ObjectiveTo investigate the possible mechanism of Jishe Qushi Capsule （脊蛇祛湿胶囊， JQC） in treating rheumatoid arthritis （RA） from the perspective of macrophage polarization mediated by neutrophil extracellular traps （NETs）. MethodsTwenty-four female SD rats were randomly divided into four groups， blank control group， model group， JQC group， and peptidylarginine deiminase 4 （PAD4） inhibitor group with 6 rats in each group. All groups but the blank control group were subjected to the induction of collagen-induced arthritis （CIA）. After successful model establishment， rats in the JQC group received intragastric administration of JQC 1.47 g/kg daily； rats in the PAD4 inhibitor group received intraperitoneal injections of the PAD4 inhibitor 4 mg/kg weekly. Rats in the blank， model， and PAD4 inhibitor groups received 2 ml of pure water daily by gavage. All treatments lasted 4 weeks. Joint lesions of each group were assessed on day 7， 14， 21， 28， and 35 after model establishment， and arthritis index （AI） scores were recorded. At 24 h after the final administration， histopathology of knee joints， including HE staining， safranin O-fast green staining， and TRAP staining， was performed. Flow cytometry was used to detect the counts of M1 and M2 macrophages in peripheral blood. ELISA was used to determine serum levels of TRACP， NETs， TNF-α， IL-1β， and iNOS. Western Blotting and qRT-PCR were used to measure MPO， NE， RANKL， OPG， and p65 protein and mRNA expression in knee cartilage tissue. ResultsCompared with the blank control group， the model group showed increased AI scores （P＜0.05）， marked synovial inflammatory infiltration， angiogenesis， and bone-cartilage destruction， increased TRAP-positive osteoclasts， increased M1 macrophages and decreased M2 macrophages， elevated serum TRACP， NETs， TNF-α， IL-1β， and iNOS （P＜0.05）， elevated MPO， NE， RANKL， and p65 protein/mRNA expression and decreased OPG protein/mRNA expression in knee cartilage tissue （P＜0.05）. Compared with the model group， the JQC group exhibited improved synovial inflammation， angiogenesis， and bone-cartilage damage， reduced AI scores on day 21， 28， and 35， decreased osteoclast counts， decreased M1 macrophages and increased M2 macrophages， reduced serum TRACP， NETs， TNF-α， IL-1β， and iNOS （P＜0.05）， decreased MPO， NE， RANKL， and p65 protein/mRNA expression and increased OPG expression （P＜0.05）. Compared with the PAD4 inhibitor group， the JQC group showed significantly lower AI scores， reduced M1 macrophages， increased M2 macrophages （P＜0.05）， reduced serum TRACP， TNF-α， IL-1β， and iNOS， decreased MPO， RANKL， and p65 expression， and increased OPG levels （P＜0.05）. ConclusionThe therapeutic mechanism of JQC for RA may involve inhibition of NETs formation， downregulation of the RANKL/NF-κB signaling pathway， and regulation of macrophage M1/M2 polarization imbalance， thereby suppressing osteoclastogenesis and inflammatory bone destruction.

Objective To construct the rheumatoid arthritis fibroblast-like synoviocytes(RAFLS)model,and to investigate the effects of usnic acid on the inflammatory pathway of high-mobility group protein B1(HMGB1)/receptor for activated glycation end products(RAGE)and the expression levels of vascular en-dothelial growth factor(VEGF),interleukin(IL)-6 and IL-1β.Methods The patients with RA undergoing joint replacement surgery in the orthopedic department of the Second Affiliated Hospital of Guizhou Universi-ty of Traditional Chinese Medicine were selected and the synovial tissues were obtained during operation.The cells were divided into the blank control group(fetal calf serum),solvent control group(fetal calf serum+10％hydroxypropyl betacyclodextrin),usnic acid high dose group(usnic acid 50 μg/mL),usnic acid middle dose group(usnic acid 10 μg/mL),usnic acid low dose group(usnic acid 2.5 μg/mL)and hydroxychloroquine group(hydroxychloroquine 50 mmol/L).The cell proliferation after different concentrations of usnic acid treatment was detected by MTT,the HMGB1 and RAGE protein expression in cells of each group was detec-ted by Western blot,and the expression levels of HMGB1,VEGF,IL-6 and IL-1β were detected by ELISA.Re-sults Compared with the blank control group,the proportions of cellular apoptosis in the usnic acid high,middle and low doses groups and hydroxychloroquine group were increased(P＜0.05);the expression levels of HMGB1 and RAGE protein in the usnic acid high,middle and low doses groups and hydroxychloroquine group were significantly decreased(P＜0.05),the expression levels of HMGB1,VEGF,IL-6 and IL-1β were decreased(P＜0.05);compared with the hydroxychloroquine group,the cellular apoptosis proportions of the usnic acid high,middle and low doses groups were decreased(P＜0.05),the HMGB1 protein expression level in the usnic acid low dose group was significantly increased(P＜005),the RAGE protein expression level in the the usnic acid middle amd low doses groups was significantly increased(P＜0.05).Conclusion Usnic acid alleviates the inflammatory reaction of synoviocytes possibly by regulating HMGB1/RAGE inflammatory pathway and VEGF,IL-6 and IL-1β inflammatory factors expression levels.

Objective To explore the effect of a herbalcompound Gehua Jiejue Dizhi Decoction (GJDD) on the liver fat deposition and the expression of PXR, and the mRNA and protein expression of its target genes CYP3A11 and CYP3A25in the liver tissues of mouse models of alcoholic fatty liver.Methods Twenty-nine healthy male C57BL/6J mice were randomly divided into control group (n=5), model group (n=8), high dose GJDD group (n=8)and low dose GJDD group (n=8).The mouse model of alcoholic fatty liver was prepared according to the National Institute on Alcohol Abuse and Alcoholism (NIAAA) method.Then, the mice were treated with the high dose and low dose GJDD for 9 days.Serum glutamic-pyruvic transaminase (AST) and aspartate aminotransferase (AST) were detected by enzyme-linked immunosorbent assay (ELISA).Liver fat deposition was detected by oil red O staining.Real-time RT-PCR and immunohistochemistry were performed to examine the expressions of PXR, CYP3A11 and CYP3A25.Results Compared with the model group, the liver fat deposition in the intervention groups was significantly reduced in a dose-dependent manner, with a significant increase of the expression of PXR and CYP3A25 (P < 0.01).The serum ALT level was significantly reduced in the model group (P < 0.01), while the transcriptional levels of CYP3A11 mRNA in the groups were similar (P ≥ 0.05).Conclusions Gehua Jiejue Dizhi Decoction has obvious therapeutic effect on the AFLD in mice, which may be related to the activation of PXR and its target genes CYP3A25.