OBJECTIVE To investigate the protective effect and mechanism of vincamine derivative Vin24 on the pathological symptoms of diabetic peripheral neuropathy(DPN)in mice.METHODS Forty 8-week-old male C57BL/6N mice were randomly di-vided into control group(Control),model group(STZ),vincamine group(STZ+Vin)and Vin24 group(STZ+Vin24).Except the con-trol group,the rest three groups of mice were intraperitoneally injected with streptozocin(STZ,150 mg·kg-1)to induce type 1 diabe-tes and administration was started six weeks later.Thirty 18-week-old male db/db mice were randomly divided into model group(db/db),vincamine group(db/db+Vin)and Vin24 group(db/db+Vin24).Ten age-matched wild-type mice were used as a control group(db/m).The vincamine group were gavaged 30 mg·kg-1 of vincamine daily.The Vin24 group was gavaged 46.8 mg·kg-1 of Vin24,while the control and model group were given the same amount of saline daily,for four weeks.Sensory functions of the mice were as-sessed by assays against tactile and thermal allodynia threshold.A Laser Speckle Imaging System was used to detect the peripheral blood flow.The epidermal tissues of foot pads were collected for PGP9.5 immunofluorescence to measure the intraepidermal nerve fiber(IENF)density.Primary dorsal root ganglia(DRG)neurons were isolated for β-tubulin Ⅲ immunofluorescence to evaluate neurite outgrowth.Additionally,DRG tissues were extracted for ATF3 immunofluorescence for the evaluation of DRG neuronal apoptosis,and Western blot analysis was used to measure the protein levels of Bcl-2,Bax,Cleaved-Caspase3 and Caspase3.RESULTS The tact-ile and thermal allodynia thresholds were decreased(P<0.01,P<0.001),and peripheral blood flow was increased(P<0.001)in Vin24-treated DPN mice.The IENF density was increased(P<0.05,P<0.01)and DRG neurite outgrowth was improved(P<0.001)in Vin24 group compared with that in the model group.Immunofluorescence assay results indicated that the number of ATF3(a marker of neuronal apoptosis)-positive neurons was obviously decreased(P<0.01,P<0.001)in DRG tissues of Vin24-treated DPN mice.Western blot results demonstrated that the protein level of anti-apoptotic protein Bcl-2 was significantly increased(P<0.05),and the protein levels of pro-apoptotic proteins Bax and Cleaved-Caspase3 were significantly decreased(P<0.05)in DRG tissues of Vin24-treated DPN mice.CONCLUSION Vincamine derivative Vin24 inhibits the activation of Cleaved-Caspase3 and reduces the neuronal apoptosis levels by regulating Bcl-2/Bax/Caspase3 pathway,and eventually alleviates DRG neuronal damage and improves peripheral neuropathy in diabetic mice.

Objective:To explore the effect of ointment massage on the postoperative recovery of newborns who had intestinal tract operation, aim to construct an effective post-operative ointment and massage scheme and to enrich the content of enhanced recovery after surgery in the field of newborns.Methods:Delphi expert inquiry method was used to construct the ointment message scheme. A total of 64 newborns undergone intestinal surgery from May 2022 to May 2023 in Guangdong Women and Children Hospital were selected as study subjects and divided into routine group (34 cases) and ointment group (30 cases) by random number table method. In addition to routine treatment and nursing, the newborns in the ointment group also received ointment massage. The postoperative gastrointestinal drainage volume, fasting days, the first feeding time, hospital stay and the number of cases of vomiting and abdominal distension between the two groups were compared.Results:A total of 16 experts with (38.93 ± 5.13) years old were inquired, 6 males and 10 females. The effective questionnaire response rates for the two rounds of expert inquiry were 16/16 and 15/16, the expert authority coefficients were both≥0.80, the Kendall′s W coefficients were 0.117 and 0.107, with statistically significant differences (both P<0.05). A ointment message scheme consisting of 8 acupoints and 7 kinds of traditional Chinese medicines was determined. In the routine group, there were 19 males and 15 females with (268.47 ± 11.27) gestational age. In the ointment group, there were 20 males and 10 femles with (271.93 ± 10.36) gestational age. The postoperative gastrointestinal drainage volume, fasting days, the first feeding time and the hospital stay in the ointment group were 74.0 ml, 6.0 d, 158.5 h and 13.0 d, which had significant differences with the 184.5 ml, 7.5 d, 192.0 h, 16.5 d in the routine group ( Z values were 2.07-2.45, all P<0.05). The incidence of vomiting and abdominal distension in the ointment group were both 8 cases, which were lower than the 19 and 18 cases in the routine group with a statistically significant difference ( χ2 = 5.58, 4.56, both P<0.05). Conclusions:The ointment massage in this study has a positive impact on the recovery of newborn infants after intestinal surgery, with high safety, in line with enhanced recovery after surgery concept, and is worthy of promotion.

Objective To evaluate the change of clinicopathological features and prognosis of papillary thyroid cancer over a 15-year period.Methods The clinicopathological features and outcomes of papillary thyroid cancer patients were analyzed in three groups according to the time of diagnosis:group Ⅰ (1997-2001),group Ⅱ (2002-2006),and group Ⅲ (2007-2011).Results As time advanced,the average age of papillary thyroid cancer patients increased,tumor stage,like size,extrathyroid invasion and lymph node metastasis decreased dramatically (P ＜ 0.01).The percentage of multifocality and bilaterality increased.The long-term follow up data (median follow up time was 6.6 years),indicated that the 15-year over all survival was 97.8％ and the 15-year disease-free survival was 90.2％.Tumor ≥3 cm,bilaterality,extrathyroid invasion,lymph node metastasis and AJCC stage were correlated with tumor recurrence.By multivariate COX-regression analysis only lymph node metastasis and bilaterality were independent risk factors.Conclusion The clinicopathological features of papillary thyroid cancer changed over 15 years,with the percentage of early-staged patients increased.Lymph node metastasis and bilaterality are two risk factors for tumor recurrence.