Objective To investigate the correlation of blood uric acid in patients with cerebral infarction complicated with hypertention.Methods 68 cerebral infarction patients with hypertention were selected,the other 43 hypertension cases were selected as the contronl group.The uric acid(UA),blood urea nitrogen(BUN),serum creatinine(CRE),glucose(Glu)and total choleststerol(TC),triglyceride(TG),high density lipoproteincholerterol (HDL),low denstiy lipoproteincholerterol(LDL)were compared.Results In the cerebral infarction complicated with hypertention group,the UA,TG,TC and LDL were (397.6 ±89.93)μmol/L,(1.97 ±1.03)mmol/L,(5.92 ± 1.28)mmol/L and (2.92 ±0.85)mmol/L,which were significantly higher than those in the control group[(342.03 ± 107.48)μmol/L,(1.15 ±0.89)mmol/L,(4.53 ±0.75)mmol/L and (2.41 ±0.53)mmol/L,t =8.976,3.015, 4.758,2.986,all P <0.05 ].There was positive correlation between UA and DBP,BUN,TC(r =0.451,0.768, 0.337).Conclusion Hypertension is a risk factor of cerebral infarction,especially in patients with cerebral infarc-tion complicated with hypertension need to detect uric acid,asymptomatic hyperuricemia should be treated actively.

: Objective To observe the effects of YQHXFF on the expression of matrix metalloproteinase-2 （MMP-2） in the rabbits with hyperlipidemia after percutaneous transluminal coronary angioplasty (PTCA). Methods 28 male New Zealand white rabbits were randomly divided into the control group, the model group and the YQHXFF intervention group. The models of restenosis were established with injuring carotid arteries in cholesterolfied rabbits. After 8 weeks, MMP-2 were measured with reverse transcription polymerize chain reaction (RT-PCR) and pathologic alter were observed with HE staining. Results The expression of MMP-2 mRNA in injured artery were much higher in the model group. Compared with those in the model group, the expression of MMP-2 in the YQHXFF intervention group markedly decreased and intimal hyperplasia markedly lighten. Conclusion YQHXFF can inhibit the expression of MMP-2 and lighten the intimal hyperplasia after PTCA.

Objective: To evaluate the knowledge, attitude and behavior on blood lipid among people in Changsha and to provide evidences for prevention and control of blood lipid abnormality. Methods: A total of 400 cases were randomly selected on the questionnaire of the knowledge, attitude and behavior on blood lipid in ordinary adults who participate in health examination in Xiangya Hospital. Blood lipid related physical examination was conducted at the same time. hTe health examination participants were divided into several groups according to their sex, age, degree of education, marriage and family income. The influential factors for knowledge, attitude and behavior were analyzed. Results: hTe knowledge score of blood lipid for health examination participants was 18.33±8.67 (total score 37), the attitude score was 6.63±2.45 (total score 9) and the behavior score was 8.32±2.65 (total score 16). hTe scores of female was higher than that of male in the terms of knowledge and behavior (bothP<0.05); the scores in the 40–49 age group were lower than those in the other age groups (all P<0.05); the scores in the junior high school group were lower than those in the other education groups (allP<0.05); the scores in the family group with less than 2 000 yuan income were lower than those in other family groups with different income (allP<0.05). The multiple stepwise regression analysis showed that: 1) the knowledge on blood lipid score was inlfuenced by ages and education background (bothP<0.05); 2) while the attitude of blood lipid was inlfuenced by four factors such as education background, systemic blood pressure, blood sugar and triglyceride(allP<0.05); 3) the behavior on blood lipid was inlfuenced by ifve factors such education background, triglyceride, systemic blood pressure, blood sugar and ages (allP<0.05). Conclusion: The knowledge, attitude and behavior on blood lipid among health examination participants were mostly influenced by education background, gender and ages. Thus, clinical medical staff should prevent the blood lipid abnormality through the health education and improve the knowledge in normal people. hTe group of 40–49 age male should be thought as the primary intervention subjects. hTe knowledge, attitude and behavior on blood lipid among the general population is also related to individual’s blood pressure, blood sugar and triglyceride. So the clinical medical staff should also improve the knowledge of blood lipid, blood pressure and blood sugar in general population for improving their attitude and unhealthy habits. In addition, the active control of blood sugar and blood pressure can enhance the overall health status of the general population.

Objective To study the effect of Angong-niuhuang pill on expression of eNOSmRNA in spontaneously hypertensive rats after intracerebral hemorrhage and to explore it's protective mechanism.Methods 120 spontaneously hypertensive rats were randomly divided into four groups: model group, western medicine treated group. Angong-niuhuang pill treated group, combining traditional Chinese medicine western medicine group, expression of eNOSmRNA in rat brain tissue was detected by RT-PCR. Results Expression of BCL-2mRNA in combining traditional Chinese medicine western medicine group was significantly higer than other goups(P＜0.01), Compared with model group, the expression of BCL-2mRNA in western medicine treated group and Angong-niuhuang pill treated group was markedly increased (P＜0.01), the differences between Angong-niuhuang pill treated group and Western medicine treated group were not obvious (P＞0.05).Conclusion Protective effect of Angong-niuhuang pill on spontaneously hypertensive rats after intracerebral hemorrhage is related to the the inducement of eNOS expression.

Objective:To analyze the diagnosis and treatment of adrenal lymphangioma.Methods:From September 2011 to March 2019, 16 case of adrenal lymphangioma (8 males, 8 females), aged from 15 to 65 years were retrospectively analyzed. Eleven cases were discovered accidentally by physical examination or imaging examination when treating other diseases, with 2 patients presenting lumbago, 2 patients presenting abdominal pain and 1 presenting weakness. CT showed that the tumors were cystic or cystic solid low density mass without enhancement (9 cases in the right, 7 cases in the left) and some had calcified lesions. The maximum diameter of the tumors was 2.5-16.0 cm. The endocrine examination was abnormal in 6 patients, including 2 patients with elevated 24-hour urinary vanillic mandelic acid (VMA) and adrenaline, 1 patient with elevated 24-hour urinary free cortisol (UFC) and elevated blood cortisol, and 3 patients with increased aldosterone. They were considered sub-clinical adrenal tumors. All patients were monitored for blood pressure, and patients with elevated VMA were given terazosin for volume expansion; Patients with elevated UFC are given hydrocortisone 200 mg intravenously during operation, hormone dosage is adjusted in time according to blood cortisol levels, and patients with elevated aldosterone were monitored on blood aldosterone and potassium. All cases underwent surgery, including 10 cases of laparoscopic adrenalectomy, 3 cases of laparoscopic adrenal tumor resection, 1 case of open adrenalectomy, and 2 cases of open adrenal tumor resection. One of the open surgery was an emergency exploratory laparotomy for ruptured lymphangioma.Results:The operations were successful, and there was no operation related complications.Sixteen cases were diagnosed as adrenal lymphangioma. The gross specimens were monocystic or multilocular cyst, and the cyst could be detected in the section. HE staining showed that the mass was composed of irregular cystic cavity filled with lymphoid fluid. A single layer of flattened endothelium lines the walls of lymphatic channels. Immunohistochemical staining was positive in D2-40(7/7), CD34(6/6), CD31(6/6), SMA (3/3) and CR(2/2); negative in CK(7/7) and CK7(3/3). So far, no recurrence has been detected after 6-95 months follow-up.Conclusions:Adrenal lymphangioma is a rare benign lesion clinically, without typical clinical symptoms. Preoperative diagnosis mainly depends on imaging examination. It is a non-functional lesion, whose endocrine examinations are mostly normal. Histopathology is reliable diagnostic modality. The therapy can refer to the principle of treatment for adrenal incidental tumors. Surgery is the first choice and prognosis is good.

Objective To investigate the correlation of spinal mechanical imbalance and thoraco-dorsal pain of ankylosing spondylitis (AS). Methods The clinical data of 90 patients with AS were collected. Patients were divided into two groups according to the presence of thoracodorsal pain: the AS with thoraco-dorsal pain group (30 cases) and the AS without thoraco-dorsal pain group (60 cases). Clinical symptoms, Bath ankylosing spondylitis disease activity index (BASDAI), Bath ankylosing spondylitis function index (BASFI), Bath ankylosing spondylitis measurement index (BASMI), ankylosing spondylitis disease activity (ASDAS), and spinal mechanical function and nuclear myocardial force test were compared using t-test, one-way analysis of variance (ANOVA) analysis and Spearman correlation analysis. Results ① There were differences between thoraco-dorsal pain group and patients without thoracodorsal pain group at the time of back muscle strength [(0.82±0.41) min vs (1.33±0.74) min, F=12.372, P=0.001]; ②Thoraco-dorsal pain in the AS group was mainly the middle and lower thoracic vertebrae, such as the inflammation of rib head and rib transverse process, facial arthritis, and spinous ligaments, etc. And the missed diagnosis rate of magnetic resonance imagin (MRI) was high. ③ In healthy control group, the anterior flexion strength of thoracodorsal pain group was signific-antly different from that of patients without thoracodorsal pain [(92.1 ±46.3) Nm vs (126.6±35.7) Nm, F=6.440, P=0.002]. ④ There was significant difference in spinal strength as well as left and right rotation strength between the thoracodorsal pain group and patients without thoracodorsal pain [(1.18 ±0.22) vs (1.05 ±0.17), F=10.044, P<0.01];⑤In the thoraco-dorsal pain group, the right/left index was related to BASDAI (r=-0.522, P=0.004). For spinal mobility, the right/left index was related to cross cutting faces to right ( r=0.435, P=0.021), cross cutting faces to left (r=0.528, P=0.004). In spinal strength, the right/left index was related to left turn (r=0.57, P=0.001); right lateral flexion (r=0.368, P=0.049) and left lateral flexion (r=0.369, P=0.049). Conclusion The thoracodorsal pain of AS is dominated by the middle and lower thoracic vertebrae, and the missed diagnosis rate of MRI is high. The imbalance of the left and right side of the spine is one of the factors of the thoracic back pain in AS.

Objective:To evaluate the accuracy of the domestic "Skywalker" surgical robot in implementing personalized lower limb alignment reconstruction scheme in total knee arthroplasty (TKA) and the short-term clinical outcome of robotic assisted TKA.Methods:From September 2020 to January 2021, the data of patients who received surgical robot assisted TKA in 5 clinical centers in China (Shanghai Ninth People's Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Southwest Hospital affiliated to Third Military Medical University, The Affiliated Hospital of Qingdao University, The First Affiliated Hospital of Chongqing Medical University and Yantai Yuhuangding Hospital, and Shanghai Ninth People's Hospital affiliated to Shanghai Jiao Tong University School of Medicine was the group leader) were prospectively collected and retrospectively analyzed. There were 24 males and 82 females with an average age of 67.6±7.3 years, (range 45-80 years); Average body mass index 26.42±4.31 kg/m 2, all the operation were performed by "Skywalker" surgical robot system according to preoperative design based on CT. The operation time, intraoperative blood loss, hospitalization days and postoperative complications were recorded, and the imaging indexes including hip-knee-ankle (HKA), lateral distal angle of femur (LDFA) and medial proximal angle of tibia (MPTA) measured before and after the operation, implant model indexes (preoperative planning implant model and postoperative implant model) and short-term clinical efficacy indexes [Western Ontario and McMaster Universities (WOMAC) osteoarthritis index] pain score, stiffness score, joint function score, total score and SF-12 score before and 3 months after the operation) were compared. Results:The average follow-up period was 109.60±9.80 d, (range 95-143 d). The average operation time of 106 patients was 105.30±23.22 min; The average intraoperative blood loss was 141.70±58.33 ml; The average length of hospitalization was 5.82±2.80 d. One patient had ischemic stroke after operation, and one patient had abnormal liver function after operation. According to the judgment of the investigator, all of them were not related to the operation. The actual angle error is the difference between the preoperative planning angle and the postoperative measurement angle. The absolute error of 99.1% (105/106) of the HKA angle was within 3°, 90.8% (69/76) of LDFA, 98.7% (75/76) of the MPTA. In 45 patients in one center where data were available, the actual implant models used in all patients were consistent with the preoperative planning size, and there were only differences in version selection such as Asian condyle. WOMAC pain score, joint function score, total score was improved from 7.34±2.85, 25.10±9.85, 34.75±13.02 to 3.34±2.66, 14.68±9.64, 18.66±13.49 before and after operation, respectively, which were statistically significant ( P<0.001) and SF-12 physiological score and psychological score were improved form 27.24±6.42, 30.68±8.26 to 38.83±5.74, 39.36±7.85 before and after operation, respectively, which were statistically significant ( t=7.33, P<0.001; t=4.53, P=0.043). Conclusion:Domestic surgical robot system "Skywalker" can assist the surgeon to achieve accurate and personalized reconstruction of lower limb alignment and achieve satisfactory short-term clinical outcomes. The long-term clinical outcomes of personalized reconstruction and survival rate of implant still need to be further studied.

Objective : To investigate the expression of alpha-actinin-4 (ACTN4) and the effect on cell proliferation in esophageal squamous cell carcinoma (ESCC) ． Methods : The expression of ACTN4 in ESCC tissues and paired normal tissues was detected by immunohistochemistry，and the correlation between ACTN4 and the clinicopathologi- cal features was analyzed statistically．The ACTN 4 shRNA lentiviral plasmids were constructed ，and the stable ECA109 strain with ACTN4 shRNA knockdown was established using lentivirus packaging technology．The knock- down efficiency on protein level was checked by Western blot，and cell proliferation was detected by colony forma- tion assays．The downstream target proteins were validated in ESCC cell line ECA109 based on the previous pro- teomics analyses in melanoma cell line A375 with or without ACTN4 shRNA knockdown. Results : The expression of ACTN4 in ESCC tissues was significantly higher than that of normal tissues．ACTN4 shRNA stable knockdown ECA109 cell strains were successfully constructed． The results of colony formation assays showed that ACTN4 knockdown inhibited the cell proliferation and down-regulated NADH ∶ Ubiquinone oxidoreductase core subunit V1 ( NDUFV1) protein expression in ECA109 cells． Conclusion Upregulation of ACTN4 in ESCC cells promotes the cell proliferation and enhances the protein expression of NDUFV1 .

Femoral neck fracture (FNF) in the elderly patients is currently a major health challenge worldwide, with excessive consumption of medical resources, high incidence of complications as well as suboptimal outcome and prognosis. Hip joint arthroplasty (HJA) has been the mainstream treatment for FNF in the elderly, but the conventional surgical approaches and techniques are still confronted with a series of bottlenecks such as dislocation, limp and limb length discrepancy. In recent years, direct anterior approach (DAA) for HJA (DAA-HJA) has been a major new choice in the field of joint replacement, which achieves improved clinical effectiveness of HJA in the treatment of elderly FNF, due to the fact that DAA approach involves the neuromuscular interface and accords with the idea of soft tissue retention and enhanced recovery after surgery. However, there is still a lack of unified understanding of standard technique and procedure of DAA-HJA in the treatment of elderly FNF. Therefore, relevant experts from the Hip Joint Group of Chinese Orthopedics Association of Chinese Medical Association, Youth Arthrology Group of Orthopedic Committee of PLA, Orthopedic Committee of Chongqing Medical Association, Branch of Orthopedic Surgeons of Chongqing Medical Doctor Association and Sport Medicine Committee of Chongqing Medical Association were organized to formulate the " Chinese expert consensus on the technical standard of direct anterior hip arthroplasty for elderly femoral neck fracture ( version 2023)" based on evidence-based medicine. This consensus mainly proposed 13 recommendations covering indications, surgical plans, prosthesis selections, surgical techniques and processes, and postoperative management of DAA-HJA in elderly patients with FNF, aiming to promote standardized, systematic and patient-specific diagnosis and treatment to improve the functional prognosis of the patients.