Objective To explore the effect of Shenfu injection on immune function in elderly patients with sepsis. Methods This study was a retrospective analysis. The elderly patients(n=126) with sepsis admitted to 4 hospitals including Shanghai Ruijin Hospital from January 2019 to December 2020 were divided into two groups according to whether Shenfu injection was used (61 cases in Shenfu group, 65 cases in control group). Basic data, comorbidities, relevant test results (including inflammatory factors, humoral immune indicators, cellular immune indicators, etc.), disease severity score, mortality rate, etc., were collected for statistical analysis. Results After seven days of Shenfu injection treatment, the indexes including the mean artery pressure (MAP), lactate (Lac), C-reactive protein (CRP), procalcitonin (PCT), prothrombin time (PT), activated partial thromboplastin time (APTT), interleukin-6(IL-6), IL-10, tumor necrosis factor-α(TNF-α), CD3 count, CD4 count, CD8 count, IgG, IgA and IgM of patients in 2 groups were significantly improved (all P<0.05). Compared with the control group, MAP(P=0.034), and the absolute count of CD3(P=0.002) and CD4(P=0.002) were significantly increased in the Shenfu treated group. Conclusions Shenfu injection combined with standard bundled regimen can improve the immune function and reduce inflammation in elderly patients with sepsis.

Objective To investigate the expression of charged multivesicular body proteins 5(CHMP5) in pyroptosis of human umbilical vein endothelial cell (HUVEC) and the effect of knocking down CHMP5 on HUVEC pyroptosis. Methods Using polyinosinic-polycytidylic acid (Poly I:C) to stimulate HUVEC to establish an in vitro model of double-stranded RNA (dsRNA) induced HUVEC injury in viral sepsis. HUVEC were randomly divided into control, Lipo, Poly I:C, siNC and siCHMP5+Poly I:C groups, and the expression of CHMP5 in each group was detected by real-time fluorescent quantitative PCR (qRT-PCR) to verify the transfection efficiency. Lactate dehydrogenase (LDH) cytotoxicity assay kit was used to detect the release rate of LDH, ELISA was used to detect the secretion of interleukin-1β(IL-1β) and transmission electron microscopy (TEM) was used to detect the ultrastructure of HUVEC to observe the integrity of the cell membrane, and Western blotting was used to detect the expression level of the cleaved caspase-3(Casp-3) and gasdermin E N-terminal(GSDME-N), and immunofluorescence staining was used to detect the expression and localization of the related proteins in each group of cells. Results In comparison with the control group, the HUVEC in the Poly I:C group were swollen and showed multiple cell membrane ruptures, and cleaved Casp-3, GSDME-N and CHMP5 protein expression was up-regulated. Compared with the control group and the siNC group, knocking down CHMP5 by RNAi technology resulted in increased release of LDH and IL-1β, up-regulation of the expression level of pyroptosis-related proteins, alteration of the distribution of GSDME protein recruitment, and significant aggravation of endothelial cell pyroptosis in the siCHMP5+Poly I:C group. Conclusions The CHMP5 is highly expressed in HUVEC pyroptosis. Knockdown of CHMP5 can enhances HUVEC cellular pyroptosis, which may be related to the inhibition of membrane repair and promoting secondary cellular pyroptosis induced by cleavage of GSDME and GSDMD proteins.

Objective To study the effect of Porphyromonas gingivalis (P.g) on non-alcoholic fatty liver disease (NAFLD) and the ameliorative effect of periodontal treatment on NAFLD. Methods Mice fed a high-fat diet for 4 weeks were randomly divided into two groups, and there were 8 mice in each group. Group A was blank control, and Group B was given suture ligation + smeared P.g. They were sacrificed after 4 weeks of intervention, and the changes in liver, inflammatory factors were tested. Eight NAFLD patients with periodontal disease were randomly divided into the subgingival scaling group and the control group (4 in each group), and the subgingival scaling group received the basic periodontal treatment. Changes in periodontal status, liver, and blood biochemistry before and after the intervention were tested in the 2 group patients. Results Compared with the control mouse group, the ligation and smear mouse group had increased liver weight, formation of lipid deposits, serum lipid, aspartate transaminase and ferritin levels, and the expression of serum inflammatory mediators was increased. Compared with the patients in the tooth brushing group, the subgingival scraping patient group showed a significantly decreased indexes such as P.g-IgG antibody titer, probing depth, as well as a downward trend in liver fat content, but the differences were not statistically significant （P>0.05）. Conclusions P.g infection can accelerate the progression of NAFLD in mice with high-fat diet, and the periodontal treatment in patients showed a mitigating effect on periodontal infection-associated NAFLD.

Objective To study the value of peripheral perfusion index (PPI) combined with acute physiology and chronic evaluation Ⅱ(APACHEⅡ) score in predicting prognosis of septic shock patients. Methods A total of 200 patients diagnosed as septic shock in the emergency department of Xinjiang Medical University First Affiliated Hospital from January to August 2023 were prospectively included. The patients were divided into survival group (84 cases) and death group (116 cases) according to their 28-day prognosis. The patients’ information including name, age, gender, vital signs after admission, Glasgow coma scale(GCS), sepsis-related organ failure assessment(SOFA), APACHEⅡ, infection site, fluid intake within 24 h of admission, antibiotic use, past medical history, types and 24 h doses of vasopressors used, mechanical ventilation status, complete blood count, liver function, renal function, coagulation indicators, onset time, and 28-day prognosis outcomes were recorded. The lactate and PPI values of the two groups of patients were measured at the time of admission (0 h), 6 h after admission, and 12 h after admission, and the lactate clearance rate at 0-6 h and 0-12 h was calculated. Cox regression was used to screen independent factors for predicting the prognosis of septic shock patients, and the area under the ROC curve(AUC) was plotted. PPI parameter combined with APACHEⅡ score were analyzed in predicting AUC, which represented patients’ prognosis. Results Compared with the death group, the survival group had higher GCS score, 0 hPPI, 6 hPPI, 12 hPPI, 0-12 h lactic acid clearance rate, and lower in age, SOFA score, APACHEⅡ score, 0 h lactic acid, 12 h lactic acid (all P<0.05). COX regression showed that 12 hPPI was an independent predictor of the prognosis of patients with septic shock, and the AUC for predicting the prognosis of patients with septic shock was 0.945, and the 12 hPPI combined with APACHEⅡ score for predicting AUC as the prognosis of patients with was 0.996. Conclusions 12 hPPI combined with APACHEⅡ score after admission has good prognostic value for 28-day prognosis of patients with septic shock.

Objective To evaluate the ability of general practice residents in diagnosing and treating hypertension and managing chronic diseases, identify existing deficiencies, and provide a basis for improving standardized training. Methods A questionnaire survey and assessment on hypertension-related knowledge were conducted among 34 general practice residents participating in standardized training at our hospital. The assessment covered five aspects: hypertension diagnosis, risk stratification, conditions for community referral, follow-up requirements, blood pressure management and non-pharmacological interventions. The influence of different factors on the assessment results was analyzed, including gender, year of rotation, and participation in rotation training in hypertension-related departments. Results The overall pass rate for the assessment among the 34 general practice residents was 76.5%. However, only 23.5% of the residents met the passing criteria in the blood pressure management and non-pharmacological interventions section, and the mean score (12.18±1.42) was significantly lower than the diagnostic criteria (14.24±1.69), risk stratification (15.00±3.79), community referral (14.00±3.48) and follow-up (13.65±3.17) (F=4.441, P=0.002). There was no significant difference between different genders, rotation years and related departments. Conclusions General practice residents have already acquired basic professional skills in the diagnosis and treatment of hypertension, but showed significant deficiencies in chronic disease management, particularly in non-pharmacological interventions. General practitioners still need further training and improvement on long-term chronic disease management and comprehensive intervention strategy to better serve for community and patients.

The patient was diagnosed as acute myeloid leukaemia with CEBPA double mutation, GATA2 and IKZF1 mutation in 2021, and relapsed after giving two courses of IA treatment (idarubicin, cytosine arabinoside). There was transient remission after four additional courses of azacitidine combined with venetoclax. The patient relapsed again due to lack of regular treatment. This paper mainly analyses the therapeutic and prognostic role of CEBPA double mutation combined with GATA2 germline mutation in acute myeloid leukaemia.

Atrial fibrillation (AF) and heart failure with preserved ejection fraction (HFpEF) are 2 common and often coexistent conditions, and have significant impact on cardiovascular morbidity and mortality. HFpEF is characterized as atrial fibrosis and left atrial myopathy, and AF could be the cause or consequence of HFpEF. Recent data suggest that sinus rhythm restoration with catheter ablation may be a useful intervention to improve disease progression in AF-HFpEF, which could reduce HFpEF severity, decrease AF burden, overall rehospitalization rate and mortality. In the review, we will focus on the pathophysiology of AF-HFpEF, the role and clinical progress of catheter ablation in these patients.

The incidence and mortality rate of gastric cancer are among the top five malignant tumors, and the majority is elderly people. However, clinical research and related guidelines for elderly patients are not insufficient. This article summarizes the recent research progress of the overall evaluation, surgical treatment, perioperative treatment, chemotherapy and targeted therapy of gastric cancer in the elderly, to provide some reference for the clinical practice.

Salt sensitivity has been proven to be closely related to the occurrence and development of hypertension, and high salt intake is one of the important risk factors for hypertension in community residents. This article provides a literature review of domestical and international research, introducing the relationship between salt sensitivity and hypertension, the current state of salt intake in the diet of community residents, application and effect of a salt-restricted dietary pattern, the different evaluation method of salt intake, and the application of multiple theoretical models in the assessment of salt intake. The article points out the importance of salt restriction dietary behavior of community residents in the prevention and treatment of hypertension. Therefore, it is crucial to investigate and evaluate the current status of salt-restricted diets in order to help to form a good habit and promote healthy behaviors among community residents.

Acute lymphoblastic leukemia (ALL) is a hematological malignancy with abnormal proliferation of primitive naive lymphocytes and inhibition of normal hematopoiesis. It originates from B-lineage or T-lineage lymphoid progenitor cells, accounting for 20%-30% of adult acute leukemia. Although the complete remission rate of newly diagnosed adult ALL patients after multi-drug combination chemotherapy can reach more than 80%, most of the patients still show relapse and refractory. The 5-year long term survival rate in the patients is only 20%-40% and the clinical characteristics and prognosis are quite different. In recent years, with the advent of targeted drugs, immunotherapy, and chimeric antigen receptor (CAR) -T cell therapy, the clinical outcomes of adult ALL patients have been greatly improved. This article reviews the current progress of new therapeutic drugs for adult ALL in detail.

Numerous microorganisms inhabit the human intestine, participate in the digestion and absorption of nutrients, and produce a large number of metabolites, participate in regulating functions and protect the host from disease damage. Bile acids are produced by cholesterol metabolism and metabolized by the gut microbiota into secondary bile acids. Bile acids facilitate lipid digestion and absorption and interact with the gut microbiota. The composition and quantity of the gut microbiota also regulate bile acid metabolism. As sepsis occurs, the poor prognosis of the disease is associated with disturbances of the gut microbiota and bile acid metabolism. This paper reviews the metabolic process of bile acids, the interaction between bile acids and the gut microbiota, and the changes of gut microbiota and bile acids during sepsis, to provide new ideas for the prevention and treatment of sepsis.

Hypertension is a common chronic disease that can endanger people’s health, which can cause a variety of complications and bring burden to people and society. The incidence rate of hypertension is high in elder patients. As age increased, the treatment compliance of patients with hypertension decreased under the influence of various factors, which can lead to poor blood pressure control. Poor blood pressure control has clearly correlation with cardiovascular disease. Knowledge, attitude and practice (KAP) is one of the basic pattern to promote human health behavior. Effective health intervention is helpful to improve cognitive level of elderly patients with hypertension, alleviate negative emotions, develop positive attitude to disease, which can improve treatment compliance and treatment effect and reduce the incidence of complications and mortality. This paper reviews the concept of KAP theory and its research status in hypertension, aiming to analyze the application and influence of KAP in hypertension population, so as to provide reference for health education and health management, and reduce the disease burden of the public.