Objective: To observe the effects of moxibustion or moxa smoke on serum lipids, aorta and liver pa-thology, and carotid plaque stability in atherosclerosis.Methods: Fifty-four 8-week-old ApoE-/- mice were randomly divided into three groups (untreated, moxibustion, and moxa smoke) and received a high-fat diet. Eighteen wild-type C57BL/6 mice of the same age were used as controls. The intervention (none, moxibustion between the nipples, or 10-15 mg/m3 moxa smoke) was applied to restrained mice 20 min per day, six days per week, for 12 weeks. At the end of the experimental period, we measured serum lipids and apolipoprotein, stained thoracic aortas and livers to observe pathological changes, and used immunohistochemical staining to assess the levels of α-smooth muscle actin, CD68, tumor necrosis factor-α, nuclear transcription factor-kB, and P38 mitogen-activated protein kinase. We also measured the levels of matrix metalloproteinase-2 and 9 and tissue metalloproteinase inhibitor-1. Results: After 12 weeks, lipid metabolism disorder and atherosclerotic plaques were observed in the ApoE-/- mice. Moxibustion or moxa smoke reduced the levels of serum total cholesterol, triglycerides, low density lipoprotein, and very low density lipoprotein but did not affect the levels of high density lipoprotein, apolipoprotein A1, or oxidized low density lipoprotein. Moxibustion or moxa smoke sup-pressed pathological changes in thoracic aortas and livers, increased fiber cap thickness, the fiber cap thickness/intimal medial thickness ratio, and collagen area percentage, and reduced extracellular lipids. Treatment with moxibustion or moxa smoke increasedα-smooth muscle actin and reduced CD68 and the vulnerability index, suppressed tumor necrosis factor-α and nuclear transcription factor-kB expres-sion, and did not affect P38 mitogen-activated protein kinase expression. Treatment lowered the levels of matrix metalloproteinase-2 and 9 and increased those of tissue metalloproteinase inhibitor-1. Conclusion: Moxibustion or moxa smoke exert protective effects in serum lipid profiles and carotid plaque stability in atherosclerotic mice by regulating plaque stability, inflammatory factors, and matrix metalloproteinases.

OBJECTIVE: To investigate the application value of fusion indocyanine green fluorescence imaging(FIGFI)in the surgical treatment of recurrent hepatocellular carcinoma.METHODS: From January 2015 to January 2018,theclinical data of 12 patients with recurrent hepatocellular carcinoma who received surgical treatment guided by three-dimensional visualization technology combined with FIGFI at Department of Hepatobiliary Surgery,Zhujiang Hospital,Southern Medical University were analyzed. High-quality thin-slice CT data were collected for three-dimensionalvisualization and reconstruction,individualized liver segmentation and preoperative surgical planning. FIGFI was used todefine the demarcation of tumors,to determine the extent of hepatectomy,and to detect small hepatocellular carcinomaand metastases during the operation. The use of FIGFI in combination with three-dimensional visualization imagesguided the precision hepatectomy. postoperative efficacy was observed by follow-up.RESULTS: All the 12 patientsunderwent successful three-dimensional reconstruction and liver resection. Preoperative CT revealed 12 lesions(80%);intraoperative FIGFI detected 15 lesions(100%);of the three newly discovered lesions,2 were hepatocellular carcinomaand 1 was cirrhosis nodule. The operation time was 267.5(183,345)minutes and the amount of bleeding was 287.5(62.5,513.5)m L. No severe complications such as abdominal hemorrhage,abdominal infection,bile leakage and liverfailure occurred postoperatively. No death occurred during the perioperative period. The median follow-up period was 29 (3-36)months; during the follow-up period, 1 casewas lost and 4 cases had metastasis or recurrence.All the patients were alive at the end of the follow-up.CONCLUSION: FIGFI is helpful to achieveanatomical, functional and radical hepatectomy inthe treatment of recurrent hepatocellular carcinoma.

Objective To investigate the association of smoking status with incident cardiovascular disease (CVD) and its subtypes among the middle-aged and older male populations. Methods This study included 13 940 males from Dongfeng-Tongji (DFTJ) cohort who were free of coronary heart disease (CHD), stroke, cancer or severely abnormal electrocardiogram (ECG) at baseline. All participants completed baseline questionnaires, physical examinations, clinical biochemical tests and blood sample collection. Cox proportional hazard models were used to estimate the hazard ratios (HRs) and 95% confident intervals (CI) for the association analyses. Results Compared with never smokers, current smokers had significant higher risks of CVD, CHD and stroke, the adjusted HRs of current smokers who smoked for more than 40 pack-years were 1.49 (95% CI: 1.32-1.68, Ptrend=0.001), 1.40 (95% CI: 1.22-1.62, Ptrend=0.026) and 1.59 (95% CI: 1.26-2.00, Ptrend=0.029) for CVD, CHD and stroke, respectively; and the adjusted HRs of current smokers who started smoking before 20 years old were 1.29 (95% CI: 1.06-1.58, Ptrend=0.007) and 1.30 (95% CI: 1.03-1.64, Ptrend=0.010) for CVD and CHD, respectively. Former smokers who had quitted smoking for 10 or more years had significant lower risks of CVD (HR: 0.80, 95% CI: 0.71-0.91, Ptrend=0.017) and stroke (HR: 0.65, 95% CI: 0.50-0.84, Ptrend=0.207) when comparing to current smokers. Conclusions Smoking is significantly associated with higher risks of CVD, CHD and stroke, and greater amount of smoking and earlier age at smoking initiation are associated with a higher risk of CVD. Smoking cessation can reduce the risk of CVD.

OBJECTIVE To detect the reversal effect of Guizhi Fuling Wan on cisplatin-resistant ovarian cancer SKOV3/DDP cells and its relationship with protein expression of phosphatase and tensin homolog (PTEN) and metadherin (MTDH). METHODS Guizhi Fuling Wan (GFW) concentrated solution was prepared according to the Chinese Pharmacopoeia 2015 edition, Wistar rats were given GFW viagavage at 4 g·kg-1·d-1,8 g·kg-1·d-1,16 g·kg-1·d-1,or given saline as blank control for 5 days.Blood samples were taken and the corresponding drug-containing low-dose sera, medium-dose sear, high-dose sera and blank sera were prepared.The XCELLigence RTCA S16 real-time label-free cell analyzer was used to detect the reversal effect by the sera combined with cisplatin or paclitaxel in SKOV3/DDP cells. Annexin V-FITC and PI double-staining were used to detect the apoptosis-inducing effect of the sera in the cells. RT-qPCR and western blot were used to detect the mRNA and protein expression of PTEN and MTDH after the cells treated with the sera. RESULTS The inhibition rate of low-dose sera against SKOV3/DDP cells was less than 5%.After the low-dose sera combined with cisplatin or pacli-taxel, the IC50 of SKOV3/DDP cells against cisplatin and paclitaxel decreased by 3.01 and 1.79-fold, respectively.The total apoptosis rates induced by the low-dose sera,medium-dose sear,high-dose sera and blank sera in SKOV3/DDP cells were 11.08±0.13,19.42±0.30,24.23±0.31,and 3.21±0.24,respec-tively; there was a significant difference between the groups (P<0.01). RT-qPCR results showed that, compared with the blank serum, the sera can up-regulate the expression of PTEN mRNA and down-regulate the expression of MTDH mRNA in a dose-dependent manner. Western blot results showed that the induction effect to PTEN protein and the inhibition effect to MTDH protein by the sera were gradually enhanced with thesera dose increasement. CONCLUSION The resistance reversal effect of Guizhi Fuling Wan on ovarian cancer SKOV3/DDP cells may be related to the inhibition of MTDH, up-regulation of PTEN and induction of apoptosis, providing with an experiment basis for the applica-tion of Guizhi Fuling Wan as a reversal agent for chemotherapy resistance of ovarian cancer.

Objective To study the effect of lateral supramalleolar perforator flap for skin and soft tissue defect of lateral malleolus.Methods From January 2012 to December 2015,36 patients with soft tissue burn of ankle in the Traditional Chinese Medicine Hospital of Cixi were selected as study objects.The average wound area was 4 ～ 10cm.The average flap size was 5 ～ 13cm.There were 17 cases received skin flap of behind perforator of the lateral malleolus.There were 19 cases received skin flap of front perforator of the lateral malleolus.The effect of repair was observed.Results All flaps survived in 36 cases after operation.There were 7 cases of 2.6cm of blood stasis,and necrosis occurred in 2 cases which healed after dressing change.Transplantation of skin flap and the original skin had good adhesion,skin color and texture was similar to the surrounding skin during the follow-up period of 6 to 12 months.The survival time and walk time of the repair of anterior perforator flap were (2.20 ± 0.70) weeks,(4.70 ± 1.10) weeks,respectively,which were longer than those of the lateral retromalleolar perforator flap [(2.10 ± 0.80) weeks,(4.20 ± 1.10) weeks],but the differences were not statistically significant (all P ＞ 0.05).The American orthopaedic foot and ankle society(AOFAS) score of the anterior perforator flap was significantly lower than that of the lateral retromalleolar perforator flap,the difference was statistically significant[(77.47 ± 3.41) points vs.(80.12 ± 4.12) points,t =2.110,P ＜ 0.05].Conclusion Lateral supramalleolar perforator flap has significant effect for skin and soft tissue defect of lateral malleolus.The operation is simple,the success rate is high,it is worth to be popularized in clinical.

The purpose of this research is to investigate the effects and mechanisms of paeonol (PL), a phenolic compound found in many traditional Chinese formulations, on reversing drug resistance in the ovarian cancer resistant SKOV3/DDP cells. The results showed that PL had significant drug-resistant reversal effect on SKOV3/DDP cells. Flow cytometry showed that PL could inhibit P-glycoprotein (P-gp) function in a concentration-dependent manner. Fluorescent quantitative PCR and cell immunofluorescence techniques were used to detect mechanisms of action. Results revealed that both the inhibitory effect on MDR1/P-gp and metadherin (MTDH) expression and the induction effect on phosphatase and tensin homolog (PTEN), by 15, 30, and 60 μmol·L^-1 PL, were increased with increased concentrations of PL (P < 0.01, P < 0.05). The inhibitory effect on MTDH mRNA and the induction effect on PTEN mRNA, by PI3K inhibitor LY294002, were stronger or equivalent to that of the 60 μmol·L^-1 PL treated group; however, the inhibition or induction effect on MTDH or PTEN protein were only comparable to the 15 μmol·L^-1 PL treated group. The present study shows that the effect of PL on SKOV3/DDP cells may be related to the inhibition of P-gp function and expression, the inhibition of MDR1, MTDH expression, and the induction of PTEN expression, all which can provide a theoretical foundation for PL as a drug resistance reversal agent on the treatment of ovarian cancer chemotherapy resistance.

Objective To compare the curative effect of the different palm dorsal approach of open reduction and internal fixation for the treatment of distal radius fractures.Methods According to the stochastic indicator method,84 patients with distal radius fractures were divided into control group and observation group,42 cases in each group.The control group was treated with dorsal approach open reduction and internal fixation,while the observation group was treated by volar approach open reduction and internal fixation.The clinical curative effect was assessed,and indicators related to the operation and the fracture healing was recorded in detail.Postoperative complications of patients were analyzed during postoperative follow-up.Results The total effective rate of the observation group was 88.10%(37/42),which was significantly higher than 66.67%(30/42) of the control group(x2=5.509,P=0.019).Compared with the control group,the operation and hospital stay time were significantly shorter,intraoperative and postoperative blood loss of the observation group decreased obviously,and the differences were statistically significant(t=2.092,2.137,2.256,2.199;P=0.040,0.036,0.027,0.031).The Gartland-Weriey score and ulnar inclination of the observation group were (9.18±2.96)points and (10.52±2.64)°,which were significantly lower than those of the control group[(12.56±3.24)points,(16.22±2.87)°],while radial height[(11.61±2.87)mm]was higher than the control group[(10.92±2.65)mm],the differences were statistically significant(t=2.206,2.316,2.185;P=0.030,0.023,0.032).The incidence rate of complications of control group was 26.19%(11/42),which was higher than 9.52%(4/42) of the observation group(x2=3.977,P=0.046).Conclusion The curative effect of volar approach of open reduction and internal fixation in the treatment of distal radius fractures was better compared with dorsal approach.At the same time,it can effectively improve the operation indicators and fracture healing effect,in addition,it can effectively reduce the incidence of postoperative complications.

Objective To observe the changes in subfoveal choroidal thickness (SFCT) and peripapillary choroidal thickness (pCT) in nonarteritic anterior ischemic optic neuropathy (NAION). Methods Nineteen newly occurred NAION patients were included. The patients were divided into group A (20 affected eyes of 19 patients) and B (18 fellow eyes of 18 patients). Twenty eyes of 20 age, gender, intraocular pressure and axial length-matched healthy volunteers (group C) were enrolled in this study. The differences of age (t=1.58), gender ratios (χ2=0.107), intraocular pressure (t=0.092) and axial length (t=0.148) between 3 groups were not significant (P>0.05). SFCT, pCT were measured at first visit, 1 month and 3 months after treatment using enhanced deep imaging technique of spectral domain optical coherence tomography. The correlation of best corrected visual acuity (BCVA) and the choroidal thickness was investigated. Results At the first visit, the mean SFCT and pCT in group A were significant thicker than group C (t=2.957, 2.844; P=0.006, 0.009). There was no difference of SFCT and pCT between group B and C (t=2.019, 2.024; P=0.053, 0.057). There was no correlation between BCVA and SFCT, pCT (F=0.161, 0.033; P=0.695, 0.859). One month after treatment, SFCT in group A was still thicker than group C (t=2.803, P=0.009); while pCT was decreased in group A when compared to group C, but the difference was not significant (t=1.871, P=0.084). Three months after treatment, the differences of SFCT and pCT were not significant between group A and C (t=1.223, 1.105; P=0.236, 0.282). Conclusions At first visit, SFCT and pCT in NAION eyes showed a significant increase when compared to normal eyes. One month later, pCT in NAION eyes decreased to normal. Three months later, both SFCT and pCT decreased. These findings may suggest that a thickened choroid is a clinical characteristic at acute stage in NAION eyes.