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:Adolescent idiopathic scoliosis is a common spinal deformity that seriously affects the physical and mental health of patients.Modal analysis will focus on analyzing the natural vibration characteristics of the thoracic spine and its stability and response under the influence of external vibration.This analysis is expected to not only enhance the understanding of the thoracic curvature of adolescent idiopathic scoliosis,but also provide new perspectives and methods for developing new treatment strategies,designing personalized braces,and evaluating surgical outcomes.OBJECTIVE:To create a three-dimensional finite element model to evaluate the response modes of the entire thoracic spine and intervertebral discs in adolescent idiopathic scoliosis patients at different vibration frequencies,and determine the potential frequency range of injury risk.METHODS:This study was jointly conducted at the Sixth Affiliated Hospital of Xinjiang Medical University and the School of Mechanical Engineering at the Boda Campus of Xinjiang University from June 2023 to June 2024.The research subject was a patient with severe spinal and thoracic curvature.CT images were obtained using Siemens dual source spiral CT scanning,and a fine T1-T12 three-dimensional finite element model was established using software such as Mimics,Geomagic Studio,Solidworks,and Hypermesh.Abaqus software was used to perform modal analysis on the model and obtain the maximum amplitude and corresponding vibration modes of the first 12 modes of the entire thoracic spine and intervertebral disc.RESULTS AND CONCLUSION:(1)The modal analysis results showed that the entire thoracic vertebrae and intervertebral discs mainly bent and twisted around the X and Y axes in the lower order modes,while increasing rotation around the Z axis in the higher order modes.(2)The T1-T3 and T6-T8 segments showed the most significant deformation and higher load burden,indicating that these regions played a crucial role in the development of scoliosis.(3)When the natural frequency was concentrated between 98.832 to 121.97 cycles/s for a long time,the vibration displacement of the entire thoracic vertebrae and intervertebral discs was large,which might lead to spinal injury.(4)Through finite element modal analysis,this study provides a scientific basis for understanding the response of the entire thoracic spine and intervertebral discs in adolescent idiopathic scoliosis patients under various vibration frequencies,thereby offering crucial insights into clinical treatment,prevention,and particularly,vibration-related protective strategies.Furthermore,by identifying the potential frequency range of injury risk,this study provides an important basis for developing vibration protection measures and optimizing spinal care strategies for adolescent idiopathic scoliosis patients.

With the rising prevalence of chronic diseases and an aging population,China's traditional segmented health-care delivery model is increasingly inadequate for meeting the growing demand for long-term,systematic health management.In response,the"Physician-Pharmacist Co-management"model has emerged,aiming to enhance the quality and continuity of care through close collaboration between physicians and pharmacists.This paper starts from the concept and origin of"Physician-Phar-macist Co-management"model,focusing on its China-specific advantages shaped by national healthcare policies and clinical real-ities.Unlike the internationally recognized Collaborative Drug Therapy Management(CDTM)model,the Chinese approach re-flects local healthcare structures and needs.Using obstructive pulmonary disease(COPD)as a case study,we examine the mod-el's application and value in managing chronic respiratory diseases.Data indicate that,after the implementation of"physician-pharmacist co-management"model in COPD patients,the CAT score decreased by approximately 24％,the annual rate of acute exacerbation-related hospitalizations declined by about 72％,and the proportion of patients with regular pulmonary rehabilitation exercise habits increased by roughly 3.3-fold.Additionally,the percentage of patients without adverse reactions rose from 47.37％to 64.41％,and the vaccination rate increased by about 2.7-fold.These findings demonstrate the model's significant advantages in improving clinical outcomes,enhancing patient adherence,and reducing healthcare costs.Despite benefits,howev-er,the"Physician-Pharmacist Co-management"model in China faces several challenges,including limited public awareness,gaps in pharmacist training,and insufficient policy support.To address these challenges,this study recommends strengthening public education,establishing comprehensive evaluation systems for pharmaceutical professionals,and improving incentive mech-anisms.Overall,the findings suggest that the"Physician-Pharmacist Co-management"model holds considerable promise for im-proving the quality of chronic disease management,enhancing patient adherence,and optimizing healthcare resource utilization in China.

BACKGROUND:Adolescent idiopathic scoliosis is a common spinal deformity that seriously affects the physical and mental health of patients.Modal analysis will focus on analyzing the natural vibration characteristics of the thoracic spine and its stability and response under the influence of external vibration.This analysis is expected to not only enhance the understanding of the thoracic curvature of adolescent idiopathic scoliosis,but also provide new perspectives and methods for developing new treatment strategies,designing personalized braces,and evaluating surgical outcomes.OBJECTIVE:To create a three-dimensional finite element model to evaluate the response modes of the entire thoracic spine and intervertebral discs in adolescent idiopathic scoliosis patients at different vibration frequencies,and determine the potential frequency range of injury risk.METHODS:This study was jointly conducted at the Sixth Affiliated Hospital of Xinjiang Medical University and the School of Mechanical Engineering at the Boda Campus of Xinjiang University from June 2023 to June 2024.The research subject was a patient with severe spinal and thoracic curvature.CT images were obtained using Siemens dual source spiral CT scanning,and a fine T1-T12 three-dimensional finite element model was established using software such as Mimics,Geomagic Studio,Solidworks,and Hypermesh.Abaqus software was used to perform modal analysis on the model and obtain the maximum amplitude and corresponding vibration modes of the first 12 modes of the entire thoracic spine and intervertebral disc.RESULTS AND CONCLUSION:(1)The modal analysis results showed that the entire thoracic vertebrae and intervertebral discs mainly bent and twisted around the X and Y axes in the lower order modes,while increasing rotation around the Z axis in the higher order modes.(2)The T1-T3 and T6-T8 segments showed the most significant deformation and higher load burden,indicating that these regions played a crucial role in the development of scoliosis.(3)When the natural frequency was concentrated between 98.832 to 121.97 cycles/s for a long time,the vibration displacement of the entire thoracic vertebrae and intervertebral discs was large,which might lead to spinal injury.(4)Through finite element modal analysis,this study provides a scientific basis for understanding the response of the entire thoracic spine and intervertebral discs in adolescent idiopathic scoliosis patients under various vibration frequencies,thereby offering crucial insights into clinical treatment,prevention,and particularly,vibration-related protective strategies.Furthermore,by identifying the potential frequency range of injury risk,this study provides an important basis for developing vibration protection measures and optimizing spinal care strategies for adolescent idiopathic scoliosis patients.

With the rising prevalence of chronic diseases and an aging population,China's traditional segmented health-care delivery model is increasingly inadequate for meeting the growing demand for long-term,systematic health management.In response,the"Physician-Pharmacist Co-management"model has emerged,aiming to enhance the quality and continuity of care through close collaboration between physicians and pharmacists.This paper starts from the concept and origin of"Physician-Phar-macist Co-management"model,focusing on its China-specific advantages shaped by national healthcare policies and clinical real-ities.Unlike the internationally recognized Collaborative Drug Therapy Management(CDTM)model,the Chinese approach re-flects local healthcare structures and needs.Using obstructive pulmonary disease(COPD)as a case study,we examine the mod-el's application and value in managing chronic respiratory diseases.Data indicate that,after the implementation of"physician-pharmacist co-management"model in COPD patients,the CAT score decreased by approximately 24％,the annual rate of acute exacerbation-related hospitalizations declined by about 72％,and the proportion of patients with regular pulmonary rehabilitation exercise habits increased by roughly 3.3-fold.Additionally,the percentage of patients without adverse reactions rose from 47.37％to 64.41％,and the vaccination rate increased by about 2.7-fold.These findings demonstrate the model's significant advantages in improving clinical outcomes,enhancing patient adherence,and reducing healthcare costs.Despite benefits,howev-er,the"Physician-Pharmacist Co-management"model in China faces several challenges,including limited public awareness,gaps in pharmacist training,and insufficient policy support.To address these challenges,this study recommends strengthening public education,establishing comprehensive evaluation systems for pharmaceutical professionals,and improving incentive mech-anisms.Overall,the findings suggest that the"Physician-Pharmacist Co-management"model holds considerable promise for im-proving the quality of chronic disease management,enhancing patient adherence,and optimizing healthcare resource utilization in China.

Objective To investigate the neuroprotective effect and mechanism of salvia polyphenolic acid for injection (SAFI) on cerebral ischemia-reperfusion injury in rats. Methods A total of 100 SD rats were randomly divided into sham surgery group,model group,low-,medium-and high-dose (5,10,20 mg·kg-1) salvia polyphenolic acid groups,with 20 rats in each group. After being continuously administrated by intraperitoneal injection of SAFI once daily for three days,the rat model of middle cerebral artery occlusion/reperfusion (MCAO/R) was established using the thread embolization method at 1 hour after the last administration. The neurological deficit of rats was evaluated by Zea Longa score. The cerebral infarction volume was detected by 2,3,5-triphenyltetrazolium chloride(TTC) staining. The levels of serum NADPH oxidase(NOX),4-hydroxynonanal(4-HNE),8-hydroxydeoxyguanosine (8-OHdG),monocyte chemoattractant protein-1 (MCP-1),tumor necrosis factor-α(TNF-α),interleukin-1β(IL-1β),interleukin-18(IL-18),interleukin-6(IL-6),and intercellular adhesion molecule-1 (ICAM-1) were detected by ELISA kits. Hematoxylin-eosin (HE) staining and Nissl staining were used to observe the pathological changes of brain tissue and the morphology of neurons. The apoptosis of neuronal cells in brain tissue was detected by TUNEL. Immunofluorescence staining was used to detect the expression level of glial fibrillary acidic protein (GFAP) in brain tissue. Western Blot was used to detect the protein expression of NLRP3 and Caspase1 in brain tissue. Results Compared with the sham surgery group,neurological deficit scores in model group increased remarkably (P<0.01). The cerebral infarction volume increased significantly (P<0.01). Serious pathological damage of brain was observed,and neuronal density decreased significantly(P<0.01). The apoptosis rate of cortical cells increased obviously (P<0.01). The levels of serum NOX,4-HNE,8-OHdG,MCP-1,TNF-α,IL-1β,IL-18,IL-6 and ICAM-1 increased significantly (P<0.05,P<0.01). The protein expression of GFAP,NLRP3 and Caspase1 in brain significantly upregulated (P<0.01). Compared with the model group,neurological deficit scores in medium-and high-dose SAFI groups decreased remarkably (P<0.01). The cerebral infarction volume decreased significantly (P<0.01). Neuronal damage was ameliorated to varying degrees,and neuronal density increased significantly(P<0.05,P<0.01). The apoptosis rate of cortical cells decreased obviously (P<0.01). The levels of serum NOX,4-HNE,8-OHdG,MCP-1,TNF-α,IL-1β,IL-18,IL-6 and ICAM-1 decreased significantly (P<0.05,P<0.01). The protein expression of GFAP,NLRP3 and Caspase1 in brain significantly downregulated(P<0.01). Conclusion SAFI has a protective effect on MCAO/R rats,which can significantly reduce oxidative stress and inflammatory responses,thereby reducing pathological damage and apoptosis of brain tissue. Its mechanism may be related to the inhibition of NLRP3/Caspase-1 signaling pathway and astrocyte activation.

With the increasing diversification of family structures and fertility patterns,more and more unmarried women choose to have children alone.This new fertility model has aroused widespread discussion and controversy in society.Given the current situation and related research on single women's fertility,the paper discussed the issues,such as Bianchin's utility theory and feminist theory,the change in the views of marriage and fertility,the social problems existing in the clinical application of frozen eggs and assisted reproductive technology(ART),as well as the protection of offspring's rights and interests.It also proposed legal and policy recommendations and countermeasures to regulate frozen eggs and ART techniques,safeguard reproductive rights,and protect offspring's rights and interests,with a view to providing ideas for the study of fertility policies for single women.

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.

Objective To analyze the awareness rate and treatment and control rate of hypertension as well as the related influencing factors among residents aged 35-75 years in Chongqing, and to provide a reference for comprehensive prevention and control of hypertension. Methods Residents between the ages of 35 and 75 years old were recruited from 8 sites of China Patient-centered Evaluative Assessment of Cardiac Events in Chongqing. All participants were interviewed with structured questionnaires, and physical examination, glucose test and lipid test were performed. The data were analyzed by SPSS 25.0. The differences in the rates of awareness, treatment and control of hypertension of different populations were compared by chi-square test. The related factors influencing the rates of awareness, treatment and control of hypertension were identified by step backward bivariate multivariate logistic regression model. Results A total of 101 036 cases were recruited into this study. The prevalence rates of dyslipidemia, hypertension and diabetes were 31.48%, 40.80% and 17.16%, respectively. The age standardized prevalence rates of dyslipidemia, hypertension and diabetes were 30.81%, 33.91% and 14.35%, respectively. The rates of awareness, treatment and control of hypertension were 45.65%, 36.03% and 11.60%, respectively. The result of multivariate logistic regression analysis indicated that factors including age, household registration, occupation, alcohol use, smoking status, body weight, central obesity, diabetes, and dyslipidemia were related to the awareness rate of hypertension. Factors including age, household registration, race, household income, alcohol use, body weight, central obesity, diabetes, and dyslipidemia were related to the treatment rate of hypertension. Factors including age, household registration, household income, alcohol use, central obesity and diabetes were related to the rate of blood pressure control. Conclusion The prevalence of hypertension was high in Chongqing, but the rate of awareness, treatment and control of hypertension was low. It is suggested that comprehensive measures should be implemented to raise the rate of awareness, treatment and control of hypertension for the prevention and control of hypertension.

ObjectiveTo investigate the efficacy and safety of SpyGlass system combined with electrohydraulic lithotripsy during endoscopic retrograde cholangiopancreatography (ERCP) in the treatment of difficult common bile duct stones. MethodsA total of 20 patients who used the SpyGlass system combined with electrohydraulic lithotripsy during ERCP for the treatment of difficult common bile duct stones in Department of Hepatobiliary Surgery, The First Affiliated Hospital of Chongqing Medical University, from December 2019 to May 2020 were enrolled. Liver function, blood amylase, and blood lipase were measured after surgery; the patients were observed in terms of body temperature, abdominal pain, hematobilia, infection, and perforation; the presence or absence of residual common bile duct stones was reexamined after surgery. ResultsOf all 20 patients, 18 underwent successful lithotripsy on the first attempt without serious complications, and 2 underwent ERCP-guided basket extraction and biliary tract cleaning with balloon due to residual stones found in the reexamination after surgery and achieved complete removal of stones. No biliary tract perforation or massive hemorrhage was observed; there was mild pancreatitis after surgery, which was improved after pharmacotherapy; some patients had increased levels of blood amylase and lipase, without any clinical symptom; there was a significant improvement in liver function after surgery. Abdominal color Doppler ultrasound performed for all patients at 3 months after cholecystolithotomy showed no residual common bile duct stones. ConclusionSpyGlass system combined with electrohydraulic lithotripsy during ERCP has a high first-attempt success rate of complete removal of stones in the treatment of difficult common bile duct stones, without marked surgical complications.