The grade of histological severity is a determining factor to evaluate the prognosis and survival rate in primary biliary cholangitis (PBC). However, liver biopsy is limited by sampling error, invasiveness, high cost, and poor compliance. Therefore, in order to overcome the limitations of liver biopsy, some non-invasive evaluation methods have been studied and applied to evaluate the progression of liver fibrosis in PBC. The prognostic score can be calculated using routine laboratory test results obtained at the time of diagnosis, which are characterized by their simplicity, affordability, ease of acquisition, and superior reproducibility. Recent studies have reported that the prognostic score can be employed as a non-invasive liver fibrosis model to diagnose the liver fibrosis stage in PBC and predict the transplant-free survival rate, in addition to being used to evaluate the patient prognosis and transplant-free survival (TFS). This paper reviews, summarizes, and explores the research progress of different prognostic scores as non-invasive liver fibrosis models via their diagnostic performance and predictive accuracy for PBC.

Lipoprotein X(LpX)is an atypical lipoprotein that abnormally accumulates in the plasma of patients with cholestatic liver disease,and it is also a major pathogenic factor for hypercholesterolemia.The formation of LpX is closely associated with the abnormal metabolism of free cholesterol,phospholipids,and other lipid components in bile.LpX cannot be cleared via the low-density lipoprotein receptor pathway and is mainly metabolized by the reticuloendothelial system.The abnormal accumulation of LpX is closely associated with various complications of cholestatic liver disease,including xanthoma and neuropathy.Although there is no significant correlation between the high level of LpX and the risk of atherosclerosis,the role of LpX in cholesterol metabolism disorders cannot be neglected.Due to the similarities in density and characteristics between LpX and low-density lipoprotein cholesterol,clinical testing may result in misdiagnosis and related treatment risks.Current studies mainly focus on the mechanisms of LpX formation,the clinical significance of LpX,related detection methods,and potential therapeutic strategies.Plasma exchange is considered the preferred treatment in the state of high LpX,while traditional lipid-lowering drugs have a limited effect on LpX.This article explores the formation and clearance mechanisms of LpX in cholestatic liver disease,along with its impact of cholestatic liver disease and related detection methods,in order to improve the understanding of the pathophysiology and clinical significance of LpX,provide new strategies for the management of cholestatic liver disease and its complications,and finally improve the prognosis of patients.

This paper introduces Professor LIU Zhibin 's clinical experience in the treatment of subjective tinnitus with acupuncture based on the "kidney-bone-brain" axis. Professor LIU proposes that the disease is most closely related to the kidney and brain. The lesion is located in the brain, and the pathogenesis is kidney essence deficiency, marrow sea loss, and ear orifice dystrophy. The "kidney-bone-brain" shows close correlation in physiological function, pathological changes and treatment. According to the "kidney-bone-brain" axis, Professor LIU proposes that the treatment of subjective tinnitus should be tonifying kidney qi, tonifying essence and filling marrow, and the principle of local acupoint selection, touching bone acupuncture, matching distal acupoints and proximal acupoints, tonifying kidney and benefiting brain should be adopted. The acupoints of Tinggong (SI19) and Yifeng (TE17) are selected to be treated with touching bone acupuncture, combined with Taixi (KI3), Shenshu (BL23), Baihui (GV20) and Shenting (GV24), so as to achieve common benefit of kidney, bone and brain, and multi-angle treatment.
Humans ; Acupuncture Therapy/history* ; Tinnitus/physiopathology* ; Acupuncture Points ; Kidney/physiopathology* ; Brain/physiopathology* ; Bone and Bones/physiopathology* ; Female ; Male ; Adult ; Middle Aged

Lipoprotein X(LpX)is an atypical lipoprotein that abnormally accumulates in the plasma of patients with cholestatic liver disease,and it is also a major pathogenic factor for hypercholesterolemia.The formation of LpX is closely associated with the abnormal metabolism of free cholesterol,phospholipids,and other lipid components in bile.LpX cannot be cleared via the low-density lipoprotein receptor pathway and is mainly metabolized by the reticuloendothelial system.The abnormal accumulation of LpX is closely associated with various complications of cholestatic liver disease,including xanthoma and neuropathy.Although there is no significant correlation between the high level of LpX and the risk of atherosclerosis,the role of LpX in cholesterol metabolism disorders cannot be neglected.Due to the similarities in density and characteristics between LpX and low-density lipoprotein cholesterol,clinical testing may result in misdiagnosis and related treatment risks.Current studies mainly focus on the mechanisms of LpX formation,the clinical significance of LpX,related detection methods,and potential therapeutic strategies.Plasma exchange is considered the preferred treatment in the state of high LpX,while traditional lipid-lowering drugs have a limited effect on LpX.This article explores the formation and clearance mechanisms of LpX in cholestatic liver disease,along with its impact of cholestatic liver disease and related detection methods,in order to improve the understanding of the pathophysiology and clinical significance of LpX,provide new strategies for the management of cholestatic liver disease and its complications,and finally improve the prognosis of patients.

The grade of histological severity is a determining factor to evaluate the prognosis and survival rate in primary biliary cholangitis (PBC). However, liver biopsy is limited by sampling error, invasiveness, high cost, and poor compliance. Therefore, in order to overcome the limitations of liver biopsy, some non-invasive evaluation methods have been studied and applied to evaluate the progression of liver fibrosis in PBC. The prognostic score can be calculated using routine laboratory test results obtained at the time of diagnosis, which are characterized by their simplicity, affordability, ease of acquisition, and superior reproducibility. Recent studies have reported that the prognostic score can be employed as a non-invasive liver fibrosis model to diagnose the liver fibrosis stage in PBC and predict the transplant-free survival rate, in addition to being used to evaluate the patient prognosis and transplant-free survival (TFS). This paper reviews, summarizes, and explores the research progress of different prognostic scores as non-invasive liver fibrosis models via their diagnostic performance and predictive accuracy for PBC.

Allostatic load is the cost of adjustments of the internal physiological milieu to accommodate external stress. A series of physiological and psychological changes will occur when the stress exceeds an individual′s coping skills, which may further lead to physical damage. Stress plays a major role in the etiology and development of major depressive disorder. The introduction of the concept of allostatic load provides new insight for the prevention, diagnosis and treatment of major depressive disorder. This article discussed the evaluation method of allostatic load and its impact on the diagnosis and treatment of depressive disorder.

Allostatic load is the cost of adjustments of the internal physiological milieu to accommodate external stress. A series of physiological and psychological changes will occur when the stress exceeds an individual′s coping skills, which may further lead to physical damage. Stress plays a major role in the etiology and development of major depressive disorder. The introduction of the concept of allostatic load provides new insight for the prevention, diagnosis and treatment of major depressive disorder. This article discussed the evaluation method of allostatic load and its impact on the diagnosis and treatment of depressive disorder.

Objective To preliminarily understand the current status of medication safety management of medical institutions in China. Methods Medication Safety Panel in China Core Group of International Network for the Rational Use of Drugs (INRUD) and Chinese Pharmacological Society Professional Committee of Drug-induced Diseases jointly established a research group. Basing on the voluntary principle,members (medical institutions)of the group did medication safety self-assessment using the questionnaires of "2011 ISMP Medication Safety Self Assessment? for Hospitals (Chinese version)", which included 10 key elements,20 core indicators,and 270 assessment projects. The questionnaires were handed out on August 17,2018 and needed to be completed and submitted within 2 months. Results As of October 19,2018,67 hospitals of 16 provincial administrative regions in total had submitted their questionnaires,including 61 (91. 0％)3A hospitals and 6 (9％)2A hospitals. The average value of total scores of medication safety self-assessment in the 67 hospitals was 58. 9％ (7. 6％ -90. 0％). None of the 67 hospitals evaluated the key element Ⅵ(medication device acquisition,use,and monitoring). The scores of the other 9 key elements from high to low were 67. 6％,66. 2％,65. 1％,64. 8％,64. 1％,58. 2％, 54. 5％,54. 4％,and 52. 5％ respectively for element Ⅶ (environmental factors,workflow and staffing patterns),element Ⅳ(drug labeling,packaging and nomenclature),element Ⅸ (patient education), element Ⅲ(communication of drug orders and other drug information),element Ⅷ (staff competency and education),element Ⅴ(drug standardization,storage and distribution),element Ⅹ (quality processes and risk management),element Ⅰ (patient information),and element Ⅱ (drug information). Conclusion The data of medication safety from 67 hospitals of 16 provincial administrative regions were obtained through the first national self-assessment questionnaire survey in medical institutions,which initially reflected the current status of medication safety in medical institutions in China.

Objective To preliminarily understand the current status of medication safety management of medical institutions in China. Methods Medication Safety Panel in China Core Group of International Network for the Rational Use of Drugs (INRUD) and Chinese Pharmacological Society Professional Committee of Drug-induced Diseases jointly established a research group. Basing on the voluntary principle,members (medical institutions)of the group did medication safety self-assessment using the questionnaires of "2011 ISMP Medication Safety Self Assessment? for Hospitals (Chinese version)", which included 10 key elements,20 core indicators,and 270 assessment projects. The questionnaires were handed out on August 17,2018 and needed to be completed and submitted within 2 months. Results As of October 19,2018,67 hospitals of 16 provincial administrative regions in total had submitted their questionnaires,including 61 (91. 0％)3A hospitals and 6 (9％)2A hospitals. The average value of total scores of medication safety self-assessment in the 67 hospitals was 58. 9％ (7. 6％ -90. 0％). None of the 67 hospitals evaluated the key element Ⅵ(medication device acquisition,use,and monitoring). The scores of the other 9 key elements from high to low were 67. 6％,66. 2％,65. 1％,64. 8％,64. 1％,58. 2％, 54. 5％,54. 4％,and 52. 5％ respectively for element Ⅶ (environmental factors,workflow and staffing patterns),element Ⅳ(drug labeling,packaging and nomenclature),element Ⅸ (patient education), element Ⅲ(communication of drug orders and other drug information),element Ⅷ (staff competency and education),element Ⅴ(drug standardization,storage and distribution),element Ⅹ (quality processes and risk management),element Ⅰ (patient information),and element Ⅱ (drug information). Conclusion The data of medication safety from 67 hospitals of 16 provincial administrative regions were obtained through the first national self-assessment questionnaire survey in medical institutions,which initially reflected the current status of medication safety in medical institutions in China.