Heart rate recovery,a widely used indicator in clinical evaluation of the autonomic nervous system,refers to the difference between maximum heart rate during exercise and the heart rate after 1 or a few minutes of cessation.It possesses advantages of being noninvasive and repeatable.Currently,heart rate recovery is extensively applied in cardiovascular diseases for evaluating disease severity,prognosis,risk of cardiovascular events,and mortality.This article primarily discusses the application value and current research progress of heart rate recovery in cardiovascular diseases.

Objective To investigate the safety and short-term efficacy of π-shaped anastomosis and circular anastomosis(reverse puncture device)in reconstruction of esophagojejunostomy after laparoscopic total gastrectomy.Methods A retrospective study was used to collect the clinical and pathological data of 75 cases of gastric cancer from January 2019 to March 2021.According to the different reconstruction methods of esophagojejunal anastomosis,the patients were divided into a linear cutting obturator group(π-shaped anastomosis group,n = 27)and a circular anastomat anastomosis group(reverse puncture device group,n = 48).The general information of the two groups,operation time,esophagojejunostomy time,intraoperative bleeding volume,number of intraoperative lymph node dissection,intraoperative complications,and postoperative complications were compared and analyzed.Results The operation time and esophagojejunostomy time in the π-shaped anastomosis group were(221.5±8.8)and(34.7±3.7)min,and the reverse puncture device group were and(246.9±5.6)and(47.2±4.6)min,respectively,the differences were statistically significant(t = 15.19,t = 11.81,P＜0.05).There were no statistical significance in the comparison of intraoperative bleeding volume and number of intraoperative lymph node dissection between the two groups(P＞0.05).In the reverse puncture device group,there were two intraoperative complications,including one case of esophageal jejunal anastomosis atresia and one case of anastomosis tear,postoperative complications occurred in 3 cases,postoperative anastomotic stenosis occurred in 2 case,and anastomotic bleeding occurred in 1 case.Conclusion Laparoscopic total esophagojejunostomy with π-shaped anastomosis and reverse puncture device are safe and feasible.In terms of esophagojejunostomy time,π-shaped anastomosis reconstruction time is shorter.When the small intestine diameter is relatively small and it is difficult to extend into the 25 mm stapler,the advantage of π-shaped anastomosis is more obvious.When the tumor is Siewert type Ⅰ and type Ⅱ adenocarcinoma of gastroesophageal junction,which infiltrates into above the dentate line,reverse puncture device method is recommended for reconstruction.

【Objective】 To analyze the profile of perioperative allogenic blood transfusion for single disease in patients who underwent spinal deformity correction surgery and risk factors of the blood transfusion, in order to provide reference for clinical decision making. 【Methods】 Clinical data from medical record homepage of 292 patients who underwent elective spinal deformity correction surgery at Chengdu Third People′s Hospital from January 2015 to December 2017 were retrospectively analyzed. Statistical analysis of the transfusion profile of allogeneic blood based on the type of single disease in patients undergoing correction surgery was performed. Multiple factor linear regression analysis was used to identify the risk factors of perioperative allogenic blood transfusion in patients with spinal deformity correction surgery. Hospital length of stay and discharge status were compared between transfusion group and non-transfusion group using Mann Whitney U test and chi-square test respectively. 【Results】 The year prevalence of perioperative allogeneic blood transfusion from 2015 to 2017 were 90.38%(47/52), 93.62%(44/47) and 81.35%(157/193), respectively. The prevalence of perioperative allogeneic blood transfusion in patients with kyphotic deformity in ankylosing spondylitis, kyphosis, adolescent idiopathic scoliosis, scoliosis and spinal stenosis were 89.08%(106/119)、79.49%(62/78)、95.24%(40/42)、84.38%(27/32) and 61.90%(13/21), respectively. Multivariate linear regression analysis showed that the regression coefficients for age and osteotomy were -0.060 (P<0.05) and 2.060 (P<0.05), respectively. Compared with non-transfusion group, the transfusion group had longer hospital length of stay (P<0.05). 【Conclusion】 Perioperative allogeneic blood transfusion in patients with spinal deformity correction surgery is closely related to the type of single disease. Age is a protective factor for perioperative allogeneic blood transfusion, while osteotomy is a risk factor for perioperative allogeneic blood transfusion in patients undergoing the spinal deformity correction surgery. Perioperative blood transfusion can also prolong the hospital length of stay of the patients.

Objective:To retrieve, evaluate and summarize the best evidence for the prevention and management of stress urinary incontinence in pregnant and postpartum patients, and provide a reference for the standardized management of clinical medical staff.Methods:All domestic and international evidences on the prevention and management of stress urinary incontinence during pregnancy and postpartum patients were systematically searched, including clinical decisions, guidelines, expert consensus and systematic reviews. The retrieval time limit was from the establishment of the database to March 20, 2022. Two researchers independently conducted literature screening and quality evaluation, and extracted and summarized the included literature.Results:A total of 10 articles were included, including 1 clinical decision, 3 guidelines and 6 systematic reviews. A total of 29 pieces of best evidence were summarized from five aspects, including risk factors, risk assessment, intervention measures, education and training and follow-up.Conclusions:This study summarizes the best evidence for the prevention and management of stress urinary incontinence in pregnant and postpartum patients. Clinicians should refer to the best evidence and combine the patient's own condition to conduct standardized management of the disease.

【Objective】 To explore the feasibility of tirofiban, a platelet surface glycoprotein (GP)Ⅱb/Ⅲa receptor antagonist intervene in transfusion-related acute lung injury (TRALI), by inhibiting platelet activation and by preventing platelet and neutrophil binding to form aggregates. 【Methods】 1) Fifty wild-type male Balb/c mice, aged 8 to 10 weeks, were randomly divided into TRALI, normal, tirofiban TRALI intervention, isotype control and tirofiban normal intervention groups. In the TRALI model, tirofiban TRALI intervention and isotype control groups, each mouse was injected intraperitoneally with lipopolysaccharide (LPS) 0.1 mg/kg, and after 18 h with 4.5 mg/kg anti-MHC-I or IgG2a isotype control antibody, in which 0.5 μg/g tirofiban was injected 30 min before anti-MHC-I injection, and was labeled as tirofiban TRALI intervention. The group without any treatment was set as normal group. The tirofiban normal intervention group was injected with only 0.5 μg/g tirofiban into the tail vein, 30 min before the injection of anti-MHC-I. 2) After antibody injection, the mice were observed for 2 h, then executed with their lungs removed, and the extent of lung injury and the intervention effect of tirofiban were analyzed by comparing the differences in lung dry to wet ratio, total protein, myeloperoxidase (MPO), inflammatory factors and quantitative results of HE staining. The platelet activation level in whole blood and immunofluorescence (IF) quantification of platelet and neutrophil fluorescence were detected by flow cytometry to analyze the mechanism of tirofiban on TRALI. 【Results】 1) The indexes of lung injury in the tirofiban TRALI intervention group and TRALI model group for HE staining were 0.663 3±0.141 9 vs. 0.173 3±0.120 4 (P<0.05), respectively; 2) Platelet activation levels(%)in whole blood in the TRALI group, normal group and tirofiban TRALI intervention group were 22.87±9.943 vs 5.070±2.234 vs 5.767±3.224(P<0.05), respectively. 3) The mean fluorescence density of platelet neutrophil aggregates for IF detection in the tirofiban intervention group and TRALI model group was 21.89±3.536 vs. 32.77±0.9624 (P<0.05). 【Conclusion】 The platelet GP Ⅱ b/Ⅲa-specific inhibitor tirofiban inhibited platelet-neutrophil binding in mice, thus could possibly intervene in TRALI.

Objective:To explore the development status, research hotspots and trends in this field in the past 20 years through the visual analysis of the related literature on stigma in China, so as to provide reference for the future related research in China.Methods:Literatures related to stigma published from January 1, 2000 to January 28, 2022 were retrieved from CNKI, Wanfang and VIP databases. CiteSpace 5.8.R3 software was used for visual analysis.Results:A total of 1 086 papers were included, and the number of published papers on stigma research was on the rise. The author with the largest number of papers was Zhou Ying. At present, a core group of authors had been formed in the research field, and the authors mainly cooperated within the team, with less inter-institutional cooperation. Institutions that published more papers were concentrated in the affiliated hospitals of universities in Shanghai, Guangzhou, and Beijing.Research hotspots focused on influencing factors, quality of life, social support and coping styles. Research fronts were self-efficacy, nursing and narrative nursing.Conclusions:In the past 20 years, the research on stigma has attracted widespread attention, and related literature has been emerging, but there is little cooperation between authors, and the geographical distribution of publishing institutions is uneven. In order to promote the development of stigma research in China, cross-author, cross-regional, and cross-institutional exchanges and cooperation should be strengthened in the future to improve the quality and level of stigma research in China.

Transfusion-related acute lung injury (TRALI), with clinical manifestation, diagnosis and pathological mechanism consistent with acute lung injury(ALI), belongs to a sub-category of ALI. Excessive deposition of fibrin in lung is one of the characteristic of ALI, and reversing fibrin formation is of great significance to intervene ALI. The decrease of fibrinolytic activity is one of the important causes of excessive deposition of fibrin in lung, and also the important pathological feature of TRALI. This article discusses the potential of modulating fibrinolytic activity to intervene TRALI from the perspective of regulating the effectiveness of fibrinolytic activity to intervene ALI.

【Objective】 To explore the efficacy and possible mechanisms of activation of Death receptor 3 (DR3) signaling pathway in the prevention of antibody-mediated transfusion-related acute lung injury (TRALI) via DR3 agonistic (αDR3) antibody. 【Methods】 8-10-week-old male wild-type Balb/c mice (40) were randomly divided into Naïve group, isotype control group, TRALI model group, and intervention group. Mice without any treatment served as Naïve group. Isotype and TRALI model were established by intraperitoneally priming 8-10-week Balb/c mice with LPS 18 h prior to injection of an IgG2a isotype antibody and anti-MHC-Ⅰ antibody via tail vein, respectively. Intervention group: mice were intraperitoneally injected with a single dose of αDR3 antibody (1 mg/kg) on day 1; after 3 days, the mice were challenged with LPS 18 h prior to injection of an anti-MHC-I antibody. The lung tissues and spleens of mice in each group were collected at the mice died or 2 hours after TRALI modeling for the lung injury severity. Spleens were collected to measure the proportion of Treg by flow cytometry. Foxp3, iNOS, and CD206 immunohistochemical staining combining with optical density analysis of lung tissues were used to represent Treg, M1 macrophages and M2 macrophages, respectively. The concentration of IL-6, IL-1β, TNF-α, and IL-10 cytokines in lung tissues was detected via Cytometric Beads Array. 【Results】 Compared with TRALI group, 1) the lung injury of mice were significantly alleviated in intervention group; 2) the proportion of Treg(%) in the spleens (9.295±1.349 vs 2.257±0.610, P<0.05), Foxp3 expression of Treg in the lungs (0.302 6±0.052 6 vs 0.230 2±0.016 3, P<0.05), and the concentration of Treg derived cytokines IL-10 in the lungs (29.52±8.885 vs 8.045±1.911, P<0.05) increased significantly in intervention group; 3) the iNOS expression of M1 macrophages (0.209 6±0.013 9 vs 0.279 6±0.045 2) and the concentration of M1 macrophage derived cytokines IL-6 (23.22±19.35 vs 301.1±157.7), IL-1β (46.76±25.34 vs 307.6±183.8), and TNF-α (45.99±14.16 vs 143.9±44.43) in the lungs was significantly reduced(P<0.05), while CD206 expression of M2 macrophages (0.291 2±0.032 1 vs 0.221 5±0.012 7) and the concentration of M2 macrophage derived IL-10 cytokines (29.52±8.885 vs 8.045±1.911) in the lungs increased significantly in intervention group(P<0.05). 【Conclusion】 Activation of DR3 signaling pathway by αDR3 antibody prevents antibody-mediated TRALI via expanding Treg, which regulates macrophage polarization by IL-10 derived from Treg.

Objective To analyze the epidemiological characteristics of morning hypertension in people with eseential hypertension in Dali Bai autonomous prefecture,and to study the management model for morning hypertension. Methods From May 2015 to January 2017,302 patients with hypertension in the People's Hospital of Dali Bai Autonomous Prefecture were divided voluntarily into two groups,including single management group (group 1)and systematic management group (group 2 ).During six to twelve months follow －up,the changes in control rate of morning hypertension,serum biochemical indicators,KAP and Mofisky score were observed before and after intervention. Results The proportion of morning hypertension in people with hypertension was 62.25%,61.11% in men and 62.86%in females.The patients with morning hypertension had higher age,BMI,WC,TC,LDL－C,SBP,DBP,CRP, FBG,SCr,Sokolow－Lyon,Cornell,LVMI,UACR and MAU,more cervical plaque,and lower HDL －C and eGFR compared with non－morning hypertension(P＜0.05 －0.001).The number of patients with target organ damage was most in patients with morning hypertension by home blood pressure monitoring(HBPM),second in ambulatory blood pressure monitoring(ABPM),least in clinic blood pressure monitoring (CBPM)(P＜0.05 －0.001).After six to twelve months follow－up,compared with before intervention,the control rate of morning hypertension was increased (43.78%vs.61.39%),and SBP,DBP,HR,BMI,WC,TC,TG,UA,Scr were decreased in both two groups,which in the group 2 were lower than those in the group 1(P＜0.05 ).Compared with before intervention,the KAP score and Mofisky in the two groups after intervention were significantly improved(P＜0.05－0.01)[K score:(9.63 ±3.01)points vs.(14.26 ±2.89)points in the group 1,(10.11±2.34)points vs.(17.23 ±1.06)points in the group2;A score:(2.05 ±1.21)points vs.(2.98 ±0.25)points in the group 1,(2.08 ±1.65)points vs.(3.56 ±0.42)points in the group 2,P score:(4.39 ±2.36)points vs.(5.89 ±3.24)points in the group 1,(4.71±3.42)points vs.(7.26 ± 1.21)points in the group 2,Mofisky questionnaire score:(61.23 ±5.79)points vs.(72.36 ±6.18)points in the group 1,(60.89 ±6.47)points vs.(88.45 ±5.48)points in the group 2],which in the group 2 were higher than those in the group 1(P＜0.01).Conclusion The control rate of morning hypertension in patients with hypertension in Dali Bai autonomous prefecture is low,the HBPM is better way to predict the target organ damage,and systematic management model is effective to improve the control rate of morning hypertension and so do in KAP and Morisky score.

Objective To investigate the effect of glucose supplement on AMPK activation in myocardium of exercised rats by measuring the myocardial AMPK activation and glycogen content after acute exercise training.Methods Rats were subjected to an acute endurance exercise and glucose supplement in varying doses and time points before and after exercise.The dynamic changes of myocardial AMPK activities was measured with Western blotting, changes of myocardial glycogen content were measured with Anthrone method.Results AMPK activation in myocardium of exercised rat was increased significantly throughout the exercise, and remained at a higher level 1 hour after acute exercise.However the level of AMPK activity was not significantly increased in exercised rat with glucose supplement.Glycogen content was not significantly changed after exercise.Rats subjected to lower dose glucose supplement did not show significant changes in glycogen content neither.But glycogen content was significantly increased in rats at 24 hours after exercise, subjected to higher dose of glucose supplement.Conclusions 1) Acute exercise induces a significant increase in AMPK activation in myocardium of exercised rats.Glucose supplement significantly inhibites the activation of AMPK induced by acute exercise.(2) Higher dose glucose supplement significantly increases glycogen content in the rat myocardium 24 h after exercise.