Objective To explore the relationship of microRNA(miR)-155,miR-92a and miR-126 with in-stent restenosis(ISR)after percutaneous coronary intervention(PCI)in elderly patients with coronary heart disease(CHD).Methods A total of 118 elderly CHD patients receiving PCI in our hospital from January 2021 to June 2023 were enrolled,and according to whether ISR occurred by coronary angiography(CAG)at 1 year after surgery,they were divided into a stenosis group(45 cases)and a non-stenosis group(73 cases).Their baseline data,number of stent,stent diameter,medication,coronary artery lesion score,and serum expression levels of miR-155,miR-92a and miR-126 were compared between the two groups.The correlation of expression levels of the three miRNAs and clinical indicators was analyzed.Multivariate logistic regression analysis was performed to identify the risk factors of ISR in elderly CHD patients.ROC curve was adopted to analyze the diagnostic value of the three miRNAs for ISR in the elderly patients.Results Signifi-cantly higher BMI,SBP and DBP,and larger proportions of stent count ≥3 and stent diameter＜3 mm were observed in the stenosis group than the non-stenosis group(P＜0.05,P＜0.01).The expression levels of miR-155 and miR-126 were obviously lower,while that of miR-92a was nota-bly higher in the stenosis group than the non-stenosis group(P＜0.01).Pearson correlation analy-sis showed that miR-155 and miR-126 were negatively correlated with BMI,SBP,DBP,and stent count,and positively correlated with stent diameter(P＜0.01);miR-92a was positively correlated with BMI,SBP,DBP,and stent count,and negatively with stent diameter(P＜0.01).Multivariate logistic regression analysis suggested that stent count,stent diameter and miR-92a were risk fac-tors for ISR in elderly CHD patients after PCI,and miR-155 and miR-126 were protective factors(P＜0.05,P＜0.01).ROC curve analysis revealed that the AUC value of miR-155,miR-92a,and miR-126 alone and combined together was 0.742,0.778,0.751 and 0.853,respectively,with a sen-sitivity of 86.67％,71.11％,73.33％and 93.33％respectively,and the combined detection showed better diagnostic value for ISR than the single detection(P＜0.01).Conclusion Down-regulation of miR-155 and miR-126 and up-regulation of miR-92a may be involved in the occurrence of ISR in elderly CHD patients after PCI.Monitoring the three miRNAs is beneficial to auxiliary clinical prediction for ISR after PCI.

Background and aims:Early and accurate diagnosis of the coexistence of Wilson's disease(WD)and chronic hepatitis B(CHB)presents a significant challenge for clinicians.The objective of this study was to retrospectively analyse the characteristics of such patients to improve clinical practice and provide a reference for clinical management.Methods:From January 2011 to December 2022,35 patients with concurrent CHB and WD(CHB+WD group)were identified.A total of 127 patients with CHB(CHB group)and 168 patients with WD(WD group)were included in the control group between January 2016 and December 2021.Propensity score matching(PSM)was performed to balance the baseline values between groups.The Kaplan-Meier(K-M)survival analysis and log-rank test were performed to compare the prognoses.Results:In the cohort of 35 patients with concurrent CHB and WD,74.3％of patients(26 patients)faced a substantial delay of up to 10 years(range:0-40 years)in WD diagnosis following their CHB diagnosis.Twenty-three(65.7％)patients had cirrhosis at the time of WD diagnosis,and 26(74.3％)patients experienced liver failure.The levels of serum copper and uric acid were lower in patients in the CHB+WD group than in those in the CHB group.Patients in the CHB+WD group presented higher alanine transaminase and total bile acid levels compared to those in the WD group.K-M survival analysis indicated that patients with CHB and WD had poorer outcomes than those with CHB alone;however,the outcomes were similar to those of individuals with WD alone.The optimal cut-point of serum ceruloplasmin(CP)in identifying WD in CHB patients was 0.10 g/L before PSM and after PSM.Conclusions:The present study emphasizes the importance of clinicians being vigilant for concurrent CHB and WD diagnoses,as delays in WD diagnosis may adversely affect patient outcomes.CHB patients with serum CP below 0.10 g/L are highly recommended to screen for WD.

Objective To investigate the relationships of cerebrospinal fluid levels of collagen triple helix repeat containing-1(CTHRC1)and olfactomedin-3(OLFM3)with cognitive impairment and cere-brospinal fluid biomarker levels in patients with Alzheimer's disease(AD).Methods Ninety-six patients with AD were selected as study objects(AD group),and divided into mild group(n=34),moderate group(n=39)and severe group(n=33)according to Clinical Deentia Scale(CDR)score.Sixty patients without cognitive impairment who underwent lumbar puncture during the same period served as the control group.Enzyme-linked immunosorbent assays were used to measure cere-brospinal fluid levels of CTHRC1,OLFM3 and biomarkers[β-amyloid(Aβ)-40,Aβ-42,Aβ42/Aβ-40,total tau(T-tau)and phosphorylated tau(P-tau)].Cognitive impairment in AD patients was as-sessed using the Mini-Mental State Examination(MMSE)and Montreal Cognitive Assessment(MoCA).The relationships of CSF CTHRC1 and OLFM3 levels with cognitive impairment and cerebrospinal flu-id biomarkers were analyzed.Results The AD group showed significantly higher cerebrospinal fluid levels of CTHRC1,T-tau and P-tau,and significantly lower levels of OLFM3,Aβ-42 and Aβ42/Aβ-40 compared to the control group(P＜0.05).The area under the curve(AUC)for diagnosing AD with cerebrospinal fluid CTHRC1 and OLFM3 was 0.839 and 0.822,respectively,and the com-bined AUC was 0.923.Cerebrospinal fluid CTHRC1 of mild group,moderate group and severe group were increased successively,and OLFM3 was decreased successively,the difference was sta-tistically significant(P＜0.05).Cerebrospinal fluid Aβ-42 and Aβ-42/Aβ-40 in mild,moderate and severe groups were decreased successively,while T-tau and P-tau were increased successively,with statistical significance(P＜0.05).The MMSE and MoCA scores of mild group,moderate group and severe group decreased successively,and the difference was statistically significant(P＜0.05).Cerebrospinal fluid CTHRC1 levels were positively correlated with disease severity,while OLFM3 levels were negatively correlated(P＜0.05).Cerebrospinal fluid CTHRC1 was negatively correlated with Aβ42,Aβ42/Aβ-40,MMSE scores and MoCA scores,and positively correlated with T-tau and P-tau(P＜0.05).Cerebrospinal fluid OLFM3 was positively correlated with Aβ-42,Aβ42/Aβ-40,MMSE scores and MoCA scores,and negatively correlated with T-tau and P-tau(P＜0.05).Conclusion In the cerebrospinal fluid of patients with AD,CTHRC1 is elevated while OLFM3 is decreased.Both CTHRC1 and OLFM3 are associated with the severity of AD,cog-nitive impairment and levels of cerebrospinal fluid biomarkers.

Objective To understand the research hotspots and development trends of Chaihu Guizhi Decoction;To provide references for related research.Methods Relevant literature about Chaihu Guizhi Decoction was retrieved from CNKI,VIP,Wanfang Data and CBM from the establishment of the databases to 31st,Dec.2023.NoteExpress 3.8 software was used to manage the bibliography,and CiteSpace 6.2.R6 software was used to draw graphs of authors,institutions and keyword co-occurrence,and conduct statistical analysis.Results A total of 1 181 Chinese articles were included,with the largest number of articles published in Henan Traditional Chinese Medicine,reaching 42;there were 54 core authors,and the top three authors were Wang Qingguo(18 articles),Cheng Fafeng(14 articles),Wang Xueqian(14 articles);multiple research institutions dominated by Beijing University of Chinese Medicine and Guangzhou University of Chinese Medicine carried out multi-level research;a total of 11 cluster labels were formed,involving clinical applications,experimental research,and so forth.The high-frequency keywords mainly included"classical prescriptions","Shang Han Lun"and"experience of famous doctors",etc.Conclusion The clinical application of Chaihu Guizhi Decoction mostly focuses on febrile diseases,and the use of gas chromatography and other methods to explore its active components and explore its mechanism based on the molecular level is the development trend in this field.

Jiegengtang is a basic formula for treating sore throat and cough. By means of bibliometrics， this study conducted a textual research and analysis on the key information such as formula origin， decocting methods， and clinical application of Jiegengtang. After the research， it can be seen that Jiegengtang is firstly contained in Treatise on Febrile and Miscellaneous Disease， which is also known as Ganjietang， and it has been inherited and innovated by medical practitioners of various dynasties in later times. The origins of Chinese medicines in this formula is basically clear， Jiegeng is the dried roots of Platycodon grandiflorum， Gancao is the dried roots and rhizomes of Glycyrrhiza uralensis， the two medicines are selected raw products. The dosage is 27.60 g of Glycyrrhizae Radix et Rhizoma and 13.80 g of Platycodonis Radix， decocted with 600 mL of water to 200 mL， taken warmly after meals， twice a day， 100 mL for each time. In ancient times， Jiegengtang was mainly used for treating Shaoyin-heat invasion syndrome， with cough and sore throat as its core symptoms. In modern clinical practice， Jiegengtang is mainly used for respiratory diseases such as pharyngitis， esophagitis， tonsillitis and lung abscess， especially for pharyngitis and lung abscess with remarkable efficacy. This paper can provide literature reference basis for the modern clinical application and new drug development of Jiegengtang.

Jiegengtang is a basic formula for treating sore throat and cough. By means of bibliometrics， this study conducted a textual research and analysis on the key information such as formula origin， decocting methods， and clinical application of Jiegengtang. After the research， it can be seen that Jiegengtang is firstly contained in Treatise on Febrile and Miscellaneous Disease， which is also known as Ganjietang， and it has been inherited and innovated by medical practitioners of various dynasties in later times. The origins of Chinese medicines in this formula is basically clear， Jiegeng is the dried roots of Platycodon grandiflorum， Gancao is the dried roots and rhizomes of Glycyrrhiza uralensis， the two medicines are selected raw products. The dosage is 27.60 g of Glycyrrhizae Radix et Rhizoma and 13.80 g of Platycodonis Radix， decocted with 600 mL of water to 200 mL， taken warmly after meals， twice a day， 100 mL for each time. In ancient times， Jiegengtang was mainly used for treating Shaoyin-heat invasion syndrome， with cough and sore throat as its core symptoms. In modern clinical practice， Jiegengtang is mainly used for respiratory diseases such as pharyngitis， esophagitis， tonsillitis and lung abscess， especially for pharyngitis and lung abscess with remarkable efficacy. This paper can provide literature reference basis for the modern clinical application and new drug development of Jiegengtang.

OBJECTIVE To study the mechanism of Compound lizard powder on reversing cisplatin（DDP） resistance in resistant gastric cancer cell MKN45/DDP through nuclear factor-κB （NF-κB）/SNAIL signaling pathway. METHODS MKN45/DDP cells were divided into model group （20% normal rat serum）， DDP group （1.3 μg/mL DDP+20% fetal bovine serum） and Compound lizard powder low- and high-dose drug-containing serum+DDP groups （17.2， 68.8 g/kg Compound lizard powder 20% drug-containing serum+1.3 μg/mL DDP）. The viability， apoptosis and intracellular autophagosome of MKN45/DDP cells were detected. The content of microtubule-associated protein 1 light chain 3 （LC3） in the cell supernatant was detected. The expressions of B-cell lymphoma 2 （Bcl-2）， Bcl-2-related X protein （Bax）， as well as the protein expression levels of phosphorylated NF-κB p65 （p-NF-κB p65） and SNAIL were detected. The molecular mechanism of Compound lizard powder in improving DDP resistance was further clarified by using NF-κB pathway agonist tumor necrosis factor-α （TNF-α）. RESULTS Compared with model group and DDP group， the cell survival rates of Compound lizard powder low- and high-dose drug-containing serum+DDP groups were significantly decreased （P＜0.05）， while the levels of apoptosis and autophagic death were significantly increased （P＜0.05）. The expression levels of Bcl-2 （except for the compound lizard powder low-dose drug-containing serum+DDP group）， p-NF-κB p65 and SNAIL protein in MKN45/DDP cells were significantly decreased （P＜0.05）. The content of LC3 and expression of Bax protein were significantly increased （P＜0.05）. High-dose Compound lizard powder drug-containing serum+DDP could effectively reverse the down-regulation of LC3 Ⅱ/LC3 Ⅰ and Bax protein expression induced by TNF- α （P＜0.05）. CONCLUSIONS Compound lizard powder drug-containing serum combined with DDP can induce apoptosis and autophagic death of MKN45/DDP cells by inhibiting NF-κB/SNAIL signaling pathway， thus reversing DDP resistance of cells.

Prone position ventilation (PPV) is an important protective strategy for lung ventilation, widely used in clinical practice, especially since the novel coronavirus infection pandemic. Since PPV is a non-physiological position, improper implementation and management can lead to serious adverse events such as pressure injury, facial edema, unplanned extubation and (or) reintubation, and even asphyxia. At present, preventive and protective strategies are mainly used to manage PPV-related complications in clinical practice. These strategies not only increase the workload of medical staff and the use of consumables, but also increase the medical cost of patients, further burdening patients and their families economically. To overcome the above problems, the medical staff of the department of critical care medicine of Tianjin Third Central Hospital designed a prone position head auxiliary support device and obtained a national utility model patent (patent number: ZL 2022 2 1751906.3). The device consists of annular plate, folding plate, support frame, reflector and wheel bodies. It serves to reduce pressure on the head and facial skin, while also exposing the mouth, nose, eyes, and ears to the hollow position of the annular plate according to the patient's position. At the same time, the patient's face or side skin can be observed through the lower reflector. The height of the annular plate was adjusted by adjusting the support frame, and the head was raised to reduce facial edema. The setting of strip groove, through hole and hook can sort out the facial pipeline, keep the drainage unobstructed, prevent catheter displacement and unplanned extubation, and has certain clinical promotion and practical value.
Humans ; Prone Position ; Equipment Design ; Respiration, Artificial/methods* ; COVID-19 ; Head ; Patient Positioning

Objective To investigate the effects of Huayu Xiaopi Decoction on the proliferation and migration of AGS cells;To explore its mechanism in treating precancerous lesions of gastric cancer.Methods AGS cells were divided into blank group,inhibitor group and Huayu Xiaopi Decoction high-,medium-and low-dosage groups.The blank group was cultured with 15%control serum,the inhibitor group was cultured with 10 μmol/L HIF-1α inhibitor,and the Huayu Xiaopi Decoction high-,medium-and low-dosage groups were cultured with 12%,6%and 3%drug containing serum,respectively.CCK-8 method was used to detect cell survival rate,cell migration ability was detected by scratch test,immunofluorescence was used to detect the expressions of proliferating cell nuclear antigen(PCNA),matrix metalloproteinase(MMP)-2 and MMP-9 in AGS cells,the expressions of HIF-1α,COX-2,VEGF,VEGFR2,MMP-2,MMP-9 mRNA and HIF-1α,COX-2,VEGF,VEGFR2 proteins in AGS cells were detected by RT-PCR and Western blot.Results Compared with the blank group,the cell survival rate and migration rate were significantly decreased in the inhibitor group and each dosage of Huayu Xiaopi Decoction groups(P<0.05),the expressions of PCNA,MMP-2 and MMP-9 significantly decreased in the inhibitor group and Huayu Xiaopi Decoction high-and medium-dosage groups(P<0.05),the mRNA expressions of HIF-1α,COX-2,VEGF,VEGFR2,MMP-2,MMP-9 and the protein expression of HIF-1α,COX-2,VEGF,VEGFR2 were significantly decreased(P<0.05).Conclusion Huayu Xiaopi Decoction can inhibit the proliferation and migration of AGS cells,and its mechanism is related to the regulation of the expression of key molecules in HIF-1α/VEGF signaling pathway.

Objective:To reveal the differences in the transcriptome maps of brain tissues in mice subjected to Flash irradiation and conventional dose rate irradiation with electron beams and to explain the biological effect and mechanisms of Flash irradiation from multiple perspectives.Methods:Following the principle of grouping based on approximate body weights, 36 female C57BL/6J mice were divided into three groups, i. e., the control, conventional dose rate irradiation (CONV), and Flash irradiation (Flash) groups, with 12 mice in each group. Both the CONV and Flash groups received a single 15 Gy whole-brain irradiation with 9 MeV electron beams. At 3 d post-irradiation, the whole-brain tissue specimens were collected for hematoxylin-eosin (HE) staining to observe pathological changes. At 1, 3, and 10 weeks post-irradiation, the motion function, cognitive ability, depression level, and spatial memory capacity of the mice were assessed using ethology. At 1 and 10 weeks after behavioral experiments, brain tissue samples were collected and snap-frozen in liquid nitrogen for reference-based transcriptome sequencing. Accordingly, the differences in the transcriptome maps of radiation-induced brain injury between CONV and Flash groups were analyzed.Results:The HE staining-based pathological result revealed that compared to the CONV group, the Flash group exhibited reduced glial cell hyperplasia and inflammatory cell infiltration in brain tissues. Ethological research result at 1 week post-irradiation showed that the CONV group manifested a significantly decreased total traveled distance compared to the control and Flash groups ( t = 5.51, 2.38, P < 0.05) and a significantly increased immobility time compared to the control group ( t = 3.60, P < 0.05). Ethological research result at 3 weeks post-irradiation indicated that compared to the CONV group, the Flash group displayed significantly alleviated cognitive impairment ( t = 3.35, P < 0.05) and reduced depression levels ( t = 2.39, P < 0.05). Ethological research result at 10 weeks post-irradiation demonstrated that the CONV group showed the worst cognitive performance, significantly differing from the control group ( t = 4.53, P < 0.05). Transcriptome sequencing result revealed that besides immune-related pathways, the Flash group also exhibited multiple upregulated metabolic pathways and fibroblast growth factor (FGF)-related pathways compared to the CONV group. Conclusions:Compared to conventional dose rate irradiation, Flash irradiation can effectively alleviate radiation-induced brain injury in mice. This effect is associated with various metabolic pathways (including amino acid metabolism) and FGF-related pathways besides immune pathways.