1.The Effect of Zhiqiao Gancao Decoction (枳壳甘草汤) on Intervertebral Disc Nucleus Pulposus Cell Apoptosis and the Hippo-YAP/TAZ Signaling Pathway in Tail Intervertebral Disc Degeneration Model Rats
Zaishi ZHU ; Zeling HUANG ; Junming CHEN ; Bo XU ; Binjie LU ; Hua CHEN ; Xingxing DUAN ; Yuwei LI ; Xiaofeng SHEN
Journal of Traditional Chinese Medicine 2025;66(5):509-517
		                        		
		                        			
		                        			ObjectiveTo investigate the possible mechanism by which Zhiqiao Gancao Decoction (枳壳甘草汤, ZGD) delays intervertebral disc degeneration (IDD) based on the Hippo-yes-associated protein (YAP)/transcriptional co-activator with PDZ-binding motif (TAZ) signaling pathway. MethodsA total of 50 SD rats were randomly divided into sham surgery group, model group, low-dose ZGD group, high-dose ZGD group, and high-dose ZGD + inhibitor group, with 10 rats in each group. In the sham surgery group, the rats were pierced in the skin and muscle at the Co6/7/8 segments of the tail with a 21G needle (depth approximately 2 mm) without damaging the intervertebral disc. In the other groups, rats were injected with a 21G needle at the Co6/7/8 segments of the tail to establish an IDD model by piercing the tail intervertebral disc 5 mm. One week after modeling, rats in the low-dose and high-dose ZGD groups were given 6.24 and 12.24 g/(kg·d) of the decoction via gastric gavage, respectively. The high-dose ZGD + inhibitor group was given 12.24 g/(kg·d) of the decoction and an intraperitoneal injection of YAP/TAZ inhibitor Verteporfin 10 mg/kg. The sham surgery and model groups were given 5 ml/(kg·d) of normal saline via gavage. The gavage was given once a day, and the intraperitoneal injection was given every other day. After 4 weeks of continuous intervention, the pathological changes of the tail intervertebral discs were observed using HE staining, Oil Red O-Green staining, and Toluidine Blue staining. Immunohistochemistry was used to detect the expression of aggrecan and MMP3 in the nucleus pulposus. TUNEL fluorescence staining was performed to detect apoptosis in the nucleus pulposus, and the apoptosis rate was calculated. Western blot was used to detect the Hippo-YAP/TAZ signaling pathway, including YAP, phosphorylated YAP (p-YAP), phosphorylated MST1/2 (p-MST1/2), phosphorylated TAZ (p-TAZ) and apoptosis-related proteins, such as Cleaved Caspase 3, P53, Bcl-2 and Bax. ResultsCompared with sham surgery group, the rats in the model group showed significant degenerative changes in the intervertebral disc. The levels of aggrecan, Bcl-2, and YAP proteins in the nucleus pulposus decreased, while the levels of p-MST1/2, p-YAP, p-TAZ, P53, Bax, Cleaved Caspase 3, MMP3 proteins, and the apoptosis rate increased (P < 0.01). Compared with the model group, the drug intervention groups showed partial recovery in intervertebral disc degeneration. The levels of aggrecan, Bcl-2, and YAP proteins increased, while the levels of p-MST1/2, p-YAP, p-TAZ, P53, Bax, Cleaved Caspase 3, MMP3 proteins, and the apoptosis rate decreased (P<0.05 or P<0.01). The high-dose ZGD group showed more significant recovery in intervertebral disc degeneration compared to the low-dose ZGD group, with a decrease in the levels of p-MST1/2, p-YAP, p-TAZ, P53, Bax, Cleaved Caspase 3, MMP3 proteins, and apoptosis rate, and an increase in the levels of aggrecan, Bcl-2, and YAP proteins (P<0.05 or P<0.01). Compared with the high-dose ZGD group, the high-dose ZGD + inhibitor group showed a reduced recovery in intervertebral disc degeneration, with an increase in the levels of p-MST1/2, p-YAP, p-TAZ, P53, Bax, Cleaved Caspase 3, MMP3 proteins, and apoptosis rate, and a decrease in the levels of aggrecan, Bcl-2, and YAP proteins (P<0.05 or P<0.01). ConclusionZGD may delay intervertebral disc degeneration by inhibiting the phosphorylation of YAP in the nucleus pulposus, maintaining the function of the Hippo-YAP/TAZ signaling pathway, and reducing apoptosis of nucleus pulposus cells. 
		                        		
		                        		
		                        		
		                        	
2.Identification of a natural PLA2 inhibitor from the marine fungus Aspergillus sp. c1 for MAFLD treatment that suppressed lipotoxicity by inhibiting the IRE-1α/XBP-1s axis and JNK signaling.
Yong RAO ; Rui SU ; Chenyan WU ; Xingxing CHAI ; Jinjian LI ; Guanyu YANG ; Junjie WU ; Tingting FU ; Zhongping JIANG ; Zhikai GUO ; Congjun XU ; Ling HUANG
Acta Pharmaceutica Sinica B 2024;14(1):304-318
		                        		
		                        			
		                        			Lipotoxicity is a pivotal factor that initiates and exacerbates liver injury and is involved in the development of metabolic-associated fatty liver disease (MAFLD). However, there are few reported lipotoxicity inhibitors. Here, we identified a natural anti-lipotoxicity candidate, HN-001, from the marine fungus Aspergillus sp. C1. HN-001 dose- and time- dependently reversed palmitic acid (PA)-induced hepatocyte death. This protection was associated with IRE-1α-mediated XBP-1 splicing inhibition, which resulted in suppression of XBP-1s nuclear translocation and transcriptional regulation. Knockdown of XBP-1s attenuated lipotoxicity, but no additional ameliorative effect of HN-001 on lipotoxicity was observed in XBP-1s knockdown hepatocytes. Notably, the ER stress and lipotoxicity amelioration was associated with PLA2. Both HN-001 and the PLA2 inhibitor MAFP inhibited PLA2 activity, reduced lysophosphatidylcholine (LPC) level, subsequently ameliorated lipotoxicity. In contrast, overexpression of PLA2 caused exacerbation of lipotoxicity and weakened the anti-lipotoxic effects of HN-001. Additionally, HN-001 treatment suppressed the downstream pro-apoptotic JNK pathway. In vivo, chronic administration of HN-001 (i.p.) in mice alleviated all manifestations of MAFLD, including hepatic steatosis, liver injury, inflammation, and fibrogenesis. These effects were correlated with PLA2/IRE-1α/XBP-1s axis and JNK signaling suppression. These data indicate that HN-001 has therapeutic potential for MAFLD because it suppresses lipotoxicity, and provide a natural structural basis for developing anti-MAFLD candidates.
		                        		
		                        		
		                        		
		                        	
3.Effect of Pax6 gene expression on hydrogen peroxide-induced aging in bone marrow mesenchymal stem cells
Jie GAO ; Xingxing ZOU ; Banghong WEN ; Yuandi LI ; Min SU ; Rong HU
Chinese Journal of Tissue Engineering Research 2024;28(31):4921-4925
		                        		
		                        			
		                        			BACKGROUND:The occurrence and development of various ophthalmic diseases are closely related to excessive oxidative stress,and the inhibition of oxidative stress response may produce preventive and therapeutic effects. OBJECTIVE:To explore the role of Pax6 gene expression on hydrogen peroxide-induced aging of mouse bone marrow mesenchymal stem cells(BM-MSCs). METHODS:Resuscitated BM-MSCs,Pax6/BM-MSCs,and shPax6/BM-MSCs were treated with hydrogen peroxide for 24 hours,and then β-galactosidase staining was performed.The proliferation index Ki67 expression and apoptosis were detected by flow cytometry.The expression of senescence-associated molecules(Wnt7a,p21,and p53)was detected by RT-PCR. RESULTS AND CONCLUSION:(1)After hydrogen peroxide treatment,the cells of the three groups showed senescence phenotype and β-galactosidase staining was positive.Compared with BM-MSCs group,the expression of positive cells in Pax6/BM-MSCs group was less and that in the shPax6/BM-MSCs group was more,and the difference was statistically significant(P<0.05).(2)The results of flow cytometry showed that compared with BM-MSCs group,the positive expression of Ki67 in the Pax6/BM-MSCs group increased and the level of apoptosis decreased,while the positive expression of Ki67 decreased and the level of apoptosis increased in the shPax6/BM-MSCs group;the difference was significantly different(P<0.05).(3)RT-PCR showed that compared with the BM-MSCs group,the expression of Wnt7a,p53,and p21 decreased in the Pax6/BM-MSCs group,while the expression of Wnt7a,p53,and p21 increased in the shPax6/BM-MSCs group;the difference was significantly different(P<0.05).(4)These findings indicate that overexpression of Pax6 can antagonize the aging progression of BM-MSCs induced by hydrogen peroxide,which may be related to Wnt signaling pathway.
		                        		
		                        		
		                        		
		                        	
4.Curcumin protects against liver cancer in a mouse model by down-regu-lating HO-1/NQO1
Haijun MOU ; Xingxing CHEN ; An'an LIU ; Li ZHANG ; Jiaxin ZHU ; Hai JIN
Chinese Journal of Pathophysiology 2024;40(3):438-443
		                        		
		                        			
		                        			AIM:To observe the effect of curcumin on a C57BL/6J mouse liver cancer model induced by N-ni-trosodiethylamine(DEN)combined with carbon tetrachloride(CCl4),and to explore its mechanism.METHODS:Forty young male C57BL/6J mice were intraperitoneally injected with DEN(25 mg/kg)14 d after birth and randomly divided in-to the following 4 groups at the 4th week(10 in each group):model control group and curcumin(100,200 and 400 mg/kg)groups.Ten male mice of the same age were used as normal control group.The mice in model group and curcumin groups were gavaged with 10%CCl4(5 mL/kg)twice a week from the 8th week on.At the same time,the mice in curcumin groups were gavaged with curcumin,and the mice in normal control group were gavaged with the same volume of distilled water once a day for 14 weeks.After administration,the mice were sacrificed,the liver surface was observed,and the number of tumor nodules was compared.The activity of alanine aminotransferase(ALT)and aspartate aminotransferase(AST)in serum was detected by an automatic biochemical instrument.The pathological changes of liver tissues were ob-served by HE staining.The mRNA expression levels of heme oxygenase-1(HO-1)and NAD(P)H-quinone oxidoreductase 1(NQO1)were detected by RT-qPCR,and the protein expression levels of HO-1,NQO1 and Ki67 were detected by Western blot and immunohistochemistry.RESULTS:Compared with normal control group,the body weight of the mice in model group was decreased significantly(P<0.01),the liver index was increased significantly(P<0.01),and the se-rum levels of ALT and AST were increased obviously(P<0.01).There was no significant difference in the mRNA expres-sion levels of HO-1 and NQO1(P>0.05),the protein levels of HO-1 and NQO1 were increased distinctly(P<0.05),and the positive expression rate of Ki67 was increased significantly(P<0.05).After curcumin treatment,the body weight of the mice was significantly increased(P<0.01),the liver index was not changed(P>0.05),and the number of tumor nodules in the liver was decreased significantly(P<0.05 or P<0.01).The serum level of AST was decreased significantly(P<0.01),the mRNA and protein expression levels of HO-1 and NQO1 were decreased significantly(P<0.05),and the posi-tive expression rate of Ki67 was decreased significantly(P<0.05).CONCLUSION:Curcumin significantly protects against liver cancer in a C57BL/6J mouse model induced by DEN combined with CCl4,and its mechanism may be related to the inhibition of HO-1 and NQO1 expression.
		                        		
		                        		
		                        		
		                        	
5.Discussion on the Treatment of Heart Failure from the Theory of "Sweat Pore-Collaterals-Zang and Fu Organs" Based on Mitochondrial Function
Yuxuan LI ; Wujiao WANG ; Peng LI ; Yuanyuan ZHANG ; Xingxing LI ; Junyan XIA ; Ruli FENG ; Dong LI ; Qian LIN ; Yan LI
Journal of Traditional Chinese Medicine 2024;65(13):1346-1352
		                        		
		                        			
		                        			Mitochondria are the main site of energy metabolism in cardiomyocytes, and at the same time mediate apoptosis and immune response, so mitochondrial dysfunction is closely related to the development of heart failure. Combined with the pathogenesis of mitochondrial dysfunction and heart failure, it is proposed that the mitochondrial function is similar to "sweat pore - collaterals - zang and fu organs", according to which the treatment of heart failure is based on the theory of "sweat pore - collaterals - zang and fu organs". It is believed that the core mechanism of heart failure is qi deficiency, and qi deficiency leads to the weakness of the sweat pore opening and closing, or even the sweat pore closure, then resulting in qi deficiency and blood stasis, collaterals stagnation fail to flourish, and qi, blood, and body fluids can not infiltrate and nourish zang-fu organs, so that the heart fail to be nourished, and the disease will develop. The treatment should be based on the method of boosting qi and opening sweat pore, using acridity to unblock the collaterals, and invigorating blood and draining water, with medicinal of boosting qi, invigorating blood, and draining water as treatment. 
		                        		
		                        		
		                        		
		                        	
6.Meta-analysis on the effects of exercise training-based respiratory rehabilitation therapy in pneumoconiosis patients
Jianwen GE ; Ting XUE ; Zhimin LI ; Xingxing MA ; Yan DONG ; Wenjuan DAI ; Dongyan LI
China Occupational Medicine 2024;51(3):285-291
		                        		
		                        			
		                        			Objective To comprehensively analyze the effectiveness of exercise training-based respiratory rehabilitation therapy on patients with occupational pneumoconiosis (hereinafter referred to as "pneumoconiosis"). MethodsLiterature on randomized controlled trials of exercise training-based respiratory rehabilitation therapy for pneumoconiosis patients published from the establishment of the database to July 2023 was retrieved from academic systems such as the China National Knowledge Infrastructure, Wanfang Data Knowledge Service Platform, VIP Database, and China Biology Medicine using bibliometrics method. The RevMan 5.4 software was used for meta-analysis of the selected literatures. Subgroup analysis was conducted to explore the source of study heterogeneity. The funnel plot method was used to test publication bias. Results A total of 55 articles were included, involving 2 436 pneumoconiosis patients in the experimental group and 2 405 pneumoconiosis patients in the control group. The result of random or fixed effect model showed that the six minutes walking distance, the total score of Short from Health Survey-36, forced vital capacity (FVC), forced expiratory volume in one second (FEV1), FEV1/FVC, arterial partial pressure of oxygen of pneumoconiosis patients increased after respiratory rehabilitation therapy (all P<0.05), while the total score of the St. George's Respiratory Questionnaire and arterial partial pressure of carbon dioxide decreased compared with the conventional treatment (all P<0.05). The result of subgroup analysis showed that the total score of the St. George's Respiratory Questionnaire, FEV1, and the index of arterial partial pressure of oxygen of pneumoconiosis patients was better in the rehabilitation treatment for ≥six months compared with those 
7.Prevalence and influencing factors on food allergy among children aged 0-5 years in China
Lahong JU ; Liyun ZHAO ; Xiaoqi WEI ; Hongyun FANG ; Jiaxi LI ; Xingxing WU ; Xiaoli XU ; Shuya CAI ; Weiyi GONG ; Dongmei YU
Chinese Journal of Epidemiology 2024;45(6):817-823
		                        		
		                        			
		                        			Objective:To describe the prevalence of food allergy among children aged 0-5 years in China and to explore related influencing factors.Methods:Multistage stratified random sampling method was used to collect data from 275 surveillance sites of the China National Nutrition and Health Survey of Chinese children and lactating mothers programs in 31 provinces (autonomous regions and municipalities) of China in 2016-2017. A total of 70 107 participants aged 0-5 years were included in this study. The study collected information of participants' demographic characteristics and food allergies by face-to-face questionnaire. The prevalence of food allergy was analyzed, using the complex data weighting method. The logistic regression models were used to analyze the influencing factors related to food allergy.Results:The overall prevalence of self-reported food allergy among children aged 0-5 years was 4.81%. Prevalence rates in infants aged 0-5 months, and 6-23 months and preschool children aged 2-5 years were 0.81%, 4.68% and 5.26%, respectively. The results of logistic analysis showed that there was a significantly positive correlation between factors including children from 6 months to 5 years old, urban area, southwest area, first-born, mothers with college education or above, and the prevalence of food allergy in children. Shrimp, poultry eggs, crab shellfish, fruit, milk and fish appeared the common allergic foods in children aged 0-5 years, with prevalence rates of self-reported food allergy as 1.55%, 1.25%, 0.99%, 0.97%, 0.87% and 0.86%, respectively. The proportion of single food allergy in children with allergies was 69.85%.Conclusions:Among children aged 0-5 years, the prevalence of self-reported food allergy increases with age, in China. Foods that is prone to allergies include fish, shrimp, crab, shellfish, poultry eggs, milk and fruits, etc. Most allergies were only caused by single food in children, under observation.
		                        		
		                        		
		                        		
		                        	
8.Qualitative study on the midwifery care needs of parturition: a Meta-synthesis
Xin ZHAO ; Ping XUAN ; Wenqin LI ; Chengchao YU ; Xiaomeng DONG ; Xingxing LI
Chinese Journal of Practical Nursing 2024;40(34):2657-2664
		                        		
		                        			
		                        			Objective:To systematically evaluate and integrate the midwifery care needs of parturition, to provide reference for formulating effective measures to improve obstetric care.Methods:A computer search was conducted on Cochrane Library, PubMed, Web of Science, Embase, China National Knowledge Infrastructure, China Biomedical Literature Database and Wanfang Database for qualitative research on midwifery care needs of parturition. The search period was from the establishment of the database to April 2024. The quality of the included literature was evaluated using the qualitative research quality evaluation criteria of the Australian Joanna Briggs Institute Evidence based Health Care Center. A thematic synthesis was used for result integration.Results:A total of 16 articles were included, and 63 major research results were extracted and summarized into 9 new categories, forming 4 integrated results: physiological comfort needs, respect needs, professional nursing support needs and social network harmonious needs.Conclusions:The needs of midwifery care during childbirth are diverse and need help and support from various aspects. It is suggested that nursing staff should pay attention to the experience and needs of childbirth, improve the management plan of nursing during childbirth, improve the cognitive experience of childbirth and promote natural childbirth.
		                        		
		                        		
		                        		
		                        	
9.Cross-sectional study of prevalence and association factors for hypertension comorbid depressive and anxiety disorders
Yushu ZHANG ; Limin WANG ; Yueqin HUANG ; Mei ZHANG ; Zhenping ZHAO ; Xiao ZHANG ; Chun LI ; Zhengjing HUANG ; Zhaorui LIU ; Tingting ZHANG ; Xingxing GAO ; Bo JIANG
Chinese Mental Health Journal 2024;38(12):1021-1027
		                        		
		                        			
		                        			Objective:To study the prevalence and association factors of depressive and anxiety disorders in the hypertensive population.Methods:Using the database obtained from the 2013 China Chronic Disease and Risk Factor Surveillance and the 2013-2015 China Mental Health Survey,4 861 hypertensive residents were used as study subjects.And using the Diagnostic and Statistical Manual of Mental Disorders,Fourth Edition(DSM-Ⅳ)as diagnostic criterion for depressive and anxiety disorders,the 12-month prevalence was calculated.Multifactorial lo-gistic regression models were used to explore the association factors of hypertension comorbid depressive and anxie-ty disorders.Results:The 12-month prevalence rates of depressive disorders and anxiety disorders were 4.1%and 5.0%in 4 861 hypertensive residents.Chinese Han[OR(95%CI):2.00(1.01-3.93)],lack of sleep[OR(95%CI):1.82(1.34-2.48)],having myocardial infarction[OR(95%CI):2.35(1.18~4.67)]and stroke in the past year[OR(95%CI):2.10(1.19-3.72)],and chronic obstructive pulmonary disease[OR(95%CI):2.11(1.11-4.05)]were risk factors of hypertension comorbid depressive disorder.Hypertensive people with controlled blood pressure[OR(95%CI):2.01(1.30-3.13)]had a higher risk of co-morbid depressive disorder than those with blood pressure above the normal range on this measurement.Chinese Han[OR(95%CI):2.51(1.32-4.80)],Southwest China[OR(95%CI):1.64(1.02-2.63)],and lack of sleep[OR(95%CI):1.45(1.09-1.93)]were risk factors of hypertension comorbid anxiety disorder.Former but current non-smoking[OR(95%CI):0.48(0.23-0.99)]was a protective factor of hypertension comorbid anxiety disorder.Conclusion:The 12-month prevalence of anxiety disorder was higher than that of depressive disorder in this hypertensive population.Both Han and sleep deprived hypertensive people had a higher risk of comorbid depressive and anxiety disorders.
		                        		
		                        		
		                        		
		                        	
10.Influencing factors analysis of right heart dysfunction in myeloproliferative neoplasm patients with BCR::ABL fusion gene-negative
Xingxing CHAI ; Xuan LU ; Wanchuan ZHUANG ; Yao HE ; Guangsheng HE ; Jianyong LI
Journal of Leukemia & Lymphoma 2024;33(10):603-609
		                        		
		                        			
		                        			Objective:To investigate the factors influencing the right heart dysfunction in myloproliferative neoplasm (MPN) patients with BCR::ABL fusion gene-negative.Methods:A retrospective case-control study was conducted. A total of 130 MPN patients with BCR::ABL fusion gene-negative admitted to the Second People's Hospital of Lianyungang from January 2020 to December 2022 were selected as the study objects. The general data, laboratory indexes and cardiac function parameters were collected. All patients were divided into the control group (non-right heart function injury, 96 cases) and the observation group (right heart function injury, 34 cases) according to whether there was right heart dysfunction judged by ultrasonic cardiogram. Multivariate logistic regression analysis was used to analyze the independent influencing factors of right heart dysfunction in MPN patients with BCR:: ABL fusion gene-negative. Taking right heart dysfunction judged by ultrasonic cardiogram as the gold standard, the receiver operating characteristic (ROC) curve was drawn to predict right heart dysfunction according to independent influencing factors, and the diagnostic efficacy of the factors was analyzed.Results:The median age was 57 years old (range 19-76 years); among the 130 patients, 62 cases were male and 68 cases were female. There were 69 cases of primary thrombocytosis, 35 cases of polycythemia vera and 26 cases of primary myelofibrosis. The proportions of patients with age > 60 years old, hypertension, embolism history, pulmonary hypertension in the observation group were higher than those in the control group, and the differences were statistically significant (all P < 0.05). There were no statistically significant differences in the composition of patients with gender, body mass index > 28 kg/m2, smoking, drinking, diabetes, hyperlipidemia and different pathological types between the two groups (all P > 0.05). The white blood cell count, neutrophil count, basophil count, monocyte count, red blood cell count, hematocrit (Hct), CD34+ cell count and platelet count in the observation group were higher than those in the control group, and the differences were statistically significant (all P < 0.05). There were no statistically significant differences in lymphocyte count, eosinophilic count, triglyceride, total cholesterol, high density lipoprotein cholesterol, low density lipoprotein cholesterol and high sensitive C-reactive protein levels between the two groups (all P > 0.05). The cardiac ejection time in the observation group was shorter than that in the control group, but the transverse diameter of right atrium, anteroposterior diameter of right ventricle, anterior wall thickness of right ventricle, isovolumic systole time, isovolumic diastole time and right ventricular Tei index in the observation group were all higher than those in the control group, and the differences were statistically significant (all P < 0.001). Multivariate logistic regression analysis showed that age > 60 years (OR = 1.520, 95% CI: 1.250-1.692, P = 0.002), embolism history (OR = 1.765, 95% CI: 1.302-2.020, P = 0.001), pulmonary arterial hypertension (OR = 1.555, 95% CI: 1.303-1.702, P = 0.001), elevated Hct (OR = 1.900, 95% CI: 1.587-2.269, P = 0.002), the increased density of CD34+ cell (OR = 1.400, 95% CI: 1.158-1.630, P = 0.001), and increased Tei index of right ventricle (OR = 2.269, 95% CI: 1.700-3.568, P = 0.001) were independent risk factors of right heart dysfunction in MPN patients with BCR::ABL fusion gene-negative. ROC curve analysis showed that the area under the curve of age > 60 years old, embolism history, pulmonary arterial hypertension, Hct, the density of CD34+ cell, and Tei index of right ventricle, in predicting right heart dysfunction in MPN patients with BCR-ABL fusion gene-negative was 0.780 (95% CI: 0.690-0.925), 0.657 (95% CI: 0.533-0.740), 0.728 (95% CI: 0.660-0.813), 0.619 (95% CI: 0.510-0.708), 0.777 (95% CI: 0.720-0.809), 0.822 (95% CI: 0.749-0.886), respectively. The area under the curve of the 6 combined items was 0.930 (95% CI: 0.850-0.987). The sensitivity and specificity were 89.69% and 96.38% respectively when the optimum critical value was reached.Conclusions:Age > 60 years old, embolism history, pulmonary arterial hypertension, elevated Hct, the increased density of CD34+ cell and increased Tei index of right ventricle are independent risk factors of right heart dysfunction in MPN patients with BCR::ABL fusion gene-negative.
		                        		
		                        		
		                        		
		                        	
            
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