Ischemic stroke(IS)is a severe cerebrovascular disease that seriously endangers human health.Gut microbiota plays a key role as an intermediate mediator in bidirectional regulation between the brain and the intestine.In recent years,trimethylamine N-oxide(TMAO)as a gut microbiota metabolite has received widespread attention in cardiovascular diseases.Elevated levels of TMAO may increase the risk of IS by affecting IS risk factors such as atherosclerosis,atrial fibrillation,hypertension,and type 2 diabetes.TMAO exacerbates neurological damage in IS patients,increases the risk of IS recurrence,and is an independent predictor of post-stroke cognitive impairment(PSCI)in patients.Current research suggests that the mechanisms of TMAO action include endothelial dysfunction,promoting of foam cell formation,influence on cholesterol metabolism,and enhancement of platelet reactivity.Lowering plasma TMAO levels through the rational use of traditional Chinese medicine,dietary management,vitamins,and probiotics can prevent and treat IS.

Objective To observe the effect of high-frequency repetitive transcranial magnetic stimulation on hemiplegic shoulder pain during convalescence of stroke.Methods A total of 40 patients with hemiplegic shoulder pain during convalescing stroke who were hospitalized in Rehabilitation Medicine Department of Jiaxing Second Hospital from January 2021 to June 2022 were selected and randomly divided into treatment group(rTMS group)and control group(sham rTMS group),with 20 cases in each group.Both groups were given anti-inflammatory and analgesic drugs and conventional rehabilitation treatment.On this basis,the treatment group was combined with rTMS treatment(stimulation frequency was 10.0Hz,stimulation intensity was 80%resting motor threshold,stimulation time was 10s,interval was 50s,total treatment time was 20 minutes,once a day from Monday to Friday,continued treatment 2 days apart,20 times as a course of treatment,a total of 4 weeks),while the control group received sham rTMS.Before treatment,2 and 4 weeks after treatment,numerical pain rating scale(NPRS)was used to assess the degree of shoulder pain,passive shoulder range of motion was measured by protractor,upper limb motor function of hemiplegic side was assessed by Fugl Meyer assessment upper extremity(FMA-UE),and the ability of daily living activities was assessed by modified Barthel index(MBI).Results After treatment,NPRS score of shoulder pain in 2 groups was significantly decreased compared with before treatment(P<0.001),passive shoulder motion and Fugl-Meyer upper limb motor function were significantly improved compared with before treatment(P<0.001),and the treatment group was significantly better than the control group,the difference between groups was statistically significant(P<0.05).The modified Barthel index in 2 groups was significantly improved compared with before treatment(P<0.001),but there was no statistical significance between 2 groups(P>0.05).Conclusion 10.0Hz high-frequency repetitive transcranial magnetic stimulation can significantly relieve hemiplegic shoulder pain during the convalession of stroke,improve the passive range of motion of the affected shoulder,and improve the upper limb motor function of the affected side,but the effect is not significant in improving the ability of daily living activities.

ObjectiveTo establish a quantitative analysis multi-components by single marker method （QAMS） for five main components （aucubin， geniposidic acid， chlorogenic acid， asperuloside and rutin） in Eucommiae Folium， to verify its feasibility and applicability in the determination of Eucommiae Folium， so as to provide a scientific basis for the development of quality standard of this herb. MethodHigh performance liquid chromatography was performed on a Welch Boltmatetm™ C₁₈ column （4.6 mm×100 mm， 2.7 μm） with methanol （A）-0.2% phosphoric acid aqueous solution （B） as the mobile phase for gradient elution （0-8 min， 3%A； 8-10 min， 3%-11%A； 10-26 min， 11%A； 26-27 min， 11%-25%A； 27-60 min， 25%-32%A）， the column temperature was set at 30 ℃， the flow rate was 0.6 mL·min^-1， the detection wavelengths were at 210 nm and 254 nm. Chlorogenic acid was used as an internal reference to establish the relative correction factors （f） between it and the other four components， and the contents of the five components in 14 batches of Eucommiae Folium were determined by QAMS and external standard method （ESM）， respectively. ResultThe f values of chlorogenic acid to aucubin， geniposidic acid， asperuloside and rutin were 3.13， 1.45， 2.64 and 0.56， respectively. Repeatability was good under different experimental conditions， relative standard deviation （RSD） was <5.0%. The contents of aucubin， geniposidic acid， chlorogenic acid， asperuloside and rutin in 14 batches of Eucommiae Folium were 1.340-28.975， 0.252-36.086， 10.016-27.443， 1.396-8.646， 0.533-1.766 mg·g^-1， respectively. There were no significant difference between content results of QAMS and that of ESM （RSD<5.0%）. ConclusionQAMS established with chlorogenic acid as the internal reference can be used to determine the contents of five components in Eucommiae Folium， and this method is simple and accurate. After comprehensive evaluation， the quality standard of Eucommiae Folium in subsequent editions of Chinese Pharmacopoeia is suggested that three main active components， chlorogenic acid， aucubin and geniposidic acid， are selected as quality markers， and their content limits are recommended not less than 1.5%， 1.0% and 1.0%， respectively. This quality standard draft can avoid the potential quality risk due to poor specificity and low content limit of the index component （chlorogenic acid） in the previous editions of Chinese Pharmacopoeia.

ObjectiveTo prepare matrine lipid-based cubic liquid crystalline nanoparticle （MAT-LLCN） gels and investigate its in vitro release and transdermal absorption behavior. MethodTaking entrapment efficiency as the index， the optimal formulation of MAT-LLCN was screened by extreme vertex mixture method based on the optimal ratio of glycerol monooleate （GMO） to poloxamer 407 （P407）， and its drug loading was investigated. MAT-LLCN gels was prepared by mixing MAT-LLCN with pre-swelled carbomer 940 as the gel matrix. The structure of MAT-lipid-based cubic liquid crystalline （LLC） was characterized by polarized light microscopy （PLM） and small angle X-ray scattering （SAXS）. The in vitro release and transdermal absorption properties of MAT-LLCN gels and MAT ordinary gels were compared by modified Franz diffusion cell method， skin structure changes caused by them were observed by hematoxylin-eosin （HE） staining. ResultThe optimal formulation of MAT-LLCN gels was 5.5% of GMO-P407 （9∶1）， 1%-6% of MAT， 0.6% of carbomer 940， adding water to sufficient amount. The prepared MAT-LLC was confirmed as body-centered （Im3m） LLC. The in vitro release behavior of MAT-LLCN gels was in accordance with the Weibull equation （R²=0.954 0）， and the release mechanism was the Fick diffusion. In vitro transdermal test showed that all the parameters of MAT-LLCN gels were higher than those of MAT ordinary gels （P<0.05）， including cumulative release rate， steady-state release rate and the amount of drug retention in skin. HE staining results showed that MAT-LLCN gels could loose the cellular arrangement of skin stratum corneum， and maintain the stability of the cell structure of the dermis. ConclusionThe prepared MAT-LLCN gels can accelerate the transdermal drug transport and form drug storage in the dermis by rapidly opening the skin stratum corneum barrier， suggesting that LLC has good application prospects in the field of transdermal drug delivery.

Objective:To investigate the effect of ship-shaped expanded polytetrafluoroethylene (e-PTFE) nasal prosthesis in rhinoplasty.Methods:From February 2016 to June 2021, 86 patients, including 9 males and 77 females, aged 18-47 (24±5) years old, were admitted to Chengdu High-tech Zone Xinyuerong Medical Aesthetic Clinic for cosmetic treatment of rhinoplasty. All patients underwent rhinoplasty with the application of ship-shaped e-PTFE and autologous cartilage. The postoperative complications, glabellar fullness, inverted brow triangle, nasal polygon aesthetic shape and patient satisfaction were evaluated. These data were measured and analyzed, including the nasal length, nasal tip height, nasal frontal angle and nasal facial angle before and after the operation.Results:In 86 patients, the incision healed in one stage after surgery, and 8 cases had nasal vestibular scar hyperplasia. All patients were followed up for 1-5 years: 84 cases obtained satisfactory nasal morphology, and 2 cases recovered naturally after adjusting and lowering the prosthesis height half a year after surgery because the interbrow area was too full. 74 patients (86%) were very satisfied, 10 cases (11.6%) were satisfied. The nasal length was (4.07±0.20) cm, the nasal tip height was (2.66±0.36) cm, the nasal frontal angle was (106.42±8.04)°, and the nasal face angle was (15.90±0.85)°before operation. The nasal length was (4.23±0.20) cm, the nasal tip height was (2.59±0.26) cm, the naso-frontal angle was (113.69±6.34)°, and the naso-facial angle was (21.57±0.78)° at eighteen months after operation. There were statistically significant differences in nasal length, naso-frontal angle and naso-facial angle ( t=-5.51, -5.96, -52.31, P<0.01), but no statistically significant differences in nasal tip height ( t=1.47, P=0.146). Conclusions:The ship-shaped e-PTFE can be shaped to reflect the aesthetic of the nose dorsum, which is similar to the anatomical structure of the nose dorsum, increase the stability and authenticity of the prosthesis, and is worthy of clinical application.

Enteric-soluble soft capsule is a kind of new preparation that does not disintegrate in the stomach ，but releases rapidly in the intestinal tract to play a pharmacodynamic role. It has the unique advantages of improving drug stability ，reducing drug irritation ，delivering drugs directionally to the intestinal tract ，and prolonging drug action time. In this paper ，the decomposition and release mechanism ，application advantages ，classification of enteric-soluble coating materials and preparation methods of enteric-soluble soft capsule are sorted and summarized ，in order to provide reference for further development of this type of preparation.

Objective:To investigate the efficacy of floating acupuncture therapy in the treatment of chronic refractory pressure ulcers and its effects on serum levels of superoxide dismutase, malondialdehyde and insulin-like growth factor-1.Methods:A total of 60 patients with chronic refractory pressure ulcers who received treatment in The Second Hospital of Jiaxing from October 2019 to October 2021 were included in this study. They were randomly divided into observation and control groups, with 30 patients in each group. The patients in the control group were given routine treatment, while the patients in the observation group were given floating acupuncture therapy based on routine treatment. Clinical efficacy, wound healing rate after 7, 14 and 21 days of treatment, the time of emerging granulation tissue, the time of shedding rotten meat, and the time of wound healing, changes in serum levels of superoxide dismutase, malondialdehyde and insulin-like growth factor-1 after 21 days of treatment relative to those before treatment were compared between the two groups.Results:Total response rate in the observation group was significantly higher than that in the control group [90.0% (27/30) vs. 66.7% (20/30), χ2 = 4.81, P < 0.05]. Wound healing rate after 7, 14 and 21 days of treatment in the observation group was significantly higher than that in the control group ( t = -5.45, -7.77, -7.51, all P < 0.001). The time of emerging granulation tissue, the time of shedding rotten meat, and the time of wound healing in the observation group were significantly shorter than those in the control group ( t = 5.69, 9.26, 8.91, all P < 0.001). After 21 days of treatment, serum levels of superoxide dismutase, malondialdehyde and insulin-like growth factor-1 in the observation group were (96.52 ± 10.43) U/mL, (4.32 ± 0.78) μmol/L, (43.52 ± 8.29) μg/L, respectively, which were significantly different from (83.76 ± 6.81) U/mL, (5.48 ± 0.92) μmol/L, (36.78 ± 9.18) ng/mL, in the control group ( t = 5.61, 5.27, 2.98, all P < 0.05). Conclusion:Floating acupuncture therapy is effective in the treatment of refractory pressure ulcer. It can accelerate wound healing, increase serum superoxide dismutase and insulin-like growth factor-1 levels, and decrease serum malondialdehyde level.

Objective:To explore the value of spectral CT in the preoperative evaluation of solid lung adenocarcinoma with different pathological grades based on the 2011 and 2020 version of the pathological grading system.Methods:A total of 76 cases of solid lung adenocarcinoma confirmed by surgery in Renji Hospital, School of Medicine, Shanghai Jiao Tong University, from January 2019 to September 2021 were analyzed retrospectively. All cases were divided into groups according to the grading system for invasive adenocarcinoma proposed by the International Association for the Study of Lung Cancer (IASLC) in 2011 and 2020 (G low group included G1 and G2 adenocarcinoma, G high group included G3 adenocarcinoma). The tumors with stage Ⅰ and Ⅱ were non-advanced and the tumors with stage Ⅲ and Ⅳ were advanced. The clinical manifestations (gender, age, smoking history and stage), routine CT parameters (tumor size, morphological characteristics, plain CT value and enhancement degree) and spectral parameters [iodine concentration, effective atomic number, enhanced monochromatic CT attenuation values of 40-200 keV (CT 40 keV-CT 200 keV), and the slope of spectral curve (k value)] were compared between G low group and G high group using independent sample t-test or Mann-Whitney U test. And the efficacy of each parameter for indicating G high adenocarcinoma was analyzed using receiver operating characteristic curve analysis and area under the curve (AUC), and the Z test was used to compare the AUC. Results:Seventy-six cases were included (59 cases of G low group and 17 cases of G high group in 2011 version; 46 cases of G low group and 30 cases of G high group in 2020 version). Among the 76 cases, 62 cases were non-advanced stage (50 cases of G low group and 12 cases of G high group in 2011 version; 37 cases of G low group and 25 cases of G high group in 2020 version) and 14 cases were advanced stage (9 cases of G low group and 5 cases in G high group in both 2011 and 2020 version). Among the non-advanced adenocarcinomas, the CT parameters of enhancement degree, k value and CT 40 keV-CT 60 keV in arterial phase and enhancement degree, k value and CT 40 keV-CT 70 keV in venous phase of G high group in 2011 grading system were significantly lower than those of G low group ( P<0.05), while other parameters were similar between G low and G high group in 2011 grading system ( P>0.05); and the CT parameters of CT 60 keV in arterial phase and CT 50 keV-CT 70 keV in venous phase of G high group in 2020 grading system were significantly lower than those of G low group ( P<0.05). Among the advanced adenocarcinomas, all of the clinical and CT parameters were similar between G low and G high group in both 2020 and 2011 grading systems ( P>0.05). For the non-advanced adenocarcinomas, there was medium to good efficacy of the CT parameters of enhancement degree, k value and CT 40 keV-CT 60 keV in arterial phase and enhancement degree, k value and CT 40 keV-CT 70 keV in venous phase for diagnosing 2011 grading system G high adenocarcinoma (AUC=0.700-0.853), with CT 50 keV in venous phase as the best; while the diagnosis efficacy of CT parameters of CT 60 keV in arterial phase and CT 50 keV-CT 70 keV in venous phase was poor for 2020 grading system G high adenocarcinoma (AUC=0.652-0.688), with CT 60 keV in venous phase as the best. After combining smoking history and CT 60 keV in venous phase, the diagnosis efficacy for 2020 grading system G high adenocarcinoma was slightly improved (AUC=0.772), but the difference had no significance ( Z=0.93, P=0.176). Conclusion:The spectral parameters are useful for distinguishing the pathological grades of solid lung adenocarcinoma. And the detecting efficacy for G high adenocarcinoma of IASLC 2011 version is slightly better than that of 2020 version.

Objective:To explore the value of dual-layer spectral detector CT in differentiating the diagnosis of lung cancer and inflammatory nodules.Methods:A total of 92 patients undergoing enhanced chest scan from March 2019 to September 2020 at Renji Hospital, School of Medicine, Shanghai Jiaotong University, were retrospectively enrolled in the study. The conventional CT parameters, spectral CT parameters were measured and the nodules′ morphological characteristics were analyzed. Later the factors with statistical significance were identified as independent variables in a logistic regression model to establish models for predicting malignant nodules. ROC curve was used to assess the diagnostic performance for the conventional CT model, spectral CT parameters and combined model, respectively. Differences in the area under the ROC curve (AUC) were analyzed by the DeLong test.Results:Lobulated sign (42 and 8, respectively, χ2=10.779, P=0.001), short burr sign (41 and 7, respectively, χ2=11.911, P=0.001), pleural indentation sign (45 and 9 respectively, χ2=11.705, P=0.001), vascular convergence sign (35 and 8, respectively, χ2=5.337, P=0.021) and the venous phase iodine concentrations (IC) value [(2.1±0.5) mg/ml, (2.3±0.5) mg/ml, t=-2.464, P=0.016], normalized iodine concentrations (NIC) value (0.40±0.06, 0.45±0.08, t=-6.943, P<0.001), and Z-effective (Z eff) values (8.38±0.21, 8.49±0.19, t=-2.122, P=0.037) were significantly different between the lung cancer group and the inflammatory group, while other CT signs and CT indicators were not significantly different between the lung cancer group and the inflammatory group ( P>0.05). The conventional CT model was established with lobulated sign, short burr sign, pleural indentation sign, vascular convergence sign, and the AUC for differential diagnosis of lung cancer and inflammatory nodules was 0.827. The spectral CT parameter model was established with venous phase IC, venous phase NIC, and venous phase Z eff value, and the AUC for differential diagnosis of lung cancer and inflammatory nodules was 0.899. The conventional CT model combined spectral CT parameter model was established with the significant factors in the univariate analysis, and the AUC for differential diagnosis of lung cancer and inflammatory nodules was 0.925. The AUC of the combined model showed no significant difference from that of the spectral CT parameter model ( Z=1.794, P=0.073). However, AUC of the combined model was significantly higher than that of evaluation based on conventional CT alone ( Z=2.156, P=0.031). Conclusion:Spectral CT parameters combined with conventional CT signs can improve the differential diagnosis efficiency between lung cancer and inflammatory nodules.

The pathogenesis of diabetic retinopathy (DR) is complex.Antisense non-coding RNA (ANRIL) in the INK4 locus in long-chain non-coding RNA (lncRNA) is closely related to cell proliferation,differentiation,and individual development.It plays an important role in the dysplasia of retinal vascular endothelial cells and is a new field in the study of the pathogenesis of DR.According to the researches at present,ANRIL may plays its role in the occurrence and development of DR through the signal pathway of nuclear factor-κB and ROS/polyadenylation diphosphate ribose polymerase,and interact with p300,miR-200b,and EZH2 to regulating the expression and function of VEGF.Specific blocking ANRIL and its related pathwaysmay become a new target in the treatment of DR.