Huangqi Guizhi Wuwutang was first documented in ZHANG Zhongjing's Synopsis of the Golden Chamber in the Eastern Han Dynasty as the principal formula for treating blood obstruction syndrome. It is composed of Astragali Radix， Cinnamomi Ramulus， Paeoniae Radix Alba， Zingiberis Rhizoma Recens， and Jujubae Fructus. This formula exhibits the effects of replenishing Qi， warming meridians， harmonizing blood， and relieving obstruction， being primarily indicated for blood obstruction syndrome characterized by diminished Yin and Yang functions with external manifestations of bodily numbness. Traditional Chinese medicine （TCM） emphasizes strict adherence to pathogenesis while applying tailored therapies， employing consistent treatment approaches for conditions with diverse clinical presentations but shared pathogenesis， which embodies the principle of treating different diseases with the same method. In modern clinical practice， Huangqi Guizhi Wuwutang is widely applied in multisystem disorders presenting with symptoms such as cutaneous numbness， cold-induced pain and stiffness， and soreness and weakness， including diabetic peripheral neuropathy， cervical radiculopathy， rheumatoid arthritis， coronary heart disease， pediatric spastic cerebral palsy， and recovery phases of cerebral infarction， demonstrating proven efficacy. Modern pharmacological studies confirm its anti-inflammatory， antioxidant-stress， hemorheological-improving， immunomodulatory， and neuroprotective effects by regulating multiple signaling pathways such as nuclear factor （NF）-κB/NOD-like receptor protein 3 （NLRP3） and nuclear factor erythroid 2-related factor 2 （Nrf2）-antioxidant response element （ARE）， thereby addressing common pathological processes including inflammation， hypercoagulability， oxidative stress， immune dysregulation， and neural injury， highlighting the integrated regulatory advantages of TCM formulas with multi-target， multi-level， multi-component， and multi-pathway mechanisms. According to the theory of treating different diseases with the same method and focusing on three core syndromes of blood obstruction， this article systematically reviews and elucidates the clinical extensions and shared mechanisms of this formula， aiming to provide evidence-based insights for the modern adaptation and precise application of this classical formula in orthopedic and related disciplines for chronic musculoskeletal disorders.

Objective:To construct a rapid admission evaluation model for medical consumables of same category,and to achieve a balance between scientificity,efficiency and practicality in the management of medical consumables.Methods:Based on the mini health technology assessment(Mini-HTA)model,combined with expert heuristics,a rapid qualitative analysis of the intended use and technical characteristics of the same category of medical consumables were conducted.Expert opinions were solicited through the Delphi method,and a rapid admission evaluation model of same category of medical consumables was constructed.A total of 80 high-value medical consumables of 10 categories in clinical use in Sichuan Provincial People's Hospital from June 2023 to March 2024 were selected,and the traditional admission process method and expert heuristics optimization method were used to make admission decisions for medical consumables,with 40 high-value medical consumables for each method.The differences in the decision-making process and approval time between the two different admission methods were compared and analyzed.Results:The admission decision-making system indicators of the rapid admission evaluation model of medical consumables of same category included 6 primary indicators of clinical efficacy,reliability,economics,values and aspirations,hospital management and corporate services,and 25 secondary indicators.The approval process for medical consumables admission decision-making using the rapid admission evaluation model of medical consumables of same category had been reduced from 10 in the traditional admission process to 2,and the approval time had been shortened from an average of 7.03 days to 2.43 days.Conclusion:The rapid admission evaluation model for the approval of medical consumables of same category based on expert heuristics can significantly optimize the admission approval process of medical consumables,improve the comprehensiveness and transparency of medical consumables admission decisions,and improve the management efficiency of medical consumables.

Objective:To introduce the surgical method of Ortho-Bridge system (OBS) in the treatment of distal femoral fractures in elderly patients and investigate its clinical effect.Methods:From January 2018 to July 2021, 24 elderly patients who suffered distal femoral fractures were treated with bilateral OBS. There were 8 males and 16 females aging from 62 to 87 years, with an average age of 72.6 years. It included 15 cases of simple distal femoral fractures. According to AO classification, there were one case of A1, two of A2, five of A3, two of C1, three of C2 and two of C3. Nine cases of femoral periprosthetic fractures after total knee arthroplasty (TKA) were classified as type II according to rorabeck's classification. After operation, all patients were guided to perform knee joint functional exercise and to measure the range of motion of the knee joint. Then imaging examinations were used to evaluate the fracture healing and measure the femoral-tibial and femoral angles. The American Hospital for Special Surgery (HSS) knee joint scoring system was used to evaluate the knee function.Results:All 24 patients successfully completed the operation. The operation time was 84-115 min, with an average of 96.6 min; the intraoperative blood loss was 150-335 ml, with an average of 240 ml. All patients were followed up for 8-17 months, with an average of 13.6 months. Except for 1 case of nonunion due to few primary bone grafts, which required secondary bone grafting, the other 23 cases achieved bone union. The healing time was 3.5-6 months, with an average of 4.6 months. At 1, 3, and 6 months after operation and at the last follow-up, the flexion angles of knee were 92.2°±10.2°, 98.6°±13.3°, 106.4°±13.7°, 115.7°±15.3°, and the extension angles were -4.7°±4.1°, -1.2°±4.2°, 0.7°±4.5°, 1.8°±4.6°, respectively; and all differences were statistically significant ( F=17.03 and 12.68, P<0.001). The knee flexion and extension angles at the last follow-up were greater than 1, 3, and 6 months after operation, and the differences were statistically significant ( P<0.001). The femoral-tibial angle was 171.2°±2.4° and 170.7°±3.2°, and the femoral angle was 80.3°±1.7° and 79.6°±2.1°, respectively, at the immediate postoperative and last follow-up, with no significant difference. The HSS scores at 1, 3, 6 months after operation and at the last follow-up were 71.5±7.5, 74.6± 9.3, 78.9±10.4 and 84.7±9.4 respectively, with significant difference ( F=9.17, P<0.001). At the last follow-up, the HSS score was higher than that at 1, 3, and 6 months after the operation, and the differences were statistically significant ( P<0.001), and the knee function was evaluated according to the HSS scoring system: excellent in 12 cases, good in 9, fair in 3, with an excellent and good rate of 88% (21/24). There was no OBS crack or fixation failure in all patients, and no prosthetic loosening and instability occurred in patients with periprosthetic femoral fractures after TKA. Statistical analysis of the data at the last follow-up between the distal femoral fracture group and the periprosthetic femoral fracture group after TKA showed that the knee flexion function and HSS score of the periprosthetic femoral fracture group after TKA (126.8°±3.7°, 92.2±4.1) were both better than the simple distal femur fracture group (108.9°±15.7°, 80.2±8.8). The difference was statistically significant ( t=4.22, 4.52, P<0.05). One patient had incision fat liquefaction and healed after debridement; bone nonunion occurred in 1 case, which healed after iliac bone grafting. Conclusion:Double OBS has a good clinical effect in the treatment of distal femoral fractures in the elderly, especially in patients with periprosthetic femoral fractures after TKA.

Objective:To compare the biomechanical parameters of Ortho-Bridge system (OBS) and locking compression plate+locking attachment plate (LCP+LAP) in the fixation of femoral periprosthetic type B1 fracture.Methods:The same periprosthetic type B1 fracture of human femur were made, including simple fracture model and comminuted fracture model, 12 in each. And the simple fracture models were randomly divided into 6 pieces of OBS system fixation group and 6 pieces of LCP+LAP system fixation group, and the complex fracture models were also randomly divided into 6 pieces of OBS system fixation group and 6 pieces of LCP + LAP system fixation group. Then the four groups of models were tested by axial compression and torsion tests, and the stiffness of the models under axial compression and torsion angle of the models under torsion test were collected. The axial compression failure test was carried out to collect the vertical load of the ultimate failure test. The axial stiffness, torsion angle and axial failure load of OBS and LCP+LAP fixed simple and comminuted fractures were statistically analyzed by t test. Results:For the test of fixed simple fracture, there was no significant difference ( t=0.535, P=0.522) in the axial stiffness between the OBS group (868.87±157.14 N) and the LCP+LAP group (904.53±44.76 N), whereas the results of torsion test showed that the LCP+LAP group had a higher torsion angle 7.17°±0.52° than the OBS group 5.45°±0.44° ( t=5.616, P<0.001); When fixing comminuted fractures, the OBS group had a higher axial stiffness (145.33±10.34 N) than the LCP+LAP group (84.15±8.94 N) ( t=10.961, P<0.001), but the LCP+LAP group had a higher torsion angle 7.75°±1.17° than the OBS group 5.23°±0.31° ( t=4.652, P=0.001). Ultimate failure test data showed that the failure pressure of OBS fixed group (4 967.49±132.88 N) was higher than LCP+LAP group (3 967.41±145.16 N) ( t=12.447, P<0.001). In the LCP+LAP group, there was destruction of the contact cortex at the fracture site, while in the OBS group, there was destruction of the contact cortex at the fracture site as well as fractures around the proximal fixation screw. Conclusion:OBS group has similar axial compression resistance to LCP+LAP group, but better torsion resistance than LCP+LAP group when it is used to fix B1 simple fracture around femoral prosthesis. When comminuted fracture is fixed, the axial compression resistance and torsion resistance of OBS group are better than LCP+LAP group. The stress is dispersed during OBS fixation, which can better avoid the failure of internal fixation during early functional exercise.

Objective To study and observe the clinical efficacy of using non skid plate by posteromedial approach for fixing splitting or compression tibial plateau fracture.Methods Twenty eight cases of patients who were treated for fixing splitting or compression tibial plateau fracture from January 2014 to January 2016 in people's hospital of Xinyu were retrospectively reviewed.All patients were treated byposterior medial approach with non skid plate for fixation,all patients were followed up by postopera tive imaging and clinical follow-up to observe its clinical curative efficacy.Results Twenty-eight patients were followed up,the mean follow-up time was 12 months.All patients had no internal fixation loosening fracture,send,vascular and nerve damage and other adverse reactions.All the patients were healed within 4 to 7 months,the average healing time was 18.5 weeks.After healing,knee joint function was evaluated,18 cases were excellent,5 cases were good,the excellent and good rate was 82.1 ％.Conclusion The efficacy of using non skid plate by posteromedial approach for fixing splitting or compression tibial plateau fracture is good,it is worthy of clinical application.

Objective To analyze cases diagnosed with glomerular minor lesion (GML) by light microscopy and immunofluorescence,uncover their final pathology diagnosis by electron microscopy,and thereby clarify the pathological and clinical meaning of GML.Methods One hundred and forty-eight patients receiving renal biopsy between 2003 and 2008 in Peking Union Medical College Hospital,with diagnosis of GML described by light microscopy and immunofluorescence examination were retrospectively studied.All the clinical data and pathological observation were collected and analyzed,including intact results of electron microscopic examination which were considered as golden standards of pathological diagnosis.Results The 148 patients with GML had heterogenous clinical features,with isolated hematuria as the most common presentation.Electron microscopy revealed various pathological presentations:thin basement membrane nephropathy (TBMN,66.2％),mesangial proliferative glomerulonephritis (MsPGN,20.3％),Alport syndrome (2.7％),membranous nephropathy (MN,3.4％),normal tissue (4.7％).Among GML patients with isolated hematuria,TBMN ranked as the most common pathology (76.9％).Conclusions GML is only an equivocal description of pathological manifestation by light microscopy and immunofluorescence examination.And electron microscopy is necessary to obtain accurate pathology diagnosis for patients undergoing renal biopsies.

Objective To evaluate t le effects of various mutants of PAK6 kinase on the proliferation of prostate cancer cells and their roles in the pathology of prostate cancer. Methods Variant mutants of PAK6 kinase, including wild type ( WT),kinase activated type (SN) and kinase inactivated type (KM) , were in vitro constructed according to the PAK6 sequence,and were transfected into the LNCaP cells by Lipo-fectamine. G418 was used to select the stable cell line. Phosphorylated PAK6 antibody was used in Western blot to detect the kinase expression in the eel.s. The proliferation rate was measured by MTT assay;the growth effects of the cells stimulated by androgen were also recorded and compared. Results Different LNCaP cell lines expressing wild type, kinase activated and kinase inactivated PAK6 were prepared successfully. Wild type (WT) PAK6 and the kinase activated PAK6-SN significantly inhibited the growth of LNCaP cells by 32. 1% and 39. 3%,respectively (P

Objective To evaluate the minimally invasive technique of laparoscopy by retroperitoneal access for the treatment of parapelvic cyst. Methods Twelve patients(7 men and 5 women;mean age,52 years;age range,34-75 years) with parapelvic cysts were included.The cyst size ranged from 2.8 cm?3.0 cm to 2.5 cm?11.5 cm.The cysts were on the left side in 6 cases and on the right in another 6 cases.Laparoscopic resection or de-roofing of the parapelvic cysts by retroperitoneal access was performed in them.The relevant parameters of the procedures were summarized.Results The success rate of the operation was 100%.The mean operative time of the first 6 patients was 190 min,while it was 86 min in the rest 6 patients.The mean intraoperative blood loss was 25 ml.No injury to the kidney pedicle or pelvis occurred.The mean hospital stay was 9 d.In 11 patients,no recurrence of the cyst occurred during a follow-up of 7-31 months.Only 1 patient with concomitant renal cyst had recurrence of the cyst found by B-ultrasound 2 years after operation.Conclusions Therapeutic laparoscopy by retroperitoneal access has advantages of minimal trauma,less blood loss,rapid recovery and better effect,therefore it is the ideal treatment choice for parapelvic cyst.

AIM: To study the effects of CIK cocultured with DC that pulsed with RCC antigen on renal carcinoma cells.METHODS: DC and CIK cells were generated respectively by cytokines from PBMC of healthy blood donor.Cell surface markers were analyzed by flow cytometry.Then CIK were cocultured with autologous DC that was(or not) pulsed with RCC antigen(786-0 cells).Cytotoxic activity against 786-0 or PC3 cells was measured by MTT assay under three different conditions: CIK cocultured with DC which was pulsed with 786-0 antigen(group A);CIK cocultured with DC which is not pulsed with 786-0 antigen(group B);CIK without DC(group C).RESULTS: The cytotoxic activity of three groups against 786-0 cells was(70.64?8.26)%,(53.40?7.33)%,(46.64?6.01)%,respectively(E/T=(20∶1)).Significant differences between group A and group B or between group A and group C were observed(P

AIM: To establish a quality control method of analysing Lajiao Fengshi Plaster qualitatively and quantitatively. METHODS: Capsaicin was identificated by TLC and menthol,borneol were determinated by GC Lajiao Fengshi Plaster,silica gel as plate,ligarine(60～90?C)-acetoacetate(3(∶)2) as mobile phase,0.5% solution of dichloroquinonechlorimide R in methanol R.as chromogenic agent to identificate capsaicin.The internal standard of GC,naphthalene was employed.10% PEG-20M as the stationary phase,column temperature at 150(?C,) and FID as the detector to determine methol and borneol. RESULTS: There were the same spot corresponding in colour and position sample and reference capsaicin,but negative control had not such colour spot in the same plate of TLC.Menthol,borneol and naphthalene had been separated well under the chromatographic condition.The average recovery of menthol,borneol were 97.44%(RSD=0.93%),98.09%(RSD=1.26%),respectively. CONCLUSION: The method is sensitive,accurate and reproducible and can be used to control the quality of Lajiao Fengshi Plaster.