Objective:To explore the possible anti-atherosclerotic mechanisms of glucose co-transporter-2 inhibitor canagliflozin.Methods:ApoE -/-mice fed on Western diet were randomly assigned into the model group ( n=10) and the canagliflozin group ( n=10). C57BL/6J mice fed on normal diet were chosen as the control group ( n=10). Mice in the canagliflozin group were gavaged with canagliflozin for 14 weeks. The presence and severity of atherosclerosis were evaluated with HE and oil red O stainings in aortic root section slices. PCR assay was performed to determine the mRNA expression levels of nitric oxide synthase. Hepatic transcriptome analysis and hepatic amino acid detection were conducted using RNA-seq and targeted LC-MS, respectively. Results:HE staining and oil red O staining of the aortic root showed that AS models were successfully established in ApoE -/-mice fed on Western diet for 14 weeks. Canagliflozin alleviated the severity of atherosclerosis in pathology. Hepatic transcriptome analysis indicated that canagliflozin impacted on amino acid metabolism, especially arginine synthesis in ApoE -/-mice. Targeted metabolomics analysis of amino acids showed that canagliflozin reduced hepatic levels of L-serine, L-aspartic acid, tyrosine, L-hydroxyproline, and L-citrulline, but raised the hepatic level of L-arginine. Compared to the model group, the canagliflozin group exhibited higher serum arginine and nitric oxide levels as well as elevated nitric oxide mRNA expression in aortic tissues ( P<0.05). Conclusion:Canagliflozin regulated the amino acid metabolism, reduced the levels of glucogenic amino acids,and promoted the synthesis of arginine in atherosclerotic mice.

Objective:To explore the effects of canagliflozin on cardiac function and its regulation of ferroptosis in rats with heart failure with preserved ejection fraction (HFpEF).Methods:Thirty-two 7-week-old Dahl salt-sensitive rats were selected and randomly divided into four groups: the control group (fed with low-salt diet), the HFpEF group (fed with high-salt diet), the canagliflozin 20 group (fed with high-salt diet and 20 mg·kg -1·d -1 canagliflozin), and the canagliflozin 30 group (fed with high-salt diet and 30 mg·kg -1·day -1 canagliflozin). Body weight and blood pressure of the rats in each group were monitored. Metabolic cage tests were conducted at the10 th week of the experiment, and echocardiography was performed at the 12 th week, after which the rats were killed. Blood and left ventricular samples were collected. HE staining, Masson staining, Prussian blue iron staining, and reactive oxygen species staining were performed to observe the cardiomyocyte size and shape, degree of interstitial fibrosis, iron staining, reactive oxygen species production under optical microscope. The ultrastructure of cardiomyocytes was observed under electron microscope. Western blotting and real-time fluorescent quantitative reverse transcription polymerase chain reaction (RT-qPCR) were used to detect the expression levels of proteins and mRNA related to ferroptosis in left ventricular myocardial tissue of rats in each group. Results:After 1 week of adaptive feeding, all rats survived. Metabolic cage results showed that compared with control group, rats in the HFpEF group, canagliflozin 20 group and canagliflozin 30 group had more food intake, water intake and urine output, and lower body weight (all P<0.05). These changes were more pronounced in canagliflozin 20 group and canagliflozin 30 group than in HFPEF group, and only the body weight at the 12 th week showed a statistically significant difference between canagliflozin 20 group and canagliflozin 30 group ( P<0.05). The blood pressure of 6 th week and 12 th week, heart weight and left ventricular corrected mass of 12 th week of rats in HFpEF group were higher than those in control group, canagliflozin 20 group and canagliflozin 30 group, while the ratio of early mitral valve peak velocity to late mitral valve peak velocity of 12 th week was lower (all P<0.05). HE and Masson staining showed that compared to control group, the myocardial fibers in the left ventricular myocardial tissue of rats in HFpEF group were disordered, with larger cell diameter ((0.032±0.004) mm vs. (0.023±0.003) mm, P<0.05), irregular shape, obvious proliferation of interstitial collagen fibers, and higher collagen volume fraction (0.168±0.028 vs. 0.118±0.013, P<0.05). Compared with HFpEF group, rats in the canagliflozin 20 group and canagliflozin 30 had more orderly arranged myocardial fibers, more regular cardiomyocyte shape, smaller cell diameter, and lower collagen volume fraction ( P<0.05). It was observed under electron microscopy that, compared to control group, most of the striated muscles in myocardial tissue of HFpEF group were broken, and the Z line and M line could not be clearly distinguished, some changes such as mitochondrial swelling, membrane thickening, cristae reduction or even disappearance occurred. In the canagliflozin 20 group and canagliflozin 30 group, the arrangement of striated muscles in the myocardial tissue of rats tended to be more regular, and the morphological changes of mitochondria were milder. Prussian blue iron staining results showed that the iron content in myocardial tissue of rats in HFpEF group was higher than that in control group, canagliflozin 20 group and canagliflozin 30 group. Reactive oxygen species staining results showed that the reactive oxygen species content in the myocardial tissue of rats in HFpEF group was higher than that of control group, canagliflozin 20 group and canagliflozin 30 group. Biochemical analysis of myocardial tissue showed that Fe 2+ and malondialdehyde content in myocardial tissue of rats in HFpEF group were higher than those in control group, canagliflozin 20 group and canagliflozin 30 group, while glutathione content was lower (all P<0.05). Western blot and RT-qPCR detection results showed that compared to control group, rats in HFpEF group had higher expression levels of transferrin receptor 1 (protein relative expression level: 1.37±0.16 vs. 0.31±0.12), acyl-CoA synthetase long-chain family member 4 (protein relative expression level: 1.31±0.15 vs. 0.63±0.09) protein and mRNA, and lower expression levels of ferritin heavy chain 1 (protein relative expression level: 0.45±0.08 vs. 1.41±0.15) protein and mRNA (all P<0.05). There was no statistically significant difference in these indicators between canagliflozin 20 group and the canagliflozin 30 group (all P>0.05). There was no significant difference in levels of glutathione peroxidase 4 protein and mRNA expression in myocardial tissue of rats in four groups( P>0.05). Conclusion:Canagliflozin improves cardiac function in HFpEF rats by regulating the ferroptosis mechanism.

ObjectiveTo investigate the possible mechanism of compound Yinqi Sanhuang Jiedu Decoction （茵芪三黄解毒汤， YSJD） against the progression of hepatic fibrosis （HF）. MethodsThirty-eight C57BL/6J mice were randomly divided into blank group， model group， silybin group and low-， medium- and high-dose YSJD groups， with eight mice in the model group and six mice each in other groups. Except for the blank group， all mice were injected intraperitoneally with 10% carbon tetrachloride （CCl₄） to establish a HF model， twice a week for 8 weeks. The drug intervention started one week after the first modeling； the low-， medium- and high-dose YSJD groups were given 8.325， 16.65 and 33.3 g/（kg·d） of YSJD suspension by gavage， respectively， while the silybin group was given 55 mg/（kg·d） of silybin suspension by gavage， and the blank group and the model group were given 0.2 ml normal saline by gavage， all for 8 weeks. The liver hardness of living mice was observed using a small animal ultrasound detector， and grey-scale ultrasound was recorded. The liver tissue was observed by Sirius scarlet staining， and the proportion of collagen fiber deposition was calculated. Liver function indicators including alanine aminotransferase （ALT） and aspartate aminotransferase （AST）， and serum laminin （LN）， hyaluronic acid （HA）， pre-collagen type III （PCIII） and collagen type IV （CIV） were also detected. The protein expression of transforming growth factor β1 （TGF-β1）， Vimentin， E-cadherin， α smooth muscle actin （α-SMA） in liver tissue were detected. ResultsCompared to the blank group， the model group showed increased gray value， collagen deposition，serum ALT， AST， HA， LN and PCIII levels， decreased expression of E-cadherin， and increased expression of N-cadherin，α-SMA，Vimentin and TGF-β1 in liver tissues （P＜0.05）. Compared to the model group， the ultrasonic gray value and the proportion of collagen fiber deposition in liver of silybin group and YSJD medium- and high-dose groups decreased， and the serum ALT， AST， LN， HA and PCⅢ levels decreased. Compared to the model group， the expression of E-cadherin in liver tissues of silybin group and all three YSJD groups increased， while the expressions of N-cadherin， Vimentin， TGF-β1 and α-SMA decreased （P＜0.05）， and among them， most improvements were seen in the medium-dose YSJD group （P＜0.05）. ConclusionThe effect of YSJD on significantly reducing the extent of HF in mice caused by CCl₄ may be related to its ability to regulate liver hardness and inhibit the occurrence of epithelial mesenchymal transition in mice.

Objective:To explore the value of contrast-enhanced ultrasound (CEUS) combined with Ovarian-Adnexal Reporting and Data System (O-RADS US) risk stratification and management system in differential diagnosis of ovarian-adnexal mass.Methods:Fifty-six patients with ovarian-adnexal mass who received transabdominal transvaginal ultrasound and CEUS in the Third People′s Hospital of Longgang District from September 2018 to January 2021 were enrolled. The images were classified by O-RADS US and diagnosed by CEUS by experienced and senior radiologist. On the basis of O-RADS US classification, the enhancement time, enhancement level and enhancement mode of CEUS were combined to upgrade or degrade the classification results of O-RADS US. The diagnostic accuracy was assessed using ROC curve analysis, the area under the ROC curve (AUC) was calculated. The reproducibility of O-RADS US was assessed by another senior radiologist.Results:The AUC of O-RADS US for diagnosing benign and malignant ovarian-adnexal masses was 0.844(0.722, 0.927), the AUC of CEUS was 0.833(0.710, 0.920), the AUC of O-RADS US combined with CEUS was 0.940(0.842, 0.986) (compared with O-RADS US, P=0.020; compared with CEUS, P=0.031). The intra-class correlation coefficient (ICC) was 0.897(0.824, 0.940) for O-RADS US. Conclusions:CEUS combined with O-RADS US classification can effectively improve the diagnostic efficiency for benign and malignant ovarian-adnexal masses.

ObjectiveTo observe the effect of aerobic exercise on core symptoms and executive function in children with attention deficit hyperactivity disorder (ADHD). MethodsFrom June, 2020 to December, 2021, 64 children with ADHD at outpatient in Dushu Lake Hospital were randomly divided into control group (n = 32) and observation group (n = 32). The control group sat down and watched the cartoon for 20 minutes, and the observation group performed cycling exercise while watching the cartoon, for twelve weeks. The core symptoms were assessed with Conners Parent Symptom Questionnaire (PSQ), while the inhibition, conversion and refresh functions were assessed with the psychological test software E-Prime 2.0 system. ResultsAfter twelve weeks of treatment, the PSQ factor scores decreased in the observation group (t > 4.775, P < 0.001), and were lower than that of the the control group (t > 3.184, P < 0.001). The response time and accuracy of inhibition, conversion, and refresh functions decreased in the observation group (t > 2.259, P < 0.05), and were lower than that of the control group (t > 2.007, P < 0.05). ConclusionAerobic exercise could reduce the core symptoms of poor attention and hyperactivity impulsivity, and improve the executive functioning in children with ADHD.

Objective:To investigate whether the bladder neck descent and the area of levator ani hiatus obtained on the maximum Valsalva were consistent at the lithotomy position and separating-legs-holding-knees position.Methods:Forty four subjects who underwent perineal pelvic floor four-dimensional ultrasound at 6-8 weeks postpartum in Third Hospital of Longgang Shenzhen from November 2019 to January 2020 were enrolled in this study. All subjects were able to effectively complete the maximum Valsalva maneuver both at the lithotomy position and the separating-legs-holding-knees position. The bladder neck descent and hiatus area of the levator Ani on the maximum Valsalva at these two positions were measured and compared.Results:The bladder neck descent at the separating-legs-holding-knees position was higher than that at the lithotomy position [(41.06±8.25)mm vs (39.96±8.10)mm; t=-2.965, P=0.005], and the hiatus area of levator Ani at the separating-legs-holding-knees position was larger than that at the lithotomy position[(27.55±4.90)cm 2 vs (26.32±4.76)cm 2; t=-3.820, P<0.001]. Conclusions:The bladder neck descent and the area of levator Ani hiatus on the maximum Valsalva at separating-legs- holding-knees position are larger than those on the maximum Valsalva at the lithotomy position.

Objective:To evaluate the clinical effect of the treatment of scar formation after severe acne type Ⅳ by acupuncture.Methods:In Henan Traditional Chinese Medicine Hospital, 60 patients with acne who met the inclusion criteria were selected and divided into observation group and control group according to the randomized controlled grouping method. The observation group(9 male and 21 female, age 18-29) was treated with fire needle and salicylic acid.The control group(10 male and 20 female, age 18-27 ) was treated with needle and salicylic acid.The patients in both groups were treated with tanshinone capsule and salicylate acne pill orally.The course of treatment was 8 weeks. The two groups of clinical efficacy, acne severity score scale (Gags) to evaluate symptom improvement, vancouver scar scale, acne scar weight score were observed and compared.Results:Eight weeks after treatment, the effect rate was 90.00% (27/30) in the observation group and 68.97% (20/29) in the control group. The scores of Vancouver scar scale were (3.66 ± 0.91) in the observation group and (5.06 ± 1.09) in the control group ( P< 0.01). The scores of acne scar weight score were (39.40 ± 16.90) in the observation group and (53.16 ± 17.19) in the control group( P< 0.01). The scores of Gags in the observation group and the control group were (10.31 ± 2.14) and (17.55 ± 2.63)( P< 0.01), respectively. Conclusions:The treatment of Ⅳ grade severe acne skin lesions by fire needle is safe, effective, reliable and easy to operate. It can safely and effectively improve the patient’s facial skin lesions, and reduce the possibility of scar formation and pigmentation, so it is worthy of clinical application.

Objective:To evaluate the clinical effect of the treatment of scar formation after severe acne type Ⅳ by acupuncture.Methods:In Henan Traditional Chinese Medicine Hospital, 60 patients with acne who met the inclusion criteria were selected and divided into observation group and control group according to the randomized controlled grouping method. The observation group(9 male and 21 female, age 18-29) was treated with fire needle and salicylic acid.The control group(10 male and 20 female, age 18-27 ) was treated with needle and salicylic acid.The patients in both groups were treated with tanshinone capsule and salicylate acne pill orally.The course of treatment was 8 weeks. The two groups of clinical efficacy, acne severity score scale (Gags) to evaluate symptom improvement, vancouver scar scale, acne scar weight score were observed and compared.Results:Eight weeks after treatment, the effect rate was 90.00% (27/30) in the observation group and 68.97% (20/29) in the control group. The scores of Vancouver scar scale were (3.66 ± 0.91) in the observation group and (5.06 ± 1.09) in the control group ( P< 0.01). The scores of acne scar weight score were (39.40 ± 16.90) in the observation group and (53.16 ± 17.19) in the control group( P< 0.01). The scores of Gags in the observation group and the control group were (10.31 ± 2.14) and (17.55 ± 2.63)( P< 0.01), respectively. Conclusions:The treatment of Ⅳ grade severe acne skin lesions by fire needle is safe, effective, reliable and easy to operate. It can safely and effectively improve the patient’s facial skin lesions, and reduce the possibility of scar formation and pigmentation, so it is worthy of clinical application.

Objective To evaluate the effect of weight-bearing alignment training (WBAT) in correcting anterior pelvic tilt in children with cerebral palsy.Methods Twenty-seven children with cerebral palsy and anterior pelvic tilt were recruited and randonly assigned to a WBAT group,a strengthening group and a standing group,each of 9.In addition to routine medication and rehabilitation training,the 3 groups received WBAT,strengthening training or standing training respectively for 20 minutes a day,5 times a week for 4 weeks.Before and immediately after the treatment,the subjects' anterior superior iliac spine-posterior superior iliac spine angles (ASIS-PSIS angles) were assessed along with their anterior-posterior angles (A-P angles) and distances in a 1-minute walk test.Results The WBAT group showed significant improvement in their average ASIS-PSIS angle (to 18.61 ± 3.13°),A-P angle (to 23.31±3.81°) and the distance in the 1-minute walk test after the treatment.The standing group had significant progress in improving their A-P angles (to 24.48±4.33°),and the strengthening group had significant improvement in the distance walked in the 1-minute walk test.The average improvements in the ASIS-PSIS angle and walk distance in the WBAT group were significantly better than in the other 2 groups.Conclusion WBAT is superior to strengthening and standing training in improving the ASIS-PSIS angle,A-P angle and walking ability of children with cerebral palsy and anterior pelvic tilt.

Objective To observe the clinical efficacy of butylphthalide soft capsules for treatment of acute cerebral infarction and its effect on the neurological function and inflammatory reaction of patients.Methods A total of 100 patients with acute cerebral infarction in the First Hospital of Zhangjiakou City and the Third Hospital Affiliated to Hebei North University from January 2016 to October 2016 were selected and divided into control group (n =50) and treatment group (n =50) according to the treatment protocols.The patients in the control group were given anti-platelet aggregation,statins,and other routine treatment;based on this,the patients in treatment group were orally administrated with butylphthalide soft capsules.The elbow venous blood of patients in the two groups was collected and the C reactive protein(CRP),interleukin-6 (IL-6) levels,the platelet aggregation rate were detected.The change of National Institute of Health stroke scale(NIHSS) score of patients after four weeks treatment was compared between the two groups.The recovery of neurological function of patients in the two groups was evaluated by modified Rankin grading after three months treatment.Results There was no statistic difference in the CRP,IL-6 levels and platelet aggregation rate before treatment between the two groups (P ＞ 0.05).The CRP,IL-6 levels and platelet aggregation rate of patients in the two groups after one week treatment were significantly lower than those before treatment (P ＜ 0.05);and the CRP,IL-6 levels and platelet aggregation rate of patients in the treatment group were significantly lower than those in the control group after one week treatment (P ＜ 0.05).The NIHSS score of patients in the treatment group was significantly lower than that in the control group after four weeks treatment (P ＜ 0.05);the Rankin score of patients in the treatment group was significantly lower than that in the control group after three months treatment (P ＜ 0.05).The total effective rate of patients in the treatment group was significantly higher than that in the control group (x2 =13.22,P ＜ 0.05).Conclusion Butylphthalide soft capsules can significantly reduce the inflammatory reaction in patients with acute cerebral infarction,improve and recover the neurologic impairment;and its curative effect is remarkable.