Objective To study the expression of microtubule-associated protein-2 (MAP-2) in the CA3 region of the hippocampus and any effect of acupuncture combined with exercise training on the recovery of learning and memory after experimental cerebral infarction.Methods Eighty Wistar rats were randomly divided into a sham-operation group (n = 8 ) and an operation group (n = 72 ) subdivided randomly and equally into a model group, an exercisetraining group and an acupuncture plus exercise training group, with 24 rats in each group. After right middle cerebral artery occlusion or a mock operation, the expression of MAP-2 in the CA3 region of the hippocampus was detected with immunohistochemistry 1, 3 and 5 weeks after the operation. Learning and memory function was assessed at the 5th week post operation.Results MAP-2- positive fibers were arranged in an orderly way and distributed densely in the shamoperation group. After cerebral infarction, number of MAP-2 positive neurons and dendrite fibers decreased in the CA3 region of the affected side. A week after the operation, MAP-2 positive fibers had increased significantly in the acupuncture plus exercise group compared with the model group and the exercise group. At the 3rd and 5th week post operation, expression of MAP-2 and optical density had increased significantly compared with the model group and the exercise training group. At the 5th week post operation, Y maze discrimination and learning tests showed that learning and memory had improved significantly more in the acupuncture plus exercise training group compared with the model group and the exercise training group.Conclusions Exercise training combined with acupuncture can promote changes in dendritic plasticity and increase MAP-2 expression in the CA3 region after cerebral infarction. This may be correlated positively with the recovery of learning and memory after cerebral infarction, at least in rats.

Objective To observe the clinical effect of multidisciplinary rehabilitation on diabetic foot.Methods98 diabetic foot patients were divided into the routine treatment group (50 cases), treated only with conventional treatment, and the multidisciplinary rehabilitation group (48 cases) added with multidisciplinary rehabilitation besides conventional treatment.ResultsAfter one month treatment, blood flow parameters of the patients with 0 grade diabetic foot in the multidisciplinary rehabilitation group were markedly improved showed by color Doppler ultrasonograghy of lower limbs ( P<0.05); after two months treatment, the effect of the multidisciplinary rehabilitation group was better than that of the routine treatment group ( P<0.05).ConclusionThe multidisciplinary rehabilitation has obvious effect on diabetic foot and can improve disease recovery earlier.

BACKGROUND: Although the sternohyoid muscular valves are traditionally used as reparative material for functional reconstruction after partial laryngectomy, the late-term results are not so satisfactory.OBJECTIVE: To investigate the efficacy of using external layer mucoperiosteum valve of thyroid cartilage to repair the wound surface and reconstruct vocal function.DESIGN: A self-controlled observational trial using the patients as subjects.SETTING: Department of otolaryngology of a municipal hospital.PARTICIPANTS: A total of 57 patients with laryngocarcinoma were selected from the Department of Otolaryngology, Shantou Second People' s Hospital, from June 1998 to May 2004. Among them, there were 56 men and 1 woman who were aged 37 to 78 years with the average age of 60. 38 years and whose disease duration was two months to one year with the average of five months.METHODS: In the 57 patients with laryngocarcinoma, their external layer mucoperiosteum valves of thyroid cartilages in the affected side were preserved and inverted into laryngeal cavities, which were used to cover the wound surface and rebuild the vocal fold.MAIN OUTCOME MEASURES: The final outcome indices: changes in the symtoms and function and Karnofsky scores before and after treatment. Risk indices: adverse events and side effects.RESULTS: The operations on the 57 patients were successful. The incidence of respiratory tract obstruction and hoarseness in the patients before operation was 38.9% and 98. 1%, but 1.9% and 96. 3% after treatment. Karnofsky score was 40 and 70 before and after treatment, respectively. No complications of pharyngeal stricture occurred in the near and long term.CONCLUSION: Vertical partial laryngectomy and laryngeal reconstruction with mucoperiosteum valve are easy to operate. The recovery of the wound surface is good, phonation efficacy is satisfacory, and respiratory function is not affected. The treatment has low incidence of complications and satisfactory long-term results.

Active management of the third stage of labour involves giving a prophylactic uterotonic, early cord clamping, controlled cord traction and uterine massage. Active management of the third stage, as the main package of procedure to prevent postpartum hemorrhage, can effectively shorten the third stage of labor and reduce the incidence of severe postpartum hemorrhage, this is a major cause of women dying in developing countries. In developed countries, severe bleeding occurs much less often, yet active management has become standard practice in many countries for several decades. The most common complications of active management of the third stage of labor are pain and side effects of oxytocin, in addition to serious complications such as inversion of uterus and retained placental. Therefore, in recent years, a variety of interventions have been adopted in the third stage of labour, especially for low-risk pregnant women, which have been questioned and the evidence for using active management for all women is insufficient. The purpose of this article is to compare the effectiveness and variations of different management of the third stage of labour, and provide the basis for reasonable and individualized management of the third stage of labour, ultimately promote the natural labour.

Objective To investigate the difference in intestinal flora among patients with esophageal squamous cell carcinoma and normal population and to provide a basis for the early diagnosis of esophageal squamous cell carcinoma as a marker. Methods DNA was extracted from biopsy tissue samples of 30 patients with esophageal squamous cell carcinoma (observation group) and 25 healthy people (control group) by microbial amplification sequencing. The integrity and quality of DNA were detected. The composition and abundance of intestinal flora in the samples of the two groups were determined. Results A great similarity in beta diversity was found between the two groups, but some differences were also observed. The relative abundance of Proteobacteria and Verrucomicrobia in the observation group was higher than that in the control group (P<0.05). The relative abundance of Megamonas in the observation group was lower than that in the control group (P=0.025). Conclusion Strengthening the study on the changes in intestinal flora among patients with esophageal squamous cell carcinoma may be of great significance for its prevention and treatment.

Objective:To construct a representative index system for evaluating pediatric orthopedic nursing quality, providing a basis for hospital pediatric orthopedic nursing quality assessment and monitoring.Methods:From April to July 2023, using the "structure-process-outcome" three-dimensional quality structure model as the theoretical framework, a literature review was conducted, and an item pool was formulated. Through two rounds of Delphi method expert consultations, the hierarchical analysis method was finally employed to determine the indicators and their weights at each level.Results:The effective recovery rates of the questionnaire of the two rounds of expert consultations were 100% (20/20), the authority coefficients of experts were 0.87 and 0.88, the coefficients of variation were 0.00 to 0.27 and 0.00 to 0.24. The Kendell harmony coefficients of the second and third indicators in the two rounds of inquiry were 0.140, 0.166 and 0.192, 0.161(all P<0.05). The final pediatric orthopedic nursing quality evaluation index system included 3 primary indicators, 21 secondary indicators and 83 tertiary indicators. Among the primary indicators, the weight of process quality was the highest at 0.493 4, followed by outcome quality at 0.310 8, and the lowest was structural quality at 0.195 8. In the secondary indicators, "assessment criteria of limb blood circulation" had the highest weight at 0.099 8. Conclusions:The constructed pediatric orthopedic nursing quality evaluation index system covers key aspects and is more operationally feasible. It provides better guidance for nursing interventions and quality control.

Autophagy is a lysosome-dependent intracellular degradation process，and it is a key mechanism of diabetic cardiomyopathy （DCM）. Autophagy has dual regulatory effects on DCM. Under physiological conditions，normal autophagy can promote the decomposition of damaged cardiomyocytes and metabolites，so as to reduce the damage of harmful substances to the body and provide energy for cardiomyocytes. Under pathological conditions，the inhibited autophagy of cardiomyocytes will cause the accumulation of damaged cells and metabolites，which will cause damage to cardiomyocytes and eventually aggravate cardiac dysfunction in the patients with DCM. However，the over autophagy of cardiomyocytes will lead to autophagic death of a large number of cardiomyocytes and result in pathological myocardial remodeling and cardiac dysfunction，thus promoting the progression of DCM. Therefore，the restoration of a normal autophagy level is the key means to protect cardiomyocytes and improve the prognosis of DCM. Chinese medicine can regulate autophagy to treat DCM. Specifically，it can promote autophagy （making up for deficiency） or inhibit autophagy （removing excess） to restore the balance of autophagy，thereby alleviating DCM.

OBJECTIVE： To establish a method to determine the contents of rhynchophylline and isorhynchophylline in Uncaria rhynchophylla. METHODS： The separation degree of ionic liquid 1-butyl-3-methylimidazolium chloride （C4mimCl） as mobile phase additive was compared with that of mobile phase without additives and with traditional additive triethylamine （which damaged the chromatographic column）. The optimum concentration of C4mimCl was screened and the contents of rhynchophylline and isorhynchophylline in U. rhynchophylla from 4 habitats in Jiangxi province were determined by the newly established method. The determination was performed on Dikmatech Diamonsil Plus C18 column， the mobil phase was acetonitrile-buffer （0.1％ phosphoric acid+3.0 mmol/L C4mimCl）， gradient elution. UV detection wavelength was set at 245 nm and the flow rate was 1    mL/min. Sample size was 10 μL. RESULTS： When mobile phase had no additives or 3.0 mmol/L triethylamine and 3.0 mmol/L C4mimCl were added as additives， the separation of rhynchophylline from the front peak was 1.02， 1.23 and 1.72， and the separation from the back peak was 1.06， 6.00 and 4.25， respectively. The symmetry factors were 0.81， 0.86 and 1.13， respectively. The separation of isorhynchophylline from the front peak was 0.96， 3.89 and 4.05， and the separation from the back peak was 1.02， 2.34 and 2.36， respectively. The symmetry factors were 0.88， 0.81 and 0.96， respectively. The linear range of rhynchophylline and isorhynchophylline were 4.93-157.76 （r＝0.999 9） and 4.98-159.50 μg/mL （r＝1.000）， respectively. The quantitative limits were 0.486 4， 0.793 6 μg/mL， respectively. RSDs of precision， repeatability， stability and durability tests were all less than 5％ （n＝6）. The recovery rates were 102.9％-107.8％ （RSD＝1.7％，n＝6） and 95.4％-106.3％ （RSD＝3.9％，n＝6）， respectively. The content of rhynchophylline and isorhynchophylline in U. rhynchophylla from 4 habitats were 0.758-1.343         and 1.511-1.823 mg/g， respectively. CONCLUSIONS： Addition of C4mimCl into mobile phase can enhance its separation. Established HPLC method is rapid， accurate and reproducible， which can be used for content determination of rhynchophylline and isorhynchophylline in U. rhynchophylla.

Atherosclerotic cardiovascular disease is a common disease with high incidence rate and mortality worldwide. Atherosclerosis is an important pathological basis for the formation of ischemic cardiovascular diseases such as cardiovascular disease， which is related to inflammation， oxidative stress， apoptosis， vascular endothelial damage， foam cell formation， platelet activation， and so on， involving mitogen-activated protein kinase （MAPK）， phosphoinositide 3-kinase/protein kinase B （PI3K/Akt）， cyclic adenosine monophosphate/protein kinase A （cAMP/PKA）， Ras homolog gene family member A （RhoA）/Rho-associated coiled-coil containing protein kinase （ROCK）， nuclear factor-kappa B （NF-κB）， and other signaling pathways. In the past few decades， high-intensity statins were mainly used to treat atherosclerosis by reducing blood lipid levels， which usually caused obvious side effects. Therefore， the development of safer and more effective drugs and treatment modes is the focus of research at this stage. In recent years， Chinese medicine has been playing an increasingly important role in the prevention and treatment of cardiovascular diseases in China. There are many studies on the mechanism of Chinese medicine in the prevention and treatment of atherosclerosis， and it is found that a variety of single Chinese medicine regulate the formation process of atherosclerosis by regulating targeted signal molecules. This paper reviewed the research results of related signaling pathways involved in the pathological formation of atherosclerosis and the mechanism of Chinese medicine in the prevention and treatment of cardiovascular diseases， thereby providing references for the clinical treatment of cardiovascular diseases.