Diabetic ulcer （DU） wound is one of the chronic and serious complications of diabetes characterized by prolonged wound healing， and it is more common in foot and lower extremity ulcers. DU has brought great economic and psychological pressure to patients and seriously affected the quality of life of patients because of its great difficulty in treatment， long treatment process， and high morbidity and mortality. Therefore， how to help the rapid healing of DU wounds， reduce the disability rate and mortality rate， protect limb function， and improve the quality of life is an important topic and hot spot in the field of medical research. The pathogenesis of DU is complex， mainly including microcirculation disorder， peripheral neuropathy， inflammation and infection， and excessive apoptosis of cells， involving physiological processes such as wound inflammation， granulation tissue hyperplasia and re-epithelialization. A large number of previous studies have found that Chinese medicine can regulate phosphatidylinositol 3-kinase/protein kinase B （PI3K/Akt）， Wnt/β-catenin， nuclear factor-κB （NF-κB）， Notch， nuclear factor E₂-related factor 2 （Nrf2）， transforming growth factor-β （TGF-β）/Smad， and other signaling pathways， regulate abnormal glucose metabolism， improve microcirculation， inhibit inflammation and oxidative stress， regulate cell proliferation and excessive apoptosis， and promote wound tissue growth to promote the rapid healing of DU wounds under the guidance of treatment based on traditional Chinese medicine （TCM） syndrome differentiation and internal and external treatment. Therefore， this paper reviewed Chinese medicinal monomers or Chinese medicinal compounds in recent years in regulating the above signaling pathways and the expression of key protein molecules and promoting the rapid healing of DU wounds， aiming to provide ideas and a theoretical basis for the in-depth study and clinical application of Chinese medicine in promoting the healing of DU wounds.

【Objective】 To observe the effect of Xiaozhongzhitong Mixture on ischemia-reperfusion injury of rat skin flaps and p38MAPK-PPARγ/NF-κB signaling pathway. 【Methods】 After flap operation, the survival of rat back flaps and flap survival rate were observed. HE staining, TUNEL staining, and qRT-PCR were used to detect the degree of nuclear destruction, as well as the distribution characteristics and mRNA expression levels of p38MAPK, PPARγ, and Nf-κB in vascular endothelial cells of rat flaps, respectively. 【Results】 The flap survival area in sham operation group was the largest, and it was the smallest in model control group and PPARγ inhibitor group. HE staining and TUNEL staining results showed that the flap tissue cells of rats in model control group and PPARγ inhibitor group were severely damaged and obvious apoptotic cells were seen. In model group, rats’ skin flap tissue cells were arranged in a single layer, and the nucleus was intact and clear. qRT-PCR experiment results showed that compared with model group, the expressions of p38MAPK and Nf-κb in the flap tissue of rats in Xiaozhong Zhicong Mixture group were inhibited (P<0.05), while the expression of PPARγ was increased (P<0.05). When the blocker was added, the expressions of p38MAPK, NF-κB and PPARγ in the flap tissue were further suppressed. 【Conclusion】 Xiaozhongzhitong Mixture can alleviate the infiltration of inflammatory cells in the rat model of skin flap ischemia-reperfusion injury, reduce inflammation and the production of apoptotic cells, thereby alleviating the ischemia-reperfusion injury of skin flaps and promoting the survival of the flaps. The mechanism may be related to the inhibition of p38MAPK-PPARγ/NF-κB signaling pathway.

Objective:To investigate the effect of prospective intervention on emergence agitation and postoperative recovery in patients with chronic sinusitis during preoperative visits.Methods:A total of 80 patients with chronic sinusitis who underwent general anesthesia in Dayi County People′s Hospital of Chengdu City from December 2019 to October 2020 were selected and randomly divided into group D and group G, with 40 patients in each group. Group D received preoperative visit with conventional methods and group G received preoperative visit with prospective intervention methods. The hemodynamic changes of patients in the two groups at 30 min before the operation (T 1) and 1 (T 2), 5 (T 3), 10 (T 4) and 30 min (T 5) after tracheal tube extraction were recorded. The anxiety and depression scores of patients before the intervention and 1 d after the operation were compared between the two groups. The incidence of emergence agitation after the operation and complications during anesthesia awakening period were observed in the two groups, sino-nasal outcome test-20 (SNOT-20) was used to assess the postoperative recovery. Results:The incidence of emergence agitation in group G was lower than that in group D: 7.5%(3/40) vs. 25.0%(10/40), the difference was statistically significant ( χ2 = 4.50, P<0.05). There was no significant difference in systolic blood pressure, diastolic blood pressure and heart rate between the two groups at T 1 and T 5 ( P>0.05), but the level of above indicators in group G at T 2, T 3 and T 4 were significantly higher than those in group D ( P<0.05). The scores of State-Trait Anxiety Inventory(S-AI) and Self-Rating Depression Scale (SDS) in group G at the first day after the operation were significantly lower than those in group D: (35.45 ± 5.32) scores vs. (39.35 ± 4.91) scores, (35.42 ± 7.82) scores vs. (38.76 ± 5.21) scores, the differences were statistically significant ( P<0.05). The incidence of complications during anesthesia awakening period in group G was slightly lower than that in group D ( P>0.05). After the operation, the scores of sinusitis symptoms and nasal symptoms in the two groups were significantly decreased compared with those before the operation, and the scores of group G were significantly lower than those in group D ( P<0.05). Conclusions:Prospective intervention before anesthesia in patients with chronic sinusitis surgery can reduce stress response, improve bad mood, reduce the incidence of emergence agitation, and promote the postoperative recovery.

Objective:To explore the effect of the X-BL mixed teaching mode on Pharmacology course. Methods:In Pharmacology course of the 2017 pharmacy major of our university, 3 teaching units were randomly selected as the control group while the rest 3 teaching units were selected as the experimental group. Traditional teaching mode was carried out in control group. In the experimental group, we designed a X-BL mixed teaching mode composed of web-based learning (WBL), case-based learning (CBL), and team-based learning (TBL). Teaching effects of the two groups were compared using online unit tests and questionnaires. Test scores were analyzed by SPSS 20.0, and differences between groups were analyzed by t test. Results:The test scores of each unit of the experimental group were significantly higher than those of the control group ( P<0.01), and the low scores were all zeroed. The questionnaires showed that the two groups showed similar learning willingness, but the experimental group students were more satisfied with teaching method, teaching quality, classroom atmosphere, teacher guidance and learning effect than the control group. Conclusion:The X-BL mixed teaching mode, which focused on case teaching and group learning, integrated online and offline teaching, and information teaching, has showed a better teaching effect than traditional teaching in the Pharmacology courses. This teaching mode may have certain promotion value in the future teaching applications.

Applying the effective teaching theory to the small-class teaching of pharmacology can improve the flexibility of small-class teaching mode under the guidance of the concept of effective teaching and high efficiency. The course chapters were randomly selected for traditional teaching mode or small-class teaching mode based on effective teaching theory in the same class. Practice has proved that the small-class teaching based on AO-AMFM can enhance student analysis and make careful smart objective and teaching frame work before class, and can also reach prompt activation, multi-learning, effective feedback and multi-summary, which can significantly improve students' learning enthusiasm and learning efficiency.

Trauma is the leading cause of death for people under 40 years old in the world. At present, the rescue and treatment system of trauma patients in China is not yet well established, and the mortality of trauma patients is higher than those in the developed countries. Improving the treatment system is the key to reducing the trauma mortality. In order to innovate the service mode of trauma first aid, further promote the establishment of regional trauma first aid system, improve the ability of trauma treatment, reduce the mortality and disability rate of trauma patients in Jiangxi Province, recently Health Commission of Jiangxi Province and the First Affiliated Hospital of Nanchang University have reached a consensus on the establishment of Jiangxi trauma first aid center. In order to provide reference for the construction of trauma treatment system, the author analyzes the following aspects including functional positioning, basic requirements, organization management, and evaluation of core indicators.

Objective To study the effect of soluble amyloid precursor protein α (sAPPα) on nerve cell apoptosis and neurological function in subarachnoid hemorrhage (SAH) rats.Methods Sixty male SD rats were randomly divided into control group (n=20),SAH+saline group (n=20) and SAH+sAPPα group (n=20).A SAH model was established by injecting autologous blood into cistern magna in rats.After a SAH model was established for SAH + saline group and SAH + sAPPα group by injecting saline and sAPPα respectively into the cistern magna of rats,the apoptotic cells were detected by immunofluorescene with TUNEL staining and the neurological function was scored in 10 rats from each group on day 3 after injection of sAPPα and saline.Results The number of apoptotic cells in brain tissue was significantly greater in SAH+saline group than in control group (P＜0.05) and was significantly smaller in SAH+sAPPα group than in SAH+ saline group (P＜0.05).The neurological function score was 26.7±0.5,13.9±0.7 and 23.0±0.8 respectively in control group,SAH + saline group and SAH + sAPPα group.Conclusion sAPPα alleviates secondary damage of neurological function by inhibiting the apoptosis of nerve cells in rats after SAH and can thus improve their neurological function.

Objective To identify the reasons and treatment strategies of epidural fluid collection (EFC) secondary to cranioplasty in patients with traumatic brain injury after decompressive craniectomy.Methods From June 2013 to July 2017,a retrospective analysis was performed on clinical data of 150 patients with traumatic brain injury after decompressive craniectomy in our hospital.A total of 47 patients experienced EFC following cranioplasty and 103 not.Risk factors of EFC after cranioplasty were analyzed by multiple factor Logistic regression.Results For the 47 EFC patients,32 patients had no obvious clinical symptoms and EFC was absorbed gradually through conservative therapy;15 patients had clinical symptoms,such as mental deterioration,headache,or limb weakness.EFC disappeared through vacuation in 4 patients and subcutaneous drainage in 11.The proportions of patients with skull defect＞80 cm2,dural defect and dural calcification in patients with EFC were significantly higher as compared with those without EFC (P＜0.05).Multiple factor Logistic regression analysis showed that skull defect＞80 cm2 and dural mater calcification were independent risk factors for EFC after cranioplasty.Conclusions Patients with large skull defect＞80 cm2 and dural calcification are prone to have EFC after cranioplasty.Careful evaluation of imaging data,good surgical skills and strengthening postoperative management can reduce incidence of EFC after cranioplasty.

Objective To study the prescription and preparation technology of breviscapine microemulsion for parenteral injection,and to evaluate its quality.Methods The prescription was selected and optimized through single-factor test and the pseudo-ternary phase diagram method.The preparation technology was investigated,and the particle diameter,drug content,encapsulation efficiency and haemolyticus were evaluated.Results The prescription composition of breviscapine microemulsion was soybean oil:phospholipid:HS15:PEG400:water=1:0.1:0.55:0.55:6.64 (m/m),with the drug content of 4.01 mg·mL-1,the acquired breviscapine microemulsion exhibited light yellow,uniform and transparent,with average particle diameter of 92.1 nm and encapsulation efficiency of 96.8%.The compatibility test showed no drug precipitation and the preparation was no hemolytic crisis.Conclusion The preparation of breviscapine microemulsion injection is correspond to the main index of parenteral injection.

Aim To observe the mRNA expressions of cell cycle regulators at different time points during the hypertrophic process of H9 c2 rat cardiomyoctes in-duced by angiotensin Ⅱ stimulation.Methods H9c2 myocytes were stimulated with 1.0 μmol · L-1 angio-tensin Ⅱ (Ang Ⅱ)for scheduled time.Cells were stained by Rhodamine labeled phalloidin and the cell area was measured by ImageJ software.mRNA expres-sion levels of cyclin B,D,E,cyclin dependent kinase (CDK)1,2,4,6,and CDK inhibitor p21 were de-termined by real-time PCR at different time points (0, 5,10,30 min,and 1,2,3,6,12,24,48 h).Re-sults H9 c2 cell size increased soon after stimulation of Ang Ⅱ;mRNA expressions of cyclin E,CDK4 and CDK2 all reached the peak at 5 min after stimulation of Ang Ⅱ;mRNA expression of cyclin D was increased dramatically at 10 min,followed by a decrease trend. However,the mRNA expression of cyclin B and CDK6 both showed two peaks,a p2 1 mRNA level was up to the peak at 30 min,and the expression was lowest at 3h.Although its expression increased gradually after 3h,p21 mRNA remained low level.Conclusion mRNA expression levels of the cell cycle regulators fluctuate and jointly facilitate the hypertrophic process of cardiomyocytes.