OBJECTIVE: To investigate the effect and mechanism of Hyssopus cuspidatus Boriss. extract (HCE) in ovalbumin (OVA)-induced allergic asthma. METHODS: Components identification of HCE was conducted using ultra performance liquid chromatography-quadrupole-time of flight-mass spectrometry. Mice were sensitized with OVA to establish asthmatic model, and dexamethasone was used as positive control. Respiratory reactivity, white cells counting in bronchoalveolar lavage fluid and peripheral blood, cytokine level measurement in serum and lung tissue, and histologic examination were performed to evaluate the therapeutic effect of HCE on asthma. Network pharmacology approach was used for mechanism prediction. Western blotting and untargeted lipidomics method were applied for mechanism validation. RESULTS: Fifty-two compounds were identified in HCE, predominantly terpenoids and flavonoids. HCE markedly reduced airway resistance, the eosinophil infiltration in lung tissues, and the levels of immunoglobulin E, interleukin-4, interleukin-5, and interleukin-13. Network pharmacology analysis suggested phosphatidylinositol 3-kinases (PI3K), c-Jun N-terminal kinase (JNK), and p38 Mitogen-activated protein kinase (p38 MAPK) may be key proteins of HCE in the treatment of allergic asthma. Western blot results indicated that the levels of phosphorylated PI3K, JNK, and P38 were downregulated in HCE-treated group. Moreover, HCE significantly upregulated the levels of ceramide and sphingomyelin and downregulated the level of phosphatidylcholine. CONCLUSION HCE inhibited allergic asthma via PI3K/JNK/P38 signaling pathway and lipid homeostasis regulation.

A 55-year-old male patient was admitted to the hospital due to "recurrent chest pain for 8 months, with worsening symptoms for 2 weeks". After admission, comprehensive relevant examinations led to the consideration of a giant chronic left ventricular pseudoaneurysm caused by myocardial infarction with non-obstructive coronary arteries. Surgical treatment was performed at our hospital. We discuss the diagnosis and treatment of this patient.

Ferroptosis is a form of iron-dependent cell death caused by a disorder of iron lipid metabolism.Its mechanism mainly includes lipid metabolism and iron metabolism,which are complicated and strictly regulated by various metabolic and signaling pathways.Current studies have shown that ferroptosis is associated with cancer,atherosclerosis,and neurological diseases.Traditional Chinese medicine(TCM)is characterized by various active ingredients,relatively high safety,and lower treatment costs,which possess unique advantages in clinical applications.It has been widely used in the treatment of various diseases.Taking the regulation of ferroptosis by traditional Chinese medicine as the entry point may be a new direction for the future prevention and treatment of various diseases.In this review,we discussed the mechanism of iron lipid metabolic disorders based on ferroptosis and the research progress of traditional Chinese medicine intervention to provide reference and treatment strategies for the prevention and treatment of related diseases.

By targeting the key gene csgD involved in the biofilm formation of Escherichia coli, we employed molecular docking and molecular dynamics simulation to screen the active components of Chinese medicine with inhibitory effects on the biofilm formation from the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform (TCMSP). After the anti-biofilm properties of the active components were validated in vitro, data-independent acquisition (DIA) proteomics was employed to further identify the differential proteins involved in interfering with the biofilm formation of Escherichia coli. The mechanisms of inhibition were explored with consideration to the phenotype. Through virtual screening, we identified four candidate active components, including tannic acid, narirutin, salvianolic acid B, and rosmarinic acid. Among them, tannic acid demonstrated significant inhibitory effect on the biofilm formation of E. coli. The analysis of differential proteins, combined with relevant phenotype validation, suggested that tannic acid primarily affected E. coli by intervening in pilus assembly, succinic acid metabolism, and the quorum sensing system. This study provided a lead compound for the development of new drugs against biofilm-associated infections in the future.
Biofilms/drug effects* ; Escherichia coli/metabolism* ; Molecular Docking Simulation ; Drugs, Chinese Herbal/chemistry* ; Tannins/chemistry* ; Cinnamates/metabolism* ; Benzofurans/chemistry* ; Depsides/metabolism* ; Rosmarinic Acid ; Anti-Bacterial Agents/chemistry* ; Escherichia coli Proteins/genetics* ; Medicine, Chinese Traditional

The coronavirus disease 2019 (COVID-19) epidemic has a tremendous impact on the countries around the world since the outbreak in December 2019. From December 2022, with the loosening of domestic epidemic control policies, the prevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) rose significantly and reached to its epidemic peak in the majority of the cities in China, which further overwhelmed our medical care system. The cardiac surgery departments in China lack the experience in conducting work under the COVID-19 pandemic. In this paper, we summarize the main topics that might be faced during the pandemic by reviewing the previous related literatures, which included: the cardiac surgery volume trends, the impact of SARS-CoV-2 infection on the prognosis of cardiac surgery, the timing of cardiac surgery and the surgical strategy should be modified, and possible recommendations for the manager or governors during the pandemic, so as to outline a path forward for cardiac surgery for the near future.

Objective    To investigate the surgical strategies and clinical efficacy of transmitral septal myectomy in the treatment of recurrent left ventricular outflow tract obstruction (LVOTO) after alcohol septal ablation. Methods    The clinical data of patients with recurrent LVOTO after alcohol septal ablation from July 2020 to July 2021 in the Department of Cardiac Surgery, Guangdong Provincial People's Hospital were retrospectively analyzed. Patients were preoperatively evaluated by echocardiography, cardiac magnetic resonance imaging, cardiac computed tomography, 3D modeling and printing technology. A personalized surgical strategy was preoperatively developed according to multimodality imaging assessment, while visual exploration was performed on the digital model and simulated surgical resection was performed on the printed model. Results     Two female patients were enrolled, aged 62 years and 64 years, respectively. Totally endoscopic transmitral extended myectomy was successfully performed on both patients with aortic cross-clamping time of 96 min and 85 min, respectively. LVOTO was relieved immediately (subaortic peak pressure gradient decreased from 100 mm Hg to 4 mm Hg and from 84 mm Hg to 6 mm Hg, respectively) and the mitral regurgitation significantly improved after the procedure. No patient had complete atrioventricular block or required permanent pacemaker implantation. The patients were discharged uneventfully without postoperative complications. Conclusion    Personalized totally endoscopic transmitral extended myectomy combined with multimodality imaging assessment and 3D modeling and printing has an acceptable clinical effect in patients with recurrent LVOTO after alcohol septal ablation. The procedure can precisely resect the hypertrophic septal myocardium while avoiding serious complications such as septal perforation or complete atrioventricular block.

We reported a 26-year-old male who was diagnosed with apical hypertrophic cardiomyopathy with left ventricular aneurysm. The location of the hypertrophic myocardium and the extent of resection were accurately assessed preoperatively using 3D modeling and printing technology. Myectomy was performed via transapical approach, and the intraoperative exploration was consistent with the description of the preoperative 3D modeling. The patient underwent the surgery successfully without any complications during the hospitalization, and the cardiopulmonary bypass time was 117 min, the aortic cross-clamping time was 57 min, and the hospital stay time was 7 d. The postoperative echocardiography demonstrated left ventricular cavity flow patency. This case provides a reference for the management of patients with apical hypertrophic cardiomyopathy.

Alveolar ridge preservation (ARP) has developed rapidly as a method for preserving the alveolar socket's bone volume after tooth extraction. ARP can create conditions for implant restoration, and reduce operation difficulties by decreasing alveolar ridge absorption. There are certain difficulties of ARP applicationin patients with tooth extracted due to periodontitis. This paper mainly introduces the characteristics of ARP, compares the similarities and differences among ARP, guided tissue regeneration, guided bone regeneration and immediate implant, and then summarizes their advantages and disadvantages. The paper focuses on the specificity of ARP and the progress of ARP application in patients with tooth extracted due to periodontitis, in order to offer direction for clinical application and future research on ARP.

Objective:To evaluate the clinical effectiveness of thoracoscopic extended septal myectomy in elderly patients diagnosed with hypertrophic obstructive cardiomyopathy(HOCA).Methods:From April 2019 to August 2021, 36 elderly patients with HOCM who underwent septal myectomy were retrospectively analyzed, including 20 patients under thoracoscopy and 16 patients under median sternotomy.The surgical outcomes, echocardiography and follow-up results were compared between the two groups.Results:The number of intracardiac incisions in the Thoracoscopy group was significantly lower than that in the median thoracotomy group( P=0.001).Additionally, the ventilation time of ≤24 hours was higher in the thoracoscopy group compared to the median thoracotomy group(75.0% vs 31.2%, P=0.017).It is noteworthy that there were no deaths in the thoracoscopic group.However, one patient experienced left ventricular rupture during mitral valve replacement and had to be converted to median sternotomy.This patient also developed low cardiac output syndrome after the operation but was discharged smoothly.In the median sternotomy group, one patient died in the hospital, two patients developed low cardiac output syndrome, and one patient underwent re-sternotomy due to bleeding.Importantly, neither group experienced ventricular septal perforation or complete atrioventricular block.The number of intracardiac incisions in the thoracoscopy postoperative interventricular septal thickness was significantly reduced in both groups.In the thoracoscopic group, the interventricular septal thickness was(19.2±3.5)mm and(11.3±2.2)mm, with a t-value of 8.531 and a p-value of <0.001.In the median sternotomy group, the interventricular septal thickness was(19.9±3.9)mm and(13.1±2.6)mm, with a t-value of 5.664 and a p-value of <0.001.This reduction effectively relieved left ventricular outflow tract obstruction.In the thoracoscopic group, the left ventricular outflow tract obstruction decreased from(96.2±32.9)mmHg to(8.2±3.4)mmHg, with a t-value of 11.894 and a p-value of <0.001.In the median sternotomy group, the left ventricular outflow tract obstruction decreased from(83.2±40.9)mmHg to(13.3±19.3)mmHg, with a t-value of 5.997 and a p-value of <0.001.The patients in the thoracoscopic group were followed up for an average of(13.5±8.8)months, and no complications occurred.The patients in the median sternotomy group were followed up for an average of(15.8±9.4)months.One patient in this group underwent alcohol septal ablation for residual obstruction and developed complete atrioventricular block. Conclusions:Thoracoscopic extended myectomy in elderly patients with(HOCM)can achieve comparable therapeutic effectiveness and safety compared to the median sternotomy approach.This minimally invasive procedure is associated with shorter ventilation time and can also minimize the need for additional intracardiac incisions, especially when simultaneous mitral valve treatment is necessary.

Abstract: Objective　To investigate the early diagnostic value of peripheral blood procalcitonin (PCT), C-reactive protein (CRP), fibrinogen (FIB) and D-dimer (D-D) levels in patients with pulmonary tuberculosis (PTB) complicated with bacterial pneumonia. Methods　A total of 102 patients who admitted to Department of Tuberculosis of Affiliated Nantong Hospital of Shanghai University from Jan 2021 to May 2022 were enrolled in this study and divided into a group (52 cases) with pulmonary tuberculosis (PTB) patients and a group (50 cases) with PTB patients complicated with bacterial pneumonia. The levels of PCT, CRP, FIB and D-D in the peripheral blood were measured, the differences and correlations in all indicators were compared among two groups. The sensitivity and specificity of these indicators in the early diagnosis of PTB complicated with bacterial pneumonia were analyzed by receiver operating characteristic (ROC) curve. Results　The levels of PCT, CRP, FIB and D-D in the peripheral blood from the PTB complicated with bacterial pneumonia group were 0.06 (0.04, 0.16) ng/mL, 38.00 (3.88, 96.10) mg/L, 4.51 (3.02, 6.07) g/L, and 0.59 (0.34, 1.88) mg/L, respectively, which were significantly higher than corresponding 0.04 (0.03, 0.04) ng/mL, 3.20 (0.84, 7.22) mg/L, 2.96 (2.48, 3.77) g/L, and 0.27 (0.17, 0.36) mg/L in the PTB group (Z=-4.784, -5.233, -3.853, -4.199, all P<0.001). Furthermore, the levels of CRP and FIB in the PTB complicated by bacterial pneumonia group were highly positively correlated (r=0.855, P<0.001). The area under the ROC curve (AUC) of PCT, CRP, FIB and D-D for early diagnosis of PTB complicated with bacterial pneumonia were 0.757, 0.794, 0.747 and 0.764, respectively. In addition, the AUC obtained by simultaneous measurement of PCT, CRP, FIB and D-D was as high as 0.916, and the sensitivity and specificity of diagnosing PTB complicated with bacterial pneumonia were increased to 85.7% and 96.9%, respectively, which were higher than those of individual indicators. Conclusions　Levels of peripheral blood PCT, CRP, FIB, and D-D all show varying degrees of increase in patients with PTB complicated with bacterial pneumonia, and detecting the levels of all four markers, rather than any single marker, can assist in early monitoring whether the tuberculosis patients are complicated with bacterial pneumonia.