Aim To elucidate whether Astragaloside Ⅳcould ameliorate pathological myocardial hypertrophy and fibrosis via the EGR1-SIRT1-PPARα-SCAD signa-ling pathway in TAC mice.Methods After randomi-zing mice into groups,the Sham+AS-Ⅳ group and TAC+AS-Ⅳ group were intragastrically administered 20 mg·kg-1AS-Ⅳ once daily,whereas the Sham+NS group and TAC+NS group were given equivalent saline.Six weeks post-surgery,an evaluation of cardiac function was conducted,heart weight index was compu-ted,morphological alterations in heart were noted,vari-ations in collagen and myocardial hypertrophy indexes were analyzed,ATP content,free fatty acid content,hydroxyproline content,SCAD expression,and enzyme activity were measured,and an initial investigation into the protein expression of EGR1-SIRT1-PPARα-SCAD in myocardial tissues was undertaken.Results After AS-Ⅳ intervention,the heart weight index of TAC mice decreased(P＜0.01),LVAWd,LVAWs,LVPWd and LVPWs values decreased(P＜0.01,P＜0.05),EF％and FS％values increased(all P＜0.01),myocardial hypertrophy markers and collagen area decreased,FFA content,HYP content and collagen expression de-creased(all P＜0.01),SCAD enzyme activity and ex-pression increased(P＜0.01,P＜0.05),and ATP content increased(P＜0.01).The expression of EGR1 protein decreased,and the expression of SIRT1 and PPARα protein increased(all P＜0.01).Conclu-sions AS-Ⅳ may improve fatty acid oxidation via the EGR1-SIRT1-PPARα-SCAD signaling pathway,thereby ameliorating pathological myocardial hypertrophy and fibrosis in TAC model mice.

Aim To elucidate whether Astragaloside Ⅳcould ameliorate pathological myocardial hypertrophy and fibrosis via the EGR1-SIRT1-PPARα-SCAD signa-ling pathway in TAC mice.Methods After randomi-zing mice into groups,the Sham+AS-Ⅳ group and TAC+AS-Ⅳ group were intragastrically administered 20 mg·kg-1AS-Ⅳ once daily,whereas the Sham+NS group and TAC+NS group were given equivalent saline.Six weeks post-surgery,an evaluation of cardiac function was conducted,heart weight index was compu-ted,morphological alterations in heart were noted,vari-ations in collagen and myocardial hypertrophy indexes were analyzed,ATP content,free fatty acid content,hydroxyproline content,SCAD expression,and enzyme activity were measured,and an initial investigation into the protein expression of EGR1-SIRT1-PPARα-SCAD in myocardial tissues was undertaken.Results After AS-Ⅳ intervention,the heart weight index of TAC mice decreased(P＜0.01),LVAWd,LVAWs,LVPWd and LVPWs values decreased(P＜0.01,P＜0.05),EF％and FS％values increased(all P＜0.01),myocardial hypertrophy markers and collagen area decreased,FFA content,HYP content and collagen expression de-creased(all P＜0.01),SCAD enzyme activity and ex-pression increased(P＜0.01,P＜0.05),and ATP content increased(P＜0.01).The expression of EGR1 protein decreased,and the expression of SIRT1 and PPARα protein increased(all P＜0.01).Conclu-sions AS-Ⅳ may improve fatty acid oxidation via the EGR1-SIRT1-PPARα-SCAD signaling pathway,thereby ameliorating pathological myocardial hypertrophy and fibrosis in TAC model mice.

Objective:To evaluate the efficacy of hematoporphyrin monomethyl ether-mediated photodynamic therapy (HMME-PDT) in the treatment of adult patients with port-wine stains (PWS) in China, and to analyze factors influencing the efficacy.Methods:A retrospective study was conducted on the data from 265 adult patients with PWS who underwent HMME-PDT at the Department of Dermatology, West China Hospital, Sichuan University from February 2017 to October 2023. Patients were intravenously injected with hemoporfin at doses of 5 - 6.5 mg/kg, followed by irradiation with a 532-nm green light-emitting diode at the energy density of 100 - 130 J/cm 2 (power density, 85 - 100 mW/cm 2) for 19 - 25 minutes. Treatments were conducted every 2 - 6 months. The treatment response in the treated area was observed after each treatment, and the clinical efficacy was assessed at least two months after the last treatment. Chi-square test was used to analyze the differences in efficacy between groups. Results:Among the 265 adult patients with PWS, the male to female ratio was 90∶175, the patients' age ranged from 18 to 56 years (26.48 ± 6.88 years), and they underwent 1 to 8 treatment sessions (2.67 ± 1.33 sessions). After treatment, 102 (38.4%) patients achieved complete remission, 74 (27.9%) achieved marked improvement, 59 (22.2%) had moderate improvement, and 30 (11.3%) showed no response, resulting in an overall response rate of 88.7%. Among 146 patients without hypertrophic lesions, 69 (47.3%) achieved complete remission, with a response rate of 92.5%; among 102 with slightly thickened lesions, 32 (31.4%) achieved complete remission, with a response rate of 87.3%; among 17 with markedly thickened lesions, only 1 achieved complete remission, and 11 achieved marked improvement. Among 50 patients who received more than 3 treatment sessions, 28 (56%) had complete remission, with a response rate of 100%; among 45 who received only one session of treatment, 5 (11.1%) achieved complete remission, with a response rate of 68.9%. Among 232 patients without soft tissue hyperplasia, 95 (40.9%) achieved complete remission, with a response rate of 88.8%; among 33 with soft tissue hyperplasia, 7 (21.2%) achieved complete remission, with a response rate of 87.9%. The therapeutic effects significantly differed among patients with different lesion thicknesses, among those with different treatment sessions, as well as between patients with soft tissue hyperplasia and those without (all P < 0.05). There were no significant differences in the therapeutic effect among patients of different genders, different ages, with different lesion colors, as well as between patients with nodules and those without, and between patients with treatment history and those without (all P > 0.05). During and after the treatment, patients experienced varying degrees of swelling, burning sensation, pain, and itching, all of which could be relieved by common treatment; scars occurred in 10 (3.8%) patients, and were managed by symptomatic treatment; no systemic adverse reactions, such as drug allergies or impairment of liver and kidney function, were observed during the treatment. Conclusions:HMME-PDT is safe and effective in the treatment of adult patient with PWS. The therapeutic effect of HMME-PDT was associated with lesion thickening and soft tissue hyperplasia, and increased with the increase in treatment sessions.

Objective:To investigate the clinical efficacy of 595-nm pulsed dye laser (PDL) in the treatment of port-wine stains (PWS) in infants and toddlers.Methods:A retrospective analysis was conducted based on clinical data from 155 infants and toddlers with PWS treated with 595-nm PDL at West China Hospital of Sichuan University from January 2013 to October 2023, and the efficacy was evaluated according to pre- and post-treatment photographs. The children were grouped according to gender, age, lesion color, lesion area, lesion sites, and number of treatment sessions, separately, and the differences were analyzed between different groups. Further analysis was conducted to determine factors affecting efficacy of PDL for PWS. Adverse reactions after treatment were recorded. The Mann-Whitney U test and Kruskal-Wallis H test were used to analyze unidirectional ordered R × C contingency table data, the Bonferroni approach was used for multiple comparisons, and multivariate ordered logistic regression analysis was performed for multifactorial analysis. Results:After the treatment with 595-nm PDL, 135 infants and toddlers with PWS showed good response, with an overall response rate of 87.1%. Univariate analysis indicated that the efficacy was associated with the lesion area ( P = 0.016) and the number of treatment sessions ( P < 0.001), but not with age ( P = 0.340), gender ( P = 0.164), lesion color ( P = 0.530), or lesion sites ( P = 0.077), and the smaller the lesion area, the more the treatment sessions, the better the therapeutic effect. Multivariate ordered logistic regression analysis further confirmed the correlations of efficacy with lesion area ( P = 0.010) and number of treatment sessions ( P < 0.001). Adverse reactions occurred in 5 (3.2%) cases of PWS, including 2 (1.3%) of hypopigmentation, 2 (1.3%) of hyperpigmentation, and 1 (0.6%) of scar formation. Conclusion:The 595-nm PDL was safe and effective for the treatment of PWS in infants and toddlers with few adverse reactions, making it a reliable therapeutic option.

Port-wine stains (PWS) are one of the common congenital vascular malformations in dermatology, clinically manifesting as pink or red irregular patches occurring on the skin or mucosa at birth or shortly thereafter, which are often not elevated above the skin surface. In a minority of patients, vascular malformations not only affect the skin, but also involve the eyes, brain, limbs and viscera. These patients are at risk for glaucoma, epilepsy, limb pain, and other clinical conditions. In general, these conditions are referred to as PWS-associated syndromes. These syndromes are rare diseases, can affect multiple systems and exhibit a variety of clinical manifestations, which pose challenges in their diagnosis and treatment. This review focuses on the clinical manifestations, diagnoses, pathogenesis and treatment of PWS-associated syndromes.

Port-wine stains (PWS) are vascular malformations characterized by dilated capillaries and postcapillary venules in the skin. Clinically, they mainly manifest as pink or red irregular patches, most of which may become thickened, darkened in color, or even develop into nodules over age, making treatment more challenging. The mechanisms underlying the development and progression of PWS are not very clear, and may be related to heredity, gene mutations, abnormal ratios of blood vessels to nerves, etc. This review summarizes research progress in the mechanisms underlying the development and progression of PWS, so as to provide a theoretical basis for their treatment.

Objective:To explore the medication law for treating chronic atrophic gastritis (CAG) through data mining methods.Methods:Literature on experiences in treating CAG was retrieved from CNKI, Wanfang data, and VIP from the establishment of the databases to December 31, 2023. The information on syndromes, treatment methods, and prescriptions was extracted for frequency statistics, clustering analysis, complex networks analysis were performed.Results:A total of 313 articles were included in the study, involving 581 experienced prescriptions, involving 5 kinds of TCM disease names, with "epigastric pain" as the most, followed by "fullness"; high-frequency syndromes included spleen-stomach qi deficiency syndrome, stomach collateral stasis syndrome, stomach yin deficiency syndrome, spleen-stomach damp-heat syndrome, liver-stomach qi stagnation syndrome; the main treatment methods used were promoting blood circulation and removing blood stasis, invigorating spleen and replenishing qi, regulating qi and harmonizing stomach, soothing liver and regulating qi, etc. The number of prescription drugs was mainly in 10-15 kinds of Chinese materia medica; a total of 321 kinds of Chinese materia medica were shared, and the top five Chinese medicines ranked by frequency were Atractylodis Macrocephalae Rhizoma, Poria, Paeoniae Radix Alba, Citri Reticulatae Pericarpium, Coptidis Rhizoma. The medicinal properties were mainly warm and neutral, and the tastes were mostly bitter, sweet and pungent. The meridians were mainly spleen, stomach, lung and liver meridians. The clustering analysis of high-frequency medication was mainly divided into 6 categories. The association rule analysis of Chinese materia medica and the complex network of Chinese materia medica showed the core compatibility and prescription of 5 high-frequency syndromes, respectively, showing the combination of Xiangsha Liujun Decoction, Chaihu Shugan Powder, Banxia Xiexin Decoction, Shashen Maidong Decoction and other classical prescriptions for syndrome differentiation and treatment combined with the experience of improving gastric mucosal lesions.Conclusion:Tonifying qi, removing blood stasis and detoxifying are the feature methods to treat CAG, embodying a "point surface combination" medication strategy that combines holistic diagnosis and syndrome differentiation and treatment with improvement of local mucosal lesions.

Objective To understand the epidemiological and clinical characteristics of healthcare-associated infec-tion(HAI)in neonates with different gestational ages and birth weights,and provide guidance for personalized cli-nical diagnosis and treatment.Methods According to the inclusion and exclusion criteria,240 neonates with HAI in the neonatal intensive care unit(NICU)of a hospital in Handan City from January 2018 to December 2022 were selected as the study group,720 neonates without HAI were selected as the control group based on systematic sam-pling method with a ratio of 1∶3.The incidence of HAI,distribution characteristics of infection site,pathogenic features of HAI,as well as the effect of different delivery modes on HAI in neonates with different gestational ages and birth weights were analyzed.Results Neonates with gestational age＜28 weeks and birth weight＜1 000 g had the highest incidence of HAI,which were 19.48％and 20.41％,respectively.Among neonates with gestational age＜28 weeks,unidentified site infection were the most(37.50％),while in all gestational age groups within 28-36+6 weeks,bloodstream infection(BSI)and respiratory system infection were predominant.For neonates with gestational age ≥37 weeks,BSI and unidentified site infection occurred frequently.Among neonates in all weight groups,BSI was the most frequent,followed by respiratory system infection.Pathogens from different sites of in-fections in neonates with different gestational ages and birth weights varied.Among neonates with gestational age of 28-31+6 weeks and birth weight of 1 000-1 499 g,the constituent of birth modes showed statistically significant difference between neonates with and without HAI(both P＜0.05).Conclusion Epidemiological and clinical chara-cteristics of HAI in neonates with different gestational ages and birth weights are different.For the prevention and control of HAI,individualized diagnosis and treatment plans should be developed to achieve precise prevention and control,reduce the incidence of HAI,and improve the overall treatment level of neonates.

Coronary flow capacity (CFC) is a relatively new perfusion index reflecting the vasodilator capacity of the coronary circulation, which can be obtained by a variety of invasive or non-invasive methods. CFC, combining stress myocardial blood flow (sMBF) with coronary flow reserve (CFR), can achieve a more comprehensive assessment of myocardial perfusion, thus providing a strong basis of accurate guide in the diagnosis, risk stratification, and treatment strategy of ischemic heart disease. This article reviews CFC and its significance, clinical application and progress.

OBJECTIVE: To evaluate the efficacy and safety of Wuda Granule (WDG) on recovery of gastrointestinal function after laparoscopic bowel resection in the setting of enhanced recovery after surgery (ERAS)-based perioperative care. METHODS: A total of 108 patients aged 18 years or older undergoing laparoscopic bowel resection with a surgical duration of 2 to 4.5 h were randomly assigned (1:1) to receive either WDG or placebo (10 g/bag) twice a day from postoperative days 1-3, combining with ERAS-based perioperative care. The primary outcome was time to first defecation. Secondary outcomes were time to first flatus, time to first tolerance of liquid or semi-liquid food, gastrointestinal-related symptoms and length of stay. Subgroup analysis of the primary outcome according to sex, age, tumor site, surgical time, histories of underlying disease or history of abdominal surgery was undertaken. Adverse events were observed and recorded. RESULTS: A total of 107 patients [53 in the WDG group and 54 in the placebo group; 61.7 ± 12.1 years; 50 males (46.7%)] were included in the intention-to-treat analysis. The patients in the WDG group had a significantly shorter time to first defecation and flatus [between-group difference -11.01 h (95% CI -20.75 to -1.28 h), P=0.012 for defecation; -5.41 h (-11.10 to 0.27 h), P=0.040 for flatus] than the placebo group. Moreover, the extent of improvement in postoperative gastrointestinal-related symptoms in the WDG group was significantly better than that in the placebo group (P<0.05). Subgroup analyses revealed that the benefits of WDG were significantly superior in patients who were male, or under 60 years old, or surgical time less than 3 h, or having no history of basic disease or no history of abdominal surgery. There were no serious adverse events. CONCLUSION The addition of WDG to an ERAS postoperative care may be a viable strategy to enhance gastrointestinal function recovery after laparoscopic bowel resection surgery. (Registry No. ChiCTR2100046242).
Humans ; Laparoscopy/adverse effects* ; Male ; Female ; Middle Aged ; Double-Blind Method ; Recovery of Function ; Drugs, Chinese Herbal/adverse effects* ; Treatment Outcome ; Gastrointestinal Tract/physiopathology* ; Defecation ; Aged ; Intestines/physiopathology*