OBJECTIVE To investigate the effect and mechanism of Panax notoginseng saponins （PNS） on wound healing after anal fistula surgery in rats by regulating the hypoxia-inducible factor-1α （HIF-1α）/vascular endothelial growth factor （VEGF）/ vascular endothelial growth factor receptor-2 （VEGFR2） signaling pathway. METHODS SD rats were selected to establish a postoperative rat model of anal fistula by infecting wound with Escherichia coli. The model rats were randomly grouped into model group， PNS low-dose and high-dose groups （15， 30 mg/cm2）， high-dose of PNS+2-methoxyestradiol （2ME2） group （PNS 30 mg/cm2+HIF-1α inhibitor 2ME2 4 mg/kg）， with 10 rats in each group. Another 10 normal rats were selected for back hair removal treatment as the control group. Each drug group was injected with the corresponding drug solution intramuscularly or （and） intraperitoneally， once a day， for 3 weeks. After the last administration， the wound healing rate （excluding the control group）， microvascular density （MVD）， the expression of collagen Ⅰ and fibronectin （FN） in the wound tissue were detected in each group； the levels of angiogenic factors [VEGF， E-mail：842710813@qq.com angiopoietin-Ⅰ （Ang-Ⅰ）， Ang-Ⅱ] in serum， the levels of inflammatory factors [interleukin-6 （IL-6） and IL-2] in serum binggui7183@163.com and wound tissue as well as the expressions of the related proteins of HIF-1α/VEGF/VEGFR2 signaling pathway in the wound tissue of rats were also detected in each group. RESULTS The MVD， the expression of collagen Ⅰ and FN in the wound tissue， and the levels of IL-6 and IL-2 in serum and wound tissue of rats increased significantly in the model group， compared to the control group （P＜0.05）， while the serum levels of VEGF， Ang- Ⅰ and Ang-Ⅱ decreased significantly （P＜0.05）. The wound healing rate， the MVD in wound tissue， the serum levels of VEGF， Ang-Ⅰ and Ang-Ⅱ， the expressions of collagen Ⅰ and FN in the wound tissue， and protein expressions of HIF-1α， VEGF and VEGFR2 in the PNS low-dose and high-dose groups increased significantly， compared to the model group （P＜0.05）， while the levels of IL-6 and IL-2 in serum and wound tissue decreased significantly （P＜0.05）； the high-dose PNS had a stronger effect （P＜ 0.05）. 2ME2 could weaken the effect of PNS on above indicators of rats after anal fistula surgery （P＜0.05）. CONCLUSIONS PNS can promote the production of angiogenic factors and inhibit the production of pro-inflammatory factors， thereby promoting wound healing in rats after anal fistula surgery. The above effects are related to the activation of HIF-1α/VEGF/VEGFR2 signaling pathway.

Objective To explore the changes and clinical significance of D-dimer(D-D),prothrombin fragment 1+2(F1+2)and P-selectin in patients with acute deep venous thrombosis of lower extremities(DVT)before and after catheterization and thrombolysis.Methods A total of 186 patients with acute DVT in the Third People's Hospital of Yunnan Province from March 2020 to March 2022 were selected as the study objects.And all of them underwent catheterization and hemolysis and were followed up in the outpatient form 12 months after the surgery.4 cases were lost to follow-up,and a total of 182 cases completed postoperative follow-up.Postthrombotic syndrome(PTS)was divided into PTS group(n = 27)and non-PTS group(n = 155)according to whether post-thrombotic syndrome(PTS)occurred 12 months after the surgery.The general data of the two groups and the expression of D-D,F1+2,P-selectin in plasma before and after thrombolytic therapy were compared,and the influencing factors of PTS were analyzed by Logistic analysis.Receiver operating characteristic curve(ROC)and area under curve(AUC)were plotted to analyze the value of plasma D-D,F1+2,P-selectin in predicting the occurrence of PTS,and relative risk(RR)was used to analyze the influence of different plasma D-D,F1+2,P-selectin expression on PTS.Results Age,BMI,venous patency score,and plasma D-D,F1+2,P-selectin expression 1 week and 1 month after thrombolysis in PTS group were higher than those in non-PTS group(P<0.05).Logistic showed that BMI and plasma D-D,F1+2 and P-selectin 1 week and 1 month after thrombolysis were the influential factors for PTS in acute DVT patients(P<0.05).ROC curve showed that the combined efficacy of D-D,F1+2 and P-selectin 1 month after thrombolysis was significantly better than that of D-D,F1+2 and P-selectin 1 week after thrombolysis in predicting PTS.One month after thrombolysis,the risk of PTS in patients with high plasma D-D,F1+2,P-selectin expression was 4.211,2.550 and 3.189 times higher than that in patients with low plasma D-D,F1+2,P-selectin expression.Conclusion The expression of D-D,F1+2 and P-selectin in plasma increases after thrombolysis in acute DVT patients,and the combination of D-D,F1+2 and P-selectin can predict the occurrence of PTS.

BACKGROUND:Traumatic patellar dislocation with medial patellofemoral ligament tearing at femoral attachment or body is usually performed by medial patellofemoral ligament reconstruction surgery.To promote tendon bone healing after medial patellofemoral ligament reconstruction,the researchers used a variety of biological treatment technologies including growth factors,stem cells and platelet-rich plasma. OBJECTIVE:To investigate the clinical effect of medial patellofemoral ligament reconstruction by leukocyte-and platelet-rich fibrin with autologous hamstring tendon for traumatic patellar dislocation. METHODS:Thirty-seven patients with traumatic patellar dislocation in First Hospital of Qinhuangdao from February 2019 to February 2021 were randomly divided into a trial group(n=18)and a control group(n=19).The trial group received medial patellofemoral ligament reconstruction by leukocyte-and platelet-rich fibrin with an autologous hamstring tendon.The control group received medial patellofemoral ligament reconstruction by a simple autologous hamstring tendon.Patients in the two groups were followed up for 12 months.Knee pain and functional status were evaluated by visual analog scale score,Lysholm score,Kujala patellofemoral joint score and knee range of motion.The patellar tilt angle,patellar congruence angle and patellar lateral shift rate of the patellofemoral joint were measured by MRI and CT films to evaluate the stability and improvement of the patellofemoral joint. RESULTS AND CONCLUSION:(1)The visual analog scale scores of the two groups at 6 and 12 months after operation were lower than those before operation(P<0.05).The Lysholm score and Kujala patellofemoral joint score at 6 and 12 months after operation were higher than those before operation(P<0.05).The Lysholm score and Kujala patellofemoral joint score in the trial group were higher than those in the control group 6 months after operation(P<0.05).There was no significant difference between the two groups in the visual analog scale score,Lysholm score and Kujala patellofemoral joint score 12 months after operation(P>0.05).(2)The patellar tilt angle,patellar congruence angle,patellar lateral shift rate and range of motion of the patellofemoral joint were significantly improved in both groups 12 months after operation(P<0.05).The patellar tilt angle was smaller in the trial group than that in the control group 12 months after operation(P<0.05).Patellar congruence angle,patellar lateral shift rate,range of motion and MRI score were not statistically significant between the two groups 12 months after operation(P>0.05).(3)These results confirm that medial patellofemoral ligament reconstruction by leukocyte-and platelet-rich fibrin with autologous hamstring tendon can treat traumatic dislocation effectively,improve the function of the knee joint,and restore the movement track of the patella.

AIM: To evaluate the changes in corneal epithelial thickness(CET)and corneal optical density(CD)after smart pulse technology(SPT)-assisted transepithelial photorefractive keratectomy(TPRK)and analyze their correlation.METHODS: The prospective study included 60 patients(120 eyes)with myopia and myopic astigmatism who underwent SPT-TPRK in the ophthalmology department at the First Affiliated Hospital of Xinxiang Medical University between February and August 2023. Changes in CET and CD were evaluated preoperatively and at 1 wk, 1 and 3 mo postoperatively.RESULTS: A total of 14 cases(28 eyes)were lost to follow-up, and 3 patients(6 eyes)with postoperative haze were excluded from this study, resulting in a final inclusion of 43 patients(86 eyes). At 1 wk after SPT-TPRK, CET had statistically significantly thickened compared to preoperative levels(P<0.05), particularly in the CET at 0-2 mm central corneal area(P<0.05). At 1 mo after SPT-TPRK, the CET at 0-2 mm area had statistically significantly decreased(P<0.05). At 3 mo after SPT-TPRK, the CET at 0-2 mm had essentially reached preoperative levels. Postoperative CD values increased, with a positive correlation between CET in the 0-2 mm area and CD in the whole 0-2 mm area(r=0.256, P<0.05), and a positive correlation between CET in the 2-5 mm area and CD in the anterior 2-6 mm area(r=0.319, P<0.05).CONCLUSION: Corneal epithelial remodeling takes 3 mo in areas within 2 mm of the central cornea; areas with thinner CET have faster postoperative corneal epithelial remodeling and greater thickening in the early postoperative period; CD increases in the early postoperative period compared to the preoperative value, and in some areas, there is a positive correlation between CET and CD value.

ObjectiveTo investigate the therapeutic effect of Ganmai Dazao Tang on breast cancer-related depression and explore the mechanism of the decoction in regulating immune inflammation and neurotransmitters via the mitogen-activated protein kinase （MAPK）/nuclear factor-κB （NF-κB） pathway. MethodBALB/c mice were randomized into control， model， fluoxetine （5 mg·kg^-1·d^-1）， and low- and high-dose （crude drug 20 and 40 g·kg^-1， respectively） Ganmai Dazao Tang groups （n=10）. The mouse model of 4T1 orthotopic transplantation-induced breast cancer-related depression-like behavior was established. The depression-like behavior of mice was assessed by the tail suspension test and the forced swimming test. RT-qPCR was employed to determine the mRNA levels of interleukin （IL）-17A， forkhead box P3 （FoxP3），IL-1β， IL-6， and tumor necrosis factor-α （TNF-α） in the cerebral cortex. Flow cytometry was employed to measure the proportions of immune cell subsets in the spleen and thymus. HPLC-MS/MS was employed to measure neurotransmitter levels in the cerebral cortex. Western blotting was employed to detect the activation of the MAPK/NF-κB pathway. ResultCompared with the model group， administration of Ganmai Dazao Tang at a dose of 40 g crude drug·kg^-1 continuously for 4 weeks shortened the immobility time of modeled mice in the tail suspension and forced swimming tests （P<0.05）， down-regulated the mRNA levels of IL-1β， IL-17A， and TNF-α （P<0.05）， increased the proportions of T cells， CD4⁺ T cells， B cells， helper T 17 （Th17） cells， and regulatory T （Treg） cells， and reduced the proportion of CD8⁺ T cells （P<0.05）. Furthermore， it lowered the levels of 5-hydroxyindoleacetic acid （5-HIAA） and kynurenine （Kyn）， decreased the kynurenine/tryptophan （Kyn/Trp） ratio （P<0.05）， increased the content of 5-hydroxytryptamine （5-HT）， and down-regulated the protein levels of phosphorylated extracellular signal-regulated kinase （p-ERK）， phosphorylated p38 MAPK， and phosphorylated nuclear factor-κB p65 （P<0.05）. ConclusionGanmai Dazao Tang can down-regulate the expression of inflammatory cytokines such as IL-1β， IL-17A， and TNF-α， restore 5-HT metabolism and Kyn/Trp balance， increase the 5-HT content， and reduce the activation of p38 MAPK， ERK， and the MAPK-mediated NF-κB signaling pathway to reduce neuroinflammation in the treatment of cancer-related depression.

Following the principles of evidence-based medicine,in accordance with the structure and drafting rules of standardized documents,based on literature research,according to the characteristics of chronic cough in children and issues that need to form a consensus,the TCM Guidelines for Diagnosis and Treatment of Chronic Cough in Children was formulated based on the Delphi method,expert discussion meetings,and public solicitation of opinions.The guideline includes scope of application,terms and definitions,eti-ology and diagnosis,auxiliary examination,treatment,prevention and care.The aim is to clarify the optimal treatment plan of Chinese medicine in the diagnosis and treatment of this disease,and to provide guidance for improving the clinical diagnosis and treatment of chronic cough in children with Chinese medicine.

Objective To conduct bibliometric visualization analyses of the literature domestic and overseas on active surveillance of post-marketing safety of drugs,aiming to display the current status and trend of hotspots in this field and to provide references for future research and the improvement of the Chinese management system of active surveillance.Methods The English and Chinese literature on active surveillance of post-marketing safety of drugs were searched in Web of Science and CNKI respectively and imported into CiteSpace 6.3.R2 software for the analysis of the number of publications,authors,institutions,and national cooperative networks,and the analysis of keyword co-occurrence,clustering and emergence.Results 415 Chinese and 676 English literature were included,with an overall increasing trend in annual publication volume.The author collaboration network of Chinese literature was smaller than that of English literature,and the partnership network was sparse,with no strong centralized institution.Domestic drug regulatory agencies played an important role in the field,while drug companies'monitoring research on their own products was still relatively scarce.The research topic covered active surveillance systems,technical method research,and drug safety active surveillance practice research for specific drugs and diseases.Conclusion Countries worldwide have widely considered active surveillance of post-marketing drug safety.The heat of research activities in China has shown a significant growth trend.However,there is still a significant gap compared with the international frontiers.Further cooperation needs to be strengthened to promote the improvement of the active surveillance management system in China.

Objective:To investigate effect of Mycobacterium tuberculosis BCG-infected macrophages on damage and repair of renal tubular epithelial cells during development of renal tuberculosis.Methods:A co-culture model of BCG-infected M0 macrophages(upper chamber)and HK-2 cells(lower chamber)was established by Transwell,and THP-1 human monocyte macrophages were induced by 100 ng/ml phorbol ester(PMA)24 h to become M0 macrophages,and BCG infection cell model was established.Total cell protein was collected at 12 h and 24 h of infection,respectively.Western blot was used to detect expressions of M1 macrophage marker CD86 and M2 macrophage marker CD206 protein.M1 macrophage polarization marker cytokines IL-6 and TNF-α and M2 macrophage polarization marker cytokine TGF-β expressions in cell culture supernatant were detected by ELISA;experiment was divided into HK-2 group,BCG+HK-2 group,BCG+M0+HK-2 group and M0+HK-2 group,CCK-8 was used to detect viability of HK-2 cells in each group,and Hoechst test was used to detect HK-2 cells apoptosis in each group.Epithelial cell marker E-cadhren and fibroblast markerα-SMA expressions in HK-2 cells of each group were detected by Western blot.Results:After BCG infection of M0 macrophages,M1 macrophage viability was higher than 24 h at 12 h(P<0.05),and M2 macrophage was higher than 12 h at 24 h(P<0.05).After two cells co-culture,HK-2 cell viability was higher than 12 h at 24 h(P<0.001),apoptosis level was higher than 24 h at 12 h,epithelial cell marker protein E-cadherin protein level was higher than 12 h at 24 h(P<0.001),fibroblast level of cell marker protein α-SMA protein at 12 h was higher than that at 24 h(P<0.01).Conclusion:During development of renal tuberculosis,early BCG-infected macrophages may promote inflammatory injury of renal tubular epithelial cells through M1-type polarization;with prolongation of infec-tion time,they may repair renal tubular epithelial cells through M2-type polarization and plays an important protective role.

Objective:To explore the application effect of transitional care based on Siebens domain management model in patients with atrial fibrillation.Methods:Using the convenient sampling method, a total of 150 atrial fibrillation patients who were admitted to Nanyang Central Hospital from October 2021 to December 2022 were selected as the research objects. Patients were divided into the study group and the control group using the random number table method, with 75 cases in each group. The control group received routine transitional care, while the study group received transitional care based on the Siebens domain management model. The intervention effect was evaluated using Morisky Medication Adherence Scale and Atrial Fibrillation Self Care Ability Scale.Results:There was no statistically significant difference in scores of Morisky Medication Adherence Scale and Atrial Fibrillation Self Care Ability Scale of patients between the two groups before intervention ( P>0.05). After intervention, scores of Morisky Medication Adherence Scale and Atrial Fibrillation Self Care Ability Scale of patients in the study group were higher than those of the control group, and the differences were statistically significant ( P<0.05) . Conclusions:Transitional care based on Siebens domain management model can improve medication adherence and self-care ability of atrial fibrillation patients.

Transcatheter aortic valve replacement(TAVR)is one of the most important guideline-recommended procedures for severe symptomatic aortic stenosis.Acute cerebral infarction is a serious complication after TAVR,with a high incidence rate and may significantly affect patient prognosis and quality of life.Thrombolysis and mechanical thrombectomy are standard treatments for acute cerebral infarction recommended by guidelines,but evidence of their efficacy and safety in patients undergoing TAVR is limited.We report a patient with acute cerebral infarction after TAVR,who were treated with emergency cerebral angiography and successful transcatheter thrombectomy.