Objective:To evaluate the safety and efficacy of mild hypothermia arch-clamping technique in the surgical treatment of DeBakey Type Ⅰ aortic dissection.Methods:From December 2019 to November 2023, a total of 97 patients with DeBakey type Ⅰ aortic dissection who underwent arch-clamping technique in Beijing Anzhen Hospital were prospectively enrolled. The patients were divided into mild hypothermia group and moderate hypothermia group according to the lowest rectal temperature during the circulatory arrest period. The perioperative data of the two groups were compared, and complex adverse outcomes consisting of 30-day death, stroke, paraplegia and CRRT were used as the primary endpoint. Multivariate logistic regression was used to determine the predictors of clinical adverse outcomes. Survival analysis was evaluated by the Kaplan- Meier method. Results:The overall incidence of complex adverse outcomes was 20.6%, 13.6% in the mild hypothermia group and 22.7% in the moderate hypothermia group( P=0.535), and the incidence of stroke was 4.6% and 6.7%( P=1.000), respectively. The cardiopulmonary bypass time and aortic-clamping time in the mild hypothermia group were significantly shortened (147.5 min vs. 163.0 min, P=0.032; 89 min vs. 99 min, P=0.042). There was no significant difference in long-term survival and reintervention between the two groups(91.9% vs. 89.3%, P=0.87; 9.1% vs. 5.3%, P=0.13). Conclusion:Mild hypothermia arch-clamping technique is a safe and effective method for the treatment of DeBakey type Ⅰ aortic dissection, with satisfactory short-term and long-term efficacy.

AIM To study the chemical constituents from the water fraction of rhizoma of Smilax trinervula Miq.and their biological activities.METHODS Polyamide,silica gel,Sephadex LH-20,ODS and semi-preparative HPLC were used for isolation and purification,then the structures of obtained compounds were identified by physicochemical properties and spectral data.The antitumor activities were determined by MTT mothod,and the inhibitory activities on α-glucosidase were determined by PNPG method.RESULTS Eleven compounds were isolated and identified as tyrosine(1),uridine(2),2-(2',3',4'-trihydroxybutyl)-6-(2",3",4"-trihydroxybutyl)-pyrazine(3),2-(1',2',3',4'-tetrahydroxybutyl)-6-(2",3",4"-trihydroxybutyl)-pyrazine(4),2-(1',2',3',4'-tetrahydroxybutyl)-5-(2",3",4"-trihydroxybutyl)-pyrazine(5),uracil(6),2-(1',2',3',4'-tetrahydroxybutyl)-5-(1",2",3",4"-tetrahydroxybutyl)-pyrazine(7),dioscin(8),shikimic acid(9),pyrazine(10),3,4-dihydroxyphenyethyl alcohol 8-O-β-D-glycopyranoside(11).The IC50 values of compounds 8 to human breast cancer cell MCF-7 was(2.36±0.26)μg/mL,and the IC50 values of compounds 3-5 and 7 to α-glucosidase were(1.54±0.15)-(10.53±0.38)μg/mL.CONCLUSION Compounds 1-7,10 are isolated from Smilax genus for the first time,and compound 9,11 are first isolated from this plant.Compound 8 has anti-tumor activity,and compounds 3-5,7 have α-glucosidase inhibitory activities.

AIM To study the chemical constituents from the water fraction of rhizoma of Smilax trinervula Miq.and their biological activities.METHODS Polyamide,silica gel,Sephadex LH-20,ODS and semi-preparative HPLC were used for isolation and purification,then the structures of obtained compounds were identified by physicochemical properties and spectral data.The antitumor activities were determined by MTT mothod,and the inhibitory activities on α-glucosidase were determined by PNPG method.RESULTS Eleven compounds were isolated and identified as tyrosine(1),uridine(2),2-(2',3',4'-trihydroxybutyl)-6-(2",3",4"-trihydroxybutyl)-pyrazine(3),2-(1',2',3',4'-tetrahydroxybutyl)-6-(2",3",4"-trihydroxybutyl)-pyrazine(4),2-(1',2',3',4'-tetrahydroxybutyl)-5-(2",3",4"-trihydroxybutyl)-pyrazine(5),uracil(6),2-(1',2',3',4'-tetrahydroxybutyl)-5-(1",2",3",4"-tetrahydroxybutyl)-pyrazine(7),dioscin(8),shikimic acid(9),pyrazine(10),3,4-dihydroxyphenyethyl alcohol 8-O-β-D-glycopyranoside(11).The IC50 values of compounds 8 to human breast cancer cell MCF-7 was(2.36±0.26)μg/mL,and the IC50 values of compounds 3-5 and 7 to α-glucosidase were(1.54±0.15)-(10.53±0.38)μg/mL.CONCLUSION Compounds 1-7,10 are isolated from Smilax genus for the first time,and compound 9,11 are first isolated from this plant.Compound 8 has anti-tumor activity,and compounds 3-5,7 have α-glucosidase inhibitory activities.

Objective:To evaluate the safety and efficacy of mild hypothermia arch-clamping technique in the surgical treatment of DeBakey Type Ⅰ aortic dissection.Methods:From December 2019 to November 2023, a total of 97 patients with DeBakey type Ⅰ aortic dissection who underwent arch-clamping technique in Beijing Anzhen Hospital were prospectively enrolled. The patients were divided into mild hypothermia group and moderate hypothermia group according to the lowest rectal temperature during the circulatory arrest period. The perioperative data of the two groups were compared, and complex adverse outcomes consisting of 30-day death, stroke, paraplegia and CRRT were used as the primary endpoint. Multivariate logistic regression was used to determine the predictors of clinical adverse outcomes. Survival analysis was evaluated by the Kaplan- Meier method. Results:The overall incidence of complex adverse outcomes was 20.6%, 13.6% in the mild hypothermia group and 22.7% in the moderate hypothermia group( P=0.535), and the incidence of stroke was 4.6% and 6.7%( P=1.000), respectively. The cardiopulmonary bypass time and aortic-clamping time in the mild hypothermia group were significantly shortened (147.5 min vs. 163.0 min, P=0.032; 89 min vs. 99 min, P=0.042). There was no significant difference in long-term survival and reintervention between the two groups(91.9% vs. 89.3%, P=0.87; 9.1% vs. 5.3%, P=0.13). Conclusion:Mild hypothermia arch-clamping technique is a safe and effective method for the treatment of DeBakey type Ⅰ aortic dissection, with satisfactory short-term and long-term efficacy.

Objective To observe the improvement of motor dysfunction and serum levels of C-reactive protein(CRP),blood glucose and blood lipid in post-stroke patients treated with scalp acupuncture at different needle retention time.Methods A total of 120 patients with motor dysfunction after stroke were randomly divided into control group,observation group 1 and observation group 2,with 40 cases in each group.The patients in the 3 groups were treated with scalp acupuncture,body acupuncture and routine rehabilitation exercise,once a day and 6 times a week,lasting for 2 weeks.The control group was given scalp acupuncture with retaining of needles for 30 minutes,the observation group 1 was given scalp acupuncture with retaining of needles for one hour,and the observation group 2 was given scalp acupuncture with retaining of needles for 2 hours.Before and after treatment,the 3 groups were observed in the changes of the scale scores of National Institutes of Health Stroke Scale(NIHSS),Fugl-Meyer Assessment(FM A),Berg Balance Scale(BBS)and modified Barthel Index(MBI),and the levels of laboratory indicators of peripheral blood CRP,fasting plasma glucose(FPG),total cholesterol(TC),triglyceride(TG),high-density lipoprotein cholesterol(HDL-C)and low-density lipoprotein cholesterol(LDL-C).After treatment,the clinical safety of the three groups was evaluated.Results(1)After treatment,the scale scores of NIHSS in the three groups were lower(P＜0.01)and the scale scores FMA,BBS and MBI were higher than those before treatment(P＜0.05 or P＜0.01).The comparison of post-treatment scale scores showed that the differences among the three groups were statistically significant(P＜0.01).The intergroup comparison showed that the decrease of NIHSS score and the increase of FMA,BBS and MBI scores in the observation group 2 were significantly superior to those in the control group and the observation group 1(P＜0.01);the improvement of FMA score in the observation group 1 was significantly superior to that in the control group(P＜0.01),while the improvement of NIHSS,BBS and MBI scores tended to be superior to that in the control group without statistically significant differences(P＞0.05).The results indicated that the curative effect of scalp acupuncture plus exercise regimen was positively correlated with the duration of needle retention for scalp acupuncture.(2)After treatment,the laboratory indicator levels of CRP and FPG in the peripheral blood of the three groups,the levels of TG and LDL-C in the two observation groups and the level of HDL-C in the observation group 2 were improved compared with those before treatment(P＜0.05 or P＜0.01).Statistically significant differences were presented in the post-treatment levels of CRP and TG in peripheral blood among the three groups(P＜0.05 or P＜0.01).The intergroup comparison showed that the improvement of CRP and TG levels in the observation group 2 was significantly superior to that in the control group,and the improvement of CRP level in the observation group 2 was significantly superior to that in the observation group 1,the differences being statistically significant(P＜0.05 or P＜0.01).The TC level in the three groups after treatment did not differ from that before treatment,and there was no significant difference in TC level after treatment among the three groups either(P＞0.05).(3)During the treatment,no adverse reactions such as fainting,needle breaking and hematoma occurred in the three groups,the vital signs of the patients were stable,and there were no obvious abnormal changes in pulse,blood pressure and respiratory rate.Conclusion Scalp acupuncture can effectively improve the motor function of post-stroke patients in a pasitive time-effect relationship with the needle retention,and better the curative effect can be achieved by retaining of the needle for 2 h.

Objective To elucidate the potential mechanisms by which mesothelin(MSLN)contributes to chemotherapy resistance in high-grade serous ovarian cancer(HGSOC).Methods A Meta-analysis utilizing public ovarian cancer databases was performed to evaluate the correlation between MSLN expression levels and overall survival(OS)in ovarian cancer patients.Pathway enrichment analysis was employed to identify key signaling pathways regulated by MSLN and their roles in chemotherapy resistance.Additionally,the TCGA-HGSOC database was analyzed to examine genomic features associated with MSLN-mediated chemotherapy resistance.To validate the biological function of MSLN in chemotherapy resistance,an intraperitoneal metastasis model was established using MSLN-knockdown ID8 ovarian cancer cells in mice.Results Elevated MSLN expression was significantly associated with poor patient prognosis(HR:1.42,95%CI:1.16-1.74).Differential gene expression and pathway enrichment analyses revealed that high MSLN expression upregulates resistance-associated genes and pathways involved in drug metabolism and DNA-binding signaling.Genomic association analysis showed a negative correlation between high MSLN expression and chromosomal instability features,specifically CX3,CX11,and CX13 scores.In vivo studies demonstrated that MSLN knockdown enhanced the tumor-suppressive effects of cisplatin.Conclusion High MSLN expression represents a potential biomarker for poor prognosis and chemotherapy resistance in HGSOC patients,suggesting MSLN as a promising target for therapeutic intervention.

This study was aimed at understanding the Blastocystis,Enteroc ytozoon bieneusi,Cryptosporidium spp.,Gi-ardia duodenalis,and Pentatrichomonas hominis infection status in Chinese Milu deer(Elaphurus davidianus)in various prov-inces of China.A total of 81 fecal samples were collected from Beijing,Inner Mongolia,Hebei,and Hubei.PCR was used to detect the protozoans,and their subtypes and zoonoticity were determined through sequence and phylogenetic analyses.PCR re-sults indicated an infection prevalence of 40.74％,19.75％,and 8.64％for Blastocystis,E.bieneusi,and Cryptosporidium spp.,respectively,whereas G.duodenalis and P.hominis was not detected.Only one subtype of Cryptosporidium spp.(Cryptosporidium deer genotype)was detected.Four E.biene-usi genotypes were detected:HLJD-V,MWC-d1,BEB6,and CGC2.Five Blastocystis ST types were found:ST10,ST14,ST21,ST23,and ST25.Cryptosporidium spp.,E.bieneusi,and Blastocystis infections were prevalent,and zoonotic subtypes or genotypes of E.bieneusi and Blastocystis were i-dentified.The prevention and control of intestinal protozoa in Chinese Milu deer would support population health and is im-portant for public health.

This study was aimed at understanding the Blastocystis,Enteroc ytozoon bieneusi,Cryptosporidium spp.,Gi-ardia duodenalis,and Pentatrichomonas hominis infection status in Chinese Milu deer(Elaphurus davidianus)in various prov-inces of China.A total of 81 fecal samples were collected from Beijing,Inner Mongolia,Hebei,and Hubei.PCR was used to detect the protozoans,and their subtypes and zoonoticity were determined through sequence and phylogenetic analyses.PCR re-sults indicated an infection prevalence of 40.74％,19.75％,and 8.64％for Blastocystis,E.bieneusi,and Cryptosporidium spp.,respectively,whereas G.duodenalis and P.hominis was not detected.Only one subtype of Cryptosporidium spp.(Cryptosporidium deer genotype)was detected.Four E.biene-usi genotypes were detected:HLJD-V,MWC-d1,BEB6,and CGC2.Five Blastocystis ST types were found:ST10,ST14,ST21,ST23,and ST25.Cryptosporidium spp.,E.bieneusi,and Blastocystis infections were prevalent,and zoonotic subtypes or genotypes of E.bieneusi and Blastocystis were i-dentified.The prevention and control of intestinal protozoa in Chinese Milu deer would support population health and is im-portant for public health.

Female ; Humans ; Endometriosis

COVID-19 has been prevalent for three years. The virulence of SARS-CoV-2 is weaken as it mutates continuously. However, elderly patients, especially those with underlying diseases, are still at high risk of developing severe infections. With the continuous study of the molecular structure and pathogenic mechanism of SARS-CoV-2, antiviral drugs for COVID-19 have been successively marketed, and these anti-SARS-CoV-2 drugs can effectively reduce the severe rate and mortality of elderly patients. This article reviews the mechanism, clinical medication regimens, drug interactions and adverse reactions of five small molecule antiviral drugs currently approved for marketing in China, so as to provide advice for the clinical rational use of anti-SARS-CoV-2 in the elderly.