BACKGROUND:Chinese herbal medicine for treatment of steroid-induced necrosis of the femoral head has been shown to be effective, but its mechanism remains controversial. OBJECTIVE:To retrieve and summarize the mechanism of Chinese herbal medicine for steroid-induced necrosis of the femoral head in recent 10 years. METHODS:We retrieved articles addressing the mechanism of Chinese herbal medicine for intervention of steroid-induced necrosis of the femoral head in China National Knowledge Infrastructure published from January 2005 to December 2014. The key words were femur head necrosis, hormones, drugs, and Chinese herbal. According to inclusion and exclusion criteria, 23 articles were selected for discussion. RESULTS AND CONCLUSION:Studies concerning the mechanism of Chinese medicine for steroid-induced necrosis of the femoral head mainly focus on lowering blood lipid and anticoagulation, improving blood rheology, reducing intraosseous pressure, promoting angiogenesis and inhibiting apoptosis, as wel as cytokines and related factors. This study mainly concerns classical formulae, empirical prescription and various Chinese patent medicines, but does not address differentiation of symptoms and signs for classification of syndrome, diagnosis and treatment based on an overal analysis of the ilness and the patient’s condition, targeted rule of treatment, and prescription drugs.

BACKGROUND:Pereutaneous vertebroplasty and percutaneous kyphoplasty as the minimal y invasive treatment techniques have been widely used in the treatment of vertebral osteoporotic compression fracture, but there are controversies, and each method has its advantages and disadvantages.
OBJECTIVE:To compare the clinical efficacy between percutaneous vertebroplasty and percutaneous kyphoplasty in the treatment of vertebral osteoporotic compression fracture.
METHODS:100 patients with vertebral osteoporotic compression fracture were col ected, among them, 40 patients received percutaneous vertebroplasty, and 60 patients received percutaneous kyphoplasty. The visual analog scale score was used to assess the pain degree of the patients before treatment;the visual analog scale score was also used at 1 week after treatment. The X-ray film was taken to measure the ratio between anterior and rear edges of vertebrae.
RESULTS AND CONCLUSION:The visual analog scale scores in the two groups were significantly decreased after treatment, and there was significant difference when compared with that before treatment (P<0.05);there was significant difference in the restore of vertebral height in two groups when compared with that before treatment, but there was no significant difference in the orthopedic effect between two groups (P<0.05). The incidence of complications of bone cement leakage after treatment was 35%in the pereutaneous vertebroplasty group and 12.5%in the percutaneous kyphoplasty group, and there was significant difference in the incidence of complications between two groups (P<0.05). Pereutaneous vertebroplasty and percutaneous kyphoplasty can significantly relieve the pain of the patients with vertebral osteoporotic compression fracture, but there is no significant difference in the orthopedic effect between pereutaneous vertebroplasty and percutaneous kyphoplasty.

OBJECTIVE: To investigate the effect of Compound Rhubarb Mixture on contraction of isolated small intestinal smooth muscle of rabbit. METHODS: Serum containing Compound Rhubarb Mixture was prepared. The contraction curves of isolated small intestinal smooth muscle before and after administration of the serum were recorded by Medlab biological information collecting system. RESULTS: The serum containing Compound Rhubarb Mixture amplified the contraction amplitude of isolated small intestinal smooth muscle of rabbit. The rate of change of contraction amplitude was elevated significantly after administration, while the frequency of contraction did not change obviously. CONCLUSION: The serum containing Compound Rhubarb Mixture can enhance the contractive function of isolated small intestinal smooth muscle of rabbit.

AIM To examine the effect and mechanism of emodin on intestinal movement of constipation model. METHODS The movement of charcoal powder and the absorption of D-xylose into serum were observed. The electrical p otential difference(PD) related to Na + and glucose transport was measured across the wall of rev erted intestinal sacs. RESULTS Emodin 0 1, 0 2 g?kg -1 incr eased markedly the rate of charcoal powder moving and inhibited the absorption of D-xylose into serum. Emodin 0 2, 0 4, 0 8 and 1 6 g?L -1 decreased PD when ther e was glucose. However, emodin had little effect when glucose was free. CONCLUSION Emodin promotes intestinal movement and this effect is related to Na +,K +-ATPase.

ObjectiveTo study the relationship between fasting plasma glucose (FPG) level and the first cerebral infarction event in the population with diabetes.Methods This was a prospective cohort stndy.8 306 diabetic subjects who determined FPG ≥ 7.0 mmol/L or treated with insulin or hypoglycemic drugs and FPG ＜7.0 mmool/L as the observation population and were followed-up for (48.01 ± 3.14) months.During the course,cerebral infarction events were determined every 6 months.Results( 1 ) By the end of following-up,with the increasing levels of the baseline FPG,the total cholesterol (TC),triglyceride (TG) levels were gradually increased in the diabetic population,the differences were significant [ TC:( 4.93 ± 1.15,5.10 ± 1.20,5.15 ± 1.28,5.33 ± 1.35 ) mmol/L,TG:( 1.70 ± 1.26,1.83 ± 1.29,2.18 ± 1.76,2.41 ± 2.08 ) mmol/L,P＜0.05 ] ; the plasma low density lipoprotein-cholesterol (LDL-C),systolic blood pressure ( SBP),diastolic blood pressure ( DBP),and body mass index (BMI) levels were also increased significantly ( P＜0.05 ).(2) The ineidence of cerebral infarction event in the group of patients with 7.0 mnol/L ≤ FPG ＜ 9.0 mmol/L was the lowest,the differences were significant ( 2.1％,P ＜0.01 ).Compared with the group of 7.0 mmol/L≤ FPG＜9.0 mmol/L,after adjusting for age,sex,BMI,SBP,DBP,TC,TG,low density lipoprotein-cholesterol,high density lipoprotein-cholesterol,smoking,diabetic duration and treatment,the relative risk for cerebral infarction events were 1.85 (95％ CI 1.09-3.15,P＜0.05) and 1.54 (95％CI 1.16-2.05,P ＜ 0.01 ) for those groups with 6.1 mmol/L ≤ FPG ＜ 7.0 mmol/L and FPG ≥ 9.0 mmol/L respectively.ConclusionThe risk of new in cidence of cerebral infarction events seems to be the lowest in the group of diabetic patients whose FPGs are wihin 7.0-9.0 mmol/L range.

Objective To investigate the relationship between waist circumference and new-onset non-alcoholic fatty liver disease in non-obese patients with diabetes mellitus. Methods A total of 1 950 patients with diabetes mellitus, who determined fasting plasma glucose(FPG)≥7.0 mmol/L or who were using hypoglycemic drugs and FPG<7.0 mmol/L,and body mass index (BMI)< 25 kg/m2, was selected in this study using prospective cohort method. Patients were divided into five groups according to the baseline data of waist circumference, including waist circumference<78 cm (A group, n=387), 78 cm90 cm (E group, n=421). Multiple Logistic regression model was used to analyze influential factors of new-onset non-alcoholic fatty liver disease in non-obese patients with diabetes mellitus. Re?sults The average duration of follow-up was(47.24±5.13) months. The incidence rate was 11.85%(231/1 950) in patients with non-alcoholic fatty liver disease. The incidence rates were 6.98%, 9.28%, 12.38%, 14.19%and 15.68%in A, B, C, D and E groups, and which were increased with the increased waist circumference (P<0.05). Results of multiple Logistic re?gression model analysis showed that compared with A group,OR values were 1.97 and 2.19 in D and E groups respectively (P<0.05). Conclusion Waist circumference≥85 cm was the risk factors of new-onset non-alcoholic fatty liver disease in non-obese patients with diabetes mellitus.

Objective To explore the postoperative psychological status of donors during pediatric living donor liver transplantation (LDLT) to elucidate the correlation between resilience,anxiety and depression.Methods Random sampling was employed for selecting 60 pediatric LDLT donors undergoing LDLT from September 2014 to February 2019.They were requested to answer a questionnaire.The questionnaire concluded general information,self-rating anxiety scale (SAS),selfrating depression scale (SDS) and Chinese version of Resilience Scale.Results The score of anxiety was (46.06 ± 10.06) and depression was (50.32 ± 11.49).Both values were higher than those of Chinese norm.The score of resilience was (59.55 ± 14.62).And the total score of resilience and the score of each dimension were negatively correlated with anxiety and depression (P＜0.01).Conclusions The postoperative anxiety and depression level of donors during LDLT are higher than the ordinary.Resilience is negatively correlated with the level of anxiety and depression.The lower level of resilience,the higher anxiety and depression of donors during LDLT.For clinicians,appropriate intervention measures should be taken for improving the resilience,reducing negative emotions and boosting the quality-of-life of donors during LDLT.

Objective To observe the relationship between the peripheral blood IFN-γ secretion level and prognosis in the patients with early stage of acute cerebral hemorrhage.Methods Sixty-six inpatients with acute intracerebral hemorhage in the emergency department of this hospital from July 2015 to August 2016 were selected as the experimental group,and 60 healthy people in the physical examination center served as the blank control group.The peripheral blood mononuclear cells(PBMCs) and plasma were separated.The helper T cells(Th)1/Th2 eytokines(IFN-γ,IL-2,IL-4 and IL-10) were detected by using ELISA.The flow cytometry was used to detect intracellular cytokines;the disease condition change from 1 d of onset to 30 d in the experiment group was analyzed by using NIHSS.The relationship between the cytokines and prognosis on 30 d evaluated by NIHSS score was analyzed.Results The peripheral blood IFN-γ level had statistically significant difference between the two groups(P＜0.05),while the levels of IL-2,IL-4 and IL-10 had no statistical difference(P＞0.05).The peripheral blood IFN-γ secretion level during early stage in the experimental group was positively correlated with the prognosis(P＜0.05).Conclusion The increase of peripheral blood IFN-γ during early stage is correlated with the poor prognosis in the patients with acute intracerebral hemorrhage.

Objective To explore the expression and significance of neutrophil extracellular traps(NETs)in peripheral blood of primary Sj?gren's syndrome(pSS)patients across different disease activity levels,and the predictive value of NETs and routine laboratory markers antithrombin Ⅲ(AT Ⅲ),alkaline phosphatase(ALP)and carbohydrate antigen 125(CA125)for pSS disease activity.Methods A total of 94 newly diagnosed pSS patients at the Affiliated Lianyungang Hospital of Xuzhou Medical University from October 2021 to December 2023 were categorized into active(n=49)and non-active(n=45)groups based on the European League Against Rheumatism(EULAR)Sj?gren's Syndrome disease activity index(ESSDAI).The levels of NETs biomarkers,namely serum myeloperoxidase(MPO)-DNA,were measured using ELISA.Laboratory routine indicators and MPO-DNA were integrated into multivariate Logistic regression to screen for independent influencing factors of pSS disease activity.Pearson's correlation was used to evaluate the relationship between MPO-DNA levels and ESSDAI scores.The efficacy of MPO-DNA alone or in combination with AT Ⅲ,ALP and CA125,for predictors of disease activity was evaluated using ROC curve.Results Serum MPO-DNA(23.884±3.494 μg/L),ALP(80.159±34.318 U/L)and CA125(20.300±16.560 U/ml)levels of active pSS patients were higher than those in the non-active patients(19.024±3.324 μ g/L,67.500±21.166U/L,13.200±6.340 U/ml),while AT Ⅲ(89.180±15.040 ng/ml)was lower than that in non-active patients(94.650±11.620 ng/ml),with significant differences(t=-7.921,-2.426,-2.925,2.094,all P＜0.05).Multivariate Logistic regression analysis showed laboratory indicator MPO-DNA,ALP and CA125 were independent risk factors,while AT Ⅲ was an independent protective factor(all P＜0.05).MPO-DNA was positively correlated with ESSDAI scores(r=0.602,P＜0.01).The AUC(95％CI)of the combination of ALP,CA125 and AT Ⅲ for predicting disease activity in pSS was 0.711(0.612～0.810).The AUC(95％CI)of MPO-DNA alone for predicting disease activity in pSS was 0.837(0.758～0.915),and the AUC(95％CI)of combination of MPO-DNA,ALP,CA125 and AT Ⅲ for predicting disease activity in pSS was 0.866(0.797～0.935),showing an improving in the predictive value.Conclusion The involvement of NETs in the occurrence and expression levels of pSS is related to its disease activity.NETs combined with ALP,CA125 and AT Ⅲ have effective diagnostic performance for the disease activity of pSS.This tool can serve as a biological indicator for predicting the disease activity of pSS.

BACKGROUND:Glucocorticoids can inhibit the expression of hub genes in the parathyroid hormone type Ⅰ receptor(PTH1R)/protein kinase A(PKA)signaling axis and interfere with the osteogenic and angiogenic differentiation of bone marrow mesenchymal stem cells,leading to the disruption of blood supply in bone and bone tissue structures.Previous studies of the research team showed that Gubitongxiao granules can induce blood vessel formation and inhibit osteoblast apoptosis,which has a certain effect on the prevention and treatment of steroid-induced femoral head necrosis. OBJECTIVE:To observe the therapeutic effect of Gubitongxiao granules in a mouse model of steroid-induced femoral head necrosis,and to explore its mechanism from the PTH1R/PKA signaling axis. METHODS:An animal model of steroid-induced necrosis of the femoral head was established by intraperitoneal injection of lipopolysaccharide and gluteal muscle injection of prednisolone acetate.After identification by nuclear magnetic resonance method,60 mice that were successfully modeled were divided into model group,Gubitongxiao granule group and Tongluo Shenggu capsule group,with 20 mice in each group.Another 12 normal mice were used as control group.The corresponding groups were intragastrically given the corresponding drugs for 12 weeks,and then the samples were taken under anesthesia.Histomorphology of femoral head samples was observed by hematoxylin-eosin staining.Enzyme-linked immunosorbent assay was used to detect the serum levels of bone alkaline phosphatase,type Ⅰ amino-terminal extension peptide,parathyroid hormone,osteocalcin and alkaline phosphatase.Western blot and RT-qPCR were used to detect PTH1R,PKA,myocyte enhancer factor 2,sclerostin and guanylate-binding protein activity-stimulating peptide at protein and gene expression levels,respectively. RESULTS AND CONCLUSION:Gubitongxiao granules may reduce the serum PTH level in mice,inhibit the activation of the PTH1R/PKA signal axis,further up-regulate the protein expressions of sclerostin and myocyte enhancer factor 2,and increase the levels of bone alkaline phosphatase,type Ⅰ amino-terminal extension peptide,osteocalcin and alkaline phosphatase in mice,thus improving femoral head necrosis,which is comparable to the intervention effect of Tongluo Shenggu capsules.It is speculated that Gubitongxiao granules may prevent and treating hormonal femoral head necrosis by regulating the PTH1R/PKA signaling axis.