Objective To investigate the impact of red blood cell suspension infusion across various perioperative periods on patients with valvular heart disease. Methods The patients with valvular heart disease admitted to Tianjin Chest Hospital from 2018 to 2020 were selected. Based on the timing of perioperative red cell suspension infusion, patients were categorized into three groups: a group 1 receiving intraoperative red cell suspension infusion, a group 2 receiving red cell suspension infusion within 24 hours after entering the ICU, and a group 3 receiving red cell suspension infusion at both time points. The laboratory results, perioperative blood component infusion volume, and other relevant parameters were retrospectively analyzed. After propensity score matching, the differences in different variables among the three groups were compared. Results After propensity score matching, 102 patients were enrolled, including 52 males and 50 females, with an average age of (61.74±10.58) years. There were 34 patients in each group. The preoperative hemoglobin (Hb) value of the group 2 was significantly higher than that of the group 1 and the group 3, and the amount of red cell suspension and autoblood transfusion was the lowest (P<0.05). Group 1 had the highest postoperative Hb, as well as the highest Hb and hematocrit (HCT) levels within 24 hours post-surgery (P<0.05). The group 1 had the lowest plasma, platelet and cryoprecipitate infusion volumes, and the shortest cardiopulmonary bypass time, aortic occlusion time, postoperative ICU stay and hospital stay, and the least blood loss and total drainage volume (P<0.05). The difference between postoperative and preoperative Hb (△Hb1) was highest in group 1 (P<0.05). Conclusion For patients with valvular heart disease, intraoperative-only infusion of red blood cell suspension is associated with a better prognosis at discharge and during follow-up.

Azvudine and nirmatrelvir/ritonavir (Paxlovid) are recommended for COVID-19 treatment in China, but their safety and efficacy in the elderly population are not fully known. In this multicenter, retrospective, cohort study, we identified 5131 elderly hospitalized COVID-19 patients from 32,864 COVID-19 patients admitted to nine hospitals in Henan Province, China, from December 5, 2022, to January 31, 2023. The primary outcome was all-cause death, and the secondary outcome was composite disease progression. Propensity score matching (PSM) was performed to control for confounding factors, including demographics, vaccination status, comorbidities, and laboratory tests. After 2:1 PSM, 1786 elderly patients receiving azvudine and 893 elderly patients receiving Paxlovid were included. Kaplan-Meier and Cox regression analyses revealed that compared with Paxlovid group, azvudine could significantly reduce the risk of all-cause death (log-rank P = 0.002; HR: 0.71, 95% CI: 0.573-0.883, P = 0.002), but there was no difference in composite disease progression (log-rank P = 0.52; HR: 1.05, 95% CI: 0.877-1.260, P = 0.588). Four sensitivity analyses verified the robustness of above results. Subgroup analysis suggested that a greater benefit of azvudine over Paxlovid was observed in elderly patients with primary malignant tumors (P for interaction = 0.005, HR: 0.32, 95% CI: 0.18-0.57) compared to patients without primary malignant tumors. Safety analysis revealed that azvudine treatment had a lower incidence of adverse events and higher lymphocyte levels than Paxlovid treatment. In conclusion, azvudine treatment is not inferior to Paxlovid treatment in terms of all-cause death, composite disease progression and adverse events in elderly hospitalized COVID-19 patients.

IL-33 and its receptor ST2 play crucial roles in tissue repair and homeostasis. However, their involvement in optic neuropathy due to trauma and glaucoma remains unclear. Here, we report that IL-33 and ST2 were highly expressed in the mouse optic nerve and retina. Deletion of IL-33 or ST2 exacerbated retinal ganglion cell (RGC) loss, retinal thinning, and nerve fiber degeneration following optic nerve (ON) injury. This heightened retinal neurodegeneration correlated with increased neurotoxic astrocytes in Il33^-/- mice. In vitro, rIL-33 mitigated the neurotoxic astrocyte phenotype and reduced the expression of pro-inflammatory factors, thereby alleviating the RGC death induced by neurotoxic astrocyte-conditioned medium in retinal explants. Exogenous IL-33 treatment improved RGC survival in Il33^-/- and WT mice after ON injury, but not in ST2^-/- mice. Our findings highlight the role of the IL-33/ST2 axis in modulating reactive astrocyte function and providing neuroprotection for RGCs following ON injury.
Animals ; Interleukin-33/genetics* ; Interleukin-1 Receptor-Like 1 Protein/genetics* ; Optic Nerve Injuries/pathology* ; Retinal Ganglion Cells/pathology* ; Astrocytes/pathology* ; Mice ; Mice, Knockout ; Mice, Inbred C57BL ; Neuroprotection/physiology*

[摘 要] 目的：利用单细胞RNA测序（scRNA-seq）解析结直肠癌（CRC）肿瘤微环境（TME）中B细胞的异质性特征，为基于B细胞的预后评估与免疫治疗提供理论依据。方法：采集原发CRC患者的新鲜手术切除样本（n = 36），进行scRNA-seq。采用Seurat（v5.0）进行细胞分群，Monocle3（v1.3）和scVelo（v0.3.0）分析细胞分化轨迹，GSEA识别功能通路，pySCENIC（v0.11.2）构建基因调控网络。结果：识别B细胞（24 652个）和浆细胞（49 138个）共11个功能亚型。拟时序分析显示B细胞从初始态向组织驻留态分化。应激适应性B细胞在肿瘤中富集（10.39%），其NOD样受体信号和抗原提呈通路显著激活。组织驻留性B细胞在肿瘤中占9.09%，其C型凝集素信号和内吞作用增强。迁移性B细胞在TNM Ⅱ期组织中比例最低（16.42%），氧化磷酸化等代谢通路显著富集。浆细胞呈终末分化状态，肿瘤中以IgG型为主（20.68%）。结论：应激适应性和组织驻留性B细胞可能促进肿瘤免疫逃逸，迁移性B细胞或具抗肿瘤潜力；同时，IgG型浆细胞可能与免疫抑制有关。

This paper focuses on the necessity and feasibility of the multidimensional integration of clinic, culture and language in the international education of acupuncture-moxibustion within a cross-cultural context. In view of the current gap between theory and practice, and the barrier of culture and language in the international education of acupuncture-moxibustion, it proposes the specific integration approaches, such as the "trinity teaching method" and "modularization of acupuncture courses", which develops the framework of international education of acupuncture-moxibustion, guided by "cultural exploration" in macroscopic view and implemented through "cultural experience", aiming to achieve a seamless integration of clinic, culture, and language. This initiative not only inherits and promotes Chinese acupuncture-moxibustion, maintains its unique position in global healthcare, but also fosters dialogue and exchange between Eastern and Western medicine. Ultimately, it enhances the international recognition of Chinese acupuncture-moxibustion. By offering fresh perspectives and methodologies, this paper paves the way for a more comprehensive and systematic approaches to international education of acupuncture-moxibustion, presenting the theoretical and practical significance in advancing the globalization of traditional Chinese medicine.
Humans ; Moxibustion ; Language ; Acupuncture/education* ; Acupuncture Therapy ; Culture ; China

BACKGROUND: Arsenic trioxide (ATO) is indicated as a broad-spectrum medicine for a variety of diseases, including cancer and cardiac disease. While the role of ATO in hepatic ischemia/reperfusion injury (HIRI) has not been reported. Thus, the purpose of this study was to identify the effects of ATO on HIRI. METHODS: In the present study, we established a 70% hepatic warm I/R injury and partial hepatectomy (30% resection) animal models in vivo and hepatocytes anoxia/reoxygenation (A/R) models in vitro with ATO pretreatment and further assessed liver function by histopathologic changes, enzyme-linked immunosorbent assay, cell counting kit-8, and terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling (TUNEL) assay. Small interfering RNA (siRNA) for extracellular signal-regulated kinase (ERK) 1/2 was transfected to evaluate the role of ERK1/2 pathway during HIRI, followed by ATO pretreatment. The dynamic process of autophagic flux and numbers of autophagosomes were detected by green fluorescent protein-monomeric red fluorescent protein-LC3 (GFP-mRFP-LC3) staining and transmission electron microscopy. RESULTS: A low dose of ATO (0.75 μmol/L in vitro and 1 mg/kg in vivo ) significantly reduced tissue necrosis, inflammatory infiltration, and hepatocyte apoptosis during the process of hepatic I/R. Meanwhile, ATO obviously promoted the ability of cell proliferation and liver regeneration. Mechanistically, in vitro  studies have shown that nontoxic concentrations of ATO can activate both ERK and phosphoinositide 3-kinase-serine/threonine kinase (PI3K-AKT) pathways and further induce autophagy. The hepatoprotective mechanism of ATO, at least in part, relies on the effects of ATO on the activation of autophagy, which is ERK-dependent. CONCLUSION Low, non-toxic doses of ATO can activate ERK/PI3K-AKT pathways and induce ERK-dependent autophagy in hepatocytes, protecting liver against I/R injury and accelerating hepatocyte regeneration after partial hepatectomy.
Animals ; Arsenic Trioxide ; Autophagy/physiology* ; Reperfusion Injury/prevention & control* ; Mice ; Male ; Proto-Oncogene Proteins c-akt/physiology* ; Arsenicals/therapeutic use* ; Oxides/therapeutic use* ; Liver/metabolism* ; Extracellular Signal-Regulated MAP Kinases/metabolism* ; Mice, Inbred C57BL

Objective To rvaluate the therapeutic efficacy of balloon-dilatation covered stents in the treatment of renal artery stenosis(RAS).Methods The clinical data of 30 patients with RAS,who received intravascular ultrasonography(IVUS)-guided LifeStream balloon-dilatation covered stent implantation at the Affiliated Central Hospital of Dalian University of Technology(Dalian Municipal Central Hospital)of China from August 2022 to December 2023,were retrospectively analyzed.The various parameters of the lumen and the stent were measured,and the performance of the stent was evaluated.Results The minimum original blood vessel diameter below the base of the stenotic segment plaque was 5.40(5.17,5.80)mm and the maximum blood vessel diameter was 6.20(5.80,6.93)mm,which became 6.00(5.80,6.00)mm and 7.90(6.00,8.00)mm respectively after stent release,the differences were statistically significant(both P＜0.05).Before stent release the luminal eccentricity index was(14.72±9.37)％,which was(1.54±9.16)％after stent release,the difference was statistically significant P＜0.05).The instant stent symmetry after stent release was(82.69±14.61)％,and the stent expansion factor was(99.81±10.70)％.Ideal narrow coverage rate was obtained.During operation,poor stent adhesion occurred in 2 patients and renal artery rupture with bleeding occurred in one patient,which were solved after immediate re-expansion treatment.Spearman's correlation analysis showed that stent symmetry,stent expansion factor,and stent eccentricity index did not linearly correlate with the lumen cross-sectional area stenosis rate and the plaque eccentricity index(all P＞0.05).Conclusion For the treatment of RAS,the LifeStream balloon-dilatation covered stent is clinically safe,feasible,and effective with satisfactory immediate clinical outcomes.

Objective:To investigate the effects of oleuropein(OE)on oxygen glucose deprivation/reperfusion(OGD/R)in-duced neuronal damage and Hippo-Yes associated protein(YAP)signaling pathway.Methods:Neurons were grouped into Control group,OGD/R group,OE-L group,OE-M group,OE-H group and OE-H+YAP inhibitor(VP)group;detection of cell activity;cell proliferation and apoptosis were detected in each group;the levels of inflammatory factors and oxidative stress were detected;the ex-pression levels of Cyclin D1,cell cycle negative regulator(P21),B cell lymphoma 2(Bcl-2),Bcl-2 associated X protein(Bax),YAP and transcription coactivator with PDZ-binding motif(TAZ)were detected.Results:In OGD/R group,deep staining of neuronal cell nuclei,EdU positive rate,Cyclin D1,Bcl-2,YAP and TAZ expressions were decreased,P21,TNF-α,IL-6,MDA,SOD,apop-tosis rate and Bax expression were increased(P<0.05).The cell nucleus was gradually restored to normal by OE,the blue staining was gradually lightest,the EdU positive rate,Cyclin D1,Bcl-2,YAP and TAZ levels were increased,and the expressions of P21,TNF-α,IL-6,MDA,SOD,apoptosis rate and Bax were decreased(P<0.05);VP reverse protective effect of OE on OGD/R-induced neuronal injury.Conclusion:OE can improve OGD/R-induced neuronal damage by activating Hippo/YAP signaling pathway.

Objective:To translate the Clinical Leadership Needs Analysis Instrument (CLeeNA) into Chinese and to test its reliability and validity.Methods:The source scale was translated based on the Beaton translation model, and cultural debugging was completed through expert consultation and pre-surveys to form the Chinese version of CLeeNA. Convenience sampling was used to select 536 nurses from three Class Ⅲ Grade A hospitals in Anhui Province from August to December 2023 to conduct the survey and to verify the reliability and validity of the scale. A total of 536 questionnaires were distributed and 495 valid questionnaires were recovered, with an effective recovery rate of 92.351% (495/536) .Results:The Chinese version of CLeeNA contained 43 entries in 7 dimensions of self and team development, staff and care delivery, technology and care initiatives, financial and service management, leadership and clinical practice, patient safety and risk management, and standards of care. The content validity index at the item level ranged from 0.800 to 1.000, and the content validity index at the scale level was 0.953. Exploratory factor analysis extracted 7 common factors with a cumulative variance contribution rate of 82.098%. Confirmatory factor analysis showed that the model fit was acceptable. The total Cronbach's ɑ coefficient for the scale was 0.958, the folding coefficient was 0.898, and the retest reliability coefficient was 0.928.Conclusions:The Chinese version of CLeeNA has good reliability and validity, and can be used for measuring the clinical leadership needs of nurses.

Objective:To investigate the effects of oleuropein(OE)on oxygen glucose deprivation/reperfusion(OGD/R)in-duced neuronal damage and Hippo-Yes associated protein(YAP)signaling pathway.Methods:Neurons were grouped into Control group,OGD/R group,OE-L group,OE-M group,OE-H group and OE-H+YAP inhibitor(VP)group;detection of cell activity;cell proliferation and apoptosis were detected in each group;the levels of inflammatory factors and oxidative stress were detected;the ex-pression levels of Cyclin D1,cell cycle negative regulator(P21),B cell lymphoma 2(Bcl-2),Bcl-2 associated X protein(Bax),YAP and transcription coactivator with PDZ-binding motif(TAZ)were detected.Results:In OGD/R group,deep staining of neuronal cell nuclei,EdU positive rate,Cyclin D1,Bcl-2,YAP and TAZ expressions were decreased,P21,TNF-α,IL-6,MDA,SOD,apop-tosis rate and Bax expression were increased(P<0.05).The cell nucleus was gradually restored to normal by OE,the blue staining was gradually lightest,the EdU positive rate,Cyclin D1,Bcl-2,YAP and TAZ levels were increased,and the expressions of P21,TNF-α,IL-6,MDA,SOD,apoptosis rate and Bax were decreased(P<0.05);VP reverse protective effect of OE on OGD/R-induced neuronal injury.Conclusion:OE can improve OGD/R-induced neuronal damage by activating Hippo/YAP signaling pathway.