Objective To compare the efficacy and safety of erector spinae plane block(ESPB)and thoracic paravertebral block(TPVB)in preventing acute post-surgical pain syndrome(PSP)of breast cancer.Methods The following databases,both domestic and international,including Embase,Cochrane Library,Web of Science,PubMed,CNKI,VIP,Wanfang,and Sinomed,were searched via computer to gather clinical randomized controlled trials(RCTs)on ESPB and TPVB for breast cancer patients.The included literature was evaluated using the Cochrane bias risk assessment tool to assess quality,and meta-analysis was performed using Review Manager 5.4 software and Stata 17.0 software.Results This study comprised 14 RCTs,with a total of 1079 patients,including 540 ESPB patients and 539 TPVB patients.The analysis results indicated that there was a significant difference in pain scores during postoperative rest between ESPB and TPVB during 3-4 h(I2=53%,SMD=0.36,95%CI:0.07-0.65,P=0.020)and 5-6 h(I2=80%,SMD=0.53,95%CI:0.05-1.01,P=0.030),with TPVB being superior to ESPB.However,there was no significant difference in pain scores during postoperative rest between ESPB and TPVB at 1-2 h(I2=75%,SMD=0.28,95%CI:-0.03-0.60,P=0.080),7-8 h(I2=89%,SMD=0.24,95%CI:-0.47-0.94,P=0.510),12 h(I2=90%,SMD=0.1,95%CI:-0.40-0.60,P=0.690),24 h(I2=78%,SMD=0.33,95%CI:-0.04-0.70,P=0.080),and 48 h(I2=85%,SMD=-0.05,95%CI:-0.52-0.42,P=0.830).For the pain score during postoperative exercise,there was a significant difference between ESPB and TPVB during 3-4 h(I2=0,SMD=0.29,95%CI:0.09-0.48,P=0.004),7-8 h(I2=48%,SMD=0.37,95%CI:0.00-0.73,P=0.050),and 48 h(I2=0,SMD=0.21,95%CI:0.03-0.39,P=0.020),with TPVB being su-perior to ESPB.There was no significant difference between ESPB and TPVB at 1-2 h(I2=89%,SMD=0.42,95%CI:-0.19-1.03,P=0.180),5-6 h(I2=90%,SMD=0.29,95%CI:-0.67-1.24,P=0.560),12 h(I2=81%,SMD=0.25,95%CI:-0.22-0.72,P=0.300),and 24 h(I2=83%,SMD=0.39,95%CI:-0.10-0.89,P=0.120).There was a statistical difference in the operation time of nerve blocks between the two methods,with ESPB taking less time than TPVB(P＜0.001).However,there was no statistical difference in opioid consumption within 24 h after surgery,incidence of nausea and vomiting,and the first PCIA press time(all P＞0.05).Conclusions Compared to ESPB,TPVB tends to result in a decreased pain score after breast cancer surgery,but it also took longer to perform.There was no significant difference be-tween the two methods in terms of opioid consumption at 24 h after surgery,incidence of nausea and vomiting and the first PCIA press time.

Objective:To explore the medication law of TCM external therapy for the treatment of diabetic foot using data mining methods.Methods:Literature on TCM external treatment for diabetic foot was retrieved from CNKI, Wanfang Data, and Chongqing VIP from the establishment of the databases to June 30, 2024. Excel 2019 software was used to conduct frequency statistics on drug frequency, properties, tastes and meridian tropism, drug efficacy, and commonly used drug pairs. Ancient and Modern Medical Cases Cloud Platform V3.5 was used for association rules, and SPSS Statistics 27.0 was used for complex network analyses.Results:A total of 425 articles were included, involving 328 prescriptions and 232 drugs. The drugs with higher frequency were Carthami Flos, Angelicae Sinensis Radix, Cinnamomi Ramulus, Olibanum, etc. The main tastes were pungent, bitter, and sweet; the main properties were cold and warm; the main meridians were heart, spleen, and liver meridians. The main efficacy was promoting blood circulation and removing blood stasis, clearing heat, and tonifying deficiency; association rule analysis obtained 20 commonly used drug pairs; clustering analysis resulted in four core drug combinations; complex network analysis led to one core prescription.Conclusions:TCM external therapy for diabetic foot follows the guiding principles of "promoting blood circulation and unblocking collaterals, tonifying deficiency and clearing heat" with coordinated regulation of the "heart-liver-spleen meridians". The core prescription and stage-specific formulation strategies reflect a trinity diagnostic and therapeutic approach of "disease differentiation-syndrome differentiation-stage differentiation", providing valuable reference and insights for clinical prescription practices.

Objective To compare the efficacy and safety of erector spinae plane block(ESPB)and thoracic paravertebral block(TPVB)in preventing acute post-surgical pain syndrome(PSP)of breast cancer.Methods The following databases,both domestic and international,including Embase,Cochrane Library,Web of Science,PubMed,CNKI,VIP,Wanfang,and Sinomed,were searched via computer to gather clinical randomized controlled trials(RCTs)on ESPB and TPVB for breast cancer patients.The included literature was evaluated using the Cochrane bias risk assessment tool to assess quality,and meta-analysis was performed using Review Manager 5.4 software and Stata 17.0 software.Results This study comprised 14 RCTs,with a total of 1079 patients,including 540 ESPB patients and 539 TPVB patients.The analysis results indicated that there was a significant difference in pain scores during postoperative rest between ESPB and TPVB during 3-4 h(I2=53%,SMD=0.36,95%CI:0.07-0.65,P=0.020)and 5-6 h(I2=80%,SMD=0.53,95%CI:0.05-1.01,P=0.030),with TPVB being superior to ESPB.However,there was no significant difference in pain scores during postoperative rest between ESPB and TPVB at 1-2 h(I2=75%,SMD=0.28,95%CI:-0.03-0.60,P=0.080),7-8 h(I2=89%,SMD=0.24,95%CI:-0.47-0.94,P=0.510),12 h(I2=90%,SMD=0.1,95%CI:-0.40-0.60,P=0.690),24 h(I2=78%,SMD=0.33,95%CI:-0.04-0.70,P=0.080),and 48 h(I2=85%,SMD=-0.05,95%CI:-0.52-0.42,P=0.830).For the pain score during postoperative exercise,there was a significant difference between ESPB and TPVB during 3-4 h(I2=0,SMD=0.29,95%CI:0.09-0.48,P=0.004),7-8 h(I2=48%,SMD=0.37,95%CI:0.00-0.73,P=0.050),and 48 h(I2=0,SMD=0.21,95%CI:0.03-0.39,P=0.020),with TPVB being su-perior to ESPB.There was no significant difference between ESPB and TPVB at 1-2 h(I2=89%,SMD=0.42,95%CI:-0.19-1.03,P=0.180),5-6 h(I2=90%,SMD=0.29,95%CI:-0.67-1.24,P=0.560),12 h(I2=81%,SMD=0.25,95%CI:-0.22-0.72,P=0.300),and 24 h(I2=83%,SMD=0.39,95%CI:-0.10-0.89,P=0.120).There was a statistical difference in the operation time of nerve blocks between the two methods,with ESPB taking less time than TPVB(P＜0.001).However,there was no statistical difference in opioid consumption within 24 h after surgery,incidence of nausea and vomiting,and the first PCIA press time(all P＞0.05).Conclusions Compared to ESPB,TPVB tends to result in a decreased pain score after breast cancer surgery,but it also took longer to perform.There was no significant difference be-tween the two methods in terms of opioid consumption at 24 h after surgery,incidence of nausea and vomiting and the first PCIA press time.

At present, the surgical treatment of peripheral facial paralysis includes non-dynamic and dynamic treatment. The former suspends the facial soft tissue with various materials to reconstruct the static symmetry of the face. The latter, through nerve repair and the transplantation of vascularized neuromuscular flap, restores the facial nerve and expressive muscle contractile function of the affected side, to achieve the ideal therapeutic effect. This article summarises the relevant literatures, reviews the application of various nerve repair methods in peripheral facial paralysis, to discusses the scope of application, advantages and disadvantages, and provides reference and help for clinicians in selection of surgical methods for peripheral facial paralysis.

Ischemic stroke is one of the most important causes of death and disability in humans,but the effective methods for treating brain injury after stroke are quite limited.Sphingosine 1-phosphate (S1P) is a pleiotropic lipid.There is certain interdependence between its metabolism and regulation and the molecular mechanisms involved in important biological events following cerebral ischemia.Membrane lipid therapy with S1P as the core may be an effective neuroprotective strategy of ischemic stroke.

BACKGROUNDIt is still unclear whether the vitrification procedure itself is associated with the incidence of abnormal DNA methylation during oocytes vitrification. The purpose of this study was to evaluate the epigenetic profile of mouse oocytes, which went through vitrification either at a mature stage or at an immature stage following in vitro maturation (IVM) by analyzing the global DNA methylation.

METHODSMetaphase II (M II) stage and germinal vesicle (GV) stage oocytes were collected from adult female mice and were vitrified respectively. The M II oocytes were assessed for cryo-survival and global DNA methylation. The GV oocytes were assessed for cryo-survival and only the surviving GV oocytes were cultured in vitro for subsequent assessment of global DNA methylation in mature oocytes. In vivo matured fresh M II oocytes without undergoing vitrification were used as control. The level of global DNA methylation in the M II oocytes was then examined by immunofluorescence using an anti-5-methylcytosine (anti-5-MeC) monoclonal antibody and fluorescein isothiocyanate (FITC)-conjugated goat anti-mouse IgG under a laser scanning confocal microscope.

RESULTSIn terms of the effect of vitrification on global DNA methylation status in matured oocytes, in the M II-v group, all the examined oocytes (90/90) were found with hypermethylation, including 63.3% (57/90) of them displaying DNA methylation of a very high level, 25.6% (23/90) with a high level, and 11.1% (10/90) with an intermediate level, whereas in the GV-v group, all the matured oocytes (129/129) were also examined with hypermethylation, including 67.4% (87/129) of them displaying DNA methylation of a very high level, 23.3% (30/129) with a high level, and 9.3% (12/129) with an intermediate level. Statistically, it was similar between both groups, which were similar to the control: 68.6% (83/121) of fresh M II oocytes displayed DNA methylation of a very high level, 21.5% (26/121) with a high level, and 9.9%(12/121) with an intermediate level (P > 0.05). In terms of the effect of IVM on global DNA methylation status in matured oocytes, in the in vivo matured oocytes group, all oocytes examined (94/94) were found with hypermethylation, including 80.9% (76/94) displaying DNA methylation of a very high level and 19.1% (18/94) with a high level, whereas in the in vitro matured oocytes group, all oocytes examined (69/69) were also found with hypermethylation: 85.2% (56/69) of them displayed with DNA methylation of very high level, 11.9% (11/69) with high level, and 2% (2/69) with intermediate level. This result was similar to that in in vivo matured fresh M II oocytes (P > 0.05).

CONCLUSIONThe vitrification procedure at GV stage does not induce widespread alteration of global DNA methylation status of mouse oocytes subsequently matured in vitro.

Animals ; DNA Methylation ; physiology ; Female ; Fertilization in Vitro ; Mice ; Microscopy, Confocal ; Oocytes ; cytology ; metabolism ; Vitrification

Background It is still unclear whether the vitrification procedure itself is associated with the incidence of abnormal DNA methylation during oocytes vitrification.The purpose of this study was to evaluate the epigenetic profile of mouse oocytes,which went through vitrification either at a mature stage or at an immature stage following in vitro maturation (IVM) by analyzing the global DNA methylation.Methods Metaphase Ⅱ (M Ⅱ) stage and germinal vesicle (GV) stage oocytes were collected from adult female mice and were vitrified respectively.The M Ⅱ oocytes were assessed for cryo-survival and global DNA methylation.The GV oocytes were assessed for cryo-survival and only the surviving GV oocytes were cultured in vitro for subsequent assessment of global DNA methylation in mature oocytes.In vivo matured fresh M Ⅱ oocytes without undergoing vitrification were used as control.The level of global DNA methylation in the M Ⅱ oocytes was then examined by immunofluorescence using an anti-5-methylcytosine (anti-5-MeC) monoclonal antibody and fluorescein isothiocyanate (FITC)-conjugated goat anti-mouse IgG under a laser scanning confocal microscope.Results In terms of the effect of vitrification on global DNA methylation status in matured oocytes,in the M Ⅱ-v group,all the examined oocytes (90/90) were found with hypermethylation,including 63.3％ (57/90) of them displaying DNA methylation of a very high level,25.6％ (23/90) with a high level,and 11.1％ (10/90) with an intermediate level,whereas in the GV-v group,all the matured oocytes (129/129) were also examined with hypermethylation,including 67.4％ (87/129) of them displaying DNA methylation of a very high level,23.3％ (30/129) with a high level,and 9.3％ (12/129) with an intermediate level.Statistically,it was similar between both groups,which were similar to the control:68.6％ (83/121) of fresh M Ⅱ oocytes displayed DNA methylation of a very high level,21.5％ (26/121) with a high level,and 9.9％(12/121) with an intermediate level (P ＞0.05).In terms of the effect of IVM on global DNA methylation status in matured oocytes,in the in vivo matured oocytes group,all oocytes examined (94/94) were found with hypermethylation,including 80.9％ (76/94) displaying DNA methylation of a very high level and 19.1％ (18/94) with a high level,whereas in the in vitro matured oocytes group,all oocytes examined (69/69) were also found with hypermethylation:85.2％ (56/69) of them displayed with DNA methylation of very high level,11.9％ (11/69) with high level,and 2％ (2/69) with intermediate level.This result was similar to that in in vivo matured fresh M Ⅱ oocytes (P ＞0.05).Conclusion The vitrification procedure at GV stage does not induce widespread alteration of global DNA methylation status of mouse oocytes subsequently matured in vitro.