ObjectiveTo investigate the effect and mechanism of Shengxian Yixin Granule （升陷益心颗粒， SYG） in treating heart failure with preserved ejection fraction （HFpEF）. MethodsExperiment 1： Forty male C57BL/6 mice were randomly divided into control group， model group， low-dose ［25 mg/（kg·d）］， medium-dose ［50 mg/（kg·d）］， and high-dose ［（75 mg/（kg·d）］ SYG groups， with 8 mice per group. Except for the control group， HFpEF was induced by a high-fat diet combined with Nω-nitro-L-arginine methyl ester in drinking water for 16 weeks. After 10 weeks of modeling， treatment groups received corresponding doses of SYG by gavage， while the control group and model group received equal volume of normal saline， for 6 weeks. After 6 weeks of administration， the body weight， blood pressure including systolic blood pressure （SBP） and diastolic blood pressure （DBP）， and heart weight-to-tibia length ratio （HW/TL） were recorded. Echocardiography was used to evaluate left ventricular ejection fraction （LVEF） and the ratio of early to late diastolic transmitral flow velocity （E/A）. Plasma N-terminal pro-brain natriuretic peptide （NT-proBNP） and C-reactive protein （CRP） levels were measured by ELISA. The expression level of brain natriuretic peptide （BNP） in heart tissue was detected by qRT-PCR. Blood lipid levels， including low-density lipoprotein cholesterol （LDL-C）， triglycerides （TG）， and total cholesterol （TC）， were determined by a biochemical analyzer. Splenic proportions of M1 macrophages， M2 macrophages， T helper 17 （Th17） cells， and regulatory T （Treg） cells were analyzed by flow cytometry. Experiment 2： RAW 264.7 cells were stimulated with lipopolysaccharide （LPS） to establish an M1 macrophage polarization model， and then treated with SYG-containing serum for 24 h. The cells were divided into four groups， including blank serum group， high-dose SYG-containing serum group， LPS group， and LPS plus high-dose SYG-containing serum group. Combined with asignal transducer and activator of transcription 3 （Stat3） inhibitor for 24 h， the cells were divided into a lipopolysaccharide group， a high-dose SYG-containing serum group， an inhibitor group， and high-dose SYG-containing serum plus inhibitor group. The expression levels of inducible nitric oxide synthase （iNOS） and interleukin-1β （IL-1β） in each group were detected by qRT-PCR. The protein levels of iNOS， IL-1β， Stat3， and phosphorylated Stat3 （p-Stat3） were detected by Western Blotting. ResultsExperiment 1： Compared to the control group， the model group showed significantly decreased E/A ratio， and increased cardiac BNP expression， plasma NT-proBNP，HW/TL ratio， body weight， TC， LDL-C， SBP， and DBP， as well as shortened exhaustion distance and exhaustion time （P＜0.05 or P＜0.01）. Compared to the model group， the E/A ratio increased in the low-， medium-， and high-dose SYG groups； cardiac BNP expression decreased in the low- and high-dose groups， and plasma NT-proBNP levels decreased in the high-dose group； the HW/TL ratio and body weight decreased， while exhaustion distance and exhaustion time increased in the medium- and high-dose groups； TG levels decreased in the low- and medium-dose groups， and LDL-C levels decreased in the medium- and high-dose groups； SBP and DBP decreased in the low-， medium-， and high-dose groups （P＜0.05 or P＜0.01）. Compared to the low-dose SYG group， body weight decreased， and both exhaustion distance and exhaustion time increased in the medium- and high-dose groups （P＜0.05 or P＜0.01）. Compared to the medium-dose SYG group， the exhaustion time increased in the high-dose SYG group （P＜0.01）. Experiment 2： In the LPS‑induced M1 macrophage polarization model， compared to the blank serum group， the LPS group showed significantly increased mRNA and protein expression of iNOS and IL‑1β， as well as the p‑Stat3/Stat3 ratio （P＜0.01）. Compared to the LPS group， the high‑dose SYG-containing serum plus LPS group showed significantly decreased mRNA and protein expression of iNOS and IL‑1β， as well as the p‑Stat3/Stat3 ratio （P＜0.05 or P＜0.01）. Compared to the LPS group， the inhibitor group also showed significantly reduced these parameters （P＜0.05 or P＜0.01）. ConclusionSYG can improve cardiac function， ventricular remodeling， exercise capacity， and lipid metabolism in HFpEF mice， while inhibiting inflammatory responses. Its mechanism may be related to the regulation of the Stat3 signaling pathway and inhibition of M1 macrophage polarization.

ObjectiveTo investigate the effect and mechanism of Shengxian Yixin Granule （升陷益心颗粒， SYG） in treating heart failure with preserved ejection fraction （HFpEF）. MethodsExperiment 1： Forty male C57BL/6 mice were randomly divided into control group， model group， low-dose ［25 mg/（kg·d）］， medium-dose ［50 mg/（kg·d）］， and high-dose ［（75 mg/（kg·d）］ SYG groups， with 8 mice per group. Except for the control group， HFpEF was induced by a high-fat diet combined with Nω-nitro-L-arginine methyl ester in drinking water for 16 weeks. After 10 weeks of modeling， treatment groups received corresponding doses of SYG by gavage， while the control group and model group received equal volume of normal saline， for 6 weeks. After 6 weeks of administration， the body weight， blood pressure including systolic blood pressure （SBP） and diastolic blood pressure （DBP）， and heart weight-to-tibia length ratio （HW/TL） were recorded. Echocardiography was used to evaluate left ventricular ejection fraction （LVEF） and the ratio of early to late diastolic transmitral flow velocity （E/A）. Plasma N-terminal pro-brain natriuretic peptide （NT-proBNP） and C-reactive protein （CRP） levels were measured by ELISA. The expression level of brain natriuretic peptide （BNP） in heart tissue was detected by qRT-PCR. Blood lipid levels， including low-density lipoprotein cholesterol （LDL-C）， triglycerides （TG）， and total cholesterol （TC）， were determined by a biochemical analyzer. Splenic proportions of M1 macrophages， M2 macrophages， T helper 17 （Th17） cells， and regulatory T （Treg） cells were analyzed by flow cytometry. Experiment 2： RAW 264.7 cells were stimulated with lipopolysaccharide （LPS） to establish an M1 macrophage polarization model， and then treated with SYG-containing serum for 24 h. The cells were divided into four groups， including blank serum group， high-dose SYG-containing serum group， LPS group， and LPS plus high-dose SYG-containing serum group. Combined with asignal transducer and activator of transcription 3 （Stat3） inhibitor for 24 h， the cells were divided into a lipopolysaccharide group， a high-dose SYG-containing serum group， an inhibitor group， and high-dose SYG-containing serum plus inhibitor group. The expression levels of inducible nitric oxide synthase （iNOS） and interleukin-1β （IL-1β） in each group were detected by qRT-PCR. The protein levels of iNOS， IL-1β， Stat3， and phosphorylated Stat3 （p-Stat3） were detected by Western Blotting. ResultsExperiment 1： Compared to the control group， the model group showed significantly decreased E/A ratio， and increased cardiac BNP expression， plasma NT-proBNP，HW/TL ratio， body weight， TC， LDL-C， SBP， and DBP， as well as shortened exhaustion distance and exhaustion time （P＜0.05 or P＜0.01）. Compared to the model group， the E/A ratio increased in the low-， medium-， and high-dose SYG groups； cardiac BNP expression decreased in the low- and high-dose groups， and plasma NT-proBNP levels decreased in the high-dose group； the HW/TL ratio and body weight decreased， while exhaustion distance and exhaustion time increased in the medium- and high-dose groups； TG levels decreased in the low- and medium-dose groups， and LDL-C levels decreased in the medium- and high-dose groups； SBP and DBP decreased in the low-， medium-， and high-dose groups （P＜0.05 or P＜0.01）. Compared to the low-dose SYG group， body weight decreased， and both exhaustion distance and exhaustion time increased in the medium- and high-dose groups （P＜0.05 or P＜0.01）. Compared to the medium-dose SYG group， the exhaustion time increased in the high-dose SYG group （P＜0.01）. Experiment 2： In the LPS‑induced M1 macrophage polarization model， compared to the blank serum group， the LPS group showed significantly increased mRNA and protein expression of iNOS and IL‑1β， as well as the p‑Stat3/Stat3 ratio （P＜0.01）. Compared to the LPS group， the high‑dose SYG-containing serum plus LPS group showed significantly decreased mRNA and protein expression of iNOS and IL‑1β， as well as the p‑Stat3/Stat3 ratio （P＜0.05 or P＜0.01）. Compared to the LPS group， the inhibitor group also showed significantly reduced these parameters （P＜0.05 or P＜0.01）. ConclusionSYG can improve cardiac function， ventricular remodeling， exercise capacity， and lipid metabolism in HFpEF mice， while inhibiting inflammatory responses. Its mechanism may be related to the regulation of the Stat3 signaling pathway and inhibition of M1 macrophage polarization.

Objective To excavate the TCM syndrome of chronic heart failure from 1973 to 2023 and summarize the evolution of the characteristics of medical syndrome.Methods The relevant literature on clinical research on TCM syndromes in three databases including CNKI from January 1,1973 to October 1,2023 was searched,and SPSS 21.0 and Rstudio software were used to conduct descriptive statistical analysis,association rule analysis,and cluster analysis on the distribution characteristics of TCM syndrome types and pattern elements in the final literature.Results A total of 218 literatures,including 41604 patients,covering 29 provinces,municipalities and autonomous regions across the country,were included,of which 179 articles explicitly reported the TCM composite syndrome type,including 31123 patients.A total of 71996 pattern elements were extracted,and the common elements included qi deficiency,blood stasis,phlegm turbidity,etc.The main location of the disease include heart,liver,spleen,etc.The characteristics of TCM syndromes in different regions and different periods show certain evolution rules,from 1973 to 2023,the proportion of qi deficiency and blood stasis pattern and phlegm and stasis mutual obstruction pattern showed an upward trend.The proportion of simple false evidence increased from 1994 to 2003 compared with 1973 to 1993,but decreased from 2004 to 2023,and was lower than that from 1973 to 1993.The proportion of yang deficiency water pan syndrome showed a downward trend;The evolution of syndromes in different regions has changed from deficiency to deficiency and real mixed syndrome,for example,North China,which has the highest proportion,has changed from cardiopulmonary qi deficiency to qi deficiency and blood stasis.In recent years,the proportion of heart,liver and spleen in the chronic heart failure syndrome pattern showed an overall upward trend,the proportion of the syndrome elements of the deficiency syndrome showed a downward trend,and the proportion of the syndrome elements of the standard disease syndrome showed an upward trend.Conclusion The characteristics of chronic heart failure syndrome are always the evidence of deficiency and reality,with"deficiency and qi retention"as the core pathogenesis,and the main disease sites are the heart,liver,and spleen,and the pattern elements composed of qi deficiency,phlegm turbidity,blood stasis,and water drinking gradually occupy a dominant position,and the TCM pattern type of chronic heart failure may show a trend of"deficiency of phlegm and stasis"in the future.

ObjectiveBy exploring the influencing factors of readmission in patients with stable angina of coronary heart disease （CHD） based on real-world clinical data， to establish a risk prediction model of integrated traditional Chinese and western medicine， in order to provide a basis for early identification of high-risk populations and reducing readmission rates. MethodsA prospective clinical study was conducted involving patients with stable angina pectoris of CHD， who were divided into a training set and a validation set at a 7∶3 ratio. General information， traditional Chinese medicine （TCM）-related data， and laboratory test results were uniformly collected. After a one-year follow-up， patients were classified into a readmission group and a non-readmission group based on whether they were readmitted. Univariate and multivariate logistic regression analyses were performed to identify independent risk factors for readmission. A risk prediction model of integrated traditional Chinese and western medicine was constructed and visualized using a nomogram. The model was validated and evaluated in terms of discrimination， calibration， and clinical decision curve analysis. ResultsA total of 682 patients were included， with 477 in the training set and 205 in the validation set， among whom 89 patients were readmitted. Multivariate logistic regression analysis identified heart failure history ［OR = 6.93， 95% CI （1.58， 30.45）］， wiry pulse ［OR = 2.58， 95% CI （1.42， 4.72）］， weak pulse ［OR = 3.97， 95% CI （2.06， 7.67）］， teeth-marked tongue ［OR = 4.38， 95% CI （2.32， 8.27）］， blood stasis constitution ［OR = 2.17， 95% CI （1.06， 4.44）］， phlegm-stasis mutual syndrome ［OR = 3.64， 95% CI （1.87， 7.09）］， and elevated non-high-density lipoprotein cholesterol ［OR = 1.30， 95% CI （1.01， 1.69）］ as influencing factors of readmission. These factors were used as predictors to construct a nomogram-based risk prediction model for readmission in patients with stable angina. The model demonstrated moderate predictive capability， with an area under the receiver operating characteristic curve （AUC） of 0.818 ［95% CI （0.781， 0.852）］ in the training set and 0.816 ［95% CI （0.779， 0.850）］ in the validation set. The Hosmer-Lemeshow test showed good calibration （χ² = 4.55， P = 0.80）， and the model's predictive ability was stable. When the threshold probability exceeded 5%， the clinical net benefit of using the model to predict readmission risk was significantly higher than intervening in all patients. ConclusionHistory of heart failure， teeth-marked tongue， weak pulse， wiry pulse， phlegm-stasis mutual syndrome， blood stasis constitution， and non-high-density lipoprotein cholesterol are influencing factors for readmission in patients with stable angina of CHD. A clinical prediction model was developed based on these factors， which showed good discrimination， calibration， and clinical utility， providing a scientific basis for predicting readmission events in patients with stable angina.

Objective To excavate the TCM syndrome of chronic heart failure from 1973 to 2023 and summarize the evolution of the characteristics of medical syndrome.Methods The relevant literature on clinical research on TCM syndromes in three databases including CNKI from January 1,1973 to October 1,2023 was searched,and SPSS 21.0 and Rstudio software were used to conduct descriptive statistical analysis,association rule analysis,and cluster analysis on the distribution characteristics of TCM syndrome types and pattern elements in the final literature.Results A total of 218 literatures,including 41604 patients,covering 29 provinces,municipalities and autonomous regions across the country,were included,of which 179 articles explicitly reported the TCM composite syndrome type,including 31123 patients.A total of 71996 pattern elements were extracted,and the common elements included qi deficiency,blood stasis,phlegm turbidity,etc.The main location of the disease include heart,liver,spleen,etc.The characteristics of TCM syndromes in different regions and different periods show certain evolution rules,from 1973 to 2023,the proportion of qi deficiency and blood stasis pattern and phlegm and stasis mutual obstruction pattern showed an upward trend.The proportion of simple false evidence increased from 1994 to 2003 compared with 1973 to 1993,but decreased from 2004 to 2023,and was lower than that from 1973 to 1993.The proportion of yang deficiency water pan syndrome showed a downward trend;The evolution of syndromes in different regions has changed from deficiency to deficiency and real mixed syndrome,for example,North China,which has the highest proportion,has changed from cardiopulmonary qi deficiency to qi deficiency and blood stasis.In recent years,the proportion of heart,liver and spleen in the chronic heart failure syndrome pattern showed an overall upward trend,the proportion of the syndrome elements of the deficiency syndrome showed a downward trend,and the proportion of the syndrome elements of the standard disease syndrome showed an upward trend.Conclusion The characteristics of chronic heart failure syndrome are always the evidence of deficiency and reality,with"deficiency and qi retention"as the core pathogenesis,and the main disease sites are the heart,liver,and spleen,and the pattern elements composed of qi deficiency,phlegm turbidity,blood stasis,and water drinking gradually occupy a dominant position,and the TCM pattern type of chronic heart failure may show a trend of"deficiency of phlegm and stasis"in the future.

OBJECTIVE To investigate the ameliorative effects and potential mechanism of total secondary ginsenosides(TSG)on hypertrophic changes of primary cardiomyocytes stimulated by angiotensin Ⅱ(AngⅡ).METHODS Primary cardiomyocytes were isolated from the hearts of neonatal SD rats and divided into the following groups:control group,AngⅡgroup(2 μmol/L),TSG group(7.5 μg/mL),PFK-015 group[6-phosphofructo-2-kinase/fructose-2,6-bisphosphatase 3(PFKFB3)inhibitor,10 nmol/L],and TSG+PFK-015 group(TSG 7.5 μg/mL+PFK-015 10 nmol/L).The surface area,protein synthesis,energy metabolism-related indicators[free fatty acid(FFA),coenzyme A(CoA),acetyl coenzyme A(acetyl-CoA)],and the expressions of glycolysis-related factors[hypoxia-inducible factor 1α(HIF-1α),glucose transporter protein 4(GLUT-4),lactate dehydrogenase A(LDHA),pyruvate dehydrogenase kinase 1(PDK1)and PFKFB3]in primary cardiomyocytes of each group were measured.RESULTS Compared with the control group,the surface area of primary cardiomyocytes and protein synthesis were significantly increased,the content of FFA,protein and mRNA expressions of HIF-1α,LDHA,PDK1 and PFKFB3 were significantly increased or up-regulated in the AngⅡ group,while the contents of CoA and acetyl-CoA,the protein and mRNA expressions of GLUT-4 were significantly decreased or down-regulated(P＜0.05).Compared with the AngⅡ group,both TSG group and PFK-015 group showed significant improvements in these indexes,with the TSG+PFK-015 group generally demonstrating superior effects compared to either treatment alone(P＜0.05).CONCLUSIONS TSG can reduce the surface area of AngⅡ-induced primary cardiomyocytes,decrease protein synthesis,and inhibit their hypertrophic changes.These effects may be related to improving energy metabolism and the inhibition of glycolysis activity.

Objective Based on the technology acceptance model,to explore the influence mechanism of technical support,perceived interactivity,perceived usefulness,perceived ease of use and perceived risk on medical staff's report intention on adverse events,and to provide path suggestions for improving medical staff's report intention adverse events.Methods The multi-stage sampling method was used to select 637 medical staffs of tertiary public hospitals in Hangzhou who used the information-based platform to report adverse events as the research respondents,and the self-developed scale of report intention on adverse events was used as the research tool,monofactor analysis were conducted by Wilcoxon rank-sum test,and the structural equation model was used to analyze the influence path of their report intention on adverse events.Results Perceived ease of use and perceived usefulness have positive effects on medical staff's report intention on adverse events(β=0.264,0.658;P＜0.001);Perceived risk negatively affected the medical staff's report intention on adverse events(β=-0.143,P＜0.001).The indirect effects of perceived usefulness and perceived ease of use on medical staff's report intention on adverse events are 0.538 and 0.205,respectively.Conclusion Perceived usefulness and perceived ease of use plays a mediating role in perceived interactivity and medical staff's report intention on adverse events.

Objective Based on the technology acceptance model,to explore the influence mechanism of technical support,perceived interactivity,perceived usefulness,perceived ease of use and perceived risk on medical staff's report intention on adverse events,and to provide path suggestions for improving medical staff's report intention adverse events.Methods The multi-stage sampling method was used to select 637 medical staffs of tertiary public hospitals in Hangzhou who used the information-based platform to report adverse events as the research respondents,and the self-developed scale of report intention on adverse events was used as the research tool,monofactor analysis were conducted by Wilcoxon rank-sum test,and the structural equation model was used to analyze the influence path of their report intention on adverse events.Results Perceived ease of use and perceived usefulness have positive effects on medical staff's report intention on adverse events(β=0.264,0.658;P＜0.001);Perceived risk negatively affected the medical staff's report intention on adverse events(β=-0.143,P＜0.001).The indirect effects of perceived usefulness and perceived ease of use on medical staff's report intention on adverse events are 0.538 and 0.205,respectively.Conclusion Perceived usefulness and perceived ease of use plays a mediating role in perceived interactivity and medical staff's report intention on adverse events.

Objective Based on the technology acceptance model,to explore the influence mechanism of technical support,perceived interactivity,perceived usefulness,perceived ease of use and perceived risk on medical staff's report intention on adverse events,and to provide path suggestions for improving medical staff's report intention adverse events.Methods The multi-stage sampling method was used to select 637 medical staffs of tertiary public hospitals in Hangzhou who used the information-based platform to report adverse events as the research respondents,and the self-developed scale of report intention on adverse events was used as the research tool,monofactor analysis were conducted by Wilcoxon rank-sum test,and the structural equation model was used to analyze the influence path of their report intention on adverse events.Results Perceived ease of use and perceived usefulness have positive effects on medical staff's report intention on adverse events(β=0.264,0.658;P＜0.001);Perceived risk negatively affected the medical staff's report intention on adverse events(β=-0.143,P＜0.001).The indirect effects of perceived usefulness and perceived ease of use on medical staff's report intention on adverse events are 0.538 and 0.205,respectively.Conclusion Perceived usefulness and perceived ease of use plays a mediating role in perceived interactivity and medical staff's report intention on adverse events.

【Objective】 To explore the effect of physical fitness training on social adaptive behavior of children with global developmental delay (GDD), in order to provide treatment experience for GDD children. 【Methods】 From November 2021 to December 2022, a total of 60 children with GDD diagnosed and treated in the Third Affiliated Hospital of Jiamusi University were enrolled in this study, and were randomly divided into control group (n=30) and test group (n=30).The control group received routine rehabilitation treatment, and the test group received physical fitness training additionally.The intervention lasted for 12 weeks, with the frequency of 3times/week, 30min/time.All subjects were tested for physical fitness and children′s social adaptive behavior before and after training. 【Results】 Before treatment, the difference between the results of physical fitness test and social adaptive behavior scores of the GDD children in two groups was not statistically significant (P>0.05).After 3 months of treatment, the physical fitness test scores, except body mass index (BMI), and social adaptive behavior scores of the GDD children in two groups were significantly different from those before treatment (P<0.05), and the physical fitness test scores (except for height, weight and BMI) and the social adaptive behavior of the test group were better than those of the control group (t=2.363,4.020,3.331,3.338,P<0.05). 【Conclusion】 Physical fitness training can significantly improve the adaptive behavior, independent function, cognitive function and social/self-control ability of GDD children.