ObjectiveTo compare the effects and differences of Yiqi Liangxue Shengji Formula （益气凉血生肌方） and atorvastatin on the repair of vascular injury in rats from the perspective of metabolomics. MethodsTwenty-four male SD rats were randomly divided into sham-surgery， model， traditional Chinese medicine （TCM）， and ator-vastatin groups， with 6 rats in each group. The rat model was established by balloon-induced abdominal aorta injury. Gavage was started on the day after surgery in all groups of rats. The sham and model groups were given with deio-nized water， TCM group received Yiqi Liangxue Shengji Formula 6 g/（kg·d）， and the atorvastatin group treated with atorvastatin suspension 2 mg/（kg·d） for 4 weeks. HE staining was used to observe the pathological morphology of the injured segment of the abdominal aorta； ELISA detection was used to test serum nitric oxide （NO） and C-reactive protein （CRP） levels； UPLC MS/MS technology was used for widely targeted metabolomics detection in serum， and multivariate statistical analysis was used to screen metabolic markers and pathways of two drugs； finally， compare serum levels of key metabolic markers of the above two medications in rats of each group. ResultsCompared with the sham-surgery group， the neointima significantly thickened， the level of NO decreased significantly and the level of CRP increased in serum of the model group （P＜0.01）； compared with the model group， the degree of arterial intimal hyperplasia in TCM group and atorvastatin group reduced， with an increase in NO levels and a decrease in CRP levels （P＜ 0.05 or P＜0.01）. The results of serum metabolomics showed that TCM group obtained 49 metabolic markers and 6 metabolic pathways， while atorvastatin group obtained 41 metabolic markers and 4 metabolic pathways. The two medications jointly regulated 38 metabolites. Glycerophospholipid metabolism and arginine-related metabolism were common metabolic pathways for both medications. Lysophosphatidylcholine （16∶1/0∶0） ［LPC （16∶1/ 0∶0）］， phosphatidylcholine （15∶0/15∶0） ［PC （15∶0/15∶0）］ were the key metabolites of glycerophospholipid metabolic pathway； ornithine， spermidine were the key metabolites of arginine-related metabolic pathway. The tricarboxylic acid cycle and glutathione metabolism were the unique metabolic pathways of Yiqi Liangxue Shengji Formula. Compared with the sham-surgery group， LPC （16∶1/0∶0）， ornithine， and spermidine levels elevated and PC （15∶0/15∶0） levels decreased in the model group （P＜0.05 or P＜0.01）. Compared with the model group， LPC （16∶1/0∶0）， ornithine， and spermidine levels decreased， and PC （15∶0/15∶0） levels increased in both TCM group and atorvastatin group （P＜0.05 or P＜0.01）. The degree of LPC reduction （16∶1/0∶0） was more significant in atorvastatin group compared with that in the TCM group （P＜0.01）. ConclusionsBoth sham-surgery and atorvastatin could regulate lipid metabolism and arginine-related metabolism， exert the characteristics of lipid-lowering， anti-inflammatory， improve arginine/NO bioavailability， and improve endothelial dysfunction. Atorvastatin showed more advantages in lipid-lowering and anti-inflammatory， while Yiqi Liangxue Shengji Formula has unique characteristics in regulating energy metabolism and improving oxidative stress.

China prospective multicenter birth cohort (Prospective Omics Health Atlas birth cohort, POHA birth cohort) study was officially launched in 2022. This study, in collaboration with 12 participating units, aims to establish a high-quality, multidimensional cohort comprising 20 000 naturally conceived families and assisted reproductive families. The study involves long-term follow-up of parents and offspring, with corresponding biological samples collected at key time points. Through multi-omics testing and analysis, the study aims to conduct multi-omics big data research across the entire maternal and infant life cycle. The goal is to identify new biomarkers for maternal and infant diseases and provide scientific evidence for risk prediction related to maternal diseases and neonatal health.

Objective:To explore the application of online challenge training mode and analyze its application effect in standardized training of new nurses.Methods:Using the map training mode of the online training platform, a challenge game was designed and applied in the standardized training of new nurses. Using the convenience sampling method, 309 new nurses who joined Beijing Friendship Hospital, Capital Medical University from 2020 to 2021 were selected and grouped according to their starting date. The 103 nurses who joined in 2020 were set as the control group and traditional training was used. The 206 nurses who joined in 2021 were set as the research group and a challenge training mode was used. The scores and pass rates of theoretical assessment and OSCE assessment as well as the scores of core competency were compared between the two groups after training. A self-made questionnaire for satisfaction survey was used to investigate the satisfaction of nurses in the research group with the challenge training mode. The t-test and chi-square test were perform using SPSS 23.0. Results:Compared with the control group, the research group showed significantly higher score [(83.32±6.30) vs. (81.59±7.62)] and pass rate (94.66% vs. 83.50%) of theoretical assessment, significantly higher score [(92.19±5.08) vs. (90.66±5.47)] and pass rate (100.00% vs. 97.09%) of OSCE assessment, and a significantly higher total score of core competencies [(193.61±34.94) vs. (177.55±36.91)] ( P<0.05). Moreover, 98.06% (202) of nurses believed that the challenge training mode could stimulate learning interest and motivation, and preferred the online challenge mode training method. Additionally, 93.69% (193) of nurses believed that online learning was more efficient, and 96.60% (199) of nurses thought that online training saved time. Conclusions:The online challenge training mode can effectively stimulate the learning interest of new nurses, improve their core abilities, and increase their satisfaction with the training. This method is worth implementing and promoting in standardized nurse training.

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 clinical value of prostatic exosomal protein(PSEP)and PSA in the diagnosis of PCa with PSA in the gray zone(4-10 μg/L)and Prostate Imaging Reporting and Data System category3(PI-RADS-3)lesions.Meth-ods:From 2019 to 2022,211 patients with the PSA gray zone and PI-RADS-3 lesions underwent prostate multi-parameter MRI,pros-tate needle biopsy or transurethral resection/enucleation of the prostate.We collected the baseline urine samples from the patients,ex-amined the content of PSEP in the urine by ELISA and evaluated the performance of PSEP and PSA in the diagnosis of PCa.Re-sults:Among the total number of patients,57 were confirmed with PCa(the positive group)and the other 154 with benign prostate conditions(the negative group)by biopsy pathology.The free PSA level(fPSA),free to total PSA ratio(f/tPSA)and PSEP content were dramatically lower in the positive than in the negative group(all P<0.01).Uni-and multivariate analyses showed f/tPSA and PSEP to be independent factors for predicting PCa with the PSA gray zone and PI-RADS-3 lesions,with the AUC values of 0.70 and 0.78,best cutoff values of 0.18 and 1.45 μg/L,sensitivity of 84.21%and 70.18%,and specificity of 58.44%and 77.27%,re-spectively(P<0.01).The multivariate model with combined use of f/tPSA and PSEP(AUC:0.82,best cutoff value:0.31,sensi-tivity:82.46%,specificity:75.32%)outperformed either f/tPSA or PSEP alone in the diagnosis of PCa with the PSA gray zone and PI-RADS-3 lesions(P<0.01,P=0.04).Conclusion:For patients with the PSA gray zone and PI-RADS-3 lesions,f/tPSA and PSEP are significant predictors of PCa.The multivariate model of PSEP combined with f/tPSA can replace f/tPSA in the detection of PCa to improve diagnostic performance and avoid unnecessary prostate biopsy.

Objective To understand the current situation of protective mask wearing behavior of health care workers(HCWs),analyze the influencing factors for the failure to wear medical protective masks in a standard manner,and provide basis for the improvement of mask-wearing related training.Methods From June 2022 to March 2023,staff in a tertiary first-class hospital were selected as the research object.Real-time quantitative fitness testing using aerosol condensation particle counting method was applied to test 5 commonly used medical protective masks available in the market.Fitness factor changes of the testing instrument and assistance from professional per-sonnel were needed to comprehensively estimate the wearing condition of medical protective masks.Participants were surveyed through a self-made general information questionnaire.Heads and faces of participants were scanned by three-dimensional(3D)laser scanning technology,and scanned images were imported into Geomagic Studio 2013 software to measure head and face dimensions.Results A total of 222 HCWs were investigated,991 real-time tests and 208 times of 3D scanning were conducted.221(22.30％)tests showed failure of participants in wearing masks in a standard manner.The non-standard wearing rates of 5 types of medical protective masks were 30.56％,25.62％,25.87％,23.15％,and 7.35％,respectively.The non-standard mask-wearing rates showed statistically significant difference between groups categorized in terms of medical protective masks with different shapes,partici-pants'occupation,time of last training for wearing medical protective masks,and participants'experience in pre-vention and control of respiratory infectious disease(all P＜0.05).There were no statistically significant differences in non-standard mask-wearing rate between groups with different brands and sizes of medical protective masks,as well as gender and department of participants,etc.(all P＞0.05).The body mass index(BMI)was significantly different among participants who wear foldable medical protective masks in the standard and non-standard manner(both P＜0.05).Conclusion Wearing medical protective masks by HCWs in a non-standard manner is influenced by multiple factors.It is recommended to conduct real-time testing before formal quantitative fitness testing,so as to save time and improve testing efficiency.When conducting training on wearing medical protective masks in the fu-ture,targeted training should be provided based on mask shape and focus on logistics personnel,interns,individuals with high BMI,those who have never received training on wearing medical protective masks,and those who have never participated in the prevention and treatment of respiratory infectious diseases.

Objective To investigate the feasibility of establishing an animal model of rectovaginal fistula in rabbits by magnetic compression technique.Methods A magnetic device suitable for preparing rabbit rectovaginal fistula model was self-designed.Eight New Zealand female rabbits were used as experimental subjects.They were placed in a supine position after auricular intravenous anesthesia,and the magnets were placed on both sides of the rectovaginal septum through the vagina and anus,respectively,and the magnets were made to attract together.The operation time was recorded,the general state of the experimental rabbits was observed after operation,and the time of magnet discharge was recorded.The experimental rabbits were killed 1 week after operation to obtain rectovaginal fistula specimens,and the formation of rectovaginal fistula was observed by naked eye.Results The animal model of rectovaginal fistula was successfully established in 8 experimental rabbits.The operation process was smooth,with an average time of(1.63±0.70)minutes.The rabbits were generally in good condition after operation.The magnet was discharged from the body at(4.63±0.99)day after operation,and the rectovaginal fistula specimens were obtained 1 week after operation,and the rectovaginal fistula was well formed by naked eye observation.Conclusion The establishment of rabbit rectovaginal fistula model by magnetic compression technique has the advantages of simple operation and high success rate of model preparation.

With the in-depth study of molecular biology,non-small cell lung cancer(NSCLC)has opened the era of precision medicine based on mutation-based molecular targeting therapy.Epidermal growth factor receptor(EGFR)driver mutations are closely related to the progression of NSCLC,and EGFR-tyrosine kinase inhibitors(TKIs)developed based on this have achieved significant therapeutic effects,but acquired drug resistance is still one of the major factors limiting their long-term use.As resistance mechanisms are further investigated,in addition to secondary EGFR mutation,MET amplification,HER2 amplification,histologic transformation,etc.,receptor tyrosine kinase(RTK)fusion mutation have been shown to be a targetable mechanism of acquired resistance.Among the acquired RTK fusion mutations,rearranged during transfection(RET)fusion mutations are the accessible targets of our concern.As the RET molecule continues to be explored,drugs targeting RET fusions have been approved and marketed.There are different clinical strategies to deal with acquired RET fusion mutation mediating resistance to EGFR-TKIs treatment.In this review,the structure and function of RET,its relationship with EGFR-TKIs resistance,and treatment strategies are reviewed to further improve patient survival outcomes.

BackgroundType 1 diabetes is caused by a chronic immune response that destroys islet beta cells， resulting in elevated blood glucose. Mesenchymal stem cells can prevent and treat the development of diabetes and its complications. However， little is known about the effects and potential mechanisms of Gingival mesenchymal stem cells （GMSCs） in preventing diabetes. The aim of this study is to investigate the mechanism of GMSCs in preventing type 1 diabetes in mice and to find targets for clinical treatment of diabetes. MethodsWe injected human GMSCs into NOD mice to observe the trend of blood glucose， observed the survival of pancreatic β-cells by immunohistochemistry， and detected the change of immune cells in the spleen of mice by flow analysis. Finally， the immune cells in NOD mice were transfused into NOD-SCID mice to observe the onset of diabetes in NOD-SCID mice. ResultsGMSCs significantly reduced the incidence of diabetes in NOD mice， with 64% of control mice developing diabetes at 27 weeks of age compared with 35% in the GMSC group， P=0.013. The percentage of Follicular B cells（FO B cell） in the spleen of GMSCs-treated mice decreased from （52.2±4.1）% to （43.2±5.3）%， P=0.008， while other types of immune cells did not change significantly. The immunohistochemical results showed that GMSCs could effectively improve the survival of pancreatic β-cells， which could continuously produce insulin to control blood glucose. Finally， we found the spleen cells transfusion could prevent the development of diabetes in NOD-SCID mice. ConclusionGMSCs can reduce diabetes in mice by reducing FO B cells in the spleen.

COVID-19 is caused by a novel coronavirus-severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2), which has being spreading around the world, posing a serious threat to human health and lives. Neutralizing antibodies and small molecule inhibitors for virus replication cycle are the main antiviral treatment for novel coronavirus recommended in China. To further promote the rational use of antiviral therapy in clinical practice, the National Center for Infectious Diseases (Beijing Ditan Hospital Capital Medical University and the First Affiliated Hospital, Zhejiang University School of Medicine) invited experts in fields of infectious diseases, respiratory and intensive care to develop an Expert Consensus on Antiviral Therapy of COVID-19 based on the Diagnosis and Treatment Guideline for COVID-19 ( trial version 10) and experiences in the diagnosis and treatment of COVID-19 in China. The consensus is concise, practical and highly operable, hopefully it would improve the understanding of antiviral therapy for clinicians and provide suggestions for standardized medication in treatment of COVID-19.