Abstract:On Mar. 17, 2023, Annual Sleep Report of China 2023 (abbreviated as Report) was released in Beijing. The Report collected the data of 6 343 people in 2022, and conducted a systematic research on sleep problems from the perspectives of sociology and social psychology, reporting the sleep status of different groups, the relationship between sleep and quality of life, mental health, well being, and social mentality. The Report found that the boundaries between work and sleep are becoming more blurred, which exacerbates the differences between people in sleep time, sleep duration, and sleep quality, leading to inequalities in sleep and health. The Report has a novel research perspective and a large sample size, while it lacks reliable measurement tools and needs further intervention and longitudinal research.

Abstract:Objective To explore the disability status of the elderly with depressive symptoms or non-depressive symptoms and its influencing factors. Methods Based on the data of the 8^th questionnaire of Chinese longitudinal healthy longevity survey (CLHLS), 11 382 elderly aged 65 years or older were enrolled. Chi square test was used to analyze the relationship between depressive symptoms, demographic characteristics, sociological characteristics, life style, health status and disability; and binary logistic regression analysis was used to explore the main influencing factors of disability in the elderly. Results Totally 1 341 (11.78%) participants had depressive symptoms; the disability of the elderly with depressive symptoms (29.90%, 401/1 341) was significantly higher than that of the elderly without depressive symptoms (20.09%, 2 017/10 041) (P＜0.001). Gender, annual income, alcohol use, or number of chronic diseases was not significantly correlated to disability status in the depressive symptom group, but there was a significant correlation with disability status in the non-depressive symptom group (all P＜0.01). For the elderly with non-depressive symptoms, urban, age≥80 years, body mass index (BMI)＜18.5 kg/m² or ≥28.0 kg/m², being widowed, living in a nursing home, and with 2 or more chronic diseases were risk factors for disability (all P＜0.05); and living alone and having exercise and social activities were protective factors (all P＜0.001). For the elderly with depressive symptoms, urban, age≥80 years, BMI＜18.5 kg/m² or ≥28.0 kg/m², being widowed, and with 2 or more chronic diseases were risk factors for disability (all P＜0.05), while living alone and having social activities were protective factors (both P＜0.001). Conclusion The disability of the elderly with depressive symptoms is more common than that of the elderly with non-depressive symptoms. Urban, age≥80 years, BMI＜18.5 kg/m² or ≥28.0 kg/m², being widowed, and with 2 or more chronic diseases are the risk factors for disability, while living alone and having social activities are protective factors.

Abstract:Objective To investigate the correlation of low triiodothyronine (T3) syndrome with the severity and prognosis of patients with anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis. Methods The clinical data of 32 patients with anti-NMDAR encephalitis diagnosed in The First Affiliated Hospital of Naval Medical University (Second Military Medical University) from Jan. 2016 to Jan. 2021 were retrospectively analyzed. According to the serum free triiodothyronine (FT3) level measured for the first time after admission, the patients were divided into low T3 syndrome group and normal thyroid function group, and the demographic information and clinical characteristics of the 2 groups were compared. According to the modified Rankin scale (mRS) score at 2-4 weeks after onset, the patients were divided into good prognosis group (mRS＜3) and poor prognosis group (mRS≥3), and the clinical characteristics and laboratory findings of the 2 groups were compared. Pearson bivariate correlation analysis was used to explore the correlation of low T3 syndrome with the severity and prognosis of anti-NMDAR encephalitis. Results Among the 32 patients, 14 (43.75%) had low T3 syndrome. Compared with the patients in the normal thyroid function group, the patients in the low T3 syndrome group had higher incidence of consciousness disorder, higher mRS score at admission, higher rates of epilepsy and pulmonary infection, higher abnormal rate of cranial magnetic resonance imaging, and higher mortality (all P＜0.05). The proportions of patients with poor prognosis combined with low T3 syndrome, status epilepticus, fever, or pulmonary infection were higher than those of patients with good prognosis (all P＜0.05). Correlation analysis showed that FT3 level was negatively correlated with mRS scores (r＝－0.514，P＝0.003). Conclusion The change of thyroid hormone levels in patients with anti-NMDAR encephalitis may be related to the self-protection in vivo, and may be a potential biomarker of poor prognosis in patients with severe anti-NMDAR encephalitis. Routine monitoring of FT3 level has important clinical significance in risk stratification and prognosis prediction of anti-NMDAR encephalitis patients.

Abstract:Objective To evaluate the expression of chaperonin containing TCP1 subunit 6A (CCT6A) in non-small cell lung cancer (NSCLC) tissue, and explore its correlation with the clinicopathological features and prognosis of NSCLC patients. Methods A total of 160 NSCLC patients who underwent surgical resection were retrospectively enrolled, and their clinicopathological data and follow-up information were collected. The surgical resection samples of all patients (including 160 cases of cancer tissue samples and 50 cases of adjacent tissue samples) were collected, and the expression of CCT6A was detected by immunohistochemistry. The expression of CCT6A in cancer tissue of NSCLC patients with different clinicopathological characteristics was compared. The patients were divided into low expression group (n＝70) and high expression group (n＝90) according to the expression level of CCT6A. The relationship between the expression of CCT6A and prognosis was discussed by survival analysis and multivariate Cox regression analysis. Results CCT6A was mainly expressed in the cytoplasm and cell membrane, and its expression level in the cancer tissue was significantly higher than that in the adjacent tissue (4.8±2.9 vs 2.5±1.7, P＜0.01). The expression level of CCT6A was not correlated with clinicopathological characteristics of patients, such as age, gender, smoking, drinking, hypertension, hyperlipidemia, diabetes mellitus, tumor size, histological type, or TNM stage (all P＞0.05). However, the expression levels of CCT6A in cancer tissue of patients with high Eastern Cooperative Oncology Group performance status (ECOG PS) score, poor tumor differentiation, or lymph node metastasis were significantly higher than those of patients with low ECOG PS score, good tumor differentiation, or no lymph node metastasis (all P＜0.05). In addition, disease-free survival (DFS) and overall survival (OS) were significantly shorter in patients with high CCT6A expression in cancer tissue than in patients with low CCT6A expression (both P＜0.05). Multivariate Cox regression analysis showed that high expression of CCT6A in cancer tissue was an independent predictor of poor DFS (P＝0.001), but not an independent predictor of OS. Conclusion CCT6A is highly expressed in NSCLC tissue, and its high expression is associated with poor tumor differentiation, lymph node metastasis, and high ECOG PS score in NSCLC patients, and can be used to predict the risk of recurrence.

Abstract:Objective To investigate the protective effect of Jinyin Lidan capsule (JYLD) on carbon tetrachloride (CCl₄)-induced hepatic fibrosis in rats. Methods Totally 40 SD rats were randomly divided into 5 groups: blank group, model group, silymarin (positive drug) group, JYLD low-dose group, and JYLD high-dose group, with 8 rats in each group. Except for the blank group, rats in other groups were given intraperitoneal injection of 40% CCl₄ twice a week for 6 weeks to induce rat hepatic fibrosis. Rats in the silymarin group (0.1 g/kg), JYLD low-dose group (0.6 g/kg), and JYLD high-dose group (1.2 g/kg) were continuously gavaged once a day for 6 weeks during the modeling period. Rat liver index and spleen index were calculated after the experiment; hematoxylin-eosin staining and Masson staining were used to observe the pathological changes and fibrosis in rat liver tissue; the contents of alanine transaminase (ALT), aspartate transaminase (AST), and total bile acids (TBA) in rat serum were detected by automatic biochemistry; the antioxidant capacity of rat serum was determined by superoxide dismutase (SOD) assay kit; the levels of inflammation indicators (interleukin［IL］-6, IL-1β, and tumor necrosis factor［TNF］-α) in rat serum were detected by enzyme-linked immunosorbent assay (ELISA); the expression of α-smooth muscle actin (α-SMA) was detected by immunohistochemical staining; and the relative expression of collagen (Col) Ⅰ, Col Ⅲ,Col Ⅳ, nuclear factor κB (NF-κB), matrix metalloproteinase 2 (MMP-2), tissue inhibitor of metalloproteinase 1 (TIMP-1), and transforming growth factor β1 (TGF-β1) mRNA in rat liver tissue was determined by quantitative polymerase chain reaction, and MMP-2/TIMP-1 ratio was calculated. Results Compared with the model group, the liver index was decreased in the JYLD low- and high-dose groups (both P＜0.01); the serum ALT, AST, and TBA contents were decreased (P＜0.05, P＜0.01); the degree of hepatic fibrosis was improved, and the SOD activity in serum was increased (both P＜0.01); the levels of IL-6, IL-1β, and TNF-α were decreased (P＜0.05, P＜0.01); the positive expression of α-SMA was decreased (P＜0.05, P＜0.01); the relative expression of Col Ⅰ, Col Ⅲ, Col Ⅳ, NF-κB, MMP-2, TIMP-1, and TGF-β1 mRNA was decreased (P＜0.05,P＜0.01); and the MMP-2/TIMP-1 ratio was decreased (P＜0.05, P＜0.01). Conclusion JYLD has a protective effect on CCl₄-induced liver fibrosis in rats, and its mechanism may be related to anti-inflammatory effect, reducing extracellular matrix deposition, and inhibiting hepatic stellate cell activation.

Abstract:Objective To investigate the effect and mechanism of axon guidance molecule semaphorin 3A (SEMA3A) on the apoptosis of retinal ganglion cells (RGCs) in diabetic rats. Methods Forty adult male SD rats were randomly divided into control group (normal feeding), model group (establishing diabetic retinopathy ［DR］ model by intraperitoneal injection of streptozotocin), si-SEMA3A group (intravitreal injection of 10 μL SEMA3A-siRNA lentivirus ［titer 1×10⁹ IU/mL］ after establishing DR model), and si-SEMA3A＋DAPT group (intravitreal injection of 10 μL SEMA3A-siRNA lentivirus ［titer 1×10⁹ IU/mL］ and 10 μL Notch1 pathway inhibitor N-(N-((3,5-difluorophenyl)acetyl)-L-alanyl-L-2-phenyl)glycine-1,1-dimethylethyl ester ［DAPT, 10 μmol/L］ after establishing DR model), with 10 rats in each group. Samples were collected after 12 weeks of treatment in each group; immunofluorescence staining by double labeling of SEMA3A and POU domain transcription factor 3a (Brn3a, a RGC marker) was used to detect the expression and localization of retinal SEMA3A protein; hematoxylin-eosin staining was used to detect the density of RGCs; terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling (TUNEL) method was used to detect the apoptosis of RGCs; enzyme-linked immunosorbent assay (ELISA) was used to detect the expression levels of retinal inflammatory factors interleukin 6 (IL-6) and tumor necrosis factor α (TNF-α); and Western blotting was used to detect the expression levels of SEMA3A, Notch1, and cysteine aspartic acid specific protease 3 (caspase 3) in retinal tissues. Results The specific expression of SEMA3A in RGCs was confirmed by double-labeled immunofluorescence staining. Compared with the control group, the density of RGCs in the model group was significantly lower (P＜0.05). The density of RGCs in the si-SEMA3A group was significantly higher than that in the model group and si-SEMA3A＋DAPT group (both P＜0.05). No TUNEL-positive RGCs were detected in the retinal tissue of control rats. In the model group, there were more TUNEL-positive RGCs in the retinal tissue of rats, with a RGC apoptosis rate of (49.55±7.82) %. Compared with the model group, the apoptosis rate of the si-SEMA3A group was significantly lower (P＜0.05), while the apoptosis rate of the si-SEMA3A＋DAPT group was significantly higher than that of the si-SEMA3A group (P＜0.05). Compared with the control group, the expression levels of IL-6, TNF-α, SEMA3A, and caspase 3 in the model group were significantly higher, while the expression level of Notch1 was significantly lower (all P＜0.05). Compared with the model group, the expression levels of IL-6, TNF-α, SEMA3A, and caspase 3 were significantly lower in the si-SEMA3A group, while the expression level of Notch1 was significantly higher (all P＜0.05). The expression levels of IL-6, TNF-α, SEMA3A, and caspase 3 in the si-SEMA3A＋DAPT group were significantly higher than those in the si-SEMA3A group, while the expression level of Notch1 was significantly lower (all P＜0.05). Conclusion SEMA3A may be involved in the apoptosis of RGCs in diabetic rats via the Notch1 signaling pathway, and is expected to be a therapeutic target for DR.

Abstract:Objective To investigate the protective effect of marine traditional Chinese medicine coral calcium hydride on skin extravasation ulcer induced by epirubicin in mice, so as to provide basis for the clinical application of coral calcium hydride. Methods The mouse skin exosmotic ulcer model created by epirubicin was established. Then the mice were divided into control group (treated with routine treatment and normal saline irrigation) and experimental group (treated with routine treatment and 0.375 g/cm² coral calcium hydride in the early, middle, and late of the day, respectively). The area, degree, and healing time of exosmotic ulcer of model animals in the 2 groups were observed and recorded. After continuous treatment for 15 d, the ulcer tissue was resected and the pathomorphological changes were observed by hematoxylin-eosin (H-E) staining. The expression of Ki-67, oxidative stress-related indexes heme oxygenase 1 (HO-1), nicotinamide adenine dinucleotide phosphate oxidase 2 (NOX2), inducible nitric oxide synthase 2 (iNOS2), and superoxide dismutase 1 (SOD1) in the skin and subcutaneous tissue was detected by immunohistochemistry. Results The incidence of exosmotic ulcer was 100.0% (5/5) in the control group and 60.0% (3/5) in the experimental group. The ulcer area of the experimental group was significantly less than that of the control group (P＜0.05), and the ulcer healing speed was significantly faster than that of the control group. H-E staining showed that the subcutaneous connective tissue was disordered, with hair follicle dilated and squamous epithelium thickened in the control group, while the subcutaneous tissue in the experimental group was slightly disordered, with dilated hair follicle rarely seen and thickened squamous epithelium. Immunohistochemistry showed that the expression of Ki-67 in subcutaneous tissue of the experimental group was higher than that of the control group, the expression of iNOS2 and NOX2 in the control group was significantly higher than that of the experimental group (bothP＜0.05), and the expression of HO-1 and SOD1 in the control group was significantly lower than that of the experimental group (both P＜0.05). Conclusion Marine traditional Chinese medicine coral calcium hydride has a good protective effect on skin ulcer caused by epirubicin extravasation.

Abstract:Objective To establish a cell bubble contact injury model for studying the pathogenesis of bubble-related diseases such as decompression sickness. Methods A cell bubble contact device was designed, including a bubble generating syringe, a cell culture dish, and a punching device. Bubbles with different diameters could be obtained by changing the diameter of the bubble generating syringe end, and the dose-effect relationship between cell damage, bubble diameter and contact time was observed by propidium iodide (PI) staining and cell counting kit 8 (CCK-8) cell viability test in primary cultured rat pulmonary microvascular endothelial cells (PMVECs), so as to establish a stable cell bubble contact injury model. Results The results of PI staining showed that there was no obvious damage to PMVECs after 1, 2, 3, or 4 h of 0.5 mm bubble contacting, while bubbles with diameters of 1.0, 1.5, and 2.0 mm increased the death of PMVECs after contacting 1, 2, 3, and 4 h; and the larger the bubble diameter and the longer the contact time, the more death of PMVECs were. Compared with the control group, CCK-8 cell viability test showed that bubbles with diameters of 1.0, 1.5, and 2.0 mm significantly decreased the viability of PMVECs after contacting 1, 2, 3, and 4 h (allP＜0.01). However, the cell damage of PMVECs was obvious only when the 2.0 mm diameter bubble was touched for more than 3 h. The cell viability was (84.27±1.35)% when the bubble with diameter 2.0 mm contacted the PMVECs for 3 h. Conclusion This study establishs a stable cell bubble contact injury model, which can be used to study bubble- related diseases such as decompression sickness. In addition, for PMVECs, 3 h of bubble contact with a diameter of 2.0 mm is the optimal condition for bubble-induced injuries.

Abstract:Objective To construct a green fluorescence protein (GFP) adenovirus vector specifically labeled with peroxisomes (Ad-GFP-Peroxi). Methods The GFP sequence modified with peroxisome signal peptide sequence was designed. The sequence fragment was amplified by polymerase chain reaction and linked with adenovirus shuttle plasmid vector (pAdTrack); then the connecting product was transformed into E. coli DH5α. The recombinant plasmids were obtained from DH5α cells and sequenced for identification. The recombinant plasmid was linearized by PmeⅠ, and homologous recombination was carried out in BJ5183 competent cells containing pAdEasy-1. The recombinant plasmid was linearized by PacⅠ, and then used to infect 293A cells for virus packaging to obtain Ad-GFP-Peroxi particles. Rat cardiomocytes H9C2 were infected with Ad-GFP-Peroxi adenovirus or Ad-GFP adenovirus, and the green fluorescence intensity was observed under fluorescence microscope after 48 h. H9C2 cells infected with Ad-GFP-Peroxi adenovirus were divided into 2 groups (normal culture group and 1% oxygen concentration group), observed under confocal microscope after 24 h, and the fluorescence signal aggregation was analyzed. Results The recombinant Ad-GFP-Peroxi was successfully constructed. Compared with Ad-GFP, Ad-GFP-Peroxi could specifically display the distribution of peroxisomes in H9C2 cells. Peroxisomes accumulated in H9C2 cells after hypoxia stimulation. Conclusion Ad-GFP-Peroxi is successfully constructed by homologous recombination, and it can highly infect rat cardiomyocytes H9C2, clearly showing the distribution of peroxisomes in cardiomyocytes under confocal microscope.

Abstract:Hydroxyapatite/polymer composite scaffolds have excellent mechanical properties, biodegradability, osteogenic activity, and sustained release function. With them as cell growth factors, cell and drug carriers for bone repair have become one of the research foci in bone tissue engineering. This article mainly reviews the research progress of hydroxyapatite/polymer composite scaffolds loaded with cell growth factors, cells, and drugs in the treatment of bone injuries or defects in recent years.

Abstract:Tachyarrhythmia is an important clinical feature of septic shock. Poorly controlled persistent tachycardia is closely related to poor prognosis. The pathogenesis of septic shock-related tachyarrhythmia is complex, and drug therapy is still the main choice to control septic shock-related arrhythmia. Diversity of drug choices exists, so the selection and use of antiarrhythmic drugs need to be further studied. This article mainly reviews the research progress in the pathogenesis and treatment of septic shock-related tachyarrhythmia.

Abstract:Three major gynecological malignancies (ovarian cancer, endometrial cancer, and cervical cancer) severely affect women’s life and health. The development and progression of tumors are complex and closely related to the tumor microenvironment. Cancer-associated fibroblast (CAF) is an important part of the tumor microenvironment, having the ability to secrete a variety of cytokines and synthesize cell-matrix proteins. Fibroblast activation protein (FAP) is one of the most potential molecular markers of CAF, can promote the proliferation, migration, and invasion of tumor cells, remodel the extracellular matrix, and induce tumor neovascularization. It is an indispensable factor in tumorigenesis. The research of FAP (as a tumor diagnostic tracer and a targeted drug) has made some progress, which provides a new direction for the diagnosis and treatment of gynecological malignancies.

Abstract:Objective To investigate the job burnout of naval officers and soldiers in hot environment, explore the impact of social support on job burnout, and analyze the mediating effect of psychological capital between them. Methods A total of 588 naval officers and soldiers stationed in hot environment were randomly selected and surveyed with self-compiled general situation questionnaires, military job burnout scale, military personnel social support scale, and positive psychological capital questionnaire. Pearson product-moment correlation analysis was used to explore the correlation between variables, multiple stepwise regression analysis was used to predict the effects of social support and psychological capital on job burnout, and a structural equation model was constructed to test the mediating effect. Results The job burnout of naval officers and soldiers in hot environment was significantly higher than that of naval officers and soldiers in the ordinary environment (P＜0.01), and the diminished achievement was the most obvious (P＜0.01). There was significant correlation between social support, psychological capital, and job burnout (all P＜0.01). Objective support, support utilization, resilience, and hope could jointly explain 35.10% of variance variability of job burnout. The mediating effect model and Bootstrap test showed that psychological capital played a partial mediating effect between social support and job burnout (χ²/df＝4.762, goodness of fit index was 0.937, adjusted goodness of fit index was 0.904, normed fit index was 0.953, relative fit index was 0.939, incremental fit index was 0.962, Tucker-Lewis index was 0.951, comparative fit index was 0.962, and root mean square error of approximation was 0.080). Conclusion In the hot environment, psychological capital partially mediates the association between social support and job burnout of the naval officers and soldiers.

Abstract:Intestinal flora coevolutes with the host and plays an important role in maintaining immune homeostasis. It participates in the development and progression of a variety of diseases, directly or indirectly through metabolites. Researchers have proposed the theories of the “gut-brain axis” and “gut-lung axis” based on the interrelationship between intestinal microecology and other organs. These theories have been widely verified in basic and clinical research fields. Long voyage personnel are prone to intestinal flora disorder and often suffer from other health problems. At present, studies should be actively carried out to clarify the relationship between intestinal flora disorder and health status of long voyage personnel and explore reasonable intervention measures to maintain intestinal microecological balance, improving the quality of life and preventing diseases among them.

Abstract:Objective To explore the effects of extraction orthodontic treatment on upper airway morphology and hyoid bone position in adolescent patients with skeletal class Ⅱ high angle. Methods Sixty adolescent patients with skeletal classⅡ high angle who were treated in the Department of Orthodontics, Hospital of Stomatology, Jilin University from Jan. 2013 to Jan. 2019 were enrolled. All of them were treated with straight wire appliance. According to the different treatment strategies, they were divided into extraction group and non-extraction group, with 30 cases in each group. The upper airway, hyoid bone, and craniomaxillofacial tissue of the lateral cephalograms were fixed-point, depicted, and measured before and after orthodontic treatment. Results Compared with before treatment, the extraction group showed decreases in subspinale-nasion-supramental angle (ANB), upper incisor-SN plane (U1-SN), and lower incisor-mandibular plane (L1-MP) after treatment, while showed increases in posterior nasal spine-upper pharyngeal wall (PNS-UPW), posterior nasal spine-vallecula (PNS-V), hyoid-sella (H-S), occlusal plane-SN plane (OP-SN), and upper incisor-lower incisor (U1-L1), with statistically significant differences (all P＜0.05). Compared with before treatment, the non-extraction group showed a decrease in ANB and increases in PNS-V, H-S, and OP-SN after treatment, also with statistically significant differences (all P＜0.05). Conclusion Due to the growth and development of adolescents, the sagittal diameter and vertical height of the upper airway in adolescent patients with skeletal classⅡ high angle increase to a certain extent after treatment in both groups, and the hyoid bone position shows a trend of downward and forward displacement. Therefore, extraction orthodontic treatment has almost no adverse effect on the upper airway of adolescent patients with skeletal class Ⅱ high angle.

Abstract:Objective To compare the efficacies of nickel-titanium (NiTi) shape memory arch nail and distal tibiofibular screw in the treatment of Maisonneuve fracture (MFF). Methods The clinical data of 33 patients with MFF treated at our hospital from Jan. 2019 to Dec. 2021 were retrospectively collected. According to the treatment methods, the patients were divided into 2 groups: shape memory arch nail treatment group (arch nail group, 13 cases) and distal tibiofibular screw treatment group (screw group, 20 cases). The surgical time and intraoperative blood loss were compared between the 2 groups, and the surgical outcomes were evaluated according to the American Association of Orthopaedic Foot and Ankle Surgeons (AOFAS) scoring criteria at the last follow-up. Results There were no significant differences in the surgical time (［118.46±19.55］ min vs ［113.50±17.97］ min) or intraoperative blood loss (［90.77±53.85］ mL vs［94.50±46.53］ mL) between the 2 groups (both P＞0.05). Both groups achieved primary wound healing after surgery without local complications such as skin necrosis or wound infection. All patients in both groups were followed up for 6 to 24 months, with an average follow-up duration of (14.70±5.20) months. At the last follow-up, there were no significant differences in the overall evaluation score of ankle joint function or ankle joint symptom evaluation score of AOFAS between the 2 groups (both P＞0.05). Conclusion Both NiTi shape memory arch nail and distal tibiofibular screw are effective in treating combined injuries of the distal tibiofibular joint in MFF. In addition, NiTi shape memory arch nail not only can preserve the physiological movement of the ankle joint and distal tibiofibular joint, but also requires no routine removal before weight-bearing. Therefore, it is a treatment method worthy of promotion.

Abstract:Objective To compare the clinical efficacies of transumbilical single-port laparoscopic myomectomy, traditional multi-port laparoscopic myomectomy, and laparotomy myomectomy, and to investigate the effect of transumbilical single-port laparoscopy on myomectomy. Methods The clinical data of 97 patients who underwent myomectomy in the Department of Obstetrics and Gynaecology, Zhujiang Hospital of Southern Medical University from Jun. 2020 to Dec. 2021 were retrospectively analyzed. There were 24 cases in the single-port group (who underwent transumbilical single-port laparoscopic myomectomy), 42 cases in the multi-port group (who underwent traditional multi-port laparoscopic myomectomy), and 31 cases in the laparotomy group (who underwent laparotomy myomectomy). Surgical indicators (including operation time and intraoperative blood loss), postoperative recovery indicators (including the first postoperative exhausting time, first postoperative time out of bed, and postoperative hospital stays), and hospitalization costs were compared and analyzed. According to the preoperative imaging examination, the patients with uterine fibroids were further stratified, and the clinical efficacies of transumbilical single-port laparoscopic, multi-port laparoscopic, or laparotomy myomectomy in patients with single and multiple, subserosal and intramural uterine fibroids were compared and analyzed. The clinical efficacies of transumbilical single-port laparoscopic surgery for single and multiple, subserosal and intermural myomectomy were also compared and analyzed. Results Compared with the multi-port group and laparotomy group, the first postoperative time out of bed in the single-port group was significantly shorter (both P＜0.01). Compared with the laparotomy group, the first postoperative exhausting time and postoperative hospital stays of the single-port group were significantly shorter, while the operation time was significantly longer and the hospitalization costs was significantly higher (P＜0.05, P＜0.01). There were no significant differences in the operation time, first postoperative exhausting time, postoperative hospital stays, or hospitalization costs between the single-port group and multi-port group (all P＞0.05). The single-port group had more intraoperative blood loss than the multi-port group at the early stage (P＜0.05), but there was no significant difference in the intraoperative blood loss between the 2 groups at the later stage (P＞0.05). Among the patients with 4 different types of uterine fibroids, the comparative analysis of the 3 surgical procedures was generally consistent with the above. In the transumbilical single-port laparoscopic surgery, the operation time of the single uterine fibroid group was significantly shorter than that of the multiple uterine fibroid group (P＜0.05), the first postoperative time out of bed in the subserosal uterine fibroid group was significantly shorter than that of the intermural uterine fibroid group (P＜0.01). Conclusion The clinical efficacy of transumbilical single-port laparoscopic myomectomy is equivalent to those of conventional multi-port laparoscopy and laparotomy, but the postoperative recovery is faster. Patients with single and subserosal uterine fibroids are more suitable for transumbilical single-port laparoscopic surgery.

Abstract:Objective To observe the effect of icariin on vascular erectile dysfunction (ED) in rats and explore its mechanism. Methods The vascular ED rat model was established by ligation of bilateral internal iliac arteries. Then, they were randomly divided into 5 groups (n＝10): model group (intragastric administration of 1 mL/d normal saline), tadalafil group (intragastric administration of tadalafil solution at a dose of 0.8 mg/kg per day), and low-, middle-, and high-dose icariin groups (intragastric administration of icariin suspension at doses of 20, 40, and 80 mg/kg per day, respectively). The sham operation group (n＝10) was given 1 mL/d normal saline intragastrically. After 4 weeks of modeling, the maximum intracavernous pressure (ICP_max) was measured after stimulating the corpus cavernosum nerve of rats to evaluate the erectile function. After continuous intragastric administration for 30 d, the corpus cavernosum of rats was taken, and the levels of α-smooth muscle actin (α-SMA), sphingosine-1-phosphate (S1P), and sphingosine-1-phosphate receptor 1 (S1PR1) in the corpus cavernosum were detected by enzyme-linked immunosorbent assay. The tissue fibrosis of corpus cavernosum was measured by Masson staining, and the integral optical density (IOD) of the collected images was calculated. The relationship between ICP_max and the levels of α-SMA, S1P, and S1PR1 in corpus cavernosum in each group were analyzed by linear regression. Results The ICP_max in the tadalafil group was significantly higher than that in the low-dose icariin group, but significantly lower than that in the middle- and high-dose icariin groups (all P＜0.05). The IOD of corpus cavernosum in the tadalafil group was significantly lower than that in the low- and middle-dose groups of icariin, but significantly higher than that in the high-dose icariin group (all P＜0.05). The expression level of α-SMA in corpus cavernosum of rats in the tadalafil group was significantly lower than that in the high-dose icariin group, but significantly higher than that in the low- and middle-dose icariin groups (all P＜0.05). The expression level of S1P in corpus cavernosum in the tadalafil group was significantly lower than that in the middle- and high-dose icariin groups (both P＜0.05). The expression level of S1PR1 in corpus cavernosum in the tadalafil group was significantly lower than that in the low-, middle- and high-dose icariin groups (all P＜0.05). Linear regression analysis showed that there were linear regression relationships between α-SMA, S1P, S1PR1 levels and ICP_max (all P＜0.05). Conclusion Icariin can significantly improve the erectile function of vascular ED rats. It may improve the erectile function by regulating the levels of S1P and S1PR1 to promote the neogenesis and stability of vascular endothelium.

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