Transporter-mediated Nano-delivery System in Promoting Oral Absorption of Drugs：A Review / 中国实验方剂学杂志

Oral administration is the most convenient way of drug delivery， but due to the existence of intestinal barrier， the oral bioavailability of drugs is generally low， especially for drugs with low water solubility， poor permeability and macromolecules. For decades， researchers have demonstrated that nano-delivery system is one of the most effective strategies to solve this problem， but nano-delivery systems have shown limited improvement in the oral bioavailability of drugs. Therefore， researchers have proposed to use transporter-mediated nano-delivery systems to promote the oral absorption of drugs. The intestinal tract were highly expressed as a transporter for ingesting various nutrients（such as glucose， oligopeptides and bile acids）， which was an excellent target of oral drug delivery system. Its substrate were modified on the nano-delivery system， and the loaded drugs could cross the intestinal barrier and enter the systemic circulation more efficiently through the targeting effect of transporters. At present， more and more evidences supported the potential of transporters in the field of oral drug delivery system. Therefore， this paper reviewed the research on intestinal transporters-mediated nano-delivery system to promote oral absorption of drugs， including the distribution of intestinal transporters， three strategies of transporter substrate modification， the transport properties of different types of transporters and their effects of mediating the nano-delivery system for promoting the oral absorption of drugs or treating diseases， with the aim of providing an important theoretical reference for the development of intestinal targeted nano-delivery systems.

Effect of Faeces Bombycis Extract on Cajal Interstitial Cells in Diabetic Gastroparesis Rats Based on PI3K/Akt/mTOR Signaling Pathway / 中国实验方剂学杂志

ObjectiveTo explore the therapeutic mechanism of Faeces Bombycis on diabetic gastroparesis （DGP） rats based on phosphatidylinositol 3-kinase/protein kinase B/mammalian rapamycin target protein （PI3K/Akt/mTOR） signaling pathway. MethodDGP rat model was prepared by random selection of 15 out of 105 rats as blank group. The rats successfully constructed were randomly divided into model group， high-，medium- and low- dose groups （3.2， 1.6， 0.8 g·kg-1） and moxapride group （1.5 mg·kg-1）， with 12 rats in each group， and were given gavage for 4 weeks. The gastric emptying rate and random blood glucose were measured. The morphological changes of gastric antrum were observed by hematoxylin-eosin （HE） staining， and the expression of the c-Kit gene was analyzed by immunohistochemistry. The apoptosis of Cajal interstitial cells was observed by in situ end labeling （TUNEL） staining， and the protein expressions of PI3K， phosphorylation（p）-PI3K， Akt， p-Akt， mTOR， and p-mTOR were detected by Western blot. ResultCompared with the blank group， the gastric emptying rate of the model group decreased significantly （P<0.01）， and the glandular structure of the gastric antrum was destroyed. The expression of c-Kit decreased （P<0.01）， and the apoptosis of Cajal interstitial cells （ICC） increased. Compared with the model group， the gastric emptying rate in the high， middle， and low-dose groups of Faeces Bombycis extract and mosapride group increased significantly （P<0.01）. The glandular structure of the gastric antrum became closer， and the apoptosis of ICC decreased. The expression of c-Kit in the high dose group of Faeces Bombycis extract increased significantly. After Western blot testing， compared with the blank group， the protein expression of p-Akt/Akt， p-PI3K/PI3K， and p-mTOR/mTOR in the model group increased. Compared with the model group， the protein expression of p-Akt/Akt in the high dose group of Faeces Bombycis extract decreased （P<0.01）， and the protein expression of p-PI3K/PI3K decreased in the middle and low dose groups of Faeces Bombycis extract and mosapride group decreased （P<0.05， P<0.01）. The protein expression of p-mTOR/mTOR decreased in the low dose group of Faeces Bombycis extract （P<0.05）. In terms of random blood glucose， compared with the blank group， the random blood glucose in the model group increased significantly （P<0.01）， and compared with the model group， the random blood glucose in the high and middle dose groups of Faeces Bombycis extract decreased significantly （P<0.05）. Compared with mosapride group， the protein expression of p-Akt/Akt decreased in the high dose group of Faeces Bombycis extract （P<0.05）， and the protein expression of p-PI3K/PI3K increased in the high， middle， and low dose groups of Faeces Bombycis extract （P<0.05， P<0.01）. ConclusionFaeces Bombycis extract can increase gastric emptying rate， reduce ICC apoptosis， and lower random blood glucose in DGP rats. The high dose group of Faeces Bombycis extract has a significant effect on inhibiting ICC apoptosis， and its mechanism may be related to the regulation of the PI3K/Akt/mTOR signaling pathway.

Improved unilateral puncture PVP based on 3D printing technology for the treatment of osteoporotic vertebral compression fracture / 中国骨伤

OBJECTIVE@#To investigate the clinical effect of unilateral percutaneous vertebroplasty (PVP) combined with 3D printing technology for the treatment of thoracolumbar osteoporotic compression fracture.@*METHODS@#A total of 77 patients with thoracolumbar osteoporotic compression fractures from October 2020 to April 2022 were included in the study, all of which were vertebral body compression fractures caused by trauma. According to different treatment methods, they were divided into experimental group and control group. Thirty-two patients used 3D printing technology to improve unilateral transpedicle puncture vertebroplasty in the experimental group, there were 5 males and 27 females, aged from 63 to 91 years old with an average of (77.59±8.75) years old. Forty-five patients were treated with traditional bilateral pedicle puncture vertebroplasty, including 7 males and 38 females, aged from 60 to 88 years old with an average of(74.89±7.37) years old. Operation time, intraoperative C-arm X-ray times, anesthetic dosage, bone cement injection amount, bone cement diffusion good and good rate, complications, vertebral height, kyphotic angle (Cobb angle), visual analogue scale(VAS), Oswestry disability index (ODI) and other indicators were recorded before and after surgery, and statistically analyzed.@*RESULTS@#All patients were followed up for 6 to 23 months, with preoperative imaging studies, confirmed for thoracolumbar osteoporosis compression fractures, two groups of patients with postoperative complications, no special two groups of patients' age, gender, body mass index (BMI), time were injured, the injured vertebral distribution had no statistical difference(P>0.05), comparable data. Two groups of patients with bone cement injection, bone cement dispersion rate, preoperative and postoperative vertebral body height, protruding after spine angle(Cobb angle), VAS, ODI had no statistical difference(P>0.05). The operative time, intraoperative fluoroscopy times and anesthetic dosage were statistically different between the two groups(P<0.05). Compared with the traditional bilateral puncture group, the modified unilateral puncture group combined with 3D printing technology had shorter operation time, fewer intraoperative fluoroscopy times and less anesthetic dosage. The height of anterior vertebral edge, kyphosis angle (Cobb angle), VAS score and ODI of the affected vertebrae were statistically different between two groups at each time point after surgery(P<0.05).@*CONCLUSION@#In the treatment of thoracolumbar osteoporotic compression fractures, 3D printing technology is used to improve unilateral puncture PVP, which is convenient and simple, less trauma, short operation time, fewer fluoroscopy times, satisfactory distribution of bone cement, vertebral height recovery and kyphotic Angle correction, and good functional improvement.

cAMP-Epac1 signaling is activated in DDAVP-induced endolymphatic hydrops of guinea pigs

Abstract Objective To explore whether Cyclic Adenosine Monophosphate (cAMP)-Epac1 signaling is activated in 1-Desamino-8-D-arginine-Vasopressin-induced Endolymphatic Hydrops (DDAVP-induced EH) and to provide new insight for further in-depth study of DDAVP-induced EH. Methods Eighteen healthy, red-eyed guinea pigs (36 ears) weighing 200-350 g were randomly divided into three groups: the control group, which received intraperitoneal injection of sterile saline (same volume as that in the other two groups) for 7 consecutive days; the DDAVP-7d group, which received intraperitoneal injection of 10 mg/mL/kg DDAVP for 7 consecutive days; and the DDAVP-14d group, which received intraperitoneal injection of 10 μg/mL/kg DDAVP for 14 consecutive days. After successful modeling, all animals were sacrificed, and cochlea tissues were collected to detect the mRNA and protein expression of the exchange protein directly activated by cAMP-1 and 2 (Epac1, Epac2), and Repressor Activator Protein-1 (Rap1) by Reverse Transcription (RT)-PCR and western blotting, respectively. Results Compared to the control group, the relative mRNA expression of Epac1, Epac2, Rap1A, and Rap1B in the cochlea tissue of the DDAVP-7d group was significantly higher (p< 0.05), while no significant difference in Rap1 GTPase activating protein (Rap1gap) mRNA expression was found between the two groups. The relative mRNA expression of Epac1, Rap1A, Rap1B, and Rap1gap in the cochlea tissue of the DDAVP-14d group was significantly higher than that of the control group (p< 0.05), while no significant difference in Epac2 mRNA expression was found between the DDAVP-14d and control groups. Comparison between the DDAVP-14d and DDAVP-7d groups showed that the DDAVP-14d group had significantly lower Epac2 and Rap1A (p< 0.05) and higher Rap1gap (p < 0.05) mRNA expression in the cochlea tissue than that of the DDAVP-7d group, while no significant differences in Epac1 and Rap1B mRNA expression were found between the two groups. Western blotting showed that Epac1 protein expression in the cochlea tissue was the highest in the DDAVP-14d group, followed by that in the DDAVP-7d group, and was the lowest in the control group, showing significant differences between groups (p< 0.05); Rap1 protein expression in the cochlea tissue was the highest in the DDAVP-7d group, followed by the DDAVP-14d group, and was the lowest in the control group, showing significant differences between groups (p< 0.05); no significant differences in Epac2 protein expression in the cochlea tissue were found among the three groups. Conclusion DDAVP upregulated Epac1 protein expression in the guinea pig cochlea, leading to activation of the inner ear cAMP-Epac1 signaling pathway. This may be an important mechanism by which DDAVP regulates endolymphatic metabolism to induce EH and affect inner ear function. Oxford Centre for Evidence-Based Medicine 2011 Levels of Evidence Level 5.

Efficacy of two kinds of posterior chamber intraocular lens fixation in the treatment of lens dislocation / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To compare the efficacy of 25-gauge(25G)vitrectomy combined with intraocular lens transciliary sulcus scleral suture fixation and sutureless scleral tunnel interlamellar fixation in the treatment of complete lens dislocation.METHODS: Retrospective case-control study. A total of 40 patients(40 eyes)diagnosed with complete lens luxation in the vitreous cavity in our hospital from May 2015 to September 2021 were selected, among which 21 eyes(suture group)underwent 25G vitrectomy combined with intraocular lens fixation via ciliary sulci scleral suture, and 19 eyes(sutureless group)underwent 25G vitrectomy combined with interlamellar scleral tunnel fixation of intraocular lens. The patients in both groups were followed up until 3mo after surgery to observe the operative time, best corrected visual acuity(BCVA), corneal endothelial cell count(CECC), central corneal thickness(CCT)and postoperative complications.RESULTS: The operation time was significantly shorter in the sutureless group than in the suture group(31.79±6.01min vs. 45.38±8.04min, P&#x003C;0.001). BCVA in both groups was significantly improved after surgery(all P&#x003C;0.05), and the BCVA(LogMAR)at 1wk after operation in the sutureless group was significantly better than that in the suture group(0.32±0.14 vs. 0.57±0.25, P&#x003C;0.001). At 3mo after surgery, CECC in both groups was lower than that before surgery(all P&#x003C;0.01). The CCT at 1wk after operation in the suture group was greater than that before operation and at 3mo after operation(all P&#x003C;0.01), and there was no significant change in CCT before and after surgery in the sutureless group. During follow-up period, the total complication rate in the sutureless group was lower than that in the suture group(26% vs. 38%, P&#x003E;0.05).CONCLUSION: 25G vitrectomy combined with intraocular lens sutureless scleral tunnel interlamellar fixation in the treatment of complete lens luxation has shorter operation time, faster postoperative visual acuity improvement and fewer postoperative complications.

Seroepidemiological characteristics of hepatitis B virus among hospitalized patients aged 18 years or below in Henan Province of China / 临床肝胆病杂志

Objective To investigate the current status of hepatitis B virus (HBV) infection among hospitalized patients aged 1-18 years, as well as the status of immunity after hepatitis B vaccination. Methods Related data were collected from the patients aged 1-18 years who were hospitalized in Henan Provincial People's Hospital from July 2020 to July 2021, including serological markers for hepatitis B (HBsAg, anti-HBs, HBeAg, anti-HBe, and anti-HBc) and hepatitis B vaccination. The epidemiological situation of HBV infection was analyzed, as well as the immune effect after vaccination. The trend chi-square test was used for trend analysis. Results A total of 10 658 hospitalized patients were collected, among whom there were 6 372 male patients (59.79%) and 4 286 female patients (40.21%). In this population, the patients with positive HBsAg accounted for 0.28% (30/10 658), with a relatively high proportion of 0.68% and 0.62%, respectively, in the 17-and 18-year age groups; the patients with positive anti-HBs accounted for 51.82% (5 523/10 658), with a relatively high proportion of > 63% in the 1-4 years age groups, and there was a reduction in the proportion of patients with positive anti-HBs (fluctuating around 40%) in the 5-18 years age groups. With the increase in age, the positive rate of anti-HBs tended to decrease in both male and female patients (male: χ 2 =8.217, P =0.004; female: χ 2 =10.048, P =0.002). Conclusion Based on the data of hospitalized patients, HBV infection in the population aged 1-18 years in Henan Province has the characteristics of low prevalence rate and high immunity, and the reduction in the proportion of patients with positive anti-HBs at more than five years after vaccination should be taken seriously in this region.

Efficacy and Safety of Chinese Medicinal Prescriptions in Treatment of Acute Gouty Arthritis： A Network Meta-analysis / 中国实验方剂学杂志

ObjectiveIn the treatment of acute gouty arthritis （AGA）， western medicine is mostly used for anti-inflammatory and analgesic purposes to control the blood uric acid level， but some patients are still at risk of poor control and recurrent attacks. Chinese medicinal prescriptions， potent in resisting inflammation and relieving pain， are able to stabilize the blood uric acid level， reduce acute attacks， and improve the clinical efficacy of western medicine. However， there is a lack of evidence to support their use as evidence-based medicine. This study employed network Meta-analysis （NMA） to evaluate the efficacy and safety of common Chinese medicinal prescriptions in the treatment of AGA， aiming to provide evidence-based medical evidence for the clinical use of Chinese medicinal prescriptions in the treatment of AGA. MethodChinese and English databases were searched for prospective cohort studies and randomized controlled trials （RCTs） on Chinese medicinal prescriptions against AGA from database inception to December 1， 2022. Stata software and Review Manager were used for statistical analysis. ResultForty-four papers with 3 564 cases involved were included in the current NMA. In terms of reducing blood uric acid， the cumulative probability results showed that Mahuang Lianyao Chixiaodou Tang showed optimal efficacy （87.60%）. In terms of relieving joint pain， Danggui Niantongtang and Guizhi Shaoyao Zhimutang showed optimal efficacy （92.00% and 82.30%）. In terms of improving erythrocyte sedimentation rate （ESR）， Simiaowan was superior to other prescriptions （87.00%）. In terms of reducing C-reactive protein （CRP）， Simiaowan and Baihutang modified with Guizhitang showed superior efficacy （76.00% and 66.10%）. In terms of safety， except for the basic treatment group， Mahuang Lianyao Chixiaodou Tang had the lowest probability of adverse events， and Danggui Niantongtang had the highest probability of adverse reactions during treatment. According to the results of cluster analysis， Mahuang Lianyao Chixiaodou Tang and Simiaowan are effective and safe. ConclusionAccording to the results of NMA， Chinese medicinal prescriptions can assist in the treatment of AGA and improve the effectiveness of western medicine. For patients with AGA， clinicians can choose Mahuang Lianyao Chixiaodou Tang or Simiaowan as an auxiliary drug for routine western medicine treatment.

Research advances in the association between sarcopenia and hepatic encephalopathy in patients with liver cirrhosis / 临床肝胆病杂志

Sarcopenia is one of the manifestations of malnutrition in patients with liver cirrhosis. Most studies have shown that sarcopenia is associated with overt hepatic encephalopathy (OHE), leading to an increased risk of events such as reduced quality of life, poor clinical prognosis, and even death in patients with liver cirrhosis, but there are few studies on the association between sarcopenia and minimal hepatic encephalopathy (MHE). This article reviews the research advances in sarcopenia and hepatic encephalopathy to provide a reliable basis for clinical treatment, and it is pointed out that the nutritional status of patients can be improved to prevent MHE and even reduce the onset of OHE, thereby improving patient prognosis, increasing quality of life, and reducing the risk of death.

Investigation on public satisfaction with the enforcement of tobacco control regulations based on questionnaire survey —— a case study of Tianjin / 公共卫生与预防医学

Objective To analyze the residents' satisfaction with the enforcement of The Regulations of Tianjin Municipality on Smoking Control in Public Places (hereinafter referred to as The Regulations) and its influencing factors. Methods From November to December 2020, 16 districts of Tianjin were selected as the research site, and one street was randomly selected from each district. The accidental sampling was used to conduct a questionnaire survey on 4,160 permanent residents in Tianjin. χ2 test was used in univariate analysis and multivariate logistic regression model was used to analyze and adjust the confounding factors. The public satisfaction and its influencing factors were analyzed. Results A total of 4 022 questionnaires were collected and 2 730 were included in the study. In 2020, 89.3 percent of Tianjin residents were satisfied with the enforcement of the Regulations. Compared with residents aged 15-24, residents in other age groups were less satisfied with the enforcement of the Regulations. Compared with residents with primary school education or below, residents with high school education or bachelor's degree or the same educational level were less satisfied with the enforcement of the Regulations. Residents with chronic diseases (OR=1.885 , P<0.01) and exposure to second-hand smoke in the last 30 days (OR=1.903, P<0.01) were less satisfied with the enforcement of the Regulations, while those who supported the Regulations (OR=0.511, P<0.01) and residents who had been exposed to public service advertisements on tobacco control in the last 30 days (OR=0.043, P<0.01) were more satisfied with the enforcement of the Regulations. Conclusion The residents of Tianjin are highly satisfied with the enforcement of the Regulations. Age, education background, support for the Regulations, chronic disease, exposure to secondhand smoke in the last 30 days and exposure to public service advertisements in the last 30 days are the main influencing factors of satisfaction with the enforcement of tobacco control regulations.

Effectiveness of online and offline health education myopia intervention on primary school students / 中国学校卫生

Objective@#To assess the effectiveness of online and offline myopia prevention and control health education interventions using wearable behavior monitoring tools for non myopic elementary school students,so as to provide evidence based medical support for public health practices.@*Methods@#From May to June in 2021, two schools were selected within the same county in Jiangsu Province. School 1 conducted online and offline parental health education ( n =111), while school 2 exclusively conducted offline health education activities, representing the traditional intervention group ( n =122). Students from both schools underwent monitoring through wearable behavior tracking tools, with feedback reports provided (eye distance, eye duration, ambient light, and outdoor exposure time). Both schools relied on activities to carry out health education interventions, and organized the distribution of promotional materials and display boards. The intervention group also established WeChat groups to conduct online "Healthy Parents Action" (answering and providing feedback on health knowledge related to myopia prevention and control, myopia prevention and control, science popularization, etc. raised by parents). Evaluation criteria included myopia rates, post dilation refractive error, and axial length, with a tracking period of two years (from 2021 to 2023). Additionally, the study collected refractive parameters from non myopic students who did not participate in wearable tool monitoring in the 12 classes across the two schools.@*Results@#The baseline results indicated that there were no significant differences between the two groups in terms of refractive parameters and wearable tool monitoring results (including screen time, viewing distance, outdoor exposure time, and homework light exposure)( t/Z/χ 2=1.94,1.17,0.58,0.40,0.80,0.69,0.32, P >0.05). After a two-year follow up, in the first and second year, the myopia rate of the online Healthy Parents Action group (11.4%, 29.7%) were lower than that of the traditional group (26.2%, 50.9%), and the degree of refractive change in the intervention group [0.63(0.38,1.19)D] was lower than that of the traditional group [0.91(0.40,1.50)D], and all the differences were statistically significant( χ 2/ Z =4.93，10.37，2.29， P <0.05). However, there were no significant differences ( P >0.05) in axial length changes between the two groups over the twoyear intervention period. Nevertheless, in the second year, the axial length change in the traditional group [0.35(0.20,0.65)mm] was lower than that in the natural observation group [0.55(0.30,0.75)mm], and this difference was statistically significant ( Z =1.92, P <0.05).@*Conclusions@#Online and offline myopia prevention and control health education can effectively reduce myopia rates. The intervention mode combining wearable behavior monitoring tools with online health education may have better effects, but further large sample and multi center studies are needed to provide additional evidence and confirmation.

Mechanism of Bugansan Decoction in ameliorating learning and memory impairment in D-galactose-induced aging rats based on AGEs/RAGE/NF-κB pathway / 数字中医药（英文）

@#Objective To investigate the underlying mechanism of the compound Bugansan Decoction (补肝散, BGSD) in intervening learning and memory in D-galactose (D-gal)-induced aging rats. @*Methods@#A total of 40 rats were randomly assigned to four groups: control, model, BGSD [14.06 g/(kg·d)], and piracetam [0.4 g/(kg·d)] groups, with 10 rats in each group. D-gal [400 mg/(kg·d)] was injected intraperitoneally to establish the aging rat model. The rats' body weight, water intake, food intake, and gripping strength were recorded each week. The eightarm maze and step-down test were used to measure the rats' capacity for learning and memory. Liver, thymus, spleen, and brain tissues were weighed to calculate the corresponding organ indices; serum malondialdehyde (MDA) content and superoxide dismutase (SOD) activity were measured. Hematoxylin and eosin (HE) staining was adopted to observe the pathological changes of the hippocampus; enzyme-linked immunosorbent assay (ELISA) was used to detect the levels of tumor necrosis factor (TNF)-α, interleukin (IL)-6, and IL-1β in the hippocampus. Real-time quantitative polymerase chain reaction (RT-qPCR) was used to detect the expression of receptors for advanced glycation end products (RAGE), nuclear factor-κB (NF-κB), TNF-α, IL-6, and IL-1β mRNA in the hippocampus. Western blot (WB) was employed to detect the expression levels of advanced glycation end products (AGEs), RAGE, and NF-κB protein in the hippocampus. @*Results@#In D-gal-induced aging rats, BGSD significantly increased food intake, water intake, body weight, gripping strength, and organ indices (P < 0.05), and significantly decreased working memory error (WME), reference memory error (RME), and total memory errors (TE) in an eight-arm maze (P < 0.05). In the step-down test, step-down latency was prolonged and the frequency of errors dropped (P < 0.05). Additionally, BGSD could lessen the harm done to hippocampus neurons, increase serum SOD activity, lower MDA levels, and down-regulate the expression levels of the pro-inflammatory molecules TNF-α, IL-6, and IL-1β (P < 0.05). Further findings showed that BGSD significantly decreased hippocampal AGEs, RAGE, and NF-κB expression (P < 0.05). @*Conclusion@#By blocking the AGEs/RAGE/NF-κB signaling pathway, BGSD may regulate the neuroinflammatory damage in D-gal-induced aging rats, and thus improve learning and memory.

Clinical study of treating somatoform pain disorder with the combination of electroacupuncture and duloxetine / 针灸推拿医学（英文版）

Objective:To observe the clinical efficacy of treating somatoform pain disorder(SPD)with electroacupuncture(EA)at the Governor and Conception Vessel points plus duloxetine.Methods:Eighty-two SPD patients were randomly allocated to an observation group and a control group,with 41 cases in each group.The control group was intervened by oral administration of duloxetine hydrochloride enteric capsules at a dose of 60 mg per time once a day;based on the medication,the observation group received additional EA treatment by selecting points from the Governor and Conception Vessels.Clinical efficacy was evaluated after 8 weeks of treatments;changes in the scores of the short-form McGill pain questionnaire(SF-MPQ),self-report symptom inventory,symptom check list-90(SCL-90),Pittsburgh sleep quality index(PSQI),and generic quality of life inventory-74(GQOLI-74)were also compared.Results:After the intervention,the observation group surpassed the control group in comparing the total effective rate(P＜0.05).The SF-MPQ score,SCL-90 somatization score,and PSQI score dropped notably in both groups after treatment,and the intra-group differences were statistically significant(P＜0.05);the three scores were significantly lower in the observation group than in the control group(P＜0.05).The GQOLI-74 score got an increase in each dimension in both groups after treatment,and the intra-group differences were also statistically significant(P＜0.05);the GQOLI-74 dimension scores were all significantly higher in the observation group than in the control group(P＜0.05).Conclusion:For patients with SPD,combining EA at the Governor and Conception Vessel points and duloxetine hydrochloride enteric capsules can markedly improve their clinical symptoms and quality of life.

No-touch technique for harvesting saphenous vein in coronary artery bypass grafting and research progress / 中华胸心血管外科杂志

The saphenous vein has been one of the most commonly used vascular materials for coronary artery bypass grafting(CABG), but the low long-term patency of the vein grafts limits the surgical benefits of CABG. The traditional method of saphenous vein harvesting is more damaging to the venous structures, which has led to the development of no-touch saphenous vein harvesting techniques. In this paper, we review the clinical progress of no-touch saphenous vein in CABG and the potential mechanisms of this technique, to improve the patency of vein grafts by analyzing the latest literature and research progress at the domestic and international level.

Precise repair of small joint defect of hand with free second metatarsophalangeal joint tissue flap based on digital technology / 中华显微外科杂志

Objective:To explore the clinical effect of repairing interphalangeal joint defect of hand with free transfer of part of the 2nd metatarsophalangeal joint tissue flap precisely cut with the aid of digital 3D printing technology.Methods:From December 2016 to December 2020, 7 patients with partial joint defects of proximal interphalangeal joints of fingers were treated in Department of Hand and Foot Surgery, Shunde Hospital Affiliated to Guangzhou Medical University(Foshan Shunde Lecong Hospital). Before surgery, three-dimensional data of hand and foot bones were collected, and the 3D printing model was used to simulate the operation in vitro. During the operation, the first dorsal metatarsal artery-the 2nd dorsal metatarsal artery was used as the pedicle, and the 2nd metatarsophalangeal joint composite tissue flap with a required size was harvested with the assistance of the navigation template to tranfer and repair the small joint defects of hand. All 7 cases entered follow-up at outpatient and telephone. Results:All 7 cases survived. Postoperative follow-up was 3-24(mean 9.5) months, Range of motion of the repaired interphalangeal joint was (56 ± 6)°; According to the Evaluation Standard of Thumb and Finger Reconstruction Function of the Society of Hand Surgery of the Chinese Medical Association, 2 cases were excellent, 4 cases were good, and 1 case was poor.Conclusion:Transfer of the free 2nd metatarsophalangeal joint tissue flap assisted by 3D printing technology in repair of the small joint defect of the hand can accurately harvest the tissue flap, which is clinically reliable.

Clinicopathological characteristics and endoscopic treatment efficacy of de novo early colorectal cancer / 中华消化内镜杂志

Objective:To analyze the clinicopathological features of de novo early colorectal cancer and to evaluate the efficacy of endoscopic treatment.Methods:Patients with de novo early colorectal cancer who underwent endoscopic resection in Beijing Friendship Hospital, Capital Medical University from June 2020 to May 2022 were enrolled. The baseline data, endoscopic manifestations, treatment methods, postoperative pathological results and prognosis of the patients were collected retrospectively.Results:A total of 33 patients with de novo early colorectal cancer were enrolled with the age of 62.67 ± 8.62 years, and the male to female ratio was 7.25∶1. The long diameter of lesions was 0.96 ± 0.36 cm. The lesion morphology was mainly superficial phenotype (type 0-Ⅱ), accounting for 72.7% (24/33). Endoscopic submucosal dissection (ESD) was performed in 29 cases and endoscopic mucosal resection (EMR) was performed in 4 cases. Postoperative pathology showed that 11 cases (33.3%) were well differentiated tubular adenocarcinoma, of which the superficial submucosal layer was invaded in 2 cases. Twenty cases (60.6%) were moderately differentiated tubular adenocarcinoma, of which the superficial submucosa layer was invaded in 5 cases and the deep submucosa layer in 15 cases. Two cases (6.1%) were moderately-poorly differentiated tubular adenocarcinoma, where the deep submucosa layer was invaded in both. There was significant correlation between the depth of invasion and the degree of differentiation ( P<0.001), and moderately and moderately-poorly differentiated lesions were more likely to invade the deep submucosa layer. The en bloc resection rate was 100.0% (33/33), the complete resection rate was 97.0% (32/33), and the curative resection rate was 42.4% (14/33). Among the 19 patients who did not achieve curative resection, 13 patients received supplementary surgical treatment. No tumor residue or lymph node metastasis was found in the postoperative pathology. All patients were followed up for 3-25 months, and no signs of local recurrence or metastasis were found. Conclusion:Most de novo early colorectal cancers are superficial phenotype under endoscopy. The pathology is mainly moderately differentiated tubular adenocarcinoma. Endoscopic resection of de novo early colorectal cancer shows encouraging short-term efficacy.

Long-term outcomes and influencing factors of idiopathic nephrotic syndrome in children / 中华肾脏病杂志

Pediatric idiopathic nephrotic syndrome (INS) is characterized by massive albuminuria, hypoproteinemia, edema and hyperlipidemia, with a long course and high probability of relapse and prolongation. Long-term complications caused by long-term usage of hormones and immunosuppressants in children with INS seriously affect their physical and mental health and quality of life. Most children with steroid-sensitive nephrotic syndrome can be cured before adulthood, while some of them relapse in adulthood. Long-term prognosis of children with steroid-resistant nephrotic syndrome is poor. There have been few studies in China followed the long-term outcomes and its related factors of children with INS over 10 years. The paper reviewed the literatures on the long-term outcomes of children with INS, including renal survival, growth, mental health, learning and work, marriage and fertility, disease recurrence and long-term related complications, to explore the factors related to the poor long-term outcomes of children with INS and to assist in clinical decision-making and follow-up management.

Long-term follow-up results and risk factors of bleeding among very elderly patients with non-valvular atrial fibrillation / 中华全科医师杂志

Objective:To investigate the long-term follow-up results and the risk factors of bleeding among very elderly patients with non-valvular atrial fibrillation (NVAF).Methods:A total of 177 patients with NVAF admitted in Beijing Hospital from January 2016 to July 2016 were enrolled in the study, including 107 very elderly patients (aged≥80 years) and 70 elderly patients (aged 65-80 years). The demographic information, comorbid diseases, lifestyles, antithrombotic therapy, thromboembolism risks, bleeding risks, and medical history were documented. Patients were followed up for 5 years and the events of death, thromboembolism, bleeding and major bleeding were recorded.Results:There was no significant difference in the incidence of thromboembolic events between the two groups (15.9%(17/107) vs. 14.3%(10/70), P>0.05). The proportions of bleeding events and severe bleeding events in the very elderly group were higher than those in the elderly group (45.8%(49/107) vs.10.0%(7/70), 14.0%(15/107) vs. 1.4%(1/70), both P<0.05). According to the bleeding events during follow-up, very elderly patients were divided into bleeding group ( n=49) and non-bleeding group ( n=58). Compared with the non-bleeding group, patients in the bleeding group had an older age, a higher proportion of chronic cardiac insufficiency, chronic kidney disease, malignant tumor, bleeding history and higher bleeding risk score (HAS-BLED score) (all P<0.05). Multivariate logistic regression model analysis showed that age, HAS-BLED score, history of bleeding, and complicated malignant tumor were independent risk factors for bleeding events in very elderly patients with NVAF (all P<0.05). Conclusions:Very elderly patients with NVAF have a similar risk of thromboembolism compared with the younger elderly, but have significantly higher risk of the bleeding and major bleeding. Age, HAS-BLED score, bleeding history, and malignant tumor are independent risk factors for bleeding events in very elderly NVAF patients.

Risk factors for early acute kidney injury after classic orthotopic liver transplantation / 中华器官移植杂志

Objective:To explore the risk factors affecting the incidence of acute kidney injury(AKI)after liver transplantation(LT).Methods:From November 2019 to November 2022, clinical data were retrospectively reviewed for 105 recipients of classic orthotopic LT.There are 89 males and 16 females with an age range of(50.52±10.35)years.They are assigned into two groups of AKI(66 cases)and non-AKI(39 cases)according to the AKI diagnostic and staging criteria of Global Kidney Disease Prognosis Organization in 2012.General profiles and clinical data(e.g.previous medical history, MELD score, total bilirubin, albumin, serum creatinine level, coagulation function, anhepatic phase and time to surgery)of two groups of recipients are compared.The factors with statistically significant differences are included into multivariate Logistic regression analysis for obtaining independent risk factors for early AKI post-LT.Results:Among them, 66 patients developed AKI within 7 days post-operation with an incidence rate of 62.86%(66/105).The clinical stages of AKI are Ⅰ(46 cases, 69.70%), Ⅱ(10 cases, 15.15%)and Ⅲ(10 cases, 15.15%).Statistically significant inter-group differences exists in age, abdominal surgery history, preoperative serum level of creatinine, operative duration, anhepatic phase and intraoperative plasma transfusion(all P<0.05).Multivariate Logistic regression analysis indicated that abdominal surgery history( OR=5.803, 95% CI: 1.008~33.401, P=0.049), anhepatic phase( OR=1.054, 95% CI: 1.008~1.101, P=0.020)and preoperative serum level of creatinine( OR=0.968, 95% CI: 0.943~0.994, P=0.016)are independent risk factors for early AKI after classical orthotopic LT recipients. Conclusions:Abdominal surgery history, anhepatic phase, and preoperative serum level of creatinine are independent risk factors for early AKI in classic orthotopic LT recipients.

Analysis of imaging characteristics of papulopustular rosacea by high-frequency ultrasound combined with color Doppler flow imaging / 中华皮肤科杂志

Objective:To investigate imaging characteristics of papulopustular rosacea (PPR) by high-frequency ultrasound combined with color Doppler flow imaging.Methods:From August 2021 to August 2022, 30 patients with PPR were enrolled from the Department of Dermatology, the First Affiliated Hospital of Baotou Medical College in the Inner Mongolia Autonomous Region, and 30 healthy volunteers served as controls. The 22-MHz high-frequency ultrasound combined with color Doppler blood flow imaging was performed to measure the skin thickness, echo and blood flow parameters at the cheek, and the ultrasound results were compared between the two groups. Comparisons between groups were conducted by using t test or chi-square test. The diagnostic value was analyzed using the area under the curve (AUC) in the receiver operating characteristic (ROC) curve. Results:In the case group, there were 12 males and 18 females, and their ages ranged from 22 to 65 years (42.3 ± 12.8 years) ; in the control group, there were 10 males and 20 females, and their ages ranged from 24 to 62 years (41.0 ± 8.4 years) . The epidermal and dermal thicknesses at the cheek were significantly higher in the case group (132.64 ± 12.29 μm, 1 812.29 ± 85.52 μm, respectively) than in the control group (104.34 ± 14.45 μm, 1 671.77 ± 146.55 μm, respectively, both P < 0.05) . High-frequency ultrasound images showed that the case group was mainly characterized by irregular hypoechoic areas in the cheek dermis (80%) , while banded moderately echoic areas were common in the cheek dermis in the control group (90%) ; subepidermal low-echogenic bands and dermal irregular hypoechoic areas were more likely to appear in the case group than in the control group (93.33% vs. 43.33%, 80% vs. 10%, respectively, both P < 0.001) . Compared with the control group, the case group showed a significantly increased proportion of patients with abundant blood flow signals (93.3% vs. 10%, P < 0.05) , and significantly increased blood vessel diameters (1.60 ± 0.42 mm vs. 0.95 ± 0.32 mm, P < 0.05) ; there was no significant difference in peak systolic blood flow velocity and vascular resistance index between the two groups (both P > 0.05) . The AUC of high-frequency ultrasound combined with color Doppler flow imaging quantitative parameters (including epidermal thicknesses, dermal thicknesses, and blood vessel diameters) was 0.989 (95% CI: 0.970 - 1.000) for the diagnosis of PPR, and the sensitivity and specificity were both 96.7%, which were higher than those of single parameter-based diagnostic model. Conclusion:High-frequency ultrasound combined with color Doppler flow imaging can help improve the accuracy of the diagnosis of PPR, by accurately and non-invasively measuring skin thickness and blood flow parameters.

Atopic dermatitis with typical and atypical manifestations / 中华皮肤科杂志

Atopic dermatitis (AD) is a highly heterogeneous skin disease with various clinical manifestations. Early studies mainly focused on infant-onset AD, which is characterized by typical skin lesions such as eczematous dermatitis on the flexor sites accompanied by genetic predisposition to other allergic diseases; however, atypical manifestations and distributions of skin lesions are common among adult AD and elderly AD, e.g., distribution mainly on the extensor sites and polymorphic rashes such as prurigo nodularis. Many dermatologists are not familiar with atypical manifestations of AD, including atypical manifestations and distributions of skin lesions as well as atypical age at onset, which decreases the diagnostic rate of AD to a certain extent. This article delineates clinical features of AD with typical and atypical manifestations, in order to promote the understanding of AD among Chinese dermatologists.