BACKGROUND:The repair process of myocardial injury involves complex cellular and molecular mechanisms,especially mitochondrial calcium homeostasis,macrophage autophagy and pyroptosis pathways.Traditional Chinese medicine(TCM)has shown significant clinical efficacy in improving myocardial injury,but its mechanism of action needs to be thoroughly investigated. OBJECTIVE:To investigate the role of mitochondrial calcium homeostasis-mediated macrophage autophagy and pyroptosis pathways in myocardial injury,and to summarize the progress of TCM in this field. METHODS:A computerized search was performed for relevant literature from the database inception to March 2024 in the Web of Science,PubMed and CNKI.The search terms were"mitochondrial calcium homeostasis,macrophage autophagy,macrophage pyroptosis,traditional Chinese medicine,myocardial injury,myocardial injury reperfusion"in Chinese and English.Through literature review,we analyzed the relationship between mitochondrial calcium homeostasis and macrophage autophagy and pyroptosis,explored the mechanism of their roles in myocardial injury,and summarized the pathways of multi-targeted,multi-pathway effects of TCM. RESULTS AND CONCLUSION:The maintenance of mitochondrial calcium homeostasis has been found to be closely related to the normal function of cardiomyocytes.Macrophages can participate in the repair process of myocardial injury through autophagy and pyroptosis pathways.Autophagy contributes to cell clearance and regulation of inflammatory response,while pyroptosis affects myocardial repair by releasing inflammatory factors.TCM regulates mitochondrial calcium homeostasis and macrophage function through multiple mechanisms.For example,astragalosid regulates calcium homeostasis by lowering mitochondrial membrane potential and inhibiting cytochrome C,and epimedium glycoside plays a role in reducing β-amyloid deposition.In addition,herbal compounds and single drugs promote myocardial repair by activating or inhibiting specific signaling pathways,such as PI3K/AKT and nuclear factor-κB signaling pathways.Future studies should focus on the interactions between mitochondrial calcium homeostasis,autophagy and pyroptosis pathways,as well as how TCM can exert therapeutic effects through these pathways to provide new strategies and drugs for the treatment of myocardial injury.

Objective:To establish a method for simultaneous determination of 7 elemental impurities(V,Co,Ni,As,Cd,Hg Pb)in amlodipine besylate tablets based on inductively coupled plasma mass spectrometry(ICP-MS).Methods:After the samples were treated by microwave digestion,the solution was analyzed by ICP-MS.Ge,In,Bi were selected as the internal standards.The established method was validated.The contents of 7 elemental impurities in amlodipine besylate tablets from 54 enterprises were determined by this method.Results:The content of(V,Co,Ni,As,Cd,Hg,Pb had good linear relationship in the ranges of 1-100,1-100,1-100,1-100,1-100,0.5-4,1-100 ng·mL-1,respectively.The correlation coefficients(r)all above 0.999 4.The detec-tion limits and quantification limits were in the range of 0.000 4-0.018 4 ng·mL-1 and 0.001 4-0.061 2 ng·mL-1.The RSD of precision was less then 1.8％.The RSD of repeatability was less then 6.1％.The average re-coveries(n=9)were between 85.4％-106.5％,while their RSD was less then 4.7％.The content of 7 elemental impurities in 54 sample batches were in accordance with the limit value.Conclusion:The method is simple,rapid,accurate,reliable and highly sensitive,and can be used for the quality control of elemental impurities in amlodipine besylate tablets.

Purpose: This study was performed to compare the therapeutic efficacy of endoscopic surgery and open surgery and their effects on postoperative blood coagulation state in patients with thyroid cancer, and to provide evidence for the prevention measurement of thrombosis in the perioperative period. Methods: One hundred patients with thyroid cancer who received treatment in our hospital from January 2021 to December 2021, were randomly divided into an endoscopic group and an open surgery group, with 50 patients in each group. The patients in the open surgery group were treated by traditional open surgery, while patients in the endoscopic group accepted endoscopic surgery. The clinically therapeutic effect and blood coagulation of the 2 groups were compared. Results: Intraoperative blood loss and length of hospital stay were lower, and operative time was longer in the endoscopic group than in the open surgery group (P < 0.05). The 24-hour postoperative fibrinogen and D-dimer levels were higher in both groups than in the preoperative period, while PT was shorter (P < 0.05). There were no significant differences in postoperative complications and follow-up between the 2 groups (P > 0.05), but the incidence of complications, postoperative metastases, and thrombosis was relatively low in the endoscopic group. Conclusion In the treatment of patients with thyroid cancer, endoscopic surgery has the advantages of less blood loss, fewer complications, and so on. Endoscopic and open surgery can lead to a hypercoagulable state, but the effect of endoscopic surgery is better than that of open surgery.

Objective: To explore the clinical and genetic characteristics of a Chinese pedigree affected with a syndromic form of hereditary gingival fibromatosis (HGF). Methods: Clinical data of the pedigree members were collected. The excised gingiva were collected, and the pathological features were observed by histological sectioning. Genomic DNA was extracted from peripheral blood samples, and whole-exome sequencing was used to identify gene mutations. Results : The proband, her mother, her maternal grandfather and her maternal grandfather's sister all suffered from gum hyperplasia; female patients had congenital hirsutism and macromastia, while male patients also had congenital hirsutism, which suggests that this pedigree may have a congenital syndrome. The pathological characteristics of the gingival tissue were chronic inflammation with fibromatous hyperplasia, connective tissue enlargement, and filling with thick collagen fiber bundles. In addition, whole-exome sequencing results showed that no mutations related to known pathogenic genes were found, suggesting that new pathogenic gene mutations may be the cause. Conclusion According to the literature and our gene sequencing results, it is suggested that this may be the first pedigree with a new syndrome HGF (gingival fibromatosis + congenital hirsutism + macromastia) caused by an unknown pathogenic gene mutation.

The vagina contains at least a billion microbial cells,dominated by lactobacilli.Here we perform metagenomic shotgun sequencing on cervical and fecal samples from a cohort of 516 Chinese women of reproductive age,as well as cervical,fecal,and salivary samples from a second cohort of 632 women.Factors such as pregnancy history,delivery history,cesarean section,and breastfeeding were all more important than menstrual cycle in shaping the microbiome,and such information would be necessary before trying to interpret differences between vagino-cervical micro-biome data.Greater proportion of Bifidobacterium breve was seen with older age at sexual debut.The relative abundance of lactobacilli especially Lactobacillus crispatus was negatively associated with pregnancy history.Potential markers for lack of menstrual regularity,heavy flow,dysmenor-rhea,and contraceptives were also identified.Lactobacilli were rare during breastfeeding or post-menopause.Other features such as mood fluctuations and facial speckles could potentially be predicted from the vagino-cervical microbiome.Gut and salivary microbiomes,plasma vitamins,metals,amino acids,and hormones showed associations with the vagino-cervical microbiome.Our results offer an unprecedented glimpse into the microbiota of the female reproductive tract and call for international collaborations to better understand its long-term health impact other than in the settings of infection or pre-term birth.

Objective:To investigate the expression of microRNA (miR)-938, its effect on cell proliferation and its regulatory mechanism in hepatocellular carcinoma (HCC).Methods:HCC and paracancerous tissues were collected from 40 patients with HCC who underwent surgical resection in the Second Affiliated Hospital of Nantong University from January 2015 to June 2019, including 25 males and 15 females, with an average age of 61.4 years. HepG2 cells in the miR-938 overexpression group were transfected with miR-938 mimics, and the negative control group was transfected with the negative control sequence. Cell proliferation was detected by kit, the expression of miR-938 and the succinate dehydrogenase complex subunit D (SDHD) was detected by fluorescence quantitative polymerase chain reaction, and SDHD protein expression was detected by Western blot. The target genes of miR-938 were verified by dual luciferase reporting.Results:The relative expression of miR-938 in HCC tissues was (0.060±0.002), which was higher than that in adjacent tissues (0.030±0.002), and the difference was statistically significant ( P<0.05). The mRNA relative expression of SDHD in HCC tissues was (0.028±0.002), lower than that in adjacent tissues (0.062±0.002), and the protein expression of SDHD in HCC tissues was (0.963±0.008), lower than that in adjacent tissues (1.083±0.037), with statistical significance (both P<0.05). The proliferation activity of miR-938 overexpression group was significantly higher than that of negative control group, and the difference was statistically significant ( P<0.05). MiR-938 significantly inhibited the luciferase activity of SDHD wild-type 3’-untranslated regions. In the overexpression miR-938 cells, SDHD mRNA and protein levels were significantly lower than those in the negative control group ( P<0.05). Conclusion:MiR-938 was highly expressed in HCC tissues. MiR-938 promoted the proliferation of HCC cells by inhibiting the expression of SDHD.

Objective To investigate the effect of the application of nursing quality sensitive indicators on the nursing care of burn patients and their satisfaction with nursing care. Methods A total of 90 cases of burn patients admitted from January 2015 to December 2016 were selected as study subjects. They were divided into pre- implementation group (January 2015- December 2015) and implementation group (January 2016-December 2016) for 45 cases each based on sensitive indicators of care quality. The traditional quality management control method was adopted before implementation. The quality-sensitive indicators of nursing quality were used for quality management after the implementation. The quality monitoring indicators, nursing adverse events, and nursing satisfaction were compared before and after implementation. Results After the implementation, the implementation rate of graded nursing, the accuracy of patient identification, the qualified rate of qualified nurses, the passing rate of risk assessment, and the passing rate of high-risk drugs were 97.78%(44/45), 93.33%(42/45), 95.56%(43/45), 97.78% (44/45), and 97.78% (44/45), which were significantly higher than those before implementation 84.44%(38/45)、77.78%(35/45), 82.22%(37/45), 82.22%(37/45), and 84.44%(38/45), respectively, and the difference was statistically significant (χ2= 4.050-, 6.049, P<0.05). After the implementation, drug errors and other adverse events were used. The incidence rate of 0.22%(1/450)was significantly lower than the pre-implementation rate of 1.78%(8/450), and the difference was statistically significant (χ2=5.499, P<0.05). After implementation, patient satisfaction with service attitude, basic nursing, professional skills, and comprehensive nursing service quality was 95.56%(43/45), 97.78%(44/45), 95.56%(43/45), 97.78%(44/45), and 95.56%(43/45), which were significantly higher than those before implementation 88.89%(40/45), 84.44%(38/45), 82.22%(37/45), 80.00%(36/45)and 82.22% (37/45), and the difference was statistically significant (χ2= 4.050-7.200, P <0.05). Conclusion The application of sensitive indicators of nursing quality can help improve the care quality of burn patients, reduce the occurrence of adverse care events, and enhance patient satisfaction.

Objective To evaluate the value in the diagnosis of focal nodular hyperplasia( FNH) by combining micro-flow imaging ( MFI) and color Doppler flow imaging ( CDFI) . Methods A total of 32 patients with 32 FNH lesions were enrolled in this study . Each patient underwent CDFI ,MFI ,and contrast-enhanced ultrasonography ( CEUS ) examinations . The differences in the grade and characteristic distribution of blood flow in FNH were compared between CDFI and MFI . The results were further compared with CEUS . Results There was a significant difference between MFI and CDFI in detecting the blood flow in FNH . Twenty-six cases (81 .3％ ) were detected with blood flow of grade Ⅱ and Ⅲ by MFI , however , 18 cases ( 56 .3％ ) were detected of grade Ⅱ and Ⅲ by CDFI ( P = 0 .000) . A total of 12 (37 .5％ ) lesions were correctly showed spoke-wheel arterial flow peculiar by CDFI ,whereas the number increased to 23(71 .9％ ) in combination with MFI( P = 0 .013) . Conclusions In combination with MFI , CDFI can reveal more blood flow and detect more sensitively in FNH ,which helps to diagnose FNH . To a certain degree ,it can be applied to reduce the use of CEUS .

Objective To evaluate the correlation between cerebral blood flow perfusion and memory impairment in patients with severe stenosis of vertebral basilar artery (VBA).Methods 62 cases of patients with VBA stenosis diagnosed by digital subtraction angiography(DSA) in Beijing Tiantan Hospital from September 2016 to March 2017 were enrolled.Mental State Examination (MMSE),Clinical Memory Scale (CMS) test and CT perfusion(CTP) was performed.All patients were divided into memory normal group(n=24,including 1 excellent case,6 above normal cases,and 14 normal cases) and memory impairment group(n =38,including 18 below normal cases,12 periphery cases,8 impaired cases) according to CMS.The ratios of side-to-side period were compared between bilateral mesial temporal lobe and anterior circulation area.The relative time to peak (rTTP),relative mean transit time(rMTY),relative cerebral blood flow(rCBF) and relative cerebral blood volume (rCBV) were calculate.Results The incidence of CTP decompensation in the medial temporal lobe was higher than that in the patients with memory impairment(P＜0.05).The difference of rTTP and rMTT value between the two groups in the bilateral medial temporal lobes was statistically significant (rTFP:(1.131 ±0.037),(1.437±0.139),t=10.520,P＜ 0.05);rMTT:(1.081 ±0.059),(1.281 ±0.174),t=5.423,P＜0.05).Conclusion The patients with VBA severe stenosis are more likely to get memory impairment due to cerebral hypoperfusion.

Objective To investigate the efficacy of different adding times,treatment courses and doses of bifidobacterium and lactobacillus triple live bacteria in Helicobacter pylori (Hp) eradication.Methods A total of 280 patients Hp-infected were enrolled and randomly assigned to five groups.Group A received lansoprazole 30 mg,clarithromycin 500 mg and amoxicillin 1,000 mg bid for 14 days;group B received bifidobacterium and lactobacillus triple live bacteria 2,000 mg tid for 14 days followed by regimen of group A for another 14 days;group C1 received regimen of group A with addition of bifidobacterium and lactobacillus triple live bacteria 2,000 mg bid for 14 days;group C2:regimen of group A with addition of bifidobacterium and lactobacillus triple livc bacteria 2,000 mg tid for 14 days;and group D received regimen of group C2 followed by bifidobacterium and lactobacillus triple live bacteria 2,000 mg tid for another 14 days.4 weeks after end of treatment,Hp eradication was assessed by 13C-urea breath test.Adverse effects during the courses of treatment were recorded.Results A total of 252 (90.0％) patients completed the treatment.The completion rate in group A,B,C1,C2,and D were 78.6％ (44/56),92.9％ (52/56),87.5％ (49/56),96.4％ (54/56),and 94.6％ (53/56) respectively;the completion rate was significantly higher in group B,C2 and D than in group A (P ＜ 0.05),but there were no differences among groups B,C2 and D (P ＞ 0.05).According to intention-to-trcat (ITT) analysis,the eradication rate was 62.5％,80.4％,69.6％,85.7％,and 87.5％ in groups A,B,C1,C2,and D respectively.The eradication rate in groups B,C2 and D was significantly higher than that in group A (x2 =4.375,P =0.036;x2 =7.864,P =0.005;x2 =9.333,P =0.002),and the eradication rate was higher in group C2 than in group C1 (x2 =4.171,P =0.041),but there were no differences among groups B,C2 and D (P ＞0.05).As for per-protocol (PP) analysis,the eradication rate was 79.5％,86.5％,79.6％,88.9％ and 92.5％ in groups A,B,C1,C2,and D respectively,but no significant statistical differences were found among the five groups (P ＞ 0.05).Adverse effects included nausea,bloating,taste distortion,anorexia and constipation.The rate of adverse effects in groups A,B,C1,C2 and D was 67.9％ (38/56),26.8％ (15/56),35.7％ (20/56),21.4％ (12/56),and 17.9％ (10/56) respectively.The incidence rate was significantly lower in groups B,C2 and D than in group A (P ＜ 0.05),but no significant statistical differences were found among groups B,C2,and D (P ＞ 0.05).Conclusions The triple therapy combined with bifidobacterium and lactobacillus triple live bacteria can obviously decrease the adverse effects and improve patient compliance,thereby increasing the rate of Hp eradication.14-day therapy with probiotics is the best regimen.