Inflammatory diseases (IDs) are a general term of diseases characterized by chronic inflammation as the primary pathogenetic mechanism, which seriously affect the quality of patient′s life and cause significant social and medical burden. Current drugs for IDs include nonsteroidal anti-inflammatory drugs, corticosteroids, immunomodulators, biologics, and antioxidants, but these drugs may cause gastrointestinal side effects, induce or worsen infections, and cause non-response or intolerance. Given the outstanding performance of metal polyphenol network (MPN) in the fields of drug delivery, biomedical imaging, and catalytic therapy, its application in the diagnosis and treatment of IDs has attracted much attention and significant progress has been made. In this paper, we first provide an overview of the types of IDs and their generating mechanisms, then sort out and summarize the different forms of MPN in recent years, and finally discuss in detail the characteristics of MPN and their latest research progress in the diagnosis and treatment of IDs. This research may provide useful references for scientific research and clinical practice in the related fields.

Transcatheter aortic valve replacement(TAVR)is the use of interventional catheter to transport the artificial heart valve to the aortic valve area through the patient's arterial,venous system or left ventricular apex,then release it to replace the original aortic valve to achieve normal physiological function.The"suicide left ventricle"phenomenon refers to the paradoxical hemodynamic collapse of dynamic left ventricular obstruction caused by left ventricular hypertrophy and hypersystole after the removal of the fixed valve obstruction of aortic stenosis after TAVR.The clinical manifestation is abnormal continuous hypotension that is ineffective to positive inotropic drugs during the operation or within a few hours after the operation.With the indications for transcatheter aortic valve surgery covering patients with low,medium and high risk of severe aortic stenosis,surgery-related complications have been reported to increase gradually."Suicide left ventricle"is worth studying and exploring as a fatal potential complication.This article mainly reviews four aspects of the overview of"suicide left ventricle",pathological mechanism,risk-related indicators,prevention strategies and treatment methods to be highly vigilant and make corresponding emergency plans for patients with aortic stenosis who may have suicide left ventricle risk,so as to minimize perioperative mortality.

Objective:To investigate the implementation status of peripherally inserted central catheter (PICC) tip intracardiac electrocardiogram positioning technology in the hospitals, so as to provide reference for promoting the development of intracardiac electrocardiogram positioning technology.Methods:This study was a cross-sectional survey. Using the convenient sampling method, members of Intravenous Infusion Committee of Chinese Nursing Association selected PICC/ intravenous therapy leaders meeting the inclusion criteria from 5 to 10 hospitals in their work area as the research objects from December 2022 to January 2023. The self-made PICC Tip Intracardiac Electrocardiogram Positioning Technology Implementation Status Questionnaire was used to investigate the PICC/intravenous therapy leaders. A total of 205 questionnaires were distributed in 28 provinces/autonomous regions/municipalities directly under the Central Government, and 199 valid questionnaires were collected, with an effective recovery rate of 97.1%. Results:Among 199 hospitals, 63.3% (126/199) of them successfully implemented PICC tip intracardiac electrocardiogram positioning technology. Among the 126 hospitals that implemented PICC tip intracardiac electrocardiogram positioning technology, only 20 hospitals included it in their charging items. A total of 50.3% (100/199) of hospitals established a unified intracardiac electrocardiogram guided PICC catheterization procedure; 47.7% (95/199) of hospitals organized/participated in training programs on PICC tip intracardiac electrocardiogram positioning technology, and 57.3% (114/199) of hospital PICC/intravenous therapy leaders participated in training programs related to PICC tip intracardiac electrocardiogram positioning technology. In terms of the relevant achievements of 199 research hospitals, 56 papers, seven utility model patents and 28 awards were issued.Conclusions:The application, training and achievement output of PICC tip intracardiac electrocardiogram positioning technology need to be further improved. It is suggested to sink high-quality resources, formulate implementation procedures and evaluation standards, standardize nursing service project management, increase training efforts, and improve scientific research thinking of intravenous therapy nurses, so as to promote the standardization development of new technologies.

Objective:To explore the training needs of peripherally inserted central catheter (PICC) specialist nurses in Shandong Province for subcutaneous tunnel technique, so as to provide reference for conducting systematic and standardized training.Methods:This study was a cross-sectional survey. From October to December 2022, convenience sampling was used to select 922 PICC specialist nurses in Shandong Province as the research subject. A self-made questionnaire was used to investigate the training needs of PICC specialist nurses for subcutaneous tunnel technique.Results:A total of 922 questionnaires were distributed, and 922 valid questionnaires were collected, with an effective response rate of 100.00%. 22.78% (210/922) of PICC specialist nurses used subcutaneous tunnel technique. In terms of training willingness, 92.08% (849/922) of PICC specialist nurses had a training need for subcutaneous tunnel technique. In terms of training content needs, the total score of PICC specialist nurses for subcutaneous tunnel technique training content needs was (62.26±11.06), and the average score for each item was >4.15, and the highest scoring item was the sharing of special cases in tunnel PICC (4.60±0.77), and the lowest scoring item was PICC maintenance knowledge (4.15±1.15) .Conclusions:The application rate of subcutaneous tunnel technique is low, and PICC specialist nurses have a high training need. Managers should increase training efforts for this technique, improve training content, innovate training models, develop targeted training programs, so as to promote the application and promotion of this technique.

Objective:To systematically review thrombosis risk prediction models associated with peripherally inserted central venous catheter (PICC) in adults and provide a basis for the clinical application of these models and the development of subsequent models.Methods:Databases such as CNKI, Wanfang, VIP, PubMed, CINAHL, Web of Science, and Ovid were searched to collect studies on thrombosis risk prediction models related to adult PICC, covering all entries from the inception of the databases until December 31, 2022. Two researchers independently screened the literature, extracted data, and assessed the risk of bias.Results:Nineteen studies were included. D-dimer was the most common predictive factor; only five studies underwent external validation, and six studies evaluated model calibration. All included studies exhibited high risk of bias, primarily due to methodological deficiencies in model development and validation processes; the combined area under the receiver operating characteristic curve for nine models was 0.80 (95% Confidence Interval: 0.75-0.85) .Conclusions:Research on thrombosis risk prediction models related to adult PICC is still in its developmental stage. Most of the known models perform well with comprehensive and easily obtainable predictive factors, yet they exhibit methodological shortcomings. Future research should focus on improving the methodological quality and external validation during model development and validation processes.

Objective:To investigate the efficacy and safety of Guihuang Formula(GHF)in the treatment of type Ⅲ prostatitis with the syndrome of damp-heat stasis in the essence chamber.Methods:This study included 120 cases of type Ⅲ prostatitis with damp-heat stasis syndrome in the essence chamber,which were randomly and equally divided into a GHF and a control group,the for-mer treated with GHF and the latter with Tamsulosin Hydrochloride Sustained-Release Capsules,both for 6 successive weeks.We fol-lowed up the patients for 4 weeks,recorded the NIH-CPSI,TCM symptom scores,and results of prostatic fluid routine,blood and u-rine routine,liver and kidney function and electrocardiogram examinations,and compared them between the two groups of patients be-fore and after treatment.Results:Compared with the baseline,the total NIH-CPSI scores were significantly decreased in both the GHF and control groups after 6 weeks of treatment,even more significantly in the former group(28.34±9.23 vs 6.78±3.53,P＜0.05)than in the latter(27.81±8.28 vs 14.48±4.27,P＜0.05),so were the scores on pain,voiding symptoms,quality of life(QOL)impact,TCM symptoms and WBC count(all P＜0.05),while the number of lecithin bodies remarkably increased(P＜0.05).There were statically significant differences in the above parameters at 4,6 and 10 weeks of medication(P＜0.05),but not at 2 weeks(P＞0.05).No obvious abnormalities or adverse reactions were observed in either of the two groups during the treatment.Conclusion:Guihuang Formula is safe and effective in the treatment of type Ⅲ prostatitis with the syndrome of damp-heat stasis in the essence chamber.

mRNA vaccines and drugs enter host cells through delivery vectors and produce target proteins using the protein synthesis mechanism of cells. mRNA and target proteins can induce the body to produce innate immunity and adaptive immunity, and the target protein itself can also play a corresponding role. Tumor cells are inhibited and cleared under the above immune effects and target proteins. This article reviews the immunogenicity of mRNA, that is, the specific mechanism of stimulating the body to produce an immune response.At the same time, the main types of cells transfected by mRNA vaccine were briefly introduced. (1) Muscle cells, epidermal cells, dendritic cells and macrophages at the injection site; (2) immune cells in peripheral lymphoid organs;(3) liver cells and spleen cells, etc. Although transfected with a variety of cells, it is mainly enriched in immune cells and liver cells because immune cells express toll-like receptors and liver cells express low-density lipoprotein receptors. mRNA vaccines and drugs are mainly divided into non-replicating mRNA (nrmRNA),self-amplifying RNA (saRNA), trans-amplifying RNA (taRNA) and circular RNA (circRNA).This article reviews how these 4 types of vaccines and drugs work, and compares their advantages and disadvantages. Due to its inherent immunogenicity, instability, and low delivery efficiency in vivo, mRNA vaccines and drugs have been unable to enter the clinic. This article describes in detail how to reformation and modify the 5'cap, 5'UTR, 3'UTR, ORF, 3'Poly(A) and some nucleotides of mRNA to eliminate its immunogenicity and instability. Due to the low efficiency of the delivery carrier, the researchers optimized it. This article briefly introduces the application of non-viral vectors and their targeting, specifically involving the mechanism of action of various types of delivery vectors and their advantages and disadvantages, and summarizes some of the current targeting vectors. Targeted carriers can improve the delivery efficiency of mRNA to specific tissues and prevent side effects of systemic exposure, such as liver injury. The specific methods of using mRNA vaccines and drugs to treat cancer are as follows: mRNA can be used to encode and transcribe tumor-associated antigens, tumor-specific antigens (TSAs), therapeutic antibodies, cytokines, tumor suppressors, oncolytic viruses, CRISPR-Cas9, CARs and TCRs, so as to play an anti-tumor role. In this paper, the specific mechanism of the above methods and the current research and development of corresponding mRNA vaccines and drugs are briefly reviewed. The successful development of the COVID-19 mRNA vaccine has brought mRNA technology to the attention of the world and brought new and effective means for the prevention and treatment of cancer. mRNA vaccines and drugs have the advantages of short development cycle, dual immune mechanism, safety, high efficiency and large-scale production. At the same time, there are also many areas that need further improvement, such as the development of ideal target TSAs, the in-depth development of saRNA, taRNA and circRNA, the development of targeted nano-delivery for different tissues and organs, the expansion of mRNA administration routes, and the development of mRNA that can be stably stored at room temperature or even high temperature. These problems need to be further studied and solved. In addition to cancer therapy, mRNA vaccines and drugs can also be used in the treatment of infectious diseases, genetic diseases, regenerative medicine and anti-aging. mRNA vaccines and drugs are a very promising platform, and we believe that they will benefit cancer patients in the near future.

Objective:To compare the prognostic values of different classification by using transpulmonary pressure gradient (TPG), diastolic pressure gradient (DPG) and pulmonary vascular resistance (PVR) in patients with pulmonary hypertension due to left heart disease (PH-LHD), and investigated hemodynamic and clinical factors associated with mortality in patients with PH-LHD.Methods:This was a single-center prospective cohort study. In-hospital patients diagnosed with PH-LHD via right heart catheterization at the Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, from September 2013 to December 2019 were enrolled. Patients were divided according to TPG (cutoff value 12 mmHg; 1 mmHg=0.133 kPa), DPG (cutoff value 7 mmHg), PVR (cutoff value 3 Wood Units), and the combination of TPG and PVR. Baseline characteristic was recorded. All patients were followed up until the occurrence of endpoint event, defined as all-cause death that occurred during the follow-up period, or until April 18, 2022. Receiver operating characteristic curves were used to compare the predictive value of 3 classification methods for all-cause death in PH-LHD patients. The optimal cutoff values were calculated using Jorden index. Survival analysis was performed using Kaplan-Meier analysis, and log-rank test was used to compare the predictive efficacy of classification methods based on optimal cutoff values or guidance-recommended thresholds for the survival of PH-LHD patients. Variables showing statistical significance in the univariate analysis were incorporated into multivariate Cox regression model to analyze the independent risk factors for all-cause mortality.Results:A total of 243 patients were enrolled, aged (54.9±12.7) years old, including 169 (69.5%) males. During a median follow-up of 57 months, there were 101 (41.6%) deaths occurred. Grouping results were as follows: (1) TPG: TPG≤12 mmHg group 115 patients, TPG>12 mmHg group 128 patients; (2) DPG: DPG<7 mmHg group 193 patients, DPG≥7 mmHg group 50 patients; (3) PVR: PVR≤3 Wood Units group 108 patients, PVR>3 Wood Units group 135 patients; (4) TPG and PVR: TPG≤12 mmHg and PVR≤3 Wood Units group 89 patients, TPG>12 mmHg and PVR>3 Wood Units group 109 patients. PVR ( AUC=0. 698,95% CI:0.631-0.766) had better predictive value for all-cause mortality than TPG ( AUC=0.596, 95% CI: 0.523-0.669) and DPG ( AUC=0.526, 95% CI: 0.452-0.601) (all P<0.05). The optimal cutoff values for TPG, DPG, and PVR were13.9 mmHg, 2.8 mmHg, and 3.8 Wood Units, respectively. Kaplan-Meier analysis based on the optimal cutoff values or guidance-recommended thresholds showed that PVR and TPG were the predictors of survival ( P<0.05), while DPG did not showed significance ( P>0.05). Multivariate Cox regression analysis showed that age, PVR and log 2N-terminal pro-B-type natriuretic peptide were independent risk factors for all-cause mortality in PH-LHD patients (all P<0.05). Conclusion:Classification according to PVR was most valuable in predicting all-cause death in PH-LHD patients, while TPG showed moderate predictive ability and DPG had no predictive value.

Objective: To investigate the incidence of abnormal spinal curvature and related factors among middle school students in the Inner Mongolia Autonomous Region, so as to provide evidence for abnormal spinal curvature prevention and treatment. Methods: By using a random stratified cluster sampling method, 87 908 students of middle and high school students from all 12 counties(districts) were investigated via questionnaires for abnormal spinal curvature and health influencing factors in Inner Mongolia Autonomous Region. Chi square test was used to perform demographic characteristics and univariate analysis, and binary multivariate Logistic regression model was used to screen the risk factors for spinal curvature abnormalities in middle school students. Results: A total of 3 131(3.56%) students with spinal curvature abnormalities were detected, with boys (3.69%) higher than that of girls(3.44%), urban areas (6.15%) higher than that of the suburban counties (2.50%), and high school students ( 4.97 %) higher than that of junior high school(2.73%) students( χ 2=4.01, 702.19, 299.36, P <0.05). The detectable rate of spinal curvature abnormalities increased with grade ( χ 2 trend =309.29, P <0.05). Logistic regression analysis showed that factors influencing abnormal spinal curvature included myopia, overweight, obesity, the frequency of classroom seating arrangements, time spent on homework/reading after school every day, time spent in daytime outdoor activities, self imposed requirements for posture of sitting and standing, phase of studying, gender, and area ( OR =0.53-2.55, P <0.05). Conclusion Abnormal spinal curvature is strongly correlated to nutritional status, myopia, sitting posture when reading and writing, sedentary time, and time spent in outdoor activities. The collaboration of multiple departments is required to establish anenvironment to protect the spine, early detection and early intervention.

Objective: Hyperlipidemia is closely related to premature acute myocardial infarction (AMI). The present study was performed to explore the correlation between various blood lipid components and the risk of premature AMI. Methods: This is a cross-sectional retrospective study. Consecutive patients with acute ST-segment elevation myocardial infarction (STEMI), who completed coronary angiography from October 1, 2020 to September 30, 2022 in our hospital, were enrolled and divided into premature AMI group (male<55 years old, female<65 years old) and late-onset AMI group. Total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), non-HDL-C, lipoprotein (a) (Lp (a)), apolipoprotein B (ApoB), apolipoprotein A-1 (ApoA-1), non-HDL-C/HDL-C and ApoB/ApoA-1 were analyzed. The correlation between the above blood lipid indexes and premature AMI was analyzed and compared by logistic regression, restricted cubic spline and receiver operating characteristic curve (ROC). Results: A total of 1 626 patients with STEMI were enrolled in this study, including 409 patients with premature AMI and 1 217 patients with late-onset AMI. Logistic regression analysis showed that the risk of premature AMI increased significantly with the increase of TG, non-HDL-C/HDL-C, non-HDL-C, ApoB/ApoA-1, TC and ApoB quintiles; while LDL-C, ApoA-1 and Lp (a) had no significant correlation with premature AMI. The restricted cubic spline graph showed that except Lp (a), LDL-C, ApoA-1 and ApoB/ApoA-1, other blood lipid indicators were significantly correlated with premature AMI. The ROC curve showed that TG and non-HDL-C/HDL-C had better predictive value for premature AMI. Inconsistency analysis found that the incidence and risk of premature AMI were the highest in patients with high TG and high non-HDL-C/HDL-C. Conclusion: TG, non-HDL-C/HDL-C and other blood lipid indexes are significantly increased in patients with premature AMI, among which TG is the parameter, most closely related to premature AMI, and future studies are needed to explore the impact of controlling TG on incidence of premature AMI.
Humans ; Male ; Female ; Middle Aged ; Aged ; Cross-Sectional Studies ; Cholesterol, LDL ; Retrospective Studies ; ST Elevation Myocardial Infarction ; Apolipoprotein A-I ; Myocardial Infarction ; Cholesterol ; Apolipoproteins B ; Triglycerides ; Cholesterol, HDL ; Lipids ; Lipoproteins