Objective:To investigate effect and mechanism of hydroxysafflor yellow A(HSYA)activating neuronal autophagy on cerebral ischemia-reperfusion injury through a combination of in vitro and in vivo experiments.Methods:SD rat MCAO/R model was established by improved suture method.Rats were randomly divided into sham surgery(Sham)group,MCAO/R group and MCAO/R+HSYA group,following indicators were detected to determine extent of cerebral ischemia-reperfusion nerve damage:Z-Longa neu-rological function score was detected,TTC staining to measure cerebral infarction area,and TUNEL staining to measure cell apopto-sis;Western blot was used to detect protein expressions of autophagy related markers LC3,Beclin1,P62 and SIRT1 in rat brain tis-sue;immunofluorescence staining was used to observe expression of LC3 co-localization with neurons.OGD/R injury model of SH-SY5Y cells was established and randomly divided into Normal group,OGD/R group,OGD/R+HSYA group,OGD/R+SIRT1 inhibitor(EX-527)group and OGD/R+EX-527+HSYA group.Western blot was used to detect protein expressions of LC3,Beclin1,P62 and SIRT1.Results:Compared with Sham group,model group rats showed impaired neurological function,significantly increased neu-robehavioral scores,widespread cerebral infarction,significantly increased neuronal cell apoptosis,significantly increased autophagy related protein Beclin1 expression and LC3-Ⅱ/LC3-Ⅰ,significantly decreased P62 expression,significantly increased LC3/NeuN co-stained cells,and decreased SIRT1 expression;compared with model group,HSYA intervention group showed a significant decrease in neurological functional scores,a significant reduction in cerebral infarction area,a significant decrease in neuronal cell apoptosis,a further increase in Beclin1 expression and LC3-Ⅱ/LC3-Ⅰ,a further decrease in P62 expression,number of LC3/NeuN and P62/NeuN co-stained cells also increased,and SIRT1 expression significantly increased.Expression trends of Beclin1,LC3-Ⅱ/LC3-Ⅰ,P62 and SIRT1 of cells between normal group,model group and HSYA intervention group were same as animal experiment;compared with model group,expressions of SIRT1,Beclin1 and LC3-Ⅱ/LC3-Ⅰ in OGD/R+EX-527 group were significantly reduced,while expression of P62 was significantly increased;compared with OGD/R+EX-527 group,there was no significant change in SIRT1 expression in OGD/R+EX-527+HSYA group,LC3-Ⅱ/LC3-Ⅰ and Beclin1 expression were significantly increased,and P62 expres-sion was significantly decreased.Conclusion:HSYA can significantly improve neurological deficits in rats after cerebral ischemia-reperfusion,reduce cerebral infarction area,and decrease neuronal cell apoptosis rate,whose neuroprotective effect may be related to its activation of SIRT1,which significantly enhances neuronal autophagy.

The incidence of osteoarthritis(OA)has been gradually increasing among China's middle-aged and elderly population, creating a significant burden on healthcare systems.As the co-morbidity patterns of metabolic diseases and OA are increasingly being explored, OA is being redefined as a systemic disease driven by metabolic inflammation.This article focuses on the interactions between metabolic disorders and chronic inflammation in OA, summarizing the regulation of OA through cross-organ interaction mechanisms.The aim is to deepen the understanding of the complex pathophysiological network of OA and to propose potential new therapeutic directions.

Objective:To investigate effect and mechanism of hydroxysafflor yellow A(HSYA)activating neuronal autophagy on cerebral ischemia-reperfusion injury through a combination of in vitro and in vivo experiments.Methods:SD rat MCAO/R model was established by improved suture method.Rats were randomly divided into sham surgery(Sham)group,MCAO/R group and MCAO/R+HSYA group,following indicators were detected to determine extent of cerebral ischemia-reperfusion nerve damage:Z-Longa neu-rological function score was detected,TTC staining to measure cerebral infarction area,and TUNEL staining to measure cell apopto-sis;Western blot was used to detect protein expressions of autophagy related markers LC3,Beclin1,P62 and SIRT1 in rat brain tis-sue;immunofluorescence staining was used to observe expression of LC3 co-localization with neurons.OGD/R injury model of SH-SY5Y cells was established and randomly divided into Normal group,OGD/R group,OGD/R+HSYA group,OGD/R+SIRT1 inhibitor(EX-527)group and OGD/R+EX-527+HSYA group.Western blot was used to detect protein expressions of LC3,Beclin1,P62 and SIRT1.Results:Compared with Sham group,model group rats showed impaired neurological function,significantly increased neu-robehavioral scores,widespread cerebral infarction,significantly increased neuronal cell apoptosis,significantly increased autophagy related protein Beclin1 expression and LC3-Ⅱ/LC3-Ⅰ,significantly decreased P62 expression,significantly increased LC3/NeuN co-stained cells,and decreased SIRT1 expression;compared with model group,HSYA intervention group showed a significant decrease in neurological functional scores,a significant reduction in cerebral infarction area,a significant decrease in neuronal cell apoptosis,a further increase in Beclin1 expression and LC3-Ⅱ/LC3-Ⅰ,a further decrease in P62 expression,number of LC3/NeuN and P62/NeuN co-stained cells also increased,and SIRT1 expression significantly increased.Expression trends of Beclin1,LC3-Ⅱ/LC3-Ⅰ,P62 and SIRT1 of cells between normal group,model group and HSYA intervention group were same as animal experiment;compared with model group,expressions of SIRT1,Beclin1 and LC3-Ⅱ/LC3-Ⅰ in OGD/R+EX-527 group were significantly reduced,while expression of P62 was significantly increased;compared with OGD/R+EX-527 group,there was no significant change in SIRT1 expression in OGD/R+EX-527+HSYA group,LC3-Ⅱ/LC3-Ⅰ and Beclin1 expression were significantly increased,and P62 expres-sion was significantly decreased.Conclusion:HSYA can significantly improve neurological deficits in rats after cerebral ischemia-reperfusion,reduce cerebral infarction area,and decrease neuronal cell apoptosis rate,whose neuroprotective effect may be related to its activation of SIRT1,which significantly enhances neuronal autophagy.

The incidence of osteoarthritis(OA)has been gradually increasing among China's middle-aged and elderly population, creating a significant burden on healthcare systems.As the co-morbidity patterns of metabolic diseases and OA are increasingly being explored, OA is being redefined as a systemic disease driven by metabolic inflammation.This article focuses on the interactions between metabolic disorders and chronic inflammation in OA, summarizing the regulation of OA through cross-organ interaction mechanisms.The aim is to deepen the understanding of the complex pathophysiological network of OA and to propose potential new therapeutic directions.

Objective:To observe the therapeutic effect of Shengsan Jiedu Huayu decoction in alleviating inflammatory liver injury in rats with acute-on-chronic liver failure (ACLF) and its effect on the activation intensity for the NLRP3 signaling pathway.Methods:63 SD rats were randomly divided into a blank group, a model group, and low-, medium-, and high-dose groups of Shengsan Jiedu Huayu decoction (7.29 g/kg/d, 14.58 g/kg/d, and 29.16 g/kg/d). The ACLF rat model was replicated using carbon tetrachloride combined with d-galactosamine and lipopolysaccharide. Different dose gradients of the Shengsan Jiedu Huayu decoction were used for a five-day intervention treatment, and then rat serum and tissue samples were collected. A biochemical analyzer was used to detect the serum levels of ALT, AST, and TBIL in rats. ELISA was used to detect serum IL-18 and IL-1β content. HE staining was used to observe histomorphological changes in liver tissue. Immunohistochemistry was used to detect GSDMD expression in liver tissue. Western blot and PCR were used to detect NLRP3, Caspase1, ASC, TLR4, IL-1β, IL-18 protein, and mRNA expression levels.The groups were compared using analysis of variance and the rank-sum test.Results:Compared with the blank group, the model group’s rat liver tissue was severely injured. Serum levels of ALT, AST, and TBIL, inflammatory factors IL-1β and IL-18, and the GSDMD protein expression level, NLRP3 expression level, TLR4, caspase 1, ASC, IL-1β, IL-18 protein, and mRNA ( P<0.01) were all significantly increased in the model than the blank group ( P<0.01). Additionally, compared with the model group, the low-, medium-, and high-dose groups of Shengsan Jiedu Huayu decoction had improved liver tissue injury in ACLF rats, while the serum levels of ALT, AST, TBIL, IL-1β, IL-18, liver tissue GSDMD protein, NLRP3, TLR4, caspase 1, and ASC expressions were all lower in the different dose gradients of the Shengsan Jiedu Huayu decoction than the model group, with the most evident reduction in the high-dose group ( P<0.01). Conclusion:Shengsan Jiedu Huayu decoction can weaken the activation intensity of the NLRP3 signaling pathway, alleviate liver tissue pathological injury, reduce inflammatory factor release, and alleviate inflammatory liver injury in ACLF rats.

Objective:To summarise the effect of free perforator flap of radial collateral artery on reconstruction of first web contracture after hand injury.Methods:Retrospective analysis was conducted based on the clinical data of patients with first web contracture after hand injury in the Department of Hand and Foot Surgery and Rehabilitation, Guangdong Work Injury Rehabilitation Hospital from November 2019 to June 2022. Ten patients, 8 males and 2 females aged between 27 and 51 years old with an average of 40.5 years old were included. There were 6 left hands and 4 right hands. Width and the included angle of first web were measured before surgery. Four hands were classified as severe first web contracture, and the rest of 6 hands had moderate first web contracture. After release scars of the first web, the areas of wound were 5.5 cm × 2.0 cm - 10.5 cm × 3.0 cm. The flaps sized were 6.0 cm×2.5 cm - 11.0 cm × 3.5 cm. All of flaps carried the posterior cutaneous nerve of forearm. Donor sites were closed directly. All patients were included in postoperative follow-up regularly through outpatient clinic or via WeChat reviews. The colour, texture, process in change of the transferred flaps, donor and recipient sites healing and complications were observed.Results:All 10 flaps survived and the wound healed by first intention. The patients received 7 to 15 months (10.5 months in average) of postoperative follow-up. The flaps were not bulky, texture and colour were satisfactory and without pigmentation. Protective sensations restored in 6 patients. At the last follow-up, average included angle of the first webs was 47.14°±1.68°, in comparison with 35.43°±3.60° before surgery. The average width of first webs was 5.34 cm±0.52 cm, in comparison with 3.17 cm±0.75 cm before surgery, the differences were statistically significant ( P<0.01). Eight hands were rated excellent, and 2 were good. There were only linear scars left at the donor sites, without sign of radial nerve injury. Conclusion:The free perforator flap of radial collateral artery is a safe and effective method for repair of first web contracture after hand injury.

Objective:To compare the efficacy and safety between WangShiBaoChiWan and mosapride in the treatment of functional dyspepsia (FD).Methods:From September 2019 to September 2020, patients with postprandial fullness and early satiation who met the Rome Ⅳ criteria for FD diagnosis were enrolled from 15 hospitals, including the First Affiliated Hospital of Naval Medical University (Shanghai Changhai Hospital), Beijing Traditional Chinese Medicine Hospital Affiliated to Capital Medical College. The subjects were randomly divided into WangShiBaoChiWan (experimental) group and mosapride (control) group in the ratio of 1∶1. The treatment regimens were WangShiBaoChiWan+ mosapride simulator, WangShiBaoChiWan simulator+ mosapride, respectively with a treatment period of 2 weeks. The primary efficacy outcome was the improvement rates of main symptoms before and after treatment, the secondary efficacy primary efficacy outcome was the total clinical effective rate and the change of the single symptom score. And the safety indicator included adverse events. Independent sample t-test, paired t-test and chi-square test were used for statistical analysis. Results:A total of 251 FD patients were enrolled in the full analysis set, including 124 in the experimental group and 127 in the control group; 241 FD patients were in the per-protocol analysis set, including 117 in the experimental group and 124 in the control group. The analysis of per-protocol analysis set showed that the improvement rates of the main symptoms of the experimental group and the control group were (66±29)% and (60±30)%, respectively, and the difference was not statistically significant ( P>0.05). The improvement rate of the main symptoms of the experimental group reached 117% of that of the control group, which exceeded the expected non-inferiority standard of 80%. The total clinical effective rates of the experimental group and the control group were 76.07% (89/117) and 75.81% (94/124), respectively, and the difference was not statistically significant ( P>0.05). The results of full analysis set showed that the incidence of adverse events of the experimental group and the control group was 1.62% (2/124) and 1.57% (2/127), respectively, and the difference was not statistically significant ( P>0.05). There were no serious adverse events in the two groups. Conclusion:The improvement rate of the main symptoms of WangShiBaoChiWan is not inferior to that of mosapride in the treatment of FD, and it has good safety.

Objective:To estimate the mental symptoms in malignant tumor patients undergoing chemotherapy using DSM-5 cross cutting symptom measure.Methods:A total of 314 patients who undergoing chemotherapy in oncology department of Zhongshan Hospital, Fudan University who met all standards were chosen. The DSM-5 cross cutting symptom measure Level 1 Scale was used to assess the mental symptoms of the patients. SPSS 25.0 software was used for χ 2 test, Pearson correlation analysis and multiple regression analysis. Results:The most common symptoms in the patients were depressive symptoms(85/314, 27.1%), somatic symptoms (79/314, 25.2%), manic symptoms (78/314, 24.5% ) and anxiety symptoms (76/314, 24.3%). The proportion of anxiety symptoms in malignant tumor patients who were taken care of by other personnel(26/64, 40.6%) was significantly higher than that in patients who were taken care of by immediate relatives(50/250, 20.0%)(χ 2=12.23, P<0.05). Patients with unstable working conditions were more likely to have depressive symptoms (χ 2=7.64, P<0.05). There was a significant negative correlation between the patients' understanding of the disease and their scores of depressive symptoms, somatic symptoms, manic symptoms, anxiety symptoms and the total score of mental symptoms( r= -0.26, -0.15, -0.12, -0.25, -0.22, all P<0.05). In addition, the total score of mental symptoms of malignant tumor patients was significantly positively correlated with family burden and family status( r=0.11, 0.11, both P<0.05), and negatively correlated with patients' education ( r=-0.13, P<0.05). Multiple regression analysis showed that the degree of understanding of the disease( β=-0.203) and family status( β=0.197) were the influencing factors of mental symptoms of inpatients malignant tumors undergoing chemotherapy in general hospital ( F=13.653, P<0.001). Conclusion:Malignant tumor patients undergoing chemotherapy may have a variety of mental symptoms. The high incidence mainly includes depressive symptoms, somatic symptoms, manic symptoms and anxiety symptoms. The understanding of the patients to the disease and family situation are the main influencing factors.

Objective To detect the spatial clustering and high risk areas of pulmonary tuberculosis (PTB) in Sichuan province in 2018 and,to compare the effects of application on both SaTScan 9.4.1 software and FleXScan 3.1.2 software to detect the PTB spatial clusters.Methods Geographic information database was established by using the incidence data of PTB and demographic data reported in the'China disease prevention of infectious disease reporting information management system'in Sichuan province in 2018.Spatial clustering analysis was conducted using the Poisson model in software SaTScan 9.4.1 and FleXScan 3.1.2 to detect the high risk areas of PTB by software ArcGIS 10.5.Differences of clusters locations and scopes in the two scanning methods were compared.Results The reported incidence rate of PTB was 57.34/100 000 (47 601 cases) in Sichuan province in 2018,presenting an obvious clustering distribution.SaTScan and FleXScan scanned 8 and 10 clusters showed statistically significant differences (P＜0.05),with log-likelihood ratio (LLR) as 24.62-2 416.05 and 1.48-2 618.96,respectively.Results from scanning of the two methods showed that the most likely clusters appeared in the Daliangshan and Xiaoliangshan of Liangshan Yi ethnic aggregation areas.The other clustering areas would include some minority areas in the western Sichuan plateau,detected by both two methods differences in the shape and scope of the clustering were detected by both methods.The clustering scopes detected by SaTScan covered some counties,in which the actual incidence was not high.FleXScan could distinguish the clusters and detect more irregular shaped clusters.Conclusions Obvious spatial clusters of PTB distribution were found in Sichuan in 2018.Areas of Daliangshan,Xiaoliangshan and the minority areas in Western Sichuan plateau appeared at high risk,suggesting these were the key areas for prevention and control.FleXScan seemed more conducive in accurately distinguishing the "cold spot" areas in the highly aggregated areas,and more suitable for the application of spatial clustering detection for TB,in Sichuan province.

Objective To evaluate the method and clinical efficacy of utilizing ilioinguinal chimeric perforator bone flap to repair bone and soft tissue defects of limb.Methods From May,2004 to February,2018,there were 11 patients who were diagnosed as bone and soft tissue defect in the upper or lower extremities,7 of which were repaired by chimeric perforator bone flap with the superficial circumflex iliac artery and 4 of which were repaired by chimeric perforator bone flap with the deep circumflex iliac artery.The size of bone flap ranged from 2.5 cm×2.0 cm× 2.0 cm to 6.0 cm×3.0 cm×2.0 cm,and the flap sizes ranged from 5.0 cm×3.0 cm to 17.0 cm×13.0 cm.The donor sites of the flap were directly sutured.Nine patients were implemented by postoperative followed-up visit in hospital.And the appearance,texture,color,shallow sensation of flaps,fracture healing,limb's function and donor site were observed.Results Postoperative followed-up ranged from 3 to 18 months.All flaps survived.The flaps had satisfactory appearance,texture and color.Osseous tissue of defects healed.The function of injury limb was restored well,which metacarpo-phalangeal joint and carpometacarpal joint's movement with metacarpal defect recovered,and gait were normal without pain.As for the donor sites,1 case had hyperplastic scar while the other only had linear scars.Abdominal hernia and numbness with lower extremities were disappeared.Conclusion Ilioinguinal chimeric perforator bone flap can be designed with different pedicles based iliac bone flap according to the size of bone defects.The donor site is concealed with less trauma and less healing time.The operation position is easy to operate,and clinic efficacy is satisfactory.