Objective: To observe the protective effect of ischemic post-conditioning on myocardial reperfusion injury with the potential mechanism in experimental rabbits. Methods: A total of 36 healthy New Zealand rabbits were divided into 6 groups:①Sham group,②Ischemic reperfusion control (CON) group,③Myocardial ischemic post-conditioning (MpostC) group,④Remote ischemic post-conditioning (RPostC) group,⑤MPostC+5-HD group,⑥RPostC+5-HD group.n=6 in each group. The ischemic reperfusion injury model was established by left ventricular descending artery occlusion for 45 min followed by reperfusion for 120 min. Bilateral external iliac artery was occluded for 5 min to induce the short skeletal muscle ischemia. The indexes of cardiac function and plasma CK , LDH activities were measured at baseline, end of ischemia and 1, 2 h after reperfusion respectively, the sizes of myocardial infarction (MI) were examined and compared among different groups. Results: ①Compared with CON group, the indexes of cardiac function were improved in MPostC and RPostC groups at 1, 2 h after reperfusion,P<0.05, and compared with MPostC group and RPostC group, the indexes of cardiac function were improved in MPostC+5-HD and RPostC+5-HD groups,P<0.05.②Compared with CON group, plasma CK, LDH activities were decreased in MPostC and RPostC groups at 2 h after reperfusion,P<0.05, and compared with MPostC group and RPostC group, the CK, LDH activities were increased in MPostC+5-HD and RPostC+5-HD groups,P<0.05.③The ischemic ranges and areas were similar between CON group and the other 5 groupsP>0.05. The MI ranges and areas in MPostC and RPostC groups were much less than that in CON group,P<0.05, and compared with MPostC group and RPostC group, the MI ranges and areas increased in MPostC+5-HD and RPostC+5-HD groups,P<0.05. The MI ranges and areas were similar between CON group and MPostC+5-HD, RPostC+5-HD groups,P>0.05. Conclusion: Classical ischemic post-conditioning and remote organ ischemic post-conditioning both have protective effect on myocardial reperfusion injury in experimental rabbit, which might be related to the activation of mitochondrial ATP-sensitive potassium channels.

Objective: To investigate the preventive effect of alprostadil (prostaglandin E1) combining hydration therapy on contrast induced nephropathy (CIN) after percutaneous coronary intervention (PCI) in elder patients. Methods: A total of 175 patients with coronary artery disease (CAD) elder than 75 years received PCI in our hospital from 2011-03 to 2014-03 were retrospectively studied, those including 122/175 (69.71 %) with male gender. The patients were at the mean age of (74.7 ± 3.9) years and randomly allocated into 2 groups: Control group, based on routine treatment, the patients received regular hydration of intravenous normal saline 1 ml/(kg?h) at 6 hours prior and 12 hours after PCI,n=84 and Alprostadil+hydration group, based on routine treatment and regular hydration, the patients received intravenous alprostadil 10μg in 100ml normal saline twice a day at 1 day prior PCI and the 3rd day after PCI,n=91. The serum levels of creatinine (SCr) were examined prior PCI and 3 days continuously after PCI, creatinine clearance rates (Ccr) were calculated and the CIN occurrence rates were compared between 2 groups. Results: At the 3rd day after PCI, the mean SCr level in Alprostadil+hydration group (92.08 ± 21.65) μmol/L was lower than Control group (99.43 ± 22.77) μmol/L,P<0.05, the mean Ccr level in Alprostadil+hydration group (63.78 ± 20.58) ml/min was higher than Control group (57.09 ± 22.31) ml/min,P<0.05. The occurrence rate of CIN after PCI was higher in Control group (13.1%, 11/84 patients) than Alprostadil+hydration group (3.3%, 3/91 patients),P<0.05. Conclusion: Alprostadil combining hydration therapy may obviously protect renal function and reduce the incidence rate of CIN in elder CAD patients after PCI treatment.

Objective:To analyze the clinicopathological features, diagnosis, and treatment of anorectal malignant melanoma (ARMM), and to explore its prognostic factors and misdiagnosis. Methods:A total of 36 patients with ARMM were enrolled in this study from January 2000 to November 2016 in Nanfang Hospital, Zhujiang Hospital, and Guangdong Provincial Hospital of Traditional Chinese Medicine. Results: The clinical manifestations of ARMM were not specific. The odds of misdiagnosis were as high as 52.8% in this study. The 1-and 3-year survival rates were 75%and 35%, respectively, with median survival time of 24.51 months. Survival rate was correlated with tumor size, invasion depth, clinical stage, and lymph node metastasis (P<0.05), but was not related to patient age and gender. The median survival time of the three groups of patients (surgery alone, surgery-based combination therapy, untreated) were 39.21, 26, and 15 months. The difference was not statistically significant. No difference in survival was found between patients under-going abdominoperineal resection and wide local excision. Conclusion:ARMM has poor prognosis and is easily misdiagnosed as a ma-lignant tumor. The prognostic factors are tumor size, invasion depth, clinical stage, and lymph node metastasis. Surgical treatment can extend survival. To avoid misdiagnosis and prolong survival, early diagnosis and early treatment are recommended.

Background and purpose:Diffusion-weighted whole-body imaging with background body signal suppression (DWIBS) can be used for MR imaging systemic examination, especially the lymph node and bone diseases can be clear, and the imaging result is similar with PET. The aim of this study was to compare the value of clinical application in the diagnosis of malignant metastatic osteopathic between DWIBS and bone scintigraphy mapping. Methods:Thirty-six specimens conifrmed with malignant tumors by the pathology of operation or biopsy underwent both DWIBS imaging and bone scintigraphy mapping, chi-square test was used for comparing the detection results of bone metastasis by this two imaging methods. Results:Thirty (165 positions in all) of 36 malignant tumor patients were conifrmed as having bone metastasis, compared that 26 patients (143 positions) with DWIBS method and 23 patients (132 positions) with bone scintigraphy mapping were detected, but there was no statistical signiifcance between this two imaging methods (χ2=1.002, P=0.506). The sensitivity, positive predictive value (PPV) and accuracy of the detection rate of bone metastasis were similar in DWIBS and bone scintigraphy, with 86.7%, 96.3%, 86.1%and 76.7%, 88.5%, 72.2%, respectively;but the speciifcity and negative predictive value (NPV) in DWIBS (83.3%and 55.6%) was higher than that of in bone scintigraphy (50.0%and 30.0%). The detection rates of different bone metastasis with DWIBS and bone scintigraphy were 86.7%(143/165) and 80.0%(132/165), and it was no signiifcant difference (χ2=2.640, P=0.104);DWIBS method was better than bone scintigraphy in the detection of osseous metastasis on pelvis and limbs long bone, and there was different signiifcant (χ2=6.783 and 7.636, P=0.023 and 0.016). Conclusion:DWIBS could detect bone metastatic lesions effectively, and there is ifne consistency with bone scintigraphy. Therefore, DWIBS is to hope to be extended and applicated clinically.

Objective: To quantitatively measure biological parameters of nanophthalmos and analyze the correlation between axial length (AL) and the other biological parameters. Methods: The clinical data of 71 eyes of 43 patients identified with nanophthalmos (AL≤20 mm) from September 2012 to August 2018 in Zhongshan Ophthalmic Center were retrospectively analyzed.All enrolled patients underwent ophthalmological examinations including best-corrected visual acuity, refraction, slit-lamp biomicroscopy, fundus examination, Goldmann applanation tonometry, A-scan ultrasound examinations, ultrasound biomicroscopy, spectral domain optical coherence tomography (SD-OCT) and nonmydriatic fundus photography.Pearson correlation analysis was used to analyze the relationship between AL and all biological parameters.This study followed the Declaration of Helsinki and was approved by the Ethics Committee of Zhongshan Ophthalmic Center (NO.2017KYPJ092). All patients signed informed consent. Results: Of the 43 patients, the average age was (46.00±12.75) years, the mean intraocular pressure was (24.97±14.87)mmHg (1 mmHg=0.133 kPa). The mean best corrected visual acuity was 1.14±0.79, the mean refraction was (11.61±4.09)D.The mean AL, central corneal thickness (CCT), central anterior chamber depth(ACD), anterior chamber width (ACW), len thickness(LT) and vitreous cavity length(VCL) was (17.13±1.57)mm, (550±60)μm, (1.64±0.37)mm, (11.17±0.61)mm, (5.01±0.51)mm and (10.10±1.80)mm, respectively.The average retinal nerve fiber layer thickness (mRNFLT), macular foveal retinal thickness (FRT) and subfoveal choroidal thickness (SFCT) was (98.51±40.93), (294.46±116.83) and (488.72±133.06)μm, respectively.The ratio of ACD to AL, LT to AL, and VCL to AL was 9.6%, 29.4% and 59.3%, respectively.The ACW and VCL were positively correlated with AL(r=0.432, 0.978; both at P<0.001); whereas, LT and FRT were negatively correlated with AL(r=-0.272, P=0.027; r=-0.679, P<0.001). There was no correlation between CCT, central ACD, mRNFLT, SFCT and AL (r=0.153, -0.053, -0.322, 0.063; all at P>0.05). Conclusions Nanophthalmos has the characteristics of narrow anterior and posterior segment structure.The ratio of LT to AL is increased and the ratio of VCL to AL is decreased.The AL is positively correlated with ACW and VCL, negatively correlated with LT and FRT.

Objective To investigate the etiology of acute recurrent pancreatitis (ACP) and de-termine how to further enhance its level of treatment.Methods The clinical data of 33 patients with ACP treated in Ruijin Hospital from 2003 to 2007 were retrospectively analyzed.Results Of the 33 patients with an average age of 55 (22-86), 18 (55%) were male and 15 (45%) female.ACP occurred once in 26 patients, twice in 4 and 3 times in 3.The disease appeared whithin 1 year in 29 patients, 1-2 years in 2, 2-3 years in 1 and 3 years in 1 after being dischared from hospital.For its etiology, it was of biliary origin in 29 patients, hyperlipidemia in 1, pancreatic tumor in 1 and unknow reasons in 2.Twenty-four patients were treated with operation or endoscopy.Two patients died and the mortali-ty was 9.1%.Conclusion ACP is mainly due to biliary origin in China.Operative intervention at an appropriate opportunity can effectively reduce the recurrence of biliary-origin pancreatitis.

Ferroptosis is a novel form of cell death with iron dependence,which has been confirmed to play an important role in the pathophysiology of various diseases.This review summarizes the main metabolic pathways of ferroptosis,including iron metabolic pathways,lipid metabolic pathways and the classic GSH/GPX4 metabolic pathways.At the same time,this review discusses the regulatory effect and mechanism of ferroptosis metabolism on ulcerative colitis,aiming to provide new ideas and research directions for the treatment of ulcerative colitis.

The esophagus is referred to as the conduit for food and drink.It can be categorized into three distinct phases:an era characterized by written descriptions,a phase marked by anatomical illustrations,and a period of integration between Chinese and Western medical practices.In the initial phase of written descriptions,seminal texts such as The Yellow Emperor's Inner Classic and The Classic of Difficult Issues documented aspects regarding both length and function of the esophagus;however,these accounts were relatively succinct.The subsequent phase saw advancements in anatomical illustrations that refined our comprehension of esophageal structure and functionality.During the period of the integration of Chinese and Western medicine,insights from Western anatomy prompted a reevaluation within Chinese medicine concerning both anatomy and physiology related to the esophagus;concurrently,clini-cal cases involving esophageal disorders emerged prominently.Consequently,Chinese medicine's grasp on esophageal physiology,pa-thology,anatomy,and function became increasingly comprehensive over time.Choosing the esophagus as the starting point for observ-ing the theory of viscera in Chinese medicine is intended to illustrate that Chinese medicine's understanding of life,health and disease is based on the observation and continuous improvement of the anatomical functions of the viscera,integrating the physiological func-tions to form a highly integrated system with functional states,so as to facilitate the use of natural medicines for regulation and treatment.This is a distinctive feature different from Western medicine,and it can keep pace with the times and absorb modern re-search results,and continuously improve the theory and treatment system,so as to obtain strong vitality and benefit mankind.

Objective:To measure the proximal enamel thickness (PET) at the mesial and distal contact areas of the permanent teeth and to provide a reference for interproximal enamel reduction (IPR).Methods:From May 2016 to February 2018, 182 isolated permanent teeth were collected and screened from patients who underwent extraction at Department of Oral and Maxillofacial Surgery, Capital Medical University School of Stomatology. These teeth were extracted for orthodontic purpose or due to severe periodontitis. The patients having teeth extracted were all Beijing residents, Han nationality, and aged (39.5±10.6) years. Ninety percent of the teeth came from patients under 50 years old. These teeth were classified according to different tooth type. The mesial and distal contact areas of these teeth were marked with fluid resin. The isolated teeth were scanned using micro-CT and the enamel thickness was measured and analyzed. The parameters measured included mesial PET (PETm), distal PET (PETd), the distance from mesial contact area to occlusal plane (CAm-OP), the distance from distal contact area to occlusal plane (CAd-OP), the distance from mesial contact area to the cementoenamel junction (CAm-CEJ), the distance from distal contact area to cementoenamel junction (CAd-CEJ) and tooth width (TWmd).Results:The PET gradually increased from the anterior tooth area [(0.63±0.16) mm] to the molar area [(1.46±0.25) mm]. The sum of the PET from the second molar to the contralateral second molar in the maxillary dentition was 31.60 mm, and that of the PET from the second molar to the contralateral second molar in the mandibular dentition was 29.68 mm. The contact areas were located on the occlusal third of the proximal walls of anterior teeth and the middle third of the proximal walls of posterior teeth. The PET were positively correlated with the tooth width between the mesial and distal contact areas ( P<0.05). Conclusions:The PET was thinner in the incisor area and thicker in the molar area. IPR should be carried out close to the occlusal side of the proximal walls in anterior teeth and the cementoenamel junction side of the proximal walls in posterior teeth.

Objective:To investigate the anatomy of rectus femoris muscle flap and the anterolateral thigh muscle flap and their clinical application in reconstruction of large soft tissue defects after the removal of oral malignant tumour.Methods:From December 2006 to June 2009, 8 specimens of Chinese adult cadavers fixed in 10% formaldehyde were dissected to perform anatomy of anterolateral thigh region at the School of Basic Medical Sciences, Kunming Medical University. Anatomical images were analysed using Image-Pro Plus 6.0. Then, a retrospective study was performed on 19 patients who had postoperative defects after oral malignant tumour surgery and the defects were reconstructed with the rectus femoris muscle flap and the anterolateral thigh muscle flap from March 2020 to July 2022 at the Department of Oral and Maxillofacial Surgery, Affiliated Stomatology Hospital, Kunming Medical University. The postoperative defects of the 19 patients ranged from 3.0 cm×6.0 cm to 5.0 cm×10.0 cm. Ten rectus femoris muscle flaps, 8 anterolateral thigh muscle flaps and 1 combined rectus femoris muscle flap and anterolateral thigh muscle flap were used. The muscular flaps sized from 4.0 cm × 8.0 cm to 6.0 cm × 11.0 cm. Regular postoperative outpatient follow-ups were conducted.Results:The lengths of vessels of the harvested rectus femoris muscle flap and anterolateral thigh muscle flap were 63.4 mm± 12.9 mm and 112.5 mm± 19.6 mm, respectively. The starting outer diameters of the lateral circumflex thigh artery, the oblique branch of the lateral circumflex thigh artery and the descending branch of the lateral circumflex thigh artery were 2.92 mm±0.72 mm, 1.88 mm±0.23 mm and 2.29 mm±0.43 mm, respectively. Postoperative follow-up lasted for 7 to 32 months, with 17.5 months in average. Seventeen flaps were completely survived and the rectus femoris muscle flap was completely mucosalised 5 weeks after surgery. However, 2 rectus femoris muscle flaps had necrosis of which one was changed to a tongue flap reconstruction and the other encountered flap necrosis during postoperative radiotherapy and healed after debridement and dressing changes. There was no postoperative complication in the donor sites. Other than the 2 patients, all other 17 patients had satisfactory clinical outcomes.Conclusion:Both of the starting outer diameters and length of vessels of the femoris muscle flap and the anterolateral thigh muscle flap meet the requirements for reconstruction of maxillofacial defects, and both muscular flaps are simple to prepare, in good reconstructive results with few complication, as well as an excellent outcome. They are feasible approaches for reconstruction of large soft tissue defects left after the removal of an oral malignant tumour.