ObjectiveTo investigate the correlation between mild cognitive impairment (MCI) and traditional Chinese medicine (TCM) body constitution types in the elderly, and to provide an evidence for the control of cognitive impairment in the elderly. MethodsThe elderly aged 65 and above who participated in the community physical examinations in a community of Changning District, Shanghai were selected as the research subjects. The cognitive function was assessed by using the Clock Drawing Test combined with the Ascertain Dementia 8-item Questionnaire (AD8), the Montreal Cognitive Assessment (MoCA) and the Mini-mental State Examination (MMSE). The diagnostic criteria for MCI was identified based on the 2018 Chinese Guidelines for the Diagnosis and Treatment of Dementia and Cognitive Disorders, along with the assessment results and clinical history information. The current investigation method was used to collect the basic information and the prevalence of chronic disease of the subjects through questionnaire inquiries. The elderly subjects’ ability to take care of themselves was evaluated based on the Elderly Self⁃Care Ability Evaluation Scale, while the TCM body constitution types were determined based on the Chinese Medicine Health Care Management Service Specification. The association of the detection rate of MCI with gender, education level, history of chronic disease and TCM body constitution types were analyzed lastly. ResultsA total of 2 351 elderly people were investigated, including 1 037 males and 1 314 females, with an average age of (74.11±6.15) years. 174 subjects, accounting for 7.40%, were identified with MCI. The highest detection rate of MCI in the elderly are those with a Qi stagnation constitution (10.8%), followed by those with a dampness-heat constitution (9.1%) and a Qi deficiency constitution (8.4%). Multivariate logistic regression analysis showed that advanced age, lower educational level, a history of tuberculosis, and TCM constitutions such as dampness-heat, Qi stagnation, and Qi deficiency were the potential risk factors for MCI. ConclusionThere is a significant association between TCM constitution types such as dampness-heat, Qi stagnation, and Qi deficiency with MCI. TCM techniques can be integrated into the health management services for the elderly population, and targeted interventions can be provided to those with imbalanced constitution types so as to reduce the risk of MCI.

Objective:To evaluate the role of heme oxygenase-1 (HO-1) in endotoxin-induced acute lung injury (ALI) and the relationship with the regulation of mitochondrial quality control in mice.Methods:Clean-grade healthy male adult C57BL/6 mice, aged 6-8 weeks, weighing 20-25 g, were selected.HO-1 inducible gene knockout mice (HO-1 -/-) were prepared based on CRISPER/Cas9-mediated EGE system, and HO-1 gene overexpression mice (HO-1 + /+ ) were prepared by transfection of HO-1 overexpressed adenovirus vector.The mice were divided into 2 groups ( n=6 each) using a random number table method: control group (group WT, group HO-1 -/-, group HO-1 + /+ ) and endotoxin-induced ALI group (group ALI, group HO-1 -/-+ ALI, group HO-1 + /+ + ALI). Lipopolysaccharide 15 mg/kg was injected through the tail vein to develop the model of endotoxin-induced ALI, and the equal volume of normal saline was given instead in each control group.The mice were sacrificed by bloodletting at 12 h after lipopolysaccharide or normal saline administration.The lung tissues were harvested for microscopic examination of the pathological changes which were scored, for determination of GSH and GSSG contents, for observation of the ultrastructure of mitochondria (with a transmission electron microscope) and survival within 12 h, for measurement of mitochondrial membrane potential (MMP) levels, and for determination of the expression of mitochondrial quality control-related proteins mitochondrial fusion protein 2 (Mfn2) and dynamin-related protein 1 (Drp1), peroxisome proliferator-activated receptor gamma coactivator 1α (PGC-1α), nuclear respiratory factor 1 (NRF1), mitophagy marker protein PTEN-induced kinase 1 (PINK1) and E3 ubiquitin-protein ligase Parkin.The ratio of GSH/GSSG was calculated. Results:Compared with control group (group WT, group HO-1 + /+ and group HO-1 -/-), the 12-h survival rate and MMP were significantly decreased, the lung injury score was increased, GSH content and GSH/GSSG ratio were decreased, and the content of GSSG was increased in endotoxin-induced ALI groups (group ALI, group HO-1 + /+ + ALI and group HO-1 -/-+ ALI) ( P<0.05). Compared with group ALI, the 12-h survival rate and MMP were significantly decreased, the lung injury score was increased, the GSH content and GSH/GSSG ratio were decreased, the GSSG content was increased, and the expression of HO-1, Mfn2, PGC-1α, NRF1, PINK1 and Parkin was down-regulated, and Drp1 expression was up-regulated in group HO-1 -/-+ ALI, and 12-h survival rate and MMP were significantly increased, lung injury score was decreased, GSH content and GSH/GSSG ratio were increased, GSSG content was decreased, the expression of HO-1, Mfn2, PGC-1α, NRF1, PINK1 and Parkin was up-regulated, and the expression of Drp1 was down-regulated in group HO-1 + /+ + ALI ( P<0.05). Conclusions:HO-1 is involved in the process of endotoxin-induced ALI in mice, which is related to the regulation of mitochondrial quality control.

Objective:To evaluate the effect of transcutaneous electrical acupoint stimulation (TEAS) on mitochondrial quality control during endotoxin-induced acute lung injury (ALI) in mice.Methods:Twenty-four clean-grade healthy male C57BL/6J mice, aged 4-6 weeks, weighing 15-20 g, were divided into 4 groups ( n=6 each) according to the random number table method: control group (group C), endotoxin-induced ALI group (group L-ALI), endotoxin-induced ALI plus acupoint electroacupuncture group (group L-ALI+ EA), and endotoxin-induced ALI plus non-acupoint electroacupuncture group (group L-ALI+ SEA). Lipopolysaccharide (LPS) 15 mg/kg was injected via the caudal vein to develop the model of endotoxin-induced ALI in anesthetized mice.In group L-ALI+ EA, at 5 days before LPS injection, bilateral Zusanli and Feishu acupoints were stimulated with an electric stimulator for 30 min each time at a voltage of 1-2 mA and a frequency of 2/15 Hz until the end of the experiment.In group L-ALI+ SEA, stimulation was performed at the points 0.5 cm lateral to the acupoints of bilateral Zusanli and Feishu non-meridian and non-acupoint sites using the shallow puncture method, and the other treatment methods were the same as those previously described in group EA.Group C received no treatment.The mice were sacrificed by euthanasia at 12 h after LPS administration, and lung tissues were obtained for microscopic examination of the pathological changes (with a light microscope) and structure and morphology of mitochondria (with a transmission electron microscope) and for determination of the levels of reactive oxygen species (ROS) and mitochondrial DNA (mtDNA) and contents of glutathione (GSH) and glutathione oxidized (GSSG). The GSH/GSSG ratio was calculated.The expression of mitochondrial fusion proteins mitofusin 1 (Mfn1), Mfn2, optic atrophy1 (OPA1), dynamin-related protein 1 (Drp1), fission protein 1 (Fis1), peroxisome-proliferator-activated receptor γ coactivator-1α (PGC-1α), nuclear respiratory factor-1 (NRF1), NRF2, PTEN-induced putative protein kinase 1 (PINK1) and the E3 ubiquitin ligase (Parkin) was determined by Western blot. Results:Compared with group C, the level of ROS and contents of GSSG and mtDNA were significantly increased, GSH content and GSH/GSSG ratio were decreased, the expression of Mfn1, Mfn2, OPA1, NRF1, NRF2 and PGC-1α was down-regulated, and the expression of Drp1, Fis1, PINK1 and Parkin was up-regulated in L-ALI, L-ALI+ EA and L-ALI+ SEA groups ( P<0.05). Compared with group L-ALI, the level of ROS and contents of GSSG and mtDNA were significantly decreased, GSH content and GSH/GSSG ratio were increased, the expression of Mfn1, Mfn2, OPA1, NRF1, NRF2 and PGC-1α was up-regulated, and the expression of Drp1, Fis1, PINK1 and Parkin was down-regulated in group L-ALI+ EA ( P<0.05). Compared with group L-ALI+ EA, the level of ROS and contents of GSSG and mtDNA were significantly increased, GSH content and GSH/GSSG ratio were decreased, the expression of Mfn1, Mfn2, OPA1, NRF1, NRF2 and PGC-1α was down-regulated, and the expression of Drp1, Fis1, PINK1 and Parkin was up-regulated in group L-ALI+ SEA ( P<0.05). Conclusions:TEAS can reduce endotoxin-induced ALI probably through regulating mitochondrial quality control in mice.

ObjectiveTo investigate effect of conducting training of autism spectrum disorder （ASD） early screening skill on improving the ability to early identify ASD of medical staffs in primary care hospitals. MethodsIn September 2021， the training of ASD early screening skills was carried out for medical staffs from 20 primary care hospitals in Chengdu. After training， the training effect was evaluated. The numbers of referrals from primary care hospitals to superior hospitals， confirmed ASD as well as their average diagnostic age of children with ASD before and after training were used as evaluation indicators. ResultsAfter training， the number of children with suspected ASD referred by primary care hospitals was more than that before training ［（16.65±11.60） vs. （3.40±2.23）， t=5.431， P<0.01］， the number of children diagnosed with ASD was more than that before training［（6.85±4.93） vs. （2.45±1.67）， t=4.171， P<0.01］， and the differences were statistically significant. As for the diagnosed age of ASD children， after training， the average age was lower than that before training ［（34.95±11.67） vs. （42.2±14.64）， t=-2.553， P=0.019］. ConclusionTraining of ASD early screening skills for medical staffs in primary care hospitals may help to improve their ability to early screening ASD children.

Objective:To investigate the short-term efficacy of hip arthroscopy for different types of femoroacetabular impingement syndrome (FAI).Methods:A retrospective analysis was conducted of the 85 FAI patients who had been treated by hip arthroscopy at Department of Orthopaedic Surgery, General Hospital of Southern Theater Command of PLA from January 2016 to December 2018. They were 52 males and 33 females, aged from 19 to 59 years (average, 36.9 years). According to the anatomical morphology of the acetabulum and proximal femur, there were 26 cases of cam type, 16 cases of pincer type and 43 cases of mixed type. Routine hip arthroscopy was performed to remove the proliferative synovium. Femoral head and neck plasty was conducted for the cases of cam type, resection of the overly covered acetabulum followed by labral suture for those of pincer type, and resection of overly covered acetabulum and labral suture followed by femoral head and neck plasty for those of mixed type. Hip function was assessed one year after surgery using the modified Harris hip score (mHHS), nonarthritic hip score(NAHS), and hip outcome score activity of daily living scale (HOS-ADL); the alpha angle and central edge(CE) angle were measured after CT reconstruction.Results:The 85 patients were successfully followed up for an average of 21 months (range, from 12 to 48 months). The mHHS, NAHS and HOS-ADL for all the patients were improved significantly from preoperative 63.1±7.9, 62.5±7.5 and 62.3±7.9 to 83.4±8.7, 82.9±8.2 and 83.6±8.8 one year after surgery, respectively (all P<0.05) while the mHHS, NAHS and HOS-ADL for the patients of cam, pincer and mixed types were all significantly improved compared to their preoperative values (all P<0.05). The preoperative alpha angles for the cam and mixed types (67.3°±5.2° and 64.2°±5.2°) were significantly reduced to 50.3°±2.9° and 49.6°±2.8° one year postoperatively ( P<0.05); the preoperative CE angles for the pincer and mixed types (52.9°±4.6° and 50.9°±3.6°) were significantly reduced to 33.1°±4.5° and 31.3°±4.3° one year postoperatively ( P<0.05). Conclusion:Hip arthroscopy can effectively treat FAI of cam, pincer and mixed types, leading to good short-term efficacy.

Objective:To explore the short-term effect of arthroscopic posterior suture of the glenoid labial capsule in the treatment of recurrent posterior subluxation (RPS) of shoulder joint.Methods:A retrospective study was conducted on 16 RPS patients who had undergone arthroscopic posterior glenoid capsule folding suture from January 2016 to December 2018, including 12 males and 4 females, with an average age of 22 years (range, 18-37 years). 11 had full-thickness posterior glenoid tear (2 with SLAP injury, 7 with posterior capsular laxity), and 5 had partial posterior glenoid tear (5 with posterior capsular laxity). All 16 patients had active shoulder pain and had undergone arthroscopic posterior glenoid capsule folding suture with suture anchors. After surgery, shoulder abduction was fixed with a sling for 6 weeks to prevent internal rotation of the shoulder; full range of active and passive activities were performed 2-3 months after surgery, and normal movement was resumed 6 months after surgery. Shoulder function was assessed using the American Society of Shoulder and Elbow Surgery (ASES) score and the University of California at Los Angeles (UCLA) end-result score, and shoulder stability was assessed using the instability score in the ASES score.Results:All 16 patients were followed up for 19 months (range, 12-36 months). The shoulder instability score was reduced from 7.6±1.6 preoperatively to 2.0±1.2 postoperatively ( t=5.562, P< 0.001); the ASES score was improved from 45.9±9.8 preoperatively to 85.8±6.1 ( t=39.937, P< 0.001); the pain score was increased from 18.9±5.4 preoperatively to 40.9±4.2 ( t=22.063, P< 0.001); the daily life score was improved from 27.0±7.8 preoperatively to 44.9±3.4 ( t=17.875, P< 0.001), and the UCLA score was improved from 16.1±4.5 preoperatively to 31.9±2.6 ( t=15.813, P< 0.001). One patient had pain during boxing 12 months after surgery, and all patients had significant improvement in shoulder weakness and instability. No patient had instability recurrence. Magnetic resonance showed sutured posterior labrum tearhealed. Conclusion:Arthroscopic posterior glenoid capsule folding suture can repair the labrum injury and restore the tension of the posterior capsule. The glenoid capsule complex healed can increase the posterior obstruction of the scapula. This method can effectively treat RPS with good short-term efficacy.

Objective To study the feasibility and early efficacy of matrix?induced autologous chondrocyte implantation repairing knee joint cartilage injury. Methods The Matrix?induced autologous chondrocyte implantation was used to repair knee joint cartilage injury in 13 cases (11 males and 2 females) with knee joint cartilage injury from April 2012 to March 2013. The av?erage age was 27.5 years old. All cases were suffering from unilateral focal cartilage defect of knee joint with International Carti?lage Repair Society (ICRS) chondral defect classification system grade III or IV, visual analogue scale (VAS)>3, and all of which had corresponding pain symptoms. The average defect area was 4.2 cm2. Standardized rehabilitation exercise was carried out after matrix?induced autologous chondrocyte implantation. Patients were followed up for 1 years, and knee injury and use osteoarthritis outcome score(KOOS), International Knee Documentation Committee (IKDC), subjective knee form and Lysholm score were col?lected to assess the function. Meanwhile, magnetic resonance observation of cartilage repair tissue (MOCART) score was used to assess the magnetic resonance imaging. Results All patients had been followed?up for 1 year. One patient had meniscus repair under arthroscopy for the meniscus injury caused by downstairs sprain in 6.5 months postoperative, so the score of 12 months post?operative was excluded. The knee range of motion was decreased in 3 months postoperative (123.1°±8.0°) compared to preopera?tive one (135.4°±5.7°), and has no difference in 6 months (136.1°±6.1°) and 12 months postoperative (135.1°±3.6°) compared to preoperative one. The 5 subsets of KOOS score were decreased in 3 months compared to preoperative one, and were significantly increased in 6 months and 12 months. The IKDC has no difference in 3 months (26.1±3.9) compared to preoperative one (43.5± 6.5), and were significantly increased in 6 months (53.3±5.8) and 12 months (62.8±7.2) compared to preoperative one. The magnet?ic resonance observation of cartilage repair tissue (MOCART) score was increased in 12 month(73.3±17.9)compared to preopera?tive one(51.5 ± 12.6). Conclusion MACI is a good technology for knee joint cartilage injury. It has a good clinical effect on re? pairing cartilage injury effectively and restoring the function of knee joint.

OBJECTIVETo investigate the feasibility and safety of the new β-shaped intracorporeal Billroth II( gastrojejunostomy using laparoscopic linear stapler after totally laparoscopic distal gastrectomy.

METHODSClinical data of 17 patients with distal gastric cancer who underwent β-shape intracorporeal Billroth II( reconstruction after totally laparoscopic distal gastrectomy in our department from January 2012 to September 2014 were analyzed retrospectively. Laparoscopic linear stapler was used in intracorporeal β-shaped Billroth II( side-to-side gastrojejunostomy for reconstruction.

RESULTSAll the 17 patients underwent β-shape intracorporeal Billroth II( reconstruction after totally laparoscopic distal gastrectomy successfully. There were no conversions and perioperative deaths. The average operative time was (207.3±11.3) min and the average anastomosis time was (41.2±2.5) min. The average number of harvested lymph node was 25.5±2.0 and estimated blood loss was (160.0±10.0) ml. The mean number of stapler was 6.5±0.2. The mean time to first flatus was (2.6±0.2) d and the mean hospital stay was (10.0±0.4) d. No anastomotic stenosis, leakage or other complications were found during 6 to 14 month follow-up.

CONCLUSIONSThe β-shaped intracorporeal Billroth II( anastomosis technique after totally laparoscopic distal gastrectomy is safe and feasible. Anastomotic stenosis can be avoided using this new anastomosis method.

Constriction, Pathologic ; Gastric Bypass ; Gastroenterostomy ; Humans ; Laparoscopy ; Lymph Nodes ; Operative Time ; Reconstructive Surgical Procedures ; Retrospective Studies ; Safety ; Stomach Neoplasms

OBJECTIVETo determine 5-lipoxygenase (5-LOX) expression and the effect of zileuton, a selective 5-LOX inhibitor,on hippocampal neuron injury induced by global cerebral ischemia in rats.

METHODSGlobal cerebral ischemia was induced by bilateral common carotid artery occlusion combined with hypotension in rats. 5-LOX expression was detected by Western blot analyses and 5-LOX localization was visualized by immunohistochemistry and double immunofluorescence methods. The 5-LOX inhibitor zileuton (10, 30, 50 mg/kg) was orally administered for 3 d after ischemia.

RESULTSThe 5-LOX expression was increased in the ischemic hippocampus on d1-7 (peaked at d3), and 5-LOX protein was primarily localized in neurons and translocated to the nuclei in the hippocampal CA1 region after ischemia. The 5-LOX inhibitor zileuton (30, 50 mg/kg) reduced ischemia-induced hippocampal neurons death 3d after ischemia.

CONCLUSION5-LOX is involved in global cerebral ischemic damage in rats, and the 5-LOX inhibitor zileuton has a protective effect on neuronal damage in the rat hippocampus following global cerebral ischemia.

Animals ; Arachidonate 5-Lipoxygenase ; metabolism ; physiology ; Brain Ischemia ; metabolism ; pathology ; CA1 Region, Hippocampal ; metabolism ; pathology ; Disease Models, Animal ; Hydroxyurea ; analogs & derivatives ; pharmacology ; Lipoxygenase Inhibitors ; pharmacology ; Male ; Neurons ; drug effects ; pathology ; Rats ; Rats, Sprague-Dawley

BACKGROUND:The methods used to repair articular cartilage defects currently have the cons and pros. Fibrocartilages are commonly used to repair tissues, and the fibrocartilage lacks of the tissue biomechanical properties and chemical properties of normal hyaline cartilage. OBJECTIVE:To investigate the feasibility of biological osteochondral xenogenic graft transplantation to repair articular cartilage defects. METHODS:The normal goats were randomly divided into two groups. The donor pig knee joints were the experimental group. Cylindrical osteochondral with the diameter of 4.5 mm and length of 10 mm were col ected with the Smith&Nephew osteochondral transplantation device, and the patented technology was used for deantigen. The donor goat knee joint osteochondrals were the control group and preserved with cryopreservation. The lesions on femoral trochlea and weight-bearing surface of medial condyle were selected respectively for osteochondral implantation, and the animals were sacrificed at 16 and 32 weeks after operation for the general and pathological section observation. RESULTS AND CONCLUSION:General observation in the experimental showed that the lesions were covered by fibroid tissue;some cartilage of the grafts turned yel ow and there was clear boundary between the surface and the peripheral cartilages;the general and section observation under microscope showed that lesions of the control group were covered by the grafts basical y, and cracks could be seen on the edge of the transplant part. The results show that there is difference between effects of biological osteochondral xenogenic graft transplantation and osteochondral al ograft transplantation for the repairing of articular cartilage defects, and osteochondral al ograft transplantation bas better effect.