By reviewing modern research and integrating clinical practice， this paper interprets the correlation between "deep heat， deep syncope" and the "macrocirculation-microcirculation" uncoupling in sepsis， alongside its clinical applications in sepsis prevention and treatment. It is considered that "deep heat" corresponds to peripheral vasodilation and the hypermetabolic state at the macrocirculation level， whereas "deep syncope" manifests as hypoperfusion and impaired oxygen utilization at the microcirculation level. These two states interact detrimentally， forming the core contradiction of macrocirculation-microcirculation uncoupling in sepsis. Based on the traditional Chinese medicine （TCM） connotations of "deep heat， deep syncope" and modern medical research， this paper elucidates the systemic pathological evolution of sepsis from the inflammatory cascade to impaired oxygen utilization. Accordingly， the following therapeutic principles are proposed. In the early stage， it is suggested to clear heat and drain fire to vent the constrained yang. In the progressive stage， the focus is put on unblocking the lower jiao （焦） and expelling stasis to dredge the vessels and collaterals. In the recovery stage， the method of regulating and harmonizing yin and yang can be used to smooth the flow of qi and blood.

ObjectiveTo evaluate the larvicidal effect of ultrasonic waves against Aedes albopictus larvae at various exposure parameters (distance and time), and to preliminarily investigate the effects of different containers (water volume and depth) and ultrasonic devices on the larvicidal efficacy, so as to provide experimental evidence for the application of ultrasound-based mosquito control technology. MethodsUnder controlled laboratory conditions, two commercially available ultrasonic devices [40 kHz/300 W and (50±5) kHz/70 W] were used to systematically examine the effects of exposure distance (20, 40, 60, 80, and 100 cm), exposure duration (1, 3, 6, 15 and 60 min), larval instar(Ⅰ‒Ⅱ and Ⅲ‒Ⅳ）, and container type on the immediate mortality of Aedes albopictus larvae collected from urban areas of Shanghai. Statistical analysis of the mortality rates of larvae among different experimental groups was performed using the chi-square test. ResultsUltrasonic exposure exerted a detectable larvicidal effect against Aedes albopictus larvae of all instars. For early-instar larvae, exposure time significantly affected mortality at all tested distances (20, 40, 60, 80 and 100 cm), with χ² values ranging from 25.57 to 32.74 ( all P<0.001). No significant distance effect was observed in the first and second instar larvae after short-term exposure (1 and 3 min; P>0.05). However, a distance-dependent effect emerged from 6 min onward (P<0.05). During short-term exposure (1 min and 3 min) at close range (20 cm and 40 cm), the immediate mortality of the third and fourth instar larvae was higher than that of the first and second instar larvae. Conversely, during prolonged exposure (15 min and 60 min), the first and second instar larvae exhibited significantly higher mortality than that of the third and fourth instar larvae. These results indicated that larval mortality was jointly influenced by exposure duration and distance. Preliminary experiments indicated that larvicidal efficacy in shallow water was lower than that in deep water. No significant difference in larvicidal effect was observed between the two ultrasonic devices with different frequencies and power outputs. ConclusionUnder laboratory conditions, ultrasound can effectively kill Aedes albopictus larvae, and the larvicidal effect is jointly influenced by larval instar, exposure distance, and aquatic environment. Compact ultrasonic devices show potential for field application in biological mosquito control.

The small-molecule alkaloid halofuginone(HF)is obtained from febrifugine.Recent studies on HF have aroused widespread attention owing to its universal range of noteworthy biological activities and therapeutic functions,which range from parasite infections and fibrosis to autoimmune diseases.In particular,HF is believed to play an excellent anticancer role by suppressing the proliferation,adhesion,metastasis,and invasion of cancers.This review supports the goal of demonstrating various anticancer effects and molecular mechanisms of HF.In the studies covered in this review,the anticancer molecular mechanisms of HF mainly included transforming growth factor-β(TGF-β)/Smad-3/nuclear factor erythroid 2-related factor 2(Nrf2),serine/threonine kinase proteins(Akt)/mechanistic target of rapa-mycin complex 1(mTORC1)/wingless/integrated(Wnt)/β-catenin,the exosomal microRNA-31(miR-31)/histone deacetylase 2(HDAC2)signaling pathway,and the interaction of the extracellular matrix(ECM)and immune cells.Notably,HF,as a novel type of adenosine triphosphate(ATP)-dependent inhibitor that is often combined with prolyl transfer RNA synthetase(ProRS)and amino acid starvation therapy(AAS)to suppress the formation of ribosome,further exerts a significant effect on the tumor microenvironment(TME).Additionally,the combination of HF with other drugs or therapies obtained universal attention.Our results showed that HF has significant potential for clinical cancer treatment.

Objective This study reveals the potential mechanism of electroacupuncture in alleviating the inflamma-tory injury of sensory nerves and alleviating the abnormal sensation on the ocular surface in type 2 diabetes rats with dry eye.Methods Healthy male SD rats were induced to establish type 2 diabetes dry eye rat model.Model rats were ran-domly divided into model group,electroacupuncture group,sham-acupuncture group,and fluorometholone group in the 12th week of the experiment.The blank group was established as well,and each group was intervened for 2 weeks.The corneal fluorescein sodium staining(FL),break-up time(BUT),phenol red thread test(PRT),corneal mechanical per-ception threshold(CTT)and blink frequency were measured in each group of rats.After sampling,the expression of neu-ronal injury markers,neuron specific enolase(NSE),neurofilament light chain protein Nf Light(NF-L),phosphorylated microtubule associated protein(Phospho-TAU),as well as inflammatory factors of cysteine protease-1(Caspase-1),inter-leukin-18(IL-18),and interleukin-1β(IL-1β),were observed in the trigeminal ganglion(TG)and spinal cord caudate nu-cleus(SpVc)of each group of rats.Results At the end of the 14th week,compared with the blank group,the FL of the model group,electroacupuncture group,sham-acupuncture group,and fluorometholone group significantly increased,while PRT and BUT significantly decreased.Moreover,the CTT and blink frequency of the model group,sham-acupuncture group,and fluorometholone group significantly decreased(all P＜0.01).Compared with the model group,the electroacu-puncture group and the fluorometholone group showed a decrease in FL,as well as an increase in BUT,PRT,CTT,and blink frequency,with statistically significant differences(all P＜0.05).Compared with the electroacupuncture group,the sham-acupuncture group showed significantly higher FL along with significantly lower values in BUT,PRT,CTT,and blink frequency(all P＜0.05),while the fluorometholone group exhibited decreased FL,PRT,CTT,and blink frequency but in-creased BUT(all P＜0.05).Compared to the sham-acupuncture group,the fluorometholone group exhibited significantly lower FL,but higher BUT and PRT(all P＜0.01).In TG and Sp Vc,compared with the blank group,the expression of NSE,NF-L and Phospho-TAU increased in the model group and the sham-acupuncture group(all P＜0.05);compared with the model group,the expression of NSE,NF-L and Phospho-TAU significantly reduced in the electroacupuncture group(P＜0.01);compared with the electroacupuncture group,the expression of NSE,NF-L and Phospho-TAU increased in the electroacupuncture group and the expression of Phospho-TAU in the sham-acupuncture group also increased(P＜0.05);compared with the sham-acupuncture group,the expression of Phospho-TAU or NF-L significantly reduced in the fluoro-metholone group(all P＜0.05).The Western Blot results indicate that compared with the blank group,the protein expres-sion of Caspase-1,IL-1β,and IL-18 in TG and SpVc of the model group increased;moreover,the expression of Caspase-1 and IL-18 proteins in the sham-acupuncture group also increased(all P＜0.05).Compared with the model group,the ex-pression of Caspase-1,IL-1β,and IL-18 proteins in TG and SpVc reduced in the electroacupuncture group and the fluoro-metholone group,and the expression of IL-1 β proteins in TG and SpVc also reduced in the sham-acupuncture group(all P＜0.05).Compared with the electroacupuncture group,the expression of Caspase-1,IL-1 β,and IL-18 proteins in TG and SpVc increased in the sham-acupuncture group(all P＜0.05).Compared with the sham-acupuncture group,the expression of Caspase-1,IL-1 β,and IL-18 proteins in TG and SpVc reduced in the fluorometholone group(all P＜0.05).Conclusion Electroacupuncture can effectively alleviate the abnormal ocular surface sensation of type 2 diabetes dry eye rats by alleviating the neuroinflammatory injury in TG and SpVc.

Objective To investigate the effect of long noncoding RNAMCTP1-AS1 on the proliferation and invasion of cervical cancer cells and its related mechanisms.Methods The Cancer Genome Atlas database was used to analyze the expression of MCTP1-AS1 in cervical cancer tissues and normal cervical tissues,and the correlation between the expression level of MCTP1-AS1 and the pathological stage of cervical cancer patients was analyzed.The expression of MCTP1-AS1 in cervical cancer cell lines HCC1106,HCC94,SiHa,Hela,C33A and normal cervical epithelial cells H8 was detected.Hela cells were transfected with pcDNA-Ctrl plasmid(Ctrl group)and pcDNA-MCTP1-AS1 plasmid(MCTP1-AS1 group),respectively.the proliferation and invasion ability of Hela cells were detected,respectively.the expression of proliferation proteins CDK2 and Cyclin A and invasion proteins N-cadherin and ZEB1 in Hela cells were detected,the targeting relationship between MCTP1-AS1 and miR-10a-5p were verified.The expression of miR-10a-5p in Hela cells was detected.Results Compared with normal cervical tissue,the expression of MCTP1-AS1 in cervical cancer tissue was significantly decreased(P＜0.01).The expression level of MCTP1-AS1 was negatively correlated with the pathological stage of cervical cancer patients(P＜0.01).Compared with H8 cells,the expression of MCTP1-AS1 in cervical cancer cell lines HCC1106,HCC94,SiHa,Hela,and C33A were significantly decreased(P＜0.01).Compared to Ctrl group,overexpression of MCTP1-AS1 significantly reduced the levels of proliferative proteins CDK2 and Cyclin A,as well as invasive proteins N-cadherin and ZEB1 in Hela cells.MCTP1-AS1 directly binds to miR-10a-5p(P＜0.01).Compared to Ctrl group,MCTP1-AS1 group showed a significant decrease in miR-10a-5p expression in Hela cells(P＜0.01).Conclusion MCTP1-AS1 expression is downregulated in cervical cancer tissues and cells,and MCTP1-AS1 expression is negatively correlated with the pathological stage of cervical cancer patients.MCTP1-AS1 inhibits the proliferation and invasion of cervical cancer cells by targeting miR-10a-5p.

Healthcare-associated infection(HAI)is a global public health problem that poses a significant socio-economic burden.Hand hygiene is still considered as one of the most effective measures to prevent the spread of pathogens and reduce the incidence of HAI.This paper systematically reviews the latest progress in hand hygiene-related new products,intelligent monitoring technology,and compliance promotion strategies,aiming to provide scientific basis for the management and optimized scheme of hand hygiene in clinical practice in medical institutions in China,ultimately enhance the hand hygiene compliance of healthcare workers,ensure patient safety,and reduce the burden of HAI.

Objective This study reveals the potential mechanism of electroacupuncture in alleviating the inflamma-tory injury of sensory nerves and alleviating the abnormal sensation on the ocular surface in type 2 diabetes rats with dry eye.Methods Healthy male SD rats were induced to establish type 2 diabetes dry eye rat model.Model rats were ran-domly divided into model group,electroacupuncture group,sham-acupuncture group,and fluorometholone group in the 12th week of the experiment.The blank group was established as well,and each group was intervened for 2 weeks.The corneal fluorescein sodium staining(FL),break-up time(BUT),phenol red thread test(PRT),corneal mechanical per-ception threshold(CTT)and blink frequency were measured in each group of rats.After sampling,the expression of neu-ronal injury markers,neuron specific enolase(NSE),neurofilament light chain protein Nf Light(NF-L),phosphorylated microtubule associated protein(Phospho-TAU),as well as inflammatory factors of cysteine protease-1(Caspase-1),inter-leukin-18(IL-18),and interleukin-1β(IL-1β),were observed in the trigeminal ganglion(TG)and spinal cord caudate nu-cleus(SpVc)of each group of rats.Results At the end of the 14th week,compared with the blank group,the FL of the model group,electroacupuncture group,sham-acupuncture group,and fluorometholone group significantly increased,while PRT and BUT significantly decreased.Moreover,the CTT and blink frequency of the model group,sham-acupuncture group,and fluorometholone group significantly decreased(all P＜0.01).Compared with the model group,the electroacu-puncture group and the fluorometholone group showed a decrease in FL,as well as an increase in BUT,PRT,CTT,and blink frequency,with statistically significant differences(all P＜0.05).Compared with the electroacupuncture group,the sham-acupuncture group showed significantly higher FL along with significantly lower values in BUT,PRT,CTT,and blink frequency(all P＜0.05),while the fluorometholone group exhibited decreased FL,PRT,CTT,and blink frequency but in-creased BUT(all P＜0.05).Compared to the sham-acupuncture group,the fluorometholone group exhibited significantly lower FL,but higher BUT and PRT(all P＜0.01).In TG and Sp Vc,compared with the blank group,the expression of NSE,NF-L and Phospho-TAU increased in the model group and the sham-acupuncture group(all P＜0.05);compared with the model group,the expression of NSE,NF-L and Phospho-TAU significantly reduced in the electroacupuncture group(P＜0.01);compared with the electroacupuncture group,the expression of NSE,NF-L and Phospho-TAU increased in the electroacupuncture group and the expression of Phospho-TAU in the sham-acupuncture group also increased(P＜0.05);compared with the sham-acupuncture group,the expression of Phospho-TAU or NF-L significantly reduced in the fluoro-metholone group(all P＜0.05).The Western Blot results indicate that compared with the blank group,the protein expres-sion of Caspase-1,IL-1β,and IL-18 in TG and SpVc of the model group increased;moreover,the expression of Caspase-1 and IL-18 proteins in the sham-acupuncture group also increased(all P＜0.05).Compared with the model group,the ex-pression of Caspase-1,IL-1β,and IL-18 proteins in TG and SpVc reduced in the electroacupuncture group and the fluoro-metholone group,and the expression of IL-1 β proteins in TG and SpVc also reduced in the sham-acupuncture group(all P＜0.05).Compared with the electroacupuncture group,the expression of Caspase-1,IL-1 β,and IL-18 proteins in TG and SpVc increased in the sham-acupuncture group(all P＜0.05).Compared with the sham-acupuncture group,the expression of Caspase-1,IL-1 β,and IL-18 proteins in TG and SpVc reduced in the fluorometholone group(all P＜0.05).Conclusion Electroacupuncture can effectively alleviate the abnormal ocular surface sensation of type 2 diabetes dry eye rats by alleviating the neuroinflammatory injury in TG and SpVc.

Objective:To quantitatively analyze right ventricular reverse remodeling in patients with severe tricuspid regurgitation after transcatheter tricuspid edge-to-edge repair (T-TEER) by two-dimensional speckle tracking echocardiography, and to preliminarily evaluate the clinical efficacy of this procedure.Methods:This study was a prospective single-center cohort study. Patients diagnosed with severe tricuspid regurgitation at the Xiamen Cardiovascular Hospital Xiamen University from March 2021 to June 2023 were enrolled. All patients underwent transthoracic echocardiography and transesophageal three-dimensional echocardiography before T-TEER, and transthoracic echocardiography at 30 days, 6 months, and 9 months after T-TEER. The primary endpoint was major adverse cardiovascular and cerebrovascular events, including death, stroke, myocardial infarction, reoperation, arrhythmia, and conduction block. Other clinical evaluation indicators included New York Heart Association (NYHA) functional classification and tricuspid regurgitation grade.Results:A total of 34 patients were enrolled, aged (67.9±9.3) years, and 71% (24/34) were female. The median follow-up duration was 9 months. All patients achieved a reduction of tricuspid regurgitation by ≥2 grades at 9 months after T-TEER, with 79% (27/34) of them having mild to moderate tricuspid regurgitation. Transthoracic echocardiography at 9 months after T-TEER showed that the vena contracta width of tricuspid regurgitation ((5.42±2.33) mm vs. (11.54±4.05) mm, P<0.001), effective regurgitant orifice area ((0.24±0.09) cm2 vs. (0.52±0.14) cm2, P<0.001), regurgitant jet area ((7.95±4.02) cm2 vs. (13.93±6.10) cm2, P<0.001), inferior vena cava diameter ((19.38±2.63) mm vs. (23.56±3.31) mm, P<0.001), right ventricular end-diastolic diameter ((28.03±6.26) mm vs. (33.21±8.24) mm, P=0.001), and tricuspid annular diameter ((36.47±4.40) mm vs. (41.44±7.08) mm, P<0.001) were all reduced compared with baseline; while the tricuspid annular plane systolic excursion ((18.08±5.25) mm vs. (14.91±3.42) mm, P=0.005) and right ventricular fractional area change ((37.61±7.52)% vs. (30.79±9.06)%, P=0.004) were both increased compared with baseline. At 9 months after T-TEER, all patients had a NYHA functional classification of grade Ⅰ or Ⅱ, and no major adverse cardiovascular and cerebrovascular event occurred during the follow-up period. Conclusion:It is preliminarily confirmed that T-TEER is safe and effective in the treatment of severe tricuspid regurgitation, with significant right ventricular reverse remodeling observed in patients at 9 months after T-TEER.

Objective:To evaluate the effect of trans-nasal humidified rapid insufflation ventilatory exchange (THRIVE) on the early postoperative atelectasis in patients undergoing prolonged non-intubated intravenous anesthesia for gastrointestinal endoscopic procedures.Methods:In this randomized double-blind controlled trial, 150 patients of either sex, aged 18-80 yr, with American Society of Anesthesiologists Physical Status classification Ⅰ or Ⅱ and body mass index of 18-30 kg/m 2, scheduled for endoscopic mucosal resection of multiple colorectal polyps at Northern Jiangsu People′s Hospital Affiliated to Yangzhou University from February 18 to June 15, 2024, were divided into 2 groups ( n=75 each) using simple random allocation: THRIVE group (group T) and conventional oxygen therapy group (group C). In group T, the oxygen flow rate was 10 L/min before anesthesia induction and increased to 50 L/min after induction until the end of operation, and the inhaled oxygen concentration was 100%. Group C used conventional mask oxygen inhalation, with an oxygen flow rate of 10 L/min during anesthesia induction and maintenance. Lung ultrasonography was performed immediately before anesthesia induction and after the end of surgery, and the modified lung ultrasound score and diaphragm mobility during quiet breathing were recorded to assess the occurrence of atelectasis and diaphragmatic dysfunction. The lowest intraoperative SpO 2 value, adverse events during surgery and in the postanesthesia care unit (PACU), duration of PACU stay, adverse events within 7 days after operation, hospitalization duration, and satisfaction scores of both patients and endoscopists were recorded. Results:Compared with group C, the postoperative modified lung ultrasound score and incidence of atelectasis and diaphragmatic dysfunction were significantly decreased, the lowest intraoperative SpO 2 value was increased, the incidence of hypoxemia was decreased, the duration of PACU stay was shortened, and endoscopists′ satisfaction scores were increased ( P<0.05), and no statistically significant changes were observed in diaphragm mobility, incidence of other intraoperative adverse events, incidence of adverse events during PACU stay and within 7 days after operation, or patients′ satisfaction scores in group T ( P>0.05). Conclusions:THRIVE can reduce the risk of early postoperative atelectasis and intraoperative hypoxemia, thereby promoting postoperative recovery of patients undergoing gastrointestinal endoscopy under long-term non-intubated anesthesia.

Liquid chip technology is based on liquid carrier. Comparing to the traditional detection methods, it has unique characteristics such as multiple detection ability, high throughput, high sensitivity, good repeatability, less sample and fast analysis. It can analyse proteins, nucleic acids and other biological molecules in liquid. At present, it has been widely used in the laboratory diagnosis of tumors, autoimmune diseases, allergic diseases, cytokines related diseases, as well as infectious diseases. This article discussed the principles, detection performances, clinical applications and future prospects of liquid chip technology.