Cuproptosis is a new type of cell death that depends on intracellular copper accumulation to trigger the aggregation of mitochondrial lipoacylated protein and the degradation of iron-sulfur cluster protein,with a different mechanism of action from autophagy,ferroptosis,pyroptosis,and necroptosis.Cuproptosis is closely association with the development of liver cancer and resistance to antitumor drugs,as well as the progression of various liver diseases such as hereditary liver diseases,nonalcoholic fatty liver disease,viral hepatitis,and liver cirrhosis.This article summarizes the mechanism of cuproptosis and its role in liver diseases,in order to provide a reference for further research and treatment of liver diseases.

Objective To analyze of the therapeutic effect of Weifuchun capsules combined with quadruple therapy on elderly patients with chronic atrophic gastritis(CAG)infected with Helicobacter pylori(Hp).Methods Elderly Hp-infected CAG patients admitted to Affiliated Hospital of Shaoxing University from April 2019 to April 2023 were divided into a control group(treated with classic quadruple therapy)and an experimental group(treated with Weifuchun capsules combined with classic quadruple therapy)according to different regimens.The clinical treatment effects of two groups of patients were compared,the clinical symptom scores,changes in serum gastrointestinal hormones,inflammatory factors levels before and after treatment,and the adverse reactions and Hp recurrence were compared.Results A totol of 300 patients were included in the study,with 150 cases in each group.After treatment,the clinical symptom score,pepsinogen(PG)Ⅱ,high-sensitivity C-reactive protein(hs-CRP),serum tumor necrosis factor-α(TNF-α),interleukin(IL)-6,and IL-8 levels in the experimental group were lower than those in the control group(P＜0.05),and the levels of PG Ⅰ,gastrin-17(GAS-17)in the serum,and total effective rate were higher than those in the control group(P＜0.05).The difference in the incidence of adverse reactions between the two groups was not statistically significant(P＞0.05),and no Hp recurrence was seen in either group.Conclusion The combination of Weifuchun capsules and classic quadruple therapy has shown good efficacy in treating elderly Hp-infected CAG patients,which can effectively improve the clinical symptoms,regulate gastrointestinal hormone secretion,and has good safety.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Objective:To explore the assessment value of liver enzyme changes before and after hepatectomy on the prognosis of patients with primary hepatocellular carcinoma(HCC). Methods:A retrospective analysis was conducted on the clinical data of 421 patients with primary HCC who received at the First and Second Affiliated Hospitals of Xi'an Jiaotong University from January 2016 to December 2020.The univariate and multivariate COX regression analyses were used to screen the risk factors affecting the prognosis of patients with primary HCC,and the optimal cut-off value was selected to group the most valuable indicators among them,further analyzing the different factors among subgroups.The Kaplan-Meier method was used to assess the prognosis of the subgroups,and the survival curves were plotted and statistically tested. Results:Multivariate COX regression analysis revealed that Barcelona Clinic Liver Cancer(BCLC)stage,tumor number,alpha-fetoprotein(AFP),the quantitative change of γ-glutamyl transpeptidase(GGT)and total bilirubin(TBIL)before and after surgery were independent risk factors affecting the prognosis of patients with primary HCC(P＜0.01),and there were differences in hepatitis B virus surface antigen(HBsAg),TNM stage,BCLC stage,tumor size,tumor number,tumor differentiation degree,AFP,surgery type,intraoperative bleeding volume,postoperative albumin-bilirubin(ALBI)and white blood cell count between the high and low GGT variation groups(P＜0.05).Kaplan-Meier survival analysis showed that the prognosis of patients with primary HCC between the high and low GGT variation groups was significantly different,with a hazard ratio of 2.603 for mortality and 1.449 for recurrence(both P＜0.01). Conclusion:The quantitative change of GGT before and after hepatectomy has an evaluation value for the prognosis of patients with primary HCC,and the quantitative change of GGT greater than 29.5 is an independent risk factor for the prognosis of patients with primary HCC.

Anxiety is a major mood disorder, and the high morbidity, co-morbidity and disability of anxiety disorders seriously affect people's quality of life, so the importance and urgency of research on anxiety cannot be overstated. Animal models are the main carriers for studying the mechanism of disease occurrence and development, drug efficacy evaluation and drug development.Unconditioned anxiety model is a common anxiety model.Elevated plus maze test, open field test and light-dark box test are widely accepted paradigms for the detection of unconditioned anxiety.This kind of behavioral paradigm based on environmental exposure takes advantage of the conflict between curiosity and fear of the unfamiliar environment to simulate and detect the anxiety of animals.However, the validity of these behavioral paradigms for evaluating anxiety in animals is questionable.In this paper, we discuss the concept of anxiety, the definition of anxiety behavior in the behavioral test of unconditioned anxiety, and the factors to be considered in the test of unconditioned anxiety behavior.On this basis, new solutions were proposed to the contradictions and blind spots in order to improve the test paradigm of anxiety behavior and provide a more reliable animal model for the evaluation of anxiety.This paper presents a new approach to address the contradictions and blind spots of this paradigm.

Infectious bone defect is bone defect with infection or as a result of treatment of bone infection. It requires surgical intervention, and the treatment processes are complex and long, which include bone infection control,bone defect repair and even complex soft tissue reconstructions in some cases. Failure to achieve the goals in any step may lead to the failure of the overall treatment. Therefore, infectious bone defect has been a worldwide challenge in the field of orthopedics. Conventionally, sequestrectomy, bone grafting, bone transport, and systemic/local antibiotic treatment are standard therapies. Radical debridement remains one of the cornerstones for the management of bone infection. However, the scale of debridement and the timing and method of bone defect reconstruction remain controversial. With the clinical application of induced membrane technique, effective infection control and rapid bone reconstruction have been achieved in the management of infectious bone defect. The induced membrane technique has attracted more interests and attention, but the lack of understanding the basic principles of infection control and technical details may hamper the clinical outcomes of induced membrane technique and complications can possibly occur. Therefore, the Chinese Orthopedic Association organized domestic orthopedic experts to formulate An evidence-based clinical guideline for the treatment of infectious bone defect with induced membrane technique ( version 2023) according to the evidence-based method and put forward recommendations on infectious bone defect from the aspects of precise diagnosis, preoperative evaluation, operation procedure, postoperative management and rehabilitation, so as to provide useful references for the treatment of infectious bone defect with induced membrane technique.

Objective:To investigate the significance and importance of the interaction between surgeons and engineers during the preoperative planning phase of total knee arthroplasty (TKA) when utilizing patient-specific instrumentation (PSI).Methods:A retrospective review was conducted on 202 knees of PSI-assisted TKA performed on 178 patients between June 2018 and August 2022. The patients' mean age was 68.4±6.2 years, ranging from 53 to 86 years. Among the participants, there were 149 females and 29 males, 93 left knees and 109 right knees. The study involved 171 patients of osteoarthritis (193 knees) and 7 patients of rheumatoid arthritis (9 knees), with 194 knees presenting varus knees and 8 knees with valgus knees. The preoperative plan documents, from the initial engineer-designed plan to the final plan approved by the surgeon, were analyzed to assess the frequency, parameters, and reasons for adjustments made during the planning process.Results:The planning of the 202 PSI-assisted TKA was subjected to at least one round of surgeon-engineer interaction. Among the 202 TKA planning, 117 knees (57.9%) underwent modifications after discussion, with most plans (100 knees, 49.5%) being confirmed after one round of modification. Two rounds of modifications were performed on 10 knees (5.0%), and three rounds on 5 knees (2.5%). A maximum of four rounds of modifications were made on two knees (0.9%). Furthermore, in the case of the remaining 85 knees (42.1%), the surgeons promptly consented to the engineers' initial planning following the discussions. Specific adjustments were made in 106 knees (52.5%) regarding femoral parameters, 57 knees (28.2%) concerning tibial parameters, and 46 knees (22.8%) requiring adjustments to both femoral and tibial parameters. Notably, the most frequently adjusted parameter was the osteotomy thickness of the posterior femoral condyles, which was modified in 94 knees (80.3%). The reasons for adjusting femoral or tibial parameters were summarized, revealing the main factors as follows: 1) Discrepancy between the mediolateral and anteroposterior diameters of the femoral condyle; 2) Twisted deformity of the proximal tibia; 3) Severe flexion contracture deformity of the knee; 4) Collapse of the medial or lateral tibial plateau; 5) Evident anterior arch deformity of the femur.Conclusion:The interaction between surgeons and engineers plays a pivotal role in the preoperative phase of PSI-assisted TKA. Effective collaboration allows surgeons to accurately analyze the unique anatomical characteristics and pathological changes of each patient in a three-dimensional perspective, facilitating the formulation of individualized surgical plans.

Objective To observe the effect of risperidone combined with clozapine in the treatment of vagrants with schizophrenia and its influence on social function of the patients.Methods Eighty patients with vagrant schizophrenia were selected as the study objects by a prospective randomized controlled trial,and were randomly divided into control group(40 cases)and observation group(40 cases).The control group was treated with risperidone,and the observation group was treated with risperidone and clozapine.Both groups received continuous treatment for 8 weeks.The clinical effects of the two groups were observed.The activities of daily living,rehabilitation[Inpatient Psychiatric Rehabilitation Efficacy Rating Scale(IPROS)score],social function,myocardial enzyme profile[lactate dehydrogenase(LDH),creatine kinase(CK),creatine kinase isoenzyme(CK-MB)]in the two groups before treatment and eight weeks after treatment were compared.The adverse reactions of the two groups were statistically analyzed.Results The total effective rate of treatment in the obser-vation group was higher than that of the control group(90.00％versus 72.50％,P＜0.05).After eight weeks of treatment,the abilities of daily living and social function of the two groups were stron-ger than before treatment,and the observation group was stronger than the control group.At 8 weeks of treatment,IPROS scores in two groups were lower than before treatment,and observation group was lower than control group(P＜0.05).After 8 weeks of treatment,LDH,CK and CK-MB levels in two groups were higher than before treatment(P＜0.05),but there was no statistical significant between-group difference(P＞0.05).Conclusion Risperidone combined with clozapine has a significant effect in thetreatment of vagrants with schizophrenia,which can enhance the patients'daily living ability and social ability,improve the rehabilitation status,and does not increase the adverse reactions.

Objective To observe the effect of risperidone combined with clozapine in the treatment of vagrants with schizophrenia and its influence on social function of the patients.Methods Eighty patients with vagrant schizophrenia were selected as the study objects by a prospective randomized controlled trial,and were randomly divided into control group(40 cases)and observation group(40 cases).The control group was treated with risperidone,and the observation group was treated with risperidone and clozapine.Both groups received continuous treatment for 8 weeks.The clinical effects of the two groups were observed.The activities of daily living,rehabilitation[Inpatient Psychiatric Rehabilitation Efficacy Rating Scale(IPROS)score],social function,myocardial enzyme profile[lactate dehydrogenase(LDH),creatine kinase(CK),creatine kinase isoenzyme(CK-MB)]in the two groups before treatment and eight weeks after treatment were compared.The adverse reactions of the two groups were statistically analyzed.Results The total effective rate of treatment in the obser-vation group was higher than that of the control group(90.00％versus 72.50％,P＜0.05).After eight weeks of treatment,the abilities of daily living and social function of the two groups were stron-ger than before treatment,and the observation group was stronger than the control group.At 8 weeks of treatment,IPROS scores in two groups were lower than before treatment,and observation group was lower than control group(P＜0.05).After 8 weeks of treatment,LDH,CK and CK-MB levels in two groups were higher than before treatment(P＜0.05),but there was no statistical significant between-group difference(P＞0.05).Conclusion Risperidone combined with clozapine has a significant effect in thetreatment of vagrants with schizophrenia,which can enhance the patients'daily living ability and social ability,improve the rehabilitation status,and does not increase the adverse reactions.

Objective:To investigate the current situation of cardiopulmonary bypass(CPB) in China and analyze the causes, to guide the formulation and implementation of technology standard.Methods:The survey task force sent out a nationwide survey to obtain up-to-date information on perfusion practice by ChSECC(Chinese Society of Extracorporeal Circulation). The unit of analysis for the survey was the medical center performs CPB. The survey consisted 48 questions covering four topics of qualifications, including certification and education, policies and practices, device and equipment, techniques used.Results:There were 540 of the 714 centers for an overall response rate of 76%. According to the annual number of CPB, they were divided into 4 groups: group A(≤50 cases/year), group B(50-100 cases/year), group C(100-500 cases/year) and group D(≥500 cases/year). The response rate of center with more than group D last year was 100%. Most of the perfusionists had certification issued by ChSECC. Although there were more than 80% of group D performed regular training and assessment of perfusionist, the result was still not ideal enough. Low utilization of safety equipment was not depend on the annual operation volume in most of responding centers. Ultrafiltration and blood protection technology had high application rate in group D compared with group A and B.Conclusion:The certification rate of perfusionists are high. Lower the number of annual CPB cases, lower the proportion of regular evaluation and training, and lower rate of standards performance. No matter the amount of CPB, the application rate of safety equipment is not ideal. Higher the number of CPB cases, higher the utilization rate of CPB related technologies.