Heart failure is one of the main cardiovascular system diseases at present， and it is a clinical syndrome caused by changes in cardiac structure and function， resulting in impaired ejection function or ventricular filling. Therefore， heart failure has become the most important cardiovascular disease in the 21^st century. In recent years， the incidence of heart failure is increasing， and the survival rate of patients with heart failure is very low. Traditional Chinese medicine has rich experience in preventing and treating heart failure. With the modernization of traditional Chinese medicine， more and more attention has been paid to the research， development， and application of active ingredients in traditional Chinese medicine. Traditional Chinese medicine has unique advantages in improving the heart function of patients with heart failure by treating multiple targets and multiple pathways through syndrome differentiation. Astragalus membranacus， a traditional Chinese medicine， is a kind of medicine that benefits Qi and blood circulation and removes evil spirits. It has the functions of improving myocardial energy metabolism and hemodynamics， protecting myocardial muscle， and promoting angiogenesis. Astragalus membranaceus is often used to treat patients with heart failure， yielding remarkable results. In recent years， it has been found that astragaloside， Astragalus polysaccharide， quercetin， calyx isoflavones， and other main active ingredients of Astragalus membranacus can improve cardiac function and treat heart failure by inhibiting inflammatory response， myocardial apoptosis， and myocardial fibrosis. This paper reviewed the research progress of the action and mechanism of the active ingredients of Astragalus membranacus in the treatment of heart failure by studying relevant literature， with a view to providing a reference for its further research， development， and application in the prevention and treatment of heart failure.

ObjectiveTo study the effect and mechanism of Yixintai on mitochondrial fission proteins in the rat model of chronic heart failure. MethodTen of 60 SD rats were randomly selected as the sham operation group， and the remaining 50 rats were subjected to ligation of the left anterior descending coronary artery for the modeling of heart failure post myocardial infarction. The successfully modeled rats were randomized into model， low-， medium-， and high-dose （1.4， 2.8， and 5.6 g·kg^-1， respectively） Yixintai， and trimetazidine （10 mg·kg^-1） groups. The rats were administrated with corresponding doses of drugs by gavage， and the rats in the model group and sham operation group were given an equal volume of normal saline by gavage for 28 consecutive days. Enzyme-linked immunosorbent assay （ELISA） was then employed to measure the levels of amino-terminal pro-B-type natriuretic peptide （NT-pro BNP）， B-type natriuretic peptide （BNP）， and adenosine triphosphate （ATP） in the serum. Color Doppler ultrasound imaging was conducted to examine the cardiac function indicators. Hematoxylin-eosin staining and Masson staining were conducted to observe the pathological changes in the heart， and Image J was used to calculate collagen volume fraction （CVF）. Transmission electron microscopy was employed to observe the ultrastructural changes of myocardial cells. Terminal-deoxynucleoitidyl transferase-mediated nick-end labeling （TUNEL） was employed to measure the apoptosis rate of myocardial cells. Western blot was employed to determine the protein levels of mitochondrial fission protein 1 （Fis1） and mitochondrial fission factor （Mff） in the outer mitochondrial membrane of the myocardial tissue. ResultCompared with the sham operation group， the model group showed elevated levels of NT-pro BNP and BNP in the serum， decreased ATP content， left ventricular ejection fraction （LVEF）， and left ventricular fraction shortening （LVFS）， increased left ventricular end-diastolic diameter （LVIDd） and left ventricular end-systolic diameter （LVIDs）， disarrangement of myocardial cells， inflammatory cell infiltration， increased collagen fibers and CVF， damaged myocardium and mitochondria， and increased apoptosis rate of myocardial cells， and up-regulated expression of Fis1 and Mff in the cardiac tissue （P<0.01）. Compared with the model group， different doses of Yixintai and trimetazidine lowered the serum levels of NT-pro BNP and BNP （P<0.05）， increased the ATP content （P<0.05）， increased LVEF and LVFS （P<0.01）， decreased LVIDd and LVIDs （P<0.01）. Moreover， the drugs alleviated the myocardial inflammatory damage and fibrosis， reduced CVF （P<0.01）， repaired the myocardial mitochondrial structure， and decreased the apoptosis rate of myocardial cells （P<0.01）. Medium- and high-dose Yixintai and trimetazidine down-regulated the expression of Fis1 and Mff in the myocardial tissue （P<0.05）. ConclusionYixintai can improve mitochondrial structure， reduce myocardial cell apoptosis， and improve cardiac function by inhibiting the expression of Fis1 and Mff in the myocardial tissue.

Heart failure is a group of complex clinical syndromes in the middle and late stages of cardiovascular diseases.Mitochondrial homeostasis imbalance is one of the pathological mechanisms in the occurrence and development of heart failure.This article revolved around the"yin-yang theory"in TCM and explained the pathological mechanism of heart failure through mitochondrial homeostasis.Heart failure is the syndrome of deficiency in nature and excess in superficiality fundamental.Its basic pathogenesis is"yang deficiency and yin excess".Based on the deficiency of heart yang qi and the stagnation of yin pathogens,the combination of deficiency and excess runs through the entire disease.Mitochondrial homeostasis imbalance is a manifestation of yin-yang imbalance at the cellular micro level,mainly manifested as inhibition of mitochondrial biosynthesis,mitochondrial dynamics imbalance,mitophagy disorder,etc.,which affects mitochondrial structure and function and leads to abnormal myocardial energy metabolism.Therefore,based on the"yin-yang theory",the basic treatment method is to"tonify deficiency and damage excess"to regulate mitochondrial biosynthesis,mitochondrial dynamics,and mitophagy,thereby maintaining mitochondrial homeostasis and improving myocardial energy metabolism,which is of great significance for the prevention and treatment of heart failure.

Benign prostatic hyperplasia(BPH)is one of the major chronic complications of type 2 diabetes mellitus(T2DM),and sex steroid hormones are common risk factors for the occurrence of T2DM and BPH.The profiles of sex steroid hormones are simultaneously quantified by LC-MS/MS in the clinical serum of patients,including simple BPH patients,newly diagnosed T2DM patients,T2DM complicated with BPH patients and matched healthy individuals.The G protein-coupled estrogen receptor(GPER)inhibitor G15,GPER knockdown lentivirus,the YAP1 inhibitor verteporfin,YAP1 knockdown/overexpression lentivirus,targeted metabolomics analysis,and Co-IP assays are used to investigate the molecular mechanisms of the disrupted sex steroid hormones homeostasis in the pathological process of T2DM complicated with BPH.The homeostasis of sex steroid hormone is disrupted in the serum of patients,accompanying with the proliferated prostatic epithelial cells(PECs).The sex steroid hormone metabolic profiles of T2DM patients complicated with BPH have the greatest degrees of separation from those of healthy individuals.Elevated 17β-estradiol(E2)is the key contributor to the disrupted sex steroid hormone homeostasis,and is significantly positively related to the clinical characteristics of T2DM patients complicated with BPH.Activating GPER by E2 via Hippo-YAP1 signaling exacerbates high glucose(HG)-induced PECs prolifer-ation through the formation of the YAP1-TEAD4 heterodimer.Knockdown or inhibition of GPER-mediated Hippo-YAP1 signaling suppresses PECs proliferation in HG and E2 co-treated BPH-1 cells.The anti-proliferative effects of verteporfin,an inhibitor of YAP1,are blocked by YAP1 overexpression in HG and E2 co-treated BPH-1 cells.Inactivating E2/GPER/Hippo/YAP1 signaling may be effective at delaying the progression of T2DM complicated with BPH by inhibiting PECs proliferation.

Objective:To study the effects of silencing protein arginine methyltransferase 6 (PRMT6) gene on cell proliferation and migration of gastric cancer cell line MGC-803, and explore its related molecular mechanism.Methods:The expression levels of PRMT6 mRNA and protein in human normal gastric mucosa epithelial cell line GES-1 and human gastric cancer cell lines (AGS, SGC-7901, MGC-803) were detected by quantitative real-time polymerase chain reaction (qRT-PCR) and Western blotting. The gastric cancer cell line MGC-803 was divided into silencing control group (NC group), PRMT6 silencing group (si-PRMT6 group), nuclear factor-κB (NF-κB/p65) overexpression group (pcDNA-p65 group), si-PRMT6+ pcDNA-p65 group and PRMT6 silencing and matrix metalloproteinase 9 (MMP9) overexpression group (si-PRMT6+ pcDNA-MMP9 group). Western blotting was used to detect the protein expression levels of PRMT6, NF-κB/p65 and MMP9. CCK-8 kit and Transwell assay were used to measure cell proliferation and migration rates.Results:The results of qRT-PCR showed that the relative expression levels of PRMT6 mRNA in GSE-1, AGS, SGC-7901 and MGC-803 cells were 1.041±0.114, 2.141±0.132, 2.716±0.231, 2.825±0.300, and the difference among the four groups was statistically significant ( F=46.082, P<0.001). Compared with GSE-1 cells, PRMT6 mRNA expression levels were significantly increased in AGS, SGC-7901 and MGC-803 cells (all P<0.001). Western blotting results showed that the relative expression levels of PRMT6 protein in GSE-1, AGS, SGC-7901 and MGC-803 cells were 1.090±0.101, 2.847±0.331, 2.925±0.419 and 3.278±0.463, with a statistically significant difference ( F=22.683, P<0.001). Compared with GSE-1 cells, PRMT6 protein expression levels were significantly increased in AGS, SGC-7901 and MGC-803 cells, with statistically significant differences ( P=0.008; P=0.002; P=0.003). After 48 hours of silencing PRMT6 in MGC-803 cells, in NC group and si-PRMT6 group, the PRMT6 mRNA expression levels were 0.921±0.110 and 0.303±0.045, the PRMT6 protein expression levels were 1.032±0.105 and 0.289±0.043, the cell proliferation activities were 0.917±0.089 and 0.660±0.069, the cell migration rates were (89.122±5.109)% and (30.831±4.463)%, and the p-p65/p65 protein relative expression ratios were 0.947±0.143 and 0.285±0.023. The relative expression levels of PRMT6 mRNA and protein, cell proliferation activity, cell migration rate, protein relative expression ratio of p-p65/p65 in si-PRMT6 group were significantly lower than those in NC group, with statistically significant differences ( t=9.006, P<0.001; t=11.338, P<0.001; t=3.954, P=0.017; t=14.881, P<0.001; t=7.919, P<0.001). Western blotting results showed that the MMP9 protein relative expression levels in NC group, si-PRMT6 group, pcDNA-p65 group and si-PRMT6+ pcDNA-p65 group were 1.202±0.138, 0.318±0.018, 2.849±0.217 and 1.595±0.194, with a statistically significant difference ( F=127.410, P<0.001). Further pairwise comparison showed that the protein relative expression level of MMP9 in si-PRMT6 group was significantly lower than that in NC group ( P<0.001), while that in si-PRMT6+ pcDNA-p65 group was significantly lower than that in pcDNA-p65 group ( P=0.002). Then, MGC-803 cells were co-transfected with si-PRMT6 and pcDNA-p65 or pcDNA-MMP9 for 48 h. The cell proliferation activities in NC group, si-PRMT6 group, si-PRMT6+ pcDNA-p65 group and si-PRMT6+ pcDNA-MMP9 group were 0.923±0.054, 0.608±0.024, 0.818±0.035 and 0.807±0.029, with a statistically significant difference ( F=37.343, P<0.001). Further pairwise comparison showed that the cell proliferation activity of si-PRMT6+ pcDNA-p65 group or si-PRMT6+ pcDNA-MMP9 group was significantly higher than that of si-PRMT6 group (both P<0.001). The cell migration rates of above four groups were (85.195±3.176)%, (28.419±1.845)%, (60.490±7.231)% and (53.653±6.761)%, with a statistically significant difference ( F=59.672, P<0.001). Further pairwise comparison showed that the cell migration rate of si-PRMT6+ pcDNA-p65 group or si-PRMT6+ pcDNA-MMP9 group was significantly higher than that of si-PRMT6 group ( P=0.002; P=0.003). Conclusion:PRMT6 silencing can inhibit the proliferation and migration of gastric cancer cells MGC-803 via deactivation of NF-κB/MMP9 signaling pathway.

Objective:To evaluate the effect of continuing health management on type 2 diabetes mellitus based on WeChat platform by Meta-analysis.Methods:Clinical randomized controlled trials connected with WeChat continuing health management for type 2 diabetes was searched by database including China Knowledge Network, Wanfang, Weipu, PubMed, Elsevier Science Direct, CINAHL, Web of Science, Cochrane Library. Cochrane bias risk assessment tool was used for evaluating the methodological quality of the included literatures. Meta-analysis of the data extracted from the included literature was performed by RevMan5.2 statistical software to assess heterogeneity of the outcome indicators and extract value of mean difference ( MD) and odds ratio ( OR). Results:A total of 1 133 patients with type 2 diabetes from 9 researches were enrolled in the study. The results showed that the WeChat continuing health management group had statistically significant differences in levels of fasting blood glucose ( MD value was -0.98, 95% CI -1.14 - -0.83, P<0.01), postprandial blood glucose ( MD value was -1.27, 95% CI -1.56 - -0.97, P<0.01), glycated hemoglobin ( MD value was -0.69, 95% CI -0.82 - -0.56, P<0.01), total cholesterol ( MD value was -0.54, 95% CI -0.65 - -0.44, P<0.01), triglyceride ( MD value was -0.50,95% CI -0.67 - -0.32, P<0.01) and low-density lipoprotein ( MD value was -0.52, 95% CI -0.74 - -0.30, P<0.01) compared with the control group. Conclusions:WeChat continuing health management intervention can effectively control the blood sugar and blood lipid levels of patients with type 2 diabetes mellitus and improve their self-management ability. For the deficiencies of little included references, the result still required a large-sample and high-quality randomized controlled trials to enhance accuracy.

Objective: To investigate the possibility of adipose tissue mesenchymal stem cell-derived microvesicles (ADSC-MVs) to improve the retention volume of fat transplantation. Methods: Human adipose tissue was obtained from 5 healthy female patients aged from 20 to 30 years, who came to the hospital for abdominal liposuction. Adipose tissue mesenchymal stem cells (ADSCs) were acquired by collagenase enzymatic hydrolysis. ADSC-MVs were isolated from the supernatant of cultured ADSCs through ultra-centrifugation, and characterized by transmission electron microscope and PKH26 staining. Sixteen BALB/c-nu nude mice were randomly divided into 2 groups (n=8, mice/group) by random number table method. In EV group, the mice were subcutaneously injected 0.35 ml human fat, with 7 μg ADSC-EVs (final concentration is 20 μg/ml), while 0.35 ml human fat were in blank group. The mice were sacrificed and the grafts were harvested at 1 month and 3 months after transplantation. Weight and volume of transplanted fat were tested. Morphology of adipocytes, fibrosis and necrosis of fat tissue were confirmed by HE staining. Blood vessel density were accessed by CD31 staining.SPSS 13.0 was used for statistical analysis and Student-t test was applied to compare the data from two groups. Results: One month after fat transplantation, the volume of fat grafts in blank group was lower than that in MV group. Besides, lipoliquefaction can be observed in fat grafts of blank group. Fat grafts in MV group had a higher volume and littler necrosis and lipolique faction. Three months after grafting, the volume of fat grafts in blank group [(0.057±0.009) ml] was significantly lower than that in MV group [(0.103±0.015) ml], t=8.117, P<0.001. MV group had an increased number of vessels (29.6±4.0/field) compared with grafts from the Blank group (23.0±2.4/field), t=2.825, P=0.022. Histological analysis revealed that the fat grafts in MV group consisted less fat necrosis and fibrosis than control group. Conclusions ADSC-MVs can improve the retention volume of fat transplantation.

Objective: To analyze the related factors of postoperative complications after laparoscopic assisted D2 radical resection for advanced gastric cancer. Methods: From August 2015 to July 2017, 80 patients with advanced gastric cancer admitted to the First Hospital of Jiaxing were selected.All the patients were treated with laparoscopic-assisted D2 radical resection, and the risk factors related to postoperative complications were analyzed by logistic regression analysis model. Results: There were 33 cases (41.25%) with postoperative system complications, 19 cases (23.75%) with complications of level Ⅱ and above; 15 cases (18.75%) with postoperative local complications, among them 12 cases (15.00%) appeared level Ⅱ and above local complications.The number of concomitant diseases and age were related risk factors for systemic complications in patients with advanced gastric cancer after laparoscopic D2 radical resection (OR=1.982, 95%CI: 2.183-34.405, OR=6.587, 95%CI: 1.738-23.495, all P<0.05). The preoperative neoadjuvant chemotherapy, reconstruction method and age were the risk factors for local complications in patients with advanced gastric cancer after laparoscopic D2 radical resection (OR=8.273, 95%CI: 4.982-35.394, OR=12.304, 95%CI: 2.384-88.921, OR=6.365, 95%CI: 2.183-21.384, all P<0.05). Conclusion Treatment of advanced gastric cancer patients with laparoscopic D2 radical mastectomy, attention should be paid to control the patients' age, preoperative neoadjuvant chemotherapy, reconstruction mode, associated disease and other related risk factors.In order to ensure the safety of patients and to avoid postoperative complications.

Objective To explore the effect of divided injection of fat grafting and to provide a new sight for the strategy of clinical particle fat transplantation.Methods Adipose tissue was aspirated from the healthy female abdomen by liposuction.In the control group,0.5 ml of adipose tissue was subcutaneously injected into the nude mice.The experimental group was injected with 0.25 ml first,followed by 0.25 ml injection of adipose tissue on the 7th,14th and 30th days.To assess graft retention rate and effectiveness we measured the wet weight and observed the pathological sections with HE or perilipin immunofluorescence.Results The wet weight of the tissue between the experimental group and the control group had no statistical difference,the experimental group had less necrosis and empty tissue than the control group.The proportion of perilipin positive staining tissue in 7 day group had statistical difference from that of the control group.Conclusions The strategy of preinjection of part of the adipose tissue and then supplement of the residual tissue after 7 days may increase the proportion of active adipose tissue in the graft.

Objective To explore the nursing experience of spinal disease patients with postoperative delirium.Methods From January 2014 to December 2017,we selected 116 elderly spinal disease patients with postoperative delirium of Department of Orthopedics in China-Japan Union Hospital of Jilin University.All of the patients were randomly divided into control group and observation group,58 cases in each group.Patients of control group received routine nursing.On this basis of nursing in control group,patients of observation group were treated with specific nursing on neck brace preventing rotation and pressed bellyband in back.We compared the status of oozing of blood around incision and integrity of dressing among patients in two groups.Results Among patients in observation group,the incidence of oozing of blood around incision was 13.8％lower than that(44.8％)in control group;the integrity of dressing was 91.4％better than that(75.9％)in control group all with significant differences(χ2=13.481,5.098;P < 0.05).Conclusions Specific nursing intervention for elderly spinal disease patients with postoperative delirium can reduce the incidence of oozing of blood around incision and improve the integrity of dressing.