ObjectiveTo explore the mechanism by which Xiaoyaosan regulates HPT axis dysfunction in the rat model with the syndrome of liver depression and spleen deficiency by observing its effect on the glycoprotein hormone α-subunit （CGA）/glutathione peroxidase 2 （GPX2）/thyroid-stimulating hormone β-subunit （TSHβ） pathway for thyroid hormone synthesis. MethodsSeventy-two male SD rats were randomized into six groups： normal， model， high-dose （16.7 g·kg^-1）， medium-dose （8.35 g·kg^-1）， and low-dose （4.175 g·kg^-1） Xiaoyaosan， and fluoxetine （0.001 8 g·kg^-1） groups， with 12 rats in each group. The rat model of liver depression and spleen deficiency was induced by chronic restraint stress for 21 days. The intervention groups were treated with Xiaoyaosan decoctions or fluoxetine suspension， respectively. After modeling， hematoxylin-eosin staining was employed to observe morphological changes in the thyroid and pituitary tissue of the rats. Serum levels of triiodothyronine （T3）， tetraiodothyronine （T4）， and thyroid-stimulating hormone （TSH） were measured by enzyme-linked immunosorbent assay （ELISA）. Real-time fluorescence quantitative polymerase chain reaction （Real-time PCR） and Western blot were employed to determine the mRNA and protein levels， respectively， of TSH receptor （TSHR） in the thyroid tissue， thyrotropin-releasing hormone receptor （TRHR） and TSHβ in the pituitary tissue， and thyrotropin-releasing hormone （TRH）， CGA， GPX2， and TSHβ in the hypothalamic tissue. ResultsCompared with the normal group， the model group showed significant atrophy and irregularity of thyroid follicles， a marked reduction in colloid secretion， extensive vacuolar degeneration of adenocytes in the anterior pituitary， lowered serum levels of T3， T4， and TSH （P<0.01）， and down-regulated mRNA and protein levels of TSHR in the thyroid tissue， TRHR and TSHβ in the pituitary tissue， and TRH， CGA， GPX2， and TSHβ in the hypothalamic tissue （P<0.01）. Compared with the model group， high- and medium-dose Xiaoyaosan and fluoxetine alleviated the pathological changes in the thyroid and pituitary tissue， outperforming the low-dose Xiaoyaosan group. Moreover， they elevated the serum levels of T3， T4， and TSH （P<0.05， P<0.01）. The serum TSH level was also elevated in the low-dose Xiaoyaosan group （P<0.05）. The mRNA and protein levels of TSHR in the thyroid， TRHR and TSHβ in the pituitary， and TRH， CGA， GPX2， and TSHβ in the hypothalamus were up-regulated in the high- and medium-dose Xiaoyaosan groups （P<0.05， P<0.01）. Additionally， the mRNA and protein levels of TSHβ in the hypothalamus were up-regulated in the low-dose Xiaoyaosan group （P<0.01）. In the fluoxetine group， the mRNA and protein levels of TSHR in the thyroid， TRHR in the pituitary， and TRH， CGA， and GPX2 in the hypothalamus were up-regulated （P<0.05， P<0.01）. ConclusionThe downregulation of CGA/GPX2/TSHβ pathway may be one of the biological mechanisms underlying HPT axis dysfunction in the rat model with the syndrome of liver depression and spleen deficiency. Xiaoyaosan may regulate the HPT axis dysfunction by up-regulating the CGA/GPX2/TSHβ pathway.

ObjectiveTo observe the effects of modified Chaihu Shugansan on the calmodulin-dependent protein kinase Ⅱ（CaMKⅡ）/cAMP-response element binding protein （CREB） signaling pathway in the hippocampus and heart tissue of a rat model with myocardial ischemia and depression and explore the mechanism by which this formula prevents and treats coronary heart disease combined with depression. MethodsThe model of myocardial ischemia combined with depression was established by high-fat diet， intraperitoneal injection of isoproterenol （ISO）， and chronic unpredictable mild stress （CUMS）. A total of 108 SD male rats were randomly divided into normal group， model group， high （23.4 g·kg^-1）， medium （11.7 g·kg^-1）， and low （5.85 g·kg^-1） dose groups of modified Chaihu Shugansan， CaMKⅡ inhibitor （KN93） group， and KN93 + high， medium， and low dose groups of modified Chaihu Shugansan， with 12 rats in each group. From the first day of modeling to the end of modeling， drugs were administered once a day. In the seventh and eighth weeks， the KN93 group and the KN93 + high， medium， and low dose groups of modified Chaihu Shugansan were intraperitoneally injected with KN93 three times weekly. At the end of the eighth week， behavioral tests including sucrose preference， open field， and elevated plus maze were conducted. Electrocardiogram （ECG） lead Ⅱ changes were observed in each group of rats， and hematoxylin-eosin （HE） staining was performed to observe changes in heart tissue. Serum levels of triglycerides （TG）， total cholesterol （TC）， high-density lipoprotein （HDL）， low-density lipoprotein （LDL）， and lactate dehydrogenase （LDH） were measured by using an enzyme-labeled instrument. Creatine kinase （CK） and creatine kinase-MB （CK-MB） were detected by ultraviolet spectrophotometry， while serum monocyte chemoattractant protein-1 （MCP-1） was measured by enzyme-linked immunosorbent assay （ELISA）. Real-time fluorescence quantitative polymerase chain reaction （Real-time PCR） was used to detect mRNA expression of CaMKⅡ and CREB in hippocampal and heart tissue， and Western blot was performed to assess protein expression of CaMKⅡ， phosphorylated （p）-CaMKⅡ， CREB， and p-CREB. ResultsCompared to the normal group， the model group showed significant reductions in sucrose preference rate， total activity distance in the open field， number of entries into the center area of the open field， and percentage of entries into the open arms of the elevated plus maze （P<0.01）. The ECG showed ST-segment elevation， and HE staining showed serious degeneration of myocardial fibers， disordered arrangement， and infiltration of a large number of inflammatory cells. In addition， serum TC and LDL levels increased （P<0.01）， and HDL level decreased （P<0.01）. CK， CK-MB， LDH， and MCP-1 levels significantly increased （P<0.05， P<0.01）. The mRNA expression of CaMKⅡ and CREB and the protein expression of p-CaMKⅡ and p-CREB decreased in the hippocampal tissue （P<0.05， P<0.01）， but those increased in the heart tissue （P<0.01）. Compared to the model group， the high， medium， and low dose groups of modified Chaihu Shugansan showed improvements in these abnormalities. The KN93 group had reduced sucrose preference， total activity distance in the open field， number of entries into the center area of the open field， and percentage of entries into the open arms of the elevated plus maze （P<0.01）， as well as decreased serum CK， CK-MB， LDH， and MCP-1 levels （P<0.05， P<0.01）. KN93 also reduced ST-segment elevation， alleviated the degeneration degree of myocardial fibrosis， and lowered inflammatory cell infiltration. The mRNA expression of CaMKⅡ and CREB and the protein expression of p-CaMKⅡ and p-CREB in both the hippocampal and heart tissue were reduced （P<0.05， P<0.01）. The KN93 + high， medium， and low dose groups of modified Chaihu Shugansan showed further improvements in these abnormalities compared to the KN93 group. ConclusionThe modified Chaihu Shugansan exerts antidepressant and myocardial protective effects in rats with myocardial ischemia and depression， possibly related to bidirectional regulation of the CaMKⅡ/CREB signaling pathway， with the high-dose modified Chaihu Shugansan showing the best effects.

Background Non-optimal temperatures pose significant threats to public health. Analyzing the association between temperature exposure and the number of emergency cases of acute alcohol intoxication can provide evidence for optimizing emergency resource allocation and response strategies. Objective To analyze the overall impact and lag effects of non-optimal temperatures on the number of 120 emergency calls for acute alcohol intoxication in Wuxi, and to assess the attributable risk, in order to provide empirical evidence for formulating climate-adaptive public health strategies. Methods Call records of acute alcohol intoxication from Wuxi's 120 emergency service, concurrent air pollutant data, and meteorological data (including daily mean temperature) were collected from January 1, 2014 to December 31, 2020. Distributed lag nonlinear modeling was used for time-series analysis, with cross-basis functions to capture the nonlinear relationship and lag effects between temperature and emergency volume. Confounding factors such as long-term trends, humidity, pollutants [ultimately including ozone (O₃) and fine particulate matter (PM_2.5)], day of the week, and holidays were controlled. The maximum lag period was set to 14 days. Single-day lag and cumulative lag effects of extreme temperatures were analyzed, followed by sensitivity analysis. Effects were quantified using relative risk (RR) and 95% confidence intervals (95%CI), and attributable fractions and numbers for different temperature ranges were calculated. Results A total of 10705 emergency cases of acute alcohol intoxication were included during the study period, with males accounting for 89.5% and individuals aged 18–50 years accounting for 83.4%. A non-linear "U-shaped" association was observed between daily mean temperature and the number of emergency calls, with an optimal temperature of 13.3 ℃. The effect of the extreme low temperature (1.88 ℃) was statistically significant from lag1 to lag3 after exposure (P<0.05), with the maximum effect at lag1 (RR=1.063, 95%CI: 1.002, 1.129). The extreme high temperature (32.3 ℃) showed an immediate effect, with maximum effect at lag0 (RR=1.374, 95%CI: 1.248, 1.512). The cumulative effect analysis showed that the risk associated with high temperature was the highest at lag0–3 (RR=2.000, 95%CI: 1.667, 2.399), while the risk associated with low temperature was the highest at lag0–14 (RR=1.462, 95%CI: 1.042, 2.051). The attribution analysis indicated that the mild heat (>24.7–30.8 ℃) and heat (>30.8–33.5 ℃) contributed the largest numbers of attributable cases, with 591 cases (95%CI: 56, 1032) and 190 cases (95%CI: 51, 309), respectively. The corresponding attributable fractions were 5.81% (95%CI: 0.80%, 9.94%) and 1.87% (95%CI: 0.49%, 2.96%), respectively. Conclusion Both extreme high and low temperatures significantly increase the number of 120 emergency calls for acute alcohol intoxication in Wuxi. High temperature exhibit an acute effect, while low temperature show a delayed effect. Mild heat have a significant impact on the emergency burden. It is recommended that emergency departments optimize resource allocation according to climatic characteristics and strengthen emergency responses during extreme weather to reduce alcohol-related health burden.

Objective:To evaluate the safety and effectiveness of laparoscopic ventral mesh rectopexy (LVMR) +anal sphincter plasty for complete rectal prolapse.Methods:From Jan 1, 2018 to Dec 31, 2022, 45 patients with complete rectal prolapse diagnosed in Beijing Erlong Road Hospital received laparoscopic ventral mesh rectopexy +anal sphincter plasty were included in this study.Result:There was no mortality rate associated with LVMR in this study cohort. The follow-up period was 8-76 months, with a median follow-up period of 59 months. There were 2 cases of recurrence, with a recurrence rate of 4%. Patients with concomitant fecal incontinence symptoms had a preoperative Jorge Wexner fecal incontinence score of 13.8±2.0, and postoperative Jorge Wexner fecal incontinence scores of 7.5±1.5, 5.3±1.3, 4.3±1.1, 2.8±1.0, and 1.8±0.5 at 3, 6, 12, 36, and 60 months, respectively, all P<0.001. Patients with concomitant constipation had a preoperative Wexner constipation score of 15.7 ± 1.5, and a postoperative Wexner constipation score of 9.0±1.8, 6.8±1.5, 5.2±1.4, 4.1±0.7, 2.0±0.0 at 3, 6, 12, 36, and 60 months, respectively, all P<0.001. Conclusions:LVMR +anal Sphincter plasty is safe and effective for the treatment of complete rectal prolapse, and there are few complications related to biological patches. Anal sphincter plasty can effectively improve anal function.

Objective To compare the effects of different blood purification methods on blood lipid metabo-lism and malnutrition in maintenance hemodialysis patients. Methods From January 2015 to May 2017,80 patients with maintenance hemodialysis admitted in Wuyi Traditional Chinese Medicine Hospital of Jiangmen were selected. The patients were divided into study group and control group according to the random number table method,with 40 cases in each group. The control group was treated with hemodialysis,the study group was treated with hemoperfusion combined with hemodialysis,all patients were treated for 12 weeks. The levels of total cholesterol (TC),triglyceride (TG),low density lipoprotein cholesterol(LDL - C),hemoglobin(Hb),total protein(TP),albumin(Alb),transferrin (TRF),interleukin 6(IL - 6) and tumor necrosis factor α(TNF - α) were compared before and after treatment. The incidence of complications at the same time were observed. Results After treatment,the levels of TC,TG,LDL - C in the study group were (4. 39 ± 0. 91) mmol/ L,(1. 41 ± 0. 20) mmol/ L,(2. 55 ± 0. 31) mmol/ L,respectively,which were lower than those in the control group [(6. 21 ± 0. 55)mmol/ L,(1. 83 ± 0. 50)mmol/ L,(3. 05 ± 0. 63)mmol/ L] (t = 10. 825,4. 933,4. 504,all P < 0. 05). After treatment,the levels of Hb,TP,Alb,TRF in the study group were (106. 83 ± 22. 05)g/ L,(62. 14 ± 22. 50)g/ L,(38. 30 ± 6. 48) g/ L,(19. 70 ± 2. 20) g/ L,respectively,which were higher than those in the control group [(94. 28 ± 13. 17)g/ L,(52. 38 ± 12. 37)g/ L,(33. 17 ± 6. 80)g/ L,(16. 24 ± 1. 54)g/ L] (t = 3. 090,2. 404,3. 454,8. 146,all P < 0. 05). After treatment,the levels of IL - 6,TNF - α in the study group were (124. 52 ± 107. 23)ng/ L,(72. 13 ± 12. 55)ng/ L,respectively,which were lower than those in the control group [(294. 14 ± 108. 92) ng/ L, (112. 45 ± 21. 29) ng/ L] ( t = 7. 019,10. 318, all P < 0. 05). The incidence rate of complications of the study group was 5. 00％ ,which was lower than 22. 50％ of the control group (χ2 = 5. 165,P < 0. 05). Conclusion Hemoperfusion combined with hemodialysis in maintenance hemodialysis patients can improve their blood lipid metabolism and malnutrition,reduce inflammation and the risk of complications.

BACKGROUND: Total hip arthroplasty is a commonly used treatment, but it is difficult to accurately determine the position of the pelvis, which is easy to cause pelvic displacement postoperatively. Additionally, the implant is likely to present with angle deviation, and the precise location and direction of prosthesis is difficult to identify.OBJECTIVE: To study the position and biomechanical characteristics of prosthesis in total hip arthroplasty.METHODS: (1) One male volunteer received CT examination, and a finite element model of the pelvic was established.Three acetabular placement positions (abduction angles of 0°, 20° and 25° combined with anteversion angles of 35°, 15°and 10°) were used to perform total hip arthroplasty, and the peak von Mises stress was detected under a load of 240 N.(2) Six cadaver specimens were collected and received the same interventions with the former experiment, and the stress changes at the bone cortex surrounding femoral shaft and acetabular anterior and posterior wall were measured using resistance strain technology.RESULTS AND CONCLUSION: (1) The peak von Mises stress in the acetabulum at abduction angle of 25° combined with anteversion angle of 10° increased by 25.7%. The peak von Mises stress in the acetabular cup at abduction angles of 0°, 20° and 25° combined with anteversion angles of 35°,15° and 10° was 135.21, 68.3 and 134.2 MPa, respectively.The peak von Mises stress in the lining at abduction angles of 0°, 20° and 25° combined with anteversion angles of 35°,15° and 10° was 6.8, 3.9 and 6.7 MPa, respectively. The peak von Mises stress in the femoral shaft at abduction angles of 0°, 20° and 25° combined with anteversion angles of 35°,15° and 10° was 127.1, 100.2 and 128.2 MPa,respectively. (2) The stress at the bone cortex surrounding femoral shaft and acetabular anterior and posterior wall at abduction angles of 0° and 25° combined with anteversion angles of 35° and 10° was significantly higher than that at abduction angle of 20° combined with anteversion angle of 15°. To conclude, an abduction angle of 20° combined with anteversion angle of 15° is conductive for functional recovery of the joint.

ObjectiveTo investigate the incidence and possible related factors for fatty liver among workers engaged in light manual labor in Tianjin, China. MethodsAmong 800 healthy workers engaged in light manual labor randomly selected from a company in Tianjin, a total of 602 healthy workers completed physical examination and data collection. The content of fat and liver stiffness were determined by controlled attenuation parameter (CAP) using FibroScan, and the disease history, body mass, height, blood pressure, and living habits in all subjects were investigated. The possible related factors for different degrees of fatty liver were analyzed. Between-group comparison of continuous data was performed using the Kruskal-Wallis H test, and comparison of categorical data was performed using χ2 test with row×column tables. Pairwise comparison was performed using χ2 segmentation method, and the agreement between CAP and color ultrasound was analyzed using the Kappa coefficient. ResultsAmong the 602 subjects, there were 180 (29.9%), 195 (32.3%), and 227 (37.7%) subjects with severe fatty liver, moderate fatty liver, and no fatty liver, respectively. There were significant differences in age, body mass index, waist-hip ratio, smoking, drinking, history of diabetes, and family history between the above three groups according to CAP (P＜005 for all). With higher sensitivity, CAP achieved a significantly higher detection rate of fatty liver than traditional color ultrasound (623% vs 44.0%, P=0.000). The agreement between two methods was poor (Kappa value ＜0.4). ConclusionAmong the so-called “healthy people” engaged in light manual labor, the incidence of fatty liver has exceeded 60%, which is associated with body mass index, waist-hip ratio, bad living habits, history of diabetes, and family history of fatty liver. CAP can noninvasively detect fatty liver with higher sensitivity and less time; however, its clinical significance needs further studies.

Objective To study the effects of different sources of dendritic cells (DCs) on root resorption and healing after allo-geneic tooth transplantation in rats .Methods The BN rats and Lewis rats were respectively used as the donor and recipient teeth for establishing the animal experimental transplantation models and randomly divided into 4 groups ,20 cases in each group :the syn-geneic transplantation group(A) and the allogeneic transplantation groups(B ,C ,D) .The group A and B were infused with PBS buffer solution 0 .5 mL on 7 d before operation .The group C and D were infused with 1 × 106 donor or recipient tolerogenic DCs on 7 d before operation .5 rats randomly selected from each group were sacrificed for performing the pathological examinations of transplanted teeth at the end of 1 ,2 ,4 and 8 weeks .Results The inflammatory cellular infiltration was most severe in the group B , slightest in the group A and moderate in the group C and D .The root resorption was minimal in the group A ,maximal in the group B and moderate in the group C and D (P<0 .05);the root resorption at 2 ,4 weeks had no statistical difference between the group C and D(P>0 .05) ,but which at 8 weeks in the group D was lower than that in the group C .The periodontal membrane healing points at 8 weeks in the group C and D was less than that in the group A ,but more than that in the group B (P<0 .05);the inflam-matory absorption was highest in the group B(P<0 .05);the alternative absorption was lowest in the group A (P<0 .05) .Conclu-sion The two different sources of tolerogenic DCs all could reduce the rejection reaction of allogeneic tooth transplantation ,reduce the root resorption and promote the healing of periodontal membrane .Recipient tolerogenic DCs could reduce the root resorption in late stage even more .

Objectives To analyze the relationship between the multi-organ hypoxia damage and the death of acute high altitude sickness severe case. Methods 3220 cases from 1956. 06 to 2005.06 in the hospital were reviewed by questionnaire and the cases in MODS or death were screened out. The cause of death and feature were analyzed by the data as clinical symptom, physical signs and auxiliary examination. Results 281 cases complicated by MODS (include 35 dead cases) were found out by review. The incidence with MODS is 8.73% , and the death rate was 1.09%. The masculine incidence rate of the clinical symptom, physical signs and auxiliary examination in death were 2. 86% ~65. 71% , 2. 86% ~ 100% and 14. 29% ~ 100% , respectively. The MODS incidence in dead cases was 100%. Compared with the curing group, the MODS number, cardiac functional disturbance, brain disorder and renal functional disturbance in the death group had a significantly high incidence rate in all the 281 cases with MODS( P <0.05). With dependability analysis, there were a significantly direct correlation relationship between the death in the severe cases with acute high altitude sickness and the number of MODS ( r = 0. 3473, P < 0.001). Conclusion Hypoxia to the damage of multi-organ function play an important role in death of the severe cases with acute high altitude sickness in high attitude area, and the functional disturbance of important organs as heart, brain and kidney is the most important cause to death.

Electrolyte disturbance was prominent in patients with severe acute mountain sickness. In these patients hypoxia caused water and salt retension together with vasoactive substances and excessive free radicals might play important roles in the development of multiple organ dysfunction syndrome (MODS). More attention should be given to electrolyte monitoring in dealing with these severe mountain sickness in field.