This study investigates the mechanism by which Xintong Granules improve myocardial ischemia-reperfusion injury(MIRI) through the regulation of gut microbiota and their metabolites, specifically short-chain fatty acids(SCFAs). Rats were randomly divided based on body weight into the sham operation group, model group, low-dose Xintong Granules group(1.43 g·kg~(-1)·d~(-1)), medium-dose Xintong Granules group(2.86 g·kg~(-1)·d~(-1)), high-dose Xintong Granules group(5.72 g·kg~(-1)·d~(-1)), and metoprolol group(10 mg·kg~(-1)·d~(-1)). After 14 days of pre-administration, the MIRI rat model was established by ligating the left anterior descending coronary artery. The myocardial infarction area was assessed using the 2,3,5-triphenyltetrazolium chloride(TTC) staining method. Apoptosis in tissue cells was detected by the terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling(TUNEL) assay. Pathological changes in myocardial cells and colonic tissue were observed using hematoxylin-eosin(HE) staining. The levels of tumor necrosis factor-α(TNF-α), interleukin-1β(IL-1β), interleukin-6(IL-6), creatine kinase MB isoenzyme(CK-MB), and cardiac troponin T(cTnT) in rat serum were quantitatively measured using enzyme-linked immunosorbent assay(ELISA) kits. The activities of lactate dehydrogenase(LDH), creatine kinase(CK), and superoxide dismutase(SOD) in myocardial tissue, as well as the level of malondialdehyde(MDA), were determined using colorimetric assays. Gut microbiota composition was analyzed by 16S rDNA sequencing, and fecal SCFAs were quantified using gas chromatography-mass spectrometry(GC-MS). The results show that Xintong Granules significantly reduced the myocardial infarction area, suppressed cardiomyocyte apoptosis, and decreased serum levels of pro-inflammatory cytokines(TNF-α, IL-1β, and IL-6), myocardial injury markers(CK-MB, cTnT, LDH, and CK), and oxidative stress marker MDA. Additionally, Xintong Granules significantly improved intestinal inflammation in MIRI rats, regulated gut microbiota composition and diversity, and increased the levels of SCFAs(acetate, propionate, isobutyrate, etc.). In summary, Xintong Granules effectively alleviate MIRI symptoms. This study preliminarily confirms that Xintong Granules exert their inhibitory effects on MIRI by regulating gut microbiota imbalance and increasing SCFA levels.
Animals ; Gastrointestinal Microbiome/drug effects* ; Rats ; Male ; Myocardial Reperfusion Injury/genetics* ; Drugs, Chinese Herbal/administration & dosage* ; Rats, Sprague-Dawley ; Apoptosis/drug effects* ; Humans ; Tumor Necrosis Factor-alpha/metabolism* ; Interleukin-6/genetics* ; Malondialdehyde/metabolism*

Objective: To investigate the current status of knowledge, attitudes and practices regarding drinking water among primary school students in rural areas of China, so as to provide scientific basis for implementing health interventions related to drinking water. Methods: From November to December 2023, a stratified cluster random sampling method was employed to select 6 354 fourth to sixth grade primary school students in Shanxi, Zhejiang, Jiangxi, Guangxi and Gansu for a questionnaire survey. A uniformly designed questionnaire (including basic information, drinking water-related knowledge, attitudes and practices indicators) was distributed and completed by the students themselves. The χ 2 test was used to analyze the differences in drinking water-related indicators among students of different gender and boarder, and Logistic regression was used to analyze the influencing factors of drinking water practices among students. Results: Among the indicators of drinking water knowledge, the awareness rate of appropriate daily water intake for respective student age groups was the lowest (27.90%). The awareness rate among nonresident students was significantly higher than that among boarding students (31.29%, 15.49%, χ 2=132.75, P <0.01). Regarding attitudes toward drinking water, 13.33% of the students believed that well water or tap water could be drunk directly, and 9.58% believed that going to the toilet at school was troublesome. Regarding practices, the self-reported water intake among students was 1 000 (600, 1 200) mL. The results of multifactorial Logistic regression showed that higher grades ( OR=1.60, 95%CI =1.34-1.92), nonresident students ( OR=1.32, 95%CI = 1.15 -1.52), northern region ( OR=1.43, 95%CI =1.27-1.61), knowledge of appropriate daily water intake ( OR=1.41, 95%CI =1.24-1.60), drinking temperature ( OR=1.43, 95%CI =1.28-1.60), scientific hydration methods ( OR=1.25, 95%CI =1.08- 1.44 ), and adopting scientific hydration methods regularly ( OR=1.75, 95%CI =1.50-2.04) were the independent influences on daily water intake attainment ( P <0.05). Conclusions Rural primary school students lack knowledge about healthy drinking water, have cognitive biases about safe drinking water and exhibit unhealthy drinking behavior. It is suggested that health education be carried out in combination with the characteristics of students to enhance their drinking water literacy.

BACKGROUND: Based on the China-VHD database, this study sought to develop and validate a Valvular Heart Disease- specific Age-adjusted Comorbidity Index (VHD-ACI) for predicting mortality risk in patients with VHD. METHODS & RESULTS: The China-VHD study was a nationwide, multi-centre multi-centre cohort study enrolling 13,917 patients with moderate or severe VHD across 46 medical centres in China between April-June 2018. After excluding cases with missing key variables, 11,459 patients were retained for final analysis. The primary endpoint was 2-year all-cause mortality, with 941 deaths (10.0%) observed during follow-up. The VHD-ACI was derived after identifying 13 independent mortality predictors: cardiomyopathy, myocardial infarction, chronic obstructive pulmonary disease, pulmonary artery hypertension, low body weight, anaemia, hypoalbuminaemia, renal insufficiency, moderate/severe hepatic dysfunction, heart failure, cancer, NYHA functional class and age. The index exhibited good discrimination (AUC, 0.79) and calibration (Brier score, 0.062) in the total cohort, outperforming both EuroSCORE II and ACCI (P < 0.001 for comparison). Internal validation through 100 bootstrap iterations yielded a C statistic of 0.694 (95% CI: 0.665-0.723) for 2-year mortality prediction. VHD-ACI scores, as a continuous variable (VHD-ACI score: adjusted HR (95% CI): 1.263 (1.245-1.282), P < 0.001) or categorized using thresholds determined by the Yoden index (VHD-ACI ≥ 9 vs. < 9, adjusted HR (95% CI): 6.216 (5.378-7.184), P < 0.001), were independently associated with mortality. The prognostic performance remained consistent across all VHD subtypes (aortic stenosis, aortic regurgitation, mitral stenosis, mitral regurgitation, tricuspid valve disease, mixed aortic/mitral valve disease and multiple VHD), and clinical subgroups stratified by therapeutic strategy, LVEF status (preserved vs. reduced), disease severity and etiology. CONCLUSION The VHD-ACI is a simple 13-comorbidity algorithm for the prediction of mortality in VHD patients and providing a simple and rapid tool for risk stratification.

[This corrects the article DOI: 10.1016/j.apsb.2022.05.019.].

Objective To establish the HPLC fingerprint of Rosae Rugosae Flos;To provide references for the quality evaluation of Rosae Rugosae Flos.Methods The HPLC analysis was carried on a COSMOSIL 5C18-MS-Ⅱ column(4.6 mm×250 mm,5 μm);the mobile phase was 2.5 % acetonitrile + 0.1 % formic acid aqueous solution(A)-acetonitrile + 0.1 % formic acid(B)with gradient elution at the flow rate of 0.5 Ml/min;the column temperature was 40℃;the detection wavelength was 350 nm.The similarity of 13 batches of samples was evaluated by Similarity Evaluation System for Chromatographic Fingerprint of TCM(2012 edition).Qualitative analysis was carried out by LC-MS technology.The overall quality evaluation of Rosae Rugosae Flos was carried out by combining clustering analysis,principal component analysis and orthogonal partial least square discrimination.Results The common mode of HPLC fingerprints of Rosae Rugosae Flos was established,and the similarity of 13 samples was good.9 compounds were identified preliminary.13 batches of samples were aggregated into 3 categories by chemical pattern recognition.Conclusion The fingerprints of Rosae Rugosae Flos established in this study combines with chemical pattern recognition method,which has high sensitivity and strong specificity,can provide a basis for the quality evaluation of Rosae Rugosae Flos.

Objective:To investigate the consistency of myocardial extracellular volume between systole and diastole using dual-layer detector spectral CT.Methods:This was a cross-sectional study. Thirty-five patients who underwent cardiac spectral CT examination in West China Hospital of Sichuan University from April 2022 to December 2022 were retrospectively collected. Hematocrit was collected within 3 days before the CT scan. The delayed phases holographic spectral images in systole (45%) and diastole (75%) were obtained using dual-layer spectral CT. CT data were processed using a spectral post-processing workstation, and the extracellular volume (ECV) based on iodine density images, referred as CT-ECV, in systolic and diastolic phases were calculated, respectively. According to the American Heart Association′s 16-segment model of left ventricular, the standard short-axis images were constructed, and the myocardium was standardized into 16 segments at the basal, mid-cavity, and apical levels of the left ventricle. Two radiologists performed a subjective evaluation in the image quality of the CT-ECV images of the whole heart and the three sections in systole and diastole using a "five-point" scale. The ECV of the 16 segments and the whole heart in systole and diastole was calculated. The consistency of subjective evaluations between systole and diastole was assessed using Kappa statistics. Wilcoxon signed-rank tests were used to compare the differences in scores between systole and diastole. Paired sample t-test was used to compare the differences in CT-ECV scores between systole and diastole. The intraclass correlation coefficient was used to test the intra-and inter-observer consistency of CT-ECV measurements between two radiologists. P<0.05 was statistically significant. Results:There was good agreement between the two radiologists on subjective scores of CT-ECV image quality between systole and diastole ( Kappa>0.80), and there was no statistical difference in image quality among the basal, mid-cavity, and apical levels of the left ventricle and whole heart between systole and diastole ( P>0.05). The systolic and diastolic CT-ECV for the entire heart obtained through the delay phase were (33.29±3.46)% and (33.50±3.39)%, respectively, with no statistically significant difference ( t=-0.78, P=0.442). CT-ECV in systole and diastole were (34.15±3.94)% and (35.30±3.99)% for segment 8, (34.03±3.76)% and (35.46±3.74)% for segment 9, and (33.98±3.32)% and (35.05±3.98)% for segment 14, respectively. The mean values of the systolic CT-ECV of segments 8, 9 and 14 were significantly lower than those of diastolic CT-ECV ( t=-2.65, -3.26, -2.42, P=0.012, 0.003, 0.022, respectively). The ICCs for CT-ECV measurements of 16 segments by the two radiologists were greater than 0.90 in both systolic and diastolic, indicating good agreement. Conclusions:There is no significant difference in whole heart CT-ECV values between systolic and diastolic myocardial ECV based on dual-layer spectral CT. However, minor differences (less than 2%) are found between systolic and diastolic myocardial CT-ECV for some segments. Myocardial CT-ECV measurement should be performed on the same segment during the same phase to obtain stable and accurate ECV values.

Objective To investigate the clinical effect of unilateral percutaneous vertebroplasty(PVP)combined with 3D printing technology for the treatment of thoracolumbar osteoporotic compression fracture.Methods A total of 77 patients with thoracolumbar osteoporotic compression fractures from October 2020 to April 2022 were included in the study,all of which were vertebral body compression fractures caused by trauma.According to different treatment methods,they were di-vided into experimental group and control group.Thirty-two patients used 3D printing technology to improve unilateral transpedicle puncture vertebroplasty in the experimental group,there were 5 males and 27 females,aged from 63 to 91 years old with an average of(77.59±8.75)years old.Forty-five patients were treated with traditional bilateral pedicle puncture vertebroplasty,including 7 males and 38 females,aged from 60 to 88 years old with an average of(74.89±7.37)years old.Operation time,intraoperative C-arm X-ray times,anesthetic dosage,bone cement injection amount,bone cement diffusion good and good rate,complications,vertebral height,kyphotic angle(Cobb angle),visual analogue scale(VAS),Oswestry disability index(ODI)and other indicators were recorded before and after surgery,and statistically analyzed.Results All patients were followed up for 6 to 23 months,with preoperative imaging studies,confirmed for thoracolumbar osteoporosis com-pression fractures,two groups of patients with postoperative complications,no special two groups of patients'age,gender,body mass index(BMI),time were injured,the injured vertebral distribution had no statistical difference(P＞0.05),comparable data.Two groups of patients with bone cement injection,bone cement dispersion rate,preoperative and postoperative vertebral body height,protruding after spine angle(Cobb angle),VAS,ODI had no statistical difference(P＞0.05).The operative time,intra-operative fluoroscopy times and anesthetic dosage were statistically different between the two groups(P＜0.05).Compared with the traditional bilateral puncture group,the modified unilateral puncture group combined with 3D printing technology had shorter operation time,fewer intraoperative fluoroscopy times and less anesthetic dosage.The height of anterior vertebral edge,kyphosis angle(Cobb angle),VAS score and ODI of the affected vertebrae were statistically different between two groups at each time point after surgery(P＜0.05).Conclusion In the treatment of thoracolumbar osteoporotic compression fractures,3D printing technology is used to improve unilateral puncture PVP,which is convenient and simple,less trauma,short operation time,fewer fluoroscopy times,satisfactory distribution of bone cement,vertebral height recovery and kyphotic Angle correction,and good functional improvement.

Objective:To explore the genetic background for a patient with refractory myelodysplastic/myeloproliferative neoplasm (MDS/MPN) with co-morbid neutrophilia patient.Methods:A MDS/MPN patient who was admitted to the First Affiliated Hospital of Nanjing Medical University in May 2021 was selected as the study subject. RNA sequencing was carried out to identify fusion genes in his peripheral blood mononuclear cells. Fusion gene sequence was searched through transcriptome-wide analysis with a STAR-fusion procedure. The novel fusion genes were verified by quantitative real-time PCR and Sanger sequencing.Results:The patient, a 67-year-old male, had progressive thrombocytopenia. Based on the morphological and molecular examinations, he was diagnosed as MDS/MPN with co-morbid neutropenia, and was treated with demethylating agents and Bcl-2 inhibitors. Seventeen months after the diagnosis, he had progressed to AML. A novel fusion gene NCOR1: : GLYR1 was identified by RNA-sequencing in his peripheral blood sample, which was verified by quantitative real-time PCR and Sanger sequencing. The patient had attained morphological remission after a DCAG regimen (a combinatory chemotherapy of decitabine, cytarabine, aclarubicin and granulocyte colony-stimulating factors) plus Chidamide treatment. A significant decrease in the NCOR1: : GLYR1 expression was revealed by quantitative real-time PCR at post-chemotherapy evaluation. Conclusion:NCOR1: : GLYR1 gene is considered as the pathogenic factor for the MDS/MPN patient with neutropenia.

Objective:To investigate the application of cardiac magnetic resonance (CMR) quantitative techniques in evaluating myocardial involvement differences between new onset and longstanding systemic lupus erythematosus (SLE) patients.Methods:From August 2020 to April 2023, 14 new onset and 15 longstanding SLE patients treated at the First Affiliated Hospital of Anhui Medical University were prospectively included as the study group. Additionally, 18 age-, gender-, body surface area-, and body mass index-matched healthy volunteers were included as the control group. Clinical baseline data, electrocardiograms, and CMR results including left ventricular ejection fraction (LVEF), left ventricular end-systolic volume index (LVESVI), left ventricular end-diastolic volume index (LVEDVI), cardiac index (CI), left ventricular stroke volume index (LVSVI), left ventricular mass index (LVMI), myocardial strain, native T 1 values, and T 2 values were collected. One-way analysis of variance (ANOVA) or Kruskal-Wallis H test was used to compare the quantitative parameters among the three groups. Bonferroni correction was applied for pairwise group comparisons. Results:The native T 1 values [1 114.50 (1 089.33, 1 150.39) ms, 1 085.32 (1 051.31, 1 129.75) ms] and T 2 values [(55.9±3.4) ms, (53.3±1.5) ms] of new onset and longstanding SLE patients were higher than those of the healthy control group [native T 1 values 1052.62 (1024.75, 1077.59) ms, H=17.72, P<0.001; T 2 values (51.2±1.3) ms, F=18.70, P<0.001]. The T 2 values of the new onset SLE group was higher than that of the longstanding SLE group ( P<0.05). The LVEDVI[86.87 (80.80, 93.55) ml/m 2], LVSVI [54.63 (50.42, 59.03) ml/m 2], and LVMI [48.39 (41.65, 53.26) g/m 2] of the new onset SLE group were higher than those of the control group [LVEDVI: 71.11 (65.80, 81.28) ml/m 2, Z=3.02, P=0.003; LVSVI: 42.17 (40.36, 51.33) ml/m 2, Z=2.76, P=0.006; LVMI: 38.48 (35.22, 43.83) g/m 2, Z=3.10, P=0.002]. The LVEDVI and LVSVI of the new onset SLE group were also higher than those of the longstanding SLE group [LVEDVI: 73.30 (69.87, 84.71) ml/m 2, Z=1.97, P=0.048; LVSVI: 45.53 (42.28, 50.98) ml/m 2, Z=2.34, P=0.020]. Conclusion:Myocardial involvement is more severe in new onset SLE patients, whereas acute myocardial injury is alleviated in longstanding SLE patients. Therefore, early detection of cardiac involvement in SLE patients is crucial for improving prognosis.

Objective:To evaluate the difference in efficacy between liposuction combined with single-port endoscopic subcutaneous adenomectomy and traditional open surgery in treating adolescent male breast development disorder,and to compare their effects on patients'anxiety levels and quality of life.Methods:A total of sixty-four patients with adolescent male mammary gland dysplasia who underwent surgery at our hospital between March 2022 and June 2023 were included in this retrospective analysis,with 28 cases in the open surgery group and 36 cases in the single-hole endoscopic group.The study compared various parameters including surgery duration,intraoperative bleeding,incision length,hospitalization duration,treatment cost,and postoperative complications,alongside collecting GAD-7,SF-36,and SCAR questionnaire scores from the pa-tients.Results:The single-port endoscopy group,in comparison to the open surgery group,showed a slightly longer operation time and higher treatment cost but had a shorter hospitalization duration and smaller incision.There was no significant difference observed between the two groups concerning intraoperative bleeding.Notably,the single-port endoscopy group exhibited more significant improvements in SCAR,SF-36,and GAD-7 scores(P＜0.05).Conclusion:Com-pared with traditional open surgery,liposuction combined with single-port endoscopic subcutane-ous adenomectomy is more effective in treating adolescent gynecomastia.This approach not only offers better aesthetic outcomes but also proves effective in reducing patient anxiety and signifi-cantly enhancing their quality of life.