Objective:To investigate the effect of nourishing yin and tonifying yang method on inflammatory response and bone metabolism in patients with T2DM complicated with osteoporosis (OP).Methods:A randomized controlled trial. From January 2022 to December 2023,80 patients with T2DM and OP in our hospital were selected as the observation objects, and they were divided into two groups by random number table method, with 40 cases in each group.On the basis of conventional treatment, the control group chewed vitamin D calcium chewable tablets, and the observation group added nourishing yin and tonifying yang Chinese medicine.Both groups were treated for 6 months. TCM syndrome scores were performed before and after treatment ;the levels of fasting blood glucose (FPG), 2 hPG and HbA1c were detected by intelligent blood glucose monitor;the levels of serum neutrophils and lymphocytes were detected by automatic blood analyzer, and the neutrophil/lymphocyte ratio (NLR) was calculated;the levels of serum IL-1β and TNF-α were detected by automatic chemiluminescence analyzer, the levels of type I procollagen amino terminal propeptide (PINP), type I collagen carboxy terminal peptide β special sequence (β-CTX) and 25-hydroxy vitamin D3 [25-(OH)D3] were detected by ELISA;Bone mineral density (BMD) was detected by bone mineral density detector. The adverse reactions during treatment were observed and recorded, and the clinical efficacy was evaluated.Results:The total effective rate was 92.5 %(37/40) in the observation group and 75.0 % (30/40) in the control group,the difference between the two groups was statistically significant ( χ2=4.50, P=0.034).After treatment, the scores of soreness and weakness of waist and knees, soreness and pain of waist and back, clear and long urine, pale tongue and white coating in the observation group were lower than those in the control group ( t=3.11, 3.75, 3.51, 3.74, P<0.01);the levels of serum FPG, 2 hPG and HbA1c in the observation group were lower than those in the control group ( t=3.11,3.20,3.39, P<0.01).The levels of serum NLR (2.63 ± 0.68 vs. 3.24 ± 0.79, t=3.70), IL-1β [(81.65 ± 8.30) ng/L vs. (89.03 ± 8.98) ng/L, t=3.82] and TNF-α [(35.14 ± 5.11) μg/L vs. (39.96 ± 5.38) μg/L, t=4.11] in the observation group were lower than those in the control group ( P<0.01). After treatment, the levels of PINP [(29.83 ± 3.92) ng/L vs. (34.02 ± 4.03) ng/L, t=4.71] and β-CTX [(21.30 ± 3.95 ) ng/L vs. (25.32 ± 4.18) ng/L, t=4.42] in the observation group were lower than those in the control group ( P<0.01), the levels of 25-(OH)D3 [(42.86 ± 5.12) μg/L vs. (38.08 ± 4.55) μg/L, t=4.41] and BMD [(0.90 ± 0.18) g/cm 3vs. (0.78 ± 0.16) g/cm 3, t=3.15] were higher than those in the control group ( P<0.01).During the treatment, the incidence of adverse reactions was 12.5% (5/40) in the observation group and 10.0 % (4/40) in the control group,there was no significant difference between the two groups ( χ2=0.13, P=0.723). Conclusion:The method of nourishing yin and tonifying yang can effectively improve the TCM syndromes of T2DM patients with OP, reduce the levels of blood glucose and inflammatory factors, improve bone metabolism, improve clinical efficacy and have good treatment safety.

Objective To apply Windows presentation foundation (WPF) to rapid access and report printing of medical data.Methods Data access was realized by abstracting database to form data structure through entity framework (EF) and mapping datasheet as attribute.Multipage printing was executed by using Flow Document Scroll Viewer as the container and putting contents into different paragraphs with the block element.Results EF of WPF decreased the frequency of database access by the program greatly,and the reaction speed of the program was increased significantly.Flow document could be used for data printing.Conclusion WPF enhances the efficiency of system development and the beauty of man-machine interface,and thus is worthy promoting for medical system and software development.

Objective:To explore the role of static posturography in the assessment of fatigue due to flight tasks.Methods:Thirtymale college students were asked to perform simulated flight tasks consecutively forfour hours.Meanwhile their statie posturography and tasks performance would be repeatedly measured during the task-load at end of every hour.Based on the changed significantly parameters,the static balance index would be built by principle component analysis.Then its correlation with task-load level would be further analyzed by curve estimation.Results:Static postural control declined significantly under effect of simulated flight tasks.With task load sustaining,static balance index increased significantly and correlated linearly with duration of task load (R2=0.949).Besides,there was quadratic relationship between the change of multi-tasks performance and duration of task load (R2=0.968).And correlation of multi-tasks performance with static standing balance level also had been proved to be quadratic (R2=0.976).Conclusions:Static posturography correlated linearly with flight task-load level,which could reflect fatigue level caused by task load.

Objective To compare the difference between volume computed tomography dose index (CTDIvol) and size-specific dose estimates (SSDE) in evaluating the radiation dose of abdominal CT scan.Methods Abdominal CT scan were performed on 180 patients with a Philips 256-slices spiral CT.The anterior-posterior dimension (AP) and lateral dimension (LAT) of each patients were measured at the level of left renal vein, and the effective diameter (ED) and SSDE were calculated with recorded CTDIvol Patients were categorized into 3 groups depending on body mass index (BMI): group A, BMI ＜ 20.0 kg/m2;group B, 20.0-24.9 kg/m2;group C, BMI ＞ 24.9 kg/m2.The differences between CTDIvoland SSDE of 180 patients and three different BMI groups were compared respectively.Results There was a significant difference between CTDIvol and SSDE of the 180 patients (t =-13.354, P ＜ 0.01), CTDIvol and SSDE were (9.91 ± 2.91) and (14.01 ± 2.82) mGy, respectively.For group A, CTDIvol and SSDE were (7.96 ± 1.83) and (12.83 ± 2.52) mGy, respectively (t =-8.417, P ＜ 0.01).Group B, CTDIvol and SSDE were (9.28 ± 1.76) and (13.62 ±2.18) mGy, respectively (t =-15.051, P ＜ 0.01).Group C, CTDIvol and SSDE were (12.19 ± 3.65) and (15.39 ± 3.47) mGy, respectively (t =-4.535, P ＜ 0.01).In addition, the mean percentage values of difference between CTDIvol and SSDE for the three groups were 62.83％, 47.80％, 28.40％, respectively, which meant CTDIvol underestimated the radiation dose compared to SSDE.With the BMI increasing, the values of difference between CTDIvol and SSDE decreased.Conclusions SSDE can be used to estimate the radiation dose of abdominal CT scan for a given size person.

Purpose To investigate 1H-MRS in differentiating intracranial lymphoma from tumor-like demyelinating lesions. Materials and Methods Thirty-three cases of intracranial lymphoma confirmed by pathology and 18 cases of tumor-like demyelinating lesions confirmed by pathology or clinic were recruited in this study. Imaging data including single-voxel (TE=144 ms) 1H-MRS was retrospective analyzed. The Cho/Cr and Cho/NAA area ratios were calculated. The lipid and lactate peak was visually categorized into 5 grades based on the ratio of Lip-Lac peak to the height of the Cr peak. 1H-MRS findings of the intracranial lymphoma and the tumor-like demyelinating lesions were compared. The differentiation of the two diseases diagnosed by 1H-MRS and conventional MR were evaluated by use of receiver operating characteristic curves. Results There were significant difference of Cho/Cr, Cho/NAA ratio and Lip-Lac peak level between the intracranial lymphoma and tumor-like demyelinating lesions (P<0.001). It was more likely to be intracranial lymphoma when Cho/Cr ratio was>2.56, Cho/NAA ratio was>1.71, and Lip-Lac peak grade was>3. Cho/Cr, Cho/NAA ratio and Lip-Lac peak grade were found higher in atypical intracranial lymphomas when compared with those of tumor-like demyelinating lesions. The area under the receiver operating characteristic curve of conventional MR was increased from 0.827 to 0.870 when Cho/NAA ratio was added for analysis in the 28 uncertain cases. Conclusion 1H-MRS has great clinical significance for differentiating intracranial lymphoma from tumor-like demyelinating lesions. The values of Cho/Cr ratio>2.56, Cho/NAA ratio>1.71 and Lip-Lac grade >3 suggest intracranial lymphoma rather than TDLs. When the conventional MR imaging features can not do the differentiation, Cho/NAA ratio is a useful complement.

OBJECTIVETo investigate the distribution and expression of transforming growth factor beta (TGF-β) receptors I and II, p38 mitogen-activated protein kinase (p38 MAPK), and type I and type III collagen in the lungs of rats with silicosis and cultured pulmonary fibroblasts, and to investigate the relationship of the anti-fibrosis effect of N-acetyl-seryl-aspartyl-lysyl-proline (AcSDKP) with its inhibition of TGF-β receptor-mediated p38 MAPK pathway activity.

METHODSRats were randomly divided into control group, silicosis model group, and AcSDKP treatment group (n = 10 for each group). For the model group and AcSDKP treatment group, rats were intratracheally instilled with silica to establish a silicosis model. Cultured pulmonary fibroblasts from neonatal rats were divided into control group, TGF-β1 stimulation group, TGF-β receptor inhibition group, p38 MAPK pathway inhibition group, and AcSDKP treatment group. The protein expression of TGF-β receptors I and II, p38 MAPK, and type I and type III collagen were determined by immunohistochemistry and Western blot. The mRNA expression of TGF-β receptors I and II were determined by real-time PCR. The distribution and nuclear translocation of phospho-p38 MAPK in cultured fibroblasts were determined by laser scanner confocal microscopy.

RESULTSIn the AcSDKP treatment group, AcSDKP reduced the expression of TGF-β receptors I and II, phospho-p38 MAPK, and type I and type III collagen to 86.12%, 41.01%, 42.63%, 89.05%, and 52.71%, respectively, of those of the silicosis model group (P < 0.05). In cultured fibroblasts, AcSDKP reduced the mRNA expression of TGF-β receptors I and II to 42.26% and 54.33%, respectively, of those of the TGF-β1 stimulation group; the protein expression of TGF-β receptors I and II, phospho-p38 MAPK, and type 1 and type III collagen was reduced to 58.14%, 51.40%, 45.6%, 58.04%, and 44.74%, respectively, of those of the TGF-β1 stimulation group. The phospho-p38 MAPK translocation from plasma to the nucleus was also inhibited; the nucleus/plasma ratio of p38 MAPK and the protein expression of type I and type III collagen were reduced to 68.60%, 58.04%, and 44.74%, respectively, of those of the TGF-β stimulation group (P < 0.05).

CONCLUSIONAcSDKP can inhibit the expression of collagen through inhibition of TGF-β receptor-mediated p38 MAPK pathway activity, and is thus able to exert anti-fibrosis effect in rats with silicosis.

Animals ; Cells, Cultured ; Collagen ; metabolism ; Disease Models, Animal ; Fibroblasts ; drug effects ; metabolism ; MAP Kinase Signaling System ; drug effects ; Male ; Oligopeptides ; pharmacology ; Protein-Serine-Threonine Kinases ; metabolism ; Rats ; Rats, Wistar ; Receptors, Transforming Growth Factor beta ; metabolism ; Silicosis ; metabolism ; Transforming Growth Factor beta ; metabolism ; p38 Mitogen-Activated Protein Kinases ; metabolism

Objective To explore the neuroprotective role of Genistein (GEN) on hippocampal CA1 neurons and the possible mechanism following global cerebral ischemia ( GCI) in rats.Methods Seventy five rats were subjected to global cerebral ischemia ( GCI ) by four-vessel occlusion and randomly divided into five groups , sham, ischemia/reperfusion (I/R), GEN, ICI 182,780 and vehicle groups.Fluoro-Jade B and neuron-specific nuclear-binding protein ( NeuN) staining was used to observe CA 1 neuronal survival .TUNEL was used to detect apoptotic neurons .Spatial learning and memory function of the rats were evaluated by Morris water maze .Results The best dose of neuroprotective role of GEN was 1.0mg/kg body weight.Compared with sham, TUNEL-positive neurons in the hippocampal CA1 region increased significantly in I/R and vehicle groups (P<0.01), while post-treatment with GEN (1.0mg/kg) at 5min after ischemia by tail vein injection decreased markedly (P<0.01).Treatment of 1.0mg/kg GEN markedly attenuated spatial learning and memory deficits of the rats after ischemic insult compared to I /R group.Furthermore, ICI 182,780 significantly abolished the neuroprotective role of GEN (P <0.01).Conclusion The low-dose (1.0mg/kg) GEN significantly attenuates neuronal damage and cognitive deficits following GCI in rats , and the mechanism may be involved in estrogen receptor activity.

Objective To investigate the molecular mechanisms of protective effects of thioredoxin (Trx) on human vascular endothelial cells in atherosclerosis.Methods The cell models of Trx-overexpressing cells (Ad Trx) and the control cells (Ad-con) were established by adenovirus vector gene transfer technology in human umbilical vein endothelial cells (HUVECs).The oxidized low density lipoprotein,a risk factor of atherosclerosis,was used as a stimulator.Western blot and indirect immunofluorescence were used to detect the protein expression levels and the cellular localization of Trx,adhesion molecules (ICAM-1,VCAM-1) and the upstream signal pathways.Trx activity was detected by insulin disulfide reduction assay,and cellular reactive oxygen species (ROS)production was detected by fluorescent probe DCFH-DA.Results As compared with control group,Trx protein expression level was enhanced in Ad-trx group and the Trx activity in Ad-Trx group was upregulated by (26.2 ±3.3)％.The result of ROS detection showed that overexpression of Trx significantly inhibited the cellular ROS generation.As compared with control group,overexpression of Trx obviously inhibited the adhesion molecules expression but markedly promoted the phosphorylation of Smad3 in endothelial cells with or without oxLDL stimulation (P＜0.05).Pretreatment of cells with SIS3,a specific inhibitor of Smad3 phosphorylation,reversed Trx-induced inhibition of adhesion molecules expression.Further studies showed that pretreatment of cells with SIS3 enhanced oxLDL-induced AP-1 subunit c-fos nuclear expression.Conclusions The enhancement of Smad3 phosphorylation and c-Fos nuclear expression are mainly responsible for the Trx-induced downregulation of adhesion molecules.

ObjectiveTo observe and analyze the synapses developing process of newly generated connections of autologus activated Schwann cells (AASCs) in combination with fetal spinal cord cell suspension(FSCS) in the surrounding area of the spinal cord injury site.MethodsA total of 42 Wistar rats underwent unilateral ligation of the saphenous nerve.The portion of nerve tissues distal to the ligation site were harvested 1 week after operation.AASCs were isolated,cultured and purified.Spinal cord injury model produced in 42 Wistar rats on T7 by modified Allen impact method.Three days after injury,20 μl FSCS with a density of 1×105/μl prepared from pregnant rats (El4) in combination with AASCs were injected into the epicenter of the traumatized cavity.Animals were sacrificed at 2,4,6,8,10,12 weeks post transplantation.Light and electronmicroscopic studies as well as immunohistochemical assay were carried out to evaluate the graft survival,its differentation and integration with the host.ResultsIn the transplantation area,AASCs showed good growth and differentiation,and glial scarring surrounding the lesions was less.The neuroblast stretched out the terminal endings 4 weeks after implantation,followed by the presenting of the pre- and post-synaptic membrane.Eight weeks post transplantation,the dense or developed projections were observed in the pre- and post-synaptic membrane,the high electron dense substance full filled the synaptic cleft.All the spherical cleat vesicles,granular vesicles,elliptical vesicles and flattened-f type vesicles were discovered under the electron microscope.Ten weeks after injury,the axosomatic,dendrosomatic,dendro-dendritic,axoaxonic,and dendro-axonic synapses coexisted.Light microscopy showed that the graft cell grew gradually.Immunohistochemical assay showed that NF,5-HT,CGRP and GFAP positive fibers were in the graft.Synapses,glia fibers and blood brain barrier integrated each other.Conclusion1) The transplanted FSCS combined with AASCs can develop mature synapses with miscellaneous synaptic vesicles in the acute injured spinal cord.2) Co-existing indicate the possibility of synaptic connection between FSCS and host.

Objective To explore the clinical characteristics and risk factors of re-fracture in patients suffering from osteoporosis-related fractures as well as effective interventions.Methods From January 2006 to January 2008,a total of 273 patients with osteoporosis-related fracture were entered in the study,including out-patients and in-patients who were over 50 years old.The patients were divided into fracture group(n=225)and re-fracture group(n=48).The re-fracture rate was followed up for 2 years,during which 11 patients developed re-fracture.General data including age and sex,fracture types,femoral neck bone mineral density(BMD)T-scores tested by dual-energy X-rays absorptiometry(DEXA),Charlson index,timeinterval between two fractures as well as mobility skill assessment were collected and analyzed.Results The average age at the first fracture was 67.7±8.5 years vs.72.7±9.5 years for the re-fracture cases.Female accounted for 70.2% of the fracture group and 77.1% of the re-fracture group.The most common re-fracture type was vertebral fracture for the first time and femoral neck fracture for the second time during the followup.Risk factors for a second fracture in osteoporotic fractures patients include age(＞75 years,HR=1.23; ＞85years,HR=1.68),female sex(HR=1.36),prior vertebral fractures(HR=1.62),prior hip fractures(HR=1.27),BMD T-score＜-3.5(HR=1.38)and weakened motor skills(HR=1.27).The refracture rate in osteoporosis-related fractures was 4.9% followed up for 2 years.The second fracture happened 3.7 years after the first one on average.Conclusion The risks of second fracture among patients with initial brittle fracture are substantial.Mobility skill assessment is an important risk factor for osteoporosis fractures recurrence.There is adequate time between fracture and re-fracture for effective interventions to prevent or reduce the risks of refracture,especially for the old women with a vertebral or hip fracture.Medication,motor function rehabilitation and fall-down prevention training would be helpful.