BACKGROUND:The repair process of myocardial injury involves complex cellular and molecular mechanisms,especially mitochondrial calcium homeostasis,macrophage autophagy and pyroptosis pathways.Traditional Chinese medicine(TCM)has shown significant clinical efficacy in improving myocardial injury,but its mechanism of action needs to be thoroughly investigated. OBJECTIVE:To investigate the role of mitochondrial calcium homeostasis-mediated macrophage autophagy and pyroptosis pathways in myocardial injury,and to summarize the progress of TCM in this field. METHODS:A computerized search was performed for relevant literature from the database inception to March 2024 in the Web of Science,PubMed and CNKI.The search terms were"mitochondrial calcium homeostasis,macrophage autophagy,macrophage pyroptosis,traditional Chinese medicine,myocardial injury,myocardial injury reperfusion"in Chinese and English.Through literature review,we analyzed the relationship between mitochondrial calcium homeostasis and macrophage autophagy and pyroptosis,explored the mechanism of their roles in myocardial injury,and summarized the pathways of multi-targeted,multi-pathway effects of TCM. RESULTS AND CONCLUSION:The maintenance of mitochondrial calcium homeostasis has been found to be closely related to the normal function of cardiomyocytes.Macrophages can participate in the repair process of myocardial injury through autophagy and pyroptosis pathways.Autophagy contributes to cell clearance and regulation of inflammatory response,while pyroptosis affects myocardial repair by releasing inflammatory factors.TCM regulates mitochondrial calcium homeostasis and macrophage function through multiple mechanisms.For example,astragalosid regulates calcium homeostasis by lowering mitochondrial membrane potential and inhibiting cytochrome C,and epimedium glycoside plays a role in reducing β-amyloid deposition.In addition,herbal compounds and single drugs promote myocardial repair by activating or inhibiting specific signaling pathways,such as PI3K/AKT and nuclear factor-κB signaling pathways.Future studies should focus on the interactions between mitochondrial calcium homeostasis,autophagy and pyroptosis pathways,as well as how TCM can exert therapeutic effects through these pathways to provide new strategies and drugs for the treatment of myocardial injury.

Objective To compare the application of main concept analysis(MCA)and story narration as-sessment(SNA)in aphasia discourse assessment,and study their clinical applicability.Methods A total of 8 apha-sic and 22 healthy control subjects were recruited.Local sequential picture materials were used to elicit language samples.The differences between groups in the assessment results of the MCA and the SNA were compared,the consistency of the assessment results of the two methods were also analyzed.The inter-rater and the intra-rater reli-ability of the two methods was discussed.Results The results of the MCA showed that the number of accurate and complete(AC)main concepts(P＜0.01),the number of accurate and complete main concepts per minute(AC/min)(P＜0.05)and main concept scores(MC scores)(P＜0.05)of the aphasia group were significantly lower than those of the healthy group.The number of absent(AB)main concepts(P＜0.05)were significantly higher than those of the control group.As for the result of SNA,the score of the content of sub picture description(P＜0.05),the total score of sub picture description(P＜0.05)and the total score of overall description(P＜0.05)in the aphasia group were significantly less than those in the control group(P＜0.05).No significant difference be-tween the standardized scores of the two methods were observed,and inter-rater and the intra-rater reliability were both in a good range.Conclusion The clinical applicability of the two methods is excellent and the evaluation results are conststent.The MCA has outstanding advantages in evaluating the quality and quantity of information,while SNA examines the syntax and content organization,which can reflect the overall discourse performance.

Objective:To evaluate the clinical efficacy and safety of stereotactic surgery in patients with refractory mental disorders.Methods:A retrospective analysis was performed; clinical data, postoperative complications and medication intake of 149 patients with refractory mental disorders accepted stereotactic surgery in Department of Neurosurgery, People's Hospital, Wuhan University from August 2019 to December 2023 were collected. Outcomes were assessed at 1, 6, 12, and 24 months after surgery by Clinical Global Impression-Global Improvement (CGI-GI). Before and 1, 6, and 12 months after surgery, severities were assessed by Clinical Global Impression-Severity of Illness (CGI-SI); cognition was assessed by Montreal Cognitive Assessment (MoCA); positive and negative symptoms were evaluated by Positive and Negative Symptom Scale (PANSS); psychotic symptoms were evaluated by Brief Psychiatric Rating Scale (BPRS) and Symptom Checklist 90 (SCL-90); obsessive-compulsive symptoms, depressive symptoms, anxiety symptoms and manic symptoms were assessed by Yale-Brown Obsessive-Compulsive Symptoms Scale (Y-BOCS), Beck Depression Inventory (BDI)-II, Beck Anxiety Inventory (BAI), and Young Mania Rating Scale (YMRS), respectively; social functioning and quality of survival were evaluated by Social Disability Screening Schedule (SDSS) and World Health Organization Quality of Life-Bref Form (WHOQOL-BREF).Results:(1) Increased sleep was noted in 47 patients and fatigue in 38 patients within 1 week after surgery. Behavioral laziness and emotional apathy were still presented at 1 month after surgery in 6 patients, and complications disappeared in the rest patients. Mildly reduced initiative was presented at 12 months after surgery in 5 patients. (2) CGI-GI indicated that 149 patients were followed up 1 month after surgery with an overall efficiency of 85.90%; 135 patients were followed up at 6 months after surgery with an overall efficiency of 83.21%, 106 patients were followed up at 12 months after surgery with an overall efficiency of 79.24%, and 63 patients were followed up at 24 months after surgery with an overall efficiency of 80.95%. (3) Compared with those before surgery, significantly lower BPRS scores, significantly lower PANSS positive, negative, and overall scores, statistically lower BAI, BDI-II, YMRS, and MOAS scores, significantly lower Y-BOCS obsessional thinking, compulsive behavior and total scores, significantly higher WHOQOL-BREF (physical and psychological domains) scores, and significantly lower SDSS and SCL-90 scores were noted in patients at 1, 6, and 12 months after surgery ( P<0.05). (4) At 12 months after surgery, withdrawal drug was noted in 13 patients, reduced drug in 38, same dose in 52, and increased drug in 2 patients. Conclusion:Stereotactic surgery can obviously improve obsession, anxiety, depression, mania and aggression, and modify social functioning and quality of survival in patients with refractory mental disorders, enjoying good safety.

Objective:To explore the influencing factors of clinical nurses in general hospitals to carry out hospice care under hospice shared care model, and further improve the quality of hospice care in general hospitals under this mode.Methods:Using the descriptive phenomenological research method, 13 clinical nurses from Sir Run Run Shaw Hospital Affiliated to Medical School of Zhejiang University were selected by purposive sampling from June to September 2023. Semi-structured interviews were conducted based on the capacity opportunity-motivation-behavior model, and Colaizzi′s 7-step analysis method was used to summarize and refine the theme.Results:There were 3 males and 10 females, aged 24-38 years old. Three themes and 11 sub-themes were extracted in this study: ability factors (theoretical knowledge cannot meet clinical needs, lack of clinical practice ability, insufficient self emotional regulation ability), motivation factors (willingness to carry out hospice shared care model, sense of professional benefit, professional identity, perception of care pressure, hospice care self-efficacy), opportunity factors (the influence of Confucian culture, systematic construction of hospice shared care model in hospitals, and multiple external support).Conclusions:Nurses' hospice care under hospice shared care model is affected by internal and external factors. Nurses can learn through multiple channels, find positive work experience, and use multi-dimensional support system to provide high-quality hospice care services for patients.

Artificial vascular graft(AVG)fistula is widely used for hemodialysis treatment in patients with renal failure.However,it has poor elasticity and compliance,leading to stenosis and thrombosis.The ideal artificial blood vessel for dialysis should replicate the structure and components of a real artery,which is primarily maintained by collagen in the extracellular matrix(ECM)of arterial cells.Studies have revealed that in hepatitis B virus(HBV)-induced liver fibrosis,hepatic stellate cells(HSCs)become hyperactive and produce excessive ECM fibers.Furthermore,mechanical stimulation can encourage ECM secretion and remodeling of a fiber structure.Based on the above factors,we transfected HSCs with the hepatitis B viral X(HBX)gene for simulating the process of HBV infection.Subsequently,these HBX-HSCs were implanted into a polycaprolactone-polyurethane(PCL-PU)bilayer scaffold in which the inner layer is dense and the outer layer consists of pores,which was mechanically stimulated to promote the secretion of collagen nanofiber from the HBX-HSCs and to facilitate crosslinking with the scaffold.We obtained an ECM-PCL-PU composite bionic blood vessel that could act as access for dialysis after decellularization.Then,the vessel scaffold was implanted into a rabbit's neck arteriovenous fistula model.It exhibited strong tensile strength and smooth blood flow and formed autologous blood vessels in the rabbit's body.Our study demonstrates the use of human cells to create biomimetic dialysis blood vessels,providing a novel approach for creating clinical vascular access for dialysis.

Objective:To evaluate the effects of acupuncture combined with Tongbi Yinao Decoction in the treatment of isolated vertigo due to posterior circulation ischemia.Methods:A total of 78 elderly patients with isolated vertigo due to posterior circulation ischemia who were admitted to the Traditional Chinese Medicine Rehabilitation Department of Meishan People's Hospital from February 2019 to February 2022 were selected as the study subjects. They were divided into two groups by open randomized parallel control trail method, with 39 cases in each group. The control group was given conventional Western medicine treatment and oral administration of flunarizine hydrochloride capsules. On this basis, the observation group was treated with acupuncture combined with Tongbi Yinao Decoction. Both groups received 2 months of treatment. TCM syndrome scores before and after treatment were recorded. The Mini Mental State Examination (MMSE) was used to evaluate the patients' intelligence level. Transcranial Doppler ultrasound was used to detect blood flow velocity of the basilar artery, left vertebral artery and right vertebral artery. The blood rheometer was used to detect plasma viscosity, whole blood low shear viscosity and whole blood high shear viscosity. Adverse reactions that occurred during treatment were recorded, and clinical efficacy was evaluated.Results:The total effective rates in the observation group and the control group were 94.87% (37/39) and 76.92% (30/39), with statistical significance ( χ2=5.19, P=0.023). After treatment, the observation group in terms of vertigo and dizziness (1.05±0.12 vs. 2.14±0.74, t=9.08), chest distress and nausea (0.97±0.10 vs. 2.06±0.61, t=11.01), cyanosis of lip and nail (1.07±0.88 vs. 2.55±0.70, t=8.22), scaly dry skin (0.85±0.22 vs. 2.02±0.84, t=8.42) and the total score (3.94±1.32 vs. 8.77±2.89, t=9.49) were lower than those in the control group ( P<0.01). The MMSE score (26.39±2.20 vs. 24.20±2.37, t=4.01) was higher than that of the control group ( P<0.01). After treatment, blood flow velocity of the basilar artery [(37.55±3.61) cm/s vs. (33.50±2.96) cm/s, t=5.42], left vertebral artery [(34.27±4.87) cm/s vs. (30.58±3.74) cm/s, t=3.75] and right vertebral artery [(38.74±5.21) cm/s vs. (35.17±4.54) cm/s, t=3.23] in the observation group were higher than those in the control group ( P<0.01); The plasma viscosity [(1.32±0.19) mPa?s vs. (1.45±0.21) mPa?s, t=20.28], whole blood low shear viscosity [(8.71±0.35) mPa?s vs. (8.97±0.38) mPa?s, t=3.14] and whole blood high shear viscosity [(5.41±0.39) mPa?s vs. (5.92±0.43) mPa?s , t=5.49] were lower than those in the control group ( P<0.01). During treatment, the incidence rates of adverse reactions in the observation group and the control group were 28.2% (11/39) and 20.5% (8/39), without statistical significance ( χ2=0.63, P=0.429). Conclusion:Acupuncture combined with Tongbi Yinao Decoction can effectively maintain hemodynamics and cerebral blood flow of patients with isolated vertigo due to posterior circulation ischemia, and improve clinical efficacy, with good safety.

Modern TCM understands the pathogenesis of blood glucose fluctuation mainly from the viscera (spleen, kidney, liver, bile, small intestine), middle energizer, "yin fire theory", "Xuanfu depression" and "qi transformation". In clinic, blood glucose fluctuation is mainly divided into four syndrome types: qi-yin deficiency syndrome, yin-yang deficiency syndrome, exuberance of fire and heat syndrome, and heat stagnation in liver-stomach syndrome. TCM compounds can improve blood glucose fluctuation by improving insulin resistance, regulating intestinal microflora, promoting the secretion of glucagon-like peptide-1, and fighting oxidative stress.

With the continuous development of China's economy,the people expect for higher quality medical services,and medical humanistic care is increasingly emphasized.Under this background,the"Duplex Linkage Mode",which integrates medical social workers and volunteers,has emerged.This paper reviews the current state of applying the mode in China,ex-pounds its benefits,and details its application within hospital services.This application covers guidance for outpatient and emer-gency department,inpatient ward services,hospice care,and community residents volunteer services.In addition,this paper proposes suggestions on furth for optimizing recruitment and training programs,improving management systems,establishing intel-ligent management systems,and improving volunteer support mechanisms.These measures aim to promote the sustainable and healthy development of medical humanistic services and to support the implementation of the Healthy China Initiative.

Objective:To establish an HPLC method to determine of vanillin in lysine and vitamin B12 granules.Methods:1.0 g of lysine and vitamin B12 granules was put into a 10mL graduated centrifuge tube,1 mL of water was added to dissolve,vortex for 1 min,and methanol was added to the scale and vortex for 1 min for extraction.The samples were separated on a C18 column(250 mm × 4.6 mm,5 μm)with a mobile phase of methanol and water(35∶65)at ta flow rate of 1.0 mL·min-1.The detection wavelength was 277 nm.Results:The limit of detection of vanillin was 0.2 μg·g-1,and the concentration was linear in the range of 1.962-49.04 μg·mL-1(r=0.999 9).The recoveries of vanillin at low,medium and high levels were 91.86％-101.61％with RSD of 2.9％(n=9).6 batches of samples were determined,and the results showed that the vanillin content in 4 batches of enterprise A was 55.18-79.55 μg·g-1,and no vanillin was detected in enterprise B and enterprise C.Conclusion:The method is simple and reliable,and can be used for the rapid determination of vanillin in lysine and vitamin B12 granules.

Objective To understand the testing performance of drug manufacturers and testing institute in Yunnan province by organizing proficiency testing of microbiological examination of non-sterile drugs,and to improve the testing performance and quality management level of participants by interpretation of unsatisfactory results.Methods According to the requirements of relevant China National Accreditation Service for Conformity Assessment (CNAS),preparation values of positive or negative was determined as assigned values for qualitative items,and the median value was as assigned value for enumeration items.Using robust statistical methods and Z-score for assessment,if all the 4 items were satisfactory,it would be assessed as overall satisfactory performance,and contrariwise,it would be assessed as unsatisfactory performance.If partial item were satisfactory,it would be assessed as partially satisfactory performance.Results 152 laboratories participated in this proficiency testing program,116 laboratories obtained satisfactory performance and the satisfactory rate was 76.31％;33 laboratories obtained partially satisfactory performance,and the partially satisfactory rate was 21.71％;3 laboratories obtained unsatisfactory performance and the unsatisfactory rate was 1.97％.To classify the participants with type,the satisfactory rate for drug control institute was 88.23％ and the satisfactory rate of drug manufacturers was 74.81％.Conclusion The testing performance of participating laboratories in microbiological examination of non-sterile drugs is generally good,which can ensure the smooth implementation of the program and the accuracy and effectiveness of the results.The testing capacity and quality management level of a few laboratories need to be improved.