Sepsis is a serious complication of infection, and its further development may lead to multi-organ dysfunction syndrome. Sepsis cardiomyopathy is a common complication of sepsis and has been directly linked to high mortality. Although the pathogenesis of septic cardiomyopathy is not fully understood, in-depth study of the pathogenesis of septic cardiomyopathy and the identification of its potential therapeutic targets may reduce mortality in patients with sepsis. Ferroptosis is an iron-dependent mode of cell death that has been shown to be involved in the pathophysiological mechanisms of many diseases. Some related studies have reported that ferroptosis may be a potential mechanism of septic cardiomyopathy. This review provides new insights into the mechanisms of mitochondrial dysfunction, lipid peroxidation, xc-system, glutathione peroxidase 4 (GPX4), iron metabolism and the role of ferroptosiswith septic cardiomyopathy for further research and treatment of septic cardiomyopathy.

[Objective]To investigate the therapeutic effect of Jian'gan Xiaozhi Decoction(JGXZ)on non-alcoholic fatty liver disease(NAFLD)model mice and explore its mechanism from the perspective of mitochondrial autophagy mediated by the PTEN induced putative kinase 1(PINK1)/E3 uniquitin-protein ligase(Parkin)signaling pathway.[Methods]Sixty C57BL/6J mice were randomly and equally divided into 6 groups:control,model(NAFLD),polyene phosphatidyl choline(PPC)group 180 mg/kg intragastric administration,and JGXZ low,medium and high dose groups(8,16,32 g/kg)intragastric administration.Except for control group,the other 5 groups were given a high fat diet.The treatment lasted for 8 weeks,and the body weight of the mice was recorded weekly.After 8 weeks,blood samples were collected,the levels of serum alanine aminotransferase(ALT)and aspartate aminotransferase(AST)were measured,liver tissue was weighted and fixed,and histological changes in liver tissue were observed by hematoxylin-eosin(HE)and oil red O staining.The levels of total cholesterol(TC),triglyceride(TG),interleukin-1 β(IL-1 β),IL-6,tumor necrosis factor-α(TNF-α),malondialdehyde(MDA)and activities of glutathione peroxidase(GSH-Px),superoxide dismutase(SOD)in liver tissue were measured to evaluate the effects of JGXZ on inflammation and oxidative stress in NAFLD mice.Western blot was used to detect the protein expression levels of voltage-dependent anion channel 1(VDAC1),translocase of outer mitochondrial membrane 20(TOM20),cytochrome c oxidase subunit Ⅳ(COX Ⅳ),phosphatase and PINK1,Parkin,Beclin1,microtubule-associated protein light chain 3(LC3),and P62 to evaluate the effects of JGXZ on mitochondrial autophagy in NAFLD mice.[Result]Compared with model group,JGXZ intervention significantly improved the body weight of NAFLD model mice,reduced liver index,alleviated liver tissue lesions in NAFLD model mice,reduced TC,TG,ALT,AST levels,decreased IL-1[3,IL-6,TNF-α and MDA levels,increased GSH-Px and SOD activity,down-regulated VDAC1,TOM20,COXⅣ and P62 protein expression,and up-regulated PINK1,Parkin,Beclin1,LC3 protein expression.[Conclusion]JGXZ can alleviate liver injury in NAFLD mice by promoting the PINK 1/Parkin signaling pathway mediated activation of mitochondrial autophagy.

Objective To evaluate the feasibility of beside color Doppler ultrasound-guided popliteal vein catheter in treatment of lower extremity deep venous thrombosis (LEDVT).Methods Data of 50 patients with unilateral LEDVT were reviewed,including 25 cases underwent beside color Doppler ultrasound-guided catheter thrombolytic therapy (catheter thrombolytic group) and 25 cases underwent systemic thrombolysis and anticoagulant therapy (anticoagulant thrombolysis group).The cure rate,hospitalization time and the bilateral diameter differences were compared between the 2 groups.Results Thrombolytic effective rate was 100％ in both the 2 groups.Thirty patients were clinical cured,including 22 cases in catheter thrombolytic group and 8 cases in anticoagulant thrombolysis group.The cure rates were significantly different between the 2 groups (88.00％ [22/25] vs 32.00％ [8/25],x2 =16.333,P＜ 0.001).The hospitalization time of catheter thrombolytic group ([12.32 ± 1.49] days) was shorter than that of anticoagulant thrombolysis group ([16.44±2.95]days;t=-6.426,P＜0.001).The diameter differences between LEDVT side and contralateral side of the upper and lower 15 cm form knees in catheter thrombolytic group showed no statistical difference compared with anticoagulant thrombolysis group before the treatment (both P＞0.05),while of catheter thrombolytic group were smaller than those of anticoagulant thrombolysis group after the treatment (both P＜0.05).And the bilateral diameter differences before the treatment were larger than those after the treatment in both groups (all P ＜ 0.05).Conclusion Both of beside color Doppler ultrasound-guided catheter thrombolytic therapy and systemic thrombolysis and anticoagulant therapy can be used to treat LEDVT,while the efficacy of ultrasound-guided catheter thrombolytic therapy is better.

Objective To explore the rules of acupoint selection and manipulation application of Tuina in the treatment of diabetes peripheral neuropathy(DPN)with data mining technology.Methods The clinical research literature of Tuina for DPN from October 2022 was selected by searching four Chinese databases that CNKI,WanFang,VIP and Chinese Biomedical Literature Database.Using the traditional Chinese medicine inheritance assistance platform software,analyze and summarize the rules of selecting acupoints and applying manipulations in the treatment of DPN with Tuina.Results A total of 110 articles were included,including 65 acupoints and 33 manipulations.The acupoints with the highest frequency are Zusanli(ST 36),Sanyinjiao(SP 6),Taixi(KI 3),Yongquan(KI 1),Taichong(LR 3),Yanglingquan(GB 34),etc.The meridians mainly include Taiyin Spleen Meridian of Foot,Yangming Stomach Meridian of Foot,Taiyang Bladder Meridian of Foot and Shaoyin Kidney Meridian of Foot.Five-shu Points,Lower He-sea Points and Yuan-primary Points are commonly used specific points.The acupoints are mostly distributed in the lower limbs.The categories of Tuina manipulations mainly include squeezing-pressing manipulations,pushing rolling manipulations and composite manipulations.The Tuina manipulations mainly include kneading manipulation,pressing manipulation,point-pressing manipulation,pressing-kneading manipulation and twisting manipulation with both palms.Conclusion The acupoint selection and manipulation application of Tuina in treating DPN have certain rules,and the main treatment principles are to regulate the organs and dredge collaterals,and to replenish qi and promote blood circulation,which can provide objective basis for clinical treatment.

Objective:To investigate the protective effect of REV-ERBα agonist SR9009 on hippocampal working memory in rats with acute rapid eye movement (REM) sleep deprivation after exploratory laparotomy and its possible mechanism.Methods:Ninety SD rats were randomly divided into control group, sleep deprivation group, exploratory laparotomy group, sleep deprivation+exploratory laparotomy group, and sleep deprivation+exploratory laparotomy+SR9009 group ( n=18). Rats in the sleep deprivation group, exploratory laparotomy group, and sleep deprivation+exploratory laparotomy group were given REM sleep deprivation for 96 h or (and) exploratory laparotomy, respectively. Rats in the sleep deprivation+exploratory laparotomy+SR9009 group accepted exploratory laparotomy after REM sleep deprivation for 96 h, and accepted intraperitoneal injection of 100 mg/kg SR9009 daily from the day after surgery to the 6 th d of surgery. The reversall escape latency of rats was recorded by contrapuntal space exploration training one-5 d after surgery. On the 5 th d of surgery, reversal space exploration experiment was conducted to record the number of times of rats crossing the original platform. Western blotting was used to detect the protein expressions of REV-ERBα and BMAL1 in the hippocampus of rats. The levels of interleukin (IL)-1β and IL-6 in the hippocampus of rats were detected by enzyme-linked immunosorbent assay. Immunofluorescent staining was used to detect the expressions of neuronal nucleoprotein (NeuN) and glial fibrillary acidic protein (GFAP). Results:(1) The escape latency in the sleep deprivation group, exploratory laparotomy group, and sleep deprivation+exploratory laparotomy group was significantly longer than that in the control group on the first, 2 nd, 3 rd, 4 th, 5 th d of surgery ( P<0.05); while the escape latency in the sleep deprivation group and sleep deprivation+exploratory laparotomy group was significantly longer than that in the exploratory laparotomy group ( P<0.05); on the 2 nd, 3 rd, 4 th, 5 th d of surgery, the reversal escape latency in the sleep deprivation+exploratory laparotomy+SR9009 group was statistically shorter than that in the sleep deprivation+exploratory laparotomy group ( P<0.05). The number of times of rats crossing the original platform in the sleep deprivation group, exploratory laparotomy group, and sleep deprivation+exploratory laparotomy group was significantly smaller than that of the control group ( P<0.05); that of rats in the sleep deprivation+exploratory laparotomy group was significantly smaller than that of the exploratory laparotomy group, and that of rats in the sleep deprivation+exploratory laparotomy+SR9009 group was significantly larger than that of the sleep deprivation+exploratory laparotomy group ( P<0.05). (2) As compared with the control group, the exploratory laparotomy group, sleep deprivation group and sleep deprivation+exploratory laparotomy group had significantly decreased expressions of REV-ERBα and BMAL1, and statistically increased IL-1β and IL-6 levels in the hippocampal tissues ( P<0.05); as compared with the sleep deprivation+exploratory laparotomy group, the sleep deprivation+exploratory laparotomy+SR9009 group had significantly increased expressions of REV-ERBα and BMAL1, and statistically decreased IL-1β and IL-6 levels ( P<0.05). (3) As compared with the control group, the exploratory laparotomy group, sleep deprivation group and sleep deprivation+exploratory laparotomy group had decreased amount of neurons in the hippocampal CA3 area and increased amount of activated astrocytes; as compared with the sleep deprivation+exploratory laparotomy group, the sleep deprivation+exploratory laparotomy+SR9009 group had increased amount of neurons in the hippocampal CA3 area and decreased amount of activated astrocytes. Conclusion:Acute REM sleep deprivation can lead to work memory impairment in rats accepted exploratory laparotomy, which might be associated with neuroinflammation and REV-ERBα/BMAL1 pathway, and SR9009 could alleviate the damage.

Objective:To explore the clinical characteristics and distribution of Tranditional Chinese Medicine (TCM) syndrome types of refractory tic disorders in children based on clustering analysis.Methods:A cross-sectional study. 183 children aged 3-18 years with refractory tic disorders from pediatric encephalopathy outpatient department of the First Teaching Hospital of Tianjin University of Traditional Chinese Medicine who met the inclusion criteria from October 2015 to January 2022 were recruited. Frequency descriptive analysis, systematic clustering analysis and principal component analysis were conducted by Microsoft Office Excel 2016 and IBM SPSS Statistics 26.0 to explore the clinical characteristics and syndrome distribution of the disease.Results:The TCM symptoms of 183 children with refractory tic disorders were clustered into 6 categories, and finally 5 types of syndrome were obtained, among which the syndrome of spleen deficiency and liver hyperactivity mixed with dampness accounted for the largest proportion (27.32%), followed by the syndrome of phlegm-fire disturbing spirit (21.31%), the syndrome of wind-heat invading lung (18.03%), the syndrome of phlegm-qi stagnation (17.49%), and the syndrome of dampness and yin deficiency (15.85%).Conclusion:Through the mining and analysis of the outpatient information of pediatric encephalopathy in our hospital, the common syndrome differentiation types of refractory tic disorder are obtained, which can provide a reference for the TCM syndrome differentiation types of refractory tic disorder in children.

Objective:To investigate the prevalence of diabetes in the elderly aged ≥60 years in Liaoning Province from 2017 to 2019 and analyze the impact of blood glucose control on all-cause mortality and cardiovascular disease (CVD) mortality.Methods:A survey was conducted in the elderly aged ≥60 years in Liaoning from 2017 to 2019 to collect the information about the prevalence of diabetes and other chronic diseases in the diabetes patients. The mortality of the enrolled subjects was investigated in September 2023. Cox proportional hazards regression models were used to estimate the association between blood glucose control in the elderly with diabetes and the risks of all-cause mortality and CVD mortality.Results:The crude prevalence of diabetes in the elderly aged ≥60 years was 20.2% (2 014/9 958) in Liaoning from 2017 to 2019, and the standardized prevalence rate was 19.9%. The prevalence rates of hypertension, dyslipidemia, and overweight/obesity in the diabetes patients were 77.0%, 51.7%, and 67.5% respectively. The median follow-up time was 5.5 years, and the all-cause mortality and CVD mortality rates in the diabetes patients were 244.3/10 000 person-years and 142.9/10 000 person-years, respectively. The results of the Cox proportional hazards regression model analysis showed that compared with non-diabetic individuals, diabetes patients had an increased risk of all-cause mortality by 1.68 times [hazard ratio ( HR)=1.68, 95% CI: 1.44-1.94] and an increased risk of CVD mortality by 1.56 times ( HR=1.56, 95% CI: 1.29-1.89). The differences in risks of all-cause mortality and CVD mortality between the diabetes patients with normal fasting blood glucose and glycated hemoglobin levels and people without diabetes were not significant (all P>0.05). The failure to meet either the FPG or HbA1c target increased the risk of all-cause mortality (all P<0.05). For individuals who failed to meet the HbA1c target, there was an increased risk of CVD mortality (all P<0.05). Conclusions:The comorbidity rate of chronic diseases was higher in the elderly with diabetes than in the elderly without diabetes in Liaoning. Elderly diabetes patients can benefit from good blood glucose control.