Objective To investigate the anatomical and microscopic structures of interstitial fluid flow channels in the skin tissue of hand dorsum in human cadavers.Methods Totally 7 fresh cadavers within 12 hours post-mortem were included.MRI was used to observe the distribution of interstitial fluid flow from the first phalanx of the fingers to the wrist,precisely locating the flow channels.Based on imaging results,histological analyses were conducted to determine the histological characteristics of the flow channels.Furthermore,multi-immunofluorescence and microcomputed tomography(Micro-CT)techniques were employed to analyze the channels,and image post-processing was used to elucidate their anatomical structures at the microscopic level.Results After injecting a contrast agent into the first phalanx of ten finger specimens and applying repeated pressure,MRI image revealed centripetal long-range interstitial fluid flow along channels distinct from blood vessels and lymphatic vessels.Histological analysis and Micro-CT further confirmed that the flow primarily occurred within the fibrous connective tissue and adventitia of the skin.Conclusion The orderly fibrous connective tissue and adventitia in the skin form the interstitial fluid flow channels in the human hand dorsum skin,named as"stromal membrane channels"in the skin.

Objective To investigate the efficacy,safety and operation time of ultrasound-guided percutaneous polidocanol injection chemical ablation through 17 G coaxial needle for predominantly cystic thyroid nodules.Methods The clinical data of 176 patients with predominantly cystic thyroid nodules,who received ultrasound-guided percutaneous polidocanol injection chemical ablation at authors'hospital from January 2020 to June 2023,were retrospectively analyzed.Of the 176 patients,20 mL syringe needle was used in 96(control group)and 17 G coaxial needle was used in 80(study group).The clinical safety,efficacy,and operation time were compared between the two groups.Results After the chemical ablation therapy,the volume of thyroid nodules was obviously decreased in both groups,but the difference in the volume reduction ratio(VRR)between the two groups was not statistically significant(P＞0.05).The incidence of complications and the operation time in the study group were remarkably lower than those in the control group(both P＜0.05).Conclusion In treating predominantly cystic thyroid nodules with ultrasound-guided percutaneous polidocanol injection chemical ablation,the use of 17 G coaxial needle is superior to the use of 20 mL syringe needle in reducing the incidence of complications and in shortening the operation time,therefore,this technique is suitable for beginners to adopt.

Objective To explore the effective substances that specifically bind to RSV-F protein in the water extract of Forsythia suspensa,and verify its effect.Methods Surface plasmon resonance(SPR)affinity fishing technology was used to enrich,regenerate and recover the active components that specifically bind to RSV-F protein in the water extract of Forsythia suspensa.The recovered samples were analyzed and identified by UHPLC-MS/MS,and the active components that stably bind to F protein were screened by molecular docking,molecular dynamics simulation and SPR affinity detection,and then returned to animal experiments for pharmacodynamics verification.BALB/c mice were randomly divided into normal group,model group,positive control group,protocatechuic acid group and verbascoside group.In the experimental group,RSV was dripped into the nose to make models.Each drug group began to be given intragastric intervention on the day of modeling,and samples were taken after 4 days.HE staining was used to observe the pathological changes of lung tissue,and ELISA was used to detect the changes of inflammatory factors in lung tissue.Results A variety of active components in the aqueous extract of Forsythia suspensa could bind to RSV-F protein,among which the results of verbascoside and protocatechuic acid were more stable.In vivo pharmacodynamics experiments showed that the lung tissue of the model group had obvious pathological changes and the level of inflammatory factors increased,and the pathological state was improved after the intervention of verbascoside and protocatechuic acid compared with the normal group.Conclusion Forsythia suspensa can interfere with the expression of RSV-F protein through many active components such as verbascoside and protocatechuic acid,which may be the material basis of its anti-RSV.

The accumulation of uremic toxins such as urea nitrogen, blood creatinine, and uric acid of patients with renal failure in vivo would lead to aggravated kidney damage. In this study, coated aldehyde oxy-starch (CAO) was used as an adsorbent to investigate its in vitro adsorption performance on renal failure indexes for urea, indoxyl sulfate (INS), monomethylamine (MMA), dimethylamine (DMA), uric acid (UA), and creatinine (Cr). The effects of variables such as pH, temperature, concentration, dosage, and time on the adsorption capacity of CAO were systematically investigated, employing analytical techniques of high-performance liquid chromatography (HPLC) and gas chromatography (GC). The results revealed that CAO exhibited a strong adsorption capacity for urea, INS, and MMA, alongside a moderate adsorption capacity for DMA, UA, and Cr. The adsorption kinetics and thermodynamic studies indicated that the adsorption of urea and UA by CAO were fitted in pseudo-first-order kinetics, and the adsorption isotherm aligned with the Freundlich adsorption model. The enthalpy change ΔH of urea in adsorption was in the range of 40 to 60 kJ·mol^-1, which demonstrated the presence of strong adsorption force due to the interactions of coordinating groups. The ΔH of UA was greater than 80 kJ·mol^-1, indicating the generation of chemical bonds during the adsorption. Both of them, Gibbs free energy ΔG was less than 0, within the range of -20 to 0 kJ·mol^-1, suggested that the adsorption of urea and UA by CAO occurred spontaneously as physical adsorption process. The adsorption entropy ΔS of urea and UA was > 0, which indicated an increase in entropy throughout the adsorption. The infrared spectroscopygram showed the formation of a chemical bond, specifically the imine bond, following the adsorption of urea by CAO, thereby indicating a chemical reaction during the adsorption. This study elucidates the adsorption mechanism of CAO on various indexes of renal failure, providing a scientific basis for its clinical usage.

OBJECTIVE: To explore clinical efficacy of autologous platelet-rich plasma(PRP) in treating Rockwood type Ⅲ acromioclavicular dislocation. METHODS: From January 2019 to July 2021, 32 patients with Rockwood type Ⅲ acromioclavicular dislocation were treated with minimally invasive adjustable titanium plate internal fixation, and were divided into PRP group and control group according to whether PRP treatment was performed, with 16 patients in each group. In PRP group, there were 10 males and 6 females, aged from 28 to 47 years old with an average of (36.75±7.14) years old;the time from injury to surgery ranged from 1 to 31 h with an average of (26.13±3.98) h;5 patients on the left side and 11 patients on the right side;PRP was injected once during operation and the 4th and 8th weeks after operation respectively. In control group, there were 8 males and 8 females, aged from 30 to 52 years old with an average of (38.50±5.48) years old; the time from injury to surgery ranged from 1 to 29 h with an average of (25.48±3.11) h;7 patients on the left side and 9 patients on the right side; minimally invasive surgical treatment was performed. Visual analogue scale(VAS) was used to evaluate pain and Constant-Murley score for shoulder joint function was used to evaluate the recovery of shoulder joint movement function before operation and 1, 3, 6, and 12 months after operation respectively. RESULTS: All patients were followed up for 12 to 28 months with an average of (18.3±5.2) months. All incisions patients healed well without adverse events such as infection. Postoperative VAS of PRP group at 1, 3, and 6 months were (5.5±1.2), (3.7±1.6), and (2.4±1.2), respectively, while were lower than those of control group (6.6±1.4), (4.9±1.1), and (3.7±1.3), respectively;and had statistical differences between two groups (P<0.05). There was no statistically significant difference in VAS between two groups before operation and 12 months after operation (P>0.05). Postoperative Constant-Murley scores of PRP group at 1, 3, and 6 months were (64.09±11.61), (73.19±12.89), and (82.61±14.81) points, respectively, which were higher than those of control group were (52.32±17.42), (61.65±14.43), and (72.52±11.04) respectively;and the differences were statistically significant (P<0.05). There was no statistically significant difference in Constant-Murley scores at 12 months after operation between two groups (P>0.05). In PRP group, there was no statistically significant difference at 6 months and 12 months after operation (P>0.05), while there were statistically significant differences at the other time points (1 month after operation compared with before operation, 3 months after operation compared with 6 months after operation, and 3 months after operation compared with 1 month after operation) (P<0.05). In control group, there was no statistically significant difference when comparing 1 month and 3 months after operation (P>0.05), while at the other time points (1 month after operation with before operation, 3 months after operation with 6 months after operation, and 6 months after operation with 12 months after operation), the differences were all statistically significant (P<0.05). CONCLUSION Adjustable titanium plate fixation combined with postoperative injection of PRP for the treatment of Rockwood type III acromioclavicular joint dislocation has effect of promoting the recovery of shoulder joint function and reducing pain.
Humans ; Male ; Female ; Adult ; Middle Aged ; Platelet-Rich Plasma ; Acromioclavicular Joint/surgery* ; Bone Plates ; Titanium ; Joint Dislocations/therapy* ; Fracture Fixation, Internal/methods*

OBJECTIVE: To retrospectively analyze the clinical characteristics, co-mutated genes in newly diagnosed acute myeloid leukemia (AML) patients with NRAS and KRAS gene mutations, and the impact of NRAS and KRAS mutations on prognosis. METHODS: The clinical data and next-generation sequencing results of 80 newly diagnosed AML patients treated at our hospital from December 2018 to December 2023 were collected. The clinical characteristics, co-mutated genes of NRAS and KRAS , and the impact of NRAS and KRAS mutations on prognosis in newly diagnosed AML patients were analyzed. RESULTS: Among 80 newly diagnosed AML patients, NRAS mutations were detected in 20 cases(25.0%), and KRAS mutations were detected in 9 cases(11.3%). NRAS mutations predominantly occurred at codons 12 and 13 of exon 2, as well as codon 61 of exon 3, while KRAS mutations were most commonly occurred at codons 12 and 13 of exon 2, all of which were missense mutations. There were no statistically significant differences observed in terms of age, sex, white blood cell count(WBC), hemoglobin(Hb), platelet count(PLT), bone marrow blasts, first induction chemotherapy regimen, CR1/CRi1 rates, chromosome karyotype, 2022 ELN risk classification and allogeneic hematopoietic stem cell transplantation(allo-HSCT) among the NRAS mutation group, KRAS mutation group and NRAS/KRAS wild-type group (P >0.05). KRAS mutations were significantly correlated with PTPN11 mutations (r =0.344), whereas no genes significantly associated with NRAS mutations were found. Survival analysis showed that compared to the NRAS/KRAS wild-type group, patients with NRAS mutation had a relatively higher 5-year overall survival (OS) rate and relapse-free survival (RFS) rate, though the differences were not statistically significant (P =0.097, P =0.249). Compared to the NRAS/KRAS wild-type group, patients with KRAS mutation had a lower 5-year OS rate and RFS rate, with no significant differences observed (P =0.275, P =0.442). There was no significant difference in the 5-year RFS rate between the KRAS mutation group and NRAS mutation group (P =0.157), but the 5-year OS rate of patients with KRAS mutation was significantly lower than that of patients with NRAS mutation (P =0.037). CONCLUSION In newly diagnosed AML patients, KRAS mutation was significantly correlated with PTPN11 mutation. Compared to patients with NRAS/KRAS wild-type, those with NRAS mutation showed a more favorable prognosis, while patients with KRAS mutation showed a poorer prognosis; however, these differences did not reach statistical significance. Notably, the prognosis of AML patients with KRAS mutation was significantly inferior compared to those with NRAS mutation.
Humans ; Leukemia, Myeloid, Acute/diagnosis* ; Mutation ; Prognosis ; Proto-Oncogene Proteins p21(ras)/genetics* ; GTP Phosphohydrolases/genetics* ; Retrospective Studies ; Membrane Proteins/genetics* ; Female ; Male ; Middle Aged ; Adult ; Aged

Objective To explore the effective substances that specifically bind to RSV-F protein in the water extract of Forsythia suspensa,and verify its effect.Methods Surface plasmon resonance(SPR)affinity fishing technology was used to enrich,regenerate and recover the active components that specifically bind to RSV-F protein in the water extract of Forsythia suspensa.The recovered samples were analyzed and identified by UHPLC-MS/MS,and the active components that stably bind to F protein were screened by molecular docking,molecular dynamics simulation and SPR affinity detection,and then returned to animal experiments for pharmacodynamics verification.BALB/c mice were randomly divided into normal group,model group,positive control group,protocatechuic acid group and verbascoside group.In the experimental group,RSV was dripped into the nose to make models.Each drug group began to be given intragastric intervention on the day of modeling,and samples were taken after 4 days.HE staining was used to observe the pathological changes of lung tissue,and ELISA was used to detect the changes of inflammatory factors in lung tissue.Results A variety of active components in the aqueous extract of Forsythia suspensa could bind to RSV-F protein,among which the results of verbascoside and protocatechuic acid were more stable.In vivo pharmacodynamics experiments showed that the lung tissue of the model group had obvious pathological changes and the level of inflammatory factors increased,and the pathological state was improved after the intervention of verbascoside and protocatechuic acid compared with the normal group.Conclusion Forsythia suspensa can interfere with the expression of RSV-F protein through many active components such as verbascoside and protocatechuic acid,which may be the material basis of its anti-RSV.

Objective:To observe the effectiveness and safety of Huotujiji prescription for patients with asthenospermia of spleen-kid-ney yang-deficiency.Methods:Patients with spleen-kidney-yang deficiency type of asthenospermia were divided into two groups by ran-domized control method.The patients in the control group were treated with L-carnitine oral solution alone.And the patients in experimental group were treated with Huotujiji prescription.Semen volume,sperm concentration,PR,TCM symptom score and spouse pregnancy were compared between the two groups before and after treatment.Results:A total of 115 patients were included in the study,with 55 in the ex-perimental group and 60 in the control group.In the experimental group,the sperm concentration before and after treatment were(160.71±53.7)× 106/mL,(187.19±41.89)× 106/mL,and PR were(20.37±9.42)％,(26.7±6.92)％,respectively.PR+NP were(32.06±8.49)％and(34.89±7.25)％.After the treatment,the sperm motility of both groups significantly improved compared to pre-treatment lev-els(P＜0.05).And the experimental group's sperm concentration also showed a significant increase after the treatment(P＜0.05).The pregnancy rate of spouses in the control group was 11.67％,which was 29.09％in the experimental group.The pregnancy rate of the spouses in the two groups showed a statistically significant difference(P＜0.05).After 12weeks of treatment,the Traditional Chinese Medicine(TCM)symptom scores in the control group did not decrease significantly compared to those before treatment(P＞0.05).In contrast,the TCM symptom scores in the experimental group decreased significantly after treatment(P＜0.05).Moreover,compared with the control group,the TCM symptom scores of the experimental group decreased significantly after treatment(P＜0.05).Conclusion:Huotujiji pre-scription can safely and effectively improve the sperm quality and vitality of patients with spleen-kidney-yang deficiency type of asthenosper-mia,improve the symptoms of patients,and increase the pregnancy rate of their spouses,which is worthy of clinical promotion.

Objective To design a punching and positioning device for training Da Vinci surgical robots to improve the efficiency and accuracy of operation training.Methods The punching and positioning device mainly consisted of an abdominal girth,a connecting plate,a punching plate,a positioning disk and a punching cartridge.The abdominal girth had a long-strip shape and was made of stretch nylon elastic band;the connecting plate had a rectangular shape with its length direction perpendicular to the abdominal girth;the punching plate also had a rectangular shape and was made of hard silicone;the positioning plate was made of hard silicone and privided with a plated through hole;the punching cartridge were equipped with anti-fog components composed of heating wires and support strips,which had scale bars inside.Ten physicians were randomly divided into a control group and an experimental group,with 5 ones in each group.The two groups carried out positioning and punching respectively,with the traditional method for the control group and the device designed for the experimental group,which were compared in terms of the time consumption,ratio for lens fogging and number of collisions with the robotic arm.Results The experimental group had the time consumption and ratio for lens fogging lower significantly when compared with the control group(P＜0.05),while had no obvious difference in number of collisions with the robotic arm(P＞0.05),and the requirements of the training specifications were met.Conclusion The punching and positioning device has high efficiency and accuracy,and thus is worthy promoting for the operation training of surgical robots.[Chinese Medical Equipment Journal,2024,45(7):35-39]

Objective To design an experimental pig anesthesia device for training da Vinci surgical robot in order to achieve precise control of anesthesia depth.Methods The experimental pig anesthesia device for Da Vinci surgical robot training was composed of an animal anesthesia table,an oral opening and closing mechanism,a nasal catheter assembly and an anesthesia gas detection system.The animal anesthesia table consisted of an animal bearing surface made of high-quality stainless steel and a protective cover made of transparent acrylic material;the oral opening and closing mechanism was made up of an electric digital tensioner,a support rod,a rotating socket and binding straps;the nasal catheter assembly included an anesthesia gas ventilating catheter and a set of nasal fixed airbag;the anesthesia gas detecting system involved in a SS316 one-way inlet valve,a GT-SKSG-A-D isoflurane detector,a gas pathway,an exhaust gas collection container,an extractor fan and several vents.Results The anesthesia device achieved precise control of anesthesia depth for experimental pigs,improving anesthesia induction and preventing anesthesia gas from spilling out.Conclusion The anesthesia device enhances the success rate for experimental pig anesthesia and the efficacy for Da Vinci surgical robot training effectively.[Chinese Medical Equipment Journal,2024,45(11):27-31]