Objective To investigate the clinical efficacy of Zhikang Capsules plus Compound Huangbai Lotion for retention enema in the treatment of patients with mild to moderate distal ulcerative colitis(UC)of damp-heat in large intestine type,and to observe their effects on the serum levels of pro-inflammatory cytokines of tumor necrosis factor α(TNF-α),interleukin 6(IL-6)and C-reactive protein(CRP).Methods A total of 110 patients with mild to moderate distal UC of damp-heat in large intestine type who were treated in the Outpatient Clinics and Wards of the Third Affiliated Hospital of Henan University of Traditional Chinese Medicine from October 2022 to December 2023 were randomly divided into an observation group and a control group according to random number table method,with 55 patients in each group.The control group was given retention enema with 1 g of Xilei Powder and 50 mL of Compound Huangbai Lotion before going to bed every night,while the observation group was given retention enema with 2.4 g of Zhikang Capsules and 50 mL of Compound Huangbai Lotion before going to bed every night The course of treatment for the two groups covered 14 days.The changes in the serum inflammation factors,coagulation function indicators,traditional Chinese medicine(TCM)syndrome scores,and the Inflammatory Bowel Disease Quality of Life Questionnaire(IBDQ)scores in the two groups were observed before and after treatment.After treatment,the clinical efficacy and drug safety in the two groups were evaluated.Results(1)After 14 days of treatment,the total effective rate of the observation group was 90.91％(50/55)and that of the control group was 80.00％(44/55),and the intergroup comparison(tested by rank sum test)showed that the therapeutic efficacy of the observation group was significantly superior to that of the control group(P＜0.01).(2)After treatment,the serum levels of inflammation factors of TNF-α,IL-6,and CRP patients in the two groups were decreased compared with those before treatment(P＜0.05),and the decrease in the observation group was significantly superior to that in the control group(P＜0.05 or P＜0.01).(3)After treatment,the prothrombin time(PT)and fibrinogen(FIB)of the two groups of patients were improved compared with those before treatment(P＜0.05),while the improvement of thrombin time(TT)and activated partial thromboplastin time(APTT)were not obvious when compared with those before treatment(P＞0.05);the comparison between the two groups showed that the improvement of PT and FIB in the observation group was significantly superior to that in the control group(P＜0.05 or P＜0.01).(4)After treatment,the scores of TCM symptoms of diarrhea,mucous-purulent and bloody stool,tenesmus,scorching sensation of the anus in the two groups were decreased compared with those before treatment(P＜0.05),and the decrease in the observation group was significantly superior to that in the control group(P＜0.05 or P＜0.01).(5)After treatment,the scores of IBDQ items of general symptoms,intestinal symptoms,social functioning,emotional role functioning in the two groups were increased compared with those before treatment(P＜0.05),and the increase in the observation group was significantly superior to that in the control group(P＜0.01).(6)During the treatment,no obvious adverse reactions occurred in the two groups,with higher safety.Conclusion Zhikang Capsules plus Compound Huangbai Lotion for retention enema are effective and safe in treating mild to moderate distal UC of damp-heat in large intestine type.The therapy can effectively control the illness of UC,alleviate the clinical symptoms and negative emotions,improve the inflammatory response and coagulation function,and enhance the quality of life of the patients.

Objective To investigate the protective effect and mechanism of tanshinone ⅡA on D-galactosamine(D-GalN)-induced acute liver failure in rats.Methods SD rats were randomly di-vided into control group,model group(intraperitoneal injection of 1.1 g/kg D-GalN),low-dose group(intraperitoneal injection of 1.1 g/kg D-GalN+daily gavage of 25 mg/kg tanshinone ⅡA),and High-dose group(intraperitoneal injection of 1.1 g/kg D-GalN+daily gavage of 50 mg/kg tan-shinone ⅡA).Liver function indicators[aspartate aminotransferase(AST),alanine aminotransferase(ALT),and γ-glutamyltransferase(γ-GT)]were measured using a Hitachi7600-210 biochemical an-alyzer,and serum total bilirubin(TBIL)and direct bilirubin(DBIL)levels were determined.The mitotic index(MI)and proliferating cell nuclear antigen(PCNA)positivity in liver tissues were examined.Enzyme-linked immunosorbent assay(ELISA)was used to detect plasma levels of tumor necrosis factor(TNF-α),interleukin(IL)-1β,IL-10,and IL-6 in rats from each group.Kits were employed to measure superoxide dismutase(SOD),glutathione(GSH),and malondialdehyde(MDA)contents in liver tissues of rats from each group.The TUNEL method was adopted to detect hepatocyte apoptosis rates in liver tissues,and immunoblotting was used to assess the expression of phosphorylated extracellular signal-regulated kinase 1/2(p-ERK1/2)and extracellular signal-regu-lated kinase 1/2(ERK1/2)proteins in liver tissues.Results Compared with the control group,the model group exhibited increased p-ERK1/2 protein expression(P＜0.05).Compared with the model group,both the low-dose and high-dose groups showed decreased p-ERK1/2 protein expres-sion(P＜0.05).The model group had an increased hepatocyte apoptosis index compared with the control group(P＜0.05).Both the low-dose and high-dose groups demonstrated decreased hepato-cyte apoptosis indices compared with the model group(P＜0.05).Compared with the control group,the model group had increased MDA levels and decreased SOD and GSH levels(P＜0.05).Both the low-dose and high-dose groups exhibited decreased MDA levels and increased SOD and GSH levels compared with the model group(P＜0.05).The model group showed increased levels of TNF-α,IL-1β,IL-10,and IL-6 compared with the control group(P＜0.05).Both the low-dose and high-dose groups had decreased levels of TNF-α,IL-1 β,IL-10,and IL-6 compared with the model group(P＜0.05).Compared with the control group,the model group had decreased MI and PCNA positivity rates(P＜0.05).Both the low-dose and high-dose groups exhibited increased MI and PCNA positivity rates compared with the model group(P＜0.05).The model group had in-creased AST,ALT,γ-GT,TBIL and DBIL values compared with the control group(P＜0.05).Both the low-dose and high-dose groups showed decreased AST,ALT,γ-GT,TBIL and DBIL val-ues compared with the model group(P＜0.05).Conclusion Tanshinone ⅡA may alleviate D-GalN-induced acute liver failure in rats through the ERK1/2 signaling pathway.

Objective:To investigate the clinical experience of different types of femoral perforator flaps in the reconstruction of oral and maxillofacial head and neck defects.Methods:From January 2018 to January 2021, 573 patients with oral and maxillofacial head and neck defects reconstructed by femoral perforator flap were collected in the Department of Maxillofacial Oncology, the Third Affiliated Hospital of Air Force Military Medical University (age range of 21-76 years, with a male to female ratio of 1.23∶1). According to the type of perforator flap, the patients were divided into ALT group, AMT group, TFL flap group and free muscle flap group. The incidence of postoperative complications, wound healing time and drainage volume in femoral area were compared among the 4 groups.Results:The ALT flap was used in 527 cases: 22 flaps had vascular crisis, 14 flaps had infection, 8 flaps had necrosis, 519 flaps survived; the mean healing time of the wound was (14.50±3.19) days, and the mean drainage volume was (49.9±21.3) ml. 28 cases were repaired with AMT flap: 2 flaps had vascular crisis and 1 had infection. All the flaps survived; the mean healing time of the wound was (14.18±2.75) days, and the mean drainage volume was (50.3±23.0) ml. 11 cases were repaired by TFL flap: 1 flap had vascular crisis and 1 had infection. All the flaps survived. The mean healing time of the wound was (14.09±2.66) days, and the mean drainage volume was (54.1±25.0) ml. 7 cases were repaired by free muscle flap survived without vascular crisis, infection and other postoperative complications; the mean healing time of the wound was 14.14±1.86, and the mean postoperative drainage volume was (49.9±21.1) ml. There was no significant difference in complication rate (flap necrosis, vascular crisis, infection, etc.) and repair effect among 573 patients with different flap types. The postoperative follow-up was conducted for 6-24 months, and the donor area was smooth and good in appearance, without obvious scar or functional influence. The repair effect of the affected area was satisfactory.Conclusions:Although there is a certain proportion of perforator vessel variation in the femoral perforator flap, the flap can be designed freely according to different types of variation. The thigh perforator flap has an essential application value in the repair of oral and maxillofacial head and neck defects.

Enrichment of trace bioactive constituents and metabolites from complex biological samples is chal-lenging. This study presented a one-pot synthesis of magnetic polydopamine nanoparticles (Fe3O4@-SiO2@PDA NPs) with multiple recognition sites for the magnetic dispersive solid-phase extraction (MDSPE) of ginsenosides from rat plasma treated with white ginseng. The extracted ginsenosides were characterized by combining an ultra-high-performance liquid chromatography coupled to a high-resolution mass spectrometry with supplemental UNIFI libraries. Response surface methodology was statistically used to optimize the extraction procedure of the ginsenosides. The reusability of Fe3O4@-SiO2@PDA NPs was also examined and the results showed that the recovery rate exceeded 80％ after recycling 6 times. Furthermore, the proposed method showed greater enrichment efficiency and could rapidly determine and characterize 23 ginsenoside prototypes and metabolites from plasma. In com-parison, conventional methanol method can only detect 8 ginsenosides from the same plasma samples. The proposed approach can provide methodological reference for the trace determination and charac-terization of different bioactive ingredients and metabolites of traditional Chinese medicines and food.

Objective To introduct the experience of anesthesia and operation of complicated resection of the trachea,and promote techniques of anesthesia and operation of the tracheal resection and reconstruction. Methods Reviewing the anesthetic and operative process of 5 cases of tracheal resection and reconstruction,dis-close difficulties with corresponding methods,postoperative follow-up,summarizing suitable measures for succeed of large-segment resection and reconstruction of the trachea. Results In 4 cases of patients with benign stricture of the trachea,3 cured with good quality of life in 2 - 5 years follow-up, 1 case of resection of 6 cm trachea with one-stage reconstruction dead from anastomotic fistula and infection of mediastinum. One case with malignancy re-section of 8 cm trachea and reconstructed with Zhao's artificial trachea dead from remote metastasis one and a half year later. Conclusion The complexity of tracheal operation is with big different from case to case,therefore, preoperative precisely evaluation with careful individually protocol of anesthesia and operation,and good coopera-tion between surgeon and anesthesiologist are critical.

Objective To compare the clinical outcome of intramedullary nail with locking plate in the treatment of two-part proximal humerus fractures.Methods PubMed,SpringerLink,EMBASE,The Cochrane Library,Medline,Science Direct,CNKI,Wanfang Data and VIP database were searched for relevant studies comparing intramedullary nailing and locking plate fixation of two-part proximal humerus fractures.A meta-analysis of the two methods was conducted using the RevMan 5.0.Differences between the two methods were compared with respect to operation time,intraoperative bleeding,bone union time,Constant score and postoperative complication incidence.Results Seven studies were included in the meta-analysis,with 136 patients treated with intramedullary nail and 159 patients treated with locking plate.Intramedullary nailing showed advantages over locking plate fixation with regards to operation time (WMD =-27.71,95％ CI-36.07--19.35,P ＜ 0.05),intraoperative blood loss (WMD =-114.18,95％ CI-169.91--58.45,P ＜ 0.01) and bone union time (WMD =-2.91,95％ CI-5.80--0.01,P ＜ 0.05).While the two methods showed no significant differences in Constant score (WMD =-2.84,95 ％ CI-5.90--0.22,P ＞ 0.05) and postoperative complication incidence (OR =0.89,95％ CI 0.43-1.84,P ＞ 0.05).Conclusion Intramedullary nail is superior to locking plate in operation time,intraoperative blood loss and bone union time for the treatment of two-part proximal humerus fractures,but the two methods are similar in Constant score and postoperative complications rate.

Objective To evaluate ascending venography in the diagnosis of iliac vein compression syndrome.Methods From April 2011 to April 2013,we have had 556 patients with varicose veins suspected of Cockett syndrome.The degree of varicose veins by the International Union of Venous Clinical Classification (CEAP classification) was as following[1]:shallow varicose veins of lower limb (C2) in 190;varicose veins with limb swelling (C3) in 149 cases ; with body skin changes,such as pigmentation,eczema or lipid hard skin disease (C4) in 130; with healed ulcers (C5) in 17; with active ulcer(C6) in 70.Deep vein anterograde contrast and femoral venous cannula angiography were performed on 760 times.Results Iliac vein compression syndrome (Cockett) was detected by ascending venography in 154 patients,the diagnosis was established by following femoral venous cannula angiography.In the other 48 patients in whom Cockett syndrome was suspected by ascending venography,final diagnosis was reached by femoral venous cannula angiography.Altogether there were 202 iliac vein compression syndrome cases,with a positive rate 38.19％ (202/529).The narrowness was larger than 50％ in 173 cases.In 145 cases there were visible collateral vessels.Conclusions Deep vein ascending angiography is a useful screening method in the diagnosis and treatment of Cockett syndrome.

Objective To investigate the causes of diarrhea during autologous peripheral blood stem cell transplantation (APBSCT )and summarize the nursing strategies.Method The histories of 23 APBSCT patients suffering from diarrheas were retrospectively reviewed to find out the causes of diarrhea and summarize the nursing strategies.Results The main causes of the diarrheas included the toxicity of pretreatment chemotherapy drugs in 15 cases,antibiotics in 2 cases,gastrointestinal motility drugs in 2 cases,intestinal infections from decreased immunity in 2 cases and other diseases in 2 cases,all recovered by corresponding managements.Conclusions APBSCT-associated diarrheas may be caused by chemotherapy drug toxicity,infections,drugs and other factors.So the nurses should evaluate them correctly,adopt corresponding nursing measures,strengthen the observation of patients' condition and raise awareness of prevention for the purpose of reducing the incidence of diarrhea,promoting the recovery of patients and improving the quality of life.

The present case report was designed to summarize the clinical experience of operative technique. lung preservation, lung perfusion, and perioperative management. Of 7 cases who underwent allogenic single lung transplantation (LT), 3 were idiopathic pulmonary fibrosis, 2 were chronic obstructive pulmonary disease, 1 was silicosis, emphysema, and bulla, and I was tuberculosis in both sides and presented with destroyed lung in one side. All donors were already brain death. Donor lungs were well preserved utilizing Euro-Colins liquid or low-potassium dextran solution. Donors and recipients were matched in blood type. Of 7 cases selected,5 received single right lung transplantation, and 2 received single left LT. End-to-end anastomosis was performed for pulmonary branches and pulmonary arteries. while atrium-to-atrium anastomosis was performed for pulmonary vein. Antibiotics and immunosuppressants were routinely used prior to and subsequent to LT. Following LT, heart and lung function, usage of antibiotics, and adjustment of immunosuppressant were monitored. Stomal complications regarding bronchus and pulmonary artery and vein did not appear in any patient. Five cases survived for about 2 months, one for approximately 1 year, and one for nearly 2 years. Four cases died of multi-organ failure caused by pulmonary infection, and one of severe pulmonary hemorrhage caused by aspergillus sydowi infection. Rejection occurred in 6 cases. One case sufiered from rejection three times. Selection of indication, selection and preservafton of donor lung, LT operation and pre-and post-operative management of LT have acquired satisfactory achievements. High mortality occurred in patients with preoperative poor cardiac and pulmonary functions and postoperative severe infections accompany with application of immunosuppressant.

Objective To evaluate the application of Sigma stent in treatment for esophagn-tracheal fistula. Methods Clinical data of 22 cases of esophago-tracheal fistula treated with Sigma stent were retrospectively analyzed, including 17 cases of esophageal cancer and 5 cases of benign esophageal diseases, with length of 4 days to 2 months. One single stent was placed in 5 cases, two stents ( both in trachea and esophagus each) in 15 cases, and three stents in 2 cases, and 18 eases with tube-type trachea stent, 3 with obtuse angle L-type and 1 with Y-type. Placement of stent was by interventional method or/and endoscopy. Results Forty-one stents were successfully placed in 22 patients with no death in the procedure. And, all patients with fistula were healed successfully and could have normal eating 2 to 4 days after operation, except 1 patient who received a tracheal stent inserted first, but an esophageal stent inserted again due to incomplete seal of the fistula and another benign case who received surgical operation 1 year after stent placement due to protracted unsealed fistula, with an overall cure rate of 91% (20/22). Conclusions Placement of Sigma stent in the esophagus or/and trachea could effectively heal esophago-tracheal fistula. All the patients can eat normally after the procedure. Stent can be recycled and formation of secondary esophago-traeheal fistula can be prevented effectively with such procedure.