Objective To investigate the effects and mechanisms of modified Taohong Siwu Decoction on myocardial ischemia-reperfusion injury in rats based on transcriptome sequencing.Methods Totally 15 SPF rats were randomly divided into sham-operation group,model group and modified Taohong Siwu Decoction group,with 5 rats in each group.The modified Taohong Siwu Decoction group was pre-administered with modified Taohong Siwu Decoction by gavage for 5 days,while the sham-operation group and model group were given equal volume of distilled water by gavage,myocardial ischemia-reperfusion injury rat model was established.The cardiac function of the rats was assessed using echocardiography,serum oxidative stress and inflammatory factor contents were detected using reagent kits,TUNEL staining was used to detect myocardial cell apoptosis,transcriptome sequencing was performed on myocardial tissue,and differential expression genes were analyzed using Venn diagram and heatmap.GO and KEGG pathway enrichment analysis were performed on common differentially expressed genes.RT-qPCR was used to validate differentially expressed genes PTX3 and EGR2.Results Compared with the sham-operation group,the EF and FS of the model group rats significantly decreased(P<0.01),the cells apoptosis rate of myocardial tissue and serum LDH,TNF-α,IL-1β and IL-6 contents significantly increased(P<0.01),and SOD activity and IL-10 content significantly decreased(P<0.01).Compared with the model group,the modified Taohong Siwu Decoction group showed a significant increase in EF and FS(P<0.05),while the cell apoptosis rate of myocardial tissue and serum CK-MB,LDH,TNF-α,IL-1β and IL-6 contents significantly decreased(P<0.01),and SOD activity and IL-10 content significantly increased(P<0.01).Transcriptome sequencing revealed 4 227 differentially expressed genes(2 259 upregulated and 1 968 downregulated)between the sham-operation group and the model group,1 933 differentially expressed genes(1 301 upregulated and 632 downregulated)between the sham-operation group and the modified Taohong Siwu Decoction group,and 94 differentially expressed genes(46 upregulated and 48 downregulated)between the model group and the modified Taohong Siwu Decoction group.There were 35 common differential genes in the three groups,and the differential genes were mainly enriched in signaling pathways such as fluid shear stress and atherosclerosis,ubiquitin mediated proteolysis,C-type lectin receptor signaling pathway,sphingolipid signaling pathway,cell cycle,chemokine signaling pathway,lipid and atherosclerosis.RT-qPCR showed that gene expressions of PTX3 and EGR2 in myocardial tissue of the model group were significantly increased than that of the sham-operation group,and the gene expressions of PTX2 and EGR2 of modified Taohong Siwu Decoction group were significantly decreased than that of the model group(P<0.01).Conclusion Modified Taohong Siwu Decoction exhibits a certain protective effect against myocardial ischemia-reperfusion injury in rats,characterized by improvements in rat cardiac function,reduction in cell apoptosis and inflammatory cytokine release,as well as alleviation of oxidative stress levels.The mechanism may be related to the regulation of PTX3 and EGR2 gene expression.

Antiviral therapy is an effective means of curing chronic hepatitis C (CHC) and a key focus of preventing the spread of hepatitis C. By analyzing domestic and foreign literature, this paper provides an overview of the estimation of the antiviral treatment rate for CHC, the current situation of antiviral treatment for CHC both domestically and internationally, and the factors that affect acceptance of antiviral treatment. At present, the antiviral treatment rate for CHC cases is relatively low both domestically and internationally. The treatment status of CHC cases is related to factors such as the general situation of the case, knowing their HCV status or self-perceived condition, concurrent presence of other diseases or conditions, knowledge of hepatitis C prevention and treatment, and social interaction and behavioral guidance. In response to the relevant difficulties, in-depth research or more support is needed to improve the antiviral treatment rate of CHC cases and achieve the goal of eliminating hepatitis C by 2030. Efforts should be made to strengthen policy support, improve the diagnosis of hepatitis C, prevent and control multiple diseases together, conduct targeted publicity and education, and enhance social support.

Objective:To explore the impact of multimorbidity on disability in older adults, providing a reference for formulating strategies for the management and nursing of multimorbidity and disability in older adults.Methods:Adopting the method of cross-sectional survey research, the data of 6 469 older adults (≥60 years old) were collected from the 2018 Chinese Longitudinal Healthy Longevity Survey database in July 2023, including basic information, chronic disease prevalence, and disability measured by basic activities of daily living (BADL), and instrumental activities of daily living (IADL). They were divided into multimorbidity and non-multimorbidity groups based on whether they had two or more chronic diseases. The propensity score matching (PSM) method was used to match the basic conditions of the two groups of older adults with the proportion of 1∶1. Binary logistic regression was applied to analyze the effects of multimorbidity on BADL disability and IADL disability.Results:Among 6 469 older adults, there were 2 882 males and 3 582 females, with 3 158 aged 60-84 years old and 3 311 aged over 84 years old. BADL disability accounted for 26.5% (1 712/6 469), while IADL disability accounted for 66.8% (4 324/6 469). There were 2 335 patients in the multimorbidity group and 4 134 patients in the non-multimorbidity group. Binary Logistic regression analysis showed that the risk of BADL disability in older adults in multimorbidity group was 1.511 times higher than that in the non-multimorbidity group (95% CI 1.317-1.734, P<0.01); the risk of IADL disability in older adults in the multimorbidity group was 1.618 times higher than that in the non-multimorbidity group (95% CI 1.426-1.835, P<0.01). Conclusions:Multimorbidity would increase the risk of disability in older adults. Relevant authorities should develop relevant interventions and nursing responses to enhance the prevention and management of multimorbidity and disability in older adults.

Objective:To explore the correlation between right atrial function parameters and prognosis in patients with chronic obstructive pulmonary disease(COPD) complicated with pulmonary hypertension.Methods:Eighty-four patients with COPD combined with pulmonary arterial hypertension treated with bosentan combined with milrinone admitted to the First Affiliated Hospital of Xinjiang Medical University during the period of February 2020 to June 2022 were selected as the study subjects, and they were divided into the effective group (63 cases) and the ineffective group (21 cases) according to the treatment effect. Right cardiac function parameters were measured by Philips iE33 color ultrasonography before treatment and 72 h after treatment. Logistic regression was used to analyze the risk factors affecting the treatment outcome of patients, and receiver operating characteristics (ROC) curve was used to analyze the predictive value of right atrial function parameters in the poor prognosis of patients with COPD complicated with pulmonary hypertension.Results:The main pulmonary artery diameter (MPA), right ventricular base transverse diameter (RVd1), right ventricular middle transverse diameter (RVd2), right atrial diameter (RAd) and right ventricular free wall thickness (RVWT) in the effective group were lower than those in the ineffective group: (2.65 ± 0.23) cm vs. (2.90 ± 0.44) cm, (3.46 ± 0.43) cm vs. (3.76 ± 0.72) cm, (3.48 ± 0.42) cm vs. (3.88 ± 0.69) cm, (3.53 ± 0.81) cm vs. (4.03 ± 1.20) cm, (0.63 ± 0.12) cm vs. (0.72 ± 0.21) cm; end-diastolic to end-systolic tricuspid ring displacement (TAPSE) was higher than that in the ineffective group: (2.08 ± 0.32) cm vs. (1.82 ± 0.46) cm, there were statistical differences( P<0.05). Logistic regression analysis showed that RVd1 increased ( OR = 3.717, P<0.05), RVd2 increased ( OR = 2.162, P<0.05), RAd increased ( OR = 2.838, P<0.05) and TAPSE reduction ( OR = 1.704, P<0.05) were risk factors for treatment failure in patients. The results of ROC curve showed that the area under the curve of RVd1, RVd2, RAd, TAPSE in predicting the therapeutic effect of COPD patients with pulmonary hypertension were 0.820, 0.831, 0.872, 0.909, respectively. Conclusions:The independent influencing factors of ineffective patients with COPD combined with pulmonary arterial hypertension treated with bosentan combined with milrinone are the increase of structural parameters of the right heart and the decrease of systolic function parameters. The therapeutic effect of patients can be evaluated clinically according to the level of each parameter.

Antiviral therapy is an effective means of curing chronic hepatitis C (CHC) and a key focus of preventing the spread of hepatitis C. By analyzing domestic and foreign literature, this paper provides an overview of the estimation of the antiviral treatment rate for CHC, the current situation of antiviral treatment for CHC both domestically and internationally, and the factors that affect acceptance of antiviral treatment. At present, the antiviral treatment rate for CHC cases is relatively low both domestically and internationally. The treatment status of CHC cases is related to factors such as the general situation of the case, knowing their HCV status or self-perceived condition, concurrent presence of other diseases or conditions, knowledge of hepatitis C prevention and treatment, and social interaction and behavioral guidance. In response to the relevant difficulties, in-depth research or more support is needed to improve the antiviral treatment rate of CHC cases and achieve the goal of eliminating hepatitis C by 2030. Efforts should be made to strengthen policy support, improve the diagnosis of hepatitis C, prevent and control multiple diseases together, conduct targeted publicity and education, and enhance social support.

Primary liver cancer(PLC)is one of the most common malignant tumors of digestive system in clinic.TCM plays an important role in the treatment of PLC.After sorting out the medical records and literatures related to the syndrome types of primary liver cancer in recent years,it was found that the syndrome type of qi stagnation and blood stasis was one of the important syndrome types of primary liver cancer.This article discusses and supplements the syndrome type of qi stagnation and blood stasis from the aspects of etiology and pathogenesis,proportion of syndrome types,staging of liver cancer,objective indicators of liver cancer,etc.It provides a new understanding for the treatment of primary liver cancer based on syndrome differentiation,so as to improve the clinical cure rate of liver cancer,alleviate the clinical symptoms of patients,improve the quality of life,and prolong the survival period.

Objective:To investigate the treatment options for multiple myeloma patients with central nervous system involvement (CNS-MM) , as well as their clinical characteristics and prognostic factors.Methods:Between January 2011 and January 2022 our center diagnosed 18 people with CNS-MM. A retrospective analysis was done on the clinical information from the initial diagnosis and central nervous system involvement, and it was compared to 1∶3 matched newly diagnosed MM from the same period. Analysis was done on the clinical characteristics and survival rates of the two groups.Results:In patients with CNS-MM, the median time of onset was 14.2 (0.9-79.6) months and the median overall survival (OS) was 30.5 months from initial diagnosis and only 3.8 months in patients after CNS involvement. The CNS-MM patients showed more IgD type ( P=0.010) , severer anemia ( P=0.014) , a higher proportion of bone marrow plasma cells ( P=0.013) , more extramedullary lesions ( P=0.001) , and increased lactic dehydrogenase (LDH) ( P=0.009) when compared to the control group. Lenalidomide or pomalidomide-based combinations had higher rates of hematology and CNS remission than bortezomib or daratumumab-based regimens (75.0% vs 16.7% , P=0.019) . Patients who received IMiD-based regimens and had 2 high-risk factors at initial diagnosis (high LDH and extramedullary lesions) had a significantly lower incidence of CNS-MM ( P=0.026) . At the initial diagnosis, LDH ( P=0.008, HR=7.319, 95% CI 1.663-32.219) and extramedullary lesions ( P=0.006, HR=8.054, 95% CI 1.828-35.486) were independent risk factors for the occurrence of CNS-MM. Conclusion:Patients with CNS-MM had a poor prognosis. Patients with high LDH or extramedullary lesions at the time of the initial diagnosis are more likely to have CNS-MM. The prognosis of this patient may be improved by immunoregulator-based therapy.

Objective:To analyze the current status of frailty in elderly patients undergoing cardiac surgery, explore its risk factors, and establish a predictive model of frailty in order to provide targeted and predictive nursing programs.Methods:A total of 205 cardiac surgery patients admitted to the first affiliated hospital of Xinjiang Medical University from March 2015 to January 2019 were selected as the study subjects. Patients were divided into 2 groups according to whether they were frail: the frailty group ( n=78) and the control group ( n=127). Logistic regression was used to analyze the risk factors that affect the frailty of elderly patients undergoing cardiac surgery. The receiver operating characteristic curve (ROC) was used to evaluate the effectiveness of model X [consisting of body mass index (BMI), Mini-Mental State Examination (MMSE) score, number of diseased patients, and number of drugs] in diagnosing frailty in elderly patients undergoing cardiac surgery. Results:Of the 205 patients, 78 (38.05%) showed frailty. The proportion of high school education level and above, Tinetti Gaitassessment (TGA) score≥24 and MMSE score≥27 in the frailty group was lower than that in the control group, and the proportion of Geriatric Depression Scale-15 (GDS-15) score≥7, the number of diseases≥3 and the number of drugs≥5 in the frailty group was higher than that in the control group ( χ2 value was 9.254-26.061, P<0.05). Logistic regression analysis showed that BMI, MMSE score, number of diseased, and number of medications were independent risk factors for frailty in elderly patients undergoing cardiac surgery ( OR value was 0.032-5.275, P<0.05). The area under the ROC curve, sensitivity and specificity of frailty in elderly cardiac surgery patients assessed by model X were 0.913, 75.61% and 96.77%, respectively. Conclusion:The incidence of frailty is higher in elderly patients undergoing cardiac surgery. Model X can diagnose the frailty of elderly patients undergoing cardiac surgery and help clinical nurses to carry out targeted care.

Objective:To investigate the efficacy and safety of daratumumab in relapsed and refractory multiple myeloma (RRMM) .Methods:The clinical characteristics, adverse reactions, efficacy, and prognosis of 46 patients with RRMM treated with daratumumab in Shanghai Changzheng Hospital from September 2017 to March 2020 were retrospectively analyzed.Results:All patients were treated with daratumumab-based regimen: 8 in the Dd group, 35 in the DRd group, and 3 in the DVd group. With a median follow-up of 9.6 months, the overall response rate (ORR) was 75% [complete remission (CR) rate 18.2% ] among the 44 patients available for evaluation. The ORRs of patients resistant to bortezomib, lenalidomide, and both were 70.6% , 69.2% , and 63.6% , respectively. The CR rates of patients resistant to bortezomib, lenalidomide, and both were 17.6% , 11.5% , and 13.6% , respectively. No significant difference was observed in ORR and CR rates among the three groups. The ORRs of the DRd, DVd, and Dd groups were 85.3% , 66.7% , and 28.6% , respectively ( P=0.007) . The median PFS of 46 patients was 8.9 months, the median OS was not reached, and the 1-year OS rate was 74% . The median PFS and OS in the DRd group were longer than those in the Dd group (PFS: 14.4 months vs 2.0 months; OS: not reached vs 5.2 months) . After treatment with daratumumab, neutropenia is the most common hematological adverse reaction above grade 3. Non-hematological adverse reactions are mainly infusion-related adverse reactions and infections. Prognostic analysis showed that patients with extramedullary invasion had shorter PFS and OS compard with patients without extramedullary invasion (PFS: 5.7 vs 14.4 months, P=0.033; OS: 6.3 months vs not reached, P=0.029) . The OS of patients with an ECOG score of 3-4 was significantly shorter than patients with an ECOG score of 1-2 (5.9 months vs not reached, P=0.004) . Conclusion:Daratumumab-based regimens have good efficacy and safety in the treatment of RRMM.

Objective:To select the relevant evidence of percutaneous pericardial drainage tube nursing and summarize the best evidence.Methods:Evidence-based questions were established based on PIPOST model. BMJ Best Clinical Practice, China Biology Medicine disc (CBM) , UpTodate, Cochrane Library, Joanna Briggs Institute Evidence-based Health Care Database, China Guide Network, British Guide Network, National Guide Line Clearing House (NGC) , PubMed, EMbase, Evidence-based Medicine (EBM) , Registered Nurses' Association of Ontario (RNAO) , The European Society of Cardiology (ESC) , American Heart Association (AHA) , Chinese Journal Full-text Database and Wanfang Database were conducted computer retrieval. The search time was from the establishment of the database to December 31, 2020. Two researchers respectively evaluated the quality of the included literature and extracted data and summarized and summarized the evidence that met the standards.Results:Finally, 12 articles were included, including 1 evidence summary, 2 systematic reviews, 1 systematic assesment, 2 guidelines, 1 expert consensus and 5 case series studies. Finally, 11 pieces of evidence were formed, including 6 themes such as drainage tube selection, puncture wound nursing, drainage flow control, flushing and sealing of the tube, observation and recording points, extubation indications and care.Conclusions:This study summarizes the best evidence for percutaneous pericardial drainage tube nursing, which provides evidence-based basis for improving the quality of percutaneous pericardial drainage tube care.