ObjectiveTo examine the influences of Shenfu injection on the endogenous metabolic byproducts in the myocardium of the rat model exhibiting chronic heart failure， thus deciphering the therapeutic mechanism of the Qi-reinforcing and Yang-warming method. MethodsSD rats were randomly allocated into a control group and a modeling group. Chronic heart failure with heart-Yang deficiency syndrome in rats was modeled by multi-point subcutaneous injection of isoproterenol， and the rats were fed for 14 days after modeling. The successfully modeled rats were randomized into model， Shenfu injection （6.0 mL·kg^-1）， and trimetazidine （10 mg·kg^-1） groups and treated with corresponding agents for 15 days. The control group and the model group were injected with equal doses of normal saline， and the samples were collected after the intervention was completed. Cardiac color ultrasound was performed. Hematoxylin-eosin （HE） staining was used to observe histopathological morphology， and the serum level of N-terminal pro-brain natriuretic peptide （NT-proBNP） was assessed by enzyme-linked immunosorbent assay （ELISA）. The mitochondrial morphological and structural changes of cardiomyocytes were observed by transmission electron microscopy， and the metabolic profiling was carried out by ultra high performance liquid chromatography-quantitative exactive-mass spectrometry （UHPLC-QE-MS）. Differential metabolites were screened and identified by orthogonal partial least squares-discriminant analysis （OPLS-DA） and other methods， and then the MetaboAnalyst database was used for further screening. The relevant biological pathways were obtained through pathway enrichment analysis. The receiver operating characteristic （ROC） curve was established to evaluate the diagnostic value of each potential biomarker for myocardial injury and the evaluation value for drug efficacy. ResultsThe results of color ultrasound showed that Shenfu Injection improved the cardiac function indexes of model rats （P<0.05）. The results of HE staining showed that Shenfu injection effectively alleviated the pathological phenomena such as myocardial tissue structure disorder and inflammatory cell infiltration in model rats. The results of ELISA showed that Shenfu injection effectively regulated the serum NT-proBNP level in the model rats. Transmission electron microscopy （TEM） showed that Shenfu injection effectively restored the mitochondrial morphological structure. The results of metabolomics showed that the metabolic phenotypes of myocardial samples presented markedly differences between groups. Nine differential metabolites could be significantly reversed in the Shenfu injection group， involving three metabolic pathways： pyruvate metabolism， histidine metabolism， and citric acid cycle （TCA cycle）. The results of ROC analysis showed that the area under the curve （AUC） values of all metabolites were between 0.75 and 1.0， indicating that the differential metabolites had high diagnostic accuracy for myocardial injury， and the changes in their expression levels could be used as potential markers for efficacy evaluation. ConclusionShenfu injection significantly alleviated the damage of cardiac function， myocardium， and mitochondrial structure in the rat model of chronic heart failure with heart-Yang deficiency syndrome by ameliorating energy metabolism remodeling. Reinforcing Qi and warming Yang is a key method for treating chronic heart failure with heart-Yang deficiency syndrome.

Objective: To develop a quality appraisal tool for case reports in traditional Chinese medicine (TCM) based on their characteristics. [Methods]: An extensive literature search was conducted in Chinese Biomedical Literature Database (CBM), China National Knowledge Infrastructure (CNKI), and China Science and Technology Journal Database (CSTJ), focusing on expert consensus statements and checklists for TCM case reports. Relevant items were extracted, and a Delphi method involving 34 experts was used in two rounds to rate each item on a 5-point Likert scale. Items were screened based on measures of central tendency and coordination (including total score, mean score, percentage of items rated as unimportant, and coefficient of variation). The weighted average method was used to determine item weights and construct the appraisal tool. Internal consistency was assessed using Cronbach’s α coefficient. The finalized tool was pilot-tested by two reviewers independently appraising 20 case reports, with an additional four reviewers evaluating 5 of these cases to compare inter-rater consistency. Results: A total of 9 513 articles were retrieved, and 96 items from 25 articles were extracted. After two rounds of the Delphi method, 27 items across 10 domains were retained. The Cronbach’s α coefficient was 0.72 in the first round (acceptable range), and 0.96 in the second round, indicating strong internal consistency. The tool was piloted by six reviewers, achieving a kappa value of 0.663 and a Kendall’s coefficient of concordance of 0.845, demonstrating high consistency among reviewers. Conclusion The developed TCM case report quality appraisal tool, consisting of 27 items in 10 domains, offers a scientific and reliable means of assessing the quality of TCM case reports. The tool showed high consistency and practical utility, and its application is expected to enhance the standardization, scientific rigor, and evidence quality of TCM case reports, facilitating the integration of traditional medical knowledge with modern evidence-based standards.

Objective To observe the effects of Shenfu Injection on ferroptosis-related factors and oxidative stress-related indexes in rat cardiomyocytes treated with isoproterenol;To explore its mechanism in treating chronic heart failure.Methods Isoproterenol was used to induce rat H9c2 cardiomyocyte injury.The cells were divided into normal group,model group,Shenfu Injection group and Ferrostatin-1 group,and treated with corresponding intervention.Transmission electron microscopy was used to observe the ultrastructure of cellular mitochondria,ferrous ion fluorescent probe was used to detect Fe2+content in cells,flow cytometry was used to detect intracellular contents of ROS and Lipid-ROS;colorimetry was used to detect the contents of MDA,GSH,SOD and GSH-Px in cells;Western blot and RT-qPCR were used to detect the protein and mRNA expressions of GPX4,FTH1,SLC7A11,p53,COX2 and Nrf2 in cells.Results Compared with the normal group,the survival rate of H9c2 cells in the model group was significantly reduced(P<0.01),with cell swelling and rupture,mitochondrial shrinkage,decreased quantity and disordered arrangement,more damaged mitochondria,the contents of Fe2+,ROS,Lipid-ROS and MDA in cells significantly increased(P<0.01),while the contents of GSH,SOD and GSH-Px significantly decreased(P<0.01),the expressions of p53,COX2 protein and mRNA significantly increased(P<0.01),the expressions of GPX4,FTH1,SLC7A11 and Nrf2 protein and mRNA significantly decreased(P<0.01).Compared with the model group,the survival rates of H9c2 cells in Shenfu Injection group and Ferrostatin-1 group significantly increased(P<0.01),there was a larger number of normal mitochondria and a more complete structure,the contents of Fe2+,ROS,Lipid-ROS and MDA in cells were significantly decreased(P<0.01),while the contents of GSH,SOD and GSH-Px were significantly increased(P<0.05,P<0.01),the expressions of p53,COX2 protein and mRNA were significantly decreased(P<0.05,P<0.01),while the expressions of GPX4,FTH1,SLC7A11 and Nrf2 protein and mRNA significantly increased(P<0.01).Conclusion Shenfu Injection can reduce p53 expression,weaken its inhibitory effect on SLC7A11,thereby promoting GPX4 expression,inhibiting ferroptosis,reducing lipid peroxide accumulation,increasing cellular antioxidant capacity,and alleviating myocardial cell oxidative damage.

Objective To observe the effects of Shenfu Injection on ferroptosis-related factors and oxidative stress-related indexes in rat cardiomyocytes treated with isoproterenol;To explore its mechanism in treating chronic heart failure.Methods Isoproterenol was used to induce rat H9c2 cardiomyocyte injury.The cells were divided into normal group,model group,Shenfu Injection group and Ferrostatin-1 group,and treated with corresponding intervention.Transmission electron microscopy was used to observe the ultrastructure of cellular mitochondria,ferrous ion fluorescent probe was used to detect Fe2+content in cells,flow cytometry was used to detect intracellular contents of ROS and Lipid-ROS;colorimetry was used to detect the contents of MDA,GSH,SOD and GSH-Px in cells;Western blot and RT-qPCR were used to detect the protein and mRNA expressions of GPX4,FTH1,SLC7A11,p53,COX2 and Nrf2 in cells.Results Compared with the normal group,the survival rate of H9c2 cells in the model group was significantly reduced(P<0.01),with cell swelling and rupture,mitochondrial shrinkage,decreased quantity and disordered arrangement,more damaged mitochondria,the contents of Fe2+,ROS,Lipid-ROS and MDA in cells significantly increased(P<0.01),while the contents of GSH,SOD and GSH-Px significantly decreased(P<0.01),the expressions of p53,COX2 protein and mRNA significantly increased(P<0.01),the expressions of GPX4,FTH1,SLC7A11 and Nrf2 protein and mRNA significantly decreased(P<0.01).Compared with the model group,the survival rates of H9c2 cells in Shenfu Injection group and Ferrostatin-1 group significantly increased(P<0.01),there was a larger number of normal mitochondria and a more complete structure,the contents of Fe2+,ROS,Lipid-ROS and MDA in cells were significantly decreased(P<0.01),while the contents of GSH,SOD and GSH-Px were significantly increased(P<0.05,P<0.01),the expressions of p53,COX2 protein and mRNA were significantly decreased(P<0.05,P<0.01),while the expressions of GPX4,FTH1,SLC7A11 and Nrf2 protein and mRNA significantly increased(P<0.01).Conclusion Shenfu Injection can reduce p53 expression,weaken its inhibitory effect on SLC7A11,thereby promoting GPX4 expression,inhibiting ferroptosis,reducing lipid peroxide accumulation,increasing cellular antioxidant capacity,and alleviating myocardial cell oxidative damage.

The prevalence of dilated cardiomyopathy （DCM） has been increasing year by year，which seriously endangers the physical and mental health of patients. Establishing an animal model that conforms to the clinical characteristics of the disease is a prerequisite for conducting experimental research on DCM. This study sorted out and summarized the commonly used DCM animal models and evaluated the degree of consistency between the models and clinical practice based on the etiology and pathogenesis of traditional Chinese and western medicine and clinical diagnostic criteria. The models with high consistency with western medicine include immune models，drug toxicity models，and tachycardia models，while the models with high consistency with traditional Chinese medicine include drug toxicity models，gene correlation models，and tachycardia models. With consideration of the characteristics of the symptoms，consistency，and their respective advantages and disadvantages，the more ideal models are drug toxicity models，tachycardia models，and gene correlation models. In addition to evaluating the clinical consistency of traditional Chinese and western medicine in DCM animal models，this study also analyzed the advantages and disadvantages of existing DCM animal models，existing problems，and observation indicators of the models and pointed out the lack of standardized and unified syndrome model differentiation standards. Due to the complexity of the disease and the unclear pathogenesis，there are few studies on DCM models，and there is room for improvement. On this basis，four improvement directions are proposed to make the animal models as close to the clinical pathological and physiological processes as possible，so that the combination of disease and syndrome in animal models is more practical. These animal models can provide an experimental basis for the pathogenesis，drug intervention，efficacy evaluation，and scientific research of DCM and better serve scientific research and clinical practice.

Objective:To investigate the reasonable airflow organization and exhaust system facilities during the operation of the inspection workshop, and solve the problem of the accumulation of harmful gases such as ozone and nitrogen oxides in the workshop.Methods:In May 2023, computational fluid dynamics (CFD) technology was used to numerically simulate the diffusion of ozone and nitrogen oxides generated by industrial radiographic inspection operations, and the comparative detection method was used to analyze the ozone and nitrogen oxides concentrations before and after the renovation of the ventilation system of the inspection workshop.Results:After the renovation of ventilation system, the average concentration of ozone in the inspection workshop decreased from 0.81 mg/m 3 to 0.03 mg/m 3, and the average concentration of nitrogen oxides decreased from 0.42 mg/m 3 to 0.01 mg/m 3, and the differences were statistically significant ( t=20.51, 10.38, P<0.001) . Conclusion:The ventilation facilities of the inspection workshop are set up in the airflow organization mode of sending up and down the exhaust, and the ventilation pipes are scientifically designed through the calculation of ventilation hydraulic balance, which can effectively control the concentration of harmful gases in the inspection workshop.

Objective:To investigate the reasonable airflow organization and exhaust system facilities during the operation of the inspection workshop, and solve the problem of the accumulation of harmful gases such as ozone and nitrogen oxides in the workshop.Methods:In May 2023, computational fluid dynamics (CFD) technology was used to numerically simulate the diffusion of ozone and nitrogen oxides generated by industrial radiographic inspection operations, and the comparative detection method was used to analyze the ozone and nitrogen oxides concentrations before and after the renovation of the ventilation system of the inspection workshop.Results:After the renovation of ventilation system, the average concentration of ozone in the inspection workshop decreased from 0.81 mg/m 3 to 0.03 mg/m 3, and the average concentration of nitrogen oxides decreased from 0.42 mg/m 3 to 0.01 mg/m 3, and the differences were statistically significant ( t=20.51, 10.38, P<0.001) . Conclusion:The ventilation facilities of the inspection workshop are set up in the airflow organization mode of sending up and down the exhaust, and the ventilation pipes are scientifically designed through the calculation of ventilation hydraulic balance, which can effectively control the concentration of harmful gases in the inspection workshop.

Objective To explore the prescribing law of TCM in national patents for the treatment of benign prostatic hyperplasia(BPH);To provide a reference for clinical medication.Methods Data on TCM compound prescriptions for the treatment of BPH were retrieved from the China National Intellectual Property Administration(CNIPA)patent retrieval and analysis system,covering the period from January 1,2000,to October 31,2023.The frequency,efficacy category,properties and tastes,meridian tropism,core complex co-occurrence network,and potential TCM clusters mentioned in the patents were analyzed using Excel 2016,SPSS Modeler 18.0,SPSS Statistics 27,and Cytoscape 3.10.0 software.Results A total of 182 patents were included,involving 404 kinds of Chinese materia medica,with a total frequency of 2054 times.Among them,22 kinds of Chinese materia medica had a frequency of≥20,with the most frequently used Chinese materia medica being Astragali Radix,Glycyrrhizae Radix et Rhizoma,Phellodendri Chinensis Cortex,Epimedii Folium,Salviea Miltiorrhizae Radix et Rhizoma,Plantaginis Semen,Poria,Vaccariae Semen,Alismatis Rhizoma and Paeoniae Radix Rubra.The high-frequency herbs primarily consisted of tonifying herbs(267 times,13.00%),blood circulation-activating and stasis-resolving herbs(216 times,10.52%),and diuretic and dampness-percolating herbs(147 times,7.16%).The properties of the herbs were mainly sweet and cold,and they were mainly attributed to the liver and kidney meridians.Association rule analysis yielded 10 common drug pairs,including Cornus Officinalis-Rehmannize Radix et Praeparata,Curcumae Rhizoma-Sparganii Rhizoma,and Astragali Radix-Codonopsis Radix.The drug combination with the highest confidence was Angelicae Sinensis Radix-Phellodendri Chinensis Cortex-Glycyrrhizae Radix et Rhizoma.Clustering analysis revealed five drug combinations,while potential TCM clustering analysis identified five groups,among which the"Zingiberis Rhizoma-Os Draconis-Angelicae Pubescentis Radix-Scallion-Rice Bran-Speranskiae Herba"network demonstrated the highest degree of interconnection(Score=6).Conclusion The high-frequency herbs in national patents for the treatment of BPH with TCM compound prescriptions mainly focus on tonifying the spleen and kidney,activating blood circulation to remove stasis,and clearing heat and draining dampness,providing a reference for clinical practice.

Objective: To identify 5 specimens of C.tubulosa(Schenk) R.Wight on different parasitifers,and explore the relationship between electrophoretic fingerprint and identification on soluble-protein,meanwhile providing data for establishing electrophoresis pattern library of Chinese crude drugs.Methods: The electrophoretic characteristics of soluble-proteins from 5 specimens of C.tubulosa(Schenk) R.Wight on different parasitifers were studied with SDS-PAGE.Results: It indicated that reproducible and high resolvable electrophoresis patterns of soluble proteins of C.tubulosa(Schenk) R.Wight on different parasitifers by SDS-PAGE.Their degrees of polymorphism were 55.56%.Conclusion: Each specimen had its own unique band pattern distinguish from the others.The electrophoresis pattern of SDS-PAGE of soluble proteins can be regarded as protein fingerprints for identification of C.tubulosa(Schenk) R.Wight on different parasitifers.

OBJECTIVESTo increase the diagnosis and treatment of ectopic ACTH syndrome.

METHODSThe data of 12 ectopic ACTH syndrome patients treated from 1985 to 1999 were retrospectively analyzed.

RESULTSTwelve patients were diagnosed as having ACTH syndrome by endocrinary test and primary tumors were ascertained by imaging examination. Follow-up from 7 months to 8 years showed 3 out of 5 patients with radical resection of primary tumor died. One patient with bilateral adrenorectomy was still alive. All patients received only chemotherapy except one died.

CONCLUSIONSPatients with Cushing's syndrome should be evaluated by endocrine test and followed up by imaging screen examination. The key points to increase treatment effect include early detection, localization and resection of primary tumors.