OBJECTIVE To explore the effect mechanism of Eucommia ulmoides on improving postpartum depression in rats. METHODS Pregnant rats were randomly divided into normal group， postpartum depression group， and low-dose and high-dose groups of E. ulmoides （1.34， 2.68 g/kg， calculated by crude drug）， with 10 rats in each group. Except for the normal group， the rats in other groups suffered from fear stress to induce postpartum depression model during pregnancy； at the same time of modeling， the administration groups were given relevant medicine intragastrically， while the normal group and postpartum depression group were given physiological saline intragastrically for 21 days. Postpartum behaviors of rats during the experiment were assessed using the open field test， Morris water maze test and sucrose preference test. Additionally， the levels of corticosterone （CORT） in serum， corticotropin releasing factor （CRF） and urocortin （UCN） in hypothalamus， and adrenocorticotropic hormone （ACTH） in hypophysis were detected； meanwhile， the protein expressions of CRF receptor 1 （CRFR1）， CRFR2， and voltage-dependent anion channel 1 （VDAC1） in hippocampal tissue were measured； the proportions of apoptotic cells and JC-1 high potential cells in hippocampal tissue were determined， and the morphology of hippocampal tissue was observed. RESULTS Compared with postpartum depression group， the high-dose group of E. ulmoides showed improvements in appetite， mental state， and hair color in rats； their body weight had increased； the scores of vertical movement， horizontal movement and self-sorting significantly increased； from the 2ed to 4th day avoidance latency significantly shortened， and the times of crossing the platform and the time of crossing the platform Δ 基金项目国家自然科学基金青年基金项目（No.82204789） significantly increased/prolonged （P＜0.05）； the ratio of glucose and water consumption significantly increased at 20 days of pregnancy and 30 days postpartum （P＜0.05）； the levels of CRF， UCN， ACTH and CORT， phagocytic rate， protein expressions of CRFR2 and VDAC1， and the proportion of apoptosis cells in hippocampal tissue were decreased significantly （P＜0.05）； the proportion of JC-1 high potential cells significantly increased （P＜0.05）， and the phenomenon of edema around neuronal cells was significantly improved. CONCLUSIONS E. ulmoides can improve postpartum depression by inhibiting excessive activation of hypothalamic-pituitary-adrenal axis， decreasing the expression of CRFR2， thereby inhibiting the expression of VDAC1， and decreasing the apoptosis of neuronal cells.

OBJECTIVE To explore the effect mechanism of Eucommia ulmoides on improving postpartum depression in rats. METHODS Pregnant rats were randomly divided into normal group， postpartum depression group， and low-dose and high-dose groups of E. ulmoides （1.34， 2.68 g/kg， calculated by crude drug）， with 10 rats in each group. Except for the normal group， the rats in other groups suffered from fear stress to induce postpartum depression model during pregnancy； at the same time of modeling， the administration groups were given relevant medicine intragastrically， while the normal group and postpartum depression group were given physiological saline intragastrically for 21 days. Postpartum behaviors of rats during the experiment were assessed using the open field test， Morris water maze test and sucrose preference test. Additionally， the levels of corticosterone （CORT） in serum， corticotropin releasing factor （CRF） and urocortin （UCN） in hypothalamus， and adrenocorticotropic hormone （ACTH） in hypophysis were detected； meanwhile， the protein expressions of CRF receptor 1 （CRFR1）， CRFR2， and voltage-dependent anion channel 1 （VDAC1） in hippocampal tissue were measured； the proportions of apoptotic cells and JC-1 high potential cells in hippocampal tissue were determined， and the morphology of hippocampal tissue was observed. RESULTS Compared with postpartum depression group， the high-dose group of E. ulmoides showed improvements in appetite， mental state， and hair color in rats； their body weight had increased； the scores of vertical movement， horizontal movement and self-sorting significantly increased； from the 2ed to 4th day avoidance latency significantly shortened， and the times of crossing the platform and the time of crossing the platform Δ 基金项目国家自然科学基金青年基金项目（No.82204789） significantly increased/prolonged （P＜0.05）； the ratio of glucose and water consumption significantly increased at 20 days of pregnancy and 30 days postpartum （P＜0.05）； the levels of CRF， UCN， ACTH and CORT， phagocytic rate， protein expressions of CRFR2 and VDAC1， and the proportion of apoptosis cells in hippocampal tissue were decreased significantly （P＜0.05）； the proportion of JC-1 high potential cells significantly increased （P＜0.05）， and the phenomenon of edema around neuronal cells was significantly improved. CONCLUSIONS E. ulmoides can improve postpartum depression by inhibiting excessive activation of hypothalamic-pituitary-adrenal axis， decreasing the expression of CRFR2， thereby inhibiting the expression of VDAC1， and decreasing the apoptosis of neuronal cells.

Objective: To study the relationship between sugar sweetened beverages consumption characteristics and insomnia of college students in Yunnan Province, so as to provide evidence for sleep quality improvement of college students. Methods: A cluster random sampling method was used to select 2 515 college students from two universities (Kunming University and Dali Nursing Vocational College) in Kunming and Dali in Yunnan Province for a longitudinal study, including baseline survey (T1, November 2021) and three follow up surveys (T2: June 2022, T3: November 2022, T4: June 2023). Sugar sweetened beverages consumption of college students was collected by Semi quantitative Food Frequency Questionnaire and insomnia was assessed by Insomnia Severity Index Scale. Sugarsweetened beverages consumption was analyzed by Kruskal-Wallis test. The Mann-Whiter U test and Kruskal-Wallis test were used to compare the detection rate of insomnia in college students with different population characteristics, and the generalized estimating equations model was established to analyze the association between sugar sweetened beverages consumption and insomnia. Results: The reported rate of insomnia among college students from T1 to T4 was 21.2%, 23.6%, 30.5 % and 36.0%, respectively. The median of sugar sweetened beverages consumption per week was 5 (1,9) bottles per person, and there were significant differences in sugar sweetened beverages (carbonated beverages, fruit beverages, tea beverages, milk beverages, energy beverages) consumption among college students with different insomnia status ( χ 2=42.91, 23.67, 29.98, 61.70, 30.82, P <0.01). The analysis of the generalized estimating equation model revealed that the consumption of carbonated beverages ( β= 0.04, 95%CI =0.00-0.08) and the consumption of milk beverages among college students ( β=0.04, 95%CI =0.00-0.09) were correlated with insomnia ( P <0.05). The stratified analysis indicated that consumption of carbonated beverages by female college students was associated with insomnia [ β(95%CI )=0.06(0.01-0.11)]; consumption of milk beverages among college students from middle income family was associated with insomnia [ β (95% CI )=0.05(0.00-0.10)], and consumption of carbonated beverages and fruit beverages from college students with high household economic status were both associated with insomnia [ β (95% CI )=0.35(0.23-0.46), 0.12(0.00-0.24)] ( P <0.05). Conclusion Sugar sweetened beverages, especially carbonated beverages, are associated with insomnia among college students in Yunnan Province.

Objective:To investigate the clinical effect of intraarticular vancomycin on early periprosthetic joint infection (PJI) in knee arthroplasty and the incidence of postoperative complications.Methods:This is a retrospective cohort study. The clinical data of 1 867 patients who underwent primary knee arthroplasty at Department of Joint Surgery, the Affiliated Hospital of Qingdao University from April 2022 to June 2023 were retrospectively analysed, including total knee arthroplasty (TKA), robotic-assisted total knee arthroplasty (RA-TKA) and unicondylar knee arthroplasty (UKA). There were 687 males and 1 180 females, aged (68.0±11.2)years(range:45 to 87 years). Patients were divided into the vancomycin group and the control group according to whether or not intra-articular injection of 1 g of vancomycin powder dissolved in 30 ml of saline was performed after intraoperative joint capsule closure. In the vancomycin group, 925 patients were included, including 782 TKA, 27 RA-TKA and 116 UKA.In the control group, 942 patients were included, including 767 TKA, 99 RA-TKA and 76 UKA. Early PJI, wound complications, and vancomycin-related toxicity including acute renal collapse, ototoxicity, and allergic reactions were assessed within 3 months postoperatively. The data were compared using the independent sample t test, χ2 test, and Fisher's exact probability method, as appropriate. Major Extremity Trauma Research Consortium (METRC). Results:No PJI was found in all patients in the vancomycin group.Five cases (0.7%,5/767) of early PJI were found in TKA patients in the control group, with a statistically significant difference ( P=0.030); 1 case of early PJI was found in each RA-TKA and UKA patients, with non-significant difference compared with vancomycin group (all P>0.05). Two cases (0.3%,2/782) of incisional complications were found in TKA patients in the vancomycin group, and 4 cases (0.5%, 4/767) of incisional complications were found in TKA patients in the control group, with non-significant difference( P=0.449); no incisional complication was found in RA-TKA patients in the vancomycin group, and 1 case (1.0%,1/99) of incisional complications were found in RA-TKA patients in the control group, the difference was not statistically significant ( P>0.05); no incisional complication was found in both groups of UKA patients.No vancomycin-related acute kidney injury, ototoxicity, or allergic reactions was observed in all patients. Conclusion:Intra-articular injection of 1 g of vancomycin suspension after arthrotomy closure during TKA maybe lower the risk of early PJI without increasing the risk of wound complication and vancomycin-associated systemic toxicity.

Objective:To investigate the clinical effect of intraarticular vancomycin on early periprosthetic joint infection (PJI) in knee arthroplasty and the incidence of postoperative complications.Methods:This is a retrospective cohort study. The clinical data of 1 867 patients who underwent primary knee arthroplasty at Department of Joint Surgery, the Affiliated Hospital of Qingdao University from April 2022 to June 2023 were retrospectively analysed, including total knee arthroplasty (TKA), robotic-assisted total knee arthroplasty (RA-TKA) and unicondylar knee arthroplasty (UKA). There were 687 males and 1 180 females, aged (68.0±11.2)years(range:45 to 87 years). Patients were divided into the vancomycin group and the control group according to whether or not intra-articular injection of 1 g of vancomycin powder dissolved in 30 ml of saline was performed after intraoperative joint capsule closure. In the vancomycin group, 925 patients were included, including 782 TKA, 27 RA-TKA and 116 UKA.In the control group, 942 patients were included, including 767 TKA, 99 RA-TKA and 76 UKA. Early PJI, wound complications, and vancomycin-related toxicity including acute renal collapse, ototoxicity, and allergic reactions were assessed within 3 months postoperatively. The data were compared using the independent sample t test, χ2 test, and Fisher's exact probability method, as appropriate. Major Extremity Trauma Research Consortium (METRC). Results:No PJI was found in all patients in the vancomycin group.Five cases (0.7%,5/767) of early PJI were found in TKA patients in the control group, with a statistically significant difference ( P=0.030); 1 case of early PJI was found in each RA-TKA and UKA patients, with non-significant difference compared with vancomycin group (all P>0.05). Two cases (0.3%,2/782) of incisional complications were found in TKA patients in the vancomycin group, and 4 cases (0.5%, 4/767) of incisional complications were found in TKA patients in the control group, with non-significant difference( P=0.449); no incisional complication was found in RA-TKA patients in the vancomycin group, and 1 case (1.0%,1/99) of incisional complications were found in RA-TKA patients in the control group, the difference was not statistically significant ( P>0.05); no incisional complication was found in both groups of UKA patients.No vancomycin-related acute kidney injury, ototoxicity, or allergic reactions was observed in all patients. Conclusion:Intra-articular injection of 1 g of vancomycin suspension after arthrotomy closure during TKA maybe lower the risk of early PJI without increasing the risk of wound complication and vancomycin-associated systemic toxicity.

This report described one patient of giant polycystic liver and polycystic kidney involving iliac fossa. Preoperative computed tomography (CT) revealed a large polycystic kidney occupying partially iliac fossa space. A decompression of lower pole of original kidney was planned for placing transplanted kidney. During total liver resection plus orthotopic liver transplantation, right polycystic kidney could move up on its own and iliac fossa space was released for placing transplanted kidney smoothly. Polycystic kidney shrunk markedly post-operation. It provided references for surgical planning of combined liver-kidney transplantation for this type of disease.

Objective:To compare the efficacy of endoscopy and surgery in chronic pancreatitis.Methods:CNKI, CBM, Wanfang, PubMed, Cochrane Library, Embase and Web of Science were searched to compared endoscopy and surgery for the clinical efficacy of chronic pancreatitis. Literatures were searched from the establishment of the database to August 14, 2022. Compared pain relief, clinical response to initial treatment, complications, endocrine/exocrine insufficiency, length of hospital stay and mean number of procedures between the two groups. Manager 5.4.1 software was used for data analysis. Odds ratio ( OR) or weighted mean difference ( WMD) was calculated with 95% confidence interval (95% CI). Results:A total of seven studies were included, including three randomized controlled trials and four retrospective studies with 708 patients. There were 513 males and 195 females. Endoscopic interventions were performed in 364 patients and 344 patients underwent surgery. The results of meta-analysis showed that the total pain relief rate ( OR=0.38, 95% CI: 0.24-0.59) and the complete pain relief rate ( OR=0.47, 95% CI: 0.29-0.77), short-term (1-1.5 years) pain relief rate ( OR=0.42, 95% CI: 0.24-0.74), clinical relief rate ( OR=0.23, 95% CI: 0.10-0.55) were better than the endoscopic group, and could significantly reduce the number of reoperation ( WMD=1.64, 95% CI: 0.89-2.40), and the difference was statistically significant (all P<0.05). There were no significant differences in complications, new-onset endocrine insufficiency, new-onset exocrine insufficiency and length of hospital stay between the endoscopy group and the surgical group (all P>0.05). Conclusion:Surgical intervention is superior to endoscopic treatment in controlling pain associated with chronic pancreatitis and in clinical relief after the first treatment, and can effectively reduce the number of reoperations.

Objective:To evaluate the curative effect of 3D printing titanium trabecular metal （TTM） acetabular cups in revision of total hip arthroplasty （THA）.Methods:A retrospective case series study was conducted on the clinical data of 24 patients （25 hips） undergoing THA revision in Affiliated Hospital of Qingdao University from May 2016 to September 2019. There were 10 males and 14 females，aged 43-78 years ［（63.0 ± 11.4） years］. According to Paprosky classification，5 patients（5 hips） were classified as type Ⅰ，9 patients （10 hips） as type ⅡA，5 patients （5 hips） as type ⅡB，1 patient （1 hip） as type ⅡC and 4 patients （4 hips） as type ⅢC. All patients used 3D printing TTM cups. Seven patients （7 hips） were combined with 3D printing TTM pads，and 3 patients （3 hips） were combined with structural bone grafts. The visual analogue scale （VAS），Harris score and quality of life Health Survey Scale （SF-36） score were evaluated before operation，3 months after operation，12 months after operation and at the last follow-up. The X-ray film of hip joint was performed to evaluate the upward movement distance of hip center of rotation （HCOR），limb-length discrepancy （LLD） before operation，1 day after operation and at the last follow-up. The position of cups and bone ingrowth were evaluated at the last follow-up. The postoperative complications were observed.Results:All patients were followed up for 14-54 months ［（34.2 ± 9.3）months］. The VAS was （4.0 ± 0.7）points，（2.3 ± 0.8）points and （0.9 ± 0.2）points at postoperative 3 months，12 months and the last follow-up，significantly lower than that preoperatively ［（6.1 ± 1.0）points］ （ P < 0.05）. A statistically significant difference was found in the pairwise comparisons of postoperative VAS at postoperative 3 months，12 months and the last follow-up（ P < 0.05）. The Harris score was （64.6 ± 5.3）points，（80.5 ± 3.7）points，and （90.3 ± 3.6）points at postoperative 3 months，12 months and the last follow-up，significantly higher than that preoperatively ［（38.8 ± 6.2）points］ （ P < 0.05）. A statistically significant difference was found in the pairwise comparisons of postoperative Harris score at postoperative 3 months，12 months and the last follow-up（ P < 0.05）. The SF-36 score was （556.3 ± 21.9）points，（711.6 ± 15.9）points and （752.8 ± 23.0）points at postoperative 3 months，12 months and the last follow-up，significantly higher than that preoperatively ［（326.3 ± 30.7）points］ （ P < 0.05）. A statistically significant difference was found in the pairwise comparisons of postoperative SF-36 score at postoperative 3 months，12 months and the last follow-up（ P < 0.05）. The upward movement distance of HCOR was （13.5 ± 2.6）mm and （13.6 ± 2.6）mm on the first day after operation and at the last follow-up，significantly lower than that preoperatively ［（34.1 ± 3.5）mm］ （ P < 0.05）. The LLD was （6.2 ± 1.8）mm and （5.3 ± 1.5）mm on the first day after operation and at the last follow-up，significantly lower than that preoperatively ［（31.6 ± 5.2）mm］ （ P < 0.05）. All the cups were stable. Good bone ingrowth was found in 23 hips. There was no postoperative complication except for one patient with poor wound healing. Conclusion:For THA revision，the use of 3D printing TTM cups can effectively relieve pain，improve hip function，provide satisfactory biological fixation and and reduce complications.

OBJECTIVE: To analyze gene variants in a Chinese pedigree with oculocutaneous albinism (OCA). METHODS: Gene sequencing of the proband and his parents was performed using chip capture high-throughput sequencing and Sanger sequencing techniques, and PolyPhen-2, SIFT, MutationTaster, and FATHMM software were used to predict the function of new variants. At the same time,the pedigree and variant genes of 4 albinism patients from this pedigree were analyzed. RESULTS: Sequencing results showed that the proband's TYR gene (NM_000372) has c.230G>A (p.Arg77Gln) and c.120_121insG (p.Asp42GlyfsTer35) compound heterozygous variants. The proband's father carries c.230G>A heterozygous variant, and the mother carries c.120_121insG heterozygous variant, indicating that the proband's two variants are from his father and mother. The former is a known missense variant, which can cause abnormal or loss of the original function of the protein polypeptide chain. The latter c.120_121insG(p.Asp42GlyfsTer35) is an unreported frameshift variant of the TYR gene subregion (EX1; CDS1). PolyPhen-2, SIFT, MutationTaster and FATHMM predictions are all prompted as "harmful variants". This variant caused the amino acid encoded protein to terminate prematurely, producing a truncated protein, which eventually formed a 76-amino acid short-type TYR protein instead of the 529-amino acid wild-type TYR protein. Through the pedigree analysis, the four patients in the pedigree are all of the same type of compound heterozygous variants, and the disease-causing genes are all from the patient's parents. They belong to a special form of consanguineous marriage within 5 generations. CONCLUSION The compound heterozygous variants of c.230G>A (p.Arg77Gln) and c.120_121insG (p.Asp42GlyfsTer35) of the TYR gene may underlie the disease in this pedigree. The gene sequencing results enrich the variant spectrum of the TYR gene, and has facilitated molecular diagnosis for the patient.
Albinism, Oculocutaneous/genetics* ; Consanguinity ; Heterozygote ; Humans ; Mutation ; Pedigree

Objective:To investigate the influence of joint line alteration on the mid-term clinical effects of primary medial pivot total knee arthroplasty (MP-TKA).Methods:Data of a total 189 patients (233 knees) with 30 males (30 knees) and 159 females (203 knees) with age 66.42±6.12, diagnosed as knee osteoarthritis and underwent primary MP-TKA from January to December 2015, were retrospectively analyzed. All cases were followed up for at least 4 years. The patients were divided into four groups according to the extent of alteration, namely <-4 mm, -4- mm, 0- mm and >4 mm. Range of motion (ROM), Knee Society's Knee Scoring System (KSS), the Western Ontario and McMaster University (WOMAC) osteoarthritis index score were compared preoperatively and at 4 years postoperatively.Results:The postoperative follow-up duration was 52.20± 2.94 months (48-59 months). A total of 133 knee (57%) had joint line raised and 100 cases (43%) joint line distal shifted. The overall height of joint line before surgery was 16.56±3.54 mm (7.33-25.32 mm) and 17.34±2.92 mm (7.25-25.43 mm) postoperatively. The average alteration was 0.78±3.17 mm (-6.00-9.91 mm) with statistically significant difference ( t=-2.596, P=0.010). There was no statistical difference among the four groups in terms of gender, body mass index, pre-operative tibia slope and post condylar offset. The overall preoperative ROM of the all groups was 90.45°±20.44°, which increased from baseline to 108.95°±12.55° at 4 years postoperatively ( t=-22.381, P<0.001). There was statistical difference in term of ROM among each group ( F=7.101, P<0.001). The ROM in group 0- mm and >4 mm was significantly higher than that in group <-4 mm and -4- mm ( P<0.05). The KSS function score and clinic score at 4 years postoperatively were significantly higher that those before surgery, the WOMAC score was statistically lower at 4 years postoperatively ( F=0.723, P<0.001; F=1.138, P<0.001; F=2.502, P<0.001). There was no significant difference among the four groups in terms of KSS score and WOMAC ( P>0.05). One case in >4 mm group had gasket prolapse at 6 month after surgery and 3 cases with immediate anterior knee pain occurred in <-4 mm group. Conclusion:MP-TKA can lead to significant joint line alteration. The overall ROM after surgery is positively correlated with the quantity of joint line alteration. However, there was no correlation between quantity of joint line alteration and the joint function scores. Thus, MP-TKA can achieve good mid-term clinical effects.