BACKGROUND:β-Caryophyllene has a variety of pharmacological activities such as antioxidant,anti-inflammatory and anti-apoptotic,which may have a better therapeutic effect on osteoarthritis.OBJECTIVE:To investigate the effect and mechanism of β-caryophyllene on mouse osteoarthritis.METHODS:Forty C57BL/6J mice were randomly divided into sham group,model group,low-dose β-caryophyllene group and high-dose β-caryophyllene group,with 10 mice in each group.Hulth method was used to construct an osteoarthritis model in the latter three groups.Four weeks after modeling,70 and 140 mg/kg/d β-caryophyllene was intragastrically given in the low-and high-dose β-caryophyllene groups,respectively,and normal saline was given by gavage in the sham group and the model group,once a day,for 4 weeks.After administration,knee joint morphological changes were observed by hematoxylin-eosin staining,serum levels of inflammatory factors(tumor necrosis factor-α,interleukin-1β,interleukin-6,and interleukin-10)were detected by ELISA,and oxidative stress indexes(glutathione peroxidase,superoxide dismutase,and malondialdehyde)were detected by chemiluminescence.The expression levels of key proteins in the Sonic hedgehog(Shh)/glioma associated oncogene homolog 1(Gli1)signaling pathway were detected by immunohistochemistry and western blot.RESULTS AND CONCLUSION:(1)Compared with the sham group,a large number of inflammatory cells infiltrated in the knee joint of mice in the model group,cartilage tissue was seriously damaged,serum levels of tumor necrosis factor-α,interleukin-1β,interleukin-6,interleukin-10 and malondialdehyde were significantly increased(P＜0.01),the activities of glutathione peroxidase and superoxide dismutase were significantly decreased(P＜0.01),and the relative expression levels of Shh and Gli1 in the knee joint were significantly increased(P＜0.01).(2)Compared with the model group,in the low-and high-dose β-caryophyllene groups,inflammatory cell infiltration in the mouse knee joint was decreased,cartilage tissue injury was alleviated,serum levels of tumor necrosis factor-α,interleukin-1 β,interleukin-6 and malondialdehyde were significantly decreased(P＜0.05),the activities of glutathione peroxidase and superoxide dismutase were significantly increased(P＜0.01),and the expression levels of Shh and Gli1 in the knee joint were significantly decreased(P＜0.01).The above-mentioned improvements were more significant in the high-dose β-caryophyllene group than the low-dose β-caryophyllene group.To conclude,β-caryophyllene can improve osteoarthritis,and its mechanism may be related to reducing inflammation and oxidative stress damage by regulating the Shh/Gli1 signaling pathway.

BACKGROUND:β-Caryophyllene has a variety of pharmacological activities such as antioxidant,anti-inflammatory and anti-apoptotic,which may have a better therapeutic effect on osteoarthritis.OBJECTIVE:To investigate the effect and mechanism of β-caryophyllene on mouse osteoarthritis.METHODS:Forty C57BL/6J mice were randomly divided into sham group,model group,low-dose β-caryophyllene group and high-dose β-caryophyllene group,with 10 mice in each group.Hulth method was used to construct an osteoarthritis model in the latter three groups.Four weeks after modeling,70 and 140 mg/kg/d β-caryophyllene was intragastrically given in the low-and high-dose β-caryophyllene groups,respectively,and normal saline was given by gavage in the sham group and the model group,once a day,for 4 weeks.After administration,knee joint morphological changes were observed by hematoxylin-eosin staining,serum levels of inflammatory factors(tumor necrosis factor-α,interleukin-1β,interleukin-6,and interleukin-10)were detected by ELISA,and oxidative stress indexes(glutathione peroxidase,superoxide dismutase,and malondialdehyde)were detected by chemiluminescence.The expression levels of key proteins in the Sonic hedgehog(Shh)/glioma associated oncogene homolog 1(Gli1)signaling pathway were detected by immunohistochemistry and western blot.RESULTS AND CONCLUSION:(1)Compared with the sham group,a large number of inflammatory cells infiltrated in the knee joint of mice in the model group,cartilage tissue was seriously damaged,serum levels of tumor necrosis factor-α,interleukin-1β,interleukin-6,interleukin-10 and malondialdehyde were significantly increased(P＜0.01),the activities of glutathione peroxidase and superoxide dismutase were significantly decreased(P＜0.01),and the relative expression levels of Shh and Gli1 in the knee joint were significantly increased(P＜0.01).(2)Compared with the model group,in the low-and high-dose β-caryophyllene groups,inflammatory cell infiltration in the mouse knee joint was decreased,cartilage tissue injury was alleviated,serum levels of tumor necrosis factor-α,interleukin-1 β,interleukin-6 and malondialdehyde were significantly decreased(P＜0.05),the activities of glutathione peroxidase and superoxide dismutase were significantly increased(P＜0.01),and the expression levels of Shh and Gli1 in the knee joint were significantly decreased(P＜0.01).The above-mentioned improvements were more significant in the high-dose β-caryophyllene group than the low-dose β-caryophyllene group.To conclude,β-caryophyllene can improve osteoarthritis,and its mechanism may be related to reducing inflammation and oxidative stress damage by regulating the Shh/Gli1 signaling pathway.

Lung nodules are characterized by a mixture of deficiency and excess syndromes， with the primary disease location in the lungs and a close relationship to the spleen and kidneys. The pathogenesis involves dysfunction of the lungs， spleen， and kidneys， leading to qi stagnation， phlegm coagulation， and blood stasis， which obstruct the colla-terals， and cold-dampness obstructing the surface and lung qi failing to disperse are important causes of lung nodules. The clinical treatment strategy focuses on regulating the lung collaterals and adopting an internal-external combined approach. Firstly， dredging-techniques such as scraping， fire needling， and filiform-shaped needling are used to unblock stagnation in the collaterals and relieve surface obstructions； secondly， plastering-acupoint application therapy targets the disease site to dissolve nodules and unblock collaterals； thirdly， moxibustion is employed to provide warmth and tonification， preventing the re-accumulation of pathogens； forthly， prescription is used based on the modified Jinshui Liujun Decoction （金水六君煎） combined with Shengxian Decoction （升陷汤） to harmonize the lungs， spleen， and kidneys and to restore organ function.

Based on"collateral disease,"this paper proposes the theory of"tumor collateral stasis"as the core pathogenesis of tumors,taking tumor localization as the research object,tumor blood vessels as the structural basis,and tumor microenvironment as the biological basis."Tumor collateral stasis"is a generalization of tumor pathogenesis and a pathological product of the tumor.With the aging of the population,malignant tumors in older individuals have become a common problem worldwide.Older patients with malignant tumors are often frail,with declined organ physiological function and several comorbidities.Most of them find it difficult to tolerate the standard treatment of western medicine and require individualized diagnosis and treatment plans.Recently,traditional Chinese medicine has been explored and practiced in the treatment of older patients with malignant tumors and has achieved good therapeutic effects.Peri-tumoral acupuncture can dredge meridians,activate collaterals,warm and promote yang qi,strengthen local defenses,and promote blood circulation to resolve stasis.Under the guidance of the"tumor collateral stasis"theory,we applied peri-tumoral acupuncture to treat cancer pain,low anterior resection syndrome in rectal cancer,tumor suppression,recurrence prevention,and organ preservation,achieving excellent results.This study provides novel insights for clinical tumor treatment,especially in the treatment of older patients with malignant tumors.

Based on"collateral disease,"this paper proposes the theory of"tumor collateral stasis"as the core pathogenesis of tumors,taking tumor localization as the research object,tumor blood vessels as the structural basis,and tumor microenvironment as the biological basis."Tumor collateral stasis"is a generalization of tumor pathogenesis and a pathological product of the tumor.With the aging of the population,malignant tumors in older individuals have become a common problem worldwide.Older patients with malignant tumors are often frail,with declined organ physiological function and several comorbidities.Most of them find it difficult to tolerate the standard treatment of western medicine and require individualized diagnosis and treatment plans.Recently,traditional Chinese medicine has been explored and practiced in the treatment of older patients with malignant tumors and has achieved good therapeutic effects.Peri-tumoral acupuncture can dredge meridians,activate collaterals,warm and promote yang qi,strengthen local defenses,and promote blood circulation to resolve stasis.Under the guidance of the"tumor collateral stasis"theory,we applied peri-tumoral acupuncture to treat cancer pain,low anterior resection syndrome in rectal cancer,tumor suppression,recurrence prevention,and organ preservation,achieving excellent results.This study provides novel insights for clinical tumor treatment,especially in the treatment of older patients with malignant tumors.

Objective:To compare the efficacy and safety of transcatheter arterial embolization (TAE) and Viabahn covered stent placement (CSP) for the treatment of delayed hemorrhage after hepatobiliary and pancreatic surgery (DH-HPS).Methods:The clinical data of 41 patients with DH-HPS at the Affiliated Hospital of Xuzhou Medical University from January 2019 to June 2023 were retrospectively analyzed. Among these patients, 27 were male and 14 were female, with an average age of (63.1±10.3) years. 22 patients who underwent TAE was in TAE group and 19 who underwent Viabahn CSP was in CSP group. The interventional treatment effect, blood biochemical indexes and complications were compared between the two groups.Results:In the TAE group, the success rate of hemostasis was 90.9% (20/22), and the rebleeding rate was 9.1% (2/22) after interventional treatment. In the CSP group, the success rate of hemostasis was 94.7% (18/19), and the rebleeding rate of was 5.3% (1/19) after interventional treatment. There was no statistically significant difference in the success rate of hemostasis and the rebleeding rate between the two groups (both P>0.05). The rate of liver function exacerbation after the procedure was 100% (20/20) in the TAE group and 58.8% (10/17) in the CSP group, with a statistically significant difference between the two groups ( χ2=9.77, P=0.002). 37 patients were followed up (18.4±1.7) months, and no rebleeding occurred in all patients. Conclusion:TAE and CSP are both effective for DH-HPS, while CSP is superior to TAE in terms of liver function protection.

By analysing the similarity between defense qi and leukocytes in terms of function， site of action， and circadian rhythm， it is proposed that in traditional Chinese medicine （TCM）， the pathogenesis of leukopenia is defense qi deficiency. By analyzing the relevant discussions on the generation and transmission of defense qi in TCM classics， it is believed that the original qi in lower jiao （焦） is the source of defense qi， while the water and grain qi in middle jiao enriches defense qi， and the upper jiao transmits and distributes defense qi to the whole body. Therefore， when treating leukopenia after chemotherapy with TCM， Guilu Erxian Gelatin （龟鹿二仙胶） and Yougui Pill （右归丸） are often used to tonify the kidney and supplement essence， and moxibustion at Guanyuan （CV 4） and Qihai （CV 6） is usually accompanied to replenish the original qi in lower jiao and enrich the source of defense qi. Guipi Decoction （归脾汤）， Buzhong Yiqi Decoction （补中益气汤）， Shenling Baizhu Powder （参苓白术散）， and Sijunzi Decoction （四君子汤） are often suggested to strengthen spleen and replenish qi， in combination with moxibustion at Zhongwan （CV 12） and Zusanli （ST 36） to transport the spleen and stomach in the middle jiao to enrich the defense qi. Modified Guizhi Decoction （桂枝汤） to harmonize nutrient and defensive aspects is often used， and moxibustion at Dazhui （GV 14） and Feishu （BL 13） or scraping is added to dredge the striae and interstice in the upper jiao and promote transmission and dissemination of the defense qi. Considering the whole process of generation and distribution of defense qi， it is suggested to choose the most appropriate treatment modality flexibly， and combine internal treatment with external treatment， in order to provide ideas for the treatment of leukopenia in tumour patients.

Objective To compare and analyze the application value of domestic Octoparms and imported Celect inferior vena cava filter(IVCF)in the interventional treatment of venous thromboembolism(VTE).Methods Forty patients with VTE were randomly divided into Octoparms group(experimental group)and Celect group(control group)according to the double-blinded method of the central random system.All the patients underwent filter placement,catheter-directed thrombolysis and filter retrieval.The primary end point was the success of filter placement and retrieval,and the secondary end point included indwelling complications such as the occurrence of pulmonary embolism(PE)and filter tilt and migration.Results Forty patients were enrolled in this study,22 patients and 18 patients were divided into the experimental group and the control group,respectively.Among them,11 cases were identified with right lower extremity deep vein thrombosis,29 cases with left lower extremity deep vein thrombosis,17 cases with PE,and 6 cases with inferior vena cava thrombosis.The success rate of IVCF placement was 100%in all participants.Immediately after filter place-ment,the angle of filter tilt was(3.8±2.3)° in the experimental group and(4.9±2.8)° in the control group(t=1.44,P=0.16).Filter retrieval was successful in 21 cases(21/22,95.5%)of the experimental group and 17 cases(17/18,95.5%)of the control group.There was no significant difference between the two groups(t=0.14,P=0.89).The mean indwelling time of filter was(8.0±2.1)days in the experimental group and(9.7±3.1)days in the control group(t=0.73,P=0.47).The angle of filter tilt was(5.3±3.4)° in the experimental group and(5.7±7.7)° in the control group(t=0.19,P=0.85).There was no significant difference for filter placement and retrieval between the two groups(t=0.48 and 2.00,P=0.06 and 0.64,respectively).There were no complications of filter migration,strut penetration or new PE in both groups.Conclusion The application value of domestic Octoparms and impor-ted Celect IVCF is similar in interventional treatment of VTE.

ObjectiveTo investigate the efficacy of drug-eluting beads-transarterial chemoembolization （D-TACE） combined with infusion chemotherapy via superior mesenteric artery versus D-TACE alone in the treatment of hepatocellular carcinoma （HCC） complicated by portal vein tumor thrombus （PVTT）. MethodsA retrospective analysis was performed for the data of patients with HCC and PVTT who underwent interventional treatment in The Affiliated Hospital of Xuzhou Medical University from January 2022 to December 2023， among whom 15 patients received D-TACE combined with infusion chemotherapy via superior mesenteric artery and were enrolled as observation group， and after propensity score matching at a ratio of 1∶1， 15 patients who received D-TACE alone were enrolled as control group. Contrast-enhanced MRI of the upper abdomen was performed at 1， 2， and 3 months after surgery and every 3 months thereafter to evaluate the conditions of liver tumor and PVTT. Objective response rate （ORR） and disease control rate （DCR） were compared between the two groups. The independent-samples t test or the Mann-Whitney U test was used for comparison of continuous data between two groups， and the paired t-test or the Wilcoxon test was used for comparison of preoperative and postoperative data； the chi-square test was used for comparison of categorical data between two groups. The Kaplan-Meier curve was used to calculate the cumulative survival rate， and the Log-rank test was used for comparison between two groups. ResultsBoth groups had a technical success rate of 100%， with no serious complications after surgery. The patients were followed up for 3-26 months （mean 10.5±6.7 months）. At 3 months after surgery， there were no significant differences between the observation group and the control group in ORR （73.3% vs 53.3%， χ²=1.292， P=0.256） and DCR （93.3% vs 80.0%， χ²=1.154， P=0.283） for liver tumors， and compared with the control group， the observation group had significantly higher ORR and DCR for PVTT （ORR： 46.7% vs 13.3%， χ²=3.968， P=0.046； DCR： 100% vs 73.3%， χ²=4.615， P=0.032）. The 3-， 6-， and 12-month cumulative progression-free survival rates were 93.3%， 86.2%， and 68.9%， respectively， for the observation group and were 80.0%， 62.2%， and 24.9%， respectively， for the control group （P=0.028）， and the 3-， 6-， and 12-month cumulative overall survival rates were 100%， 88.9%， and 88.9%， respectively， for the observation group and were 93.3%， 85.6%， and 70.0%， respectively， for the control group （P=0.340）. ConclusionCompared with D-TACE alone， D-TACE combined with infusion chemotherapy via the superior mesenteric artery shows better short-term efficacy in the treatment of HCC complicated by PVTT.

This paper introduces Professor HUANG Jinchang's experience in treating low anterior resection syndrome (LARS) of rectal cancer. Based on the clinical experience in treating fecal incontinence after rectal cancer surgery, Professor HUANG Jinchang proposes that the primary pathogenesis of LARS is spleen-kidney yang deficiency with internal obstruction of damp turbidity. The treatment approach should focus on strengthening the spleen, warming the kidney, and eliminating turbidity. The Baliao acupoints are specifically selected to eliminate turbidity, promote yang , facilitate the qi flow of the viscera, and regulate the opening and closing of the anus. Emphasis is placed on deep needling at the Baliao acupoints, with flexible acupoint selection based on accompanying symptoms. Additionally, moxibustion and bloodletting cupping are used to restore regular bowel movements and improve the quality of life for patients who have undergone anus-preserving surgery for rectal cancer.
Humans ; Rectal Neoplasms/therapy* ; Acupuncture Points ; Electroacupuncture ; Male ; Female ; Fecal Incontinence/etiology* ; Postoperative Complications/etiology* ; Middle Aged ; Yang Deficiency/therapy* ; Low Anterior Resection Syndrome