Currently,surgical treatments in tennis elbow include open,arthroscopic and percutaneous procedures.Open surgery,having definite curative effects,is commonly used.There are different surgical methods based on different hypotheses about the pathogenesis of tennis elbow,such as detachment of common extensor origin,resection of annular ligament,denervation surgery and resection of microvascular nerve bundle.There is a huge difference in open surgery of tennis elbow between China and abroad.Debriding or releasing extensor carpi radialis brevis and common extensor tendon are mostly used abroad though it remains controversial whether we should release or debride with tendon,as well as whether it is better to decorticate on lateral epicondyle or not.In China,tennis elbow is treated with resection of microvascular nerve bundle except for debridement and release of tendon.As for evaluation criteria,the following methods,grip strength,grading system and visual analogue scale have been used in researches.However,cure rate and response rate are valuation criteria for resection of microvascular nerve bundle in China.The evaluation criteria are different among various surgical methods,even in the methods,especially for grading system.Each research has unique standards to define excellent,good,fair and poor outcomes.Complications of tennis elbow open surgery are rare,while subcutaneous hematoma is the common complication.

The method of preparation of a Milk Substitute, formula 5410, and its nutritive value on rats have been reported in previous communications. Further tests of its nutritive effect were made by feeding a group of 100 infants including 4 premature and 10 undernourished. Another group of 43 infants fed with human breast milk or cow's milk were observed during the same period as controls. Among the infants of the two groups there were 6 pairs of twins; one of each pair was fed with the Milk Substitute and the other with human or cow's milk. Great majority of the infants were cared by their own mothers whose cooperation had been secured, while the rest of the infants (10%) were kept in our nursery.The Milk Substitute feeding was started with infants between half and six months of age, with an average age of three months. Observations were continued until they all reached one year old. Fish liver oil and ascorbic acid were supplied to infants of both the experimental and the control groups. Vegetable soup and fruit juice were given to the infants before five months of age. Then various kinds of other foods, including rice porridge, wheat flour nudols, bread, crackers, mashed meat and vegetable and egg yolk were individually supplemented furnishing not more than 1/3 of the total caloric intake, (at the age of one year), as the family income permitted.The appetite of the experimental infants was normal. There was no digestive disturbances and abnormal frequency and appearance of the stool. The average daily caloric intake was similar to those recorded in the literature.The body weight and height of the babies in the experimental group fell well within the normal range. The average initial body weight and height of the infants in the experimental group were somewhat lower than those of the control; however, the height reached .that of the control at the age of 7 months, and the weight at about 11 months. The red blood cell counts and the hemoglobin value of the blood were normal.Values of blood alkaline phosphatase activity higher than 15 Bodansky units were shown in 20 babies of the experimental group (27%) and 8 babies of the control group (23%) at the beginning of the observation; only 4 babies in the experimental group were found abnormal high blood alkaline phosphatase value at the end. At the beginning, 3 cases of rickets and 3 cases of suspected rickets were indicated by the radiograph of the wrist bones of the babies in the experimental group, and only one suspected ricket in the control group were observed; and they all became normal at the end of the experiment. Besides, there were no other signs of any nutritional deficiency among all the infants.

Objective To study and summarize the successful experience and the safety, easibility, practicality and operation skills of totally laparoscopic extraperitoneal herniorrhaphy (TEP). Methods From October 2006 to May 2008,225 patients in our two hospitals were performed TEP (265 totally laparoscopic extraperitoneal hernia repairs for inguinal hernia), including 55 direct inguinal hernia, 197 indirect inguinal hernia and 13 complex inguinal hernia operations. Among the 225 patients, 185 patients had unilateral hernia and 40 patients had bilateral hernias, including 29 recurrent hernia. Results The operations were lasted for 30 to 182 minutes(the average operating duration was 48 minutes for unilateral hernia and 106 minutes for bilateral hernia). The patients stayed in hospital for 2 to 8 days(the average inpatient hospital stay was 3.0 ± 1.2 days). The most common complication was scrotum bematomas,which appeared in 18 cases. Urinary re-tention appeared in 21 cases. Inguinal pain appeared in 5 cases. Bladder injury appeared 1 case. All the pa-tients were followed up for 3 months- 3 years. There was only 1 case of recurrence. Conclusions The proce-dure of TEP is safe,with faster postoperative recover,less pain,lower incidence of pain,better comfort quality and lower recurrence rate. TEP should be the main laparoscopic procedure for inguinal hernia repair.

OBJECTIVE To observe the regulation effect of chidamide on energy metabolism in HCT-8 and HT-29 cells. METHODS HCT-8 and HT-29 cells were treated with chidamide 5,10 and 20 μmol · L-1. Morphological changes of these cells were observed under an ordinary optical microscope. Cell proliferation was detected by MTT. ATP production was determined by CellTiter-Glo? assay kit. Metabolic changes were tested by glycolytic stress kit. The mRNA level of lactate dehydrogenase A (LDH-A)was analyzed by real-time quantitative PCR,whereas the protein level of LDH-A was analyzed by Western blotting. RESULTS Compared with control group,cell morphology of HCT-8 and HT-29 cells in chidamide treated group was irregular,accompanied by deformation,shrinkage and cell debris, and the inhibitory rate of proliferation increased(P<0.05). There was no significant difference in ATP total content between chidamide 5 and 10 μmol · L-1 16 h treatment groups,but in chidamide 20 μmol · L-1 treatment group it was decreased(P<0.05). Chidamide 20μmol · L-1 had no effect on oxygen consumption rate, but glycolysis ATP generation rate was reduced by 30.7% and 37.9%(P<0.05),respectively. Chidamide 20μmol · L-1 had no effect on LDH-A mRNA level,but it decreased the protein level of LDH-A(P<0.01). CONCLUSION Chidamide can abate the respiratory metabolic ability of HCT-8 and HT-29 cells. The mechanism may be related to the down-regulation of LDH-A.

Objective: To investigate the current situation and related factors of facial trauma in school age children in urban areas of Fuyang, and to provide basis for child facial trauma prevention. Methods: By cluster stratified random sampling method, a questionnaire survey was conducted among parents of school age children aged 3-6 in four kindergartens in Fuyang City. A total of 1 062 valid questionnaires were included. Results: A total of 146 (13.7%) children with facial trauma were included. The ratio of boys to girls was 1.84∶1.In primary and secondary classes in kindergarten, the reporting rate of boys (24.5%,16.4%) was higher than that of girls (13.4%, 9.0%), and the difference was statistically significant ( χ 2=6.66, 4.25, P <0.05).The incidence of facial trauma was highest (19.4%) in junior kindergarten class children, which decreased with age. Falls injury(61.6%) was the leading cause of facial trauma. Most of facial trauma occurred in family (55.5%) and kindergarten (26.0%). Forehead (26.0%) and mandible (21.2%) were the main injured body sites. Skin laceration (81.5%) was the main type of injury. Facial trauma mostly occurred at 11:00-13:00(19.9%) and 17:00-19:00(27.4%), during June to August (39.7%). The results of univariate analysis showed that the facial trauma of preschool children was associated with gender, class, parentrated child temperament, parental education and family type( χ 2=14.51,18.84,39.66,6.56,12.31, P <0.05). Conclusion Facial trauma in preschool children in Fuyang is common, which varies in gender, class, temperament and family type.

Objective To verify enzyme activity inhibition of a novel histone deacetylase inhibitor ( HDACi ) JZ005 using an HDACi chemiluminescence detection kit and a cell-based screening model .Methods The plasmid with p21 gene promoter elements and luciferase reporter gene was transfected into human embryonic kidney cells 293 , and the stable transfectants were established by G418 screening.Enzyme activity inhibition of JZ005 on histone deacetylases (HDACs) was verified by the HDACi chemiluminescence detection kit and the cell-based screening model .A well-known HDACi , tri-chostatin A ( TSA) was used as the positive control .MTT assay was used to detect the protection of rat H 9c2 myocardial cells suffering from CoCl 2-induced hypoxia and treated with different concentrations of JZ 005 .The expression of acetylated histone H3 protein of normal and CoCl 2-induced hypoxia H9c2 cells before and after JZ005 treatment was assayed by West-ern blotting while the effect of drug administration on apoptosis was detected by flow cytometry ( FCM) .Results An HDA-Ci cell-based screening system targeting the p21 gene promoter was ranging established .The JZ005, a HDACi, markedly suppressed the activity of HDACs by more than 50%with the concentration ranging from 50 to 400 μmol/L.JZ005 signifi-cantly protected H9c2 cells from hypoxia injury .Cell viability was increased by 38.33%,56.00% and 35.20% compared with control,accompanied by an enhanced acetylation level of histone H 3.JZ005(25,50 and 100 μmol/L) treatment sig-nificantly decreased the number of apoptotic cells (6.63%,10.56% and 8.89%) compared to control group (12.89%). Conclusion An HDACi cell-based screening system is successfully established .JZ005 effectively protects myocardial cells against hypoxia injury while enhancing the acetylation level of histone H 3.Our results indicate that JZ005 might be developed as a potential drug for hypoxia treatment .

Acute pancreatitis is a common surgical emergency characterized by severe local or systemic complications during its progression. Diseases of the biliary system are among the serious local complications of acute pancreatitis, primarily including acute acalculous cholecystitis (AAC) and biliary stricture. AAC often occurs in the later stages of acute pancreatitis, exacerbating systemic inflammation and leading to organ failure and life-threatening conditions in severe cases. Biliary stricture is a rare but serious long-term complication of acute pancreatitis, which can induce cholangitis, progressive liver function impairment, and secondary biliary cirrhosis. Due to the clinical symptoms of acute pancreatitis that can mask biliary system diseases, some patients may not receive timely diagnosis and treatment for concurrent biliary issues during the onset of acute pancreatitis, which can be life-threatening in severe cases. Currently, the ideal treatment strategy for biliary system complications secondary to acute pancreatitis remains unclear, lacking definitive guidelines or consensus. This article integrates recent research developments from both domestic and international studies to elucidate the pathogenesis, diagnosis, and treatment strategies for biliary system complications secondary to acute pancreatitis.

Acute pancreatitis is a common surgical emergency characterized by severe local or systemic complications during its progression. Diseases of the biliary system are among the serious local complications of acute pancreatitis, primarily including acute acalculous cholecystitis (AAC) and biliary stricture. AAC often occurs in the later stages of acute pancreatitis, exacerbating systemic inflammation and leading to organ failure and life-threatening conditions in severe cases. Biliary stricture is a rare but serious long-term complication of acute pancreatitis, which can induce cholangitis, progressive liver function impairment, and secondary biliary cirrhosis. Due to the clinical symptoms of acute pancreatitis that can mask biliary system diseases, some patients may not receive timely diagnosis and treatment for concurrent biliary issues during the onset of acute pancreatitis, which can be life-threatening in severe cases. Currently, the ideal treatment strategy for biliary system complications secondary to acute pancreatitis remains unclear, lacking definitive guidelines or consensus. This article integrates recent research developments from both domestic and international studies to elucidate the pathogenesis, diagnosis, and treatment strategies for biliary system complications secondary to acute pancreatitis.

Purpose/Significance To analyze the characteristics and problems of the policy texts of hospital informatization in China,and to explore the methods of policy optimization.Method/Process Related policy documents of hospital informatization at the national level are re-trieved from March 17,2009 to August 31,2023,and the policy texts are coded and analyzed from two dimensions of policy tools and system theory.Result/Conclusion The policy of hospital informatization in China is mainly based on environment-oriented policy tools,and it is sug-gested to pay more attention to the use of demand-oriented and supply-oriented tools.In addition,it is necessary to scientifically optimize the internal structure of policy tools,strengthen the use of internal submodels,and improve the systematization of policy tools.

Objective:To investigate the role of apurinic/apyrimidinic endodeoxyribonuclease 1 (APE1) in ferroptosis of mouse dendritic cells (DCs) under simulated sepsis, providing evidence for improving immunosuppression in sepsis caused by wound infection.Methods:This study was an experimental research. The mouse DC line DC2.4 in the logarithmic growth phase (with passages 3-10) was used for the experiments (with each sample size of 3). The sepsis model was established by treating DCs with 1 μg/mL lipopolysaccharide (LPS, same concentration throughout) for 0 (untreated), 6, 12, 24, 48, and 72 h. Western blotting was used to detect the protein expressions of APE1 and anti-ferroptosis proteins glutathione peroxidase 4 (GPX4) and solute carrier family 7 member 11 (SLC7A11) in cells, flow cytometry was employed to detect reactive oxygen species (ROS) levels in cells, and live-cell imaging technology was used to measure cell lipid peroxidation levels. DCs successfully transfected with lentivirus containing APE1 short hairpin RNA sequence were divided into APE1-knockdown+phosphate buffer solution (PBS) group and APE1-knockdown+LPS group. DCs successfully transfected with empty lentivirus were divided into empty vector+PBS group and empty vector+LPS group. After stimulation with PBS or LPS and 24 h of culture, corresponding assays were conducted as above. DCs transfected with lentivirus containing APE1 overexpression RNA sequence were divided into APE1-overexpression+PBS group and APE1-overexpression+LPS group. DCs transfected with empty lentivirus were divided into empty vector+PBS group and empty vector+LPS group. After stimulation with PBS or LPS and 24 h of culture, corresponding assays were conducted as above. A total of 88 male C57BL/6J mice aged 6-8 weeks were divided into corn oil+sham injury group, corn oil+cecal ligation and puncture (CLP) group, inhibitor+sham injury group, and inhibitor+CLP group ( n=22) according to the random number table. Mice in the two inhibitor groups were gavaged with APE1 inhibitor E3330 (1 mg/mL in concentration) at 40 mg/kg per day, while mice in the two corn oil groups were gavaged with an equal amount of corn oil daily. Two weeks later, mice in the two CLP groups underwent CLP surgery to establish a sepsis model, while mice in the two sham injury groups underwent sham injury. Sixteen mice from each group were selected to observe survival within 7 d post-surgery. At 24 h post-surgery, CD11c-positive magnetic beads were used to extract spleen DCs from the remaining six mice in each group for corresponding assays ( n=3) as above. Results:Compared with that of LPS treatment at 0 h, APE1 protein expression significantly increased in cells at 6 h of LPS treatment ( P<0.05), APE1 and GPX4 protein expressions significantly decreased at 24, 48, and 72 h of LPS treatment, SLC7A11 protein expression significantly decreased at 24 h of LPS treatment ( P<0.05), while the ROS level in cells ( P<0.05) and cell lipid peroxidation level significantly increased at 24, 48, and 72 h of LPS treatment. After 24 h of culture, the GPX4 protein expression of cells in APE1-knockdown+LPS group was significantly lower than that in APE1-knockdown+PBS group ( P<0.05), while the ROS level in cells ( P<0.05) and cell lipid peroxidation level were significantly higher than those in APE1-knockdown+PBS group and empty vector+LPS group. After 24 h of culture, APE1, SLC7A11, and GPX4 protein expressions of cells in APE1-overexpression+LPS group were significantly higher than those in empty vector+LPS group ( P<0.05), while the ROS level in cells ( P<0.05) and cell lipid peroxidation level were significantly lower than those in empty vector+LPS group. At 24 h post-surgery, APE1 and GPX4 protein expressions of mice cells in inhibitor+CLP group were significantly lower than those in inhibitor+sham injury group and corn oil+CLP group ( P<0.05); the ROS level of mice cells in corn oil+CLP group (12 693±913) was significantly higher than that in corn oil+sham injury group (4 205±805, P<0.05), while the ROS level of mice cells in inhibitor+CLP group (18 085±223) was significantly higher than that in inhibitor+sham injury group (4 381±787) and corn oil+CLP group (with P values all <0.05); the cell lipid peroxidation level of mice in inhibitor+CLP group was significantly higher than that in inhibitor+sham injury group and corn oil+CLP group. Within 7 d post-surgery, the survival ratio of mice in inhibitor+CLP group was significantly lower than that in inhibitor+sham injury group ( χ2=22.67, P<0.05). Conclusions:Under simulated sepsis, the APE1 expression in mouse DCs is decreased, and oxidative stress and ferroptosis are enhanced; knocking down the APE1 exacerbates DC ferroptosis, while APE1 overexpression effectively reduces DC ferroptosis. The inhibition of APE1 expression in DCs is closely associated with poor prognosis in sepsis.