OBJECTIVE: To investigate the synergistic interaction between the deltoid muscle and the rotator cuff muscle group in patients with rotator cuff tears (RCT), as well as the impact of the critical shoulder angle (CSA) on deltoid muscle strength. METHODS: A retrospective analysis was conducted on clinical data from 42 RCT patients who met the selection criteria and were treated between March 2022 and March 2023. There were 13 males and 29 females, with an age range of 42-77 years (mean, 60.5 years). Preoperative visual analogue scale (VAS) score was 6.0±1.6. CSA measurements were obtained from standard anteroposterior X-ray films before operation, and patients were divided into two groups based on CSA measurements: CSA>35° group (group A) and CSA≤35° group (group B). Handheld dynamometry was used to measure the muscle strength of various muscle group in the shoulder (including the supraspinatus, infraspinatus, subscapularis, and anterior, middle, and posterior bundles of the deltoid). The muscle strength of the unaffected side was compared to the affected side, and muscle imbalance indices were calculated. Muscle imbalance indices between male and female patients, dominant and non-dominant sides, and groups A and B were compared. Pearson correlation analysis was used to examine the relationship between muscle imbalance indices and CSA as well as VAS scores. RESULTS: Muscle strength in all muscle groups on the affected side was significantly lower than on the unaffected side ( P<0.05). The muscle imbalance indices for the supraspinatus, subscapularis, infraspinatus, and anterior, middle, and posterior bundles of the deltoid were 14.8%±24.4%, 5.9%±9.7%, 7.2% (0, 9.1%), 17.2% (5.9%, 26.9%), 8.3%±21.3%, and 10.2% (2.8%, 15.4%), respectively. The muscle imbalance indices of the anterior bundle of the deltoid, supraspinatus, and infraspinatus were significantly lower in male patients compared to female patients ( P<0.05); however, there was no significant difference in muscle imbalance indices among other muscle groups between male and female patients or between the dominant and non-dominant sides ( P>0.05). There was a positive correlation between the muscle imbalance indices of infraspinatus and VAS score ( P<0.05), and a positive correlation between CSA and the muscle imbalance indices of middle bundle of deltoid ( P<0.05). There was no correlation between the muscle imbalance indices of other muscle groups and VAS score or CSA ( P>0.05). Preoperative CSA ranged from 17.6° to 39.4°, with a mean of 31.1°. There were 9 cases in group A and 33 cases in group B. The muscle imbalance indices of the anterior bundle of the deltoid was significantly lower in group A compared to group B ( P<0.05), while there was no significant difference in muscle imbalance indices among other muscle groups between group A and group B ( P>0.05). CONCLUSION Patients with RCT have a phenomenon of deltoid muscle strength reduction, which is more pronounced in the population with a larger CSA.
Male ; Female ; Humans ; Adult ; Middle Aged ; Aged ; Shoulder ; Rotator Cuff Injuries/surgery* ; Shoulder Joint/diagnostic imaging* ; Rotator Cuff/surgery* ; Muscle Strength ; Deltoid Muscle

Objective:To investigate the relationship between autophagy and nuclear factor E2 related factor 2(Nrf2) signaling pathway during high glucose-induced damage to Schwann cells.Methods:RSC96 were cells cultured in vitro and seeded in 96-well plates (1×10 4 cells/ml, 200 μl/well) or in 6-well plates (1×10 6 cells/ml, 2 ml/well) for 48 h. The cells were divided into 3 groups ( n=25 each) using a random number table method: control group (group C), high glucose group (group H) and high glucose+ autophagy agonist rapamycin group ( group H+ RAP). The cells were cultured in the common culture medium in group C. In group H, 50 mmol/L of glucose was added to the culture medium.In group H+ RAP, 50 mmol/L of glucose and 5 μmol/L rapamycin were added to the culture medium.At 48 h of incubation, the growth of cells was observed with inverted phase contrast microscope, the cell viability was measured using MTT method, apoptosis rate was determined by flow cytometry, malondialdehyde (MDA) content was determined by thiobarbituric acid method, superoxide dismutase (SOD) activity was detected using xanthine oxidase method, and the expression of Nrf2, P62 and microtubule-associated protein 1 light chain 3 Ⅱ (LC3 Ⅱ) was determined by Western blot. Results:Compared with group C, the cell viability and SOD activity were significantly decreased, apoptotic rate and MDA content were increased, and expression of Nrf2, P62 and LC3Ⅱ was up-regulated in group H and group H+ RAP ( P<0.05). Compared with group H, the cell viability and SOD activity were significantly increased, apoptosis rate and MDA content were decreased, the expression of Nrf2 and LCII was up-regulated and P62 expression was down-regulated in group H+ RAP ( P<0.05). Conclusion:Enhanced autophagy can activate Nrf2 signaling pathway, which is the endogenous protective mechanism of Schwann cell injury induced by high glucose.

Peripheral nerve injury (PNI) is an important clinical complication, which brings long-term physical and psychological pain and economic burden to patients. There is no satisfactory treatment plan for PNI. Although microsurgery technology has been greatly developed, some peripheral nerve defects or ruptures caused by external forces can be repaired by surgery or nerve transplantation. However, due to the weak ability of nerve cell regeneration and surgical operations may cause damage to the injured nerves, the patient's functional recovery may not be able to achieve the desired effect. Therefore, it is urgent to find a safe and effective method to treat PNI. Mesenchymal stem cells have special differentiation potential and can differentiate into a variety of cell types in vitro and in vivo, and have received widespread attention from researchers. In this paper, the research progress of mesenchymal stem cells in nerve injury repair was summarized, and the characteristics, functions of mesenchymal stem cells and the mechanism of action in peripheral nerve injury repair were reviewed.

Objective: To detect differentially expressed microRNAs in chronic hepatitis B (CHB) before being treated with pegylated interferon (PegIFN) and the relationship between their target genes and HBsAg loss. Methods: Pretreatment differentially expressed microRNAs between different response groups were screened using high throughput microarrays and validated by quantitative reverse-transcription polymerase chain reaction (RT-qPCR). Bioinformatics analysis was performed to determine their target genes potential mechanistic roles. Results: A total of 417 microRNA were differentially expressed between different response groups, among which 342 were up-regulated and 75 were down-regulated. miR-3960, miR-126-3p, miR-23 a-3p and miR-335-5p were verified to be down-regulated by RT-qPCR result in HBsAg loss group. Bioinformatic analysis result show that the relevant pathways of microRNAs include AMPK signal pathway, NOD-like signal pathway, NF-kappa B signal pathway and mTOR signal pathway. Conclusions HBsAg loss is probably achieved as the result of genes expression regulated in association with immune response, further enhance the immune response of HBV elimination and acquire HBsAg loss.

Objective To investigate the circulation and use of Akebiae Caulis and Clematidis Armandii Caulis;To provide references for clinical safe medication. Methods Literature review, field survey and telephone interview were used to conduct the investigation. Results ① The market currency of the Akebiae Caulis and Clematidis Armandii Caulis was very confused, and the mainly medicinal materials on the market were Clematidis Armandii Caulis. ② The majority used medicinal materials were Clematidis Armandii Caulis, and Akebiae Caulis was rarely used. ③ The Chinese Pharmacopoeia collected Akebiae Caulis and Clematidis Armandii Caulis separately, but there was phenomenon of using Clematidis Armandii Caulis replacing of Akebiae Caulis. Conclusion Market of Akebiae Caulis is shrinking; the phenomenon of using Clematidis Armandii Caulis to replace Akebiae Caulis widespread in clinic. There are differences in the efficacy of Akebiae Caulis and Clematidis Armandii Caulis, so they should be distinguished and cannot be used to mix or substitute.

Through detailed investigation of the market circulation of Ligustici Rhizoma et Radix, at the same time, this article collected relevant articles, conducted comparative study on genuine and conventionally used Ligustici Rhizoma et Radix from the aspects of textual research, functions, chemical composition and pharmacological effect, and discussed the results of the study.

In recent years, with the wide use of antimicrobial agents, the adverse reactions related to antimicrobial agents have attracted more and more attention.Among them, the adverse reactions in hematological system induced by antibacterial agents seriously affect patient′s health and doctor′s selection for antibiotics.For example, some beta lactam antibiotics can cause dysfunction of coagulation and hemolytic anemia.Chloramphenicol and sulfonamides can cause aplastic anemia.Linezolid can cause thrombocytopenia and anemia.It is important to understand the adverse reactions in hematological system caused by antibiotics.In this paper, the antibiotic induced adverse reactions in hematological system and their mechanism were summarized in order to provide information for the rational use of antimicrobial agents.

Objective To evaluate the effect of hydrogen-rich saline on Toll-like receptor 4 (TLR4) /nuclear factor kappa B (NF-κB) signaling pathway in the sciatic nerve of rats with diabetic neuropathic pain (DNP).Methods Pathogen-free male Sprague-Dawley rats, aged 8 weeks, weighing 180-210 g, were used in the study.DPN model was established by intraperitoneal injection of 1％ streptozocin (STZ) 65 mg/kg.Twenty-four diabetic rats were randomly divided into 2 groups (n =12 each) using a random number table: DPN group and hydrogen-rich saline group (HRS group).Another 12 normal rats were randomly selected and served as control group (group C).At 14 days after STZ injection, hydrogenrich saline 5 ml/kg was injected intraperitoneally once a day for 14 consecutive days in group HRS, while the equal volume of normal saline was given in C and DNP groups.Mechanical paw withdrawal threshold to yon Frey stimuli (MWT) and thermal paw withdrawal latency (TWL) were measured at 2 days before STZ injection (T0) , and 7, 14, 21 and 28 days after STZ injection (T1-4).The motor nerve conduction velocity (MNCV) of the right hindlimb was measured after pain threshold was measured at T4.After measurement of neurological function was completed, the expression of TLR4 and NF-κB was detected in the sciatic nerve (by Western blot) , the tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) contents in sciatic nerves were measured by enzyme-linked immunosorbent assay, and the neuronal apoptosis was detected by TUNEL.The apoptosis index was calculated.Results Compared with group C, the MWT was significantly decreased at T1-4, TWL was shortened at T2-4, and MNCV was decreased at T4, the expression of TLR4 and NF-κB, contents of TNF-α and IL-6, and apoptosis index were increased in HRS and DNP groups (P＜0.05).Compared with group DNP, the MWT was significantly increased, and TWL was prolonged at T3,4 MNCV was increased T4, and the expression of TLR4 and NF-κB, contents of TNF-α and IL-6, and apoptosis index were decreased in group HRS (P＜ 0.05).Conclusion Hydrogen-rich saline can mitigate DNP through blocking TLR4/NF-κB signaling pathway in the sciatic nerve of rats.

Objective To evaluate the effect of hydrogen?rich saline on nuclear factor erythroid 2?related factor 2 ( Nrf2)∕antioxidant response element ( ARE) pathway in the peripheral nerve in a rat model of diabetic neuropathic pain ( DNP ) . Methods Thirty?six healthy male Sprague?Dawley rats, aged 8 weeks, weighing 180-200 g, were randomly divided into 3 groups ( n=12 each) using a random number table: control group ( C group) , DNP group and hydrogen?rich saline group ( HRS group) . Diabetes melli?tus was produced by intraperitoneal 1% streptozocin ( STZ) 65 mg∕kg and confirmed by fasting blood glucose concentration>16?67 mmol∕L. Hydrogen?rich saline 5 ml∕kg was injected intraperitoneally once a day for 14 consecutive days starting from 14 days after STZ injection in group HRS, and the equal volume of normal saline was given in C and DNP groups. The mechanical paw withdrawal threshold ( MWT) and thermal paw withdrawal latency ( TWL) were measured at 2 days before STZ injection ( T0 ) , and 7, 14, 21 and 28 days after STZ injection ( T1?4 ) . After measurement of the pain threshold at T4 , the motor nerve conduction velocity ( MNCV) of the right hindlimb and distal motor latency were measured. The expression of Nrf2 in nucleoprotein and HO?1 and NQO1 in total protein was detected in the sciatic nerve by Western blot. Re?sults Compared with group C, the MWT was significantly decreased, and the TWL was shortened at T1?4 , and the expression of Nrf2 in nucleoprotein and HO?1 and NQO1 in total protein was up?regulated in DNP and HRS groups (P<0?05). Compared with group DNP, the MWT was significantly increased, and the TWL was prolonged at T3 and T4 , and the expression of Nrf2 in nucleoprotein and HO?1 and NQO1 in total protein was up?regulated in group HRS ( P<0?05) . Conclusion The mechanism by which hydrogen?rich saline mitigates DNP is related to activated Nrf2∕ARE pathway in the peripheral nerve of rats.

Objective To investigate the expressions of B7-H1 and Bcl-2 proteins in epithelial ovarian cancer,and to explore the association of the expressions of B7-H1 and Bcl-2 with clinicopathological features.Methods The expressions of B7-H1 and Bcl-2 proteins were detected by immunohistochemistry in 80 cases of epithelial ovarian cancer tissues and 20 normal ovary tissues.The association of the expressions of B7-H1 and Bcl-2 with the clinicopathological features was analyzed.Results The positive expression rates of B7-H1 and Bcl-2 in epithelial ovarian cancer tissues were 77.5％ (62/80) and 58.8％ (47/80),both higher than 15.0％ (3/20) and 10.0％ (2/20) in normal ovary tissues with significant difference (x2 =27.473,P ＜ 0.05 ; x2 =15.216,P ＜ 0.05).Both of Bcl-2 and B7-H1 expressions in epithelial ovarian cancer tissues were negatively correlated with the differentiation degree of epithelial ovarian cancer (x2 =9.367,P ＜ 0.01 ; x2 =11.702,P ＜ 0.01).The Bcl-2 expression in epithelial ovarian cancer tissues was positively correlated with the FIGO stage (x2 =7.766,P ＜ 0.01).The expression of B7-H1 was positively correlated with the expression of Bcl-2 in epithelial ovarian cancer (r =0.400,P ＜0.01).Conclusion The expressions of B7-H1 and Bcl-2 are up-regulated in epithelial ovarian cancer and they correlate to each other positively.The expressions of B7-H1 and Bcl-2 are correlated with the invasion and metastasis of epithelial ovarian cancer.The detection of B7-H1 combined with Bcl-2 may have an important clinical significance in the diagnosis and treatment for patients with epithelial ovarian cancer.