Secondary lymphedema is a chronic progressive disease caused by the obstruction of lymphatic reflux, which leads to a series of secondary affection. There is no cure at present. Exploring the pathogenesis and treatment of lymphedema is based on animal models that mimic the pathophysiology of chronic lymphedema in humans. Currently, there are many known animal models of lymphedema, such as the limb lymphedema model of mice, dogs and other animals, and the rabbit ear lymphedema model. But most of them cannot induce the persistent and stable lymphedema temporarily, which lead to a deadlock in the related research progress. Therefore, it is necessary to improve and even create new animal models of lymphedema. This paper summarises the progress of relevant literature and provides references for further improving the establishment of a lymphedema animal model. It also summarise existing methods for evaluating lymphedema or lymphatic vessel function to provide an evaluation tool for modified or new animal models.

Objective:To study the optimal timing of laparoscopic cholecystectomy (LC) after percutaneous transhepatic gallbladder drainage (PTGBD) for grade Ⅱ-Ⅲ acute cholecystitis.Methods:A multicenter, single blind and randomized controlled study was conducted at Shanghai Fifth People's Hospital Affiliated to Fudan University, Shanghai Pudong Hospital, and Shanghai Minhang District Central Hospital from October 2018 to September 2021. Patients who underwent LC after PTGBD were divided 1∶1 into the early group and the late group. LC was performed 4-6 weeks after PTGBD in the early group and 7-8 weeks after PTGBD in the late group. Gender, age, AC grade, complications after PTGBD, body mass index, complications before LC, operation time of LC, intraoperative bleeding, total treatment cost, conversion rate to open surgery and complications after LC were compared between the two groups. The 36-Item Short Form Health Survey (SF-36) before and after LC was also compared.Results:Of 248 patients who were eligible for the study, there were 52 males and 196 females, with ages ranging from 18 to 89 years, and mean ±s.d. of (52.5 ± 20.2) years. There were 126 patients in the early group and 122 patients in the late group. There were no significant differences in gender, age, AC grade, body mass index and complications before LC between the two groups (all P>0.05). The preoperative score of SF-36 in the early group was significantly better than that in late group, and the complications of PTGBD in the late group were significantly higher than the early group (both P<0.05). The operation time and total treatment cost of the early group were significantly less than those of the late group (37.2±12.8 min vs. 48.5±19.7 min, 20 856±2 136 yuan vs. 2 2207±2 049 yuan) (both P<0.05). The intraoperative bleeding volume of LC in the early group was [ M( Q1, Q3)] 40 (40, 60) ml and the late group was [ M( Q1, Q3)] 35 (25, 40) ml. The difference was also significant ( P<0.05). There was no significant differences in the conversion rates to open surgery, complications and SF-36 scores after LC between the two groups (all P>0.05). Conclusion:LC should be performed 4-6 weeks after PTGBD for grade Ⅱ-Ⅲ acute cholecystitis. Although the amount of intraoperative bleeding was higher, the operation time was shorter, the burden on patients was reduced and there was more rapid recovery.

Objective To explore the relationship between obesity and serum testosterone level among community adult males.Methods The stratified cluster sampling method was adopted to extract 1 166 male residents aged 20 years old and over in Zunyi City and conduct the questionnaire survey and physical examination.Fasting venous blood samples were collected for detecting the serum total testosterone(TT),sex hormone binding globulin(SHBG) and luteinizing hormone(LH).Then free testosterone index(cFT),free testosterone index(FTI) and testosterone secreting index(TSI) were calculated.Results The average levels of serum TT,SHBG,cFT,FTI,TSI and LH in 1 166 adult males were(16.83±4.90)nmol/L,(42.15 ± 20.21)nmol/L,(0.31 ±0.10)nmol/L,(0.46 ± 0.19) IU/L,(3.40 ± 2.04) IU/L and(6.77 ± 5.14) IU/L respectively;the Pearson correlation analysis showed that WHtR,BMI and WC were negatively correlated with TT,SHBG,TSI and LH,and were positively correlated with FTI,WHtR was negatively correlated with cFT,BMI and WC were negatively correlated with LH,the differences were statistically significant(P＜0.05).The multivariate linear regression analysis shown that WHtR was negatively correlated with TT,SHBG,TSI and LH;and was positively correlated with FTI,the differences were statistically significant(P＜0.01).Conclusion Adult male central obesity may be associated with the decrease of serum TT,SHBG,TSI and LH levels,and increase of FTI level.

Objective Using Z-score to assess the prevalence of proximal aorta dilatation in middle-aged and aged individuals during routine transthoracic echocardiogram examinations and to identify its risk factors. Methods A total of 823 middle-aged or elderly patients on routine transthoracic echocardiogram examinations were consecutively enrolled. The internal diameters of the sinus of Valsalva (SoV ) and the ascending aorta (AA ) were measured. Z-scores were calculated according to the proposed equation for SoV and AA. A dilated aortic root was defined as a Z-score ≥1.96 or the diameter of SoV or AA ≥ 40 mm. The prevalence of proximal aorta dilatation and associated factors were analyzed. Results The prevalences of proximal aorta dilatation ,SoV dilatation ,and AA dilatation were 26.1%(25/823 ) ,6.0%(49/823 ) ,and 23.7%(195/823 ) , respectively.In the aortic root dilatation group ,age and the proportion of obesity were higher (both P＜0.05) ,and there were more female subjects (30.5% or 117/384 vs.22.3% or 98/439 ,P＜0.01) . The incidences of left atrial dilation ,left ventricular dilation ,left ventricular hypertrophy ,and aortic regurgitation in the aortic root dilatation group were higher than those in the non-aortic root dilatation group(P＜0.05 ) .Logistic regression analysis demonstrated that sex (OR＝ 1.827 ,95% CI :1.248-2.673 ,P＝0.002) ,hypertension (OR＝1.441 ,95% CI :1.000-2.075 ,P＝0.050)and left ventricular hypertrophy (OR＝1.827 ,95% CI :1.248-2.673 ,P＝0.002)were independently correlated with aortic root dilatation. Conclusions The prevalence of proximal aorta dilatation is high in middle-aged and aged individuals. Proximal aorta dilatation is related to sex ,age ,and body size ,and it is often accompanied by structural abnormalities of the heart.

Objective To explore the correlation between gait parameters at 14 days and knee function and quality of life at 3 months after total knee arthroplasty (TKA). Methods Eighteen patients who underwent TKA were analyzed by using three-dimensional gait analysis system to observe their gait parameters. Knee joint function and life quality of the patients at 3 months after TKA were evaluated with WOMAC (Western Ontario and McMaster Universities Arthritis Index) and SF-36 (short form 36-item health survey scores) assessment scale and their correlations were analyzed simultaneously. Results At 14 days after TKA, single support time (SST) and peak knee flexion at swing (PKF) of the operated side of the leg were significantly smaller than those of the healthy side of the leg. The knee flexion angle at mid-stance (MKF) and knee valgus angle at mid-stance (MKV) of the operated side of the leg were significantly larger than those of the healthy side of the leg. There was a moderate negative correlation between the spatiotemporal parameters of the operated side of the leg and the WOMAC score during gait, while a high correlation between the WOMAC score and peak knee flexion at swing (PKF), MKF and MKV. Except for the step length and forward velocity, the other gait parameters were significantly correlated with SF-36 life quality score. The single support time (SST) and PKF had a highly positive correlation, while the MKF and MKV had a moderate negative correlation with SF-36 life quality score. Conclusions The SST, MKF, MKV and PKF in postoperative early gait analysis (14 days) results can be used as the effective indicators to judge postoperative knee function and rehabilitation efficacy of life quality after TKA surgery.

Through providing rhythmic stimulation to movement center, rhythmic auditory stimulation (RAS) may encourage hemiplegic patients to adjust movement pattern and external rhythm in time to improve the walking function after stroke. As an emerging intervention to treat the hemiplegic patients after stroke, RAS could effectively improve temporospatial gait parameters (gait velocity, stride length, cadence, and symmetry, etc.), joint movement pattern (angle of pelvis anterior tilt, and peak angle of knee flexion in mid-swing, etc.) and balance, which may be related to rhythmic entrainment movement system and the theory of auditory-movement synchronization. Simultaneously, frequency and dosage of RAS and the patient's lesions all have effect on the outcome of intervention.

Objective To investigate the molecular size distribution and the structure of group B me-ningococcal capsular polysaccharides for the development of vaccines .Methods The molecular size distribution of group B meningococcal capsular polysaccharides was analyzed by chromatography on a Sepharose CL -4B col-umn.The molecular weight of repeat units were measured by matrix assisted laser desorption ionization time of flight mass spectrometry (MALDI-TOF-MS).The structural characteristics of group B meningococcal capsular polysaccharides were analyzed by nuclear magnetic resonance ( NMR) based on the chemical shift of all charac-teristic protons by using group C meningococcal capsular polysaccharides and sialic acid as the controls .Results The KD value of group B meningococcal capsular polysaccharides extracted from 15 strains were ranged from 0.60 to 0.76.The molecular weight of repeat units was 284, which was identical to the theoretical value .The group B meningococcal capsular polysaccharides were 2→8 linked homopolymers of sialic acid lacking O-acetyl groups.Conclusion The group B meningococcal capsular polysaccharides had lower molecular weights , which might result in their poor immunogenicity .The structure of group B meningococcal capsular polysaccharides could be quickly and accurately analyzed by NMR technology .

Objective To monitor and analyze the antigenicity of Streptococcus pneumonia polysac-charide, its derivatives and conjugates by three immunological assays .Methods Inhibition ELISA and rate nephelometry(RN) were established for this study.Antigenicity of serotype 23F pneumococcal conjugates and their intermediates were analyzed by double immunodiffusion assay , inhibition ELISA and RN .The re-sults derived from three assays were comparatively analyzed to evaluate the changes of antigenicity during the preparing process of serotype 23F conjugate.Results Double immunodiffusion assay, inhibition ELISA and RN were all applicable to antigenicity analysis during the process of conjugate preparation .Inhibition ELISA could quantitatively detect a slight difference of polysaccharide antigenicity during the preparing process . Conclusion The antigenicity of polysaccharide during the preparing process of pneumococcal conjugates could be analytically monitored by using three immunological assays .This study provided evidence for suc-cessfully using immunological assays as the quality control means during the preparing process of pneumococ -cal conjugates .

Objective To dynamically analyze the antibodies with regard to in vitro serum bacteri-cidal activity and the quantity of IgG in healthy adults received one dose of immunization with ACYW 135 me-ningococcal polysaccharide vaccine .To investigate the term of protection with polysaccharide vaccine and the correlation between bactericidal titer and IgG concentration .Methods Twenty healthy adults were given one dose of immunization with quadrivalent meningococcal polysaccharide vaccine .Serum samples were col-lected before and after vaccination at specific time points .Test for serum bactericidal activity ( SBA ) and quantitative ELISA were performed to detect bactericidal titers and IgG concentrations in serum samples .Re-sults Certain levels of antibodies against capsular polysaccharides of serogroup A , C, Y and W135 strains had already existed prior to immunization .Moreover, bactericidal titers against serogroup A , Y and W135 strains except serogroup C strain were relatively high .Specific IgG concentrations and bactericidal titers for all serogroup stains were significantly increased on day 15 after vaccination (P<0.05), and then sustained at a high level during a time period from day 30 to day 160.Both IgG concentrations and bactericidal titers dropped to the levels similar to that before preimmunization in about 3 years.No significant correlation was observed between bactericidal titers and IgG concentrations (r<0.3, P>0.05).However, a close correla-tion was demonstrated between GMTs and GMCs of serum samples (r>0.7, P<0.05).Conclusion The geometric mean titers ( GMTs) and geometric mean concentrations ( GMCs) of serum samples collected be-fore and after vaccination at different time points were reliable and consistent parameters for the evaluation of vaccine .The term of protection of quadivalent meningococcal polysaccharide vaccine was about 3 years upon a single dose of immunization .

Atherosclerosis ; prevention & control ; Cholesterol, LDL ; blood ; Humans ; Hypercholesterolemia ; drug therapy ; United States