ObjectiveTo make clear exercise combined with Shenghui Tang interferes in acetylcholine receptor （M1AChR） to improve mitochondrial autophagy and enhance cognition of Alzheimer's disease （AD） model rats through the adenylate activated protein kinase （AMPK）/mammalian target of rapamycin （mTOR） signaling pathway. MethodsForty-eight male SD rats of SPF grade were randomly divided into a blank group， a model group， a Shenghui Tang group （9.3 g·kg^-1）， an exercise group， an exercise + Shenghui Tang group （9.3 g·kg^-1）， and a rapamycin group （1.5 mg·kg^-1）. Except for the blank group， the rat model of AD was constructed by injecting amyloid beta （Aβ_1-42） into hippocampus stereotaxically. The exercise group received treadmill exercise for 4 weeks， while the Shenghui Tang group received intragastric administration for 4 weeks， and the exercise + Shenghui Tang group received treadmill exercise and intragastric administration of Shenghui Tang for 4 weeks simultaneously. After the intervention， the Morris water maze test was used to detect the learning and memory ability. Spontaneous behavior was observed in the open field test. The pathological structure of hippocampal neurons was observed by NISSl staining. The expression level of M1AChR in hippocampus was detected by immunohistochemistry （IHC）. The autophagy ultrastructure of hippocampal neurons was observed by transmission electron microscopy. The apoptosis rate was evaluated by terminal deoxynucleotidyl transferase dUTP nick end labeling （TUNEL）. The expression of Beclin1 and microtubule-associated protein light chain 3β （LC3β） was detected by immunofluorescence （IF）. The protein expression of M1AChR， AMPK， p-AMPK， mTOR， Beclin1， LC3β， and chelate 1 （SQSTM1/p62） in hippocampus was detected by Western blot. ResultsCompared with the blank group， the model group exhibited significantly increased platform escape latency on the fifth day （P<0.01） and significantly decreased activity distance in the target quadrant and times of crossing the platform （P<0.01）. The total movement distance in the open field， the time of movement in the central area， and the average speed obviously decreased （P<0.05）. The arrangement of nerve cells in hippocampus CA1 region was dispersed， and the numbers of Nissl bodies and M1AChR positive cells significantly decreased （P<0.01）. The expression of TUNEL positive cells was significantly increased （P<0.01）. The typical autophagic lysosomal structure decreased. The protein expression of M1AChR， p-AMPK/AMPK， p-mTOR/mTOR， Beclin1， LC3Ⅱ/Ⅰ in hippocampus was significantly decreased （P<0.01）， and the protein expression of p62 was significantly increased （P<0.01）. Compared with the model group， the exercise + Shenghui Tang group exhibited obviously improved space exploration and positioning navigation ability （P<0.05， P<0.01）. The total movement distance in the open field， the time of movement in the central area， and the average speed of movement significantly increased （P<0.01）. The number of Nissl bodies significantly increased （P<0.01）. The number of M1AChR positive cells in hippocampus was significantly increased （P<0.01）. The expression of TUNEL positive cells was significantly decreased （P<0.01）. The protein expression of M1AChR， p-AMPK/AMPK， p-mTOR/mTOR， Beclin1， LC3Ⅱ/Ⅰ in hippocampus was significantly increased （P<0.01）， while the protein expression of p62 was significantly decreased （P<0.01）. Compared with the exercise + Shenghui Tang group， the Shenghui Tang group and the exercise group showed significantly increased platform escape latency on the fifth day （P<0.01） and obviously decreased activity distance in the target quadrant and times of crossing the platform （P<0.05， P<0.01）. The total movement distance in the open field， the time of movement in the central area， and the average speed of movement significantly decreased （P<0.01）. The number of Nissl bodies and the number of M1AChR positive cells significantly decreased （P<0.01）. The expression of TUNEL positive cells was obviously increased （P<0.05）. Ultrastructure of the hippocampal region showed decreased autophagy level. The protein expression of M1AChR， p-AMPK/AMPK， p-mTOR/mTOR， LC3Ⅱ/Ⅰ in the hippocampus was obviously decreased in the Shenghui Tang group （P<0.05， P<0.01）， while the protein expression of p62 was significantly increased （P<0.01）. In the exercise group， the protein expression of M1AChR， p-AMPK/AMPK， Beclin1， and LC3Ⅱ/Ⅰ was obviously decreased （P<0.05， P<0.01）， while the protein expression of p-mTOR/mTOR and p62 was significantly increased （P<0.01）. ConclusionExercise combined with traditional Chinese medicine can enhance the expression of M1AChR in the hippocampus of AD model rats， induce autophagy through the AMPK/mTOR signaling pathway， and improve the learning and memory ability of AD rats.

The tetraspanins are closely associated with the development and therapeutic prognosis of colorectal tumors. These proteins play a role in cell proliferation, metastasis, and invasion, regulate apoptosis and autophagy of colorectal tumor cells. affect immune escape by releasing exosomes, intervening the epithelial-mesenchymal transition process, and altering the tumor microenvironment, and enhance tumor stemness through specific pathways. This paper reviews the mechanisms and current research regarding the status of tetraspanins in colorectal cancer, aiming to improve early diagnosis and providing valuable insights for treatment strategies.

Objective:To compare the clinical efficacy and cost of robot-assisted laparoscopic adrenalectomy with da Vinci Xi and Si surgical system in the treatment of adrenal tumors.Methods:The clinical data of 99 patients performing robotic-assisted laparoscopic adrenalectomy in our hospital between June 2019 and December 2020 were retrospective analyzed. Among them, 57 cases were Si system robot assisted laparoscopic adrenalectomy (group Si), 35 male, 22 female; age (45.6±14.0)years; BMI(21.0±1.2); 6 with diabetes, 10 hypertension, 14 with abdominal surgery; 28 left, 29 right; 9 ASA score ≥3; tumor diameter (3.9±1.2)cm. There were 42 cases of Xi system robot-assisted laparoscopic adrenalectomy (group Xi), 21 male, 21 female; age(44.8±14.5)years; BMI(21.4±1.8); 2 with diabetes, 12 hypertension, 11 with abdominal surgery; 15 left, 27 right; 7 with ASA score ≥3; tumor diameter (3.7±1.1) cm. Sex, age, BMI, comorbidities, history of abdominal surgery, lateral division, ASA score, and tumor diameter were not significantly different between the two groups ( P>0.05). Operation method: except for the different docking procedures, the same surgical procedures were roughly performed in the two groups. The docking method of the Si group was the doctor holding the attractor as the guide. The operating room nurse introduced the robot cart under the guidance of the attractor, and then completed the docking.Group Xi docking adoptd the own laser positioning system of the robot system, without manual positioning and guidance; the mechanical arm of the Xi system was also more flexible. Complications were graded according to the Clavien-Dindo grading system. Comparing the treatment effect, safety, and cost of the two groups were compared. Results:The anesthesia times in the Si and Xi groups were (140.0±24.3) min and (125.6±26.4) min ( P=0.006), respectively. The surgical times in the Si and Xi groups were (109.0±18.8) min and (98.8±20.7) min (P=0.013), respectively. The docking times between the Si and Xi groups were (7.8±1.4) min and (5.0±0.9) min ( P<0.001), respectively. The estimated intraoperative blood loss in the Si and Xi groups was (121.5±70.8) ml and (124.7±68.9) ml ( P=0.824), respectively. The postoperative indwelling times of the drainage tube in the Si and Xi groups were (3.4±1.2) d and (3.4±1.3) d ( P=0.892), respectively. Postoperative bed times in the Si and Xi groups were (2.3±1.0) d and (2.5±1.2) d ( P=0.419), respectively. Postoperative hospitalization times in the Si and Xi groups were (6.4±1.5) d and (6.2±1.5) d ( P=0.484), respectively. Post Clavien ≥ grade 3 complications were four and two in groups Si and Xi, respectively ( P=0.642). The total cost during hospitalization in the Si and Xi groups was (51 975.2±7 320.8) Yuan and (56 830.9±8 392.5) Yuan, respectively ( P=0.003). The surgery and consumables costs for the Si and Xi groups were (23 785.3±4 063.1) Yuan and (28 021.2±6 066.8) Yuan ( P<0.001), respectively. Conclusions:Compared with the Si system, the Xi system robot-assisted laparoscopic adrenalectomy can provide similar perioperative results and safety, and shorten the time of anesthesia and surgery, but the total cost of hospitalization is increased.

Objective To explore the effect of postoperative progressive resistance training (PRT) on the upper limb function in breast cancer patients. Methods 66 breast cancer patients were randomly divided into intervention group (n=33) and control group (n=33). The intervention group accepted a 12-week PRT and the control group accepted the routine training since 4-6 weeks postoperative as they admitted to hospital for their first chemotherapy. All the patients received a same content of health education. Results The grip strength, range of motion of abduction and flexion of shoulder were more in the intervention group than in the control group after intervention (P<0.01). Conclusion PRT can effectively improve the function of upper limbs in breast cancer patients.

BACKGROUND: Experiments have demonstrated that autologous vascular endothelial cells if transplanted onto artificial vascular cavosurface, can enhance the patency rate of vasotransplantation. Whether seeding of prostheses interposition grafts with bone marrow-derived endothelial cells is effective for in vivo endothelialization of artificial vessels remains unclear.OBJECTIVE: To observe the effect of endothelialization of vascular prosthesis by seeding prostheses interposition grafts with bone marrow-derived endothelial cells in animals.DESIGN: A controlled animal experimental study.SETTING: Shanghai Sixth People's Hospital.MATERIALS: This study was carried out in the Shanghai Sixth People's Hospital between September 2000 and October 2001. Twenty hybrid dogs from Shanghai, of either gender, aged 1.0 to 2.0 years old, weighing (18.7±2.3) kg, were involved in this study.METHODS: Bone marrow-derived mononuclear cells were isolated from the dogs. The endothelialization of ePTFE prostheses interposition grafts (4 mm×4 cm and 8 mm×5 cm)was carried out. Common carotid artery transplantation:Ten laboratory dogs were involved. Common carotid artery of 4 cm was resected from each dog. ePTFE prostheses interposition grafts of 4 mm×4 cm was transplanted into the bilateral common carotid artery, and prostheses interposition grafts were performed endothelialization, namely experimental group. Those prostheses interposition grafts, which were not performed endothelialization, were named as control group. Five dogs were used in each group. Patency rate and blood flow rate of transplanted vessels were detected with a color ultrasonograph 2 weeks and 2 months after operation.Inferior caval vein transplantation: Six of the rest 10 dogs were used for experiments. Under the anesthesia, 8-10 cm inferior caval vein was dissociated from each dog. Its two ends were blocked, and about 5 cm inferior caval vein was resected. ePTFE endothelialized vascular prosthesis with 8 mm in diameter and 5 cm in length was anastomosed end to end with 5-0 Prolene. The other 4 dogs were used for control experiment. ePTFE vascular prosthesis with the same specification was used as prostheses interposition graft. Vascular patency rate was determined 2 months after operation.At the same time, coverage rate and intimal thickness of transplanted vascular endothelial cells and vascular intimal thickness were determined.MAIN OUTCOME MEASURES: ①The patency rate and blood flow rate of transplanted vessels at different time points. ②Coverage rate of transplanted vascular endothelial cells and vascular intimal thickness.RESULTS:① At 2 weeks and 2 months after common carotid artery transplantation, the patency rate of experimentalside was 100%(5/5)and 60%(3/5), respectively, and that of control side was 40%(2/5)and 0%(0/5), respectively. At postoperative 2 months, the mean blood flow rate in the experimental group was obviously smaller than that in the control group (P ＜ 0.05). At 2 months after inferior caval vein transplantation, the patency rate of experimental group and control group was 83%(5/6)and 50%(2/4), respectively. ②At 2 weeks after common carotid artery transplantation and inferior caval vein transplantation, the coverage rate of vascular endothelial cells in the experimental group was significantly larger than that in the control group, separately (P ＜ 0.05). At 2 months after each transplantation, the vascular intimal thickness in the experimental group was significantly smaller than that in the control group (P ＜ 0.05).CONCLUSION: Seeding of ePTFE prostheses interposition grafts with bone marrow-derived endothelial cells can rapidly accomplish in vivo endothelialization and inhibit intimal hyperplasy; Circulating endothelial cells, as the potential source of endothelial cells, have certain clinical application values.

Objective To determine the effect and safety of metallic stents in the treatment of acute malignant colorectal obstruction.Methods From May,2000 to June,2003, self-expanding metallic stents were implanted in 15 patients with acute left colonic obstruction caused by malignancies. The postoperative remission and complications were observed.Results Stents were implanted successfully in 12 cases(80.0%,12/15).Of the 12 cases,the obstruction were all disappeared within 24h. No death or colonic perforation happened in this series. Stent migration and anal pain developed each in one case after stent implantation. Elective radical resection was performed on 8 cases after bowel preparation and supportive therapy; and stents reserved permanently in other 4 cases. Conclusions The implantation of self-expanding metallic stents is a safe and effective method for the temporary remission or permanent treatment of acute left-colonic or rectal obstruction caused by malignancies,it can instead of colostomy.