ObjectiveTo explore the potential mechanism of Dingchuan Granule （定喘颗粒， DG） in the treatment of respiratory syncytial virus （RSV） pneumonia. MethodsA total of 60 male Sprague Dawley （SD） rats were randomly divided into control group， model group， ribavirin group， DG low-dose group， DG middle-dose group， and DG high-dose group， with 10 rats in each group. Except for the control group， rats were administrated with RSV via intranasal drip. After model establishment， the DG low-， middle-， and high-dose groups were administrated via oral gavage with DG at 3.47， 6.93， and 13.86 g/（kg·d） respectively， while the ribavirin group was administrated via oral gavage with ribavirin at 15.75 mg/（kg·d）. The drug was given once daily for one week. The rats in the control group and the model group were not given any drug， only subjected to the grasping action. Twenty-four hours after the last administration， the pathological changes of lung tissues were observed and scored using HE staining. The levels of serum inflammatory factors， including tumor necrosis factor-α （TNF-α）， interleukin-1β （IL-1β）， and interleukin-6 （IL-6）， were detected by colorimetry. The protein levels of nuclear factor （erythroid derived 2）-like 2 （Nrf2）， Kelch-like ECH-associated protein 1 （Keap1）， heme oxygenase 1 （HO-1）， and NAD（P）H quinone dehydrogenase 1 （NQO1） in lung tissues were measured by Western Blot. The RSV load as well as the gene expression levels of Nrf2， Keap1， HO-1， and NQO1 in lung tissues were determined by qRT-PCR. The level of reactive oxygen species （ROS） in rat lung tissues was detected using chemiluminescence. The levels of glutathione （GSH） and malondialdehyde （MDA） in rat lung tissues were measured by a microassay. ResultsCompared with the control group， other groups had significant increases in pathological score of lung tissue， RSV load， levels of ROS， MDA， serum TNF-α， IL-1β， and IL-6； decrease in GSH level， increases in expression level of Keap1 protein and its mRNA in lung tissue， and significant decrease in levels of Nrf2， HO-1， expression level of NQO1 protein and its mRNA （P＜0.05）. Compared with the model group， all the above-mentioned indicators in the DG low-， middle-， and high-dose groups and the ribavirin group were improved to varying degree （P＜0.05）. The levels of serum TNF-α， IL-1β， and IL-6 in rats of DG dose groups showed a dose-dependent pattern， the DG high-dose group exhibiting the best effect （P＜0.05）. The DG high-dose group was superior to the DG low- and middle-dose groups in reducing the levels of ROS and MDA， and increasing the level of GSH in lung tissues （P＜0.05）. The DG high-dose group and the ribavirin group had better effect than the DG middle-dose group in reducing the RSV load （P＜0.05）. The DG high-dose group was superior to the ribavirin group in improving the protein levels of Nrf2， Keap1， HO-1， and NQO1 （P＜0.05）. ConclusionDG could inhibit oxidative stress by regulating the Nrf2/Keap1/HO-1/NQO1 signaling pathway to improve pulmonary inflammation and treat RSV pneumonia， with the DG high-dose group showing the best effect.

Aim To investigate the effects of the fangchinoline derivative LYY-32 on the biological prop-erties of the BLM642-1290 DNA helicase,in order to lay a foundation for further research on its antitumor activity.Methods Fluorescence polarization assay,malachite green-phosphate and ammonium molybdate colorime-try,and fluorescein-labeled DNA gel electrophoresis experiments were conducted to study the effects of fangchinoline derivative LYY-32 on the DNA binding activity,ATPase activity,and DNA unwinding activity of BLM642-1290 DNA helicase.The effects of LYY-32 on the DNA unwinding activity of DNA helicase in cells were studied using fluorescent techniques and time-lapse microscopy.Ultraviolet spectral scanning was used to investigate the effects of LYY-32 on the confor-mation of the BLM642-1290 DNA helicase.Results At a concentration of 10 μmol·L-1,the inhibition rate of LYY-32 on BLM642-1290 DNA helicase binding to dsDNA was 53.17％.At a concentration of 5 μmol·L-1,the inhibition rate of LYY-32 on BLM642-1290 DNA helicase binding to ssDNA was 88.49％.The inhibition rate of LYY-32 on the ATPase activity of BLM642-1290 DNA he-licase was 89.3％at a concentration of 50 μmol·L-1.When the concentration of LYY-32 exceeded 5μmol·L-1,its inhibition rate on the DNA unwinding activity of BLM642-1290 DNA helicase was 100％.LYY-32 also significantly inhibited the DNA unwinding ac-tivity of DNA helicase in cells.However,LYY-32 had no effect on the conformation of BLM642-1290 DNA heli-case.Conclusion The DNA binding activity,AT-Pase activity,and DNA unwinding activity of BLM642-1290 DNA helicase could be significantly inhibi-ted by the fangchinoline derivative LYY-32.

Objective To investigate the differences and influencing factors of chronic heart failure(CHF)with qi deficiency and blood stasis syndrome and with other TCM syndrome types.Methods Totally 354 CHF patients from Dongzhimen Hospital of Beijing University of Chinese Medicine were enrolled from January 2019 to December 2023,including 242 cases of qi deficiency and blood stasis syndrome,52 cases of qi and yin deficiency and blood stasis syndrome,and 60 cases of yang qi deficiency and blood stasis syndrome.The general demographic sociological characteristics of patients with each syndrome type,the New York Heart Association cardiac function classification(NYHA classification),and the heart failure classification were collected.The cardiac function-related indexes and laboratory examination indicators were detected.The Minnesota Heart Failure Patients'Life Questionnaire(MLHFQ)was used to evaluate the quality of life of the patients in three areas:physical,emotional and other three domains.The differences of the above factors among patients with different syndrome types were compared,and a disordered multi-categorical logistics regression model of TCM syndrome types was constructed to analyze the association between the above factors and qi deficiency and blood stasis syndrome.Traditional Chinese Medicine Inheritance Calculation Platform 3.0 was used to analyze the frequency,property,taste and meridian tropism of prescription drugs.Results The proportion of patients with NYHAⅡ qi deficiency and blood stasis syndrome was higher than that of the group with qi and yin deficiency and blood stasis syndrome(P<0.05);the left ventricular ejection fraction in patients with yang qi deficiency and blood stasis pattern was significantly lower than that in patients with qi deficiency and blood stasis pattern(P<0.05);and the scores of the body domain,other domain and the total score of the MLHFQ questionnaire in patients with qi deficiency and blood stasis pattern were lower than those of the other two syndrome types(P<0.05);the serum neutrophils(NE%),C-reactive protein(CRP)and interleukin-6(IL-6)in the qi and yin deficiency and blood stasis syndrome were higher than those in the group with qi deficiency and blood stasis syndrome(P<0.05).Multivariate Logistics regression analysis showed that arrhythmia,CRP and IL-6 were independent influencing factors for CHF with qi deficiency and blood stasis syndrome(P<0.05).Totally 284 prescriptions were included,involving 190 kinds of Chinese materia medica.The top 10 were Astragali Radix,Ophiopogonis Radix,Lonicerae Japonicae Flos,Pseudostellariae Radix,Hordei Fructus Germinatus,Galli Gigerii Endothelium Corneumm,Puerariae Lobatue Radix,Scrophulariae Radix,Ziziphi Spinosae Semen and Citri Reticulatae Pericarpium.Conclusion Qi deficiency and blood stasis syndrome is a relatively stable stage of CHF,with cardiac function mainly distributed in grade Ⅱ,Ⅲ,with a relatively high proportion of heart failure with preserved ejection fraction,fewer other underlying diseases,lower inflammatory indicators,and relatively good quality of life.Combined arrhythmia,CRP and IL-6 indicators can be used as an auxiliary basis for syndrome differentiation of qi deficiency and blood stasis syndrome.

Objective:To investigate the knowledge, attitudes, practices (KAP), and demands of medical staff in family physician teams regarding the application of artificial intelligence (AI) in contracted services, and to analyze the influencing factors.Methods:A cross-sectional study was conducted from June to July 2023. A total of 602 medical staff members from family physician teams in Shanghai Minhang District were selected as subjects. Data on demographics (age, gender, institution, position, education, work experience, household registration, professional title, marital status, fertility status) and KAP/demand regarding AI application in contracted services were collected using a self-designed questionnaire. Intergroup differences were analyzed. Multiple stepwise linear regression was employed to identify the main factors influencing AI application demand.Results:Among the 602 participants, 484 (80.4%) were aged 30-49 years, 466 (77.40%) were females, 559 (92.9%) held a bachelor′s degree or higher, and 505 (83.9%) had intermediate or senior professional titles. The awareness rate for knowledge, positive attitude rate, and practice implementation rate regarding AI application were 47.2% (284/602), 73.1% (440/602), and 32.1% (193/602), respectively. The mean scores for knowledge, attitude, and practice were 15.72±3.40, 18.34±3.41, and 14.60±3.89, respectively. Significant differences were found among the items within each KAP dimension (knowledge: F=7.688, P<0.001; attitude: F=5.106, P<0.001; practice: F=6.763, P<0.001). Within knowledge, item K3 (awareness of intelligent elderly monitoring devices) scored lowest (3.00±0.79), differing significantly from K1, K2, K4, and K5 (all P<0.05). Within attitude, item A5 (willingness to fully trust AI′s accuracy and convenience in contracted services) scored lowest (3.57±0.75), differing significantly from A3 and A4 (all P<0.05). Within practice, item P3 (increasing reliance on AI in daily contracted services) scored lowest (2.79±0.93), differing significantly from P1 and P2 (all P<0.05). KAP scores differed significantly across demographic subgroups. Knowledge scores differed significantly by age, gender, and marital status (all P<0.05). Attitude scores differed significantly by gender, household registration, and fertility status (all P<0.05). Practice scores differed significantly by gender, position, and marital status (all P<0.05). Regarding demand, the most frequently selected areas were follow-up services (28.74%, 173/602), data management (26.25%, 158/602), and data collection (25.42%, 153/602). Univariate analysis identified age, gender, education, professional title, fertility status, and KAP scores as significant factors influencing AI application demand (all P<0.05). Multiple stepwise linear regression revealed that older age ( t=3.905, P<0.001), female gender ( t=3.548, P<0.001), and higher practice scores ( t=-3.044, P=0.002) were significant predictors of greater AI application demand. Conclusions:Significant variations exist in the KAP levels regarding AI application among family physician team members. Gender, age, and practice behavior significantly influence demand. Tailored strategies for different subgroups, coupled with timely targeted training and practical exercises, are recommended to enhance the effective and widespread adoption of AI technology in family physician contracted services.

Objective:This study evaluates the horizontal sound localization ability of young and middle-aged individuals with symmetric sensorineural hearing loss (SNHL) in noisy environments. It also examines the impact of hearing loss severity and signal-to-noise ratio (SNR) on localization accuracy.Methods:In this cross-sectional study, conducted from April 2023 to April 2024, 135 young and middle-aged patients (73 males and 62 females, aged 18-60 years) with SNHL who sought care at Beijing Chaoyang Hospital, were categorized into mild, moderate, and moderate-to-severe hearing loss groups (45 per group), with 45 normal-hearing controls (23 males and 22 females, aged 20-60 years). Participants completed localization tasks in quiet and noisy environments with SNR levels of 5 dB, 0 dB, -5 dB, and-10 dB. Root mean square error (RMSE) was used to measure localization accuracy. Repeated measures ANOVA assessed the effects of hearing loss and SNR on RMSE, while, Pearson correlation evaluated the relationship between binaural 4-frequency pure-tone average (4fPTA) and RMSE. Multiple linear regression analyzed the predictive role of 4fPTA and age.Results:(1) Two-way repeated measures ANOVA showed that both hearing loss severity and SNR significantly affected RMSE ( F=92.67, P<0.01; F=430.29, P<0.01), with a significant interaction between the two factors( F=92.67, P<0.01). (2) RMSE increased with hearing loss severity. At SNRs of 5 dB, 0 dB, and-5 dB, the moderate-to-severe group had significantly higher RMSE than the mild and moderate groups ( P<0.01). No significant differences were found between mild and moderate groups ( P=0.53, 0.57, 0.22). At-10 dB SNR, significant differences were observed across all groups ( P<0.01). (3) RMSE increased non-linearly as SNR decreased. Mean RMSE values under quiet conditions and at SNRs of 5 dB, 0 dB, -5 dB, and-10 dB were (7.43±5.01)°, (9.80±5.74)°, (11.60±6.22)°, (14.56±7.07)°, and (18.74±8.02)°, respectively. (4) RMSE was significantly positively correlated with binaural 4fPTA ( r=0.54-0.58, P<0.01). Multiple linear regression analysis indicated that the binaural average 4fPTA significantly predicted RMSE ( P<0.01), explaining 30.5%-34.1% of RMSE variance. Age did not significantly contribute to RMSE variation. Conclusions:The degree of hearing loss and background noise SNR significantly affect horizontal sound localization in young and middle-aged SNHL patients. RMSE increases with hearing loss severity and decreases with higher SNR. The interaction between hearing loss and SNR is significant, and RMSE correlates with binaural 4fPTA. However, the regression model based on 4fPTA and age explains only part of the RMSE variance, suggesting other contributing factors.

Objective:Committee of Minimally Invasive Cardiovascular Surgery(CMICS) conducts an annual summary of minimally invasive cardiovascular surgery procedures performed throughout the country, which includes a comprehensive survey of the total number of minimally invasive procedures by region and the distribution of minimally invasive procedures by hospital. Since CMICS first published the 2018-2019 China Minimally Invasive Cardiovascular Surgery Data White Paper in 2020, the report has received great attention from peers within and outside the industry. In this statistical report, CMICS will focus on publishing the data related to minimally invasive cardiovascular surgery in China from 2021 to 2023 for reference and use by industry peers.

Tuberculosis remains a significant global public health threat.Early diagnosis and effective treatment are crucial to combat this disease.Yet,traditional diagnostic methods for tuberculosis face limitations due to their low sensitivity,extended detection periods,and dependence on sputum samples.Molecular diagnostic techniques,while offering higher sensitivity,still primarily rely on sputum samples,thereby impeding significant advancements in tuberculosis diagnosis.In clinical settings,there exists a pressing demand for diagnostic approaches that are not solely reliant on sputum samples.In recent years,extracellular vesicles(EVs),as emerging biomarkers,have demonstrated substantial potential in various diseases,including tumors and infectious diseases.A multitude of studies indicate that EVs also exhibit potential in the field of tuberculosis.This review provides an in-depth analysis of the biological characteristics of EVs and their role in the pathogenesis of tuberculosis.It systematically summarizes the progress and significance of EV-based biomarkers in tuberculosis diagnosis,treatment monitoring,and disease mechanism exploration,while addressing the challenges and future prospects in this field.The aim is to offer valuable insights and up-to-date research findings to researchers and clinicians engaged in tuberculosis-related studies.

Objective:To explore the safety and efficacy of intraosseous regional administration (IORA) of vancomycin for preventing infection in primary total knee arthroplasty (TKA).Methods:A total of 124 patients with knee osteoarthritis undergoing TKA between February 2024 and May 2024 at nine hospitals were enrolled. Preoperative infection prophylaxis involved either IORA (0.5 g vancomycin administered via intraosseous regional infusion before incision) or intravenous infusion (1 g vancomycin via peripheral vein). The IORA group included 15 males and 47 females with a median age of 66.5 years (range, 60.0-70.0 years), while the intravenous group included 14 males and 48 females with a median age of 66.0 years (range, 61.8-70.3 years) years. Intraoperative samples were collected including fat and synovium tissues after incision, before prosthesis placement, and after tourniquet release; distal femoral cancellous bone during femoral osteotomy; proximal tibial cancellous bone during tibial osteotomy; proximal intercondylar cancellous bone before prosthesis placement; and peripheral blood from non-infused arms at surgery initiation and after tourniquet release. Vancomycin concentrations were measured using liquid chromatography-tandem mass spectrometry. Vital sign changes were recorded from admission to 5~10 minutes post-IORA (IORA group) or post-incision (intravenous group). Follow-ups were conducted on postoperative day 1 and 3, and at 1 and 3 months, to document complications including IORA-related adverse events, periprosthetic joint infections, surgical site infections, red man syndrome, acute kidney injury, deep vein thrombosis and so on.Results:Vancomycin concentrations in bone, fat, and synovial tissue samples were significantly higher in the IORA group than in the intravenous group ( P<0.05), while vancomycin concentrations in blood samples were significantly lower in the IORA group than in the intravenous group ( P<0.05). Only 7.3%(41/558) of tissue samples in the IORA group had vancomycin concentrations below 2.0 μg/g (the minimum inhibitory concentration of vancomycin against coagulase-negative staphylococcus), compared to 59.3%(331/558) in the intravenous group (χ 2=11.285, P<0.001). In the intravenous group, 16.9%(21/124) of blood samples had vancomycin concentrations exceeding 15.0 mg/L (the threshold associated with a significantly increased risk of nephrotoxicity), while all concentrations in the IORA group were below this threshold, the difference was statistically significant (χ 2=22.943, P<0.001). There were no statistically significant difference ( P>0.05) in vital signs changes before and after vancomycin administration between the two groups. Two patients in the intravenous group experienced incision exudate, while no other related complications occurred in either group. Conclusions:Compared to the traditional intravenous infusion of 1 g vancomycin, intraosseous injection of a low dose (0.5 g) of vancomycin achieves higher local tissue concentrations in the knee joint with a lower incidence of adverse reactions and is safe for infection prophylaxis. Despite guidelines not recommending the routine use of vancomycin for preventing infection after primary TKA, intraosseous injection of 0.5 g vancomycin may be considered intraoperatively for primary TKA in the following scenarios: patients in medical institutions with a high prevalence of methicillin-resistant staphylococcus aureus (MRSA) infections, patients with potential preoperative MRSA colonization, or patients with cephalosporin allergy.

Objective To evaluate the changes of bronchial mucosa observed by fiberoptic bronchoscopy after bronchial arterial embolization(BAE)treatment.Methods A total of 176 patients,who received BAE at the First Affiliated Hospital of Guangzhou Medical University of China from May 2019 to March 2024,were enrolled in this study.The pre-BAE and post-BAE bronchial mucosa was checked by fiberoptic bronchoscopy.Results Of the 176 patients,fiberoptic bronchoscopy showed no abnormal findings in 143 and showed abnormal findings in 33.All the abnormal findings were mucosal congestion and oedema,in some cases coexisting vascular bulge was seen,but no manifestations of ischemia or necrosis of the bronchial mucosa could be found.In 22 patients,the preoperative and postoperative 7-day fiberoptic bronchoscopy revealed that both preoperative and postoperative examinations showed no obvious abnormalities of the bronchial mucosa in 13 patients,preoperative examination had abnormalities of the bronchial mucosa in 9 patients,postoperative examination showed no obvious abnormalities of the bronchial mucosa in 3 patients,and in one patient the postoperative degree of bronchial mucosal congestion and oedema was significantly improved when compared with its preoperative degree.Conclusion BAE does not cause ischemic necrosis or shedding of bronchial mucosa,and BAE can reduce the degree of bronchial mucosal congestion in some patients.