Objectives:To explore the effect of L-glutamine(Gln) on intestinal injury following total hepatic inflow occlusion.Methods:Male Wistar rats were assigned randomly to three groups(n=40) :Group A,sham-operation;Group B,control group,rats were pretreated with 4 ml 0.9% saline intraperitonally twice per day on 5 consecutive days;Group C,rats were pretreated with Gln dissolved in 4 ml 0.9% saline intraperitoneally twice per day on 5 consecutive days.The rats in group B and C underwent total hepatic inflow occlusion for 35min by the pringle' s manoeuvre.Ten rats from each group were randomly sacrificed before occlusion and at 2,4,24h after reperfusion respectively.The levels of MDA,SOD,GSH in intestine tissue were measured.The levels of serum TNF-? and portal vein endotoxin were detected.Results:Compared with group A,the levels of GSH and SOD decreased after reperfusion(P

Objective:To explore the effect of L-glutamine(Gln) on liver Bcl-2mRNA expres sion and apoptosis after total hepatic inflow occlusion in rats.Methods:Male Wistar rats were assigned randomly to three groups(n=40):Group A sham-operation group,group B control group,rats were pretreated with 4 ml 0.9% saline intraperitonally twice per day on 5 consecutive days,group C,rats were pretreated with Gln dissolved in 4 ml 0.9% saline intraperitoneally twice per day on 5 consecutive days.The rats from group B and C underwent total hepatic inflow occlusion for 35min by the pringle's manoeuvre.Ten rats from each group were randomly chosen and killed before the initiation of occlusion at 2 h,4 h,24 h after reperfusion respectively.The levels of MDA,GSH in liver tissue were measured.The serum concentrations of ALT,AST,LDH were assayed on a standard biochemistry autoanalyser.The expression levels of Bcl-2 mRNA in liver were assessed by RT-PCR.The apoptosis of liver were observed by DUTP method.The percentage of apoptosis was analyzed.Results:Compared with group B,the levels of GSH in group C increased after reperfusion(P

Objective:To explore the effects of miR-27a on the phenotype and cytokine secretion in LPS-stimulated dendritic cells.Methods:Murine bone marrow-derived dendritic cells were transfected with miR-27a mimics and negative control mimics,and then stimulated by LPS for 24 hours.Dendritic cells exposed to LPS were collected for analysis of the DC immunophenotype by flow cy-tometry and supernatants were collected to determine cytokine lever.Moreover,the capability of stimulating allogeneic CD4 T+cell prolif -eration was measured by MLR ( mixed lymphocyte reaction) .Results: The levels of MHCⅡ, CD80, and CD86 were significantly increased in LPS-stimulated dendritic cells when compared with imDC ( P<0.001).Transfection with miR-27a mimics resulted in sig-nificantly lower expression levels in levels of MHCⅡ,CD80,and CD86 (P<0.001).For cytokine secretion,transfection with miR-27a mimics enhanced IL-10 production (P<0.01) and reduced the production of IL-12 (P<0.05).For MLR,transfection with miR-27a mimics suppressed allogeneic CD4+T cell proliferation.Conclusion: MiR-27a may play critical roles in regulating the maturation process and cytokine secretion in LPS-stimulated dendritic cells.

Objective To investigate the anatomical relation between Zuckerkandl's tubercle and recurrent laryngeal nerve and the superior parathyroid glands anatomy in endoscopic thyroidectomy.Methods From Jul.2012 to Jun.2014 implementation of the 120 cases of endoscopic thyroid surgery (at least one side of the line lobectomy) intraoperative Zuckerkandl tubercle of the presence, all the patients from Subei People's Hospital and location of the relationship between anatomy recurrent laryngeal nerve and superior parathyroid glands.Zuckerkandl tubercle identified by intraoperative recunent laryngeal nerve to expose and superior parathyroid glands.Results Zuckerkandl tubercle appear in the vast majority of cases: on the left is 86％ (51/59), 88％ in the right side (65/74), most of superior parathyroid glands were located on the top of Zuckerkandl tubercle.Looking for recurrent laryngeal nerve by Zuckerkandl tubercle method is more direct, can reduce surgical bleeding and shmten the operation time.Conclusion Recurrent laryngeal nerve and superior parathyroid glands and have close anatomical relationship with Zuckerkandl tubercle.In endoscopic thyroidectomy by intraoperative discern Zuckerkandl tubercle can better avoid injury recurrent laryngeal nerve and superior parathyroid glands.

Objective:To explore the application of 3D printing mirror models and segmentation models in preoperative planning for patellar fractures.Methods:Retrospectively analyzed were the data of 46 patellar fractures which had been treated at Department of Orthopedics, Liyang City People's Hospital from January 2016 to August 2020 using 3D printing mirror models and segmentation models in preoperative planning. There were 26 males and 20 females, aged from 19 to 79 years (average, 51.5 years). All the fractures belonged to AO type C. According to the design requirements of a solid model, the patients with DICOM CT data of bilateral lower extremities were assigned into the mirror model group (24 cases) while those with DICOM CT data of only a unilateral lower extremity into the segmentation model group (22 cases). In the mirror model group, CT scans of bilateral knee joints and the proximal tibia exceeding 15 cm were required, while in the segmentation model group, CT scans of only the affected knee joint were required. The original DICOM data were extracted and imported into software Mimics 19.0. In the mirror model group, after the "three-level long-short axis control" method was used to judge the symmetry, the original fracture model and the mirror model were created and printed respectively. During the operation, the fracture line drawn by the mirror model was used to find the fracture fragments with a similar shape which were to be assembled and fixated. The fracture fragments in the segmentation model group were divided into independent entities, converted into STL files and printed separately before the bone fragments were assembled and fixated in sequence. X-ray films were taken after operation. Recorded were the simulated operation time, visual analog scale (VAS) of the knee joint at one month after operation, and B?stman scores at one and 6 months after operation.Results:All patients were followed up for 6 to 24 months (mean, 13.6 months). In preoperative planning, only the mirror model was suitable for patients with comminuted fracture with compression and impaction, both models were suitable for fractures without impaction, compression or impaction, and the segmentation model was suitable for patients with bilateral fractures at the same site, poliomyelitis, one limb missing, and previous fracture. In the mirror model group in which the patients were controlled bilaterally using the "three-level long-short axis control" method, there was no significant difference among the 6 sets of data at 3 levels on both sides ( P>0.05). For the segmentation model group and the mirror model group, the time for preoperative simulated operation averaged 11.2 min and 9.2 min respectively, the VAS score at one month after operation was both lower than 3 points, and the B?stman scores at one and 6 months after operation were both larger than 20 points. Conclusions:The mirror image model of the unaffected patella can be used as the fracture recovery model for the affected side, but the symmetry needs to be verified in advance in case of severe degeneration. Both the 3D printed mirror model and the 3D segmentation model are suitable for preoperative planning for patellar fractures as they are complementary. Patients in both groups can obtain good joint function after treatment.

Objective:To evaluate the reliability of a region-locked 3D-printed template combined with a bi-directional matching scheme in assistance of screw placement for thoracolumbar fractures.Methods:From January 2019 to March 2023, 52 patients with thoracolumbar fracture were treated at Department of Orthopedics, The People's Hospital of Liyang. They were 29 males and 23 females, with an age of (58.2±13.3) years. They were divided into a template group and a free-hand group according to the different screw placements. In the template group of 25 cases, a region-locked 3D-printed template combined with a bi-directional matching scheme was used to assist the pedicle positioning; in the free-hand group of 27 cases, the free hand screw placement was assisted only by image data and C-arm fluoroscopy. The operation time, intraoperative fluoroscopy frequency, intraoperative blood loss, complications, and placement accuracy were compared between the 2 groups. Visual analogue scale (VAS), Oswestry disability index (ODI), and anterior height ratio of the injured vertebra were compared between preoperation, 1 week postoperation, and the final follow-up, as well as between the 2 groups.Results:There were no statistically significant differences in the preoperative general data between the 2 groups, showing comparability ( P>0.05). All patients were followed up for (11.2±4.2) months. The differences were not statistically significant between the 2 groups in intraoperative blood loss, rate of complications, VAS or ODI at preoperation, 1 week postoperation, or the final follow-up, or in anterior height ratio of the injured vertebra ( P>0.05). In the template group, the operation time [(80.1±18.5) min] was significantly longer than that in the free-hand group [(69.4±16.6) min], the intraoperative fluoroscopy frequency [2 (2, 3) times] significantly lower than that in the free-hand group [3 (3, 4) times], and the placement accuracy [98.4% (127/129)] significantly higher than that in the free-hand group [91.8% (112/122)] (all P<0.05). All patients showed significant improvements in VAS, ODI and anterior height ratio of the injured vertebra at postoperative 1 week compared with the preoperative values, and the improvements at the last follow-up were significantly larger than those at postoperative 1 week ( P<0.05). No injury to the spinal cord, nerve root or blood vessel was observed postoperatively. Conclusions:In the treatment of thoracolumbar fractures, the screw placement assisted by a region-locked 3D-printed template combined with a bi-directional matching scheme is better than free-hand screw placement in terms of improved accuracy and reduced fluoroscopy, but the former incurs longer operative exposure than the latter. There is no significant difference between the 2 methods of screw placement in clinical efficacy.

Objective:Using primary care chronic disease management as a case,it aims to explore an economic incentive model for integrated primary healthcare services based on value pricing.Additionally,practical needs and implementation recommendations are proposed.Methods:With the help of the health technology assessment framework,it proposes that integrated health services can be priced through service effectiveness and service utility,and develops an economic incentive model with value pricing at its core based on the patient-centered incentive model for innovative healthcare services,including financing,payment,appraisal,and distribution,and puts forward feasible suggestions in the light of the needs and actuality of primary integrated services in China.Conclusion and Recommendation:The value-based pricing model for integrated health services serves as a theoretical foundation for the transformation of primary healthcare service functions and the enhancement of service dynamics,aligning with China's value-oriented service procurement strategy.This research contributes to the academic discourse by providing localized insights and a scholarly tone,contributing to the advancement of knowledge in the field.

Objective:Using primary care chronic disease management as a case,it aims to explore an economic incentive model for integrated primary healthcare services based on value pricing.Additionally,practical needs and implementation recommendations are proposed.Methods:With the help of the health technology assessment framework,it proposes that integrated health services can be priced through service effectiveness and service utility,and develops an economic incentive model with value pricing at its core based on the patient-centered incentive model for innovative healthcare services,including financing,payment,appraisal,and distribution,and puts forward feasible suggestions in the light of the needs and actuality of primary integrated services in China.Conclusion and Recommendation:The value-based pricing model for integrated health services serves as a theoretical foundation for the transformation of primary healthcare service functions and the enhancement of service dynamics,aligning with China's value-oriented service procurement strategy.This research contributes to the academic discourse by providing localized insights and a scholarly tone,contributing to the advancement of knowledge in the field.

Objective:Using primary care chronic disease management as a case,it aims to explore an economic incentive model for integrated primary healthcare services based on value pricing.Additionally,practical needs and implementation recommendations are proposed.Methods:With the help of the health technology assessment framework,it proposes that integrated health services can be priced through service effectiveness and service utility,and develops an economic incentive model with value pricing at its core based on the patient-centered incentive model for innovative healthcare services,including financing,payment,appraisal,and distribution,and puts forward feasible suggestions in the light of the needs and actuality of primary integrated services in China.Conclusion and Recommendation:The value-based pricing model for integrated health services serves as a theoretical foundation for the transformation of primary healthcare service functions and the enhancement of service dynamics,aligning with China's value-oriented service procurement strategy.This research contributes to the academic discourse by providing localized insights and a scholarly tone,contributing to the advancement of knowledge in the field.

Objective:Using primary care chronic disease management as a case,it aims to explore an economic incentive model for integrated primary healthcare services based on value pricing.Additionally,practical needs and implementation recommendations are proposed.Methods:With the help of the health technology assessment framework,it proposes that integrated health services can be priced through service effectiveness and service utility,and develops an economic incentive model with value pricing at its core based on the patient-centered incentive model for innovative healthcare services,including financing,payment,appraisal,and distribution,and puts forward feasible suggestions in the light of the needs and actuality of primary integrated services in China.Conclusion and Recommendation:The value-based pricing model for integrated health services serves as a theoretical foundation for the transformation of primary healthcare service functions and the enhancement of service dynamics,aligning with China's value-oriented service procurement strategy.This research contributes to the academic discourse by providing localized insights and a scholarly tone,contributing to the advancement of knowledge in the field.