The surgical management of empyema (excluding those caused by mycobacterium tuberculosis and non-tuberculous mycobacteria) is rapidly evolving towards minimally invasive, precise, and stepwise approaches. The traditional three-stage classification (exudative, fibrinopurulent, and organizing) has limitations in guiding dynamic clinical decision-making. For the first time, this consensus explicitly identifies two critical junctures in the pathological progression of empyema: "early transformation" (stage Ⅰ to Ⅱ) and "late transformation" (stage Ⅱ to Ⅲ), and thereby constructs a corresponding "identification-early warning-intervention" stepwise therapeutic framework. The consensus emphasizes that proactive debridement via video-assisted thoracoscopic surgery should be performed during the early transformation phase to halt disease progression. Conversely, during the late transformation phase, therapeutic goals should be rationally adjusted to prioritize adequate drainage, avoiding futile pleural decortication. Moreover, the consensus underscores the pivotal role of precise perioperative etiological diagnosis (e.g. metagenomic nest-generation sequencing) and standardized anti-infective therapy. Integrating practical experiences from multiple thoracic surgery centers in China and relevant evidence-based literature, this consensus formulates recommendations on the precise definitions of staging, surgical indications for each phase, key technical points, perioperative management, and training systems. It aims to promote the standardized and individualized surgical management of empyema, ultimately optimizing patient prognosis.

Objective To explore and analyze the implementation effect of the combined traditional Chinese medicine(TCM)and Western medicine DRG payment model in TCM hospitals,aiming to provide a reference for the reform of medical in-surance payment methods in such hospitals.Methods R language was utilized to statistically analyze the costs and other indica-tors of the sample hospitals before and after the implementation of the combined TCM and Western medicine DRG payment within 1-2 years.Results Following the implementation of the combined TCM and Western medicine DRG payment,there was a de-crease in average hospitalization costs and average length of stay,accompanied by an increase in CMI(average weight).The cost structure underwent changes:the proportions of western medicine fees and auxiliary examination fees decreased,whereas the pro-portion of TCM treatment fees increased.Significant statistical differences were observed in each group of data(p＜2.2e-16).Conclusion The combined TCM and Western medicine DRG payment reform model can facilitate TCM hospitals in reducing medical costs,controlling medical expenses,optimizing the cost structure,and promoting the development of TCM diagnosis and treatment characteristics.

Objective To explore and analyze the implementation effect of the combined traditional Chinese medicine(TCM)and Western medicine DRG payment model in TCM hospitals,aiming to provide a reference for the reform of medical in-surance payment methods in such hospitals.Methods R language was utilized to statistically analyze the costs and other indica-tors of the sample hospitals before and after the implementation of the combined TCM and Western medicine DRG payment within 1-2 years.Results Following the implementation of the combined TCM and Western medicine DRG payment,there was a de-crease in average hospitalization costs and average length of stay,accompanied by an increase in CMI(average weight).The cost structure underwent changes:the proportions of western medicine fees and auxiliary examination fees decreased,whereas the pro-portion of TCM treatment fees increased.Significant statistical differences were observed in each group of data(p＜2.2e-16).Conclusion The combined TCM and Western medicine DRG payment reform model can facilitate TCM hospitals in reducing medical costs,controlling medical expenses,optimizing the cost structure,and promoting the development of TCM diagnosis and treatment characteristics.

BACKGROUND: Consummate innervation plays an important role in bone formation. Nerve injury can impact normal bone metabolism, whereas bone regeneration depends on nerve regeneration in the innervation site to some degrees. Modified implant surface structure or usage of growth factors in local region can promote osseointegretion.OBJECTIVE: To retrospectively analyze effects of nervous system dominance bone metabolism and denervation on bone remodeling, innervated establishment and osseoperception during osseointegration following implantation.METHODS: The first author retrieved Pubmed database (http://www.ncbi.nlm.nih.gov/PubMed) and Wanfang database (http://www.wanfangdata.com.cn) (1990/2008) for publications of effects of nervous system dominance bone metabolism and denervation on bone remodeling, innervated establishment and osseoperception during osseointegration following implantation,with the key words of "bone metabolism, innervation, osseointegrationosseoperception" . Articles of repetitive contents were excluded. A total of 54 literatures were primarily obtained. According to inclusion criteria, 28 literatures were selected for summary.RESULTS AND CONCLUSION: Signals derived from the nervous system exert potent effects on osteoclast and osteoblast function. A ubiquitous innervation of all periosteal surfaces exists and its disruption affects bone remodeling. Several neuropeptides, neurohormones, nerotransmitters and their receptors are detectable in bone, and make it clear that nervous system is involved in bone metabolism and regeneration. Establishment of innervation of soft and hard tissue around implants may play an important role in osseointegration and osseoperception. Further studies will be required to explore the basic of anatomy,neurophysiology and neuropathology, which forms osseoperception.

Platelet-rich plasma is a volume of autogenous plasma with a high platelet concentration. Platelet-rich gel which is polymerized from platelet-rich plasma becomes a hot topic in the repairing of jaw bones in oral and dentofacial surgery. Presently, the mechanism of platelet-rich gel in enhancement of bone defect repair has not been clarified. Generally, we believed that the unifiation of blood platelet degranulation released many high-concentration growth factor during polymerization stimulated bone formation and accelerated bone repair. In addition, the application of platelet-rich gel has some problems. Thus, wide application of platelet-rich gel in tissue engineering deserves further studies. With the development, platelet-rich gel should be widely used in bone tissue engineering.

Objective To study the setting up a model of orthotopic liver transplantation (OLT) in pigs. Methods In pigs, OLT were performed based on the porcine anatomical and physiological features, and the extracorporeal veno venous bypass was established during the anhepatice stage. Results Fourteen pigs(87.5%) of 16 OLT survived after the operation, and the haemodynamics?serum biochemical parameters and core temperature were maintained in the normal value during OLT. Conclusions Extracorporeal venovenous bypass and perfect surgical techniques based on the anatomical and physiological features are the key to successful OLT in pigs.