Objective To observe the value of rheolytic mechanical thrombectomy for treating acute popliteal and infrapopliteal artery thromboembolism.Methods A total of 66 patients with acute popliteal and infrapopliteal artery thromboembolism were retrospectively included,including 31 cases underwent rheolytic mechanical thrombectomy(group A)and 35 underwent manual aspiration thrombectomy through a guide catheter(group B).Clinical data,technical success rate,immediate thrombi clearance grade,complication rates and follow-up vascular patency of the affected limbs were compared between groups.Results No significant difference of patients'baseline characteristics was observed between groups(all P＞0.05).The technical success rates were 100%in both groups.Group A showed higher immediate thrombi clearance rate but lower dosage of urokinase,indwelling time of the thrombolytic catheter and hospital stay than group B(all P＜0.05).The incidence of hemoglobinuria after intervention was higher in group A than in group B(P＜0.05),but no significant difference of bleeding risk nor reperfusion syndrome rates was noticed between groups(both P＞0.05).After treatment,1 patient in group A died due to cardiogenic shock while 2 patients in group B required amputation due to prolonged limb ischemia.Among 63 patients who completed the 12-month follow-up,no significant difference of vascular patency in affected limb was observed among 1,3 nor 6 months post-intervention(all P＞0.05),but group A exhibited higher vascular patency in affected limb than group B at 12 months post-intervention(P＜0.05).Conclusion Rheolytic mechanical thrombectomy could be used to treat lower limb ischemia caused by popliteal and infrapopliteal artery thromboembolism with satisfactory clinical effect.

Acute lower limb ischemia(ALLI),especially in the popliteal and infrapopliteal artery,poses a serious threat to human health.Endovascular intervention technology,which had gradually developed in recent years,replaced surgical intervention for treatment of ALLI.The current status of endovascular intervention therapy for ALLI caused by popliteal and infrapopliteal artery thrombosis and embolization were reviewed in this article.

Objective To observe the value of rheolytic mechanical thrombectomy for treating acute popliteal and infrapopliteal artery thromboembolism.Methods A total of 66 patients with acute popliteal and infrapopliteal artery thromboembolism were retrospectively included,including 31 cases underwent rheolytic mechanical thrombectomy(group A)and 35 underwent manual aspiration thrombectomy through a guide catheter(group B).Clinical data,technical success rate,immediate thrombi clearance grade,complication rates and follow-up vascular patency of the affected limbs were compared between groups.Results No significant difference of patients'baseline characteristics was observed between groups(all P＞0.05).The technical success rates were 100%in both groups.Group A showed higher immediate thrombi clearance rate but lower dosage of urokinase,indwelling time of the thrombolytic catheter and hospital stay than group B(all P＜0.05).The incidence of hemoglobinuria after intervention was higher in group A than in group B(P＜0.05),but no significant difference of bleeding risk nor reperfusion syndrome rates was noticed between groups(both P＞0.05).After treatment,1 patient in group A died due to cardiogenic shock while 2 patients in group B required amputation due to prolonged limb ischemia.Among 63 patients who completed the 12-month follow-up,no significant difference of vascular patency in affected limb was observed among 1,3 nor 6 months post-intervention(all P＞0.05),but group A exhibited higher vascular patency in affected limb than group B at 12 months post-intervention(P＜0.05).Conclusion Rheolytic mechanical thrombectomy could be used to treat lower limb ischemia caused by popliteal and infrapopliteal artery thromboembolism with satisfactory clinical effect.

Acute lower limb ischemia(ALLI),especially in the popliteal and infrapopliteal artery,poses a serious threat to human health.Endovascular intervention technology,which had gradually developed in recent years,replaced surgical intervention for treatment of ALLI.The current status of endovascular intervention therapy for ALLI caused by popliteal and infrapopliteal artery thrombosis and embolization were reviewed in this article.

Objective To analyse whether Resveratrol can inhibit the inflammatory response in septic cardiomyopathy by modulating the mammalian target of rapamycin-transcription factor EB(mTOR-TFEB)signaling pathway.Methods A total of 32 clean-grade male Sprague-Dawley(SD)rats were selected and divided into sham operation group(Sham group),sepsis model group[cecal ligation and puncture(CLP)group],Resveratrol group(Res group)and mTOR inhibitor group(Torin1 group),with 8 rats in each group.Sepsis was induced by CLP.The sham group only underwent laparotomy and did not perform CLP.In the Torin1 group,20 mg·kg-1·d-1 of mTOR inhibitor Torin l injection was injected intraperitoneally 10 days before molding,once a day for 10 days.The Sham group and the CLP group were given the same amount of normal saline through the same route before molding.The Res group was injected intraperitoneally with 60 mg/kg Resveratrol injection before molding.At 6 hours after model establishment,the heart function was evaluated by echocardiography;Serum cardiac troponin I(cTnI)levels were detected by enzyme linked immunosorbent assay(ELISA).The mRNA expressions of interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)were detected by real-time fluorescence quantitative polymerase chain reaction(RT-qPCR).The protein expressions of phosphorylation-mTOR(p-mTOR),TFEB(nuclear),TFEB(total)and light chain 3-Ⅱ(LC3-Ⅱ)of myocardial tissue were detected by Western blotting.The interaction between Resveratrol and mTOR was simulated using a network pharmacology approach.Results Compared with the sham group,the left ventricular ejection fraction(LVEF)and left ventricular short-axis shortening rate(FES)were significantly reduced in the CLP group[LVEF:0.37±0.02 vs.0.69±0.01,FES(%):17.8±3.1 vs.33.9±2.8,both P<0.01],serum cTnI levels were elevated(ng/L:1 935.96±47.78 vs.87.95±7.98,P<0.01),the mRNA expression levels of IL-6 and TNF-α were significantly up-regulated[IL-6 mRNA(2-ΔΔCt):26.10±2.08 vs.1.61±0.03,TNF-α mRNA(2-ΔΔCt):12.80±1.51 vs.1.26±0.22,both P<0.01),serum levels of inflammatory cytokines IL-6 and TNF-α mRNA were increased[IL-6 mRNA(2-ΔΔCt):26.10±2.08 vs.1.61±0.03,TNF-α mRNA(2-ΔΔCt):12.80±1.51 vs.1.26±0.22,both P<0.01),the expression level of p-mTOR protein in myocardial tissue was significantly increased(p-mTOR/β-actin:0.60±0.07 vs.0.30±0.05),while the protein levels of TFEB(total),TFEB(nuclear)and LC3-Ⅱwere significantly decreased[TFEB(total)/β-actin:0.52±0.08 vs.0.80±0.09,TFEB(nuclear)/H3:0.36±0.06 vs.0.09±0.07,LC3-Ⅱ/β-actin:0.25±0.08 vs.0.48±0.08,all P<0.01];Compared with the CLP group,the Res group and the Torin1 group had significantly higher LVEF and FES[LVEF:0.66±0.02,0.67±0.03 vs.0.37±0.02;FES(%):32.5±3.5,33.7±3.3 vs.17.8±3.1,both P<0.01],serum cTnI level was decreased(ng/L:1 216.88±36.66,1 225.78±35.64 vs.1 935.96±47.78,both P<0.01),mRNA levels of serum inflammatory cytokines IL-6 and TNF-α were decreased[IL-6 mRNA(2-ΔΔCt):3.91±0.46,4.14±0.39 vs.26.1±2.08,TNF-α mRNA(2-ΔΔCt):4.67±1.16,5.16±1.25 vs.12.8±1.51,both P<0.01],the p-mTOR protein expression in myocardial tissue was significantly decreased(p-mTOR/β-actin:0.22±0.05,0.24±0.06 vs.0.60±0.07,all P<0.01),the protein levels of TFEB(total),TFEB(nuclear),LC3-Ⅱwere significantly increased[TFEB(total)/β-actin:0.86±0.06,0.84±0.07 vs.0.52±0.08;TFEB(nuclear)/H3:0.96±0.08,0.86±0.07 vs.0.36±0.06;LC3-Ⅱ/β-actin:0.57±0.07,0.55±0.06 vs.0.25±0.08,all P<0.01].Network pharmacology was used to verify that resveratrol binds well to mTOR.Conclusion Resveratrol enhanced cardiac autophagy via the mTOR-TFEB pathway,thereby attenuating myocardial inflammation and subsequent cardiac injury in septic rats.

Acute myocardial infarction(AMI)is a common cardiovascular emergency in clinic.Early reperfusion is a typical and effective method for the treatment of AMI.However,the recovery of blood supply after reperfusion therapy will accelerate the damage of ischemic myocardium and cause myocardial ischemia-reperfusion injury(MI/RI).In recent years,studies have found that TCM has the unique advantages of multi-component,multi-channel and multi-target in the intervention of MI/RI.Janus tyrosine kinase/signal transducer and activator of transcription(JAK/STAT)signaling pathway is closely related to MI/RI,which can reduce MI/RI process by regulating inflammation,oxidative stress,cell proliferation,differentiation and apoptosis.This article reviewed the mechanism of JAK/STAT signaling pathway in MI/RI and the research of TCM targeting this pathway,in order to provide references for the prevention and treatment of MI/RI and further drug development.

Objective To analyse whether Resveratrol can inhibit the inflammatory response in septic cardiomyopathy by modulating the mammalian target of rapamycin-transcription factor EB(mTOR-TFEB)signaling pathway.Methods A total of 32 clean-grade male Sprague-Dawley(SD)rats were selected and divided into sham operation group(Sham group),sepsis model group[cecal ligation and puncture(CLP)group],Resveratrol group(Res group)and mTOR inhibitor group(Torin1 group),with 8 rats in each group.Sepsis was induced by CLP.The sham group only underwent laparotomy and did not perform CLP.In the Torin1 group,20 mg·kg-1·d-1 of mTOR inhibitor Torin l injection was injected intraperitoneally 10 days before molding,once a day for 10 days.The Sham group and the CLP group were given the same amount of normal saline through the same route before molding.The Res group was injected intraperitoneally with 60 mg/kg Resveratrol injection before molding.At 6 hours after model establishment,the heart function was evaluated by echocardiography;Serum cardiac troponin I(cTnI)levels were detected by enzyme linked immunosorbent assay(ELISA).The mRNA expressions of interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)were detected by real-time fluorescence quantitative polymerase chain reaction(RT-qPCR).The protein expressions of phosphorylation-mTOR(p-mTOR),TFEB(nuclear),TFEB(total)and light chain 3-Ⅱ(LC3-Ⅱ)of myocardial tissue were detected by Western blotting.The interaction between Resveratrol and mTOR was simulated using a network pharmacology approach.Results Compared with the sham group,the left ventricular ejection fraction(LVEF)and left ventricular short-axis shortening rate(FES)were significantly reduced in the CLP group[LVEF:0.37±0.02 vs.0.69±0.01,FES(%):17.8±3.1 vs.33.9±2.8,both P<0.01],serum cTnI levels were elevated(ng/L:1 935.96±47.78 vs.87.95±7.98,P<0.01),the mRNA expression levels of IL-6 and TNF-α were significantly up-regulated[IL-6 mRNA(2-ΔΔCt):26.10±2.08 vs.1.61±0.03,TNF-α mRNA(2-ΔΔCt):12.80±1.51 vs.1.26±0.22,both P<0.01),serum levels of inflammatory cytokines IL-6 and TNF-α mRNA were increased[IL-6 mRNA(2-ΔΔCt):26.10±2.08 vs.1.61±0.03,TNF-α mRNA(2-ΔΔCt):12.80±1.51 vs.1.26±0.22,both P<0.01),the expression level of p-mTOR protein in myocardial tissue was significantly increased(p-mTOR/β-actin:0.60±0.07 vs.0.30±0.05),while the protein levels of TFEB(total),TFEB(nuclear)and LC3-Ⅱwere significantly decreased[TFEB(total)/β-actin:0.52±0.08 vs.0.80±0.09,TFEB(nuclear)/H3:0.36±0.06 vs.0.09±0.07,LC3-Ⅱ/β-actin:0.25±0.08 vs.0.48±0.08,all P<0.01];Compared with the CLP group,the Res group and the Torin1 group had significantly higher LVEF and FES[LVEF:0.66±0.02,0.67±0.03 vs.0.37±0.02;FES(%):32.5±3.5,33.7±3.3 vs.17.8±3.1,both P<0.01],serum cTnI level was decreased(ng/L:1 216.88±36.66,1 225.78±35.64 vs.1 935.96±47.78,both P<0.01),mRNA levels of serum inflammatory cytokines IL-6 and TNF-α were decreased[IL-6 mRNA(2-ΔΔCt):3.91±0.46,4.14±0.39 vs.26.1±2.08,TNF-α mRNA(2-ΔΔCt):4.67±1.16,5.16±1.25 vs.12.8±1.51,both P<0.01],the p-mTOR protein expression in myocardial tissue was significantly decreased(p-mTOR/β-actin:0.22±0.05,0.24±0.06 vs.0.60±0.07,all P<0.01),the protein levels of TFEB(total),TFEB(nuclear),LC3-Ⅱwere significantly increased[TFEB(total)/β-actin:0.86±0.06,0.84±0.07 vs.0.52±0.08;TFEB(nuclear)/H3:0.96±0.08,0.86±0.07 vs.0.36±0.06;LC3-Ⅱ/β-actin:0.57±0.07,0.55±0.06 vs.0.25±0.08,all P<0.01].Network pharmacology was used to verify that resveratrol binds well to mTOR.Conclusion Resveratrol enhanced cardiac autophagy via the mTOR-TFEB pathway,thereby attenuating myocardial inflammation and subsequent cardiac injury in septic rats.

Objective:To investigate whether stress hyperglycemia (SH) is an independent risk factor for the occurrence and mortality of sepsis-associated encephalopathy (SAE).Methods:From August 2016 to October 2021, sepsis patients admitted to the ICU of Guangdong Provincial People's Hospital were selected as the study subjects. According to whether they developed to SH (RBG>11.1 mmol/L) within 7 days of enrollment, the pat ients were divided into the SH group and the non-SH group for analysis. Logistic regression was used to analyze whether SH was an independent risk factor for SAE occurrence, and ROC curve was used to analyze the predictive value of SH to SAE. Kaplan-Meier curve was used to compare the 90-day survival of SAE patients with or without SH. Cox regression analysis was used to analyze the risk factors of 28-day and 90-day death in SAE patients.Results:A total of 183 sepsis patients were included, including 62 patients in the SH group and 121 in the non-SH group. Logistic regression analysis demonstrated that SH was an independent risk factor for SAE ( OR=4.452, 95% CI: 2.021-9.808, P <0.001). ROC curve demonstrated that SH could accurately predict SAE (AUC=0.831; Sensitivity=78.4%; Specificity=76.8%; and Yoden index=0.553). Kaplan-Meier curve demonstrated that the 90-day survival of SAE patients with SH significantly declined (log-rank test: P<0.01). Cox regression analysis suggested that SH was a risk factor for death at day 28 and day 90 in SAE patients (28 d, HR=2.272, 95% CI: 1.212-4.260, P=0.010; 90 d, HR=2.456, 95% CI: 1.400-4.306, P<0.01). Conclusions:SH is an independent risk factor for SAE and can predict SAE occurrence. SH significantly reduces 90-day survival and increase mortality at 28 and 90 days in SAE patients.

Myocardial infarction （MI） is a common cardiovascular disease in clinical practice and one of the main causes of cardiovascular mortality. Its pathogenesis is complex and associated with oxidative stress reactions. Nuclear factor E₂-related factor 2 （Nrf2） is a key factor in regulating oxidative stress reactions. It can regulate the expression of heme oxygenase-1 （HO-1）， playing a role in maintaining the oxidative-reductive homeostasis in the body. During the course of MI， the biological activity and levels of Nrf2 and HO-1 decrease， leading to weakened tissue antioxidant and anti-inflammatory capabilities， endothelial damage in myocardial blood vessels， release of vascular cell adhesion factors， and impaired endothelial function. In recent years， many basic research studies have explored the role and mechanisms of traditional Chinese medicine （TCM） in treating MI by modulating the Nrf2/HO-1 signaling pathway. The results have indicated that the Nrf2/HO-1 signaling pathway is an important potential target for TCM in the treatment of MI. This article reviewed the mechanism of the Nrf2/HO-1 signaling pathway in MI and the research progress of TCM in targeting and regulating this pathway， aiming to provide a theoretical basis for the prevention and treatment of MI and further drug development.

Objective To clarify the intervention effect of Angelica Radix Astragali ultrafiltrate(RAS-RH)on radiation-induced myocardial fibrosis by inhibiting the overexpression of cardiac CILP1.Methods Forty SPF Wistar male rats were randomly divided into normal group,model group,Benazepril hydrochloride group,RAS-RH group and Benazepril hydrochloride +RAS-RH group.Cardiomyocytes were induced by X-ray.The rat model of myocardial fibrosis was prepared by injury.The benazepril hydrochloride group was given benazepril hydrochloride 1.0 mg·kg-1 by gavage;the RAS-RH group was given RAS-RH 0.6 g·kg-1 by gavage;benazepril hydrochloride was given by gavage Pril + RAS-RH group was given benazepril hydrochloride 1.0 mg·kg-1 and RAS-RH 0.6 g·kg-1 by gavage;model group and normal group were given equal volume of normal saline by gavage,once a day,After 4 weeks of drug intervention,the serum NT-ProBNP,CTnⅠ and CTnT contents of the rats in each group were detected by ELISA method;HE staining was used to evaluate the pathological changes of myocardial tissue of the rats in each group;Masson staining was used to evaluate the myocardial collagen deposition of the rats in each group and calculated Collagen volume fraction(CVF);immunohistochemistry to detect the expression levels of α-SMA,Col-Ⅰ,Col-Ⅲ protein in myocardial tissue of rats in each group;Western blot method to detect TGF-β1 and smad3 in myocardial tissue of rats in each group,CILP1 protein expression.Results Compared with the blank group,the serum levels of NT-ProBNP,CTnⅠ and CTnT in the model group were significantly increased(P<0.01).Blue-stained fibrous tissue increased significantly,myocardial CVF increased significantly,and myocardial tissue α-SMA,Col-Ⅰ,Col-Ⅲ,TGF-β1,Smad3,CILP1 protein expression increased(P<0.01);Serum contents of NT-ProBNP,cTnⅠ and CTnT in rats in napril group,RAS-RH group and benazepril hydrochloride + RAS-RH group were significantly decreased(P<0.01).Sexual cell infiltration was improved,myocardial CVF was significantly decreased(P<0.01),and the protein expressions of α-SMA,Col-Ⅰ,Col-Ⅲ,TGF-β 1,Smad3 and CILP1 in myocardial tissue were significantly decreased(P<0.05).Conclusion Angelica sinensis ultrafiltrate can alleviate X-ray radiation-induced myocardial fibrosis in rats by inhibiting the overexpression of CILP 1 in the heart.