OBJECTIVE To investigate the metabolic changes in MEG-01 megakaryocytes after treatment with linezolid （LZD） from metabolomic perspective and its impact on the the proliferation of cells and generation of platelet precursors. METHODS MEG-01 cells were seeded in proliferation medium and divided into blank control group （untreated）， solvent control group （4‰DMSO）， and 100， 200， 400， 800 μg/mL LZD groups. The proliferation status of cells in each group was observed under the microscope； cell proliferation and viability were assessed. Cells were also seeded in differentiation medium and divided into blank control group （untreated）， solvent control group （4‰DMSO）， and 400 μg/mL LZD group； after 14 days of culture， platelet precursor generation was observed under the microscope； immunofluorescence staining was performed to count the proportion of cells producing pseudopodia， the relative length of pseudopodia was measured， and the expression levels of CD41 and CD42b mRNA were assessed. Cells from the solvent control group and the 400 μg/mL LZD group， cultured in differentiation medium for 14 days， were extracted and subjected to non-targeted metabolomics and targeted energy metabolomics analysis using liquid chromatography-tandem mass spectrometry. The relative content of pyruvate in cells， after being cultured for 14 days with the addition of pyruvate （10 mmol/L） or LZD （400 μg/mL）+pyruvate （10 mmol/L）， was measured and observed， as well as its effects on cell proliferation and platelet precursor generation. RESULTS 400 μg/mL LZD could significantly inhibit the proliferation of MEG-01 cells and the generation of platelet precursors （P＜0.01）. Non-targeted metabolomic analysis of MEG-01 cells after 400 μg/mL LZD treatment revealed significant changes in energy metabolism-related pathways such as mTOR signaling pathway， alanine， aspartate and glutamate metabolism， and central carbon metabolism in cancer. Targeted energy metabolomic analysis further showed that the relative contents of adenosine triphosphate， guanosine triphosphate， and pyruvate in MEG-01 cells were significantly reduced （P＜0.01）， while the relative contents of lactate were significantly increased （P＜0.01）. Compared with the LZD group， the relative content of pyruvate， cell count， the proportion of cells producing pseudopodia and the relative length of pseudopodia were significantly increased in the LZD+pyruvate group （P＜0.01）. CONCLUSIONS LZD may reduce pyruvate production by inhibiting mitochondrial energy metabolism， thereby suppressing megakaryocyte proliferation and platelet precursor production， ultimately leading to the occurrence of thrombocytopenia.

Objectives:To evaluate the cost-effectiveness of typical pharmaceutical smoking cessation intervention strategies in China in the context of primary cancer prevention.Methods:Markov cohort simulation models were established to simulate the burden of 12 smoking caused cancer, including lung cancer, oral cancer, nasopharyngeal cancer, laryngeal cancer, esophageal cancer, gastric cancer, pancreatic cancer, liver cancer, kidney cancer, bladder cancer, cervical cancer, and acute myeloid leukemia. Taking incremental cost effectiveness ratio (ICER) as the main indicator, the model sets one year as the cycling period for 50 periods and simulates the cohort of 10 000 thirty-five-year-old current smokers with various smoking cessation strategies. To ensure the robustness of conclusion, univariate sensitivity analysis, probability sensitivity analysis, and age-group sensitivity analysis were conducted.Results:The results showed that varenicline intervention was the most cost-effective intervention. Compared to the next most effective option, incremental cost of each additional quality-adjusted life year is 11 140.28 yuan, which is below the threshold of willingness to pay (1 year GDP per capita). The value of ICER increased as the increasing age group of adopting intervention, but neither exceeded the threshold of willingness to pay. One-way sensitivity analysis showed that the value of discount rate, the hazard ratio and cost of intervention strategy had a greater impact on the result of ICER.Conclusion:In China, the use of varenicline to quit smoking is highly cost effective in the context of cancer primary prevention, especially for younger smokers.

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.

Medical imaging is an important auxiliary means of disease diagnosis. In the process of diagnosis, diseases are usually presented in a static way, which is one of the characteristics of imaging diagnosis. However, this static representation of diseases imposes certain limitations, which can, to some extent, lead to the loss of medical humanities. Therefore, it is very important for imaging diagnostic doctors to correctly use philosophical thinking to understand, analyze, and solve problems. The reinforcement of philosophical thinking in imaging diagnosis entails commitment to the "patient-centered" perspective in medicine as well as the integration of comprehensiveness, regularity, and proactivity. This not only effectively trains the diagnostic thinking of imaging diagnostic doctors but also improves their humanistic quality, thereby addressing the problems associated with these limitations. This allows the diagnosis to be both technically accurate and emotionally attuned.

Objective:To explore the correlation between enlarged perivascular spaces and other imaging markers of cerebrovascular disease in patients with ischemic stroke.Methods:Totally 287 patients with ischemic stroke hospitalized in neurology department from January 2018 to January 2019 were selected. According to the severity of EPVS in different parts of the brain, the correlations between the severity of EPVS in different parts of the brain and cerebral microbleeds (CMBs), white matter hyperintensity (WMH), lacunar infarcts (LIs) were analyzed. SPSS 22.0 software was used for analysis. Chi-square test, independent sample t-test, rank-sum test and non parametric Mann-Whitney U test were used for group comparison, and Logistic regression analysis was used for multivariate analysis. Results:EPVS was common and severe in patients with ischemic stroke. Periventricular white matter hyperintensity(PWMH)( β=1.604, P<0.001, OR=4.971, 95% CI=2.015-12.263), CMBs ( β=1.224, P=0.018, OR=3.339, 95% CI=1.232-9.383) and LIs ( β=0.626, P=0.047, OR=1.871, 95% CI=1.009-3.470) were independent risk factors for BG-EPVS. PWMH ( r=0.614), DWMH ( r=0.622), LIs ( r=0.532) were positively correlated with the severity of BG-EPVS (all P<0.01). Conclusion:The imaging makers of CSVD are related to BG-EPVS, which can affect the severity of brain BG-EPVS in patients with ischemic stroke.

Objective:To retrieve, evaluate, and integrate domestic and foreign evidence on the prevention of central venous access device medical adhesive-related skin injury (CVAD-MARSI) , and analyze and summarize the best evidence, so as to provide a reference for establishing a sound intravenous infusion treatment system and CVAD-MARSI management mechanism.Methods:Evidence-based nursing methods were applied, and the evidence on the prevention of CVAD-MARSI in British Medical Journal (BMJ) Best Practice, UpToDate, Australia Joanna Briggs Institute (JBI) Evidence-Based Practice Database, Canada Registered Nurses' Association of Ontario, Scottish Intercollegiate Guidelines Network, National Institute for Health and Clinical Excellence, Cochrane Library, Intravenous Nurses Society, PubMed, Medlive, Chinese Biomedical Literature Database, Wanfang Data, China National Knowledge Infrastructure (CNKI) was retrieved according to the "6S" model system. The evidence included guidelines, best practices, systematic reviews, expert consensus, and evidence summary. The search time limit was from January 1, 2011 to February 1, 2021. Two researchers independently completed the quality evaluation of the included literature, and carried out the evidence extraction and summary of literature that met the quality standards.Results:A total of 10 articles were included, including 3 guidelines, 1 systematic review, 5 expert consensuses, and 1 evidence summary. The best evidence covered 5 aspects including patient evaluation, skin preparation, dressing use, improvement of comfort, and organization management, with a total of 26 pieces of evidence.Conclusions:Clinical medical and nursing staff can take measures in terms of patient evaluation, skin preparation, dressing use, improvement of comfort, and organization management. In the process of evidence application, the best targeted evidence should be selected combined with the clinical situation, so as to reduce the harm of CVAD-MARSI.

Objective: To explore peptidomic changes of peptides in saliva and gingival crevicular fluid (GCF) before and after treatment of gingivitis. Methods: From January 2017 to September 2017, seventeen participants at the age of 24-62 (6 males and 11 females) at Department of Preventive Dentistry, Peking University School and Hospital of Stomatology with gingivitis were recruited in the present study. Their clinical parameters were measured and recorded. Saliva and GCF samples were collected from each of the participants at the baseline and 7 days after ultrasonic supragingival scaling, respectively. Matrix-assisted laser desorption-ionization time-of-flight mass spectrometry (MALDI-TOF MS) was employed to detect the changes of peptidomic profiles, while ano-liquid chromatography-electrospray ionization-tandem mass spectrometry (nano-LC/ESI-MS/MS) was performed to identify the possible proteins from which the peptides might derive. Results: Initially, four peptide peaks [mass-to-charge ratio (m/z) values: 1 030.6, 1 043.4, 1 053.4 and 1 064.6] were screened out exhibiting a decreasing trend after treatment (P<0.05). Besides, five peptide peaks from gingival crevicular fluid (P<0.05) exhibited differential expression, among which 1 055.5 and 1 168.3 demonstrating a decrease after treatment, while 3 363.7, 3 480.9 and 3 489.5 increased overtime. Certain positive correlations were detected between some peptides and clinical parameters. Principle component analysis using the above mentioned peptide peaks showed a distinct distribution before and after treatment and peptides from GCF showed a slightly better capacity to discriminate patients before and after treatment. The peptides with m/z values of 1 055.5 in GCF and 1 064.6 in saliva were identified to be segments of serum albumin and complement C3, respectively. Conclusions Several differentially expressed peptides were detected in saliva and GCF by MALDI-TOF MS, exhibiting the potentiality to act as biomarkers in gingivitis patients.

Objective To explore peptidomic changes of peptides in saliva and gingival crevicular fluid (GCF) before and after treatment of gingivitis. Methods From January 2017 to September 2017, seventeen participants at the age of 24?62 (6 males and 11 females) at Department of Preventive Dentistry, Peking University School and Hospital of Stomatology with gingivitis were recruited in the present study. Their clinical parameters were measured and recorded. Saliva and GCF samples were collected from each of the participants at the baseline and 7 days after ultrasonic supragingival scaling, respectively. Matrix?assisted laser desorption?ionization time?of?flight mass spectrometry (MALDI?TOF MS) was employed to detect the changes of peptidomic profiles, while ano?liquid chromatography?electrospray ionization?tandem mass spectrometry (nano?LC/ESI?MS/MS) was performed to identify the possible proteins from which the peptides might derive. Results Initially, four peptide peaks [mass?to?charge ratio (m/z) values: 1 030.6, 1 043.4, 1 053.4 and 1 064.6] were screened out exhibiting a decreasing trend after treatment (P<0.05). Besides, five peptide peaks from gingival crevicular fluid (P<0.05) exhibited differential expression, among which 1 055.5 and 1 168.3 demonstrating a decrease after treatment, while 3 363.7, 3 480.9 and 3 489.5 increased overtime. Certain positive correlations were detected between some peptides and clinical parameters. Principle component analysis using the above mentioned peptide peaks showed a distinct distribution before and after treatment and peptides from GCF showed a slightly better capacity to discriminate patients before and after treatment. The peptides with m/z values of 1 055.5 in GCF and 1 064.6 in saliva were identified to be segments of serum albumin and complement C3, respectively. Conclusions Several differentially expressed peptides were detected in saliva and GCF by MALDI?TOF MS, exhibiting the potentiality to act as biomarkers in gingivitis patients.

Objective To explore the improvement of cognitive impairment in patients with mild and moderate vascular cognitive impairment( VCI) treated with cerebralcare granule ( CG) and basic treat-ment.Methods From October in 2014 to December in 2016 year,143 cases of VCI patients were admitted from six hospitals in some areas of Hebei Province as the research objects,and divided into CG treatment group (experimental group,n=98) and conventional treatment group (control group,n=66).Three months and six months after treatment,the score of mental state examination ( MMSE) ,the Montreal cognitive assess-ment scale ( MoCA) and the daily living capacity scale( ADL) of the two groups were compared after 3 and 6 moths of treatment.Results ①The total score of MMSE in the experimental group was higher than that of the control group for six months after treatment, and the difference was statistically significant ( ( 23. 76 ± 4.02) vs (21.52±5.13),P<0.05).②Six months after treatment,the total score of MoCA ((21.06±4.66) vs (18.32±5.20)) and visual spatial/executive function((3.05±1.37) vs (2.42±1.66)),calculation force ((2.24±0.84) vs (1.83±1.05)) and orientation ability((5.20±1.12) vs (4.06±1.35)) scores in the ex-perimental group were significantly higher than those in the control group (P<0.05) .③Six months after treat-ment,the ADL score in the experimental group was lower than that before treatment,and the difference was statistically significant((24.96±8.74) vs (29.20±11.55),P<0.05);while there was no significant difference in the ADL score between the experimental group and the control group after 6 months (P>0.05).Conclusion CG can improve cognitive function in mild to moderate VCI patients,mainly in visual space/execution func-tion,calculation ability and orientation ability,and with the extension of treatment time,the curative effect is more obvious.