BACKGROUND:Traditional Chinese medicine compound prescription has a long history in the treatment of primary osteoporosis,and the curative effect is definite,but the medication rule and mechanism are not clear. OBJECTIVE:Using the methodology of data mining and network pharmacology,to explore and verify the law of drug use and molecular mechanism of modern traditional Chinese medicine in the treatment of primary osteoporosis. METHODS:The relevant documents included in CNKI,WanFang,VIP and PubMed were used as data sources,and the relevant data were statistically counted and extracted by Microsoft EXCEL2019,IBMSPSS25.0 and other software.The high-frequency drugs obtained from the data statistics were analyzed by association rules analysis and cluster analysis,and the core drug combination of traditional Chinese medicine compound prescription in the treatment of primary osteoporosis was obtained by combining the two results.The therapeutic mechanism of this combination was explained by network pharmacology and verified by molecular docking. RESULTS AND CONCLUSION:Finally,151 articles were included and 207 prescriptions were selected,involving 285 flavors of Chinese herbs.(1)Ten groups of important drug combinations were obtained through the above two analyses,among which the core drug combination with the highest confidence and improvement was"Drynaria-Eucommia-Angelica."The key components of the combination in the treatment of primary osteoporosis were quercetin,kaempferol,naringenin and so on.The core targets were SRC proto-oncogene,phosphoinositide-3-Kinase regulatory subunit 1 and RELA proto-oncogene.The main pathways were cancer signaling pathway,JAK-STAT signaling pathway,VEGF signaling pathway,and NF-κB signaling pathway.(2)The key active components were docked with the core targets,and the two showed a good combination.To conclude,Chinese herbal compound therapy in the treatment of primary osteoporosis can use a variety of active components to exert its efficacy through multiple signal pathways and acting on multiple targets,which can provide a theoretical basis for the research and development of new drugs for the follow-up treatment of primary osteoporosis.

Prehospital emergency care is the primary stage in the treatment of critically ill patients, where efficient and accurate monitoring methods are crucial for patient survival and prognosis. End-tidal carbon dioxide (EtCO₂) monitoring is a real-time, non-invasive method that can sensitively capture the status of respiratory, circulatory, and metabolic functions, particularly in the urgent and complex pre-hospital environment, a immediate detection and non-invasive method, can sensitively capture the respiratory, circulatory, and metabolic status of patients. It provides valuable guidance for rapid decision-making and precise interventions. This is particularly valuable in the complex and urgent prehospital environment, providing critical data for rapid decision-making and precise intervention. This paper systematically reviews the advancements in the application of EtCO₂ monitoring across various fields, including sepsis identification, trauma assessment, cardiac arrest, respiratory critical care, endotracheal intubation confirmation, and management of metabolic diseases, aiming to explore its application value and prospects in pre-hospital emergency care.
Humans ; Emergency Medical Services/methods* ; Carbon Dioxide/analysis* ; Monitoring, Physiologic/methods* ; Critical Illness ; Capnography/methods*

Humans ; Cytomegalovirus ; Cytomegalovirus Infections ; Antigens, Viral ; Immunity ; Autoimmune Diseases ; CD8-Positive T-Lymphocytes

Objective:To investigate the influence of hemoglobin glycation index (HGI) on the risk of incident chronic kidney disease (CDK) among nondiabetic patients.Methods:Prospective cohort study. At baseline, a total of 7 407 nondiabetic patients without a history of CKD from Pingguoyuan Community of the Shijingshan District in Beijing were included from December 2011 to August 2012, who were then divided into three groups according to the tertiles of their baseline HGI levels. The CKD incidence rate was compared among the different HGI groups at last follow-up. Cox multivariable regression was applied to evaluate whether HGI measures predicted CKD risk. Test for trend across tertiles were examined using ordinal values in separate models.Results:The mean age of the subjects was (56.4±7.5) years, and 4 933 (66.6%) were female. At mean follow-up of 3.23 years, 107 (1.4%) individuals developed CKD. The incidence of CKD was gradually increasing from the low to high HGI groups [1.1% (28/2 473) vs. 1.2% (31/2 564) vs. 2.0% (48/2 370), P=0.016]. In the multivariate Cox regression analysis, after adjustment for potential confounders, the high HGI group had a 68.5% increased risk of CKD compared with the low HGI group ( HR=1.685, 95% CI 1.023 to 2.774). CKD risk increased with increasing HGI tertiles ( P for trend=0.028). Conclusion:High HGI is associated with an increased risk for CKD in the nondiabetic population, indicating that HGI may help identify individuals at high risk for CKD.

To investigate the sources of inconsistent findings between two randomized control trials ["initiation strategies for renal-replacement therapy in the intensive care unit" (AKIKI trial)vs "effect of early vs delayed initiation of renal replacement therapy on mortality in critically ill patients with acute kidney injury" (ELAIN trial)],regarding "timing of renal replacement therapy (RRT) on mortality in patients with acute kidney injury (AKI).By reanalysis of the published data,it was found that demographics,severity of primary disease and stage of AKI before initiation of RRT were quite different between AKIKI and ELAIN trials.Interestingly,similar mortalities were demonstrated in late group of ELAIN trial,both of early and late groups of AKIKI trial [all patients were classified at Kidney Disease:Improving Global Outcomes (KDIGO) classification stage 3 of AKI,P＞0.05] although a significant reduction of mortality was determined in early group of ELAIN trial (KDIGO stage 2 of AKI).Therefore,it was concluded that inconsistent results were largely attributable to the heterogeneity of enrolled patients between ELAIN vs AKIKI trials,including demographics and severity of AKI(AKI stage) before initiation of RRT.

Objective To evaluate the result of early repair for urinary fistula caused by iatrogenic injury to ureter,bladder and urethra during resection of rectal cancer.Methods We retrospectively analyzed 26 cases of urinary fistula after resection of rectal cancer patients encountered in Department of General Surgery,Henan Tumor Hospital from October 2005 to May 2016.Urinary fistula was divided into four types according to the site of fistula.Results Surgery was performed ever after the diagnosis of the fistula was identified.In type Ⅰ fistula (6 cases of posterior urethral fistula) the treatment was stent placement and packing of the greater omentum.2 cases of bladder top fistula (type Ⅱ),were treated by fistula repair and cystostomy.Type Ⅲ involved 12 cases (bladder triangle fistula).The treatment was ureter stenting replantation,and cystostomy Type Ⅳ:ureteral fistula in 6 cases,the treatment was end-to-end anastomosis and stenting.After surgery 24 cases were cured and 2 cases (all of type Ⅲ fistula) ended up with permanent bilateral ureterocutaneostomy.Conclusion It is safe and effective to make early remedy repair for ureter,bladder and urethral fistula iatrogenically during rectal cancer resection.

Objective To summarize and analyze the epidemiological and clinical characteristics of patients with subacute thyroiditis(SAT),so as to provide a basis for prevention and treatment.Methods The epidemiological and clinical data of 1 865 patients with SAT,who were treated in the Shandong Institute of Prevention and Control for Endemic Disease in 2015-2006,were collected.The SAT patients' sex,age,urban and rural areas,occupation and time of onset distributions,summary onset clinical manifestations,laboratory findings,treatment and outcome were analyzed retrospectively.Results The average age of the 1 865 patients with SAT was 42.16 years old,the youngest was 9 years old,and the oldest was 74 years old.Most of the patients were 21-50 years old,which was accounted for 62.36％ (1 163/1 865),and most of the patients were female,which was accounted for 83.70％ (1 561/1 865).Most of the patients lived in rural areas,which was accounted for 60.54％ (1 129/1 865).Most patients were onset in January,accounted for 20.48％ (382/1 865),and the least in July,accounted for 1.77％ (33/1865).For the clinical classification,the moderate type and the light type were the largest part with 1 716 cases,accounted for 92.01％,while the severe type was 149 cases,accounted for 7.99％.The clinical manifestations were as follows:the neck discomfort in 1 701 cases,accounted for 91.21％;neck pain,sore throat and palpitate in 1 439 cases,1 351 cases and 1 341 cases,accounted for 77.16％,72.44％ and 71.90％,respectively.Laboratory test results were as following:1 865 cases of thyroid 131I absorption rate reduced(100％);1 396 cases of thyroid nodules increased(74.85％);532 cases of FT3 and FT4 significantly increased,while TSH significandy decreased (28.53 ％);949 cases of FT3 and FT4 increased,while TSH decreased (50.88％);53 cases of FT3 and FT4 decreased,while TSH increased (2.84％);331 cases of FT3,FT4 and TSH in the normal range(17.75％).The thyroid 13I absorption rate significantly increased and thyroid nodules significantly reduced with treatment,the difference was statistically significant (t =-34.93,133.2,all P ＜ 0.001).1 813 patients were cured,while 52 cases arised hypothyroidism.Conclusion Majority of SAT patients are young women.The peak of the incidence of SAT lies in autumn and winter.The proportion of the moderate type is the highest.Early diagnosis and treatment is the key to improve the prognosis of patients with SAT.

Objective To analyze the relationship between the brain functional alterations of patients with Cushing's disease (CD) and patients' mental symptom by applying the Evaluating Emotional Scales and task functional magnetic resonance imaging (Task fMRI).Methods Task fMRI was performed on 8 patients with diagnosed CD admitted in the Department of Endocrinology of Chinese PLA General Hospital from Nov. 2015 to Nov. 2016 and 21 healthy people with matched age, gender and education level as control. Meanwhile, Self-Rating Depression Scale (SDS), Self-Rating Anxiety Scale (SAS), Positive and Negative Affective Scale (PANAS) and Cushing Quality of Life Scale (Cushing QOL) were obtained to assess the brain functions.Results Significant depression and anxiety were observed in patients with CD, and their positive affective score was substantially lower while the negative affective score was relatively higher compared with that in the controls. Task fMRI revealed that, when watching the positive pictures, the activation degree of left cerebellum and right postcentral gyrus weakened in CD patients than in the controls, and the positive correlations existed between the activation degree of left cerebellum and the 16 o'clock adrenocorticotrophic hormone (ACTH) level, and between the activation degree of right postcentral gyrus and the urinary free cortisol (UFC) level in CD patients. In contrast, when watching the negative pictures, the activation degree of left cerebellum, bilateral parahippocampal gyrus and left inferior frontal gyrus was weakened in CD patients than in the controls, and the activation degree of left cerebellum was negatively correlated to the 0 o'clock cortisol level and SAS score, but is positively correlated to the UFC level. When watching the neutral pictures, the activation degree of left cerebellum and left parahippocampal gyrus was weakened in CD patients than in the controls.Conclusions CD patients may have impaired brain function with depression and anxiety mental symptoms. By Task fMRI, it can be found that the weakened activation degree of left inferior frontal gyrus, right postcentral gyrus, bilateral parahippocampal gyrus and left cerebellum may be related to CD patients' mental symptoms.

Objective To observe the formation process with 3.0 T MRI dynamically, and to discuss the feasibility of molecular imaging studies on restenosis. Methods The models were built with balloon (2.0 F) injury which were separated into restenosis group (n=48) and control group (n=48). Zero h, 24 h, 1 week, 2 week, 4 week and 8 week after surgery, 3.0 T MRI scanning (T1WI, T2WI, PDWI) was performed respectively, the vascular of injured side were obtained for HE staining to observe the pathological changes, to analyze the measurement of neointimal area (IA), intimal proliferation index (IHI), lumen area (LA) and stenosis rates, correlation between HE staining measurements and MR images were analyzed. Two weeks after the injury, the restenosis model of rats (n=8) and control rats (n=8) were injected ultrasmall superparamagntiec iron oxide (USPIO,1 mmol/kg) by tail vein, respectively. 3.0 T MRI scanning (T2WI) was underwent at 0 h and 24 h after injection, the change of the arterial wall T2 signal was quantitatively analyzed and the relative signal intensity (rSI) and relative change rate (rSIC) of the vessel wall were calculated. Reference to MRI images, corresponding line segments were taken for Perl's blue staining and immunohistochemically staining of macrophages. One-way ANOVA, Pearson and t test were used for statistical analysis. Results In the early?term (0 h,24 h), the wall and surrounding high signal organization boundary was not clear, there was no obvious morphological change of the lumen. In the medium?term (1, 2 week), signal of the injured wall increased with different extents, wall thickening and luminal narrowing was progressive, the inwall was coarse. In the later?term (4, 8 week) wall signal got slightly lower, wall thickness, lumen change were not significant, the wall area and LA were significantly associated with pathologic measurement result (r value were 0.978, 0.732; P<0.05). In the control group, signal of wall and lumen morphological change were not significant among the different time points. IA were (0.131 ± 0.011) mm2, (0.588 ± 0.017) mm2, (1.061 ± 0.033) mm2, (1.192 ± 0.034) mm2;1, 2, 4, 8 week after injury, respectively, IHI were 0.235 ± 0.022, 0.578 ± 0.013, 0.715 ± 0.011, 0.737 ± 0.009, respectively, stenosis rates were (5.586 ± 0.987)%, (25.395 ± 1.112)%, (40.019 ± 1.298)%, (41.890 ± 0.951)%, respectively, difference between groups were statistically (P<0.05). In the control group, there was no significant differences of medium area, luminal stenosis and neointimal formation respectively at different time points (P>0.05). rSI was 1.582±0.051 after the injection of USPIO, then 24 h after injection of USPIO, T2 signal of the vessel wall was reduced significantly, rSI was 1.260 ± 0.088, rSIC was (-20.249 ± 6.489) % with statistical difference (t value was 8.924,P<0.05). But there was no statistical difference in control rats (P>0.05). Perl's staining combined with immunohistochemical staining confirmed that the iron particles were taken by the macrophage's phagocytosis just in the neointimal. Conclusion 3.0 T MRI is capable of demonstrating the vessel wall and lumen changes dynamically, and the measurements are correlated with pathological results. USPIO can be consumed by macrophages in the neointimal, resulting in T2 signal of the vessel wall decreased significantly.

Objective To retrospectively study the serum IgG and IgM antibodies against toxoplasma, rubella virus, cytomegalovirus and herpes simplex virus type 1&2 in various populations, and analyze the clinical values.Methods From 2008 to 2015, 2 661 pregnant women, 324 infertile women, 2 492 women with abnormal pregnancy history, 623 women with recent abnormal pregnancy, 261 infants with intrauterine growth retardation and other diseases, 170 women for preconceptual examination, and 702 women for physical examination in Beijing were included .Commercial EIA kits were used to detect serum IgG and IgM antibodies to toxoplasma, rubella virus, cytomegalovirus and herpes simplex virus type 1&2. Positive reactions of IgM antibodies to any pathogens were re-tested with another kind of commercial EIA kit. PEMS3.1 software was used for statistical analysis.Results The prevalence of serum IgG or IgM antibodies against toxoplasma, rubella virus, cytomegalovirus and herpes simplex virus type 1& 2 were found within 0.7%-1.6%(0-1.2%) , 85.3%-92.0% ( 0.4%-2.7%) , 89.1%-94.9% ( 0.7%-1.7%) , 74.8%-86.0% ( 0 -0.7%) , 8.1% -17.4% ( 0 -4.1%) respectively in the studied population groups.The prevalence of TORCH IgG and IgM antibodies were not found to be higher in both populations with past suspicious exposure ( infertile women and women with abnormal pregnancy history ) and recent suspicious exposure ( women with recent abnormal pregnancy and infants with intrauterine growth retardation and other diseases) than that in pregnant women and women for preconceptual and physical examination. Conclusion No associations between TORCH infections and the suspicious exposure were found in the populations above.