Objective To analyze trend changes of disease burden of hypertensive nephropathy (HTN) between 2012 and 2023 in Chongqing, and to provide the suggestion for HTN prevention and treatment. Methods Death cases of HTN from Chongqing death registration data between 2012 and 2023 were analyzed to calculate indicators such as mortality, age standardization mortality rate (ASMR), rate of years of life lost (YLL) and Average years of life lost. The mortality of HTN between male and female, urban and rural were compared by Chi-square test. The trend change was explained by average annual percent of change (AAPC). Results The mortality and standardized mortality of HTN in Chongqing decreased from 5.44/100 000 and 3.13/100 000 in 2012 to 2.76/100 000 and 1.07/100,000 in 2023 respectively. The average annual percent change (AAPC) was -5.41% and -8.35% respectively, and the differences in the change trends were statistically significant (P<0.01). The mortality and standardized mortality of HTN in males and females decreased with AAPC of 5.50%, 8.07%, 5.27% and 8.69% respectively, and the differences in the change trends were all statistically significant (all P< 0.05). From 2012 to 2014, 2019 and 2021, the mortality rate of HTN in rural areas was higher than that in urban areas (all P < 0.05). The mortality and standardized mortality of HTN in rural areas decreased with AAPC of 6.58% and 9.46% respectively, and the differences in the change trends were all statistically significant (all P<0.05). The rate of YLL and standardized YLL of HTN in Chongqing decreased from 96.02/100 000 and 60.42/100 000 in 2012 to 44.98/100 000 and 21.49/100 000 in 2023 respectively. The AAPC was -5.83% and -7.80% respectively, and the differences in the change trends were statistically significant (both P < 0.05). AYLL of HTN were 17.88 years in 2012, and it was 17.08 years in 2023. There were no statistically significant differences in the changes (both P > 0.05). The standardized AYLL of HTN in rural areas increased at an average annual rate of 1.14%, and the difference was statistically significant (P < 0.05). Conclusion The mortality and YLL rate of HNT in Chongqing was lower than it in China. Moreover, its trend was decreased. It should be strengthened early screening and healthy management of HNT.

OBJECTIVE: Left ventricular remodeling induced by myocardial ischemia/reperfusion injury (MI/RI) is a common cardiac dysfunction. Accumulating evidence has demonstrated that autophagy plays a vital role in protecting against ventricular remodeling. This study aims to investigate the performance of Compound Danshen Tablets (CDT) in rescuing ventricular remodeling and whether autophagy as the potential mechanism. METHODS: The left anterior descending arteries of rats were temporarily ligated for 30 min to construct the MI/RI model. Ventricular remodeling was induced by reperfusion for 28 d, during which the MI/RI rats were administered CDT (300 mg/kg and 600 mg/kg), atorvastatin (2 mg/kg), and diltiazem (16 mg/kg). Cardiac function and structure were examined by echocardiography. Immunohistochemistry, Masson's trichrome staining, and hematoxylin-eosin (HE) staining were utilized to assess the fibrosis and histological alterations in the heart tissue. The expression of autophagy-related proteins was detected using Western blotting. RESULTS: CDT attenuated the cardiac dysfunction, structural changes, histopathological changes and fibrosis induced by MI/RI. CDT significantly enhanced the level of Beclin1 and microtubule-associated protein 1 light chain 3 beta (LC3β), and reduced p62 levels in MI/RI rats. Moreover, CDT significantly increased the phosphorylation of adenosine monophosphate-activated protein kinase (AMPK) and inhibited mammalian target of rapamycin (mTOR) phosphorylation. CONCLUSION CDT ameliorated MI/RI-induced ventricular remodeling by activating autophagy and improving autophagic flux via the AMPK/mTOR signaling pathway.

Background and objective Neoantigen reactive T cell(NRT)has the ability to inhibit the growth of tumors expressing specific neoantigens.However,due to the difficult immune infiltration and the inhibition of tumor micro en-vironment,the therapeutic effect of NRT in solid tumors is limited.In this study,we designed NRT cells(7×19 NRT)that can express both interleukin-7(IL-7)and chemokine C-C motif ligand 19(CCL19)in mouse lung cancer cells,and evaluated the difference in anti-tumor effect between 7×19 NRT cells and conventional NRT cells.Methods We performed next-generation sequencing and neoantigen prediction for mouse Lewis lung carcinoma(LLC),prepared RNA vaccine,cultured NRT cells,constructed retroviral vectors encoding IL-7 and CCL19,transduced NRT cells and IL-7 and CCL19 were successfully ex-pressed,and 7×19 NRT was successfully obtained.The anti-tumor effect was evaluated in vivo and in vitro in mice.Results The 7×19 NRT cells significantly enhanced the proliferation and invasion ability of T cells by secreting IL-7 and CCL19,achieved significant tumor inhibition in the mouse lung cancer and extended the survival period of mice.The T cell infiltration into tumor tissue and the necrosis of tumor tissue increased significantly after 7×19 NRT treatment.In addition,both 7×19 NRT treatment and conventional NRT treatment were safe.Conclusion The anti-solid tumor ability of NRT cells is significantly enhanced by the arming of IL-7 and CCL19,which is a safe and effective genetic modification of NRT.

Codonopsis Radix is a Codonopsis plant belonging to Campanulaceae family.It is widely used as a Chinese medicinal for invigorating qi in Chinese medicine clinics.The chemical compositions of Codonopsis Radix mainly contain flavonoids,alkaloids,sugars,saponins,steroids,amino acids,etc..It mainly exhibits the pharmacological effects such as enhancing the immune system function,improving gastrointestinal function,anti-inflammation,anti-tumor,improving the ability of learning and memory,regulating the cardio-cerebral vascular system,and slowing down the aging process,and so on.Based on a large number of literature studies on Codonopsis Radix at home and abroad in recent years,this paper summarizes its pharmacological effects.The aim of the review is to provide a certain theoretical basis and rationale for the research and application of Codonopsis Radix.

ObjectiveTo investigate the ameliorative effect and mechanism of total saponins of Codonopsis Radix （TSC） on learning and memory impairment induced by D-galactose in aging mice. MethodTwenty-four male C57BL/6J mice were randomly assigned into four groups （n=6）： normal group， model group （200 mg·kg^-1 D-galactose）， TSC group （200 mg·kg^-1）， and donepezil group （3 mg·kg^-1）. After one week of pre-treatment， the mice in the model， TSC， and donepezil groups were administrated with corresponding agents for 8 weeks. In the ninth week， the Morris water maze test was performed to assess the learning and memory abilities. Histopathological changes in the brain were evaluated by hematoxylin-eosin （HE） and Nissl staining. Immunohistochemistry was used to detect the expression of nuclear factor kappa-B （NF-κB）， tumor necrosis factor-α （TNF-α）， and brain-derived neurotrophic factor （BDNF） in the brain tissue. The serum levels of glutathione peroxidase （GSH-Px）， catalase （CAT）， superoxide dismutase （SOD）， malondialdehyde （MDA）， TNF-α， interleukin-1β （IL-1β）， and interleukin-18 （IL-18） were measured by enzyme-linked immunosorbent assay， on the basis of which the effects of TSC on neuroinflammation and memory impairment in D-galactose-induced aging mice were assessed. ResultCompared with the normal group， the model group exhibited decreased cognitive function， decreased activities of CAT， SOD， and GSH-Px in the serum （P<0.01）， and upregulated levels of MDA， TNF-α， IL-1β， and IL-18 （P<0.01）. In addition， partial neuronal damage and degeneration were observed in the hippocampus and cortex of the model group， accompanied by downregulated BDNF expression （P<0.05） and upregulated NF-κB and TNF-α expression （P<0.05）. Compared with the model group， TSC alleviated D-galactose-induced cognitive dysfunction， enhanced the activities of CAT， SOD， and GSH-Px （P<0.01）， lowered MDA， TNF-α， IL-1β， and IL-18 levels （P<0.01）， and ameliorated the pathological changes in the hippocampus and cerebral cortex. Additionally， TSC upregulated BDNF expression （P<0.05， P<0.01） and downregulated NF-κB and TNF-α expression （P<0.05， P<0.01） in the hippocampus and cerebral cortex. ConclusionTSC exerts a protective effect on cognitive dysfunction induced by D-galactose in aging mice by inhibiting oxidative stress and inflammation.

This article summarizes the new progress in the diagnosis and treatment strategies on drug-resistant cytomegalovirus(CMV)infections in organ transplant recipients, including the prevention and treatment medications for CMV infection, the diagnosis and treatment strategies, and the immunological treatment regimen for drug-resistant CMV infection.The article is aimed to provide references for the prevention and treatment of drug-resistant CMV infection in organ transplant recipients.

Objective:To assess the effect of exercise prescription on patients with chronic obstructive pulmonary disease (COPD) and respiratory failure through meta-analysis.Methods:A comprehensive search was conducted in PubMed, The Cochrane Library, EMbase, CNKI, Wanfang, VIP, and China National Knowledge Infrastructure from the database establishment date to February 1, 2023. The search included randomized controlled trials that involved exercise prescription for patients with COPD and respiratory failure. Two independent researchers conducted literature searches, data extraction, and methodological quality evaluation. Meta-analysis was performed using Review Manager 5.3.Results:A total of 11 studies with 862 patients were included in the analysis. The meta-analysis revealed that the exercise prescription was beneficial in improving lung function [forced expiratory volume in one second (FEV 1): standardized mean difference ( SMD)=1.53(95% CI: 1.28, 1.78), P<0.001; forced vital capacity (FVC): SMD=1.55(95% CI: 0.25, 2.84), P=0.020; FEV 1/FVC: SMD=1.68(95% CI: 0.81, 2.55), P<0.001], gas exchange ability [arterial partial pressure of oxygen (PaO 2): SMD=1.13(95% CI: 0.92, 1.34), P<0.001; arterial partial pressure of carbon dioxide (PaCO 2): SMD=-1.23(95% CI:-1.60, -0.85), P<0.001], improving 6 minutes walking distance test (6MWT) [ SMD=2.20(95% CI: 1.13, 3.27), P<0.001], relieving dyspnea [Borg score: SMD=-1.74(95% CI:-3.26, -0.22), P=0.020; St George′ respiratory questionnaire (SGRQ) score: SMD=-1.10(95% CI:-1.53, 0.66), P<0.001], and reducing mechanical ventilation time [ SMD=-2.08(95% CI:-3.33, -0.83), P=0.001]. Conclusion:Exercise prescription can improve the pulmonary function, gas exchange ability, cardiorespiratory endurance, quality of life, dyspnea and reduce the duration of mechanical ventilation and negative outcomes for patients with COPD and respiratory failure.

Objective: This study was designed to investigate the protective effects of didymin (Did) on doxorubicin (DOX)-induced cardiotoxicity. Methods: After pretreatment with Did (2, 4, 8 mg/kg intraperitoneal i.p.) for 7 d, the male C57 mice were injected with single dose of DOX (20 mg/kg i.p.). The cardioprotective effect of Did was observed on the 7th day after DOX treatment. Results: DOX delayed body growth and caused cardiac tissue injury, oxidative stress, and mitochondrial dysfunction. Similar experiments in H9C2 cardiomyocytes showed that DOX reduced cell viability, increased generation of reactive oxygen species (ROS) and fragmentation of DNA, decreased mitochondrial membrane potential, and induced cardiomyocyte apoptosis. However, all of these adverse effects were suppressed by Did pretreatment. Did increased protein expression of glutamate-L-cysteine ligase catalytic subunit (GCL), heme oxygenase 1 (HO-1), and nuclear factor erythroid 2-related factor 2 (Nrf2). Besides, Did also induced activation of PI3K/AKT. Conclusion: These findings indicated Did prevented DOX-induced cardiac injury and apoptosis via activating PI3K/AKT/Nrf2 signaling pathway.

Objective:To investigate the characteristics of newly diagnosed patients with chronic obstructive pulmonary disease (COPD) in Shenzhen primary care.Methods:Random sampling was conducted in 10 jurisdictions of Shenzhen, permanent residents who were over 40 years old and lived for more than 6 months were included for lung function test, COPD Population Screener (COPD-PS) questionnaire and information survey, the prevalence of COPD was estimated, and statistical comparison was made between the two groups of subjects with newly diagnosed and previously diagnosed COPD.Results:Among 3 916 subjects, 3 591 had completed the whole screening process. The results showed that 280 COPD patients were diagnosed and the estimated standardized prevalence of COPD was 5.92% (95% CI: 4.05-8.34). Among them, 251 (89.64%) were newly diagnosed COPD patients and 29 (10.36%) were previously diagnosed COPD patients. Compared with previously diagnosed COPD, the proportion of female in the newly diagnosed COPD was higher (50.20% vs 10.34%, P<0.001), educational level in the newly diagnosed COPD was lower (the proportion of primary school and below was higher, 42.23% vs 20.69%, P=0.023), the proportion of those with frequent wheezing symptoms in the newly diagnosed COPD was lower (4.78% vs 51.72%, P<0.001), the proportion of those with mild degree of airway obstruction (GOLD 1) in the newly diagnosed COPD was higher (81.67% vs 20.69%, P<0.001). The detection rates of COPD-PS in newly diagnosed COPD and previously diagnosed COPD were 43.03% and 41.38% respectively. The area under the receiver operating characteristic curve of COPD-PS was 0.705. Conclusion:The phenomenon of insufficient diagnosis of COPD in Shenzhen primary care is common and we should vigorously popularize pulmonary function examination.

Objective:To explore whether the adoption of high-flow nasal cannula (HFNC) as an initial oxygen therapy in emergency department (ED) could reduce the intubation rate and improve the clinical outcomes of patients with dyspnea and hypoxemia compared with conventional oxygen therapy (COT).Methods:A perspective single-center randomized controlled trial was conducted in the First Affiliated Hospital of Zhengzhou University from October 1, 2019 to September 30, 2020. A total of 210 eligible patients with acute dyspnea and hypoxemia in ED were recruited and randomized (in 1:1) to receive HFNC or COT for 1 h immediately after the grouping. The primary outcome was the rate of intubation within 24 h. The secondary outcomes included total intubation rate, escalation of breathing support method, patients’ disposition, length of ICU stay and hospital mortality. Continuous outcomes were analyzed by independent samples t test or Mann-Whitney U test according to the data distribution. Discontinuous outcomes were compared with the Chi-square test. Kaplan-Meier curve analysis was performed for 60-day survival. Results:Finally, 105 patients were recruited in each group. HFNC reduced the intubation rate within the first 24 h (4.8% vs. 14.3%, P = 0.019) and the rate of patients escalated to upgrade oxygen therapy (34.3% vs. 53.3%, P = 0.005), but did not affect the total intubation rate during the whole attendance ( P = 0.509). In ED, HFNC helped more patients to achieve the targeted saturation of pulse oxygen (90.5% vs. 78.1%, P = 0.02), and reduced respiratory rate (RR) to < 25 breaths per min (68.6% vs. 49.0%, P = 0.004), but did not affect the length of hospital stay, hospital mortality and 60-day survival rate ( P > 0.05). Conclusions:Initial application of HFNC in ED could reduce the intubation rate within 24 h, decrease the rate of escalation of oxygen therapy, improve oxygenation and relieve dyspnea.