OBJECTIVE To study the pharmacological substance basis of Shaoyao gancao decoction for relieving acute and chronic pain. METHODS The antispasmodic effect of Shaoyao gancao decoction， ethyl acetate extract of Shaoyao gancao decoction and its effluent part of macroporous resin and 90% ethanol elution part of macroporous resin （the concentration of 4 drugs was 13.44 g/mL according to crude drug） was observed by in vitro small intestine tension test in rats. The acetic acid writhing test was conducted in mice to evaluate the analgesic effects of macroporous resin efflux site and macroporous resin 90% ethanol elution site （the dosage of 2.4 g/kg according to crude drug）. The levels of tumor necrosis factor-α （TNF-α）， interleukin-1β （IL- 1β）， prostaglandin E2 （PGE2） and cyclooxygenase-2 （COX-2） in serum of mice were detected. The serum prototype and metabolites of mice after intragastric administration of macroporous resin 90% ethanol elution site were identified by high performance liquid chromatogre-time-of-flight mass spectrometry. RESULTS In vitro experiment showed that 90% ethanol eluting part of macroporous resin represented the best antispasmodic effect， and the inhibitory rate of small intestine tension was significantly higher than macroporous resin efflux site of Shaoyao gancao decoction （P＜0.05） without statistical significance， compared with Shaoyao gancao decoction （P＞0.05）. In the acetic acid writhing experiment， compared with model group， the writhing times of mice in the macroporous resin 90% ethanol elution part group were reduced significantly （P＜0.05）， the writhing latency was prolonged significantly （P＜0.05）， and the levels of COX-2， IL-1β， PGE2 and TNF-α in serum were decreased significantly （P＜0.05）. Ten kinds of protoproducts including paeoniflorin and glycyrrhizic acid were identified from serum of mice， and twenty-two kinds of metabolites including hydroxylated glycyrrhizin and glucosylated liquiritin were identified. CONCLUSIONS The effective part of Shaoyao gancao decoction for relieving acute and chronic pain is 90% ethanol elution part prepared by macroporous resin from the ethyl acetate extract. Ten components， including glycyrrhetinic acid and paeoniflorin， may be the basis of its pharmacological substances.

Objective To investigate the international occupational classification of rehabilitation-therapy professionals,and analyze the core competencies,to improve the occupational system of rehabilitation-therapy professionals in China. Methods According to Standard Country or Area Codes for Statistical Use that prepared by the Statistics Division of the United Nations and Human Development Index of each country or area,the occupational classification of rehabil-itation-therapy professionals in the International Labour Organization(ILO)and 17 typical countries or areas was compared,and rehabilitation competency framework(RCF)was used to analyze the core competencies. Results The occupational classification or similar documents of ILO and 15 countries or areas were obtained.Except China categorizing rehabilitation-therapy professionals as technicians,all the documents set detailed occupations of rehabilitation-therapy professionals such as physical therapist and speech therapist as formal full-time occupa-tion;and ILO and 14 countries or areas defined these detailed occupations as professional occupation.The core competencies of technicians only involved a very small number of competencies and activities in RCF,while the core competencies of detailed occupations of rehabilitation-therapy professionals covered the vast majority of competencies and activities in RCF.There were differences in RCF competencies and activities involved in the core competencies of detailed occupations of rehabilitation-therapy professionals. Conclusion The core competencies are different between rehabilitation-therapy professionals and technicians,and among different detailed occupations of rehabilitation-therapy professionals.It is important for China to establish the detailed occupations of rehabilitation-therapy professionals as formal full-time occupation.The education re-lated to therapy and rehabilitation in China is gradually aligning with international standards,legislation on occu-pational qualification admission for rehabilitation-therapy professionals should be carried out,and make the reha-bilitation-therapy professionals to be professional occupation.

Objective:To explore the influence of deviation of the bolt in femoral neck system (FNS) on the short-term outcomes in young and middle-aged patients with displaced femoral neck fracture.Methods:A retrospective analysis was conducted of the 114 young and middle-aged patients with displaced femoral neck fracture who had been treated with FNS at Department of Orthopaedics, Suzhou Municipal Hospital from December 2019 to January 2023. Based on the postoperative measurements of the deviation of the bolt tip to the central axis of the femoral head and neck (W), the patients were divided into a central group (W≤20%) and a deviation group (W>20%). In the central group of 63 cases, there were 27 males and 36 females with a mean age of (46.4±8.0) years. In the deviation group of 51 cases, there were 20 males and 31 females with a mean age of (45.1±9.8) years. The 2 groups were compared in terms of weight-bearing time, fracture healing time, tip-apex distance, degree of femoral neck shortening, Harris Hip Score and EuroQol five-dimensional questionnaire-5L (EQ-5D-5L) utility value at the last follow-up, as well as complications and revision surgeries.Results:There was no statistically significant difference in the preoperative general information, auxiliary reduction or quality of fracture reduction between the 2 groups, showing comparability between groups ( P>0.05). There was no significant difference in the partial weight-bearing time between the 2 groups ( P>0.05). In the central group, the full weight-bearing time [15.0 (14.0, 16.0) weeks] and fracture healing time [14.0 (12.0, 15.0) weeks] were significantly shorter than those in the deviation group [16.0 (15.0, 19.0) weeks; 15.0 (13.0, 17.0) weeks], the tip-apex distance [(21.4±3.4) mm] was significantly shorter than that in the deviation group [(23.5±2.7) mm], the Harris Hip Score [(90.6±6.1) points] and EQ-5D-5L utility value [0.9 (0.8, 0.9)] at the last follow-up were significantly higher than those in the deviation group [(87.7±6.2) points; 0.9 (0.8, 0.9)], and the incidences of moderate and severe femoral neck shortening [25.4% (16/63)], avascular necrosis of the femoral head [0 (0/63)] and revision surgery [0 (0/63)] were significantly lower than those in the deviation group [66.7% (34/51), 7.8% (4/51), 9.8% (5/51)] (all P< 0.05). Conclusion:A closer positioning of the FNS bolt to the central axis of the femoral head and neck favors satisfactory short-term outcomes and a lower revision surgery rate in young and middle-aged patients with displaced femoral neck fracture.

Objective: Cardiac magnetic resonance (CMR) is a diagnostic tool that provides precise and reproducible information about cardiac structure, function, and tissue characterization, aiding in the monitoring of chemotherapy response in patients with lightchain cardiac amyloidosis (AL-CA). This study aimed to evaluate the feasibility of CMR in monitoring responses to chemotherapy in patients with AL-CA. Materials and Methods: In this prospective study, we enrolled 111 patients with AL-CA (50.5% male; median age, 54 [interquartile range, 49–63] years). Patients underwent longitudinal monitoring using biomarkers and CMR imaging. At followup after chemotherapy, patients were categorized into superior and inferior response groups based on their hematological and cardiac laboratory responses to chemotherapy. Changes in CMR findings across therapies and differences between response groups were analyzed. Results: Following chemotherapy (before vs. after), there were significant increases in myocardial T2 (43.6 ± 3.5 ms vs. 44.6 ± 4.1 ms; P = 0.008), recovery in right ventricular (RV) longitudinal strain (median of -9.6% vs. -11.7%; P = 0.031), and decrease in RV extracellular volume fraction (ECV) (median of 53.9% vs. 51.6%; P = 0.048). These changes were more pronounced in the superior-response group. Patients with superior cardiac laboratory response showed significantly greater reductions in RV ECV (-2.9% [interquartile range, -8.7%–1.1%] vs. 1.7% [-5.5%–7.1%]; P = 0.017) and left ventricular ECV (-2.0% [-6.0%–1.3%] vs. 2.0% [-3.0%–5.0%]; P = 0.01) compared with those with inferior response. Conclusion Cardiac amyloid deposition can regress following chemotherapy in patients with AL-CA, particularly showing more prominent regression, possibly earlier, in the RV. CMR emerges as an effective tool for monitoring associated tissue characteristics and ventricular functional recovery in patients with AL-CA undergoing chemotherapy, thereby supporting its utility in treatment response assessment.

  Objective  Myocardial fibrosis is a potential mechanism of light-chain myocardial amyloidosis(AL-CA). This research aimed at exploring the correlation between multiparameter cardiac magnetic resonance (CMR) and myocardial fibrosis by relating the CMR myocardial tissue characteristics, the morphological and the functional parameters with gallium-68-labeledfibroblast activation protein inhibitor 04 positron emission tomography (⁶⁸Ga-FAPI PET).  Methods  We gave the patients diagnosed with AL-CA in Peking Union Medical College Hospital from August to December 2021 the examinations of CMR and ⁶⁸Ga-FAPI PET/CT. We recorded and analyzed the information on clinical manifestations and examinations of the patients.  Results  A total of 23 patients with AL-CA were included, 15 (65.2%)of which were male and the mean age was 58.3±6.5 years. Patients with high ⁶⁸Ga-FAPI-04 uptake had shown growth in myocardial extracellular volume (ECV), significantly higher than those in the negative group (P=0.047). In addition, patients' myocardial ECV was positively correlated with myocardial FAPI uptake (r=0.628, P=0.001;r=0.727, P < 0.001;r=0.661, P=0.001). Patients in the positive group showd reduced left ventricular (LV) ejection fraction (EF)(P < 0.001).LVEF (r=-0.798, P < 0.001;r=-0.794, P < 0.001; r=-0.795, P < 0.001) and right ventricular (RV)EF (r=-0.735, P < 0.001;r=-0.739, P < 0.001;r=- 0.684, P < 0.001) showd negatively correlated with myocardial FAPI uptake, LV circumferential strain (r=0.668, P < 0.001;r=0.708, P < 0.001;r=0.705, P < 0.001), LV longitudinal strain (r=0.629, P=0.001;r=0.635, P=0.001; r=0.597, P=0.003), and RV longitudinal strain (r=0.575, P=0.004; r=0.792, P < 0.001;r=0.673, P < 0.001) were negatively correlated with myocardial FAPI uptake.  Conclusions  FAPI-related fibroblast activation is concurrent with CMR-related abnormal myocardial interstitial characteristics that leads to the decreased function of the myocardial movement. Patients with increased FAPI uptake present with increased ECV, decreased EF, and decreased strain with morphological abnormalities.

Neovascularization plays an important role in many physiological and pathological processes, but its mechanism is still unclear. Since vascular cells are subjected to a variety of biochemical and biomechanical stimulations in vivo and live in a complex microenvironment, it is necessary to construct the vascular model in vitro and simulate the in vivo microenvironment to explore the mechanism of neovascularization. Recently, owing to the advance of micromachining and microfluidic technology, various in vitro microvascular models have emerged. Variables such as shear stress, interstitial flow and biochemical gradient of angiogenic factors have been controlled in these models, which greatly promotes the research of neovascularization. The construction, development and biomechanical design of various microvascular models are reviewed in this paper.

Objective:To evaluate the role of extracellular signal-regulated kinase 1/2 (ERK1/2)/cyclic adenosine monophosphate response element-binding protein (CREB)/brain-derived neurotrophic factor (BDNF) signaling pathway in dexmedetomidine-induced inhibition of propofol-caused apoptosis in isolated hippocampal neurons of fetal rats.Methods:Pregnant Sprague-Dawley rats at 16 days of gestation were sacrificed, and the fetal rats were taken out, and hippocampal neurons of fetal rats were obtained and primarily cultured in vitro for 7 days.The neurons were divided into 9 groups ( n=12 each) using a random number table method: control group (group C), fat emulsion group (group I), dimethyl sulfoxide (DMSO) group, dexmedetomidine group (group D), propofol group (group P), propofol plus dexmedetomidine group (group PD), PD98059 plus propofol plus dexmedetomidine group (group PDP), MH89 plus propofol plus dexmedetomidine group (group HDP), and KG501 plus propofol plus dexmedetomidine group (group KDP). Group C received no treatment.In group I, 20% fat emulsion was added, and the neurons were incubated for 30 min, and 0.25% DMSO was added in group DMSO, and the neurons were incubated for 30 min.Dexmedetomidine at a final concentration of 10 μmol/L was added, and the neurons were incubated for 30 min in group D. Propofol at a final concentration of 100 μmol/L was added, and the neurons were incubated for 3 h in group P. In group PD, dexmedetomidine at a final concentration of 10 μmol/L was added, the neurons were incubated for 30 min, propofol at a final concentration of 100 μmol/L was added, and the neurons were incubated for 3 h. In PDP, HDP and KDP groups, 25 μmol PD98059 (p-ERK1/2 inhibitor), 10 μmol H89 (p-CREB inhibitor) and 25 μmol KG501 (CREB inhibitor) were added, respectively, the neurons were incubated for 30 min, dexmedetomidine at a final concentration of 10 μmol/L was added, the neurons were incubated for 30 min, and propofol at a final concentration of 100 μmol/L was added, and the neurons were incubated for 3 h. The cell ultrastructure was observed with the transmission electron microscope, the apoptosis in neurons was detected by flow cytometry, the expression of ERK1/2, CREB and BDNF mRNA was detected by quantitative real-time polymerase chain reaction, and the expression of p-ERK1/2, CREB, p-CREB, BDNF and cleaved caspase-3 was detected by Western blot. Results:Compared with group C, the apoptosis rate was significantly increased, the expression of p-ERK1/2 and p-CREB was down-regulated, and the expression of cleaved caspase-3 was up-regulated in P, PD, PDP, HDP and KDP groups, and the expression of BDNF was significantly down-regulated in P, PDP, HDP and KDP groups ( P<0.05). Compared with group P, the apoptosis rate was significantly decreased, the expression of p-ERK1/2, p-CREB and BDNF was up-regulated, and the expression of cleaved caspase-3 was down-regulated in group PD ( P<0.05). Compared with group PD, the apoptosis rate was significantly increased, the expression of p-ERK1/2, p-CREB and BDNF was down-regulated, and the expression of cleaved caspase-3 was up-regulated in PDP, HDP and KDP groups ( P<0.05). Conclusion:The ERK1/2/CREB/BDNF signaling pathway is involved in dexmedetomidine-induced inhibition of propofol-caused apoptosis in isolated hippocampal neurons of fetal rats.

Objective:To compare the short-term outcomes between robotic completely portal surgery and robotic-assisted surgery used for lung cancer treatment.Methods:Lung cancer patients treated with robotic surgery in our institution from October 2014 to August 2018 were enrolled. Baseline information and postoperative outcomes were collected. All patients were divided into two approaches and abbreviated as 3-armed utility incision assisted lung surgery(RAL-3) and 4-armed completely portal lung surgery(RPL-4). Short-term outcomes of two approaches were compared after propensity score-matched(PSM) analysis.Results:A total of 471 patients were included in this study: 252 patients underwent robotic-assisted surgery with a utility incision and 219 patients underwent robotic completely portal surgery. After propensity score-matched( PSM) analysis, each group included 159 cases. The comparison of the two groups showed that there were no significant differences in chest tube duration( P=0.307), postoperative hospital stays( P=0.829), analgesics use( P=0.789), the postoperative visual analogue pain score(VAS)( P>0.05), the SF-12 score( P>0.05) and complications( P=0.265). However, RPL-4 caused less blood loss(52.11 ml vs. 70.00 ml, P<0.001) and shorter surgical time of RPL-4(122.74 min vs. 153.16 min, P<0.001). Conclusion:RPL-4 showed relatively shorter operative time and less intraoperative blood loss than RAL-3. Both RAL-3 and RPL-4 are safe and feasible for patients with lung.

Objective To study the effect of simulated microgravity on activity of the store-operated calcium (SOC) channels in osteocytes and its possible mechanism, so as to elucidate the potential mechanism of weightlessness bone loss. Methods Osteocytes (MLO-Y4) as the experimental subjects were divided into simulated microgravity (SM) group and normal gravity group (CON). After rotating for 24 h and 48 h, confocal microscope was used to detect the intracellular calcium ion concentration level to reflect activity of the SOC channels after thapsigargin (TG)-induced endoplasmic reticulum (ER) depletion. Immunofluorescence staining was used to observe the distribution of ER membrane protein IP3R and spectrin membrane skeleton, in order to preliminarily explore the possible mechanism of functional changes of SOC channels. Results During the period of calcium release from ER, ［Ca2+］i had no significant difference between SM group and CON group for 24 h and 48 h; while during the period of extracellular calcium influx by SOC channels, ［Ca2+］i of SM group had significant differences in the first 4 minutes for 24 h, as well as in the whole time for 48 h. Compared with CON group, the spectrin membrane skeleton of SM group was gathered at the rim of membrane, while ER membrane protein IP3R of SM group was gathered at the nuclear envelope of ER. These two tendencies were more obvious for 48 h. Conclusions The stimulated microgravity could inhibit activity of SOC channels in osteocytes. Changes in the distribution of the spectrin membrane skeleton and ER membrane protein IP3R under the simulated microgravity might reduce the activity of SOC channels by affecting the conformation coupling process between the membrane and ER.

Microfluidic technology refers to the technique of precise fluid control by manipulating submillimeter-scale fluids. In recent years, the use of microfluidic technology has realized the construction of organ-on-chips. The organ-on-chip refers to a micro-model with physiological functions, and cultivating living cells in a continuously perfused micro-chamber to simulate the physiological functions of tissues and organs. As the physiological function of the organ-on-chip has many advantages such as definite function, controllable microenvironment, rich measurement information, low chemical consumption, low cost, promising automation and high throughput, it has a huge application prospect in the field of drug development to solve the bottleneck problems in cellular and animal experiments, which has caused a great concern in the academic community. Although the organ-on-chip is still a very young research field, some microfluidic organ-on-chips have been developed and their potential applications are explored, including drug target optimization, drug screening and toxicity tests, and biomarker identification. In this review, the progress made in microfluidic organ microchips and their potential significance in clinical research were analyzed.