Objective To assess the coordinated regulation and the molecular mechanisms of 17β-estradiol and 1,25-dihydroxyvitamin D3 [ 1,25-( OH ) 2 D3 ] on the proliferation and differentiation of osteoblastic MC3T3-E1 cells.Methods MC3T3-E1 cells were cultured in phenol-red free α-MEM medium supplemented with 10％ FBS,MTT assay was performed to determine the effects of 17β-estradiol and 1,25-( OH )2 D3 on MC3T3-E1 cells proliferation.After cells were treated with different agents,cell cycle related genes [ cyclin E,proliferation cell nuclear antigen ( PCNA ),and cyclin-dependent kinase inhibitor 2b ( Cdkn2b ) ] and markers of osteoblastic differentiation [ type Ⅰ collagen ( COL Ⅰ ),alkaline phosphatase ( ALP),osteopontin ( OPN ) ] were detected with SYBR green-based quantitative PCR.ALP activity was detected with BCIP/NBT method.Results 17β-estradiol could promote proliferation of MC3T3-E1 cells,which was accordant to its ability to increase cyclin E and PCNA and to inhibit Cdkn2b mRNA expression in MC3T3-E1 cells.However,1,25-( OH)2D3 had no effect on the proliferation of MC3T3-E1 cells and also did not enhance the proliferation of MC3T3-E1 cells stimulated by 17β-estradiol.On the other hand,17β-estradiol promoted the gene expression of differentiation markers Col Ⅰ,ALP,and OPN,and 1,25-(OH) 2 D3 synergistically increased the expression of these genes with 17 β-estradiol.Conclusion As two of the most important hormones which regulate bone metabolism,estrogen and vitamin D may coordinately promote osteoblast differentiation,but may not regulate osteoblasts proliferation synergistically.

Objective To explore the detailed underlying molecular and signaling mechanisms in the effects of icariin on bone formation by an in vitro cell model. Methods The proliferation of MC3T3-E1 osteoblast-like cells was evaluated by MTT, and gene expression of cell cycle related proteins in MC3T3-E1 cells after icariin treatment was detected by real-time PCR. The phosphorylation of MAPK signals, including ERK, P38, and JNK was determined by Western blot, and then the inhibitors of MAPK signals were used to treat cells with icariin alone or together to determine the role of MAPKs in the process of icariin treatment on MC3T3-E1 cell proliferation. Alkaline phosphatase and Alizarin red staining were used to detect the formation of mineralization nodules, and gene expressions of alkaline phosphatase, type Ⅰ collagen, and osteocalcin in osteoblasts after being treated by icariin were evaluated by real-time PCR. ICI182780, and nilutamide was used to decide the participation of estrogen and androgen receptor signals in the process of icariin treatment on the differentiation and mineralization of MC3T3-E1 cells. Results Treatment with icariin promoted MC3T3-E1 cell growth in a time- and dose-dependent manner. This treatment also revealed that icariin increased the expression of mRNAs encoding both cyclin E and PCNA, positive regulators of cell growth, but decreased levels of mRNAs encoding Cdkn2b, a negative regulator of cell cycle progression. When MC3T3-E1 cells were cultured in a differentiated condition, icariin enhanced mineralized nodule formation and increased the expression of mRNAs encoding alkaline phosphatase, type Ⅰ collagen, and osteocalcin. Treatment with icariin significantly induced phosphorylation of both ERK and JNK and this phosphorylated effect occurred very rapidly within 5 minutes and reached peak at 15 minutes. Furthermore, the stimulated effects of icariin on proliferation and gene expression of cyclin E, PCNA, and Cdkn2b in MC3T3-E1 cells were dramatically attenuated by treatment with both U0126 and SP600125, inhibitors of MAPKs. Interestingly, such stimulating effects of icariin were at least partly reduced by treatment with ICI182780, an inhibitor of estrogen receptor. Icariin induced mineralized nodule formation and gene expression of alkaline phosphatase, type Ⅰ collagen, and osteocalcin in MC3T3-E1 cells were also partly reduced when the cells were treated with ICI182780. Conclusions Our findings indicate that the anabolic effect of icariin on bone formation is, at least partly, mediated through the MAPK signaling pathway in order to modulate osteoblast proliferation and differentiation.

Objective To investigate the effects of icarrin on the activity and protein expression of core binding factor otl(Cbfa1) in rat osteoblasts cultured in vitro,and to explore whether mitogen-activated protein kinase (MAPK) pathway is involved in this process.Methods Calvarial osteoblasts were obtained from newborn (<24 h) SD rats by trypsin-coUagenase digestion method.The second generation osteoblasts were cultured in the medium containing icariin (10 ng/ml) or estradiol (10-8 mol/L) with or without extracellular-signal regulated kinase (ERK) inhibitor (UO126) or p38MAPK inhibitor (SB203580).Nuclear protein was extracted from osteoblasts.And then the activity of Cbfa1 was detected by ELISA.The amounts of Cbfa1 protein were detected by Western blot.Results Calvarial osteoblasts were obtained successfully and were used in this study after indentified by alkaline phosphatase and mineralized nodus staining.Cbfa1 expression and the activity in osteoblasts were up-regulated by both icariin and estradiol (P<0.05).The effects were partly inhibited by addition of U0126or SB203580 (P<0.05).Conclusions Either icarrin or estradiol can stimulate the proliferation and maturation of cultured osteoblasts in vitro via up-regulating the activity and expression of Cbfal.The MAPK signal pathway inhibitor seems to partly decrease Cbfa1 activity.It suggests that MAPK pathway may be involved in the transduction of icariin's impact on proliferation and mineralization of osteoblasts.

There is an urgent need for innovative graduate students in clinical medicine who possess the ability to apply interdisciplinary knowledge to address complex and cutting-edge challenges in the background of new medical science. The two training modes, "X + Medicine" and "Medicine + X", are essential measures to promote the construction of new medical science. The "X + Medicine" mode is better suited for cultivating the exceptional medical talents; however, it has limitations such as constrained applicability and talent attrition. The "Medicine + X" mode can be applied in various ways in general medical schools, but it has not broken through the boundaries of traditional disciplines or achieved a substantial scale. In order to provide useful insights for cultivating innovative graduate students in clinical medicine who meet the needs of new medical science, we propose the integration of curriculums, the implementation of quantitative evaluation, and the increase in funding for scientific research to make the "X + Medicine" more adaptable to China's national conditions and to mitigate talent loss. Additionally, we suggest strengthening overall management and expanding collaboration with other schools and companies to improve the "Medicine + X" mode.

Objective To observe the value of amide proton transfer(APT)imaging for assessing central nervous system damages in stable chronic obstructive pulmonary disease(COPD)and the correlations with MR spectroscopy(MRS)and lung function parameters.Methods Thirty-nine stable COPD patients(COPD group)and 34 healthy subjects(control group)were prospectively enrolled.Images of plain head MR,3D-APT and thalami MRS were acquired,and parameters of lung function were obtained.The basic data,outcomes of voxel-based morphometry(VBM)analysis,APT values in multiple brain regions and thalami MRS metabolite parameters were compared between groups,and the correlations of thalamus APT values with thalamus MRS metabolites parameters and lung function parameters were explored.Results Lung function parameters in COPD group were lower than those in control group,while cerebrospinal fluid volume(CSFV)and total brain volume(TIV)in COPD group were lager than those in control group(all P＜0.05).Compared with those in control group,APT values of bilateral thalami,right temporal lobe and right occipital lobe in COPD group were higher,and the peak value of N-acetyl aspartate(NAA)of bilateral thalami and NAA/creatin of right thalamus in COPD group were lower(all P＜0.05).Within COPD group,APT values of bilateral thalami were positively correlated(r=0.641),while APT values of left thalamus showed negative correlation(r=-0.435)with NAA values left thalamus and negative correlation(r=-0.432)with the forced expiratory volume in the first one second after bronchodilator administration(FEV1)(all P＜0.05).Conclusion APT values of central nervous system elevated and NAA values decreased in COPD patients.There were negative correlations between left thalamus APT and NAA values,also between APT values of left thalamus and FEV1.

Purpose The feasibility and application value of 3D amide proton transfer weighted(APTw)imaging is used to evaluate central nervous system injury in stable chronic obstructive pulmonary disease(COPD)patients.Materials and Methods A total of 36 COPD patients who attended the First Affiliated Hospital of Henan University of Chinese Medicine from January 2022 to August 2023 were selected along with 31 age-and gender-matched healthy volunteers.All subjects underwent pulmonary function tests,routine blood tests,Montreal cognitive assessment scale(MoCA)assessment and 3.0T MRI scan.The APT values of each brain region were measured independently and assessed for consistency by two observers,and the differences in APT values of each brain region were compared between the two groups to explore the correlation between the APT values of multiple brain regions and the pulmonary function,blood indices,and MoCA scores.Results The measurement consistency of APT values in multiple brain regions among observers was good(ICC>0.75).The APT values of brain regions in the COPD group were higher than those in the healthy control group,with statistically significant differences between the bilateral pallidum(t=2.490,2.168),the right thalamus(t=2.754),the nucleus accumbens(t=2.137),the temporal lobe gray matter(t=3.533)and the occipital lobe gray matter(t=2.345)compared with those in the healthy control group(all P<0.05);the APT values of the multiple brain regions were in a negative correlation(r=-0.390--0.084),with a stronger correlation between bilateral pallidum(r=-0.390,-0.370,both P<0.05);lung function indexes(forced vital capacity,forced expiratory volume in one second,forced expiratory volume in one second/forced vital capacity,forced expiratory volume in one second/prediction)in the COPD group showed a negative correlation trend with the APT values of the multibulbar areas(r=-0.339--0.010,all P>0.05),while white blood cell count,red blood cell count,hemoglobin concentration and platelet count showed a positive correlation trend with multi brain APT values(r=0.084-0.587).Conclusion As a novel MRI technology,APTw has potential application value in early detection of central nervous system damage in COPD patients and non-invasive monitoring of disease progression.

BACKGROUND: Although intensively studied in patients with cardiovascular diseases (CVDs), the prognostic value of diastolic blood pressure (DBP) has little been elucidated in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). This study aimed to reveal the prognostic value of DBP in AECOPD patients. METHODS: Inpatients with AECOPD were prospectively enrolled from 10 medical centers in China between September 2017 and July 2021. DBP was measured on admission. The primary outcome was all-cause in-hospital mortality; invasive mechanical ventilation and intensive care unit (ICU) admission were secondary outcomes. Least absolute shrinkage and selection operator (LASSO) and multivariable Cox regressions were used to identify independent prognostic factors and calculate the hazard ratio (HR) and 95% confidence interval (CI) for adverse outcomes. RESULTS: Among 13,633 included patients with AECOPD, 197 (1.45%) died during their hospital stay. Multivariable Cox regression analysis showed that low DBP on admission (<70 mmHg) was associated with increased risk of in-hospital mortality (HR = 2.16, 95% CI: 1.53-3.05, Z = 4.37, P <0.01), invasive mechanical ventilation (HR = 1.65, 95% CI: 1.32-2.05, Z = 19.67, P <0.01), and ICU admission (HR = 1.45, 95% CI: 1.24-1.69, Z = 22.08, P <0.01) in the overall cohort. Similar findings were observed in subgroups with or without CVDs, except for invasive mechanical ventilation in the subgroup with CVDs. When DBP was further categorized in 5-mmHg increments from <50 mmHg to ≥100 mmHg, and 75 to <80 mmHg was taken as reference, HRs for in-hospital mortality increased almost linearly with decreased DBP in the overall cohort and subgroups of patients with CVDs; higher DBP was not associated with the risk of in-hospital mortality. CONCLUSION: Low on-admission DBP, particularly <70 mmHg, was associated with an increased risk of adverse outcomes among inpatients with AECOPD, with or without CVDs, which may serve as a convenient predictor of poor prognosis in these patients. CLINICAL TRIAL REGISTRATION Chinese Clinical Trail Registry, No. ChiCTR2100044625.
Humans ; Blood Pressure ; Pulmonary Disease, Chronic Obstructive/therapy* ; Cohort Studies ; Respiration, Artificial ; Inpatients ; Hospital Mortality