Objective To evaluate the effects of the method of blood-cooling and blood stasis-resolving on heart function and prognosis in patients with sepsis-induced myocardial dysfunction(SIMD).Methods Sixty patients with SIMD admitted to the department of critical care medicine of Affiliated Hospital of Nanjing University of Chinese Medicine from June 2022 to October 2024 were enrolled as study subjects.The patients were divided into treatment group and control group according to random number table,with 30 patients in each group.All patients received conventional treatments,the patients in the treatment group were given Taohe Chengqi decoction(Persicae Semen 12 g,Chinese rhubarb 12 g,Cinnamon twig 6 g,Licorice root 6 g and Sodium Sulfate 6 g),the decoction was concentrated to 200 mL and taken in 2 divided doses in the morning and evening,one dose daily;and the patients in the control group were given the same amount of warm water.The total course of treatment lasts for 7 days.The differences in indicators of cardiac function[brain natriuretic peptide(BNP),cardiac troponin I(cTnI),MB isoenzyme of creatine kinase(CK-MB),aspartate aminotransferase(AST)]and echocardiographic parameters[left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD),mitral orifice early/late diastolic blood flow velocity ratio(E/A ratio),E/mitral and tricuspid valve ostia and the peak early diastolic velocity(E/e')]at admission,at 1st and 7th day after treatment,and prognosis indexes[mechanical ventilation time,intensive care unit(ICU)length of stay,total hospital stay,28-day survival rate]were compared between two groups.Draw the Kaplan-Meier survival curve and compare the difference in the 28-day cumulative survival rate between the two groups of patients.Results After 7 days therapy,LVEF of the treatment group was significantly higher than that the control(0.524±0.132 vs.0.458±0.118,P<0.05)and E/e'ratio of the treatment group was significantly lower than the control group[11.17(9.57,12.04)vs.11.82(11.28,13.72),P<0.05].There were no significant differences in the 28-day mortality and total hospital stay time between the two groups,but mechanical ventilation time[days:7.00(0.00,11.00)vs.12.50(3.50,21.75),P<0.05]and stay time of ICU[days:14.50(7.75,25.00)vs.21.00(14.25,31.50),P<0.05]in the treatment group were shorter than those in the control group.The Kaplan-Meier survival showed that the cumulative 28-day survival rate was similar between two groups(Log-Rank:χ2=1.448,P=0.229).Conclusion The method of blood-cooling and blood stasis-resolving could decrease mechanical ventilation time and length of stay in ICU of SIMD patients and could increase LVEF in the treatment group.

Transcatheter aortic valve replacement (TAVR) has emerged as the standard treatment for severe aortic stenosis, demonstrating comparable efficacy to traditional surgery in low and intermediate-risk patients. However, the bioprosthetic valves utilized in TAVR have a limited lifespan, and bioprosthetic valve failure, including calcification, rupture or infection may develop, leading to poor clinical outcomes. Elevated blood pressure has been identified as a key factor in aortic valve calcification, and its role in bioprosthetic valve failure is gaining increasing attention. Hypertension may accelerate the calcification process and exacerbate valve failure due to increased mechanical stress on the valve, activation of the renin-angiotensin system, and enhanced thrombus formation. Furthermore, elevated blood pressure interacts with prosthesis mismatch and paravalvular leak, jointly affecting valve durability. This review explores the impact of elevated blood pressure on bioprosthetic valve calcification and failure after TAVR, and emphasizes the importance of blood pressure control, optimized preoperative assessment, and appropriate valve selection in reducing valve failures.
Humans ; Transcatheter Aortic Valve Replacement/adverse effects* ; Calcinosis/etiology* ; Bioprosthesis ; Heart Valve Prosthesis/adverse effects* ; Prosthesis Failure ; Aortic Valve Stenosis/surgery* ; Aortic Valve/surgery* ; Hypertension/physiopathology*

Objective To evaluate the effects of the method of blood-cooling and blood stasis-resolving on heart function and prognosis in patients with sepsis-induced myocardial dysfunction(SIMD).Methods Sixty patients with SIMD admitted to the department of critical care medicine of Affiliated Hospital of Nanjing University of Chinese Medicine from June 2022 to October 2024 were enrolled as study subjects.The patients were divided into treatment group and control group according to random number table,with 30 patients in each group.All patients received conventional treatments,the patients in the treatment group were given Taohe Chengqi decoction(Persicae Semen 12 g,Chinese rhubarb 12 g,Cinnamon twig 6 g,Licorice root 6 g and Sodium Sulfate 6 g),the decoction was concentrated to 200 mL and taken in 2 divided doses in the morning and evening,one dose daily;and the patients in the control group were given the same amount of warm water.The total course of treatment lasts for 7 days.The differences in indicators of cardiac function[brain natriuretic peptide(BNP),cardiac troponin I(cTnI),MB isoenzyme of creatine kinase(CK-MB),aspartate aminotransferase(AST)]and echocardiographic parameters[left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD),mitral orifice early/late diastolic blood flow velocity ratio(E/A ratio),E/mitral and tricuspid valve ostia and the peak early diastolic velocity(E/e')]at admission,at 1st and 7th day after treatment,and prognosis indexes[mechanical ventilation time,intensive care unit(ICU)length of stay,total hospital stay,28-day survival rate]were compared between two groups.Draw the Kaplan-Meier survival curve and compare the difference in the 28-day cumulative survival rate between the two groups of patients.Results After 7 days therapy,LVEF of the treatment group was significantly higher than that the control(0.524±0.132 vs.0.458±0.118,P<0.05)and E/e'ratio of the treatment group was significantly lower than the control group[11.17(9.57,12.04)vs.11.82(11.28,13.72),P<0.05].There were no significant differences in the 28-day mortality and total hospital stay time between the two groups,but mechanical ventilation time[days:7.00(0.00,11.00)vs.12.50(3.50,21.75),P<0.05]and stay time of ICU[days:14.50(7.75,25.00)vs.21.00(14.25,31.50),P<0.05]in the treatment group were shorter than those in the control group.The Kaplan-Meier survival showed that the cumulative 28-day survival rate was similar between two groups(Log-Rank:χ2=1.448,P=0.229).Conclusion The method of blood-cooling and blood stasis-resolving could decrease mechanical ventilation time and length of stay in ICU of SIMD patients and could increase LVEF in the treatment group.

To clarify the causal factors of a case with severe Chlamydia psittaci pneumonia in Jiujiang District， Jiangxi Province and provide a scientific basis for effective prevention and control. Basic information and epidemiological data of the case were collected by epidemiological survey， and the samples from the close contacts and environment were collected for pathogen detection. A 37-year-old female patient was admitted to the hospital due to "fever with cough for five days and worsening dyspnea". The results of targeted next-generation sequencing （tNGS） of pathogenic microorganisms in the bronchoalveolar lavage fluid of the case indicated that the patient was infected with Chlamydia psittaci. Our epidemiological investigation revealed a clear history of chicken and duck exposure. Four throat swab samples of close contacts and one spleen， liver and lung sample of sick chicken and duck were collected for testing. One of the duck tissue samples tested positive， while the other samples were negative. The severe pneumonia was likely caused by exposure to the external environment contaminated by Chlamydia psittaci. Poultry farming should be regulated to prevent the transmission infection from poultry to humans．Additionally， awareness among medical staff should be increased to prevent severe outcomes．

As the backbone force of China's social and economic construction, the health status of workers is closely related to the nation's productivity and social development. Currently, cancers have become one of the major diseases threatening the health of workers. However, there are still many shortcomings in the cancer screening services for the workers. To standardize cancer screening services for workers, ensure the quality of screening services, and improve the overall screening effectiveness, 19 institutions, including Peking Union Medical College Hospital of the Chinese Academy of Medical Sciences, have jointly formulated the Group Standard "Specification for service of cancer screening for workers (T/CHAA 023-2023)". This standard follows the principles of "legality, scientific rigor, advancement, and feasibility" and combines the frontier scientific advances in cancer screening. It clarifies the relevant requirements for service principles, service design, service delivery, service management, service evaluation, and improving worker cancer screening. Implementing this group standard will help connect the common screening needs of workers, employers, and cancer screening service providers, standardize the screening process, improve screening quality, and ultimately increase the early diagnosis rate and survival rate of cancer patients. Consequently, this group standard will help safeguard workers' health rights and interests, ensure the labor force resources, promote the comprehensive coordinated and sustainable development of society, and contribute to realizing the "Healthy China 2030" strategic policy.

Inflammatory bowel disease (IBD) is a complex condition resulting from environmental, microbial, immunologic, and genetic factors. With the advancement of Mendelian randomization research in IBD, we have gained new insights into the relationship between these factors and IBD. Many animal models of IBD have been developed using different methods, but few studies have attempted to model IBD by combining environmental factors and microbial factors. In this review, we examine how environmental factors and microbial factors affect the development and progression of IBD, and how they interact with each other and with the intestinal microbiota. We also summarize the current methods for creating animal models of IBD and compare their advantages and disadvantages. Based on the latest findings from Mendelian randomization studies on the role of environmental factors in IBD, we discuss which environmental and microbial factors could be used to construct a more realistic and reliable IBD experimental model. We propose that animal models of IBD should consider both environmental and microbial factors to better mimic human IBD pathogenesis and to reveal the underlying mechanisms of IBD at the immune and genetic levels.We highlight the importance of environmental and microbial factors in IBD pathogenesis and offer new perspectives and suggestions for improving experimental animal modeling. Our goal is to create a model that closely resembles the clinical picture of IBD.

Objective:To explore the effects of lower concentrations of ropivacaine on ultrasound-guided nerve block in pediatric orthopedic surgery.Methods:Using a retrospective study method, 75 children who underwent orthopedic surgery at Wu Jiang District Children′s Hospital from May 2023 to February 2024 were selected and divided into Group A (25 cases, 0.15% ropivacaine nerve block), Group B (25 cases, 0.20% ropivacaine nerve block) and Group C (25 cases, 0.25% ropivacaine nerve block). The heart rate; mean arterial pressure; onset time of anesthesia; analgesic maintenance time; recovery time of movement and sensation; child face, legs, activity, cry, consolability behavioral tool (FLACC) score at 2 h after surgery; adverse reactions incidence of postoperative local anesthetic drugs were compared.Results:There was no statistically significant difference in the physical indicators of heart rate and mean arterial pressure among the three groups ( P>0.05). As the concentration of ropivacaine increased, the onset time of anesthesia in the three groups of children was shortened: (11.04 ± 1.02) vs. (10.44 ± 1.04) and (7.16 ± 0.85) min, and the differences between the three groups were statistically significant ( P<0.05); There was no statistically significant difference in the analgesic maintenance time among the three groups ( P>0.05). As the concentration of ropivacaine increased, the recovery time of movement and sensation was increased: (194.64 ± 20.43) min vs. (207.72 ± 22.34) and (250.32 ± 30.18) min, (176.44 ± 16.18) min vs. (189.24 ± 20.66) and (224.08±29.56) min, and the differences among the three groups were statistically significant ( P<0.05). There was no statistically significant difference in FLACC scores among the three groups of patients at 2 h after surgery ( P>0.05). The total incidence of adverse reactions in Group A was lower than that in Groups B and C: 4% (1/25) vs. 24% (6/25) and 52% (13/25), and the differences among the three groups were statistically significant ( P<0.05). Conclusions:The 0.15% ropivacaine used for ultrasound-guided nerve block in pediatric orthopedic surgery can achieve good anesthesia effects with low incidence of adverse reactions, and is worthy of clinical promotion.

Objective To investigate the risk factors of 28-day mortality in septic patients and develop optimizing clinical prediction model based on machine learning algorithms.Methods Data from patients admitted to the department of intensive care unit(ICU)of the Affiliated Hospital of Nanjing University of Chinese Medicine from January 2019 to December 2023 were retrospectively analyzed.The data extracted included①gender,age,history of hypertension,diabetes,coronary heart disease,chronic obstructive pulmonary disease(COPD)and chronic kidney disease(CKD);②Vital signs and results of laboratory examination at admission were also collected,then acute physiology and chronic health evaluationⅡ(APACHEⅡ)score and sequential organ failure assessment(SOFA)score were calculated;③The other laboratory test results not included in APACHEⅡscore and SOFA score,such as blood lactate acid(Lac),alanine aminotransferase(AST),hemoglobin(Hb),procalcitonin(PCT),brian natriuretic peptide(BNP),C-reactive protein(CRP),activated partial thromboplastin time(APTT),D-dimer and troponin I(TNI)were also gathered.According to the 28-day survival,the patients were divided into a survival group and a death group.The difference of the clinical data and related loboratory indicators between the two groups of sepsis patients were compared.LASSO regression and Boruta algorithm were used to screen predictive variables.Models of Logistic regression(LG),neural network(NN)and light gradient boosting machine(LightGBM)were constructed.The data was divided into training set and verification set under a ratio of 7:3,and fivefold cross-validation was used to evaluate the stability of the models.Confusion matrix,receiver operator characteristic curve(ROC curve)and calibration curve were also used to assess the recognition ability and accuracy of three models.Decision curve analysis(DCA)was conducted to evaluate the models'utility in decision-making.Shapley additive explanations(SHAP)analysis was used to explain the best-performing model.Results A total of 426 patients were included in the study,of which 256 survived and 170 died.Compared with death group,the age(72.09±14.08 vs.76.88±11.32,P<0.05),COPD[11.33%(29/256)vs.20.00%(34/170)],CKD[20.31%(52/256)vs.31.77%(54/170)],Lac on admission[mmol/L:1.72(1.20,2.66)vs.2.25(1.60,3.50)],AST[U/L:32.00(18.00,59.75)vs.37.00(24.00,76.50)],CRP[mg/L:71.23(22.51,151.79)vs.87.00(37.00,173.36)],APACHEⅡscore(19.96±6.55 vs.22.83±6.92)and SOFA score[7(5,10)vs.9(5,12)]in surrial group were significantly decreased,the difference were statistically significant(all P<0.05).Age,APACHEⅡscore,Lac,PCT and CRP were revealed as independent predictors of 28-day mortality in sepsis by LASSO regression and Boruta algorithm,the above 5 variables were incorporated into the LG,NN and LightGBM models,and the five-fold cross-validation showed that the LightGBM model had the best stability.The confusion matrix,ROC curve and calibration curves of the 3 models were plotted,and the results showed that the F1 score of the 3 models were 0.61,0.63 and 0.74,respectively;area under the curve(AUC)was 0.68,0.74 and 0.87,respectively;the Log Loss was 0.62,0.41 and 0.34,respectively;and the Brier scores were 0.22,0.13 and 0.09,respectively,indicating that LightGBM model was optimal.DCA showed that LightGBM model had the greatest clinical net benefit.SHAP showed that the predicted results were in good agreement with the actual results.Conclusion The LightGBM model exhibited the best performance in predicting 28-day mortality in septic patients and has the potential to help clinicians identify high-risk patients and guide clinical decision-making.

Existing antidepressant treatments are generally suboptimal for patients with bipolar disorder(BD).Several studies have explored the efficacy of light therapy(LT)in patients with bipolar depression,along with investigating parameters,devices,and safety aspects of LT.This paper provides a review of these aspects.Numerous meta-analyses and randomized controlled trials have indicated that LT could significantly improve depressive symptoms in BD patients,with both low and high intensity white light having this effect,while the antidepressant effect of blue light remains unclear.LT takes effect rapidly,preferably in the morning,with each session lasting between 30 to 60 minutes,but there is no consensus on the most beneficial LT course for BD patients.The most commonly used device for LT is a lightbox.However further exploration is need regarding the safety of LT glasses.When LT devices that meet safety standards is selected,the overall safety of LT will be high and risk of manic or hypomanic switch will be low for BD patients.In conclusion,LT holds promise for patients with bipolar depression,and further research on LT for BD patients should be conducted to explore LT strategies and develop LT prescriptions.

Micro-computed tomography(Micro-CT)is a non-invasive technology that is widely used in animal experiments to assist in the detection of bone,lung,oral,metabolic,middle and inner ear diseases,as well as tumors,and in other animal disease models.The technique can provide diverse scientific and reliable imaging data for animal experiments and has accordingly become an indispensable experimental method in animal experiments.In this review,we introduce the imaging principles of Micro-CT,review its application in the study of animal disease models,summarize the limitations of Micro-CT technology,and consider its future prospects.