ObjectiveTo investigate the mechanism of action of Huangqi Chifengtang （HQCFT） on rats with atherosclerosis （AS） by regulating the gut microbiota and their metabolites. MethodsA rat model of AS was induced through high-fat diet feeding and vitamin D₃ injection， and the modeling lasted for 12 weeks. Fifty eight-week-old male SD rats were randomly divided into five groups： A blank group， a model group， a group receiving a low dose of HQCFT at 1.53 g·kg^-1 （HQCFT-L group）， a group receiving a high dose of HQCFT at 3.06 g·kg^-1 （HQCFT-H group）， and a group receiving atorvastatin calcium tablets at 1.8 mg·kg^-1 （Ato group）， with 10 rats in each group. Oral gavage administration started on the day after model establishment， once daily for four weeks. The efficacy of HQCFT was verified using aortic hematoxylin-eosin （HE） staining and determination of lipid levels and hemorrheology. The real-time polymerase chain reaction （Real-time PCR） was used for detecting inflammatory factor levels in the aorta， high-throughput sequencing for analyzing the gut microbiota composition in intestinal contents， targeted metabolomics for detecting short-chain fatty acid （SCFA） levels， and non-targeted metabolomics for identifying metabolomic profiles of intestinal contents. ResultsCompared with that in the blank group， the aortic tissue of rats in the model group showed significant AS lesions， including endothelial damage， inflammatory infiltration， and formation of fibrous plaques and calcified foci. Moreover， serum triacylglycerol （TG）， total cholesterol （TC）， and low-density lipoprotein cholesterol （LDL-C） levels were significantly elevated （P<0.05）， while high-density lipoprotein cholesterol （HDL-C） levels were significantly reduced （P<0.05）. Significant increases were observed in whole blood viscosity， plasma viscosity， and the mRNA expression levels of NOD-like receptor pyrin domain containing 3 （NLRP3）， Caspase-1， interleukin （IL）-β， IL-6， and tumor necrosis factor-α （TNF-α） in aortic tissue （P<0.05）. Additionally， gut microbiota composition， SCFA levels， and metabolomic profiles were significantly altered. Compared with those in the model group， serum TC， TG， and LDL-C levels， as well as the whole blood viscosity and plasma viscosity， were significantly reduced in all groups treated with HQCFT （P<0.05）. Significant decreases were observed in NLRP3 mRNA expression levels in all groups treated with HQCFT， Caspase-1， IL-β， and IL-6 mRNA expression levels in the HQCFT-H group， and TNF-α mRNA expression levels in the HQCFT-L group （P<0.05）. HQCFT reversed the increase in the F/B ratio and dialled back the decrease in the relative abundance of Blautia and the increase in that of Desulfovibrio. HQCFT promoted the production of acetic acid， valeric acid， and propionic acid. Non-targeted metabolomics identified 39 differential metabolites， which were mainly enriched in metabolic pathways such as arachidonic acid metabolism and primary bile acid biosynthesis. ConclusionThe mechanism by which HQCFT ameliorates AS injury may be related to the improvement of dyslipidemia and body inflammatory responses by altering gut microbiota composition， promoting SCFA production， and regulating the levels of metabolites in intestinal contents.

ObjectiveTo investigate the mechanism of action of Huangqi Chifengtang （HQCFT） on rats with atherosclerosis （AS） by regulating the gut microbiota and their metabolites. MethodsA rat model of AS was induced through high-fat diet feeding and vitamin D₃ injection， and the modeling lasted for 12 weeks. Fifty eight-week-old male SD rats were randomly divided into five groups： A blank group， a model group， a group receiving a low dose of HQCFT at 1.53 g·kg^-1 （HQCFT-L group）， a group receiving a high dose of HQCFT at 3.06 g·kg^-1 （HQCFT-H group）， and a group receiving atorvastatin calcium tablets at 1.8 mg·kg^-1 （Ato group）， with 10 rats in each group. Oral gavage administration started on the day after model establishment， once daily for four weeks. The efficacy of HQCFT was verified using aortic hematoxylin-eosin （HE） staining and determination of lipid levels and hemorrheology. The real-time polymerase chain reaction （Real-time PCR） was used for detecting inflammatory factor levels in the aorta， high-throughput sequencing for analyzing the gut microbiota composition in intestinal contents， targeted metabolomics for detecting short-chain fatty acid （SCFA） levels， and non-targeted metabolomics for identifying metabolomic profiles of intestinal contents. ResultsCompared with that in the blank group， the aortic tissue of rats in the model group showed significant AS lesions， including endothelial damage， inflammatory infiltration， and formation of fibrous plaques and calcified foci. Moreover， serum triacylglycerol （TG）， total cholesterol （TC）， and low-density lipoprotein cholesterol （LDL-C） levels were significantly elevated （P<0.05）， while high-density lipoprotein cholesterol （HDL-C） levels were significantly reduced （P<0.05）. Significant increases were observed in whole blood viscosity， plasma viscosity， and the mRNA expression levels of NOD-like receptor pyrin domain containing 3 （NLRP3）， Caspase-1， interleukin （IL）-β， IL-6， and tumor necrosis factor-α （TNF-α） in aortic tissue （P<0.05）. Additionally， gut microbiota composition， SCFA levels， and metabolomic profiles were significantly altered. Compared with those in the model group， serum TC， TG， and LDL-C levels， as well as the whole blood viscosity and plasma viscosity， were significantly reduced in all groups treated with HQCFT （P<0.05）. Significant decreases were observed in NLRP3 mRNA expression levels in all groups treated with HQCFT， Caspase-1， IL-β， and IL-6 mRNA expression levels in the HQCFT-H group， and TNF-α mRNA expression levels in the HQCFT-L group （P<0.05）. HQCFT reversed the increase in the F/B ratio and dialled back the decrease in the relative abundance of Blautia and the increase in that of Desulfovibrio. HQCFT promoted the production of acetic acid， valeric acid， and propionic acid. Non-targeted metabolomics identified 39 differential metabolites， which were mainly enriched in metabolic pathways such as arachidonic acid metabolism and primary bile acid biosynthesis. ConclusionThe mechanism by which HQCFT ameliorates AS injury may be related to the improvement of dyslipidemia and body inflammatory responses by altering gut microbiota composition， promoting SCFA production， and regulating the levels of metabolites in intestinal contents.

Objective:To explore the effectiveness of the I-PASS ABCDE structured handoff model in patients with respiratory failure in the intensive care unit (ICU) .Methods:A total of 35 nurses working in the ICU of the Affiliated Hospital of Jining Medical University were selected by convenience sampling from January 2020 to September 2021. From January to October 2020, the traditional handoff model was used (control group), while from November 2020 to September 2021, the I-PASS ABCDE structured handoff model was implemented (intervention group). The defect rate of clinical handoff, nurses' understanding of patients' conditions, handoff effectiveness, time spent on handoff, and nurse satisfaction with the handoff model were compared between the two groups.Results:The defect rate of clinical handoff in the intervention group was significantly lower than that in the control group. Scores for nurses' understanding of patients' conditions and handoff effectiveness were significantly higher in the intervention group than in the control group ( P<0.05), indicating statistical significance. Although handoff duration was longer in the intervention group than in the control group, the difference was not statistically significant ( P>0.05). Nurse satisfaction with the handoff model was significantly higher in the intervention group than in the control group ( P<0.05) . Conclusions:The application of the I-PASS ABCDE structured handoff model in ICU patients with respiratory failure can reduce handoff defects, improve handoff quality, and enhance nurses' satisfaction.

Objective:To compare the influence of titanium mesh repair outside and under the temporal muscle on the cerebral hemodynamic status and postoperative brain function of patients with skull defects after decompressive craniectomy (DC).Methods:A retrospective analysis was performed on clinical data of patients with skull defects after DC who underwent titanium mesh cranioplasty at Yibin Sixth People′s Hospital from January 2019 to January 2024. Patients were divided into a control group ( n=35, subgaleal cranioplasty) and an observation group ( n=35, subtemporal cranioplasty). Surgical outcomes, 1-year complication rates, cerebral hemodynamic parameters [mean velocity (Vm) of the middle cerebral artery (MCA), regional cerebral blood flow (CBF) in the cerebral cortex, basal ganglia, and thalamus], and functional scores [National Institutes of Health Stroke Scale (NIHSS), Minimum Mental State Examination (MMSE), and Fugl-Meyer Assessment (FMA)] were compared preoperatively, at 14 days postoperatively, and 3 months postoperatively. Results:The observation group had significantly longer operation time and postoperative swelling duration, as well as higher intraoperative blood loss than the control group (all P<0.05). At 6 months postoperatively, the complication rate in the observation group was significantly lower than that in the control group ( P<0.05). At 14 days postoperatively, MCA Vm and regional CBF in the cortex, basal ganglia, and thalamus increased in both groups, with more significant improvements in the observation group (all P<0.05). At 3 months postoperatively, NIHSS scores decreased while MMSE and FMA scores increased in both groups compared to preoperative levels. The observation group showed significantly lower NIHSS scores and higher MMSE/FMA scores than the control group (all P<0.05). Conclusions:Both surgical approaches are clinically valuable for repairing skull defects after DC. Patients should choose the appropriate procedure based on their individual conditions.

Objective:To compare the influence of titanium mesh repair outside and under the temporal muscle on the cerebral hemodynamic status and postoperative brain function of patients with skull defects after decompressive craniectomy (DC).Methods:A retrospective analysis was performed on clinical data of patients with skull defects after DC who underwent titanium mesh cranioplasty at Yibin Sixth People′s Hospital from January 2019 to January 2024. Patients were divided into a control group ( n=35, subgaleal cranioplasty) and an observation group ( n=35, subtemporal cranioplasty). Surgical outcomes, 1-year complication rates, cerebral hemodynamic parameters [mean velocity (Vm) of the middle cerebral artery (MCA), regional cerebral blood flow (CBF) in the cerebral cortex, basal ganglia, and thalamus], and functional scores [National Institutes of Health Stroke Scale (NIHSS), Minimum Mental State Examination (MMSE), and Fugl-Meyer Assessment (FMA)] were compared preoperatively, at 14 days postoperatively, and 3 months postoperatively. Results:The observation group had significantly longer operation time and postoperative swelling duration, as well as higher intraoperative blood loss than the control group (all P<0.05). At 6 months postoperatively, the complication rate in the observation group was significantly lower than that in the control group ( P<0.05). At 14 days postoperatively, MCA Vm and regional CBF in the cortex, basal ganglia, and thalamus increased in both groups, with more significant improvements in the observation group (all P<0.05). At 3 months postoperatively, NIHSS scores decreased while MMSE and FMA scores increased in both groups compared to preoperative levels. The observation group showed significantly lower NIHSS scores and higher MMSE/FMA scores than the control group (all P<0.05). Conclusions:Both surgical approaches are clinically valuable for repairing skull defects after DC. Patients should choose the appropriate procedure based on their individual conditions.

Objective:To explore the effectiveness of the I-PASS ABCDE structured handoff model in patients with respiratory failure in the intensive care unit (ICU) .Methods:A total of 35 nurses working in the ICU of the Affiliated Hospital of Jining Medical University were selected by convenience sampling from January 2020 to September 2021. From January to October 2020, the traditional handoff model was used (control group), while from November 2020 to September 2021, the I-PASS ABCDE structured handoff model was implemented (intervention group). The defect rate of clinical handoff, nurses' understanding of patients' conditions, handoff effectiveness, time spent on handoff, and nurse satisfaction with the handoff model were compared between the two groups.Results:The defect rate of clinical handoff in the intervention group was significantly lower than that in the control group. Scores for nurses' understanding of patients' conditions and handoff effectiveness were significantly higher in the intervention group than in the control group ( P<0.05), indicating statistical significance. Although handoff duration was longer in the intervention group than in the control group, the difference was not statistically significant ( P>0.05). Nurse satisfaction with the handoff model was significantly higher in the intervention group than in the control group ( P<0.05) . Conclusions:The application of the I-PASS ABCDE structured handoff model in ICU patients with respiratory failure can reduce handoff defects, improve handoff quality, and enhance nurses' satisfaction.

Objective:To explore the differential efficacies of conventional chemotherapy, autologous hematopoietic stem cell transplantation (auto-HSCT) and allogeneic hematopoietic stem cell transplantation (allo-HSCT) for T lymphoblastic lymphoma (T-LBL) .Method:From January 2012 to December 2022, the relevant clinical data were retrospectively reviewed for 82 T-LBL patients hospitalized at Affiliated Tongji Hospital. According to different treatments, they were assigned into two groups of non-transplantation (49 cases) and transplantation (33 cases). The transplantation group was divided further into two groups of allo-HSCT (22 cases) and auto-HSCT (11 cases) according to different transplantation modes. In non-transplantation group, remission was induced mostly by cyclophosphamide+messosodium+doxorubicin+dexamethasone+vincrine/methotrexate+Hyper CAVD A/B. Six patients achieved remission based upon cyclophosphamide+cytarabine+6-mercaptopurine (CAT), etoposide+vincristine+doxorubicin+cyclophosphamide+cyclophosphamide+ prednisone (EPOCH), high-dose methotrexate+dexamethasone and vincristine+pirubicin+ cyclophosphamide+ pemasase+prednisone (VDCLP). The transplantation group underwent HSCT after multi-drug combination intensive induction therapy. Efficacy and survival were analyzed by observing the rates of overall survival (OS) and progression-free survival (PFS) .Result:There were 64 males and 18 females with a median age of 23 (11~74) year. Among them, 62 cases (75.61%) had clinical stage Ⅲ~Ⅳ. And 43 cases (53.44%) had systemic symptoms (B symptom) of fever, night sweats and weight loss at an onset of disease. Fifty cases (61.00%) had an involvement of bone marrow and 33 cases (80.5%) belonged to Ann Arbor stage Ⅲ and above. There were 65 cases (79.27%) with Eastern Cooperative Oncology Group (ECOG) score ≤2 and 17 cases (20.73%) with ECOG score >2. International Prognostic Index (IPI) was ≤3 (63 cases, 76.83%) and >3 (19 cases, 23.17%). Follow-up period was 27.5 (5~118) month. And 3-year OS and PFS were 53.64% (95% CI: 42.35%~64.62%) and 47.56% (95% CI: 36.53%~58.82%). Significant inter-group difference existed in 3-year OS[42.86% (95% CI: 29.12%~57.71%) vs 69.70% (95% CI: 51.13%~83.79%), P=0.014]and 3-year PFS was 38.76% (95% CI: 25.54%~53.76%) and 60.61% (95% CI: 42.24%~76.57%). And the difference was statistically significant ( P=0.032) . Conclusion:As a consolidation therapy, HSCT may improve the long-term outcomes of T-LBL patients as compared with chemotherapy alone.

Objective:To investigate the effect of thoracolumbar osteoporotic vertebral compression fracture (OVCF) combined with lumbar degenerative spondylolisthesis (LDS) on spinopelvic sagittal parameters in the elderly.Methods:A case-control study was conducted to analyze the clinical data of 77 patients with thoracolumbar OVCF admitted to Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine from December 2016 to December 2021. There were 16 males and 61 females with the age of 61-92 years [(73.9±8.4)years]. All patients had single-level thoracolumbar fractures (T 11-L 2). Simple thoracolumbar OVCF was found in 49 patients (OVCF group) and thoracolumbar OVCF combined with LDS in 28 (OVCF+LDS group). The pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS), lumbar lordosis (LL), thoracic kyphosis (TK), thoracolumbar kyphosis (TLK), sagittal vertical axis (SVA) and Roussouly types were detected and compared between the two groups before operation. Results:There was no significant difference in PT and SVA between the two groups (all P>0.05). The PI, SS, LL, TK and TLK in OVCF+LDS group were (55.8±11.0)°, (34.1±10.9)°, (45.7±9.1)°, (35.7±6.1)° and (24.8±5.2)°, significantly larger than (47.9±8.8)°, (27.0±9.4)°, (33.1±7.9)°, (29.5±6.2)° and (18.4±5.5)° in OVCF group (all P<0.01). Roussouly types I-IV counted 22, 16, 5 and 6 patients in OVCF group, compared to 8, 5, 6 and 9 patients in OVCF+LDS group ( P<0.05). Conclusions:Elderly patients with thoracolumbar OVCF combined with LDS can significantly alter spinopelvic sagittal parameters, and LDS may aggravate the thoracolumbar kyphosis of OVCF. To avoid sagittal imbalance, surgery should be performed as soon as possible.

As an important method of systems biology, metabolomics not only plays an important role in life science but also has been increasingly widely used in radiation protection research. Based on the clinical studies of metabolomics and metabolomics methods in rodent and primate models, this article summarizes the methods and techniques of metabolomics in the diagnosis of radiation damage, the study of radiation damage mechanisms, and the development of radiation protection drugs.

The endovascular exclusion is an effective treatment of aortic aneurysm diseases in frail and elderly patients who cannot suffer the open surgery. However, as the key treatment device of this technique, traditional stent-grafts are not suitable to treat complex aortic aneurysm diseases in emergency. The emergence of the fenestrated stent-graft and in-situ fenestration has brought new dawn to the treatment of these patients. This study reviews the advances in complex aortic aneurysms treated by the fenestrated stent-graft and the in-situ fenestration. In addition, the novel concept of the fabric structure designed for "in-situ fenestrated stent-graft" is proposed for the in-situ fenestration technique. It is expected to break through the bottleneck of the present fenestrated stent-grafts. It would be beneficial to the bailout of complex aortic aneurysm diseases and thereby benefitting more patients.