OBJECTIVE To study the safety of Shuangshu decoction in rats and its efficacy in improving functional dyspepsia （FD） in rats. METHODS In safety test， 40 rats were divided into blank control group， Shuangshu decoction low-dose， medium- dose and high-dose groups [108， 216， 324 g/（kg·d）， calculated by raw medicine， the same applies below]； they were given relevant medicine intragastrically， for continuous 14 days. The mortality and toxic reactions of rats were recorded， and the organ indexes of the liver， kidney， spleen， lung and heart of rats were calculated； the pathological morphological changes in the liver， kidney， spleen， lung， heart， stomach， duodenum， and colon were observed to evaluate the acute toxicity of Shuangshu decoction. Another 40 rats were grouped and administered in the same way for 30 consecutive days. The mortality and toxic reactions of the rats were recorded， and the corresponding organ indexes were calculated. The pathological morphological changes in the corresponding organs were observed， and blood routine and serum biochemical indicators were measured， in order to assess the subacute toxicity of Shuangshu decoction. In pharmacodynamic experiments: 50 rats were divided into blank control group， model group， and Shuangshu decoction low-， medium-， and high-dose groups （9.45， 18.9， 37.8 g/kg）， with 10 rats in each group. Except for blank control group， rats in all other groups were used to establish the FD rat model by subcutaneous injection of loperamide （3.5 mg/kg）. Rats in each group were administered the corresponding drug solution/normal saline intragastrically， once a day， for 14 consecutive days. After the last medication， fecal moisture content， intestinal propulsion rate， gastric emptying rate and serum level of motilin were all detected， and interstitial cell of Cajal （ICC） ultrastructure of rats was observed in colon tissue. RESULTS The safety experiments showed that no death occurred in each dose group， and no significant difference was found in organ coefficient， routine blood and serum biological index， compared to blank control group （P＞0.05）； no abnormality was found in organ appearance and pathological sections. The results of the pharmacodynamic experiments showed that， compared with the blank control group， the fecal moisture content， gastric emptying rate， intestinal propulsion rate， and serum motilin levels in the model group were significantly decreased （P＜0.05）； in the colonic tissue， the mitochondria in the ICC exhibited severe swelling with the disappearance of cristae， and the endoplasmic reticulum was dilated. Compared with model group， the rats in Shuangshu decoction high-dose group showed significant increases in the above quantitative indicators （P＜ 0.05）； additionally， there was a large number of mitochondria in the ICC of the colonic tissue， with clear cristae and regular arrangement. CONCLUSIONS Shuangshu decoction is safe and has a beneficial improving effect on FD rats； its mechanism of action may be related to the regulation of gastrointestinal hormone expression to promote gastric emptying and intestinal propulsion， as well as the repair of mitochondrial structure in ICCs to restore gastrointestinal function.

Objective To investigate the differences in plasma metabolites between patients with altitude-related hypertension(ARH)and healthy individuals,and analyze the potential pathogenesis of ARH.Methods Convenient sampling was conducted on a unit of male healthy officers and soldiers who resident at altitude of＜500 m and migrated to an altitude of 4 200 m in July 2020.Twenty of them diagnosed with ARH were assigned into the ARH group,and another 30 non-ARH individuals served as the control group.Their blood pressure,body mass index(BMI),blood oxygen saturation,and heart rate were measured and recorded,and fasting venous blood samples were harvested to screen and identify plasma metabolites with ultra-high performance liquid chromatography-tandem mass spectrometry(UHPLC-MS/MS).Metabolite fingerprinting was performed using unsupervised Principal Component Analysis(PCA)and supervised Orthogonal Partial Least Squares Discrimination Analysis(OPLS-DA)models in order to assist in biomarker screening.The quality of the OPLS-DA model was assessed and validated to guarantee the stability and reliability of the model.Differential plasma metabolites were screened using independent sample t test and fold change(FC)analysis,and volcano plots were drawn.Finally,Kyoto Encyclopedia of Genes and Genomes(KEGG)enrichment pathway analysis was used to perform functional pathway enrichment and topological analysis on the screened differential metabolites.Results Compared to the control group,the ARH group showed significantly higher systolic and diastolic blood pressure and heart rate,and lower arterial oxygen saturation(P＜0.05).PCA analysis showed that 81.96％of the variance was explained in the positive ion mode and 79.25％in the negative ion mode,indicating significant metabolic differences between the 2 groups.OPLS-DA model analysis indicated that in the positive ion mode,PC1 explained 77.36％of the variance and PC2 explained 12.25％of the variance,with R2Y=0.96 and Q2Y=0.91;in the negative ion mode,PC1 explained 84.15％of the variance and PC2 explained 17.24％of the variance,with R2Y=0.99 and Q2Y=0.86.Inter-group difference exceeded 75％,and intra-group difference was less than 20％.The 7-fold cross-validation and 200 permutation test confirmed that the model was stable and reliable.In the positive ion mode,the Y-axis intercepts of the R2 and Q2 fitted lines were 0.58 and-0.48,respectively;in the negative ion mode,the Y-axis intercepts were 0.93 and-0.41,respectively.A total of 32 significantly different metabolites were screened out,including amino acids,nucleosides,fatty acids,and organic alkaloids.KEGG analysis revealed that among the 10 metabolic pathways,4 were amino acid metabolic pathways,with the aminoacyl-tRNA biosynthesis pathway having the most enriched metabolites.Conclusion Based on UHPLC-MS/MS technology,untargeted metabolomics analysis identifies 32 significantly different metabolites,which may serve as characteristic biomarkers for ARH,and the aminoacyl-tRNA biosynthesis pathway may be associated with the pathogenesis of ARH.

Objective:To study the clinical effect of sacrospinous ligament fixation (SSLF) and traditional vaginal hysterectomy on pelvic organ prolapse (POP) .Methods:A retrospective analysis was performed on 68 patients with POP of degree II-IV admittedl from Jan. 2017 to Dec. 2019. Among them, 33 patients were treated with SSLF (observation group) and 35 patients were treated with vaginal total hysterectomy (control group). Intraoperative blood loss, operative time, postoperative indwelling catheter and average length of hospital stay were compared between the two groups. The patients were followed up for 6 months, and the scores of pelvic floor dysfunction questionnaire-20 (PFDI-20) and sexual quality questionnaire -12 (PISQ-12) were used to evaluate the subjective satisfaction degree of postoperative recovery.Results:In the observation group, the intraoperative blood loss (173.94±52.14) ml, postoperative indurating catheter time (2.72±0.45) d and average length of hospital stay (7.09±0.63) d were observed. There were statistically significant differences in intraoperative blood loss (228.86±53.40) ml, postoperative induration time (4.54±0.61) d and mean hospital stay (9.22±0.81) d in the control group ( P<0.05). There was no significant difference in the operation time between the observation group (99.57±9.50) min and the control group (101.06±8.64) min, ( P>0.05). The improvement of PFDI-20 and PISQ-12 in both groups was significant before and after treatment. The PISQ-12 score of the observation group was higher than that of the control group 6 months after surgery, and the difference was statistically significant ( P <0. 05). There was no significant difference in PFDI-20 score between the two groups ( P>0.05). There was statistical significance in the positions of pop-Q indicators in the two surgical methods ( P < 0.05) . Conclusions:SSLF with uterus preservation and total vaginal hysterectomy are both effective in treatment of moderate and severe POP. However, SSLF with uterus preservation has less intraoperative blood loss, and the postoperative recovery is significantly better than that with total vaginal hysterectomy. In addition, it satisfies patients’ desire to preserve uterus, improves the postoperative sexual life quality, which is worthy of promotion.

【Objective】 To revise the Social Connectedness Scale-Revised （SCS-R） so as to explore the factor structure of SCS-R in the context of Chinese culture and test its reliability and validity. 【Methods】 Totally 900 college students were asked to complete the Chinese version of the Social Connectedness， and 850 valid questionnaires were collected. In addition， the Distress Disclosure scale （DDI） and UCLA Loneliness Scale were used as the criteria. One month later， 100 students were randomly selected for retest. 【Results】 ① The results of exploratory factor analysis showed that one factor with more than one eigenvalue was selected， and the cumulative variance explained was 62.44%. ② Confirmatory factor analysis showed that the data fit well （χ²=33.438， df=14， χ²/df=2.388， RMSEA=0.04， CFI=0.996， TLI=0.991）. ③ The Chinese version of the social connectedness scale is a one-dimensional scale. Its internal consistency coefficient is 0.916 and test-retest reliability is 0.845. ④ Social connectedness is significantly positively correlated with distress disclosure and negatively correlated with loneliness， indicating that the scale has good criterion-related validity. 【Conclusion】 The Chinese version of the social connectedness scale has satisfactory reliability and validity， and has cross-cultural adaptability.

Objective:To evaluate the clinical outcome of the reconstruction of finger-pulp defects, using modified dorsal digital fasciocutaneous flap.Methods:Between June 2018 and March 2019, 14 patients with finger-pulp defects were admitted to the Department of Hand and Foot Surgery. There were 14 males and 2 females, aged from 27 to 63 years, with the mean age of 49 years. The defect areas of finger pulp were 1.6 cm × 1.4 cm-2.5 cm × 1.6 cm. All of the finger-pulp defects were treated by the modified dorsal digital fasciocutaneous flap and the inverted L-shaped incision was made at the distal part of the pedicle. The defects at donor sites were reconstructed with full-thickness skin grafts harvested from the forearm. Viability of the flap was recorded postoperatively. At the last follow-up, aesthetics, sensibility of the flap and hand performance were assessed.Results:All of the 14 flaps survived successfully, the areas were 1.8 cm×1.6 cm-2.7 cm×1.8 cm. Partial distal blister occurred on the flap in only one case, which was solved by aspiration without surgical intervention. All cases acquired follow-up visits for 5 to 12 months with a mean time of 8.9 months. The texture of flaps was similar to surrounding skin and the shape of reconstructed finger pulp was satisfactory. According to the assessment of total active movement, the results were excellent in 9 fingers, good in 5 fingers. The 2-point discrimination of flap was 8 to 11 mm (mean, 9.9 mm).Conclusions:It is an effective and simple method for the reconstruction of finger-pulp defects using modified dorsal digital fasciocutaneous flap. The clinical effectiveness is definite.

Objective:To evaluate the clinical outcome of the reconstruction of finger-pulp defects, using modified dorsal digital fasciocutaneous flap.Methods:Between June 2018 and March 2019, 14 patients with finger-pulp defects were admitted to the Department of Hand and Foot Surgery. There were 14 males and 2 females, aged from 27 to 63 years, with the mean age of 49 years. The defect areas of finger pulp were 1.6 cm × 1.4 cm-2.5 cm × 1.6 cm. All of the finger-pulp defects were treated by the modified dorsal digital fasciocutaneous flap and the inverted L-shaped incision was made at the distal part of the pedicle. The defects at donor sites were reconstructed with full-thickness skin grafts harvested from the forearm. Viability of the flap was recorded postoperatively. At the last follow-up, aesthetics, sensibility of the flap and hand performance were assessed.Results:All of the 14 flaps survived successfully, the areas were 1.8 cm×1.6 cm-2.7 cm×1.8 cm. Partial distal blister occurred on the flap in only one case, which was solved by aspiration without surgical intervention. All cases acquired follow-up visits for 5 to 12 months with a mean time of 8.9 months. The texture of flaps was similar to surrounding skin and the shape of reconstructed finger pulp was satisfactory. According to the assessment of total active movement, the results were excellent in 9 fingers, good in 5 fingers. The 2-point discrimination of flap was 8 to 11 mm (mean, 9.9 mm).Conclusions:It is an effective and simple method for the reconstruction of finger-pulp defects using modified dorsal digital fasciocutaneous flap. The clinical effectiveness is definite.

Objective:To investigate the anatomy and therapeutic effecton skin soft tissue defect at the great toe of perforator flap from distal deep branch of medial plantar artery.Methods:The arteries of one adult foot specimens were filled with red latex and vascular anatomy was performed. Branch distribution and anastomosis of medial plantar artery and dorsal foot artery were observed. The clinical data of 12 patients with skin soft tissue defect at the great toe repaired by retrograde perforator flap from distal deepbranch of medial plantar artery from September 2016 to September 2019 in Affiliated Hospital of Zunyi Medical University was selected, and the donor sites were repaired with skin grafts. The flap survival and complications were observed.Results:Anatomy result demonstrated that deep branch of the medial plantar artery was direct continuation of the medial plantar artery. It traveled along between short toe flexor muscle and abductor hallucis muscle, and gave out several perforators. The proximal perforators passed through the abductor hallucis muscle, and anastomosed with superficial branch of medial plantar artery, anterior medial malleolus artery, and medial tarsal artery. Three perforators were issued at the proximal end of the first metatarsophalangeal joint, namely articular perforator, cutaneous perforator, and communication branch. The cutaneous perforator was main blood supply source for perforator flap from distal deep branch of medial plantar artery.A total of 12 skin flaps were harvested from 12 patients, with an area from 4.5 cm×3.0 cm to 9.0 cm×6.0 cm. Postsurgery dark purple and a few blisters occurred in three flaps, and the sutures at the pedicle were immediately removed, and the flap was coated with antibiotic ointment to keep it moist, then the flap color gradually improved after postsurgery 5 days.12 skin flaps eventually survived completely. All patients were followed up by telephone for 2-12 months. The flap color, texture and appearance were excellent. The traumatic feet walked normally.Conclusions:The perforator flap from distal deep branch of medial plantar artery has reliable blood supply for retrograde repairing small and medium skin defect at the great toe of distal the first metatarsophalangeal joint, with simple operation, less trauma, and positive postoperative effect.

Objective:To investigate the anatomy and therapeutic effecton skin soft tissue defect at the great toe of perforator flap from distal deep branch of medial plantar artery.Methods:The arteries of one adult foot specimens were filled with red latex and vascular anatomy was performed. Branch distribution and anastomosis of medial plantar artery and dorsal foot artery were observed. The clinical data of 12 patients with skin soft tissue defect at the great toe repaired by retrograde perforator flap from distal deepbranch of medial plantar artery from September 2016 to September 2019 in Affiliated Hospital of Zunyi Medical University was selected, and the donor sites were repaired with skin grafts. The flap survival and complications were observed.Results:Anatomy result demonstrated that deep branch of the medial plantar artery was direct continuation of the medial plantar artery. It traveled along between short toe flexor muscle and abductor hallucis muscle, and gave out several perforators. The proximal perforators passed through the abductor hallucis muscle, and anastomosed with superficial branch of medial plantar artery, anterior medial malleolus artery, and medial tarsal artery. Three perforators were issued at the proximal end of the first metatarsophalangeal joint, namely articular perforator, cutaneous perforator, and communication branch. The cutaneous perforator was main blood supply source for perforator flap from distal deep branch of medial plantar artery.A total of 12 skin flaps were harvested from 12 patients, with an area from 4.5 cm×3.0 cm to 9.0 cm×6.0 cm. Postsurgery dark purple and a few blisters occurred in three flaps, and the sutures at the pedicle were immediately removed, and the flap was coated with antibiotic ointment to keep it moist, then the flap color gradually improved after postsurgery 5 days.12 skin flaps eventually survived completely. All patients were followed up by telephone for 2-12 months. The flap color, texture and appearance were excellent. The traumatic feet walked normally.Conclusions:The perforator flap from distal deep branch of medial plantar artery has reliable blood supply for retrograde repairing small and medium skin defect at the great toe of distal the first metatarsophalangeal joint, with simple operation, less trauma, and positive postoperative effect.

Objective To investigate oxidative damage effect of the serum of severe preeclamptic patients on human umbilical vein endothelial cells (HUVEC).Methods (1) HUVEC were randomly divided into 4 groups according to the following:blank group as control,normal group added 20％ normal sera of pregnant women,group PE added 20％ sera of severe preeclamptic patients,and group PE + Cat added 20％ sera of severe preeclamptic patients plus 3 x 103 U/ml catalase.After cultured for 24 hours,the injury morphology and APO2.7 expression of HUVEC were detected by transmission electron microscopy and flow cytometry respectively.(2) Under the real-time scanning by laser scanning confocal microscopy,HUVEC were randomly divided into 4 groups according to the following:control group added 100 μmol/L H2O2 as positive control,normal group,group PE,and group PE + Cat.HUVEC of each group was scanned for 120 seconds to determine levels of reactive oxidative species (ROS),calcium homeostasis,and mitochondria membrane potential.Results (1) Obvious injury morphology of HUVEC was observed in group PE,and it was obviously improved by catalase in group PE + Cat.Percentage of HUVEC expressed APO2.7 was (37.8 ± 1.1) ％ in group PE,which was significantly higher than (13.4 ± 1.1) ％ in blank group or (13.5 ± 1.5) ％ in normal group,but significantly lower than (19.2 ± 1.6) ％ in group PE + Cat (all P ＜ 0.01).(2) The fluorescence intensity curves of intracellular ROS and calcium showed slowly rising in group PE,but no obvious changes in normal group and PE + Cat.The values of ROS and calcium in group PE (12.0±1.3,4.1 ±0.7) were higher than those in normal group (1.1 ±0.4,0.6 ±0.4),but lower than those in group PE + Cat (1.5 ± 0.5,0.9 ± 0.5 ; all P ＜ 0.01).Conclusion The serum of severe preeclamptic patients caused oxidative damage on HUVEC by increasing intracellular ROS generation,calcium overload,and decreasing mitochondrial membrane potential.

Objective To analyzed the left ventricular (LV) regional and global strains in coronary artery stenosis by using three-dimensional speckle tracking imaging (3D-STI) and two-dimensional speckle tracking imaging (2D-STI) for the assessment of left ventricular systolic function,and to compare the clinical values between 3D-STI and 2D-STI in the detection of coronary stenosis.Methods 39 patients with coronary artery stenosis and 32 sex-age matched controls were enrolled in this study.Coronary artery stenosis group was divided into ischemic group and non-ischemic group.Real-time three dimensional full volume and two-dimensional dynamic image of the LV were obtained and then analyzed by off-line analysis software.The parameters of 3D-STI were three-dimensional longitudinal strain (3D-LS),circumferential strain (3D-CS),radial strain (3D-RS),area strain (3D-AS),global longitudinal strain (3D-GLS),global circumferential train (3D-GCS),global radial strain (3D-GRS) and global area strain (3D-GAS).The parameters of 2D-STI were two-dimensional longitudinal strain (2D-LS),circumferential strain (2D-CS),radial strain (2D-RS),global longitudinal strain (2D-GLS),global circumferential train (2D-GCS) and global radial strain (2D-GRS).The global/regional strains derived from 3D-STI and 2D-STI in patient group and controls were analyzed for comparing their efficacy in detecting coronary artery stenosis.Results Compared with non-ischemic group,2D-LS,2D-CS,3D-LS,3D-CS and 3D-AS were lower in ischemic group (P ＜0.05).ROC curves showed the sensitivity of 2D-LS,3D-LS and 3D-AS for the diagnosis of myocardial ischemia was 60.1％,64.2 ％ and 74.0 ％,while the specificity of them was 60.0％,61.0％ and 63.1％,respectively.There was no significant difference in 2D-GCS and 2D-GRS between coronary artery stenosis group and control group (P ＞ 0.05).Compared with control group,2D-GLS,3D-GLS,3D-GCS,3D-GRS and 3D-GAS were significantly lower in coronary artery stenosis group (P ＜0.05).ROC curves showed the sensitivity of 2D-GLS,3D-GLS and 3D-GAS in the diagnosis of coronary artery stenosis was 61.3％,73.3％ and 79.3 ％,while the specificity was 65.4％,66.0 ％ and 70.8 ％,respectively.The sensitivity and specificity of 3D-GAS were the highest in these parameters.It is revealed that 2D-GLS,2D-GCS and 2D-GRS were correlated with LVEF (r1 =-0.668,P1 ＜0.001 ;r2 =-0.551,P2 ＜0.001 ;r3 =0.310,P3 ＜0.05),and 3D-GLS,3D-GCS,3D-GRS,3D-GAS were correlated with LVEF (r1 =-0.634,P1 ＜0.001 ;r2 =-0.672,P2＜0.001 ;r3 =0.698,P3＜0.001 ;r4 =-0.707,P4＜0.001).The correlate of 3D-GAS and LVEF was higher than other parameters.Conclusions 3D-STI is superior to 2D-STI in assessing regional and global left ventricular systolic function in patients with coronary artery stenosis,and 3D-GAS derived from 3D-STI is a ideal parameter of detecting significant coronary artery stenosis based on its highest sensitivity and specificity.