Objective To analyze the medication law and compatibility characteristics of TCM compounds for the treatment of myocardial infarction in the national patent database.Methods TCM compounds for treating myocardial infarction were retrieved from CNIPA patent publication website.A prescription database was built using Excel 2019 software to statistically analyze the frequency of medicinal use and their properties,taste and meridian tropism;SPSS Modeler 18.0 software was used to analyze the association rules of drugs;a network of Chinese materia medica co-occurrence was constructed using Cytoscape 3.10.0,and systematic clustering analysis was performed on the Chinese materia medica in the core network.Results A total of 146 patents of TCM compounds were included,involved 440 kinds of Chinese materia medica.High frequency drugs included Salviea Miltiorrhizae Radix et Rhizoma,Chuanxiong Rhizoma,Angelicae Sinensis Radix,Glycyrrhizae Radix et Rhizoma,etc.The main property was warm,the main tastes were bitter,sweet and pungent,and the medicines mostly belongs to the liver meridian,heart meridian and spleen meridians.Commonly used medicinal pairs included Angelicae Sinensis Radix-Chuanxiong Rhizoma,Astragali Radix-Salviea Miltiorrhizae Radix et Rhizoma,Paeoniae Radix Rubra-Angelicae Sinensis Radix,etc.Commonly used tripartite combinations included Paeoniae Radix Rubra-Chuanxiong Rhizoma-Angelicae Sinensis Radix,Carthami Flos-Angelicae Sinensis Radix-Chuanxiong Rhizoma,Carthami Flos-Chuanxiong Rhizoma-Angelicae Sinensis Radix,etc.Clustering analysis showed four types of combinations.Conclusion TCM compound patents for the treatment of myocardial infarction is based on promoting blood circulation,removing blood stasis,and relieving pain,while also using methods such as eliminating phlegm,tonifying qi,warming yang,and nourishing yin.It can provide references for clinical medication.

Cardiovascular diseases （CVD），a group of common diseases in clinical practice，are witnessing a steady rise in both incidence and mortality rates，posing a challenge to public health. Gualou Xiebai Banxiatang，originating from Synopsis of the Golden Chamber （《金匮要略》），was initially used to treat severe cases of chest impediment. The formula consists of Trichosanthis Fructus，Allii Macrostemonis Bulbus，Pinelliae Rhizoma，and Baijiu. It has a wide range of clinical applications，with therapeutic effects including moving Qi to relieve depression，activating Yang to dissipate mass，and expelling phlegm to alleviate chest congestion. In recent years，clinical research has confirmed that Gualou Xiebai Banxiatang，with or without modification，used alone or in combination with Western medicine，has definite effects in the treatment of CVD such as hyperlipidemia，coronary atherosclerotic heart disease，hypertension，heart failure，and arrhythmia. It can alleviate disease symptoms and reduce the risk of re-hospitalization. Basic research indicates that the mechanisms of Gualou Xiebai Banxiatang include improving endothelial functions，exhibiting anti-inflammatory properties，countering oxidative stress，preventing apoptosis，inhibiting ventricular remodeling，regulating mitochondrial functions，improving hemorheology，and modulating autophagy and neurotransmitters. This article reviews relevant articles in recent years with focuses on the compatibility，clinical application，and mechanism of Gualou Xiebai Banxiatang. This review is expected to provide a theoretical basis for the mechanism research and clinical application of this formula in treating CVD and to offer ideas and reference for in-depth research.

Objective To analyze the medication law and compatibility characteristics of TCM compounds for the treatment of myocardial infarction in the national patent database.Methods TCM compounds for treating myocardial infarction were retrieved from CNIPA patent publication website.A prescription database was built using Excel 2019 software to statistically analyze the frequency of medicinal use and their properties,taste and meridian tropism;SPSS Modeler 18.0 software was used to analyze the association rules of drugs;a network of Chinese materia medica co-occurrence was constructed using Cytoscape 3.10.0,and systematic clustering analysis was performed on the Chinese materia medica in the core network.Results A total of 146 patents of TCM compounds were included,involved 440 kinds of Chinese materia medica.High frequency drugs included Salviea Miltiorrhizae Radix et Rhizoma,Chuanxiong Rhizoma,Angelicae Sinensis Radix,Glycyrrhizae Radix et Rhizoma,etc.The main property was warm,the main tastes were bitter,sweet and pungent,and the medicines mostly belongs to the liver meridian,heart meridian and spleen meridians.Commonly used medicinal pairs included Angelicae Sinensis Radix-Chuanxiong Rhizoma,Astragali Radix-Salviea Miltiorrhizae Radix et Rhizoma,Paeoniae Radix Rubra-Angelicae Sinensis Radix,etc.Commonly used tripartite combinations included Paeoniae Radix Rubra-Chuanxiong Rhizoma-Angelicae Sinensis Radix,Carthami Flos-Angelicae Sinensis Radix-Chuanxiong Rhizoma,Carthami Flos-Chuanxiong Rhizoma-Angelicae Sinensis Radix,etc.Clustering analysis showed four types of combinations.Conclusion TCM compound patents for the treatment of myocardial infarction is based on promoting blood circulation,removing blood stasis,and relieving pain,while also using methods such as eliminating phlegm,tonifying qi,warming yang,and nourishing yin.It can provide references for clinical medication.

Spinal surgical site infection (SSI), especially deep SSI after internal fixation is difficult in treatment, with long course of disease and poor prognosis. At present, there are many controversies in the diagnosis and treatment of spinal SSI, with unsatisfactory overall efficacy of its diagnosis and treatment. Besides, no diagnosis and treatment guideline based on evidence-based medicine has been in existence. To this end, the Spinal Infection Group of the Orthopedic Branch of the Chinese Medical Doctor Association and the Spinal Infection Group of the Spinal Surgery Branch of the Chinese Rehabilitation Medicine Association jointly organized relevant experts to formulate Evidence-based clinical guideline for the diagnosis and treatment of surgical site infection in spinal trauma ( version 2024) based on an evidence-based approach. A total of 10 recommendations were proposed on the diagnosis and treatment of spinal SSI, so as to provide a clinical reference for the diagnosis and treatment of spinal SSI.

Objective:To evaluate the bone hook pulling technique in reduction of valgus-impacted femoral neck fractures.Methods:A retrospective study was conducted to analyze the clinical data of 12 patients who had been treated from September 2021 to September 2022 for valgus-impacted femoral neck fractures at Department of Orthopaedics and Traumatology, Honghui Hospital. There were 6 males and 6 females with an age of (43.8±10.1) years. By the Garden classification, the 12 cases were all type Ⅰ; by the Pauwels classification, 10 cases were type Ⅰ and 2 cases type Ⅱ. All patients were definitively diagnosed preoperatively by radiographs and CT images. The bone hook pulling technique was used to extend the bone hook from the lateral side to the medial side of the lesser trochanter, pull the bone hook to the lateral side, and reset the fracture with the help of pulling force and the action of the surrounding soft tissue hinge. The fractures were then fixed with the Femoral Neck System (FNS). Length of surgical incision, number of fluoroscopy for bone hook-related operations, operation time, quality of fracture reduction, fracture healing time, functional recovery of the hip and shortening of the femoral neck at the last follow-up were recorded.Results:The 12 valgus-impacted femoral neck fractures were successfully reset by the hook pulling technique. In this cohort, the length of surgical incision was (4.6±0.7) cm, the number of fluoroscopy for bone hook-related operations (4.3±0.7) times, and the operation time (54.3±4.2) min. The 12 patients were followed up for (11.5±4.2) months postoperatively and the fracture healing time (4.2±0.7) months. According to the Garden score, the quality of postoperative fracture reduction was assessed as grade Ⅰ in 10 cases and as grade Ⅱ in 2 cases. According to the Harris hip score, the hip function was assessed as excellent in 10 cases and as good in 2 cases at the last follow-up. The length of femoral neck shortening was (1.17±0.68) mm at the last follow-up in the 12 patients; no complications related to fracture reduction were observed.Conclusion:In the reduction of valgus-impacted femoral neck fractures, bone hook pulling technique shows advantages of operational simplicity, a high rate of successful reduction, and satisfactory clinical effects.

Objectives:To explore the causal relationship between body mass index,uric acid and congestive heart failure(CHF),and provide genetic evidence to support the association between uric acid-mediated body mass index and the risk of CHF. Methods:Using the published data set of genome-wide association studies(GWAS)in East Asia,inverse variance weighting(IVW)method was used as the main analysis method,and MR-Egger method,weighted median model(WME),simple model and weighted model were used to analyze the causal relationship between body mass index,uric acid and CHF.MR-Egger regression was used to detect pleiotropy,Cochran Q test was used to detect heterogeneity,leave-one-out sensitivity was used to detect bias,funnel plot was drawn to detect bias,and MR-PRESSO package was used to remove outlier single nucleotide polymorphism(SNP).After Mendelian analysis,the mediating effect ratio was calculated,and the reverse Mendelian randomization study results between body mass index,uric acid and CHF were analyzed. Results:IVW method showed that body mass index(OR=1.685,95%CI:1.417-2.003,P<0.001)and uric acid(OR=1.225,95%CI:1.087-1.380,P<0.001)were risk factors of CHF in two-sample Mendelian analysis.Body mass index(OR=1.204,95%CI:1.139-1.273,P<0.001)was a risk factor for uric acid.The mediating effect of uric acid was 7.23%.The P values of MR-Egger regression intercept terms were all>0.05,that is,there was no pleiotropy of the selected SNP,and the causal inference method was valid.The Cochran Q test P values of body mass index and uric acid,and body mass index and CHF were<0.01,indicating heterogeneity.IVW analysis of CHF and body mass index in reverse Mendelian analysis was OR=0.977,95%CI:0.947-1.008,P>0.05 and CHF and uric acid was OR=1.000,95%CI:0.963-1.038,P>0.05,so the reverse causal inference was not valid.However,the analysis of uric acid and body mass index showed pleiotropy,so the causal inference method was invalid. Conclusions:There is a causal and positive correlation between body mass index and CHF.There is a causal relationship and positive correlation between uric acid and CHF.However,uric acid is an incomplete mediator between body mass index and CHF.

This study was performed to investigate the inhibitory effects of Xuebijing injection(XBJ)on lipopolysaccharide(LPS)-induced inflammatory signals on EA.hy926 vascular endothelial cells and the underlying mechanism,and to provide a theoretical basis for the treatment of sepsis with XBJ.WST-1 assay was used to detect the effects of XBJ on the cell viability;Western blot analysis was performed to detect the protein expression levels of IκBα,p-p65,p-ERK,p-JNK,p-p38,p-AMAD17 in cell lysates and the content of sTLR4 fragment in the concentrated culture supernatants.ADAM17 sheddase activity in cells was detected by using a commercial available kit.Data showed that all of the TLR4-mediated inflammatory signals were significantly inhibited by the treatment of XBJ(P＜0.01).ADAM17 phosphorylation and shedding activity were induced by XBJ treatment,simultaneously the sTLR4 contents in the culture media were increased.XBJ-induced shedding of TLR4 was suppressed by the preteatment of 10 μmol/L TAPI-1(an ADAM17 inhibitor).Taken together,XBJ can induce the shedding of TLR4 from cell membrane by up-regulating ADAM17 shedding activity,thereby inhibiting the activation of TLR4-mediated intracellular inflammatory signals in EA.hy926 cells.

Objective:To explore the efficacy of long intramedullary nails versus short intramedullary nails in the treatment of AO/OTA 31-A3 intertrochanteric fractures.Methods:A retrospective analysis was conducted on 60 patients with AO/OTA 31-A3 intertrochanteric femur fractures treated between March 2019 and August 2022. The patients were randomly divided into two groups (the long nail group and the short nail group). Thirty-four patients were treated with long intramedullary nails, including 16 males and 18 females, aged 68.41±17.84 years old (range 31-96 years). Twenty-six patients were treated with short intramedullary nails, including 13 males and 13 females, aged 72.23±13.97 years old (range 31-90 years). The causes of injury, fracture classification (AO/OTA classification), intraoperative blood loss, operation time, fracture healing time, imaging indexes (fracture reduction quality, postoperative neck trunk angle, and medial support), Harris score of the hip joint at the last follow-up, one-year mortality rates and complications were compared between the two groups.Results:The follow-up time was 24.26±6.67 months in the long nail group and 24.31±5.60 months in the short nail group, and the general information of the two groups were comparable. Between the long nail and short nail group, the intraoperative blood loss was 281.47±235.28 ml vs. 121.92±84.14 ml and the operation time was 110.44±24.63 min vs. 81.15±28.54 min with significant differences ( P<0.05). While the length of hospital stay was 12.35±4.81 d vs. 10.89±4.30 d, the good rate of fracture reduction was 55.9% vs. 61.53%, the fracture healing time was 120.44±16.43 d vs. 128.07±18.33 d, the presence rate of medial support was 67.6% vs. 79.4%, and the excellent rate of Harris score was 65.4% vs. 65.4% with no significant difference between the two groups ( P>0.05). One-year mortality rates was 5.3% vs. 7.1% and complications was 11.7% vs. 15.4% with no significant difference between the two groups ( P>0.05). Conclusion:Both long intramedullary nails and short intramedullary nails are effective in the treatment of AO/OTA 31-A3 intertrochanteric femur fractures. However, surgical time and intraoperative blood loss was less in the short nail group.

Background and Aims:Graft materials such as covered stents and artificial vascular grafts have been widely used to treat peripheral arterial disease (PAD). However,the increasing prevalence of chronic graft thrombosis and chronic lower limb arterial thrombosis has brought attention to the challenge of removing chronic thrombi. This study evaluated the feasibility of using the Rotarex mechanical thrombectomy system for treating chronic thrombosis formation in PAD patients.Methods:A retrospective analysis was conducted on the clinical data of 10 PAD patients with chronic thrombosis admitted consecutively to the Department of Vascular Surgery,Hainan Provincial People's Hospital,from July 2023 to December 2023. All patients were male,with an average age of (70.4±8.6) years. The cohort included five synthetic graft cases,one with a covered stent and four with autologous arteries. The occlusion sites included the iliac artery (2 cases),superficial femoral artery (7 cases),and popliteal artery (4 cases),with a median occlusion duration of 5.5 (3-38) months. The Rotarex mechanical thrombectomy system was used in combination with balloon angioplasty or stent implantation to restore lower limb blood flow. The debulking success rate,procedural success rate,and changes in hemoglobin (Hb),and ankle-brachial index (ABI) were evaluated. Patients were followed up at 3 and 6 months after operation with ultrasound examination,Rutherford classification,and ABI assessment.Results:The Rotarex mechanical thrombectomy achieved a 100％ success rate in both debulking and procedural outcomes. The median operative time was 150 (120-270) min. All patients underwent percutaneous transluminal angioplasty (PTA) following thrombectomy. Nine stents were deployed in six patients:five in the distal segments of the occluded vessels,three in the proximal segments,and one fully covering the diseased segment. Preoperative Hb was (131.30±24.55) g/L,which decreased to (114.20±25.28) g/L postoperatively,showing a statistically significant difference (t=4.253,P=0.002). The preoperative ABI was 0.46±0.15,which improved to 0.95±0.19 postoperatively,also showing a significant difference (t=17.528,P<0.001). No perioperative complications,such as distal arterial embolism,arterial injury,or acute renal dysfunction,were observed. The follow-up rate was 100％ at 3 months and 80％ at 6 months. At 3 months,ultrasound examinations showed patent target vessels in all patients,with Rutherford classification of grade 0 in 8 cases and grade 1 in 2 cases and an ABI of 0.84±0.17. At 6 months,two patients were lost to follow-up. Among the remaining 8 patients,ultrasound revealed moderate stenosis in 2 cases and patent vessels in 6 cases,with Rutherford classification of grade 0 in 4 cases and grade 1 in 4 cases,and an ABI of 0.76±0.16.Conclusion:The Rotarex mechanical thrombectomy system is a safe and feasible option for treating chronic thrombosis in PAD patients.

Background and Aims:Graft materials such as covered stents and artificial vascular grafts have been widely used to treat peripheral arterial disease (PAD). However,the increasing prevalence of chronic graft thrombosis and chronic lower limb arterial thrombosis has brought attention to the challenge of removing chronic thrombi. This study evaluated the feasibility of using the Rotarex mechanical thrombectomy system for treating chronic thrombosis formation in PAD patients.Methods:A retrospective analysis was conducted on the clinical data of 10 PAD patients with chronic thrombosis admitted consecutively to the Department of Vascular Surgery,Hainan Provincial People's Hospital,from July 2023 to December 2023. All patients were male,with an average age of (70.4±8.6) years. The cohort included five synthetic graft cases,one with a covered stent and four with autologous arteries. The occlusion sites included the iliac artery (2 cases),superficial femoral artery (7 cases),and popliteal artery (4 cases),with a median occlusion duration of 5.5 (3-38) months. The Rotarex mechanical thrombectomy system was used in combination with balloon angioplasty or stent implantation to restore lower limb blood flow. The debulking success rate,procedural success rate,and changes in hemoglobin (Hb),and ankle-brachial index (ABI) were evaluated. Patients were followed up at 3 and 6 months after operation with ultrasound examination,Rutherford classification,and ABI assessment.Results:The Rotarex mechanical thrombectomy achieved a 100％ success rate in both debulking and procedural outcomes. The median operative time was 150 (120-270) min. All patients underwent percutaneous transluminal angioplasty (PTA) following thrombectomy. Nine stents were deployed in six patients:five in the distal segments of the occluded vessels,three in the proximal segments,and one fully covering the diseased segment. Preoperative Hb was (131.30±24.55) g/L,which decreased to (114.20±25.28) g/L postoperatively,showing a statistically significant difference (t=4.253,P=0.002). The preoperative ABI was 0.46±0.15,which improved to 0.95±0.19 postoperatively,also showing a significant difference (t=17.528,P<0.001). No perioperative complications,such as distal arterial embolism,arterial injury,or acute renal dysfunction,were observed. The follow-up rate was 100％ at 3 months and 80％ at 6 months. At 3 months,ultrasound examinations showed patent target vessels in all patients,with Rutherford classification of grade 0 in 8 cases and grade 1 in 2 cases and an ABI of 0.84±0.17. At 6 months,two patients were lost to follow-up. Among the remaining 8 patients,ultrasound revealed moderate stenosis in 2 cases and patent vessels in 6 cases,with Rutherford classification of grade 0 in 4 cases and grade 1 in 4 cases,and an ABI of 0.76±0.16.Conclusion:The Rotarex mechanical thrombectomy system is a safe and feasible option for treating chronic thrombosis in PAD patients.