Objective To observe the effect and safety of Mailuoning Injection(MLN) in treating patients with type 2 diabetes mellitus accompanying lower extremity atherosclerotic obliterans.Methods The selected patients were assigned by randomized digital table to a treated group (120 cases treated with MLN) and a control group (60 cases treated with alprostadil). The clinical efficacy was assessed after 4 weeks of treatment. Results The total effective rate in the treated group was 95.0%, better than that in the control group,83.3%(P＜0.01).Conclusion MLN has the effect of activating blood circulation.dissolving stasis and dredging collaterals, reducing the formation of thrombi. MLN is effective and safe when applied in clinical practice for the treatment of lower extremity diabetic atherosclerotic obliterans.

Objective To observe the effect of Shenqi Jiangtang granule (SJG) on atherosclerotic disease (LEAD) of lower extremity in patients with early type 2 diabetes mellitus (T2DM). Methods The patients were randomly assigned to a control group and a treatment group. 30 patients in the treatment group were treated by SJG and 30 patients in the control group were given Cilostazo. Both groups were treated for 3 months. Lower extremity vascular color Doppler image, blood levels of interleukin-6 (IL-6) were measured before and after the treatment. Results The thickness of atherosclerosis (AS) plaque and arterial media were obviously reduced (t=3.376, 3.468, P<0.05) , serum levels of IL-6 were also be lowered obviously (t=3.345, P<0.05) in the treatment group. While these indexes remained unchanged in the control group. Conclusion SJG has remarkable action in reducing the thickness of AS plaque and media of artery. The mechanism might be related with its reducing serum IL-6 level.

Objective To observe the effect of Shenqi Jiangtang Keli (SJK) on atherosclerotic disease (LEAD) of lower extremity in patients with early type 2 diabetes meliitus (T2DM). Methods The patients were randomly assigned to a control group and a treatment group. The 30 patients in the treatment group were treated by SJK and the 30 in the control group were given Cilostazo, with both groups were treated for 3 months. Lower extremity vascular color Doppler image, blood levels of interleukin-6 (IL-6) were measured before and after the treatment,. Results The thickness of atherosclerosis (AS) plaque and arterial intimamedia were obviously reduced (t=3.376, 3.468, P< 0.05 ), serum levels of IL-6 were also be lowered obviously (t=3.345, P<0.05) in the treatment group. While these indexes remained unchanged in the control group. Conclusion SJK has remarkable action in reducing the thickness of AS plaque and intima-media of artery. Its mechanism might be related with reducing serum IL-6 level.

Objective To evaluate the feasibility,safety and operation timing of laparoscopic cholecys-tectomy in treatment of gallbladder calculi incarceration. Methods The data of 280 cases of gallbladder stone incarceration performed by LC were retrospectively analyzed. Results Eight out of 280 cases were converted to open cholecystectomy. The successful rate of LC was 97. 1%. There were no complications such as bile and intestinal injury. Conclusion LC for gallbladder calculi incarceration is safe and feasible as long as operators have skilled technique and make right decisions on operation timing.

One patient with the pedicle screw threatening the aorta was treated with adjusting the position of pedicle screw by anterolateral approach. No nervous lesion was found after adjusting. Radiograph showed the position and length of screw at T11 left pedicle of vertebral arch were good. No adverse reaction was detected after 2-years of follow-up.

Objective To investigate the potential of ginkgolide B(GB)in mitigating vascular endothelial injury by antagonizing endoplasmic reticulum stress(ERS)and elucidate its underlying molecular mechanism.Methods An injury model of human bone marrow-derived endothelial progenitor cells(EPCs)induced by tunica-mycin(TM)was established.Cell proliferation was assessed using MTS assay,while cell viability was determined through Calcein-AM/EthD-I double staining.Transwell assay was employed to evaluate cell migration ability.DCFH-DA staining was utilized to measure intracellular ROS levels,and NADPH activity was quantified via ELISA.JC-1 and DiOC6 staining were performed for qualitative and quantitative assessment of mitochondrial membrane potential respectively.Qrt-pcr analysis was conducted to determine mRNA expression levels,whereas western blot analysis enabled detection of protein expression levels in the cells.Results GB dose-dependently attenuated tunicamycin-induced ERS-mediated endothelial injury in hEPCs,as evidenced by decreased cell viability,impaired cell migration,and angiogenesis inhibition(P<0.01).Furthermore,GB treatment significantly reduced ROS production and NADPH levels within the cells(P<0.01),while also inhibiting ERS-mediated decline in mitochondrial membrane potential concentration-dependently(P<0.01).Additionally,GB inhibited the expression of ERS-related proteins such as GRP78,ATF4,CHOP etc.,regulated apoptosis-related protein Bcl-xl,Bax cleaved caspase-4 cytochrome c;thereby effectively counteracting endoplasmic reticulum stress-induced cellular damage.Conclusions GB exerts a protective effect on vascular endothelium by antagonizing endoplasmic reticulum stress;this mechanism may be attributed to its ability to reduce intracellular reactive oxygen species levels.It also suppresses the expression of ERS-related proteins(CHOP78 and ATF4),and modulates apoptosis-associated proteins(Bcl-xl,Bax,cleaved caspase-4,and cytochrome c).

Objective:To explore the clinical efficacy of periosteum-covered iliac crest autografts for treatment of severe osteochondral lesions of talus （OCLTs）.Methods:A retrospective case series study was used to analyze the clinical data of 26 patients with severe OCLTs treated at Zhejiang Armed Police Corps Hospital from January 2013 to October 2019. There were 21 males and 5 females，aged 17-49 years ［（36.3 ± 10.9）years］. All patients were treated using periosteum-covered iliac crest autografts. The visual analogue scale （VAS），American Orthopedic Foot and Ankle Society （AOFAS） ankle-hindfoot score and ankle joint range of motion （ROM） were assessed before operation，6 months after operation and at the last follow-up （≥ 12 months）. The area of talus injury with MRI at the same level was recorded before operation and at the last follow-up. The healing of talus and joint surface was detected with CT at the last follow-up. The healing of the incision and osteotomy site and complications were observed.Results:All patients were followed for 12 to 22 months［（15.1 ± 3.2）months］. The VAS was （2.4 ± 0.9）points and （1.7 ± 0.6）points at postoperative 6 months and at the last follow-up，significantly lower than the preoperative （5.4 ± 1.2）points （ P < 0.01）. Meanwhile，the VAS at the last follow-up was significantly lower than that at postoperative 6 months （ P < 0.01）. The AOFAS ankle-hindfoot score was （71.7 ± 7.8）points and （87.8 ± 6.2） points at postoperative 6 months and at the last follow-up，significantly lower than the preoperative （66.5 ± 7.5） points （ P < 0.01）. Meanwhile，the AOFAS ankle-hindfoot at the last follow-up was significantly lower than that at postoperative 6 months （ P < 0.01）. The ankle ROM was （58.4 ± 5.5）° and （70.0 ± 4.9）° at postoperative 6 months and at the last follow-up，significantly improved when compared to the preoperative （42.3 ± 8.1）° （ P < 0.01）. Meanwhile，the ankle ROM at the last follow-up was significantly improved when compared to that at postoperative 6 months （ P < 0.01）. The area of talus injury with MRI at the same level was 0.67（0.55，0.89）cm 2 at the last follow-up，significantly improved when compared to preoperative 2.64（1.98，3.68）cm 2 （ P < 0.01）. The transplantation had neither obvious defects nor joint surface steps based on CT findings. All surgical incisions were healed by first intention. There were no complications such as incision infection，skin necrosis，nonunion of osteotomy，malunion or severe ankle joint disorder except that 8 patients had residual local subchondral bone?marrow?edema-like?signal?and 2 patients showed delayed healing of medial malleolus osteotomy. Conclusion:For patients with severe OCLTs，periosteum-covered iliac crest autografts can effectively relieve ankle pain，improve ankle function，and reduce the area of injury.

Autologous ozonized blood transfusion(AOBT) is a therapy of re-transfusion of 100-200 mL of autologous blood after shaking and agitation with appropriate amount of oxygen-ozone in vitro. The oxidation of blood through the strong oxidation of ozone can enhance the non-specific immune response of the body, regulate the internal environment and promote health. This therapy has been increasingly applied in clinical practice, while no unified standard for the operation process in terms of ozone concentration, treatment frequency and treatment course had been established. This operation process of AOBT is primarily explored in order to standardize the operation process and ensure its safety and efficacy.