (2026 Edition). Based on years of clinical experience and the latest evidence-based medical evidence, this consensus formulates 15 systematic recommendations covering the entire process of V-A ECMO, including initiation, management during support, and weaning, aiming to promote standardized application of hemodynamic management in V-A ECMO.

ObjectiveTo investigate the expression of C1q tumor necrosis factor-related protein 3 （C1QTNF3） in liver cancer tissue， its association with the clinicopathological features of patients， and its potential value in predicting the prognosis of liver cancer. MethodsRelated data were collected from TIMER， UALCAN， TNMplot， and GEO databases， and the bioinformatics methods were used to measure the expression level of C1QTNF3 in pan-cancer， normal tissue/liver cancer tissue， and cancerous tissue/paracancerous tissue. Cancerous and paracancerous tissue samples were collected from 90 patients with liver cancer， and related clinical data were collected， including age， sex， tumor diameter， and tumor number. The independent-samples t test or the paired t-test was used for comparison of continuous data between groups， and the chi-square test was used for comparison of categorical data between groups. The Kaplan-Meier method was used to plot survival curves， and the Log-rank test was used to investigate the association between the expression level of C1QTNF3 and the survival of patients with liver cancer. The Cox regression model was used to identify the risk factors for the prognosis of patients with liver cancer， and the receiver operating characteristic （ROC） curve was used to analyze the ability of C1QTNF3 expression at different time points for predicting the prognosis of patients with liver cancer. ResultsThe bioinformatics analysis showed that the expression of C1QTNF3 was upregulated in various malignant tumors， especially in liver cancer tissue （P<0.001）， and the expression level of C1QTNF3 in liver cancer tissue was significantly higher than that in normal tissue and paracancerous tissues （all P<0.01）. The immunohistochemical staining results of 90 patients with liver cancer showed that C1QTNF3 was mainly expressed in cytoplasm， with a small amount in nucleus， and it had negative expression in paracancerous tissue and positive expression in liver cancer tissue. The positive expression rate and strong positive expression rate of C1QTNF3 protein in liver cancer tissue were significantly higher than those in paracancerous tissue （positive expression rate： 76.67% vs 33.33%， χ²=34.141， P<0.01； strong positive expression rate： 54.44% vs 5.56%， χ²=51.217， P<0.01）. The liver cancer patients with a tumor diameter of ≥5 cm， an advanced stage， the presence of liver cirrhosis， negative HBsAg， and gamma-glutamyl transpeptidase （GGT）≥50 U/L had a significantly higher strong positive expression rate of C1QTNF3 protein than those with a tumor diameter of <5 cm， an early stage， the absence of liver cirrhosis， positive HBsAg， and GGT<50 U/L （all P<0.05）. The univariate Cox regression analysis showed that tumor diameter， recurrence， and C1QTNF3 expression were influencing factors for the prognosis of patients with liver cancer （all P<0.05）， and the multivariate Cox regression analysis showed that the expression level of C1QTNF3 and recurrence were independent risk factors for the survival of patients with liver cancer （both P<0.05）. The survival curve analysis showed that for all patients with liver cancer， the patients with high （strong positive） expression of C1QTNF3 had significantly lower overall survival rate and disease-free survival rate than those with low expression （χ²=17.010 and 13.647， both P<0.001）； for liver cancer patients with a tumor diameter of ≥5 cm， an early/advanced stage， recurrence， the presence of liver cirrhosis， positive HBsAg， alanine aminotransferase （ALT） <40 U/L， ALT≥40 U/L， and GGT≥50 U/L， the patients with high expression of C1QTNF3 had a significant reduction in overall survival rate （χ²=11.086， 5.578， 5.295， 19.159， 16.391， 13.774， 10.119， 8.152， and 12.035， all P<0.05）. The ROC curve analysis showed that C1QTNF3 expression had the strongest predictive potential at 5 years， with an area under the ROC curve of 0.77. ConclusionC1QTNF3 is highly expressed in liver cancer tissue， and the expression level of C1QTNF3 and recurrence are closely associated with the survival of patients with liver cancer. Patients with high expression of C1QTNF3 protein tend to have a lower survival rate.

Pharmacoepidemiology is an interdisciplinary field that applies epidemiological methods to study drug use,effectiveness,and associated risk in populations.Standardizing research methods in this field is crucial for ensuring research quality and promote the development of the discipline.Based on the Guide on Methodological Standards in Pharmacoepidemiology in China(2nd edition),this article interprets the relevant contents about classic research types and their derivative designs.It aims to clarify the types of study methodological designs in pharmacoepidemiology,systematically describe the characteristics and applications classical derivative designs,and compare these with research design frameworks outlined in international pharmacoepidemiological guidelines.Compared to the first edition,the second edition of the guideline has updated and detailed the types of research,updating the research design to original research(interventional research and non-interventional research),secondary research(systematic review,Meta-analysis,economic analysis,etc.),and tertiary research(umbrella review,etc.).Additionally,a variety of derivative designs have been added,including target trial emulation,nested case-control and case-cohort studies,case-crossover designs,self-controlled case series and self-controlled risk interval designs,case-population studies,interrupted time-series analysis,and case-coverage(ecological)designs for vaccine surveillance.This article strengthens the operability of the theoretical guidance of pharmacoepidemiological research methods in practice and provides a reference for conducting high-quality pharmacoepidemiological research.

Plant-derived bioactive peptides have become a research hotspot in the fields of food and medicine due to their high source safety,easy absorption and utilization by the human body,and potential edible and medicinal value.Bioactive peptides can be classified into antihypertensive,hypoglycemic,hypolipidemic,anticancer,antioxidant,antimicrobial,and anti-inflammatory peptides according to their functions.Among these,antihypertensive,hypoglycemic,and hypolipidemic peptides are collectively referred to as cardiovascular active peptides,which can be used for the treatment and prevention of cardiovascular diseases and have an important role in the development of modem biomedicine.This review focused on the preparation methods,separation,purification,and identification techniques of bioactive peptides,as well as their mechanisms of action and applications in regulating cardiovascular diseases,aiming to provide a reference for further development and application of plant-derived cardiovascular peptides.

Objective:To explore the differences in balance ability and brain activation level between the cerebral palsy(CP)adolescents and the typically developing(TD)adolescents.Method:Eight adolescents with CP or TD were recruited in this study.The center of pressure(COP)was measured using an AMTI three-dimensional force platform to assess the standing balance under perturbation or non-perturbation condition.Brain activation level was also measured using the fNIRS device to collect the oxy-genated hemoglobin concentrations(ΔHbO2)in the supplementary motor area(SMA),precental gyrus(PreCG),postcentral gyrus(PoCG)and superior parietal lobule(SPL).Result:①Balance ability indicators:During the perturbation condition,DeltaAP,RMS,RMSAP,SPAP in the CP group were significantly greater than those in the control group.In the CP group,DeltaAP,DeltaML,RMS,RMSAP,SPAP during the perturbation condition were significantly greater than those during the non-pertur-bation condition.②Brain activation level indicators:During the perturbation conditions,the ΔHbO2 of SMA in the CP group were significantly greater than those in the control group.In the CP group,the ΔHbO2 of SMA,PreCG,PoCG during the perturbation condition were significantly greater than those during the non-per-turbation condition.Conclusion:Compared to the TD adolescents,the CP adolescents had poorer balance in the anterior-posterior direction and higher level of SMA activation in the external perturbation condition.Under the external perturba-tion condition,the balance ability decreased in the anterior-posterior direction,while the activation level of SMA,PreCG and PoCG increased in the adolescents with CP.

Objective To explore the predictive value of the atherogenic index of plasma(AIP),triglyceride-glucose(TyG)index,and cerebral small vascular disease(CSVD)imaging load score regarding the early prognosis of patients with acute ischemic stroke(AIS)after intravenous thrombolysis.Methods A total of 379 inpatients diagnosed with AIS at the Shengli Oilfield Central Hospital and treated with intravenous thrombolysis from January 2022 to December 2023 were retrospectively analyzed.Relevant data were collected,and the CSVD imaging load score was evaluated.The patients were classified into the good prognosis group(≥18％)and the poor prognosis group(＜18％)based on the early neurological improvement rate 14 d after thrombolysis.An investigation into the independent risk factors influencing the early prognostic outcomes in patients suffering from AIS was conducted utilizing binary Logistic regression analysis.The efficacy of early prognosis prediction in patients undergoing intravenous thrombolysis was assessed through receiver operating characteristic(ROC)curve analysis.Results Systolic blood pressure,AIP,TyG index,neutrophil to lymphocyte ratio(NLR),cerebral microbleeds(CMB),enlarged perivascular spaces(EPVS)and a CSVD imaging load score of 2 points or higher served as independent risk factors influencing the early prognosis in AIS patients undergoing thrombolysis.The ROC curve analysis revealed that the area under the curve(AUC)for the CSVD imaging load score was 0.821,with a sensitivity of 80.4％and a specificity of 74％.The AUC of the AIP was 0.951,with a sensitivity of 89.2％and a specificity of 91.7％.The AUC of the TyG index was 0.918,with a sensitivity of 93.1％and a specificity of 82.7％.Conclusions The AIP,TyG index,and CSVD imaging load score serve as efficacious indicators in assessing the premature prognostication of AIS patients who underwent subsequently to intravenous thrombolytic therapy.

Objective:To evaluate the mid-term efficacy of sleeve gastrectomy combined with single anastomosis gastric-ileal bypass (SASI) for treating gastroesophageal reflux disease (GERD) after laparoscopic sleeve gastrectomy (LSG).Methods:Clinical data of 10 patients with post-LSG GERD undergoing SASI at the Department of Hernia and Bariatric Surgery, the First Affiliated Hospital of University of Science and Technology of China between Jan 2022 and Oct 2024 was retrospectively analyzed. Surgical safety and mid-term outcomes were evaluated.Results:The mean follow-up period was (25.40±17.33) months. The GerdQ score significantly decreased from (14.00±2.05) preoperatively to (5.70±1.49) postoperatively ( t=10.330, P<0.001), with a GERD remission rate of 90 % (9/10). Postoperative body weight and body mass index (BMI) both showed statistically significant reductions compared to preoperative values. Weight dropped from (110.29±22.92) kg to (84.95±15.89) kg ( t=5.889, P<0.001), and BMI decreased from (38.98±7.16) kg/m2 to (30.02±4.88) kg/m2 ( t=6.086, P<0.001). The percentage of excess weight loss was 65.88%±32.85%, and the percentage of total weight loss was 22.43%±9.65%. Only one patient experienced transient postoperative diarrhea, which resolved spontaneously, and no severe malnutrition cases were observed. Conclusion:SASI effectively improves GERD symptoms after LSG with favorable safety, serving as a suitable revisional surgical option for those patients.

Plant-derived bioactive peptides have become a research hotspot in the fields of food and medicine due to their high source safety,easy absorption and utilization by the human body,and potential edible and medicinal value.Bioactive peptides can be classified into antihypertensive,hypoglycemic,hypolipidemic,anticancer,antioxidant,antimicrobial,and anti-inflammatory peptides according to their functions.Among these,antihypertensive,hypoglycemic,and hypolipidemic peptides are collectively referred to as cardiovascular active peptides,which can be used for the treatment and prevention of cardiovascular diseases and have an important role in the development of modem biomedicine.This review focused on the preparation methods,separation,purification,and identification techniques of bioactive peptides,as well as their mechanisms of action and applications in regulating cardiovascular diseases,aiming to provide a reference for further development and application of plant-derived cardiovascular peptides.

Objective:To explore the differences in balance ability and brain activation level between the cerebral palsy(CP)adolescents and the typically developing(TD)adolescents.Method:Eight adolescents with CP or TD were recruited in this study.The center of pressure(COP)was measured using an AMTI three-dimensional force platform to assess the standing balance under perturbation or non-perturbation condition.Brain activation level was also measured using the fNIRS device to collect the oxy-genated hemoglobin concentrations(ΔHbO2)in the supplementary motor area(SMA),precental gyrus(PreCG),postcentral gyrus(PoCG)and superior parietal lobule(SPL).Result:①Balance ability indicators:During the perturbation condition,DeltaAP,RMS,RMSAP,SPAP in the CP group were significantly greater than those in the control group.In the CP group,DeltaAP,DeltaML,RMS,RMSAP,SPAP during the perturbation condition were significantly greater than those during the non-pertur-bation condition.②Brain activation level indicators:During the perturbation conditions,the ΔHbO2 of SMA in the CP group were significantly greater than those in the control group.In the CP group,the ΔHbO2 of SMA,PreCG,PoCG during the perturbation condition were significantly greater than those during the non-per-turbation condition.Conclusion:Compared to the TD adolescents,the CP adolescents had poorer balance in the anterior-posterior direction and higher level of SMA activation in the external perturbation condition.Under the external perturba-tion condition,the balance ability decreased in the anterior-posterior direction,while the activation level of SMA,PreCG and PoCG increased in the adolescents with CP.

Objective: To explore the associations between caregivers nutrition literacy and pediatric nonalcoholic fatty liver disease (NAFLD), so as to provide scientific evidence for the key contents of family intervention measures. Methods: In September 2022, a study involving 1 609 thirdgrade students and their caregivers from six schools in Yinzhou, Haishu, and Zhenhai Districts of Ningbo City, Zhejiang Province, was conducted. Venous blood samples were collected to measure lipid profiles and investigate the prevalence of nonalcoholic fatty liver disease (NAFLD) among the children. Family Food Environment Questionnaire was used to assess the nutrition literacy levels of the caregivers. Generalized linear regression analysis was employed to explore the correlation between caregivers nutrition literacy levels and the prevalence of NAFLD in children. Results: Among the surveyed students, 191 were in the NAFLD group, whereas 1 418 were in the nonNAFLD group. The median nutrition literacy score of caregivers in the NAFLD group and nonNAFLD group all were 11.00 (9.00,12.00), which was not significantly different (Z=-0.40, P=0.71). The generalized linear regression results revealed that the level of nutrition literacy of caregivers had no significant effect on childrens Triglyceride-glucose (TyG) index and Triglyceride-glucose-Waisttoheight ratio (TyG-WHtR) [β(95%CI) were 0.001(-0.005-0.006) and 0.000(-0.014-0.014), P>0.05]. Conclusions The nutrition literacy level of caregivers has no significant correlation with the direct incidence of NAFLD in children. As for family intervention measures, it is necessary not only to improve the nutrition literacy level of caregivers but also to effectively apply nutritional knowledge in practice to optimize health management.