Osteoporosis is a prevalent skeletal condition characterized by reduced bone mass and strength, leading to increased fragility. Buqi-Tongluo (BQTL) decoction, a traditional Chinese medicine (TCM) prescription, has yet to be fully evaluated for its potential in treating bone diseases such as osteoporosis. To investigate the mechanism by which BQTL decoction inhibits osteoclast differentiation in vitro and validate these findings through in vivo experiments. We employed MTS assays to assess the potential proliferative or toxic effects of BQTL on bone marrow macrophages (BMMs) at various concentrations. TRAcP experiments were conducted to examine BQTL's impact on osteoclast differentiation. RT-PCR and Western blot analyses were utilized to evaluate the relative expression levels of osteoclast-specific genes and proteins under BQTL stimulation. Finally, in vivo experiments were performed using an osteoporosis model to further validate the in vitro findings. This study revealed that BQTL suppressed receptor activator of NF-κB ligand (RANKL)-induced osteoclastogenesis and osteoclast resorption activity in vitro in a dose-dependent manner without observable cytotoxicity. The inhibitory effects of BQTL on osteoclast formation and function were attributed to the downregulation of NFATc1 and c-fos activity, primarily through attenuation of the MAPK, NF-κB, and Calcineurin signaling pathways. BQTL's inhibitory capacity was further examined in vivo using an ovariectomized (OVX) rat model, demonstrating a strong protective effect against bone loss. BQTL may serve as an effective therapeutic TCM for the treatment of postmenopausal osteoporosis and the alleviation of bone loss induced by estrogen deficiency and related conditions.
Animals ; NFATC Transcription Factors/genetics* ; Drugs, Chinese Herbal/pharmacology* ; Ovariectomy ; Osteoclasts/metabolism* ; Female ; Osteogenesis/drug effects* ; Rats, Sprague-Dawley ; Rats ; NF-kappa B/genetics* ; Osteoporosis/genetics* ; Signal Transduction/drug effects* ; Bone Resorption/genetics* ; Cell Differentiation/drug effects* ; Humans ; RANK Ligand/metabolism* ; Mitogen-Activated Protein Kinases/genetics* ; Transcription Factors

Objective:To explore and analyze the value of CT texture combined with baseline data in lymph node metastasis of cN0 papillary thyroid microcarcinoma (PTMC), in order to provide evidence for the evaluation of lymph node metastasis of PTMC.Methods:106 patients with single stage cN0 papillary PTMC confirmed by operation and pathology in Department of Radiology and Hernia Department of Huzhou First People’s Hospital from Aug. 2020 to Aug. 2022 were selected for retrospective analysis. Metastatic lymph nodes and non-metastatic lymph nodes were delineated in CT images, and they were divided into a lymph node metastasis group (22 cases) and a group without lymph node metastasis (84 cases). At the same time, lymph node CT texture feature images were obtained in both groups. Logistic regression was used to analyze the relationship between CT texture and lymph node metastasis, and ROC curve was drawn to evaluate the predictive value of CT texture for lymph node metastasis in cN0 stage PTMC patients. The patients were divided into<1/4 group (51 cases), 1/4-<1/2 group (36 cases), and ≥1/2 group (19 cases) according to the different contact range between tumor and thyroid margin in CT signs. The baseline data and lymph metastasis distribution of each group were analyzed.Results:The results of single factor analysis showed that there were no differences in tumor location, tumor calcification or thyroglobulin in CT texture between LNM group and non-LNM group ( P>0.05). The incidence of tumor contact with thyroid margin, tumor diameter ≥7 mm, age<45 and male ratio of sex in LNM group were higher than those in non-LNM group ( P<0.05). Multivariate Logistic regression analysis showed that tumor was in contact with thyroid margin ( OR=6.080, 95% CI: 1.738-21.273), tumor diameter ≥7 mm ( OR=2.779, 95% CI: 1.135-6.805), age<45 years old ( OR=6.074, 95%CI: 1.980-18.636) and gender male ( OR=12.642, 95% CI: 3.125-51.136) were independent risk factors for lymph node metastasis in cN0 stage PTMC patients ( P<0.05). There were no significant differences in gender, age, tumor diameter, tumor location, tumor calcification or thyroglobulin among<1/4 group, 1/4-1/2 group and ≥1/2 group ( P>0.05). The incidence of LNM in ≥1/2 group was higher than that in<1/4 group and 1/4-1/2 group, and pairwise comparison between groups had statistical significance ( P<0.05) . Conclusions:It is an independent risk factor for lymph node metastasis in cN0 stage PTMC patients with tumor and thyroid boundary contact, tumor diameter ≥7 mm, age<45 years old, male, and the wider the tumor and thyroid boundary contact, the higher the risk of lymph node metastasis. CT texture analysis combined with baseline data has important reference value in predicting lymph node metastasis of cN0 TMPC.

Objective To Summarize perioperative nursing for 20 patients with the hyperreflexia of neurogenic detrusor by injection of botulinum toxin A.Methods Mental states of patients were assessed by Huaxi Emotional Distress Index questionnaire and psychological support was given to these patients,patients were assisted and instructed to record the urine diary correctly,cautions for the use of botulinum toxin A was interpreted,drinking water and activities were guided,and adverse reactions,follow-up results at 6,12 weeks were observed.Life quality by Incontinence Quality of Life Questionnaire was observed,the times of urinary incontinence,maximum pressure volume of bladder,maximum pressure of detrusor and the effect of urinary incontinence were compared.Results The absolute value of evasion and restrictive behavior,psychological effects,social fear disorders were (38.5 ± 19.6),(38.8 ±22.5),(28.1 ±20.3),respectively,on admission,and (41.2 ±27.1),(43.7 ± 26.5),(33.5 ± 28.8),respectively,at 6 weeks after nursing,and were (40.9 ± 27.7),(39.6 ± 24.3),(36.3 ± 28.7),respectively,at 12 weeks after nursing.The evasion and restrictive behavior,social fear disorderswere improved at 6,12 weeks after nursing as compared to nursing before.Conclusion Perioperative care for patients with the hyperreflexia of neurogenic detrusor by injection ofbotulinum toxin A can not only improve therapeuticeffect,improve social status,but also improve patients'self-management ability and quality of life.

Objective To Summarize perioperative nursing for 20 patients with the hyperreflexia of neurogenic detrusor by injection of botulinum toxin A.Methods Mental states of patients were assessed by Huaxi Emotional Distress Index questionnaire and psychological support was given to these patients,patients were assisted and instructed to record the urine diary correctly,cautions for the use of botulinum toxin A was interpreted,drinking water and activities were guided,and adverse reactions,follow-up results at 6,12 weeks were observed.Life quality by Incontinence Quality of Life Questionnaire was observed,the times of urinary incontinence,maximum pressure volume of bladder,maximum pressure of detrusor and the effect of urinary incontinence were compared.Results The absolute value of evasion and restrictive behavior,psychological effects,social fear disorders were (38.5 ± 19.6),(38.8 ±22.5),(28.1 ±20.3),respectively,on admission,and (41.2 ±27.1),(43.7 ± 26.5),(33.5 ± 28.8),respectively,at 6 weeks after nursing,and were (40.9 ± 27.7),(39.6 ± 24.3),(36.3 ± 28.7),respectively,at 12 weeks after nursing.The evasion and restrictive behavior,social fear disorderswere improved at 6,12 weeks after nursing as compared to nursing before.Conclusion Perioperative care for patients with the hyperreflexia of neurogenic detrusor by injection ofbotulinum toxin A can not only improve therapeuticeffect,improve social status,but also improve patients'self-management ability and quality of life.

Purpose To explore the clinical value of ultrasound in charactering brain anomalies in open spina bifida at 11-13+6 weeks of gestation.Materials and Methods Abdominal and transvaginal ultrasound was performed in 125 cases of normal fetus and 4 cases of confirmed open spina bifida at 11-13+6 weeks of gestation to compare the morphology of intracranial translucency (IT), diencephalon and midbrain.Results Fetal IT was readily recognized in all 125 normal cases, with diencephalons and midbrain showing number 8 shape. In 4 cases of open spina bifida, fetal IT cannot be identified, and the expected 8 shape of diencephalon and midbrain was distorted.Conclusion Fetal brain characteristics including intracranial translucency and the shape of diencephalon and midbrain in 11-13+6 weeks gestation are valuable ultrasound screening indicators for open spina bifida.

Objective To observe the seroreversion of serological tests for syphilis in neonates born to mothers with syphilis and to evaluate the influence of antisyphilitic treatment on the time of seroreversion in uninfected neonates.Methods A total of 115 neonates born to mothers with syphilis were recruited in this study,and underwent toluidine red unheated serum test (TRUST),Treponema pallidum particle assay (TPPA)and 19S IgM-TPPA at birth.Follow up was scheduled at 1,3,6,9,12,18 and 24 months of age,and cancelled as soon as both TRUST and TPPA became negative during the 24 months.Both TRUST and TPPA were carried out at each follow-up visit.Kaplan-Meiter survival analysis and Wilcoxon rank-sum test were conducted to assess these data by using SPSS 13.0 software.Results At birth,TPPA was positive in all (100％) of the neonates,TRUST in 97 neonates (84.3％) with the titer ranging from 1 ∶ 1 to 1 ∶ 256,19S IgM-TPPA in 3 neonates who were diagnosed with congenital syphilis (CS).CS was ruled out in the other 112 neonates with negative 19S IgM-TPPA after follow up.Of the 3 neonates with CS,all became negative for TRUST within 12-18 months after birth,2 remained positive for TPPA at 24 months of age,1 remained positive for TPPA at 20 months of age,and all were still followed at the time of this writing.The cumulative seroreversion rate was 82.2％,98.9％ and 100％for TRUST at 0-3,4-6 and 7-9 months of age,respectively in 90 uninfected neonates,3.1％,30.2％,85.4％ and 100％ for TPPA at 0-3,4-6,7-9 and 10-12 months of age,respectively in 96 uninfected neonates.Of 16 neonates who missed some follow-up visits,all turned negative for TRUST and TPPA within 15 months after birth.As far as the TP-seropositive uninfected neonates were concerned,no statistical differences were observed in the seroreversion time of TRUST or TPPA between neonates receiving antisyphilitic treatment and those without antisyphilitic treatment (x2 =0.54,2.41,respectively,both P ＞ 0.05).The seroreversion of TRUST occurred earlier than that of TPPA (Z =10.45,P ＜ 0.01).Conclusions Most uninfected neonates born to syphilitic mothers turn negative for TRUST within 6 months after birth,and for TPPA within 12 months.And the seroreversion of TRUST usually occurs earlier than that of TPPA.Antisyphilitic treatment shows no significant influence on the seroreversion time of TRUST or TPPA in these seropositive uninfected infants.

Objective To compare the effects of combined ‘en bloc' liver-pancreas transplantation (LPT) with portal vein drainage and simultaneous combined kidney-pancreas transplantation (KPT) with systemic venous drainage on the pancreatic endocrine function and related metabolism.Methods Four LPT patients and 6 KPT ones with normal hepato-renal function, good quality of life and periodic follow-up received measurement of serum insulin, insulin provocation test, fasting glucose, oral glucose tolerance test, C-peptide, glycated hemoglobin, triglyceride and total cholesterol; and their laboratory test parameters were compared and analyzed.Results In KPT group, 2-h insulin level, C-peptide level and total cholesterol level were significantly higher at 6th month, 3rd and 6th month postoperation (all P<0.05). But there was no significant difference in other parameters between the two groups at 6th month after operation.Conclusion Either KPT or LPT can achieve excellent endocrine function, carbohydrate and lipid metabolism; and the results show that portal venous drainage does not offer major metabolic advantages within 6 months after operation.