1.Effects and mechanisms of action of Yiqi wenyang huwei decoction in improving bronchial asthma in rats
Yunqing YANG ; Jianyu XIE ; Wei TANG ; Chao YE ; Qiangqiang YU ; Peng SUN ; Yuping YANG ; Jianwei YU
China Pharmacy 2026;37(10):1264-1271
OBJECTIVE To investigate the effects and potential mechanism of Yiqi wenyang huwei decoction (YQWY) in improving airway inflammation and remodeling in rats with bronchial asthma (BA) based on the Toll-like receptor 4 (TLR4)/myeloid differentiation primary response protein 88 (MyD88)/nuclear factor-κB (NF-κB) signaling pathway. METHODS Male SD rats were randomly divided into the normal group, the model group, the dexamethasone group (positive control, 0.5 mg/kg), and YQWY low-, medium- and high-dose groups (5, 10, 20 g/kg, calculated by the crude drug), with 8 rats in each group. Except for the normal group, rats in all other groups were sensitized twice with ovalbumin combined with aerosol challenge to establish a BA model. From day 14 to day 34 of the experiment, the rats in each group were administered the corresponding drug solution or normal saline intragastrically, once a day, 1 hour before aerosol challenge. At 24 hours after the final aerosol challenge, asthma symptom scores were assessed, serum levels of immunoglobulin E (IgE) were measured, and the levels of inflammatory cytokines (interleukin-4, interleukin-5, interleukin-13 and tumor necrosis factor-α) and the numbers of inflammatory cells (white blood cell, eosinophil, neutrophil, lymphocyte, monocyte and basophil) in bronchoalveolar lavage fluid were determined. Pathological changes in lung tissue were observed. The mRNA expressions of TLR4, MyD88 and NF-κB, as well as the protein expressions of TLR4, MyD88, NF-κB p65 and phosphorylated NF-κB p65 in lung tissue, were detected. RESULTS Compared with the model group, the pathological changes, such as inflammatory cell infiltration, abnormal deposition of collagen fibers, and goblet cell hyperplasia in the lung tissue of rats in each drug group, were alleviated to varying degrees. The asthma symptom scores (except for the YQWY low-dose group), the levels of IgE and inflammatory cytokines (except for interleukin-5 in the YQWY medium-dose group), the number of inflammatory cells (except for monocyte and basophil in the YQWY low-dose group), the mRNA expression of TLR4, MyD88 and NF-κB, as well as the protein expressions of TLR4, MyD88, NF-κB p65 and phosphorylated NF-κB p65 (except for MyD88 and NF-κB p65 proteins in the YQWY low-dose group as detected by Western blo t) were all significantly reduced or down-regulated ( P <0.05 or P <0.01). CONCLUSIONS YQWY can alleviate asthma-like manifestations in BA rats and improve their airway inflammation and remodeling; these effects may be related to the formula’s inhibition of the abnormal activation of the TLR4/MyD88/NF-κB signaling pathway.
2.Guizhi Fulingwan Alleviate Hepatic Fibrosis by Modulating mtDNA/NLRP3/Caspase-1/GSDMD Signaling Pathway
Yu TANG ; Xuli YANG ; Qiang YANG ; Xiaojie WANG ; Yongxiang GAO ; Xueping LI
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(14):91-99
ObjectiveTo investigate the mechanism of Guizhi Fulingwan (GFW) against hepatic fibrosis, focusing on elucidating the regulatory effect of GFW on the mitochondrial DNA (mtDNA)/NOD-like receptor protein 3 (NLRP3)/cysteinyl aspartate-specific proteinase-1 (Caspase-1)/gasdermin D (GSDMD) signaling pathway. MethodsForty-two male Sprague-Dawley (SD) rats were randomly allocated into six groups (n=7): control, model, low/medium/high-dose (0.14, 0.28, 0.56 g·kg-1·d-1) GFW (GFW-L, GFW-M, GFW-H), and Dahuang Zhechong pills (DZW, 1.8 g·kg-1·d-1). The rat model of hepatic fibrosis was induced by intraperitoneal injection of carbon tetrachloride. General conditions of the rats were observed. Serum levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels were measured. Liver histopathology and collagen deposition were observed through hematoxylin and eosin (HE) staining and Masson's trichrome staining. Transmission electron microscopy (TEM) was employed to observe structural alterations and damage of cellular ultrastructures including mitochondria. Mitochondrial membrane potential (MMP, ΔΨm) was detected by flow cytometry. Serum levels of interleukin-1β (IL-1β) and interleukin-18 (IL-18) were measured by enzyme-linked immunosorbent assay (ELISA). The mRNA levels of mtDNA and NLRP3 in the liver tissue were quantified by Real-time polymerase chain reaction (Real-time PCR). The protein levels of key molecules in the NLRP3/Caspase-1/GSDMD signaling pathway in the liver tissue were determined by Western blot. ResultsCompared with the control group, the model group exhibited a decrease in body weight (P<0.01), an increase in liver index (P<0.01), elevations in serum ALT and AST levels (P<0.01), and typical fibrotic features such as disorganized hepatocytes, inflammatory infiltration, and increased collagen deposition in the liver tissue. TEM revealed significant karyotheca degeneration, mitochondrial swelling, endoplasmic reticulum expansion, and organelle efflux in the model group. In addition, the model group showed decreased ΔΨm (P<0.01), up-regulated mRNA levels of mtDNA and NLRP3 (P<0.01) and protein levels of NLRP3, Caspase-1, and GSDMD (P<0.01) in the liver tissue, and increased serum levels of IL-1β and IL-18 (P<0.01). Compared with that in the model group, the body weight increased in GFW-L, GFW-M, and DZW groups (P<0.05) and markedly increased in the GFW-H group (P<0.01). The liver index decreased in the GFW groups and DZW group (P<0.01). The serum ALT level declined in the GFW-L group (P<0.05), and the serum ALT and AST levels decreased in the GFW-M, GFW-H, and DZW groups (P<0.01). Histopathological damage and fibrosis were alleviated to varying degrees, and TEM revealed mitigated ultrastructural injuries including mitophagy, mitochondrial swelling, and endoplasmic reticulum expansion in the drug intervention groups. The ΔΨm increased in GFW groups without statistical significance. The mRNA level of mtDNA in the liver tissue was down-regulated in the GFW-M (P<0.05), GFW-H (P<0.01), and DZW (P<0.01) groups. The mRNA level of NLRP3 was down-regulated in GFW-M, GFW-H, and DZW groups (P<0.01). Western blot analysis showed significantly down-regulated protein level of NLRP3 in all the GFW groups and the DZW group (P<0.01). The protein level of GSDMD-N was down-regulated in GFW-H and DZW groups (P<0.01). The protein level of cleaved Caspase-1 was down-regulated in GFW-M (P<0.05), GFW-H (P<0.01), and DZW (P<0.01) groups. In addition, the serum levels of IL-1β and IL-18 declined in GFW-H and DZW groups (P<0.01). ConclusionGFW can suppress pyroptosis to ameliorate CCl4-induced hepatic fibrosis, potentially through mitigating mitochondrial damage, inhibiting inflammasome assembly and activation, and blocking pro-inflammatory cytokine release.
3.Qiangjing Tablets Alleviate Oxidative Stress Damage in Varicocele by Regulating Keap1/Nrf2 Signaling Pathway
Liang DONG ; Fang YANG ; Jingyi ZHANG ; Xinyi TANG ; Yulin LI ; Xujun YU ; Degui CHANG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(14):347-359
ObjectiveTo explore the mechanism by which Qiangjing tablets (QJT) alleviate the spermatogenic function damage caused by varicocele (VC) based on the Kelch-like ECH-associated protein 1 (Keap1)/nuclear factor erythroid 2-related factor 2 (Nrf2) signaling pathway-mediated oxidative stress. MethodsTen Sprague-Dawley (SD) rats were randomly assigned into a control group and a model group. Pathological examination confirmed the stability of the model. Thirty-six SD rats were randomized into control, model, low-dose (0.23 g·kg-1) QJT, medium-dose (0.46 g·kg-1) QJT, high-dose (0.92 g·kg-1) QJT, and mazhilin (61.7 mg·kg-1) groups, with 6 rats in each group. A rat model of experimental left varicocele (ELV) was established by partially ligating the left renal vein to simulate the human nutcracker syndrome. The rats were administrated with corresponding agents once a day for 28 consecutive days. The in vitro testicular culture model of rats was established through the Transwell chamber method and intervened with QJT-containing sera (2.3, 4.6, and 9.2 g·kg-1). Microscopic observation was carried out for the morphology of the left kidney. A micrometer was used to measure the diameter of the left spermatic vein (LSV). The body weights of rats were recorded weekly, and the epididymis and testis weights were measured. The pathological changes of the testicular tissue was observed via hematoxylin-eosin (HE) staining. The levels of testosterone (T) in the cell culture supernatant and reactive oxygen species (ROS) in the rat testicular tissue were measured by enzyme-linked immunosorbent assay (ELISA). Flow cytometry was employed to determine the ROS content. Immunohistochemical staining was conducted to analyze Keap1, Nrf2, 3β-hydroxysteroid dehydrogenase (3β-Hsd), GATA-binding protein-4 (Gata-4), and proto-oncogene receptor tyrosine kinase (C-kit). The ultrastructure of the tissue was observed by transmission electron microscopy (TEM). Cell apoptosis was detected by terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling (TUNEL) staining. The expression of Keap1, Nrf2, glutathione S-transferase α2 (Gsta2), glutathione S-transferase μ1 (Gstm1), heme oxygenase-1 (HO-1), quinone oxidoreductase 1 (Nqo1), and thioredoxin reductase 1 (Txnrd1) was quantified by Real-time quantitative polymerase chain reaction(Real-time PCR) and Western blot. ResultsCompared with the control group, the ROS content and the percentage of apoptotic cells in the model group were significantly increased (P<0.01), the T concentration was significantly decreased (P<0.01), the mRNA and protein expressions of Keap1 were significantly increased (P<0.01), and the mRNA and protein expressions of Nrf2, Gsta2, Gstm1, HO-1, Nqo1 and Txnrd1 were significantly decreased (P<0.05). Compared with the model group, the ROS content and the percentage of apoptotic cells in each dose group of the Qiangjing Tablets were significantly reduced (P<0.05), and the mRNA and protein expressions of Keap1 were significantly decreased (P<0.05), while the mRNA and protein expressions of Nrf2, Gsta2, Gstm1, HO-1, Nqo1 and Txnrd1 were significantly increased (P<0.05). ConclusionQJT improves sperm motility in the rat model of VC by modulating the Keap1/Nrf2 signaling pathway and reducing oxidative stress injury.
4.The Potential Role of β-Asarone inCalcium Imbalance and Mitochondrial Dysfunction in Melanoma Cells
Yuze LIU ; Wei TANG ; Biao YU ; Qinghua YANG ; Wenbing LAI
Annals of Dermatology 2026;38(1):75-83
Background:
The treatment landscape for melanoma, a particularly malignant skin cancer, is constrained by notable drug resistance and toxicity. β-Asarone, a natural compound from Acorus tatarinowii, has shown anticancer potential. Disruption of calcium homeostasis and mitochondrial dysfunction are key regulators of tumor cell survival and death.
Objective:
This research was conducted to investigate the impact of β-Asarone on B16F10 melanoma cells, focusing on its potential to induce apoptosis by modulating calcium signaling and mitochondrial function.
Methods:
Cell proliferation and apoptosis were evaluated using CCK-8, colony formation, EdU, and TUNEL assays. Intracellular calcium levels and mitochondrial membrane potential were measured using Fluo-4 AM, Rhod-2 AM, and JC-1 staining. Reactive oxygen species (ROS) generation and adenosine triphosphate (ATP) levels were assessed by fluorescent probes and ATP assay. Western blotting was utilized to detect apoptosis-related proteins, AMP-activated protein kinase (AMPK) pathway activation, and mitochondrial dynamics (OPA1, DRP1, FIS1).
Results:
Treatment with β-Asarone notably inhibited the proliferation of B16F10 cells while simultaneously inducing apoptosis. Fluorescent probe analysis revealed that β-Asarone triggered cytosolic and mitochondrial Ca 2+ overloaded in both the cytosol and mitochondria, accompanied by decreased mitochondrial membrane potential, elevated ROS levels, and reduced ATP production. Western blot analysis showed increased expression of DRP1 and FIS1, decreased OPA1, and enhanced AMPK phosphorylation, indicating that β-Asarone promotes mitochondrial fission through AMPK activation, likely driven by intracellular calcium imbalance.
Conclusion
This study demonstrates that β-Asarone induces apoptosis in B16F10 melanoma cells by triggering Ca 2+ overload and mitochondrial dysfunction.
5.Pseudolaric Acid B-linked Double-network Hydrogel Alleviates Pruritus by Inhibiting The Growth of Staphylococcus aureus
Ye YOU ; Yan YANG ; Tong-Yu LI ; Cheng-Long CAI ; Ting WANG ; Chan ZHU ; Zong-Xiang TANG
Progress in Biochemistry and Biophysics 2026;53(6):1734-1745
ObjectiveThis study aimed to elucidate the mechanistic role of Staphylococcus aureus in the pathogenesis of atopic dermatitis (AD), a chronic inflammatory skin disorder characterized by pruritus and barrier dysfunction. A key focus was screening traditional Chinese medicine (TCM) active components with dual antibacterial and antipruritic efficacy, followed by systematic evaluation of their in vitro antibacterial activity. Additionally, a novel drug delivery system was constructed to enable localized efficient drug delivery, inhibiting S. aureus proliferation and alleviating its induced pruritus, thereby providing new strategies for targeted AD therapy. MethodsMale C57BL/6J mice aged 6-8 weeks (body weight 18-22 g) were used to establish an AD model via repeated oxazolone sensitization. On day 14, microbial samples were collected from the lesional area (1 cm²) using sterile cotton swabs, followed by vortex mixing, serial dilution, and plating on 5% sheep blood agar plates (incubated at 37°C for 24 h). Single colonies with complete transparent β-hemolytic zones were isolated and identified as vancomycin-intermediate S. aureus (VISA) via 16S rRNA sequencing. An S. aureus mono-infection animal model was then established by applying gauze saturated with bacterial suspension (McFarland turbidity 0.1) to the nape and back skin of mice. The pruritic phenotype and inflammatory cell infiltration induced by S. aureus were evaluated using comprehensive approaches including behavioral assays (e.g., scratching frequency recording), hematoxylin-eosin (HE) staining, and toluidine blue staining. The in vitro antibacterial efficacy of the TCM monomer pseudolaric acid B (PAB) and double network hydrogel (DN) was separately assessed by disk diffusion assay, while the minimum inhibitory concentration (MIC) of PAB was determined via broth dilution method. Further validation of the pharmacodynamic characteristics of the composite system (PAB@DN, composed of PAB and DN) was conducted through behavioral assays, HE staining, and dermatitis scoring, with its drug release profile evaluated by mass spectrometry analysis. Based on scratching behavioral analysis and dermatitis scoring, the optimal ratio and concentration of PAB@DN were optimized. ResultsThe S. aureus load in AD lesional tissues was significantly higher than in normal skin ((5.3±0.33)×10⁶ CFU vs. (3.6±0.26)×10⁷ CFU, P<0.001). In the S. aureus mono-infection group, mice exhibited a 6.7-fold increase in scratching frequency compared to the control group. HE staining revealed marked epidermal thickening ((10.4±2.39) μm vs. (85.6±1.95) μm, P<0.000 1), and toluidine blue staining showed a 23-fold increase in mast cell degranulation. Pseudolaric acid B exhibited a significant concentration-dependent inhibitory effect onS. aureus growth, with its in vitro antibacterial effect being 57% that of the antibiotic cefepime (inhibition zone diameter: PAB (1.885±0.036) cm vs. cefepime (3.636±0.005) cm, P<0.000 1) and a minimum inhibitory concentration (MIC) of 1 g/L. The carrier double network hydrogel (DN) itself lacked direct antibacterial activity (no significant difference in inhibition zone diameter compared to the control) but effectively ameliorated the dry symptoms of AD-like lesions. The PAB@DN composite system demonstrated a synergistic effect compared to individual components, resulting in a 50% reduction in scratching behavior, an 86% decrease in dermatitis score, and a 60% reduction in epidermal thickening. It also reduced the S. aureus load in mouse skin by approximately 34%, with the optimal effective formulation being PAB at 1 g/L loaded onto DN. ConclusionS. aureus colonization plays a critical driving role in the onset and progression of AD. Using an S. aureus infection model, this study confirmed that the pseudolaric acidB-hydrogel composite delivery system (PAB@DN) can effectively alleviate S. aureus-induced pruritus and skin damage, providing experimental evidence for microbiota-targeted therapy of AD.
6.Population composition and seasonal distribution of mosquitoes in Laoshan District, Qingdao City
Zi-long TANG ; Na YU ; Yang YU ; Fan YIN ; Bing-hui LI ; Hong-yu WANG ; Ke-jia HUANG
Acta Parasitologica et Medica Entomologica Sinica 2026;33(2):114-120
Objective The study aimed to elucidate the population composition and seasonal distribution characteristics of mosquitoes in Laoshan District, Qingdao City, providing a scientific basis for the prevention and control of mosquito-borne infectious diseases. Methods Mosquito surveillance was conducted in Laoshan District in Qingdao City using light traps from April to November 2020-2022. Dominant mosquito species were identified using the Berger-Parker dominance index(I)and mosquito density was compared using the Kruskal-Wallis H test. The seasonal distribution characteristics of adult mosquitoes were analyzed using concentration and circular distribution method. Spearman rank correlation analysis was used to study the relationship between mosquito populations and meteorological factors with mean monthly temperature, mean monthly relative humidity, and mean monthly rainfall. Results The mean mosquito density for the trapping period was 9.771 females/(trap·night)in 2020,9.771 in 2021, and 9.427 in 2022. There was no statistically significant difference in mosquito density between different years(H = 0.095, P = 0.954). In total, 2 781 adult female mosquitoes comprising five species from four genera were captured over three years. Culex pipiens(I = 0.654), Aedes albopictus(I = 0.202), and Aedes aegypti(I = 0.118)were identified as dominant species. Seasonal fluctuations in the adult mosquitoes were unimodal, and primarily concentrated from June to September. The peak period of adult mosquito varied between years with statistical significance. (F = 3.838, P < 0.05). Mosquito density was highly correlated with mean monthly temperature, mean monthly relative humidity and mean monthly precipitation(P< 0.05). Conclusions Cx. pipiens pallens, Ae. albopictus, and Ar. inamoratus are the dominant mosquito species in the Laoshan District of Qingdao City. The activity of adult mosquitoes is seasonal, and primarily concentrated in summer and autumn, during which the risk of mosquito-borne diseases such as dengue fever is increased.
7.Application of the Bayesian mixture model based on a principal stra-tum strategy in clinical trials
Yiwen WU ; Yue SUN ; Zixuan LU ; Jiahe PAN ; Er YU ; Hongmei WO ; Shaowen TANG ; Yang ZHAO ; Juncheng DAI ; Honggang YI
Chinese Journal of Clinical Pharmacology and Therapeutics 2025;30(7):942-949
AIM:To evaluate the application effec-tiveness of a Bayesian mixture model based on the principal stratum strategy for estimating the com-plier average causal effect(CACE)in clinical trials with non-compliance.METHODS:Using a non-infe-riority randomized controlled trial investigating a novel drug for primary type 2 diabetes mellitus(non-inferiority margin:-0.4)as a case study,the primary analysis applied a Bayesian mixture model under the monotonicity assumption to estimate CACE of between-group differences in glycated he-moglobin(HbA1c)changes within the compliant stratum,followed by non-inferiority testing.Sensi-tivity analyses included a Bayesian mixture model relaxing the monotonicity assumption and compar-ing results with per-protocol set(PPS)analysis.RE-SULTS:In the primary analysis,the posterior mean of CACE for HbA1c change in the compliant stratum was 0.081%,with a one-sided 97.5%credible inter-val lower bound of-0.124,exceeding the non-infe-riority margin(-0.4%),supporting the non-inferiori-ty efficacy of the novel drug in the compliant stra-tum(P(H1|Data)=1).Consistent findings were ob-served in PPS analyses(estimated effect:0.136%;one-sided 97.5%credible interval lower bound:-0.069%),further validating methodological robust-ness.CONCLUSION:In clinical trials with noncom-pliance as an intercurrent event,the Bayesian mix-ture model under the principal stratum strategy ef-fectively adjusts for compliance-related bias and yields conservative,robust estimates of causal ef-fects,supporting its value in efficacy evaluation un-der complex compliance scenarios.
8.Expert consensus on integrated diagnosis and treatment techniques for oropharyngeal squamous cell carcinoma
Wei SHANG ; Haoyue XU ; Zongxuan HE ; Xiaoying LI ; Haijun LU ; Xiaohong ZHAN ; Dapeng HAO ; Yan SUN ; Wei GUO ; Zhangui TANG ; Guoxin REN ; Zhijun SUN ; Jian MENG ; Jie ZHANG ; Jichen LI ; Yue HE ; Chunjie LI ; Jianhua WEI ; Lizheng QIN ; Yaowu YANG ; Qing XI ; Wei WU ; Kai YANG ; Bing HAN ; Lingxue BU ; Shuangyi WANG ; Kai SONG ; Jiaqi ZHU ; Hongyu HAN ; Yu KONG ; Jieying LI ; Man HU ; Mingjin XU ; Moyi SUN
Journal of Practical Stomatology 2025;41(6):725-736
In recent decades,the incidence of human papillomavirus(HPV)-associated oropharyngeal squamous cell carcinoma(OPSCC)has shown a marked increase.Significant changes have also occurred in the OPSCC diagnosis and treatment paradigm.Deter-mining HPV status prior to treatment is now essential,and radiotherapy/chemotherapy,immunotherapy,and minimally invasive surgical techniques have progressively emerged as key modalities for managing OPSCC.However,alongside these paradigm shifts,a comprehen-sive technical consensus guiding the entire diagnostic and therapeutic process for OPSCC patients is currently lacking.Given China's large population base and the rising incidence of OPSCC,an expert panel convened to develop a clinical technical consensus on OPSCC diagno-sis and management tailored to China's specific context.This consensus aims to further enhance and standardize understanding of OPSCC management techniques among relevant healthcare professionals.
9.Impacts of ultrasound-guided stellate ganglion block combined with general anesthesia on hemodynamics and postoperative cognitive function in patients undergoing shoulder arthroscopic surgery
Yu YANG ; Xinrui DU ; Zongxiao YANG ; Chaojing ZHOU ; Yan JIANG ; Peiyan YANG ; Jing PU ; Chao PU ; Fulin TANG
China Journal of Endoscopy 2025;31(6):70-77
Objective To investigate the impacts of ultrasound-guided stellate ganglion block(SGB)on hemodynamics and postoperative cognitive function in patients undergoing shoulder arthroscopic surgery.Methods From January 2024 to June 2024,120 patients undergoing shoulder arthroscopic surgery in our hospital were randomly assigned into general anesthesia group(n=60,implementing general anesthesia)and assisted SGB group(n=60,implementing ultrasound-guided SGB combined with general anesthesia).The intraoperative hemodynamics,postoperative stress status[serum cortisol(Cor)and interleukin-6(IL-6)],postoperative pain level[evaluated by visual analogue scale(VAS)score],postoperative biomarkers[serum matrix metalloproteinase-9(MMP-9)and neurospecific protein S-100β(S-100β)],and postoperative cognitive function[evaluated using the mini-mental state examination(MMSE)]were compared between the two groups.Results There was no statistically significant difference in intraoperative blood loss and surgical time between the two groups of patients(P>0.05).After induction of anesthesia(T1),the mean arterial pressure(MAP)and heart rate(HR)of the two groups of patients were significantly lower than when they entered the operating room(T0),the differences were statistically significant(P<0.05).The MAP and HR during the beginning of the surgery(T2),30 min after the start of the surgery(T3),and at the end of the surgery(T4)were higher than those at T0,the differences were statistically significant(P<0.05).While the MAP and HR in the assisted SGB group during T1,T2,T3 and T4 time points were lower than those in the general anesthesia group,the differences were statistically significant(P<0.05).The VAS scores of the assisted SGB group were significantly lower than those of the general anesthesia group at 12 and 24 h after surgery,and the differences were statistically significant(P<0.05).The levels of serum Cor and IL-6 in the two groups at 12 and 24 h after surgery were higher than those at 1 d before surgery,but the levels of serum Cor and IL-6 in the assisted SGB group were lower than those in the general anesthesia group,the differences were statistically significant(P<0.05).The levels of serum MMP-9 and S-100β in the two groups at 24 and 72 h after surgery were higher than those at 1 d before surgery(P<0.05),but the levels of serum MMP-9 and S-100β in the assisted SGB group were lower than those in the general anesthesia group,the differences were statistically significant(P<0.05).The MMSE score of the two groups at 3 and 5 d after surgery were lower than those at 1 d before surgery,but the MMSE score of the assisted SGB group was higher than that of the general anesthesia group,the difference was statistically significant(P<0.05).Conclusion The implementation of ultrasound-guided SGB during shoulder arthroscopic surgery can maintain intraoperative hemodynamic stability,obviously alleviate postoperative stress and pain,obviously reduce serum MMP-9 and serum S-100β levels,and help alleviate postoperative cognitive dysfunction.It is worthy clinical application.
10.Patient experience of robot-assisted percutaneous kyphoplasty with bone cement injection into injured vertebrae under local anesthesia
Jiahong LI ; Shu LIN ; Liuyi TANG ; Jiang HU ; Yang YU ; Wei ZHANG
Chinese Journal of Tissue Engineering Research 2025;29(22):4647-4652
BACKGROUND:Percutaneous kyphoplasty assisted by C-arm under local anesthesia requires continuous adjustment of the puncture direction under multiple C-arm fluoroscopy.The establishment time of the working channel is longer,and the intraoperative pain stimulation of patients is larger.With the help of the robot,the puncture can be successfully performed at one time,which can significantly improve the experience of patients and reduce the risk of bone cement leakage.OBJECTIVE:To compare the patient experience and other outcomes of percutaneous kyphoplasty using robot-assisted and conventional C-arm fluoroscopy under local anesthesia.METHODS:A total of 241 patients with single-stage osteoporotic vertebral compression fracture were selected from Sichuan Academy of Medical Sciences·Sichuan Provincial People's Hospital(Affiliated Hospital,University of Electronic Science and Technology of China).132 patients underwent robot-assisted percutaneous kyphoplasty under local anesthesia(robot-assisted group).109 cases of conventional C-arm assisted percutaneous kyphoplasty under local anesthesia(conventional fluoroscopy group).Patients'intraoperative experience evaluation,bone cement injection amount,operation time,working channel establishment time,hospitalization cost and complications were recorded.Puncture deviation and bone cement leakage were evaluated by imaging on the first day after surgery.RESULTS AND CONCLUSION:(1)The intraoperative experience of 59 patients in the robot-assisted group was rated as"very good",43 as"good",16 as"average",10 as"poor",and 4 as"very poor,"while that of 30 patients in the conventional fluoroscopy group was rated as"very good",44 cases were"good",21"average",9"poor",and 5"very poor."There was a significant difference between the two groups in intraoperative experience evaluation(Z=-2.546,P=0.011).Intraoperative pain visual analog scale score was lower in the robot-assisted group than that in the conventional fluoroscopy group(t=-9.513,P=0.000).Totally 84 patients in the robot-assisted group and 47 patients in the conventional fluoroscopy group were willing to undergo percutaneous kyphoplasty again when necessary,and there was a significant difference between the two groups(Z=-2.730,P=0.006).(2)The operation time and hospitalization cost of the robot-assisted group were more than those of the conventional fluoroscopy group(t=2.860,P=0.003;t=36.522,P=0.000).The working channel establishment time of robot-assisted group was shorter than that of conventional fluoroscopy group(t=-27.066,P=0.000).The puncture deviation of robot-assisted group was better than that of conventional fluoroscopy group(Z=-3.656,P=0.000).The cement leakage of robot-assisted group was lower than that of conventional fluoroscopy group(χ2=7.284,P=0.007).(3)It is concluded that under local anesthesia,patients with robot-assisted percutaneous kyphoplasty have good surgical experience,with advantages of accurate puncture,short time to establish working channel,and low leakage rate of bone cement.


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