Gouty arthritis （GA） is an inflammatory disorder caused by monosodium urate （MSU） crystal deposition， accompanied by elevated oxidative stress and aberrant release of inflammatory cytokines， resulting in joint tissue damage and intense pain. Nuclear factor E₂-related factor 2 （Nrf2）， a key transcription factor regulating the antioxidant defence system， exerts cytoprotective effects through dissociation from Kelch-like ECH-associated protein 1 （Keap1） and activates downstream antioxidant response element （ARE）-mediated pathways. It can upregulate the expression of heme oxygenase-1 （HO-1）， NADH quinone oxidoreductase 1 （NQO1）， superoxide dismutase （SOD）， and glutathione transferase （GST） to preserve redox homeostasis. Moreover， Nrf2 can suppress activation of NOD-like receptor protein 3 （NLRP3） inflammasomes， reduce pro-inflammatory cytokine production and release， modulate nuclear factor-κB （NF-κB） transcriptional activity， regulate gut microbiota balance， enhance mitophagy， and inhibit apoptosis， so as to reduce joint inflammation and pain and promote body recovery. This review systematically examined recent advancements in traditional Chinese medicine （TCM） for GA prevention and treatment via regulating the Nrf2 signaling pathway. It delineated Nrf2's molecular mechanisms and its role in GA pathogenesis and elucidated how TCM intervenes in multiple pathways including Keap1/Nrf2/ARE， Nrf2/HO-1（NQO1）， and Nrf2/NF-κB/NLRP3 to exert therapeutic effects. The study demonstrated that TCM monomers and compounds effectively counteract oxidative damage， attenuate inflammatory responses， promote autophagy， and inhibit apoptosis via regulating the Nrf2 signaling pathway. These findings not only clarify the scientific basis of TCM in GA treatment but also offer strategic insights for developing novel Nrf2-targeted anti-gout drugs.

Objective:To analyze the efficacy of arthroscopic release of the lateral patellofemoral retinaculum (LPR) combined with medial patellofemoral ligament (MPFL) compression for the treatment of moderate to severe patellofemoral arthritis.Methods:A prospective study method was used to select 101 patients with moderate to severe patellofemoral arthritis who were admitted to the Jinzhou Medical University Shanghai Fengxian District Central Hospital from January 2021 to December 2023. They were randomly divided into group A (50 cases, LPR release surgery under knee arthroscopy) and group B (51 cases, LPR release surgery combined with MPFL compression surgery under knee arthroscopy). Perioperative indexes, pain degree of patellofemoral joint, patellofemoral trajectory correction, knee joint function and patellofemoral joint function were compared between the two groups before and 6 months after surgery.Results:During the study period, both group A and group B were excluded or separated, and ultimately 47 and 49 patients were enrolled in group A and group B, respectively. The operation time of group B was longer than that of group A: (35.27 ± 3.09) min vs. (25.64 ± 2.66) min, with statistically significant differences ( P<0.05). Six months after surgery, both groups experienced a reduction in pain, with group B being milder than group A: no pain 75.51% (37/49) vs. 44.68% (21/47), mild pain 24.49% (12/49) vs. 38.30% (18/47), moderate pain 0 vs. 14.89% (7/47), and severe pain 0 vs. 2.13% (1/47). The difference was statistically significant ( P<0.05). Six months after surgery, the patellofemoral adaptation angle, patellofemoral tilt angle, and patellofemoral lateral displacement distance in both groups decreased, and group B was smaller than group A: (8.02 ± 1.62)° vs. (10.35 ± 1.54)°, (8.71 ± 1.08)° vs. (10.85 ± 0.75)°, 1.00 (1.00, 1.00) mm vs. 1.00 (1.00, 1.00) mm, with statistically significant differences ( P<0.05). Both groups showed an increase in Lysholm knee score scale and patellar Kujala score, with group B being higher than group A: (89.92 ± 4.02) points vs. (84.21 ± 5.65) points and (89.18 ± 2.57) points vs. (87.40 ± 3.38) points, with statistically significant differences ( P<0.05). Conclusions:Arthroscopic release of LPR combined with MPFL compression surgery is more effective in treating moderate to severe patellofemoral arthritis than arthroscopic release of LPR. It can improve the correction of patellofemoral trajectory, reduce pain, and facilitate the recovery of knee and patellar joint function.

Objective:To analyze the efficacy of arthroscopic release of the lateral patellofemoral retinaculum (LPR) combined with medial patellofemoral ligament (MPFL) compression for the treatment of moderate to severe patellofemoral arthritis.Methods:A prospective study method was used to select 101 patients with moderate to severe patellofemoral arthritis who were admitted to the Jinzhou Medical University Shanghai Fengxian District Central Hospital from January 2021 to December 2023. They were randomly divided into group A (50 cases, LPR release surgery under knee arthroscopy) and group B (51 cases, LPR release surgery combined with MPFL compression surgery under knee arthroscopy). Perioperative indexes, pain degree of patellofemoral joint, patellofemoral trajectory correction, knee joint function and patellofemoral joint function were compared between the two groups before and 6 months after surgery.Results:During the study period, both group A and group B were excluded or separated, and ultimately 47 and 49 patients were enrolled in group A and group B, respectively. The operation time of group B was longer than that of group A: (35.27 ± 3.09) min vs. (25.64 ± 2.66) min, with statistically significant differences ( P<0.05). Six months after surgery, both groups experienced a reduction in pain, with group B being milder than group A: no pain 75.51% (37/49) vs. 44.68% (21/47), mild pain 24.49% (12/49) vs. 38.30% (18/47), moderate pain 0 vs. 14.89% (7/47), and severe pain 0 vs. 2.13% (1/47). The difference was statistically significant ( P<0.05). Six months after surgery, the patellofemoral adaptation angle, patellofemoral tilt angle, and patellofemoral lateral displacement distance in both groups decreased, and group B was smaller than group A: (8.02 ± 1.62)° vs. (10.35 ± 1.54)°, (8.71 ± 1.08)° vs. (10.85 ± 0.75)°, 1.00 (1.00, 1.00) mm vs. 1.00 (1.00, 1.00) mm, with statistically significant differences ( P<0.05). Both groups showed an increase in Lysholm knee score scale and patellar Kujala score, with group B being higher than group A: (89.92 ± 4.02) points vs. (84.21 ± 5.65) points and (89.18 ± 2.57) points vs. (87.40 ± 3.38) points, with statistically significant differences ( P<0.05). Conclusions:Arthroscopic release of LPR combined with MPFL compression surgery is more effective in treating moderate to severe patellofemoral arthritis than arthroscopic release of LPR. It can improve the correction of patellofemoral trajectory, reduce pain, and facilitate the recovery of knee and patellar joint function.

Objective:To evaluate the inflammatory factors effects of early endoscopic therapy for elderly patients with acute biliary pancreatitis (ABP) and its clinical efficacys.Methods:206 elderly patients with ABP admitted from Jan. 2010 to Dec. 2019 were divided into observation group (102 cases) and the control group (104 cases) according to treatment method. The observation group received endoscopic retrograde cholangiopancreatography (ERCP) , endoscopic sphincterotomy (EST) and endoscopic naso-biliary drainage (ENBD) , while the control group received conventional treatment. Clinical symptoms, changes of inflammatory factors, complications and prognosis were observed in each group.Results:CRP, SAA, IL-6, IL-8 and TNF-a after treatment were significantly lowered than those before treatment ( P<0.05) . In addition, the levels of CRP, SAA, IL-6, IL-8 and TNF-a in the observation group were significantly lower than those in the control group ( P<0.05) . The time to abdominal pain extinction, time to fever cessation, hospital stay in observation group were (3.92±1.54) , (3.63±1.41) , and (14.35±2.46) d, significantly less than those in the control group [ (5.81±1.72) , (5.45±2.13) , (19.37±3.12) d, P<0.05]. APACHE Ⅱ score of the observation group was (10.02±2.67) point after treatment, significantly lower than that in the control group [ (12.35±3.62) point, t=4.42, P<0.05]. The incidence of complications in the observation group was 10.78% after treatment, significantly lower than that in the control group [ (24.03%) , χ2=6.27, P< 0.05]. The mortality in the observation group was 1.96%, lower than 4.81% in the control group, with no statistical significance. Conclusion:Early endoscopic therapy is safe and highly effective for elderly patients with ABP, with the advantages of shorter hospital stay, quicker subsided inflammation, and lower incidence of complications.

Objective:To investigate the clinical features of children’s acute facial trauma, and to explore the clinical effects of plastic surgery in the repair of children’s acute facial trauma.Methods:The clinical data of children with acute facial trauma who were admitted to Children’s Hospital Affiliated to Zhejiang University School of Medicine from June 2017 to June 2018 were retrospectively analyzed. All children received plastic surgery treatment, and were followed up at 3, 6 and 12 months after operation. Scar cosmesis assessment and rating (SCAR) was used to evaluate the scar condition, and the parents’ satisfaction with scar was investigated. The clinical characteristics of acute facial trauma in children were analyzed. Graphpad prism 8.0.0 was used for statistical analysis, one-way ANOVA was used for comparison between groups, LSD- t test was used for pairwise comparison between groups, multivariate regression analysis was used to explore the main factors affecting parents’satisfaction with scar. P<0.05 showed that the difference was statistically significant. Results:A total of 338 children (364 wounds) with acute facial trauma were included, consisting of 223 males and 115 females, aged from 1 to 14 years, with an average of 4.5 years. All wounds were successfully repaired by plastic surgery. The SCAR scores at 3 months, 6 months and 12 months after operation were 2.9±1.0, 1.9±0.7 and 1.8±0.8 respectively, showing significant difference among there groups( P< 0.01). The SCAR score at 3 months after operation was significantly different from that at 6 and 12 months after operation ( P<0.01). There was no significant difference in SCAR score between 6 months and 12 months after operation ( P>0.05). The parents’ satisfaction scores at 3, 6 and 12 months after operation were 7.4±0.7, 7.9±0.7 and 8.2±0.8 respectively, showing significant difference among there groups( P<0.01). The parents’ satisfaction score at 12 months after operation was significantly different from that at 3 and 6 months after operation ( P<0.01). There was no significant difference in parents’satisfaction score between 3 months and 6 months after operation ( P>0.05). Multivariate regression analysis showed that whether there were multiple wound affected areas and scar width were the main factors influencing patients’ satisfaction with scar. Conclusions:Acute facial trauma in children is mostly caused by blunt trauma, and it is common in the forehead. According to the characteristics of the wound, using plastic surgery technique to repair children’s acute facial trauma can achieve the best wound healing and improve the prognosis of scar. It is expected to further improve the patient’satisfaction.

Objective:To investigate the clinical features of children’s acute facial trauma, and to explore the clinical effects of plastic surgery in the repair of children’s acute facial trauma.Methods:The clinical data of children with acute facial trauma who were admitted to Children’s Hospital Affiliated to Zhejiang University School of Medicine from June 2017 to June 2018 were retrospectively analyzed. All children received plastic surgery treatment, and were followed up at 3, 6 and 12 months after operation. Scar cosmesis assessment and rating (SCAR) was used to evaluate the scar condition, and the parents’ satisfaction with scar was investigated. The clinical characteristics of acute facial trauma in children were analyzed. Graphpad prism 8.0.0 was used for statistical analysis, one-way ANOVA was used for comparison between groups, LSD- t test was used for pairwise comparison between groups, multivariate regression analysis was used to explore the main factors affecting parents’satisfaction with scar. P<0.05 showed that the difference was statistically significant. Results:A total of 338 children (364 wounds) with acute facial trauma were included, consisting of 223 males and 115 females, aged from 1 to 14 years, with an average of 4.5 years. All wounds were successfully repaired by plastic surgery. The SCAR scores at 3 months, 6 months and 12 months after operation were 2.9±1.0, 1.9±0.7 and 1.8±0.8 respectively, showing significant difference among there groups( P< 0.01). The SCAR score at 3 months after operation was significantly different from that at 6 and 12 months after operation ( P<0.01). There was no significant difference in SCAR score between 6 months and 12 months after operation ( P>0.05). The parents’ satisfaction scores at 3, 6 and 12 months after operation were 7.4±0.7, 7.9±0.7 and 8.2±0.8 respectively, showing significant difference among there groups( P<0.01). The parents’ satisfaction score at 12 months after operation was significantly different from that at 3 and 6 months after operation ( P<0.01). There was no significant difference in parents’satisfaction score between 3 months and 6 months after operation ( P>0.05). Multivariate regression analysis showed that whether there were multiple wound affected areas and scar width were the main factors influencing patients’ satisfaction with scar. Conclusions:Acute facial trauma in children is mostly caused by blunt trauma, and it is common in the forehead. According to the characteristics of the wound, using plastic surgery technique to repair children’s acute facial trauma can achieve the best wound healing and improve the prognosis of scar. It is expected to further improve the patient’satisfaction.

Objective:To investigate the clinical effect of hyperbaric oxygen (HBO) combined with platelet-rich plasma (PRP) in the reconstruction of anterior cruciate ligament injury (ACLI).Methods:A total of 100 ACLI patients who were treated in the Department of Joint Trauma Surgery of Qingdao Jiaozhou Central Hospital from January 2018 to May 2019 were randomly divided into two groups according to the random number table: observation group and control group. Each group had 50 cases. The patients in the control group were only treated with PRP, while the patients in the observation group were treated with hyperbaric oxygen combined with PRP. Then the curative effect of the two groups, Lysholm, Tegner, and IDKC scores of knee joint, serum insulin-like growth factor-1 (IGF-1), bone gla protein (BGP), and matrix metalloproteinase-1 (MMP-1) were observed after 3 consecutive courses of treatment.Results:After 3 consecutive courses of treatment, the total effective rate of the observation group (90.0%) was significantly higher than that of the control group (68.0%) ( P<0.05); the difference was statistically significant. The scores of Lysholm, Tegner, and IDKC of the knee joint in the observation group and the control group were significantly higher than those before treatment, and the scores of Lysholm, Tegner, and IDKC of the knee joint in the observation group were significantly higher than those in the control group ( P<0.05). The contents of IGF-1, BGP, and MMP-1 in the two groups were significantly lower than those before treatment, and those contents of observation group were significantly lower than those of the control group ( P<0.05). Conclusion:HBO combined with platelet-rich plasma can effectively improve the therapeutic effect of ACLI reconstruction, improve the serum contents of IGF-1, BGP, and MMP-1. This treatment, therefore, is worthy of popularization and application in clinic.

Objective:To investigate the clinical effect of hyperbaric oxygen (HBO) combined with platelet-rich plasma (PRP) in the reconstruction of anterior cruciate ligament injury (ACLI).Methods:A total of 100 ACLI patients who were treated in the Department of Joint Trauma Surgery of Qingdao Jiaozhou Central Hospital from January 2018 to May 2019 were randomly divided into two groups according to the random number table: observation group and control group. Each group had 50 cases. The patients in the control group were only treated with PRP, while the patients in the observation group were treated with hyperbaric oxygen combined with PRP. Then the curative effect of the two groups, Lysholm, Tegner, and IDKC scores of knee joint, serum insulin-like growth factor-1 (IGF-1), bone gla protein (BGP), and matrix metalloproteinase-1 (MMP-1) were observed after 3 consecutive courses of treatment.Results:After 3 consecutive courses of treatment, the total effective rate of the observation group (90.0%) was significantly higher than that of the control group (68.0%) ( P<0.05); the difference was statistically significant. The scores of Lysholm, Tegner, and IDKC of the knee joint in the observation group and the control group were significantly higher than those before treatment, and the scores of Lysholm, Tegner, and IDKC of the knee joint in the observation group were significantly higher than those in the control group ( P<0.05). The contents of IGF-1, BGP, and MMP-1 in the two groups were significantly lower than those before treatment, and those contents of observation group were significantly lower than those of the control group ( P<0.05). Conclusion:HBO combined with platelet-rich plasma can effectively improve the therapeutic effect of ACLI reconstruction, improve the serum contents of IGF-1, BGP, and MMP-1. This treatment, therefore, is worthy of popularization and application in clinic.

Objective To investigate the relationship between the expression of ASPP2 mRNA and the methylation of ASPP2 gene in gastric cancer cells,to observe the inhibitory effect of 5-Aza-CdR on the growth of gastric cancer cells,to observe the effect of demethylation on the expression of ASPP2 mRNA and the methylation of ASPP2 gene in gastric cancer cells,and to explore the molecular mechanism of gastric cancer.Methods Real-time PCR was used to detect the expression of ASPP2 mRNA in two gastric cancer cells and normal gastric epithelial cells.BSP was used to detect the methylation of ASPP2 gene in two gastric cancer cells and normal gastric epithelial cells.CCK-8 was used to detect the growth inhibition rate of gastric cancer cells treated with 5-Aza-CdR of different concentrations,then they were used to detect expression of ASPP2 mRNA and the methylation of ASPP2 gene in gastric cancer cells again after the demethylation.Results ① The expression of ASPP2 mRNA in MKN-45 cells was significantly lower than that in GES-1 cells(P＜0.01).The expression of ASPP2 mRNA in MGC-803 cells was significantly lower than that in GES-1 cells (P＜0.01).There was no significant difference in MGC-803 cells and MKN-45 cells(P＞0.05).② The methylation rate of ASPP2 in MKN-45 cells was significantly higher than that in GES-1 cells (P＜0.01).The methylation rate of ASPP2 in MGC-803 cells was not significantly different from that in GES-1 cells (P＞0.05).The methylation rate of ASPP2 in MKN-45 cells was significantly higher than that in MGC-803 cells (P＜0.01).③ At the same time,the growth inhibition rate of each 5-Aza-CdR concentration group increased as the drug concentration depended.4.The expression of ASPP2 mRNA in MKN-45 cells was significantly higher than that before treatment (P＜0.01),the expression of ASPP2 mRNA in MGC-803 cells was not significantly different from that before treatment(P＞0.05).The methylation rate of ASPP2 in MKN-45 cells was significantly lower than that before treatment (P＜0.01).The methylation rate of ASPP2 in MGC-803 cells was not significantly different from that before treatment (P＞0.05).Conclusion ① Abnormal hypermethylation of ASPP2 gene in MKN-45 cells may be a molecular mechanism of decreased ASPP2 mRNA expression.② 5-Aza-CdR can inhibit the growth of MKN-45 and MGC-803 cells,and it can enhance the expression of ASPP2 mRNA in MKN-45 cells.Reversal of methylation in the promoter region of ASPP2 gene is the possible mechanism.③ Abnormal hypermethylation of the promoter region of ASPP2 gene may lead to silencing of mRNA expression that may be associated with gastric cancer.

OBJECTIVE: To improve the method of vermillion flap and orbicularis oris bundle anastomosis in repair of transverse facial cleft. METHODS: Based on the precise fixed point, the modified vermillion flap was designed slender at the new corner of the upper lip, and was inserted into the lower lip after removing part tissue. The orbicularis oris was divided into two bands and cross-stitched. RESULTS: Fifteen patients with unilateral transverse facial cleft form the Children's Hospital of Zhejiang University during September 2016 and December 2018 were operated, and the position and shape of the commissure were almost normal. CONCLUSIONS The cosmetic effect and oral function are satisfactory when the modified vermillion flap and bundle anastomosis of orbicularis oris is used to repair transverse facial cleft.
Anastomosis, Surgical ; Child ; Cleft Lip ; surgery ; Facial Muscles ; surgery ; Humans ; Lip ; surgery ; Surgical Flaps ; surgery ; Treatment Outcome