Objective To observe the clinical efficacy of Yiqi Shengjin Powder combined with conventional Western medicine in the treatment of diabetic heart disease,and the effects on cardiac autonomic nervous function,cardiac function and inflammatory factors.Methods Totolly 84 patients with diabetic heart disease were divided into control group and treatment group with random number table method,with 42 cases in each group.The control group developed personalized hypoglycemic plans and heart disease treatment drugs based on the patients'blood glucose levels.The treatment group took Yiqi Shengjin Powder in addition to the control group,and after an interval of 0.5 hours with Western medicine,they took it with warm water,2 bags each time,twice a day,for 6 consecutive weeks of treatment.TCM therapeutic effects of two groups,TCM symptoms score,sinus rhythm RR interval(SDNN),root mean square of adjacent interval difference(RMSSD),standard deviation of RR interval mean(SDANN),high frequency(HF),low frequency(LF),various indicators of cardiac function[left ventricular ejection fraction(LVEF),left ventricular end systolic diameter(LVESD),left ventricular end diastolic diameter(LVEDD)],inflammatory factors[interleukin-6(IL-6),transforming growth factor beta 1(TGF-β1),tumor necrosis factor alpha(TNF-α)]and adverse reactions before and after treatment were observed.Results The total effective rate of the treatment group was 90.48%(38/42),while that of the control group was 73.81%(31/42).The therapeutic effect of the treatment group was better than that of the control group(P<0.05).Compared with before treatment,both group showed a significant decrease in chest pain,tightness,palpitations,palpitations and shortness of breath,excessive dreaming and sweating,five heart restlessness and fatigue scores after treatment(P<0.05);after treatment,the treatment group showed a decrease in chest pain,tightness,palpitations,palpitations and shortness of breath,excessive dreaming and sweating,five heart restlessness and fatigue scores compared to the control group(P<0.05).Compared with before treatment,both group showed a significant increase in SDNN,SDANN,RMSSD,HF and LF after treatment(P<0.05);after treatment,the SDNN,SDANN,RMSSD,HF and LF levels in the treatment group were significantly higher than those in the control group(P<0.001).Compared with before treatment,LVEF increased,LVEDD and LVESD decreased in both group after treatment(P<0.001);after treatment,the LVEF of the treatment group increased compared to the control group,while LVEDD and LVESD decreased compared to the control group(P<0.001).Compared with before treatment,the serum levels of TNF-α,TGF-β1 and IL-6 in both groups decreased(P<0.001);after treatment,the serum levels of TNF-α,TGF-β1 and IL-6 in the treatment group were lower than those in the control group(P<0.001).There was no statistical significance in adverse reactions between the two groups(P>0.05).Conclusion Yiqi Shengjin Powder combined with conventional Western medicine therapy for patients with diabetes heart disease has significant effect and high safety.It can effectively improve patients'cardiac autonomic nervous function and cardiac function,reduce inflammatory reaction,and has no serious adverse reactions.

Objective:To evaluate the feasibility and outcomes of transnasal endoscopic clipping of the paraclival internal carotid artery (ICA) in skull base surgery.Methods:The paraclival ICA was anatomically dissected in cadaveric head specimens. The clinical data of 15 patients with skull base lesions involving the ICA who admitted to the Department of Otorhinolaryngology Head and Neck Surgery at Tianjin Huanhu Hospital from January 2021 to December 2023 were retrospectively analyzed. Among them, 4 patients underwent transnasal endoscopic clipping of the paraclival ICA and concurrent lesion resection. The surgical methods were summarized, and the key points and indications of this technique were analyzed.Results:Intraoperative clipping of the ICA was successful and hemostatic in all 4 patients. Postoperatively, 3 patients had no complications, while 1 patient developed delayed ischemic cerebral infarction. Two patients were cured, 1 patient was maintained on immunotherapy, and 1 patient died. During follow-up, the clip was in situ in 1 patient, had detached in another, and was obscured by temporal muscle coverage in the remaining 2 patients.Conclusions:Transnasal endoscopic clipping of the paraclival ICA represents a potential option for managing the ICA in skull base surgery. However, it carries significant risks and limitations, mandating careful patient selection based on specific circumstances.

Objective:To evaluate the feasibility and outcomes of transnasal endoscopic clipping of the paraclival internal carotid artery (ICA) in skull base surgery.Methods:The paraclival ICA was anatomically dissected in cadaveric head specimens. The clinical data of 15 patients with skull base lesions involving the ICA who admitted to the Department of Otorhinolaryngology Head and Neck Surgery at Tianjin Huanhu Hospital from January 2021 to December 2023 were retrospectively analyzed. Among them, 4 patients underwent transnasal endoscopic clipping of the paraclival ICA and concurrent lesion resection. The surgical methods were summarized, and the key points and indications of this technique were analyzed.Results:Intraoperative clipping of the ICA was successful and hemostatic in all 4 patients. Postoperatively, 3 patients had no complications, while 1 patient developed delayed ischemic cerebral infarction. Two patients were cured, 1 patient was maintained on immunotherapy, and 1 patient died. During follow-up, the clip was in situ in 1 patient, had detached in another, and was obscured by temporal muscle coverage in the remaining 2 patients.Conclusions:Transnasal endoscopic clipping of the paraclival ICA represents a potential option for managing the ICA in skull base surgery. However, it carries significant risks and limitations, mandating careful patient selection based on specific circumstances.

Objective To observe the clinical efficacy of Yiqi Shengjin Powder combined with conventional Western medicine in the treatment of diabetic heart disease,and the effects on cardiac autonomic nervous function,cardiac function and inflammatory factors.Methods Totolly 84 patients with diabetic heart disease were divided into control group and treatment group with random number table method,with 42 cases in each group.The control group developed personalized hypoglycemic plans and heart disease treatment drugs based on the patients'blood glucose levels.The treatment group took Yiqi Shengjin Powder in addition to the control group,and after an interval of 0.5 hours with Western medicine,they took it with warm water,2 bags each time,twice a day,for 6 consecutive weeks of treatment.TCM therapeutic effects of two groups,TCM symptoms score,sinus rhythm RR interval(SDNN),root mean square of adjacent interval difference(RMSSD),standard deviation of RR interval mean(SDANN),high frequency(HF),low frequency(LF),various indicators of cardiac function[left ventricular ejection fraction(LVEF),left ventricular end systolic diameter(LVESD),left ventricular end diastolic diameter(LVEDD)],inflammatory factors[interleukin-6(IL-6),transforming growth factor beta 1(TGF-β1),tumor necrosis factor alpha(TNF-α)]and adverse reactions before and after treatment were observed.Results The total effective rate of the treatment group was 90.48%(38/42),while that of the control group was 73.81%(31/42).The therapeutic effect of the treatment group was better than that of the control group(P<0.05).Compared with before treatment,both group showed a significant decrease in chest pain,tightness,palpitations,palpitations and shortness of breath,excessive dreaming and sweating,five heart restlessness and fatigue scores after treatment(P<0.05);after treatment,the treatment group showed a decrease in chest pain,tightness,palpitations,palpitations and shortness of breath,excessive dreaming and sweating,five heart restlessness and fatigue scores compared to the control group(P<0.05).Compared with before treatment,both group showed a significant increase in SDNN,SDANN,RMSSD,HF and LF after treatment(P<0.05);after treatment,the SDNN,SDANN,RMSSD,HF and LF levels in the treatment group were significantly higher than those in the control group(P<0.001).Compared with before treatment,LVEF increased,LVEDD and LVESD decreased in both group after treatment(P<0.001);after treatment,the LVEF of the treatment group increased compared to the control group,while LVEDD and LVESD decreased compared to the control group(P<0.001).Compared with before treatment,the serum levels of TNF-α,TGF-β1 and IL-6 in both groups decreased(P<0.001);after treatment,the serum levels of TNF-α,TGF-β1 and IL-6 in the treatment group were lower than those in the control group(P<0.001).There was no statistical significance in adverse reactions between the two groups(P>0.05).Conclusion Yiqi Shengjin Powder combined with conventional Western medicine therapy for patients with diabetes heart disease has significant effect and high safety.It can effectively improve patients'cardiac autonomic nervous function and cardiac function,reduce inflammatory reaction,and has no serious adverse reactions.

Humans ; Multiple Myeloma/genetics* ; Neoplasm, Residual/diagnosis* ; Flow Cytometry ; High-Throughput Nucleotide Sequencing

Objective:To explore the current status of surgery for portal hypertension to grasp current status and future development of surgery in China.Methods:This study is jointly sponsored by China Hepatobiliary & Pancreatic Specialist Alliance & Portal Hypertension Alliance in China (CHESS).Comprehensive surveying is conducted for basic domestic situations of surgery for portal hypertension, including case load, surgical approaches, management of postoperative complications, primary effects, existing confusion and obstacles, liver transplantation(LT), laparoscopic procedures and transjugular intrahepatic portosystemic shunt(TIPS), etc.Results:A total of 8 512 cases of portal hypertension surgery are performed at 378 hospitals nationwide in 2021.Splenectomy plus devascularization predominated(53.0%)and laparoscopy accounted for 76.1%.Primary goal is preventing rebleeding(67.0%) and 72.8% of hospitals used preventive anticoagulants after conventional surgery.And 80.7% of teams believe that the formation of postoperative portal vein thrombosis is a surgical dilemma and 65.3% of hospitals practiced both laparoscopy and TIPS.The major reasons for patients with portal hypertension not receiving LT are due to a lack of qualifications for LT(69.3%)and economic factors(69.0%).Conclusions:Surgery is an integral part of management of portal hypertension in China.However, it is imperative to further standardize the grasp of surgical indications, the handling of surgical operation and the management of postoperative complications.Moreover, prospective, multi-center randomized controlled clinical studies should be performed.

Objective:To explore the impact of serum carbamoyl phosphate synthase 1 (CPS1) level on prognosis of patients with hepatitis E-related acute liver failure (HEV-ALF).Methods:This retrospective analysis included 100 HEV-ALF patients, 100 patients with acute hepatitis E (AHE) and 100 healthy controls who admitted or underwent health checkup from December 2018 to June 2019 in six hospitals, including the First Affiliated Hospital, Zhejiang University School of Medicine. HEV-ALF patients were divided into non-survial ( n=21) and survival ( n=79) subgroups according to results of 30-day follow-up results. HEV-ALF patients were also divided into the high ( n=50) and low ( n=50) serum CPS1 level groups. HEV-ALF patients were further divided into the improvement ( n=55), fluctuation ( n=32) and deterioration ( n=13) subgroups. The general clinical data from all participants were collected. Serum CPS1 levels were detected by enzyme linked immunosorbent assay. The survival time in the high and low serum CPS1 level groups were presented in the Kaplan-Meier curve. The correlation between serum CPS1 level and HEV-ALF related conventional parameters was also analyzed by linear regression. The efficacy of serum CPS1 level on predicting the 30-day mortality of HEV-ALF patients was estimated by the receiver operating characteristic curve and area under curve (AUC). Results:Serum CPS1 level was significantly higher in HEV-ALF patients than in AHE patients [958.59 (665.52, 1 105.83) pg/ml vs 549.38 (495.02, 649.08) pg/ml, P<0.001], and serum CPS1 level was significantly higher in AHE patients than in healthy controls [549.38 (495.02, 649.08) pg/ml vs 469.89 (373.32, 564.53) pg/ml, P<0.001]. The level of serum CPS1 was significantly lower in the HEV-ALF survival group than in the HEV-ALF non-survival group [922.6 (652.7, 1, 042.3) pg/ml vs 1 252.8 (933.3, 1 555.8) pg/ml, P<0.001]. In addition, the survival time was shorter in the high serum CPS1 level group than in the low serum CPS1 level group [24.59 (22.11, 27.06) d vs 28.16 (26.25, 30.07) d, P=0.045]. Serum CPS1 levels were increased in the fluctuation and deterioration groups [Fluctuation: 1 328.3 (1 184.3, 1 964.0) pg/ml vs 1 245.7 (1 102.0, 1 937.6) pg/ml, P<0.01; Deterioration: 1 483.6 (1 275.9, 1 656.8) pg/ml vs 1 332.2 (1 197.4, 1 509.8) pg/ml, P<0.01], while decreased in the improvement group [810.3 (599.7, 904.5) pg/ml vs 922.6 (679.5, 1 039.6) pg/ml, P<0.01] over time. Besides, a linear positive correlation was found between serum CPS1 level and alanine aminotransferase (ALT) and total bilirubin (TBIL) (ALT: r=0.339, P<0.001; TBIL: r=0.304, P=0.002). The AUC of serum CPS1 level to predict the 30-day mortality of HEV-ALF patients was 0.803 (95% CI 0.666-0.941), the sensitivity and specificity were 66.67% and 97.47%, respectively. Conclusion:Serum CPS1 level was significantly increased in HEV-ALF patients, and closely related to the prognosis of patients with HEV-ALF.

Objective:To evaluate the efficacy and safety of sodium hyaluronate gel in preventing adhesion after prophylactic enterostomy.Methods:One hundred and twenty four patients from 6 hospitals were enrolled in this prospective multi-center randomized controlled trial. Patients were randomized into the study group ( n=59) or the control group ( n=65).All patients underwent prophylactic enterostomy. Patients of study group received odium hyaluronate gel for adhesion-prevention,while those in control group did not receive any adhesion-prevention treatment. The incidence of moderate to severe adhesion around the incision in the stoma area were evalutated during stoma reduction surgery. Results:The incidence of moderate to severe adhesion around the incision in the stoma area was 6.3% in the study group, the difference was statistically significant ( P<0.05) compared to that of the control group (32.6%). Conclusion:Sodium hyaluronate gel can safely and effectively reduce the incidence of moderate and severe adhesions after abdominal surgery.

Objective:To study the medication rules of treating cervical spondylosis by National TCM master Liu Bailing based on data mining and network pharmacology, and explore the potential action mechanism of its core compounds.Methods:By collecting the prescriptions of National TCM master Liu Bailing treating cervical spondylosis in the past 8 years, this paper analyses the frequency, nature, flavor, meridian, hierarchical clustering and association rules of those prescriptions by RStudio to obtain the core prescription. Then, the effective components of the core prescription were collected by using TCMSP, and the network of "medicine-component-target" was constructed by using Cytoscape 3.8.0; by searching for databases like GEO, DisGeNET, TTD HPO and Genecards were retrieved to obtain the target data set of cervical spondylosis; by using STRING 11.0 platform to construct protein interaction network; by using DAVID platform to cary out gene ontology (GO) and KEGG pathway enrichment analysis; by using Auto Dock software for molecular docking.Results:In the 844 prescriptions, there are 199 Chinese medicines and the properties are mainly warm, plain and cold; the flavors were mainly sweet, pungent and bitter; mainly belong to the liver, spleen, and kidney meridians. The Association Rule shows that the core compound is made up of Salvia miltiorrhiza, Gastrodia elata, Rhizoma corydalis, Alisma rhizoma, centipede, Astragalus membranaceus and Rhizome of Pueraria. Besides, 140 effective constituents and 247 targets of the core prescription were screened, and the main constituents were quercetin, kamanol, luteolin, tanshinone ⅡA, β-sitosterol, etc. 13 core targets among the core prescription treating cervical spondylosis were obtained, which were enriched into 30 pathways including toll-like receptor signaling pathway, TNF signaling pathway and HIF-1 signaling pathway. Conclusion:National TCM master Liu Bailing treatment of cervical spondylosis mainly focuses on expelling wind and relieving pain, dredging meridians and soothing tendons, and the mechanism of action of the core prescription may focus on inhibiting inflammatory response and relieving oxidative stress, providing guidance and reference for the clinical treatment of cervical spondylosis.

MicroRNAs(miRNAs)are important regulators of gene expression.The large-scale detection and profiling of miRNAs have been accelerated with the development of high-throughput small RNA sequencing(sRNA-Seq)techniques and bioinformatics tools.However,generating high-quality comprehensive miRNA annotations remains challenging due to the intrinsic complexity of sRNA-Seq data and inherent limitations of existing miRNA prediction tools.Here,we present iwa-miRNA,a Galaxy-based framework that can facilitate miRNA annotation in plant species by combining computational analysis and manual curation.iwa-miRNA is specifically designed to generate a comprehensive list of miRNA candidates,bridging the gap between already annotated miRNAs provided by public miRNA databases and new predictions from sRNA-Seq datasets.It can also assist users in selecting promising miRNA candidates in an interactive mode,contributing to the accessibility and reproducibility of genome-wide miRNA annotation.iwa-miRNA is user-friendly and can be easily deployed as a web application for researchers without programming experience.With flexible,interactive,and easy-to-use features,iwa-miRNA is a valu-able tool for the annotation of miRNAs in plant species with reference genomes.We also illustrate the application of iwa-miRNA for miRNA annotation using data from plant species with varying genomic complexity.