BACKGROUND:In the initial stage of growth plate injury inflammation,platelet-derived growth factor BB promotes the repair of growth plate injury by promoting mesenchymal progenitor cell infiltration,chondrogenesis,osteogenic response,and regulating bone remodeling. OBJECTIVE:To elucidate the action mechanism of platelet-derived growth factor BB after growth plate injury. METHODS:PubMed,VIP,WanFang,and CNKI databases were used as the literature sources.The search terms were"growth plate injury,bone bridge,platelet-derived growth factor BB,repair"in English and Chinese.Finally,66 articles were screened for this review. RESULTS AND CONCLUSION:Growth plate injury experienced early inflammation,vascular reconstruction,fibroossification,structural remodeling and other pathological processes,accompanied by the crosstalk of chondrocytes,vascular endothelial cells,stem cells,osteoblasts,osteoclasts and other cells.Platelet-derived growth factor BB,as an important factor in the early inflammatory response of injury,regulates the injury repair process by mediating a variety of cellular inflammatory responses.Targeting the inflammatory stimulation mediated by platelet-derived growth factor BB may delay the bone bridge formation process by improving the functional activities of osteoclasts,osteoblasts,and chondrocytes,so as to achieve the injury repair of growth plate.Platelet-derived growth factor BB plays an important role in angiogenesis and bone repair tissue formation at the injured site of growth plate and intrachondral bone lengthening function of uninjured growth plate.Inhibition of the coupling effect between angiogenesis initiated by platelet-derived growth factor BB and intrachondral bone formation may achieve the repair of growth plate injury.

【Objective】 To investigate the clinical application of heparinase-modified TEG (hmTEG) in evaluating coagulation status and monitoring anticoagulant therapy in severe non-ICU patients with COVID-19. 【Methods】 The clinical data of severe non-ICU patients with COVID-19 confirmed to be infected with novel coronary disease (SARS-CoV-2) from December 2022 to May 2023 were analyzed retrospectively. The patients were divided into therapeutic dose group and prophylactic dose group according to the initial dose of enoxaparin. The changes of platelet count, activated partial thromboplastin time, prothrombin time, thrombin time, fibrinogen, D-dimer, TEG and hmTEG before and after heparin treatment were compared between the two groups, so as to evaluate the changes of coagulation function and bleeding risk of COVID-19 severe non-ICU patients after anticoagulation with different doses of heparin. 【Results】 A total of 179 severe non-ICU patients with COVID-19 were enrolled in this study, including 102 patients in therapeutic dose group and 77 patients in prophylactic dose group. Before receiving heparin anticoagulation, except for age(63.4±11.6 vs 59.8±9.1) D-dimer(678 ng/mL vs 621 ng/mL) and MA values [(69.1±10.2)mm vs (65.6±8.5)mm], there were no statistical differences in platelet count, activated partial thromboplastin time, prothrombin time, thrombin time, fibrinogen, R value, K time, α angle and coagulation index (CI) between the therapeutic dose group and the prophylactic dose group (P>0.05). After receiving heparin anticoagulation, there were significant differences in CKR value [(12.2±4.1)min vs (10.2±3.3)min] and CKHR value [(8.1±3.2)min vs (7.1±2.6)min] between therapeutic dose group and prophylactic dose group (P<0.05), but no significant differences in other parameters between groups (P>0.05). Meanwhile, the proportion of heparin overdose in the therapeutic dose group was significantly higher than that in the prophylactic dose group 15.69%(16/102) vs 5.19%(4/77)(P<0.05). However, there was no difference in the incidence of VTE events 2.35 %(2/85) vs 2.78%(2/72), gastrointestinal bleeding 2.35%(2/85) vs 1.39%(1/72), ICU admission 4.71%(4/85) vs 4.17%(3/72) and death events 3.53%(3/85) vs 2.78%(2/72) between the two groups (P>0.05). 【Conclusion】 In the current epidemic trend of COVID-19, in order to reduce the occurrence of bleeding events, the heparin dose should be selected more carefully in the prevention of thrombosis in severe non-ICU patients with COVID-19. The individualized assessment of bleeding risk by hmTEG is more conducive to the adjustment and control of heparin dose.

Objective To explore the clinical effect of umbilical moxibustion on chronic heart failure with yang deficiency and blood stasis and water retention syndrome.Methods 80 patients with chronic heart failure who were hospitalized in the Department of Cardiology,Shenzhen Hospital(Longgang),Beijing University of Chinese Medicine from January 1,2021 to December 31,2022 were selected as research samples and randomly divided into control group(40 cases,40 cases completed)and observation group(40 cases,40 cases completed).The control group received standard drug treatment,while the observation group received umbilical moxibustion treatment on the basis of drug treatment.Ten days after treatment,NT-proBNP,NYHA cardiac function classification,cardiac color Doppler indexes(including LVEF,LVEDD,LVSD),Minnesota quality of life score,6-minute walking distance and TCM syndrome score were compared between the two groups before and after treatment,and the occurrence of adverse reactions was monitored and recorded.Results The total effective rate in the observation group was higher than that in the control group(χ2=3.865,P=0.049).NYHA cardiac function classification,NT-proBNP,LVEF,LVEDD,LVESD and 6-minute walking distance in both groups were significantly improved compared with those before treatment,and the improvement of the above indexes in the observation group was more significant(P<0.05).The Minnesota quality of life score and TCM syndrome score of the two groups decreased compared with those before treatment,and the decline of the patients in the observation group exceeded that of the control group(P<0.05).During the treatment,the two groups had adverse reactions(such as gastrointestinal reaction,hypotension,skin allergy,etc.),and there was no difference between the two groups(P>0.05).Conclusion On the basis of drug therapy,umbilical moxibustion is better than simple drug therapy in treating chronic heart failure with yang deficiency,blood stasis and water stagnation,which can improve the cardiac function and quality of life of patients with chronic heart failure.

Objective:Cardiac arrest (CA) represents a significant public health challenge, posing a substantial threat to individual health and survival. To enhance the survival rates of patients experiencing out-of-hospital cardiac arrest (OHCA), Baoan District in Shenzhen City has undertaken exploratory initiatives and practical interventions, yielding promising preliminary outcomes.Methods:1.Innovate emergency medical services by developing a "four-circle integration" system that connects to the hospital. This system encompasses the social emergency medical system, the out-of-hospital emergency medical system, the in-hospital emergency medical service system, and the intensive care treatment system. 2.Develop a comprehensive model for the construction of a social emergency medical training system, characterized by party leadership, government oversight, departmental coordination, professional guidance, technological support, and community involvement, termed the "Baonan Model." Additionally, establish evaluation criteria to assess the effectiveness of the social emergency medical training system in Baonan District; 3. Develop a cardiac arrest registration system and a social emergency medical training management system for Baonan District; 4. Enhance the proficiency in treatment techniques and the quality of cardiopulmonary resuscitation among emergency medical professionals; 5. Strengthen and advance the development of a "five-minute social rescue network" to address the critical "emergency window period." .Result:In Baonan District, 9.18% of the public is trained in emergency medical skills. The bystander CPR rate for OHCA is 26.11%, AED use is at 4.78%, the 30-day survival rate is 6.31%, and the discharge survival rate is 4.44%.Conclusion:The implementation of the aforementioned measures can substantially enhance the survival rate of patients experiencing OHCA at the time of discharge.

ObjectiveBy comparing the difference of volatile components of the decoction pieces before and after being processed by braising method of Jianchangbang and steaming method included in the 2020 edition of Chinese Pharmacopoeia， the influence of processing methods on the flavor formation of Polygoni Multiflori Radix （PMR） was compared. MethodHeadspace-gas chromatography-mass spectrometry （HS-GC-MS） was used to detect the volatile components of 30 batches of PMR samples from 3 origins with 3 processing methods. The GC was performed under programmed temperature （starting temperature of 40 ℃， rising to 150 ℃ at 5 ℃·min^-1， and then rising to 195 ℃ at 10 ℃·min^-1） with high purity helium as carrier gas and the split ratio of 10∶1. Mass spectrometry conditions were electron impact ion source （EI） and the detection range of m/z 50-650， the peak area normalization method was used to calculate the relative mass fraction of each component. The chromaticity values of different processed products were measured by a precision colorimeter， the relationship between chromaticity values and relative contents of volatile components was investigated by OriginPro 2021， principal component analysis （PCA） and orthogonal partial least squares-discriminant analysis （OPLS-DA） were performed on the sample data by SIMCA14.1. The differential components of different processed products of PMR were screened according to the principle of variable importance in the projection （VIP） value>1.5， and the material basis of different odor formation of PMR and its processed products was explored. ResultA total of 59 volatile components were identified， among which 34 were raw products， 33 were braised products， and 27 were steamed products. PCA and OPLS-DA results showed that there were significant differences between the three， but there was no significant difference between samples from different origins of the same processing method. Color parameters of a^*， b^*， E^*ab had no significant correlation with contents of volatile components， while L^* was negatively correlated with contents of 2-methyl-2-butenal， 2-methyltetrahydrofuran-3-one and 2，3-dihydro-3，5-dihydroxy-6-methyl-4（H）-pyran-4-one （P<0.05）. The contents of pungent odor components such as caproic acid， nonanoic acid and synthetic camphor decreased after processing， while the contents of sweet flavor components such as 2-methyl-2-butenal， furfural and 5-hydroxymethylfurfural increased after processing， and the contents of furfural， 5-methyl-2-furanmethanol， 5-hydroxymethylfurfural and other aroma components in the braised products were significantly higher than that in the steamed products. ConclusionHS-GC-MS can quickly identify the volatile substance basis that causes the different odors of PMR and its processed products. The effect of processing methods on the odor is greater than that of origin. There is a significant correlation between the color parameter of L^* and contents of volatile components， the "raw" taste of PMR may be related to volatile components such as caproic acid， pelargonic acid and synthetic camphor， the "flavor" after processing may be related to the increase of the contents of 2-methyl-2-butenal， furfural， 5-hydroxymethylfurfural， methyl maltol and furfuryl alcohol.

Background: Chicken anemia virus (CAV) causes chicken infectious anemia, which results in immunosuppression; the virus has spread widely in chicken flocks in China. Objectives: The aim of this study was to understand recent CAV genetic evolution in chicken flocks in Guangxi Province, southern China. Methods: In total, 350 liver samples were collected from eight commercial broiler chicken farms in Guangxi Province in southern China from 2018 to 2020. CAV was detected by conventional PCR, and twenty CAV complete genomes were amplified and used for the phylogenetic analysis and recombination analysis. Results: The overall CAV-positive rate was 17.1%. The genetic analysis revealed that 84 CAVs were distributed in groups A, B, C (subgroups C1-C3) and D. In total, 30 of 47 Chinese CAV sequences from 2005-2020 belong to subgroup C3, including 15 CAVs from this study. There were some specific mutation sites among the intergenotypes in the VP1 protein. The amino acids at position 394Q in the VP1 protein of 20 CAV strains were consistent with the characteristics of a highly pathogenic strain. GX1904B was a putative recombinant. Conclusions Subgroup C3 was the dominant genotype in Guangxi Province from 2018–2020.The 20 CAV strains in this study might be virulent according to the amino acid residue analysis. These data help improve our understanding of the epidemiological trends of CAV in southern China.

Objective: To explore the effect of sevoflurane post-conditioning on oxygen-glucose deprivation/reoxygenation(OGD/R) damage of primary hippocampal neurons, oxidative stress and autophagy. Methods: Hippocampal neurons were cultured in uterine endometrial rats for(18±0.5) days. After 7 days, the cultured hippocampal neurons were randomly divided into three groups: normal control group(CON group), oxygen-glucose deprivation/reoxygenation(OGD/R) group and sevoflurane post-conditioning group(OGD/R+SEVO group). Primary hippocampal neurons in the CON group were cultured normally; OGD/R group was treated with oxygen-glucose deprivation for 1.5 hours and reoxygenation for 24 hours to establish oxygen and glucose deprivation/reoxygenation injury model; OGD/R+SEVO group was treated with sevoflurane for 1 hour and then reoxygenated for 23 hours. After treatments, the activity of each group of LDH was detected by colorimetric method, TUNEL staining method detected the changes of hippocampal nerve cells in each group, immunofluorescence method detected mitochondrial ROS and the expression of autophagy proteins LC3 B,and Western blot analysis detected the expression of PINK1 and Parkin. Results: Compared with CON group, the release of lactate dehydrogenase increased(P<0.01); neuronal apoptosis increased; mitochondrial ROS and the expression of autophagy marker proteins LC3 B increased(P<0.01), PINK1 and Parkin also increased in OGD/R group(P<0.001,P<0.05). Compared with OGD/R group, the release of lactate dehydrogenase was reduced(P<0.05), the apoptosis was inhibited, mitochondrial ROS and the expression of autophagy marker proteins LC3 B were reduced(P<0.05), PINK1 and Parkin protein were reduced(P<0.01,P<0.05) in OGD/R+SEVO group. Conclusion Sevoflurane post-conditioning can protect primary hippocampal neurons by reducing OGD/R-induced excessive autophagy, reducing oxidative stress, and reducing apoptosis, and its mechanism of reducing autophagy may be related to the PINK1/Parkin pathway.

Objective To evaluate the treatment effect of combination of dexmedetomidine and droperidol on emergence agitation during general anesthesia recovery period in the elderly undergoing thoracotomy. Methods Sixty patients with severe emergence agitation during general anesthesia recovery period undergoing thoracotomy for esophageal cancer or pulmonary lobectomy, aged 66-75 years, falling into ASA physical status Ⅱ or Ⅲ, were divided into three groups, 20 patients in each according to table of random number: group droperidol (group F) and group dexmedetomidine (group D) and group dexmedetomidine combining droperidol (group DF). In group F, 0.06 mg/kg droperidol was administrated via central vein. In group D, 1 μg/kg dexmedetomidine was pumped via central vein in 10 min, followed by continuous infusion of dexmedetomidine in 0.2 μg·kg-1·h-1 for 1 h. While in group DF, 0.03 mg/kg droperidol was administrated via central vein and 0.5 μg/kg dexmedetomidine was pumped via central vein in 10 min, then followed by continuous infusion of dexmedetomidine in 0.2 μg·kg-1·h-1 for 1 h. The agitation scores and the Ramsay scores were collected after the beginning of anti-agitation. Arterial blood partial pressure of carbon dioxide was tested. Postoperative complications including nausea and vomiting were recorded. Results Compared with group D, the agitation scores at 5, 10, 15 and 20 min in group DF were lower (P ＜ 0.05). Comparing with group F, the agitation scores at 60, 90 and 120 min in group DF were lower (P ＜ 0.05). The incidence of over-sedation in group DF and in group D was less than that in group F (P ＜ 0.05). PaCO2 was unaltered in all the groups after treatment. The incidence of nausea, vomiting, bradycardia, hypertension, hypotension and respiration depression and long QT interval between the groups were comparable. Conclusion Combination of dexmedetomidine and droperidol is effective and safe in the treatment of agitation during sevoflurane general anesthesia recovery period in the elderly undergoing thoracotomy.

Objective To explore the relationship between serum albumin (ALB) combined with red blood cell distribution width (RDW) in progression and prognosis of children with heart failure. Method A total of 144 children with heart failure were divided into light, medium, and heavy group according to the modified ROSS score; another aspect, they also were divided into survival group and death group. ALB, RDW, and modified ROSS score were measured to assess the relationship between the factors and the death by logistic regression analysis. Results There are 73 boys and 71 girls. The cases of mild, moderate, and severe group were 78, 39, and 27, respectively. Age and gender difference in three groups were not statistically significant (P>0.05). The ratio of high RDW was 54.86% (79/144), the ratio of low serum ALB was 33.33% (48/144). Chi-square analysis indicated that a severer status of the disease correlated with a lower ALB level (P <0.05) and a higher RDW. The analysis of rank correlation indicating the degree of heart failure was negatively correlated with the related trends of ALB and RDW (P<0.05). Logistic regression analysis indicating a higher risk of death of the disease correlated with a lower ALB level (P<0.05, OR=0.839)and a higher modified ROSS score(P<0.05,OR=1.324).Conclusions The ALB,RDW,and the modified ROSS score are closely related to the severity in heart failure children. The ALB and the modified ROSS score have important clinical prognostic significance in evaluating the prognosis.

Objective To evalute the role of phosphatidylinositol 3?kinase(PI3K)∕serine?threo?nine kinase(Akt)∕endothelial nitric oxide synthase(eNOS)signaling pathway in sevoflurane postcondi?tioning?induced attenuation of brain injury in a rat model of hemorrhagic shock and resuscitation(HSR). Methods Seventy?two pathogen?free healthy adult male Sprague?Dawleg rats, weighing 300-350 g, were divided into 4 groups(n=18 each)using a random number table: sham operation group(group S), group HSR, sevoflurane postconditioning group(group SP)and sevoflurane postconditioning plus PI3K∕Akt signaling pathway specific inhibitor wortmannin group(group SP+WT). Hemorrhagic shock was in?duced by withdrawing blood(40% of the total blood volume)from the right common carotid artery over an interval of 30 min, and 1 h later the animals were resuscitated with infusion of the shed blood via the left jugular vein over 30 min. In group SP+WT, wortmannin 0.6 mg∕kg was administrated via the jugular vein at 30 min before establishment of the model. In SP and SP+WT groups, 2.4% sevoflurane was inhaled for 30 min starting from the onset of infusion of the shed blood. At 10 min before withdrawing blood(T0), im?mediately after the end of withdrawing blood(T1), at 30 min and 1 h after the end of withdrawing blood (T2,3)and immediately after infusion of the shed blood(T4), blood samples from the common carotid ar?tery were collected for blood gas analysis, the blood lactate concentration was recorded, and mean arterial pressure was simultaneously recorded. At 24 h after infusion of the shed blood, 6 rats were randomly select?ed from each group and sacrificed, and their brains were immediately removed for determination of cerebral infarct volume(by TTC staining), expression of hippocampal caspase?3(by immuno?histochemistry), and expression of Akt, phosphorylated Akt(p?Akt)and eNOS(by Western blot). The ratio of p?Akt∕Akt was calculated. Results Compared with group S, the mean arterial pressure was significantly decreased and the blood lactate concentration was increased at T1?3, the cerebral infarct volume was increased, and the expression of caspase?3 was up?regulated in the other three groups, and the ratio of p?Akt∕Akt was sig?nificantly increased, and eNOS expression was up?regulated in group SP(P<0.05). Compared with group HSR, the cerebral infarct volume was significantly decreased, the expression of caspase?3 was down?regula?ted, the ratio of p?Akt∕Akt was increased, and eNOS expression was up?regulated in group SP(P<0.05). Compared with group SP, the cerebral infarct volume was significantly increased, the expression of caspase?3 was up?regulated, the ratio of p?Akt∕Akt was decreased, and eNOS expression was down?regula?ted in group SP+WT(P<0.05). Conclusion PI3K∕Akt∕eNOS signaling pathway activation mediates sevoflurane postconditioning?induced attenuation of brain injury in a rat model of HSR.