Objective To detect the expression profile of heme oxygenase-1(HO-1)during the process of wound repair in radiation-wound combined injury(R-W-CI),and evaluate its wound healing improving effects of R-W-CI by HO-1 knockdown with siRNA.Methods A total of 36 male C57BL/6J mice(8 weeks old)were randomly and equally divided into a simple skin wound group(W group)and a skin wound group combined with whole-body radiation(6 Gy)injury(R-W-CI group).During the wound healing process,the wounds were photographed and recorded,and the residual areas were quantified by Image J.Wound tissues were sampled and stained with HE staining for pathological and histological observation,and the damage to the hematopoietic system was assessed by dynamic examination of the peripheral blood.The expression and changes of HO-1 in wound tissues were detected by q-PCR and Western blotting.Then,26 male C57BL/6J mice(8 weeks old)were randomly and equally divided into siRNA knockdown HO-1 group(si-HO-1 group)and siRNA negative control group(si-NC group).After radiation combined injury was inflicted,60 μL of F127 gel loaded with si-HO-1(5 μm/L)was applied to each wound in the si-HO-1 group,and an equal amount of F127 gel loaded with negative control si-NC was applied to the wound in the si-NC group.The knockdown of HO-1 in wound tissues was detected by Western blotting,and the changes in wound area were observed.In the wound tissues harvested in 3 d after wounding,the expression of cytokines IL-1β,IL-6 and TNF-α was examined by q-PCR and the proliferation of granulation tissues was evaluated by Ki67 immunohistochemical staining.HE staining was performed on wound tissues on day 3 and day 9 post-injury to assess the improvement effect of knockdown of HO-1 on wound healing of radiation combined injuries.Results Compared with the W group,semi-quantitative analysis of the residual wound area showed that healing was significantly delayed in the R-W-CI group on days 7 and 10 post-injury(P＜0.01).HE staining on day 7 showed that in the R-W-CI group,the re-epithelialization was delayed,and the growth of granulation tissues was poor;and at the same time,peripheral blood leukocytes and their classified counts showed a significant decrease in the early period after injury(P＜0.05).Further tests indicated that the expression of HO-1 protein was slightly higher in the wound of the R-W-CI group than that of the W group in 3 and 7 d after injury,though no significant difference(P＞0.05),whereas statistical difference was seen in 10 d(P＜0.05),accompanied by the distribution of the full-length and truncated forms of HO-1 protein.Quantitative PCR obtained similar results in the mRNA expression of HO-1 in wounds in both 7 and 10 d after injury(P＜0.05).siRNA intervention could effectively knock down the HO-1 protein level of the wounds(P＜0.05),promote wound contraction(P＜0.05),reduce the width of the wound(P＜0.01),up-regulate the inflammatory cytokines IL-6 and TNF-α in 3 d,enhance the proliferation of repair cells in wound margin,and improve the growth of the granulation tissue in the R-W-CI model when compared with the conditions after si-NC intervention.Conclusion There exists a sustained high expression level of HO-1 during wound repair,and wound knockdown of HO-1 by siRNA can improve the lack of inflammation status and promote wound healing in R-W-CI mice.

Objective:To analyze the molecular mechanism of Zhenqi Fuzheng Capsules in the adjuvant treatment of AIDS by network pharmacology method and molecular docking technology.Methods:The active components and targets of Zhenqi Fuzheng Capsules were obtained through TCMSP, and the AIDS-related targets were obtained through GeneCards, OMIM and DrugBank databases. The intersection target PPI network was constructed through STRING 11.5 database, and Cytoscape 3.9.1 software was used for network topology analysis; Metascape database was used for GO function and KEGG pathway enrichment analysis of core targets; Cytoscape 3.9.1 was used to construct Zhenqi Fuzheng Capsules component-target-pathway network; Autodock Tools software was used to carry out molecular docking of core targets and active components.Results:Totally 31 active components and 180 targets of Zhenqi Fuzheng Capsules were screened out. TNF, IL6, AKT1, IL1B, TP53, VEGFA, RELA, EGFR and CASP3 were identified as the core targets. GO functional enrichment analysis obtained 1 436 biological processes, 53 cellular components, and 117 molecular functions. KEGG pathway enrichment analysis obtained 167 pathways, which were related to pathways in cancer, AGE-RAGE signaling pathway in diabetic complications, and IL-17 signaling pathway was closely related. Molecular docking results showed that core targets such as AKT1 and TNF had good binding activity to quercetin, kaempferol, and luteolin.Conclusion:The main active components of Zhenqi Fuzheng Capsules in the adjuvant treatment of AIDS are quercetin, kaempferol and luteolin, which may treat AIDS through the IL-17 signaling pathway.

As a common emotional and psychogenic disorder, anxiety disorder seriously threats the human physical and mental health. Ventral tegmental area (VTA) is the canter of the mesocortical limbic circuit, with extensive bidirectional connections to forebrain areas, and plays important role in regulating reward, motivation, cognition, and disgust. Besides, VTA is involved in anxiety regulation by forming functional connections with multiple brain regions and connecting external stimulus information and feedback output behaviours. This article briefly summarizes the different cell subsets of VTA and its involvement in anxiety-related neural circuits.

ObjectiveTo explore the therapeutic effect and mechanism of Yiqi Huoxue Tongbian prescription on slow transit constipation （STC） in rats. MethodThe rat model of STC was established by gavage of loperamide hydrochloride. Rats were assigned into control， model， mosapride， low-， medium-， and high-dose （3.51， 7.02， and 14.04 g·kg^-1， respectively） Yiqi Huoxue Tongbian prescription groups. The changes of general signs， fecal moisture content， and intestinal propulsion rate were measured after model establishment and drug administration. The colonic mucosal changes were observed by hematoxylin eosin staining. Enzyme-linked immunosorbent assay was employed to determine the content of substance P （SP） and vasoactive intestinal peptide （VIP） in the colon of rats in each group. The gray values of aquaporin （AQP） 3， AQP4， AQP8， and c-Kit in rat colon tissue were measured by immunohistochemistry and Western blot， and the changes of intestinal flora were detected by 16S rRNA high-throughput sequencing. ResultCompared with the model group， 10 days of treatment with Yiqi Huoxue Tongbian prescription increased the fecal moisture content and intestinal propulsion rate （P<0.01）. The medium- and high-dose Yiqi Huoxue Tongbian prescription groups and the mosapride group showed no obvious mucosal inflammation and neat arrangement of goblet cells with a large number in the colon tissue. Moreover， the three groups showed increased SP content （P<0.01） and decreased VIP content （P<0.01） in the serum. The medium- and high-dose Yiqi Huoxue Tongbian prescription groups showed down-regulated protein levels of AQP3， AQP4， and AQP8 （P<0.01） and up-regulated protein level of c-Kit （P<0.01）. The drug administration groups presented slightly increased observed species， Chao1， ACE， and Shannon， Simpson， and PD whole tree. The principal component analysis showed that the control group had a short distance with the high- and medium-dose Yiqi Huoxue Tongbian prescription groups， indicating that high- and medium-dose Yiqi Huoxue Tongbian prescription can recover the intestinal flora to that in the control group. ConclusionYiqi Huoxue Tongbian prescription can alleviate the defecation status of rats with slow transit constipation by down-regulating the expression of AQP3， AQP4， and AQP8 to reduce the absorption of water in the intestine， up-regulating the expression of c-Kit to increase the number and distribution of Cajal interstitial cells， and regulating the balance of flora in the colon tissue.

Objective:To evaluate the diagnostic value of coronary angiography-based fractional flow reserve(caFFR)versus a wire-based fractional flow reserve(FFR)in elderly patients with stable ischemic heart disease.Methods:A total of 168 patients(186 vessels)who underwent a pressure wire(PW)-based FFR measurement from Jan.2015 to Dec.2019 in Beijing hospital were enrolled and analyzed retrospectively.Coronary angiography images and matched steady-state aortic pressure of patients were sent to the core laboratory for caFFR measurement under the blind method.All patients were divided into the non-elderly group(<65 years, n=93)and the elderly group(≥65 years, n=75). The diagnostic value of caFFR was evaluated by using the wire-based FFR cut-off value of ≤0.80 as the reference standard.The correlation and consistency of caFFR and wire-based FFR were analyzed, and compared between the non-elderly and elderly groups.Results:The caFFR had a good correlation and consistency with wire-based FFR in the elderly group( r=0.796, P<0.01). In non-aged versus elderly groups, diagnostic accuracy of caFFR was 91.9% versus 93.1%, diagnostic sensitivity of caFFR was 91.8% vs.93.2%, diagnostic specificity of caFFR was 92.3% vs.93.0%, all P>0.05.The area under the receiver-operating characteristic curve of caFFR had no significant difference between the non-elderly and elderly patients(0.964 vs.0.972, Z=0.00823, 95% CI: -0.037-0.052, P>0.05). Conclusions:The caFFR has a good diagnostic correlation and consistency with wire-based FFR in the elderly group, and caFFR's diagnostic performance in the elderly is similar to that in the non-elderly patients.

Objective: To observe the uptake of ⁹⁹Tc^m-3 polyethylene glycol Arg-Gly-Asp dimer (3PRGD₂) in rat models of rheumatoid arthritis (RA), in order to provide theoretical foundation for early diagnosis of RA. Methods: The healthy female SD rats were divided into collagen induced arthritis (CIA) group (n=100), osteoarthritis (OA) group (n=20) and control group (n=20). Bovine collagen type Ⅱ emulsion was used for arthritis induction to establish CIA models. OA models were established by injection of L-cysteine and papain. Gamma imaging was performed before and 15 d, 30 d after the model establishment. The mediastinum was selected as non-target (NT) area and the target (T)/NT ratios were calculated. The serum levels of vascular endothelial growth factor (VEGF), tumor necrosis factor-α (TNF-α), α_Vβ₃ before and after the model establishment were measured. Pathological and immunohistochemical detection were performed. One-way analysis of variance, Pearson and Spearman correlation analyses were used to analyze the data. Results: There were 58 CIA models successfully established. Before the model establishment, T/NT ratios of CIA group, OA group and control group were 0.215±0.049, 0.210±0.050, 0.209±0.051, respectively (F=0.093, P>0.05). The T/NT ratios of the above three groups were 0.405±0.230, 0.223±0.045, 0.211±0.049 (F=12.601, P<0.05) 15 d post-model establishment, and those were 0.572±0.182, 0.238±0.045, 0.212±0.055 (F=65.147, P<0.05) 30 d post-model establishment. T/NT ratios of CIA group were positively correlated with the levels of serum VEGF, TNF-α, α_Vβ₃, pathological score and the levels of immunohistochemical markers (VEGF, TNF-α, α_Vβ₃, CD31, CD34; r values: 0.391-0.721, r_s values: 0.365-0.669, all P<0.05). Conclusion ⁹⁹Tc^m-3PRGD₂ can be specifically up-taken by RA lesions in rat models, thus has the potential in early synovial neovascularization imaging of RA.

Objective To observe the effect of electrical stimulation on the movement of rabbits esophagus, and to promote effective esophageal peristalsis and determine the best electrical pacing parameters. Methods After anesthesia, 24 healthy rabbits underwent open surgery and the lower esophagus was exposed. The esophagus was stimulated with the multi-channel signal generator, and the changes of esophagus pressure and the length of esophageal contraction with high resolution manometry were recorded. (1) The effects on contraction pressure of esophagus body and lower esophageal sphincter (LES) after single site electrical stimulation under different parameters were observed. The stimulation modes utilized were electric current 3 mA, 5 mA and 8 mA, frequency 5 Hz, 10 Hz and 20 Hz, pulsewidth 0. 25 ms, 25 ms and 50 ms, waveform of single phase and double phase. (2) The esophagus was sequentially stimulated. The stimulation mode utilized was electric current 5 mA, frequency 20 Hz, pulsewidth 25 ms, stimulation duration 3 s, single phase square wave. Results At electrical stimulation on the esophagus body and LES, contraction delay was 13. 00±1. 54 ms and 12. 00±0. 73 ms respectively. The contraction pressure of esophageal body was significantly positively related tothe electric current (R=0. 968, P<0. 01), the pulse width(R=0. 971, P<0. 01), and the frequency (R =0. 947, P <0. 01). The length of contraction in 10 Hz group was shorter than that of the 20 Hz group(1. 33±0. 06 cm VS 1. 80±0. 00 cm, P<0. 05). The contraction pressure of LES was also significantly positively related to the electric current(R=0. 965, P<0. 01),the pulse width (R=0. 973, P<0. 01), and the frequency (R=0. 842, P<0. 01). The pressure of lower esophageal sphincter of single phase square wave was greater than that of the double phase square group (P<0. 05). Under the same parameters, the contraction pressure of LES group was lower than that of the esophageal body group (27. 33±1. 15 mmHg VS 104. 00±6. 00 mmHg, P<0. 05). Esophageal sequential contraction was induced by multi-points sequential electrical stimulation. Conclusion Single point electric stimulation can cause esophageal contraction immediately without obvious delay. Within a certain range, the esophageal contraction pressure is positively correlated with electric current, frequency and pulse width. The contraction pressure of single square phase wave is greater than that of the double square phase wave. The contraction pressure of esophageal body is greater than that of LES after electric stimulation. Multi-points sequential electrical stimulation can promote sequential movement of esophagus.

The Chinese clinical medical national licensing examination is the profession ad-mittance exam, which is undertake the responsibility of selecting qualified physicians. It also promotes the medical education in China. The standard for examination, the examination content, methods for measuring the Chinese clinical medical national licensing examination as well as the reform and de-velopment, has a certaln guiding role to China's medical education and medical education reform. While reviewing the medical students' performance in the examination, we can discover the weakness in medical education, which is then conducive to the promotion of teaching reform and innovation. The competence based medical licensing examination reform in China, advocating the cultivation of clinical comprehensive ability as the core content to tralning and evaluating, is conducive to continuously im-proving the quality of medical education in China, and to tralning more qualified physicians in the country.

Objective To study the anatomic features of surface vasa vasorum on longissimus in thoracolumbar segments,and its protection function during the internal fixation for thoracolumbar fracture via Wiltse approach.Methods From March 2010 to October 2012,a total of 97 patients with thoracolumbar fractures underwent posterior internal fixation with pedicle screw system.The trend and distribution of surface vasa vasorum on longissimus in thoracolumbar segments were observed in the operation,and the vessels were protected during the surgical procedures by using specific devices and techniques.Operative time and intra-operative blood loss were recorded.Visual analogue scale (VAS) values were evaluated after 3 days,1 month,6 months postoperatively,and 1 month after the removal of internal fixation.MRI images of longissimus in thoracolumbar segments were compared after preoperative and postoperative 6 months.Results Surface vasa vasorum distribution on 194 longissimus and 402 inter-pedicle areas of 97 patients were observed.In 402 areas,94.3％ of surface vasa vasorum presented sarciniform,while only 5.7％ of surface vasa vasorum presented tube shape.In 379 areas of sarciniform distribution,9.8％ of blood vessel bundles were located in vertebral pedicle area;76.0％ of blood vessel bundles were located in the upper inter-pedicle areas;12.4％ of blood vessel bundles were located in middle inter-pedicle areas;1.8％ of blood vessel bundles were located in lower inter-pedicle areas.In 379 areas,87.3％ of blood vessel bundles could be completely retained;12.7％ of blood vessel bundles were treated by electro coagulation and burning.Intra-operative blood loss was 21±9.3 ml.VAS values after 3 days,1 month,6 months postoperatively,and 1 month after the removal of internal fixation were 3.3± 1.6,2.1± 1.4,1.2±0.7 and 1.1±0.7.The longissimus treated with electro coagulation demonstrated pimelosis change on MRI after postoperative 6 months.Conclusion Surface vasa vasorum on longissimus in thoracolumbar segments are generally of sarciniform,and most of them are located in upper inter-pedicle areas.The protection of vasa vasorum can reduce the intra-operative lesion and postoperative pimelosis change of longissimus.

Objective To study the effect of precise locating technique of C?arm fluoroscopy in order to reduce the radia?tion exposure during the surgical procdure for thoracolumbar fracture. Methods From March 2010 to Octorber 2012, a total of 92 cases with thoracolumbar fracture underwent postierior internal fixation procdures with pedicle instrumentation. C?arm fluoros?copy was used in 44 cases with precise locating technique, while in 48 cases with traditional methods. In precise locating group,C?arm fluoroscopy was used after anesthesia. Once an ideal view was got, the position parameters of C?arm fluoroscopy machine were recorded. The machine was positioned according to the recording for the secondary fluoroscopy. Pre?operative and intra?operative number of times of exposure, length of exposure time, time for fluoroscopy and total operating time were recorded and compared be?tween two groups. Results Pre?operative number of times of exposure, exposure time, and time for fluoroscopy in precise locating group were (5.51±2.47), (2.26±1.05) s and (9.83±3.67) min,which were higher than those of (4.02±2.42), (1.78±0.98) s and (8.29± 3.52) min in traditional group. However, intra?operative number of times of exposure, exposure time, and time for fluoroscopy in precise locating group were (5.26±3.64), (2.24±1.24) s and (10.39±4.82) min,which were lower than those of (9.74±4.38), (4.21± 2.38) s and (24.69±6.35) min in traditional group,and total number of times of exposure, exposure time, time for fluoroscopy and total operating time in precise locating group were(10.77±4.16), (4.50±1.83) s, (20.22±5.03) min and(70.52±18.33)min,which were also lower than those of (13.76±5.31), (5.99±3.27) s , (32.98±7.83) min and(81.86±21.57)min in traditional group. Conclu?sion Precise locating technique of C?arm fluoroscopy reduces the radiation exposure during the surgical procdure for thoracolum?bar fracture.