The rupture of carotid vulnerable plaques is the core pathological basis for major cardiovascular and cerebrovascular events. However， the insufficient alignment between existing animal models and the clinical disease and syndrome characteristics of traditional Chinese and western medicine has limited research progress. In this study， biomedical databases in China and abroad were systematically searched， and the modeling mechanisms and evaluation systems of carotid vulnerable plaque animal models were systematically assessed based on diagnostic criteria of both traditional Chinese and western medicine. Analysis of the clinical correspondence indicated that existing animal models can be categorized into four types： simple high-fat diet， surgical induction combined with high-fat feeding， genetic engineering combined with high-fat feeding， and drug induction combined with high-fat feeding. Among these， the compound strategy of surgical induction combined with high-fat feeding has become the current mainstream approach， showing good concordance with western medicine. The study found that the double balloon injury rabbit model and the ApoE^-/- mouse carotid artery tandem constriction combined with high-fat feeding model demonstrated a high degree of clinical correspondence with both traditional Chinese and western medicine in terms of vulnerable plaque imaging and pathological features. Nevertheless， existing models still face significant technical limitations in faithfully simulating plaque pathology and in translating findings to clinical applications. To address these challenges， integrating complex comorbidity mechanism construction， multimodal dynamic mechanism monitoring， and collaborative evaluation systems of traditional Chinese and western medicine could enable the development of highly concordant carotid vulnerable plaque disease-syndrome combination animal models. Such models would provide a reproducible experimental platform for targeted drug development to regulate plaque stability and for individualized precision treatment， as well as a theoretical basis for innovation in clinical diagnostic and therapeutic strategies.

AIM:To observe the anti-scarring effects and safety of triamcinolone acetonide(TA)-loaded hydrogel sustained-release sheeting on stab incision glaucoma surgery(SIGS)with “one-step tunnel method” in rabbit eyes.METHODS:A total of 48 healthy New Zealand white rabbits were randomly selected and divided into 4 groups(12 rabbits in each group), trabeculectomy(Trab)group, SIGS group, polyvinyl alcohol hydrogel(PVAH)sheeting was implanted under the conjunctiva flap during SIGS(PVAH group), and hydrogel sustained-release sheeting loaded with TA was implanted under the conjunctiva flap during SIGS(TA/PVAH group). On the 1, 2, 3, and 4 wk after surgery, the intraocular pressure, filtering bubble morphology, anterior chamber reaction, and other complications were observed and recorded in each group. Then animals were euthanized, and the surgery area tissues of right eye were taken for pathological tissue paraffin section. Masson staining, picric acid-Sirius rose red staining, as well as α-smooth muscle actin(α-SMA)and fibroblast growth factor 2(FGF2)immunohistochemistry staining was performed on every section. The infiltration of inflammatory cells, proliferation of fibroblasts and synthesis of type I and type III collagen fibers in local tissues were observed. The average positive area ratio of α-SMA and FGF2 antibody immunohistochemical staining in each group was calculated and compared.RESULTS: The TA/PVAH group maintained diffuse and elevated functional filtering blebs, while flat filtering blebs appeared in Trab, SIGS and PVAH groups at 2 wk after surgery. Functional filtering blebs were present in 1 eye(33%), 2 eyes(67%)in the PVAH and TA/PVAH group at 4 wk after surgery, respectively, while the other filtering blebs were flattened. Masson staining showed that the hydrogels in PVAH and TA/PVAH groups did not degrade at 4 wk after surgery. Compared with the Trab and SIGS groups, the filtration passages were more obvious, with less collagen fiber proliferation. Sirius red staining showed that the expression of type I collagen and type III collagen in the TA/PVAH group was less than that in the Trab group, SIGS group and PVAH group at 4 wk after surgery. Immunohistochemical staining showed that the α-SMA expression in the TA/PVAH group was significantly lower than that in the Trab and SIGS groups at 1 wk after surgery(P<0.01). The α-SMA expression was the highest in the Trab and SIGS groups at 2 wk after surgery, while the α-SMA expression in the PHAP and TA/PVAH groups was significantly lower than that in the first two groups(P<0.01). Compared with the Trab group, the expression of FGF2 in the PVAH and TA/PVAH group was significantly increased at 1, 2, 3 and 4 wk after surgery(P<0.05). Compared with the SIGS group, FGF2 expression in the TA/PVAH group was significantly increased at 4 wk after surgery(P<0.05).CONCLUSION:In SIGS surgery of rabbit eyes, implanting hydrogel sustained-release sheeting loaded with TA under conjunctival flap can effectively inhibit the scarring of the filtering bleb, which may be the interaction of the anti-scar effect of TA and the stent function of hydrogel.

Objective To investigate the expression level and clinical application value of serum resistin in patients with systemic lu-pus erythematosus(SLE).Methods Forty-five SLE patients visited Nanjing Drum Tower Hospital,Clinical College of Nanjing Uni-versity of Chinese Medicine from January to August 2023 were enrolled in the study.The patients were scored and grouped according to the SLE disease activity index(SLEDAI),with SLEDAI＜9 score in the inactive group(n=32)and SLEDAI≥9 score in the active group(n=13).Thirty-four healthy individuals who underwent physical examination in our hospital were recruited as healthy controls.The clinical data and laboratory related indicators such as urine protein and serum complement C3 levels were collected from SLE pa-tients and healthy controls.Serum resistin levels were detected by enzyme-linked immunosorbent assay(ELISA).The clinical screening value of serum resistin for SLE was evaluated with the receiver operating characteristic(ROC)curve.The correlations of serum resistin levels with different laboratory indicators were determined by Pearson correlation analysis.Results The serum resistin levels in SLE patients([7.64±0.64]ng/mL)were significantly higher than that in healthy controls([2.56±0.43]ng/mL),and the difference was statistically significant(t=6.195,P＜0.01).The serum resistin levels in active SLE patients([10.10±1.45]ng/mL)were significant-ly higher than that in inactive SLE patients([6.64±0.60]ng/mL),and the difference was statistically significant(t=2.632,P＜0.05).The area under the ROC curve(AUCROC)of serum resistin for screening SLE was 0.897.When the cut-off value was 5.893 ng/mL,the sensitivity was 86.67%and the specificity was 82.35%.The serum resistin level in SLE patients was positively correlated with urine protein(r=0.692,P＜0.01),while negatively correlated with serum complement C3(r=-0.354,P＜0.05).Conclusion The expression levels of serum resistin in SLE patients are significantly increased and positively correlated with SLE disease activity and urine protein.Serum resistin may become a novel biomarker for the diagnosis and therapeutic effect assessment of SLE.

Objective:To explore the clinical application value of spiral computed tomography(CT)three-dimensional(3D)scanning reconstruction combined with 3D printing technique in surgery for acetabular fracture.Methods:A total of 71 patients with acetabular fractures admitted to Xinjiang Uiger Municipal People's Hospital from January 2018 to December 2020,who underwent surgical treatment,were selected as the research objects.According to different treatment methods,they were divided into observation group(38 cases)and control group(33 cases).The observation group adopted spiral CT 3D reconstruction,and 3D printing was used to assist the treatment of internal fixation,and the control group adopted conventionally surgical treatment.And then,the surgical effect and recovery situation of the two groups were compared.Results:The quality score(Malta)of fracture reduction and the hip score of sub-item percentile of observation group were significantly higher than those of the control group,and the intraoperative blood loss,the times of intraoperative fluoroscopy,the operation time and hospitalization time of observation group were significantly lower than those of control group(t=23.426,4.216,3.425,17.783,P<0.05),respectively.There was significant difference in the excellent rate of fracture reduction between two groups(x2=4.059,P<0.05).The pain,function and joint activity scores of hip joint function scores of patients in observation group were significantly higher than those of control group(t=-4.873,-5.776,-6.247,P<0.05),respectively.The incidence of complications in observation group was significantly lower than that in control group(x2=4.059,P<0.05).Conclusion:In the perioperative period,the application of spiral CT 3D reconstruction combined with 3D printing of acetabular fractures can further ensure the safety and feasibility of the operation,and improve the quality and efficiency of the surgery,and promote postoperative recovery.

Objective To explore the mediating effect of emotion regulatory self-efficacy (ERSE) in the relationship between musculoskeletal disorders and turnover intention in operating room nurses. Methods A total of 372 operating room nurses from five hospitals in Shenyang City were selected as the research subjects using covenient sampling method. The Musculoskeletal Disorders Questionnaire, Turnover Intention Scale, and Emotional Self-Regulation Efficacy Scale were used to study the prevalence of work-related musculoskeletal disorders (WMSDs), turnover intention, and ERSE among the study subjects. The Bootstrap method was used for mediation effect analysis of ERSE. Results The prevalence of WMSDs among operating room nurses was 69.9%. The scores for turnover intention and ERSE among operating room nurses were (13.6±6.3) and (34.7±16.2), respectively. ERSE played a partial mediating role in the relationship between WMSDs and turnover intention among operating room nurses, with an effect value of 0.04 and the 95% confidence interval of 0.01 to 0.08, accounting for 8.1% of the total effect. Conclusion WMSDs and ERSE directly influence turnover intention among operating room nurses. WMSDs can indirectly increase turnover intention by reducing ERSE among operating room nurses.

Objective:To investigate the role and underlying mechanisms of inhibiting high mobility group box-1 (HMGB1) in the expression of matrix metalloproteinase-9 (MMP-9) in spinal cord astrocytes (AS) in rats after spinal cord injury (SCI).Methods:After an SCI model was established in Sprague-Dawley (SD) rats using a modified Allen's Weight-Dropping method and ethyl pyruvate (EP) or glycyrrhizin (GL) was used to inhibit the effect of HMGB1, the rats were divided into a sham group, an SCI group, an SCI+EP (50 mg/kg) group, and an SCI+GL (100 mg/kg) group. The expression levels of glial fibrillary acid protein (GFAP) and MMP-9 in spinal cord AS were observed. After the spinal cord AS in SD rats was cultured and incubated by the oxygen-glucose deprivation/reoxygenation (OGD/R) procedure, the expression of MMP-9 protein was detected at 6 h/R 6 h, 12 h, 24 h, and 48 h after OGD. The time point with the highest expression was chosen in the subsequent experiments as an OGD/R group. HMGB1 was inhibited by HMGB1 shRNA or EP to observe the effect of HMGB1 on the expression of MMP-9 protein in AS treated with OGD/R. Then, toll-like receptor 4 (TLR4) inhibitor, TIR-domain-containing adaptor inducing interferon- β (TRIF) inhibitor, and nuclear factor-kappa B (NF- κB) inhibitor were used to investigate the effects of TLR4/TRIF/NF- κB signaling pathway during the regulation of HMGB1 on MMP-9 in vitro. Results:Western blot showed that the expression of MMP-9 protein in the spinal cord was significantly increased in rats at 1 d after SCI, and the expression of MMP-9 protein in the SCI+EP group and the SCI+GL group was significantly lower than that in the SCI group ( P<0.001). Immunofluorescence showed that GFAP and MMP-9 proteins were co-localized in the spinal cord after SCI, and the expression of GFAP and MMP-9 proteins in the SCI+EP and SCI+GL groups was significantly lower than that in the SCI group ( P<0.05). Since the expression of MMP-9 protein in the spinal cord AS cultured in vitro was significantly higher in the OGD 6h/R 12h group than that in the normal group and the OGD 6h/R 6h, 24, and 48 h groups, the OGD 6h/R 12h was taken as the OGD/R group. The MMP-9 protein expression in AS in the OGD/R+HMGB1 shRNA group and the OGD/R+EP group was significantly lower than that in the OGD/R group ( P<0.001). In the cultured AS, moreover, inhibiting TLR4, TRIF, and NF- κB reduced MMP-9 protein expression after OGD 6 h/R 12 h when compared with that in the OGD/R group ( P<0.001). Conclusions:HMGB1 inhibition may result in a reduction in MMP-9 expression both in the spinal cord AS in SCI rats and in AS after OGD/R treatment in vitro. HMGB1 may regulate MMP-9 protein expression in AS after OGD/R treatment via the TLR4/TRIF/NF- κB signal pathway.

Objective:To investigate the effects of bifidobacterium combined with salicylic acid on skin inflammation and intestinal microecology in acne patients with chloasma.Methods:Sixty acne patients with chloasma who received treatment in the Department of Cosmetic Dermatology, Wenzhou Heping Plastic Hospital from July 2020 to November 2021 were included in this study. They were randomly divided into three groups: lifestyle intervention group ( n = 20), bifidobacterium combined with salicylic acid intervention group ( n = 20), and isotretinoin intervention group ( n = 20). The lifestyle intervention group was treated by routine lifestyle care. The minocycline intervention group was administered with minocycline together with food based on lifestyle intervention. The bifidobacterium combined with salicylic acid intervention group was treated by bifidobacterium combined with salicylic acid based on lifestyle intervention. Clinical efficacy, skin condition score, changes in serum Toll like receptor 2 (TLR-2) and interleukin-17 (IL-17) levels after treatment relative to those before treatment, and the incidence of adverse reactions were compared among the three groups. Results:The response rate in the bifidobacterium combined with salicylic acid intervention group was 95.00% (19/20), which was higher than 55.00% (11/20) in the isotretinoin intervention group and significantly higher than 20.00% (4/20) in the lifestyle intervention group ( Z = 22.94, P < 0.05). After 14 weeks of treatment, the skin condition score in the bifidobacterium combined with salicylic acid intervention group was (53.15 ± 0.23) points, which was significantly higher than (32.95 ± 0.23) points in the isotretinoin intervention group and (10.18 ± 0.25) points in the lifestyle intervention group ( F = 164 761.37, P < 0.05). Serum levels of Toll-like receptor 2 and interleukin-17 in the bifidobacterium combined with salicylic acid intervention group were (35.31 ± 5.52) pg/mL and (164.23 ± 10.12) pg/mL, respectively, which were significantly lower than (52.13 ± 5.45) pg/mL and (198.32 ± 10.23) pg/mL in the isotretinoin intervention group and (62.56 ± 6.11) pg/mL and (245.23 ± 11.31) pg/mL in the lifestyle intervention group ( F = 116.33, 296.24, both P < 0.05). The incidence of adverse reactions in the bifidobacteria combined with salicylic acid intervention group was significantly lower than 65.00% (13/20) in the isotretinoin intervention group and 90.00% (18/20) in the lifestyle intervention group ( Z = 41.02, P < 0.05). Conclusion:Bifidobacterium combined with salicylic acid intervention for the treatment of acne complicated by chloasma can greatly improve skin conditions, alleviate skin inflammation, and reduce adverse reactions. Therefore, bifidobacterium combined with salicylic acid intervention is a safe and highly efficient method for the treatment of acne complicated by chloasma and deserves clinical promotion.

Objective:To explore the imaging characteristics and clinical value of CT angiography (CTA) of the aorta in active arteritis.Methods:A retrospective analysis was conducted on the clinical data and laboratory examination results of 77 patients with Takayasu arteritis (TAK) admitted to the Rheumatology and Immunology Department of People′s Hospital of Xinjiang Uygur Autonomous Region from January 2015 to October 2022. They were divided into two groups: 62 cases in the TAK active group and 15 cases in the TAK inactive group. Among them, 17 patients were followed up, 13 cases became inactive, and 4 cases remained active. A total of 94 aortic CTA imaging results were divided into 2 groups, with 66 cases in the TAK active group and 28 cases in the TAK inactive group.All patients underwent plain chest and abdominal CT scans, aortic CTA, and post-processing examinations, with 12 active TAK patients undergoing delayed aortic enhancement scans. The t-test, Mann Whitney U test, χ2 Testing, Fisher′s exact probability method and Pearson/Spearman correlation analysis were used for data analysis. The imaging features of the two groups were measured and compared, the correlation between imaging features and laboratory results, Kerr score were investigated. The diagnositic efficacy of imaging features were explored and imaging features before and after treatment were analyzed. Results:In the TAK active and inactive groups, course of disease[14 (1, 29) months vs 33(8, 69)months, Z=2.70, P=0.007], Physical malaise or weight loss[32.3%(20/62) vs 20.0%(3/15), χ2=4.08, P=0.043], increased ESR [98.4% (61/62) vs 13.3% (2/15)], χ2=64.69, P<0.001], CRP level[69.4% (43/62) vs 6.7%(1/15), χ2=29.94, P<0.001] were statistically significant. The vascular wall thickness of the two groups was significantly different [(4.2±1.4)mm vs (2.4±0.8)mm, t=7.81, P<0.001], CT mean value of the garterial wall [(81±8) Hu vs (70±13)Hu, t=2.82, P=0.011], CT max value of the arterial wall [(106±12)Hu vs (96±12)Hu, t=2.38, P=0.024], relative CT value 1 of the arterial wall (0.20±0.08 vs 0.14±0.04, t=2.56, P=0.016), relative CT value 2 of the arterial wall (1.23±0.18 vs 1.06±0.17, t=2.63, P=0.013), CT mean value of periaortic adipose tissue [(-31±12)Hu vs (-58±20)Hu, t=4.80, P<0.001)], CT max value of periaortic adipose tissue [-35(-45,-25)Hu vs -87(-95, -42)Hu, Z=4.27, P<0.001], CT mean value of adipose tissue around branches[-28(-33, -14)Hu vs -76(-83, -31)Hu, Z=3.37, P=0.001], CT max value of adipose tissue around branches[-7(-13,-1)Hu vs -59(-72, -14)Hu, Z=3.74, P<0.001], relative CT values of adipose tissue around the aorta (0.26 ± 0.09 vs 0.51 ± 0.19, t=4.47, P<0.001)], relative CT values of adipose tissue around branches (0.17 ± 0.09 vs 0.28 ± 0.18, t=2.35, P=0.025) were significant different. The wall thickness value, relative CT value of periaortic adipose tissue, and CT mean value of periaortic adipose tissue had high diagnostic efficacy, with cut-off values of 3.25 mm, 0.455, and -55 Hu, respectively. The AUCs were 0.911, 0.887, and 0.863, respectively. The Youden index was 0.687, 0.730, and 0.715, respectively. The sensitivity and specificity were 0.758 and 0.929, 0.909 and 0.821, 0.894 and 0.821, respectively. After treatment, 11 active TAK patients became inactive, with reduced wall thickening, enhancement, and density of perivascular adipose tissue. Thirteen patients with active TAK underwent delayed aortic enhancement scanning, and it was found that the low-density loop sign of the aortic intima was more clearly displayed during this period, and the enhancement amplitude of the vascular wall tended to be uniform. Conclusion:Aortic CTA is an effective method for qualitative evaluation of TAK activity.

Objective:To optimize the formula and preparation of exendin W /O/W multiple emulsion , and study the main proper-ties in vitro to lay foundation for the development of exendin prolonged action preparation .Methods:Using multiple emulsion yield and centrifugal separation time as the comprehensive index , the formula and preparation of exendin multiple emulsion were optimized by or-thogonal tests, and the morphology, particle size, stability, encapsulation efficiency and drug release in vitro were studied.Results:The optimal formula was as follows:the volume ratio of W1 phase to O phase was 1:1.2, the quality percentage of emulsifierⅠin the O phase was 10％, poloxamer 407 in W2 phase was 10％, and the quantity ratio of W1/O to W2 phase was 1:1.The optimal prepara-tion conditions were as follows:the stirring speed for W1/O was 10000 r· min-1 , and the stirring time was 10 min, and that for W1/O/W2 was 2500 r· min-1 with the stirring time of 3 min.The multiple emulsion was spherical with the mean size of (46.3 ±2.6)μm, and the centrifugal and viscosity stability were both promising .The drug encapsulation efficiency was above 90％, and the drug release in vitro accorded with a Higuchi equation: Y=13.7930X+5.5981(r=0.9883), showing notable sustained and prolonged property .Conclusion:The optimal formula and preparation process of exendin multiple emulsion are simple with high drug content , good stability and notable sustained release property in vitro.

Objective:To improve the stability of exendin W/O/W multiple emulsion.Methods:The amount of electrolyte sodium chloride in the internal water phase and that of thickener PVP in the external water phase were both screened for exendin W/O/W mul-tiple emulsion,and the cryoprotectant in the freeze-drying process was optimized in order to further optimize the formula and preparation of exendin W/O/W multiple emulsion. Verification experiment was carried out to study the main properties of the optimized exendin W/O/W multiple emulsion in vitro. Results: The optimal quality volume percentage concentration of sodium chloride in the internal water phase was 0.10%,and that of PVP in the external water phase was 0.15%,and the best cryoprotectant was 10% mycose. The main in vitro properties of exendin W/O/W multiple emulsion showed no significant changes before the freeze-drying and after the rehy-dration. Conclusion:Through the optimization of the internal and external water phase of exendin W/O/W multiple emulsion,the sta-bility is enhanced,which lays foundation for the in vivo studies.