Objective To analyze the clinical efficacy of left subclavian artery (LSA) revascularization combined with thoracic endovascular aortic repair (TEVAR) for Stanford type B aortic dissection with insufficient proximal landing zone. Methods A retrospective analysis was conducted on the clinical data of patients with Stanford type B aortic dissection and insufficient proximal landing zone who underwent TEVAR combined with LSA revascularization or TEVAR alone at the Central Hospital of Wuhan from 2017 to 2021. Patients were divided into a revascularization group and a simple stent group based on the surgical approach. Perioperative data of the two groups were compared. Results A total of 144 patients were included. In the simple stent group, there were 113 patients, including 85 males and 28 females, with a median age of 56.0 (48.0, 68.0) years. In the revascularization group, there were 31 patients, including 23 males and 8 females, with a median age of 54.0 (48.2, 59.7) years. There were statistical differences in operation time, hospital stay, preoperative lesion diameter, and preoperative and postoperative right vertebral artery diameter between the two groups (P<0.05). The simple stent group had 12 (10.6%) patients of complications, which was lower than the revascularization group (9 patients, 29.0%) postoperatively. At three months postoperatively, the most common complication in the simple stent group was endoleak (5 patients), while in the revascularization group it was hoarseness (2 patients). There was no death in the two groups within 1 year postoperatively. Conclusion Both different surgical approaches have good effects on the treatment of type B aortic dissection with insufficient proximal landing zone, but further validation is needed through multicenter, large-sample, and long-term follow-up studies.

Objective To compare the clinical efficacy of typeⅡhybrid surgery versus Sun’s surgery in treating acute Stanford A aortic dissection. Methods A retrospective analysis was conducted on the clinical data of patients with acute Stanford A aortic dissection who were treated at the Central Hospital of Wuhan affiliated to Tongji Medical College, Huazhong University of Science and Technology from 2016 to 2022. According to the surgical method, patients were divided into a typeⅡhybrid group and a Sun’s surgery group, and the clinical efficacy of the two groups was compared. Results A total of 52 patients were included, with 22 in the typeⅡhybrid surgery group and 30 in the Sun’s surgery group. The typeⅡhybrid group consisted of 18 males and 4 females, with an average age of (58.18±6.00) years, while the Sun’s surgery group consisted of 22 males and 8 females, with an average age of (53.03±11.89) years. All surgeries were successfully completed. There were 4 (13.3%) perioperative deaths in the Sun’s surgery group, including 2 patients of multiple organ failure, 1 patient of paraplegia, and 1 patient of uncontrollable postoperative bleeding. There was 1 (4.5%) perioperative death in the typeⅡhybrid surgery group, who was suspected of acute coronary syndrome and took a loading dose of dual antiplatelet drugs preoperatively. The patient underwent secondary thoracotomy for hemostasis, was re-cannulated during the operation, and finally died of circulatory failure after implantation of intra-aortic balloon pumping. There was no statistical difference in perioperative mortality between the two groups (P=0.381). Compared with the Sun’s surgery group, the typeⅡhybrid surgery group had shorter cardiopulmonary bypass time [153.00 (135.00, 185.25) min vs. 182.50 (166.50, 196.75) min, P=0.013], aortic cross-clamping time [77.00 (70.50, 92.00) min vs. 102.50 (93.50, 109.75) min, P<0.001], postoperative ICU stay [4.00 (2.83, 6.00) days vs. 8.00 (6.38, 11.78) days, P<0.001], postoperative ventilator support time [72.00 (29.50, 93.25) h vs. 87.65 (39.13, 139.13) h, P=0.138], less intraoperative blood loss [(1586.82±209.41) mL vs. (1 806.00±292.62) mL, P=0.004], postoperative 24 h drainage volume [612.50 (507.50, 762.50) mL vs. 687.50 (518.75, 993.75) mL, P=0.409], and shorter postoperative hospital stay [18.00 (13.00, 20.25) days vs. 22.00 (17.00, 29.25) days, P=0.013]. There was no statistically significant difference in the incidence of other early postoperative complications such as secondary thoracotomy for hemostasis, tracheotomy, renal dysfunction requiring dialysis, stroke, and paraplegia between the two groups (P>0.05). Conclusion For patients with acute Stanford A aortic dissection, typeⅡhybrid surgery is safe and effective; compared with traditional Sun’s surgery, typeⅡhybrid surgery has relatively less trauma, lower incidence of complications, satisfactory short-term results, and further research is needed on long-term prognosis.

Complex systems exist widely,including medicines from natural products,functional foods,and bio-logical samples.The biological activity of complex systems is often the result of the synergistic effect of multiple components.In the quality evaluation of complex samples,multicomponent quantitative analysis(MCQA)is usually needed.To overcome the difficulty in obtaining standard products,scholars have proposed achieving MCQA through the"single standard to determine multiple components(SSDMC)"approach.This method has been used in the determination of multicomponent content in natural source drugs and the analysis of impurities in chemical drugs and has been included in the Chinese Pharmacopoeia.Depending on a convenient(ultra)high-performance liquid chromatography method,how can the repeatability and robustness of the MCQA method be improved?How can the chromatography conditions be optimized to improve the number of quantitative components?How can computer software technology be introduced to improve the efficiency of multicomponent analysis(MCA)?These are the key problems that remain to be solved in practical MCQA.First,this review article summarizes the calculation methods of relative correction factors in the SSDMC approach in the past five years,as well as the method robustness and accuracy evaluation.Second,it also summarizes methods to improve peak capacity and quantitative accuracy in MCA,including column selection and two-dimensional chromatographic analysis technology.Finally,computer software technologies for predict-ing chromatographic conditions and analytical parameters are introduced,which provides an idea for intelligent method development in MCA.This paper aims to provide methodological ideas for the improvement of complex system analysis,especially MCQA.

ObjectiveTo analyze the polarized light microscopic characteristics， the composition of physical phases and their relative contents of Maifanitum from different origins， and to establish the Fourier characteristic fingerprint of Maifanitum powder crystals by X-ray diffraction（XRD）. MethodA total of 26 batches of Maifanitum samples were selected， and the microscopic characteristics of the sample powders and grinding flakes were observed by polarized light microscopy under single polarized light and orthogonal polarized light， and the main phase compositions and their relative contents were analyzed by powder crystal XRD technique， and the XRD Fourier characteristic fingerprint of Maifanitum was established. The incident light source of XRD was Cu target Kβ radiation， the light tube voltage and light tube current were 40 kV and 40 mA， respectively， the divergence slit was 1°， the scattering slit was 1°， the receiving slit was 0.2 mm， the scanning speed was 5°·min^-1 with continuous scanning and scanning range of 5-90°（2θ）， and the step length was 0.02°. ResultThe polarized light micrographs of powders and grinding flakes of Maifanitum were obtained， and the main phases were plagioclase， potassium feldspar and quartz， and a few samples also contained illite， pyrite， iron dolomite， calcite， iron amphibole and chlorite， etc. The relative total content of feldspar phases was 61.9%-82.4%， and the relative content of quartz was 12.6%-33.6%. The XRD Fourier fingerprint analysis method of Maifanitum with 13 common peaks as the characteristic fingerprint information was established， and the similarity calculated by the mean correlation coefficient method was 0.920 9-0.997 7， the similarity calculated by the mean angle cosine method was 0.940 5-0.998 4， the similarity calculated by the median correlation coefficient method was 0.921 1-0.997 5， and the similarity calculated by the median angle cosine method was 0.947 5-0.998 2. ConclusionThe polarized light microscopic identification characteristics of Maifanitum are mainly plagioclase， quartz and potassium feldspar， and the technique of powder crystal XRD Fourier fingerprint analysis can be used for the identification of Maifanitum.

This article summarizes the definitions, influencing factors, and intervention measures of medication adherence in patients with ischemic stroke coexisting with atrial fibrillation. It serves as a reference for medical and nursing staff to timely and accurately identify patients with medication adherence issues, and to implement practical and effective intervention measures from multiple dimensions to enhance the medication adherence in patients with ischemic stroke coexisting with atrial fibrillation.

Pharmaceutical analysis is a discipline based on chemical, physical, biological, and information technologies. At present, biotechnological analysis is a short branch in pharmaceutical analysis; however, bioanalysis is the basis and an important part of medicine. Biotechnological approaches can provide information on biological activity and even clinical efficacy and safety, which are important characteristics of drug quality. Because of their advantages in reflecting the overall biological effects or functions of drugs and providing visual and intuitive results, some biotechnological analysis methods have been gradually applied to pharmaceutical analysis from raw material to manufacturing and final product analysis, including DNA super-barcoding, DNA-based rapid detection, multiplex ligation-dependent probe amplification, hyperspectral imaging combined with artificial intelligence, 3D biologically printed organoids, omics-based artificial intelligence, microfluidic chips, organ-on-a-chip, signal transduction pathway-related reporter gene assays, and the zebrafish thrombosis model. The applications of these emerging biotechniques in pharmaceutical analysis have been discussed in this review.

Objective     To analyze the clinical effect of hybrid surgery on complex type B aortic dissection in 5 years. Methods     A retrospective analysis of 47 patients with complex type B aortic dissection in the Central Hospital of Wuhan affiliated to Tongji Medical College of Huazhong University of Science and Technology from 2014 to 2017 was conducted, including 42 males and 5 females with an average age of 54.9±11.2 years. Twenty-one patients underwent the left common carotid artery to the left subclavian artery bypass (a bypass group), and 26 patients underwent the left common carotid artery to the left subclavian artery transposition (a transposition group). Results     All patients accepted hybrid surgery successfully. There was no statistical difference in arterial occlusion time or intraoperative blood loss between the two groups (P>0.05). The 5-year follow-up rate was 100.0% (47/47). During the follow-up period, 12 (25.5%) patients developed complications, including 5 (10.6%) patients of endoleak, 5 (10.6%) patients of hoarseness, 2 (4.3%) patients of stroke/dizziness. There was no patient of left upper limb weakness, paraplegia or retrograde aotic dissection. The reconstructed left subclavian artery remained patent in 46 (97.9%) patients. The overall 5-year survival rate was 100.0%. Conclusion     The long-term therapeutic outcome of hybrid surgery for the treatment of complex type B aortic dissection is satisfying. In 5 years, the rebuilt left subclavian artery has a remarkable patency rate. Endoleak and hoarseness are the most common surgical complications.

Objective:To analyze the epidemiological, clinical characteristics and treatment of coronavirus disease 2019 (COVID-19) in Northeastern Sichuan, and summarize experience in time to provide reference for clinical diagnosis and treatment.Methods:A retrospective study was conducted. Fifty-nine patients with COVID-19 admitted to Bazhong Central Hospital and Dazhou Central Hospital from January 27th to February 9th, 2020 were selected as the subjects. The data of demography, epidemiology, laboratory examination, chest CT and related clinical treatment were collected. According to the severity of the disease, the patients were divided into three types: mild, general and severe types, and the differences of the above indices among different clinical types were compared.Results:① General information and epidemiology: 31 cases (52.5%) were male, 28 cases (47.5%) were female, the average age was (42.0±16.4) years old, and the patients over 40 years old accounted for the largest proportion (35 cases, 59.3%). The proportion of clinical type was 72.9% (43 cases) in general type, and 62.7% (37 cases) were imported type. With the increase of disease severity, the average age of patients also showed a significant increase trend [the age of the mild, general and severe patients were (30.9±13.6), (42.7±15.3), (55.8±18.9) years old, P < 0.01]. The proportion of patients with more than one basic disease in severe patients was significantly higher than those in mild and general patients [66.7% (4/6) vs. 20.0% (2/10), 9.3% (4/43), both P < 0.05]. In the distribution of clinical symptoms, the proportion of severe patients with chest distress/dyspnea was significantly higher than those in mild and general patients [66.7% (4/6) vs. 10.0% (1/10), 11.6% (5/43), both P < 0.05]. ② Laboratory examination index: the total number of white blood cell count (WBC), neutrophils count (NEU), C-reactive protein (CRP) in severe patients were higher than those in mild patients and general patients [WBC (×10 9/L): 7.21±4.35 vs. 5.85±1.69, 5.43±2.04; NEU (×10 9/L): 6.09±4.43 vs. 3.95±1.45, 3.54±1.83; CRP (mg/L): 16.00 (8.20, 46.43) vs. 5.00 (0.00, 16.13), 15.00 (3.13, 28.58)], the albumin (Alb) level in severe patients was lower than those in mild and general patients (g/L: 38.00±5.35 vs. 49.23±5.27, 39.81±2.15, both P < 0.05), while the hemoglobin (Hb) level in mild patients was higher than that in severe and general patients (g/L:155.2±12.1 vs. 141.3±6.8, 131.1±11.7, both P < 0.05). ③ Chest imaging: the CT manifestations of typical cases were single or multiple ground glass shadows. With the progress of the disease, the focus gradually increased, the scope gradually expanded, and multiple solid shadows of lung lobes were involved. ④ Treatment: all patients received at least 2 kinds of antiviral therapy, and the application rate of Interferon and Ribavirin in severe patients were higher than those in mild and general patients [100.0% (6/6) vs. 80.0% (8/10), 97.7% (42/43); 83.3% (5/6) vs. 0% (0/10), 20.9% (9/43); all P < 0.05]. ⑤ Prognosis: until March 6th 2020, 50 patients (84.8%) were discharged from the hospital after rehabilitation, and the remaining 9 patients were still under treatment, none deaths. Conclusions:The proportion of severe patients with chest distress/dyspnea is higher, the older the patients are and the more basic diseases are, the more likely they are to develop into severe type. High resolution chest CT could be considered for suspected cases or even fever patients, which may show the progress of the disease.

【Objective】 To investigate the effect of transfusion-transmitted Zika virus (ZIKV) on the expression of non-coding circular RNA (hsa_circ_0001613) and the role of hsa_circ_0001613 in Zika virus replication. 【Methods】 Human adenocarcinomic alveolar basal epithelial cells (A549) were seeded on a 12-well plate at 1.8×10⁵/ well and infected with ZIKV at 0.05 MOI. The Total RNAs were isolated every day for 5 days after infection, and the relative expression level of hsa_circ_0001613 was detected by qRT-PCR. In addition, 10nM siRNA-hsa_circ_0001613 was transfected into 2×10⁵/ well A549 cells to specifically knock down the expression level of hsa_circ_0001613. 24h later, the cells were infected with ZIKV (MOI=0.05). Total RNAs were isolated at day 1-5 post-infection, proteins were extracted 96h post-infection. ZIKV replication, relative host antiviral gene expression, and interferon stimulated response element (ISRE) activity were tested using qRT-PCR, western blot and dual luciferase assay, respectively. 【Results】 The relative expression of hsa_circ_0001613 decreased significantly after 1-5 days of ZIKV infection. Knockdown of hsa_circ_0001613 inhibited ZIKV replication. Meanwhile, hsa_circ_0001613 knockdown significantly upregulated IFN-α/β and its downstream interferon-stimulated genes (ISGs) expression, also increased ISRE activity. 【Conclusion】 ZIKV infection significantly suppressed hsa_circ_0001613 expression in A4549 cells. Preliminary study indicated that hsa_circ_0001613 knockdown inhibited ZIKV replication possibly through activating type-Ⅰ IFN signaling pathway as showed by increased ISGs expression and ISRE activity.

Objective To explore the operation procudure and notice of establishing a rat model of abdominal heterotopic heart transplantation by single operator,and summarize the detailed skill and experience for beginners.Methods 68 pairs male SD(recipients)/Wistar(donors) rats,preoperative anesthesia for recipients and donors at the same time,8/0 line was preparing for blocking recipients vena cava and abdominal aortic,blocking the branch vessel.Left and right superior vena ligature respectively with hilar,cutting the ascending aorta,perfusion cardioplegia,free pulmonary artery,across transverse sinus of pericardium for pulmonary artery cutting,atrial wash,free donor heart.Choosed appropriate incision of receptor abdominal blood vessels,mattress suture at 6 and 12 points,a single suture for vent gases,continuous suture in artery,single needle in vein,reperfusion after exhaust gas.Recording operation time,HE staining,IL-1β/CD3 immunohistochemistry slice,flow cytometry analysis of CD4+T/CD8+T lymphocytes subsets in the peripheral blood.Results Sixty-eight cases were treated by single operater,the operation time was(58.8±4.5)minutes,artery suture time was(7.6±2.2)minutes,vein suture time was(13.5±4.2)minutes,the total donor heart ischemic time was(31.8±4.5)minutes,the success rate was 88.2％.The rejection reaction was stronger on the third and fifth day after surgery,with high expression of IL-1β/CD3 in cardiac allografts.The CD4+T/CD8+T lymphocytes subsets increased in the peripheral blood at first day after heart transplantation.Conclusion By fully preparation and skillfully operation,establishing a rat model of abdominal heterotopic heart transplantation by single operator has a stable success rate.