Objective: To explore the effect of high mobility group box-1 protein (HMGB1) on the balance of Th17/Treg in patients with immune thrombocytopenia (ITP). Methods: A total of 30 patients who were first diagnosed as ITP in the Fifth People's Hospital of Datong from July 2017 to April 2018 were selected as the case group, and another 30 healthy volunteers in the corresponding period were taken as the control group. The proportion of Th17 and Treg cells was detected by using flow cytometry, and the concentration of HMGB1, interleukin (IL)-17 and transforming growth factor β (TGF-β) in plasma was tested by using enzyme-linked immunosorbent assay (ELISA). Isolated peripheral blood mononuclear cells (PBMC) were cultured in vitro. After the treatment with recombinant human HMGB1 (rhHMGB1), real-time polymerase chain reaction (RT-PCR) was applied to detect the mRNA expression changes in Treg cell transcription factor intracellular forkhead helix transcription factor 3 (Foxp3) and Th17 cell transcription factor retinoid related orphan receptor γt (RORγt). The differences of indicators in Treg cell transcription factor peripheral blood between the case group and the control group were compared, and the balance correlation between HMGB1 and Th17/Treg was analyzed. Results: Compared with the healthy control group, the proportion of Th17 cells and the expression level of HMGB1 and IL-17 in peripheral blood of ITP patients were increased (all P < 0.01), while the proportion of Treg cells and the level of TGF-β were decreased (all P < 0.01). The proportion of Th17 cells and the expression level of IL-17 and HMGB1 in peripheral blood of ITP patients were positively correlated with the concentration of HMGB1 (all P < 0.01); the proportion of Treg cells and the level of TGF-β were negatively correlated with the expression level of HMGB1 (all P < 0.01). In vitro experiments, the expression of intracellular RORγt mRNA was increased compared with the negative control group (1.50±0.24 vs. 0.93±0.22, t = 9.612, P < 0.01), and the expression of Foxp3 mRNA was decreased compared with the negative control group after the stimulation of PBMC by rhHMGB1 (0.72±0.19 vs. 1.08±0.18, t = 7.387, P < 0.01). Conclusion The high level of HMGB1 in the peripheral blood of ITP patients induces Th17/Treg imbalance and aggravates inflammatory reactions, which may be an important cause of ITP.

OBJECTIVETo observe the effect of zi-hua burn cream on the survival of skin flaps in rats, and its mechanisms.

METHODS72 Wistar rats, were randomly divided into four groups as zi-hua group(n = 18, external application of alfalfa burn cream), control group (n = 18, external application of heparin sodium cream), model group (n = 18, external application of vaseline) , negative control (n = 18, no operation). 8 cm x 2 cm random skin flaps with pedicle on the side of head were designed on the back of Wistar rats. The drug was applied on the flap surface, 2 times a day. The survival of skin flaps was observed. The change of serum superoxide dismutase (SOD), malondialdehyde (MDA), nitric oxide (NO), turner necrosis factor-alpha(TNF-alpha)and interleukin-6(IL-6)were compared at 1,2,3,7 d after operation, and histologic examination was performed.

RESULTSThe survival rate of zi-hua group (73.58 - 10. 74)% was significantly higher than that of model group (33.40 - 16.05) %, showing a statistical difference (Q = 10.63, P <0.01). There was no significant difference between the zi-hua group and control group (71.65 +/- 11. 92) %. The level of serum SOD, NO in zi-hua group and control group was higher than that in model group, while the level of serum MDA, TNF-alpha and IL-6 was lower than that in model group(P <0.01). On 7 day after operation, skin flaps tissue edema,necrosis and inflammatory cell infiltration in zi-hua group and control group was less obvious than that in model group. There was significant proliferation of granuloma and fibroblast and formation of neonatal capillary in zi-hua group and control group. The vascular density in zi-hua group was obviously higher than that in the model group and control group(P <0. 01).

CONCLUSIONSZi-hua burn cream could significantly improve the blood supply of skin flaps, increase the survival rate of skin flaps in rats. Its mechanism may be associated with the anti-free-radical-damage action, improve local microcirculation, improve the NO content, reduce the TNF-alpha and IL-6 level, reduce inflammation factor release, improve oxidative stress state, and reduce inflammation reaction.

Animals ; Drugs, Chinese Herbal ; pharmacology ; Graft Survival ; drug effects ; Interleukin-6 ; blood ; Male ; Malondialdehyde ; blood ; Rats ; Rats, Wistar ; Skin Transplantation ; Superoxide Dismutase ; blood ; Surgical Flaps ; Tumor Necrosis Factor-alpha ; blood

Objective: To assess the clinical effect of anisodamine combined with gabapentin on painful diabetic neuropathy(PDN). Methods: From June 2013 to February 2017, 120 patients with PDN in the Fifth People's Hospital of Datong were assigned into anisodamine group, gabapentin group and combined group according to the digital table, with 40 cases in each group, the patients were treated with anisodamine, gabapentin and combination therapy respectively.The abnormal foot plantar pressure, MCV and SCV of median nerve and common peroneus nerve, VAS and total effective rate of three groups were compared. Results: After treatment, the indicators of the combined group were improved more significantly than those of the anisodamine group and gabapentin group in abnormal foot plantar pressure[(6.10±1.66) vs.(10.80±2.64) vs.(6.37±1.44), F=14.602, P<0.01], total effective rate (92.5% vs.62.2% vs.75.0%, χ²=10.155, P=0.006), MCV[(50.33±5.54)m/s vs.(41.12±4.47)m/s vs.(42.32±4.40)m/s, F=9.404, P=0.001], and SCV of median nerve[(48.51±6.19)m/s vs.(41.81±5.72)m/s vs.(41.76±7.17)m/s, F=3.728, P=0.037], MCV of common peroneus nerve[(40.60±5.69)m/s vs.(32.04±4.47)m/s vs.(33.52±7.76)m/s, F=5.614, P=0.009]and SCV of common peroneus nerve[(42.72±4.97)m/s vs.(36.21±6.16)m/s vs.(35.45±5.54)m/s, F=4.265, P=0.025]. After treatment, the VAS scores of the three groups decreased, which were (4.49±1.61)points, (5.82±1.58)points, (6.37±1.44)points, respectively, the difference was statistically significant(F=14.602, P=0.000), and the decrease was more significant in the combined group. Conclusion Compared with the anisodamine group and gabapentin group, the combined treatment is more effective on PDN.

AIM: To investigate the effects of small incision extracapsular excision and phacoemulsification on the number of corneal endothelial cells, macular thickness and surgically induced corneal astigmatism in cataract patients.METHODS: Retrospective research. A total of 296 age-related cataract patients(296 eyes)admitted to our hospital from May 2019 to February 2023 were selected. They were divided into a small incision extracapsular excision group(144 eyes)and a phacoemulsification group(152 eyes)according to surgical method. The uncorrected visual acuity, best corrected visual acuity, numbers of corneal endothelial cells, macular thickness, surgically induced corneal astigmatism and postoperative complications between the two groups of patients at 7d, 1 and 3mo after surgery were compared.RESULTS: The uncorrected visual acuity and best corrected visual acuity of patients in the small incision extracapsular excision group after 7d of surgery were better than those of the phacoemulsification group, the number of corneal endothelial cells after 7d and 1, 3mo of surgery were higher than that of the phacoemulsification group, the macular thickness after 7d and 1mo of surgery was lower than that of the phacoemulsification group, and the incidence rate of postoperative corneal edema and incidence rate of total complications were lower than those of the phacoemulsification group(all P<0.05). Furthermore, there was no statistical significance in the values of surgically induced corneal astigmatism after 1, 7d and 1, 3mo of surgery compared with phacoemulsification group(P>0.05).CONCLUSION: Compared with phacoemulsification, the changes in the number of corneal endothelial cells and thickness of the macular area after small incision extracapsular excision are relatively small, visual recovery is faster, and the complications reduced.

Objective: To investigate the effects and the potential mechanism of shikonin on rat random flaps. Methods: Seventy-two wistar male rats in grade SPF were randomly divided into negative control group, tetramethylpyrazine group (TMP group) or shikonin treatment group. The random skin flap sized 8 cm×2 cm, with a cephalic based pedicle, was performed on the back of the rat. Each group was administered accordingly by intraperitoneal injection once per day for 7 days: shikonin treatment group (1 mg/kg), TMP group (10 mg/kg) and control group (1 ml/kg). Morphological changes of skin flaps were observed by HE staining. The positive expression of iNOS and COX-2 in skin flap tissues after operation were detected by immunofluorescence staining. The serum contents of TNF-α and IL-6 were detected by ELISA. Results: Inflammatory cell infiltration and inflammatory reaction of flap was more severe in control group at different time points after operation. The number of inflammatory cells in shikonin treatment group and TMP group were significantly decreased, compared with controls (P<0.01). The decrease of the inflammatory cell numbers in shikonin treatment group was more significant. The proliferation of granulation tissue and fibroblast in skin flap was obvious, and the survival rates of the skin flap were significantly increased in shikonin treatment group and TMP group (both P<0.01). The numbers of iNOS or COX-2 positive cells in shikonin treatment group and TMP group were significantly decreased, when compared with controls (both P<0.01). Compared with TMP group, the numbers of iNOS and COX-2 positive cells in shikonin treatment group were significantly decreased (P<0.01 and P<0.05, respectively)in early period after operation. Compared with the control group, serum levels of TNF-α and IL-6 in shikonin treatment group and TMP group were significantly decreased (all P<0.01). The shikonin treatment group developed more significant reduce. Conclusions Shikonin can significantly improve inflammatory response of skin flap in rats, which might be related to inhibiting the expression of iNOS and COX-2, decreasing serum levels of TNF-α and IL-6 , and reducing the release of inflammatory cytokines .

Objective To investigate the effects of Jianpi Zhidong Decoction combined with aripiprazole on muscle function and behavioral abnormality in children with pediatric multiple tics. Methods A total of 90 children with pediatric multiple tics were selected as research objects, and they were randomly divided into aripiprazole group and Zhidong Decoction group, with 45 cases in each group. The efficacy, score of muscle function, score of behavioral tics, score of neurological function and incidence of adverse reactions were compared between the two groups. Results After treatment, the total effective rate was 82.22% in the Zhidong Decoction group, which was significantly higher than 44.44% in the aripiprazole group (P < 0.05). After treatment, the score of tics intensity, score of number of tics and score of tics frequency in both groups decreased significantly, and scores of these indexes in the Zhidong Decoction group were significantly lower than those in the aripiprazole group (P < 0.05). After treatment, the score of vocal tic and score of motor tic in both groups decreased significantly, and the scores of these indexes in the Zhidong Decoction group were significantly lower than those in the aripiprazole group (P < 0.05). After treatment, the levels of 5-hydroxytryptamine (5-HT) and dopamine (DA) in both groups decreased significantly, and the levels of 5-HT and DA in the Zhidong Decoction group were significantly lower than those in the aripiprazole group (P < 0.05); after treatment, the levels of norepinephrine (NE) and γ-aminobutyric acid (GABA) in both groups increased significantly, and the levels of NE and GABA in the Zhidong Decoction group were significantly higher than those in the aripiprazole group (P < 0.05). The incidence rate of adverse reactions was 6.67% in the Zhidong Decoction group, which was significantly lower than 26.67% in the aripiprazole group (P < 0.05). Conclusion The combination of Jianpi Zhidong Decoction and aripiprazole has a significant therapeutic effect in treating children with pediatric multiple tics, which can effectively improve muscle function, abnormal behaviors and neurological function, reduce the incidence rate of adverse reactions, and has higher safety.

Objective: To study the clinical effect of fasudil plus cattle encephalon glycoside and ignotin injection in treating diabetic deafness and tinnitus. Methods: From January 2016 to December 2016, 60 patients with diabetic deafness and tinnitus in the Fifth People's Hospital of Datong were selected and randomly divided into two groups according to the digital table, with 30 cases in each group.The treatment group received fasudil injection plus cattle encephalon glycoside and ignotin injection (iv gtt), and the control group received cattle encephalon glycoside and ignotin injection.The effective rate after treatment for 10 days and 20 days were compared between the two groups. Results: Compared with the control group, the effective rate of hearing in the treatment group was not higher at 10 days after treatment (26.7% vs.16.7%, χ²=0.884, P=0.347), while it was higher in the treatment group at 20 days after treatment (53.3% vs.26.7%, χ²=4.444, P=0.035). The effective rate of tinnitus in the treatment group at 10 days after treatment was not higher compared with the control group (30.0% vs.20.0%, χ²=1.491, P=0.222), while it was higher in the treatment group at 20 days after treatment (56.7% vs.30.0%, χ²=4.344, P=0.037). As far as hearing threshold: there were no statistically significant differences between the control group and the observation group before treatment and 10 days after treatment(all P>0.05). The hearing threshold of the observation group was significantly better than that of the control group at 20 days after treatment (t=-2.511, P=0.02). Conclusion The combination therapy of fasudil injection plus cattle encephalon glycoside and ignotin injection has better efficacy for diabetic deafness and tinnitus.

【Objective】 To explore the effect and mechanism of Fasudil in the treatment of experimental autoimmune myocarditis (EAM) in mice so as to provide a theoretical basis for the clinical use of Fasudil in treating myocarditis. 【Methods】 Balb/c male mice were used as the research objects, and the EAM mice model was constructed using MyHC-α614-629 polypeptide. Mononuclear cells were isolated and cultured to detect the number of mononuclear cells in mouse spleen. Inflammation infiltration, fibrosis and IL-6 expression in mouse myocardial tissue were detected by HE staining, Masson staining and immunohistochemistry, respectively. The protein expressions of Notch1 and IL-6 were detected by Western blotting. qRT-PCR was used to detect the expressions of pro-inflammatory factors (IL-1α, IL-1β and IL-6) as well as key genes of TLRs and NOTCH signaling pathway. 【Results】 EAM mice showed increased HW, decreased BW, increased HW/e-BW, and increased inflammatory infiltration and fibrosis in myocardial tissue. The above-mentioned symptoms or pathological features were improved in EAM mice treated with Fasudil. The analysis showed that the pro-inflammatory factors IL-1α, IL-1β and IL-6 in the myocardial tissue of EAM mice were significantly increased, but only the expression of IL-6 was statistically different after Fasudil treatment compared with the control group. In addition, TLRs signaling pathway might also play an important role in the EAM mice treated with Fasudil. The expressions of IL-6 and Notch1 were consistent, and the expressions of the key genes of NOTCH signaling pathway (Notch1, Hes1 and Jag2) were down-regulated after Fasudil treatment. 【Conclusion】 Fasudil exerts a protective effect on down-regulation of IL-6 expression by inhibiting the NOTCH signaling pathway in EAM mice.

Objective To explore whether adiponectin activates AMP-activated protein kinase(AMPK) via LKB1 pathway or not in skeletal muscle and liver tissues.Methods Male Sprague-Dawley rats ( n =28 ) were divided into normal control diet( NC,n =15 ) and high-fat diet( HF,n =13 ) groups.After 16 weeks feeding,fasting blood free fatty acids( FFA ),triglyceride( TG ),total cholesterol( TC ),fasting plasma glucose( FPG ),fasting insulin(FINS),and adiponectin were determined.The protein levels of AMPKα,phosphorylated AMPKα ( p-AMPK ),and LKB1 in the skeletal muscle and liver tissues were analyzed with Western blot.Cultured primary skeletal muscle cells and hepatic cells were incubated with aditonectin and radicicol.The expression of AMPKα,p-AMPKα,and LKB1 inthese cells were analyzed with immunofluorescence method.Results Compared with NC group,body weight,FFA,TG,FPG,and FINS in rats of HF group were significantly higher( all P＜0.05 ) while serum adiponeetin level was lower( P＜0.05 ).The levels of AMPKα phosphorylation and LKB1 expression in the skeletal muscle and liver tissues of HF group were lower than those in NC group. In primary skeletal muscle cells and hepatic cells,adiponectin significantly increased the levels of AMPKα phosphorylation and LKB1 expression ( all P＜ 0.05 ),which were decreased by radicicol ( P＜0.05 ).Conclusion Adiponectin may activate AMPK via LKB1 pathway in skeletal muscle and liver tissues of rats.

OBJECTIVETo explore the clinical efficacy and safety of balloon kyphoplasty for the aged osteoporotic vertebral compression fractures.

METHODSFrom June 2006 to August 2009, balloon kyphoplasty was performed on 26 patients (30 vertebral bodies), who presented painful vertebral compression fractures. They were 10 males and 16 femals, with an average age of 70 years ranging from 59 to 78 years. The operative segments were 4 cases in T11 vertebraes, T12 in 10, L1 in 12, L2 in 3, L4 in 1. The reduction of compressed vertebrae was displayed by X-ray, and the patients were followed up by observation of the visual analog scale and complications.

RESULTSAll cases had rapid, significant and sustained improvements in postoperative pain following balloon kyphoplasty. Visual analog scale was reduced from (8.6 +/- 0.2) to (2.0 +/- 0.3) points. The anterior and midline vertebral body heights in 30 fractured vertebral bodies increased from pre-operative (18.34 +/- 3.25) mm, (14.36 +/- 2.56) mm up to pro-operative (20.51 +/- 1.34) mm, (19.66 +/- 1.28) mm (P < 0.05) respectively. No severe leakage occured.

CONCLUSIONBalloon kyphoplasty in treatment of osteoporotic vertebral compression fractures can restore the height of fractured vertebra, relieve pain and improve the spinal function with satisfactory clinical outcomes.

Aged ; Bone Cements ; Female ; Fractures, Compression ; surgery ; Humans ; Male ; Middle Aged ; Osteoporosis ; complications ; Pain Measurement ; Spinal Fractures ; surgery ; Vertebroplasty ; methods