ObjectiveTo observe the clinical effectiveness and safety of Xiaozhong Zhitong Mixture （消肿止痛合剂） combined with antibiotic bone cement in the treatment of diabetic foot ulcer （DFU） with damp-heat obstructing syndrome. MethodsA total of 72 DFU patients with damp-heat obstructing syndrome were randomly assigned to treatment group （36 cases） and the control group （36 cases）. Both groups received standard treatment and topical antibiotic bone cement for ulcer wounds， while the treatment group received oral Xiaozhong Zhitong Mixture （50 ml per time， three times daily） in additionally. Both groups underwent daily wound dressing changes for 21 consecutive days. Ulcer healing rate， serum levels of tumor necrosis factor-alpha （TNF-α）， interleukin-1 beta （IL-1β）， malondialdehyde （MDA）， superoxide dismutase （SOD）， C-reactive protein （CRP）， and white blood cell （WBC） count were observed before and after treatment， and visual analog scale （VAS） scores for wound pain， traditional Chinese medicine （TCM） syndrome scores， and the DFU Healing Scale （DMIST scale） were also compared. Liver and kidney function were evaluated before and after treatment， and adverse events such as allergic reactions， worsening ulcer pain were recorded. ResultsTotally 35 patients in the treatment group and 33 in the control group were included in the final analysis. The ulcer healing rate in the treatment group was （87.93±9.34）%， significantly higher than （81.82±12.02）% in the control group （P = 0.035）. Compared to pre-treatment levels， both groups showed significant reductions in serum CRP， WBC， MDA， IL-1β， and TNF-α levels， with an increase in SOD level （P＜0.05）. TCM syndrome scores， VAS， and DMIST scores also significantly decreased in both groups （P＜0.05）， with greater improvements in the treatment group （P＜0.05）. No significant adverse reactions were observed in either group during treatment. ConclusionXiaozhong Zhitong Mixture combined with antibiotic bone cement has significant advantages in promoting DFU healing， reducing inflammatory response， and alleviating oxidative stress in DFU patients with damp-heat obstructing syndrome， with good safety for DFU patients with damp-heat obstructing syndrome.

Objective To investigate the protective mechanisms of huanglian jiedu decoction(HLJDD)against hypertensive cardiac hypertrophy(HCH)in rats.Methods The HCH model was constructed in SD rats through abdominal aortic constriction(AAC).Rats were randomly divided into the sham operation(Sham)group,model(Mod)group,Mod+HLJDD high,medium and low-dose(Mod+H,Mod+M,Mod+L)groups,and Mod+Captopril(Cap)group using a simple random sampling method.Blood pressure,echocardiography,hematoxylin-eosin staining,and Masson staining were performed to assess the impact of HLJDD on HCH.Based on the results of part one,rats were further randomly divided into Sham group,Mod group,Mod+Notch1 inhibitor(DAPT)group,Mod+Notch1 agonist(Jagged-1)group,Mod+HLJDD high-dose(HLJDD)group,Mod+HLJDD high-dose+Notch1 inhibitor(DAPT+H)group,and Mod+HLJDD high-dose+Notch1 agonist(Jagged-1+H)group using a simple random sampling method.Hematoxylin-eosin staining and Masson staining were observed.Real-time fluorescence quantitative polymerase chain reaction(RT-qPCR)and Western blot were used to detect the expression levels of related inflammatory factors,to further explore the mechanisms of HLJDD.Results Compared with the Mod group,rats in the Mod+H group exhibited reduced blood pressure(P＜0.05),improved cardiac func-tion(P＜0.05),relieved myocardial injury and decreased myocardial fibrosis(P＜0.05).Compared with the Mod group,the DAPT group displayed aggravated myocardial injury and fibrosis,decreased expression levels of Notch1 and Hes1(P＜0.05),and increased ex-pression levels of inflammatory factors and NF-κB p65(P＜0.05).The Jagged-1 group and HLJDD group showed opposite results.Compared with HLJDD group,the DAPT+H group displayed aggravated myocardial injury and fibrosis,decreased expression levels of Notch1 and Hes1(P＜0.05,P＜0.01),and increased expression levels of inflammatory factors and NF-κB p65(P＜0.05).The Jag-ged-1+H group showed opposite results,indicating that HLJDD can partially activate the Notch1signaling pathway while inhibiting the NF-κB signaling pathway and the release of inflammatory factors.Conclusion HLJDD can alleviate AAC-induced HCC in rats,and its mechanism may be achieved through the modulation of the Notch1/NF-κB signaling pathway.Additionally,a certain negative feed-back regulatory relationship exists between the Notch1 signaling pathway and the NF-κB signaling pathway.

Objective To investigate the protective mechanisms of huanglian jiedu decoction(HLJDD)against hypertensive cardiac hypertrophy(HCH)in rats.Methods The HCH model was constructed in SD rats through abdominal aortic constriction(AAC).Rats were randomly divided into the sham operation(Sham)group,model(Mod)group,Mod+HLJDD high,medium and low-dose(Mod+H,Mod+M,Mod+L)groups,and Mod+Captopril(Cap)group using a simple random sampling method.Blood pressure,echocardiography,hematoxylin-eosin staining,and Masson staining were performed to assess the impact of HLJDD on HCH.Based on the results of part one,rats were further randomly divided into Sham group,Mod group,Mod+Notch1 inhibitor(DAPT)group,Mod+Notch1 agonist(Jagged-1)group,Mod+HLJDD high-dose(HLJDD)group,Mod+HLJDD high-dose+Notch1 inhibitor(DAPT+H)group,and Mod+HLJDD high-dose+Notch1 agonist(Jagged-1+H)group using a simple random sampling method.Hematoxylin-eosin staining and Masson staining were observed.Real-time fluorescence quantitative polymerase chain reaction(RT-qPCR)and Western blot were used to detect the expression levels of related inflammatory factors,to further explore the mechanisms of HLJDD.Results Compared with the Mod group,rats in the Mod+H group exhibited reduced blood pressure(P＜0.05),improved cardiac func-tion(P＜0.05),relieved myocardial injury and decreased myocardial fibrosis(P＜0.05).Compared with the Mod group,the DAPT group displayed aggravated myocardial injury and fibrosis,decreased expression levels of Notch1 and Hes1(P＜0.05),and increased ex-pression levels of inflammatory factors and NF-κB p65(P＜0.05).The Jagged-1 group and HLJDD group showed opposite results.Compared with HLJDD group,the DAPT+H group displayed aggravated myocardial injury and fibrosis,decreased expression levels of Notch1 and Hes1(P＜0.05,P＜0.01),and increased expression levels of inflammatory factors and NF-κB p65(P＜0.05).The Jag-ged-1+H group showed opposite results,indicating that HLJDD can partially activate the Notch1signaling pathway while inhibiting the NF-κB signaling pathway and the release of inflammatory factors.Conclusion HLJDD can alleviate AAC-induced HCC in rats,and its mechanism may be achieved through the modulation of the Notch1/NF-κB signaling pathway.Additionally,a certain negative feed-back regulatory relationship exists between the Notch1 signaling pathway and the NF-κB signaling pathway.

Objective:To evaluate the safety and efficacy at 1-year follow-up of the use of drug-coated balloon (DCB) for the treatment of femoropopliteal in-stent restenosis (ISR).Methods:This study enrolled 252 patients undergoing Orchid DCB angioplasty for peripheral arterial disease in the femoral-popliteal segment. The clinical data were retrospectively analyzed.Results:Forty-nine patients were eligible, including 29 (59.2%) chronic total occlusions belonging to TransAtlantic Inter-Society Consensus-Ⅱ(TASC Ⅱ) D, 7 (14.3%) thrombosis, and 14 (28.6%) moderate to severe calcifications. The mean lesion length was (215.9±97.1) mm. 69.4% were of occlusive lesions (Tosaka Ⅲ category). Only 1 provisional stent was implanted. 98% patients had severe claudication or even worse. Of these cases, 34 (73.9%) showed improvements in Rutherford category, while 11 (23.9%) did not change and 1 (2.2%) case deteriorated. The average value of ABI was 0.478±0.264 before surgery and 0.907±0.207 at the end of follow-up. The improvement in Rutherford category ( P<0.01) and ABI ( P<0.005) were both significant. The primary patency (PP) was 80.4%, and the freedom from clinically driven TLR was 84.8% at 1 year. During the follow-up period, there was no all-cause death and major limb amputation. Conclusion:This multicenter study demonstrated the effectiveness of DCB as a treatment for complicated and extensive ISR lesions within 12 months.

Objective To study the clinical value of esophageal stent placement with radiation therapy for the middle-late pa-tients with esophageal cancer.Methods To perform esophageal stent placement and radiation therapy for the middle-late 35 pa-tients,and to perform radiation therapy for the middle-late 37 patients,then observe the clinical curative effects.Results The treat-ment group were significantly alleviated with dysphagia symptom after operation,which 32 cases sticked the entire radiation,ac-counting for 91.4%,no one can′t complete the treatment because of nutritional status reason.Survival time of one month after ra-diotherapy was up to 100.0%,and survival time of six months was 85.7% (30/35).But the contrast group with dysphagia symp-tom were aggravated or no relief,and needed parenteral nutrition.There were 23 cases to complete the entire radiation,accounting for 62.2%,and 5 cases happened esophageal tracheal fistula.Survival time of one month after radiotherapy was 83.8%(31/37),and survival time of six months was 62.2% (23/37).Two groups of cases in radiotherapy resistance difference was statistically signifi-cant,one month and six months of survival time were statistically significant (all P <0.05 ).Conclusion Esophageal stent place-ment with radiotherapy is more efficient than only radiation therapy to the middle-late patients with esophageal cancer.