Cardiovascular diseases （CVD），a group of common diseases in clinical practice，are witnessing a steady rise in both incidence and mortality rates，posing a challenge to public health. Gualou Xiebai Banxiatang，originating from Synopsis of the Golden Chamber （《金匮要略》），was initially used to treat severe cases of chest impediment. The formula consists of Trichosanthis Fructus，Allii Macrostemonis Bulbus，Pinelliae Rhizoma，and Baijiu. It has a wide range of clinical applications，with therapeutic effects including moving Qi to relieve depression，activating Yang to dissipate mass，and expelling phlegm to alleviate chest congestion. In recent years，clinical research has confirmed that Gualou Xiebai Banxiatang，with or without modification，used alone or in combination with Western medicine，has definite effects in the treatment of CVD such as hyperlipidemia，coronary atherosclerotic heart disease，hypertension，heart failure，and arrhythmia. It can alleviate disease symptoms and reduce the risk of re-hospitalization. Basic research indicates that the mechanisms of Gualou Xiebai Banxiatang include improving endothelial functions，exhibiting anti-inflammatory properties，countering oxidative stress，preventing apoptosis，inhibiting ventricular remodeling，regulating mitochondrial functions，improving hemorheology，and modulating autophagy and neurotransmitters. This article reviews relevant articles in recent years with focuses on the compatibility，clinical application，and mechanism of Gualou Xiebai Banxiatang. This review is expected to provide a theoretical basis for the mechanism research and clinical application of this formula in treating CVD and to offer ideas and reference for in-depth research.

ObjectiveTo investigate the effect of Naoqingtong decoction （NQT） on the kidney damage and the inflammatory factors NOD-like receptor protein 3 （NLRP3）， apoptosis-associated speck-like protein containing a C-terminal caspase recruitment domain （ASC）， cysteinyl aspartate-specific proteinase-1 （Caspase-1）， interleukin-6 （IL-6）， and tumor necrosis factor-α （TNF-α） in spontaneously hypertensive rats （SHRs）. MethodsTwenty-four SHRs were randomized into a model group， a low-dose （12.9 g·kg^-1·d^-1） NQT （NQT-L） group， a high-dose （25.8 g·kg^-1·d^-1） NQT group （NQT-H）， and a captopril （CTP， 20 mg·kg^-1·d^-1） group， with 6 rats in each group. In addition， 6 homozygous male Wistar-Kyoto rats were used as the control group. The control and model groups were administrated with the same amount of normal saline by gavage for 8 weeks. General behaviors of rats were observed during the intervention period， and the blood pressure was measured periodically. At the end of intervention， the body mass was weighed， and both kidneys were collected and weighed for the calculation of the renal index. Hematoxylin-eosin staining was performed to observe the pathological changes in the kidney tissue. Real-time fluorescence quantitative polymerase chain reaction （Real-time PCR） and Western blot were employed to determine the expression levels of NLRP3， ASC， Caspase-1， IL-6， and TNF-α in the kidney tissue. ResultsDuring the experiment period， the control group had normal mental status， food intake， and activity， while the model group showed thinning of hair， loss of luster， reduced activity， loss of appetite， fecal adhesion， and irritability， and some of the skin had scratches or blood scabs. The above symptoms were alleviated to different degrees after 8 weeks of NQT administration. An intelligent non-invasive sphygmomanometer was used to measure the tail artery pressure of rats， which showed that the systolic and diastolic blood pressure of rats in the model group was higher than that in the control group （P<0.01）. Compared with the model group， drug interventions lowered the systolic and diastolic blood pressure （P<0.05， P<0.01）. Compared with the control group， the model group showed severe pathological damage in the kidney tissue， which was alleviated in each drug intervention group. Compared with the control group， the model group showed up-regulated expression levels of NLRP3， ASC， Caspase-1， IL-6， and TNF-α in the kidney tissue （P<0.05， P<0.01）. Compared with the model group， the drug intervention groups showed down-regulated expression levels of NLRP3， ASC， Caspase-1， IL-6， and TNF-α in the kidney tissue （P<0.05， P<0.01）. ConclusionNQT can lower the blood pressure in SHRs by inhibiting the activation of NLRP3 inflammasomes， suppressing renal inflammation， and ameliorating hypertensive kidney damage.

Objective To investigate the application effect of postural gravity traction combined with floss and titanium clip pulley external traction in endoscopic submucosal dissection(ESD)for early intestinal lesions.Methods A total of 100 patients with early colorectal lesions admitted to the Affiliated Hospital of Jiangsu University from January 2022 to September 2024 were selected as the research subjects and divided in-to the observation group and the control group,with 50 cases in each group.The control group underwent con-ventional intestinal ESD treatment,while the observation group used positional gravity traction combined with dental floss and titanium clips to form pulley external traction in ESD treatment.Clinical data including opera-tion time,number of submucosal injections,intraoperative blood loss,lesion resection effect,complication inci-dence,and hospital stay were compared between the two groups.Results The total operation time in the ob-servation group was shorter than that in the control group,and the total number of submucosal injections was less than that in the control group,with statistically significant differences(P<0.05).There were no signifi-cant differences in intraoperative blood loss,complete resection rate,complication incidence,en bloc resection rate,and hospital stay between the two groups(P>0.05).For lesions≤1 cm or>5 cm in size,there were no significant differences in operation time,complete resection rate and en bloc resection rate between the two groups(P>0.05).For lesions>1-3 cm or>3-5 cm in size and laterally spreading lesions,significant differences were observed in operation time,number of submucosal injections,complete resection rate,and en bloc resection rate between the two groups(P<0.05).For pedunculated polyps,there were no significant differences in the number of submucosal injections,complete resection rate and en bloc resection rate between the two groups(P>0.05),but the operation time differed significantly(P<0.05).Conclusion Postural gravity traction combined with dental floss and titanium clip to form pulley external traction is simple to oper-ate in ESD for early intestinal lesions.It can maintain a clear field of view,shorten operation time,reduce the incidence of complications,and is safe and effective.

OBJECTIVE: To investigate the effect of stretch on long non-coding RNA taurine upregulated gene 1 (TUG1)-mediated miR-545-3p/cannbinoida receptor 2 (CNR2) pathway regulating bone regeneration in the distraction area of rats during distraction osteogenesis. METHODS: Thirty-six 10-week-old male Sprague Dawley rats were randomly divided into 3 groups ( n=12 in each group): group A (femoral fracture+injection of interfering RNA), group B (distraction osteogenesis+injection of interfering RNA), and group C (distraction osteogenesis+injection of TUG1). Groups A and B were injected with 60 μg of interfering RNA at the beginning of incubation period (immediate after operation), the beginning of distraction phase (7 days after operation), and the end of distraction phase (21 days after operation), and group C was injected with 60 μg of synthetic TUG1 in vivo interfering sequence at the same time. The general situation of rats in each group was observed during the experiment. The mineralization of fracture space or distraction area was observed by X-ray films at 21, 35, and 49 days after operation. At 49 days after operation, the samples of the distraction area were taken for HE staining to observe the mineralization, and real-time fluorescence quantitative PCR (qRT-PCR) was used to detect the expressions of osteoblast-related genes such as TUG1, miR-545-3p, CNR2, alkaline phosphatase (ALP), osteocalcin (OCN), and osteopontin (OPN). Blood samples were collected from the abdominal aorta of the rats, and the expressions of ALP and C terminal telopeptide of type Ⅰ (CTX-Ⅰ) protein were detected by ELISA assay. RESULTS: The results of X-ray film and HE staining observations showed that osteogenesis in group C was superior to groups A and B at the same time point. The results of qRT-PCR showed that the relative mRNA expressions of TUG1, CNR2, ALP, OCN, and OPN in group C were significantly higher than those in group A and group B, and the relative mRNA expression of miR-545-3p in group C was significantly lower than that in group A and group B ( P<0.05). The relative mRNA expressions of TUG1 and ALP in group B were significantly higher than those in group A, and the relative mRNA expression of miR-545-3p in group B was significantly lower than that in group A ( P<0.05). There was no significant difference in the relative mRNA expressions of CNR2, OCN, and OPN between group A and group B ( P>0.05). The results of ELISA showed that the expressions of ALP and CTX-Ⅰ protein were significantly higher in group C than in group A and group B, and in group B than in group A ( P<0.05). CONCLUSION Under the action of stretch, the expression of TUG1 in the femoral distraction area of rats increases, which promotes the expression of CNR2 by inhibiting the expression of miR-545-3P, which is helpful to the mineralization of the extension area and osteogenesis.
Animals ; MicroRNAs/genetics* ; Rats, Sprague-Dawley ; Male ; Osteogenesis, Distraction/methods* ; Rats ; RNA, Long Noncoding/metabolism* ; Osteopontin/genetics* ; Osteogenesis ; Bone Regeneration ; RNA, Small Interfering/genetics* ; Osteocalcin/genetics* ; Alkaline Phosphatase/metabolism* ; Osteoblasts/cytology* ; Signal Transduction ; Femoral Fractures/surgery*

Objective To explore the value of quantitative analysis of perirenal fat combined with Mayo adhesive probability(MAP)score in predicting the WHO/International Society of Urological Pathology(ISUP)nuclear grade of renal cell carcinoma(RCC).Methods The imaging data of 139 pathologically confirmed RCC patients were retrospectively analyzed.The patients were divided into low-grade group(grade Ⅰ-Ⅱ,n=112)and high-grade group(grade Ⅲ-Ⅳ,n=27)according to the WHO/ISUP nuclear grade.Spearman correlation analysis was used to assess the relationship between fat features and WHO/ISUP nuclear grade.The multivariate logistic regression model was used to detemine the related factors of high-grade RCC,and the area under the curve(AUC)of the receiver operating characteristic(ROC)curve was used to evaluate the diagnostic performance of each parameter.Results The AUC of perirenal adipose tissue(PAT)％alone for evaluating high-grade RCC was the highest,at 0.77[95％confidence interval(CI)0.69-0.83].The stepwise multivariate logistic regression model showed that perinephric fat stranding(PFS)[odds ratio(OR)=34.54,95％CI 7.60-156.87,P＜0.001],PAT％(OR=0.46,95％CI 0.32-0.66,P＜0.001),and tumor location(OR=0.26,95％CI 0.07-0.92,P=0.037)were related factors of high-grade RCC,with an AUC of 0.90(95％CI 0.84-0.94).Conclusion Quantitative analysis of perire-nal fat combined with MAP score can effectively predict the WHO/ISUP nuclear grade of RCC,providing a novel approach for per-sonalized treatment strategies to improve prognosis.

Objective To explore the causal relationship between myopia and specific immune cells through Mende-lian randomization(MR)analysis.Methods Data were mined from the Genome-Wide Association Studies(GWAS)data-base,and 731 immune cell characteristics were selected as exposure factors and myopia as the outcome factor.A signifi-cance threshold was established to filter single nucleotide polymorphisms(SNPs)significantly associated with immune cells and myopia,and the influence of weak instrument variable bias was eliminated.The primary analysis method employed was the inverse variance weighted(IVW)approach,supplemented by simple mode,weighted median,weighted mode,and MR-Egger regression for data analysis.The causal relationship between circulating immune cells and myopia was assessed using odds ratios(OR)and 95％confidence intervals.For the SNPs of immune cells that met the hypothesis,Cochran's Q test was used to evaluate heterogeneity,and MR-Egger regression and MR-PRESSO methods were employed to exclude hor-izontal pleiotropy.The leave-one-out analysis was utilized to assess whether significant results were driven by individual SNPs.To avoid reverse causal relationships,myopia was taken as the exposure variable and immune cell phenotypes as outcome variables in the reverse MR analysis.Additionally,multivariate Mendelian randomization(MVMR)was used to e-valuate the causal and independent effects of these immune cells on myopia.Results(1)The results from the two-sam-ple MR IVW method indicated that Memory B cell AC and CD24+CD27+AC(B cells)were protective factors against my-opia.In contrast,Naive CD8br％CD8br(T cells),CD39+CD8br AC(T cells),CD25 on CD39+activated Treg(T cells),PDL-1 on CD 14+CD 16+monocytes and CD80 on myeloid DC were identified as risk factors for myopia.These re-sults are consistent with those of MR-Egger and other methods.MR-Egger regression and MR-PRESSO analyses demonstra-ted that there was no horizontal pleiotropy(P＞0.05).(2)The reverse two-sample MR analysis revealed no bidirectional causal relationships between myopia and the aforementioned seven immune cells(all P＞0.05).(3)In the MVMR analysis,the significant causal relationship between CD80 on myeloid DC and myopia remained robust after adjusting for potential confounding variables.Conclusion This study reveals the complex causal relationships between various immune pheno-types and myopia through genetic methods,and demonstrates the intricate regulatory patterns of interactions between the immune system and myopia.

Objective To investigate the effect of probiotics on febrile seizures(FS)in rats and NOD-like receptor pyrin domain-containing protein 3(NLRP3)inflammasome activation in hippocampus.Methods A total of 120 rats were randomly divided into three groups:a control group,a model group,and a probiotic treatment group,with 40 rats in each group.FS rat models were established in both the model group and the probiotic group.The probiotic group was administered with microecological preparations via gavage,while the model group and the control group were fed with distilled water.After the intervention,the model group and the probiotic group were subjected to a hot water bath stimulus again to induce a secondary FS episode.Relevant indicators were recorded,and samples were collected for detection and analysis.Results For the blank group,the structure of neurons in hippocampus was complete,the morphology was regular,and the size is uniform.For the model group,hippocampal zones varied in width,cell number in hippocampus decreased,and the arrangement of hippocampal neurons was irregular.For the probiotics group,cell number in hippocampus were more than the model group,and the changes in the structure were fewer than those in the model group.Compared with the model group,the latent time of FS was significantly longer,the duration of FS was significantly shorter,and the level of FS was significantly lower in the probiotics group(P＜0.05).The relative expression levels of NLRP3,interleukin-1β(IL-1β),and interleukin-18(IL-18)proteins in hippocampal tissues and serum of the probiotic group were significantly fewer than those in the model group but significantly higher than those in the control group,with statistically significant differences between groups(P＜0.05).The numbers of Bifidobacterium and Lactobacillus decreased sequentially from the control group to the probiotic group and then to the model group,while the numbers of Escherichia coli and Enterococcus faecalis increased correspondingly,with statistically significant differences between groups(P＜0.05).The levels of dia mine oxidase(DAO),D-lactate,and NO in serum of the probiotic group were lower than those in the model group but higher than those in the control group,with statistically significant differences between groups(P＜0.05).Conclusion Probioticseffectively alleviate FS episodes by inhibiting NLRP3 inflammasome activation,reducing inflammatory cytokine levels,modulating intestinal microbiota composition,and preserving intestinal barrier function,providing a novel strategy for the prevention and treatment of FS.

Objective To analyze the medication law and compatibility characteristics of TCM compounds for the treatment of myocardial infarction in the national patent database.Methods TCM compounds for treating myocardial infarction were retrieved from CNIPA patent publication website.A prescription database was built using Excel 2019 software to statistically analyze the frequency of medicinal use and their properties,taste and meridian tropism;SPSS Modeler 18.0 software was used to analyze the association rules of drugs;a network of Chinese materia medica co-occurrence was constructed using Cytoscape 3.10.0,and systematic clustering analysis was performed on the Chinese materia medica in the core network.Results A total of 146 patents of TCM compounds were included,involved 440 kinds of Chinese materia medica.High frequency drugs included Salviea Miltiorrhizae Radix et Rhizoma,Chuanxiong Rhizoma,Angelicae Sinensis Radix,Glycyrrhizae Radix et Rhizoma,etc.The main property was warm,the main tastes were bitter,sweet and pungent,and the medicines mostly belongs to the liver meridian,heart meridian and spleen meridians.Commonly used medicinal pairs included Angelicae Sinensis Radix-Chuanxiong Rhizoma,Astragali Radix-Salviea Miltiorrhizae Radix et Rhizoma,Paeoniae Radix Rubra-Angelicae Sinensis Radix,etc.Commonly used tripartite combinations included Paeoniae Radix Rubra-Chuanxiong Rhizoma-Angelicae Sinensis Radix,Carthami Flos-Angelicae Sinensis Radix-Chuanxiong Rhizoma,Carthami Flos-Chuanxiong Rhizoma-Angelicae Sinensis Radix,etc.Clustering analysis showed four types of combinations.Conclusion TCM compound patents for the treatment of myocardial infarction is based on promoting blood circulation,removing blood stasis,and relieving pain,while also using methods such as eliminating phlegm,tonifying qi,warming yang,and nourishing yin.It can provide references for clinical medication.

Fracture of humeral capitellum (FHC) in children is often detected on the coronal plane of the distal humerus.It is an intra-articular fracture, often a Salter-Harris type Ⅲ epiphyseal fracture, which is extremely rare in clinical practice and accounts for only about 1% of elbow fractures in children.This type of fracture tends to extend medially involving the trochlea, so it is also known as capitellar trochlea fracture.The rarity of this fracture makes it difficult to differentiate it from other elbow fractures on X-ray, which finally leads to miss-diagnosis or misdiagnosis as epicondylar humerus fracture or intercondylar fracture, etc.Since FHC is an intra-articular and epiphyseal fracture, inappropriate treatment will results in irreversible consequences, so the diagnosis and treatment of FHC in children are challenging.Currently, there are few studies on FHC in children, and most of related studies are case reports.Therefore, the classification and treatment of FHC in children are performed based on only the experience of FHC treatment in adults.Incisional reduction and internal fixation is the preferred treatment for most FHC children, but the efficacy of this treatment lacks the support of controlled studies with a large sample size.The mechanism of injury, staging, diagnosis, treatment, postoperative rehabilitation, and complications of pediatric FHC were reviewed in this paper to improve clinicians' understanding of pediatric FHC.

Fracture of humeral capitellum (FHC) in children is often detected on the coronal plane of the distal humerus.It is an intra-articular fracture, often a Salter-Harris type Ⅲ epiphyseal fracture, which is extremely rare in clinical practice and accounts for only about 1% of elbow fractures in children.This type of fracture tends to extend medially involving the trochlea, so it is also known as capitellar trochlea fracture.The rarity of this fracture makes it difficult to differentiate it from other elbow fractures on X-ray, which finally leads to miss-diagnosis or misdiagnosis as epicondylar humerus fracture or intercondylar fracture, etc.Since FHC is an intra-articular and epiphyseal fracture, inappropriate treatment will results in irreversible consequences, so the diagnosis and treatment of FHC in children are challenging.Currently, there are few studies on FHC in children, and most of related studies are case reports.Therefore, the classification and treatment of FHC in children are performed based on only the experience of FHC treatment in adults.Incisional reduction and internal fixation is the preferred treatment for most FHC children, but the efficacy of this treatment lacks the support of controlled studies with a large sample size.The mechanism of injury, staging, diagnosis, treatment, postoperative rehabilitation, and complications of pediatric FHC were reviewed in this paper to improve clinicians' understanding of pediatric FHC.