The prescription Mahuang Shengmatang in the Treatise on Cold Damage （《伤寒论》） has sparked considerable debate among medical practitioners throughout history， with varying opinions on its indications， pathogenesis described in the text， principle of compatibility， and clinical applications. Both ancient and modern interpreters of Mahuang Shengmatang often focus on herbal compatibility as a primary approach to deduce the pathogenesis and treatment methods. Building upon this foundation， this paper utilizes herbal dosage as a clue to discern the primary and secondary herbs in the prescription. It further analyzes the principle of compatibility based on herbal indications， summarizing the indications and therapeutic principles of this prescription. Ultimately， it reveals the underlying pathogenesis reflected in the text. The internal closure of heat and toxin leads to the stagnation of Qi， preventing Yang Qi from reaching the extremities and causing cold hands and feet. When the pathogenic Qi finds no outlet， it floods both the upper and lower regions of the body， attacking the throat and causing cough with expectoration of pus and blood， and descending to the large intestine to consume Yin fluids， resulting in persistent diarrhea. Based on this pathogenesis， the paper expands the scope of symptoms and signs associated with the prescription， providing a more detailed portrayal of the applicable patient population and enhancing the basis for clinical prescription references. Additionally， the paper presents considerations on several controversial topics， suggesting that the "lower pulse" described in the text refers to the lower limb arterial pulsation， and the symptoms and signs resemble those of septic shock in modern medicine. Therefore， Mahuang Shengmatang should be categorized as a prescription for treating warm diseases and it is not developed by ZHANG Zhongjing. By employing a detailed discussion on the syndrome， pathogenesis， and clinical application in the texts of Mahuang Shengmatang from the dosage， principle of compatibility， and herbal indications， this paper not only enriches the theoretical foundation of Mahuang Shengmatang but also provides a comprehensive perspective and fresh ideas for understanding its clinical application.

Prostaglandin E2(PGE2),an arachidonic acid metabolite,is a biologically active lipid small molecule,which was known as an inflammatory mediator previously.Macrophages are important cellular component of intrinsic immune system and the first line of defense against pathogenic invasion.Macrophages are highly plastic and can be simply divided into classically activated M1 type and alternative activated M2 type depending on their morphology and function.In healthy state,these two phenotypes of macro-phages are in a dynamic balance to maintain immune homeostasis;when body is stimulated by infection or inflammation,M1/M2 can be converted to each other,thus participating in disease onset and progression and influencing disease regression.It has been shown that PGE2 can regulate macrophage polarization in inflammatory diseases,involving complex mechanisms such as signaling pathways,metabolic processes,and miRNA regulatory networks.Therefore,this paper will briefly summarize mechanism of PGE2 regulation of macrophage polarization and effects of this regulation in inflammatory diseases.

With the rapid development of gene editing technology, the study of spermatogonial stem cells (SSCs) holds great significance in understanding spermatogenesis and its regulatory mechanism, developing transgenic animals, gene therapy, infertility treatment and protecting rare species. Biogenesis of lysosome-related organelles complex 1 subunit 1 (BLOC1S1) is believed to have anti-brucella potential. Exploring the impack of BLOC1S1 on goat SSCs not only helps investigate the ability of BLOC1S1 to promote SSCs proliferation, but also provides a cytological basis for disease-resistant breeding research. In this study, a BLOC1S1 overexpression vector was constructed by homologous recombination. The BLOC1S1 overexpression cell line of goat spermatogonial stem cells was successfully constructed by lentivirus packaging, transfection and puromycin screening. The overexpression efficiency of BLOC1S1 was found to be 18 times higher using real time quantitative PCR (RT-qPCR). Furthermore, the results from cell growth curve analysis, flow cytometry for cell cycle detection, and 5-ethynyl-2'-deoxyuridine (EdU) staining showed that BLOC1S1 significantly increased the proliferation activity of goat SSCs. The results of RT-qPCR, immunofluorescence staining and Western blotting analyses revealed up-regulation of proliferation-related genes (PCNA, CDK2, CCND1), and EIF2S3Y, a key gene regulating the proliferation of spermatogonial stem cells. These findings strongly suggest that the proliferative ability of goat SSCs can be enhanced through the EIF2S3Y/ERK pathway. In summary, this study successfully created a goat spermatogonial stem cell BLOC1S1 overexpression cell line, which exhibited improved proliferation ability. This research laid the groundwork for exploring the regulatory role of BLOC1S1 in goat spermatogonia and provided a cell platform for further study into the biological function of BLOC1S1. These findings also establish a foundation for breeding BLOC1S1 overexpressing goats.
Animals ; Male ; Goats ; Stem Cells ; Spermatogonia/metabolism* ; Cell Proliferation ; Flow Cytometry ; Testis/metabolism*

The adjacent anatomy of the pelvis is complicated, with digestive, urinary, reproductive and other organs as well as important blood vessels and nerves. Therefore, accurate resection of pelvic tumors and precise reconstruction of defects after resection are extremely difficult. The development of medical 3D printing technology provides new ideas for precise resection and personalized reconstruction of pelvic tumors. The “triune” application of 3D printing personalized lesion model, osteotomy guide plate and reconstruction prosthesis in pelvic tumor limb salvage reconstruction treatment has achieved good clinical results. However, the current lack of normative guidance standards such as preparation and application of 3D printing personalized lesion model, osteotomy guide plate and reconstruction prosthesis restricts its promotion and application. The formulation of this consensus provides normative guidance for 3D printing personalized pelvic tumor limb salvage reconstruction treatment.

Objective:To analyze the factors of missed diagnosis and misdiagnosis of gallbladder adenomyomatosis(GBA) by ultrasonography according to the contrast between ultrasonography and pathology.Methods:Four hundred and forty-six cases of patients with pathological diagnosis of GBA and complete preoperative case informations were retrospectively collected from January 2010 to November 2018 in the PLA General Hospital, and the preoperative ultrasound diagnosis, clinical symptoms, pathological classification were analyzed. The coincidence rate and missed diagnosis rate of GBA by ultrasound were calculated. The ultrasonic diagnosis of GBA missed diagnosis and misdiagnosis factors were analyzed according to the multiple factors and single factor Logistic regression.Results:The coincidence rate of ultrasonic diagnosis was 46.9%(200/426), the missed diagnosis rate was 35.2%(150/426), and the misdiagnosis rate was 17.8%(76/426). Misdiagnosed cases included 65 cases (85.5%) of gallbladder occupation, 7 cases (9.2%) of gallbladder stones, and 4 cases (5.3%) of chronic cholecystitis. The results of multi-fact OR Logistics regression analysis showed that gallbladder stones ( OR=5.112, P<0.001), chronic cholecystitis ( OR=4.613, P<0.001), gallbladder occupation ( OR=6.565, P<0.001) and cholesterol crystals ( OR=8.634, P<0.001) were independent influencing factors for accurate diagnosis of GBA by ultrasound. Conclusions:Ultrasound has a high rate of missed diagnosis and misdiagnosis for GBA operation group at present. Since most cases are complicated with other gallbladder diseases, it is important to scan carefully for GBA besides the diagnosis of a single gallbladder disease.

Objective To investigate the validity and reliability of Item Erectile Function Scale (I-EF) for neurogenic erectile dysfunc-tion (ED). Methods 104 patients with spinal cord injury were assessed with I-EF. They were measured with pudendal somatosensory ner-vous evoked potential (SEP), bulbocavernosus reflex potential time (BCR) and nocturnal penile tumescence (NPT) detection. 34 patients ac-cepted medicine for ED, and were assessed with I-EF after treatment. 21 patients with medium ED were assessed by 2 testers, and retested 2-4 weeks later. Results The patients who recorded their potential of SEP and BCR got the scores of Q1, Q2 above 7, and the absence with the scores of 3. Those found NPT 1-3 times got the score of Q3 above 7, and the absence with the scores of 3. The incidence of reflex erec-tions and NPT were more in complete suprasacral ones than in complete sacral ones (P<0.05). There was significant improvement after med-ication in patients with mild to medium ED (P<0.05). The interclass correlation coefficient (ICC) was 0.93 between testers and 0.90 between test-retest. Conclusion I-EF can be used to assess neurogenic erectile dysfunction for rehabilitation.

OBJECTIVETo assess the stiffness and thickness of the plantar fascia using shear wave elastography (SWE) in healthy volunteers of different ages and in patients with plantar fasciitis.

METHODSThe bilateral feet of 30 healthy volunteers and 23 patients with plantar fasciitis were examined with SWE. The plantar fascia thickness and elasticity modulus value were measured at the insertion of the calcaneus and at 1 cm from the insertion.

RESULTSThe elderly volunteers had a significantly greater plantar fascia thickness measured using conventional ultrasound (P=0.005) and a significantly lower elasticity modulus value than the young volunteers (P=0.000). The patients with fasciitis had a significantly greater plantar fascia thickness (P=0.001) and a lower elasticity modulus value than the elderly volunteers (P=0.000). The elasticity modulus value was significantly lower at the calcaneus insertion than at 1 cm from the insertion in patients with fasciitis (P=0.000) but showed no significantly difference between the two points in the elderly or young volunteers (P=0.172, P=0.126).

CONCLUSIONSWE allows quantitative assessment of the stiffness of the plantar fascia, which decreases with aging and in patients with plantar fasciitis.

Adult ; Aged ; Case-Control Studies ; Elasticity Imaging Techniques ; Fascia ; diagnostic imaging ; Fasciitis, Plantar ; diagnostic imaging ; Female ; Humans ; Male ; Middle Aged

Purpose To investigate the prognosis and influencing factor of hematoma complicated from ultrasonography-guided EnCor vacuum-assisted breast biopsy system in minimally invasive surgery for breast lesions, and to provide reference for clinical treatment. Materials and Methods 280 female patients with 486 benign breast lesions underwent minimally invasive excision using a ultrasonography-guided EnCor vacuum-assisted device, occurrence and the inlfuence factors of hematoma complicated from the operation was observed. Results All the 486 lesions were completely excised with EnCor system, hematoma (≥1cm) were found in 47 cases after 24 hours and almost disappeared in 6 months. After analysis of the occurrence of hematoma, it was found that the following situations would lead to a higher incidence of hematoma, which included lumps ≥ 2.5 cm, more than two lesions removed at one time, lumps locating deep inside the areola or the edge of breasts, bigger and less dense breasts, operation in menstrual period, pressure bandaging after operation less than 12 hours and operation without using adrenaline (P<0.05 or P<0.01). Conclusion Benign lesions breast can be effectively excised using ultrasonography-guided EnCor vacuum device, and the factors listed below could affect the occurance of hematoma complicated from the surgery, including the size, location and number of the resected nodules, breast shape, surgery during menstrual period, postoperative pressure bandaging and the use of hemostatics.

Objective To assess the stiffness and thickness of the plantar fascia using shear wave elastography (SWE) in healthy volunteers of different ages and in patients with plantar fasciitis. Methods The bilateral feet of 30 healthy volunteers and 23 patients with plantar fasciitis were examined with SWE. The plantar fascia thickness and elasticity modulus value were measured at the insertion of the calcaneus and at 1 cm from the insertion. Results The elderly volunteers had a significantly greater plantar fascia thickness measured using conventional ultrasound (P=0.005) and a significantly lower elasticity modulus value than the young volunteers (P=0.000). The patients with fasciitis had a significantly greater plantar fascia thickness (P=0.001) and a lower elasticity modulus value than the elderly volunteers (P=0.000). The elasticity modulus value was significantly lower at the calcaneus insertion than at 1 cm from the insertion in patients with fasciitis (P=0.000) but showed no significantly difference between the two points in the elderly or young volunteers (P=0.172, P=0.126). Conclusion SWE allows quantitative assessment of the stiffness of the plantar fascia, which decreases with aging and in patients with plantar fasciitis.

Objective To assess the stiffness and thickness of the plantar fascia using shear wave elastography (SWE) in healthy volunteers of different ages and in patients with plantar fasciitis. Methods The bilateral feet of 30 healthy volunteers and 23 patients with plantar fasciitis were examined with SWE. The plantar fascia thickness and elasticity modulus value were measured at the insertion of the calcaneus and at 1 cm from the insertion. Results The elderly volunteers had a significantly greater plantar fascia thickness measured using conventional ultrasound (P=0.005) and a significantly lower elasticity modulus value than the young volunteers (P=0.000). The patients with fasciitis had a significantly greater plantar fascia thickness (P=0.001) and a lower elasticity modulus value than the elderly volunteers (P=0.000). The elasticity modulus value was significantly lower at the calcaneus insertion than at 1 cm from the insertion in patients with fasciitis (P=0.000) but showed no significantly difference between the two points in the elderly or young volunteers (P=0.172, P=0.126). Conclusion SWE allows quantitative assessment of the stiffness of the plantar fascia, which decreases with aging and in patients with plantar fasciitis.