Patients with Takayasu arteritis combined with aortic valve disease often have a poor prognosis following surgical valve replacement, frequently encountering complications such as perivalvular leakage, valve detachment, and anastomotic aneurysm. This article presents a high-risk case wherein severe aortic valve insufficiency associated with Takayasu arteritis was successfully managed through transcatheter aortic valve implantation via the transapical approach. The patient had satisfactory valve function with no complications observed during the six-month postoperative follow-up. This case provides a minimally invasive and feasible alternative for the clinical management of such high-risk patients.

Objective: To evaluate the effect of exercise prescription intervention among patients with type 2 diabetes mellitus (T2DM), so as to provide the evidence for guiding appropriate physical activity and glycemic control in this population. Methods: In July 2023, T2DM patients managed by two community health service centers in Qingjiangpu District, Huai'an City, Jiangsu Province, were selected as the study participants and randomly assigned divided into a control group and an intervention group. The control group received routine chronic disease management under the basic public health services, while the intervention group, in addition to receiving the same routine chronic disease management, was provided with exercise prescription to guide their physical activity at baseline (T0), after 3 months of intervention (T1), and after 6 months of intervention (T2). Data on weight-related indicators, glycated hemoglobin (HbA1c), and blood lipid were collected through physical examinations and laboratory tests at T0 and after 12 months of intervention (T3). The differences in indicators between the two groups before and after the intervention were analyzed using generalized estimating equations. Results: The intervention group consisted of 197 patients, including 99 males, accounting for 50.25%. The median disease duration was 7.10 (interquartile range, 7.80) years, and 113 patients had suboptimal HbA1c levels, accounting for 57.36%. The control group included 196 patients, including 99 females, accounting for 50.51%. The median disease duration was 6.10 (interquartile range, 7.00) years, and 100 patients had suboptimal HbA1c levels, accounting for 51.02%. Before the intervention, no statistically significant differences were observed between the two groups in gender, educational level, disease duration, pharmacological treatment, smoking, alcohol consumption, and HbA1c levels (all P>0.05). In the intervention group, the proportion of participants engaging in aerobic exercise and strength training increased from 78.17% and 8.12% at T0 to 85.79% and 16.24% at T3, respectively (both P<0.05). The results of the generalized estimating equations revealed significant interactions between group and time for waist-to-hip ratio, total cholesterol (TC), and low-density lipoprotein cholesterol (LDL-C) following the intervention (all P<0.05). A statistically significant difference in waist-to-hip ratio was found between the two groups (P<0.05), with a greater reduction observed in the intervention group compared to the control group. Significant differences in TC and LDL-C levels were noted across different intervention time points (both P<0.05). Specifically, the intervention group demonstrated reductions of 0.35 mmol/L in TC and 0.42 mmol/L in LDL-C from baseline to follow-up (both P<0.05). Conclusion The 12-month exercise prescription intervention can effectively enhance exercise participation and reduce waist-to-hip ratio, TC, and LDL-C levels among patients with T2DM.

Objective To explore the anesthesia management experience in the interventional treatment of pediatric congenital heart diseases (CHD) percutaneously guided by transthoracic echocardiography (TTE) on a mobile operating platform. Methods From March to July 2023, a total of 13 patients from remote areas underwent interventional treatment for CHD on the mobile operating platform of Fuwai Yunnan Cardiovascular Hospital. Patients who received non-tracheal intubation general anesthesia were retrospectively included. Results Eight children who had difficulty cooperating with the surgery (due to young age, emotional tension, crying) received monitored anesthesia care with local anesthesia supplemented by sedative and analgesic drugs while maintaining spontaneous breathing under the monitoring and management of an anesthesiologist (i.e., non-tracheal intubation general anesthesia). Among them, there were 5 males and 3 females, with an age of (6.95±3.29) years and a body weight of (19.50±6.04) kg. Through transthoracic echocardiography, they were diagnosed with atrial septal defect (6 patients), residual shunt after patent ductus arteriosus ligation (1 patient), and severe pulmonary valve stenosis (1 patient). The surgery proceeded smoothly, with satisfactory anesthesia and surgical effects, complete analgesia, and satisfactory postoperative recovery. There was 1 patient of body movement and 1 patient of respiratory depression during the operation, and both patients completed the surgery successfully after treatment. All children had no serious surgery- and anesthesia-related complications. The anesthesia time was 40.5 (34.5, 47.5) min, the surgery time was 39.0 (33.0, 45.5) min, and the recovery time was 43.0 (28.0, 52.5) min Conclusion Interventional surgery for CHD guided by TTE at a mobile platform is a minimally invasive approach without radiation damage. Non-tracheal intubation general anesthesia with spontaneous breathing can be safely and effectively implemented in children who cannot cooperate.

Objective To evaluate the clinical effect of dextromethorphan and its effect on daily living of patients with poststroke pseudobulbar affect. Methods Sixty patients with poststroke pseudobulbar affect admitted in our hospital from May 2013 to October 2016 were enrolled. Then they were randomly divided into the control group and the treatment group,with 30 patients in each group.Patients in the control group were treated with fluox-etine therapy and patients in the treatment group were treated with dextromethorphan therapy.The center for neuro-logic study lability scale(CNS-LS)and activity of daily living(Barthel index,BI)before and 30 days after the treat-ments in the two groups had been accessed. Results Thirty days after the treatment,CNS-LS of the treatment group had obvious improvement compared with that before treatment(P < 0.01),but CNS-LS of the control group had no obvious improvement compared with that before treatment(P > 0.05). And significant improvement has been found 30 days after the treatment between the two groups(P<0.01).Furthermore,significant difference was found on BI between these two groups(P<0.05).Conclusions Dextromethorphan is effective in treatment of pa-tients with poststroke pseudobulbar affect and it can improve the activity of daily living of these patients.

Objective To observe the clinical effects of breaking blood expelling stasis method of traditional Chinese medicine (TCM) combined with edaravone on patients with acute hypertensive intra-cerebral hemorrhage and preliminarily discuss its protection mechanism on this disease. Methods Ninety-two patients with hypertensive intra-cerebral hemorrhage within 72 hours after occurrence admitted to Zengcheng District People's Hosipital of Guangzhou from May 2013 to December 2017 were enrolled, they were divided into conventional therapy group and combined treatment of TCM and western medicine group by random numbers produced by a computer, 46 cases in each group. The conventional therapy group was treated with conventional therapy, and the combined treatment of TCM and western medicine group was treated with conventional therapy, additionally the treatment of Poxue Zhuyu decoction (the ingredients of the decoction: leech 10 g, gradfly 10 g, rhubarb 15 g, cattail pollen 5 g, trichosanthes fruit 10 g, radix notoginseng 5 g, colla plastri testudinis 10 g, grassleaf sweetflag rhizome 10 g, ground beetle 3 g, dried lacquer 3 g, peach seed 10 g) and edaravone for 10 days. The levels of interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) in serum were tested by enzyme-linked immunosorbent assay (ELISA) before and 7 days after treatment in the two groups; and the differences in National Institutes of Health stroke scale score (NIHSS) before and 14 days, 90 days after treatment as well as the changes of brain edema around the hematoma 14 days after treatment were compared between the two groups, and the incidence of adverse reaction was observed. Results After treatment, the levels of TNF-α, IL-6 and intra-cerebral hemorrhage quantities in the two groups were all decreased compared with those before treatment, and the degrees of decrease of TNF-α and cerebral hemorrhage volume in combined treatment of TCM and western medicine group were more significant than those in the conventional treatment group [TNF-α (ng/L): 21.00±6.10 vs. 29.40±11.33, cerebral hemorrhage volume (mL): 5.23±0.60 vs. 8.50±0.64, both P <0.05]. The IL-6 in the two groups were recovered to approximately normal levels after the treatment (ng/L: 13.60±5.36 vs. 15.40±6.13, P > 0.05). With the prolongation of therapeutic time, the scores of NIHSS of the two groups were significantly lowered than those before treatment, and the degree of reduction in the combined TCM and western medicine group on 90 days after treatment was more obvious than that of the conventional treatment group (4.34±0.67 vs. 7.73±0.61, P < 0.05). The volumes of edema around hematomas were increased after treatment in the two groups, but the degree of increase in combined treatment of TCM and western medicine group was slower than that of the conventional group (cm3: 7.57±0.64 vs. 10.16±0.60, P < 0.05). There was no statistical significant difference in the incidence of adverse reactions in comparison between the combined treatment of TCM and western medicine group and conventional therapy group [18.2% (8/44) vs. 20.5% (9/44), P > 0.05]. Conclusions Using breaking blood expelling stasis and edaravone for treatment of acute hypertensive intra-cerebral hemorrhage can accelerate the absorption of brain hematoma and improve the neurological function, and its mechanism may be relevant to the inhibition of some inflammatory factors.

Objective Ischemic preconditioning and postconditioning can provide certain protection for myocardium .The ar-ticle was designed to observe the protective effect of salidroside on myocardial ischemia reperfusion injury ( MIRI) and explore its mech-anisms. Methods SD rats were randomly divided into 6 groups with 6 rats for each: sham operation group (S group), ischemia-reperfusion group(I/R group), salidroside preventive group(salidroside treatment followed by ischemia-reperfusion), salidroside treat-ment group (ischemia-reperfusion followed by salidroside treatment ), salidroside preventive+LY group(LY294002 preventive group) and salidroside treatment+LY group(LY294002 treatment group).Salidroside was administered once a day for three days before mod-elling in both salidroside preventive group and LY 294002 preventive group;while salidroside was given immediately after the reperfu-sion in both salidroside treatment group and LY 294002 treatment group .The same volume of NS was administered only to the rats in S group and I/R group.The PI3K inhibitor(LY294002) was given additionally 35 mins before LAD ligation in both LY294002 preventive group and LY294002 treatment group .All injections were given intraperitoneally .Akt, p-Akt, GSK-3βand p-GSK-3βin myocardium were examined with immunocytochemical method in all groups .The protein expression and phosphorrylation status of Akt /GSK-3βwere determined by western blot. Results The levels of Akt/GSK-3βin myocardium of S group(0.246 ±0.002), I/R group(0.457 ± 0.012), LY294002 preventive group(0.303 ±0.005), LY294002 treatment group(0.361 ±0.019) decreased significantly in com-parison to those of salidroside preventive group (0.857 ±0.014) and salidroside treatment group(0.683 ±0.009)(P<0.05).The levels of p-GSK-3β/GSK-3βin myocardium of S group (0.137 ±0.004), I/R group(0.380 ±0.026), LY294002 preventive group(0.148 ± 0.013), LY294002 treatment group(0.267 ±0.050) also decreased significantly in comparison to those of salidroside preventive group (0.944 ±0.045) and salidroside treatment group (0.895 ±0.043) (P<0.05).As to the comparison between salidroside preventive group and salidroside treatment group , there was no significant difference (P>0.05). Conclusion The result indicates that salidro-side protects myocardium against MIRI in rats .The cardioprotective effect might be associated with the increased protein expression and the phosphorylation rate of Akt/GSK-3β.

OBJECTIVE:To prepare epirubicin hydrochloride solid lipid nanoparticle(EPI-SLN) and investigate its physicochemical property. METHODS: EPI-SLN was prepared by ultrasonic dispersion technique with glyceryl behenate as matrix,and the appearance,particle size,? electric potential,and entrapment efficiency of the SLN were evaluated and its stability at 3 month storing at 4 ℃ was investigated. RESULTS: EPI-SLN assumed spherical shape with a particle diameter of (212.8?6.2) nm,? electric potential of (-24.7?0.3) mV and entrapment efficiency of 82 %. The EPI-SLN at 4 ℃ was stable after storing for 3 months,showing no marked change in mean diameter,? electric potential or entrapment efficiency. CONCLUSION: The prepared EPI-SLN is up to the standard.

OBJECTIVE To investigate related factors of urinary tract infection due to indwelling catheter.(METHODS) A total of 19 cases of urinary tract infection due to indwelling catheter were retrospectively analyzed.RESULTS Among 49 patients with indwelling catheter 19 patients got urinary tract infection,the infection rate was 38.78%.The incidence of urinary tract infection of patients at 1-10 d,11-20 d,21-30 d and over 30 d catheter was 20.00%,30.77%,37.50%,and 69.23%,respectively. Escherichia coli was the most common pathogen(isolated),the others were Enterococcus faecalis,Candida albicans,Enterobacter cloacae,et al.CONCLUSIONS The operation of indwelling catheter,continued times of indwelling catheter,improper application of antibiotics are the important risk factors of urinary tract infection.The infection rate could be decreased after taking(prevention) measures according to various related factors.

OBJECTIVE To investigate approaches to the prevention of sharps injuries. METHODS A retrospective questionnaire was performed for 193 nurses of a general hospital from the time of Jan 2004 to Jun 2005. RESULTS The questionnaires indicated that 46.1% nurses had suffered sharps injuries,with averaged of 1.6 times per person,of which 36.7% and 32.4% were caused respectively by syringe needles and glass wares.Opening ampules,disposal of used sharps,installing the syringe needles and transmitting sharp devices were the four major events in which sharps injuries might happen,accounted for 29.5%,22.3%,15.8% and 10.1%,respectively.It is also noted that 79.1% nurses suffering from the injury wore no gloves. CONCLUSIONS Occupational hazards of sharps injuries are threatening nurses.Certain prophylactic measures should be taken to control and prevent sharps injuries.