OBJECTIVE: To evaluate the effectiveness of correcting post-traumatic equinovarus deformity using Ilizarov external fixation technique combined with limited osteotomy. METHODS: A retrospective analysis was conducted on clinical data from 29 patients with post-traumatic equinovarus deformity treated between July 2018 and March 2023. The cohort included 18 males and 11 females, with ages ranging from 15 to 57 years (mean, 24.3 years). All patients exhibited ankylosed ankle joints with equinovarus deformity. During surgery, external fixators were installed according to Ilizarov pinning principles, and minimally invasive osteotomy was performed at the ankle joint. Concurrently, soft tissue release was achieved via minimally invasive Achilles tendon lengthening. Postoperatively, multiplanar deformity correction was accomplished through gradual adjustment of the external fixator. The fixator was removed after bony union at the osteotomy site, followed by bracing. The surgical duration, intraoperative blood loss, fixator wear time, and complications were recorded. Postoperative outcomes included assessment of deformity correction and bony union at the osteotomy site. Functional improvement and pain relief were evaluated using pre- and post-operative scores from the American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot score and visual analogue scale (VAS) score. RESULTS: All 29 patients were followed up 12-24 months (mean, 18 months). The mean surgical duration was 85.6 minutes, with a mean intraoperative blood loss of 110 mL. Full deformity correction was achieved within 26-80 days (mean, 40.7 days) through progressive fixator adjustments. At correction completion, all ankles restored to a neutral or 5°-10° dorsiflexed position with plantigrade foot function. Superficial pin tract infections occurred in 3 patients (10.3%), resolved with local wound care, enhanced nursing, and oral antibiotics. No deep or systemic infections was observed. One patient sustained a calcaneal half-pin fracture due to a fall during fixator wear, but no bone fragment displacement occurred. No vascular or neurological complication was reported. Complete bony union was achieved at all osteotomy sites without nonunion. At last follow-up, the AOFAS ankle-hindfoot score improved from preoperative 42.7±8.7 to postoperative 65.7±9.3, and the VAS score decreased from preoperative 4.5±1.3 to postoperative 2.5±1.1, with significant differences ( P<0.05). Functional outcomes were rated as excellent in 14 cases, good in 13 cases, fair in 1 case, and poor in 1 case, with an excellent and good rate of 93.1%. CONCLUSION The progressive correction strategy combining Ilizarov external fixation technique with limited foot osteotomy effectively corrects post-traumatic equinovarus deformity while preserving soft tissue integrity. This method is associated with minimal, largely controllable complications and achieves alignment stability and fusion outcomes comparable to traditional open surgery, making it an effective treatment for complex foot and ankle deformities.
Humans ; Male ; Female ; Osteotomy/methods* ; Adult ; Retrospective Studies ; Ilizarov Technique ; Middle Aged ; Adolescent ; External Fixators ; Young Adult ; Treatment Outcome ; Ankle Joint/surgery* ; Clubfoot/etiology* ; Minimally Invasive Surgical Procedures/methods*

Objective:To investigate the prognostic value of aldosterone synthase (CYP11B2) immunohistochemical expression in adrenal specimens for surgical outcomes of primary aldosteronism (PA).Methods:The clinical data of 99 patients who underwent total unilateral adrenalectomy from June 2022 to January 2023 at Beijing Anzhen Hospital was retrospectively analysed. The clinical data of 99 patients who underwent unilateral total adrenalectomy at Beijing Anzhen Hospital from June 2022 to January 2023 were retrospectively analyzed.There were 59 patients in the PA group, age (53.02±10.56) years, body mass index (BMI) (26.28±4.33) kg/m 2, preoperative aldosterone 29.0(15.9, 61.5)ng/dl, plasma renin 1.3(0.6, 2.8)μIU/ml, aldosterone renin ratio (ARR) 19.3(9.1, 59.2) μg/μIU, preoperative potassium (3.60±0.69) mmol/L, and systolic blood pressure (156.54±21.39) mmHg (1 mmHg=0.133 kPa).There were 40 cases in the nonfunctioning adenoma (NFA) group, age (57.23±9.39) years, BMI (27.07±3.46) kg/m 2, preoperative aldosterone 9.0(7.2, 14.1) ng/dl, plasma renin 18.0(5.2, 47.6)μIU/ml, ARR 0.6(0.2, 1.4) μg/μIU, preoperative potassium (4.17±0.41) mmol/L, and systolic blood pressure (157.97±26.87) mmHg. The differences between the two groups were statistically significant for potassium ( P<0.01), aldosterone ( P=0.012), renin ( P<0.01), and ARR ( P<0.01).Surgical outcomes were assessed using the Consensus on the Outcome of Surgery for Primary Aldosteronism (PASO) (complete/partial/no success for clinical and biochemical outcomes). CYP11B2 expression was evaluated by immunohistochemistry using the 2022 World Health Organization's histopathology of primary aldosteronism (HISTALDO) criteria. The correlation between the expression of CYP11B2 and surgical outcomes was assessed. Results:The mean follow-up of 99 patients was (11.73±4.92) months. Of these, 36 out of 59 PA patients had positive CYP11B2 expression in their adrenal specimens, while 23 were negative; all 40 NFA patients were negative for CYP11B2. Among the 36 CYP11B2-positive PA patients, there were 19 cases of aldosterone-producing adenomas, 3 aldosterone-producing nodules, 4 aldosterone-producing micronodules, 8 multiple aldosterone-producing micronodules, and 2 aldosterone-producing diffuse hyperplasia. 36 cases of CYP11B2-positive PA patients had complete clinical success in 15 cases, partial success in 20 cases, and no success in 1 case, and complete biochemical success in 24 cases, partial success in 11 cases, and no success in 1 case; 23 CYP11B2-negative PA patients had complete clinical success in 4 cases, partial success in 15 cases, and no success in 4 cases, and complete biochemical success in 6 cases, partial success in 15 cases, and no success in 2 cases. Adrenal specimens from CYP11B2-positive PA patients had significantly better clinical ( P=0.038) and biochemical ( P=0.008) success rates than CYP11B2-negative PA patients. Patients with aldosterone-producing adenomas had complete clinical success in 8 cases, partial success in 11 cases, and no success in 0 cases, and biochemical success was completely achieved in 16 cases, partially achieved in 2 cases, and not successful in 1 case. They also had significantly higher clinical ( P=0.028) and biochemical ( P<0.01) success rates compared to CYP11B2-negative PA patients. Conclusions:Patients with PA who had immunohistochemical staining for CYP11B2 positivity and high expression in adrenal specimens had a better postoperative clinical and biochemical prognosis. Patients with aldosterone-producing adenomas had the greatest postoperative outcome of all pathological subtypes of PA.

Objective:To investigate expressions of LDHA,CD56 and NKG2D in liver cancer tissues,and to further explore effects and correlations of Bufalin(BF)on LDHA and NK cells in hepatocellular carcinoma.Methods:Immunohistochemistry(IHC)was used to detect differential expressions of LDHA and NK cell specific molecular markers CD56 and NKG2D in 91 postoperative paraffin pathological specimens of hepatocellular carcinoma,as well as correlation between these markers in cancer and adjacent tissues.A Hepa1-6 subcutaneous tumor bearing hepatocellular carcinoma model was constructed by C57BL/6 mice and randomly divide into Control(Ctrl)group,BF+Pyruvic acid(BF+PA)group,Oxamate(OX)group,BF group,with 5 mice per group.Growth rate and volume of subcutaneous tumors were observed;IHC was used to detect expressions of LDHA and mouse NK cell specific molecular markers NK1.1 and NKG2D in tumors of each group of mice;ELISA was used to detect concentrations of perforin,TNF-α and IFN-γ in serum of mice in each group.Results:LDHA was highly expressed in human liver cancer tissues(P<0.001),while CD56 and NKG2D were highly expressed in adjacent tissues(P<0.001);LDHA expression was negatively correlated with CD56(r=-0.529 8,P<0.000 1)and NKG2D(r=-0.320 1,P<0.001);CD56 expression was positively correlated with NKG2D(r=0.612 2,P<0.000 1).Subcutaneous tumor experiment of mouse hepatocellular carcinoma showed that compared with Ctrl group and BF+PA group,subcutaneous tumor growth rate of OX group and BF group slowed down and showed a trend of tumor reduction;IHC detection showed that compared with Control group,LDHA expression in BF group was significantly downregulated(P<0.01),NK1.1 and NKG2D expressions were significantly increased(P<0.000 1);ELISA showed that compared with Ctrl group,LDHA in serum of BF group increased perforin,TNF-α,IFN-γ expressions(P<0.000 1),and enhanced NK cell killing ability.Conclusion:BF can inhibit LDHA expression in hepatocellular carcinoma cells and increase infiltration rate of NK cells in hepatocellular carcinoma tissues,which may enhance killing ability of NK cells in tumor microenvironment and inhibit growth of hepatocellular carcinoma.

Objective:To investigate expressions of LDHA,CD56 and NKG2D in liver cancer tissues,and to further explore effects and correlations of Bufalin(BF)on LDHA and NK cells in hepatocellular carcinoma.Methods:Immunohistochemistry(IHC)was used to detect differential expressions of LDHA and NK cell specific molecular markers CD56 and NKG2D in 91 postoperative paraffin pathological specimens of hepatocellular carcinoma,as well as correlation between these markers in cancer and adjacent tissues.A Hepa1-6 subcutaneous tumor bearing hepatocellular carcinoma model was constructed by C57BL/6 mice and randomly divide into Control(Ctrl)group,BF+Pyruvic acid(BF+PA)group,Oxamate(OX)group,BF group,with 5 mice per group.Growth rate and volume of subcutaneous tumors were observed;IHC was used to detect expressions of LDHA and mouse NK cell specific molecular markers NK1.1 and NKG2D in tumors of each group of mice;ELISA was used to detect concentrations of perforin,TNF-α and IFN-γ in serum of mice in each group.Results:LDHA was highly expressed in human liver cancer tissues(P<0.001),while CD56 and NKG2D were highly expressed in adjacent tissues(P<0.001);LDHA expression was negatively correlated with CD56(r=-0.529 8,P<0.000 1)and NKG2D(r=-0.320 1,P<0.001);CD56 expression was positively correlated with NKG2D(r=0.612 2,P<0.000 1).Subcutaneous tumor experiment of mouse hepatocellular carcinoma showed that compared with Ctrl group and BF+PA group,subcutaneous tumor growth rate of OX group and BF group slowed down and showed a trend of tumor reduction;IHC detection showed that compared with Control group,LDHA expression in BF group was significantly downregulated(P<0.01),NK1.1 and NKG2D expressions were significantly increased(P<0.000 1);ELISA showed that compared with Ctrl group,LDHA in serum of BF group increased perforin,TNF-α,IFN-γ expressions(P<0.000 1),and enhanced NK cell killing ability.Conclusion:BF can inhibit LDHA expression in hepatocellular carcinoma cells and increase infiltration rate of NK cells in hepatocellular carcinoma tissues,which may enhance killing ability of NK cells in tumor microenvironment and inhibit growth of hepatocellular carcinoma.

Objective:To investigate the prognostic value of aldosterone synthase (CYP11B2) immunohistochemical expression in adrenal specimens for surgical outcomes of primary aldosteronism (PA).Methods:The clinical data of 99 patients who underwent total unilateral adrenalectomy from June 2022 to January 2023 at Beijing Anzhen Hospital was retrospectively analysed. The clinical data of 99 patients who underwent unilateral total adrenalectomy at Beijing Anzhen Hospital from June 2022 to January 2023 were retrospectively analyzed.There were 59 patients in the PA group, age (53.02±10.56) years, body mass index (BMI) (26.28±4.33) kg/m 2, preoperative aldosterone 29.0(15.9, 61.5)ng/dl, plasma renin 1.3(0.6, 2.8)μIU/ml, aldosterone renin ratio (ARR) 19.3(9.1, 59.2) μg/μIU, preoperative potassium (3.60±0.69) mmol/L, and systolic blood pressure (156.54±21.39) mmHg (1 mmHg=0.133 kPa).There were 40 cases in the nonfunctioning adenoma (NFA) group, age (57.23±9.39) years, BMI (27.07±3.46) kg/m 2, preoperative aldosterone 9.0(7.2, 14.1) ng/dl, plasma renin 18.0(5.2, 47.6)μIU/ml, ARR 0.6(0.2, 1.4) μg/μIU, preoperative potassium (4.17±0.41) mmol/L, and systolic blood pressure (157.97±26.87) mmHg. The differences between the two groups were statistically significant for potassium ( P<0.01), aldosterone ( P=0.012), renin ( P<0.01), and ARR ( P<0.01).Surgical outcomes were assessed using the Consensus on the Outcome of Surgery for Primary Aldosteronism (PASO) (complete/partial/no success for clinical and biochemical outcomes). CYP11B2 expression was evaluated by immunohistochemistry using the 2022 World Health Organization's histopathology of primary aldosteronism (HISTALDO) criteria. The correlation between the expression of CYP11B2 and surgical outcomes was assessed. Results:The mean follow-up of 99 patients was (11.73±4.92) months. Of these, 36 out of 59 PA patients had positive CYP11B2 expression in their adrenal specimens, while 23 were negative; all 40 NFA patients were negative for CYP11B2. Among the 36 CYP11B2-positive PA patients, there were 19 cases of aldosterone-producing adenomas, 3 aldosterone-producing nodules, 4 aldosterone-producing micronodules, 8 multiple aldosterone-producing micronodules, and 2 aldosterone-producing diffuse hyperplasia. 36 cases of CYP11B2-positive PA patients had complete clinical success in 15 cases, partial success in 20 cases, and no success in 1 case, and complete biochemical success in 24 cases, partial success in 11 cases, and no success in 1 case; 23 CYP11B2-negative PA patients had complete clinical success in 4 cases, partial success in 15 cases, and no success in 4 cases, and complete biochemical success in 6 cases, partial success in 15 cases, and no success in 2 cases. Adrenal specimens from CYP11B2-positive PA patients had significantly better clinical ( P=0.038) and biochemical ( P=0.008) success rates than CYP11B2-negative PA patients. Patients with aldosterone-producing adenomas had complete clinical success in 8 cases, partial success in 11 cases, and no success in 0 cases, and biochemical success was completely achieved in 16 cases, partially achieved in 2 cases, and not successful in 1 case. They also had significantly higher clinical ( P=0.028) and biochemical ( P<0.01) success rates compared to CYP11B2-negative PA patients. Conclusions:Patients with PA who had immunohistochemical staining for CYP11B2 positivity and high expression in adrenal specimens had a better postoperative clinical and biochemical prognosis. Patients with aldosterone-producing adenomas had the greatest postoperative outcome of all pathological subtypes of PA.

Humans ; Fasciitis/pathology* ; Fibroma/pathology* ; Gene Rearrangement ; Proto-Oncogene Proteins/genetics* ; Ubiquitin Thiolesterase

Heart failure with high prevalence is the endpoint of many cardiovascular diseases. Once diagnosed， patients usually need lifelong medication， which seriously affects their quality of life. The drugs commonly used to treat heart failure include angiotensin-converting enzyme inhibitors， beta-blockers， aldosterone receptor antagonists， and diuretics. However， the long-term use of those drugs can lead to side effects such as hypotension， depletion of body fluid， and electrolyte imbalance and even increase mortality. According to the theory of traditional Chinese medicine （TCM）， Qi deficiency and blood stagnation is the major cause of heart failure and when Qi is not moving， blood is not flowing. Therefore， the TCM clinical treatment of heart failure uses the Chinese medicinal materials which replenish Qi， activate blood， and dispell stasis to treat both internal cause and external symptoms. Recent studies have demonstrated that Chinese herbal medicines such as Astragali Radix， Ginseng Radix et Rhizoma， Notoginseng Radix et Rhizoma， Salviae Miltiorrhizae Radix et Rhizoma， Angelicae Sinensis Radix， as well as the compound formulas such as Buyang Huanwutang， Simiao Yongantang， Qili Qiangxin capsules， and Qishen Yiqi drops， play a significant role in the prevention and treatment of heart failure via replenishing Qi， activating blood， and dispelling stasis. Inhibition of oxidative stress and inflammatory responses， mitigation of myocardial fibrosis， improvement of calcium cycling， and protection of mitochondrial function represent the key mechanisms for the treatment of heart failure with Chinese medicinal materials. Focusing on the pathogenic mechanisms and signaling pathways of heart failure， this paper systematically describes the pharmacological effects， molecular mechanisms， and research progress in the clinical application of Chinese medicinal herbs with effects of replenishing Qi， activating blood， and dispelling stasis and their compound formulas in the prevention and treatment of heart failure， aiming to provide scientific evidence for the development and clinical use of anti-heart failure Chinese medicinal materials.

Objective To investigate the effect of insulin pump combined with dipeptidyl peptidase-Ⅳ (DPP-Ⅳ) inhibitor on the treatment of newly diagnosed type 2 diabetes mellitus (T2 DM). Methods Totally 51 newly diagnosed patients with T2 DM were randomly divided into experimental group (insulin pump combined with DPP-Ⅳ inhibitor) and control group (insulin pump alone). After 15 days of treatment, the clinical effect was compared between two groups. Results After treatment, the blood sugar related indexes in both groups significantly improved (P ＜ 0. 05), and the blood sugar control of the experimental group was significantly better than that of the control group (P ＜ 0. 05). The pancreatic β cell function index, area under curve of C-peptide and insulin resistance index in the experimental group were significantly better than those in the control group (P ＜0. 05). The dosage of insulin, the ratio of patients with blood sugar reaching the standard completely, the time of blood sugar reaching the standard and the increase value of body mass in the experimental group were significantly better than those in the control group (P ＜ 0. 01). The incidence rate of hypoglycemia was 8. 00％ (2/26) in the experimental group and 12. 00％ (3/25) in the control group, and there was no significant difference between the two groups (P＞ 0. 05). During the treatment, no severe hypoglycemic events and liver and kidney function damage occurred in both groups. Conclusion Insulin pump combined with DPP-Ⅳ inhibitor is effective in the treatment of newly diagnosed T2 DM, which can effectively control blood sugar, reduce insulin resistance and weight gain.

Objective To investigate the effect of insulin pump combined with dipeptidyl peptidase-Ⅳ (DPP-Ⅳ) inhibitor on the treatment of newly diagnosed type 2 diabetes mellitus (T2 DM). Methods Totally 51 newly diagnosed patients with T2 DM were randomly divided into experimental group (insulin pump combined with DPP-Ⅳ inhibitor) and control group (insulin pump alone). After 15 days of treatment, the clinical effect was compared between two groups. Results After treatment, the blood sugar related indexes in both groups significantly improved (P ＜ 0. 05), and the blood sugar control of the experimental group was significantly better than that of the control group (P ＜ 0. 05). The pancreatic β cell function index, area under curve of C-peptide and insulin resistance index in the experimental group were significantly better than those in the control group (P ＜0. 05). The dosage of insulin, the ratio of patients with blood sugar reaching the standard completely, the time of blood sugar reaching the standard and the increase value of body mass in the experimental group were significantly better than those in the control group (P ＜ 0. 01). The incidence rate of hypoglycemia was 8. 00％ (2/26) in the experimental group and 12. 00％ (3/25) in the control group, and there was no significant difference between the two groups (P＞ 0. 05). During the treatment, no severe hypoglycemic events and liver and kidney function damage occurred in both groups. Conclusion Insulin pump combined with DPP-Ⅳ inhibitor is effective in the treatment of newly diagnosed T2 DM, which can effectively control blood sugar, reduce insulin resistance and weight gain.

Objective:To establish a HPLC method for the simultaneous determination of adenosine,genistein and 5-hydroxymel-lein in Xylarin nigripes powder.Methods:The chromatographic separation was carried out on a Pntulips@BP-C18column (250 mm× 4.6 mm,5 μm) at 35℃. The mobile phase consisted of acetonitrile-0.1% formic acid with gradient elution at a flow rate of 1.0 ml ·min-1,and the detection wavelength was 254 nm. Results:The linear range of adenosine was 0.162-1.62 μg(r=0.999 2). The average recovery was 98.12% and the RSD was 1.32% (n=6). The linear range of genistein was 0.02-0.2 μg(r=0.999 9). The average recovery was 98.89% and the RSD was 1.10% (n =6). The linear range of 5-hydroxymellein was 0.022-0.22 μg(r =0.999 9). The average recovery was 99.87% and the RSD was 0.98% (n=6). Conclusion:The method can be used to determine the contents of adenosine,genistein and 5-hydroxymellein,which provides the basis for the quality control and the further research of Xylaria nigripes.