Objective To analyze the distribution rule of TCM syndromes and syndrome elements in chronic atrophic gastritis with osteoporosis by retrospective study method, and provide evidence for TCM treatment. Methods TCM symptoms, syndromes and syndrome elements of 127 cases of chronic atrophic gastritis with osteoporosis were retrospectively investigated and statistically analyzed. Results The distribution of TCM syndromes in chronic atrophic gastritis with osteoporosis was as follows:there were 51 cases of asthenia syndrome of both qi and yin, accounted for 40.16%;28 cases of yang deficiency syndrome of spleen and kidney, accounted for 22.05%;21 cases of syndrome of qi deficiency and blood stasis, accounted for 16.54%. The distribution of syndrome elements was:there were 82 cases of qi deficiency, accounted for 64.57%;61 cases of yin deficiency, accounted for 48.03%;28 cases of yang deficiency, accounted for 22.05%;21 cases of blood stasis, accounted for 16.54%;12 cases of qi stagnation, accounted for 9.54%;6 cases of dampness-heat, accounted for 4.72%. Conclusion The basic pathogenesis of chronic atrophic gastritis with osteoporosis is deficiency of both spleen and kidney. Deficiency of kidney is mainly qi deficiency, yin deficiency, yang deficiency, or even deficiency of both yin and yang. Reinforcing spleen and kidney is the important principle of treatment.

Objective To explore the effects of Yishen-Jianpi decoction on bone mineral density (BMD) and serum sclerostin level in chronic atrophic gastritis in rats. Methods Wistar rats were randomly divided into normal control group, model group, Weimeisu group, low-, medium-and high-dose Yishen-Jianpi Decoction groups. Chronic atrophic gastritis was induced via depriving of water by replacement with 0.1%ammonia water for 180 days. After modeling, the rats in the Yishen-Jianpi decoction groups of low-, medium-and high-dose received intragastric administration of Yishen-Jianpi decoction of 7.5, 15, 30 g/(kg?d), respectively;the Weimeisu group received intragastric administration of Weimeisu suspension 0.28 g/(kg?d);the normal control group and the model group received intragastric administration of equivalent volume of normal saline. After 90 d continuous administration the specimens were drawn. The femur BMD and BMC were detected with dual energy X-ray absorptiometry. The serum sclerostin level was measured with enzyme-linked immunosorbent assay. The serum levels of parathyroid hormone (PTH) and human calcitonin (CT) were detected with radioimmunoassay. Results Compared with the normal control group (n=10), the femur BMD (0.168 ± 0.007 g/cm2 vs. 0.235 ± 0.029 g/cm2), BMC (0.383 ± 0.022 g vs. 0.637 ± 0.085 g), and the serum CT level (26.76 ± 11.54 pg/m vs. 33.85 ± 13.12 pg/ml) in the model group (n=9) were significantly decreased (all P<0.05), while the serum level of sclerostin (105.78 ± 34.43 pg/ml vs. 71.51 ± 23.21 pg/ml) and PTH (11.52 ± 4.34 ng/dl vs. 8.46 ± 2.39 ng/dl) were significantly increased (all P<0.05). Compared with the model group, the femur BMD (0.197 ± 0.011 g/cm2, 0.201 ± 0.017 g/cm2, 0.206 ± 0.021 g/cm2 vs. 0.168 ± 0.007 g/cm2), BMC (0.538 ± 0.036 g, 0.546 ± 0.039 g, 0.569 ± 0.048 g vs. 0.383 ± 0.022 g), serum CT level (30.42 ± 12.61 pg/ml, 31.35 ± 12.75 pg/ml, 30.83 ± 13.10 pg/ml vs. 26.76 ± 11.54 pg/ml) in the Yishen-Jianpi decoction groups of low-(n=10), medium-(n=10) and high-dose (n=9) were significantly increased (all P<0.05), while serum levels of sclerostin (86.32 ± 24.28 pg/ml, 87.65 ± 24.75 pg/ml, 86.82 ± 25.56 pg/ml vs. 105.78 ± 34.43 pg/ml) and PTH (9.36 ± 2.76 ng/dl, 9.76 ± 2.85 ng/dl, 9.84 ± 2.97 ng/dl vs. 11.52 ± 4.34 ng/dl) were significantly decreased (all P<0.05). Conclusions Yishen-Jianpi decoction can reduce serum sclerostin level, and has protective effects against osteoporosis in chronic atrophic gastritis in rats.

Objective:To explore a new method of whole-process digital esthetic prosthodontic rehabilitation combined with periodontic surgery for complicated anterior teeth esthetic defects accompanied by soft tissue morphology,to provide an alternative choice for solving this problem under the guidance of three-dimensional (3 D) printing digital dental model and surgical guide,thus completing periodontic surgery and digital esthetic rehabilitation of anterior teeth.Methods:In this study,12 patients with complicated esthetic problems accompanied by soft tissue morphology in their anterior teeth were included.The dentition and facial images were obtained by intra-oral scanning and three-dimensional (3D) facial scanning and then calibrated.Two esthetic designs and prosthodontic outcome predictions were created by computer aided design/computer aided manufacturing (CAD/CAM) software combined with digital photography,including consideration of white esthetics and comprehensive consideration of pink-white esthetics.The predictive design of prostheses and the facial appearances of the two designs were evaluated by the patients.If the patients chose the design of comprehensive consideration of pink-white esthetics,they would choose whether they would receive periodontic surgery before esthetic rehabilitation.The dentition design cast of those who chose periodontic surgery would be 3D printed for the guide of periodontic surgery accordingly.Results:In light of the two digital designs based on intra-oral scanning,facing scanning and digital photography,the satisfaction rate of the patients was significantly higher for the comprehensive consideration of pink-white esthetic design (P ＜ 0.05) and more patients tended to choose priodontic surgery before esthetic rehabilitation.The 3 D printed digital dental model and surgical guide provided significant instructions for periodontic surgery,and achieved success transfer from digital design to clinical application.The prostheses were fabricated by CAD/CAM,thus realizing the whole-process digital esthetic rehabilitation.Conclusion:The new method for esthetic rehabilitation of complicated anterior teeth esthetic defects accompanied by soft tissue morphology,including patient-involved digital esthetic analysis,design,esthetic outcome prediction,3D printing surgical guide for periodontic surgery and digital fabrication is a practical technology.This method is useful for improvement of clinical communication efficiency between doctor-patient,doctor-technician and doctors from different departments,and is conducive to multidisciplinary treatment of this complicated anterior teeth esthetic problem.

Objective To investigate antimicrobial resistance among gram-positive cocci in China in 2008.Methods From June 2008 to December 2008,1171 consecutive and non-repetitive gram-positive cocci were collected from 12 teaching hospitals.The MICs of antibacterial agents was determined by agar dilution method.Results The prevalence of MRSA and methicillin-resistant coagulase-negative Staphylococci(MRSCoN) was 49.9%(232/465) and 74.0%(179/242),respectively.The MRSA prevalence ranged from 33.3% to 65% in different regions.About 71.1%(108/152) of Staphylococcus aureus from respiratory tract specimens,48.3%(28/58) of Staphylococcus aureus from blood samples,and 36%(68/189) of Staphylococcus aureus from the pus,wound and sterile body fluid samples were resistant to methicillin.The susceptible rates of MRSA to trimethoprim/sulfamethoxazole(SXT) and chloramphenicol were 81.5%(183/232) and 89.7%(208/232).Susceptibility to gentamicin, erythromycin, clindamycin, tetracyclines,rifampicin,and quinolones were from 3.9% to 35.0%.All Staphylococci isolates were susceptible to vancomycin,teicoplanin,and linezolid.Three vacomycin-resistant Enterococcus faecium strains were found in this study.About 96.2%(101/105) of Enterococcus faecalis and 97%(130/134) of Enterococcus faecium were susceptible to linezoild.Fifty-one out of 105 of Enterococcus faecalis(48.6%)and 101 out of 134 Enterococcus faecium(75.4%)were resistant to high concentration gentaroicin.The susceptibility of Enterococcus faecalis to all the antibiotics except for chloramphenicol and tetracycline was higher than that of Enterococcus faecium.Enterococcus faecium isolates showed a high resistant prevalence to most of antibiotics except glycopeptides and linezolid.The prevalence of PISP among 225 isolates was was 36.6%(15/41),and the prevalence of PNSSP from the other patients ranged from 15.4% to 26.6%.The susceptible rates of PSSP to cefprozil,cefuroxime and cefaclor were 67.5%(114/169),66.3%(112/169) and 61.5%(104/169),respectively.All the PISP isolates were resistant to the above three antibiotics.Teicoplanin,vancomycin and linezolid were the most active agents against Staphylococcus pneumoniae(susceptible rate,100%).About 96.9%,97.8% and 98.2% Staphylococcus pneumoniae isolates were susceptible to gatifloxacin,levofloxacin,and moxifloxacin,respectively.The susceptible rates of Staphylococcus pneumoniae to ceftriaxone,chloramphenicol and amoxicillin/clavulanic acid were 81.3%,77.3%,and 68.0%,respectively.The susceptibility of Staphylococci pneumoniae to macrolides,SXT and tetracycline ranged from 11.6% to 23.6%.Conclusions The prevalence of VRE is low in China.However,methicillin-resistance among Staphylococci isolates was high.The prevalence of PNNSP isolated from (≤)3 years children is higher than in the other age population.Teicoplanin,vancomycin,and linezolid remain high activity against Staphylococci,Enterococcus faecalis,Enterococcus faecium,and Staphylococcus pneumoniae.

Objective To investigate antimicrobial resistance among gram-positive cocci in China in 2009. Methods From June to December 2009, 1169 consecutive and non-repetitive gram-positive cocci were collected from 12 teaching hospitals at 9 cities. The minimal inhibitory concentration (MIC) of antibacterial agents was determined by agar dilution method. Results The prevalences of methicillinresistant Staphylococcus aureus (MRSA) and methicillin-resistant coagulase-negative Staphylococci (MRCoNS) were 45.3% (211/466) and 89. 5% (214/239), respectively. The isolation rate of MRSA was 33. 3%-68. 1% from different samples. All Staphylococci isolates were susceptible to vacomycin, teicoplanin and linezolid. Five point five percent (7/128) E. faecium strains were resistant to vacomycin. All E.faecalis strains were susceptible to vacomycin. About 99. 1% (108/109) of E. faecalis and E. faecium were susceptible to linezoild. The prevalence of penicillin-intermediate Streptococcus pneumoniae (PISP) was 21.6% (48/222). Only 1 (0. 5%, 1/222) Streptococcus pneumoniae strain was resistant to penicillin.Teicoplanin, vancomycin, linezolid and tigecycline were the most active agents against Streptococcus pneumoniae (susceptible rate 100% ). Conclusions The high prevalence of methicillin-resistance is among Staphylococcus strains. Different samples show a different MRSA prevalence. Teicoplanin, vancomycin and linezolid show very high activity to Staphylococci,E. faecalis, E. faecium and Streptococcus pneumoniae.

Objective To evaluate the performance of modified Hodge test on the detection of carbapenemases among Enterobacteriaceae with decreased susceptibility to carbapenems. Methods Fortynine Enterobacteriaceae isolates with decreased susceptibility to carbapenems ( MIC of imipenem, meropenem or ertapenem was ≥ 2 μg/ml ) were collected from 16 teaching hospitals from 2004 to 2008. MICs of imipenem, meropenem and etapenem were determined by agar dilution method. Carbapenemases were detected by modified Hodge test. Carbepenemase-causing positive results and AmpCs-causing positive results were differentiated by phenyl boronic acid and oxacillin. Beta-lactamases encoding genes including blaNDM-1were detected by PCR and sequencing. Results Thirty-six of 49 isolates were non-susceptible to imipenem (MIC >4 μg/ml), 31 were non-susceptible to meropenem (MIC > 4 μg/ml) and 47 were non-susceptible to ertapenem (MIC > 2 μg/ml). Twenty-three isolates showed positive modified Hodge test result, including 9 weak-positive results and 14 strong-positive results. Through PCR detection and sequencing, 2 out of 9 isolates showing weak-positive results carried blaKPC-2 and other 7 did not carry any carbapenemase genes but AmpCs/ESBLs genes. Among the 14 isolates showing strong-positive results, 4 carried blaKPC-2, 8 carried blaIMP-4 and 2 caried blaIMP-8. All 26 isolates with negative modified Hodge test result didn't carry any carbapenemase genes. No isolate carried blaNDM-1. Carbapenemases genes PCR detection was regarded as a gold standard, and the sensitivity, specificity, positive predictive value and negative predictive value of modified hodge test was 100%, 79%, 70% and 100% on the detection of carbapenemases among Enterobacteriaceae with decreased susceptibility to carbapenems. Conclusions Modified Hodge test revealed great sensitivity but showed a few false positive results. True and false positive results can be effectively differentiated by phynel boronic acid and oxacillin.

Objective : This study aimed to explore the influencing factors of dynamic changes in traditional Chinese medicine (TCM) constitution based on general statistics, Apriori-DEMATEL algorithm, and DoWhy causal inference framework methods. Methods: Dynamic collection of TCM constitution identification data was conducted from the population aged 18 − 60, containing collection time and constitution type, and 11 constitution influencing factors including dietary habit, sleeping habit, sleeping duration, exercise habit, emotion state, stress level, living environment, work/life calamity, family atmosphere, business trip frequency, and overtime situation. General statistical analysis was used to analyze the relative percentage of corresponding influencing factors of different types of constitution changes, the Apriori-DEMATEL algorithm was used to analyze the correlation between 11 constitution influencing factors such as dietary habit and constitution changes, and the DoWhy causal inference framework was used to analyze the causality between dietary habit,sleeping habit, sleeping duration, exercise habit, emotion state, and stress level, explore the frequency of constitution type transformation-change factors, and determine the key influencing factors causing dynamic changes in constitution type. Result: After preprocessing, 13536 valid data points were obtained. Based on the Apriori-DEMATEL algorithm, the factors were divided into six original factors including dietary habit, sleeping habit, sleeping duration, exercise habit, emotion state, and stress level, and five result factors includ ing living environment, work/life calamity, family atmosphere, business trip frequency, and overtime situation. Combining with general statistics, we found that among the original factors, changes in dietary habit, sleeping habit, sleeping duration, and stress level had a greater impact on other factors. In the process of constitution conditioning, attention should be paid to these four factors to maintain constitution balance. Among the five resultfactors, the absolute values of work/life calamity and family atmosphere were relatively large, indicating that these two factors were easily influenced by other factors. The dietary habit,sleeping habit, sleeping duration, exercise habit, emotion state, and stress level have higher centrality in changes, indicating that these six factors had important in constitution changes. According to the statistical frequency of constitution changes corresponding to each factor, we found that the changes of these six factors accounted for a large proportion of the constitution transformation frequency among Qi deficiency constitution, balanced constitution, and allergic constitution, indicating that the changes of these six factors played an important role in the changes of the three constitution types. Combined with the results of the Apriori-DEMATEL algorithm, and DoWhy causal inference framework analysis, it was inferred that dietary habit and sleeping duration indirectly lead to constitution changes by affecting the changes of other factors. Conclusion This study explored the influencing factors of dynamic changes in TCM constitution from the perspective of dynamic data and multiple analysis methods, and the results showed that the changes of dietary habit, sleeping habit, sleeping duration, exercise habit, emotion state, and stress level had a great impact on the changes of Qi deficiency constitution, balanced constitution and allergic constitution. Attention should be paid to the changesof these six factors in daily life, and corresponding improvement plans should be formulated to reduce the probability of transforming into biased constitution. Our study also provided data support and objective analysis reference for the analysis of influencing factors of dynamic changes in TCM constitution types.

As an important enzyme for gluconeogenesis, mitochondrial phosphoenolpyruvate carboxykinase (PCK2) has further complex functions beyond regulation of glucose metabolism. Here, we report that conditional knockout of Pck2 in osteoblasts results in a pathological phenotype manifested as craniofacial malformation, long bone loss, and marrow adipocyte accumulation. Ablation of Pck2 alters the metabolic pathways of developing bone, particularly fatty acid metabolism. However, metformin treatment can mitigate skeletal dysplasia of embryonic and postnatal heterozygous knockout mice, at least partly via the AMPK signaling pathway. Collectively, these data illustrate that PCK2 is pivotal for bone development and metabolic homeostasis, and suggest that regulation of metformin-mediated signaling could provide a novel and practical strategy for treating metabolic skeletal dysfunction.
Mice ; Animals ; Metformin/pharmacology* ; Phosphoenolpyruvate Carboxykinase (ATP)/metabolism* ; Gluconeogenesis/genetics* ; Mice, Knockout

BACKGROUNDAberrant epithelial repair has been observed in chronic rhinosinusitis (CRS) patients; however, the mechanism of epithelial cell repair regulation is unclear. Epidermal growth factor (EGF) plays an important role in regulating epithelial cell repair in lower airway and may be a critical factor in the remodeling processes of CRS. The objective of our research is to evaluate the differences between CRS and normal subjects and between chronic rhinosinusitis without nasal polys (CRSsNP) and chronic rhinosinusitis with nasal polys (CRSwNP) in the regulation of EGF pathways and the regulating proliferative position of classic Ras/Raf/MEK/ERK pathways.

METHODSWe evaluated the proliferation rates of ethmoidal mucosal cells before and after stimulation with EGF, epidermal growth factor receptor (EGFR) kinase inhibitor AG1478, and extracellular signal-regulated kinase 1/2 (ERK1/2) inhibitor PD98059 using MTT assays. We also analyzed the sinonasal epithelial cells collected from control subjects and patients with CRS subtypes CRSsNP and CRSwNP for the expression of ERK1/2, phosphorylated ERK1/2, P21, P15, and P27 using western blotting analyses.

RESULTSThe proliferation rates of sinonasal epithelial cells before and after EGF stimulation were lower in CRS patients than in the controls. AG1478 or PD98059 inhibitor treatment of control epithelial cells did not result in a significant difference in proliferation. Although, AG1478 and PD98059 inhibited the proliferation of CRS cells, the degree of proliferation inhibition was markedly different in CRSsNP. AG1478 suppressed the proliferation of CRSwNP epithelial cells, whereas PD98059 had no effect. The ratio of ERK1/2 phosphorylation in CRS cells was lower than that of the control cells. Cyclin-dependent kinase inhibitors were highly expressed in CRS cells compared with that of control cells. ERK1/2 and P27 showed differential expression in CRSsNP and CRSwNP.

CONCLUSIONSDifferences existed in EGF pathways in CRS patients and normal subjects as well as in CRSsNP and CRSwNP. Classical Ras/Raf/MEK/ERK pathway may assume absolute superiority in control cells. Ras/Raf/MEK/ERK classical pathway and other pathways might be active at the same time to stimulate epithelial cell proliferation in CRSsNP. The function of Ras/Raf/MEK/ERK classical pathway was weaker in CRSwNP than in CRSsNP and when the classical pathway was blocked in CRSwNP, some other pathway could have completely compensated the proliferation induced by the Ras/Raf/MEK/ERK pathway.

Adult ; Aged ; Cell Proliferation ; drug effects ; Cells, Cultured ; Epidermal Growth Factor ; pharmacology ; Epithelial Cells ; cytology ; drug effects ; Female ; Humans ; Male ; Middle Aged ; Nasal Mucosa ; cytology ; Sinusitis ; metabolism

Objective To investigate the antimicrobial resistance profile of the clinical isolates collected from selected hospitals across China. Methods Twenty-nine general hospitals and five children's hospitals were involved in this program. Antimicrobial susceptibility testing was carried out according to a unified protocol using Kirby-Bauer method or automated systems. Results were interpreted according to CLSI 2017 breakpoints. Results A total of 190 610 clinical isolates were collected from January to December 2017, of which gram negative organisms accounted for 70.8％ (134 951/190 610) and gram positive cocci 29.2％ (55 649/190 610). The prevalence of methicillin-resistant strains was 35.3％ in S. aureus (MRSA) and 80.3％ in coagulase negative Staphylococcus (MRCNS) on average. MR strains showed much higher resistance rates to most of the other antimicrobial agents than MS strains. However, 91.6％ of MRSA strains were still susceptible to trimethoprim-sulfamethoxazole, while 86.2％ of MRCNS strains were susceptible to rifampin. No staphylococcal strains were found resistant to vancomycin. E. faecalis strains showed much lower resistance rates to most of the drugs tested (except chloramphenicol) than E. faecium. Vancomycin-resistant Enterococcus (VRE) was identified in both E. faecalis and E. faecium. The identified VRE strains were mainly vanA, vanB or vanM type based on phenotype or genotype. The proportion of PSSP or PRSP strains in the non-meningitis S.pneumoniae strains isolated from children decreased but the proportion of PISP strains increased when compared to the data of 2016. Enterobacteriaceae strains were still highly susceptible to carbapenems. Overall, less than 10％ of these strains (excluding Klebsiella spp.) were resistant to carbapenems. The prevalence of imipenem-resistant K. pneumoniae increased from 3.0％ in 2005 to 20.9％ in 2017, and meropenem-resistant K. pneumoniae increased from 2.9％ in 2005 to 24.0％ in 2017, more than 8-fold increase. About 66.7％ and 69.3％ of Acinetobacter (A. baumannii accounts for 91.5％) strains were resistant to imipenem and meropenem, respectively. Compared with the data of year 2016, P. aeruginosa strains showed decreasing resistance rate to carbapenems. Conclusions Bacterial resistance is still on the rise. It is necessary to strengthen hospital infection control and stewardship of antimicrobial agents. The communication between laboratorians and clinicians should be further improved in addition to surveillance of bacterial resistance.