Objective To investigate the therapeutic efficacy of Wenyang Yiqi Therapy,the method of warming yang and replenishing qi in traditional Chinese medicine(TCM),combined with Alendronate Sodium Vitamin D3 in the treatment of elderly patients with osteoporosis(OP)of the spleen-kidney yang deficiency syndrome,and to observe its effect on bone metabolism and serum inflammatory factors.Methods A total of 110 cases of elderly patients with OP of spleen-kidney yang deficiency syndrome who admitted to the Department of Orthopedics and Traumatology of Traditional Chinese Medicine of Wuxi Ninth People's Hospital from October 2021 to October 2023 were randomly divided into a trial group and a control group,with 55 patients in each group.The two groups were treated with Alendronate Sodium Vitamin D3,and additionally the trial group was treated with Wenyang Yiqi Therapy by using Chinese herbal medicines of Epimedii Folium,Astragali Radix,Ostreae Concha,Angelicae Sinensis Radix,Cyathulae Radix,Psoraleae Fructus,Taxilli Herba,etc.The course of treatment for the two groups covered three months.Before and after treatment,the two groups were observed in the changes of traditional Chinese medicine(TCM)syndrome scores,bone mineral density(BMD),Visual Analogue Scale(VAS)score of pain,bone metabolism indicators of β-C-terminal telopeptide of type 1 collagen(β-CTX),total procollagen type 1 N-terminal propeptide(PINP)and bone gla-protein(BGP),and serum inflammatory factor indicators of interleukin 6(IL-6)and tumor necrosis factor α(TNF-α)].After treatment,the clinical efficacy of the two groups of patients was evaluated.Results(1)After three months of treatment,the total effective rate of the trial group was 94.55%(52/55)and that of the control group was 74.55%(41/55),and the intergroup comparison(tested by chi-square test)showed that the efficacy of the trial group was significantly superior to that of the control group(P<0.01).(2)After treatment,the scores of TCM symptoms of soreness and weakness in the waist and knee,aversion of cold with cold limbs,fatigue and tiredness,and nocturnal frequent polyuria in the two groups were decreased compared with those before treatment(P<0.05),and the decrease in the trial group was significantly superior to that in the control group(P<0.01).(3)After treatment,the BMD of patients in the two groups were increased(P<0.05)while the pain VAS scores were decreased compared with those before treatment(P<0.05),and the increase in BMD and the decrease in pain VAS score of the trial group were significantly superior to that of the control group(P<0.01).(4)After treatment,the serum levels of bone metabolism indicators of β-CTX and PINP in the two groups were decreased compared with those before treatment(P<0.05),and the serum BGP level was increased compared with that before treatment(P<0.05).And the decrease of the serum β-CTX and PINP levels as well as the increase of the serum BGP levels in the trial group were significantly superior to that in the control group(P<0.01).(5)After treatment,the serum levels of inflammatory factors of IL-6 and TNF-αof patients in the two groups were decreased compared with those before treatment(P<0.05),and the decrease in the trial group was significantly superior to that in the control group(P<0.01).Conclusion Wenyang Yiqi Therapy combined with Alendronate Sodium Vitamin D3 exerts certain efficacy in the treatment of elderly patients with OP of spleen-kidney yang deficiency syndrome.The combined therapy is effective on alleviating the symptoms such as soreness in the waist and legs,improving bone metabolism,increasing BMD,and inhibiting the inflammatory responses,which will provide evidence for the clinical treatment.

Objective To investigate the relationship between uric acid stone formation and visceral fat area based on computed tomography.Methods As many as 247 patients admitted to our hospital were retrospectively reviewed from January 2017 to January 2018.There were 161 males (65.2％) and 86 females (34.8％).The average age was 51 (20-88 years).According to the results of stone analysis after surgery,the patients were divided into uric acid stone group and non-uric acid stone group.According to the abdominal CT scan,Image J software was used to measure the anthropometric measurements like waist circumference,total fat area (TFA),and visceral fat area (VFA),and subcutaneous fat area (SFA).The clinical characteristics of different stone components were compared.An univariate and multivariate logistic regression analysis was used to identify the independent factors associated with uric acid stone formation.Different anthropometric measurements were compared by using the area under receiver operating characteristic curve.Results The uric acid stones in high VFA group (28/110;25.5％) were obviously more frequent than that in the low VFA group (7/137;5.1％) (P ＜ 0.05).The results of the univariate logistic regression analysis showed that age,diabetes,hyperlipidemia,TFA,waist circumference,body mass index (BMI),VFA,uric acid,and urine pH were statistically significant (P ＜ 0.05).Multivariate logistic regression analysis revealed that diabetes (OR =3.408,95％ CI 1.123-10.340,P =0.030),VFA (OR =6.740,95％ CI 1.95 1-23.279,P =0.003),uric acid (OR =3.182,95 ％ CI 1.120-9.040,P =0.030) and urine pH (OR =4.052,95％ CI 1.095-14.989,P =0.036) were independent factors associated with uric acid stone formation.The area under the curve of TFA,waist circumference,BMI,VFA,and SFA were 0.659,0.665,0.632,0.723 and 0.544,respectively.Conclusions Diabetes,VFA,uric acid and urine pH are independent factors influencing the formation of uric acid stones.Compared with other anthropometric measurements such as TFA,waist circumference,BMI,and SFA,VFA can better assess abdominal obesity and predict the formation of uric acid stones.

Through the construction practice of the optic nerve disease picture database,the paper discusses the system architecture,database field,data content,picture processing,organization and implementation,and other issues about the construction of the clinical case picture database,states and analyzes the operation effect,points out deficiencies,and provides reference for the construction of relevant picture databases.

Objective CD8 +T cells increased in the airway of patients with chronic obstructive pulmonary disease and exis -ted constantly .The aim was to investigate the role of CD 8 +T-cells in rats with chronic bronchitis ( CB) which was induced by cigarette smoking and intratracheal injection with lipopolysaccharide ( LPS) . Methods 18 health Wistar rats were radomly divided into sham smoking group(group A), CB group(group B) and N-acetylcysteine prevention group (group C).The rats in group B and group C re-ceived intratracheal injection with LPS twice and exposed to cigarette smoking for 4 weeks to induce CB model .The rats in Group C re-ceiving intragastric administration with N-acetylcysteine (NAC)(200mg/kg) before received LPS and smoking.Group A was the sham smoking group.The lung tissue of all rats were stained by HE then evaluated about pathological scores .The expression of nuclear fac-tor-κB (NF-κB), major histocompatibility complex class I (MHCI), CD8 +T cell and Vascular endothelial growth factor (VEGF) in airway were detected by immunohistochemisty which was stained by labeled streptavidin biotin method . Results The pathological scores of airway ( 10 .83 ±3 .31 ) in group B were higher than (1.17 ±2.40) in group A(P <0.05).The pathological scores of airway(4.66 ±2.25) in group C were less than (10.83 ±3.31) in group B(P <0.05).The expression of NF-κB(4.84), MHC I (2.48),CD8 +T cell(5.35)and VEGF(5.02) in airway increased in group B when compared with (1.18, 1.25, 1.33) and (1.18) in group A respectively(P <0.05).The expression of NF-κB (2.18), MHC I(1.46),CD8 +(2.35)and VEGF(2.02) in airway decreased in group C when compared with (4.84), MHC I(2.48),CD8 +T cell(5.35)and VEGF(5.02) in group B respectively (P<0.05 ). There were positive correlations between the expression of NF-κB, MHC I and CD8 +T cells in airways(r=0.670, r=0.701, respec-tively, all P<0.01).There were positive correlations between the expression of CD 8 +T cells and VEGF the pathological scores of air-ways(r=0.689, r=0.782, respectively, all P<0.01). Conclusion NAC can inhibit airway inflammation which is regulated by CD8 +T-cells and VEGF through suppressing the expression of NF -κB and MHC I.

Objective To explore the application of a three-dimensional simulation system in extended liver resections.Methods A three-dimensional surgical simulation system was used for preoperative assessment and for computer simulation to estimate the resected liver volume,the residual liver volume,and the surgical resection margins.The software virtual liver resection was used to choose the most optimal surgical option.The actual resection,the postoperative liver volume and the actual surgical resection margins were compared.Results 1 patient was diagnosed by ultrasound to develop ascites on post-operative day 2.Another patient was diagnosed by transthoracic ultrasound to have moderate pleural effusion on postoperative day 1.Postoperative liver failure developed in 1 patient.There was no patient who developed bile leakage.The average length of stay was 6 ～ 85 days (average 22 d).There was no recurrence within 1 month after surgery and there was no postoperative deaths.Condusions The three-dimensional surgery simulation system was effective.It gave an accurate evaluation and simulation of the liver surgery.In extended liver resection,it gave good guidance and help.

The basic design plan of unified intelligence system with a demonstration effect was worked out using the system integration method, and its technical implementation was elaborated in aspects of enterprise service bus, database integration, platform service, and key business application from the operational point. Its extended appli-cation in clinical practice, scientific research, decision-making and hospital management was studied in order to further improve the hospital management level.

Objective To research the consistency of testing results with three different antimajor histocompatibility complex class Ⅰ-related chain A(MICA) specific antibody reagents in order to evaluate their clinical application's value.Method An collaborative study of 18 laboratories was undertaken at the 16th International HLA and Irnmunogenetics Workshop.Total of 16 sera(4 batchs)were tested for anti-MICA antibodies by Luminex method with three different reagents (Kit-A,-B and -C).Result Anti-MICA antibodies were found in 15 sera,except one sera(no.S04) ; No.S10 sera showed positive results in all the laboratories.The anti-MICA antibodies were divided into MICA-G1 group (MICA01,02,07,12,17 and 18) and MICA-G2 group (MICA 04,06,08/27,09 and 19).MICA-G1 group specific antibodies were detected in 5 sera with Kit-A and-B reagent; but there were false-positive results of anti-MICA08/27 and MICA19 antibodies in this 5 sera with Kit-C.MICA-G2group specific antibodies can be detected in other 5 sera with Kit-A and-B,But the MICA specific antibodies testing gave different results with Kit-A,-B and-C in all the last 5 sera samples.Testing of MICA08/27 showed highest consistency results (86.67％,13/15) with Kit-A,-B and-C; and testing of MICA19 showed lowest consistency results (40％,6/15) with this 3 reagents.There were 80％ consistency results of anti-MICA specific antibodies in 13 sera with Kit-B.Conclusion There are the same effect to judgment positive or negative result for anti-MICA antibodies with 3 different reagents,but the results of anti-MICA specific antibodies are not the same.Therefore,it's better to use two or more reagents to test anti-MICA specific antibodies,or choose reagent with wide detection range.

BACKGROUNDRat renal transplantation is an essential experimental model and requires greater microsurgical skills. Thus, training novices to perform quick and reliable microvascular anastomosis is of vital importance for rat renal transplantation. In this study, we developed and evaluated a staged microvascular anastomosis training program for novices, harvesting and transplanting both kidneys from one rat donor.

METHODSFive trainees without any prior microsurgical experience underwent a training program in which the goals were staged according to difficulty. Each trainee had to achieve satisfactory results as evaluated by a mentor before entering the next stage. Rat renal transplantation was accomplished by end-to-end technique with a bladder patch. In the intensive rat renal transplantation stage, the trainees required an average of 20 independent attempts at isotransplantation as final training assessment.

RESULTSAfter 2 months of intensive practice, all trainees had achieved stable and reproducible rat renal transplantation, with a satisfactory survival rate of 85.9% at postoperative Day 7. The total mean operative time was 78.0 minutes and the mean hot ischemia time was 26.2 minutes. With experience increasing, the operative time for each trainee showed a decreasing trend, from 90-100 minutes to 60-70 minutes. After 20 cases, the mean operative time of the trainees was not statistically significantly different from that of the mentor.

CONCLUSIONHarvesting and transplanting both kidneys from one rat donor after a staged microvascular anastomosis training program is feasible for novices without any prior microsurgical skills.

Animals ; Kidney Transplantation ; education ; Male ; Microsurgery ; education ; Operative Time ; Rats ; Rats, Sprague-Dawley ; Tissue and Organ Harvesting ; education

Objective To establish a simple, feasible and precise quality control method for the determination of contents and related substances of demethyl levophencynonate hydrochloride (L-LPC)tablets.Methods The mobile phase consisted of methanol,acetonitrile and sodium acetate buffer solution(pH 5.0),at a ratio of 4∶3∶3,at a flow rate 1.0 ml/min and a detection wavelength of 220 nm.Samples were injected 100 μl and determined at room temperature.Results The calibration curves showed good linearity (R2 =1) within the test range of 0.1-50μg/ml.The recovery of the method was about (100.15 ±0.73)%, and the stability of working solutions was acceptable in 8 h (RSD=0.36%).Conclusion The results indicated that the developed method can be readily used as a quality control method.

Objective To explore the relations of morphologies of intracranial tiny aneurysms with gender,age,hypertension and aneurysm lesions of the patients.Methods A retrospective analysis of clinical data of 112 patients with intracranial tiny aneurysms,admitted to our hospital from January 2009 to December 2012,was performed; according to the aneurysm morphologies,these patients were divided into regular-shape and irregular-shape groups (n=56).The influences of age,gender,hypertension and aneurysm lesions of the patients in aneurysm morphologies were analyzed.Results Gender,age and hypertension were not the independent influence factors of aneurysm morphologies,while aneurysm lesions could significantly affect the aneurysm morphologies,being the independent influence factor of aneurysm morphologies (P=0.005).In the comparison of different distributions of tiny aneurysms,the intemal carotid artery and vertebral basilar artery had less irregular aneurysms than anterior communicating artery; the morphologies of small aneurysms in the anterior cerebral artery,posterior communicating artery and middle cerebral artery showed no significant differences as compared with those in the anterior communicating artery,which tended to having irregular shapes.Conclusion The aneurysm lesions are related to the aneurysm morphologies; anterior communicating artery is prone to having irregular-shape aneurysms.