1.Efficacy Connotation and Mechanisms of Shudi Qiangjin Pills Against Steroid-induced Osteonecrosis of Femoral Head Based on "Disease-Syndrome-Formula" Association Network
Zhijian CHEN ; Suya ZHANG ; Longlong DING ; Guixin ZHANG ; Bo LIU ; Baohong MI ; Yanqiong ZHANG ; Na LIN ; Weiheng CHEN ; Chunzhu GONG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(2):88-99
ObjectiveTo elucidate the efficacy connotation of Shudi Qiangjin pills (SQP) against liver and kidney deficiency in steroid-induced osteonecrosis of femoral head (SONFH) from the perspective of the "disease-syndrome-formula" association and to clarify the underlying mechanisms based on in vivo and in vitro experiment validation. MethodsThe chemical components and the corresponding putative targets of SQP were collected from the Integrative Pharmacology-based Research Platform of Traditional Chinese Medicine (TCMIP) v2.0, the Encyclopedia of Traditional Chinese Medicine (ETCM) v2.0, and HERB databases. The SONFH-related genes were identified based on the differential expression profiles of peripheral blood of patients with SONFH compared to the healthy volunteers, and the disease phenotype-related targets were collected from the TCMIP v2.0 database. Then, the interaction network of "SONFH-related genes and candidate targets of SQP" was constructed based on "gene-gene interaction information", and the major network targets were screened by calculating the topological characteristic values of the network followed by the functional mining according to the Kyoto Encyclopedia of Genes and Genomes (KEGG) database and the SoFDA database. After that, the SONFH rat model was prepared by lipopolysaccharide combined with methylprednisolone injection, and 2.5, 5, 7.5 g·kg-1 SQP (once per day, equivalent to 1, 2, and 3 times the clinical equivalent dose, respectively) or 7.3×10-3 g·kg-1 of alendronate sodium (ALS, once per week, equivalent to the clinical equivalent dose) was given for 8 weeks. The effect characteristics of SQP and ALS in the treatment of SONFH were evaluated by micro-computed tomography scanning, hematoxylin and eosin staining, alkaline phosphatase (ALP) staining, immunohistochemical staining, enzyme-linked immunosorbent assay, and terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling(TUNEL)staining, and a comparative efficacy analysis was conducted with ALS. In addition, SONFH cell models were prepared by dexamethasone stimulation of osteoblasts, and the intervention was carried out with the medicated serum of SQP at the aforementioned three doses. Cell counting kit-8, ALP staining, ALP activity assay, alizarin red staining, and flow cytometry were employed to investigate the regulatory effect of SQP on osteoblasts. The expression levels of osteogenesis-related proteins and key factors of the target signaling axis were detected by quantitative real-time polymerase chain reaction and Western blot. ResultsThe network analysis results demonstrated that the candidate targets of SQP primarily exerted their therapeutic effects through key signaling pathways, including phosphoinositide 3-kinase(PI3K)/protein kinase B(Akt), lipid metabolism and atherosclerosis, prolactin, chemokines, and neurotrophic factors pathways. These pathways were significantly involved in critical biological processes such as muscle and bone metabolism and the regulation of the "neuro-endocrine-immune" network, thereby addressing both modern medical symptoms (e.g., delayed skeletal maturation and recurrent fractures) and traditional Chinese medicine (TCM) symptoms (e.g., fatigue, aversion to cold, cold limbs, and pain in the limbs and joints in patients with SONFH characterized by liver and kidney deficiency syndrome. Among these pathways, the PI3K/Akt signaling pathway exhibited the highest degree of enrichment. The in vivo experimental results demonstrated that starting from the 4th week after modeling, the modeling group exhibited a significant reduction in body weight compared to the control group (P<0.05). After six weeks of treatment, all dosage groups of SQP showed significantly higher body weights compared to the model group (P<0.01). Compared with the normal group, the model group exhibited significant decreases in bone mineral density (BMD), bone volume fraction (BV/TV), trabecular number (Tb.N), osteocalcin (OCN), alkaline phosphatase (ALP) levels in femoral head tissue, and serum bone-specific alkaline phosphatase (BALP) (P<0.01), along with significant increases in trabecular separation (Tb.Sp), empty lacunae rate in tissue, and apoptosis rate (P<0.01). In comparison to the model group, the SQP intervention groups showed significant improvements in BMD, BV/TV and Tb.N (P<0.01), significant reductions in Tb.Sp, empty lacunae rate and apoptosis rate (P<0.05), and significant increases in protein levels of OCN and ALP as well as BALP content (P<0.05). The in vitro experimental results revealed that all dosage groups of SQP medicated serum showed no toxic effects on osteoblast. Compared with the normal group, the model group displayed significant suppression of osteoblast proliferation activity, ALP activity, and calcified nodule formation rate (P<0.01), significant decreases in mRNA transcription levels of OCN and Runt-related transcription factor 2 (RUNX2) (P<0.01), significant reductions in protein content of osteopontin (OPN), typeⅠ collagen (ColⅠ)A1, B-cell lymphoma-2 (Bcl-2), PI3K, and phosphorylated (p)-Akt (P<0.01), and a significant increase in apoptosis rate (P<0.01). Compared with the model group, the SQP medicated serum intervention groups exhibited significant increases in proliferation activity, ALP activity, calcified nodule formation rate, mRNA transcription levels of OCN and RUNX2, and protein content of OPN, ColⅠA1, Bcl-2, PI3K, and p-Akt (P<0.05), along with a significant decrease in apoptosis rate (P<0.01). ConclusionSQP can effectively reduce the disease severity of SONFH with liver and kidney deficiency syndrome and improve bone microstructure, with the therapeutic effects exhibiting a dose-dependent manner. The mechanism may be related to its regulation of key processes such as muscle and bone metabolism and the correction of imbalances in the "neuro-endocrine-immune" network, thereby promoting osteoblast differentiation and inhibiting osteoblast apoptosis. The PI3K/Akt signaling axis is likely one of the key pathways through which this formula exerts its effects.
2.The Effects of Tai Chi Training on Bone Density,Bone Turnover Markers,and Heart Rate Variability in High-Risk Osteoporosis Population
Jiaming LIN ; Chao LI ; Wei ZHAO ; Jun ZHOU ; Xiaoying CHEN ; Xiangyu XI ; Haijun HE ; Baohong MI ; Yuefeng CHEN ; Weiheng CHEN
Journal of Traditional Chinese Medicine 2025;66(15):1566-1571
ObjectiveTo explore the effects of the Tai Chi training on bone density, bone turnover markers, and heart rate variability for people with high-risk osteoporosis, and to provide evidence for the prevention of osteoporosis at early stage. MethodsSixty-six cases of people with high risk of osteoporosis were included, and they were divided into 33 cases each in the intervention group and the control group using the random number table method. The control group received osteoporosis health education three times a week, and the intervention group received Tai Chi training under the guidance of a trainer three times a week for 40 mins each time on the basis of the control group, and both groups were intervened for 12 weeks. Dual-energy X-ray absorptiometry was used to measure the bone density of L1~L4 vertebrae, bilateral femoral necks and bilateral total hips in the two groups before and after the intervention; enzyme-linked immunosorbent assay was used to determine bone turnover markers before and after the intervention, including pro-collagen type Ⅰ pro-amino-terminal prepropyl peptide (P1NP) and β-collagen type Ⅰ cross-linking carboxy-terminal peptide (β-CTX). Seven cases with good compliance in the intervention group were selected. After wearing the heart rate sensor, they successively performed Tai Chi training and walking activities recommended by the guideline for 20 mins each, and the heart rate variability (HRV) during exercise was collected, including time-domain indexes such as standard deviation of normal sinus intervals (SDNN), root-mean-square of the difference between adjacent RR intervals (RMSSD), frequency-domain metrics such as low-frequency power (LF), high-frequency power (HF), and low-frequency/high-frequency power ratio (LF/HF), as well as nonlinear metrics such as approximate entropy (ApEn), sample entropy (SampEn). ResultsFinally, 63 cases were included in the outcome analysis, including 30 cases in the intervention group and 33 cases in the control group. After the intervention, the differences of L1~L4 vertebrae, bone density of bilateral femoral neck and bilateral total hip in the intervention group were not statistically significant when compared with those before intervention (P>0.05), while the bone density of all parts of the control group decreased significantly compared with that before intervention (P<0.05), and the difference in the bone density of the L1~L4 vertebrae, bilateral femoral neck, and the right total hip before and after the intervention of the intervention group was smaller than that of the control group (P<0.05). The differences in P1NP and β-CTX between groups before and after intervention was not statistically significant (P>0.05). Compared with walking exercise, LF decreased, HF increased and LF/HF decreased during Tai Chi exercise (P<0.05); the time domain indexes and non-linear indexes between groups had no statistically significant difference (P>0.05). ConclusionTai Chi exercise can maintain lumbar, hip, and femoral bone density and improve sympathetic/parasympathetic balance in people at high risk for osteoporosis, but cannot significantly improve bone turnover markers.
3.Salvianolic Acid B and Ginsenoside Rg1 Combination Attenuates Cerebral Edema Accompanying Glymphatic Modulation.
Lingxiao ZHANG ; Yanan SHAO ; Zhao FANG ; Siqi CHEN ; Yixuan WANG ; Han SHA ; Yuhan ZHANG ; Linlin WANG ; Yi JIN ; Hao CHEN ; Baohong JIANG
Neuroscience Bulletin 2025;41(11):1909-1923
Cerebral edema is characterized by fluid accumulation, and the glymphatic system (GS) plays a pivotal role in regulating fluid transport. Using the Tenecteplase system, magnesium salt of salvianolic acid B/ginsenoside Rg1 (SalB/Rg1) was injected intravenously into mice 4.5 h after middle cerebral artery occlusion and once every 24 h for the following 72 h. GS function was assessed by Evans blue imaging, near-infrared fluorescence region II (NIR-II) imaging, and magnetic resonance imaging (MRI). SalB/Rg1 had significant effects on reducing the infarct volume and hemorrhagic transformation score, improving neurobehavioral function, and protecting tissue structure, especially inhibiting cerebral edema. Meanwhile, the influx/efflux drainage of GS was enhanced by SalB/Rg1 according to NIR-II imaging and MRI. SalB/Rg1 inhibited matrix metalloproteinase-9 (MMP-9) activity, reduced cleaved β-dystroglycan (β-DG), and stabilized aquaporin-4 (AQP4) polarity, which was verified by colocalization with CD31. Our findings indicated that SalB/Rg1 treatment enhances GS function and attenuates cerebral edema, accompanying the regulation of the MMP9/β-DG/AQP4 pathway.
Animals
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Ginsenosides/administration & dosage*
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Brain Edema/etiology*
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Male
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Benzofurans/administration & dosage*
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Glymphatic System/diagnostic imaging*
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Mice
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Infarction, Middle Cerebral Artery/drug therapy*
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Aquaporin 4/metabolism*
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Disease Models, Animal
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Mice, Inbred C57BL
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Matrix Metalloproteinase 9/metabolism*
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Neuroprotective Agents/pharmacology*
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Depsides
4.Expert consensus on peri-implant keratinized mucosa augmentation at second-stage surgery.
Shiwen ZHANG ; Rui SHENG ; Zhen FAN ; Fang WANG ; Ping DI ; Junyu SHI ; Duohong ZOU ; Dehua LI ; Yufeng ZHANG ; Zhuofan CHEN ; Guoli YANG ; Wei GENG ; Lin WANG ; Jian ZHANG ; Yuanding HUANG ; Baohong ZHAO ; Chunbo TANG ; Dong WU ; Shulan XU ; Cheng YANG ; Yongbin MOU ; Jiacai HE ; Xingmei YANG ; Zhen TAN ; Xiaoxiao CAI ; Jiang CHEN ; Hongchang LAI ; Zuolin WANG ; Quan YUAN
International Journal of Oral Science 2025;17(1):51-51
Peri-implant keratinized mucosa (PIKM) augmentation refers to surgical procedures aimed at increasing the width of PIKM. Consensus reports emphasize the necessity of maintaining a minimum width of PIKM to ensure long-term peri-implant health. Currently, several surgical techniques have been validated for their effectiveness in increasing PIKM. However, the selection and application of PIKM augmentation methods may present challenges for dental practitioners due to heterogeneity in surgical techniques, variations in clinical scenarios, and anatomical differences. Therefore, clear guidelines and considerations for PIKM augmentation are needed. This expert consensus focuses on the commonly employed surgical techniques for PIKM augmentation and the factors influencing their selection at second-stage surgery. It aims to establish a standardized framework for assessing, planning, and executing PIKM augmentation procedures, with the goal of offering evidence-based guidance to enhance the predictability and success of PIKM augmentation.
Humans
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Consensus
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Dental Implants
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Mouth Mucosa/surgery*
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Keratins
5.Research Progress in Pharmacological Effects of Tripterygium Wilfordii in the Treatment of Breast Cancer and Bone Metastasis
Jing ZHANG ; Jingwei LI ; Zichao CHEN ; Baohong LI ; Yixuan ZOU ; Hui LIU ; Xiuyun ZHANG ; Zhen ZHANG
Traditional Chinese Drug Research & Clinical Pharmacology 2024;35(8):1272-1280
Breast cancer is one of the most prevalent malignant tumors.Bone metastasis is a common complication during the entire course of breast cancer.The vicious cycle of"tumor-bone microenvironment"was easily formed,which led to the occurrence of bone-related events such as bone pain,pathological fractures,and hypercalcemia,etc.Studies have found that active ingredients of Tripterygium wilfordii exhibit the effect of anti-breast cancer and regulation of bone microenvironment,including inhibition of tumor cell proliferation and migration,inhibition of tumor angiogenesis,induction of autophagy in tumor cells,regulation of bone formation in osteoblast cell,inhibition of bone resorption in osteoclast cell,promoting the differentiation of bone marrow mesenchymal stem cells into osteoblasts,and regulation of immune microenvironment,which may be helpful to inhibit breast cancer and bone metastasis.This article systematically reviewed the research progress on pharmacological effects of Tripterygium wilfordii in preventing breast cancer and bone metastasis,analyzed the limitations and application prospects of the current research.
6.Clinical Characteristics of Adverse Events and Influencing Factors of Osteoking
Pengxuan DONG ; Rui QUAN ; Jun ZHOU ; Na LIN ; Baohong MI ; Weiheng CHEN
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(18):132-138
ObjectiveTo observe the clinical characteristics and influencing factors of adverse events of Osteoking and provide a basis for its rational use in clinical practice. MethodA prospective and multicenter Cohort study with large samples was conducted to observe the effects of Osteoking in the treatment of 922 patients with knee osteoarthritis from 20 hospitals from May 1, 2020 to December 31, 2021. Patients who were treated with Osteoking were set as the exposed cohort, and those who were not treated with Osteoking were set as the non-exposed cohort. The gender, age, body mass index (BMI), occupation, allergy history, past medical history, hospital information, medication, and the occurrence of adverse events of the patients were recorded, and the incidence of adverse events was analyzed, as well as its characteristics and factors. ResultA total of 922 patients with knee osteoarthritis were involved, including 274 males (29.72%) and 648 females (70.28%), from which 617 cases were in the exposed cohort, and 305 cases were in the non-exposed cohort. A total of 25 adverse events occurred in both cases, accounting for 2.71% of the total number of cases, with 17 cases in the exposed cohort (2.76%) and eight cases in the non-exposed cohort (2.62%). There was no difference in the incidence rate between the two groups (P=0.907). The age group with the highest incidence of adverse events was between 50 and 59 years old in the exposed cohort (4.61%). The incidence rate in women was 3.49%, slightly higher than 1.07% in men, but there was no difference (P=0.156). According to the systematic classification of adverse events, five cases were respiratory, thoracic, and mediastinal diseases, with an incidence rate of 0.81%. There were two cases of infection and infection diseases, two cases of skin and subcutaneous tissue diseases, two cases of heart-related diseases, two cases of symptoms and signs (not otherwise classified), and two cases of eye organ diseases, and the incidence rate was 0.32%. There was one case of systemic disease, one case of neuropathy, one case of heart organ disease, and one case of vascular hypotension disease, and the incidence rate was 0.16%. During the trial, a total of seven adverse reactions occurred. Among them, there were two cases of dry pharynx, two cases of dizziness, one case of drowsiness, one case of hypotension, and one case of eye discharge, with an incidence rate of 1.13%. Through binary Logistic regression analysis, it was found that among the factors that may affect the occurrence of adverse events in the exposed group, traditional Chinese medicine hospitals were the protective factors for the occurrence of adverse events (OR=0.200, P=0.002), while gender, age, BMI, occupation, allergy history, past medical history, and hospital level cannot be considered to have an impact on the occurrence of adverse events. ConclusionOsteoking can be used to treat knee osteoarthritis of patients of all ages and genders by doctors from hospitals of different levels with higher safety, with occasional and mild adverse events, and seeing a doctor in a traditional Chinese medicine hospital can reduce the occurrence of adverse reactions.
7.Real-World Study on the Clinical Efficacy of Different Medication Regimens of Wangbi Tablet (尪痹片) in the Treatment of Knee Osteoarthritis
Kuayue ZHANG ; Chao LI ; Zhuoyun WU ; Yawei DONG ; Zelu ZHENG ; Yuzhi LIU ; Jun ZHOU ; Jiaming LIN ; Yuefeng CHEN ; Baohong MI ; Weiheng CHEN
Journal of Traditional Chinese Medicine 2024;65(22):2316-2325
ObjectiveTo investigate the differences in clinical efficacy of different medication regimens of Wangbi Tablets (尪痹片) for knee osteoarthritis (KOA) in a real-world setting, providing a basis for rational clinical use of Wangbi Tablets. MethodsA prospective registry study was conducted, involving 2,999 KOA patients registered in 30 hospitals nationwide from January 26th, 2019, to December 17th, 2021. Based on the use of Wangbi Tablets during the observation period, patients were divided into a monotherapy group (1,507 cases) and a combination therapy group (1,492 cases), and the combination group can be further divided into Wangbi Tablets plus Chinese medicine (CM), Wangbi Tablets plus western medicine (WM), and Wangbi Tablets plus Chinese and western medicine (CM+WM) subgroups. The baseline data of patients in the monotherapy group and the combination group were compared, including age, gender, body weight, medication time, clinical stage, K-L grade, and others. Efficacy indicators included the Visual Analog Scale (VAS) score, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, and EuroQol five-dimensional (EQ-5D) health index, which were evaluated before and after 4-, 8- and 12-week treatment, and the difference before and after treatment was calculated after 4, 8 and 12 weeks of treatment. The difference between the baseline and 12 weeks of treatment of all the above indicators was used as the dependent variables, and gender, age, body mass index (BMI), course of disease, K-L grade, and clinical stage were used as independent variables, when multiple linear regression was taken to explore the influencing factors of the efficacy. At the same time, the occurrence of major symptoms (including morning stiffness, joint swelling, soreness of waist and knees, fear of wind, and fear of cold) was counted, and the disappearance of symptoms at each time point was counted after 4, 8, and 12 weeks of treatment. ResultsAt baseline, there were no statistically significant differences in gender and age distribution between the monotherapy and combination therapy groups (P>0.05); the proportion of patients in the acute stage and recovery stage was higher in the monotherapy group than in the combination therapy group, while the proportion in the remission stage was lower (P<0.05); the VAS score was higher in the monotherapy group, and the EQ-5D index was lower (P<0.01), with no statistically significant difference in total WOMAC score between the two groups (P>0.05). Compared to those measured before treatment and at previous timepoint, the VAS score and WOMAC total score significantly decreased in both groups, while EQ-5D value increased (P<0.05). The difference in VAS score between baseline and after 12-week treatment was higher in the monotherapy group than the combination group, while the differences in WOMAC total score and EQ-5D value between baseline and after 4-, 8- and 12-week treatment were higher in the combination group (P<0.05). Multiple linear regression showed that VAS score before treatment had greatest impact on pain improvement (P<0.01), and compared to Wangbi Tablets monotherapy, the combination of Wangbi tablets with WM or CM had larger associations with pain improvement (P<0.05); and Wangbi Tablets had better efficacy when the course of treatment was >28 days (P<0.01). Wangbi Tablets plus WM had a better effect on improving the overall function of the knee joint than Wangbi Tablets alone (P<0.01); and the efficacy of Wangbi Tablets with a course of treatment >28 days was better (P<0.05). The improvement of quality of life of patients in the attack and remission stages was more obvious than that in the recovery stage (P<0.01); Wangbi Tablets plus WM or CM had a better effect on improving quality of life than Wangbi Tablets alone (P<0.05). Before treatment, the proportion of patients with morning stiffness, soreness of waist and knees, fear of wind and chills in the monotherapy group was higher than that in the combination group (P<0.01). The proportion of main symptoms in both groups decreased after 4, 8 and 12 weeks of treatment (P<0.05). After 4 weeks of treatment, the disappearance rate of each main symptom in the combination group was higher than that in the monotherapy group, and after 12 weeks of treatment, the disappearance rate of fear of wind in the monotherapy group was higher than that in the combination group, while the disappearance rate of joint swelling and soreness of waist and knees was lower (P<0.05). ConclusionWangbi Tablets, whether used alone or in combination with other medications, is effective throughout the course of KOA, with greater benefits in improving joint function and quality of life during the acute and remission stages compared to the recovery stage. Combination therapy had a faster onset of effect, but began to converge with monotherapy after 8 weeks. The best efficacy was observed with the combination of Wangbi Tablets with WM, followed by combination with CM.
8.Study on the characteristics of pattern elements and the distribution of patterns of three kinds of early hip joint diseases with "different diseases with the same pattern"
Jun ZHOU ; Wenlong LI ; Zhi LIANG ; Yan YAN ; Baohong MI ; Rongtian WANG ; Weiheng CHEN
Journal of Beijing University of Traditional Chinese Medicine 2024;47(3):417-428
Objective To analyze the characteristics of pattern elements and the distribution of patterns of femoral head necrosis, hip osteoarthritis, and hip rheumatoid arthritis, in order to provide a theoretical basis for the "different diseases with the same pattern" of chronic bone diseases. Methods A cross-sectional survey was conducted to select patients with femoral head necrosis Association Research Circulation Osseous Ⅰ-Ⅱ stages, hip osteoarthritis Kellgren & Lawrence Ⅰ-Ⅱ stages, and acute or subacute hip rheumatoid arthritis who visited the Minimally Invasive Arthrology Department, Traumatology Department, and Rheumatology and Immunology Department of Beijing University of Chinese Medicine Third Affiliated Hospital from June 2020 to June 2022. The " case report form - traditional Chinese medicine pattern manifestation scale" previously developed by our team was used to collect the pattern manifestations, which were included into an Excel 2020 spreadsheet to establish a database. SPSS 20.0 software was used for factor analysis and cluster analysis to extract pattern element information, such as disease nature and location, in order to summarize the characteristics of pattern elements, the distribution of patterns, and the similarities and differences of the three kinds of early hip joint diseases.Results A total of 410 patients were included, including 150 patients with femoral head necrosis, 160 patients with hip osteoarthritis, and 100 patients with hip rheumatoid arthritis. The pattern elements of the disease nature of femoral head necrosis include phlegm (dampness), blood stasis, yang deficiency, essence deficiency, and qi deficiency. The pattern types were initially divided into four categories: syndrome of meridian obstruction (43.33%), syndrome of phlegm and blood stasis blocking collaterals (38.00%), syndrome of liver and kidney deficiency (12.00%), and syndrome of kidney essence deficiency (6.67%). The pattern elements of the disease nature of hip osteoarthritis include phlegm (dampness), blood stasis, qi deficiency, essence deficiency, yang deficiency, and cold (dampness). The pattern types were preliminarily divided into five categories: syndrome of spleen and kidney deficiency (37.50%), syndrome of meridian obstruction (26.87%), syndrome of cold and dampness obstruction (18.75%), syndrome of phlegm and blood stasis obstruction (9.38%), and syndrome of liver and kidney deficiency (7.50%). The pattern elements of the disease nature of hip rheumatoid arthritis include phlegm (dampness), blood stasis, qi deficiency, yin and yang deficiency, cold (dampness), and essence deficiency. The pattern types were preliminarily divided into four categories: syndrome of phlegm and blood stasis obstruction (34.00%), syndrome of cold and dampness obstruction (28.00%), syndrome of blood stasis blocking collaterals (23.00%), and syndrome of liver and kidney deficiency (15.00%). Overall, the top five pattern manifestations of the three kinds of hip joint diseases were hip joint pain (96.59%), tenderness (93.90%), fixed pain (87.56%), heavy joints (85.37%), and sourness of lower limbs (75.37%). The pattern elements of the disease nature include phlegm (dampness), blood stasis, qi deficiency, etc. The pattern types were preliminarily divided into five categories: syndrome of phlegm stasis blocking collaterals (33.17%), syndrome of meridian obstruction (31.95%), syndrome of cold dampness obstruction (21.46%), syndrome of liver and kidney deficiency (7.32%), and syndrome of spleen and kidney deficiency (6.10%). There were 21 similar pattern manifestations in the three kinds of early hip joint diseases, with blood stasis and spleen deficiency being the main pattern.Conclusion The common pattern characteristics of three kinds of early hip joint diseases are spleen deficiency and blood stasis. In addition, femoral head necrosis is accompanied with phlegm-dampness pattern, hip osteoarthritis is accompanied with kidney deficiency and phlegm-dampness pattern, hip rheumatoid arthritis is accompanied with kidney deficiency and cold-dampness pattern.
9.Imaging features of severe unilateral transverse sinus and sigmoid sinus thromboses and efficacy and safety of intravascular interventional therapy in them
Tengfei LI ; Qi TIAN ; Shuailong SHI ; Jie YANG ; Ye WANG ; Zhen CHEN ; Yuncai RAN ; Baohong WEN ; Dong GUO ; Shaofeng SHUI ; Xinwei HAN ; Xiao LI ; Ji MA
Chinese Journal of Neuromedicine 2024;23(1):42-47
Objective:To summarize the imaging features of severe unilateral transverse sinus and sigmoid sinus thromboses, and evaluate the efficacy and safety of intravascular interventional therapy in them.Methods:Thirty-seven patients with severe unilateral transverse sinus and sigmoid sinus thromboses clinically mainly manifested as intracranial hypertension and accepted endovascular intervention in Department of Interventional Radiology, First Affiliated Hospital of Zhengzhou University from June 2012 to September 2022 were chosen; their clinical data were retrospectively analyzed and imaging features were summarized. Short-term efficacy was evaluated according to blood flow restoration degrees and pressure gradient reduction in the occlusive sinus and modified neurological symptoms before and after endovascular intervention. Hospitalized complications were observed; safety and long-term efficacy were evaluated according to postoperative clinical follow-up and imaging results 6-12 months after endovascular intervention.Results:(1) Preoperative brain MRI and (or) CT showed different degrees of swelling of the brain tissues, with the affected side as the target; mixed signals/density shadow could be seen in the blocked transverse sinus and sigmoid sinus; venous cerebral infarction or post-infarction cerebral hemorrhage could be combined in some patients. MRV, CTV and DSA showed poor or completely occluded transverse sinus and sigmoid sinus while normal in the contralateral side; obvious thrombus filling-defect was observed in the occluded venous sinus after mechanical thrombolysis. (2) Occlusive sinus blood flow was restored in all patients after endovascular intervention, and pressure gradient of the occlusive segment decreased from (16.6±3.3) mmHg before to (2.8±0.8) mmHg after endovascular intervention. Before discharge, clinical symptoms of all patients were significantly improved (modified Rankin scale [mRS] scores of 0 in 30 patients, 1 in 5 patients, 2 in 1 patient and 3 in 1 patient), and 2 patients had unilateral limb movement disorder (muscle strength grading III and IV, respectively). All patients received clinical follow-up for (9.6±3.0) months. At the last follow-up, neurological function obviously improved compared with that before endovascular intervention, without new neurosystem-related symptoms (mRS scores of 0 in 30 patients, 1 in 6, and 2 in 1 patient). In 34 patients received MRV or DSA follow-up, 28 had complete recanalization of occlusive sinus and 6 had partial recanalization, without obvious stenosis or recurrent occlusion.Conclusions:Severe unilateral transverse sinus and sigmoid sinus thrombosis can cause local intracranial venous blood stasis, and then cause "increased regional venous sinus pressure", which is manifested as unilateral brain tissue swelling and even venous cerebral infarction or post-infarction cerebral hemorrhage. Early diagnosis and endovascular intervention can obviously improve the prognosis of these patients, enjoying good safety.
10.OCT and IVUS evaluating stent apposition and endothelialization after FD implantation in aneurysm animal models
Ji MA ; Shuhai LONG ; Jie YANG ; Zhen LI ; Haiqiang SANG ; Yi TANG ; Yuncai RAN ; Yong ZHANG ; Baohong WEN ; Shanshan XIE ; Ke CHEN ; Enjie LIU ; Xinwei HAN ; Tengfei LI
Chinese Journal of Neuromedicine 2024;23(3):256-262
Objective:To investigate the application value of optical coherence tomography (OCT) and intravascular ultrasound (IVUS) in evaluating flow diverter (FD) apposition and endothelialization in aneurysm animal models, and analyze the effect of incomplete stent apposition (ISA) on aneurysm lumen healing and stent endothelialization.Methods:Lateral common carotid artery aneurysm models in swines were established by surgical method and then FD was implanted. Immediately after surgery, OCT and IVUS were used to evaluate the locations and degrees of ISA, and difference between these 2 methods in evaluating FD apposition was compared. DSA was performed at 12 weeks after surgery to evaluate the aneurysm occlusion (Kamran grading) and stent patency. OCT and IVUS were used again to observe the stent endothelial situation; by comparing with histopathologic results, effect of ISA on aneurysm healing and stent endothelialization was analyzed.Results:Lateral common carotid artery aneurysm models in 6 swines were established, and 6 Tubridge FDs were successfully implanted. Compared with IVUS (3 stents, 4 locus), OCT could detect more ISA (6 stents, 14 locus); and the vascular diameter change area (7 locus), aneurysm neck area (4 locus) and the head and tail of FD (3 locus) were the main sites of FD malapposition; average distance between stent wire and vessel wall was (560.14±101.48) μm. At 12 weeks after surgery, DSA showed that 1 patient had a little residual contrast agent at the aneurysm neck (Kamran grading 3), and the remaining 5 had complete aneurysm occlusion (Kamran grading 4). One FD had moderate lumen stenosis, and the other 5 FDs had lumen patency. OCT indicated mostly disappeared acute ISA; ISA proportion decreased to 21.4 % (3/14), including 2 in the aneurysm neck and 1 in the partial stent. Histopathological results showed bare stent woven silk, without obvious endothelial coverage; in one FD with luminal stenosis, intimal hyperplasia was mainly composed of vascular smooth muscle cells.Conclusion:In carotid artery aneurysm model with FD implantation, OCT can detect more ISA than IVUS; most acute ISA have good outcome at 12 th week of follow-up, while severe ISA can cause delayed FD endothelialization and delayed aneurysm occlusion.

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