Hepatic ischemia/reperfusion injury is an important restricting factor of clinical liver resection and liver transplantation.When the liver is transiently deprived of blood followed by repeffusion,a large number of various mediators are released that can lead to cellular and,eventually,organ dysfunction.This review summarizes the pathogenesis and the protection mechanisms of hepatic ischemia/reperfusion injury.

Objective To study the effects of ginkgo biloba extract(GBE)on c-reactive protein(CRP) and tumor necrosis factor-α(TNF-α)in serum and alveolar lavage fluid(BALF)from rats with chronic obstructive pulmonary disease(COPD). Methods 90 rats were randomly divided into groups A,B,C,D,E and F. There were 15 rats in each group. The rat model of COPD were established in groups B,C,D,E and F. Groups C and D were given intraperitoneal injections with GBE from day l to day l4 and day 29 to day 42. Groups E and F weregiven intraperitoneal injections with erythromycin from day l to day l4 and day 29 to day 42. After the end of experi-ment ,the contents of CRP and TNF-α in serum and BALF were detected in all groups. Results The contents of CRP and TNF-α in the serum and the BALF were markedly lower in groups C,D,E and F than in group B (P<0.05);and the contents of CRP in the serum and the BALF and TNF-αin the BALF were lower in groups C, E and F than in group D(P<0.05). Conclusions GBE can inhibit the airway and systemic inflammatory response in COPD rats. Early intervention is more effective.

Objective To observe the effect of Fufei Gushen Decoction on the BODE index, an index for body mass index(BMI), airflow obstruction, dyspnea, and exercise capacity, in severe and extremely severe chronic obstructive pulmonary disease (COPD) patients with lung-kidney deficiency interweaved with phlegm and blood stasis at stable stage. Methods Eighty qualified COPD patients were randomly divided into treatment group and control group, 40 cases in each group. Both groups were given inhalation of Seretide (Salmeterol Xinafoate and Fluticasone Propionate Powder for inhalation) , and the treatment group was given oral use of Fufei Gushen Decoction additionally. The treatment for the two groups lasted for 3 months. Before and after treatment, BMI, the percentage of forced expiratory volume in one second of the predicted value (FEV1%) , dyspnea index of modified British Medical Research Council (MMRC), and exercise performance index of 6-min walking test (6MWT) in the two groups were observed. Results (1) After treatment, FEV1%, MMRC dyspnea index, 6MWT scores and BODE index overall scores of severe and extremely severe patients in the treatment group were much improved(P < 0.05 compared with those before treatment ), but BMI was not much improved(P > 0.05). MMRC dyspnea index, 6MWT scores and BODE index overall scores of severe and extremely severe patients inthe control group were much improved (P<0.05 compared with those before treatment) , b ut the improvement of FEV1% and BMI was not obvious(P > 0.05).(2) Except for BMI, the parameters of FEV1%, MMRC dyspnea index, 6MWT scores and BODE index overall scores of the treatment group were much improved as compared with those of the control group after treatment(P < 0.05). Conclusion Fufei Gushen Decoction combined with inhalation of Seretide exerts certain effects on decreasing the BODE index scores, relieving symptoms, and improving pulmonary function, exercise performance and the quality of life of COPD patients with lung-kidney deficiency interweaved with phlegm and blood stasis at stable stage.

Objective:To explore the research hotspot and trends of home rehabilitation exercise for patients with Parkinson's disease.Methods:Literature related to home-based rehabilitation exercises for Parkinson's disease patients included in the core set of Web of Science database from establishment of databases to March 31, 2023 was retrieved. The source countries, institutions, authors, key words and references of the literature were visually analyzed by CiteSpace software, and the scientific knowledge map was drawn.Results:A total of 472 articles were included, and the annual publication volume was increasing year by year. The top three countries in terms of publication volume were the United States (176 articles) , the United Kingdom (54 articles) and Australia (54 articles) . The top three institutions with the highest number of publications were La Trobe University, Catholic University of Leuven and Radboud University. The research in this field mainly focused on randomized controlled trials and Meta-analysis. The initial stage of the research mainly focused on the effect of Parkinson's disease on the body, later transferred to gait research, and in recent years, began to focus on the application of virtual reality technology in the home-based rehabilitation of Parkinson's disease patients.Conclusions:Home-based rehabilitation exercises for Parkinson's disease patients can be carried out in many ways, but it is limited by disease symptoms and other influencing factors. Virtual reality technology, telemedicine, wearable devices and other technologies can promote the development of home-based rehabilitation exercises. It is necessary to increase the research efforts of such technology in the future and explore comprehensive home-based rehabilitation exercises programs.

Objective:To evaluate the clinical effects of posterior reduction in the treatment of acute severe traumatic lumbar spondylolisthesis.Methods:A retrospective study was conducted to analyze the clinical data of 12 patients with acute severe traumatic lumbar spondylolisthesis who had been treated by posterior reduction at Department of Spinal Surgery, Zhengzhou Orthopaedic Hospital from June 2010 to December 2018. There were 7 males and 5 females with an age of (25.7±1.8) years. The spondylolisthesis was at L4 in 4 cases and at L5 in 8 cases, and grade Ⅲ in 7 cases, grade Ⅳ in 4 cases and grade Ⅴ in 1 case according to the Meyerding classification. By the American Spinal Injury Association (ASIA) grading, the preoperative neurological function was at level B in 6 cases, at level C in 4 cases, and at level D in 2 cases. All the 12 patients underwent posterior reduction and internal fixation with pedicle screws, as well as intervertebral bone graft fusion. Operation time and intraoperative blood loss were recorded. Clinical efficacy was evaluated by visual analogue scale (VAS) and Oswestry disability index (ODI) before and after surgery, and neurological function was evaluated by ASIA grading. X-ray, CT plain scan and reconstruction were used to observe internal fixation and bone grafting.Results:All patients were followed up for (18.5±2.1) months. The operation time was (165.7±42.3) min and the blood loss (497.7±75.3) mL. The VAS pain scores [(2.7±0.3) points and (1.8±0.2) points] and ODIs (18.2%±2.3% and 14.5%±2.6%) at 2 weeks after operation and at the last follow-up were significantly lower than the preoperational values [(8.5±0.6) points and 72.3%±12.3%] ( P<0.05), but there was no statistically significant difference between 2 weeks after operation and the last follow-up ( P>0.05). At the last follow-up, X-rays and CT scans showed good fixation and adequate bone grafting; the spondylolisthesis was grade 0 in 10 cases and grade I in 2 cases; the ASIA level of neurological function was C in 2 cases, D in 3 cases, and E in 7 cases. Healing of surgical incision was delayed in 2 patients but responded to symptomatic treatment. Follow-ups observed no such complications as loosening or pulling out of internal fixation. Conclusion:In the treatment of acute severe traumatic lumbar spondylolisthesis, posterior reduction can effectively restore the spondylolisthesis sequence and restore spinal stability, leading to satisfactory curative outcomes.

Objective:To evaluate the relationship between the mechanism underlying the antidepressant effect of S-ketamine and hippocampal gamma-aminobutyric acid B receptor (GABA BR) in mice. Methods:A total of 54 male C57BL/6(B6) mice, aged 8 weeks, weighing 25-30 g, were used in this study. Forty mice were selected to develop the depression model by chronic social defeat stress. Twenty-six depression-susceptible mice were screened out by social avoidance test at day 11 after developing the model and divided into 2 groups ( n=13 each) by a random number table method: depression-susceptible group (Sus group) and depression-susceptible + S-ketamine group (Sus + S-ket group). The remaining 14 mice served as control group (C group). Starting from day 12 after developing the model, S-ketamine 10 mg/kg was intraperitoneally injected every day for 3 consecutive days in Sus+ S-ket group, while the equal volume of normal saline was given instead in C group and Sus group. The open field test was performed at 1 h after the last administration, and the total distance of movement was recorded. The forced swimming test was performed at 1 day after the open field test, and the immobile time was recorded. The sucrose preference test was performed to calculate the proportion of sucrose consumption at 1 day after the forced swimming test. One hour after the end of behavioral test, mice were sacrificed, and the hippocampal tissues were removed. Western blot was used to detect the expression of GABA BR1, GABA BR2, mammalian target of rapamycin (mTOR), phosphorylated mTOR (p-mTOR), brain-derived neurotrophic factor (BDNF), tyrosine kinase receptor B (TrkB), phosphorylated TrkB (p-TrkB), glutamate receptor 1 (GluR1) and postsynaptic dense protein 95 (PSD95). The p-mTOR/mTOR ratio and p-TrkB/TrkB ratio were calculated. The fluorescence intensity of BDNF in hippocampal CA1 region was detected by immunofluorescence. The number of dendritic spines in hippocampal CA1 region was measured by Golgi staining. Results:In the open field test, no statistically significant difference in the total distance was detected among the three groups ( P>0.05). Compared with C group, the immobile time in the forced swimming test was significantly prolonged, the proportion of sucrose consumption was decreased, the expression of hippocampal GABA BR1, GABA BR2, BDNF, GluR1 and PSD95 was down-regulated, and the ratios of p-mTOR/mTOR and p-TrkB/TrkB were decreased, the fluorescence intensity of BDNF and total number of dendritic spines in the hippocampal CA1 region were decreased in Sus group ( P<0.05), and no significant change was found in the parameters mentioned above in Sus+ S-ket group ( P>0.05). Compared with Sus group, the immobile time in the forced swimming test was significantly shortened, the proportion of sucrose consumption was increased, the expression of hippocampal GABA BR1, GABA BR2, BDNF, GluR1 and PSD95 was up-regulated, the ratios of p-mTOR/mTOR and p-TrkB/TrkB were increased, and the fluorescence intensity of BDNF and total number of dendritic spines in the hippocampal CA1 region were increased in Sus+ S-ket group ( P<0.05). Conclusions:The mechanism underlying the antidepressant effect of S-ketamine may be related to up-regulation of hippocampal GABA BR expression, activation of mTOR-BDNF signaling pathway, and improvement in synaptic plasticity in mice.

Depression is one of the major types of psychiatric disorders, and often accompanies hyperalgesia except for mood alteration. At present, the mechanism of depression related hyperalgesia is mainly focused on monoamines, inflammatory cytokines, brain-derived neurotrophic factors and related neural circuits. At present, there is still a lack of specific treatment drugs for depression related hyperalgesia; and psychological therapy and traditional Chinese medicine therapy can play active auxiliary roles. In this review, the latest research progress of the above contents are noted to provide references for research and prevention of this disease.

Depression is one of the major types of psychiatric disorders, and often accompanies hyperalgesia except for mood alteration. At present, the mechanism of depression related hyperalgesia is mainly focused on monoamines, inflammatory cytokines, brain-derived neurotrophic factors and related neural circuits. At present, there is still a lack of specific treatment drugs for depression related hyperalgesia; and psychological therapy and traditional Chinese medicine therapy can play active auxiliary roles. In this review, the latest research progress of the above contents are noted to provide references for research and prevention of this disease.

Objective:To evaluate the clinical efficacy of pushing reduction with our self-designed spinal fracture reduction device in the treatment of A3N0/1 thoracolumbar fractures.Methods:A retrospective study was conducted to analyze the medical records of 53 patients who had undergone surgery for thoracolumbar vertebrae fracture at Department of Minimally Invasive Spine Surgery, Zhengzhou Orthopedic Hospital from January 2019 to January 2022. All patients were treated by internal fixation via the Wiltse approach and bone grafting through the pedicle of the injured vertebrae. Clinical data: 35 males and 18 females; age: (37.8±10.2) years; injured segments: 23 cases at the thoracic spine and 30 cases at the lumbar spine; time from injury to surgery: (3.3±1.5) days. According to whether our self-designed spinal fracture reduction device was used or not, the patients were assigned into group A (23 cases) in which the injured vertebrae were pushed and reduced using our novel spinal fracture reduction device after vertebral distraction reduction by the pedicle screw and group B (30 cases) in which the injured vertebrae were distracted and reduced using the pedicle screw alone. The operation time, intraoperative blood loss and complications were compared between the 2 groups. The anterior vertebral body height ratio (AVBHr), middle vertebral body height ratio (MVBHr), posterior vertebral body height ratio (PVBHr), Cobb angle of the injured vertebra, visual analogue scale (VAS) and Oswestry disability index (ODI) at preoperation, postoperative 3 and 6 months, and the last follow-up were compared between the 2 groups.Results:There was no statistically significant difference in the preoperative general data between the 2 groups, indicating comparability ( P>0.05). All patients were followed up for (16.3±5.9) months. All incisions healed at one stage postoperatively without any related complications. The operation time in group A was significantly longer than that in group B [(115.1±16.6) min. versus (101.0±11.5) min.], the intraoperative blood loss in group A was significantly greater than that in group B [(136.5±17.0) mL versus (121.6±19.8) mL], the MVBHr at postoperative 3 months in group A (93.9%±4.0%) was significantly better than that in group B (83.3%±7.6%), and the MVBHr, AVBHr, Cobb angle, VAS, and ODI at the last follow-up in group A [86.6%±5.5%, 89.8%±4.1%, 4°(4°, 6°), 1 (0, 1) point, and 4.7%±2.0%] were significantly better than those in group B [78.0% (74.0%, 79.0%), 84.5%±4.9%, 12.2°±3.3°, 2 (1, 3) points, and 7.3%±2.7%] (all P<0.05). However, there was no statistically significant difference in PVBHr between the 2 groups at postoperative 3 months or at the last follow-up ( P>0.05). Conclusion:In the treatment of A3N0/1 thoracolumbar fractures, pushing reduction with our self-designed spinal fracture reduction device can directly and effectively reduce the fracture zone of the injured vertebra, which is conducive to maintaining postoperative vertebral reduction, reducing vertebral height loss and kyphotic deformity at a later stage, relieving lumbar pain and improving lumbar spine function.

Objective:To analyze and compare the radiation dose and image quality of kilo-voltage cone beam CT systems on different Varian accelerator platforms, providing data to support clinical decisions on selecting optimal protocols for image-guided radiotherapy based on cost-effective ratio (image quality / radiation dose).Methods:The radiation dose and image quality of various CBCT systems and scanning protocols on Varian Edge, Truebeam and ix (new and old) LINACs were obtained using a CT dose index (CTDI) phantom combined with a CT ionization chamber and a Catphan604 phantom, respectively. Figure of merit (FOM) was used to evaluate the cost-effective ratio of the image guidance schemes.Results:Considerable inter-system varieties of FOMs were observed, varying from 0.65 (Image Gently-full trajectory) to 48.46 (Image Gently-half trajectory). The inter-protocol varieties were also large, where the mean±SD was 22.14±13.47.Conclusions:Considering the explicit inter-system and inter-protocol varieties, it is clinically favorable to evaluate the image guidance schemes based on machine-specific measurement. For instance, parameters and equipment with low CTDI w can be beneficial for dose-sensitive patients. High CNR regimen favors patients with high image quality requirements. For ordinary patients, cost-effective ratio in terms of FOM can be very helpful to guide the decision-making of clinical image-guided radiotherapy.