The paper was aimed to review the modeling methods of spleen-yang deficiency, which can be classified into imitating traditional Chinese medicine (TCM) etiology methods and modern medicine methods. At present, methods of modeling were not generally accepted and the main presented problems were as follows. Modern medicine methods did not conformed to the rules of TCM etiology and pathogenesis. The evaluation of yang deficiency models was not accurate. Some modeling methods can lead to other diseases at the same time. The names of spleen deficiency model were not unified. It was difficult to distinguish the modeling methods of spleen-yang deficiency and spleen-qi deficiency, and etc. Model evaluation of spleen-yang deficiency was various. However, the domestic standard evaluation system had not been formed. The main model evaluation problems were as follows. Macro symptoms of the model lacked of objective and quantitative evaluation. It lacked of evaluation indexes of pulse and tongue with TCM characteristics. The disproof of prescription selection was not unified. Similar syndromes had not been ruled out. The microscopic indexes were fragmented, and etc. This paper reviewed on animal modeling methods of spleen-yang deficiency.

OBJECTIVETo analyze the clinical effects of intramedullary fixation of Kirschner pin for the treatment of distal fibula fractures.

METHODSFrom April 2007 to June 2010, thirty patients with the distal fibula fractures were treated with intramedullary fixation of Kirschner pin. There were 22 males and 8 females with an average age of 35.6 years old (22 to 60 years), length of hospital stay was 10 to 30 days (means 15.8 days). There were 20 cases of Transverse fracture and 10 cases of oblique fracture. Evaluation of the function of the ankle joint is based on the American Orthopaedic Foot and Ankle Society (AOFAS) standard evaluation systems.

RESULTSAll the cases were followed up. The mean followed-up time was 15.5 months (3 to 30 months). All fractures were bone healed, no case suffered infection and nonunion, no case suffered nervus fibularis superficialis injury. According to the AOFAS (American Orthopaedic Foot and Ankle Society) evaluation systems, the total scores after operation was 96.1 +/- 4.3 (the pain was 39.0 +/- 4.0, the fracture force line was 10, the function was 47.1 +/- 2.1. Twenty-eight patients obtained excellent results, 2 good.

CONCLUSIONThis method can be easily operated with the advantages of less pain and safety. It can effectively attenuate the financial burden of the patients. Thus worth being popularized in clinicic and basic level hospital.

Adult ; Female ; Fibula ; injuries ; Fracture Fixation, Intramedullary ; methods ; Humans ; Male ; Middle Aged

Objective:To evaluate the safety and effectiveness of transjugular intrahepatic portosystemic shunt (TIPS) in hepatocellular carcinoma (HCC) patients with Vp4 portal vein tumor thrombus (PVTT).Methods:Data of 15 patients undergoing TIPS for HCC with Vp4 PVTT and portal hypertension (PTN) in Peking University First Hospital from July 2018 to February 2023 were retrospectively analyzed, including 14 males and 1 female, aged (61.5±11.1) years old, ranging from 40 to 78 years old. The success rate of TIPS, portal pressure gradient (PPG) before and after procedure, perioperative adverse effects and complications were recorded. The survival status of patients was followed up by telephone review after surgery. Kaplan-Meier method was used for survival analysis.Results:The procedure of TIPS was performed uneventfully in all patients, with a technical success rate of 100% (15/15). PPG before and after TIPS were (31.73±5.48) mmHg (1 mmHg=0.133 kPa) and (17.60±3.66) mmHg, respectively, and the difference was statistically significant ( P<0.001). No perioperative death, hepatic artery or bile duct injury, acute liver failure or other major complications occurred. Compared with the preoperative status, the performance status scores [0(0, 0) vs. 3(3, 3)] and Child-Pugh scores [6(5, 8) vs. 9(8, 10)] were lower in patients one month after TIPS (all P<0.05). The median survival time was 228 d. Kaplan-Meier curves showed that the cumulative survival rates at 3, 6, 12 and 24 months after TIPS were 100%, 64.3%, 32.7% and 8.2%, respectively. Conclusion:TIPS could be safe and effective for HCC with Vp4 PVTT and severe PTN.

Objective:To investigate the impact of overweight/obesity on postoperative complications in breast reduction surgery.Methods:A retrospective study was conducted on patients who underwent breast reduction surgery in our hospital from 2016 to 2022. Basic patient information and postoperative complications, such as poor wound healing, infection, hematoma, nipple necrosis, etc., were collected. Patients were categorized into normal/low weight group and overweight/obese group according to their body mass index (BMI). The differences in postoperative complications between the two groups were compared and statistically analyzed.Results:The study included 82 patients, 48 in the normal/low weight group and 34 in the overweight/obese group. The gender, age, and surgical methods of the two groups of patients were relatively balanced, and there was no statistical difference. However, the incidence of postoperative complications was 50.0% (17/34) in overweight/obeseitg group, higher than 18.8% (9/48) in normal/low weight group. Common complications included delayed healing such as infection or dehiscence in 8 cases (9.8%), skin necrosis in 5 cases (6.1%), and hypertrophic scars in 5 cases (6.1%). The incidence of skin necrosis and delayed healing in the overweight/obese group was higher than that in the normal/low weight group, but the difference was not statistically significant ( P>0.05). Postoperative hematoma and hypertrophic scars occurred in both groups, while fat liquefaction and thrombosis only occurred in the overweight/obese group. Conclusions:Overweight/obesity is an important risk factor for postoperative complications in breast reduction surgery. Patients should be evaluated before surgery, and necessary measures should be taken to reduce the risk of complications.

Objective: To determine the effect of gut microbiota on a rat model of post-traumatic stress disorder(PTSD)and explore the correlation of gut microbiota with behavior and neurotransmitters.Methods: We established a single prolonged stress(SPS)model to examine the pathogenesis of PTSD on rat behavior,gut microbiota,and neurotransmitter levels.Rats were separated into control and model groups,and neurotransmitter levels were measured using enzyme linked immunosorbent assay.Then,16 S rRNA sequencing was used to compare the gut microbiota between the control and model groups.Results: Compared with those in the control group,freezing time significantly increased,while number of standing upright,crossing frequency,time spent in the central arena,and total distance traveled were significantly reduced in the model group after exposure to SPS(all P<.05).Meanwhile,serotonin,or 5-hydroxytryptamine,levels in the brain in the model group were significantly lower than those the control group(P=.0332).In addition,changes were observed in the gut microbiota diversity and relative abundances of bacterial phyla,orders,families,and genera in the model group.Especially,changes in Firmicutes,Bacteroidetes,Cyanobacteria,and Proteobacteria levels were most pronounced after SPS exposure.Correlation analysis showed that the strongest positive correlation was found between Bac-teroidaceae and 5-HT(P =.0009).Moreover,RF32 abundance was the most negatively related to 5-HT(P=.0009),crossing frequency(P=.0007),and total distance(P=.0003).Conclusion: Our results suggest that SPS model rats showed differences in behavior,neurotransmitter levels,and gut microbiota with control rats.Moreover,Firmicutes,Bacteroidetes,Cyanobacteria,and Proteobacteria were most relevant to the exhibited fear-like and anxiety-like behaviors and significant serotonin content reduction in SPS model rats.

Objective:To evaluate the analgesic effects of lidocaine cream and ice application during botulinum toxin type A treatment on bilateral gastrocnemius hypertrophy.Methods:A retrospective study was conducted, including 60 patients who underwent botulinum toxin type A treatment for bilateral gastrocnemius hypertrophy at Peking University Shenzhen Hospital from January 2020 to January 2022. Patients were divided into two groups based on the analgesic methods: lidocaine surface anesthesia group (lidocaine group, 30 cases) and ice application analgesia group (ice group, 30 cases). The lidocaine group consisted of 2 males and 28 females, with a mean age of (27.0±5.0) years, while the ice group consisted of 30 females, with a mean age of (26.2±4.4) years. Depending on individual needs, 100-200 U of botulinum toxin type A was injected into the calf muscle of each patient. In the lidocaine group, nurses applied lidocaine cream to the injection area and covered it with a film before injection. In the ice group, nurses used custom-made ice packs to surround the injection site for 10 minutes. Pain levels were assessed using the visual analog scale (VAS) during injection, including pain scores for needle puncture and drug injection. The incidence of postoperative adverse reactions and patient satisfaction rates were also recorded.Results:The VAS score for needle puncture pain was (2.60±1.25) in the lidocaine group and (2.30±1.12) in the ice group, with no statistically significant difference ( P=0.331). However, the VAS score for drug injection pain was significantly higher in the lidocaine group (3.47±1.25) than that in the ice group (2.77±1.28, P=0.036). The overall analgesic VAS score was (3.37±1.16) in the lidocaine group, also significantly higher than that (2.60±1.25) in the ice group ( P=0.017). Two patients in the lidocaine group experienced localized swelling, and one reported localized itching with a rash, while no adverse reactions were observed in the ice group. Patient satisfaction rates were 86.7% (26/30) in the lidocaine group and 93.3% (28/30) in the ice group. Conclusions:Ice application provides superior analgesic effects compared to lidocaine cream surface anesthesia during botulinum toxin type A treatment for bilateral gastrocnemius hypertrophy.