The neurotoxin peptide, hainantoxin-Ⅵ (HNTX- Ⅵ), has been isolated from the venom of Chinese tarantula Ornithoconus hainana by a combination of ion exchange chromatography and reverse phase HPLC. The toxin was found to contain 34 amino acid residues with 6 conserved cysteine residues. The effects of HNTX-VI on voltage-gated sodium channels were studied via whole-cell patch clamp techniques. Although several inhibitors of mammalian neuronal sodium channel activation (hainantoxin Ⅰ-Ⅴ) had been characterized from the same venom, the present study indicated that HNTX-Ⅵ had the ability to slow the inactivation kinetics of the sodium channels in Cockroach Periplaneta Americana dorsal unpaired median (DUM) neurons in a similar manner to δ-atractoxins. After HNTX-Ⅵ treatment, steady-state sodium channel inactivation became incomplete, leading to a non-inactivating component at potentials more positive than - 55 mV. The novel function of the tarantula toxin HNTX-Ⅵ not only supplies a useful tool for exploring the gating mechanisms of sodium channels but also provides theoretical foundations for exploiting novel and safe insecticides.

Objective To observe the effects of electroacupuncture combined with edaravone on the conduction velocity of sciatic nerve and oxidative stress in rats with diabetic peripheral neuropathy. Methods 60 Sprague Dawley (SD) rats were included. 10 of them were selected as normal group. The other rats were modeled as diabetic peripheral neuropathy with streptozotocin. 48 of them were randomly selected and divided into electroacupuncture group (n=12), edaravone group (n=12), electroacupuncture + edaravone group (n=12), and model group (n=12). The threshold temperature for wave tail was tested, the levels of superoxidase dismutase (SOD) and malonaldehyde (MDA) were determined, and the conduction velocity of sciatic nerve were measured, before, and 4 and 8 weeks after modeling. Results 8 weeks after modeling, the conduction velocity and SOD increased in the electroacupuncture group, edaravone group and electroacupuncture+edaravone group compared with the model group (P<0.01), with the MDA decrease (P<0.01), while it was improved more in the electroacupuncture+edaravone group than in the electroacupuncture group or the edaravone group (P<0.01). Conclusion Both electroacupuncture and edaravone can inhibit oxidative stress and improve nerve conduction velocity of the sciatic nerve in rats with diabetic peripheral neuropathy, and it is more effective of combination.

OBJECTIVE To assess the guideline role of preoperative subjective and objective assessment on nasal obstruction in chronic rhinosinusitis(CRS) patient during perioperative period. METHODS The patients with CRS who's chief complaint was nasal obstruction were divided into experimental group and control group according to different doctors. Visual analog scale, rhinomanometry and acoustic rhinometry were used to assess subjective and objective nasal obstruction, and nasal endoscopy and sinus CT examination were applied to evaluate the condition of nasal cavity and nasal sinuses. Patients were taken corresponding appropriate strategies in experimental group, but conventional empirical measures in control group during perioperative period. Postoperative follow-up were performed in 6 months and 1 year. SPSS21.0 was used for statistical analysis. RESULTS There was no statistical difference in nasal obstruction symptom score, total rhinomanometry before operation between experimental group and control group(P>0.05). There were statistical difference between the 2 groups after operation in nasal obstruction symptom score, total rhinomanometry. At the 2 postoperative time points (6 months, 1 year after operation) compared with preoperative period, significant differences were found in the parameters evaluated between the two groups(P<0.05). The curative effect in different postoperative time showed statistical significance(P<0.05). CONCLUSION Preoperative subjective and objective assessment for nasal obstruction can be used not only in the evaluation of severity and treatment effect, but also in the guideline of perioperative treatment for CRS combined with nasal endoscopy and sinus CT examination, which can improve nasal obstruction and the treatment effect of CRS.

Objective: To analyze the clinical effect of the endoscopic holistic rhinoplasty in order to improve its clinical application and safety. Methods: The patients with external nasal deformities and complained nasal congestion were assessed before operation and undergoing endoscopic holistic rhinoplasty from January 2015 to June 2017. Therefore, the internal nasal plasty and external nasal plasty were performed simultaneously, so as to correct the abnormalities of internal and external nasal structures, restore nasal ventilation function, and achieve the purpose of external nose cosmetology. The nasal congestion, visual analog scale, rhinomanometry and acoustic rhinometry and patient satisfaction were used to assess the efficacy. SPSS 21.0 was used for statistical analysis. Paired sample t test was used for preoperative and postoperative comparison, and P<0.05 was taken as statistically significant difference. Results: All the patients were followed up from one month to one year without complications. Postoperative nasal obstruction VAS score (1.63±0.76) was significantly lower than preoperative(6.35±0.65) (t=6.315, P<0.001). The minimum nasal cross-sectional area was (0.38±0.29) cm² preoperatively and (0.52±0.14) cm² postoperatively, which was significantly higher than that before the operation (t=9.732, P<0.001). Postoperative nasal volume (9.21±3.23) cm³ was significantly higher than preoperative (6.44 ± 1.04) cm³ (t=9.559, P<0.001), and postoperative nasal resistance (0.26 ± 0.07) kPa·s/L was lower than preoperative (0.65±0.21) kPa·s/L(t=7.524, P<0.001). The postoperative satisfaction survey result were very satisfactory in 41 cases (78.85%), accounted satisfaction in 11 cases (21.15%). Conclusions The application of the endoscopic holistic rhinoplasty has a good clinical effect and a high degree of satisfaction.

Objective:To investigate the clinical efficacy of 3D printed osteotomy guide plate combined with "Jail" screw technique in the treatment of tibial plateau fractures involving external posterior condylar collapse.Methods:From January 2016 to January 2021, 41 patients (22 males and 19 females) with tibial plateau fractures involving external posterior condylar collapse were treated with 3D printed osteotomy guide plate combined with "Jail" screw technique and followed up. The age was 47.4±11.5 years (range, 22-69 years). According to Schatzker fracture type, 18 cases were type IV, 14 cases were type V and 9 cases were type VI. All fractures were closed, and 12 of them were complicated with lateral meniscus injury, but none of them were complicated with nerve and vascular injury. The time from injury to operation was 7.2±3.4 d (range, 4-17 d). All patients underwent 3D CT scanning and digital modeling before operation. According to the modeling results, a 1∶1 solid size fracture model was made by 3D printing, and the osteotomy guide plate and the "Jail" screw preset guide plate were designed. During the operation, the tibial lateral condyle osteotomy was performed with customized osteotomy guide plate. After reduction, the fixation of the fracture was performed with the preset guide plate using "Jail" screw. Postoperative fracture reduction was evaluated according to Rasmussen score, and knee function was evaluated by Hospital for Special Surgery (HSS) score.Results:All the 41 patients were followed up for 15.2±5.8 months (range, 6-26 months). Immediate postoperative radiographs showed good fracture reduction, and the average healing time was 14.1±1.2 weeks (range, 12-17 weeks). One year after operation, the Rasmussen score of knee joint was 17.4±1.6 points (range, 13-19 points), of which 31 cases were excellent, 8 cases were good, and 2 cases were fair, with an excellent/good rate of 95% (39/41). HSS scores was 87.3±5.6 points (range, 68-95 points), including 30 excellent cases, 10 good cases and 1 fair case, with an excellent/good rate of 98% (40/41). The range of motion of knee joint was 126.8°±3.8°. At the last follow-up, no serious complications such as common peroneal nerve injury, popliteal vascular injury, postoperative infection, or internal fixation failure occurred.Conclusion:3D printed osteotomy guide plate combined with "Jail" nail placement technique is an effective method for tibial plateau fractures involving external posterior condylar collapse, and the postoperative treatment results are satisfactory. The use of customized osteotomy guide plate is more accurate and less damaging. The use of "Jail" screw preset guide plate can ensure more accurate screw placement.

Objective To analyze the clinical features of 258 cases of nasal-sinus benign and malignant tumors to improve the accuracy of clinical diagnosis.Methods The clinical data of 258 patients with nasal-sinus tumor confirmed by pathology were retrospectively analyzed and the clinic differences between benign and malignant tumors were compared.Results The clinic manifestations of sinonasal neoplasm were varied.The incidences of epistaxis or blood in the tears,headache,facial numbness or pain,eye pain or epiphora were significantly higher in the benign tumors group than in the malignant tumors group (P＜0.05).Among 196 patients undergoing surgery,the coincidence rates of preoperative and postoperative paraffin sections were similar in the two groups (P＞0.05).Among 63 surgical patients with malignant tumors,the coincidence rate of 232 incised-margin frozen sections and postoperative paraffin sections was 98.70％ (229/232).Among 34 cases,the coincidence rate of frozen sections and postoperative paraffin sections was 91.18％0 (31/34),in which 6 cases were immediately intraoperative frozen,and 66.67％ (4/6) of the cases that changed into malignancy from benignity were not consistent with the preoperative diagnosis of paraffin sections.Conclusion The sinonasal tumors are lacking specificity in clinical manifestations,but rapid intraoperative frozen section examination is helpful to improve the diagnosis rate;continuously frozen pathological examination should be performed in malignant tumor margins.

Objective To investigate the clinical efficacy of 3D printing technique combined with osteotomy in the treatment of complex tibial plateau fractures involving the posterolateral condyle.Methods The clinical data of 47 patients with complicated tibial plateau fractures involving the posterolateral condyle who were treated with 3D printing technology and tibial lateral condyle osteotomy from January 2012 to February 2015 were retrospectively analyzed.There were 19 males and 28 females aged from 21 to 69 years (mean 50.3 years).All of them were closed fractures without neurological and vascular injuries.The time between injury and operation was 4 to 19 days (average,6.7 days).All the patients were treated with tibial lateral condyle osteotomy and bilateral plate fixation with anterolateral approach and posteromedial approach.Three-dimensional CT scans were performed preoperatively and 1 ∶ 1 to mimics model was made by 3D printing technique based on the data after conversion.Refer to the 3D fracture model to accurately design the osteotomy line to improve the operation scheme.During the operation,anterior and lateral anterior combined with posterior medial incision were performed,and the tibia external condyle osteotomy was conducted to accurately expose the external posterior condyle fracture block of the tibia platform,and bilateral plate was applied after reduction.The fracture reduction was evaluated according to the Rasmussen score of the knee joint.The knee joint function was evaluated by the score of the hospital for special surgery (HSS).Results All 47 patients were followed up for 13.2 months (range,7-19 months).Immediate postoperative X-ray showed good fracture reduction.The union time of fracture was 14.3 weeks (range,12-18 weeks).The knee joint Rasmussen score one year after operation was 13-18 (average,15.73),including 33 cases excellent,12 cases good and 2 cases fair.The excellent and good rate was 95.7％ (45/47).HSS score was 67 to 94 (average,82.67),among which 31 cases were excellent,13 cases good,2 cases fair,and 1 case poor (postoperative refusal to rehabilitate exercise resulted in joint stiffness).The excellent and good rate of 89.9％ (44/47).Knee joint activity was-5°-0°-135°,with the average range of 125.5°.No common peroneal nerve injury,important vascular injury,postoperative infection,internal fixation failure and other serious complications was found.Conclusion 3D printing technology can help to accurately display the specific situation of the posterior tibial condyle fractures,which is conducive to the surgeon to develop a more intuitive plan of reduction.The method of tibial lateral condyle osteotomy can clearly reveal the tibial plateau posterolateral condylar fractures.With accurate osteotomy the surgical field can be fully exposed,and ultimately achieve a satisfactory result.Therefore,3D printing combined with tibial lateral condyle osteotomy is an effective method for complex tibial plateau fractures involving the posterolateral condyle.

Objective:To compare the short-term therapeutic effects of Gamma 3 U-Blade system and Gamma 3 nails in the treatment of elderly patients with osteoporotic unstable intertrochanteric fracture.Methods:The data of 70 elderly patients with osteoporotic unstable intertrochanteric fracture were retrospectively analyzed who had been admitted to the Department of Orthopedics, Wuhan Fourth Hospital from June 2018 to December 2020. They were divided into 2 groups according to their treatments. In the U-Blade group of 35 cases subjected to fixation with Gamma 3 U-Blade system, there were 14 males and 21 females with an age of (77.7 ± 4.8) years; in the Gamma 3 nail group of 35 cases subjected to fixation with Gamma 3 nails, there were 14 males and 21 females with an age of (79.3 ± 5.2) years. The 2 groups were compared in terms of operation time, intraoperative blood loss, apex distance, fracture union time, postoperative complications, timed up and go (TUG) at postoperative 2 weeks, 3 months and 6 months, and hip function at postoperative 9 months.Results:There was no statistically significant difference in the preoperative general data between the 2 groups, showing comparability ( P>0.05). There was no significant difference either in operation time, intraoperative blood loss or apex distance between the 2 groups ( P>0.05). The fracture union time [(12.0 ± 0.2) weeks] and Harris hip score at postoperative 9 months [90 (90, 91)] in the U-Blade group were insignificantly different from those in the Gamma 3 nail group [(12.0 ± 0.3) weeks and 91 (89, 91)] ( P>0.05). The rate of implant-related complications in the U-Blade group [0% (0/35)] was significantly lower than that in the Gamma 3 nail group [17.1% (6/35)] and the TUGs at postoperative 2 weeks and 3 months [(80.2 ± 3.6) s and 45 (43, 49) s] in the former were significantly shorter than those in the latter [(89.3 ± 4.2) s and 56 (54, 59) s] ( P<0.05). Conclusion:In the treatment of elderly patients with osteoporotic unstable intertrochanteric fracture, compared with traditional Gamma 3 nails, Gamma 3 U-Blade system can reduce implant-related complications and facilitate early recovery of walking ability.

Objective:To compare the efficacy of fusion and non-fusion hybrid operation with Dynesys system with the traditional fusion operation with rigid instrumentation in the patients with multi-segment lumbar degenerative disease.Methods:A total of 30 patients with multi-segment lumbar degenerative disease who were subjected to operation from January 2017 to October 2019 in Shenzhen People's Hospital were included in the study. There were 13 males and 17 females, age: 60.8±13.2 years, range: 25 to 83 years. 28 patients with two segments, 1 with three segments, and 1 with four segments. The patients were divided into two groups, i.e the hybrid operation group (13 cases, 9 males and 4 females, average age: 56.6 years, range: 25 to 83 years) versus the traditional fusion group (17 cases, 4 males and 13 females, average age: 63.9 years, range: 46 to 80 years). The main outcome measures were visual analogue scale (VAS), Oswestry disability index (ODI), range of motion (ROM), adjacent segment degeneration (ASD) and complications.Results:There were no statistically significant differences in operation data, such as operation time, intraoperative blood loss, postoperative drainage volume and length of hospitalization, between the two groups. There were no significant differences for ROM in the surgical segments between the two groups before operation (hybrid group and traditional group were 9.6°±4.9° vs. 8.9°±6.1°, t=0.341, P=0.736, respectively). However, after 12 months follow-up, the ROM disappeared in the traditional group and was partially preserved in the hybrid group, with statistically significant differences (hybrid group and traditional group were 5.4°±2.7° vs. 0°, t=9.104, P=0.001, respectively). There was a statistical difference in intervertebral disc height between the two groups at 12 months post-operation, though no statistical difference was found before operation (8.8±1.9 mm vs. 10.5±1.7 mm, t=2.927, P=0.006). There was no statistically significant difference in the intervertebral disc height of the upper adjacent vertebrae between the two groups before and after operation. There were statistically significant differences in ODI scores before operation (63.4%±11.0% vs. 71.3%±9.2%, t=2.146, P=0.041), and 12 months post-operation (17.2%±2.1% vs. 15.5%±2.3%, t=2.091, P=0.046), while no statistical difference was found in VAS scores. Conclusion:The fusion and non-fusion hybrid operation with Dynesys system has comparable clinical efficacy with the traditional fusion operation with rigid instrumentation in the treatment of multisegment lumbar degenerative disease. Meanwhile, the hybrid surgery can preserve the motion of surgical segments and provide a dynamic stability of the vertebral body. The hybrid surgery can be used as a new surgical method for multi-segment lumbar degenerative disease.

Objective To investigate the effect of lower thoracic epidural block on intestinal epithelial cell apoptosis during hemorrhagic shock and resuscitation in rats.Methods Sixty-four male SD rats placed with lower thoracic epidural catheter were randomly divided into four groups (n=1 6 each):group Sham (sham operation),group HSR (hemorrhagic shock and resuscitation),group NS (hemorrhagic shock and resuscitation+epidural saline 100 μl/kg),and group TEA (hemorrhagic shock and resuscitation+epidural 0.075% ropivacaine 100 μl/kg).The hemorrhagic shock was made described by Chaudry.Rats were resuscitated by transfusing shed blood and normal saline 60 min after hemorrhagic shock.Malondialdehyde (MDA)content,superoxide dismutase (SOD)activity, and protein expression of Bax and Bcl-2 in intestinal epithelium were detected,and epithelial apoptosis index was calculated at 2 h after resuscitation.Results Compared with group Sham,intestinal epithe-lial MDA,Bax expression and epithelial apoptosis were significantly increased,while SOD activity were markedly decreased in groups HSR,NS and TEA (P<0.05).Compared with groups HSR and NS,intestinal epithelial MDA,Bax expression and epithelial apoptosis were significantly decreased, while SOD activity and Bcl-2 expression were markedly increased in group TEA (P <0.05 ). Conclusion Lower thoracic epidural block can enhance the antioxidant and anti-apoptotic ability,and inhibit the oxidative stress and cell apoptosis of intestinal epithelium.Therefore,it can promote the survival rate after hemorrhagic shock and resuscitation through protecting intestinal barrier.