Myocardial infarction （MI） refers to an acute clinical syndrome of myocardial necrosis due to persistent ischemia and hypoxia， resulting from the sharp reduction or interruption of coronary blood flow. Nuclear factor κB （NF-κB） is the key factor in inducing inflammatory response， and it is involved in the production of pro-inflammatory factors and myocardial cell apoptosis. This article systematically describes the molecular regulation mechanism of the NF-κB signaling pathway in MI， and reviews the related research on the prevention and treatment of MI through the regulation of this signaling pathway by active ingredients and compound formulas from traditional Chinese medicine （TCM）. It has been found that active ingredients from TCM， such as ginsenoside Rg3， baicalein， curcumin， tanshinone ⅡA， gambogic acid， as well as compound formulas， including Qili qiangxin capsules， Yiqi huoxue decoction， Lingbao huxin dan， Danhong injection， Baoyuan decoction combined with Taohong siwu decoction， can improve myocardial fibrosis， alleviate inflammatory responses， and inhibit cardiomyocyte apoptosis by suppressing the NF-κB signaling pathway. Thereby， they achieve the goal of preventing and treating MI.

ObjectiveTo investigate the current status of secondary prevention of stable angina in patients with coronary heart disease in three regions of China， namely Henan Province， Xinjiang Uygur Autonomous Region， and Tianjin City， and analyze the the influencing factors. MethodsA cross-sectional study was conducted to include patients with stable angina with coronary heart disease in Henan， Tianjin and Xinjiang from August 10， 2020 to March 14， 2021. General information， traditional Chinese medicine （TCM） syndrome elements， prescriptions and other data of patients were collected， and clinical characteristics， blood pressure， blood lipid and blood glucose of patients were analyzed； the patients were divided into groups according to whether their blood pressure， blood lipid and blood glucose were up to standard. With the most common syndrome element as the main variable， region， age and gender as covariables， Logistic regression equation was incorporated to analyze the influencing factors for the patients' blood pressure， blood lipid and blood glucose being up to standard. ResultsA total of 1061 coronary heart disease patients with stable angina were included， including 658 in Henan， 210 in Xinjiang， and 193 in Tianjin. The clinical characteristics of patients in the three regions showed statistical different in age， sex， disease course， complication， blood pressure， blood lipid， blood glucose， smoking， drinking， living habits， and medication treatment （P＜0.05 or P＜0.01）. For the included patients， qi deficiency （79.55%， 844/1061） and blood stasis （39.96%， 424/1061） were the main syndrome elements. The overall compliance rate of blood pressure was 48.89% （506/1035）， blood lipids 12.68% （133/1049） and blood glucose 48.18% （504/1046）. Qi deficiency was the independent factor affecting the blood pressure of coronary heart disease patients with stable angina combined with hypertension （P = 0.029，95%CI ［1.048， 2.369］）， and the independent factors influencing the blood lipid standard of coronary heart disease patients with stable angina （P = 0.011， 95%CI ［1.133， 2.646］）， but not the independent factors affecting blood glucose standard in coronary heart disease patients with diabetes （P＞0.05）. ConclusionCoronary artery disease patients with stable angina have geographical variability in clinical characteristics and distribution of TCM syndrome elements， and the overall control of blood pressure， blood lipids， and blood glucose is poor， and qi deficiency syndrome is an independent risk factor affecting the control of blood pressure and blood lipids.

Objective    To investigate the safety and feasibility of early mobilization in critically ill patients with femoral catheters, and to provide reference for guiding clinical rehabilitation training. Methods    The literature on the safety and feasibility of early mobilization in critically ill patients with femoral catheters included in PubMed, EMbase, OVID, Springer-link, Wiley Online Library, and Web of Science up to June 2021 was searched, and relevant data were extracted for analysis. Results    Seventy-two papers were initially screened, and 12 papers that met the criteria were finally included, covering 1 056 patients, and 489 patients had femoral catheters. Patients underwent 6 495 sessions of physical therapy, and a total of 62 patients had adverse events, including 14 (2.86%, 14/489) patients with catheter-related adverse events. Conclusion    Although early mobilization in critically ill patients with femoral catheters may lead to adverse catheter-related events, the incidence is low. Therefore, the associated risks and benefits should be weighed in clinical practice, and femoral catheter is not recommended as a contraindication for early mobilization in critically ill patients.

Humans ; Adult ; Serum Albumin, Human ; Consensus ; Cardiac Surgical Procedures ; Thoracic Surgery

Glioblastoma (GBM) is the most common and aggressive malignant brain tumor in adults and is poorly controlled. Previous studies have shown that both macrophages and angiogenesis play significant roles in GBM progression, and co-targeting of CSF1R and VEGFR is likely to be an effective strategy for GBM treatment. Therefore, this study developed a novel and selective inhibitor of CSF1R and VEGFR, SYHA1813, possessing potent antitumor activity against GBM. SYHA1813 inhibited VEGFR and CSF1R kinase activities with high potency and selectivity and thus blocked the cell viability of HUVECs and macrophages and exhibited anti-angiogenetic effects both in vitro and in vivo. SYHA1813 also displayed potent in vivo antitumor activity against GBM in immune-competent and immune-deficient mouse models, including temozolomide (TMZ) insensitive tumors. Notably, SYHA1813 could penetrate the blood-brain barrier (BBB) and prolong the survival time of mice bearing intracranial GBM xenografts. Moreover, SYHA1813 treatment resulted in a synergistic antitumor efficacy in combination with the PD-1 antibody. As a clinical proof of concept, SYHA1813 achieved confirmed responses in patients with recurrent GBM in an ongoing first-in-human phase I trial. The data of this study support the rationale for an ongoing phase I clinical study (ChiCTR2100045380).

Objective    To compare the in-hospital outcomes of transapical transcatheter aortic valve replacement (TA-TAVR) for bicuspid aortic valve (BAV) patients and tricuspid aortic valve (TAV) patients. Methods    Patients (including BAV and TAV patients) who underwent TA-TAVR with the J-ValveTM in West China Hospital from July 2014 to July 2020 were included consecutively. The clinical outcomes of the patients were analyzed. Results    A total of 354 patients were included in the study, 75 in the BAV group and 279 in the TAV group. There were 229 males and 125 females with a mean age of 72.2±6.0 years. No death occurred during the procedure, and the overall technical success rate was 97.7%. The all-cause in-hospital mortality rate was 1.4%. Twenty (26.7%) patients with BAV and 46 (16.5%) patients with TAV had mild or higher perivalvular leaks immediately after the procedure. No patients with BAV required permanent pacemaker implantation postoperatively, while 13 (4.7%) TAV patients required permanent pacemaker implantation, with an overall pacemaker implantation rate of 3.7%. One (1.3%) BAV patient and 7 (2.5%) TAV patients developed acute kidney injury postoperatively. One (1.3%) BAV patient and 1 (0.4%) TAV patient developed peri-operative myocardial infarction. The average postoperative hospital stay was 7.6±3.6 d for BAV patients and 8.6±6.1 d for TAV patients. There was no statistical difference in primary or secondary in-hospital outcomes between BAV and TAV patients (P>0.05). Conclusion    Compared to TAV patients, BAV patients have similar in-hospital outcomes, with a low incidence of adverse clinical outcomes, which provides preliminary evidence for its implementation in Chinese patients with a high proportion of BAV.

We reported a 65-year-old female who was admitted to our institute with "recurrent subxiphoid pain accompanied by dyspnea for more than 10 days". Electrocardiogram examination suggested acute extensive anterior ST segment elevation myocardial infarction. Preoperative transthoracic echocardiography suggested ventricular septal rupture. The patient was planned for the repair of ventricular septal rupture with cardiopulmonary bypass. The formation of left ventricular aneurysm was diagnosed by intraoperative transesophageal echocardiography (TEE). The surgeon decided to abdopt the modified incision of left ventricular approach guided by TEE, which greatly improved the prognosis of the patient. The surgery duration was 197 min, aortic cross-clamping time was 56 min, cardiopulmonary bypass time was 69 min, and the patient was safely admitted to ICU after the surgery. Extubation was performed on the first day postoperatively, and the intra-aortic balloon pump support was retreated on the second day postoperatively. Postoperative echocardiography showed that no obvious residual shunt was observed after ventricular septal repairment and ventricular aneurysm resection. The patient was discharged on the 12th day after the surgery. Additionally, the mental condition was good and daily activities were not limited within 6 months postoperatively.

Objective:To evaluate the efficacy by using domestic recombinant human thyroid-stimulating hormone (rhTSH) in patients with differentiated thyroid cancer (DTC) before or after 131I therapy. Methods:From May 2019 to November 2020, a total of 24 patients with DTC (5 males, 19 females, median age 41 years) in Peking Union Medical College Hospital and Affiliated Tumor Hospital of Zhengzhou University were enrolled into the open-label, dose escalation phase Ⅰ study. All patients were divided into 4 domestic rhTSH dose groups: 0.9 mg×1 d (group A), 0.9 mg×2 d (group B), 1.8 mg×1 d (group C), 1.8 mg×2 d (group D) in succession, with 6 patients in each group. Each patient underwent rhTSH phase and thyroid hormone withdrawal (THW) phase. The end point included safety, tolerability, the quality of life (hypothyroidism symptom and sign score (Billewicz score), profile of mood states (POMS)), effectiveness (thyroid-stimulating hormone (TSH) and thyroglobulin (Tg) levels, diagnostic whole-body scan (Dx-WBS)) and pharmacokinetic characteristics (peak time, peak concentration) of rhTSH. Paired t test and Wilcoxon signed rank test were used for statistical analysis. Results:There were no dose-limiting toxicities, serious adverse events, or no grade ≥3 adverse events reported. The quality of life in rhTSH phase was significantly better than those in THW phase, including the lower Billewicz score (-53.00(-53.00, -53.00) vs -39.50(-47.00, -23.00); S=119.50, P<0.001) and the lower POMS score (91.92±12.06 vs 99.67±19.13; t=0.95, P=0.025). Serum TSH level was increased from 0.04(0.02, 0.11) mU/L (baseline) to 150.00(105.20, 173.31) mU/L 24 h after the last rhTSH administration, which was increased along with the elevation of rhTSH doses. In the THW phase, patients′ TSH levels were≥30 mU/L after 23 d (median) of THW, with the median of 73.51(57.22, 106.22) mU/L. Median Tg level of baseline was 0.10(0.10, 0.41) μg/L, which reached a peak of 0.85(0.12, 3.01) μg/L at 48 h after rhTSH administration. The peak Tg level in the THW phase was 0.88(0.15, 8.04) μg/L. The Dx-WBS consistency rate between rhTSH and THW phase was 95.8%(23/24). Conclusion:rhTSH is a safe and effective method to stimulate the serum Tg level and radioiodine uptake in patients undergoing post-operation or post- 131I assessment for DTC, as well as maintain a higher quality of life in comparison to THW phase.

African swine fever (ASF) is a devastating disease of pigs caused by African swine fever virus (ASFV), which is considered to be the No. 1 killer to the global pig industry. Highly virulent strains are usually responsible for the peracute and acute forms that provoke high mortality rates that may reach 100%. Since ASF was first introduced in August 2018 into China, 137 outbreaks in domestic and wild pigs had been reported from 32 provinces by June 06, 2019, causing severe socioeconomic consequences. Efforts to develop an ASFV vaccine began in the 1960s, but all failed, the major reason is the lack of in-depth research on the biological characteristics of ASFV. It will be a great challenge for China to control the spread of current ASF, develop safe and effective vaccines. In this review, we outline the biological characteristics of ASFV, including its morphology and basic structure, transmission routes, pathogenicity, genome and proteins, entry mechanism, immune escape, and analyzed the difficulties in vaccine development. We hope to provide basic information for the control of current ASF and understanding of etiology in China.

Objective:To investigate factors related to bloodstream infections in patients with catheter-associated urinary tract infections(CAUTI)aged over 80 years.Methods:Clinical data of patients with CAUTI aged 80 years in our hospital from August 2014 to September 2019 were retrospectively analyzed.Independent and relevant factors for bloodstream infections in patients were analyzed by using univariate and multivariate methods with SPSS20.0 statistical software.Results:There were 138 patients with bloodstream infections, giving an infection rate of 9.28%.Univariate and multivariate analysis showed that the timing of catheterization(delayed or no extubation after infection), urinary tract operation, glucocorticoid use, tumor chemotherapy, serum albumin concentration reduction, blood glucose and multi-drug resistant bacterial infection were independent risk factors for bloodstream infections in patients with CAUTI aged over 80 years.Conclusions:Early extubation, blood glucose control, correction of hypoproteinemia, reduction of multi-drug resistant bacterial infection, rational use of glucocorticoids and tumor chemotherapy, and heightened attention to patients undergoing urinary tract surgery can reduce the risk of bloodstream infections in patients with CAUTI aged over 80 years.