OBJECTIVE To study the mechanism of action of Rehmannia glutinosa-medicated serum （RG） in regulating lipopolysaccharide （LPS）-induced polarization of BV2 microglia to interfere with neuroinflammation. METHODS An in vitro neuroinflammation model of BV2 cells induced by LPS was established. Cells were divided into control group， LPS group， 10%RG group， 20%RG group， BAY 11-7082 [nuclear factor kappa B （NF-κB） inhibitor] group， and 20%RG+BAY 11-7082 group. Except for the control group， cells in all other groups were pretreated with corresponding drugs for 12 h and then stimulated with LPS for 24 h. The morphology of cells in each group was observed， and the fluorescence intensity of ionized calcium binding adaptor molecule 1 （Iba-1）， inducible nitric oxide synthase （iNOS）， CD206， the mRNA expression of tumor necrosis factor-α （TNF-α）， interleukin-6 （IL-6）， IL-1β， iNOS， IL-4， IL-10， transforming growth factor-β （TGF-β）， arginase-1 （Arg-1）， and the Toll-like receptor 4 （TLR4）/NF-κB/NOD-like receptor thermal protein domain associated protein 3 （NLRP3） signaling pathway-related protein expression were detected. RESULTS Compared with the control group， the LPS group showed significant changes in cell morphology， exhibiting a typical M1 activated morphology. The fluorescence intensity of Iba-1 and iNOS， the relative expression levels of TNF-α， IL-6， IL-1β， iNOS mRNA， the relative expression levels of TLR4， NLRP3， caspase-1 p20， IL-1β p17 protein， and the phosphorylation levels of NF-κB p65 and inhibitor of nuclear factor kappa B α were significantly increased （P＜0.05）. The fluorescence intensity of CD206 and the relative expression levels of IL-4， IL-10， TGF-β， and Arg-1 mRNA were significantly reduced （P＜0.05）. Compared with the LPS group， the changes in the above indicators in the cells of the 10%RG group， 20%RG group， BAY 11-7082 group， and 20%RG+BAY 11-7082 group were significantly reversed （P＜0.05）， and there was no statistically significant difference in the comparison of the last three groups （P＞0.05）. CONCLUSIONS RG can effectively inhibit the overall activation of microglia and correct their M1/M2 polarization imbalance， and its mechanism may be closely related to the inhibition of excessive activation of the TLR4/NF-κB/NLRP3 signaling pathway.

Objective:To investigate the risk factors and their predictive efficacy for early postoperative complications in elderly patients with hip fracture.Methods:A retrospective cohort study was conducted on the clinical data of 203 elderly patients with hip fracture admitted to the 908th Hospital of the Joint Logistics Support Force of the PLA and the First Affiliated Hospital of Nanchang University from January 2022 to December 2023, including 54 males and 149 females, aged 65-100 years [(80.5±7.7)years]. There were 96 patients with femoral neck fracture and 107 patients with intertrochanteric fracture. According to the AO/OTA classification, the fracture was classified as type 31A in 107 patients and type 31B in 96. Among them, 81 patients were treated with proximal femoral nail antirotation (PFNA), 65 with semi-hip arthroplasty, 52 with total hip arthroplasty (THA), and 5 with closed reduction and cannulated nail internal fixation. The patients were divided into complication group ( n=65) and non-complication group ( n=138) according to whether complications (mainly including delirium, lung infection, stress ulcer, and deep vein thrombosis of the lower limbs) occurred within 15 days after surgery. The gender, age, age stage, educational level, cause of injury, associated underlying diseases before surgery, AO/OTA classification, American Society of Anesthesiologists (ASA) classification, 5-factor modified frailty index (mFI-5) score, prognostic nutritional index (PNI), anesthesia method, operation method, operation time, intraoperative blood loss, length of hospital stay, etc., were recorded in the two groups. Univariate analysis and multivariate binary logistic regression analysis were used to evaluate the correlation between the above indexes and the occurrence of early postoperative complications in elderly patients with hip fracture and to determine their independent risk factors. The receiver operating characteristic (ROC) curve was plotted and the area under the curve (AUC) was calculated to evaluate the predictive efficacy of each risk factor for the occurrence of early postoperative complications in elderly patients with hip fracture. Results:Univariate analysis showed a certain correlation between age, age stage, associated underlying diseases before surgery, AO/OTA classification, ASA classification, mFI-5 score, PNI, operation method, and length of hospital stay and the occurrence of early postoperative complications in elderly patients with hip fracture ( P<0.05), while gender, educational level, cause of injury, anesthesia method, operation time, and intraoperative blood loss were not correlated with the occurrence of early postoperative complications in elderly patients with hip fracture ( P>0.05). The results of multivariate binary logistic regression analysis showed that the associated underlying diseases before surgery ( OR=5.46, 95% CI 1.33, 22.39, P<0.05), mFI-5 score ( OR=15.90, 95% CI 5.36, 47.15, P<0.01), and PNI ( OR=0.70, 95% CI 0.60, 0.81, P<0.01) were significantly correlated with the occurrence of early postoperative complications in elderly patients with hip fracture. The results of ROC curve analysis showed that mFI-5 score (AUC=0.85, 95% CI 0.80, 0.91) and PNI (AUC=0.87, 95% CI 0.82, 0.93) had moderate predictive efficacy, while the early warning efficacy of associated underlying diseases was low (AUC=0.54, 95% CI 0.45, 0.62). The combination of the above risk factors was more effective in predicting early postoperative complications in elderly patients with hip fracture (AUC=0.95, 95% CI 0.92, 0.98). Conclusions:The mFI-5 score, PNI, and associated underlying diseases before surgery are independent risk factors for early postoperative complications in elderly patients with hip fracture. The mFI-5 score and PNI have a higher predictive efficacy than associated diseases before surgery on the occurrence of early postoperative complications in elderly patients with hip fracture, while the combination of the above risk factors provides a significantly better predictive performance.

Objective:To investigate the risk factors and their predictive efficacy for early postoperative complications in elderly patients with hip fracture.Methods:A retrospective cohort study was conducted on the clinical data of 203 elderly patients with hip fracture admitted to the 908th Hospital of the Joint Logistics Support Force of the PLA and the First Affiliated Hospital of Nanchang University from January 2022 to December 2023, including 54 males and 149 females, aged 65-100 years [(80.5±7.7)years]. There were 96 patients with femoral neck fracture and 107 patients with intertrochanteric fracture. According to the AO/OTA classification, the fracture was classified as type 31A in 107 patients and type 31B in 96. Among them, 81 patients were treated with proximal femoral nail antirotation (PFNA), 65 with semi-hip arthroplasty, 52 with total hip arthroplasty (THA), and 5 with closed reduction and cannulated nail internal fixation. The patients were divided into complication group ( n=65) and non-complication group ( n=138) according to whether complications (mainly including delirium, lung infection, stress ulcer, and deep vein thrombosis of the lower limbs) occurred within 15 days after surgery. The gender, age, age stage, educational level, cause of injury, associated underlying diseases before surgery, AO/OTA classification, American Society of Anesthesiologists (ASA) classification, 5-factor modified frailty index (mFI-5) score, prognostic nutritional index (PNI), anesthesia method, operation method, operation time, intraoperative blood loss, length of hospital stay, etc., were recorded in the two groups. Univariate analysis and multivariate binary logistic regression analysis were used to evaluate the correlation between the above indexes and the occurrence of early postoperative complications in elderly patients with hip fracture and to determine their independent risk factors. The receiver operating characteristic (ROC) curve was plotted and the area under the curve (AUC) was calculated to evaluate the predictive efficacy of each risk factor for the occurrence of early postoperative complications in elderly patients with hip fracture. Results:Univariate analysis showed a certain correlation between age, age stage, associated underlying diseases before surgery, AO/OTA classification, ASA classification, mFI-5 score, PNI, operation method, and length of hospital stay and the occurrence of early postoperative complications in elderly patients with hip fracture ( P<0.05), while gender, educational level, cause of injury, anesthesia method, operation time, and intraoperative blood loss were not correlated with the occurrence of early postoperative complications in elderly patients with hip fracture ( P>0.05). The results of multivariate binary logistic regression analysis showed that the associated underlying diseases before surgery ( OR=5.46, 95% CI 1.33, 22.39, P<0.05), mFI-5 score ( OR=15.90, 95% CI 5.36, 47.15, P<0.01), and PNI ( OR=0.70, 95% CI 0.60, 0.81, P<0.01) were significantly correlated with the occurrence of early postoperative complications in elderly patients with hip fracture. The results of ROC curve analysis showed that mFI-5 score (AUC=0.85, 95% CI 0.80, 0.91) and PNI (AUC=0.87, 95% CI 0.82, 0.93) had moderate predictive efficacy, while the early warning efficacy of associated underlying diseases was low (AUC=0.54, 95% CI 0.45, 0.62). The combination of the above risk factors was more effective in predicting early postoperative complications in elderly patients with hip fracture (AUC=0.95, 95% CI 0.92, 0.98). Conclusions:The mFI-5 score, PNI, and associated underlying diseases before surgery are independent risk factors for early postoperative complications in elderly patients with hip fracture. The mFI-5 score and PNI have a higher predictive efficacy than associated diseases before surgery on the occurrence of early postoperative complications in elderly patients with hip fracture, while the combination of the above risk factors provides a significantly better predictive performance.

For patients with malignant pancreatic cancer combined with vascular invasion,radical pancreaticoduodenectomy with vascular resection and anastomosis is the treatment of choice.Because this procedure is difficult to manage and with high risks,it is a great challenge to surgeons.A 50-year old patient with pancreatic head cancer whose portal vein and superior mesenteric vein were involved received radical pancreaticoduodenectomy in the Second Affiliated Hospital of Harbin Medical University.In the surgery,the tumor and its surrounding tissues were dissected,and then the portal vein and splenic vein were reconstructed.The patient was discharged at the 10th day after the surgery with favorable prognosis.

OBJECTIVEThe aim of this study is to develop a simple and rapid HPLC method and investigate the effect of glycyrrhizin on pharmacokinetic fate of paeoniflorin after intravenous administration.

METHODPaeoniflorin and glycyrrhizin was administrated to rat via vena caudalis, and paeoniflorin in rat plasm was determined by RP HPLC method and internal standard method. All data were subsequently processed by the pharmacokinetic Software WinNonLin. The non-compartmental pharmacokinetic parameters of area under the plasma concentration-time curve (AUC/min x mg x L(-1)), clearance (CL/mL x min(-1) x kg(-1) ) and volume of distribution (Vd/mL x kg(-1)) were calculated based on moment methods.

RESULTThe values of AUC, V(d) and CL was 166.81 +/- 26.94, 394.33 +/- 29.52, 18.40 +/- 3.12 in control group, respectively; however, the values of AUC, V(d), CL was 235.44 +/- 46.48, 266.63 +/- 48.43 and 13.16 +/- 2.59 in experimental group.

CONCLUSIONGlycyrrhizin significantly influenced the pharmacokinetic fate of paeoniflorin, increasing the value of AUC and decreasing CL and V(d).

Animals ; Benzoates ; administration & dosage ; blood ; pharmacokinetics ; Bridged-Ring Compounds ; administration & dosage ; blood ; pharmacokinetics ; Female ; Glucosides ; administration & dosage ; blood ; pharmacokinetics ; Glycyrrhizic Acid ; administration & dosage ; Injections, Intravenous ; Male ; Monoterpenes ; Random Allocation ; Rats ; Rats, Sprague-Dawley

Objective To investigate the effective route and proper method in transfecting gene into liver graft mediated by adeno-associated virus vector.Methods Three routes including hepatic artery,portal vein and hepatic artery+portal vein,and 3 methods,i.e.routine,circulation and clamping were employed for infusion.The best infusion route and method of gene transfection into liver graft were determined by observing the color change of liver and detecting liver function and transfoetion rate of liver cells.The safety of these methods was evaluated.Results In all the infusion procedures,the color of the liver grafts turned from red to white,no apparent color differenee of the livers and no enlargement nor mottling were observed under surgical microscope.The liver color was back to normal immediately after blood flow was restored.No significantly statistical differences of the ALT values were observed among all the groups(F=0.343,1.265,0.055,P＞0.05).Adeno-associated virus vectors coding for the enhanced green fluorescence protein(AAV2-EGFP)were successfully transfected into liver cells by the 3 infusion routes 1 week later,and the difierences of transfection rates via the 3 routes had no statistical significance(F=0.080,0.091,0.045,P＞0.05).The transfoction rate of AAV2-EGFP was the highest at any time points when using the clamping method,and then followed by circulation method and routine method,with statistical differenee(F=3.880,2.976,5.129,P＜0.05).The transfection rates of AAV2-EGFP were increased progressively and peaked at the 6th week,and then they were decreased gradually.Conclusions Infusion via hepatic artery is the effective route for gene transfection and clamping the vessels can elevate the transfection rate of AAV2-EGFP.All procedures were performed without detectable liver injury.The transfection of gene into liver graft mediated by adeno-associated virus vector is a slow and persistent process.

Objective To select a safe and feasible way by comparing the two main styles of splitting liver transplantation classical splitting and modified splitting.Methods In order to compare the distribution of artery, vein and bile duct of all segments of liver, 58 formaldehyde fixed livers and 8 fresh livers were divided into two groups. One group was subjected to classical splitting and the other group to modified splitting. Results Among 66 livers, 66.7?% of the segment VIII and 100?% of the segment V (all or some) drained to middle hepatic vein. In classical splitting group, the vein drainage of 5th and 8th segments of right graft was destroyed.Conclusion Modified splitting is safer and more reliable than classical splitting, so the former is the first choice when the size of donor liver is suitable.

ObjectiveTo explore the development and mechanism of hepatic cell apoptosis, and the effect of anti-apoptosis apoptosis of Se in the liver in obstructive jaundice rats. Methods(GPx) activity and (ROS) level were measured by biochemical methods,terminal-deoxynucleotidyl medicated nick end labeling (TUNEL)in different groups at different time points, and analysed by multivariate regression. Results Apoptosis cells appeared on day 3 after common bile duct(CBD) ligation ,significantly increased on day 7,reached the peak level on day 11, and began to decrease on day 14. The longer the time of obstructive jaundice in rats, the higher the level of ROS and apotosis index(AI), while the level of GPx decreased progressively. AI reached the peak 11-day after CBD ligation. Less hepatic apoptosis appeared after the rats treated with Se at every time point (P

Objective To study vascular anatomy between the pancreatic head and duodenum,providing anatomy basis for performing surgery of pancreatic head,duodenum and distal common bile duct in surgical practice. Methods Anatomy study was performed in 30 formaldehyde fixed and 10 fresh bodies in reference to blood supply to duodenum,the distal common bile and Vater ampulla. Results The anterior and posterior pancreaticoduodenal arterial arcade gives off branches to descending and horizontal portion of the duodenum. The posterior superior pancreaticoduodenal artery goes to distal common bile duct. The papilla artery arising from the posterior superior pancreaticoduodenal artery goes to Vater ampulla. Conclusions The pancreaticoduodenal anterior and posterior arterial arcades are main arteries that give off branches to the descending and horizontal portion of the duodenum,distal common bile duct and the Vater ampulla,hence should be carefully protected in duodenum-preserving resection of the pancreatic head.