The traditional Chinese medicine （TCM） myocardial infarction （MI） unit is a standardized， regulated， and continuous integrated care unit guided by TCM theory and built upon existing chest pain centers or emergency care units. This unit emphasizes multidisciplinary collaboration and forms a restructured clinical entity without altering current departmental settings， offering comprehensive diagnostic and therapeutic services with full participation of TCM in the treatment of MI. Its core medical model is patient-centered and disease-focused， providing horizontally integrated TCM-based care across multiple specialties and vertically constructing a full-cycle treatment unit for MI， delivering prevention， treatment， and rehabilitation during the acute， stable， and recovery phases. Additionally， the unit establishes a TCM-featured education and prevention mechanism for MI to guide patients in proactive health management， reduce the incidence of myocardial infarction， and improve quality of life.

The endothelial glycocalyx(EG)is a polyglycoprotein complex present on the internal vascular surface,and its impairment is associated with the progression of multiple diseases,including atherosclerosis,stroke,sepsis,diabetes,kidney disease,hypertension,and lung edema.Therefore,glycocalyx health can be used as a biomarker to evaluate vascular health.Aging leads to dysfunctional changes in the glycocalyx;for example,its thickness decreases,and the genes of enzymes involved in its synthesis and digestion are dysregulated.As a natural barrier to the vascular system,age-related glycocalyx disruption is associated with vascular dysfunction,including impairment of vascular contraction and dilation,enhancement of permeability,dysregulation of inflammatory and immune reactions,and imbalance of anticoagulation and thrombin.From the perspective of'structure determines function'studies on the changing regularity of the thickness,components,microstructure,and mechanical properties of EG with aging and its relationship with vascular dysfunction are of great significance for the prevention,diagnosis,and treatment of atherosclerosis and other age-related cardiovascular diseases.

A novel amide alkaloid,bursatamide A(1),featuring an unprecedented propyl-hexahydronaphthalene carbon frame-work,was isolated from the infrequently studied sea hare Bursatella leachi,alongside a new 3-phenoxypropanenitrile alkaloid,bursatellin B(2),and twelve known compounds.The structures of 1 and 2 were elucidated through comprehensive spectroscopic data analyses,while their relative and absolute configurations(ACs)were established through total synthesis and a series of quantum chem-ical calculations,including calculated electronic circular dichroism(ECD)spectra,optical rotatory dispersion(ORD)methods,and DP4+probability analyses.Bursatamide A(1)demonstrated inhibitory effects against the human pathogenic bacteria Listeria monocyt-ogenes and Vibrio cholerae.Erythro-bursatellin B(21),a diastereoisomer of 2,exhibited notable antibacterial activity against the fish pathogenic bacterium Streptococcus parauberis FP KSP28,with an MIC90 value of 0.0472 μg·mL-1.

Objective:To analyze the clinical characteristics of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine breakthrough infections in children, and to provide reference basis for the SARS-CoV-2 vaccination in children.Methods:A total of 97 children aged 3 to 14 years and diagnosed with coronavirus disease 2019 (COVID-19) admitted to Xi′an People′s Hospital (Xi′an Fourth Hospital) from December 27, 2021 to February 7, 2022 were included. According to the COVID-19 vaccination status, the enrolled children were divided into unvaccinated group, partially vaccinated group and fully vaccinated group, and the clinical data of the children in the three groups were collected and compared. Chi-square test, two independent sample t-test and Kruskal-Wallis H test were used for statistical analysis. Results:Totally 97 children including 49 males and 48 females were enrolled, with 87(89.7%) children of mild type, 10(10.3%) children of common type, and no severe or critical case. The proportions of unvaccinated, partially vaccinated and fully vaccinated preschool-aged children (3 to 6 years old) were 56.5%(13/23), 30.8%(12/39) and 17.1%(6/35), respectively, while those of school-aged children (7 to 14 years old) were 43.5%(10/23), 69.2%(27/39) and 82.9%(29/35), respectively. The vaccination proportion in preschool-aged children was significantly lower than that in school-age children ( χ2=9.94, P=0.007). The proportion of the children with fever in fully vaccinated group was 17.1%(6/35), which was lower than that in unvaccinated group (43.5%, 10/23), and the difference was statistically significant ( χ2=4.82, P=0.028). The cycle threshold (Ct) values of the open reading frame ( ORF)1 ab gene in the unvaccinated, partially vaccinated and fully vaccinated groups were 33.77(26.87, 36.58), 35.23 (33.45, 38.57) and 37.12 (34.91, 39.39), respectively, and there was a statistically significant difference among the groups ( H=7.76, P=0.021). The Ct values of the nucleocapsid protein ( N) gene in the three groups were 32.26(25.85, 36.18), 35.12(33.18, 37.96) and 37.26(34.27, 39.24), respectively, and the difference among the groups was statistically significant ( H=7.84, P=0.020). The Ct values of ORF1 ab gene and N gene in fully vaccinated group were higher than those in unvaccinated group, and the differences were statistically significant ( Z=-2.69, P=0.007 and Z=-2.39, P=0.017, respectively). The duration of viral shedding in fully vaccinated children was (9.9±4.1) d, which was shorter than that in unvaccinated children ((12.8±3.7) d), and the difference was statistically significant ( t=2.72, P=0.009). Conclusions:The majority of children with breakthrough infections with SARS-CoV-2 are mild. Vaccination may effectively shorten the duration of viral shedding. And fully vaccination is associated with mild clinical symptoms and lower serum viral load compared to unvaccinated children.

Objective:To provide a theoretical basis for diagnosing and treating recurrent Kawasaki disease based on data analysis of clinical symptoms.Methods:Data analysis of children with recurrent Kawasaki disease admitted to Beijing Children′s Hospital of Capital Medical University from January 2016 to December 2019 was conducted, including comparisons of the initial onset and the recurrence on patients′ clinical features, auxiliary examination and treatment.Results:During the four-year scale, 3 041 children with Kawasaki disease were admitted to the department of Cardiology.The recurrence data involved 65 children[male∶female 3.1∶1, average aged(2.42 ± 2.04) years]. First, children′s fever duration was(5.66 ± 2.37) days in recurrence data, significantly shorter than that of their initial onset.The recurrence data also reported a lower incidence of rash and limb changes, together with respiratory and gastrointestinal symptoms.Then, 19 cases out of the 65 children got coronary artery lesion(CAL) at their initial onset.A relief of CAL was reported from 15 children when the disease recurred, along with 11 new-reported CAL cases.Intravenous immunoglobulin(IVIG) refractory Kawasaki disease cases accounted for nine at the initial onset and 12 at the recurrent onset, respectively.Five IVIG refractory recurrent cases reported significant relief after 2 g/kg IVIG treatment.Conclusion:The recurrent Kawasaki disease in children usually occurs among children under three years old, within the first year after the initial onset.Most of the recurrent cases report a shorter fever duration and less typical clinical symptoms than their first onset.In some cases, IVIG treatment showed effects initially but failed to work when the disease recurred.Therefore, glucocorticoid or infliximab should be considered for further treatment.

Objective:To establish a comprehensive and effective scoring model based on ultrasonic characteristics for predicting the restenosis risk after superficial femoral artery stenting, in order to assess the possibility of in-stent restenosis and to provide guidance for the selection of therapeutic strategies.Methods:A retrospective review of a database of 328 patients (381 limbs) undergoing superficial femoral artery stents in Xuanwu Hospital, Capital Medical University from January 2016 to January 2018 was made as a modeling group.In the modeling cohort, the multivariate logistic regression analysis was performed to screen independent risk factors for in-stent restenosis. A predictive scoring model of restenosis risk was established with weighted score of independent risk factors according to the odd ratio values. Based on the best cut-off value of the receiver operating characteristic (ROC) curves, the scoring table was divided into low-risk and high-risk groups of restenosis.Results:Multivariate logistic regression analysis showed that 8 factors were included in the score system to establish the scoring model of in-stent restenosis risk prediction including calcified plaque, peak systolic velocity of popliteal artery<40 cm/s, runoff scores≥4, ankle-brachial index<0.5, female (1 point each); complicated stroke, complicated chronic renal disease, total lesion length 15.0-24.9 cm (2 points each); total lesion length≥25.0 cm (3 points), a total of 12 points in the model. The validation indicated that the scoring system had good predictive value(AUC=0.775, 95% CI=0.727-0.824, P<0.001) and goodness of fit (Hosmer-Lemeshow χ 2=4.921, P=0.766). The agreement with digital subtraction angiography(DSA) was good (Kappa value=0.609). The scoring system was further divided into the low-risk restenosis (0-5 points) and high-risk restenosis (6-12 points) according to the best cut-off value of 5.5, with a sensitivity of 68.1%, a specificity of 74.6%, and the accuracy of 72.7%. Conclusions:The superficial femoral artery in-stent restenosis risk predicting score model based on ultrasonic characteristics may accurately predict the restenosis preoperatively. It provides a theoretical basis for the precise surgical plans.

Concerning on the safety risks caused by electromagnetic interference of patients implanted with high-risk active implantable medical devices in the environment of domestic MUs, this study evaluates and focuses on the requirements of electromagnetic compatibility in domestic and international standards for rail transit vehicles, the main mechanism of risks caused by EMI, the actual measurement of environmental data in MUs and the working performance of various active implantables in the compartment. The test results shows that all kinds of active implantable medical device samples works normally in the CRH2A EMU in China, and there is still a large margin between the measured radiation emission in MU and the limit required by the standards.
China ; Electromagnetic Fields ; Electromagnetic Radiation ; Humans ; Pacemaker, Artificial ; Prostheses and Implants

OBJECTIVE：To study the anti-inflammatory effects of water extract from Inner Mongolia medicine Agi （i. e. the aerial part of Artemisia frigida ），and to preliminarily explore its mechanism. METHODS ：Totally 60 mice were randomly divided into model control group （water），aspirin group （positive control ，0.4 g/kg），Agi water extract high-dose ，medium-dose and low-dose groups （60.0，30.0，15.0 g/kg，by crude medicine ），with 12 mice in each group. After intragastric administration for consecutive 5 d，the ear swelling of mice was induced by 2，4-dinitrochlorobenzene. Another 60 mice were grouped and admini- stered by the same way ，and the foot swelling of mice was induced by carrageenan. The ear swelling degree and inhibitory rate ， paw swelling rate were calculated to evaluate the anti-inflammatory effect of Agi water extract. The contents of TNF-α，IL-1β and PGE2 in plantar inflammatory tissue induced by carrageenan in mice were determined by ELISA. The content of MDA was determined by thiobarbituric acid trace method and NO by nitrate reductase method. RESULTS ：Compared with model control group，the degrees of ear swelling of mice were decreased significantly in aspirin group and Agi water extract high-dose ， medium-dose，low-dose groups （P＜0.05 or P＜0.01），and the inhibitory rates of ear swelling were 72.3％，71.1％，52.6％， 36.8％，respectively；the paw swelling rates of mice in aspirin group and Agi high-dose，medium-dose groups were decreased significantly，while those were decreased significantly in Agi water extract low-dose group 0.5 h and 4.0 h after inducing inflammation（P＜0.05 or P＜0.01）；the contents of TNF-α，IL-1β，PGE2，NO and MDA in plantar inflammatory tissue of mice in aspirin group and Agi water extract high-dose ，medium-dose groups were decreased significantly （P＜0.05 or P＜0.01）. CONCLUSIONS：Inner Mongolia medicine Agi water extract has obvious anti-inflammatory effects on ear swelling induced by 2，4-dinitrochlorobenzene and paw swelling induced by carrageenan ，and its mechanism may be related to the inhibition of TNF-α， IL-1β and PGE2 generation，the reduction of NO and MDA excessive release in inflammatory tissues.

Objective:To explore the value of ex- vivo porcine stomach model for endoscopic submucosal dissection (ESD) training for international trainees. Methods:Fifteen international students received ESD training and learning for twenty days. Firstly, students learned basic theory of ESD and completed a questionnaire. Then they were randomized to receive endoscopic training either on the vitro animal (group A) or on training experience (group B) of the clinical observation. At last, one case was assessed by an experienced endoscopist. The total and step-by-step operating time, complete resection, size of specimen and complications were recorded. All students completed the questionnaire once again. SPSS 20.0 was used for t test and chi-square test. Results:There was significant difference in total ESD operation time between group A and group B ( P<0.05). There were significant differences between the two groups on cutting time and dissection time, but there was no difference on marking time, injection time and operating speed. There was only one case of block resection and perforation in each group. For group A, their mastery and clinic confidence of ESD had been obviously increased after the animal training course. Compared with the operation before the training in group A, it was found that the total time and cutting time of the ESD after the training were also significantly improved. Conclusion:Theory combined with endoscopic training on vitro animal model can make the trainees familiar with the basic theory and master the operational skills, which is helpful and valuable for them to perform ESD in further clinic practice.

Post-stroke depression often seriously affects the prognosis and quality of life of patients and many clinical trials had shown that Chai Hu Shu Gan San (柴胡疏肝散) combined with selective serotonin reuptake inhibitors (SSRIs) had good efficacy and minor side effects. We aimed to conduct this metaanalysis to evaluate the efficacy and safety of Chai Hu Shu Gan San as an adjuvant drug for SSRI in treating post-stroke depression. We searched PubMed, EMBASE, Cochrane Library, Wanfang, China Biology Medicine disc (CBM), Chongqing VIP, and CNKI (China National Knowledge Infrastructure) from their date of foundation to December 15, 2018. Literature screening, data extraction and quality assessment were conducted by two authors independently. The data synthesis and analysis were performed by using Review Manager (RevMan) 5.3 software and sensitivity analysis was conducted to assess the robustness of the results. Finally, a total of 22 articles were included. The meta-analysis confirmed the advantages of the combination of SSRI and Chai Hu Shu Gan San, mainly from four aspects: the Hamilton Depression (HAMD) scale score (MD=3.66; 95% DI=2.33-4.98; p<0.001), the Modified Edinburgh Scandinavian Stroke Scale (MESSS) score (MD=4.87; 95% CI=2.32-7.43; p<0.001), the efficacy rate (OR=3.50; 95% CI =2.61-4.69; p<0.001) and the incidence of adverse reactions (OR=0.28; 95% CI=0.17-0.46; p<0.001). No significant publication bias was observed, and sensitivity analysis suggested a good stability of the results. According to the present evidence, we concluded that Chai Hu Shu Gan Sa