Clinical Nursing Intervention of Moxibustion on Abdominal Distension Symptoms in Heart Failure (Heart and Kidney Yang Deficiency and Blood Stasis Blocking Collaterals Syndrome)

Objective:To investigate the clinical nursing intervention effect of moxibustion on abdominal distension symptoms in heart failure(heart and kidney yang deficiency and blood stasis blocking collaterals syndrome).Methods:62 patients with heart failure(heart and kidney yang deficiency and blood stasis blocking collaterals syndrome)admitted to our hospital from February 2023 to February 2024 were selected and divided into the observation group(n=31)and the control group(n=31)by using the random numerical table method.The control group adopted conventional nursing interventions,and the observation group received the nursing program of the control group with the addition of moxibustion nursing interventions.The nursing effectiveness,quality of life scores,and nursing satisfaction were compared between the two groups.Results:The nursing effectiveness of the observation group was significantly higher than the control group(P<0.05);the quality of life score of the observation group was significantly higher than the control group(P<0.05);the nursing satisfaction of the observation group was significantly higher than that of the control group(P<0.05).Conclusion:The use of moxibustion nursing intervention in patients with heart failure(heart and kidney yang deficiency and blood stasis blocking collaterals syndrome)can effectively relieve the symptoms of abdominal distension,improve patients'quality of life,and increase nursing satisfaction,which has promotion and application values.

A Comparative Study on Intertextuality of The Tell-Tale Heart and The Yellow Wallpaper

Intertextuality theory is one of extremely important critical methods in a host of western literary theories and provides a new perspective for numerous research scholars and common readers to comprehend and elaborate literature and literary works.This thesis uses multiple and comprehensive ways mainly based on the theory of intertextuality.Theory of symbolism and the method of close reading are also used to explored the internal connection of two short stories:The Tell-Tale Heart and The Yellow Wallpaper.The author attempts to build blocks to application practice of the intertextuality theory in specific works,and elaborate the value and significance of intertextuality comprehension from two aspects including literary reading and literary inheritance.

DYNAMIC PRINCIPLE FOR INTERACTION BETWEEN HEART AND ARTERIAL SYSTEM

Various steady models for interaction between heart and arterial system have been given in liter- ature,In our recent study,a dynamic principle,i.e.the principle of least cardiac work is proposed,and a dy- namic model for interaction of heart and arterial system is established.Preliminary results of our experiments show that both the principle and the model are consistent with the physiological phenomena.It reveals that the pres- ent analysis may offer a new measure for the study of dynamic process of interaction between heart and arterial system.

Efficacy and safety of Guipi Decoction combined with conventional Western medicine in the treatment of insomnia with deficiency of heart and spleen:a meta-analysis

Objective:To systematically evaluate the efficacy and safety of Guipi Decoction combined with Western medicine in the treatment of insomnia with deficiency of heart and spleen.Methods:English databases(PubMed,Web of Science,The Cochrane Library,EMBASE)and Chinese databases(CNKI,Wanfang database,China Biomedical Literature Service System,VIP database)were searched by computer.Randomized controlled trials of Guipi Decoction on insomnia with deficiency of heart and spleen were searched from the database construction to November 2021.After the first and second authors independently screened the literature,extracted the data and evaluated the risk of bias in the included studies,meta-analysis was performed using RevMan5.3 software.Results:A total of 9 RCTS were included after screening,including 914 patients.Meta-analysis results showed that:Total effective rate[RR=1.22,95%CI(1.16,1.30),P<0.00001],total PSQI score[MD=-3.05,95%CI(-3.96,-2.14),P=0.008],number of night awakening times[[MD=-1.18,95%CI(-1.42,-0.94),P<0.00001],adverse reaction rate[RR=0.32,95%CI(0.21,0.51),P<0.00001]were better than the control group,and the differences were statistically significant.Conclusion:The current evidence shows that,compared with pure using conventional western medicine,belongs to the spleen decoction combined western medicine therapy,cases both deficiency type of insomnia in the total effective rate,reducing the total PSQI score(improve sleep quality,sleep efficiency,sleep disorder,daytime function,etc.),reducing frequency of nighttime awakening,security,have more advantages.However,due to the limitation of the quality and quantity of articles included in the study,more randomized,double-blind,large-sample clinical studies are needed to confirm the above conclusions.

Clinical Observation on the Treatment of Insomnia in Germany with Deficiency of Heart and Spleen by the Ear Bean Therapy

Objective: To observe the effect of insomnia patients with deficiency of heart and spleen in Germany by the therapy of ear points pressing with bean. Methods: A total of 80 cases of insomnia with deficiency of heart and spleen in Germany were divided into the observation group and the control group, with 40 cases in each group. The patients in the control group were treated with oral modified Guipi Decoction(归脾汤), while the patients in the observation group were treated with oral traditional Chinese medicine(TCM) and the therapy of ear points pressing with bean. The efficacy, sleep quality, the TCM syndromes score and the incidence of adverse reactions were compared between the two groups. Results: The effective rate in the observation group was higher than that in the control group, and there was statistical difference between the two group(P<0.05). After treatment, the Pittsburgh sleep quality index scale(PSQI) score, insomnia severity index(ISI) score and the TCM syndromes score in the two groups were decreased sharply(P<0.01), and those scores in the observation group were lower than that in the control group(P<0.05). There was no adverse reaction between the two groups. Conclusion: The therapy of ear points pressing with bean is effective on insomnia in Germany, which is worth further study and promotion.

Evaluating the role of herg potassium-channel protein in the development of heart and vasculature

The role of human ether a-go-go related gene(hERG) in electrically excitable cells has long been known.hERG currents IKr contribute to the re-polarisation phase 3 of the cardiac action potential. Mutations of this channel causes long QT syndrome. N629D hERG mutation(GFGN to GFGD) alters the pore selectivity signature sequence.N629D was over-expressed, via adenoviral gene transfer,in car-diomyocytes derived from mouse embryonic stem cells,the "IKr" showed outward rectification and an inward tail current,while WT IKr showed inward rectification and a positive tail current.N629D "IKr" phenotype also altered resting membrane potential and caused arrhythmia.Since hERG was reported to express in early stage of cardiogenesis,the role of the ERG potassium channel in cardiac development was elaborated in an in vivo model of a homozygous. The hERG N629D mutation was introduced into the orthologous mouse gene,mERG,by homologous recombination in mouse embryonic stem cells. N629D/N629D homozygous mutation results in embryonic lethality(died by E11.5).The mutation displayed defect cardiac morphogenesis including altered looping architecture,poorly developed bulbus cordis,and distorted aortic sac and branchial arches. N629D/N629D myocytes from embryonic day 9.5 embryos manifested complete loss of IKr function, depolarized resting potential,prolonged action potential duration(LQT),failure to repolarize,and propensity to oscillatory arrhythmias.Because deletion of transcription factor Hand2 produces apoptosis in similar regions and with a similar final developmental phenotype,Hand2 expression was evaluated. Robust decrease in Hand2 expression was observed in the secondary heart field in N629D/N629D embryos. mERG protein expression in the developing embryonic heart is not homogeneous.The protein expression is exaggerated in the right ventricle and in the outflow tract.N629D/N629D embryos manifest extensive apoptosis particularly in the first branchial arch and the facial region.Given that cells from the branchial arch populate the outflow tract,the early apoptosis,in the branchial arch and facial region would prevent those cells from contributing to the development of the outflow tract in N629D/N629D hearts.The working model is that the Hand2 expres- sion is down regulated in N629D/N629D embryonic right ventricle and outflow tract because progenitor cells that populate the outflow tract undergo apoptosis while in the facial region and branchial arch. Thus tissues that would be expected to express Hand2 are absent,simply because those structures fail to develop.N629D/N629D embryos also displayed defects in both extraembryonic and intraem-bryonic vasculature.Yolk sac from N629D/N629D homozygous embryos revealed primary vascular networks formed,while they failed to remodel into more complex vascular structures,unlike wild-type yolk sacs at E9.5 N629D/N629D embryo yolk sacs at E9.5 display absence of visible vessels.Intraembry-onic vessels in the mutant showed less complex branching in comparison with the normal vessels structure in WT embryo,dorsal aorta exhibited abnormally formation and small lumens.Whole mount in situ hybridization displayed hERG was also expressed in E9.5 yolk sac and dorsal aorta.Immunofluorescence showed the co-localization of hERG and Cd31 and smooth muscle actin in E10.5. The role of hERG protein in the development of vasculature is further evaluated by using Cre-loxP-based mouse model for tissue specific hERG mutation expression.

STUDY AND APPLICATION ABOUT COMPUTED SYSTEM FOR EXTERNAL CARDIAC MASSAGE, MONITOR OF HEART AND BODY TEMPERATURE

Objective:To make and study computed system for external cardiac massage,monitor of heart and body temperature and observe its clinical effect.Method:The system was made and applied.Result:The effect of system was obvious.Conclusion: The system was an effective clinical equipment in treatment of patient with cardiac arrest.

Preservation of donor's heart and lung and discrimination and postoperative immunotherapy of graft rejection:a report of 2 cases of heart-lung transplantation

Objective To summarize preservation measures of donor’s heart and lung,and postoperative imrnunotherapy,as well as clinical experience of discrimination and management for graft rejection. Methods Clinical data of 2 cases of heart - lung transplantation in our depart-

Emerging pathways of communication between the heart and non-cardiac organs

The breakthrough discovery of cardiac natriuretic peptides provided the first direct demonstration of the connection between the heart and the kidneys for the maintenance of sodium and volume homeostasis in health and disease. Yet,little is still known about how the heart and other organs cross-talk. Here, we review three physiological mechanisms of communication linking the heart to other organs through: i) cardiac natriuretic peptides, ii) the microRNA-208 a/mediator complex subunit-13 axis and iii) the matrix metalloproteinase-2(MMP-2)/C-C motif chemokine ligand-7/cardiac secreted phospholipase A2(sPLA2) axis-a pathway which likely applies to the many cytokines, which are cleaved and regulated by MMP-2. We also suggest experimental strategies to answer still open questions on the latter pathway. In short, we review evidence showing how the cardiac secretome influences the metabolic and inflammatory status of non-cardiac organs as well as the heart.

Symptomatic Val122del mutated hereditary transthyretin amyloidosis: Need for early diagnosis and prioritization for heart and liver transplantation

Background: Hereditary transthyretin(ATTRv) amyloidosis is an autosomal dominant disease linked to transthyretin gene mutations which cause instability of the transthyretin tetramer. After dissociation and misfolding they reassemble as insoluble fibrils(i.e. amyloid). Apart from the common Val30 Met mutation there is a very heterogeneous group of non-Val30 Met mutations. In some cases, the clinical picture is dominated by a rapidly evolving restrictive and hypertrophic cardiomyopathy. Methods: A case series of four liver recipients with the highly clinically relevant, rare and particularly aggressive Val122 del mutation is presented. Medical and surgical therapeutic options, waiting list policy for ATTRv-amyloidosis, including the need for heart transplantation, and status of heart-liver transplantation are discussed. Results: Three patients needed a staged(1 patient) or simultaneous(2 patients) heart-liver transplant due to rapidly progressing cardiac failure and/or neurologic disability. Domino liver transplantation was impossible in two due to fibrotic hepatic transformation caused by cardiomyopathy. After a follow-up ranging from 3.5 to 9.5 years, cardiac(allograft) function was maintained in all patients, but neuropathy progressed in three patients, one of whom died after 80 months. Conclusions: This is the first report in(liver) transplant literature about the rare Val122 del ATTRv mutation. Due to its aggressiveness, symptomatic patients should be prioritized on the liver and, in cases with cardiomyopathy, heart waiting lists in order to avoid the irreversible neurological and cardiac damage that leads to a rapid lethal outcome.

Metabolic Acidosis in the Surgical Intensive Care Unit: Risk Factors, Clinical Correlates and Outcome. Findings from a High Dependency Heart and Vascular Surgical Center in Nigeria

Background: Metabolic acidosis (MA) is a common finding on the surgical ward, more so in the intensive care unit. Diseases affecting the major organ systems of the body and higher grades of surgery are common risk factors for MA. It is associated with poor treatment outcome. Aim: To determine the risk factors and clinical correlates of metabolic acidosis and assess its relationship with treatment outcome. Methodology: A retrospective study at the “Tristate Heart and vascular Center” in Ilishan-Remo South west Nigeria, on patients that had cardiac and vascular surgeries from January 2015 to December 2019. Three hundred and forty two participants took part in the study. The demographic, clinical and laboratory findings were entered. Statistical analysis was with Student’s t-test and Chi square. Results: Two hundred and six males and 136 females were studied. The incidences of metabolic acidosis prior to induction, on post-operative day one (POD1) and on POD28 were 20.7%, 39.8% and 14.1% respectively. Nine (2.6%) participants died during admission, of this, 6 (66.7%) had MA at presentation but all (100%) had MA on POD1. The Risk factors for MA were advanced age, comorbidities, open heart surgery, elevated systolic blood pressure and low eGFR. Metabolic acidosis was a risk factor for prolonged hospital stay, perioperative death and declining kidney function which was commoner among participants with preexisting kidney dysfunction. Conclusion: The incidence of metabolic acidosis was 20.7% at induction of anesthesia, rose to 39.8% on POD1 and by POD28, it has significantly reduced to 14.1%. While advancing age and comorbidities were risk factors for MA, the occurrence of MA increased the risk of declining kidney function, prolonged hospital stay and death.

POWER OF DUAL-WAVELENGTH APPROACHES IN STUDYING PHYSIOLOGICAL AND FUNCTIONAL CHANGES OF INTACT HEART AND IN VIVO BRAIN

Since the dual-wavelength spectrophotometer was developed,it has been widely used for studying biological samples and applied to extensive investigations of the electron transport in respiration and redox cofactors,redox state,metabolic control,and the generation of reactive oxygen species in mitochondria.Here,we discuss some extension of dual-wavelength approaches in our research to study the physiological and functional changes in intact hearts and in vivo brain.Specifically,we aimed at(1)making nonratiometricfluorescent indicator become ratiometricfluorescence function for investigation of Ca^(2+) dynamics in live tissue;(2)eliminating the effects of physiological changes on measurement of intracellular calcium;(3)permitting simultaneous imaging of multiple physiological parameters.The animal models of the perfused heart and transiently ischemic insult of brain are used to validate these approaches for physiological applications.

Multiple miscarriages in a female patient with two-chambered heart and situs inversus totalis:A case report

BACKGROUND Single atrium with single ventricle,or a two-chambered heart,is an extremely rare congenital malformation.Few cases with two-chambered heart surviving to adulthood have been reported.CASE SUMMARY We reported an adult female patient with a two-chambered heart and situs inversus totalis accompanied by multiple pregnancies and abortions.Magnetic resonance imaging detected a two-chambered heart.B-ultrasound-guided uterine aspiration was performed to absorb 8 g and 10 g of organized villus and decidual tissues,respectively,with a small amount of bleeding.Postoperatively,cyanosis and fatigue-induced shortness of breath were gradually relieved.The patient has currently outlived all similar cases reported so far.CONCLUSION Hemodynamic changes in pregnant women with two-chambered heart impaired cardiac function,responsible for hypoperfusion and miscarriage.

Heart and Brain:A neutro-genomic link

The philosophy of heart and brain are very ancient in our literature where the things good for the heart are not suggested good for the brain and vice-versa.Modern medicine is characterized by a high degree of specialization and the heart-brain connection that could be targeted to treat these complex cardiovascular/brain disorders.The idea that adverse diet/genome interactions can cause disease is not new.In the recent era the science of nutritional genomics have increased our understanding of diet-health-gene interactions and have provided a number of benefits for individuals,groups and societies.Since dietary chemicals are regularly ingested and participate indirectly and directly in regulating gene expression,it follows that a subset of genes regulated by diet must be involved in disease initiation,progression,and severity.In this regards Liver X Receptor(LXR)-a,a key transcription factors,associated with the several chronic pathological situation including coronary heart disease and neurodegenerative diseases have recently been found to be regulated by the dietary components.The crucial findings at molecular biology unit,Post Graduate Institute of Medical Education and Research(PGIMER),Chandigarh,INDIA have not only forced us to explore nutritional genomics as a holistic systems approach to understand the relationship between diet and health,but also to look into the disease preventing and health promoting foods that match our lifestyles,cultures and genetics.After all,we are what we eat.

Performance of HEART and TIMI scores in predicting major adverse cardiovascular events(MACEs)of chest pain patients in the emergency department:A prospective observational study

Objective:To compare the value of HEART and TIMI scores in predicting major adverse cardiovascular events(MACEs)of patients with chest pain in the emergency department at a tertiary care hospital in Ahmedabad,a city in western India.Methods:A prospective study was conducted on chest pain patients from January to December 2019.All adult patients with non-traumatic chest pain presenting to the emergency department were included,and their HEART and TIMI scores were evaluated.The patients were followed up within 4 weeks for monitoring any major adverse cardiac events or death.The receiver-operating characteristics(ROC)curve was used to determine the value of HEART and TIMI scores in predicting MACEs.Besides,the specificity,sensitivity,positive predictive value(PPV),and negative predictive value(NPV)of the two scores were assessed and compared.Results:A total of 350 patients were evaluated[mean age(55.03±16.6)years,56.6%of males].HEART score had the highest predictive value of MACEs with an area under the curve(AUC)of 0.98,followed by the TIMI score with an AUC of 0.92.HEART score had the highest specificity of 98.0%(95%CI:96.4%-99.6%),the sensitivity of 75.0%(95%CI:70.7%-79.3%),and PPV of 97.0%(95%CI:94.1%-99.9%)and NPV of 82.5%(95%CI:74.6%-90.4%)for low-risk patients.TIMI score had a specificity of 95.0%(95%CI:92.4%-97.6%),sensitivity of 75.0%(95%CI:69.4%-80.6%),PPV of 92.3%(95%CI:88.1%-96.5%)and NPV of 82.3%(95%CI:73.8%-90.8%)for low-risk patients.Conclusions:HEART score is an easier and more practical triage instrument to identify chest pain patients with low-risk for MACEs compared to TIMI score.Patients with high HEART scores have a higher risk of MACEs and require early therapeutic intervention and aggressive management.

Heart and ventilatory measures in crayfish during copulation

Monitoring heart rate (HR) and ventilatory rate (VR) during defined sensory stimuli and during aggressive and submissive social interactions has provided additional information of a crayfish's physiological state which is not achieved by behavioral observations. In this study, the HR and VR of crayfish were monitored before, during and after the act of copulation in both heterosexual partners. The female crayfish abruptly reduces HR and VR during copulation but the male maintains HR and VR. After separation from copulation the female HR and VR are elevated, potentially paying back the O2 debt. The tight relationship with HR and VR in direction of change indicates a potential neural coupling. These physiological changes in cardiac and respiratory systems suggest an autonomic-like regulation of HR and VR. How these neuronal functions are driven and regulated remains to be determined. Olfactory cues from the female to the male during copulation may be reduced by the reduction in VR in the female. These studies offer experimental paradigms for future neuronal and pharmacological investigations into autonomic regulation of HR and VR as well as the neural circuitry involved.

The Pairing of Heart and Small Intestine Xin Xiao Chang Xiang Biao Li 心 小 肠 相 表 里

This paper investigates the reasoning, based on both Chinese and Western medical data, which will lead to an understanding of the relation of the heart and small intestine, organs which Chinese Medicine, in the Fire energy phase, link both functionally and anatomically. The direct relationship between the liver and the gall bladder and between the kidneys and the bladder is recognised and accepted in both Chinese and Western Medicine. This is not the case with the pairings which in Eastern morphophisiology are formed by the heart and small intestine and the lungs and large intestine. These pairings are not recognised in Western Medicine. The writer in her dual capacity of Doctor of Western Medicine and acupuncturist is investigating the reasons why in Chinese Medicine the heart and small intestine and their meridians form a relation which couples them. For this the comparative method was used between data from Western anatomy which demonstrate the interorganic and functional relation between the small intestine and the heart and the Chinese energy dynamic of the corresponding zangfu and jingluo. Biomedicine which does not relate the heart with the small intestine brings in the materiality of its anatomic descriptions which are valuable for the interpretation of Oriental Medicine. This interrelation between the two organs and their meridians are well explicated in Chinese Medicine whose traditional concepts in this respect are corroborated by Western anatomical descriptions which, nevertheless, do not admit the functional-organic coupling of the heart and small intestine.

Holmes Heart and HIV: A Rare Combination of Two “H”s in a 23-Year-Old Widow

A 23-year-old, lean, scoliotic female presented to our hospital with a history of shortness of breath and cyanosis on exertion. Her 2D echocardiography revealed single left ventricle with both atrio-ventricular valves opening in it. She had normally related great arteries, with severe pulmonary artery hypertension, without pulmonary stenosis. Her blood tests indicated that she was reactive to human immunodeficiency virus (HIV-1). The patients died within 2 months despite treatments with anti-retroviral therapy and decongestive therapy.