Objective To explore the regulation of Chaihuang Qingyi Huoxue Granule on intestinal microecological changes in rats with severe acute pancreatitis (SAP) and the potential mechanism for its treatment of SAP. Methods Forty-eight rats were randomly divided into sham operation group (SHAM),SAP model group (SAP),and Chaihuang Qingyi Huoxue Granule (CH)group,with 16 rats in each group. Each group was further divided into 12 h and 24 h subgroups. The SAP model was induced by retrograde injection of 5％ sodium taurocholate into the pancreaticobiliary duct through duodenal wall. The SHAM and SAP groups received normal saline by gavage,while the CH group received 1.2 g·kg-1 Chaihuang Qingyi Huoxue Granule solution by gavage every six hours. At 12 h and 24 h after operation,eight rats from each group were sacrificed to collect abdominal aortic blood,pancreatic and ileal tissues for analysis. Ascites,pancreatic and ileal tissues were observed. Serum amylase(AMY) and lipase (LPS) levels were measured biochemically. Pathological changes in pancreatic and ileal tissues were investigated by HE staining. Claudin-1 protein expression in ileal tissue was detected by Western Blot. Changes in the intestinal flora of ileocecal contents were analyzed by 16S rDNA high-throughput sequencing. Results Compared to the SHAM group at the same time points,the SAP group exhibited extensive pancreatic edema and necrosis. Serum AMY and LPS levels,pancreatic and ileal histopathological scores increased,and Claudin-1 protein expression in ileal tissue markedly decreased (all P<0.05). The differences in abundance of microbial community increased,while the evenness of community composition reduced. The microbial richness showed no significant change (P>0.05),but the microbial diversity decreased(P<0.05). Proteobacteria were dominant intestinal bacteria. Relative abundances of Oscillospira,Ruminococcus,Bifidobacterium,and Bacteroides S24-7 decreased,whereas relative abundances of Shigella and Allobaculum increased. The differences in abundance of microbial community reduced,and the evenness of community composition increased. The microbial richness showed no significant change(P>0.05),but the microbial diversity increased (P<0.05). Firmicutes and Bacteroidetes were the dominant intestinal bacteria. Relative abundances of Oscillospira,Ruminococcus,Bifidobacterium,and Bacteroides S24-7 increased,whereas relative abundances of Shigella and Allobaculum decreased. After the intervention of CH,pathological damage in ileal tissue was improved. The expression of Claudin-1 protein in the intestinal mucosal barrier increased compared to the model group(P<0.05). The differences in abundance of microbial community reduced,and the evenness of community composition increased. CH group showed an increase in some beneficial bacteria and decrease in pathogenic bacteria compared to model group. Conclusion Chaihuang Qingyi Huoxue Granule may reduce pancreas injury in rats with SAP,which may be involved in modulating the intestinal microecology and improving intestinal mucosal barrier function.

OBJECTIVE: To summarize the clinical features, surgical methods, and prognosis of bucket-handle meniscal tears (BHMTs), and provide guidance for clinical treatment. METHODS: The clinical data of 91 BHMTs patients (91 knees), who met the selection criteria and were admitted between January 2015 and January 2021, was retrospectively analyzed. There were 68 males and 23 females. Age ranged from 16 to 58 years with an average of 34.4 years. The injury was caused by sports in 68 cases, traffic accident in 15 cases, and falls or sprains in 8 cases. There were 49 cases of left knee injury and 42 cases of right knee injury. The time from the onset of symptoms to the admission ranged from 1 day to 13 months (median, 18 days), including >1 month in 35 cases and ≤1 month in 56 cases. Medial BHMTs occurred in 52 cases and lateral BHMTs in 39 cases. There were 36 cases with ACL rupture and 12 cases with discoid meniscus. The knee extension was limited more than 10° in 55 cases. According to the condition of meniscus injury, the meniscus suture with Inside-out combined with All-inside techniques (54 cases) or meniscoplasty (37 cases) under arthroscopy were selected. ACL reconstruction was performed in all patients with ACL rupture with autogenous hamstring tendon. Postoperative complications were observed. International Knee Documentation Committee (IKDC) score, Lysholm score, and Tegner score were used to evaluate knee function, and clinical failure was recorded. RESULTS: Two patients developed intermuscular venous thrombosis, which improved after oral anticoagulant therapy. No vascular injury, postoperative infection, joint stiffness, or other complications occurred in all patients. All patients were followed up 24-95 months, with a median of 64 months. A total of 12 cases (13.19%) failed the operation and were re-operated or given oral anti-inflammatory analgesics and rehabilitation therapy. At last follow-up, IKDC score and Lysholm score of 91 patients significantly increased when compared with those before operation ( P<0.05), while Tegner score significantly decreased ( P<0.05). The above indexes of patients treated with meniscus suture and meniscoplasty were also significantly different from those before operation ( P<0.05). CONCLUSION BHMTs occurs mostly in young men and is one of the important reasons for the limitation of knee extension after trauma. Arthroscopic meniscus suture and meniscoplasty can obtain good effectiveness according to individual conditions of patients. But the latter can better preserve the shape and function of meniscus, and theoretically can obtain better long-term outcomes, which needs to be confirmed by further research with larger sample size.
Male ; Female ; Humans ; Adolescent ; Young Adult ; Adult ; Middle Aged ; Treatment Outcome ; Retrospective Studies ; Meniscus ; Knee Joint/surgery* ; Menisci, Tibial/surgery* ; Knee Injuries/diagnosis* ; Rupture ; Tibial Meniscus Injuries/surgery* ; Arthroscopy/methods* ; Anterior Cruciate Ligament Injuries/surgery*

Objective To explore the diagnostic value of MRI in adnexal torsion.Methods A retrospective study was conducted on 32 patients with adnexal torsion confirmed by surgery and pathology.The MRI features were analyzed in combination with clinical data.Results Among the 32 cases of adnexal torsion,there were 12 cases of ovarian cyst,5 cases of cystic ovarian teratoma,4 cases of theca cell tumor,6 cases of ovarian cystadenoma,1 case of high-grade serous carcinoma,1 case of corpus luteum hematoma,1 case of simple ovarian torsion,1 case of ovarian goiter,1 case of fibrotheca cell tumor with serous cystadenoma;There were 13 cases on the left side and 19 cases on the right side;The torsion angle of adnexal was about 90 °-1 440 °.MRI showed that 13 of 32 patients were cystic masses and 19 were cystic solid masses;torsion pedicle can be seen near the mass,of which 13 cases showed"whirlpool sign",27 cases showed"T2WI dot low signal sign",10 cases showed"nodule sign",5 cases showed"triangle sign",and 9 cases had structural disorder around the mass.Enhancement showed no obvious enhancement in 12 cases,and mild enhancement in 20 cases.Thirty cases complicated with pelvic effusion;The uterus moved to the affected side in 9 cases,to the healthy side in 20 cases,and no obvious deviation in 3 cases.Conclusion The MRI imaging features of adnexal torsion are characteristic,which are cystic or cystic solid lesions.The torsion pedicle is characterized by"whirlpool sign"and"T2WI dot low signal sign",etc.The enhancement is mild or no enhancement.Combined with the clinical history,it is of great value for the preoperative diagnosis and treatment of adnexal torsion.

Objective To study the protein binding rates ofgardenioside,paeoniflorin and naringin in Weiyanling granules in bovine serum albumin,rat plasma and human plasma.Methods The equilibrium dialysis method was carried to determine the binding-rates of three components in Weiyanling granules in bovine serum albumin,rat plasma and human plasma.The HPLC method was used to determine the mass concentration of three components in weiyanling granules in inner and outer dialysis and to calculate the plasma protein-binding rates.Results The linear relationship,precision,extraction recovery and stability of gardenoside,paeoniflorin and naringin all conformed to the methodological requirements.Within the low,middle and high concentration (5.084,10.04 and 20.08 g/L) of Weiyanling granules,the protein-binding rates of gardenioside and bovine serum albumin were 23.77％ ± 13.39％,10.75％ ± 1.34％,5.82％ ± 6.53％,respectively;the protein-binding rates of paeoniflorin were 51.81％ ± 6.53％,30.12％ ± 6.61％,21.39％ ± 9.45％,respectively;the protein-binding rates of naringin were 70.21％ ± 3.31％,67.61％ ± 1.31％,56.00％ ± 3.46％,respectively;the protein-binding rates of gardenioside and rat plasma were 71.56％ ± 3.00 ％,43.56％ ± 12.22％,40.63％ ± 4.73％,respectively;the protein-binding rates ofpaeoniflorin and rat plasma were 55.72％ ± 1.60％,47.59％ ± 6.33％,40.07％ ± 0.72％,respectively;the protein-binding rates of naringin and rat plasma were 85.85％ ± 3.53％,85.38％ ± 0.99％,79.99％ ± 2.57％,respectively;the protein-binding rates of gardenioside and human plasma were 13.56％ ± 2.40％,3.02％ ± 2.41％,5.82％ ± 2.08％,respectively;the protein-binding rates of paeoniflorin and human plasma were 9.49％ ± 5.23％,5.01％ ± 1.10％,3.98％ ± 1.54％,respectively;the protein-binding rates of naringin and human plasma were 25.04％ ± 2.61％,26.09％ ± 13.82％,20.20％ ± 2.24％,respectively.Conclusions Within 5.084,10.04 and 20.08 g/L,the protein binding-rate of gardenioside,paeoniflorin and naringin were shown asfollow,rat plasma ＞bovine serum albumin ＞ human plasma.There were significant differences in species.

Objective To investigate the clinical application of SWI in detecting calcifications of vertebral artery wall.Methods 1 95 patients who accepted craniocerebral CT scans,and MRI scans (includingT1 WI,T2 WI,T2 GFLAIR,SWI)in recent three years in the Affiliated Hospital of Binzhou Medical University were reviewed.Taking CT as a standard,the calcification of intracranial vertebral artery wall was analyzed using conventional MRI and SWI sequences,and their sensitivities and specificities were calculated.Correlations among various imaging modalities were assessed by measuring the maximum diameter of calcifications.Results The sensitivity of SWI was 93%, and the specificity of SWI was 9 9%.The sensitivity of conventional MRI was 3 1%,and the specificity of conventional MRI was 9 1%. The correlation between SWI and CT was R2＝0.77 (0.60－0.89),while the correlation between conventional MRI and CT was R2＝0.22 (0.02－0.80).Conclusion SWI has high sensitivity and specificity in detecting calcification of intracranial vertebral artery wall,and has a good correlation with CT in measuring calcification,which can be a inspection method to detect calcification of intracranial vertebral artery wall.

Objective To evaluate the accuracy of measurements of atherosclerotic middle cerebral artery (MCA) stenosis with 3.0 T high-resolution magnetic resonance imaging (HR-MRI).Methods Forty patients with symptomatic atherosclerotic stenosis of middle cerebral artery (MCA) confirmed by digital subtraction angiography (DSA) in the Affiliated Hospital of Binzhou Medical College from September 2017 to May 2018 were enrolled in the study.Patients were scanned by HR-MRI sequence (including T1WI,T2WI,PDWI).The MCA M1 stenosis rate on HR-MR images was assessed by warfarin-aspirin symptomatic intracranial artery disease (WASID) method and area measurement algorithm,respectively,and based on the stenosis rate the degree of stenosis (semi-quantitative measurement) was determined.The accuracy of the two measurement methods was evaluated with DSA results as the gold standard.Results The HR-MRI images showed the structure of the vessel wall clearly in 30 patients meeting the measurement requirements.The inner edge of the vessel was clearly distinguishable and smooth,showing eccentric stenosis.The stenosis rate of MCA measured by DSA,WASID method and area measurement algorithm were (82± 17)％,(70± 12)％,(81 ± 16)％,respectively (P＞0.05).The result of area measurement algorithm was better correlated with DSA (r=0.893);and the coincidence of the stenosis degree rate of two measurement method was 90％(27/30).Conclusion The area measurement algorithm based on the HS-MRI has high accuracy in measuring the degree of MCA stenosis,which is of high clinical application value.

Objective To establish a method for the simultaneous content determination ofquercetin,kaempferol and pinocembrin in Penthorum Chinense Pursh.Methods The HPLC analysis was carried out on Alltima C18 (250 mm × 4.6 mm,5 μm) with a mixture of methanol-0.2％ phosphate (45:55) as the mobile phase.The determination wavelength was set at 270 nm with the flow rate of 1.0 ml/min.The column temperature was set at 30 ℃.Results The quercetin,kaempferol and pinocembrin showed good linearity in the range of 0.316-10.120 μg (r=0.999 9),0.012-0.397 μg (r=0.999 6) and 0.063-2.016 μg (r=0.999 8) respectively.The average recovery rates of quercetin,kaempferol and pinocembrin were 99.34％ (RSD=1.51％),99.76％ (RSD=l.96％) and 98.34％ (RSD=1.56％) respectively.Conclusions The method is accurate and sensitive,which can be used for the content determination of quercetin,kaempferol and pinocembrin in Penthorum Chinense Pursh.

Objective To evaluate the clinical effect of arthroscopic treatment of femoroacetabular impingement syndrome(FAI) for patients over 50 years old,and explore the occurrence regularity and treating rules for such a disease.Methods The clinical data of 71 patients(78 hips with FAI) over 50 years old who underwent arthroscopic treatment for FAI in our department between May 2012 and May 2017 were studied retrospectively.Physical examination,X-ray and CT 3D scans were made preoperatively for explicit diagnosis.The follow-up period ranged from 6 to 66 months,with an average of 31.78 ± 18.07 months.Every patient had a joint space greater than 2 mm,and a grade Ⅰ or Ⅱ hip osteoarthrosis according to the Trnnis scale.Under the hip arthroscopy the synovial hyperplasia was cleaned,the damaged labrum and cartilage were repaired,and the femoroacetabular hyperplasia and the impingement factors were removed to restore the normal shape of femoroacetabular.The joint clearance,changes ofthe alpha angle when at Dunn position and centre edge(CE) angle at normotopia on the X-ray,the intraoperative injuries of cartilages and glenoid labrum and surgical satisfaction and complications were measured and recorded.The modified Harris hip score(mHHS) and visual analogue scale(VAS) were used to evaluate the hip function recovery and pain relief of patients.Results The average age of the patients was 55.15 ± 5.02 years old,ranging from 50 to 69.Among the 23 males and 48 females,there were 33 left hips with FAI and 45 right hips with FAI.The average preoperative joint clearance was 4.81 ± 0.87 mm,and all incisions were healed by first intention after the treatment.The average α angle of the patients decreased from 50.11 ± 4.75 to 42.72 ± 4.7 degrees after the treatment,with the α angle of 7 patients(8.97％) bigger than 55 degree,and that of 40 patients(51.28％) smaller than 50 degree.The average CE angle decreased from 36.54 ± 9.14 degrees to 35.19 ± 8.55 degrees after the treatment,with that of 27 patients(34.62％) bigger than 40 degrees.Before the treatment,the main clinical manifestations were hip pain and swelling,including 36 cases(46.15％) with hip joint lock,70 (89.74％) with groin tenderness.Moreover,75 cases(96.15％) were positive in hip adduction internal rotation test(FADIR) and 64 cases(83.33％) were positive in the hip abduction and external rotation impingement test.However,the pain was relieved or disappeared after the treatment.The average VAS score decreased significantly from preoperative 4.42 ± 1.42 points to 1.31 ± 1.28 at the last follow-up,while the average mHHS score increased significantly from preoperative(52.4 ± 19.38) points to(81.72 ± 10.82) during the last follow-up,and the difference was statistically significant (P＜0.01).Significant improvement was observed in the mHHs and VAS scores of 89％ patients(P＜0.01).1 patient(1.28％) underwent hip replacement during the follow-up period.No serious complications occurred.Conclusion In most cases,arthroscopic treatment of FAI in old patients(over 50 years old),who were with osteoarthrosis and hip labrum injury,can significantly improve the joint function and relieve pain.It is a treatment with safety.

OBJECTIVE:To establish a method for simultaneous determination of hyperoside,quercitrin,luteoloside, kaempferol,quercetin,rutin,luteolin and isorhamnetin in total flavanones of Sedum sarmentosum Bunge. METHODS:UPLC-MS/MS method was adopted. The determination was performed on ZOBAX SB C18column with mobile phase consisted of methanol-5 mmol/L ammonium formate aqueous solution(45:55,V/V)at the flow rate of 0.4 mL/min. The column temperature was 30 ℃, and sample size was 2 μL. The electrospray ionization source(ESI)was used;ion source temperature was 400 ℃;desolvation temperature was 300 ℃;desolvation gas flow was 600 L/h;capillary voltage was 3 000 V;nebuliser pressure was 45 psi;the work mode was multiple reaction monitoring mode;detection mode was negative ion mode. The established method was used to determine the contents of 8 components in 3 batches of total flavanones of Sedum sarmentosum Bunge. RESULTS:The linear ranges of hyperoside,quercitrin,luteoloside,kaempferol,quercetin,rutin,luteolin and isorhamnetin were 10.0-640.0,0.5-32.0, 4.5-288.0,8.0-512.0,50.0-3 200.0,2.0-128.0,12.5-800.0 and 25.2-1 612.8 ng/mL(r≥0.991 4),respectively. The limits of detection were 5.0,0.25,2.25,4.0,25.0,1.0,6.25 and 12.6 ng/mL,respectively.The limits of quantitation were 10.0,0.5,4.5, 8.0,50.0,2.0,12.5 and 25.2 ng/mL,separately. RSDs of precision,stability(24 h)and reproducibility tests were no more than 4.3%(n=6). The recoveries were 95.9%-100.6%,and RSDs were 1.5%-3.8%(n=6). The contents of hyperoside,quercitrin, luteoloside,kaempferol,quercetin,rutin,luteolin and isorhamnetin in 3 batches of total flavanones of Sedum sarmentosum Bunge were 507.88-560.37,42.95-50.36,63.52-71.80,1 695.10-1 753.27,10 569.28-10 612.99,25.76-30.13,2 795.22-2 877.43 and 4 869.55-4 971.30 μg/g,respectively. CONCLUSIONS:The established method can be used for simultaneous determination of 8 components in total flavanones of Sedum sarmentosum Bunge.

Objective To explore the imaging features of appendiceal mucinous neoplasms and their correlation with the pathology results.Methods The imaging data of 1 6 patients with histopathology proved appendiceal mucinous neoplasms were analyzed retrospectively including mucinous adenoma in 2,low-grade appendiceal mucinous neoplasm (LAMN)in 10,and appendiceal adenocarcinoma in 4. The imaging features were correlated with the result of pathology.Results Mucinous cystadenoma was usually a long oval or strip low density cystic structures with smooth capsule wall and well defined border.Mucinous adenocarcinoma usually presented as a irregular solid-cystic mass with ill-defined border and nodular or separation enhancement.The tumor often infiltrated adjacent bowels,and some of them were accompanied with pseudomyxoma peritonei (PMP)and abdominal implantation metastasi.LAMN had low potential malignancy.The imaging features were between cystadenoma and cystadenocarcinoma.Most cases were similar to mucinous cystadenoma, and some were like to mucinous cystadenocarcinoma.Conclusion The appendiceal mucinous neoplasms have various imaging manifestations. Some cases show some CT and MRI characteristics,which are benefit to the diagnosis of these diseases.