Objective To construct an animal model of dilated cardiomyopathy(DCM)with heart failure toxin syndrome that conforms to the characteristics of traditional Chinese medicine(TCM)syndrome and identify potential biomarkers or intervention targets for DCM with heart failure toxin syndrome.Methods Fifteen male SD rats were divided into a blank control,doxorubicin,or DCM with heart failure toxin syndrome group using a random number table method,with five rats per group.The doxorubicin group received intraperitoneal injection of doxorubicin at a dose of 1.25 mg/kg,administered on the first and fourth days of each week,along with a standard diet.The DCM with heart failure toxin syndrome group,in addition to the doxorubicin treatment,was given 42％white liquor(10 mL/kg)via gavage every other day,along with a 45％high-fat feed and 10％fructose water.The blank control group received intraperitoneal injection of an equivalent volume of phosphate-buffered saline at the same time points as the doxorubicin group,along with a standard diet.The model was established for 10 weeks.At the fourth and tenth weeks of modeling,echocardiography was performed to measure left ventricular ejection fraction(LVEF),fractional shortening(FS),systolic left ventricular posterior wall thickness(LVPWs),diastolic left ventricular posterior wall thickness,systolic left ventricular internal diameter(LVIDs),and diastolic left ventricular internal diameter(LVIDd);macroscopic changes in fur color of the rats were assessed using the red-green-blue colorimetric method.After modeling,the open field test was conducted to evaluate the exercise tolerance of the rats,and the grip strength test was performed to assess changes in forelimb grip strength.Hematoxylin-eosin,Masson,and wheat germ agglutinin staining were used to evaluate pathological changes in cardiac tissue.Bulk RNA sequencing analysis was performed to identify differentially expressed genes(DEGs)in the hearts of rats between the blank control and the DCM with heart failure toxin syndrome groups.Using DCM,the Blue value of rat fur color,and forelimb grip strength as phenotypic traits,weighted gene co-expression network analysis(WGCNA)was performed to screen for characteristic module gene sets(MEs)associated with DCM with heart failure toxin syndrome.Overlapping analysis was performed on DEGs,immune-related gene sets,and MEs,and the intersecting genes were identified as potential biomarkers or intervention targets for DCM with heart failure toxin syndrome.The sensitivity and specificity of these targets were evaluated using receiver operating characteristic(ROC)curve analysis.Results Compared with the blank control group,at the tenth week of modeling,the LVEF,FS,and LVPWs of rats in the doxorubicin group and the DCM with heart failure toxin syndrome group decreased,whereas LVIDs and LVIDd increased,and the movement distance of the open field test and forelimb grip strength were reduced(P＜0.05).At the 10th week of modeling,the Blue value of fur color in the DCM with heart failure toxin syndrome group was significantly lower than that of the blank control and doxorubicin groups(P＜0.05).Compared with the blank control group,rats in the doxorubicin and DCM with heart failure toxin syndrome groups exhibited significant cardiac dilation and increased immune cell infiltration in cardiac tissue,accompanied by collagen deposition and cardiomyocyte hypertrophy.Bulk RNA sequencing identified 2,003 DEGs,including 1,082 downregulated genes and 921 upregulated genes.WGCNA results revealed that the MEturquoise module had the strongest positive correlation with DCM and the strongest negative correlation with the Blue value and forelimb grip strength.The overlapping analysis identified four intersecting genes:bone morphogenetic protein 6(Bmp6),serine-threonine-protein kinase 1(Pak1),proto-oncogene JunD(JunD),and S100 calcium-binding protein A3(S100A3).ROC curve analysis demonstrated that these four genes exhibited high sensitivity and specificity for DCM with heart failure toxin syndrome.Conclusion The rat model constructed by intraperitoneal injection of doxorubicin combined with a high-fat feed,fructose water,and white liquor gavage closely aligns with the characteristics of the DCM with heart failure toxin syndrome.Bmp6,JunD,Pak1,and S100A3 are potential biomarkers or therapeutic targets for DCM heart failure toxin syndrome.

Objective To construct an animal model of dilated cardiomyopathy(DCM)with heart failure toxin syndrome that conforms to the characteristics of traditional Chinese medicine(TCM)syndrome and identify potential biomarkers or intervention targets for DCM with heart failure toxin syndrome.Methods Fifteen male SD rats were divided into a blank control,doxorubicin,or DCM with heart failure toxin syndrome group using a random number table method,with five rats per group.The doxorubicin group received intraperitoneal injection of doxorubicin at a dose of 1.25 mg/kg,administered on the first and fourth days of each week,along with a standard diet.The DCM with heart failure toxin syndrome group,in addition to the doxorubicin treatment,was given 42％white liquor(10 mL/kg)via gavage every other day,along with a 45％high-fat feed and 10％fructose water.The blank control group received intraperitoneal injection of an equivalent volume of phosphate-buffered saline at the same time points as the doxorubicin group,along with a standard diet.The model was established for 10 weeks.At the fourth and tenth weeks of modeling,echocardiography was performed to measure left ventricular ejection fraction(LVEF),fractional shortening(FS),systolic left ventricular posterior wall thickness(LVPWs),diastolic left ventricular posterior wall thickness,systolic left ventricular internal diameter(LVIDs),and diastolic left ventricular internal diameter(LVIDd);macroscopic changes in fur color of the rats were assessed using the red-green-blue colorimetric method.After modeling,the open field test was conducted to evaluate the exercise tolerance of the rats,and the grip strength test was performed to assess changes in forelimb grip strength.Hematoxylin-eosin,Masson,and wheat germ agglutinin staining were used to evaluate pathological changes in cardiac tissue.Bulk RNA sequencing analysis was performed to identify differentially expressed genes(DEGs)in the hearts of rats between the blank control and the DCM with heart failure toxin syndrome groups.Using DCM,the Blue value of rat fur color,and forelimb grip strength as phenotypic traits,weighted gene co-expression network analysis(WGCNA)was performed to screen for characteristic module gene sets(MEs)associated with DCM with heart failure toxin syndrome.Overlapping analysis was performed on DEGs,immune-related gene sets,and MEs,and the intersecting genes were identified as potential biomarkers or intervention targets for DCM with heart failure toxin syndrome.The sensitivity and specificity of these targets were evaluated using receiver operating characteristic(ROC)curve analysis.Results Compared with the blank control group,at the tenth week of modeling,the LVEF,FS,and LVPWs of rats in the doxorubicin group and the DCM with heart failure toxin syndrome group decreased,whereas LVIDs and LVIDd increased,and the movement distance of the open field test and forelimb grip strength were reduced(P＜0.05).At the 10th week of modeling,the Blue value of fur color in the DCM with heart failure toxin syndrome group was significantly lower than that of the blank control and doxorubicin groups(P＜0.05).Compared with the blank control group,rats in the doxorubicin and DCM with heart failure toxin syndrome groups exhibited significant cardiac dilation and increased immune cell infiltration in cardiac tissue,accompanied by collagen deposition and cardiomyocyte hypertrophy.Bulk RNA sequencing identified 2,003 DEGs,including 1,082 downregulated genes and 921 upregulated genes.WGCNA results revealed that the MEturquoise module had the strongest positive correlation with DCM and the strongest negative correlation with the Blue value and forelimb grip strength.The overlapping analysis identified four intersecting genes:bone morphogenetic protein 6(Bmp6),serine-threonine-protein kinase 1(Pak1),proto-oncogene JunD(JunD),and S100 calcium-binding protein A3(S100A3).ROC curve analysis demonstrated that these four genes exhibited high sensitivity and specificity for DCM with heart failure toxin syndrome.Conclusion The rat model constructed by intraperitoneal injection of doxorubicin combined with a high-fat feed,fructose water,and white liquor gavage closely aligns with the characteristics of the DCM with heart failure toxin syndrome.Bmp6,JunD,Pak1,and S100A3 are potential biomarkers or therapeutic targets for DCM heart failure toxin syndrome.

Rosacea is a chronic facial inflammatory skin disease. It has been proved that heredity, immunity, neurovascular disorders, microorganisms, skin barrier damage and ultraviolet rays are closely related to the occurrence of rosacea. However, the exact pathogenesis of rosacea has not been fully elucidated. This review summarizes recent advances in the pathogenesis of rosacea in the past 5 years.

Objective To explore the postoperative characteristics and management experience of patients with coronavirus disease 2019 (COVID-19) undergoing cardiac and vascular surgery. Methods From December 7, 2022 to January 5, 2023, the patients with COVID-19 who were admitted to Cardiovascular Hospital Affiliated to Kunming Medical University and underwent cardiac and vascular surgery were selected. The clinical history, surgical information, postoperative recovery process and treatment plan were analyzed retrospectively. Results There were 18 patients in this group, including 11 (61.1%) males and 7 (38.9%) females, with an average age of 58.1±10.9 years. There were 7 patients of hypertension, 5 patients of diabetes, 3 patients of respiratory diseases, and 2 patient of chronic renal insufficiency. There were 5 (27.8%) patients receiving emergency operations and 13 (72.2%) elective operations. All the 18 patients underwent cardiac and vascular surgery in the period of COVID-19, and the time between the last positive nucleic acid test and the surgery was 1.50 (1.00, 6.25) days. There were 8 patients of pulmonary imaging changes, including 3 patients with chest patch shadow, 3 patients with thickened and disordered lung markings, and 2 patients with exudative changes before operation. Antiviral therapy was not adopted in all patients before operation. Three patients were complicated with viral pneumonia after operation, including 2 patients with high risk factors before operation, who developed into severe pneumonia after operation, and underwent tracheotomy. One patient with thrombus recovered after anticoagulation treatment. Another patient of mild pneumonia recovered after antiviral treatment. The other 15 patients recovered well without major complications. There was no operation-related death in the whole group. One patient died after surgery, with a mortality rate of 5.6%. Conclusion Patients with COVID-19 are at high risk of cardiac and vascular surgery, and patients with high-risk factors may rapidly progress to severe pneumonia. Patients with preoperative lung imaging changes or other basic visceral diseases should consider delaying the operation. Early antiviral combined with immunomodulation treatment for emergency surgery patients may help improve the prognosis.

Objective To explore the postoperative characteristics and management experience of patients with coronavirus disease 2019 (COVID-19) undergoing cardiac and vascular surgery. Methods From December 7, 2022 to January 5, 2023, the patients with COVID-19 who were admitted to Cardiovascular Hospital Affiliated to Kunming Medical University and underwent cardiac and vascular surgery were selected. The clinical history, surgical information, postoperative recovery process and treatment plan were analyzed retrospectively. Results There were 18 patients in this group, including 11 (61.1%) males and 7 (38.9%) females, with an average age of 58.1±10.9 years. There were 7 patients of hypertension, 5 patients of diabetes, 3 patients of respiratory diseases, and 2 patient of chronic renal insufficiency. There were 5 (27.8%) patients receiving emergency operations and 13 (72.2%) elective operations. All the 18 patients underwent cardiac and vascular surgery in the period of COVID-19, and the time between the last positive nucleic acid test and the surgery was 1.50 (1.00, 6.25) days. There were 8 patients of pulmonary imaging changes, including 3 patients with chest patch shadow, 3 patients with thickened and disordered lung markings, and 2 patients with exudative changes before operation. Antiviral therapy was not adopted in all patients before operation. Three patients were complicated with viral pneumonia after operation, including 2 patients with high risk factors before operation, who developed into severe pneumonia after operation, and underwent tracheotomy. One patient with thrombus recovered after anticoagulation treatment. Another patient of mild pneumonia recovered after antiviral treatment. The other 15 patients recovered well without major complications. There was no operation-related death in the whole group. One patient died after surgery, with a mortality rate of 5.6%. Conclusion Patients with COVID-19 are at high risk of cardiac and vascular surgery, and patients with high-risk factors may rapidly progress to severe pneumonia. Patients with preoperative lung imaging changes or other basic visceral diseases should consider delaying the operation. Early antiviral combined with immunomodulation treatment for emergency surgery patients may help improve the prognosis.

Objective:To explore forecast indicators for the prognosis of sepsis in adult extremely severe burn patients.Methods:Case data of adults with extremely severe burns combined with sepsis admitted to the Second Affiliated Hospital of Zhejiang University School of Medicine from January 2017 to December 2021 were retrospectively collected. According to the prognosis, all patients were divided into a death group and a survival group. The general conditions of the two groups were compared. The clinical symptoms, vital signs, platelet count (PLT), white blood cell count (WBC), neutrophil ratio, procalcitonin (PCT), blood sodium, blood glucose, hemoglobin and albumin levels at diagnosis of sepsis were also compared between the two groups. The independent sample t test, Mann?Whitney U test, or Fisher's exact probability test was used for group comparison. Variables with statistical significance in univariate analysis were included in the Cox regression model for multivariate analysis to assess the effect of each index on the outcome of extremely severe burn patients with sepsis. The predictive value of each index for sepsis outcome was analyzed by the receiver operating characteristic curve (ROC). Results:A total of 60 patients with particularly severe burn sepsis were selected, including 41 males and 19 females aged 18 to 84 years. The diagnosis time of sepsis was 14 (7, 24) days after injury. There were 29 patients in the death group and 31 patients in the survival group, and the mortality rate was 48.3%. Compared with the survival group, PLT and hemoglobin levels in the death group decreased significantly (both P<0.05), and PCT and blood sodium levels increased significantly (both P<0.05), while the other indicators did not change significantly (all P>0.05). The results of multivariate Cox regression analysis showed that hemoglobin ( HR=0.936, 95% CI: 0.935-0.991) and serum sodium levels ( HR=1.031, 95% CI: 1.010-1.052) at the time of sepsis diagnosis were independent risk factors affecting the prognosis of sepsis in extra-severe burn patients (both P<0.05). ROC curve analysis showed that the AUCs of hemoglobin, blood sodium and PCT for predicting the prognosis of extremely severe burn patients with sepsis were 0.747, 0.811 and 0.690, respectively (all P<0.05). The cut-off value of hemoglobin for predicting prognosis was 77 g/L, with a sensitivity of 69.0% and specificity of 74.2%. The cut-off value of blood sodium for predicting prognosis was 138 mmol/L, with a sensitivity of 89.7% and specificity of 61.3%. The cut-off value of PCT was 3.51 μg/L, with a sensitivity of 65.5% and specificity of 74.2%. Conclusions:Hemoglobin, blood sodium and PCT may be predictors of outcome in extremely severe burn patients with sepsis.

Tetrapyrrole compounds are a class of compounds with important functions. They exist in living organisms and have been widely used in agriculture, food, medicine, and other fields. The cumbersome process and high cost of chemical synthesis, as well as the shortcomings of unstable quality of animal and plant extraction methods, greatly hampered the industrial production and applications of tetrapyrrole compounds. In recent years, the rapid development of synthetic biology has provided new tools for microorganisms to efficiently synthesize tetrapyrrole compounds from renewable biomass resources. This article summarizes various strategies for the biosynthesis of tetrapyrrole compounds, discusses methods to improve its biosynthesis efficiency and future prospects, with the aim to facilitate the research on biosynthesis of tetrapyrrole compounds.
Biomass ; Plants/genetics* ; Synthetic Biology ; Tetrapyrroles

Objective: To evaluate snack consumption and the influencing factors associated with student participation in the Nutrition Improvement Program, and to provide a scientific basis for improving the program. Methods: Among the 50 monitoring counties that implemented the Compulsory Education Student Nutrition Improvement Program, two primary schools and two junior schools were randomly selected according to different food supply patterns (i.e., school, company, and mix). This study randomly selected one or two classes from each grade, which ranged from grade 3 to grade 9. A questionnaire, which addressed snack consumption and choice, was distributed to 27 374 students. Results: The findings revealed that 14.0% of students from poor rural areas in central and western regions consumed snacks two or more times per day, and 21.6% of students spent 3 yuan or more on snacks each day. The top three choices of snacks included fruit and vegetables (50.6%), biscuits and bread (50.1%), and puffed food (40.0%). Students who had mothers who worked outside the home, parents who worked outside the home, who consumed corporate meals, and who had access to a small shop on campus were more likely to consume snacks one or more times per day(OR=1.35，1.19，1.11，1.51，P<0.05). Conclusion The phenomenon of snack consumption among primary and middle school students from poor rural areas in central and western regions is common, and the selection of unhealthy snacks was identified as a problem. A health education system with comprehensive support and guidance from individuals, families, schools, and society should be established to guide students to opt for healthier snacks.

Objective: To evaluate temporal trend in food supply among pilot schools involved in the National Nutrition Improvement Program for Rural Compulsory Education Students (NNIPRCES). Methods: Ten percent of pilot schools were randomly selected and asked to report the information on food supplies. Daily intake of energy, carbohydrates and protein for each student were calculated and compared with the reference value in Nutrition Guidelines of School Meals (WS/T 554-2017). Results: Energy and protein supply increased among those pilot schools. The supply of energy increased from 1 566.5 kcal in 2012 to 1 927.4 kcal in 2017, protein increased from 49.0 g to 61.0 g. The energy ratio of fat increased from 31.9% to 34.9%, while energy ratio of carbohydrate decreased significantly (F=83.38, 128.36, 20.27 and 17.28, all P<0.05). The proportion of reasonable energy supply from carbohydrate and fat in 2017 were 17.5% and 26.8%, respectively. Conclusion The supply of energy and macronutrients in the pilot areas were unreasonable, more measures including dietary guide and monitoring need to be adopted to improve students nutrition status among rural areas.

Objective: To analyze the prevalence of stunting among students received subsidies of the National Nutrition Improvement Program for rural Compulsory Education Students (NNIPRCES) during 2012-2017. Methods: By using the data from 2012-2017 NNIPRCES survey, students aged 6-15 with valid height records were included. Stunting was defined according to the Screening Criteria of Malnutrition for School Age Children and Adolescents (WS/T 456—2014). To explore the association of the risk of stunting between different regions, gender or age groups in rural students. Results: The prevalence of stunting among students aged 6-15 who received subsidies of NNIPRCES during 2012-2017 were 8.0%, 7.9%, 6.9%, 6.5%, 6.0% and 5.3%, declined by 2.7, 1.8, 4.0 percentage points in average, as well as in central and western region, respectively. The prevalence of stunting declined with 2.7 percentage points for boys and ,2.9 percentage points for girls. The prevalence of stunting declined most at the age of 13, with 4.0 percentage points. Conclusion The prevalence of stunting of students has declined after the implementation of NNIPRCES from 2012 to 2017. However, the total prevalence of stunting was still high and the development was unbalanced between central and western region, which requires more target intervening strategies to improve the nutritional status of students.