Objective:To explore the clinical efficacy of the fourth-generation minimally invasive surgery (MIS) for the treatment of hallux valgus.Methods:A retrospective analysis was conducted on 26 patients (42 feet) who underwent fourth-generation MIS for hallux valgus at Peking University People's Hospital from October 2019 to March 2023. The patients included 5 males (9 feet) and 21 females (33 feet), with an average age of 49.9±15.1 years (range 19-75 years). The hallux valgus deformity was corrected through minimally invasive extra-articular transverse osteotomy of the distal metatarsal combined with Akin osteotomy, fixation with a single fully threaded screw, and lateral soft tissue release after osteotomy. The hallux valgus angle (HVA) and intermetatarsal angle (IMA) were measured before surgery and at the final follow-up. The American Orthopaedic Foot and Ankle Society (AOFAS) scoring system and the visual analogue scale (VAS) were used to evaluate the treatment efficacy.Results:All 26 patients (42 feet) were followed up for a mean duration of 9.6±5.2 months (range 6-30 months). All 42 feet successfully underwent surgery, with an average operation time of 69.1±16.2 minutes (range 30-105 minutes) and an average blood loss of 10.0±7.4 ml (range 1-30 ml). No serious complications such as major vessel, nerve, or tendon damage occurred during the surgery for any patient. During the follow-up, one foot developed stiffness in the first metatarsophalangeal joint due to a lack of timely functional exercise after surgery. No other complications such as recurrence, delayed union, or nonunion were observed. By the final follow-up, one patient (2 feet) requested removal of the internal fixation. The HVA before surgery and at the final follow-up was 29.5±7.4 and 9.2±4.6, respectively, while the IMA was 11.9±3.8 and 5.0±3.6. The AOFAS score improved from 56.6±10.2 to 91.7±6.8, and the VAS score decreased from 5.2±2.3 to 0.9±1.1, all with significant differences ( P<0.05). Conclusion:The fourth-generation minimally invasive surgery for hallux valgus, characterized by minimally invasive transverse osteotomy, fixation with a single fully threaded screw, lateral soft tissue release after osteotomy, and Akin osteotomy is simple, safe, effective and easy to operate with fewer complications.

Objective:To explore the clinical efficacy of the fourth-generation minimally invasive surgery (MIS) for the treatment of hallux valgus.Methods:A retrospective analysis was conducted on 26 patients (42 feet) who underwent fourth-generation MIS for hallux valgus at Peking University People's Hospital from October 2019 to March 2023. The patients included 5 males (9 feet) and 21 females (33 feet), with an average age of 49.9±15.1 years (range 19-75 years). The hallux valgus deformity was corrected through minimally invasive extra-articular transverse osteotomy of the distal metatarsal combined with Akin osteotomy, fixation with a single fully threaded screw, and lateral soft tissue release after osteotomy. The hallux valgus angle (HVA) and intermetatarsal angle (IMA) were measured before surgery and at the final follow-up. The American Orthopaedic Foot and Ankle Society (AOFAS) scoring system and the visual analogue scale (VAS) were used to evaluate the treatment efficacy.Results:All 26 patients (42 feet) were followed up for a mean duration of 9.6±5.2 months (range 6-30 months). All 42 feet successfully underwent surgery, with an average operation time of 69.1±16.2 minutes (range 30-105 minutes) and an average blood loss of 10.0±7.4 ml (range 1-30 ml). No serious complications such as major vessel, nerve, or tendon damage occurred during the surgery for any patient. During the follow-up, one foot developed stiffness in the first metatarsophalangeal joint due to a lack of timely functional exercise after surgery. No other complications such as recurrence, delayed union, or nonunion were observed. By the final follow-up, one patient (2 feet) requested removal of the internal fixation. The HVA before surgery and at the final follow-up was 29.5±7.4 and 9.2±4.6, respectively, while the IMA was 11.9±3.8 and 5.0±3.6. The AOFAS score improved from 56.6±10.2 to 91.7±6.8, and the VAS score decreased from 5.2±2.3 to 0.9±1.1, all with significant differences ( P<0.05). Conclusion:The fourth-generation minimally invasive surgery for hallux valgus, characterized by minimally invasive transverse osteotomy, fixation with a single fully threaded screw, lateral soft tissue release after osteotomy, and Akin osteotomy is simple, safe, effective and easy to operate with fewer complications.

Objective To evaluate the role of activator protein-1 (AP-1 ) in electro-acupuncture (EA )-induced up-regulation of heme oxygenase-1 (HO-1 ) expression in lung tissues in a rabbit model of endotoxic shock .Methods Seventy healthy male New Zealand white rabbits ,aged 2 months ,weighing 1.5-2.0 kg ,were randomly divided into 7 groups ( n=10 each ) using a random number table :normal control group (group C ) , endotoxic shock-induced acute lung injury (ALI ) group (group ALI ) , EA + ALI group (group EL ) , non-acupoint+EA+ ALI group (group NEL ) , curcumin (HO-1 inhibitor ) group (group Cur ) , dimethyl sulfoxide group (group D ) ,and EA+ALI+curcumin group (group ELC ) .Bilateral 15 min EA stimulation of Zusanli and Feishu (according to atlas of animals acupoints ) was performed (frequency 15Hz ) once a day for 5 consecutive days before lipopolysaccharide (LPS ) administration in EL and ELC groups ,while in group NEL ,EA stimulation was performed at non-acupoints located 0.5 cm lateral to Zusanli and Feishu acupoints with the same parameters . The animals were anesthetized with urethane and tracheostomized .The animals kept spontaneous breathing .Right internal carotid artery was cannulated for blood pressure monitoring . Ear vein was cannulated for drug administration .At 5 days after EA stimulation ,curcumin 25 mg/kg (in 0.5 ml of 0.1% dimethyl sulfoxide ) was injected in Cur and ELC groups ,0.1% dimethyl sulfoxide 0.5 ml was injected in D group ,and the equal volume of normal saline was given in the other groups .LPS 5 mg/kg (in 2 ml of 0.9% normal saline ) was injected intravenously at 30 min after administration in ALI ,EL ,NEL and ELC groups ,while the equal volume of normal saline was given in the other three groups .Endotoxic shock was confirmed by decrease in mean arterial pressure to 75% of the baseline value within 2 h after LPS injection .Blood samples were collected from the common carotid artery at 6 h after LPS or normal saline administration and the rabbits were then sacrificed .The lungs were removed for microscopic examination and the pathological changes were scored .The wet/dry lung weight ratio (W/D ratio ) was calculated .The malondialdehyde (MDA ) content and superoxide dismutase (SOD ) activity in lung tissues were detected ,and the expression of HO-1 mRNA ,HO-1 ,c-Jun mRNA and c-Jun in lung tissues was determined by Western blot .Results Compared with group C ,the pathological score ,W/D ratio and MDA content were significantly increased ,and the SOD activity was decreased in ALI ,EL ,NEL and ELC groups ,the expression of HO-1 mRNA ,HO-1 ,c-Jun mRNA and c-Jun was up-regulated in groups ALI ,EL and NEL ( P<0.05 ) ,while no significant change was found in the expression of c-Jun mRNA and c-Jun in group ELC ( P>0.05) .There was no significant difference in the parameters mentioned above between Cur and D groups ( P>0.05 ) .Compared with group ALI ,the pathological score ,W/D ratio and MDA content were significantly decreased ,and SOD activity was increased ,and the expression of HO-1 mRNA and HO-1 was up-regulated in EL and ELC groups ( P<0.05) ,the expression of c-Jun mRNA and c-Jun was up-regulated in group EL ,while down-regulated in group ELC ( P<0.05) ,and no significant change was found in the parameters mentioned above in group NEL ( P>0.05) .The pathological score ,W/D ratio and MDA content were significantly higher ,and the SOD activity and expression of HO-1 mRNA ,HO-1 ,c-Jun mRNA and c-Jun were lower in group ELC than in group EL ( P<0.05) .Conclusion EA up-regulates HO-1 expression through activating AP-1 during endotoxic shock-induced ALI in rabbits ,thus protecting the lung .

OBJECTIVETo observe the clinical efficacy of shensong yangxin capsule (SYC) on ventricular premature beat (VPB) differentiated in TCM as palpitation of Qi-yin deficiency syndrome or Xin collateral stagnation syndrome, and cardiovascular autonomic nervous function in patients with coronary heart disease (CHD).

METHODSThe randomized, double-blind, parallel contrast method was adopted, patients were randomly assigned by 3:1 ratio into two groups. One hundred and sixty-five patients in SYC treated group and 56 in the control group (treated with Xinlvning tablet), and the therapeutic course for both groups was 4 weeks.

RESULTSThe clinical efficacy on VPB and in improving TCM syndromes was better in SYC group than that in the control group (P < 0.01). After treatment, the heart rate variability (HRV) and QT dispersion in the two groups were improved in a certain degree. The changes of SDNN, SDANN, SDNN Index and PNN50 in the two groups were significantly different (P < 0.05, P < 0.01), the efficacy in the treated group was superior to that in the control group.

CONCLUSIONSYC has definite effect on VPB and TCM Syndromes, it can obviously meliorate the activity of cardiovascular autonomic nervous system in the patients with CHD.

Adult ; Aged ; Autonomic Nervous System ; drug effects ; physiopathology ; Capsules ; Coronary Disease ; complications ; drug therapy ; Double-Blind Method ; Drug Administration Schedule ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Heart ; innervation ; Humans ; Male ; Middle Aged ; Phytotherapy ; Ventricular Premature Complexes ; drug therapy ; etiology