Objectives:Recently,domestical developed left ventricular assist devices(LVAD)have been frequently introduced into clinical practice.This study aims to report the anesthesia protocol and perioperative outcomes in Chinese patients receiving LVAD implantation surgery.Methods:This retrospective analysis included patients who underwent LVAD implantation at our center from June 2017 to November 2024.During and after separation from cardiopulmonary bypass,we optimized right heart function through careful adjustments in heart rate,rhythm,preload,myocardial contractility,and afterload.Vasoactive agents were administered as needed,and mechanical ventilation parameters were optimized.We implemented blood conservation strategies and established strict transfusion criteria to minimize allogenic blood transfusions.Results:A total of 100 patients were included in the analysis,with 54.0%classified as Interagency Registry for Mechanically Assisted Circulatory Support(INTERMACS)I or II.Before leaving the operating room,the mean arterial pressure(MAP),mean pulmonary arterial pressure(mPAP),central venous pressure(CVP),lactic acid levels,and urinary output after cardiopulmonary bypass were recorded as(74±7)mmHg,(25±7)mmHg,(7±3)mmHg,(2.3±1.9)mmol/L,and(8.2±5.4)ml/(kg·h),respectively.The transfusion rates for red blood cells and fresh frozen plasma were 20.0%and 28.0%.The in-hospital mortality rate was 3.0%,with a low incidence of severe complications including right heart failure(12%).Left ventricular ejection fraction increased from(23.7±4.8)%preoperatively to(25.3±10.5)%prior to discharge.Conclusions:Patients who received LVAD at our center exhibited low rates of postoperative mortality and complications and significant improvement in left heart function before discharge.

Objective:To analyze the association between household and leisure-time physical activity (HLPA) and the risk of cardiometabolic multimorbidity (CMM) in the elderly.Methods:This retrospective cohort study utilized three longitudinal datasets from the Chinese Longitudinal Healthy Longevity and Happy Family Study (CLHLS-HF) covering 2008-2018, 2011-2018, and 2014-2018. A total of 10 876 participants aged ≥65 years who completed at least one follow-up were enrolled for cohort analysis. The general data, lifestyle, histories of chronic diseases, and physical examination results were collected. The HLPA score was utilized as an indicator to assess the degree of HLPA participation of the study subjects, the subjects were divided into 4 groups by quartile of HLPA score (Q1, Q2, Q3, and Q4), and were stratified jointly by sex, type of residence and household income; stratified Cox regression was applied to analyze the association between HLPA score and the risk of CMM morbidity, and Cox regression combined with restricted cubic spline (RCS) model was utilized to analyze the dose-response relationship between HLPA score and CMM morbidity.Results:The cohort was observed for a total of 51 630.24 person-years, with a median follow-up time of 3.95 (2.57, 6.04) years, with 576 new cases of CMM and an incidence density of 11.16 per 1 000 person-years. Compared with the HLPA score Q1 group, the risk of CMM morbidity was significantly reduced by 31%, 41%, and 44% in the elderly in the Q2 ( HR=0.69, 95% CI: 0.53-0.90), Q3 ( HR=0.59, 95% CI: 0.45-0.77) and Q4 ( HR=0.56, 95% CI: 0.42-0.74) groups, respectively (all P<0.05). The HLPA score was non-linearly associated with CMM morbidity ( P for nonlinear=0.010), with the risk of CMM morbidity decreasing with the increase of HLPA score, with a significant downward trend up to the median, after which the decline leveled off. There was an interaction between the HLPA score and exercise ( P for interaction=0.016); there was a negative association between the HLPA score and the risk of CMM morbidity in the no-exercise population ( HR=0.65, 95% CI: 0.52-0.80, P<0.001). Conclusion:There is a nonlinear negative association between HLPA and the risk CMM morbidity in elderly in China, and interventions focused on those who do not exercise may yield better results.

Objectives:Recently,domestical developed left ventricular assist devices(LVAD)have been frequently introduced into clinical practice.This study aims to report the anesthesia protocol and perioperative outcomes in Chinese patients receiving LVAD implantation surgery.Methods:This retrospective analysis included patients who underwent LVAD implantation at our center from June 2017 to November 2024.During and after separation from cardiopulmonary bypass,we optimized right heart function through careful adjustments in heart rate,rhythm,preload,myocardial contractility,and afterload.Vasoactive agents were administered as needed,and mechanical ventilation parameters were optimized.We implemented blood conservation strategies and established strict transfusion criteria to minimize allogenic blood transfusions.Results:A total of 100 patients were included in the analysis,with 54.0%classified as Interagency Registry for Mechanically Assisted Circulatory Support(INTERMACS)I or II.Before leaving the operating room,the mean arterial pressure(MAP),mean pulmonary arterial pressure(mPAP),central venous pressure(CVP),lactic acid levels,and urinary output after cardiopulmonary bypass were recorded as(74±7)mmHg,(25±7)mmHg,(7±3)mmHg,(2.3±1.9)mmol/L,and(8.2±5.4)ml/(kg·h),respectively.The transfusion rates for red blood cells and fresh frozen plasma were 20.0%and 28.0%.The in-hospital mortality rate was 3.0%,with a low incidence of severe complications including right heart failure(12%).Left ventricular ejection fraction increased from(23.7±4.8)%preoperatively to(25.3±10.5)%prior to discharge.Conclusions:Patients who received LVAD at our center exhibited low rates of postoperative mortality and complications and significant improvement in left heart function before discharge.

Objective:To analyze the association between household and leisure-time physical activity (HLPA) and the risk of cardiometabolic multimorbidity (CMM) in the elderly.Methods:This retrospective cohort study utilized three longitudinal datasets from the Chinese Longitudinal Healthy Longevity and Happy Family Study (CLHLS-HF) covering 2008-2018, 2011-2018, and 2014-2018. A total of 10 876 participants aged ≥65 years who completed at least one follow-up were enrolled for cohort analysis. The general data, lifestyle, histories of chronic diseases, and physical examination results were collected. The HLPA score was utilized as an indicator to assess the degree of HLPA participation of the study subjects, the subjects were divided into 4 groups by quartile of HLPA score (Q1, Q2, Q3, and Q4), and were stratified jointly by sex, type of residence and household income; stratified Cox regression was applied to analyze the association between HLPA score and the risk of CMM morbidity, and Cox regression combined with restricted cubic spline (RCS) model was utilized to analyze the dose-response relationship between HLPA score and CMM morbidity.Results:The cohort was observed for a total of 51 630.24 person-years, with a median follow-up time of 3.95 (2.57, 6.04) years, with 576 new cases of CMM and an incidence density of 11.16 per 1 000 person-years. Compared with the HLPA score Q1 group, the risk of CMM morbidity was significantly reduced by 31%, 41%, and 44% in the elderly in the Q2 ( HR=0.69, 95% CI: 0.53-0.90), Q3 ( HR=0.59, 95% CI: 0.45-0.77) and Q4 ( HR=0.56, 95% CI: 0.42-0.74) groups, respectively (all P<0.05). The HLPA score was non-linearly associated with CMM morbidity ( P for nonlinear=0.010), with the risk of CMM morbidity decreasing with the increase of HLPA score, with a significant downward trend up to the median, after which the decline leveled off. There was an interaction between the HLPA score and exercise ( P for interaction=0.016); there was a negative association between the HLPA score and the risk of CMM morbidity in the no-exercise population ( HR=0.65, 95% CI: 0.52-0.80, P<0.001). Conclusion:There is a nonlinear negative association between HLPA and the risk CMM morbidity in elderly in China, and interventions focused on those who do not exercise may yield better results.

The onset of primary hepatic carcinoma (PHC) is usually occult, and early symptoms are not obvious. Most patients are at advanced stages of disease at diagnosis, and the prognosis is poor. Paraneoplastic syndrome (PNS) refers to the clinical manifestations indirectly caused by tumor metabolites or abnormal immune reactions that cannot be explained by the primary lesion, local tumor spread or distant metastasis. Hypercholesterolemia, hypercalcemia and hypoglycemia are the most commonly seen clinical presentations of PNS in PHC patients. Adequate understanding of PNS is of great importance in early diagnosis and treatment of PHC. In this review, we summarized the clinical manifestations and prognostic mechanisms of PNS in patients with PHC.

Objective To investigate the neuroprotective effect and its mechanism of local hypothermia combined with nicotinamide phosphoribosyltransferase (NAMPT) on cerebral ischemia-reperfusion injury in rats.Methods Fifty-four Sprague-Dawley rats were randomly divided into sham operation group,model group,NAMPT group,local hypothermia group,and combined treatment group (NAMPT + local hypothermia).A rat model of local cerebral ischemia-reperfusion was induced by suture method.Infarct volume and cerebral edema volume were assessed by 2,3,5-triphenyltetrazolium chloride staining after 2 h cerebral ischemia and 24 h reperfusion in rats.Evans blue staining was used to assess the extent of blood-brain barrier damage,and a 12-point scale was used to assess neurological deficits.Results The infarct volume in the local hypothermia group,NAMPT group,and combination treatment group was significantly lower than that in the model group (all P ＜0.05).The infarct volume in the combination treatment group was significantly lower than that in the NAMPT group (P ＜0.05).The infarct volume in the combination treatment group was lower than that in the local hypothermia group,but it did not reach statistical significance.The neurological function scores of the local hypothermia group,NAMPT group,and combination treatment group were significantly lower than those of the model group (all P ＜0.05).The score of the combined treatment group was significantly lower than that of the NAMPT group and the local hypothermia group (all P＜0.05).Evans blue leakage in the local hypothermia group,NAMPT group,and combination treatment group was lower than that in the model group (all P ＜0.05),but the differences between each treatment group were not statistically significant.Conclusion NAMPT and local hypothermia combination therapy showed better neuroprotective effects on cerebral ischemia-reperfusion injury,suggesting that the combination therapy had clinical transformation prospects.

Objective To study the role of human MutS homolog 2 (hMSH2), a newly identified protein ligand that was recognized by Vγ9δ2 T cells , in innate anti-gastric carcinoma immunity .Methods Flow cytometry and laser confocal microscopy were used to identify hMSH 2 that ectopically expressed on gas-tric carcinoma cell line 803.An anti-hMSH2 antibody was used to block hMSH2 to evaluate its effects on the cytotoxicity of Vγ9δ2 T cells and their cytokines secretion .Subcellular distribution of hMSH 2 in gastric car-cinoma tissues was examined by tissue microarray immunohistochemistry analysis .Results Ectopic mem-brane expression of hMSH 2 was observed on 803 cells at a relatively high level .Vγ9δ2 T cells blocked with specific anti-hMSH2 antibody showed a decreased cytotoxicity and a reduced IFN-γbut an increased TNF-αsecretion.Ectopic expression of hMSH2 was found in various types of gastric carcinoma tissues at different stages.Enhanced expression of hMSH2 was detected in specimens collected from patients with chronic super-ficial gastritis.Conclusion Ectopically expressed hMSH2 served as a stress-induced endogenous ligand which could promote the cytotoxicity of Vγ9δ2 T cells against gastric carcinoma cells and enhance their IFN-γsecretion.hMSH2 played an essential role in innate anti-gastric carcinoma immunity .

OBJECTIVETo establish a RP-HPLC method for simultaneous determination of thymine, hypoxanthine and uracil contents in medical pipefish.

METHODSamples were extracted with distilled water by ultrasonic wave and separated on Waters C18 column eluted with a mobile phase of 0.05 mol x L(-1) KFI2PO4-acetonitrile (97:3). The flow rate was 0.6 mL x min(-1). The determination wavelength was 260 nm and the column temperature was set at 40 degrees C.

RESULTThe method had good linearity in the range of 0.033-0.660 (r = 0.9996), 0.620-12.400 (r = 0.9999), 0.048-0.960 microg (r = 0.9995), with average recoveries of 98.67% (RSD 1.6%), 99.03% (RSD 0.74%), 98.65% (RSD 1.8%), for thymine, hypoxanthine and uracil respectively.

CONCLUSIONThe simultaneous determination method of thymine, hypoxanthine and uracil in medical pipefish is established by RP-HPLC for the first time. The contents of the three constituents in different kinds of medical pipefish are significantly different. The method is simple, rapid and sensitive, and can be used for control the quality of medical pipefish.

Animals ; Chromatography, High Pressure Liquid ; methods ; Hypoxanthine ; analysis ; Medicine, Chinese Traditional ; Smegmamorpha ; Thymine ; analysis ; Uracil ; analysis

Since the first intein was found, more and more attenti on were paid on it. It not only enrichs the content of the process that the gene transfers its information but also can be used in protein purification. The rec ent advance in the sequence characteristic, transfer, evolution and the mechanis m of splicing of intein was summarized.