ObjectiveTo investigate the mechanism by which Wendantang regulates the silent information regulator 3 （SIRT3）/peroxisome proliferator-activated receptor-gamma coactivator-1α （PGC-1α） pathway to influence energy metabolism and thereby prevent and treat myocardial ischemia （MI） in a rat model of hyperlipidemia （HL）. MethodsThirty SD rats were randomly assigned into five groups： control， model， low-dose （3.702 g·kg^-1·d^-1） Wendantang， high-dose （7.404 g·kg^-1·d^-1） Wendantang， and positive control （trimetazidine， 0.006 g·kg^-1·d^-1）， with six rats in each group. The control group was fed normally， while the other groups were fed with a high-fat diet for six weeks for the modeling of HL. Subsequently， the drug intervention groups were administrated with corresponding drugs by gavage， and the control and model groups received an equivalent volume of normal saline for 14 days. One hour after the last gavage， the other groups except the control group were injected intraperitoneally with posterior pituitary hormone （30 U·kg^-1） to induce MI. Electrocardiography （ECG） was employed to detect changes in the electrocardiogram. Hematoxylin-eosin staining was performed to observe cardiac pathological changes. Enzyme-linked immunosorbent assay was employed to measure the serum levels of cardiac troponin I（cTnI）， myoglobin （MYO）， and creatine kinase-MB （CK-MB）. Colorimetry was used to determine the levels of total cholesterol （TC） and triglycerides （TG） in the serum and ATP， malondialdehyde （MDA）， and superoxide dismutase （SOD） in the myocardial tissue. Western blot was employed to determine the protein levels of SIRT3， PGC-1α， adenosine monophosphate-activated protein kinase （AMPK）， and phosphorylated AMPK （p-AMPK） in the myocardial tissue. Real-time PCR was employed to measure the mRNA levels of SIRT3， PGC-1α， and AMPKα in the myocardial tissue. ResultsCompared with the control group， the model group showed significant J-point deviation and elevation in the ECG image， increased heart rate， disarrangement of myocardial fibers with unclear boundaries， elevated levels of CK-MB， cTnI， MYO， TC， and TG （P<0.05， P<0.01）， declined levels of SOD and ATP （P<0.01）， down-regulated mRNA levels of SIRT3， PGC-1α， and AMPK （P<0.05）， and down-regulated protein levels of SIRT3， PGC-1α， and p-AMPK （P<0.05）. Compared with the model group， the low-dose and high-dose Wendantang groups and the trimetazidine group showed inhibited J-point deviation and elevation in the ECG image， slowed heart rate， reduced inflammatory cell infiltration， alleviated disarrangement of myocardial fibers， declined levels of CK-MB， cTnI， MYO， TC， and TG （P<0.05， P<0.01）， elevated level of SOD （P<0.01）， up-regulated mRNA levels of SIRT3， PGC-1α， and AMPK （P<0.05， P<0.01） and up-regulated protein levels of SIRT3， PGC-1α， and p-AMPK （P<0.05， P<0.01）. ConclusionWendantang can effectively intervene in HL-associated MI in rats by reducing oxidative stress in myocardial cells， alleviating lipid metabolism disorders， and improving myocardial energy metabolism via the SIRT3/PGC-1α signaling pathway.

Objective To evaluate the surgical efficacy of unilateral pneumonectomy for the treatment of tuberculous destroyed lung, analyze the causes of severe postoperative complications, and explore clinical management strategies. Methods A retrospective analysis was conducted on the clinical data of patients with tuberculous destroyed lung who underwent unilateral pneumonectomy at the Public Health Clinical Center of Chengdu from 2017 to 2023. Postoperative severe complications were statistically analyzed. Patients were divided into a non-severe complication group and a severe-complication group, and the causes, management, and outcomes of complications were analyzed. Results A total of 134 patients were included, comprising 69 males and 65 females, with a mean age of 17-73 (40.43±12.69) years. There were 93 patients undergoing left pneumonectomy and 41 patients undergoing right pneumonectomy. Preoperative sputum smear was positive in 35 patients, all of which converted to negative postoperatively. There were 58 patients with hemoptysis preoperatively, and none experienced hemoptysis postoperatively. Postoperative incisional infection occurred in 8 (5.97%) patients, and postoperative pulmonary infection in 26 (19.40%) patients. Severe postoperative complications occurred in 17 (12.69%) patients, including empyema in 9 (6.72%) patients, bronchopleural fistula with empyema in 1 (0.75%) patient, severe pneumonia in 3 (2.24%) patients, postpneumonectomy syndrome in 1 (0.75%) patient, chylothorax in 1 (0.75%) patient, ketoacidosis in 1 (0.75%) patient, and heart failure with severe pneumonia in 1 (0.75%) patient. Perioperative mortality occurred in 2 (1.49%) patients, both of whom underwent right pneumonectomy. Multivariate logistic regression analysis revealed that a history of ipsilateral thoracic surgery, concomitant Aspergillus infection, and greater blood loss were independent risk factors for severe complications following unilateral pneumonectomy for tuberculous destroyed lung (P<0.05). Conclusion Unilateral pneumonectomy for patients with tuberculous destroyed lung can significantly improve the clinical cure rate, sputum conversion rate, and hemoptysis cessation rate. However, there is a certain risk of severe perioperative complications and mortality, requiring thorough perioperative management and appropriate management of postoperative complications.

Objective To investigate whether the gastric juice volume(GV)of obese women who took carbohydrate 2 hours before operation was equal to or less than that of those who are not routine drinking.Methods Obese patients undergoing elective laparoscopic gynecological surgery under general anesthesia with BMI of 28-32 kg/m2 and ASA grade of Ⅰ-Ⅱ,aged 18-65 years old were selected.The patients were divid-ed into the carbohydrate group(CHO group)and the fasting group(Control group)by random number table method,with 51 cases in each group.The Control group was fasted from 11 pm before surgery,while the CHO group was given 300 mL of carbohydrate orally 2 hours before anesthesia.The main outcome measure was compared with a non-inferiority limit(△)of 17 mL and the mean difference in gastric juice volume between the two groups in the right lateral decubitus position(RLDP)examined by gastric ultrasound.The secondary outcome measures included CSA in right lateral position under gastric ultrasound,Perlas classification,GV/kg,gastric juice pH value,patient satisfaction and gastric emptying time.Results The mean difference of gas-tric juice volume was 7.18 mL(95％CI:-0.06 to 14.43),and the upper limit of 95％CI was lower than the preset non-inferiority limit(△=17.05 mL).There was no statistically significant difference in the mean(standard deviation)gastric juice volume between the control group and the CHO group[40(26,66)mL vs.58(34,65)mL;P=0.43].The gastric volume GV/kg was similar in the two groups(P=0.66),and there was no significant difference in the number distribution of Perlas grades between the two groups(P＞0.05).There was significant difference in patient satisfaction between the two groups(P＜0.05).Conclusion Ac-cording to the evaluation of gastric ultrasound,compared with fasting at midnight,300ml carbohydrate intake at 2 hours before surgery is not inferior to fasting at midnight in terms of gastric fluid volume in obese women as assessed by gastric ultrasound.

It uses research methods such as questionnaire surveys and in-depth interviews with key informants to investigate the quantitative data,settlement costs,satisfaction,and other actual operations of the"dual channel"electronic prescription circulation and medical insurance online settlement pilot project in Shenzhen in June 2022.It explores and analyzes its advantages in effectively eliminating counterfeit paper prescriptions,real-time sharing of pharmacy inventory,transparency of drug prices,and limitations in prescription circulation coverage.And it makes suggestions for optimizing the prescription review process,such as creating a unified and standardized prescription circu-lation model,constructing a standardized and efficient management system for purchased drug catalogs,and strengthening information privacy and data security,are proposed.

It uses research methods such as questionnaire surveys and in-depth interviews with key informants to investigate the quantitative data,settlement costs,satisfaction,and other actual operations of the"dual channel"electronic prescription circulation and medical insurance online settlement pilot project in Shenzhen in June 2022.It explores and analyzes its advantages in effectively eliminating counterfeit paper prescriptions,real-time sharing of pharmacy inventory,transparency of drug prices,and limitations in prescription circulation coverage.And it makes suggestions for optimizing the prescription review process,such as creating a unified and standardized prescription circu-lation model,constructing a standardized and efficient management system for purchased drug catalogs,and strengthening information privacy and data security,are proposed.

It uses research methods such as questionnaire surveys and in-depth interviews with key informants to investigate the quantitative data,settlement costs,satisfaction,and other actual operations of the"dual channel"electronic prescription circulation and medical insurance online settlement pilot project in Shenzhen in June 2022.It explores and analyzes its advantages in effectively eliminating counterfeit paper prescriptions,real-time sharing of pharmacy inventory,transparency of drug prices,and limitations in prescription circulation coverage.And it makes suggestions for optimizing the prescription review process,such as creating a unified and standardized prescription circu-lation model,constructing a standardized and efficient management system for purchased drug catalogs,and strengthening information privacy and data security,are proposed.

It uses research methods such as questionnaire surveys and in-depth interviews with key informants to investigate the quantitative data,settlement costs,satisfaction,and other actual operations of the"dual channel"electronic prescription circulation and medical insurance online settlement pilot project in Shenzhen in June 2022.It explores and analyzes its advantages in effectively eliminating counterfeit paper prescriptions,real-time sharing of pharmacy inventory,transparency of drug prices,and limitations in prescription circulation coverage.And it makes suggestions for optimizing the prescription review process,such as creating a unified and standardized prescription circu-lation model,constructing a standardized and efficient management system for purchased drug catalogs,and strengthening information privacy and data security,are proposed.

It uses research methods such as questionnaire surveys and in-depth interviews with key informants to investigate the quantitative data,settlement costs,satisfaction,and other actual operations of the"dual channel"electronic prescription circulation and medical insurance online settlement pilot project in Shenzhen in June 2022.It explores and analyzes its advantages in effectively eliminating counterfeit paper prescriptions,real-time sharing of pharmacy inventory,transparency of drug prices,and limitations in prescription circulation coverage.And it makes suggestions for optimizing the prescription review process,such as creating a unified and standardized prescription circu-lation model,constructing a standardized and efficient management system for purchased drug catalogs,and strengthening information privacy and data security,are proposed.

It uses research methods such as questionnaire surveys and in-depth interviews with key informants to investigate the quantitative data,settlement costs,satisfaction,and other actual operations of the"dual channel"electronic prescription circulation and medical insurance online settlement pilot project in Shenzhen in June 2022.It explores and analyzes its advantages in effectively eliminating counterfeit paper prescriptions,real-time sharing of pharmacy inventory,transparency of drug prices,and limitations in prescription circulation coverage.And it makes suggestions for optimizing the prescription review process,such as creating a unified and standardized prescription circu-lation model,constructing a standardized and efficient management system for purchased drug catalogs,and strengthening information privacy and data security,are proposed.

It uses research methods such as questionnaire surveys and in-depth interviews with key informants to investigate the quantitative data,settlement costs,satisfaction,and other actual operations of the"dual channel"electronic prescription circulation and medical insurance online settlement pilot project in Shenzhen in June 2022.It explores and analyzes its advantages in effectively eliminating counterfeit paper prescriptions,real-time sharing of pharmacy inventory,transparency of drug prices,and limitations in prescription circulation coverage.And it makes suggestions for optimizing the prescription review process,such as creating a unified and standardized prescription circu-lation model,constructing a standardized and efficient management system for purchased drug catalogs,and strengthening information privacy and data security,are proposed.