Objective To explore the effect of endoscopic surgery via trans-axilloareolar sternocleidomastoid intermuscular approach for unilateral thyroid cancer.Methods A total of 116 patients with unilateral thyroid cancer admitted to our hospital from January 2020 to March 2023 were selected,and all of them underwent unilateral thyroidectomy+isthmus resection+central lymph node dissection under endoscopy.The patients were divided into the observation group and the control group according to random number table method,with 58 cases in each group.Patients in the observation group received the trans-axilloareolar sternocleidomastoid intermuscular approach,and patients in the control group received subclavian approach.The surgical-related indicators,stress indicators[adrenocorticotropic hormone(ACTH),norepinephrine(NE),cortisol(Cor)]before and after surgery,parathyroid hormone(PTH),blood calcium level,postoperative incision aesthetics satisfaction,and occurrence of complications were compared between the two groups.Results There was no statistically significant difference in the operation time,intraoperative blood loss,or postoperative drainage volume of patients between the two groups(P>0.05).The dissection number of lymph nodes in the central region of patients in the observation group was greater than that in the control group(P<0.05).In the two groups,the levels of NE,Cor,and ACTH 1 day and 3 days after surgery were higher than those before surgery(P<0.05),and the levels of NE,Cor and ACTH 1 day after surgery were higher than those 3 days after surgery(P<0.05);the levels of NE,Cor and ACTH 1 day and 3 days after surgery of patients in the observation group were lower than those in the control group(P<0.05).In the two groups,the levels of PTH and serum calcium 1 day and 3 days after surgery were lower than those before surgery(P<0.05),and the levels of PTH and serum calcium 3 days after surgery were lower than those 1 day after surgery(P<0.05),while there were no significant differences in the levels of PTH or serum calcium 1 day and 3 days after surgery between the two groups(P>0.05).The satisfaction of postoperative incision aesthetics in the observation group(100%)was higher than that in the control group(72.41%),with statistically significant difference(P<0.05).No statistically significant difference was found in the incidence of complications between the two groups(P>0.05).Conclusion Endoscopic surgery via trans-axilloareolar sternocleidomastoid intermuscular approach is safe and feasible for unilateral thyroid cancer,which has a mild stress response and inconspicuous incisions,with high satisfaction of incision aesthetics for patients.

Objective To explore the effect of endoscopic surgery via trans-axilloareolar sternocleidomastoid intermuscular approach for unilateral thyroid cancer.Methods A total of 116 patients with unilateral thyroid cancer admitted to our hospital from January 2020 to March 2023 were selected,and all of them underwent unilateral thyroidectomy+isthmus resection+central lymph node dissection under endoscopy.The patients were divided into the observation group and the control group according to random number table method,with 58 cases in each group.Patients in the observation group received the trans-axilloareolar sternocleidomastoid intermuscular approach,and patients in the control group received subclavian approach.The surgical-related indicators,stress indicators[adrenocorticotropic hormone(ACTH),norepinephrine(NE),cortisol(Cor)]before and after surgery,parathyroid hormone(PTH),blood calcium level,postoperative incision aesthetics satisfaction,and occurrence of complications were compared between the two groups.Results There was no statistically significant difference in the operation time,intraoperative blood loss,or postoperative drainage volume of patients between the two groups(P>0.05).The dissection number of lymph nodes in the central region of patients in the observation group was greater than that in the control group(P<0.05).In the two groups,the levels of NE,Cor,and ACTH 1 day and 3 days after surgery were higher than those before surgery(P<0.05),and the levels of NE,Cor and ACTH 1 day after surgery were higher than those 3 days after surgery(P<0.05);the levels of NE,Cor and ACTH 1 day and 3 days after surgery of patients in the observation group were lower than those in the control group(P<0.05).In the two groups,the levels of PTH and serum calcium 1 day and 3 days after surgery were lower than those before surgery(P<0.05),and the levels of PTH and serum calcium 3 days after surgery were lower than those 1 day after surgery(P<0.05),while there were no significant differences in the levels of PTH or serum calcium 1 day and 3 days after surgery between the two groups(P>0.05).The satisfaction of postoperative incision aesthetics in the observation group(100%)was higher than that in the control group(72.41%),with statistically significant difference(P<0.05).No statistically significant difference was found in the incidence of complications between the two groups(P>0.05).Conclusion Endoscopic surgery via trans-axilloareolar sternocleidomastoid intermuscular approach is safe and feasible for unilateral thyroid cancer,which has a mild stress response and inconspicuous incisions,with high satisfaction of incision aesthetics for patients.

AIM: To investigate the effect of Conbercept on serum lncRNA MALAT1 levels, central macular thickness(CMT)and best corrected visual acuity(BCVA)in patients with diabetic macular edema(DME), and to observe its efficacy and safety.METHODS: A total of 300 patients(300 eyes)with DME were included in this study, all of whom had monocular lesions. They were divided into non-injection group with 100 patients(100 eyes), control group with 100 patients(100 eyes)treated with Ranibizumab injections and study group with 100 patients(100 eyes)treated with Conbercept injections according to a random numbers table.RESULTS: The BCVA, serum lncRNA MALAT1 level and CMT were measured before and 1, 2 and 3mo after treatment. In addition, the clinical efficacy was assessed and the patients were followed up to record the adverse reactions. There were no significant changes in BCVA(LogMAR), serum lncRNA MALAT1 level and CMT in the non- injection group(P>0.05). The BCVA(LogMAR)in the control group and study group at 1, 2 and 3mo after treatment was significantly higher than that before treatment(all P<0.05). The BCVA(LogMAR)of patients in the study group at 1, 2 and 3mo after treatment was significantly higher than that before treatment(all P<0.05), but there was no significant difference between the study group and control group. The level of serum lncRNA MALAT1 in the control group decreased at 1, 2 and 3mo after treatment, and it decreased more significantly in the study group at 1, 2 and 3mo after treatment. The level of serum lncRNA MALAT1 in the study group was significantly lower than that in the control group(all P<0.05).The CMT of patients in the control group decreased at 1, 2 and 3mo after treatment; however, the CMT of patients in the study group decreased more significantly at 1, 2 and 3mo after treatment. The CMT of the study group was significantly lower than that of the control group(all P<0.05).The incidence of adverse reactions in the study group(2.0%)was significantly lower than that in the control group(11.0%).CONCLUSION: Conbercept can significantly reduce the level of serum lncRNA MALAT1, CMT and macular edema and improve BCVA in patients with DME. Its therapeutic efficacy and safety are significantly better than Ranibizumab.

As a primary treatment for strabismus, extraocular muscle surgery can achieve the purpose of correcting the eye position, improving the appearance and reconstructing the third-level visual function. Previous studies have found that the vascular density(VD)and thickness of retina increased in the early stage after extraocular muscle surgery, where multiple mechanisms involved. In recent years, with the appearance of detection means such as optical coherence tomography angiography(OCTA), our quantitative understanding of retinal microscopic changes and their mechanisms brought about by traditional extraocular muscle surgery has become more and more profound. The increase of retinal VD in the early postoperative period may be closely related to the recovery of postoperative visual function. However, the related studies are few, and the association between microscopic changes and visual function after extraocular muscle surgery and its mechanism need to be further clarified. This article will review the microscopic changes of retina and their mechanisms after extraocular muscle surgery from multiple perspectives to improve our understanding of the relationship between the mechanism of its influence and visual function, with a view to provide references for the choice of extraocular muscle surgery scheme and related clinical research.

OBJECTIVE: To observe the changes of symptoms, Chinese medicine (CM) syndrome, and lung inflammation absorption during convalescence in patients with coronavirus disease 2019 (COVID-19) who had not totally recovered after hospital discharge and whether CM could promote the improvement process. METHODS: This study was designed as a prospective cohort and nested case-control study. A total of 96 eligible patients with COVID-19 in convalescence were enrolled from Beijing Youan Hospital and Beijing Huimin Hospital and followed up from the hospital discharged day. Patients were divided into the CM (64 cases) and the control groups (32 cases) based on the treatment with or without CM and followed up at 14, 28, 56, and 84 days after discharge. In the CM group, patients received the 28-day CM treatment according to two types of CM syndrome. Improvements in clinical symptoms, CM syndrome, and absorption of lung inflammation were observed. RESULTS: All the 96 patients completed the 84-day follow-up from January 21 to March 28, 2020. By the 84th day of follow-up, respiratory symptoms were less than 5%. There was no significant difference in the improvement rates of symptoms, including fatigue, sputum, cough, dry throat, thirst, and upset, between the two groups (P>0.05). Totally 82 patients (85.42%) showed complete lung inflammation absorption at the 84-day follow-up. On day 14, the CM group had a significantly higher absorption rate than the control group (P<0.05) and the relative risk of absorption for CM vs. control group was 3.029 (95% confidence interval: 1.026-8.940). The proportions of CM syndrome types changed with time prolonging: the proportion of the pathogen residue syndrome gradually decreased, and the proportion of both qi and yin deficiency syndrome gradually increased. CONCLUSIONS Patients with COVID-19 in convalescence had symptoms and lung inflammation after hospital discharge and recovered with time prolonging. CM could improve lung inflammation for early recovery. The types of CM syndrome can be transformed with time prolonging. (Registration No. ChiCTR2000029430).
Adult ; Aged ; COVID-19/drug therapy* ; Case-Control Studies ; Convalescence ; Female ; Follow-Up Studies ; Humans ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Patient Discharge ; Pneumonia/drug therapy* ; Prospective Studies ; SARS-CoV-2

Objective:To explore the potential synergistic protective mechanism of Glycyrrhizae Radix et Rhizoma-Granati Pericarpium formula compound by using the methods and tools of network pharmacology，and provide a basis for the modernization of traditional Chinese medicine（TCM） compounds and the discovery of new drugs. Method:Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform （TCMSP） was used to obtain the active components of Glycyrrhizae Radix et Rhizoma-Granati Pericarpium formula and their corresponding targets. The obtained targets were input to the UniProt database to inquire the gene names corresponding to the targets. By searching the CTD database，Genecards database and OMIM database of disease-related websites，the anti-sunburn targets were obtained. The interaction of the active targets was analyzed with online STRING database to screen the predicted core targets. The gene ontolog（GO） gene function enrichment analysis and Kyoto encyclopedia of genes and genomes（KEGG） pathway enrichment analysis of the predictive targets were performed by using DAVID database. Cytoscape 3.6.1 software was used to make "drug-component-target" network diagram，"protein-protein interaction" network diagram and "component-target-pathway" network diagram. Online website Draw Venn Diagram was used to show the relationship between disease targets and drug predicted targets. R Studio software was used to draw the functional enrichment analysis diagram of GO gene and KEGG pathway. Molecular docking between the active ingredients and the core targets was performed using GOLD software. Result:The 16 active compounds were collected，such as liquiritin，glycyrrhizin，kaempferol and quercetin. The active components mainly acted on 5 core targets：protein kinase B1（AKT1），interleukin（IL）-6，vascular endothelial growth factor（VEGFA），tumor necrosis factor（TNF） and tumor suppressor gene （TP53） and played a role in anti-sunburn effect primarily through these pathways such as hepatitis B，pathways in cancer，toxoplasmosis，chagas disease（American trypanosomiasis），and TNF signaling pathway. Conclusion:Based on the method of network pharmacology，the present study has preliminarily explored the anti-sunburn targets and pathways of Glycyrrhizae Radix et Rhizoma-Granati Pericarpium formula，and further verified the characteristics of multi-component and multi-target treatment of diseases in TCM，so as to provide certain scientific ideas for the modernization research of Chinese herbal compound prescriptions.

Objective:To report our experience of treating open comminuted limb fractures caused by gunshots using the Masquelet technique.Methods:Between January 2016 and July 2018, 3 patients were admitted to Institute of Orthopedics, 920 Hospital of Joint Logistic Service of People's Liberation Army for open comminuted limb fractures caused by gunshots.They were all male, aged from 18 to 41 years (average, 30.7 years).Their fractures were complicated with perforating wounds and belonged to Gustilo type ⅢB for open fractures.The bone defects were 5 to 9 cm in length (average, 6.7 cm), located at the proximal femur in 2 cases and at the upper middle humerus in one.They were treated by standard Masquelet technique at 2 stages.The postoperative functions of the hip, knee and shoulder were evaluated according to the Harris hip score, Lowa knee score and Constant-Murley shoulder function score.Results:The 3 patients obtained an average follow-up of 17.3 months.The bone defects were all repaired in the 3 patients without any signs of infection.The 2 patients with femoral defects were rated as both excellent by the Harris hip score, as excellent in one and as good in the other by the Lowa knee score; the patient with humeral defects was rated as excellent by the Constant-Murley shoulder function score.Conclusion:Masquelet technique is a desirable treat-ment of segmental long bone defects caused by gunshots.

In order to study the storage and period of validity of emodin standard solution and chrysophanol standard solution in this study, the content of emodin and chrysophanol was determined by HPLC through classical constant temperature test, and the change rule of the content of the standard solution was studied, which could be applied to standardize the management of the standard substance of traditional Chinese medicine. The results showed that the content of emodin and chrysophanol standard solution matched with the first order reaction rule. Under the storage condition of 10 °C, the change rate constant of emodin and chrysophanol were Ke=4.661 7×10⁻⁷ and Kc=4.438 9×10⁻⁷, respectivedy; and the period of validity of emodin standard solution and chrysophanol standard solution were 1 806 d and 1 896 d respectively. The determination and standardization of the period of validity of the standard solution will not only help to reduce the loss of the standard substance and save the cost of drug testing, but also help to standardize the use of the standard substance, which will contrite to obtain more accurate and satisfactory experimental results, and provide a basis for the setting of the storage period and standardized management of the reference solution of Chinese medicine.
Anthraquinones ; analysis ; Chromatography, High Pressure Liquid ; Drugs, Chinese Herbal ; Emodin ; analysis

Objective To observe the effect of isokinetic training of knee flexors and extensors on walking ability in patients with knee osteoarthritis(KOA). Methods From December,2016 to June,2017,120 patients with KOA in our hospital were randomly divided into blank group(n=40),control group(n=40)and observation group(n=40).All the groups were injected with sodium hyal-uronate intraluminally,and received joint mobilization.The control group added conventional strength training, including isotonic and isometric static squat exercise of muscles around the knee. The observation group re-ceived knee isokinetic training additionally,the training mode was ordinary isokinetic/centripetal mode.Before and four weeks after treatment, the peak torque (PT), the Lysholm score and Visual Analogue Scale (VAS) for pain,ten-meter walking time and six-minute walking distance were tested. Results After treatment,the PT value of knee flexors and extensors,the scores of VAS and Lysholm,ten-meter walking time and six-minute walking distance significantly improved in all groups(P<0.05),among which the observa-tion group was the best(P<0.05). Conclusion Isokinetic muscle strength training of knee flexors and extensors can improve the walking ability of patients with KOA.

AIM To establish the quality standard for Weigela japonica Thunb.var.sinica (Rehd.) Bailey (W.j.).METHODS TLC was adopted in this medicinal material's qualitative identification after morphological identification and microscopic identification.The contents of water,total ash,acid-insoluble ash and extracts were detected according to Chinese Pharmacopoeia methods.Then the contents of scopoletin and total coumarins were determined by HPLC and UV,respectively.RESULTS The morphologies and microscopic characters of W.j.could be distinguished from other same generic plants.The clear TLC spot displayed good resolution.The contents of water,total ash,acid-insoluble ash,water-soluble extract and acid-soluble extract were no more than 12.0％,no more than 2.0％,no more than 0.5％,no less than 5.0％ and no less than 4.5％,respectively.Scopoletin and total coumarins showed good linear relationships within the ranges of 1.25-40.0 μg/mL(r =0.999 7)and 2.0-64.0 μg/mL (r =0.999 9),whose average recoveries were 98.19％ (RSD =0.90％) and 99.21％ (RSD =2.5％),respectively.CONCLUSION This accurate and reliable method can be used for the quality control of W.j..