The prescription of Qidong Yixin oral liquid is derived from the experience of national medical master Ren Jixue in treating viral myocarditis （VMC）. It has the functions of tonifying Qi， nourishing the heart，calming the mind， and relieving palpitations. It is used to treat VMC and angina pectoris of coronary heart disease caused by deficiency of both Qi and Yin. However，the understanding of its efficacy evidence， advantageous aspects， dosage and administration， and medication safety remains insufficient in clinical practice. Therefore，the development of the Expert Consensus on the Clinical Application of Qidong Yixin Oral Liquid （hereinafter referred to as consensus） was initiated. Consensus strictly followed the process and methods of the expert consensus on the clinical application of Chinese patent medicines of the China Association of Chinese Medicine，successively completing multiple tasks such as the consensus project initiation，determination of clinical problems，evidence search and evaluation，formation of recommendation opinions and consensus suggestions，solicitation of opinions，peer review， submission for review and release， and so on. Consensus formed a total of 10 recommendation opinions and 12 consensus suggestions，clarifying the clinical positioning，efficacy advantages，syndrome differentiation，dosage and administration，combination therapy，timing of medication，adverse reactions，contraindications， and precautions of Qidong Yixin oral liquid，indicating that it has good clinical advantages and safety in the treatment of VMC and angina pectoris of coronary heart disease，providing norms and references for physicians to safely and rationally apply Qidong Yixin oral liquid. Consensus was reviewed and approved for release by the Standardization Office of the China Association of Chinese Medicine on December 23， 2024. Standard number：GSCACM-376-2024.

AIM:To analyze the characteristics of pathogenic bacteria in patients with infectious eye diseases at Shangrao Central Hospital from 2020 to 2024, providing a basis for the precise clinical prevention and control and the development of effective strategies.METHODS: A retrospective analysis was carried out on clinical specimens including the cornea, lacrimal duct, conjunctiva, and intraocular fluid samples, from patients with infectious eye diseases between May 2020 and December 2024. All the specimens underwent microbiological cultures and identification.RESULTS: A total of 447 patients enrolled ultimately in this study, including 250 males and 197 females, with an average age of 58.5±17.1 y. Among the 447 ocular specimens, bacterial infection was confirmed in 146 cases(32.7%). Of these positive samples, male patients accounted for 63.7%(93/146)and patients aged 51-70 y had the highest infection rate(88/146, 60.3%). Furthermore, migrant workers represented the predominant demographic affected by ocular infections, accounting for an overwhelming majority at 95.9%(140/146). When compared to other etiologies of disease, trauma emerged as the primary cause of ocular infections(P<0.01). In cases of bacterial ocular infections, Gram-positive cocci comprised approximately 61.2%, with Staphylococcus identified as the principal pathogen affecting the lacrimal duct, conjunctivae, and intraocular fluid. Streptococcus pneumoniae was found to be the main pathogen associated with corneal infections. Gram-negative bacteria were predominantly Pseudomonas aeruginosa. Fungal infections were observed in an alarming rate of 91.8% among corneal specimens. Fusarium was identified as the leading fungal pathogen responsible for these cases at a proportion of 45.9%.CONCLUSION: The distribution of pathogenic bacteria causing ocular infections demonstrates obvious tissue specificity. Trauma is identified as a major inducement of corneal fungal infection. Clinically, it is essential to pay particular attention to patients with ocular trauma, especially those engaged in agricultural labor who present with ocular infections, and fungal tests should be conducted as early as possible.

AIM: To analyze changes in the anterior chamber angle structure in patients with implantable collamer lens with central-port(ICL V4c)implantation, and to investigate their associations with preoperative anterior segment anatomical parameters.METHODS: Retrospective case study. Patients with myopia or myopia combined with astigmatism who underwent ICL V4c implantation in the Refractive Surgery Center of the Department of Ophthalmology, the 2nd Affiliated Hospital of Harbin Medical University between July 2024 and November 2024 were recruited. Preoperative and postoperative uncorrected visual acuity, best-corrected visual acuity, intraocular pressure, anterior chamber angle(ACA), white-to-white distance(WTW), anterior chamber depth(ACD), angle to angle distance(ATA), horizontal sulcus-to-sulcus distance(HSTS), vertical sulcus-to-sulcus distance(VSTS),crystalline lens rise(CLR), pupil diameter(PD), iris thickness at 750 μm from the scleral spur(IT750),maximal iris thickness(ITM), iris curvature(I-Curv), and iris cross-sectional area(I-Area), angle opening distance(AOD750), thetrabecular-iris angle(TIA750)and the trabecular-iris space area(TISA750)in the temporal, nasal, superior, and inferior directions,as well as the vault at various postoperative time points were measured.RESULTS: The study involved 40 patients(79 eyes)with myopia or myopia combined with astigmatism who underwent ICL V4c implantation(10 males and 30 females)with the mean age of 24.73±3.79 y. Compared with preoperative measurements, at 1 mo postoperatively, the AOD750, TIA750, and TISA750 parameters at the four angles(temporal, nasal, superior, and inferior)all showed a significant reduction(P<0.01). Statistically significant differences in vault were observed at postoperative 1d(0.49±0.1), postoperative 1 wk(0.43±0.14), and postoperative 1 mo(0.41±0.14)(all P<0.001). Correlation analysis indicated that the postoperative state of the anterior chamber angle was jointly influenced by anterior chamber parameters(ACD, ATA, HSTS、VSTS), iris morphology(I-Area, IT750), pupil size(PD), and surgical factors(ICL size, early vault), and that the combination of influencing factors varied across different orientations. Regression analysis showed that ACD was positively correlated with all postoperative anterior chamber angle parameters(P<0.05). IT750 exhibited negative correlations with the temporal and inferior angles(P<0.05). I-Area was positively correlated with temporal AOD750 and TISA750(P<0.05), and PD had negative correlations with temporal TIA750 and nasal AOD750(P<0.05).CONCLUSION: Postoperative anterior chamber angle narrowing is a common phenomenon after ICL V4c implantation. The degree of change exhibits a significant correlation with multiple preoperative anterior segment anatomical parameters. Preoperative comprehensive assessment of ACD, PD, and IT750 may facilitate the evaluation of the risk of postoperative angle changes and the enhancement of surgical safety.

Objective To investigate the causal relationship between metabolic syndrome and breast cancer by using a bidirectional two-sample Mendelian randomization (MR) approach. Methods Genome-wide association study (GWAS) summary statistics for metabolic syndrome and breast cancer were acquired from the Integrative Epidemiology Unit GWAS database and the GWAS Catalog, with populations encompassing the United States and East Asia. A bidirectional causal design was employed: a forward analysis with metabolic syndrome as the exposure and breast cancer as the outcome, followed by a reverse analysis wherein their roles were interchanged. The inverse-variance weighting (IVW) method was primarily used for effect estimation, supplemented by MR-Egger regression, the weighted median method, the simple mode method, and the weighted mode method. Instrument variable strength was screened using the F-statistic (F>10). Robustness of the results was assessed through heterogeneity tests, horizontal pleiotropy tests, forest plots, and leave-one-out sensitivity analyses. Results The IVW analysis indicated no significant causal relationship between metabolic syndrome and breast cancer (OR=1.00, 95%CI: 0.97-1.03), P>0.05). Sensitivity analyses yielded consistent results, suggesting the good robustness of the study findings. Conclusion This study found no evidence to support a causal relationship, either positive or negative, between metabolic syndrome and breast cancer.

Hypertension ranks among the most prevalent chronic non-communicable diseases worldwide, with its prevalence rising steadily and exerting substantial impacts on the demographic composition of voluntary blood donors and the safety of blood supply. The eligibility of hypertensive individuals for safe blood donation and the relevant screening and management strategies have long remained controversial in transfusion medicine. This article systematically reviews the epidemiological characteristics of hypertension, donation-related physiological alterations and underlying risk mechanisms. By synthesizing evidence from international multicenter studies and regulatory practices across major nations, it conducts a comprehensive analysis of blood donation safety and donor admission criteria for hypertensive patients. Available evidence demonstrates that for hypertensives with well-stabilized blood pressure and no severe cardiac, cerebral or renal complications or target organ damage, the overall incidence of adverse reactions following blood donation is comparable to that in healthy donors, and no definitive correlation has been identified between blood pressure levels and vasovagal responses. Current mainstream international management frameworks are gradually shifting from screening reliant on a single blood pressure cutoff value toward an integrated strategy combining stratified risk classification and individualized dynamic assessment, with core focus on long-term blood pressure control, consistency of medication regimens and complication status. Meanwhile, emerging technologies including artificial intelligence, ambulatory blood pressure monitoring and wearable devices have opened innovative avenues for blood donation risk evaluation and full-cycle donor management. In light of existing clinical evidence, future efforts should further refine the multi-dimensional risk stratification system, facilitate the implementation of intelligent screening and continuous monitoring technologies, and scale up health education and follow-up management for hypertensive populations. Such measures aim to appropriately expand the pool of eligible blood donors while safeguarding donation safety, ultimately achieving coordinated improvement in blood safety and blood supply capacity.

Introduction: Metabolic dysfunction–associated steatotic liver disease (MASLD) is common among patients with type 2 diabetes (T2D) and increases the risk of cirrhosis, yet fibrosis often remains clinically silent until hepatic decompensation occurs. Current diabetes guidelines recommend noninvasive fibrosis risk stratification, such as the fibrosis-4 index (FIB-4), during routine diabetes care, but real-world adoption remains unclear. This study aimed to evaluate the implementation of FIB-4 as a risk stratification tool in patients with T2D. Methodology: This was a retrospective study of consecutive patients with T2D who were seen in the Diabetes Clinic of University of Malaya Medical Centre in 2023. Patients were identified as having a higher risk of future cirrhosis based on elevated FIB-4 ≥1.3. Results: The data for 1,009 patients were analyzed, median age 62 (52–71) years, 40.7% male. Elevated FIB-4 was seen in 28.8% (291/1,009). Only 12.0% (35/291) with elevated FIB-4 were referred for further hepatology evaluation, whereas 3.3% (24/718) with low FIB-4 were referred. Among the patients with elevated FIB-4, those referred were more likely known to have hepatic steatosis, had higher alanine aminotransferase, aspartate aminotransferase, gammaglutamyl transferase, and lower low-density lipoprotein cholesterol and platelet count. Over a median follow-up of 1.71 (0.99–1.95) years, totaling 1,440 person-years, two liverrelated events (0.2%) occurred (one each in the elevated and low FIB-4 group, respectively). Sixteen patients (4.0%) experienced cardiovascular events, including one patient (0.6%) in the elevated FIB-4 group and 15 (2.9%) in the low FIB-4 group. Conclusion Despite automated FIB-4 reporting, this risk stratification tool was underutilized in T2D, resulting in missed opportunities for early identification and management of more severe liver disease. Integration of FIB-4 into diabetes care workflows, alongside structured referral pathways and clinician education, may improve early detection and reduce long-term hepatic complications in T2D.
Diabetes Mellitus, Type 2 ; Risk Assessment ; Liver Diseases ; Referral and Consultation

Objective To compare and analyze malaria epidemic trends and characteristics of initial confirmed cases before and after malaria eliminating in Qingjiangpu District, Huai′an City, and to provide a scientific basis for improving strategies to prevent imported malaria retransmission. Methods Malaria case data from Qingjiangpu District were obtained from the National Infectious Disease Information Reporting System for 2010-2023. Case investigation and epidemiological data were summarized and analyzed for the pre-elimination period (2010-2016)and post-elimination period(2017-2023). Results A total of 185 malaria cases were reported between 2010 and 2023, with one locally acquired case in both 2010 and 2011; the remainder were imported, primarily falciparum malaria. Post-elimination cases decreased from 140 to 45, showing a statistically significant difference in case distribution ratios(χ2=9.642, P<0.05). Seasonal peaks occurred in early January and mid-July before elimination but showed no distinct pattern afterward. Malaria cases were mainly imported from Africa countries, and most patients were young adult males. Post-elimination, the proportion of migrant workers decreased, while technical and business personnel increased significantly(χ2=17.855, P<0.05). Both time-to-diagnosis and time-to-certification changed markedly after elimination, with township health centers showing improved diagnostic accuracy at initial visits. All confirmed patients were treated at designated municipal medical institutions. Conclusions After malaria elimination in Qingjiangpu District, imported malaria remains a serious concern, with cases reported each year. Therefore, it is necessary to continue strengthening the malaria monitoring system, enhance screening and evaluation of key populations, improve health education, raise diagnostic and treatment capacity across all medical institutions, and consolidate the achievements of malaria elimination.

Objective: To analyze the spatio-temporal distribution of pulmonary tuberculosis (PTB) among students in Suzhou City, Jiangsu Province from 2015 to 2023, so as to provide the evidence for the prevention and control of PTB in schools. Methods: Data of PTB cases among students in Suzhou City from 2015 to 2023 were collected from Chinese Disease Prevention and Control Information System and Suzhou Report of Investigation and Disposal of Tuberculosis in Schools. The seasonal incidence of PTB among students was analyzed using seasonal index (SI). The spatio-temporal clustering characteristics of PTB among students were analyzed using spatial autocorrelation and retrospective spatio-temporal permutation scanning. Results: Totally 1 374 PTB cases among students were reported in Suzhou City from 2015 to 2023. PTB cases were reported in each month, and the SIs were 100.69%, 124.38%, 108.98%, 135.04%, 106.61% and 106.61% in April, May, July, September, October and November, respectively, indicating the prevalence of PTB among students. Spatial autocorrelation analysis showed there was a positive spatial correlation of PTB among students in 2019 and 2020 (Moran's I=0.053 and 0.089, both P<0.05). From 2015 to 2023, there were high-high clustering sites mainly in Hengtang Street and Shishan Street. Retrospective spatio-temporal permutation scanning showed a primary cluster in Hengtang Street, with aggregation time in 2017, and 6 secondary clusters covering 25 towns (streets). Conclusion From 2015 to 2023, the PTB cases among students in Suzhou City were mainly concentrated in summer and autumn, and were predominantly clustered in Hengtang Street and Shishan Street.

ObjectiveTo develop a systematic case management model based on the International Classification of Functioning, Disability and Health (ICF) Vocational Rehabilitation Core Set (VR-CS) and explore its application pathways and efficacy in vocational rehabilitation. The 13 core categories of VR-CS are applied in vocational rehabilitation case management practices, utilizing comprehensive functional assessments to design and implement structured and individualized case management plans. This, in turn, seeks to enhance individuals' vocational independence, social participation and overall quality of life. MethodsThis study adopted a combined approach of theoretical research and empirical case analysis. Based on the 13 core categories of VR-CS, a comprehensive vocational assessment was conducted across three dimensions: body function and structure, activities and participation, and environmental factors. The study theoretically analyzed how to develop and implement holistic and individualized vocational rehabilitation plans, along with dynamic monitoring processes. Three types of typical vocational rehabilitation cases were examined, including individuals with major depressive disorder, high-functioning autism and mild cognitive impairment, to illustrate the evidence and effectiveness of VR-CS-based case management. ResultsThe VR-CS-based case management method, grounded in the ICF bio-psycho-social model, constructed an integrated and individualized case management system. This system combined the assessment and analysis of vocational rehabilitation needs, goal setting and planning, multidisciplinary team intervention, individualized interventions, process monitoring and dynamic adjustments, return-to-work activities, and long-term follow-up services.The case management model developed through VR-CS demonstrated significant and systematic efficacy in promoting vocational independence and social participation. This study provided a detailed analysis of the primary methods and steps involved in designing and implementing case management and elaborates on the practical applications of this model from the three representative cases. At the body function and structure level, case management included the evaluation of energy and drive functions (b130), high-level cognitive training (b164), and the enhancement of exercise tolerance (b455). Case management focused on accurately setting short- and long-term goals around functional limitations and needs. Dynamic monitoring during interventions ensured timely adjustments to intervention measures. This process improved physical endurance and cognitive function, enhanced sustained work capacity in complex vocational environments. At the activities and participation level, the focus was on skill acquisition (d155), stress management and psychological adjustment (d240), and the cultivation of complex interpersonal communication abilities (d720). Individuals engaged in regular professional skills training, role-playing and simulated work scenarios to progressively enhance vocational adaptability and social interaction skills. Through this process, individuals acquired practical skills, gradually boosting self-efficacy and vocational confidence, thereby facilitating the reshaping of their social roles. At the environmental and personal factors level, case management pathways involved active participation from immediate family (e310), positive shifts in societal attitudes (e460), and the effective utilization of health and employment policy resources (e580, e590). By integrating social and community resources comprehensively, the program created a more inclusive and supportive rehabilitation environment. By designing and implementing systematic case management programs, individuals showed significant improvements in psychological well-being, vocational adaptability and social interaction skills. The majority of cases achieved stable employment or continued participation in social activities following the intervention. ConclusionVR-CS provides a systematic, multidimensional and person-centered case management framework. This framework applies the bio-psycho-social model, analyzing individuals' primary functional impairments and vocational rehabilitation needs from the perspectives of body functions, psychological states and environmental factors. On this basis, a comprehensive, targeted and holistic case management plan is developed and implemented. The VR-CS-based case management approach not only enhances vocational capabilities but also improves overall quality of life and social adaptability.

Acute lung injury （ALI） is one of the most common and critical diseases in clinical practice， with extremely high morbidity and mortality， seriously threatening human life and health. The pathogenesis of ALI is complex， in which the inflammatory response is a key factor. Studies have shown that NOD-like receptor protein 3 （NLRP3） inflammasomes are involved in ALI through mechanisms such as inflammation induction， increased microvascular permeability， recruitment of neutrophils， oxidative stress， and pyroptosis， playing a key role in the occurrence and progression of ALI. Therefore， regulating NLRP3 inflammasomes and inhibiting the release of inflammatory factors can alleviate the damage in ALI. At present， ALI is mainly treated by mechanical ventilation and oxygen therapy， which have problems such as high costs and poor prognosis. In recent years， studies have shown that traditional Chinese medicine （TCM） can reduce the inflammatory response and the occurrence of oxidative stress and pyroptosis by regulating the NLRP3 inflammasome， thus alleviating the damage and decreasing the mortality of ALI. Based on the relevant literature in recent years， this article reviews the research progress in TCM treatment of ALI by regulating NLRP3 inflammasomes， discusses how NLRP3 inflammasomes participate in ALI， and summarizes the active ingredients， extracts， and compound prescriptions of TCM that regulate NLRP3 inflammasomes， aiming to provide new ideas for the clinical treatment of ALI and the development of relevant drugs.