Department of Kidney Transplantation, the First Affiliated Hospital of Xi'an Jiaotong University reported a case of vasoplegic syndrome (VS). During a livingdonor kidney transplantation, the patient developed abrupt hypotension immediately after allograft reperfusion, with blood pressure dropping to 50/30 mmHg (1 mmHg=0.133 kPa). The diagnosis of VS was confirmed through multidisciplinary consultation, integration of clinical indicators, and ultrasonographic assessment. Management included vasopressor therapy (dopamine, norepinephrine, and epinephrine), fluid resuscitation, blood transfusion, and albumin administration. Hemodynamics were subsequently stabilized, and kidney allograft function returned to normal. At more than three months of followup, both kidney function and blood pressure remained stable.

Aim To study the regulatory effect of acupuncture pretreatment on ferroptosis of nerve cells in rats with ischemic stroke.Methods Sixty SD rats were randomly divided into sham middle cerebral artery occlusion(MCAO)group,MCAO group,and acupuncture+MCAO group.In the acupuncture+MCAO group,the acupuncture points of DU26,PC6,and SP6,were selected for acupuncture pretreatment,once a day for a total of 5 days.After pre-treatment,MCAO or sham MCAO models were prepared.The Zausinger sextintegral method was used to score the neuro-logical function of rats,and the infarct volume of brain tissue was calculated by TTC staining.Electron microscopy was used to observe the pathomorphological changes of brain tissue.The iron content was detected by colorimetric method,the content of malondialdehyde(MDA)and glutathione(GSH)was determined by ELISA,and the expression of glutathione peroxidase 4(GPX4)was detected by immunofluorescence.Results Compared with the sham MCAO group,the MCAO group had a decrease in neurological function scores,a significant increase in infarct volume,a decrease in the number of mitochondria under electron microscopy,a rupture and vacuolization of the inner mitochondrial cristae,an in-crease in the contents of iron and MDA in brain tissue,and a decrease in GSH content and GPX4 expression.Compared with the MCAO group,the acupuncture+MCAO group had an increase in neurological function scores,a decrease in infarct volume,a large number of mitochondria under electron microscopy,a clear structure,a decrease or disordered arrangement of some mitochondrial crest structures,a decrease in the contents of iron and MDA in brain tissue,and an increase in GSH content and GPX4 expression.Conclusion Acupuncture pretreatment can alleviate neurological damage in rats,and its mechanism may be related to regulating iron,GSH and MDA contents in brain tissue,and GPX4 expression,improving cell antioxidant capacity and inhibiting nerve cell ferroptosis.

BACKGROUND:Periprosthetic fracture of the femoral of the knee after total knee arthroplasty is one of the common complications,and there is a lack of biomechanical research on the periprosthetic fractures of the femoral of the knee under different bone strength conditions.The three-dimensional finite element analysis can provide a biomechanical basis for clinical practice. OBJECTIVE:To investigate the biomechanical changes of anterior femoral notching after total knee arthroplasty under different bone strengths,and to provide a mechanical basis for the clinical prevention of supracondylar femoral periprosthetic fractures after knee arthroplasty. METHODS:The femoral CT data of healthy adults were obtained,and the three-dimensional model of femoral lateral replacement of the knee joint was established by Mimics,Geomagic studio,and Solidworks software.Anterior femoral notching models of different depths were constructed,and the models were imported into ANSYS software to analyze the changes of biological stress on the femoral condyle with different bone strengths and different anterior femoral notching depths.The stress changes of the femoral anterior condyle section after and before the filling of anterior femoral notching with bone cement were analyzed. RESULTS AND CONCLUSION:(1)Under any bone strength,the supracondylar stress increased with the depth of anterior femoral notching.In normal bone conditions,there was a stress abrupt change point when the anterior femoral notching depth was between 3 mm and 4 mm.In the case of osteoporosis,there was a stress abrupt point when the anterior femoral notching depth was between 2 mm and 3 mm.(2)When anterior femoral notching occurred during knee arthroplasty and the depth exceeded the thickness of the bone cortex,the supracondylar stress of the femoral gradually increased as the bone strength decreased.(3)The stress of the anterior femoral condyle section decreased when the model with an anterior femoral notching depth of 3 mm was filled with bone cement.(4)The results show that anterior femoral notching should be avoided during knee arthroplasty,especially in patients with osteoporosis.If anterior femoral notching occurs during surgery,bone cement can be used to evenly fill the anterior femoral notching to reduce the supracondylar stress of the femur and reduce the incidence of periprosthetic fractures of the femoral joint

Based on the theory of the five-body constituents from Huangdi Neijing (Yellow Emperor's Internal Classic), the approach and methods of acupuncture for facial aging are explored. Acupuncture for facial aging can be guided by the concept of the five-body constituents, targeting the facial "skin, flesh, vessels, tendons, and bones", and utilizing five different types of needles-facial needles, needle knives, filiform needles, retaining needles, and elongated needles and filiform needles-to maximize their respective advantages in treating facial aging. Facial needles are applied to the "skin" by selecting facial acupoints or local ashi points (at wrinkle or pigmentation sites). Needle knives are used for the "flesh" to perform longitudinal dredging and transverse dissection of the facial muscle layers. Filiform needles target the "vessels" with needling at Renying (ST9) to improve facial complexion. Retaining needles act on the "tendons" with needling from Taiyang (EX-HN5) to Xiaguan (ST7), and Jiache (ST6) to Daying (ST5), using clockwise twisting to generate a retaining needle sensation and lifting to achieve an overall facial lifting effect.
Humans ; Acupuncture Therapy/methods* ; Face ; Skin Aging ; Acupuncture Points ; Aging

Objective To establish a stable and reproducible animal model of abdominal intestinal firearm penetrating injury in a cold high-altitude environment.Methods Twenty landrace pigs were randomly and equally assigned to a low-altitude normal temperature(LN)group and a high-altitude cold(HC)group.The HC group was placed in a cold environment at high altitudes,and the LN group was placed in a normal-temperature environment at low altitudes.They were raised for 48 hours respectively.After anesthesia,they were suspended on the shooting range,and the right lower abdomen of the experimental pigs was shot with a gun.After injury,they were simply bandaged and transported back to the laboratory for observation in the normal temperature environment of the low altitudes.The vital signs and injuries at 0,2,4,8,12 and 24 h and 24 h survival rates of experimental pigs were compared.Laparotomy was immediately performed on the dead pigs and the experimental pigs still alive at 24 h to explore the injuries and observe the pathology of the small intestine and colon.Results The 24 h survival rate of the HC group was 70％,with no statistically significant difference compared to the LN group's 90％(P＞0.05).After the injury,the body temperature of both groups gradually increased.The body temperature of the HC group was significantly higher than the LN group at 0,2,4 and 8 h time points(P＜0.001),and the LN group exceeded the HC group at 24 h(P＜0.05).Both groups showed an initial increase followed by a decrease in heart rate,with the HC group significantly higher than the LN group only at 0 h(P＜0.01),and no statistically significant differences were observed at other time points(P＞0.05).Both groups showed an early increase and later decrease in respiratory rate,with the HC group higher than the LN group at 0,4,8,12 and 24 h(P＜0.05 or P＜0.001).There was no statistically significant difference(P＞0.05)between the HC group and the LN group in small intestine rupture,small intestine contusion,mesenteric injury,colon rupture and wound diameter.The pathology of the small intestine and colon in the HC group showed extensive necrosis and shedding of the mucosa layer,severe congestion and edema of the submucosa,and extensive lymphocyte infiltration.The LN group also showed similar symptoms but to a lesser extent.Conclusion This study established a pig model of abdominal firearm intestinal perforation injury in a cold environment at high-altitudes.The model has strong operability and stable damage,which can provide a reference for subsequent research.

Objective To investigate the changes of anti-Müllerian hormone(AMH),inhibin-B(INHB)and inhibin-A(INHA)levels in boys with cryptorchidism,analyze their clinical application value,and provide labo-ratory data for the diagnosis and treatment of cryptorchidism.Methods A total of 1 310 boys with cryp-torchidism who were hospitalized or visited the outpatient department in the hospital from July 2020 to July 2023 were included in the case group.Another 50 boys who underwent physical examination at the hospital and had no abnormalities in reproductive system development such as testicles were selected as the control group.Venous blood was collected from all the research subjects in a fasting state and placed into biochemical tubes.After centrifuging the serum,the changes in the levels of anti-Müllerian hormone(AMH),Inhibin B(INHB),and Inhibin A(INHA)in the two groups were detected by the chemiluminescence method.The differences between the two groups were analyzed,and the receiver operating characteristic(ROC)curve was used to evaluate the diagnostic value of AMH,INHB,and INHA for cryptorchidism.Results The AMH lev-els in boys with cryptorchidism were significantly higher than those in the control group(P＜0.01),while the INHB and INHA levels were significantly lower than those in the control group(P＜0.01).ROC curve analy-sis showed that the area under the curve(AUC)of AMH was 0.65(95％CI:0.56-0.74,P＜0.01).When the Youden index was 26.85％and the cut off value was 37.19 ng/mL,it had relatively good sensitivity(88.85％)but relatively low specificity(38.00％).The AUC of INHB was 0.63(95％CI:0.57-0.70,P＜0.01).When the Youden index was 24.17％and the cut off value was 77.17 pg/mL,it had relatively poor sensitivity(38.17％)but relatively good specificity(86.00％).Both AMH and INHB have certain clinical val-ue in the differential diagnosis of boys with cryptorchidism.The AUC of INHA was 0.81(95％CI:0.79-0.84,P＜0.01).When the Youden index was 75.86％and the cut off value was 5.165 pg/mL,it had a rela-tively good sensitivity(77.86％)and specificity(98.00％).Conclusion The changes in the levels of serum AMH and INHB have certain diagnostic value for boys with cryptorchidism,while INHA has a good diagnos-tic value and can be used as an auxiliary diagnostic indicator for boys with cryptorchidism.

OBJECTIVE To screen for GJB2,mitochondrial DNA12S rRNA 1555A>G and SLC26A4 gene mutations in 27 non syndromic hereditary hearing loss families,clarify the genetic causes.METHODS 125 members from 27 deaf families were for questionnaire surveys,audiological examinations,and peripheral blood DNA extraction.The GJB2,SLC26A4,and mitochondrial DNA A1555G coding regions were amplified and directly sequenced.RESULTS Twelve families and 52 individuals were screened for deafness gene mutations,the detection rate in 27 families was 44%(12/27),and the detection rate in all the members was 42%(52/125).The detection rate of gene mutation for GJB2 is 31%(39/125),for SLC26A4 is 6%(8/125),and for mitochondrial DNA1555A>G mutation is 4%(5/125).CONCLUSION GJB2,SLC26A4 and mitochondrial A1555G have a high detection rate in families with hereditary deafness.Mutation screening of these three genes can clarify the genetic causes of most deafness families and can be used as genetic screening targets for hereditary deaf families.

Objective:To investigate the ameliorative effects of N-acetyl-D-mannosamine(ManNAc) on glucose and lipid metabolic disorders in obese mice.Methods:In vivo experiments were conducted using 21 four-week-old C57BL/6JGpt mice, randomly divided into three groups( n=7 per group): a normal control group, a high-fat diet(HFD) control grooup, and a ManNAc treatment group(400 mg·kg -1·d -1). The intervention lasted for 20 weeks. Body weight, food intake, and fasting blood glucose levels were monitored weekly. Glucose tolerance tests(GTT), insulin sensitivity tests(ITT), and respiratory metabolism monitoring were performed in the 17th, 18th, and 19th weeks, respectively. At the end of the experiment, whole-body fat distribution was assessed, and serum lipid profiles were measured. Liver and adipose tissue weights were recorded, and histological analyses including HE staining of liver, adipose and pancreatic tissues were performed. Liver transcriptome sequencing and quantitative real-time PCR(qPCR) were conducted to evaluate hepatic gene expression. In vitro, a hepatic steatosis model was established by inducing HepG2 cell with 0.4 mmol/L oleic acid, followed by treatment with 500 μg/mL ManNAc. Lipid accumulation was assessed using BODIPY staining, and the expression of lipid metabolism-related genes was quantified by qPCR. Results:ManNAc administration attenuated HFD-induced weight gain, reduced total body fat volume, and decreased liver and adipose tissue weights as well as intracellular lipid accumulation. Pancreatic islet numbers increased, while fasting blood glucose levels, glucose tolerance, and insulin sensitivity significantly improved. Serum levels of triglycerides, total cholesterol, and low-density lipoprotein levels were decreased, accompanied by enhanced energy expenditure. Additionally, hepatic expression of Cd36, Fabp3, and Scd1 was downregulated. In vitro, ManNAc significantly reduced lipid accumulation in HepG2 cells and downregulated the expression of Cd36, Fabp3, and Scd1 genes.Conclusion:ManNAc may improve glucose and lipid metabolism by modulating the PPARs-mediated fatty acid metabolic pathway, reducing lipogenesis, promoting fatty acid oxidation and energy expenditure, and enhancing insulin sensitivity, ultimately ameliorating disorders in obese mice.

Objective To investigate the distribution and antimicrobial resistance profiles of clinically isolated Haemophilus influenzae and Moraxella catarrhalis in hospitals across China from 2015 to 2021,and provide evidence for rational use of antimicrobial agents.Methods Data of H.influenzae and M.catarrhalis strains isolated from 2015 to 2021 in CHINET program were collected for analysis,and antimicrobial susceptibility testing was performed by disc diffusion method or automated systems according to the uniform protocol of CHINET.The results were interpreted according to the CLSI breakpoints in 2022.Beta-lactamases was detected by using nitrocefin disk.Results From 2015 to 2021,a total of 43 642 strains of Haemophilus species were isolated,accounting for 2.91％of the total clinical isolates and 4.07％of Gram-negative bacteria in CHINET program.Among the 40 437 strains of H.influenzae,66.89％were isolated from children and 33.11％were isolated from adults.More than 90％of the H.influenzae strains were isolated from respiratory tract specimens.The prevalence of β-lactamase was 53.79％in H.influenzae strains.The H.influenzae strains isolated from children showed higher resistance rate than the strains isolated from adults.Overall,779 strains of H.influenzae did not produce β-lactamase but were resistant to ampicillin(BLNAR).Beta-lactamase-producing strains showed significantly higher resistance rates to these antimicrobial agents than the β-lactamase-nonproducing strains.Of the 16 191 M.catarrhalis strains,80.06％were isolated from children and 19.94％isolated from adults.M.catarrhalis strains were mostly susceptible to both amoxicillin-clavulanic acid and cefuroxime,evidenced by resistance rate lower than 2.0％.Conclusions The emergence of antibiotic-resistant H.influenzae due to β-lactamase production poses a challenge for clinical anti-infective treatment.Therefore,it is very important to implement antibiotic resistance surveillance for H.influenzae and guide rational antibiotic use.All local clinical microbiology laboratories should actively improve antibiotic susceptibility testing and strengthen antibiotic resistance surveillance for H.influenzae.

Objective The optimum formulation process was selected to prepare the ethosomes of Cortex Dictamni-Fructus Kochiae,and its prescription was verified and its properties were studied.Methods The formulation was optimized by single factor and response surface test.The appearance,particle size,Zeta potential and stability were investigated.The encapsulation rate was used as the evaluation index.Results The optimum preparation process of ethosomes of Cortex Dictamni-Fructus Kochiae is as follows:Using the dosage of lyophilized powder 409.06 mg,soybean lecithin 258.07 mg,cholesterol 90.87 mg,ethanol volume fraction 22.76％,stirred for 2 hours at 700 r·min-1 at 50 ℃ water bath temperature,The appearance of the prepared ethosomes suspension was light yellow,and the particles were nearly spherical in shape.The average particle size was(103.1±0.78)nm,the Zeta potential was(-36.0±3.65)mV,and the average encapsulation rates of Xibutanone,ash,and saponin Ⅰc were(89.25±0.91)％,(80.16±1.52)％,(86.59±0.58)％,respectively.After 14 days of storage at room temperature,the results showed that:The ethosomal suspension is still a light yellow,uniform,and stable liquid,and there is no stratified precipitation phenomenon.Conclusion The method of ethanol injection is easy to operate,high encapsulation rate and good stability,which lays a foundation for further study on the skin administration of this preparation.