OBJECTIVE To analyze the serum chemical composition of rats after intragastric administration of water extract of crude Anemarrhenae Rhizoma-crude Phellodendri Chinensis and salted Anemarrhenae Rhizoma-salted Phellodendri Chinensis based on liquid chromatography-mass spectrometry(LC-MS)technology,predict the effect of salt processing on the treatment of type 2 dia-betes in Anemarrhenae Rhizoma-Pheellodendri Chinensis combined with network pharmacology,and preliminarily verify it through in vitro experiments.METHODS Rats were continuously intragastrically administered with crude Anemarrhenae Rhizoma-crude Phello-dendri Chinensis drug pair and salted Anemarrhenae Rhizoma-salted Phellodendri Chinensis drug pair water extract twice,with an in-terval of 1 h.After 60 min of the last administration,the blood was taken from the abdominal aorta,and the protein was precipitated by methanol.After dissolution,the chromatographic column was Shim-pack GIST C18(4.6 mm×150 mm,5 μm);the mobile phase A was 0.1%formic acid water,and the mobile phase B was 0.1%formic acid-acetonitrile;gradient elution,positive and negative ion full scan mode,mass scan range 100-1 500 m/z.Combined with the secondary spectrum of the database and literature,the blood compo-nents of crude Anemarrhenae Rhizoma-crude Phellodendri Chinensis drug pair and salted Anemarrhenae Rhizoma-salted Phellodendri Chinensis drug pair were analyzed and identified.The disease targets of type 2 diabetes were retrieved,and the protein interaction net-work analysis,GO and KEGG pathway enrichment analysis were performed on the intersection targets of blood components and diseases.The"blood components-targets"network diagram was constructed,and the selected core components and core targets were verified by molecular docking using AutoDock software.In the verification experiment,HepG2 cells were used as the experimental ob-ject,and the insulin resistance model was induced by high insulin and high glucose.CCK8 method was used to test the effect of Rhizo-ma Anemarrhenae-Phellodendri Chinensis on cell proliferation before and after salt processing.Western blot was used to detect the ex-pression of PI3K-AKT signaling pathway-related proteins.RESULTS 15 prototype components and 1 mangiferin metabolic compo-nent were identified in the serum of rats.17 prototype components and 1 mangiferin metabolite were identified in the rat serum of the water extract of Anemarrhenae Rhizoma-Phellodendri Chinensis after salt processing.The contents of mangiferin,berberine and 3-isobutylglutaric acid in the blood components after salt-processing were higher than those in the raw products.According to the results of KEGG and GO,the treatment of type 2 diabetes may be related to the transcriptional regulation of RNA polymerase,inflammatory re-sponse,AGE-RAGE,PI3K-AKT pathway and insulin resistance.Cell experiments showed that the ratio of p-PI3K/PI3K,p-AKT/AKT and GLUT4 protein expression could be up-regulated before and after salt processing,and the effect of salt processing group was better than that of the crude group.CONCLUSION This experiment preliminarily revealed the components of Anemarrhenae Rhizo-ma-Phellodendri Chinensis drug pair entering the blood before and after salt exposure,and suggested that ferulic acid,berberine,ber-berrubine,mangiferin,mTOR,SIRT1,EGFR and PPARA may be the main components and targets of Rhizoma Anemarrhenae-Phel-lodendri Chinensis after salt processing to enhance the therapeutic effect of type 2 diabetes.The mechanism may be to enhance the role of PI3K-AKT and other related signaling pathways,providing an important reference for the pharmacodynamic material basis and clini-cal application of Anemarrhenae Rhizoma-Phellodendri Chinensis before and after salt processing.

Objective:To analyze the compliance with enhanced recovery after surgery (ERAS) protocol in geriatric patients with fresh fracture.Methods:A retrospective study was conducted on the data of the patients with fresh extremity fracture which had been included in the ERAS perioperative protocol database during May 2019 and January 2022 at Department of Orthopaedic Trauma, Beijing Jishuitan Hospital. The patients ≥65 years were selected as a study group which was matched by a control group of the patients < 65 years in sex, fracture type and date frame of hospitalization at a ratio of 1∶1. The 2 groups were compared in the compliance with the 14 ERAS core perioperative elements.Results:The study group and the control group each included 66 patients who were matched in sex and fracture type. 62.1% (41/66) of the patients in the study group had combined diseases, significantly more than that [16.7% (11/66)] in the control group( P<0.001). Altogether, the compliance with the 14 ERAS core perioperative elements was 78.6 (71.4, 85.7) % in both groups, showing no significant difference between them ( P>0.05). Respectively, the compliance with the postoperative oral intake in the study group (80.3%, 53/66) was significantly lower than that in the control group (92.4%, 61/66) ( P<0.05); the compliance with the other 13 elements showed no statistically significant difference between the 2 groups ( P>0.05). Conclusion:The ERAS perioperative protocol can be carried out smoothly in geriatric patients with fresh fracture whose compliance may be comparable to that of the none-elderly patients.

Objective:To analyze the factors which may influence postoperative early ambulation in patients with fresh fracture so as to further optimize the perioperative protocol based on the concept of enhanced recovery after surgery (ERAS).Methods:A retrospective analysis was conducted of the patients who had been treated for a single fresh fracture at the extremity, pelvis or acetabulum from May 2019 to July 2019. Collected were the data concerning basic features of patients, perioperative ERAS management and surgery, as well as early ambulation on the day of surgery or the first day after surgery. The patients were divided into an early ambulation group and a non-early ambulation group according to the time of ambulation. Statistical analyses were performed of the relationships between early ambulation and 20 potential factors concerning basic features of patients, perioperative ERAS management and surgery. Logistic correlation analysis was performed to identify risk factors for postoperative early ambulation.Results:A total of 306 patients were included, including 96 upper limb, 203 lower limb, 5 acetabular and 2 pelvic fractures. Of them, 150 ambulaed from bed on the day of surgery or the first day after surgery while 156 did not. Significant differences were observed between the 2 groups in fracture site, intake of carbohydrate liquids the night before surgery and the day of surgery, catheter indwelling, intraoperative liquid transfusion volume and postoperative complications ( P < 0.05). Logistic correlation analysis of the relationship between the above factors and postoperative early ambulation found that fracture site and intraoperative liquid transfusion volume were significantly correlated with postoperative early ambulation ( P < 0.05). Conclusions:About half of the patients with a single fresh fracture may ambulate early after surgery. Fracture site and intraoperative liquid transfusion volume may be significantly correlated with postoperative early ambulation.

Objective The three-dimensional (3D) solid model of medulla oblongata-upper cervical spinal cord based on specimen pathological section data was established, and the stress and strain levels of medulla oblongata-upper cervical spinal cord under dentate process compression were obtained by finite element analysis, so as to provide references for clinical research. Methods Mimics was used to process the slice data, so as to establish the point cloud model. SolidWorks was used to locate, edit and optimize the point cloud model, so as to establish the 3D solid model. HyperMesh was used to establish the finite element model and ANSYS was used for finite element analysis. Results The medulla oblongata-upper cervical spinal cord model with clear boundary between gray matter and white matter and white matter fiber bundle was established. The stress and strain levels and stress-strain curves of white matter and gray matter under different compression degrees were obtained. Conclusions Combined with pathological sections of specimens and reverse engineering, the 3D medulla oblongata-upper cervical spinal cord model with clear morphology and structure of gray/white matter can be established. When the medulla oblongata-upper cervical spinal cord is compressed, the stress level of gray matter is lower than that of white matter, and about 20% of compression is the critical state of white matter. When the disease develops beyond the critical state, the biomechanical properties of white matter may fail, resulting in gray matter damage.

Objective:To study the clinical effect of Microbotox in improving mandibular fat accumulation, lifting mandibular contour and achieving lower face and neck rejuvenation.Methods:From May 2020 to January 2021, patients with mandibular fat accumulation and skin relaxation of mandible and neck were treated in Plastic Surgery Hospital, Chinese Academy of Medical Sciences. Multiple microdroplets of botulinum toxin type A was injected into the dermis or the interface between the dermis and the superficial muscle layer in lower face and neck. Botulinum toxin was diluted to 20 U/ml and injected with 0.6 U per point. The scope of Microbotox was demarcated by the line between earlobe-mouth corner as the upper border, the depressor anguli oris as the anterior border, the front edge of sternocleidomastoid muscle front edge as the posterior border, and the jugular notch as the inferior border. Treatment effect was evaluated postoperatively by the subjective satisfaction of patients and the accessment of a third-party physicians.Results:A total of 25 patients were included, including 10 males and 15 females, with the age of 39.4±3.7 years. The patient subjective satisfaction was 96%(24/25), and 96%(24/25) of patients received improved result , evaluated by a third-party physician. There were no serious complications except one case of local congestion and four cases of local pain and swelling, which could be relieved in a short time.Conclusions:Characterized by improving mandibular fat accumulation, lifting mandibular contour, reducing cervicomental angle, improving skin texture and neck wrinkles, Microbotox is effective and practical.

Objective:To study the clinical effect of Microbotox in improving mandibular fat accumulation, lifting mandibular contour and achieving lower face and neck rejuvenation.Methods:From May 2020 to January 2021, patients with mandibular fat accumulation and skin relaxation of mandible and neck were treated in Plastic Surgery Hospital, Chinese Academy of Medical Sciences. Multiple microdroplets of botulinum toxin type A was injected into the dermis or the interface between the dermis and the superficial muscle layer in lower face and neck. Botulinum toxin was diluted to 20 U/ml and injected with 0.6 U per point. The scope of Microbotox was demarcated by the line between earlobe-mouth corner as the upper border, the depressor anguli oris as the anterior border, the front edge of sternocleidomastoid muscle front edge as the posterior border, and the jugular notch as the inferior border. Treatment effect was evaluated postoperatively by the subjective satisfaction of patients and the accessment of a third-party physicians.Results:A total of 25 patients were included, including 10 males and 15 females, with the age of 39.4±3.7 years. The patient subjective satisfaction was 96%(24/25), and 96%(24/25) of patients received improved result , evaluated by a third-party physician. There were no serious complications except one case of local congestion and four cases of local pain and swelling, which could be relieved in a short time.Conclusions:Characterized by improving mandibular fat accumulation, lifting mandibular contour, reducing cervicomental angle, improving skin texture and neck wrinkles, Microbotox is effective and practical.

Objective To investigate the incidence of motor system disorders or symptoms that occurred among naval afloat personnel onboard a certain naval surface ship after a prolonged distant voyage.Methods In the year of 2015,a randomized questionnaire survey was carried out among the naval afloat personnel,who experienced a prolonged ocean-going voyage greater than 5 months with a total distance as far as 32 500 nautical miles,covering 4 continents and crossing 2 great oceans.All the subjects finished the questionnaire survey independently and all the questionnaire survey forms were recovered on site and statistical analyses were made by Excel and SPSS 13.0 software.Results Totally,109 copies of questionnaire were issued and 95 copies were recovered,and 90 copies were confirmed valid,with a total valid rate of 94.7％.The average age of the subjects (11 females and 79 males) was (25.12 ± 4.63) years.There were 22 naval afloat personnel with past motor system chronic diseases,accounting for 24.4％.Before prolong distant voyage,52 people complained of motor system disorders (52/90),accounting for 58％,but after prolonged distant voyage,58 people complained of motor system disorders (58/90),accounting for 65.2％.Before prolonged distant voyage,in the ship crew who lived in the relatively dry cabins,22 people complained of motor system disorders (22/33),accounting for 66.7％,but after prolonged distant voyage,21 people complained of motor system disorders (21/33),accounting for 63.6％.However,Before prolonged distant voyage,in the ship crew who lived in the relatively humid cabins,25 people complained of motor system disorders (25/46),accounting for 54.3％,but after prolonged distant voyage,34 people complained of motor system disorders (34/46),accounting for 73.9％.Conclusions Various environmental factors during prolonged distant voyage,particularly humidity in living cabins,exerted negative effects on musculoskeletal system.More strict prophylactic countermeasures should be applied.Due to high incidence of musculoskeletal system disorders,poor knowledge of the naval ship crew about the prevention and treatment of the disorders and their urgent desire to obtain required necessary consultation on the disorders,corresponding medical service should be provided in accordance with the above-mentioned features.

Objective To investigate the incidence of motor system disorders or symptoms that occurred among naval afloat personnel onboard a certain naval surface ship after a prolonged distant voyage.Methods In the year of 2015,a randomized questionnaire survey was carried out among the naval afloat personnel,who experienced a prolonged ocean-going voyage greater than 5 months with a total distance as far as 32 500 nautical miles,covering 4 continents and crossing 2 great oceans.All the subjects finished the questionnaire survey independently and all the questionnaire survey forms were recovered on site and statistical analyses were made by Excel and SPSS 13.0 software.Results Totally,109 copies of questionnaire were issued and 95 copies were recovered,and 90 copies were confirmed valid,with a total valid rate of 94.7％.The average age of the subjects (11 females and 79 males) was (25.12 ± 4.63) years.There were 22 naval afloat personnel with past motor system chronic diseases,accounting for 24.4％.Before prolong distant voyage,52 people complained of motor system disorders (52/90),accounting for 58％,but after prolonged distant voyage,58 people complained of motor system disorders (58/90),accounting for 65.2％.Before prolonged distant voyage,in the ship crew who lived in the relatively dry cabins,22 people complained of motor system disorders (22/33),accounting for 66.7％,but after prolonged distant voyage,21 people complained of motor system disorders (21/33),accounting for 63.6％.However,Before prolonged distant voyage,in the ship crew who lived in the relatively humid cabins,25 people complained of motor system disorders (25/46),accounting for 54.3％,but after prolonged distant voyage,34 people complained of motor system disorders (34/46),accounting for 73.9％.Conclusions Various environmental factors during prolonged distant voyage,particularly humidity in living cabins,exerted negative effects on musculoskeletal system.More strict prophylactic countermeasures should be applied.Due to high incidence of musculoskeletal system disorders,poor knowledge of the naval ship crew about the prevention and treatment of the disorders and their urgent desire to obtain required necessary consultation on the disorders,corresponding medical service should be provided in accordance with the above-mentioned features.

In this study, a multiplex RT-PCR method was developed for detection of seven diarrhea-associated porcine viruses, including porcine teschovirus (PTV), porcine sapovirus (PSV), porcine deltacornavirus (PDCoV), porcine kobuvirus (PKV), porcine sapovirus (PSaV), porcine astrovirus (PAstV) and porcine torovirus (PToV). A total of 419 samples were screened by this method and results showed that PKV had the highest positive rate of 26.98%?45.79% and its mixed infection rate reached 9.52%-18.54%. On account of high positive rate of PKV and its important role in diarrhea disease, complete genomic sequences of three PKV positive samples were further sequenced. Three PKV labeled as PD-PKV, JS-PKV and CM-PKV were classified into porcine kobuvirus genus and had far genetic distance with other kobuviruses. The complete genome homologies among them were 88.1%-89.1%. CM-PKV had the highest identity with the Chinese strain JS-02a-CHN/2013 reported in 2013 while JS-PKV and PD-PKV were most closed to the K-30-HUN/2008/HUN strain reported in Hungary in 2008. This illustrates the significant genetic differences of the different PKV isolates in Shanghai while its relationship with the viral pathogenicity still needs to be explored. This research provides references for further understanding the prevalence of PKV and its role in swine diarrhea.

Objective To research the clinical evaluation of potassium dehydroandrograpolide succinate injection in the treatment of COPD combined with CAP and its influence on plasma IL-33, PCT and hs-CRP levels.Method 91 patients with COPD combined with CAP in our hospital from April 2015 to August 2016 were selected and divided into the observation group (48 cases) and the control group (43 cases).The control group was given routine treatment, the observation group was given on the basis of the above treatment of potassium dehydroandrograpolide succinate injection.The clinical efficacy and plasma IL-33, PCT and hs-CRP levels were compared between the two groups after treatment.Results Before treatment, the IL-33, PCT, hs-CRP of two groups of patients had no significant difference.After treatment, the total effective rate of the observation group was 91.67% higher than that of the control group 74.42%, the difference was statistically significant (P<0.05).All the clinical symptoms time of the observation group was significantly lower than that of the control group, and the clearance rate of the observation group (85.42%) was significantly higher than that of the control group (67.44%), the difference was statistically significant (P<0.05), the indexes of the two groups of patients were decreased, the indexes of the observation group significantly lower than that in control group, the difference was statistically significant (P<0.05).There was no significant difference in the incidence of adverse reactions between the observation group and the control group .Conclusion Potassium dehydroandrograpolide succinate injection can significantly improve their plasma IL-33, PCT and hs-CRP levels, the respiratory pathogen and inflammatory mediators are effectively removed, and has good clinical effect, and no serious adverse reactions during treatment.