Objective To conduct a Meta-analysis on the efficacy and safety of traditional Chinese medicine for soothing the liver for soothing the liver in the treatment of double heart disease.Methods China National Knowledge Infrastructure(CNKI),VIP Database,Wanfang Database,China Biology Medicine disc(CBMdisc),Chinese Clinical Trial Registry,PubMed Database,Cochrane Library were searched.Randomized controlled trials on the treatment of cardiovascular diseases combined with mental disorders(anxiety and depression,etc.)with traditional Chinese medicine for soothing the liver were collected from March 28,2025.The control group received conventional treatment,while the observation group was treated with additional soothing the liver traditional Chinese medicine in addition to the conventional therapy.The outcome indicators included the overall clinical efficacy,the score of the self-rating depression scale(SDS),the score of the self-rating anxiety scale(SAS),and the incidence of adverse reactions.A Meta-analysis was conducted using Stata 15.0 statistical software,and a funnel plot was drawn to evaluate publication bias in the literature.Results A total of 14 literatures were included,all of which were in Chinese.The results of the Meta-analysis showed that compared with the control group,the observation group treated with addition traditional Chinese medicine for soothing the liver could effectively improve the clinical efficacy[odds ratio(OR)=2.14,95%confidence interval(95%CI)was1.71-2.68,P=0.00],and improve the depressive and anxious state of patients[depression:Standardized mean difference(SMD)=-2.00,95%CI was-2.92 to-1.07,P=0.00;anxiety:SMD=-1.88,95%CI was-2.42 to-0.99,P=0.00].The incidence of adverse reactions in the experimental group was significantly lower than that in the control group(16.1%vs.34.0%,χ2=29.347,P<0.05).Conclusion The total effective rate and safety of patients treated with traditional Chinese medicine for soothing the liver on the basis of conventional treatment are higher.

Objective To characterize the clinical features of the group of gout patients to facilitate earlier identifi-cation,and optimize the diagnosis and treatment of the condition.Methods The retrospective study analyzed 24 gout patients with shoulder joint(s)involved and consulted by physicians of Peking Union Medical College Hospital from March 2021 to April 2025,while 70 outpatient gout patients matched by clinical course duration and sex were enrolled as control group.Clinical data including medical history,laboratory tests,therapeutic interventions.Prog-nosis was systematically collected to delineate the distinctive clinical manifestations of the patients.Results All 24 gout patients with shoulder joints involved were male,aged(43.16±13.13)years and had an average BMI of 27.70±4.63.The duration of gout was 8(5,12)years while of those patients had an early onset before 30 years old.The maximal serum uric acid concentration was(754.15±175.79)μmol/L.It was shown by case review that 16.67％of the patients were asymptomatic,and 79.17％suffered from shoulder pain.A quarter of the patients developed subcutaneous tophi.All the patients affected(P＜0.05).The affected joints ascended from lower extremities to the upper averagely took 4.72±2.80 years and had heavier burden of hyperuricemia(P＜0.05),while no significant difference was found in renal function and inflammation level.Conclusions Gout patients with shoulder joints involvement are older and have atypical manifestation.The diagnosis needs support of imaging or ar-throcentesis.

OBJECTIVE: To summarize the research and clinical application progress of foot lengthening surgery. METHODS: Relevant research literature on foot lengthening surgery in recent years at home and abroad was reviewed, and a summary was made from aspects such as the types of lengthening surgery, the types of foot diseases treated by clinical application, effectiveness, and complications. RESULTS: Bone defects and shortening deformities of the foot are relatively common clinically. As an innovative treatment method, foot lengthening surgery has gradually attracted attention, mainly including the Ilizarov technique and one-stage bone grafting lengthening surgery. The former promotes bone regeneration based on the tension-stress principle and is widely used in the treatment of calcaneal defects and congenital metatarsal brachymetatarsia, achieving good curative effects. However, there are also complications such as pin-tract infection, joint stiffness and contracture, non-union and delayed union of bone, re-fracture, and alignment deviation. The latter has a short treatment cycle, but the lengthening length is limited. Bone graft resorption and soft tissue complications are its main complications. CONCLUSION Foot lengthening surgery will develop towards the direction of personalization, intelligence, and precision. With the help of multi-center research, biological materials, and intelligent technologies, the effectiveness and safety will be further improved to better restore the function and appearance of the foot.
Humans ; Bone Transplantation/methods* ; Bone Lengthening/methods* ; Ilizarov Technique ; Osteogenesis, Distraction/methods* ; Foot Deformities/surgery* ; Postoperative Complications ; Treatment Outcome ; Foot/surgery*

Objective To conduct a Meta-analysis on the efficacy and safety of traditional Chinese medicine for soothing the liver for soothing the liver in the treatment of double heart disease.Methods China National Knowledge Infrastructure(CNKI),VIP Database,Wanfang Database,China Biology Medicine disc(CBMdisc),Chinese Clinical Trial Registry,PubMed Database,Cochrane Library were searched.Randomized controlled trials on the treatment of cardiovascular diseases combined with mental disorders(anxiety and depression,etc.)with traditional Chinese medicine for soothing the liver were collected from March 28,2025.The control group received conventional treatment,while the observation group was treated with additional soothing the liver traditional Chinese medicine in addition to the conventional therapy.The outcome indicators included the overall clinical efficacy,the score of the self-rating depression scale(SDS),the score of the self-rating anxiety scale(SAS),and the incidence of adverse reactions.A Meta-analysis was conducted using Stata 15.0 statistical software,and a funnel plot was drawn to evaluate publication bias in the literature.Results A total of 14 literatures were included,all of which were in Chinese.The results of the Meta-analysis showed that compared with the control group,the observation group treated with addition traditional Chinese medicine for soothing the liver could effectively improve the clinical efficacy[odds ratio(OR)=2.14,95%confidence interval(95%CI)was1.71-2.68,P=0.00],and improve the depressive and anxious state of patients[depression:Standardized mean difference(SMD)=-2.00,95%CI was-2.92 to-1.07,P=0.00;anxiety:SMD=-1.88,95%CI was-2.42 to-0.99,P=0.00].The incidence of adverse reactions in the experimental group was significantly lower than that in the control group(16.1%vs.34.0%,χ2=29.347,P<0.05).Conclusion The total effective rate and safety of patients treated with traditional Chinese medicine for soothing the liver on the basis of conventional treatment are higher.

Heart failure(HF)has complex pathophysiological mechanisms and is associated with high mortality and readmission rates.As the terminal manifestation of cardiovascular disease and the main cause of death,HF remains a critical focus in the medical community.Despite advances in standardized treatment through western medicine,many patients remain at high risk for cardiovascular events.Shenfu Qiangxin pill,a traditional Chinese patent medicine,has shown promising results in recent years regarding its mechanisms and clinical applications for HF treatment.This article elaborates on the latest research trends of Shenfu Qiangxin pill in the treatment of HF,examining its composition,efficacy,and mechanisms from both traditional Chinese and western medical perspectives.It also explores its clinical applications and safety,highlighting its potential and prospects in HF treatment and providing a theoretical basis for clinical practice.

Objective:To analyze the clinical characteristics of idiopathic systemic capillary leak syndrome (ISCLS).Methods:This retrospective case series analysis included 10 patients with confirmed ISCLS who were hospitalized at Peking Union Medical College Hospital from January 1983 to August 2023. Data collected encompassed general information, symptoms, laboratory results, treatment, and prognosis.Results:Among 10 ISCLS patients, 8 were males and 2 were females. The age of onset ranged from 29 to 63 years, and it was ≥40 years in 6 cases. Nine patients had nonspecific prodromal symptoms. All 10 experienced hypotension, hemoconcentration, hypoalbuminemia, and acute kidney injury during the leakage phase, with hemodynamic recovery in the subsequent phase. Neurological abnormalities were observed in 6 patients. Three patients had coagulation disorders, and 4 showed elevated levels of IL-6, IL-8, and TNF-α. M protein was found in all patients, with 8 showing IgGκ and 2 IgGλ. Acute-phase treatment primarily involved fluid resuscitation and vasopressors. In the stable phase, 4 patients had fewer episodes with anti-plasma cell therapy; 2 continued to have episodes despite intravenous immunoglobulin (IVIG); 2 had poor outcomes with theophylline; 1 improved without treatment; and 1 was lost to follow-up.Conclusions:ISCLS is a rare disease with adult-onset, presenting nonspecific prodromal symptoms and marked hypotension during episodes. All patients had monoclonal gammopathy. Effective treatment for the stable phase is lacking, though anti-plasma cell therapy may offer some benefit.

Heart failure(HF)is the terminal stage of the development of various heart diseases.As a serious disease with impaired cardiac pumping function,it has a high hospitalization rate and mortality,and has long been a focus of attention in the medical community.The ejection fraction refers to the percentage of blood pumped out by the left ventricle during each contraction to left ventricular end diastolic volume(LVEDV).It is an important indicator for measuring the pumping function of the heart and is often used to classify heart failure.With the continuous deepening of domestic and foreign research,significant progress has been made in the classification,pathophysiology,diagnosis,and treatment strategies of heart failure,and more cutting-edge new drugs and devices have great potential in treatment.This article aims to review the latest research results on heart failure with different ejection fractions,explore the latest treatment strategies for various types of heart failure,provide more effective diagnosis and treatment strategies and plans for clinical and scientific research,and enhance public awareness and attention to heart failure diseases.

Heart failure(HF)is the terminal stage of the development of various heart diseases.As a serious disease with impaired cardiac pumping function,it has a high hospitalization rate and mortality,and has long been a focus of attention in the medical community.The ejection fraction refers to the percentage of blood pumped out by the left ventricle during each contraction to left ventricular end diastolic volume(LVEDV).It is an important indicator for measuring the pumping function of the heart and is often used to classify heart failure.With the continuous deepening of domestic and foreign research,significant progress has been made in the classification,pathophysiology,diagnosis,and treatment strategies of heart failure,and more cutting-edge new drugs and devices have great potential in treatment.This article aims to review the latest research results on heart failure with different ejection fractions,explore the latest treatment strategies for various types of heart failure,provide more effective diagnosis and treatment strategies and plans for clinical and scientific research,and enhance public awareness and attention to heart failure diseases.

BACKGROUND: Limited data are available on the comparison of clinical outcomes of complete vs. incomplete percutaneous coronary intervention (PCI) for patients with chronic total occlusion (CTO) and multi-vessel disease (MVD). The study aimed to compare their clinical outcomes. METHODS: A total of 558 patients with CTO and MVD were divided into the optimal medical treatment (OMT) group ( n = 86), incomplete PCI group ( n = 327), and complete PCI group ( n = 145). Propensity score matching (PSM) was performed between the complete and incomplete PCI groups as sensitivity analysis. The primary outcome was defined as the occurrence of major adverse cardiovascular events (MACEs), and unstable angina was defined as the secondary outcome. RESULTS: At a median follow-up of 21 months, there were statistical differences among the OMT, incomplete PCI, and complete PCI groups in the rates of MACEs (43.0% [37/86] vs. 30.6% [100/327] vs. 20.0% [29/145], respectively, P = 0.016) and unstable angina (24.4% [21/86] vs. 19.3% [63/327] vs. 10.3% [15/145], respectively, P = 0.010). Complete PCI was associated with lower MACE compared with OMT (adjusted hazard ratio [HR] = 2.00; 95% confidence interval [CI] = 1.23-3.27; P = 0.005) or incomplete PCI (adjusted HR = 1.58; 95% CI = 1.04-2.39; P = 0.031). Sensitivity analysis of PSM showed similar results to the above on the rates of MACEs between complete PCI and incomplete PCI groups (20.5% [25/122] vs. 32.6% [62/190], respectively; adjusted HR = 0.55; 95% CI = 0.32-0.96; P = 0.035) and unstable angina (10.7% [13/122] vs. 20.5% [39/190], respectively; adjusted HR = 0.48; 95% CI = 0.24-0.99; P = 0.046). CONCLUSIONS For treatment of CTO and MVD, complete PCI reduced the long-term risk of MACEs and unstable angina, as compared with incomplete PCI and OMT. Complete PCI in both CTO and non-CTO lesions can potentially improve the prognosis of patients with CTO and MVD.
Humans ; Treatment Outcome ; Percutaneous Coronary Intervention/methods* ; Coronary Occlusion/surgery* ; Prognosis ; Angina, Unstable/surgery* ; Chronic Disease ; Risk Factors

We wished to summarize the clinical features of common variable immunodeficiency (CVID) complicated by non-cirrhotic portal hypertension (NCPH) and to deepen our understanding of it. The case data of CVID complicated with NCPH admitted to Peking Union Medical College Hospital from January 1983 to May 2021 were analyzed retrospectively to summarize their clinical characteristics. Six patients with CVID combined with NCPH (three of each sex; 16-45 years) were assessed. Four patients had portal hypertension. All patients had anemia, splenomegaly, a normal serum level of albumin and transaminases, and possibly increased levels of alkaline phosphatase and gamma-glutamyl transpeptidase. Two patients were diagnosed with esophagogastric fundic varices by gastroscopy. Two patients underwent splenectomy (which improved hematologic abnormalities partially). Four patients had autoimmune disease. Two cases were diagnosed with nodular regenerative hyperplasia (NRH) upon liver biopsy. Six patients were administered intravenous immunoglobulin-G (0.4-0.6 g/kg bodyweight) once every 3-4 weeks as basic therapy. Often, CVID complicated with NCPH has: (1) The manifestations of portal hypertension as the primary symptom. (2) Autoimmune-related manifestations. Imaging can provide important diagnostic clues. The etiology may be related to hepatic NRH and splenomegaly due to recurrent infections.