BACKGROUND:At present,open reduction and internal fixation and minimally invasive needle aspiration are commonly used in patients with Sanders types Ⅱ and Ⅲ calcaneal fractures.However,there is little comparison between the clinical efficacy of the two methods and high-level clinical evidence is still available. OBJECTIVE:To compare the curative effect of Sanders types Ⅱ and Ⅲ calcaneal fractures treated by three-dimensional digital model-assisted minimally invasive needle penetration and tarsal sinus incision and manual reduction and internal fixation with steel plate. METHODS:From January 2021 to October 2022,80 patients with Sanders types Ⅱ and Ⅲ calcaneal fractures who were treated in the Department of Orthopedics,Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine in Hebei Province were randomly divided into control group(40 cases)and observation group(40 cases).The control group was treated with manual reduction and internal fixation with steel plate through the traditional tarsal sinus incision,while the observation group was treated with a three-dimensional digital model assisted with minimally invasive needle penetration fixation.The operation time,blood loss,hospitalization time and fracture healing time of the two groups were recorded.The changes in Maryland score,AO-FAS score,pain visual analog scale score,quality of life score(SF-36 score),and imaging parameters(B?hler angle,Gissane angle,calcaneal length,width and height)were observed before and 12 months after operation in the two groups.The complications during the follow-up were recorded. RESULTS AND CONCLUSION:(1)Operation time,blood loss,hospitalization time and fracture healing time in the observation group were lower than those in the control group(all P<0.05).(2)The Maryland score,AO-FAS score,SF-36 score,B?hler angle,Gissane angle,calcaneal length and height of the two groups after treatment were significantly higher than those before treatment(all P<0.05).Visual analog scale score and calcaneal width were significantly lower than those before treatment(all P<0.05).(3)After 12 months of follow-up,the incidence of complications in the observation group was lower than that in the control group(all P<0.05).(4)In conclusion,the treatment of Sanders types Ⅱ and Ⅲ calcaneal fractures with three-dimensional digital model-assisted minimally invasive needle penetration fixation can significantly improve the operation time,bleeding volume and other perioperative indicators,and can reduce the occurrence of multiple complications.The recovery of ankle function,relief of pain symptoms,and improvement of quality of life are equivalent to traditional therapy.

Objective:To study the effect of baicalein on the expression of glutamate receptor related protein in PC12 cells injured by Aβ 25-35. Methods:PC12 cells were divided into control group, model group, estradiol group and baicalein group with different concentrations. The survival condition of PC12 cells in each group were detected by thiazole blue (MTT). PC12 cells were divided into control group, model group, estradiol group and baicalein group. The control group and model group were cultured with DMEM medium, and the estradiol group was added with 1×10 -3 μmol/L estradiol DMEM medium, baicalein group was added with 1 μmol/L baicalein DMEM medium. After 2 hours of intervention, 20 μmol/L Aβ 25-35 was added to the model group, estradiol group and baicalein group with induced PC12 cell injury. After 22 hours of intervention, flow cytometry was used to detect the apoptosis of PC12 cells. The expression of estrogen receptor β (ER β), phosphorylated c-Jun N-terminal kinase (p-JNK/JNK) and ionic receptor N-methyl-D-aspartate receptor 1 (NMDAR1), glutamate receptor 2 (GluR2) and calcium/calmodulin dependent protein kinase Ⅱ (CaMK Ⅱ) were detected by Western blot. Results:Compared with model group, 1 μmol/L baicalein significantly increased the proliferation rate [(95.80±2.47)% vs. (64.34±3.84)%]. The apoptosis rate of PC12 cells[(7.83±0.67)% vs. (12.84±0.91)%] was significantly decreased in baicalein group ( P<0.01). The expression of NMDAR1 (0.582±0.012 vs. 0.352±0.012), GluR2(0.538±0.017 vs. 0.355±0.006), ER β (0.362±0.015 vs. 0.262±0.018) in baicalein group were significantly increased ( P<0.01), the expression of p-JNK/JNK (0.476±0.013 vs. 0.752±0.014) and CaMK Ⅱ(0.499±0.019 vs. 0.670±0.016) in baicalein group were significantly decreased ( P<0.01). Conclusions:Baicalein has a protective effect on PC12 cells injured by Aβ 25-35. Its mechanism may be related to the inhibition of p-JNK/JNK activity by activating ERβ and regulating the expression of glutamate receptor related protein.

ObjectiveBased on ultra performance liquid chromatography-quadrupole time-of-flight mass spectrometry （UPLC-Q-TOF/MS）， the changes of endogenous markers in rat plasma at the different stage， namely modeling and administration of Shenling Baizhusan （SLBZS）， and the mechanism of SLBZS in the treatment of ulcerative colitis （UC） were studied. MethodIn the modeling stage， rats were randomly divided into normal group， spleen deficiency with dampness retention-UC （SDDR-UC） and pure-UC （P-UC） model group. In the administration stage， SLBZS was given to the above two different model groups. After modeling and administration， rat plasma was collected and determined by UPLC-Q-TOF/MS. The mobile phase was 0.1% formic acid aqueous solution （A）-acetonitrile （B） for gradient elution （in positive ion mode：0-2 min， 99%A； 2-9 min， 99%-73%A； 9-10 min， 73%-44%A； 10-13 min， 44%-38%A； 13-19 min， 38%-28%A； 19-21 min， 28%-2%A； 21-23 min， 2%A； 23-25 min， 2%-10%A； 25-27 min， 10%-99%A； in negative ion mode：0-2 min， 85%A； 2-3 min， 85%-65%A； 3-5.5 min， 65%-44%A； 5.5-8 min， 44%-25%A； 8-10 min， 25%-2%A； 10-16 min， 2%-85%A）. The electrospray ionization （ESI） temperature was 120 ℃ under the positive and negative ion modes， and the acquisition range was 50-1 000. Partial least squares-discriminant analysis （PLS-DA） was used to analyze the changes of endogenous metabolites in the above two different model rats from the different stage. MetaboAnalyst 5.0 was used to analyze the metabolic pathways of these identified metabolites. ResultSixteen potential biomarkers were screened and identified in the modeling stage， among which 11 potential biomarkers were common in the two model rats， which mainly affected the primary bile acid biosynthesis pathway. Twenty-three potential biomarkers were screened and identified during the administration stage， among which 3 potential biomarkers were shared by the two model rats， and SDDR-UC and P-UC model rats had 11 and 9 potential biomarkers， respectively. It mainly affected 6 pathways such as purine metabolism， pentose phosphate pathway， pyrimidine metabolism， retinol metabolism， primary bile acid biosynthesis and steroid hormone synthesis. ConclusionThe primary bile acid biosynthesis pathway appears in the different stage of modeling and administration of UC， showing a dynamic change process. The therapeutic effect of SLBZS on SDDR-UC rats may be related to inhibiting the expression of nuclear transcription factor -κB （NF-κB） signaling pathway， activating farnesoid X receptor （FXR） and enhancing the expression of cytochrome P450.

Objective:To study the protective effect of neoeriocitrin on PC12 cell injury induced by amyloid β protein fragment 25-35 (Aβ 25-35), and explore its role in preventing and treating AD. Methods:The MTT method was used to detect the effect of Neoeriocitrin on the proliferation of normal PC12 cells and Aβ 25-35 damaged PC12 cells, and the intervention concentration of neoeriocitrin solution was screened. The PC12 cells were divided into the normal control group, model group, estradiol group and neoeriocitrin group according to the random number table method. The normal control group and model group were cultured with DMEM for 24 h; DMEM and 1×10 -3 μmol/L estradiol solution were added to the estradiol group; DMEM and 6×10 4 μmol/L neoeriocitrin solution were added to the neoeriocitrin group. After 2 hours of culture, except for the normal control group, the remaining groups were added with 20 μmol/L Aβ 25-35 stock solution, and the culture was continued for 22 h. AnnexinV-FITC/PI double labeling was used to detect apoptosis rate, Western blot method was used to detect estrogen receptor β (estrogen receptor β, ERβ) and p-P38/P38 protein expression. The content of acetylcholine (ACh) was detected, and the activity of Choline acetyl transferase (ChAT) and Acetylcholin esterase (AChE) in the supernatant of PC12 cells were detected. Results:Compared with the model group, the cell apoptosis rate [(8.080 ± 0.578)% vs. (18.500 ± 0.870)%] significantly decreased ( P<0.01), the expression of ERβ protein (0.348 ± 0.042 vs. 0.273 ± 0.006) significantly increased ( P<0.01), p-P38/P38 protein expression (0.372 ± 0.058 vs. 0.571 ± 0.063) significantly decreased ( P<0.01), the content of ACh [(14.319 ± 1.039) μg/mg vs. (9.157 ± 1.605) μg/mg], ChAT activity [(0.715 ± 0.053) U/mg vs. (0.280 ± 0.093) U/mg] significantly increased ( P<0.01), AChE activity [(2.607 ± 2.048) U/mg vs. (6.038 ± 1.867) U/mg] significantly reduced ( P<0.01). Conclusions:Neoeriocitrin can promote the proliferation of PC12 cells damaged by Aβ25-35, inhibit cell apoptosis, and has a certain cytoprotective effect. Its mechanism may be related to the regulation of ERβ expression and inhibition of P38 protein phosphorylation, thereby improving the function of the cholinergic system related.

Objective:To investigate the mechanism of anti-proliferative scar of psoralen.Methods:Fibroblasts were cultured in vitro. The fibroblasts were divided into normal group (normal fibroblasts), scar group (hypertrophic scar fibroblasts), and TGF-β1 group (10 ng/ml TGF-β1 treated hypertrophic scar fibrils cells 5 min-12 hours), Smurf2 RNA interference group (Smurf2 siRNA transfected hypertrophic scar fibroblasts for 72 hours), psoralen group (10 μmol/L psoralen treatment of hypertrophic scar fibroblasts for 72 hours). The psoralen+TGF-β1 group (proliferative scar fibroblasts were added to the psoralen for 72 hours and then added to TGF-β1 for 6 hours). The expressions of Smurf2 and α-SMA protein were detected by Western blot method. The expression of type I collagen mRNA was detected by RT-PCR. The secretion of TGF-β1 protein was detected by ELISA.Results:Compared with the normal group, the expression of Smurf2 protein (0.83 ± 0.08 vs. 0.38 ± 0.07) in the scar group significantly increased ( P<0.05). Compared with the scar group, the expression of TGF-β1 (2.2 ± 0.18 vs. 4.2 ± 0.47) significantly decreased in Smurf2 RNA interference group ( P<0.05). The expression of Smurf2 (0.71 ± 0.06 vs. 0.42 ± 0.04) and α-SMA (1.42 ± 0.12 vs. 0.91 ± 0.09) proteinin the TGF-β1 group significantly increased ( P<0.05), and the expression of type I collagen mRNA (0.72 ± 0.09 vs. 0.41 ± 0.07) significantly increased ( P<0.05). The expression of Smurf2 (0.05 ± 0.01 vs. 0.42 ± 0.04) and α-SMA (0.71 ± 0.07 vs. 0.91 ± 0.09) proteinin in psoralen group significantly decreased ( P<0.05). The expression of collagen mRNA (0.12 ± 0.04 vs. 0.41 ± 0.07) significantly decreased ( P<0.05). Conclusions:Psoralen may inhibit the expression of α-SMA protein and decrease the expression of type I collagen by TGF-β1/Smurf2 signaling to inhibit scar formation.

Objective To evaluate the clinical experience of extracorporeal membrane oxygenation (ECMO) treatment on two cases of infection with the critical Corona Virus Disease 2019 (COVID-19) complicated by fulminant myocarditis (FM) . Methods This study selects two COVID-19 cases comorbid with fulminant myocarditis and had been treated with ECMO in Shenzhen Third People's Hospital from January 2020 to February 2020. We compare the index of inflammation, immunization, D-dimer and lactic acid before and after ECMO treatment in 24 and 96 hours, cardiopulmonary function before and after ECMO treatment in 24, 48, 72, 96 hours,. We also analyze the complications and clinical outcomes of the two cases during the ECMO treatment. Results Both patients were elderly obese men with chronic cardiopulmonary disease. Comparing the laboratory test results and imaging data of the two patients, the acute lung injury score, oxygenation index, albumin level, hypersensitive C-reactive protein, lactate and lactate dehydrogenase levels in 2 patients after ECMO treatment were improved as compared with those before ECMO treatment. Finally, case 1 died of multiple organ failure and his cardiac function continued to deteriorate, while, case 2 successfully withdrew and his cardiac function gradually improved. Conclusions For critical COVID-19 patients with fulminant myocarditis, ECMO treatment can improve pulmonary function in the short term, provide valuable time for rescuing COVID-19 patients with fulminant myocarditis.

Objective:To explore the effect of subclinical hypothyroidism(SCH) on complications after coronary artery bypass grafting(CABG).Methods:The data of CABG patients hospitalized in TEDA International Cardiovascular Disease Hospital from January 2016 to December 2017 were retrospectively analyzed. According to the thyroid function after admission, the patients were divided into normal thyroid function group(NC group, 814 cases, 0.27 mIU/L≤TSH≤4.2 mIU/L) and subclinical hypothyroidism group(SCH group, 106 cases, TSH>4.2 mIU/L). The preoperative clinical data, surgical conditions, recent complications and one-year bridge stenosis rate were compared between the two groups in male or female.Results:Compared with NC group, SCH group had more female patients(53.8% vs 24.4%, P=0.000), lower smoking rate (38.7% vs 58.0%, P=0.000). There was no statistical difference in other baseline data and postoperative complications( P>0.05). Subgroup analysis depending on gender showed that the incidence of respiratory tract infection increased in female patients with SCH(10.5% vs 3.5%, P=0.034) compared with those in NC group, there was no significant difference in male. The TSH level was an independent risk factor for respiratory tract infection in female patients( OR=1.307, 95% CI=1.110-1.539, P=0.001). Compared with the male patients, the prevalence of hypertension(84.2% vs. 67.3%, P=0.041), diabetes mellitus(45.6% vs 16.3%, P=0.001), hospitalization time in ICU(44 h vs. 42 h, P=0.003), acute renal failure(10.5% vs 0, P=0.019) and massive blood transfusion(8.8% vs 0, P=0.034)increased. Conclusion:SCH appears to influence the postoperative outcome for female patients by increasing the development of postoperative respiratory tract infection.

Objective: To investigate the clinicopathological features and molecular phenotypes of gastric cancer with enteroblastic dif-ferentiation (GCED). Methods: A retrospective analysis of 337 patients with gastric adenocarcinoma diagnosed by the pathology de-partment of the First Affiliated Hospital of Zhejiang University in March 2013-2017 was conducted. Of them, 8 patients were diag-nosed with gastric carcinoma with intestinal blastocyte differentiation. All the patients were elderly, including 6 men and 2 women. The onset age was 68-83 years (mean 76.6 years). Two cases had serum AFP≥200 μg/L before treatment. According to the histopatho-logical morphology, the immunophenotype was analyzed by immunohistochemistry, the SALL4 gene was detected using reverse tran-scription-polymerase chain reaction (RT-PCR), and the relevant literature was reviewed. Results: Microscopically, all cases had primi-tive enteroid structures, consisting of cubic or columnar cells with clear cytoplasm, and immunohistochemical staining showed positivi-ty for either AFP and GPC3 or SALL4. The expression of SALL4 mRNA was significantly increased by RT-PCR. Follow-up from 1 to 5 years showed that 5 patients had liver and other organ metastases, 2 patients died, and 1 patient survived without a tumor. Conclusions:GCED is a rare invasive gastric adenocarcinoma with a worse prognosis than that of normal intestinal adenocarcinoma. The treatment of general intestinal adenocarcinoma has little effect. There are some characteristic changes in histology. It would be helpful for diag-nosis and differential diagnosis if clinicians are familiar with the tumor spectrum and genetic characteristics. Target therapy for an origi-nal marker, such as SALL4, has a bright future.

To investigate the effects of molybdenum (Mo) and/or cadmium (Cd) on antioxidant function and the apoptosis-related genes in duck spleens. Sixty healthy 11-day-old ducks were randomly divided into six groups of 10 ducks (control, low Mo group, high Mo, Cd, low Mo + Cd, and high Mo + Cd groups). All were fed a basal diet containing low or high dietary doses of Mo and/or Cd. Relative spleen weight, antioxidant indices, apoptosis-related gene mRNA expression levels, and ultrastructural changes were evaluated after 120 days. The results showed that the relative spleen weight decreased significantly in the high Mo + Cd treatment group which compared with control group. Malondialdehyde levels increased and xanthine oxidase and catalase activities decreased in the Mo and/or Cd groups compared with levels in the control group. Bak-1 and Caspase-3 expressions were upregulated in the high Mo + Cd group, while Bcl-2 was downregulated. In addition, mitochondrial crest fracture, swelling, vacuolation, deformed nuclei, and karyopyknosis in both Mo + Cd treated groups were more severe than in the other groups. The results suggest that Mo and/or Cd can induce oxidative stress and apoptosis of spleen via effects on the mitochondrial intrinsic pathway. Moreover, the results indicate the two elements have a possible synergistic relationship.
Apoptosis* ; Cadmium* ; Caspase 3 ; Catalase ; Diet ; Ducks* ; Malondialdehyde ; Molybdenum* ; Oxidative Stress ; RNA, Messenger ; Spleen* ; Xanthine Oxidase

Objective To compare the air permeability,water absorption and water locking properties of two different foam dressings,thus to provide theoretical and experimental evidence to alternative optimization for acute and chronic wound.Methods Five Mepilex foam dressings(group 1) and PermaFoam Comfort dressings(group 2) each was selected.Simulated wound exudation was made by NaCl and CaCl·H2O.The water-absorbing rate of dressings at post immersion 24 h (PIH),the water-absorbing speed of dressings at post immersion 1,5,10,20 min,the diffusion diameter of exudation dripped on the surface of dressings for 5 min,the beaker filled with exudation was sealed tightly by dressing for 24 h,and the weight was gotten before and after 24 h.Statistical analysis was performed.Results (1) The water-absorbing rate:the group 1(616±19)% was significantly higher than (313±13)% of the group 2 (t=29.137,P<0.01);(2) The water-absorbing speed:the group 1 (119.68±2.59)g·s-1·m-2,(24.39±0.62)g·s-1·m-2,(12.33±0.29)g·s-1·m-2,(12.33±0.29)g·s-1·m-2 were significantly higher than those of the group 2[(65.85±4.37)g·s-1·m-2,(13.82±1.03)g·s-1·m-2,(7.16±0.41)g·s-1·m-2,(3.66±0.12)g·s-1·m-2,t=23.704,t=19.708,22.947,31.764,all P<0.01];(3) The water holding capacity:the group 1 (5.66±0.15)cm was significantly higher than (2.2±0.12)cm of the group 2,(t=39.089,P<0.01);(4) The air permeability:there was no statistically significant difference between the two groups(t=0.189,P>0.05).Conclusion The Mepilex foam dressing is more suitable for the early stage of acute wound with large exudation in short time,while the PermaFoam Comfort dressings is better for chronic wound or the later period of acute with less exudation in a relative slow seepage velocity.