OBJECTIVE: To investigate the regulatory effect of electroacupuncture (EA) at "Neiguan" (PC6) on mitochondrial autophagy in rats with myocardial ischemia-reperfusion injury (MIRI) at different phases (ischemia and reperfusion phases), and to explore the bidirectional regulatory effects of EA at "Neiguan" (PC6) and its potential mechanism. METHODS: Forty-five male SD rats were randomly divided into 6 groups according to the random number table method, namely, sham-operation group (n=9), model-A group (n=6), model-B group (n=9), EA-A1 group (n=6), EA-B1 group (n=6), and EA-B2 group (n=9). Except the rats in the sham-operation group, the MIRI model was established in the other groups with the physical ligation and tube pushing method. In the model-A group, the samples were collected directly after ligation, and in the model-B group, the samples were collected after ligation and reperfusion. In the EA-A1 group, EA was delivered while the ligation was performed, and afterwards, the samples were collected. In the EA-B1 group, while the ligation was performed, EA was operated at the same time, and after reperfusion, the samples were collected. In the EA-B2 group, during ligation and the opening of the left anterior descending branch of the coronary artery, EA was delivered, and after reperfusion, the samples were collected. EA was performed at bilateral "Neiguan" (PC6), with a disperse-dense wave, a frequency of 2 Hz/100 Hz, a current of 1 mA, and a duration of 30 min. HE staining was employed to observe the morphology of cardiomyocytes, TUNEL was adopted to detect the apoptosis of cardiomyocytes, transcriptome sequencing was to detect the differentially expressed genes in the left ventricle, JC-1 flow cytometry was to detect the mitochondrial membrane potential (MMP) of cardiomyocytes, Western blot was to detect the protein expression of phosphatase and tensin homolog-induced kinase 1 (Pink1), Parkin and p62 in the left ventricle of rats, and ELISA was to detect the levels of serum creatine kinase isoenzyme (CK-MB) and cardiac troponin I (cTn-I) in the rats. RESULTS: Compared with the sham-operation group, the cardiomyocytes of rats in the model-B group were severely damaged, with disordered arrangement, unclear boundaries, broken muscle fibers, edema and loose distribution; and the cardiomyocytes in the EA-B2 group were slightly damaged, the cell structure was partially unclear, the cells were arranged more regularly, and the intact cardiomyocytes were visible. Compared with the sham-operation group, the apoptosis of cardiomyocytes increased in the model-B group (P<0.001); and when compared with the model-B group, the apoptosis alleviated in the EA-B2 group (P<0.001). The differentially expressed genes among the EA-B2 group, the sham-operation group and the model-B group were closely related to cell autophagy and mitochondrial autophagy. Compared with the sham-operation group, MMP of cardiomyocytes was reduced (P<0.001), the protein expression of Pink1, Parkin, and p62 of the left ventricle and the levels of serum CK-MB and cTn-I were elevated in the model B group (P<0.001). In comparison with model-A group, the MMP of cardiomyocytes and the levels of serum CK-MB and cTn-I were reduced (P<0.001, P<0.05), and the protein expression of Pink1 in the left ventricle rose in the EA-A1 group (P<0.01). Compared with the model-B group, MMP of cardiomyocytes increased (P<0.001), the protein expression of Pink1, Parkin, and p62 of the left ventricle, and the levels of serum CK-MB and cTn-I decreased (P<0.001) in the EA-B1 group and the EA-B2 group. When compared with the EA-A1 group, MMP of cardiomyocytes increased (P<0.001), and the protein expression of Pink1, Parkin, and p62 of the left ventricle, and the levels of serum CK-MB and cTn-I decreased in the EA-B1 group (P<0.01). CONCLUSION EA at "Neiguan" (PC6) can ameliorate MIRI in rats, which may be achieved through the Pink1/Parkin-mediated mitochondrial autophagy pathway. EA can alleviate myocardial injury by enhancing mitochondrial autophagy at the ischemia phase, and it can reduce reperfusion injury by weakening mitochondrial autophagy at the reperfusion phase.
Animals ; Electroacupuncture ; Male ; Myocardial Reperfusion Injury/metabolism* ; Rats, Sprague-Dawley ; Rats ; Acupuncture Points ; Autophagy ; Humans ; Mitochondria/genetics*

Objective:To compare the clinical application of the anterolateral thigh perforator flap (ALTPF) and the calf pedicled propeller perforator flap (PPPF) in reconstruction of soft tissue defect of foot and ankle.Methods:A retrospective observational study was conducted. From March 2013 to June 2019, 48 patients with soft tissue defect around ankle and in foot were reconstructed with ALTPF and PPPF in the Department of Orthopaedics, 920th Hospital of the Joint Logistic Support Force, People's Liberation Army of China. According to the types of flap, the patients were divided into 2 groups: ALTPF group (21 patients,13 males and 8 females, aged 16-67 years, mean 38.71 years±15.30 years. Donor sites were all directly sutured.) and PPPF group (27 patients, 12 males and 15 females, aged 12-69 years, mean 35.18 years±13.96 years. Five cases in the donor site required partial skin grafting, and the rest 22 cases were repaired by directly suture.). The wound size of the former was 5 cm×6 cm-15 cm×18 cm, and at 2 cm×3 cm-14 cm×17 cm for the latter. The surgical time and flap size of the 2 groups were recorded during the surgery. The survival and complications of the flap were observed, and the days of hospital stay were recorded after surgery. Follow-ups were conducted by outpatient clinic and via telephone and WeChat interviews. The colour, texture, appearance, donor scar, complications and thinning of the flap were observed during the follow-up. The ankle function was evaluated according to the score of American Orthopaedic Foot and Ankle Society (AOFAS), and the donor scar was evaluated according to the score of Vancouver Scar Scale (VSS). SPSS 22.0 statistical software was used for data analysis, and P<0.05 was considered statistically significant. Results:The surgical time for the ALTPF group was 118-203 (154.71±25.42) min, and that for the PPPF group was 52-92 (72.78±10.04) min. The size of the flap in the ALTPF group was 5 cm×8 cm-8 cm×18 cm (75.00 cm 2±8.69 cm 2), while it was 3 cm×7 cm-7 cm×17 cm (53.56 cm 2±19.49 cm 2) in the PPPF group. In the ALTPF group, 3 flaps had vascular complications within 24 hours after surgery, which survived after exploration and thrombectomy. Partial necrosis occurred in 1 flap. The rest 17 flaps survived uneventfully. In the PPPF group, 2 flaps had partial necrosis due to infection and they healed after dressing changes, 3 flaps had venous occlusion and survived after phlebotomy, partial suture removal and massage. The rest 22 flaps in 2 groups survived uneventfully. The postoperative days of hospital stay for the ALTPF group was 6-14 (8.71±2.03) days, and that was 4-12 (6.03±2.16) days in the PPPF group. Flap thinning was performed on 19 flaps in the ALTPF group and 2 in the PPPF group. Follow-up was performed for 7 to 21 months. All the flaps were good in colour, shape and texture. All donor sites healed well. At the final follow-up, 19 patients achieved ankle function of excellent, 1 of good and 1 of fair in the ALTPF group, and 21 patients achieved ankle function of excellent, 4 of good and 2 of fair in the PPPF group, according to the AOFAS. According to the VSS, scores of donor site scar was rated 4-8 (6.33±1.35) points for the ALTPF group, and 3-10 (5.92±1.80) points for the PPPF group. Statistical analysis showed no significant differences between the 2 groups in terms of early postoperative complications, flap survival rate, ankle function, and VSS scores ( P>0.05). However, there were statistically significant differences between the 2 groups in terms of surgical time, hospital stay, flap size, and the number of flap thinning ( P<0.05). Conclusion:Both ALTPF and PPPF have good clinical effects in reconstruction of soft tissue defect of foot and ankle. For small to medium-sized wounds, PPPF is the preferred choice due to the advantages in surgical time and postoperative hospital stay. For larger wounds, the ALTPF is the first choice with multiple surgery.

Objective:To compare the clinical application of the anterolateral thigh perforator flap (ALTPF) and the calf pedicled propeller perforator flap (PPPF) in reconstruction of soft tissue defect of foot and ankle.Methods:A retrospective observational study was conducted. From March 2013 to June 2019, 48 patients with soft tissue defect around ankle and in foot were reconstructed with ALTPF and PPPF in the Department of Orthopaedics, 920th Hospital of the Joint Logistic Support Force, People's Liberation Army of China. According to the types of flap, the patients were divided into 2 groups: ALTPF group (21 patients,13 males and 8 females, aged 16-67 years, mean 38.71 years±15.30 years. Donor sites were all directly sutured.) and PPPF group (27 patients, 12 males and 15 females, aged 12-69 years, mean 35.18 years±13.96 years. Five cases in the donor site required partial skin grafting, and the rest 22 cases were repaired by directly suture.). The wound size of the former was 5 cm×6 cm-15 cm×18 cm, and at 2 cm×3 cm-14 cm×17 cm for the latter. The surgical time and flap size of the 2 groups were recorded during the surgery. The survival and complications of the flap were observed, and the days of hospital stay were recorded after surgery. Follow-ups were conducted by outpatient clinic and via telephone and WeChat interviews. The colour, texture, appearance, donor scar, complications and thinning of the flap were observed during the follow-up. The ankle function was evaluated according to the score of American Orthopaedic Foot and Ankle Society (AOFAS), and the donor scar was evaluated according to the score of Vancouver Scar Scale (VSS). SPSS 22.0 statistical software was used for data analysis, and P<0.05 was considered statistically significant. Results:The surgical time for the ALTPF group was 118-203 (154.71±25.42) min, and that for the PPPF group was 52-92 (72.78±10.04) min. The size of the flap in the ALTPF group was 5 cm×8 cm-8 cm×18 cm (75.00 cm 2±8.69 cm 2), while it was 3 cm×7 cm-7 cm×17 cm (53.56 cm 2±19.49 cm 2) in the PPPF group. In the ALTPF group, 3 flaps had vascular complications within 24 hours after surgery, which survived after exploration and thrombectomy. Partial necrosis occurred in 1 flap. The rest 17 flaps survived uneventfully. In the PPPF group, 2 flaps had partial necrosis due to infection and they healed after dressing changes, 3 flaps had venous occlusion and survived after phlebotomy, partial suture removal and massage. The rest 22 flaps in 2 groups survived uneventfully. The postoperative days of hospital stay for the ALTPF group was 6-14 (8.71±2.03) days, and that was 4-12 (6.03±2.16) days in the PPPF group. Flap thinning was performed on 19 flaps in the ALTPF group and 2 in the PPPF group. Follow-up was performed for 7 to 21 months. All the flaps were good in colour, shape and texture. All donor sites healed well. At the final follow-up, 19 patients achieved ankle function of excellent, 1 of good and 1 of fair in the ALTPF group, and 21 patients achieved ankle function of excellent, 4 of good and 2 of fair in the PPPF group, according to the AOFAS. According to the VSS, scores of donor site scar was rated 4-8 (6.33±1.35) points for the ALTPF group, and 3-10 (5.92±1.80) points for the PPPF group. Statistical analysis showed no significant differences between the 2 groups in terms of early postoperative complications, flap survival rate, ankle function, and VSS scores ( P>0.05). However, there were statistically significant differences between the 2 groups in terms of surgical time, hospital stay, flap size, and the number of flap thinning ( P<0.05). Conclusion:Both ALTPF and PPPF have good clinical effects in reconstruction of soft tissue defect of foot and ankle. For small to medium-sized wounds, PPPF is the preferred choice due to the advantages in surgical time and postoperative hospital stay. For larger wounds, the ALTPF is the first choice with multiple surgery.

[This corrects the article DOI: 10.1016/j.apsb.2021.12.005.].

Objective To investigate the role of human umbilical cord mesenchymal stem cell-derived extracellular vesicle (hUC-MSC-EV) in the regeneration of fibrotic liver. Methods C57BL/6 mice were randomly divided into the 70% normal liver resection group (Oil+PHx group), 70% liver fibrosis resection group (CCl₄+PHx group) and 70% liver fibrosis resection+mesenchymal stem cell-derived extracellular vesicle (MSC-EV) treatment group (CCl₄+PHx+MSC-EV group), with 8 mice in each group. LX-2 cell lines were assigned into the phosphate buffer solution (PBS) group, transforming growth factor (TGF)-β group and TGF-β+MSC-EV group. The serum levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST) and lactate dehydrogenase (LDH) in mice after partial liver resection were detected in each group. The expression levels of liver fibrosis and proliferation-related parameters were analyzed in each group. The messenger RNA (mRNA) expression levels of epidermal growth factor (EGF), fibroblast growth factor (FGF), vascular endothelial growth factor (VEGF) and hepatocyte growth factor (HGF) in LX-2 cells were detected in each group, and their effects on HGF expression in mouse liver were observed. Results Compared with the Oil+PHx group, the serum levels of AST, ALT and LDH were up-regulated, and the degree of fibrosis was more severe, the positive area of Sirius red and α-smooth muscle actin (α-SMA) staining was larger, and the expression level of α-SMA protein was up-regulated in the CCl₄+PHx group. Compared with the CCl₄+PHx group, the serum levels of AST, ALT and LDH were decreased, the degree of fibrosis was slighter, the positive area of Sirius red and α-SMA staining was decreased, and the expression level of α-SMA protein was down-regulated in the CCl₄+PHx+MSC-EV group, and the differences were statistically significant (all P < 0.05). Compared with the Oil+PHx group, the protein expression levels of Ki67 and proliferating cell nuclear antigen (PCNA) were lower in the CCl₄+PHx group. Compared with the CCl₄+PHx group, the protein expression levels of Ki67 and PCNA were increased in the CCl₄+PHx+MSC-EV group, and the differences were statistically significant (all P < 0.05). Compared with the PBS group, the expression level of CollagenⅠ mRNA in LX-2 cells was increased, the expression level of α-SMA protein was up-regulated and the expression level of HGF protein was decreased in the TGF-β group. Compared with the TGF-β group, the expression level of CollagenⅠ mRNA in LX-2 cells was decreased, the expression levels of HGF mRNA and protein were increased, and the expression level of α-SMA protein was decreased in the TGF-β+MSC-EV group, the differences were statistically significant (all P < 0.05). The expression level of HGF protein in the CCl₄+PHx group was lower than that in the Oil+PHx group, whereas the difference was not statistically significant (P > 0.05). The expression level of HGF protein in the CCl₄+PHx+MSC-EV group was higher than that in the CCl₄+PHx group, and the difference was statistically significant (P < 0.05). Conclusions The regenerative capacity of fibrotic liver is weaker than that of normal liver. hUC-MSC-EV may alleviate liver fibrosis and improve liver regeneration by promoting HGF secretion from actived hepatic stellate cells and effectively enhancing the regenerative capacity of fibrotic liver.

Head and neck squamous cell carcinoma (HNSCC) is one of the most common human cancers; however, its outcome of pharmacotherapy is always very limited. Herein, we performed a batch query in the connectivity map (cMap) based on bioinformatics, queried out 35 compounds with therapeutic potential, and screened out parbendazole as a most promising compound, which had an excellent inhibitory effect on the proliferation of HNSCC cell lines. In addition, tubulin was identified as a primary target of parbendazole, and the direct binding between them was further verified. Parbendazole was further proved as an effective tubulin polymerization inhibitor, which can block the cell cycle, cause apoptosis and prevent cell migration, and it exhibited reasonable therapeutic effect and low toxicity in the in vivo and in vitro anti-tumor evaluation. Our study repositioned an anthelmintic parbendazole to treat HNSCC, which revealed a therapeutic utility and provided a new treatment option for human cancers.

Objective To investigate the effects of enhanced recovery after surgery (ERAS) combined with laparoscopic common bile duct exploration (LCBDE) in elderly patients with choledocholithiasis.Methods From Jan 2015 to Dec 2016,in the control group 40 patients received conventional perioperative management and 40 patients in the ERAS group followed the ERAS protocol.The operative details and outcomes were compared in the two groups.Results No perioperative death occurred during the study period.There was no statistically significant difference between the two groups in operative time and intraoperative blood loss (t =1.04,0.88,P ＞0.05).Patients in ERAS group showed significantl shorter time of gastrointestinal tract peristalsis,off-bed,postoperative infusion,food intake,and abdominal drainage tube removal,as well as reduced weight loss,length of hospital stay and total cost than those in the control group (P ＜ 0.05).There were no significant difference of preoperative CRP and PCT,IL-6 in the 2 groups (t =1.18,0.44,1.49,P ＞ 0.05),However,the CRP and PCT,IL-6 levels in ERAS group were significantly lower than those in control group at postoperative days 1,4,7 (P ＜ 0.05).Furthermore,postoperative complications developed in 3 (7.5％),and 12 (30.0％) respectively (x2 =6.47,P ＜ 0.05).Conclusions Minimally invasive surgery combined with ERAS is safe and cost-effective approach for elderly patients of choledocholithiasis.

Objective To observe the effect ropivacaine mesylate combined with sufentanil on walking epidural laboranalgesia.Methods 360 puerperae who accepted 0.12％ ropivacaine mesylate combined with sufentanil (0.5 μg/ml) epidural analgesia were analgesic group;at the same time and under the similar conditions,the 356 cases of puerprtae unused analgesic were control group.With visual analogue scale(VAS) assessing the uterine contraction pain and improved Bromage scale assessing lower limb movement block,recording the analgesic effect,every labor time,delivery mode,and the condition of postpartum hemorrhage,fetal distress and neonatal Apgar score in every group.Results Labor pain of pain group significant relief,the active period shorten and the vaginal eutocia percentage were higher than those in the control group; Labor time of the secend and the third stage,vaginal birth rate and oxytocin utilization rate had no differences between the two groups.Conclusion The effect of epidural block labor analgesia on 0.12％ ropivacaine mesylate combined with sufentanil is obvious and security.There is no motor nerve block and do not affect the stage of labor and neonatal.It still can reduce the rate of cesarean section and improve maternal satisfaction.

AIM: To establish a method of simultaneously determining ginsenoside Rg1,ginsenoside Re and ginsenoside Rb1 in Tangniaole Granule (Radix Trichosanthis, Rhizoma Dioscoreae, Radix et Rhizoma Ginseng Rubra, Rhizoma Anemarrhenae, Radix Astragali, etc.). METHODS: Three components: ginsenoside Rg1, ginsenoside Re and ginsenoside Rb1 in Tangniaole Granule were determined simultaneously by HPLC, using a Diamonsil C_ 18 ( 4.6 mm?250 mm, 5 ?m), acetonitrile-water as a mobile phase. The detection wavelength was at 203 nm. RESULTS: The relationship among the concentrations and the peak areas of ginsenoside Rg1, ginsenoside Re and ginsenoside Rb1 were linear respectively. The RSD of precision, stability, repeatability and recovery were all less than 3%. CONCLUSION: The method is simultaneous determination for three components in Tangniaole Granule, and can be applied to the quality control of Tangniaole Granule.