Construction and application of a mixed-reality distance teaching model in neurosurgery / 中华医学教育探索杂志

Objective:To explore the application effects of a neurosurgical mixed-reality distance teaching (NMDT) model in standardized residency training in neurosurgery.Methods:We built an NMDT system using mixed-reality technology and remote interaction technology, and designed the implementation procedure according to the teaching objectives. After the teaching activities were completed, a teaching satisfaction questionnaire survey was conducted among 20 neurosurgery resident trainees, in which they provided satisfaction scores for the same teaching content with different teaching models (i.e., the NMDT model and traditional teaching model). SPSS 22.0 software was used to perform the t test for data analysis. Results:There were significant differences between the NMDT model and the traditional teaching model in key indicators including the score for "completion of teaching objectives" (9.20±0.68 vs. 8.25±0.70, P<0.001) and the score for "satisfaction with learning gains" score (8.95±0.67 vs. 8.05±0.92, P=0.001). The NMDT model also outperformed the traditional teaching model in the other individual scores and the total score. Conclusions:The NMDT model can improve teaching quality, increase training efficiency, and enrich teaching content, which is worthy of promotion.

Clinical analysis of laparoscopic treatment of chronic traumatic diaphragmatic hernia in 29 cases / 中华外科杂志

Objective: To examine the safety and effectiveness of laparoscopic individualized surgical treatment for chronic traumatic diaphragmatic hernia (CTDH). Methods: The clinical data and follow-up data of 29 CTDH cases admitted to the Qilu Hospital of Shandong University or the First Affiliated Hospital of Shandong First Medical University from June 2015 to January 2023 were retrospectively analyzed. There were 21 males and 8 females, aged (49.4±17.8) years (range: 19 to 79 years). The main clinical manifestations were symptoms of the digestive system and respiratory system, and only 4 cases were asymptomatic. All patients received laparoscopic treatment (conversion to open surgery was not excluded). Intraoperative exploration (location of the hernia, contents of the hernia, diameter of the hernia ring), surgical conditions (surgical repair plan, operation time, blood loss, postoperative complications) and postoperative follow-up were analyzed and discussed. Results: Laparoscopic repair was successfully completed in 27 cases, including simple suture in 6 cases, suture and patch repair in 17 cases, the anterior abdominal wall muscle flap reversal suture and patch repair of in 3 cases, and patch bridge repair in 1 case. The operation time was (112.8±44.7) minutes (range: 60 to 200 minutes). The amount of bleeding (M(IQR)) was 35 (58) ml (range: 10 to 300 ml). The other 2 patients were converted to laparotomy. Except for one patient with transverse colon strangulation necrosis who died of aggravated pulmonary infection after surgery, the remaining 28 patients were discharged successfully. The follow-up time was 36 (24) months (range: 1 to 60 months). During the follow-up period, only two patients had occasional left upper abdominal discomfort. Twenty-seven patients with left diaphragmatic hernia had no recurrence, and the symptoms of 1 patient with right diaphragmatic hernia were relieved. Conclusion: Customized laparoscopic surgical repair for CTDH according to the location and size of the diaphragmatic defect can achieve good surgical results.

Analysis of the causes of long-standing pelvic anterior sacral space infection and discussion of management techniques / 中华肿瘤杂志

Objective: To investigate the causes and management of long-term persistent pelvic presacral space infection. Methods: Clinical data of 10 patients with persistent presacral infection admitted to the Cancer Hospital of Zhengzhou University from October 2015 to October 2020 were collected. Different surgical approaches were used to treat the presacral infection according to the patients' initial surgical procedures. Results: Among the 10 patients, there were 2 cases of presacral recurrent infection due to rectal leak after radiotherapy for cervical cancer, 3 cases of presacral recurrent infection due to rectal leak after radiotherapy for rectal cancer Dixons, and 5 cases of presacral recurrent infection of sinus tract after adjuvant radiotherapy for rectal cancer Miles. Of the 5 patients with leaky bowel, 4 had complete resection of the ruptured nonfunctional bowel and complete debridement of the presacral infection using an anterior transverse sacral incision with a large tipped omentum filling the presacral space; 1 had continuous drainage of the anal canal and complete debridement of the presacral infection using an anterior transverse sacral incision. 5 post-Miles patients all had debridement of the presacral infection using an anterior transverse sacral incision combined with an abdominal incision. The nine patients with healed presacral infection recovered from surgery in 26 to 210 days, with a median time of 55 days. Conclusions: Anterior sacral infections in patients with leaky gut are caused by residual bowel secretion of intestinal fluid into the anterior sacral space, and in post-Miles patients by residual anterior sacral foreign bodies. An anterior sacral caudal transverse arc incision combined with an abdominal incision is an effective surgical approach for complete debridement of anterior sacral recalcitrant infections.

Saliva microbiota and metabolite in individuals with caries or periodontitis / 中华口腔医学杂志

Objective: To detect and analyze the characteristics of oral microbiota in species composition, function and metabolism among caries, periodontitis and oral healthy individuals, hunting for the microbiome-derived biomarkers with specificity and sensitivity to estimate the occurrence of these two diseases. Methods: Saliva samples were collected from 10 patients with high caries risk [decayed-missing-filled teeth (DMFT)≥6, HC group] in Department of Endodontics, 10 patients with periodontitis of grade Ⅱ A-Ⅲ C (PG group) in Department of Periodontology and 10 oral healthy individuals (HH group) from School of Stomatology, The Fourth Military Medical University during from March 2022 to June 2022. A baseline examination was conducted on all participants, including their oral conditions of caries and periodontal health. Metagenomic sequencing (Illumina PE150 platform) and liquid chromatography-mass spectrometry were used to detect microorganisms and their metabolites in the samples respectively. The sequencing data were analyzed to obtain the information of microbial taxonomic composition, functional genes and metabolites in each group of samples. The basic oral conditions and saliva samples of subjects in each group were evaluated and collected by the same professional endodontist. Results: There were no significant difference in baseline characteristics such as age and sex among the subjects in each group (P>0.05). DMFT in HC group (9.0±1.7) was significantly higher than that in HH group (0) and PG group (0) (F=243.00, P<0.001). Sequencing data analysis showed that the taxonomic compositions of salivary microbiota in each group were mainly Firmicutes, Bacteroidetes, Proteobacteria, Actinobacteria and Fusobacteria at the phylum level, and Streptococcus, Neisseria, Rothia, Prevotella at the genus level. Differential analysis showed that, compared with the HH group, HC group and PG group had significant differences in taxonomic composition (P<0.05), and the most significant among them was Prevotella. At the species level, Prevotella pallens was the most significant change in HC group, and Porphyromonas gingivalis in PG group. Metabolite analysis showed that there were significant differences in metabolites between HC group and PG group. The results showed that, compared with the HH group, the most significant metabolite change was 3-hydroxy-1, 5-diphenylpentan-1-one in HC group (P=0.001) and N1 acetylspermine in PG group (P=0.002) respectively. Compared with the PG group, the metabolite of HC group with the most significant difference is D-glucosamine 6-phosphate (P=0.006). The metabolism gene function analysis showed that, the enrichment of carbohydrate metabolism related genes was highest in HC group, followed with HH group, and it was lowest in PG group. In addition, compared with the HH group, the abundance of functional genes related to glucose metabolism, such as ABC transporter and phosphotransferase system, were significantly decreased in PG group (P<0.05), but significantly increased in HC group (P<0.05). Conclusions: There is a significant correlation between the alternation of carbohydrate metabolism of salivary microbiota with the occurrence of caries and periodontitis. In the future, Prevotella pallens and 3-hydroxy-1, 5-diphenylpentan-1-one may be the potential biomarkers of caries; while Porphyromonas gingivalis and N1 acetylspermine work in the predictions of periodontitis.

Clinical characteristics and significance of the supraspinatus fragment in proximal humeral fractures / 中华骨科杂志

Objective:To investigate the clinical characteristics and significance of supraspinatus fragments in proximal humerus fractures.Methods:A total of 210 patients with proximal humerus fractures who underwent surgical treatment in the Department of Orthopaedic and Trauma Surgery, Affiliated Hospital of Yunnan University from July 2016 to December 2020 were retrospectively analyzed. There were 91 males and 119 females, aged 52.4±11.3 years (range, 18-87 years). Preoperatively, the shoulder joint X-ray, CT and 3D reconstruction, and MRI were evaluated for the presence of a small fracture mass on the lateral side of the interarticular sulcus and an "M" shaped fracture mass at the interarticular sulcus. Intraoperative observation, management, postoperative functional exercise and follow-up were performed by the same group of doctors. Postoperative outpatient review was performed at 2, 4, 6, 12, and 24 weeks, shoulder joint X-ray and CT were taken at 2, 6, and 24 weeks to observe the presence of subacromial displaced bone mass. Constant-Murley scale was used to assess shoulder joint function.Results:All 210 patients completed the surgery successfully, and none of them had vascular, nerve or ligament injuries during the operation. According to Neer's classification: 59 cases of two-part humeral greater tuberosity fractures, 36 cases of two-part humeral surgical neck fractures, 50 cases of three-part humeral greater tuberosity fractures, and 65 cases of four-part proximal humeral fractures. 61.0% (128/210) of the patients showed the presence of a supraspinatus fragment on preoperative imaging, including 42 two-part humeral greater tuberosity fractures, 1 two-part humeral surgical neck fracture, and 31 three-part humeral greater tuberosity fractures with a small lateral fracture mass over the intertubular groove; 54 four-part proximal humeral fractures had an "M" shaped fracture mass containing the intertubular groove. All patients were followed up for 11.8±2.4 months (range, 6-20 months). Postoperative X-ray showed that all fractures healed, and the healing time was 3.4±0.3 months (range, 3-5 months). The Constant-Murley scale of the shoulder joint was 86.3±11.5 (range, 61-100).Conclusion:Supraspinatus fragments are more common in proximal humerus fractures. Proper recognition and management of supraspinatus fragments can help understand the mechanism of proximal humeral fracture occurrence, the relationship between fracture displacement and rotator cuff injury, reduce the incidence of postoperative complications, and improve the shoulder joint function.

Clinical application effect of pedunculated rectus abdominis muscle combined with bilateral ureters for repairing refractory bladder-vaginal stump fistula through external vesical drainage / 中华肿瘤杂志

Objective: To investigate the efficacy and safety of pedunculated rectus abdominis combined with bilateral ureteral extravestheter drainage in the treatment of refractory bladder-vaginal stump fistula. Methods: The clinical data of 8 cases of the refractory bladder-vaginal stump fistula were admitted to the Second Hospital of Hebei Medical University and Henan Cancer Hospital and underwent the clinical treatment of bladder-vaginal stump from December 2019 to December 2022 were collected. The reason of refractory bladder-vaginal stump fistula was analyzed, the operation manner of pedunculated rectus abdominis combined with peduncle and bilateral ureter for the treatment of bladder-vaginal stump through extrabladder drainage was explored. The operation time, bleeding volume and clinical effect were record. Results: The median operation time of 8 patients was 150 minutes(120~180 min), and the median blood loss was 400 ml(200~600 ml). During the perioperative period, there were 2 cases of incision infection, delayed healing by debridement and dressing, 2 cases of incision rupture and suture wound healing after reoperation, and 2 cases of urinary tract infection were cured by anti-infection. When followed up for 6 months, 8 cases of vesicovaginal stump fistula were cured. Conclusion: Bilateral ureteral external drainage of the rectus abdominis muscle, has a practical effect in the treatment of refractory bladder-vaginal stump fistula, which can be one of the clinical repairing treatment.

Clinical application effect of pedunculated rectus abdominis muscle combined with bilateral ureters for repairing refractory bladder-vaginal stump fistula through external vesical drainage / 中华肿瘤杂志

Objective: To investigate the efficacy and safety of pedunculated rectus abdominis combined with bilateral ureteral extravestheter drainage in the treatment of refractory bladder-vaginal stump fistula. Methods: The clinical data of 8 cases of the refractory bladder-vaginal stump fistula were admitted to the Second Hospital of Hebei Medical University and Henan Cancer Hospital and underwent the clinical treatment of bladder-vaginal stump from December 2019 to December 2022 were collected. The reason of refractory bladder-vaginal stump fistula was analyzed, the operation manner of pedunculated rectus abdominis combined with peduncle and bilateral ureter for the treatment of bladder-vaginal stump through extrabladder drainage was explored. The operation time, bleeding volume and clinical effect were record. Results: The median operation time of 8 patients was 150 minutes(120~180 min), and the median blood loss was 400 ml(200~600 ml). During the perioperative period, there were 2 cases of incision infection, delayed healing by debridement and dressing, 2 cases of incision rupture and suture wound healing after reoperation, and 2 cases of urinary tract infection were cured by anti-infection. When followed up for 6 months, 8 cases of vesicovaginal stump fistula were cured. Conclusion: Bilateral ureteral external drainage of the rectus abdominis muscle, has a practical effect in the treatment of refractory bladder-vaginal stump fistula, which can be one of the clinical repairing treatment.

Inhibition of ADAMTS by iPSC⁃MSCs in vitro protects cartilage matrix in patients with osteoarthritis / 安徽医科大学学报

Objective @# To study the protective effect and mechanism of iPSC⁃MSCs on cartilage matrix in knee oste⁃ oarthritis (KOA) patients in vitro. @*Methods @#Cartilage tissues removed from KOA patients with joint replacement surgery were collected and subjected to tissue and cellular experiments , respectively. Cartilage tissue was cut into small pieces and randomly divided into a control group , an IL⁃1β ( 10 ng/ml) induction group , and iPSC⁃MSCs 96 h and then co⁃cultured with different amounts of iPSC⁃MSCs ( 1 × 104 , 1 × 105 , 1 × 106 ) cells for 72 h. For in tissues , the pathological changes of isolated cartilage tissues were examined by HE staining. The levels of ADAMTS⁃4 , ADAMTS⁃5 , and type II collagen expression were analyzed by immunohistochemistry , while the levels of MMP13 , IL⁃6 , and IL⁃10 in culture supernatants were detected by ELISA kits. The 2 to 5 generations of chondrocytes , which were extracted from cartilage tissue of KOA patients , were stimulated with IL⁃1β ( 10 ng/ml) for 48 h and then co⁃cultured with different concentrations of iPSC⁃MSCs ( 1 × 104 , 1 × 105 , 1 × 106 ) cells for 72 h. Immunofluorescence and Western blot detected the expression of RUNX2 , ADAMTS⁃4 , and ADAMTS⁃5 in chondrocytes. @*Results @#Comparison with the control group , in the IL⁃1β⁃induced group , the levels of RUNX2 , ADAMTS⁃4 , and ADAMTS⁃5 increased , the level of type II collagen decreased , the levels of MMP⁃13 and IL⁃6 in the culture supernatant increased ( P < 0. 05) , and the level of IL⁃10 decreased ( P < 0. 05) ; Compared with the IL⁃1β⁃induced decreased the expression of RUNX2 , ADAMTS⁃4 , and ADAMTS⁃5 , promoted type II collagen expression and elevated IL⁃10 levels. @*Conclusion @#iPSC⁃MSCs inhibited ADAMTS⁃4 and ADAMTS⁃5 expression in vitro , reduced cartilage extracellular matrix degradation , and played a role in articular cartilage protection.

Advances in Treatment of Brain Metastasis from Lung Cancer / 肿瘤防治研究

Lung cancer is the malignant tumor with the highest incidence and mortality in China, and is prone to brain metastasis in the process of disease development, which seriously affects the quality of life and survival of patients. The treatment methods for brain metastasis of lung cancer include surgery, chemotherapy, whole brain radiotherapy, stereotactic radiosurgery, molecular targeted therapy, immunotherapy, anti-angiogenesis therapy, etc. It's one of the research hotspots to choose reasonable and effective treatment schemes for different patients. This paper reviews the research progress in the treatment of brain metastasis from lung cancer, to provide reference for selecting more reasonable clinical treatment for the patients.

Efficacy and safety of percutaneous transluminal pulmonary angioplasty in patients with chronic thromboembolic pulmonary hypertension / 中华心血管病杂志

Objective: To explore the efficacy and safety of percutaneous transluminal pulmonary angioplasty (PTPA) in patients with chronic thromboembolic pulmonary hypertension (CTEPH). Methods: This prospective single arm study included 19 CTEPH patients (7 male, age(56.3±12.5)years) admitted to Wuhan Asia Heart Hospital from January 2017 to June 2019 and received PTPA interventional therapy. Baseline data, including age, sex, WHO functional class, 6-minute walk distance (6MWD), NT-proBNP, right heart catheterization values, were collected. Patients received single or repeated PTPA. Number of dilated vessels from each patient was analyzed, patients were followed up for 24 weeks and right heart catheterization was repeated at 24 weeks post initial PTPA. All-cause death, perioperative complications, and reperfusion pulmonary edema were reported. WHO functional class, 6MWD, NT-proBNP, right heart catheterization values were compared between baseline and at 24 weeks follow up. Results: Nineteen CTEPH patients received a total of 56 PTPA treatments. The pulmonary artery pressure (mPAP) decreased from (40.11±7.55) mmHg (1 mmHg=0.133 kPa) to (27.53±4.75) mmHg (P<0.001), and the total pulmonary resistance (TPR) decreased from (13.00±3.56) Wood U to (5.48±1.56) Wood U (P<0.001), cardiac output increased from (3.19±0.63) L/min to (5.23±0.94) L/minutes (P<0.01) at 24 weeks post PTPA. The WHO functional class improved significantly (P<0.001), 6MWD increased from (307.08±129.51) m to (428.00±112.64) m (P=0.002), the NT-proBNP decreased at 24 weeks post PTPA (P=0.002). During the follow-up period, there was no death; hemoptysis occurred in 4 patients during the operation, none of which resulted in serious adverse clinical consequences. One patient developed reperfusion pulmonary edema and recovered after treatment. Conclusion: PTPA treatment is safe and can significantly improve the hemodynamics and WHO functional class of patients with CTEPH.

Influence of Yuanzhisan Containing Ginseng Radix et Rhizoma or Codonopsis Radix on Memory Disorder / 中国实验方剂学杂志

Objective:To explore the effects of Yuanzhisan （YZS） containing Ginseng Radix et Rhizoma （YZSR） or Codonopsis Radix （YZSD） on memory disorder based on network and experimental pharmacology. Method:The active components and targets of YZS were retrieved from the component database and literature， and the targets of memory disorder from the disease databases. The intersection targets revealed by Veen diagram were subjected to pathway analysis. The common active components of YZSR and YZSD were molecularly docked onto the core targets. Scopolamine hydrobromide was used to establish the memory disorder model， which was employed in the behavioral experiments for evaluating the effect of YZSR and YZSD on memory disorder. Result:There existed 33 active components for Ginseng Radix et Rhizoma and 31 for Codonopsis Radix， with four common active components and 380 common targets. YZSR contained 85 active components and 790 drug targets， and YZSD 81 active components and 781 drug targets. The mapping of 425 memory disorder targets with those of YZSD and YZSD yielded 133 and 130 intersection targets， respectively. The metabolic pathways involved calcium ion signaling pathway， hypoxia-inducible factor-1 （HIF-1） signaling pathway， mitogen-activated protein kinase （MAPK） signaling pathway， etc. As revealed by molecular docking， the binding energy of common active components to the targets was negative， and the binding effect of frutinone A was the best. Behavioral experiment results showed that both YZSR and YZSD alleviated the memory disorder. In the step-down test， the number of errors in the YZSD group was significant lower than that in the model group （<italic>P</italic><0.01）. In Morris water maze test， the movement distance of the YZSD group was remarkably shortened in comparison with that of the model group （<italic>P</italic><0.05）. In the open field test， the movement distances of both the YZSR and YZSD group were shortened in contrast to that in the normal group （<italic>P</italic><0.05）. Conclusion:YZS had a certain effect on memory disorder. There are similarities and differences between YZSR and YZSD in the treatment of memory disorder.

The value of neck circumference for identifying metabolic syndrome in type 2 diabetes / 中国医师进修杂志

Objective:To investigate the value of neck circumference (NC) for identifying metabolic syndrome (MS) in patients with type 2 diabetes.Methods:a total of 413 type 2 diabetic patients (188 male and 225 female) in Qinhuangdao Chinese Medicine Hospital from August 2018 to July 2019 were recruited. Waist circumference (WC), NC and metabolic indicators were measured. The association between WC, NC and metabolic indicators was explored. Area under the curve (AUC) was used to evaluate the abilities of NC.Results:The average age of male was (55.35 ± 14.15) years, and the detection rate of MS was 74.47% (140/188). The average age of female was (60.19 ± 10.29) years, and the detection rate of MS was 71.11% (160/225). In male group, WC showed a negative correlation with age and high density lipoprotein-cholesterol (HDL-C) ( P<0.05); NC showed a negative correlation with glycated hemoglobin, total cholesterol (TC) and HDL-C ( P<0.05), and a positive correlation with diastolic blood pressure (DBP) ( P<0.05). In female group, WC showed a positive correlation with fasting plasma glucose (FPG) and systolic blood pressure (SBP), and a negative correlation with HDL-C; NC showed a positive correlation with FPG and SBP. WC and HC were good indexes for identifying metabolic syndrome in type 2 diabetes (WC: AUC male 0.862, female 0.870; NC: AUC male 0.745, female 0.752). After applying the ROC analysis, neck circumferences ≥ 34.5 cm in males and ≥ 31.75 cm in females were determined as the best cutoff values to predict MS in type 2 diabetes. Conclusions:NC is a helpful tool to detect MS in type 2 diabetes.

Establishment and Application of Rationality Evaluation Criteria for Tumor Nutritional Standardized Treatment / 中国药房

OBJECTIVE：To establish the eva luation criteria for the rationality of tumor nutritional standardized treatment ，and to provide reference for nutritional standardized treatment in tumer patients . METHODS ：Based on domestic and foreign guidelines or expert consensus ，the rationality evaluation standard of tumor nutritional standardized treatmentwas formulated in our hospital （Bozhou Municipal People ’s Hospital ）. 50 nutritional treatment medical records in our hospital from Jan. to Jun. 2019 were evaluated by weighted TOPSIS ；according to the evaluation results ，nutritional intervention was carried out ，and 50 nutritional treatment medical records （group B ）from Aug. to Dec. 2019 were re-evaluated by the same method after intervention. RESULTS ： The established evaluation criteria for the rationality of tumor nutritional standardized treatment in our hospital included 18 indicators，such as malnutrition diagnosis ，description of the nature of malnutrition ，nutrition screening and evaluation ，etc. After analysis ，the rational rate of nutritional treatment was only 18％ in group A （Ci of ideal solution with 9 medical records≥0.6），and 78％ in group B （Ci of ideal solution with59 medical records ≥0.6）. There was statistical significance in the rationality of nutritional treatment before and after nutritional intervention （Ci≥0.6）（P＜0.05）. CONCLUSIONS ：The established rational evaluation method of tumor nutritional standardized treatment is feasible ，and the evaluation results are intuitive and reasonable. Nutrition intervention is helpful to reduce the irrational rate of nutritional treatment.

Effect of calorie-enriched formula on postoperative catch-up growth in infants with cyanotic congenital heart disease: a propective randomized controlled study / 中国当代儿科杂志

OBJECTIVE@#To study the effect of calorie-enriched formula on postoperative catch-up growth in infants with cyanotic congenital heart disease (CHD).@*METHODS@#A total of 100 infants with cyanotic CHD who underwent surgical operation from January to December, 2017, were randomly divided into a high-calorie group (receiving calorie-enriched formula after surgery) and a conventional group (receiving standard formula after surgery), with 50 infants in each group. All infants were followed up for 6 months. The observation indices included body height, body weight, prealbumin, and N-terminal pro-brain natriuretic peptide before surgery, at the time of ventilator weaning and extubation after surgery, and at 1, 3, and 6 months after surgery. Height-for-age Z-score (HAZ), weight-for-age Z-score (WAZ), and weight-for-height Z-score (WHZ) were also assessed. Adverse reactions were recorded for both groups.@*RESULTS@#There were 25 cases (50%) and 21 cases (42%) of malnutrition in the high-calorie group and the conventional group respectively before surgery (@*CONCLUSIONS@#Compared with the standard formula, calorie-enriched formula can better help with postoperative catch-up growth in infants with cyanotic CHD.

The protective effect of Medicoscab Tincture on deep partial thickness burn rats and its mechanism / 中国药理学通报

Aim To investigate the effect of Medi- coscab Tincture could increase the healing rate of burn coscab Tincture on the wound repair of deep partial thickness burn in rats and its possible mechanism. Methods SD100 rats were used to make a rat model of deep partial thickness burn. The rats were randomly divided into five groups; normal, model control, positive control, Medicoscab Tincture high-dose, and Medicoscab Tincture low-dose. The dosing group was changed daily for 14 consecutive days. The healing rate and water content of wound were measured at 3 d, 7 d and 14 d after burn. The activities of superoxide dismutase (SOD) and catalase (CAT) and the content of malondialdehyde ( MDA) were determined by bio-chemical analysis. Serum levels of tumor necrosis fac- tor-a (TNF-a), interleukin-1 (3 (IL-1(3) and interleu- kin-6 (IL-6) in rats were determined. Results Medi- wound and decrease the water content of burn wound tissue in rats ( P < 0. 05 ). The activity of SOD significantly increased, the content of MDA decreased (P < 0. 05), and the contents of TNF-a, IL-1 (3 and IL-6 in serum of burned rats decreased ( P < 0. 05, P < 0.01). Conclusions Medicoscab Tincture can improve the wound healing rate, reduce the wound water content, increase SOD activity, reduce the content of MDA in the wound, and reduce the serum levels of inflammatory factors TNF-a, IL-1 (3 and IL-6. Therefore, Medicoscab Tincture has a protective effect on deep partial thickness burn in rats.

Changes of serum biomarkers in rats after blast-induced traumatic brain injury in cabin and the related clinical significance / 中华创伤杂志

Objective:To investigate the early changes of serum biomarkers in rats with mild blast-induced traumatic brain injury (bTBI) in cabin.Methods:Explosion source in the simulated cabin was detonated by initiator. The bTBI rat models caused by explosion shock wave in cabin were established. A total of 24 adult male Sprague-Dawley rats were divided into normal control group ( n=6) and bTBI group ( n=18), according to the random number table. Rats in bTBI group were subdivided at 3, 24, and 72 h post-blast, with 6 rats at each time point. Shock wave pressure at the rat head was measured during the explosion. At 3, 24, and 72 h post-blast, the general condition of rats was observed. Rat blood was collected by cardiac puncture. Then brains were taken completely and quickly for pathological observation. HE staining was used to observe the changes of neurons in hippocampal CA1 area. The collected serum was tested for levels of biomarkers, including interleukin- 6 (IL-6), neuron specific enolase(NSE), S100-β, alpha Ⅱ-spectrin breakdown product-145 (SBDP-145) and Tau. Results:The maximum peak value of the shock wave pressure curve at the rat head was (818.2±33.3)kPa, and the duration was about 1 000 μs. After the explosion, the activity of the rats decreased significantly, the hair was dull, and the appetite decreased. General observation showed that the brain tissue was obviously swollen, the blood vessels on the brain surface were thickened, and there was a little patchy bleeding, but no obvious brain contusion was seen. HE staining showed that some neurons in the hippocampus CA1 area had apoptosis or necrosis. At 3, 24, and 72 hours post-blast, the levels of IL-6 were (155.3±10.7)pg/ml, (171.3±25.3)pg/ml and (155.6±18.2)pg/ml, all of which were significantly higher than that in normal control group [(116.3±7.3)pg/ml]( P<0.05); the levels of NSE were (12.0±1.0)ng/ml, (11.0±1.0)ng/ml and (11.0±1.2)ng/ml, all of which were significantly higher than that in normal control group [(8.1±0.5)ng/ml]( P<0.05); the levels of S100-β were (71.9±10.7)pg/ml, (58.0±11.5)pg/ml and (56.5±12.2)pg/ml, all of which were significantly higher than that in normal control group [(35.2±2.5)pg/ml] ( P<0.05); the levels of SBDP-145 were (29.4±2.8)ng/ml, (24.5±4.8)ng/ml and (20.7±2.1)ng/ml, and only the level at 3 h post-blast was significantly higher than that in normal control group [(20.9±1.2)ng/ml]( P<0.05); the levels of Tau were (141.4±11.7)pg/ml, (189.5±28.2)pg/ml and (179.1±32.5)pg/ml, all of which were significantly higher than that in normal control group [(97.8±5.9)pg/ml]( P<0.05). Conclusion:The serum levels of IL-6, NSE, S100-β, SBDP-145 and Tau in mild bTBI rats increase in various degrees at early time, which provides a theoretical basis for use of serum markers in the early diagnosis of mild bTBI.

Hepatic biloma after minimally invasive interventional therapies: treatment and outcomes / 中华肝胆外科杂志

Objective:To study the treatment and outcomes of hepatic biloma after minimally invasive interventional therapies.Methods:From January 2013 to December 2018, patients who underwent transcatheter arterial chemoembolization, percutaneous microwave ablation, and percutaneous biliary drainage (PTBD) at the Affiliated Hospital to Jiangnan University (Wuxi No.3 Hospital) and developed postoperative biloma that required treatment were included into this study.Results:Of 43 bilomas, 14 were treated with percutaneous drainage. There were 9 males and 5 females, with an average age of 61(29-85) years. These bilomas could be classified into the following 3 types: extrahepatic bilomas (2 patients), simple bilomas (10 patients) and infected bilomas (2 patients). The treatments included PTBD, drainage of percutaneous biloma or a combination of both.Conclusion:Biloma is a known complication after minimally invasive interventional therapies. These bilomas could be classified to guide treatment and to improve prognosis.

Gait Characteristics of Female Patients before and after Unilateral Total Knee Arthroplasty / 医用生物力学

Objective To investigate gait characteristics of both lower limbs in female patients before and after unilateral total knee arthroplasty (TKA). Methods Based on three-dimensional (3D) motion capture system and independent-sample t test, gait parameters of 10 female patients were compared in both lower limbs and compared with those of 10 healthy subjects before and after TKA. Results The preoperative stance phase, peak adduction angle, adduction-abduction range of motion (ROM) and peak flexion moment of the unoperated knee were significantly higher than those of the operated knee (P<0.05), while postoperative gait parameters were similar in both sides. Compared with the control group, the patients had significantly lower speed and stride length, longer double support time before TKA (P<0.05). Moreover, the operated knee demonstrated significantly lower peak extension and adduction angles, adduction-abduction ROM, peak flexion and abduction moments, higher peak adduction moment, and the unoperated knee revealed significantly lower peak extension angle, higher peak flexion and adduction moments than the control group before TKA (P<0.05). The greater differences of peak knee extension angles and adduction moments of both sides still existed in the two groups after TKA (P<0.05). Conclusions Unilateral TKA could ease pain and reduce gait deviations in both lower limbs of patients. However, there were still gait differences compared with the control group. Patients still suffered deficits in joint function, such as muscle strength and proprioception, and revealed pathological gait and posture. It’s advised that patients should enhance muscle strength of the operated limb, and take gait correction exercises. Female patients should also control walking speed to avoid increasing pressure on the knee after TKA.

Analysis on the changes of Beagle dog’s intracranial pressure and influencing factors caused by free field live bomb explosion / 解放军医学杂志

Objective To investigate the effect of Beagle's cranium on shockwave blocking after free field explosion, and whether a quantitative relationship exists between intra- and extracranial pressure. Methods Eighteen Beagle dogs were used in the free field explosion experiment. The explosion source was 1 kg and 3.5 kg column-shaped trinitrotoluene (TNT), which was located 1.5 m above the land to rule out the possibility of reflex. Measurment instruments were located 1-6 m from the explosion source. Head of Beagle dog was located at the same location as that of measurment instruments. After Beagle dog was anaesthetised, pressure sensor was planted under parietal bone. One side of the sensor borehole faced to the brain tissue, and the other side of the sensor borehole faced to the cranium to measure the pressure from the skull direction. All Beagle dogs were recumbent fixed, the head was positively faced to the source of explosion. Pressures from the bone and from the brain tissue were measured respectively. Results One dog died after the explosion and the remaining 17 dogs were alive. Twenty-four hours later, Tarlov scores of the alive dogs were graded 4-5, and neurofunctional score in large animals was more than 13. The peak explosive wave pressure was 207(47.6-207) kPa with a mean of 122 kPa. The maximal impact pressure impulse reached to 88 Pa·s. The pressure curve from the cranium direction of Beagle dog was similar to that from the brain tissue, but the pressure curve from the brain tissue direction changed more gently. A logarithmic trend existed of the peak pressure of the shockwave from the cranium direction and the external shockwave at the same position (correlation coefficient = 0.804). Conclusions In free field explosion, shockwave can enter the brain through cranium, chest and abdomen. The cranium has some blocking effect on the shockwave, and partial shockwave pressure can be uploaded to the brain tissue through the chest and abdomen, but because of the blocking of the body tissue, the change curve is relatively smooth.

Application of anatomical reduction and fixation of lesser trochanter through posterior-lateral approach in treating intertrochanteric fractures in the elderly / 中华老年医学杂志

Objective To observe the feasibility and clinical curative effect of anatomical reduction and fixation of lesser trochanter through posterior-lateral approach for the treatment of comminuted femoral intertrochanteric fractures in elderly patients.Methods A total of 19 cases with comminuted femoral intertrochanteric fracture,aged 60 to 84 years were enrolled in this study.According to Evans-Jensen classification,13 cases had type Ⅱ B and 6 cases had type Ⅲ femoral fracture.Through the posterior-lateral approach,the lesser trochanter was fully exposed,reduced and fixed by screw.The proximal and distal femur were well fixed with dynamic hip screw(DHS)or proximal femoral locking plate(PFLP).The lesser trochanter reduction was observed by intraoperative vision and postoperative X-ray.The function evaluation after hip surgery was performed by using Sanders hip function score.Results All 19 patients obtained the anatomic reattachment in the lesser trochanter.All patients were followed up for an average of 18 months.After treatment,the Sanders hip function score were excellent in 7 patients (36.8 ％),fine in 12 cases (63.2 ％).And curative efficacy was good in all cases(100％).There was no significant difference in the curative effect between patients with different classification and gender.Conclusions Through the posterior-lateral approach,the surrounding structures of the lesser trochanter can be fully exposed,and the lesser trochanter can be anatomically repositioned.The posterior-lateral approach to anatomical reduction and fixation of lesser trochanter is an effective and feasible method for the treatment of comminuted intertrochanteric fracture in the elderly.