In recent decades, the global community has encountered several significant viral outbreaks, including the Ebola epidemic in West Africa, the Zika virus epidemic in South America, and the recent worldwide COVID-19 pandemic. In these instances, the deployment of effective vaccines has been instrumental in protecting public health. Nevertheless, as new challenges emerge in the prevention and management of infectious diseases, the traditional model of global vaccine development confronts both unprecedented opportunities and challenges. These circumstances underscore the limitations inherent in conventional vaccine development, particularly the protracted timelines and substantial costs involved. This article examines innovative approaches in contemporary vaccine clinical trials, investigates randomization techniques specific to vaccine studies, and delineates essential statistical considerations pertinent to vaccine trial design. The objective is to provide scientific support for vaccine development and to foster ongoing innovation and optimization within the realm of vaccine research and development.

Objective:To evaluate the diagnostic performance of resting echocardiography in detecting severe coronary artery stenosis.Methods:A total of 136 patients with suspected coronary artery disease（CAD）who presented to Sichuan Provincial People's Hospital between January 2021 and December 2024 were prospectively enrolled. All patients underwent both coronary computed tomography angiography（CCTA）and transthoracic echocardiography within one week. Based on CCTA results，the patients were divided into non-severe stenosis group（ n=78）and severe stenosis group（ n=58）. Echocardiographic parameters including left atrial maximum volume（LAVmax），left ventricular global longitudinal strain（GLS），left ventricular longitudinal strain of endo-myocardium，mid-myocardium，epi-myocardium（LSendo，LSmid，LSepi），early diastolic mitral inflow velocity（E），early diastolic mitral annular velocity of the lateral and septal walls（e'），and E/e' were measured. Predictive factors for severe coronary stenosis were identified using LASSO regression，and a nomogram model was developed via multivariate Logistic regression. Model performance was evaluated using ROC curves，calibration curves，and decision curve analysis. Results:Multivariate Logistic regression analysis revealed LSendo，LAVmax，and E/e' as independent predictors of severe coronary artery stenosis. The nomogram constructed based on these predictors achieved an area under the curve of 0.798（95% CI=0.723-0.873），with sensitivity and specificity of 0.756 and 0.759，respectively. Conclusions:The resting echocardiography-based nomogram model demonstrates good diagnostic efficacy for severe coronary artery stenosis. It may serve as a noninvasive tool to assist in risk stratification and clinical decision-making in patients with suspected CAD.

Objective:To study the development status and characteristics of the Traditional Chinese Medicine(TCM)service capacity of primary medical institutions(referred as primary)in Beijing.Methods:The case-base aggregation method was used to analyze the total amount,distribution,and development changes of total TCM costs in primary healthcare institutions in Beijing.Results:From 2019 to 2023,the average annual growth rate of the TCM costs of primary healthcare institutions in Beijing was 10.09％,and the proportion in total TCM costs increased from 16.01％to 18.19％.The average annual growth rate of the TCM costs of community health service centers(stations)was 11.78％,but there were negative growths in outpatient departments,clinics,and village clinics.The proportion of the primary TCM costs in its health costs increased from 29.16％to 32.56％.The average annual growth rate of income from primary herbal medicines and processed Chinese medicines were 16.75％and 10.13％.Conclusion:The primary TCM undertaking has developed steadily,and Beijing should continue to guide high-quality TCM resources to sink.Multiple measures should be taken to promote the development of TCM in outpatient departments,clinics,and village clinics.The coordination between prices and medical insurance reimbursement and payment methods should be strengthened.Supervision over the quality and use of Chinese medicine should be strengthened,and the technical service capabilities of primary TCM should be enhanced.

Cholestatic liver disease(CLD)is a liver condition caused by disorders in bile acid secretion and metabolism due to various reasons,and it has the common pathological features of various chronic liver diseases.In recent years,the role of cholangiocyte senescence(CS)in the pathogenesis of CLD has attracted more and more attention,and CS not only participates in the development and progression of CLD,but it is also significantly associated with the course and prognosis of the disease.Targeted clearance of senescent cholangiocytes or blocking senescence-related pathways can improve CLD.This article summarizes the role of CS in CLD,related influencing factors,and the research advances in CLD,in order to provide a theoretical reference for subsequent studies on CLD.

Objective:To analyze the risk factors for dysphagia in older adult patients with Parkinson's disease.Methods:The clinical data of 100 older adult patients with Parkinson's disease admitted to Zhejiang Xin'an International Hospital between January 2022 and December 2023 were retrospectively analyzed. The patients were divided into two groups based on the presence of dysphagia: an occurrence group ( n = 40) and a non-occurrence group ( n = 60). General data and clinical characteristics of both groups were compared. Multivariate logistic regression analysis was performed to analyze the risk factors associated with the occurrence of dysphagia in older adult patients with Parkinson's disease. Results:In the cohort of 100 patients, the percentages of those aged 70 years and above, those with a Parkinson's disease H-Y classification greater than 3, those with an Eating Assessment Tool-10 (EAT-10) score of 3 or higher, and the Unified Parkinson's Disease Rating Scale (UPDRS) score in the occurrence group were 75.00% (30/40), 75.00% (30/40), 80.00% (32/40), and (17.23 ± 1.02), respectively. These measurements were higher than those in the non-occurrence group [16.67% (28/60), 43.33% (26/60), 33.33% (20/60), (13.23 ± 0.48), χ2 = 7.91, 9.77, 20.94, t = 22.44, P < 0.05]. The level of uric acid in the occurrence group was significantly lower than that in the non-occurrence group [(345.63 ± 11.35) μmol/L vs. (375.62 ± 10.24) μmol/L, t = 12.41, P < 0.05]. The results of the multivariate logistic regression analysis indicated that age of 70 years and older, H-Y classification greater than 3, Eating Assessment Tool-10 score of 3 or higher, Unified Parkinson's Disease Rating Scale score, and uric acid level were relevant risk factors for dysphagia in older adult patients with Parkinson's disease ( OR = 3.44, 3.82, 3.86, 3.60, 3.71, all P < 0.05). Conclusions:Age of 70 years and older, H-Y classification greater than 3, Eating Assessment Tool-10 score of 3 or higher, Unified Parkinson's Disease Rating Scale score, and uric acid level are relevant risk factors for dysphagia in older adult patients with Parkinson's disease.

In recent decades, the global community has encountered several significant viral outbreaks, including the Ebola epidemic in West Africa, the Zika virus epidemic in South America, and the recent worldwide COVID-19 pandemic. In these instances, the deployment of effective vaccines has been instrumental in protecting public health. Nevertheless, as new challenges emerge in the prevention and management of infectious diseases, the traditional model of global vaccine development confronts both unprecedented opportunities and challenges. These circumstances underscore the limitations inherent in conventional vaccine development, particularly the protracted timelines and substantial costs involved. This article examines innovative approaches in contemporary vaccine clinical trials, investigates randomization techniques specific to vaccine studies, and delineates essential statistical considerations pertinent to vaccine trial design. The objective is to provide scientific support for vaccine development and to foster ongoing innovation and optimization within the realm of vaccine research and development.

Non-alcoholic fatty liver disease(NAFLD)is a chronic liver disease caused by excessive lipid accumulation in the liver.Its incidence rate is increasing year by year and has become an increasingly serious public healthy problem.The pathogenesis of NAFLD is complex and has not been fully clarified at present.It is mainly related to multiple factors such as genetics,metabolism,intestinal flora and immune response.In order to explore the medication rules and mechanism of action of traditional Chinese medicine(TCM)in the treatment of NAFLD,and to provide references for the treatment of NAFLD with TCM and the research and development of new drugs,this article summarizes the TCM pathogenesis of NAFLD(such as"phlegm and blood stasis interlacing","liver depression and spleen deficiency",etc.)and modern etiology and pathogenesis(such as insulin resistance,lipid disorder,mitochondrial dysfunction,oxidative stress,etc.).The clinical research and experimental data at home and abroad in recent years were integrated to analyze the pathological process of NAFLD intervention by TCM through multiple targets,including improving insulin resistance and lipid metabolism disorders,inhibiting oxidative stress and mitochondrial dysfunction,etc.TCM has shown unique advantages in the prevention and treatment of NAFLD.However,the depth of its mechanism analysis and the level of clinical research still need to be improved.In the future,it is necessary to deepen the mechanism research by combining multi-omics technology to accelerate the modernization development of TCM.

T-cell lymphoma (TCL) is a rare type of non-Hodgkin lymphoma. CHOP/CHOP-like regimens are commonly used to treat TCL, but the prognosis is poor. Chimeric antigen receptor T cell therapy has shown its unique advantages in B-cell lymphoma, while its efficacy in TCL is still unclear. Some studies on different targets are ongoing, providing new directions for treatment of patients with TCL.

Acute myeloid leukemia (AML) is the most common type of acute leukemia in adults. Combination chemotherapy followed by hematopoietic stem cell transplantation is the preferred treatment option. Chimeric antigen receptor T-cell, as a rapidly developing cell therapy method, currently has no marketed products for the treatment of AML. This article reviews the research progress of chimeric antigen receptor T-cell therapy for the treatment of AML.

Multiple myeloma(MM)is a prevalent hematological malignancy.Despite the availability of various therapeutic agents,disease relapse remains inevitable.In recent years,B cell maturation antigen(BCMA)-targeted chimeric antigen receptor T(CAR-T)cell therapy has demonstrated remarkable success in treating relapsed/refractory(R/R)MM,offering new hope for RRMM patients.Currently,four types of BCMA-CAR-T products are available on the global market,and their application in RRMM is becoming increasingly widespread.However,RRMM patients who receive BCMA-CAR-T treatment still exhibit a high relapse rate.Research on maintenance therapy following BCMA-CAR-T treatment is currently limited,and multiple strategies exist for managing post-relapse RRMM after BCMA-CAR-T therapy.