Approximately 300 million tons of plastic are produced globally each year,which has a serious impact on human health,marine life and the livestock industry.Microplastics have also been detected in meat and milk samples.Research has shown that nanoplastics(NP)(＜1 μm)and mi-croplastics(MP)(1 μm-5 mm)can affect the digestive,immune and reproductive systems of ani-mals.This experiment aims to investigate whether NP and MP regulate autophagy and damage the nervous system and spatial memory of animals.This experiment was divided into control group,nanoplastic group(PS-NP group,0.1 μm)and microplastic group(PS-MP group,1 μm),with 20 mice in each group.The mice were given 0.5 mL of PS-NP and PS-MP every day for 35 consecutive days,followed by neck amputation and brain analysis.The results showed that NPs and MPs of dif-ferent diameters caused varying degrees of damage to the brains of mice.In the behavioral tests of new object recognition,barnes maze and Y-shaped maze spatial memory,compared with the control group,the PS-NP group and PS-MP group showed a significant decrease in spatial memory ability of mice.HE staining results showed that neuronal cells in the PS-NP and PS-MP groups of mice exhibited shrinkage,decreased cell volume and deepened staining.The number of Nissl bodies de-creased,leading to dissolution and disappearance.RT-PCR and Western blot results showed that compared with the control group,the expression of glutamate receptors NR1,NR2A and NR2B in-creased in mice administered NP and MP orally,while the expression of autophagy related proteins Parkin,LC3B and Beclin1 was inhibited.In summary,this study suggests that nanoplastics and mi-croplastics stimulate glutamate receptors in mice by inhibiting the autophagy pathway,leading to impaired spatial memory.

This study systematically elucidates the contemporary understanding of the theory of"the lung and large intestine being interior-exteriorly related"within both traditional Chinese and Western medical theoretical frameworks,while providing an in-depth summary of national medical master Han Mingxiang's clinical experience in diagnosing and treating phlegm-heat obstructing lung syndrome in acute exacerbation chronic obstructive pulmonary disease(AECOPD).Theoretically,this doctrine originates from the Huangdi Neijing and has been developed into a comprehensive system by subsequent medical practitioners.Modern medical research from embryological,microbiological,and other perspectives has confirmed the close physiological and pathological relationship between the lung and intestine,particularly evidenced by the proposed"gut-lung axis"theory.Based on over 6 decades of clinical practice,professor Han identified the core pathogenesis of AECOPD as involving"phlegm,blood stasis,toxins,and deficiency,"with phlegm-heat obstructing lung syndrome being the most prevalent manifestation.The pathological characteristics include impaired lung qi descent,internal accumulation of phlegm-heat,and intestinal obstruction.The therapeutic approach emphasizes"clearing heat and resolving phlegm,relieving cough and asthma"as the primary treatment principle,focusing on"clearing lung heat,eliminating phlegm pathogens,and descending rebellious qi",while adhering to the concept of"simultaneous treatment of lung and intestine."In terms of herbal prescription,professor Han skillfully employs modified Xuanbai Chengqi decoction,which integrates lung-ventilating,phlegm-resolving,and purgative effects.Importantly,he emphasizes the precise timing and dosage of purgative herbs,particularly for patients with deficiency patterns,advocating discontinuation or dose reduction once intestinal patency is achieved to avoid overtreatment.For remission phase management,professor Han advocates the"reinforcing earth to generate metal"approach using modified Bufei decoction combined with Yigong powder,which strengthens spleen qi to nourish lung function.This therapeutic strategy embodies the fundamental treatment principle of"treating the acute manifestations first,then addressing the root cause."This research not only deepens the understanding of classical Chinese medical theories but also provides more scientifically grounded intervention strategies for the clinical prevention and treatment of lung distension.The findings offer valuable insights into integrative approaches for AECOPD management,combining traditional wisdom with contemporary medical understanding.

With the rapid development of competitive sports, the incidence of anterior cruciate ligament (ACL) injury is on the rise. Such injuries may shorten athletes′ career and lead to other long-term adverse consequences. Although athletes generally recover well after ACL reconstruction, many still struggle to return to their pre-injury performance levels. Advances in the understanding of ACL anatomy and injury mechanisms, along with the evolution of surgical techniques and rehabilitation methods, have provided more individualized and tailored options for athletes following ACL injuries. However, there is currently no consensus in China regarding surgical and rehabilitation strategies for competitive athletes aiming to return to sports after ACL injuries. To this end, the Sports Medicine Committee of the Chinese Research Hospital Association and the Editorial Board of the Chinese Journal of Trauma jointly formulated the Expert consensus on surgical treatment and rehabilitation for competitive sports athletes returning to sports after anterior cruciate ligament injury ( version 2025), and presented 14 recommendations covering surgical indications, preoperative rehabilitation, surgical timing, surgical strategies and postoperative rehabilitation strategies, aiming to improve the surgical treatment and rehabilitation system for ACL injuries in competitive athletes and facilitate their return to high-level sports performance after injury.

Approximately 300 million tons of plastic are produced globally each year,which has a serious impact on human health,marine life and the livestock industry.Microplastics have also been detected in meat and milk samples.Research has shown that nanoplastics(NP)(＜1 μm)and mi-croplastics(MP)(1 μm-5 mm)can affect the digestive,immune and reproductive systems of ani-mals.This experiment aims to investigate whether NP and MP regulate autophagy and damage the nervous system and spatial memory of animals.This experiment was divided into control group,nanoplastic group(PS-NP group,0.1 μm)and microplastic group(PS-MP group,1 μm),with 20 mice in each group.The mice were given 0.5 mL of PS-NP and PS-MP every day for 35 consecutive days,followed by neck amputation and brain analysis.The results showed that NPs and MPs of dif-ferent diameters caused varying degrees of damage to the brains of mice.In the behavioral tests of new object recognition,barnes maze and Y-shaped maze spatial memory,compared with the control group,the PS-NP group and PS-MP group showed a significant decrease in spatial memory ability of mice.HE staining results showed that neuronal cells in the PS-NP and PS-MP groups of mice exhibited shrinkage,decreased cell volume and deepened staining.The number of Nissl bodies de-creased,leading to dissolution and disappearance.RT-PCR and Western blot results showed that compared with the control group,the expression of glutamate receptors NR1,NR2A and NR2B in-creased in mice administered NP and MP orally,while the expression of autophagy related proteins Parkin,LC3B and Beclin1 was inhibited.In summary,this study suggests that nanoplastics and mi-croplastics stimulate glutamate receptors in mice by inhibiting the autophagy pathway,leading to impaired spatial memory.

With the rapid development of competitive sports, the incidence of anterior cruciate ligament (ACL) injury is on the rise. Such injuries may shorten athletes′ career and lead to other long-term adverse consequences. Although athletes generally recover well after ACL reconstruction, many still struggle to return to their pre-injury performance levels. Advances in the understanding of ACL anatomy and injury mechanisms, along with the evolution of surgical techniques and rehabilitation methods, have provided more individualized and tailored options for athletes following ACL injuries. However, there is currently no consensus in China regarding surgical and rehabilitation strategies for competitive athletes aiming to return to sports after ACL injuries. To this end, the Sports Medicine Committee of the Chinese Research Hospital Association and the Editorial Board of the Chinese Journal of Trauma jointly formulated the Expert consensus on surgical treatment and rehabilitation for competitive sports athletes returning to sports after anterior cruciate ligament injury ( version 2025), and presented 14 recommendations covering surgical indications, preoperative rehabilitation, surgical timing, surgical strategies and postoperative rehabilitation strategies, aiming to improve the surgical treatment and rehabilitation system for ACL injuries in competitive athletes and facilitate their return to high-level sports performance after injury.

This study systematically elucidates the contemporary understanding of the theory of"the lung and large intestine being interior-exteriorly related"within both traditional Chinese and Western medical theoretical frameworks,while providing an in-depth summary of national medical master Han Mingxiang's clinical experience in diagnosing and treating phlegm-heat obstructing lung syndrome in acute exacerbation chronic obstructive pulmonary disease(AECOPD).Theoretically,this doctrine originates from the Huangdi Neijing and has been developed into a comprehensive system by subsequent medical practitioners.Modern medical research from embryological,microbiological,and other perspectives has confirmed the close physiological and pathological relationship between the lung and intestine,particularly evidenced by the proposed"gut-lung axis"theory.Based on over 6 decades of clinical practice,professor Han identified the core pathogenesis of AECOPD as involving"phlegm,blood stasis,toxins,and deficiency,"with phlegm-heat obstructing lung syndrome being the most prevalent manifestation.The pathological characteristics include impaired lung qi descent,internal accumulation of phlegm-heat,and intestinal obstruction.The therapeutic approach emphasizes"clearing heat and resolving phlegm,relieving cough and asthma"as the primary treatment principle,focusing on"clearing lung heat,eliminating phlegm pathogens,and descending rebellious qi",while adhering to the concept of"simultaneous treatment of lung and intestine."In terms of herbal prescription,professor Han skillfully employs modified Xuanbai Chengqi decoction,which integrates lung-ventilating,phlegm-resolving,and purgative effects.Importantly,he emphasizes the precise timing and dosage of purgative herbs,particularly for patients with deficiency patterns,advocating discontinuation or dose reduction once intestinal patency is achieved to avoid overtreatment.For remission phase management,professor Han advocates the"reinforcing earth to generate metal"approach using modified Bufei decoction combined with Yigong powder,which strengthens spleen qi to nourish lung function.This therapeutic strategy embodies the fundamental treatment principle of"treating the acute manifestations first,then addressing the root cause."This research not only deepens the understanding of classical Chinese medical theories but also provides more scientifically grounded intervention strategies for the clinical prevention and treatment of lung distension.The findings offer valuable insights into integrative approaches for AECOPD management,combining traditional wisdom with contemporary medical understanding.

Objective:To analyze the effect of mucosal ligament preservation on the outcome of arthroscopic repair of meniscus injury.Methods:A total of 77 patients with knee meniscus tears caused by sports injuries who underwent arthroscopic meniscus repair or suture in Zhengzhou Orthopaedic Hospital from June 2022 to June 2023, were retrospectively analyzed. Including 45 males and 32 females, aged 38.57±13.54 years (range, 52-87 years), body mass index 24.72±4.01 kg/m 2 (range, 34.14-13.61 kg/m 2). All patients complained of knee pain, limited activity and walking weakness. The symptoms were not relieved after 1 month of conservative treatment, which seriously affected daily work and life. According to the intraoperative treatment of mucosal ligament, the patients were divided into mucosal ligament preservation group and mucosal ligament removal group. The visual analogue score (VAS), Lysholm score, and total blood loss were compared between the two groups. Results:All patients successfully completed the operation and were followed up for an average of 5.23±2.16 months (range, 3-9 months). The operation time was 47.59±16.81 min in mucosal ligament preservation group and 45.25±15.93 min in mucosal ligament removal group, and there was no significant difference between the two groups ( t=0.628, P=0.532). The total blood loss in the mucosal ligament preservation group was 246±193 ml, which was less than 343±211 ml in the mucosal ligament removal group, and the difference was statistically significant ( t=2.095, P=0.040). None of the patients received allogeneic blood transfusion. The hematocrit of the mucosal ligament preservation group was 42.48%±4.57% before operation and 39.42%±4.65% on the third day after operation, while that of the mucosal ligament removal group was 41.24%±4.16% and 38.95%±3.80%. The difference between the two groups was statistically significant ( t=0.016, P=0.004; t=0.004, P=0.016). There was no significant difference between the two groups before operation and on the third day after operation ( t=0.217, P=0.545; t=0.629, P=0.159). The preoperative VAS score of mucosal ligament preservation group was 7.25±1.10, which was higher than that of 3 months after operation (0.83±1.06), and the difference was statistically significant ( t=0.062, P<0.001). The preoperative VAS score of mucosal ligament removal group was 7.16±1.21, which was higher than that of 3 months after operation (1.05±1.13), and the difference was statistically significant ( t=0.017, P<0.001). There was no significant difference in VAS scores between the two groups before operation and at 3 months after operation ( t=0.144, P=0.740; t= 0.273, P=0.603). The preoperative Lysholm score of mucosal ligament preservation group was 31.76±7.54, which was significantly lower than that of 3 months after operation 87.30±4.12 ( t=-39.329, P<0.001); The Lysholm score of the mucosal ligament removal group was 34.13±7.32 before operation, which was lower than 89.05±4.45 at 3 months after operation, and the difference was statistically significant ( t=-40.172, P<0.001); There was no significant difference in Lysholm score between the two groups before operation and 3 months after operation ( t=1.395, P=0.167; t=1.766, P=0.081). Conclusion:The preservation of mucosal ligament in arthroscopic surgery for meniscus injury does not prolong the operation time. It can reduce the total intraoperative blood loss, and the postoperative knee function recovery is similar to that of mucosal ligament removal.

Objective This study aimed to evaluate the influence of ceramic type and thickness on the masking abili-ty and final aesthetic effects of chairside machinable all-ceramic crowns.Methods Six kinds from three types chairside machinable ceramic materials(IPS e.max CAD HT/MT/LT,IPS Empress LT,and VITA Suprinity HT/T)in shade A2 were fabricated to slice specimens into 1.0,1.5,and 2.0 mm-thick sections(n=10).The color parameters of the speci-mens against black and white tiles and four resin substrates(A2,A4,B3,and C4 shade)were measured with a spectro-photometer.The translucency parameter(TP)was calculated using color parameters measured over standard white and black backgrounds.The color differences(ΔE)were cal-culated between there substrate shades(A4,B3,C4)and A2 shade(control group).Two-way analysis of variance(ANOVA)was performed on the TP values.The two va-riables were ceramic type and ceramic thickness.Three-way ANOVA was used to determine the effects of ceramic materials,ceramic thickness,and substrate shades on the ΔE values,followed by Tukey test for multiple comparisons(α=0.05).Results Ceramic type,ceramic thickness,and sub-strate shade significantly affected the ΔE values(P<0.001).The L* and b* values of the specimens increased with in-creasing ceramic thickness,except in substrate A2,whereas the ΔE values decreased.The color difference of all 1.0 mm-thick specimens or all specimens over the substrates C4 shade exceeded the clinically acceptable threshold(ΔE>3.3).Conclusion The masking ability of chairside machinable all-ceramic crowns is influenced by ceramic type and thick-ness,and ceramic material.The thickness of ceramic less than 2.0 mm cannot mask the gray shade abutment.

Chronic hepatitis C is a kind of viral hepatitis caused by hepatitis C virus infection, which can further progress to cirrhosis, liver failure, hepatocellular carcinoma, and even death. Presently, there is no preventive vaccine yet. Therefore, preventing infection and safe and effective drug treatment are currently the most effective strategies for dealing with hepatitis C virus infection. Since 2014, the clinical application of direct-acting antiviral drugs has brought revolutionary changes to the treatment of chronic hepatitis C. Direct-acting antiviral drugs have an excellent hepatitis C virus clearance effect, are well tolerated, have a good safety profile, and can significantly improve liver function, metabolic disorders, immune dysfunction, etc. However, some studies have pointed out that even if the hepatitis C virus is cleared during the treatment of chronic hepatitis C-related cirrhosis with direct-acting antiviral drugs, a considerable proportion of patients still have severe liver failure, hepatocellular carcinoma, and even liver disease-related death, so there are still some problems in the treatment of chronic hepatitis C- related cirrhosis with direct-acting antiviral drugs that need to be further explored. This article reviews the research progress of direct-acting antiviral drugs so as to provide meaningful references for the treatment of patients with chronic hepatitis C-related cirrhosis.

OBJECTIVE: To observe the effects of acupuncture combined with bloodletting on the expression of inflammatory factors in serum, the morphology of sensitized skin tissue and the mast cell degranulation in urticaria rats, and to explore the potential mechanism of this therapy for urticaria. METHODS: Among 42 SD rats of SPF grade, 6 rats were randomly collected for the preparation of sensitized antiserum; and the rest 36 rats were randomized into a blank group, a model group, a positive drug group, an acupuncture group, a bloodletting group and a combined treatment group (acupuncture + bloodletting), 6 rats in each one. The rat model of urticaria was established by passive cutaneous anaphylaxis. In the positive drug group, loratadine (1 mg•kg^-1) by gavage was administered once a day. In the acupuncture group, 1 h after gavage with 0.9% NaCl (1 mL), acupuncture was delivered at "Baihui" (GV 20), "Zhongwan" (CV 12), and bilateral "Quchi" (LI 11) and "Xuehai" (SP 10) for 15 min, once daily . In the bloodletting group, 1 h after gavage with 0.9% NaCl (1 mL), bloodletting was operated at "Dazhui" (GV 14) and bilateral "Geshu" (BL 17), around 0.1 mL of bleeding volume at each point, once daily. In the combined treatment group, 1 h after gavage with 0.9% NaCl (1 mL), the interventions as the acupuncture group and the bloodletting group were adopted, once daily. All the interventions started on day 6 of modeling, lasting 2 weeks. After intervention completion, antigenic stimulation was performed in the rats of each group. Using ELISA, the levels of serum immunoglobulin E (IgE), tryptase (TPS), interleukin-4 (IL-4), interleukin-5 (IL-5), tumor necrosis factor-α (TNF-α) were detected. The diameter of the blue spots of the sensitized skin on the back was measured with ruler in each rat. The morphology of sensitized skin tissue was observed using HE staining, and the degranulation of mast cells was observed using Toluidine blue staining. RESULTS: Compared with the blank group, in the model group, the levels of serum IgE, TPS, IL-4, IL-5 and TNF-α increased (P<0.01), the diameter of blue spot on the sensitized part of the rat back was larger (P<0.01), the degranulation rate of mast cells was elevated (P<0.01), and there were obvious inflammatory cell infiltration and edema in the dermis of sensitized skin tissue on the rat back. Compared with the model group, the serum levels of IgE, TPS, IL-4, IL-5 and TNF-α were reduced in the positive drug group, the acupuncture group, the bloodletting group and the combined treatment group (P<0.01, P<0.05); skin blue spot diameter was smaller in the positive drug group and the combined treatment group (P<0.05); the degranulation rate of mast cells decreased in the positive drug group, the acupuncture group, the bloodletting group and the combined treatment group (P<0.01); and the dermal edema, inflammatory infiltration were attenuated in the positive drug group, the acupuncture group, the bloodletting group and the combined treatment group. Compared with the acupuncture group and the bloodletting group, the serum levels of IgE, TPS, IL-4, IL-5 and TNF-α, as well as the degranulation rate of mast cells in the sensitized tissue were lower in the positive drug group and the combined treatment group (P<0.05). CONCLUSION Acupuncture combined with bloodletting effectively suppress mast cell degranulation in the sensitized skin tissue on the back of urticaria rats, and ameliorate the histopathological morphology. Its effect mechanism may be related to inhibiting the differentiation and proliferation of helper T cells 2 and regulating the humoral immune response.
Animals ; Rats ; Mast Cells/immunology* ; Acupuncture Therapy ; Rats, Sprague-Dawley ; Male ; Cell Degranulation ; Humans ; Bloodletting ; Urticaria/immunology* ; Female ; Acupuncture Points ; Tumor Necrosis Factor-alpha/blood* ; Interleukin-4/blood* ; Interleukin-5/blood* ; Combined Modality Therapy ; Immunoglobulin E/blood* ; Disease Models, Animal