ObjectiveTo study the effect of Wulingsan on cerebral edema after intracerebral hemorrhage （ICH） in mice and explore the treatment mechanism. MethodsThe mouse model of ICH was established by injection of collagenase into the caudate nucleus. Mice were randomly assigned into the following groups： sham， ICH， intervention before modeling with low-dose and high-dose （3.69， 11.07 g·kg^-1， respectively） Wulingsan， and intervention after modeling with high-dose Wulingsan. The modified neurological severity score （mNSS） was recorded， and the small animal MRI T2 sequential scanning was performed to measure the volume of cerebral hemorrhage after the modeling of ICH in each group. The Y-maze test， open field test， and Morris water maze test were conducted to evaluate the neurological behaviors of mice in each group. Hematoxylin-eosin staining was employed to observe the pathological changes in the brain tissue. Immunohistochemistry was employed to observe the expression of aquaporin 4 （AQP4）， neuronal nuclei （NeuN）， and glial fibrillary acidic protein （GFAP） in the brain tissue. Western blot was employed to determine the protein levels of AQP4， Claudin-5， and zonula occludens-1 （ZO-1） in the hematoma area. ResultsCompared with the sham group， the ICH group showed increases in the mNSS， the cerebral hemorrhage volume， and the escape latency in the Morris water maze test （P<0.01）， decreases in the times of touching the platform and times of entering the quadrant where the platform was located in the Morris water maze test， and reductions in the spontaneous alternation rate in the Y-maze test and the ratio of distance of center travel to total travel distance in the open field test （P<0.01）. Moreover， pathological changes such as cell disarrangement， cell space enlargement， and cell swelling were observed in the ICH group. Immunohistochemistry results showed that the ICH group had higher proportions of AQP4- and GFAP-positive cells and lower proportion of NeuN-positive cells than the sham group （P<0.01）. Compared with the sham group， the ICH group showed an up-regulated protein level of AQP4 and down-regulated protein levels of Claudin-5 and ZO-1 （P<0.01）. Compared with the ICH group， the intervention with Wulingsan decreased the mNSS， the volume of cerebral hemorrhage， and the escape latency in the Morris water maze test （P<0.05， P<0.01）， while increasing the times of touching the platform and times of entering the quadrant where the platform was located in the Morris water maze test， the spontaneous alternation rate in the Y-maze test， and the ratio of distance of center travel to total travel distance in the open field test （P<0.05， P<0.01）. Furthermore， the intervention with Wulingsan alleviated the pathological changes in the brain tissue after ICH， decreased the proportion of AQP4- and GFAP-positive cells （P<0.01）， increased the proportion of NeuN-positive cells （P<0.01）， down-regulated the protein level of AQP4 （P<0.01）， and up-regulated the protein levels of Claudin-5 and ZO-1 （P<0.01）. ConclusionThe intervention with Wulingsan could reduce the neural function score and the cerebral hemorrhage volume， up-regulate the expression of Claudin-5 and ZO-1， and down-regulate the expression of AQP4 to ameliorate the neurological function defect and cerebral edema after ICH， thereby protecting the brain.

Abstract To analyzes the characteristics, problems and enlightenment of physical activity observation tools, so as to provide reference for researchers to quickly and accurately choose appropriate observation tools to evaluate children s and adolescents physical activity. Literature search is conducted in eight databases of Chinese and English, including CNKI, Wanfang, VIP, Web of Science, PubMed, Medline, ERIC, and SPORTDiscus. Ultimately, eight observation tools for assessing physical activity in children and adolescents are included. Through summarization and comparison, it is found that the applications of those tools cover multiple age groups, the observation indicators cover multiple dimensions for each with varying emphases, and the applicable contexts vary in their specific background information, and recording methods tend to be quantitative. However, several issues remain to be addressed in practical applications. First, the observation indicators need to be supplemented and improved; second, physical activity in community environments and academic classrooms requires further attention; third, physical activity intensity needs to be scientifically evaluated; fourth, observation and recording methods need to be integrated and innovated; fifth, the number of observation subjects needs to be expanded. Future research could focus on developing observation tools tailored to the characteristics of Chinese children and adolescents, while drawing on foreign observation tools to comprehensively assess physical activity among children and adolescents.

Objective To observe the safety and effectiveness of ultrasound-guided femoral nerve combined with femoral artery block to reduce tourniquet reaction in patients undergoing knee arthroplasty.Methods 100 patients(18～75 years old,body mass index 18～30 kg/m2)who were classified as grade Ⅰ-Ⅲ according to ASA standard and received unilateral total knee arthroplasty.The patients were randomly divided into two groups,the ultrasound-guided femoral nerve combined with femoral artery block with general anesthesia was utilized in group NA with 50 cases,and femoral nerve block alone with general anesthesia was used in group N with 50 cases.The target nerve block was guided by ultrasound before induction of anesthesia in both two groups,and anesthesia induction was performed after the block effect was etermined.Patients in two groups underwent surgery under general anesthesia of the laryngeal mask,and all patients under went self-controlled intravenous analgesia(PCIA).If a patient had a visual analogue score(VAS)score>5 after surgery,flurbiprofenate 50 mg will be given intravenously as a remedy for anal-gesia.The patients'SBP,DBP and HR were recorded before anesthesia(T1),1 min before tourniquet inflation(T2),15 min after tourniquet inflation(T3),30 min(T4),45 min(T5),and 60 min(T6),the number of cases of tourniquet hypertension occurring in patients intraoperatively and the amount of nicardipine and esmolol were recorded,and the movement and static VAS scores at 2,6,12,and 24 h after surgery were recorded.the postoperative rescue analgesic requirements and the time of getting out of bed were recorded.The incidence of adverse reactions such as nausea,vomiting,deliriumand infection were also recorded.Results Compared with group N,SBP,DBP and HR were significantly lower in group NA at 45 and 60 min after tourniquet inflation,and the incidence of tourniquet hypertension and the amount of nicardipine and esmolol were also significantly lower(P<0.05),and the time of getting out of bed was advanced(P<0.05);the movement and static VAS scores,the time of the first remedial analgesia,and number of times of remedial analgesia,as well as the occurrence of nausea,vomiting,delirium and infection were not statistically significant.Conclusion Ultrasound-guided femoral nerve combined with femoral artery block can be safely and effectively used to reduce the reaction of tourniquet in patients with knee arthroplasty,and can shorten the time of getting out of bed after surgery,contributing to promoting postoperative rehabilitation.

Objective To investigate the application of exoscope in resection of parasagittal meningioma.Methods A retrospective analysis was conducted on 50 patients with parasagittal meningioma undergoing surgical treatment in a same medical group of our neurosurgical department from March 2021 to March 2023.According to their surgical procedures,they were divided into exoscope group(n=22)and microscope group(n=28).The surgical efficacy,surgical complications and surgical experience were compared between the 2 groups and analyzed.Results There were no significant differences between the 2 groups in terms of sex ratio(male/female:10/12 vs 12/16),mean age(50.7±10.2 vs 52.3±11.1 years)and mean tumor size(20.79±25.04 vs 20.60±21.38 cm3).No statistical differences were observed in the duration of operation(217.73±59.66 vs 220.54±56.82 min),intraoperative blood loss(181.82±105.27 vs 189.29±103.06 mL),or total resection rate(90.9％vs 89.3％)between the 2 groups.Postoperative neurological dysfunction,infection rate and other complications also presented no notable differences between them.In the operation of parasagittal meningioma,exoscope can provide a larger view of the parasagittal sinus,such as the subdural border,which is difficult to be exposed by single microscope.Moreover,exoscope presented a higher level of comfort operating and better intraoperative teaching display compared to the surgical microscope.Conclusion For parasagittal meningiomas,exoscope is a safe and effective option,with similar surgical outcomes and postoperative complications as surgical microscope.What's more,exoscope presents more comfortable intraoperative ergonomic posture,higher surgical team participation,and better teaching effect.

Objective To explore the medication law of Professor Ding Ying in the treatment of Henoch-Sch?nlein purpura;To analyze Professor Ding Ying's academic thought and clinical experience in the treatment of Henoch-Sch?nlein purpura.Methods Professor Ding Ying's prescriptions for the treatment of Henoch-Sch?nlein purpura in The First Affiliated Hospital of Henan University of Chinese Medicine from January 2013 to January 2020 were selected.Through the analysis of the Integrated Platform for Inheriting Famous Doctors,drug-drug and drug-symptom networks were constructed,and in-depth analysis of its core drug groups and their associated patterns was conducted.Results Totally 195 cases were included in the study,involving 585 times of diagnosis and 585 prescriptions.153 kinds of Chinese materia medica were involved in the prescriptions,with a total frequency of 8 017 times.The medicinal properties were mainly cold,warm and neutral,the medicinal taste was mainly bitter,and the meridians are mainly liver meridian and heart meridian.The analysis of drug weight grade showed that Rehmanniae Radix,Angelicae Sinensis Radix,Forsythiae Fructus,Lonicerae Japonicae Caulis,Moutan Cortex,Arnebiae Radix,Chuanxiong Rhizoma,Kochia Fructus,Piperis Kadsurae Caulis,Trachelospermi Caulis et Folium,Cynanchi Paniculati Radix et Rhizoma,Tripterygium wilfordii,Coicis Semen,Scutellariae Radix,Bubali Cornu,Amomi Fructus,Paeoniae Radix Alba,Spirodelae Herba and Glycyrrhizae Radix et Rhizoma were the core prescriptions for the treatment of Henoch-Sch?nlein purpura.Drug-drug co-occurrence analysis showed that Rehmanniae Radix-Angelicae Sinensis Radix,Rehmanniae Radix-Moutan Cortex,Forsythiae Fructus-Moutan Cortex,Kochia Fructus-Lonicera Japonicae Caulis,Chuanxiong Rhizoma-Lonicera Japonicae Caulis,Lonicerae Japonicae Caulis-Angelicae Sinensis Radix,Kochia Fructus-Forsythiae Fructus,Moutan Cortex-Arnebiae Radix,Angelicae Sinensis Radix-Moutan Cortex,Rehmanniae Radix-Forsythiae Fructus,Forsythiae Fructus,Rehmanniae Radix-Lonicera Japonicae Caulis were commonly used in the treatment of Henoch-Sch?nlein purpura.Clustering analysis showed 10 potential drug groups.Conclusion Professor Ding Ying emphasizes the combination of disease,syndrome,and symptoms in the treatment of Henoch-Sch?nlein purpura,as well as the application of couplet medicines.Clinical treatment follows the concept of"dispelling pathogens and calming the collaterals",making good use of heat clearing and detoxifying drugs,heat clearing and wind dispelling drugs,and heat clearing and dampness dispelling drugs to"dispel pathogens",and making good use of blood activating and cooling drugs,as well as blood nourishing and unblocking drugs to"calm the collaterals".

Objective To investigate the effects of high-calorie diet and age on brain function of ApoE-/-mice.Methods A total of 20 adult ApoE mice(8 months old)and elderly ApoE-/-mice(18 months old)were randomly divided into normal diet adult group,normal diet elderly group,high-calorie diet adult group,and high-calorie diet elderly group,with 5 animals in each group.The mice were fed with corresponding standard diet and high-fat diet for 8 weeks.Their body mass was monitored,and blood glucose was detected with glucose tolerance test.The relative contents of NAA and Cho in the hippocampus and hypothalamus were detected by Magnetic resonance spectroscopy.Y-Maze and open field tests were performed to detect cognitive function,and West-ern blotting was applied to detect the expression of synaptic associated protein 25(SNAP-25),synaptophysin,postsynaptic dense protein-95(PSD-95),iNOS and IL-1β.Results Compared with the normal diet adult group,the NAA content in the hippocampus,Cho and NAA contents in the hypothalamus,spontaneous alternation rate,and expression levels of SNAP-25,synaptophysin and PSD-95 in brain tissue(P＜0.05,P＜0.01)were decreased,and the expression of iNOS and IL-1β(P＜0.01)was increased in the high-calorie diet adult group.The normal diet elderly group had reduced contents of NAA in the hippocampus and Cho in the hypothalamus,and expression levels of SNAP-25,synaptophysin and PSD-95(P＜0.05,P＜0.01),and elevated expression of iNOS and IL-1β(P＜0.01)when compared with the normal diet adult group.Compared with the normal diet elderly group,high-calorie diet resulted in decreased Cho and NAA in both hippocampus and hy-pothalamus,central distance/total distance and down-regulation of SNAP-25,synaptophysin and PSD-95(P＜0.05,P＜0.01),and enhanced expression of iNOS and IL-1β(P＜0.01)in the elderly mice.Compared with the high-calorie diet adult group,the high-calorie diet elderly group had reduced NAA in hippocampus,central distance/total distance and average speed,and decreased expression of synaptophysin(P＜0.05,P＜0.01),and increased expression of iNOS and IL-1β(1.61±0.10 vs 1.35±0.13,2.04±0.08 vs 1.54±0.11,P＜0.05,P＜0.01).Conclusion High-calorie diet results in metabolic disorders and neuroinflammation,inhibits the expression of syn-aptic proteins,and thus leads to cognitive dysfunction in ApoE mice.Long-term high-calorie diet and ageing promote the decline of brain function in ApoE mice.

Objective:This study aimed to explore the clinical value of myostatin(MST) and follistatin(FST) as biological biomarkers in evaluating sarcopenia in elderly women.Methods:This was a retrospective cross-sectional study that enrolled 350 females aged 20-89 years who underwent physical examinations in Shanghai Huadong Hospital in 2021. Demographic characteristics, muscle mass, fat mass, bone mineral density, hand grip strength, gait speed, and serum indices of MST and FST were collected.Results:The serum levels of MST did not change significantly with age. However, the serum levels of FST increased with age. In women aged≥60 years, MST was positively correlated with total lean mass and appendicular skeletal muscle index(ASMI; r=0.236, P=0.041; r=0.289, P=0.014), while FST was negatively correlated with ASMI( r=-0.265, P=0.030). In multivariate stepwise regression analysis, after adjusting for age, body mass index, hip bone mineral density, and total fat mass, only FST was independently correlated with ASMI( β=-0.238, P=0.006), while MST was not correlated with ASMI. The receiver operating characteristic curve was plotted using muscle mass reduction as the state variable and serum FST level as the test variable. The area under the curve was 0.753. And when the FST cutoff value was 17.49 ng/mL, the maximum Jordan index was 0.46, with a sensitivity of 77.3% and a specificity of 68.7%. Women aged ≥60 years were divided into three groups based on serum FST levels. Compared to the upper third of the serum FST level group, the low third of the FST level group had a significantly reduced risk of suffering from sarcopenia( OR=0.098, P =0.036). Conclusions:Serum FST lever has a better correlation with muscle mass among elderly women, making it a promising biomarker for evaluating muscle mass.

Objective To investigate the efficacy of biportal endoscopic transforaminal lumbar interbody fusion(BE-LIF)in the treatment of lumbar spondylolisthesis complicated with osteoporosis.Methods From June 2021 to June 2022,36 cases of lumbar spondylolisthesis complicated with osteoporosis were treated with BE-LIF,including 9 males and 27 females,aged(65.94±6.83)years(range:51～76 years).All were single segment,and the responsible segment was L3/4 in 4 cases,L4/5 in 26 cases,and L5/S1 in 6 cases.Imagingexamination showed 1 and 2 degree of spondylolisthesis in 28 and 8 cases,and degenerative and ischemic spondylolisthesis in 24 and 12 cases respectively.Preoperative average bone mineral density T value of the lumbar spine was(-3.19±0.82)SD,and T value of the femur(-2.26±0.86)SD.Oswestry disability index(ODI)was used to evaluate lumbar spine function;visual analogue scale(VAS)to evaluate low back pain and leg pain.ODI,VAS of low back and leg pain were recorded respectively before the operation,at discharge and at the last follow-up.MacNab criteria were used to evaluate the surgical efficacy at the last follow-up.The anterior and posterior disc height,segmental lordotic angle and percentage of slip were measured on the lateral lumbar X-ray films before and after the operation.All patients received standard anti-osteoporosis treatment after surgery.Results All patients completed the opera-tion in one stage.The average operation time was(160.97±35.01)min(range:105～245 min),and the average intraoperative blood loss was(72.50±47.53)ml(range:20～150 mL).The mean follow-up time was(15.17±6.53)months(range:6～26 months).There were statistically significant differences in both VAS score of back and leg and ODI score at discharge and last follow-up when compared with those before the surgery(F=107.48,103.66,55.52,P<0.001).Macnab criteria of the last follow-up showed excellent in 21 cases,good in 12 cases,fair in 3 cases,and the excellent and good rate was 91.7%.Radiographic results showed that the height of the ante-rior and posterior disc height,segmental lordotic angle and percentage of slip were all improved immediately after surgery and at the last follow-up when compared with those before operation,but the anterior and posterior disc height,segmental lordotic angle at the last follow-up were decreased comparing with those immediate after the operation;the difference was statistically significant(P<0.001).The fusion rate at the last follow-up was 91.7%(33/36).The complication rate was 13.8%(5/36),including 1 case of intraoperative endplate injury,1 case of nerve root cuff tear,1 case of delayed postoperative wound infection,and 2 cases of posterior cage migration.Conclusion BE-LIF for the treatment of lumbar spondylolisthesis complicated with osteoporosis can achieve better immediate reduction effect,good clinical outcomes and high fusion rate in short-term follow-up,but the anterior and posterior disc height,segmental lordotic angle are partially lost at the last follow-up.There are still complications,and beginners should be cautious when performing the operation.Postoperative standardized anti-osteoporosis treatment is still an important measure to ensure the curative effect of surgery.

Laparoscopic sleeve gastrectomy, as the significantly effective weight loss surgery currently recognized, is widely used at home and abroad, and the quality of life of postoperative patients also receives widespread attention. At present, domestic researchers often use universal scales to evaluate the quality of life of postoperative patients, but such scales cannot truly reflect the quality of life of postoperative patients. This paper reviews the universal and specific assessment tools for quality of life in patients after laparoscopic sleeve gastrectomy, elaborates on the advantages and disadvantages of each tool, compares and analyzes the specific assessment tools, and proposes the shortcomings of the specific assessment tools and future research directions. The aim is to provide a reference for selecting and developing suitable assessment tools for the quality of life of patients after laparoscopic sleeve gastrectomy in China.

With the application of accelerated rehabilitation surgery mode in metabolic bariatric surgery, the postoperative hospital stay of patients is gradually shortened, but it also leads to the lack of postoperative knowledge of patients after discharge. Adequate guidance on discharge readiness is beneficial for improving the self-management ability of patients and improving dietary, medication and exercise compliance. This paper reviews the status quo, assessment tools, influencing factors and intervention measures of discharge readiness of patients undergoing metabolic bariatric surgery, in order to provide references and ideas for developing discharge readiness evaluation tools and related studies for patients undergoing metabolic bariatric surgery in China.