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Introduction: Venous thromboembolism (VTE), including deep venous thrombosis and pulmonary embolism, is a common and potentially fatal post-surgery complication. Research has shown that 50% of VTE causes are intraoperative, with the risk of occurrence highest during and immediately post-surgery. Therefore, strategies for early assessment and prevention should be established. Objective: To identify optimal equipment selection, compression protocols, and strategies for complication prevention and management during intraoperative intermittent pneumatic compression (IPC), this study aims to synthesize the best available evidence. The objective is to inform accurate risk assessment and facilitate early mechanical prophylaxis against venous thrombosis. Methods: The Practical Application to Clinical Evidence model proposed by the Joanna Briggs Institute was utilized. Indicators were identified using the available best evidence from January 2023 to October 2023, and a baseline review was conducted. Negative factors were identified based on clinical evidence-based practice. The implementation rates of different indicators before (n = 372) and after (n = 405) evidence-based practice, the incidence rates of intraoperative IPC-related adverse events and VTE, and the risk of venous thrombosis before (n = 50) and after (n = 50) practice were identified and compared. Furthermore, medical staff's knowledge of best practices for intraoperative IPC was assessed through pre- and post-intervention surveys involving 109 operating room personnel. Results: All review indicators significantly improved (P < 0.01) after the evidence-based practice, and 9 reached 100%. Two intraoperative venous thrombosis events occurred before the evidence-based practice, with an incidence rate of 0.53%; no intraoperative venous thrombosis event occurred after the evidence-based practice, with no significant difference (X2 = 2.171, P = 0.141 > 0.05). However, there were significant differences in intraoperative venous blood hemodynamics before and after the practice (P < 0.05). Moreover, 9 IPC-related adverse events, including 4 cases of skin pressure, 3 cases of skin allergy, and 2 cases of lower limb circulation disorders, were reported before the evidence-based practice, with an incidence rate of 2.4%. Notably, no intraoperative IPC-associated adverse events occurred after the evidence-based practice(X2 = 9.913, P < 0.01). Meanwhile, the score of comprehension of the standard utilization of IPC for preventing venous thrombosis by medical staff in the operating room was 93.34 ± 3.64 after the evidence-based practice, which was higher than that (67.55 ± 5.45) before the evidence-based practice. Overall, the clinical practice was significantly improved the evidence-based practice. Conclusions: Applying intraoperative IPC utilization standards based on the best evidence in clinical practice effectively reduces the intraoperative IPC-associated adverse event rate and the risks of intraoperative venous thrombosis. It also improves the execution rates and compliance with mechanical prevention standards in the operating room by medical staff. Future research should prioritize the development and refinement of best clinical practices for intraoperative venous thrombosis prevention, with a particular emphasis on the integration of mechanical prophylaxis strategies. [ABSTRACT FROM AUTHOR]

Background: The main sedative which is propofol in painless gastroenteroscopy, has a high risk of reducing blood pressure and respiratory depression. Remimazolam (a short-acting benzodiazepine) is expected to be widely used in painless gastroenteroscopy due to its rapid onset, rapid metabolism and light respiratory and circulation inhibition. Methods: A randomized, single-blind, parallel, controlled study, 123 outpatients who were undergoing painless colonoscopy and ramdomly divided into group A, B and C, in Hangzhou First People's Hospital, July-December 2021. All patients were intravenously injected with 5 µg sufentanil for analgesic preconditioning. The group A was induced by 0.2 mg/kg remimazolam besylate. The group B was induced by 0.25 mg/kg remimazolam besylate. And the group C was inducted by 2.0 mg /kg propofol. If the patients had limb movement or MOAA/S score > 3 and so on, remimazolam besylate was added at 2.5 mg/ time in group A and B, and propofol emulsion injection was added at 0.5 mg/kg/ time in group C. During the operation, according to the actual situation, remimazolam was per added 2.5 mg in the experimental group, and propofol was 0.5 mg/kg in the control group. Heart rate (HR), non-invasive blood pressure (BP), respiratory rate (RR), pulse oxygen saturation (SpO2), and improved vigilance/sedation score (MOAA/S) of patients was recorded from entering endoscopy room to get out of the anesthesia recovery room, also including perioperative adverse events, other medications or treatments, the time of patients waking up and leaving the hospital. Results: The successful rate of induction in three groups was 100%. There was no significant difference in the sedation completion rate among the three groups (Group A:90.2%, Group B: 92.7%, Group C: 92.7%, P = 1.000). The rate of adverse events after administration: group A(27.0%) and B(36.8%) both lower than group C(71.0%),P < 0.001;There was no significant difference between group A and group B, P > 0.744;The average time from the last drug administration to meet the discharge criteria of the subjects in three groups was as follows: The average time of group A(16.2 min) and Group B(16.5 min) both shorter than group C(19.6 min), P = 0.001; There was no significant difference between group A and group B, P = 0.742. Conclusions: This study revealed that remimazolam is a safe and effective medication for colonoscopy sedation, the security of remimazolam is better than propofol, and the sedative effect with the initial dose of 0.25 mg/kg of remimazolam is optimal. Trial registration: China Clinical Trial Center with registration number: 2100052615,02/11/2021. [ABSTRACT FROM AUTHOR]

Objective This study investigated the clinical outcome of monochorionic diamniotic (MCDA) twins with selective intrauterine growth restriction (sIUGR). Study Design International Peace Maternal and Child Health Hospital of Shanghai ultrasound database was investigated to identify all MCDA delivered from January 2013 to December 2017. After identifying 43 pairs of MCDA twins with sIUGR and 282 pairs of normal MCDA twins, we compared clinical outcomes between the two groups. Results Compared with normal twins, sIUGR fetuses had significantly shorter gestational age at delivery, smaller average birth weight of both twins, more significant intertwin difference in birth weight, lower Apgar scores, and higher intrauterine fetal demise (IUFD) rate, and smaller placental weight. The rate of abnormal umbilical cord insertions and abnormal blood flow in the ductus venosus (DV) and middle cerebral artery (MCA) is significantly higher in the sIUGR group. In addition, the subtype analysis of sIUGR groups indicated the poorest outcomes in type II with no significant difference between type I and III. Conclusion MCDA twins with sIUGR generally exhibited limited clinical outcomes than normal MCDA twins. These limitations are mainly associated with abnormal umbilical cord insertions and blood flow in the DV and MCA. Clinical outcomes differed among the three types of sIUGR, with type II having the worst prognosis and the highest IUFD rate. Key points sIUGR generally exhibited limited clinical outcomes than normal MCDA twins. These limitations are mainly associated with blood flow of the DV and MCA. sIUGR with type II has the worst prognosis and the highest IUFD rate. [ABSTRACT FROM AUTHOR]

Danshen-Shanzha Formula (DSF) is a well-known herbal combination comprising Radix Salvia Miltiorrhiza (known as Danshen in Chinese) and Fructus Crataegi (known as Shanzha in Chinese), It has been documented to exhibit considerable benefits for promoting blood circulation and removing blood stasis, and was used extensively in the treatment of atherosclerotic cardiac and cerebral vascular diseases over decades. Despite several breakthroughs achieved in the basic research and clinical applications of DSF over the past decades, there is a lack of comprehensive reviews summarizing its features and research, which hinders further exploration and exploitation of this promising formula. This review aims to provide a comprehensive interpretation of DSF in terms of its ethnopharmacological relevance, preparation methods, chemical constituents, pharmacokinetic properties and pharmacological effects. The related information on Danshen, Shanzha, and DSF was obtained from internationally recognized online scientific databases, including Web of Science, PubMed, Google Scholar, China National Knowledge Infrastructure, Baidu Scholar, ScienceDirect, ACS Publications, Online Library, Wan Fang Database as well as Flora of China. Data were also gathered from documentations, printed works and classics, such as the Chinese Pharmacopoeia, Chinese herbal classics, etc. Three essential avenues for future studies were put forward as follows: a) Develop and unify the standard preparation method of DSF as to achieve optimized pharmacological properties. b) Elucidate the functional mechanisms as well as the rationality and rule for the compatibility art of DSF by focusing on the clinic syndromes together with the subsequent development of preclinic study system in vitro and in vivo with consistent pathological features, pharmacokinetical behaviour and biomarkers. c) Perform more extensive clinical studies towards the advancement of mechanism-based on evidence-based medicine on the safety application of DSF. This review will provide substantial data support and broader perspective for further research on the renowned formula. [ABSTRACT FROM AUTHOR]

Orchidaceae are one of the two largest families of flowering plants, new orchid genera are being described at a rate of about 13 per year. Bletilla sinensis is one of five species in the Bletilla. It has high medicinal value and can promote blood circulation and anti-inflammation. However, its phylogenetic status is controversial. In this study, the chloroplast genes of B. sinensis were sequenced and assembled, and download 73 complete chloroplast genes of orchid plants from NCBI to construct a molecular evolutionary tree, which provided new clues for the classification of B. sinensis. The results showed that the length of chloroplast genes was 156,941 bp, the GC content was 37.12%, and it contained 139 genes. The results of the molecular evolutionary tree show that the genus Bletilla is a single branch and has an independent evolutionary status. However, our sample is not in the same branch as the Bletilla, indicating that this sample may have an independent and effective taxonomic status. Based on the chloroplast genome structure and composition of this species, it also supports its independent taxonomic status from the Bletilla. Judging from the genetic distance between genera of Orchidaceae, the genetic distance between this sample and any other genera is greater than 0.02, which is greater than the genetic distance between the other two identified genera. In addition, the integration of morphological data from the Flora of China found that there are certain differences in morphology from other species of the genus Bletilla. Therefore, the above results suggest that this group should be a new genus of Orchidaceae. [ABSTRACT FROM AUTHOR]

Cardiovascular diseases (CVDs) are the leading cause of deaths among adult populationinChina, whose incidence and mortality rates continue rising with a trend towards youngerages. Although numerous drugs are used to prevent and treat CVDs, the long-termprognosisof patients with CVDs is still not very satisfactory. Therefore, there is an urgent needtoexplore new safe and effective drugs for CVDs in clinical practice. As a traditional medicinein China, Ginkgo biloba has a history of more than 2,000 years in clinical practice experience, meanwhile its therapeutic role in CVDs has been revealed in more and more clinical studies. As a living fossil of traditional Chinese medicine, Ginkgo biloba, a deciduous tree plant of theGinkgo family and genus, contains active medicinal ingredients in its leaves, kernels, outerskins and roots. Ginkgo biloba leaves are the main medicinal part, which are mild innature, sweet, bitter and astringent in taste. Ginkgo biloba activates the circulation of blood, relievespains, and lowers lipids, which is mainly used to treat chest obstruction and heartaches, stroke hemiplegia, and asthma, as well as hyperlipidemia, etc. This paper aims to reviewthemedicinal properties of Ginkgo biloba and its active ingredients in the treatment of CVDs, with emphasis on the antioxidant, apoptosis-inhibiting, anti-inflammatory mechanismandother mechanisms, so as to provide a scientific basis for their clinical application as well asfurther development and utilization. [ABSTRACT FROM AUTHOR]

Introduction: Ischemic stroke (IS) is a detrimental neurological disease with limited treatment options. Recanalization of blocked blood vessels and restoring blood supply to ischemic brain tissue are crucial for post-stroke rehabilitation. The decoction Naodesheng (NDS) composed of five Chinese botanical drugs, including Panax notoginseng (Burk.) F. H. Chen, Ligusticum chuanxiong Hort., Carthamus tinctorius L., Pueraria lobata (Willd.) Ohwi, and Crataegus pinnatifida Bge., is a blood-activating and stasis-removing herbal medicine commonly used for the clinical treatment of cerebrovascular diseases in China. However, the material basis of NDS on the effects of blood circulation improvement and vascular tone regulation remains unclear. Methods: A database comprising 777 chemical metabolites of NDS was constructed. Then, the interactions between various herbal metabolites of NDS and five vascular tone modulation G-protein-coupled receptors (GPCRs), including 5-HT1AR, 5-HT1BR, ß2-AR, AT1R, and ETBR, were assessed by molecular docking. Using network analysis and vasomotor experiment of the cerebral basilar artery, the potential material basis underlying the vascular regulatory effects of NDS was further explored. Results: The Naodesheng Effective Component Group (NECG) was found to induce relaxation of rat basilar artery rings precontracted using Endothelin-1 (ET-1) and KCl in vitro in a dose-dependent manner. Several metabolites of NDS, including C. tinctorius, C. pinnatifida, and P. notoginseng, were found to be the main plant resources of metabolites with high docking scores. Furthermore, several metabolites in NDS, including formononetin-7-glucoside, hydroxybenzoyl-coumaric anhydride, methoxymecambridine, puerarol, and pyrethrin II, were found to target multiple vascular GPCRs. Metabolites with moderate-to-high binding energy were verified to have good rat basilar arteryrelaxing effects, and the maximum artery relaxation effects of all three metabolites, namely, isorhamnetin, kaempferol, and daidzein, were found to exceed 90%. Moreover, metabolites of NDS were found to exert a synergistic effect by interacting with vascular GPCR targets, and these metabolites may contribute to the cerebrovascular regulatory function of NDS. Discussion: The study reports that various metabolites of NDS contribute to its vascular tone regulating effects and demonstrates the multi-component and multitarget characteristics of NDS. Among them, metabolites with moderate-to-high binding scores in NDS may play an important role in regulating vascular function. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the effect of manual acupuncture on endometrial blood flow parameters by three-dimensional (3D) power Doppler ultrasound in women undergoing in vitro fertilization embryo transfer (IVF-ET). Methods: Seventy patients undergoing IVF-ET were equally randomized into traditional or sham acupuncture treatment group for totally 4 days (from the day of oocyte aspiration to the day of embryo transfer) of treatment by random envelope method at the Reproductive Medicine Center and Outpatient Department of Integrated Traditional Chinese and Western Medicine, Tongji Hospital, Tongji Medicine College, Huazhong University of Science and Technology from January 2013 to December 2015. Patients in the traditional acupuncture group accepted traditional acupuncture methods with manual acupuncture, and Zhongji (CV3), Qihai (CV 6), Sanyinjiao (SP6), Taichong (LR 3), Tianshu (ST 25), Guilai (ST 29) and Zusanli (ST 36) were chosen. Patients at the sham acupuncture group accepted shallow acupuncture methods at 4 non-meridian points at each shoulder and upper arm. Outcome measures included endometrial ultrasonic indices such as vascularization index (VI), flow index (FI) and vascularization flow index (VFI), endometrial thickness and volume, subendometrial VI (sVI), subendometrial FI (sFI), subendometrial VFI (sVFI), implantation rate, clinical pregnancy rate, abortion rate, live birth rate and number of live births. Results: Finally, 34 patients in the traditional acupuncture group and 35 in the sham acupuncture group completed this trial. VI, FI and VFI of the traditional acupuncture group were significantly higher than those in the sham acupuncture group (P<0.05). No significant differences were found in endometrial thickness, endometrial volume, sVI, sFI, sVFI, implantation rate, clinical pregnancy rate, abortion rate, live birth rate and number of live births (P>0.05). Conclusions: Manual acupuncture performed after oocyte aspiration and before transplantation improved the endometrial blood flow parameters VI, RI and VFI in women who underwent IVF-ET, instead of sVI, sFI and sVFI. Therefore, acupuncture might be beneficial in women undergoing IVF-ET by increasing endometrial blood flow and endometrial receptivity. (Registration No. ChiCTR2100053354) [ABSTRACT FROM AUTHOR]

Background: Xiangxi Tujia and Miao Autonomous Prefecture, located in Hunan Province, China, is a culturally rich region with a diverse population. The locals have a deep martial arts history and possess a wealth of traditional knowledge for treating bruises. Methods: In order to investigate this topic, we conducted ethnobotanical studies by visiting local medicinal markets and conducting interviews. Results: We identified 43 botanical drugs used for treating bruises, categorized into four types: sprains, contusions, strains, and bone injuries. The local people typically prefer to mash these botanical drugs freshly or make medicinal wine for external use. Treatment often involves a combination of drugs to promote blood circulation and remove blood stasis, with medications to dispel rheumatism, clear heat, and detoxify, tailored to the humid climate and high precipitation in mountainous areas. Based on the fidelity level values, the local plant resources with high acceptance, utilization, or potential value in the treatment of bruises included Sargentodoxa cuneata, Lycopodium japonicum, Dioscorea cirrhosa, Panax japonicus, Achyranthes bidentata, Lysimachia heterogenea and so on. Conclusion: Herbal medicine and related knowledge for treating bruises are diverse and rich in the Xiangxi region. However, the local traditional medicinal knowledge faces challenges regarding inheritance due to regional modernization. Therefore, it is crucial to protect and further study this knowledge in the future. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Clinical Nursing in Practice is the property of Journal of Clinical Nursing in Practice (Editorial Board, Shanghai Jiao Tong University Press) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Paeonia rockii has been a traditional medicinal material from time immemorial. It is an important plant resource of ethnic medicine and chinese herbal medicine. It has unique effects on heat and cool blood, promoting blood circulation and dispersing blood stasis, analgesia and promoting menstruational flow. It is also a first-class protected plant. With the increasing demand for the bark and roots of P. rockii in China's medicinal market, the continuous high-intensity and disorderly excavation has led to a sharp decline in wild resources. P. rockii is in imminent danger and needs to be saved and protected urgently. In this study, the distribution records of P. rockii in China, combined with environmental factors, are used to simulate the current potential distribution area of P. rockii through MaxEnt model. The environmental factors affecting the distribution of P. rockii are obtained by using the contribution rate of environmental factors and a jackknife test analysis, and the appropriate value of environmental factors is determined by using the response curve. The results show that the AUC value of test set data is 0.985 and that of training set data is 0.987. The prediction accuracy of the Maxent model is extremely high and the simulation effect is very good. At present, the high suitable areas of P. rockii are mainly distributed in the shape of cake in Southern Ningxia, southern Gansu and southern Shanxi, accounting for 15.58% of the total suitable areas. The most important environmental factor affecting the geographical distribution of P. rockii is the altitude; Under the future climate change scenario, the total suitable area of P. rockii shows a decreasing trend, among which the area of high suitable area shows an obvious decreasing trend, the mass center of high suitable area of P. rockii generally tends to migrate to the northwest, and the migration range is large under the scenario of high concentration emission. The research results can provide scientific data support for P. rockii to to cope with the changes in suitable areas caused by climate change and the establishment of effective protection, clarify the change and heterogeneity of P. rockii in different regions of China in the future, and clarify its ecological needs, which has certain practical significance. [ABSTRACT FROM AUTHOR]

Copyright of African Journal of Reproductive Health is the property of Women's Health & Action Research Centre and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Promotion of angiogenesis and restoration of the blood flow in the ischemic penumbra is an effective treatment for patients with ischemic stroke (IS). Radix astragali-safflower (AS), a classic herbal pair for accelerating blood circulation and dispersing blood stasis, has been used for thousands of years to treat patients with IS in China. Even so, the mechanism of the treatment of IS by AS is still undecipherable. In the current study, network pharmacology was firstly employed to unveil the mechanism of AS in treating IS, which showed that AS might promote angiogenesis associated with PTGS2 silence. Middle cerebral artery occlusion/reperfusion (MCAO/R) model rats were then used as the experimental animals to verify the prediction result. The experimental results revealed that treatment with AS improved the cerebral infarct volume, neurological damage, and cerebral histopathological damage; inhibited cell apoptosis; increased the contents of PDGF-BB, EPO, and TGF-β1; and reduced the levels of PF4, Ang-2, and TIMP-1 in serum. Immunohistochemical staining demonstrated that the expression of PTGS2 was dramatically increased in the hippocampus and cerebral cortex of rats with MCAO/R, and this trend was reversed by the treatment of AS. Immunofluorescent staining expressed that AS reversed the down-regulation of VEGF and further promoted the expression of CD31, which indicated that AS promoted angiogenesis in MCAO/R rats. The abnormal protein or mRNA expression of PTGS2, PGI2, bFGF, TSP-1, and VEGF in the penumbra were transposed by AS or Celecoxib (an inhibitor of PTGS2). In conclusion, the protective mechanism of AS for IS promoted angiogenesis and was involved with PTGS2 silence. [ABSTRACT FROM AUTHOR]

Asplenium ruprechtii Sa. Kurata (A. ruprechtii), in Chinese name of Guo Shan Jue, originally belonged to the genus of Camptosorus (Aspleniaceae), and now has been classified in the genus of Asplenium according to molecular evidence. As a folk medicine in northern provinces of China, it is used for anti-inflammatory, hemostasis, promoting blood circulation, dissipating blood stasis, and relieving pain. Previously, the extract of A. ruprechtii had been made into herbal medicine injections in clinics for the treatment of severe thromboangiitis obliterans. Due to its remarkable curative effect, the studies on the chemical constituents of A. ruprechtii began early in the 1970–1980s. More than eighty compounds in kinds of flavonoids, glycosides, triterpenoid saponins, and iridoid glycosides were successively isolated, which showed a wide range of biological activities. In this paper, the work on the chemical constituents and pharmacological activity studies of A. ruprechtii from 2001 to 2021 were reviewed. The summary of this manuscript will provide reference for further research and in-depth development of the A. ruprechtii. [ABSTRACT FROM AUTHOR]

Plant-derived alkaloids are a kind of very important natural organic compounds. Nitidine chloride is one of the main active ingredients in Zanthoxylum nitidum (Roxb.) DC. which is a frequently-used Chinese herbal medicine. Z. nitidum has many kinds of efficacy, such as activating blood circulation and removing stasis, promoting qi circulation and relieving pain, and detoxication and detumescence. In China, Z. nitidum is usually used for the treatment of gastrointestinal diseases, toothache, and traumatic injury. At present, there are numerous studies of nitidine chloride with regard to its pharmacology, pharmacokinetics, toxicology, etc. However, a systematic, cutting-edge review of nitidine-related studies is extremely lacking. The present paper aimed at comprehensively summarizing the information on the extraction, separation and purification, pharmacology, pharmacokinetics, toxicology and formulation of nitidine chloride. The knowledge included in the present study were searched from the following academic databases involving Web of Science, PubMed, Google scholar, Elsevier, CNKI and Wanfang Data, till July 2022. In terms of nitidine chloride extraction, enzymatic method and ultrasonic method are recommended. Resin adsorption and chromatography were usually used for the separation and purification of nitidine chloride. Nitidine chloride possesses diversified therapeutical effects, such as anti-tumor, anti-inflammation, anti-colitis, anti-malaria, anti-osteoporosis, anti-rheumatoid and so on. According to pharmacokinetics, the intestinal absorption of nitidine chloride is passive diffusion, and it is rarely excreted with urine and feces in the form of prototype drug. Nitidine chloride has a moderate binding to plasma protein, which is independent of the drug concentration. As to toxicology, nitidine chloride showed certain toxicity on liver, kidney and heart. Certain new formulations, such as nanoparticle, microsphere and nanomicelle, could increase the therapeutic effect and decrease the toxicity of nitidine chloride. Despite limitations such as poor solubility, low bioavailability and certain toxicity, nitidine chloride is still a promising natural alkaloid for drug candidates. Extensive and intensive exploration on nitidine chloride is essential to promote the usage of nitidine-based drugs in the clinic practice. [ABSTRACT FROM AUTHOR]

Background: Ischemic stroke refers to ischemic necrosis or softening of limited brain tissue caused by ischemia and hypoxia due to impaired blood circulation in the brain. Ischemic stroke is a major classification of cerebrovascular disease, accounting for about 80% of patients with cerebrovascular disease in China, with a high rate of disability and death. Recently, miRNAs were reported to participate in ischemic stroke pathogenesis and development. In the study, we aimed to study the role and underlying mechanism of miR-641 in ischemic stroke. Methods: Serum samples were extracted from acute ischemic stroke (AIS) patients and healthy controls. The oxygen-glucose deprivation/reoxygenation (OGD/R) method was used to treat SH-SY5Y cells to construct an ischemic stroke in vitro model. Real-time quantitative polymerase chain reaction (qRT-PCR) assay and western blot analysis were conducted to detect miR-641 and MCL-1 expressions. The targeted relationship between miR-641 and MCL-1 was confirmed by dual-luciferase reporter, RNA pull-down, and rescue assays. CCK-8, flow cytometry, and ELISA assays were performed to measure cell viability, apoptosis, and inflammation. The activation of the Wnt/ß-catenin pathway was verified by western blot assay. Results: MiR-641 was increased while MCL-1 was decreased in serum samples from AIS patients, serving as highly-sensitive biomarkers in AIS diagnosis. After OGD/R treatment, SH-SY5Y cell viability, and MCL-1 expression were decreased, along with increased miR-641 expression, cell apoptosis, and inflammation. MiR-641 aggravated while MCL-1 mitigated OGD/R-triggered injury and inflammation in SH-SY5Y cells. MCL-1 was a downstream target of miR-641, which could be negatively regulated by miR-641. Finally, miR-641 exacerbated the progression of OGD/R-triggered SH-SY5Y cell injury via the MCL-1/Wnt/ß-catenin pathway. Conclusions: MiR-641 may be a novel therapeutic agent for ischemic stroke by modulating the MCL-1/Wnt/ß-catenin axis on neuronal damage in brain tissue in the ischemic region after ischemic stroke. [ABSTRACT FROM AUTHOR]

This study was conducted to evaluate the effect of multidisciplinary collaborative nursing intervention on AVF in patients with chronic kidney disease (CKD) undergoing hemodialysis. Patients (n = 84) with CKD who underwent the first autologous AVF were randomly divided into control group and multidisciplinary collaborative nursing intervention (MCNI) group and they received routine nursing procedure and multidisciplinary collaborative nursing intervention procedure, respectively. The natural blood flow and vessel diameter in MCNI group were higher than that in control group at the fourth week after surgery (p <.05). The vessel diameter in MCNI group at 2 and 4 weeks after operation was significantly larger than that in control group (p <.05).In conclusions, the implementation of multidisciplinary collaborative nursing intervention procedure can significantly promote the maturation of AVF, effectively increase the blood flow of AVF and promote the growth of vessel diameter. [ABSTRACT FROM AUTHOR]

Rhizome Chuanxiong (RCX), the dried rhizomes of Ligusticum striatum DC., is a geoauthentic TCM herb distributed in Sichuan province of China that possesses efficacy in promoting blood circulation, removing blood stasis and alleviating pain. Rhizome Chuanxiong total alkaloids (RCXTAs) are one of the major characteristic constituents of RCX with the effects of antimigraine, neuroprotective, cardioprotective and other cardiovascular and cerebrovascular diseases. Over the past years, rapid development of technology has advanced some aspects of RCXTAs. The aim of this review is to illustrate the recent advances in the chemical analysis and biological activities of RCXTAs, and to highlight new challenges. [ABSTRACT FROM AUTHOR]

Objective To investigate the clinical effect of cerebral vascular disease treated by transplantations of the short-segment radial artery (RA) using the internal maxillary artery (IMA) as the feeding artery. Methods and Results The clinical data of 5 cases with cerebral vascular disease treated by IMA-RA-cerebral artery bypass (IMAB) from August 2018 to April 2021 in the First Hospital of China Medical University were retrospectively analyzed. There were 3 cases of dissecting aneurysms [one case of right middle cerebral artery (MCA) M2 segment, one case of left MCA M1 segment, one case of right posterior cerebral artery (PCA) P2 segment], and 2 cases of vertebral basilar artery ischemia [one case of bilateral vertebral artery (VA) occlusion, one case of severe basilar artery (BA) stenosis]. Two patients underwent the IMA-RA-M2 bypass, and 3 patients underwent the IMA-RA-P2 bypass. Intraoperative indocyanine green angiography (ICGA) and Doppler ultrasonography confirmed patency of the RA in 4 cases and occluded RA in one case (the anastomosis of IMA-RA was opened, the intima of IMA was dissociated from the media, and RA was unobstructed after resuture). One patient developed basal ganglia infarction after the surgery. The RA blood flow was measured by ultrasound 123, 51, 77, 69 ml/min in 4 patients at one week after the surgery. One patient had a RA blood flow of 89 ml/min on 6 months after the surgery (69 ml/min on one week after the surgery), and one patient had a RA blood flow of 66 ml/min 26 months after the surgery (51 ml/min on one week after the surgery). One patient with dissociated M1 segment aneurysm with ischemic onset developed ischemic infarction in basal ganglia region after open aneurysm and bypass, and modified Rankin Scale (mRS) increased by one point on one week after surgery. mRS score of 3 patients decreased by one point and one patient had no change; after 8-40 months of follow-up, all patients recovered well, with mRS score of 0 in 2 cases, one in 2 cases, and 2 in one case. Conclusions The IMAB can provide moderate flow of blood supply to brain tissue, and the RA has good patency and stable flow during long-term follow-up. This operation can be used to treat patients with cerebral vascular disease of choosy and reduce the risk of cerebral ischemia effectively. [ABSTRACT FROM AUTHOR]

Background: Chinese herbs for supplementing qi and activating blood circulation (CH) combined with N-acetylcysteine (NAC) is widely used for idiopathic pulmonary fibrosis (IPF) in China, but there is a lack of literature to evaluate its efficacy and clinical value. Purpose: This study compared CH + NAC with other treatments by network meta-analysis to clarify its clinical value. Methods: Cochrane Library, PubMed, Embase, Web of Science, China National Knowledge Infrastructure, WanFang Data, VIP Database, and China Biology Medicine were searched. Outcomes included lung function (DLCO (%), VC (%), FVC (%), FVC (L)), 6-min walking distance (6MWD), score of St George's respiratory questionnaire (SGRQ), blood gas analysis (PaO2, PaCO2). The data were analyzed by Review Manager 5.4, Stata 12.0 and ADDIS 1.16.5. Results: 23 studies including 1390 patients (702 in intervention group and 688 in control group) were collected to compare 8 outcome indicators among different treatments involving CH, CH+NAC, CH+PFD, NAC, PFD and PFD+NAC on IPF. Network meta-analysis showed that CH was better than NAC in terms of DLCO (%) (MD = 5.14, 95%CI: 1.01 to 8.68) and 6MWD (MD = 49.17, 95%CI: 25.97 to 71.36) as well as PFD + NAC was better than NAC in terms of FVC (L) (MD = -0.56, 95%CI: -0.83 to -0.31). In rankings results, CH + NAC is the best in terms of FVC (%), SGRQ, PaO2 and PaCO2; CH is the best in terms of DLCO (%), VC (%) and 6MWD; CH + PFD is the best in terms of FVC (L). Conclusion: CH related treatments may have advantages in the treatment of IPF and CH + NAC may have clinical application value. However, limited by the quality and quantity of researches included, more rational and scientific randomized controlled trials containing large sample sizes need to be conducted to further verify our conclusions. [ABSTRACT FROM AUTHOR]

Fan Hong Hua (番红花 saffron) is a natural product that has long been used in food and dye industries and fortreating various disorders. Saffron has a long history of applications in traditional Chinese medicine, following its introduction to China in 1979. According to the theory of traditional Chinese medicine, saffron is sweet, slightly cold in nature and enters heart and liver meridians. Moreover, this spice can invigorate blood circulation, eliminate blood stasis, cool blood and eliminate heat toxins. Saffron has been used to treat asthma, phlegm, insomnia, Alzheimer’s disease, depression, fright, shock, hemoptysis, heartburn, and pain. Among the almost 70 bioactive ingredients of saffron, major constituents of this herb include safranal, crocin, and crocetin, which are responsible for the unique taste and color of saffron. These ingredients have been investigated using modern pharmaceutical research methods as potential therapeutics to treat disorders such as Alzheimer’s disease, cardiovascular diseases, cancer, digestive system disorders, ocular issues, and COVID-19 infections. However, focus and emphasis on understanding the pharmacological effects of saffron in treating diseases are required. This article briefly reviews the history, cultivation processes, different qualities properties, and traditional and modern applications of this unique herb. [ABSTRACT FROM AUTHOR]

Background: Distant metastasis to vital organs is the major contributor to breast cancer mortality, and regional lymph node metastasis is an important facilitator of distant metastasis and recurrence in this cancer. The early diagnosis and precise treatment of lymph node metastasis are crucial for staging and prognosis in breast cancer. Herein, we report a visualized precision medicine nanoplatform of metastatic lymph nodes for ultrasonic/photoacoustic (US/PA) dual modal imaging-guided in situ targeted hyperthermia-combined chemotherapy. Results: Carbon nanoparticles (CNs), approved by the China Food and Drug Administration, were loaded with docetaxel and rationally combined with anti-hypoxia-inducible factor 1α antibody-modified poly (lactic-co-glycolic acid) (PLGA) nanoparticles to achieve the combination of passive targeting at the lymph nodes and intracellular targeting at HIF 1α factor. The accumulation and retention of nanoparticles in metastatic lymph nodes via lymphatic delivery were enhanced. Docetaxel could be effectively offloaded by CNs that have active carbon nanoparticles, and the PLGA membrane prevented drug leakage. The nanoparticles exhibited excellent photothermal performance with a photothermal conversion efficiency of 28.9%, killing tumor cells in metastatic lymph nodes through hyperthermia. In vitro and in vivo systematic evaluations revealed that hyperpyrexia triggered the rupture of nanoparticles caused by the phase transition of perfluorohexane, resulting in docetaxel release for achieving in situ hyperthermia-combined chemotherapy. Conclusions: The laser-triggered highly efficient in situ chemotherapy nanosystem achieves targeted synergistic chemo-hyperthermia treatment of metastatic lymph nodes, and lymphatic delivery represents a strategy to avoid additional injury caused by drugs entering the blood circulation. [ABSTRACT FROM AUTHOR]

The medicine traditional culture to dispel wind and eliminate dampness in Xiangxi Region has a long history. However, the resources of these medicinal plants and the existing situation of related traditional knowledge are not clear enough. In this study, the species composition, related traditional knowledge, quantitative evaluation, actual use evaluation and the collection of Hunan Traditional Chinese Medicine Standard(2009 edition)of medicinal plants for dispelling wind and eliminating dampness were analyzed with ethnobotanical investigation methods. The results were as follows: (1) A total of 71 dispelling wind and eliminating dampness medicinal plant species from 65 genera and 48 families were documented in the ethnobotanical investigation. Most of them were Ranunculaceae and Araliaceae. (2) The roots, whole plants and stems(vines)of this medicinal plants were mainly part used. (3) Most of the documented species were herbs, followed by vines, shrubs, and few trees. (4) The intergenerational transmission of traditional medicinal knowledge and medicinal plants were under uncertainty threat. (5) The medical plant Aristolochia mollissima, Clematis chinensis and Anisomeles indica showed the highest fidelity level(FL)of knowledge consistency, and they were the most commonly used medicinal plants for dispelling wind and eliminating dampness in Xiangxi Region. (6) The local prices of medicinal plants are less affected by the market and maintained at a relatively stable level. The local people had few understanding of the consumption demand of medicinal materials. (7) There were 25 kinds of medicinal plants included in the Standard of Traditional Chinese Medicinal Materials of Hunan Province(2009 Edition), and the functional descriptions such as dispelling wind and eliminating dampness, dispelling wind and removing blood stasis, activating blood circulation and collaterals. The study shows a rich diversity of medicinal plants and related traditional knowledge for dispelling wind and eliminating dampness in Xiangxi Region. With the continuous improvement of China's resources legislation at the present stage, we propose to strengthen the protection of the traditional knowledge so as to improve the biodiversity and sustainable utilization level of such resources, use of multi-disciplinary knowledge and technical means to strengthen the exploration and innovation of traditional medicine resources in the region, so that the rich medicinal plant resources can better contribute to human health in the future. [ABSTRACT FROM AUTHOR]

Objective: To investigate the combined anti-inflammatory effect of activating blood circulation and detoxifying Chinese medicines in unstable angina (UA) patients. Methods: This study was an open-labeled, randomized controlled trial conducted in 5 centers in Beijing. A total of 154 patients were randomized into two groups at a 1:1 ratio by random numbers. Based on the conventional treatment, patients in the activating blood circulation (ABC) group were treated with Guanxin Danshen Droping Pill (冠心丹参滴丸, 0.4 g, thrice daily), and patients in the activating blood circulation and detoxifying (ABCD) group were treated with Guanxin Danshen Droping Pill (0.4 g, thrice daily) and Andrographis tablet (0.2 g, thrice daily) for 4 weeks. The primary outcome was the serum level of high sensitive C reaction protein (hs-CRP), and the secondary outcome index included the serum levels of tumor necrosis factor α (TNF-α), interleukin 6 (IL-6), soluble CD40 ligand (sCD40L), thrombomodulin (TM), the score of angina pectoris, the score of blood stasis syndrome, and the score of Chinese medicine symptoms, observed at week 0 and week 4. Results: A total of 144 patients completed the trial (ABC group, n=70; ABCD group, n=74). There were no significant differences in the clinical baseline characteristics between the two groups. When compared with the ABC group, ABCD group showed better performance in reducing the level of inflammatory factors, especially hs-CRP (P<0.05), IL-6 (P<0.01) and TNF-α (P<0.01). In term of clinical symptoms, ABCD group played a better role in improving the scores of angina pectoris and blood stasis syndrome than ABC group (all P<0.05). Conclusions: The combination of Guanxin Danshen Dropping Pill and Andrographis tablet exert significant anti-inflammatory effect on UA patients, which is superior to single Guanxin Danshen Dropping Pill. (Registration No. ChiCTR-TRC-13004072) [ABSTRACT FROM AUTHOR]

Copyright of Journal of Clinical Nursing in Practice is the property of Journal of Clinical Nursing in Practice (Editorial Board, Shanghai Jiao Tong University Press) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Clinical Nursing in Practice is the property of Journal of Clinical Nursing in Practice (Editorial Board, Shanghai Jiao Tong University Press) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

BACKGROUND: As China pays more attention to the development of Traditional Chinese Medicine(TCM), the researches on TCM treatments for cartilage diseases are increasing year by year in recent 20 years. Nevertheless, there is a lack of metrological analysis about the literature in this field. OBJECTIVE: Based on the method of mapping knowledge domains, to describe the knowledge structure and research hotspots of TCM treatments for cartilage diseases in the past 20 years, and to explore the dynamic frontiers in this field. METHODS: We perform descriptive statistical analysis about annual publication volume, distribution of journals and funds and cited frequency of the literatures in the 2000-2019 related literature, retrieved from the Web of Science and CNKI. In addition, CiteSpace was used for co-presence analysis of the institutions and authors as well as for cluster analysis of the keywords. The visualized mapping knowledge domains were drawn. RESULTS AND CONCLUSION: In China, the research interest of TCM treatments for cartilage diseases is on the rise in recent 20 years. With a gradual increase in literatures funded by national funds and a rapid increase in English literatures, more and more high-quality researches have emerged. In this field, it focuses on basic research that explores the mechanism of TCM treatments for cartilage diseases. The main representative drugs are Chinese medicine for invigorating the kidney, promoting blood circulation, and nourishing the liver. The method of invigorating the kidney is the main therapy for the treatment of cartilage diseases. Although the authors and the institutions have carried out some cooperation, there still exit some problems, such as excessively dispersive research groups, insufficient cross-regional cooperation and lack of influential teams or leaders. For example, Dai Qiyi’s team mainly explored the effects of patellar manipulations and Xiaoyao San on the cartilage, and Li Rongheng’s team mainly focused on the effects of Fuyuan Capsule on osteoarthritic cartilage. In the field of TCM treatments for cartilage diseases, the changes of research hotspots went through three stage: From 2000 to 2005, it mostly explored the prevention and treatments of cartilage diseases with integration of TCM and western medicine; from 2006 to 2013, it mainly studied the mechanism of Chinese herbal treatments of cartilage diseases by means of animal and cell experiments; from 2014 to 2019, it started to explore the treatments of cartilage diseases with integration of TCM and regenerative medicine such as tissue engineering. As for the dynamic frontiers in this field, it can be predicted that in the future, more researches will be carried out in the microscopic field such as cell apoptosis and signaling pathways, and in regenerative medicine fields such as tissue engineered cartilage and mesenchymal stem cell differentiation. Furthermore, in these fields, increasing achievements cooperated by TCM and modern medicine will constantly emerge. [ABSTRACT FROM AUTHOR]

Purpose: To study the active ingredients of Chuanxiong (CX) in promoting blood circulation and removing blood stasis. Methods: Blood-activating effects and serum HPLC fingerprints of CX extracts from different parts of China were studied and the spectrum-effect relationship between them was established by grey correlation analysis. Results: After treatment with CX extracted using different solvents, hemorheology indices were lower than those in the model group, and the effect of dichloromethane was better than that of other solvents (p < 0.05 or p < 0.01). There were 6 common peaks by fingerprint analysis. Peaks 1 - 5 were identified as senkyunolide I, senkyunolide H, senkyunolide A, coniferyl ferulate and ligustilide, respectively. Conclusion: Analysis of the spectrum-effect relationship indicates the contribution of the five components to the blood-activating effect of CX. The findings lend some scientific justification for using CX to remove blood stasis, and selection of quality evaluation indices for CX. [ABSTRACT FROM AUTHOR]

Objective To investigate the efficacy and safety of low dose rt-PA combined with transcranial Doppler ultrasonography (TCD) in the intravenous thrombolysis treatment of acute ischemic stroke. Methods A total of 139 patients with acute ischemic stroke admitted to Anhui No. 2 Provincial People's Hospital from July 2016 to May 2019 were randomly divided into the rt-PA standard dose group (0.90 mg/kg, total dose ≤ 90 mg), low dose group (0.60 mg/kg, total dose ≤ 60 mg) and low dose combined with TCD group (combined treatment group). TCD was used to continuously monitor the blood flow of middle cerebral artery for 2 h at the beginning of thrombolysis in the combined treatment group. TCD was only performed before and 2 h after thrombolysis in the standard dose group and low dose group. Two hours after thrombolysis, the recanalization rates of intracranial vessels in different treatment groups were compared. National Institutes of Health Stroke Scale (NIHSS) score was used to evaluate the severity of clinical symptoms in each group, and the incidence of symptomatic intracranial hemorrhage 24-48 h after thrombolysis was recorded. The self-care ability of 90 d after thrombolytic therapy was evaluated by modified Rankin Scale (mRS), and the mortality rate was calculated. Results The recanalization rate in the combined treatment group were higher than those in the standard dose group (P = 0.037) and low dose group (P = 0.030), and the NIHSS score 2 h after thrombolysis was lower than that in the standard dose group (P = 0.046) and low dose group (P = 0.026); the incidence of symptomatic intracranial hemorrhage (P = 0.017, 0.024) and 90 d mortality (P = 0.005, 0.016) in the low dose group and combined treatment group were lower than those in the standard dose group. Conclusions Low dose rt-PA combined with TCD assisted intravenous thrombolysis can improve the recanalization rate without increasing the risk of symptomatic intracranial hemorrhage and death. [ABSTRACT FROM AUTHOR]

AL3810, a molecular dual inhibitor of the vascular endothelial growth factor receptor (VEGFR) and fibroblast growth factor receptor (FGFR), has earned the permission of phase II clinical trial for tumor treatment by China FDA. As a reversible ATP-competitive inhibitor, AL3810 targets ATP-binding site on intracellular region of VEGFR and FGFR, whereas, AL3810 lacking interplay with extracellular region of receptors rendered deficient blood–brain tumor barrier (BBTB) recognition, poor brain penetration and unsatisfactory anti-glioma efficacy. Integrin α v β 3 overexpressed on capillary endothelial cells of BBTB as well as glioma cells illuminated ligand-modified liposomes for pinpoint spatial delivery into glioma. The widely accepted peptide c(RGDyK)-modified liposome loading AL3810 of multiple dosing caused hypothermia, activated anti-c(RGDyK)-liposome IgG and IgM antibody and pertinent complements C3b and C5b-9, and experienced complement-dependent opsonization. We newly proposed a pentapeptide mn with superb α v β 3-binding affinity and tailored AL3810-loaded mn-modified liposome that afforded impervious blood circulation, targeting ability, and glioma therapeutic expertise as vastly alleviated immune opsonization on the underpinning of the finite antibodies and complements assembly. Stemming from attenuated immunogenicity, peptide mn strengthened liposome functions as a promising nanocarrier platform for molecular targeting agents. Compared with c(RGDyK)-liposome, α v β 3-targeted mn-liposome abated the opsonic effect as lower anti-liposome IgG and IgM antibody titer, less complements activation and subsequently less phagocytosis by macrophages. Stemming from attenuated immunogenicity, mn-liposome successfully realized AL3810 delivery for glioma-targeted therapy. Image 1 [ABSTRACT FROM AUTHOR]

Objective: To characterize the inferior adrenal artery (IAA) pulsatility index (PI) in intrauterine growth-restricted (IUGR) fetuses without brain sparing.Methods: Twenty-three IUGR fetuses with a normal Doppler cerebroplacental ratio (CPR) and 23 normal controls were included in this prospective cross-sectional study. The PI of the IAA was recorded using routine transabdominal Doppler ultrasound. The differences in Doppler characteristics, perinatal outcomes, and steroidogenesis in the umbilical vein at birth (adrenocorticotropic hormone [ACTH] and cortisol [F] levels) were compared between the 2 groups. The correlations between IAA-PI and steroidogenesis were assessed in the IUGR group.Results: IAA-PI was significantly lower in IUGR fetuses than in normal controls (0.85 vs 1.18 at first scan, 0.78 vs 0.92 at last scan; both P < 0.001). The plasma F and ACTH levels in IUGR cases were significantly higher than those of the normal controls (18.2 vs 12.4 µg/dL and 280.5 vs 125.6 pg/mL for F and ACTH, respectively; both P < 0.001). There were negative correlations between IAA-PI and plasma F values and between IAA-PI and ACTH values in the IUGR group (r = -0.774 and -0.82 at first scan, r = -0.525 and -0.45 at last scan, respectively; P < 0.001).Conclusion: Increased adrenal gland blood flow with concomitant increases in ACTH and F levels were observed in IUGR fetuses. IAA-PI is useful to assess early blood redistribution and may be beneficial for evaluating the steroidogenic response in high-risk pregnancies. [ABSTRACT FROM AUTHOR]

Objective: To investigate the pathological features of blood stasis syndrome (BSS) in non-diabetic peripheral neuropathy. Methods: Clinical data of 31 patients with non-diabetic peripheral neuropathy who had undergone nerve biopsy during December 2004 and December 2010 in Xuanwu Hospital Capital Medical University were retrospectively analyzed. According to Chinese medicine (CM) syndrome differentiation and signs, 26 patients were blood stasis type and 5 patients were non-blood stasis type. Clinical and pathological data were compared in detail. Results: Clinically, although both groups shared similar symptoms of limb numbness, weakness and sensory disturbances, the prevalence of neuralgia was much grievous in BSS group (73.1%, 26/31) compared with the non-BSS group (0%, 0/5). As for signs, dermal nutrients disturbance (84.6%, 22/26), dark or purple tongue (100.0%, 26/26), and sublingual varices (80.7%, 21/26) were more common in the BSS group than the non-BSS group (0%, 60%, 20%, respectively). The prevalence of qi deficiency cases (19/26) in the BSS group was significantly higher compared with the non-BSS group (1/5). The unique histological manifestations of BSS were axonal degeneration (16/26 vs 2/5 in non-BSS group), which was the hallmark of ischemia. Cases with BSS had prominent microangiopathy (61.5%, 16/26), manifested as epineurium vasculitis (inflammatory cell infiltrated to the vessel wall, obliteration and recanalization, vascular proliferation, extravascular hemosiderin deposition), angiotelectasis, proliferation and hyaline degeneration of endoneurium capillary. In the BSS group, impaired blood-nerve barrier was indicated by sub-perineurial edema (46.2%, 11/26) and endoneurial edema (15.4%, 4/26). The Renaut body (15.4%, 4/26) and amyloid deposition (3.8%, 1/26) found in the BSS group were absent in the non-BSS group. Conclusions: BBS was common in non-diabetic peripheral neuropathies. The nerves exhibited ischemic alteration of primary axon degeneration and secondary demyelination. The interstitial tissue revealed microcirculation impairment, blood-nerve barrier disturbance, amyloid deposition and proliferation changes. The high prevalence of qi deficiency also highlights the therapy of promotion of blood circulation and removal of blood stasis. [ABSTRACT FROM AUTHOR]

The vascular causes of lower‐extremity ulcers cannot be neglected because they can directly affect treatment methods. No detailed epidemiological statistics have described vascular etiological diagnosis in China. This study aimed to explore the prevalence of clinical vascular etiological examination of lower‐extremity ulcers and improve the diagnosis and treatment effectiveness of lower‐extremity ulcers. Data were collected from the WoundCareLog database, which includes 2413 cases of lower‐extremity ulcers from 478 hospitals nationwide. Data analysis revealed that 1698 (70.4%) lower‐extremity blood flow examinations (including physical examination [PE] and assistant examinations [AE]) were performed, of which 61.7% were PE, 10.4% were AE only, and 27.9% were the combined PE and AE[PAE]. The proportion of nonexaminations was higher in the nondiabetic group than in the diabetic group (χ2 = 34.5; P <.01). The positive rates of vascular etiological examination in the diabetic and nondiabetic groups were 69.7% and 70.7%, respectively. Among the four economic regions of China, there were statistically significant differences in the use of the different examination methods. The examination of vascular diseases in lower‐extremity ulcers in China has not been fully popularized and requires improvement; there was no statistically significant difference between examination rates by doctors and nurses, which is mainly based on PE. However, PE has certain rates of misdiagnosis and missed diagnosis. The false‐positive and false‐negative rates were 25.7% and 57.6%, respectively. The use of an AE can compensate for this deficiency by making diagnosis more precise, while the quantitative diagnostic criteria allow disease diagnosis to transcend geographical and operator differences and maximize uniformity. The vascular B‐ultrasound examination is more suitable for the medical environment in China because of its mature technology, high hospital penetration rate, and low cost. [ABSTRACT FROM AUTHOR]

BACKGROUND: As a non-invasive detection method, dynamic contrast-enhanced magnetic resonance imaging is widely used in the field of tumor. It can be used for the differentiation of benign and malignant tumors, the grading of tumor grade and the prediction and evaluation of prognosis. In recent years, the application research in the field of bone and joint has gradually become a hot spot, which can be used in the determination of bone marrow blood perfusion, the evaluation of bone tissue activity, the early detection of bone perfusion abnormality and the evaluation of blood circulation of joint inflammatory lesions. OBJECTIVE: To summarize the technical situation of dynamic contrast-enhanced magnetic resonance imaging and its application research in bone and joint. METHODS: The keywords were "(bone OR joint) AND (dynamic contrast-enhanced MRI) OR dynamic contrast-enhanced magnetic resonance imaging) OR DCE-MRI" in English and Chinese, respectively. The first author searched PubMed, Springeriink and China National Knowledge Infrastructure databases for the articles published between 1984 and 2019. The relevant literature was reviewed on the application of dynamic contrast-enhanced magnetic resonance imaging in bone and joint in recent years. Finally, 55 articles were summarized and analyzed. RESULTS AND CONCLUSION: (1) At present. dynamic contrast-enhanced magnetic resonance imaging technology and data processing have not been standardized. T1WI imaging is mainly used in bone and joint. Qualitative, semi-quantitative and full quantitative analysis of its data is feasible. (2) Qualitative analysis and semi-quantitative analysis are simple and easy to operate. Quantitative indicators are clear, can objectively describe the shape of the curve, but cannot reflect the concentration of contrast agent between tissues and blood vessels, and are easily affected by the sequence of scanning parameters, so cannot detect the pharmacokinetic information of tissue. Quantitative analysis can obtain the concentration changes and generation parameters of contrast media between substructures in tissues, and evaluate the microangiogenesis and function of tissues. (3) Dynamic contrast-enhanced magnetic resonance imaging can noninvasively evaluate the microcirculation perfusion of bone and joint. It has certain reference value for the discussion of the pathogenesis, diagnosis and differential diagnosis, prediction of prognosis, evaluation of curative effect and choice of treatment of many bone and joint diseases. [ABSTRACT FROM AUTHOR]

Cardiovascular disease (CVD), especially atherosclerosis, is a leading cause of morbidity and mortality globally; it causes a considerable burden on families and caregivers and results in significant financial costs being incurred. Hawthorn has an extensive history of medical use in many countries. In China, the use of hawthorn for the treatment of CVD dates to 659 AD. In addition, according to the theory of traditional Chinese medicine, it acts on tonifying the spleen to promote digestion and activate blood circulation to dissipate blood stasis. This review revealed that the hawthorn extracts possess serum lipid-lowering, anti-oxidative, and cardiovascular protective properties, thus gaining popularity, especially for its anti-atherosclerotic effects. We summarize the four principal mechanisms, including blood lipid-lowering, anti-oxidative, anti-inflammatory, and vascular endothelial protection, thus providing a theoretical basis for further utilization of hawthorn. [ABSTRACT FROM AUTHOR]

Background: Electrolyte disturbance is one of the complications of subarachnoid hemorrhage (SAH) and its prognostic value is not fully understood. The focus of this study is to evaluate the impact of dysnatremia and dyskalemia on functional outcomes in patients with aneurysmal SAH. Materials and methods: Patients with spontaneous aneurysmal SAH who were admitted to our intensive care unit (ICU) between 1st January 2011 and 31st December 2016 were included. Demographic data, biochemical parameters from days 1 to day 11 of ICU admission, disease severity, and clinical outcome were recorded. The prognosis was estimated using the Glasgow outcome scale (GOS) at 3 months after the initial insult. Results: A total of 244 patients were included in this study. There were 139 patients (57.0%) with hyponatremia (Na < 135 mmol/L) while 82 patients (33.6%) had hypernatremia (Na >146 mmol/L). Hyponatremia, hypernatremia, and sodium fluctuation >12 mmol/L were more commonly found in those patients with poor outcome. However, both hypokalemia and hyperkalemia were not shown to have a significant effect on the patient's prognosis. Logistic regression analysis identified the following independent predictors of poor outcome (GOS 1-3 at 3 months): age >55 years old, acute physiology and chronic health evaluation IV (APACHE IV) score >50, World Federation of Neurosurgical Societies (WFNS) grade >3, Fisher grade >2, presence of intracranial hemorrhage (ICH)/intraventricular hemorrhage (IVH), use of mannitol, use of loop diuretic aneurysms, involving posterior circulation, and hypernatremia >146 mmol/L. Conclusion: Hypernatremia, but not hyponatremia, in patients with aneurysmal SAH is associated with poor outcome. Both hypokalemia and hyperkalemia were not shown to have a significant effect on the patient's prognosis. Further studies are required to determine whether the treatment of dysnatremia can influence outcomes. Clinical significance: Dysnatremia and dyskalemia are common in patients with aneurysmal SAH, but only hypernatremia is associated with poor outcome. Further studies are required to determine whether the treatment of dysnatremia can influence outcomes. [ABSTRACT FROM AUTHOR]

Sect. Moutan is the only woody taxon belongs to the family of Paeoniaceae, and comprises eight species that are distributed abundantly throughout China. Cortex of tree peony, commonly called as "Danpi" in Chinese, is listed in the Pharmacopeia of the People's Republic of China. "Danpi" has been used in traditional medicine for the treatment of various diseases including clear heat and cool blood, promote blood circulation to remove stasis, reduce inflammation and relieve pain. And this plant is also popularly known as "National color and smells" and "King of flowers" since ancient time in China. The purpose of this review is to provide updated, comprehensive and categorized information on the ethnobotany, cultural information, phytochemistry and pharmacological research of tree peony in order to explore their therapeutic potential and evaluate future research opportunities. Furthermore, to identify scientific lacunae and to open new perspectives for future research. • Sect. Moutan is the woody taxon belongs to the Paeoniaceae. • Provide detailed information on the ethnobotany, culture, phytochemistry and pharmacological research of Moutan. • To explore tree peony therapeutic potential and to open new perspectives for future research. [ABSTRACT FROM AUTHOR]

Purpose. To investigate the characteristics of blood in nonsyndromic retinitis pigmentosa (RP) and reveal the pathogenesis of blood cells involved in blood stasis in RP. Design. This is a retrospective observational study. Methods. We collected vein blood from 101 cases of patients with nonsyndromic RP and 120 cases of normal individuals according to a single-blind study and used routine clinical examination to detect the indicators of blood. All the subjects were mainly from the central south of China. Data were analyzed statistically between the RP group and normal control. Results. The indicator of platelet distribution width (PDW) in patients with RP was higher than that in the normal group; the indicators of red blood cell (RBCs), hemoglobin (HGB), hematocrit (HCT), basophils (BASs), platelets (PLTs), and plateletcrit (PCT) in the RP group were lower than those in the normal control. The differences were statistically very significant between the RP group and normal group (p<0.01). There were no statistical differences in the other indicators between the RP and normal group. Conclusions. The changes in RBCs and PLTs in patients with RP implied that RP induces RBC aggregation and platelet activation, leading to blood stasis which in turn initiates more apoptosis. [ABSTRACT FROM AUTHOR]

Objectives: At present, there is no effective method of evaluating the electrophysiological changes in cardiac myocytes during off-pump coronary artery bypass grafting (OPCAB). Therefore, we preliminarily explored the relationship between electrophysiological characteristics and the changes in cardiac function of 24 patients undergoing OPCAB. Methods: We used the CARTO3 system for epicardial electrophysiological mapping before surgery, during left anterior descending branch anastomosis, diagonal branch anastomosis and after surgery for 24 patients undergoing OPCAB. Data, including local activation time (LAT), bipolar voltage value (BV) and conduction velocity, were processed and analyzed by the system. Intraoperative invasive blood pressure, heart rate and arterial blood gas analysis data were recorded. Continuous electrocardiography (ECG) monitoring was performed three days after surgery. Routine resting myocardial perfusion imaging (MPI) and adenosine stress-gated MPI were performed before surgery. Patients were re-examined before discharge. Results: By analyzing the change in the LAT value, we found that the order of excitation of local myocardial cells changed after surgery. In addition, the LAT change in myocardial cells closer to the anastomosis was more significant. The earliest pacing point on the left anterior descending (LAD) coronary artery territory map was the third point (from the proximal to distal LAD) before OPCAB, but the earliest pacing point moved down to the fourth point (closer to the anastomosis) after the diagonal (DIA) anastomosis was complete. On the DIA territory map, the earliest pacing point was the fourth point before OPCAB; this moved up to the third point (closer to the anastomosis) after DIA bypass grafting. The voltages of all points were increased after myocardial revascularization. Compared with the preoperative period, the third, fourth and fifth points on the LAD territory map increased significantly after LAD anastomosis was complete (p=0.007, p=0.001, p=0.009, respectively). On the DIA territory map, the voltages of the first, second and third points were remarkably increased after completing the DIA anastomosis compared to before OPCAB and after LAD anastomosis completion (p=0.001, p=0.008, p<0.001 and p=0.006, p=0.032, p=0.002, respectively). The average conduction velocity (ACV) of all mapped points increased after OPCAB compared with before OPCAB (p<0.05). Postoperative resting MPI and adenosine stress-gated MPI showed that left ventricular global systolic function improved, the left ventricular ejection fraction (LVEF) increased significantly (p<0.05) and the left ventricular end systolic volume (LVESV) decreased significantly (p<0.05) compared to the preoperative MPI. Conclusions: Adequate surgical coronary revascularization could lead to more stable electrical activity of local cardiomyocytes, thus, illustrating the specific mechanism of coronary revascularization for improving the cardiac function from an electrophysiological perspective. [ABSTRACT FROM AUTHOR]

Objective. Blood stasis (BS) constitution represents a tendency to stagnation and positively associates with the severity of atherosclerosis. In this study, we have identified the interaction effect between BS constitution and atherosclerosis on cognitive impairment in the elderly people. Methods. Eligible elderly people ≥65 years old who attended physical examination in the Mawei community of Fuzhou city during 2015 were enrolled in this study. We explored the characteristics of Traditional Chinese Medicine (TCM) constitution and atherosclerotic factors in the normal and cognitive impairment groups and their interaction effect between participants’ Minimental State Examination (MMSE) scores in the elderly people. Results. The prevalence of cognitive impairment in the elderly people was 13.0%. Red blood cell (RBC), hemoglobin (HB), ankle brachial index (ABI), brachial-ankle pulse wave velocity (BaPWV), and blood stasis (BS) were significantly different between normal and cognitive impairment group (P<0.05). Logistic regression analysis indicated that RBC (odds ratio (OR)=0.530 (0.343-0.817), P=0.004), HB (OR=0.980 (0.967-0.993), P=0.003), ABI (OR=2.199(1.112-4.347), P=0.023), and blood stasis constitution (OR=1.808 (1.022-3.202), P=0.042) were correlated with cognitive impairment. The interactions of blood stasis with HB, ABI, and BaPWV significantly impacted the MMSE score (P<0.05). Conclusion. Elderly individuals with blood stasis may be at a higher risk of arterial stenosis and sclerosis, leading to susceptibility to cognitive impairment. [ABSTRACT FROM AUTHOR]

Abstract Background Peripherally-inserted central catheter-related venous thrombosis has serious complications including the loss of vascular access, recurrent venous thrombosis, and post-thrombotic syndrome. Current guidelines recommend non-pharmacological strategies to prevent peripherally-inserted central catheter-related venous thrombosis. There is little evidence for the effectiveness of handgrip exercise on the prevention of peripherally-inserted central catheter-related venous thrombosis. Objectives To examine the effectiveness of handgrip exercise using an elastic ball to prevent peripherally-inserted central catheter-related venous thrombosis in patients with solid cancers. Design A randomized controlled trial. Settings One teaching hospital in Nanjing, China. Participants In total, 120 subjects with solid cancers were eligible; each had a new peripherally-inserted central catheter. They were recruited and randomly assigned into two exercise groups and one control group. Methods Subjects from exercise groups 1 and 2 performed a 3-week, 25-repetition handgrip exercise, 3 and 6 times daily, respectively. The control group subjects performed a gentle limb exercise with no frequency and intensity requirements. Ultrasound was used to detect venous thrombosis development and examine axillary vein blood flow over the three points. Results There were 32 cases of peripherally-inserted central catheter-related venous thrombosis detected. Two venous thrombosis cases in the control group were symptomatic, but all venous thrombosis cases in the exercise groups were asymptomatic. All venous thromboses were partial. There were significant differences in the incidence of venous thrombosis among the three groups (χ2 = 12.813, p = 0.002; χ2 = 9.340, p = 0.009; χ2 = 11.480, p = 0.003; and χ2 = 10.534, p = 0.005, respectively) at days 2, 3 and 21. The incidence of venous thrombosis in the two exercise groups was lower than that in the control group over the 3 time points (all, p < 0.05). The between-group effects and interaction effect in vein maximum velocity and time-mean flow velocity showed significant differences (F = 4.180, p = 0.025; F = 4.010, p = 0.045; and F = 2.928, p = 0.025) at days 2, 3, and 21, respectively. The axillary vein blood flow parameters in the control group were lower than those in the two exercise groups at day 21 (all, p < 0.05). However, no significant differences occurred in the incidence of venous thrombosis and axillary vein blood flow parameters between the two exercise groups. Conclusion Handgrip exercise using an elastic ball daily for three weeks could decrease the incidence of peripherally-inserted central catheter-related venous thrombosis. The method is simple, with no negative consequence reported. Further studies are required to confirm this conclusion and to explore the optimal frequency of handgrip exercise. [ABSTRACT FROM AUTHOR]

Cancer-associated vein obstruction (CAVO) is a common complication in oncological patients, but the effective therapeutic options are scant. We report a patient with reiterative recurrent CAVO who was successfully treated with intraluminal brachytherapy using a self-expandable stent loaded with linear radioactive iodine-125 seeds (RIS) strand. During follow-up, her clinical symptoms were well improved. Three-month imaging follow-up revealed satisfactory patency of the iliofemoral vein, and the stents combined with RIS strands performed well. No serious complications associated with the implantation of stent and RIS strands were documented in any of the sessions. Intraluminal brachytherapy using a self-expandable stent loaded with linear RIS may be a safe and effective option for CAVO as long as it includes not only blood flow restoration but also brachytherapy administration for cancer. [ABSTRACT FROM AUTHOR]

Curcumae Rhizoma-Sparganii Rhizoma (CR-SR) is a classic herbal pair to promote blood circulation and remove blood stasis in ancient China. However, the molecular mechanism is still unclear. To screen out the anti-liver fibrosis active ingredients in CR-SR. Moreover, preliminary exploration the molecular mechanism of CR-SR to ameliorates liver fibrosis. In this research, plant taxonomy has been confirmed in the "The Plant List" database (www.theplantlist.org). The chemical components of CR-SR were analysed by ultra-performance liquid chromatography-quadrupole/time-of-flight mass spectrometry (UPLC-Q/TOF-MS). "Component-Target-Pathway-Disease" network of CR-SR components were built by network pharmacology. Then, the interaction between primary components and predicted protein targets based on network pharmacology were validated by molecular docking. The pharmacological actions of CR-SR were verified by blood biochemical indexes, histopathologic examination of CCL 4 induced rats' model. The core protein targets were verified by Western blot. The effects of screened active components by molecular autodocking were verified by HSC-T6 cell experiment. The result shows that 57 chemical constituents in CR-SR herbal pair were identified by UPLC-Q/TOF-MS, in which, 27 compounds were closely connected with liver fibrosis related protein targets. 55 protein targets screened out by "component-target-pathway-disease network" maybe the underlying targets for CR-SR to cure liver fibrosis. Moreover, the 55 protein targets are mainly related to RNA transcription, apoptosis, and signal transduction. The molecular autodocking predicted that ten components can bond well with PTGS2 and RELA protein targets. The blood biochemical indexes, histopathologic examination of CCL 4 induced rats experiment showed that CR-SR has well intervention effect of liver fibrosis. The Western blot analysis indicated that CR-SR could significantly inhibit RELA, PTGS2, IL-6, SRC, and AKT1 protein expression to exert the anti-fibrosis effect. The HSC-T6 cell experiment indicated that both formononetin (FNT) and curdione could significantly inhibit the activation of HSC and reduce the expression of PTGS2, and p-AKT1 which was accordance with the molecular autodocking results. This study proved the molecular mechanism of CR-SR multi-component and multi-target anti-liver fibrosis effect through mass spectrometry, network pharmacology, and western blotting technology. The research provides a theoretical evidence for the development and utilization of CR-SR herbal pair. [Display omitted] • This study has identified 55 primary components of CR-SR herb pair by UPLC-Q/TOF-MS. • Establishment "Compound-Target-Pathway-Disease" Network of 57 components of CR-SR in treating liver fibrosis. • Verified the anti-liver fibrosis pharmacological action of CR-SR by CCL 4 induced hepatic fibrosis rats model. • Verified the anti-liver fibrosis potential protein targets of CR-SR by western blot in vivo and in vitro. [ABSTRACT FROM AUTHOR]

Background: Placenta accreta (PA), a severe complication during delivery, is closely linked with massive hemorrhage which could endanger the lives of both mother and baby. Moreover, the incidence of PA has increased dramatically with the increasing rate of cesarean deliveries in the past few decades. Therefore, studies evaluating the effects of different perioperative managements based on different modalities in the treatment of PA are necessary. Among the numerous treatment measures, prophylactic abdominal aortic balloon occlusion (AABO) in combination with cesarean section for PA seems to be more advantageous than others. However, up to now, all studies on AABO were almost retrospective. Current evidence is insufficient to recommend for or against routinely using the AABO technology for control intraoperative hemorrhage in patients with PA. Thus, we hope to carry out a prospective, randomized controlled trial (RCT) study to confirm the effectiveness of the AABO technology in patients with PA.Methods/design: This trial is an investigator-initiated, prospective RCT that will test the superiority of AABO in combination with cesarean section compared to the traditional hysterectomy following cesarean section for parturients with PA. A total of 170 parturients with PA undergoing cesarean section will be randomized to receive either AABO in combination with cesarean section or the traditional hysterectomy following cesarean section. The primary outcome is estimated blood loss. The most important secondary outcome is the occurrence of cesarean hysterectomy during delivery; others include blood transfusion volume, operating time, neonate's Apgar scores (collected at 1, 5 and 10 min), length of stay in intensive care unit, total hospital stay, and balloon occlusion-relative data.Discussion: This prospective trial will test the superiority of AABO in combination with cesarean section compared to the traditional hysterectomy following cesarean section for parturients with PA. It may provide strong evidence about the benefits and risks of AABO in combination with cesarean section for parturients with PA.Trial Registration: Chinese Clinical Trial Registry, ChiCTR-INR-16008842 . Registered on 14 July 2016. [ABSTRACT FROM AUTHOR]

Thermoregulation models of the human body have been widely used in thermal comfort studies. The existing models are complicated and not fully verified for application in China. This paper presents a simplified thermoregulation model which has been statistically validated by the predicted and measured mean skin temperature in warm environments, including 21 typical conditions with 400 Chinese subjects. This model comprises three parts: i) the physical model; ii) the controlled system; and iii) the controlling system, and considers three key questions formerly ignored by the existing models including: a) the evaporation efficiency of regulatory sweat; b) the proportional relation of total skin blood flow and total heat loss by regulatory sweating against body surface area; and c) discrepancies in the mean skin temperatures by gender. The developed model has been validated to be within the 95% confidence interval of the population mean skin temperature in three cases. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the effects of estrogen in combination with aspirin and intrauterine balloon on the uterine endometrial repair and reproductive prognosis in patients after surgery for severe intrauterine adhesion (sIUA). We prospectively recruited 114 patients with sIUA. Intrauterine device (IUD) was placed and oral estrogen was administered after surgery. Patients were divided into control group and aspirin group. In addition, patients in aspirin group were subdivided into nonballoon group and balloon group. Results showed that, after therapy, the increase in endometrial thickness of aspirin groups was superior to control group (P<0.05). The scores of intrauterine adhesion and menstruation were significantly improved in balloon group as compared to nonballoon group and control group, and significant differences were also observed between nonballoon group and control group (P<0.05). Of 97 patients, 44.3% became pregnant after surgery, the live birth rate was 27.8%, and the miscarriage rate was 37.2%, but there were no significant differences among three groups (P>0.05). Thus, aspirin may promote the uterine endometrial growth and repair after surgery for sIUA, and IUD in combination with intrauterine balloon may reduce the recurrence of intrauterine adhesion, but their effect on the reproductive prognosis is required to be further studied. [ABSTRACT FROM AUTHOR]

Background. This study compared outcomes of abdominal lifting and compression cardiopulmonary resuscitation (ALP-CPR) with standard CPR (STD-CPR). Materials and Methods. Patients with cardiac arrest seen from April to December 2014 were randomized to receive standard CPR or ALP-CPR performed with a novel abdominal lifting/compression device. The primary outcome was return of spontaneous circulation (ROSC). Results. Patients were randomized to receive ALP-CPR (n=40) and STD-CPR (n=43), and the groups had similar baseline characteristics. After CPR, 9 (22.5%) and 7 (16.3%) patients in the ALP-CPR and STD-CPR groups, respectively, obtained ROSC. At 60 minutes after ROSC, 7 (77.8%) and 2 (28.6%) patients, respectively, in the ALP-CPR and STD-CPR groups survived (P=0.049). Patients in the ALP-CPR group had a significantly higher heart rate and lower mean arterial pressure (MAP) than those in the STD-CPR group (heart rate: 106.8 versus 79.0, P<0.001; MAP: 60.0 versus 67.3 mm Hg, P=0.003). The posttreatment PCO2 was significantly lower in ALP-CPR group than in STD-CPR group (52.33 versus 58.81, P=0.009). PO2 was significantly increased after ALP-CPR (45.15 to 60.68, P<0.001), but it was not changed after STD-CPR. PO2 after CPR was significantly higher in the ALP-CPR group (60.68 versus 44.47, P<0.001). There were no differences between genders and for patients who are > 65 or ≤ 65 years of age. Conclusions. The abdominal lifting and compression cardiopulmonary resuscitation device used in this study is associated with a higher survival rate after ROSC than standard CPR. [ABSTRACT FROM AUTHOR]