The rupture of carotid vulnerable plaques is the core pathological basis for major cardiovascular and cerebrovascular events. However， the insufficient alignment between existing animal models and the clinical disease and syndrome characteristics of traditional Chinese and western medicine has limited research progress. In this study， biomedical databases in China and abroad were systematically searched， and the modeling mechanisms and evaluation systems of carotid vulnerable plaque animal models were systematically assessed based on diagnostic criteria of both traditional Chinese and western medicine. Analysis of the clinical correspondence indicated that existing animal models can be categorized into four types： simple high-fat diet， surgical induction combined with high-fat feeding， genetic engineering combined with high-fat feeding， and drug induction combined with high-fat feeding. Among these， the compound strategy of surgical induction combined with high-fat feeding has become the current mainstream approach， showing good concordance with western medicine. The study found that the double balloon injury rabbit model and the ApoE^-/- mouse carotid artery tandem constriction combined with high-fat feeding model demonstrated a high degree of clinical correspondence with both traditional Chinese and western medicine in terms of vulnerable plaque imaging and pathological features. Nevertheless， existing models still face significant technical limitations in faithfully simulating plaque pathology and in translating findings to clinical applications. To address these challenges， integrating complex comorbidity mechanism construction， multimodal dynamic mechanism monitoring， and collaborative evaluation systems of traditional Chinese and western medicine could enable the development of highly concordant carotid vulnerable plaque disease-syndrome combination animal models. Such models would provide a reproducible experimental platform for targeted drug development to regulate plaque stability and for individualized precision treatment， as well as a theoretical basis for innovation in clinical diagnostic and therapeutic strategies.

AIM:To observe the anti-scarring effects and safety of triamcinolone acetonide(TA)-loaded hydrogel sustained-release sheeting on stab incision glaucoma surgery(SIGS)with “one-step tunnel method” in rabbit eyes.METHODS:A total of 48 healthy New Zealand white rabbits were randomly selected and divided into 4 groups(12 rabbits in each group), trabeculectomy(Trab)group, SIGS group, polyvinyl alcohol hydrogel(PVAH)sheeting was implanted under the conjunctiva flap during SIGS(PVAH group), and hydrogel sustained-release sheeting loaded with TA was implanted under the conjunctiva flap during SIGS(TA/PVAH group). On the 1, 2, 3, and 4 wk after surgery, the intraocular pressure, filtering bubble morphology, anterior chamber reaction, and other complications were observed and recorded in each group. Then animals were euthanized, and the surgery area tissues of right eye were taken for pathological tissue paraffin section. Masson staining, picric acid-Sirius rose red staining, as well as α-smooth muscle actin(α-SMA)and fibroblast growth factor 2(FGF2)immunohistochemistry staining was performed on every section. The infiltration of inflammatory cells, proliferation of fibroblasts and synthesis of type I and type III collagen fibers in local tissues were observed. The average positive area ratio of α-SMA and FGF2 antibody immunohistochemical staining in each group was calculated and compared.RESULTS: The TA/PVAH group maintained diffuse and elevated functional filtering blebs, while flat filtering blebs appeared in Trab, SIGS and PVAH groups at 2 wk after surgery. Functional filtering blebs were present in 1 eye(33%), 2 eyes(67%)in the PVAH and TA/PVAH group at 4 wk after surgery, respectively, while the other filtering blebs were flattened. Masson staining showed that the hydrogels in PVAH and TA/PVAH groups did not degrade at 4 wk after surgery. Compared with the Trab and SIGS groups, the filtration passages were more obvious, with less collagen fiber proliferation. Sirius red staining showed that the expression of type I collagen and type III collagen in the TA/PVAH group was less than that in the Trab group, SIGS group and PVAH group at 4 wk after surgery. Immunohistochemical staining showed that the α-SMA expression in the TA/PVAH group was significantly lower than that in the Trab and SIGS groups at 1 wk after surgery(P<0.01). The α-SMA expression was the highest in the Trab and SIGS groups at 2 wk after surgery, while the α-SMA expression in the PHAP and TA/PVAH groups was significantly lower than that in the first two groups(P<0.01). Compared with the Trab group, the expression of FGF2 in the PVAH and TA/PVAH group was significantly increased at 1, 2, 3 and 4 wk after surgery(P<0.05). Compared with the SIGS group, FGF2 expression in the TA/PVAH group was significantly increased at 4 wk after surgery(P<0.05).CONCLUSION:In SIGS surgery of rabbit eyes, implanting hydrogel sustained-release sheeting loaded with TA under conjunctival flap can effectively inhibit the scarring of the filtering bleb, which may be the interaction of the anti-scar effect of TA and the stent function of hydrogel.

Objective:To compare the safety of dexmedetomidine and midazolam in weaning mechanical ventilation patients after cardiopulmonary bypass (CPB) in ICU.Methods:From August 2016 to December 2018, 51 patients admitted to the People's Hospital of Jinhua for mechanical ventilation after ICU CPB cardiac surgery were randomly divided into dexmedetomidine group and midazolam group according to the numerical table method.During mechanical ventilation, dexmedetomidine was used to sedate the study group(26 cases), and midazolam was used in the control group (25 cases). The total time of mechanical ventilation, CPOT score, ICDSC score, incidence of sinus bradycardia during mechanical ventilation were counted, and the anterograde amnesia was observed after extubation.The safety and related factors of drug withdrawal in patients undergoing mechanical ventilation after CPB surgery of two different sedations were compared and evaluated.Results:Statistical analysis showed that the CPOT score of the dexmedetomidine group was (1.04±0.45)points, which was significantly lower than that of the midazolam group[(2.24±0.83)points], the difference was statistically significant between the two groups( t=-6.40, P<0.01). The ICDSC score of the dexmedetomidine group was (0.96±0.20)points, which of the midazolam group was (1.04±0.35)points, the difference was no statistically signiyicant between the two groups( t=-0.99, P>0.05). The total time of mechanical ventilation was (29.71±17.96)h in the dexmedetomidine group and (26.13±20.02)h in the midazolam group, there was no statistically significant difference between the two groups( t=0.67, P>0.05). During mechanical ventilation sedation, the dexmedetomidine group had more bradycardia, the difference was statistically significant(χ 2=11.96, P<0.01). There was no anterograde amnesia in the dexmedetomidine group, but all of the patients in the midazolam group had anterograde amnesia. Conclusion:Compared with the midazolam group, the CPOT score was lower in the dexmedetomidine sedation group with the same SAS score of 4(superficial sedation), which in line with the principles of " deep analgesia, shallow sedation". Although bradycardia occurs during the use of drugs, it can recover spontaneously after withdrawal and is safe to use.

Objective To observe the effects of nasal feeding with different enteral nutrition (EN) agents, TPF-D emulsion and Briprin (SP) suspension on blood glucose level in patients with hyperglycemia under mechanical ventilation after cardiac surgery of extracorporeal circulation (CPB). Methods Forty patients with mechanical ventilation and hyperglycemia after CPB cardiac surgery admitted to the Department of Intensive Care Unit (ICU) of Jinhua People's Hospital from August 2016 to October 2018 were selected. According to the different EN preparations given after the surgery, the patients were divided into two groups: a TPF-D group (21 cases) and a Briprin group (19 cases). Both groups were given reasonable analgesia, sedation and other conventional treatment to maintain the hemodynamic stability and balances between water electrolytes and acid-base. EN therapy was applied within 24 ~48 hours after ICU admission and caloric requirements were calculated according to ideal body weight. The EN treatment in TPF-D group was given by TPF-D nasal feeding, the drip rate started from 20-30 mL/h and gradually increased to 50-100 mL/h according to patients' tolerance; in the Briprin group, EN was given by nasal feeding of SP, and the feeding mode was the same as that of TPF-D group. The mechanical ventilation time, postprandial 2 hours blood glucose level and blood glucose increase rate of the two groups were observed; the glycosylated albumin (GA) and serum triglyceride (TG) levels were measured 3 days after EN administration, and the first postoperative defecation time was also observed in the two groups. Results After EN therapy, there were no statistically significant differences in mechanical ventilation time and TG level after 3 days of EN treatment between the TPF-D group and the SP group [mechanical ventilation time (hours): 31.52±19.56 vs. 27.26±14.35, TG (mmol/L) after 3 days of EN therapy: 1.32±0.37 vs. 1.62±0.57, both P > 0.05]. The glucose level and glucose increase rate at postprandial 2 hours, and GA level after 3 days of EN therapy in TPF-D group were obviously lower than those in the SP group [glucose level 2 hours postprandial (mmol/L): 7.68±1.20 vs. 11.60±1.69, the glucose increase rate at 2 hours postprandial: (-0.01±0.15)% vs. (0.39±0.24)%, and GA after 3 days of EN therapy: (12.81±1.64)% vs. (16.32±2.35)%, all P < 0.01]. The time of the first bowel movement in the TPF-D group was earlier than that in the SP group (days: 2.48±0.51 vs. 3.84±0.69, P < 0.01). Conclusion The effect of applying TPF-D EN emulsion was less than that of SP suspension on glucose level in post-operative CPB patients with hyperglycemia and after mechanical ventilation, showing when using TPF-D, the stability of blood glucose is better and defecation earlier.

Objective To verify the reliability of dose parameters of radiotherapy under reference and non-reference conditions by using TLD.Methods Dose parameters were verified by using TLDs under reference and non-reference conditions,including the maximum dose in axel of 5 electron beams with energy of 9 MeV and the variations of dose by depth,source-skin distance,exposure field and 45° wedge for 10 photon beams with energy of 6 MV in 5 hospitals.Results The average relative deviation of 6 MV photon beam measured between TLDs and finger ionization chambers were 4.45％,within ± 7％ as required by IAEA.The average relative deviation of 9 MeV electron beam measured between TLDs and plane parallel chambers were 2.45％,within ± 5％ was required by IAEA.Conclusions Measuring dosimetric parameters by using TLDs under reference and non-reference conditions was reliable and feasible.

Objective To explore the influence of drug dosage, solvent and other main influencing factors on the successful establishment of alloxan-induced hyperglycemia mouse model and the effect on the stability of this model. Methods 160 6-8-week-old Kunming mice ofSPF grade, (male:female=1:1) were used in this study.The influences of different dosages of alloxan and solvent combinations on the successful establishment rate of the model, survival rate, body weight, fasting blood glucose, blood glucose area under curve, serum insulin level and their stabilities were dynamically observed for six weeks.Results By single intraperitoneal injection of 160 mg/kg bw alloxan ( pH 4.5 citrate sodium as solvent) , we were able to obtain a stable experimental hyperglycemic mouse model with higher levels of successful establishment rate (70%), survival rate (75%), fasting blood glucose (15-20 mmol/L), glucose area under the curve (55-65 mmol/L) and a lower but not loss of serum insulin levels (21 mIU/L).Conclusions In the present study we have carefully considered the influence of main factors such as drug dosages, solvent, etc., on the alloxan-induced experimental hyperglycemic mouse model, and successfully established this model after 6-week period observation of its stability.This model may provide a useful tool in the research of experimental diabetes and hypoglycemic functional studies.

Objective To investigate the outcomes of unselected peripheral T cell lymphoma (PTCL) patients treated with in-tensive first-line chemotherapy with high-dose therapy followed by autologous stem cell transplantation (ASCT).Methods Here a nonrandom study was reported for 23 PTCL patients treated with first-line intensive chemotherapy followed by autologous stem cell trans-plantation and 23 PTCL patients treated with conventional chemotherapy during January in 2000 to 2011 .All patients had received E-CHOP for 6~8 cycles, and autologous stem cell transplantation group was administrated with intensive chemotherapy followed by ASCT after complete remission or partial remission .Results There was no statistically significant difference in short-term therapeutic effect between two groups( P >0.05), but the 5-year overall survival(OS) of autologous stem cell transplantation group( 58%) was higher than conventional chemotherapy group , as well as 5-year disease-free survival time (DFS) (45%in autologous stem cell transplanta-tion group, and 21%in conventional chemotherapy group ) with both statistical significance ( P <0.05).Only the incidence of Ⅳ° myelosuppression in autologous stem cell transplantation group ( 100%) was higher than that in conventional chemotherapy group ( 13%) ( P <0.01 ) .Conclusions First-line intensive chemotherapy followed by autologous stem cell transplantation for peripheral T cell lymphoma was quietly safe utility , it was better than conventional chemotherapy which would be considered as first -line method.