Objective To compare the clinical outcomes of subxiphoid robot-assisted thoracoscopic surgery (SRATS) and intercostal robot-assisted thoracoscopic surgery (IRATS) in the treatment of anterior mediastinal tumors. Methods A retrospective analysis was conducted on patients with anterior mediastinal tumors who underwent robot-assisted surgery in the Department of Thoracic Surgery, Gansu Provincial Hospital, from May 2020 to July 2022. According to the surgical approach, patients were divided into an SRATS group and an IRATS group. Perioperative data were compared between the two groups. Results A total of 87 patients were included. There were 41 patients in the SRATS group [23 males, 18 females; mean age, (44.51±11.28) years] and 46 patients in the IRATS group [21 males, 25 females; mean age, (46.67±8.76) years]. Compared with the IRATS group, the SRATS group had significantly less intraoperative blood loss [(24.41±6.67) mL vs. (37.93±9.23) mL, P<0.001], shorter postoperative drainage duration [(1.73±0.59) days vs. (2.54±0.50) days, P<0.001], lower postoperative drainage volume [(94.46±34.08) mLvs. (116.72±24.90) mL, P=0.001], lower visual analogue scale (VAS) pain scores on postoperative day 1 [(3.66±0.76) points vs. (4.15±0.84) points, P=0.005] and day 3 [(2.41±0.59) points vs. (2.89±0.82) points, P=0.003], shorter postoperative hospital stay [(4.12±0.81) days vs. (4.98±1.02) days, P<0.001], and lower hospitalization costs [(4.51±0.65) ten thousand yuan vs. (4.86±0.68) ten thousand yuan, P=0.020]. There were no statistical differences between the two groups in operative time or incidence of postoperative complications (P>0.05). Conclusion Both SRATS and IRATS are safe and effective for the treatment of anterior mediastinal tumors. However, SRATS is less invasive and more conducive to enhanced postoperative recovery.

Objective To explore the potential causal relationship between childhood obesity and the risk of inflammatory bowel disease(IBD)based on Mendel randomization(MR).Methods The genome-wide association study(GWAS)data for childhood obesity included 5 530 cases and 8 318 controls.The GWAS data for IBD included 5 673 cases and 213 119 controls.The GWAS data for ulcerative colitis included 4 320 cases and 210 300 controls.The GWAS data of Crohn's disease included 2 056 cases and 210 300 controls.The risk association between obesity and the occurrence of IBD was analyzed using the inverse variance weighted meth-od(IVW),general model,weighted model,weighted median,and MR-Egger.Results Fourteen independent single nucleotide polymorphisms(SNP)significantly associated with childhood obesity were screened out as instrumental variables.IVW analysis results showed that no potential causal association was found between childhood obesity and IBD(OR=1.048,95%CI:0.976-1.125),ulcerative colitis(OR=1.026,95%CI:0.946-1.113),and Crohn's disease(OR=1.123,95%CI:0.993-1.269,P>0.05).Conclusion There was no causal relationship between childhood obesity and the risk of IBD.

PURPOSE: The rate of complications among patients undergoing surgery has increased due to infection with SARS-CoV-2 and other variants of concern. However, Omicron has shown decreased pathogenicity, raising questions about the risk of postoperative complications among patients who are infected with this variant. This study aimed to investigate complications and related factors among patients with recent Omicron infection prior to undergoing orthopedic surgery. METHODS: A historical control study was conducted. Data were collected from all patients who underwent surgery during 2 distinct periods: (1) between Dec 12, 2022 and Jan 31, 2023 (COVID-19 positive group), (2) between Dec 12, 2021 and Jan 31, 2022 (COVID-19 negative control group). The patients were at least 18 years old. Patients who received conservative treatment after admission or had high-risk diseases or special circumstances (use of anticoagulants before surgery) were excluded from the study. The study outcomes were the total complication rate and related factors. Binary logistic regression analysis was used to identify related factors, and odds ratio (OR) and 95% confidence interval (CI) were calculated to assess the impact of COVID-19 infection on complications. RESULTS: In the analysis, a total of 847 patients who underwent surgery were included, with 275 of these patients testing positive for COVID-19 and 572 testing negative. The COVID-19-positive group had a significantly higher rate of total complications (11.27%) than the control group (4.90%, p < 0.001). After adjusting for relevant factors, the OR was 3.08 (95% CI: 1.45-6.53). Patients who were diagnosed with COVID-19 at 3-4 weeks (OR = 0.20 (95% CI: 0.06-0.59), p = 0.005), 5-6 weeks (OR = 0.16 (95% CI: 0.04-0.59), p = 0.010), or ≥7 weeks (OR = 0.26 (95% CI: 0.06-1.02), p = 0.069) prior to surgery had a lower risk of complications than those who were diagnosed at 0-2 weeks prior to surgery. Seven factors (age, indications for surgery, time of operation, time of COVID-19 diagnosis prior to surgery, C-reactive protein levels, alanine transaminase levels, and aspartate aminotransferase levels) were found to be associated with complications; thus, these factors were used to create a nomogram. CONCLUSION Omicron continues to be a significant factor in the incidence of postoperative complications among patients undergoing orthopedic surgery. By identifying the factors associated with these complications, we can determine the optimal surgical timing, provide more accurate prognostic information, and offer appropriate consultation for orthopedic surgery patients who have been infected with Omicron.
Humans ; COVID-19/complications* ; Male ; Female ; Middle Aged ; Postoperative Complications/epidemiology* ; SARS-CoV-2 ; Orthopedic Procedures/adverse effects* ; Aged ; Nomograms ; Adult ; Retrospective Studies ; Risk Factors

Objective To explore the effect of endoscopic surgery via trans-axilloareolar sternocleidomastoid intermuscular approach for unilateral thyroid cancer.Methods A total of 116 patients with unilateral thyroid cancer admitted to our hospital from January 2020 to March 2023 were selected,and all of them underwent unilateral thyroidectomy+isthmus resection+central lymph node dissection under endoscopy.The patients were divided into the observation group and the control group according to random number table method,with 58 cases in each group.Patients in the observation group received the trans-axilloareolar sternocleidomastoid intermuscular approach,and patients in the control group received subclavian approach.The surgical-related indicators,stress indicators[adrenocorticotropic hormone(ACTH),norepinephrine(NE),cortisol(Cor)]before and after surgery,parathyroid hormone(PTH),blood calcium level,postoperative incision aesthetics satisfaction,and occurrence of complications were compared between the two groups.Results There was no statistically significant difference in the operation time,intraoperative blood loss,or postoperative drainage volume of patients between the two groups(P>0.05).The dissection number of lymph nodes in the central region of patients in the observation group was greater than that in the control group(P<0.05).In the two groups,the levels of NE,Cor,and ACTH 1 day and 3 days after surgery were higher than those before surgery(P<0.05),and the levels of NE,Cor and ACTH 1 day after surgery were higher than those 3 days after surgery(P<0.05);the levels of NE,Cor and ACTH 1 day and 3 days after surgery of patients in the observation group were lower than those in the control group(P<0.05).In the two groups,the levels of PTH and serum calcium 1 day and 3 days after surgery were lower than those before surgery(P<0.05),and the levels of PTH and serum calcium 3 days after surgery were lower than those 1 day after surgery(P<0.05),while there were no significant differences in the levels of PTH or serum calcium 1 day and 3 days after surgery between the two groups(P>0.05).The satisfaction of postoperative incision aesthetics in the observation group(100%)was higher than that in the control group(72.41%),with statistically significant difference(P<0.05).No statistically significant difference was found in the incidence of complications between the two groups(P>0.05).Conclusion Endoscopic surgery via trans-axilloareolar sternocleidomastoid intermuscular approach is safe and feasible for unilateral thyroid cancer,which has a mild stress response and inconspicuous incisions,with high satisfaction of incision aesthetics for patients.

Objective:To explore the clinical efficacy, safety and possible neuroimaging mechanism of deep transcranial magnetic stimulation (dTMS) and repetitive transcranial magnetic stimulation (rTMS) in the treatment of refractory migraine.Methods:Thirty patients with refractory migraine were selected from the Department of Neurology, Affiliated Hospital of North Sichuan Medical College from October 2022 to August 2023. The patients were randomly divided into dTMS group ( n=10), rTMS group ( n=10) and sham stimulation group ( n=10). The dTMS group was treated with H7 coil and the rTMS group with "8" coil, and the sham stimulation group was treated with sham stimulation rTMS with the frequency of 10 Hz. The stimulation site was the contralateral primary motor cortex (M1) of headache, which was treated for 2 weeks (3 600 pulses per time, 5 times per week, 10 times in total). Visual Analogue Scale (VAS) and Headache Impact Test-6 (HIT-6) evaluations were performed before treatment, on the first day after treatment, and 1, 3 and 6 months after treatment. The resting-state functional magnetic resonance images of the 3 groups of patients before and after treatment were collected and analyzed by MATLAB2018b, SPM12 and RESTPLUS softwares, and the brain regions with different regional homogeneity (ReHo) before and after treatment were obtained. The general clinical data and scale scoring data were analyzed and processed by SPSS 26.0 version software. Results:There were significant differences in VAS scores among the dTMS group (before treatment 6.70±0.68, the first day after treatment 5.60±0.70, 1 month after treatment 5.00±0.82, 3 months after treatment 3.50±0.85, 6 months after treatment 3.90±1.45), the rTMS group (before treatment 6.90±0.74, the first day after treatment 5.90±0.74, 1 month after treatment 5.30±0.82, 3 months after treatment 5.30±0.82, 6 months after treatment 6.80±0.63) and the sham stimulation group (before treatment 6.60±0.97, the first day after treatment 6.70±0.95, 1 month after treatment 6.90±1.10, 3 months after treatment 6.70±0.68, 6 months after treatment 7.10±0.88; F=16.054, P<0.001), VAS scores among different time points ( F=34.292, P<0.001), and the interaction between groups and time ( F=24.136, P<0.001). Compared with those before treatment, VAS scores in the dTMS group and the rTMS group decreased on the first day after treatment, 1 month and 3 months after treatment (all P<0.05); VAS scores decreased in the dTMS group 6 months after treatment ( P<0.05). Compared with the sham stimulation group, the VAS scores of the dTMS group were lower at the same time points after treatment (all P<0.05), and the VAS scores of the rTMS group were lower on the first day after treatment, 1 month and 3 months after treatment (all P<0.05). Compared with the rTMS group, VAS scores were lower at 3 and 6 months after dTMS treatment (both P<0.05). There were significant differences in HIT-6 scores among groups ( F=13.173, P<0.001), HIT-6 scores among different time points ( F=60.788, P<0.001), and interaction between groups and time ( F=35.576, P<0.001). Compared with those before treatment, the HIT-6 scores in the dTMS group decreased on the first day after treatment ( P<0.05); the HIT-6 scores in the dTMS group and the rTMS group decreased 1 month and 3 months after treatment (both P<0.05); the HIT-6 scores decreased in the dTMS group 6 months after treatment ( P<0.05). Compared with the sham stimulation group, the HIT-6 scores were lower in the dTMS group at the same time points after treatment (all P<0.05), and the HIT-6 scores were lower in the rTMS group at 1 and 3 months after treatment (both P<0.05). Compared with the rTMS group, HIT-6 scores were lower at 3 and 6 months after dTMS treatment (both P<0.05). Analysis of ReHo results: compared with those before treatment, the ReHo values of the right cerebellar angle area 1 increased in the dTMS group and the sham stimulation group, decreased in the rTMS group. The ReHo values of the right middle occipital gyrus, left dorsolateral superior frontal gyrus and right cerebellar area 8 increased in the dTMS group, but decreased in the rTMS group and the sham stimulation group. The ReHo values of the left precentral gyrus and left superior temporal gyrus decreased in the dTMS group, while those in the rTMS group and the sham stimulation group increased. There were no obvious adverse reactions in the 3 groups during the treatment and follow-up period. Conclusions:dTMS and rTMS may help to improve the headache degree and quality of life of patients with refractory migraine, and they are safe, which may be related to the changes of brain network in the right cerebellar angle area 1, right middle occipital gyrus, left dorsolateral superior frontal gyrus, left precentral gyrus, left superior temporal gyrus and right cerebellar area 8.

Objective:To explore the effect and mechanism of Andrias davidianus skin mucopolysaccharides (ASMP) on full-thickness skin defect wound healing in diabetic mice. Methods:This study was an experimental study. The ASMP with polysaccharide content of (70.0±0.3)% was prepared; the proliferation activity of human umbilical vein endothelial cells (HUVECs) was detected by cell counting kit-8, showing that the optimal concentration of ASMP was 0.05 mg/mL. The HUVECs were taken and divided into blank control group, vascular endothelial growth factor (VEGF) group, and ASMP group according to the random number table method (the same grouping method below), which were cultured with conventional medium and the media containing 50 ng/mL VEGF and 0.05 mg/mL ASMP, respectively, and then cultured under hypoxic (with volume fraction of oxygen being 5%) and normal-oxygen conditions for 12 hours, and the length of tube formation was observed. Human monocytic leukemia cells were induced with phorbol ester to differentiate into M0 macrophages. These cells were then divided into blank control group, lipopolysaccharide (LPS) group, and ASMP group, which were cultured respectively using conventional medium, LPS-containing medium followed by conventional medium, and LPS-containing medium followed by 0.05 mg/mL ASMP-containing medium. After 48 hours of culture, the expressions of CD86 and CD206 proteins (expressed as relative fluorescence intensity, the same below) were measured by immunofluorescence, and the mRNA expression levels of arginase-1 (Arg1) and CD206 were detected by real-time fluorescence quantitative reverse transcription polymerase chain reaction. Eighteen male C57 mice aged 8-10 weeks were used, and diabetic model was successfully established using streptozotocin combined with a high-fat and high-sugar diet. Full-thickness skin defect wounds were created on the backs of the mice, and the mice were divided into blank control group, alginate dressing group, and ASMP group (with 6 mice in each group), which were treated with physiological saline, alginate dressing, and ASMP, respectively. Wound healing was observed on post injury day (PID) 3, 7, 10, and 14, and the wound healing rates of mice were calculated. On PID 7, the expressions of CD31 and CD206 proteins in the wound tissue of mice were observed by immunofluorescence. On PID 14, the thickness of granulation tissue in wounds of mice was observed by hematoxylin-eosin staining. The sample size for all experiments was 3.Results:After 12 hours of culture in normal-oxygen condition, compared with that in blank control group, the tube formation length of HUVECs in VEGF and ASMP groups was significantly increased (with q values of 10.08 and 16.91, respectively, P<0.05). After 12 hours of culture in hypoxic condition, compared with that in blank control group, the tube formation length of HUVECs in VEGF and ASMP groups was significantly increased (with q values of 11.61 and 16.91, respectively, P<0.05); compared with that in VEGF group, the tube formation length of HUVECs in ASMP group was significantly increased ( q=5.30, P<0.05). After 48 hours of culture, the relative fluorescence intensity of CD206 protein in M0 macrophages in ASMP group was 31.90±1.76, significantly higher than 1.00±0.25 in blank control group and 2.21±0.42 in LPS group (with q values of 50.75 and 48.75, respectively, both P values <0.05); the relative fluorescence intensity of CD86 protein was 5.82±0.63, significantly lower than 53.73±4.61 in LPS group ( q=30.90, P<0.05). After 48 hours of culture, the mRNA expressions of Arg1 and CD206 in M0 macrophages in ASMP group were significantly higher than those in blank control group (with q values of 35.02 and 13.09, respectively, P<0.05) and LPS group (with q values of 32.24 and 11.24, respectively, P<0.05). On PID 3, there was no statistically significant difference in intercomparison in the wound healing rate of mice among the blank control, alginate dressing, and ASMP groups ( P>0.05). Compared with those in blank control group, the wound healing rates of mice in alginate dressing group on PID 10 and 14 were significantly increased (with q values of 11.76 and 12.50, respectively, P<0.05), and the wound healing rates of mice in ASMP group on PID 7, 10, and 14 were significantly increased (with q values of 5.84, 15.90, and 14.96, respectively, P<0.05); compared with those in alginate dressing group, the wound healing rates of mice in ASMP group on PID 7 and 10 were significantly increased (with q values of 4.77 and 4.14, respectively, P<0.05). On PID 7, the relative fluorescence intensity of CD31 protein in wound tissue of mice in alginate dressing and ASMP groups was significantly stronger than that in blank control group (with q values of 7.63 and 16.85, respectively, P<0.05); the relative fluorescence intensity of CD31 protein in wound tissue of mice in ASMP group was significantly stronger than that in alginate dressing group ( q=9.22, P<0.05). On PID 7, the relative fluorescence intensity of CD206 protein in wound tissue of mice in alginate dressing and ASMP groups was significantly stronger than that in blank control group (with q values of 8.76 and 29.36, respectively, P<0.05), and the relative fluorescence intensity of CD206 protein in wound tissue of mice in ASMP group was significantly stronger than that in alginate dressing group ( q=20.61, P<0.05). On PID 14, the wound granulation tissue of mice in ASMP group was thicker compared with that in blank control group and alginate dressing group. Conclusions:ASMP can significantly enhance the ability of new blood vessel formation and optimize the immune microenvironment by promoting HUVEC tube formation as well as inducing macrophages to polarize toward the M2 type, thereby accelerating full-thickness skin defect wound healing in diabetic mice.

Objective:To explore the clinical efficacy, safety and possible neuroimaging mechanism of deep transcranial magnetic stimulation (dTMS) and repetitive transcranial magnetic stimulation (rTMS) in the treatment of refractory migraine.Methods:Thirty patients with refractory migraine were selected from the Department of Neurology, Affiliated Hospital of North Sichuan Medical College from October 2022 to August 2023. The patients were randomly divided into dTMS group ( n=10), rTMS group ( n=10) and sham stimulation group ( n=10). The dTMS group was treated with H7 coil and the rTMS group with "8" coil, and the sham stimulation group was treated with sham stimulation rTMS with the frequency of 10 Hz. The stimulation site was the contralateral primary motor cortex (M1) of headache, which was treated for 2 weeks (3 600 pulses per time, 5 times per week, 10 times in total). Visual Analogue Scale (VAS) and Headache Impact Test-6 (HIT-6) evaluations were performed before treatment, on the first day after treatment, and 1, 3 and 6 months after treatment. The resting-state functional magnetic resonance images of the 3 groups of patients before and after treatment were collected and analyzed by MATLAB2018b, SPM12 and RESTPLUS softwares, and the brain regions with different regional homogeneity (ReHo) before and after treatment were obtained. The general clinical data and scale scoring data were analyzed and processed by SPSS 26.0 version software. Results:There were significant differences in VAS scores among the dTMS group (before treatment 6.70±0.68, the first day after treatment 5.60±0.70, 1 month after treatment 5.00±0.82, 3 months after treatment 3.50±0.85, 6 months after treatment 3.90±1.45), the rTMS group (before treatment 6.90±0.74, the first day after treatment 5.90±0.74, 1 month after treatment 5.30±0.82, 3 months after treatment 5.30±0.82, 6 months after treatment 6.80±0.63) and the sham stimulation group (before treatment 6.60±0.97, the first day after treatment 6.70±0.95, 1 month after treatment 6.90±1.10, 3 months after treatment 6.70±0.68, 6 months after treatment 7.10±0.88; F=16.054, P<0.001), VAS scores among different time points ( F=34.292, P<0.001), and the interaction between groups and time ( F=24.136, P<0.001). Compared with those before treatment, VAS scores in the dTMS group and the rTMS group decreased on the first day after treatment, 1 month and 3 months after treatment (all P<0.05); VAS scores decreased in the dTMS group 6 months after treatment ( P<0.05). Compared with the sham stimulation group, the VAS scores of the dTMS group were lower at the same time points after treatment (all P<0.05), and the VAS scores of the rTMS group were lower on the first day after treatment, 1 month and 3 months after treatment (all P<0.05). Compared with the rTMS group, VAS scores were lower at 3 and 6 months after dTMS treatment (both P<0.05). There were significant differences in HIT-6 scores among groups ( F=13.173, P<0.001), HIT-6 scores among different time points ( F=60.788, P<0.001), and interaction between groups and time ( F=35.576, P<0.001). Compared with those before treatment, the HIT-6 scores in the dTMS group decreased on the first day after treatment ( P<0.05); the HIT-6 scores in the dTMS group and the rTMS group decreased 1 month and 3 months after treatment (both P<0.05); the HIT-6 scores decreased in the dTMS group 6 months after treatment ( P<0.05). Compared with the sham stimulation group, the HIT-6 scores were lower in the dTMS group at the same time points after treatment (all P<0.05), and the HIT-6 scores were lower in the rTMS group at 1 and 3 months after treatment (both P<0.05). Compared with the rTMS group, HIT-6 scores were lower at 3 and 6 months after dTMS treatment (both P<0.05). Analysis of ReHo results: compared with those before treatment, the ReHo values of the right cerebellar angle area 1 increased in the dTMS group and the sham stimulation group, decreased in the rTMS group. The ReHo values of the right middle occipital gyrus, left dorsolateral superior frontal gyrus and right cerebellar area 8 increased in the dTMS group, but decreased in the rTMS group and the sham stimulation group. The ReHo values of the left precentral gyrus and left superior temporal gyrus decreased in the dTMS group, while those in the rTMS group and the sham stimulation group increased. There were no obvious adverse reactions in the 3 groups during the treatment and follow-up period. Conclusions:dTMS and rTMS may help to improve the headache degree and quality of life of patients with refractory migraine, and they are safe, which may be related to the changes of brain network in the right cerebellar angle area 1, right middle occipital gyrus, left dorsolateral superior frontal gyrus, left precentral gyrus, left superior temporal gyrus and right cerebellar area 8.

Objective To explore the effect of endoscopic surgery via trans-axilloareolar sternocleidomastoid intermuscular approach for unilateral thyroid cancer.Methods A total of 116 patients with unilateral thyroid cancer admitted to our hospital from January 2020 to March 2023 were selected,and all of them underwent unilateral thyroidectomy+isthmus resection+central lymph node dissection under endoscopy.The patients were divided into the observation group and the control group according to random number table method,with 58 cases in each group.Patients in the observation group received the trans-axilloareolar sternocleidomastoid intermuscular approach,and patients in the control group received subclavian approach.The surgical-related indicators,stress indicators[adrenocorticotropic hormone(ACTH),norepinephrine(NE),cortisol(Cor)]before and after surgery,parathyroid hormone(PTH),blood calcium level,postoperative incision aesthetics satisfaction,and occurrence of complications were compared between the two groups.Results There was no statistically significant difference in the operation time,intraoperative blood loss,or postoperative drainage volume of patients between the two groups(P>0.05).The dissection number of lymph nodes in the central region of patients in the observation group was greater than that in the control group(P<0.05).In the two groups,the levels of NE,Cor,and ACTH 1 day and 3 days after surgery were higher than those before surgery(P<0.05),and the levels of NE,Cor and ACTH 1 day after surgery were higher than those 3 days after surgery(P<0.05);the levels of NE,Cor and ACTH 1 day and 3 days after surgery of patients in the observation group were lower than those in the control group(P<0.05).In the two groups,the levels of PTH and serum calcium 1 day and 3 days after surgery were lower than those before surgery(P<0.05),and the levels of PTH and serum calcium 3 days after surgery were lower than those 1 day after surgery(P<0.05),while there were no significant differences in the levels of PTH or serum calcium 1 day and 3 days after surgery between the two groups(P>0.05).The satisfaction of postoperative incision aesthetics in the observation group(100%)was higher than that in the control group(72.41%),with statistically significant difference(P<0.05).No statistically significant difference was found in the incidence of complications between the two groups(P>0.05).Conclusion Endoscopic surgery via trans-axilloareolar sternocleidomastoid intermuscular approach is safe and feasible for unilateral thyroid cancer,which has a mild stress response and inconspicuous incisions,with high satisfaction of incision aesthetics for patients.

Objective:To explore the effect and mechanism of Andrias davidianus skin mucopolysaccharides (ASMP) on full-thickness skin defect wound healing in diabetic mice. Methods:This study was an experimental study. The ASMP with polysaccharide content of (70.0±0.3)% was prepared; the proliferation activity of human umbilical vein endothelial cells (HUVECs) was detected by cell counting kit-8, showing that the optimal concentration of ASMP was 0.05 mg/mL. The HUVECs were taken and divided into blank control group, vascular endothelial growth factor (VEGF) group, and ASMP group according to the random number table method (the same grouping method below), which were cultured with conventional medium and the media containing 50 ng/mL VEGF and 0.05 mg/mL ASMP, respectively, and then cultured under hypoxic (with volume fraction of oxygen being 5%) and normal-oxygen conditions for 12 hours, and the length of tube formation was observed. Human monocytic leukemia cells were induced with phorbol ester to differentiate into M0 macrophages. These cells were then divided into blank control group, lipopolysaccharide (LPS) group, and ASMP group, which were cultured respectively using conventional medium, LPS-containing medium followed by conventional medium, and LPS-containing medium followed by 0.05 mg/mL ASMP-containing medium. After 48 hours of culture, the expressions of CD86 and CD206 proteins (expressed as relative fluorescence intensity, the same below) were measured by immunofluorescence, and the mRNA expression levels of arginase-1 (Arg1) and CD206 were detected by real-time fluorescence quantitative reverse transcription polymerase chain reaction. Eighteen male C57 mice aged 8-10 weeks were used, and diabetic model was successfully established using streptozotocin combined with a high-fat and high-sugar diet. Full-thickness skin defect wounds were created on the backs of the mice, and the mice were divided into blank control group, alginate dressing group, and ASMP group (with 6 mice in each group), which were treated with physiological saline, alginate dressing, and ASMP, respectively. Wound healing was observed on post injury day (PID) 3, 7, 10, and 14, and the wound healing rates of mice were calculated. On PID 7, the expressions of CD31 and CD206 proteins in the wound tissue of mice were observed by immunofluorescence. On PID 14, the thickness of granulation tissue in wounds of mice was observed by hematoxylin-eosin staining. The sample size for all experiments was 3.Results:After 12 hours of culture in normal-oxygen condition, compared with that in blank control group, the tube formation length of HUVECs in VEGF and ASMP groups was significantly increased (with q values of 10.08 and 16.91, respectively, P<0.05). After 12 hours of culture in hypoxic condition, compared with that in blank control group, the tube formation length of HUVECs in VEGF and ASMP groups was significantly increased (with q values of 11.61 and 16.91, respectively, P<0.05); compared with that in VEGF group, the tube formation length of HUVECs in ASMP group was significantly increased ( q=5.30, P<0.05). After 48 hours of culture, the relative fluorescence intensity of CD206 protein in M0 macrophages in ASMP group was 31.90±1.76, significantly higher than 1.00±0.25 in blank control group and 2.21±0.42 in LPS group (with q values of 50.75 and 48.75, respectively, both P values <0.05); the relative fluorescence intensity of CD86 protein was 5.82±0.63, significantly lower than 53.73±4.61 in LPS group ( q=30.90, P<0.05). After 48 hours of culture, the mRNA expressions of Arg1 and CD206 in M0 macrophages in ASMP group were significantly higher than those in blank control group (with q values of 35.02 and 13.09, respectively, P<0.05) and LPS group (with q values of 32.24 and 11.24, respectively, P<0.05). On PID 3, there was no statistically significant difference in intercomparison in the wound healing rate of mice among the blank control, alginate dressing, and ASMP groups ( P>0.05). Compared with those in blank control group, the wound healing rates of mice in alginate dressing group on PID 10 and 14 were significantly increased (with q values of 11.76 and 12.50, respectively, P<0.05), and the wound healing rates of mice in ASMP group on PID 7, 10, and 14 were significantly increased (with q values of 5.84, 15.90, and 14.96, respectively, P<0.05); compared with those in alginate dressing group, the wound healing rates of mice in ASMP group on PID 7 and 10 were significantly increased (with q values of 4.77 and 4.14, respectively, P<0.05). On PID 7, the relative fluorescence intensity of CD31 protein in wound tissue of mice in alginate dressing and ASMP groups was significantly stronger than that in blank control group (with q values of 7.63 and 16.85, respectively, P<0.05); the relative fluorescence intensity of CD31 protein in wound tissue of mice in ASMP group was significantly stronger than that in alginate dressing group ( q=9.22, P<0.05). On PID 7, the relative fluorescence intensity of CD206 protein in wound tissue of mice in alginate dressing and ASMP groups was significantly stronger than that in blank control group (with q values of 8.76 and 29.36, respectively, P<0.05), and the relative fluorescence intensity of CD206 protein in wound tissue of mice in ASMP group was significantly stronger than that in alginate dressing group ( q=20.61, P<0.05). On PID 14, the wound granulation tissue of mice in ASMP group was thicker compared with that in blank control group and alginate dressing group. Conclusions:ASMP can significantly enhance the ability of new blood vessel formation and optimize the immune microenvironment by promoting HUVEC tube formation as well as inducing macrophages to polarize toward the M2 type, thereby accelerating full-thickness skin defect wound healing in diabetic mice.

Liver fibrosis and cirrhosis are the common outcomes of various chronic liver diseases after progression,and studies have shown that liver fibrosis and early liver cirrhosis can be reversed.Compound traditional Chinese medicine prescriptions have a marked therapeutic effect in reversing liver fibrosis and early liver cirrhosis,and their mechanism of action remains unclear.By reviewing related articles in China and globally,this article summarizes the six main phenotypic mechanisms involved in the efficacy of compound traditional Chinese medicine prescriptions,i.e.,inhibiting liver inflammation and regulating liver immune response,regulating hepatic stellate cell activation and extracellular matrix(ECM)generation,promoting ECM degradation,reversing hepatic sinusoidal capillarization,regulating hepatocyte regeneration,and regulating gut microbiota,and in addition,this article also analyzes the advances and shortcomings in current studies on each phenotype.Future studies on compound traditional Chinese medicine prescriptions should focus on experimental exploration and rescue experiments to verify the above phenotypes and further explore the upstream and downstream signaling pathways with a marked effect.This article aims to help clarify the direction and ideas of studies on the therapeutic mechanism of compound traditional Chinese medicine prescriptions,in order to provide a basis for clarifying the scientific essence of compound traditional Chinese medicine prescriptions.