Objective To evaluate the efficacy and safety of chinese mednine in treatment of avascular necrosis by evidence-based medicine principles.Methods Search 1994-2010 Chinese full-text periodical database,VIP Articles journal database and the Wanfang database have been published in the medical treatment of avascular necrosis of the clinical trial literature,Revman 4.2 software was used for statistical analysis.Results A total of 11 randomized controlled trials included 1490 cases of patients meet the criteria,compared with the control group of traditional Chinese medicine treatment of avascular necrosis of the efficiency test results of the analysis of the merger:Z =2.89,P ＜ 0.01,the combined RR of 2.00,95％ confidence interval(1.25,3.19); All trials were not reported significant adverse reactions.Conclusion Chinese medicine treatment of avascular necrosis had good efficacy and safety.

Objective To explore the diagnosis and differential diagnosis of tricholemmal carcinoma and the significance of expression of cytokeratin(CK)and oncogene protein(c-erbB-2)in it.Method Twenty-two cases of tricholemmal carcinoma were studied with histologic and immunohistochemical tech-niques,and compared with those in squamous cell carcinoma.The neoplastic cells were stained with cytok-eratin-H,cytokeratin-L and c-erbB-2immunohistochemically(S-P method).Results The morphological characteristics of the tricholemmal carcinoma were the lobular structure and sudden keratinization in the cen-ter of the lobule,which were the key points to be differentiated with squamous cell carcinoma.The positive rate of cytokeratin-H of tricholemmal carcinoma was81.8%(18/22),and the positive cells distributed in the middle zone between the keratinized lobular center and tumor cells in the peripheral area,which differed from squamous cell carcinoma.Cytokeratin-L expression was not found in tricholemmal carcinoma.The posi-tive rate of c-erbB-2was50%(11/22)in tricholemmal carcinoma,with positive cells distributed to the mar-gin of the carcinoma cell nests,and increased with the poor differentiation.Conclusions The particular dis-tribution of cytokeratin-H suggests the tricholemmal origin of tricholemmal carcinoma.C-erbB-2may take part in the activation and differentiation of this tumor.

Purpose　To study the main points of the diagnosis and differential diagnosis of the lymphadenitis in CSD. Methods　Expression of CD45, CD3 and CD68 were evaluated immunohistochemically (S-P method). Results　Five cases of microabscess in early stage and 21 cases of microabscess-granuloma were found. The histologic features were the formation of microabscess and granuloma. The early microabscess in the lymphnodes were surounded by B lymphocytes (CD20+) and macrophages (CD68+). The typial microabscess granuloma were surrounded by epitheloid cells (CD68+) and CD3 positive T lymphocytes. Conclusion　The main characteristic of the lymphadenitis of cat scratch disease is the formation of granuloma with microabscess. The immumohistochemical markers are useful to distinguish the proliferative cell types. This lesion may result from bacterial infection which induces the cell immune reaction.

Objective To investigate the correlation between the level of presenilin-associated rhomboidlike protein (PARL) and the sperm motility,survival rate and deformity rate of sperm in workers exposed to aluminum.Methods A total of 162 male workers exposed to aluminum in a large aluminum enterprise in Guangxi were selected as the exposure group,and the 162 staff members of the service company were selected as the control group by matching the age and length of service.The concentration of aluminum in the working environment and the aluminum content in the blood and urine were determined by graphite furnace atomic absorption spectrometry and high performance liquid chromatography.Enzyme linked immunosorbent assay was used to measure the level of PARL protein in sperm and sperm function was evaluated.Results The average concentrations of aluminum in the batching,electrolysis and casting of aluminum exposure group were (6.72± 1.45),(7.23± 1.50) and (7.35± 1.72)mg/m3,which were significantly higher than those of the control group (F=8.314,P＜0.001).The content of aluminum in blood and urine of exposed group were significantly higher than those of control group (P＜0.05),while the levels of PARL of exposed group were significantly lower than those of control group (P＜0.05).Moreover,the sperm survival rate and sperm motility of exposed group were significantly lower than those of the control group,and the sperm deformity rates of exposed group were significantly higher than those of the control group(P＜0.05).Pearson correlation analysis showed that there was a positive correlation of sperm motility,sperm survival rate and protein level of PARL (rsprm motility=0.713,P=0.012;rsperm survival rate =0.628,P=0.008);while the sperm deformity rate and protein level of PARL showed a significant negative correlation (rsperm deformity rate =0.953,P =0.002).Conclusion The sperm function was significantly impaired in aluminum exposed workers,and the changes of sperm motility,survival rate and malformation rate were closely related to the protein level of PARL.

BACKGROUND:With the aging of the global population,the incidence rate of osteoporosis is also increasing.It is very important to further understand its pathogenesis and propose new therapeutic targets.Recent studies have shown that ferroptosis is closely related to the pathogenesis of some bone diseases,such as inflammatory arthritis,osteoporosis and osteoarthritis. OBJECTIVE:To summarize the previous studies on the mechanism of ferroptosis in osteoporosis,so as to provide new therapeutic ideas and potential therapeutic targets for osteoporosis. METHODS:The first author used the computer to search the documents published from 2000 to 2022 in CNKI,WanFang,VIP,PubMed and Web of Science with the key words of"ferroptosis,osteoporosis,osteoblasts,osteoclasts,iron chelators,reactive oxygen species,nuclear factor erythroid 2-related factor 2,heme oxygenase-1,glutathione peroxidase 4,review"in Chinese and English.A total of 70 articles were finally included according to the inclusion criteria. RESULTS AND CONCLUSION:Ferroptosis is significantly different from necrosis,apoptosis and autophagy.In terms of cell morphology and function,it does not have the morphological characteristics of typical necrosis,nor does it have the characteristics of traditional apoptosis,such as cell contraction,chromatin condensation,the formation of apoptotic bodies and the disintegration of cytoskeleton.Contrary to autophagy,ferroptosis does not form a classical closed bilayer membrane structure(autophagic vacuole).Morphologically,ferroptosis is mainly manifested by obvious contraction of mitochondria,increased membrane density,and reduction or disappearance of mitochondrial cristae,which are different from other cell death modes.Iron overload can destroy bone homeostasis by significantly inhibiting osteogenic differentiation and stimulating osteoclast formation,leading to osteoporosis.Iron overload interferes with the differentiation of stem cells to osteoblasts,leading to a weakened osteoblast function and further imbalance of bone metabolism in the body,which eventually leads to osteoporosis.Stimulated by iron overload,osteoclast bone resorption is enhanced and bone loss exceeds new bone formation.Iron chelators have been proved to have osteoprotective effects by inhibiting osteoclast activity and stimulating osteogenic differentiation of osteoblasts.Its potential mechanism is related to inhibiting osteoclast differentiation and promoting osteoblast differentiation.Antioxidants can prevent reactive oxygen species production and inhibit bone absorption,thus improving bone metabolism and effectively preventing osteoporosis.