Objective To investigate the effects of denosumab(DEN)and alendronate(AL)on bone mineral density(BMD)around the prosthesis after total hip arthroplasty(THA).Methods A retrospective analysis was conducted on the clinical data of primary osteoporosis(POP)patients who underwent THA at the Affiliated Jinhua Hospital of Zhejiang University School of Medicine from March 2022 to March 2023,the patients were divided into the DEN group and the AL group according to the postoperative protocols.The main observation index was the bone density around the implant(Gruen zone:1st and 7th zones;time points:postoperative day 5(T1),6 months(T2),and 12 months(T3);detection method:dual-energy X-ray absorptiometry).The secondary observation index was the bone metabolism index(bone calcitonin(OC),β-collagen special sequence(β-Crosslaps),and type 1 procollagen N-terminal peptide(P1NP);time points:preoperative(T4),6 months(T2),and 12 months(T3);detection method:enzyme-linked immunosorbent assay).Results A total of 120 patients were included in the study,with 59 in the DEN group and 61 in the AL group.At baseline,there was no statistically significant difference in serum OC,β-Crosslaps and P1NP levels between the two groups(P＞0.05).Periprosthetic BMD showed a decreasing trend in both groups,and periprosthetic BMD was higher in the DEN group than in the AL group in both Gruen zone 1 and Gruen zone 7 at the T2 and T3 time points(P＜0.05).In terms of bone transformation markers,serum OC,β-Crosslaps and P1NP levels showed decreasing trends with prolonged treatment time in both groups(P＜0.05).In addition,serum OC,β-Crosslaps and P1NP levels were significantly lower in the DEN group than in the AL group at T2 and T3 time points(P＜0.05).Conclusion Compared with AL,DEN is more effective in preventing periprosthetic bone loss of the proximal femur and has a better safety profile.

Cerebral ischemia-reperfusion injury （CIRI） has a very high incidence， disability， and mortality rates， which seriously affects human life and health. In recent years， modern medicine has made some progress in the diagnosis and treatment of CIRI， but there are still problems such as difficulties in postoperative rehabilitation and adverse drug reactions， and new therapeutic drugs for CIRI are urgently needed. As an important class of active ingredients in traditional Chinese medicine， flavonoids can play antioxidant， apoptosis inhibition， anti-inflammatory， and other pharmacological effects to improve brain tissue damage， which is important for improving the quality of life of CIRI patients and slowing down the aging of the social population. Numerous studies have found that flavonoids in traditional Chinese medicine can regulate cell surface receptors Toll-like receptor 4/nuclear factor-kappaB （TLR4/NF-κB）， phosphatidylinositol 3-kinase/protein kinase B （PI3K/Akt）， adenylate-activated protein kinase/mammalian target of rapamycin protein （AMPK/mTOR）， Ras homologous gene family member A/Rho-associated coiled-coil protein kinase （RhoA/ROCK）， nuclear factor E₂-associated factor 2/Kelch-like epoxychloropropane-associated protein-1/haemoglobin oxygenase 1 （Nrf2/Keap1/ HO-1）， Notch， and other signaling pathways， so as to regulate the transcription and expression of related proteins after CIRI， alleviate brain tissue injury， and improve CIRI. This paper analyzed the relevant literature in China and abroad in recent years， reviewed the mechanism of action and related pathways of flavonoids in traditional Chinese medicine to improve CIRI， and explored the new therapeutic direction of CIRI at the metabolic level， with a view to providing a basis for the further development and application of flavonoids in traditional Chinese medicine.

ObjectiveBased on non-targeted metabolomics， to analyze the regulation of endogenous differential metabolites in serum of type 2 diabetes mellitus（T2DM） rats by Fuling Yunhua granules， and to clarify the metabolic pathways through which this granules exerted its effect on improving T2DM. MethodSeventy SD rats， half male and half female， were randomly divided into the control group， model group， and high， medium， low dose groups of Fuling Yunhua granules（20.70， 10.35， 5.18 g·kg^-1 in raw drug amount） and the positive drug group（pioglitazone hydrochloride tablets， 8.1 mg·kg^-1）. Except for the control group， other groups were fed with high-sugar and high-fat diet combined with intraperitoneal injection of streptozotocin（STZ） to establish a T2DM rat model. After successful modeling， the treatment groups were administered the corresponding drugs by gavage， and the control group and model group were treated with an equal volume of saline by gavage， once/d， for 28 d. Fasting blood glucose（FBG） and glycosylated hemoglobin A1c（GHbA1c） levels were measured in all groups of rats during the administration period， and hematoxylin-eosin（HE） staining was used to observe the pathomorphological changes in the pancreatic tissues of rats at the end of the administration period. The endogenous metabolite levels in rat serum were detected by ultra-performance liquid chromatography-linear ion trap-electrostatic field orbitrap high-resolution mass spectrometry（UPLC-LTQ-Orbitrap MS）， and the data were processed using principal component analysis（PCA） and orthogonal partial least squares-discriminant analysis（OPLS-DA）. Differential metabolites were identified by the Human Metabolome Database（HMDB） and the Kyoto Encyclopedia of Genes and Genomes（KEGG）， and screened for differential metabolites with variable importance in the projection（VIP） value>1， P<0.05， and fold change（FC）<0.6 or FC>1. And the metabolic pathway enrichment analysis of the screened differential metabolites was performed by MetaboAnalyst 5.0， then the screened differential metabolites were diagnosed and evaluated by the receiver operating characteristic（ROC） curves. ResultCompared with the control group， the FBG level of rats in the model group increased significantly（P<0.01）， the GHbA1c content tended to increase， but the difference was not statistically significant， and the pancreatic tissue of rats was obviously damaged， the number of pancreatic islets decreased， and the pancreatic β-cells were obviously reduced， atrophied and enlarged. Compared with the model group， the FBG levels of rats in the high dose group of Fuling Yunhua granules and the positive drug group were significantly reduced after 2 weeks of administration（P<0.05， P<0.01）， the GHbA1c content of rats in the high dose group of Fuling Yunhua granules was significantly reduced（P<0.05）， and the pancreatic tissue lesions of rats in the different dose groups of Fuling Yunhua granules were reduced. The results of non-targeted metabolomics showed that 46 differential metabolites were significantly changed in the model group compared with the blank group. Pathway enrichment analysis found that T2DM mainly affected biological processes including biosynthesis of primary bile acid， D-amino acid metabolism， steroid hormone biosynthesis， and glycerophospholipid metabolism in rats. Compared with the model group， the levels of 8 differential metabolites in the high dose group of Fuling Yunhua granules were significantly adjusted， and the pathway enrichment analysis found that D-amino acid metabolism， retinol metabolism， glycine， serine and threonine metabolism， tryptophan metabolism and other metabolic pathways were mainly involved. ROC curves further analysis revealed that the four characteristic differential markers of 11-cis-retinol， D-piperidinic acid， D-serine， and p-cresol sulfate had high diagnostic value for the treatment of T2DM with Fuling Yunhua granules. ConclusionFuling Yunhua granules can improve the symptoms of T2DM rats by regulating the amino acid metabolic and retinol metabolic pathways through the modulation of endogenous differential metabolites.

Objective To investigate the application effects of different myocardial protective solutions in total thoracoscopic minimally invasive aortic valve replacement surgery.Methods The clinical data of 72 patients with total thoracoscopic minimally invasive aortic valve replacement surgery in this hospital from May 2020 to January 2024 were analyzed retrospectively.The patients were divided into the St Thomas cardioplegia group(STH group,n=13),del Nido cardioplegia group(DN group,n=24),histidine tryptophan ketoglutar-ate solution group(HTK group,n=35)according to the different myocardial protective solutions.The levels of lactate(Lac)before and during surgery,the highest levels of myocardial creatine kinase isoenzyme(CK-MB),high-sensitivity troponin T(TnT)and creatinine(Cr)before operation,on the operative day and after surgery as well as the duration of extracorporeal circulation,aortic cross-clamping time,maximum flow rate,minimum bladder temperature,cardioplegia perfusion times,number of defibrillation after aortic de-clamping,postoperative ventilator assisted time,ICU stay duration and postoperative hospitalization duration were com-pared among the three groups.Results Except for 1 case of HTK was discharged automatically after surgery,the other 71 cases recovered and discharged according to the doctor's advice.There were no statistically signif-icant differences in the age,body weight,extracorporeal circulation time,aortic blocking time,maximum flow volume of extracorporeal circulation,minimum bladder temperature of extracorporeal circulation,Lac before extracorporeal circulation,highest Lac during extracorporeal circulation,assistant time of postoperative venti-lator,ICU stay duration,postoperative hospitalization duration,serum Cr before operation,Cr on operative day,preoperative TnT,postoperative TnT on operative day,postoperative highest TnT,preoperative CK-MB,postoperative CK-MB on operative day and postoperative highest CK-MB among the three groups(P＞0.05).There were statistically significant differences in the defibrillation ratio after aortic de-clamping and perfusion frequency of myocardial protective solution(P＜0.05).There was statistically significant difference in the perfusion frequency of myocardial protective solution in pairwise comparison among groups(P＜0.05),and the defibrillation ratio after aortic de-clamping had statistical difference between the DN group and HTK group(P＜0.05).Conclusion DN,STH and HTK all have good myocardial protective effect in total thoraco-scopic minimally invasive aortic valve surgery.HTK has the advantages of less perfusion times and decreasing the operative procedures compared with DN and STH;DN has the advantage of lower use for electrical defib-rillation correcting arrhythmias after aortic opening over HTK.

Objective To investigate the relationship between serum levels of microRNA-130a(miR-130a),angiotensin Ⅱ(AngⅡ)and the degree of coronary artery lesions in patients with acute coronary syn-drome(ACS).Methods A total of 160 ACS patients admitted to the hospital from January 2021 to February 2023 were selected as the ACS group.According to total Gensini score,ACS patients were divided into mild group(57 cases),moderate group(54 cases)and severe group(49 cases).At the same time,160 healthy peo-ple were selected as the control group.The clinical data of all subjects were collected.The serum levels of miR-130a and AngⅡ were detected by real-time fluorescence quantitative PCR and enzyme-linked immunosor-bent assay,respectively.The clinical data and serum levels of miR-130a and AngⅡ were compared between control group and ACS group.The serum levels of miR-130a and AngⅡ were compared between ACS patients with different degrees of disease.Pearson correlation analysis was used to analyze the correlation between ser-um miR-130a level and AngⅡ in ACS patients.Multivariate Logistic regression was used to analyze the risk factors of ACS.Receiver operating characteristic curve was used to analyze the diagnostic value of serum miR-130a and AngⅡ levels for moderate and severe ACS.Results Compared with the control group,the ACS group had significantly higher proportions of patients with a history of hypertension and diabetes and signifi-cantly higher serum levels of miR-130a and AngⅡ(P<0.05).The serum levels of miR-130a and AngⅡ were increased sequentially in the mild group,moderate group and severe group(P<0.05).Serum miR-130a level was positively correlated with AngⅡ level in ACS patients(P<0.05).Hypertension,diabetes history and ele-vated serum levels of miR-130a and AngⅡ were independent risk factors for ACS(P<0.05).The area under the curve(AUC)of serum miR-130a,AngⅡ and their combination in the diagnosis of moderate ACS were 0.728,0.823 and 0.885,respectively,and the AUC of the combination of miR-130a and AngⅡ was higher than that of miR-130a,AngⅡ(P<0.05).The AUC of serum miR-130a,AngⅡ and their combination in the diagnosis of severe ACS were 0.731,0.730 and 0.825,respectively.The AUC of the combination of miR-130a and AngⅡ was higher than that of miR-130a and AngⅡ(P<0.05).Conclusion ACS patients serum miR-130-a,AngⅡ level is higher,and the serum miR-130a,AngⅡ levels are associated with the ACS degree of cor-onary artery lesions,the combination of the both degree of coronary artery lesions with high diagnostic value.

Lamiophlomis Herba， one of the medicinal herbs commonly used by the Tibetan ethnic minority， has the effect of activating blood， stopping bleeding， dispelling wind， and relieving pain and is frequently used to treat trauma， traumatic bleeding， rheumatic arthralgia， and dampness and dampness-heat. By a review of ancient Tibetan medicine classics， materia medica classics， and modern literature， this paper systematically analyzed the name， nature， taste， original plant， medicinal part， harvest， processing， efficacy， and indications of Lamiophlomis Herba. The textual research showed that Lamiophlomis Herba was first recorded in the Somaratsa （《月王药诊》） in the middle of the eighth century. This medicinal herb was mainly recorded with a plain and warm nature and a sweet， bitter， and astringent taste. The herb was recorded as non-toxic in other books except the Tibetan Medicinal Plants in Gannan of Qinghai-Tibet Plateau （《青藏高原甘南藏药植物志》）. In the books of the past dynasties， the aboveground part of Lomiophlomis rotatd was used as medicine. In addition， there were also records of using the whole herbs of Ajuga ovalifolia， A. ovalifolia var. calantha， and Oreosolen wattii as the medicine. In ancient times， the herb was mainly harvested before Frost's Descent in the 8^th-9^th months of the lunar calendar， while it was mainly harvested during the flowering-fruiting stage in autumn in modern times. Due to the decreased reserve of Lamiophlomis Herba， the medicinal part evolved from whole herb or fresh leaves to the aboveground part. According to the ancient and modern records， this herb mainly has the functions of nourishing bone and marrow， eliminating dampness and dampness-heat， stopping bleeding， and relieving pain. In ancient times， it was used for treating parasitic diseases， menostaxis， spermatorrhea， diarrhea， and nourishing the body. This paper aims to provide a basis for further development and study of Lamiophlomis Herba through the textual research.

【Objective】 To investigate the feasibility of laparoscopic simple prostatectomy (LSP) in the treatment of large volume benign prostate hyperplasia (BPH). 【Methods】 Clinical and follow-up data of 30 patients with large volume BPH treated with LSP in our hospital during Feb.2019 and Dec.2021 were retrospectively analyzed. All patients underwent extraperitoneal LSP operation. The perioperative and 1-12 month postoperative follow-up data were analyzed. 【Results】 The average prostate volume was (92.4±38.9) mL, operation time (125±45) min, and weight of resected prostate (60.25±16.90) g. The hemoglobin decreased by (12.21±7.25) g/d after operation. No blood transfusion was needed. There was no need for bladder irrigation after operation in 21 cases (70%), and 9 cases (30%) had bladder irrigation time of (0.95±0.49) d. The postoperative catheter indwelling time was (6.92±2.51) d, and hospital stay (5.36±1.63) d. During the follow-up of (9.25±5.4) months, there was 1 case of postoperative intestinal obstruction (Clavien-Dindo grade II), 1 case of transient urinary incontinence (Clavien-Dindo grade I), and 1 case of delayed hematuria (Clavien-Dindo grade I). No urethral stricture occurred. The maximum urinary flow rate (Qmax), post-void residual urine volume (PVR), International Prostate Symptom Score (IPSS) and quality of life (QoL) 3 months after operation were significantly improved compared with those before operation (P<0.05). There was no significant difference in sexual function before and after operation (P>0.05). 【Conclusion】 LSP is safe and effective in the treatment of large volume BPH. It has advantages of complete resection of glands, minor bleeding and short postoperative bladder irrigation time. However, it still needs to be confirmed by a prospective control study of large samples.

Objective:To identify a novel bombesin bioactive peptide from the skin secretion of Hylarana Latouchii, and to explore its effect on insulin secretion in islet cells.Methods:The skin secretion from Hylarana Latouchii was extracted by electrical stimulation, and the single chain of bombesin peptide was cloned and sequenced. The peptide QUB2995 was synthesized via solid-phase synthesis, then purified using reversed-phase high performance liquid chromatography (HPLC). Matrix assisted laser desorption time-of-flight mass spectrometry (MALDI-TOF) was applied to validate. QPCR and ELISA were used to probe the effect of QUB2995 on insulin secretion in MIN6 and INS-1 cells.Results:A novel bombesin peptide named QUB2995 (GAFGDFLKGAAKA GALKILSIAQCKLSGTC) was found in the skin secretion of Hylarana Latouchii through molecular cloning. The bioactive peptide could significantly promote the proliferation and insulin secretion from mouse islet MIN6 cells and rat islet INS-1 cells. The effect reached a climax at the concentration of 10 -5 mol/L. Conclusion:A novel bombesin bioactive peptide named QUB2995 was found from Hylarana Latouchii. It could significantly promote insulin secretion in MIN6 cells of mouse islets and INS-1 cells of rat islets, indicating its potential in the treatment of diabetes.

Objective:To investigate the hemodynamic changes of the main arteries and veins of the extremities and the heart in patients with hypertrophic scar secondary to extensive burns after pressure treatment, and to analyze the relevant mechanisms.Methods:A retrospective before-after self-control study was conducted. From January 2017 to February 2022, 37 patients with hypertrophic scar secondary to extensive burns who met the inclusion criteria were hospitalized in the Burn Rehabilitation Department of Guangdong Industrial Injury Rehabilitation Hospital, including 25 males and 12 females, aged 23-52 years. The patients were admitted to the hospital within 12 weeks after wound healing, and within one week after admission, rehabilitation therapists, occupational therapists, and tailors custom-made pressure products such as full-body pressure garment, pressure pants, vests, split finger gloves, split finger socks, hoods, and plastic collars, with the pressure at each part maintained at 2.67-4.00 kPa when wearing. Before the first treatment with pressure products (hereinafter referred to as before pressure treatment) and at 1 h of the first treatment with pressure products (hereinafter referred to as 1 h of pressure treatment), color Doppler ultrasonography was performed to check the pulse rate of the axillary artery, the lumen diameter, peak systolic velocity (PSV), and resistance index of the axillary artery and femoral artery on the left side, the lumen diameter, cross-sectional area, and average blood flow velocity of the axillary vein and femoral vein, and the mitral valve E peak, mitral valve A peak, tricuspid valve E peak, aortic valve PSV, and pulmonary valve PSV of the heart; an optical chromatographic skin detector was used to detect the red color, red pigment, and surface brightness of the scar on the back of the hand to reflect the filling and distribution of the scar microvessels. Data were statistically analyzed with paired sample t test. Results:Compared with those before pressure treatment, the PSV of the axillary artery of patients was significantly slowed down at 1 h of pressure treatment ( t=55.42, P<0.01); the average blood flow velocity of the axillary vein was significantly accelerated ( t=-60.50, P<0.01); the pulse rate, lumen diameter, and resistance index of the axillary artery, as well as the lumen diameter and cross-sectional area of the axillary vein did not change obviously ( P>0.05); the average blood flow velocity of the femoral vein was significantly accelerated ( t=-80.52, P<0.01); the lumen diameter, PSV, and resistance index of the femoral artery, as well as the lumen diameter and cross-sectional area of the femoral vein had no significant change ( P>0.05); the mitral valve E peak and mitral valve A peak of the heart decreased significantly (with t values of 10.71 and 21.96, respectively, P<0.01); the tricuspid valve E peak of the heart increased significantly ( t=7.57, P<0.01); the PSV of the aortic valve and pulmonary valve of the heart did not change obviously ( P>0.05). At 1 h of pressure treatment, the red color and red pigment values of the scar on the back of the hand of patients were 15.3±1.1 and 16.8±1.2, respectively, which were significantly lower than 24.5±1.3 and 23.8±1.2 before pressure treatment (with t values of 8.32 and 8.04, respectively, P<0.01). The brightness value of the scar surface on the back of the hand of patients at 1 h of pressure treatment was similar to that before pressure treatment ( P>0.05). Conclusions:After pressure treatment for the hypertrophic scar in patients secondary to extensive burn, the average blood flow velocity of the axillary vein and femoral vein in patients are obviously accelerated, the PSV of the axillary artery is significantly slowed down, the peak values of mitral valve E and mitral valve A of the heart are significantly decreased, and the tricuspid valve E peak is significantly increased. These hemodynamic changes may be related to the reduction of microvascular blood flow in the local area of scar after systemic pressure treatment.

Objective:To identify the etiology and genetics of the human parainfluenza virus type 3 (HPIV3) virus which caused an acute respiratory tract infection outbreak in a primary school in Shenyang.Methods:Throat swab samples were collected from 17 students of the primary school where the epidemic of acute respiratory infection outbreak in December 2020 in Shenyang, Liaoning province. TaqMan low-density arrays (TLDA) real-time PCR was performed to simultaneously detect multiple respiratory pathogens. The HN gene was amplified using nested RT-PCR and sequenced, followed by phylogenetic analysis for those HPIV3 positive samples.Results:Of the 17 specimens, 10 were HPIV3 positive by TLDA Real-time PCR, and were accompanied by conditional pathogen infection, consequently, amplification result ed in 7 complete HN sequences. Phylogenetic analysis showed that the infected HPIV3 virus of the outbreak belonged to HPIV subtype C3a. All the 7 strains detected in this study belonged to subbranch C3a.1 evolutionary branch, with a nucleotide homology of 99.9%, a nucleotide homology of 94.56 with the prototype strain Wash/47885/57 and 99.5% with the most phylogenetically close strain of ZJ/11-s-165/KP690785/CHN/11.Conclusions:The HPIV3 virus caused the acute respiratory tract infection outbreak in Shenyang in 2020 and HPIV subtype C3a1 was detected firstly in Northeast China.