Chronic heart failure （CHF） is the final stage of cardiovascular diseases. It is a complex syndrome， with dyspnea and edema as the main clinical manifestations， and it is characterized by complex disease conditions， difficult cure， and high mortality. Ferroptosis， a new type of programmed cell death， is different from other types of programmed cell death. Ferroptosis is iron-dependent， accompanied by lipid peroxide accumulation and mitochondrial shrinkage， becoming a hot research topic. Studies have confirmed that ferroptosis plays a key role in the occurrence and development of CHF. The regulation of ferroptosis may become a potential target for the treatment of CHF in the future. The theory of Qi deficiency and stagnation refers to the pathological state of original Qi deficiency and abnormal transportation and distribution of Qi， blood， and body fluid， which has guiding significance for revealing the pathogenesis evolution of some chronic diseases. We believe that Qi deficiency and stagnation is a summary of the pathogenesis of ferroptosis in CHF. Deficiency of Qi （heart Qi） is the root cause of CHF， and stagnation （phlegm turbidity and blood stasis） is the branch of this disease. The two influence each other in a vicious circle to promote the development of this disease. Traditional Chinese medicine （TCM） plays an important role in the treatment of CHF， improving the prognosis and quality of life of CHF patients. This paper explores the correlation between the theory of Qi deficiency and stagnation and the mechanism of ferroptosis in CHF. Furthermore， this paper reviews the mechanism of Chinese medicines and compound prescriptions in preventing and treating CHF by regulating ferroptosis according to the principles of replenishing Qi and dredging to remove stagnation， aiming to provide new ideas and methods for the treatment of CHF with TCM.

Heart failure （HF） is a group of syndromes caused by cardiac dysfunction with impaired ventricular pumping， seriously affecting patients' health and quality of life. The pathogenesis of HF is complex， including myocardial contractility decline， myocardial fibrosis， and ventricular remodeling， and it is related to neuroendocrine regulation， inflammation， and cardiomyocyte autophagy. Autophagy is a key regulatory mechanism by which cells degrade themselves to maintain body homeostasis. In the process of HF， moderate autophagy can remove aging and damaged cardiomyocytes and maintain the balance of myocardial energy metabolism， while abnormal autophagy may lead to functional decline and pathological changes of cardiomyocytes. The adenosine monophosphate-activated protein kinase （AMPK）/mammalian target of rapamycin （mTOR） signaling pathway is one of the classical pathways regulating autophagy. This pathway can mediate the autophagy of cardiomyocytes and play a role in protecting the cardiac function and delaying HF progression. Traditional Chinese medicine （TCM） with a long history has a unique theoretical system and shows satisfactory therapeutic effects and wide application prospects amid the integration with modern medicine. The clinical practice of TCM has accumulated rich experience in the treatment of cardiovascular diseases. A large number of studies have shown that the active components and compound prescriptions of TCM and Chinese patent medicines can mediate autophagy by regulating the AMPK/mTOR signaling pathway to treat HF. This article explains the role of AMPK/mTOR signaling pathway-mediated autophagy in the treatment of HF， introduces the understanding of autophagy， AMPK/mTOR signaling pathway， and HF based on TCM theories， and reviews the research progress in the regulation of autophagy by TCM in the treatment of HF via the AMPK/mTOR pathway. This review is expected to tap the potential of TCM in the treatment of cardiovascular diseases， provide theoretical support for subsequent experimental studies， and demonstrate the advantages of TCM in clinical practice to achieve more accurate treatment.

Heart failure is a group of complex clinical syndromes that represent the final stage of cardiovascular disease development， characterized by an extremely high mortality rate. However， due to the complexity of the pathological mechanisms， an effective treatment method has not yet been found. Mitochondria are among the most critical organelles in cells， playing an essential role in energy supply and widely participating in various life activities， such as the regulation of oxidative stress and apoptosis. The normal functioning of mitochondria is crucial for maintaining the body's normal life activities. In recent years， studies have found that mitochondrial dysfunction is associated with the occurrence and progression of various diseases， particularly closely related to the onset of heart failure. An imbalance in mitochondrial homeostasis is a key factor in cardiomyocyte death and the onset of heart failure. Mitochondrial autophagy， as a means of regulating mitochondrial homeostasis， is significant for the prevention and treatment of heart failure. Traditional Chinese medicine （TCM） therapy is a unique treatment approach in China now widely applied in clinical practice， demonstrating significant efficacy in treating heart failure， with unique advantages. Modern pharmacological research indicates that Chinese medicine monomers and compounds can target and regulate mitochondrial homeostasis in cardiomyocytes， affect mitochondrial autophagy， and protect cardiomyocytes， though the specific mechanisms remain unclear. Therefore， this paper explored the mechanisms of the PTEN-induced putative kinase 1 （PINK1）/Parkin pathway in mitochondrial autophagy and heart failure， reviewed the effects of PINK1/Parkin-mediated mitochondrial autophagy on heart failure， and discussed the therapeutic effects of PINK1/Parkin-mediated mitochondrial autophagy on heart failure in conjunction with TCM. This paper is expected to provide new ideas and methods for the prevention and treatment of heart failure from the perspective of PINK1/Parkin regulation of mitochondrial autophagy.

Objective:To analyze the effect of immersive scenario simulation training on improving the competency of infection prevention for health-care workers (HCWs).Methods:Taking the implementation time of immersive scenario simulation teaching training in Sir Run Run Shaw Hospital, Zhejiang University School of Medicine (August 2020) as the boundary, 352 new HCWs entered the hospital before the training (August 2019) were included as control group taking traditional teaching method, and 298 new HCWs entered the hospital after the training (August 2020) were included as observation group taking immersive scenario simulation combined with theoretical training. The mastery status of nosocomial infection-related knowledge and the implementation status of infection control measures (hand hygiene compliance, hand hygiene accuracy, correct personal protective equipment (PPE) selection, 100% of pass rate of PPE on and off, and qualified disposal of medical waste) were compared between the two groups of HCWs after theoretical teaching and different forms of practical training. The training effect (final assessment results) and training satisfaction (Minnesota satisfaction questionnaire, MSQ) of the two groups of HCWs were compared. SPSS 22.0 was used for t test and chi-square test. Results:The assessment results of the two groups of new HCWs trained by theoretical lecturing and immersive scenario simulation training were significantly improved compared with those just received theoretical lecturing, and the results of observation group were significantly higher than those of control group ( P<0.05). The implementation status of infection control measures after practical training were obviously improved in the two groups of HCWs compared to after theoretical lecturing, and the correct rates of PPE selection and all the procedure of donning and doffing PPE of observation group were significantly higher than those of control group ( P<0.05), but there were no significant differences in the hand hygiene accuracy and qualified disposal of medical waste between the two groups ( P>0.05). At the end of training, the final assessment results and satisfaction MSQ score of HCWs in observation group were significantly higher than those in control group ( P<0.05). Conclusion:Immersive scenario simulation teaching and training intervention is beneficial to improve the mastery of nosocomial infection knowledge of new HCWs, standardize their clinical infection control behaviors such as hand hygiene and aseptic operation, and finally obtain good training effect of infection prevention competency.

Objective:To investigate the effect of Caprini risk score-based care on the prevention of venous thromboembolism of patients with major orthopedic surgery.Methods:Totally 124 patients with major orthopedic surgery were randomly divided into experimental group and control group, each group contained 62 cases. The control group received routine thrombosis prevention nursing, patients in the experimental group carried out Caprini risk score-based intervention. The rate of VTE was compared between two groups, the levels of D-Dimer as well as thigh circumference was measured after 24 hours of admission, 3 days after surgery, 5 days after surgery and at discharge day. At discharge day, the inpatients satisfaction with nursing service scale was used to assessment the satisfaction with nursing service of inpatients.Results:The rate of VTE in the experimental group was 1.6% (1/62) and 6.5% (4/62) in the control group, the difference was not statistically significant ( χ2 value was 1.876, P=0.171). Three days after surgery, 5 days after surgery and at discharge day, the D-Dimer were (1.26±0.65) μg/ml, (1.27±0.35) μg/ml, (0.96±0.27) μg/ml in the experimental group, 5 days after surgery and at discharge day, the thigh circumference were (29.81±4.15) cm, (28.86±3.40) cm in the experimental group, significantly lower than those in the control group [(1.64±0.58) μg/ml, (1.51±0.55) μg/ml, (1.25±0.44) μg/ml, (31.84±5.22) cm, (30.83±3.91) cm], the difference was statistically significant ( t value was 2.405-4.485, P<0.05). The health education and guidance, personality traits, service quality, discharge guidance scores and total satisfaction scores were 26.31±3.06, 35.73±3.64, 27.89±3.11, 8.47±1.18 and 111.08±6.33, significantly higher than those in the control group (24.15±2.31, 33.92±2.66, 26.27±3.41, 7.42±1.82 and 106.52±5.85), the difference was statistically significant ( t value was 2.750-4.433, P<0.05). Conclusions:Caprini risk score-based nursing care significantly alleviates the hypercoagulable states and relieves the degree of swelling of the affected of patients with major orthopedic surgery, as well as improves patients' satisfaction with nursing work.

Objective:To explore the effect of swallowing training combined with respiratory intervention on the swallowing function and early neurodevelopment of preterm infants.Methods:Sixty-two preterm infants in neonatal intensive care were randomly divided into a study group of 30 and a control group of 32. All received routine treatment and nursing care plus touching, but the study group was additionally provided with swallowing and respiratory training. The duration of gastric tube use was observed, and a 20-item neonatal behavioral neurological assessment (NBNA) was administered at 40 weeks of corrected gestational age.Results:The average period of gastric intubation in the study group [(56.27±22.26) days] was significantly shorter than the control group′s average [(68.97±23.96) days]. The study group′s average NBNA score was significantly higher. Moreover, the NBNA scores were significantly negatively correlated with the intubation times.Conclusions:Swallowing training combined with respiratory intervention can improve the swallowing function of preterm infants, shorten the time a gastric tube is needed, and improve their early neurodevelopment.

We propose a novel palm-vein recognition model based on the end-to-end convolutional neural network. In this model, the convolutional layer and the pooling layer were alternately connected to extract the image features, and the categorical attribute was estimated simultaneously via the neural network classifier. The classification error was minimized via the mini-batch stochastic gradient descent algorithm with momentum to optimize the feature descriptor along with the direction of the gradient descent. Four strategies including data augmentation, batch normalization, dropout, and L2 parameter regularization were applied in the model to reduce the generalization error. The experimental results showed that for classifying 500 subjects form PolyU database and a self-established database, this model achieved identification rates of 99.90% and 98.05%, respectively, with an identification time for a single sample less than 9 ms. The proposed approach, as compared with the traditional method, could improve the accuracy of palm vein recognition in clincal applications and provides a new approach to palm vein recognition.
Algorithms ; Databases, Factual ; Hand ; blood supply ; diagnostic imaging ; Humans ; Neural Networks (Computer) ; Veins ; diagnostic imaging

Objective:To explore the correlation between cerebrovascular hemodynamic index (CVHI) accumulative score and subclinical arteriosclerosis indicators.Methods:A total of 27 184 cases were collected from the Health Management Center,the Third Xiangya Hospital,Central South University.Linear regression analysis was carried out to confirm the correlations between CVHI accumulative score and the modified Framingham stroke profile (FSP),as well as between CVHI accumulative score and cerebrovascular diseases (ICVD) scale.The correlation between CVHI accumulative score and brachial-ankle pulse wave velocity (baPWV),carotid plaque orcarotid intima-media thickness (CIMT) was analyzed by multifactor logistic regression model in 11 580 cases.Moreover,the correlation between CVHI accumulative score and microalbuminuria or serum cystatin C was performed by multifactor logistic regression model in 9 860 cases.Results:In this study,the people whose CVHI accumulative score was less than 75 accounted for 12.98％.The CVHI accumulative score was negatively related with the modified FSP score (r=-0.484,P＜0.01) or ICVD score (r=-0.455,P＜0.01).The multifactor logistic regression model found that the baPWV,carotid plaque,microalbuminuria and serum cystatin C were independent predictors for CVHI accumulative score.Conclusion:The CVHI accumulative score is correlated with the modified FSP score,ICVD score and indexes of subclinical arteriosclerosis (baPWV,carotid plaque,microalbuminuria and serum cystatin C).The CVHI accumulative score could be used as a tool for zero-level and primary prevention of cerebral stroke.

OBJECTIVE:To compare in vitro percutaneous permeation characteristics of glycyrrhizic acid in 6 kinds of glycyrrhetate creams,and to provide reference for further development and utilization. METHODS:Modified Franz diffusion cell and isolated rat skin were adopted for in vitro percutaneous permeation test. 24 h accumulative permeation of glycyrrhizic acid in 6 kinds of glycyrrhetate creams(monoammonium glycyrrhizinate,diammonium glycyrrhizinate,monopotassium glycyrrhizinate, dipotassium glycyrrhizate,trisodium glycyrrhizinate,disodium glycyrrhetate)were determined by HPLC. The permeation characteristics of 6 kinds of glycyrrhetate creams were evaluated by calculating percutaneous absorption rate. RESULTS:24 h accumulative permeation of 6 kinds of glycyrrhetate in rat skin in descending order was as follows:trisodium glycyrrhizinate (23.933 μ g/cm2)>dipotassium glycyrrhizinate(22.952 μ g/cm2)>disodium glycyrrhizinate(15.424 μ g/cm2)>monopotassium glycyrrhizinate(10.703 μg/cm2)>diammonium glycyrrhizinate(9.557 μg/cm2)>monoammonium glycyrrhizinate(1.621 μg/cm2). The percutaneous permeation rate in descending order was as follows as trisodium glycyrrhizinate [1.010 2 μ g/(cm2·h)]>dipotassium glycyrrhizinate [0.974 5 μg/(cm2·h)]>disodium glycyrrhizinate [0.641 2 μg/(cm2·h)]>diammonium glycyrrhizinate [0.399 9 μg/(cm2·h)]>monopotassium glycyrrhizinate[0.362 8 μg/(cm2·h)]>monoammonium glycyrrhizinate[0.072 6 μg/(cm2·h)]. CONCLUSIONS:The permeation rate of trisodium glycyrrhizinate is the highest among 6 kinds of glycyrrhetate creams in vitro.

Objective To explore the 5,10-methylenetetrahydrofolate reductase (MTHFR) and 5-methyltetrahydro-folate-homocysteine methyltransferase reductase ( MTRR ) gene polymorphisms among the Han women in Zhangjiagang city .Methods A total of 4008 Han women were recruited .Their oral epithelial cells were collected to extract genome DNA in order to detect gene polymorphisms of MTHFR and MTRR using fluorescence quantitative PCR.Then the results were compared with those in other cities in China .Results The genotype frequencies of MTHFR C677T CC, CT and TT among Zhangjiagang women are 32.2%, 49.5%and 18.3%, respectively.The C allele frequency is 64.3%, T allele frequency is 35.7%.The genotype frequencies of MTHFR A1298 C AA, AC and CC are 68.7%,28.7% and 2.5%, respectively .The A allele frequency is 80.8%, C allele frequency is 19.2%.The genotype frequencies of MTRR A66 G AA, AG and GG are 54.4%, 38.5%and 7.1%, respectively . The A allele frequency is 76.3%, G allele frequency is 26.4%.Conclusions The MTHFR, MTRR polymorphism distribution of Han women in Zhangjiagang city is region specific.