BACKGROUND:Traditional Chinese medicine has been proved to have a significant role in anti-osteoporosis,and the effectiveness and mechanism of Ligustri Lucidi Fructus and its the active ingredients against osteoporosis have gradually gained the attention of scholars.OBJECTIVE:To analyze and summarize the research progress of Ligustri Lucidi Fructus and its active ingredients against osteoporosis in vitro and in vivo.METHODS:We searched the relevant literature included in CNKI and PubMed databases using the search terms of"Osteoporosis,Bone marrow mesenchymal stem cells,Osteoblast,Osteoclast,Ligustri Lucidi Fructus,Signal path"in Chinese and English,respectively.According to the needs of the research,we established the corresponding criteria and screened the literature.A total of 82 papers were included in the final review.RESULTS AND CONCLUSION:(1)The active ingredients of Ligustri Lucidi Fructus that exert anti-osteoporotic effects in vitro and in vivo mainly involve the following:Salidroside activates the Wnt/β-catenin signaling pathway by inhibiting the expression of Sclerostin and Dickkopf-related protein 1.This activation process enhances the expression of phosphorylated low-density lipoprotein receptor-related protein 6 in ovariectomized rats and primary osteoblasts,while decreasing the expression of glycogen synthase kinase 3β.Further,it promotes the expression of β-catenin,runt-related transcription factor 2 and cellular myelocytomatosis oncogene in the nucleus,thereby promoting the bone formation capacity of osteoblasts.The advantage is that it acts directly on osteoblasts to promote bone formation,which provides a new strategy for the treatment of osteoporosis.(2)Olive bittersweet significantly increases bone mineral density and regulates bone metabolism by decreasing terminal interleukin-6 and alkaline phosphatase concentrations in Sprague-Dawley rats.In vitro experiments showed that olive bittersweet promotes the proliferation of osteoblasts and up-regulates the protein and mRNA expression of osteoprotegerin,while inhibiting the protein and mRNA expression of receptor activator of nuclear factor-κB ligand.This mechanism of action is closely related to the regulation of the balance of the osteoprotegerin/receptor activator of nuclear factor-κB ligand system,demonstrating the advantage of increasing bone mineral density and maintaining bone health by regulating factors related to bone metabolism,but there is no significant effect on Ca2+concentration,which may limit its use in some specific types of osteoporosis.(3)By decreasing the expression of phosphatidylinositol 3 kinase,reducing the phosphorylation of protein kinase B and the expression of osteoclast-specific marker protein c-Fos,pineconiferin effectively inhibits the activation of phosphatidylinositol 3 kinase/protein kinase B/c-Fos pathway in osteoclasts.This inhibition reduces the proliferation and maturation of osteoclasts,which can help to reduce bone resorption.The advantage of this inhibition is that it can directly target osteoclasts,which provides a new target for osteoporosis treatment.However,the specific regulatory mechanism of osteoclasts needs to be studied in depth,and its long-term effect and safety need to be further evaluated.(4)The active ingredients of Ligustri Lucidi Fructus have shown good therapeutic effects on osteoporosis,but their mechanism of action is complex,involving the interaction of multiple genes,proteins and signaling pathways.In the future,large-scale clinical trials need to be carried out to verify its effectiveness and safety,and the strategy of combining the active ingredients of Ligustri Lucidi Fructus with other drugs needs to be further explored in order to obtain better therapeutic effects.

BACKGROUND:Traditional Chinese medicine has been proved to have a significant role in anti-osteoporosis,and the effectiveness and mechanism of Ligustri Lucidi Fructus and its the active ingredients against osteoporosis have gradually gained the attention of scholars.OBJECTIVE:To analyze and summarize the research progress of Ligustri Lucidi Fructus and its active ingredients against osteoporosis in vitro and in vivo.METHODS:We searched the relevant literature included in CNKI and PubMed databases using the search terms of"Osteoporosis,Bone marrow mesenchymal stem cells,Osteoblast,Osteoclast,Ligustri Lucidi Fructus,Signal path"in Chinese and English,respectively.According to the needs of the research,we established the corresponding criteria and screened the literature.A total of 82 papers were included in the final review.RESULTS AND CONCLUSION:(1)The active ingredients of Ligustri Lucidi Fructus that exert anti-osteoporotic effects in vitro and in vivo mainly involve the following:Salidroside activates the Wnt/β-catenin signaling pathway by inhibiting the expression of Sclerostin and Dickkopf-related protein 1.This activation process enhances the expression of phosphorylated low-density lipoprotein receptor-related protein 6 in ovariectomized rats and primary osteoblasts,while decreasing the expression of glycogen synthase kinase 3β.Further,it promotes the expression of β-catenin,runt-related transcription factor 2 and cellular myelocytomatosis oncogene in the nucleus,thereby promoting the bone formation capacity of osteoblasts.The advantage is that it acts directly on osteoblasts to promote bone formation,which provides a new strategy for the treatment of osteoporosis.(2)Olive bittersweet significantly increases bone mineral density and regulates bone metabolism by decreasing terminal interleukin-6 and alkaline phosphatase concentrations in Sprague-Dawley rats.In vitro experiments showed that olive bittersweet promotes the proliferation of osteoblasts and up-regulates the protein and mRNA expression of osteoprotegerin,while inhibiting the protein and mRNA expression of receptor activator of nuclear factor-κB ligand.This mechanism of action is closely related to the regulation of the balance of the osteoprotegerin/receptor activator of nuclear factor-κB ligand system,demonstrating the advantage of increasing bone mineral density and maintaining bone health by regulating factors related to bone metabolism,but there is no significant effect on Ca2+concentration,which may limit its use in some specific types of osteoporosis.(3)By decreasing the expression of phosphatidylinositol 3 kinase,reducing the phosphorylation of protein kinase B and the expression of osteoclast-specific marker protein c-Fos,pineconiferin effectively inhibits the activation of phosphatidylinositol 3 kinase/protein kinase B/c-Fos pathway in osteoclasts.This inhibition reduces the proliferation and maturation of osteoclasts,which can help to reduce bone resorption.The advantage of this inhibition is that it can directly target osteoclasts,which provides a new target for osteoporosis treatment.However,the specific regulatory mechanism of osteoclasts needs to be studied in depth,and its long-term effect and safety need to be further evaluated.(4)The active ingredients of Ligustri Lucidi Fructus have shown good therapeutic effects on osteoporosis,but their mechanism of action is complex,involving the interaction of multiple genes,proteins and signaling pathways.In the future,large-scale clinical trials need to be carried out to verify its effectiveness and safety,and the strategy of combining the active ingredients of Ligustri Lucidi Fructus with other drugs needs to be further explored in order to obtain better therapeutic effects.

Epicurus’ view of life and death is based on the atomism of naturalism and the epistemology of sensationalism in ancient Greek. He advocated that people should face death calmly, and separate death from the pain of feeling by explaining the true meaning of death to break people’s fear of death. He claimed that people should face desires with rational thinking and pursue a happy life. His view of life and death helped people to treat life and death rationally, alleviate death anxiety, make people actively face the difficulties in life, correctly identify desires and needs, and help individuals pursue a healthy and happy life.

Socrates understood the significance of health and disease to humans from the dimensions of body and soul, and advocated that humans should live a life consistent with nature. Socrates’ virtue of temperance, which is most closely related to health, emphasizes that self-control is the foundation of training a healthy body and mind, and having temperance is the premise for constructing healthy city-state. Faced with the problems of unhealthy lifestyle, infinite expansion of consuming desires, and materialization of interpersonal relations in modern society, Socrates’ health ethics thought has certain practical significance in transforming medical model and reconstructing positive health concept.

ObjectiveTo investigate the dietary preference and nutritional knowledge needs of the elderly people who dined at meal service sites. MethodsUsing the form of stratified and convenience sampling method with self-designed questionnaire was used， in November 2021， to select 700 elderly people who dine at meal service sites in 7 jurisdictions in Shanghai were selected， and a self-designed questionnaire was used to investigate the basic information. Results91.64% of the elderly surveyed would eat at relatively fixed meal service sites， and the total Dietary Diversity Score （DDS9） was 3.56±1.46. 41.45% of the elderly with diseases preferred unhealthy cooking methods. Only 8.03% of the surveyed seniors said they were unwilling to accept targeted and personalized nutrition tips and reminders. Multivariate logistic regression analysis showed that the probability reaching the “understanding” level of “Food Guide Pagoda for Chinese Residents” and “Four Principles Recommended by the Core Dietary Guidelines for the Elderly” was different in the elderly with different education levels. The willingness of the elderly to expect to receive different nutrition tips and reminders was related to whether they cared about the corresponding contents. There was a statistically significant difference （P<0.05） among the elderly who were concerned about different health problems in terms of the willingness to receive different nutritional tips. There were significant differences in the proportion of elderly people with different health status for intervention （χ²=5.402， P<0.05）. ConclusionThe elderly who dine at meal service sites are highly dependent on the sites， have a low level of dietary diversification， and do not have a high degree of understanding of nutrition-related knowledge， and have a high demand for targeted nutritional interventions. Nutritional interventions for the sick elderly should be piloted through multiple channels.

【Objective】 To analyze the related factors and countermeasures of adverse reactions to whole blood donation(ARBD) for medical student donors, so as to further reduce the incidence of ARBD. 【Methods】 The demographic data of medical/non-medical student donors and those suffered from ARBD from 2016 to 2018 were retrospectively analyzed, and the relationship between ARBD and age, gender, frequency of blood donation, blood volume, blood type, pulse, ALT, blood pressure, hemoglobin, etc. was statistically analyzed. 【Results】 The incidence of ARBD in all medical student donors from 2016 to 2018 was 1.16%, lower than that of non-medical students (1.51%). The ARBD rate(2.30%) of senior medical students (> 20 years old) was significantly lower than that of non-medical students (3.93%) and higher than that of junior medical students (≤20 years old)(0.70%). The ARBD rate of novel medical student donors was 1.27%, lower than that of novel non-medical students (2.12%) (P<0.05). Male medical students(1.68%) were more likely to develop ARBD than females(0.78%), donations within 200 mL(55%) than 300mL(0.26%) and 400mL(0), Hb<120 g/L(13.04%) than Hb≥120 g / L( 1.10% ), and blood type A(1.70%) than type O (0.88%) (P<0.05). Logistic regression analysis showed that blood volume and blood type were related factors. ARBD was more likely to occur in Type A blood than type O, and was more likely to occur when blood volume was lower. ARBD occurred frequently during phlebotomy, due to mental stress(75%) and hunger(8.92%)(P<0.05), while 96.43% of ARBD could recover within 10 minutes. 【Conclusion】 Novel, male, older than 20 years, Hb<120 g / L, blood type A and donation unit ≤200 mL were main risks for ARBD in medical student donors. Popularizing the knowledge of voluntary blood donation and strengthening pre-donation communication are important measures to prevent ARBD.

Objective:To investigate the efficacy of endovascular embolization in the treatment of traumatic carotid cavernous fistula (TCCF) and the influencing factors of outcomes.Methods:Patients with Barrow A type TCCF underwent intravascular embolization in the Department of Neurosurgery, General Hospital of Ningxia Medical University from January 2009 to November 2019 were enrolled. They were treated with detachable balloons or Onyx-18 combined with coils via transarterial approach, and clinical and imaging follow-up were performed after operation. Recurrence was defined as a lesion that was completely embolized immediately, but the original fistula was redeveloped during imaging follow-up. The clinical recovery was defined as the disappearance of intracranial vascular murmur, pulsatile exophthalmos, conjunctival hyperemia and edema, the movement of eyeball without disorder and the restoration of vision loss. Multivariate logistic regression analysis was used to determine the independent risk factors for affecting imaging recurrence and clinical recovery. Results:A total of 54 patients with Barrow A type TCCF were enrolled. Their age was 42.5±10.6 years (range, 28-70 years); 36 were male (66.7%). Clinical manifestations: 40 patients (74.1%) had ocular symptoms (exophthalmos, conjunctival congestion, etc.), 35 (64.8%) had intracranial vascular murmur, 36 (66.7%) had visual impairment (decreased vision, visual field defect), 32 (59.3%) had headache, 15 (28.3%) had abducens nerve palsy, and 4 (9.1%) had epistaxis. Fourty-seven patients (87.0%) had superior ophthalmic vein drainage, 19 (35.2%) had superior and inferior petrosal sinus drainage, and 9 (16.7%) had cortical vein drainage. Twenty-eight patients (51.9%) were treated with Onyx-18 combined with coils, and 26 (48.1%) were treated with detachable balloons. After operation, 47 patients (87.0%) were immediately totally embobilized, 4 of them were totally embolized with Onyx-18 and coils after the failure of balloon embolization; 7 patients (13.0%) achieved subtotal embolization. Forty-seven patients (87.0%) recovered after surgery, and the symptoms of 4 patients were better than before admission but the vision did not fully recover (among them, 3 had the symptoms of abducens nerve palsy), 2 had mild hemiplegia, and no patients died after surgery. At postoperative follow-up, 5 (9.3%) recurred, and then they achieved total embolization with Onyx-18 combined with coils. Multivariate logistic regression analysis showed that subtotal embolization was an independent risk factor for postoperative imaging recurrence (odds ratio 16.63, 95% confidence interval 1.74-159.33; P=0.015), and the presence of cortical venous drainage was an independent risk factor for affecting postoperative clinical recovery (odds ratio 19.08, 95% confidence interval 1.61-226.58; P=0.020). Conclusion:Both of Onyx-18 combined with coils and detachable balloons are safe and effective for the treatment of TCCF. Subtotal embolization is associated with imaging recurrence, and the presence of cortical venous drainage is an independent influencing factor of clinical recovery.

Medical philosophy has important guiding significance for the development of medicine. Ancient Greek medical philosophy has rich connotation and strong vitality. In the study of ancient Greek medical philosophy and combined with"the positioning of basic medicine"and"doctor-patient relationship"and other outstanding is-sues in the current development of medicine, we found that the rational examination of medical theory and medical treatment in ancient Greek medical philosophy, ways of thinking and analytical methods of medical philosophy and the character that physician should have had an important value in the development of modern medicine. We should pay attention to basic medical research,pursue innovative thinking, be good at using critical thinking and pay atten-tion to the training of humanistic spirit among medical workers.

With the rapid development of molecular biology,molecular targeted therapy has become an important tumor therapy after surgery,radiotherapy and chemotherapy.It plays an increasingly important role in tumor therapy.Molecular targeted therapy reflects that the clinical medicine tends to precision,but also contains a profound philosophical thought and philosophical basis.On the one hand,the clinical application of molecular targeted therapy reflects the profound philosophical thoughts of the universality of the connection,the universality and theparticularity,and the whole and the part.On the other hand,the further application and development of molecular targeted therapy also need the guidance of philosophical theory.

As a kind of new technology, ethical issues are inevitable in medical and non-medical gene en-hancement application. It is unrealistic to unilaterally support or object to the research and application of medical and non -medical gene enhancement. Based on standardizing the ethical principle of gene enhancement tech-niques, we should build management measures of the research, development and application that adapted to ethi-cal, social and legal standards, so that we can draw on the advantages and avoid the disadvantages, and use gene enhancement reasonably and bring benefits to mankind and society.