Gut microbiota-mediated therapeutic effect of Shengmai formula (SMF) on sepsis in mice / 中国药科大学学报

@#To investigate the effects of Shengmai formula (SMF) on tissue damages, serum inflammatory factors and the proportion of innate immunocytes in peripheral blood, sepsis models using either intraperitoneal injection of 20 mg/kg lipopolysaccharide (LPS) or cecal ligation and puncture (CLP) were established.The role of gut microbiota in septic mice during SMF treatment was further investigated.LPS-induced sepsis model was carried out 4 days after daily gavage administration with 0.3 g/kg, 0.6 g/kg, 1.2 g/kg SMF or intraperitoneal injection with 0.6 g/kg SMF.Survival rates of septic mice were determined.Histological evaluations of liver, lung and kidney were analyzed by H&E staining. Serum IL-6, TNF-α, Alanine transaminase (ALT), Aspartate aminotransferase (AST), Blood urea nitrogen (BUN) and Creatinine (Cr) levels were determined.LPS and CLP-induced sepsis models were established, and the proportion of monocytes, macrophages and neutrophils in peripheral blood were analyzed by flow cytometry after gavage administration or intraperitoneal injection of SMF.The therapeutic effects of SMF after antibiotics treatment were further determined, and the therapeutic effects of fecal microbiota from SMF-treated mice were investigated.The results show that LPS-induced sepsis caused death of mice, damages in liver, lung and kidney with increased infiltration of leukocytes and elevated levels of serum IL-6, ALT, AST, BUN and Cr, which were all reversed by gavage administration of SMF.Gavage administration of SMF could significantly reduce the proportion of peripheral macrophages in LPS model and monocytes, macrophages, neutrophils in CLP model.Intraperitoneal injection of SMF showed no therapeutic benefits in septic mice.Depletion of gut microbiota using antibiotics cocktail reversed the therapeutic effects of SMF on sepsis, indicating the involvement of gut microbiota.Fecal microbiota from SMF-treated donors was transplanted into pseudo-sterile recipients, and we found FMT could significantly ameliorate sepsis of recipients.These results showed that gavage administration of SMF reduced serum inflammatory factors and alleviated tissue damages in septic mice by regulating gut microbiota. This study provides a theoretical basis for the treatment of clinical sepsis with SMF.

Effect of critical shoulder angle on deltoid muscle strength reduction in patients with rotator cuff tears / 中国修复重建外科杂志

OBJECTIVE@#To investigate the synergistic interaction between the deltoid muscle and the rotator cuff muscle group in patients with rotator cuff tears (RCT), as well as the impact of the critical shoulder angle (CSA) on deltoid muscle strength.@*METHODS@#A retrospective analysis was conducted on clinical data from 42 RCT patients who met the selection criteria and were treated between March 2022 and March 2023. There were 13 males and 29 females, with an age range of 42-77 years (mean, 60.5 years). Preoperative visual analogue scale (VAS) score was 6.0±1.6. CSA measurements were obtained from standard anteroposterior X-ray films before operation, and patients were divided into two groups based on CSA measurements: CSA>35° group (group A) and CSA≤35° group (group B). Handheld dynamometry was used to measure the muscle strength of various muscle group in the shoulder (including the supraspinatus, infraspinatus, subscapularis, and anterior, middle, and posterior bundles of the deltoid). The muscle strength of the unaffected side was compared to the affected side, and muscle imbalance indices were calculated. Muscle imbalance indices between male and female patients, dominant and non-dominant sides, and groups A and B were compared. Pearson correlation analysis was used to examine the relationship between muscle imbalance indices and CSA as well as VAS scores.@*RESULTS@#Muscle strength in all muscle groups on the affected side was significantly lower than on the unaffected side ( P<0.05). The muscle imbalance indices for the supraspinatus, subscapularis, infraspinatus, and anterior, middle, and posterior bundles of the deltoid were 14.8%±24.4%, 5.9%±9.7%, 7.2% (0, 9.1%), 17.2% (5.9%, 26.9%), 8.3%±21.3%, and 10.2% (2.8%, 15.4%), respectively. The muscle imbalance indices of the anterior bundle of the deltoid, supraspinatus, and infraspinatus were significantly lower in male patients compared to female patients ( P<0.05); however, there was no significant difference in muscle imbalance indices among other muscle groups between male and female patients or between the dominant and non-dominant sides ( P>0.05). There was a positive correlation between the muscle imbalance indices of infraspinatus and VAS score ( P<0.05), and a positive correlation between CSA and the muscle imbalance indices of middle bundle of deltoid ( P<0.05). There was no correlation between the muscle imbalance indices of other muscle groups and VAS score or CSA ( P>0.05). Preoperative CSA ranged from 17.6° to 39.4°, with a mean of 31.1°. There were 9 cases in group A and 33 cases in group B. The muscle imbalance indices of the anterior bundle of the deltoid was significantly lower in group A compared to group B ( P<0.05), while there was no significant difference in muscle imbalance indices among other muscle groups between group A and group B ( P>0.05).@*CONCLUSION@#Patients with RCT have a phenomenon of deltoid muscle strength reduction, which is more pronounced in the population with a larger CSA.

Combination of Internal-braceTM technology and modified Brostrom procedure for treatment of chronic ankle instability / 中华创伤杂志

Objective To investigate the surgical methods and short-term effects of Internal-braceTM technology combined with modified Brostrom procedure for treatment of chronic ankle instability.Methods A retrospective case series study was made on 17 patients with chronic ankle instability treated using the Internal-braceTM technology combined with modified Brostrom procedure from May 2015 to April 2016.There were 10 males and 7 females,at age of 24 and 36 years (mean,31.8 years).A left ankle injury occurred in 6 patients and a right ankle injury in 11 patients.Operation time,postoperative complications and incision healing was documented after operation.Ankle stability was tested using the anterior drawer test and lateral stress test,and ankle range of motion was detected.American orthopedic foot and ankle society (AOFAS) score was used for postoperative efficacy evaluation.Results Operation time was 45 to 84 minutes (mean,64.5 minutes).None of the patients revealed neurological deficits after operation.All incisions healed by the first intension.Full weight bearing was started two weeks after operation.All patients were followed up for mean 3.5 months (range,1-6 months).At the final follow-up,both anterior drawer test and lateral stress test were negative.All patients had a normal range of motion of the ankle after operation.AOFAS score was increased from preoperative (36.2 ± 13.4)points to (91.2 ± 6.7) points at the final follow-up (P ＜ 0.01).According to the AOFAS score,the results were excellent in 15 patients and good in 2 patients,with the good rate of 100％.Conclusion For chronic ankle instability,Internal-braceTM technology comnbined with modified Brostrom procedure benefits wound healing and functional recovery,reduces incidence of complications and exhibits satisfactory short-term outcome.

FasT-Fix technique for suturing degree Ⅲ horizontal meniscus tears / 中华创伤杂志

Objective To investigate the results of FasT-Fix technique in repair of degree Ⅲ horizontal meniscus tears.Methods From June 2010 through June 2013,12 patients with degree Ⅲ horizontal meniscus tears underwent arthroscopic vertical mattress suture using the FasT-Fix technique.There were 7 males and 5 females at mean age of 34.7 years.All the patients were diagnosed with combined anterior cruciate ligament (ACL) rupture with preoperative Lysholm score of (64.9 ± 9.4)points.Arthroscopic meniscus repair was performed prior to ACL reconstruction.A second-look arthroscopy examined the healing status of the meniscus at 6 to 18 months postoperatively (mean,12 months).Lysholm score was evaluated during outpatient follow-up.Results All the patients were available to the follow-up of 26 months (range,12-36 months).Second-look arthroscopy showed complete healing in 9 patients and incomplete healing in 3 patients.At final follow-up,Lysholm score was (93.4 ± 5.0) points.Conclusion FasT-Fix technique can repair degree Ⅲ horizontal meniscus tears with vertical mattress sutures and reconstruct ACL,which has advantages of allowing maximal preservation of the horizontally torn meniscus,minor trauma,easy operation and definite efficacy.

Treatment of posterior and anterior ankle impingement syndrome with combined anterior, tarsal sinus and posterolateral approaches under arthroscopy / 中华创伤杂志

Objective To discuss the methods and effects of arthroscopic treatment of posterior and anterior ankle impingement syndrome through anterior approach,tarsal sinus approach plus posterolateral approach.Methods The study enrolled 12 patients with posterior and anterior ankle impingement syndrome treated from January 2012 to March 2014.There were 8 males and 4 females,agedl7-65 years (mean,45 years).Left ankle injury was noted in 9 patients and right ankle injury in 3 patients.Eight patients had a history of obvious ankle injury (5 acute and 3 chronic sprains).Arthroscopic surgery was performed to manage the posterior and anterior ankle impingement syndrome through the combined anterior,tarsal sinus and posterolateral approaches,and prone position and posteromedial incision were not used during operation.Postoperative outcome was evaluated using the American Orthopedic Foot and Ankle Society (AOFAS) score.Results Operation time was 45-80 min (mean,62 min).Arthroscopy confirmed anterior bone impingement in all patients.Three patients suffered from posterior bony impingement of the talus,while nine patients os trigonum injury.Duration of follow-up was 10-18 months (mean,14 months).AOFAS score was (91.4-± 6.5) points after operation,significantly higher (34.4 ± 12.6) points before operation (t =14.607,P ＜0.01).All patients had normal ankle range of motion after operation.There were no complications such as neurovascular injury.All the surgical incisions achieved primary healing.Conclusion The procedure avoids body position shift and posteromedial incision during operation,and attains a good vision to the anterior and posterior portions and satisfactory short-term outcome.

Restriction endonuclease digest - melting curve analysis: a new SNP genotyping and its application in traditional Chinese medicine authentication / 药学学报

Single nucleotide polymorphisms (SNP) is an important molecular marker in traditional Chinese medicine research, and it is widely used in TCM authentication. The present study created a new genotyping method by combining restriction endonuclease digesting with melting curve analysis, which is a stable, rapid and easy doing SNP genotyping method. The new method analyzed SNP genotyping of two chloroplast SNP which was located in or out of the endonuclease recognition site, the results showed that when attaching a 14 bp GC-clamp (cggcgggagggcgg) to 5' end of the primer and selecting suited endonuclease to digest the amplification products, the melting curve of Lonicera japonica and Atractylodes macrocephala were all of double peaks and the adulterants Shan-yin-hua and A. lancea were of single peaks. The results indicated that the method had good stability and reproducibility for identifying authentic medicines from its adulterants. It is a potential SNP genotyping method and named restriction endonuclease digest - melting curve analysis.