Objective:To investigate the predictive value of cardiac MR (CMR)-derived left ventricular end-systolic wall stress (LVESWS) and biventricular strain parameters for different types of heart failure in patients with myocardial infarction.Methods:This retrospective cohort study included 231 patients diagnosed with myocardial infarction by clinical and CMR criteria at the Second Affiliated Hospital of Kunming Medical University between January 2015 and July 2023. The endpoint was the occurrence of heart failure, and patients were divided into 3 groups: no heart failure ( n=85), heart failure with preserved ejection fraction (HFpEF, n=74), and heart failure with reduced ejection fraction (HFrEF, n=72). Clinical indicators such as age and infarct size were collected. CMR parameters analysis included LVESWS, left ventricular global radial strain (LVGRS), left ventricular global circumferential strain (LVGCS), left ventricular global longitudinal strain (LVGLS), right ventricular global radial strain (RVGRS), right ventricular global circumferential strain (RVGCS), right ventricular global longitudinal strain (RVGLS), left ventricular end-diastolic volume index (LVEDVI), and left ventricular end-systolic volume index (LVESVI). Differences in clinical baseline data and CMR parameters among the 3 groups were tested. Univariate Cox regression analysis was performed, followed by multivariate Cox modeling of statistically significant factors. Receiver operating characteristic (ROC) analysis was conducted for the influencing factors identified in the multivariate Cox model, and Kaplan-Meier survival curves for survival time were plotted. Results:Significant differences were observed in biventricular strain parameters (LVGRS, LVGCS, LVGLS, RVGRS, RVGCS, RVGLS), LVESWS, LVEDVI, and LVESVI among the 3 groups (all P<0.05). Univariate and multivariate Cox regression analyses showed that RVGCS, age, and infarct size were independent influencing factors for HFpEF after myocardial infarction (all P<0.01), while LVESWS and LVGLS were independent influencing factors for HFrEF after myocardial infarction (all P<0.001). Further ROC analysis revealed that the areas under the curve (AUC) for RVGCS, infarct size, age, RVGCS combined with age, and RVGCS combined with age and infarct size in predicting HFpEF were 0.771, 0.607, 0.615, 0.793, and 0.805, respectively. The AUCs for LVESWS, LVGLS, and LVESWS combined with LVGLS in predicting HFrEF were 0.943, 0.925, and 0.971, respectively. Kaplan-Meier survival curves based on optimal cutoff values showed statistically significant differences in survival time between HFpEF and non-heart failure patients when grouped by RVGCS and age (all P<0.05), but no significant difference when grouped by infarct size ( P=0.400). Statistically significant differences in survival time were observed between HFrEF and non-heart failure patients when grouped by LVESWS and LVGLS (all P<0.001). Conclusion:CMR-derived LVESWS and biventricular strain parameters demonstrate significant predictive value for different types of heart failure after myocardial infarction and can serve as valuable imaging markers for heart failure management and risk stratification in patients with myocardial infarction.

Objective:To investigate the predictive value of cardiac MR (CMR)-derived left ventricular end-systolic wall stress (LVESWS) and biventricular strain parameters for different types of heart failure in patients with myocardial infarction.Methods:This retrospective cohort study included 231 patients diagnosed with myocardial infarction by clinical and CMR criteria at the Second Affiliated Hospital of Kunming Medical University between January 2015 and July 2023. The endpoint was the occurrence of heart failure, and patients were divided into 3 groups: no heart failure ( n=85), heart failure with preserved ejection fraction (HFpEF, n=74), and heart failure with reduced ejection fraction (HFrEF, n=72). Clinical indicators such as age and infarct size were collected. CMR parameters analysis included LVESWS, left ventricular global radial strain (LVGRS), left ventricular global circumferential strain (LVGCS), left ventricular global longitudinal strain (LVGLS), right ventricular global radial strain (RVGRS), right ventricular global circumferential strain (RVGCS), right ventricular global longitudinal strain (RVGLS), left ventricular end-diastolic volume index (LVEDVI), and left ventricular end-systolic volume index (LVESVI). Differences in clinical baseline data and CMR parameters among the 3 groups were tested. Univariate Cox regression analysis was performed, followed by multivariate Cox modeling of statistically significant factors. Receiver operating characteristic (ROC) analysis was conducted for the influencing factors identified in the multivariate Cox model, and Kaplan-Meier survival curves for survival time were plotted. Results:Significant differences were observed in biventricular strain parameters (LVGRS, LVGCS, LVGLS, RVGRS, RVGCS, RVGLS), LVESWS, LVEDVI, and LVESVI among the 3 groups (all P<0.05). Univariate and multivariate Cox regression analyses showed that RVGCS, age, and infarct size were independent influencing factors for HFpEF after myocardial infarction (all P<0.01), while LVESWS and LVGLS were independent influencing factors for HFrEF after myocardial infarction (all P<0.001). Further ROC analysis revealed that the areas under the curve (AUC) for RVGCS, infarct size, age, RVGCS combined with age, and RVGCS combined with age and infarct size in predicting HFpEF were 0.771, 0.607, 0.615, 0.793, and 0.805, respectively. The AUCs for LVESWS, LVGLS, and LVESWS combined with LVGLS in predicting HFrEF were 0.943, 0.925, and 0.971, respectively. Kaplan-Meier survival curves based on optimal cutoff values showed statistically significant differences in survival time between HFpEF and non-heart failure patients when grouped by RVGCS and age (all P<0.05), but no significant difference when grouped by infarct size ( P=0.400). Statistically significant differences in survival time were observed between HFrEF and non-heart failure patients when grouped by LVESWS and LVGLS (all P<0.001). Conclusion:CMR-derived LVESWS and biventricular strain parameters demonstrate significant predictive value for different types of heart failure after myocardial infarction and can serve as valuable imaging markers for heart failure management and risk stratification in patients with myocardial infarction.

ObjectiveTo explore the suitability of four qualitative research methods in the development of TCM scale. MethodsTaking the development of "Seven Emotions Scale" as an example， we conducted semi-structured interviews with 31 patients of emotional disorders and 10 healthy people by objective sampling， and collected psychological feelings and emotional cognition data related to seven emotions according to the interview outline. Two qualitative methods， descriptive qualitative research and descriptive phenomenology， were used to analyze the data and construct the item library of the scale. The conceptual framework of the scale was constructed by using commonly used grounded theory and frame analysis. ResultsDuring data analysis， it is found that the themes extracted from descriptive phenomenology were not easily understood by the interviewees， and it is difficult for the researchers to truly achieve the "suspension" required by phenomenology. Considering the feasibility and convenience of the researchers' actual operation， as well as whether the initial purpose of the scale research can be intuitively included in the interviewees' views and feelings， descriptive phenomenology is not suitable for the formation of scale items. Using descriptive qualitative research method to analyze the interview data of healthy people and patients with emotional disorders， 306 and 476 scale items were obtained respectively. Through grounded theory， five selective codes were obtained： physical symptoms， external manifestations， psychological feelings， behaviors and emotional control. Using frame analysis， four themes including physical symptoms， psychological feelings， behavior and emotional cognition were constructed. Both methods can be used to construct the conceptual frame of scale， but the framework analysis is more convenient and can better ensure the transparency of the research. ConclusionDescriptive qualitative research methods can be used to form the item library of TCM scales. Framework analysis is more suitable for the construction of the conceptual framework of the scale than grounded theory， while descriptive phenomenology is not suitable for the development of TCM scales.

Diarrhea is a common and frequent disease in clinical practice.Many factors cause diarrhea,and numerous research method with animal models of diarrhea have been explored.Despite this,drugs for the treatment of diarrhea in clinical practice are limited,and some existing drugs are only suitable for diarrhea caused by a single factor.Therefore,the construction and selection of appropriate animal models of diarrhea are not only important for in-depth studies of the pathogenesis,but are also effective means for the clinical screening and evaluation of drugs for comprehensively preventing and treating diarrhea.This article reviews the literature on the establishment and evaluation of animal models of functional,bacterial,viral,and symptomatic diarrhea,as well as progress of therapeutic drug research,to provide a reference for animal experimental research into the prevention and treatment of diarrhea.

AIM:To investigate the impact of celastrol intervention on excitatory amino acid transporter 2(EAAT2)and its neuroprotective role in subarachnoid hemorrhage(SAH).METHODS:Western blot analysis was uti-lized to assess the EAAT2 expression level within 72 h after SAH,while glutamate concentration in cortical brain tissues was measured.Computational simulation was employed to explore the binding of celastrol with EAAT2.Seventy SD rats were randomly assigned to sham,model,model+GT949(an EAAT2 agonist),model+dihydrokainic acid(DHK;an EAAT2 inhibitor),and model+celastrol groups.Glutamate concentration in cortical brain tissues was quantified,and brain edema was assessed by dry-wet weight method.Western blot analysis was conducted to evaluate the expression of EAAT2,aquaporin 4 and apoptosis-related proteins(Bax,Bcl-2,caspase-3 and caspase-9),and TUNEL staining was employed to assess the apoptotic cell count in each group.RESULTS:(1)EAAT2 level decreased while glutamate con-centration increased.(2)Celastrol was found to directly bind to EAAT2,enhancing EAAT2 expression and reducing glu-tamate concentration after SAH.(3)Celastrol demonstrated the ability to inhibit brain edema after SAH.(4)Celastrol was effective in reducing neuronal apoptosis after SAH.CONCLUSION:Celastrol has the potential to up-regulate EAAT2 expression,lower glutamate level,mitigate brain edema,and decrease neuronal apoptosis after SAH.

Objective:To establish the ultra high performance liquid chromatography (UPLC) fingerprints of Mume flos at different flowering stages; To provide reference for the quality research of Mume flos.Methods:The fingerprints of Mume flos were established by UPLC method, and the common peaks were identified by high performance liquid chromatography high resolution mass spectrometry (LC-MS). Chemometrics analysis was carried out with the fingerprints' common peak area of plum blossom at different flowering stages as a variable. Semiquantitative analysis of changes in flavonoids and phenolic acids in Mume flos at different flowering stages was conduct using peak area calculation method.Results:Totally 31 common peaks were identified in the fingerprints of plum blossom medicinal materials at different flowering stages and 9 components were identified. Clustering analysis (HCA) and principal component analysis (PCA) both classified plum blossom medicinal herbs at different flowering stages into three categories. Among them, there were significant differences between the groups at the bud stage, blooming period, and final flowering period, while the differences between the groups at blooming period and final flowering period were relatively small. The orthogonal partial least squares discriminant analysis (OPLS-DA) screened 16 different components with VIP>1.0. The contents of phenolic acids in different flowering stages were as follows: bud stage>blooming period>final flowering period, while the contents of flavonoids were as follows: blooming period>final flowering period>bud stage.Conclusions:This method is simple and reliable, and can provide reference for the quality evaluation of plum blossom medicinal materials at different flowering stages.

Objective Neuromuscular electrical stimulation(NMES)-evoked kinesthetic information in muscle spindle can be purely extracted from the mixed motor and sensory afferents using Ischemic nerve block(INB).This study aims to investigate the somatosensory cortical response evoked by NMES activating muscle spindle afferents in forearm.Methods All subjects performed four experimental tasks designed according to a 2×2 factors,including one factor of the INB state(without INB and within INB)and the other of the stimulation intensity(above and below motor threshold).During the experiment,we recorded EEG data with 64 channels and then beta event-related desynchronization(Beta ERD)were utilized quantize somatosensory cortical excitability evoked by the tasks.The subjective perception about the sensation and movement of the right hand were evaluated by a psychophysical test after the right wrist was performed by INB.Results INB significantly reduced beta ERD on the contralateral somatosensory cortex evoked by NMES above the motor threshold,and there was significant difference of NMES-evoked beta ERD values on the contralateral somatosensory cortex between above and below motor threshold.Meanwhile,contralateral dominance of NMES-evoked beta ERD on the somatosensory cortex was transferred to ipsilateral hemisphere under INB.Conclusion INB can significantly reduce NMES-evoked somatosensory cortical response above motor threshold and decrease cortical perception on the stimulus intensity,which may be due to INB resulting in rapid functional reorganization of somatosensory cortex.

Chemical cleaning and disinfection are crucial steps for eliminating infection in root canal treatment.However,irrigant selection or irrigation procedures are far from clear.The vapor lock effect in the apical region has yet to be solved,impeding irrigation efficacy and resulting in residual infections and compromised treatment outcomes.Additionally,ambiguous clinical indications for root canal medication and non-standardized dressing protocols must be clarified.Inappropriate intracanal medication may present side effects and jeopardize the therapeutic outcomes.Indeed,clinicians have been aware of these concerns for years.Based on the current evidence of studies,this article reviews the properties of various irrigants and intracanal medicaments and elucidates their effectiveness and interactions.The evolution of different kinetic irrigation methods,their effects,limitations,the paradigm shift,current indications,and effective operational procedures regarding intracanal medication are also discussed.This expert consensus aims to establish the clinical operation guidelines for root canal irrigation and a position statement on intracanal medication,thus facilitating a better understanding of infection control,standardizing clinical practice,and ultimately improving the success of endodontic therapy.

Objective The monosaccharide composition of Abelmoschus Manihot Radix polysaccharide was identified and then we evaluated the therapeutic effect on slow transit constipation.Finally,the pharmacodynamic substances and molecular mechanisms in the polysaccharide from Abelmoschus Manihot Radix to improve slow transit constipation were explored by network pharmacology and molecular docking techniques.Methods The polysaccharide from Abelmoschus Manihot Radix has been prepared by aqueous-alcoholic precipitation and has been determined by HPAEC method;The mice model of slow transit constipation was made by sc loperamide(10 mg?kg-1)and the therapeutic effect for the treatment of constipation was evaluated by two indicators:fecal water content and small intestinal propulsion rate;Pathological changes in the colon tissue of STC mice were observed by HE.Immunohistochemical method was used to detect zonula occludens-1(ZO-1)and claudin-1 expression in colon tissue of STC mice;qRT-PCR method was used to detect mRNA expressions of AQP3,AQP4,TNF-α,IL-1β and IL-6 in each group;Network pharmacology and molecular docking technology were used to explore the potential targets and pathways of the polysaccharide from Abelmoschus Manihot Radix in treating slow transit constipation.Results The Polysaccharide from Abelmoschus Manihot Radix significantly increased fecal water content and intestinal propulsion rate in mice caused by slow transit constipation,decreased the expressions of AQP3,AQP4,TNF-α,IL-1β and IL-6 mRNA(P<0.01,P<0.001),protected the integrity of the colonic barrier in STC mice,and increased the protein expressions of ZO-1 and claudin-1 in colon tissues of STC mice.By network pharmacology,it was found that monosaccharides such as rhamnose,fucose and glucuronic acid could mainly act on key targets such as STAT3,JUN,CASP3,HSP90AA1,VEGFA and IL-1β and regulate the Inflammatory mediator regulation of TRP channels,EGFR tyrosine kinase inhibitor resistance and AGE-RAGE signaling pathway in diabetic complications to improve the symptoms of constipation in mice.Western blot results showed that intervention with polysaccharides from the roots of Solanum palmatum significantly reduced the expression of CASP3,VEGFA and IL-1β protein in the colon tissue of constipated mice.Conclusion The polysaccharide from Abelmoschus Manihot Radix can treat slow transit constipation through multi-component,multi-target and multi-pathway therapy.It provides a scientific basis for the further clinical application of Abelmoschus Manihot and drug development(National patent ZL202310894613.3.has been authorized)and it is expected to promote the efficient utilisation of resources from the non-medicinal parts of Abelmoschus Manihot.

Objective The monosaccharide composition of Abelmoschus Manihot Radix polysaccharide was identified and then we evaluated the therapeutic effect on slow transit constipation.Finally,the pharmacodynamic substances and molecular mechanisms in the polysaccharide from Abelmoschus Manihot Radix to improve slow transit constipation were explored by network pharmacology and molecular docking techniques.Methods The polysaccharide from Abelmoschus Manihot Radix has been prepared by aqueous-alcoholic precipitation and has been determined by HPAEC method;The mice model of slow transit constipation was made by sc loperamide(10 mg?kg-1)and the therapeutic effect for the treatment of constipation was evaluated by two indicators:fecal water content and small intestinal propulsion rate;Pathological changes in the colon tissue of STC mice were observed by HE.Immunohistochemical method was used to detect zonula occludens-1(ZO-1)and claudin-1 expression in colon tissue of STC mice;qRT-PCR method was used to detect mRNA expressions of AQP3,AQP4,TNF-α,IL-1β and IL-6 in each group;Network pharmacology and molecular docking technology were used to explore the potential targets and pathways of the polysaccharide from Abelmoschus Manihot Radix in treating slow transit constipation.Results The Polysaccharide from Abelmoschus Manihot Radix significantly increased fecal water content and intestinal propulsion rate in mice caused by slow transit constipation,decreased the expressions of AQP3,AQP4,TNF-α,IL-1β and IL-6 mRNA(P<0.01,P<0.001),protected the integrity of the colonic barrier in STC mice,and increased the protein expressions of ZO-1 and claudin-1 in colon tissues of STC mice.By network pharmacology,it was found that monosaccharides such as rhamnose,fucose and glucuronic acid could mainly act on key targets such as STAT3,JUN,CASP3,HSP90AA1,VEGFA and IL-1β and regulate the Inflammatory mediator regulation of TRP channels,EGFR tyrosine kinase inhibitor resistance and AGE-RAGE signaling pathway in diabetic complications to improve the symptoms of constipation in mice.Western blot results showed that intervention with polysaccharides from the roots of Solanum palmatum significantly reduced the expression of CASP3,VEGFA and IL-1β protein in the colon tissue of constipated mice.Conclusion The polysaccharide from Abelmoschus Manihot Radix can treat slow transit constipation through multi-component,multi-target and multi-pathway therapy.It provides a scientific basis for the further clinical application of Abelmoschus Manihot and drug development(National patent ZL202310894613.3.has been authorized)and it is expected to promote the efficient utilisation of resources from the non-medicinal parts of Abelmoschus Manihot.