Evaluation of the clinical efficacy of nasointestinal ileus tube in the operation of extensive adhesive small bowel obstruction / 国际外科学杂志

Objective:To evaluate the feasibility and clinical effectiveness of placing a nasointestinal ileus tube (NTI) during extensive adhesive bowel obstruction (ABO) surgery.Methods:A retrospective analysis was performed for the clinical and follow-up data of 60 patients with extensive ABO admitted to the Department of General Surgery of Daxing District Hospital of Capital Medical University from April 2019 to April 2021, of which 30 patients underwent intraoperative NIT intraintestinal alignment (observation group) and 30 patients who did not undergo NIT intraintestinal alignment (control group) during the same period. There were 12 males and 18 females in the observation group. There were 16 males and 14 females in the control group. The operation time, gastrointestinal function recovery time, discharge time, total effective rate and postoperative complication rate were compared between the two groups, and the quantitative data of the recurrence rate of intestinal obstruction at 24 months after surgery were expressed as mean ± standard deviation ( ± s), and the t-test was used for comparison between groups. Numerological data were presented as cases (percentage) [ n (%)], and chi-square tests were used for comparison between groups. Results:All patients were successfully completed the surgery and discharged from the hospital. There was no statistically significant difference in total effective rate between the control group and the observation group( χ2=3.16, P=0.237). The surgical time in the observation group was slightly longer than that in the control group [(110.6±4.6) min vs (94.3±2.5) min, t=17.27, P=0.001]. The recovery time of gastrointestinal function and hospitalization time in the observation group were shorter than those in the control group[(8.13±1.00) d vs (8.70±0.70) d, t=2.53, P=0.014; (12.83±1.57) d vs (13.67±1.03) d, t=0.03, P=0.018]. The incidence of postoperative complications was lower than that in the control group (10% vs 30%, P=0.028), and the difference was statistically significant. Conclusion:Intraoperative application of NIT is safe and effective, and can significantly reduce the recurrence rate of postoperative intestinal obstruction.

Comparison of clinical efficacy of NOSES combined with ERAS and conventional laparoscopic surgery in treatment of rectal cancer / 解放军医学杂志

Objective To compare the clinical efficacy of natural orifice specimen extraction surgery(NOSES)combined with enhanced recovery after surgery(ERAS)and conventional laparoscopic surgery in treatment of rectal cancer patients.Methods A hundred patients with rectal cancer in the Department of Colorectal and Anal Surgery,the 940th Hospital of Joint Logistics Support Force of PLA were selected as the research objects from January 2019 to December 2021,including 49 cases treated with NOSES combined with ERAS were set as the observation group,and 51 cases treated with conventional laparoscopic surgery of rectal cancer were set as the control group.Postoperative C-reactive protein(CRP),procalcitonin(PCT),interleukin-6(IL-6),white blood cell count(WBC),percentage of neutrophil(NEUT),K+ concentration,postoperative peristalsis recovery time,first time out-of-bed activity,first liquid feeding time,removal time of urinary,and drainage tubes,hospital stay and intraoperative blood loss,number of lymph node detection,positive margin rate,incidence of complications,and pain score were compared between the two groups.Results The observation group showed significant lower postoperative CRP,PCT,IL-6 levels when compared with control group(P<0.05),while no significant difference in K+ concentration between the two groups(P>0.05).The recovery time of intestinal peristalsis,the time of the first out-of-bed activity,the first liquid feeding time,the time of removal of the urinary tube and the drainage tube,and the number of days of hospitalization in observation group were all superior to the control group(P<0.05).The observation group with the duration of surgery was longer than the control group,and the difference was statistically significant(P<0.05).There were no significant differences in intraoperative bleeding,number of lymph nodes detected and positive rate of resection margins between the two groups(P>0.05).There was no significant difference in the incidence of complications between the two groups(4.1%vs.7.8%,P>0.05).The observation group showed significant lower pain scores than control group on the 1st,2nd and 3rd day after surgery(P<0.05).Conclusions NOSES combined with ERAS in treatment of rectal cancer patients is safe and feasible,can narrow the surgical incision,alleviate stress response and postoperative pain,improve postoperative efficacy and reduce the occurrence of complications,so is worthy of promotion and application.

Research advances on the applications of functional magnetic resonance imaging for evaluating kidney transplant function / 中华器官移植杂志

After kidney transplantation , timely detection of changes in transplanted kidney function may guide clinical managements and prevent or delay irreversible damage to transplanted kidney. Functional magnetic resonance imaging (fMRI) of transplanted kidney is a promising non-invasive technique of acquiring microstructural and microfunctional profiles of transplanted kidney. In recent years, various diffusion imaging modalities, arterial spin labeling (ASL) and blood oxygen level dependent-magnetic resonance imaging (BOLD-MRI) have gradually been applied for transplant kidneys. Transplant kidney function may be evaluated non-invasively from such microscopic perspectives as water molecule diffusion, blood flow perfusion and blood oxygen level. This review focused upon evaluating the renal function and identifying the causes of the renal function decline of transplanted kidney through various fMRI techniques and provide new rationales for clinical diagnosis.

Analysis of oligoclonal bands detection results of 3 217 patients with neurological disorders / 中华检验医学杂志

Objective:To study positive rates and typing of oligoclonal bands (OCB) in patients with neurological disorders, and to reveal the clinical significance and applicational value of OCB test.Methods:A retrospective analysis was performed on the detection results of 3 217 patients with neurological disorders who undertook both serum and cerebrospinal fluid OCBs in the First Hospital of Peking University from January 2012 to August 2022. According to the final diagnosis, the patients were divided into 13 groups including multiple sclerosis (479 cases), neuromyelitis optica spectrum disorders (935 cases), autoimmune encephalitis (192 cases), viral encephalitis (94 cases), nervous system complication after HSCT (232 cases), Guillain-Barré syndrome (644 cases), chronic inflammatory demyelinating polyneuropathy (157 cases), etc. Cerebrospinal fluid and serum OCBs were detected using isoelectric focusing electrophoresis combining immunofixation, then classified into Ⅰ-Ⅴ types according to the morphology. Consequently, positive rates and types were analyzed for each group. χ2 test was used for comparison between groups. Results:The positive rates of cerebrospinal fluid OCB in multiple sclerosis, nervous system complication after hematopoietic stem cell transplantation (HSCT), autoimmune encephalitis, viral encephalitis, neuromyelitis optica spectrum disorders, Guillain-Barré syndrome and chronic inflammatory demyelinating polyneuropathy were respectively 66.8% (320/479), 48.7% (113/232), 46.4%(89/192), 19.1% (18/94), 17.6% (165/935), 9.9% (64/644), 5.1% (8/157). For patients with multiple sclerosis, neuromyelitis optica spectrum disorders, viral encephalitis, and autoimmune encephalitis, Type Ⅱ bands took the majority of cerebrospinal fluid OCB-positive cases with the rates of 94.1% (301/320), 78.7% (70/89), 77.8% (14/18), and 77.6% (128/165) respectively, indicating intrathecal IgG synthesis; for patients with nervous system complication after HSCT, Guillain-Barré syndrome and chronic inflammatory demyelinating polyneuropathy, type Ⅳ bands took the majority of cerebrospinal fluid OCB-positive cases with the rates of 94.7% (107/113), 82.8% (53/64) and 100% (8/8), indicating no obvious intrathecal IgG synthesis. The positive rates of cerebrospinal fluid oligoclonal bands were significantly different among all groups (χ 2=1 268.31, P<0.001). Conclusion:The positive rates of cerebrospinal fluid oligoclonal bands are different among different neurological disorders, in which the positive rate of cerebrospinal fluid OCB is higher with type Ⅱ bands as the majority type in multiple sclerosis, which indicates that the detection and typing of cerebrospinal fluid OCB are helpful for the diagnosis of various neurological diseases, especially for multiple sclerosis.

Clinical observation of a modified minimally invasive intraocular lens fixation surgery / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To observe the clinical effect of invisible anchor hook intraocular lens(IOL)fixation surgery.METHODS: Prospective and uncontrolled case study. A total of 19 patients(19 eyes)with aphakia, IOL dislocation, or lens dislocation from January 2019 to December 2020 were selected for this study, all of whom underwent anchor hook IOL scleral fixation implantation surgery. The main postoperative observation indicators are best corrected visual acuity(BCVA), uncorrected visual acuity(UCVA), corneal endothelial cell density, tilt of IOL position, and complications.RESULTS: The UCVA(LogMAR)before and at 1 mo after surgery was 1.06±0.63 and 0.40±0.26, respectively(P&#x003C;0.01), BCVA(LogMAR)before and at 1 mo after surgery was 0.27±0.51 and 0.06±0.15, respectively(P=0.09), and the average corneal endothelial cell density was 2406±625 and 2004±759 cells/mm2(P=0.13). The complications that occurred at 1 d postoperatively were 2 and higher grade aqueous flare(3 eyes), wrinkling of the corneal posterior elastic layer(2 eyes), and transient elevated intraocular pressure(2 eyes). No IOL dislocation occurred during 24 mo follow-up.CONCLUSION:The anchor hook type IOL scleral interlayer fixation technique, which involves anterograde insertion and retrograde fixation of the interstitial thread, is similar to the principle of anchor hook and achieves good IOL stability and visual effects.

Role of Wnt signaling Pathway in Diabetic Osteoporosis and Traditional Chinese Medicine Intervention： A Review / 中国实验方剂学杂志

Diabetic osteoporosis （DOP） is a kind of bone complication caused by diabetes， which is characterized by the decrease of bone mineral density， the change of bone microstructure and the increase of bone fragility. The process of DOP is closely related to high glucose， insulin resistance， oxidative stress and other mechanisms. The Wnt/β-catenin signaling pathway plays an important role in mediating insulin resistance and bone metabolic balance in diabetes. Regulation of Wnt signal transduction promotes the expression of glycogen synthase kinase-3β（GSK-3β）phosphorylation and improves glucose and lipid metabolism. The Wnt/β-catenin signaling pathway is also an important way regulating osteocyte-driven bone remodeling， which not only plays an important regulatory role in the balance between osteoblasts and osteoclasts and improve bone metabolic homeostasis， but also promotes the expression of osteopontin， osteocalcin and type Ⅰ collagen， and improves bone proliferation and osteogenic differentiation by regulating the Wnt pathway. In recent years， the research of traditional Chinese medicine （TCM） in the prevention and treatment of DOP has gradually increased， and the exploration of TCM to interfere with the Wnt pathway to improve DOP has made some progress. This paper collects and summarizes the studies on the Wnt signaling pathway in glucose metabolism， bone metabolism and DOP worldwide in the past decade， as well as the related literature on the intervention of DOP by TCM compounds （classical and other compounds）， single Chinese medicine and TCM monomers based on the Wnt pathway， in order to provide a reference and direction for the development of new drugs for clinical prevention and treatment of DOP.

Application of a self-designed pre-positioned 3D honeycomb guide device in internal fixation with percutaneous cannulated screws for treatment of femoral neck fractures / 中华创伤骨科杂志

Objective:To evaluate our self-designed pre-positioned 3D honeycomb guide device in the internal fixation with percutaneous cannulated screws for femoral neck fractures.Methods:A retrospective study was conducted to analyze the data of 60 patients with femoral neck fracture who had been treated with cannulated screw fixation at Department of Orthopaedics, Kunshan Hospital of Traditional Chinese Medicine Affiliated to Nanjing University of Traditional Chinese Medicine from June 2019 to June 2022. According to the difference in intraoperative positioning for placement of cannulated screws, the patients were divided into a study group of 30 cases whose placement of cannulated screws was assisted by our self-designed pre-positioned 3D honeycomb guide device, and a control group of 30 cases whose cannulated screws were positioned freehand. In the study group, there were 17 males and 13 females with an age of (44.9±9.2) years, and 2 cases of type Ⅱ, 18 cases of type Ⅲ, and 10 cases of type Ⅳ by the Garden classification. In the control group, there were 11 males and 19 females with an age of (43.5±7.9) years), and 1 case of type Ⅱ, 16 cases of type Ⅲ, and 13 cases of type Ⅳ by the Garden classification. Closed reduction and inverted triangle internal fixation with 3 cannulated screws were conducted for all fractures. The Garden crossline index, operation time, fluoroscopy frequency, needle drillings, fracture healing time, and Harris hip functional score at the last follow-up were compared between the 2 groups. The postoperative imaging indicators in the 2 groups were measured, including screw spacing, distance from screw to neck cortex, screw coverage area, parallel deviation between screws, and deviation from screw to neck axis.Results:There were no statistically significant differences in the baseline characteristics between the 2 groups, indicating comparability ( P>0.05). All patients were followed up for (14.4±1.9) months after surgery. In the study group, operation time [(33.1±5.5) min], fluoroscopy frequency [(13.7±2.2) times], needle drillings [(3.7±0.6) times], distance from screw to neck cortex [(12.4±2.8) mm], parallel deviation between screws in the anteroposterior view (2.2°±1.1°), parallel deviation between screws in the lateral view (2.4°±1.0°), deviation from screw to neck axis in the anteroposterior view (4.0°±0.9°) and deviation from screw to neck axis in the lateral view (3.2°±0.8°) were all significantly smaller than those in the control group [(46.5±8.6) min, (23.1±5.2) times, (11.0±2.2) times, (19.0±3.3) mm, 6.5°±2.6°, 7.1°±2.9°, 7.7°±2.6°, and 9.2°±3.1°] (all P<0.05). The screw spacing [(45.7±5.8) mm] and screw coverage area [(74.1±10.9) mm 2] in the study group were both significantly larger than those in the control group [(31.3±7.7) mm and (55.5±9.0) mm 2] ( P<0.05). There was no statistically significant difference between the 2 groups in Garden crossline index, fracture healing time, follow-up time, or Harris hip functional score at the last follow-up ( P>0.05). Follow-ups revealed 1 case of bone non-union in the study group and 2 cases of bone non-union and screw withdrawal in the control group, but no such complications as infection, deep vein thrombosis, screw penetration or rupture, or femoral head necrosis in either group. Conclusion:In the internal fixation with percutaneous cannulated screws for the treatment of femoral neck fractures, our self-designed pre-positioned 3D honeycomb guide device can shorten surgical time, significantly reduce fluoroscopy frequency and needle drillings, and effectively improve accuracy of screw placement.

Effect of the impaction of posterior wall on the prognosis following open reduction and internal fixation for fractures of acetabular posterior wall / 中华创伤骨科杂志

Objective:To evaluate the effect of the impaction of posterior wall on the prognosis following open reduction and internal fixation for fractures of acetabular posterior wall.Methods:A retrospective study was conducted to analyze the data from the 83 patients with fracture of acetabular posterior wall who had been consecutively treated by open reduction and internal fixation at Department of Orthopaedics and Traumatology, Beijing Jishuitan Hospital from January 2017 to December 2020. The patients were divided into 2 groups based on involvement of posterior wall impaction. In the impaction group of 33 cases, there were 26 males and 7 females with an age of (47.4±11.6) years; in the non-impaction group of 50 cases, there were 43 males and 7 females with an age of (41.3±12.0) years. The quality of postoperative fracture reduction, the function of the affected hip at the last follow-up, and the complication rate during follow-up were compared between the 2 groups. Multifactorial binary logistic regression and age subgroups were used to analyze the effects of posterior wall impaction on functional outcomes.Results:The age, rate of associated injuries in other body parts, and rate of posterior wall comminution in the impaction group were significantly higher than those in the non-impaction group ( P<0.05), but there was no statistically significant difference in other general data of patients between the 2 groups ( P>0.05). All patients were followed up for (44.5±13.3) months after surgery. The rate of anatomical reduction in the non-impaction group (96.0%, 48/50) was significantly higher than that in the impaction group (57.6%, 19/33) ( P<0.05), and the good and excellent rate by the modified Merle d'Aubigné & Postel scale at the last follow-up in the non-impaction group (84.0%, 42/50) was significantly higher than that in the impaction group (51.5%, 17/33) ( P<0.05). There was no significant difference in the incidence of complications between the 2 groups ( P>0.05). After adjusting for age and gender, the difference in hip function was still significantly different between the 2 groups ( OR=0.23, 95% CI: 0.06 to 0.79, P=0.020). The effect of posterior wall impaction on functional outcomes was statistically significant in patients aged ≥50 years ( P=0.008), whereas the difference was not statistically significant in patients aged <50 years ( P=0.194). Conclusions:Compared with non-impaction ones, acetabular fractures of posterior wall impaction tend to lead to poorer quality of reduction, which in turn affects the postoperative recovery of hip joint function. The impact of impaction fractures on functional recovery is more significant in patients aged 50 years and above.

Expression of MutS homolog 3 in oral squamous cell carcinoma and its significance / 中国现代医生

Objective To investigate the expression of MutS homolog 3(MSH3)in oral squamous cell carcinoma and its significance.Methods The MSH3 protein expression was examined by immunohistochemistry in 20 normal oral mucosa and 60 oral squamous cell carcinoma tissues.Results Our results showed that MSH3 expression in oral squamous cell carcinoma tissues was lower than normal oral mucosa.The MSH3 expression in oral squamous cell carcinoma tissues with better differentiation was higher than that with worse differentiation.The positive MSH3 expression decreased from oral squamous cell carcinoma patients without lymph nodal metastasis to that with metastasis.MSH3 expression was not related to the patients'gender,age,tumour location or size.Conclusion Downregulation of MSH3 is consistent with poorly differentiation and nodal metastasis in oral squamous cell carcinoma.MSH3 may play a significant role in the malignant progression of oral squamous cell carcinoma.

The function and drug development progress of free fatty acid receptor 1 in chronic inflammatory diseases / 药学学报

As a member of G protein coupled-receptors superfamily, free fatty acid receptor 1 (FFAR1), is also known as GPR40, has been shown to regulate numerous pathophysiological processes in a variety of tissues and organs. The activated FFAR1 has a variety of biological functions. For instance, it can not only regulate metabolism of fatty acids and glucose, but also play an important role in immune inflammatory response, it may be a potential drug target for the treatment of various chronic inflammatory diseases. In this review, we focus on the recent researches of FFAR1's action in the regulation of pathophysiological processes, its molecular mechanism and new agonists development. At the same time, this review will take the discovery of series FFAR1 agonists as examples, and display the applied prospects of FFAR1.

Ketogenic diet improves low temperature tolerance in mice by up-regulating PPARα in the liver and brown adipose tissue / 生理学报

The aim of the present study was to investigate the effects of short-term ketogenic diet on the low temperature tolerance of mice and the involvement of peroxisome proliferator-activated receptor α (PPARα). C57BL/6J mice were divided into two groups: normal diet (WT+ND) group and ketogenic diet (WT+KD) group. After being fed with normal or ketogenic diet at room temperature for 2 d, the mice were exposed to 4 °C low temperature for 12 h. The changes in core temperature, blood glucose, blood pressure of mice under low temperature condition were detected, and the protein expression levels of PPARα and mitochondrial uncoupling protein 1 (UCP1) were detected by Western blot. PPARα knockout mice were divided into normal diet (PPARα-/-+ND) group and ketogenic diet (PPARα-/-+KD) group. After being fed with the normal or ketogenic diet at room temperature for 2 d, the mice were exposed to 4 °C low temperature for 12 h. The above indicators were also detected. The results showed that, at room temperature, the protein expression levels of PPARα and UCP1 in liver and brown adipose tissue of WT+KD group were significantly up-regulated, compared with those of WT+ND group. Under low temperature condition, compared with WT+ND, the core temperature and blood glucose of WT+KD group were increased, while mean arterial pressure was decreased; The ketogenic diet up-regulated PPARα protein expression in brown adipose tissue, as well as UCP1 protein expression in liver and brown adipose tissue of WT+KD group. Under low temperature condition, compared to WT+ND group, PPARα-/-+ND group exhibited decreased core temperature and down-regulated PPARα and UCP1 protein expression levels in liver, skeletal muscle, white and brown adipose tissue. Compared to the PPARα-/-+ND group, the PPARα-/-+KD group exhibited decreased core temperature and did not show any difference in the protein expression of UCP1 in liver, skeletal muscle, white and brown adipose tissue. These results suggest that the ketogenic diet promotes UCP1 expression by up-regulating PPARα, thus improving low temperature tolerance of mice. Therefore, short-term ketogenic diet can be used as a potential intervention to improve the low temperature tolerance.

Therapeutic effect of ursodeoxycholic acid-berberine supramolecular nanoparticles on ulcerative colitis based on supramolecular system induced by weak bond / 中国中药杂志

Ulcerative colitis(UC) is a recurrent, intractable inflammatory bowel disease. Coptidis Rhizoma and Bovis Calculus, serving as heat-clearing and toxin-removing drugs, have long been used in the treatment of UC. Berberine(BBR) and ursodeoxycholic acid(UDCA), the main active components of Coptidis Rhizoma and Bovis Calculus, respectively, were employed to obtain UDCA-BBR supramolecular nanoparticles by stimulated co-decocting process for enhancing the therapeutic effect on UC. As revealed by the characterization of supramolecular nanoparticles by field emission scanning electron microscopy(FE-SEM) and dynamic light scattering(DLS), the supramolecular nanoparticles were tetrahedral nanoparticles with an average particle size of 180 nm. The molecular structure was described by ultraviolet spectroscopy, fluorescence spectroscopy, infrared spectroscopy, high-resolution mass spectrometry, and hydrogen-nuclear magnetic resonance(H-NMR) spectroscopy. The results showed that the formation of the supramolecular nano-particle was attributed to the mutual electrostatic attraction and hydrophobic interaction between BBR and UDCA. Additionally, supramolecular nanoparticles were also characterized by sustained release and pH sensitivity. The acute UC model was induced by dextran sulfate sodium(DSS) in mice. It was found that supramolecular nanoparticles could effectively improve body mass reduction and colon shortening in mice with UC(P<0.001) and decrease disease activity index(DAI)(P<0.01). There were statistically significant differences between the supramolecular nanoparticles group and the mechanical mixture group(P<0.001, P<0.05). Enzyme-linked immunosorbent assay(ELISA) was used to detect the serum levels of tumor necrosis factor-α(TNF-α) and interleukin-6(IL-6), and the results showed that supramolecular nanoparticles could reduce serum TNF-α and IL-6 levels(P<0.001) and exhibited an obvious difference with the mechanical mixture group(P<0.01, P<0.05). Flow cytometry indicated that supramolecular nanoparticles could reduce the recruitment of neutrophils in the lamina propria of the colon(P<0.05), which was significantly different from the mechanical mixture group(P<0.05). These findings suggested that as compared with the mechanical mixture, the supramolecular nanoparticles could effectively improve the symptoms of acute UC in mice. The study provides a new research idea for the poor absorption of small molecules and the unsatisfactory therapeutic effect of traditional Chinese medicine and lays a foundation for the research on the nano-drug delivery system of traditional Chinese medicine.

Research progress on the effects and mechanisms of electroacupuncture on radiation-induced brain injury / 生理学报

Radiation-induced brain injury is a serious complication after cranio-cerebral radiotherapy, which affects the patient's quality of life and survival. A large number of studies have shown that various mechanisms such as neuronal apoptosis, blood-brain barrier damage, and synaptic dysfunction may be related to radiation-induced brain injury. Acupuncture has an important role in clinical rehabilitation of various brain injuries. As a new type of acupuncture, electroacupuncture has the characteristics of strong control ability, uniform and long-lasting stimulation, and is widely used in clinic. This article reviews the effects and mechanisms of electroacupuncture on radiation-induced brain injury, in order to provide a theoretical basis and experimental support for reasonable clinical application.

Regulation of ischemic stroke by circadian rhythm and intervention by traditional Chinese medicine / 中国中药杂志

Circadian rhythm is an internal regulatory mechanism formed in organisms in response to the circadian periodicity in the environment, which modulates the pathophysiological events, occurrence and development of diseases, and the response to treatment in mammals. It significantly influences the susceptibility, injury, and recovery of ischemic stroke, and the response to therapy. Accumulating evidence indicates that circadian rhythms not only regulate the important physiological factors of ischemic stroke events, such as blood pressure and coagulation-fibrinolysis system, but also participate in the immuno-inflammatory reaction mediated by glial cells and peripheral immune cells after ischemic injury and the regulation of neurovascular unit(NVU). This article aims to link molecular, cellular, and physiological pathways in circadian biology to the clinical consequences of ischemic stroke and to illustrate the impact of circadian rhythms on ischemic stroke pathogenesis, the regulation of NVU, and the immuno-inflammatory responses. The regulation of circadian rhythm by traditional Chinese medicine is reviewed, and the research progress of traditional Chinese medicine intervention in circadian rhythm is summarized to provide a reasonable and valuable reference for the follow-up traditional Chinese medicine research and molecular mechanism research of circadian rhythm.

Knowledge graph analysis of pyroptosis research in traditional Chinese medicine based on VOSviewer and CiteSpace / 中国中药杂志

To explore the research hotspots and frontier directions of pyroptosis in the field of traditional Chinese medicine(TCM), the authors searched CNKI and Web of Science for literature related to pyroptosis in TCM, screened literature according to the search strategy and inclusion criteria, and analyzed the publication trend of the included literature. VOSviewer was used to draw author cooperation and keyword co-occurrence network diagrams, and CiteSpace was employed for keyword clustering, emergence, and timeline view. Finally, 507 Chinese literature and 464 English literature were included, and it was found that the number of Chinese and English literature was increasing rapidly year by year. The co-occurrence of the authors showed that in terms of Chinese literature, there was a representative research team composed of DU Guan-hua, WANG Shou-bao and FANG Lian-hua, and for English literature, the representative research team was composed of XIAO Xiao-he, BAI Zhao-fang and XU Guang. The network visualization of Chinese and English keywords revealed that inflammation, apoptosis, oxidative stress, autophagy, organ damage, fibrosis, atherosclerosis, and ischemia-reperfusion injury were the primary research diseases and pathological processes in TCM; berberine, resveratrol, puerarin, na-ringenin, astragaloside Ⅳ, and baicalin were the representative active ingredients; NLRP3/caspase-1/GSDMD, TLR4/NF-κB/NLRP3, and p38/MAPK signaling pathways were the main research pathways. Keyword clustering, emergence, and timeline analysis indicated that the pyroptosis research in TCM focused on the mechanism of TCM monomers and compounds intervening in diseases and pathological processes. Pyroptosis is a research hotspot in the area of TCM, and the current discussion mainly focuses on the mechanism of the therapeutic effect of TCM.

Latent period and incubation period with associated factors of COVID-19 caused by Omicron variant / 中华预防医学杂志

Objective: To estimate the latent period and incubation period of Omicron variant infections and analyze associated factors. Methods: From January 1 to June 30, 2022, 467 infections and 335 symptomatic infections in five local Omicron variant outbreaks in China were selected as the study subjects. The latent period and incubation period were estimated by using log-normal distribution and gamma distribution models, and the associated factors were analyzed by using the accelerated failure time model (AFT). Results: The median (Q1, Q3) age of 467 Omicron infections including 253 males (54.18%) was 26 (20, 39) years old. There were 132 asymptomatic infections (28.27%) and 335 (71.73%) symptomatic infections. The mean latent period of 467 Omicron infections was 2.65 (95%CI: 2.53-2.78) days, and 98% of infections were positive for nucleic acid test within 6.37 (95%CI: 5.86-6.82) days after infection. The mean incubation period of 335 symptomatic infections was 3.40 (95%CI: 3.25-3.57) days, and 97% of them developed clinical symptoms within 6.80 (95%CI: 6.34-7.22) days after infection. The results of the AFT model analysis showed that compared with the group aged 18-49 years old, the latent period [exp(β)=1.36 (95%CI: 1.16-1.60), P<0.001] and incubation period [exp(β)=1.24 (95%CI: 1.07-1.45), P=0.006] of infections aged 0-17 years old were prolonged. The latent period [exp(β)=1.38 (95%CI: 1.17-1.63), P<0.001] and the incubation period [exp(β)=1.26 (95%CI: 1.06-1.48), P=0.007] of infections aged 50 years old and above were also prolonged. Conclusion: The latent period and incubation period of most Omicron infections are within 7 days, and age may be a influencing factor of the latent period and incubation period.

Early identification and influencing factors of post-traumatic stress disorder in high-stress rescue workers / 中华预防医学杂志

Objective: To explore the risk intensity and related influencing factors of post-traumatic stress disorder (PTSD) among high-stress rescue workers, and to provide effective tools for the risk assessment of PTSD in military rescue workers. Method: From June to August 2022, cluster sampling was used to select the high-stress rescue personnel of an Army department as the survey subjects. The acute Stress reaction (ASD) scale and PTSD checklist were used to evaluate the risk of PTSD in military rescue personnel. Multivariate logistic regression were used to analyze the influencing factors of PTSD. Results: The age of 4 460 subjects was (24.38±4.072) years old, including 4 396 males (98.6%). The positive rate of initial screening for ASD was 2.85% (127/4 460). The positive rate of PTSD was 0.67% (30/4 460). Multivariate logistic regression model analysis showed that female, older age, recent trauma exposure history, passive smoking and alcohol consumption were at higher risk of ASD, the values of OR (95%CI) were 4.183 (1.819-9.618), 6.278 (1.363-28.912), 3.094 (1.500-6.379), 2.059 (1.298-3.267) and 2.607 (1.614-4.211), respectively; Lower education level was associated with lower risk of ASD, OR (95%CI) was 0.593 (0.359-0.978); People who are older, thinner, have a history of mental illness, and drink alcohol were at higher risk for PTSD, the values of OR (95%CI) were 20.144 (2.459-165.043), 10.287 (2.218-47.700), 91.104 (8.592-965.980) and 2.866 (1.144-7.180), respectively. Conclusion: Gender, age, education level, passive smoking, alcohol consumption, past history of mental illness and body mass index may be related to the potential risk of PTSD in rescue workers,passive smoking, alcohol consumption, and weight controlling should be focused on to reduce potential risks of PTSD.

Analysis of the clinical effect of percutaneous pedicle screw fixation combined with transpedicular bone grafting in the treatment of thoracolumbar fracture / 中国骨伤

OBJECTIVE@#To investigate the clinical efficacy of percutaneous screw fixation combined with minimally invasive transpedicular bone grafting and non-bone grafting in the treatment of thoracolumbar fractures.@*METHODS@#From Janury 2021 to June 2022, 40 patients with thoracolumbar fracture were divided into the experimental group and the control group. There were 26 patients in the experimental group, including 21 males and 5 females with an aberage age of (47.3±12.3) years old, who underwent percutaneous pedicle screw fixation combined with transpedicular autogenous bone grafting. In the control group, 14 patients received percutaneous pedicle screw fixation only. including 7 makes and 7 females with an average age of (50.2±11.2) years old. The operative time, intraoperative blood loss, anterior height ratio of injured vertebrae, Cobb angle, visual analogue score (VAS), MacNab scores, loosening or broken of the implants. were compared and analyzed.@*RESULTS@#There was no significant difference in operation time, intraoperative blood loss, VAS and anterior height ratio of injured vertebrae between the two groups. Compared with the preoperative results, VAS and anterior height ratio of injured vertebrae were improved statistically(P<0.05). For Cobb angle of injured vertebra, there was no significant difference between the two groups before surgery (P=0.766). While at 1 week, 3 months and 12 months after surgery, there were statistically differences between the two groups (P values were 0.042, 0.007 and 0.039, respectively). The Cobb angle of injured vertebrae one year after operation was statistically decreased in both groups compared with that before surgery (P<0.001). One year after surgery, the excellent and good rate of Macnab scores was 96.15% in the experimental group and 92.86% in the control group, and there was no statistical differences between the two groups (P=0.648). There was one patient in the control group suffering superficial wound infection on the third day, which was cured by dressing change and anti-infection treatment. There were no postoperative screw loosening and broken in both groups.@*CONCLUSION@#The two surgical methods have the advantages of less trauma, less pain and quicker recovery, which can restore the height of the injured vertebra, reconstruct the spinal sequence and reduce the fracture of the vertebral body. Transpedicular autogenous bone grafting can increase the stability of the fractured vertebra and maintain the height of the vertebra better after surgery, thus reducing the possibility of complications such as kyphosis, screw loosening and broken.

Effect of Synergistic Treatment with Qingjin Huazhuo Formula （清金化浊方） on Thrombotic Events in Hospitalized Patients of Acute Exacerbation of Chronic Obstructive Pulmonary Disease with Phlegm Heat Stasis Obstructing in the Lung Syndrome： A Retrospective Cohort Study / 中医杂志

ObjectiveTo analyze the effect and possible mechanism of the synergistic treatment with Qingjin Huazhuo Formula （清金化浊方， QHF） on the occurrence of thrombotic events in hospitalized patients with acute exacerbation of chronic obstructive pulmonary disease （AECOPD） and phlegm heat stasis obstructing in the lung syndrome. MethodsIn a retrospective cohort study， 305 AECOPD inpatients with the syndrome of phlegm heat stasis obstructing in the lung were included. According to whether using QHF （the course of treatment ≥ 7 days）， they were divided into the exposure group （193 cases） and the non-exposure group （112 cases）. Totally， 109 pairs of cases were obtained by 1∶1 propensity score matching （PSM）. After matching， the occurrence of thrombotic events during hospitalization， the remission of main symptoms or signs （including cough， expectoration， wheezing， cyanosis） after 10 days （±3 days） of treatment， and the difference of the indicators including D-dimer， percentage of neutrophils （NEUT%）， C-reactive protein （CRP）， arterial partial pressure of oxygen （PaO2）， and arterial partial pressure of carbon dioxide （PaCO2） before treatment and after 10 days （±3 days） of treatment during the first auxiliary examination. ResultsAfter matching， the incidence of thrombotic events during hospitalization in the exposure group （5 cases， 4.59%） were lower than that of the non-exposure group （15 cases， 13.76%， P＜0.05）. The exposure factor that taking QHF for 7 days or above was a protective factor for thrombotic events in AECOPD hospitalized patients with phlegm heat stasis obstructing in the lung syndrome （RR = 0.333， 95% CI 0.126 to 0.885）. The remission rates of cough （100/109， 91.74%）， expectoration （103/109， 94.50%）， wheezing （102/109， 93.58%）， and cyanosis （97/109， 88.99%） in the exposure group were significantly higher than those in the non-exposure group （90/109， 82.57%； 94/109， 86.24%； 89/109， 81.65%； 86/109， 78.90%） after treatment （P＜0.05）. After treatment， the levels of D-dimer， NEUT%， CRP and PaCO2 in both groups significantly decreased （all P＜0.05）， and the level of PaO2 significantly increased （P＜0.05）. The difference of the levels of D-dimer， NEUT% and PaO2 in the exposure group before and after treatment were larger than those in the non-exposure group （P＜0.05）， while the pre-post difference of CRP and PaCO2 were not significantly different between the two groups （P＞0.05）. ConclusionThe synergistic treatment with QHF can effectively reduce the occurrence of thrombotic events， alleviate the clinical symptoms or signs such as cough， expectoration， wheezing， and cyanosis， and can improve lung function in hospita-lized patients with AECOPD and phlegm heat stasis obstructing in the lung syndrome. Its mechanism may be related to improving blood coagulation and inflammatory status.

The application of MOOC combined with peer mutual assistance in cardiopulmonary resuscitation teaching / 中华医学教育探索杂志

Objective:To explore the application effect of massive open online course (MOOC) combined with peer mutual assistance in cardiopulmonary resuscitation teaching.Methods:A total of 140 students in the same class of Batch 2015 were divided into the experimental group and the control group. In the teaching of cardiopulmonary resuscitation, the experimental group was based on the MOOC teaching platform, watched videos and topic tests before class, and used the peer mutual assistance in class. While the control group adopted traditional classroom teaching mode. The teaching effect of the two groups were evaluated by comparing the operation assessment scores and questionnaire survey of students' satisfaction with teaching. SPSS 22.0 was used for t-test and Chi-square test. Results:The operating assessment score of the experimental group was (82.20±2.31), and the operating assessment score of the control group was (75.80±1.72). The difference was statistically significant ( t=3.27, P<0.05). The questionnaire survey showed that the course satisfaction and learning motivation of the experimental group were better than those of the control group. In learning burden, the two groups had similar results ( P=0.739). Conclusion:MOOC combined with peer mutual assistance in cardiopulmonary resuscitation teaching can help students better master skills, improve students' course satisfaction and learning motivation, without increasing their learning burden.