Ischemic cardiovascular and cerebrovascular diseases， encompassing ischemic heart disease and ischemic cerebrovascular disease， possess the features of high prevalence， disability， and mortality rates， thus ranking as the leading cause of global mortality. The shared etiology of ischemic heart disease and ischemic cerebrovascular disease involves local hypoperfusion caused by vascular stenosis， atherosclerosis， and infarction. Their intricate pathological processes involve various mechanisms such as inflammation， pyroptosis， apoptosis， and autophagy. However， interventions targeting individual pathological pathways offer limited therapeutic effects. There is an urgent need to explore novel treatment strategies or medications capable of simultaneously intervening in multiple pathological pathways. Mesenchymal stem cells， through their paracrine effects， play a role in tissue repair， with exosomes playing an important role. Mesenchymal stem cell-derived exosomes exhibit immunomodulatory and reparative properties similar to their parent cells while also reducing the side effects and infusion toxicity associated with the direct application of stem cells. Thus， they hold broad prospects for the treatment of ischemic cardiovascular and cerebrovascular diseases. Traditional Chinese medicine （TCM） and formulations， with their characteristics of multiple components， targets， and multi-level system regulation， can improve the cellular microenvironment by modulating mesenchymal stem cell-derived exosomes， thereby exerting therapeutic effects on ischemic cardiovascular and cerebrovascular diseases. This viewpoint highlights the concept of microscopic pattern differentiation in modern TCM and represents another significant area of TCM modernization. This article provided a comprehensive overview of the therapeutic effects and mechanisms of mesenchymal stem cell-derived exosomes in ischemic cardiovascular and cerebrovascular diseases while discussing the application of TCM in regulating mesenchymal stem cell-derived exosomes in ischemic cardiovascular and cerebrovascular diseases， offering new insights for the prevention and treatment of ischemic cardiovascular and cerebrovascular diseases using TCM.

Objective To analyze the medication law of Professor Yuan Jinsheng,a renowned TCM practitioner in China,for treating palpitations through data mining methods.Methods Clinical prescriptions for treating palpitations by Professor Yuan Jinsheng from January 2016 to May 2023 were collected.The prescriptions were screened based on inclusion and exclusion criteria,a prescription compatibility network was constructed based on R Studio 4.3.1,and the medication law of prescriptions was analyzed.Results Totally 331 prescriptions were screened,involving 180 types of Chinese materia medica,with a total frequency of 3 625.The most frequently used drugs(≥30 times)were mainly tonics.The main properties were warm and neutral,the main tastes were sweet,bitter,and pungent,which belonged to heart,spleen and lung meridians.The top 5 drugs with high correlation were tonifying,blood circulation-activating and stasis-resolving,qi-regulating,and heat-clearing.Correlation analysis reveals high-frequency drugs,which were mainly Glycyrrhizae Radix et Rhizoma Praeparata cum Melle,Rehmannine Radix,Ophiopogonis Radix,Astragali Radix and Codonopsis Radix.The clustering analysis results showed that the efficacy was mainly tonifying deficiency,regulating qi,activating blood circulation,and resolving stasis.Conclusion Professor Yuan Jinsheng's prescription compatibility for treating palpitations primarily focuses on tonics,qi-regulating,and blood circulation-activating and stasis-resolving herbs,embodying the principles of treating palpitations from the perspective of the heart and spleen and the combined use of multiple organs.

Objective:To reveal the molecular characteristics of mononuclear phagocytes (MPs) in rat model of peripheral nerve injury (PNI) using single-cell RNA sequencing (scRNA-seq) technology that would provide the developmental changes and major biological process involved in the function of MPs after PNI.Methods:Twenty-seven male SD rats (200-300 g in weight) were selected from the Department of Hand and Foot Microscopy and Wound Repair Surgery, Henan Provincial People's Hospital (People's Hospital of Zhengzhou University) and the Department of Orthopaedics of First Affiliated Hospital of Zhengzhou University from July 2023 to December 2023. The rats were divided into a Sham operation group (Sham group), a 3 days post crush group (3 dpc group) and a 7 days post crush group (7 dpc group), following the randomised table method with 9 rats per group. After 7 days of environmental acclimatisation, the 3 dpc group and 7 dpc group were subjected to have the right sciatic nerve crushed in order to create a model of crush injury. And as a control group, the Sham group was subjected to Sham surgery only. Nine right sciatic nerves of rats were collected from each group at the corresponding time pints. Single-cell isolation was performed on the 10X Genomics platform. ScRNA-seq libraries were constructed using the Gel Bead Kit V3 and the libraries were sequenced using an Illumina Novaseq 6000 sequencer. Dimensionality reduction was performed using Principal Component Analysis and T-Distributed Stochastic Neighbor Embedding to visualise and explore the cellular heterogeneity within the dataset. Nine distinct cell clusters and their corresponding marker genes were identified based on the dimensionality-reduced data. Differential gene expression analysis was then performed to identify differentially expressed genes (DEGs) in MPs between different groups. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis were performed to uncover the biological processes and pathways based on the DEGs. Monocle program for pseudo-time analysis was used to infer the developmental trajectory of MPs after injury.Results:A total of 19 054 cells were obtained by sequencing, and the results showed that the proportion of MPs in peripheral nerves was significantly up-regulated after PNI, and MPs were classified into 9 cellular subgroups based on the clustering analysis of the scRNA-seq data, which were Cluster 1 (3 398 cells), Cluster 2 (3 388 cells), Cluster 3 (3 262 cells), Cluster 4 (2 825 cells), Cluster 5 (2 753 cells), Cluster 6 (1 894 cells), Cluster 7 (648 cells), Cluster 8 (492 cells) and Cluster 9 (394 cells), respectively. Based on the expression of different cell subpopulation markers, MPs in the Sham group, 3 dpc group and 7 dpc group of sciatic nerves were classified into 9 cell clusters and the distributions of different MPs clusters in the 9 sciatic nerve samples were identified, among which, the Sham group had the lowest number of MPs cells in the sciatic nerve samples (a total of 2 719 cells) and the clusters were mainly dominated by clusters 5 (1 119 cells) and clusters 6 (1 240 cells). The 3 dpc group had the highest number of MPs cells (9 760 cells in total) and the clusters were mainly dominated by cluster 2 (1 760 cells), cluster 3 (3 130 cells) and cluster 4 (2 300 cells). The MPs (6 575 cells in total) in the 7 dpc group were mainly dominated by cluster 1 (2 406 cells) and cluster 2 (1 628 cells). Compared with the Sham group, the GO and KEGG annotations of the DEGs were significantly upregulated in the 3 dpc group, indicating that MPs in the rat sciatic nerves would have the ability to bind to extracellular molecules and remove debris from the injury site at 3 days post-injury, and the 7 dpc group would have the ability to activate the signalling pathways related to nerve repair. The proposed time-series analysis revealed that, in the uninjured condition, the MPs were mainly in the cluster 5 (Ccl17 +Cd80 +) and cluster 6 (Fcmr +Slc9a9 +). At 3 days post-injury, MPs developed into cell types dominated by cluster 2 (Cd8b +Meis3 +), cluster 3 (Il10 +Cd163 +) and cluster 4 (Ccl24 +Prg4 +). At 7 days post-injury, the effector state of cluster 2 among the main cell types of MPs was still maintained but the other parts had developed into cluster 1 (Hspa1b +Apobec1 +) related phenotypes. Conclusion:The molecular characteristics of MPs in the peripheral nerve revealed through scRNA-seq data provide valuable insights into the role of MPs in mediating inflammation and neural regeneration after PNI.

Objective:This study assesses the results of the clover technique for the treatment of tricuspid regurgitation(TR) due to severe prolapse or tethering.Methods:From March 2016 to November 2018, 28 patients with severe TR due to prolapsing or tethered or adhesion leaflets underwent clover technique. Annuloplasty was associated in 27 patients(97%). The aetiology of TR was rheumatic in 19 cases(68%), subacute bacterial endocarditis in 4(14%), degenerative in 3(11%) and ischemia of right ventricular(the peacing leads compress the septum leaflet in 1 case) in 2(7%). The main mechanism of TR was prolapse/flail of one leaflet in 7 patients(23%), of two leaflets in 13 patients(46%) and of all three leaflets in 6 patients(21%). The remaining 2 patients(7%) presented with severe leaflets’tethering.Results:None deaths occurred during hospitalisation and one patient dischargedvoluntary 12 days after surgery. Follow-up of the 27 hospital survivors was 100% complete[mean length(1.2±0.8)years, range 0.25-1.70 years]. At the last echocardiogram, no or mild TR was detected in 25 patients(88.7%), moderate(2+ /4+ ) in two(9.6%) and severe(4+ /4+ ) in one patient(3.6%). Mean tricuspid valve area and gradient were(4.3±0.6 )cm 2 and(2.8±1.4)mmHg(1 mmHg=0.133 kPa). There was no obvious valve stenosis in all cases. In all patients, echocardiography was performed and no signs of tricuspid stenosis were detected. At the multivariable analysis, the degree of TR at hospital discharge was identified as the only predictor of TR 2+ at follow-up. Conclusion:Clover procedure is simple and safe in the surgical management of various causes of TR besides severe tethering and calcification, it is an effective supplementary measure for annuloplasty.

Objective: To compare the efficacies of two training protocols, i.e. the multimedia instruction and the conventional method, in periodontal surgery teaching for undergraduate students. Methods: One hundred and twenty-three dental undergraduates in their pre-clinical training course were recruited and divided into two groups according to the learning grade matching principle: the experimental group (multimedia instruction, 60 students) and the control group (conventional method, 63 students). The teaching aim was to train the students gingivectomy and periodontal flap surgery by using the pig jaws. The conventional teaching method of teacher-demonstrating and student-practicing was used in the control group, and the practice time of the students′ for each surgery was 45 minutes. A standardized teaching video combined with the teachers′ explanations of the key steps was used in the experimental group. The students′ practice time for each surgery was 60 minutes. The efficacy of teaching protocol was evaluated by the teachers according to the scoring criteria set by the teaching group. Results: In gingivectomy training, accuracy of fixed points, angle of postoperative gingival margin and morphology of gingiva of the experimental group were better than those of the control group. The experimental group also had more complete and continuous excised gingivae and more thorough adjacent gingival removal. The total scores of the experimental group were significantly higher than those of the control group (92.8±2.6 vs. 89.9±3.7, P<0.05). In periodontal flap surgery training, the experimental group operated the blade around the shape of the tooth better in internal bevel incision than the control group. Additionally, the incision position of internal bevel incision, periosteal integrity after flapping and flap depth of the experimental group were better than those of the control group. Besides, the experimental group had smoother flap edge and more thorough debridement. The total scores of the experimental group were significantly higher than those of the control group (92.2±4.1 vs. 89.2±4.4, P<0.05). Conclusions The teaching efficacy of multimedia instruction was better than that of the conventional method. Its value needs to be further tested in future teaching practice.

Hyperbaric oxygen (HBO) medicine is an applied interdiscipline concerning basic me-dicine,clinical medicine,physics and psychology.Indications of HBO treatment involve multiple systems of the body.Based on the practice of almost 30 years,we explore how to adopt heuristic and experiencing style to strengthen the combination of theory and clinical application fortifying practical operation in the teaching. Meanwhile,discussing obstacles in HBO treatment and learning frontiers and progress through literatures or animal experiments can cultivate students' solid theoretical foundation and basic analysis and operation skills,and improve their interest in clinical and scientific research work of hyperbaric oxygen.

Objective To study the relationship between heart rate and failure of biological valve,and whether reduce the heart rate could delay the failure of biological valve.Methods Retrospective analysis of 92 bioprosthetic valve replacement cases in our institution from April 1996 to March 2001.The follow-up was carried out through the outpatient service,telephone and letter.The patients were divided into two groups based on the heart rate:Group A:basic heart rate no more than 75 beats per minute;Group B:basic heart rate greater than 75 beats per minute.Blood pressure,heart function,echocardiogram and reoperation rate was collected.Results In group A,the average follow-up time and the longest follow-up time was better than the patients in group B but has no significant difference.Echocardiographic data showed that the proportion of valve leaflets stiffness and calcification in group A was significantly lower than group B(7.7％ vs.17.9％,P ＜0.05).Redo operation rate in group A was lower than those in group B (7.7％ vs.22.6％,P ＜ 0.05).There were only 1 case(1.5 ％) suffering from the tearing in all three valve leaflets in group A while it was 8 cases(8.7％) in group B (2.6％ vs.15.1％,P ＜ 0.05).Conclusion Basic heart rate has a significant effect on the failure of the mitral bioprosthesis.To decrease the basic heart rate can delay the failure of the mitral bioprosthesis and improve the durability.

Aged ; Aortic Valve ; physiology ; Female ; Heart Rate ; physiology ; Humans ; Male ; Middle Aged ; Retrospective Studies

Objective To study the general pharmacological effects of Aloe's whole-leaf freeze-dried powder (AWFD), and observe its influence on cardiovascular system, nervous system and respiratory system of laboratory animals, so as to offer an experimental basis for clinical application. Methods Forty-eight mice were randomized into blank control group, high dosage group, medium dosage group and low dosage group of AWFD (12 mice for each group). AWFD high, medium and low dosage groups were treated by intragastric at the dose of 12.20, 3.90, 0.65 g/(kg?d), blank control group was treated by equal volume of sterilized distilled water. After three days, general behavior, spontaneous activity, coordinated movement, sleep situation induced by sodium pentobarbital in subthreshold dose and suprathreshold dose were observed. Twenty-four beagle were randomized into blank control group, high dosage group, medium dosage group and low dosage group of AWFD (6 beagles for each group). AWFD high, medium and low dosage groups were treated by duodenum at the dose of 6.10, 3.41, 0.71 g/(kg?d), blank control group was treated by equal volume of sterilized distilled water. The influence on blood pressure, heart rate, electrocardiogram, breathing flow and frequency in anesthetic dogs were observed. Results Three dosages of AWFD had no obvious influence on spontaneous activity and coordinated movement in mice, and had no evidently influence on sleep number and duration, but the high dosage group of AWFD had influence on sleep latency (P<0.01). AWFD had no impact on blood pressure, heart rate, electrocardiogram, breathing flow and frequency in anesthetic dogs. Conclusion AWFD has no evident effects on cardiovascular system and respiratory system in laboratory animal, however, the impact on the central nervous system remains to be further verified.

Objective To observe the antioxidative dosage-effect relationship of grape seed proanthocyanidin extract (GSPE). Methods The mice were randomly divided into seven groups:blank group, model group, 5 mg/kg GSPE group, 15 mg/kg GSPE group, 45 mg/kg GSPE group, 135 mg/kg GSPE group and 405 mg/kg GSPE group. The mice in blank group were dealt with saline solution by intraperitoneal injection, the others were dealt with D-galactose (120 mg/kg) by intraperitoneal injection for seven weeks to make oxidative damage model. Meanwhile, the mice were given corresponding dose of the drug. Subsequently the level of malondialdehyde (MDA) and activity of superoxide dismutase (SOD) in the serum were measured to observe the antioxidative dosage-effect relationship of GSPE. Results The 45, 135, 405 mg/kg GSPE group reduced the MDA level, and the 15, 45, 135, 405 mg/kg GSPE group increased the SOD activity. Conclusion GSPE has significant antioxidant activity on mice dealt with D-galactose above the dose of 15 mg/kg, suggesting that the clinical use of GSPE should guarantee a certain dose to play a good antioxidant effect.