Panvascular diseases are systemic diseases with atherosclerosis as the pathological core， involving multiple vascular beds and target organs throughout the body. Due to their wide range and complexity， the traditional single-discipline prevention and treatment model struggles to meet the needs of systematic management， while clinical diagnosis often remains one-sided and insufficient， leading to delayed treatment. Literature reviews show that panvascular diseases involve a wide range of lesion sites， numerous influencing factors， and are prone to endangering life and health. It is urgent to construct a comprehensive and whole-course prevention and treatment management system， with vascular health as the goal and patients as the core. First， early screening and risk assessment should be conducted for high-risk groups. In terms of treatment decisions for patients， multi-disciplinary collaboration is needed to establish a scientific and standardized prevention and treatment path. Second， it is important to attach great importance to a people-centered approach， enhance patients' familiarity with the disease through cognitive intervention， and shift from passive treatment to active health care. Thirdly， it is needed to leverage the advantages of modern science and technology， promote the deep integration of artificial intelligence innovations and modern medicine， and help traditional diagnosis and treatment plans evolve towards precision， intelligence， and personalization. This will open up new paths for the modernization of the whole-course management of pan-vascular diseases. Fourth， efforts should be made to continue to carry forward and innovate the characteristics of traditional Chinese medicine， adhere to equal emphasis on modern and traditional medicine， promote complementary advantages and coordinated development of Chinese and Western medicine， and form a unique Chinese model for the whole-course management of panvascular diseases. Fifth， through the reintegration and redistribution of government， medical insurance， and medical resources， comprehensive talents in the broad vascular disciplines should be cultivated and an efficient hierarchical management model established， providing reference and guidance for the whole-course management of comprehensive diseases in the future.

OBJECTIVES: To investigate the protective effects of dexmedetomidine (DEX) against heat stress (HS)-induced oncosis in human skeletal muscle cells (HSKMCs) and its underlying mechanisms. METHODS: A HSKMC model of HS-induced oncosis were established by 43 ℃ water bath for 4 h, and the effects of treatments with 30 μmol/L DEX, ML385 (a Nrf2 inhibitor) +DEX, si-Nrf2+HS, and si-Nrf2+DEX prior to modeling on cell viability was assessed using CCK-8 assay. Oncosis characteristics were evaluated using transmission electron microscopy and Annexin V-FITC/PI flow cytometry. The oxidative stress markers (GSH, GSH-Px, MDA, SOD and ROS), mitochondrial membrane potential, energy metabolism, and inflammatory cytokines (TNF-α, IL-6 and IL-1β) in the cells were quantified using standard kits, and the expressions of porimin, caspase-3 and Nrf2 pathway proteins were analyzed using Western blotting and qRT-PCR. RESULTS: HS induced typical oncotic features in HSKMCs including organelle swelling and cytoplasmic vacuolization. DEX pretreatment significantly attenuated these changes, reduced Annexin V⁺/PI⁺ cell ratio and cellular porimin expression, and lowered the levels of ROS and MDA while restoring GSH and SOD levels. DEX pretreatment also significantly increased the mitochondrial membrane potential and ATP level, upregulated the expressions of Nrf2, p-Nrf2, HO-1 and NQO1, and suppressed the expressions of TNF-α, IL-6 and IL-1β. The protective effects of DEX were obviously attenuated by interventions with ML385 or si-Nrf2. CONCLUSIONS DEX mitigates HS-induced HSKMC oncosis by activating the Nrf2/HO-1 pathway to relieve oxidative stress, mitochondrial dysfunction, and inflammatory responses.
Humans ; Dexmedetomidine/pharmacology* ; NF-E2-Related Factor 2/metabolism* ; Oxidative Stress/drug effects* ; Heat-Shock Response/drug effects* ; Signal Transduction/drug effects* ; Membrane Potential, Mitochondrial ; Muscle, Skeletal/cytology* ; Heme Oxygenase-1/metabolism* ; Apoptosis/drug effects*

[Objective]To explore the scientific connotation of ZHANG Zhongjing's stomach Qi theory with gut microbiota theory and to provide a basis for its clinical application.[Methods]Relevant records on the spleen and stomach,and their functions were collected from traditional Chinese medical classics such as Huangdi Neijing,Shanghan Lun and Jingui Yaolue.Based on the theory of gut microbiota and gut microecology,the scientific connotation of ZHANG Zhongjing's stomach Qi theory was explored from both physiological and pathological perspectives.Furthermore,the scientific basis of this theory in preventing disease transmission and predicting prognosis in clinical practice was preliminarily analyzed.[Results]The modern connotation of ZHANG Zhongjing's theory of stomach Qi can be explained from the roles of gut microbiota and the gut microecological environment in human physiology and their mechanisms of influence in pathological processes.The gut microbiota converts food and maintains normal metabolism,corresponding to stomach Qi's role in generating biochemical fluids.It also promotes the development of the intestinal mucosal immune barrier and inhibits pathogenic bacteria,reflecting stomach Qi's defensive role.Furthermore,the microbiota maintains intestinal barrier integrity,aligning with stomach Qi's regulation in the lower-Jiao,and influences cognition through the gut-brain axis,which corresponds to the calming aspects of stomach Qi.At the level of pathological states,gut microecological imbalance,primarily characterized by dysbiosis,exemplifies the pathological features of Taiyin disease related to stomach deficiency and cold,Yangming disease associated with stomach excess and heat,and Jueyin disease marked by mixed cold,heat,deficiency and excess,as described in the Zhongjing system.It is acknowledged that gut microbial imbalance is both a cause of diseases,which can further exacerbate disease progression,and a consequence of diseases.This highlights the impact of the pathological state of stomach Qi on disease characteristics,transmission and prognosis,underscoring the significance of ZHANG Zhongjing's academic thought on"preserving stomach Qi."[Conclusion]Taking the theory of gut microecology as an entry point,this study explores the scientific connotation of stomach Qi theory,aligning it with modern biological understanding.The gut microbiota and gut microecology theory can serve as a bridge between Zhongjing's academic thought of"preserving stomach Qi"and modern medicine,providing theoretical basis and new research ideas for enhancing the clinical efficacy and interpretability of classical prescriptions.

Objective:To investigate the impact of receptor-interacting protein kinase 3 (RIPK3) on major adverse cardiovascular events (MACE) in patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI), as well as the predictive performance of RIPK3 combined with traditional cardiovascular risk factors.Methods:This study was a single-center prospective cohort study. It included patients with AMI who underwent PCI at Peking Union Medical College Hospital between September 2017 and November 2017. Baseline clinical data were collected, and plasma samples were obtained 6 hours after PCI to measure RIPK3 levels. Follow-up was conducted via outpatient visits or phone calls to record the occurrence of MACE, including cardiovascular death, hospitalization for heart failure, and vascular events (recurrent AMI or stroke). The predictive performance of RIPK3, traditional cardiovascular risk factors and their combination for MACE was compared using receiver operating characteristic (ROC) curves. Patients were divided into low- and high-RIPK3 level groups based on the optimal cutoff value of RIPK3. Multivariate Cox proportional hazards regression analysis was used to assess the impact of RIPK3 levels on MACE after PCI in AMI patients. Kaplan-Meier survival curves were plotted, and the log-rank test was used to compare MACE incidence between the low-and high-RIPK3 groups.Results:A total of 103 AMI patients who underwent PCI were included, aged 63.0 (56.0, 69.0) years, and 83 (80.6%) were male. The follow-up time was 5.17 (2.81, 5.17) years, during which 44 patients (42.7%) experienced MACE. The ROC curve analysis showed that the area under the curve ( AUC) for traditional cardiovascular risk factors was 0.68 (95% CI: 0.58-0.78), while the AUC for plasma RIPK3 was 0.72 (95% CI: 0.62-0.82). The combined AUC for traditional risk factors and RIPK3 was 0.75 (95% CI: 0.65-0.85). Multivariate Cox proportional hazards regression analysis indicated that plasma RIPK3 level is greater than or equal to the optimal cutoff value of 440.9 μg/L ( HR=3.31, 95% CI: 1.53-8.30, P=0.005) was an independent risk factor for MACE in AMI patients after PCI. Kaplan-Meier survival analysis demonstrated that the high-RIPK3 group had a significantly higher risk of MACE after PCI compared to the low-RIPK3 group (log-rank P=0.006). Conclusions:Elevated plasma RIPK3 level is an independent risk factor for MACE in AMI patients after PCI. Plasma RIPK3 combined with traditional cardiovascular risk factors can more effectively predict the occurrence of MACE in AMI patients after PCI. AMI patients with RIPK3≥440.9 μg/L have a higher risk of MACE after PCI.

Alzheimer's disease(AD)is an age-related neurodegenerative disease that mainly manifests clinically as progressive functional impairments in cognition,memory,and language.With the accelerated transition toward an older population in China,the number of people suffering from AD in China is increasing.The exact pathogenesis of AD remains unclear,with current therapeutic strategies mainly limited to symptomatic treatments.Animal models are important tools for preclinical research,enabling explorations of molecular mechanisms,behavioral functions,and treatment strategies of diseases.Future mechanistic research and drug development of AD should involve the establishment of animal models that are consistent with clinical pathological characteristics.This review summarizes the AD animal models commonly used in research,providing details on the strains,age,modeling method and doses.It also discusses research on traditional Chinese medicine(TCM)components and their pharmacodynamic mechanisms in related AD animal models,aiming to provide references for the development of new animal models and in-depth exploration of the specific pharmacological activities,targets,metabolic pathways,and clinical applications of each TCM component.

Objective:To preliminarily evaluate the lumen gain of sonodynamic therapy (SDT) mediated by sinoporphyrin sodium at carotid and femoral atherosclerotic plaque sites, and to assess whether concomitant statin use, lesion location, plaque echogenicity/type, and baseline stenosis severity modify the therapeutic response.Methods:This single-center, prospective, exploratory pilot clinical study enrolled patients with peripheral artery disease who attended the outpatient cardiology clinic of the First Affiliated Hospital of Harbin Medical University between February and September 2016. All enrolled patients received optimized oral medical therapy in combination with a single session of SDT. Vascular evaluation was performed using color Doppler ultrasound before treatment and 1 and 4 weeks after treatment. The primary efficacy endpoint was the percent change from baseline in luminal diameter stenosis at the site of the atherosclerotic plaque (%Δ) at week 4, while the secondary efficacy endpoint was %Δ at week 1. Subgroup analyses were conducted according to prior statin use, plaque location, plaque characteristics, and baseline degree of luminal stenosis.Results:A total of 24 patients, aged (70.7±2.2) years were enrolled. There were 20 (83%) males. Compared to baseline, luminal diameter stenosis at the plaque site reduced by week 4 ((50.1±1.2)% vs. (57.2±1.1)%, P<0.001), %Δ was(12.32±1.05)%; and luminal diameter stenosis also reduced by week 1 ((51.7±1.2)% vs. (57.2±1.1)%, P<0.001)), %Δ was(9.61±0.85)%. In subgroup analyses, the treatment effect on diameter stenosis was independent of prior statin use; SDT reduced stenosis in both carotid and femoral plaques; with superior efficacy observed in hypoechoic and mixed-echo plaques; and efficacy was observed across mild, moderate, and severe baseline stenosis categories (all P<0.05). Conclusion:In this single-center pilot study, SDT demonstrates therapeutic efficacy across mild, moderate, and severe stenoses, as well as in hypoechoic and mixed-echo plaques, showing potential to rapidly promote luminal gain at carotid and femoral atherosclerotic plaque sites.

Objective:To investigate the difference in brain activity intensity between methamphetamine (MA) dependent patients (MA group) and healthy controls (control group) using fractional amplitude of low-frequency fluctuation (fALFF), and to establish a classification model between these two groups using support vector machine (SVM).Methods:From February 2014 to October 2019, a total of 46 male MA-dependent patients and 46 male healthy controls were recruited from the Affiliated Kangning Hospital of Ningbo University. The study collected resting-state functional magnetic resonance imaging (rs-fMRI) data and analyzed the differences in brain functional activity between the two groups. This analysis was conducted using both static and dynamic fractional amplitude of low-frequency fluctuations (d-fALFF). Additionally, the study examined the correlation between fALFF/d-fALFF values in specific brain regions and the total scores, as well as each factor score, of the Brief Psychiatric Rating Scale (BPRS). Furthermore, the relationship between fALFF/d-fALFF values and the age of first use and total dose of MA in the MA group was investigated. Finally, the fALFF map and d-fALFF map of brain regions with significant differences between groups were used as features for constructing classification.Results:Compared to the healthy control group, those dependent on MA showed significantly increased fALFF mainly in the nucleus accumbens, caudate nucleus, thalamus, and amygdala nucleus( t=-5.21--2.72, all P<0.05). The MA group exhibited decreased fALFF in the superior frontal gyrus, middle frontal gyrus, orbital gyrus, and cingulate gyrus( t=3.59-5.00, all P<0.05). Most of the brain regions with decreased d-fALFF overlapped with those exhibiting decreased fALFF( t=3.33-4.87, all P<0.05). The results of the correlation analysis showed that the fALFF value of the right nucleus accumbens was positively correlated with the age of first use of MA ( r=0.537, P<0.001). There is no significant relationship between the abnormal fALFF and d-fALFF values in the MA group and the total scores and each factor scores of BPRS, as well as the total dose of MA taken (after removing outliers). Based on fALFF and d-fALFF values, the SVM classifier achieved accuracies of 90.33%±6.89% and 71.56%±7.80%, respectively. Conclusions:There are significant abnormalities in the low-frequency fluctuation of the resting brain in patients dependent on MA. These abnormalities reflect the rigidity of prefrontal cortex activity, functional impairment, and dysfunction of the anti-reward system. These factors may be one of the causes for MA dependent behavior and repeated episodes. In addition, the fALFF values may be helpful for distinguishing MA dependent individuals from the control group.

Objective:To investigate the mediating role of psychological capital between the perception of decent work and work engagement among Operating Room nurses, and to provide insights for improving their work engagement.Methods:From December 2023 to February 2024, a total of 307 Operating Room nurses from four class ⅢGrade A hospitals in Beijing, Chongqing, Dalian, and Zhuhai were recruited using convenience sampling. Data were collected using a general information questionnaire, Work Engagement Scale, Decent Work Scale, and Nurses' Psychological Capital Scale. Pearson correlation analysis was conducted to examine the relationships among psychological capital, perception of decent work, and work engagement. Structural equation modeling and mediation analysis were performed using AMOS 24.0 software.Results:A total of 307 questionnaires were distributed, and 301 valid responses were collected, with an effective response rate of 98.05%. The mean scores for work engagement, perception of decent work, and psychological capital were (41.01±10.76), (67.30±17.86), and (93.30±15.15), respectively. Work engagement was positively correlated with both the perception of decent work and psychological capital (all P<0.01), and the perception of decent work was positively correlated with psychological capital ( P<0.01). Psychological capital partially mediated the relationship between the perception of decent work and work engagement, with the mediating effect accounting for 62.63%. Conclusions:Psychological capital plays a partial mediating role between the perception of decent work and work engagement among Operating Room nurses. Nursing managers can enhance nurses' work engagement by improving their perception of decent work and strengthening their psychological capital.

Alzheimer's disease(AD)is an age-related neurodegenerative disease that mainly manifests clinically as progressive functional impairments in cognition,memory,and language.With the accelerated transition toward an older population in China,the number of people suffering from AD in China is increasing.The exact pathogenesis of AD remains unclear,with current therapeutic strategies mainly limited to symptomatic treatments.Animal models are important tools for preclinical research,enabling explorations of molecular mechanisms,behavioral functions,and treatment strategies of diseases.Future mechanistic research and drug development of AD should involve the establishment of animal models that are consistent with clinical pathological characteristics.This review summarizes the AD animal models commonly used in research,providing details on the strains,age,modeling method and doses.It also discusses research on traditional Chinese medicine(TCM)components and their pharmacodynamic mechanisms in related AD animal models,aiming to provide references for the development of new animal models and in-depth exploration of the specific pharmacological activities,targets,metabolic pathways,and clinical applications of each TCM component.

[Objective]To explore the scientific connotation of ZHANG Zhongjing's stomach Qi theory with gut microbiota theory and to provide a basis for its clinical application.[Methods]Relevant records on the spleen and stomach,and their functions were collected from traditional Chinese medical classics such as Huangdi Neijing,Shanghan Lun and Jingui Yaolue.Based on the theory of gut microbiota and gut microecology,the scientific connotation of ZHANG Zhongjing's stomach Qi theory was explored from both physiological and pathological perspectives.Furthermore,the scientific basis of this theory in preventing disease transmission and predicting prognosis in clinical practice was preliminarily analyzed.[Results]The modern connotation of ZHANG Zhongjing's theory of stomach Qi can be explained from the roles of gut microbiota and the gut microecological environment in human physiology and their mechanisms of influence in pathological processes.The gut microbiota converts food and maintains normal metabolism,corresponding to stomach Qi's role in generating biochemical fluids.It also promotes the development of the intestinal mucosal immune barrier and inhibits pathogenic bacteria,reflecting stomach Qi's defensive role.Furthermore,the microbiota maintains intestinal barrier integrity,aligning with stomach Qi's regulation in the lower-Jiao,and influences cognition through the gut-brain axis,which corresponds to the calming aspects of stomach Qi.At the level of pathological states,gut microecological imbalance,primarily characterized by dysbiosis,exemplifies the pathological features of Taiyin disease related to stomach deficiency and cold,Yangming disease associated with stomach excess and heat,and Jueyin disease marked by mixed cold,heat,deficiency and excess,as described in the Zhongjing system.It is acknowledged that gut microbial imbalance is both a cause of diseases,which can further exacerbate disease progression,and a consequence of diseases.This highlights the impact of the pathological state of stomach Qi on disease characteristics,transmission and prognosis,underscoring the significance of ZHANG Zhongjing's academic thought on"preserving stomach Qi."[Conclusion]Taking the theory of gut microecology as an entry point,this study explores the scientific connotation of stomach Qi theory,aligning it with modern biological understanding.The gut microbiota and gut microecology theory can serve as a bridge between Zhongjing's academic thought of"preserving stomach Qi"and modern medicine,providing theoretical basis and new research ideas for enhancing the clinical efficacy and interpretability of classical prescriptions.