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Ambient mass spectrometry imaging (MSI) enables hundreds of analytes in tissue sections to be directly mapped at atmospheric pressure with minimal sample preparation. This field is currently experiencing rapid growth, with numerous reported ambient ionization techniques resulting in a "hundred flowers bloom" situation. Nanospray desorption electrospray ionization (nano-DESI), developed by the Laskin group in 2010, is a widely used liquid-extraction-based ambient ionization technique that was first used for mass spectrometry imaging of tissue in 2012. The nano-DESI probe comprises a primary capillary and a nanospray capillary, with the latter efficiently transferring analyte-containing droplets via a tiny liquid bridge formed between the probe and sample surface, thereby enabling nanoelectrospray ionization (nano-ESI) in front of the inlet of a mass spectrometer. The advantages of nano-DESI MSI include minimal sample preparation, high spatial resolution, and high sensitivity. These features are well-suited for imaging various sample types, including frozen tissue sections, microbial communities, and environmental samples. A PubMed-database search using the "nano-DESI" keyword revealed 72 related articles in the 2010-2024 period, with 34 of them published between 2021 and 2024, which indicates that nano-DESI has rapidly developed as an ambient ionization technique over recent years. Herein, we briefly introduce key nano-DESI-MSI research progress reported in the past three years with the aim of better understanding and facilitating the use of this technology. We first discuss advances in ion-source development. Since no commercial nano-DESI source exists, designing and constructing ion sources remain technical challenges that limit its development. Nano-DESI has been successfully coupled with various types of mass spectrometer, including LTQ Orbitrap, quadrupole-Orbitrap (Q Exactive), 6560 IM QTOF, timsTOF Pro2, triple quadrupole, and FTICR. These couplings have significantly expanded the applications range of the nano-DESI technique. Secondly, lipid analysis is a major nano-DESI-MSI applications area. While the complexities of lipid structures present great challenges for nano-DESI MSI, new nano-DESI coupling techniques have enabled the identification and imaging of fine lipid structures. Several novel imaging methods have recently been introduced to address difficulties associated with identifying lipid structures, such as distinguishing carbon-carbon double bonds (C=C) and sn -positional isomers. We finally highlight recent research progress in the nano-DESI MSI of intact protein assembles and proteoforms, which is a growing hotspot in the field. Unlike small lipid molecules, large protein molecules are very challenging to image and consequently demand higher instrumental performance (e.g., ionization efficiency, mass range, and sensitivity). In a similar manner to the ESI technique, nano-DESI tends to generate multiply charged molecular ions, which endows it with a significant advantage when imaging large protein molecules. Recent years have witnessed important nano-DESI-MSI progress for studying protein-ligand interactions and identifying and imaging endogenous proteoforms. In summary, this article focuses on nano-DESI research progress in terms of ion-source development, lipid-structure analysis, and spatial proteomics over the past three years and discusses key challenges that need to be addressed in the field.

This study aims to explore the improvement effect of Sijunzi Decoction on intestinal barrier in diabetic mice. A type 2 diabetes mellitus(T2DM) model was established in C57BL/6J mice by feeding them with high-sugar and high-fat diet combined with streptozotocin(STZ). The T2DM mice were randomly divided into a control group, a T2DM group, a donepezil(DON) group, a rosiglitazone(RGZ) group, and Sijunzi Decoction groups(7. 5, 15, and 30 g·kg~(-1)), and orally administered for six weeks. The body weight and fasting plasma glucose(FBG) of mice were recorded. Fasting plasma insulin(FINS) and insulin resistance index(HOMA-IR) were observed to assess insulin resistance(IR). Intestinal flora and levels of serotonin(5-HT), lipopolysaccharide(LPS), and short-chain fatty acids(SCFAs) in serum were analyzed. Changes in colonic structure and tight junction proteins occludin, claudin-1,and ZO-1 were observed through HE staining and immunohistochemistry. Spontaneous alternation test was conducted to observe the effect on spatial memory ability. Compared with the results in the control group, FBG and HOMA-IR in the T2DM group were significantly increased(P< 0. 01); species richness index(Sobs index), Shannon diversity index(Shannon index), and species abundance estimate index(Chao index) were decreased; LPS was significantly increased(P< 0. 001), while the levels of 5-HT,SCFAs, occludin, claudin-1, and ZO-1 were significantly decreased(P< 0. 01), indicating impaired colonic barrier function;spontaneous alternation accuracy was significantly decreased(P<0. 05). After 6 weeks of Sijunzi Decoction treatment, compared with the results in the T2DM group, FBG and HOMA-IR in the Sijunzi Decoction 15 g·kg~(-1) group were significantly decreased(P<0. 01);Sobs index, Shannon index, and Chao index were increased; LPS was significantly decreased(P<0. 01), while the levels of 5-HT,SCFAs, occludin, claudin-1, and ZO-1 were significantly increased(P< 0. 05), indicating improved colonic barrier function;spontaneous alternation accuracy was increased(P<0. 001). In conclusion, Sijunzi Decoction has the effect of improving intestinal barrier in diabetic mice.

Objective: To compare the safety and efficacy of different anticoagulants in patients with indications for anticoagulation after transcatheter aortic valve replacement (TAVR). Methods: This is a retrospective study. Patients who underwent TAVR from April 2016 to February 2022 in Guangdong Provincial People's Hospital and had indications for anticoagulation were included and divided into two groups according to the type of anticoagulants, i.e. non-vitamin K antagonist oral anticoagulant (NOAC) and warfarin, and patients were followed up for 30 days. The primary endpoint was the combination of death, stroke, myocardial infarction, valve thrombosis, intracardiac thrombosis and major bleeding. The incidence of endpoints was compared between two groups, and multivariate logistic regression analysis was applied to adjust the bias of potential confounders. Results: A total of 80 patients were included. Mean age was (74.4±7.1) years, 43 (53.8%) were male. Forty-nine (61.3%) patients used NOAC, 31 used warfarin, and major indication for anticoagulants was atrial fibrillation (76/80, 95.0%). The adjusted risks of the primary endpoint ( OR =0.23, 95% CI 0.06-0.94, P =0.040) of NOAC were lower than that of warfarin, mainly driven by a lower risk of major bleeding ( OR =0.19, 95% CI 0.04-0.92, P =0.039). Conclusions: The short-term outcome of NOAC is better than that of warfarin in patients with indications for anticoagulation after TAVR. Randomized controlled trials of large sample size with long-term follow-up are needed to further testify this finding.

Objective: To investigate the status quo of the quality of life of schizophrenia patients in a city in Sichuan Province and to explore, thereof, the urban-rural differences in the factors influencing their quality of life., Methods: A total of 824 schizophrenia patients were selected for the study through multistage stratified cluster random sampling method. All the subjects were selected from a pool of patients covered by the Sichuan Provincial Information System for the Comprehensive Management of Severe Mental Disorders. Questionnaire surveys were conducted with the Schizophrenia Quality of Life Scale (SQLS), the Social Support Rating Scale (SSRS), the general circumstance questionnaire, and the lifestyle questionnaire. In addition, univariate and multiple linear regression models were used to analyze the influencing factors of quality of life among schizophrenia patients living in urban areas and those in rural areas., Results: Rural patients had poorer quality of life than urban patients did in all measurement domains ( P <0.05). Marital status, vocational skills, physical exercise, and social support were influencing factors of the quality of life among urban patients ( P <0.05). Age, marital status, annual household income, vocational skills, participation in community rehabilitation activities, and the time required to walk to the nearest medical institution were influencing factors of the quality of life among rural patients ( P <0.05)., Conclusion: Targeted measures for the enhancement of the quality of life of schizophrenia patients should be formulated on the basis of urban and rural characteristics in terms of economic support, vocational skills training, input in mental health services, community rehabilitation services, and social support., (Copyright© by Editorial Board of Journal of Sichuan University (Medical Sciences).)

Objective: To prospectively explore the risk factors of suicide in patients with schizophrenia., Methods: Data on schizophrenia patients in Sichuan Province between 2006 and 2018 were obtained from the National Severe Mental Disorders Information System, and the Cox proportional hazards regression model was used to explore for risk factors for suicide in schizophrenia patients., Result: A total of 170006 patients with schizophrenia were included in the study. At the end of the follow-up period, 160570 patients were alive and 9436 died from various causes, 929 of which being suicide deaths, resulting in a suicide rate of 223.61/100, 000 person-years. The Cox proportional hazards regression model suggested that risk factors for suicide in patients with schizophrenia included poverty ( HR =1.20, 95% CI : 1.02-1.41), higher education level (primary school [ HR =1.32, 95% CI : 1.09-1.60], middle school [ HR =1.40, 95% CI : 1.14-1.73], high school and above [ HR =1.93, 95% CI : 1.49-2.52]) in comparison with illiteracy and semi-literacy, suicide attempts ( HR =2.70, 95% CI : 1.70-4.29), strict medication compliance ( HR =1.91, 95% CI : 1.66-2.20), history of antipsychotic drug therapy ( HR =1.42, 95% CI : 1.06-1.90), younger age group of patients of 46-60 ( HR =1.95, 95% CI : 1.60-2.39), 31-45 ( HR =3.61, 95% CI : 2.92-4.47), and 15-30 ( HR =12.37, 95% CI : 9.69-15.78) compared with the 61-90 age group, and doing agriculture jobs ( HR =1.36, 95% CI : 1.13-1.65)., Conclusion: Young and middle-aged schizophrenia patients with higher education levels, especially those with a history of suicide attempts, are at high risk for suicide. Focused interventions should be directed at high-risk groups to reduce suicide deaths in patients with schizophrenia., (Copyright© by Editorial Board of Journal of Sichuan University (Medical Sciences).)

Objective: To compare the prognosis of transcatheter aortic valve replacement (TAVR) in patients with bicuspid aortic valve (BAV) or tricuspid aortic valve (TAV) stenosis. Methods: This was a retrospective study. Patients with symptomatic severe aortic stenosis, who underwent TAVR with follow-up time more than one year in Guangdong Provincial People's Hospital from April 2016 to August 2018, were included. According to aortic CT angiography, the patients were divided into BAV group and TAV group. The primary endpoint was the composite event of all-cause death and stroke, and the secondary endpoints were TAVR-related complications. Incidence of clinical endpoints and parameters derived from echocardiography were compared between the groups, and Kaplan-Meier survival analysis was used to compare the composite event between the two groups. Results: A total of 49 patients were included. The age was (73.6±6.3) years, and 25(51.0%) were male. There were 32 patients in BAV group and 17 in TAV group, the follow-up time was 466 (390, 664) days. The incidence of composite endpoint of death and stroke at one year were comparable in BAV and TAV groups (6.3% (2/32) vs. 5.9% (1/17), P =1.00). Kaplan-Meier curves also showed a similar risk of the composite endpoint( HR =1.03，95% CI 0.09-11.24，Log-rank P =0.98) between two groups. The incidence of all-cause death, stroke, myocardial infarction, severe bleeding, major vascular complications, new-onset atrial fibrillation or atrial flutter, and permanent pacemaker implantation were all similar between the two groups(all P >0.05), and there was no acute kidney injury (stage 2 or 3) in both groups. Echocardiographic parameters at one year were similar between the two groups (all P >0.05). Conclusions: The midterm prognosis of TAVR in patients with BAV and TAV stenosis is similar. Clinical trials of large sample size with long-term follow-up are warranted to verify our findings.

Objective: To explore the diagnosis and treatment of pregnancy-associated acute Stanford type A aortic dissection to improve the maternal and fetal outcomes., Methods: We analyzed the perioperative data of 5 pregnant women with acute Stanford type A aortic dissection treated between June, 2009 and February, 2017., Results: The median age of the women was 30 years (range, 22-34 years) with gestational weeks of 23-38 weeks upon diagnosis. All the 5 patients received surgical interventions. Three patients underwent caesarean delivery and hysterectomy, and the fetuses survived after the surgery; 2 patients chose to continue pregnancy following the surgery, among whom one died due to postoperative complications and the other underwent termination of pregnancy. During follow-up, the surviving patients showed no endoleak in the descending aorta stent and the distal dissection remained stable., Conclusion: The maternal and fetal outcomes of pregnancy-associated acute Stanford type A aortic dissection can be improved by multidisciplinary cooperation and optimization of the surgical approaches according to the time of pregnancy, fetal development and conditions of the aortic lesions.

Synovial chondromatosis of the temporomandibular joint(TMJ) is an extremely rare condition. A case of synovial chondromatosis with postoperative recurrence and involvement of base of skull was reported. The clinic pathological features, diagnosis and treatment were discussed with literature review.

Objective: To study the benefit of prophylactic antibiotics (PA) in totally percutaneous aortic endovascular repair (PEVAR) in the catheterization laboratory for reducing stent-graft infection and postimplantation syndrome (PIS)., Methods: The clinical data were analyzed of patients undergoing thoracic endovascular aortic repairs. The patients were divided into non-PA group and PA group according to the use of prophylactic antibiotics before PEVAR. The diagnosis of infection was made by two senior physicians with reference to Hospital Acquired Infection Diagnostic Criteria Assessment released by the Ministry of Health of China., Results: The 95 enrolled patients included 35 with PA and 60 without PA group, who were comparable for baseline characteristics. Infection-related deaths occurred in 1 case in non-PA group and retrograde Stanford type A dissection and death occurred in 1 case in PA group (1.67% vs 2.85%, P=1.00). The PA and non-PA groups showed no significant difference in the incidence of postoperative infection (5% vs 2.86%, P=1.000), hospital stay (9.30±7.21 vs 10.06±5.69, P=0.094), infection-related mortality (1.67% vs 0%, P=1.00), or postoperative fever (70.90% vs 91.43%, P=0.20). The body temperature showed significant variations at different time points after procedure (F=19.831, P<0.001) irrelevant to the use of prophylactic antibiotics (F=0.978, P=0.326)., Conclusion: The current data do not support the benefit of PA in reducing postoperative infection and PIS in patients undergoing PEVAR, but the patients without PA may have worse clinical outcomes in the event of postoperative infections.

Objectives: To observe the protective effect of retrograde venous perfusion of cryogenic liquid via accessory hemiazygos vein and treated with resveratrol on spinal cord injury and evaluate the expression changes of microtubule-associated protein 2 (MAP-2) after spinal cord ischemia reperfusion injury (SCII) in swine., Methods: Eighteen swine were divided into 3 groups: group I/R (n = 6, operation group), group CL (n = 6, retrograde venous perfusion of cryogenic liquid), group CL+Res (n = 6, retrograde venous perfusion of cryogenic liquid and treated with resveratrol after ischemia). In the group I/R, the aorta was clamped for 60 minutes and then removed. In the group CL and CL+Res, 9 g/L cold (4 °C) saline solution (perfusion rate, 16.65 ml/min) was infused into the accessory hemiazygos vein during ischemia.In the group CL+Res, the swine were treated with resveratrol (10 mg/kg) after spinal cord ischemia. Arterial pressure, blood gas analysis and the spinal canal and nasopharyngeal temperature changes were monitored during the surgery. Nervous function were assessed at 6 hours, 1, 2 days, 1, 2, 4 weeks and MAP-2 expression were detected at 4 weeks after reperfusion by using Western blot analysis in spinal cord tissue., Results: After operation 18 swine were all survival. Behavioral scores of all groups decreased until 1 week after reperfusion and increased as time went by. The scores of group CL and CL+Res were higher than group I/R (F = 8.612, 17.276 and 11.985, P = 0.035,0.011 and 0.023) at 6 hours, 1, 2 days, group CL+Res were higher than group CL(P = 0.021) at 1 days after surgery. After descending aortic cross clamping, the spinal canal and nasopharyngeal temperature were obviously decreased in all groups and dropped to the lowest at 60 minutes after ischemia and 20 minutes after reperfusion in group I/R and the other groups respectively(F = 23.187-55.029, P < 0.01).In group CL(0.54 ± 0.26) and CL+Res (0.66 ± 0.31), the MAP-2 expression were higher than group I/R(0.37 ± 0.18) (F = 9.381, P = 0.037) , and the level in group CL+Res was higher than in group CL (P = 0.021) ., Conclusion: Retrograde venous perfusion of cryogenic liquid via accessory hemiazygos vein and treated with resveratrol can relieve the ischemia-induced spinal cord injury in swine.

Objectives: To investigate if there is altered microRNAs (miRNAs) expression in aortic dissection (Debakey Type A) and normal aorta tissue., Methods: Total RNA was exacted from aorta of 5 patients with aortic dissection (AD) and four patients without aortic diseases (NA). miRNAs of the aortic tissues were analyzed by miRNA microarray. Reverse transcription polymerase chain reaction (RT-PCR) was performed to verify the expression of miRNAs in larger sample size (AD = 11 and NA = 9)., Results: hsa-miR-146b-5p&#95;st, hsa-miR-19a&#95;st and hsa-miR-505&#95;st were significantly upregulated while hsa-miR-1268&#95;st and hsa-miR-939&#95;st were significantly downregulated [fold change > 2, q-value (%) ≤ 5] in AD group compared with NA group. RT-PCR verified hsa-miR-146b-5p&#95;st miRNAs change in AD group., Conclusions: Altered miRNAs expression might play an essential role in the pathogenesis of aortic dissection formation and hsa-miR-146b-5p&#95;st might serve as a new diagnosis biomarker of aortic dissection.

Objective: To explore the prevalence of coronary artery disease and risk factors in patients with abdominal aortic aneurysm (AAA)., Methods: Coronary angiography was performed immediately after abdominal angiography in 70 elderly (> 50 years) consecutive patients with AAA. Medical history and imaging characteristics were evaluated., Results: CAD was diagnosed in 63 patients (90.0%) by coronary angiography: 20 (28.6%) patients with single-vessel disease (SVD), 15(21.4%) with 2VD, 22 (31.4%) with 3VD and 6 (8.6%) with left main disease + 3VD. Multi-variance logistic analysis showed that peripheral disease was the strongest predictor for CAD in AAA patients., Conclusion: Coronary angiography should be performed in elderly AAA patients due to the high prevalence of CAD in this patient cohort.

Objective: To summarize the experience with surgical treatment of constrictive pericarditis., Methods: A retrospective analysis of the post-operative clinical data was conducted in 128 surgical patients with chronic constrictive pericarditis., Results: Two early postoperative death occurred in this group due to severe low cardiac output syndrome, with the mortality rate of 1.57%. The postoperative complications included low cardiac output syndrome (13.2%), arrhythmia (7.02%), acute renal insufficiency (3.9%), respiratory insufficiency (3.1%), wound infection (2.3%), postoperative chest bleeding (1.6%) and cerebral infarction (0.78%). Relapse occurred in one case because of incomplete pericardial resection., Conclusions: Constrictive pericarditis should be confirmed as soon as possible with actively surgery, and the extent of pericardial resection should be decided according to the individual conditions. Complete untethering of the diseased pericardium should be performed with active prevention of postoperative complications.

Objective: To study the effect of betaine on the formation of atherosclerotic plaque in apolipoprotein E (ApoE)-deficient mice and explore its anti-inflammatory mechanism., Methods: Seven-week-old ApoE-deficient mice (C57BL/6J background) were divided into four groups randomly based on body weight: model group and three betaine groups. Wild-type mice with the same age and genetic background were used as control group. The control group and model group were fed AIN-93G diet. Three betaine groups were fed AIN-93G diet supplemented with 1, 2, 4 g betaine/100 g diet, respectively. Serum tumor necrosis factor-alpha (TNF-alpha), monocyte chemoattractant protein-1, lipid levels and methylation status of TNF-alpha promotor in aorta were determined at 0, 7 and 14 weeks. The percentage of aorta sinus plaque to lumen area was measured at 14-week., Results: The percentage of aorta sinus plaque to lumen area of 1% and 2% betaine groups were (11.43+/-2.65)% and (12.09+/-3.07)%, respectively, which were 41% and 33% smaller than that of the model group (t=3.117, 3.010, respectively, and P<0.01). Serum TNF-alpha level of three betaine groups were (56.33+/-3.86), (63.04+/-4.67) and (65.52+/-3.97) pg/ml, respectively, which were lower than that of the model group (79.40+/-4.68) pg/ml (t=9.270, 6.571 and 5.576, respectively, P<0.001), but there was no significant difference in the methylation status of TNF-alpha promotor among all five groups., Conclusion: Betaine could inhibit the development of atherosclerosis via anti-inflammation.

Objective: To investigate the clinical therapeutic effects of endovascular repair for patients with DeBakey III aortic dissection., Methods: From December 2002 to June 2007, endovascular TALENT stent-graft exclusion was performed in 75 (65 males, mean age 54.4 +/- 12.6 years) patients with DeBakey III aortic dissection (1 young woman due to Ehlers-Danlos syndrome, 2 young men due to primary aldosteronism and trauma respectively). All patients were diagnosed by contrast enhanced computed tomography (CT) or MRI. Stent-grafts were deployed via femoral artery to exclude the tear of dissection. Aortic angiography was performed immediately after procedure., Results: Eighty-one stent-grafts were installed in 75 patients successfully without operation related dissection. Endoleakage immediately after stent-graft deploying was evidenced in 25 patients and disappeared after stent placements (n = 6) or balloon dilation (n = 19). Two patients died from aortic rupture within 2 days after procedure. Iliac artery was torn in a female patient with Ehlers-Danlos syndrome, this patient developed hemorrhagic shock after stent-graft placement and recovered after anti-shock treatments and iliac artery replacement with synthetic artery. During the follow-up of 1 - 24 months, 2 patients (including the woman with Ehlers-Danlos syndrome) suddenly died half a year after procedure. The remaining patients were alive and well. Repeat CT during follow up showed that reduced lumen size and thrombosis in the false lumen. There was no aortic rupture, endoleak and stent migration during the follow-up period except descending aortic dissection distal of the stent-graft in 1 patient 1 year after procedure and the patient were successfully treated surgically without complication., Conclusions: Endovascular repair is a safe and effective treatment for patients with DeBakey III aortic dissection, suitable for old patients with high risk of surgery. Ehlers-Danlos syndrome should be considered in young DeBakey III aortic dissection patients without hypertension. Further studies are warranted on endovascular repair therapy for artery complication of Ehlers-Danlos syndrome.

Objective: To explore early diagnosis, treatment and prevention of gastrointestinal (GI) bleeding after cardiac surgery., Methods: In the last 13 years, cases complicated with GI bleeding after cardiac surgeries were analyzed retrospectively., Results: Fourty-four GI bleeding occurred post-operatively in (6 +/- 3) d. The mortality was 23% (10/44). Thirty-eight were located in upper GI tract, of them 26 underwent conservative therapy while 4 died of other than GI bleeding cause; six underwent laparotomy while 1 and 3 died of septicemia and multi-organ failure respectively; six underwent gastric endoscopic hemostasis by electrocautery or clipping the bleeding vessel while all survived. Six were located in lower GI tract, and 2 of them underwent laparotomy without finding bleeding section and died of multi-organ failure. By multivariable logistic regression analysis, deaths were highly related to the post-operative ventilator-dependence, acute renal insufficiency, intra-aortic balloon pump (IABP) assisting and laparotomy., Conclusion: The mortality of GI bleeding after cardiac surgeries is very high, early gastrointestinal endoscopic examination and minimally invasive intervention can treat this complication more effectively. GI bleeding must be prevented whenever complicating post-operative ventilator-dependence, acute renal insufficiency, and IABP assisting after cardiac surgery.

Objective: The aim of this study was to develop a new perimembranous VSD occluder and to evaluate it., Methods: The shape of VSD occluder was designed as fabric frame "I" shape that comprised two types: symmetric and asymmetric. The safety, efficacy, feasibility and complication were tested in 22 animal models and in 58 VSD patients in clinical trial. The device were compared with Amplatzer occluder in this study., Results: The new perimembranous VSD occluder was passed the national material test. In animal study, artificial VSD were all occluded by using the new devices with no complication in follow up except one pig expresented wound infection. In clinical trial, all 58 VSD cases were healing with the new device. One patient suffered with atria-ventricular block 5 days after procedure and was free from AV block with medicine therapy. Compared with Amplatzer perimembranous VSD occluder, the new devices had lower frequency of residual shunt., Conclusion: The new perimembranous VSD occluder is a safe and effective perimembranous VSD interventional apparatus, and the effect of the new occluders seems not worse than that of the Amplatzer ones.