Objective To investigate the weight loss efficacy and mechanisms of oligopeptide-herbal medicine composite,and to provide new approaches for obesity treatment.Methods Twenty-three SPF female SD rats were randomly divided into control group(n=3)and modeling group(n=20).The control group was fed an ordinary diet for 6 consecutive weeks,and the modeling group was fed a high-fat diet for 6 consecutive weeks to establish a simple obesity rat model.After successful modeling,the modeling group was randomly divided into model group(n=10)and treatment group(n=10).The treatment group started anoint-and-massage therapy with oligopeptide-herbal medicine composite(3 g per rat per time,once a day,20 min each time),which was recorded as day 1.The control group and model group were not treated with oligopeptide-herbal medicine composite but received the same massage,and continued to be fed ordinary feed and high-fat feed respectively.Ten rats in the model group and ten in the treatment group were each divided into 3 groups,with 3,3,and 4 rats in each group.On days 3,6,and 9 after treatment,the rats in the three groups were weighed and cardiac blood collection was performed after isoflurane respiratory anesthesia.After euthanasia by cardiac bloodletting,abdominal subcutaneous adipose tissue(aSAT)and perirenal white adipose tissue(pWAT)samples were collected and weighed.Serum triglycerides(TG)and high-density lipoprotein cholesterol(HDL-C)levels were measured.Image J software was used to measure aSAT thickness and the diameter and area of perirenal white adipocytes and abdominal subcutaneous adipocytes.Immunofluorescence technique was used to observe the number of telocytes(TCs),cell junctions and exosomes per unit area of aSAT.Transmission electron microscopy was used to measure the length of telopodes(Tps)of dermal and subcutaneous TCs in abdominal skin,and to observe the distribution of exosome vesicles,rough endoplasmic reticulum,mitochondria,and cell junctions.Results Compared with the control group,the body weight of rats in the modeling group increased significantly(P＜0.05).Compared with the control group,rats in the model group showed a significant increase in serum TG level,a significant decrease in HDL-C level,and a significant increase in pWAT mass(all P＜0.05).Compared with the model group,the treatment group showed a significantly increased rate of body weight reduction,significantly decreased pWAT mass,significantly decreased serum TG level,and significantly increased HDL-C level(all P＜0.05).Compared with the model group,the treatment group showed significant reductions in aSAT thickness,as well as cell diameter and area in both aSAT and pWAT(all P＜0.05).Compared with the model group,the treatment group showed significantly increased number of TCs per unit area of aSAT,number of exosomes from TCs in aSAT,and Tps length(all P＜0.05).The treatment group showed an increasing trend in the numbers of mitochondria,rough endoplasmic reticulum,and cell junctions in TCs.Conclusion Oligopeptide-herbal medicine composite applied via anoint-and-massage therapy effectively improves obesity-related symptoms such as dyslipidemia and fat accumulation in obese rats by regulating TCs and their intercellular communication.

Objective To investigate the weight loss efficacy and mechanisms of oligopeptide-herbal medicine composite,and to provide new approaches for obesity treatment.Methods Twenty-three SPF female SD rats were randomly divided into control group(n=3)and modeling group(n=20).The control group was fed an ordinary diet for 6 consecutive weeks,and the modeling group was fed a high-fat diet for 6 consecutive weeks to establish a simple obesity rat model.After successful modeling,the modeling group was randomly divided into model group(n=10)and treatment group(n=10).The treatment group started anoint-and-massage therapy with oligopeptide-herbal medicine composite(3 g per rat per time,once a day,20 min each time),which was recorded as day 1.The control group and model group were not treated with oligopeptide-herbal medicine composite but received the same massage,and continued to be fed ordinary feed and high-fat feed respectively.Ten rats in the model group and ten in the treatment group were each divided into 3 groups,with 3,3,and 4 rats in each group.On days 3,6,and 9 after treatment,the rats in the three groups were weighed and cardiac blood collection was performed after isoflurane respiratory anesthesia.After euthanasia by cardiac bloodletting,abdominal subcutaneous adipose tissue(aSAT)and perirenal white adipose tissue(pWAT)samples were collected and weighed.Serum triglycerides(TG)and high-density lipoprotein cholesterol(HDL-C)levels were measured.Image J software was used to measure aSAT thickness and the diameter and area of perirenal white adipocytes and abdominal subcutaneous adipocytes.Immunofluorescence technique was used to observe the number of telocytes(TCs),cell junctions and exosomes per unit area of aSAT.Transmission electron microscopy was used to measure the length of telopodes(Tps)of dermal and subcutaneous TCs in abdominal skin,and to observe the distribution of exosome vesicles,rough endoplasmic reticulum,mitochondria,and cell junctions.Results Compared with the control group,the body weight of rats in the modeling group increased significantly(P＜0.05).Compared with the control group,rats in the model group showed a significant increase in serum TG level,a significant decrease in HDL-C level,and a significant increase in pWAT mass(all P＜0.05).Compared with the model group,the treatment group showed a significantly increased rate of body weight reduction,significantly decreased pWAT mass,significantly decreased serum TG level,and significantly increased HDL-C level(all P＜0.05).Compared with the model group,the treatment group showed significant reductions in aSAT thickness,as well as cell diameter and area in both aSAT and pWAT(all P＜0.05).Compared with the model group,the treatment group showed significantly increased number of TCs per unit area of aSAT,number of exosomes from TCs in aSAT,and Tps length(all P＜0.05).The treatment group showed an increasing trend in the numbers of mitochondria,rough endoplasmic reticulum,and cell junctions in TCs.Conclusion Oligopeptide-herbal medicine composite applied via anoint-and-massage therapy effectively improves obesity-related symptoms such as dyslipidemia and fat accumulation in obese rats by regulating TCs and their intercellular communication.

Objective:To develop a double-set endotracheal intubation and evaluate its effectiveness.Methods:The development of a double-set endotracheal intubation was achieved by integrating endotracheal intubation with dental pads. From November 2023 to July 2024, convenience sampling was used to select 60 patients with endotracheal intubation admitted to the ICU of the First Hospital of Jiaxing as participants. Patients were divided into an experimental group ( n=30) and a control group ( n=30) using a random number table method. Experimental group was treated with a double-set endotracheal intubation, while control group was treated with a regular endotracheal intubation. The incidence of oral mucosal membrane pressure injury and oral ulcers during endotracheal intubation, the Chinese version of the modified Beck Oral Assessment score, plaque index, and endotracheal intubation duration were compared between two groups of ICU patients. Results:The duration of endotracheal intubation in experimental group was shorter than that in control group ( P<0.05), and the difference was statistically significant ( P<0.05). The number of cases with oral mucosal membrane pressure injury and oral ulcers in experimental group, as well as the Chinese version of the modified Beck Oral Assessment score, were lower than those in control group, and the differences were statistically significant ( P<0.05). There was no statistically significant difference in the plaque index between two groups ( P>0.05) . Conclusions:Double-set endotracheal intubation can effectively improve the efficiency of intubation in ICU patients, reduce the local pressure on oral tissues caused by intubation, improve the oral condition of patients, and have good clinical effects.

Objective:To develop a double-set endotracheal intubation and evaluate its effectiveness.Methods:The development of a double-set endotracheal intubation was achieved by integrating endotracheal intubation with dental pads. From November 2023 to July 2024, convenience sampling was used to select 60 patients with endotracheal intubation admitted to the ICU of the First Hospital of Jiaxing as participants. Patients were divided into an experimental group ( n=30) and a control group ( n=30) using a random number table method. Experimental group was treated with a double-set endotracheal intubation, while control group was treated with a regular endotracheal intubation. The incidence of oral mucosal membrane pressure injury and oral ulcers during endotracheal intubation, the Chinese version of the modified Beck Oral Assessment score, plaque index, and endotracheal intubation duration were compared between two groups of ICU patients. Results:The duration of endotracheal intubation in experimental group was shorter than that in control group ( P<0.05), and the difference was statistically significant ( P<0.05). The number of cases with oral mucosal membrane pressure injury and oral ulcers in experimental group, as well as the Chinese version of the modified Beck Oral Assessment score, were lower than those in control group, and the differences were statistically significant ( P<0.05). There was no statistically significant difference in the plaque index between two groups ( P>0.05) . Conclusions:Double-set endotracheal intubation can effectively improve the efficiency of intubation in ICU patients, reduce the local pressure on oral tissues caused by intubation, improve the oral condition of patients, and have good clinical effects.

Objective:To construct a core competence evaluation index system for Anesthesia Intensive Care Unit (AICU) nurses, and to provide reference for the career orientation, training and management of AICU nurses.Methods:The first draft of the core competence evaluation index system of AICU nurses was developed by literature evaluation, semi-structured interview and group discussion. Using the purposive sampling method, 26 experts were selected for 2 rounds of expert consultation from August to September 2021 to determine the evaluation index system of core competence of AICU nurses, and the weights of indicators at all levels were determined by analytic hierarchy process.Results:The effective recovery rates of the 2 rounds of expert letter consultation questionnaire were respectively 92.31% (24/26) and 91.67% (22/24) , the expert authority coefficients were respectively 0.93 and 0.93, and the Kendall's harmony coefficients were respectively 0.28 and 0.19 (all P<0.01) . The final evaluation index system of AICU nurses' core competence included 4 first-level indicators (theoretical knowledge, nursing practice, comprehensive ability, personal characteristics) , 14 second-level indicators and 52 third-level indicators. Conclusions:The constructed evaluation index system of core competence of AICU nurses is scientific and reliable, which can provide a reference for the career orientation, training and management of AICU nurses.

The Philippines’ medical system is mainly based on the provincial responsibility system and the limited hierarchical. The Philippine government implement Philhealth program which can provide medical insurance for most people. The top 10 fatal diseases in this country includes ischemic heart disease, stroke, lower respiratory tract infection and so on. Of these diseases, the increasing rate of hypertensive heart disease, chronic kidney disease and diabetes are fast. Bone setting, massage and herbal medicine are the major form of traditional medicine in the Philippines. The acceptance of acupuncture and moxibustion by the government and local people is relatively high acupuncture and moxibustion therapy has been included in its medical insurance. There are many limitations on the development of Traditional Chinese Medicine (TCM) theory and Chinese herbal medicine in the Philippines, and the clinical application of acupuncture and Chinese herbal medicine is still limited. TCM education in the Philippines is still not systematic. Therefore, it is suggested to improve the education system of TCM, strengthen the promotion of acupuncture and moxibustion, give full play of the advantages of TCM for native high-risk diseases, and to make use of modern technologies such as telemedicine.

BACKGROUND: Patients with hip instability due to cerebral palsy, hemiplegia, infantile paralysis and extensive damage in gluteus medius, appear with high dislocation rate after arthroplasty, which is a great challenge for clinicians.OBJECTIVE: To investigate the reconstruction of the hip joint stability with the dual-mobility acetabular cup, and to prevent the dislocation after replacement in patients with hip neuromuscular lesions.METHODS: Twelve cases of hemiplegia, infantile paralysis, developmental dysplasia of the hip and recurrent dislocation after hip arthroplasty admitted in the Orthopedic Treatment Center, the Second Affiliated Hospital of Henan University of Chinese Medicine from January 2010 to July 2014 were enrolled, then underwent joint replacement or revision with dual-mobility cup, and the dynamic stability of the hip was achieved by adjusting the abductor lever arm.RESULTS AND CONCLUSION: (1) The followed-up time was from 20 to 60 months. (2) One year later, one case suffered Vancouver A right femoral fracture and received conservative treatment at 1 year postoperatively; one case of dislocation at postoperative 1 week, and dislocation, infection and loosening occurred in none cases. (3) These results manifest that those patients with neuromuscular disease and hip instability treated with hip joint arthroplasty using dual-mobility acetabular cup can reconstruct the stability of the hip joint and prevent the occurrence of postoperative dislocation.

Thirteen cases of developmental dysplasia hip underwent total hip arthroplasty with cementless biocon cup and femoral stem at the Department of Orthopedics,Second Hospital Affiliated to Henan College of Traditional Chinese Medicine from January to 2004 to December 2006 were selected.They consisted of 5 male with 5 hips and 8 female with 8 hips with the average age of 51 years(range,28-62 years) and 9 cases of Crowe-Ⅲ and 4 cases of Crowe-Ⅳ.Before operation,the lower limbs were shortened from 3 to 6 cm.13 patients were followed up for 24 months(range,12-36 months),the lower limbs were lengthened from 2 to 6 cm,and both lower limbs basically recovered the balance.There were no complication appeared such as dislocation,femoral fracture,femoral nerve or sciatic nerve injury,as well as prosthetic loosening.The hip pain and dysfunction in all the patients were obvious relieved after operation.

BACKGROUND: Tendon injury and dysfunction often occurs in military training, but the exactly epidemiological, pathological, physiological, healing and remodeling mechanisms of tendonopathy is still unclear, even the pain due to chronic tendon dysfunction should be further studied.OBJECTIVE: To evaluate the effect of forced training on the muscular strength of ankle joint and the cross-sectional area (CSA) of achilles tendon of infantry soldiers, and look for effective training methods.DESIGN: One-sample contrasting study.SETTING: Fourth Military Medical University of Chinese PLA; InStitute of Military Training-related Medical Sciences, the 150 Hospital of Chinese PLA.PARTICIPANTS: The study was carried out in the Institute of Military Training-related Medical Sciences, the 150 Hospital of Chinese PLA from March to June 2004. Thirty male light infantry recruits and thirty one-year-trained male soldiers were regarded as recruit group and one-year soldier group. The enlisted age ranged from 17 to 18 years. Recruits did not have the history of special training and injury of ankle joints. All of them were able to undertake routinely physical training.METHODS: The recruits participated in routinely physical trainings, such as grenade throwing and 5 km cross-country race, and forced trainings, such as dorsiflexors and plantarflexors on ankle joint, twice a day for each training item for 8 successive weeks. The forced training included calf raise for 50 times and sit-ups for 50 times on 45° arched board.Moreover, one-year soldiers were undertaken routinely physical trainings. Eight weeks later, the isokinetic testing of ankle joint and CSA of achilles tendon were measured before and after trainings.MAIN OUTCOME MEASURES: Comparisons of CSA of achilles tendon and changes of muscular strength of ankle joint between recruits before routine training and after 8-week forced training and one-year soldiers after routine training.RESULTS: All 60 soldiers were involved in the final analysis. Partial correlation was showed between CSA and body weight (r =0.446, P=0.015), and there was no difference in CSA before and after training. The relative peak torque, endurance and torque acceleration energy of plantarflexors, dorsiflexors and evertors were distinctively higher in recruit group and one-year soldier group after training than those in recruit group before training (P ＜ 0.05); however, there was no difference between recruit group and one-year soldier group after training.CONCLUSION: Forced training method can improve physical readiness in a short time. No changes of CSA of achilles tendon after training show that the improvement of ankle muscular strength may be through the rebuilding of its inner-structure rather than through the hypertrophy of the tendon.

[Objective] To evaluate the treatment with total hip arthroplasty(THA)using Zweym?ller system for short females with Crowe-Ⅲ and Ⅳ developmental dysplasia hip(DDH).[Method]From January 2004 to December 2006,thirteen THA procedures were performed in 12 female patients with 13 hips.The age of the patients was from 28 to 62 years old(average 51 years).The height was from 1.48 to 1.55 meters.Based on Crowe classification,8 patients with 9 hips were type-Ⅲ,and 4 patients with 4 hips were type-Ⅳ.before surgery,the discrepancy of lower limbs was from 3 cm to 5 cm.All patieds had severe hip pain and dysfunction.The Harris hip score ranged from 35 to 64 points with 40 points on the average.In all procedures the soft tissue was released entirely,the acetabular component was placed in the true acetabulum without femoral osteotomy.[Result]After operation,the legs lengthened from 2 to 5 cm.During the follow-up of 12 to 36 months(average 24 months),no femoral fracture,femoral or sciatic nerve palsy or loosening was detected except one dislocation according to clinical outcomes and X-ray findings.The Harris score was improved from 60 to 95.There was significant difference between before and after operation(P