OBJECTIVE: To observe the effects of moxibustion at "Xinshu" (BL15) and "Feishu" (BL13) on myocardial transferrin receptor 1 (TfR1), ferroptosis suppressor protein 1 (FSP1), atrial natriuretic peptide (ANP), and typeⅠcollagen myocardial collagen fibers (CollagenⅠ) in rats with chronic heart failure (CHF), and to explore the mechanism of moxibustion for ameliorating myocardial fibrosis and improving cardiac function in CHF. METHODS: Fifty SD rats were randomly divided into a normal group (n=10) and a modeling group (n=40). The CHF model was established in the modeling group by ligating the left anterior descending coronary artery. After successful modeling, the rats were randomly divided into a model group (n=9), a moxibustion group (n=8), a rapamycin (RAPA) group (n=9), and a moxibustion+RAPA group (n=9). In the moxibustion group, moxibustion was delivered at bilateral "Feishu"(BL13) and "Xinshu" (BL15), 15 min at each point in each intervention, once daily, for 4 consecutive weeks. In the RAPA group, RAPA solution was administered intraperitoneally at a dose of 1 mg/kg, once daily for 4 consecutive weeks. In the moxibustion+RAPA group, RAPA solution was administered intraperitoneally after moxibustion. Ejection fraction (EF) and left ventricular fractional shortening (FS) were measured after modeling and intervention. After intervention, morphology of cardiac muscle was observed using HE staining and Masson's trichrome staining. Total iron content in myocardial tissue was detected using a colorimetric method. Western blot and qPCR were adopted to detect the protein and mRNA expression of TfR1, FSP1, ANP, and CollagenⅠ in myocardial tissue. RESULTS: Compared with the normal group, the EF and FS values decreased (P<0.01); necrosis, edema, degeneration, and arrangement disorder were presented in cardiomyocytes; inflammatory cells were obviously infiltrated, the structure of myocardial fibers was disarranged, the collagen fibers were obviously deposited and fibrosis increased (P<0.01); the total iron content and the protein and mRNA expression of TfR1, ANP, and CollagenⅠ in myocardial tissue were elevated (P<0.01), while the protein and mRNA expression of FSP1 were reduced (P<0.01) in the model group. Compared with the model group, the moxibustion group showed that EF and FS increased (P<0.01); myocardial cell morphology was improved, and myocardial fibrosis was alleviated (P<0.01); the total iron content and the protein and mRNA expression of TfR1, ANP, and CollagenⅠ in myocardial tissue decreased (P<0.01), while the protein and mRNA expression of FSP1 increased (P<0.01, P<0.05). Compared with the model group, the myocardial fibrosis was increased (P<0.05); the total iron content and the protein and mRNA expression of TfR1, ANP, CollagenⅠ in myocardial tissue were increased (P<0.01), while protein and mRNA expression of FSP1 decreased (P<0.01) in the RAPA group. When compared with the RAPA group and the moxibustion + RAPA group, EF and FS were elevated (P<0.01, P<0.05); myocardial cells were improved in morphology, the total iron content and the protein and mRNA expression of TfR1, ANP, and CollagenⅠ in myocardial tissue decreased (P<0.01), while protein and mRNA expression of FSP1 increased (P<0.01) in the moxibustion group. In comparison with the moxibustion + RAPA group, the RAPA group showed the decrease in EF and FS (P<0.01), the worsened myocardial fibrosis (P<0.01), the increase in the total iron content and the protein and mRNA expression of TfR1, ANP, and CollagenⅠ in myocardial tissue (P<0.01), and the decrease in the protein and mRNA expression of FSP1 (P<0.01). CONCLUSION Moxibustion at "Feishu" (BL13) and "Xinshu" (BL15) can slow down the process of myocardial fibrosis and improve cardiac function in CHF rats. The mechanism of moxibustion may be related to inhibiting ferroptosis through regulating autophagy.
Animals ; Rats ; Heart Failure/physiopathology* ; Moxibustion ; Rats, Sprague-Dawley ; Male ; Receptors, Transferrin/genetics* ; Myocardium/metabolism* ; Acupuncture Points ; Humans ; Chronic Disease/therapy* ; Antigens, CD/metabolism*

OBJECTIVE: To investigate the association between long-term glycemic control and cerebral infarction risk in patients with diabetes through a large-scale cohort study. METHODS: This prospective, community-based cohort study included 12,054 patients with diabetes. From 2006 to 2012, 38,272 fasting blood glucose (FBG) measurements were obtained from these participants. FBG trajectory patterns were generated using latent mixture modelling. Cox proportional hazards models were applied to assess the subsequent risk of cerebral infarction associated with different FBG trajectory patterns. RESULTS: At baseline, the mean age of the participants was 55.2 years. Four distinct FBG trajectories were identified based on FBG concentrations and their changes over the 6-year follow-up period. After a median follow-up of 6.9 years, 786 cerebral infarction events were recorded. Different trajectory patterns were associated with significantly varied outcome risks (Log-Rank P < 0.001). Compared with the low-stability group, Hazard Ratio ( HR) adjusted for potential confounders were 1.37 for the moderate-increasing group, 1.23 for the elevated-decreasing group, and 2.08 for the elevated-stable group. CONCLUSION Sustained high FBG levels were found to play a critical role in the development of ischemic stroke among patients with diabetes. Controlling FBG levels may reduce the risk of cerebral infarction.
Humans ; Cerebral Infarction/blood* ; Middle Aged ; Male ; Female ; Blood Glucose/analysis* ; Fasting/blood* ; Aged ; Prospective Studies ; Risk Factors ; Diabetes Mellitus/blood* ; Adult ; Proportional Hazards Models

Geriatric oral health care encounters significant challenges with the increase in the proportion of older individuals. Age-related changes in the dentition, muscles, and joints result in a decline in objective masticatory function, subjective restoration requirements, and acceptability among the elderly population, with individual variations influenced by systemic health. Considering functional requirements, the adaptability of stomatognathic and systemic health conditions, health economics and other factors, the authors believe that it should not be limited to the conventional "one-to-one" strategy for replacing missing teeth in geriatric prosthodontics. There is an urgent need for a precise and adaptable restoration strategy that is more suitable for older individuals. The proposal of a new concept of functional tooth loss updates the minimal restoration standards for elderly patients and establishes the theory of age-friendly functional restoration. Based on the restoration strategy of functional tooth loss, this paper proposes a new concept termed "age-friendly functional restoration of the stomatognathic system", which integrates treatment considerations including endodontics, periodontology, mucosa, muscles, temporomandibular joint, and systemic health. Efforts should be made in four areas as follows. Firstly, the "assessment of accessible function" should be enhanced by considering the interrelationship between stomatognathic and systemic health. Secondly, the "evaluation of appropriate function" is supposed to be optimised in view of subjective needs and objective evaluation of the stomatognathic system. Moreover, the "formulation of treatment plans" needs to be accomplished with the aid of assistive technologies, such as artificial intelligence, to accurately exert appropriate functional restoration. Lastly, the "management and maintenance of health" is likely to be strengthened through follow-ups, propaganda and education, and preventive healthcare, so as to improve quality of life and ultimately achieve healthy ageing among older individuals.
Humans ; Tooth Loss/therapy* ; Aged ; Stomatognathic System ; Oral Health ; Dental Care for Aged ; Dental Restoration, Permanent/methods*

Objective To analyze the caregiver presence needs and their influencing factors among hospitalized elderly non-surgical patients and provide a basis for formulating relevant policies.Methods A descriptive qualitative study method was adopted.Through purposive sampling,semi-structured interviews were conducted on elderly non-surgical patients and their families and medical staff in Peking Union Medical College Hospital from September to October 2023.MAXQDA 2020 and the 7-step phenomenological analysis method of Colaizzi were used to classify and code the interview contents and identify themes.Results The categories of caregiver presence needs of elderly non-surgical patients included basic living assistance needs,disease monitoring needs,psychological support needs,as well as the needs for family members to provide economic support and participate in treatment decision-making.The influencing factors included advanced age,frailty,the lack of self-care ability in patients with comorbidities,the susceptibility of patients to sudden situations during the disease exacerbation period,the increased risk of unexpected events in patients with psychological distress,and patients' concerns about social support and medical decision-making.Conclusion The caregiver presence needs of elderly non-surgical patients during hospitalization are high and influenced by multiple factors.
Humans ; Caregivers/psychology* ; Aged ; Hospitalization ; Social Support ; Male ; Qualitative Research ; Female

Objective To study the predictive value of the Prognostic Assessment Scale for Patients with Spontaneous Intracerebral Hemorrhage(ICH-LR2S2)and the Prehospital Risk Assessment Scale for Prehospital Deterioration Risk Assessment Scale(ICH-APS)for the development of stroke-associated pneu-monia(SAP)in patients with spontaneous intracerebral hemorrhage.Methods A total of 349 patients with spontaneous intracerebral hemorrhage who were hospitalized for the first time in this hospital from July 2023 to July 2024 were selected as the research subjects.The general demographic data and medical documentations of the patients were collected,and ICH-LR2S2 score and ICH-APS score were carried out within 48 hours after admission.According to whether pneumonia occurred within 7 days after admission,the patients were divided into the SAP group and the non-SAP group,and the diagnostic efficiency of the ICH-LR2S2 score and ICH-APS score for SAP in patients with spontaneous intracerebral hemorrhage was evaluated.Results Among the 349 patients with spontaneous intracerebral hemorrhage,98 patients(28.08％)had pneumonia.The results of multivariate logistic regression analysis showed that age,history of chronic obstructive pulmonary disease(COPD),nasogastric tube,tracheal intubation,National Institutes of Health Stroke Scale(NIHSS)score,Glasgow Coma Scale(GCS)score,C-reactive protein,fasting blood glucose,dysphagia,ICH-LR2S2 score,ICH-APS-A score,and ICH-APS-B score were independent influencing factors for SAP in patients with spontane-ous intracerebral hemorrhage(P＜0.05).The results of the receiver operating characteristic(ROC)curve showed that the ICH-LR2S2 score had the highest diagnostic efficiency for SAP in patients with spontaneous intracerebral hemorrhage,with an area under the curve(AUC)of 0.837,a sensitivity of 0.827,a specificity of 0.783,and a Youden index of 0.610.Conclusion ICH-LR2S2 score has a high predictive value for the occur-rence of SAP in patients with spontaneous intracerebral hemorrhage.

The single photon counting imaging detector based on microchannel plate(MCP)has the characteristics of high sensitivity and low dark count rate,and has been applied to the optical remote sensing detection of weak ultraviolet spectral signals in space.In this work,by using planar array single photon counting imaging detector as the detector,flat-field concave grating as the splitter,and electrodeless discharge lamp(EDL)as the excitation light source,a dispersion detection system suitable for hydride generation-atomic fluorescence spectrometry(HG-AFS)was developed.The wavelength calibration of the system was carried out,and the negative high pressure and EDL stability time of the planar array single photon counting imaging detector were analyzed and optimized.The characteristic emission spectral lines of As and Bi elements excited in the wavelength range of 180-320 nm were analyzed,and the scattering interference in the wavelength range of 257.3-306.7 nm was discussed.The results showed that the AFS dispersion detection system based on the planar array single photon counting imaging detector could detect and analyze the HG-AFS fluorescence signal initially,and the influence of scattering interference on the detection results was effectively avoided.The system had the advantages including simple structure,no refrigeration and temperature control,no moving parts and simultaneous measurement of multi-band.

Accurate analysis of metal nanoparticles(MNPs)in sediments is a prerequisite for assessing the ecological risks of MNPs in aquatic environmental sediments.In this study,an analytical method for quantitative detection of concentration and particle size distribution of silver-containing nanoparticles(Ag-NPs),zinc-containing nanoparticles(Zn-NPs),cerium-containing nanoparticles(Ce-NPs),and titanium-containing nanoparticles(Ti-NPs)in sediments was established based on ultrasonic extraction-single particle inductively coupled plasma mass spectrometry(SP-ICP-MS).The effects of sample preparation conditions such as extraction solvent type,solid-liquid ratio,ultrasonic time,and settling time on the recovery of MNPs were investigated.The results showed that the extraction of MNPs from sediment by distilled water could effectively eliminate the high background signal interference introduced by the extractant under the conditions of solid-liquid ratio of 1∶400(g∶mL),ultrasonic extraction time of 1 h and settling time of 3 h.The detection limits for particle size of Ag-NPs,Zn-NPs,Ce-NPs and Ti-NPs in sediments were 31,35,26 and 85 nm,respectively,while the detection limits of particle concentrations were 1.21×104,1.90×104,5.26×107 and 1.48×107 particles/g,respectively.The spiking recoveries of Ag-NPs,Zn-NPs,Ce-NPs and Ti-NPs in sediments were 62.1％-108.7％,with relative standard deviations below 10％.This method could rapidly,accurately and simultaneously determine the concentration and particle size distribution of various MNPs in sediments,and was successfully applied to analysis of Ag-NPs,Zn-NPs,Ce-NPs,and Ti-NPs in authentic marine sediments.

Objective To investigate the effect of simple carbohydrate given 2 h before operation on postoperative insulin resistance and gastrointestinal function in elderly patients with trauma undergoing spinal anesthesia.Methods This was a randomized controlled clinical study.A total of 90 elderly patients with intertrochanteric femoral fracture/femoral neck fracture admitted to the Traumatic Orthopedics Department of the Fourth Medical Center of Chinese PLA General Hospital from October 2023 to February 2024 were randomly divided equally into control group(fasting with water before surgery)and carbohydrate group(CHO group,drinking 200 ml of pulsatile water at 2 h before surgery).All the patients received spinal anesthesia.The control group excluded 2 patients who completed surgery and were admitted to the ICU,2 patients received epidural anesthesia,and finally included 41 patients;3 patients were excluded from the CHO group under epidural anesthesia,2 patients underwent surgery under general anesthesia,and finally 40 patients were included.Baseline data of patients were collected,including gender,age,Charlson comorbidity index(CCI),presence or absence of diabetes,body mass index(BMI),American Association of Anesthesiologists(ASA)classification,etc.The patient's surgical time,intraoperative blood loss,first postoperative exhaust time,type of surgery,length of hospital stay,mean arterial pressure(MAP)and heart rate(HR)at four time points during surgery[entry(T1),post-anesthesia(T2),mid-operation(T3),and exit(T4)],perioperative blood glucose,insulin levels,C-reactive protein(CRP),and intestinal barrier function indicators(diamine oxidase,D-lactate,and bacterial endotoxin),as well as self-rating anxiety scale(SAS),visual analogue scale of pain(VAS),and Ramsay scores were recorded.Preoperative and postoperative use of the delirium diagnostic scale(3D-CAM)assessed the presence of delirium in patients.Results Eighty-one patients aged(77.7±9.5)years were included.Compared with control group,the first exhaust time in CHO group was significantly shorter[4.59(3.25,7.39)h vs.10.23(7.97,14.76)h,P<0.001],postoperative insulin resistance index(HOMA-IR)was significantly decreased[5.13(2.38,10.30)vs.7.34(2.31,12.55),P<0.001].The change rate of HOMA-IR(ΔHOMA-IR)also decreased significantly(P<0.001);There were no significant differences in intestinal barrier function indexes between the two groups(P>0.05);The levels of D-lactic acid and bacterial endotoxin in control group were significantly increased after operation,and the differences were statistically significant(P=0.010,P=0.031),In CHO group,there was no significant difference in preoperative and postoperative indexes(P>0.05).There was no significant difference in the perioperative scale score,incidence of delirium and the length of hospital stay between the two groups(P>0.05).Conclusions Taking simple carbohydrates 2 h before surgery can significantly shorten the first exhaust time,reduce insulin resistance and the incidence of delirium,and improve gastrointestinal function in elderly trauma patients undergoing spinal anesthesia,thus providing clinical basis for accelerated postoperative rehabilitation in elderly patients.

Objective To establish a stable,reliable,and clinically relevant porcine model of endotoxin-induced acute respiratory distress syndrome(ARDS).Methods Ten 8-month-old male Bama minipigs were deeply sedated,followed by invasive mechanical ventilation and electrocardiographic monitoring.Lipopolysaccharide(LPS)was intravenously pumped at 600 μg/(kg·h)for 3 hours,then maintained at 15 μg/(kg·h)thereafter.Dynamic monitoring was performed at five time points after LPS injection(LPS 0,1,3,5,and 8 h),including arterial blood gas analysis and chest computed tomography(CT)scans.Pathological examination of lung tissues obtained via bronchoscopic biopsy(HE staining and transmission electron microscopy)was conducted.These indicators were comprehensively used to evaluate the success of the animal model.Results At 5 hours after LPS administration,8 minipigs developed symptoms such as skin cyanosis,elevated body temperature,and respiratory distress.The oxygenation index decreased to<300 mmHg.Chest CT scans showed diffuse pulmonary infiltrates.Histopathology revealed alveolar edema and hyaline membrane formation.Transmission electron microscopy demonstrated disruption of pulmonary blood-air barrier,depletion of lamellar bodies in type Ⅱ pneumocytes,inflammatory cell infiltration,and exudation of plasma proteins and fibrin.Compared with LPS 0 h,at LPS 8 h,the oxygenation index and arterial blood pH were significantly decreased(P<0.001),while blood lactic acid and serum potassium were significantly increased(P<0.05);serum calcium and base excess were significantly decreased(P<0.05),and the lung injury score based on HE-stained lung sections was significantly increased(P<0.01).Conclusion The porcine ARDS model established by continuous LPS injection can dynamically simulate the pathophysiological characteristics and typical pathological manifestations of clinical septic ARDS,making it an effective tool to study the pathogenesis,prevention,and treatment strategies of septic ARDS.

Traditional Chinese medicine(TCM) capable of clearing heat and removing toxin is most commonly used in clinical practice and has the effect of removing fire-heat and toxin. Studies have shown that most of the Ilex plants have the effect of clearing heat and removing toxin, among which the varieties of I. cornuta, I. pubescens, I. rotunda, I. latifolia, and I. chinensis are most widely used. These plants generally contain triterpenoids and their glycosides, alkaloids, flavonoids, phenylpropanoids, and other chemical components, especially pentacyclic triterpenoids. According to their skeletons, pentacyclic triterpenoids can be divided into the oleanane type, the ursane type, the lupinane type, etc. Among them, ursane-type components are the most abundant, and 136 species have been found so far. These components have been proved to have pharmacological effects such as anti-inflammatory, anti-tumor, hypolipidemic, anti-thrombosis, cardiomyocyte-protective, antibacterial, and hepatoprotective effects. Therefore, this paper systematically reviews the domestic and foreign literature on Ilex plants with a focus on the research progress on pentacyclic triterpenoids and their pharmacological activities, aiming to provide reference for the development of TCM resources with the effect of clearing heat and removing toxin.
Ilex/chemistry* ; Plants, Medicinal/chemistry* ; Pentacyclic Triterpenes/pharmacology* ; Medicine, Chinese Traditional ; Drugs, Chinese Herbal/pharmacology* ; Humans ; Animals