ObjectiveTo investigate the potential targets and mechanisms of Draconis Sanguis (DS), a valuable traditional Chinese medicine derived from the resin of the palm tree Daemonorops draco Bl (D. Sanguis, Xue Jie), in the treatment of myocardial infarction (MI).MethodsWe explored the potential mechanisms of DS in the treatment of MI using network pharmacology, bioinformatic techniques, and transcriptomic analysis, followed by validation through in vivo and in vitro experiments.ResultsNetwork pharmacology and bioinformatic analyses identified five genes (Fpr1, Glul, Mme, Mmp9, and Pla2g7) as potential targets for MI treatment. Moreover, DS significantly ameliorated cardiac function, inflammatory responses, and MI-induced myocardial fibrosis in vivo. Transcriptomic and bioinformatic analyses identified Pla2g7 as the most critical target in the DS treatment of MI. Molecular docking revealed that the key active ingredient in DS has a strong affinity for this gene. Furthermore, DS reduced the expression of Pla2g7 (P = .0009), NLRP3 (P = .003), interleukin-18 (P .001), and interleukin-1β (P = .004) mRNAs in vivo.ConclusionsThe results indicate that DS can downregulate the expression of Pla2g7 and reduce the inflammatory response. This demonstrates the potential therapeutic target of DS and the mechanism underlying its cardioprotective effects.

Objective:To explore the expression and ultrastructure distribution of cofilin and its potential mecha-nisms in postsynaptic mitochondrial anchoring and synaptic plasticity in the pre-B?tzinger complex(pre-B?tC)in rats.Methods:Using neurokinin 1 receptor(NK1R)as a morphological marker of the pre-B?tC,we examined the expres-sion and ultrastructure distribution of cofilin in pre-B?tC neurons of normoxic(NOR)and acute intermittent hypoxic(AIH)rats by combining Western blot,RT-qPCR,immunofluorescence,and immunoelectron microscopy.Results:Cofilin was expressed in the nuclei,somata and dendrites of NK1R-positive neurons in the pre-B?tC and its expression decreased after AIH intervention in this region detected.The results of immunoelectron microscopy showed that cofilin was expressed in the dendritic spines and postsynaptic filamentous or flocculent structures of pre-B?tC neurons.A total of 317 synapses were detected in pre-B?tC(NOR:122;AIH:195).In the NOR group,65.6％of the postsynaptic had cofilin expression,while in the AIH group,the proportion decreased to 47.2％.Combining with the role of cofilin in the regulation of actin severing,it is suggested that the severing effect of cofilin on postsynaptic actin is weakened af-ter AIH intervention,which may further enhance the postsynaptic mitochondrial anchoring.Conclusion:Cofilin,an ac-tin binding protein,plays a crucial role in regulating shearing and depolymerization of actin.Decreased cofilin expres-sion induced by AIH suggests an enhanced actin polymerization,which may be involved in the postsynaptic anchoring of mitochondria and the regulation of synaptic plasticity in the pre-B?tC.

Objective To investigate the clinical effect of hemorrhoidal artery ligation combined with ultrasonic knife resection,suture,ligature and suspension in the treatment of mixed hemorrhoids with annular prolapse.Methods A retrospective analysis was conducted to select 80 patients with annular prolapse mixed hemorrhoids admitted to the anorectal Department of our hospital from January 2022 to April 2023.According to different treatment plans,they were divided into control group(n=40 cases)who received external stripping and internal ligation combined with tape ligation,and study group(n=40 cases)who received hemorrhoidal artery ligation combined with ultrasonic knife resection,suture,ligation and suspension.The operative effect,operative status,postoperative anal pain,anal edema,stool blood score and quality of life were evaluated.Results The effective rate of the study group was 97.50％,which was higher than that of the control group(77.50％)(P＜0.05).The operation time,intraoperative blood loss,hospital stay and wound healing time of the research group were(25.03±10.00)minutes,(10.00±5.32)ml,(7.25±1.54)days and(12.21±2.00)days respectively.[is better than that of control group(29.85±14.00)minutes,ml(17.85±10.25),(11.87±2.35),(18.89±4.85)days],two groups of comparison,the difference was statistically significant(P＜0.05).The VAS scores of anal pain in the study group on 1 day,3 days and 7 days after the operation were(4.25±0.85)points,(2.89±0.54)points and(2.00±0.30)points,respectively.The scores of perianal edema were(1.87±0.36)points,(1.41±0.30)points,and(1.00±0.20)points,respectively.The hematochezia scores were(1.85±0.21)points,(1.34±0.18)points,and(0.85±0.13)points,respectively.Which were better than that of control group[(7.56±1.10),(6.54±1.03),(4.87±1.00)][(2.40±0.58),(2.03±0.49),(1.87±0.45)][(2.45±0.55),(2.03±0.47),(1.88±0.25)],and the differences were statistically significant(P＜0.05).The recurrence rate was 2.50％in the study group and 17.50％in the control group(P＜0.05).The scores of SF,MH,PF and GH of the Modified Health Survey Summary Form(SF-36)in the study group were(88.54±10.22,87.87±10.58,88.97±10.00,89.95±10.05)higher than those of the control group(67.52±10.00,70.10±11.25,71.10±9.85,70.00±10.00)(P＜0.05).Conclusion Hemorrhoidal artery ligation combined with ultrasonic knife resection,suture,ligature and suspension in the treatment of patients with annular prolapse mixed hemorrhoids has ideal surgical effect and little trauma,which is beneficial to promoting postoperative rehabilitation,alleviating anal pain,improving anal edema and hematostoecium,and improving quality of life.

Objective:To explore the expression and ultrastructure distribution of cofilin and its potential mecha-nisms in postsynaptic mitochondrial anchoring and synaptic plasticity in the pre-B?tzinger complex(pre-B?tC)in rats.Methods:Using neurokinin 1 receptor(NK1R)as a morphological marker of the pre-B?tC,we examined the expres-sion and ultrastructure distribution of cofilin in pre-B?tC neurons of normoxic(NOR)and acute intermittent hypoxic(AIH)rats by combining Western blot,RT-qPCR,immunofluorescence,and immunoelectron microscopy.Results:Cofilin was expressed in the nuclei,somata and dendrites of NK1R-positive neurons in the pre-B?tC and its expression decreased after AIH intervention in this region detected.The results of immunoelectron microscopy showed that cofilin was expressed in the dendritic spines and postsynaptic filamentous or flocculent structures of pre-B?tC neurons.A total of 317 synapses were detected in pre-B?tC(NOR:122;AIH:195).In the NOR group,65.6％of the postsynaptic had cofilin expression,while in the AIH group,the proportion decreased to 47.2％.Combining with the role of cofilin in the regulation of actin severing,it is suggested that the severing effect of cofilin on postsynaptic actin is weakened af-ter AIH intervention,which may further enhance the postsynaptic mitochondrial anchoring.Conclusion:Cofilin,an ac-tin binding protein,plays a crucial role in regulating shearing and depolymerization of actin.Decreased cofilin expres-sion induced by AIH suggests an enhanced actin polymerization,which may be involved in the postsynaptic anchoring of mitochondria and the regulation of synaptic plasticity in the pre-B?tC.

Objective To investigate the clinical effect of hemorrhoidal artery ligation combined with ultrasonic knife resection,suture,ligature and suspension in the treatment of mixed hemorrhoids with annular prolapse.Methods A retrospective analysis was conducted to select 80 patients with annular prolapse mixed hemorrhoids admitted to the anorectal Department of our hospital from January 2022 to April 2023.According to different treatment plans,they were divided into control group(n=40 cases)who received external stripping and internal ligation combined with tape ligation,and study group(n=40 cases)who received hemorrhoidal artery ligation combined with ultrasonic knife resection,suture,ligation and suspension.The operative effect,operative status,postoperative anal pain,anal edema,stool blood score and quality of life were evaluated.Results The effective rate of the study group was 97.50％,which was higher than that of the control group(77.50％)(P＜0.05).The operation time,intraoperative blood loss,hospital stay and wound healing time of the research group were(25.03±10.00)minutes,(10.00±5.32)ml,(7.25±1.54)days and(12.21±2.00)days respectively.[is better than that of control group(29.85±14.00)minutes,ml(17.85±10.25),(11.87±2.35),(18.89±4.85)days],two groups of comparison,the difference was statistically significant(P＜0.05).The VAS scores of anal pain in the study group on 1 day,3 days and 7 days after the operation were(4.25±0.85)points,(2.89±0.54)points and(2.00±0.30)points,respectively.The scores of perianal edema were(1.87±0.36)points,(1.41±0.30)points,and(1.00±0.20)points,respectively.The hematochezia scores were(1.85±0.21)points,(1.34±0.18)points,and(0.85±0.13)points,respectively.Which were better than that of control group[(7.56±1.10),(6.54±1.03),(4.87±1.00)][(2.40±0.58),(2.03±0.49),(1.87±0.45)][(2.45±0.55),(2.03±0.47),(1.88±0.25)],and the differences were statistically significant(P＜0.05).The recurrence rate was 2.50％in the study group and 17.50％in the control group(P＜0.05).The scores of SF,MH,PF and GH of the Modified Health Survey Summary Form(SF-36)in the study group were(88.54±10.22,87.87±10.58,88.97±10.00,89.95±10.05)higher than those of the control group(67.52±10.00,70.10±11.25,71.10±9.85,70.00±10.00)(P＜0.05).Conclusion Hemorrhoidal artery ligation combined with ultrasonic knife resection,suture,ligature and suspension in the treatment of patients with annular prolapse mixed hemorrhoids has ideal surgical effect and little trauma,which is beneficial to promoting postoperative rehabilitation,alleviating anal pain,improving anal edema and hematostoecium,and improving quality of life.

Objective To explore the current status,hotspots and trends of research on the TCM regulation of cellular autophagy;To provide reference for related research.Methods The literature related to the TCM regulation of cellular autophagy was retrieved from CNKI,Wanfang Data,VIP and CBM from the establishment of the databases to December 31,2022.Authors and institutional collaboration networks were drawn using CiteSpace 5.7.R5.keywords emergence analysis and timeline view were drawn.VOSviewer 1.6.18 software was used to draw keyword co-occurrence mapping.Results A total of 2 001 articles were included,with a general upward trend in the number of publications.The cooperation teams were mainly represented by Jia Lianqun,Yang Guanlin,Song Nan and others.Research institutions with more publications included Hunan University of Chinese Medicine,Liaoning University of Chinese Medicine,and Guangzhou University of Chinese Medicine.The keywords of the literature formed 9 meaningful clusters,showing that the research hotspots in this field mainly focused on apoptosis,mitochondrial autophagy,experimental studies,signaling pathways,and herbal monomers,etc.TCM interventions that attracted much attention included electroacupuncture,moxibustion,resveratrol,curcumin,etc,mainly involving PI3K/Akt,AMPK/mTOR and other signaling pathways.Conclusion The research on cellular autophagy in the field of TCM has been highly popular in recent years.Experimental studies,molecular mechanisms,related diseases,and TCM intervention are the research hotspots in this field.The research trend is dominated by TCM monomer,TCM theory research and other directions,mainly focusing on apoptosis,oxidative stress and other pathways to carry out extensive research.

Objective To explore the mechanism of Marsdenia tenacissima in the treatment of breast cancer through network pharmacology and experimental verification.Methods Literature retrieval was conducted to obtain the active components of Marsdenia tenacissima.The SwissTargetPrediction database was used to predict the potential targets of these active components.Targets of breast cancer were obtained from GeneCards,GEPIA2,OMIM,PharmGKB and TTD databases.The intersection targets were obtained,and a Marsdenia tenacissima-breast cancer-targets network was constructed using Cytoscape 3.9.0 software.The core targets were identified through protein-protein interaction(PPI)network analysis,followed by GO and KEGG pathway enrichment analysis to screen relevant signaling pathways.Molecular docking validation was performed for the top 10 key targets and major active components.The human breast cancer cell line MDA-MB-231 was treated with Marsdenia tenacissima injection in vitro.Cell proliferation ability was detected by CCK-8 assay and colony formation assay.Cell apoptosis was detected by Calcein-AM/PI staining and flow cytometry.Cell migration ability was detected by Transwell assay.Western blot experiment was used to validate the PI3K-AKT signaling pathway.Results Totally 37 active components and 276 potential targets against breast cancer were screened from Marsdenia tenacissima,including 11alpha-O-Benzoyl-12beta-O-acetyl tenacigenin B,Caffeic acid,Drevogenin A and Kaempferol.25 core targets were screened by PPI network such as AKT1,EGFR,TNF,CTNNB1 and IL-6,which mainly affected the estrogen signaling pathway,ErbB signaling pathway,HIF-1 signaling pathway and PI3K-AKT signaling pathway,etc.The molecular docking results showed that the main active components of Marsdenia tenacissima exhibited good binding activities with the core targets AKT1,ALB,CASP3,ESR1 and TNF.The results of in vitro experiments showed that Marsdenia tenacissima injection could inhibit the proliferation and migration ability of MDA-MB-231 cells(P<0.01,P<0.001)and induce apoptosis(P<0.001),as well as inhibit the activation of PI3K-AKT signaling pathway(P<0.05,P<0.01).Conclusion Marsdenia tenacissima may exert its anti-breast cancer effects through multiple targets and pathways,and the mechanism may be related to the inhibition of PI3K-AKT signaling pathway.

Objective To observe the effects of Guanxinning tablet on atherosclerotic plaque,renal function,hemorheology,blood homocysteine(Hcy)and immunoinflammation in patients with blood stasis type chronic renal failure complicated by hemodialysis and carotid atherosclerosis.Methods According to the diagnosis,inclusion and exclusion criteria,67 patients with blood stasis type chronic renal failure complicated with carotid atherosclerosis and undergoing hemodialysis from Lishui Second People's Hospital and Lishui Hospital of Traditional Chinese Medicine from January 2023 to January 2024 were selected and randomly divided into control group(33 cases)and observation group(34 cases).The control group received routine treatment of chronic renal failure and hemodialysis.In the observation group,Guanxinning tablet was added to the basic treatment,and the levels of carotid atherosclerotic plaque,renal function,hemorheology,blood Hcy and immunoinflammation were detected in both groups before and after treatment.Results There were no significant differences in general information,carotid atherosclerotic plaque,renal function,hemorheology,blood Hcy level and immunoinflammation level between the two groups before treatment(P>0.05).After treatment,the observation group was superior to the control group in reducing carotid plaque,improving carotid intimedia thickening,improving renal function,reducing inflammatory index level and improving immune function(P<0.05),but there was no significant difference in reducing blood Hcy level compared with the control group(P>0.05).Conclusion Guanxinning tablet can improve the chronic inflammation in the body of patients with blood stasis type chronic renal failure combined with hemodialysis and carotid atherosclerosis,reduce blood viscosity,inhibit red blood cell aggregation,thereby improving carotid atherosclerosis,reducing carotid atherosclerotic plaque,improving renal function and improving immune function of patients,but does not reduce blood Hcy level.

Objective To investigate the effects of bone marrow mesenchymal stem cell-derived exosomes(BMSCs-Exo)on the regulation of epithelia-mesenchymal transition(EMT)in human peritoneal mesothelial cells(HPMCs)treated with glucose-based peritoneal dialysis fluid(PDF).Methods BMSCs-Exo were verified by transmission electron microscopy(TEM),nanoparticle tracking analyzer(NTA)and Western blot.Cultured HPMCs(HMrSV5)were divided into 5 groups;control group,high glucose-based PDF(1.5％,2.5％,and 4.25％)group,siNLRP3 group,siNC group and BMSCs-Exo treated group.Expression of E-cadherin,vimentin,α-smooth muscle actin(α-SMA)and NLRP3 inflammasome-related proteins were detected by Western blot.Real time RT-PCR was used to detected the expression of α-SMA,E-cadherin and TGF-β1 mRNAs in HMrSV5 cells.The concentration of TGF-β1,IL-1 β and IL-18 in the culture supernatant was determined by ELISA.Results The exosomes isolated were spherical and double-membrane vesicles with 40-150 nm in diameter,which expressed CD9,CD81,TSG101 and Alix protein.Our results showed that the level of α-SMA and vimentin were significantly up-regulated and E-cadherin(epithelial marker)was significantly decreased in HMrSV5 cells treated with high glucose PDF com-pared with the normal HMrSV5 cells.The expression of NLRP3,pro-caspase-1 and pro-IL-1β were also significantly up-regulated in HMrSV5 cells treated with high glucose PDF compared with the normal HMrSV5 cells.The level of TGF-β1,IL-1 β and IL-18 in high glucose PDF treated HMrSV5 cells culture supernatant was up-regulated in a dose dependent manner.The protein level of α-SMA was decreased and E-cadherin level was increased by an NLRP3 siRNA to inhibit the activation of NLRP3.Compared with 4.25％PDF treated cells,E-cadherin expression was up-regulated,while the expression of α-SMA and vimentin were down-regulated in BMSCs-Exo treatment cells(P＜0.05).Furthermore,the protein expression of NLRP3,pro-caspase-1 and pro-IL-1β in 4.25％PDF-treated HMrSV5 cells were significantly reduced by BMSCs-Exo.BMSCs-Exo also reduced the level of TGF-β1,IL-1 β and IL-8 in the 4.25％PDF-treated HMrSV5 cells culture supernatants(P＜0.05).Conclusions High glucose PDF-induced EMT in HPMCs might be mediated by NLRP3 inflammatory signaling pathway,which can be inhibited by BMSCs-Exo.

Objective:To analyze the clinical characteristics of patients undergoing extracorporeal cardiopulmonary resuscitation (ECPR), and to explore the risk factors leading to poor prognosis.Methods:The clinical data of 95 patients with ECPR admitted to the First Affiliated Hospital of Zhengzhou University from January 2020 to May 2023 were retrospectively analyzed. According to the survival status at the time of discharge, the patients were divided into the survival group and death group. The difference of clinical data between the two groups was compared to explore the risk factors related to death and poor prognosis. Risk factors associated with death were identified by Binary Logistic regression analysis. Results:A total of 95 patients with ECPR were included in this study, 62 (65.3%) died and 33 (34.7%) survived at discharge. Patients in the death group had longer low blood flow time [40 (30, 52.5) min vs. 30 (24.5, 40) min ] and total cardiac arrest time[40 (30, 52.5) min vs. 30(24.5, 40) min], shorter total hospital stay [3 (2, 7.25) d vs. 19 (13.5, 31) d] and extracorporeal membrane oxygenation (ECMO) assisted time [26.5 (17, 50) h vs. 62 (44, 80.5) h], and more IHCA patients (56.5% vs. 33.3%) and less had spontaneous rhythm recovery before ECMO (37.1% vs. 84.8%). Initial lactate value [(14.008 ± 5.188) mmol/L vs.(11.23 ± 4.718) mmol/L], APACHEⅡ score [(30.10 ± 7.45) vs. (25.88 ± 7.68)] and SOFA score [12 (10.75, 16) vs. 10 (9.5, 13)] were higher ( P< 0.05). Conclusions:No spontaneous rhythm recovery before ECMO, high initial lactic acid and high SOFA score are independent risk factors for poor prognosis in ECPR patients.