BACKGROUND:Silk fibroin as natural biological macromolecules has good biocompatibility, but it is difficult to make the three-dimensional scaffold with uniform structure because of its higher crystalization performance and bigger brittleness. OBJECTIVE:To improve the crystalization of silk fibroin through the addition of chitosan, and to get three-dimensional tissue engineering scaffolds with better mechanical strength. METHODS: CaCl2/CH3CH2OH/H2 RESULTS AND CONCLUSION:The introduction of chitosan could improve the properties of scaffolds. The porosity of the composite scaffold with lower porosity was more uniform and orderly with higher content of O ternary solution was used to dissolve silkworm cocoon to extract silk fibroin and form solution. Silk fibroin solution and chitosan solution were mixed according to different mixing ratios of 2:1, 1:1, 1:2, respectively, and then porous silk protein/chitosan scaffolds were prepared by freeze-drying method and treated by methanol. Scaffold morphology was observed by scanning electron microscopy, the chemical structure and crystaline state of the scaffolds were characterized through infrared spectrum and X-ray diffraction test, respectively. Also, the porosity and water uptake were tested and periodic cycle compression mechanical properties under the water environment were determined. chitosan. When the mixture rate of chitosan and silk fibroin was 1:2, the water uptake rate was the highest in the composite scaffolds, and also higher than that of the silk fibroin scaffold but lower than that of the chitosan scaffold. With the increase of silk fibroin, the composite scaffolds had better elasticity and stronger ability to maintain the shape.

ObjectiveTo investigate the clinical effect of Shipiyin combined with diosmin in the treatment of lymphedema with spleen Yang deficiency syndrome（SYDS）after modified radical mastectomy and the specific effect on the function of the affected limb. MethodEighty-two patients with lymphedema with SYDS after modified radical mastectomy from outpatient and inpatient department of breast department and oncology department of the First Affiliated Hospital of Hunan University of Chinese Medicine were randomly divided into an observation group（41 cases） and a control group（41 cases）. The control group was given diosmin tablets（0.9 g per time， two times per day）on the basis of conventional treatment，and the observation group was given Shipiyin（one dose per day）on the basis of the control group. The course of treatment was 14 days. The clinical symptoms were observed and the limb circumference，traditional Chinese medicine（TCM） syndrome score，functional assessment of cancer therapy-breast cancer（FACT-B） score，disability of arm， shoulder and hand questionnaire（DASH） score，and joint range of motion were measured to analyze the TCM syndrome therapeutic effect and clinical efficacy. ResultAfter 14 days of treatment， the total effective rate of the observation group was 85.37% （35/41） and that of the control group was 63.41% （26/41） in the TCM symptoms， showing a statistically significant difference （Z=-2.212， P<0.05）. In terms of the clinical efficacy， the total effective rate in the observation group was 82.93% （34/41） and that in the control group was 75.61% （31/41）， indicating a statistically significant difference （Z=-2.061， P<0.05）. Compared with the situations before treatment， the scores of clinical symptoms such as the swelling of the upper limb， pain， sense of heaviness， stuffiness， fatigue， fullness， tightness， and skin keratosis and pruritus in the two groups were significantly lowered （P<0.01） after treatment. Compared with the control group， the observation group could better improve the swelling and fullness（P<0.01），as well as the feeling of pain，heaviness，stuffiness，fatigue，tightness，skin keratosis and pruritus （P<0.05）of the upper limbs of patients. The affected limb circumference， TCM syndrome score， and DASH score decreased significantly， while the FACT-B score and upper limb joint range of motion increased significantly in the two groups after treatment （P<0.01）. Compared with the control group， the observation group showed significantly reduced limb circumference at 10 cm proximal to the elbow striae， lowered TCM syndrome score， elevated FACT-B score（P<0.05）， decreased DASH score and improved range of motion of the upper limb joint （P<0.01） after treatment. ConclusionShipiyin combined with diosmin has better clinical efficacy in the treatment of lymphedema with SYDS after modified radical mastectomy than diosmin alone，which can better improve the clinical symptoms，signs，quality of life and limb functional activity of patients. This provides a new clinical program for the treatment of lymphedema after breast cancer surgery with integrated Chinese and western medicine.