Chronic heart failure （CHF） represents the terminal stage of cardiovascular diseases， and its prevalence remains high in China. In this study， existing animal models of CHF were retrieved and categorized. In combination with the characteristics of CHF from traditional Chinese medicine （TCM） and Western medicine perspectives， the models were weighted， and their clinical consistency was evaluated. The advantages and disadvantages of the models were assessed. Among them， models with higher TCM clinical consistency included the doxorubicin-induced model， the isoproterenol-induced model， and the left anterior descending coronary artery ligation model， each with a TCM consistency rate of 90%. The animal model established by the left anterior descending coronary artery ligation showed a high degree of clinical consistency with Western medicine， with a consistency rate of 82%. Each model exhibited its own advantages and disadvantages， with a general lack of modeling methods combining diseases and syndromes of TCM and Western medicine. At present， the inducement factors used for animal models are relatively singular， mainly reflecting the etiology and pathogenesis of Western medicine， with insufficient correlation to the pathogenesis of TCM. The characteristics of TCM syndromes are not fully represented， and the consistency between TCM and Western medicine is generally not high. TCM has the advantage of a multi-dimensional syndrome differentiation and treatment approach. It is necessary to integrate the characteristics of diseases and syndromes of TCM and Western medicine， adopt multi-factor modeling methods to reflect the pathological process of CHF， improve existing models， and establish animal models of CHF that better align with the characteristics of clinical diseases and syndromes of TCM and Western medicine， so as to provide a reliable reference for clinical prevention and treatment.

Chronic heart failure （CHF） represents the terminal stage of cardiovascular diseases， and its prevalence remains high in China. In this study， existing animal models of CHF were retrieved and categorized. In combination with the characteristics of CHF from traditional Chinese medicine （TCM） and Western medicine perspectives， the models were weighted， and their clinical consistency was evaluated. The advantages and disadvantages of the models were assessed. Among them， models with higher TCM clinical consistency included the doxorubicin-induced model， the isoproterenol-induced model， and the left anterior descending coronary artery ligation model， each with a TCM consistency rate of 90%. The animal model established by the left anterior descending coronary artery ligation showed a high degree of clinical consistency with Western medicine， with a consistency rate of 82%. Each model exhibited its own advantages and disadvantages， with a general lack of modeling methods combining diseases and syndromes of TCM and Western medicine. At present， the inducement factors used for animal models are relatively singular， mainly reflecting the etiology and pathogenesis of Western medicine， with insufficient correlation to the pathogenesis of TCM. The characteristics of TCM syndromes are not fully represented， and the consistency between TCM and Western medicine is generally not high. TCM has the advantage of a multi-dimensional syndrome differentiation and treatment approach. It is necessary to integrate the characteristics of diseases and syndromes of TCM and Western medicine， adopt multi-factor modeling methods to reflect the pathological process of CHF， improve existing models， and establish animal models of CHF that better align with the characteristics of clinical diseases and syndromes of TCM and Western medicine， so as to provide a reliable reference for clinical prevention and treatment.

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.

Based on the strategy of metabolomics combined with bioinformatics, this study analyzed the potential allergens and mechanism of pseudo-allergic reactions (PARs) induced by the combined use of Reduning injection and penicillin G injection. All animal experiments and welfare are in accordance with the requirements of the First Affiliated Experimental Animal Ethics and Animal Welfare Committee of Henan University of Chinese Medicine (approval number: YFYDW2020002). Based on UPLC-Q-TOF/MS technology combined with UNIFI software, a total of 21 compounds were identified in Reduning and penicillin G mixed injection. Based on molecular docking technology, 10 potential allergens with strong binding activity to MrgprX2 agonist sites were further screened. Metabolomics analysis using UPLC-Q-TOF/MS technology revealed that 34 differential metabolites such as arachidonic acid, phosphatidylcholine, phosphatidylserine, prostaglandins, and leukotrienes were endogenous differential metabolites of PARs caused by combined use of Reduning injection and penicillin G injection. Through the analysis of the "potential allergen-target-endogenous differential metabolite" interaction network, the chlorogenic acids (such as chlorogenic acid, neochlorogenic acid, cryptochlorogenic acid, and isochlorogenic acid A) and β-lactam allergens in the combination of the two may be mainly regulated by PLD1, PLA2G12A and CYP1A1. The three upstream signal target proteins mainly activate the arachidonic acid metabolic pathway, promote the degranulation of mast cells, release downstream endogenous inflammatory mediators, and induce PARs.

Objective To explore the clinical effect of closed reduction and internal fixation with percutaneous cannulated screws through posterior to anterior(PA)approach with reference to posteromedial vertical syndesmotic line(PVSL)for the treatment of posterior malleolus fractures.Methods A total of 23 patients with posterior malleolus fractures in our hospital from January 2020 to January 2022 were slected,and received closed reduction and internal fixation with percutaneous cannulated screws through PA approach with reference to PVSL.The fracture reduction,functional recovery of ankle joint,occurrence of complications,and rehabilitation of patients after surgery were recorded.Results After surgery,23 patients were followed up for 6 to 20 months.After surgery,the posterior malleolar fracture fragments of all patients were of good reduction,with the displacement less than 2 mm.The X-ray showed that all fractures healed,with the fracture healing time of 3 to 6 months.The American Orthopaedic Foot and Ankle Society(AOFAS)ankle-hindfoot scores ranged from 76 to 100 points,with an average of(89.8±8.2)points;the ankle joint function was excellent in 17 cases,good in 5 cases,and moderate in 1 case,with an excellent and good rate of 95.7%.No complications such as screw loosening or breakage occurred in all cases.Conclusion The closed reduction and internal fixation with percutaneous cannulated screws through PA approach with reference to PVSL has a significant surgical effect for posterior malleolus fractures,which is worthy of clinical promotion and application.

Objective:To analysis the job preference and heterogeneity of medical students by distinguishing their birthplaces,and to provide reference for optimizing the management of primary health care resources.Methods:Using a cluster sampling method,an online survey of discrete choice experiment was conducted with 925 medical students from six teaching hospitals in Beijing,741 valid questionnaires were obtained,the effective recovery rate was 80.1%.The mixed logit model was used to perform regression analysis on six job attributes and estimate the willingness to pay.Results:There were significant differences in the choice of work location among medical students from different birthplaces.The subgroup results showed that compared to medical students from city,undergraduates from rural and county district preferred a work with sufficient career development opportunities.The results of undergraduate subgroup showed that undergraduates from rural district preferred a work with good environment than those from other birthplaces.Conclusion:There is heterogeneity in job preferences of medical students from different birthplaces.Policy makers should pay attention to the medical students'birthplace,also take the educational level into account to optimize the diversified job attributes,formulating targeted intervention to attract primary health care talents.

The clinical research in the field of extracorporeal life support (ECLS) in 2023 has focused on the efficacy of veno-arterial extracorporeal membrane oxygenation (ECMO) in patients with infarct-related cardiogenic shock. Additionally, the research also explored the efficacy of prone positioning during veno-venous ECMO, transfusion strategies, and the impact of obesity on outcomes. Awake veno-venous ECMO has shown novel therapeutic potential, but its optimal practice methods and management strategies remain to be determined. In in-hospital cardiac arrest patients, extracorporeal cardiopulmonary resuscitation has demonstrated higher survival rates and better neurological recovery compared to conventional cardiopulmonary resuscitation. The effectiveness of extracorporeal carbon dioxide removal varies among patients with different types of respiratory failure. Future research should focus on optimizing the application strategies and process management of ECLS technologies, investigating personalized therapy, and studying how to improve long-term rehabilitation and quality of life for survivors.

Liquid chromatography-tandem mass spectrometry (LC-MS/MS) technology has the characteristics of high specificity and high throughput, making it rapidly applied and developed in the field of clinical testing. Its application in the monitoring of therapeutic drugs can effectively improve the quantitative accuracy and sensitivity, and formulate a personalized and optimal dosing plan for patients. However, this technology still faces some challenges, and automation, quality control, and quantitative traceability will be the future development direction.