ObjectiveThis paper aims to analyze the clinical characteristics and medication rationality of liver injury related to Epimedii Folium preparation （EP） and explore the possible risk factors of liver injury， so as to provide a reference for the safe clinical application of Epimedii Folium （EF）. MethodA retrospective analysis was conducted on liver injury cases related to EP from 2012 to 2016. ResultThe number of reported liver injury cases and the proportion of severe cases related to the use of EP show an increasing trend， indicating the objective existence of liver injury caused by EP. There are more cases of liver injury related to EP in women than in men， with an onset age range of 15-91 years old and a median onset age of 60 years old （median onset ages for men and women are 59 and 60 years old， respectively）. The time span from taking EP alone to the occurrence of liver injury is 1-386 days， with a median of 38 days. The time span from taking both EP and Western medicine to the occurrence of liver injury is 1-794 days， with a median of 34 days. EF-related liver injury preparations are mostly composed of traditional Chinese medicines that promote immunity and tonify the liver and kidney， indicating that immune stress in the body may be the mechanism of liver injury caused by the use of EP alone or in combination. There is no increasing trend of toxicity with time or dose in the liver injury caused by EP. By further exploring its risk factors， it is found that patients have unreasonable medication methods such as excessive dosage， repeated use， and multi-drug combination， which may also be one of the important risk factors for EF-related liver injury. ConclusionEP has a certain risk of liver injury and should be emphasized in clinical diagnosis and treatment. Immune stress may be the mechanism of liver injury caused by EP， and in clinical use， it is necessary to be vigilant about the risk of liver injury caused by unreasonable use and combined use with Western medicine.

BACKGROUND:As a unique structure of the cervical spine,the occurrence,development and progression of the uncovertebral joint directly affect the stability and range of motion of the cervical spine,and are also closely related to the pathogenesis of cervical spondylosis.A thorough understanding of the developmental characteristics of the uncovertebral joint is of great significance for the pathogenesis,diagnosis,and treatment of cervical spondylosis. OBJECTIVE:By using imaging and three-dimensional reconstruction technology to measure and observe the cervical uncinate process-related angle in a large sample of different age groups,the aim is to reveal the characteristics of its changes with age and vertebral growth,as well as its relationship with cervical spine stability. METHODS:Using a retrospective research design,we collected 1 447 cases of raw CT imaging data that meet the study requirements for complete cervical spine segments.The raw data were imported into Mimics 21.0 software in DICOM format for post-processing and measurement of angle of uncinate process and sagittal angle of uncinate process.The data were grouped based on gender,age,and side. RESULTS AND CONCLUSION:(1)With the increase of vertebral sequence,the angle of uncinate process increased in a V-shaped shape,and the lowest peak was at C5.The overall population showed a sharp peak with the increase of age,and the peak value mostly occurred in the age range of 30-39 years.(2)The sagittal angle of the uncinate process increased like a fishhook with the increase of the vertebral sequence,and the overall angle of the uncinate process increased with age,and the peak value mostly occurred in the age range of 20-29 years.The uncinate process angle and sagittal angle showed only partial significant differences between sides and genders(P<0.05).(3)It is concluded that the angle of the uncinate process increased with the increase of vertebral sequence in a V-shaped manner.The sagittal angle of the uncinate process increases like a fish hook with increasing vertebral order,while the two angles generally peak with increasing age.The angle of the uncinate process is about 131°,which may be closely related to the stability of the cervical spine,while the sagittal angle of the uncinate process is about 14°,and its function may play a certain role in limiting the excessive rotation of the cervical spine.

Objective To analyze the main active components and potential molecular mechanism of Sophora flavescens against breast cancer based on network pharmacology and molecular docking. Methods The chemical constituents were collected and screened by TCMSP, ETCM database and literature review. The targets of active ingredients were predicted by Swiss Target Prediction database. Breast cancer-related targets were collected by GeneCards, TTD, Drugbank and OMIM. The anti-breast cancer targets of Sophora flavescens were screened by Venny 2.1.0 software. Cytoscape software was used to construct the network diagram of Sophora flavescens-key active ingredients-targets. STRING database was used to analyze the common targets, and PPI network diagram was constructed. GO function enrichment analysis and KEGG pathway enrichment analysis of key target proteins were performed by DAVID database and Hiplot online platform. Schrodinger software was used to calculate the molecular docking between the active ingredients and targets. Molecular biological methods were used to verify the key targets. Results A total of 36 active components with clear structures were screened from Sophora flavescens. 70 anti-breast cancer targets of Sophora flavescens were screened out. 12 core targets including EGFR, AKT1, ESR1, SRC, CYP19A1, AR and ABCB1 participate in endocrine resistance, EGFR tyrosine kinase inhibitors and estrogen signaling pathways in breast cancer. Moreover, the docking score between the core component and the key target AR is the highest. In vitro experiments showed that the extract of Sophora flavescens can inhibit the proliferation of breast cancer cells, induce cell apoptosis and up-regulate AR protein expression. Conclusion It was revealed that Sophora flavescens plays an anti-breast cancer role by regulating complex biological processes through multiple components acting on multiple targets and signaling pathways. The upregulation of AR protein by Sophora flavescens may become a new therapeutic strategy for the treatment of breast cancer.

Psoraleae Fructus (PF) is a well-known traditional herbal medicine in China, and it is widely used for osteoporosis, vitiligo, and other diseases in clinical settings. However, liver injury caused by PF and its preparations has been frequently reported in recent years. Our previous studies have demonstrated that PF could cause idiosyncratic drug-induced liver injury (IDILI), but the mechanism underlying its hepatotoxicity remains unclear. This paper reports that bavachin isolated from PF enhances the specific stimuli-induced activation of the NLRP3 inflammasome and leads to hepatotoxicity. Bavachin boosts the secretion of IL-1β and caspase-1 caused by ATP or nigericin but not those induced by poly(I:C), monosodium urate crystal, or intracellular lipopolysaccharide. Bavachin does not affect AIM2 or NLRC4 inflammasome activation. Mechanistically, bavachin specifically increases the production of nigericin-induced mitochondrial reactive oxygen species among the most important upstream events in the activation of the NLRP3 inflammasome. Bavachin increases the levels of aspartate transaminase and alanine aminotransferase in serum and hepatocyte injury accompanied by the secretion of IL-1β via a mouse model of lipopolysaccharide-mediated susceptibility to IDILI. These results suggest that bavachin specifically enhances the ATP- or nigericin-induced activation of the NLRP3 inflammasome. Bavachin also potentially contributes to PF-induced idiosyncratic hepatotoxicity. Moreover, bavachin and PF should be evaded among patients with diseases linked to the ATP- or nigericin-mediated activation of the NLRP3 inflammasome, which may be a dangerous factor for liver injury.
Adenosine Triphosphate ; Animals ; Chemical and Drug Induced Liver Injury/etiology* ; Flavonoids ; Humans ; Inflammasomes ; Mice ; NLR Family, Pyrin Domain-Containing 3 Protein ; Nigericin

BACKGROUND:With the change of modern living habits, the incidence of cervical disease and cervical related diseases is increasingly at younger age. Based on this feature, the discussion of the relationship between the cervical spine and vertebral body as wel as regular feature can provide theoretical basis for early diagnosis, prevention and treatment of cervical spondylosis. OBJECTIVE:To analyze the correlation structure of the cervical vertebra uncinate process with the vertebral body and intervertebral foramen among adolescents. METHODS:A total of 66 cases without injuries, neurological symptoms or signs of 6 to 20 years old were scanned with multi-row thin-slice spiral CT from C1-T1. The original data were loaded in DICOM format into three-dimensional reconstruction software for measurement and statistical analysis. RESULTS AND CONCLUSION:(1) In addition to uncinate process height and vertebral body height, the uncinate process spacing, uncinate base width and diameter between the vertebrae and a uncinate process base radius vector length and vertebral bodies were positively correlated (P<0.05). (2) Uncinate high uncinate base long uncinate base width and height between the foramen in addition to the uncinate process had a positive correlation with the length of the substrate (P<0.05). (3) In conclusion, there is a certain correlation in juvenile cervical uncovertebral joint between the uncinate process and vertebral body and intervertebral foramen. With the growth of age, cervical activity is increased and the uncinate hyperplasia, trauma, and fracture can oppress spinal nerve within the intervertebral foramen to cause corresponding nerve root type of cervical spondylosis.

Objective To explore the morphological characteristics and change rule of thoracic joint angles in children aged from 10 to 12 years through thinner CT scanning and 3D reconstruction,and to provide theoretical basis for early diagnosis,treatment and prevention.Methods Totally 30 normal cases aged from 10 to 12 years were admitted into this study.There was no bone destruction,deformity,fractures,tumors and spine surgery involved.DICOM 3.0 data of multi-slice spiral CT (0.625 ～ 1.25 mm),ranging from T1 to T12,were used for 3D reconstruction,measurement and statistical analysis.Results The difference between left and right sagittal section angle of zygopophysis was less than 10°.There was no significant differences between T1,T11,and T12for sagittal section angle of upper zygopophysis (P ＞ 0.05).So was it between T3,T4,T9,T10 and T11 for sagittal section angle of lower zygopophysis (P ＞ 0.05).While there were significant differences between others(P ＜ 0.05).The was no significant difference between left and right coronal plane angle of zygopophysis (P ＞ 0.05).Coronal plane angle of lower and upper zygopophysis tended to be ‘ spike-like’,and the maximum points were at T7 to T9.For horizontal plane angle,left and right upper zygopophysis made significant differences between T2,T4,T8,T10 and T12 only,so did T7 lower zygopophysis (P ＜ 0.05).Horizontal angle of upper zygopophysis tended to be stable in the upper thoracic both in the left and right side,while a decreasing trend was shown in lower thoracic.Horizontal angle of lower zygopophysis showed a decreasing trend generally except individual vertebrae.Both upper and lower zygopophysis showed negative angle at T11 and T12 levels.Conclusion Thoracic joint angles(coronal,sagittal and horizontal angle) in children aged from 10 to 12 years can directly reflect the developmental regularity with growth,and it verified the tendency that horizontal facet joints of the cervical spine gradually changes to coronal facet joints thoracic spine and then changes to sagittal facet joints of lumbar spine.And the left and right side facet joints are basically symmetrical with the angle difference less than 10°.

Multi-Efficacy of One Drug (MEOD) refers to the traditional Chinese medicines (TCM) with diverse efficacies.MEOD,one of the important characteristics of TCM,is regarded as the basis of clinical rational drug use.However,there have been few reports on the MEOD research so far.In this paper,with rhubarb selected as a typical model drug,metabolomics and network pharmacology analysis are integrated to investigate the mechanisms of MEOD with the employment of the two animal models of constipation and jaundice.Then,the biological target network of MEOD is established for promoting the precision of the quality control and clinical use of TCM.

Objective The correlation analysis was proceeded between youth cervical hook and transverse foramen by using imaging scanning and three-dimensional reconstruction method,which can provide theoretical basis for early diagnosis,treatment and prevention of ju-venile cervical spondylosis.Methods A total of 66 teenagers who had no trauma,neurological symptoms or signs were selected with aged from 6 to 20 years old,who were scanned by multi slice spiral CT,ranged from C1 to T1 .The original data in DICOMformat to import 3D re-construction software was related index measurement and subsequent statistical analysis.Results There was a correlation between hook height,base width,base length of luschca joint and transverse diameter,longitudinal diameter.Conclusion Hook vertebral meridian of lus-chca joint and transverse foramen has a close contact.Factors such as fracture and hyperplasia of luschca joint,vertebral artery of transverseforamen can be oppressed that cause corresponding vertebral artery type of cervical spondylosis.

Objective To investigate the effects of transarterial chemoembolization (TACE)treatment interval on the prognosis of patients with advanced hepatocellular caisinoma(HCC).Methods We retrospectively collected clinical data of 123 advanced HCC patients treated with repeated TACE.The patients were divided into two groups (group A with fixed repeated treatment interval and group B with that according to the clinical needs).Cox regression,survival curve and log-rank test were used to assess the effects of the treat-ment intervals on prognosis.Results The treatment intervals of the group A and group B were (1.1±0.3)months and (3.0±1.5) months,respectively (P <0.001).Multivariate Cox analysis showed the efficacy (P =0.024)and repetition periods (P <0.001 ) were independent prognostic factors.Conclusion TACE interval is independent risk factor for the prognosis of patients with ad-vanced HCC.Repeated TACE treatment according to clinical needs may be more favorable for prognosis of the patients.

Objective To provide regional anatomical data for clinical application through observing the type, length and diameter of variation in the medial cubital vein of upper limb. Methods Dissected the medial cubital vein of upper limb in 35 (70 sides) adult cadavers (male 38, female 7), and observed the morphological structure. The length and vessel diameter of the medial cubital vein were measured. Results The variation of the medial cubital vein of upper limb was divided into six type. TypeⅠincluded 29 cases (41. 43%) of male and 8 cases (11. 43%) of female;Type Ⅱ included 14 cases (20. 00%) of male and 4 cases (5. 71%) of female;Type Ⅲ included 7 cases (10. 00%) of male and 2 cases (2. 86%) of female;TypeⅣincluded 3 cases (4. 29%) of male and 0 cases of female;TypeⅤincluded 2 cases (2. 86%) of male and 0 cases of female;TypeⅥincluded 1 cases (1. 43%) male and 0 cases of female. Conclusion This study enriched anthropology data of the medial cubital vein and it has the role of guiding in clinical applications.