Myocardial fibrosis is the pathological basis of hypertensive heart disease, which is the key to control cardiovascular complications. Traditional Chinese medicine (TCM) has the advantage of targeting many components of a system and providing more integrated regulation than modern medicine. While, modern medicine tends to target a single pathological link. This study was aimed to investigate effects and mechanisms in the treatment of myocardial fibrosis in hypertension with TCM from a different perspective, which provided references for clinical treatment.

Objective To investigate the effects of glycosaminoglycans (HGAG) on the immune function of peripheral blood cells from patients with pulmonary tuberculosis.Methods Peripheral blood monouclear cells (PBMC) were isolated from peripheral blood of 40 healthy people (healthy group) and 30 tuberculosis patients (tuberculosis group) and cocultured with HGAG in vitro for 24 hours.Flow cytometry was used to detect the expression of CD45RA and CD45RO,as well as the expression of CD1a and CD83.Results The results showed that the expression of CD45RA and CD45RO in the tuberculosis group was the most significant (P ＜ 0.05) at the concentration of 50 μg/m coculturing with HGAG.The expression of CD45RA and CD45RO were most obvious in the healthy group at the concentration of 10 μg/ml and 50 μg/ml respectively (P ＜0.001).The difference of CD45RA between the two groups was no significant (P ＞0.05),while the difference of CD45RO was statistically significant (P ＜ 0.01) before co-culturing.The expression of CD45RA and CD45RO at 10 μg/ml and 50 μg/ml after co-culturing with HGAG were statistically significant (P ＜ 0.05).There was no statistical difference in CD1a and CD83 in healthy group before and after co-culturing (P ＞ 0.05),while there was statistically difference (P ＜ 0.05) before and after culturing in tuberculosis group.Before co-culturing,there was no significant difference in the expression of CD1a between the healthy group and the tuberculosis group (P ＞ 0.05),but CD83 expression was statistically different (P ＜ 0.001).After co-culturing,there were no significant differences in CD1a and CD83 expression between healthy and healthy groups (P ＞ 0.05).Conclusions HGAG can down-regulate the expression of CD45RA and up-regulate the expression of CD45RO in a certain concentration range,and promote the maturation of dendritic cells (DC) in tuberculosis patients and regulate the cellular immunity of patients with pulmonary tuberculosis in vitro.

Objective:To investigate the surgical effect of various circulatory pathways on replantation of severed distal segments of digits.Methods:From June 2017 to June 2023, a total of 137 patients (162 digits) who received digit replantation surgery in the Department of Trauma Orthopaedics and Microsurgery of Guilin People's Hospital were retrospectively studied. The patients were 82 males (97 digits) and 55 females (65 digits) aged 11.0 months to 51.0 years old, with 31.7 years old in average. The injured digits were 36 thumbs, 43 index fingers, 32 middle fingers, 28 ring fingers and 23 little fingers. Causes of injury: 55 digits were of electric saw, 68 of sharp object cut, 26 of twisting crush and 13 of degloving injury. According to the circulatory pathways, 66 patients (88 digits) were assigned to a physiological replantation group (PRG), 50 patients (53 digits) to an arterio-venolisation group (AVG) and 21 patients (21 digits) to a nail bed bloodletting group (NBG). Functional recovery was evaluated according to the Evaluation Standard of Severed Finger Functional of Hand Surgery of Chinese Medical Association. Analysis of variance or chi-square test was employed to analyse the age, gender, time from injury to surgery, surgery time, incidence of vascular compromise of the replanted digit, survival rate, score of functional recovery of the affected digit at 6 months after surgery, and incidence of postoperative complications in each group. P<0.05 was considered statistically significant. Results:All patients were included in the 6-10 months of postoperative follow-up, with an average of 7.2 months. Regarding the score of functional recovery of affected digit according to the Evaluation Standard of Severed Finger Functional of Hand Surgery of Chinese Medical Association, PRG (86.3 points±7.9 points) was higher than that of NBG (78.3 points±11.2 points) and AVG (70.7 points±8.6 points), with statistically significant differences ( P<0.05 for both). In terms of the incidence of vascular compromise, PRG (3 digits for 3.4%) was lower than that of NBG (1 digit for 4.8%) and AVG (6 digits for 11.3%), with statistically significant differences ( P<0.05 for both). Of the survival rate, PRG (81 digits for 92.0%) was superior to that of NBG (18 digits for 85.7%) and AVG (42 digits 79.2%), with statistically significant differences ( P<0.05 for both). While of the incidence of postoperative complications, PRG (12.6%) was lower than that of AVG (17.1%) and NBG (21.2%), with statistically significant differences ( P<0.05 for both). Conclusion:For a severed distal segment of digit, the physiological replantation is preferred. For the digit with undetectable return veins, effective replantation can be achieved by the arterio-venolisation or nail bed exsanguination.

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been infected rapidly and is generally susceptible to population. Moreover, it has become the most serious public health problem in the world. In the process of coronavirus disease 2019 (COVID-19) treatment, the traditional Chinese medicine (TCM) intervention has achieved positive efficacy and which is widely recognized. However, the COVID-19 epidemic is still very serious, especially due to the characteristics of asymptomatic infection such as concealment, limitations and subjective symptoms, which has increased the difficulty of prevention and control. In view of asymptomatic infection, isolation is the main management. There is little mention of specific treatment options in each version of COVID-19 treatment plan. Through systematic study of TCM theory, we explored the way of diagnosis and treatment of asymptomatic infections. Based on the theory of latent evil, clearing away latent pathogens to truncate the course of disease and reduce the incidence. Based on the theory of prevention of disease, strengthen the lung and stomach to protect the place from pathogen and prevent the transmission of disease evil. It is supplemented by accurate treatment according to individual, timing and local conditions, in order to provide reference for the treatment of asymptomatic infection.

Objective Bibliometric approaches are used to investigate the characteristics and benefits of traditional Chinese medicine treatments for dominant diseases that can be applied in clinical therapy to effectively manage geriatric diseases.Methods Clinical research literature on the use of traditional Chinese medicine in the treatment of geriatric diseases within the past 10 years was retrieved from CNKI,Wanfang,VIP,and CBM databases.The research trends and clinical efficiency of each disease were statistically analyzed to determine the dominant diseases of TCM.Results A total of 22 859 articles were collected,with 3768 included in the research.In accordance with the International Statistical Classification of Diseases and Related Health Problems(ICD-11)of the World Health Organization,the diseases were classified into 17 categories and 149 diseases.The diseases primarily affect the circulatory system,skeletal musculoskeletal or connective tissue system,and digestive system.Conclusions Traditional Chinese medicine clinical trials on the treatment of geriatric illnesses cover a diverse spectrum of diseases,although the distribution of focus is unequal.Potential dominant illnesses were eventually identified to include osteoporosis,constipation,and hypertension,with heart failure,stroke,coronary heart disease,diabetes and its complications,and insomnia being potential sub-dominant diseases.

Objective To explore the clinical characteristics of patients with heart failure(HF)treated with lyophilized Yiqifumai injection based on real-world data,providing evidence for the rational and standardized use of Yiqifumai injection.Methods Hospitalized HF patients from 81 hospitals across China were included in this study between April and November 2023.We collected demographics information[sex,age,New York Heart Association(NYHA)functional classification],length of hospital stay,duration of medication use,and biomarkers such as N-terminal pro-brain natriuretic peptide(NT-proBNP),left ventricular ejection fraction(LVEF),and left ventricular end-diastolic diameter(LVEDD).Clinical features of HF patients treated with Yiqifumai injection were analyzed,and comparisons were made among different HF subtypes.Results A total of 457 HF patients were included:96 with heart failure with reduced ejection fraction(HFrEF),70 with HF with mildly reduced ejection fraction(HFmrEF),and 291 with HF with preserved ejection fraction(HFpEF).The majority of HFpEF type and HFrEF type patients were classified as NYHA class Ⅲ[48.1％(140/291)and 54.2％(52/96),respectively],while most HFmrEF type patients were classified as class Ⅳ[41.4％(29/70)].The longest average hospital stay was recorded in HFmrEF type patients[(9.30±3.02)days],while the shortest was recorded in HFrEF type patients[(8.77±3.11)days].The shortest average medication duration was found in the HFrEF type[(8.54±2.95)days],while the longest was observed in HFpEF type patients[(8.82±2.82)days].Serum NT-proBNP levels were significantly decreased post-treatment in all three types[ng/L:HFrEF was 2 435.00(1 169.25,5 607.75)vs.5 334.00(2 077.33,9 108.88),HFmrEF type was 2 313.25(598.09,6 224.67)vs.4 559.21(1 325.75,8 922.75),HFpEF type was 824.00(169.46,2298.75)vs.1 265.00(215.00,3 458.80),all P<0.05],with the most pronounced decrease observed in the HFrEF type.LVEF was significantly improved in the HFrEF type[0.340(0.290,0.378)vs.0.336(0.280,0.360),P<0.05],while no significant changes were noted in the HFmrEF type and HFpEF type.No significant differences in LVEDD were found before and after treatment in any type(all P>0.05).Conclusion In the real-world setting,the advantages of Yiqifumai injection in treating HFrEF are more pronounced,while further evidence from evidence-based medicine is needed to support its use in other types of heart failure.