Influence of triglyceride/high-density lipoprotein cholesterol ratio on the onset of primary liver cancer / 临床肝胆病杂志

ObjectiveTo investigate the influence of triglyceride （TG）/high-density lipoprotein cholesterol （HDL-C） ratio on the onset of primary liver cancer. MethodsA prospective cohort study was conducted. Physical examination data were collected from 99 750 cases of on-the-job and retired employees of Kailuan Group who participated health examination from July 2006 to December 2007， and they were followed up till December 31， 2021 to observe the onset of primary liver cancer. A one-way analysis of variance was used for comparison of normally distributed continuous data between multiple groups， and the Kruskal-Wallis H test was used for comparison of continuous data with skewed distribution between multiple groups； the chi-square test was used for comparison of categorical data between groups. According to the tertiles of TG/HDL-C ratio， the subjects were divided into Q1， Q2， and Q3 groups， and the incidence density of primary liver cancer was calculated for each group. The Kaplan-Meier method was used to calculate the cumulative incidence rate of primary liver cancer in each group， and the log-rank test was used to compare the difference in cumulative incidence rate between groups. The Cox proportional hazards model was used to analyze the influence of TG/HDL-C ratio on the onset of primary liver cancer. ResultsThere were significant differences between the three groups in age， proportion of male subjects， waist circumference， body mass index， fasting blood glucose， systolic pressure， diastolic pressure， triglyceride， total cholesterol， HDL-C， low-density lipoprotein cholesterol， alanine aminotransferase， high-sensitivity C-reactive protein， chronic liver diseases， hypertension， diabetes， the family history of malignant tumor， drinking， smoking， physical exercise， and educational level （P<0.05）. During the mean follow-up time of 14.06±2.71 years， there were 484 cases of new-onset liver cancer， among whom there were 446 male subjects and 38 female subjects. The incidence density of primary liver cancer was 0.39/1 000 person-years in the Q1 group， 0.35/1 000 person-years in the Q2 group， and 0.30/1 000 person-years in the Q3 group， and the cumulative incidence rates of primary liver cancer in the three groups were 6.03‰， 5.28‰， and 4.49‰， respectively， with a significant difference between the three groups based on the long-rank test （χ2=6.06， P=0.048）. After adjustment for the confounding factors considered， the Cox proportional hazards model showed that compared with the Q3 group， the Q1 group had a hazard ratio of 2.04 （95% confidence interval ［CI］： 1.61‍ ‍—‍ ‍2.58， Pfor trend<0.05）， and the Q2 group had a hazard ratio of 1.53 （95%CI： 1.21‍ ‍—‍ ‍1.92， Pfor trend<0.05）. ConclusionThe reduction in TG/HDL-C ratio is associated with an increase in the rask of primary liver cancer， especially in people with chronic liver diseases.

Practical Research on the Teaching of "Medical Interpersonal Communication" Integrate into the Red Doctor’s Spirit for Students Majoring in Public Health Management / 中国医学伦理学

The red doctor’s spirit is an important spiritual guidance for the cultivation of medical talents during the development of medical and health services in China. The teaching reform, which is oriented towards position competence, requires that students majoring in public health management should not only master solid medical knowledge and professional skills, but also possess an ability to handle medical public relations, such as shaping an excellent image of the organization, improving the medical interpersonal communication, and managing public relations crisis. Under the guidance of inheriting the red gene and innovating the medical education, the driving force of learning should be "serving the people to improve their health" led by "political firmness" , the learning goal "striving for perfection" inspired by "excellent technology" , and the working criterion "respecting patients, involving full participation and shouldering public responsibility" embodied in "making selfless dedication and helping the wounded and dying" . The article based on the characteristic culture of red medicine in the Air Force Medical University, applied the teaching method of role-playing case simulations to explore the teaching practice road of "theory-experience-practice-reflection" .

Effects of Xihuang Pills on proliferation and apoptosis of prostate cancer LNCaP cells based on AR/m TOR signaling pathway / 中国中药杂志

Based on the androgen receptor(AR)/mammalian target of rapamycin(mTOR)signaling pathway, the effects of Xihuang Pills-medicated serum on the proliferation and apoptosis of prostate cancer LNCaP cells were investigated. The drug-containing serum of SD rats was prepared by intragastric administration of Xihuang Pills suspension. The effects of low-, medium-, and high-dose Xihuang Pills-containing serum on the in vitro proliferation of LNCaP cells were detected by cell counting kit-8(CCK-8). Flow cytometry was used to detect the apoptosis level of LNCaP cells after intervention with different concentrations of Xihuang Pills. Protein expression of cleaved cysteinyl aspartate-specific proteinase caspase-3(cleaved caspase-3), B-cell lymphoma-2(Bcl-2), and AR as well as the phosphorylation level of mTOR protein were detected by Western blot. The results showed that compared with the blank serum, the drug-medicated serum could blunt the activity of LNCaP cells. Low-, medium-, and high-dose Xihuang Pills-containing serum could significantly increase the cell apoptosis rate, increase the expression of cleaved caspase-3 protein, decrease the expression of Bcl-2 protein, reduce the expression of AR protein, and down-regulate the level of phosphorylated mTOR(p-mTOR). To study the effect of Xihuang Pills on the growth of LNCaP cells in vivo, different doses of Xihuang Pills were used to intervene in the subcutaneous graft model in nude mice inoculated with LNCaP cells. The expression levels of AR, mTOR, p-mTOR, Bcl-2, and cleaved caspase-3 were detected by Western blot. The results showed that the volumes of subcutaneous graft tumor in the low-dose, medium-dose, and high-dose Xihuang Pills groups significantly decreased compared with that in the model group. The weight of subcutaneous transplanted tumor in each group with drug intervention was significantly lower than that in the model group. Compared with the model group, the low-dose, medium-dose, and high-dose Xihuang Pills groups showed increased cleaved caspase-3 protein expression, decreased Bcl-2 and AR protein expression, and reduced p-mTOR protein expression. Further experiments showed that AR agonist R1881 could block the anti-proliferation and pro-apoptotic effects of Xihuang Pills. The mechanism of Xihuang Pills against prostate cancer is related to the inhibition of the AR/mTOR signaling pathway, inhibition of LNCaP cell proliferation, and induction of apoptosis in cancer cells.

Effects of intravascular hypothermia combined with early post-pyloric feeding on neurological function and prognosis in patients with first severe ischemic stroke / 中国实用护理杂志

Objective:To investigate the effects of intravascular hypothermia combined with early post-pyloric feeding on the neurological function and prognosis in patients with severe ischemic stroke, and to provide a theoretical basis for clinical decision-making on the optimal nutritional support strategy for patients with severe ischemic stroke during intravascular hypothermia treatment.Methods:This was a retrospective, non-randomized, controlled study. A total of 78 patients with first severe ischemic stroke who were admitted to the ICU of Neurology Department, Xuanwu Hospital, Capital Medical University from January 2018 to December 2021 were selected. General information and clinical data of the patients were collected and grouped according to intrvascular hypothermia combined with nutritional support. Patients were divided into early post-pyloric feeding group of 52 cases and early parenteral nutrition group of 26 cases. The neurological prognosis, disease prognosis, nutritional status and complications related to nutritional support of the two groups were retrospectively analyzed.Results:The Glasgow score at 30th day after intravascular hypothermia in the early postpyloric feeding group was (11.25 ± 4.92) points, which was higher than that in the early parenteral nutrition group (8.40 ± 5.53), and the difference was statistically significant ( t=-2.45, P<0.05). After treatment, the serum total protein and hemoglobin of early postpyloric feeding group were (59.56 ± 5.09) g/L and (131.06 ± 19.58) g/L, respectively, which were higher than those of early parenteral nutrition group (56.52 ± 7.94) g/L and (122.07 ± 17.72) g/L. The difference was statistically significant ( t=-2.03, -1.91, P<0.05). The clinical pulmonary infection score of the early postpyloric feeding group was (7.33 ± 0.96) points, which was lower than that of the early parenteral nutrition group (9.42 ± 2.11). The mechanical ventilation time and ICU stay time were (17.46 ± 10.47) days and (28.89 ± 12.59) days, respectively. Compared with the early parenteral nutrition group (25.77 ± 15.20) days and (37.07 ± 17.15) days, the differences were statistically significant ( t=3.28, 2.83, 2.52, all P<0.05). There were no significant differences in catheter-associated bloodstream infection and ICU hospitalization mortality between the two groups (both P>0.05). Conclusions:Intravascular hypothermia combined with early post-pyloric feeding can improve the nutritional status of patients with severe ischemic stroke, effectively control pulmonary infection, shorten mechanical ventilation and hospital stay, and promote neurological repair.

Effect of Gupi Xiaoji Decoction on mitochondrial structure and function of human hepatoma cell line HepG2 / 中国药理学通报

Aim To observe the effect of Gupi Xiaoji Decoction (GPXJY) on the structure and function of mitochondria of human hepatoma cell HepG2 cells and explore its possible mechanism. Methods CCK8 was used to detect cell proliferation, Mito-Tracker Green fluorescence staining was used to observe the mitochondrial structure, flow cytometry was used to detect the membrane potential, Elisa was used to detect the ATP content, fluoroscopic electron microscopy was used to observe the microstructure changes, and high-content screening(HCS) was used to detect the related proteins. Results Fluorescence staining showed that GPXJY damaged the mitochondria of HepG2 cells and decreased the content of ATP. The results of flow cytometry showed that GPXJY could reduce the mitochondrial membrane potential of HepG2 cells. The results of electron microscope showed that GPXJY made the mitochondria of cancer cells swell and so on. HCS found that GPXJY significantly reduced the average fluorescence intensity of Bcl-2 in HepG2 cells, and significantly increased the average fluorescence intensity of apoptosis promoting proteins Bax, cytochrome-c, caspase-3 and cleaved-caspase-3, which was statistically significant. Conclusion GPXJY can regulate the structure and function of mitochondria in HepG2 cells.

Anti-neutrophil cytoplasmic antibody-associated vasculitis with gastrointestinal bleeding as the main symptom: a case report and literature review / 中华危重病急救医学

Anti-neutrophil cytoplasmic antibody-associated vasculitis (AAV) has a wide range of symptoms, and it is difficult for clinicians to make a quick and correct diagnosis. On November 11, 2021, a 36-year-old male patient with AAV was admitted to the emergency and critical care department of Yichang Central People's Hospital. He was admitted to the emergency intensive care unit (EICU) with gastrointestinal symptoms (abdominal pain, black stool) as the main physical signs, and was initially diagnosed as AAV with gastrointestinal hemorrhage (GIH). No bleeding point was found after repeated gastroscopy and colonoscopy. Abdominal emission CT (ECT) showed diffuse hemorrhage in the ileum, ascending colon and transverse colon. Multi-disciplinary consultation in the whole hospital considered the diffuse hemorrhage caused by small vascular lesions in the digestive tract caused by AAV. Pulse therapy with methylprednisolone 1 000 mg/d and immunosuppressive therapy with cyclophosphamide (CTX) 0.2 g/d were administered. The patient's symptoms quickly relieved and transferred out of the EICU. After 17 days of treatment, the patient finally died of massive gastrointestinal bleeding. A systematic review of relevant literatures combined with the case diagnosis and treatment process found that only a minority of AAV patients present with gastrointestinal symptoms as their first symptoms, and patients with GIH were very rare. Such patients had a poor prognosis. This patient delayed the use of induced remission and immunosuppressive agents due to the treatment of gastrointestinal bleeding, which may be the main cause of life-threatening GIH secondary to AAV. Gastrointestinal bleeding is a rare and fatal complication of vasculitis. Timely and effective induction and remission treatment is the key to survival. Whether patients should receive maintenance therapy, the duration of maintenance therapy, and the search for markers of disease diagnosis and treatment response are directions and challenges for further research.

Expert consensus on implementation strategy of awake prone positioning for non-intubated patients in China (2023) / 中华危重病急救医学

The awake prone position plays an important role in the treatment of hypoxemia and the improvement of respiratory distress symptoms in non-intubated patients. It is widely used in clinical practice because of its simple operation, safety, and economy. To enable clinical medical staff to scientifically and normatively implement prone position for awake patients without intubation, the committees of consensus formulation, guided by evidence-based methodology and Delphi method, conducted literature search, literature quality evaluation and evidence synthesis around seven topics, including indications and contraindications, evaluation, implementation, monitoring and safety management, termination time, complication prevention and health education of awake prone position. After two rounds of expert letter consultation, Expert consensus on implementation strategy of awake prone positioning for non-intubated patients in China (2023) was formulated, and provide guidance for clinical medical staff.

Introduction and application of deep integration strategy of extracurricular scientific research management and information technology for undergraduates in military medical universities / 中华医学教育探索杂志

This study deeply analyzes the common problems of three military medical universities in the management of undergraduate extracurricular scientific research, such as lack of communication means, limited online resources, backward laboratory opening and low utilization rate of equipment. We have built a cloud platform management system for undergraduate extracurricular scientific research. This system firstly sets up a teaching resources storage module including videos, PPTs, documents, pictures, electronic materials, question bank, etc. Then four subsystems for different roles of students, mentors, experimental teaching staff and administrators are constructed. Finally, this system realizes independent experiments by students, real-time evaluation by mentors, instrument sharing and efficient management through the seamless connection with the user terminal equipment. And the study also makes evaluation on the present usage.

Research progress of protein post-translational modification in hepatocellular carcinoma / 中国药理学通报

Liver cancer has the characteristics of high incidence rate, high malignancy and hidden disease.At present, the treat¬ment of liver cancer mainly includes surgery, radiotherapy and chemotherapy, but the prognosis is poor.Therefore, it is very important to explore the pathogenesis of liver cancer and find ef¬fective drugs on this basis.Protein post-translational modifica¬tion is a hot topic in epigenetics.Recent studies have found that the occurrence and development of liver cancer is related to the abnormality of post-translational modification, and can be used as a target for the diagnosis and treatment of liver cancer.This article reviews the relationship between the major protein post- translational modifications discovered in recent years and liver cancer, and provides clues for the diagnosis, treatment and prognosis of liver cancer.

Effects of 10-Week Nordic Hamstring Training on Knee Eccentric Control Angle and Muscle Strength / 医用生物力学

Objective To compare the effects of different support method on eccentric control angle and muscle strength of knee joints in 10-week Nordic hamstring exercise.Methods Twenty-eight college male football players were randomly divided into hand support group (HS group, n=14) and non-hand support group (NHS group, n=14) for 10 weeks. The eccentric control angle and eccentric muscle strength of knee joints were tested before and after the intervention.Results After 10 weeks of Nordic hamstring training, the eccentric control flexion angle of knee joint in HS group and NHS group was significantly decreased by 8° and 10°, and the knee joint angle in NHS group was 12° lower than that in HS group (P<0.05); the peak torque of hamstring and quadriceps femoris in both HS group and NHS group was significantly increased, and the peak torque of hamstring centrifugal motion at 60°/s and 120°/s in NHS group was 16 and 13 N·m higher than that in HS group, respectively (P<0.05).Conclusions NHS group is better than HS group in improving knee flexion angle and centrifugal muscle force. It is suggested that Nordic hamstring training should be taken as one of the daily training tasks for football players to prevent hamstring injury.

Research advances on functional training robots in burn rehabilitation / 中华烧伤杂志

Patients with deep burns are prone to suffer cicatrix hyperplasia or contracture, leading to problems including dysfunction in limbs, which impacts patients' life quality and makes it difficult for them to return to society. Thereby, the rehabilitation treatment after deep burns is particularly important. Currently, exercise therapy plays an important role in burn rehabilitation, which is mainly based on therapies such as continuous manual assistance training and manual stretching practice to provide patients with physical exercise to limbs and to correct the functional dysfunction of limbs in patients. With the continuous progress in technology, functional training robots have been developed to meet the needs. The emergence of functional training robots saves manpower and provides patients refined and standardized functional exercise treatment. From the aspects of production technology and multi-technology integration, this paper mainly introduces the recent innovation and development of functional training robots and the advantages of the application of functional training robots in the field of burn rehabilitation.

Textual Research on Trionycis Carapax / 中国实验方剂学杂志

Trionycis Carapax is a commonly used Chinese medicine in clinical practice. Modern research on Trionycis Carapax mainly focuses on experimental research and clinical observation， which has been rarely reported in the literature. Based on the literature on medicinal herbs， medical books， prescriptions of all dynasties， this study carried out systematic textual research on the historical evolution and changes of the name， origin， producing areas， quality， efficacy， indications， processing methods， and contraindications of the Trionycis Carapax. As revealed by the textual analysis， the origin of Trionycis Carapax is Trionyx sinensis， and the carapace of T. steindachneri is not suitable for the preparation of Trionycis Carapax. The genuine producing areas of Trionycis Carapax include Yueyang， Jingzhou， southeast Anhui， and western Jiangsu in the middle and lower reaches of the Yangtze river. Regarding the quality， the number of ribs of Trionycis Carapax， such as seven ribs and nine ribs， is often used as the quality evaluation standard in ancient Chinese herbal books. However， through literature research and field inspections on the medicinal material markets， it is not advisable to take rib number as a quality evaluation criterion in modern times. With the change of the times， the efficacy and indications of Trionycis Carapax have gradually expanded on the basis of Shennong’s Classic of Materia Medica （Shen Nong Ben Cao Jing）， and later generations widely apply it in internal medicine， surgery， gynecology， pediatrics， etc. It should be noted that the treatment of labor heat and bone steaming by Trionycis Carapax is derived from Shennong’s Classic of Materia Medica， not Treatise on the Nature of Medicinal Herbs （Yao Xing Lun） mentioned in ancient books such as Amplification on Materia Medica （Ben Cao Yan Yi）. The processing methods of Trionycis Carapax are diverse， which are dominated by traditional vinegar processing. In terms of contraindications， Trionycis Carapax should not be compatible with bauxite and marble and is contraindicated in pregnant women. Those with spleen deficiency， weak stomach， and liver deficiency without heat should use it with caution. This study is expected to provide the basis for radical reform and further development and clinical utilization of Trionycis Carapax.

Data Mining and Systems Pharmacology to Elucidate Effectiveness and Mechanisms of Chinese Medicine in Treating Primary Liver Cancer / 中国结合医学杂志

OBJECTIVE@#To identify specific Chinese medicines (CM) that may benefit patients with primary liver cancer (PLC), and to explore the mechanism of action of these medicines.@*METHODS@#In this retrospective, singlecenter study, prescription information from PLC patients was used in combination with Traditional Chinese Medicine Inheritance Supports System to identify the specific core drugs. A system pharmacology approach was employed to explore the mechanism of action of these medicines.@*RESULTS@#Taking CM more than 6 months was significantly associated with improved survival outcomes. In total, 77 putative targets and 116 bioactive ingredients of the core drugs were identified and included in the analysis (P<0.05). A total of 1,036 gene ontology terms were found to be enriched in PLC. A total of 75 pathways identified from Kyoto Encyclopedia of Genes and Genomes were also enriched in this disease, including fluid shear stress, interleukin-17 signaling, signaling between advanced glycan end products and their receptors, cellular senescence, tumor necrosis factor signaling, p53 signaling, cell cycle signaling, steroid hormone biosynthesis, T-helper 17 cell differentiation, and metabolism of xenobiotics by cytochrome. Docking studies suggested that the ingredients in the core drugs exert therapeutic effects in PLC by modulating c-Jun and interleukin-6.@*CONCLUSIONS@#Receiving CM for 6 months or more improves survival for the patients with PLC. The core drugs that really benefit for PLC patients likely regulates the tumor microenvironment and tumor itself.

Mechanism of Artesunate in Reversing Epithelial-mesenchymal Transition and Akt /Snail Signaling Pathway in Colorectal Carcinoma / 中国实验方剂学杂志

Objective:To investigate the effects of artesunate （ART） on epithelial-mesenchymal transformation （EMT） of colorectal cancer HCT-8 cells，and explore the effects of ART on cell migration，invasion，EMT ability， and protein kinase B （Akt）/Snail signaling pathway of colorectal cancer. Method:3-（4-5-Dimethylthiazol-2-yl）2，5-diphenyltetrazolium bromide （MTT） assay was used to detect the effects of ART at different concentrations on the proliferation of HCT-8 cells. Wound healing assay and Transwell assay were used respectively to detect the effects of ART on migration and invasion of colorectal cancer cells. The effects of different concentrations of ART on the distribution of EMT-related proteins vimentin and E-cadherin in HCT-8 cells were detected by double-immunofluorescent staining. The effects of ART on protein expression levels of EMT markers E-cadherin，vimentin and N-cadherin in HCT-8 cells and the expression of Akt1， p-Akt1， and Snail1 in the Akt/Snail signaling pathway were determined by Western blot. Result:The dose-dependent inhibitory effects of ART on the proliferation of HCT-8 cells were determined and the inhibition rate was calculated. A dose-response curve was plotted accordingly. The half-maximal inhibitory concentration （IC₅₀） of ART on HCT-8 cells was （16.67±1.95） μmol·L^-1. The following four groups were set up： a control group （0 μmol·L^-1），and low-， medium-， and high-dose ART groups（2， 10， 50 μmol·L^-1）. Compared with the results in the control group，ART inhibited the migration and invasion of HCT-8 cells（<italic>P</italic><0.05）. Specifically， the expression of E-cadherin in HCT-8 cells was significantly up-regulated，and that of vimentin and N-cadherin was significantly down-regulated （<italic>P</italic><0.05）. The expression levels of p-Akt1 and Snail1 were significantly decreased after ART treatment，thus inhibiting EMT（<italic>P</italic><0.05）. Conclusion:The findings of this study suggested that ART inhibited the EMT-triggered migration and invasion of HCT-8 cells presumedly by inhibiting the activation of the Akt/Snail pathway to reverse EMT.

The application of an end-effector-based lower limb robot to the gait training of stroke survivors / 中华物理医学与康复杂志

Objective:To observe the effect of gait training assisted by an end-effector-based robot on the gait, balance, walking and general lower limb motor functioning of stroke survivors.Methods:Thirty-nine stroke survivors were randomized into a training group ( n=21) and a control group ( n=18). In addition to routine hemiplegia rehabilitation, the control group was given medium frequency electrical stimulation while the training group underwent 20 minutes of gait training assisted by an end-effector-based robot six days a week for 4 weeks. Before and after the intervention, both groups were evaluated using the functional ambulatory categories (FAC), the Fugl-Meyer lower extremity assessment, the Wisconsin Gait Scale and the Berg balance scale (BBS). Results:There were no significant differences between the groups before the intervention. Afterward significant improvement was observed in both groups in all measurements, with the training group scored better in terms of FAC and BBS.Conclusion:Using an end-effector-based robot in gait training might be more advantageous for improving the gait, balance, walking and general lower limb functioning of stroke survivors.

Mechanism of gasdermin D on intestinal injury in severe acute pancreatitis by mediating pyroptosis / 中华危重病急救医学

Objective:To investigate the function of gasdermin D (GSDMD) in intestinal damage of mice with severe acute pancreatitis (SAP).Methods:The healthy C57BL/6 mice were divided into four groups randomly, including normal saline (NS) group, small interfering RNA (siRNA)-NS group, SAP model group and siRNA-SAP group, with 6 mice in each group. The SAP mouse model was reproduced by intraperitoneal injection of caerulein 50 μg/kg combined with lipopolysaccharide (LPS) 10 mg/kg; the NS group was given the same amount of NS; in the siRNA-SAP group and siRNA-NS group, siRNA 50 mg/kg was injected through the tail vein three times before modeling or injection of NS. The blood of mice eyeball in each group was taken 12 hours after modeling, and serum interleukins (IL-1β, IL-18) levels were detected by enzyme linked immunosorbent assay (ELISA). The mice were sacrificed to observe the general changes in abdominal cavity, the pancreas and ileum tissues were taken to observe the pathological changes under a light microscope. The expression of long-chain non-coding RNA uc.173 (lnc uc.173) was detected by reverse transcription-polymerase chain reaction (RT-PCR). Immunohistochemical method was used to detect the expression of tight junction proteins zonula occluden-1 (ZO-1) and Occludin in intestinal mucosal epithelial cells. Western blotting was used to detect the GSDMD protein expression level in the intestinal tissue.Results:The serum levels of IL-1β and IL-18 in the SAP model group were significantly higher than those in the NS group and the siRNA-NS group [IL-1β (ng/L): 146.66±1.40 vs. 44.48±5.76, 81.49±10.75, IL-18 (ng/L): 950.47±177.09 vs. 115.43±16.40, 84.84±21.90, all P < 0.05]; and the levels of IL-1β and IL-18 in the siRNA-SAP group were significantly lower than those in the SAP model group [IL-1β (ng/L): 116.26±15.54 vs. 146.66±1.40, IL-18 (ng/L): 689.96±126.08 vs. 950.47±177.09, both P < 0.05]. General observation showed that there were no obvious abnormalities in the abdominal cavity of the mice in the NS and siRNA-NS groups; the mice in the SAP model group and the siRNA-SAP group had different degrees of edema and congestion in the intestine; compared with the SAP model group, the abnormalities in the siRNA-SAP group was significantly reduced. Under light microscope, there were no obvious changes in the pancreas and intestinal mucosa in the NS group and the siRNA-NS group; the pancreatic tissue of the SAP model group and the siRNA-SAP group had different degrees of edema, inflammatory cell infiltration, and lobular structure damage, and the intestinal mucosa was damaged to a certain degree, and the villi were broken to varying degrees, but the damage in the siRNA-SAP group was lighter. The results of RT-PCR showed that the expression of lnc uc.173 in the intestinal tissues of the model SAP group was significantly lower than that of the NS group and the siRNA-NS group (2 -ΔΔCt: 0.26±0.12 vs. 1.01±0.37, 0.67±0.32, both P < 0.05), while the expression of lnc uc.173 in the siRNA-SAP group was significantly higher than that in the SAP model group (2 -ΔΔCt: 0.60±0.39 vs. 0.26±0.12, P < 0.05). Immunohistochemistry showed that ZO-1 and Occludin proteins in the NS group were distributed along the epithelial cells of the intestinal mucosa, showing a strong expression; ZO-1 and Occludin expressions were significantly reduced in the SAP model group and siRNA-SAP group, but the expressions in the siRNA-SAP group was higher than that in the SAP model group. Western blotting showed that the expression level of GSDMD protein in the intestinal tissues of the SAP model group was significantly higher than that of the NS group and the siRNA-NS group [GSDMD protein (GSDMD-N/β-actin): 1.99±0.46 vs. 1, 1.00±0.78, both P < 0.05]. Compared with the SAP model group, the expression of GSDMD protein in the siRNA-SAP group was significantly decreased [GSDMD protein (GSDMD-N/β-actin): 1.42±0.42 vs. 1.99±0.46, P < 0.05]. Conclusions:The systemic inflammatory response and intestinal mucosal barrier damage of SAP mice may be related to the increase of GSDMD expression in intestinal tissues. GSDMD mediates cell pyrolysis to promote the release of inflammatory factors, cause intestinal injury, and down-regulate the expression of intestinal epithelial cell tight junction proteins such as ZO-1 and Occludin, resulting in intestinal mucosal damage.

Dynamic Plantar Pressure Features of Ankle Joints at Different Stress Positions / 医用生物力学

Objective To explore the characteristics of plantar pressure of ankle joints at different limb laterality and different stress positions. Methods Twenty-three healthy subjects were recruited to perform walking trails. Each subject was tested for plantar pressure in ankle neutral position, ankle inversion and ankle eversion through simple custom-designed walkways and plantar pressure plate. The evaluation indices were peak pressure, contact area, contact time percentage, M/L (ratio of sum of medial plantar peak pressure to sum of lateral peak pressure), A/P (ratio of sum of toe peak pressure to heel peak pressure). Results The peak pressure of the first metatarsus bone in the dominant foot was significantly larger than that in the non-dominant foot, and the peak pressure of the fifth metatarsus bone was significantly smaller than that on the non-dominant foot. The M/L of dominant side was significantly larger than that of the non-dominant side. Except for the peak pressures of the mid-foot and the first toe, there were significant differences in other regions among the three ankle positions. The percentage of contact time in each area during inversion was greater than that in neutral position, and the percentage of contact time of plantar regions during eversion was longer than that in neutral position except the second toe. The M/L in inversion, neutral and eversion position were 1.24±0.46, 1.06±0.26, 0.88±0.25. The M/L of dominant foot was greater than that of the non-dominant foot, and the A/P during inversion and eversion was greater than that in neutral positions. Conclusions The stability of the dominant foot was better than that of the non-dominant foot. The standing stability decreased during inversion and eversion. During inversion, the body shifted inward and forward to maintain the stability. During eversion, the center of gravity shifted outward and forward to maintain the stability.

Multidisciplinary treatment discussion of a personalized approach of laparoscopic right hemicolectomy for variant middle colic artery and ileocolic vein / 中国肿瘤临床

Objective: To investigate the variants of middle colic artery (MCA) and ileocolic vein (ICV) and their influence on the deci-sion regarding approach of laparoscopic right hemicolectomy. Methods: We analyzed the diagnosis and treatment of one right colon cancer patient with variant MCA and ICV who was admitted to the Tianjin Medical University Cancer Hospital in March 2018. The pa-tient underwent laparoscopic right hemicolectomy via a limited medial approach after a multidisciplinary treatment (MDT) discussion. Following were the observation indicators: 1) surgical and postoperative recovery situations; 2) postoperative pathological examina-tion; and 3) follow-up situation. Results: 1) Surgical and postoperative recovery situations: the patient successfully underwent laparo-scopic right hemicolectomy via a limited medial approach. No intraoperative or postoperative complications occurred. Duration of postoperative hospital stay was 11 days. 2) Postoperative pathological examination: the number of dissected lymph nodes was 39. Postoperative pathological tumor stage was pT3N0. Postoperative pathological tumor type was moderately differentiated adenocarci-noma. 3) Follow-up situation: the patient was followed-up for 10 months with disease-free survival. Conclusions: Individual and stan-dard surgery will be the best choice for treating colon cancer patients. MDT can facilitate clinical decision-making and benefit patients.

Clinical efficacy of laparoscopic right hemicolectomy via limited medial approach / 中华消化外科杂志

Objective To investigate the clinical efficacy of laparoscopic fight hemicolectomy via limited medial approach.Methods The retrospective and descriptive study was conducted.The clinical data of 32 patients [15 males and 17 females,average age 62 years (range,49-70 years] with right colon cancer who were admitted to the Tianjin Medical University Cancer Hospital between July 2016 and April 2018 were collected.All the patients underwent laparoscopic right hemicolectomy via cranial-caudal-medial approach followed no-touch isolation technique.Observation indicators:(1) surgical and postoperative recovery situations;(2) postoperative pathological examination;(3) follow-up situations.Follow-up using outpatient examination and telephone interview to detect postoperative survival of patients and tumor metastasis or recurrence up to May 2018.Measurement data were represented as average (range).Results (1) Surgical and postoperative recovery situations:32 patients underwent successfully laparoscopic right hemicolectomy via limited medial approach,without conversion to open surgery and perioperative death.The operation time,volume of intraoperative blood loss,time to initial anal exsufflation,time for fluid diet intake and duration of postoperative hospital stay were 180 minutes (range,150-260 minutes),100 mL (range,50-350 mL),3 days (range,2-6 days),4 days (range,3-7 days) and 12 days (range,10-22 days),respectively.Of 3 with postoperative complications in the 32 patients,1 with paralytic ileus,1 with wound infection and 1 with diarrhea were improved by symptomatic treatment.(2) Postoperative pathological examination:the number of dissected lymph nodes,number of dissected central lymph nodes and length of surgical specimen were 28 (range,19-43),8 (range,6-12) and 30 cm (range,25-39 cm),respectively,with negative incision margins.Postoperative tumor pathological staging showed that stage pTl,pT2,pT3 and pT4a were detected in 2,8,19 and 3 patients,and stage pN0,pN1 and pN2 in 16,12 and 4 patients,respectively.Postoperative tumor pathological typing showed that 3,7,18 and 4 patients were respectively diagnosed with mucinous adenocarcinoma,high differentiated adenocarcinoma,moderate differentiated adenocarcinoma and low differentiated adenocarcinoma.(3) Follow-up situations:32 patients were followed-up for 1-22 months,with an average time of 11 months.During the follow-up,6 patients were complicated with distant metastasis and the others had disease-free survival.Conclusion Laparoscopic right hemicolectomy via limited medial approach is safe and feasible,with a good short-term outcome.

Correlation between Adolescent Scoliosis and Biomechanical Factors / 中国康复理论与实践

Objective To study the relationship between adolescent scoliosis and various biomechanical factors. Methods A total of 637 students in grade four to six in a primary school of Zhaoyang District in Zhaotong,Yunnan,Chi-na were screened for scoliosis in December,2016.Finally,a case control study of 19 patients with idiopathic sco-liosis who had been diagnosed by X-ray was carried out.According to the matching criteria,42 students were col-lected as control group.Then,eleven biomechanical factors were analyzed and evaluated in two groups.Those factors included unequal shoulders,cervical lateral flexion,cervical rotation,thoracic lateral flexion,thoracic ro-tation,lumbar lateral flexion,lumbar rotation,lateral tilt of pelvis,anterior and posterior pelvic tilt,leg inequality and flat foot. Eventually, the biomechanical factors were statistically analyzed with binary Logistic regression analysis. Results and Conclusion The unequal shoulders,thoracic rotation,lateral tilt of pelvis,leg inequality and flat foot were the risk factors for scoliosis(P<0.05).Detailed posture assessment should be carried out to find the biomechani-cal factors leading to abnormal posture,and achieve the goals of the more targeted medical intervention for the patients with spinal asymmetry.