BACKGROUND:The repair process of myocardial injury involves complex cellular and molecular mechanisms,especially mitochondrial calcium homeostasis,macrophage autophagy and pyroptosis pathways.Traditional Chinese medicine(TCM)has shown significant clinical efficacy in improving myocardial injury,but its mechanism of action needs to be thoroughly investigated. OBJECTIVE:To investigate the role of mitochondrial calcium homeostasis-mediated macrophage autophagy and pyroptosis pathways in myocardial injury,and to summarize the progress of TCM in this field. METHODS:A computerized search was performed for relevant literature from the database inception to March 2024 in the Web of Science,PubMed and CNKI.The search terms were"mitochondrial calcium homeostasis,macrophage autophagy,macrophage pyroptosis,traditional Chinese medicine,myocardial injury,myocardial injury reperfusion"in Chinese and English.Through literature review,we analyzed the relationship between mitochondrial calcium homeostasis and macrophage autophagy and pyroptosis,explored the mechanism of their roles in myocardial injury,and summarized the pathways of multi-targeted,multi-pathway effects of TCM. RESULTS AND CONCLUSION:The maintenance of mitochondrial calcium homeostasis has been found to be closely related to the normal function of cardiomyocytes.Macrophages can participate in the repair process of myocardial injury through autophagy and pyroptosis pathways.Autophagy contributes to cell clearance and regulation of inflammatory response,while pyroptosis affects myocardial repair by releasing inflammatory factors.TCM regulates mitochondrial calcium homeostasis and macrophage function through multiple mechanisms.For example,astragalosid regulates calcium homeostasis by lowering mitochondrial membrane potential and inhibiting cytochrome C,and epimedium glycoside plays a role in reducing β-amyloid deposition.In addition,herbal compounds and single drugs promote myocardial repair by activating or inhibiting specific signaling pathways,such as PI3K/AKT and nuclear factor-κB signaling pathways.Future studies should focus on the interactions between mitochondrial calcium homeostasis,autophagy and pyroptosis pathways,as well as how TCM can exert therapeutic effects through these pathways to provide new strategies and drugs for the treatment of myocardial injury.

Objective To explore the efficacy and mechanism of the aqueous extract of Sauropus spatulifolius in treating constipation based on network pharmacology analysis and experiments.Meth-ods Network pharmacology analysis was conducted using an online platform to investigate the molec-ular mechanism of Sauropus spatulifolius in treating constipation.Loperamide-induced mouse consti-pation models and intestinal epithelial cell(IEC)injury models were constructed.Therapeutic effects were evaluated using indicators such as the time to the first black stool,fecal water content,and gas-trointestinal transit rate.Annexin V-FITC staining was used to assess apoptosis,JC-1 staining was used to detect mitochondrial membrane potential,chemiluminescence was used to measure adenosine triphosphate(ATP)levels,and western blotting was used to detect the expression of relevant proteins.Results Network pharmacology analysis revealed that 29 active components in Sauropus spatulifolius targeted 19 genes associated with constipation,with AKT1 identified as one of the key genes.Exper-imental results demonstrated that the aqueous extract of Sauropus spatulifolius effectively alleviated loperamide-induced constipation symptoms in mice,including weight loss,reduced intestinal motili-ty,prolonged defecation time,and decreased fecal water content.Additionally,the aqueous extract of Sauropus spatulifolius inhibited IEC-6 cell apoptosis,restored mitochondrial membrane potential,and maintained intracellular ATP levels.The therapeutic mechanism involved downregulating the ex-pression of Bel-2-associated X protein(Bax),cytochrome C,Cleaved-Caspase3,and aquaporin 3(AQP3),as well as enhancing protein kinase B(Akt)phosphorylation.Conclusion The aque-ous extract of Sauropus spatulifolius effectively ameliorates constipation symptoms in mouse models,and its mechanism may be related to improving intestinal cell energy metabolism,inhibiting IEC ap-optosis,and reducing AQP3 expression,suggesting that Sauropus spatulifolius could serve as a po-tential drug for the clinical treatment of constipation.

Objective: To investigate the effects of polydatin on a high-fat diet-induced non-alcoholic fatty liver disease(NAFLD) mouse model and hepatoma G2(HepG2) cell model, and to reveal its potential molecular mechanisms. Methods: Thirty 6-week-old male SPF C57BL/6J mice were randomly divided into a normal diet group and a high-fat diet group. After the NAFLD mouse model was established in the high-fat diet group, they were further divided into a model group and a polydatin treatment group. The polydatin treatment group was administered polydatin by gavage at a dose of 250 mg/(kg·d) for 10 weeks, during which body weight was monitored and oral glucose and insulin tolerance tests were performed. At the end of the experiment, a series of tests to evaluate the effects of polydatin on mouse liver weight, blood lipids, liver lipid accumulation, and liver injury markers were performed. The expression of G0/G1 switch gene 2(G0S2) and adipose triglyceride lipase(ATGL) was measured by qRT-PCR and Western blot, and gene expression was further verified using immunohistochemical staining. The effects of polydatin on HepG2 cell activity was assessed by CCK-8 assay, lipid accumulation was observed by oil red O staining, and the expression of G0S2 and ATGL was detected by qRT-PCR and Western blot. Results: Polydatin significantly reduced the body weight, liver weight, and serum and liver tissue levels of aspartate aminotransferase(AST), alanine aminotransferase(ALT), triglyceride(TG), and total cholesterol (TC) in mice (P < 0. 05) , al⁃leviated pathological liver damage , decreased G0S2 expression (P < 0. 05) , and increased ATGL expression (P <0. 05) . At the cellular level , polydatin reduced lipid droplet accumulation , improved lipid metabolism , decreased G0S2 expression ( P < 0. 05 ) , and increased ATGL expression ( P < 0. 05 ) . Even in cells with knockdown of G0S2 , polydatin still promoted fat decomposition (P < 0. 01) . Conclusion Polydatin promotes hepatic fat break⁃down by regulating the expression of G0S2 and ATGL , helping to alleviate metabolic disorders and liver damage in the NAFLD mouse model caused by a high⁃fat diet , offering a new strategy for treating NAFLD.

Objective To compare the application of main concept analysis(MCA)and story narration as-sessment(SNA)in aphasia discourse assessment,and study their clinical applicability.Methods A total of 8 apha-sic and 22 healthy control subjects were recruited.Local sequential picture materials were used to elicit language samples.The differences between groups in the assessment results of the MCA and the SNA were compared,the consistency of the assessment results of the two methods were also analyzed.The inter-rater and the intra-rater reli-ability of the two methods was discussed.Results The results of the MCA showed that the number of accurate and complete(AC)main concepts(P＜0.01),the number of accurate and complete main concepts per minute(AC/min)(P＜0.05)and main concept scores(MC scores)(P＜0.05)of the aphasia group were significantly lower than those of the healthy group.The number of absent(AB)main concepts(P＜0.05)were significantly higher than those of the control group.As for the result of SNA,the score of the content of sub picture description(P＜0.05),the total score of sub picture description(P＜0.05)and the total score of overall description(P＜0.05)in the aphasia group were significantly less than those in the control group(P＜0.05).No significant difference be-tween the standardized scores of the two methods were observed,and inter-rater and the intra-rater reliability were both in a good range.Conclusion The clinical applicability of the two methods is excellent and the evaluation results are conststent.The MCA has outstanding advantages in evaluating the quality and quantity of information,while SNA examines the syntax and content organization,which can reflect the overall discourse performance.

Objective:To evaluate the effects of acupuncture combined with Tongbi Yinao Decoction in the treatment of isolated vertigo due to posterior circulation ischemia.Methods:A total of 78 elderly patients with isolated vertigo due to posterior circulation ischemia who were admitted to the Traditional Chinese Medicine Rehabilitation Department of Meishan People's Hospital from February 2019 to February 2022 were selected as the study subjects. They were divided into two groups by open randomized parallel control trail method, with 39 cases in each group. The control group was given conventional Western medicine treatment and oral administration of flunarizine hydrochloride capsules. On this basis, the observation group was treated with acupuncture combined with Tongbi Yinao Decoction. Both groups received 2 months of treatment. TCM syndrome scores before and after treatment were recorded. The Mini Mental State Examination (MMSE) was used to evaluate the patients' intelligence level. Transcranial Doppler ultrasound was used to detect blood flow velocity of the basilar artery, left vertebral artery and right vertebral artery. The blood rheometer was used to detect plasma viscosity, whole blood low shear viscosity and whole blood high shear viscosity. Adverse reactions that occurred during treatment were recorded, and clinical efficacy was evaluated.Results:The total effective rates in the observation group and the control group were 94.87% (37/39) and 76.92% (30/39), with statistical significance ( χ2=5.19, P=0.023). After treatment, the observation group in terms of vertigo and dizziness (1.05±0.12 vs. 2.14±0.74, t=9.08), chest distress and nausea (0.97±0.10 vs. 2.06±0.61, t=11.01), cyanosis of lip and nail (1.07±0.88 vs. 2.55±0.70, t=8.22), scaly dry skin (0.85±0.22 vs. 2.02±0.84, t=8.42) and the total score (3.94±1.32 vs. 8.77±2.89, t=9.49) were lower than those in the control group ( P<0.01). The MMSE score (26.39±2.20 vs. 24.20±2.37, t=4.01) was higher than that of the control group ( P<0.01). After treatment, blood flow velocity of the basilar artery [(37.55±3.61) cm/s vs. (33.50±2.96) cm/s, t=5.42], left vertebral artery [(34.27±4.87) cm/s vs. (30.58±3.74) cm/s, t=3.75] and right vertebral artery [(38.74±5.21) cm/s vs. (35.17±4.54) cm/s, t=3.23] in the observation group were higher than those in the control group ( P<0.01); The plasma viscosity [(1.32±0.19) mPa?s vs. (1.45±0.21) mPa?s, t=20.28], whole blood low shear viscosity [(8.71±0.35) mPa?s vs. (8.97±0.38) mPa?s, t=3.14] and whole blood high shear viscosity [(5.41±0.39) mPa?s vs. (5.92±0.43) mPa?s , t=5.49] were lower than those in the control group ( P<0.01). During treatment, the incidence rates of adverse reactions in the observation group and the control group were 28.2% (11/39) and 20.5% (8/39), without statistical significance ( χ2=0.63, P=0.429). Conclusion:Acupuncture combined with Tongbi Yinao Decoction can effectively maintain hemodynamics and cerebral blood flow of patients with isolated vertigo due to posterior circulation ischemia, and improve clinical efficacy, with good safety.

Modern TCM understands the pathogenesis of blood glucose fluctuation mainly from the viscera (spleen, kidney, liver, bile, small intestine), middle energizer, "yin fire theory", "Xuanfu depression" and "qi transformation". In clinic, blood glucose fluctuation is mainly divided into four syndrome types: qi-yin deficiency syndrome, yin-yang deficiency syndrome, exuberance of fire and heat syndrome, and heat stagnation in liver-stomach syndrome. TCM compounds can improve blood glucose fluctuation by improving insulin resistance, regulating intestinal microflora, promoting the secretion of glucagon-like peptide-1, and fighting oxidative stress.

Objective:To explore the influencing factors of clinical nurses in general hospitals to carry out hospice care under hospice shared care model, and further improve the quality of hospice care in general hospitals under this mode.Methods:Using the descriptive phenomenological research method, 13 clinical nurses from Sir Run Run Shaw Hospital Affiliated to Medical School of Zhejiang University were selected by purposive sampling from June to September 2023. Semi-structured interviews were conducted based on the capacity opportunity-motivation-behavior model, and Colaizzi′s 7-step analysis method was used to summarize and refine the theme.Results:There were 3 males and 10 females, aged 24-38 years old. Three themes and 11 sub-themes were extracted in this study: ability factors (theoretical knowledge cannot meet clinical needs, lack of clinical practice ability, insufficient self emotional regulation ability), motivation factors (willingness to carry out hospice shared care model, sense of professional benefit, professional identity, perception of care pressure, hospice care self-efficacy), opportunity factors (the influence of Confucian culture, systematic construction of hospice shared care model in hospitals, and multiple external support).Conclusions:Nurses' hospice care under hospice shared care model is affected by internal and external factors. Nurses can learn through multiple channels, find positive work experience, and use multi-dimensional support system to provide high-quality hospice care services for patients.

Artificial vascular graft(AVG)fistula is widely used for hemodialysis treatment in patients with renal failure.However,it has poor elasticity and compliance,leading to stenosis and thrombosis.The ideal artificial blood vessel for dialysis should replicate the structure and components of a real artery,which is primarily maintained by collagen in the extracellular matrix(ECM)of arterial cells.Studies have revealed that in hepatitis B virus(HBV)-induced liver fibrosis,hepatic stellate cells(HSCs)become hyperactive and produce excessive ECM fibers.Furthermore,mechanical stimulation can encourage ECM secretion and remodeling of a fiber structure.Based on the above factors,we transfected HSCs with the hepatitis B viral X(HBX)gene for simulating the process of HBV infection.Subsequently,these HBX-HSCs were implanted into a polycaprolactone-polyurethane(PCL-PU)bilayer scaffold in which the inner layer is dense and the outer layer consists of pores,which was mechanically stimulated to promote the secretion of collagen nanofiber from the HBX-HSCs and to facilitate crosslinking with the scaffold.We obtained an ECM-PCL-PU composite bionic blood vessel that could act as access for dialysis after decellularization.Then,the vessel scaffold was implanted into a rabbit's neck arteriovenous fistula model.It exhibited strong tensile strength and smooth blood flow and formed autologous blood vessels in the rabbit's body.Our study demonstrates the use of human cells to create biomimetic dialysis blood vessels,providing a novel approach for creating clinical vascular access for dialysis.

With the continuous development of China's economy,the people expect for higher quality medical services,and medical humanistic care is increasingly emphasized.Under this background,the"Duplex Linkage Mode",which integrates medical social workers and volunteers,has emerged.This paper reviews the current state of applying the mode in China,ex-pounds its benefits,and details its application within hospital services.This application covers guidance for outpatient and emer-gency department,inpatient ward services,hospice care,and community residents volunteer services.In addition,this paper proposes suggestions on furth for optimizing recruitment and training programs,improving management systems,establishing intel-ligent management systems,and improving volunteer support mechanisms.These measures aim to promote the sustainable and healthy development of medical humanistic services and to support the implementation of the Healthy China Initiative.

Objective:To establish an HPLC method to determine of vanillin in lysine and vitamin B12 granules.Methods:1.0 g of lysine and vitamin B12 granules was put into a 10mL graduated centrifuge tube,1 mL of water was added to dissolve,vortex for 1 min,and methanol was added to the scale and vortex for 1 min for extraction.The samples were separated on a C18 column(250 mm × 4.6 mm,5 μm)with a mobile phase of methanol and water(35∶65)at ta flow rate of 1.0 mL·min-1.The detection wavelength was 277 nm.Results:The limit of detection of vanillin was 0.2 μg·g-1,and the concentration was linear in the range of 1.962-49.04 μg·mL-1(r=0.999 9).The recoveries of vanillin at low,medium and high levels were 91.86％-101.61％with RSD of 2.9％(n=9).6 batches of samples were determined,and the results showed that the vanillin content in 4 batches of enterprise A was 55.18-79.55 μg·g-1,and no vanillin was detected in enterprise B and enterprise C.Conclusion:The method is simple and reliable,and can be used for the rapid determination of vanillin in lysine and vitamin B12 granules.