Abstract Objective: The objective of this study was to investigate the clinical effect of overlap anastomosis and functional end-to-end anastomosis (FEEA) in laparoscopic radical resection of colorectal cancer (CRC). Methods: The clinical data of 180 patients who underwent laparoscopic radical resection of CRC and side-to-side anastomosis were retrospectively collected; the patients were divided into the Overlap group and FEEA group, according to the anastomosis method that was used to treat them. Results: The Overlap group had a shorter operation time, anastomosis time, post-operative hospital stay, post-operative feeding time, and post-operative exhaust time than the FEEA group (p < 0.05). The total incidence of post-operative complications was 14.4% (13/90) in the FEEA group and 0.7% (6/90) in the Overlap group, and there was no significant difference between the two groups (p > 0.05). Conclusions: Overlapping anastomosis can shorten the operation time and accelerate the recovery of intestinal function without increasing the incidence of post-operative complications, and it will not affect the quality of life and survival of patients in the short term after surgery.

Resumen Objetivo: Investigar el efecto clínico de la anastomosis superpuesta y de la anastomosis funcional de extremo a extremo (AFEE) en la resección radical laparoscópica del cáncer colorrectal (CCR). Método: Se recolectaron retrospectivamente los datos clínicos de 180 pacientes sometidos a resección radical laparoscópica de CCR y anastomosis de lado a lado. Los pacientes se dividieron en grupo de anastomosis superpuesta y grupo AFEE, según el método de anastomosis que se utilizó para tratarlos. Resultados: El grupo de anastomosis superpuesta tuvo un tiempo de operación, un tiempo de anastomosis, una estancia hospitalaria posoperatoria, un tiempo de alimentación posoperatorio y un tiempo de escape posoperatorio más cortos que el grupo AFEE (p < 0.05). La incidencia total de complicaciones posoperatorias fue del 14.4% (13/90) en el grupo AFEE y del 0.7% (6/90) en el grupo de anastomosis superpuesta, y no hubo diferencias significativas entre los dos grupos (p > 0.05). Conclusiones: La anastomosis superpuesta puede acortar el tiempo operatorio y acelerar la recuperación de la función intestinal sin aumentar la incidencia de complicaciones posoperatorias, y sin afectar la calidad de vida y la supervivencia de los pacientes a corto plazo después de la cirugía.

Abstract Objectives Research has demonstrated that obesity may be associated with rheumatoid arthritis (RA). In addition, gut microbiota and its metabolites contribute to the occurrence and development of RA and obesity. However, the mechanism by which obesity affects RA remains unclear. In this study, we aimed to investigate whether gut microbiota and their metabolites alter the effects of high fat diet (HFD) on the severity of collagen-induced arthritis (CIA) in mice. Methods Briefly, mice were divided into normal group (N), CIA model group (C), HFD group (T), and HFD CIA group (CT). Hematoxylin and Eosin staining(HE) and Safranin O-fast green staining were conducted, and levels of blood lipid and inflammatory cytokines were measured. 16S rDNA sequencing technique and liquid chromatography-mass spectrometry (LC-MS)-based metabolomics were performed to explore changes in the microbiota structure to further reveal the pathomechanism of HFD on CIA. Results HFD aggravated the severity of CIA in mice. The CT group had the highest proportion of microbial abundance ofBlautia, Oscillibacter, Ruminiclostridium-9, andLachnospiraceaeUCG 006 at the genus level, but had a lower proportion of Alistipes. Additionally, the fecal metabolic phenotype of the combined CT group shows significant changes, with differential metabolites enriched in 9 metabolic pathways, including primary bile acid biosynthesis, arginine biosynthesis, sphingolipid metabolism, purine metabolism, linoleic acid metabolism, oxytocin signaling pathway, aminoacyl-tRNA biosynthesis, the pentose phosphate pathway, and sphingolipid signaling pathway. Correlation analysis revealed that some of the altered gut microbiota genera were strongly correlated with changes in fecal metabolites, total cholesterol (TC), triglyceride (TG), and inflammatory cytokine levels. Conclusions This study shows that HFD may aggravate inflammatory reaction in CIA mice by altering the gut microbiota and metabolic pathways. RA. . (RA) addition However unclear (HFD collageninduced collagen induced (CIA Briefly N, N , (N) C, C (C) T, T (T) CT. (CT) stainingHE HE staining(HE Ofast O fast conducted measured S chromatographymass chromatography mass LCMSbased LC MS based ofBlautia Oscillibacter Ruminiclostridium9, Ruminiclostridium9 Ruminiclostridium 9, Ruminiclostridium-9 00 level Alistipes Additionally pathways biosynthesis metabolism pathway aminoacyltRNA aminoacyl tRNA TC, TC (TC) TG, TG (TG) (RA (N (C (T (CT Ruminiclostridium- 0 (TC (TG

ABSTRACT In this paper, the robust finite-time control for impact angle guidance of missile dynamic system with uncertainties is investigated by combining linear extended state observer (LESO) and adaptive non-singular fast terminal sliding mode method. Specially for dealing with existing uncertainties including time-varying parametric perturbation and nonparametric disturbances in high order line-of-sight rates and target acceleration, a robust LESO strategy is proposed for designing sliding mode-based impact angle guidance, which can guarantee that estimation error converges to the neighborhood of the origin in finite-time. Based on the proposed LESO framework, an adaptive non-singular fast terminal sliding mode guidance law is considered for realizing interception of maneuvering targets, which can guarantee asymptotically stability of the system. Simulation results are shown for confirming effectiveness of the proposed guidance strategy of this paper. Compared with former methods, accuracy of estimation is increased by nearly two times, and miss distance is reduced by nearly two times. paper finitetime finite time (LESO nonsingular non singular method timevarying varying lineofsight line sight acceleration modebased based finitetime. time. framework targets methods times

Abstract Despite the record speed of developing vaccines and therapeutics against the SARS-CoV-2 virus, it is not a given that such success can be secured in future pandemics. In addition, COVID-19 vaccination and application of therapeutics remain low in developing countries. Rapid and low cost mass production of antiviral IgY antibodies could be an attractive alternative or complementary option for vaccine and therapeutic development. In this article, we rapidly produced SARS-CoV-2 antigens, immunized hens and purified IgY antibodies in 2 months after the SARS-CoV-2 gene sequence became public. We further demonstrated that the IgY antibodies competitively block RBD binding to ACE2, neutralize authentic SARS-CoV-2 virus and effectively protect hamsters from SARS-CoV-2 challenge by preventing weight loss and lung pathology, representing the first comprehensive study with IgY antibodies. The process of mass production can be easily implemented in most developing countries and hence could become a new vital option in our toolbox for combating viral pandemics. This study could stimulate further studies, optimization and potential applications of IgY antibodies as therapeutics and prophylactics for human and animals.

Abstract Introduction: nutritional status and platelet-to-lymphocyte ratio (PLR) have been found to be associated with prognosis in patients with hepatocellular carcinoma (HCC) undergoing transcatheter arterial chemoembolization (TACE). Objectives: to evaluate the association between nutritional status and PLR in patients with HCC undergoing TACE. Methods: a total of 152 HCC patients received TACE were enrolled. The nutritional status was evaluated by Patient-Generated Subjective Global Assessment (PG-SGA). Patients with PG-SGA A and PG-SGA (B or C) were classified as the well-nourished and malnourished groups. Results: according to the PG-SGA, 130 (85.5 %) patients were malnourished. The median PLR was significantly different between well-nourished and malnourished groups (p = 0.008). A positive correlation was found between PLR and PG-SGA score (r = -0.265, p = 0.001). The optimal PLR cutoff value was 102.165 to predict malnutrition, with a sensitivity of 65.4 %, specificity of 72.7 %, and an area under the curve (AUC) of 0.677 (95 % confidence interval (CI): 0.550-0.804; p = 0.008). A logistic stepwise regression model showed that the PLR was associated with nutritional status in Model 1 without adjustment, as well as if adjusted by age, sex, type of TACE (c-TACE/DEB-TACE) and Child–Pugh stage (odds ratio, 0.190; 95 % CI: 0.062-0.582; p = 0.004). Conclusions: nutritional status measured by PG-SGA was significantly associated with PLR in patients with HCC undergoing TACE.

Resumen Introducción: se ha encontrado que el estado nutricional y el índice plaquetas-linfocitos (PLR) se asocian con el pronóstico en pacientes con carcinoma hepatocelular (CHC) sometidos a quimioembolización transarterial (TACE). Objetivos: evaluar la asociación entre el estado nutricional y la PLR en pacientes con CHC sometidos a TACE. Métodos: se evaluaron 152 pacientes con CHC que recibieron TACE. El estado nutricional fue evaluado por Evaluación Global Subjetiva Generada por el Paciente (PG-SGA). Los pacientes con PG-SGA A y PG-SGA (B o C) se clasificaron como los grupos bien nutridos y desnutridos. Resultados: según la PG-SGA, 130 (85,5 %) pacientes estaban desnutridos. La mediana de PLR fue significativamente diferente entre los grupos bien nutridos y desnutridos (p = 0,008). Se encontró una correlación positiva entre PLR y la puntuación PG-SGA (r = -0,265, p = 0,001). El valor de corte óptimo de PLR fue de 102,165 para predecir la malnutrición, con una sensibilidad del 65,4 %, una especificidad del 72,7 % y un área bajo la curva (AUC) de 0,677 (intervalo de confianza [IC] del 95 %: 0,550-0,804; p = 0,008). Un modelo de regresión logística escalonada mostró que el PLR se asoció con el estado nutricional en el Modelo 1 sin ajuste, así como cuando se ajustó por edad, sexo, tipo de TACE (c-TACE/DEB-TACE) y etapa Child-Pugh (odds ratio, 0,190; IC 95 %: 0,062-0,582; p = 0,004). Conclusiones: el estado nutricional medido por PG-SGA se asoció significativamente con PLR en pacientes con CHC sometidos a TACE.

Abstract Purposes: Braided and laser-cut stents both are efficacious and safe for coiling intracranial aneurysms. The study aimed to compare outcomes following braided stent-assisted coil embolization versus laser engraved stent-assisted coil embolization in 266 patients who were diagnosed with unruptured intracranial aneurysms of different types and locations. Methods: Patients with unruptured complex intracranial aneurysms underwent braided (BSE cohort, n = 125) or laser engraved (LSE cohort, n = 141) stent-assisted embolization. Results: The deployment success rate was higher for patients of the LSE cohort than those of the BSE cohort (140 [99%] vs. 117 [94%], p = 0.0142). Seventy-one (fifty-seven percentages) and 73 (52%) were coil embolization procedure success rates of the BSE and the LSE cohorts. Periprocedural intracranial hemorrhage was higher in patients of the BSE cohort than those of the LSE cohort (8 [6%] vs. 1 [1%], p = 0.0142). Four (three percentages) patients from the LSE cohort and 3 (2%) patients from the BSE cohort had in-stent thrombosis during embolization. Permanent morbidities were higher in patients of the LSE cohort than those of the BSE cohort (8 [6%] vs. 1 [1%], p = 0.0389). Higher successful procedures (76% vs. 68%) and fewer postprocedural intracranial hemorrhage (0% vs. 5%) and mortality (0% vs. 5%) were reported for patients of the BSE cohort in posterior circulation aneurysmal location than those of the LSE cohort. Laser engraved stent has fewer problems with deployment and may have better periprocedural and follow-up outcomes after embolization. Conclusions: Braided stent-assisted embolization should be preferred when the aneurysm is present in the posterior circulation. Purposes lasercut cut stentassisted assisted 26 locations Methods 125 141 Results 140 (14 99% 99 [99% vs 11 94%, 94 94% , [94%] 0.0142. 00142 0.0142 . 0 0142 0.0142) Seventyone Seventy one fiftyseven fifty seven percentages 7 52% 52 (52% cohorts 8 ( 6% 6 [6% 1%, 1% [1%] three 2% 2 (2% instent 0.0389. 00389 0.0389 0389 0.0389) 76% 76 (76 68% 68 0% (0 5% 5 followup follow up Conclusions 12 14 (1 9 [99 [94% 0014 0.014 014 (52 [6 [1% (2 0038 0.038 038 (7 [9 [94 001 0.01 01 (5 [ [1 003 0.03 03 00 0.0 0.

Abstract Background and objective Systemic sclerosis (SSc) is an immune-mediated rheumatic disease characterized by fibrosis and vascular lesions. Interstitial lung disease is an early complication of SSc and the main cause of death from SSc. Although baricitinib shows good efficacy in a variety of connective tissue diseases, its role in systemic sclerosis-related interstitial lung disease (SSc-ILD) is unclear. The objective of our study was to explore the effect and mechanism of baricitinib in SSc-ILD. Methods We explored crosstalk between the JAK2 and TGF-β1 pathways. In vivo experiments, SSc-ILD mice model were constructed by subcutaneous injection of PBS or bleomycin (7.5 mg/kg) and intragastric administration of 0.5% CMC-Na or baricitinib (5 mg/kg) once every two days. We used ELISA, qRT-PCR, western blot and immunofluorescence staining to evaluate the degree of fibrosis. In vitro experiments, we used TGF-β1 and baricitinib to stimulate human fetal lung fibroblasts (HFLs) and assessed protein expression by western blot. Results The vivo experiments showed that baricitinib notably alleviated skin and lung fibrosis, decreased the concentration of pro-inflammatory factors and increased those of the anti-inflammatory factors. Baricitinib affected the expression of TGF-β1 and TβRI/II inhibitiing JAK2. In the vitro experiments, following the culture of HFLs with baricitinib or a STAT3 inhibitor for 48 h, the expression levels of TβRI/II decreased. Conversely, with successful inhibition of TGF-β receptors in HFLs, JAK2 protein expression decreased. Conclusions Baricitinib attenuated bleomycin-induced skin and lung fibrosis in SSc-ILD mice model by targeting JAK2 and regulating of the crosstalk between the JAK2 and TGF-β1 signaling pathways. (SSc immunemediated immune mediated lesions diseases sclerosisrelated related SScILD ILD (SSc-ILD unclear SScILD. ILD. JAK TGFβ1 TGFβ TGF β1 β pathways 7.5 75 7 5 (7. mg/kg mgkg mg kg 05 0 0.5 CMCNa CMC Na ( days ELISA qRTPCR, qRTPCR qRT PCR, PCR qRT-PCR (HFLs proinflammatory pro inflammatory antiinflammatory anti TβRIII TβRI II STAT 4 h Conversely bleomycininduced induced 7. (7 0.

Abstract The surfactant-polymer-based (S/P) fracturing fluid combines the advantages of the surfactant-based and polymer-based fracturing fluids. In this study, the synergistic tackifying of cationic surfactants and carboxymethyl hydroxyethyl cellulose and the potential application in hydraulic fracturing fluid was investigated. Firstly, cetyltrimethylammonium chloride (CTAC) and salicylic acid (SA) with a weight ratio of 4:1 were optimized as the main agent of the small molecule surfactant gel, which was then mixed with carboxymethyl 2-hydroxyethyl ether cellulose (CMHEC) and salicylic acid (SA) to obtain the S/P gel. The proppant suspension performance, gel-breaking properties, salt-resistance and thermal stability of the optimized S/P were evaluated to confirm their potential application in the hydraulic fracturing fluid. These results showed that the performance of the S/P fracturing fluid system was much better than the performance of the surfactant fracturing fluid and also the performance of polymer fracturing fluid. surfactantpolymerbased based SP S P (S/P surfactantbased polymerbased fluids study investigated Firstly CTAC (CTAC SA (SA 41 4 1 4: gel 2hydroxyethyl 2 CMHEC (CMHEC gelbreaking breaking properties saltresistance salt resistance

Abstract Objective The study explored improvements in pulmonary inflammation and fibrosis in a bovine type II collagen-induced rheumatoid arthritis-associated interstitial lung disease mouse model after treatment with baricitinib and the possible mechanism of action. Methods A rheumatoid arthritis-associated interstitial lung disease mouse model was established, siRNA Jak2 and lentiviral vectors were transfected with human embryonic lung fibroblast cells. And the levels of relevant proteins in mouse lung tissue and human embryonic lung fibroblasts were detected by Western blotting. Results The levels of JAK2, p-JAK2, p-STAT3, p-SMAD3, SMA, TGFβR2, FN and COL4 were increased in the lung tissues of model mice (P < 0.5) and decreased after baricitinib intervention (P < 0.05). The expression levels of p-STAT3, p-SMAD3, SMA, TGFβR2, FN and COL4 were reduced after siRNA downregulation of the JAK2 gene (P < 0.01) and increased after lentiviral overexpression of the JAK2 gene (P < 0.01). Conclusion Baricitinib alleviated fibrosis in the lung tissue of rheumatoid arthritis-associated interstitial lung disease mice, and the mechanism of action may involve the downregulation of Smad3 expression via inhibition of the Jak2/Stat3 signaling pathway, with consequent inhibition of the profibrotic effect of transforming growth factor-β1. collageninduced collagen induced arthritisassociated arthritis associated established Jak cells blotting JAK pJAK2, pJAK2 pJAK p p-JAK2 pSTAT3, pSTAT3 pSTAT STAT3, STAT3 STAT p-STAT3 pSMAD3, pSMAD3 pSMAD SMAD3, SMAD3 SMAD p-SMAD3 SMA TGFβR2 TGFβR COL P 0.5 05 0 5 0.05. 005 0.05 . 0.05) 0.01 001 01 0.01. Smad Jak2Stat3 JakStat Stat3 Stat Jak2/Stat pathway factorβ1. factorβ1 factorβ factor β1. β1 β factor-β1 p-JAK p-STAT p-SMAD 0. 00 0.0 Jak2Stat factor-β

RESUMO Introdução O exercício de kung fu tem um efeito significativo no tratamento da hérnia discal lombar, atendendo efetivamente à circulação interna e externa do sistema funcional corporal humano, a função de movimento do disco intervertebral lombar pode ser efetivamente reparada. Objetivo Analisar e explorar o efeito de reabilitação com kung fu nos sintomas da hérnia de disco intervertebral lombar. Métodos 85 pacientes com hérnia de disco lombar foram divididos aleatoriamente em um grupo de controle e um grupo de kung fu. Resultados A comparação entre o grupo de artes marciais antes e depois do experimento mostrou uma diferença muito significativa (p<0,05); não houve diferença significativa no grupo controle. A taxa efetiva total no grupo de kung fu foi de 97,67%, e a taxa de recidiva foi de 2,33%. A taxa efetiva total do grupo de controle foi de 90,48%, e a taxa de recidiva foi de 21,43%. Conclusões O exercício de kung fu é benéfico para o relaxamento dos músculos da cintura, alivia o tônus muscular, aumenta a força muscular; pode melhorar os sintomas clínicos e os sinais de hérnia de disco lombar. Nível de evidência II; Estudos terapêuticos - Investigação de resultados.

ABSTRACT Introduction Kung fu exercise has a significant effect in treating lumbar disc herniation, effectively meeting the internal and external circulation of the human body functional system, the lumbar intervertebral disc movement function can be effectively repaired. Objective analyze and explore the effect of kung fu rehabilitation on symptoms of lumbar intervertebral disc herniation. Methods 85 patients with lumbar disc herniation were randomly divided into a control and a kung fu group. Results The comparison between the martial arts group before and after the experiment showed a very significant difference (p<0.05); there was no significant difference in the control group. The total effective rate in the kung fu group was 97.67%, and the relapse rate was 2.33%. The total effective rate of the control group was 90.48%, and the relapse rate was 21.43%. Conclusions Kung fu exercise is beneficial for the relaxation of waist muscles, relieves muscle tone, increases muscle strength, may improve clinical symptoms and signs of lumbar disc herniation. Evidence level II; Therapeutic Studies - Investigating the results.

RESUMEN Introducción el ejercicio de kung fu tiene un efecto significativo en el tratamiento de la hernia discal lumbar, atendiendo eficazmente a la circulación interna y externa del sistema funcional del cuerpo humano, la función de movimiento del disco intervertebral lumbar puede repararse eficazmente. Objetivo Analizar y explorar el efecto de la rehabilitación con kung fu en los síntomas de la hernia discal intervertebral lumbar. Métodos 85 pacientes con hernia discal lumbar fueron divididos aleatoriamente en un grupo de control y un grupo de kung fu. Resultados La comparación entre el grupo de artes marciales antes y después del experimento mostró una diferencia altamente significativa (p<0,05); no hubo diferencia significativa en el grupo de control. La tasa de efectividad total en el grupo de kung fu fue del 97,67%, y la tasa de recaída fue del 2,33%. La tasa efectiva total del grupo de control fue del 90,48%, y la tasa de recidiva del 21,43%. Conclusiones El ejercicio de kung fu es beneficioso para la relajación de los músculos de la cintura, alivia el tono muscular, aumenta la fuerza muscular; puede mejorar los síntomas y signos clínicos de la hernia discal lumbar. Nivel de evidencia II; Estudios terapéuticos - Investigación de resultados.

A series of novel betulin-28-hydrazone derivatives (7a-7o) were synthesized. All compounds were evaluated for their in vitro cytotoxicities in four human carcinoma cells (HepG2, MCF-7, HCT-116 and A549). Among them, compound 7l displayed the most potent cytotoxicity with an IC50 (concentration of the tested compound that inhibits 50% of cell growth) value of 7.37 ± 0.38 μM against MCF-7 cells. The preliminary cellular mechanism studies indicated that compound 7l could induce MCF-7 cells apoptosis. The above findings indicated that compound 7l may be used as a lead compound for antitumor agents with improved efficacy.

Abstract Vitamin D is necessary for maintaining the bone function, and its deficiency is linked with the development of obesity. Moreover, bone health is correlated with obesity through many mechanisms by modulating bone marrow mesenchymal stem cells to differentiate as adipose cells, inflammatory response, glucose metabolism, oxidative homeostasis, energy metabolism and gut microbiota. Based on previous studies, vitamin D, obesity, and bone health are linked with each other at multiple levels. However, our knowledge of the associations of vitamin D with coexisting abnormalities, such as bone health-related issues and obesity, is still in its infancy. The complex relationships still need to be investigated and elucidated further. Therefore, in this review, the relationships between vitamin D, obesity and bone health have been discussed. This review identified that evidence proving the capacity to reduce or prevent obesity-related disorders by targeting vitamin D intakes is mainly unknown. However, the inverse relationships of vitamin D levels with obesity and bone health-related issues are apparent.

Abstract Xuezhikang (XZK) is an extract of Chinese red yeast rice. It has multiple protective effects in cardiovascular systems. However, the underlying mechanism by which XZK affects free fatty acid (FFA)-induced lipogenesis in hepatocellular steatosis model is still unknown. Herein, we investigated this mechanism in HepG2 cells. The HepG2 cells were treated with palmitate acid (PA) to induce lipogenesis. Then the PA-induced HepG2 cells were subsequently treated with XZK. After 24 h of treatment, we determined the intracellular triglyceride (TG) contents and average areas of lipid droplets. To study the involvement of AMPK signaling pathway, we pre-treated the PA-induced HepG2 cells with Compound C, an AMPK inhibitor, before XZK treatment. Expressions of p-AMPK and AMPK were determined by Western blot. The results showed that XZK decreased TG content and lipid accumulation in hepatocellular steatosis model. Compound C abolished the effects of XZK. These results demonstrated for the first time that XZK protects hepatocytes against lipid accumulation induced by free fatty acids. Its effects may be mediated by the activation of AMPK pathway.

A study was conducted to evaluate the effect of yeast peptide supplementation on growth performance, nutrient digestibility, and blood metabolites in geese. One-day-old Sichuan white geese (n = 300, 95.16 ± 1.98 g) were randomly assigned to five dietary treatment groups containing either 0 (control), 100, 200, 300, or 400 mg/kg commercial yeast peptide product. Compared with the control, dietary supplemental yeast peptide at 200 mg/kg substantially improved feed conversion ratio, body slope length, half-eviscerated percentage, and the apparent digestibility of phosphorus. With the increase in dietary yeast peptide, breast width, carcass percentage, serum triglyceride and high-density lipoprotein increased linearly. The average daily gain, pelvis width, half-diving depth, low density lipoprotein, and digestibility of gross energy exhibited quadratic responses with the increase in dietary yeast peptide, with the 200 mg/kg or 300 mg/kg feeding level being the most effective. It can be concluded that dietary supplementation of yeast peptides improves growth performance and affects nutrient digestibility and blood metabolites, which were optimized at 200 mg/kg or 300 mg/kg of yeast peptide in the present study.

RESUMO Objetivo: Avaliar o efeito da pomada Chahuang, uma pomada à base de ervas chinesas, na prevenção de flebite em pacientes com cateter central de inserção periférica. Método: Este foi um estudo multicêntrico randomizado controlado, com 171 pacientes elegíveis aleatoriamente designados em um de três grupos: o grupo de pomada Chahuang, o grupo de creme de polissulfato de mucopolissacarídeo e o grupo de controle. Os graus de lesões das veias em 72 horas após a inserção do cateter central perifericamente inserido foram o resultado primário. Os desfechos secundários foram a espessura da parede vascular, edema tecidual e microtrombos avaliados por Color Doppler Flow Imaging, o fator de crescimento endotelial vascular e a expressão da endotelina-1 (ET-1) in vivo. Resultados: Comparado com o grupo controle, o grupo de pomada Chahuang apresentou incidência significativamente menor de flebite pós-operatória, edema de tecido e microtrombos 72 horas após a inserção do cateter central inserido perifericamente (todos P <0,01). A expressão de VEGF e ET-1 foi significativamente inibida no grupo de pomada Chahuang após 3 dias de tratamento (ambos P <0,01). Não houve diferenças estatísticas no grau de lesões das veias, microtrombos ou edema de tecido entre os grupos de pomada de Chahuang e polissulfato de mucopolissacarídeo (todos P> 0,05). Conclusão: A pomada Chahuang demonstrou fornecer prevenção e proteção eficazes contra flebite após a inserção do cateter central perifericamente inserido.

ABSTRACT Objective: To assess the effect of Chahuang ointment, a Chinese herbal ointment, on the prevention of phlebitis in patients with peripherally inserted central catheters. Method: This was a multicenter randomized controlled trial, with 171 eligible patients randomly assigned into one of three groups: the Chahuang ointment group, the Mucopolysaccharide Polysulfate cream group, and the control group. The degrees of vein injuries at 72 hours after peripherally inserted central catheter insertion were the primary outcome. Secondary outcomes were the vascular wall thickness, tissue edema and microthrombus evaluated by Color Doppler Flow Imaging, the vascular endothelial growth factor, and endothelin-1 (ET-1) expression in vivo. Results: Compared with the control group, the Chahuang ointment group showed significantly lower incidence of postoperative phlebitis, tissue edema, and microthrombus at 72 hours after peripherally inserted central catheter insertion (all P<0.01). The VEGF and ET-1 expression were significantly inhibited in the Chahuang ointment group after 3 days of treatment (both P<0.01). There were no statistical differences in the degree of vein injuries, microthrombus, or tissue edema between the Chahuang ointment and mucopolysaccharide polysulfate groups (all P>0.05). Conclusion: Chahuang ointment was shown to provide effective prevention and protection against phlebitis after peripherally inserted central catheter insertion.

RESUMEN Objetivo: Evaluar el efecto de la pomada Chahuang, una pomada herbal china, sobre la prevención de la flebitis en pacientes con catéteres centrales insertados periféricamente. Método: Este fue un ensayo controlado aleatorio multicéntrico, con 171 pacientes elegibles asignados al azar en uno de tres grupos: el grupo de ungüento Chahuang, el grupo de crema de polisulfato de mucopolisacárido y el grupo de control. Los grados de lesiones de las venas a las 72 horas después de la inserción del catéter central insertado periféricamente fueron el resultado primario. Los resultados secundarios fueron el grosor de la pared vascular, el edema tisular y el microtrombo evaluados por imágenes de flujo con Doppler en color, el factor de crecimiento endotelial vascular y la expresión de endotelina-1 (ET-1) in vivo. Resultados: En comparación con el grupo de control, el grupo de ungüento Chahuang mostró una incidencia significativamente menor de flebitis posoperatoria, edema tisular y microtrombos a las 72 horas después de la inserción del catéter central insertado periféricamente (todos P <0,01). La expresión de VEGF y ET-1 se inhibió significativamente en el grupo de pomada de Chahuang después de 3 días de tratamiento (ambos P <0,01). No hubo diferencias estadísticas en el grado de lesiones venosas, microtrombos o edema tisular entre los grupos de pomada de Chahuang y polisulfato de mucopolisacárido (todos P> 0,05). Conclusión: Se demostró que la pomada de Chahuang proporciona una prevención y protección eficaces contra la flebitis después de la inserción de un catéter central insertado periféricamente.