BACKGROUND:The repair process of myocardial injury involves complex cellular and molecular mechanisms,especially mitochondrial calcium homeostasis,macrophage autophagy and pyroptosis pathways.Traditional Chinese medicine(TCM)has shown significant clinical efficacy in improving myocardial injury,but its mechanism of action needs to be thoroughly investigated. OBJECTIVE:To investigate the role of mitochondrial calcium homeostasis-mediated macrophage autophagy and pyroptosis pathways in myocardial injury,and to summarize the progress of TCM in this field. METHODS:A computerized search was performed for relevant literature from the database inception to March 2024 in the Web of Science,PubMed and CNKI.The search terms were"mitochondrial calcium homeostasis,macrophage autophagy,macrophage pyroptosis,traditional Chinese medicine,myocardial injury,myocardial injury reperfusion"in Chinese and English.Through literature review,we analyzed the relationship between mitochondrial calcium homeostasis and macrophage autophagy and pyroptosis,explored the mechanism of their roles in myocardial injury,and summarized the pathways of multi-targeted,multi-pathway effects of TCM. RESULTS AND CONCLUSION:The maintenance of mitochondrial calcium homeostasis has been found to be closely related to the normal function of cardiomyocytes.Macrophages can participate in the repair process of myocardial injury through autophagy and pyroptosis pathways.Autophagy contributes to cell clearance and regulation of inflammatory response,while pyroptosis affects myocardial repair by releasing inflammatory factors.TCM regulates mitochondrial calcium homeostasis and macrophage function through multiple mechanisms.For example,astragalosid regulates calcium homeostasis by lowering mitochondrial membrane potential and inhibiting cytochrome C,and epimedium glycoside plays a role in reducing β-amyloid deposition.In addition,herbal compounds and single drugs promote myocardial repair by activating or inhibiting specific signaling pathways,such as PI3K/AKT and nuclear factor-κB signaling pathways.Future studies should focus on the interactions between mitochondrial calcium homeostasis,autophagy and pyroptosis pathways,as well as how TCM can exert therapeutic effects through these pathways to provide new strategies and drugs for the treatment of myocardial injury.

GBA1 gene mutation is an important genetic risk factor for Parkinson’s disease (PD). This paper reports a case of a 43-year-old male PD patient carrying a rare heterozygous Thr408Met mutation in the GBA1 gene identified through whole-exome sequencing, leading to a diagnosis of GBA1-associated PD. The patient’s motor symptoms were primarily characterized by bradykinesia and rigidity, without significant cognitive decline. Treatment with low-dose levodopa combined with a dopamine agonist resulted in significant symptomatic improvement.

Objective:To construct an assessment tool for laparoscopic left lateral sectionectomy skills.Methods:From November 2023 to January 2024, 22 clinical experts in hepatopancreatobiliary surgery from different regions of China were selected for this study. A preliminary indicator system was established through literature review, and the indicators and their weights at each level were determined using the Delphi method and analytic hierarchy process (AHP).Results:In the two rounds of consultation, the expert positive coefficients were 100.00% and 90.91%, authority coefficients were 0.984 and 0.985, Kendall coefficients were 0.231 and 0.193 ( P<0.001), and Cronbach's α coefficients were 0.905 and 0.865, respectively. A skill assessment tool for laparoscopic left lateral sectionectomy skills was constructed consisting of 5 primary indicators and 23 secondary indicators. AHP analysis showed that the concordance rate of each matrix of the secondary indicators was <0.1, meeting the consistency test requirements. Conclusions:The assessment tool for laparoscopic left lateral sectionectomy skills developed in this study is objective and reliable for evaluating the surgical skills of novice surgeons.

Background and objective Pembrolizumab(PEM)has been shown to be effective in clinical trials for the treatment of advanced non-small cell lung cancer(NSCLC),but clinical trials were based on cohorts of patients selected on specific criteria,and whether the findings are consistent with real-world patients is debatable.The aim of this study is to evaluate the efficacy and safety of PEM in the treatment of advanced NSCLC based on real-world data.Methods A retro-spective collection of real-world data from patients with advanced NSCLC receiving PEM was conducted.Propensity score matching was used to eliminate inter-group differences and assess the efficacy and safety of PEM compared to chemotherapy.Results Among 450 matched patients,the incidence rates of any-grade adverse events were 79.87％in the PEM group and86.71％inthe chemotherapy group,while the incidence rates of grade＞3 adverse events were 4.03％and 7.31％,respectively.The objective response rates were 48.63％for PEM and 36.00％for chemotherapy(P=0.011).The median progression-free survival was 15.5 months for PEM and 8.8 months for chemotherapy(P＜0.001),and the median overall survival was not reached for PEM and 26.2 months for chemotherapy(P＜0.001).Conclusion PEM treatment for advanced NSCLC demonstrates favorable survival outcomes and acceptable safety in real-world clinical practice.

Objective·To investigate the effect of early postoperative administration of zoledronic acid on fracture healing and functional recovery in elderly patients with osteoporotic femoral intertrochanteric fracture treated with proximal femoral nail antirotation(PFNA)surgery,and explore other potential prognostic factors.Methods·A total of 174 patients with femoral intertrochanteric fractures of 80 years old or above who underwent PFNA treatment in Ruijin Hospital,Shanghai Jiao Tong University School of Medicine from January,2016 to February,2022,were divided into experimental group(n=26)and control group(n=148)according to whether they received zoledronic acid early after surgery.All patients were followed up twice at 6 weeks and 12 weeks after surgery.The patients in the experimental group were matched with the control group by propensity score matching(PSM)at a ratio of 1:3(the matching factors included age,gender,fracture type,and body mass index).General characteristics,as well as fracture healing and functional recovery at the two follow-up visits were compared between the two groups after matching.Subsequently,Logistic regression was used to explore the potential prognostic factors on fracture healing at 12 weeks after surgery.Results·PSM resulted in 25 patients in the experimental group and 65 patients in the control group,and there were no statistically significant differences in baseline characteristics between the two groups.The fracture healing rates at 6 weeks and 12 weeks after surgery in the experimental group(16.0%and 96.0%,respectively)were higher than those in the control group(1.5%and 73.8%),and the differences were statistically significant(P<0.05).Harris hip function score in the experimental group at 12 weeks was significantly higher than that of the control group(P=0.019).The results of Logistic regression analysis showed that good surgical reduction(OR=12.52,95%CI 2.67?58.74,P=0.001),early postoperative administration of zoledronic acid(OR=10.14,95%CI 1.01?102.09,P=0.049),and higher serum albumin level(OR=1.15,95%CI 1.02?1.29,P=0.025)were the favorable factors of early fracture healing,while unstable fracture(OR=0.10,95%CI 0.03?0.31,P=0.000)was the unfavorable factor.Conclusion·For elderly patients with osteoporotic intertrochanteric femoral fractures treated with PFNA surgery,early postoperative administration of zoledronic acid can promote fracture healing and lead to better functional recovery;in addition,good surgical reduction and higher serum albumin levels are favorable factors for fracture healing,whereas unstable fracture presents as a hindrance to the healing process.

Objective: To investigate the antibacterial effect of a new photosensitizer, indocyanine green (ICG)-mediated photodynamic therapy, on a biofilm of Fusobacterium nucleatum (F. nucleatum) in vitro. Methods: The biocompatibility of the photosensitizer ICG was detected by CCK8. F. nucleatum (108 CFU/mL) was cultured in anaerobic conditions (80% N2, 10% H2 and 10% CO2) mixed with the photosensitizer ICG at concentrations of 0, 10, 20, 30, and 40 μg/mL and then treated with antibacterial photodynamic therapy (808 nm near infrared light with an intensity of 0.1 W/cm2 for 3 min), and a mature biofilm was formed after 2 days. The bacteriostatic effects of different concentrations of ICG on F. nucleatum biofilms were compared by colony formation unit count (CFU). The effect of ICG on the formation of F. nucleatum biofilms and biofilm metabolic activity was determined by crystal violet quantification and MTT assays. The effect of ICG on the formation of extracellular polysaccharides in F. nucleatum biofilms was determined by the phenol-sulfuric acid method. The change in the number of bacteria was observed by confocal microscopy. Results : CFU and biomass of the biofilm gradually decreased with increasing ICG concentration, and there were significant differences compared with the control group. Meanwhile, the metabolic activity of the biofilm and the production of extracellular polysaccharides also showed a significant difference between the ICG groups and the control group (P<0.01). At the same time, laser confocal microscopy showed that the number of living bacteria decreased gradually. Conclusion Antibacterial photodynamic therapy with photosensitizer ICG can effectively inhibit the formation of F. nucleatum biofilms.

OBJECTIVE To explore the way to re-use epidermal growth factor receptor-tyrosine kinase inhibitors （EGFR-TKI） in patients with EGFR-TKI-induced interstitial pneumonia （IP）， using osimertinib as an example. METHODS The IP treatment regimen and re-use of EGFR-TKI regimen in a patient who developed IP after the use of osimertinib were analyzed. And a literature review was made by combining the characteristics of the cases which reported in the literature and the characteristics of this case. RESULTS The patient’s IP symptoms due to treatment with osimertinib had resolved after treatment. The patient’s IP symptoms also did not worsen after using almonertinib in combination with hormones as re-use of EGFR-TKI regimen. However， almonertinib was discontinued as the patient experienced disease progression. The adverse reactions of IP needed to be dealt with in time， the EGFR-TKI should be discontinued and symptomatic treatment should be given. CONCLUSIONS EGFR-TKI targeted therapy could be re-selected by replacing EGFR-TKI， adjusting the dose of EGFR-TKI， and using hormones in combination. EGFR-TKI-induced adverse drug reactions of IP are rare， but need to be observed closely. If other EGFR-TKI is used， close monitoring of adverse reactions and curative effects are also required in order to adjust the patient’s treatment plan in time.

Objective:To investigate the CT angiography (CTA) characteristics and etiological screening of ischemic stroke (IS) in young adults.Methods:A total of 61 young IS patients (17-35 years old) admitted to Huzhou Nanxun District Traditional Chinese Medicine Hospital and Lishui Central Hospital from January 2019 to December 2021 were selected as the observation group, and the characteristics of brain CTA were observed. One hundred and thirty-six cases of young medical examiners of the same age were selected as the control group. The general clinical data of the two groups of subjects were recorded. Univariate analysis and multivariate Logistic regression were used to analyze the related factors affecting the incidence of patients in the observation group.Results:The results of CTA examination of 61 patients showed that the infarcts of the patients were usually located in the basal ganglia in 50.82%(31/61), and in the lobe of the brain in 39.34%(24/61), and the lesions were mostly multiple in 60.66%(37/61). Most of the diseased vessels were anterior circulation arteries in 67.21% (41/61), internal carotid artery disease was more common in 47.54%(29/61), and vertebrobasilar artery disease was more common in posterior circulation in 29.51%(18/61). The results of multivariate Logistic analysis showed that hypertension, diabetes, family history of stroke, smoking, alcoholism, dyslipidemia and serum homocysteine >6 μmol/L were independent influencing factors of the incidence of young IS patients ( P<0.05). Conclusions:In young IS patients, infarcts in the basal ganglia and cerebral lobes are common, with multiple lesions, internal carotid artery lesions and vertebrobasilar artery lesions are more common. The incidence of this disease is multi-factorial, and the incidence is higher in young people with hypertension, diabetes, family history of stroke, smoking, alcoholism, dyslipidemia and hyperhomocysteinemia.

Abdomen/diagnostic imaging* ; Artificial Intelligence ; Body Composition ; Magnetic Resonance Imaging ; Practice Guidelines as Topic

Infectious diarrhea is an important public health problem, which has a significant impact on global disease burden. Under the background of climate change, rainstorms increase and floods occur frequently. Most studies show that the incidences of infectious diarrhea disease increase significantly after rainstorm and flood events. However, there is a lack of systematic summary on the path of rainstorm and flood events affecting the incidence of infectious diarrhea, including the key links and mechanisms underlying environmental-social interaction. This study comprehensively combed the literature from environmental factors, socio-economic and cultural factors, and population and individual susceptibility factors. The potential mechanisms of infectious diarrhea caused by rainstorm and flood events were discussed from the aspects of spreading of pathogens, affecting sanitation facilities and (or) drinking water treatment infrastructure, the regulatory role of individual and behavioral factors, and long-term effects. Based on the "pressure-state-response" model, a social driving process model of rainstorm and flood leading to incidence of infectious diarrhea was constructed. This model could provide reference for future quantitative modeling and other research directions. It is helpful to guide the public health departments to accurately identify factors affecting the incidence of infectious diarrhea after rainstorm and flood, so as to take targeted intervention measures.