Aim To observe the effect of a treatment proposal named “Golden Triangle” ( Atorvastatin, Tongxinluo,and Aspirin) on the vasa vasorum angio-genesis of early atherosclerosis lesions in rabbits carotid artery. Method Seventy-two healthy New Zealand rabbits with half males and half females were divided into 6 groups randomly ( n =12 ):control group, model group, Tongxinluo group ( TXL ) , atorvastatin group ( ATO ) , aspirin group ( ASP ) , golden triangle group ( ATS) . The control group was fed with common feed-stuff, and all the other groups′ right carotid arteries were equipped with the silicone tube,and were then fed with fatty feedstuff. The Tongxinluo group, the Atorvas-tatin group and the Aspirin group were given suspen-sion of Tongxinluo supermicro powder(0. 3 g·kg-1 · d-1 ) , Atorvastatin ( 2. 5 mg · kg-1 · d-1 ) and Aspirin (12 mg·kg-1·d-1),the golden triangle group were given suspension of Tongxinluo supermicropowder (0. 3g·kg-1 ·d-1),atorvastatin(2. 5 mg·kg-1 · d-1 ) and Aspirin ( 12 mg · kg-1 · d-1 ) . All the groups were fed with medicine for 4 weeks. Tissue slice of carotid artery was stained with HE and observed un-der light microscope. The change of blood liquid was detected by biochemical assay. Immunohistochemical staining was used to detect the protein expression of CD34 around the carotid artery adventitia. Color micro-sphere method was used to detect the blood flow vol-ume change of the cartoid artery microvascular. VEFG, VEGFR-2 gene and protein expression in the cartoid artery were detected by Real-time PCR and Western Blot. Result Compared with the control group,the content of VEGF, VEGFR-2 gene and pro-tein expression and the microvascular blood flow vol-ume of cartoid artery microvascular in the model were significantly increased ( P <0. 01 ) . But those in each drug group were lighter than those in the model group (P<0. 01,P <0. 05). In the ATS group,the content of VEGF, VEGFR-2 gene and protein expression and the microvascular blood flow volume of cartoid artery microvascular were lower than those in the TXL, ATO and ASP group ( P <0. 01 , P <0. 05 ) . Compared with the ASP group,the content of VEGFR-2 protein expres-sion was significantly decreased(P<0. 01)in the TXL and ATO group. VEGF,VEGFR-2 gene and protein ex-pression in different subgroups showed no significant difference( P >0. 05 ) . The content of CD34 was de-creased in TongxinLuo group,atorvastatin group,aspirin group and ATS group. Conclusion The ATS project can reduce the expression of VEGF,VEGFR-2, inhibit the vasa vasorum angiogenesis and decrease proinflam-matory substances in the tunica media and intima of vascular wall. It plays an important role in intervening in the process of AS.

AIM:To investigate the effect of a treatment proposal , which consisted of tongxinluo , atorvastatin and aspirin, on adventitial inflammation of early atherosclerosis in rabbit carotid artery .METHODS: The atherosclerotic model was established in the rabbits with silicone collar , which was positioned around the carotid arterial adventitia +high-cholesterol diet .New Zealand rabbits ( n =72 ) were randomly divided into 6 groups ( n=12 ): control group , model group, tongxinluo group, atorvastatin group, aspirin group, and three-drug combination group.The rabbits in control group were fed with common foodstuffs , and the rabbits in all the other groups were fixed the right carotid arteries with the silicone tube, and were fed with fatty foodstuffs .The rabbits in tongxinluo group , atorvastatin group and aspirin group were given the suspension of tongxinluo supermicropowder (0.3 g· kg-1· d-1), atorvastatin (2.5 mg· kg-1· d-1) and aspirin (12 mg· kg-1· d-1) respectively,and the rabbits in three-drug combination group were given the suspension of tongxinluo su-permicropowder (0.3 g· kg-1· d-1), atorvastatin (2.5 mg· kg-1· d-1) and aspirin (12 mg· kg -1· d-1) together. The rabbits in each group were fed with the corresponding medicines for 4 weeks .The tissue slices of carotid artery were observed under light microscope with HE staining .The change of blood lipid was detected by biochemical assay .The pro-tein levels of MCP-1, IL-1βand IL-10 in the carotid arterial adventitia were detected by ELISA .The immunohistochemical staining was used to detect the protein expression of IL-8 around the carotid arterial adventitia .RESULTS:Compared with control group, the contents of TC, TG and LDL-C were significantly increased , and the content of IL-10 was significantly decreased in model group .The levels of TC , TG and LDL-C were significantly decreased in tongxinluo group and atorvasta-tin group compared with model group , no significant difference between tongxinluo group and atorvastatin group was ob -served.In the three-drug combination group, the levels of TC, TG and LDL-C were lower than those in atorvastatin group and tongxinluo group .Compared with control group , the contents of MCP-1 and IL-1βwere significantly increased , and the content of IL-10 was significantly decreased in model group .Compared with model group , the contents of MCP-1 and IL-1βwere decreased in tongxinluo group , atorvastatin group and aspirin group , no significant difference between the 3 groups was observed.The content of IL-10 was decreased in three-drug combination group , and the contents of TC , TG and LDL-C were lower than those in tongxinluo group , atorvastatin group and aspirin group .The content of IL-8 was decreased in tongxinluo group , atorvastatin group , aspirin group and three-drug combination group .CONCLUSION: The strategy of three-drug combination enhances the effect of regulating the lipid metabolism and inhibiting the adventitia inflammation .It plays an important role to intervene in the process of atherosclerosis .

Objective:To compare the medium and long-term efficacy between the deltoid split approach and the conventional deltopectoral approach in locking plate fixation for proximal humerus fractures.Methods:A retrospective study was performed in the 65 patients with proximal humerus fracture who had been operatively treated at Department of Orthopedics, The Third People's Hospital of Nantong from January 2018 to December 2020. They were 20 males and 45 females with an age of (64.6±9.2) years. Of them, 34 were assigned to fixation with proximal humerus internal locking system (PHILOS) through the deltoid split approach (minimally invasive group), and 31 to PHILOS fixation through the deltopectoral approach (conventional group). The 2 groups were compared in terms of general data, operation time, intraoperative blood loss, hospital stay, fracture union time, intraoperative fluoroscopy, postoperative 2-year imaging scores, and Constant-Murley shoulder score at the last follow-up.Results:There was no significant difference in the preoperative general data between the 2 groups, showing comparability ( P>0.05). In the minimally invasive group and the conventional group, respectively, the intraoperative blood loss was (97.9±16.6) mL and (155.8±27.4) mL, and the frequency of intraoperative fluoroscopy (12.0±1.8) times and (6.7±1.8) times, both showing a statistically significant difference ( P<0.05). There was no significant difference in operation time, hospital stay, or fracture union time ( P>0.05). All patients were followed up for (43.9±5.5) months. There was no statistically significant difference between the 2 groups in postoperative 2-year imaging scores ( P>0.05). Compared with the conventional group, patients in the minimally invasive group had significantly lower Constant-Murley strength scores and significantly lower Constant-Murley scores for the Neer four-part fractures ( P<0.05). Postoperatively, one case of screw protrusion and one case of complete ischemic necrosis occurred in both groups while one case of partial ischemic necrosis was observed in the minimally invasive group and 3 cases of partial ischemic necrosis were observed in the conventional group. Conclusions:In locking plate fixation for proximal humerus fractures, compared with the deltopectoral approach, the deltoid split approach shows advantages of less soft tissue damage, less intraoperative bleeding, and less destruction of the blood supply to the humeral head. However, the deltopectoral approach may be more appropriate for the Neer four-part fractures.