Pan-vascular medicine is an emerging discipline focusing on atherosclerotic diseases,with the concept of multidisciplinary integration,emphasizing on exploring the mechanism of disease development from the whole of the organism's structure and function.At present,the basic mechanism system of pan-vascular diseases has yet to be perfected.The pan-vascular concept is highly compatible with the idea of Chinese medicine that focuses on the overall view.Deficiency of all qi is the root cause of pan-vascular diseases,while phlegm,blood stasis,and water-dampness and other tangible evils stagnate in the veins and channels as the symptoms of the disease,therefore,the disease mechanism can be highly summarized as"stagnation due to qi deficiency".Deficiency leads to the stagnation,blocking the veins and channels,and the deficiency worsens due to the stagnation and then damages the veins and channels,thus,it develops into a disease.Based on the theory of"stagnation due to qi deficiency",this paper takes endothelial cell dysfunction as the entry point of pan-vascular diseases,and considers that low endothelial cell immunity is the initiating factor of pan-vascular diseases,and that the widespread persistence of microinflammatory state is the key pathology to pan-vascular diseases.

Although the development of COVID-19 vaccines has been a remarkable success, the heterogeneous individual antibody generation and decline over time are unknown and still hard to predict. In this study, blood samples were collected from 163 participants who next received two doses of an inactivated COVID-19 vaccine (CoronaVac®) at a 28-day interval. Using TMT-based proteomics, we identified 1,715 serum and 7,342 peripheral blood mononuclear cells (PBMCs) proteins. We proposed two sets of potential biomarkers (seven from serum, five from PBMCs) at baseline using machine learning, and predicted the individual seropositivity 57 days after vaccination (AUC = 0.87). Based on the four PBMC's potential biomarkers, we predicted the antibody persistence until 180 days after vaccination (AUC = 0.79). Our data highlighted characteristic hematological host responses, including altered lymphocyte migration regulation, neutrophil degranulation, and humoral immune response. This study proposed potential blood-derived protein biomarkers before vaccination for predicting heterogeneous antibody generation and decline after COVID-19 vaccination, shedding light on immunization mechanisms and individual booster shot planning.
Humans ; COVID-19 Vaccines ; Leukocytes, Mononuclear ; Proteomics ; COVID-19/prevention & control* ; Vaccination ; Antibodies ; Antibodies, Viral ; Antibodies, Neutralizing

Tbx18,Wt1,and Tcf21 have been identified as epicardial markers during the early embryonic stage.However,the gene markers of mature epicardial cells remain unclear.Single-cell transcriptomic analysis was performed with the Seurat,Monocle,and CellphoneDB packages in R software with standard pro-cedures.Spatial transcriptomics was performed on chilled Visium Tissue Optimization Slides(10x Genomics)and Visium Spatial Gene Expression Slides(10x Genomics).Spatial transcriptomics analysis was performed with Space Ranger software and R software.Immunofluorescence,whole-mount RNA in situ hybridization and X-gal staining were performed to validate the analysis results.Spatial transcriptomics analysis revealed distinct transcriptional profiles and functions between epicardial tissue and non-epicardial tissue.Several gene markers specific to postnatal epicardial tissue were identified,including Msln,C3,Efemp1,and Upk3b.Single-cell transcriptomic analysis revealed that cardiac cells from wildtype mouse hearts(from embryonic day 9.5 to postnatal day 9)could be categorized into six major cell types,which included epicardial cells.Throughout epicardial development,Wt1,Tbx18,and Upk3b were consistently expressed,whereas genes including Msln,C3,and Efemp1 exhibited increased expression during the mature stages of development.Pseudotime analysis further revealed two epicardial cell fates during maturation.Moreover,Upk3b,Msln,Efemp1,and C3 positive epicardial cells were enriched in extracellular matrix signaling.Our results suggested Upk3b,Efemp1,Msln,C3,and other genes were mature epicardium markers.Extracellular matrix signaling was found to play a critical role in the mature epicardium,thus suggesting potential therapeutic targets for heart regeneration in future clinical practice.

Aconitine,a common and main toxic component of Aconitum,is toxic to the central nervous system.However,the mechanism of aconitine neurotoxicity is not yet clear.In this work,we had the hypothesis that excitatory amino acids can trigger excitotoxicity as a pointcut to explore the mechanism of neurotoxicity induced by aconitine.HT22 cells were simulated by aconitine and the changes of target cell metabolites were real-time online investigated based on a microfluidic chip-mass spectrometry system.Meanwhile,to confirm the metabolic mechanism of aconitine toxicity on HT22 cells,the levels of lactate dehydrogenase,intracellular Ca2+,reactive oxygen species,glutathione and superoxide dismutase,and ratio of Bax/Bcl-2 protein were detected by molecular biotechnology.Integration of the detected results revealed that neurotoxicity induced by aconitine was associated with the process of excitotoxicity caused by glutamic acid and aspartic acid,which was followed by the accumulation of lactic acid and reduction of glucose.The surge of extracellular glutamic acid could further lead to a series of cascade reactions including intracellular Ca2+overload and oxidative stress,and eventually result in cell apoptosis.In general,we illustrated a new mechanism of aconitine neurotoxicity and presented a novel analysis strategy that real-time online monitoring of cell metabolites can provide a new approach to mechanism analysis.

Objective:To explore the medical experience and staged care needs of patients undergoing ophthalmic ambulatory surgery.Methods:In this qualitative study, 21 ophthalmic ambulatory surgery patients from Henan Provincial Ophthalmology Hospital were selected by purposive sampling for semi-structured in-depth interviews from February to June 2022, and the content of the interviews was analyzed by Colaizzi's analysis.Results:A total of 4 first-level themes were extracted from the content analysis, including medical experience, preoperative preparation-related information needs, nursing needs for postoperative complications, and home rehabilitation nursing and follow-up needs. Among them, the medical experience included saving time for medical treatment, insufficient preoperative preparation, and anxiety.Conclusions:For ophthalmic ambulatory surgery patients, it is necessary to strengthen information support, provide targeted health education for ambulatory surgery, provide psychological and emotional support, and further improve the postoperative rehabilitation management process to enhance the quality of nursing services for ambulatory surgery.

Objective:To retrieve the evidence of scraping operation in patients with neck, shoulder and low back pain, and evaluate and summarize the evidence.Methods:Identified evidence-based problems based on the population, intervention, professional, outcome, setting and type of evidence (PIPOST) model, and searched UpToDate, British Medical Journal (BMJ) Clinical Evidence, Guidelines International Network, Registered Nurses' Association of Ontario, Scottish Intercollegiate Guidelines Network, New Zealand Guidelines Group, World Health Organization, American College of Physicians Club, BMJ Best Practice, Agency for Healthcare Research and Quality, Joanna Briggs Institute Evidence-Based Health Care Center Database, Nursing Consult, China Guideline Clearinghouse, Cochrane Library, Embase, PubMed, CINAHL, Web of Science, Medlive, China National Knowledge Infrastructure and SinoMed. The retrieval time limit was from March 1, 2012 to April 30, 2022. Four researchers independently evaluated the quality of the article, and two researchers summarized the evidence of the included article.Results:A total of 9 articles were included, including 1 guideline, 2 systematic reviews, and 6 randomized controlled trials. A total of 20 pieces of scraping application evidence were extracted from patients with neck, shoulder and low back pain, including 6 aspects, involving preparation before scraping, scraping intervention methods, scraping degree, precautions, contraindications, and handling of abnormal conditions.Conclusions:The best evidence of scraping therapy to improve patients' neck, shoulder and low back pain summarized in this study can provide a reference for improving the operation practice of medical and nursing staffs and nursing outcomes.

Objective:To investigate the effectiveness of scanning glucose monitoring system in dawn phenomenon of patients with type 2 diabetes mellitus (T2DM) based on continuous glucose monitoring system (CGMS) .Methods:A total of 45 patients with T2DM hospitalized in the Endocrine Department of Xinxiang Central Hospital from June 2019 to June 2020 were selected as the research subjects by convenience sampling method. All selected patients were asked to wear the scanning glucose monitoring system after admission, and then the CGMS for continuous glucose monitoring after 48 hours. The scanning glucose monitoring system and the CGMS were taken off at the same time after 72 hours. The blood glucose analysis report of the same period was checked to determine whether the dawn phenomenon occurred. The consistency to determine dawn phenomenon was analyzed between CGMS and scanning blood glucose monitoring by Kappa test. According to the CGMS judgment results, the receiver operating characteristic curve (ROC) of the scanning blood glucose monitoring system was drawn to evaluate the optimal tangent value of the night blood glucose for predicting dawn phenomenon and the next day fasting blood glucose for evaluating dawn phenomenon.Results:Among the 45 study subjects, there was no statistical difference in determining the incidence of dawn phenomena between CGMS and scanning glucose monitoring system [55.56% (25/45) vs. 46.67% (21/45) , χ 2=0.711, P>0.05]. Consistency analysis showed that Kappa value was 0.895, and the consistency of CGMS and scanning glucose monitoring system in judging dawn phenomenon was good (Kappa=0.895, 95% CI 1.130-4.883, P<0.01) . The optimal tangent value of night blood glucose for predicting dawn phenomenon was 8.31 mmol/L, and the optimal tangent value of the next day fasting blood glucose for evaluating dawn phenomenon was 7.25 mmol/L. The value of the area under the ROC curve were 0.729 and 0.803 respectively. Conclusions:Scanning blood glucose monitoring can accurately judge the dawn phenomenon. When the night blood glucose value is 8.31 mmol/L, it indicates that the dawn phenomenon may occur. When the next day's fasting blood glucose value is 7.25 mmol/L, it indicates that the dawn phenomenon may already occur.

Objective:To observe the presence or absence of necroptosis in PC12 cells after radiation injury, and to detect the expression of receptor-interacting protein 3(RIP3) and evaluate its regulatory effect on necroptosis.Methods:PC12 cells were treated with different doses of irradiation and their necroptosis was detected by lactate dehydrogenase (LDH) release at different time points. After pretreatment with necroptosis inhibitor Necrostatin-1(Nec-1), the changes of cell necroptosis were detected by LDH. The expression level of RIP3 after irradiation intervention was detected by Western blot (WB). After pretreatment with the RIP3-specific inhibitor GSK′872, the changes of cell necroptosis were detected by LDH. The best transfection sequence of RIP3 knockout was screened by WB. The cells were divided into the control group, irradiation group, solvent control group, no-load control group and pretreatment group. WB, immunofluorescence staining, MTT, LDH and Annex V-fluorescein Isothiocyanate/Propidium Iodide (AnnexV-FITC/PI) flow cytometry were used for detection and analysis.Results:After 4 Gy irradiation, the degree of cell necrosis was the highest after 3 hours of culture, and the expression level of RIP3 protein was up-regulated. The cell necrosis was decreased after Nec-1, GSK′872 and RIP3 gene knockdown pretreatment.Conclusions:The radiation injury of 4 Gy can induce the necroptosis of PC12 cells, and the most significant effect can be observed when cultured for 3 hours after irradiation. RIP3 is involved in the process of necroptosis of PC12 cells induced by radiation injury, and plays a pivotal positive regulatory role.

Objective To study the safety and short-term clinical outcome of different body mass index (BMI) patients with rectal cancer undergoing laparoscopic total mesorectal excision (TME). Methods The clinical data of 179 rectal cancer patients who had underwent laparoscopic TME from November 2016 to November 2017 were retrospectively analyzed. The patients were divided into 3 groups according to the BMI:leanness group (BMI<18.5 kg/m2, 15 cases), normal group (BMI 18.5 to 22.9 kg/m2, 89 cases) and overweight/obesity group (BMI ≥23.0 kg/m2, 75 cases). The general clinical data and the operation-related situation were compared. Results The rate of preoperative complications in overweight/obesity group was significantly higher than that in leanness group and normal group: 45.33％(34/75) vs. 4/15 and 28.09％(25/89), the preoperative albumin level in leanness group was significantly lower than that in normal group and overweight/obesity group:(36.3 ± 2.8) g/L vs. (38.6 ± 3.2) and (39.1 ± 3.7) g/L, and there were statistical differences (P<0.05). The operation time and blood loss in overweight/obesity group were significantly higher than those in leanness group and normal group: (149.2 ± 32.9) min vs. (129.3 ± 28.7) and (133.5 ± 23.6) min, (135.5 ± 29.0) ml vs. (117.5 ± 22.6) and (122.5 ± 25.9) ml, and there were statistical differences (P<0.05). There were no statistical differences in sex, age, tumor location, tumor maximum diameter, depth of tumor invasion, lymph node metastases, surgical approach, circumferential margin, number of lymph node dissections, length of resected specimens, incidence of postoperative complications, surgical site infection, postoperative urinary retention, postoperative exhaust time and postoperative hospitalization among 3 groups (P>0.05). Conclusions The differences of BMI mean different complications and nutritional status of patients. Overweight and obesity can lead to difficult operation of laparoscopic TME, but do not affect the radical cure of operations and the safety of clinical outcomes.

Objective To investigate the decisional value of susceptibility weighted imaging(SWI) in intravenous thrombolytic therapy to acute cerebral infarction.Methods According to cerebral microbleeds(CMBs) by SWI, 35 cases of acute cerebral infarction in window-time random were divided into experimental group(14 cases) with CMBs and control group(21 cases) without CMBs.After intravenous thrombolysis, the number of hemorrhagic transformation(HT) was counted by SWI, and statistic difference was compared between the experimental group and the control group(P<0.05).Results After intravenous thrombolytic therapy of acute infarction,12 cases with HT among experimental group, and only 2 cases with HT among control group, there was significant statistically difference between two groups(P<0.05).Conclusion SWI sequence has greater sensitivity in detecting CMBs,and can also assess the state of blood brain barrier(BBB) and vascular wall indirectly.It plays a very important role in giving a decision in the treatment of intravenous thrombolytic with window-time.