Objective To investigate the value of hs-cTnT in predicting all-cause death in the elderly with SCAD.Methods A prospective cohort observation study was conducted on 274 old adults with SCAD hospitalized in our department from January 2016 to January 2019.Their hs-cTnT level was measured,and according to the results,they were divided into lower(≤13.0 ng/L,94 cases),middle(14.0-22.0 ng/L,94 cases)and upper(≥23.0 ng/L,86 cases)tertile groups.The general clinical data were compared among the three groups.Kaplan-Meier survival curve was drawn to analyze the survival differences among groups.Cox proportional hazards regression analysis was applied to identify risk factors for mortality.ROC curve analysis was applied to evaluate the predictive value of hs-cTnT for all-cause mortality.Results During a me-dian follow-up period of 32 months,62(22.63％)patients died among the 274 patients,account-ing for 75.8％dying of non-cardiovascular diseases.There were statistically differences in the three tertile groups in terms of age,male ratio,proportions of hypertension,chronic obstructive pulmonary disease and chronic kidney disease,number of comorbidities,estimated glomerular fil-tration rate,albumin and hemoglobin levels,left ventricular ejection fraction,left ventricular mass index,and mortality rate(P＜0.05,P＜0.01).COX proportional hazards regression model showed the upper tertile group had significantly lower cumulative survival rate than the middle and lower tertile groups(Plog rank＜0.01).Multivariate Cox proportional hazards regression analysis indicated that hs-cTnT≥23.0 ng/L level was still a risk factor for death in both model 2(HR=3.749,95％CI:1.703-8.256,P=0.001)and model 3(HR=2.990,95％CI:1.358-6.581,P=0.007).ROC curve analysis revealed that the AUC value of hs-cTnT level in predicting death was 0.736,with a cut-off value of 25 ng/L.Conclusion For elderly SCAD patients,despite the existence of multiple comorbidities and the priority of non-cardiovascular death,hs-cTnT,a marker reflecting myocar-dial injury,is still a predictor for risk of death in the population.

Objective To explore the effect of high-sensitivity cardiac troponin T(hs-cTnT)and frailty on all-cause mortality risk in elderly inpatients without acute coronary syndrome(ACS).Methods A prospective cohort study was conducted on 613 non-ACS inpatients admitted to our department from June 2015 to December 2019.According to the tertile fo hs-cTnT level,the patients were divided into the low hs-cTnT group(＜13 ng/L,n=184),median hs-cTnT group(13-19 ng/L,n=226),high hs-cTnT group(＞19 ng/L,n=203).Based on the results of Fried frailty scale,they were also assigned into a non-frail group(n=410)and a frail group(n=203).So,there were six groups,that is,low hs-cTnT and non-frail group(n=139),low hs-cTnT with frailty group(n=45),median hs-cTnT and non-frail group(n=172),median hs-cTnT with frail-ty group(n=54),high hs-cTnT and non-frail group(n=99),and high hs-cTnT with frailty group(n=104).Baseline clinical data were collected in all the patients.All of them were followed for 2 years to observe all-cause mortality.The effects of hs-cTnT and frailty on mortality risk were analyzed.The predictive value of hs-cTnT combined with Fried frailty classification for mortality was evaluated.Results During the 2-year follow-up,83(13.5％)all-cause deaths occurred.Cox regression analysis revealed that after adjustment for confounders,the high hs-cTnT and non-frail group had increased mortality risk than the low hs-cTnT and non-frail group(HR=3.005,95％CI:1.171-7.711,P=0.022),while the high hs-cTnT with frailty group had the high-est risk(HR=4.470,95％CI:1.775-11.255,P=0.001).ROC curve analysis demonstrated that an AUC value of hs-cTnT,Fried frailty score and their combination in predicting mortality was 0.694(95％CI:0.656-0.730,P＜0.01),0.669(95％CI:0.631-0.707,P＜0.01),and 0.723(95％CI:0.686-0.758,P＜0.01),respectively.Conclusion For the elderly non-ACS inpatients,those with hs-cTnT elevation and frailty are at the highest risk for all-cause mortality.The combination of hs-cTnT and Fried frailty score demonstrates higher predictive value than either indicator alone.

Objective To explore the relationship between triglyceride-glucose(TyG)index and hypertension in patients with cerebral hemorrhage.Methods A total of 1718 patients with cere-bral hemorrhage admitted to our hospital from January,2013 to May,2023 were enrolled in this study.According to the TyG index quartile,437 cases were assigned into Q1 group(≤8.375),424 cases into Q2 group(TyG index 8.376～8.737),429 cases into Q3 group(TyG index 8.738～9.087),and 428 cases into Q4 group(≥9.088).The general clinical data were compared in the four groups.Logistic regression analysis was used to study the correlation between TyG index and hy-pertension.Results There were significant differences among the four groups in terms of age,hy-pertension,diabetes,SBP,DBP,TC,TG,HDL-C,LDL-C,FBG,glycated hemoglobin and TyG in-dex(P＜0.05,P＜0.01).Logistic regression analysis showed that when the TyG index was a con-tinuous variable,it was significantly correlated with the risk of hypertension(OR=1.999,95％CI:1.393-2.869,P=0.001).When the index was used as a categorical variable,with Q1as a ref-erence,TyG index in Q3 and Q4 was associated with an increase in OR of hypertension(OR=1.869,95％CI:1.220-2.865,P=0.004;OR=1.844,95％CI:1.125-3.020,P=0.015).After ad-justing cofounders,the association of TyG index and risk of hypertension was stronger in the fe-males(OR=2.618,95％CI:1.312-5.221,P=0.006)than the males(OR=1.783,95％CI:1.151-2.761,P=0.010),and in the patients ≥65 years old(OR=3.277,95％CI:1.600-6.741,P=0.001)than those＜65 years old(OR=1.782,95％CI:1.076-2.949,P=0.025).Conclusion TyG index is closely associated with hypertension in patients with cerebral hemorrhage,especially in women and elderly.

Objective To explore the relationship between triglyceride-glucose(TyG)index and hypertension in patients with cerebral hemorrhage.Methods A total of 1718 patients with cere-bral hemorrhage admitted to our hospital from January,2013 to May,2023 were enrolled in this study.According to the TyG index quartile,437 cases were assigned into Q1 group(≤8.375),424 cases into Q2 group(TyG index 8.376～8.737),429 cases into Q3 group(TyG index 8.738～9.087),and 428 cases into Q4 group(≥9.088).The general clinical data were compared in the four groups.Logistic regression analysis was used to study the correlation between TyG index and hy-pertension.Results There were significant differences among the four groups in terms of age,hy-pertension,diabetes,SBP,DBP,TC,TG,HDL-C,LDL-C,FBG,glycated hemoglobin and TyG in-dex(P＜0.05,P＜0.01).Logistic regression analysis showed that when the TyG index was a con-tinuous variable,it was significantly correlated with the risk of hypertension(OR=1.999,95％CI:1.393-2.869,P=0.001).When the index was used as a categorical variable,with Q1as a ref-erence,TyG index in Q3 and Q4 was associated with an increase in OR of hypertension(OR=1.869,95％CI:1.220-2.865,P=0.004;OR=1.844,95％CI:1.125-3.020,P=0.015).After ad-justing cofounders,the association of TyG index and risk of hypertension was stronger in the fe-males(OR=2.618,95％CI:1.312-5.221,P=0.006)than the males(OR=1.783,95％CI:1.151-2.761,P=0.010),and in the patients ≥65 years old(OR=3.277,95％CI:1.600-6.741,P=0.001)than those＜65 years old(OR=1.782,95％CI:1.076-2.949,P=0.025).Conclusion TyG index is closely associated with hypertension in patients with cerebral hemorrhage,especially in women and elderly.

Objective To investigate the value of hs-cTnT in predicting all-cause death in the elderly with SCAD.Methods A prospective cohort observation study was conducted on 274 old adults with SCAD hospitalized in our department from January 2016 to January 2019.Their hs-cTnT level was measured,and according to the results,they were divided into lower(≤13.0 ng/L,94 cases),middle(14.0-22.0 ng/L,94 cases)and upper(≥23.0 ng/L,86 cases)tertile groups.The general clinical data were compared among the three groups.Kaplan-Meier survival curve was drawn to analyze the survival differences among groups.Cox proportional hazards regression analysis was applied to identify risk factors for mortality.ROC curve analysis was applied to evaluate the predictive value of hs-cTnT for all-cause mortality.Results During a me-dian follow-up period of 32 months,62(22.63％)patients died among the 274 patients,account-ing for 75.8％dying of non-cardiovascular diseases.There were statistically differences in the three tertile groups in terms of age,male ratio,proportions of hypertension,chronic obstructive pulmonary disease and chronic kidney disease,number of comorbidities,estimated glomerular fil-tration rate,albumin and hemoglobin levels,left ventricular ejection fraction,left ventricular mass index,and mortality rate(P＜0.05,P＜0.01).COX proportional hazards regression model showed the upper tertile group had significantly lower cumulative survival rate than the middle and lower tertile groups(Plog rank＜0.01).Multivariate Cox proportional hazards regression analysis indicated that hs-cTnT≥23.0 ng/L level was still a risk factor for death in both model 2(HR=3.749,95％CI:1.703-8.256,P=0.001)and model 3(HR=2.990,95％CI:1.358-6.581,P=0.007).ROC curve analysis revealed that the AUC value of hs-cTnT level in predicting death was 0.736,with a cut-off value of 25 ng/L.Conclusion For elderly SCAD patients,despite the existence of multiple comorbidities and the priority of non-cardiovascular death,hs-cTnT,a marker reflecting myocar-dial injury,is still a predictor for risk of death in the population.

Objective To explore the effect of high-sensitivity cardiac troponin T(hs-cTnT)and frailty on all-cause mortality risk in elderly inpatients without acute coronary syndrome(ACS).Methods A prospective cohort study was conducted on 613 non-ACS inpatients admitted to our department from June 2015 to December 2019.According to the tertile fo hs-cTnT level,the patients were divided into the low hs-cTnT group(＜13 ng/L,n=184),median hs-cTnT group(13-19 ng/L,n=226),high hs-cTnT group(＞19 ng/L,n=203).Based on the results of Fried frailty scale,they were also assigned into a non-frail group(n=410)and a frail group(n=203).So,there were six groups,that is,low hs-cTnT and non-frail group(n=139),low hs-cTnT with frailty group(n=45),median hs-cTnT and non-frail group(n=172),median hs-cTnT with frail-ty group(n=54),high hs-cTnT and non-frail group(n=99),and high hs-cTnT with frailty group(n=104).Baseline clinical data were collected in all the patients.All of them were followed for 2 years to observe all-cause mortality.The effects of hs-cTnT and frailty on mortality risk were analyzed.The predictive value of hs-cTnT combined with Fried frailty classification for mortality was evaluated.Results During the 2-year follow-up,83(13.5％)all-cause deaths occurred.Cox regression analysis revealed that after adjustment for confounders,the high hs-cTnT and non-frail group had increased mortality risk than the low hs-cTnT and non-frail group(HR=3.005,95％CI:1.171-7.711,P=0.022),while the high hs-cTnT with frailty group had the high-est risk(HR=4.470,95％CI:1.775-11.255,P=0.001).ROC curve analysis demonstrated that an AUC value of hs-cTnT,Fried frailty score and their combination in predicting mortality was 0.694(95％CI:0.656-0.730,P＜0.01),0.669(95％CI:0.631-0.707,P＜0.01),and 0.723(95％CI:0.686-0.758,P＜0.01),respectively.Conclusion For the elderly non-ACS inpatients,those with hs-cTnT elevation and frailty are at the highest risk for all-cause mortality.The combination of hs-cTnT and Fried frailty score demonstrates higher predictive value than either indicator alone.

Objective To reveal the pharmacodynamic material basis of Kaixinsan by using high performance liquid chromatography-tandem mass spectrometry(HPLC-MS/MS)and the integrated analysis of"chemical component spectrum-plasma exposure component spectrum-mitochondrial function".Methods Through a review of literature,databases,and previous studies,the chemical components of ginseng,polygala,poria,and acorus were systematically cataloged.A qualitative analysis method for the chemical constituents in the aqueous extract of Kaixinsan was developed,allowing for the identification of its chemical components.A qualitative analysis for rat plasma based on HPLC-MS/MS was established,which was applied to analyze the plasma exposure component spectrum following oral administration of Kaixinsan aqueous extract in rats.Aerobic respiration was evaluated using a seahorse cell energy metabolism analyzer,and the effect of key components of Kaixinsan on mitochondrial aerobic respiration was assessed.Results Four main types of components were identified in the Kaixinsan aqueous extract,including saponins,oligosaccharide esters,xanthones,and triterpenes,comprising a total of 231 identified compounds.Analysis of rat plasma 30 minutes after gavage with Kaixinsan identified 55 compounds.The analysis revealed that ginsenoside Rg1,3,6'-disinapoylsucrose,polygalaxanthone Ⅲ and poricoic acid B could significantly enhance mitochondrial respiratory capacity using in vitro cellular assays to detect aerobic respiration of four main components entered blood.Conclusions Saponins,oligosaccharide esters,xanthones,and triterpenes may be the material basis for the pharmacological effect of Kaixinsan by improving mitochondrial function.The integrated analysis of"chemical component spectrum-plasma exposure component spectrum-mitochondrial function"provides a new approach for in-depth exploration of the material basis underlying the efficacy of traditional Chinese medicine.

ObjectiveTo explore the possible mechanism of the Yiqi Jiedu formula （YQ） in treating ischemic stroke （IS） from the perspective of the microbial-gut-brain axis （MGBA）. MethodRats were randomly divided into five groups， with six in each group， including sham surgery group， model group， and low， medium， and high dose YQ groups （1， 5， and 25 mg·kg^-1）. Except for the sham surgery group， all other groups were established with a middle cerebral artery occlusion （MCAO） model using the thread occlusion method. The success of modeling was determined through neurobehavioral scoring， and the protective effect of YQ on IS was evaluated. Then， the changes in gut microbiota before and after MCAO modeling and YQ administration were compared using 16S rDNA sequencing technology， and the possible biological pathways related to the effect of this formula were analyzed. The expression of inflammatory factors such as interleukin-6 （IL-6）， interleukin-17A （IL-17A）， and interleukin-10 （IL-10） in serum was detected by enzyme-linked immunosorbent assay （ELISA）. Western blot was used to detect the expression of tight junction proteins ZO-1 and Occludin in brain and intestinal tissue， and hematoxylin-eosin staining （HE） was used to observe pathological changes in the cerebral cortex and colon， so as to validate the possible mechanism of action. ResultYQ significantly improved the neurobehavioral score of MCAO rats （P<0.01） and played a good regulatory role in intestinal microbial disorders caused by enriched pathogens and opportunistic pathogens during the acute phase. Among them， significantly changed microorganisms include Morgentia， Escherichia Shigella， Adlercreutzia， and Androbacter. Bioinformatics analysis found that these bacteria may be related to the regulation of inflammation in the brain. Compared with the blank group， the detection of inflammatory factors in the serum of IS model rats showed an increase in inflammatory factors IL-6 and IL-17A （P<0.01） and a decrease in the content of anti-inflammatory factor IL-10 （P<0.01）. Compared with the model group， the content of inflammatory factors IL-6 and IL-17A in the serum of the treatment group decreased （P<0.05）， and that of anti-inflammatory factor IL-10 increased （P<0.01）. The expression results of barrier proteins ZO-1 and Occludin in brain and intestinal tissue showed that the expression levels of both decreased in IS model rats （P<0.05）， while the expression levels of both increased in the treatment group （P<0.05）. ConclusionAcute cerebral ischemia can lead to an imbalance of intestinal microbiota and damage to the intestinal barrier， and it can increase intestinal permeability. YQ can regulate intestinal microbiota imbalance caused by ischemia， inhibit systemic inflammatory response， and improve the disruption of the gut-blood brain barrier， preventing secondary cascade damage to brain tissue caused by inflammation. The MGBA may be an important mechanism against the IS.

ObjectiveTo investigate the mechanism of neferine（Nef） in promoting vascular regeneration against cerebral ischemia through modulation of mitochondrial calcium uniporter（MCU） ion channel. MethodTaking the area of subintestinal vessels in microvascular deficiency zebrafish as an index， the vascular regenerative efficacy of Nef was evaluated， and the median effective concentration（EC₅₀） was calculated. Rats were randomly divided into a sham operation group， a model group， a positive drug group（butylphthalide， 6 mg·kg^-1）， and Nef low， medium， and high dose groups（0.125， 0.625， 3.125 μg·kg^-1）. Except for the sham operation group， the middle cerebral artery occlusion（MCAO） model was established in other groups. After modeling， the groups were administered the corresponding dose of drugs by gavage， while the sham operation and model groups received equal volumes of saline， once a day for 7 consecutive days. Neurobehavioral scores were assessed for each group of rats， and the infarct rate of ischemic brain tissue was calculated by 2，3，5-triphenyltetrazolium chloride（TTC） staining. The regional cerebral blood flow（rCBF） of each group was measured using a speckle contrast imaging. Immunofluorescence and Western blot were conducted to detect the expression of vascular endothelial growth factor（VEGF）， platelet endothelial cell adhesion molecule-1（CD31）， and hypoxia-inducible factor-1α（HIF-1α） proteins in each group. Human umbilical vein endothelial cells（HUVECs） were divided into the normal group， model group， positive drug group（astragaloside Ⅳ， 10 μmol·L^-1）， and Nef group （32 nmol·L^-1）. In the verification of mitochondrial protection of Nef and its mechanism in promoting vascular regeneration， the spermine（MCU agonist） and Nef+spermine group were added. HUVECs model of oxygen-glucose deprivation（OGD） was established in all groups except the normal group， the cell viability was assessed using 3-（4，5-dimethylthiazol-2-yl）-2，5-diphenyltetrazolium bromide（MTT） assay， and cell migration ability was evaluated through scratch and tube formation assays. Fluorescent probes（Rhod-2 AM， Fluo-3 AM， JC-1， Calcein AM） and a cellular energy metabolism analyzer were used to analyze the mitochondrial protective effects of Nef. Molecular docking was performed to predict the binding ability of Nef with MCU and HIF-1α， and Western blot was used to detect the effects of Nef on the protein expressions of MCU， B-cell lymphoma-2 associated X protein（Bax）， Caspase-3 and HIF-1α in the OGD model HUVECs. ResultThe results of vascular regeneration in microvascular deficiency zebrafish showed that compared to the normal group， the area of subintestinal vessels in the model group significantly decreased（P<0.01）. Compared to the model group， different concentrations of Nef could significantly increase the area of subintestinal vessels（P<0.01）， with the maximum tolerated concentration of 10.24 μmol·L^-1 and the EC₅₀ of 0.23 μmol·L^-1. Anti-cerebral ischemia results on MCAO rats showed that compared to the sham operation group， the model group had a significant decrease in rCBF and a significant increase in infarct rate， while CD31 expression significantly decreased（P<0.01）， and VEGF and HIF-1α protein expressions significantly increased（P<0.05）. Compared to the model group， the treated groups showed significant increases in rCBF， significant reductions in infarct volume， and significant increases in CD31， VEGF， and HIF-1α protein expression（P<0.01）. Cell experiment results showed that compared to the normal group， the model group had decreased cell viability and migration ability， increased intracellular Ca²⁺ and mitochondrial Ca²⁺ levels， reduced mitochondrial permeability transition pore（MPTP） opening， and decreased mitochondrial energy metabolism capability， with increased expressions of MCU， Bax， Caspase-3 and HIF-1α proteins（P<0.05， P<0.01）. Compared to the model group， the Nef group showed increased cell viability and migration ability， decreased intracellular Ca²⁺ and mitochondrial Ca²⁺ levels， increased MPTP opening， enhanced mitochondrial energy metabolism capability， decreased expressions of MCU， Bax and Caspase-3 proteins， and increased HIF-1α protein expression（P<0.05， P<0.01）. ConclusionNef can stabilize mitochondrial membrane potential and inhibit mitochondrial apoptosis. By down-regulating the expression of MCU， it suppresses the activation of intracellular Bax and Caspase-3 while activating the HIF-1α signaling pathway， enhancing the expression of VEGF and CD31， thereby promoting vascular regeneration to treat ischemic brain injury.

Objective:To compare the effects of different test meals on postprandial triglycerides and to optimize the standard meal composition and the blood sampling protocol for the oral fat tolerance test.Methods:This study is a prospective, open-label, randomized, cross-over trial. In March 2023, 36 volunteers were recruited in Hebei General Hospital. They underwent a health examination and oral glucose tolerance test. Twenty-six healthy volunteers(11 males and 15 females) were included in this study, with an average age of(39.08±4.56) years. Each volunteer received 75 g protein meal, 75 g fat meal, 700 kcal fixed-calorie high-fat mixed meal, and a high-fat mixed meal with energy adjusted based on 10 kcal/kg body weight. A one-week washout period of regular diet was applied before each trial. Blood was collected at fasting status and 1, 2, 3, 4, 5, and 6 hours after a meal to detect serum triglycerides, total cholesterol, low density lipoprotein-cholesterol(LDL-C), high density lipoprotein-cholesterol(HDL-C), glucose, and insulin. The variations of postprandial metabolic indicators over time following the consumption of different test meals were analyzed. The disparities in postprandial metabolic responses between the two types of mixed meals were compared.Results:The protein meal, fat meal, fixed-calorie high-fat mixed meal, and adjusted-calorie high-fat mixed meal resulted in postprandial triglyceride increases of 22.45%, 115.40%, 77.14%, and 63.63%, and insulin increase of 560.43%, 85.69%, 554.18%, and 598.97%, respectively, and with reductions in total cholesterol, LDL-C, and HDL-C ranging from 5.64%-21.81%, respectively. The blood glucose changed slightly. Changes in metabolic indicators mainly occured within 4 hours. The comparison of the characteristics of postprandial triglycerides between the two high-fat mixed meals showed no statistically significant differences( P>0.05). Conclusion:A standardize protocol with a 700 kcal fixed-calorie high-fat mixed meal as test meal, and blood lipid levels measured at fasting and at 1, 2, 3, and 4 hours after consumption, can serve as an optimized approach for oral fat tolerance test.