Ginsenoside Rc,a dammarane-type tetracyclic triterpenoid saponin primarily derived from Panax ginseng,has garnered significant attention due to its diverse pharmacological properties.This review outlined the sources,putative biosynthetic pathways,extraction,and quantification techniques,as well as the pharmacokinetic properties of ginsenoside Rc.Furthermore,this study explored the pharmaco-logical effects of ginsenoside Rc against metabolic syndrome(MetS)across various phenotypes including obesity,diabetes,atherosclerosis,non-alcoholic fatty liver disease,and osteoarthritis.It also highlighted the impact of ginsenoside Rc on multiple associated signaling molecules.In conclusion,the anti-MetS effect of ginsenoside Rc is characterized by its influence on multiple organs,multiple targets,and multiple ways.Although clinical investigations regarding the effects of ginsenoside Rc on MetS are limited,its proven safety and tolerability suggest its potential as an effective treatment option.

Objective:To investigate the efficacy and safety of prolonged dual antiplatelet therapy (DAPT) (aspirin + clopidogrel) after coronary artery bypass grafting (CABG) for more than 12 months.Methods:1 900 patients who received CABG treatment in Tianjin Chest Hospital from January 2019 to October 2020 were continuously included, and 1 528 patients were finally identified according to the inclusion and exclusion criteria. According to whether the patients continued to take DAPT treatment 12 months after discharge, they were divided into the extended DAPT group and the standard DAPT group. Cox multivariate regression and propensity score matching (PSM) analysis were performed on major cardiovascular and cerebrovascular adverse events (MACCE) and clinically related bleeding events in the two groups during 12-24 months after discharge to evaluate the efficacy and safety of extended DAPT treatment for more than 12 months. Results:Of the 1 528 patients, 624 (40.8%) continued to take DAPT 12 months after discharge. Compared with patients receiving standard DAPT, patients receiving extended DAPT had a lower incidence of MACCE within 12 to 24 months ( HR=0.597, 95% CI: 0.399-0.892, P=0.012); ( HR=0.519, 95% CI: 0.338-0.798, P=0.003), and there was no significant increase in clinically relevant bleeding risk ( HR=1.209, 95% CI: 0.522-2.798, P=0.658), ( HR=1.112, 95% CI: 0.452-2.737, P=0.817). At the same time, prolonged DAPT treatment also brought a good net benefit. Conclusion:Prolonged DAPT treatment after CABG for more than 12 months significantly reduced the risk of ischemia at 12-24 months after surgery, and did not significantly increase the risk of bleeding at 12-24 months after surgery. It may be beneficial for patients treated with CABG to continue DAPT (aspirin+ clopidogrel) on the basis of intensive DAPT therapy for 1 year.

According to the age of onset, childhood acne can be divided into neonatal acne, infantile acne, preschool acne, and prepubertal acne. Neonatal acne and infantile acne can serve as predictive factors for severe adolescent acne, preschool acne may be related to underlying endocrine diseases, and prepubertal acne is a sign of pubertal maturation. The treatment of childhood acne is similar to that of adolescent acne, and adverse effects of drugs and their impact on the growth and development of children should be considered.

Cognitive impairment often occurs in elderly patients with heart failure.In this paper, we reviewed the possible mechanism of cognitive impairment in elderly patients with heart failure.The possible pathological mechanism of cognitive impairment in elderly patients with heart failure was discussed from the aspects of decreased cardiac output, renal damage, atrial fibrillation, inflammatory reaction, neuroregulation, depression and high homocysteine level, and the effect of cognitive impairment on heart failure was also summarized, so as to improve both the clinicians' awareness of cognitive impairment and the level of diagnosis and treatment in elderly patients with heart failure.

Objective To determine the expression of caspase-14 in skin lesions of patients with chronic actinic dermatitis (CAD),and to explore the effect of ultraviolet B (UVB) radiation on its mRNA and protein expression in HaCaT cells.Methods In 2016,skin samples were collected from lesions of 10 patients with CAD (test group),10 patients with eczema (positive control group) and from normal skin of 10 healthy controls after cosmetic surgery (negative control group) in the Department of Dermatology,First Affiliated Hospital of Kunming Medical University.Immunohistochemical staining was performed to determine the expression of caspase-14 in the normal skin,CAD and eczema lesions.Cultured HaCaT cells were divided into several groups:UVB groups irradiated with 0,30,60,90 mJ/cm2 UVB separately,and 5-AzaC groups irradiated with 0,30,60,90 mJ/cm2 UVB separately followed by the treatment with the methylase inhibitor 5-AzaC for 24 hours.Then,the cells were collected,and real-time fluorescence-based quantitative PCR (RT-PCR) and Western blot analysis were conducted to determine the mRNA and protein expression of caspase-14 respectively in HaCaT cells in the UVB groups and 5-AzaC groups.Statistical analysis was carried out with SPSS22.0 software by using chi-square test for the comparison of rates,and t test and two-factor analysis of variance for the comparison of means.Results In the CAD and eczema lesions,caspase-14 was mainly expressed in the spinous and granular layers,but not in the stratum comeum.However,caspase-14 was markedly expressed in the stratum corneum of the normal skin tissues.Of the 10 CAD samples,5 were positive for caspase-14,and 9 of 10 normal skin samples were positive for caspase-14.The positive rate of caspase-14 significantly differed between the two above groups (x2 =7.30,P ＜ 0.05).RT-PCR and Western blot analysis showed significant changes in the mRNA and protein expression of caspase-14 in HaCaT cells after irradiation with different doses of UVB (F =87.54,23.46,both P ＜ 0.05),which showed a decreasing trend along with the increase in the dose of UVB.After exposure to 0,30,60 and 90 mJ/cm2 UVB,the mRNA and protein expression of caspase-14 was significantly higher in the 5-AzaC groups than in the UVB groups (all P ＜ 0.05).Conclusions In CAD lesions,the expression of caspase-14 markedly decreased,and was absent in the stratum corneum.UVB radiation can downregulate the mRNA and protein expression of caspase-14 in HaCaT cells.

Objective To investigate the gap between the needs and actual perception of the quality of care for patients with interventional therapy, and explore the factors that affect the quality of nursing services. Methods A total of 264 cases of liver cancer patients with interventional therapy in 4 Class Ⅲ Grade A hospitals from April 2016 to April 2017 were recruited using random cluster sampling method and investigated by service quality (SERVQUAL) questionnaires. Results In the service quality gap model, patients' expectation scores of nursing service quality in 5 dimensions including tangible, reliability, responsiveness, assurance, and empathy were (4.34±0.49),(4.35±0.55),(4.45±0.26), (4.54±0.32), and (4.45±0.44). Patients' perceived scores of nursing service quality in those 5 dimensions were (4.11±0.35),(4.23±0.54),(4.32±0.17),(4.34±0.26), and (4.23±0.35), which were lower than expectation scores. The differences were statistically significant between two scores (t=-8.898, -3.578, -9.824, -11.206, -9.050; P< 0.01). Logistic regression analysis showed that patients with other chronic diseases and operation history were the common factors that affect the actual perception and demand scores of patients before and after interventional therapy in 5 dimensions of the SERVQUAL model. Conclusions The hospital should strengthen the training and management of nursing staff of nursing intervention, and take a series of measures from multi-level and multi-angle to improve the quality of nursing intervention before and after the treatment and increase patient's satisfaction.

Objective To study the effects of semaphorin 5A (SEMA5A) gene silencing by lentivirus?mediated short hairpin RNA(shRNA)on biological activity of malignant melanoma cell line A375. Methods Two pairs of interference sequences for SEMA5A gene(shRNA1 and A375?shRNA2)and a pair of control interference sequences were designed to build lentiviral vectors, which were then transfected into HEK293T cells to gain lentivirus. A375 cells were divided into three groups:experimental group(A375?shRNA1 and A375?shRNA2 cells)transfected with the lentivirus containing shRNA1 or shRNA2, negative control group (A375?con cells) transfected with that containing the control shRNA, and blank control group(A375 cells)receiving no transfection. The A375 cells with stable knockdown of SEMA5A gene expression were screened by puromycin. Subsequently, reverse transcription?PCR and Western?blot analysis were performed to detect mRNA and protein expressions of Semaphorin 5A in these cells, and methyl thiazolyl tetrazolium(MTT)assay was applied to evaluate the growth of cells. The scratch assay and invasion assay were conducted to estimate migration and invasion ability of cells. Results The lentivirus containing the SEMA5A?targeting shRNAs or control shRNA was successfully transfected into A375 cells, and stably transfected cells were gained after puromycin selection. The expressions of semaphorin 5A mRNA and protein in the A375?shRNA2 cells were significantly reduced compared with those in the A375?con and A375 cells(all P < 0.05). MTT assay showed that the growth of A375?shRNA2 cells was significantly slower than that of A375?con and A375 cells(both P<0.05), while there was no significant difference in the growth rate between A375?con and A375 cells(P>0.05). The scratch assay showed that there was no obvious cell migration into the scratch in the experiment group, whereas the scratch was almost covered by cells in the negative control group and blank control group. The invasion assay showed that the number of A375?shRNA2 cells passing through the Transwell chamber was significantly smaller than that of A375 and A375?con cells(both P<0.05), while there was no significant difference between that of A375 and A375?con cells(P > 0.05). Conclusion The silencing of SEMA5A gene by lentivirus?mediated shRNA could effectively down?regulate the expression of semaphorin 5A, and inhibit the growth, invasion and migration of A375 cells.

Objective To study in vitro hydrodynamics of a pneumatic pulsatile ventricular assist device developed ex?clusively by China, and establish an animal model for the detection by the device. Methods The hydromechanics experi?ment was performed on an in vitro test loop using MEDOS-System to drive the ventricular assist device, and lycerl-water so?lution was used as circulating medium. The changes of afterload pressure and the output of the pump were monitored, and the impermeability and stability were also assessed after the experiment. Six adult dogs were used as the experimental animals. The device worked in the left heart assistance mode for 1 hour then the ventricular fibrillation was induced by potassium chloride, and then defibrillated after 5 min while the device remained working. The hemodynamics data were monitored con?secutively during the trial. Results The ventricular assist device worked stably and reliably during the hemodynamic exper?iment. The pump can generate more than 4 L/min flow against the afterload pressure of 100 mmHg. There were no significant changes in heart rate at different time points in experimental dogs after left ventricular assist. Comparison between after auxil?iary immediately and former auxiliary, the diastolic blood pressure of dogs increased 30 mmHg with the ventricular assist, and the diastolic pressure increased 19 mmHg. No obvious fluctuation in blood pressure was found during the auxiliary pro?cess. The diastolic blood pressure stayed at 60 mmHg when the heart was in ventricular fibrillation, and returned to normal after electrical defibrillation. Conclusion The ventricular assist device works stably in vitro test, and the pump can meet the need of adult’s ventricular assist. It is effective and security to dogs in short term. The effects of long-term use need to be future proved.

Objective To investigate the effect of rhBNP in treating pulmonary hypertension after mitral value replacement (MVR) compared with PGE1.Methods 60 patients with pulmonary hypertension after MVR were randomly divided into 3 groups(control group, PGE1 group and rhBNP group).Hemodynamic factors(MAP, CVP, mPAP, etc.) were monitored before and after taking medicine at 1 h, 6 h, 24 h, respectively including drug withdrawal 2 h.TXA2 and cGMP were analyzed by ELISA.To observe the levels of TXA2 and cGMP in plasma before and after treatment with rhBNP and PGE1 for three times (24 h, 1 week and 3 months).Information about patients'mechanical ventilation time was also recorded.Results Patients' mechanical ventilation time in PGE1 group was the shortest.MAP, mPAP, PRVI, PAWP were reduced after treatment by medicine 1 h for in PGE1 group.However, these indexes were rebound after drug withdrawal.mPAP, PRVI, PAWP in rhBNP group decreased after treatment by medicine at 6 h.The decreased level of mPAP was less than that in PGEI group.In control group, TXA2 went down and cGMP went up after operation.After taking medicine at 24 h, TXA2 decreased and cGMP increased in both PGE1 and rhBNP group.The increased level in rhBNP group was higher than that of control group.With medicine, the decreased level of TXA2 in PGE1 was also higher than that in rhBNP group.The going-up of cGMP in rhBNP was higher than that in PGE1.Conclusion Both rhBNP and PGE1 can reduce pulmonary artery pressure, PGE1 is more effective than that of rhBNP.

Objective To evaluate the efficacy and safety of hydroxychloroquine combined with butyli flufenamatum ointment and other drugs for the treatment of polymorphous light eruption (PLE).Methods A total of 48 patients with PLE were randomly and equally classified into group 1 and group 2.Both groups took hydroxychloroquine 200 mg twice a day and loratadine 10 mg per day for the initial 4 weeks,then took hydroxychloroquine 100 mg twice a day alone for another 4 weeks.Group 1 also topically applied butyli flufenamatum ointment twice a day during the 8 weeks,while group 2 applied mometasone furoate cream twice a day for the first 2 weeks followed by butyli flufenamatum ointment twice a day for another 6 weeks.Each treatment cycle lasted 2 weeks,and both groups received 4 cycles of treatment.Patients were evaluated for the response rate at the end of each cycle,and for the total symptom score and erythema score before and after the 8-week treatment.Statistical analysis was carried out using t test,chi-square test,Fisher's exact test and repeated-measures analysis of variance with the SPSS17.0 software.Results On day 14,28,42 and 56,the total score improved in 0,3,12 and 19 patients in group 1 respectively,and in 1,4,12 and 20 patients in group 2 respectively;the erythema score improved in 1,5,13 and 18 patients in group 1 respectively,and in 0,5,11 and 17 patients in group 2 respectively.No significant difference was observed between the two groups in response rates at any of the above four time points (P ＞ 0.05).Both the total score and erythema score significantly decreased after the 8-week treatment in both groups compared with the pretreatment scores (both P ＜ 0.05).No serious adverse reaction was observed in either of the two groups.Conclusions Hydroxychloroquine combined with loratadine and butyli flufenamatum ointment shows high efficacy and safety for the treatment of PLE.Topical butyli flufenamatum ointment is highly effective for the treatment of PLE,especially for PLE cases mainly presenting with erythema.