BACKGROUND:Previous studies have shown that Huaizhen Yanggan Capsule has anti-inflammatory,analgesic,and antioxidant effects,but the mechanism of drug efficacy and whether it has therapeutic effects on knee osteoarthritis have not been elaborated.OBJECTIVE:To evaluate the anti-inflammatory and analgesic effects of Huaizhen Yanggan Capsule and its protective effect on knee osteoarthritis model mice.METHODS:(1)Experiment 1:The anti-inflammatory effect of Huaizhen Yanggan Capsule on mice was evaluated by ear swelling induced by xylene.The levels of interleukin-6 and tumor necrosis factor-α in ear tissues were detected by ELISA.The morphology of ear tissues of anti-inflammatory mice was observed by hematoxylin-eosin staining.(2)Experiment 2:The analgesic effect of Huaizhen Yanggan Capsule on mice was evaluated by hot plate analgesia experiment.The levels of 5-hydroxytryptamine,prostaglandin E2,bradykinin,and β-endorphin in serum of mice were detected by ELISA.(3)Experiment 3:The therapeutic effect of Huaizhen Yanggan Capsule on knee osteoarthritis was studied by injecting sodium iodoacetate into knee osteoarthritis model mice.The analgesic effect was evaluated by step analysis.The total antioxidant capacity kit was used to detect the total antioxidant capacity in serum.Micro-CT scan was used to analyze bone structure and bone volume fraction.The tissue morphology of articular cartilage was observed by hematoxylin-eosin staining and safranin O-fast green staining.The injury degree of articular cartilage was evaluated by modified Mankin's score.The expression of tumor necrosis factor α,interleukin 6,and type Ⅱ collagen in articular cartilage was detected by immunohistochemical staining.RESULTS AND CONCLUSION:(1)In experiment 1,compared with blank group,Huaizhen Yanggan Capsule group could significantly inhibit the degree of ear swelling(P＜0.05),and decrease the levels of tumor necrosis factor α and interleukin 6 in ear tissue(P＜0.05).(2)In experiment 2,compared with blank group,Huaizhen Yanggan Capsule medium and high dose groups could significantly increase the pain threshold(P＜0.05),decrease the levels of 5-hydroxytryptamine,prostaglandin E2,and bradykinin in serum(P＜0.05),and increase the level of β-endorphin(P＜0.05).(3)In experiment 3,compared with the model group,the stride length of mice was significantly increased(P＜0.05);the serum total antioxidant capacity was significantly increased(P＜0.05);the subchondral bone destruction was inhibited by Micro-CT scanning,and bone volume fraction was significantly increased(P＜0.05)in Huaizhen Yanggan Capsule group.The surface of articular cartilage was flat and the modified Mankin's score was significantly decreased by hematoxylin-eosin and saffrane-O-solid green staining(P＜0.05).The expression of type Ⅱ collagen was increased by immunohistochemical staining(P＜0.05),and the expression levels of interleukin 6 and tumor necrosis factor α were decreased(P＜0.05).(4)The results suggest that Huaizhen Yanggan Capsule may have anti-inflammatory,analgesic and joint protective effects.It can relieve the pain of knee osteoarthritis model mice,enhance the antioxidant capacity of the body,and improve the cartilage tissue morphology and the bone microstructure of subchondral bone,inhibiting the progression of osteoarthritis.

BACKGROUND:Previous studies have shown that Huaizhen Yanggan Capsule has anti-inflammatory,analgesic,and antioxidant effects,but the mechanism of drug efficacy and whether it has therapeutic effects on knee osteoarthritis have not been elaborated.OBJECTIVE:To evaluate the anti-inflammatory and analgesic effects of Huaizhen Yanggan Capsule and its protective effect on knee osteoarthritis model mice.METHODS:(1)Experiment 1:The anti-inflammatory effect of Huaizhen Yanggan Capsule on mice was evaluated by ear swelling induced by xylene.The levels of interleukin-6 and tumor necrosis factor-α in ear tissues were detected by ELISA.The morphology of ear tissues of anti-inflammatory mice was observed by hematoxylin-eosin staining.(2)Experiment 2:The analgesic effect of Huaizhen Yanggan Capsule on mice was evaluated by hot plate analgesia experiment.The levels of 5-hydroxytryptamine,prostaglandin E2,bradykinin,and β-endorphin in serum of mice were detected by ELISA.(3)Experiment 3:The therapeutic effect of Huaizhen Yanggan Capsule on knee osteoarthritis was studied by injecting sodium iodoacetate into knee osteoarthritis model mice.The analgesic effect was evaluated by step analysis.The total antioxidant capacity kit was used to detect the total antioxidant capacity in serum.Micro-CT scan was used to analyze bone structure and bone volume fraction.The tissue morphology of articular cartilage was observed by hematoxylin-eosin staining and safranin O-fast green staining.The injury degree of articular cartilage was evaluated by modified Mankin's score.The expression of tumor necrosis factor α,interleukin 6,and type Ⅱ collagen in articular cartilage was detected by immunohistochemical staining.RESULTS AND CONCLUSION:(1)In experiment 1,compared with blank group,Huaizhen Yanggan Capsule group could significantly inhibit the degree of ear swelling(P＜0.05),and decrease the levels of tumor necrosis factor α and interleukin 6 in ear tissue(P＜0.05).(2)In experiment 2,compared with blank group,Huaizhen Yanggan Capsule medium and high dose groups could significantly increase the pain threshold(P＜0.05),decrease the levels of 5-hydroxytryptamine,prostaglandin E2,and bradykinin in serum(P＜0.05),and increase the level of β-endorphin(P＜0.05).(3)In experiment 3,compared with the model group,the stride length of mice was significantly increased(P＜0.05);the serum total antioxidant capacity was significantly increased(P＜0.05);the subchondral bone destruction was inhibited by Micro-CT scanning,and bone volume fraction was significantly increased(P＜0.05)in Huaizhen Yanggan Capsule group.The surface of articular cartilage was flat and the modified Mankin's score was significantly decreased by hematoxylin-eosin and saffrane-O-solid green staining(P＜0.05).The expression of type Ⅱ collagen was increased by immunohistochemical staining(P＜0.05),and the expression levels of interleukin 6 and tumor necrosis factor α were decreased(P＜0.05).(4)The results suggest that Huaizhen Yanggan Capsule may have anti-inflammatory,analgesic and joint protective effects.It can relieve the pain of knee osteoarthritis model mice,enhance the antioxidant capacity of the body,and improve the cartilage tissue morphology and the bone microstructure of subchondral bone,inhibiting the progression of osteoarthritis.

Hemorrhagic shock (HS) is one of the leading causes of death among young adults worldwide. Multiple organ dysfunction in HS is caused by an imbalance between tissue oxygen supply and demand, which is closely related to the poor prognosis of patient. Mitochondrial dysfunction is one of the key mechanisms contributing to multiple organ dysfunction in HS, while mitochondrial quality control regulates mitochondrial function through a series of processes, including mitochondrial biogenesis, mitochondrial dynamics, mitophagy, mitochondrial-derived vesicles, and mitochondrial protein homeostasis. Modulating mitochondrial quality control can improve organ dysfunction. This review aims to summarize the effects of mitochondrial dysfunction on organ function in HS and discuss the potential mechanisms of mitochondrial quality control, providing insights into the injury mechanisms underlying HS and guiding clinical management.

Objective:To investigate the correlation of relative cross-sectional area of lumbar paravertebral muscle and psoas with lumbar curvature and its clinical significance.Methods:This study was conducted as a retrospective cross-sectional study. Among the patients treated at the Department of Orthopedics and Traumatology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from January to April 2023, 107 middle-aged and young patients with changes in lumbar physiological curvature or no apparent abnormalities were included in this study based on MRI findings. The relative cross-sectional area (RCSA) values of the left and right paravertebral muscles and psoas were measured at the lower margin of the L3 vertebral body and at the L3/L4, L4/L5, and L5/S1 intervertebral discs. Furthermore, the correlation between these RCSA values and lumbar curvature was analyzed.Results:The 107 patients were (30.51 ± 4.64) years old, and the proportion of females accounted for 71.96%. There were differences in RCSA between the lower margin of L3, L3/L4, L4/L5, and L5/S1 intervertebral discs (left psoas F = 30.21, P < 0.001; right psoas F = 31.63, P < 0.001; left paravertebral muscle F = 31.04, P < 0.001; right paravertebral muscle F = 26.55, P < 0.001). From L3 to S1, the RCSA of the psoas increased, while the RCSA of the paravertebral muscle decreased. The RCSA values of the total paravertebral muscle/RCSA values of the total psoas major muscle were positively correlated with lumbar curvature at the lower margin of the L3 vertebral body ( r = 0.40, P < 0.001). This correlation could be seen at both L3/L4 ( r = 0.31, P = 0.001) and L4/L5 ( r = 0.24, P = 0.012). However, after considering the influence of left and right muscle groups on lumbar curvature, there was no correlation between the muscle cross-sectional area at the L5/S1 disc position and lumbar curvature ( P > 0.05). Nevertheless, there was still a correlation between the muscle cross-sectional area at other lumbar segments ( P < 0.05). Conclusion:An increase in the RCSA of the psoas relative to the paraspinal muscle may lead to straightening of the lumbar spine curvature, whereas an increase in the RCSA of the paraspinal muscle relative to the psoas may result in an increase in lumbar spine curvature. Improving the quality of the paraspinal muscle may restore the physiological curvature of the lumbar spine, which holds clinical application value.

Hemorrhagic shock, a life-threatening organ hypoperfusion caused by rapid, massive blood loss, is the leading cause of traumatic death in peacetime and wartime. The vascular endothelial glycocalyx (vEG) plays an important role in maintaining microcirculatory homeostasis. Severe ischemia and hypoxia of hemorrhagic shock can damage the vEG, leading to endothelial dysfunction and exacerbated microcirculatory and organ impairments. Therefore, early prevention and treatment of vEG damage in hemorrhagic shock can improve microcirculation dysfunction, which is of paramount importance for therapeutic efficacies and outcomes. There have been many studies on the prevention and treatment of vEG damage in hemorrhagic shock, but none is based on the management of vEG damage. The authors reviewed the progress on the mechanism and preventive and therapeutic strategies of vEG damage caused by hemorrhagic shock, hoping to provide reference for the further research of hemorrhagic shock-induced vEG damage.

Objective:To explore the clinical characteristics and treatment of a head-neck separation type of Monteggia equivalent fractures in children.Methods:From March 2016 to February 2019, 12 children sought medical attention at Pediatric Orthopedic Hospital, Honghui Hospital Affiliated to Xi'an Jiaotong University for a head-neck separation type of Monteggia equivalent fractures. They were 8 boys and 4 girls, aged from 3 to 14 years (average, 8.3 years). All cases were treated with closed reduction, deformity correction and plaster fixation at emergency department after X-ray examination. In line with the treatment principles for Monteggia fractures, after the ulnar length was first restored and stabilized, a proper fixation method was chosen according to the location and type of the ulnar fracture, followed by treatment of the radial neck fracture. The fracture union and complications were evaluated according to the X-ray films after operation, and the therapeutic efficacy was evaluated according to the Mayo elbow performance score (MEPS) at the final follow-up.Results:The head-neck separation type of Monteggia equivalent fractures in children was characterized by a fracture of ulnar diaphysis or metaphysis and a fracture of the radial neck with complete separation of the head and neck, a longitudinal axis of the radius off the capitellum center at the distal fracture end but normal proximal humeroradial relationship. The fractures were classified into 2 types depending on the angulation direction of the ulnar fracture and the direction of distal displacement of the radial neck fracture: 7 cases belonged to the extension-valgus type and 5 cases to the flexion-varus type. The 12 patients were followed up for 8 to 38 months (average, 16.0 months). Of the ulnar fractures, one was treated with closed reduction and Kirschner wire fixation, 4 with elastic intramedullary nail fixation, 5 with plate fixation, one untreated, and one with manual reduction only. Of the radial neck fractures, 11 were treated with closed reduction and elastic intramedullary nail fixation, and one with open reduction and K-wires fixation. All fractures got united after 8 to 12 weeks (mean, 9.6 weeks). The time for removal of internal fixation ranged from 12 to 50 weeks (mean, 31.2 weeks). Avascular necrosis occurred in one case and bulk formation of proximal metaphysis in another. By the MEPS at the final follow-up, the therapeutic efficacy was excellent in 10 cases, good in one and fair in one.Conclusions:The head-neck separation type of Monteggia equivalent fractures in children is different from common Monteggia fractures or radial neck fractures, because its clinical manifestations are characterized by a fracture of ulnar diaphysis or metaphysis and a fracture of the radial neck with complete separation of the head and neck, a longitudinal axis of the radius off the capitellum center at the distal fracture end but normal proximal humeroradial relationship. The treatment options for ulnar fractures include closed reduction with Kirschner wire fixation, elastic intramedullary nailing, open reduction and bone plate fixation or no fixation, while radial neck fractures are mostly treated by closed reduction and elastic intramedullary nailing. Early functional exercise can lead to satisfactory clinical outcomes.

Objective:To systematically review the qualitative researches on the experience of exercise rehabilitation in discharged patients after lung cancer surgery, so as to provide a theoretical basis for the formulation of intervention strategies.Methods:Qualitative researches on the experience of exercise rehabilitation in discharged patients after lung cancer surgery was retrieved by computer in Chinese and English databases such as PubMed, Embase, CINAHL, Web of Science, APA PsycInfo, China National Knowledge Infrastructure, WanFang Data, and VIP. The retrieval time limit was from the establishment of the database to September 20, 2021. The quality of the article was evaluated using the quality evaluation criteria for qualitative research of the Joanna Briggs Institute Evidence-Based Health Care Center (2016) in Australia. The results were analyzed by pooled synthesis method.Results:A total of 8 articles were included, and 49 research results were extracted. The results were grouped into 8 new categories, which were further integrated into 4 integrated results, namely, obstacles for discharged patients after lung cancer surgery to participate in exercise rehabilitation, facilitators for discharged patients after lung cancer surgery to participate in exercise rehabilitation, benefits felt by the patients, patients' opinions and suggestions on exercise rehabilitation program design.Conclusions:The participation of exercise rehabilitation in discharged patients after lung cancer surgery is affected by many factors. When formulating exercise rehabilitation program, medical and nursing staff should formulate exercise rehabilitation program that meets the individual needs of patients according to the obstacles and facilitators of patients participating in exercise rehabilitation, combined with the patients' attitudes and opinions on the implementation of exercise rehabilitation.

"The Expert Group on Tumor Ablation Therapy of Chinese Medical Doctor Association, The Tumor Ablation Committee of Chinese College of Interventionalists, The Society of Tumor Ablation Therapy of Chinese Anti-Cancer Association and The Ablation Expert Committee of the Chinese Society of Clinical Oncology" have organized multidisciplinary experts to formulate the consensus for thermal ablation of pulmonary subsolid nodules or ground-glass nodule (GGN). The expert consensus reviews current literatures and provides clinical practices for thermal ablation of GGN. The main contents include: (1) clinical evaluation of GGN, (2) procedures, indications, contraindications, outcomes evaluation and related complications of thermal ablation for GGN and (3) future development directions.
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Objective:To explore the effects of narrative therapy on cognition, emotion and treatment satisfaction of convalescent patients with occupational acute chemical toxic encephalopathy.Methods:From June to July 2019, 60 convalescent patients with occupational chemical poisoning encephalopathy were randomly divided into narrative group and control group, with 30 cases in each group. The control group received routine clinical treatment. On the basis of receiving the original clinical treatment, patients in the narrative group added narrative treatment once a week to explain discomfort in specific life situations through conversation from the perspective of disease and psychology. 30 min each time for 6 weeks. The patients were investigated with Montreal Cognitive Assessment Scale (MoCA scale) every 2 weeks to evaluate the degree of cognitive impairment. The changes of depression, anxiety and treatment satisfaction were investigated before and after intervention.Results:There was no significant difference in MoCA scores between the two groups before intervention ( P>0.05) . After 6 weeks of treatment, MoCA scores of narrative group and control group gradually increased with the extension of treatment time, and the increase degree of MoCA score of narrative group was greater than that of control group ( P<0.01) . Before intervention, there was no significant difference in depression, anxiety score, prevalence and satisfaction index between narrative group and control group ( P>0.05) . After the intervention, the scores and prevalence of depression and anxiety in the narrative group were significantly lower than those in the control group, and the scores of feeling in the process of seeing a doctor and how to obtain their own disease information were significantly higher than those in the control group ( P<0.05) . Conclusion:Narrative therapy can improve the cognitive function and emotion of patients with occupational chemical poisoning, and improve the treatment satisfaction of patients.

Objective:To explore the effects of narrative therapy on cognition, emotion and treatment satisfaction of convalescent patients with occupational acute chemical toxic encephalopathy.Methods:From June to July 2019, 60 convalescent patients with occupational chemical poisoning encephalopathy were randomly divided into narrative group and control group, with 30 cases in each group. The control group received routine clinical treatment. On the basis of receiving the original clinical treatment, patients in the narrative group added narrative treatment once a week to explain discomfort in specific life situations through conversation from the perspective of disease and psychology. 30 min each time for 6 weeks. The patients were investigated with Montreal Cognitive Assessment Scale (MoCA scale) every 2 weeks to evaluate the degree of cognitive impairment. The changes of depression, anxiety and treatment satisfaction were investigated before and after intervention.Results:There was no significant difference in MoCA scores between the two groups before intervention ( P>0.05) . After 6 weeks of treatment, MoCA scores of narrative group and control group gradually increased with the extension of treatment time, and the increase degree of MoCA score of narrative group was greater than that of control group ( P<0.01) . Before intervention, there was no significant difference in depression, anxiety score, prevalence and satisfaction index between narrative group and control group ( P>0.05) . After the intervention, the scores and prevalence of depression and anxiety in the narrative group were significantly lower than those in the control group, and the scores of feeling in the process of seeing a doctor and how to obtain their own disease information were significantly higher than those in the control group ( P<0.05) . Conclusion:Narrative therapy can improve the cognitive function and emotion of patients with occupational chemical poisoning, and improve the treatment satisfaction of patients.