Four compounds were isolated from the ethanolic extract of the bark of Alseodaphnehainanensis Merr. , The structures were identified as: a neolignan eusiderin A [(7R, 8R)-3,4,5,3′-tetram-ethox-△8’，9’-8-o-4’，7-o-5’lignan]（I）two benzylisoquinoline alkaloids (6,7-dimethoxyisoquinolinyl)-(4′-methoxyphenyl) methanone(Ⅱ), and( 6, 7-methylenedioxyisoquinolinyl )-( 4′-methoxyphenyl ) methanone (Ⅲ), and 4-hydroxy-3-methoxy benzoic acid ( Ⅳ ) on the basis of HR-SIMS，1HNMR，13CNMRand 2D-NMR spectroscopic analysis. CompoundsⅠ～Ⅲ were obtained from the Alseodaphne genus forthe first time.

Objective To investigate the role of high-mobility group box-1 (HMGB1) in the pathogenesis and the treatment of rheumatoid arthritis (RA) and the pathogenesis of TWP in treatment of RA.Methods A rat model of collagen induced arthritis (CIA) was developed and CIA rats were divided into the model group, the TWP group, the MTX group and the combination treatment group. And the tissues and blood were drawn from the rats 4 weeks later. HMGB1 expression in synovium, joint and the sera were tested by immunohistochemical stain and ELISA. Results HMGB l expression of the model in the synovium, joint and serum [(23.8±2.2) ng/ml] were remarkably higher than the control [(7.4±1.6) ng/ml] (P＜0.01); HMGB1 expression of the treatment groups in synovium, joint and serum [ (13.3±3.1), (17.4±4.9), (11.7±1.5 ) ng/ml]is obviously lower than the model (P＜0.01), and were higher than that of the controls(P＜0.05). Conclusion HMGB1 participates in the hyperplasia of synovial membrane, cartilage and bone destruction of CIA. The molecular mechanism for the TWP and MTX in the trentment of synovitis and bone destruction of RA is correlated with the expression of HMGB1.

Mesenehymal stem cells(MSCs)have been successfully isolated from almost all tissues in Mammals,and their multi-lineage differentiation ability leads to the attractive application of MSCs in regenerative medicine.More understanding of the biological characteristics of MSCs,the interaction between MSCs and the local environment,the molecules regulating MSC homing and differentiation have been achieved,which will benefit the effective clinical trials using MSCs as repair cells and/or vehicles for exogenous genes.

Objective To observe the effect of osteopontin (OPN) and integrin αtvβ3 in collageninduced arthritis (CIA) and the possible mechanism of Tripterygium wilfordii polyglycoside (TWP) in the treatment of rheumatoid arthritis (RA). Methods CIA rats model were developed and were randomly divided into the experimental group and the TWP group.And tissue samples were obtained 4 weeks later.Then the expressions of OPN and integrin αvβ3 in the synovium,synovium fluid and serum of each group were determined by immunohistochemical stain and ELISA.Variance analysis was used for data analysis.Results The concentrations of OPN of the normal controls,experimental group and the TWP group in the serum were (5.7±2.9), (7.8±6.2), (5.0±1.9) ng/ml respectively and there were significant differences between these 3 groups (F=6.74,P=0.016).The concentration of OPN (measured by mean grey value) in the synovium and cartilage of the three groups were 229±15,81±15,93±13 and 211±17,91±19,100±15 and there were significant differences between the three groups (F=52.48,P＜0.01; F=18.98,P=0.01).The concentrations of protein αvβ3 (measured by mean grey value) in the synovium and cartilage were 235±16,91±16,131±14 and 198±10,99±15,113±14,respectively and there were significant differences between the three groups (F=23.03,P=0.002; F=12.04,P=0.008).The expressions of OPN and integrin αvβ3 in the synovium,synovium fluid and serum of the experimental group were markedly higher than that of the controls.The expressions of OPN and integrin αvβ3 in the synovium,synovium fluid and serum of the treatment group were obviously lower than the experimental group.Conclusion OPN and integrin αtvβ3 are involved in the hyperplasia of the synovium,cartilage and bone destruction in CIA rats.The underlying molecular mechanism that TWP is effective in treating synovitis and bone destruction of RA is possibly related to down-regulation of the expression of OPN protein and integrin αvβ3.

OBJECTIVETo study the clinical effects of Fuzheng Huayu Gantang comprehensive therapeutic program (FHGP) on post-hepatitis B liver cirrhosis associated with glyco-metabolic abnormality (LCGA).

METHODSThe patients with LCGA enrolled in the randomized controlled clinical trial were assigned to 2 groups, the treated group (68 cases) and the control group (74 cases), they were treated respectively by FHGP and conventional TCM and Western medicine therapeutic program for 3 months. Indexes including fasting plasma glucose (FPG), 2 h postprandial plasma glucose (2 h PG), fasting insulin (FINS) were detected, homeostasis model assessment insulin resistance (HOMA-IR) was calculated, and the score of syndrome was recorded before and after treatment. Then the effects on syndrome and glyco-metabolic abnormality were evaluated through statistical analysis.

RESULTSLevel of 2 h PG after treatment was lowered in both groups (P < 0.01), but significant difference was found in the pre-treatment to post-treatment decrement of FPG and HOMA-IR between the two groups (P < 0.05). The syndrome improving rate and the total effective rate on glyco-metabolic abnormality in the treated group were significantly better than those in the control group respectively (85.3% vs 64.9% , P < 0.01; 80.9% vs 62.2%, P < 0.05).

CONCLUSIONFHGP has the capability to improve the syndrome and glyco-metabolic abnormality of patients with LCGA.

Adolescent ; Adult ; Aged ; Blood Glucose ; metabolism ; Combined Modality Therapy ; Drug Therapy ; methods ; Female ; Hepatitis B, Chronic ; complications ; Humans ; Insulin Resistance ; Liver Cirrhosis ; etiology ; metabolism ; therapy ; Male ; Medicine, Chinese Traditional ; methods ; Middle Aged ; Phytotherapy ; methods ; Treatment Outcome

Characteristics of collapsed tibial plateau fracture determines that the joint surface must remain anatomical reduction,line of force in tibial must exist and internal fixation must be strong. However, while renewing articular surface smoothness, surgeons have a lot of problems in dealing with bone defect under the joint surface. Current materials used for bone defect treatment include three categories: autologous bone, allograft bone and bone substitutes. Some scholars think that autologous bone grafts have a number of drawbacks, such as increasing trauma, prolonged operation time, the limited source, bone area bleeding,continuous pain, local infection and anesthesia,but most scholars believe that the autologous cancellous bone graft is still the golden standard. Allograft bone has the ability of bone conduction, but the existence of immune responses, the possibility of a virus infection, and the limited source of the allograft cannot meet the clinical demands. Likewise, bone substitutes have the problem that osteogenesis does not match with degradation in rates. Clinical doctors can meet the demand of the patient's bone graft according to patient's own situation and economic conditions.
Bone Substitutes ; Bone Transplantation ; Humans ; Tibial Fractures ; surgery

Objective:To study the effects of the conditioned medium (CM) from human lung adenocarcinoma cell line A549 on the viability and apoptosis of human umbilical vein endothelial cells (HUVECs) and the role of PI3K-Akt signaling pathway in the process. Methods:HUVECs were cultured with CM of A549 cells. Cell viability was detected by XTT assay. The morphological changes of HUVECs were analyzed by Hoechst 33258 staining and fluorescence microscopy. The apoptosis was detected by flow cytometry. Expression levels of total Akt and phosphorylated Akt were assessed by Western blotting. PI3K inhibitors wortmannin(WT)and Akt1 siRNA(siAkt1)were used to block PI3K-Akt signaling pathway. The mRNA transcription of Akt subtype was determined by RT-PCR.Results:A549 CM significantly increased cell viability after 24 h treatment (P=0.037) and inhibited apoptosis (P=0.001) of HUVECs. CM time-dependently activated phosphorylation of Akt. Akt was phosphorylated at 15 min after CM treatment and reached the peak at 30 min and then tended to decline. Both WT and siAkt1 blocked the effects of CM. Conclusion:The CM of A549 cells increased the survival and inhibit the apoptosis of HUVECs. Akt1 played a significant role in the process.

Objective To investigate the treatment and prevention strategies of hematomas in operation area after anterior approach surgery for cervical spondylosis.Methods A retrospective review was conducted on 12 with hematoma compression in operation area out of 785 patients managed by anterior cervical surgery from January 2007 to July 2013,including 10 males and 2 females at age ranging from 40-71 years (mean 56.8 years).Surgery method was anterior cervical corpectomy and interbody fusion using titanium mesh cage plus plate and intraoperative blood loss was 300-1 200 ml.Primary clinical manifestations were neurological dysfunction in 5 patients,dyspnea in 6,and both neurological dysfunction and dyspnea in 1.There were 10 patients with the presence of symptoms at postoperative 0.5-22 hours,1 at postoperative 73 hours,and 1 at postoperative 74 hours.All the 12 patients underwent a second anterior cervical exploration.Results There were 5 patients with epidural hematoma,6 with subcutaneous hematoma,and 1 with both hematomas.After surgical interventions,the patients presented improvement in respiratory and neurological function,with inapparent respiratory abnormality and improved neurological function at discharge.One patient was died of cardiovascular-associated disease after being discharged from hospital.The left 11 patients were followed up for mean 19.8 months (range,6-43 months),with improved Japanese Orthopedic Association (JOA) score at final follow-up.Conclusions Hematoma took place frequently in the early period,especially within 24 hours in operation area after anterior approach to cervical disorders and close attention should be paid to respiratory and limb sensation and motion functions.Early detection and early surgical interventions are the key countermeasures to avoiding the severe results.

Objective To investigate the methods and effects of posterior fixation and fusion in treatment of complete thoracolumbar fracture and dislocation.Methods The study enrolled 8 cases of complete thoracolumbar fracture and dislocation treated by posterior fixation and fusion with pedicle screwrod system between January 2006 and December 2012.There were 7 males and 1 female,at mean age of 31.9 years (range,19-49 years).Mean time interval between injury and surgery was 8.1 days (range,4-12 days).Fracture-dislocation classification was AO type C,Denis three-column injury,and Meyerding grade V.According to American Spinal Injury Association (ASIA),there 5 cases at grades A,1 at grade B,1 at grade C 1 at grade E.Fracture-dislocation segments included T5-T6 in 1 case,T12-L1 in 3,L1-L2 in 2,L3-L4 in 1 and L4-L5 in 1.Results Mean duration of surgery was 220.6 minutes (range,135-335 minutes) and mean intraoperative blood loss was 1 150 ml (range,500-2 400 ml).Seven cases sustained dural laceration during the operation,which were sutured or covered with autologous fat grafts,but 3 of them were subjected to cerebrospinal fluid leakage and healed after conservative therapy.Anatomic reduction was achieved in 6 cases,partial reduction in 1 and non-reduction in 1.Mean Cobb angle improved from 29.3 ° (range,8 °-51 °) preoperatively to 1.9 ° (range,-5°-10 °) postoperatively.After a mean follow-up of 39.3 months (range,2-76 months),2 cases were recovered from preoperative ASIA grade A and B to C respectively and 6 cases (4 A,1 C,1 E) revealed no significant improvement.There was no implant loosening or breakage.One case was died of lung-related complications at postoperative 4 years.One case sustained lumbar deep infection at postoperative 3 weeks and managed by debridement,irrigation,drainage and implant retention.Conclusion Posterior fixation and fusion is the general treatment principle for complete thoracolumbar fracture and dislocation,but the degree of reduction depends on severity of the injured spinal cord.

ObjectiveTo study the regulatory effect of Tripterygium wilfprdii polyglycoside (TWP) on the expression of EGFR and ErbB-2 induced arthritis rats.The effect of TWP on arthritis was also explored.MethodsAfter the model of CIA rats were established,the expression of EGFR and ErbB-2 in the synovium and articular cartilage were tested by immunohistochemical stain and real time PCR.ANOVA was used for statistical analysis.ResultsThe protein and mRNA expression of EGFR and ErbB-2 in the synovium (EGFR 0.268±0.059,ErbB-2 0.25±0.04,EGFR mRNA:14.2±0.55,ErbB-2 mRNA 23.46±3.64) and articular cartilage (EGFR 0.193±0.018,ErbB-2 0.217±0.033,EGFR mRNA:4.16±0.50,ErbB-2 mRNA 9.23±0.66) of the model group were significantly higher than those of the control group(P＜0.01).After being treated with TWP and MTX,the protein and mRNA expression of the EGFR and ErbB-2 decreased markedly (P＜0.01).Conclusion EGFR and ErbB-2 may play an important role in the pathogenesis of arthritis development.The molecular mechanism that TWP can treat synovitis and bone destruction of RA is related to the inhibition of EGFR and ErbB-2.