Objective To explore the role and correlation of peroxisome proliferator-activated receptor γ (PPAR-γ) and Toll-like receptor 4 (TLR4) on pulmonary vascular remodeling of chronic obstructive pulmonary disease(COPD).Methods Ninety male patients who underwent surgery for squamous cell carcinoma were enrolled as our subjects.All patients were divided into COPD group and uon-COPD group based on lung function,and 45 cases in each group.Peripheral lung tissues without tumor infiltrated after lobectomy were taken to assess the degree of arterial inflammation,percentage of wall thickness to vessel diamater (WT％) and percentage of wall area to total vascular area(WA％) were measured through Hematoxylin-Eosin(HE) staining under light microscope.The expression of PPARγand TLR4 were determined by immunohistochemistry.Results The distribution of WA％ and WT％ in COPD group were (43.98 ±6.43)％ and (27.37 ±3.34)％,higher than that of non-COPD group ((26.09 ± 2.82) ％,t =-13.949,P =0.000 ; (15.57 ± 1.75) ％,t =-7.140,P =0.000).The expression of PPAR-γand TLR4 in COPD group were (10.74 ± 8.81) ％,(3 1.41 ± 14.67) ％ respectively,and (28.22 ± 15.08)％,(4.67 ± 4.47)％ in non-COPD group.The differences were statistic significantly(t =5.483,P =0.000; t =-9.555,P =0.000).And there was negative correlation between the expression of PPARγand TLR4 (r =-0.404,P ＜ 0.01).Conclusion The pulmonary vascular of COPD patients showed the obviously inflammatory cell infiltration,fibrosis and proliferation,and PPAR-γ and TLR4 participate in the regulation of pulmonary vascular remodeling.

Objective Nasal administration,as a common means of treatment of respiratory diseases,may normally cause bronchospasm,cough and other adverse reactions,the efficiency of nasal nebulizers has been criticized as well.This paper aims to develop a medicine atomizing device,pharmaceutically atomized in solving the existing problems,providing a modern instrument for treatment of respiratory diseases by traditional Chinese medicine.Methods The device could prepare medicine by decoction and filtration,which means this unit is divided into two functional modules,medicine preparation and herbal atomization.1 200 W heating plate is placed in decoction unit and is programmed to fit traditional decoction protocol.Steam and ultrasonic nebulised medicine are combined in atomizing unit.Another non-contact infrared heating unit also located in to control the temperature precisely.Different forms of traditional Chinese medicine and different filtration methods were selected to optimize the atomizing effect.Results An implementation of two sequence of filtration enabled optimization of atomizing.After 15 volunteers'trial,this device functioned well on Bama nasal medical protocol,and could effectively avoid the adverse reactions of the traditional way of cold fog atomizing.Conclusions The nasal nebulizer equipment on which Chinese herbal medicine treatments could directly performed,produced atomized mist particle size suitable for nasal treatment,and by generating warm steam to avoid the common clinical administration caused choking to hypoxia and other adverse reactions.Meanwhile,instrument has a friendly interactive feature to meet the clinical requirements for medicine nebulizer treatment.

Objective To study the effects of Shuanghuanglian Oral Solution (only for children) on general condition, body weight, food intake, growth and development, blood routine and pathologic changes of SD weanling rats; To provide experimental references for clinical safe medication.Methods SD weanling rats were randomly divided into control group,Shuanghuanglian (only for children) Oral Solution low-, medium- and high-dose group according to body mass, with 30 rats in each group. Each administration group was given corresponding amount of Shuanghuanglian Oral Solution (only for children) concentrated ointment for gavage, once a day, for 33 d. The toxicity of the rats during dosing period and recovery period (medicine withdrawal 25 d) was observed.Results There were no significant differences in general condition, individual development, organ mass and coefficient, and internal fixation and pathological findings of rats in administration groups during dosing period and recovery period. The body mass and food intake of female and male rats in the Shuanghuanglian Oral Solution high-dose group were lower than those in the control group. The blood routine test during dosing period showed that the lymphocyte ratio of female rats and male rats in Shuanghuanglian Oral Solution high-dose group decreased significantly, neutrophil ratio increased significantly, and then returned to normal level in recovery period.Conclusion Shuanghuanglian Oral Solution (only for children) concentrated ointment has no toxic effect on the whole body organs and tissues of juvenile rats, and the safety is good.

Objective To explore the correlation between the expressions of matrix metalloproteinase -9 (MMP-9), Toll-likeReceptor 4 ( TLR4) and lung revascularization in patients with chronic obstructive pulmonary disease .Methods Lung tissues frompatients with chronic obstructive pulmonary disease (COPD) (COPD group,n =25) and those without COPD (non-COPD group,n =25) were obtained from surgically resected specimens .The ratio of the area of the wall to that of the pulmonary arterioles (WA %) andthe ratio of the thickness of the wall to the external diameter of the pulmonary arterioles (WT %) were analyzed by computer-based imageanalysis system.Immunohistochemical technique was applied to investigate the expressions of TLR 4, proliferative cell nuclear antigen(PCNA) and MMP-9 in vascular smooth muscle cells.Results ⑴ The inflammatory infiltration degree, WA %, and WT %were significantly higher than that of non -COPD group ( P <0.01), respectively.⑵Compared with non-COPD group, the expressionsof PCNA, TLR4, and MMP-9 in vascular smooth muscle cells were increased significantly ( P <0.01).⑶The expressions of TLR4,MMP-9 had a positive correlation with WA%, WT%, degree of inflammatory infiltration, and the expression of PCNA ( r =0.67,0.74,0.47,0.44;0.59,0.71,0.61,0.33, P <0.01), up-regulated expression of TLR4 was closely related with the expression of MMP-9 ( r =0.55, P <0.01).Conclusions The pulmonary arterioles of COPD patients showed marked inflammatory and arteriolemuscularization, the TLR4 might aggravate inflammation,induced upregulation of MMP-9 expression, played an important role in the pulmonary vascular remodeling process.

OBJECTIVE To screen potential adverse drug event （ADE） signals for the treatment of multiple sclerosis （MS） with ofatumumab， and to provide reference for the safe use of drugs in clinical practice. METHODS Using “ofatumumab” and the trade name “Kesimpta” as the search keywords， adverse event （AE） reports related to ofatumumab included in FDA Adverse Event Reporting System database from January 2009 to December 2023 were screened， and their reason contained the “multiple sclerosis”； ADE signal mining and analysis were conducted by reporting odds ratio method and proportional reporting ratio method. RESULTS A total of 21 759 eligible AE reports were selected， involving 62 449 AE cases； 27 system organ classes included general diseases and various reactions at the site of administration （15 021 cases）， neurological diseases （9 668 cases）， infectious and invasive diseases （5 967 cases）， injury， poisoning and surgical complications （4 952 cases）， musculoskeletal and connective tissue disorders （4 647 cases）. A total of 21 759 AE reports correspond to 606 ADE signals， including 234 ADE positive signals. A total of 107 ADE positive signals were not included in drug instruction of ofatumumab， including flu-like diseases， nasopharyngitis， cough， urinary tract infection， sore throat， insomnia， runny nose， anemia， hair loss， atrial fibrillation， and thrombocytopenia， etc. CONCLUSIONS In the process of using ofatumumab for MS， sufficient attention should be paid to ADE included in drug instructions. The ADE with strong signal strength screened in this study should also be paid special attention to， such as flu-like diseases， hemocytopenia， temperature intolerance， optic neuritis， and moyamoya disease. The increased risk of infection， cardiovascular disease， and potential damage to the respiratory and spiritual systems caused by ofatumumab can not be ignored.

ObjectiveTo observe the clinical effectiveness and safety of Xiaozhong Zhitong Mixture （消肿止痛合剂） combined with antibiotic bone cement in the treatment of diabetic foot ulcer （DFU） with damp-heat obstructing syndrome. MethodsA total of 72 DFU patients with damp-heat obstructing syndrome were randomly assigned to treatment group （36 cases） and the control group （36 cases）. Both groups received standard treatment and topical antibiotic bone cement for ulcer wounds， while the treatment group received oral Xiaozhong Zhitong Mixture （50 ml per time， three times daily） in additionally. Both groups underwent daily wound dressing changes for 21 consecutive days. Ulcer healing rate， serum levels of tumor necrosis factor-alpha （TNF-α）， interleukin-1 beta （IL-1β）， malondialdehyde （MDA）， superoxide dismutase （SOD）， C-reactive protein （CRP）， and white blood cell （WBC） count were observed before and after treatment， and visual analog scale （VAS） scores for wound pain， traditional Chinese medicine （TCM） syndrome scores， and the DFU Healing Scale （DMIST scale） were also compared. Liver and kidney function were evaluated before and after treatment， and adverse events such as allergic reactions， worsening ulcer pain were recorded. ResultsTotally 35 patients in the treatment group and 33 in the control group were included in the final analysis. The ulcer healing rate in the treatment group was （87.93±9.34）%， significantly higher than （81.82±12.02）% in the control group （P = 0.035）. Compared to pre-treatment levels， both groups showed significant reductions in serum CRP， WBC， MDA， IL-1β， and TNF-α levels， with an increase in SOD level （P＜0.05）. TCM syndrome scores， VAS， and DMIST scores also significantly decreased in both groups （P＜0.05）， with greater improvements in the treatment group （P＜0.05）. No significant adverse reactions were observed in either group during treatment. ConclusionXiaozhong Zhitong Mixture combined with antibiotic bone cement has significant advantages in promoting DFU healing， reducing inflammatory response， and alleviating oxidative stress in DFU patients with damp-heat obstructing syndrome， with good safety for DFU patients with damp-heat obstructing syndrome.

TSCI have dyskinesia and sensory disturbance that can cause various life-threaten complications. The patients with traumatic spinal cord injury (TSCI), seriously affecting the quality of life of patients. Based on the epidemiology of TSCI and domestic and foreign literatures as well as expert investigations, this expert consensus reviews the definition, injury classification, rehabilitation assessment, rehabilitation strategies and rehabilitation measures of TSCI so as to provide early standardized rehabilitation treatment methods for TSCI.

Ankylosing spondylitis (AS) combined with lower cervical fracture is often categorized into unstable fracture, with a high incidence of neurological injury and a high rate of disability and morbidity. As factors such as shoulder occlusion may affect the accuracy of X-ray imaging diagnosis, it is often easily misdiagnosed at the primary diagnosis. Non-operative treatment has complications such as bone nonunion and the possibility of secondary neurological damage, while the timing, access and choice of surgical treatment are still controversial. Currently, there are no clinical practice guidelines for the treatment of AS combined with lower cervical fracture with or without dislocation. To this end, the Spinal Trauma Group of Orthopedics Branch of Chinese Medical Doctor Association organized experts to formulate Clinical guidelines for the treatment of ankylosing spondylitis combined with lower cervical fracture in adults ( version 2024) in accordance with the principles of evidence-based medicine, scientificity and practicality, in which 11 recommendations were put forward in terms of the diagnosis, imaging evaluation, typing and treatment, etc, to provide guidance for the diagnosis and treatment of AS combined with lower cervical fracture.