Background: s/Aims: Non-invasive models stratifying clinically significant portal hypertension (CSPH) are limited. Herein, we developed a new non-invasive model for predicting CSPH in patients with compensated cirrhosis and investigated whether carvedilol can prevent hepatic decompensation in patients with high-risk CSPH stratified using the new model. Methods: Non-invasive risk factors of CSPH were identified via systematic review and meta-analysis of studies involving patients with hepatic venous pressure gradient (HVPG). A new non-invasive model was validated for various performance aspects in three cohorts, i.e., a multicenter HVPG cohort, a follow-up cohort, and a carvediloltreating cohort. Results: In the meta-analysis with six studies (n=819), liver stiffness measurement and platelet count were identified as independent risk factors for CSPH and were used to develop the new “CSPH risk” model. In the HVPG cohort (n=151), the new model accurately predicted CSPH with cutoff values of 0 and –0.68 for ruling in and out CSPH, respectively. In the follow-up cohort (n=1,102), the cumulative incidences of decompensation events significantly differed using the cutoff values of <–0.68 (low-risk), –0.68 to 0 (medium-risk), and >0 (high-risk). In the carvediloltreated cohort, patients with high-risk CSPH treated with carvedilol (n=81) had lower rates of decompensation events than non-selective beta-blockers untreated patients with high-risk CSPH (n=613 before propensity score matching [PSM], n=162 after PSM). Conclusions Treatment with carvedilol significantly reduces the risk of hepatic decompensation in patients with high-risk CSPH stratified by the new model.

Background: s/Aims: Non-invasive models stratifying clinically significant portal hypertension (CSPH) are limited. Herein, we developed a new non-invasive model for predicting CSPH in patients with compensated cirrhosis and investigated whether carvedilol can prevent hepatic decompensation in patients with high-risk CSPH stratified using the new model. Methods: Non-invasive risk factors of CSPH were identified via systematic review and meta-analysis of studies involving patients with hepatic venous pressure gradient (HVPG). A new non-invasive model was validated for various performance aspects in three cohorts, i.e., a multicenter HVPG cohort, a follow-up cohort, and a carvediloltreating cohort. Results: In the meta-analysis with six studies (n=819), liver stiffness measurement and platelet count were identified as independent risk factors for CSPH and were used to develop the new “CSPH risk” model. In the HVPG cohort (n=151), the new model accurately predicted CSPH with cutoff values of 0 and –0.68 for ruling in and out CSPH, respectively. In the follow-up cohort (n=1,102), the cumulative incidences of decompensation events significantly differed using the cutoff values of <–0.68 (low-risk), –0.68 to 0 (medium-risk), and >0 (high-risk). In the carvediloltreated cohort, patients with high-risk CSPH treated with carvedilol (n=81) had lower rates of decompensation events than non-selective beta-blockers untreated patients with high-risk CSPH (n=613 before propensity score matching [PSM], n=162 after PSM). Conclusions Treatment with carvedilol significantly reduces the risk of hepatic decompensation in patients with high-risk CSPH stratified by the new model.

Background: s/Aims: Non-invasive models stratifying clinically significant portal hypertension (CSPH) are limited. Herein, we developed a new non-invasive model for predicting CSPH in patients with compensated cirrhosis and investigated whether carvedilol can prevent hepatic decompensation in patients with high-risk CSPH stratified using the new model. Methods: Non-invasive risk factors of CSPH were identified via systematic review and meta-analysis of studies involving patients with hepatic venous pressure gradient (HVPG). A new non-invasive model was validated for various performance aspects in three cohorts, i.e., a multicenter HVPG cohort, a follow-up cohort, and a carvediloltreating cohort. Results: In the meta-analysis with six studies (n=819), liver stiffness measurement and platelet count were identified as independent risk factors for CSPH and were used to develop the new “CSPH risk” model. In the HVPG cohort (n=151), the new model accurately predicted CSPH with cutoff values of 0 and –0.68 for ruling in and out CSPH, respectively. In the follow-up cohort (n=1,102), the cumulative incidences of decompensation events significantly differed using the cutoff values of <–0.68 (low-risk), –0.68 to 0 (medium-risk), and >0 (high-risk). In the carvediloltreated cohort, patients with high-risk CSPH treated with carvedilol (n=81) had lower rates of decompensation events than non-selective beta-blockers untreated patients with high-risk CSPH (n=613 before propensity score matching [PSM], n=162 after PSM). Conclusions Treatment with carvedilol significantly reduces the risk of hepatic decompensation in patients with high-risk CSPH stratified by the new model.

The purpose of this study was to investigate the damage mechanism of pathogenic E.coli on mouse brain microvascular endothelial cells(BMEC cells)and mouse alveolar macrophages(MH-S cells),as well as the lung and brain of healthy mice.In this study,BMEC cells and MH-S cells were infected with pathogenic E.coli strains,and cell morphological changes were observed.Plate counting method was used to detect the adhesion and invasion ability of the strains to cells and the number of bacteria in the lungs and brains of mice.RT-qPCR was used to detect the ex-pression of TNF-α,IL-1β and IL-6 genes in cells and mouse organs at different time periods.West-ern blot was used to detect the expression of p-NF-κB,p-JAK2 and p-STAT3 proteins related to inflammation in cells and mouse organs after infection.The results showed that the cell culture medium of the infection group was turbid,the cell vision became dark and blurred,some cells shrank and died,and more fragments were produced.The adhesion rate and invasion rate of BMEC cells at 3 h were significantly lower than those at 6 h(P＜0.050),and the adhesion rate and inva-sion rate of MH-S cells at 3 h were significantly higher than those at 6 h(P＜0.010).Infected mice had a large area of swelling and bleeding in the brain,and the lungs had different degrees of swell-ing and bleeding.The bacterial load in the brain and lung was the highest at 12 h.Compared with the control group,the mRNA expression levels of IL-1β,IL-6 and TNF-α in the infection group were significantly increased at 3 h and 6 h(P＜0.050),and the mRNA expression levels of inflam-matory factors in BMEC cells and MH-S cells were the highest at 6 and 3 h,respectively.The mR-NA expression of inflammatory factors in the brain and lung of infected mice showed a trend of in-creasing first and then decreasing with time,with the highest expression at 12 h after infection.The expression levels of p-NF-κB protein in BMEC cells,MH-S cells,lung and brain tissues of mice in the infection group were significantly higher than those in the control group(P＜0.001),and the expression levels of p-JAK2 protein and p-STAT3 protein were significantly lower than those in the control group(P＜0.050).The above results showed that pathogenic E.coli could adhere and invade BMEC cells and MH-S cells,colonize in lung and brain tissues of mice,promote the expres-sion of NF-κB protein in cells and tissues,inhibit the expression of JAK2 protein and STAT3 pro-tein,and then stimulate cells and tissues to produce inflammatory response.

Objective:The investigation and research on the application status of Hepatic Venous Pressure Gradient (HVPG) is very important to understand the real situation and future development of this technology in China.Methods:This study comprehensively investigated the basic situation of HVPG technology in China, including hospital distribution, hospital level, annual number of cases, catheters used, average cost, indications and existing problems.Results:According to the survey, there were 70 hospitals in China carrying out HVPG technology in 2021, distributed in 28 provinces (autonomous regions and municipalities directly under the central Government). A total of 4 398 cases of HVPG were performed in all the surveyed hospitals in 2021, of which 2 291 cases (52.1%) were tested by HVPG alone. The average cost of HVPG detection was (5 617.2±2 079.4) yuan. 96.3% of the teams completed HVPG detection with balloon method, and most of the teams used thrombectomy balloon catheter (80.3%).Conclusion:Through this investigation, the status of domestic clinical application of HVPG has been clarified, and it has been confirmed that many domestic medical institutions have mastered this technology, but it still needs to continue to promote and popularize HVPG technology in the future.

Neuromuscular disease (NMD) is a group of hereditary or acquired myopathy typically manifested as motor dysfunction. There is still no consensus in the standardized tools for evaluation of motor function. Among the tools widely used, Motor Function Measure can be used in all kinds of NMD, while North Star Ambulatory Assessment and Performance of the Upper Limb can be for Duchenne muscular dystrophy, and Hammersmith Functional Motor Scale, the Children's Hospital of Philadelphia Infant Test of Neuromuscular Disorders and Upper Limb Module for spinal muscular atrophy.

Objective To discuss the clinical manifestation and treatment of the complications caused by injected polyacrylamde hydro-gel( PAAG) for breast augmentation. Methods This retrospective research was performed among 212 patients who undergoing breast aug-mentation with injected polyacrylamde hydrogel. The clinical manifestation and treatment outcome of the complications were analyzed and summarized,which is aim to search an effective treatment method. Results For the 212 patients,the main complications were breast multi-ple indurations (131 cases),fever (9 cases),infection (14 cases),breast pain (65 cases),PAAG displacement (28 cases) and secondary deformity or asymmetry (25 cases). 152 cases experienced one clinical symptom,the rest patients simultaneously undergone no less than two clinical symptoms. Patients were received open operation with periareolar incision ( surgery group) or vacuum absorption by needle ( aspira-tion group) for dislodging PAAG. No significant difference was found in wound healing,breast shape satisfaction and pain anesis between the two groups. Whilethe surgery group was better than the aspiration group in efficiency for taking out PAAG and the incidence of reoperation, with statistical significance. Conclusion A plenty of complications occurred after breast augmentation with injected polyacrylamde hydrogel, the method of open operation with periareolar incision is a better way for eliminating PAAG and treating the complications.

Plastic and Aesthetic surgery is a science which creates beauty by combining know-ledge and art. Combined with the professional characteristics of plastic surgery, we reformed the cur-riculum content and teaching mode of continuous education, including a established interactive theoret-ical learning model based on Journal club, the strengthening of clinical practice integrated with multiple related disciplines, the expanding the knowledge of Sociology, Psychology and Ethics, and the construc-tion of a long-term platform of network resources. Therefore, a comprehensive and specialized continu-ous education model in the department of plastic and aesthetic surgery was ultimately formed, whose preliminary assessment was favorable, and could be helpful in the cultivation of high-quality plastic and aesthetic surgeons in the future.

Objective To explore an effective and hidden incision scar method for epicanthus correction. Methods 80 patients of bi-lateral single eyelid with epicanthus were divided into group A,group B and group C. Twenty-five patients with 50 eyes of group A received“Z” plasty correction of epicanthus,25 cases with 50 eyes of group B received the traditional“Y-V” plasty correction of epicanthus,30 cases with 60 eyes of group C treated with modified “Y-V” plasty correction of epicanthus. The curative effective was observed. Results Three groups were followed up for 6~24 months, the appearances of 25 patients in group A were significantly improved,of whom 2 cases had uni-lateral recurrence,8 cases with obvious postoperative scar. The eyelid shapes of patients in group B were natural after surgery,12 cases with obvious scar. all patients in group C were found no postoperative hypertrophic scars. Conclusion The three surgical treatment were effec-tive for epicanthus,but the design approaches of“Z” plasty correction and“Y-V” plasty correction are more complex,and postoperative scar is obvious,meanwhile the modified “Y-V” plasty correction is simple with incision hidden good shape scar formation.

Objective To investigate effect of the venom peptide liquor on adjunctive arthritis (AA) in mice .Methods The male Kunming mice were randomly divided into 6 groups ,named as the control group ,model group ,positive control group(1 mg/kg dex-amethason) ,wine group(10 mL/kg) ,low dosage of venom peptide liquor group(8 .3 mL/kg) and high dosage of venom peptide liq-uor group(33 .2 mL/kg);the right toes ,ankle diameter and whole body weight were measured at 7-day intervals ;the spleen index , serum level of circulating immune complexes(CIC) were determined after the thirty-fourth day when the mice was put to death .Re-sults The level of CIC in AA mice decreased significantly (P<0 .05) ,the decrease of spleen index and the reduction of toe and an-kle swelling in the low dose group were significant(P<0 .01) .Conclusion The venom peptide liquor exhibited apparent inhibitory effect on AA in mice .