ObjectiveThis paper aims to investigate the protective effects of the Tanyu Tongzhi Youhua prescription（TYTZP） against myocardial ischemia/reperfusion injury in rats via regulation of the cyclic GMP-AMP synthase （cGAS）/stimulator of interferon genes （STING） signaling pathway. MethodsFifty-six 8-week-old male Sprague-Dawley （SD） rats were randomly divided into sham group， model group， ticagrelor group （32.4 mg·kg^-1）， RU320521 （RU.521cGAS inhibitors） group （5 mL·kg^-1）， groups of TYTZP with low dose （3.6 g·kg^-1）， medium dose （7.2 g·kg^-1）， and high dose （14.4 g·kg^-1）， with eight rats per group. The ticagrelor group and groups of TYTZP with different doses received pre-treatment for seven days according to their respective protocols. The RU.521 group received an intraperitoneal injection one hour before modeling. A rat model of the no-reflow phenomenon in myocardial ischemia/reperfusion injury was established by ligating the left anterior descending coronary artery in situ. Myocardial no-reflow area was determined by thioflavin staining. Histopathological morphology of myocardial tissue was observed via hematoxylin and eosin （HE） staining. Cardiac function was detected by echocardiography. Myocardial microcirculation function change was observed by using real-time myocardial contrast echocardiography. The myocardial enzyme levels in the serum were measured by serum biochemical analysis. The double-stranded DNA （dsDNA） levels were detected by using PicoGreen. The protein expression of cGAS， STING， and nuclear factor-κB （NF-κB） p65 in myocardial tissue was detected by Western blot. The levels of cardiac troponin Ⅰ （cTNⅠ）， cardiac troponin T （cTNT）， interleukin-6 （IL-6）， interleukin-1β （IL-1β）， and tumor necrosis factor-α （TNF-α） in the peripheral blood were measured by enzyme-linked immunosorbent assay （ELISA）. ResultsCompared with the sham group， the model group showed a significantly increased myocardial no-reflow area （P<0.01）. Myocardial fiber rupture and disarray and inflammatory cell infiltration were observed by HE staining. The ultrasound results indicated that left ventricular ejection fraction （LVEF） and left ventricular fractional shortening （LVFS） （P<0.01） were significantly decreased. Real-time myocardial contrast echocardiography showed that the peak time of myocardial blood perfusion was significantly prolonged （P<0.01）， and the levels of creatine kinase （CK）， creatine kinase isoenzyme （CK-MB）， lactate dehydrogenase （LDH）， cTNⅠ， cTNT， and dsDNA were significantly elevated （P<0.01）. Western blot results showed that the myocardial protein expressions of cGAS， STING， and NF-κB p65 were upregulated （P<0.01）. ELISA results showed that the inflammatory factors in the serum such as IL-6， IL-1β， and TNF-α were increased （P<0.01）. Compared with the model group， the group of the TYTZP significantly reduced the levels of myocardial enzyme， troponins， and dsDNA （P<0.01， P<0.05）， improved cardiac function and myocardial microcirculation， alleviated histopathological morphology and inflammatory infiltration， inhibited activation of the cGAS/STING pathway， reduced the expression of NF-κB p65 （P<0.01， P<0.05）， and inhibited inflammatory response. ConclusionThe TYTZP mitigates the no-reflow phenomenon in myocardial ischemia/reperfusion injury， and its mechanism is associated with inhibiting the activation of the cGAS/STING pathway and attenuating inflammatory responses.

ObjectiveThis paper aims to investigate the protective effects of the Tanyu Tongzhi Youhua prescription（TYTZP） against myocardial ischemia/reperfusion injury in rats via regulation of the cyclic GMP-AMP synthase （cGAS）/stimulator of interferon genes （STING） signaling pathway. MethodsFifty-six 8-week-old male Sprague-Dawley （SD） rats were randomly divided into sham group， model group， ticagrelor group （32.4 mg·kg^-1）， RU320521 （RU.521cGAS inhibitors） group （5 mL·kg^-1）， groups of TYTZP with low dose （3.6 g·kg^-1）， medium dose （7.2 g·kg^-1）， and high dose （14.4 g·kg^-1）， with eight rats per group. The ticagrelor group and groups of TYTZP with different doses received pre-treatment for seven days according to their respective protocols. The RU.521 group received an intraperitoneal injection one hour before modeling. A rat model of the no-reflow phenomenon in myocardial ischemia/reperfusion injury was established by ligating the left anterior descending coronary artery in situ. Myocardial no-reflow area was determined by thioflavin staining. Histopathological morphology of myocardial tissue was observed via hematoxylin and eosin （HE） staining. Cardiac function was detected by echocardiography. Myocardial microcirculation function change was observed by using real-time myocardial contrast echocardiography. The myocardial enzyme levels in the serum were measured by serum biochemical analysis. The double-stranded DNA （dsDNA） levels were detected by using PicoGreen. The protein expression of cGAS， STING， and nuclear factor-κB （NF-κB） p65 in myocardial tissue was detected by Western blot. The levels of cardiac troponin Ⅰ （cTNⅠ）， cardiac troponin T （cTNT）， interleukin-6 （IL-6）， interleukin-1β （IL-1β）， and tumor necrosis factor-α （TNF-α） in the peripheral blood were measured by enzyme-linked immunosorbent assay （ELISA）. ResultsCompared with the sham group， the model group showed a significantly increased myocardial no-reflow area （P<0.01）. Myocardial fiber rupture and disarray and inflammatory cell infiltration were observed by HE staining. The ultrasound results indicated that left ventricular ejection fraction （LVEF） and left ventricular fractional shortening （LVFS） （P<0.01） were significantly decreased. Real-time myocardial contrast echocardiography showed that the peak time of myocardial blood perfusion was significantly prolonged （P<0.01）， and the levels of creatine kinase （CK）， creatine kinase isoenzyme （CK-MB）， lactate dehydrogenase （LDH）， cTNⅠ， cTNT， and dsDNA were significantly elevated （P<0.01）. Western blot results showed that the myocardial protein expressions of cGAS， STING， and NF-κB p65 were upregulated （P<0.01）. ELISA results showed that the inflammatory factors in the serum such as IL-6， IL-1β， and TNF-α were increased （P<0.01）. Compared with the model group， the group of the TYTZP significantly reduced the levels of myocardial enzyme， troponins， and dsDNA （P<0.01， P<0.05）， improved cardiac function and myocardial microcirculation， alleviated histopathological morphology and inflammatory infiltration， inhibited activation of the cGAS/STING pathway， reduced the expression of NF-κB p65 （P<0.01， P<0.05）， and inhibited inflammatory response. ConclusionThe TYTZP mitigates the no-reflow phenomenon in myocardial ischemia/reperfusion injury， and its mechanism is associated with inhibiting the activation of the cGAS/STING pathway and attenuating inflammatory responses.

Summarizing the nursing experience of nutritional support therapy during the perioperative period for a child with short bowel syndrome undergoing small intestine transplantation.Nursing key points:dynamic assessment of nutritional risk,development and timely adjustment of nutritional support programs;implementation of nutritional support strategies to promote growth and development;combination with exercise interventions to improve nutritional status;to strengthen the monitoring of rejection,to promote the recovery of intestinal function;to strengthen the continuity of care,and do a good job of nutritional monitoring and guidance.After 141 days of careful treatment and nursing care,the child was discharged successfully.

Summarizing the nursing experience of nutritional support therapy during the perioperative period for a child with short bowel syndrome undergoing small intestine transplantation.Nursing key points:dynamic assessment of nutritional risk,development and timely adjustment of nutritional support programs;implementation of nutritional support strategies to promote growth and development;combination with exercise interventions to improve nutritional status;to strengthen the monitoring of rejection,to promote the recovery of intestinal function;to strengthen the continuity of care,and do a good job of nutritional monitoring and guidance.After 141 days of careful treatment and nursing care,the child was discharged successfully.

Objective To explore the pharmacodynamic material basis and mechanism of Tanyu Tongzhi Optimized Prescription in the treatment of atherosclerosis(AS)using network pharmacology and animal experiments.Methods UPLC-Q-TRAP-MS/MS was used to identify the blood-entering components of Tanyu Tongzhi Optimized Prescription and conduct network pharmacological analysis.Important components and their core targets for the treatment of AS were screened,and molecular docking was conducted.The AS model mice were constructed and treated with Tanyu Tongzhi Optimized Prescription.HE staining and oil red O staining were used to observe aortic tissue morphology.The blood lipid status was detected by an automatic blood biochemical analyzer.The contents of serum inflammatory factors were detected by ELISA,and the mRNA expressions of aortic core targets were detected by RT-qPCR.Results It was identified and predicted that 30 blood-entering components of Tanyu Tongzhi Optimized Prescription might exert therapeutic effects on AS by regulating core targets such as IL6,TNF,IL1B,AKT1 and NFKB1,and regulating the TNF signaling pathway,Toll-like receptor signaling pathway,PI3K-Akt signaling pathway,etc.Animal experiments showed that Tanyu Tongzhi Optimized Prescription could reduce aortic plaque area and inflammatory cell infiltration,alleviate lipid deposition and vascular stenosis,improve blood lipid levels,and significantly reduce the serum contents of TNF-α,IL-1β,and mRNA expressions of TNF-α,IL-6,AKT1 and NF-κB in aortic tissue(P<0.05,P<0.01).Conclusion The effect of Tanyu Tongzhi Optimized Prescription may regulate TNF,Toll-like receptor and other signaling pathways by acting on core targets such as IL6,TNF,IL1B,and inhibit inflammatory response,so as to treat AS.

OBJECTIVE To comprehensively assess the rationality and safety of clinical application of ceftazidime-avibactam(CAZ/AVI)so as to provide bases for reasonable and safe application of the drugs.METHODS A total of 137 patients who were hospitalized in Tianjin First Central Hospital and were treated with CAZ/AVI from Jan.2023 to Jan.2024 were recruited as the research subjects.The relevant informations involving the baseline da-ta,infection sites,etiological tests,status of drug utilization and adverse reactions were investigated and statically analyzed.The rating form was designed based on relevant guideline consensus and package insert,and the rational-ity and safety of clinical application of days were evaluated.RESULTS Totally 137 valid cases were enrolled in the study,88(64.23％)of whom were male,and 49(35.77％)were female,with the mean age(52±21.89)years old and the average medication duration(12.2±6.45)days.Totally 79 case-times of drug administration were un-reasonable,involving 75 patients;unsuited indications,unreasonable treatment course,absence of special consul-tation and ward round records and no curative effect evaluation after drug administration for 48-72 hours were the major manifestations.The total effective rate of CAZ/AVI treatment was 87.62％,5 patients had CAZ/AVI-associated adverse reactions,with the incidence of adverse reactions 3.65％.CONCLUSION It is necessary for the hospital to further standardize and optimize the clinical utilization of CAZ/AVI,strictly conform to the medica-tion indications,and strengthen the medication surveillance so as to raise the rationality and safety of medication.

OBJECTIVE To comprehensively assess the rationality and safety of clinical application of ceftazidime-avibactam(CAZ/AVI)so as to provide bases for reasonable and safe application of the drugs.METHODS A total of 137 patients who were hospitalized in Tianjin First Central Hospital and were treated with CAZ/AVI from Jan.2023 to Jan.2024 were recruited as the research subjects.The relevant informations involving the baseline da-ta,infection sites,etiological tests,status of drug utilization and adverse reactions were investigated and statically analyzed.The rating form was designed based on relevant guideline consensus and package insert,and the rational-ity and safety of clinical application of days were evaluated.RESULTS Totally 137 valid cases were enrolled in the study,88(64.23％)of whom were male,and 49(35.77％)were female,with the mean age(52±21.89)years old and the average medication duration(12.2±6.45)days.Totally 79 case-times of drug administration were un-reasonable,involving 75 patients;unsuited indications,unreasonable treatment course,absence of special consul-tation and ward round records and no curative effect evaluation after drug administration for 48-72 hours were the major manifestations.The total effective rate of CAZ/AVI treatment was 87.62％,5 patients had CAZ/AVI-associated adverse reactions,with the incidence of adverse reactions 3.65％.CONCLUSION It is necessary for the hospital to further standardize and optimize the clinical utilization of CAZ/AVI,strictly conform to the medica-tion indications,and strengthen the medication surveillance so as to raise the rationality and safety of medication.

Objective To explore the pharmacodynamic material basis and mechanism of Tanyu Tongzhi Optimized Prescription in the treatment of atherosclerosis(AS)using network pharmacology and animal experiments.Methods UPLC-Q-TRAP-MS/MS was used to identify the blood-entering components of Tanyu Tongzhi Optimized Prescription and conduct network pharmacological analysis.Important components and their core targets for the treatment of AS were screened,and molecular docking was conducted.The AS model mice were constructed and treated with Tanyu Tongzhi Optimized Prescription.HE staining and oil red O staining were used to observe aortic tissue morphology.The blood lipid status was detected by an automatic blood biochemical analyzer.The contents of serum inflammatory factors were detected by ELISA,and the mRNA expressions of aortic core targets were detected by RT-qPCR.Results It was identified and predicted that 30 blood-entering components of Tanyu Tongzhi Optimized Prescription might exert therapeutic effects on AS by regulating core targets such as IL6,TNF,IL1B,AKT1 and NFKB1,and regulating the TNF signaling pathway,Toll-like receptor signaling pathway,PI3K-Akt signaling pathway,etc.Animal experiments showed that Tanyu Tongzhi Optimized Prescription could reduce aortic plaque area and inflammatory cell infiltration,alleviate lipid deposition and vascular stenosis,improve blood lipid levels,and significantly reduce the serum contents of TNF-α,IL-1β,and mRNA expressions of TNF-α,IL-6,AKT1 and NF-κB in aortic tissue(P<0.05,P<0.01).Conclusion The effect of Tanyu Tongzhi Optimized Prescription may regulate TNF,Toll-like receptor and other signaling pathways by acting on core targets such as IL6,TNF,IL1B,and inhibit inflammatory response,so as to treat AS.

Objective:To analyze the status of respiratory pathogen detection and the clinical features in children with Mycoplasma pneumoniae pneumonia (MPP). Methods:A prospective, multicenter study was conducted to collect clinical data, including medical history, laboratory examinations and multiplex PCR tests of children diagnosed with MPP from 4 hospitals in China between November 15 th and December 20 th, 2023. The multiplex PCR results and clinical characteristics of MPP children in different regions were analyzed. The children were divided into severe and mild groups according to the severity of the disease. Patients in the severe group were further divided into Mycoplasma pneumoniae (MP) alone and Multi-pathogen co-detection groups based on whether other pathogens were detected besides MP, to analyze the influence of respiratory pathogen co-detection rate on the severity of the disease. Mann-Whitney rank sum test and Chi-square test were used to compare data between independent groups. Results:A total of 298 children, 136 males and 162 females, were enrolled in this study, including 204 children in the severe group with an onset age of 7.0 (6.0, 8.0) years, and 94 children in the mild group with an onset age of 6.5 (4.0, 7.8) years. The level of C-reactive protein, D-dimer, lactic dehydrogenase (LDH) were significantly higher (10.0 (5.0, 18.0) vs. 5.0 (5.0, 7.5) mg/L, 0.6 (0.4, 1.1) vs. 0.5 (0.3, 0.6) mg/L, 337 (286, 431) vs. 314 (271, 393) U/L, Z=2.02, 2.50, 3.05, all P<0.05), and the length of hospitalization was significantly longer in the severe group compared with those in mild group (6.0 (6.0, 7.0) vs. 5.0 (4.0, 6.0) d, Z=4.37, P<0.05). The time from onset to admission in severe MPP children was significantly shorter than that in mild MPP children (6.0 (5.0, 9.5) vs. 9.0 (7.0, 13.0) d, Z=2.23, P=0.026). All patients completed the multiplex PCR test, with 142 cases (47.7%) MPP children detected with 21 pathogens including adenovirus 25 cases (8.4%), human coronavirus 23 cases (7.7%), rhinovirus 21 cases (7.0%), Streptococcus pneumoniae 21 cases (7.0%), influenza A virus 18 cases (6.0%). The pathogens with the highest detection rates in Tianjin, Shanghai, Wenzhou and Chengdu were Staphylococcus aureus at 10.7% (8/75), adenovirus at 13.0% (10/77), adenovirus at 15.3% (9/59), and both rhinovirus and Haemophilus influenzae at 11.5% (10/87) each. The multi-pathogen co-detection rate in severe MPP children was significantly higher than that in mild MPP group (52.9% (108/204) vs. 36.2% (34/94), χ2=10.62, P=0.005). Among severe MPP children, there are 89 cases in the multi-pathogen co-detection group and 73 cases in the simple MPP group. The levels of LDH, D-dimer and neutrophil counts in the multi-pathogen co-detection group were significantly higher than those in the simple MPP group (348 (284, 422) vs. 307 (270, 358) U/L, 0.8 (0.5, 1.5) vs. 0.6 (0.4, 1.0) mg/L, 4.99 (3.66, 6.89)×10 9vs. 4.06 (2.91, 5.65)×10 9/L, Z=5.17, 4.99, 6.11, all P<0.05). Conclusions:The co-detection rate of respiratory pathogens, LDH and D-dimer in children with severe MPP were higher than those with mild MPP. Among severe MPP children the stress response of children in co-detection group was more serious than that of children with simple MPP.

Objective To conduct Rh blood group serological testing and third-generation sequencing(TGS)on 22 RhD variant voluntary blood donors in Chongqing and explore the phenotypic distribution and genotyping of RhD variants in Chongqing.Methods From January to August 2023,individuals who participated in blood donation in our blood center were selected as the study objects.RhD variant phenotype identification was performed using routine serological methods.Once the RhD variants were identified,tests on different antigenic epitopes of RhD were conducted using a D-screen assay kit.Furthermore,after the genomic DNA from 22 RhD variant blood samples was extracted,imbraided primers design and multi-segment amplification and splicing were used to sequence the full-length RHD gene for TGS.The RHD gene sequence was analyzed using SnapGene software.Results Among the 22 RhD variants,8 were DVI type 3(36.36%),with the main mutation of RHD-CE(3-6)-D hybrid allele.Six cases(27.27%)showed partial weak D15 type,with the main mutation of c.845G>A.There were 6 cases of Asia type Del(27.27%),with the main mutation of c.1227G>A.One case was weak D17 type with a mutation of c.340C>T and 1 case speculated to be partial D(c.491A>T,p.Asp164Val,missense mutation).Conclusion The most common RhD variant phenotype among blood donors in Chongqing is DVI type 3,and the full-length haplotype sequence of RHD variant alleles can be obtained by Pacific Bioscience single-molecule real-time sequencing(SMRT).