Objective The goal of this study was to investigate the correlation between the level of serum vitamin D and bone metabolism and disease activity in ankylosing spondylitis(AS) patients,and thus to explore the role of vitamin D in bone metabolism in AS patients.Methods The serum levels of BALP,TRACP-5b,25-(OH)D3 and blood lymphocytes VDR of 80 AS patients were measured by enzyme-linked immunosorbent assay (ELISA) and compared with those of the control group.Bone mineral density (BMD)was measured by dual-energy X-ray absorptiometry (DEXA).The ESR and CRP level of AS patients were also measured.The correlation between those parameters was analyzed and evaluated.Patients were divided into normal,insufficient and deficient subgroups according to the serum 25-(OH)D3 levels for further comparison.Indepondent saimple t test,t'test andx2 test were used for statistical analysis.Results The 25-(OH)D3 of AS patients [(11.9±2.7) μg/L] was significantly lower than that of the control groups [(22.3±7.9) μg/L] (P＜0.05),while the serum levels of BALP [(3.9±2.7) μg/L] and TRACP-5b [(46±25) ng/L] of AS patients were significantly higher than those of the control group [(2.4±1.0) μg/L] (P＜0.05).According to linear correlation analysis,25-(OH)D3 was negatively correlated with CRP (r=0.324,P=0.003).The ESR,BALP,TRACP-5b in the deficient subgroup were higher than those in the normal and insufficient subgroups(P＜0.05).Conclusion The plasma 25-(OH)D3 may decrease in AS patients,and this may activate bone metabolism,results in increased morbidity of osteoporo-sis,and negatively affect disease activity.

5-fluorouracil (5-Fu) has been the basic drug in the first-line chemotherapy for colorectal cancer so far. A large number of studies have focused on the discovery of gene polymorphism sites for predicting the efficacy or adverse reactions of 5-Fu. Multiple polymorphic sites of genes such as TYMS, DPYD, and MTHFR may play a role in it. However, no consistent conclusion has been reached over the effect of same polymorphic site on the therapeutic outcome. The application of whole genome sequencing and multi-gene joint analysis may carry out more comprehensive and in-depth researches in the future. This paper reviews the progress of related gene polymorphism of 5-Fu-based chemotherapy efficacy and adverse reactions in colorectal cancer.

Clinical data of 899 patients,who received colposcopic examination,were retrospectively analyzed.Both Reid's colposcopic index(RCI)score and biopsy were performed.The study showed that the value of RCI score was positively related to the severity of cervical lesions(F=2.043,P=0.03).The specificity of RCI for cervicitis,cervical intraepithelial neoplasia(CIN)Ⅰ were 98.8%,95.7% respectively;while sensitivity and negative predictive value for CIN Ⅱ,CIN Ⅲ were 77.7%,70.0%and 96.8%.97.4%,respectively.So RCI scoring can increase the diagnostic value of colposcope.

Objective To investigate the changes and significance of Th1/Th2 cytokines in ankylosing spondyhtis (AS).Metbotis Serum and synovial fluid levels of TNF-α,IL.17.IL-10 and IL-4 were detected by en-zyme linked immunosorbent assay(ELISA)in AS cases.Results The serun levels of TNF-α,IL-17 and IL-10 were significantly higher,while the serum level of IL-4 Was significantly lower in AS group than in normal group.The levels of TNF-α.IL-17 and IL-4 in synovial fluid were significantly higher than in serum.Conclusion Disequilibrium exists in Th1/Th2 cytokine network of AS.and there is a strong predominance of Th1.

Objective To summarize and evaluate the characteristics of current recurrent spontaneous abortion(RSA)animal models at home and abroad,and to provide reference and guidance for the standardized preparation of RSA models.Methods"Recurrent spontaneous abortion"and"animal model"were used as co-keywords in CNKI,Wanfang,VIP,PubMed and Web of Science databases to search the RSA animal experimental literature,covering the period up to January 20,2024,and a total of 1 411 articles were collected.The analysis focused on construction methods and essential elements of RSA animal models,the modeling process and result evaluation,as well as the application of these models in pharmacological and pharmacodynamic research.An Excel table was established for systematic analysis and discussion.Results A total of 138 experimental studies were obtained after screening.In constructing RSA animal models,immunological models were the most widely used in Western medicine(96.92％),with the Clark model being the main one(92.31％).In traditional Chinese medicine(TCM)models,70.00％were kidney deficiency-luteal inhibition-syndrome combination models,20.00％were kidney deficiency and blood stasis models,and 10.00％were deficiency-heat syndrome models.Most animals were selected at 6-8 weeks(33.86％)and 8 weeks(32.28％)of age.The majority of animals were paired for mating at 18:00 on the day of cage pairing.In 81.03％of literatures,vaginal plugs were checked once the following morning,with 8:00 being the most common time(17.02％).The most commonly used drug administration cycle was 14 days of continuous gavage after pregnancy.Among the tested drugs,Western drugs were mainly protein-based(29.17％),while TCM drugs were mainly TCM decoction(81.11％).The most frequently used methods for detecting indicators included visual observation of embryos(22.54％),western blot(15.96％),PCR(13.58％),ELISA(12.91％),HE staining(10.80％)and immunohistochemistry(9.39％).Conclusion The etiology of RSA is complex,and corresponding animal models should be established based on different etiologies.Clark model is commonly used in the construction of Western medicine model,while the kidney deficiency-luteal inhibition-syndrome combination model is predominant in TCM.RSA animal model is widely used in related research,but systematic evaluation needs to be strengthened.

Humans ; Clavicle ; Fractures, Bone/surgery*

Objective To study the inhibitory mechanism of hydroxysafflor yellow A (HSYA)on abnor-mal proliferation of vascular endothelial cells.Methods Co-cultured model in vitro was established, with supernatant fraction of LS180 human colon adenocarcinoma cells tumor cells and ECV304 human umbilical vein endothelial cells.Then mRNA expressions of vascular endothelial growth factors (VEGF) and VEGF receptors (KDR),basic fibroblast growth factor (bFGF)and bFGF receptors(bFGFR),pro-teoglycan related to cell proliferation (HSPG2),p53 and c-myc were detected using real-time fluores-cence quantitative PCR;protein expressions of VEFG,KDR,bFGF and bFGFR in supernatant fraction were measured by ELISA.Results In the cell co-cultured model,the HSYA concentration of 0.66 and 0.33 mg/L inhibited mRNA and protein expressions of VEGF,KDR,bFGF and bFGFR ,inhibited mR-NA expressions of c-myc and HSPG2,while upregulated p53 mRNA expression.Conclusion HSYA in-hibited angiogenesis and abnormal proliferation of vascular endothelial cells in co-cultured model by regu-lating expressions of VEGF,VEGFR,bFGF,bFGFR,HSPG2,c-myc,wild type p53.HSYA may be a potential tumor angiogenesis inhibitor.

Objective:To explore the impact of early and late antibody-mediated rejection (AMR) on treatment options and allograft outcomes after kidney transplantation (KT).Methods:From January 2013 to December 2022, the study retrospectively enrolled 141 KT allograft recipients receiving allograft biopsy and diagnosed as AMR according to the Banff 2019 criteria. Recipients with a diagnosis of AMR within 30 days post-KT were classified into early AMR group (n=19) while the remainders assigned as late AMR group (n=122). The outcome endpoints included recipient survival rate, death-censored graft survival rate, follow-up estimated glomerular filtration rate (eGFR) and immunodominant donor-specific antibody (DSA) intensity. Wilcoxon's test was utilized for assessing the differences in eGFR and DSA intensity while Kaplan-Meier curve and Log-rank test were employed for evaluating graft survival impact. Treatment regimens for AMR were collected and categorized.Results:The median follow-up duration was 2.6(1.2, 5.2) year. No graft failure was noted in early AMR group while 44 recipients in late AMR group experienced graft failure, with 34 cases (77.2%) due to AMR progression. The 5-year death-censored graft survival rate was significantly better in early AMR group than that in late AMR group [100% vs 60.1%(50.5%, 71.6%), P=0.002]. The one-year change in eGFR for early AMR group was significantly superior to that of late AMR group [19.3(-2.6, 38.1) vs -3.3(-14.0, 5.4), P=0.001]. One-year mean fluorescent intensity (MFI) of early AMR group was 1 158(401.5, 3 126.5). It was significantly lower than that when diagnosed with early AMR [3 120.5(2 392.8, 9 340.0)] and one-year MFI of late AMR group [8 094(2 251.5, 13 560.5)] ( P=0.005, P<0.001). Early AMR group primarily received standard treatment (3/19, 15.8%) and regimens centered on rituximab and/or bortezomib (7/19, 43.8%). Late AMR group mainly received standard (16/122, 13.1%) or intensified regimens (9/122, 7.4%) and regimens focused upon rituximab and/or bortezomib (32/122, 26.2%) and MP monotherapy (21/122, 17.2%). Conclusion:The outcome for early AMR is significantly better than that for late AMR. For early AMR, early and robust immunosuppression is recommended. For late AMR, early detection and timely treatment are crucial and individualized strategies should be implemented.

OBJECTIVETo compare the efficacy difference between acupotomy and acupuncture in the treatment of avascular necrosis of femoral head at the early and middle stages.

METHODSThe randomized controlled prospective study method was adopted. Sixty cases of avascular necrosis of femoral head at Ficat-ArletⅠto Ⅱ stages were randomized into an acupotomy group (32 cases) and an acupuncture group (28 cases) by the third part. In the acupotomy group, the acupotomy was adopted for the loose solution at the treatment sites of hip joint, once every two weeks, totally for 3 times. In the acupuncture group,points around the hip joint were selected and stimulated with warm acupuncture therapy, once every day, for 6 weeks. Harris hip score was observed before and after treatment. The efficacy was evaluated in the two groups.

RESULTSHarris hip score was improved significantly after treatment in the two groups (both<0.05). The result in acupotomy group was better than that in the acupuncture group (<0.05). The effective rate was 90.6% (29/32) in the acupotomy group, better than 75.0% (21/28) in the acupuncture group after treatment (<0.05).

CONCLUSIONSHarris hip score and the effective rate in the acupotomy group are better than those in the treatment with routine acupuncture for avascular necrosis of femoral head at the early and middle stages.

“Deficiency cause， cold accumulation， and qi stagnation” originates from Essentials from the Golden Cabinet （《金匮要略》）， which is a guiding principle for the pathogenesis of women's diseases， pioneering the differentiation and treatment of women's diseases based on patterns， and having a profound influence on future generations. Following the classical principles and simplifying the complexities， this paper explored the pathogenesis and mechanism of polycystic ovary syndrome （PCOS） from the perspective of “deficiency cause， cold accumulation， and qi stagnation”， and believed that depletion of essence and blood， long-term accumulation of internal cold， and qi constraint and blood stasis are the causes of PCOS， with depletion of essence and blood， and lack of nourishment of zang-fu （脏腑） organs as the root， and cold pathogen invasion， qi constraint and blood stasis as the branch. The main treatment principle is “treating deficiency with supplementation”， and dispelling pathogen while reinforcing healthy qi， along with “treatment of cold by warming” and “treatment of stagnation by dispersing”. This is of great significance for the treatment of polycystic ovary syndrome. Clinically， these methods can be used flexibly to guide treatment and formula selection for PCOS， with the goal of harmonizing qi and blood and regulating menstruation.