The analysis presented here is based on the blood components of Guanxin Qiwei tablets, the key anti-atherosclerosis pathway of Guanxin Qiwei tablets was screened by network pharmacology, and the anti-atherosclerosis mechanism of Guanxin Qiwei tablets was clarified and verified by cell experiments. HPLC-Q-Exactive-MS/MS technique was used to analyze the components of Guanxin Qiwei tablets into blood, to determine the precise mass charge ratio of the compounds, and to conduct a comprehensive analysis of the components by using secondary mass spectrometry fragments and literature comparison. Finally, a total of 42 components of Guanxin Qiwei tablets into blood were identified. To better understand the interactions, we employed the Swiss Target Prediction database to predict the associated targets. Atherosclerosis (AS) disease targets were searched in disease databases Genecard, OMIM and Disgent, and 181 intersection targets of disease targets and component targets were obtained by Venny 2.1.0 software. Protein interactions were analyzed by String database. The 32 core targets were selected by Cytscape software. Gene Ontology (GO) enrichment analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis were performed in DAVID database. It was found that the anti-atherosclerosis pathways of Guanxin Qiwei tablets mainly include lipid metabolism and atherosclerosis and AGE-RAGE signaling pathway in diabetic complications and other signal pathways. The core targets and the core compounds were interlinked, and it was found that cryptotanshinone and tanshinone ⅡA in Guanxin Qiwei tablets were well bound to TNF, PPARγ, AKT1, PTG2 and other targets. The lipid metabolism and atherosclerotic pathway was verified using human hl-7702 hepatocytes. This study preliminarily identified the potential pharmacodynamic components of Guanxin Qiwei tablets in the treatment of AS diseases and predicted their pathways of action, and verified the relationship between regulating lipid metabolism and atherosclerosis of Guanxin Qiwei tablets in vitro, providing a reference for the further study of the pharmacodynamic material basis and mechanism of action of this prescription. This experiment was approved by the Medical Ethics Committee of Inner Mongolia Medical University (No. YKD202401262).

Objective To investigate the correlation between the expression of Toll-like receptor 4(TLR4)and chitosanase 3-like protein 1(CHI3L1)in colon cancer tissue and the prognosis of patients after radical surgery.Methods A total of 152 patients who underwent radical colon cancer surgery in our hospital from January 2017 to May 2018 were collected and divided into the good prognosis group(n=97)and the poor prognosis group(n=47)according to the 5-year survival status after surgery.Immunohistochemical staining was applied to detect the expression levels of TLR4 and CHI3L1 in colon cancer tissues and adjacent tissues;the correlation between the expression of TLR4 and CHI3L1 in colon cancer tissue and the prognosis of patients was analyzed,and the influencing factors for prognosis of colon cancer patients were analyzed.Results The positive expression rates of TLR4 and CHI3L1 in colon cancer tissues were obviously higher than those in adjacent tissues(P<0.05).The expression of TLR4 in colon cancer tissue was related to the degree of tumor differentiation,clinical staging,and lymph node metastasis of colon cancer patients(P<0.05),the expression of CHI3L1 was related to the tumor diameter,degree of tumor differentiation,clinical staging,and lymph node metastasis of colon cancer patients(P<0.05).Compared with the good prognosis group,the poor prognosis group had higher proportions of patients with poorly differentiated tumor,clinical stageⅢ,lymph node metastasis,and positive expression of TLR4 and CHI3L1(P<0.05).The 5-year survival rate of patient with TLR4 positive expression was 60.38%,which was lower than that of 86.84% of patients with TLR4 negative expression(χ2=9.104,P<0.05);the 5-year survival rate of patients with CHI3L1 positive expression was 58.06%,which was lower than that of 84.31% of patients with CHI3L1 negative expression(χ2=10.935,P<0.05).The positive expression of TLR4 and CHI3L1,poorly differentiated tumor,clinical stage Ⅲ,and lymph node metastasis were the independent risk factors for the prognosis of colon cancer patients(P<0.05).Conclusion TLR4 and CHI3L1 are related to the occurrence and clinicopathological features of colon cancer,and the positive expression of TLR4 and CHI3L1 in colon cancer tissues is not conducive to the prognosis of patients,so both of them are expected to become clinical treatment targets.

The effect and mechanism of chronic stress on psychosomatic diseases are important topics in stress research.The establishment of animal models to simulate human chronic stress is of great significance to investigations of stress responses,the pathogenesis of related diseases,clinical treatment,and drug development.In this paper,animal models of chronic stress commonly used in China and abroad are reviewed;the classification of stressors,animal selection,model construction,pathological manifestations,and evaluation indexes are summarized;and the advantages and disadvantages and application of various models are discussed.The paper provides a reference for the study and selection of models of chronic stress response.

Objective:This study aims to analyze the characteristics and current status of gene therapy drug policy documents and to provide recommendations for optimizing China's gene therapy drug policy system.Methods:A three-dimensional analytical framework of"policy instruments-interactive subjects-policy phases"was constructed using content analysis and word frequency analysis.This framework was applied to the relevant policy documents issued from March 2009 to March 2024,enabling multidimensional classification and cross-comparison.Results:Among the 37 national-level policy documents included,246 text items were identified under the dimension of policy instruments,with supply-based instruments(45.9%)and environmental instruments(41.5%)being more prevalent,while demand-based instruments(12.6%)were less represented.The distribution of policy instruments was skewed,and internal structural differences were observed.In the dimension of interactive subjects,195 text items were identified,with drug manufacturing and R&D enterprises(36.9%),drug regulatory and accreditation agencies(22.1%),patients and subjects(19.0%),medical institutions and healthcare professionals(11.8%),and other government departments(10.2%)playing uneven roles.In the dimension of policy phases,the policies were categorized into three stages:drug R&D,production,and usage,with some policies covering multiple phases.Conclusions and suggestions:The study suggests combining and optimizing policy instruments for balanced application,strengthening demand-oriented policies,considering the needs of different interacting entities to formulate comprehensive policies,promoting cross-subject collaboration for win-win outcomes,and enhancing phase-linkage efficiency to build a comprehensive chain ecosystem for gene therapy drug development.

Objective:To evaluate the safety and efficacy of enhanced recovery after surgery(ERAS) in the perioperative period of congenital choledochal cysts in children.Methods:This is a multicenter prospective randomized controlled study. The clinical data of 273 pediatric congenital choledochal cysts(CCC) patients who underwent surgery at 14 medical centers with complete follow-up data were collected through the medical data analysis platform. Among them, 123 cases in ERAS group were managed perioperatively in strict accordance with ERAS mode, and 150 cases in conventional group were managed according to traditional mode. The length of hospital stay,time to first farting, time to complete feeding, the incidence of complications, cost and readmission rate within 30 days,stress indexes and liver function were compared between the two groups.Results:Compared with the conventional group, median time to start farting (2.0 d vs. 3.0 d, P<0.001), median time to complete feeding (5.0 d vs. 7.0 d, P<0.001), median postoperative hospitalization time (6.0 d vs. 9.0 d, P<0.001),the median total length of stay(13.0 d vs. 15.0 d, P<0.001) were shorter,the median hospitalization cost (37,000 yuan vs.43,000 yuan P<0.001) was lower, and stress indexes recovered quickly. The incidence of postoperative hospital stay and readimission rate within 30 d were not statistically different between the two groups. Conclusion:It is safe and feasible to implement ERAS for children with CCC in the perioperative period, which can reduce stress response, speed up recovery,and save medical costs.

Objective To investigate the relationship between the expression of Klotho,apoptosis-related factors and oxidative stress injury of the trabecular meshwork in patients with glaucoma.Methods Totally 86 patients(86 eyes)with glaucoma admitted to our hospital from October 2021 to October 2023 were selected as the study group.Tissue sam-ples of trabecular meshwork were obtained during the operation.Trabecular meshwork donor tissues(45 cases)from pa-tients with non-eye diseases were taken as the control group.Hematoxylin-Eosin(HE)staining was used to examine the histopathological characteristics,and the expression levels of Klotho,apoptosis-associated speck-like protein containing a CARD(ASC),cysteine-aspartic proteases-1(Caspase-1),superoxide dismutase(SOD)and peroxidase(POD)in trabecu-lar meshwork tissues were detected.The expression levels of Klotho,ASC,Caspase-1,SOD and POD of patients in the two groups and those expression levels in glaucoma patients with different average visual field defects were compared.The cor-relation between expression levels of Klotho,apoptosis-related proteins and oxidative stress injury of the trabecular mesh-work in glaucoma patients was analyzed by the Pearson method.Results HE staining results showed that the trabecular meshwork structure of patients in the study group was disorganized,with interlaced layers,thickened trabecular bundles and cell nucleus shrinkage,while the lamellas of trabecular meshwork tissues and trabecular cell bundles in the control group were orderly arranged,with normal forms of trabecular cells.In the study group,the expression level of Klotho in trabecular meshwork tissues was lower and the expression levels of ASC and Caspase-1 were higher than those of the con-trol group(all P＜0.05).There were statistically significant differences in the expression levels of Klotho,ASC,Caspase-1,SOD and POD in patients with different average visual field defects(all P＜0.05).With the increase in disease severity,the expressions of Klotho and SOD showed a significant decrease,while the expressions of ASC,Caspase-1 and POD showed a significant increase(all P＜0.05).Pearson correlation analysis showed that Klotho in the trabecular mesh work was negatively correlated with POD and positively correlated with SOD,while ASC and Caspase-1 were positively correlated with POD and negatively correlated with SOD(all P＜0.05).Conclusion The expression of Klotho is low in the trabec-ular meshwork tissues of patients with glaucoma,while the expressions of ASC and Caspase-1 are high.These expressions are correlated with the average visual field defect,reflecting the stress injury degree of trabecular meshwork tissues.

Objective To evaluate the performance of the disposable medical protective clothing in blocking the penetration of infectious agents,in order to provide data support for the setting of such performance indexes when the GB 19082 is revised.Methods Totally 10 batches of different brands and models of protective clothing were selected,and tests were carried out for penetration resistance to synthetic blood,phage,wet microorganisms,dry microorganisms and contaminated liquid aerosol and particle filtration efficiency according to YY/T 0700-2008,YY/T 0689-2008,YY/T 0506.6-2009,GB 19082-2009,YY/T 0506.5-2009 and YY/T 1799-2020.Results There were 2 batches of protective clothing with anti-synthetic blood penetration performance level 2,3,4,5 and 6,respectively;all the protective clothing had the highest level 6 for anti-wet microorganisms penetration,part of whom had the levels for the resistance to phage penetration lower than those for preventing anti-synthetic blood penetration;all of the protective clothing had the particle filtration efficiencies higher than 95％,and had the highest level 3 for anti-dry microorganisms penetration;there're 5 batches of protective clothing with the highest level 3 for contaminated liquid aerosol penetration,1 batch with level 2 and the remained 4 batches with undetermined levels,which all had an average logarithmic reduction higher than 4.5 after penetration.Conclusion Particle filtration efficiency and resistance to phage penetration may be involved in the requirements for resistance to infective agent penetration in revised GB 19082 for evaluating the ability of protective clothing materials to block microorganisms in airborne particles and liquid contaminants.[Chinese Medical Equipment Journal,2024,45(5):16-21]

Objective By population survey,to explore the epidemiological characteristics of gastric precancerous lesions in Lishui District of Nanjing and provide objective basis for the prevention and treatment of early gastric cancer.Methods From July 2021 to December 2022,21 977 patients who received endoscopy and/or 13C-UBT in Lishui District People's Hospital and 6 medical community units in Nanjing City were retrospectively analyzed for demography characteristics,detection rate of gastric precancerous lesions,and H.Pylori infection rate.Results(1)590 cases of gastric precancerous lesions were detected(detection rate 2.68%);(2)The total detection rate of precancerous lesions and three pathological types in males were all higher than those in females(all P<0.001);(3)The minimum age for the total detection rate of precancerous lesions in males and the mini-mum age for each pathological type were lower than in females(P<0.001,0.009,0.005,0.002);(4)The popu-lation total H.pylori infection rate was 23.10%,the H.pylori infection rate in patients with precancerous lesions was higher than that in non-precancerous lesions(P<0.001),both H.pylori infection rate of male and female in precancerous lesions were all higher than those of non-precancerous lesions of the same sex(all P<0.001),in addition,the H.pylori infection rate of male whether in precancerous or non-precancerous lesions was higher than that of female(all P<0.001);(5)The precancerous lesions detection rate in male,female,and the overall age range of 20～29 to 70～79 years is positively correlated with age growth(P<0.001),and rapidly decreases after the age of 79,the of H.pylori infection rate was also positively correlated with age growth(P<0.001),and the trend of age change(P<0.001)was parallel to the precancerous lesions detection rate.Conclusions The detec-tion rate of gastric precancerous lesions in this region is above the average level in China;the total H.pylori infec-tion rate is at a relatively low level in China;the H.pylori infection rate is parallel to the age trend of the detection rate of gastric precancerous lesions,and increases with age.

Objective:To explore the clinical application value of spiral computed tomography(CT)three-dimensional(3D)scanning reconstruction combined with 3D printing technique in surgery for acetabular fracture.Methods:A total of 71 patients with acetabular fractures admitted to Xinjiang Uiger Municipal People's Hospital from January 2018 to December 2020,who underwent surgical treatment,were selected as the research objects.According to different treatment methods,they were divided into observation group(38 cases)and control group(33 cases).The observation group adopted spiral CT 3D reconstruction,and 3D printing was used to assist the treatment of internal fixation,and the control group adopted conventionally surgical treatment.And then,the surgical effect and recovery situation of the two groups were compared.Results:The quality score(Malta)of fracture reduction and the hip score of sub-item percentile of observation group were significantly higher than those of the control group,and the intraoperative blood loss,the times of intraoperative fluoroscopy,the operation time and hospitalization time of observation group were significantly lower than those of control group(t=23.426,4.216,3.425,17.783,P<0.05),respectively.There was significant difference in the excellent rate of fracture reduction between two groups(x2=4.059,P<0.05).The pain,function and joint activity scores of hip joint function scores of patients in observation group were significantly higher than those of control group(t=-4.873,-5.776,-6.247,P<0.05),respectively.The incidence of complications in observation group was significantly lower than that in control group(x2=4.059,P<0.05).Conclusion:In the perioperative period,the application of spiral CT 3D reconstruction combined with 3D printing of acetabular fractures can further ensure the safety and feasibility of the operation,and improve the quality and efficiency of the surgery,and promote postoperative recovery.

Objective:To study the efficacy of closed reduction with a self-developed T-frame plus robotic navigation in the treatment of supracondylar humeral fractures of Gartland type Ⅲ in children.Methods:A retrospective study was conducted to analyze the data of 67 children with supracondylar fracture of Gartland type Ⅲ who had undergone surgery at The Fifth Hospital of Harbin from January 2023 to March 2024. There were 35 males and 32 females with an age of (5.6±1.2) years. The children were divided into 2 groups according to different surgical methods. The control group (33 cases) was treated by closed reduction and internal fixation with percutaneous K-wire and the study group (34 cases) by closed reduction with a self-developed T-frame plus robotic navigation for internal fixation with percutaneous K-wire. The operation time, anatomical reduction, intraoperative fluoroscopy frequency, intraoperative needle adjustment, Flynn score at the last follow-up and complications were compared between the 2 groups.Results:There was no significant difference in the preoperative general data between the 2 groups, indicating comparability ( P>0.05). All children were followed up for (6.3±2.5) months after surgery. There were no significant differences in operation time, Flynn score at the last follow-up or incidence of complications between the study and the control groups ( P>0.05). The rate of anatomical reduction in the study group (97.1%, 33/34) was significantly higher than that in the control group (54.5%, 18/33), and the intraoperative fluoroscopy frequency [(11.6±2.5) times] and needle adjustment (5.6±1.2) times in the study group were significantly lower than those in the control group [(37.2±2.1) times and (28.7±3.9) times] ( P<0.05). Conclusions:In the treatment of supracondylar humeral fractures of Gartland type Ⅲ in children, our self-developed T-frame can play a good role in fracture reduction and temporary fixation, avoiding iatrogenic secondary injuries caused by freguent reduction and adjustment of needle threading in the course of robotic navigation.