Heart failure refers to a group of clinical syndromes caused by structural or functional abnormalities of the heart that lead to impaired ejection or filling of the ventricles. The traditional Chinese medicine （TCM） theory of cardiac and renal coordination holds that the kidney governs water and plays a key role in maintaining the balance of fluid metabolism. Therefore， the treatment of water retention in heart failure can start from the heart and kidney. The basic pathogenesis of heart failure is kidney deficiency， blood stasis， and water stagnation， and the therapies including dredging the heart and kidneys， warming yang and excreting water， tonifying kidneys and activating blood， and dredging meridians and collaterals. Aquaporins （AQPs）， the key molecular basis of water metabolism， are involved in the pathogenesis of water retention in heart failure together with the arginine vasopressin system （AVP）， renin-angiotensin-aldosterone system （RAAS）， and diuretic resistance. Studies have shown that herbal medicines that regulate the heart and kidney can alleviate water retention in heart failure by targeting AQPs， thereby delaying or even reversing the progression of heart failure. This paper expounds the TCM name and pathogenesis of heart failure from the theory of cardiac and renal coordination， the role of AQPs in the pathogenesis of water retention in heart failure， and the modern connotation of the therapy of tonifying heart and kidney for heart failure， aiming to provide ideas for the prevention and treatment of water retention in heart failure by TCM.

Objective:To investigate the clinical efficacy of hyperbaric oxygen(HBO) combined with vacuum sealing drainage (VSD) in the treatment of 46 patients with early osteofascial compartment syndrome (OCS), and to analyze the value of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) for prognostic prediction.Methods:A total of 46 patients with early OCS admitted to the Department of Orthopedics of Yantai Mountain Hospital from September 2015 to March 2020 were retrospectively analyzed. According to the treatment methods, they were divided into observation group ( n=46) and control group ( n=43). The control group was treated with VSD and conventional symptomatic treatment, while the observation group was treated with HBO on the basis of the treatments of the control group. The clinical efficacy was compared after 3 courses of treatment. The pain was graded before and after treatment by visual analogue scale (VAS); the time of swelling subsiding and length of hospital stay were respectively recorded; the freshness and infection of granulation tissue at the incision site of the affected limb were observed, and primary suture or secondary skin grafting was conducted based on evaluation; enzyme linked immunosorbent assay (ELISA) was applied to measure the levels of serum TNF-α and IL-6 at different time points for the prediction of the development of the disease. Results:After 3 courses of treatment, the effective rate of the observation group (97.8%) was significantly higher than that of the control group (81.4%) ( P<0.05). The secondary skin grafting rate in the observation group (53.5%) was significantly lower than that in the control group (21.7%), and the rate of granulation tissue without infection (80.4%) was significantly higher than that of the control group (51.2%) ( P<0.05). The time of swelling subsiding [(13.14 ±3.42)d] and length of hospital stay [(16.55±3.52)d] in the observation group were significantly lower than those in the control group [time of swelling subsiding: (22.39 ±4.48)d; length of hospital stay: (26.87±5.51)d] ( P<0.05). The VAS scores of the observation group were significantly lower than those of the control group on the 7th, 14th, and 21st days after operation ( P<0.05). The levels of serum TNF-α and IL-6 in the observation group were significantly lower than those in the control group on the 7th and 14th days after operation ( P<0.05), but no significant difference was observed on the 21st day ( P>0.05). Conclusion:HBO combined with VSD in the treatment of early OCS can improve the blood circulation of the affected limb, reduce the incidence of incision infection, promote wound healing, and reduce limb pain, so as to improve the curative effect.

Objective:To investigate the clinical efficacy of hyperbaric oxygen(HBO) combined with vacuum sealing drainage (VSD) in the treatment of 46 patients with early osteofascial compartment syndrome (OCS), and to analyze the value of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) for prognostic prediction.Methods:A total of 46 patients with early OCS admitted to the Department of Orthopedics of Yantai Mountain Hospital from September 2015 to March 2020 were retrospectively analyzed. According to the treatment methods, they were divided into observation group ( n=46) and control group ( n=43). The control group was treated with VSD and conventional symptomatic treatment, while the observation group was treated with HBO on the basis of the treatments of the control group. The clinical efficacy was compared after 3 courses of treatment. The pain was graded before and after treatment by visual analogue scale (VAS); the time of swelling subsiding and length of hospital stay were respectively recorded; the freshness and infection of granulation tissue at the incision site of the affected limb were observed, and primary suture or secondary skin grafting was conducted based on evaluation; enzyme linked immunosorbent assay (ELISA) was applied to measure the levels of serum TNF-α and IL-6 at different time points for the prediction of the development of the disease. Results:After 3 courses of treatment, the effective rate of the observation group (97.8%) was significantly higher than that of the control group (81.4%) ( P<0.05). The secondary skin grafting rate in the observation group (53.5%) was significantly lower than that in the control group (21.7%), and the rate of granulation tissue without infection (80.4%) was significantly higher than that of the control group (51.2%) ( P<0.05). The time of swelling subsiding [(13.14 ±3.42)d] and length of hospital stay [(16.55±3.52)d] in the observation group were significantly lower than those in the control group [time of swelling subsiding: (22.39 ±4.48)d; length of hospital stay: (26.87±5.51)d] ( P<0.05). The VAS scores of the observation group were significantly lower than those of the control group on the 7th, 14th, and 21st days after operation ( P<0.05). The levels of serum TNF-α and IL-6 in the observation group were significantly lower than those in the control group on the 7th and 14th days after operation ( P<0.05), but no significant difference was observed on the 21st day ( P>0.05). Conclusion:HBO combined with VSD in the treatment of early OCS can improve the blood circulation of the affected limb, reduce the incidence of incision infection, promote wound healing, and reduce limb pain, so as to improve the curative effect.

BACKGROUND: Several different patterns of wavebreak have been described by mapping of the tissue surface during fibrillation. However, it is not clear whether these surface patterns are caused by multiple distinct mechanisms or by a single mechanism. METHODS: To determine the mechanism by which wavebreaks are generated during ventricular fibrillation, we conducted optical mapping studies and single cell transmembrane potential recording in 6 isolated swine right ventricles. RESULTS: Among 763 episodes of wavebreak (0.75 times/sec/cm2), optical maps showed 3 patterns: 80% due to a wavefront encountering the refractory waveback of another wave, 11.5% due to wavefronts passing perpendicularly each other and 8.5% due to a new (target) wave arising just beyond the refractory tail of a previous wave. Computer simulations of scroll waves in 3-D tissue showed that these surface patterns could be attributed to two fundamental mechanisms: head-to-tail interactions and filament break. CONCLUSION: We conclude that during sustained ventricular fibrillation in swine RV, surface patterns of wavebreak are produced by two fundamental mechanisms: head-to-tail interaction between waves and filament break.
Computer Simulation ; Heart Ventricles* ; Membrane Potentials ; Swine* ; Ventricular Fibrillation*