ObjectiveTo evaluate pharmacological effects of Shengmai injection（SMI）on cerebral ischemia and study its neuroprotective mechanism. MethodsMale specific pathogen-free （SPF） Sprague-Dawley （SD） rats were randomly divided into a sham group， a model group， a low-dose SMI group（3 mL·kg^-1）， a middle-dose SMI group（6 mL·kg^-1）， a high-dose SMI group（12 mL·kg^-1）， and a Ginaton group（4 mL·kg^-1）according to the random number table method， with 12 rats in each group. The rat model of cerebral ischemia-reperfusion（MCAO/R）was prepared via the suture method. The administration groups were intraperitoneally injected with corresponding concentrations of SMI or Ginaton injection after reperfusion， which was conducted for 3 consecutive days. The sham group and model group were administered the equivalent volume of physiological saline. The pharmacological effects of SMI on brain injury in MCAO/R rats were evaluated by neurological function scores， cerebral infarction area， hematoxylin-eosin （HE） staining， Nissl staining， terminal deoxynucleotidyl transferase dUTP nick-end labeling （TUNEL） staining， and Western blot. The dominant link and key protein of SMI treating cerebral injury were explored using proteomic analysis. The related mechanisms of SMI were further validated using enzyme-linked immunosorbent assay （ELISA）， Western blot， and chloride ion fluorescence probe with oxygen-glucose deprivation/reoxygenation（OGD/R）-treated PC12 cells and MCAO/R rats. ResultsCompared with the sham group， the model group showed significantly increased neurological function scores， cerebral infarction area， neuronal apoptosis rate， and expression levels of apoptosis related proteins （P<0.05， P<0.01）and significantly decreased density of Nissl bodies and neurons（P<0.01）. Compared with the model group， the SMI groups exhibited significantly decreased neurological function scores， cerebral infarction area， neuronal apoptosis rate， and expression levels of apoptosis related proteins （P<0.05， P<0.01）and significantly increased density of Nissl bodies and neurons （P<0.05）. The proteomic analysis results showed that oxidative stress and inflammatory response were important processes of SMI intervening in MCAO/R injury， and the chloride intracellular channel protein 1 （CLIC1） was one of key proteins in its action network. The levels of representative indicators of oxidative stress and inflammatory response in the MCAO/R rats of the SMI groups were significantly reduced， compared with those in the model group（P<0.05， P<0.01）， and the expression levels of CLIC1 and downstream NOD-like receptor protein 3 （NLRP3） decreased （P<0.01）. In addition， the experimental results based on the OGD/R PC12 cells showed that SMI significantly increased the cell survival rate（P<0.01） and significantly decreased the intracellular chloride ion concentration（P<0.05）. ConclusionSMI has neuroprotective effects. Oxidative stress and inflammatory response are key processes of SMI intervening in MCAO/R injury. The potential mechanism is closely related to the regulation of CLIC1.

Objective:To explore the effects of anterior cruciate ligament (ACL) reconstruction combined with lateral extra-articular tenodesis (LET) on the postoperative knee stability in the patients with ACL injury combined with high grade pivot-shift phenomenon.Methods:A retrospective study was conducted to analyze the 62 patients with primary ACL injury and high-grade pivot-shift phenomena who had been treated and followed up for at least 1 year at Sports Medicine Center, The First Affiliated Hospital, Army Medical University between January 2021 and December 2022. There were 37 males and 25 females, with an age of (29.3±7.0) years. By the different treatment methods, the patients were divided into a trial group of 25 cases treated by ACL reconstruction plus LET and a control group of 37 cases treated by ACL reconstruction only. The International Knee Documentation Committee (IKDC) subjective score, knee Lysolm score, anterior-posterior stability of the knee (KT-1000 side-to-side disparity), rotational stability (axial shift test), and anterior subluxation of the lateral compartment (ASLC) were compared between preoperation and 1 year postoperation, as well as between the 2 groups.Results:There were no significant differences between the 2 groups in the preoperative general data, indicating comparability ( P>0.05). Surgical procedures went on uneventfully in all patients. At 1 year postoperatively in the trial group, the IKDC subjective score [(86.0±7.2) points] and Lysholm score [(87.1±6.0) points] were significantly higher than those in the control group [(81.8±6.8) points and (82.1±5.5) points], and the side-to-side disparity [0.7 (0.0, 2.0) mm] was significantly smaller than that in the control group [2.3 (0.0, 4.0) mm], the percentage of postoperative residual pivot-shift positivity [8.0% (2/25)] was significantly lower than that in the control group [32.4% (12/37)], and the ASLC [(4.5±2.6) mm] was significantly smaller than that in the control group [(6.2±2.6) mm] (all P<0.05). At 1 year postoperatively in both groups, the of IKDC subjective score,Lysolm score, side-to-side disparity, axial shift test, and ASLC were significantly better than the preoperative values ( P<0.05). Conclusion:In the treatment of the patients with ACL injury plus high grade pivot-shift phenomenon, compared with ACL reconstruction alone, ACL reconstruction plus LET enhances their postoperative knee stability and functional outcomes, reduces their residual rotational laxity, and improves their ASLC.

Objective:To explore the effects of anterior cruciate ligament (ACL) reconstruction combined with lateral extra-articular tenodesis (LET) on the postoperative knee stability in the patients with ACL injury combined with high grade pivot-shift phenomenon.Methods:A retrospective study was conducted to analyze the 62 patients with primary ACL injury and high-grade pivot-shift phenomena who had been treated and followed up for at least 1 year at Sports Medicine Center, The First Affiliated Hospital, Army Medical University between January 2021 and December 2022. There were 37 males and 25 females, with an age of (29.3±7.0) years. By the different treatment methods, the patients were divided into a trial group of 25 cases treated by ACL reconstruction plus LET and a control group of 37 cases treated by ACL reconstruction only. The International Knee Documentation Committee (IKDC) subjective score, knee Lysolm score, anterior-posterior stability of the knee (KT-1000 side-to-side disparity), rotational stability (axial shift test), and anterior subluxation of the lateral compartment (ASLC) were compared between preoperation and 1 year postoperation, as well as between the 2 groups.Results:There were no significant differences between the 2 groups in the preoperative general data, indicating comparability ( P>0.05). Surgical procedures went on uneventfully in all patients. At 1 year postoperatively in the trial group, the IKDC subjective score [(86.0±7.2) points] and Lysholm score [(87.1±6.0) points] were significantly higher than those in the control group [(81.8±6.8) points and (82.1±5.5) points], and the side-to-side disparity [0.7 (0.0, 2.0) mm] was significantly smaller than that in the control group [2.3 (0.0, 4.0) mm], the percentage of postoperative residual pivot-shift positivity [8.0% (2/25)] was significantly lower than that in the control group [32.4% (12/37)], and the ASLC [(4.5±2.6) mm] was significantly smaller than that in the control group [(6.2±2.6) mm] (all P<0.05). At 1 year postoperatively in both groups, the of IKDC subjective score,Lysolm score, side-to-side disparity, axial shift test, and ASLC were significantly better than the preoperative values ( P<0.05). Conclusion:In the treatment of the patients with ACL injury plus high grade pivot-shift phenomenon, compared with ACL reconstruction alone, ACL reconstruction plus LET enhances their postoperative knee stability and functional outcomes, reduces their residual rotational laxity, and improves their ASLC.

Objective:To investigate the effect of CRT on thapsigargin (TG)-induced epithelial mesenchymal transition (EMT) of pancreatic cancer (PC) cells.Methods:Immunohistochemistry was used to investigate the differential CRT expression in PC tissues. Western blot (WB) and transwell were used to detect the effect of CRT silencing on TG induced EMT phenotype. Fluro-4/AM and confocal microscopy were used to detect intracellular calcium level in PC cells.Results:CRT was overexpressed in PC tissues ( P<0.01). Overexpression of CRT was positively associated with lymph node metastasis ( P=0.017) and UICC stage ( P=0.021) of PC patients, and negatively associated with E-cadherin expression ( P=0.013). High CRT and low E-cad expression contributed to the poor prognosis of PC patients ( P=0.023). In PC cells, TG induced EMT phenotype was reversed by siRNA-mediated CRT silencing. TG induced EMT was significantly reversed by CRT silencing in vitro. Conclusions:CRT mediates TG induced intracytoplasmic Ca 2+, and ultimately promotes EMT of PC cells.