Objective:To investigate the protective effect of Xuebijing injection on acute lung injury (ALI) associated with cardiopulmonary bypass (CPB) by regulating the apoptosis of polymorphonuclear neutrophils (PMN).Methods:Thirty male Sprague-Dawley (SD) rats were randomly divided into sham operation group (Sham group), CPB model group (CPB group) and Xuebijing pretreatment group (XBJ group) according to the random number table method, with 10 rats in each group. Rats in the CPB group and XBJ group undergoing CPB procedures for 60 minutes. Rats in the Sham group did not undergo CPB. Rats in the XBJ group received intraperitoneal injection of 4 mL/kg Xuebijing injection 2 hours before CPB. Rats in the Sham group and CPB group were injected with an equal amount of normal saline. 4 hours after CPB, arterial blood was collected for blood gas analysis to calculate respiratory index (RI), and lung tissue of rats was collected for determination of lung index (LI) and pulmonary water containing rate. PMN in bronchoalveolar lavage fluid (BALF) were collected and the activity of caspase-3 was detected. The apoptosis rate was detected by flow cytometry. The expressions of microRNA-142-3p (miR-142-3p) and FoxO1 mRNA were detected by real-time fluorescence quantitative polymerase chain reaction (RT-qPCR). The protein expression of FoxO1 was detected by Western blotting. In addition, HL-60 cells were divided into control oligonucleotide transfection group, miR-142-3p mimics transfection group, and miR-142-3p inhibitor transfection group. After 48 hours of transfection, the activity of miR-142-3p binding to FoxO1 was detected using dual luciferase reporter genes.Results:Compared with Sham group, RI, LI and pulmonary water containing rate were significantly increased in CPB group. The caspase-3 activity and apoptosis rate of PMN obtained from BALF were significantly decreased, the expression of miR-142-3p was decreased, and the expression of FoxO1 protein was increased. However, compared with CPB group, RI, LI and pulmonary water containing rate were significantly decreased in XBJ group [RI: 0.281±0.066 vs. 0.379±0.071, LI: 4.50±0.26 vs. 5.71±0.42, pulmonary water containing rate: (80.31±32.50)% vs. (84.59±3.41)%, all P < 0.01]. The caspase-3 activity and apoptosis rate of PMN obtained from BALF were significantly increased [caspase-3 activity: 0.350±0.021 vs. 0.210±0.014, apoptosis rate: (15.490±1.382)% vs. (8.700±0.701)%, both P < 0.01], the expression of miR-142-3p was significantly up-regulated (2 -ΔΔCt: 2.61±0.17 vs. 0.62±0.05, P < 0.01), and the protein expression of FoxO1 was decreased [FoxO1/GAPDH (relative expression level): 0.81±0.04 vs. 1.22±0.06, P < 0.01]. However, there was no statistically significant difference in FoxO1 mRNA expression among the three groups. The bioinformatics analysis results showed that miR-142-3p can bind to the FoxO1 3'untranslated region (3'UTR). In HL-60 cells, compared with control oligonucleotide transfection group, the transfection of miR-142-3p mimics could reduce the expression of FoxO1 protein [FoxO1/GAPDH (relative expression level): 0.48±0.06 vs. 1.00±0.05, P < 0.01], however, the transfection of miR-142-3p inhibitor increased the expression of FoxO1 protein [FoxO1/GAPDH (relative expression level): 1.37±0.21 vs. 1.00±0.05, P < 0.05]. But, transfection with miR-142-3p mimics or inhibitor had no effect on FoxO1 mRNA expression. The luciferase reporter gene showed that miR-142-3p could bind to the FoxO1 3'UTR to inhibit FoxO1 expression. Conclusion:Xuebijing injection may promote the apoptosis of pulmonary alveolar PMN through the miR-142-3p/FoxO1 axis, and play a role in the prevention and treatment of CPB-induced ALI.

Objective:To compare the clinical efficacy between a single palmar lateral transverse approach and the modified Henry approach in the locking plate fixation for distal radius fractures.Methods:A retrospective study was conducted to analyze the data of 82 patients with distal radius fracture who had undergone locking plate fixation through either a single palmar lateral approach or the modified Henry approach between January 2016 and December 2022 at Department of Traumatic Orthopaedics, Taihe Hospital, Affiliated to Hubei University of Medicine. There were 25 males and 57 females, with an age of (53.8±12.7) years. Based on the difference in surgical approach, the patients were divided into a single transverse approach group ( n=42) and a modified Henry approach group ( n=40). The 2 groups were compared in terms of injury cause, injury location, time from injury to surgery, AO fracture classification, tourniquet time during surgery, incision length, fracture reduction, Patient and Observer Scar Assessment Scale (PSAS & OSAS) and Disability of the Arm, Shoulder, and Hand (DASH) score at the last follow-up, and complications after surgery. Results:There were no statistically significant differences in the baseline characteristics between the 2 groups, indicating comparability ( P>0.05). All patients were followed up for (8.2±3.5) months. Follow-ups revealed one case of injury to the palmar cutaneous branch of the median nerve but no other complications like infection, non-union, internal fixation failure, or tendon injury in the single transverse approach group. The single transverse approach group was significantly superior over the modified Henry approach group in incision length [(2.4±0.9) cm versus (5.3±1.6) cm], OSAS (8.1±4.2 versus 10.3±5.7), and PSAS (10.1±5.8 versus 14.7±6.4) ( P<0.05). There were no significant differences between the 2 groups in tourniquet time, fracture reduction quality, and DASH score at the last follow-up ( P>0.05). Conclusion:In locking plate fixation for distal radius fractures, in comparison with the modified Henry approach, a single palmar lateral approach is more minimally invasive so that more aesthetically pleasing outcomes can be achieved to facilitate patients' rapid return to work and society.

Objective To explore the predictive value of serum cathepsin S(CTSS),progranulin(PGRN)and chemo-kine ligand 12(CXCL12)for acute exacerbation of chronic obstructive pulmonary disease(COPD).Methods A total of 202 patients with COPD who were admitted to the Tongling Municipal Hospital from January 2020 to February 2023 were selected as the research subjects.The patients were divided into an acute exacerbation group(n=64)and a non-acute exacerbation group(n=138)according to whether acute exacerbation occurred.Clinical data such as serum CTSS,PGRN and CXCL12 levels,age,gender,body mass index(BMI),disease course,smoking history,forced expiratory volume in one second/forced vital capacity ratio(FEV1％),and COPD assessment test(CAT)score in the stable period were collected.Univariate analysis was made to compare the differences in relevant indicators between the two groups,and multivariate logistic regression analysis was made to identify the independent risk factors for acute exacerbation in COPD patients.The Pearson correlation method was used to analyze the correlation between serum CTSS,PGRN,CXCL12 levels and FEV1％,CAT score.Relative risk analysis was used to evaluate the influence of different CTSS,PGRN and CXCL12 levels on acute exacerbation in COPD patients.The predictive efficacy of serum CTSS,PGRN and CXCL12 levels on acute exacerbation in COPD patients was evaluated by receiver operating characteristic(ROC)curve.Results Univariate analysis showed that there was no significant difference in age,sex,BMI and disease course of patients between the two groups(P＞0.05),while there were significant differences in the propor-tion of patients with smoking history,FEV1％,CAT score,and serum CTSS,PGRN and CXCL12 levels between the two groups(P＜0.05).Multivariate logistic regression analysis showed that elevated serum CTSS,PGRN and CXCL12 levels were risk factors for acute exacerbation in COPD patients(P＜0.05).There were significant differences in serum CTSS,PGRN and CXCL12 levels among patients with different FEV1％and CAT scores(P＜0.05).Pearson correlation analysis showed that serum CTSS,PGRN and CXCL12 levels were negatively correlated with FEV1％and positively correlated with CAT score(P＜0.05).Risk analysis showed that the risk of acute exacerbation in COPD patients with high serum CTSS,PGRN and CXCL12 levels was 2.089 times[95％confidence interval(CI):1.341-3.253],2.294 times(95％CI:1.363-3.862)and 2.359 times(95％CI:1.459-3.815)of the COPD patients with low serum CTSS,PGRN and CXCL12 levels.ROC analysis indica-ted that the area under the curve for predicting the risk of acute exacerbation in COPD patients based on serum CTSS,PGRN and CXCL12 levels alone was 0.780,0.811 and 0.755,respectively;the area under the curve for predicting the risk of acute exacerbation in COPD patients based on the combination of serum CTSS,PGRN and CXCL12 levels was 0.923.Conclusion Serum CTSS,PGRN and CXCL12 levels are risk factors for acute exacerbation of COPD.Abnormal elevation of serum CTSS,PGRN and CXCL12 levels can significantly increase the risk of acute exacerbation of COPD.The combination of serum CTSS,PGRN and CXCL12 levels is more effective in predicting the risk of acute exacerbation of COPD.

Objective To explore the short-term efficacy of endovascular isolation treatment for type A aortic intramural hematoma(AIH)with pericardial effusion,and to discuss the endovascular isolation treatment strategy for type A AIH with pericardial effusion.Methods A total of 12 patients with type A AIH complicated by pericardial effusion,who were admitted to the First Affiliated Hospital of Hunan University of Traditional Chinese Medicine of China between February 2018 and November 2021,were enrolled in this study.Before surgery,the intima of the ascending aorta was intact in all patients,but a rupture at the proximal intima of the aortic arch or the thoracic descending aorta was detected.All patients received endovascular isolation treatment.Among them,4 patients received endovascular isolation treatment within one week after the onset of disease,and 8 patients received selective operation after receiving conservative treatment for one week.The patients were followed up for one year.Results Among the patients who received endovascular isolation treatment within one week after the onset of disease,one patient recovered smoothly,two patients developed type A dissection within 3 months after surgery,and one died early after surgery.All the 8 patients,who received selective operation after receiving conservative treatment for one week,recovered smoothly.Conclusion For patients with type A AIH complicated by mild to moderate pericardial effusion,selective endovascular isolation treatment after receiving the conservative treatment to alleviate the ascending aortic hematoma can achieve ideal therapeutic effect.

Objective:To investigate the clinical effects of a single lateral-rectus approach (LRA) in the Ti-Robot-assisted treatment of acetabular fractures involving the posterior column.Methods:A retrospective study was conducted to analyze the clinical data of 16 patients with acetabular fracture who had been admitted to Department of Trauma Orthopedics, Taihe Hospital from August 2021 to March 2023. There were 13 males and 3 females with a mean age of 51.5 (35.8, 56.8) years. By the Judet-Letournel classification, there were 4 anterior and posterior semi-transverse fractures, 2 T-shaped fractures, and 10 double-column fractures. The time from injury to operation was 6.0 (5.3, 7.8) d. All their acetabular fractures involving the posterior column were treated by a single LRA with the assistance of a Ti-Robot. Operation time, blood loss, complications, quality of fracture reduction, modified Merle d'Aubigné & Postel scores and acetabular recovery at the last follow-up were recorded.Results:In this cohort, the operation time was (4.1±0.6) h and the blood loss 400 (300, 575) mL. By the Matta evaluation, the fracture reduction was excellent in 10 cases, good in 5 cases, and poor in 1 case. The follow-up time was (11.3±3.9) months. Bone union was achieved in all fractures after 3.0 (2.3, 4.0) months. By the modified Merle d'Aubigné & Postel scores at the last follow-up, 9 cases were excellent, 6 cases were good and 1 case was fair. Injury to the lateral femoral cutaneous nerve occurred in 1 patient, and deep venous thrombosis in 6 patients. Follow-ups revealed no iatrogenic vascular injury, loosening or rupture of internal fixation, or incision infection.Conclusion:A single LRA approach can be used in the minimally invasive treatment assisted by a Ti-Robot for acetabular fractures involving the posterior column, demonstrating advantages of minimal invasion, high reduction quality and good functional recovery of the hip joint.

Objective:To understand the psychology of patients undergoing breast augmentation, and to provide reference for preoperative communication between clinicians and patients.Methods:From September 2016 to September 2017, the Guangdong Second Provincial General Hospital formulated a 37-question questionnaire based on BREAST-Q and Chinese national conditions, and investigated patients who planned to undergo breast augmentation in 34 hospitals.Results:A total of 2066 valid questionnaires were collected. Fifty-four percent of women were dissatisfied with their nude appearance, which was more dissatisfied compared with their appearance when dressed. Surgical safety (20.1%), surgical effect (16.8%), surgical method and incision selection (16.5%), breast implant material (14.5%) and doctor′s skill (11.6%) were the five most important factors for considering breast augmentation. Only 26.6% of the respondents were supported by their family members or partners when they made the decision to have breast augmentation. Most women had limited knowledge of breast augmentation, with only 24.9 percent of respondents having a thorough understanding of the procedure.Conclusions:Women undergoing breast augmentation have an urgent need to improve their appearance, and their decision-making process is affected by many factors, among which surgical safety is the most worrying factor for patients. This group of people have limited knowledge about surgery, and the popularization of breast augmentation by plastic surgeons remains to be strengthened.

Objective:To explore the application value of the method of judging the density of small shadows in the lung area by using CT and CT reference films for pneumoconiosis.Methods:The chest imaging data of 244 employees of a large copper company in Tongling City, Anhui Province who underwent occupational physical examination at Tongling Municipal Hospital in Anhui Province from January 2016 to December 2019 were retrospectively analyzed. Totally 244 cases underwent chest CT scan and chest DR radiography at the same time. The shape and size of the small shadows (the size of the circular and quasi-circular nodules in the lung area were represented by p, q, r, and the size of the irregular small shadows were represented by s, t, u), the overall density, the density of small shadows in each lung area, the large shadows, and the diagnosis stage were observed and compared. The small shadow density of each lung area was judged by the method of judging the small shadow density of CT lung area and the reference film, and other observation indicators were judged according to GBZ70-2015 Diagnosis of Occupational Pneumoconiosis. Results:There was a significant difference between CT and DR in judging s-shaped small shadows and no small shadows ( P<0.05), and there was no statistically significant difference in judging p, q, r, t, and u-shaped small shadows ( P>0.05). CT and DR had medium to high consistency in the judgment of the overall density of small shadows (Kappa=0.692, P=0.001), and the diagnostic coincidence rate was 82.38% (201/244). There was moderate to high agreement between CT and DR in the density of small shadows shown in the right upper, right lower, left upper, left middle, and left lower lung regions (Kappa ranged from 0.40 to 0.75, P<0.05), and the consistency in the right middle lung region was poor (Kappa=0.381, P=0.001). Eleven large shadows were detected in 8 cases by DR, 31 large shadows were detected in 23 cases by CT, and 20 (8.20%) large shadows were detected more frequently by CT than DR. The agreement between CT and DR for the diagnosis and staging of silicosis was excellent (Kappa=0.843, P=0.001), and the diagnostic coincidence rate was 91.80% (224/244). Conclusion:Applying the method of determining the density of small shadows in the lung area of pneumoconiosis and reference films, combined with GBZ70-2015 Diagnosis of Occupational Pneumoconiosis, can make a more accurate diagnosis of silicosis.

Objective To investigate the risk factors for postoperative deep wound infection after open reduction and internal fixation for closed calcaneal fractures.Methods From January 2014 to January 2017,190 patients with closed calcaneal fracture were treated at Department of Traumatic Orthopaedics,Taihe Hospital.They were 118 males and 72 females with an average of 39.8 years (range,from 18 to 73 years).They were divided into a deep infection group and a non deep infection group according to the presence or absence of deep wound infection in the follow-up period.The 2 groups were compared in the general clinical data.In statistical analysis,the related risk factors were first screened by single factor analysis and followed by multivariate logistic regression analysis to identify the independent risk factors associated with the postoperative deep wound infection in patients with closed calcaneal fracture.Results The 190 patients were followed up for an average of 21.3 months(range,from 13 to 31 months).Postoperative deep wound infection occurred in 11 patients,giving an overall incidence of 5.7％ (11 / 190).The single factor analysis showed that the deep infection group incurred significantly longer time for tourniquet and used significantly more conventional extensile lateral approach than the non deep infection group (P ＜ 0.05).There were no significant differences between the 2 groups in general data,injury cause,fracture type,drainage,or incision closure technique (P ＞ 0.05).The multivariate logistic regression analysis revealed that tourniquet time ＞ 80 min (OR=5.949,95％ CI:1.216～ 29.108,P=0.028) and conventional extensile lateral approach (OR =5.414,95％ CI:1.507 ～ 19.452,P =0.01) were independent risk factors fo r the postoperative deep wound infection in patients with closed calcaneal fracture after open reduction and internal fixation.Conclusions Tourniquet time and conventional extensile lateral approach may be the independent risk factors for postoperative deep wound infection in patients with closed calcaneal fracture after open reduction and internal fixation.Therefore,it is important to adopt the sinus tarsi approach and control tourniquet time within 80 minutes for prevention of deep wound infection as long as the surgical quality is ensured.

Objective To study the influencing factors of the medical behaviors between urban and rural residents in Hubei province .Methods The survey selected 454 families in Wuhan and Macheng ;investigated their family income ,health condition and medical behaviors ,multiple correspondence and logistic regression were applied to study the influence factors of medical behaviors . Results 845 people(85.05％ )selected primary medical institutions ,and 126 people(12.83％ )selected secondary medical institution in Macheng ;321 people(47.53％ )selected primary medical institutions , and 283 people (42.30％ )selected tertiary medical institutions in Wuhan ;Macheng and Wuhan′s Cronbach′s alpha reliability coefficients for multiple correspondence model are 0.57 and 0.72 respectively ,and nagelkerke R2 for logistic regression model are 0.56 and 0.59 respectively ;Both urban and rural residents selected medical institutions depending on types of diseases ;family income influences the selection of medical institution of Macheng residents ;age and economic contribution have a great effect on medical behaviors of Wuhan resident .Conclusions Family economic income constitutes a major factor for senior people ,while such factor poses different influences over different medical insurance and economic level of these people .

Objective To evaluate the effects of dietary intervention with low glycemic index (LGI) and low glycemic load (LGL) on dietary knowledge and dietary modification of patients with type 2 diabetes mellitus (T2DM).Methods This study was a cluster randomized controlled study.From June to September 2010,105 T2DM patients were randomly sampled from 3 residential areas (n =35 in each) in Jin Pen Ling community,Changsha,Hunan province and divided into three groups with a random number table:whole-day dietary intervention group (group A,n =35),breakfast dietary intervention group (group B,n =35),and control group (group C,n =35).Interventions included 3-month health education and dietary intervention.Dietary knowledge,dietary oils,glycemic index (GI),and glycemic load (GL) of the three groups were compared before and after intervention.Results Before intervention,all the three groups showed a low level of knowledge about GI (57.7 ％),and high levels of average GI value of each meal (69.71 ± 8.55),GL value per day (132.45 ± 16.25),and daily cooking oil intake [(39.95 ± 20.64)g].The average knowledge level about GI increased after intervention in both group A (96.3％ vs.57.1％,P ＜0.05) and group B (94.5％ vs.60.5％,P＜0.05),but not in group C (54.8％ vs.55.3％,P＞0.05).The reduction of daily cooking oilintake in group A was larger than those in group B and group C [(7.81 ± 3.91) g vs.(-5.12 ± 1.37) g,(7.81 ± 3.91) g vs.(-3.45 ± 5.95) g,both P ＜ 0.05];so was the average GI value of each meal [group A,(5.95±2.27);groupB (-0.85±1.87);groupC,(-2.87±1.93);allP＜0.05].The changes of GL values in group A (11.31 ±4.31) was better than in group B (1.23 ±27.82) and group C (-0.43 ± 18.40)(both P ＜0.05).Conclusions The average GI value,GL value,and daily cooking oil intake of T2DM patients were all at a high level before intervention,while the level of knowledge about GI was at a low level.Health education providing GI knowledge may effectively improve the knowledge about GI in T2DM patients,while LGI and LGL dietary intervention may promote diet modification.Whole-day dietary intervention may be more effective than breakfast intervention.