Objective To explore the valve regurgitation status of left heart after the implantation of left ventricular assist device (LVAD) and its effect on prognosis of patients with LVAD implantation. Methods A total of 35 patients with cardiomyopathy who underwent magnetic levitation LVAD implantation at Zhongshan Hospital, Fudan University from February 2021 to July 2024 were retrospectively selected. Clinical data during hospitalization were collected, including preoperative basic data and postoperative valve regurgitation status. Telephone follow-ups were conducted to monitor patients’ survival status and transthoracic echocardiography was used to assess left valve function. Kaplan-Meier survival curves and log-rank test were employed to compare the survival rate of patients with different levels of valve regurgitation. Results The 35 patients had a mean age of (53.9±11.1) years, with 85.7% male, and 3 patients (8.6%) died during hospitalization. Preoperatively, 17 patients (48.6%) had moderate or greater mitral regurgitation, while all 35 patients had less than moderate aortic regurgitation. One month postoperatively, thirty patients were followed up, among which 24 patients (80%) had less than moderate mitral regurgitation, including 11 cases with alleviated regurgitation compared to pre-surgery; 6 patients (20%) had moderate or greater mitral regurgitation, including 4 cases with stable regurgitation and 2 cases with progression of regurgitation compared to pre-surgery; 2 patients (6.7%) had progression of aortic regurgitation to moderate or greater. The follow-up time was 1.2 (1.0, 2.1) years, with 1-year survival rate of 91.4% and 3-year survival rate of 71.1%. Survival analysis showed that the 3-year survival rate of patients with moderate or greater mitral regurgitation one month postoperatively was significantly lower than that of patients with less than moderate regurgitation (66.7% vs 83.3%, P＝0.046). Conclusions After the implantation of magnetic levitation LVAD, most patients showed improvement in mitral regurgitation, while aortic regurgitation remained unchanged. The degree of mitral regurgitation one month postoperatively is associated with prognosis.

With reference to the Information and Documentation-Resource Description (GB/T 3792-2021) and Bibliographical Description for Ancient Chinese Books (GB/T 3792.7-2008) and other cataloging standards and rules, drawing on the practical experience of cataloging ancient TCM books, Bibliographical Cataloging for Ancient TCM Books was formulated. This standard specifies the entry items and their order of ancient TCM books, cataloging identifier, cataloging text, cataloging information source, and cataloging item details. The standard can provide standardized and unified guiding principles and methods for the work of ancient TCM books, and promote the sharing and utilization of ancient TCM books.

Objective:To explore the therapeutic effect of compound Kuijie Ankang Decoction on ulcerative colitis (UC) model mice by non targeted metabonomics; To explore its mechanism.Compound Kuijie Ankang.Methods:The mice were randomly divided into blank control group, model group, Kuijie Ankang Decoction group and sulfasalazine group, with 12 mice in each group. Except the blank control group, the other groups were given 1.5% DSS solution for free drinking to prepare UC model. After successful modeling, Kuijie Ankang Decoction group was intragastrically administered with compound Kuijie Ankang Decoction of 9.68 g/kg, sulfasalazine group was intragastrically administered with sulfasalazine capsule suspension of 320 mg/kg, model group and blank control group were intragastrically administered with equal volume of purified water, once a day, for 7 consecutive days. The body mass and disease activity index (DAI) score of mice were measured. ELISA was used to measure the levels of tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), interleukin-6 (IL-6), and interleukin-10 (IL-10) in the colon tissue of mice; the protein expressions of Claudin-1 and Zo-1 in colon tissue were detected by immunofluorescence method. HE staining was used to observe the pathological changes in the colon, and UHPLC-OE-MS technology was used to analyze the endogenous metabolite structure of mouse colon tissue, differential metabolites and related metabolic pathways were screened.Results:Compared with the model group, the colon length in Kuijie Ankang Decoction group and sulfasalazine group increased ( P<0.01), the DAI score decreased ( P<0.01), the levels of TNF-α, IL-1β and IL-6 in colon tissue decreased ( P<0.01), the level of IL-10 increased ( P<0.01), and the average optical density of Claudin-1 and Zo-1 protein increased ( P<0.01 or P<0.05). Metabolomics analysis identified 26 potential differential metabolites, including nicotinamide adenine dinucleotide, guanine, gamma aminobutyric acid, and thiamine, affecting 26 key metabolic pathways, including lysine biosynthesis, thiamine metabolism, cysteine and methionine metabolism. Conclusion:Kuaijie Ankang Decoction may improve metabolites such as Gamma aminobutyric acid and thiamine through metabolic pathways such as lysine biosynthesis to alleviate inflammatory reactions, thereby exerting therapeutic effects on ulcerative colitis in mice.

Objective To explore the efficacy of endoscopic therapy for esophageal and gastric variceal bleeding(EGVB),investigate the risk factors for rebleeding within 1 year,and establish a predictive model accordingly.Methods A retrospective study was conducted using the clinical and follow-up data of 120 EGVB patients who underwent endoscopy at our hospital between January 2021 and December 2022.The efficacy of endoscopic therapy was analyzed,and the patients were divided into a bleeding group and a non-bleeding group based on whether rebleeding occurred within 1 year after treatment.The factors influencing rebleeding within 1 year after treatment were analyzed,and a predictive model was established using logistic regression analysis.The model's goodness of fit was evaluated using the Hosmer-Lemeshow test,and its clinical value was analyzed using the receiver operating characteristic(ROC)curve.Results The hemostasis success rate within 72 hours after endoscopic therapy was 100％in all 120 patients.Four weeks after endoscopic treatment,endoscopic reexamination showed that the complete and partial disappearance rate of varices was 75.83％(91/120),with rebleeding occurring in 10 cases(8.33％).There were 34 cases(28.33％)of cumulative rebleeding at 6 months and 63 cases(52.50％)at 1 year after endoscopic therapy.Nine patients(7.50％)died within 1 year after endoscopic therapy,all of whom were rebleeding cases.A total of 63 patients with rebleeding were included in the bleeding group,and 57 patients without rebleeding were included in the non-bleeding group.Serum sodium＜135 mmol/L(odds ratio[OR]=3.837,95％confidence interval[CI]:1.095-13.445),Child-Pugh grade C(OR=3.835,95％CI:1.137-12.935),esophageal varices degree G3(OR=5.113,95％CI:1.565-16.707),and main portal vein diameter＞12 mm(OR=5.964,95％CI:2.295-15.497)were identified as risk factors of rebleeding within 1 year after endoscopic therapy in EGVB patients(P＜0.05).The risk prediction model for rebleeding within 1 year after endoscopic therapy in EGVB patients was shown as P=1/{1+e[-(-3.815+1.345×serum sodium+1.344×Child-Pugh grade+1.786×main portal vein diameter+1.632×esophageal varices degree)]}.The Hosmer-Lemeshow x2 was 3.158(P=0.856).The area under the curve(AUC)for predicting rebleeding within 1 year after endoscopic therapy in EGVB patients was 0.815,indicating good predictive performance.Clinical validation showed that the model had an accuracy of 82.30％,with sensitivity and specificity being 81.03％and 83.63％,respectively.Conclusion Endoscopic therapy for EGVB achieves a high rate of acute bleeding control,but patients remain at risk of rebleeding.Rebleeding is associated with serum sodium＜135 mmol/L,Child-Pugh grade C,main portal vein diameter＞12 mm,and esophageal varices degree G3.The logistic regression model can effectively predict the probability of rebleeding within 1 year after endoscopic therapy.

Objective:To investigate the protective effect of prunetin on the neurons in the rats with cerebral ischemia reperfusion injury(CIRI),and to clarify its possible mechanisms.Methods:Thirty-six SD rats were randomly divided into sham operation group,model group,low dose of prunetin group(3.5 mg·kg-1),medium dose of prunetin group(7.0 mg·kg-1),high dose of prunetin group(14.0 mg·kg-1),and positive drug edaravone(Eda)group(n=6).Zealonga method was used to evaluate the neurological function damage of the rats in various groups;open field experiment was used to evaluate the autonomous motor function;Triphenyltetrazolium chlorde(TTC)staining was used to evaluate the areas of cerebral infarction of the rats in various groups;HE staining and Nissl staining were used to observe the pathomorphology of brain tissue of the rats in various groups.Additionally,twenty-one SD rats were randomly divided into sham operation group,model group,prunetin group,c-Jun N-terminal kinase(JNK)inhibitor group,p38 inhibitor group,JNK inhibitor+prunetin group,and p38 inhibitor+prunetin group(n=3).TUNEL staining was used to detect the positive rates of apoptosis of neurons of the rats in various groups;Western blotting method was used to detect the expression levels of apoptosis-related proteins and JNK/p38 signaling pathway-related proteins in brain tissue of cerebral infarction side of the rats in various groups.Results:Compared with sham operation group,the neurological deficit score of rats in model group was significantly increased(P＜0.001),the total motor distance was shortened(P＜0.001),and the ratio of cerebral infarction area was increased(P＜0.001).In sham group,the neuronal structure in the rat brain tissue was clear and well-organized,with an abundance of Nissl bodies and no apparent pathological changes observed.Compared with model group,the neurological deficit scores of the rats in medium and high doses of prunetin groups were decreased(P＜0.05),total motor distances of rats were increased(P＜0.05),and the cerebral infarction areas of rats were decreased(P＜0.05);the neurons showed disarrayed arrangement,cytoplasmic condensation,nuclear consolidation,and lysing and deletion of Nissl bodies were decreased.Compared with sham operation group,the positive rate of apoptosis of neurons in model group was significantly increased(P＜0.001),the expression level of B-cell lymphoma-2(Bcl-2),Bcl-2-associated X protein(Bax)and cleaved Caspase-3 proteins in brain tissue of the rats were significantly increased(P＜0.05 or P＜0.01).Compared with model group,the positive rats of apoptosis of neurons of the rats in prunetin group were decreased(P＜0.05),the expression level of Bcl-2 protein in brain tissue of the rats was increased(P＜0.001),and the expression levels of Bax and cleaved Caspase-3 proteins were significantly decreased(P＜0.05).Compared with inhibitor groups,the positive rates of apoptosis of neurons in inhibitor+prunetin groups were decreased(P＜0.01),and the expression levels of p-JNK and p-p38 proteins in brain tissue of the rats as well as the ratios of p-JNK/JNK and p-p38/p38 were decreased(P＜0.05).Conclusion:Prunetin has the effect of reducing the neurological function damage,decreasing the area of cerebral infarction,reducing the pathological damage,and inhibiting neuronal apoptosis in the rats,and its mechanism may be related to inhibiting neuronal apoptosis through regulating the JNK/p38 signaling pathway.

Objective:To discuss the protective effect of TUG-891 on ischemic stoke(IS)induced by ischemia-hypoxia,and to clarify its potential mechanism.Methods:A total of 60 healthy male C57BL/6 mice were randomly divided into sham operation group(n=20),model group[distal middle cerebral artery occlusion(dMCAO)group,n=20],and model+TUG-891 group(dMCAO+TUG-891 group,n=20).After modeling,the mice were intraperitoneally injected with TUG-891 solution(35 mg·kg?1·d?1)for 3 consecutive days.Modified neurological severity score(mNSS)and rotarod test were used to evaluate the neurological function of the mice in various groups;2,3,5-triphenyltetrazolium chloride(TTC)staining was used to observe the cerebral infarction volumes of the mice in various groups;biochemical method was used to detect the malondialdehyde(MDA)level and superoxide dismutase(SOD)activity in the supernatant of brain tissue of the mice in various groups;Hematoxylin-Eosin(HE)and NISSL staining were used to observe the pathomerphology of brain tissue of the mice in various groups;terminal deoxynucleotidyl transferase dUTP nick-end labeling(TUNEL)staining was used to detect the apoptotic indexes of neuronal cells in brain tissue of the mice in various groups;Western blotting method was used to detect the expression levels of glucose-regulated protein 78(GRP78),protein kinase R-like endoplasmic reticulum kinase(PERK),phosphorylated PERK(p-PERK),and C/EBP homologous protein(CHOP)proteins in brain tissue of the mice in various groups.Results:The mNSS and rotarod test results shoued that compared with sham operation group,the mNSS of the mice in dMCAO group was significantly increased(P<0.01),and the time on the rod was significantly decreased(P<0.01);compared with dMCAO group,the mNSS of the mice in dMCAO+TUG-891 group was decreased(P<0.05),and the time on the rod was increased(P<0.05).The TTC staining results shoued that compared with sham operation group,the volume of white infarct foci in the cerebral cortex of the mice in dMCAO group was increased(P<0.01);compared with dMCAO group,the cerebral infarction volume of the mice in dMCAO+TUG-891 group was significantly decreased(P<0.01).The HE staining results showed that compared with sham operation group,the cortex of the mice in dMCAO group was severely damaged,manifested by disordered arrangement of neuronal cells and obvious nuclear pyknosis in the infarct area,and the morphology of cortical infarct area of the mice in dMCAO+TUG-891 group was improved;the NISSL staining results showed that the Nissl bodies in the cortical infarct area of the mice in dMCAO group became thinner,elongated,and lost more.The pathological damage of brain tissue of the mice in dMCAO+TUG-891 group was significantly improved.Compared with sham operation group,the MDA level in brain tissue of the mice in model group was significantly increased(P<0.01),and the SOD activity was decreased(P<0.01);compared with model group,the MDA level in brain tissue of the mice in TUG-891 group was significantly decreased(P<0.01),and the SOD activity was significantly increased(P<0.01).The TUNEL staining results showed that compared with sham operation group,the apoptotic index of neuronal cells in brain tissue of the mice in dMCAO group was increased(P<0.01);compared with dMCAO group,the apoptotic index of neuronal cells in brain tissue of the mice in dMCAO+TUG-891 group was decreased(P<0.01).Compared with sham operation group,the expression levels of GRP78,p-PERK,and CHOP proteins in brain tissue of the mice in dMCAO group were increased(P<0.05);compared with dMCAO group,the expression levels of GRP78,p-PERK,and CHOP proteins in brain tissue of the mice in dMCAO+TUG-891 group were decreased(P<0.05).Conclusion:TUG-891 can alleviate neurological injury caused by ischemic stroke,and its mechanism may be related to the inhibition of endoplasmic reticulum stress and apoptosis.

As a type of acute cerebrovascular disease,stroke is one of the most common fatal and disabling diseases in the world,which seriously threatens the quality of life of patients;however,there are still limited treatment methods for this disease in clinical practice.Traditional Chinese medicine(TCM)has a long history and good efficacy in the treatment of stroke,and the active components of TCM can alleviate nerve injury caused by stroke by improving the development and progression of various pathophysiological mechanisms such as nerve inflammation,oxidative stress,and blood-brain barrier damage.This article reviews the role of active components of TCM in the treatment of ischemic stroke,in order to provide more ideas and options for the clinical treatment of this disease in the future.

Objective:To investigate the impact of the number of cesarean deliveries on adverse maternal and neonatal outcomes.Methods:A retrospective analysis was conducted on 11 904 singleton pregnant women who underwent cesarean delivery at the Third Affiliated Hospital of Guangzhou Medical University from January 1st, 2019 to December 31st, 2023. The women were grouped according to the number of cesarean deliveries: those undergoing their first cesarean delivery (1CD group, 7 231 cases), those undergoing their second cesarean delivery (2CD group, 3 749 cases), those undergoing their third cesarean delivery (3CD group, 841 cases), and those undergoing their fourth or more cesarean deliveries (4CD group, 83 cases). Differences in clinical characteristics, related surgical procedures, and adverse maternal and neonatal outcomes among the groups were compared. Binary logistic regression analysis was used to assess the impact of the number of cesarean deliveries on related surgical procedures and adverse maternal and neonatal outcomes.Results:(1) During the 5-year period, the total number of women undergoing cesarean delivery in our hospital showed a slight downward trend, while the proportion of women undergoing three or more cesarean deliveries increased. (2) Compared with women undergoing their first cesarean delivery, women in each repeat cesarean delivery group were older, had higher proportions of advanced maternal age and pre-pregnancy body mass index, and had more pregnancies, deliveries, and induced abortions; the incidence of placenta previa, placental implantation, antepartum hemorrhage, gestational hyperglycemia, and failed trial of labor requiring conversion to surgery was higher, while the incidence of premature rupture of membranes was lower; the proportions of ureteral stent placement, adhesiolysis of the pelvic and abdominal cavities, uterine rupture, uterine reconstruction, uterine artery ligation, hysterectomy, postpartum hemorrhage, and postoperative intestinal obstruction were higher, and the amount of postpartum hemorrhage was greater; the gestational age at delivery of neonates was earlier, but the rates of preterm birth at 28-31 +6 and 32-33 +6 weeks of gestation were lower; the differences were statistically significant ( P<0.05) for all comparisons. (3) The number of cesarean deliveries was not an independent risk factor for the dose-dependent occurrence of placenta previa (a OR=0.99, 95% CI: 0.98-1.01; P=0.261). In women without placenta previa, the number of cesarean deliveries was not a risk factor for placental implantation (a OR=1.12, 95% CI: 0.90-1.39; P=0.320). However, in women with placenta previa, the number of cesarean deliveries was a risk factor for placental implantation (a OR=4.01, 95% CI: 3.08-5.22; P<0.001). In the overall population, the number of cesarean deliveries was a risk factor for ureteral stent placement, adhesiolysis of the pelvic and abdominal cavities, bladder rupture repair, uterine rupture, uterine reconstruction, uterine artery ligation, hysterectomy, postpartum hemorrhage, and preterm birth (all P<0.05). However, the number of cesarean deliveries was not a risk factor for postoperative intestinal obstruction, admission to the intensive care unit, neonatal asphyxia, admission to the neonatal intensive care unit, or neonatal death (all P<0.05). Conclusions:The number of cesarean deliveries could lead to adverse maternal and neonatal outcomes, but the relationship is not simply dose-dependent. It is speculated that the occurrence of severe adverse maternal and neonatal outcomes is more closely related to maternal complications and comorbidities, as well as whether multidisciplinary comprehensive management was received.

Objective:To compare the impact of preoperative pulmonary vascular resistance(PVR) levels on the prognosis of patients undergoing left ventricular assist device(LVAD)implantation.Methods:A retrospective analysis was conducted on the clinical data of 33 patients among September 2021 and June 2024, who underwent LVAD implantation at Zhongshan Hospital, Fudan University. 29 males and 4 females, with a mean age of(53.61±9.65)years old. The cohort included 30 cases of dilated cardiomyopathy, 2 cases of ischemic cardiomyopathy, and 1 case of noncompaction cardiomyopathy. Patients were grouped based on a preoperative PVR threshold of 3 WU, Preoperative data from Swan-Ganz catheterization, liver and renal function indicators, as well as other relevant clinical parameters were recorded. Patients were followed up to assess differences in survival outcomes.Results:Preoperative PVR was elevated in 18 cases(60%)of the patients, with a mean preoperative PVR of(3.16±1.71)WU. Immediate postoperative right heart catheterization was performed in 20 patients, showing a significant reduction in PVR from(3.85±1.72)WU preoperatively to(1.80±1.38)WU postoperatively( P<0.05). The cardiac index improved significantly from(1.95±0.63)L·min -1·m -2 preoperatively to(4.25±1.26)L·min -1·m -2 postoperatively( P<0.001). The mean follow-up duration was(14.78±12.06)months, no significant difference in postoperative survival was observed between the two groups(100% vs. 80%, P=0.667). Conclusion:Increased pulmonary resistance is often secondary to left heart dysfunction. After the implantation of a LVAD, pulmonary resistance can be improved. For patients with relatively normal right heart function before surgery, elevated pulmonary resistance does not affect the short-term outcomes of the implantation.