Objective To compare the efficacy of renal proximal renal artery denervation(pRDN)and full-length renal artery denervation(fRDN)for treatment of hypertension.Methods Fifty-six hypertensive patients were enrolled and randomly assigned to full-length renal artery denervation group(n=25)and proximal renal artery denervation group(n=31).After the procedure,24-hour ambulatory blood pressure monitoring(24 h-ABPM)at 6 months and office blood pressure at 12 months was recorded for statistical analysis.Results The blood pressure at follow-up reduced significantly in both groups,while there was no significant difference between groups.The baseline office blood pressure in fRDN group and pRDN group was(180±15)/(104±10)mmHg and(180±12)/(103±8)mmHg,respectively,which decreased to(142±9)/(82±7)mmHg and(143±10)/(83±6)mmHg at 12 months postoperatively(P＜0.001 within groups and P＞0.05 between groups).The baseline 24 h-ABPM in the two groups was(162±13)/(95±8)mmHg and(160±12)/(94±8)mmHg,respectively,which decreased to(142±11)/(83±7)mmHg and(141±8)/(81±7)mmHg at 6 months postoperatively(P＜0.001 within groups and P＞0.05 between groups).However,there was no significant difference in the reduction of office blood pressure and ambulatory blood pressure between the two groups.No treatment-related adverse events were observed.Conclusions pRDN has similar antihypertensive effect to fRDN.

Objective To investigate the clinical characteristics and prognosis of pneumococcal meningitis(PM),and drug sensitivity of Streptococcus pneumoniae(SP)isolates in Chinese children.Methods A retrospective analysis was conducted on clinical information,laboratory data,and microbiological data of 160 hospitalized children under 15 years old with PM from January 2019 to December 2020 in 33 tertiary hospitals across the country.Results Among the 160 children with PM,there were 103 males and 57 females.The age ranged from 15 days to 15 years,with 109 cases(68.1% )aged 3 months to under 3 years.SP strains were isolated from 95 cases(59.4% )in cerebrospinal fluid cultures and from 57 cases(35.6% )in blood cultures.The positive rates of SP detection by cerebrospinal fluid metagenomic next-generation sequencing and cerebrospinal fluid SP antigen testing were 40% (35/87)and 27% (21/78),respectively.Fifty-five cases(34.4% )had one or more risk factors for purulent meningitis,113 cases(70.6% )had one or more extra-cranial infectious foci,and 18 cases(11.3% )had underlying diseases.The most common clinical symptoms were fever(147 cases,91.9% ),followed by lethargy(98 cases,61.3% )and vomiting(61 cases,38.1% ).Sixty-nine cases(43.1% )experienced intracranial complications during hospitalization,with subdural effusion and/or empyema being the most common complication[43 cases(26.9% )],followed by hydrocephalus in 24 cases(15.0% ),brain abscess in 23 cases(14.4% ),and cerebral hemorrhage in 8 cases(5.0% ).Subdural effusion and/or empyema and hydrocephalus mainly occurred in children under 1 year old,with rates of 91% (39/43)and 83% (20/24),respectively.SP strains exhibited complete sensitivity to vancomycin(100% ,75/75),linezolid(100% ,56/56),and meropenem(100% ,6/6).High sensitivity rates were also observed for levofloxacin(81% ,22/27),moxifloxacin(82% ,14/17),rifampicin(96% ,25/26),and chloramphenicol(91% ,21/23).However,low sensitivity rates were found for penicillin(16% ,11/68)and clindamycin(6% ,1/17),and SP strains were completely resistant to erythromycin(100% ,31/31).The rates of discharge with cure and improvement were 22.5% (36/160)and 66.2% (106/160),respectively,while 18 cases(11.3% )had adverse outcomes.Conclusions Pediatric PM is more common in children aged 3 months to under 3 years.Intracranial complications are more frequently observed in children under 1 year old.Fever is the most common clinical manifestation of PM,and subdural effusion/emphysema and hydrocephalus are the most frequent complications.Non-culture detection methods for cerebrospinal fluid can improve pathogen detection rates.Adverse outcomes can be noted in more than 10% of PM cases.SP strains are high sensitivity to vancomycin,linezolid,meropenem,levofloxacin,moxifloxacin,rifampicin,and chloramphenicol.[Chinese Journal of Contemporary Pediatrics,2024,26(2):131-138]

Objective To analyze the effects of different anastomotic methods on flap survival rate and wound healing factors of patients with transplantation of superficial branch perforator flap of superficial circumflex iliac artery(SCIA).Methods A total of 100 patients with skin defects of limbs admitted to our hospital from January 2019 to August 2022 were selected and divided into end-to-end anastomosis group(56 cases)and end-to-side anastomosis group(44 cases)according to different anastomosis methods.In the end-to-end anastomosis group,the end of the flap artery was anastomosed with the end of the aortic branch in the affected area.In the end-to-side anastomosis group,the end of recipient flap artery was anastomosed with the side of aorta.Patients in both groups were followed up for 6 to 12 months,the arterial caliber,lateral caliber and anastomosis time were compared between the two groups.The survival of the flap,the occurrence of venous crisis,the shape and function of the flap and donor area were observed.Results There was no statistically significant difference in the arterial caliber or lateral caliber of patients between the two groups(P>0.05).The anastomosis time of patients in the end-to-end anastomosis group was significantly shorter than that in the end-to-side anastomosis group(P<0.05).All 56 cases in the end-to-end anastomosis group survived.In the end-to-side anastomosis group,venous crisis occurred in 4 cases,with venous thrombosis,2 cases survived after re-anastomosis,2 cases were changed to abdominal pedicled flap when venous crisis occurred again,the appearance and function of the flap and donor area were satisfactory 6 months to 1 year after surgery(P<0.05).There was no significant difference in color,thickness,vascular distribution or flexibility of donor area of patients between the two groups(P>0.05).There was no significant difference in pain,appearance,vitality and recreation of recipient area of patients between the two groups(P>0.05).Conclusion The application of different arterial anastomosis methods in the transplantation of superficial branch perforator flap of SCIA for the treatment of skin and soft tissue defects of limbs is safe and reliable,the postoperative survival of the flap is good,the healing is not affected by the anastomosis method,and the appearance of the affected area is satisfactory,which is worthy of clinical promotion.

For the treatment of atrial fibrillation,Professor WU Wei innovatively put forward the theory of heart-blood-vessels trinity and the theory of stasis-toxin causing palpitation.It is believed that atrial fibrillation is caused by stasis and toxin,and affects the heart,blood and vessels.The core pathogenesis of atrial fibrillation is due to qi stagnation,blood stasis and toxin.The treatment for atrial fibrillation should be closely based on the pathogenesis,the therapeutic principles of treating from the perspective of stasis and together by removing toxin gradually is advocated.And the therapy of regulating qi,activating blood and removing stasis is also the way to remove toxin.The medication is based on the modified Taoren Honghua Decoction,which is mainly composed of Persicae Semen,Carthami Flos,Chuanxiong Rhizoma,Corydalis Rhizoma,Rehmanniae Radix,Paeoniae Radix Rubra,Salviae Miltiorrhizae Radix et Rhizoma,Jujubae Fructus,Puerariae Lobatae Radix,Nardostachyos Radix et Rhizoma,Ostreae Concha,Poria,and Polygonati Odorati Rhizoma.According to the characteristics of Lingnan climate and atrial fibrillation mostly being easy to affect the emotions,the pungent drugs in the prescription are usually removed,and the specific herbal pair of Puerariae Lobatae Radix-Nardostachyos Radix et Rhizoma is added to remove toxin according to the differentiation of disease.Moreover,for the treatment of atrial fibrillation,Professor WU Wei also adopts traditional Chinese medicine(TCM)external treatment such as foot bath,acupuncture and moxibustion,and physical-breathing exercise as well as health-care methods for comprehensive regulation,relieving the toxin and restoring the original qi.During the treatment atrial fibrillation,Professor WU Wei follows the principle of precise intervention and comprehensive regulation with Chinese medicine,so as to achieve the purpose of eliminating symptoms,restoring sinus rhythm and improving physical constitution.The thoughts of Professor WU Wei for the syndrome differentiation and treatment of atrial fibrillation will provide reference for the treatment of atrial fibrillation with TCM.

Objective To explore the effect of Mongolian medicine Naru-3 pills on the treatment of neuropathic pain(NP)with pregabalin combined with nerve block.Methods Forty-one hospitalized pa-tients in the department of pain medicine diagnosed with NP from October 2022 to September 2023 were se-lected,including 20 males and 21 females,aged 40-80 years,BMI≥18.5 kg/m2.The patients were di-vided into two groups by random number table method:Mongolian medicine Naru-3 pills group(observation group,n=20)and conventional treatment group(control group,n=21).The control group received conventional treatment:oral pregabalin capsule combined with ultrasound-guided nerve block in pain area.The observation group was added oral administration of Mongolian medicine Naru-3 pills(2 g/10 capsules)on the basis of conventional treatment,taking 3-5 capsules orally before going to bed every night for 2 weeks.The numerical rating scale(NRS)pain score,short-form McGill pain questionnaire(SF-MPQ)score,and Pittsburgh sleep quality index(PSQI)were recorded before treatment and 2 weeks,1 month,and 2 months after the treatment.The serum concentrations of IL-6,IL-8,IL-1β,and TNF-α were detected by enzyme-linked immunosorbent assay(ELISA)1 day before treatment and 2 weeks after treatment.Occur-rence of adverse reactions during treatment such as nausea,vomiting,bloating,palpitations,drowsiness,and dizziness were recorded.Results Compared with 1 day before treatment,NRS pain score,SF-MPQ score,and PSQI were lower in both groups 2 weeks,1 month,and 2 months after the treatment(P＜0.05),the serum concentrations of IL-6,IL-1β,and TNF-α were reduced in both groups 2 weeks after the treatment(P＜0.05).Compared with the control group,NRS pain score,SF-MPQ score,and PSQI were lower in the observation group 2 weeks,1 month,and 2 months after the treatment(P＜0.05);the serum concentrations of IL-6,IL-1 β,and TNF-α were reduced in the observation group 2 weeks after the treatment(P＜0.05).There was no significant difference in the incidence of adverse reactions between the two groups.Conclusion Mongolian Naru-3 pills combined with conventional therapy can effectively reduce the pain of NP patients,improve the quality of sleep of patients,and may have the effect of regulating neuroinflammation.

The blood-brain barrier (BBB) plays a crucial role in maintaining the homeostasis of the brain's internal environment, which poses challenges to the treatment of central nervous system diseases. Drug carriers can aid in the delivery of therapeutic agents across the BBB to exert their pharmacological effects. The article reviewed the pathways for drug delivery across the BBB, the intracerebral fate and the classification of drug carriers and focuses on the functions and characteristics of liposomes, exosomes, apoptotic bodies, cell-penetrating peptides, and cell-targeting peptides. The review will provide an outlook on the future and challenge of research in the field of drug delivery across the BBB.

This study is based on ultra-high-performance liquid chromatography(UPLC), gas chromatography-mass spectrometry(GC-MS), and network pharmacology methods to analyze and predict potential quality markers(Q-markers) of Artemisiae Argyi Folium. First, UPLC and GC-MS techniques were used to analyze the content of 12 non-volatile components and 8 volatile components in the leaves of 33 Artemisia argyi germplasm resources as candidate Q-markers. Subsequently, network pharmacology was employed to construct a "component-target-pathway-efficacy" network to screen out core Q-markers, and the biological activity of the markers was validated using molecular docking. Finally, cluster analysis and principal component analysis were performed on the content of Q-markers in the 33 A. argyi germplasm resources. The results showed that 18 candidate components, 60 targets, and 185 relationships were identified, which were associated with 72 pathways related to the treatment of 11 diseases and exhibited 5 other effects. Based on the combination of freedom and component specificity, six components, including eupatilin, cineole, β-caryophyllene, dinatin, jaceosidin, and caryophyllene oxide were selected as potential Q-markers for Artemisiae Argyi Folium. According to the content of these six markers, cluster analysis divided the 33 A. argyi germplasm resources into three groups, and principal component analysis identified S14 as having the highest overall quality. This study provides a reference for exploring Q-markers of Artemisiae Argyi Folium, establishing a quality evaluation system, further studying its pharmacological mechanisms, and breeding new varieties.
Molecular Docking Simulation ; Network Pharmacology ; Plant Breeding ; Chromatography, High Pressure Liquid/methods* ; Gas Chromatography-Mass Spectrometry ; Artemisia/chemistry* ; Drugs, Chinese Herbal/chemistry*

BACKGROUND: Myocardial ischemia-reperfusion (I/R) is a serious and irreversible injury. Bone marrow-derived mesenchymal stem cells (MSCs) is considered to be a potential therapy for I/R injury due to the paracrine effects. High-mobility group box 1 (HMGB1) is a novel mediator in MSC and regulates the response of inflammation injury. Signal Transduction and Transcription Activator 3 (STAT3) is a critical transcription factor and important for release of paracrine factors. However, the relationship between HMGB1 and STAT3 in paracrine effect of MSC remains unknown. METHODS: In vitro, hypoxia/reoxygenation injury model was established by AnaeroPack System and examined by Annexin V flow cytometry, CCK8 assay and morphology observation. Detection of apoptotic proteins and protein expression of HMGB1 and STAT3 by Western blot. RESULTS: The conditioned medium of MSCs with or without LPS pretreatment was cocultured with H9C2 cells for 24 h before hypoxia treatment and MSC showed obvious cardiomyocytes protect role, as evidence by decreased apoptosis rate and improved cells viability, and LPS pretreated MSC exhibited better protect role than untreated MSC. However, such effect was abolished in HMGB1 deficiency group, silencing HMGB1 decreased the secretion of vascular endothelial growth factor (VEGF), hepatocyte growth factor (HGF), insulin growth factor (IGF), cell viability, and the expression of STAT3. Furthermore, STAT3 silence attenuated the protective effect of LPS in MSC. CONCLUSIONS These findings suggested that LPS improved MSC-mediated cardiomyocytes protection by HMGB1/STAT3 signaling.

Tumor brings great threat to human public health. In recent years, incidence rate and mortality of tumor were rapidly increased in the world. Anti-tumor therapies have undergone the development of cytotoxic therapy, targeted therapy, and immunotherapy. Among them, tumor immunotherapy is rapidly developed and becomes an important anti-tumor therapy in recent years, although it also brings some related side effects. Tumor microenvironment (TME) is composed of immune cells, vascular vessels, fibroblasts, the extracellular matrix, etc. TME significantly affects the efficacy of immunotherapy. Macrophages in the TME are named as tumor associated macrophages (TAMs). Recently, increasing studies have shown that TAMs play an important role in the regulation of tumor immunity, especially in tumor immune surveillance and immune escape. Currently, more and more anti-tumor immunotherapy strategies targeting TAMs are at the development stage. Based on the important role of TAMs in the TME and their potential as therapeutic targets in tumor immunotherapy, we first reviewed the subtypes and functions of TAMs, as well as the roles of TAMs in tumors. Furthermore, we summarized the research progress on anti-tumor strategies targeting TAMs and the current status of drug targeting TAMs. The current review will provide new ideas and novel insights for tumor immunotherapy.

Objective:To evaluate the effect of Mongolian medicine Eerdun Wurile on postoperative cognitive function in elderly patients undergoing thoracoscopic lobectomy.Methods:Sixty elderly patients of either gender, aged ≥60 yr, of American Society of Anesthesiologists Physical Status classification Ⅱ or Ⅲ, with body mass index≤28 kg/m 2, with preoperative Mini-Mental State Examination (MMSE) score ≥27 points, undergoing thoracoscopic lobectomy under general anesthesia, were divided into 2 groups ( n=30 each) using the random number table method: control group (group C) and Eerdun Wurile group (group E). Eerdun Wurile 15 capsules per day were taken for 7 consecutive days starting from 3 days before surgery in group E, and placebo was given instead in group C. The peripheral venous blood samples were collected before medication at 3 days before surgery (T 1) and 24 and 72 h after surgery (T 2, 3) for determination of the concentrations of serum brain-derived neurotrophic factor (BDNF), interleukin-1beta (IL-1β), tumor necrosis factor-alpha (TNF-α) and Tau proteins by enzyme-linked immunosorbent assay. The patients′ cognitive function was assessed by MMSE at T 1 and 5 days after surgery (T 4), and the occurrence of cognitive decline (MMSE score < 27) was recorded. Results:Compared with group C, the serum BDNF concentration was significantly increased at T 2 and T 3, and the concentrations of IL-1β, TNF-α and Tau protein were decreased, the MMSE score was increased at T 4, and the incidence of cognitive decline was decreased in group E ( P<0.05). Conclusions:Mongolian medicine Eerdun Wurile can improve postoperative cognitive function in elderly patients undergoing thoracoscopic surgery, and the mechanism may be related to reduction of systemic inflammatory responses and promotion of nerve cell repair and regeneration.