Objective To observe the morphology changes in articular cartilage of knee osteoarthritis ( KOA) model rats after intervention with Shudi Jisheng Zhuanggu Decoction (SJZD). Methods SD rats were randomized into 7 groups, namely blank control group, model group, Paracetamol group ( 0.270 g/kg) , Zhuangu Guanjie Pills group ( 1.08 g/kg) , and high-, middle- and low-dosage SJZD groups ( 27.450, 13.725, 6.863 g/kg, respectively). Rats were injected with papain solution into the right knee joint to build models of KOA before administration of drugs. Thickness of right knee joint was measured to evaluate the effect of SJZD on the swelling degree of knee joint. Histological changes of knee cartilage were evaluated by Mankin scoring method after the cartilage sections being stained with hematoxylin-eosin (HE). Results Swelling degree of knee joint and Mankin scores were significantly increased in the model group compared to the blank control group ( P<0.01). In comparison with the model group, the swelling degree of knee joint and Mankin scores of SJZD groups were significantly decreased (P<0.05 or P<0.01), and the pathological changes were relieved. Conclusion SJZD can ameliorate the pathological changes of knee articular cartilage in rats with KOA, so as to delay cartilage degeneration and protect the cartilage.

Objective To investigate the effectiveness and safety of oral olive oil combined with polyethylene glycol electrolyte ( PEG ) on bowel preparation before colonoscopy for chronic constipation patients. Methods A randomized, single-blind, prospective study was conducted on 180 patients with chronic constipation, who underwent colonoscopy at Tangdu Hospital of the Fourth Military Medical University from November 2017 to May 2018. Patients were randomly divided into three groups. Patients in group A took 60 mL olive oil and a piece of crystal sugar at 7:30 pm the day before colonoscopy, followed by 1500 mL PEG at 8:00 pm before the test, and 1500 mL PEG at 5:00 am the day of colonoscopy. Patients in group B took 60 mL olive oil and a piece of crystal sugar after administration of PEG at 8:00 pm the day before colonoscopy, followed by 1500 mL PEG at 5:00 am the day of colonoscopy. The group C was given 1500 mL PEG at 8:00 pm the day before colonoscopy, and another 1500 mL PEG at 5:00 am the day of colonoscopy. We recorded the time of first defecation after taking medication, the number of defecation before sleep, the total number of defecation, the score of Boston bowel preparation scale ( BBPS) of the right, middle and left colon, and the adverse reactions, and compared the data among the three groups. The measurement data was compared using the analysis of variance. After the difference was found, the LSD-t test was used to compare between the two groups. The enumeration data was compared using the Pearsonχ2 test. Results One patient in the group B terminated colonoscopy due to unable to continue cooperation during the examination. Group B and C both excluded one patient because of a large mass found in the descending colon of patients. Finally, there were 60 cases in the group A, 58 in the group B, and 59 in the group C. There was no statistical difference between the three groups in the general resource ( P>0. 05) . The time of first defecation after taking medication for the group A, B and C was (2. 25±2. 32) h, (2. 43±2. 39) h and (3. 36±2. 79) h respectively, with statistical difference (F=3. 36, P=0. 037). The time of first defecation was longer in the group C than that of the group A and B ( P = 0. 016 and P = 0. 046, respectively). The number of defecation before sleep for the group A, B and C was 3. 47±2. 09, 3. 24±1. 76 and 2. 49±1. 58 respectively, with statistical difference (F=4. 65, P=0. 011). The number of defecation before sleep was lesser in the group C than that of the group A and B ( P=0. 004, P=0. 027, respectively) . The total number of defecation for the group A, B and C was 7. 20 ± 2. 67, 6. 81 ± 2. 31 and 5. 64 ± 2. 22 respectively. The difference among the three groups was statistically significant ( F=6. 68, P=0. 002) . For the group A and B, the total number of defecation was both more than that of the group C ( P=0. 001, P=0. 010) . There were no statistical differences among the three groups in the BBPS score of the left and middle colon and the total BBPS score ( all P>0. 05) . The BBPS score of the right colon for the group A, B and C was 2. 03 ± 0. 82, 1. 95 ± 0. 87 and 1. 53 ± 0. 80 respectively, with statistical difference ( F=6. 38, P=0. 002) , and was lower in the group C than that of the group A and B ( P= 0. 001, P= 0. 006, respectively) . Adverse reactions after taking medication including nausea, vomiting, abdominal pain, and bloating were respectively reported in 7, 3, 0 and 3 cases in the group A, 5, 3, 0 and 6 in the group B, and 4, 2, 1 and 4 in the group C, and there was no statistical difference among the three groups (χ2=4. 35, P=0. 824) . Conclusion Administration of olive oil compared with PEG can improve the cleanness of right colon for chronic constipation patients, shorten the time of first defecation after taking medication, and increase the number of defecation before sleep and the total number of defecation during bowel preparation. Taking olive oil before or after PEG at the night before colonoscopy has no significantly effect on bowel preparation and adverse reactions.

Objective: To explore the application value of laparoscopic gastric plication (LGP) combined with duodeno-jejunal omega switch (DJOS) in modified adjustable gastric banding. Methods: The retrospective and descriptive study was conducted. The clinical data of a female 46-year-old patient who had failure to undergo the adjustable gastric banding in the Hospital of Ludwig Maximilian University from December 2016 to December 2018 were collected. LGP and DJOS were performed in two-stages after completion of preoperative examinations. Observation indicators: (1) surgical and postoperative situations; (2) follow-up. Follow-up using outpatient examiantion and telephone interview was performed to collect the information of body mass index (BMI), insulin therapy, and long-term complications until December 2018. Count data were represented as absolute numbers. Results: (1) Surgical and postoperative situations: the patient underwent LGP in the first stage and DJOS in the second stage successfully. For the LGP, the operation time, time of intestinal reconstruction, volume of intraoperative blood loss, time to first flatus, time to drainage tube removal, time to resume to normal diet, and duration of postoperative hospital stay were 96 minutes, 58 minutes, 210 mL, 32 hours, 48 hours, 42 days, and 3 days, respectively. For the DJOS, the above indicators were 148 minutes, 117 minutes, 260 mL, 47 hours, 72 hours, 21 days, and 7 days, respectively. There was no complication occurred in either LGP or DJOS. (2) Follow-up: the patient was followed up for 24 months after LGP. The BMI of this patient decreased to 45.3 kg/m² at 6 months after LGP, and decreased to 37.2 kg/m² at 18 months after DJOS. Insulin therapy was discontinued. There was no long-term complication such as malnutrition, dumping syndrome, or biliary reflux. Conclusion LGP combined with DJOS can enrich treatment methods of obese patient with BMI >50 kg/m², which offers a safer surgical procedure option for patients after gastric binding.

Patients with hepatocellular carcinoma (HCC) and bone metastasis (BM) suffer from greatly reduced life quality and a dismal prognosis. However, BM in HCC has long been overlooked possibly due to its relatively low prevalence in previous decades. To date, no consensus or guidelines have been reached or formulated for the prevention and management of HCC BM. Our narrative review manifests the increasing incidence of HCC BM to sound the alarm for additional attention. The risk factors, diagnosis, prognosis, and therapeutic approaches of HCC BM are detailed to provide a panoramic view of this disease to clinicians and specialists. We further delineate an informative cancer bone metastatic cascade based on evidence from recent studies and point out the main factors responsible for the tumor-associated disruption of bone homeostasis and the formation of skeletal cancer lesions. We also present the advances in the pathological and molecular mechanisms of HCC BM to shed light on translational opportunities. Dilemmas and challenges in the treatment and investigation of HCC BM are outlined and discussed to encourage further endeavors in the exploration of underlying pathogenic and molecular mechanisms, as well as the development of novel effective therapies for HCC patients with BM.
Bone Neoplasms/secondary* ; Carcinoma, Hepatocellular/therapy* ; Humans ; Liver Neoplasms/therapy* ; Prognosis

Ginsenoside Rg1 (Rg1), the major effective component of ginseng, has been shown to have multiple bioactivities, but low oral bioavailability. The aim of this study was to develop a simple, sensitive and rapid high performance liquid chromatography-tandem mass spectrometry (LC-MS/MS) method, which could be used to validate and quantify the concentrations of Rg1 and its metabolites in Sprague-Dawley rat bile, urine, and feces after oral administration (25 mg/kg). Calibration curves offered satisfactory linearity (>0.995) within the determined ranges. Both intra-day and inter-day variances were less than 15%, and the accuracy was within 80-120%. The excretion recoveries of Rg1, ginsenoside Rh1 (Rh1), and protopanaxatriol (Ppt) in bile, urine, and feces combined were all greater than 70%. The fecal excretion recoveries of Rg1, Rh1, and Ppt were 40.11%, 22.19%, and 22.88%, respectively, whereas 6.88% of Rg1 and 0.09% of Rh1 were excreted in bile. Urinary excretion accounted for only 0.04% of Rg1. In conclusion, the observed excretion profiles for Rg1 and its metabolites after oral administration are helpful for understanding the poor oral bioavailability of Rg1 and will aid further investigations of Rg1 as a pharmacologically active component.