Aim To investigate the mechanism of Banxia Baizhu Tianma Decoction(BBTD)in interfer-ing methamphetamine(MA)addiction using network pharmacology.Methods The mechanism of BBTD intervention in MA addiction was analyzed using net-work pharmacology,and MA-dependent SH-SY5Y cell model was further constructed to observe the effects of BBTD on cell model and PI3K-Akt pathway.Results A total of 88 active ingredients and 583 potential tar-gets of BBTD were screened.KEGG analysis showed that BBTD might intervene in MA addiction through PI3K-Akt,cAMP and other pathways.The molecular docking results showed that key active ingredients ex-hibited strong binding ability with core targets of PI3K-Akt pathway.In vitro experiments showed that MA-de-pendent model cells had shorter synapses,tended to be elliptical in morphology,had blurred cell boundaries,showed typical cell damage morphology,and had high intracellular expression of cAMP(P＜0.01)and low expression of 5-HT(P＜0.05).BBTD intervention could counteract the above morphology,cAMP,and 5-HT changes,suggesting that it had therapeutic effects on MA-dependent model cells.Western blot showed that MA modeling elevated the p-PI3K/PI3K(P＜0.05)and p-Akt/Akt(P＜0.01);BBTD inter-vention decreased their relative expression.Conclu-sions Gastrodin and other active ingredients in BBTD have therapeutic effects on MA addiction,and the mechanism may be related to regulation of PI3K-Akt pathway relevant targets.

Aim To construct CX3CR1GFP transgenic mice based on the Cre/Loxp system,and to analyze the expression efficiency of CX3CR1GFP.Methods Targeted vectors were designed using restriction enzyme-based cloning technology to create a linearized targeted vector for transfecting embryonic stem cells(ES).The ES cells with a deletion of the neomycin resistance gene(neo)were then cloned into blastocysts to generate chimeric CX3CR1+/GFPmice.These mice were subsequently bred with wild-type mice(WT),and repeated backcrossing was performed to obtain CX3CR1GFP/GFP mice.DNA and mRNA from WT and CX3CR1GFP mice were extracted and genotyped using agarose gel electrophoresis.The expression level of CX3CR1 in various tis-sues of the mice was detected by RT-qPCR.Western blot analy-sis was used to analyze the expression of GFP protein in periph-eral blood mononuclear cells(PBMC)and various tissues.The labeling efficiency of immune cells in bone marrow was detected by flow cytometry.The expression of GFP in different mouse tis-sues was observed by immunofluorescence.Results The results of agarose gel electrophoresis showed that the transgenic mouse genotype was CX3CR1GFP/GFP homozygote.RT-qPCR and West-ern blot showed that EGFP were targeted to replace CX3CR1 gene,so CX3CR1 expression was very low in CX3CR1GFP mice,while GFP expression was significantly upregulated.Flow cytom-etry and immunofluorescence showed that GFP effectively marked CX3CR1GFP mice,expressed in various tissues and cells with different expression levels.Conclusion This study con-structs and identifies the CX3CR1GFP genetic reporter mice,and GFP is stably expressed in mice,which provides a foundation for further research into the potential mechanisms of CX3CR1 in im-mune regulation.

Objective To explore the efficacy of high tibial osteotomy(HTO)combined with medial meniscus centraliza-tion in knee osteoarthritis.Methods A total of 26 patients who underwent surgery from October 2018 to October 2020 were re-viewed.Among them,14 patients underwent high tibial osteotomy combined with arthroscopic meniscus centralization surgery were centralized group,including 8 males and 6 females,with an average age of(50.2±1.4)years old and follow-up time of(16.8±4.0)months.Twelve patients with high tibial osteotomy were in the control group,including 6 males and 6 females,with an average age of(50.9±1.8)years and follow-up time of(19.0±4.8)months.Operation time,the knee Lysholm score,knee 2000 IKDC score,MRI,femoral tibial angle(FTA),hip knee ankle angle(HKA),and intraoperative and postoperative compli-cations were recorded.Results All the incisions healed without any complication.The operation time in the centralized group was longer than that in the control group[(65.0±2.1)min vs(52.0±2.1)min,P＜0.05].The medial meniscus extrusion reduction value in the centralized group was significantly reduced compared with the control group[(2.8±1.4)mm vs(1.1±2.2)mm,P＜0.05].The FTA,HKA,knee Lyshlom score,and 2000 IKDC score between two groups were no significantly(P＞0.05).Postop-erative knee Lyshlom score and knee 2000 IKDC score improved in both groups(P＜0.05).Conclusion HTO combined with centralization of medial meniscus can improve the reduction of medial meniscus and improve knee function.The medium and long-term curative effect still needs long-term follow-up of more cases.

Objective To investigate the effect of erector spinae plane block on postoperative delirium and cognitive function in elderly patients with lung cancer undergoing thoracoscopic radical surgery.Methods A total of 90 elderly patients with lung cancer underwent thoracoscopic radical surgery were selected and randomly divided into the control group and the observation group,with 45 cases in each group.The patients in the control group were given general anesthesia,while the patients in the observation group were given erector spinae plane block before general anesthesia.The vital signs at different time points,opioid dosage,number of analgesic pump compressions,incision pain visual analogue scale(VAS)score,cognitive function and postoperative delirium of patients between the two groups were compared.Results At the end of anesthesia,the mean arterial pressure(MAP)and heart rate of patients in the observation group were significantly lower than those in the control group(P<0.05).The dosage of remifentanil during operation,sufentanil during perioperative period and number of analgesia pumps compressions of patients in the observation group were significantly less than those in the control group(P<0.05).The incision pain VAS scores 6 hours,12 hours,24 hours and 48 hours after surgery of patients in the observation group were significantly lower than those in the control group(P<0.05).The scores of cognitive function 6 hours and 24 hours after surgery of patients in the observation group were significantly higher than those in the control group(P<0.05);and the incidence of delirium 6 hours and 24 hours after surgery in the control group was significantly higher than those in the observation group(P<0.05).Conclusion Erector spinae plane block can significantly relieve the perioperative pain of elderly patients with lung cancer undergoing thoracoscopic radical surgery,reduce the dosage of opioids and the incidence of postoperative delirium,improve the postoperative cognitive function of patients,which provides a new idea for reducing the incidence of postoperative mental diseases.

Objective To explore the effects of different CO2 pneumoperitoneum pressures during operation on delirium and cognitive function of elderly patients undergoing laparoscopic radical resection of rectal cancer.Methods A total of 92 elderly patients who underwent laparoscopic radical resection of rectal cancer were selected as the research subjects,and the patients were randomly divided into H group and L group,with 46 cases in each group.Patients in H group used CO2 pneumoperitoneum pressure of 15 mmHg during surgery,while patients in L group used CO2 pneumoperitoneum pressure of 11 mmHg during surgery.The cognitive function scores,postoperative delirium,blood gas analysis results,vital signs and adverse reactions during anesthesia awakening period of patients in the two groups were compared.Results The cognitive function scores 6 hours and 24 hours after surgery of patients in L group were significantly higher than those in H group(P<0.05).The incidences of delirium 6 hours and 24 hours after surgery in L group were significantly lower than those in H group(P<0.05).There was no statistically significant difference in mean arterial pressure(MAP),heart rate or pulse oxygen saturation(SpO2)before and after pneumoperitoneum of patients between the two groups(P>0.05).There were statistically significant differences in pH and partial pressure of carbon dioxide(PaCO2)at the end of pneumoperitoneum of patients between the two groups(P<0.05).The incidences of delayed awakening and agitation during the awakening period of patients in H group were significantly higher than those in L group(P<0.05).Conclusion For elderly patients undergoing laparoscopic radical resection of rectal cancer,CO2 pneumoperitoneum of 11 mmHg pressure has a smaller effect on postoperative cognitive function and a lower incidence of postoperative delirium and adverse reactions during the awakening period,which may be related to the level of PaCO2 in the blood of patients,and should be paid attention to.

Intramedullary needle(IMN)has the advantages of high healing rate and low incidence of complications in treatment of tibial fracture,and has become one of the most commonly used fixation methods for the treatment of tibial fracture.However,due to the patient's own factors,fracture location and fracture type,infection and surgical treatment,bone nonunion after IMN still occurs in clinic.Bone nonunion leads to the increase of medical cost and prolonged the hospitalization time of patients,which causes great pain to patients,and also brings great challenges to the treatment of orthopedic surgeons.Therefore,this paper reviews the influencing factors of bone nonunion after IMN for tibial fracture,in order to provide reference for clinical treatment.

Objective Personalized calculation of contrast agent dose based on body surface area(BSA)was conducted to explore the feasibility of obtaining virtual single energy or reconstruction fusion through dual-energy CT without affecting the enhancement effect of portal vein trunk under the condition of reducing the contrast agent dose.Methods A total of 60 patients who received enhanced upper abdominal CT examination in the First Affiliated Hospital of Army Medical University were selected and divided into the normal dose group and the reduced dose group.The normal dose group used the BSA estimated value as the contrast agent dose,and the reduced dose group used the BSA estimated value reduced by 20%as the contrast agent dose.Both groups of patients were treated with dual-energy CT scanning in portal vein stage,and the scanning parameters were the same.After scanning,Syngo dual-energy post-processing software of Siemens multi-mode image workstation was used to reconstruct and fuse the 5 mm layer thickness image of the portal vein stage in the reduced dose group by two methods:"optimum contrast(OC)"and"monoenergetic(Mono)".The CT value and SD value of the portal vein trunk and the normal liver parenchyma of images in each group were measured.The contrast to noise ratio(CNR)of theportal vein and the liver parenchyma and portal vein signal to ratio(SNR)were calculated.Results Compared with the normal dose group,there was no statistically significant difference in the subjective score in the reduced dose OC group(P>0.05),but the CNR and SNR of the portal vein trunk in the images were significantly improved(P<0.05).The portal vein CT value and the difference between portal vein and liver parenchyma in the reduced dose Mono group were significantly lower than those in the normal dose group,and the subjective score was the lowest,with statistical differences(P<0.05).Conclusion In the case of reducing the contrast agent dose by 20%,the dual-energy CT reconstruction fusion method can not only reduce the damage of contrast agent to patients,but also significantly improve the lesion display,and improve the consistency of liver enhancement image quality.

Objective To investigate the factors influencing prognosis in patients with acute myocardial infarction complicated with cardiogenic shock undergoing primary percutaneous coronary intervention(PPCI).Methods Patients with acute myocardial infarction complicated with cardiogenic shock who underwent PPCI at our hospital between January 2015 and December 2019 were enrolled.Clinical baseline characteristics,coronary angiography and PCI-related parameters,and mechanical support information were collected.The patients were followed up for one year and divided into survival and death groups based on their survival status within one year.Differences in various factors between the two groups were compared.Results A total of 40 patients were enrolled,including 26 in the survival group and 14 in the death group.There were no differences in baseline data,diagnosis,risk factors,and comorbidities between the two groups.The survival group had a lower heart rate and higher blood pressure trend at admission compared to the death group.Myocardial enzymes were significantly lower in the survival group compared to the death group(median CK peak:496.00(198.25,2 830.00)U/L vs.3 040.00(405.75,5 626.53)U/L,P=0.003;median CK-MB peak:52.65(31.75,219.50)U/L vs.306.00(27.25,489.63)U/L,P=0.006).When comparing coronary angiography and PCI-related indicators between the two groups,the survival group had a higher rate of complete revascularization compared to the control group(53.85％vs.21.43％,P=0.048).The survival group had a higher proportion of extracorporeal membrane oxygenation(ECMO)combined with intra-aortic balloon pump(IABP)support compared to the control group[38.46％vs.7.14％,P=0.034].Conclusions Survival in patients with acute myocardial infarction complicated with cardiogenic shock undergoing PPCI is associated with lower level of myocardial enzymes,ECMO combined with IABP support and complete revascularization.

Objective To compare the efficacy of renal proximal renal artery denervation(pRDN)and full-length renal artery denervation(fRDN)for treatment of hypertension.Methods Fifty-six hypertensive patients were enrolled and randomly assigned to full-length renal artery denervation group(n=25)and proximal renal artery denervation group(n=31).After the procedure,24-hour ambulatory blood pressure monitoring(24 h-ABPM)at 6 months and office blood pressure at 12 months was recorded for statistical analysis.Results The blood pressure at follow-up reduced significantly in both groups,while there was no significant difference between groups.The baseline office blood pressure in fRDN group and pRDN group was(180±15)/(104±10)mmHg and(180±12)/(103±8)mmHg,respectively,which decreased to(142±9)/(82±7)mmHg and(143±10)/(83±6)mmHg at 12 months postoperatively(P＜0.001 within groups and P＞0.05 between groups).The baseline 24 h-ABPM in the two groups was(162±13)/(95±8)mmHg and(160±12)/(94±8)mmHg,respectively,which decreased to(142±11)/(83±7)mmHg and(141±8)/(81±7)mmHg at 6 months postoperatively(P＜0.001 within groups and P＞0.05 between groups).However,there was no significant difference in the reduction of office blood pressure and ambulatory blood pressure between the two groups.No treatment-related adverse events were observed.Conclusions pRDN has similar antihypertensive effect to fRDN.

The medicinal value of vanilla planifolia is of great interest.We analyzed the common princi-pal components of VOCs in different parts of vanilla planifolia,and the human serum albumin (HSA),β-lactoglobulin (β-La) andα-lactalbumin (α-La) were used as template proteins to establish a chain a-nalysis approach with the 'solid phase microextraction gas chromatography-mass spectrometry-multispec-troscopy-physical modelling-pharmacokinetics' (S-M-P-P ) .The mechanisms of the transport and phar-macodynamics for the common principal components of vanilla planifolia were analyzed.The results showed that the common primary VOCs in different parts of vanilla planifolia was vanillin (Van),which attenuated the endogenous fluorescence of HSA/β-La/α-La by static bursting,and formed hydrogen bonds and Van der Waals forces with HSA,and noncovalent complexes with β-La/α-La through hydro-phobic forces.Their interaction facilitates the transport of Van in vivo to intestinal and hepatic tissues and its metabolism by CYP1A2 and CYP2C9 enzymes to exert its pharmacological effects.This study provides a comprehensive and in-depth investigation of the transport mechanisms and pharmacological effects of VOCs from vanilla planifolia,which provides an important reference for understanding the medicinal po-tential of plant derived VOCs.