This study was aimed to observe the effect ofRong-Shuan (RS) capsule on rodent tolerance against cerebral ischemia, hypoxia and cerebral reserve capacity, which was related to promote blood circulation and remove blood stasis. Acute cerebral ischemia and anoxia models were established by permanent left carotid artery ligation on C57 BL/6 mice and hypoxia inhalation (O2?N2 = 8?92) for 15 min. Duodenal administration of RS capsule at different doses (100, 200 or 400 mg·kg-1) or saline were given 10 min after ischemia onset. The local brain blood circulation changes and neurobehavioral function were evaluated 24 h after ischemia onset. SD rats were given RS capsule at different doses (75, 150, 300 mg·kg-1) or saline. The effect of RS capsule on improvement of microcirculation disturbance induced by high molecular dextran was observed. The results showed that compared with the sham operation group, the brain blood circulation in the model group was significantly decreased; the cerebral infarction area increased; and the behavioral score after cerebral hypoxia was significantly increased (P < 0.05, orP < 0.01). Meanwhile, after the injection of high molecular dextran among rats in the model group, the cerebral leptomeninx microcirculation was obviously slowed down at 3 timepoints, which were 10, 20 and 30 min. Compared with the model group, RS capsule (400 mg·kg-1) can significantly increase the local blood circulation in the brain of mice, improve behavioral disturbance, reduce cerebral ischemia area (P< 0.05, orP < 0.01). RS capsule can also improve blood flow velocity and flow pattern in cerebral leptomeninx microcirculation disturbance induced by high molecular dextran at different timepoints (P < 0.05, orP < 0.01). It was concluded that RS capsule can increase the tolerance against cerebral ischemia, hypoxia and cerebral reserve capacity in order to protect the neural tissues to promote neuronal recovery.

Objective To compare expression of Toll?like receptors 7 and 9(TLR7, TLR9)as well as their regulatory molecules myeloid differentiation factor 88(MyD88)and nuclear factor?κB(NF?κB)in peripheral blood mononuclear cells(PBMCs)between patients with vitiligo and healthy individuals, and to explore their significance. Methods Flow cytometry was performed to measure expression of TLR7 and TLR9 in PBMCs among 36 patients with vitiligo and 22 healthy controls, and real?time fluorescence?based quantitative PCR(RT?PCR)was conducted to determine mRNA expression of MyD88 and NF?κB in the above blood samples. Results Compared with healthy controls, patients with vitiligo showed higher expression of TLR7 and mRNA expression of MyD88 and NF?κB, but lower expression of TLR9. However, significant differences were only observed in the mRNA expression of NF?κB(t=2.814, P=0.008), but not in the expression of TLR7 and TLR9 or the mRNA expression of MyD88 between patients and controls (t = 1.477, 1.761, 0.058, all P > 0.05). Conclusion NF?κB, as a key signaling molecule of TLR7 and TLR9 regulation pathways, increases obviously in patients with vitiligo, suggesting that NF?κB may be involved in the pathogenesis of vitiligo.

Objective:To evaluate the efficacy of dual-tuberosity locking plate for the treatment of proximal humeral fractures.Methods:This study retrospectively analyzed data of patients with proximal humeral fractures treated with a new locking plate from July 2017 to July 2019. Finally, 19 eligible patients were included, including 12 females and 7 males, with an average age of 64.0±12.8 years (range, 32-85 years). According to the Neer classification of proximal humeral fractures, 1 case was two-part fractures, 9 cases three-part fractures and 9 cases four-part fractures. Among them, 9 cases combined with greater and lesser tuberosities fractures and 10 cases with isolated greater tuberosity fractures. Constant-Murley and disabilities of the arm shoulder and hand (DASH) scores, the change of neck-shaft angle, the change of humeral head height, tuberosity consolidation and other complications were recorded at the latest follow-up.Results:The mean follow-up time was 16.1 months (range, 12-18 months). All fractures were healed within follow-up period. Mean Constant-Murley score was 84.2±11.0 (range, 55-98), DASH score was 19.4±11.6 (range, 2.3-47.8) and VAS was 1.6±1.3 (range, 0-4) at the latest follow-up. As for the radiographic results, 19 patients had a mean neck-stem angle of 141.9°±9.8° (range, 132.17°-162.66°) on the first day after surgery, and a mean humeral head height of 18.0±5.9 mm (range, 7.45-27.12 mm). The mean neck-stem angle was 148.6°±7.5° (range, 132.70°-159.39°) and the mean humeral head height was 17.4± 5.5 mm (range, 5.02-27.31 mm) at the latest follow-up. The average change of neck-stem angle was 3.29° (range, 0.68°-33.10°), and mean change of humeral head height was 0.68 mm (range, 1.32-6.56 mm). No fractures developed greater or lesser tuberosity absorption or malunion, but 4 cases suffered loss of fixation and 1 developed primary intra-articular screw penetration as well as wound infection.Conclusion:In the open reduction and internal fixation of the proximal humeral fractures, the new locking plate can fix greater and lesser tuberosity fractures simultaneously, which helps reduce their displacement and deformity of tuberosities. By given that, satisfactory radiographic outcomes and shoulder functions can be obtained.

Objective:To learn the key driving factors in the management of scientific and technological achievements transformation in public hospitals, so as to provide basis for improving the effectiveness of achievements transformation.Methods:From March to July 2021, 1 226 medical staff from 7 municipal hospitals in Hangzhou were investigated by stratified random sampling. The questionnaire included the main demographic information, the perceived importance and actual performance of the management mechanism(6 dimensions, 18 items)which was scored by Likert 5. Descriptive analysis was carried out and paired samples were compared by t-test, and the difference was significant when P<0.05. Importance matrix analysis was carried out on all items to identify the key driving factors for the transformation of achievements in public hospitals. Results:1 157 valid questionnaires were finally included. The difference between the scores of perceived importance and actual performance of the various management mechanisms was significance( P<0.001). The gap was presented as follows: evaluation mechanism(1.29), investment mechanism(0.88), organization and leadership mechanism(0.87), guarantee mechanism of services(0.44), benefit and distribution mechanism(0.15), incentive mechanism(-0.11). Matrix analysis results showed that, " special funds support" , " grasp market demand and accurately connect" , " formulate corresponding supporting systems" , " professional transformation team with multidisciplinary background" , " classified and multi-level achievement transformation evaluation index system" , " full life cycle management" , " incorporate into central work and key tasks" and " scientific and technological achievement transformation reporting system and application monitoring system" were the key driving factors for the transformation of scientific and technological achievements in public hospitals. Conclusions:The perceived importance of medical staff to the transformation of scientific and technological achievements in public hospitals is acceptable, while the actual performance is relatively weak. The management effectiveness should be improved and give priority to consolidate the management foundation, build index evaluation system, provide the life cycle management service and improve scientific interaction as well as consultation service mechanism.

Objective To compare the efficacy of adriamycin chemo-ganglionectomy and radiofre-quency thermocoagulation ( RFT ) of semilunar ganglion in treating craniofacial postherpetic neuralgia ( PHN) . Methods A total of 95 patients with PHN in the areas innervated by maxillary and mandibular divisions of trigeminal nerve, aged 55-90 yr, with the course of disease 6 months-3 yr, were divided into 2 groups using a random number table method: adriamycin chemo-ganglionectomy group ( ADM group, n=48) and RFT group ( n=47) . Hartel anterior approach to puncture was performed via the foramen ovale un-der the guidance of CT in two groups. In group ADM, 0. 5％ adriamycin 2. 5 mg ( 0. 5 ml) was injected via the foramen ovale, and RFT of gasserian ganglion was performed in group RFT. Visual Analog Scale (VAS) and the short-form McGill pain questionnaire (SF-MPQ) scores were evaluated before and after treatment. The rate of effective treatment was calculated, and treatment-related complications were recor-ded. Results Compared with group RFT, no significant change was found in VAS or SF-MPQ scores be-fore treatment, VAS and SF-MPQ scores were increased and the rate of effective treatment was decreased at 1 and 7 days after treatment, VAS and SF-MPQ scores were decreased and the rate of effective treatment was increased at 6 and 12 months after treatment, the incidence of facial numbness, hypoesthesia, masti-catory muscle weakness and weakened corneal reflex was decreased in group ADM ( P<0. 05) . Conclusion Compared with semilunar ganglion RFT, the long-term efficacy of adriamycin chemo-ganglionectomy of semilunar ganglion in treating craniofacial PHN is enhanced, and the safety is higher.

Objective:To investigate the effects of exercise prescription on quality of life in patients with pituitary adenomas after surgery.Methods:A total of 82 patients with pituitary adenomas who met the inclusion criteria from December 2017 to September 2018 were enrolled. The control group received routine nursing care. The intervention group was given exercise prescription on the first day after surgery and 3 months after discharge from hospital. Both groups of patients completed the Health Status Survey(SF-36) before and after the intervention.Results:Before the intervention, there was no significant difference in baseline date of patients between two groups( P>0.05). After intervention, the general health dimension score (53.03±11.30) of the control group was significantly higher than the score within the group before treatment ( Z value was -4.398, P<0.05). The physiological function (86.67±7.46), physical function (66.67±29.28), role-emotional (71.30±22.75), vitality (68.33±8.78), general health dimension (61.39±10.66) of the intervention group were significant higher than the score within the group before treatment ( Z values were -4.809--2.041, P<0.05) . After the intervention, the significant difference were found in role-physical, general health, vitality, social function(77.18±15.71) and physiological health dimensions (73.75±10.00) between the intervention and control group ( Z values were -3.122- -2.467, t value was 3.044, P<0.05). After the intervention, non-function patients′ physiological function (72.06±23.19), general health (60.59±10.75), vitality (69.71±10.23) and social function (81.04±10.22) were significantly higher than the control group ( Z values were -2.832- -2.059, P<0.05). Conclusion:Exercise prescription can improve the quality of life in patients with pituitary adenomas after surgery.

Objective To analyze the current status of cognition and satisfaction of medical staff in public hospitals in Hangzhou towards medical prevention integration,in order to provide reference and reference for promoting the development of medical prevention integration.Methods A questionnaire survey was conducted on 421 medical staff from three public hospitals in Hangzhou using stratified random sampling.Results Only 29.5%of medical staff expressed a strong or relatively good under-standing of medical prevention integration work;The overall satisfaction score of medical staff with medical prevention integration is(3.54±0.74).The results of logistic regression analysis show that age,professional title,education level,and monthly in-come are important factors affecting the satisfaction of medical staff with medical prevention integration(P＜0.05).Conclusion The awareness and satisfaction of medical staff in public hospitals in Hangzhou regarding the integration of medical and preven-tive measures need to be strengthened.It is recommended to improve basic construction,optimize health policies,promote infor-mation integration,and strengthen work cohesion.

Objective:This study aimed to share preliminary experiences of single-incision plus two ports laparoscopic proximal gastrectomy with right-sided overlap and single-flap valvuloplasty (ROSF).Methods:Following the 6th edition of the Japanese Gastric Cancer Treatment Guidelines, proximal gastrectomy with lymphadenectomy was performed. Using a single-port approach, the esophagus was transected at least 2 cm above the tumor's upper margin with linear staplers. The stomach was then extracted through a periumbilical incision, and the proximal stomach was subsequently transected extracorporeally, while ensuring appropriate resection margins on both the greater and lesser curvatures. A single flap was created before returning the remnant stomach to the abdominal cavity and re-establishing pneumoperitoneum. The No.2 clip was used to grasp and elevate the esophageal stump. An incision was made at the right lower edge of the esophageal stump to guarantee that the esophageal lumen was open. The linear stapler was then inserted into the openings of the stomach and esophagus to perform a side overlap anastomosis with a length of 3 cm. Another barbed suture was used to close the common opening of the esophagus and the stomach, and the same barbed suture were used to suture the gastric wall to the lower edge of the muscle flap. The first barbed suture was then used to sequentially suture the proximal brim of the flap to the esophagus and the right brim of the flap to the right brim of the mucosal window. After completion of anastomosis, a drainage tube was inserted through the right upper port. This procedure was employed from November 2023 to March 2024 on five patients diagnosed with adenocarcinoma of the esophagogastric junction and upper stomach. The cohort consisted of three males and two females, with an age range of 62 to 75 years and a body mass index (BMI) of 13.7 to 24.2 kg/m2. All cases were preoperatively staged as T1-2N0M0, confirmed by endoscopic biopsy and enhanced CT scans of the chest, abdomen, and pelvis.Results:All five patients successfully underwent the surgery. The median surgery time was 180-325 minutes, with the intraoperative blood loss of 30-50 ml. The number of lymph nodes harvested ranged from 18 to 27. The time to first flatus, and restore liquid diet and was 2.0-5.0 and 1.0-3.0 days, respectively. The postoperative length of stay was 9.0-11.0 days. The pain scores on the Numeric Rating Scale (NRS). On the first day, the pain scores were 3.0 in two cases, 2.0 in two cases, and 1.0 in one case. On the second day, the pain scores were 2.0 in two cases and 1.0 in three cases. On the third day, the pain scores were 1.0 in four cases and 2.0 in one case. No short-term postoperative complications were observed, and there were no perioperative deaths.Conclusion:Single-incision plus two ports laparoscopic proximal gastrectomy with ROSF is safe and feasible.

Objective:This study aimed to share preliminary experiences of single-incision plus two ports laparoscopic proximal gastrectomy with right-sided overlap and single-flap valvuloplasty (ROSF).Methods:Following the 6th edition of the Japanese Gastric Cancer Treatment Guidelines, proximal gastrectomy with lymphadenectomy was performed. Using a single-port approach, the esophagus was transected at least 2 cm above the tumor's upper margin with linear staplers. The stomach was then extracted through a periumbilical incision, and the proximal stomach was subsequently transected extracorporeally, while ensuring appropriate resection margins on both the greater and lesser curvatures. A single flap was created before returning the remnant stomach to the abdominal cavity and re-establishing pneumoperitoneum. The No.2 clip was used to grasp and elevate the esophageal stump. An incision was made at the right lower edge of the esophageal stump to guarantee that the esophageal lumen was open. The linear stapler was then inserted into the openings of the stomach and esophagus to perform a side overlap anastomosis with a length of 3 cm. Another barbed suture was used to close the common opening of the esophagus and the stomach, and the same barbed suture were used to suture the gastric wall to the lower edge of the muscle flap. The first barbed suture was then used to sequentially suture the proximal brim of the flap to the esophagus and the right brim of the flap to the right brim of the mucosal window. After completion of anastomosis, a drainage tube was inserted through the right upper port. This procedure was employed from November 2023 to March 2024 on five patients diagnosed with adenocarcinoma of the esophagogastric junction and upper stomach. The cohort consisted of three males and two females, with an age range of 62 to 75 years and a body mass index (BMI) of 13.7 to 24.2 kg/m2. All cases were preoperatively staged as T1-2N0M0, confirmed by endoscopic biopsy and enhanced CT scans of the chest, abdomen, and pelvis.Results:All five patients successfully underwent the surgery. The median surgery time was 180-325 minutes, with the intraoperative blood loss of 30-50 ml. The number of lymph nodes harvested ranged from 18 to 27. The time to first flatus, and restore liquid diet and was 2.0-5.0 and 1.0-3.0 days, respectively. The postoperative length of stay was 9.0-11.0 days. The pain scores on the Numeric Rating Scale (NRS). On the first day, the pain scores were 3.0 in two cases, 2.0 in two cases, and 1.0 in one case. On the second day, the pain scores were 2.0 in two cases and 1.0 in three cases. On the third day, the pain scores were 1.0 in four cases and 2.0 in one case. No short-term postoperative complications were observed, and there were no perioperative deaths.Conclusion:Single-incision plus two ports laparoscopic proximal gastrectomy with ROSF is safe and feasible.

OBJECTIVE To study the effect of 60Co-γ irradiation on the sterilization effect and main components of Rubus chingii Hu. METHODS Irradiated Rubus chingii Hu by 0, 6, 10, 15, 30 kGy doses of 60Co-γ, used the microbial count method to determine the microbial level of Rubus chingii Hu before and after irradiation. Analyzed the components of Rubus chingii Hu by high resolution mass spectrometry, investigated the effects of irradiation on the quality of Rubus chingii Hu by comparing the components of Rubus chingii Hu samples before and after irradiation, analyzing the quantitative results of ellagic acid and kaempferol 3-O-yunxiangoside, and evaluating the similarity of fingerprints. RESULTS The results of microbial examination of Rubus chingii Hu after different doses of irradiation all met the requirements, cluster analysis and principal component analysis of 20 components showed no significant difference. And there was no significant difference in the contents of ellagic acid and kaempferol 3-O-glucoside before and after irradiation. The similarity of fingerprints before and after irradiation was between 0.995 and 1.000. CONCLUSION Irradiation can effectively control the microbial level in Rubus chingii Hu, and there is no significant effect on the chemical composition of Rubus chingii Hu, the results provide a basis for the application of irradiation in the sterilization process of Rubus chingii Hu.