BACKGROUND:Cartilage defects are one of the major clinical challenges faced by orthopedic surgeons.Tissue engineering is an interdisciplinary approach that combines knowledge of engineering and cell biology to provide new ideas and approaches for the repair of cartilage defects. OBJECTIVE:To prepare a multi-component composite scaffold based on silk fibroin,gelatin,and chitosan to screen for a three-dimensional porous scaffold suitable for cartilage regeneration by evaluating its physicochemical properties and biological performance. METHODS:Four groups of porous scaffolds were prepared by vacuum freeze-drying method using silk fibroin,gelatin and chitosan as the base materials,namely chitosan/gelatin scaffold,silk fibroin/chitosan scaffold,silk fibroin/gelatin scaffold and silk fibroin/chitosan/gelatin scaffold.The suitable cartilage scaffolds were screened by scanning electron microscopy,X-ray diffractometer,porosity,water absorption and swelling rate,biodegradation rate and mechanical property detection.Then cartilage scaffolds were co-cultured with chondrocytes isolated and extracted from patients with osteoarthritis.The feasibility of porous scaffolds for cartilage injury repair was evaluated in vitro by cell adhesion rate assay,cell live-dead staining and cell activity proliferation assay. RESULTS AND CONCLUSION:(1)All four groups of scaffolds had porous structures.The comprehensive physical performance test results showed that the silk fibroin/gelatin/chitosan scaffold was more in line with the requirements of cartilage defect repair.This scaffold had a pore size of(176.00±53.68)μm,the porosity of(80.15±2.57)%,and water absorption and swelling rate of(3 712±358)%.After immersion in PBS containing lysozyme for 28 days in vitro,the biodegradation rate was(46.87±3.25)%,and it had good mechanical properties.(2)Chondrocytes could adhere well on the silk fibroin/gelatin/chitosan scaffold,and the cell adhesion rate increased with time.CCK8 and live/dead cell double staining results showed that silk fibroin/gelatin/chitosan scaffold had good biocompatibility and low cytotoxicity.(3)The results showed that silk fibroin/gelatin/chitosan scaffold had a highly hydrated 3D structure,suitable pore size and porosity,good biodegradability and superior mechanical properties,which can provide a good reticular skeleton and microenvironment for nutrient transport and chondrocyte attachment and proliferation.

The unique professionalism of the medical industry,the complexity of diseases,and the lag of medical insurance supervision and other factors bring challenges to the supervision of medical insurance funds.Taking the practice of a tertiary public hospital in Weifang City,Shandong Province in the construction of a full-process,multi-dimensional and three-dimensional medical insurance intelligent monitoring system as an example,it retrospectively analyzed the construction and operation of the hospital's medical insurance intelligent monitoring system since 2020,summarized the achievements,and put forward constructive suggestions on further improving the medical insurance intelligent monitoring system.

OBJECTIVETo observe the efficacy differences between herb-partitioned moxibustion on navel and clomiphene for anovulatory infertility.

METHODSWith double-blind double-dummy randomized control method, a total of 40 patients with anovulatory infertility were randomly divided into a moxibustion group and a clomiphene group, 20 cases in each one. Blinding was conducted on both patients and doctors. The patients in the moxibustion group were treated with herb-partitioned moxibustion on navel and oral administration of clomiphene placebo, while the patients in the clomiphene group were treated with placebo-partitioned moxibustion on navel and oral administration of clomiphene. The herb-partitioned moxibustion and placebo-partitioned moxibustion were given at the end of menstruation, 1.5 hours per treatment, once a week, and no treatment was given during menstruation. The oral administration of clomiphene and clomiphene placebo were given from 5 days into menstruation, 50 mg, once a day, for consecutive 5 days. One menstrual cycle was taken as one treatment course, and 3 treatment courses were conducted. After 3 treatment courses, the endometrial thickness (ET), maximum follicular diameter (MFD), ovulation rate (OR) and effective rate (ER) were evaluated between the two groups.

RESULTS(1) Compared before treatment, ET was significantly increased after treatment in the two groups (both<0.05); after treatment, the ET in the moxibustion group was higher than that in the clomiphene group (<0.05). (2) After treatment, MFD was significantly increased in the moxibustion group (<0.05) and insignificantly increased in the clomiphene group (>0.05); the MFD in the moxibustion group was higher than that in the clomiphene group (<0.05). (3) The OR was 75.0% (15/20) and 65.0% (13/20) in the two groups respectively, which were not significantly different (>0.05). (4) The total ER in the moxibustion group was 95.0% (19/20), which was superior to 70.0% (14/20) in the clomiphene group (<0.05).

CONCLUSIONSThe clinical efficacy of herb-partitioned moxibustion at navel on anovulatory infertility was superior to that of clomiphene, but their effects on OR was similar.

Objective To study the effects of extracted active components of Chaenomeles Speciosa (EACCS) on non-alcoholic fatty liver disease (NAFLD) in mice; To discuss the possible molecular mechanism. Methods Forty male KM mice were randomized into four groups, namely normal group, model group, low-dose (50 mg/kg) EACCS group and high-dose (100 mg/kg) EACCS group. Except that the normal group was daily given routine diet, the other groups were given high-fat–high-fructose diet (HFFD). The mice were put to death 4 weeks later. Body weight, liver weight and serum TG were measured. HE and oil red O staining were used to observe liver tissue morphology. RT-PCR and Western blot were used to detect the expression of lipid metabolism related genes. Results Compared with the normal group, the liver size, liver index (P<0.01) and epididymal fat index (P<0.05) increased significantly;The ALT and GLU in serum increased (P<0.05), TG increased (P<0.05), and pathological findings showed significant steatosis; RT-PCR and Western blot showed that the expression levels of SIRT1 and FoxO1 mRNA decreased and the level of SERBP-1c increased in the model group. Compared with the model group, the hepatic lipid accumulation of EACCS groups was obviously improved, and the serum ALT, GLU, and TG levels significantly decreased, the expression levels of hepatic SIRT1 and FoxO1 mRNA increased. Conclusion EACCS has protective effects on NAFLD mice induced by HFFD, and its mechanism may be related to the activation of SIRT1-FoxO1 signaling pathway in the liver tissues.