This paper introduces the clinical experience of Professor AN Junming in treating spinal cord injury(SCI)with FANG's scalp acupuncture plus body acupuncture.Professor AN Junming holds that the key pathogenesis of SCI should be"deficient kidney and cold Governor Vessel",and the treatment should target the axis of"brain-Governor Vessel-kidney-Conception Vessel".SCI will definitely cause damage to the Governor Vessel and the counterflow of Qi and blood.Hence,treating SCI with acupuncture-moxibustion should unblock the Governor Vessel and strengthen Yang.The kidney and the Governor Vessel mutually benefit and support each other.After SCI,the kidney essence is weakened and damaged,and the kidney Yang is deficient.Thus,warming and tonifying kidney Yang should be the key to the treatment.Further,as the Governor Vessel is injured,the disease of Yang will gradually affect Yin,and the Conception Vessel will consequently get involved over time.Therefore,in the treatment,points from the Conception and Governor Vessels should be selected simultaneously to"treat Yang from Yin"and balance Yin and Yang.Based on the above considerations,Professor AN Junming usually treats SCI with FANG's scalp acupuncture plus body acupuncture to unblock the Conception and Governor Vessels,supplement the kidney and marrow,harmonize Qi and blood,and balance Yin and Yang,providing novel ideas and methods for clinical treatment.

Objective:To evaluate the safety and efficacy of mild hypothermia arch-clamping technique in the surgical treatment of DeBakey Type Ⅰ aortic dissection.Methods:From December 2019 to November 2023, a total of 97 patients with DeBakey type Ⅰ aortic dissection who underwent arch-clamping technique in Beijing Anzhen Hospital were prospectively enrolled. The patients were divided into mild hypothermia group and moderate hypothermia group according to the lowest rectal temperature during the circulatory arrest period. The perioperative data of the two groups were compared, and complex adverse outcomes consisting of 30-day death, stroke, paraplegia and CRRT were used as the primary endpoint. Multivariate logistic regression was used to determine the predictors of clinical adverse outcomes. Survival analysis was evaluated by the Kaplan- Meier method. Results:The overall incidence of complex adverse outcomes was 20.6%, 13.6% in the mild hypothermia group and 22.7% in the moderate hypothermia group( P=0.535), and the incidence of stroke was 4.6% and 6.7%( P=1.000), respectively. The cardiopulmonary bypass time and aortic-clamping time in the mild hypothermia group were significantly shortened (147.5 min vs. 163.0 min, P=0.032; 89 min vs. 99 min, P=0.042). There was no significant difference in long-term survival and reintervention between the two groups(91.9% vs. 89.3%, P=0.87; 9.1% vs. 5.3%, P=0.13). Conclusion:Mild hypothermia arch-clamping technique is a safe and effective method for the treatment of DeBakey type Ⅰ aortic dissection, with satisfactory short-term and long-term efficacy.

Objective:To explore and model risk factors in patients with major adverse cardiovascular events (MACEs) after acute type A aortic dissection (ATAAD), and to develop and validate a personalized machine learning model to assess risk factors and predict MACEs in these patients.Methods:Clinical data of patients who attended Beijing Anzhen Hospital and underwent surgical treatment for ATAAD from January 2018 to October 2022 were retrospectively analyzed. Using MACEs as the endpoint, 70% of these patients were randomly divided into the training set and the remaining 30% into the validation set. LASSO regression was applied to explore key clinical variables in the training set. The optimal predictive model was selected from nine machine learning algorithms based on area under the curve. And Shapley Additive explanations was used to elucidate the predictive model. Results:Of the 481 patients included in this study, 135 (35.6%) patients experienced an endpoint event. By combining the results of the training and validation sets, when assessing the validity of the single model with the highest predictive accuracy for the outcome, it was shown that the logistic model (0.774, 95% CI: 0.717-0.830) was the most effective in the combined effect and had a high model accuracy (0.743, 95% CI: 0.720-0.766). According to the results of the LASSO, the factors most associated with postoperative MACEs were history of cerebrovascular disease, coronary artery involvement, shock status on admission to the operating room, FDP, PLT, CPB, ascending aortic clamping, and age. Conclusion:In this study, nine machine learning models were developed to predict the occurrence of postoperative MACEs in patients with acute type A aortic dissection. The logistic model performed significantly better compared to other algorithms. Our study successfully predicted postoperative MACES and identified the factors most associated with MACEs.

Objective:To analyze the different expression of neutrophil's protein from the patients with active pulmonary tuber-culosis(TB)and healthy controls(HC)from the perspective of proteomics,and to explore the diagnosis of the secreted proteins related to neutrophil activation in serum.Methods:Neutrophil protein in peripheral blood of 15 patients with TB and 15 HC was identified by label free quantitative proteomics,which were further validated in by ELISA and nephelometry.Results:A total of 358 differentially expressed proteins were identified in our study,54 differentially expressed proteins related to neutrophil activation or degranulation were focused,and seven proteins AHSG,AACT,C3,AAT,AAG,HP and A1BG were validated in 40 TB patients and 40 HC,and the results confirmed that the following proteins were highly expressed in the serum of the TB group:AACT,C3,AAT,AAG,HP and A1BG,while AHSG was lowly expressed,and only the validation results of AHSG were consistent with the trend of proteomics results.In addition,we further investigated the expression level of AHSG in the diagnosis of 24 patients with active pulmonary TB,24 patients with lung cancer,24 HC,and 16 patients with latent tuberculosis infection(LTBI),and found the expression of AHSG was down-regu-lated in TB group compared with the other groups.The sensitivity and specificity of AHSG in differentiating TB patients from HC patients,lung cancer patients,LTBI patients and non-TB patients in the test set were 83.33%,79.17%;78.00%,91.67%;75.00%,87.50%;75.00%,85.94%.Conclusion:Proteomic profiles of neutrophils from TB and HC are obtained from a proteomic perspective,and further validation shows that AHSG has a good differential diagnostic ability for HC,lung cancer and LTBI.

Objective To investigate the efficiency and mechanism of C1q tumor necrosis factor-related protein 3(CTRP3)on reprogramming of cardiac fibroblasts(CFs)into induced cardiomyocyte-like cells(iCMs)by Sendai virus(SeV)vector overexpressing Gata4,Mef2c and Tbx5(SeVGMT).Methods CFs were divided into Control,NC-Lv,CTRP3-Lv,NC-sh,and CTRP3-sh groups.NC-Lv,CTRP3-Lv,NC-sh,and CTRP3-sh were transfected into CFs using Lipofectamine 3000 reagent for 48 hours.Lipofectamine 3000 reagent was then mixed with SeVGMT and incubated at room temperature for 48 hours,the culture medium was then replaced,and cells were cultured for 21 days.Cell morphology was observed under a microscope at 0,3,7,14,and 21 days.Expression levels of the myocardial-specific proteins α-myosin heavy chain(α-MHC),α-actin,cardiac troponin T(cTnT),connexin 43(Cx43),cardiac muscle α-actin(Actc1),and myosin heavy chain 6(Myh6)were detected at different time points by immunofluorescence,quantitative reverse transcription-polymerase chain reaction,and Western blot,and the proportions of beating cells at different time points were calculated.Results The relative fluorescence intensity and mRNA and protein levels of α-MHC,α-actin,cTnT,Cx43,Actc1,and Myh6 in CFs in each group increased with increasing culture time(P＜0.05),with significantly higher expression levels of myocardial-specific proteins at 14 days of culture than at 7 days(P＜0.05).The relative fluorescence intensities and mRNA and protein levels of α-MHC,α-actin,cTnT,Cx43,Actc1,and Myh6 in CFs at 3,7,14,and 21 days of culture were significantly increased in the CTRP3-Lv group compared with the NC-Lv group(P＜0.05),but were significantly decreased in CFs in the CTRP3-sh group compared with the NC-sh group(P＜0.05).Beating cells appeared in CFs in each group at 7 days of culture.The proportion of beating cells in each group increased with increasing culture time(P＜0.05),and the proportion was significantly higher at 14 days than at 7 days(P＜0.05).The proportion of beating cells among CFs was increased in the CTRP3-Lv group at 7,14,and 21 days of culture compared with the NC-Lv group(P＜0.05),while the proportion of beating cells in the CTRP3-sh group was decreased compared with the NC-sh group(P＜0.05).Conclusions CTRP3 can enhance SeVGMT reprogramming of CFs into iCMs.

This paper introduces the clinical experience of Professor AN Junming in treating spinal cord injury(SCI)with FANG's scalp acupuncture plus body acupuncture.Professor AN Junming holds that the key pathogenesis of SCI should be"deficient kidney and cold Governor Vessel",and the treatment should target the axis of"brain-Governor Vessel-kidney-Conception Vessel".SCI will definitely cause damage to the Governor Vessel and the counterflow of Qi and blood.Hence,treating SCI with acupuncture-moxibustion should unblock the Governor Vessel and strengthen Yang.The kidney and the Governor Vessel mutually benefit and support each other.After SCI,the kidney essence is weakened and damaged,and the kidney Yang is deficient.Thus,warming and tonifying kidney Yang should be the key to the treatment.Further,as the Governor Vessel is injured,the disease of Yang will gradually affect Yin,and the Conception Vessel will consequently get involved over time.Therefore,in the treatment,points from the Conception and Governor Vessels should be selected simultaneously to"treat Yang from Yin"and balance Yin and Yang.Based on the above considerations,Professor AN Junming usually treats SCI with FANG's scalp acupuncture plus body acupuncture to unblock the Conception and Governor Vessels,supplement the kidney and marrow,harmonize Qi and blood,and balance Yin and Yang,providing novel ideas and methods for clinical treatment.

Objective:To analyze the different expression of neutrophil's protein from the patients with active pulmonary tuber-culosis(TB)and healthy controls(HC)from the perspective of proteomics,and to explore the diagnosis of the secreted proteins related to neutrophil activation in serum.Methods:Neutrophil protein in peripheral blood of 15 patients with TB and 15 HC was identified by label free quantitative proteomics,which were further validated in by ELISA and nephelometry.Results:A total of 358 differentially expressed proteins were identified in our study,54 differentially expressed proteins related to neutrophil activation or degranulation were focused,and seven proteins AHSG,AACT,C3,AAT,AAG,HP and A1BG were validated in 40 TB patients and 40 HC,and the results confirmed that the following proteins were highly expressed in the serum of the TB group:AACT,C3,AAT,AAG,HP and A1BG,while AHSG was lowly expressed,and only the validation results of AHSG were consistent with the trend of proteomics results.In addition,we further investigated the expression level of AHSG in the diagnosis of 24 patients with active pulmonary TB,24 patients with lung cancer,24 HC,and 16 patients with latent tuberculosis infection(LTBI),and found the expression of AHSG was down-regu-lated in TB group compared with the other groups.The sensitivity and specificity of AHSG in differentiating TB patients from HC patients,lung cancer patients,LTBI patients and non-TB patients in the test set were 83.33%,79.17%;78.00%,91.67%;75.00%,87.50%;75.00%,85.94%.Conclusion:Proteomic profiles of neutrophils from TB and HC are obtained from a proteomic perspective,and further validation shows that AHSG has a good differential diagnostic ability for HC,lung cancer and LTBI.

Objective To investigate the efficiency and mechanism of C1q tumor necrosis factor-related protein 3(CTRP3)on reprogramming of cardiac fibroblasts(CFs)into induced cardiomyocyte-like cells(iCMs)by Sendai virus(SeV)vector overexpressing Gata4,Mef2c and Tbx5(SeVGMT).Methods CFs were divided into Control,NC-Lv,CTRP3-Lv,NC-sh,and CTRP3-sh groups.NC-Lv,CTRP3-Lv,NC-sh,and CTRP3-sh were transfected into CFs using Lipofectamine 3000 reagent for 48 hours.Lipofectamine 3000 reagent was then mixed with SeVGMT and incubated at room temperature for 48 hours,the culture medium was then replaced,and cells were cultured for 21 days.Cell morphology was observed under a microscope at 0,3,7,14,and 21 days.Expression levels of the myocardial-specific proteins α-myosin heavy chain(α-MHC),α-actin,cardiac troponin T(cTnT),connexin 43(Cx43),cardiac muscle α-actin(Actc1),and myosin heavy chain 6(Myh6)were detected at different time points by immunofluorescence,quantitative reverse transcription-polymerase chain reaction,and Western blot,and the proportions of beating cells at different time points were calculated.Results The relative fluorescence intensity and mRNA and protein levels of α-MHC,α-actin,cTnT,Cx43,Actc1,and Myh6 in CFs in each group increased with increasing culture time(P＜0.05),with significantly higher expression levels of myocardial-specific proteins at 14 days of culture than at 7 days(P＜0.05).The relative fluorescence intensities and mRNA and protein levels of α-MHC,α-actin,cTnT,Cx43,Actc1,and Myh6 in CFs at 3,7,14,and 21 days of culture were significantly increased in the CTRP3-Lv group compared with the NC-Lv group(P＜0.05),but were significantly decreased in CFs in the CTRP3-sh group compared with the NC-sh group(P＜0.05).Beating cells appeared in CFs in each group at 7 days of culture.The proportion of beating cells in each group increased with increasing culture time(P＜0.05),and the proportion was significantly higher at 14 days than at 7 days(P＜0.05).The proportion of beating cells among CFs was increased in the CTRP3-Lv group at 7,14,and 21 days of culture compared with the NC-Lv group(P＜0.05),while the proportion of beating cells in the CTRP3-sh group was decreased compared with the NC-sh group(P＜0.05).Conclusions CTRP3 can enhance SeVGMT reprogramming of CFs into iCMs.

Objective:To evaluate the safety and efficacy of mild hypothermia arch-clamping technique in the surgical treatment of DeBakey Type Ⅰ aortic dissection.Methods:From December 2019 to November 2023, a total of 97 patients with DeBakey type Ⅰ aortic dissection who underwent arch-clamping technique in Beijing Anzhen Hospital were prospectively enrolled. The patients were divided into mild hypothermia group and moderate hypothermia group according to the lowest rectal temperature during the circulatory arrest period. The perioperative data of the two groups were compared, and complex adverse outcomes consisting of 30-day death, stroke, paraplegia and CRRT were used as the primary endpoint. Multivariate logistic regression was used to determine the predictors of clinical adverse outcomes. Survival analysis was evaluated by the Kaplan- Meier method. Results:The overall incidence of complex adverse outcomes was 20.6%, 13.6% in the mild hypothermia group and 22.7% in the moderate hypothermia group( P=0.535), and the incidence of stroke was 4.6% and 6.7%( P=1.000), respectively. The cardiopulmonary bypass time and aortic-clamping time in the mild hypothermia group were significantly shortened (147.5 min vs. 163.0 min, P=0.032; 89 min vs. 99 min, P=0.042). There was no significant difference in long-term survival and reintervention between the two groups(91.9% vs. 89.3%, P=0.87; 9.1% vs. 5.3%, P=0.13). Conclusion:Mild hypothermia arch-clamping technique is a safe and effective method for the treatment of DeBakey type Ⅰ aortic dissection, with satisfactory short-term and long-term efficacy.

Objective:To explore and model risk factors in patients with major adverse cardiovascular events (MACEs) after acute type A aortic dissection (ATAAD), and to develop and validate a personalized machine learning model to assess risk factors and predict MACEs in these patients.Methods:Clinical data of patients who attended Beijing Anzhen Hospital and underwent surgical treatment for ATAAD from January 2018 to October 2022 were retrospectively analyzed. Using MACEs as the endpoint, 70% of these patients were randomly divided into the training set and the remaining 30% into the validation set. LASSO regression was applied to explore key clinical variables in the training set. The optimal predictive model was selected from nine machine learning algorithms based on area under the curve. And Shapley Additive explanations was used to elucidate the predictive model. Results:Of the 481 patients included in this study, 135 (35.6%) patients experienced an endpoint event. By combining the results of the training and validation sets, when assessing the validity of the single model with the highest predictive accuracy for the outcome, it was shown that the logistic model (0.774, 95% CI: 0.717-0.830) was the most effective in the combined effect and had a high model accuracy (0.743, 95% CI: 0.720-0.766). According to the results of the LASSO, the factors most associated with postoperative MACEs were history of cerebrovascular disease, coronary artery involvement, shock status on admission to the operating room, FDP, PLT, CPB, ascending aortic clamping, and age. Conclusion:In this study, nine machine learning models were developed to predict the occurrence of postoperative MACEs in patients with acute type A aortic dissection. The logistic model performed significantly better compared to other algorithms. Our study successfully predicted postoperative MACES and identified the factors most associated with MACEs.