Objective To investigate the changes of lithium metabolic balance in normal controls and in patients with type-two diabetes mellitus.Method Lithium was measured by atomic absorbent spectrometry.Results (2 91?0 54)?mol/d of lithium intake (2 37?0 51)?mol/d in urine and (0 28?0 05)?mol/d in stool,(0 27?0 24)?mol/d of lithium equilibrium value(LEV),(2 64?0 51)?mol/d of intestinal lithium absorption value(ILAV),(90 4?18)% of intestinal lithium absorption rate(ILAR) and (81 0?1 5)% of ratio of urine lithium excretion to lithium intake(ULE/LI)in normal controls;as well as (2 24?0 25)?mol/d of lithium in food,(2 15?0 36)?mol/d in urine,(0 35?0 05)?mol/d in stool,(-0 25?0 06)?mol/d of LEV,(1 89?0 33)?mol/d of ILAV,(84 3?2 1)% of ILAR and (95 6?3 2)% RU/I in diabetic patients respectively.Lithium in food and stool,LEV,ILAV and ILAR in diabetes were lower than those in controls (P

OBJECTIVE To investigate the transgenerational effects of a hypothala mic-pituitary-ad-renal (HPA)axis -associated neuroendocrine metabolic progra mming alteration fro m F1 to adult second generation (F2)with prenatal ethanol ingestion.METHODS Pregnant Wistar rats were ad ministered with ethanol (4 mg·kg -1·d -1 )fro m gestational day 1 1 until delivery.F1 rats were fed a high-fat diet fro m postnatal week 4 (PW4)and were cross-mated in PW 16 -20.F2 rats were fed a standard diet fro m PW4 and rectal te mperature was measured in PW20,oral glucose tolerance test (OGTT)was con-ducted in PW21 ,blood sa mples and hypothala mus were collected in PW24 to investigate seru m lipids and HPA axis activity.RESULTS Co mparing to the F2 control group ,rectal te mperature in F2 ethanol group were higher (P<0.01 ),sugar tolerance in F2 male group was i mpaired (P<0.05),seru m corti-costerone and hypothala mus arginine vasopressin (AVP) mRNA were increased (P <0.05);seru m insulin were decreased (P<0.05)and male rats showed i mpaired glucose tolerance (P<0.05);seru m high-density lipoproteincholesterol (HDL-C)decrease (P <0.05)and total cholesterol (TCH)/HDL-C and low density lipoproteincholesterol (LDL-C)/HDL-C ratios were markedly increased (P <0.05,P <0.01 ).CONCLUSION Prenatal ethanol exposure induced metabolic syndro me has transgenerational effects,which may originate fro m the intrauterine progra mming of altered HPA axis-associated neuroen-docrine metabolis m.

Objective To investigate the effects of melatonin (MT) on rats with acute paraquat (PQ) poisoning. Method Fifty-four Sprague-Dawley (SD) rats were randomly divided into three groups (each group 18 rats) and given the following treatment: intragastric injection of PQ at 50 mg/kg (PQ); intragastric injection of paraquat followed by intraperitoneal injection of MT at 10mg/kg once a day (MT); intragastric injection of normal saline (Control). Serum assays for malondialdehyde (MDA) levels and superoxide dismutase (SOD) and glu tathione peroxidase (GSH-Px) activities were determined on the 1st, 3rd and 7th day post treatment. Clinical manifestations of poisoning and pathological changes in the lungs were also observed. Results Serum MDA levels were significantly increased (P ＜ 0.01), and SOD and GSH-Px activities significantly decreased (P ＜ 0.05) in the PQ group compared to the control group. Serum MDA levels were significantly decreased, and serum SOD and GSH-Px activities increased in MT group compared to the PQ group (P ＜ 0.05). Clinical manifestations of intoxication and pathological lung changes were also ameliorated in poisoned rats treated with MT. Condutions Administration of MT alleviates clinical manifestations of acute paraquat poisoning in rats by Limiting the damage from lipid peroxidation.

Objective:To report a case of large persistent primitive trigeminal artery aneurysm treated with dense reticular blood flow guide device (flow diverter, FD).Methods:The imaging and clinical data before and after treatment with FD of a 54 years old female patient with large persistent primitive trigeminal artery aneurysm with abducent nerve and oculomotor nerve insufficiency in the Department of Neurosurgery, the First Affiliated Hospital of Jinan University in December 2018 were analyzed retrospectively, and the related literature was reviewed.Results:Digital subtraction angiography (DSA) showed that the left primitive trigeminal artery was not closed, and the internal carotid artery communicated with the basilar artery through the original trigeminal artery. The aneurysm was located at the beginning of the original trigeminal artery and the size was about 18.41 mm×12.8 mm. The contrast agent in the aneurysm was significantly retained after the cavernous sinus segment of the internal carotid artery was implanted with FD. Eight months after operation, the left blepharoptosis disappeared, strabismus disappeared and eyeball movement was normal. DSA showed that there was no obvious development of aneurysm in the original trigeminal artery.Conclusion:For mature persistent primitive trigeminal artery related large or giant aneurysm, FD may be a better means of treatment.

Objective:To investigate the clinical efficacy of femoral component revision surgery in addressing polyethylene sleeve wear in rotating hinge knee joints.Methods:A retrospective analysis was conducted on 21 patients who underwent treatment for polyethylene sleeve wear in rotating hinge knee joints at the Department of Orthopaedics, the Fourth Medical Center, PLA General Hospital, spanning from August 2008 to April 2023. There were 8 males and 13 females with a median age of 63(38, 76) years. Among them, 11 cases involved the left side, and 10 cases involved the right side. The average body mass index (BMI) was 25.0(22.5, 31.0) kg/m 2, and all cases underwent unilateral knee joint revision. The time interval from receiving the hinge knee joint prosthesis to revision was 10.5(6.0, 17.0) years, with 18 cases undergoing primary revision and 3 cases undergoing revision for the second time. Revision surgery of the femoral component sleeve was performed in all patients due to polyethylene sleeve wear. Visual analogue scale (VAS), range of motion (ROM) of the knee joint, changes in hip-knee-ankle angle (HKA), and Knee Society score (KSS) were collected and recorded to assess the surgical outcomes. Results:All patients were followed up for a median duration of 12.5(11.7, 13.4) months. Preoperatively, the VAS score was 5(3, 7) points, which significantly decreased to 0(0, 1) points at the last follow-up ( Z=5.721, P<0.001). At the last follow-up, the KSS scores decreased from 41.19±13.65 points preoperatively to 79.81±7.80 points, indicating a statistically significant difference ( t=12.560, P<0.001). HKA increased from 174.65°±5.20° preoperatively to 178.71°±2.79°, with a statistically significant difference ( t=5.533, P<0.001). Knee joint ROM increased from 69.05°±34.37° preoperatively to 110.00°±10.12°, also demonstrating a significant improvement ( t=5.960, P<0.001). Notably, patients exhibited knee joint stability with no passive flexion or extension laxity. Conclusion:Femoral component sleeve revision surgery effectively addresses polyethylene sleeve wear in rotating hinge knee joint prostheses, thereby mitigating the substantial loss of bone and soft tissue associated with overall revision procedures. The early postoperative clinical outcomes are promising and indicative of the efficacy of this surgical intervention.

Objective:To evaluate the feasibility and efficacy of remote follow-up based on knee scoring system after total knee arthroplasty (TKA).Methods:A total of 71 patients with knee osteoarthritis who underwent TKA from July 2021 to September 2022 at Department of Orthopaedic Surgery, First Medical Center, Chinese PLA General Hospital were retrospectively analyzed. There were 12 patients included in the study, including 6 males and 6 females, aged 72.83±4.22 years (range, 68-78 years), who were followed up using an online approach (remote follow-up group). According to the sample size of 1:2, patients who received outpatient follow-up during the same period were selected as controls (outpatient follow-up group), including 12 males and 12 females, aged 72.16±4.50 years (range, 65-80 years). Western Ontario and McMaster University Osteoarthritis Index (WOMAC), Oxford Knee Score (OKS), and 2011 New Knee Society Score (KSS) were used to assess outcomes after TKA.Results:The follow-up completion rate in the remote follow-up group was 17% (12/71). There were statistically significant differences in WOMAC scores between the two groups before and after operation ( F=106.18, P<0.001; F=34.33, P<0.001). The WOMAC score of remote follow-up group at the last follow-up was 11.21±5.64, which was lower than 43.83±8.52 before operation and 33.96±9.19 at 2-4 weeks after operation, and the difference was statistically significant ( P<0.001, P<0.001). The WOMAC scores of the outpatient follow-up group at the last follow-up was 13.33±5.36, which was lower than 42.00±7.21 before operation and 32.83±11.00 at 2-4 weeks after operation, and the difference was statistically significant ( P<0.001, P<0.001). There were statistically significant differences in OKS between the two groups before and after operation ( F=168.65, P<0.001; F=66.18, P<0.001). The OKS of remote follow-up group at the last follow-up was 15.13±4.92, which was lower than 44.50±5.84 before operation and 36.83±6.31 at 2-4 weeks after operation, and the difference was statistically significant ( P< 0.001, P<0.001). The OKS of the outpatient follow-up group at the last follow-up was 16.58±3.63, which was lower than 41.42±5.05 before operation and 33.33±6.60 at 2-4 weeks after operation, and the difference was statistically significant ( P<0.001, P<0.001). There were statistically significant differences in the 2011 new KSS between the two groups before and after operation ( F=164.21, P<0.001; F=51.78, P<0.001). The 2011 new KSS of remote follow-up group at the last follow-up was 83.67±6.27, which was higher than 41.33±10.33 before operation and 50.42±11.07 at 2-4 weeks after operation, and the difference was statistically significant ( P<0.001, P<0.001). The 2011 new KSS of the outpatient follow-up group at the last follow-up was 83.17±6.28, which was higher than 40.08±8.91 before operation and 44.37±9.04 at 2-4 weeks after operation, and the difference was statistically significant ( P<0.001, P<0.001). There was no significant difference in the three scores between the two groups before operation, 2-4 weeks, 6 weeks, 2-3 months or 4 months after operation ( P>0.05). Conclusion:The effect of remote follow-up based on knee scoring scale after TKA is similar to that of outpatient follow-up, but the rate of loss to follow-up in both groups is high. The scoring scale should be continuously optimized to improve patient compliance.

OBJECTIVE: To explore the correlation between endothelial microparticles(EMPs) and subacute 1,2-dichloroethane(1,2-DCE) toxic encephalopathy. METHODS: A total of 24 patients with subacute 1,2-DCE toxic encephalopathy were selected as the case group, and 24 healthy individuals were selected as the control group using a convenient sampling method. Blood plasma was collected from the fasting venous blood of patients in these two groups, and the level of EMPs in the plasma was detected by flow cytometry. RESULTS: The levels of plasma EMPs of patients in the control group and the case group were(692.0±174.4) ×10~3/L and(839.8±155.8) ×10~3/L respectively. The levels of plasma EMPs in patients with mild, moderate and severe case subgroups were(691.6±101.9) ×10~3/L,(900.6±46.6) ×10~3/L and(1 026.8±69.8)×10~3/L respectively. The EMPs level of patients in the case group was higher than that of the control group(P<0.01). The level of EMPs in the moderate and severe case subgroups was higher than that of the control group and mild case subgroup(P<0.01). CONCLUSION: Endothelial injury was found in patients with subacute 1,2-DCE toxic encephalopathy and endothelial injury is related to the severity of poisoning.

ObjectiveTo compare the therapeutic effects of oral Chinese medicines （including Chinese patent medicines） on coronary artery disease （CAD） by the Bayesian network Meta-analysis. MethodThe randomized controlled trials of treating CAD with oral Chinese medicines were retrieved from the China National Knowledge Infrastructure （CNKI）， Wanfang Data， VIP， PubMed， Web of Science， Embase， and Cochrane Library from the inception to December 1， 2022. The Cochrane risk of bias assessment tool was used to evaluate the quality of the included articles. The direct meta-analysis was performed to compare the performance of oral Chinese medicines alone and in combination with Western medicine in the treatment of CAD in terms of intima-media thickness （IMT）， vascular endothelial function， plaque score， hypersensitive C-reactive protein （hs-CRP）， total cholesterol （TC）， triglyceride （TG）， high-density lipoprotein cholesterol （HDL-C）， low-density lipoprotein cholesterol （LDL-C）， and total response rate. Furthermore， the Bayesian network Meta-analysis was performed to compare the therapeutic effects of different Chinese medicines. ResultA total of 41 articles were included. The direct meta-analysis results showed that Chinese medicines combined with Western medicine outperformed Western medicine alone in recovering all the indicators of CAD. The Bayesian network meta-analysis yielded the following results. In terms of the total response rate， modified Huangqi Guizhi Wuwutang and Sanqi Huayu pills had obvious advantages over other Chinese medicines. In terms of IMT and plaque score， Xiaoban Huazhuo decoction， Yiqi Tongluo formula， Ruangan Jiangzhi capsules， and Guanxin Shutong capsules had obvious advantages over other Chinese medicines. In terms of blood lipid indicators， Shenqi Roumai mixture， Ruangan Jiangzhi capsules， Xiaoban Huazhuo decoction， Qiwei Sanxiong decoction， and Sanqi Huayu pills were superior to other Chinese medicines. The Chinese medicines above mainly had the functions of activating blood， resolving stasis， resolving phlegm， and dredging vessels. ConclusionThe combination of oral Chinese medicines and Western medicine is effective in treating CAD. Clinicians can use the drugs targeting abnormal indicators according to the results of this Bayesian network meta-analysis combined with the actual situation of patients to achieve better therapeutic effects.