Objective:To analyze the clinical characteristics of patients undergoing extracorporeal cardiopulmonary resuscitation (ECPR), and to explore the risk factors leading to poor prognosis.Methods:The clinical data of 95 patients with ECPR admitted to the First Affiliated Hospital of Zhengzhou University from January 2020 to May 2023 were retrospectively analyzed. According to the survival status at the time of discharge, the patients were divided into the survival group and death group. The difference of clinical data between the two groups was compared to explore the risk factors related to death and poor prognosis. Risk factors associated with death were identified by Binary Logistic regression analysis. Results:A total of 95 patients with ECPR were included in this study, 62 (65.3%) died and 33 (34.7%) survived at discharge. Patients in the death group had longer low blood flow time [40 (30, 52.5) min vs. 30 (24.5, 40) min ] and total cardiac arrest time[40 (30, 52.5) min vs. 30(24.5, 40) min], shorter total hospital stay [3 (2, 7.25) d vs. 19 (13.5, 31) d] and extracorporeal membrane oxygenation (ECMO) assisted time [26.5 (17, 50) h vs. 62 (44, 80.5) h], and more IHCA patients (56.5% vs. 33.3%) and less had spontaneous rhythm recovery before ECMO (37.1% vs. 84.8%). Initial lactate value [(14.008 ± 5.188) mmol/L vs.(11.23 ± 4.718) mmol/L], APACHEⅡ score [(30.10 ± 7.45) vs. (25.88 ± 7.68)] and SOFA score [12 (10.75, 16) vs. 10 (9.5, 13)] were higher ( P< 0.05). Conclusions:No spontaneous rhythm recovery before ECMO, high initial lactic acid and high SOFA score are independent risk factors for poor prognosis in ECPR patients.

Objective: To explore the impact of five-flavor Sophora flavescens enteric-coated capsules (FSEC) on the intestinal flora of rats with ulcerative colitis (UC), so as to provide the reference for the mechanism of FSEC in treating UC. Methods: Forty SPF-grade Wistar rats were randomly divided into the control group, the model group, the mesalazine group and the FSEC group. Except the control group (0.9% sodium chloride solution), the other 3 groups used 3% dextran sulfate sodium (DSS) for 7 days to establish UC model. After successful modeling, the control group and the model group were given 2 mL/kgbw of 0.9% sodium chloride solution by gavage for 2 weeks, while the mesalazine group and the FSEC group were given 2 mL/kgbw of mesalazine suspension (0.2 g/kg) and FSEC granule suspension (2.16 g/kg), respectively. Pathological changes of colon tissue were observed after hematoxylin-eosin (HE) staining. Rat fecal samples were collected, and 16S rDNA high-throughput sequencing and bioinformatics analysis were performed on intestinal flora. The α and β diversity of intestinal flora among the four groups were compared, and the dominant flora was screened using LEfSe analysis. Results: Compared with the control group, the model group showed a significant loss of colonic crypts and a large infiltration of inflammatory cells. Compared with the model group, the mesalazine group and the FSEC group exhibited a slight loss of colonic crypts, a small amount or an absence inflammatory cell infiltration, and improved tissue damage. The α-diversity analysis showed that compared with the control group, the Chao1 and Shannon indices in the model group increased, while the Simpson index decreased; compared with the model group, the Chao1 and Shannon indices in the mesalazine group and the FSEC group decreased, and the Simpson index increased（all P<0.05）. The β-diversity analysis showed that the sample distance between the FSEC group and the control group were more closer than that between the model group and the control group. LEfSe analysis results showed that the dominant bacteria in the model group were mainly from the Alistipes and Oscillospira. In the FSEC group, the dominant bacteria were from the Ruminococcus and Prevotella. Conclusion FSEC can improve the structures of intestinal flora, increase the abundance of beneficial bacteria such as Ruminococcus and Prevotella, reduce the abundance of pathogenic bacteria such as Alistipes, and alleviate the inflammatory response in UC rats.

Objective To explore the current status,hotspots and trends of research on the TCM regulation of cellular autophagy;To provide reference for related research.Methods The literature related to the TCM regulation of cellular autophagy was retrieved from CNKI,Wanfang Data,VIP and CBM from the establishment of the databases to December 31,2022.Authors and institutional collaboration networks were drawn using CiteSpace 5.7.R5.keywords emergence analysis and timeline view were drawn.VOSviewer 1.6.18 software was used to draw keyword co-occurrence mapping.Results A total of 2 001 articles were included,with a general upward trend in the number of publications.The cooperation teams were mainly represented by Jia Lianqun,Yang Guanlin,Song Nan and others.Research institutions with more publications included Hunan University of Chinese Medicine,Liaoning University of Chinese Medicine,and Guangzhou University of Chinese Medicine.The keywords of the literature formed 9 meaningful clusters,showing that the research hotspots in this field mainly focused on apoptosis,mitochondrial autophagy,experimental studies,signaling pathways,and herbal monomers,etc.TCM interventions that attracted much attention included electroacupuncture,moxibustion,resveratrol,curcumin,etc,mainly involving PI3K/Akt,AMPK/mTOR and other signaling pathways.Conclusion The research on cellular autophagy in the field of TCM has been highly popular in recent years.Experimental studies,molecular mechanisms,related diseases,and TCM intervention are the research hotspots in this field.The research trend is dominated by TCM monomer,TCM theory research and other directions,mainly focusing on apoptosis,oxidative stress and other pathways to carry out extensive research.

Objective To explore the mechanism of Marsdenia tenacissima in the treatment of breast cancer through network pharmacology and experimental verification.Methods Literature retrieval was conducted to obtain the active components of Marsdenia tenacissima.The SwissTargetPrediction database was used to predict the potential targets of these active components.Targets of breast cancer were obtained from GeneCards,GEPIA2,OMIM,PharmGKB and TTD databases.The intersection targets were obtained,and a Marsdenia tenacissima-breast cancer-targets network was constructed using Cytoscape 3.9.0 software.The core targets were identified through protein-protein interaction(PPI)network analysis,followed by GO and KEGG pathway enrichment analysis to screen relevant signaling pathways.Molecular docking validation was performed for the top 10 key targets and major active components.The human breast cancer cell line MDA-MB-231 was treated with Marsdenia tenacissima injection in vitro.Cell proliferation ability was detected by CCK-8 assay and colony formation assay.Cell apoptosis was detected by Calcein-AM/PI staining and flow cytometry.Cell migration ability was detected by Transwell assay.Western blot experiment was used to validate the PI3K-AKT signaling pathway.Results Totally 37 active components and 276 potential targets against breast cancer were screened from Marsdenia tenacissima,including 11alpha-O-Benzoyl-12beta-O-acetyl tenacigenin B,Caffeic acid,Drevogenin A and Kaempferol.25 core targets were screened by PPI network such as AKT1,EGFR,TNF,CTNNB1 and IL-6,which mainly affected the estrogen signaling pathway,ErbB signaling pathway,HIF-1 signaling pathway and PI3K-AKT signaling pathway,etc.The molecular docking results showed that the main active components of Marsdenia tenacissima exhibited good binding activities with the core targets AKT1,ALB,CASP3,ESR1 and TNF.The results of in vitro experiments showed that Marsdenia tenacissima injection could inhibit the proliferation and migration ability of MDA-MB-231 cells(P<0.01,P<0.001)and induce apoptosis(P<0.001),as well as inhibit the activation of PI3K-AKT signaling pathway(P<0.05,P<0.01).Conclusion Marsdenia tenacissima may exert its anti-breast cancer effects through multiple targets and pathways,and the mechanism may be related to the inhibition of PI3K-AKT signaling pathway.

Objective To investigate the effects of bone marrow mesenchymal stem cell-derived exosomes(BMSCs-Exo)on the regulation of epithelia-mesenchymal transition(EMT)in human peritoneal mesothelial cells(HPMCs)treated with glucose-based peritoneal dialysis fluid(PDF).Methods BMSCs-Exo were verified by transmission electron microscopy(TEM),nanoparticle tracking analyzer(NTA)and Western blot.Cultured HPMCs(HMrSV5)were divided into 5 groups;control group,high glucose-based PDF(1.5％,2.5％,and 4.25％)group,siNLRP3 group,siNC group and BMSCs-Exo treated group.Expression of E-cadherin,vimentin,α-smooth muscle actin(α-SMA)and NLRP3 inflammasome-related proteins were detected by Western blot.Real time RT-PCR was used to detected the expression of α-SMA,E-cadherin and TGF-β1 mRNAs in HMrSV5 cells.The concentration of TGF-β1,IL-1 β and IL-18 in the culture supernatant was determined by ELISA.Results The exosomes isolated were spherical and double-membrane vesicles with 40-150 nm in diameter,which expressed CD9,CD81,TSG101 and Alix protein.Our results showed that the level of α-SMA and vimentin were significantly up-regulated and E-cadherin(epithelial marker)was significantly decreased in HMrSV5 cells treated with high glucose PDF com-pared with the normal HMrSV5 cells.The expression of NLRP3,pro-caspase-1 and pro-IL-1β were also significantly up-regulated in HMrSV5 cells treated with high glucose PDF compared with the normal HMrSV5 cells.The level of TGF-β1,IL-1 β and IL-18 in high glucose PDF treated HMrSV5 cells culture supernatant was up-regulated in a dose dependent manner.The protein level of α-SMA was decreased and E-cadherin level was increased by an NLRP3 siRNA to inhibit the activation of NLRP3.Compared with 4.25％PDF treated cells,E-cadherin expression was up-regulated,while the expression of α-SMA and vimentin were down-regulated in BMSCs-Exo treatment cells(P＜0.05).Furthermore,the protein expression of NLRP3,pro-caspase-1 and pro-IL-1β in 4.25％PDF-treated HMrSV5 cells were significantly reduced by BMSCs-Exo.BMSCs-Exo also reduced the level of TGF-β1,IL-1 β and IL-8 in the 4.25％PDF-treated HMrSV5 cells culture supernatants(P＜0.05).Conclusions High glucose PDF-induced EMT in HPMCs might be mediated by NLRP3 inflammatory signaling pathway,which can be inhibited by BMSCs-Exo.

Objective To observe the effects of Guanxinning tablet on atherosclerotic plaque,renal function,hemorheology,blood homocysteine(Hcy)and immunoinflammation in patients with blood stasis type chronic renal failure complicated by hemodialysis and carotid atherosclerosis.Methods According to the diagnosis,inclusion and exclusion criteria,67 patients with blood stasis type chronic renal failure complicated with carotid atherosclerosis and undergoing hemodialysis from Lishui Second People's Hospital and Lishui Hospital of Traditional Chinese Medicine from January 2023 to January 2024 were selected and randomly divided into control group(33 cases)and observation group(34 cases).The control group received routine treatment of chronic renal failure and hemodialysis.In the observation group,Guanxinning tablet was added to the basic treatment,and the levels of carotid atherosclerotic plaque,renal function,hemorheology,blood Hcy and immunoinflammation were detected in both groups before and after treatment.Results There were no significant differences in general information,carotid atherosclerotic plaque,renal function,hemorheology,blood Hcy level and immunoinflammation level between the two groups before treatment(P>0.05).After treatment,the observation group was superior to the control group in reducing carotid plaque,improving carotid intimedia thickening,improving renal function,reducing inflammatory index level and improving immune function(P<0.05),but there was no significant difference in reducing blood Hcy level compared with the control group(P>0.05).Conclusion Guanxinning tablet can improve the chronic inflammation in the body of patients with blood stasis type chronic renal failure combined with hemodialysis and carotid atherosclerosis,reduce blood viscosity,inhibit red blood cell aggregation,thereby improving carotid atherosclerosis,reducing carotid atherosclerotic plaque,improving renal function and improving immune function of patients,but does not reduce blood Hcy level.

OBJECTIVE: To investigate the early effectiveness of transiliac-transsacral screws internal fixation assisted by augmented reality navigation system HoloSight (hereinafter referred to as "computer navigation system") in the treatment of posterior pelvic ring injuries. METHODS: A retrospective analysis was made in the 41 patients with posterior pelvic ring injuries who had been treated surgically with transiliac-transsacral screws between June 2022 and June 2023. The patients were divided into navigation group (18 cases, using computer navigation system to assist screw implantation) and freehand group (23 cases, using C-arm X-ray fluoroscopy to guide screw implantation) according to the different methods of transiliac-transsacral screws placement. There was no significant difference in gender, age, body mass index, causes of injuries, Tile classification of pelvic fracture, days from injury to operation, usage of unlocking closed reduction technique between the two groups ( P>0.05). The time of screw implantation, the fluoroscopy times, the guide wire adjustment times of each screw, and the incidence of complications were recorded and compared between the two groups. The position of the transiliac-transsacral screw was scanned by CT within 2 days after operation, and the position of the screw was classified according to Gras standard. RESULTS: The operation was successfully completed in both groups. The time of screw implantation, the fluoroscopy times, and the guide wire adjustment times of each screw in the navigation group were significantly less than those in the freehand group ( P<0.05). There were 2 cases of incision infection in the freehand group, and the incision healed by first intention after active dressing change; there was no screw-related complication in the navigation group during operation and early period after operation; the difference in incidence of complications between the two groups (8.7% vs. 0) was not significant ( P=0.495). According to the Gras standard, the screw position of the navigation group was significantly better than that of the freehand group ( P<0.05). CONCLUSION Compared with the traditional freehand method, the computer navigation system assisted transiliac-transsacral screws internal fixation in the treatment of posterior pelvic ring injuries has advantages of improving the accuracy of screw implantation and reducing radiation damage and the time of screw implantation.
Humans ; Retrospective Studies ; Surgical Wound Infection ; Replantation ; Body Mass Index

OBJECTIVE To provide ideas and reference for the treatment and pharmaceutical care of infective endocarditis （IE） caused by Micrococcus luteus complicated with severe pneumonia. METHODS The clinical pharmacist participated in the treatment of a patient with IE caused by M. luteus complicated with severe pneumonia； all anti-infective treatment plans were agreed upon after the doctor invited the clinical pharmacist for consultation. After the implementation of the plan， the clinical pharmacist conducted pharmaceutical care of effectiveness and safety for the plan， including adopting suitable drug， adjusting the dose of vancomycin by using parameters such as steady-state valley concentration and creatinine clearance rate， monitoring renal function and adverse drug reactions. RESULTS IE caused by M. luteus was cured after surgery and full treatment with anti-bacterial drugs， the severe pneumonia was improved， and the decline of renal function caused by drugs and the primary disease were recovered； clinical pharmacists had ensured the effect of anti-infection treatment by assisting in the formulation of treatment plans and the implementation of pharmaceutical care， avoiding further renal damage and solving the problem of cefoperazone sulbactam- related drug fever. CONCLUSIONS IE caused by M. luteus is relatively serious， and the treatment drug can be vancomycin and rifampicin. During the treatment， it is necessary to monitor the renal function， and adjust the dose of vancomycin or change other drugs； anti-infection pharmaceutical care provided by clinical pharmacists can guarantee the effectiveness and safety of anti- infection plan， and avoid the occurrence of severe adverse drug reactions.

Autophagy is an intracellular degradation process that delivers cytoplasmic constituents to the lysosome. Abnormality of autophagy is related to many human diseases, which provides a new clue to the pathophysiology of human cancer. However, the role of autophagy in normal liver physiology and the pathogenesis of liver diseases need to be further clarified. This article reviews the role of autophagy in the occurrence and development of hepatocellular carcinoma and the molecular mechanisms.

Objective:To explore the expressions of long non-coding RNA LINC00673 and ISG15 protein in pancreatic cancer and their clinical significances.Methods:The clinical data of 57 patients diagnosed as pancreatic ductal carcinoma (PDAC) at the Affiliated Cancer Hospital of Xiangya Medical College of Central South University from January 2014 to December 2018 were retrospectively analyzed. The relative expressions of LINC00673 in pancreatic cancer tissues and paracancerous normal tissues (within 3 cm from the edge of cancer tissues) were examined by using quantificational reverse transcription-polymerase chain reaction (qRT-PCR). The ISG15 protein expressions in pancreatic cancer tissues and paracancerous normal tissues were examined by using immunohistochemistry. The difference in LINC00673 expression between ISG15 protein positive and negative patients was compared. The correlation between LINC00673 and ISG15 protein expressions in pancreatic cancer was analyzed by Spearman rank correlation analysis. Moreover, the correlations of LINC00673 and ISG15 protein expressions with clinical stage and pathological classification of pancreatic cancer patients were analyzed.Results:The positive expression of ISG15 protein in pancreatic cancer tissues was 40.4% (23/57), which was higher than that in paracancerous normal tissues [15.8% (9/57)] ( χ2 = 7.90, P = 0.004), and the relative expression of LINC00673 in pancreatic cancer tissues was 0.99±0.36, which was lower than that in paracancerous normal tissues (1.26±0.41) ( t = 4.80, P < 0.001). For 23 (40.4%) ISG15-positive patients and 34 (59.7%) ISG15-negative patients, the relative expression of LINC00673 was 0.77±0.46 and 0.45±0.27 ( P < 0.001). Spearman analysis showed that there was a correlation between LINC00673 and ISG15 protein expressions ( ρ = -0.429, P = 0.001). The relative expression of LINC00673 decreased in patients with low differentiated or undifferentiated tumor, vascular invasion and lymph node metastasis (all P < 0.05), but there was no correlation between LINC00673 expression and patients' age, tumor site, preoperative CA199 level, and TNM stage (all P > 0.05); ISG15 protein expression increased in patients with low differentiated or undifferentiated tumor, TNM stage Ⅲ-Ⅳ, vascular invasion and lymph node metastasis (all P < 0.05), but there was no correlation between ISG15 protein expression and patients' gender, age, tumor site, and preoperative CA199 level (all P > 0.05). Conclusions:The expression of LINC00673 in pancreatic cancer is related to vascular invasion, tumor differentiation degree and lymph node metastasis, and the expression of ISG15 in pancreatic cancer is related to vascular invasion, tumor differentiation degree, lymph node metastasis and TNM stage. The combined detection of LINC00673 and ISG15 protein could be a valuable prognostic indicator for pancreatic cancer. The therapies targeting LINC00673 and ISG15 protein signaling pathways are expected to be a potential option for immunotherapy of pancreatic cancer.