Purpose: Erectile dysfunction (ED) is a common male sexual dysfunction. Gut microbiota plays an important role in various diseases. To investigate the effects and mechanisms of intestinal flora dysregulation induced by high-fat diet (HFD) on erectile function. Materials and Methods: Male Sprague–Dawley rats aged 8 weeks were randomly divided into the normal diet (ND) and HFD groups. After 24 weeks, a measurement of erectile function was performed. We performed 16S rRNA sequencing of stool samples. Then, we established fecal microbiota transplantation (FMT) rat models by transplanting fecal microbiota from rats of ND group and HFD group to two new groups of rats respectively. After 24 weeks, erectile function of the rats was evaluated and 16S rRNA sequencing was performed, and serum samples were collected for the untargeted metabolomics detection. Results: The erectile function of rats and the species diversity of intestinal microbiota in the HFD group was significantly lower, and the characteristics of the intestinal microbiota community structure were also significantly different between the two groups. The erectile function of rats in the HFD-FMT group was significantly lower than that of rats in the ND-FMT group. The characteristics of the intestinal microbiota community structure were significantly different. In the HFD-FMT group, 27 metabolites were significantly different and they were mainly involved in the several inflammation-related pathways. Conclusions Intestinal microbiota disorders induced by HFD can damage the intestinal barrier of rats, change the serum metabolic profile, induce low-grade inflammation and apoptosis in the corpus cavernosum of the penis, and lead to ED.

Purpose: Erectile dysfunction (ED) is a common male sexual dysfunction. Gut microbiota plays an important role in various diseases. To investigate the effects and mechanisms of intestinal flora dysregulation induced by high-fat diet (HFD) on erectile function. Materials and Methods: Male Sprague–Dawley rats aged 8 weeks were randomly divided into the normal diet (ND) and HFD groups. After 24 weeks, a measurement of erectile function was performed. We performed 16S rRNA sequencing of stool samples. Then, we established fecal microbiota transplantation (FMT) rat models by transplanting fecal microbiota from rats of ND group and HFD group to two new groups of rats respectively. After 24 weeks, erectile function of the rats was evaluated and 16S rRNA sequencing was performed, and serum samples were collected for the untargeted metabolomics detection. Results: The erectile function of rats and the species diversity of intestinal microbiota in the HFD group was significantly lower, and the characteristics of the intestinal microbiota community structure were also significantly different between the two groups. The erectile function of rats in the HFD-FMT group was significantly lower than that of rats in the ND-FMT group. The characteristics of the intestinal microbiota community structure were significantly different. In the HFD-FMT group, 27 metabolites were significantly different and they were mainly involved in the several inflammation-related pathways. Conclusions Intestinal microbiota disorders induced by HFD can damage the intestinal barrier of rats, change the serum metabolic profile, induce low-grade inflammation and apoptosis in the corpus cavernosum of the penis, and lead to ED.

Purpose: Erectile dysfunction (ED) is a common male sexual dysfunction. Gut microbiota plays an important role in various diseases. To investigate the effects and mechanisms of intestinal flora dysregulation induced by high-fat diet (HFD) on erectile function. Materials and Methods: Male Sprague–Dawley rats aged 8 weeks were randomly divided into the normal diet (ND) and HFD groups. After 24 weeks, a measurement of erectile function was performed. We performed 16S rRNA sequencing of stool samples. Then, we established fecal microbiota transplantation (FMT) rat models by transplanting fecal microbiota from rats of ND group and HFD group to two new groups of rats respectively. After 24 weeks, erectile function of the rats was evaluated and 16S rRNA sequencing was performed, and serum samples were collected for the untargeted metabolomics detection. Results: The erectile function of rats and the species diversity of intestinal microbiota in the HFD group was significantly lower, and the characteristics of the intestinal microbiota community structure were also significantly different between the two groups. The erectile function of rats in the HFD-FMT group was significantly lower than that of rats in the ND-FMT group. The characteristics of the intestinal microbiota community structure were significantly different. In the HFD-FMT group, 27 metabolites were significantly different and they were mainly involved in the several inflammation-related pathways. Conclusions Intestinal microbiota disorders induced by HFD can damage the intestinal barrier of rats, change the serum metabolic profile, induce low-grade inflammation and apoptosis in the corpus cavernosum of the penis, and lead to ED.

Purpose: Erectile dysfunction (ED) is a common male sexual dysfunction. Gut microbiota plays an important role in various diseases. To investigate the effects and mechanisms of intestinal flora dysregulation induced by high-fat diet (HFD) on erectile function. Materials and Methods: Male Sprague–Dawley rats aged 8 weeks were randomly divided into the normal diet (ND) and HFD groups. After 24 weeks, a measurement of erectile function was performed. We performed 16S rRNA sequencing of stool samples. Then, we established fecal microbiota transplantation (FMT) rat models by transplanting fecal microbiota from rats of ND group and HFD group to two new groups of rats respectively. After 24 weeks, erectile function of the rats was evaluated and 16S rRNA sequencing was performed, and serum samples were collected for the untargeted metabolomics detection. Results: The erectile function of rats and the species diversity of intestinal microbiota in the HFD group was significantly lower, and the characteristics of the intestinal microbiota community structure were also significantly different between the two groups. The erectile function of rats in the HFD-FMT group was significantly lower than that of rats in the ND-FMT group. The characteristics of the intestinal microbiota community structure were significantly different. In the HFD-FMT group, 27 metabolites were significantly different and they were mainly involved in the several inflammation-related pathways. Conclusions Intestinal microbiota disorders induced by HFD can damage the intestinal barrier of rats, change the serum metabolic profile, induce low-grade inflammation and apoptosis in the corpus cavernosum of the penis, and lead to ED.

Purpose: Erectile dysfunction (ED) is a common male sexual dysfunction. Gut microbiota plays an important role in various diseases. To investigate the effects and mechanisms of intestinal flora dysregulation induced by high-fat diet (HFD) on erectile function. Materials and Methods: Male Sprague–Dawley rats aged 8 weeks were randomly divided into the normal diet (ND) and HFD groups. After 24 weeks, a measurement of erectile function was performed. We performed 16S rRNA sequencing of stool samples. Then, we established fecal microbiota transplantation (FMT) rat models by transplanting fecal microbiota from rats of ND group and HFD group to two new groups of rats respectively. After 24 weeks, erectile function of the rats was evaluated and 16S rRNA sequencing was performed, and serum samples were collected for the untargeted metabolomics detection. Results: The erectile function of rats and the species diversity of intestinal microbiota in the HFD group was significantly lower, and the characteristics of the intestinal microbiota community structure were also significantly different between the two groups. The erectile function of rats in the HFD-FMT group was significantly lower than that of rats in the ND-FMT group. The characteristics of the intestinal microbiota community structure were significantly different. In the HFD-FMT group, 27 metabolites were significantly different and they were mainly involved in the several inflammation-related pathways. Conclusions Intestinal microbiota disorders induced by HFD can damage the intestinal barrier of rats, change the serum metabolic profile, induce low-grade inflammation and apoptosis in the corpus cavernosum of the penis, and lead to ED.

Palliative care is a way to help end-of-life populations improve their quality of life， and its development in practice cannot be separated from the level of education in palliative care. At present， some medical schools in palliative care education compared with western developed countries have problems such as imperfect construction of hospice curriculum system， lack of medical students’ hospice knowledge； insufficient interdisciplinary teaching faculty， weak palliative care awareness of medical students； single teaching evaluation mode； weak palliative care practice teaching links. To this end， it is necessary to improve the palliative care curriculum system， explore rich and diverse teaching methods； strengthen interdisciplinary teaching and faculty development， enhancing the awareness of palliative care among medical students；establish a scientific and effective evaluation method， carry out multi-dimensional dynamic assessment； expand the palliative care practice teaching base， and accurately improve the practical skills of medical students in palliative care， and other countermeasures to improve the level of palliative care education， and to help the strategy of Healthy China.

AIM:To investigate the synergistic efficacy of travoprost and betahistine mesylate in early open angle glaucoma.METHODS:This study is a prospective, randomized, controlled, open label single center clinical trial that enrolled 82 patients(82 eyes)with early primary open-angle glaucoma from January 2020 to January 2023(eligible eyes were included, and the right eye was selected if both eyes met the inclusion criteria). The patients were randomly divided into a monotherapy group(41 eyes)treated with only travoprost eye drops and a combination therapy group(41 eyes)treated with travoprost eye drops and oral betahistine mesylate according to a 1:1 ratio using a random number table method. Followed-up for 12 mo, the intraocular pressure(IOP), retinal nerve fiber layer(RNFL)thickness, ocular hemodynamics [peak systolic velocity(PSV), end diastolic velocity(EDV), resistance index(RI), pulsatility index(PI)], liver and kidney function, quality of life, and clinical symptom scores before and after treatment were compared between the two groups of patients.RESULTS:Totally 4 patients were unable to complete all follow-up visits due to various factors, including 2 cases in the monotherapy group and 2 cases in the combination therapy group, with a lost rate of follow-up of 5%. The IOP in the combination therapy group was significantly lower than that in the monotherapy group at all time points(all P<0.05). Additionally, the rate of reduction in RNFL thickness was significantly slower in the combination therapy group compared to the monotherapy group(all P<0.05). Hemodynamic parameters revealed that PSV and EDV were significantly higher in the combination therapy group at 12 mo, while RI and PI were significantly lower than those in the monotherapy group(all P<0.05). The quality of life scores and visual analog scale(VAS)scores were also significantly better in the combination therapy group compared to the monotherapy group(all P<0.05). There were no statistically significant differences in liver functions, including alanine aminotransferase(ALT), aspartate aminotransferase(AST), total bilirubin(TBIL), and kidney functions, including serum creatinine(Scr), blood urea nitrogen(BUN), and uric acid(UA)between the two groups at 6 and 12 mo after treatment, with no serious damage to liver and kidney or other systemic adverse reactions observed in either groups. Furthermore, the incidence of headache in the combination group was lower than that of the monotherapy group(P=0.042), and there were no statistical significance in the incidence of other adverse reactions(all P>0.05).CONCLUSION:The combination therapy of travoprost and betahistine mesylate exhibits significant synergistic effects in patients with early primary open angle glaucoma, offering better IOP control, neuroprotection of the optic nerve, and oxidative stress inhibition. This combination may provide a new clinical reference for comprehensive glaucoma treatment.

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 correlation between the expression of serum long non-coding RNA bladder cancer associated transcript 1(LncRNA BLACAT1)and long non-coding RNA(LncRNA)-H19 levels and the severity of elderly knee osteoarthritis(KOA).Methods A total of 120 elderly KOA patients who underwent diagnosis and treatment in Jingmen Hospital of Traditional Chinese Medicine from November 2021 to February 2023 were selected as subjects(KOA group).Based on the Kelgren-Lawrence(K-L)classification,these KOA group patients were grouped into mild group(n=41),moderate group(n=45),and severe group(n=34).Meanwhile,those who underwent health examinations at the same time were regarded as control group(n=120).Real-time fluorescence quantitative PCR method was applied to measure the levels of serum LncRNA BLACAT1 and LncRNA-H19.The serum levels of LncRNA BLACAT1 and LncRNA-H19 were compared between KOA group and the control group.The serum levels of LncRNA BLACAT1 and LncRNA-H19 in KOA patients with different degrees of illness were analyzed.Spearman correlation was applied to analyze the relationship between the expression of serum LncRNA BLACAT1,LncRNA-H19 levels and the severity of KOA patients.Receiver operating characteristic(ROC)curve was applied to analyze the diagnostic value of serum LncRNA BLACAT1 and LncRNA-H19 levels for KOA.Results The serum levels of LncRNA BLACAT1(1.31±0.31)and LncRNA-H19(1.41±0.37)in KOA patients were higher than those in the healthy control group(0.99±0.24,1.03±0.25),and the differences were statistically significant(t=8.941,9.322,all P＜0.05).The serum levels of LncRNA BLACAT1(1.53±0.36)and LncRNA-H19(1.71±0.44)in the severe group were higher than those in the mild(1.13±0.27,1.18±0.29)and moderate groups(1.32±0.31,1.40±0.38)(q=7.806,4.183;8.709,5.200),and the serum levels of the moderate group were higher than that of the mild group(q=3.983,3.884),and the differences were statistically significant,respectively(all P＜0.05).Spearman correlation analysis results showed that the serum levels of LncRNA BLACAT1 and LncRNA-H19 were positively correlated with the severity of the disease(r=0.552,0.414,all P＜0.05).The results of ROC showed that the AUCs of LncRNA BLACAT1 and LncRNA-H19 alone diagnosed KOA were 0.860 and 0.869,with specificity of 74.2％and 80.8％,and sensitivity of 66.7％and 69.1％,respectively.The AUC of the combined diagnosis of KOA was 0.966,with a sensitivity and a specificity of 90.0％,81.7％,respectively.Conclusion The serum levels of LncRNA BLACAT 1 and LncRNA-H19 in KOA patients were elevated and were positively correlated with the severity of KOA patients.Combined detection of the two could effectively predict the occurrence of KOA.

During coronavirus disease 2019 epidemic, the treatment of severe trauma has been impacted. The Consensus on emergency surgery and infection prevention and control for severe trauma patients with 2019 novel corona virus pneumonia was published online on February 12, 2020, providing a strong guidance for the emergency treatment of severe trauma and the self-protection of medical staffs in the early stage of the epidemic. With the Joint Prevention and Control Mechanism of the State Council renaming "novel coronavirus pneumonia" to "novel coronavirus infection" and the infection being managed with measures against class B infectious diseases since January 8, 2023, the consensus published in 2020 is no longer applicable to the emergency treatment of severe trauma in the new stage of epidemic prevention and control. In this context, led by the Chinese Traumatology Association, Chinese Trauma Surgeon Association, Trauma Medicine Branch of Chinese International Exchange and Promotive Association for Medical and Health Care, and Editorial Board of Chinese Journal of Traumatology, the Chinese expert consensus on emergency surgery for severe trauma and infection prevention during coronavirus disease 2019 epidemic ( version 2023) is formulated to ensure the effectiveness and safety in the treatment of severe trauma in the new stage. Based on the policy of the Joint Prevention and Control Mechanism of the State Council and by using evidence-based medical evidence as well as Delphi expert consultation and voting, 16 recommendations are put forward from the four aspects of the related definitions, infection prevention, preoperative assessment and preparation, emergency operation and postoperative management, hoping to provide a reference for severe trauma care in the new stage of the epidemic prevention and control.