ObjectiveTo evaluate the clinical efficacy of Shenqi Yangxin decoction in the treatment of ischemic cardiomyopathy （ICM） with Qi and Yin deficiency and blood stasis syndrome and its effect on serum hydrogen sulfide （H₂S） and calcium ion （Ca²⁺）. MethodsA total of 64 ICM patients with Qi and Yin deficiency and blood stasis syndrome who met the inclusion criteria were randomly divided into a control group （n=32） and a treatment group （n=32）. All patients received conventional Western medicine treatment. The treatment group was additionally given Shenqi Yangxin decoction. The TCM syndrome score， Minnesota Living with Heart Failure Questionnaire （MLHFQ） score， left ventricular ejection fraction （LVEF）， N-terminal pro-B-type natriuretic peptide （NT-proBNP）， 6-minute walk test （6MWT）， New York Heart Association （NYHA） cardiac function classification， and serum H₂S and Ca²⁺ levels were compared between the two groups pre- and post-treatment. ResultsTwo cases dropped out from each group during the study. Finally， 30 patients in each group were included in the analysis. There were no significant differences in age， gender， course of coronary heart disease， underlying diseases， and laboratory tests between the two groups. Compared with baseline， the TCM syndrome score， MLHFQ score， and NT-proBNP in both treatment group and control group decreased significantly （P<0.01）， LVEF， 6MWT， and H₂S increased significantly （P<0.01）， and serum Ca²⁺ increased （P<0.05）. Compared with the control group after treatment， the MLHFQ score and NT-proBNP in the treatment group decreased （P<0.05）， the TCM syndrome score decreased significantly （P<0.01）， LVEF， 6MWT， and serum Ca²⁺ increased （P<0.05）， and H₂S increased significantly （P<0.01）. The improvement degree of the NYHA cardiac function classification in the treatment group was higher than that in the control group， but there was no significant difference. ConclusionShenqi Yangxin decoction is effective in treating ICM patients with Qi and Yin deficiency and blood stasis， which could significantly improve cardiac function and quality of life， and its therapeutic effect may be related to the regulation of serum H₂S and Ca²⁺ levels.

Objective:To systematically evaluate and integrate the exercise experience of patients with chronic obstructive pulmonary disease, so as to provide a basis for formulating personalized exercise programs according to the actual needs of patients.Methods:The qualitative studies on the exercise experience of patients with chronic obstructive pulmonary disease were searched in CNKI, CBM, Wanfang, Web of Science, PubMed, Embase and Scopus Database by computer. The search time was from the establishment of the database to January 31,2023. The quality of the included studies was evaluated using the Australian Joanna Briggs Institute evidence-based Health Care Center Qualitative Research Quality evaluation standard (2016), and the results of the included literature were integrated using the collection integration method.Results:A total of 10 studies were included, 67 research results and 9 categories were extracted, and 3 integrated results were obtained. Integration result 1: the effects of exercise training on patients, including physical function enhancement, psychological condition improvement, social benefit improvement, exercise beliefs and knowledge increased; integration result 2: factors that promote patients′ exercise, including physical benefits increase exercise confidence and expectation, social encouragement stimulates exercise motivation, appropriate external conditions to improve compliance; integration result 3: factors that hinder movement, including illness and poor psychological condition, unfavorable external conditions and life burden.Conclusions:Pulmonary rehabilitation exercise training benefits patients from various aspects such as physical function, psychological condition, and social interaction. This study deeply discusses the exercise training experience of chronic obstructive pulmonary disease patients and understands the factors that promote and hinder patients′ exercise, which can provide a basis for formulating personalized exercise plans.

The quality of Chinese materia medica (CMM) is a challenging and focused topic in the modernization of traditional Chinese medicine (TCM). A profound comprehension of the morphology, structure, active constituents, and dynamic changes during the whole process of CMM growth is essential, which needs highly precise contemporary techniques for in-depth elucidation. Magnetic resonance imaging (MRI) is a cutting-edge tool integrating the benefits of both nuclear magnetic resonance (NMR) spectroscopy and imaging technology. With real-time, non-destructive, and in situ detection capabilities, MRI has been previously used for monitoring internal and external structures of plants alongside compounds during physiological processes in vivo. Here, factors involved in the holistic quality evaluation of CMMs were investigated. Given the applications of MRI in various plants, several representative CMMs were used as examples to demonstrate a methodology of quality visualization by MRI, embodying holistically monitoring the real-time macroscopic morphology, mesoscopic structure, and microscopic metabolites non-destructively in situ. Taken together, the review not only presents a pioneering application mode for utilizing MRI for CMM quality visualization but also holds promise for advancing the quality control and evaluation of CMMs.

The quality of Chinese materia medica(CMM)is a challenging and focused topic in the modernization of traditional Chinese medicine(TCM).A profound comprehension of the morphology,structure,active constituents,and dynamic changes during the whole process of CMM growth is essential,which needs highly precise contemporary techniques for in-depth elucidation.Magnetic resonance imaging(MRI)is a cutting-edge tool integrating the benefits of both nuclear magnetic resonance(NMR)spectroscopy and imaging technology.With real-time,non-destructive,and in situ detection capabilities,MRI has been previously used for monitoring internal and external structures of plants alongside compounds during physiological processes in vivo.Here,factors involved in the holistic quality evaluation of CMMs were investigated.Given the applications of MRI in various plants,several representative CMMs were used as examples to demonstrate a methodology of quality visualization by MRI,embodying holistically monitoring the real-time macroscopic morphology,mesoscopic structure,and microscopic metabolites non-destructively in situ.Taken together,the review not only presents a pioneering application mode for uti-lizing MRI for CMM quality visualization but also holds promise for advancing the quality control and evaluation of CMMs.

Due to the rapid proliferation and growth of tumor cells, hypoxic microenvironment exists in many solid tumors, and hypoxia inducible factors (HIF) are critical for sensing oxygen tension within tumors and subsequently mediating the activation of hypoxia responses. Hepatocellular carcinoma (HCC) is one of the most hypoxic tumors. This article summarizes the mechanism of action of HIF in promoting the development and progression of HCC by promoting glycolysis, angiogenesis, invasion and metastasis, immune escape, and cancer stem cell formation. At present, the development of targeted drugs for HIF inhibitors has broad prospects in the treatment of HCC, and the detection of HIF also has a potential value in prognostic evaluation HCC.

Objective: Shortage of kidney allografts is a major barrier to end-stage renal disease patients receiving kidney transplantation, and it is necessary to enlarge the donor pool and find better ways of using available allografts. The global incidence of nephrolithiasis is increasing, nephrolithiasis affects approximately 10％ of adults worldwide, and it also affects the kidney donors. However, there is little information about the use of cadaveric kidney allografts with nephrolithiasis. This study aims to evaluate the safety and outcome of kidney transplantation with allografts from the deceased donors with nephrolithiasis. Methods: A total of 520 deceased donors who was at least 10 years old, and 945 adult recipients with single kidney transplantation at the Department of Kidney Transplantation, the Second Xiangya Hospital from 2016 to 2020 were included in this study. The donors were divided into 2 groups according to nephrolithiasis diagnoses: The donors with nephrolithiasis (D+) and the donors without nephrolithiasis (D?). The recipients were assigned into 3 groups according to their donors and the allografts they received: The allografts from donors without nephrolithiasis (D?K?), the allografts without nephrolithiasis from donors with nephrolithiasis (D+K?), and the allografts with nephrolithiasis (D+K+). The demographic and clinical data of enrolled subjects were retrospectively analyzed. The allograft discard ratio between different donors were analyzed. The one-year survival of allografts and recipients, as well as the allograft function and the complications of kidney transplantation were compared. Results: Fifty out of 520 donors had nephrolithiasis, and the nephrolithiasis incidence was 9.6％. We recovered 1040 kidneys, and total discard rate was 4.4％ (46/1040). The D+ group had a rate of 7％ discard. The donors with kidney discard accounted for 12％ in the D+ group, and this was higher than that of donors in the D? group (5.1％, P<0.05). The total incidence of delayed graft function (DGF) was 7.5％, and there were no significant differences in the incidence of DGF in recipients among the D?K?, D+K?, and D+K+ group (7.5％ vs 6.5％ vs 8.2％, P>0.05). During the one-year follow-up, 8 allografts lost function and 19 recipients died with a functional allograft. Recipients in the D?K?, D+K?, and D+K+ groups also had no significant difference between a one-year allograft and patient survival rate (P>0.05). However, recipients in the D+K+ group had a higher level of serum creatinine [(139.2±62.46) μmol/L vs (117.19±51.22) μmol/L, P<0.05] and lower estimated glomerular filtration rate [eGFR; (56.67±23.31) mL/(min·1.73 m?2) vs (66.86±21.90) mL/(min·1.73 m?2), P<0.05] compared with recipients in the D?K? group at 12 months after transplantation. During the first year after transplantation, 4 recipients developed urolithiasis, and recipients who received allografts from the D+ group donors had a higher incidence of urolithiasis than those who received allografts from the D? group donors (2.2％ vs 0.2％, P<0.05). There were no significant differences in the incidence of urinary tract infections and ureteral strictures at 1 year between recipients of D+ and D? donors (both P>0.05).Conclusion: The cadaveric kidney allografts with nephrolithiasis could be safely used for transplantation, and the short-term outcome is acceptable. However, nephrolithiasis in donors may increase the rate of kidney discard, disturb the short-term function of allografts, and increase the risk of urolithiasis in recipients. Further research with a long-term study is needed to verify the long-term outcome of kidney transplantation using cadaveric kidney allografts with nephrolithiasis.

Objective:To investigate the effects of different local complications of acute pancreatitis (AP) on the microcirculation of multiple organs in the upper abdomen.Methods:A dynamic volume perfusion computed tomography (DVPCT) scan in the upper abdomen was prospectively conducted in 101 patients with AP and 24 patients with neither AP nor other obvious upper abnominal lesions diagnosed in People′s Hospital of Deyang City from April 1 to October 31, 2019, 86 patients with AP (AP group) and 21 controls (control group) were enrolled in the study. AP patients were divided into no local complications group (21 cases), acute peripancreatic fluid collection (APFC) group (19 cases), acute necrotic collection (ANC) group (27 cases), walled-off necrosis (WON) group (11 cases) and walled-off necrosis with infection (WONI) group (8 cases). The blood flow (BF) of pancreas, liver, spleen, two kidneys and adrenal glands was measured by deconvolution. The hepatic arterial perfusion (HAP), hepatic portal perfusion (HPP) and hepatic perfusion index (HPI) of each group were calculated by maximum slope. T test was used for statistical analysis. Results:The BF of pancreas, spleen and left adrenal gland of ANC group was (139.89±34.28), (141.42±47.85) and (107.87±26.41) mL·min -1·(100 g) -1, respectively, the BF of pancreas, spleen and left adrenal gland of WON group was (130.00±44.83), (106.12±38.16) and (98.38±41.39) mL·min -1·(100 g) -1 respectively, and the BF of pancreas, spleen and left adrenal gland of WONI group was (127.91±35.86), (102.09±23.73) and (105.66±27.01) mL·min -1·(100 g) -1, respectively, which were all lower than those of control group ((161.22±31.60), (174.00±62.73) and (134.53±36.36) mL·min -1·(100 g) -1), and the differences were statistically significant ( t=2.440, 2.043, 2.943; 2.296, 3.796, 2.548; 2.448, 4.479, 2.154; all P<0.05). The BF of left kidney cortex of WONI group was lower than that of control group ((247.44±39.32) mL·min -1·(100 g) -1 vs. (294.80±39.13) mL·min -1·(100 g) -1), and the difference were statistically significant ( t=2.910, P<0.05). The HAP of ANC group, WON group and WONI group was (18.63±9.54), (19.10±7.47) and (19.51±6.26) mL·min -1·(100 g) -1, respectively, and the HPI was (25.01±15.51)%, (45.98±31.42)% and (35.92±24.95)%, respectively, which were all higher than those of control group ((12.18±5.14) mL·min -1·(100 g) -1 and (13.44±6.49)%), and the differences were statistically significant ( t=2.997, 3.088, 3.235; 3.503, 3.397, 2.517; all P<0.05) . The HPP of ANC group, WON group and WONI group was (72.37±21.76), (48.83±35.10) and (57.55±29.45) mL·min -1·(100 g) -1, respectively, which were all lower than that of control group ((86.43±17.98) mL·min -1·(100 g) -1), and the differences were statistically significant ( t=2.391, 3.331 and 3.226, all P<0.05). The HAP and HPI of APFC group were both higher than those of control group ((18.67±10.24) mL·min -1·(100 g) -1 vs. 12.18±5.14) mL·min -1·(100 g) -1 and (23.75±20.41)% vs. (13.44±6.49)%), and the differences were statistically significant ( t=2.572 and 2.108, both P<0.05) . Conclusions:AP complicated with ANC, WON and WONI can reduce the BF of pancreas, spleen and left adrenal gland, and WONI can induce the decrease of BF of left kindney cortex. AP complicated with ANC, WON and WONI can increase HAP and HPI, but decrease HPP. Furthermore, AP complicated with APFC can increase HAP.

Objective To evaluate the safety and clinical efficacy of the treatment for symptomatic uterine fibroids with MR guided focused ultrasound surgery(MRgFUS)in China. Methods Twenty five selected patients with symptomatic uterine fibroids underwent MRgFUS treatment in our perspective clinical study. Immediately after treatment the patients accepted pelvic enhanced MRI scans, and recorded the non-perfused volume(NPV)and calculated the non-perfused volume ratio(NPV%). We recorded the symptom severity score(SSS) and standard SSS change(ΔSSS)of the patients before, during and 1 week after treatment together with 1, 3, 6, 12 months and several years follow-up. The patients accepted pelvic enhanced MRI scans in the follow-up of 12 months after treatment,and recorded the volume and the volume change(ΔV) of fibroids. We observed the adverse reactions during the treatment and the follow-ups. Wilcoxon test or t test and Pearson or Spearman correlation analysis were used to analyze the data. Results Totally 31 fibroids of 25 patients were completed the treatment. Twenty two patients completed the 12 months follow-up and 15 patients completed the long-term follow-up which was during 34 to 66 months, median follow-up duration was(55 ± 11)months. The NPV was 4.5 to 295.0 cm3, median was 37.0 cm3. The NPV%was 6%to 94%, average was(64 ± 23)%. According to our follow up, the standard SSS continued to decline. Compared with screening standard SSS, all the follow-up standard SSS had significant difference(P<0.05), except for that of the first week. Among all the follow up, only the standard SSS change of 1 week after the treatment had a correlation with NPV%(r=0.552,P=0.005), and the others had no significant correlation with NPV%(P>0.05). The uterine fibroids volume decreased in the 12 months follow-up, which had a significant difference with the volume before treatment(P<0.05). And there was also correlation between the fibroids volume change and NPV(r=0.587,P=0.017). There was no correlation between the volume or volume change and standard SSS or standard SSS change(all P>0.05). None serious adverse effects occurred in all cases. Conclusion MRgFUS is a safe and effective way to treat uterine fibroids.

OBJECTIVETo explore the effect of vitamin A (VA) combined iron supplements on iron metabolic homeostasis for preschoolers.

METHODSAbout 445 preschoolers with aged 3-6 years old from eight kindergartens in Pixian county, Chengdu were recruited into this trial from March to September, 2011. All subjects met the inclusion criteria were randomly divided into four groups using random number table: sole VA supplementation group (VA group, a single oral dose of VA at about 200 000 units), sole iron supplementation group (FE group, daily oral supplementation with the element iron 1-2 mg·kg(-1)·d(-1) for five days a week, lasting for 6 months), the combined supplementation of VA and iron group (VF group) and control group (CO group, no VA and iron supplementation). The concentration of serum VA, serum ferritin (SF), serum transferring receptor (sTfR), C-reactive protein (CRP) and hemoglobin (Hb) were measured from 3 ml vein blood. The sTfR-SF index (TFR-F index) and total body iron content (TBIC) before and after intervention were calculated. The differences of these indexes between groups before and after intervention were analyzed.

RESULTSThe level of sTfR before intervention in VA group ((1.78 ± 0.17) mg/L) was significantly higher than that of after intervention ((1.18 ± 0.11)mg/L) (t = 28.88, P < 0.01). The levels of TFR-F index and TBIC in FE and VF groups before intervention ( (1.59 ± 0.37), (1.63 ± 0.40) and (9.04 ± 2.71), (9.26 ± 2.33) mg/kg, respectively) were all lower than those of after intervention (TFR-F index:(1.84 ± 0.51), (1.87 ± 0.45) and TBIC:(12.42 ± 3.49), (13.01 ± 2.98)mg/kg) (t values were 3.93, 3.78, 7.57 and 9.41, respectively, all P values were <0.01). The incidence of iron deficiency in VA, FE, and VF groups before intervention were 26% (25/95), 31% (30/98) and 31% (28/90) and were 41% (39/95), 10% (10/98) and 18% (16/90) for after intervention, respectively. The difference of this index in VA, FE and VF groups were significant (χ(2) values were 4.59, 12.50 and 4.31, respectively, all the P values were <0.05).

CONCLUSIONCombined VA and iron was as effective as VA alone or iron alone in decreasing the iron deficiency, the impact of VA intervention on iron metabolic homeostasis was mainly manifested in iron usage and mobilization, but showed no effect on total body iron content.

Anemia, Iron-Deficiency ; epidemiology ; Child ; Child, Preschool ; Dietary Supplements ; Female ; Homeostasis ; Humans ; Iron ; administration & dosage ; metabolism ; Male ; Nutritional Status ; Vitamin A ; administration & dosage ; pharmacology