AIM: To study the distribution, location and quantity of myocardial collagen(Col) in different phases after myocardial infarction(MI). METHODS: The method of immunohistochemical technique combined with automatic image analysis was used to investigate the changes of collagen Ⅰ and Ⅲ. RESULTS:Contents of Col Ⅰ, Col Ⅲ and the ratio of Ⅰ/Ⅲ were all increased in infarcted area (IA)after MI,and the increase of Col Ⅰ was higher, the collagen fibers still construct a network in acute phase, in chronic stage, all necrosis myocytes were replaced by collagen, the fibers were dense, and paralelled with cardiac cavity surface.In the septum,noninfarcted area, contents of collagen type Ⅰ and Ⅲ, the ratio of Ⅰ/Ⅲ were increased.In acute phase, the increase of type Ⅲ is dominant,with in chronic phase, type Ⅰ is. Right ventricle(RV) has no significant change in acute phase,untill chronic phase,it changed like septum,the increase in collgen is mainly type Ⅰ. CONCLUSION: The collgen remodeled after myocardial infarction were reparative fibrosis in IA phase, and reactive fibrosis in NIA phase. Remodeling occured later in RV than in septum.

Objective To explore the role of salidroside in HIRI and its related mechanism. MethodsA total of 90 male SD rats were randomly divided into the sham group, the model group, the low, medium and high dose group, 18 rats in each group. The low, medium and high dose group rats were injected with 7.5, 15, 30 mg/kg salidroside solution, and the sham group and model group were injected with saline in the same volume, one time per day. After 7 days, all the rats were set up with the model of IR except the rats in Sham groups. The AST and ALT of serum, contrast between groups liver tissue by Optical microscope with HE dyeing at 4, 8, 16 h after reperfusion. Western Blot was used to detect the expression of protein of MAPK, JNK, ERK and NF-κB.ResultsFour, 8, 16 h after reperfusion, the level of ALT (540.67 ± 15.91 U/L vs.697.67 ± 5.98 U/L, 307.50 ± 12.97 U/L vs.962.50 ± 17.63 U/L, 103.33 ± 3.95 U/L vs.198.17 ± 9.73 U/L) and AST (651.17 ± 7.39 U/L vs.944.67 ± 11.38 U/L, 415.50 ± 10.97 U/L vs.1561.83 ± 15.76 U/L, 168.33 ± 5.81 U/L vs. 280.33 ± 12.35 U/L) in the high dose group were significantly lower than those in the model group. Eight and 16 hours after reperfusion, the expression of MAPK (1.28 ± 0.19 vs. 2.10 ± 0.12, 1.64 ± 0.14 vs.1.89 ± 0.14), JNK (1.80 ± 0.10 vs. 2.42 ± 0.11, 0.84 ± 0.17 vs. 3.32 ± 0.19), ERK (2.43 ± 0.10 vs.5.95 ± 0.09, 2.07 ± 0.13 vs. 6.61 ± 0.14), NF-κB (2.32 ± 0.16 vs. 3.08 ± 0.10, 2.11 ± 0.13 vs. 2.74 ± 0.17) in the high dose group were significantly lower than the model group (P<0.05).Conclusions The salidroside could reduce the liver ischemia- reperfusion injury, and its mechanisms may rugulate the MAPK/NF-κB signaling pathways.

Surgical resection of liver diseases such as liver cancer,traumatic hepatic rupture,it was often faced with ischemia-reperfusion injury of the residual liver,which significantly increased the risk of surgical treatment and impact the postoperative recovery of patients.Autophagy was a way of programmed cell death after hepatic ischemia reperfusion.When researching hepatic ischemia-reperfusion injury simulated by animal experiments,it ofen detected the level change of autophagy marker molecular LC3-Ⅱ representing the activity of cell autophagy.Now the authors write the research progress of LC3-Ⅱ in hepatic ischemia-reperfusion injury.

Objective To explore the protective effect of astilbin in hepatic ischemia-reperfusion injury (HIRI).Methods SD rats were divided into Sham group (control group),HIRI group (ischemia-reperfusion group),astilbe (low dose group,middle dose group,high dose group),and estabilished the model of rat HIRI.After liver were reperfused with blood (in 4 h,8 h,16 h),collecting the specimens of blood and liver tissues.Detection of serum alanine aminotransferase (ALT),aspertate aminotransferase (AST);Then observed the changes of liver cell microstructure;Western blot analysised the expression of HMGB1,TLR4,NF-kB,TNF-α in liver tissue.Results The serum ALT levels of Sham group in 4 h,8 h,16 h were (58.11 ±4.81) U/L,(57.12 ± 5.33) U/L,(57.63 ±4.54) U/L,the serum ALT levels of HIRI group in 4 h,8 h,16 h were (540.38 ± 21.41) U/L,(831.21 ± 20.11) U/L,(191.95 ± 15.35) U/L.Compared with Sham group,the serum ALT levels of HIRI group were significantly increased(P ＜ 0.01).Compared with HIRI group,The serum ALT levels of three dose groups in 4 h,8 h,16 h were significantly declined,including high dose group lower the most obvious (The serum ALT levels of high dose group in 4 h,8 h,16 h were (223.75 ± 10.53) U/L,(412.14 ±23.59) U/L,(205.25 ± 15.48) U/L (P ＜0.01).The results of light microscope indicated that drug groups significantly reduce the liver cell damage.The results of Western blot displayed that High dose group of HMGB1,TLR4 protein expression in 4 h,8 h,16 h drop significantly than HIRI group(P ＜0.05).High dose group of NFkB,TNF-α protein expression in postoperative 8 h,16 h decrease significantly than HIRI group (P ＜ 0.05),but in postoperative 8 h,there was no statistically significant difference compared with group HIRI (P＞0.05).Conclusion Astilbe pretreatment can reduce HIRI and its mechanism may be associated with downregulating the axis of HMGB1/TLR4/NF-kB/TNF-α,proceed to the next inhibiting the inflammatory response.

Objective To research the effect and autophagy in hepatic ischemia-reperfusion injury based on relevant indicators of the specimens of rat liver which ischemia reperfusion model by salidroside pretreatment. Methods A total of 90 male SD rats were randomly divided into the sham group, the model group, the low, medium and high dose group, 18 rats in each group. The low, medium and high dose group rats were treated with 7.5, 15, 30 mg/kg salidroside solution by gavage, and the sham group and model group and model group were filled with saline in the same volume,one time per day. After 7 days, all the rats were set up with the model of IR except the rats in sham groups. The AST and ALT of serum, contrast between groups liver tissue by Optical microscope with HE dyeing at 4, 8, 16 h after reperfusion. Western Blot was used to detect the expression of protein of LC3 and Beclin-1. The number and morphology of autophagy in each group of liver cells were observed by electron microscopy. Results After reperfusion 4, 8, 16 h, the level of ALT (662.36 ± 5.82 U/L vs. 983.67 ± 8.96 U/L, 436.49 ± 12.93 U/L vs. 1536 ± 10.77 U/L, 168.61 ± 8.34 U/L vs. 280.42 ± 17.37 U/L) of the high dose group weresignificantly lower than the model group, and the AST (513.29 ± 11.74 U/L vs. 656.38 ± 7.67 U/L, 276.29 ± 9.21 U/L vs. 930.19 ± 15.62 U/L, 97.83 ± 4.29 U/L vs. 211.23 ± 7.87 U/L) of the high dose group were significantly lower than the model group. After reperfusion 8, 16 h, the expression of LC3-Ⅱ (1.21 ± 0.16 vs. 1.91 ± 0.12, 2.00 ± 0.14 vs. 1.09 ± 0.11) in the high dose group were significantly lower than the model group, and the results were same to Beclin1 (3.53 ± 0.19 vs. 7.15 ± 0.14, 2.65 ± 0.27 vs. 7.60 ± 0.21) (P<0.05). After reperfusion 8 h, the number of autophagosome (3.24 ± 0.62 vs.7.84 ± 0.45) in the high dose group were significantly lower than the model group (P<0.05). Conclusions The hepatic ischemia-reperfusion injury was serious, and inhibiting autophagy was one of possible mechanisms to protect liver cells by salidroside.

Objective:To explore the mechanism of gypenoside ⅩⅦ against cerebral ischemia/reperfusion (I/R) through nuclear factor erythroid 2-related factor 2/antioxidant responsive element (Nrf2/ARE) signaling pathway.Methods:Forty SPF Sprague Dawley (SD) rats were randomly divided into sham operated group, I/R model group, 25, 50 and 100 mg/kg gypenoside ⅩⅦ groups ( n = 8). Gypenoside ⅩⅦ groups were administered 25, 50 or 100 mg/kg (0.01 mL/g) gypenoside ⅩⅦ by intragastric administration for 14 days; the other two groups received the same dose of saline. Rat cerebral I/R model was established by modified line bolt method; rats in the sham operated group underwent the same procedure without producing substantial embolization. After 24 hours of reperfusion, the neurological deficit scores of the rats in each group were assessed. Rat abdominal aortic whole blood was collected and the serum reactive oxygen species (ROS), heme oxygenase-1 (HO-1), γ-glutamylcysteine synthase (γ-GCS), superoxide dismutase (SOD), quinone NADH oxidoreductase 1 (NQO1), and malondialdehyde (MDA) were detected. Then whole brain tissue was harvested and penumbra tissue was isolated from cerebral cortex, the general condition of rat brain tissue and the volume of cerebral infarction were evaluated, the histopathological changes in the brain were observed under light microscopy, the mRNA expressions of Nrf2 and Keap1 were measured by real-time fluorescent quantitative polymerase chain reaction (RT-qPCR), the protein expressions of Nrf2 and Keap1 were determined by Western blotting. Results:After 24 hours of reperfusion, compared with the sham operated group, the score of neurological deficit and infarct volume were significantly increased, the NQO1, SOD and γ-GCS levels in serum were significantly decreased, MDA, HO-1 and ROS levels in serum were significantly increased, the Nrf2 and Keap1 mRNA and protein expressions in the ischemic penumbra were significantly increased in rats from I/R model group. Compared with the I/R model group, the neurological deficit scores (1.50±0.53, 1.37±0.52 vs. 2.75±0.46) and brain infarct volume [(19.8±5.1)%, (21.4±6.4)% vs. (42.3±5.8)%] were significantly reduced, serum NQO1, SOD, HO-1 and γ-GCS were significantly increased [NQO1 (ng/L): 186.05±10.38, 220.75±16.22 vs. 131.36±5.95, SOD (kU/L): 63.23±5.30, 72.70±8.62 vs. 36.75±6.55, HO-1 (ng/L): 60.57±7.93, 60.35±4.72 vs. 42.72±4.95, γ-GCS (kU/L): 8.81±0.53, 8.72±0.69 vs. 6.80±0.56], serum MDA and ROS levels were significantly reduced [MDA (μmol/L): 5.94±0.66, 5.61±0.53 vs. 10.88±1.34, ROS (kU/L): 69.11±4.23, 67.12±4.52 vs. 104.43±7.54], the mRNA and protein expressions of Nrf2 and Keap1 in the ischemic penumbra were significantly increased in rats from 50 mg/kg and 100 mg/kg gypenoside ⅩⅦ groups [Nrf2 mRNA (2 -△△Ct): 1.90±0.13, 2.13±0.18 vs. 1.48±0.11, Keap1 mRNA (2 -△△Ct): 1.78±0.11, 1.85±0.10 vs. 1.43±0.10, Nrf2/β-actin: 0.73±0.04, 0.79±0.03 vs. 0.60±0.03, Keap1/β-actin: 0.71±0.01, 0.76±0.03 vs. 0.61±0.01], all the comparative differences were statistically significant (all P < 0.01); 25 mg/kg gypenoside ⅩⅦ had no significant effect. Conclusion:Gypenoside ⅩⅦ (50 mg/kg and 100 mg/kg) may play a role in anti-cerebral I/R injury by regulating NQO1, SOD, HO-1, γ-GCS, ROS and MDA through Nrf2/ARE signaling pathway.

Objective:To construct a rapid admission evaluation model for medical consumables of same category,and to achieve a balance between scientificity,efficiency and practicality in the management of medical consumables.Methods:Based on the mini health technology assessment(Mini-HTA)model,combined with expert heuristics,a rapid qualitative analysis of the intended use and technical characteristics of the same category of medical consumables were conducted.Expert opinions were solicited through the Delphi method,and a rapid admission evaluation model of same category of medical consumables was constructed.A total of 80 high-value medical consumables of 10 categories in clinical use in Sichuan Provincial People's Hospital from June 2023 to March 2024 were selected,and the traditional admission process method and expert heuristics optimization method were used to make admission decisions for medical consumables,with 40 high-value medical consumables for each method.The differences in the decision-making process and approval time between the two different admission methods were compared and analyzed.Results:The admission decision-making system indicators of the rapid admission evaluation model of medical consumables of same category included 6 primary indicators of clinical efficacy,reliability,economics,values and aspirations,hospital management and corporate services,and 25 secondary indicators.The approval process for medical consumables admission decision-making using the rapid admission evaluation model of medical consumables of same category had been reduced from 10 in the traditional admission process to 2,and the approval time had been shortened from an average of 7.03 days to 2.43 days.Conclusion:The rapid admission evaluation model for the approval of medical consumables of same category based on expert heuristics can significantly optimize the admission approval process of medical consumables,improve the comprehensiveness and transparency of medical consumables admission decisions,and improve the management efficiency of medical consumables.

Asthma is characterized by chronic airway inflammation and airway hyper-responsiveness. However, the differences in pathophysiology and phenotypic symptomology make a diagnosis of "asthma" too broad hindering individualized treatment. Four asthmatic inflammatory phenotypes have been identified based on inflammatory cell profiles in sputum: eosinophilic, neutrophilic, paucigranulocytic, and mixed-granulocytic. Paucigranulocytic asthma may be one of the most common phenotypes in stable asthmatic patients, yet it remains much less studied than the other inflammatory phenotypes. Understanding of paucigranulocytic asthma in terms of phenotypic discrimination, distribution, stability, surrogate biomarkers, underlying pathophysiology, clinical characteristics, and current therapies is fragmented, which impedes clinical management of patients. This review brings together existing knowledge and ongoing research about asthma phenotypes, with a focus on paucigranulocytic asthma, in order to present a comprehensive picture that may clarify specific inflammatory phenotypes and thus improve clinical diagnoses and disease management.
Humans ; Asthma/drug therapy* ; Inflammation/diagnosis* ; Respiratory System ; Phenotype ; Biomarkers ; Sputum ; Eosinophils ; Neutrophils