ObjectiveTo observe the clinical efficacy and safety of Tangning Tongluo tablets in the treatment of nonproliferative diabetic retinopathy （DR）. MethodsFourteen research centers participated in this study， which spanned a time interval from September 2021 to May 2023. A total of 240 patients with nonproliferative DR were included and randomly assigned into an observation group （120 cases） and a control group （120 cases）. The observation group was treated with Tangning Tongluo tablets， and the control group with calcium dobesilate capsules. Both groups were treated for 24 consecutive weeks. The vision， DR progression rate， retinal microhemangioma， hemorrhage area， exudation area， glycosylated hemoglobin （HbA1c） level， and TCM syndrome score were assessed before and after treatment， and the safety was observed. ResultsThe vision changed in both groups after treatment （P<0.05）， and the observation group showed higher best corrected visual acuity （BCVA） than the control group （P<0.05）. The DR progression was slow with similar rates in the two groups. The fundus hemorrhage area and exudation area did not change significantly after treatment in both groups， while the observation group outperformed the control group in reducing the fundus hemorrhage area and exudation area. There was no significant difference in the number of microhemangiomas between the two groups before treatment. After treatment， the number of microhemangiomas decreased in both the observation group （Z=-1.437， P<0.05） and the control group （Z=-2.238， P<0.05）， and it showed no significant difference between the two groups. As the treatment time prolonged， the number of microhemangiomas gradually decreased in both groups. There was no significant difference in the HbA1c level between the two groups before treatment. After treatment， the decline in the HbA1c level showed no significant difference between the two groups. The TCM syndrome score did not have a statistically significant difference between the two groups before treatment. After treatment， neither the TCM syndrome score nor the response rate had significant difference between the two groups. With the extension of the treatment time， both groups showed amelioration of TCM syndrome compared with the baseline. ConclusionTangning Tongluo tablets are safe and effective in the treatment of nonproliferative DR， being capable of improving vision and reducing hemorrhage and exudation in the fundus.

ObjectiveTo explore the optimal construction method and the biological basis for establishing a mouse model of ischemic heart disease（IHD） with Qi and Yin deficiency syndrome by intraperitoneal injection of isoproterenol（ISO）. MethodsA total of 144 male C57BL/6J mice were randomly assigned into three normal groups and nine model groups according to body mass， with 12 mice in each group. The model groups 1， 4， and 7 were administered ISO via intraperitoneal injection at a dose of 5 mg·kg^-1·d^-1 for four consecutive days， the model groups 2， 5， and 8 received ISO at a dose of 10 mg·kg^-1·d^-1 for seven consecutive days， while the model groups 3， 6， and 9 were given ISO at a dose of 15 mg·kg^-1·d^-1 for 14 consecutive days. The normal groups were administered an equivalent volume of normal saline via intraperitoneal injection. After the modeling process， body mass， 24-hour food and water intake， grip strength， and spontaneous activity of the mice were measured. Cardiac function was assessed using echocardiography， the serum levels of norepinephrine（NE）， cyclic adenosine monophosphate（cAMP）， and cyclic guanosine monophosphate（cGMP） were determined via enzyme-linked immunosorbent assay（ELISA）. The content of adenosine triphosphate（ATP） in myocardial tissue was measured by biochemical analysis， while histopathological changes in myocardial tissue were observed via hematoxylin-eosin（HE） staining. An orthogonal experimental design was applied for intuitive analysis and variance analysis to screen the optimal modeling conditions of the mouse model of IHD with Qi and Yin deficiency syndrome. A data-dependent acquisition（DDA） proteomic technique was employed to quantitatively detect differentially expressed proteins in myocardial tissue between the optimal model group and the normal group. And bioinformatics analysis was conducted to explore the potential biological mechanisms underlying the Qi and Yin deficiency model of IHD. ResultsOrthogonal results showed that the injection cycle had a great influence on model establishment， and the optimal modeling condition was identified as intraperitoneal injection of ISO at 15 mg·kg^-1·d^-1 for 14 consecutive days. Under this condition， compared with the normal group， the model group demonstrated significant reductions in body mass， food intake， water intake， grip strength， total distance and average speed of exercise， ejection fraction（EF）， fractional shortening（FS）， serum levels of NE and cGMP， and myocardial ATP content（P<0.01）， while immobility time， cAMP level， and the cAMP/cGMP value were significantly increased（P<0.05， P<0.01）. HE staining results revealed that myocardial tissue in the model group had disordered cell arrangement， inflammatory cell infiltration， myocardial fiber rupture， and fibrous tissue proliferation. Proteomic analysis identified 141 differentially expressed proteins in the model group compared with the normal group， with 52 up-regulated and 89 down-regulated. Gene Ontology（GO） functional annotation and Kyoto Encyclopedia of Genes and Genomes（KEGG） pathway enrichment analysis indicated that the cellular components（CC） were mainly related to mitochondria and the inner mitochondrial membrane， the biological processes（BP） were associated with complement activation， platelet activation， and responses to metal ions， suggesting that the potential functional pathways involved the complement and coagulation cascade， as well as porphyrin metabolism. ConclusionContinuous intraperitoneal injection of ISO at a dose of 15 mg·kg^-1 for 14 days successfully establishes a mouse model of IHD with Qi and Yin deficiency syndrome， and the underlying mechanisms may be related to the regulation of iron ions by complement C3， C5 and Cp， and plays a role in the regulation through the BP of complement activation， platelet activation， and responses to metal ions， and the signaling pathways of the complement and coagulation cascade and porphyrin metabolism.

ObjectiveTo explore the optimal construction method and the biological basis for establishing a mouse model of ischemic heart disease（IHD） with Qi and Yin deficiency syndrome by intraperitoneal injection of isoproterenol（ISO）. MethodsA total of 144 male C57BL/6J mice were randomly assigned into three normal groups and nine model groups according to body mass， with 12 mice in each group. The model groups 1， 4， and 7 were administered ISO via intraperitoneal injection at a dose of 5 mg·kg^-1·d^-1 for four consecutive days， the model groups 2， 5， and 8 received ISO at a dose of 10 mg·kg^-1·d^-1 for seven consecutive days， while the model groups 3， 6， and 9 were given ISO at a dose of 15 mg·kg^-1·d^-1 for 14 consecutive days. The normal groups were administered an equivalent volume of normal saline via intraperitoneal injection. After the modeling process， body mass， 24-hour food and water intake， grip strength， and spontaneous activity of the mice were measured. Cardiac function was assessed using echocardiography， the serum levels of norepinephrine（NE）， cyclic adenosine monophosphate（cAMP）， and cyclic guanosine monophosphate（cGMP） were determined via enzyme-linked immunosorbent assay（ELISA）. The content of adenosine triphosphate（ATP） in myocardial tissue was measured by biochemical analysis， while histopathological changes in myocardial tissue were observed via hematoxylin-eosin（HE） staining. An orthogonal experimental design was applied for intuitive analysis and variance analysis to screen the optimal modeling conditions of the mouse model of IHD with Qi and Yin deficiency syndrome. A data-dependent acquisition（DDA） proteomic technique was employed to quantitatively detect differentially expressed proteins in myocardial tissue between the optimal model group and the normal group. And bioinformatics analysis was conducted to explore the potential biological mechanisms underlying the Qi and Yin deficiency model of IHD. ResultsOrthogonal results showed that the injection cycle had a great influence on model establishment， and the optimal modeling condition was identified as intraperitoneal injection of ISO at 15 mg·kg^-1·d^-1 for 14 consecutive days. Under this condition， compared with the normal group， the model group demonstrated significant reductions in body mass， food intake， water intake， grip strength， total distance and average speed of exercise， ejection fraction（EF）， fractional shortening（FS）， serum levels of NE and cGMP， and myocardial ATP content（P<0.01）， while immobility time， cAMP level， and the cAMP/cGMP value were significantly increased（P<0.05， P<0.01）. HE staining results revealed that myocardial tissue in the model group had disordered cell arrangement， inflammatory cell infiltration， myocardial fiber rupture， and fibrous tissue proliferation. Proteomic analysis identified 141 differentially expressed proteins in the model group compared with the normal group， with 52 up-regulated and 89 down-regulated. Gene Ontology（GO） functional annotation and Kyoto Encyclopedia of Genes and Genomes（KEGG） pathway enrichment analysis indicated that the cellular components（CC） were mainly related to mitochondria and the inner mitochondrial membrane， the biological processes（BP） were associated with complement activation， platelet activation， and responses to metal ions， suggesting that the potential functional pathways involved the complement and coagulation cascade， as well as porphyrin metabolism. ConclusionContinuous intraperitoneal injection of ISO at a dose of 15 mg·kg^-1 for 14 days successfully establishes a mouse model of IHD with Qi and Yin deficiency syndrome， and the underlying mechanisms may be related to the regulation of iron ions by complement C3， C5 and Cp， and plays a role in the regulation through the BP of complement activation， platelet activation， and responses to metal ions， and the signaling pathways of the complement and coagulation cascade and porphyrin metabolism.

Diabetic retinopathy(DR)is a common ocular chronic microvascular complication of diabetes mellitus and is the leading blinding fundus disease in people over 40 years of age.Current studies have shown that neuroglial vascular u-nit(NGVU)injury causes a variety of characteristic fundus changes in DR patients,including exudation,cotton wool spots,microangioma,bleeding,and neovascularization.Recent studies have confirmed that retinal NGVU injury in DR pa-tients occurs before retinal microangiopathy and is closely related to impaired visual function,so NGVU is expected to be a potential therapeutic target for the prevention and treatment of early DR in the future.In this paper,the research progress on the relationship between NGVU and DR treatment is reviewed,intending to provide new research directions for the pre-vention and intervention of early DR progression.

Objective:To investigate the anti-inflammatory and analgesic effects of Zhonghua Dieda Pills; To preliminarily explore its mechanism on adjuvant arthritis model rats.Methods:Three inflammatory models and two pain models were used to investigate the anti-inflammatory and analgesic effects of Zhonghua Dieda Pills. After establishing the adjuvant arthritis rat model, the rats were divided into normal group, model group, dexamethasone group (0.8 mg/kg), and Zhonghua Dieda Pills (2.0, 1.0, 0.5 g/kg) groups according to random number table method. Each group was given corresponding drugs once a day for 5 weeks. The toe volume was measured at 1, 3 and 5 weeks after administration, and the swelling degree was calculated; the organ indices of rats were calculated and the histopathological changes of articular cartilage were observed by HE staining; the expressions of interleukin-1β (IL-1β), tumor necrosis factor-α (TNF-α) and transforming growth factor-β (TGF-β) in joint tissues were detected by immunohistochemistry.Results:Zhonghua Dieda Pills (2.0 g/kg) group significantly reduced the swelling of foot and plantar of rats, reduced the swelling of ear of mice, and reduced the dry weight of granuloma of rats ( P<0.05); Zhonghua Dieda Pills (1.4 g/kg) group significantly reduced the number of twisting of rats, and the pain threshold after 3 h of administration was significantly higher than that of the control group ( P<0.05); Zhonghua Dieda Pills (2.0 g/kg) group significantly reduced the swelling of the foot and metatarsal of arthritic rats after 3-5 weeks of administration ( P<0.05), decreased the thymus index ( P<0.05), and reduced the expression levels of IL-1β, TNF-α and TGF-β in joint tissues ( P<0.05). Conclusion:Zhonghua Dieda Pills have confirmed anti-inflammatory and analgesic effects, which may play a therapeutic role in adjuvant arthritis model rats by reducing the levels of inflammatory factors such as IL-1β, TNF-α and TGF-β.

Objective:To compare the clinical effective of clavicular hook plate with extra suture hole and traditional hook plate in the treatment of acute acromioclavicular dislocation.Methods:This study retrospectively analyzed the clinical data of traumatic acromioclavicular dislocation patients who were treated by operation from March 2017 to September 2020. The patients were included in traditional hook plate (THP) group and triangle stabilization technique hook plate (TSTHP) group according fracture fixations. TSTHP group adopted clavicular hook plate with extra suture hole. There were 27 patients in THP group with 18 male patients and 9 female patients; average age with 37.56±8.94 years old; 16 patients injured left side and 11 patients injured right side; crush injuries of 10 patients, traffic injuries of 9 patients and sports injuries of 8 patients; Rockwood classification of type III (9 patients), type IV (10 patients) and type V (8 patients). There were 20 patients in TSTHP group with 15 male patients and 5 female patients; average age with 38.95±9.91 years old; 13 patients injured left side and 7 patients injured right side; crush injuries of 9 patients, traffic injuries of 8 patients and sports injuries of 3 patients; Rockwood classification of type III (5 patients), type IV (9 patients) and type V (6 patients). The operation time, intraoperative bleeding, postoperative coracoclavicular space, visual analogue scale (VAS) and shoulder joint Constant-Murley score were compared between the two groups.Results:The operation time and blood loss of THP group and TSTHP group were 51.07±11.27 min, 87.41±15.34 ml and 55.65±8.59 min, 90.50±14.32 ml, respectively. The difference was not statistically significant ( t=1.52, 0.70, all P>0.05). Patients in both groups were followed up for 12 to 14 months after operations, with an average of 12.28 months. Six months after surgery, the coracoclavicular spaces of THP group and TSTHP group were 12.16±0.90 mm and 11.26±0.70 mm, respectively. The difference was statistically significant ( t=3.70, P<0.001). Postoperative VAS scores (2 days, 3 months, 6 months and 12 months) of TSTHP group [1.8±0.77, 0.00(0.00, 1.00), 0.00 (0.00, 0.00), 0.00(0.00, 0.00)] were significantly better than THP group [4.22±1.25, 2.00 (1.00, 3.00), 1.00 (0.00, 1.00), 0.00 (0.00, 1.00)]. The difference was statistically significant ( t=7.65, P<0.001; Z=4.85, P<0.001; Z=3.44, P=0.001; Z=2.96, P=0.003). Postoperative Constant-Murley scores (3 months, 6 months and 12 months) of TSTHP group (87.00±5.18, 91.25±2.75, 92.30±2.74) were significantly better than THP group (76.96±5.21, 83.22±3.86, 85.22±3.49). The difference was statistically significant ( t=6.54, 7.93, 7.51; P<0.001). The postoperative complication rates of THP group were higher than TSTHP group [70.4% (19/27) vs. 5.0% (1/20)]. Conclusion:In the treatment of acute acromioclavicular dislocation, the clavicular hook plate with extra suture hole can obtain satisfactory clinical effect compared with the THP, and clavicular hook plate with extra suture hole is more conducive to early recovery of shoulder function and reduce postoperative complications.

Objective:To explore the method and effect in repairing the defect of fingertip with lateral V-Y advancement flap with one side palmar proper digital artery.Methods:From October 2014 to May 2019, Department of the Hand and Foot Surgery, the Third People's Hospital of Jining(Yanzhou District People's Hospital of Jining City) treated 34 digits of 27 cases with a defect area of 0.5 cm×0.5 cm-1.5 cm×2.0 cm. A lateral V-Y advancement flap with one side palmar proper artery was used to repair the fingertip defect, and the flap size was 1.7 cm×1.0 cm-4.5 cm×1.5 cm. Twenty cases entered long-time follow-up after operation, with 7 cases lost in follow-up, 16 cases were reviewed at outpatient and 4 by WeChat.Results:All the flaps of 34 digits of 27 cases survived. The color of the flaps were close to or completely normal to the surrounding tissue, the texture was soft and the appearance was good. The TPD of the flap was 2.0-6.0 mm. The follow-up time ranged from 22 to 77 months, with an average of 31.45 months. The flexion and extension function of the digits were good with total range of motion(ROM) of the thumb was > 90 °; total active motion (TAM) of the fingers was 260 °-200 °. The fingers of 1 case had hook nail or hook finger deformity. According to the Evaluation Trial Standard of Upper Limb Partial Function of Hand Surgery of Chinese Medical Association, 18 cases were excellent and 2 cases were good.Conclusion:The lateral V-Y advancement flap with one side palmar proper digital artery is easy to operate. The blood supply of the flap is reliable, with good sensation. The flexion and extension of the digits are good, and the appearance and texture of the flap are good.

Objective To analyze the risk factors and predictors related to postoperative delirium(POD) in liver transplantation. Methods The clinical data of 232 liver transplant recipients were retrospectively analyzed. Recipients were assigned to POD group (n=60) and non-POD (n=172) group according to the presence of POD. The intra- and post-operative conditions were compared between the two groups of liver transplant recipients. The risk factors for occurrence of POD in liver transplant recipients were analyzed using multifactorial analysis. And the value of predicting the occurrence of POD in liver transplant recipients according to the risk factors were assessed. Results The incidence of POD in liver transplant recipients was 25.9%. The operation time and anhepatic phase in the POD group were longer than those in the non-POD group. Intraoperative infusion of erythrocyte, infusion of cryoprecipitate, and lactic acid level were higher than those in the non-POD group (all P < 0.05). The levels of postoperative alanine aminotransferase (ALT), aspartate aminotransferase (AST), prothrombin time international normalized ratio (PT-INR), and plasma fibrinogen in the POD group were significantly higher than those in the non-POD group (all P < 0.05). Preoperative hepatic encephalopathy, elevated blood ammonia, high score of model for end-stage liver disease (MELD), elevated postoperative AST level and long intraoperative anhepatic phase were the independent risk factors for POD in liver transplant recipients (all P < 0.05). Preoperative elevated blood ammonia and high MELD score showed profound value in predicting the occurrence of POD in liver transplant recipients, with best cut-off values of 42.6 μmol/L and 18 points, sensitivity of 0.650 and 0.767 as well as specificity of 0.826 and 0.727, respectively. Conclusions The incidence of POD is high in liver transplant recipients. Preoperative hepatic encephalopathy, elevated blood ammonia, high MELD score, elevated postoperative AST level, and long intraoperative anhepatic phase are independent risk factors for liver transplant POD. Preoperative elevated blood ammonia and high MELD score are predictors of POD in transplant recipients.

Objective    To explore the safety and feasibility of spontaneous breathing anesthesia combined with tubeless uniportal thoracoscopy in pulmonary bullae surgery. Methods    Totally 112 patients with pulmonary bullae in the Affiliated Hospital of Inner Mongolia Medical University from March 2015 to May 2017 were enrolled. According to the random number chosen by computer, the patients were randomly divided into two groups: a tubeless group (spontaneous breathing anesthesia combined with tubeless uniportal thoracoscopy) and a control group (uniportal thoracoscopy by general anesthesia with tracheal intubation) . There were 49 males and 7 females with an average age of 25.5±6.5 years in the tubeless group, and 50 males and 6 females with an average age of 23.5±4.5 years in the control group. The difference of the lowest intraoperative arterial oxygen saturation (SaO2), SaO2 at postoperative one hour, operation time, postoperative awakening time, hospital stay, hospitalization cost and postoperative pain score were analyzed. Results    There was no significant difference between the two groups in the operation time, the lowest SaO2, SaO2 at one hour after the operation and the partial pressure of carbon dioxide (PaCO2). The awakening time and duration of postoperative hospital stay in the tubeless group was shorter than those in the control group (P=0.000). The cost of hospitalization in the tubeless group was less than that in the control group (P=0.000). The discomfort caused by urinary tract and visual analogue score (VAS) in the tubeless group were better than those in the control group. Conclusion    It is safe and feasible to use spontaneous breathing anesthesia combined with tubeless uniportal thoracoscopy in pulmonary  bullae resection.

The function of Traditional Chinese Medicine (TCM) represents the overall effect of the formula. The effect is the expression of numerous biological effects of chemical components of TCM in certain pathological conditions of the body function adjustment, and these chemicals are the material basis of the TCM function. Limited by many conditions, few studies have been done on the material base of TCM function, and most of them have been supplemented by the substance basis of TCM efficacy. This leads to the disconnection between the theory of traditional Chinese medicine and modern research, and it is difficult to scientifically explain the functional indications of Chinese medicine. This paper discusses and summarizes the ideas and methods of modern research and evaluation of the material base of TCM function.Under the guidance of TCM theory and clinical practice, we set up an index system for evaluating the TCM function, and further explained the material basis and action mechanism of TCM formula. Through the organic combination of multidisciplinary and multi-technology, it provides a reference for the establishment of a comprehensive research model of the functional material basis of TCM formula.