Objective:To report the preclinical trial results of the application of a domestic high-flow percutaneous left ventricular assist device (pLVAD) in patients with low cardiac output syndrome (LCOS) following cardiac surgery.Methods:Six patients who developed LCOS after direct cardiac surgery were implanted with a domestic high-flow pLVAD. Clinical outcomes, including hemodynamic changes, complications, and survival rates were observed post-implantation.Results:Four patients underwent pLVAD implantation under digital subtraction angiography (DSA) guidance, while two patients had the procedure performed under ultrasound guidance. The implantation process was straightforward, rapid, and uneventful, with no instances of bleeding or arrhythmias. The flow rate at the initiation of pLVAD support was 3.8-5.0 (4.22±0.44)L/min, and the flow rate during pump removal was 1.0-1.3(1.18±0.15)L/min. The duration of pLVAD support was 16.5-165.0(101.3±60.65)h. Hemodynamic parameters showed immediate improvement following pLVAD support: mean arterial pressure increased from (62.67±4.46)mmHg to (80.50±18.96)mmHg (1 mmHg=0.133 kPa, P=0.049), cardiac output increased from (2.45±0.66)L/min to (4.35±1.32)L/min( P=0.01), cardiac index improved from (1.95±0.21)L·min -1·m -2 to (2.77±0.33)L·min -1·m -2( P<0.001), pulmonary artery diastolic pressure decreased from (27.50±1.87) mmHg to(18.33±4.18)mmHg( P=0.001), and left ventricular ejection fraction improved from 0.27±0.04 to 0.37±0.06 ( P=0.004). No visible hemoglobinuria was noted during the support period. No malignant arrhythmias or cerebrovascular complications occurred. One patient required transition to surgical LVAD implantation, while the other five patients had the pLVAD successfully removed and were discharged. Three months later, all six patients were alive, with functional status classified as New York Heart Association (NYHA) Class Ⅰ-Ⅱ. Conclusion:The implantation of a domestic high-flow pLVAD provides a safe and effective therapeutic option for patients with LCOS following cardiac surgery.

Objective:To report the preclinical trial results of the application of a domestic high-flow percutaneous left ventricular assist device (pLVAD) in patients with low cardiac output syndrome (LCOS) following cardiac surgery.Methods:Six patients who developed LCOS after direct cardiac surgery were implanted with a domestic high-flow pLVAD. Clinical outcomes, including hemodynamic changes, complications, and survival rates were observed post-implantation.Results:Four patients underwent pLVAD implantation under digital subtraction angiography (DSA) guidance, while two patients had the procedure performed under ultrasound guidance. The implantation process was straightforward, rapid, and uneventful, with no instances of bleeding or arrhythmias. The flow rate at the initiation of pLVAD support was 3.8-5.0 (4.22±0.44)L/min, and the flow rate during pump removal was 1.0-1.3(1.18±0.15)L/min. The duration of pLVAD support was 16.5-165.0(101.3±60.65)h. Hemodynamic parameters showed immediate improvement following pLVAD support: mean arterial pressure increased from (62.67±4.46)mmHg to (80.50±18.96)mmHg (1 mmHg=0.133 kPa, P=0.049), cardiac output increased from (2.45±0.66)L/min to (4.35±1.32)L/min( P=0.01), cardiac index improved from (1.95±0.21)L·min -1·m -2 to (2.77±0.33)L·min -1·m -2( P<0.001), pulmonary artery diastolic pressure decreased from (27.50±1.87) mmHg to(18.33±4.18)mmHg( P=0.001), and left ventricular ejection fraction improved from 0.27±0.04 to 0.37±0.06 ( P=0.004). No visible hemoglobinuria was noted during the support period. No malignant arrhythmias or cerebrovascular complications occurred. One patient required transition to surgical LVAD implantation, while the other five patients had the pLVAD successfully removed and were discharged. Three months later, all six patients were alive, with functional status classified as New York Heart Association (NYHA) Class Ⅰ-Ⅱ. Conclusion:The implantation of a domestic high-flow pLVAD provides a safe and effective therapeutic option for patients with LCOS following cardiac surgery.

Objective:To identify the trajectory of fatigue-related symptom clusters(fatigue-decreased appetite-pain)in patients with lung cancer receiving immunotherapy and their influencing factors.Methods:From March 2022 to March 2023,114 patients with lung cancer receiving immunotherapy for the first time in Fudan University Shanghai Cancer Center were selected as research subjects.A 6-month longitudinal follow-up was performed using the PRO-CTCAE-based subset for lung cancer immunotherapy,and the demographic,disease physiological,psychological,social and healthy lifestyle data of patients were collected before the first dose.Growth mixed model and logistic regression analysis were used to identify the trajectory categories and influencing factors of fatigue-related symptom clusters.Results:Two fatigue trajectories of patients with lung cancer receiving immunotherapy were identified,named"mild to moderate fatigue persistent group"and"mild fatigue production-relief group".Three trajectories of decreased appetite were identified and named"decreased appetite aggravation group","mild decreased appetite maintenance group"and"decreased appetite exacerbation-relief group".Three trajectories of pain were identified,named"mild pain relief group","mild pain maintenance group"and"mild to moderate pain aggravation group".Logistic regression analysis showed that the age(OR=1.076,P=0.015)and targeted therapy(OR=10.743,P=0.009)were influential factors for fatigue.Duration of disease(OR=0.112,P=0.015),pemetrexed(OR=3.210,P=0.027)and targeted therapy(OR=7.077,P=0.032)were influential factors for pain.No influencing factors for decreased appetite have been identified.Conclusion:There is variability in the trajectory of symptom change in the fatigue-related symptom cluster in patients receiving immunotherapy for lung cancer.A small number of patients showed a trend of persistent worsening of appetite loss and pain.Future studies may continue to analyze intervention nodes based on symptom profile categories and help healthcare professionals identify key populations through influencing factors to provide personalized and holistic symptom management for patients with lung cancer receiving immunotherapy.

Objective:To extract the early result of postoperative echocardiographic evaluation in patients underwent left ventricular assist device (LVAD) implantation, and to assess the efficacy of surgical treatment for end-staged heart failure.Methods:Between June 2019 and May 2023, the patients underwent left ventricular assist device implantation were enrolled in this study. Demographic baseline characteristics and perioperative echocardiographic parameters were collected and analyzed.Results:A total of 28 patients were included in the study. After LVAD implantation, the heart sizes of the patients obviously reduced and the left heart contractibility function improved. The right ventricular contractibility remained stable. The proportion of the patients with moderate to severe mitral regurgitation was significantly reduced, but patients with mild to moderate aortic insufficiency increased. No serious complications such as death, pericardial tamponade and thrombosis events were observed during the follow-up period.Conclusion:LVAD implantation improved the left cardiac function, while the right cardiac function remained stable. However, it should be paid attention that the aortic valve function was impaired after the surgery. Generally, the early results of LVAD implantation for the treatment of end-stage heart failure were satisfactory.

Objective:To identify the trajectory of fatigue-related symptom clusters(fatigue-decreased appetite-pain)in patients with lung cancer receiving immunotherapy and their influencing factors.Methods:From March 2022 to March 2023,114 patients with lung cancer receiving immunotherapy for the first time in Fudan University Shanghai Cancer Center were selected as research subjects.A 6-month longitudinal follow-up was performed using the PRO-CTCAE-based subset for lung cancer immunotherapy,and the demographic,disease physiological,psychological,social and healthy lifestyle data of patients were collected before the first dose.Growth mixed model and logistic regression analysis were used to identify the trajectory categories and influencing factors of fatigue-related symptom clusters.Results:Two fatigue trajectories of patients with lung cancer receiving immunotherapy were identified,named"mild to moderate fatigue persistent group"and"mild fatigue production-relief group".Three trajectories of decreased appetite were identified and named"decreased appetite aggravation group","mild decreased appetite maintenance group"and"decreased appetite exacerbation-relief group".Three trajectories of pain were identified,named"mild pain relief group","mild pain maintenance group"and"mild to moderate pain aggravation group".Logistic regression analysis showed that the age(OR=1.076,P=0.015)and targeted therapy(OR=10.743,P=0.009)were influential factors for fatigue.Duration of disease(OR=0.112,P=0.015),pemetrexed(OR=3.210,P=0.027)and targeted therapy(OR=7.077,P=0.032)were influential factors for pain.No influencing factors for decreased appetite have been identified.Conclusion:There is variability in the trajectory of symptom change in the fatigue-related symptom cluster in patients receiving immunotherapy for lung cancer.A small number of patients showed a trend of persistent worsening of appetite loss and pain.Future studies may continue to analyze intervention nodes based on symptom profile categories and help healthcare professionals identify key populations through influencing factors to provide personalized and holistic symptom management for patients with lung cancer receiving immunotherapy.

Heart transplantation is the primary therapeutic option for patients with end-stage heart failure. The shortage of donors has been the main limiting factor for the increasing quantity of heart transplantation. With persistent updating and introduction of novel technologies, the donor pool has been increasingly expanded, such as using the heart from older donors, donors infected with hepatitis C virus, donors dying from drug overdose or donation after cardiac death (DCD) donors, etc. Meantime, the proportion of recipients with advanced age, multiple organ dysfunction, mechanical circulatory support and human leukocyte antigen antibody sensitization has been significantly increased in recent years. The shortage of donors, complication of recipients' conditions, individualized management of immunosuppressive therapy and prevention and treatment of long-term cardiac allograft vasculopathy are all challenges in the field of heart transplantation. In this article, novel progresses on donor pool expansion, improving the quality of recipients, strengthening the diagnosis and treatment of rejection, and preventing cardiac allograft vasculopathy were reviewed, aiming to prolong the survival and enhance the quality of life of patients with end-stage heart failure on the waiting list or underwent heart transplantation.

Adhesive intestinal obstruction is the most common type of ileus, and conserva-tive treatment serves as its preferred treatment option. In the course of conservative treatment, gastrointestinal decompression will relieve symptoms, prevent ileus progression and promote gas-trointestinal function recovery, which has significant clinical effects. Currently, decompression effects of nasointestinal tubes and nasogastric tubes are controversial. There is a previous Meta-analysis evaluating decompression effects of these two methods, but this analysis includes non-randomized controlled trial and lacks research about Chinese patients. Therefore, the authors con-duct a Meta-analysis to evaluate decompression effects of nasointestinal tubes versus nasogastric tubes for adhesive intestinal obstruction.

Background: Colorectal cancer (CRC) is one of the most common cancers in China and even in the world, and metastasis is the main cause of death. However, there is lack of sufficient molecular biomarkers for predicting effectively the occurrence of metastasis. Aims: To explore the expression of fibulin-2 (FBLN2) in CRC and the underlying mechanism of its effect on tumor invasion and metastasis. Methods: Bioinformatics data of PRJNA218851 data set from the SRA database were extracted to screen CRC metastasis-associated genes. Then these differentially expressed genes were applied for gene enrichment analysis to identify the most significant pathways. Data from TCGA and clinical CRC samples were used to analyze the expression of FBLN2 in CRC tissues and normal tissues, and the relationship between FBLN2 and clinicopathological features and prognosis of CRC patients. Expression of FBLN2 in normal colorectal mucosal cell line, CRC cell lines, and clinical CRC samples was detected by real-time PCR. After FBLN2 was knockdown or over expressed in CRC cells, CCK-8 assay, clone formation assay, Transwell cell invasion and migration assay, and wound healing assay were performed to observe the effect of FBLN2 on the proliferation, invasion and migration abilities of CRC cells. Gene set enrichment analysis was conducted to screen the potential downstream pathway of FBLN2, and then the pathway screened was verified. Results: The expression of FBLN2 was low in eight CRC cell lines and CRC tissues, yet the expression in metastatic CRC was significantly higher than that in non-metastatic ones. Compared with CRC patients with low FBLN2 expression, CRC patients with high FBLN2 expression were prone to have lymph node metastasis and distant metastasis, and with higher clinical stage and poorer prognosis. Knockdown of FBLN2 could decrease the invasion and migration abilities of CRC cells, but had no impact on cell proliferation. FBLN2 was positively correlated with CDH2, Snai1 and vimentin, indicating that the epithelial-mesenchymal transition (EMT) pathway might be the downstream pathway of FBLN2. Conclusions: FBLN2 is low expressed in CRC but the expression is increased in metastatic CRC. Therefore, it might be used as a molecular biomarker for screening early metastasis. FBLN2 might enhance CRC invasion and metastasis through activating EMT pathway and is associated with poor prognosis.

Objective To explore the anti-inflammatory and analgesic effects of Shuangwu numbness-relief decoction. Methods The anti-inflammatory effect was assessed by xylene-induced mouse auricular swelling and peritoneal capillary permeability;and the analgesic effect was assessed by hot plate method and acetic acid-induced twisting method. Results Shuangwu numbness-relief decoction at moderate or high dose had a significant inhibitory effect on mouse auricular swelling, with a significant difference as compared with the control group (P<0.01);the decoction at low , moderate , or high dose group played a marked inhibitory role in the increase in mouse peritoneal capillary permeability (P<0.01). Shuangwu numbness-relief decoction at moderate or high dose effectively reduced the writhing frequency in mice (P < 0.01). The decoction at high dose increased the pain threshold in mice one hour after intragastric administration (P < 0.05), and the decoction at moderate or high dose increased the pain threshold two hours after administration (P < 0.05). Conclusions Shuangwu numbness-relief decoction has an obvious anti-inflammatory and analgesic effect.

ObjectiveTo investigate the effectiveness and safety of insulin glargine in the treatment of patients with type 2 diabetes mellitus (T2DM),and verify the new remedy called one central and three steps for T2DM.MethodsUsed multicenter,random,open and self-control study.Two hundred and three cases with T2DM treated with insulin glargine were divided into four groups according to different therapy:30 cases with one needle method,106 cases with one needle and one pill method,48 cases with one long-acting and several short-acting method,and 19 cases with one long-acting,one pill and several short-acting method.The changes of blood glucose,glycosylated hemoglobin (HbA1c),weight and so on before and after treatment were observed.ResultsThe levels of fasting plasma glucose(FPG),2 h postprandial plasma glucose (2hPPG) and HbA1c decreased significantly after treatment than those before treatment[(5.78 ±0.76)mmol/L,(8.37 ±:1.37) mmol/L,(6.81 ±0.38)％ vs. (11.73 ±4.49) mmol/L,(16.73 ±4.96) mmol/L,(9.43 ± 2.31 )％,P ＜ 0.01 ].The weight and body mass index had no obvious changes before and after treatment( P ＞ 0.05 ).There was significant difference in the level of FPG,2hPPG and HbA1c before and after treatment in four groups respectively(P＜0.01 ).There was only 1 case who occurred hypoglycemia during the treatment.ConclusionThe therapy,one central and three steps,is not only effective and safe,but also convenient and cheap for T2DM.