ObjectiveTo investigate the molecular network and key targets of cancer-related fever in colorectal cancer using bioinformatics methods, and to predict potential traditional Chinese medicine (TCM) formulations through reverse network pharmacology. MethodsCommon gene targets for colorectal cancer and cancer-related fever were obtained from the GeneCards database. Gene ontology (GO) enrichment analysis and Kyoto encyclopedia of genes and genomes (KEGG) pathway enrichment analysis were performed using the Metascape platform to identify relevant biological processes and signaling pathways. A protein-protein interaction (PPI) network was constructed using the STRING database and Cytoscape (version 3.10.1) software to screen for core targets. The top 40 key targets were selected and reversely matched with corresponding active ingredients of TCM using the traditional Chinese medicine systems pharmacology database and analysis platform (TCMSP), followed by molecular docking validation. Finally, a multi-dimensional network of “key targets-active ingredients-TCM network” was constructed to analyze the properties, flavors, and meridian tropism patterns of frequently occurring TCMs. ResultsA total of 308 common targets for colorectal cancer and cancer-related fever were identified. GO enrichment analysis indicated that these targets were primarily involved in processes such as negative regulation of cell proliferation and development of the vascular system. KEGG pathway analysis suggested that these targets were significantly enriched in microRNAs in cancer, proteoglycans, and various signaling pathways. From the PPI network, 52 core targets were screened, among which 16 targets matched with TCM ingredients, and molecular docking demonstrated stable binding. A total of 261 potential TCMs were screened, including 54 high-frequency herbs (node Degree value≥18). These high-frequency herbs were predominantly bitter and cold in nature, mainly attributing to the liver, lung, spleen, and stomach meridians. Common TCMs included Glycyrrhizae Radix et Rhizoma (Gancao), Gleditsiae Spina (Zaojiaoci), and Chrysanthemi Flos (Juhua). ConclusionThe TCM formulation predicted through the reverse network pharmacology reflects a compatibility characteristics of combining cold and warm properties, as well as reinforcing and reducing methods, which aligns with the TCM pathogenesis understanding of cancer-related fever. This paper provides new insights and reference for clinical treatment based on syndrome differentiation.

ObjectiveTo investigate the potential role of Lachnospira in lung cancer. MethodsDifferences in Lachnospira abundance between lung cancer patients and healthy controls were analyzed using The Cancer Microbiome Atlas (TCMA) database. A total of 78 lung cancer patients (lung cancer group) and 70 healthy controls were enrolled from our hospital. The abundance of Lachnospira in fecal samples, lung cancer tissues, and adjacent non-cancerous tissues from the two groups was detected using 16S rRNA gene sequencing, and its association with patients' clinical characteristics was analyzed. The Kaplan-Meier method was used to evaluate the relationship between Lachnospira abundance and overall survival. ResultsTCMA analysis results showed that Lachnospira abundance in fecal samples of lung cancer patients was significantly lower than that in healthy controls (P<0.05), and its abundance in lung cancer tissues was significantly lower than that in adjacent non-cancerous tissues (P<0.05). Furthermore, Lachnospira abundance was significantly higher in lung adenocarcinoma tissues than that in lung squamous cell carcinoma tissues (P<0.05). The results from clinical sample testing further validated the above findings, and Lachnospira abundance showed a significant correlation with clinical stage (stage Ⅰ-Ⅱ vs. stage Ⅲ-Ⅳ) (P<0.05). Kaplan-Meier survival analysis based on both TCMA and clinical samples indicated that patients in the high-abundance group had significantly longer survival than those in the low-abundance group. ConclusionLachnospira may play an important role in the occurrence, development, and prognosis of lung cancer.

ObjectiveTo investigate the value of single-wrist joint Doppler ultrasound scoring in assessing the activity of rheumatoid arthritis (RA). MethodsOne hundred RA patients admitted to hospital were enrolled. After admission, routine clinical and laboratory examinations were performed. Based on the disease activity score in 28 joints (DAS28), these patients were divided into a low-moderate activity group (53 cases) and a high activity group (47 cases). Ultrasound and magnetic resonance imaging (MRI) examinations of the hands and wrist joints were performed on all patients. The wrist ultrasound scores, the rheumatoid arthritis magnetic resonance imaging score (RAMRIS), and laboratory indicators were compared between the two groups. Correlations among various single-wrist ultrasound scores, wrist RAMRIS scores, and DAS28 scores were analyzed. The diagnostic efficacy of single-wrist ultrasound scoring versus unilateral hand and wrist ultrasound scoring and RAMRIS for RA activity was compared. ResultsDuring the ultrasound examination, there were statistically significant differences in the synovitis score, mid-wrist synovitis score, radial-side wrist synovitis score, ulnar-side wrist synovitis score, tenosynovitis/tendinitis score, tenosynovitis/tendinitis of the 3rd finger flexor tendon score, tenosynovitis/tendinitis of the 4th finger flexor tendon score, tenosynovitis/tendinitis of the extensor carpi radialis brevis and longus tendons score, and the total single-wrist ultrasound score between the high and low-moderate activity groups (all P<0.05). During the MRI examination, significant differences (all P<0.05) were found between the two groups in synovitis score, bone marrow edema score, and bone erosion score. The total single-wrist ultrasound score, synovitis score, tenosynovitis/tendinitis score, gray-scale ultrasound score, power Doppler ultrasound score, and RAMRIS were positively correlated with DAS28. ConclusionSingle-wrist joint ultrasound scoring is closely related to RA activity in patients with a history of wrist pain or swelling. It has diagnostic potential for RA activity in patients with symptoms of wrist joint involvement, and its diagnostic efficacy is similar to that of unilateral hand and wrist ultrasound scoring. RAMRIS and single-wrist ultrasound scoring focus on different aspects, and can complement each other in diagnosing RA activity.

ObjectiveTo explore the causal relationship between Brugada syndrome (BrS) and immune cell phenotypes, providing evidences for elucidating its underlying immunological mechanisms. MethodsA bidirectional two-sample Mendelian randomization (MR) analysis was employed to investigate the causal relationship between 731 immune cell phenotypes and susceptibility to BrS. Genetic variants associated with immune traits were identified using Genome-Wide Association Study (GWAS) data from the Blood Cell Consortium, and outcome assessment was performed using GWAS data of BrS. Instrumental variables were selected based on strict significance thresholds. The causal relationship was evaluated using random-effects inverse-variance weighted and weighted median methods. Meanwhile, heterogeneity and pleiotropy of the models were tested to ensure robust results. ResultsSeveral immune cell phenotypes associated with BrS risk were identified. Protective factors included CD11c on monocytes, CD16-CD56 on natural killer cells, CD3 on regulatory T cell (Treg), CD3 on CD8bright cells, CD4 Treg and CD45 CD33bright HLA-DR+ monocytes in the activation cluster, HLA-DR on hematopoietic stem cells, and CD20 on IgD-CD38- B cells. Risk factors included IgD-CD24- activated B cells, HLA-DR on CD14+CD16+ monocytes, CD80 on plasmacytoid dendritic cells, CD39 on activated Treg, and CD8 on CD28+CD45RA-CD8bright cells. Reverse MR analysis revealed positive causal relationships between BrS, and CD62L-HLA-DR++ monocytes, CD86+ myeloid dendritic cells and CD62L-HLA-DR++ monocytes. ConclusionThis study provides evidences for a complex relationship between immune cell phenotypes and susceptibility to BrS, suggesting that immune modulation could be a potential therapeutic strategy. This finding opens a novel direction for investigating the role of immune cells in the pathogenesis of BrS.

ObjectiveTo investigate the clinical value of left atrial appendage (LAA) echocardiographic structural and blood flow parameters in predicting the prognosis of left atrial (LA) structure and left ventricular diastolic function after radiofrequency catheter ablation (RFCA) in patients with atrial fibrillation (AF). MethodsA total of 50 consecutive patients with non-valvular AF treated by RFCA were enrolled. Transesophageal and transthoracic echocardiography were performed before the procedure; transthoracic echocardiography was repeated at 1 month, and 3 and 6 months post-ablation. Repeated measures ANOVA, correlation analysis, univariate linear regression, and linear mixed-effects models were used to evaluate the predictive value of LAA echocardiographic structural parameters ［LAA width (LAAW) and LAA depth (LAAD),］ and its blood flow parameter ［LAA emptying velocity (LAAEV)］. ResultsThe age of the patients was （65.0±8.5） years, and approximately 46.00% had concurrent cardiac dysfunction. Repeated measures ANOVA showed significant improvements in both LA structural indexes and left ventricular diastolic function indexes after ablation (all P<0.001). The improvement in LA volume index (LAVI) reached a plateau by 3 months post-ablation, while E/e′ began to improve significantly from 3 months onwards. After screening for LAA echocardiographic parameters significantly correlated with LA structure and left ventricular diastolic function using static correlation analysis and univariate linear regression, further analysis with linear mixed-effects models revealed that throughout the follow-up period, for every 1 cm/s increase in preoperative LAAEV, the LA anteroposterior diameter decreased by an average of 0.29 mm (β=-0.29, P<0.001), LAVI decreased by an average of 0.58 mL/m2 (β=-0.58, P<0.001), and E/e′ decreased by an average of 0.14 (β=-0.14, P<0.001). For every 1 mm increase in preoperative LAAD, LAVI increased by an average of 0.42 mL/m2 (β=0.42, P<0.01). LAAD had a negative impact on changes in LA anteroposterior diameter and LA superoinferior diameter only at 6 months post-ablation. Conclusion  LAA echocardiographic structural and blood flow parameters are effective predictors of the dual benefits in LA structure and function post-RFCA in AF patients. Patients with higher LAAEV and shallower LAAD tend to experience dual improvements in LA structure and left ventricular diastolic function during the intermediate-to-late postoperative phases.

Objective  To investigate the value of uric acid (UA), homocysteine (Hcy), and C-reactive protein (CRP) in predicting major adverse cardiovascular events(MACEs) after percutaneous coronary intervention (PCI) among patients with acute ST-segment elevation myocardial infarction (STEMI). Methods  A retrospective analysis was conducted on 460 patients with STEMI who had undergone PCI. Patients were divided into MACEs and non-MACEs groups based on the occurrence of MACEs within three months after the treatment. Baseline data, and levels of UA, Hcy and CRP were compared between the two groups. Logistic regression analysis was used to identify risk factors, and ROC curve analysis was performed to evaluate the predictive value of UA, Hcy, and CRP, individually and in combination, for MACEs after PCI in STEMI patients. Results  During the three-month follow-up, among the 460 STEMI patients, 101 (21.96%) experienced MACEs including 34 cases of acute myocardial infarction, 26 cases of readmission for heart failure, 32 cases of malignant arrhythmias, and 9 cases of cardiogenic shock. The levels of UA, Hcy, and CRP were significantly higher in the MACEs group than those in the non-MACEs group (all P<0.05). Logistic regression analysis identified UA, Hcy, and CRP as risk factors for MACEs after PCI in STEMI patients (all P<0.05). ROC curve analysis showed that the AUC values for UA, Hcy, and CRP in predicting MACEs after PCI in STEMI patients were 0.879, 0.752, and 0.769, respectively. The combined prediction of all three markers yielded an AUC value of 0.949 (95%CI 0.923-0.975). Conclusion  STEMI patients are prone to MACEs after PCI, which may be related to the expression levels of UA, Hcy, and CRP. The combination of these three biomarkers demonstrates the highest predictive efficacy for MACEs after PCI, suggesting potential clinical application value.

Objective  To compare the clinical efficacy and safety of an inhaled corticosteroid (ICS) combined with a long-acting β2-receptor agonist (LABA) regimen versus an ICS combined with a LABA and a long-acting muscarinic antagonist (LAMA) regimen in asthma-chronic obstructive pulmonary disease overlap syndrome (ACOS). Methods  A total of 76 patients with ACOS were enrolled, and randomly divided into a control group (ICS/LABA, n=38) and an observation group (ICS/LABA/LAMA, n=38). Both groups were treated for 12 weeks. Pulmonary function ［forced expiratory volume in the first second (FEV1), forced vital capacity (FVC), etc.］, symptom scores ［dyspnea visual analogue scale (VAS) and daytime/nighttime symptom scores］, and quality of life ［St. George's respiratory questionnaire (SGRQ) score］ before and after treatment, as well as the incidence of adverse reactions were compared between the two groups. Results  After 12 weeks of treatment, both groups showed significant improvements in pulmonary function parameters, symptom scores, and total SGRQ scores compared with baseline levels (all P<0.01). After treatment, the observation group showed significantly higher levels of FEV1 and FVC than the control group (both P<0.05); significantly lower scores for dyspnea VAS, daytime/nighttime symptoms than the control group (all P<0.01); and a significantly lower total SGRQ score than the control group (P<0.001). The incidence of adverse reactions in the observation group was significantly lower than that in the control group (5.26% vs. 26.32%, P<0.05). Conclusion  The ICS/LABA/LAMA regimen is superior to the ICS/LABA regimen in improving pulmonary function, symptoms, and quality of life among patients with ACOS; and it has higher safety, offering a preferable treatment option for ACOS.

Objective  To explore the effect of levosimendan on elderly patients with acute anterior myocardial infarction (AAMI) complicated by heart failure (HF) after percutaneous coronary intervention (PCI). Methods  Eighty-four elderly patients who had met inclusion and exclusion criteria were selected, and divided into two groups using a random number table method, with 42 patients in each group. Both groups underwent PCI. In the control group, patients with HF were treated primarily with conventional medications, including dual antiplatelet therapy, statins, and enoxaparin. In the levosimendan group, patients received levosimendan in addition to the medications used in the control group. After one week of treatment, the two groups were compared and analyzed across five dimensions: clinical efficacy, serum cytokine levels (NT-proBNP, soluble growth stimulation expressed gene 2 protein, and serum myeloperoxidase) before and after treatment, left ventricular function indexes (left ventricular end-diastolic diameter, left ventricular ejection fraction, and left ventricular fractional shortening) before and after treatment, hemodynamic parameters (cardiac index and central venous pressure) before and after treatment, and the incidence of major adverse cardiovascular events (MACEs), to assess the value of levosimendan therapy. Results  The total effective rate in the levosimendan group was significantly higher than that in the control group ［97.62% (41/42) vs. 83.33% (35/42); χ2=4.974, P=0.048］. Serum cytokine levels decreased significantly in both groups after one week of treatment, and all cytokine levels in the levosimendan group were significantly lower than those in the control group (all P<0.05). After treatment, improvements in all left ventricular function indexes, cardiac index, and central venous pressure were all significantly greater in the levosimendan group than those in the control group (all P<0.05). The incidence of MACEs was significantly lower in the levosimendan group than that in the control group ［7.14% (3/42) vs. 16.67% (7/42); χ2=4.098, P=0.045］. Conclusion  Levosimendan is effective, safe, and feasible for treating elderly patients with AAMI complicated by HF after PCI, making it worthy of clinical promotion.

Objective  To analyze the effect of bedaquiline-containing treatment regimens on the electrocardiogram (ECG) of patients with multidrug-resistant tuberculosis (MDR-TB) and rifampicin-resistant tuberculosis (RR-TB) across different age groups. Methods  A total of 106 MDR-TB/RR-TB patients receiving bedaquiline-containing regimens for at least 28 weeks were enrolled. They were divided into a youth group (<45 years, n=52), a middle-aged group (45 years≤age<60 years, n=31), and an elderly group (≥60 years, n=23). QTcF value (QT interval corrected for heart rate using the Fridericia's formula) was monitored within 1 week before treatment, and at weeks 4, 8, 12, 16, 20, 24 and 28 of treatment. The incidence of significantly prolonged QT interval, ST-T changes, and arrhythmias was compared among the three groups. Results  The mean QTcF value at different time points after bedaquiline administration was overall higher than the baseline (F=20.238, P<0.001). The mean QTcF value in the middle-aged group was higher than that in the youth group ［(427.92±26.68) ms vs. (420.46±25.66) ms, P=0.002］, but showed no statistically significant difference compared with the elderly group ［(424.58±29.33) ms］. The incidence of significantly prolonged QT interval, ST-T changes, and ventricular arrhythmias in the middle-aged group was higher than that in the youth and elderly groups, however the inter-group differences were not statistically significant (P>0.05). Concomitant use of clofazimine （OR=3.682, 95%CI 1.435-9.445, P=0.007) and the occurrence of serum calcium <2.11 mmol/L during treatment (OR=2.790, 95%CI 1.382-5.633, P=0.004) were independent risk factors for significantly prolonged QT interval in these patients. Conclusion  Bedaquiline could prolong the QTcF value in MDR-TB/RR-TB patients, and increase the incidence of ST-T changes and arrhythmias. However, there was no significant difference in the incidence of ECG changes among different age groups. Clinicians should closely monitor patients' ECG manisfestations, and enhance safe and effective treatment regimens.

Objective  To investigate the clinical value of cardiac autonomic function-related indicators, including heart rate variability (HRV), deceleration capacity of heart rate (DC), QT interval dispersion (QTd), and corrected QT interval dispersion (QTcd), in coronary atherosclerotic heart disease (CAHD). Methods  A total of 226 patients with CAHD were selected as the research subjects (CAHD group), and 69 non-CAHD patients admitted during the same time period served as the control group. The CAHD group was further divided into three subgroups based on the severity of disease: stable angina pectoris (SAP) group (n=37), unstable angina pectoris (UAP) group (n=92), and acute myocardial infarction (AMI) group (n=97). Differences in various autonomic function indicators were compared between the CAHD group and the control group, as well as among the CAHD subgroups. The diagnostic value of individual and combined autonomic function indicators for CAHD was evaluated using ROC curve analysis. Results  The very low frequency power (VLF), low frequency power (LF), standard deviation of NN intervals (SDNN), mean of the standard deviation of NN intervals (SDNN index), root mean square of successive RR interval differences (rMSSD), percentage of adjacent NN intervals differing by more than 50 ms (pNN50), and DC in the CAHD group were all significantly lower than those in the control group (all P<0.05). Significant differences were observed among the CAHD subgroups in high frequency power (HF), rMSSD, pNN50, and DC (P<0.05). The values of HF, rMSSD, pNN50, and DC in the AMI group were significantly lower than those in the SAP and UAP groups, while the values in the UAP group were lower than those in the SAP group (all P<0.05). ROC curve analysis showed that SDNN and DC exhibited high diagnostic value for CAHD (AUC=0.796 and 0.712, respectively; both P<0.05), while their combination yielded the highest diagnostic value (AUC=0.888, P<0.05). Conclusion  Decrease of the cardiac autonomic function-related indicator SDNN and DC is closely associated with the occurrence and severity of CAHD. The combined detection of these indicators holds certain value for the diagnosis of CAHD.

Objective  To comparatively analyze the value of lung ultrasound and pulse-indicated continuous cardiac output (PiCCO) monitoring in assessing acute heart failure with pulmonary edema. Methods  Forty patients with acute heart failure were selected. All patients received lung ultrasound, echocardiography, PiCCO monitoring and NT-proBNP detection. According to the degree of pulmonary edema, these patients were divided into mild pulmonary edema group and severe pulmonary edema group. Echocardiographic parameters ［left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD), left atrial diameter (LAD), interventricular septal thickness at end-diastole (IVSD), pulmonary artery pressure (PAP), inferior vena cava diameter (IVCD), ratio of early to late diastolic mitral inflow velocity (E/A) and early diastolic mitral annular velocity (E/e′)］, PiCCO parameters ［heart rate, systolic blood pressure, diastolic blood pressure, central venous pressure (CVP), cardiac output (CO), global end-diastolic volume index (GEDVI), cardiac index (CI), left ventricular contractility index (dPmx), systemic vascular resistance index (SVRI) and extravascular lung water index (EVLWI)］, as well as the diagnostic efficacy of related parameters were compared between the two groups. ResultsNo statistically significant difference was found in E/A between the two groups (P>0.05). Compared with the severe pulmonary edema group, the mild pulmonary edema group had higher LVEF, but lower LVEDD, LVESD, IVSD, LAD, PAP, IVCD, E/e′, and total B-line score (all P<0.05). No statistically significant differences were observed in systolic blood pressure, CVP, CO, CI, dPmx, or SVRI between the two groups (all P>0.05). Compared with the severe pulmonary edema group, the mild pulmonary edema group had higher diastolic blood pressure, but lower heart rate, EVLWI, and GEDVI (all P<0.05). The total score of B-line of lung ultrasound has high diagnostic value in severe pulmonary edema. Conclusion  Lung ultrasound can serve as an effective tool for assessing pulmonary edema in patients with acute heart failure. The total score of B-line provides important reference value for distinguishing the severity of the condition, and reliable quantitative basis for clinical diagnosis.

Objective  To investigate the characteristics of vasovagal syncope (VVS) in children and adolescents, and to analyze its risk factors. Methods  A total of 118 children and adolescents who had undergone head-up tilt test due to syncope or presyncope were enrolled. Based on the test results, they were divided into a negative group and a VVS group. Clinical information, changes of heart rate and blood pressure, P wave dispersion (Pd), and ventricular repolarization parameters were recorded and compared between the two groups. Results  In the stage of based head-up tilt test, the mean heart rate and heart rate difference in the VVS group were significantly higher than those in the negative group (both P<0.01). During the stage of sublingual nitroglycerin head-up tilt test, compared with the negative group, symptoms such as dizziness, visual disturbance, nausea, pallor, tinnitus, limb twitching, and limb weakness were more common in the VVS group (P<0.05). The Pd, QT dispersion, corrected QT dispersion, and Tpeak-Tend interval (Tp-Te) in the VVS group were all longer than those in the negative group (P<0.001). Multivariate Logistic regression analysis showed that prolonged Pd and Tp-Te were risk factors for the VVS group. Conclusion  The VVS group exhibits increased heart rate and is prone to presyncope. Prolonged Pd and Tp-Te are risk factors for VVS in children and adolescents.

Objective  To evaluate the efficacy of negative-pressure drainage in preventing delayed perforation after colonic endoscopic submucosal dissection (ESD). Methods  A retrospective analysis was conducted on the clinical data of 29 patients who had undergone ESD for early colorectal cancer or precancerous lesions and had received postoperative placement of negative-pressure drainage tubes. The clinical characteristics, surgical procedures, postoperative complications, and follow-up outcomes were analyzed. The efficacy of negative-pressure drainage in preventing delayed perforation after colonic ESD was preliminarily assessed. Results  Among all 29 patients with colonic lesions, an en bloc resection rate of 100% was achieved. Complete resection was achieved in all except one case with lesions exceeding 1 000 μm beyond the submucosa. Intraoperative perforation occurred in 4 cases, all of which was promptly detected and closed with titanium clips. All patients were followed up for at least 2 months postoperatively, and no complications such as delayed perforation or bleeding occurred. Conclusion  Intestinal catheterization with negative-pressure drainage could effectively prevent delayed perforation after colonic ESD, particularly in patients experiencing intraoperative microperforation or presenting with large lesions.

Objective  To investigate the correlation between treadmill exercise test (TET) results and sex, age group, metabolic equivalents (METs), and ST-segment changes of subjects in primary healthcare institutions, and to provide a basis for cardiovascular disease screening at the primary care level. Methods  A retrospective analysis was conducted on the data of 1 903 TET cases. Chi-square tests were used to compare the differences in TET positive rate, ST-segment changes (including ST-segment depression or elevation), change of systolic blood pressure, and METs values between sexes and among age groups. Results  Among the 1 903 subjects, 245 had positive TET results (12.87%). The positive rate was significantly higher in males than that in females (14.59% vs. 10.67%; χ2=7.19, P=0.011). There was a statistically significant difference in ST-segment changes between sexes (χ2=6.67, P=0.034); the proportion of males in those with ST-segment depression was significantly higher than that with normal ST-segment (64.82% vs. 55.16%, P<0.01). The difference in TET positive rates among different age groups was statistically significant (χ2=12.34, P=0.006), with the ≥70 years group having a significantly higher TET positive rate compared with <20 years and 51-70 years groups (all P<0.05). Male subjects predominantly achieved ≥7 METs (58.62%, 864/1 474), and this proportion was significantly higher than that in females (41.38%, 610/1 474; χ2=38.52, P<0.01). Conclusion  TET can serve as an effective tool for cardiovascular disease screening in primary hospitals, but its accuracy should be improved by combining it with other examinations.

Objective  To verify the rationality and feasibility of a novel percutaneously implanted pulsatile left ventricular assist device (LVAD). Methods  The novel pulsatile cardiac assist device consisted of an implantable catheter, an outer tube, and a driving unit. The ventricular segment and the ascending aortic segment at the tip of the catheter were placed in the left ventricle and the ascending aorta, respectively. Both segments were equipped with perfusion side holes, and each side hole had a special one-way membrane valve structure. During blood aspiration from the left ventricle, the small holes in the ascending aortic segment closed while those in the left ventricle opened; during ejection, the small holes in the left ventricle closed while those in the ascending aorta opened, thereby achieving pulsatile blood aspiration from the left ventricle to the ascending aorta. An in vitro measurement setup using glycerinwater solution was employed to test the flow rate of the novel left ventricular assist device. Results  This percutaneously implanted pulsatile left ventricular assist device provided a pulse frequency of 25-40 beats/min and a flow support exceeding 2 L/min. Conclusion  The device provides relatively stable pulsatile flow support and has certain advantages in mimicking physiological pulse flow; however, further animal experiments are needed to evaluate its rationality and operability.

Objective  To retrospectively analyze the intervention effect of humanized nursing based on Watsons caring theory in elderly patients with non-small cell lung cancer (NSCLC) after operation. Methods  A total of 107 elderly patients who had undergone NSCLC surgery in our hospital from May 2023 to September 2024 were selected. Among them, patients from May 2023 to January 2024 were assigned to a control group (54 cases), and patients from February to September 2024 were assigned to an observation group (53 cases). The control group received routine nursing, while the observation group received humanized nursing guided by Watson's caring theory in addition to routine nursing. The postoperative complication rate, as well as self-care ability ［assessed by the exercise of self-care agency scale (ESCA)］, self-management efficacy ［assessed by the strategies used by people to promote health (SUPPH)］ and psychological state ［assessed by the Hamilton anxiety scale (HAMA) and the Hamilton depression scale (HAMD)］ scores before and after intervention were compared between the two groups. ResultsCompared with the control group (20.37%), the observation group showed a significantly lower postoperative complication rate (5.66%), with a statistically significant difference (P＜0.05). Compared with the control group after intervention, the observation group exhibited significantly increased ESCA and SUPPH scores, as well as significantly decreased HAMA and HAMD scores after intervention (all P＜0.001). Conclusion  The application of humanized nursing based on Watson's caring theory in elderly patients after NSCLC surgery could regulate their psychological state, improve the level of self-management efficacy and self-care ability, and reduce the incidence of postoperative complications.

Objective  To understand the perception of stroke risk and its influencing factors in patients with atrial fibrillation (AF), and to provide reference for formulating targeted preventive measures. Methods  Using purposive sampling method, 15 inpatients with AF were selected as research subjects for face-to-face semi-structured interviews. The interview data were collated and analyzed using the Colaizzi's 7-step method for phenomenological data analysis. Results  Three themes were extracted, comprising 10 subthemes: cognition of stroke risk (weak fundamental knowledge of AF and inconsistent perception of stroke risk); promoting factors for risk perception (fundamental support of health literacy, empowering value of authoritative information, awakening effect of personal experience and synergistic reinforcement effect of social support); hindering factors for risk perception (predicament and biases in information acquisition, cognitive interference of disease characteristics, negative influence of social psychology and limiting factors of the external environment). Conclusion  The perception of stroke risk in patients with AF presents multi-dimensional and complex characteristics, with their cognitive level being jointly influenced by multiple factors. Clinical medical staff should formulate individualized intervention measures based on the key influencing factors to improve patients correct cognition and perception ability of stroke risk.

Objective  To compare the effectiveness of the plan-do-check-act (PDCA) cycle combined with a diversified teaching method versus traditional teaching methods in electrocardiogram (ECG) practice teaching. Methods  A total of 134 residents participating in standardized residency training were selected as the study subjects. The residents were randomly divided into an experimental group (77 cases) and a control group (57 cases) by batch. The control group received traditional lecture-based teaching, while the experimental group received teaching using the PDCA cycle combined with a diversified teaching method. The ECG examination scores and the results of questionnaire surveys on related teaching effectiveness were analyzed and evaluated for both groups. Results  The diagnostic accuracy for critical value ECGs in the experimental group was significantly higher than that in the control group (P<0.05). The average ECG examination scores of the experimental group were also significantly higher than those of the control group. The questionnaire survey showed that the experimental group demonstrated significant improvements in self-learning ability, mastery of the knowledge, and teacher-student interaction; the new teaching method did not increase learning stress. Furthermore, the experimental group's “integrating in-class and out-of-class activites to motivate students” was significantly higher than that of the control group (P<0.05). Conclusion  The PDCA cycle combined with the diversified teaching method significantly improves residents' accuracy in diagnosing critical value ECGs, enhances their learning initiative and interest, and increases teaching satisfaction. This teaching model holds promising application prospects and potential for promotion in clinical practice teaching.

Interstitial lung disease (ILD) is one of the most severe pulmonary complications of rheumatoid arthritis (RA), significantly increasing the risk of mortality and disability in affected patients. Early and accurate assessment of disease risk, progression, and prognosis is crucial for improving patients' outcomes. Although currently the clinical diagnosis of rheumatoid arthritis-associated interstitial lung disease (RA-ILD) relies mainly on high-resolution CT scans and pulmonary function tests, these methods still have significant shortcomings in early screening and disease course monitoring. Therefore, the exploration of reliable and non-invasive biomarkers has emerged as a critical direction in current research. This article reviews the latest research progress on biomarkers related to RA-ILD, and discusses the current application status of omics technologies in this field.

Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by autoantibody-mediated multi-system inflammation. Cardiovascular involvement represents a leading cause of mortality in SLE patients with high prevalence. This paper reviews the epidemiological patterns, clinical manifestations, and diagnostic approaches associated with cardiovascular involvement in SLE. From a metabolomics perspective, this article focuses on elucidating the underlying mechanisms, namely the mediating role of energy metabolism imbalance, lipid metabolism reprogramming, amino acid metabolism abnormalities, and gut microbiota metabolites. By comparing the metabolic profiles between SLE patients and healthy individuals, specific metabolic alterations associated with cardiovascular involvement are revealed. Furthermore, the application value of metabolomics in elucidating disease mechanisms, identifying biomarkers, and developing therapeutic targets is demonstrated.

Patients with ischemic stroke frequently experience concurrent arrhythmias, the most common of which is atrial fibrillation. Atrial fibrillation detected after stroke (AFDAS) may represent a clinical entity distinct from known AF identified prior to the stroke. AFDAS is associated with an increased risk of stroke recurrence, but its pathogenesis is complex and encompasses multiple pathophysiological processes. It is currently believed to likely involve complex changes in the central autonomic network and humoral regulation, such as autonomic nervous system dysfunction, immune and inflammatory responses, and atrial remodeling. An in-depth exploration of these mechanisms contributes to the development of more precise and effective strategies for the prevention and treatment of AFDAS.

Percutaneous coronary intervention (PCI) is the primary method for coronary revascularization in patients with coronary heart disease. However, patients remain at high risk for major adverse cardiovascular events after procedure, and traditional risk factors offer limited predictive value. This review systematically examines recent research literature to summarize the prognostic value of metabolic indicators related to blood lipids, blood glucose, nutrition, and renal function following PCI. The discussion focuses on the research advances regarding low-density lipoprotein cholesterol (LDL-C) cumulative exposure, lipoprotein(a), monocyte to high-density lipoprotein cholesterol ratio (MHR), neutrophil to high-density lipoprotein cholesterol ratio (NHR), triglyceride-glucose (TyG) index and its derivatives (such as TyG-BMI and TyG-WC), stress hyperglycemia ratio (SHR), serum albumin, homocysteine, serum uric acid, and other indicators. Evidences indicate that increased lipoprotein(a), MHR, NHR, TyG index and its composite indexes, decreased serum albumin, and abnormal serum uric acid levels (demonstrating a U-shaped relationship) are all independent predictors of adverse outcomes after PCI. Compared with single indicators, composite indexes such as TyG-BMI and neutrophil-to-albumin ratio (NAR), which integrate information from different pathophysiological dimensions, exhibit superior predictive capabilities. Notably, parts of novel composite indexes, such as TyG-BMI and NAR, have demonstrated significant incremental predictive value over traditional risk scores, including the GRACE and SYNTAX scores. Furthermore, long-term exposure to unfavorable metabolic states (such as a high cumulative burden of LDL-C or TyG index) is significantly associated with increased long-term cardiovascular risk. Systematic evaluation and integration of multi-dimensional metabolic indicators hold significant clinical importance for constructing post-PCI risk prediction models, enabling early intervention, and improving long-term prognosis.

Cardiovascular diseases have become a major burden on the social healthcare system due to their high incidence and mortality. Noninvasive cardiac output measurement technology, with its core advantages of being real-time, noninvasive, and enabling continuous monitoring, can accurately capture dynamic changes in cardiac function. This opens new pathways for the prevention, diagnosis, treatment, and rehabilitation of cardiovascular diseases. This article primarily reviews the application and progress of noninvasive cardiac output measurement technology in the cardiac function evaluation and cardiac rehabilitation of patients with coronary artery disease, hypertension, and heart failure. It analyzes the technology's advantages in precise subtyping, personalized treatment, risk warning, and rehabilitation guidance, aiming to provide reference for promoting its application and development in cardiac assessment and rehabilitation.

The triglyceride-glucose (TyG) index, calculated from fasting triglyceride and fasting plasma glucose, is a simple, cost-effective, and reproducible surrogate marker of insulin resistance. Previous studies have shown that TyG index is closely associated with the occurrence, progression, and prognosis of various cardiovascular diseases. This review systematically summarizes epidemiological evidences linking TyG index to coronary artery disease, hypertension, heart failure, atrial fibrillation, cerebrovascular diseases, and peripheral artery disease, as well as its associations with disease severity and adverse outcomes. Additionally, by integrating related mechanisms such as insulin resistance, atherosclerotic dyslipidemia, chronic low-grade inflammation, and oxidative stress, this review elaborates on the potential clinical value of TyG index in risk stratification and prognostic assessment of cardiovascular diseases.

Idiopathic pulmonary fibrosis (IPF) is a highly fatal interstitial lung disease with complex pathogenesis. Existing antifibrotic agents, such as pirfenidone and nintedanib, can delay disease progression and improve patients' quality of life, but they are unable to reverse the pathological process of fibrosis. In recent years, significant progress has been made in targeted therapies for IPF, with innovative drugs targeting the transforming growth factor-β signaling pathway, fibroblast growth factor receptor, and immune regulationrelated pathways successively entering clinical trial phase. In addition, drugs targeting lysosomal regulation and collagen metabolism have also shown great research potential. Despite these advances, current therapies still face challenges, including limited efficacy, high incidence of adverse reactions, and high economic costs. This article summarizes the latest advances in the treatment of IPF, providing reference for future research and clinical application.

As the global population migrates to and settles in regions at varying altitudes, the impact of altitude on the regulation of blood pressure has attracted increasing attention, becoming an important topic in clinical and public health research. Due to differences in oxygen concentration and atmospheric pressure, the mechanisms underlying blood pressure regulation across different altitudinal environments exhibit complex and diverse characteristics. The hypoxic environments at high altitudes not only affect short-term fluctuations in blood pressure, but also contribute to long-term adaptive physiological adjustment. However, related epidemiological data vary across regions and populations, and no consistent conclusions have been formed. This paper systematically reviews the mechanisms underlying the impact of different altitudes on blood pressure levels. By integrating the latest epidemiological studies and adaptive physiological changes, it explores the complexity of blood pressure regulation in various altitudinal environments and its clinical significance, aiming to provide a scientific basis and research directions for the prevention and management of cardiovascular diseases in regions at different altitudes.