BACKGROUND:Many studies concerning influence of traditional Chinese medicine on animal movement capacity have been conducted.However,studies on the improvement of exercise capacity by traditional Chinese medicine are few,especially comparisons among traditional Chinese medicineOBJECTIVE:To explore the influence of different traditional Chinese medicine preparations on the exercise capacity in mice to screen compound preparations with precise effects.METHOD:A total of 80 8-week-old pure male Kunming mice were randomly assigned to 8 groups(n=10):control and compound 1-7 groups.There were no significant differences in body mass of all groups The compound 1 comprised Xuejie and Shexiang;compound 2 comprised Qingui,Baizhu and Baishao;compound 3 comprised Baizhu,Baizhi and Sanqi;compound 4 comprised Baizhi,Ruxiang,Danggui and Radix glycryrrhizae;compound 5 comprised Guiwei;compound 6 comprised Sichuan Honghua and Danshen;compound 7 comprised Danggui and Shexiang.Of the 7 prescriptions,compound 1-5 were empirical formula,compound 6 was common medicine used during training,and compound 7 was prescription of traditional Chinese medicine The 7 compound groupswere respectivelytreatedwith 1.17,0.78,0.78,1.17,7.02,5.53,and 11.70 g/kg per day for 4 weeks,and control group was intragastrically infused with normal saline.From day 4 to 6,load-free swimming training was performed 20 minutes a day for 3 days,followed by swimming for 6 days a week after 1 day of rest.The intensity was gradually increased frOm 30 minutes per day by 10 minutes per day for 2 hours,followed by loading swimming with load of 2%of the body mass,increased by 1%per day until the final experiment.During the entire procedure,a great intensity swimming training was performed every week to make the mice exhausted.Mice training and serum creatine kinase and lactate dehydrogenase 4 weeks following treatment were observed.RESULTS AND CONCLUSION:A total of 80 mice were included in the final analysis The compounds showed little influence on mice body mass;the compound 2 and compound 6 groups had longest exhaustive time All compounds inhibited serum creatine kinase activity following exercise,in particular compound 6 and 2(P＜0.05).Compared with control group,the serum lactate dehydrogenase activity of each compound group was decreased,in particular,compound 2 and 6 groups showed significant differences(P＜0.05).Compound 2 and 6 significantly enhanced the exercise capacity of mice and delayed injury of body.The mechanism may highly relate to components in the compounds,Danggui,Sichuan Honghua and Danshen.

BACKGROUND: As a metal internal fixation material, magnesium alloy has more unique advantages, such as biodegradability and elastic modulus. The elastic modulus of magnesium alloy is similar to the compact bone,which is enough to avoid stress-shelter effect. However, biological activity represents bonding ability with the bone in the body for fracture fixation materials, which is of great significance for studies on new kinds of magnesium alloys.OBJECTIVE: To observe the microstructure of Mg-Zn-Gd alloys and to analyze the corrosion products on the material surface after immersed in simulation body fluid.METHODS: The Mg-Zn-Gd alloys were manufactured by the method of fusion casting. Scanning electron microscope with spectrometer was applied to observe microstructure and distribution of precipitated phase and corrosion products of Mg-Zn-Gd alloys in simulated body fluid.RESULTS AND CONCLUSION: The Mg-Zn-Gd alloy was composed of α-Mg solid solution containing Gd and Zn elements and eutectic structure. The eutectic structure was almost feathery, oval-shaped, herringbone-shaped and strip-shaped along the grain boundary. The main ingredients of eutectic structure included Mg, Zn and Gd elements.Deposition layer was composed of O, Mg, Ca and P elements on the surface of Mg-Zn-Gd alloy after 72 hours soak in Hank's solution. X-ray diffraction analysis showed that film layer contained Mg(OH)2 phase, which promoted calcium salt deposition and reduced the corrosion rate. So Mg-Zn-Gd alloy can obtain better biological activity.

OBJECTIVE: To observe the short-term efficacy of autogenous bone pate and Palva graft for obliterating huge remnant mastoid cavity in canal wall down approach. METHOD: Retrospective analysis clinical data of twenty-one cholesteatomatous cases operated by one surgeon from 2004 to 2007. In twelve cases, simultaneous III type tympanoplasty (Sheehy, P. O. P) was performed. Other 9 cases had undergone mastoidectomy elsewhere before the admission. Six of them were still draining with huge remnant mastoid cavity, and the rest three patients had relapsed cholesteatomas with intermittent draining and huge mastoid cavity. Normal saline solution perfusion was used to measure the volume of remnant mastoid cavity. The criterion of huge remnant mastoid cavity is more than 8 ml. RESULT: Of twelve primary cases with III type tympanoplasty, 11 patients maintained a small, dry, and healthy mastoid cavity after twenty-seven days. The average increase of hearing level of them was 17.5dB, and the air-bone gap is less than 20 dB. Of one patient, bone pate was infected and was discharged. A dry mastoid cavity was achieved until fifty-five days after surgery. The patient is keeping a big air-bone gap caused by displacement of ossicle chain prosthesis. Just eighteen days later, other nine cases of revision mastoidectomy achieved a small, dry, and healthy mastoid cavity, with lightly improved hearing level. CONCLUSION Obliteration of a canal wall down huge mastoid cavity by Palva graft with autologous bone pate is a reliable and effective technique that results in a small, dry, low-maintenance mastoid cavity. The short-term efficacy of simultaneous III tympanoplasty is satisfactory if patient selection is suitable.
Adolescent ; Adult ; Cholesteatoma ; surgery ; Cholesteatoma, Middle Ear ; surgery ; Female ; Humans ; Male ; Mastoid ; surgery ; Middle Aged ; Retrospective Studies ; Surgical Flaps ; Transplantation, Autologous ; Treatment Outcome ; Tympanoplasty ; methods ; Young Adult

Objective:To compare the clinical effects of endoscopic thyroidectomy using the modified gasless transaxillary approach (TA group) and transsubclavian approach (TS group) in the treatment of cN0 papillary thyroid carcinoma (PTC) .Methods:A total of 190 PTC patients (mean age 39.88±9.35 years,38 males, 152 females), who underwent unilateral thyroidectomy in the Department of Thyroid Surgery, the First Hospital of Jilin University from Oct. 2020 to Oct. 2022 were retrospectively analyzed, including 65 cases in TA group, 43 cases in TS group and 82 cases through traditional neck approach (TN group). The endoscopic group (TA+TS) consists of the TA group and the TS group. Comparative analyses were performed on operation time, full exposure rate of central compartment, postoperative hospitalization time, postoperative drainage, hospitalization costs, the number of dissected lymph nodes and postoperative complications. The t-test or Wilcoxon rank sum test, the χ2 test or the exact probability method were used for statistical analysis. Results:All endoscopic operations were successfully completed without conversion to traditional neck approach. ① Compared with the TN group, the endoscopic group (TA+TS) had longer operation time[TN group =74.5 (65-87) min, (TA+TS) group =102 (89-121) min, P<0.001], lower full exposure rate of central compartment (TN group=100%, (TA+TS) group=89.8%, P=0.008), more postoperative drainage[TN group=60 (45-76) ml, (TA+TS) group =100 (80-130) ml, P<0.001], higher hospitalization costs[TN group=￥23638 (22158-25901), (TA+TS) group =￥26967 (25572-28284), P<0.001], and higher parathyroid autotransplantation rate (TN group=4.9%, (TA+TS) group =50.9%, P<0.001). There were no significant differences in the number of dissected lymph nodes, the number of metastatic lymph nodes, preoperative and postoperative parathyroid hormone (PTH) ( P>0.05). ② Compared with the TS group, the TA group had longer operation time[TA group=110 (97-127) min, TS group=89 (80-111) min, P<0.001], lower full exposure rate of central compartment (TA group=83.1%, TS group=100%, P=0.012), longer postoperative hospitalization time[TA group=3 (3-4) d, TS group=3 (3-3) d, P=0.002], more postoperative drainage[TA group=110 (82-140) ml,TS group=95 (65~120) ml, P=0.046] and higher hospitalization costs (TA group=￥27510±2578,TS group=￥26609±1878, P=0.038). There were no significant differences in the number of dissected lymph nodes, the number of metastatic lymph nodes, preoperative and postoperative PTH, and parathyroid autotransplantation between the two groups ( P>0.05) . Conclusions:Endoscopic thyroidectomy through axillary/subclavian approach is safe and feasible for the treatment of cN0 PTC. There was no significant difference in the number of dissected central lymph nodes compared with conventional surgery, and the incision was well concealed. In comparison, transsubclavian endoscopic surgery has better clinical application value, with shorter operation time, higher full exposure rate of central compartment and faster postoperative recovery.

Objective:To observe any effect of electroacupuncture (EA) on the expression of phosphorylated extracellular signal-regulated protein kinase (p-ERK1/2) and phosphorylated cyclic adenosine monophosphate response element binding protein (p-CREB) in the spinal dorsal horns of diabetics experiencing neuropathic pain.Methods:Eight rats were randomly selected from 30 healthy male Sprague-Dawley rats as the normal group (N), and the remaining twenty-two rats were treated with a single high-dose intraperitoneal injection of streptozotocin (STZ) to establish a neuropathic pain model. The rats modeled successfully were randomly divided into a model group (M, n=8) and an EA group ( n=8). In the EA group, electroacupuncture was applied at the bilateral Hou san li and Kunlun acupoints starting on the 15th day after the STZ injection. The daily sessions lasted 30 minutes for 1 week. Body weight (BW), fasting blood glucose (FBG) and paw withdrawal latency (PWL) were observed before the STZ injection and on the 7th, 14th, and 21st days afterward. The expression of p-ERK1/2 and p-CREB in the dorsal horns of the rats′ spinal cords was detected using western blotting. The count of p-CREB-positive cells in the dorsal horns and their co-localization with neurons was detected using immunofluorescence. Results:In comparison with the N group, the average BW of the M group on the 7th, 14th and 21st days after the STZ injection was significantly lower, while the average FBG was significantly higher. There was no significant difference between the M and N groups in the average PWL on the 7th day after the STZ injection, but it had decreased significantly in the M group on the 14th and 21st days. Compared with the M group, the average PWL of the EA group was significantly longer on the 21st day after the injection. The expression of p-ERK1/2 and p-CREB protein in the spines of the M group was significantly higher than in the N group. p-CREB positive cells were more numerous in the M group compared with the N group, while in the EA group they were fewer. P-CREB was co-located with neurons in the spinal dorsal horn.Conclusion:EA can alleviate neuropathic pain effectively, perhaps by inhibiting the expression of p-ERK1/2 and p-CREB in the dorsal horns of the spinal cord.

Objective: To investigate the incidence of postoperative pancreatic fistula (POPF) and its risk factors after radical gastrectomy. Methods: The prospective study was conducted. The clinicopathological data of 2 089 patients who underwent radical gastrectomy in 22 medical centers between December 2017 and November 2018 were collected, including 380 in the Zhongshan Hospital of Fudan University, 351 in the Renji Hospital of Shanghai Jiaotong University School of Medicine, 130 in the Ruijin Hospital of Shanghai Jiaotong University School of Medicine, 139 in the Peking University Cancer Hospital, 128 in the Fujian Provincial Cancer Hospital, 114 in the First Hospital Affiliated to Army Medical University, 104 in the First Affiliated Hospital of Nanchang University, 104 in the Affiliated Hospital of Qinghai University, 103 in the Weifang People′s Hospital, 102 in the Fujian Medical University Union Hospital, 99 in the First Affiliated Hospital of Air Force Medical University, 97 in the Sir Run Run Shaw Hospital Affiliated to Zhejiang University School of Medicine, 60 in the Hangzhou First People′s Hospital Affiliated to Zhejiang University School of Medicine, 48 in the Fudan University Shanghai Cancer Center, 29 in the First Affiliated Hospital of Xi′an Jiaotong University, 26 in the Lishui Municipal Central Hospital, 26 in the Guangdong Provincial People′s Hospital, 23 in the Jiangsu Province Hospital, 13 in the First Affiliated Hospital of Sun Yat-Sen University, 7 in the Second Hospital of Jilin University, 4 in the First Affiliated Hospital of Xinjiang Medical University, 2 in the Beijing Chao-Yang Hospital of Capital Medical University. Observation indicators: (1) the incidence of POPF after radical gastrectomy; (2) treatment of grade B POPF after radical gastrectomy; (3) analysis of clinicopathological data; (4) analysis of surgical data; (5) risk factors for grade B POPF after radical gastrectomy. Measurement data with normal distribution were represented as Mean±SD, and comparison between groups was analyzed using ANOVA. Count data were described as absolute numbers or percentages, and comparison between groups was analyzed using the chi-square test. Univariate analysis was conducted using the t test or chi-square test based on data excluding missing data of clinico-pathological and surgical data. Multivariate analysis was conducted using the Logistic regression model based on factors with P<0.20 in univariate analysis. Results: There were 2 089 patients screened for eligibility, including 1 512 males, 576 females and 1 without sex information, aged (62±11)years. The body mass index (BMI) was (23±3)kg/m². (1) The incidence of POPF after radical gastrectomy: the total incidence rate of POPF in the 2 089 patients was 20.728%(433/2 089). The incidence rates of biochemical fistula, grade B pancreatic fistula, and grade C pancreatic fistula were 19.627%(410/2 089), 1.101%(23/2 089), 0, respectively. (2) Treatment of grade B POPF after radical gastrectomy: 2 of 23 patients with grade B POPF after radical gastrectomy had drainage tube placed for more than 21 days and received anti-infective therapy. Four of 23 patients with grade B POPF after radical gastrectomy had ascites detected by imaging examination, of which 2 received peritoneal drainage guided by ultrasound, 1 received failed puncture drainage, 1 received no puncture drainage, and they were given anti-infective therapy. Eleven of 23 patients with grade B POPF after radical gastrectomy had no ascites detected by imaging examinations, and they were given anti-infective therapy and inhibitors of pancreas secretion for clinical manifestation as fever or elevated white blood cells. Six patients with no typical clinical manifestations were given somatostatin to inhibite pancreas secretion and prolonged duration of abdominal drainage tube placement (with a median time of 7 days). All the 23 patients recovered well after treatment, without reoperation. (3) Analysis of clinicopathological data: for the 2 089 patients, BMI, cases with or without neoadjuvant therapy were (23±3)kg/m^2, 1 487, 160 of patients without pancreatic fistula, (23±3)kg/m^2, 386, 22 of patients with biochemical fistula, and (24±3)kg/m^2, 22, 1 of patents with grade B pancreatic fistula, showing significant differences between the three groups (F=5.787, χ²=8.269, P<0.05). (4) Analysis of surgical data: for the 2 089 patients, cases with open surgery, laparoscopic assisted surgery, totally laparoscopic surgery (surgical method), cases with D₁ lymph lode dissection, D₂ lymph lode dissection, and other lymph lode dissection (range of lymph lode dissection), cases with no omentectomy, partial omentectomy, and total omentectomy (range of omentectomy), cases with no usage of energy facility, usage of CUSA, LigaSure, LigaSure+ CUSA as energy facility, cases with or without biological glue, the number of lymph node dissection were 737, 624, 292, 24, 1 580, 51, 418, 834, 381, 63, 1 530, 23, 16, 1 431, 201, 33±14 of patients without pancreatic fistula, 146, 189, 74, 11, 389, 9, 110, 171, 128, 35, 359, 6, 9, 378, 31, 31±14 of patients with biochemical fistula, and 14, 5, 4, 0, 20, 3, 6, 13, 4, 2, 18, 1, 2, 22, 1, 37±16 of patients with grade B pancreatic fistula, showing significant differences between the three groups (χ²=15.578, 9.397, 15.023, 28.245, 8.359, F=4.945, P<0.05). (5) Risk factors for grade B POPF after radical gastrectomy: results of univariate analysis showed that usage of energy facility was a related factor for grade B POPF after radical gastrectomy (χ²=9.914, P<0.05). Results of multivariate analysis showed that laparoscopic assisted surgery, combined evisceration, application of LigaSure + CUSA, the number of lymph lode dissection were independent factors for for grade B POPF after radical gastrectomy (odds ratio=0.168, 3.922, 9.250, 1.030, 95% confidence interval: 0.036-0.789, 1.031-14.919, 1.036-82.602, 1.001-1.059, P<0.05). Conclusions The incidence of grade B POPF after radical gastrectomy is relatively low. Laparoscopic assisted surgery, combined evisceration, application of LigaSure + CUSA, and the number of lymph lode dissection are independent risk factors for grade B POPF. Trial Registration: This study was registrated at ClinicalTrial.gov in United States with the registration number of NCT03391687.