Objective:To evaluate the relationship between immunoglobulin heavy chain-binding protein (BIP) and Na v1.8 in peripheral nerve in a rat model of neuropathic pain. Methods:Forty-four SPF healthy male Sprague-Dawley rats, weighing 210-260 g, were used in this study.Neuropathic pain was induced by chronic constriction injury (CCI) in anesthetized rats.The experiment was performed in two parts.Experiment Ⅰ Twenty rats were divided into 2 groups ( n=10 each) using a random number table method: sham operation group (group Sham) and group CCI.Experiment Ⅱ Twenty-four rats were divided into 3 groups ( n=8 each) using a random number table method: sham operation group (group Sham), CCI plus normal saline group (group CCI+ NS) and CCI plus BIP inhibitor HA15 group (group CCI+ H). Starting from 4th day after surgery, 0.9% normal saline 1 ml was intraperitoneally injected in group CCI+ NS, and HA15 0.7 mg/kg was intraperitoneally injected in group H, once a day for 3 consecutive days.The mechanical paw withdrawal threshold (MWT) and thermal paw withdrawal latency (TWL) were measured at 1 day before surgery and 3, 5 and 7 days after surgery (T 0-T 4), and the expression of BIP and Na v1.8 in dorsal root ganglion (DRG) and sciatic nerve was detected by Western blot on 7th day after completion of behavioral testing in two groups.The expression and colocalization of BIP and Na v1.8 in DRG and sciatic nerve were determined by immunofluorescence on 7th day after completion of behavioral testing in group Ⅰ, and the interaction between BIP and Na v1.8 was evaluated by co-immuno-precipitation. Results:Experiment Ⅰ Compared with group Sham, the MWT was significantly decreased, and TWL was shortened at T 1-T 4, the expression of Na v1.8 in DRG was down-regulated, the expression of BIP was up-regulated, and the expression of Na v1.8 and BIP in sciatic nerve was up-regulated in group CCI ( P<0.05), and BIP and Na v1.8 on the sciatic nerve were co-localized, BIP could co-precipitate Na v1.8 from DRG, and Na v1.8 could also coprecipitate BIP in group CCI.Experiment Ⅱ Compared with group Sham, the MWT was significantly decreased, and TWL was shortened at T 1-T 4, the expression of Na v1.8 in DRG was down-regulated, the expression of BIP was up-regulated, and the expression of Na v1.8 and BIP in sciatic nerve was up-regulated in group CCI+ NS ( P<0.05). Compared with group CCI+ NS, the MWT was significantly increased, and TWL was prolonged at T 3, 4, and the expression of Na v1.8 in DRG was down-regulated in group CCI+ H ( P<0.05). Conclusion:BIP can mediate the redistribution of Na v1.8 in peripheral nerve and is involved in the pathophysiological mechanism of neuropathic pain in rats.

Quinolones are widely used due to the wide antimicrobial spectrum and strong activity .The common adverse reactions of quinolones include gastrointestinal disturbances ,central nervous system reaction ,skin reaction ,etc .These adverse reactions are mild in severity and self-healing .Since some agents were withdrawn from the market due to severe adverse effects ,we should pay more attention to quinolones .Both internal and abroad literatures were reviewed ,the adverse effects , the high risk factors of the adverse effects and the application in special population were summarized to provide reference for ra-tional clinical drug use .

AIM: By assessing the impact of prolonged prophylactic anticoagulation on venous thromboembolism in patients undergoing total hip/ knee arthroplasty, we dared to hope to further clarify whetherprolonged prophylactic anticoagulation duration can benefit patients undergoing total hip/ knee arthroplasty. METHODS: The incidence of venous thromboembolism and bleeding events within 90 days of total hip/knee arthroplasty in patients who underwent total hip/knee arthroplasty in the department of orthopaedic surgery was retrospectively analyzed from January 2019 to April 2022. The Kaplan-Meier method survival curve was used to determine whether there is a relationship between the duration of prophylactic anticoagulation and the incidence of postoperative bleeding. RESULTS: A total of 115 patients undergoing primary total hip/knee surgery from January 2019 to April 2022, were enrolled in this study. Among them, there were 38 cases in the short-term prophylactic anticoagulation group and 77 cases in the extended prophylactic anticoagulation group. There were 23 cases (20%) of venous thromboembolism within 90 days after surgery, of which 12 cases (31.58%) were in the short-term anticoagulation group and 11 cases (14.29%) were in the extended anticoagulation group, and there was a statistical difference in the incidence of venous thromboembolism within 90 days after surgery between the two groups in terms of the duration of anticoagulation prevention. CONCLUSION: The results show a significant correlation between the duration of prophylactic anticoagulation and the incidence of venous thromboembolism within 90 days after total hip/knee arthroplasty, which suggests that prophylactic anticoagulation for 15-35 days after undergoing total hip arthroplasty or total knee arthroplasty reduces the incidence of postoperative VTE, and there is no significant difference in bleeding risk depending on the duration of anticoagulant prophylaxis.

Objective:To explore the application and practice of "flipped classroom" in the teaching of general surgery interns.Methods:A total of 20 internship groups (3 to 5 people in each group) were randomly selected from the general surgery practice group in the Department of General Surgery of the Second Clinical Medical College of North Sichuan Medical College. They were randomly divided into the flipped group (45 people) and the traditional group (40 people), with 10 subgroups in each group. The flipped group adopted the flipped classroom teaching mode (students' self-study by handing out materials before class, students and teachers' discussion in class, and students and teachers' evaluation after class), while the control group adopted the current conventional teaching mode (students' preview before class, teachers' explanation in class, and teachers' question answering after class). At the end of the teaching, a questionnaire was used to evaluate the participation and completion of each student. The teaching effect was evaluated by medical history collection and case analysis. The participation, completion, and teaching effect between the two groups were compared and analyzed. SPSS 23.0 software was used for t-test and Chi-square test. Results:The participation of the flipped group was better than that of the traditional group [(17.45±1.83) vs. (15.57±1.52)], and the difference was statistically significant ( P < 0.05). There was no statistically significant difference between the flipped group and the traditional group. There was no significant difference in medical history collection scores between the two groups. The case analysis of the flipped group was better than that of the traditional group [(87.30±6.06) vs. (81.50±5.88), P < 0.05]. The questionnaire shows that about 90% of the students think that flipped classroom can improve their interest in learning [96% (43/45)], improve their autonomous learning ability [89% (40/45)], and have better learning effect. At the same time, 78% (35/45) of students think that learning time is too long. Conclusion:The flipped classroom teaching model can improve the teaching participation of general surgery students, improve students' interest in learning, improve their self-learning ability, and improve students' thinking ability of medical record analysis.

Objective : To explore the effects of different phenotypes macrophages (Mφs) on the proliferation，mi- gration and osteogenic differentiation of periodontal ligament stem cells (PDLSCs) ． Methods : PDLSCs were isola- ted and cultured by tissue block method．Tohoku Hospital Pediatrics-1 (THP-1) cell line was stimulated to activate into unpolarized Mφs (M0) ，then induced to polarize into type I Mφs (M1) and type II Mφs (M2) ．Quantitative real-time PCR (qPCR) detected the inflammatory factors tumor necrosis factor α (TNF-α) ，interleukin (IL) -1 β , IL-6，IL-10 and transforming growth factor-β (TGF-β) mRNA expression level．After collecting culture superna- tants with different phenotypes，PDLSCs were stimulated，native control (NC) group did not receive the culture su- pernatant of Mφs．The effects of PDLSCs proliferation were assessed via Methylthiazolyldiphenyl-tetrazolium bro- mide (MTT) assay，while scratch assays were employed to evaluate their migration．Western blot was utilized to analyze the protein expression of Runt-related transcription factor 2 ( RUNX2) and alkaline phosphatase ( ALP) . Additionally，Alizarin Red staining was performed to investigate the deposition of calcified nodules in PDLSCs. Results: qPCR showed the relative expression of TNF-α , IL-1 β and IL-6 in M1 Mφs were higher than those in M0 and M2 Mφs (P＜0. 05) ，and the relative expression of IL-10 and TGF-β in M2 Mφs were higher than those in M0 and M1 Mφs (P＜0. 05) ; Western blot showed the expression of RUNX2 and ALP proteins in PDLSCs in M0 and M2 groups was higher than those in the NC group (P ＜0. 05) ，Alizarin Red staining showed increased calcified nodule deposition in PDLSCs in M0，M1 and M2 groups compared to the NC group ; MTT assay showed the prolifer- ation of PDLSCs in the M0 and M1 groups was suppressed compared to the NC group (P＜0. 05) ; and scratch ex- periment showed the migratory capacity of PDLSCs in the M1 and M2 groups was stronger than that in the NC group． Conclusion M0 and M1 Mφs inhibit PDLSCs proliferation，M1 and M2 Mφs promote PDLSCs migration， and all types of Mφs promote osteogenic differentiation of PDLSCs.