Osteoporosis is a prevalent skeletal condition characterized by reduced bone mass and strength, leading to increased fragility. Buqi-Tongluo (BQTL) decoction, a traditional Chinese medicine (TCM) prescription, has yet to be fully evaluated for its potential in treating bone diseases such as osteoporosis. To investigate the mechanism by which BQTL decoction inhibits osteoclast differentiation in vitro and validate these findings through in vivo experiments. We employed MTS assays to assess the potential proliferative or toxic effects of BQTL on bone marrow macrophages (BMMs) at various concentrations. TRAcP experiments were conducted to examine BQTL's impact on osteoclast differentiation. RT-PCR and Western blot analyses were utilized to evaluate the relative expression levels of osteoclast-specific genes and proteins under BQTL stimulation. Finally, in vivo experiments were performed using an osteoporosis model to further validate the in vitro findings. This study revealed that BQTL suppressed receptor activator of NF-κB ligand (RANKL)-induced osteoclastogenesis and osteoclast resorption activity in vitro in a dose-dependent manner without observable cytotoxicity. The inhibitory effects of BQTL on osteoclast formation and function were attributed to the downregulation of NFATc1 and c-fos activity, primarily through attenuation of the MAPK, NF-κB, and Calcineurin signaling pathways. BQTL's inhibitory capacity was further examined in vivo using an ovariectomized (OVX) rat model, demonstrating a strong protective effect against bone loss. BQTL may serve as an effective therapeutic TCM for the treatment of postmenopausal osteoporosis and the alleviation of bone loss induced by estrogen deficiency and related conditions.
Animals ; NFATC Transcription Factors/genetics* ; Drugs, Chinese Herbal/pharmacology* ; Ovariectomy ; Osteoclasts/metabolism* ; Female ; Osteogenesis/drug effects* ; Rats, Sprague-Dawley ; Rats ; NF-kappa B/genetics* ; Osteoporosis/genetics* ; Signal Transduction/drug effects* ; Bone Resorption/genetics* ; Cell Differentiation/drug effects* ; Humans ; RANK Ligand/metabolism* ; Mitogen-Activated Protein Kinases/genetics* ; Transcription Factors

Objective:To investigate the value of contrast-enhanced ultrasound (CEUS) as a preoperative planning strategy for lymphaticovenous anastomosis (LVA) in improving the quality of LVA and the outcome of short-term limb volume reduction in patients with secondary upper limb lymphedema.Methods:Patients with breast cancer-related upper extremity lymphedema who underwent LVA at the Department of General Surgery Cancer Center Division of Breast Surgery of Zhejiang Provincial People’s Hospital from August 2021 to August 2023 were enrolled retrospectively. According to whether preoperative ultrasound lymphography was performed, the patients were divided into CEUS assisted group and control group. In the CEUS assisted group, preoperative CEUS lymphography combined with high-frequency ultrasound color Doppler imaging was utilized for precise localization of lymphatic vessels and recipient veins, as well as surgical target planning for LVA. In the control group, preoperative indocyanine green lymphography was employed to guide surgical exploration. Mann-Whitney U test was used to compare the number of LVA surgical exploration incisions per limb and the number of successful anastomoses per limb between the two groups. The success rate of anastomosis (total number of successful anastomoses/total number of surgical exploration incisions) was compared by the chi-square test. The duration of single anastomosis, mean arm circumference, and the difference between preoperative and postoperative mean arm circumference were compared by independent sample t-test. Paired-sample t-test was used to compare the improvement of the mean arm circumference of the operated limb of the two groups after 3 months of follow-up. P < 0.05 was considered statistically significant. Results:A total of 47 female patients were enrolled, including 27 patients in the CEUS assisted group, with an average age of (57.1±9.0) years and a median edema course of 2 years. There were 20 cases in the control group, with an average age of (58.1±9.6) years and a median duration of edema of 2 years. The CEUS group, compared with the control group, exhibited a higher number of surgical exploration incisions per limb [6.0 (4.0, 7.0) cases vs. 5.0 (3.0, 6.0) cases], a greater number of successful anastomoses per limb [5.0 (3.0, 6v0) cases vs. 3.0 (2.0, 3.0) cases], and a significantly increased overall success rate of anastomosis [82.8% (125/151) vs. 61.4% (54/88)]. Additionally, there was a significant increase in the preoperative and postoperative mean arm circumference difference [(6.2±3.3) cm vs. (3.9±1.9) cm]. The duration of single anastomosis was significantly shortened [(57.4±16.0) min vs. (92.8±18.5) min], with statistically significant differences observed in all comparisons (all P < 0.05). The preoperative and postoperative mean arm circumference were compared between the CEUS group [(31.4±4.6) cm vs. (25.3±4.7) cm] and the control group [(31.3±4.3) cm vs. (27.5±3.8) cm], respectively, with statistically significant differences observed in both groups (both P < 0.01). Conclusion:CEUS lymphography, as a preoperative planning strategy for LVA, can significantly increase the number and success rate of LVA anastomosis in patients with secondary upper limb lymphedema, shorten the duration of single anastomosis, and improve the short-term effect of limb volume reduction after LVA.

Objective:To investigate the value of contrast-enhanced ultrasound (CEUS) as a preoperative planning strategy for lymphaticovenous anastomosis (LVA) in improving the quality of LVA and the outcome of short-term limb volume reduction in patients with secondary upper limb lymphedema.Methods:Patients with breast cancer-related upper extremity lymphedema who underwent LVA at the Department of General Surgery Cancer Center Division of Breast Surgery of Zhejiang Provincial People’s Hospital from August 2021 to August 2023 were enrolled retrospectively. According to whether preoperative ultrasound lymphography was performed, the patients were divided into CEUS assisted group and control group. In the CEUS assisted group, preoperative CEUS lymphography combined with high-frequency ultrasound color Doppler imaging was utilized for precise localization of lymphatic vessels and recipient veins, as well as surgical target planning for LVA. In the control group, preoperative indocyanine green lymphography was employed to guide surgical exploration. Mann-Whitney U test was used to compare the number of LVA surgical exploration incisions per limb and the number of successful anastomoses per limb between the two groups. The success rate of anastomosis (total number of successful anastomoses/total number of surgical exploration incisions) was compared by the chi-square test. The duration of single anastomosis, mean arm circumference, and the difference between preoperative and postoperative mean arm circumference were compared by independent sample t-test. Paired-sample t-test was used to compare the improvement of the mean arm circumference of the operated limb of the two groups after 3 months of follow-up. P < 0.05 was considered statistically significant. Results:A total of 47 female patients were enrolled, including 27 patients in the CEUS assisted group, with an average age of (57.1±9.0) years and a median edema course of 2 years. There were 20 cases in the control group, with an average age of (58.1±9.6) years and a median duration of edema of 2 years. The CEUS group, compared with the control group, exhibited a higher number of surgical exploration incisions per limb [6.0 (4.0, 7.0) cases vs. 5.0 (3.0, 6.0) cases], a greater number of successful anastomoses per limb [5.0 (3.0, 6v0) cases vs. 3.0 (2.0, 3.0) cases], and a significantly increased overall success rate of anastomosis [82.8% (125/151) vs. 61.4% (54/88)]. Additionally, there was a significant increase in the preoperative and postoperative mean arm circumference difference [(6.2±3.3) cm vs. (3.9±1.9) cm]. The duration of single anastomosis was significantly shortened [(57.4±16.0) min vs. (92.8±18.5) min], with statistically significant differences observed in all comparisons (all P < 0.05). The preoperative and postoperative mean arm circumference were compared between the CEUS group [(31.4±4.6) cm vs. (25.3±4.7) cm] and the control group [(31.3±4.3) cm vs. (27.5±3.8) cm], respectively, with statistically significant differences observed in both groups (both P < 0.01). Conclusion:CEUS lymphography, as a preoperative planning strategy for LVA, can significantly increase the number and success rate of LVA anastomosis in patients with secondary upper limb lymphedema, shorten the duration of single anastomosis, and improve the short-term effect of limb volume reduction after LVA.

Objective To explore the influence factors for bronchopulmonary dysplasia(BPD) in different gestational age preterm infants.Methods The medical records of 118 premature infants who were diagnosed as BPD at West China Second Hospital,Sichuan University from January 1,2011 to December 31,2015 were retrospectively analyzed.According to the gestational age,the premature infants were divided into extremely-early-premature infants group (＜ 28 weeks),very-early-premature infants group (28-31 weeks) and late-premature infants group (32-36 weeks).The differences in pregnancy complications,the use of glucocorticoids before delivery,gender,mode of production,medication for preterm infants with different gestational age preterm infants were analyzed.Results One hundred and eighteen preterm infants included 18 extremely-early-premature infants,82 very-early-premature infants,and 18 late-preterm infants;71 baby boys and 47 baby girls,with birth weight ≤1 000 g in 27 cases,1 000-1 500 g in 70 cases,1 500-2 000 g in 15 cases,and ＞2 000 g in 6 cases.There was a statistically significant difference as for the full use of continuous positive airway pressure between the extremely-early-premature infants group (9 cases) and the late-preterm infants group(2 cases) (x2 =6.415,P =0.011).The late-preterm infants group whose mothers experienced preeclampsia were more seriously affect than extremely-early premature infants group (x2 =4.018,P =0.045) and very-early-premature infants group (x2 =4.878,P =0.027),and there was no statistically significant difference between extremely-early-premature infants group and very-early-premature infants group (x2 =0.279,P =0.597).A significantly increased total oxygen duration was observed in extremely-early-premature infants group [(56.56 ± 29.58) d] compared with very-early-premature infants group[(43.15 ± 14.86) d] and late-preterm-infants group [(37.75 ± 16.87) d] (F =8.185,P =0.000) with statistically significant difference.A significantly increased hospitalization time was observed in extremely-early-premature infants group [(56.56 ± 29.58) d] com-pared with very early premature infants group [(46.23 ± 14.04) d] and late-preterm-infants group [(39.06 ± 29.81) d] (F =5.606,P =0.004).Conclusions The number of BPD in extremely-early-premature infants and very-early-premature infants increases compared with that in the late-preterm infants.Gestational age is the high risk factor for the occurrence of BPD,the gestational age should be delayed as late as possible.Prevention of extremely-early-premature birth and very-early-premature birth,and avoidance of intrauterine hypoxia and rational use of oxygen are the important measures for prevention of BPD occurred in premature infants and reducing hospitalization time.

Objective To develop a multivariate logistic regression model , and to predict the risk of ma-lignant partially cystic thyroid nodules .Methods 470 patients(662 nodules)treated with surgery and confirmed by pathological diagnosis were screened out .Their ultrasonographic morphology and vascularity of thyroid nod-ules, thyroid stimulating hormone(TSH)and clinical information were collected and analyzed retrospectively .The model was developed to calculate the individual risk and ROC curve was used to evaluate the predictive index . Results The regression model was:Z=-3.60+1.40X2+2.47X3+1.05X4+0.57X9+0.07X10+1.02X12 ( X2 represents eccentric acute-angle configuration , X3 represents microcalcification , X4 represents cystic-solid margin,X9 represents echogenecity of solid portion , X10 represents TSH,X12 represents gender );M=eZ/1+eZ (M represents probability of malignancy , e represents natural constant 2.72).When applied the model to the ver-ification group, the accuracy, sensitivity, specificity, misdiagnosis rate, missed diagnosis rate, negative likeli-hood ratio(LR-)and positive likelihood ratio(LR+)was 96.95%,100%, 96.68%, 3.32%, 0%, 0 and 30.12 respectively.The largest area under the receiver-operating characteristics curve (AUC)was 0.88,which proved the model has high diagnostic value .Conclusions The model has high accuracy to predict the risk of malignan-cy.M is closely related to malignant risk of partially cystic thyroid nodules .

Objective A multivariate logistic regression model was built to estimate the risk of malignant partially cystic thyroid nodules.Methods Data of ultrasonographic morphology,microcalcifications,margin,colloid crystals and echogenicity of 766 thyroid nodules (of 506 patients) were analyzed retrospectively.All patients underwent surgery and the diagnosis were confirmed by pathology.The model was built to calculate the individual risk and evaluate the predictive index.Results The regression model was Z =-2.30 + 1.42X2 + 2.39X3 + 1.17X4-1.35 X7 + 0.62X9 ; P =eZ/1 + ez (P represents probability of malignancy,e represents natural constant 2.72).The largest area under the receiver-operating characteristics curve (AUC) was 0.86.When apply the model to the verification group(266 nodules),the accuracy,sensitivity,specificity,misdiagnosis rate,missed diagnosis rate,negative likelihood ratio and positive likelihood ratio were 93.61％,83.33％,94.63％,5.37％,16.67％、0.18 and 15.52 respectively.Conclusions This model based on the ultrasonographic variables increases the diagnostic accuracy of malignancy in patients with partially cystic thyroid nodules.

Biochemistry is one of the important basic subjects in medical college. It is hard for students to master because of its complicated theories and abstract contents. It has been found that carrying out case-teaching method in biochemistry teaching is good for students to arouse study interest and enhance the abilities of autonomic learning, question-analyzing and question-solving as well as consolidate theory knowledge. It is worth generalizing as a new teaching method for biochemistry in medical college.

We analyze the characteristics of foreign students and the problems in biochemistry teaching process by summarizing the practice of medical biochemistry teaching for undergraduate foreign students in Wenzhou Medical College. After careful thought on these problems,we brought forward some ideas and methods which may be useful to reform the teaching mode and improve the teaching results of medical biochemistry for foreign students.

Based on the practice of bilingual education in medical biochemistry,this paper discussed the advantages,problems and solutions of bilingual education in medical biochemistry of teaching-centred medical college or university.This study will be helpful for developing bilingual teaching of biochemistry in other teaching-centred medical colleges or universities.

Objective: To observe the inhibitory effect of scopolamine(Spm) and chlopromazine (Clo) on withdrawal syndromes in morphine dependent rats. Methods: The intensity of withdrawal syndromes on the model of morphine dependent rats was recorded after single or muiltiple subcutaneous administration(sc) of Spm and Clo at different doses. Results: Withdrawal syndromes were markedly decreased when single Spm 1 mg/kg and Clo 0.5 mg/kg combined with morphine were injected (P<0.05). Spm+Clo(sc) had much stronger effects on inhibiting withdrawal syndromes after intraperitoneal (ip) naloxone in morphine dependent rats (P<0.01). Conclusion: Spm can act on Ach-receptor and relieve morphine withdrawal syndromes. Clo may have a synergistic action with Spm via α2-receptor in the locus coeruleus of the rat brain stem.