Correlation between enlarged perivascular space and cerebral venous reflux in recent small subcortical infarcts within the lenticulostriate artery territory / 中华神经科杂志

Objective:To summarize the incidence of cerebral venous reflux (CVR) in patients with recent small subcortical infarct (RSSI) and explore its correlation with enlarged perivascular spaces (EPVS).Methods:Patients with RSSI in the lenticulostriate artery admitted to the Department of Neurology of the First Affiliated Hospital of Zhengzhou University from January 2019 to December 2022 were included. The baseline demographic data, medical history, and laboratory results of the patients were collected. CVR was assessed by time-of-flight magnetic resonance angiography. Patients were stratified into 2 groups based on the presence (CVR group) or absence of CVR (non-CVR group), and baseline characteristics as well as laboratory test results were compared between the 2 groups. The location and number of EPVS were evaluated using a visual grading scale, with EPVS with higher scores defined as high-grade EPVS (HEPVS). Simultaneous evaluation of cerebral white matter hyperintensities and lacunar infarctions was conducted, followed by intergroup comparisons. The relationship between EPVS and CVR was studied using multiple Logistic regression analysis.Results:A total of 571 patients with RSSI in the lentiform artery area were ultimately included, including 180 females (31.5%). Their age was (59.37±12.87) years. Among them, 73 patients (12.8%) exhibited CVR based on imaging findings, so the incidence of CVR was 12.8%. In comparison between the CVR group ( n=73) and the non-CVR group ( n=498), the proportion of females [21.9% (16/73) vs 32.9% (164/498), χ 2=3.578, P=0.059] was lower and the proportion of history of smoking [38.4% (28/73) vs 27.7% (138/498), χ 2=3.499, P=0.061] was higher in the CVR group, but without statistical significance. Additionally, the history of alcohol consumption [34.2% (25/73) vs 21.7% (108/498), χ 2=5.621, P=0.018] and the proportion of patients with concomitant HEPVS in the basal ganglia area [41.1% (30/73) vs 25.3% (126/498), χ 2=7.999, P=0.005] was higher in the CVR group with statistical significance. Multiple Logistic regression analysis showed that HEPVS in the basal ganglia region remained independently associated with CVR ( OR=1.988, 95% CI 1.190-3.320, P=0.009). Conclusion:EPVS in the basal ganglia region is significantly associated with CVR in the RSSI population, suggesting that venous dysfunction may be closely related to the formation of EPVS.

A Sensor for Detection of Breast Tumor with Three-dimensional Electrical Impedance Tomography / 分析化学

An intensive breast array sensor was designed based on three-dimensional electrical impedance tomography in this work.Firstly,an electrical impedance sensor for detection of breast cancer was developed.The sensor adopted the integrated design of excitation electrode array and ground electrode to achieve structural simplification.It realized electric field densification through conical matrix and double-layer circumferentially arranged electrode array and improved the detection accuracy of target object through taper optimization.Secondly,the imaging system was designed,and the sensor was optimized by numerical simulation.The simulation results showed that halving the number of electrodes did not affect imaging accuracy of the sensor,but could improve the imaging speed.Finally,the performance of the sensor was verified by experiment.The signal-to-noise ratio and channel consistency of the system were at a good level.The sensor was used to reconstruct three-dimensional image of the experimental model with relative volume of the detection field of 0.4%.The image correlation coefficient of the single target imaging was above 0.6 and the position of the double target object could be clearly identified,and thus the visual detection of breast cancer was realized.

Prevention and treatment of vasovagal reflex during and after operation in diseases of urinary system / 中国现代医生

@#Objective To explore the prevention and treatment of vasovagal reflex during and after operation in diseases of urinary system.Methods From February 2020 to April 2023,1436 patients who completed inpatient surgery in Department of Urology,Songshan Hospital,Qingdao University Medical College were selected to analyze the emergency management measures of vasovagal reflex during and after operation and summarize the diagnosis and treatment experience.Results Among 1436 patients,vasovagal reflex occurred in 4 cases during operation and 14 cases after operation,with an incidence of 1.25%.Most patients showed simultaneous decrease in blood pressure and heart rate.After intravenous injection of atropine and dopamine,blood pressure and heart rate returned to normal,and various concomitant symptoms disappeared,and no death cases were reported.Conclusion Urological specialists should pay attention to vasovagal reflex,sum up experience,do early identification,timely treatment to ensure the safety of patients.

A Rapid Non-invasive Method for Skin Tumor Tissue Early Detection Based on Bioimpedance Spectroscopy / 生物化学与生物物理进展

ObjectiveIn recent years, with the intensification of environmental issues and the depletion of ozone layer, incidence of skin tumors has also significantly increased, becoming one of the major threats to people’s lives and health. However, due to factors such as high concealment in the early stage of skin tumors, unclear symptoms, and large human skin area, most cases are detected in the middle to late stage. Early detection plays a crucial role in postoperative survival of skin tumors, which can significantly improve the treatment and survival rates of patients. We proposed a rapid non-invasive electrical impedance detection method for early screening of skin tumors based on bioimpedance spectroscopy (BIS) technology. MethodsFirstly, we have established a complete skin stratification model, including stratum corneum, epidermis, dermis, and subcutaneous tissue. And the numerical analysis method was used to investigate the effect of dehydrated and dry skin stratum corneum on contact impedance in BIS measurement. Secondly, differentiation effect of different diameter skin tumor tissues was studied using a skin model after removing the stratum corneum. Then, in order to demonstrate that BIS technology can be used for detecting the microinvasion stage of skin tumors, we conducted a simulation study on the differentiation effect of skin tumors under different infiltration depths. Finally, in order to verify that the designed BIS detection system can distinguish between tumor microinvasion periods, we conducted tumor invasion experiments using hydrogel treated pig skin tissue. ResultsThe simulation results show that a dry and high impedance stratum corneum will bring about huge contact impedance, which will lead to larger measurement errors and affect the accuracy of measurement results. We extracted the core evaluation parameter of relaxed imaginary impedance (Zimag-relax) from the simulation results of the skin tumor model. When the tumor radius (Rtumor) and invasion depth (h)>1.5 mm, the designed BIS detection system can distinguish between tumor tissue and normal tissue. At the same time, in order to evaluate the degree of canceration in skin tissue, the degree of tissue lesion (εworse) is defined by the relaxed imaginary impedance (Zimag-relax) of normal and tumor tissue (εworse is the percentage change in virtual impedance of tumor tissue relative to that of normal tissue), and we fitted a Depth-Zimag-relax curve using relaxation imaginary impedance data at different infiltration depths, which can be applied to quickly determine the infiltration depth of skin tumors after being supplemented with a large amount of clinical data in the future. The experimental results proved that when εworse=0.492 0, BIS could identify microinvasive tumor tissue, and the fitting curve correction coefficient of determination was 0.946 8, with good fitting effect. The simulation using pig skin tissue correlated the results of real human skin simulation with the experimental results of pig skin tissue, proving the reliability of this study, and laying the foundation for further clinical research in the future. ConclusionOur proposed BIS method has the advantages of fast, real-time, and non-invasive detection, as well as high sensitivity to skin tumors, which can be identified during the stage of tumor microinvasion.

The clinical application of targeted next-generation sequencing and metagenomics next-generation sequencing in pathogenic microorganism detection / 中华预防医学杂志

Infectious diseases seriously threaten human health. The early detection of the causative organism and antibiotic resistance genes of infection remains a major clinical challenge. Next-generation sequencing has been widely used in diagnosing infectious diseases. Cheaper and faster targeted next-generation sequencing technology is progressively being used in clinical practice. However, the awareness among clinicians about the clinical utility of this technology is limited. The article presents the theoretical background, advantages and disadvantages, clinical applications of targeted next-generation sequencing, and its contrasts with metagenomics next-generation sequencing. It provides a reference for clinicians to select laboratory methods for identifying pathogens in clinical practice.

The clinical application of targeted next-generation sequencing and metagenomics next-generation sequencing in pathogenic microorganism detection / 中华预防医学杂志

Infectious diseases seriously threaten human health. The early detection of the causative organism and antibiotic resistance genes of infection remains a major clinical challenge. Next-generation sequencing has been widely used in diagnosing infectious diseases. Cheaper and faster targeted next-generation sequencing technology is progressively being used in clinical practice. However, the awareness among clinicians about the clinical utility of this technology is limited. The article presents the theoretical background, advantages and disadvantages, clinical applications of targeted next-generation sequencing, and its contrasts with metagenomics next-generation sequencing. It provides a reference for clinicians to select laboratory methods for identifying pathogens in clinical practice.

The regulatory mechanism of physiological sleep-wake / 中国药理学通报

This paper explains the mechanism of the mutual switching between physiological sleep and wakefulness from the aspects of the sleep circadian system and the sleep homeostasis system. In the circadian rhythm system, with the suprachiasmatic nucleus as the core, the anatomical connections between the suprachiasmatic nucleusand various systems that affect sleep are summarized, starting from the suprachiasmatic nucleus, passing through the four pathways of the melatonin system, namely, subventricular area of the hypothalamus, the ventrolateral nucleus of the preoptic area, orexin neurons, and melatonin, then the related mechanisms of their regulation of sleep and wakefulness are expounded. In the sleep homeostasis system, with adenosine and prostaglandin D2 as targets, the role of hypnogen in sleep arousal mechanisms in regulation is also expounded.

Earthworm Protein Protects Vascular Endothelial Function in Spontaneously Hypertensive Rats via PI3K/Akt/Nrf2 Signaling Pathway / 中国实验方剂学杂志

ObjectiveTo observe the effect of earthworm protein on the expression of phosphatidylinositol 3-kinase/protein kinase B/nuclear factor E2-related factor 2 （PI3K/Akt/Nrf2） pathway in the aorta of spontaneously hypertensive rats （SHR） and explore mechanism of earthworm protein in treating hypertensive vascular endothelial dysfunction （VED）. MethodTen 10-week-old Wistar Kyoto （WKY） rats and fifty SHR rats were selected for a week of adaptive feeding. WKY rats were selected as the normal group， and fifty SHR rats were randomized according to body weight into model， valsartan （8×10-3 g·kg-1·d-1）， and high-， medium-， and low-dose （0.2， 0.1， 0.05 g·kg-1·d-1， respectively） earthworm protein groups. The normal and model groups were administrated with equal volume of double distilled water by gavage. During the drug intervention period， the general situations of rats in each group were observed and their blood pressure was monitored at specific time points every other week before and after administration. After 8 weeks of drug intervention， enzyme-linked immunosorbent assay was employed to measure the levels of angiotensin-Ⅱ （Ang-Ⅱ） and endothelin-1 （ET-1） in the serum of rats in each group. The corresponding kits were used to determine the levels of nitric oxide （NO）， malondialdehyde （MDA）， glutathione peroxidase （GPX）， superoxide dismutase （SOD）， and ferrous ion （Fe2+）. Hematoxylin-eosin （HE） staining was employed to observe the changes in the intima of the aorta. Fluorescence quantitative polymerase chain reaction （Real-time PCR） was employed to measure the mRNA levels of PI3K， Akt， Nrf2， heme oxygenase-1 （HO-1）， and glutathione peroxidase 4 （GPX4） in the aortic tissue. Western blotting was used to determine the protein levels of p-PI3K （Tyr467/199）， PI3K， p-Akt （Ser473）， Akt， Nrf2， HO-1， and GPX4 in the thoracic aorta. ResultCompared with the normal group， the model group had decreased body mass， increased irritability， severe endothelial damage， elevated blood pressure and serum levels of Ang-Ⅱ， ET1， MDA， and Fe2+ （P<0.01）， lowered NO level （P<0.01）， and down-regulated mRNA and protein levels of p-PI3K （Tyr467/199）， PI3K， p-Akt （Ser473）， Akt， Nrf2， HO-1， and GPX4 in the aortic tissue （P<0.01）. Compared with the model group， drug intervention caused no significant change in the body mass， calmed the rats， alleviated the endothelial damage， lowered blood pressure and serum levels of Ang-Ⅱ， ET1， MDA， and Fe2+ （P<0.01）， elevated the NO level （P<0.05）， and up-regulated the mRNA and protein levels of p-PI3K （Tyr467/199）， PI3K， p-Akt （Ser473）， Akt， Nrf2， HO-1， and GPX4 （P<0.05）. ConclusionThe earthworm protein can exert antihypertensive effects by ameliorating VED in SHR. Specifically， it may regulate the PI3K/Akt/Nrf2 signaling pathway to inhibit oxidative stress and ferroptosis.

LONP1 ameliorates liver injury and improves gluconeogenesis dysfunction in acute-on-chronic liver failure / 中华医学杂志(英文版)

BACKGROUND@#Acute-on-chronic liver failure (ACLF) is a severe liver disease with complex pathogenesis. Clinical hypoglycemia is common in patients with ACLF and often predicts a worse prognosis. Accumulating evidence suggests that glucose metabolic disturbance, especially gluconeogenesis dysfunction, plays a critical role in the disease progression of ACLF. Lon protease-1 (LONP1) is a novel mediator of energy and glucose metabolism. However, whether gluconeogenesis is a potential mechanism through which LONP1 modulates ACLF remains unknown.@*METHODS@#In this study, we collected liver tissues from ACLF patients, established an ACLF mouse model with carbon tetrachloride (CCl 4 ), lipopolysaccharide (LPS), and D-galactose (D-gal), and constructed an in vitro hypoxia and hyperammonemia-triggered hepatocyte injury model. LONP1 overexpression and knockdown adenovirus were used to assess the protective effect of LONP1 on liver injury and gluconeogenesis regulation. Liver histopathology, biochemical index, mitochondrial morphology, cell viability and apoptosis, and the expression and activity of key gluconeogenic enzymes were detected to explore the underlying protective mechanisms of LONP1 in ACLF.@*RESULTS@#We found that LONP1 and the expressions of gluconeogenic enzymes were downregulated in clinical ACLF liver tissues. Furthermore, LONP1 overexpression remarkably attenuated liver injury, which was characterized by improved liver histopathological lesions and decreased serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) in ACLF mice. Moreover, mitochondrial morphology was improved upon overexpression of LONP1. Meanwhile, the expression and activity of the key gluconeogenic enzymes were restored by LONP1 overexpression. Similarly, the hepatoprotective effect was also observed in the hepatocyte injury model, as evidenced by improved cell viability, reduced cell apoptosis, and improved gluconeogenesis level and activity, while LONP1 knockdown worsened liver injury and gluconeogenesis disorders.@*CONCLUSION@#We demonstrated that gluconeogenesis dysfunction exists in ACLF, and LONP1 could ameliorate liver injury and improve gluconeogenic dysfunction, which would provide a promising therapeutic target for patients with ACLF.

Network Meta-analysis of Chinese medicine injection combined with conventional western medicine in treatment of stable angina pectoris / 中国中药杂志

This study aimed to systematically evaluate the efficacy and safety of different Chinese medicine injections combined with conventional western medicine for stable angina pectoris. PubMed, Cochrane Library, EMbase, Web of Science, CNKI, Wanfang, VIP, and SinoMed were searched to collect randomized controlled trial(RCT) of Chinese medicine injection combined with conventio-nal western medicine in the treatment of stable angina pectoris from the inception of the databases to July 8, 2022. Two researchers independently screened the literature, extracted the data, and evaluated the risk of bias of the included studies. Stata 15.1 was used for network Meta-analysis. A total of 52 RCTs were included, involving 4 828 patients treated by 9 Chinese medicine injections(Danhong Injection, Salvia Miltiorrhiza Polyphenol Hydrochloride Injection, Tanshinone Sodium Ⅱ_A Sulfonate Injection, Salvia Miltiorrhiza Ligustrazine Injection, Dazhu Hongjingtian Injection, Puerarin Injection, Safflower Yellow Pigment Injection, Shenmai Injection and Xuesaitong Injection). The network Meta-analysis showed that:(1)in terms of improving the efficacy of angina pectoris, the surface under the cumulative ranking curve(SUCRA) followed the order of conventional western medicine combined with Salvia Miltiorrhiza Ligustrazine Injection>Tanshinone Sodium Ⅱ_A Sulfonate Injection>Danhong Injection>Salvia Miltiorrhiza Polyphenol Hydrochloride Injection>Xuesaitong Injection>Shenmai Injection>Puerarin Injection>Safflower Yellow Pigment Injection>Dazhu Hongjingtian Injection;(2)in terms of improving the efficacy of electrocardiogram(ECG), SUCRA followed the order of conventional western medicine combined with Salvia Miltiorrhiza Ligustrazine Injection>Puerarin Injection>Danhong Injection>Salvia Miltiorrhiza Polyphenol Hydrochloride Injection>Shenmai Injection>Xuesaitong Injection>Safflower Yellow Pigment Injection>Tanshinone Sodium Ⅱ_A Sulfonate Injection>Dazhu Hongjingtian Injection;(3)in terms of increasing high-density lipoprotein cholesterol(HDL-C), SUCRA followed the order of conventional western medicine combined with Danhong Injection>Shenmai Injection>Safflower Yellow Pigment Injection>Xuesaitong Injection>Tanshinone Sodium Ⅱ_A Sulfonate Injection>Dazhu Hongjingtian Injection;(4)in terms of lowering low-density lipoprotein cholesterol(LDL-C), SUCRA followed the order of conventional western medicine combined with Safflower Yellow Pigment Injection>Danhong Injection>Shenmai Injection>Tanshinone Sodium Ⅱ_A Sulfonate Injection>Dazhu Hongjingtian Injection>Xuesaitong Injection;(5)in terms of safety, the overall adverse reactions of Chinese medicine injection combined with conventional western medicine were less than those of the control group. Current evidence indicated that Chinese medicine injection combined with conventional western medicine could improve the curative effect of stable angina pectoris with higher safety. Limited by the number and quality of included studies, the above conclusion needed to be verified by more high-quality studies.

Effects of thyroid-stimulating hormone suppressive therapy on programmed death ligand 1 and matrix metalloproteinase-2 expression in thyroid cancer tissue and prognosis / 中国基层医药

Objective:To investigate the effects of thyroid-stimulating hormone (TSH) suppressive therapy on the expression of programmed death ligand 1 (PD-L1) and matrix metalloproteinase 2 (MMP-2) in thyroid cancer tissue and prognosis.Methods:A total of 102 patients with thyroid cancer who underwent surgical resection in Weihai Central Hospital, Qingdao University from April 2016 to April 2018 were included in this study. They were divided into a hormone replacement group and a TSH suppressive therapy group ( n = 51/group). The hormone replacement group was given hormone replacement therapy after surgical resection, and the TSH suppressive therapy group was given TSH suppressive therapy. The expression of PD-L1 and MMP-2 in the pericancerous tissue was compared between the two groups during surgery and 3 and 6 months after surgery. Tumor recurrence and metastasis were compared between the two groups after 6 months, 1 year, and 3 years of follow-up. Results:At 3 and 6 months after surgery, the PD-L1 positive expression rate in the TSH suppressive therapy group was 9.8% (5/51) and 13.7% (7/51), respectively, and the MMP-2 positive expression rate in the TSH suppressive therapy group was 9.8% (5/51) and 13.7% (7/51), respectively, which were significantly lower than 25.5% (13/51), 31.4% (16/51), 27.5% (14/51), and 33.3% (17/51) in the hormone replacement group ( χ2 = 4.32, 5.24, 4.55, 5.45, P = 0.038, 0.022, 0.033, 0.020). At 3 years after surgery, the tumor recurrence and metastasis rate in the TSH suppressive therapy group was 5.9% (3/51), which was significantly lower than 17.6% (10/51) in the hormone replacement group ( χ2 = 4.32, P = 0.038). Conclusion:For patients with thyroid cancer undergoing surgery, TSH suppressive therapy can better inhibit the expression of PD-L1 and MMP-2 in thyroid cancer tissue, reduce the risk of long-term recurrence and metastasis, and have a better clinical application value for improving the prognosis compared with hormone replacement therapy.

Model establishment and progress of focused gene therapy for dilated cardiomyopathy / 中国实验动物学报

Dilated cardiomyopathy is a main disease that causes heart failure and exhibits etiological heterogeneity.Nearly a quarter of dilated cardiomyopathy in patients is related to genetics,and ventricular dilation and myocardial systolic dysfunction are the main characteristics of the disease.LMNA mutation is a major cause of hereditary dilated cardiomyopathy,and arrhythmia is a major clinical manifestation of hereditary dilated cardiomyopathy with LMNA mutation.In recent years,establishment of a dilated cardiomyopathy model in C57/B6 mice and its treatment by focused gene therapy has been a research focus,and some important conclusion have been drawn from the establishment of large animal models in dogs and pigs.However,large animals,especially non-human primates,are closer to humans.At present,dilated cardiomyopathy is not involved in the heart disease model of non-human primates.Therefore,this article reviews studies on rodent and large animal models of dilated cardiomyopathy at the genetic level and proposes the idea of developing a dilated cardiomyopathy model in a non-human primate.It also provides new ideas to study the pathogenesis and clinical treatment.

Establishment of finite element model and biomechanical analysis of external fixation and combined external and internal fixation for bone transport in treatment of a case with bone defect of lower limb / 中华显微外科杂志

Objective:To establish a finite element model for bone transport before surgery in the treatment of femoral and tibial bone defects with external fixation and combined intramedullary nails with external fixations, and evaluate the stability and properties of biomechanics.Methods:Between May 2022 and August 2022, a male volunteer in the Department of Trauma and Microreconstructive Surgery, the First Affiliated Hospital of Xinjiang Medical University was selected. The right lower limb was scanned using 64-slice CT. Data were imported into Mimics 21.0 to establish normal geometric models of femur and tibia. The models were arranged in 4 groups: a femoral external fixator group, a femoral external fixator combined with intramedullary nail group, a tibial external fixator group and a tibial external fixator combined with intramedullary nail group. Hypermesh 10.0 was used for meshing. Finite element analysis was performed by Ansys v.11 to measure the distribution and characteristics of equivalent stress in the transported bone segment, proximal and distal tibia, and fixtures in the 2 treatment modalities, respectively.Results:Peak Von Mises equivalent stress of cortical bone and external fixation was found higher in both of the femoral and tibial external fixator combined with intramedullary nail groups than that in the external fixator group, with stress reduction on cortical bone at approximately 76.9% and 77.8%, respectively. The stress reduction on external fixator was about 81.4% and 76.3%, respectively. Peak displacement of the structure in both of the femoral and tibial external fixator combined with intramedullary nail groups was lower than that in the external fixator group, with 78.4% and 60.1% reduction in displacement, respectively.Conclusion:Bone transport with intramedullary nailing combined with external fixator in treatment of femoral and tibial defects would offer better biomechanical advantages. It can facilitates bone regeneration and bone mineralisation during distraction phase and consolidation phase.

The brain protective effects of ropivacaine on cerebral ischemia/reperfusion injury in rats and its influence on cGAS/STING pathway / 中风与神经疾病杂志

@#Objective To investigate the brain protective effects of ropivacaine on cerebral ischemia-reperfusion injury in rats and its influence on cyclic adenosine-adenosine synthase/stimulator of interferon gene (cGAS/STING) pathway.Methods SD rats were randomly divided into sham operation group,model group,low-dose ropivacaine group (0.075 mg/kg),medium-dose ropivacaine group(0.15 mg/kg),and high-dose ropivacaine group (0.30 mg/kg),positive control group(nimodipine,5 mg/kg),with 8 rats in each group,except for the sham operation group,the rats in the other groups were given suture method to construct a rat model of cerebral ischemia and reperfusion,and the neurological deficit scores of the rats in each group on the 0th,3rd,and 7th day of administration were measured;hematoxylin-eosin staining (HE) was used to detect the pathological changes of brain tissues in each group;2、3、5-Triphenyte-trazoliumchloride(TTC) method was used to detect cerebral infarction area; enzyme-linked immunosorbent (ELISA) was used to detect the levels of tumor necrosis factor(TNF-α),interleukin(IL-1β),IL-6,superoxide dismutase(SOD) and malondialdehyde (MDA) in brain tissue; qRT-PCR was used to detect the level of mitochondrial DNA (mtDNA);Western blotting was used to detect the expression of cGAS/STING pathway protein in the brain tissues.Results Compared with the sham operation group,the brain tissue of the rats in the model group was seriously damaged,cerebral infarction area,the nerve defect score,TNF-α,IL-1β,IL-6,MDA levels in brain tissue,Cytoplasmic mtDNA level,cGAS and STING proteins expression were significantly increased,and the SOD levels in brain tissue were significantly reduced (P<0.05);compared with those in the model group,the brain tissue damage of the rats in the ropivacaine groups and the positive control group was relieved,cerebral infarction area,the nerve defect score,TNF-α,IL-1β,IL-6,MDA levels in brain tissue,Cytoplasmic mtDNA level,cGAS,STING proteins expression were significantly reduced,and SOD levels in brain tissue were significantly increased (P<0.05). Conclusion Ropivacaine has a certain protective effect on cerebral ischemia-reperfusion injury,and can inhibit cGAS/STING pathway.

The effect of abdominal visceral fat area on perioperative complications and pancreatic fistula in primary gastric carcinoma patients after laparoscopic assisted radical gastrectomy / 中华普通外科杂志

Objective:To study the effect of visceral fat area (VFA) on postoperative complications and pancreatic fistula in patients undergoing laparoscopic assisted radical gastrectomy for gastric careinoma.Methods:Clnical data of 214 primary gastric cancer patients undergoing laparoscopic assisted radical gastrectomy between Jan 2017 and Jan 2022 at the Department of General Surgery, Shouguang People's Hospital were retrospectively reviewed.Results:There were 85 patients in high VFA group and 129 patients in the low VFA group. The body mass index (25.1±3.4) kg/m 2 and visceral fat area (143.4±41.1) cm 2 in the high VFA group were higher than those in the low VFA group (21.2±2.9) kg/m 2 and visceral fat area (58.7±31.9) cm 2. The operative time was (228.3±53.1) min vs. (206.3±62.9) min ( t=5.538, P=0.017). The intraoperative blood loss was (264.6±173.6) ml vs. (213.9±156.2) ml ( t=3.373, P=0.035). The postoperative hospital stay was (12.5±4.0) d vs. (10.3±3.7) d ( t=7.781, P=0.013). Twenty-three cases developed postoperative complications in the high VFA group vs. 20 cases in the low VFA group ( χ2=4.261, P=0.039). Patients in the high VFA group had an incidence of clinically relevant pancreatic fistula of 10.6% vs. 3.1% in patients in the low VFA group ( χ2=5.034, P=0.038). Univariate and multivariate analysis of clinically relevant pancreatic fistulas in patients with different VFA groups showed that men ≥134.6 cm 2 and women ≥91.1 cm 2 with VFA and operative time ≥250 min were independent risk factors for the occurence of clinically relevant pancreatic fistulas after laparoscopic assisted radical gastrectomy. Conclusions:VFA increases the difficulty of laparoscopic-assisted radical gastrectomy, resulting in increased postoperative complications. VFA and operation time are independent risk factors for clinically relevant pancreatic fistula after radical gastrectomy for gastric cancer.

Chinese Medicine Regulates Signaling Pathways Related to Proliferation and Osteogenic Differentiation of Bone Marrow Mesenchymal Stem Cells： A Review / 中国实验方剂学杂志

Bone marrow mesenchymal stem cells （BMSCs） are derived from stem cells isolated from bone marrow and have the potential for multidirectional differentiation and self-renewal. Under certain conditions， BMSCs can be induced to differentiate into osteoblast （OB）， chondrocyte， adipocyte， fibroblast， etc. BMSCs play an important role in maintaining the stability of bone structure and balancing bone metabolism. Promoting the proliferation of BMSCs and inducing their differentiation into OB of great significance for the clinical prevention and treatment of osteoporosis， bone defects， fracture healing， and other diseases. Because the proliferation and osteogenic differentiation of BMSCs are complex processes controlled by multiple genes and regulated by multiple signal transduction pathways， traditional Chinese medicine （TCM） happens to have the advantages of multi-bioactive component， multi-target， and multi-pathway synergism， which can affect the proliferation and differentiation of BMSCs through multiple channels and induce the proliferation of BMSCs. The transcription and expression of genes related to osteogenesis can be enhanced to promote the differentiation of BMSCs into OB， so as to achieve the purpose of preventing and treating osteoporosis， bone defects， and other bone diseases. Based on the literature on the intervention of TCM monomers and compounds in the proliferation and osteogenic differentiation of BMSCs， this study reviewed TCM monomers and compounds in promoting the proliferation and osteogenic differentiation of BMSCs by regulating secreted glycoprotein （Wnt）， neurogenic locus notch homolog protein （Notch）， mitogen-activated protein kinase （MAPK）， phosphatidylinositol-3 kinase （PI3K） /protein kinase B （Akt）， bone morphogenetic protein （BMP）/Smad， Janus kinase （JAK）/signal transducer and activator of transcription protein （STAT）， osteoprotegerin （OPG）/receptor activator of nuclear factor-kappa B （RANK）/RANK ligand （RANKL）， and other signaling pathways to provide new ideas for the research and clinical application of Chinese medicine in the prevention and treatment of orthopedic diseases.

Effects of metacarpal inclination angle and ulnar deviation angle on radius length shortening after distal radius fracture combined with internal fixation of ulnar styloid fracture / 国际外科学杂志

Objective:To investigate the effects of metacarpal inclination angle and ulnar deviation angle on radius length shortening after internal fixation of distal radius fracture combined with ulnar styloid fracture.Methods:A retrospective case-control study was conducted to analyze the clinical data of 84 patients with distal radius fracture complicated with ulnar styloid fracture treated by Beijing Daxing District People′s Hospital from February 2018 to January 2022. According to whether the ulnar styloid fracture was fixed or not, the patients were divided into two groups: 18 patients with ulnar styloid fractures who were surgically fixed were in the fixation group, and 66 patients with ulnar styloid fractures who were not surgically fixed were in the non-fixation group. The perioperative indexes (operation time, intraoperative blood loss, surgical incision length), wrist joint function indexes [Gartland-Werley score, disability of the arm, shoulder, and hand (DASH) score, forearm rotation, ulnar deviation, metacarpal flexion, radial deviation, dorsal extension, grip strength] and complications (bone nonunion, osteolysis, ulnar pain, internal fixation failure, lower ulnar and radial instability, postoperative infection) were compared between the two groups. The changes of metacarpal inclination angle, ulnar deviation angle and distal radius distance of the two groups were analyzed by generalized estimation equation (GEE). The patients were followed up for 12 months, they were divided into two groups: non-shortening group (radius shortening distance < 4 mm, n=61) and radius shortening group (radius shortening distance ≥ 4 mm, n=23) according to whether the radius shortening distance was ≥ 4 mm at the last follow-up. The influencing factors of postoperative radius shortening were evaluated by Logistic regression analysis. Results:Compared with the non-fixation group, the Gartland-Werley score(1.79±0.62 vs 4.65±0.97), DASH score (16.43±4.71 vs 28.72±6.06) and the incidence of complications (11.11% vs 39.40%) in the fixation group were significantly lower, and the forearm rotation angle [(81.29±6.60)° vs (70.79+ 5.15)°], ulnar deviation angle [(21.36±2.35)° vs (16.77±2.11)°], metacarpal flexion angle [(45.84±2.80)° vs (37.55±2.45)°] and dorsal extension angle [(50.23±5.16)° vs (40.65±3.580°] were significantly larger in the fixation group, all the differences were statistically significant ( P<0.05). GEE analysis and evaluation showed that treatment time, treatment plan and their interaction had significant effects on metacarpal inclination, ulnar deviation and distal radius ( P<0.05). The change of metacarpal inclination angle and ulnar deviation angle were independent influencing factors of radius shortening after internal fixation ( P<0.05). Conclusions:In the treatment of distal radius fracture combined with ulnar styloid fracture, internal fixation of distal radius combined with ulnar styloid process can improve wrist joint function, reduce the incidence of complications, and improve metacarpal inclination angle and ulnar deviation angle. A certain degree of radius shortening will occur after internal fixation. The changes of metacarpal inclination angle and ulnar deviation angle are the independent influencing factors of radius shortening after internal fixation.

Research progress on the influencing factors of health literacy in patients with coronary heart disease based on the perspective of health ecology / 中国实用护理杂志

The self-health management level of patients with coronary heart disease depends largely on their health literacy level. The theory of health ecology believes that the factors affecting individual health are multi-level. Based on the perspective of health ecology, this paper analyzed the influencing factors of health literacy of patients with coronary heart disease from five aspects: personal characteristics, behavior, interpersonal network, living and working conditions, environmental policies, so as to provide a basis for formulating targeted and systematic strategies for improving the health literacy of patients with coronary heart disease in the future.

Optimization of preparation technology and in vitro release of baicalin-glycyrrhizic acid solid nanocrystals / 中国药房

OBJECTIVE To optimize the preparation technology of baicalin （BCN）-glycyrrhizic acid （GA） solid nanocrystals （BCN-GA-SN）， to characterize them and investigate their in vitro release characteristics. METHODS According to the compatibility ratio of classic couplet medicinals “Scutellaria baicalensis-Glycyrrhiza uralensis”， the compatibility ratio of BCN and GA was determined as 6∶1 （m/m）； BCN-GA nanosuspension was prepared by precipitation method combined with high-pressure homogenization method. The preparation technology of BCN-GA nanosuspension was optimized by using mean particle size and polydispersity index （PDI） as indexes and with types and dosage of stabilizers， stirring speed and time， high-pressure homogenization pressure and frequency as factors. The freeze-dried consolidation process of BCN-GA nanosuspension was optimized to prepare BCN-GA-SN using average particle size， PDI and redispersibility index （RDI） as indicators， with the type and dosage of freeze-dried protective agents as factors； then， the physicochemical properties and in vitro release of BCN-GA-SN were investigated. RESULTS The optimal preparation technology of BCN-GA-SN was as follows： BCN-GA nanosuspension was prepared by using 15% sodium dodecyl sulfate as a stabilizer， stirring at 1 000 r/min for 15 minutes， and homogenizing at 100 MPa for 20 times； then， BCN-GA nanosuspension was freeze-dried and solidified with 5% mannitol （corresponding to the dosage of BCN）. The average particle size of prepared BCN-GA-SN was （442.2±5.7） nm with PDI of 0.225±0.015 and RDI of 1.055± 0.013. The prepared BCN-GA-SN presented as the irregularly spherical shape with more uniform size； the drug-loading amount of BCN in the nanocrystal was （62.5±0.7）%， and that of GA was （9.4±0.2）%； the in vitro release results showed that the cumulative dissolution of BCN-GA-SN was higher than that of the physical mixture of BCN and GA. CONCLUSIONS BCN-GA-SN is prepared successfully in this study with uniform particle size and even distribution， which can effectively improve the dissolution of BCN.

Changes in Cerebral Blood Flow in Patients Who Receive Different Durations of Hemodialysis: An Arterial Spin Labeling MRI Study

Background@#and Purpose This study aimed to determine the changes in cerebral blood flow (CBF) in patients who received different durations of hemodialysis (HD) using arterial spin labeling magnetic resonance imaging. @*Methods@#The study included 46 patients who received HD and 24 demographically similar healthy controls (HCs). Patients who received HD were divided into three subgroups based on its duration: HD-1 (n=15, dialysis duration ≤24 months), HD-2 (n=16, dialysis duration >24 and ≤72 months), and HD-3 (n=15, dialysis duration ≥73 months). All subjects completed the Mini Mental State Examination and Montreal Cognitive Assessment tests, and the patients who received HD underwent laboratory tests. Group-level differences in the global and regional CBFs between patients who received HD and HCs were assessed. Correlation analysis was performed to evaluate the associations among CBF, clinical variables, and cognitive function. @*Results@#Compared with HCs, global and regional CBFs were significantly increased in the HD-1 and HD-2 groups (p0.05). However, compared with the HD-1 group, the HD-3 group had significantly decreased global and regional CBFs (p<0.05). The cognitive function was worse in patients who received long-term HD than in HCs. Increased dialysis duration and hemoglobin level were predictive risk factors for decreased CBF in patients who received long-term HD. @*Conclusions@#Patients who received long-term HD with normal CBF had worse cognitive function, which may be related to increased dialysis duration.