Objective To compare arthroscopic double-pulley knotless suture bridge with conven tional arthroscopic suture bridge in repair of rotator cuff tear.Methods From May 2013 to May 2015,70patients with rotator cuff tear were repaired at our department.They were 38 males and 32 females,with a mean age of 53.7 years.They were randomized into 2 equal groups to receive repair either using arthroscopic double-pulley knotless suture bridge (the experimental group) or using conventional arthroscopic suture bridge (the control group).The 2 groups were compared postoperatively in terms of VAS (visual analogue scale),Constant,ASES (American Shoulder and Elbow Surgeons) and UCLA (University of California at Los Angeles) scores,shoulder range of motion,and rotator cuff retear.Results The 2 groups were compatible with no significant differences in gender,age,laterality,tear type,or preoperative function or range of motion of the shoulder joint (P ＞ 0.05).At 12 months postoperatively,the VAS,Constant,ASES and UCLA scores and shoulder range of motion in the experimental group were respectively 1.1 ± 1.3,86.0 ±8.9,13.3 ± 0.8,32.0 ± 2.9,156.8° ± 15.0° and 55.9° ± 5.8°,significantly improved than the preoperative values (P ＜0.05).At 12 months postoperatively,the VAS,Constant,ASES and UCLA scores and shoulder range of motion in the control group were respectively 1.3 ± 1.3,86.6 ±4.2,13.1 ± 1.0,31.1 ±2.6,153.3°±10.0° and 55.7° ± 5.1 °,significantly improved than the preoperative values (P ＜ 0.05).At 12 months postoperatively,there were no significant differences between the 2 groups in VAS,Constant,ASES or UCLA scores or shoulder range of motion (P ＞ O.05).No case of rotator cuff retear occurred in the experimental group while 5 cases were observed in the control group,showing a significant difference (0 versus 14.3％) (P ＜ 0.05).Conclusions Compared with conventional arthroscopic suture bridge,arthroscopic double-pulley knotless suture bridge presents no significant differences in range of motion or function of the shoulder joint in repair of rotator cuff tear.However,the latter may lead to a lower incidence of rotator cuff retear and,additionally,is less skillfully demanding.

Objective:To study the antidepressant effect of Baihe Zhimu decoction (BZD)and its influence in the key factors (CaM,CaMKⅡ,CREB)of CaM signaling pathway in hippocampus of the rats with depression,and to explore the antidepressant effect of BZD. Methods:Fifty rats were divided into control group,model group, fluoxetine group,low and high doses of BDZ groups (n = 10).Expect for control group,all the rats in other groups were made depression models by means of chronic unpredictable mild stress along with isolated raising,for 21 d.Then the rats were fed with NS, fluoxetine (1.8 mg · kg-1 ), and BZD (1.5 and 3.0 g · kg-1 ), respectively;for 28 d.The learning and memory ability,autonomous activities and the fixed time in 5 min of the rats were tested by Morris water amaze,Open-field Test and Forced Swimming Test respectively. The damage and repair status of hippocampal neurons were observed by Nissl staining method;the expression levels of CaM,CaMKⅡ protein,CREB mRNA in hippocampus of the rats were detected by Western blotting and RT-PCR method. Results:Compared with model group,the total time of rats in the platform quadrant of Morris water maze in BZD groups and fluoxetine group,the total distance and the number of crossing platform were increased (P <0.05 or P <0.01),and the time of first crossing platform were shortened (P <0.01);the total scores in open field test were increased (P <0.01),the fixed time with 5 min in the forced swimming test was shortened (P <0.05 or P <0.01).Compared with fluoxetine group,the fixed time within 5 min of the rats in swimming test was shortened (P <0.05).The result of Nissl staining showed that the hippocampal neuron injury in BZD groups and fluoxetine group was improved compared with model group.The molecular test results showed that the CaM and CaMKⅡprotein expression levels in hippocampus of the rats in BZD groups and fluoxetine group were increased compared with model group (P < 0.05 or P < 0.01).Compared with model group,the CREB mRNA expression levels in fluoxetime group and BZD groups were increased (P < 0.05 or P < 0.01).Conclusion:BZD has antidepressant effect and can improve the hippocampal neuron injury of the rats with depression and its mechanism is related to increasing the expression levels of CaM,CaMKⅡ and CREB in hippocampus CAM signaling pathway of the rats.

Objective A case would be discussed on suspected demyelination due to electrolyte disturbance to provide references for clinical pharmacists to carry out pharmaceutical care. Methods A pharmaceutical care case on PCI postoperative acute heart failure and contrast induced nephropathy with suspected demyelization due to electrolyte disturbance was introduced through a combination of analysis on clinical symptoms,renal function,electrolyte,blood glucose level and further discussion on consciousness change reason, diuretic use, electrolyte management, and other related issues. Results Clinical pharmacist should provide more care to patients with abnormal blood sodium and osmotic pressure,pay more attention to the calculation and evaluation of rehydration sodium/filling quantity and speed, accumulate more knowledge of contrast induced nephropathy, and raise their awareness on the identification of high risk population. Conclusion Arrhythmia,heart failure,renal failure,infection can beincentives to one another,and thus doctors and pharmacists must pay more attention to the comprehensive situations.

Objective To analyze the clinical effects of arthroscopic en masse repair with footprint ending shift using double-row suture-bridge technique for delaminated rotator cuff tears under tension.Methods A total of 58 patients with delaminated rotator cuff tears under tension from August 2013 to August 2016 who underwent arthroscopic en masse repair using doublerow suture-bridge technique were retrospectively analyzed.There were 33 males and 25 females with a mean age of 53.0±7.8 years (range 39-74) with 24 patients left side involved and 34 right side.They were divided into 2 groups to receive en masse repair either footprint ending shift or on the footprint.There were 28 patients with footprint ending shift and 30 patients on the footprint.Clinical effects were evaluated by University of California Los Angeles (UCLA) score,American Shoulder and Elbow Surgeons (ASES) score,visual analogue scale (VAS),Constant-Murley score and shoulder range of motion at preoperatively and postoperatively.Results The average follow-up duration was 23.2±0.8 months (range 21-24).The two groups were compatible with no significant difference in age,gender,tear size,follow-up duration,preoperative function and range of motion of the shoulder joint (P＞0.05).At the last follow up,the UCLA,ASES,VAS,Constant-Murley scores and shoulder range of motion in the group footprint ending shift were respectively 32.4±2.5,12.8±0.9,1.0±1.1,93.4±5.6,158.3°±9.3°,58.9°±5.0° with significantly differences compared with preoperative scores (P ＜ 0.05).The postoperative value in the group on footprint were respectively 31.6±2.9,12.8±0.9,0.7 ± 1.2,91.3±7.1,156.1°± 10.7°,59.6°±4.6° with significantly differences compared with the preoperative scores (P ＜ 0.05).There were no significant difference between the two groups (P ＞ 0.05).The operation duration in the group footprint ending shift was 100.9±6.0 min,while that in the group on footprint was 106.6±6.1 min.There was significantly difference in the operation duration between two groups (t=-3.600,P=0.001).Conclusion Arthroscopic en masse repair using double-row suture-bridge technique can successfully treat delaminated rotator cuff tears under tension.Compared with arthroscopic en masse repair on footprint using double-row suture-bridge technique,the footprint ending shift is easier and time saving without significant difference in function of the shoulder joint and the range of motion in repair of delaminated rotator cuff tear under tension.

Objective:To investigate associations of serum low-density lipoprotein cholesterol (LDL-C) with hematoma enlargement, early neurological deterioration (END), and outcome in patients with acute spontaneous intracerebral hemorrhage (ICH).Methods:"A multi-center registration study for spontaneous intracerebral hemorrhage in Inner Mongolia" (registration number: ChiCTR2000029494) database was used to include patients with ICH who completed their first head CT scan within 6 hours after onset, underwent blood lipid examination, CT follow-up within 24 hours of onset, and accurately measured hematoma volume using 3D Slicer software between June 2020 and September 2022. HE was defined as hematoma volume increasing >33% or >6 ml at 24 hours, or ventricular hematoma volume increasing ≥1 ml compared to the baseline. END was defined as an increase of ≥4 in the National Institutes of Health Stroke Scale (NIHSS) score from the baseline or death within 24 hours after onset. The follow-up was conducted at 3 months after onset, and the modified Rankin Scale score >2 was defined as poor outcome. Multivariate logistic analysis was used to determine the independent correlation between LDL-C and HE, END, and outcome. Results:A total of 338 patients with ICH were enrolled, including 206 males (60.9%). LDL-C was 2.39±1.22 mmol/L. Eighty-eight patients (26.0%) developed HE, 67 (19.8%) developed END, and 162 (47.9%) had poor outcome at 3 months. Multivariate logistic analysis showed that after adjusting for confounding factors, there was a significant independent negative correlation between LDL-C and HE (odds ratio 0.312, 95% confidence interval 0.208-0.467; P<0.001) and END (odds ratio 0.408, 95% confidence interval 0.275-0.606; P<0.001), but not with the outcome at 3 months. Conclusion:Lower LDL-C is associated with HE and END in patients with ICH, but not with the outcome.

Objective To evaluate the clinical efficacy of arthroscopic bursal layer-only double-row suture-bridge repair for delaminated rotator cuff tear which is difficult to reposit in comparison with separate double-layer repair and whole-layer repair.Methods From May 2013 through June 2016,82 patients with delaminated rotator cuff tear difficult to reposit were treated at Department of Joint Surgery,The Affiliate Hospital to Chengde Medical University.They were 47 males and 35 females with a mean age of 53.0 ± 7.9 years.They were divided into 3 groups according to their surgical procedures.In group A,28 cases were treated by arthroscopic whole-layer double-row suture-bridge procedure;in group B,29 cases were treated by arthroscopic separate double-layer double-row suture-bridge procedure;in group C,25 cases were treated by arthroscopic bursal layer-only double-row suture-bridge procedure.The 3 groups were compared in terms of University of California Los Angeles (UCLA) score,American Shoulder and Elbow Surgeons (ASES) score,visual analogue scale (VAS),Constant shoulder score,range of motion of shoulder joint and rotator cuff retear preoperatively and postoperatively.Results The patients in the 3 groups were comparable because their preoperative general data showed no significant significances (P ＞ 0.05).The operation time for groups A,B and C was respectively 105.5 ±5.6 min,117.4 ±6.9 min and 88.0 ±4.2 min,showing significant differences between the 3 groups (P ＜ 0.05).The 82 patients were followed up for 21 to 24 months (average,23.3 months).At 24 months postoperatively,UCLA,ASES,VAS,Constant score,shoulder anteflexion and lateral extorsion were respectively 32.4 ± 2.5,12.8 ± 0.9,1.0 ± 1.1,93.4 ± 5.6,158.3° ± 9.3°and 58.9°±5.0°in group A,32.2±2.5,12.9±1.0,0.9±1.0,92.8±6.0,156.4°±9.5°and 59.3°± 5.6° in groups B,and32.4±2.4,12.9±0.9,0.7±0.9,94.3±5.2,156.0°±9.5°and57.6°°5.4°in group C,showing no significant differences between the 3 groups (P ＞ 0.05).The occurrence of rotator cuff retear in groups A,B and C were respectively 17.9％ (5/28),13.8％ (4/29) and 12.0％ (3/25),showing no significant differences between the 3 groups (P ＞ 0.05).Conclusions In repair of delaminated rotator cuff tear difficult to reposit,although the arthroscopic bursal layer-only double-row suture-bridge repair is similar to conventional arthroscopic whole-layer double-row suture-bridge repair and arthroscopic separate double-layer double-row suture-bridge repair in functional recovery and range of motion of the shoulder and incidence of rotator cuff retear,it can reduce obviously operation time and make the operation easier.

It is found that acupuncture can significantly improve the clinical symptoms of rheumatoid arthritis (RA) such as pain and joint stiffness, and improve rheumatoid factor, high-sensitivity CRP, ESR and other clinical indicators. It can inhibit the proliferation of synovial cells, the apoptosis of chondrocytes, and regulate polarization balabce of mononuclear macrophages, T cells, as well as inhibit the inflammatory function of multiple immune cells, in order to improve inflammation state of RA joints. In clinical treatment of RA, bladder meridian, stomach meridian, spleen meridian , and Governor Vessel are mostly selected. Acupoints with the efficacy of warming meridian, dispelling coldness and dredging collaterals were commonly selected such as Zusanli (ST36), Yanglinquan (GB34), Dazhui (GV14), Quchi (LI11). Several researches have proved that combined therapy of acupuncture and medicine is worthy promotion in clinic.

Objective To evaluate the efficacy,safety of rigid gas permeable contact lens (RGPCL) wearing for over 5 years in different degrees of keratoconus eyes.Methods A retrospective case study was performed.The clinical data of 217 eyes with different degree of keratoconus from 126 keratoconus patients who fitted with RGPCL in Beijing Tongren Hospital from 2000-2010 over 5 years were analyzed.The eyes were divided into mild keratoconus group (Ks≤45.0 D),moderate keratoconus group (45.0 D＜ Ks ＜ 52.0 D) and severe keratoconus group (Ks ≥52.0 D) according to the severity.Uncorrected visual acuity (UCVA,LogMAR),spectacle corrected visual acuity (SCVA) and RGP corrected visual acuity (RGPVA) was examined before RGPCL wearing and the end of followingup after RGPCL wearing.The refraction,corneal curvature,corneal astigmatism were measured with auto-refractomer/keratometer and keratoconus screening analysis system of computer-assisted corneal topography.Comparisons of the changes of corrected visual acuity and corneal parameters were assessed.Results The RGPVA was 0.09±0.17,0.05±0.07 and 0.07 ±0.07 in the mild,moderate and severe keratoconus group,respectively,showing a significant difference among the three groups (F=0.522,P=0.594);The △Ks was (2.25±5.42),(0.26±3.44) and (-4.52±3.44)D,and △Kf was (2.06±4.98),(1.02±3.41) and (-2.03±5.05)D,and the change value of corneal astigmatism was (0.19±2.87),(-0.78±2.84) and (-2.44±3.77)D in the mild,moderate and severe keratoconus group(all at P＜ 0.05),respectively,with the minimum amount of change in the severe keratoconus group.The variation of differential sector index (△DSI) was-0.33 ± 1.64,0.14±3.01 and-2.11 ±4.28;the variation of center/ surround index (△CSI) was-0.41 ± 1.07,0.03±2.22 and-2.49±4.15;the variation of standard deviation of power (△SDP) was-0.43 ±0.64,-0.02 ±0.89 and-1.67 ± 1.68;the variation of keratoconus prediction index (△KPI)was 0.00±0.07,0.03±0.09 and-0.05±0.11 in the mild,moderate and severe keratoconus group,respectively,and the reduced amount in above parameters was much more in the severe keratoconus group than that in the mild and moderate keratoconus group (all at P＜0.01).Mild conjunctivitis and corneal affection occurred in 12 eyes (5.5％)during the follow-up.Conclusions Long-term wearing RGPCL can improve the visual acuity and slow the tendency of corneal curvature increase in keratoconus eyes,and this procedure is safe and effective for the correction of different degree of keratoconus.

Objective To explore the biological basis of different diseases with the same syndrome for pulmonary related comorbidities(pulmonary hypertension,obstructive sleep apnea syndrome,chronic obstructive pulmonary disease,lung cancer)in idiopathic pulmonary fibrosis(IPF)through genomic bioinformatics analysis.Methods GSE110147,GSE113439,GSE135917,GSE106986 and GSE118370 datasets were downloaded as research subjects.The differential genes between each disease group and the control group were screened.Cytoscape 3.10.0 software was used for topology analysis to screen core genes.OmicShare was used to perform GO and KEGG pathway enrichment analyses on core genes.Results A total of 23 core genes related to IPF was obtained.GO enrichment analysis showed that core genes were mainly enriched in biological processes such as cellular process,metabolic process,biological regulation/biological process,developmental process,localization,response to stimulus,immune system process and signaling;in cellular components such as cellular anatomical entity and protein-containing complex;in molecular functions such as binding,catalytic activity,structural molecule activity,molecular adaptor activity,molecular function regulator and transcription regulator activity.KEGG pathway enrichment analysis showed that core genes were mainly enriched in ribosome biogenesis in eukaryotes,AGE-RAGE signaling pathway in diabetic complications,Th17 cell differentiation,JAK-STAT signaling pathway,RNA polymerase,neutrophil extracellular trap formation.Conclusion Using genomic bioinformatics analysis to explore the core genes and signaling pathways of pulmonary related comorbidities in IPF can reveal the mechanism of different diseases with the same syndrome for pulmonary related comorbidities in IPF to a certain extent.

Chronic obstructive pulmonary disease （COPD）， as a chronic respiratory disease that can be prevented and intervened but cannot be completely cured， has increasing incidence and mortality rates year by year， often complicated by one or more comorbidities. However， there is currently no specific treatment available. Therefore， the healthcare issues related to COPD are urgent and prominent. Traditional Chinese medicine （TCM） delays the progression of COPD through multiple mechanisms， pathways， and targets. As a result， exploring the pathogenesis of COPD and identifying TCM treatment approaches and effective prescriptions are key issues that urgently need to be addressed in clinical practice. In TCM， COPD is categorized into syndromes such as "cough"， "asthma"， and "lung distension". It is believed that the deficiency in the origin runs through the entire disease. When external pathogens invade， Qi becomes disordered， and phlegm and blood stasis begin to accumulate， leading to an excess condition in the manifestation. Modern medicine research on the pathogenesis of COPD mainly involves aspects such as inflammatory response， oxidative stress， autophagy imbalance， and aging. Studies have found that Chinese medicine monomers， single herbs， and compound prescriptions can improve COPD by inhibiting inflammation， reducing oxidative damage， correcting autophagy， and delaying aging. However， there is no study that intuitively organizes the various pathogenesis mechanisms of COPD and their interrelationships. At the same time， research on the therapeutic effects of TCM on COPD primarily focuses on exploring a single mechanism or pathway， without integrating multiple mechanisms， pathways， and targets. Additionally， there are very few studies that summarize the corresponding relationships between the various pathogenesis mechanisms of COPD and the regulatory effects and signaling pathways of Chinese medicine. This study， for the first time， combines the latest literature in China and abroad to explain the various pathogenesis mechanisms of COPD and their interrelationships using a combination of graphs， text， and tables. It also outlines the signaling pathways， targets， and mechanisms of Chinese medicine monomers， single herbs， and compound prescriptions in regulating COPD， in order to provide new ideas and strategies for the in-depth research and systematic treatment of COPD with TCM.