BACKGROUND:Zinc-based alloy medical implant materials have excellent mechanical properties,complete degradability and good biocompatibility,and are mainly used in orthopedic implants,cardiovascular stents,bile duct stents,tracheal stents,nerve catheters,etc. OBJECTIVE:To review the research progress of biodegradable zinc-based alloys in bone defect repair and prospect the promising research direction and achievements of zinc-based materials. METHODS:After searching PubMed,Web of Science,WanFang Data,and CNKI databases from the establishment of the database to June 2023,various relevant articles on biodegradable zinc-based alloys for bone implant material research were collected.The basic characteristics of biodegradable zinc based alloys were summarized,and the role of zinc-based alloys in promoting bone tissue repair was sorted and summarized.The current research hotspots and shortcomings were discussed. RESULTS AND CONCLUSION:(1)Zinc-based alloys have good biocompatibility.Using zinc-based alloys as the matrix material,with the help of scaffold structure construction technology and coating optimization process,the bone conductivity of zinc-based alloys will be effectively improved,and their degradation products will have efficient bone induction to regulate the gene expression of osteoblasts and osteoclasts,thereby promoting the repair and reconstruction of bone defects.(2)However,in the research on optimizing zinc-based alloys,the coating process is relatively insufficient,and additive loading technology is still lacking.(3)Zinc-based alloys have excellent mechanical and biological properties.Through special processes,their bone conductivity and osteoinductivity can be increased to effectively improve their ability to promote bone repair and reconstruction,and it is expected to further achieve the development of personalized transplant materials.Further research and development are needed to optimize the integration of coating and additive loading technologies into zinc-based alloys.

BACKGROUND: The available evidence regarding the benefits of percutaneous coronary intervention (PCI) on patients receiving dialysis with coronary artery disease (CAD) is limited and inconsistent. This study aimed to evaluate the association between PCI and clinical outcomes as compared with medical therapy alone in patients undergoing dialysis with CAD in China. METHODS: This multicenter, retrospective study was conducted in 30 tertiary medical centers across 12 provinces in China from January 2015 to June 2021 to include patients on dialysis with CAD. The primary outcome was major adverse cardiovascular events (MACE), defined as a composite of cardiovascular death, non-fatal myocardial infarction, and non-fatal stroke. Secondary outcomes included all-cause death, the individual components of MACE, and Bleeding Academic Research Consortium criteria types 2, 3, or 5 bleeding. Multivariable Cox proportional hazard models were used to assess the association between PCI and outcomes. Inverse probability of treatment weighting (IPTW) and propensity score matching (PSM) were performed to account for potential between-group differences. RESULTS: Of the 1146 patients on dialysis with significant CAD, 821 (71.6%) underwent PCI. After a median follow-up of 23.0 months, PCI was associated with a 43.0% significantly lower risk for MACE (33.9% [ n  = 278] vs . 43.7% [ n  = 142]; adjusted hazards ratio 0.57, 95% confidence interval 0.45-0.71), along with a slightly increased risk for bleeding outcomes that did not reach statistical significance (11.1% vs . 8.3%; adjusted hazards ratio 1.31, 95% confidence interval, 0.82-2.11). Furthermore, PCI was associated with a significant reduction in all-cause and cardiovascular mortalities. Subgroup analysis did not modify the association of PCI with patient outcomes. These primary findings were consistent across IPTW, PSM, and competing risk analyses. CONCLUSION This study indicated that PCI in patients on dialysis with CAD was significantly associated with lower MACE and mortality when comparing with those with medical therapy alone, albeit with a slightly increased risk for bleeding events that did not reach statistical significance.
Humans ; Percutaneous Coronary Intervention/methods* ; Male ; Female ; Coronary Artery Disease/drug therapy* ; Retrospective Studies ; Renal Dialysis/methods* ; Middle Aged ; Aged ; China ; Proportional Hazards Models ; Treatment Outcome

Objective To investigate the relationship between nuclear factor(NF)-κB signaling pathway and gender differences in alcoholic liver fibrosis. Methods C57BL/6 N mice at 7-8 weeks of age were randomly divided into: male normal group, male model group, female normal group and female model group of 20 mice each. The normal group was fed with control liquid diet for 8 weeks, and the model group was fed with alcoholic liquid diet for 8 weeks combined with 31.5% ethanol gavage (5g/kg twice a week) to establish an alcoholic liver fibrosis model. The mice were executed at the end of 8 weekends, and the alanine aminotransferase (ALT), aspartate aminotransferase (AST) activity, estradiol (E

ObjectiveThe differential expression of microRNAs （miRNAs） between the active stage and the remission stage of ulcerative colitis （UC） was analyzed by bioinformatics method， and the regulatory relationship was constructed by screening the differentially expressed genes （DEGs）. The mechanism of Xizhuo Jiedu recipe in the treatment of UC was speculated and verified by animal experiments. MethodThe miRNAs data set of colonic mucosa tissue of UC patients was obtained from the gene expression database （GEO）， and the most differentially expressed miRNAs were screened by GEO2R， Excel， and other tools as research objects. TargetScan， miRTarbase， miRDB， STRING， TRRUST， and Matescape databases were used to screen key DEGs， predict downstream transcription factors （TFs）， gene ontology （GO）， and conduct Kyoto Encyclopedia of Genes and Genomes （KEGG） enrichment analysis. The key signaling pathways were selected for animal experiments. In animal experiments， the UC mouse model was prepared by making the mouse freely drink 2.5% dextran sodium sulfate （DSS）. Xiezhu Jiedu recipe and mesalazine were given by gavage for seven days， and the inflammatory infiltration of colonic mucosa was observed by hematoxylin-eosin （HE） staining. Real-time fluorescence quantitative polymerase chain reaction （Real-time PCR） was used to detect the mRNA expression of miR-155-5p in colon tissue. Immunohistochemistry and Western blot were used to detect the protein expression levels of cytokine signal transduction inhibitor （SOCS1）， phosphorylated transcriptional signal transductor and activator 3 （p-STAT3）， phosphorylated Janus kinase 2 （p-JAK2）， and retinoic acid-associated orphan receptor-γt （ROR-γt）. The expression levels of transforming growth factor-β （TGF-β）， interleukin-17 （IL-17）， interleukin-6 （IL-6）， and interleukin-10 （IL-10） in serum were detected by enzyme linked immunosorbent assay （ELISA）. ResultThe GSE48957 dataset was screened from the GEO database， and miR-155-5p was selected as the research object from the samples in the active and remission stages. 131 DEGs were screened. The GO/KEGG enrichment analysis was closely related to biological processes such as positive regulation of miRNA transcription and protein phosphorylation， as well as signaling pathways such as stem cell signaling pathway， IL-17 signaling pathway， and helper T cell 17 （Th17） cell differentiation. The Matescape database was used to screen out 10 key DEGs， among which SOCS1 was one of the key DEGs of miR-155-5p. Further screening of the TFS of key DEGs revealed that STAT3 was one of the main TFs of SOCS1. The results of animal experiments showed that Xiezhu Jiedu Recipe could effectively down-regulate the mRNA expression of miR-155-5p and protein expression of p-STAT3， p-JAK2， and ROR-γt in colon tissue of UC mice and the expression of IL-17 and IL-6 in serum of UC mice， up-regulate the protein expression of SOCS1 and the expression of TGF-β and IL-10， increase the level of anti-inflammatory factors， and reduce inflammatory cell infiltration. ConclusionIt is speculated that Xizhuo Jiedu recipe may interfere with SOCS1 by regulating the expression of miR-155-5p in UC mice， inhibit the phosphorylation of STAT3， inhibit the differentiation of CD4⁺ T cells into Th17 cells， reduce the levels of pro-inflammatory factors （IL-17 and IL-6）， and increase the levels of anti-inflammatory factors （TGF-β and IL-10）. As a result， the inflammation of colon mucosa in UC mice was alleviated.

Objective:To systematically evaluate the methodological quality and reporting quality of randomized controlled tri-als(RCT)on the treatment of BPH with traditional Chinese medicine(TCM),in order to provide some methodological reference for clinical practice and research.Methods:We searched CNKI,VIP,Wanfang Data and PubMed for RCTs on the treatment of BPH with TCM published in China from January 2013 to November 2023.Two researchers screened the literature separately,and evaluated the methodological and reporting quality of the RCTs based on the Cochrane bias risk assessment tool and CONSORT TCM compound.Results:Totally,88 RCTs were included in this study.In terms of methodological quality,according to the Cochrane bias risk assess-ment tool,27 biases in the process of randomization were identified as of low-risk and the other 61 of a certain risk.Among the alloca-tion-related biases deviating from the established interventions,76 were of low risk,10 of a certain risk and 2 of high risk;among the compliance-related biases deviating from the established interventions,76 were of low risk and 12 of a certain risk;among the biases due to missing outcome data,86 were of low risk and 2 of a certain risk,while all the biases due to outcome measurement were of low risk;and among the biases from selective reporting,65 were of low-risk,2 of a certain risk and 21 of high-risk.In terms of reporting quality,according to the evaluation criteria of consort TCM compound,appropriate key words were used in 1 RCT(0.01％),the ran-dom assignment sequence method described in 27(30.68％),the details of assignment limitation given in 5(5.68％),assignment concealment mentioned in 3(3.41％),the blind method and assignment concealment employed in 3(3.41％),fall-offs recorded in 10(11.36％),adverse events reported in 38(43.18％),and limitations of the trials analyzed in 18(20.45％).All the RCTs lacked complete intervention measures,subject flow chart,clinical trial registration and research schemes.Conclusion:At present,the methodological quality and reporting quality of RCTs on the treatment of BPH with TCM are generally low,with the main problems of incomplete experimental designs,lack of detailed description of randomized and blind methods,and insufficient TCM symptom eval-uation of outcome indicators.Researchers should be cautious in adopting and applying the results reported,follow the CONSORT state-ment in design,registration,implement and reporting of the scheme,fully consider the clinical characteristics of TCM in the treatment of BPH,and reasonably design and report the evaluation indicators.

Liver fibrosis is a reversible pathological process caused by chronic liver damage and a major risk factor for hepatocellular carcinoma (HCC). Hepatic stellate cell (HSC) activation is considered the main target for liver fibrosis therapy. However, the efficiency of this strategy is limited due to the complex microenvironment of liver fibrosis, including excessive extracellular matrix (ECM) deposition and hypoxia-induced imbalanced ECM metabolism. Herein, nilotinib (NIL)-loaded hyaluronic acid (HA)-coated Ag@Pt nanotriangular nanozymes (APNH NTs) were developed to inhibit HSCs activation and remodel the microenvironment of liver fibrosis. APNH NTs efficiently eliminated intrahepatic reactive oxygen species (ROS) due to their inherent superoxide dismutase (SOD) and catalase (CAT) activities, thereby downregulating the expression of NADPH oxidase-4 (NOX-4) and inhibiting HSCs activation. Simultaneously, the oxygen produced by the APNH NTs further alleviated the hypoxic microenvironment. Importantly, the released NIL promoted collagen depletion by suppressing the expression of tissue inhibitor of metalloproteinase-1 (TIMP-1), thus synergistically remodeling the microenvironment of liver fibrosis. Notably, an in vivo study in CCl₄-induced mice revealed that APNH NTs exhibited significant antifibrogenic effects without obvious long-term toxicity. Taken together, the data from this work suggest that treatment with the synthesized APNH NTs provides an enlightening strategy for remodeling the microenvironment of liver fibrosis with boosted antifibrogenic activity.

Objective:To study the actual effect of the use of personal protective equipment of the examined individuals, and provide reference and basis for the correct use of personal protective equipment and the radiological health administrative law enforcement.Methods:From February to June 2022, the imaging department of Qingdao Municipal Hospital selected 170 patients who underwent X-ray imaging examination (oral panoramic, dental radiography, DR photography, CT scanning), including 25 with oral panoramic and dental radiography, 60 with CT scanning and 60 with DR imaging. The thermoluminescent dosimeter was used to detect the ambient dose equivalent at the point of concern for 170 examined individuals who have used personal protective equipment to cover their sensitive parts, and to analyze the data detected at the same point as above when routinely using the same equipment.Results:There was a statistically significant difference in the dose equivalent at the same points inside and outside the lead neckband ( t=-2.23, P<0.05). There was no statistically significant difference in the dose equivalent at the same point inside and outside the lead collar during dental radiography ( P>0.05). During DR photography (chest PA, lateral and lumbar AP), the examined individuals were wearing lead aprons. Among them, there was a statistically significant difference in the dose equivalent at the same points inside and outside the lead aprons of children′s chest PA and adults′ chest PA ( U=10.00, 19.00, P<0.05). There was no statistically significant difference in the dose equivalent at the same points inside and outside the lead aprons of adult′s chest PA and lumbar AP ( P>0.05). When performing CT scan (chest or upper abdomen), there was a statistically significant difference in the dose equivalent at the same points of wrapped lead aprons( U=878.50, 11.00, P<0.05). Conclusions:The correct use of personal protective equipment is a complex technical problem. It is very important to fully and accurately understand the optimization principle of radiation protection and correctly use personal protective equipment for the examined individuals. The administrative punishment of radiation health on the use of personal protective equipment of the examined individuals should be cautious.

Aim To explore the effect of Tanxiang Qingyan Tablets on rat model with chronic bronchitisand the effect of MyD88/NF-κB/ICAM-1 signaling pathway expression in bronchopulmonary tissues of rats.Methods A rat model of chronic bronchitis was established by smoking method combined with lipopolysaccharide(LPS,2g·L-1)tracheal injection.The rats were randomly divided into normal group,sham operation group,model group,and positive drug(Guilong Ruikening tablets)1 g·kg-1)group,Tanxiang Qingyan Tablet high,medium and low dose(1.44,0.72,0.36 g·kg-1)group,with intragastric interventionin continuous 15 days.The pathological changes of bronchopulmonary tissues were observed by HE staining,and the infiltration of bronchial inflammatory cells was counted; ELISA method was used to detect the contents of tumor necrosis factor(TNF-α)and interleukin 10(IL-10)in peripheral serum; Western blot and immunohistochemical methodswere employed to detectmyeloid cell differentiation protein 88(MyD88),nuclear transcription factor-κB(NF-κB)and anti-intercellular adhesion molecule 1(ICAM-1)protein expression in bronchopulmonary tissues.Results Compared with normal group and sham operation group,the bronchial mucosal epithelial cells of model group were severely damaged,the alveolar septum was widened,the bronchial inflammatory infiltrationsignificantly increased,the serum TNF-α levels significantly increased,IL-10 levels decreased, and MyD88,NF-κB and ICAM-1 protein expression levels increased significantly(P<0.05,0.01)in bronchopulmonary tissues; compared with model group,the pathological damage and inflammatory changes of the bronchopulmonary tissues of rats in Tanxiang Qingyan Tablet group were reduced,and the serum TNF-α content was significantly reduced,IL-10 content did not change significantly,and MyD88,NF-κB and ICAM-1 protein expression levels in bronchopulmonary tissues were significantly down-regulated(P<0.05,0.01).Conclusions Tanxiang Qingyan Tablets can effectively improve bronchopulmonary tissue inflammatory infiltration,which may be related to reducing the release of inflammatory mediators such as TNF-α and regulating the expression of MyD88/NF-κB/ICAM-1 signaling pathway.

Objective: To explore the safety and effectiveness of stereotactic body radiation therapy (SBRT) for oligometastases from colorectal cancer (CRC). Methods: This is a prospective, single-arm phase Ⅱ trial. Patients who had histologically proven CRC, 1 to 5 detectable liver or lung metastatic lesions with maximum diameter of any metastases ≤5 cm were eligible. SBRT was delivered to all lesions. The primary endpoint was 3-year local control (LC). The secondary endpoints were treatment-related acute toxicities of grade 3 and above, 1-year and 3-year overall survival (OS) and progression free survival (PFS). Survival analysis was performed using the Kaplan-Meier method and Log rank test. Results: Petients from 2016 to 2019 who were treated in Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College. Forty-eight patients with 60 lesions were enrolled, including 37 liver lesions and 23 lung lesions. Forty-six patients had 1 or 2 lesions, with median diameter of 1.3 cm, the median biologically effective dose (BED(10)) was 100.0 Gy. The median follow-up was 19.5 months for all lesions. Twenty-five lesions developed local failure, the median local progression free survival was 15 months. The 1-year LC, OS and PFS was 70.2% (95% CI, 63.7%~76.7%), 89.0% (95% CI, 84.3%~93.7%) and 40.4% (95%CI, 33.0%~47.8%). The univariate analysis revealed that planning target volume (PTV) and total dose were independent prognostic factors of LC (P<0.05). For liver and lung lesions, the 1-year LC, OS and PFS was 58.7% and 89.4% (P=0.015), 89.3% and 86.5% (P=0.732), 30.5% and 65.6% (P=0.024), respectively. No patients developed acute toxicity of grade 3 and above. Conclusion: SBRT is safe and effective treatment method for oligometastases from CRC under precise respiratory motion management and robust quality assurance.
Colorectal Neoplasms ; Humans ; Liver/pathology* ; Lung/pathology* ; Prospective Studies ; Radiosurgery/methods*

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.