The traditional Chinese medicine （TCM） myocardial infarction （MI） unit is a standardized， regulated， and continuous integrated care unit guided by TCM theory and built upon existing chest pain centers or emergency care units. This unit emphasizes multidisciplinary collaboration and forms a restructured clinical entity without altering current departmental settings， offering comprehensive diagnostic and therapeutic services with full participation of TCM in the treatment of MI. Its core medical model is patient-centered and disease-focused， providing horizontally integrated TCM-based care across multiple specialties and vertically constructing a full-cycle treatment unit for MI， delivering prevention， treatment， and rehabilitation during the acute， stable， and recovery phases. Additionally， the unit establishes a TCM-featured education and prevention mechanism for MI to guide patients in proactive health management， reduce the incidence of myocardial infarction， and improve quality of life.

[Objective]To analyze the collating characteristics of Jingui Yuhan Yaolue Shuyi,hoping to provide a reference for the study of Jingui Yaolue.[Methods]By using the method of bibliography,the collated text in Jingui Yuhan Yaolue Shuyi is classified and sorted out,and summarized by combining with the theory of traditional Chinese medicine.[Results]Tanba Motokata was an authority of Japanese textual criticism,Jingui Yuhan Yaolue Shuyi was a supplement for his father's Jingui Yuhan Yaolue Jiyi(hereinafter referred to as Jiyi)in collation and annotation,which collected thirty years of academic accumulation.In the book,Tanba Motokata prepared all of the versions at the time of wide collation,and the collation attitude was rigorous.He used the collation method of no change of the original text,combined the medical theory and used the four methods of emendation,carefully collated the text of Jingui Yaolue,didn't negate at will,made up the unfinished part of Jiyi.[Conclusion]Jingui Yuhan Yaolue Shuyi is an excellent annotation of Jingui Yaolue,which is an important reference for the collation of ancient books of traditional Chinese medicine.

Objective To investigate the effect of Jiaotaiwan on brain insulin-PI3K/AKT pathway in a mouse model of Alzheimer's disease(AD).Methods Fifty 3-month-old male APP/PS1 double transgenic mice were randomized into AD model group,low-,medium-and high-dose Jiaotaiwan treatment groups,and donepezil treatment group.Cognitive functions of the mice were assessed using water maze and open field tests,and neuronal pathologies were observed with HE staining and Nissl staining;immunohistochemistry was used to detect amyloid Aβ deposition in the brain.Fasting serum insulin levels of the mice were measured,and the expressions of Aβ42,insulin-PI3K/AKT pathway components and downstream glucose transporters in the brain tissue were detected with RT-qPCR and Western blotting.Results The AD mouse models exhibited obvious impairment of learning and memory abilities,significantly reduced hippocampal neurons,and obvious Aβ amyloid plaques in the brain tissue with increased Aβ42 protein expression(P<0.05)and insulin resistance index,decreased hippocampal PI3K expressions,lowered expressions of AKT and InR,reduced expressions of GLUT1,GLUT3,and GLUT4,and increased expression of GSK3β in both the hippocampus and cortex.Treatment with Jiaotaiwan and donepezil both effectively improved memory ability of the mouse models,increased the number of hippocampal neurons,reduced Aβ amyloid plaques and increased the expressions of PI3K,AKT,InR,GLUT1,GLUT3 and GLUT4 in the hippocampus and cortex.Conclusion Jiaotaiwan improves learning and memory abilities of APP/PS1 double transgenic mice and delay the development of AD by activating the PI3K/AKT pathway and regulating the expression levels of its downstream GLUTs in the brain.

Objective To investigate the effect of Jiaotaiwan on brain insulin-PI3K/AKT pathway in a mouse model of Alzheimer's disease(AD).Methods Fifty 3-month-old male APP/PS1 double transgenic mice were randomized into AD model group,low-,medium-and high-dose Jiaotaiwan treatment groups,and donepezil treatment group.Cognitive functions of the mice were assessed using water maze and open field tests,and neuronal pathologies were observed with HE staining and Nissl staining;immunohistochemistry was used to detect amyloid Aβ deposition in the brain.Fasting serum insulin levels of the mice were measured,and the expressions of Aβ42,insulin-PI3K/AKT pathway components and downstream glucose transporters in the brain tissue were detected with RT-qPCR and Western blotting.Results The AD mouse models exhibited obvious impairment of learning and memory abilities,significantly reduced hippocampal neurons,and obvious Aβ amyloid plaques in the brain tissue with increased Aβ42 protein expression(P<0.05)and insulin resistance index,decreased hippocampal PI3K expressions,lowered expressions of AKT and InR,reduced expressions of GLUT1,GLUT3,and GLUT4,and increased expression of GSK3β in both the hippocampus and cortex.Treatment with Jiaotaiwan and donepezil both effectively improved memory ability of the mouse models,increased the number of hippocampal neurons,reduced Aβ amyloid plaques and increased the expressions of PI3K,AKT,InR,GLUT1,GLUT3 and GLUT4 in the hippocampus and cortex.Conclusion Jiaotaiwan improves learning and memory abilities of APP/PS1 double transgenic mice and delay the development of AD by activating the PI3K/AKT pathway and regulating the expression levels of its downstream GLUTs in the brain.

Objective To evaluate the apparent diffusion coefficient(ADC)values of different bone marrow infiltration patterns in multiple myeloma(MM)patients with MR whole-body diffusion weighted imaging(WB-DWI)and to determine the ADC thresholds for different bone marrow infiltration patterns.Methods Nineteen MM patients diagnosed for the first time were selected.The lesions types of each site(cervical spine,ribs,sternum,humerus,scapula,sacral spine,ilium,femur,thoracic spine,and lumbar spine)after the WB-DWI images were visually evaluated,which were divided into focal group(including focal lesion in combined focal and diffuse infiltration)[region of interest(ROI)=141],pure diffuse infiltration group(ROI=150),diffuse lesion in combined focal and diffuse infiltration group(ROI=127),"salt-and-pepper"group(ROI=54),and normal appearance group(ROI=68).ADC values were measured and compared between each group and the receiver operating characteristic(ROC)curve was drawn to distinguish different patterns of bone marrow infiltration.Results There was no statistically significant difference in ADC values between the diffuse lesion in combined focal and diffuse infiltration group and the"salt-and-pepper"group(P＞0.99),and there was statistically significant difference in ADC values between the other groups(P＜0.05).The ROC curve showed that the area under the curve(AUC)for identifying focal group and the"salt-and-pepper"group was 0.889[95％confidence interval(CI)0.844-0.934],the AUC for identifying pure diffuse infiltration group and the normal appearance group was 0.968(95％CI 0.949-0.987).ADC values were able to accurately and visually differentiate between the different patterns of bone marrow infiltration.Conclusion The ADC values can be used as a quantitative tool to objectively distinguish different bone marrow infiltration patterns in MM patients.

[Objective]To analyze the annotation features of Jingui Yuhan Yaolue Shuyi,hoping to provide a reference for the study of Jingui Yaolue.[Methods]By using the method of bibliography the annotation texts in the book of Jingui Yuhan Yaolue Shuyi are classified and sorted out,the annotation features of Jingui Yuhan Yaolue Shuyi are systematically analyzed in combination with the relevant works such as Shuowen Jiezi,Shuowen Jiezi Judou and Liji.[Results]Tanba Motokata was a leading authority of Japanese textual criticism,Jingui Yuhan Yaolue Shuyi was to supplement his father's Jingui Yuhan Yaolue Jiyi in collation and annotation.The annotations in the book extensively collected the classics of the ancients,the coexistence of the examination and the collection of notes;proficient in elementary school,precisely analyzing the interchangeable words and ancient and modern characters;with a wide variety of schools,analyzing and commenting on the annotations of the predecessors;explaining the experience of treatment to provide reference for clinical operation.[Conclusion]Jingui Yuhan Yaolue Shuyi was an excellent annotation of Jingui Yaolue,which was collection of Tanba Motokata nearly thirty years of Zhongjing academic research essence,systematic studying this book has high reference significance for the study of Jingui Yaolue.

Objectve:To study the effect of gabexate mesylate (GM) on acute lung injury (ALI) in septic rats based on metabonomics.Methods:Fifty-seven SD rats were randomly(random number) divided into three groups: sham operation group (SC group), cecal ligation puncture induced septic ALI group (CLP group), and intraperitoneal administration of GM at 1 h after CLP (CLP-GM group). Twenty-four h after the experiment, the survival of rats in the SC, CLP and CLP-GM groups was observed, the lung tissue was collected for HE staining to observe the pathological changes, and the plasma was collected for metabonomics detection to analyze the characteristics of metabolites.Results:Compared with the SC group, the infiltration of inflammatory cells in the lung tissue of rats in the CLP groupincreased significantly, and the metabolic profile of plasma changed significantly. However, the pathological and metabonomic characteristics of the CLP-GM group showed that the above changes were reversed after the application of GM. Twelve major differential metabolites were found in plasma. The metabolic pathways involved in the disorder included biosynthesis of phenylalanine, tyrosine and tryptophan, phenylalanine metabolism and sphingolipid metabolism.Conclusions:GM may improve septic ALI by regulating amino acid metabolism, sphingolipid metabolism and other metabolic pathways.

Objective:To observe the changes of arterial blood gas indexes in pigs with the free-field primary blast lung injury (PBLI) model, and to explore the value of arterial blood gas indexes in predicting moderate to severe PBLI.Methods:Nine adult healthy Landrace pigs were selected to construct the pig free-field PBLI model. Arterial blood samples were taken 15 minutes before the explosion (before injury) and 10, 30, 60, 120, and 180 minutes after the explosion (after injury). Arterial blood gas indexes and pulse oxygen saturation (SpO 2) were measured, compare the changes of blood gas analysis indexes and SpO 2 levels at different time points, and observe the changes of gross injury scores and pathological injury scores of lung tissue. Analyze the correlation between the blood gas indicators. Results:As time prolonged, at each time point, pH, arterial partial pressure of oxygen (PaO 2), and SpO 2 were lower than those before the injury, and blood lactic acid (Lac) and arterial partial pressure of carbon dioxide (PaCO 2) were higher than those before the injury. Compared with that before the injury, the pH value in the blood decreased significantly 10 minutes after the injury (7.39±0.06 vs. 7.46±0.02, P < 0.05), and the Lac increased significantly (mmol/L: 3.61±2.89 vs. 1.10±0.28, P < 0.05), and lasts until 180 minutes after injury (pH value: 7.37±0.07 vs. 7.46±0.02, Lac (mmol/L): 2.40±0.79 vs. 1.10±0.28, both P < 0.05); while PaO 2 and SpO 2 decreased significantly at 180 minutes after injury [PaO 2 (mmHg, 1 mmHg = 0.133 kPa): 59.40±10.94 vs. 74.81±9.39, P < 0.05; SpO 2: 0.75±0.11 vs. 0.89±0.08, P < 0.05], PaCO 2 increased significantly (mmHg: 56.17±5.38 vs. 48.42±4.93, P < 0.05). Correlation analysis showed that the gross injury score of lung blast injury animals was positively correlated with the pathological injury score ( r = 0.866, P = 0.005); PaO 2 and SpO 2 were positively correlated ( r = 0.703, P = 0.000); pH value and Lac were negative Correlation ( r = -0.400, P = 0.006); pH value is negatively correlated with PaCO 2 ( r = -0.844, P = 0.000). Conclusion:This study successfully established a large mammalian free-field PBLI model, arterial blood gas analysis is helpful for the early diagnosis of PBLI, whether SpO 2 can be used to evaluate the severity of lung injury remains to be further verified.

The oral microbial community is widely regarded as a latent reservoir of antibiotic resistance genes. This study assessed the molecular epidemiology, susceptibility profile, and resistance mechanisms of 35 methicillin-resistant Staphylococcus epidermidis (MRSE) strains isolated from the dental plaque of a healthy human population. Broth microdilution minimum inhibitory concentrations (MICs) revealed that all the isolates were nonsusceptible to oxacillin and penicillin G. Most of them were also resistant to trimethoprim (65.7%) and erythromycin (54.3%). The resistance to multiple antibiotics was found to be largely due to the acquisition of plasmid-borne genes. The mecA and dfrA genes were found in all the isolates, mostly dfrG (80%), aacA-aphD (20%), aadD (28.6%), aphA3 (22.9%), msrA (5.7%), and the ermC gene (14.3%). Classical mutational mechanisms found in these isolates were mainly efflux pumps such as qacA (31.4%), qacC (25.7%), tetK (17.1%), and norA (8.6%). Multilocus sequence type analysis revealed that sequence type 59 (ST59) strains comprised 71.43% of the typed isolates, and the eBURST algorithm clustered STs into the clonal complex 2-II(CC2-II). The staphyloccoccal cassette chromosome mec (SCCmec) type results showed that 25 (71.43%) were assigned to type IV. Moreover, 88.66% of the isolates were found to harbor six or more biofilm-associated genes. The aap, atlE, embp, sdrF, and IS256 genes were detected in all 35 isolates. This research demonstrates that biofilm-positive multiple-antibiotic-resistant ST59-SCCmec IV S. epidermidis strains exist in the dental plaque of healthy people and may be a potential risk for the transmission of antibiotic resistance.
Anti-Bacterial Agents ; therapeutic use ; Dental Plaque ; microbiology ; Female ; Humans ; Methicillin ; Methicillin-Resistant Staphylococcus aureus ; isolation & purification ; Staphylococcal Infections ; diagnosis ; Staphylococcus epidermidis ; isolation & purification

Objective:To explore the value of X-ray signs with applying low dose of contrast agent to confirm successful puncture in direct shoulder MR arthrography.Methods:In total 669 patients who underwent shoulder MR arthrography in Peking University Third Hospital from January 2016 to August 2018 were retrospectively analyzed. All patients received the anterior approach puncture in shoulder arthrography. X-ray films were taken after 1-2 ml contrast agent was injected. Six X-ray signs of contrast agent distribution were recorded. MR arthrography findings were used to confirm whether the puncture was success. Kappa analysis was used to verify the consistency between each 2 signs. The accuracy rate of each X-ray sign to confirm the successful puncture was calculated. X-ray signs were paired to define the best diagnostic index of successful puncture.Results:Successful puncture was performed in arthrographies for all 669 cases .The displaying rates of six signs were as follows. Contrast agent distribution at overlapping humeral head away from the needle was 66.8% (447/669), in axillary recess was 64.7% (433/669), in glenohumeral space was 93.9% (628/669), in subscapular bursa was 69.8% (467/669), in sheath of long head tendon of biceps brachii (LHBT) was 1.9% (13/669), between LHBT and supraspinatus tendon was 17.2% (115/669). Consistency of each 2 signs was poor (Kappa<0.2), in which the poorest consistency was found between contrast agent overlapping humeral head away from the needle and contrast agent in glenohumeral space (Kappa=-0.115). With combining the above 2 signs, the accuracy rate for defining successful puncture was 100% (669/669).Conclusion:In direct shoulder arthrography by anterior approach, X-ray signs with low dose of contrast agent can be regard as the method to confirm successful puncture. The accuracy rate of the signs of contrast agent distribution at overlapping humeral head away from the needle or in glenohumeral space to define a successful puncture is 100%.