OBJECTIVE To form an expert consensus on the clinical application of parenteral direct thrombin inhibitors （DTIs） in patients during the perioperative period. METHODS Led by Sichuan Academy of Medical Sciences & Sichuan Provincial People’s Hospital （the Affiliated Hospital of UESTC）， a multidisciplinary working group was established. Through literature review and the Delphi method， clinical questions related to the rational perioperative use of parenteral DTIs were identified. A structured design was adopted using the “Population-Intervention-Comparison-Outcome” framework； systematic searches were conducted in CNKI， Medline， Embase and other databases. Relevant evidence from randomized controlled trials and cohort studies was included and synthesized. Evidence quality was assessed using the Grades of Recommendations Assessment，Development and Evaluation （GRADE） approach， and recommendations were formulated through multiple rounds of Delphi surveys and expert consensus meetings. RESULTS &CONCLUSIONS Seven recommendations （each with an expert consensus rate exceeding 90%） on the use of parenteral DTIs in perioperative patients were developed. These recommendations specify drug selection， dosing ranges， key monitoring points， and safety management strategies for parenteral DTIs in various scenarios， including the perioperative period of ventricular assist device implantation， the perioperative period of cardiac surgery， perioperative patients with lower-extremity atherosclerotic disease， the perioperative period of percutaneous coronary intervention in patients with acute coronary syndrome， the perioperative period of carotid artery stenting in patients with carotid stenosis， the perioperative period of patients with right heart thrombosis， and patients who develop related thrombosis and dysfunction after a central venous catheter insertion. In addition， warning and management pathways for perioperative bleeding and thrombotic events were proposed. This expert consensus， which is formulated based on the best available evidence， provides evidence-based guidance for standardized and individualized use of parenteral DTIs in perioperative period.

Neuropathic pain （NP） is a chronic pain syndrome resulting from injury， inflammation， or dysfunction of the somatosensory nervous system. Its pathogenesis is complex and intimately associated with peripheral sensitization and maladaptive neuroplasticity within the central nervous system. The core clinical manifestations， including spontaneous pain， allodynia， and paresthesia， severely compromise patients’ quality of life and pose substantial challenges to clinical management. Endoplasmic reticulum stress （ERS）， a critical cellular defense mechanism against disrupted intracellular homeostasis， is primarily initiated and modulated through three canonical branches of the unfolded protein response （UPR）： the protein kinase RNA-like endoplasmic reticulum kinase （PERK） pathway， the inositol-requiring transmembrane kinase/endonuclease 1α （IRE1α） pathway， and the activating transcription factor 6 （ATF6） pathway. These signaling cascades play a pivotal role in the pathological progression of NP. Traditional Chinese medicine （TCM） exhibits unique advantages in the treatment of NP. Leveraging its hallmark characteristics of multi-target， multi-pathway， and holistic regulation， TCM can systematically modulate the ERS signaling network to inhibit neuronal apoptosis， attenuate neuroinflammatory infiltration， and rectify autophagic dysfunction， ultimately promoting the repair and regeneration of damaged neural tissue. This review systematically summarizes the core role of ERS in the occurrence and development of NP. It focuses on the latest research progress regarding ERS pathway modulation in NP amelioration by representative TCM interventions， including potential core bioactive components （e.g.， tanshinoneⅡ_A， catalpol， and formononetin）， classic and empirical compound formulas （e.g.， Huangqi Guizhi Wuwu decoction， Compound Qiying granules， and Tangluoning）， and TCM external therapies （e.g.， electroacupuncture， moxibustion with seed-sized moxa cone， and acupotomy）. Through an in-depth analysis of the functional characteristics and mechanisms of these TCM interventions， particularly their bidirectional regulation and multi-target synergy， this review aims to provide a solid theoretical foundation for further optimizing TCM-based strategies for NP prevention and treatment and to delineate future directions for clinical translation of related research achievements and targeted drug development.

Objective To examine the mechanism by which the HDAC3-Akt signaling pathway regulates the proliferation of aortic smooth muscle cells.Methods Rabbit vascular smooth muscle cells(rVSMCs)were subjected to various treatments,in-cluding DMSO(control),RGFP966(HDAC3 inhibitor),Flag(control for gene intervention),HDAC3 overexpression,and HDAC3 overexpression combined with Akt inhibitor MK2206.The5-Ethynyl-2'-deoxyuridine(EdU)assay and thecell counting assay were used to detect the proliferative capacity of cells in each group.The expression level of PCNA,p-H3,Akt and p-Akt in each group were examined by Western blotting.Results Compared with the control group(DMSO),the expression levels of p-Akt,PCNA,and p-H3 in the RGFP966 inhibitor group were significantly decreased(all P＜0.05).Concurrently,both the cell counting and EdU assays demonstrated a reduction in proliferation in the RGFP966-treated group compared to the DMSO group(both P＜0.05).In contrast,the HDAC3 overexpression group exhibited a significant increase in the expression levels of p-Akt,PCNA,and p-H3 compared to the Flag group(all P＜0.05).Cell counting assay and EdU assay showed that the prolifera-tion level in the HDAC3 overexpression group was elevated compared with the Flag group(both P＜0.05).Akt inhibitor MK2206 could reversed this effect induced by HDAC3 overexpression.Conclusion HDAC3 can effectively promote the prolif-eration of aortic smooth muscle cells,which might be mediated through Akt signaling pathway.

Phospholipid pharmaceutical excipients are primarily composed of a glycerol backbone,fatty acid chains,and phosphate groups.Due to their amphiphilic structure and unique physicochemical properties,they are commonly used as emulsifiers and carrier materials in pharmaceutical formulations.The pharmacopoeias of various countries have included phospholipid based pharmaceutical excipients and specified the testing methods and limits for their critical quality attributes.This article focuses on the current inclusion status,characteristic indicators,component content determination indicators,and functionality-related indicators determination methods and limits of phospholipid pharmaceutical excipients of various countries,in order to provide references and a basis for the rational applicatione of phospholipid pharmaceutical excipients.

Objective To examine the mechanism by which the HDAC3-Akt signaling pathway regulates the proliferation of aortic smooth muscle cells.Methods Rabbit vascular smooth muscle cells(rVSMCs)were subjected to various treatments,in-cluding DMSO(control),RGFP966(HDAC3 inhibitor),Flag(control for gene intervention),HDAC3 overexpression,and HDAC3 overexpression combined with Akt inhibitor MK2206.The5-Ethynyl-2'-deoxyuridine(EdU)assay and thecell counting assay were used to detect the proliferative capacity of cells in each group.The expression level of PCNA,p-H3,Akt and p-Akt in each group were examined by Western blotting.Results Compared with the control group(DMSO),the expression levels of p-Akt,PCNA,and p-H3 in the RGFP966 inhibitor group were significantly decreased(all P＜0.05).Concurrently,both the cell counting and EdU assays demonstrated a reduction in proliferation in the RGFP966-treated group compared to the DMSO group(both P＜0.05).In contrast,the HDAC3 overexpression group exhibited a significant increase in the expression levels of p-Akt,PCNA,and p-H3 compared to the Flag group(all P＜0.05).Cell counting assay and EdU assay showed that the prolifera-tion level in the HDAC3 overexpression group was elevated compared with the Flag group(both P＜0.05).Akt inhibitor MK2206 could reversed this effect induced by HDAC3 overexpression.Conclusion HDAC3 can effectively promote the prolif-eration of aortic smooth muscle cells,which might be mediated through Akt signaling pathway.

Phospholipid pharmaceutical excipients are primarily composed of a glycerol backbone,fatty acid chains,and phosphate groups.Due to their amphiphilic structure and unique physicochemical properties,they are commonly used as emulsifiers and carrier materials in pharmaceutical formulations.The pharmacopoeias of various countries have included phospholipid based pharmaceutical excipients and specified the testing methods and limits for their critical quality attributes.This article focuses on the current inclusion status,characteristic indicators,component content determination indicators,and functionality-related indicators determination methods and limits of phospholipid pharmaceutical excipients of various countries,in order to provide references and a basis for the rational applicatione of phospholipid pharmaceutical excipients.

Anxiety disorders,dopaminergic neurons and ventral tegmental area(VTA)are related closely.VTA dopaminergic neurons play an important role in the regulation of anxiety.Numerous research results in animals indicated that the VTA dopaminergic neurons,involving in multiple neural pathways,respectively regulate anxiety-like behavior in physiological or pathological condition.Dopamine,the main neurotransmitters in VTA regulates anxiety through dopamine D1 and D2 receptors.In addition,the VTA glutamate,GABA and acetylcholine also play directly or indirectly roles in regulating anxiety.The clinical imaging research showed that the integrity of dopaminergic VTA structural of anxiety disorder group is lower than healthy control.Current researches of VTA dopamine neurons involving in the regulation of anxiety-like behavior is developing at a high speed and deserving further exploration,which will further elucidate the pathogenesis and provide new ideas for prevention and treatment of anxiety disorders.

Objective:To investigate the application value of Hisense computer-assisted surgery system (CAS) three-dimensional reconstruction in the precision treatment of pediatric liver tumors.Methods:The retrospective and descriptive study was conducted. The clinicopathological data of 82 children with liver tumors who were admitted to Affiliated Hospital of Qingdao University from January 2013 to September 2021 were collected. There were 39 males and 43 females, aged 13(19)months. Children underwent upper abdominal dynamic enhanced computed tomography (CT) examination, and three-dimensional reconstruction was performed on CT images of arterial, equili-brium and venous phases with Hisense CAS. Surgical feasibility and scheme were evaluated and conducted based on the results of upper abdominal dynamic enhanced CT examination, and then revised according to three-dimensional reconstruction results of Hisense CAS. Observation indicators: (1) comparison of surgical scheme between two-dimensional enhanced CT images and three-dimensional reconstruction results of Hisense CAS; (2) intraoperative and postoperative situations; (3) follow-up. Follow-up was conducted by outpatient examination to detect postoperative compli-cations and residual liver compensation up to November 2021. Measurement data with normal distribution were represented as Mean± SD. Measurement data with skewed distribution were represented as M(IQR) or M(range). Count data were described as absolute numbers or percentages. Results:(1) Comparison of surgical scheme between two-dimensional CT images and three-dimensional reconstruction results of Hisense CAS. ① Based on the two-dimensional CT images, 42 cases of 82 children could undergo one-stage resection and 40 children could not. However, based on the three-dimensional reconstruction results of Hisense CAS, 48 cases of 82 children could undergo one-stage resection and 34 children could not. There were 6 children with one-stage resection feasibility based on the three-dimensional reconstruction results of Hisense CAS rather than the two-dimensional CT images. For the 34 children undergoing chemotherapy firstly, 31 cases had surgical feasibility after chemotherapy based on the two-dimensional CT images and 3 cases could not undergo surgery because of unapparent tumor regression or tumor surrounding impor-tant vessels. However, the 34 children had surgical feasibility after chemotherapy based on the three-dimensional reconstruction results of Hisense CAS. The revision rate of surgical feasibility was 11.0%(9/82) for the 82 children. ② Based on the two-dimensional CT images, 15 cases of 82 children underwent liver left lobectomy, 21 cases underwent liver right lobectomy, 7 cases underwent mesohepatectomy, 13 cases underwent extended left hemihepatectomy, 23 cases underwent extended right hemihepatectomy, 3 cases underwent segmental hepatectomy. However, based on the three-dimensional reconstruction results of Hisense CAS, 20 cases of 82 children underwent liver left lobectomy, 29 cases underwent liver right lobectomy, 7 cases underwent mesohepatectomy, 7 cases underwent extended left hemihepatectomy, 14 cases underwent extended right hemihepatectomy, 5 cases underwent segmental hepatectomy. The revision rate of surgical scheme was 36.6%(30/82) for the 82 children. (2) Intraoperative and postoperative situations. The operation time, volume of intraoperative blood loss, duration of postoperative hospital stay of the 82 children were (182±18)minutes, 20(10)mL, (10.2±1.9)days, respectively. (3) Follow-up. All the 82 children were followed up for 10 (range, 2?18)months. There was no obvious complication occurred to the 82 children after surgery, and the residual liver can satisfy the liver compensation of body. All the children survived well.Conclusion:Three-dimensional reconstruction of Hisense CAS is conducive to judging the surgical feasibility and formulation of accurate surgical plan of children with liver tumors.

Objective:To quantify the kinematic changes in the gait cycle among youths with chronic, nonspecific low back pain (CNLBP).Methods:A Qualisys 3D optical motion capture system was used to document the gait kinematics of 11 youths with CNLBP and 11 healthy counterparts. Gait profile scores and movement analysis profiles were then calculated.Results:The young CNLBP subjects exhibited gait abnormalities, as reflected by the significant difference of the gait variable the range of motion of the dominant knee between the CNLBP and healthy groups [(5.66±1.83)° vs (3.64±1.13)°]. Gait profile scores and movement analysis profiles are applicable to evaluating them.Conclusions:There manifested gait abnormalities in youth CNLBP patients. Gait profile scores and movement analysis profiles are applicable to evaluating them.

Objective To study the protective effect of a mixed recombinant Bifidobacterium (Bb) vaccine of Taenia solium in piglets. Methods Healthy piglets of 40 days old were randomly divided into experimental group and control group, 4 in each group. Experimental group was given 1011 CFU rBb-TSO45W-4B vaccine and rBb-TSOL18 vaccine (in the ratio of 1 : 1). Control group was given Bb liquid medium (MRS). A total of two times of immunization were conducted, once for every two weeks. At different time points after immunization, the serum was separated from precaval vein blood to detect the level of IgG by enzyme linked immunosorbent assay (ELISA). Piglets were challenged with Taenia solium eggs on the 4th week after the last immunization and killed 3 months after infection. The cysticerci were separated to count and calculate the reduction rate of cysticerci. Blood from precaval vein was collected to separate serum and prepare peripheral blood lymphocytes (PBMC). The levels of IgG,IgG1 and IgG2a in serum sampl es and the levels of interleukin ( IL )-2 , interferon (IFN)-γ, IL-4 and IL-10 in PBMC culture supernatant were determined by ELISA. The level of PBMC proliferation was tested using methyltetrazolium (MTT) assay. Results In experimental group, the level of serum IgG increased from the 2nd to the 8th weeks after immunization, and reached the highest level on the 4th week after immunization (mg/L:270 . 64 ± 1 . 94 vs 207.74 ± 2.24, t=42.479, P<0.05). Reduction rate of cysticercus was 80.48%. Compared with control group, the levels of IgG and IgG2a in serum were significantly increased, while the level of IgG1 was significantly decreased (mg/L: 364.15 ± 11.52 vs 245.94 ± 8.81, 89.74 ± 1.13 vs 62.61 ± 0.84, 20.52 ± 1.00 vs 34.11 ± 0.65, t=16.303, 38.579, - 22.772, P < 0.05). The levels of IL-2 and IFN-γ in PBMC culture supernatant were significantly increased, while the levels of IL-4 and IL-10 were significantly decreased (ng/L:215.24 ± 3.31 vs 174.19 ± 2.14, 28.21 ± 0.27 vs 17.69 ± 0.28, 40.35 ± 0.34 vs 52.57 ± 0.29, 71.34 ± 0.36 vs 94.82 ± 0.45, t =20.839, 53.623,-54.743,- 81.266, P<0.05). The level of PBMC proliferation was significantly increased (0.620 ± 0.051 vs 0.242 ± 0.053, t=10.259, P<0.05). Conclusions It is concluded that the mixed rBb vaccine of Taenia solium might give piglets a certain protection. Th1 type immune response plays an important role in the protection.