ObjectiveTo observe the clinical efficacy of Sanren Runchang formula in treating constipation-predominant irritable bowel syndrome （IBS-C） by regulating the brain-gut axis and the effects of the formula on serum levels of 5-hydroxytryptamine （5-HT）， vasoactive intestinal peptide （VIP）， and substance P （SP）. MethodsA randomized controlled design was adopted， and 72 IBS-C patients meeting Rome Ⅳ criteria were randomized into observation and control groups （36 cases）.The observation group received Sanren Runchang formula granules twice daily， and the control group received lactulose oral solution daily for 4 weeks. IBS Symptom Severity Scale （IBS-SSS）， IBS Quality of Life Scale （IBS-QOL）， and Bristol Stool Form Scale （BSFS） were used to assess clinical symptoms， and bowel movement frequency was recorded. The Self-Rating Anxiety Scale （SAS） and Self-Rating Depression Scale （SDS） were employed to evaluate psychological status. ELISA was employed to measure the serum levels of 5-HT， VIP， and SP. ResultsThe total response rate in the observation group was 91.67% （33/36）， which was higher than that （77.78%， 28/36） in the control group （χ²=4.50， P<0.05）. After treatment， both groups showed increased defecation frequency and BSFS scores， decreased IBS-SSS total score， abdominal pain and bloating scores， IBS-QOL health anxiety， anxiety， food avoidance， and behavioral disorders scores， SAS and SDS scores， serum 5-HT and VIP levels， and increased SP levels （P<0.05， P<0.01）. Moreover， the observation group showed more significant changes in the indicators above than the control group （P<0.05， P<0.01）. The SP level showed no significant difference between the two groups. During the 4-week follow-up， the recurrence rate was 5.88% in the observation group and 31.25% in the control group. No adverse events occurred in observation group， and 2 cases of mild diarrhea occurred in the control group. ConclusionSanren Runchang formula demonstrated definitive efficacy in alleviating gastrointestinal symptoms and improving the psychological status and quality of life in IBS-C patients， with a low recurrence rate. The formula can regulate serum levels of neurotransmitters such as 5-HT and VIP， suggesting its potential regulatory effect on the brain-gut axis through modulating neurotransmitters and neuropeptides. However， its complete mechanism of action requires further investigation through detection of additional brain-gut axis-related biomarkers.

Recurrence of acute clinical symptoms in inflammatory bowel disease often leads to increase of unplanned readmission rate,thus the disease burden of patients and the shortage of medical resources are aggravated.This article reviews the summary in unplanned readmissions of inflammatory bowel disease pa-tients,influencing factors and risk prediction models aiming at providing a basis to early identify the risk of unplanned readmissions,formulate the nursing decision as early as possible and reduce the medical burden.

Objective:A large single-center, premature acute myocardial infarction (AMI) age (≤45 years) cohort was established to investigate the clinical features and the factors affecting major adverse cardiac events (MACE).Methods:This is a prospective and observational study. 603 patients with a clear diagnosis of AMI admitted to the Tianjin Chest Hospital from March 2015 to December 2017 were continuously selected. All patients were aged ≤45 years old, and a single-center large-sample premature AMI cohort was established. The patient's clinical basic conditions, laboratory indicators, imaging data, coronary angiography and treatment were collected. All patients were followed up for 1 year. MACE events such as cardiac death, recurrent AMI, revascularization, severe heart failure requiring hospitalization and stroke were recorded. Kaplan Meier method was used to draw the survival curve. Cox regression analysis was used to analyze the influence of risk factors, clinical characteristics and intervention methods on the long-term prognosis of MACE events.Results:A total of 603 AMI patients were included, 575 males (95.36%), 28 females (4.64%), and median age 41 (37, 44) years old. There were 422 patients (69.98%) with acute ST segment elevation myocardial infarction (STEMI), 206 patients (48.82%) with anterior myocardial infarction, and 181 patients (30.02%) with non ST segment elevation myocardial infarction (NSTEMI). Smoking was the most common risk factor for premature AMI (77.45%), followed by hyperlipidemia (48.42%) and hypertension (48.09%); smoking was the most common risk factor for male patients (80.35%), and hyperlipidemia was the most common risk factor for female patients (35.71%). 302 (50.08%) patients with premature AMI were treated with symptom onset to first medical contact (SO-to-FMC) ≤12 h; 563 patients (93.37%) had coronary angiography; coronary angiography showed that no significant stenosis, single-vessel disease, double-vessel disease, three-vessel disease, and patients with left main disease were 15(2.66%), 212(37.66%), 153(25.37%), 167(29.66%), 16(2.84%) cases; 318(56.48%) patients with vascular occlusion; The proportion of male combined with left main lesions was lower than that of female group (2.41% vs 12.50%, P=0.026); A total of 45 patients (7.46%) were recorded MACE. The 1-year MACE incidence was lower in the male group than in the female group (6.96% vs 17.86%, P=0.032). Multivariate COX regression analysis: there were 5 indicators that entered the regression model and were statistically significant: female ( HR:4.184; 95% CI:1.583-11.064; P=0.004), SO-to-FMC≤12 h ( HR:0.447; 95% CI:0.224-0.889; P=0.022), left ventricular ejection fraction (LVEF)≤40% ( HR:3.727; 95% CI:1.876-7.405; P<0.001), low-density lipoprotein (LDL) ( HR:1.315; 95% CI:1.041-1.662; P=0.022), homocysteine (Hcy) ( HR:1.011; 95% CI:1.002-1.019; P=0.011) were independent predictor of MACE occurrence in patients with early-onset AMI within 1 year. Conclusions:Smoking is the most common risk factor for young men with AMI. The most common risk factors for young women's AMI is hyperlipidemia, and the proportion of patients with left main artery disease is higher than that of men, but the proportion of patients receiving emergency intervention is lower than that of men, and the long-term prognosis of young women is poor. Early detection and control of these risk factors is a key measure to prevent the onset of AMI.

Objective To evaluate the relationship between the expression of Nucleotide-binding oligomerization domain-like receptor family pyrin domain-containing 3 (NLRP3) in nerve tissues and mitochondrial function during mechanical stretch-induced damage to mouse alveolar epithelial cells.Methods Alveolar epithelial type Ⅱ cell line MLE-12 cells were divided into 3 groups (n=13 each) using a random number table:control group (group C),cyclic stretch group (group CS) and cyclic stretch plus NLRP3 inhibitor TAK-242 group (group CS+T).MLE-12 cells underwent 20％ cyclic stretch at a frequency of 0.5 Hz (stretch ∶ intermittence =1 ∶ 1) for 4 h in group CS.In group CS+T,after being incubated for 1 h with 1 μ mol/L TAK-242,MLE-12 cells underwent 20％ cyclic stretch for 4 h,and the parameters were similar to those previously described in group CS.The reactive oxygen species (ROS) content and mitochondrial membrane potential (△ΨM) were measured using chemiluminescence assay.Enzyme-linked immunosorbent assay was used to determine the concentration of interleukin-1 beta (IL-1β) in the supernatant.The expression of NLRP3 in MLE-12 cells was detected using Western blot.Results Compared with group C,the △ΨM of cells was significantly decreased,the ROS content and IL-1β concentration were increased,and the expression of NLRP3 was up-regulated in group CS,and the △ΨM of cells was significantly decreased,the ROS content was increased,and the expression of NLRP3 was up-regulated in group CS+T (P＜0.05).Compared with group CS,the △ΨM of cells was significantly increased,the ROS content and IL-1β concentration were decreased,and the expression of NLRP3 was down-regulated in group CS+T (P＜ 0.05).Conclusion Mechanical stretch induces damage to mitochondria through up-regulating the expression of NLRP3,thus leading to damage to mouse alveolar epithelial cells.

The air quality of simulated moxibustion clinic was tested, which could provide references for the evaluation on air pollution in moxibustion clinic. After the clinical environment of moxibustion was established,the contents of CO,NO, PM 10 and PM 2.5 in the air at 5 different time points (0.5 h, 1 h and 2 h after 10 moxa sticks were ignited as well as 5 min ventilation after 0.5 h moxibustion burning and 5 min ventilation after 1 h moxibustion burning) were measured by testing organizations.0.5 h, 1 h and 2 h after 10 moxa sticks were ignited, the content ranges of CO,NO, PM 10 and PM 2.5 in the air were 15.9 to 37.0 mg/m,0.012 6 to 0.022 4 mg/m,0.22 to 1.28 mg/mand 0.13 to 0.53 mg/m, respectively; the contents of CO, PM 10 and PM 2.5 were higher than national standard. With 5 min ventilation after 0.5 h moxibustion burning and 5 min ventilation after 1 h moxibustion burning, the content ranges of CO,NO,PM 10 and PM 2.5 were 0.3 to 0.4 mg/m,0.015 5 to 0.018 0 mg/m,0.11 to 0.13 mg/mand 0.04 mg/m, respectively; the contents of CO, PM 10 and PM 2.5 were lower than national standard. It is concluded that long-time moxibustion could cause relatively high concentration of moxa smoke, and the contents of CO, PM 10 and PM 2.5 in the air will exceed the national standard. However, by keeping good ventilation, the contents of CO,NO,PM 10 and PM 2.5 in the air can be controlled within safe ranges.

Objective To evaluate the effect of recombinant human annexin A5 on the expression of phosphorylated protein kinase C alpha (p-PKCα) and p120-catenin during endotoxin-induced damage to cardiomyocytes.Methods H9c2 cells cultured in vitro were randomly divided into 3 groups (n=18 each) using a random number table:control group (group C),endotoxin group (group L),and recombinant human annexin A5 group (group A).Recombinant human annexin A5 (final concentration 5 ng/ml) was added,and the cells were incubated for 2 h in group A,and then lipopolysaccharide (final concentration 1 μg/ml) was added,and the cells were incubated for 4 h in L and A groups.At 4 h of incubation,cell apoptosis was detected using the cell apoptosis detection kit,the intercellular space was measured using the confocal microscopy,and the expression of p-PKCα and p120-catenin was determined by Western blot.The apoptosis rate was calculated.Results Compared with group C,the apoptosis rate was significantly increased,the intercellular space was significantly widened,the expression of p120-catenin was significantly down-regulated,and the expression of p-PKCα was significantly up-regulated in group L (P＜0.05).Compared with group L,the apoptosis rate and intercellular space were significantly decreased,the expression of p120-catenin was significantly up-regulated,and the expression of p-PKCα was significantly down-regulated in group A (P＜0.05).Conclusion Recombinant human annexin A5 can inhibit phosphorylation of PKCα and up-regulate the expression of p120-catenin,thus attenuating endotoxin-induced damage to cardiomyocytes.