Objective:To investigate the effects of Schisandrin A on the proliferation and apoptosis of prostate cancer cell and its mechanism.Methods:Human prostate cancer DU145 cell were cultured in vitro and grouped into DU145 group (normal culture), Schisandrin A L group (50 μmol/L Schisandrin A was added), Schisandrin A M group (100 μmol/L Schisandrin A was added), Schisandrin A H group (150 μmol/L Schisandrin A was added) and Simvastatin group (50 μmol/L Simvastatin was added). Cell morphology of each group was observed under microscope, cell proliferation ability was detected by CCK8 method, cell migration ability was detected by cell scratch assay, cell invasion ability was detected by Transwell assay, and cell apoptosis was detected by flow cytometry, the expression of phosphorylation (p) - mammalian STE20-like protein kinase 1 (MST1), MST1, p-large tumor suppressor 1 (LATS1), LATS1, p-Yes associated protein (YAP) and YAP protein were detected by Western blotting. Measurement data were expressed as mean± standard deviation ( ± s), one-way ANOVA for comparisons between multiple groups, and t-test for comparisons between two groups. Results:Compared with DU145 group, the number of cells in Schisandrin A L, M, H groups and Simvastatin group decreased, and the cells gradually shrunk and the spacing became larger, the cell survival rate [(100.00±0.00)%, (88.41±9.36)%, (62.34±7.31)%, (42.57±5.01)%, (45.47±5.65)%], migration [(90.11±13.43)%, (74.16±8.08)%, (57.53±7.34)%, (41.34±6.79)%, (43.44±5.26)%] and invasion [(89.01±10.31)%, (73.11±9.23)%, (55.62±7.67)%, (41.13±6.35)%, (40.36±5.68)%], and the expression of p-YAP/YAP protein (0.98±0.08, 0.83±0.11, 0.69±0.07, 0.55±0.07, 0.53±0.05) were significantly decreased, the apoptosis rate [(2.88±0.34)%, (5.20±0.57)%, (8.37±0.94)%, (12.71±1.58)%, (12.03±2.21)%] and the expression of p-MST1/MST1 (0.41±0.04, 0.53±0.07, 0.75±0.07, 0.89±0.08, 0.88±0.07] and p-LATS1/LATS1 protein (0.40±0.04, 0.52±0.06, 0.64±0.06, 0.77±0.08, 0.79±0.08) were significantly increased, and the differences were statistically significant ( P<0.05). Conclusion:Schisandrin A may inhibit the proliferation of prostate cancer cell and promote cell apoptosis by inhibiting Hippo-YAP signaling pathway.

Objective:To investigate the perioperative impact of closure of mesenteric fissure in laparoscopic right hemicolectomy.Methods:The prospective randomized controlled trial was conducted. The clinical data of 320 patients who underwent laparoscopic right hemicolectomy in 11 medical centers, including The First Affiliated Hospital of China Medical University et al, from November 2022 to August 2023 were selected. Based on block randomization, patients were alloca-ted into the mesenteric fissure non-closure group and the mesenteric fissure closure group. Observa-tion indicators: (1) grouping of the enrolled patients; (2) intraoperative conditions; (3) postopera-tive conditions. Measurement data with skewed distribution were represented as M( Q1, Q3) and com-parison between groups was conducted using the Mann-Whitney U test. Count data were represen-ted as absolute numbers or percentages, and comparison between groups was conducted using the chi-square test or Fisher's exact probability. Comparison of ordinal data was conducted using the rank sum test. Comparison of visual analog scores was analyzed using generalized estimating equations. Results:(1) Grouping of the enrolled patients. A total of 320 patients with colon cancer were screened for eligibility, including 156 males and 164 females, aged 68(59,73)years. All the 320 patients were allocated into the mesenteric fissure non-closure group with 164 cases and the mesenteric fissure closure group with 156 cases. There was no significant difference in the age, body mass index, American Society of Anesthesiologist score, maximum tumor diameter, anastomosis location, anastomosis method, surgical approach, range of lymph node dissection, tumor staging between the two groups ( P>0.05) and there was a significant difference in the sex between them ( P<0.05). (2) Intraoperative conditions. There was no significant difference between the mesenteric fissure closure group and the mesenteric fissure non-closure group in the volume of intraoperative blood loss, operation time, conversion to laparotomy, intraoperative complication ( P>0.05). Three patients in the mesenteric fissure non-closure group were converted to laparotomy. One patient in the mesenteric fissure closure group was converted to laparotomy, and 2 cases with intraoperative complication were mesenteric hematoma. (3) Postoperative conditions. There was no significant difference between the mesenteric fissure non-closure group and the mesenteric fissure closure group in the overall postoperative complications ( χ2=0.28, P>0.05). There was no significant difference in the occurrence of postoperative intestinal obstruction, abdominal distension, ascites, pleural effusion, gastric paralysis, anastomotic bleeding, anastomotic leakage, or surgical wound infection between the two groups ( P>0.05). There was no significant difference between the two groups in the reoperation, postoperative gastric tube replacement. There was no significant differ-ence in time to postoperative first flatus, time to postoperative initial liquid food intake, time to post-operative resumption of bowel movements, duration of postoperative hospital stay, total hospital expenses between the two groups ( Z=-0.01, 0.43, 1.04, -0.54, -0.36, P>0.05). One patient in the mesenteric fissure non-closure group received reoperation. No perioperative internal hernia or death occurred in either group. The visual analog score decreased with time in both groups. There was no significant difference in the visual analog score between the mesenteric fissure closure group and the mesenteric fissure non-closure group [ β=-0.20(-0.53,0.13), P>0.05]. Conclusion:Compared with closure of mesenteric fissure, non-closure of mesenteric fissure during laparoscopic right hemi-colectomy dose not increase perioperative complications or postoperative management risk.

Objective:To explore the effect of group cognitive behavior therapy (GCBT) on anxiety, depression and quality of life in patients with chronic obstructive pulmonary disease (COPD) in community.Methods:From August to November 2019, patients with moderate COPD in 18 communities in Xuzhou City were randomly divided into the intervention group ( n=240) and the control group ( n=223). The control group received routine management and the intervention group received group cognitive behavioral therapy intervention for 8 weeks on the basis of routine management.Before and after the intervention, FEV 1% predicted value and FEV 1/FVC were measured by pulmonary function tester.Hospital Anxiety and Depression Scale (HADS) was used to evaluate the anxiety and depression of patients.St.George's respiratory questionnaire (SGRQ), COPD assessment test (CAT) and modified medical research council dyspnea (mMRC) were used to evaluate the quality of life of patients.SPSS 20.0 software was used for analysis.The χ 2 test, independent sample t-test, paired sample t-test were used for statistical analysis. Results:After 8 weeks of intervention, the anxiety and depression scores of the intervention group were lower than those of the control group (anxiety: (8.23±4.02) vs (10.71±3.60); depression: (7.87±3.73) vs (10.20±3.72)( t=6.415, 6.185, both P<0.01). After the intervention, there was no significant difference in FEV 1%((51.7±12.3)% vs (52.0±12.6)%) predicted value and FEV 1/FVC((57.3±10.8)% vs (56.9±10.7)%) between the two groups( t=-0.259, 0.400, both P>0.05). The scores of CAT, mMRC and SGRQ in the intervention group were lower than those in the control group((17.35±5.78) vs (20.90±8.00), (1.55±0.82) vs (2.30±1.21), (41.78±21.56) vs (57.08±24.46))( t=-5.061, -7.227, -6.580, all P<0.01). Conclusion:Group cognitive behavioral therapy can relieve the anxiety and depression and improve the quality of life of patients with COPD.

Objective:To explore the effect of stepwise nursing in postoperative rehabilitation of patients with spinal cord injury.Methods:From January 2020 to June 2021, convenience sampling was used to select 91 patients with spinal cord injury admitted to the Henan Third Provincial People's Hospital as the research object. The patients were divided into the observation group ( n=46) and the control group ( n=45) by random number table method. The control group received routine nursing, while the observation group received stepwise nursing on the basis of the control group. The postoperative functional independence and quality of life were compared between the two groups. Results:After six months of intervention, the scores of the Spinal Cord Independence Measure Ⅲ and the scores of each dimension of the Generic Quality of Life Inventory 74 in the observation group were higher than those in the control group, and the differences were statistically significant ( P<0.05) . Conclusions:Stepwise nursing can promote postoperative functional recovery and improve the quality of life of patients with spinal cord injury.

Pulmonary fibrosis (PF) is a chronic, progressive, fatal interstitial lung disease with limited available therapeutic strategies. We recently reported that the protein kinase glycogen synthase kinase-3

Objective To explore the efficacy of temporary titanium plate screwing for positional maintenance in reduction and internal fixation for displaced acetabular fractures.Methods A retrospective study was conducted of the 28 patients (28 hips) with displaced acetabular fracture who had been treated by open reduction and internal fixation from October 2013 to March 2016.They were 20 males and 8 females,aged from 24 to 68 years (average,42.3 years).The time from injury to surgery ranged from 7 to 21 days(average,14.5 days).According to the Letournel-Judet classification,there were 2 posterior column fractures,4 transverse fractures,5 posterior column plus posterior wall fractures,6 transverse plus posterior wall fractures,2 T-shaped fractures,3 anterior and posterior transverse fractures and 6 double column fractures.The posterior acetabular approach or combined anterior and posterior approach was used.In all the patients temporary titanium plate screwing was conducted to fix one side of the fracture so as to facilitate accomplishment of open reduction and internal fixation without losing the indirect anatomic reduction of the intraarticular fracture.After the open reduction and internal fixation was accomplished,the temporary screw fixation was removed in 26 patients but retained in 2 patients as needed.The reduction quality,complications and outcomes at the final follow-ups were recorded.Results All the 28 patients were followed up for 10 to 36 months (mean,15.6 months).By the Matta criteria,anatomical reduction was achieved in 26 cases,unsatisfactory reduction in one and poor reduction in one,yielding an anatomic reduction rate of 92.9％.By the improved Mere d'Aubigne & Postel criteria,the clinical outcomes at the final follow-up were excellent in 27 cases and good in one,yielding a good to excellent rate of 100％.Postoperatively,heterotopic ossification of different severities occurred in 11 cases but did not affect their joint function;transient paralysis of the sciatic nerve was reported in 6 cases but recovered 3 months after surgery.No complications like avascular necrosis of the femoral head or walking pain were observed during follow-ups.Conclusion Temporary fixation with titanium plate screws during open reduction and internal fixation for displaced acetabular fractures can effectively improve the reduction and fixation of the articular surface,leading to satisfactory short-term clinical outcomes.

Objective To investigate the feasibility and clinical effect of Kocher-Langebeck (K-L) approach without cutting the short external rotator muscles of hip for treatment of cetabular posterior column fractures.Methods A retrospective case series study was performed on 28 patients with acetabular fractures admitted from June 2015 to February 2017.There were 23 males and 5 females,averagely aged 43.6 years (range,26-71 years).According to the Letournel classification,there were 9 patients with simple fractures,14 back wall and back pillar fractures and 5 cross fractures.All patients were combined with posterior dislocation.The patients were given tibial tubercle traction after hip joint reduction in the hospital.During the surgery,K-L approach was adopted without cutting the short external rotator muscles of hip.Operation duration and intraoperative bleeding were recorded.Visual analogue score (VAS) was recorded before and after operation.The X-ray at 1 day,6 weeks,3 months and 1 year after operation were reviewed to evaluate fracture healing time.Matta criteria were used to assess the surface flatness of joint.The modified Merle d'Aubigné-Postel scoring system was applied to evaluate the function of hip joint.Intraoperative and postoperative complications were recorded.Results The operation duration was 76-120 min (mean,94 min),and the intraoperative blood loss was 120-320 ml (mean,265 ml).All patients were followed up for average 16 months (range,10-24 months).Preoperative VAS was 5-10 points [(7.5 ± 1.3) points],and 0-3 points [(0.9 ± 0.8) points] 6 months after operation (P ＜ 0.01).All fractures healed and the average healing duration was 10.1 weeks (range,6-12 weeks).According to the Matta criteria,24 patients were graded excellent and 4 good,with excellence rate of 100％.According to the modified Merle d'Aubigné-Postel grading system,clinical results were graded excellent in 23 patients,good in 5,with excellence rate of 100％.Transient sciatic nerve injury occurred in 3 patients after surgery,and the nerve function of these patients fully recovered within 3 months after operation.There were no infection,heterotopic ossification and other complications.The wound healing was good,without liquefaction or cracking.Sciatic nerve injury was found in five patients,three of whom were performed with a transient lesion and recovered within 3 months.Conclusion In the posterior pathway surgery for acetabular posterior column fractures,the K-L approach without cutting the short external rotator muscles of hip can be used to complete the internal fixation with a high rate of fracture healing,sound reduction outcome,satisfactory functional recovery and few complications.

Objective To explore the application of micro screws in holistic management of comminuted fracture of posterior acetabular wall combined with posterior hip dislocation.Methods From October 2013 to March 2016,38 patients (38 hips) were managed for comminuted fracture of posterior acetabular wall combined with posterior hip dislocation.They were 29 males and 9 females,aged from 15 to 71 years (average,38.6 years).According to the Letournel-Judet classification,there were 35 simple fractures of posterior acetabular wall and 3 complex fractures (2 fractures of posterior column plus posterior wall and one transverse plus posterior wall fracture).All fractures were comminuted and involved the posterior wall.The posterior Kocher-Langenbeck approach was selected for all the patients.Intraoperative exploration revealed the comminuted posterior walls were complicated with broken acetabular rims and ruptured glenoid rims to various degrees.Micro screws or micro screw-plate system were used to repair the comminuted fractures and broken acetabular rims,bridge support fixation with a locking plate followed pelvic reconstruction,and at the same time the ruptured glenoid rims were sutured so that the whole posterior articular structure around the posterior wall was repaired and reconstructed in a holistic manner.Results All the 38 patients were followed up for 12 to 36 months (average,17.6 months).By the Matta assessment,the reduction was excellent in 36 cases and fine in 2,giving an excellent to good rate of 100％.All fractures got united after 9 to 14 weeks (average,10.2 weeks).By the improved Merle d'Aubigne & Postel criteria,the clinical outcome was excellent in 35 cases and good in 3,giving an excellent to good rate of 100％.After surgery,heterotopic ossification occurred in one case,and transient paralysis of the sciatic nerve in 3 cases.No infection,necrosis of the femoral head,joint pain,joint malfunction or unstable walking was observed.Conclusion In the management of comminuted fracture of posterior acetabular wall combined with posterior hip dislocation,the lesions of the whole posterior wall can be repaired primarily in a holistic manner by repairing the shattered posterior wall of the acetabulum wth micro plate and screw system and simultaneous suture and fixation of the broken actabular rim and ruptured glenoid rim.

Objective To investigate effectiveness of the modified Kocher-Langenbeck (K-L) approach for acetabular fractures.Methods A consecutive series of 58 patients with acetabular fracture were treated operatively from January 2013 to December 2016.They were divided into 2 groups according to the approaches used.In the experimental group of 30 patients (25 males and 5 females with an average age of 42.6 ± 13.8 years),the modified K-L approach was used not to dissect the external rotation short muscles and the anterior approach was also used when necessary.In the control group of 28 patients (24 males and 4 females with an average age of 45.2 ± 10.2 years),the traditional K-L approach was used and in combination with the anterior approach when necessary.The 2 groups were comnpared in terms of operation time,intraoperative blood loss,reduction,fracture union time and functional recovery of the affected hip at the last follow-up.Results The experimental group reported significantly shorter operation time (94.2 ± 32.8 min) and significantly less intraoperative bleeding (220.8 ± 96.7 mL) than the control group (135.8 ± 88.0 min and 405.5 ±95.7 mL) (P ＜ 0.05).According to the Matta's criteria for reduction,the experimental group had 24 excellent,4 good and 2 fair cases (an excellent to good rate of 93.3％) while the control group had 20 excellent,3 good and 5 fair cases (an excellent to good rate of 82.1％),showing no significant differences between the 2 groups (P ＞ 0.05).All the 58 patients obtained follow-up for 6 to 24 months (average,16 months).The fracture union time was 10.1 ± 1.9 weeks for the experimental group and 9.9 ±2.1 weeks for the control group,showing no significant differences between the 2 groups (P ＞ 0.05).According to the modified Merle d'Aubigne & Postel scoring for the functional recovery of the affected hip at the last follow-up,the experimental group had 23 excellent,5 good and 2 fair cases (an excellent to good rate of 93.3％) while the control group had 12 excellent,6 good,6 fair and 4 poor cases (an excellent to good rate of 64.2％),showing a significant difference between the 2 groups (P ＜ 0.05).Conclusion Compared with the traditional K-L approach,the modified K-L approach has advantages of small trauma,less hemorrhage and good postoperative recovery so that it can be a good choice among the posterior approaches for acetabular fractures.

Objective: To explore whether human adipose-derived stem cells (ADSCs) express PD-L1 and Gal-9 and its potential influence factors. Methods: ADSCs isolated from 28 healthy female donors who underwent liposuction of the abdomen or breast tissue were cultured and characterized. The expression of PD-L1 and Gal-9 were detected using flow cytometry. The impact of donor age, body mass index (BMI), donor site and interferon-γ (IFN-γ) on the expression of PD-L1 and Gal-9 was analyzed using multivariate linear regression analysis. Results: The cultured cells fulfilled the criteria for defining MSCs according to the international standards and expressed PD-L1 and Gal-9. Breast-derived ADSCs had higher expression levels of PD-L1 (37.24%±8.20%) and Gal-9 ( 4.41%±2.65%) than those in abdomen-derived ADSCs (28.80%±8.59% and 2.51%±1.39%, respectively) (P=0.018, P=0.039). Multivariate linear regression analysis showed that donor age and site were independent risk factors affecting PD-L1 expression (P=0.009, P=0.006). The expression of PD-L1 decreased by 0.385% for every one year of age increase, and it was 8.58% higher in the breast-derived ADSCs than in the abdomen-derived ADSCs. Donor site was an independent risk factor for Gal-9 expression (P=0.041). Gal-9 positive expression rate in the breast-derived ADSCs was 1.898% higher than that in the abdomen-derived ADSCs. BMI was not a risk factor affecting PD-L1 or Gal-9 expression on ADSCs. The expression of PD-L1 and Gal-9 on ADSCs were significantly upregulated after 48 hours stimulation with 20 ng/ml IFN-γ in vitro. Conclusions Human ADSCs expressed PD-L1 and Gal-9. Donor age, site and IFN-γ treatment were independent risk factors affecting the expression of PD-L1 and Gal-9 on ADSCs.