1.Expert consensus on non-surgical treatment for acute lateral ankle sprain (version 2025)
Hui CHE ; Wenge DING ; Shiming FENG ; Xueping GU ; Qinwei GUO ; Jianchao GUI ; Yinghui HUA ; Yuefeng HAO ; Qinglin HAN ; Bo HU ; Xiaojun LIANG ; Guoping LI ; Yunxia LI ; Qi LI ; Yanlin LI ; Xin MA ; Jun MA ; Xudong MIAO ; Jianzhong QIN ; Xiaodong QIN ; Xu SUN ; Kefu SUN ; Weidong SONG ; Dai SHI ; Zhongmin SHI ; Youlun TAO ; Xu WANG ; Youhua WANG ; Liheng WANG ; Anli WANG ; Aiguo WANG ; Weidong WU ; Yajun XU ; Weidong XU ; Renjie XU ; Yongsheng XU ; Tengbo YU ; Lianqi YAN ; Xiaodong YUAN ; Yuan ZHU ; Mingzhu ZHANG ; Hongtao ZHANG ; Xintao ZHANG ; Xiaofei ZHENG
Chinese Journal of Trauma 2025;41(6):517-529
Acute lateral ankle sprain (ALAS) is one of the most common sport injuries, with high incidence, recurrence and disability rates. Currently, exercise rehabilitation-based non-surgical treatment is the primary management approach for ALAS. However, there remain improper practices such as excessive immobilization or uncontrolled activity, which contribute to recurrent sprains and chronic ankle instability, significantly impairing patients′ athletic function and quality of life. To standardize the non-surgical management of ALAS, improve the cure rates, and reduce the recurrence and disability rates, Chinese Sports Rehabilitation Medicine Training Project of Chinese Medical Association, Foot and Ankle Basics and Orthopedics Group, Orthopedic Branch of Chinese Medical Doctor Association, and Sports Medicine Branch of Jiangsu Medical Association organized relevant experts to formulate Expert consensus on non-surgical treatment for acute lateral ankle sprain ( version 2025), following the principles of scientific vigor, practicality, and innovation. Thirteen recommendations were proposed for standardized treatment protocols across different healing phases, aiming to provide references for standard management of ALAS and improve the therapeutic outcomes.
2.Effects of dual-task training on abnormal gait and fall risk among stroke survivors
Yuefeng WU ; Xiaoqiong DONG ; Tong ZHU ; Fang ZHANG ; Panke SHI ; Qingchuan JIAO ; Jianqiu GONG
Chinese Journal of Physical Medicine and Rehabilitation 2025;47(8):704-709
Objective:To observe any effect of dual-task training on abnormal gait and fall risk among hemiplegic stroke survivors.Methods:A total of 90 stroke survivors were randomly divided into a control group, a cognitive dual-task group, and a motor dual-task group, each of 30. All 3 groups received conventional post-stroke medication and rehabilitation training, but the cognitive and motor dual-task groups received cognitive or motor dual-task training as well. Before and after 4 weeks of the training, everyone′s balance, walking and lower limb motor functioning were assessed using the Berg Balance Scale (BBS), the Timed Up and Go test (TUGT) and the Fugl-Meyer lower extremity assessment (FMA-LE). Additionally, three-dimensional gait analysis was performed to document gait speed, bilateral spatial asymmetry, bilateral temporal asymmetry, and the dual-task cost (DTC) of gait speed.Results:Significant improvement was observed in the average BBS scores, TUGT times, FMA-LE scores, gait speed, DTC of gait speed, bilateral spatial asymmetry ratios, and bilateral temporal asymmetry ratios of all 3 groups after the experiment. The averages of the cognitive dual-task group were then significantly better than the control group′s averages. The motor dual-task group′s average BBS score (42.67±7.87), TUGT time [(22.30±8.53)s], gait speed (0.58±0.2m/s), DTC of gait speed (19.02±5.99%), and bilateral spatial asymmetry ratio (19.79±10.41%) were then significantly better than the control group′s averages but not significantly different from those of the cognitive dual-task group.Conclusions:Dual-task training can significantly improve the balance, walking and lower limb motor function of stroke survivors, correcting their abnormal gait patterns and consequently reducing their fall risks.
3.Mechanism of Herbal Cake-separated Moxibustion in Improving Neuroimmune Inflammation in Rats with Chronic Fatigue Syndrome by Interfering TLR4/MyD88/NF-κB Pathway
Chuntao ZHAI ; Yawei HOU ; Linjuan SHI ; Yixiao WANG ; Wei LI ; Yuefeng TIAN
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(4):140-149
ObjectiveTo explore the mechanism of herbal cake-separated moxibustion using the classical formula Xiaoyaosan in alleviating neuroimmune inflammatory responses in chronic fatigue syndrome (CFS) rats, based on the regulation of the toll-like receptor 4 (TLR4)/myeloid differentiation factor 88 (MyD88)/nuclear transcription factor-κB (NF-κB) signaling pathway. MethodsFifty SPF-grade SD rats aged 6-8 weeks were randomly divided into five groups: Normal group, model group, sham herbal cake moxibustion group, Chinese medicine intragastric administration group, and herbal cake-separated moxibustion group, with 10 rats in each group. Except for the normal group, all other groups underwent a 21-day modeling process, followed by behavioral testing. The herbal cake-separated moxibustion and sham herbal cake moxibustion groups received interventions at the Shenque (CV8), Guanyuan (CV4), Zusanli (ST36), and Qimen (LR14) acupoints. The Chinese medicine intragastric administration group was treated with a Xiaoyaosan suspension via gavage. Behavioral tests were conducted after 10 days of continuous intervention. Serum levels of interleukin (IL)-1β, IL-6, and tumor necrosis factor-α (TNF-α), as well as hippocampal levels of IL-1β, IL-6, TNF-α, and NF-κB, were detected by enzyme-linked immunosorbent assay (ELISA). Morphological changes in the hippocampus were observed using hematoxylin-eosin (HE) staining. Real-time quantitative polymerase chain reaction (Real-time PCR) was used to detect mRNA expression levels of TLR4, MyD88, and NF-κB in the hippocampus. Western blot analysis was performed to detect the relative expression levels of TLR4, MyD88, NF-κB, and p65 proteins in the hippocampus. ResultsCompared with the normal group, the model group showed a significant decrease in upright times during the open field test (P<0.01), as well as significant reductions in total movement distance, resting time, and center region duration (P<0.01). In the tail suspension test, immobility time increased (P<0.01), and struggle times decreased (P<0.01). Serum and hippocampal levels of IL-1β, IL-6, and TNF-α, as well as hippocampal NF-κB levels and TLR4, MyD88, and NF-κB mRNA expression, were significantly elevated (P<0.01). After treatment, compared with the model group, the total movement distance and upright times in the open field test were significantly increased in all treatment groups (P<0.01), while resting time and center region duration were notably prolonged (P<0.05, P<0.01). Immobility time in the tail suspension test was significantly shortened (P<0.01), and struggle times significantly increased (P<0.05). Serum and hippocampal levels of IL-1β, IL-6, TNF-α, hippocampal NF-κB levels, and TLR4 and NF-κB mRNA expression were significantly reduced (P<0.05, P<0.01). Compared with the sham herbal cake moxibustion group, the herbal cake-separated moxibustion group showed a significant extension in center region duration during the open field test (P<0.05) and a significant increase in upright times (P<0.01). In the tail suspension test, immobility time was reduced (P<0.01), and struggle times increased (P<0.01). Serum TNF-α levels in the Chinese medicine intragastric administration group were significantly reduced (P<0.01), while serum IL-6 levels, as well as hippocampal levels of IL-1β, TNF-α, NF-κB, and TLR4, MyD88, and NF-κB mRNA expression, were significantly decreased in both the Chinese medicine intragastric administration group and the herbal cake-separated moxibustion group (P<0.05, P<0.01). Compared with the Chinese medicine intragastric administration group, the herbal cake-separated moxibustion group exhibited significantly increased upright times in the open field test (P<0.01). In the tail suspension test, immobility time was reduced (P<0.01), and struggle times increased (P<0.01). Serum IL-1β, hippocampal TNF-α levels, and TLR4, MyD88, and NF-κB mRNA expression were significantly decreased (P<0.05, P<0.01). ConclusionHerbal cake-separated moxibustion effectively improves fatigue and memory function in CFS rats, regulates neuroimmune inflammatory responses, and its mechanism may be related to the modulation of the TLR4/MyD88/NF-κB signaling pathway.
4.Herbal Cake-separated Moxibustion Improves Cognitive Function in Rat Model of Chronic Fatigue Syndrome via PI3K/Beclin1 Signaling Pathway
Chuntao ZHAI ; Yawei HOU ; Linjuan SHI ; Yixiao WANG ; Yuefeng TIAN
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(13):149-158
ObjectiveTo explore the mechanism of moxibustion with the classical prescription Xiaoyaosan as the herbal cake in improving cognitive function in the rat model of chronic fatigue syndrome (CFS) by regulating autophagy via phosphatidylinosiol 3-kinase (PI3K)/autophagy key molecule yeast Atg6 homologue 1 (Beclin1) signaling pathway. MethodsFifty SPF-grade SD rats aged 6-8 weeks were randomly grouped as follows: control, model, sham cake-separated moxibustion, intragastric administration with Chinese herbs, and herbal cake-separated moxibustion, each with 10 rats. The other groups except the control group were subjected to modeling by exhaustive swimming and chronic restraint stress for 21 days, and the behavioral test was performed after modeling. Herbal cake-separated moxibustion and sham cake-separated moxibustion were carried out at Shenque (CV8), Guanyuan (CV4), Zusanli (ST36), and Qimen (LR14). The rats in the intragastric administration with Chinese herbs group were treated with Xiaoyaosan suspension by gavage. After continuous intervention for 10 days, rat behaviors were observed and the levels of interleukin (IL)-4, IL-10, blood urine nitrogen (BUN), and malondiadehyde (MDA) in the serum and hippocampal tissue of rats in each group were determined by enzyme-linked immunosorbent assay. The morphological changes of the hippocampal tissue were observed by hematoxylin-eosin staining. The relative mRNA and protein levels of PI3K and Beclin1 in the hippocampal tissue were determined by Real-time quantitative polymerase chain reaction (Real-time PCR) and Western blot, respectively. ResultsCompared with the normal group, the model group showed reduced crossings, shortened residence time in the target quadrant, and prolonged average escape latency on days 1, 2, 3, and 4 (P<0.01) in the Morris water maze test. In the new object recognition test, the model group showed decreased recognition index of exploration time and recognition index of exploration times (P<0.01), lowered levels of IL-4 and IL-10 and elevated levels of BUN and MDA in the serum and hippocampus (P<0.01), and down-regulated mRNA and protein levels of PI3K and Beclin1 (P<0.01). After treatment, compared with the model group, each treatment group showed increased crossings, prolonged residence time in the target quadrant, and shortened average escape latency on days 1, 2, 3, and 4 (P<0.05, P<0.01). In addition, the treatment elevated the levels of IL-4 and IL-10 and lowered the levels of BUN and MDA in the serum and hippocampus (P<0.05, P<0.01), and up-regulated the mRNA and protein levels of PI3K and Beclin1 (P<0.05, P<0.01). Compared with the sham cake-separated moxibustion group, the herbal cake-separated moxibustion group and the intragastric administration with Chinese herbs group showed increased crossings, prolonged residence time in the target quadrant (P<0.05), elevated level of IL-4, lowered level of MDA, and up-regulated relative mRNA and protein levels of PI3K and Beclin1 in the hippocampus (P<0.05, P<0.01). The serum levels of MDA and BUN in the intragastric administration with Chinese herbs group were significantly decreased. The average escape latency of the herbal cake-separated moxibustion group was significantly shortened on days 2 and 3 (P<0.05, P<0.01). In addition, this group showed elevated serum level of IL-4, lowered serum level of MDA, and declined BUN level in the hippocampus (P<0.05, P<0.01). Compared with the intragastric administration with Chinese herbs group, the herbal cake-separated moxibustion group presented risen serum level of IL-4 and up-regulated mRNA level of Beclin1 (P<0.05) and relative protein levels of PI3K and Beclin1 (P<0.05, P<0.01). ConclusionHerbal cake-separated moxibustion can effectively alleviate fatigue and improve the memory, reduce inflammatory response and oxidative stress, and decrease autophagy of hippocampal neurons in CFS rats by regulating the PI3K/Beclin1 signaling pathway.
5.Herbal Cake-separated Moxibustion Improves Cognitive Function in Rat Model of Chronic Fatigue Syndrome via PI3K/Beclin1 Signaling Pathway
Chuntao ZHAI ; Yawei HOU ; Linjuan SHI ; Yixiao WANG ; Yuefeng TIAN
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(13):149-158
ObjectiveTo explore the mechanism of moxibustion with the classical prescription Xiaoyaosan as the herbal cake in improving cognitive function in the rat model of chronic fatigue syndrome (CFS) by regulating autophagy via phosphatidylinosiol 3-kinase (PI3K)/autophagy key molecule yeast Atg6 homologue 1 (Beclin1) signaling pathway. MethodsFifty SPF-grade SD rats aged 6-8 weeks were randomly grouped as follows: control, model, sham cake-separated moxibustion, intragastric administration with Chinese herbs, and herbal cake-separated moxibustion, each with 10 rats. The other groups except the control group were subjected to modeling by exhaustive swimming and chronic restraint stress for 21 days, and the behavioral test was performed after modeling. Herbal cake-separated moxibustion and sham cake-separated moxibustion were carried out at Shenque (CV8), Guanyuan (CV4), Zusanli (ST36), and Qimen (LR14). The rats in the intragastric administration with Chinese herbs group were treated with Xiaoyaosan suspension by gavage. After continuous intervention for 10 days, rat behaviors were observed and the levels of interleukin (IL)-4, IL-10, blood urine nitrogen (BUN), and malondiadehyde (MDA) in the serum and hippocampal tissue of rats in each group were determined by enzyme-linked immunosorbent assay. The morphological changes of the hippocampal tissue were observed by hematoxylin-eosin staining. The relative mRNA and protein levels of PI3K and Beclin1 in the hippocampal tissue were determined by Real-time quantitative polymerase chain reaction (Real-time PCR) and Western blot, respectively. ResultsCompared with the normal group, the model group showed reduced crossings, shortened residence time in the target quadrant, and prolonged average escape latency on days 1, 2, 3, and 4 (P<0.01) in the Morris water maze test. In the new object recognition test, the model group showed decreased recognition index of exploration time and recognition index of exploration times (P<0.01), lowered levels of IL-4 and IL-10 and elevated levels of BUN and MDA in the serum and hippocampus (P<0.01), and down-regulated mRNA and protein levels of PI3K and Beclin1 (P<0.01). After treatment, compared with the model group, each treatment group showed increased crossings, prolonged residence time in the target quadrant, and shortened average escape latency on days 1, 2, 3, and 4 (P<0.05, P<0.01). In addition, the treatment elevated the levels of IL-4 and IL-10 and lowered the levels of BUN and MDA in the serum and hippocampus (P<0.05, P<0.01), and up-regulated the mRNA and protein levels of PI3K and Beclin1 (P<0.05, P<0.01). Compared with the sham cake-separated moxibustion group, the herbal cake-separated moxibustion group and the intragastric administration with Chinese herbs group showed increased crossings, prolonged residence time in the target quadrant (P<0.05), elevated level of IL-4, lowered level of MDA, and up-regulated relative mRNA and protein levels of PI3K and Beclin1 in the hippocampus (P<0.05, P<0.01). The serum levels of MDA and BUN in the intragastric administration with Chinese herbs group were significantly decreased. The average escape latency of the herbal cake-separated moxibustion group was significantly shortened on days 2 and 3 (P<0.05, P<0.01). In addition, this group showed elevated serum level of IL-4, lowered serum level of MDA, and declined BUN level in the hippocampus (P<0.05, P<0.01). Compared with the intragastric administration with Chinese herbs group, the herbal cake-separated moxibustion group presented risen serum level of IL-4 and up-regulated mRNA level of Beclin1 (P<0.05) and relative protein levels of PI3K and Beclin1 (P<0.05, P<0.01). ConclusionHerbal cake-separated moxibustion can effectively alleviate fatigue and improve the memory, reduce inflammatory response and oxidative stress, and decrease autophagy of hippocampal neurons in CFS rats by regulating the PI3K/Beclin1 signaling pathway.
6.Expert consensus on non-surgical treatment for acute lateral ankle sprain (version 2025)
Hui CHE ; Wenge DING ; Shiming FENG ; Xueping GU ; Qinwei GUO ; Jianchao GUI ; Yinghui HUA ; Yuefeng HAO ; Qinglin HAN ; Bo HU ; Xiaojun LIANG ; Guoping LI ; Yunxia LI ; Qi LI ; Yanlin LI ; Xin MA ; Jun MA ; Xudong MIAO ; Jianzhong QIN ; Xiaodong QIN ; Xu SUN ; Kefu SUN ; Weidong SONG ; Dai SHI ; Zhongmin SHI ; Youlun TAO ; Xu WANG ; Youhua WANG ; Liheng WANG ; Anli WANG ; Aiguo WANG ; Weidong WU ; Yajun XU ; Weidong XU ; Renjie XU ; Yongsheng XU ; Tengbo YU ; Lianqi YAN ; Xiaodong YUAN ; Yuan ZHU ; Mingzhu ZHANG ; Hongtao ZHANG ; Xintao ZHANG ; Xiaofei ZHENG
Chinese Journal of Trauma 2025;41(6):517-529
Acute lateral ankle sprain (ALAS) is one of the most common sport injuries, with high incidence, recurrence and disability rates. Currently, exercise rehabilitation-based non-surgical treatment is the primary management approach for ALAS. However, there remain improper practices such as excessive immobilization or uncontrolled activity, which contribute to recurrent sprains and chronic ankle instability, significantly impairing patients′ athletic function and quality of life. To standardize the non-surgical management of ALAS, improve the cure rates, and reduce the recurrence and disability rates, Chinese Sports Rehabilitation Medicine Training Project of Chinese Medical Association, Foot and Ankle Basics and Orthopedics Group, Orthopedic Branch of Chinese Medical Doctor Association, and Sports Medicine Branch of Jiangsu Medical Association organized relevant experts to formulate Expert consensus on non-surgical treatment for acute lateral ankle sprain ( version 2025), following the principles of scientific vigor, practicality, and innovation. Thirteen recommendations were proposed for standardized treatment protocols across different healing phases, aiming to provide references for standard management of ALAS and improve the therapeutic outcomes.
7.Effects of dual-task training on abnormal gait and fall risk among stroke survivors
Yuefeng WU ; Xiaoqiong DONG ; Tong ZHU ; Fang ZHANG ; Panke SHI ; Qingchuan JIAO ; Jianqiu GONG
Chinese Journal of Physical Medicine and Rehabilitation 2025;47(8):704-709
Objective:To observe any effect of dual-task training on abnormal gait and fall risk among hemiplegic stroke survivors.Methods:A total of 90 stroke survivors were randomly divided into a control group, a cognitive dual-task group, and a motor dual-task group, each of 30. All 3 groups received conventional post-stroke medication and rehabilitation training, but the cognitive and motor dual-task groups received cognitive or motor dual-task training as well. Before and after 4 weeks of the training, everyone′s balance, walking and lower limb motor functioning were assessed using the Berg Balance Scale (BBS), the Timed Up and Go test (TUGT) and the Fugl-Meyer lower extremity assessment (FMA-LE). Additionally, three-dimensional gait analysis was performed to document gait speed, bilateral spatial asymmetry, bilateral temporal asymmetry, and the dual-task cost (DTC) of gait speed.Results:Significant improvement was observed in the average BBS scores, TUGT times, FMA-LE scores, gait speed, DTC of gait speed, bilateral spatial asymmetry ratios, and bilateral temporal asymmetry ratios of all 3 groups after the experiment. The averages of the cognitive dual-task group were then significantly better than the control group′s averages. The motor dual-task group′s average BBS score (42.67±7.87), TUGT time [(22.30±8.53)s], gait speed (0.58±0.2m/s), DTC of gait speed (19.02±5.99%), and bilateral spatial asymmetry ratio (19.79±10.41%) were then significantly better than the control group′s averages but not significantly different from those of the cognitive dual-task group.Conclusions:Dual-task training can significantly improve the balance, walking and lower limb motor function of stroke survivors, correcting their abnormal gait patterns and consequently reducing their fall risks.
8.Changes of topological attributes of brain structural network in patients with postpartum depression
Kai XIE ; Yang LI ; Xiaolan ZHU ; Yujiao CAI ; Yifeng LUO ; Zhihong CAO ; Yuefeng LI ; Jiajia SHI
Chinese Journal of Perinatal Medicine 2024;27(6):468-476
Objective:To investigate the features of the brain structural network in patients with postpartum depression (PPD).Methods:This cross-sectional study included PPD patients who visited the mental health counseling clinic after delivery at the Jiangsu University Affiliated Yixing Hospital from June 2013 to September 2022 (PPD group). Matched non-PPD postpartum women based on age, years of education, and body mass index who came for postpartum follow-up (non-PPD postpartum group), and non-pregnant women who visited the hospital or underwent physical examinations during the same period (non-pregnant group) were also included. Demographic data and diffusion tensor imaging (DTI) data were collected for all three groups. The brain was partitioned into 90 regions using an anatomical template to construct the brain structural network. Network-based statistics (NBS) were applied to further screen and construct subnetworks. The efficacy of the subnetworks in identifying PPD was evaluated through multivariable logistics regression models and receiver operating characteristic curves. A comparison of the connectivity strength of white matter tracts and topological attributes of brain structural network parameters was conducted using independent samples t-tests, and the results were corrected using the false discovery rate (FDR) method. Results:(1) A total of 116 subjects were included, with 40 in the non-pregnant group, 40 in the non-PPD postpartum group, and 36 in the PPD group. PPD group had higher Edinburgh Postnatal Depression Scale (EPDS) scores than the non-pregnant and non-PPD postpartum groups [(18.0±4.1) scores vs. (2.5±1.2) and (6.1±2.1) scores, F=340.40; t=24.65,10.60 and 16.16 in pairwise comparison; all P<0.001]. (2) Compared to the non-pregnant group, there was a decrease in the connectivity strength of nine white matter tracts within the brain structural network of the postpartum group (including left dorsolateral superior frontal gyrus-left anterior cingulate and paracingulate gyrus, left dorsolateral superior frontal gyrus-right amygdala, left dorsolateral superior frontal gyrus-left insula, left insula-left lentiform nucleus, left insula-left hippocampus, left hippocampus-right amygdala, left hippocampus-left precuneus, left anterior cingulate and paracingulate gyrus-right amygdala, and right amygdala-right hippocampus) (all P<0.05, FDR corrected). No increased connection strengths were observed. There were no significant differences in the connection strengths of these nine tracts between the non-PPD and PPD groups. (3) A characteristic subnetwork for the maternal group was successfully constructed based on the nine tracts, which exhibited typical small-world properties (σ>1). Compared to the non-PPD maternal group, the characteristic path length in the PPD group was increased [(3.904±0.328) vs. (4.130±0.433), t=-2.58], and global efficiency was decreased [(0.361±0.036) vs. (0.331±0.053), t=2.91] (both P<0.05). Local property comparisons showed that the node efficiency values for the left dorsolateral superior frontal gyrus, left insula, left anterior cingulate and paracingulate gyrus, left hippocampus, right hippocampus, right amygdala, left precuneus and left putamen in the PPD group were significantly reduced [(0.273±0.023) vs. (0.267±0.030), t=0.98; (0.299±0.035) vs. (0.276±0.041), t=2.64; (0.265±0.019) vs. (0.258±0.025), t=1.38; (0.318±0.028) vs. (0.305±0.031), t=1.92; (0.312±0.027) vs. (0.302±0.031), t=1.50; (0.322±0.030) vs. (0.298±0.026), t=3.71; (0.356±0.040) vs. (0.338±0.056), t=1.62; (0.346±0.028) vs. (0.331±0.036), t=1.74; all P<0.05]. However, only the differences in node efficiency values for the left insula and right amygdala remained significant after FDR correction (corrected P=0.041 and 0.003). (4) Global efficiency, as well as node efficiency for the left insula and right amygdala, demonstrated good value for identifying PPD [areas under the curve (AUC) and their 95% CI were 0.827 (0.732-0.922), 0.741 (0.628-0.854), and 0.761 (0.653-0.867), respectively], with even better performance when combined [0.897 (0.828-0.969)]. (5) In the PPD group, global efficiency ( r=-0.43, P=0.008), node efficiency for the left insula ( r=-0.39, P=0.019), and node efficiency for the right amygdala ( r=-0.42, P=0.011) were all negatively correlated with EPDS scores. Conclusion:Aberrations in global efficiency, node efficiency for the left insula, and node efficiency for the right amygdala may serve as characteristic neuroimaging biomarkers for PPD.
9.Mechanism of Yitangkang Granule in Promoting Podocyte Autophagy Through Regulation of PI3K/Akt/FoxO1 Signaling Pathway Mediated by SIRT1 via AGE-RAGE Axis
Yuefeng CHENG ; Jiaxiang YU ; Hanwen ZHANG ; Chao QU ; Yifei HUO ; Xiaorui ZHANG ; Yan SHI ; Wenshun ZHANG
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(17):113-121
ObjectiveTo explore the underlying mechanism by which the Chinese medicine compound Yitangkang granule(YTK) treats diabetic kidney disease (DKD) by observing its effects on podocyte autophagy through the regulation of phosphatidylinositol 3-kinase (PI3K)/protein kinase B (Akt)/forkhead transcription factor O1 (FoxO1) signaling pathway mediated by silent information regulator 1 (SIRT1) via advanced glycation end products (AGE)/receptor for AGE (RAGE) axis. MethodNinety-six 8-week-old healthy male SPF-grade Wistar rats were selected and randomly divided into blank control group (B), model control group, high-dose YTK (40 g·kg-1), medium-dose YTK (20 g·kg-1), low-dose YTK (10 g·kg-1), and Western medicine control (20 mg·kg-1 losartan) groups. The DKD rat model was established by high-fat diet feeding combined with intraperitoneal injection of streptozotocin. After successful modeling, the rats in each group received the corresponding treatments for eight weeks. The levels of superoxide dismutase (SOD), malondialdehyde (MDA), glutathione peroxidase (GSH-Px), and catalase (CAT) were measured according to the instructions of the respective assay kits. Hematoxylin and eosin (HE) staining was used to observe pathological changes in kidney tissues. Immunohistochemistry was employed to detect the average optical density values of α-smooth muscle actin (α-SMA), fibronectin (FN), desmin, and nephrin. Western blot analysis was used to measure the expression levels of PI3K, phosphorylated PI3K (p-PI3K), Akt, phosphorylated Akt (p-Akt), RAGE, SIRT1, Caspase-3, and FoxO1 proteins in kidney tissues of DKD rats. ResultCompared with the blank control group, the model group showed significantly lower levels of SOD, GSH-Px, and CAT, and significantly higher levels of MDA (P<0.01). The rats exhibited severe kidney damage. The positive expression of podocyte marker proteins α-SMA, FN, and desmin increased significantly, while nephrin and podocin significantly decreased (P<0.01). The expression levels of PI3K, p-PI3K, Akt, p-Akt, RAGE, and Caspase-3 proteins were significantly elevated, while SIRT1 and FoxO1 protein levels were significantly reduced (P<0.01). Compared with the model control group, rats in the YTK treatment groups showed significantly higher levels of SOD, GSH-Px, and CAT, and significantly lower levels of MDA in serum (P<0.01). The degree of kidney damage was reduced to varying extents. The average optical density values of podocyte marker proteins α-SMA, FN, and desmin were significantly decreased, while nephrin and podocin significantly increased (P<0.01). The expression levels of PI3K, p-PI3K, Akt, p-Akt, RAGE, and Caspase-3 in kidney tissues were significantly reduced, while SIRT1 and FoxO1 expression levels significantly increased (P<0.01). The Chinese medicine groups demonstrated a clear dose-response trend. ConclusionYTK may alleviate kidney pathological damage, reduce proteinuria, and protect kidney function in DKD rats, thereby delaying the progression of DKD by improving podocyte autophagy through the AGE-RAGE axis-mediated SIRT1 regulation of the PI3K/Akt/FoxO1 signaling pathway. Additionally, a dose-response relationship was observed in the Chinese medicine groups.
10.Pure single-port lumpectomy non-lipolysis breast-conserving surgery in the treatment of early-stage breast cancer
Qianhe ZHOU ; Yuefeng SHANG ; Tong LIU ; Bo LEI ; Runze SHI ; Jianyu LIU ; Zhigao LI
Chinese Journal of Endocrine Surgery 2023;17(2):143-149
Objective:To summarize the clinical data and experience of pure single-port lumpectomy non-lipolysis breast-conserving surgery (PSLN-BCS) in patients with early-stage breast cancer.Methods:A retrospective analysis was conducted on 400 patients who underwent breast-conserving surgery for early-stage breast cancer in the Second Department of Breast Surgery at Harbin Medical University Cancer Hospital from Jan. 2022 to Jan. 2023. Patients were divided into two groups: PSLN-BCS group ( n=200) and conventional breast-conserving surgery (C-BCS) group ( n=200). The surgical time, intraoperative blood loss, postoperative drainage within three days, and short-term (3 months to 6 months after surgery) complications, including the incidence of residual fluid after drain removal and incision infection were observed. Long-term (6 months after surgery) complications, including the incidence of skin and pectoralis major muscle adhesions in the surgical area and cosmetic results after breast-conserving surgery, were also evaluated. Statistical analysis was performed using R language, and quantitative data were expressed as mean ± standard deviation ( ± s) and analyzed using t-test, while count data were analyzed using χ2 test. A p-value less than 0.05 was considered statistically significant. Results:PSLN-BCS had a longer average surgical time than C-BCS (198.341min vs 62.961min, P<0.001, 95% CI:132.028 vs 138.732). PSLN-BCS had less intraoperative bleeding (18.824 ml vs 22.627 ml, P=0.003, 95% CI: -6.294 vs -1.311) and lower postoperative drainage volume (346.157 ml vs 406.191 ml, P<0.001, 95% CI: -70.571-a-49.496). There were no significant differences in short-term postoperative complications such as subcutaneous fluid accumulation ( χ2=2.33, P=0.127) or incisional infection ( χ2=0.14, P=0.708) between the two groups. The incidence of skin and muscle adhesions in the surgical area was lower in patients who underwent PSLN-BCS at 6 months postoperatively ( χ2=11.58, P<0.001). Patients who received PSLN-BCS achieved better cosmetic outcomes, with a statistically significant difference ( χ2=273.00, P<0.001) compared to those who received C-BCS. Conclusion:Pure single-port lumpectomy non-lipolysis breast-conserving surgery is a safe and effective treatment option for early-stage breast cancer and can be considered as a surgical option for patients with cosmetic requirements.

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