OBJECTIVE: To explore and verify the effect and potential mechanism of Brucea javanica Seed Oil Emulsion Injection (YDZI) and Shengmai Injection (SMI) on peripheral microcirculation dysfunction in treatment of gastric cancer (GC). METHODS: The potential mechanisms of YDZI and SMI were explored through network pharmacology and verified by cellular and clinical experiments. Human microvascular endothelial cells (HMECs) were cultured for quantitative real-time polymerase chain reaction, Western blot analysis, and human umbilical vein endothelial cells (HUVECs) were cultured for tube formation assay. Twenty healthy volunteers and 97 patients with GC were enrolled. Patients were divided into surgical resection, surgical resection with chemotherapy, and surgical resection with chemotherapy combining YDZI and SMI groups. Forearm skin blood perfusion was measured and recorded by laser speckle contrast imaging coupled with post-occlusive reactive hyperemia. Cutaneous vascular conductance and microvascular reactivity parameters were calculated and compared across the groups. RESULTS: After network pharmacology analysis, 4 ingredients, 82 active compounds, and 92 related genes in YDZI and SMI were screened out. β-Sitosterol, an active ingredient and intersection compound of YDZI and SMI, upregulated the expression of vascular endothelial growth factor A (VEGFA) and prostaglandin-endoperoxide synthase 2 (PTGS2, P<0.01), downregulated the expression of caspase 9 (CASP9) and estrogen receptor 1 (ESR1, P<0.01) in HMECs under oxaliplatin stimulation, and promoted tube formation through VEGFA. Chemotherapy significantly impaired the microvascular reactivity in GC patients, whereas YDZI and SMI ameliorated this injury (P<0.05 or P<0.01). CONCLUSIONS YDZI and SMI ameliorated peripheral microvascular reactivity in GC patients. β-Sitosterol may improve peripheral microcirculation by regulating VEGFA, PTGS2, ESR1, and CASP9.
Humans ; Microcirculation/drug effects* ; Drugs, Chinese Herbal/administration & dosage* ; Stomach Neoplasms/physiopathology* ; Emulsions ; Male ; Plant Oils/administration & dosage* ; Brucea/chemistry* ; Middle Aged ; Female ; Drug Combinations ; Human Umbilical Vein Endothelial Cells/metabolism* ; Seeds/chemistry* ; Injections ; Vascular Endothelial Growth Factor A/metabolism* ; Aged ; Network Pharmacology

OBJECTIVE: To investigate the clinical efficacy of acrylic cement (PMMA) mixed with calcium sulfate combined with percutaneous kyphoplasty (PKP) in the treatment of osteoporotic fracture (OVCF). METHODS: The clinical data of 191 patients with OVCF treated with PKP from January 2020 to March 2021 were retrospectively analyzed. Among them, 82 patients with 94 vertebral bodies were treated with PMMA mixed with calcium sulfate as the observation group, and 109 patients with 125 vertebral bodies were treated with pure PMMA as the control group. Among the 82 patients in the observation group, there were 16 males and 66 females, with a mean age of (75.35±11.22) years old, including 36 thoracic vertebrae and 58 lumbar vertebrae. In the control group, there were 109 patients, 22 males and 87 females, with an average age of (74.51±9.21) years old, including 63 thoracic vertebrae and 62 lumbar vertebrae. The visual analog scale (VAS) before operation and 1 day, 3 months and 1 year after operation were calculated. The Oswestry disability index (ODI), Cobb's angle, vertebral body height and the probability of postoperative bone cement leakage were used to analyze the efficacy of the two groups. RESULTS: All the patients were followed up for more than one year. Compared with the control group, there was no significant difference in operation time, bleeding volume and bone cement injection volume between the two groups(P>0.05), while the leakage rate of bone cement was significantly lower in the observation group (P<0.05). In addition, there was no significant difference in VAS, ODI, Cobb angle, and vertebral body height between the two groups before operation, and 1 day, 3 months, and 1 year after operation (P>0.05), but each index was improved compared with that before operation (P<0.05). CONCLUSION PMMA mixed with calcium sulfate has equivalent efficacy in treating OVCF than PMMA alone, but can effectively reduce the probability of cement leakage.
Female ; Male ; Humans ; Aged ; Aged, 80 and over ; Middle Aged ; Polymethyl Methacrylate ; Calcium Sulfate/therapeutic use* ; Osteoporotic Fractures/surgery* ; Bone Cements/therapeutic use* ; Kyphoplasty ; Retrospective Studies ; Lumbar Vertebrae/surgery*

OBJECTIVE: To investigate the clinical efficacy of percutaneous screw fixation combined with minimally invasive transpedicular bone grafting and non-bone grafting in the treatment of thoracolumbar fractures. METHODS: From Janury 2021 to June 2022, 40 patients with thoracolumbar fracture were divided into the experimental group and the control group. There were 26 patients in the experimental group, including 21 males and 5 females with an aberage age of (47.3±12.3) years old, who underwent percutaneous pedicle screw fixation combined with transpedicular autogenous bone grafting. In the control group, 14 patients received percutaneous pedicle screw fixation only. including 7 makes and 7 females with an average age of (50.2±11.2) years old. The operative time, intraoperative blood loss, anterior height ratio of injured vertebrae, Cobb angle, visual analogue score (VAS), MacNab scores, loosening or broken of the implants. were compared and analyzed. RESULTS: There was no significant difference in operation time, intraoperative blood loss, VAS and anterior height ratio of injured vertebrae between the two groups. Compared with the preoperative results, VAS and anterior height ratio of injured vertebrae were improved statistically(P<0.05). For Cobb angle of injured vertebra, there was no significant difference between the two groups before surgery (P=0.766). While at 1 week, 3 months and 12 months after surgery, there were statistically differences between the two groups (P values were 0.042, 0.007 and 0.039, respectively). The Cobb angle of injured vertebrae one year after operation was statistically decreased in both groups compared with that before surgery (P<0.001). One year after surgery, the excellent and good rate of Macnab scores was 96.15% in the experimental group and 92.86% in the control group, and there was no statistical differences between the two groups (P=0.648). There was one patient in the control group suffering superficial wound infection on the third day, which was cured by dressing change and anti-infection treatment. There were no postoperative screw loosening and broken in both groups. CONCLUSION The two surgical methods have the advantages of less trauma, less pain and quicker recovery, which can restore the height of the injured vertebra, reconstruct the spinal sequence and reduce the fracture of the vertebral body. Transpedicular autogenous bone grafting can increase the stability of the fractured vertebra and maintain the height of the vertebra better after surgery, thus reducing the possibility of complications such as kyphosis, screw loosening and broken.
Male ; Female ; Humans ; Adult ; Middle Aged ; Pedicle Screws ; Bone Transplantation ; Blood Loss, Surgical ; Lumbar Vertebrae/injuries* ; Thoracic Vertebrae/injuries* ; Fracture Fixation, Internal/methods* ; Spinal Fractures/surgery* ; Treatment Outcome ; Retrospective Studies

ObjectiveTo investigate inhibitory effect of extracts from Veronica peregrina （EVP） on the osteoclastic bone metastasis induced by breast cancer cells. MethodBone metastasis model was established by injection of MDA-MB-231 cells， a human breast cancer cell line， into the left ventricle of BALB/c nude mice. The expression of human cytokeratin-19 （Ck-19） gene in mouse bone marrow was determined by nested polymerase chain reaction（PCR） to assess the bone metastasis of MDA-MB-231 cells. To assess the effects of EVP on the activation of bone marrow macrophages （BMMs）， we counted the multinuclear cells and measured the secretion of Cathepsin K. Western blot was adopted to assess the effects of EVP on receptor activator of nuclear factor-κB （RANK）， Runt-related transcription factor 2 （ Runx2 ）， phosphorylated Runx2 （p-Runx2）， and matrix metalloproteinase-9 （MMP-9） in BMMs. Gelatin zymography was employed to determine the activities of matrix metalloproteinases （MMPs）. ResultCompared with that in the blank group， Ck-19 expression was down-regulated in EVP groups （P<0.05）. The multinucleated cells increased when the BMMs were induced by soluble receptor activator of nuclear factor-κB ligand （sRANKL）， which was inhibited by EVP （P<0.05）. The level of cathepsin K in the supernatant of sRANKL group increased compared with that of the blank group， while EVP groups had lower cathepsin K levels than sRANKL group （P<0.05）. Compared with the blank group， the sRANKL group showed up-regulated RANK expression， Runx2 phosphorylation， and MMP-9 expression （P<0.05）， while the expression levels of RANK， p-Runx2， and MMP-9 were down-regulated when the cells were incubated with EVP （P<0.05）. Furthermore， exposure of BMMs to sRANKL resulted in an increase in gelatin hydrolyzation compared with the blank group （P<0.01）， which， however， was reversed in EVP groups （P<0.05）. ConclusionEVP significantly inhibits bone marrow metastasis of MDA-MB-231 cells， which may be associated with the suppression of osteoclast activation by inhibiting Runx2 phosphorylation.

Objective: To compare the treatment effect of distraction osteogenesis (DO) and maxillomandibular advancement (MMA) for severe obstructive sleep apnea hypopnea syndrome (OSAHS) patients and to guide clinical decisions about treatment of OSAHS. Methods: Thirty-seven OSAHS patients which accepted maxillomandibular advancement (MMA) or distraction osteogenesis (DO) in Stomatological Hospital of the Department of Maxillofacial Trauma and Orthognathic Surgery, School of Stomatology, The Forth Military Medical University from June 2017 to June 2019 were collected. Their preoperative and postoperative data of cephalometry, polysomnography (PSG), Pittsburgh sleep quality index (PSQI) and Epworth sleepiness scale (ESS) scores were collected and analyzed. With propensity score matching method, the treatment effect of MMA and DO was analyzed and compared. Results: According to the statistics of MMA group, only AHI was correlated with operative successful rate and cure rate. With the increase of AHI, the treatment effect of MMA on OSAHS patients gradually decreased. The cut-off point of AHI as a predictor of MMA treatment failure was 78.2 n/h. All the matched cases were severe OSAHS patients. Statistical analysis showed that the mandibular elongation of DO patients[(24.00±4.39) mm] was significantly more than that of MMA group [(11.20±1.37) mm] (t=-6.11, P<0.001), the improvement of PSG index [including lowest oxygen saturation (LSpO₂), longest apnea (LA) and longest hypopnea (LH)] in DO group [LSpO₂=(93.40±1.82)%; LA=(18.28±8.32) s; LH=(61.84±32.94) s] was significantly higher than that in the MMA group [LSpO₂=(86.00±4.06)%, LA=(64.08±21.78) s, LH=(172.40±30.70) s](t=-3.72, P=0.005; t=4.39, P=0.003; t=5.49, P=0.004). The PSQI and the ESS scores of DO group (PSQI=4.20±0.83; ESS=3.40±1.52) were also significantly better than that of MMA group (PSQI=8.80±2.39, ESS=9.40±2.88)(t=4.07, P=0.001; t=4.12, P=0.002). Conclusions: For severe OSAHS patients, the objective and subjective indicators of DO treatment group showed a better therapeutic effect than that of MMA.
Humans ; Mandibular Advancement ; Osteogenesis, Distraction ; Retrospective Studies ; Sleep Apnea, Obstructive/surgery* ; Treatment Outcome

BACKGROUND: Shenyankangfu Tablet (SYKFT) is a Chinese patent medicine that has been used widely to decrease proteinuria and the progression of chronic kidney disease. OBJECTIVE: This trial compared the efficacy and safety of SYKFT, for the control of proteinuria in primary glomerulonephritis patients, against the standard drug, losartan potassium. DESIGN, SETTING, PARTICIPANTS AND INTERVENTION: This was a multicenter, double-blind, randomized, controlled clinical trial. Primary glomerulonephritis patients, aged 18-70 years, with blood pressure ≤ 140/90 mmHg, estimated glomerular filtration rate (eGFR) ≥ 45 mL/min per 1.73 m MAIN OUTCOME MEASURES: The primary outcome was change in the 24-hour proteinuria level, after 48 weeks of treatment. RESULTS: A total of 735 participants were enrolled. The percent decline of urine protein quantification in the SYKFT group after 48 weeks was 8.78% ± 2.56% (P = 0.006) more than that in the losartan 50 mg group, which was 0.51% ± 2.54% (P = 1.000) less than that in the losartan 100 mg group. Compared with the losartan potassium 50 mg group, the SYKFT plus losartan potassium 50 mg group had a 13.39% ± 2.49% (P < 0.001) greater reduction in urine protein level. Compared with the losartan potassium 100 mg group, the SYKFT plus losartan potassium 100 mg group had a 9.77% ± 2.52% (P = 0.001) greater reduction in urine protein. With a superiority threshold of 15%, neither was statistically significant. eGFR, serum creatinine and serum albumin from the baseline did not change statistically significant. The average change in TCM syndrome score between the patients who took SYKFT (-3.00 [-6.00, -2.00]) and who did not take SYKFT (-2.00 [-5.00, 0]) was statistically significant (P = 0.003). No obvious adverse reactions were observed in any group. CONCLUSION: SYKFT decreased the proteinuria and improved the TCM syndrome scores of primary glomerulonephritis patients, with no change in the rate of decrease in the eGFR. SYKFT plus losartan potassium therapy decreased proteinuria more than losartan potassium therapy alone. TRIAL REGISTRATION NUMBER NCT02063100 on ClinicalTrials.gov.

Gastrectomy ; Humans ; Lymph Node Excision ; Lymph Nodes ; Lymphatic Metastasis ; Retrospective Studies ; Stomach Neoplasms/surgery*

Objective: To observe the clinical efficacy of addition and subtraction therapy of Xuanshen Ganju Tang combined with Sanniutang to post infection cough (PIC) with lung injury caused by dryness and heat, and investigate its effects on allergic inflammation and neurogenic inflammatory mediators.Method: One hundred and eighty eligible patients with PIC were randomly divided into control group (58 cases) and observation group (122 cases) according to the visiting sequence. Patients in control group got compound methoxyphenamine capsules, 2 capsules/time and tid. Patients in observation group got addition and subtraction therapy of Xuanshen Ganju Tang,combined with Sanniutang, 1 dose/day. The treatment course was 7 days in both groups. Symptom scores for cough (day and night), visual analogue scale of coughing (VAS) and scores for lung injury caused by dryness and heat injury were graded. Time to relieve a cough, time to relieve symptoms, time to vanish cough, and cough recurrence were recorded. Life quality was evaluated by cough-specific quality of life questionnaire (CQLQ), and the levels of tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), IL-6, IL-8 and substance P in sputum neurogenic inflammatory mediators (SP), neuropeptide A (NKA) and calcitonin gene related peptide (CGRP) were detected.Result: Ridit analysis showed that the clinical efficacy in observation group was better than that in control group (P<0.05). After treatment, scores of coughing at daytime and night, VAS and lung injury caused by dryness and heat were all lower than those in control group (P<0.01). Time to relieve a cough, time to relieve symptoms, and time to vanish cough were all shorter than those in control group (P<0.01). Remission rate of cough and vanishing rate of cough in observation group were higher, while recurrence rate of cough was lower than those in control group (P<0.05). Expect for emotional health and fear of personal safety, scores of other items in CQLQ, the total score and levels of TNF-α, IL-1β, IL-6, IL-8, SP, NKA and CGRP in observation group were all lower than those in control group (P<0.01).Conclusion: Addition and subtraction therapy of Xuanshen Ganju Tang combined with Sanniutang can control systems of cough, shorten coughing course, reduce recurrence rate, improve patients' life of quality, and can inhibit allergic inflammation and neurogenic inflammatory mediators in the treatment of PIC with symptom of lung injury caused by dryness and heat, with a better clinical efficacy than pure compound methoxyphenamine capsules.

Objective: To observe the effect and mechanism of modified Buzhong Yiqi Tang and pursed-lips breathing (PLB) on serum tumor necrosis factor-alpha (TNF-α), interleukin-8 (IL-8), IL-6, IL-1β and serum cystatin C (Cys-C) in patients of chronic obstructive pulmonary disease (COPD) at the stable stage. Method: Totally 120 cases of COPD treated at Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine from September 2017 to March 2018 conformed to the inclusion criteria, and were randomly divided into treatment group (60 cases) and control group (60 cases). Cases of control group received Tiotropium (18 μg/time, qd). In addition to the therapy of control group, cases of treatment group were also given Buzhong Yiqi Tang and PLB. Both groups were treated for 6 months. Percent of forced expiratory volume in one second in predicted value (FEV₁%), ratio of FEV₁ to forced vital capacity (FEV₁/FVC), six-minute walk distance (6MWD),TNF-α, IL-8, IL-6, IL-1β and Cys-C were compared between both groups. Result: After treatment, the clinical efficacy rate of observation group was 93.33%, which was evidently higher than 86.67%of control group (P<0.05). Compared with before treatment, both groups showed decreases in TNF-a,IL-8, IL-6,IL-1β, Cys-C but increases in FEV₁%, FEV₁/FVC (P<0.05). Compared with control group, treatment group showed decreases in TNF-a, IL-8, IL-6, IL-1β, Cys-C but increases in FEV₁%, FEV₁/FVC (P<0.05). Conclusion: Buzhong Yiqi Tang and PLB has an anti-inflammatory effect on COPD by reducing levels of inflammation cytokines TNF-α, IL-8,IL-6, IL-1β and chronic inflammation markers serum Cys-C and inflammatory reaction, and alleviating airflow obstruction, promoting the levels of FEV₁%, FEV₁/FVC, pulmonary function control inflammatory factors, so as to improve pulmonary function and the quality of life in patients with COPD.

Objective:To study the changes in total phenolic and flavonoid content and antioxidant enzyme activity of Polygala tenuifolia callus in MS medium with different concentrations of H₂O₂,in order to explore the physiological mechanism of Polygala tenuifolia callus in adapting to H₂O₂ environmental stress at the cellular level. Method:Five gradients of 0,5,10,15,20 mmol·L^-1 were set for H₂O₂ concentration and added to MS medium, with P. tenuifolia callus as the experimental material. Total phenols,total flavonoids and antioxidant enzyme activities of callus were determined after 5,10,15,20,25 d of culture,respectively. Result:The contents of total phenols and flavonoids were the highest when the concentration of H₂O₂ was 5 mmol·L^-1 for 15 d. The SOD activity was the highest when the callus was cultured for 5 d and the exogenous H₂O₂ concentration was 5 mmol·L^-1. POD activity was the highest at 25 d and 5 mmol·L^-1 concentration of exogenous H₂O₂.CAT activity was the highest at 25 d and 15 mmol·L^-1 concentration of exogenous H₂O₂. Conclusion:P. tenuifolia callus has the ability to adapt to the environmental stress of H₂O₂ at a certain concentration. When it is subjected to the environmental stress of H₂O₂,P. tenuifolia callus can alleviate the damage by regulating its secondary metabolites and protecting enzyme system. It can significantly promote the content of total phenols and flavonoids in secondary metabolites at 5-10 mmol·L^-1. SOD activity was significantly increased at 5 d and the concentration of exogenous H₂O₂ of 5 mmol·L^-1. POD activity was significantly increased at 25 d and the concentration of exogenous H₂O₂ of 5 mmol·L^-1. CAT activity was significantly increased at 25 d and concentration of exogenous H₂O₂ of 15 mmol·L^-1.