ObjectiveTo observe the pharmacodynamic effects of Cinnamomi Cortex on the incretin effect in the rat model of diabetes mellites （DM） induced by streptozotocin （STZ） and explore the underlying mechanism from glucagon-like peptide-1 （GLP-1） and dipeptidyl peptidase-4 （DPP-4）. MethodForty SD rats were randomly assigned into blank， model， sitagliptin （0.1 g·kg^-1）， and low- and high-dose Cinnamomi Cortex （0.45 and 0.9 g·kg^-1， respectively） groups. The DM rat model was established by a high-fat diet combined with intraperitoneal injection of 40 mg·kg^-1 STZ in other groups except the blank group. The intervention lasted for 8 weeks. The status， body weight， water intake， food intake， and fasting blood glucose （FBG） of the rats were observed and determined. Hematoxylin-eosin staining was employed to reveal the pathological changes of the pancreas， and immunohistochemistry to detect the expression of glucagon in the pancreas. Biochemical assay was employed to measure the serum levels of lipid metabolism indexes such as total cholesterol （TC）， triglyceride （TG）， low-density lipoprotein （LDL）， and high-density lipoprotein （HDL）. Enzyme-linked immunosorbent assay was employed to determine the levels of glycosylated hemoglobin， insulin， glucagon， GLP-1， and glucose-dependent insulinotropic polypeptide （GIP） in rat serum， and Western blot to determine the protein levels of GLP-1 and DPP-4 in the pancreas. ResultAfter 8 weeks of intervention， the model group showed higher body weight， FBG， TC， TG， LDL， glycosylated hemoglobin， glucagon， insulin， and insulin resistance index and lower HDL， GLP-1， and GIP than the blank group （P<0.05， P<0.01）. The Cinnamomi Cortex groups showed lower body weight， FBG， TC， TG， LDL， glycosylated hemoglobin， glucagon， insulin， and insulin resistance index and higher HDL， GLP-1， and GIP than the model group （P<0.05， P<0.01）. The Cinnamomi Cortex groups showed recovered morphology of islet cells and no nucleus aggregation. Compared with the model group， the Cinnamomi Cortex groups showed declined levels of glucagon in the center of islet cells. Compared with the blank group， the model group showed up-regulated protein level of DPP-4 and down-regulated protein level of GLP-1 （P<0.01）. Compared with the model group， the high-dose Cinnamomi Cortex groups showed down-regulated protein level of DPP-4 and up-regulated protein level of GLP-1 （P<0.05）. ConclusionCinnamomi Cortex may reduce blood glucose and improve incretin effect to lower the blood glucose level by regulating DPP-4 and GLP-1 in DM rats.

Objectives:To explore the cardiac magnetic resonance(CMR)features of early ventricular aneurysm formation in patients with acute anterior myocardial infarction. Methods:One hundred and eight patients with acute anterior myocardial infarction who underwent primary percutaneous coronary intervention and completed CMR scans within two weeks were retrospectively analyzed and divided into non-ventricular aneurysm group(n=72)and ventricular aneurysm group(n=36)according to the absence or presence of early ventricular aneurysm after primary percutaneous coronary intervention.The obtained CMR images were imported into CVI42 software for image analysis,and a logistic regression analysis model was established to evaluate CMR features useful for the diagnosis of early ventricular aneurysm formation. Results:Aging and larger area of late gadolinium enhancement(LGE)and worse left ventricular systolic function and lower myocardial strain were features of patients in the ventricular aneurysm group as compared to the non-ventricular aneurysm group.LGE area(OR=1.32,95%CI:1.071-1.628,P=0.009),apical angle(OR=1.24,95%CI:1.041-1.475,P=0.016),septal mitral annular plane systolic excursion(septal MAPSE,OR=0.36,95%CI:0.169-0.757,P=0.007)and global longitudinal strain(GLS,OR=0.53,95%CI:0.154-0.953,P=0.046)were associated with early ventricular aneurysm formation.ROC curves were analyzed for the above four CMR parameters,and the AUC were 0.922,0.921,0.905,and 0.814,respectively.The optimal cutoff values were 28.5%,90°,8.245 mm,and 10.155%,respectively. Conclusions:Estimation of LGE area,apical angle,septal MAPSE and GLS using CMR technique can help diagnose early ventricular aneurysm in patients with acute anterior myocardial infarction.

ObjectiveTo study the effect of serum containing Sanwubai San on TGF-β₁ induced epithelial mesenchymal transition （EMT） of human gastric cancer SGC-7901 cells and its mechanism in vitro based on transforming growth factor-β/Smad（TGF-β/Smad）signaling pathway. MethodTwenty-eight male SD rats （SPF grade， three months） were randomly divided into blank group and Sanwubai low （0.031 25 g·kg^-1·d^-1， ig）， medium （0.062 5 g·kg^-1·d^-1， ig） and high （0.125 g·kg^-1·d^-1， ig） dose groups， seven in each group. The blank group was given the same volume of ultrapure water （ig）. The gavage was performed once a day for seven consecutive days. The serum containing the drug was taken from the abdominal aorta 45 min after the last administration. Cell counting kit-8 （CCK-8） method was used to detect the effect of serum in Sanwubai San high dose group on the activity of SGC-7901 cells. Changes of cell morphology after treatment with TGF-β₁ and serum containing Sanwubai San were observed by microscopy， and the migration rate and invasion rate of the SGC-7901 cells were detected by cell scratch assay and transwell assay， respectively. Western blot was used to detect the expression of E-cadherin， snail， TGF-β₁， Smad3， p-Smad3 and Smad7 proteins. ResultCompared with the blank group， 10%， 15% and 20% high-dose Sanwubai San inhibited the activity of SGC-7901 cells in a concentration and time dependent manner. Compared with the conditions in the blank group， the cells in the model group lost spindle shape， and most cells became round and long. Compared with the model group， the Sanwubai San groups had decreased pseudopodia and small cells with the morphology returning to normal. Compared with the conditions in the blank group， enhanced ability of cell migration and invasion （P<0.01）， lowered expression of E-cadherin and Smad7 （P<0.01）， and increased expression of Snail， p-Smad3 and TGF-β₁ （P<0.01） were found in the model group， with the total protein level of Smad3 remaining unchanged. Compared with the conditions in the model group， the cell migration ability was inhibited in the Sanwubai San high and medium dose groups （P<0.01） after 24 h， and the ability was inhibited in all three Sanwubai San groups after 48 h （P<0.01）， while the invasion ability was enhanced. In addition， the Sanwubai San high and medium dose groups had elevated expression of E-cadherin （P<0.01） and Smad7 （P<0.01）， and decreased expression of Snail （P<0.01）， and the expression of TGF-β₁ and p-Smad3 was down-regulated in the three Sanwubai San groups （P<0.01）. ConclusionSanwubai San could inhibit TGF-β₁ induced EMT in SGC-7901 cells， and its mechanism might be related to the regulation of TGF-β/Smad signaling pathway.

Objective:To compare the efficacy of 3D printing technology-assisted and conventional open reduction and internal fixation of multiple rib fracture.Methods:A retrospective cohort study was conducted to analyze the clinical data of 61 patients with multiple rib fracture admitted to Mindong Hospital Affiliated to Fujian Medical University and Fujian Provincial Hospital from July 2018 to March 2020. There were 44 males and 17 females, with age range of 18-73 years [(45.1±12.9)years]. Unilateral lung contusion and laceration occurred in 31 patients, while bilateral in 30. There were 19 patients accompanied by hempneumothorax and 16 by flail chest. Totally, 31 patients received 3D printing technology assisted open reduction and internal fixation (3D-assisted incision group) and 30 patients received conventional open reduction and internal fixation (conventional incision group). The incision length, operation time, intraoperative blood loss, postoperative 3-day visual analogue scale (VAS), duration of pain, indwelling time of chest tube, total length of hospital stay, postoperative bone callus formation time and rate of rib bone plate loosening were comapared in two groups. The short form 36 health survey (SF-36) score (ie, physical function, physical function, physical pain, general health, energy, social function, emotional function, mental health) preoperatively, at postoperative 6-month and at the last follow-up was compareted between two groups. Complications were observed at the same time.Results:All patients were followed up for 18-38 months [(26.4±5.5)months]. In 3D-assisted incision group, the incision length was (5.9±1.3)cm, with operation time for (84.6±7.8)minutes, intraoperative blood loss for (85.5±13.9)ml, postoperative 3-day VAS for (2.5±0.5)points, duration of pain for (5.9±0.7)days, indwelling time of chest tube for (3.4±0.7)days, total length of hospital stay for (7.0±1.0)days, postoperative callus formation time for (2.6±0.7)weeks and rate of rib bone plate loosening for 3.2%(1/31). By contrast, in conventional incision group, the incision length was (10.9±2.4)cm, with operation time for (127.1±12.5)minutes, intraoperative blood loss for (183.0±30.9)ml, postoperative 3-day VAS for (6.5±0.9)points, duration of pain for (11.2±1.8)days, indwelling time of chest tube for (7.8±0.8)days, total length of hospital stay for (15.1±1.2)days, postoperative callus formation time for (4.6±0.8)weeks and rate of rib bone plate loosening for 20.0%(6/30) ( P<0.05 or 0.01). There was no significant difference in preoperative SF-36 score between the two groups ( P>0.05). At 6 months after surgery, the subscores of SF-36 in 3D-assisted incision group were higher than those in conventional incision group except for "mental health" ( P<0.05 or 0.01). At the last follow-up, all the subscores of SF-36 in 3D-assisted incision group were higher than those in conventional incision group ( P<0.05 or 0.01). There were no obvious complications such as pulmonary infection or atelectasis. Conclusions:For multiple rib fracture, 3D printing technology-assisted open reduction and internal fixation is superior to conventional open reduction and internal fixation for it can shorten incision length, operation time, indwelling time of chest tube, total length of hospital stay and postoperative bone callus formation time, reduce intraoperative blood loss, relieve postoperative pain, reduce rate of rib bone plate loosening and improve quality of life of the patients.

The vagina contains at least a billion microbial cells,dominated by lactobacilli.Here we perform metagenomic shotgun sequencing on cervical and fecal samples from a cohort of 516 Chinese women of reproductive age,as well as cervical,fecal,and salivary samples from a second cohort of 632 women.Factors such as pregnancy history,delivery history,cesarean section,and breastfeeding were all more important than menstrual cycle in shaping the microbiome,and such information would be necessary before trying to interpret differences between vagino-cervical micro-biome data.Greater proportion of Bifidobacterium breve was seen with older age at sexual debut.The relative abundance of lactobacilli especially Lactobacillus crispatus was negatively associated with pregnancy history.Potential markers for lack of menstrual regularity,heavy flow,dysmenor-rhea,and contraceptives were also identified.Lactobacilli were rare during breastfeeding or post-menopause.Other features such as mood fluctuations and facial speckles could potentially be predicted from the vagino-cervical microbiome.Gut and salivary microbiomes,plasma vitamins,metals,amino acids,and hormones showed associations with the vagino-cervical microbiome.Our results offer an unprecedented glimpse into the microbiota of the female reproductive tract and call for international collaborations to better understand its long-term health impact other than in the settings of infection or pre-term birth.

Objective: To investigate the clinical effect of preoperative computed tomography (CT) measurement of acetabulum femoral neck combined anteversion in primary total hip arthroplasty (THA). Methods: From March 2016 to may 2018, 48 patients (90 hips) with developmental dysplasia of the hip (DDH) who were treated with THA in the orthopaedic department of Jiangmen Central Hospital were measured by X-ray and spiral CT three-dimensional reconstruction technology before operation, and the best combined anteversion angle of acetabulum was determined before implementing THA, which was CT group; the remaining 42 patients were not measured by CT before operation, which was X-ray group. The difference of acetabulum cup anteversion angle, acetabulum femoral neck combined anteversion angle and preoperation angle were evaluated by three-dimensional computed tomography (3D-CT) in CT group. Results: There was no significant difference in operative time, intraoperative blood loss, time of getting out of bed and length of lower limbs between the two groups (P>0.05). In CT group, the acetabulum cup anteversion and acetabulum femoral neck anteversion were close to the pre-operative angle at 2 and 3 months postoperatively (P>0.05). The Harris hip score of CT group was significantly higher than that of X-ray group at 2 and 3 months after operation, and the incidence of deep vein thrombosis was 6.25%, significantly lower than that of X-ray group (21.43%) (P<0.05). The incidence of dislocation, infection and periprosthetic fracture was slightly lower than that of X-ray group, but the difference was not statistically significant (P>0.05). Conclusions For DDH patients who received THA for the first time, preoperative CT measurement of acetabulum femoral neck combined with anteversion is conducive to the formulation of the best combined anteversion adjustment scheme, which can obtain the maximum initial stability, improve the surgical effect and reduce the occurrence of dislocation of prosthesis.

Objective:To investigate the clinical effect of thoracoscopy combined with puncture-positioned internal fixation of multiple rib fractures accompanied with hemopneumothorax.Methods:A retrospective case-control study was used to analyze the clinical data of 68 patients with multiple rib fractures accompanied with hemopneumothorax admitted to Fujian Provincial Hospital from September 2016 to December 2018, including 49 males and 19 females, aged 25-86 years [(47.3±7.4)years]. There were 55 patients with unilateral lung contusion and laceration, and rest 13 patients with bilateral lung contusion and laceration. A total of 36 patients were treated by thoracoscopy combined with puncture-positioned internal fixation (thoracoscopy group) and 32 patients by open reduction group (open reduction group). The incision length, operation time, intraoperative blood loss, chest tube drainage time, ICU hospitalization time, total hospitalization time, and complications were recorded. Numeric rating scale (NRS) score was assessed at postoperative 1, 2, 3, 7 days. The MOS 36-item short-form health survey (SF-36) was conducted at the latest follow-up.Results:All patients were followed up for 8-34 months [(18.9±4.3)months]. Thoracoscopy group showed incision length of (4.3±1.3)cm, operation time of (66.3±12.1)minutes, intraoperative blood loss of (86.5±23.4)ml, chest tube drainage time of (5.3±1.1) days, ICU hospital stay of (2.3±0.8)days, total hospital stay of (6.8±1.7)days, and total complication rate of 8%, showing significant differences compared to open reduction group [(11.6±2.2)cm, (105.9±19.4)minutes, (191.4±35.6)ml, (8.1±1.6)days, (4.7± 1.4)days, (10.6±2.1)days, 29%] ( P<0.05 or 0.01). In thoracoscopy group, the NRS scores at day 1, 2, 3, and 7 were respective (6.6±1.2)points, (5.9±1.0)points, (4.4±0.9)points and (2.7±0.7)points, significantly lower than those in open reduction group [(7.3±1.2)points, (7.0±1.1)points, (5.7±1.0)points and (3.9±0.8)points] ( P<0.05 or 0.01). The SF-36 score in thoracoscopy group was (86.4±12.1)points, significantly higher than that in open reduction group [(75.6±11.5)points] ( P<0.01). Conclusions:Compared with open reduction and internal fixation, thoracoscopy combined with puncture-positioned internal fixation for multiple rib fractures has the advantages of smaller surgical incision, shorter operation time, less intraoperative bleeding, shorter chest tube drainage time, shorter ICU hospital stay, shorter total hospital stay, and less postoperative complications. The technique can also reduce the postoperative pain and improve the patients' quality of life.

BACKGROUND: It is of great significance to study the resilience of articular cartilage for human daily routine and their match quality. OBJECTIVE: To analyze the micromechanical properties of articular cartilage resilience under different loads and at time points. METHODS: The swine cartilage samples coated with tracers were compressed using the MTF-100 tensile machine, and the cartilage compression and resilience were recorded by CCD. Images were processed using digital image correlation technology.RESULTS AND CONCLUSION: During resilience, the strain value on the superficial surface of the cartilage was decreased most, successively followed by the middle layer and the deep layer, while the time of a decrease from 20%, 10% and 6% to 3% was similar. The longer the resilience time was, the more slowly the strain changed in different layers of the cartilage, but the ultimate strain was less than 1%. On the same layer under different compressive stress, the larger load caused faster strain change firstly, and then the smaller load brought about faster strain change. The effect of different continuous compressive time on the same layer of cartilage was similar with the load. These results showed that 90% resilience of the articular cartilage occurred within the first 15 minutes. The mechanical resilience of different layers of the articular cartilage has a close relationship with the loading and the loading time, and both compressive time and loading do harm to the resilience of articular cartilage. Besides, the cartilage will rebound to the state before compression.

Objective To explore the effects of 1,25-dihydroxyvitamin D3 on renal expression of TGFβ1,Smad3 and Smad7.Methods 40 Sprague-Dawley mts were randomized into 4 groups:normal control rats (group A),diabetic nephropathy group (group B),small dose 1,25-dihydroxyvitamin D treatment group (0.5 μg · kg-1 · d-1,group C) and large dose 1,25-dihydroxyvitamin D treatment group (1 μg · kg-1 · d-1,group D),each group had 10 rats.After 12 weeks,the renal function,blood glucose,glycosylated hemoglobin and the urine trace albumin content of each rats were tested.Results The biochemical indicators in group B were higher than those in group A,(t =-16.566,P ＜0.05;t =-16.949,P ＜0.05;t =-11.844,P ＜0.05;t =-19.778,P ＜0.05;t =-14.013,P ＜ 0.05).Compared with group B,the biochemical indicators and the expression of TGFβ1,Smad3 mRNA reduced in group C and group D,and the expression of Smad7 mRNA increased (F =37.892,P ＜ 0.05;F =70.068,P ＜ 0.05;F =21.95,P ＜0.05;F =77.619,P ＜0.05;F =37.670,P ＜0.05;F =1062.562,P ＜0.05;F =2463.789,P ＜0.05;F =81.745,P ＜ 0.05).There were no significant differences between group C and group D (t =0.538,P＞0.05;t =1.737,P＞0.05;t =0.671,P＞0.05;t =1.763,P ＞0.05;t =0.997,P ＞0.05;t =1.653,P ＞0.05;t=1.543,P＞0.05;t =-1.313,P ＞0.05).Conclusion 1,25-dihydroxyvitamnin D3 has protective effect on diabetic nephropathy rats model,the mechanism may be associated with inhibiting the expression of TGF β1 and Smad3,increasing the expression of Smad7.

Objective To investigate the effect of continued nursing on postoperative outcomes of discharged patients with chronic suppurative otitis media.Methods Toally 198 discharged patients were randomized into the control group (n=98) and the observation group (n=100).The patients in both groups received normal health education and additionally the continued nursing was used in the observation group for health education by way of phone call follow-up,on-the-spot consultation and QQ consultation.The mastery of related knowledge and skills,incidence of secondary tympanic membrane and readmission rate were compared.Results Six months after discharge,the observation group was significantly better than those the control group in the mastery of related knowledge and skills (P＜0.05).The incidence of secondary tympanic membrane perforation was not statistically significant between the groups(P＞ 0.05).The readmission rate at the second week and the third week between the two groups had no statistically significant difference (P＞ 0.05).However,the readmission rate at the first,second,third and sixth month were statistically different (P＜0.05).Conclusion Continued nursing to the postoperative discharged patients with chronic suppurative otitis media can improve the follow-up rate after discharge and self-nursing capacity,and as a result promote their recovery.