ObjectiveTo elucidate the chemical composition of Danshenyin and its blood components in rats after oral administration. MethodsUltra performance liquid chromatography-quadrupole-time-of-flight tandem mass spectrometry（UPLC-Q-TOF-MS/MS） coupled with PeakView 1.2 software was used to systematically characterize and identify the components of Danshenyin aqueous extract and its migratory components in rat blood after oral administration based on the retention time， quasi-molecular ion peaks， secondary fragmentation ions， and literature reports， and a preliminary compounds identification of Salviae Miltiorrhizae Radix et Rhizoma aqueous extract， the co-decoction of Santali Albi Lignum and Amomi Fructus was carried out to attribute the chemical constituents of the aqueous extract of Danshenyin. ResultsA total of 73 compounds， including 21 phenolic acids， 23 diterpenes， 6 flavonoids， 7 organic acids， 3 volatile oils and 13 others， were identified from the aqueous extract of Danshenyin. And 36 prototypes and 15 metabolites were identified in rat plasma， the major metabolic pathways included reduction， hydration， hydroxylation， demethylation， methylation， sulfation and others， these metabolites were mainly derived from tanshinones and salvianolic acids. ConclusionThe main blood components of the aqueous extract of Danshenyin are salvianolic acids and tanshinones， which may be the material basis of the efficacy. This study can provide reference for pharmacological research， quality control， and clinical application of Danshenyin.

Objective:To evaluate the clinical value of holographic imaging-based digital localization technology in robot-assisted partial nephrectomy（RAPN）for the treatment of completely endophytic renal tumors.Methods:A retrospective analysis was conducted on the clinical data of 23 patients with completely endophytic renal tumors who underwent RAPN at the First Affiliated Hospital of Xiamen University between December 2022 and December 2024. Patients were divided into two groups based on the use of holographic imaging：the holographic imaging group（16 cases）and the conventional group（7 cases）. There was no statistically significant difference between the holographic imaging group and the conventional group in terms of age［（41.9 ± 13.4）years vs.（46.9 ± 13.4）years］，body mass index［（25.6 ± 4.8）kg/m2 vs.（24.7 ± 3.1）kg/m2］，maximum tumor diameter［（3.1 ± 0.9）cm vs.（3.0 ± 9.0）cm］，tumor volume［（13.2 ± 9.0）cm3 vs.（34.9 ± 9.9）cm3］，R.E.N.A.L. score［（9.4 ± 1.2）points vs.（9.9 ± 0.7）points］，PADUA score［（10.4 ± 0.7）points vs.（9.4 ± 0.7）points］，proportion of T 1a stage patients［12 cases（75.0%）vs. 6 cases（85.7%）］and preoperative serum creatinine［（67.4 ± 9.5）μmol/L vs.（78.0 ± 16.0）μmol/L］. In the holographic group，holographic models were reconstructed based on preoperative enhanced CT or MRI images and used for preoperative planning and intraoperative localization. In the conventional group，surgeons relied on preoperative CT or MRI images for cognitive fusion during RAPN. Perioperative parameters such as warm ischemia time，operative time，tumor localization time，positive surgical margin rate，and renal function were compared between the two groups. Results:The operative time in the holographic group was significantly shorter than that in the conventional group［（152.8 ± 12.9）min vs.（218.4 ± 105.5）min， P = 0.001］. Warm ischemia time［（26.9 ± 3.4）min vs.（30.7 ± 3.8）min， P < 0.001］，localization time［（4.2 ± 0.9）min vs.（8.9 ± 1.7）min， P < 0.001］，and estimated blood loss［（47.0 ± 17.7）ml vs.（128.6 ± 87.8）ml， P < 0.001］were also significantly lower in the holographic group. In the conventional group，one patient underwent radical nephrectomy，while no patient in the holographic imaging group required conversion to radical nephrectomy. No cases of positive surgical margins were identified in either group. Serum creatinine levels measured one month after surgery showed no statistically significant differences between the two groups［（79.5 ± 15.7）μmol /L vs.（104.9 ± 22.5）μmol /L］. Conclusions:The application of holographic imaging-based digital localization technology in RAPN for completely endophytic renal tumors significantly reduces operative time，localization time，warm ischemia time，and intraoperative blood loss. This technology improves surgical efficiency and success rates，offering distinct clinical advantages.

Objective To investigate the behavioral changes and monoamine neurotransmitter levels in a rat model of chronic unpredictable mild stress(CUMS)-induced depression and explore the potential effects of Vitamin B12(VitB12)on CUMS model rats and the underlying mechanisms.Methods A total of 72 Sprague-Dawley(SD)rats were randomly assigned to 3 groups,a control group,a CUMS group(subjected to three weeks of CUMS),and a CUMS+VitB12 group(CUMS rats receiving microinjections of VitB12 in the neck).The body mass of the rats was measured,and behavioral assessments were conducted using the sucrose preference test,open field test,and forced swimming test.High-performance liquid chromatography(HPLC)was used to analyze the levels of monoamine neurotransmitters,including 5-hydroxytryptamine(5-HT),norepinephrine(NE),and dopamine(DA),in each group of rats.Hematoxylin-eosin(HE)staining was performed to observe pathological changes in hippocampal neurons.Western blot was performed to detect the expression of signal pathway-related proteins,including brain-derived neurotrophic factor(BDNF),tropomyosin receptor kinase B(TrkB),and cyclic adenosine monophosphate(cAMP)response element-binding protein(CREB)in the hippocampal tissue.Results Starting from week 5,rats in the CUMS group exhibited lower average body mass compared to the control group,while the CUMS+VitB12 group showed a significant increase in body mass compared to the CUMS group(P＜0.05).At weeks 3 and 6,sucrose preference of rats in the CUMS group was significantly lower than that in the control group(P＜0.001).At week 3,sucrose consumption in the CUMS+VitB12 group was significantly higher than that in the CUMS group(P＜0.01),with a more pronounced increase observed in week 6(P＜0.001).Starting from week 4,the CUMS group showed reduced scores in grid crossing,grooming,and rearing activities in the open field test compared to the control group,indicating reduced locomotor activity and exploratory behavior(P＜0.001).The CUMS+VitB12 group showed improved behavioral performance compared to the CUMS group(P＜0.01,P＜0.001).In the forced swimming test at weeks 3 and 6,the immobility time of rats in the CUMS group was significantly longer than that in the control group(P＜0.01).At week 6,the immobility time of rats in the CUMS+VitB12 group was significantly shorter compared to that of the CUMS group(P＜0.01).HPLC results showed that the levels of 5-HT,NE,and DA in the cerebral cortex of rats in the CUMS group were significantly lower than those in the control group(P＜0.01,P＜0.001),while these neurotransmitter levels were significantly higher in the CUMS+VitB12 group compared to those in the CUMS group(P＜0.05,P＜0.01).HE staining results showed that the number of hippocampal cells in the CUMS group was significantly reduced,with shrunken nuclei,while the CUMS+VitB12 group showed an increased number of neurons with intact morphology compared to the CUMS group(P＜0.05).Western blot analysis showed that the expression levels of BDNF,TrkB,and CREB proteins in the hippocampus were significantly lower in rats in the CUMS group than those in the control group(P＜0.05),while the expression levels of BDNF,TrkB,and phosphorylated CREB(p-CREB)were significantly higher in the CUMS+VitB12 group compared to the CUMS group(P＜0.05).Conclusion In CUMS rats,the levels of monoamine neurotransmitters(5-HT,NE,and DA)in the cerebral cortex of the brain are decreased,accompanied by a decrease in neuronal cells,which results in anxiety-and depression-like behaviors.VitB12 can upregulate the levels of these neurotransmitters,ameliorate the cytopathological conditions,and regulate the BDNF/TrkB/p-CREB signaling pathway,thereby alleviating depressive symptoms.

Severe intra-abdominal infections are life-threatening conditions and a significant challenge for surgeons. This article presents a case of an elderly patient with a severe intra-abdominal infection complicated by an anastomotic leak. This patient had experienced prolonged sepsis and multiple surgical traumas. Upon admission to our department, exploratory surgery revealed extensive bowel edema and adhesions, an anastomotic leak, and abdominal contamination with infection. In accordance with the principles of damage control surgery, the anastomotic leak was exteriorized, the abdomen was left open, and continuous intra-abdominal lavage with dual-lumen catheters was implemented to effectively control the infection. Negative pressure wound therapy was used to manage the open abdomen, and a negative pressure-assisted drainage device was used to manage the enteroatmospheric fistula. After granulation of the abdominal wound, split-thickness skin grafting was performed. The enteroatmospheric fistula was converted into an enterocutaneous fistula. A 3D-printed stoma baseplate was used to manage the digestive fistula. Concurrently, enhanced parenteral and enteral nutritional support was provided. Six months later, the patient successfully underwent definitive fistula resection and abdominal wall defect repair.

Objective:To evaluate the efficacy of vacuum sealing drainage (VSD) in the comprehensive management of full-thickness perineal wound dehiscence following pelvic exenteration (PE).Methods:This study employed a descriptive case series design. We retrospectively analyzed the clinical data of 29 patients who developed postoperative perineal wound infections with full-thickness dehiscence after PE. These cases included 16 patients from the Department of General Surgery at Jiangyin People's Hospital (Jiangsu Province) and 13 patients from the Department of Colorectal Surgery at the Second Affiliated Hospital of Naval Medical University (Shanghai Changzheng Hospital). VSD was applied to manage the dehisced wounds, with outcomes assessed based on wound healing time, complications, and follow-up data.Results:A total of 29 patients were included in the study. The operative time for PE was (498 ± 83) minutes. Among them, 23 patients underwent combined sacrococcygeal resection. The median number of VSD devices used was 28 (22, 39). The postoperative perineal wound healing time was 95 (82, 110) days in patients who underwent combined sacrococcygeal resection, 74 (63, 89) days in those without sacrococcygeal resection, 93 (79, 102) days in those treated with simple pelvic-abdominal isolation using a biological basement membrane mesh and 76 (60, 91) days in those who received combined pelvic packing with a pedicled omental flap. All patients uniformly developed Clavien-Dindo grade III complications at 2 weeks postoperatively, manifesting as perineal wound infection and dehiscence, which were successfully managed with VSD therapy. Subsequent evaluation identified delayed (>30 days) grade III complications, including enterocutaneous (3 cases) and urinary (2 cases) fistulae, all requiring surgical revision. All patients completed the follow-up at 6 months postoperatively. Three patients still presented with minimal exudate from the perineal wound, which resolved after standardized wound care and packing with alginate silver ion dressings. Four cases (13.8%) developed stoma high-output syndrome, which improved after oral medication. Eight patients (27.6%) developed adhesive intestinal obstruction, which improved with conservative treatment.Conclusions:VSD demonstrates unique advantages in managing complex wounds. For full-thickness perineal wound dehiscence after PE, VSD is a safe and effective therapeutic strategy.

Severe intra-abdominal infections are life-threatening conditions and a significant challenge for surgeons. This article presents a case of an elderly patient with a severe intra-abdominal infection complicated by an anastomotic leak. This patient had experienced prolonged sepsis and multiple surgical traumas. Upon admission to our department, exploratory surgery revealed extensive bowel edema and adhesions, an anastomotic leak, and abdominal contamination with infection. In accordance with the principles of damage control surgery, the anastomotic leak was exteriorized, the abdomen was left open, and continuous intra-abdominal lavage with dual-lumen catheters was implemented to effectively control the infection. Negative pressure wound therapy was used to manage the open abdomen, and a negative pressure-assisted drainage device was used to manage the enteroatmospheric fistula. After granulation of the abdominal wound, split-thickness skin grafting was performed. The enteroatmospheric fistula was converted into an enterocutaneous fistula. A 3D-printed stoma baseplate was used to manage the digestive fistula. Concurrently, enhanced parenteral and enteral nutritional support was provided. Six months later, the patient successfully underwent definitive fistula resection and abdominal wall defect repair.

Objective:To evaluate the efficacy of vacuum sealing drainage (VSD) in the comprehensive management of full-thickness perineal wound dehiscence following pelvic exenteration (PE).Methods:This study employed a descriptive case series design. We retrospectively analyzed the clinical data of 29 patients who developed postoperative perineal wound infections with full-thickness dehiscence after PE. These cases included 16 patients from the Department of General Surgery at Jiangyin People's Hospital (Jiangsu Province) and 13 patients from the Department of Colorectal Surgery at the Second Affiliated Hospital of Naval Medical University (Shanghai Changzheng Hospital). VSD was applied to manage the dehisced wounds, with outcomes assessed based on wound healing time, complications, and follow-up data.Results:A total of 29 patients were included in the study. The operative time for PE was (498 ± 83) minutes. Among them, 23 patients underwent combined sacrococcygeal resection. The median number of VSD devices used was 28 (22, 39). The postoperative perineal wound healing time was 95 (82, 110) days in patients who underwent combined sacrococcygeal resection, 74 (63, 89) days in those without sacrococcygeal resection, 93 (79, 102) days in those treated with simple pelvic-abdominal isolation using a biological basement membrane mesh and 76 (60, 91) days in those who received combined pelvic packing with a pedicled omental flap. All patients uniformly developed Clavien-Dindo grade III complications at 2 weeks postoperatively, manifesting as perineal wound infection and dehiscence, which were successfully managed with VSD therapy. Subsequent evaluation identified delayed (>30 days) grade III complications, including enterocutaneous (3 cases) and urinary (2 cases) fistulae, all requiring surgical revision. All patients completed the follow-up at 6 months postoperatively. Three patients still presented with minimal exudate from the perineal wound, which resolved after standardized wound care and packing with alginate silver ion dressings. Four cases (13.8%) developed stoma high-output syndrome, which improved after oral medication. Eight patients (27.6%) developed adhesive intestinal obstruction, which improved with conservative treatment.Conclusions:VSD demonstrates unique advantages in managing complex wounds. For full-thickness perineal wound dehiscence after PE, VSD is a safe and effective therapeutic strategy.

Objective:To evaluate the clinical value of holographic imaging-based digital localization technology in robot-assisted partial nephrectomy（RAPN）for the treatment of completely endophytic renal tumors.Methods:A retrospective analysis was conducted on the clinical data of 23 patients with completely endophytic renal tumors who underwent RAPN at the First Affiliated Hospital of Xiamen University between December 2022 and December 2024. Patients were divided into two groups based on the use of holographic imaging：the holographic imaging group（16 cases）and the conventional group（7 cases）. There was no statistically significant difference between the holographic imaging group and the conventional group in terms of age［（41.9 ± 13.4）years vs.（46.9 ± 13.4）years］，body mass index［（25.6 ± 4.8）kg/m2 vs.（24.7 ± 3.1）kg/m2］，maximum tumor diameter［（3.1 ± 0.9）cm vs.（3.0 ± 9.0）cm］，tumor volume［（13.2 ± 9.0）cm3 vs.（34.9 ± 9.9）cm3］，R.E.N.A.L. score［（9.4 ± 1.2）points vs.（9.9 ± 0.7）points］，PADUA score［（10.4 ± 0.7）points vs.（9.4 ± 0.7）points］，proportion of T 1a stage patients［12 cases（75.0%）vs. 6 cases（85.7%）］and preoperative serum creatinine［（67.4 ± 9.5）μmol/L vs.（78.0 ± 16.0）μmol/L］. In the holographic group，holographic models were reconstructed based on preoperative enhanced CT or MRI images and used for preoperative planning and intraoperative localization. In the conventional group，surgeons relied on preoperative CT or MRI images for cognitive fusion during RAPN. Perioperative parameters such as warm ischemia time，operative time，tumor localization time，positive surgical margin rate，and renal function were compared between the two groups. Results:The operative time in the holographic group was significantly shorter than that in the conventional group［（152.8 ± 12.9）min vs.（218.4 ± 105.5）min， P = 0.001］. Warm ischemia time［（26.9 ± 3.4）min vs.（30.7 ± 3.8）min， P < 0.001］，localization time［（4.2 ± 0.9）min vs.（8.9 ± 1.7）min， P < 0.001］，and estimated blood loss［（47.0 ± 17.7）ml vs.（128.6 ± 87.8）ml， P < 0.001］were also significantly lower in the holographic group. In the conventional group，one patient underwent radical nephrectomy，while no patient in the holographic imaging group required conversion to radical nephrectomy. No cases of positive surgical margins were identified in either group. Serum creatinine levels measured one month after surgery showed no statistically significant differences between the two groups［（79.5 ± 15.7）μmol /L vs.（104.9 ± 22.5）μmol /L］. Conclusions:The application of holographic imaging-based digital localization technology in RAPN for completely endophytic renal tumors significantly reduces operative time，localization time，warm ischemia time，and intraoperative blood loss. This technology improves surgical efficiency and success rates，offering distinct clinical advantages.

Objective:To investigate the mechanism by which baicalein alleviates osteoarthritis by regulating Sirtuin (Sirt) to inhibit the senescence of fibroblast-like synoviocytes (FLS).Methods:FLS were extracted from synovium of non-osteoarthritis patients (3 patients) and osteoarthritis patients (3 patients), and assessed the senescence of FLS in osteoarthritis patients by Western blot, β-galactosidase staining and immunofluorescence, and examined the changing levels of Sirt family proteins and mRNAs in FLS. The relative expression level of Sirt1 in FLS was knocked down by transfection with Sirt1 siRNA, and the antioxidative capacity and senescence degree of FLS were analyzed. Chondrocytes were co-cultured with FLS and functional changes in chondrocytes were detected by Western blot. After inducing FLS senescence with bleomycin (BLM), different concentrations of baicalein were administered to detect the expression levels of Sirt1, p16, and p21 proteins and intracellular reactive oxygen species (ROS). The expression level of Sirt1 in FLS was knocked down, and BLM and baicalein treatments were applied. The relative expression levels of Sirt1 and ROS were detected using Western blot and ROS assays. After BLM-induced FLS senescence, baicalein and Compound C were added. The relative expression levels of phosphorylated AMP-activated protein kinase (pAMPK), nuclear factor erythroid 2-related factor 2 (NRF2), p16, p21, and ROS were detected by Western blot and ROS assays.Results:The relative expression of p16 and p21 in FLS in the osteoarthritic group were 3.66±0.38 and 3.55±0.34, which were higher than those in non-osteoarthritis group 1.00±0.07 and 1.00±0.09 ( t=11.860, P<0.001; t=12.520, P<0.001). The relative expression levels of Sirt1 and Sirt6 in FLS in the osteoarthritis group were 0.30±0.04 and 0.16±0.01, which were smaller than those in the non-osteoarthritis group 1.00 ± 0.03 and 1.00±0.04 ( t=23.840, P<0.001; t=34.130, P<0.001). After baicalein treatment, the relative expression of ROS was 2.58±0.28, 1.65±0.14 and 1.00±0.24 in the BLM, BLM+Bai and control groups, respectively, with statistically significant differences between the groups ( F=35.700, P<0.001), which was greater in the BLM and BLM+Bai than in the control group, and lower in the BLM+Bai than in the BLM group ( P<0.05). The relative expression of pAMPK and NRF2 was 0.28±0.02 and 0.38±0.09 after Compound C+Baicalein treatment, which was lower than that of 0.56±0.07 and 0.60±0.08 in the BLM+Bai group ( P<0.05). The relative expression of ROS increased from 1.75±0.16 to 3.45±0.12 ( P<0.001). The proportion of positivity in the BLM+Bai+Compound C, BLM+Bai and control groups was 47.30%±4.29%, 18.18%±3.89% and 7.70%±3.53% ( F=109.700, P<0.001), respectively, with the BLM+Bai+Compound C group being higher than that in the BLM+Bai group ( P<0.05). Conclusion:The downregulation of Sirt1 expression in patients with osteoarthritis leads to FLS senescence and accelerates the progression of osteoarthritis. Baicalein can inhibit FLS senescence by activating Sirt1/AMPK/NRF2 pathway, which may delay the progression of osteoarthritis and improve the function of chondrocytes.

Objective To explore the effect of nicotinamide transmethylase on intracellular reactive oxygen species(ROS)in iron death of hepatocellular carcinoma cells and its mechanism.Methods Methyl nicotinamide(MNA)expression in cells was detected using a tandem liquid chromatography-mass spectrometry.The average fluorescence intensity of ROS and lipid peroxidation was measured using a flow cytometer.Western blot was used to detect changes in the expression of human liver cancer cells(SK-Hep-1,Hep3B).Forty patients with primary hepatocellular carcinoma who received treatment in our hospital from March 2019 to February 2020 were selected as the study subjects,and their adjacent tissue samples and liver cancer tissue samples were collected.Immunohistochemical methods were used to detect the levels of nicotinamide N-methyltransferase(NNMT)and ROS in adjacent and liver cancer tissues.CCK-8 method was used to detect the survival activity of cells with different iron concentrations.Results The MNA levels in the liver cancer tissue group were higher than those in the adjacent tissue group(P<0.05).Compared with the adjacent tissue group,the average fluorescence intensity expression of ROS in the liver cancer tissue group increased,while the average fluorescence intensity expression of lipid peroxidation decreased(P<0.05).Compared with the adjacent tissue group,the expression levels of SK Hep-1 and Hep3B cells in the liver cancer tissue group increased(P<0.05).Compared with the control group,NNMT groups 2,10,20,and 25 μmol/L The cell survival activity level increased(P<0.05);Compared with the NNMT group,the iron inhibition group had different iron concentrations(2μmol/L,10μmol/L,20μmol/L,25μmol/L.The expression of cell viability decreased(P<0.05).Conclusion ROS mediated by nicotinamide methyltransferase can be guided to produce ROS and energy disorders,leading to increased tumor cell death.