Objective:To evaluate systematically the outcomes of prevention of fragility fracture with alendronate use for 3 to 4 years.Methods:We searched CENTRAL, MEDLINE, EMBASE and CBM for relevant randomized controlled trials published before 16 July, 2020. The quality of included studies was evaluated according to the Cochrane tool for assessing risk of bias. Fix- or random-effects were taken for meta-analysis depending on the magnitude of heterogeneity. Sensitivity analysis was used for high risk studies to assess the robustness of results. The results were reported according to The PRISMA 2009 Check-list.Results:A total of 8 reports from 4 studies were included. Two reports from 2 studies were rated as high-risk while the other 6 reports from the other 2 studies as low-risk. The meta-analyses showed that use of alendronic acid for 3 to 4 years effectively prevented new vertebral fracture ( RR=0.54, 95% CI: 0.44 to 0.66, RD=-0.03), clinical fracture ( RR=0.82, 95% CI: 0.73 to 0.92, RD=-0.03), non-vertebral fracture ( RR=0.84, 95% CI: 0.75 to 0.95, RD=-0.02), clinical vertebral fracture ( RR=0.51, 95% CI: 0.34 to 0.76, RD=-0.01) and hip fracture ( RR=0.56, 95% CI: 0.37 to 0.87, RD=-0.01), but did not prevent wrist fracture ( RR=0.85, 95% CI: 0.67 to 1.09), serious adverse event ( RR=0.95, 95% CI: 0.80 to 1.14) or upper gastrointestinal adverse event ( RR=1.02, 95% CI: 0.96 to 1.07). By the sensitivity analysis of the 6 results from the high-risk reports, the HRs for clinical fracture, non-vertebral fracture, vertebral fracture, hip fracture, wrist fracture, and serious adverse event were, respectively, 0.81, 0.85, 0.49, 0.62, 0.94 and 0.94. Conclusions:Alendronate use for 3 to 4 years can effectively prevent fragility fractures in postmenopausal women with low bone mass or osteoporosis, leading to better prevention effect on vertebral fracture than on non-vertebral fracture.

Objective To study the effects of 6-week aerobic treadmill exercise on the genes expression in skeletal muscle of C57BL/6 mice.Gene array was performed and the data was analyzed to evaluate the adaptive changes at gene level caused by exercise.Methods Twenty male C57BL/6 mice were randomly divided into two groups:control group(C) and aerobic exercise group (E).The mice from group E were forced to run on treadmill for 6 weeks.After 6 weeks,all mice were fasted for 16 hours,and then sacrificed.Their flexor muscle was removed.4 samples from each group were analyzed with gene chips to dissect the differentially expressed genes between the two groups.Results Our results showed that 723 genes were differentially expressed in E group as compared with C group after the 6 weeks aerobic exercise,among which 510 genes were up-and 213 down-regulated.There were 6 differentially expressed calcium signaling genes and 2 ofwhich(Gnall and Pdgfra) were up-regulated,while the others(Phka1,Picd4,RYR1 and Ppid)were down regulated.

Objective:To discuss the influence of Tongfengning Capsule (TFN) in the levels of uricacid (UC),creatinine (Cr) and urea nitrogen (BUN) in mouse serum and the activities of the xanthine oxidase (XOD),adenosine deaminase (ADA) activity in the liver homogenate of the mice with hyperuricemia,and to observe the improvement effect of TFN on the pathological changes of liver tissue and to clarify its mechanisms.Methods:The models of mouse hyperuricemia were induced by yeast extract with potassium oxonate.Seventy mice were divided into blank control group,model group,low (200 mg · kg 1),medium (400 mg · kg-1) and high (800 mg · kg-1) doses of TFN groups,allopurinol positive drug control group (50 mg · kg-1),Tongfengshu (TFS,600 mg · kg-1) positive drug control group (n=10).The levels of UC,Cr,BUN in serum and the activities of XOD,ADA in homoggenate were detected and the histopathological changes of the kidney tissue of the mice were measured with HE staining.Results:Compared with blank control group,the levels of serum UC,Cr and BUN ofthe mice in model group were significantlyincreased (P＜0.01),and the activities of XOD and ADA in liver tissue were also increased (P＜0.01).Compared with model group,the levels of serum UC,Cr and BUN of the mice in positive drug control groups and different doses of TFN groups were decreased (P＜0.01),and the activities of XOD and ADA in liver tissue were also decreased (P＜0.05),especially in high dose of TFN group.Compared with model group,the pathologic changes such as renal glomerulus atrophy,renal interstitial fibrosis and expansion of renal tubule of the mice in positive drug control groups and high dose of TFN group were improved to a certain extent.Conclusion:TFN has improvement effcet on the hyperuricemia in the mice and its mechanism is related to the inhibition of uricogenesis and the promotion of UC excretion.

The correspondence between prescription and syndrome is the advantage and characteristic of traditional Chinese medicine(TCM)treatment.However,the pathogenesis of clinical diseases is complex and the condition is changeable,and the clinical application is difficult to achieve the maximum effect under the existing cognition of the correspondence between prescription and syndrome.In this paper,the five categories of physiological characteristics,pathological characteristics,constitution,syndrome,and disease of the longitudinal classification of"TCM state"are introduced into the correspondence of prescription and syndrome.Under the vertical perspective of"TCM state",the theoretical connotation of the correspondence between prescription and syndrome is interpreted as"correspondence between prescription and state",namely correspondence of"prescription-physiological characteristics",correspondence of"prescription-pathological characteristics",correspondence of"prescription-constitution",correspondence of"prescription-syndrome",and correspondence of"prescription-disease".It is hoped to accurately grasp the corresponding connotation of the correspondence between prescription and syndrome,in order to deepen the clinical thinking mode of TCM.

Based on the"You Gu Wu Yun"theory in traditional Chinese medicine(TCM),this paper believes that"Gu"in"You Gu Wu Yun"is extended to"state"from the perspective of"TCM state".In order to avoid the adverse reactions of TCM,the macro,meso,and micro three views should be used together,and macro,meso,and micro parameters should be integrated.We should also carefully identify the physiological characteristics,pathological characteristics,constitution,syndrome,and disease of human body by combining qualitative and quantitative method,highlighting the relationship between the prescription and the"state".The correspondence between prescription and the"state"will reduce the risk of adverse reactions of TCM.In this paper,we hope to focus on the guiding role of the"You Gu Wu Yun"theory in TCM research,to give full play to the characteristics and advantages of TCM,and to dialectically treat the role of TCM.

Objective To investigate the correlations between the FBN1 gene mutation types and the clinical phenotype . Methods 87 probands with Marfan or Marfan-like syndromes and their family members were enrolled in this study ( total 300 cases).The clinical manifestations of each patients involving the ocular, cardiovascular system, skeletal system and other im-plicated systems were collected and evaluated .According to the clinical manifestations , these patients were divided into two groups, namely aortic dissection group and aortic root aneurysm group.Blood samples were taken from patients and DNA se-quencing was performed on each patient by the genetic aortic disease gene Panel .The detected single nucleotide variants ( SNVs)/indel were interpreted according to the ACMG guidelines, and the pathogenic variation was confirmed through Sanger sequencing.The aortic wall tissue was obtained from MFS patients who underwent surgery .The correlations between genotypes and clinical phenotypes were further explored by comparing the aortic wall tissue histological specimens of each genotype pa-tient.Results A total of 92 FBN1 mutations(31％) were detected in 300 people with Marfan syndromes or Marfan-like syn-dromes, 18 of which were undiscovered mutations.There were 49 missense mutations(53.26％), 13 splicing mutations (14.13％), 17 frameshift mutations(18.48％), and 13 nonsense mutations(14.13％).In this cohort, 24 cases had aortic dissection and 25 cases were aortic root aneurysm.Statistical analysis revealed that patients with aortic dissection mostly ap-peared in frameshift mutations(29.17％ vs.4.00％, P =0.017).However, patients with aortic root aneurysm mostly ap-peared in missense mutations(72.00％ vs.37.50％, P =0.015), and accompanied with ectopia lentis(41.67％ vs. 8.33％, P=0.008).Pathological specimens staining found that elastic fibers in the aortic wall of patients with frameshift mu-tations are sparser, and the smooth muscle cells are more deficient and more disorganized than patients with missense muta-tions.Conclusion FBN1 gene frameshift mutations result a lack of elastic fibers and disorganized smooth muscle cells in aor-tic wall and are presented more in patients with aortic dissection than aortic root aneurysm .