The embryo development technique in Zebrafish, Brachydanio rerio, is a toxicity testing method making use of the high sensitivity of fish embryo development in early stage to study and evaluate the specific effecting mechanism, the most sensitive effecting time, embryo toxicity and teratogenicity of chemicals through observing the development process of zebrafish embryo after chemical exposure to fertilized ova. This technique has been widely used to test toxicity of chemicals with the advantages of low cost, high sensitivity, simple to operate and simultaneous to detect multi-endpoints. The main methodology, technical characteristics and the status of world-wide application of this technique are reviewed in this paper. Based on the urgent environmental problems in China, the prospects to use this method for monitoring toxicity of mixed pollutants in wastewater are put forward.

Objective To study the analgesic sites and mechanism of total alkaloids in Papaver nudicaule (TAPN). Methods The sites of analgesic action of TAPN were observed by adopting Formalin test and two different routes of intracerebroventricular (icv), intrathecal (ith) in mice and rats and comparing ED 50 of TAPN in writhing reaction in mice induced by acetic acid by ip and iv administration. Results TAPN significantly lowered pain score of the early and late phase of Formalin response and was more sensitive in the late phase. Inhibition of TAPN at the same dose by ip administration in writhing reaction in mice induced by acetic acid was stronger than that by iv. The ED 50 value of TAPN at any time by ip administration was lower than that by iv administration. By means of central microinjection, TAPN by icv administration induced remarkable analgesic effect in mice, but TAPN by ith administration had no significant analgesic effect. Conclusion The sites of analgesic action of TAPN are mainly at periphery. TAPN has also central analgesic effect, and the site may be at the level above the spinal cord.

BACKGROUND:Endogenous hydrogen sulfide can be used as a new gaseous signaling molecule, and has important signal transfer function and biological regulation effects. OBJECTIVE:To study the neuroprotective effects of hydrogen sulfide in rats with acute cauda equina syndrome. METHODS: The 72 Sprague-Dawley rats were randomly assigned to three groups. Experimental group, model group: laminectomy was performed at the lumbar 4 (L4) level of the vertebra, and a piece of silicone (10 mm long, 1 mm thick, and 1 mm wide) was placed under the laminae of the L5-6 vertebra to produce the animal model of cauda equina syndrome. Sham surgery group: a simple laminectomy was performed in L4, but silicone was not implanted. In the experimental group, 20 μmol/kg NaHS was injected intraperitonealy at 1 hour before model establishment. Model and sham surgery groups: an equal volume of saline was injected intraperitonealy. At 12, 24, 48 and 72 hours after model establishment, malonaldehyde and glutathione levels in cauda equina nerve tissue were detected. Simultaneously, hematoxylin-eosin staining and TUNEL staining were performed at 48 hours. RESULTS AND CONCLUSION:Hematoxylin-eosin staining demonstrated that cauda equina nerve tissue was dense and regular, with complete myelin sheath, no axon sweling in the sham surgery group. Cauda equina nerve tissue was sparse, with the presence of demyelination, and partial axons and myelin sheath sweling in the model group. Cauda equina nerve tissue was tight, with axonal sweling and demyelination in the experimental group. TUNEL staining demonstrated that the number of positive cels was less in the spinal cord and dorsal root ganglia in the sham surgery group. Abundant positive cels were detected in the spinal cord and dorsal root ganglia in the model group. The number of positive cels was significantly lower in the experimental group than that in the model group. Malonaldehyde levels were lower in the sham surgery and experimental groups than in the model group (P < 0.05, P < 0.01), but glutathione levels were higher than model group (P < 0.05,P < 0.01). These results indicated that hydrogen sulfide could decrease oxidative stress and protect cauda equina nerve in rats with acute cauda equina syndrome.

Objective To study the relationship between analgesic effect of total alkaloids in Papaver nudicaule(TAPN) and prostaglandins(PGs) with opium receptors.Methods The analgesic effect of TAPN was studied by hot-plate, writhing,electric-evoked methods of mice.The analgesic mechanisms of TAPN and PGs with opium receptors were studied by the writhing numbers induced by different substances(Ach,AA,MgSO_4),the PGE_2 level in celiac fluid in mice after treated by AA writhing test and the antagonistic experiment of Naloxone.Results The inhibitory effect of TAPN on the writhing induced by Ach and AA in mice was stronger than that induced by MgSO_4.TAPN could also lower the PGE_2 level in celiac fluid.In the antagonistic experiment of Naloxone,no antagonism to the analgesic effect of TAPN had been found by ip or icv Naloxone.Conclusion It may be the mainly peripheral analgesic mechanism that TAPN could lower the PGE_2 level in celiac fluid.Its central analgesic mechanisms are not related to opium receptors.

Objective:To summarize the evidence from guidelines, consensus and systematic reviews and provide the optimal recommendations on the management of oral and pharyngeal symptom cluster in patients with head and neck cancer during radiotherapy.Methods:National Guidelines Clearinghouse and databases such as CNKI and PubMed were searched for publications on pain management from January 2016 to March 2023, and for publications on other symptom management from the establishment of database to March 2023. Quality of included articles was evaluated, data were extracted, and evidence were synthesized.Results:We included 28 guidelines, 19 expert consensus, and 16 systematic reviews. The evidence synthesis included 144 items covering 12 aspects, namely general principles, assessment, optimizing radiotherapy plan, oral care, swallowing function intervention, nutritional management, psychosocial intervention, physical intervention, medication, other interventions, health education, and follow-up.Conclusion:Evidence about the management of oral and pharyngeal symptom cluster was adequate. Considering the interaction between various symptoms, healthcare professionals could integrate management measures and construct multimodal management plan for the management of oral and pharyngeal symptom cluster in patients with head and neck cancer during radiotherapy.

Ambient fine particulate matter (PM_2.5) is particulate matter with an aerodynamic diameter less than 2.5 μm, and has an extremely wide range of sources. It affects the environmental quality in many cities and regions around the world, and associates with lots of negative effects on public health. E-cigarettes, a group of products that atomize e-liquid by an atomizer and then deliver nicotine and/or other substances to the respiratory system, have been introduced as smoking cessation products or replacement of tobacco cigarettes in recent years. The usage rate of e-cigarettes has grown rapidly all over the world. When these two pollutants coexist in the same atmosphere, they would induce certain adverse health effects not only on the e-cigarette users, but also on the people around them. Besides causing cardiopulmonary toxicity, the co-existing pollutants may associate with higher risks of developmental toxicity and carcinogenicity. In addition, the combined exposure may be related with the occurrence of depression. Therefore, there is an urgent need to conduct studies on the toxic potential of the combined exposure to PM_2.5 and e-cigarettes, which is also important for the evaluation and control of the atmospheric compound pollution associated health risk. This paper reviewed the current situation of PM_2.5 pollution and e-cigarettes use, introduced the epidemiological studies of PM_2.5 and e-cigarette combined exposure, their toxic effects in vivo and in vitro, and possible mechanisms, aiming to provide a reference for subsequent toxicity studies.

Objective: Using previous total mesorectal excision with pelvic autonomic nerve preservation (PANP+TME) and simple total mesorectal excision (TME) without emphasis on retained nerves as control, we explore the advantages of nerve plane-oriented laparoscopic total mesorectal excision (NPO+LTME) on urinary and sexual function. Methods: A retrospective cohort study was carried out. Case inclusion criteria: (1) male patients with pathologically confirmed middle and low rectal adenocarcinoma (4 to 11 cm from the anus); (2) stage T1-2tumor; (3) normal sexual life before operation. Exclusion criteria: (1) no pathological diagnosis before surgery; (2) local recurrence or distant metastasis; (3) preoperative neoadjuvant chemoradiotherapy; (4) opensurgery and laparoscopic surgery conversionto open; (5) no follow-up data. According to the above criteria, clinical data of 173 male patients with low and middle rectal adenocarcinoma who underwent radical operation for laparoscopic rectal cancer from July 2003 to July 2018 at the Department of Gastrointestinal Surgery, Wuhan University People′s Hospital were collected. According to different surgical methods, patients were divided into TME group (58 cases), PANP+TME group (63 cases) and NPO+LTME group (52 cases). There were no significant differences in the baseline data including age, body mass index and pathological examination between the 3 groups (all P>0.05). The nerve plane referred to the nerve, the adipose tissue, the extremely finecapillaries around the nerve with overlying fine membranous tissue. NPO+LTME referred to the process of laparoscopic TME guided by the nerve plane, performing in the loose connective tissue between the nerve plane and the rectal properfascia, in order to ensure the integrity of the nerve plane, and maximally protect the patient's urinary and reproductive functions. The operation time, intraoperative blood loss, urinary catheter removal time, urinary function grading, postoperative first erection time, and erectile function and ejaculation function were observed and compared among the 3 groups at 3- and 6-month after operation. Results: In the NPO+LTME group, the PANP+TME group and the TME group, the operation time was (181.9±24.5) minutes, (176.7±29.2) minutes and (137.7±16.2) minutes, respectively (F=54.868, P<0.001); the intraoperative blood lost was (6.0±1.4) ml, (6.5±1.8) ml and (12.8±4.6) ml, respectively (F=95.016, P<0.001); the time to postoperative removal of the catheter was (2.4±1.1) days, (3.7 ±1.7) days and (6.5±2.4) days, respectively (F=79.409, P<0.001); the first postoperative erection time was (1.6±0.6) days, (8.9±2.7) days and (15.9±6.8) days (F=177.677, P<0.001), respectively, whose differences were all statistically significant (all P<0.01). In comparison of urinary function grading, the proportion of grade I (normal function, no urinary dysfunction) in the NPO+LTME, the ANP+TME group and the TME group was 84.1% (53/63), 39.7% (23/58) and 19.2% (10/52), respectively, and the difference was statistically significant (H=52.915, P<0.001). At postoperative 3- and 6-month, proportion of patients with grade I erectile function (normal erectile function) was 77.8% (49/63) and 85.7% (54/63), 44.8% (26/58) and 53.4% (31/58), 28.8% (15/52) and 48.1% (25/52) in the NPO+LTME group, the PANP+TME group, and the TME group, respectively. The differences were statistically significant (H=91.709, P<0.001; H=79.692, P<0.001). The proportion of patients with grade I ejaculation function (with ejaculation, no abnormalities in routine semen examination before and after surgery) at 3- and 6-month after surgery in the NPO+LTME group, the PANP+TME group and the TME group was 82.5% (52/63) and 87.3% (55/63), 53.4% (31/58) and 60.3% (35/58), 28.8% (15/52) and 46.1% (24/52), respectively. The differences were statistically significant as well (H=86.543, P<0.001; H=78.667, P<0.001). Patients in the NPO+LTME group had no grade III erections and ejaculation disorders. Conclusion The surgical procedure of NPO+LTME can promote the recovery of postoperative neurological function and preserve urination and sexual function better.

Objective:To investigate the effects of four types of perforator flaps pedicled with cutaneous neurotrophic vessels in repairing wounds on the volar side of hands.Methods:A retrospective observational study was conducted. From May 2012 to July 2021, 122 patients with wounds on the volar side of hands who met the inclusion criteria were admitted to the Department of Hand Surgery of the Second Hospital of Tangshan, including 74 males and 48 females, aged 18-76 years. There were 15 cases of palm injury alone, 101 cases of finger injury alone, and 6 cases of simultaneous palm and finger injury. The wounds with area ranging from 1.5 cm×1.2 cm to 15.0 cm×6.0 cm were all repaired by transplantation of perforator flaps pedicled with cutaneous neurotrophic vessels, including 16 cases of the ulnar artery perforator flap carrying the medial antebrachial cutaneous nerve, 20 cases of the dorsal metacarpal artery perforator flap carrying the dorsal metacarpal cutaneous nerve, 21 cases of the digital artery dorsal perforator flap of thumb carrying the terminal branch of lateral antebrachial cutaneous nerve, and 65 cases of the digital artery dorsal perforator flap of the 2 nd to 5 th finger carrying the dorsal branch of digital nerve, with the sizes of flaps ranging from 1.8 cm×1.4 cm to 20.0 cm×6.0 cm. High-frequency color Doppler ultrasonography was performed to locate and measure the perforators and cutaneous nerves of the flaps preoperatively. The cutaneous nerves carried by the flaps were all anastomosed with the nerves at the recipient sites during the operation. The donor sites were closed directly or repaired with split- or full-thickness free skin graft from the ipsilateral thigh or proximal medial forearm. The survival of the flaps and skin grafts at the flap donor sites, and the healing of incisions at the flap donor sites were observed postoperatively. The patients were followed up, and at the last follow-up, the static two-point discrimination distances of the flaps were measured, the degree of satisfaction of patients with the appearances of the flaps and flap donor sites were evaluated based on the evaluation criteria of Michigan Hand Function Questionnaire, and the functions of the affected hands were evaluated according to the trial criteria for upper limb function evaluation of the Hand Surgery Society of the Chinese Medical Association. Results:After surgery, the distal end of the ulnar artery perforator flap carrying the medial antebrachial cutaneous nerve transplanted in one patient and the digital artery dorsal perforator flap of the 2 nd to 5 th finger carrying the dorsal branch of digital nerve transplanted in two patients were partially necrotic but healed after dressing change; the flaps transplanted in the other 119 patients all survived. All skin grafts at the flap donor sites survived, and all incisions at the flap donor sites healed after surgery. The follow-up period was 10 to 36 months, with an average of 16 months. At the last follow-up, the static two-point discrimination distances of the ulnar artery perforator flaps carrying the medial antebrachial cutaneous nerve was 10 to 20 mm. Ten patients were strongly satisfied and 6 patients were satisfied in the evaluation of satisfaction with the appearance of the flaps. Seven patients were strongly satisfied and 9 patients were satisfied in the evaluation of satisfaction with the appearance of the flap donor sites. Functional evaluation of the affected hand was excellent in 7 cases, good in 7 cases, and fair in 2 cases. For the dorsal metacarpal artery perforator flap carrying the dorsal metacarpal cutaneous nerve, the static two-point discrimination distances of the flaps was 8 to 18 mm; 13 patients were strongly satisfied and 7 patients were satisfied in the evaluation of satisfaction with the appearance of the flaps; 10 patients were strongly satisfied and 10 patients were satisfied in the evaluation of satisfaction with the appearance of the flap donor sites; the functional evaluation of the affected hand was excellent in 11 cases, good in 7 cases, and fair in 2 cases. For the digital artery dorsal perforator flap of thumb carrying the terminal branch of lateral antebrachial cutaneous nerve, the static two-point discrimination distances of the flaps was 6 to 11 mm; 17 patients were strongly satisfied and 4 patients were satisfied in the evaluation of satisfaction with the appearance of the flaps; 13 patients were strongly satisfied and 8 patients were satisfied in the evaluation of satisfaction with the appearance of the flap donor sites; the functional evaluation of the affected hand was excellent in 15 cases and good in 6 cases. For the digital artery dorsal perforator flap of the 2 nd to 5 th finger carrying the dorsal branch of digital nerve, the static two-point discrimination distances of the flaps was 5 to 12 mm; 43 patients were strongly satisfied and 22 patients were satisfied in the evaluation of satisfaction with the appearance of the flaps; 47 patients were strongly satisfied and 18 patients were satisfied in the evaluation of satisfaction with the appearance of the flap donor sites; the functional evaluation of the affected hands were excellent in 39 cases, good in 21 cases, and fair in 5 cases. Conclusions:With the assistance of high-frequency color Doppler ultrasonography, four types of perforator flaps pedicled with cutaneous neurotropic vessels which are used to repair different types of wounds on the volar side of the hand can have reliable blood supply, are easy to cut, cause minimal secondary damage to the donor area, and have good recovery of the flap sensation after surgery.

E-cigarettes have gained considerable popularity worldwide recently， which have also drawn the attention of adolescents and pregnant women. However， recent studies have uncovered the negative effects of e-cigarettes on our cardiovascular system， respiratory system， nervous system， blood system and so on. Furthermore， several studies indicate that e-cigarettes can significantly impair users’ reproductive ability. In this review， we collected the most recent studies on the effects of e-cigarettes on reproductive system based on human studies， animal studies and in vitro preclinical studies. In addition， the review shows the urgency of setting e-cigarettes exposure standards. As a result， we recommend setting strict limits on the production and sales of e-cigarettes， thus encouraging consumers to consume reasonably.

Objective:To explore the protective effect of nerve plane-oriented laparoscopic total mesorectal excision (NPO+ LTME) for postoperative urinary and sexual function in patients with rectal cancer.Methods:Retrospective analysis was performed on rectal cancer patients who received surgical treatment at Renmin Hospital of Wuhan University from Jan 2016 to Dec 2018, including 114 patients in the NPO+ LTME group and 92 patients in the laparoscopic TME combined with pelvic autonomic nerve preservation (LTME+ PANP) group. Surgical and tumor-related indicators were recorded and compared between the two groups, and postoperative urination and sexual function were followed up.Results:There was no significant difference in baseline indicators between the two groups ( P>0.05). The operative time of the two groups was (150±7) min and (154±7) min, respectively ( t=3.585, P<0.05). Intraoperative bleeding was (9±3) ml and (15±6) ml ( t=7.654, P<0.05), respectively.Three months after surgery, the rate of urinary dysfunction in the NPO+ LTME group was lower than that in the LTME+ PANP group ( Z=2.549, P<0.05), but there was no difference between the two groups 6 and 12 months after surgery ( Z=0.814, P>0.05 and Z=1.275, P>0.05). At 3, 6 and 12 months after surgery, the erectile function in NPO+ LTME group was better than that in LTME+ PANP group ( Z=4.917, P<0.05; Z=4.947, P<0.05 and Z=4.081, P<0.05); The rate of ejaculation dysfunction was also lower than that of the LTME+ PANP group ( Z=4.464, P<0.05; Z=4.948, P<0.05 and Z=4.434, P<0.05); In addition, postoperative female sexual function was superior to LTME+ PANP group ( Z=2.532, P<0.05; Z=2.364, P<0.05; Z=2.076, P<0.05). Conclusion:NPO+ LTME has good surgical safety and also has certain advantages for patient sexual function and early urinary function protection.