BACKGROUND:The micro/nanostructured gradient biomimetic surface of implant materials can simulate the structure of the extracellular environment in human bone tissue,thereby achieving perfect bone integration function.However,further research is needed on the mechanisms by which the surface microstructure of bone implant materials regulates cell function and promotes osteogenesis. OBJECTIVE:To analyze the effect of titanium sheet microstructure surface on osteogenic differentiation of MC3T3-E1 osteoblasts. METHODS:(1)At a constant voltage of 5 V or 20 V,nanotube arrays of different diameters were prepared on the surface of titanium sheets by acid etching and anodic oxidation techniques,and were recorded as group R5 and group R20,respectively.The surface morphology,roughness,and hydrophilicity of pure titanium sheet(without acid etching or anodizing treatment)were measured in group R5 and group R20.(2)MC3T3-E1 osteoblasts of logarithmic growth stage were inoculated on the surface of pure titanium sheets,R5 group and R20 group respectively.After 24 hours of osteogenic induction culture,the expression of mechanical sensitive channel protein 1 was analyzed by RT-PCR and immunofluorescence staining.Osteoblast inducible base with or without the mechanosensitive channel protein 1 activator Yada1 was added,and alkaline phosphatase staining was performed after 7 days of culture.Alizarin red staining was performed after 14 days of culture. RESULTS AND CONCLUSION:(1)The surface of pure titanium sheets was smooth under scanning electron microscope.Relatively uniform and orderly nanotube arrays with average diameters of about 30 nm and 100 nm were observed on the surface of titanium sheets of groups R5 and R20,respectively.The results of scanning electron microscope were further verified by atomic force microscopy.The surface roughness of titanium sheet of group R5 was higher than that of pure titanium(P<0.05),and the water contact angle was lower than that of pure titanium(P<0.05).The surface roughness of titanium sheet in group R20 was higher than that in group R5(P<0.05),and the water contact angle was lower than that in group R5(P<0.05).(2)RT-PCR and immunofluorescence staining showed that the expression of mechanosensitive channel protein 1 in group R5 was higher than that in pure titanium group(P<0.05),and the expression of mechanosensitive channel protein 1 in group R20 was higher than that in group R5(P<0.05).Under the osteogenic induction,compared with the condition without Yada1,there were no significant changes in the activity of alkaline phosphatase and the deposition of calcified nodules in pure titanium group after Yada1 addition,while the activity of alkaline phosphatase and the deposition of calcified nodules in groups R5 and R20 after Yada1 addition were significantly increased(P<0.05).With or without Yada1,the alkaline phosphatase activity and calcified nodule deposition in group R5 were higher than those in pure titanium group(P<0.05),and the alkaline phosphatase activity and calcified nodule deposition in group R20 were higher than those in group R5(P<0.05).(3)The results show that the surface microstructure of titanium sheet can promote the osteogenic differentiation of osteoblast MC3T3-E1 by activating mechanosensitive channel protein 1.

Objective To observe the clinical efficacy of Shengdi Xiexin Decoction combined with proton pump inhibitors(PPIs)in the treatment of acute non-variceal upper gastrointestinal bleeding(ANVUGIB)with stomach-heat congestion syndrome.Methods Sixty-two patients with ANVUGIB of stomach-heat congestion syndrome admitted to Dongguan Hospital of Guangzhou University of Chinese Medicine between January and December 2024 were randomly divided into a treatment group(n=31)and a control group(n=31)using a random number table.The control group received conventional western therapy(e.g.,Omeprazole Sodium),while the treatment group additionally received Shengdi Xiexin Decoction.Both groups were treated for 7 days,followed by 8 weeks of follow-up.The changes in traditional Chinese medicine(TCM)syndrome scores,hematological parameters[hemoglobin(Hb),red blood cells(RBC),hematocrit(Hct),albumin(ALB)],tissue perfusion and metabolic markers[blood urea nitrogen/creatinine ratio(BUN/Cr),lactate(Lac)levels],hemostasis time,time to resume oral diet,hospital stay duration,hospitalization costs,and rebleeding rates were observed to evaluate the clinical efficacy and drug safety.Results(1)After 7 days of treatment,the total effective rate was significantly higher in the treatment group(90.32％,28/31)than that in the control group(74.19％,23/31).The intergroup comparison(by chi-square test)showed that the treatment group,efficacy was superior to that of the control group(P＜0.05).(2)The treatment group showed significantly short hemostasis time,time to resume oral diet,and hospital stay duration(P＜0.05),as well as significantly low hospitalization costs(P＜0.05)compared to the control group.(3)Both groups exhibited significant reductions in the scores of epigastric burning pain,abdominal distension,acid regurgitation,restlessness,excessive thirst,scanty dark uring and dry stools,and total TCM syndrome scores(P＜0.05).The treatment group demonstrated significantly greater improvements in the scores of abdominal distension,acid regurgitation,restlessness,dark uring and dry stools,and total TCM syndrome scores(P＜0.05),while no significant differences were observed in epigastric burning pain and excessive thirst(P＞0.05).(4)Hb and Hct levels increased significantly in both groups(P＜0.05),with a greater increase in the treatment group(P＜0.05).Although RBC and ALB levels showed an upward trend,no significant differences were observed between groups(P＞0.05).Following treatment,intergroup comparisons revealed that the treatment group demonstrated significantly greater increases in Hb and Hct levels than the control group(P＜0.05).In contrast,the two groups showed comparable effects in elevating RBC and ALB levels,with no statistically significant differences(P＞0.05).(5)BUN/Cr ratio and Lac levels decreased significantly in both groups(P＜0.05),with a more pronounced reduction in the treatment group(P＜0.05).(6)No significant differences were found in early or delayed rebleeding rates between groups(P＞0.05).(7)Neither group experienced significant adverse events.Conclusion Shengdi Xiexin Decoction combined with PPIs significantly improves clinical outcomes in ANVUGIB patients with stomach-heat congestion syndrome.It is effective on enhancing hematological parameters,correcting tissue hypoperfusion,alleviating symptoms,shortening hemostasis time and hospitalization durations,and reducing medical costs,demonstrating excellent safety.

Objective:To investigate the value of ultrasound guided preoperative percutaneous portal vein puncture indocyanine green (ICG) in laparoscopic anatomic liver S8 resection.Methods:The clinical data of 15 patients with hepatocellular carcinoma who underwent laparoscopic anabolic S8 hepatectomy in Mengchao Hepatobiliary Hospital of Fujian Medical University from January 2023 to December 2023 were retrospectively analyzed, including 13 males and 2 females with the age of (57.77±11.53) years. Clinical data such as China liver cancer staging (CNLC), target portal vein puncture operation time, operation time, intraoperative blood loss, postoperative complications and perioperative death were recorded.Results:Among the 15 patients, 11 were CNLC Ia stage and 4 were CNLC Ib stage. The operation time of target portal vein puncture for the 15 patients was (11.33±4.51) min, and they all successfully completed percutaneous portal vein puncture ICG fluorescence injection under ultrasound guidance. However, the dyeing effect was not up to expectations for 2 patients. All patients completed laparoscopic anatomical resection of the liver S8 segment, including 6 cases of resection of the liver S8 segment, 8 cases of resection of the posterior segment of the liver S8 segment, and 1 case of resection of the anterior segment of the liver S8 segment. The operative time of laparoscopic anabolic S8 hepatectomy was 181.3 (119.0, 237.0) min, the intraoperative blood loss was 203.3 (100.0, 300.0) ml, there was no intraoperative blood transfusion, and the postoperative hospital stay was (12.00±3.88) d. No positive surgical margin was found in postoperative pathology, and the tumor diameter of 15 patients was (3.29±1.10) cm. No complications of Clavien-Dindo grade Ⅲ or above occurred after surgery, and no perioperative death occurred, and only 1 patient developed pulmonary infection after surgery.Conclusion:Preoperative ultrasound-guided percutaneous portal vein puncture ICG can effectively assist laparoscopic anatomic S8 hepatectomy in patients with hepatocellular carcinoma.

Objective:To investigate the clinical value of multiparameteric quantitative ultrasound combined with a non-invasive prediction model for assessing high-risk steatohepatitis.Methods:One hundred and ninety-four cases with metabolic-associated fatty liver disease (MAFLD) who underwent liver biopsy in Huashan Hospital, Fudan University, from June 2021 to September 2022 were selected. Shear wave elastography (SWE), shear wave dispersion (SWD) imaging, and attenuation imaging (ATI) examinations were conducted in all patients before biopsy. High-risk steatohepatitis was defined as a total activity score of ≥4 in patients with steatohepatitis, hepatocellular ballooning, and liver lobular inflammation based on pathological hepatic steatosis, inflammatory activity, and fibrosis scoring system (SAF), and fibrosis stage≥F2. Binary logistic regression analysis was used to identify the factors influencing high-risk steatohepatitis. A predictive model for diagnosing high-risk steatohepatitis was constructed using R language. The DeLong test was used to compare the area under the curve between groups. Measurement data was compared between groups using the t-test or rank-sum test, and count data were compared between groups using the χ2 test. Results:There were 46 cases (23.7%) with high-risk steatohepatitis. The quantitative ultrasound parameters included elastic modulus ( OR=2.958, 95% CI: 1.889-4.883, P<0.001), dispersion coefficient ( OR=1.786, 95% CI: 1.424-2.292, P<0.001) and attenuation coefficient ( OR=42.642, 95% CI: 3.463-640.451, P=0.004). Serological indexes of fasting blood glucose ( OR=1.196, 95% CI: 1.048-1.392, P=0.011), alanine aminotransferase ( OR=1.012, 95% CI: 1.006-1.019, P<0.001), aspartate aminotransferase ( OR=1.027, 95% CI: 1.014-1.042, P<0.001), γ-glutamyl transferase ( OR=1.008, 95% CI: 1.001-1.017, P=0.041) and HDL cholesterol ( OR=0.087, 95% CI: 0.016-0.404, P=0.003) were the factors influencing its progression. The AUCs of elastic modulus, dispersion coefficient, attenuation coefficient, multiparametric ultrasound model, serological index model, and ultrasound combined with serology model for the diagnosis of high-risk steatohepatitis were 0.764, 0.758, 0.634, 0.786, 0.773 and 0.825, respectively. The results of the DeLong test showed that the ultrasound combined with the serological model was significantly better than the serological index model and the elastic modulus, dispersion coefficient, and attenuation coefficient alone ( P=0.024, 0.027, 0.038 and <0.001). Conclusion:The combination of multiparametric quantitative ultrasound is helpful for the non-invasive diagnosis of high-risk steatohepatitis and possesses great clinical significance.

Objective:To investigate the application value of indocyanine green (ICG) injection via percutaneous transhepatic portal vein under ultrasound guidance during laparoscopic anatomical liver resection.Methods:The retrospective and descriptive study was conducted. The clinicopatho-logical data of 17 male patients with hepatocellular carcinoma who underwent laparoscopic anatomical liver resection in Mengchao Hepatobiliary Hospital of Fujian Medical University from October 2022 to May 2024 were collected. The patients were aged 59(range, 27-74)years. Patients underwent ICG fluorescence-guided laparoscopic anatomical liver resection after ICG injection via percutaneous transhepatic portal vein under ultrasound guidance. Obsevation indicators: (1)surgical situations; (2) postoperative situations; (3) follow-up. Measurement data with normal distribution were represented as Mean± SD. Measurement data with skewed distribution were represented as M(range). Count data were represented as absolute numbers. Results:(1) Surgical situations. All 17 patients were successfully punctured and injected with ICG via percutaneous transhepatic portal vein under ultrasound guidance, with a puncture time of 6(range,3-12)minutes. The fluorescence staining successfully displayed at the target liver segment without infiltration, and the distance from the fluorescence staining border to the tumor edge was greater than 1.0 cm, which was consistent with preoperative three-dimensional reconstruction imaging. Among the 17 patients, 11 cases had punctures in one branch of the portal vein, 4 cases had punctures in two branches, and 2 had punctures in three branches. The operation time was (229±51)minutes, volume of intraoperative blood loss was 200(range, 100-300)mL. No blood transfusion or conversion to open surgery was required during the operation. (2) Postoperative situations. Two of 17 patients had a small pleural effusion of grade Ⅰ-Ⅱ of Clavien-Dindo classification, and were recovered without treatment. The duration of postoperative hospital stay was 5(range, 5-6)days. Postoperative pathological examina-tion showed hepatocellular carcinoma with negative surgical margin. The tumor diameter was 4.5(range, 1.8-12.5)cm. (3) Follow-up. All the 17 patients were followed up for 14(range, 2-30)months, without tumor recurrence.Conclusion:Injection of ICG via percutaneous transhepatic portal vein under ultrasound guidance during laparoscopic anatomical liver resection is safe and feasible.

Objective:To investigate the application value of indocyanine green (ICG) injection via percutaneous transhepatic portal vein under ultrasound guidance during laparoscopic anatomical liver resection.Methods:The retrospective and descriptive study was conducted. The clinicopatho-logical data of 17 male patients with hepatocellular carcinoma who underwent laparoscopic anatomical liver resection in Mengchao Hepatobiliary Hospital of Fujian Medical University from October 2022 to May 2024 were collected. The patients were aged 59(range, 27-74)years. Patients underwent ICG fluorescence-guided laparoscopic anatomical liver resection after ICG injection via percutaneous transhepatic portal vein under ultrasound guidance. Obsevation indicators: (1)surgical situations; (2) postoperative situations; (3) follow-up. Measurement data with normal distribution were represented as Mean± SD. Measurement data with skewed distribution were represented as M(range). Count data were represented as absolute numbers. Results:(1) Surgical situations. All 17 patients were successfully punctured and injected with ICG via percutaneous transhepatic portal vein under ultrasound guidance, with a puncture time of 6(range,3-12)minutes. The fluorescence staining successfully displayed at the target liver segment without infiltration, and the distance from the fluorescence staining border to the tumor edge was greater than 1.0 cm, which was consistent with preoperative three-dimensional reconstruction imaging. Among the 17 patients, 11 cases had punctures in one branch of the portal vein, 4 cases had punctures in two branches, and 2 had punctures in three branches. The operation time was (229±51)minutes, volume of intraoperative blood loss was 200(range, 100-300)mL. No blood transfusion or conversion to open surgery was required during the operation. (2) Postoperative situations. Two of 17 patients had a small pleural effusion of grade Ⅰ-Ⅱ of Clavien-Dindo classification, and were recovered without treatment. The duration of postoperative hospital stay was 5(range, 5-6)days. Postoperative pathological examina-tion showed hepatocellular carcinoma with negative surgical margin. The tumor diameter was 4.5(range, 1.8-12.5)cm. (3) Follow-up. All the 17 patients were followed up for 14(range, 2-30)months, without tumor recurrence.Conclusion:Injection of ICG via percutaneous transhepatic portal vein under ultrasound guidance during laparoscopic anatomical liver resection is safe and feasible.

Objective:To investigate the value of ultrasound guided preoperative percutaneous portal vein puncture indocyanine green (ICG) in laparoscopic anatomic liver S8 resection.Methods:The clinical data of 15 patients with hepatocellular carcinoma who underwent laparoscopic anabolic S8 hepatectomy in Mengchao Hepatobiliary Hospital of Fujian Medical University from January 2023 to December 2023 were retrospectively analyzed, including 13 males and 2 females with the age of (57.77±11.53) years. Clinical data such as China liver cancer staging (CNLC), target portal vein puncture operation time, operation time, intraoperative blood loss, postoperative complications and perioperative death were recorded.Results:Among the 15 patients, 11 were CNLC Ia stage and 4 were CNLC Ib stage. The operation time of target portal vein puncture for the 15 patients was (11.33±4.51) min, and they all successfully completed percutaneous portal vein puncture ICG fluorescence injection under ultrasound guidance. However, the dyeing effect was not up to expectations for 2 patients. All patients completed laparoscopic anatomical resection of the liver S8 segment, including 6 cases of resection of the liver S8 segment, 8 cases of resection of the posterior segment of the liver S8 segment, and 1 case of resection of the anterior segment of the liver S8 segment. The operative time of laparoscopic anabolic S8 hepatectomy was 181.3 (119.0, 237.0) min, the intraoperative blood loss was 203.3 (100.0, 300.0) ml, there was no intraoperative blood transfusion, and the postoperative hospital stay was (12.00±3.88) d. No positive surgical margin was found in postoperative pathology, and the tumor diameter of 15 patients was (3.29±1.10) cm. No complications of Clavien-Dindo grade Ⅲ or above occurred after surgery, and no perioperative death occurred, and only 1 patient developed pulmonary infection after surgery.Conclusion:Preoperative ultrasound-guided percutaneous portal vein puncture ICG can effectively assist laparoscopic anatomic S8 hepatectomy in patients with hepatocellular carcinoma.

ObjectiveTo explore the underlying mechanism of Bushen Huatan prescription in alleviating postmenopausal osteoporosis （PMOP） by maintaining the balance of osteogenesis and adipogenic differentiation in ovariectomized rats with osteoporosis. MethodSeventy-five 6-month-old non-pregnant female SD rats were randomly divided into sham-operation group， model group， atorvastatin group， liviol group， and Bushen Huatan prescription group. Bilateral ovaries were removed in the four groups except the sham-operation group， while only the same mass of adipose tissue around the ovaries was removed in the sham-operation group. On the 5^th week after surgery， drugs were consecutively administrated for 8 weeks. Rats in the Bushen Huatan prescription group received 9.4 mg·kg^-1 of the prescription， rats in the atorvastatin group received 0.92 mg·kg^-1 of atorvastatin， rats in the Liviol group received 0.23 mg·kg^-1 of liviol， and rats in the model group and the sham-operation group received saline once a day. Micro-computed tomography （Micro CT） was used to detect bone mineral density （BMD） of rat tibia in each group. Hematoxylin-eosin （HE） staining was used to detect the relative area of rat bone marrow adipose tissue （BMAT） in each group. Real-time fluorescence quantitative polymerase chain reaction （Real-time PCR） and Western blot were used to detect the relative expression levels of Runt-related transcription factor 2 （Runx2）， peroxisome proliferator-activated receptor （PPARγ）， leptin （LPN）， and leptin receptor （OBR） in bone tissues. ResultAs compared with the sham operation group， the BMD of rats in the model group decreased （P<0.05）， while the relative area of BMAT increased （P<0.05）. In addition， the expression levels of LPN， OBR， and Runx2 decreased in the model group （P<0.05）， while the level of PPARγ increased （P<0.05）. As compared with the model group， the BMD of rats in the atorvastatin group， the Livial group， and the Bushen Huatan prescription group increased （P<0.05）， and the relative area of BMAT decreased （P<0.05）. The expression levels of LPN， OBR， and Runx2 in these groups increased （P<0.05）， while the expression level of PPARγ decreased （P<0.05）. ConclusionBushen Huatan prescription plays the anti-osteoporosis role in the rat model of PMOP through up-regulating LPN and OBR in bone tissues and maintaining the balance of osteogenesis and adipogenic differentiation， thereby reducing postmenopausal bone loss and playing a role in the prevention and treatment of PMOP.

Objective:To investigate the effects of nedaplatin combined with docetaxel on serum tumor markers and T lymphocyte subsets in patients with epithelial ovarian cancer.Methods:Ninety-two patients with epithelial ovarian cancer who received treatment from March 2016 to December 2017 were included in this study. They were randomly assigned to undergo nedaplatin combined with docetaxel (observation group, n = 46) or cisplatin combined with paclitaxel (control group, n = 46). Both groups received two 21-day courses of treatment. Serum tumor marker level, T lymphocyte subset level, clinical efficacy, incidence of adverse reactions, and 2-year survival rate were compared between the two groups. Results:After treatment, serum cancer antigen 125 (CA125), cancer antigen 199 (CA199), and carcinoembryonic antigen (CEA) levels were (45.84 ± 22.46) U/mL, (35.13 ± 15.03) U/mL, (16.21 ± 3.20) U/mL, respectively in the control group and they were (28.33 ± 20.11) U/mL, (14.82 ± 10.11) U/mL, (5.16 ± 1.33) U/mL, respectively in the observation group. After treatment, CA125, CA199, and CEA levels in each group were significantly decreased compared with before treatment. After treatment, CA125, CA199, and CEA levels were significantly lower in the observation group than in the control group ( t = 3.94, 7.61, 21.63, all P < 0.05). After treatment, the numbers of CD3 +, CD4 +, CD8 + cells in the control group were (16.22 ± 3.12)%, (15.20 ± 1.46)%, (29.21 ± 5.17)%, respectively, and they were (31.22 ± 4.11)%, (24.99 ± 1.71)%, (24.25 ± 4.45)% respectively in the observation group. After treatment, the numbers of CD3 + and CD4 + cells in the observation group were significantly higher than those in the control group ( t = 19.72, 29.53, both P < 0.05). After treatment, the number of CD8 + cells in the observation group was significantly lower than that in the control group ( t = 4.93, P < 0.05). Total response rate was significantly higher in the observation group than in the control group [78.26% (36/46) vs. 58.70% (27/46), χ2 = 4.08, P < 0.05]. The incidence of adverse reactions was significantly lower in the observation group than in the control group [23.91% (11/46) vs. 45.65% (21/46), χ2 = 4.79, P < 0.05]. The 2-year survival rate was significantly higher in the observation group than in the control group [43.48% (20/46) vs. 23.91% (11/46), χ2 = 3.94, P < 0.05]. Conclusion:Nedaplatin combined with docetaxel is highly effective on epithelial ovarian cancer. The combined therapy can greatly reduce serum CA125, CA199, and CEA levels but has no great effects on T lymphocyte subsets. It can increase the survival rate but has no serious adverse reactions.

Objective:To analyze the prevalence of malnutrition among human immunodeficiency virus-exposed uninfected (HEU) children and to identify the associated factors in Hunan Province.Methods:All children born to human immunodeficiency virus (HIV)-infected mothers retrieved from Information System of Prevention of Mother-to-Child Transmission of human immunodeficiency virus Management (IPMTCT) in Hunan Province between July 2013 and June 2019 were included. Information including maternal demographic characteristic, maternal comorbidities/complications, anti-retroviral therapy during pregnancy, anti-retroviral prophylaxis for children, birth weight, and disease during follow-up was collected. The length and weight of children at one, three, six, nine, 12 and 18 months of follow-up time points were detected, and the prevalences of stunting, underweight, wasting and malnutrition among HEU children were evaluated. The generalized estimating equation was used to fit the logistic regression model to analyze the associated factors for malnutrition.Results:A total of 656 HEU children were finally included. The prevalences of stunting, underweight, wasting, and malnutrition among HEU children were highest at one month of age, which were 11.9%(78/656), 9.1%(60/656), 7.0%(45/656) and 21.0%(138/656), respectively. Maternal comorbidities/complications (adjusted odds ratio (a OR)=2.30, 95% confidence interval ( CI) 1.48 to 3.58), mono/dual anti-retroviral therapy during pregnancy (a OR=2.38, 95% CI 1.54 to 3.68), birth weight <2 500 g (a OR=2.66, 95% CI 1.69 to 4.21) and disease during follow-up (a OR=1.73, 95% CI 1.10 to 2.70) were the risk factors for malnutrition among HEU children (all P<0.050). Both taking zidovudine (a OR=0.60, 95% CI 0.38 to 0.94) and nevirapine (a OR=0.31, 95% CI 0.18 to 0.52) for anti-retroviral prophylaxis were the protective factors for malnutrition among HEU children (both P<0.050). Conclusions:The prevalence of malnutrition among HEU children is high. The prevalence of malnutrition is affected by maternal comorbidities/complications, anti-retroviral therapy during pregnancy, and birth weight, diseases during follow-up and anti-retroviral prophylaxis for children.