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Fibrosis is a typical aging-related pathological process involving almost all organs, including the heart, kidney, liver, lung, and skin. Fibrogenesis is a highly orchestrated process defined by sequences of cellular response and molecular signals mechanisms underlying the disease. In pathophysiologic conditions associated with organ fibrosis, a variety of injurious stimuli such as metabolic disorders, epigenetic changes, and aging may induce the progression of fibrosis. Sirtuins protein is a kind of deacetylase which can regulate cell metabolism and participate in a variety of cell physiological functions. In this review, we outline our current understanding of common principles of fibrogenic mechanisms and the functional role of SIRT3/6 in aging-related fibrosis. In addition, sequences of novel protective strategies have been identified directly or indirectly according to these mechanisms. Here, we highlight the role and biological function of SIRT3/6 focus on aging fibrosis, as well as their inhibitors and activators as novel preventative or therapeutic interventions for aging-related tissue fibrosis.
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Sirtuina 3 , Sirtuinas , Humanos , Hígado , FibrosisRESUMEN
Difluoromethylation reactions are increasingly important for the creation of fluorine-containing heterocycles, which are core groups in a diverse range of biologically and pharmacologically active ingredients. Ideally, this typically challenging reaction could be performed photocatalytically under mild conditions. To achieve this separation of redox processes would be required for the efficient generation of difluoromethyl radicals and the reduction of oxygen. A covalent organic framework photocatalytic material was, therefore, designed with dual reactive centers. Here, anthracene was used as a reduction site and benzothiadiazole was used as an oxidation site, distributed in a tristyryl triazine framework. Efficient charge separation was ensured by the superior electron-donating and -accepting abilities of the dual centers, creating long-lived photogenerated electron-hole pairs. Photocatalytic difluoromethylation of 16 compounds with high yields and remarkable functional group tolerance was demonstrated; compounds included bioactive molecules such as xanthine and uracil. The structure-function relationship of the dual-active-center photocatalyst was investigated through electron spin resonance, femtosecond transient absorption spectroscopy, and density functional theory calculations.
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The common wheat line 4N0461 showed adult-plant resistance to leaf rust. 4N0461 was crossed with susceptible cultivars Nongda4503 and Shi4185 to map the causal resistance gene(s). Segregation of leaf rust response in F2 populations from both crosses was 9 resistant:7 susceptible, indicative of two complementary dominant resistance genes. The genes were located on chromosome arms 3BS and 4BL and temporarily named LrN3B and LrN4B, respectively. Subpopulations from 4N0461 × Nongda4503 with LrN3B segregating as a single allele were used to fine-map LrN3B locus. LrN3B was delineated in a genetic interval of 0.07 cM, corresponding to 106 kb based on the Chinese Spring reference genome (IWGSC RefSeq v1.1). Four genes were annotated in this region, among which TraesCS3B02G014800 and TraesCS3B02G014900 differed between resistant and susceptible genotypes, and both were required for LrN3B resistance in virus-induced gene silencing experiments. Diagnostic markers developed for checking the polymorphism of each candidate gene, can be used for marker-assisted selection in wheat breeding programs.
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Basidiomycota , Mapeo Cromosómico , Cromosomas de las Plantas , Resistencia a la Enfermedad , Genes de Plantas , Enfermedades de las Plantas , Triticum , Triticum/genética , Triticum/microbiología , Resistencia a la Enfermedad/genética , Enfermedades de las Plantas/genética , Enfermedades de las Plantas/microbiología , Basidiomycota/patogenicidad , Basidiomycota/fisiología , Cromosomas de las Plantas/genética , Marcadores Genéticos , Genotipo , AlelosRESUMEN
Streptococcus suis is one of the most common zoonotic pathogens, in humans and can cause meningitis, endocarditis, arthritis and sepsis. Human cases of Streptococcus suis infection have been reported worldwide, and most of those cases occurred in Asia. Hearing loss is the most common sequela of Streptococcus suis meningitis. Streptococcus suis infection complicated with acute cerebral infarction has rarely been reported. Therefore, to provide a reference for this disease, we reported a case of acute multiple brain infarctions associated with Streptococcus suis infection. In our report, a 69yearold male patient had Streptococcus suis meningitis and sepsis, which were associated with multiple acute cerebral infarctions in the pons and bilateral frontotemporal parietal occipital lobes. After treatment, the patient exhibited cognitive impairment, dyspraxia and irritability. There are limited case reports of cerebral infarction associated with Streptococcus suis infection, and further research is needed to determine the best treatment method.
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Infarto Encefálico , Infecciones Estreptocócicas , Streptococcus suis , Humanos , Streptococcus suis/aislamiento & purificación , Masculino , Infecciones Estreptocócicas/microbiología , Infecciones Estreptocócicas/complicaciones , Anciano , Infarto Encefálico/microbiología , Infarto Encefálico/diagnóstico por imagen , Infarto Encefálico/complicaciones , Meningitis Bacterianas/microbiología , Meningitis Bacterianas/complicaciones , Meningitis Bacterianas/tratamiento farmacológico , Sepsis/microbiología , Sepsis/complicaciones , Antibacterianos/uso terapéuticoRESUMEN
OBJECTIVE: Essential tremor (ET) is the most common movement disorder. Deep brain stimulation (DBS) targeting the ventral intermediate nucleus (VIM) is known to improve symptoms in patients with medication-resistant ET. However, the clinical effectiveness of VIM-DBS may vary, and other targets have been proposed. The authors aimed to investigate whether the same anatomical structure is responsible for tremor control both immediately after VIM-DBS and at later follow-up evaluations. METHODS: Of 68 electrodes from 41 patients with ET, the authors mapped the distances of the active contact from the VIM, the dentatorubrothalamic tract (DRTT), and the caudal zona incerta (cZI) and compared them using Friedman's ANOVA and the Wilcoxon signed-rank follow-up test. The same distances were also compared between the initially planned target and the final implantation site after intraoperative macrostimulation. Finally, the comparison among the three structures was repeated for 16 electrodes whose active contact was changed after a mean 37.5 months follow-up to improve tremor control. RESULTS: After lead implantation, the VIM was statistically significantly closer to the active contact than both the DRTT (p = 0.008) and cZI (p < 0.001). This result did not change if the target was moved based on intraoperative macrostimulation. At the last follow-up, the active contact distance from the VIM was always significantly less than that of the cZI (p < 0.001), but the distance from the DRTT was reduced and even less than the distance from the VIM. CONCLUSIONS: In patients receiving VIM-DBS, the VIM itself is the structure driving the anti-tremor effect and remains more effective than the cZI, even years after implantation. Nevertheless, the role of the DRTT may become more important over time and may help sustain the clinical efficacy when the habituation from the VIM stimulation ensues.
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Estimulación Encefálica Profunda , Temblor Esencial , Núcleos Talámicos Ventrales , Zona Incerta , Humanos , Temblor Esencial/terapia , Temblor Esencial/cirugía , Estimulación Encefálica Profunda/métodos , Zona Incerta/cirugía , Femenino , Masculino , Persona de Mediana Edad , Anciano , Núcleos Talámicos Ventrales/cirugía , Resultado del Tratamiento , Adulto , Estudios de Seguimiento , Anciano de 80 o más AñosRESUMEN
Investigations into the selective oxidation of inert sp3 C-H bonds using polymer photocatalysts under mild conditions have been limited. Additionally, the structure-activity relationship of photocatalysts often remains insufficiently explored. Here, a series of thiophene-based covalent triazine frameworks (CTFs) are used for the efficient and selective oxidation of hydrocarbons to aldehydes or ketones under ambient aerobic conditions. Spectroscopic methods conducted in situ and density functional theory (DFT) calculations revealed that the sulfur atoms within the thiophene units play a pivotal role as oxidation sites due to the generation of photogenerated holes. The effect of photogenerated holes on photocatalytic toluene oxidation was investigated by varying the length of the spacer in a CTF donor-acceptor based photocatalyst. Furthermore, the manipulation of reactive oxygen species was employed to enhance selectivity by weakening the peroxidative capacity. As an illustrative example, this study successfully demonstrated the synthesis of a precursor of the neurological drug AMG-579 using a photocatalytic protocol.
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Several studies have reported that sleep quality often decreases in patients after surgery, especially in elderly patients, which seriously affects postoperative prognosis and outcomes, inducing diseases such as postoperative delirium, long-term chronic pain, and potentially fatal cardiovascular events. With the popularization of comfortable medicine, medical workers pay more attention to the postoperative sleep quality of patients. The causes underlying the decrease in postoperative sleep quality may include postoperative pain, the severity of surgical trauma and stress, perioperative anxiety and depression, and postoperative complications. Patients with insomnia often use acupoint therapies as a safe and effective alternative to drugs. Acupoint therapies are among the oldest medical therapies of Traditional Chinese Medicine and are gradually gaining recognition among medical workers worldwide. Various types of acupoint stimulation methods such as transcutaneous electrical acupoint simulation (TEAS), acupressure, acupuncture, and electroacupuncture can change the brain's local electrical activity, inhibit the central nervous system, and achieve deep sedation through stimulating the related acupoints, which provides a novel idea and basis for improvement in factors affecting postoperative sleep quality. This review explores the mechanism of acupoint therapies from several aspects of affecting the sleep quality of patients after surgery and its clinical results. We found that acupoint therapies effectively improve sleep quality and alleviate the postoperative complications of patients, and we emphasize the importance of acupoint therapies to guide future research and clinical practice. Large-scale, multicenter studies are needed to determine the optimal duration, frequency, and timing of acupoint stimulation for improving postoperative sleep quality.
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Electroacupuntura , Estimulación Eléctrica Transcutánea del Nervio , Humanos , Anciano , Puntos de Acupuntura , Estimulación Eléctrica Transcutánea del Nervio/métodos , Calidad del Sueño , Complicaciones Posoperatorias/etiologíaRESUMEN
BACKGROUND: Intracranial hemorrhage (ICH) in acute leukemia (AL) patients leads to high morbidity and mortality, treatment approaches for ICH are generally ineffective. Thus, early identification of which subjects are at high risk of ICH is of key importance. Currently, machine learning can achieve well predictive capability through constructing algorithms that simultaneously exploit the information coming from clinical features. METHODS: After rigid data preprocessing, 42 different clinical features from 948 AL patients were used to train different machine learning algorithms. We used the feature selection algorithms to select the top 10 features from 42 clinical features. To test the performance of the machine learning algorithms, we calculated area under the curve (AUC) values from receiver operating characteristic (ROC) curves along with 95% confidence intervals (CIs) by cross-validation. RESULTS: With the 42 features, RF exhibited the best predictive power. After feature selection, the top 10 features were international normalized ratio (INR), prothrombin time (PT), creatinine (Cr), indirect bilirubin (IBIL), albumin (ALB), monocyte (MONO), platelet (PLT), lactic dehydrogenase (LDH), fibrinogen (FIB) and prealbumin (PA). Among the top 10 features, INR, PT, Cr, IBIL and ALB had high predictive performance with an AUC higher than 0.8 respectively. CONCLUSIONS: The RF algorithm exhibited a higher cross-validated performance compared with the classical algorithms, and the selected important risk features should help in individualizing aggressive treatment in AL patients to prevent ICH. Efforts that will be made to test and optimize in independent samples will warrant the application of such algorithm and predictors in the future.
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Algoritmos , Leucemia , Humanos , Curva ROC , Aprendizaje Automático , Hemorragias Intracraneales/diagnóstico , Hemorragias Intracraneales/diagnóstico por imagenRESUMEN
Biocatalysis has become a powerful tool in synthetic chemistry, where enzymes are used to produce highly selective products under mild conditions. Using photocatalytically regenerated cofactors in synergistic combination with enzymes in a cascade fashion offers an efficient synthetic route to produce specific compounds. However, the combination of enzymes and photocatalysts has been limited due to the rapid degradation of the biomaterials by photogenerated reactive oxygen species, which denature and deactivate the enzymatic material. Here, we design core-shell structured porous nano-photoreactors for highly stable and recyclable photobiocatalysis under aerobic conditions. The enzymatic cofactor NAD+ from NADH can be efficiently regenerated by the photoactive organosilica core, while photogenerated active oxygen species are trapped and deactivated through the non-photoactive shell, protecting the enzymatic material. The versatility of these photocatalytic core-shell nanoreactors was demonstrated in tandem with two different enzymatic systems, glycerol dehydrogenase and glucose 1-dehydrogenase, where long-term enzyme stability was observed for the core-shell photocatalytic system.
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Coenzimas , Glucosa 1-Deshidrogenasa , BiocatálisisRESUMEN
Synthesis of covalent organic frameworks (COFs) with desirable organic units furnishes advanced materials with unique functionalities. As an emerging class of two-dimensional (2D) COFs, sp2 -carbon-conjugated COFs provide a facile platform to build highly stable and crystalline porous polymers. Herein, a 2D olefin-linked COF was prepared by employing nanographene, namely, dibenzo[hi,st]ovalene (DBOV), as a building block. The DBOV-COF exhibits unique ABC-stacked lattices, enhanced stability, and charge-carrier mobility of ≈0.6â cm2 V-1 s-1 inferred from ultrafast terahertz photoconductivity measurements. The ABC-stacking structure was revealed by the high-resolution transmission electron microscopy and powder X-ray diffraction. DBOV-COF demonstrated remarkable photocatalytic activity in hydroxylation, which was attributed to the exposure of narrow-energy-gap DBOV cores in the COF pores, in conjunction with efficient charge transport following light absorption.
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PURPOSE: To assess the accuracy of gadobenate-enhanced MRI for predicting microvascular invasion (MVI) in patients operated for hepatocellular carcinoma (HCC). METHODS: The 164 patients who met the inclusion criteria were assigned to one of two groups: the MVI-positive group and the MVI-negative group. Imaging results were compared between the two groups using the Kruskal test, chi-square test, independent sample t test, and logistic regression analysis. RESULTS: Differences in the capsule (p = 0.037) and margin (p = 0.004) of the tumor, rim enhancement (p = 0.002), peritumoral enhancement in the arterial phase (p < 0.001), and peritumoral hypointensity in the hepatobiliary phase (HBP) (p < 0.001) were statistically significant. The results of multivariate analysis identified rim enhancement in the arterial phase (odds ratio (OR) = 2.115; 95% confidence interval (CI), 1.002-4.464; p = 0.049) and peritumoral hypointensity in the HBP (OR = 5.836; 95% CI, 2.442-13.948; p < 0.001) as independent risk factors for MVI. Use of the two predictors in combination identified 32.79% (20/61) of HCCs with MVI with a specificity of 95.15% (98/103). CONCLUSIONS: Rim enhancement in the arterial phase and peritumoral hypointensity in the HBP were identified as independent risk factors for MVI in patients with HCC. KEY POINTS: ⢠Rim enhancement in the arterial phase and peritumoral hypointensity in the hepatobiliary phase were independent risk factors for microvascular invasion in patients with HCC. ⢠Use of the two predictors in combination had a sensitivity of 32.79% and a specificity of 95.15% for predicting microvascular invasion.
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Carcinoma Hepatocelular/patología , Gadolinio DTPA/farmacología , Neoplasias Hepáticas/patología , Hígado/patología , Imagen por Resonancia Magnética/métodos , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Medios de Contraste/farmacología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Invasividad Neoplásica , Oportunidad Relativa , Estudios Retrospectivos , Adulto JovenRESUMEN
KEY MESSAGE: Three major loci for pre-harvest sprouting tolerance (PHST) were mapped on chromosomes 1AL, 3BS, and 6BL, and two CAPS and one dCAPS markers were validated. Sixteen lines with favorable alleles and increased PHST were identified. Pre-harvest sprouting (PHS) significantly affects wheat grain yield and quality. In the present study, the PHS tolerance (PHST) of 192 wheat varieties (lines) was evaluated by assessment of field sprouting, seed germination index, and period of dormancy in different environments. A high-density Illumina iSelect 90K SNP array was used to genotype the panel. A genome-wide association study (GWAS) based on single- and multi-locus mixed linear models was used to detect loci for PHST. The single-locus model identified 23 loci for PHST (P < 0.0001) and explained 6.0-18.9% of the phenotypic variance. Twenty loci were consistent with known quantitative trait loci (QTLs). Three single-nucleotide polymorphism markers closely linked with three major loci (Qphs.ahau-1A, Qphs.ahau-3B, and Qphs.ahau-6B) on chromosomes 1AL, 3BS, and 6BL, respectively, were converted to two cleaved amplified polymorphic sequences (CAPS) and one derived-CAPS markers, and validated in 374 wheat varieties (lines). The CAPS marker EX06323 for Qphs.ahau-6B co-segregated with a novel major QTL underlying PHST in a recombinant inbred line population raised from the cross Jing 411 × Wanxianbaimaizi. Linear regression showed a clear dependence of PHST on the number of favorable alleles. Sixteen varieties showing an elevated degree of PHST were identified and harbored more than 16 favorable alleles. The multi-locus model detected 39 marker-trait associations for PHST (P < 0.0001), of which five may be novel. Six loci common to the two models were identified. The combination of the two GWAS methods contributes to efficient dissection of the complex genetic mechanism of PHST.
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Germinación/genética , Triticum/genética , Alelos , Mapeo Cromosómico , Estudios de Asociación Genética , Marcadores Genéticos , Genotipo , Desequilibrio de Ligamiento , Modelos Genéticos , Fenotipo , Polimorfismo de Nucleótido Simple , Sitios de Carácter Cuantitativo , Semillas/fisiología , Triticum/fisiologíaRESUMEN
BACKGROUND: Several studies have noted that the discriminatory ability and stratification performance of the AJCC 8th edition staging system is not entirely satisfactory. We aimed to improve the American Joint Committee on Cancer (AJCC) 8th edition staging system for intrahepatic cholangiocarcinoma (ICC). METHODS: A multicentric database from three Chinese mainland centers (n = 1601 patients) was used to modify the 8th edition staging system. This modified TNM (mTNM) staging system was then validated using the SEER database (n = 761 patients). A new TNM staging system, by incorporating serum tumor markers (TNMIS) into the mTNM staging system was then proposed. RESULTS: The 8th edition staging system did not provide an adequate stratification of prognosis in the Chinese multicentric cohort. The mTNM staging system offered a better discriminatory capacity in the multicentric cohort than the original 8th edition. External validation in the SEER cohort showed that the mTNM staging system also had a good stratification performance. After further incorporating a serum marker stage into the mTNM staging, the TNMIS staging system was able to stratify prognosis even better. CONCLUSION: The proposed mTNM staging system resulted in better stratification performance and the TNMIS staging system provided even more accurate prognostic classification than the conventional TNM system.
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Antígenos de Carbohidratos Asociados a Tumores/sangre , Neoplasias de los Conductos Biliares/patología , Antígeno Carcinoembrionario/sangre , Colangiocarcinoma/patología , Estadificación de Neoplasias/métodos , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Neoplasias de los Conductos Biliares/mortalidad , Biomarcadores de Tumor/sangre , China , Colangiocarcinoma/mortalidad , Estudios de Cohortes , Bases de Datos Factuales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Invasividad Neoplásica , Pronóstico , Factores de Riesgo , Programa de VERF , Adulto JovenRESUMEN
BACKGROUND: Osteoprotegerin (OPG) is supposed to participate in the development of atherosclerosis and cardio-cerebrovascular disease. However, the results of research on relationship between OPG and ischemic stroke (IS) are controversial. Therefore, we carried out the first systematic review and meta-analysis to evaluate prognostic effect of osteoprotegerin in patients with IS. METHODS: We comprehensively searched databases of PubMed, Embase, and the Cochrane Library through 21 August 2023 to identify observational studies that evaluated effect of OPG on poor functional outcome (modified Rankin Scale [mRS] Score of 3-6) and mortality in patients with IS. Adjusted odds ratios (aOR) with a 95% confidence interval (CI) of each included study were used as much as possible to assess the pooled effect. RESULTS: Five studies that enrolled 4,506 patients in total fulfilled our inclusion criteria. Three studies were included in the pooled analysis for each endpoint since one of the included studies had provided data on poor functional outcome as well as mortality. OPG was neither associated with poor functional outcome (aOR 1.29, 95% CI 0.90-1.85) nor with mortality (aOR 1.57, 95% CI 0.90-2.74) in patients with IS. CONCLUSIONS: There is insufficient evidence to demonstrate the correlation between OPG and mortality or poor functional outcome in IS patients. OPG cannot be applied to predict worse neurological function in IS patients based on the current evidence.
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Accidente Cerebrovascular Isquémico , Osteoprotegerina , Humanos , Accidente Cerebrovascular Isquémico/mortalidad , Accidente Cerebrovascular Isquémico/tratamiento farmacológico , PronósticoRESUMEN
Deep Brain Stimulation (DBS) is an experimental treatment for medication-refractory neuropathic pain. The ventral posteromedial (VPM) and ventral posterolateral (VPL) nuclei of the thalamus are popular targets for the treatment of facial and limb pain, respectively. While intraoperative testing is used to adjust targeting of patient-specific pain locations, a better understanding of thalamic somatotopy may improve targeting of specific body regions including the individual trigeminal territories, face, arm, and leg. To elucidate the somatotopic organization of the ventral nuclear group of the dorsal thalamus using in vivo macrostimulation data from patients undergoing DBS for refractory neuropathic pain. In vivo macrostimulation data was retrospectively collected for 14 patients who underwent DBS implantation for neuropathic pain syndromes at our institution. 56 contacts from 14 electrodes reconstructed with LeadDBS were assigned to macrostimulation-related body regions: tongue, face, arm, or leg. 33 contacts from 9 electrodes were similarly assigned to one of three trigeminal territories: V1, V2, or V3. MNI coordinates in the x, y, and z axes were compared by using MANOVA. Across the horizontal plane of the ventral nuclear group of the dorsal thalamus, the tongue was represented significantly medially, followed by the face, arm, and leg most laterally (p < 0.001). The trigeminal territories displayed significant mediolateral distribution, proceeding from V1 and V2 most medial to V3 most lateral (p < 0.001). Along the y-axis, V2 was also significantly anterior to V3 (p = 0.014). While our results showed that the ventral nuclear group of the dorsal thalamus displayed mediolateral somatotopy of the tongue, face, arm, and leg mirroring the cortical homunculus, the mediolateral distribution of trigeminal territories did not mirror the established cortical homunculus. This finding suggests that the facial homunculus may be inverted in the ventral nuclear group of the dorsal thalamus.
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Estimulación Encefálica Profunda , Neuralgia , Humanos , Núcleos Talámicos Ventrales , Estimulación Encefálica Profunda/métodos , Estudios Retrospectivos , Tálamo/fisiología , Neuralgia/terapiaRESUMEN
Background: Hyperlipidemia (HLP) presents a significant challenge to global public health. Mounting evidence suggests that statins, the recommended first-line lipid-lowering agents, have significant adverse effects. Consequently, the quest for natural and efficacious alternative therapies is steadily emerging as a research priority for HLP prevention and treatment. Consumption of tea, which is rich in diverse biologically active compounds with the capacity to regulate lipid metabolism and combat obesity, has emerged as a promising alternative therapy. Sea buckthorn leaves are rich in a multitude of biologically active substances, have a hypolipidemic effect, and can be used as a raw material for tea because of their unique flavor. There is a suggestion that combining Aspergillus cristatus with tea could modify or boost the lipid-lowering active compounds present in tea, thereby increasing its efficacy in regulating lipid metabolism. Results: Sea Buckthorn Leaf Fu Tea (SBLFT) was obtained by fermentation when sea buckthorn leaves contained 42 % moisture, inoculated with Aspergillus cristatus 0.2 mL/g, and incubated for 8 d at constant temperature. Animal experiments demonstrated that SBLFT significantly inhibited body weight gain in HLP rats and reduced lipid content and serum oxidative stress. In addition, liver tissue sections and functional indices showed that SBLFT can improve liver morphology and function abnormalities. Reverse transcription-polymerase chain reaction results indicated that the expression of Liver kinase B1 (LKB1), adenosine 5'-monophosphate (AMP)-activated protein kinase (AMPK), acetyl CoA carboxylase 1 (ACC1), and sterol-regulatory element binding protein-1 (SREBP1c) gene related to lipid metabolism was altered. Conclusion: SBLFT improved HLP, specifically via promoting the expression of LKB1 in the liver of HLP rats, activating AMPK, and inhibiting ACC1 and SREBP1c expression, resulting in the inhibition of fatty acid and triglyceride synthesis-related enzymes at the transcriptional level.
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[This corrects the article DOI: 10.3389/fnimg.2022.1009399.].
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Objective: The aim of this study is to evaluate the clinical efficacy of Tongxinluo capsules in preventing coronary restenosis based on meta-analysis and network pharmacology research methods and to preliminarily explore its intervention mechanism. Methods: First, through meta-analysis, we comprehensively searched databases such as CNKI, Wanfang, PubMed, the Cochrane Library, and Web of Science to find out the randomized controlled trials of Tongxinluo capsules in the treatment of coronary restenosis until February, 2022. According to the Cochrane Library, risk bias assessment tools were used to evaluate the included literature and Review Manager 5.2 software was used to conduct statistical analysis of the included studies. Then, based on network pharmacology, through TCMSP database and BATMAN-TCM database screening, the chemical components of Tongxinluo capsules and their related effects, symptom, and common targets were analyzed. String net was used to construct protein-protein interaction (PPI) network, and R3.6.1 software was used to carry out GO biological process enrichment analysis and KEGG signaling pathway enrichment analysis to clarify key pathways. Results: The meta-analysis finally included 10 RCTs with a total of 1318 subjects. Meta-analysis results showed that Tongxinluo capsules combined with conventional cardiovascular drugs could significantly improve the clinical efficacy of preventing in-stent restenosis and the clinical efficacy of preventing angina pectoris. There was no significant difference in the clinical efficacy of preventing myocardial infarction. Network pharmacology obtained a total of 101 chemical components and 149 targets through the online database. The results of network analysis showed that the targets were mainly involved in receptor ligand activity, carboxylic acid binding, steroid hormone receptor activity, and other related action pathways and were also involved in AGE-RAGE signaling pathway, cell senescence signaling pathway, and other related pathways. Conclusion: Tongxinluo capsules combined with conventional cardiovascular drugs can improve the clinical efficacy of preventing in-stent restenosis and angina pectoris and have a significant effect on reducing inflammatory factors. The comprehensive result of the effect is mainly through the participation of receptor ligand activity, carboxylic acid binding, steroid hormone receptor activity, and other ways to achieve the purpose of treating coronary restenosis.
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OBJECTIVE: Preoperative anxiety is a psychological state that commonly occurs before surgery and may have a negative impact on postoperative outcomes. This study aimed to investigate the effects of preoperative anxiety on postoperative sleep quality and recovery outcomes among patients undergoing laparoscopic gynecological surgery. METHODS: The study was conducted as a prospective cohort study. A total of 330 patients were enrolled and underwent laparoscopic gynecological surgery. After assessing the patient's preoperative anxiety score on the APAIS scale, 100 patients were classified into the preoperative anxiety (PA) group (preoperative anxiety score > 10) and 230 patients into the non-preoperative-anxiety (NPA) group (preoperative anxiety score ≤ 10). The Athens Insomnia Scale (AIS) was assessed on the night before surgery (Sleep Pre 1), the first night after surgery (Sleep POD 1), the second night after surgery (Sleep POD2), and the third night after surgery (Sleep POD 3). Postoperative pain was evaluated by the Visual Analog Scale (VAS), and the postoperative recovery outcomes and adverse effects were also recorded. RESULT: The AIS score in the PA group was higher than that of the NPA group at Sleep-pre 1, Sleep POD 1, Sleep POD 2, and Sleep POD 3 (p < 0.05). The VAS score was higher in the PA group than in the NPA group within 48 h postoperatively (p < 0.05). In the PA group, the total dosage of sufentanil was significantly higher, and more rescue analgesics were required. Patients with preoperative anxiety showed a higher incidence of nausea, vomiting, and dizziness than those without preoperative anxiety. However, there was no significant difference in the satisfaction rate between the two groups. CONCLUSION: The perioperative sleep quality of patients with preoperative anxiety is worse than that of patients without preoperative anxiety. Moreover, high preoperative anxiety is related to more severe postoperative pain and an increased requirement for analgesia.