Objective:To explore the clinical efficacy of autologous platelet-rich plasma (PRP) in the treatment of acute injury to the anterior talofibular ligament (ATFL).Methods:A retrospective study was conducted to analyze the data of 96 patients who had been admitted to Department of Orthopedic Trauma Repair, The Nanhua Hospital Affiliated to Hengyang Medical School for acute ATFL injuries of grades Ⅰ & Ⅱ from January 2022 to December 2023. They were divided into 2 groups according to their different treatments. In the PRP group subjected to local PRP injection combined with conservative treatment, there were 49 patients (28 males and 21 females), with an age of (32.5±6.5) years. In the conservative group subjected to traditional conservative treatment, there were 47 patients (24 males and 23 females), with an age of (30.5±5.3) years. The 2 groups were compared in terms of visual analog scale (VAS) pain scores, talar anterior translations, Karlsson scores, American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot scores before and 6 months after treatment.Results:No statistically significant differences were observed in the baseline characteristics between the 2 groups before treatment, indicating comparability ( P>0.05). All patients were followed up for (9.1±1.7) months. In both groups, the VAS pain scores significantly decreased after treatment than the pre-treatment ones, the talar anterior translations significantly reduced after treatment than the pre-treatment ones, and the AOFAS and Karlsson scores significantly increased after treatment than the pre-treatment ones ( P < 0.05). After 6 months of treatment, the talar translation distance [(2.5±0.4) mm], AOFAS ankle hind foot score [(91.7 ± 4.0) points], and Karlsson score [(93.0±3.5) points] in the PRP group were significantly better than those in the conservative group [(6.1±0.9) mm, (87.1±4.3) points, (89.0±4.0) points]( P < 0.05). Conclusion:In the treatment of acute ATFL injury, PRP therapy demonstrates good clinical efficacy, for it can significantly reduce pain, promote functional recovery, and improve joint stability.

Objective:To investigate the prevalence of cardiometabolic multimorbidity (CMM) in Chinese middle-aged and elderly population, and the associated factors of cognitive function in CMM patients.Methods:It was a cross-sectional study. Data of demographic characteristics, lifestyle, chronic disease, and cognitive function in middle-aged and elderly subjects were obtained from the Harmonized CHARLS D version 2015 database, subjects with emotional and psychiatric disorders and memory-related disorders, and those with missing chronic disease data were excluded. The factors associated with cognitive function in CMM patients were analyzed with generalized linear regression model.Results:A total of 15 007 respondents aged (61.07±9.70) years were included in the analysis, 7 338 (48.9%) of whom were males. There were 3 303 cases of CMM with a prevalence rate of 22.01%, and the proportion of females was 54.9% (1 814/3 033), and the proportion of males was 45.1% (1 489/3 033). Generalized linear regression analysis showed that age, educational level, place of residence, depressive symptoms were correlated with cognitive function scores of CMM patients (all P<0.05). Conclusion:The prevalence rate of CMM in middle-aged and elderly people in China is higher, and age, education level, place of residence, depressive symptoms are associated with cognitive function in CMM patients.

Objective:To investigate the prevalence of cardiometabolic multimorbidity (CMM) in Chinese middle-aged and elderly population, and the associated factors of cognitive function in CMM patients.Methods:It was a cross-sectional study. Data of demographic characteristics, lifestyle, chronic disease, and cognitive function in middle-aged and elderly subjects were obtained from the Harmonized CHARLS D version 2015 database, subjects with emotional and psychiatric disorders and memory-related disorders, and those with missing chronic disease data were excluded. The factors associated with cognitive function in CMM patients were analyzed with generalized linear regression model.Results:A total of 15 007 respondents aged (61.07±9.70) years were included in the analysis, 7 338 (48.9%) of whom were males. There were 3 303 cases of CMM with a prevalence rate of 22.01%, and the proportion of females was 54.9% (1 814/3 033), and the proportion of males was 45.1% (1 489/3 033). Generalized linear regression analysis showed that age, educational level, place of residence, depressive symptoms were correlated with cognitive function scores of CMM patients (all P<0.05). Conclusion:The prevalence rate of CMM in middle-aged and elderly people in China is higher, and age, education level, place of residence, depressive symptoms are associated with cognitive function in CMM patients.

Objective:To explore the clinical efficacy of autologous platelet-rich plasma (PRP) in the treatment of acute injury to the anterior talofibular ligament (ATFL).Methods:A retrospective study was conducted to analyze the data of 96 patients who had been admitted to Department of Orthopedic Trauma Repair, The Nanhua Hospital Affiliated to Hengyang Medical School for acute ATFL injuries of grades Ⅰ & Ⅱ from January 2022 to December 2023. They were divided into 2 groups according to their different treatments. In the PRP group subjected to local PRP injection combined with conservative treatment, there were 49 patients (28 males and 21 females), with an age of (32.5±6.5) years. In the conservative group subjected to traditional conservative treatment, there were 47 patients (24 males and 23 females), with an age of (30.5±5.3) years. The 2 groups were compared in terms of visual analog scale (VAS) pain scores, talar anterior translations, Karlsson scores, American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot scores before and 6 months after treatment.Results:No statistically significant differences were observed in the baseline characteristics between the 2 groups before treatment, indicating comparability ( P>0.05). All patients were followed up for (9.1±1.7) months. In both groups, the VAS pain scores significantly decreased after treatment than the pre-treatment ones, the talar anterior translations significantly reduced after treatment than the pre-treatment ones, and the AOFAS and Karlsson scores significantly increased after treatment than the pre-treatment ones ( P < 0.05). After 6 months of treatment, the talar translation distance [(2.5±0.4) mm], AOFAS ankle hind foot score [(91.7 ± 4.0) points], and Karlsson score [(93.0±3.5) points] in the PRP group were significantly better than those in the conservative group [(6.1±0.9) mm, (87.1±4.3) points, (89.0±4.0) points]( P < 0.05). Conclusion:In the treatment of acute ATFL injury, PRP therapy demonstrates good clinical efficacy, for it can significantly reduce pain, promote functional recovery, and improve joint stability.

OBJECTIVE To investigate the effect of asiaticoside (AS) on endothelial-to-mesenchymal transition (EndoMT) in hypoxia pulmonary hypertension (HPH). METHODS Male Sprague-Dawley (SD) rats were divided into normoxia control group, hypoxia model group, and AS 25 and 50 mg · kg-1 group. Hypoxia model group and AS group were subjected to intermittent hypoxia exposure. Control group and model group received 1-1.5 mL saline daily, and AS groups were ig administrated with AS 25 and 50 mg·kg-1 for 4 weeks. Human pulmonary artery endothelial cells (HPAECs) were divided into normoxia control group and hypoxia AS groups. Hypoxia groups were cultured with AS 0, 25, 50, 100 and 200 mg·L-1 for 72 h under hypoxic (5%O2, 5%CO2) conditions. Anti-proliferation effect of AS was investigated by CCK-8 assay. Then, HPAECs were divided into normoxia control group, normoxia AS 100 mg · L-1 group, hypoxia model group, and hypoxia AS 100 mg · L-1 group. After five days of culture, migration ability of cells was detected by Transwell test. Expression of CD31 andα-SMA was detected by immunofluorescence and Western blotting in both in vivo and in vitro experiments. RESULTS In both in vivo and in vitro experiments, compared with normoxia control group, expression of CD31 was reduced (P<0.01) andα-smooth muscle actin (α-SMA) was increased (P<0.01) in hypoxia model group in both immunofluorescent analysis and Western blotting. Compared with hypoxia model group, expression of CD31 was increased andα-SMA was decreased (P<0.05, P<0.01) in AS treatment groups. Compared with normoxia control group, proliferation and migration ability of HPAEC were elevated in hypoxia model group (P<0.05). Compared with hypoxia group, AS 100 mg · L-1 depressed proliferation and migration of HPAEC under hypoxia exposure up to 72 h (P<0.05). CONCLUSION EndoMT might be involved in HPH and could be partly inhibited by AS.

Aim To investigate the relationship between monocyte chemoattractant protein-1(MCP-1) and pulmonary artery hypertension after acute pulmonary thromboembolism(PTE), and to explore the effects and mechanisms of resveratrol with MCP-1 in the acute PTE as well.Methods The acute PTE model of Sprague-Dawley rats was replicated using self-thrombosis.The rats were randomly divided into five groups(Normal, Solvent, acute PTE, antibody Cl142, and resveratrol), and 1h, 4h, 8h and 3 points were observed in each group.A model of acute PTE was established by infusion of an autologous blood clot into the pulmonary artery through a polyethylene catheter.Resveratrol or Cl142, dissolved in 1％ dimethyl sulfoxide(DMSO), was administered to the animals through caudalvein 1 h prior to the beginning of acute PTE modeling.Rats in normal control group and solvent control group were injected with normal saline and 1％ DMSO respectively.The mean pulmonary artery pressure(MPAP) and the mRNA and protein expression of MCP-1 were measured at each time point.Results ① The acute PTE group MPAP, MCP-1 mRNA and protein expression were significantly higher than those of the control group(P<0.05) at the same time;② The resveratrol group′s MPAP and MCP-1 mRNA, protein expression were significantly lower than those of the acute PTE group(P<0.05) at the same time;③ The Cl142 group MPAP and MCP-1 mRNA, protein expression were markedly reduced in the acute PTE group(P<0.05) at the same time.Conclusions The large expression of MCP-1 after acute PTE is involved in the formation of pulmonary hypertension after acute PTE.Resveratrol can reduce the pressure of pulmonary artery after acute PTE by down-regulating the MCP-1 expression.

The paper reviewed the history of drug price addition system and its impact on hospital management. Based on such facts,authors stated that the significance of abolishing drug price addition helped hospital management not to run their hospitals as a business, helped medical practitioners to make their clinical decisions based on medical needs, and to make the health care service deserve the professionals′value and contributions. Following the abolishment, the hospitals need to reform their internal operating mechanisms before they can achieve better performance.

The authors reviewed the practice of integrated health care delivery system( IDS) at home and abroad, and based on experiences of collaborations between medical service institutions in Zhejiang province,proposed the strategic positioning,responsibilities and service innovation of urban public hospitals in a regional medical service system. It is held that the direction of China′s health care reform should move towards IDS in the future,and such hospitals should play an active role in the process via integration of its own resource and provide multi-level,diversified services for the regional health care system.

OBJECTIVE To study the therapeutic effect and the underlying mechanism of asiatico?side on bleomycin-induced rat interstitial pulmonary fibrosis(IPF). METHODS Male Sprague-Dawley (SD)rats were divided into normal control group,bleomycin 5 mg·kg-1 model group and asiaticoside 50 mg · kg-1 group. The model and asiaticoside group were administrated with bleomycin 5 mg · kg-1 to induce IPF,while the asiaticoside group was administrated with asiaticoside 50 mg·kg-1 by gastric perfusion. Hematein eosin(HE)and Masson staining were carried out to analyze the histopathological changes in the lung. Lung homogenates were used to examine hydroxyproline(HYP) content,and serum samples were used to measure the concentration of interferon-γ(IFN-γ),interleukin-4(IL-4) and tumor necrosis factor-α(TNF-α). In addition,immunohistochemical methods were used to locate lung transforming growth factor-β1(TGF-β1)and adenosine 2A receptor(A2AR)expression,and Western blotting was used to examine the expression levels of TGF-β1 and A2AR. RESULTS On the 7th,14th and 28th days,the scores of pulmonary inflammation were higher in model group than in control group (P<0.01),and the asiaticoside group showed mitigated alveolitis(P<0.01,P<0.05) compared with model group. Compared with control group,the scores of pulmonary fibrosis in model group were elevated(P<0.01),and the asiaticoside group showed reduced pulmonary fibrosis(P<0.05). On the 14th and 28th days,HYP content in the model group〔1.85±0.10,(2.48±0.18)mg·g-1〕was higher than in the control group〔0.79 ± 0.07,(0.84 ± 0.08)mg · g-1〕(P<0.01),but HYP content in the asiaticoside group〔1.32±0.131,(1.71±0.13)mg·g-1〕was lower than in the model group(P<0.05). IL-4 and TNF-αin the asiaticoside group were lower than in model group(P<0.05),but were higher in the model group than in the control group(P<0.01,P<0.05). The expression level of TGF-β1 protein in the asiaticoside group was lower than in the model group(P<0.05),but was higher in the model group than in the control group(P<0.05). The expression level of A2AR protein in the asiaticoside group was higher than in the model group(P<0.05),but was lower in the model group than in the control group(P<0.05). CONCLUSION Asiaticoside can mitigate bleomycin-induced IPF by inhibiting the expression of IL-4, TNF-αand TGF-β1,and raising the level of A2AR.

AIM:To establish a fast , accurate and economical technique for culturing mouse pulmonary arte-riolar smooth muscle cells ( PASMCs ) , and to explore the effects of hypoxia on the proliferation and apoptosis of the PASMCs.METHODS:In sterile condition, the pulmonary artery was isolated from the male BALB/c mice by digesting with collagenase I, and the cells were cultured in fetal bovine serum-coated flask.Centrifugal procedure was not used dur-ing the cell passage .The cell morphology was observed under an inverted phase-contrast microscope .α-Smooth muscle ac-tin was identified by immunocytochemistry and immunofluorescence .The effects of hypoxia on the proliferation and apopto-sis of the PASMCs were detected by CCK-8 assay and TUNEL assay .RESULTS:PASMCs were identified by the methods of immunocytochemistry , immunofluorescence staining and observation of morphology .Unlike the rat PASMCs with typical subcultured peak-vally pattern, the mouse PASMCs showed a lot different without a peak-vally pattern.The cells could be subcultured after 5 d to 7 d and there was 3 to 5 generations depending on the activity of the cells .CCK-8 assay demonstra-ted that the A values of PASMCs exposed to hypoxia increased after 24 h ( P<0.05) as compared with normoxia .TUNEL result showed that the apoptotic index of the PASMCs in hypoxia decreased after 24 h (P<0.05).CONCLUSION:This technique for obtaining cultured mouse PASMCs is simple , fast, accurate and economical .The digestion time is easy to control.Hypoxia promotes the proliferation and inhibits the apoptosis of PASMCs .