By reviewing modern research and integrating clinical practice， this paper interprets the correlation between "deep heat， deep syncope" and the "macrocirculation-microcirculation" uncoupling in sepsis， alongside its clinical applications in sepsis prevention and treatment. It is considered that "deep heat" corresponds to peripheral vasodilation and the hypermetabolic state at the macrocirculation level， whereas "deep syncope" manifests as hypoperfusion and impaired oxygen utilization at the microcirculation level. These two states interact detrimentally， forming the core contradiction of macrocirculation-microcirculation uncoupling in sepsis. Based on the traditional Chinese medicine （TCM） connotations of "deep heat， deep syncope" and modern medical research， this paper elucidates the systemic pathological evolution of sepsis from the inflammatory cascade to impaired oxygen utilization. Accordingly， the following therapeutic principles are proposed. In the early stage， it is suggested to clear heat and drain fire to vent the constrained yang. In the progressive stage， the focus is put on unblocking the lower jiao （焦） and expelling stasis to dredge the vessels and collaterals. In the recovery stage， the method of regulating and harmonizing yin and yang can be used to smooth the flow of qi and blood.

Objective The objective of this study is to investigate whether there is a correlation between a high TyG index(serum triglyceride glucose index)and higher mortality rates among patients undergoing peritoneal dialysis(PD).Methods This study utilized a single-center retrospective cohort as the basis for its methods..From January 1,2007 to December 31,2015,a total of 519 PD patients kept under observation until December 31,2018.There searchers employed the Kaplan-Meier method and Cox proportional hazards modelsto examine the cor-relation between TyG index levels and mortality.Results Over a period of 40.5 months,104(20.0%)individuals with Parkinson's disease passed away,with 55(52.9%)of these deaths attributed to cardiovascular disease(CVD).The serum median TyG index at baseline was 8.44(6.48,11.94).Through Cox regression analysis subject to the adjustments of such parameters as gender,age,body mass index(BMI),presence of cardiovascular disease,hypertension,diabetes mellitus,hemoglobin,serum albumin,serum Ferritin,total cholesterol,renal residual function(RRF),An increased risk of all-cause mortality(HR = 2.22,95%CI:1.43～3.44,P＜0.001)and CVD mortality(HR = 2.50,95%CI:1.34～4.65,P = 0.004)was observed with a higher baseline TyG index(8.44).A comparable impact was observed in the correlation between the average TyG index over time(TA-TyG index)and both all-cause mortality and CVD mortality.(HR = 1.90,95%CI:1.25～2.90,P = 0.003;HR = 2.05,95%CI:1.14～3.70,P = 0.017,respectively).Conclusion PD patients with a higher serum TyG index have a greater risk of all-cause mortality and mortality related to cardiovascular disease.

Aim Investigating the effects of exercise during pregnancy on blood pressure and brain ischemia-reperfusion injury in 1-month-old(1M)and 3-month-old(3M)offspring of spontaneously hypertensive rat(SHR).Methods SHR and Wistar Kyoto rats(WKY)were selected,they were paired in a 1∶1 male-to-female ratio within the same strain,and the first day of pregnancy was confirmed by the presence of copulatory plugs and sperm on a vaginal smear.Pregnant rats were randomly divided into pregnancy sedentary group(p-WKY-SED,p-SHR-SED)and pregnancy exercise group(p-WKY-EX,p-SHR-EX).The rats in the exercise group were performed non-weight-bearing swimming for 60 minutes per day,6 days per week,in water 40 cm deep at a temperature of 34～35 ℃,until the 20th day of preg-nancy.The body weight of the pregnant rats,as well as physiological indicators such as fetal weight,body length,and placental efficiency were monitored to reflect the growth and development of the fetus.1M and 3M offspring were selected as research subjects,non-invasive blood pressure was measured in the tail artery,a rat middle cerebral artery occlusion(MCAO)model was prepared by using the thread embolism method,and the area of cerebral infarction was observed 24 hours after reperfusion.Results(1)Compared with p-WKY-SED group,the body weight of p-SHR-SED pregnant rats was significantly decreased(P＜0.01);there was no significant difference in the litter size among all groups of preg-nant rats(P＞0.05).(2)Compared with p-SHR-SED group,exercise during pregnancy can significantly increase the body weight and placental efficiency of both female and male fetal rats in the p-SHR-EX group(P＜0.05),and decrease the weight of the placenta(P＜0.05).(3)Compared with p-WKY-SED group,the body weight of both female and male offspring rats at 1M and 3M was significantly decreased in the p-SHR-SED group,and their blood pressure was significantly increased(P＜0.01);Compared with p-SHR-SED group,exercise during pregnancy had no significant effect on the body weight and blood pressure of 1M offspring in the p-SHR-EX group(P＞0.05),but it could significantly reduce the blood pressure of 3M male offspring in the p-SHR-EX group(P＜0.01);The body weight and blood pressure of 3M male off-spring were significantly higher in p-WKY-SED group and p-SHR-SED group than those of female in the same group(P＜0.01).(4)Compared with p-WKY-SED group,the infarct area of MCAO injury in both female and male offspring rats at 1M and 3M was significantly increased in the p-SHR-SED group(P＜0.01);Compared with p-SHR-SED group,exercise during pregnancy can significantly reduce the infarct area of MCAO injury in both female and male offspring at 1M and 3M in the p-SHR-EX group(P＜0.05).Conclusion Aerobic exercise during pregnancy can significantly improve blood pressure in the offspring of hypertensive rats,and reduce their susceptibility to ischemic reperfusion injury in the brain as adults.

Aim Investigating the effects of exercise during pregnancy on blood pressure and brain ischemia-reperfusion injury in 1-month-old(1M)and 3-month-old(3M)offspring of spontaneously hypertensive rat(SHR).Methods SHR and Wistar Kyoto rats(WKY)were selected,they were paired in a 1∶1 male-to-female ratio within the same strain,and the first day of pregnancy was confirmed by the presence of copulatory plugs and sperm on a vaginal smear.Pregnant rats were randomly divided into pregnancy sedentary group(p-WKY-SED,p-SHR-SED)and pregnancy exercise group(p-WKY-EX,p-SHR-EX).The rats in the exercise group were performed non-weight-bearing swimming for 60 minutes per day,6 days per week,in water 40 cm deep at a temperature of 34～35 ℃,until the 20th day of preg-nancy.The body weight of the pregnant rats,as well as physiological indicators such as fetal weight,body length,and placental efficiency were monitored to reflect the growth and development of the fetus.1M and 3M offspring were selected as research subjects,non-invasive blood pressure was measured in the tail artery,a rat middle cerebral artery occlusion(MCAO)model was prepared by using the thread embolism method,and the area of cerebral infarction was observed 24 hours after reperfusion.Results(1)Compared with p-WKY-SED group,the body weight of p-SHR-SED pregnant rats was significantly decreased(P＜0.01);there was no significant difference in the litter size among all groups of preg-nant rats(P＞0.05).(2)Compared with p-SHR-SED group,exercise during pregnancy can significantly increase the body weight and placental efficiency of both female and male fetal rats in the p-SHR-EX group(P＜0.05),and decrease the weight of the placenta(P＜0.05).(3)Compared with p-WKY-SED group,the body weight of both female and male offspring rats at 1M and 3M was significantly decreased in the p-SHR-SED group,and their blood pressure was significantly increased(P＜0.01);Compared with p-SHR-SED group,exercise during pregnancy had no significant effect on the body weight and blood pressure of 1M offspring in the p-SHR-EX group(P＞0.05),but it could significantly reduce the blood pressure of 3M male offspring in the p-SHR-EX group(P＜0.01);The body weight and blood pressure of 3M male off-spring were significantly higher in p-WKY-SED group and p-SHR-SED group than those of female in the same group(P＜0.01).(4)Compared with p-WKY-SED group,the infarct area of MCAO injury in both female and male offspring rats at 1M and 3M was significantly increased in the p-SHR-SED group(P＜0.01);Compared with p-SHR-SED group,exercise during pregnancy can significantly reduce the infarct area of MCAO injury in both female and male offspring at 1M and 3M in the p-SHR-EX group(P＜0.05).Conclusion Aerobic exercise during pregnancy can significantly improve blood pressure in the offspring of hypertensive rats,and reduce their susceptibility to ischemic reperfusion injury in the brain as adults.