Rosuvastatin(RVS)is an excellent drug with anti-inflammatory and lipid-lowering properties in the aca-demic and medical fields.However,this drug faces a series of challenges when used to treat atherosclerosis caused by hyperhomocysteinemia(HHcy),including high oral dosage,poor targeting,and long-term toxic side effects.In this study,we applied nanotechnology to construct a biomimetic nano-delivery system,macrophage membrane(M?m)-coated RVS-loaded Prussian blue(PB)nanoparticles(MPR NPs),for improving the bioavailability and targeting capacity of RVS,specifically to the plaque lesions associated with HHcy-induced atherosclerosis.In vitro assays demonstrated that MPR NPs effectively inhibited the Toll-like receptor 4(TLR4)/hypoxia-inducible factor-1α(HIF-1α)/nucleotide-binding and oligomerization domain(NOD)-like receptor thermal protein domain associated protein 3(NLRP3)signaling pathways,reducing pyroptosis and inflammatory response in macrophages.Additionally,MPR NPs reversed the abnormal distribution of adenosine triphosphate(ATP)-binding cassette transporter A1(ABCA1)/ATP binding cassette transporter G1(ABCA1)/ATP binding cassette transporter G1(ABCG1)caused by HIF-1α,promoting cholesterol efflux and reducing lipid deposition.In vivo studies using apolipoprotein E knockout(ApoE-/-)mice confirmed the strong efficacy of MPR NPs in treating atherosclerosis with favorable bio-security,and the mechanism behind this efficacy is believed to involve the regulation of serum metabolism and the remodeling of gut microbes.These findings suggest that the synthesis of MPR NPs provides a promising nanosystem for the targeted therapy of HHcy-induced atherosclerosis.

OBJECTIVE：To study th e improvement effect and mechanism of Dajianzhong decoction on irritable bowel syndrome（IBS）visceral pain model rats. METHODS ：Totally 48 male non-weaning rats were randomly divided into normal control group ，model group ，pinaverium bromide group （positive control ，45 mg/kg）and Dajianzhong decoction high-dose ， medium-dose and low-dose groups （2.16，1.08，0.54 g/kg，by crude drug ），with 8 rats in each group. Except for normal control group，IBS visceral pain model was established by mother and child separation ，acetic acid enema ，ovalbumin intraperitoneal Remote limb precondition - ing protects against ischemia induced neuronal death through ameliorating neuronal oxidative DNA damage injection in other groups for 57 d. On the 58th day ，the rats in administration groups were given the corresponding drugs intragastrically，and model group and normal control group were given constant volume of purified water ，once a day ，for consecutive 14 d. The general condition of rats was observed ；abdominal wall withdrawal reaction （AWR）was adopted to evaluate the visceral sensitivity of rats in each group under 20，40，60，and 80 mmHg （1 mmHg＝0.133 kPa）pressure；HE staining method was used to observe the colon pathological features of rats in each group. Western blotting assay was used to detect the protein expression of intestinal glial cells markers fibrillary acidic protein （GFAP），nerve growth factor （NGF）and its receptor TrkA in colon tissue. RESULTS ：The mucosal layer of colon tissue in rats of model group was discontinuous ，gland edema was observed and lymphocytes ，neutrophils and eosinophils were scattered in the lamina propria. In Dajianzhong decoction low-does group，the mucosal layer of colon tissue was incomplete ，some glands were slightly edematous ，and a few lymphocytes ， neutrophils in the lamina propria. The colonic mucosa epithelial structure was intact ，glands arranged regularly ，and no degenerative necrosis and inflammatory cells were observed in Dajianzhong decoction medium- and high-dose groups and pinaverium bromide group. Compared with normal control group ，AWR scores under 20，40，and 60 mmHg pressure ，relative protein expression of GFAR ，NGF and TrkA were all increased significantly in model group and Dajianzhong decoction low-does groups（P＜0.05 or P＜0.01）. Compared with model group ，AWR scores under 20，and 40 mmHg pressure in Dajianzhong decoction medium- and high-dose groups and pinaverium bromide group ，AWR scores under 60 mmHg pressure in Dajianzhong decoction high-dose group and pinaverium bromide group ，relative protein expression of GFAP ，NGF，TrkA in colon tissue in Dajianzhong decoction medium- and high-dose groups and pinaverium bromide group were all decreased significantly （P＜0.05 or P＜0.01）. CONCLUSIONS ：Dajianzhong decoction could improve the visceral pain of IBS model rats by inhibiting the activation of intestinal glial cells and reducing the expression of NGF and TrkA.

Objective Compare the efficacy of superselective arterial embolization with observation in the treatment of HFP caused by trauma.Methods From Jan,2013 to Dec,2017,6 traumatic HFP patients were involved into the study,the age range from 18 to 44 years old,with an average age of 26.2 years.The fistula was measured by doppler ultrasonography before the treatment with its longest diameter,and which ranges from 0.8 to 1.4 cm,the average diameter is 1.14 cm.All patients are divided into two groups according to their treatment.Operation group:4 patients underwent the pudendal artery superselective gelatin sponge vascular embolization.Control group:2 cases were treated with local cold compressing under watchful waiting.In control group,patients are treated by local cold compress with ice bag for 3 weeks:15 mins × 10 times every day.The erectile hardness of the patients was observed and the fistula was evaluated by doppler ultrasonography 3 weeks later,and all the patients were reexamined by doppler ultrasonography 1 year later.The erectile hardness was divided into four grades according to the patient~ subjective feelings:grade Ⅰ,the penis was enlarged but not rigid;grade Ⅱ,the penis had hardness,but not enough to insert into the vagina;grade Ⅲ,the penis could be inserted into the vagina,but not to achieve complete erection;grade Ⅳ,the penis fully erect and firm.The erectile function was evaluated with the International Index of Erectile Function-5(IIEF-5) after 1-year's follow-up.Results 4 patients in the operation group were operated successfully without obvious complications after operation.Median follow-up time of all the patients was 21 months (5-50).In group operation,4 cases of surgical patients did not have the recurrence of priapism.There was no obvious abnormality in the color doppler ultrasound of penis.The score of IIEF-5 was 25,24,24 and 23,respectively.Postoperative erectile function made a complete recovery.In group observation,2 patients under watchful waiting still have grade Ⅱ-Ⅲ sustained priapism,IIEF-5 score is 21 and 19 respectively,the penis color doppler ultrasound scan still showed the change of arteriovenous fistula.Conclusion Superselective arterial embolization is effective in the treatment of HFP,and the recovery of sexual function is better after operation compared with watchful waiting.

Objective To understand the status quo of the body mass index (BMI) among rural left‐behind elderly people in Chongqing ,and to analyze the impact of diet on BM I value to provide the dietary suggestions for improving the nutrional status of rural left behind elderly people .Methods The self‐designed questionnaire was used to conduct the on-site investigation on the ru‐ral left‐behind elderly people .The SPSS19 .0 statistical software was used for analysis .Results The average BMI value of surveyed people was (22 .14 ± 3 .22)kg/m2 ,the BMI value had statistically significant difference between different genders (χ2 =8 .170 ,P=0 .043) ,the normal proportion of BMI values in males was higher than that in females ;the BMI value had statistical difference a‐mong different ages(χ2 =18 .568 ,P=0 .029) ,the proportion of malnutrition was increased with the age increase .In the eating be‐haviors ,the food flavor was negatively correlated with the BMI value ,the choice of cooking oil was positively correlated with the BMI value(P<0 .05);the consumption frequency of fruits ,beans and bean products ,fish and shrimp was negatively correlated with the BMI value ,the consumption frequency of livestock meat and eggs was positively correlated with the BMI value(P<0 .05) .Con‐clusion In order to promote the nutritional status and health condition of rural left‐behind elderly people ,the cognition of their own physical constitution should be enhanced ,and the rational dietary habit and food consumption habit should be cultivated .

Objective To explore the protective mechanism of HSP70 protein in traumatic brain injury (TBI)‐related acute gastric mucosal lesions in mice .Methods Forty adult male Balb/c mice were randomly divided into sham (A) ,TBI (B) ,TBI+ geranylgeranylacetone (GGA) (C) ,and TBI+saline (D) groups .TBI was induced via the Feeney impact model .GGA (800 mg/kg) was administered via oral tube beginning before the model was built in group C .The expressions of HSP70 protein in brain and gastric mucosa were determined by immunohistochemistry , and the apoptotic index was detected by TUNEL method .Results The injury area in mouse brain and gastric mucosa was greater in group B than in groups A and C (P<0 .05) .After model induction ,the content of HSP70 protein in group B was markedly higher in the brain and gastric mucosa ,which was notably higher than in group A (P<0 .05) .Obviously apoptotic cells were observed in groups B and D ,which were significantly higher than in groups A and C .GGA pretreatment enhanced the up‐regulated expression of HSP70 and decreased the apoptotic index distinctly ;HSP70 expression was higher in group C than in groups B and D ,but the apoptotic index was lower (P<0 .05) .Conclusion GGA can induce HSP70 protein expression in mouse brain and gastric mucosa .HSP70 is involved in the process of apoptosis inhibition .GGA can be used in the prevention and therapy of TBI‐related acute gastic mucosal lesions .

Aim To explore the effect of miRNA-143 ( miR-1 4 3 ) on homocysteine ( Hcy ) induced-vascular smooth muscle cells ( VSMCs ) proliferation and the mechanism .Methods VSMCs were cultured and in-cubated with Hcy by using primary cultured method . Then, cells were treated with different concentrations of Hcy and folate .VSMCs proliferation was determined with MTT assay , miR-143 was measured by qRT-PCR, and methylation of miR-143 was determined with meth-ylated PCR.Results After cells were treated with dif-ferent concentrations of Hcy , the proliferation of VSMCs was significantly increased , mRNA expression of miR-143 was decreased and methylation of miR-143 was increased .The proliferation of VSMCs was signifi-cantly decreased when transfected VSMCs with miR-143 precursor , and cell proliferation was increased by using miR-143 inhibitor transfection .Conclusion Hy-pomethylation of miR-143 may inhibit VSMCs prolifera-tion.

Objective:To assess the metabolic side effects of the following atypical antipsychoties head-to-head:amisulpride,olanzapine,aripiprazole,quetiapine,risperidone,ziprasidone.Methods:We searched the MED-LINE,EMBASE,Cochrane Library,PubMed,CNKI,Web of science,Sinomed,WANGFANG DATA databases for randomized,blineded studies comparing the above mentioned atypical antipsychoties in the treatment of schizophre-nia or related disorders.At last three reviewers extracted the data independently.All the data would be analysed with meta ananlysis and the analysis software of the RevMan 5.1 provided by Cochrane network.Results:There were 49 studies in which 45 were written in English and 4 were written in Chinese included in the review.Olanzapine pro-duced statistically significantly more weight gain than all other second-generation antipsychotics.Risperidone pro- duced significantly more weight gain than amisulpride.Olanzapine produced statistically significantly more increase in glucose levels from baseline to endpoint than all other second-genetation antipsychotics.Risperidone produced statistically significantly more increase in glucose levels from baseline to endpoint than aripiprazole,quetiap-ine.Olanzapine produced statistically significantly more increase in cholesterol than aripiprazole,risperidone and zi-prasidone.Quetiapine produced significantly more increase in cholesterol than risperidone and ziprasi-done.Risperidone produced significantly more increase in cholesterol compared to aripiprazole and ziprasidone.Conclusion:Some atypical antipsychoties lead to substantially more metabolic side effects than other a-typical antipsychoties.When choosing an atypical antipsychotic agent for an individual patient these side effects with their potential cause of secondary diseases should be weighed against efficacy and characteristics of the individual patient.

BACKGROUND:There is a general consensus that patients undergoing joint arthroplasty surgery wil be in hypercoagulable state and easily to induce deep vein thrombosis. Thromboelastography is a new kind of method to monitor blood coagulation state, but not widely used in orthopaedics. No final conclusion has yet been reached on whether we can guide the clinical prevention of deep vein thrombosis and medication through using thromboelastography to monitor perioperative coagulation state of patients treated with joint arthroplasty. OBJECTIVE:To investigate the correlation between thromboelastography and routine coagulation functional tests, and evaluate the clinical application value of thromboelastography in monitoring the perioperative coagulation state of patients treated with joint arthroplasty.
METHODS:A total of 204 patients who treated with joint arthroplasty at First Affiliated Hospital of Soochow University from November 2014 to August 2015 were retrospectively analyzed. The thromboelastography, routine coagulation, platelet and other data before and after the replacement were respectively col ected. The correlative analysis was conducted between the thromboelastography result and the results of conventional coagulation test, that is, routine coagulation and platelet count. RESULTS AND CONCLUSION:In total knee arthroplasty group, activated partial thromboplastin time and reaction time showed good consistency (φ=0.713, Kappa value=0.647);Prothrombin time had moderate correlation and general consistency with reaction time (φ=0.392, Kappa value=0.362);Coagulation time and fibrinogen had moderate correlation and consistency (φ=0.392, Kappa value=0.488);Aggregates formation rate (αangle) and fibrinogen had moderate correlation and consistency;the remaining parameters had poor correlation and consistency. In total hip arthroplasty group, there was a weak correlation and consistency between the reaction time, activated partial thromboplastin time and prothrombin time;the other correlations were poor. However, there was a higher proportion of consistent clotting trend between some parameters of thrombelastography and routine coagulation. In total hip arthroplasty group, the consistent proportion of coagulation time and fibrinogen accounted for 67.6%;the consistent proportion of aggregates formation rate (αangle) and fibrinogen accounted for 78.3%. These results suggest that thromboelastography and routine coagulation tests have some correlations and consistency. Thromboelastography parameters have more consistent tendency on the data. Thrombelastography can serve as an auxiliary mean to monitor coagulation state of perioperative joint arthroplasty.

OBJECTIVETo study the clinical effect and surgical operating points of pararectus approach for the internal fixation of acetabular both-column fractures with concurrent displaced quadrilateral plate fractures.

METHODSFrom January 2012 to December 2013, in the Third Affiliated Hospital of Southern Medical University, 15 patients with acetabular both-column fractures and displaced quadrilateral plate fractures were surgically managed through the pararectus approach. There were 11 male and 4 female patients, with an average age of 40 years (from 19 to 61 years). According to Judet-Letournel classification, there were 9 anterior column plus posterior hemitransverse fractures, 6 both-column fractures, 8 cases involving the pelvic fracture. All these fractures were treated through the pararectus approach, in the horizontal position with general anesthesia. The pre-bended plate was placed in interior pelvic ring to fix the anterior wall, anterior column and quadrilateral plate in direct sight. Then, the posterior column was exposed and fixed with antegrade lag screw. Patients were followed up in 4 weeks, 12 weeks, 6 months, 1 year after the operation, and the anteroposterior radiograph of pelvis and the X-ray examination of the fractured hip was performed.

RESULTSAll the 15 cases underwent the operation successfully. Postoperative X-ray and CT exams showed excellent and good reduction of anterior column, posterior column and quadrilateral plate, with none surgical complication occurred. According to the Matta radiological evaluation postoperatively, reduction of acetabular fracture was rated as excellent in 9 cases, good in 3 cases and poor in 3 cases. The rate of excellent and good was 12/15. After 8 to 18 months' follow-up (median follow-up time was 14 months), all the patients gained bone union. According to the modified Merle D'Aubigne and Postel scoring system, 9 cases were excellent, 4 were good, and 2 were fair. The rate of excellent and good was 13/15.

CONCLUSIONSSurgical management of acetabular fractures through the pararectus approach can provide adequate exposure of reducing and fixing both-column acetabular fractures with concurrent displaced quadrilateral plate fractures, which has a good effect in clinical application.

Acetabulum ; pathology ; surgery ; Adult ; Anesthesia, General ; Bone Plates ; Bone Screws ; Female ; Fracture Fixation, Internal ; methods ; Hip Fractures ; pathology ; surgery ; Humans ; Male ; Middle Aged ; Pelvic Bones ; pathology ; surgery ; Postoperative Period ; Spinal Fractures ; Treatment Outcome ; Young Adult

Objective To explore the effect of extracorporeal shock wave therapy (ESWT) combined with hyperbaric oxygen on nonunion after surgery. Methods 83 patients with nonunion were treated with ESWT combined with hyperbaric oxygen (treatment group), and 32 cases served as control group. ESWT application was conducted using a protocol totaling 3000 shocks per treatment. The treatment group received 3~5 times of treatment, at the same time hyperbaric oxygen therapy was performed. The control group received no treatment and was followed up at least 3 months after treatment. Results The overall success rate was 78.31% in the treatment group, while only 12.50% recovered in the control group (P<0.01). The complications of treatment group were less and negligible. Conclusion Treatment of nonunion by extracorporeal shock wave combined with hyperbaric oxygen is safe and effective.