Abstract:Objective To explore the application value of echocardiography in evaluating the improvement of cardiac structure and hemodynamic status after rheumatic mitral valve disease surgery.Methods From March 2012 to June 2023,a total of 112 patients with rheumatic mitral stenosis and/or mitral regurgitation who underwent mitral valve replacement or mitral valve repair in Beijing Anzhen Hospital,Capital Medical University and underwent echocardiography review after operation were retrospectively enrolled.The cardiac structure and function indexes before and after operation were compared to evaluate the postoperative clinical efficacy.Results The mean age of 112 patients was(69±3)years,90 patients(80.4％)were female.75 patients(67.0％)underwent mitral valve replacement,37 patients(33.0％)underwent mitral valve repair,and 93 patients(83.0％)underwent tricuspid valve repair at the same time.The median follow-up time was 32(13,62)months.The diameters of bilateral atria and left atrial anteroposterior diameter after operation were significantly smaller than those before operation(all P＜0.001).The amplitude of ventricular septal motion after surgery was significantly smaller than that before surgery,the area of mitral valve orifice was significantly larger than that before surgery,and the area of mitral regurgitation was significantly smaller than that before surgery[(5±2)mm vs(7±2)mm,(2.3±0.4)cm2 vs(1.3±0.5)cm2,2.7(1.9,3.8)cm2 vs 6.0(2.3,10.0)cm2](all P＜0.05).Postoperative pulmonary artery systolic pressure,tricuspid regurgitation pressure gradient,tricuspid regurgitation peak velocity and tricuspid regurgitation area were significantly lower than those before operation(all P＜0.001).Conclusions Mitral valve replacement or repair can significantly improve the cardiac structure and hemodynamic status of patients with rheumatic mitral valve disease.Echocardiography is an important tool to evaluate the effect of surgery.

Abstract:Objective To explore the correlation between afternoon blood pressure level and target organ damage in patients with hypertension,and to provide a new clinical basis for blood pressure management.Methods A total of 252 hypertensive patients who received ambulatory blood pressure monitoring were recruited from the hypertension center of Beijing Anzhen Hospital,Capital Medical University from January to December 2022.According to the third level of afternoon systolic blood pressure,the patients were divided into low afternoon blood pressure group,middle afternoon blood pressure group and high afternoon blood pressure group,with 84 cases in each group.Multivariate Logistic regression analysis was used to evaluate the association of afternoon systolic blood pressure with left ventricular hypertrophy,proteinuria and arteriosclerosis.Subgroup analysis was used to verify the interaction effect of this association in patients with different age,gender,smoking and drinking status.Results Multivariate Logistic regression analysis showed that compared with the low afternoon blood pressure group,the high afternoon blood pressure group had more severe left ventricular hypertrophy,proteinuria,and arteriosclerosis damage,which still existed after adjusting for age,gender and other factors(all P＜0.05).Afternoon systolic blood pressure was analyzed as a continuous variable.After adjusting for confounding factors,the degree of left ventricular hypertrophy(odds ratio=1.07,95％confidence interval:1.04-1.11),proteinuria(odds ratio=1.05,95％confidence interval:1.02-1.07)and arteriosclerosis(odds ratio=1.04,95％confidence interval:1.02-1.06)damage increased with the increase of afternoon systolic blood pressure(all P＜0.05).Subgroup analysis showed that the association between afternoon systolic blood pressure and target organ damage was consistent across subgroups of gender,age,smoking and drinking status,and no significant interaction was found(all P＞0.05).Conclusions The afternoon systolic blood pressure level is positively correlated with target organ damage in hypertensive patients,which is consistent in different population subgroups,suggesting that afternoon blood pressure monitoring is of great clinical significance in assessing the risk of target organ damage in hypertensive patients.

Abstract:Objective To investigate the effect and safety of perioperative hydration therapy combined with furosemide on contrast-induced nephropathy(CIN)after percutaneous coronary intervention(PCI).Methods A total of 556 patients who underwent PCI in the Department of Cardiology,the First People's Hospital of Kashi,Xinjiang Uygur Autonomous Region from January to December 2023 were collected.All patients were divided into control group and observation group by random number table method,with 278 cases in each group.The observation group was treated with hydration and furosemide during the perioperative period,and the control group was treated with hydration alone.The basic clinical data of the two groups were compared.The renal function and the incidence of CIN were compared before and after operation.The influencing factors of CIN were analyzed by binary Logistic regression.The incidence of adverse reactions during hospitalization was compared between the two groups.Results The proportion of male in the observation group was lower than that in the control group,and the proportion of hypertension history,contrast agent dosage,and proportion of taking β-blockers were higher than those in the control group(all P＜0.05).The levels of serum creatinine,cystatin C and serum uric acid in the two groups were significantly higher than those before operation(all P＜0.05).The incidence of CIN in the observation group was lower than that in the control group[19.4％(54/278)vs 27.3％(76/278)](P=0.027).Binary Logistic regression analysis showed that contrast agent dosage was an independent risk factor for CIN after PCI(odds ratio=1.016,95％confidence interval:1.009-1.024,P=0.019).Furosemide was a protective factor for CIN after PCI(odds ratio=0.359,95％confidence interval:0.143-0.904,P=0.030).There was no significant difference in the incidence of adverse reactions between the two groups during hospitalization(P=0.102).Conclusion Perioperative hydration combined with furosemide can reduce the incidence of CIN after PCI,and does not increase the incidence of adverse reactions during hospitalization,with high safety.

Abstract:Objective To evaluate the left ventricular reverse remodeling at 1 year after transcatheter edge-to-edge repair(TEER)of moderate to severe mitral regurgitation(MR)in patients with different etiologies.Methods The clinical and echocardiographic data of 91 patients with moderate to severe MR Who underwent TEER treatment in the Interventional Center of Valvular Heart Disease,Beijing Anzhen Hospital,Capital Medical University from June 2021 to November 2023 were retrospectively analyzed.According to the etiology,the patients were divided into degenerative mitral regurgitation(DMR)group(70 cases)and functional mitral regurgitation(FMR)group(21 cases).Clinical baseline data and echocardiographic data before and 1 year after surgery were collected.Left ventricular reverse remodeling and functional changes were compared between the two groups one year after surgery.Results Compared with the DMR group,the effective regurgitation orifice area and effective valve orifice area in the FMR group were smaller,the left ventricular end-diastolic volume(LVEDV)and left ventricular end-systolic volume(LVESV)were larger,and the left ventricular ejection fraction was smaller(all P＜0.05).One year after operation,the left ventricular end-diastolic diameter,left ventricular end-systolic diameter,LVEDV,LVESV and left atrial diameter of the two groups were lower than those before operation,the mean mitral valve pressure gradient was higher than that before operation,and the New York Heart Association heart function classification was significantly improved(all P＜0.05).The proportion of normal left ventricular shape was increased compared with baseline[DMR group:31.4％(22/70)vs 20.0％(14/70),FMR group:61.9％(13/21)vs 33.3％(7/21)],and the proportion of eccentric left ventricular hypertrophy was decreased(all P＜0.05).Conclusions For patients with moderate to severe MR of different etiologies,TEER treatment can effectively improve the degree of MR Regurgitation in the mid-term after operation,improve cardiac function,promote left ventricular reverse remodeling,and restore normal left ventricular morphology in some patients.

Abstract:Objective To observe the analgesic effect of esmketamine in general anesthesia with double-lumen endotracheal intubation for thoracoscopic pneumonectomy.Methods A total of 118 patients who underwent thoracoscopic pneumonectomy in Anhui Chest Hospital from July 1,2022 to June 30,2023 were selected as the research objects.They were divided into the control group and the observation group by simple random method,with 59 cases in each group.The control group was given propofol and remifentanil for anesthesia maintenance after anesthesia induction,and the observation group was added esketamine for combined anesthesia maintenance on the basis of the control group after anesthesia induction.The intraoperative hemodynamics,perioperative opioid consumption,postoperative analgesia and adverse reactions were compared between the two groups.Results There was no significant difference in mean arterial pressure(MAP)and heart rate between the two groups before anesthesia induction(T0)(both P＞0.05).The MAP and heart rate immediately after intubation(T1)and at 5 min after double-lumen tube insertion(T2)were lower than those at T0 in both groups(all P＜0.05).There was no significant difference between 10 min after removal of double-lumen tube(T3)and T0 in the same group(all P＞0.05).The MAP and heart rate of the observation group at T,were higher than those of the control group at the same time point,but there were no statistically significant differences in MAP and heart rate between the two groups at T2 and T3(all P＞0.05).The perioperative doses of remifentanil and sufentanil in the observation group were lower than those in the control group(both P＜0.001).The time of first pressing analgesic pump after surgery in the obser-vation group was later than that in the control group[(80±12)min vs(46±8)min],the actual and effective pressing times within 24 hours and the dosage of ketochromate tromethamine were less than those in the control group[(5.8±3.2)times vs(10.3±4.1)times,(5.9±3.0)times vs(10.3±4.3)times,(304±20)mg vs(712±29)mg](all P＜0.05).However,there was no significant difference in the incidence of visual analogue scale score＞4 between the two groups(P＞0.05).The levels of prostaglandin E2,cortisol and norepinephrine in the two groups at 24 hours after operation were higher than those before operation,but those in the observation group were lower than those in the control group(all P＜0.05).The incidence of nausea and vomiting in the observation group was lower than that in the control group,and the difference was statistically significant(P=0.038).However,there was no significant difference in the incidence of dizziness,respiratory depression,pruritus,restlessness and hallucination between the two groups(all P＞0.05).Conclusion The application of esmketamine in general anesthesia with double-lumen endotracheal intubation in thoracoscopic pneumonectomy can stabilize hemodynamics,reduce the dosage of opioids,and have good analgesic effect.

Abstract:Objective To investigate the effect of glucagon like peptide 1(GLP-1)metabolite GLP-1(28-36)amide on transforming growth factor-β(TGF-β)-mediated proliferation and activation of pulmonary fibroblasts and its possible mechanism.Methods Mouse lung fibroblasts(MLg cells)were divided into control group,TGF-βgroup,TGF-β+liraglutide group,TGF-β+GLP-1(28-36)amide group.The phosphorylation level of Smad homolog 3(SMAD3)in MLg cells was detected by Western blotting.Cell counting kit-8 was used to detect the proliferation of MLg cells.Ligand fishing of MLg cell lysates was performed by biotin-labeled GLP-1(28-36)amide[BIOT(28-36)]and streptomycin agarose.The protein samples obtained from fishing were analyzed by high performance liquid chromatography-tandem mass spectrometry.According to the mass spectrometry data,the top 100 abundant proteins were screened for bioinformatics analysis to further screen the proteins that might interact with GLP-1(28-36)amide.Autodock vina1.5.6 software was used to verify the binding between proteins.Results Compared with the control group,the phosphorylation level of SMAD3 in MLg cells was increased(P＜0.01)and the cell proliferation rate was increased(P＜0.05)in TGF-β group.Compared with TGF-β group,the phosphorylation level of SMAD3 in TGF-β+GLP-1(28-36)amide group was decreased[(0.677±0.046)vs(1.414±0.037)](P＜0.05),and there was no significant difference in proliferation rate(P＞0.05).Bioinformatics analysis showed that mitochondrial protein YME1-like 1atpase(YME1L1),phosphoglycerate mutase 5(PGAM5),mitochondrial translation elongation factor Tu(TUFM),heat shock protein family D member 1(HSPD1),solute carrier family 25 member 5(SLC25A5)may be related to GLP-1(28-36)amides bind to each other.Autodock vina1.5.6 software was used for molecular Docking and Pymol 3.1 software was used for visualization.The docking scores of the above-mentioned proteins with GLP-1(28-36)amide were all＜-4 kcal/mol.Conclusion GLP-1(28-36)amide can inhibit TGF-β-mediated activation of pulmonary fibroblasts,which may act through mitochondrial related pathways.The proteins that can directly bind to GLP-1(28-36)amide may be mitochondrial proteins such as YME1L1,PGAM5,TUFM,HSPD1,and SLC25A5.

Abstract:Objective To investigate the protective effect of dimethyl fumarate(DMF)on acute gouty arthritis in rats and its mechanism.Methods Twenty-one male SD rats were randomly divided into physiological saline group,urate crystal(MSU)group,and MSU+DMF group after one week of feeding in an environment without specific pathogens,with seven rats in each group.In the physiological saline group,no model was made,and physiological saline was administered by gavage;The model of acute gouty arthritis was made by MSU in MSU group and MSU+DMF group,and the rats were gavaged with physiological saline and DMF respectively.The degree of ankle swelling and gait behavior rating were compared between the groups,and the pathological sections of rat ankle synovium were stained with hematoxylin-eosin.The histopathological changes and inflammatory cell infiltration of rats in each group were observed.The protein expressions of scutellarin D,NOD like receptor protein 3(NLRP3)and caspase-1 in synovial tissue of rats in each group were determined by integrated optical density method.The serum levels of interleukin-1 β(IL-1β),IL-6 and tumor necrosis factor α(TNF-α)were determined by enzyme-linked immunosorbent assay.Results The joint swelling degrees of MSU+DMF group and MSU group were greater than those of normal saline group at 4,8,24 and 48 h after treatment,but the joint swelling degrees of MSU+DMF group were less than those of MSU group(all P＜0.05).At 4,8,24,48 h after treatment,the MSU+DMF group and MSU group had significantly higher gait behavior rating than the physiological group,but the MSU+DMF group had significantly lower gait behavior rating than the MSU group(all P＜0.05).The MSU group had a large number of inflammatory cell infiltration and obvious inflammatory response.Compared with the MSU group,the MSU+DMF group had less inflammatory response,less inflammatory cell infiltration,and more uniform distribution of synovial cells.The protein expression of NLRP3,caspase-1,and gasdermin D and the levels of IL-1β,IL-6,and TNF-α in the synovial tissue of the MSU group were significantly higher than those in the physiological saline group,and those in the MSU+DMF group were significantly lower than those in the MSU group[inflammatory factors:(64±7)ng/L vs(106±13)ng/L,(27±4)ng/L vs(59±8)ng/L,(11.3±1.5)ng/L vs(27.8±3.9)ng/L](all P＜0.05).Conclusions DMF has a protective effect on MSU induced acute gouty arthritis in rats,which may be related to the inhibition of NLRP3 inflammasome and NLRP3 inflammatory pathway.

Abstract:Gastroesophageal reflux disease(GERD)is a common digestive system disease with complex etiology and recurrent episodes,which has brought great trouble to clinicians.As a surgical method for the treat-ment of gastric cancer and other diseases,proximal gastrectomy destroys the physiological structure of the cardia and its surrounding area,which may lead to the occurrence of acid reflux and reflux phenomenon in the residual stomach after surgery,which may cause GERD.This situation seriously affects the quality of life of patients.This article mainly summarizes the pathogenesis,treatment methods and the progress of anti-reflux surgery for GERD after proximal gastrectomy,aiming to provide a reference for the selection of treatment options for GERD after proximal gastrectomy.

Abstract:Klinefelter syndrome(KS)is a common sex chromosome abnormality in males and the most common cause of congenital male hypogonadism.This paper reports a case of KS combined with dermatomyositis with positive anti-melanoma differentiation-associated gene 5(MDA5)antibody.The patient was a 44-year-old male who presented with bilateral shoulder and knee joint swelling and pain with limb weakness,bilateral periorbital purple rash,sparse pubic hair,short penis,no laryngeal,low testosterone level,elevated follicle-stimulating hormone and luteinizing hormone levels,elevated serum lactate dehydrogenase,positive anti-MDA5 antibody,and a chromosome karyotype of 47,XXY.The patient was diagnosed with KS combined with dermatomyositis with positive anti-MDA5 antibody,and had bilateral femoral head necrosis and osteoporosis.This article reviews the diagnosis and treatment process of the patients,focuses on the potential risk of bone metabolic diseases in these patients,and reminds the first doctor to prevent and monitor the occurrence of bone metabolic diseases,so as to prevent disease before disease and prevent disease from becoming worse,which is very important to improve the quality of life of patients.

Abstract:Objective To investigate the anesthetic effect of nalbuphine combined with bupivacaine for caudal block on pediatric daytime laparoscopic surgery and its effect on hemodynamics.Methods A total of 120 children undergoing daytime laparoscopic surgery in Hebei Children's Hospital from June 2023 to February 2024 were selected.According to the random number table method,they were divided into the composite group and the control group,with 60 cases in each group.The control group was given bupivacaine caudal block,and the composite group was given nalbuphine on the basis of the control group.The sedation,pain response index,hemo-dynamic index,sacral block effect and adverse reactions were compared between the two groups.Results At 4 and 8 h after operation,the Ramsay score and visual analogue scale score of the composite group were significantly lower than those of the control group(both P＜0.05).The levels of heart rate and mean arterial pressure at 5 min after injection and skin incision in the composite group were higher than those in the control group(all P＜0.05).The onset times of sensory and motor block in the composite group were shorter than that in the control group[(57±6)svs(79±8)s,(145±16)s vs(181±21)s],and the durations of sensory and motor block were longer than that of the control group[(177±20)min vs(137±16)min,(106±13)min vs(78±9)min](all P＜0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P=0.378).Conclusion Nalbuphine combined with bupivacaine for caudal block in pediatric daytime laparoscopic surgery has good clinical application effect,which can effectively maintain the body's hemodynamic level,improve the sedative and analgesic effects,prolong the drug effect time,and has high safety.

Abstract:Objective To investigate the relationship between serum omentin-1 and prostate specific antigen(PSA)and polycystic ovary syndrome(PCOS),and to provide new ideas for the diagnosis and treatment of PCOS.Methods A total of 40 PCOS patients who visited the Department of Reproductive Medicine,the Second Affiliated Hospital of Shandong First Medical University from February to December 2021 were selected as the PCOS group.During the same period,40 infertility patients with regular menstruation due to tubal factors or male factors were selected as the control group.Liver function,renal function,fasting blood glucose,fasting insulin,blood lipids,reproductive endocrine hormones,omentin-1 and PSA levels were detected in all patients.The differences of the above indicators between the two groups were compared.Results The levels of luteinizing hormone,luteinizing hormone/follicle-stimulating hormone,testosterone,waist circumference,waist-hip ratio,triglyceride,fasting insulin,homeostasis model assessment of insulin resistance index(HOMA-IR)and PSA in PCOS group were significantly higher than those in control group,while the level of omentin-1 was significantly lower than that in control group(all P＜0.05).Correlation analysis showed that omentin-1 was negatively correlated with testosterone,HOMA-IR and alanine aminotransferase(r=-0.479,P=0.033;r=0.450,P=0.046;r=-0.679,P=0.001).PSA was positively correlated with testosterone,fasting insulin and HOMA-IR(r=0.562,P=0.010;r=0.472,P=0.035;r=0.574,P=0.008),and negative correlated with omentin-1(r=-0.472,P=0.036).Conclusion Serum omentin-1 and PSA are closely related to insulin resistance and hyperandro-genism in PCOS patients.

Abstract:Triple-negative breast cancer(TNBC)is a highly heterogeneous subtype of breast cancer.Due to its lack of specific treatment markers,its recurrence rate,mortality rate,and aggressiveness are all higher than other types of breast cancer.In recent years,the focus of tumor research has been on the tumor microenvironment,and tumor-associated macrophages(TAM)account for more than 50％of the stromal cells in breast cancer and are the most abundant immune cells in the tumor microenvironment.A large number of studies on the relationship between TAM and tumor-related mechanisms have found that TAM play an important role in tumor development and progression,making them a promising biomarker for TNBC treatment and prognosis prediction.This review summa-rizes the role of TAM in TNBC and potential treatment strategies.

Abstract:Coronary artery aneurysm(CAA)is a rare coronary artery anomaly defined as a coronary artery that is dilated more than 1.5 times the diameter of the adjacent normal coronary artery or the largest coronary artery.Although the detection rate of CAA has increased with the popularity of coronary CT angiography,the understanding of such diseases is still limited.This article reviews the relevant literature and summarizes the related research of CAA in order to improve people's understanding of this disease.

Abstract:Bachmann bundle is the dominant pathway of interatrial electrical impulse conduction,and its structure and function damage can lead to interatrial conduction block(IAB).IAB plays an important role in the occurrence and maintenance of atrial fibrillation.Bachmann bundle pacing can correct interatrial conduction delay and improve atrial electromechanical synchronization compared with traditional right atrial appendage pacing,which is a research hotspot in the field of physiological pacing.This article reviews the anatomical structure and electro-physiological characteristics of Bachmann bundle,its clinical significance,as well as the technical methods and clinical applications of Bachmann bundle pacing.

Abstract:Linezolid is an oxazolidinone antibacterial drug whose mechanism of action is mainly to inhibit bacterial growth by targeting bacterial ribosomes and interfering with bacterial protein synthesis,and is mainly used for the treatment of gram-positive bacteria,including Enterococcus faecalis,Staphylococcus aureus,and Staphylococcus aureus resistant to vancomycin.Although linezolid is an effective antimicrobial drug,its potential to cause lactic acidosis is a rare and fatal side effect.Current treatment guidelines have some recommendations.First,monitor blood linezolid and lactate levels while linezolid is being administered.Second,linezolid should not be combined with drugs that affect mitochondrial function.Third,patients with hepatic and renal insufficiency or linezolid therapy for＞1 month should be monitored for hyperlactatemia.Fourth,if hyperlactic acidosis occurs,it is recommended to stop linezolid and correct the acidosis as soon as possible.This article reports a case of lactic acidosis after taking linezolid for tuberculous pleurisy,which was confirmed to be a side effect of linezolid after exclusion of other causes such as metabolism,hypoxia or organ damage.It aims to improve clinicians'knowledge of the diagnosis and treatment of lactic acidosis caused by linezolid.

Abstract:Objective To evaluate the diagnostic value of superb microvascular imaging(SMI),contrast-enhanced ultrasound(CEUS)and both combination in thyroid micropapillary carcinoma(TMC).Methods Totally 45 patients with suspected TMC were examined by ultrasound,SMI and CEUS,and then underwent surgical resection in Beijing Anzhen Hospital,Capital Medical University from July 2017 to September 2023.The pathological results were obtained.Pathological diagnosis was used as a golden indicator,and the diagnostic value of SMI,CEUS and SMI combined with CEUS in TMC was compared.Results Among 45 patients,55 thyroid nodules were detected.SMI found 44 malignant thyroid nodules and 11 benign thyroid nodules,and the SMI diagnosis of TMC had a conformity rate of 89.1％,sensitivity of 100％,specificity of 45.5％,misdiagnosis rate of 54.5％,missed diagnosis rate of 0,positive predictive value of 88％,negative predictive value of 100％,and Kappa value of 0.571.CEUS found 49 malignant nodules and 6 benign nodules,and the CEUS diagnosis of TMC had a coincidence rate of 94.5％,sensitivity of 98.0％,specificity of 66.7％,misdiagnosis rate of 33.3％,missed diagnosis rate of 2.0％,positive predictive value of 96％,negative predictive value of 80％,and Kappa value of 0.697.SMI combined with CEUS found 48 malignant thyroid nodules and 7 benign thyroid nodules,and SMI combined with CEUS diagnosis of TMC had a coincidence rate of 96.4％,sensitivity of 100％,specificity of 71.4％,misdiagno-sis rate of 28.6％,missed diagnosis rate of 0,positive predictive value of 96％,negative predictive value of 100％,and Kappa value of 0.814.Conclusion The diagnostic coincidence rate of SMI combined with CEUS is higher than that of single SMI and CEUS.SMI can be used as a preliminary screening method for TMC patients.

Abstract:Objective To investigate the preventive effect of Taohong Siwu decoction on deep vein throm-bosis after total knee arthroplasty.Method A total of 120 patients with knee osteoarthritis who underwent total knee arthroplasty in the First Affiliated Hospital of Guangzhou University of Chinese Medicine from March 2022 to August 2023 were selected.According to the random number table method,they were divided into the control group and the observation group,with 60 cases in each group.The control group was treated with total knee replacement,and the observation group was treated with Taohong Siwu decoction on the basis of the control group.The symptom scores,glycocalyx damage markers,inflammatory factors,coagulation index and the incidence of deep vein thrombosis were compared between the two groups.Results The scores of tongue coating and pulse,pain of affected limbs,skin color and skin temperature after operation in the two groups were lower than those before operation,and those in the observation group were lower than those in the control group(all P＜0.05).The leg circumferences of upper and lower 10 cm of patella in the two groups after operation were smaller than those before operation,and those in the observation group were smaller than those in the control group(all P＜0.05).The levels of syndecan 1,heparin sulfate,and hyaluronic acid after operation in the two groups were lower than those before operation,and those in the observation group were lower than those in the control group(all P＜0.05).The levels of tumor necrosis factor-α and interleukin-6 in the two groups after operation were lower than those before operation,and those in the observation group were lower than those in the control group.The activated partial thromboplastin times in the two groups were longer than those before operation,and that in the observation group was longer than that in the control group(all P＜0.05).The incidence of deep vein thrombosis was 3.3％(2/60)in the observation group and 13.3％(8/60)in the control group,and the difference between the groups was statistically significant(x2=3.927,P=0.048).Conclusion Taohong Siwu decoction for patients with total knee arthroplasty has a significant effect on improving the glycocalyx damage markers and alleviating the inflammatory response of the body,and the incidence of postoperative deep vein thrombosis of the lower extremities is effectively controlled.

Abstract:Objective To explore the dilemma and breakthrough direction of the development of cardiac surgery professional database,hoping to bring beneficial reference for the construction of cardiac surgery professional database.Methods The operation database and follow-up system in Valve Surgery Center,Beijing Anzhen Hospital,Capital Medical University were extracted and compared,and the operation of the database and the existing problems were summarized and reviewed retrospectively.Results The operation information database had been running for more than 20 years since 2001,including 15 420 cases of valve surgery,and had become a part of clinical work.In the past 20 years,the age of patients undergoing valve surgery had changed in many aspects,such as age,diseased valves and surgical methods,indicated the changes of valve diseases and the progress of surgical techniques.The age of patients treated by valve surgery increased from(46±15)years old in 2001 to(58±13)years old in 2023.A total of 962 patients were enrolled in the follow-up system within 2 years since 2013,and 691 patients were followed up,with a follow-up rate of 71.8％.However,the bottleneck of sustainable development appeared later.Compared with the surgical database,there were differences in the follow-up system in terms of service subject orientation,information collection mode,and database working mode.Conclusion The construction of cardiac surgery database in the era of big data required the combination of national top-level design and practical exploration.The establishment of a patient-centered,national-level longitudinal database,combined with a disease-centered,professional-level horizontal database.Covering perfect basic and professional informa-tion,should be the future direction of professional database development.

Abstract:Cardiac surgery faces severe challenges in the perioperative management of patients due to its characteristics of deep trauma and high risk of postoperative complications.Rapid rehabilitation medicine,by integrating multidisciplinary collaboration programs such as preoperative pre-rehabilitation,application of minimally invasive techniques,and goal-oriented fluid management,constructs an optimized path covering the entire perioperative process.It can effectively regulate surgical stress responses,reduce complications such as pulmonary infections,and shorten the length of stay in the intensive care unit and the length of hospital stay.This article systematically reviews the latest progress of rapid rehabilitation medicine in the field of cardiac surgery,focusing on key technological breakthroughs such as the optimization of minimally invasive surgical approaches,extracorporeal circulation blood management,precise body temperature maintenance,and dynamic monitoring of coagulation function,providing a theoretical basis for promoting the standardized implementation of the concept of rapid rehabilitation medicine in cardiac surgery.

Abstract:Objective To investigate the effect of compound Xueshuantong capsule combined with sodium hyaluronate eye drops in the treatment of dry eye.syndrome.Methods A total of 98 patients with dry eye syndrome treated in Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from March 2021 to December 2023 were selected.According to the random number table method,they were divided into the control group(49 cases)and the observation group(49 cases).The control group was treated with sodium hyalur-onate eye drops(1 drop/time,3 times/d).The observation group was treated with compound Xueshuantong capsule combined with sodium hyaluronate eye drops,and the usage of sodium hyaluronate eye drops was the same as that of the control group;compound Xueshuantong capsule was 3 capsules/time,3 times/day orally.Both groups were treated for 4 weeks.After treatment,the therapeutic effect was evaluated,and the improvement times of eye dryness,visual acuity fluctuation,burning sensation and foreign body sensation were compared between the two groups.The levels of nucleotide-binding oligomerization domain-like receptor 1(NOD-1),C-reactive protein(CRP)and interleukin-6(IL-6)in tear were compared between the two groups before and after treatment.The adverse reactions were recorded.Results The total effective rate of the observation group was significantly higher than that of the control group[95.9％(47/49)vs 81.6％(40/49)](P=0.025).The improvement times of eye dryness,visual acuity fluctuation,burning sensation and foreign body sensation in the observation group were shorter than those in the control group(all P＜0.05).After treatment,the concentrations of NOD-1,CRP and IL-6 in the two groups were lower than those before treatment(all P＜0.05).The concentrations of NOD-1,CRP and IL-6 in the observation group were lower than those in the control group(all P＜0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P=0.558).Conclusion The combined use of compound Xueshuantong capsule and sodium hyaluronate eye drops in the treatment of dry eye syndrome can quickly improve the clinical symptoms of patients,and has a significant improvement in the eye inflammation of patients,with good safety.