1.Herbal Textual Research on Zanthoxylum armatum and Zanthoxyli Radix in Famous Classical Formulas
Zhen ZENG ; Yanmeng LIU ; Yihan WANG ; Yapeng WANG ; Erwei HAO ; Chun YAO ; Zhilai ZHAN
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(13):252-262
This article systematically analyzes the historical evolution of the name, origin, medicinal parts, harvesting and processing, and other aspects of Manjiao and Zanthoxyli Radix by referring to the herbal medicine, medical books, prescription books and other documents of the past dynasties, combined with the relevant modern research materials, in order to provide a basis for the development of famous classical formulas containing the two medicinal materials. According to the herbal textual research, Manjiao was first recorded in Shennong Bencaojing of the Han dynasty with aliases such as Zhujiao, Goujiao and Zhijiao. Throughout history, Manjiao was sourced from the stems and roots of Zanthoxylum armatum in the Rutaceae family, and its leaves and fruits can also be used in medicine. The traditional recorded production area was mainly in Yunzhong(now Tuoketuo region in Inner Mongolia), with mentions in Zhejiang, Hunan, Fujian, Guangdong, Guangxi, Yunnan, Taiwan, and other provinces. Presently, this species is distributed from the south of Shandong, to Hainan, Taiwan, Tibet and other regions. The roots can be harvested year-round, while the fruits are harvested in autumn after maturity. In ancient times, the roots and stems were mostly used for brewing or soaking in wine, whereas nowadays, the roots are often sliced and then used as a raw material in traditional Chinese medicine, and the fruits should be stir-fried before use. Manjiao has a bitter taste and warm property, and was historically used to treat wind-cold dampness, joint pain, limb numbness, and knee pain. Modern researches have summarized its effects as dispelling wind, dispersing cold, promoting circulation, and relieving pain, and it is used for treating rheumatoid arthritis, toothache, bruises, as well as an anthelmintic. Zanthoxyli Radix initially known as Rudi Jinniugen, recorded in Bencao Qiuyuan of the Qing dynasty, with the alternate name of Liangbianzhen. In recent times, it is more commonly referred to as Liangmianzhen, sourced from the dried roots of Z. nitidum of the Rutaceae family, mainly produced in Guangxi and Guangdong. It can be harvested throughout the year, cleaned, sliced, and dried after harvesting. Zanthoxyli Radix is pungent, bitter, warm and slightly toxic, with the functions of promoting blood circulation, removing stasis, relieving pain, dispelling wind, and resolving swelling. Based on the results of herbal textual research, it is clarified that the ancient Manjiao and the modern Zanthoxyli Radix are not the same species. This article corrects the mistaken belief of by previous scholars that Zanthoxyli Radix is the same as ancient Manjiao, and suggests that formulas described as Manjiao should use Z. armatum as the medicinal herb, while those described as Liangmianzhen or Rudi Jinniu should use Z. nitidum. The processing was performed according to the processing requirements prescribed in the formulas, otherwise, the raw products are recommended for use.
2.Herbal Textual Research on Zanthoxylum armatum and Zanthoxyli Radix in Famous Classical Formulas
Zhen ZENG ; Yanmeng LIU ; Yihan WANG ; Yapeng WANG ; Erwei HAO ; Chun YAO ; Zhilai ZHAN
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(13):252-262
This article systematically analyzes the historical evolution of the name, origin, medicinal parts, harvesting and processing, and other aspects of Manjiao and Zanthoxyli Radix by referring to the herbal medicine, medical books, prescription books and other documents of the past dynasties, combined with the relevant modern research materials, in order to provide a basis for the development of famous classical formulas containing the two medicinal materials. According to the herbal textual research, Manjiao was first recorded in Shennong Bencaojing of the Han dynasty with aliases such as Zhujiao, Goujiao and Zhijiao. Throughout history, Manjiao was sourced from the stems and roots of Zanthoxylum armatum in the Rutaceae family, and its leaves and fruits can also be used in medicine. The traditional recorded production area was mainly in Yunzhong(now Tuoketuo region in Inner Mongolia), with mentions in Zhejiang, Hunan, Fujian, Guangdong, Guangxi, Yunnan, Taiwan, and other provinces. Presently, this species is distributed from the south of Shandong, to Hainan, Taiwan, Tibet and other regions. The roots can be harvested year-round, while the fruits are harvested in autumn after maturity. In ancient times, the roots and stems were mostly used for brewing or soaking in wine, whereas nowadays, the roots are often sliced and then used as a raw material in traditional Chinese medicine, and the fruits should be stir-fried before use. Manjiao has a bitter taste and warm property, and was historically used to treat wind-cold dampness, joint pain, limb numbness, and knee pain. Modern researches have summarized its effects as dispelling wind, dispersing cold, promoting circulation, and relieving pain, and it is used for treating rheumatoid arthritis, toothache, bruises, as well as an anthelmintic. Zanthoxyli Radix initially known as Rudi Jinniugen, recorded in Bencao Qiuyuan of the Qing dynasty, with the alternate name of Liangbianzhen. In recent times, it is more commonly referred to as Liangmianzhen, sourced from the dried roots of Z. nitidum of the Rutaceae family, mainly produced in Guangxi and Guangdong. It can be harvested throughout the year, cleaned, sliced, and dried after harvesting. Zanthoxyli Radix is pungent, bitter, warm and slightly toxic, with the functions of promoting blood circulation, removing stasis, relieving pain, dispelling wind, and resolving swelling. Based on the results of herbal textual research, it is clarified that the ancient Manjiao and the modern Zanthoxyli Radix are not the same species. This article corrects the mistaken belief of by previous scholars that Zanthoxyli Radix is the same as ancient Manjiao, and suggests that formulas described as Manjiao should use Z. armatum as the medicinal herb, while those described as Liangmianzhen or Rudi Jinniu should use Z. nitidum. The processing was performed according to the processing requirements prescribed in the formulas, otherwise, the raw products are recommended for use.
3.Material basis and action mechanism of drug-containing serum of Modified Erxian Pill inhibiting macrophage pyroptosis
Siyuan LI ; Yuru WANG ; Ye XU ; Di GUO ; Nan NAN ; Yang LIU ; Jie ZHAO ; Huiqin HAO
Chinese Journal of Tissue Engineering Research 2025;29(19):4029-4037
BACKGROUND:Our previous study found that Modified Erxian Pill could alleviate inflammation in collagen-induced arthritis rats,but its mechanism needs to be further verified. OBJECTIVE:To analyze the components absorbed in the blood of Modified Erxian Pill,and observe the effect of the drug-containing serum of Modified Erxian Pill on pyroptosis of J774A.1 macrophages. METHODS:(1)Analysis of components absorbed in the blood of Modified Erxian Pill:Ultra-high performance liquid chromatography-high resolution mass spectrometry was used to detect and identify Modified Erxian Pill and its components absorbed in the blood.(2)Effect of the drug-containing serum of Modified Erxian Pill on pyroptosis of J774A.1 macrophages:Molecular docking technology was used to initially verify the sesquiterpenoids and NLRP3 in components absorbed in the blood of Modified Erxian Pill.J774A.1 macrophages were randomly divided into blank control group,lipopolysaccharide+adenosine triphosphate group,and lipopolysaccharide+adenosine triphosphate+Modified Erxian Pill with low(2.5%),medium(5%),and high(10%)dose groups.The release of lactate dehydrogenase in the cell supernatant of each group was detected according to the kit instructions.The levels of interleukin-1β and interleukin-18 in cell supernatant were detected in each group by ELISA.The cell membrane damage was detected by Hoechst/PI staining.The expression levels of NLRP3,Caspase-1,GSDMD,and GSDMD-N protein in the cells of each group were detected by western blot assay. RESULTS AND CONCLUSION:(1)A total of 32 active components of Modified Erxian Pill were identified,and 21 components entered the blood.The main components into blood included a variety of sesquiterpenoids.(2)Molecular docking results showed that 3-O-Acetyl-13-deoxyphomenone,Incensol oxide,Atractylenolide III,Rupestonic acid,and 3,7-Dihydroxy-9,11-eremophiladien-8-one had good binding activity with NLRP3.(3)Compared with the blank control group,lactate dehydrogenase activity and the expression levels of interleukin-1β and interleukin-18 were significantly increased in cell supernatant of lipopolysaccharide+adenosine triphosphate group(P<0.001).Hoechst/PI staining showed that the number of PI-positive cells was significantly increased.After the intervention of lipopolysaccharide+adenosine triphosphate+Modified Erxian Pill group,all of them showed different degrees of reduction.(4)Compared with the blank control group,NLRP3,Caspase-1,GSDMD,and GSDMD-N protein expression levels were significantly increased in the lipopolysaccharide+adenosine triphosphate group(P<0.05).Compared with lipopolysaccharide+adenosine triphosphate group,the protein expressions of NLRP3,Caspase-1,GSDMD,and GSDMD-N were significantly decreased in the lipopolysaccharide+adenosine triphosphate+Modified Erxian Pill group(P<0.05),and had a certain dose dependence.These findings verify that the drug-containing serum of Modified Erxian Pill may inhibit the pyroptosis of J774A.1 macrophages by regulating the NLRP3/Caspase-1/GSDMD pathway.
4.Herbal Textual Research on Abri Herba and Abri Mollis Herba in Famous Classical Formulas
Zhen ZENG ; Yanmeng LIU ; Yihan WANG ; Erwei HAO ; Chun YAO ; Zhilai ZHAN
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(17):193-201
This article systematically analyzes the historical evolution of the name, origin, academic name, medicinal parts, origin, harvesting, processing and other aspects of Abri Herba and Abri Mollis Herba by referring to the herbal medicine, medical books, prescription books and other documents of the past dynasties, combined with the modern literature, so as to provide a basis for the development of famous classical formulas containing this type of medicinal materials. According to the herbal textual research, Abri Herba was first recorded in Lingnan Caiyaolu, with other aliases such as Huangtoucao and Xiye Longlincao. It originates from the dried whole plant of Abrus cantoniensis, a Fabaceae plant, which can be used medicinally except for its fruits. Currently, this species is mainly distributed in Guangdong and Guangxi, and also found in Hunan and Thailand, it can be harvested throughout the year, mainly in spring and autumn. The roots, stems, and leaves can be used for medicinal purposes, but the pods are toxic and need to be removed. After harvesting, impurities and pods are removed, and it is dried and processed for medicinal use. Abri Herba has a sweet and slightly bitter taste, is cool in nature, and is associated with the liver and stomach meridians, it is used for clearing heat and relieving dampness, dispersing blood stasis and relieving pain, and is mainly used to treat jaundice-type hepatitis, stomach pain, rheumatic bone pain, contusion and ecchymosis pain, and mastitis. Abri Mollis Herba was first recorded in the 1982 edition of Zhongyaozhi as another origin for Abri Herba, and was singled out in some monographs such as Xinhua Bencao Gangyao in 1988 for use, while some other monographs use it as a local habitual products or confused products of Abri Herba with aliases such as Daye Jigucao, Qingtingteng, and Maoxiangsi. It comes from the dried whole herb of A. mollis without pods, and is mainly produced in Guangxi and Guangdong, and occasionally found in Hong Kong, Hainan and Fujian. The collection and processing are similar to Abri Herba, after harvesting, impurities and pods are removed, and it is dried and cut for medicinal use. Abri Mollis Herba has a sweet and light taste, is cool in nature, and is associated with the liver and stomach meridians, with the efficacy of clearing heat and detoxifying, and promoting dampness, it is mainly used to treat infectious hepatitis, mastitis, furuncles, burns and scalds, and pediatric malnutrition. Based on the research, A. mollis was first recorded to be used as a medicine in the same origin as A. cantoniensis, and as plants of the same genus, have similar morphological characteristics, and their medicinal parts, collection and processing, properties and flavors, and meridian affiliations are consistent. And in the folk, Abri Mollis Herba is often used as Abri Herba, which has been used for a long time and is now dominated by the cultivation of A. mollis. So it is recommended that the subsequent version of Chinese Pharmacopoeia should include A. mollis in the origin of Abri Herba, and it is also recommended that in famous classical formulas refered to Jiguccao can use A. cantoniensis and A. mollis as the sources of the herb, refered to Mao Jiguccao can use A. mollis as the sources of the herb. Processing is carried out according to the requirements specified in the original formulas, and raw products are recommended to be included in the medicine if there are no requirements.
5.Herbal Textual Research on Abri Herba and Abri Mollis Herba in Famous Classical Formulas
Zhen ZENG ; Yanmeng LIU ; Yihan WANG ; Erwei HAO ; Chun YAO ; Zhilai ZHAN
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(17):193-201
This article systematically analyzes the historical evolution of the name, origin, academic name, medicinal parts, origin, harvesting, processing and other aspects of Abri Herba and Abri Mollis Herba by referring to the herbal medicine, medical books, prescription books and other documents of the past dynasties, combined with the modern literature, so as to provide a basis for the development of famous classical formulas containing this type of medicinal materials. According to the herbal textual research, Abri Herba was first recorded in Lingnan Caiyaolu, with other aliases such as Huangtoucao and Xiye Longlincao. It originates from the dried whole plant of Abrus cantoniensis, a Fabaceae plant, which can be used medicinally except for its fruits. Currently, this species is mainly distributed in Guangdong and Guangxi, and also found in Hunan and Thailand, it can be harvested throughout the year, mainly in spring and autumn. The roots, stems, and leaves can be used for medicinal purposes, but the pods are toxic and need to be removed. After harvesting, impurities and pods are removed, and it is dried and processed for medicinal use. Abri Herba has a sweet and slightly bitter taste, is cool in nature, and is associated with the liver and stomach meridians, it is used for clearing heat and relieving dampness, dispersing blood stasis and relieving pain, and is mainly used to treat jaundice-type hepatitis, stomach pain, rheumatic bone pain, contusion and ecchymosis pain, and mastitis. Abri Mollis Herba was first recorded in the 1982 edition of Zhongyaozhi as another origin for Abri Herba, and was singled out in some monographs such as Xinhua Bencao Gangyao in 1988 for use, while some other monographs use it as a local habitual products or confused products of Abri Herba with aliases such as Daye Jigucao, Qingtingteng, and Maoxiangsi. It comes from the dried whole herb of A. mollis without pods, and is mainly produced in Guangxi and Guangdong, and occasionally found in Hong Kong, Hainan and Fujian. The collection and processing are similar to Abri Herba, after harvesting, impurities and pods are removed, and it is dried and cut for medicinal use. Abri Mollis Herba has a sweet and light taste, is cool in nature, and is associated with the liver and stomach meridians, with the efficacy of clearing heat and detoxifying, and promoting dampness, it is mainly used to treat infectious hepatitis, mastitis, furuncles, burns and scalds, and pediatric malnutrition. Based on the research, A. mollis was first recorded to be used as a medicine in the same origin as A. cantoniensis, and as plants of the same genus, have similar morphological characteristics, and their medicinal parts, collection and processing, properties and flavors, and meridian affiliations are consistent. And in the folk, Abri Mollis Herba is often used as Abri Herba, which has been used for a long time and is now dominated by the cultivation of A. mollis. So it is recommended that the subsequent version of Chinese Pharmacopoeia should include A. mollis in the origin of Abri Herba, and it is also recommended that in famous classical formulas refered to Jiguccao can use A. cantoniensis and A. mollis as the sources of the herb, refered to Mao Jiguccao can use A. mollis as the sources of the herb. Processing is carried out according to the requirements specified in the original formulas, and raw products are recommended to be included in the medicine if there are no requirements.
6.Preparation,characterization and tissue distribution of polyethylene glycol-modified Curcumin solid lipid nanoparticle inhalable micropowder
Nan LI ; Zi WANG ; Di HAO ; Lingyu KONG ; Xu LI
China Pharmacy 2025;36(19):2387-2392
OBJECTIVE To prepare polyethylene glycol (PEG)-modified flower lactose (FL) loaded Curcumin (Cur) solid lipid nanoparticle (SLN) inhalable micropowder (referred to as “PEG-Cur-FL”). METHODS PEG-Cur-FL was prepared by the solvent emulsification diffusion low-temperature solidification method, and its encapsulation efficiency, drug loading capacity, powder properties, aerodynamic particle size, in vitro deposition properties, and in vitro release characteristics were characterized. The mice were divided into Cur-SLN-FL (unmodified with PEG) group and PEG-Cur-FL group, with 55 mice in each group. Both groups of mice were given a single inhalation of 5 mg/kg (calculated as Cur) of the corresponding drug micropowder through an air tube. At 0.25, 0.5, 1, 2, 4, 6, 8, 12, 24, 48 and 72 hours after administration, eyeballs were removed to collect blood and tracheal, lung, liver and kidney tissues were separated. The mass concentration of Cur in mouse plasma and various tissue samples was measured, and the tissue distribution and retention of the drug were analyzed. RESULTS The encapsulation efficiency and drug loading capacity of PEG-Cur-FL were (86.2±1.8)% and (4.2±0.2)%, respectively; the bulk density and tap density were (0.24±0.01) g/cm3 and (0.30±0.01) g/cm3, respectively; the aerodynamic particle size was (2.74±0.64) μm; the in vitro effective site deposition rate (secondary drug deposition rate) was (45.07±2.79)%. Compared with Cur raw materials, Cur-SLN- FL and PEG-Cur-FL had sustained release effects under both leakage and non-leakage conditions, and PEG-Cur-FL had a smoother sustained release in artificial lung fluid, with release characteristics consistent with the Weibull model. The results of in vivo distribution showed that the drug concentration in the lung tissue of PEG-Cur-FL group was significantly lower than that of Cur- SLN-FL group during the same period after 1 hour of administration, while the drug concentration in the lung tissue at 4 to 48 hours was significantly higher than that of Cur-SLN-FL group during the same period (P<0.05); the plasma drug concentrations of the PEG-Cur-FL group at all time points from 0.25 to 12 hours were significantly lower than those of the Cur-SLN-FL group during the same period (P<0.05), and the drug concentrations in liver and kidney tissues were also lower than those of the Cur-SLN-FL group during the same period (P<0.05). CONCLUSIONS PEG-Cur-FL is prepared successfully; the inhalable micropowder has good inhalability and release performance; after administration through the trachea, the effective concentration of Cur in lung tissue can be increased, while reducing its plasma drug concentration and drug distribution concentration in non-target organs.
7.Advances of studies on myelin regeneration by GABAergic networks in neurodevelopment and brain diseases
Xiao-Di FAN ; Ye-Hao ZHANG ; Jian-Xun LIU
Chinese Pharmacological Bulletin 2024;40(5):801-806
Differentiation of oligodendrocyte precursor cells(OPCs)into mature oligodendrocytes(OLs)is a key event for axonal myelination in the central nervous system(CNS).Stud-ies have shown that neurotransmitters like GABA,GABAergic synapses and network regulation play important roles in the pro-liferation,differentiation,migration and myelination of oligoden-drocytes.Therefore,the paper reviews recent studies on the bio-logical functions of GABA and its receptors in oligodendrocyte lineages,the interaction between GABAergic interneurons and OPCs,the network regulation of GABAergic interneurons media-ting myelination,and potential future drug candidates.Based on this,understanding the mechanisms that control OLs differentia-tion is essential for identifying therapeutic strategies that promote myelin repair,and research surrounding GABAergic may have potential implications for the development of novel repair thera-pies for demyelinating diseases.
8.Effect of quercetin on Erastin-induced ferroptosis in chondrocytes
Hao WANG ; Fu-Li ZHOU ; Ren-Di ZHU ; Ying-Jie ZHAO ; Ren-Peng ZHOU ; Wei HU ; Chao LU
Chinese Pharmacological Bulletin 2024;40(10):1945-1952
Aim To explore the effect of quercetin(Que)on ferroptosis and the potential mechanisms in an Erastin-induced ferroptosis model in chondrocytes.Methods A model of Erastin-induced ferroptosis was established in C28/I2 chondrocytes.Cells were treated with different concentrations of Que.Cell viability and cytotoxicity were assessed by MTT and LDH assays.The expression levels of Prdx6 and ferroptosis-related proteins ACSL4 and GPX4 in chondrocytes were deter-mined by Western blot.Lipid ROS production in chon-drocytes was measured by flow cytometry,while the changes in mitochondrial membrane potential were de-tected by RH123 staining.Prdx6 mRNA expression in chondrocytes was quantified by RT-qPCR.The chan-ges in the expression of the ferroptosis-related proteins ACSL4 and GPX4 were detected by immunofluores-cence staining.Results Compared to the Erastin-in-duced ferroptosis model group,Que significantly im-proved the viability of C28/I2 chondrocytes and re-duced cell cytotoxicity.It decreased the expression of the ferroptosis-related protein ACSL4 and increased the expression of GPX4.Que also inhibited the production of lipid ROS in chondrocytes and strengthened their mitochondrial membrane potential.In addition,the ex-pression of Prdx6 was significantly reduced in the Eras-tin group compared to the control group,while Que treatment upregulated the expression of Prdx6.Mean-while,the inhibitory effect of Que on chondrocyte fer-roptosis was reduced by the use of MJ33,an inhibitor of Prdx6.Conclusion Que can inhibit Erastin-induced ferroptosis of C28/I2 chondrocytes,possibly by upregu-lating Prdx6,and thus play a protective role in chon-drocytes.
9.A multicenter clinical study on the treatment of lateral epicondylitis of humerus by manipulation
Xiao-Zhou HOU ; Jing YIN ; Hai-Yang WANG ; Jin-Yu GU ; Tian-Hao WAN ; Man-Hong YANG ; Di XIA ; Qing ZHANG
China Journal of Orthopaedics and Traumatology 2024;37(3):251-257
Objective To investigate clinical effect of tendons pulling,poking and kneading for the treatment of external humeral epicondylitis.Metods From January 2018 to December 2021,a multicenter randomized controlled study was per-formed to collect 192 patients with external humeral epicondylitis in Wangjing Hospital,Beijing Dianli Hospital,and Beijing Fengsheng Osteotraumatology Hospital,respectively,and they were divided into treatment group and control group by random number table method.There were 96 patients in treatment group,including 36 males and 60 females,aged from 28 to 60 years old with an average of(41.20±5.50)years old;the course of disease ranged from 1 to 14 days with an average of(5.24±1.35)days;they were treated once every other day for 2 weeks.There were 96 patients in control group,including 33 males and 63 females,aged from 26 to 60 years old with an average of(43.35±7.75)years old;the course of disease ranged from 1 to 14 days with an average of(5.86±1.48)days;they were treated with topical voltaalin combined with elbow joint fixation for 2 weeks.Visual analogue scale(VAS)and Hospital for Surgery Scoring System(HSS)elbow pronation and supination angles,wrist metacarpal flexion and dorsal extension angles,elbow tenderness between two groups were compared before treatment and at 1,3,5,7,11 and 13 days after treatment;Hospital for Surgery Scoring System 2(HSS2)was compared before treatment and the final treatment.Results All patients were followed up for 10 to 14 days with an average of(12±1.6)days.VAS between treatment group and control group before treatment were 6.83±1.36 and 6.79±1.58,respectively,and decreased to 1.49±1.09 and 2.11±1.81 after the final treatment.VAS of treatment group were significantly lower than those of control group at 1,3,5,7,9,11 and 13 days after treatment(P<0.05).HSS between two groups were 61.73±11.00 and 36.47±12.45 before treatment,respectively,and increased to 94.42±5.9 and 91.44±9.11 at the final treatment.HSS of treatment group were signifi-cantly higher than those of control group at 1,3,5,7,9,11 and 13 days after treatment(P<0.05).On the 5th day after treat-ment,the external and internal rotation angles of elbow in treatment group were(66.41±12.69)° and(66.35±13.54)°,while those in control group were(62.08±16.03)° and(61.77±16.35)°.On the 7th day after treatment,the external and internal ro-tation angles of elbow were(69.79±12.64)° and(70.02±13.55)° in treatment group,and(65.28±15.86)° and(65.09± 16.67)° in control group.Elbow joint motion in treatment group was higher than that in control group(P<0.05).On the 5th day after treatment,angles of wrist dorsiflexion and palm flexion were(39.43±15.94)°and(46.68±11.10)° in treatment group,and(38.51±18.49)° and(44.27±13.58)° in control group.On the 7th day after treatment,angles of wrist dorsiflexion and palm flexion were(42.52±16.50)° and(49.23±10.96)° in treatment group,and(41.18±20.09)° and(46.64±14.63)° in control group.The motion of wrist joint in treatment group was higher than that in control group(P<0.05).On the 13th day after treatment,HSS2 in treatment group 93.61±6.32 were higher than those in control group 92.06±7.94(P<0.05).There was no significant difference in elbow tenderness between two groups at each time point(P>0.05).Conclusion Voltaren external treatment combined with elbow fixation and tendons pulling,poking and kneading could effectively improve symptoms of exter-nal humeral epicondylitis.Compared with voltaren external treatment,tendons pulling,poking and kneading has advantages of longer analgesic time and better elbow function recovery.
10.Construction and validation of a nomogram for predicting the prognosis of patients with septic shock in department of emergency medicine
Tong WANG ; Jun LI ; Di HAO ; Anlong QI
Chinese Critical Care Medicine 2024;36(6):578-584
Objective:To construct a nomogram model for predicting the 28-day mortality of patients with septic shock in the emergency medicine department and to validate the predictive efficacy.Methods:Based on the database of the emergency medicine department of Chu Hsien-I Memorial Hospital of Tianjin Medical University, Tianjin Medical University General Hospital and the Second Hospital of Tianjin Medical University, the data of 913 patients with septic shock admitted to the emergency medicine department from January 2017 to October 2020 were collected, including baseline demographic information and clinical characteristics, laboratory indices, and the main endpoints (28-day mortality). The patients were divided into a training set and a validation set based on simple random sampling. All significant variables from the one-way binary Logistic regression analysis of the training set were included in the multivariate Logistic regression analysis to analyze the risk factors for 28-day mortality in patients with septic shock and to construct a column-line graphical model. The predictive efficacy of the nomogram model was assessed using calibration curves and receiver operator characteristic curve (ROC curve).Results:A total of 860 patients with septic shock meeting the criteria were finally enrolled, including 472 in the training set and 388 in the validation set. The 28-day mortalities were 52.5% (248/472) and 54.1% (210/388) for the training and validation sets, respectively. In the training set, age, respiratory rate (RR), the levels of C-reactive protein (CRP), D-dimer, white blood cell count (WBC), neutrophil count (NEU), neutrophil/lymphocyte ratio (NLR), monocyte/lymphocyte ratio (MLR), mean platelet volume (MPV), and platelet count (PLT) in the death group were significantly higher than those in the survival group, and the levels of base remaining (BE), lymphocyte count (LYM), hemoglobin (Hb) and the proportion of chronic obstructive pulmonary diseases (COPD) were significantly lower than those in the survival group (all P < 0.05). Multifactorial Logistic regression analysis showed that NLR [odds ratio ( OR) = 0.023 0, 95% confidence interval (95% CI) was -0.204 4 to 0.113 0], MPV ( OR = 0.179 8, 95% CI was -0.877 6 to 0.172 7), Hb ( OR = 0.007 8, 95% CI was 0.010 3 to 0.040 8), procalcitonin (PCT; OR = 1.957 0, 95% CI was 1.243 0 to 3.081 0), and D-dimer ( OR = 0.000 1, 95% CI was -0.000 4 to 0.000 1) were independent predictors of 28-day mortality in patients with septic shock in the emergency department (all P < 0.05). A column-line graph model was established based on the above variables, and the ROC curves showed that the area under the ROC curve (AUC) of the nomogram model in the training set and validation set for predicting the 28-day mortality of patients with septic shock was 0.907 (95% CI was 0.864 to 0.940) and 0.822 (95% CI was 0.781 to 0.863), respectively. The calibration curves showed good agreement between the predicted and observed results for both the training and validation sets. Conclusion:The nomogram model constructed based on NLR, MPV, Hb, PCT and D-dimer has significant clinical value in predicting the 28-day mortality of patients with septic shock in the emergency medicine department.

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