ObjectiveThis paper aims to investigate the protective effects of the Tanyu Tongzhi Youhua prescription（TYTZP） against myocardial ischemia/reperfusion injury in rats via regulation of the cyclic GMP-AMP synthase （cGAS）/stimulator of interferon genes （STING） signaling pathway. MethodsFifty-six 8-week-old male Sprague-Dawley （SD） rats were randomly divided into sham group， model group， ticagrelor group （32.4 mg·kg^-1）， RU320521 （RU.521cGAS inhibitors） group （5 mL·kg^-1）， groups of TYTZP with low dose （3.6 g·kg^-1）， medium dose （7.2 g·kg^-1）， and high dose （14.4 g·kg^-1）， with eight rats per group. The ticagrelor group and groups of TYTZP with different doses received pre-treatment for seven days according to their respective protocols. The RU.521 group received an intraperitoneal injection one hour before modeling. A rat model of the no-reflow phenomenon in myocardial ischemia/reperfusion injury was established by ligating the left anterior descending coronary artery in situ. Myocardial no-reflow area was determined by thioflavin staining. Histopathological morphology of myocardial tissue was observed via hematoxylin and eosin （HE） staining. Cardiac function was detected by echocardiography. Myocardial microcirculation function change was observed by using real-time myocardial contrast echocardiography. The myocardial enzyme levels in the serum were measured by serum biochemical analysis. The double-stranded DNA （dsDNA） levels were detected by using PicoGreen. The protein expression of cGAS， STING， and nuclear factor-κB （NF-κB） p65 in myocardial tissue was detected by Western blot. The levels of cardiac troponin Ⅰ （cTNⅠ）， cardiac troponin T （cTNT）， interleukin-6 （IL-6）， interleukin-1β （IL-1β）， and tumor necrosis factor-α （TNF-α） in the peripheral blood were measured by enzyme-linked immunosorbent assay （ELISA）. ResultsCompared with the sham group， the model group showed a significantly increased myocardial no-reflow area （P<0.01）. Myocardial fiber rupture and disarray and inflammatory cell infiltration were observed by HE staining. The ultrasound results indicated that left ventricular ejection fraction （LVEF） and left ventricular fractional shortening （LVFS） （P<0.01） were significantly decreased. Real-time myocardial contrast echocardiography showed that the peak time of myocardial blood perfusion was significantly prolonged （P<0.01）， and the levels of creatine kinase （CK）， creatine kinase isoenzyme （CK-MB）， lactate dehydrogenase （LDH）， cTNⅠ， cTNT， and dsDNA were significantly elevated （P<0.01）. Western blot results showed that the myocardial protein expressions of cGAS， STING， and NF-κB p65 were upregulated （P<0.01）. ELISA results showed that the inflammatory factors in the serum such as IL-6， IL-1β， and TNF-α were increased （P<0.01）. Compared with the model group， the group of the TYTZP significantly reduced the levels of myocardial enzyme， troponins， and dsDNA （P<0.01， P<0.05）， improved cardiac function and myocardial microcirculation， alleviated histopathological morphology and inflammatory infiltration， inhibited activation of the cGAS/STING pathway， reduced the expression of NF-κB p65 （P<0.01， P<0.05）， and inhibited inflammatory response. ConclusionThe TYTZP mitigates the no-reflow phenomenon in myocardial ischemia/reperfusion injury， and its mechanism is associated with inhibiting the activation of the cGAS/STING pathway and attenuating inflammatory responses.

ObjectiveThis paper aims to investigate the protective effects of the Tanyu Tongzhi Youhua prescription（TYTZP） against myocardial ischemia/reperfusion injury in rats via regulation of the cyclic GMP-AMP synthase （cGAS）/stimulator of interferon genes （STING） signaling pathway. MethodsFifty-six 8-week-old male Sprague-Dawley （SD） rats were randomly divided into sham group， model group， ticagrelor group （32.4 mg·kg^-1）， RU320521 （RU.521cGAS inhibitors） group （5 mL·kg^-1）， groups of TYTZP with low dose （3.6 g·kg^-1）， medium dose （7.2 g·kg^-1）， and high dose （14.4 g·kg^-1）， with eight rats per group. The ticagrelor group and groups of TYTZP with different doses received pre-treatment for seven days according to their respective protocols. The RU.521 group received an intraperitoneal injection one hour before modeling. A rat model of the no-reflow phenomenon in myocardial ischemia/reperfusion injury was established by ligating the left anterior descending coronary artery in situ. Myocardial no-reflow area was determined by thioflavin staining. Histopathological morphology of myocardial tissue was observed via hematoxylin and eosin （HE） staining. Cardiac function was detected by echocardiography. Myocardial microcirculation function change was observed by using real-time myocardial contrast echocardiography. The myocardial enzyme levels in the serum were measured by serum biochemical analysis. The double-stranded DNA （dsDNA） levels were detected by using PicoGreen. The protein expression of cGAS， STING， and nuclear factor-κB （NF-κB） p65 in myocardial tissue was detected by Western blot. The levels of cardiac troponin Ⅰ （cTNⅠ）， cardiac troponin T （cTNT）， interleukin-6 （IL-6）， interleukin-1β （IL-1β）， and tumor necrosis factor-α （TNF-α） in the peripheral blood were measured by enzyme-linked immunosorbent assay （ELISA）. ResultsCompared with the sham group， the model group showed a significantly increased myocardial no-reflow area （P<0.01）. Myocardial fiber rupture and disarray and inflammatory cell infiltration were observed by HE staining. The ultrasound results indicated that left ventricular ejection fraction （LVEF） and left ventricular fractional shortening （LVFS） （P<0.01） were significantly decreased. Real-time myocardial contrast echocardiography showed that the peak time of myocardial blood perfusion was significantly prolonged （P<0.01）， and the levels of creatine kinase （CK）， creatine kinase isoenzyme （CK-MB）， lactate dehydrogenase （LDH）， cTNⅠ， cTNT， and dsDNA were significantly elevated （P<0.01）. Western blot results showed that the myocardial protein expressions of cGAS， STING， and NF-κB p65 were upregulated （P<0.01）. ELISA results showed that the inflammatory factors in the serum such as IL-6， IL-1β， and TNF-α were increased （P<0.01）. Compared with the model group， the group of the TYTZP significantly reduced the levels of myocardial enzyme， troponins， and dsDNA （P<0.01， P<0.05）， improved cardiac function and myocardial microcirculation， alleviated histopathological morphology and inflammatory infiltration， inhibited activation of the cGAS/STING pathway， reduced the expression of NF-κB p65 （P<0.01， P<0.05）， and inhibited inflammatory response. ConclusionThe TYTZP mitigates the no-reflow phenomenon in myocardial ischemia/reperfusion injury， and its mechanism is associated with inhibiting the activation of the cGAS/STING pathway and attenuating inflammatory responses.

Objective To explore the pharmacodynamic material basis and mechanism of Tanyu Tongzhi Optimized Prescription in the treatment of atherosclerosis(AS)using network pharmacology and animal experiments.Methods UPLC-Q-TRAP-MS/MS was used to identify the blood-entering components of Tanyu Tongzhi Optimized Prescription and conduct network pharmacological analysis.Important components and their core targets for the treatment of AS were screened,and molecular docking was conducted.The AS model mice were constructed and treated with Tanyu Tongzhi Optimized Prescription.HE staining and oil red O staining were used to observe aortic tissue morphology.The blood lipid status was detected by an automatic blood biochemical analyzer.The contents of serum inflammatory factors were detected by ELISA,and the mRNA expressions of aortic core targets were detected by RT-qPCR.Results It was identified and predicted that 30 blood-entering components of Tanyu Tongzhi Optimized Prescription might exert therapeutic effects on AS by regulating core targets such as IL6,TNF,IL1B,AKT1 and NFKB1,and regulating the TNF signaling pathway,Toll-like receptor signaling pathway,PI3K-Akt signaling pathway,etc.Animal experiments showed that Tanyu Tongzhi Optimized Prescription could reduce aortic plaque area and inflammatory cell infiltration,alleviate lipid deposition and vascular stenosis,improve blood lipid levels,and significantly reduce the serum contents of TNF-α,IL-1β,and mRNA expressions of TNF-α,IL-6,AKT1 and NF-κB in aortic tissue(P<0.05,P<0.01).Conclusion The effect of Tanyu Tongzhi Optimized Prescription may regulate TNF,Toll-like receptor and other signaling pathways by acting on core targets such as IL6,TNF,IL1B,and inhibit inflammatory response,so as to treat AS.

Summarizing the nursing experience of nutritional support therapy during the perioperative period for a child with short bowel syndrome undergoing small intestine transplantation.Nursing key points:dynamic assessment of nutritional risk,development and timely adjustment of nutritional support programs;implementation of nutritional support strategies to promote growth and development;combination with exercise interventions to improve nutritional status;to strengthen the monitoring of rejection,to promote the recovery of intestinal function;to strengthen the continuity of care,and do a good job of nutritional monitoring and guidance.After 141 days of careful treatment and nursing care,the child was discharged successfully.

Objective To explore the pharmacodynamic material basis and mechanism of Tanyu Tongzhi Optimized Prescription in the treatment of atherosclerosis(AS)using network pharmacology and animal experiments.Methods UPLC-Q-TRAP-MS/MS was used to identify the blood-entering components of Tanyu Tongzhi Optimized Prescription and conduct network pharmacological analysis.Important components and their core targets for the treatment of AS were screened,and molecular docking was conducted.The AS model mice were constructed and treated with Tanyu Tongzhi Optimized Prescription.HE staining and oil red O staining were used to observe aortic tissue morphology.The blood lipid status was detected by an automatic blood biochemical analyzer.The contents of serum inflammatory factors were detected by ELISA,and the mRNA expressions of aortic core targets were detected by RT-qPCR.Results It was identified and predicted that 30 blood-entering components of Tanyu Tongzhi Optimized Prescription might exert therapeutic effects on AS by regulating core targets such as IL6,TNF,IL1B,AKT1 and NFKB1,and regulating the TNF signaling pathway,Toll-like receptor signaling pathway,PI3K-Akt signaling pathway,etc.Animal experiments showed that Tanyu Tongzhi Optimized Prescription could reduce aortic plaque area and inflammatory cell infiltration,alleviate lipid deposition and vascular stenosis,improve blood lipid levels,and significantly reduce the serum contents of TNF-α,IL-1β,and mRNA expressions of TNF-α,IL-6,AKT1 and NF-κB in aortic tissue(P<0.05,P<0.01).Conclusion The effect of Tanyu Tongzhi Optimized Prescription may regulate TNF,Toll-like receptor and other signaling pathways by acting on core targets such as IL6,TNF,IL1B,and inhibit inflammatory response,so as to treat AS.

Summarizing the nursing experience of nutritional support therapy during the perioperative period for a child with short bowel syndrome undergoing small intestine transplantation.Nursing key points:dynamic assessment of nutritional risk,development and timely adjustment of nutritional support programs;implementation of nutritional support strategies to promote growth and development;combination with exercise interventions to improve nutritional status;to strengthen the monitoring of rejection,to promote the recovery of intestinal function;to strengthen the continuity of care,and do a good job of nutritional monitoring and guidance.After 141 days of careful treatment and nursing care,the child was discharged successfully.

OBJECTIVE To comprehensively assess the rationality and safety of clinical application of ceftazidime-avibactam(CAZ/AVI)so as to provide bases for reasonable and safe application of the drugs.METHODS A total of 137 patients who were hospitalized in Tianjin First Central Hospital and were treated with CAZ/AVI from Jan.2023 to Jan.2024 were recruited as the research subjects.The relevant informations involving the baseline da-ta,infection sites,etiological tests,status of drug utilization and adverse reactions were investigated and statically analyzed.The rating form was designed based on relevant guideline consensus and package insert,and the rational-ity and safety of clinical application of days were evaluated.RESULTS Totally 137 valid cases were enrolled in the study,88(64.23％)of whom were male,and 49(35.77％)were female,with the mean age(52±21.89)years old and the average medication duration(12.2±6.45)days.Totally 79 case-times of drug administration were un-reasonable,involving 75 patients;unsuited indications,unreasonable treatment course,absence of special consul-tation and ward round records and no curative effect evaluation after drug administration for 48-72 hours were the major manifestations.The total effective rate of CAZ/AVI treatment was 87.62％,5 patients had CAZ/AVI-associated adverse reactions,with the incidence of adverse reactions 3.65％.CONCLUSION It is necessary for the hospital to further standardize and optimize the clinical utilization of CAZ/AVI,strictly conform to the medica-tion indications,and strengthen the medication surveillance so as to raise the rationality and safety of medication.

OBJECTIVE To comprehensively assess the rationality and safety of clinical application of ceftazidime-avibactam(CAZ/AVI)so as to provide bases for reasonable and safe application of the drugs.METHODS A total of 137 patients who were hospitalized in Tianjin First Central Hospital and were treated with CAZ/AVI from Jan.2023 to Jan.2024 were recruited as the research subjects.The relevant informations involving the baseline da-ta,infection sites,etiological tests,status of drug utilization and adverse reactions were investigated and statically analyzed.The rating form was designed based on relevant guideline consensus and package insert,and the rational-ity and safety of clinical application of days were evaluated.RESULTS Totally 137 valid cases were enrolled in the study,88(64.23％)of whom were male,and 49(35.77％)were female,with the mean age(52±21.89)years old and the average medication duration(12.2±6.45)days.Totally 79 case-times of drug administration were un-reasonable,involving 75 patients;unsuited indications,unreasonable treatment course,absence of special consul-tation and ward round records and no curative effect evaluation after drug administration for 48-72 hours were the major manifestations.The total effective rate of CAZ/AVI treatment was 87.62％,5 patients had CAZ/AVI-associated adverse reactions,with the incidence of adverse reactions 3.65％.CONCLUSION It is necessary for the hospital to further standardize and optimize the clinical utilization of CAZ/AVI,strictly conform to the medica-tion indications,and strengthen the medication surveillance so as to raise the rationality and safety of medication.

Objective To conduct Rh blood group serological testing and third-generation sequencing(TGS)on 22 RhD variant voluntary blood donors in Chongqing and explore the phenotypic distribution and genotyping of RhD variants in Chongqing.Methods From January to August 2023,individuals who participated in blood donation in our blood center were selected as the study objects.RhD variant phenotype identification was performed using routine serological methods.Once the RhD variants were identified,tests on different antigenic epitopes of RhD were conducted using a D-screen assay kit.Furthermore,after the genomic DNA from 22 RhD variant blood samples was extracted,imbraided primers design and multi-segment amplification and splicing were used to sequence the full-length RHD gene for TGS.The RHD gene sequence was analyzed using SnapGene software.Results Among the 22 RhD variants,8 were DVI type 3(36.36%),with the main mutation of RHD-CE(3-6)-D hybrid allele.Six cases(27.27%)showed partial weak D15 type,with the main mutation of c.845G>A.There were 6 cases of Asia type Del(27.27%),with the main mutation of c.1227G>A.One case was weak D17 type with a mutation of c.340C>T and 1 case speculated to be partial D(c.491A>T,p.Asp164Val,missense mutation).Conclusion The most common RhD variant phenotype among blood donors in Chongqing is DVI type 3,and the full-length haplotype sequence of RHD variant alleles can be obtained by Pacific Bioscience single-molecule real-time sequencing(SMRT).

Objective:To investigate the effectiveness of new cryoprotective agents in preserving and transplanting human adipose tissue.Methods:The adipose tissue samples were obtained from healthy adult females who underwent liposuction at the Department of Plastic Surgery of Peking University Third Hospital from January to March 2022. The adipose tissue samples were centrifuged and then randomly divided into 9 groups. These groups were cryopreserved in liquid nitrogen using different cryoprotective agents [group A, group B, and dimethyl sulfoxide (DMSO) group] and cryopreservation times (1-month, 2-month, and 3-month groups), respectively. The cryoprotective agent formulation in group A was dextrose glycoside 40 (DEX), amino acids, vitamins, and inorganic salts. In group B, the formulation included DMSO and DEX. The ratio of cryoprotective agent in the DMSO group was 10% DMSO, 20% fetal bovine serum (FBS), and 70% DMEM-12. For cryopreservation, 5 ml cryogenic tubes were used with a fat to cryoprotective agent ratio of 3∶2, and each group contains 6 tubes for cryopreservation. After thawing the adipose tissue, HE staining was used to observe the histological morphology. Immunohistochemical staining was employed for the quantitative analysis of lipid droplet-encapsulated protein (Perilipin), and the Perilipin positivity rate was calculated by the ratio of the number of positive cells to the total number of cells. Adipocyte viability was assessed using the CCK-8 method. Thirty-eight healthy, clean nude mice were selected and divided into 3 groups of 12 mice each according to the use of different cryoprotective agents (groups A, B, and DMSO), while the other 2 mice were used as the day 0 control group. The mean fat freezing duration for all groups was 3 months. After nude mice were anesthetized intraperitoneally, 0.9 ml of thawed cryopreserved fat was injected into the dorsum bilaterally. The rate of adipose tissue retention was calculated by MRI scanning and three-dimensional software at 1, 2, and 3 months after transplantation, and compared between the groups. The fat grafts were explanted from the mice after they were sacrificed, and then subjected to histological morphology and quantitative analysis of Perilipin by using HE staining and immunohistochemical staining. GraphPad Prism 8.0 software was used for statistical analysis of the data. The data that conformed to a normal distribution were expressed as Mean ± SD. The overall comparison between multiple groups used analysis of variance for repeated measures. The comparison of data between groups at the same time point used Tukey’s multiple comparison test.Results:The morphology of adipose tissue in different cryoprotective agent groups closely resembled that of normal fresh adipose tissue after being cryopreserved in liquid nitrogen for 1-3 months. The difference in the proportion of Perilipin-stained positive cells in each group was not statistically significant ( P>0.05). The CCK-8 method indicated that the effect of the DMSO group was superior to groups A and B at 1 and 3 months of cryopreservation ( P<0.01), and that the DMSO group and group B were superior to group A at 2 months of cryopreservation ( P<0.01). In the animal experiments, there was no statistically significant difference between the groups in the volume retention rate 1-3 months after cryopreserved fat transplantation ( P>0.05). Additionally, the adipose tissues in each group exhibited varying degrees of localized necrosis accompanied by an inflammatory reaction 1-3 months after transplantation. There was no statistically significant difference in the Perilipin staining positivity between the groups ( P>0.05). Conclusion:The use of new cryoprotective agents for cryopreserving adipose tissue does not show a significant difference compared to the traditional cryoprotective agent. However, it is theoretically safer as it avoids the potential toxic effects of using DMSO or FBS on the human body.