Based on the "Qi-blood-meridians" system， it is proposed that recurrence after radiofrequency ablation （RFA） for arrhythmia originates from damage to the heart and injury to the meridians caused by thermal burns. Disorder of qi movement， blood obstruction and heat constraint are the prerequisites for recurrence， while internal consumption of deficient qi， yin damage and scarce blood are key factors in frequent episodes. Latent pathogen of both phlegm and stasis， along with condensation of pathogenic yin， is the main cause of disease progression. Accordingly， self-made Tong Xin Beverage （通心饮） with 18 herbs is used throughout the postoperative intervention process to nourish the heart， unblock the meridians， restore vessels in balance of yin and yang. Self-made Qingxin Dingji Decoction （清心定悸汤） can be used to promote qi movement， diffuse stagnation， relieve heat and activate blood circulation so as to facilitate early recovery. Self-made Peiben Yangxin Decoction （培本养心汤） can boost qi and nourish yin， harmonize the ying （营） level and nourish blood， thereby improving long-term prognosis. In addition， Shiwei Wendan Decoction combined （十味温胆汤） with Taoren Honghua Decoction （桃仁红花煎） resolves phlegm， dissipates masses， removes stasis， and softens hardness， which can be used to prevent disease aggravation. These approaches aim to provide ideas and references for clinical practice.

This paper discussed the pathogenesis and treatment ideas of recurrent angina pectoris after percutaneous coronary intervention （PCI） based on qi and blood vessels. It is believed that patients after PCI often have poor qi and blood circulation and damaged vessels and collaterals as the basis， and subsequently suffer from binding of phlegm and stasis， accumulated and sticky， which further lead to the vessels congested and blocked， qi and blood declined， and the body and functions of the heart damaged. Accordingly， in terms of the treatment principles， it has been proposed to regulate qi and transport blood， unblock and nourish vessels， dissolve phlegm and dispel stasis， direct turbidity downward and unblock collaterals， supplement qi and nourish the body， unblock vessels and rejuvenate meridians， by using self-made Tiaoqi Yunxue Formula （调气运血方）， self-made Huoxue Jiangzhuo Formula （活血降浊方） and self-made Shenrong Tongmai Formula （参茸通脉方） in their modifications respectively， in order to provide reference for clinical diagnosis and treatment.

Objective:To select and obtain relevant evidence on the prevention and management of gastric retention in premature infants, so as to form the best summary of evidence.Methods:According to the "6S" evidence model system, we searched the domestic and foreign evidence-based databases, relevant guide websites, and association websites for all literature on the prevention and management of gastric retention in premature infants, including clinical decisions, guidelines, best practice information books, evidence summaries, systematic evaluations, and expert consensus. The search period was from January 1, 2013 to June 8, 2023.Results:A total of 12 articles were included, including 5 guidelines, 1 recommended practice, 5 systematic reviews, 1 expert consensuses. A total of 20 pieces of best evidence were collected, mainly involving 6 aspects of feeding management, placement of gastric tube, position management, gastric residue monitoring, gastric residue treatment, intervening measure.Conclusions:This study summarized the best evidence for the prevention and management of gastric retention in premature infants, so as to provide theoretical basis for clinical management of gastric retention and promote the establishment of enteral nutrition in premature infants.

Background Multimorbidity imposes a heavy burden on individuals, families, and society. There are relatively few studies exploring patterns of multimorbidity among middle-aged adults in China. Objective To explore the current status of multimorbidity, associated risk factors, and multimorbidity patterns among adults aged 45-64 years in China, so as to provide a scientific basis to prevent and control multimorbidity in China. Methods A total of 5494 adults aged 45-64 years from the Chinese Health and Nutrition Survey (CHNS) in 2018 were selected. Of these, 2494 (45.39%) were men and 3000 (54.61%) were women. The nine diseases included were hypertension, diabetes, dyslipidaemia, obesity, mild cognitive impairment (MCI), myocardial infarction, stroke, asthma, and tumor. The prevalence of each disease or multimorbidity was expressed as N (%). Comparisons of multimorbidity prevalence between different groups were performed using the χ² test or Cochran-Armitage trend test. Association rule with the Apriori algorithm was used to explore the pattern of multimorbidity, with parameters set at a minimum conditional support of 3.00%, a minimum rule confidence of 50.00%, and a lift of >1.20. Logistic regression was used to evaluate the associations between selected risk factors and multimorbidity. Results In 2018, 37.44% of participants reported multimorbidity in 15 provinces of China. The prevalence of diseases in descending order was dyslipidaemia (39.99%), hypertension (39.48%), obesity (16.42%), MCI (14.47%), diabetes (14.16%), tumor (1.09%), stroke (1.04%), myocardial infarction (0.71%), and asthma (0.64%). A total of seven multimorbidity patterns were identified in this group. Obesity paired with hypertension, and diabetes paired with dyslipidemia were the two major patterns of multimorbidity in the general population and age or sex subgroups. The multimorbidity patterns of different populations were concentrated in the combination of obesity, hypertension, diabetes, and dyslipidemia. The risk of multimorbidity was lower in females than in males (OR=0.85, 95%CI: 0.75, 0.97). The multimorbidity risk was 1.56 times higher in the 55-64 years group than in the 45-54 years group (OR=1.56, 95%CI: 1.40, 1.75). Drinking in the past year increased the risk of multimorbidity by 25% (OR=1.25, 95%CI: 1.08, 1.45) compared to no alcohol comsumption in the past year. High and medium levels of physical activity were associated with a decreased OR (high: OR=0.74, 95%CI: 0.65, 0.85; medium: OR=0.81, 95%CI: 0.70, 0.93) with low level of physical activity as reference. Conclusion In 2018, there was a high prevalence rate of multimorbidity among middle-aged adults in China. The main multimorbidity patterns were obesity-hypertension and diabetes-dyslipidemia. Surveillance and interventions should be strengthened particularly for men, individuals with alcohol consumption or insufficient physical activity, and those with major multimorbidity patterns.

Objective:Analyze the mediating and moderating effects of the relationship between food intake and blood glucose levels.Methods:This study uses data from the China Health and Nutrition Survey project in the survey 2018, involving 11 043 adults aged 18 years or older, who have complete dietary data, waist circumference (WC), glycated hemoglobin A1c (HbA1c) indicators, and other key variables. Food consumption data was gathered via three consecutive 24-hour dietary recalls and weighing accounting method, which included two weekdays and one weekend day. The average daily intake of various foods and total energy intake were calculated. The mediation effect and moderation effect analysis were conducted using simple mediation models, direct moderation effect models, and moderated mediation analysis theoretical models. The confidence interval method (bootstrap method) was performed for testing and analysis.Results:A total of 4 951 males and 6 092 females were included in the stratified analysis by gender. The mediating effects on the rice, wheat, and red meat→WC→HbA1c were all statistically significant in males. The standardized coefficients were -0.009 ( P<0.001), 0.013 ( P<0.001), and -0.005 ( P=0.008), respectively. In females, the mediating effect on the wheat→WC→HbA1c was statistically significant, and the standardized coefficient was 0.017 ( P<0.001); the impact of red meat intake on HbA1c is negatively regulated by the intake of dark vegetables, with a direct moderating effect; the standardized coefficient of the interaction term between red meat and dark vegetables was -0.024 ( P=0.008). Dark vegetables have a moderated mediator on the pathway from rice to WC and HbA1c ( a3b1=-0.003, P=0.041) in males. The mediating effect of WC is negatively regulated by the intake of dark vegetables (mediation effect difference U1/-1=-0.006, P=0.048). Dark vegetables showed a moderated mediator on the pathway from wheat to WC and HbA1c ( a3b1=-0.004, P=0.045) in females. The mediating effect of WC is negatively regulated by the intake of dark vegetables (mediation effect difference U1/-1=-0.009, P=0.049). Conclusions:Changes in WC indicators caused by rice, wheat, and red meat intake. WC could mediate between rice, wheat, red meat, and HbA1c. Dark vegetables directly or indirectly regulate HbA1c levels by interacting with rice, wheat, and red meat.

Objective:To compare the effects of deep anesthesia extubation with sugammadex and neostigmine on perioperative respiratory adverse events (PRAE) and the duration of anesthesia recovery room (PACU) in children undergoing adenoidectomy.Methods:The clinical data of 470 children with adenoidectomy who underwent deep anesthesia extubation from February 2021 to April 2022 in Shenzhen Hospital of Southern Medical University were retrospectively analyzed. According to the use of muscle relaxant, they were divided into sugammadex group (group S) and neostigmine group (group N). Group S was intravenously injected with sugammadex 2 mg/kg after operation, and group N was intravenously injected with neostigemine 0.05 mg/kg combined with atropine 0.02 mg/kg when the train-of-four (TOF) value was >25%. The extubation time and PACU residence time of the two groups were recorded. Changes of heart rate (HR) and mean arterial pressure (MAP) immediately after surgery (T 0), within 1min after extubation (T 1), 5 min after extubation (T 2), and 20 min after extubation (T 3). PRAE was record. Results:There were 138 cases of propensity score matching in group S and group N respectively. The extubation time and PACU residence time in group S were shorter than those in group N (all P<0.05). At T 1, T 2 and T 3, HR and MAP in group S were significantly lower than those in group N (all P<0.05). The incidence of persistent cough and decreased blood oxygen in group S was lower than that in group N (all P<0.05). Conclusions:Compared with neostigmine, postoperative deep anesthesia extubation with sugammadex antagonistic residual muscle relaxant can shorten the duration of extubation and PACU retention after adenoidectomy, accelerate the recovery of children, make the peri-extubation cycle more stable, and reduce the occurrence of PRAE.

The accurate annotation of transcription start sites(TSSs)and their usage are critical for the mechanistic understanding of gene regulation in different biological contexts.To fulfill this,specific high-throughput experimental technologies have been developed to capture TSSs in a genome-wide manner,and various computational tools have also been developed for in silico pre-diction of TSSs solely based on genomic sequences.Most of these computational tools cast the problem as a binary classification task on a balanced dataset,thus resulting in drastic false positive predictions when applied on the genome scale.Here,we present DeeReCT-TSS,a deep learning-based method that is capable of identifying TSSs across the whole genome based on both DNA sequence and conventional RNA sequencing data.We show that by effectively incorporating these two sources of information,DeeReCT-TSS significantly outperforms other solely sequence-based methods on the precise annotation of TSSs used in different cell types.Furthermore,we develop a meta-learning-based extension for simultaneous TSS annotations on 10 cell types,which enables the identification of cell type-specific TSSs.Finally,we demonstrate the high precision of DeeReCT-TSS on two independent datasets by correlating our predicted TSSs with experimentally defined TSS chromatin states.The source code for DeeReCT-TSS is available at https://github.-com/JoshuaChou2018/DeeReCT-TSS_release and https://ngdc.cncb.ac.cn/biocode/tools/BT007316.

Objective:To investigate the effect of ionizing radiation on the N 6-methyladenine (m 6A) modification profile of circular RNA (circRNA) in mouse bone marrow cells and provide scientific basis for revealing the relationship between RNA epigenetic modification and hematopoietic radiation injury. Methods:A total of twenty four C57BL/6 J mice were randomly divided into two groups: the healthy control group ( n=12), and ionizing radiation group ( n=12) irradiated in total body with 4 Gy of 137Cs γ-rays. At 5 min after irradiation, mice were killed and bone marrow cells were collected from the femur. Total RNAs were extracted and the changes in circRNA m6A modification profiles were investigated by RNA immunoprecipitation-high-throughput sequencing (MeRIP-Seq) technology and bioinformatics analysis. The representative alterations of m 6A peaks were validated by MeRIP-PCR assay. Results:325 and 455 m 6A sites were identified on circRNAs in the healthy control group and ionizing radiation group (178 common sites, 147 specific sites in the healthy control group and 277 specific sites in ionizing radiation group), respectively. 1 275 and 1 017 deriving genes of m 6A-circRNAs were identified in the healthy control group and ionizing radiation group (767 common genes, 508 specific genes in the healthy control group and 250 specific genes in ionizing radiation group), respectively. Compared with the control healthy group, 414 (178) m 6A peaks was significantly up- (down-) regulated in the ionizing radiation group( P < 10 -10; fold-change cut-off > 5). Moreover, Gene Ontology (GO) assay revealed that the deriving genes of circRNAs with differentially methylated m 6A sites between two groups involves various functions including chromatin regulation, ciliary transition fiber and poly (A)-specific ribonuclease activity. Kyoto Encyclopedia of Genes and Genomes (KEGG) assay revealed that the deriving genes of circRNAs with differentially methylated m 6A sites between two groups included numerous pathways such as platelet activation, Fc γ R-mediated phagocytosis and B cell receptor signaling pathway. Conclusions:Ionizing radiation triggers rapid alterations in the m 6A modification profile of circRNA in mouse bone marrow cells. The deriving genes of differentially methylated circRNAs are associated with a variety of functions and signaling pathways of hematopoietic radiobiology.

Objective To detect the protein expression change in the proliferation of human retinal microvascular endothelial cells (hRMECs) stimulated with 4-Hydroxynonenal (4-HNE).Methods hRMECs were in a logarithmic growth phase, and then were separated into 4-HNE-stimulated group and negative control group. The concentration of 4-HNE included 5, 10, 20 and 50 μmol/L in 4-HNE-stimulated group, while the negative control group was added in the same volume of ethanol (the solvent of 4-HNE). Then the cells were stimulated with 4-HNE for 24 hours following by CCK-8 kits incubating for 4 hours to detect absorbance. It was found that 10 μmol/L 4-HNE had the most obvious effect on the proliferation of hRMECs. Therefore, the cellular proteins from 10 μmol/L 4-HNE-stimulated group and negative control group were acquired and prepared by FASP sample preparation method. Data independent acquisition was used for data acquisition, and the GO analysis and pathway enrichment were performed for analysis of differentially expressed proteins. Results CCK-8 kits detection results showed that theA value of the 10 and 20 μmol/L 4-HNE-stimulated groups were significantly higher than negative control group and 5 μmol/L 4-HNE-stimulated group (F=25.42, P<0.01), while there were no differences between 10 and 20 μmol/L 4-HNE-stimulated groups, and theA value of 50 μmol/L 4-HNE-stimulated groups was lower than negative control. A total of 2710 quantifiable proteins were identified by peoteomics,and 118 proteins were differentially expressed (fold change>1.5,P<0.05). Seventy-two proteins were up-regulated after 4-HNE stimulation, whereas 46 proteins were down-regulated. Particularly, the expressions of Heme oxygenase-1, Sulfoxdoxin-1, Heat shock protein A1B, Thioredoxin reductase-1, Glutathione reductase, ATPase and prothrombin were increased when cells were added in 4-HNE, whereas the expressions of apolipoprotein A1 and programmed cell death protein 4 were decreased. These differentially expressed proteins were mainly involved in the biological processes such as oxidative stress, cell detoxification, and ATPase-coupled membrane transport.Conclusion After stimulated with 4-HNE, the oxidative stress, cell detoxification, and ATPase-coupled membrane transport protein expression may change in hRMECs in order to regulate oxidative stress and growth situation.

Objective: To determine the changes of protein expressions in human retinal microvascular pericytes (HRMPCs) stimulated with high glucose by using quantitative proteomics, which provides new clues for future investigation of diabetic retinopathy (DR). Methods: HRMPCs were divided into two groups.The cells in control group were cultured in DMEM basic medium with 25 mmol/L glucose, while the cells in high glucose group were cultured in DMEM medium with 35 mmol/L glucose.The amount of living cells was measured by cell counting kit-8(CCK-8). The proteins were collected from the two groups and then were digested with trypsin.Peptides of 2 μg were injected into the time of flight-mass spectrometer and the acquisition mode was DDA.The results were further analyzed using bioinformatics software. Results: CCK-8 results showed that the absorbance (A₄₅₀) of HRMPCs in high glucose group was 0.75±0.04, which was significantly lower than 0.91±0.05 in control group (t=5.784, P=0.000 2). In total, 1 972 proteins were identified and 54 of them were significantly different between the two groups (fold change >1.5). Among them, 13 proteins were up-regulated, including CTNNB1 and CTBP2; while 41 proteins were down-regulated, including SQSTM1 and HMGCS1.The differentially expressed proteins were mainly involved in citric acid cycle and aerobic respiration. Conclusions The expressions of many proteins in HRMPCs change under the stimulation of high glucose, which may influence the respiration and the ATP production of cells and eventually induce the loss of pericyte.