1.Effect of Modified Duhuo Jisheng Mixture Regulating PI3K/Akt/mTOR Signaling Pathway on Synoviocyte Pyroptosis in Rabbit Models of Knee Osteoarthritis
Zifeng YE ; Yiwei YUAN ; Liguo QIU ; Xuyi TAN ; Liang OU ; Gaoyan KUANG ; Min LU
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(1):170-179
ObjectiveTo explore the potential mechanisms of action of the modified Duhuo Jisheng Mixture (JDJM) in treating synovial lesions in knee osteoarthritis (KOA). MethodsA total of 43 male New Zealand white rabbits were randomly allocated into a blank group (n=8) and a model group (n=35). The KOA model was induced by immobilizing the right hind limb with a high-molecular resin plaster bandage, with a modeling period of 6 weeks, resulting in successful modeling in 32 rabbits. These rabbits were then randomly allocated to the model group, celecoxib group, JDJM group and JDJM+740Y-P group, each consisting of 8 rabbits. The celecoxib group received celecoxib via gavage at a single dose of 0.009 3 g·kg-1, while the JDJM was administered a single dose of 6.8 mL·kg-1 (4.515 2 g·kg-1) of the herbal preparation via gavage. The phosphatidylinositol 3-kinase/protein kinase B/mammalian target of rapamycin (PI3K/Akt/mTOR) pathway activator + JDJM group received 4.515 2 g·kg-1 of the herbal preparation via gavage along with an auricular vein injection of 0.15 μmol·kg-1 740Y-P. For a period of 6 weeks, the remaining groups received an equal volume of physiological saline via gavage daily. After the medication period, the knee joint pain threshold and circumference were measured, and hematoxylin-eosin (HE) staining was performed to assess the pathological changes in the synovial tissues. Enzyme-linked immunosorbent assay (ELISA) measured the levels of interleukin-1β (IL-1β), interleukin-6 (IL-18) and tumor necrosis factor-α (TNF-α) in the joint fluid. Real-time fluorescence quantitative polymerase chain reaction (Real-time PCR) was used to assess the mRNA expression of PI3K, Akt, mTOR, NOD-like receptor protein 3 (NLRP3), cysteine-requiring aspartate protease-1 (Caspase-1) and gasdermin D (GSDMD) in the synovial tissues. Immunohistochemical (IHC) assay was performed to assess the protein expression of NLRP3, Caspase-1 and GSDMD. Western blot was carried out to analyze the protein expression of p-PI3K/PI3K, p-Akt/Akt, p-mTOR/mTOR, NLRP3, Caspase-1 and GSDMD. ResultsCompared to the blank group, the model group showed a significant increase in knee joint circumference and decrease in pain threshold, the synovial tissue pathology score was higher (P<0.05), and the levels of IL-1β, IL-18, and TNF-α in the joint fluid significantly increased (P<0.01). PI3K, Akt, mTOR phosphorylation as well as mRNA and protein expression increased (P<0.01), while the mRNA and protein expression levels of NLRP3, Caspase-1 and GSDMD also significantly increased (P<0.01). Compared to the model group, the celecoxib and JDJM groups exhibited a significant reduction in knee joint circumference and increase in pain threshold, the synovial tissue pathology score was lower (P<0.05), and the levels of IL-1β, IL-18, and TNF-α in the joint fluid decreased (P<0.01). The mRNA and protein expression of p-PI3K, p-Akt, p-mTOR, NLRP3, Caspase-1 and GSDMD were reduced (P<0.01). Compared to the JDJM group, the JDJM+740Y-P group showed a decrease in the improvement of synovial lesions, an increase in knee joint circumference, and a decrease in pain threshold. The synovial tissue pathology score was lower (P<0.05), and the levels of IL-1β, IL-18, and TNF-α in the joint fluid were higher (P<0.01). The mRNA and protein expression of p-PI3K/PI3K, p-Akt/Akt, p-mTOR/mTOR, NLRP3, Caspase-1 and GSDMD increased (P<0.01). ConclusionJDJM is effective in treating KOA. Its mechanism may involve modulating the PI3K/Akt/mTOR pathway in synovial tissues, inhibiting pyroptosis, reducing inflammatory factor release, and protecting bony structures.
2.Microbial Culture Results and Pathogen Profiles of Donor Corneas in Eye Bank
Jianping JI ; Huicong HU ; Zhancong OU ; Rongrong CHEN ; Jiabi LIANG ; Nandan WU ; Xiaojuan DONG ; Ting HUANG
Journal of Sun Yat-sen University(Medical Sciences) 2026;47(5):886-898
ObjectiveTo analyze the microbial culture positivity rate, pathogen spectrum, prevalence of multidrug-resistant organisms (MDROs), and differences among donor procurement sources in corneas from the Eye Bank of Guangdong Province, and to provide evidence for eye bank quality control and the prevention of post-keratoplasty infections. MethodsThis retrospective study included 7 442 donor corneas procured by the Eye Bank of Guangdong Province and used for keratoplasty at Zhongshan Ophthalmic Center, Sun Yat-sen University, between 2018 and 2025. During surgery, donor corneoscleral rim tissue was excised for bacterial and fungal culture. Culture-positive specimens underwent microbial identification and antimicrobial susceptibility testing (AST). Culture-positive corneas were compared across study years, pathogen categories, and donor procurement sources. ResultsOf the 7 442 donor corneas, 251 were culture-positive, corresponding to an overall culture positivity rate of 3.37%, with annual rates ranging from 1.50% to 5.31%. Among culture-positive corneas, 178 (70.92%) yielded bacteria alone, 72 (28.68%) yielded fungi alone, and 1 (0.40%) yielded both bacteria and fungi. Candida spp. and Aspergillus spp. were the predominant fungal isolates. Gram-negative bacteria were more frequently isolated than Gram-positive bacteria. The most common bacterial isolates were Acinetobacter baumannii, Staphylococcus epidermidis, Stenotrophomonas maltophilia, Enterococcus faecium, and Pseudomonas fluorescens. MDROs accounted for 75.47% of bacterial isolates, predominantly Acinetobacter baumannii, Staphylococcus epidermidis, and Enterococcus faecium, and demonstrated an increasing trend over the study period. Donor corneas procured through the Hospital Cornea Retrieval Program (HCRP) had a higher culture positivity rate than those obtained through Organ Procurement Organization (OPO) (P<0.000 1). Among culture-positive donor corneas, the proportion of fungal culture-positive corneas was significantly higher in the HCRP group than in the OPO group (P=0.001 5), whereas the proportion of MDROs among bacterial culture-positive corneas was significantly higher in the OPO group than that in the HCRP group (P=0.005 2). ConclusionsThe overall culture positivity rate of donor corneas from the Eye Bank of Guangdong Province is relatively low, indicating that the risk of microbial contamination is controlled. However, pathogen profiles and antimicrobial resistance patterns varies by procurement source. Ongoing microbiological and antimicrobial resistance surveillance, together with optimized donor risk assessment and timely reporting of culture results, may further improve eye bank quality management and help inform strategies for preventing post-keratoplasty infections.
3.Analysis of Postoperative Obesity and Glucolipid Metabolism Characteristics in Children and Adolescent with Craniopharyngioma
Zulin LIU ; Chenchen GAO ; Dilong WANG ; Huilian DAI ; Lele HOU ; Hui OU ; Zhe MENG ; Liyang LIANG
Journal of Sun Yat-sen University(Medical Sciences) 2026;47(4):747-755
ObjectiveTo investigate the incidence, glucolipid metabolism characteristics, and associated factors of postoperative overweight/obesity in children and adolescent with craniopharyngioma. MethodsA retrospective study was conducted using follow-up data from 44 patients (aged 0-18 years) diagnosed with craniopharyngioma who underwent surgical treatment and received follow-up care at Sun Yat-sen Memorial Hospital, Sun Yat-sen University, between January 2006 and February 2024. The incidence and glucolipid metabolism characteristics of overweight/obesity were summarized, and potential influencing factors were analyzed. ResultsA total of 44 patients were enrolled. The mean age at surgery was (8.57 ± 4.25) years, and the mean age at last follow-up was (16.02 ± 5.36 )years. The mean follow-up duration was (7.45 ± 4.64) years (range, 8 months to 17.5 years). The preoperative incidence of overweight/obesity was 40.91% (predominantly overweight, 27.27%), which increased to 68.18% postoperatively (predominantly obesity, 50.00%). Postoperatively, all patients (44/44, 100%) underwent fasting plasma glucose (FPG) testing, among whom 2 (4.55%) had impaired fasting glucose (IFG). Fasting insulin (FINS) was measured in 20 patients, and insulin resistance was identified in 11 (55.00%). Oral glucose tolerance testing (OGTT) with insulin release assessment was performed in 12 patients, and all (100%) exhibited abnormal insulin secretion, including 5 (41.67%) with hyperinsulinemia and 3 (25.00%) diagnosed with diabetes mellitus (DM). All patients (44/44, 100%) underwent lipid profile assessment. The incidence of dyslipidemia was 81.82% (36/44), including elevated non-high-density lipoprotein cholesterol (29/44, 65.91%), hypertriglyceridemia (29/44, 65.91%), low high-density lipoprotein cholesterol (22/44, 50.00%), and mixed hyperlipidemia (13/44, 29.55%). Logistic regression analysis indicated that preoperative overweight/obesity and postoperative abnormal glucose metabolism were significant factors associated with postoperative overweight/obesity. Compared with normal-weight patients, those with postoperative overweight/obesity had higher FINS levels (14.22 mU/L vs. 3.57 mU/L), higher insulin resistance index(HOMA-IR) (2.88 vs. 0.52), and a higher incidence of abnormal glucose metabolism (77.78% vs. 23.08%). However, no significant difference was observed in the incidence of dyslipidemia (94.44% vs. 73.08%). ConclusionsChildren and adolescent with craniopharyngioma exhibit a higher incidence of overweight/obesity than healthy peers preoperatively, which becomes more pronounced after surgery. This is accompanied by a high incidence of glucolipid metabolic disorders, placing these patients at increased risk of metabolic syndrome, which warrants clinical attention and regular metabolic assessment. In patients who develop postoperative obesity, particular attention should be given to the risk of glucose metabolism abnormalities, and further monitoring of glucose homeostasis is recommended.
4.Microbial Culture Results and Pathogen Profiles of Donor Corneas in Eye Bank
Jianping JI ; Huicong HU ; Zhancong OU ; Rongrong CHEN ; Jiabi LIANG ; Nandan WU ; Xiaojuan DONG ; Ting HUANG
Journal of Sun Yat-sen University(Medical Sciences) 2026;47(5):886-898
ObjectiveTo analyze the microbial culture positivity rate, pathogen spectrum, prevalence of multidrug-resistant organisms (MDROs), and differences among donor procurement sources in corneas from the Eye Bank of Guangdong Province, and to provide evidence for eye bank quality control and the prevention of post-keratoplasty infections. MethodsThis retrospective study included 7 442 donor corneas procured by the Eye Bank of Guangdong Province and used for keratoplasty at Zhongshan Ophthalmic Center, Sun Yat-sen University, between 2018 and 2025. During surgery, donor corneoscleral rim tissue was excised for bacterial and fungal culture. Culture-positive specimens underwent microbial identification and antimicrobial susceptibility testing (AST). Culture-positive corneas were compared across study years, pathogen categories, and donor procurement sources. ResultsOf the 7 442 donor corneas, 251 were culture-positive, corresponding to an overall culture positivity rate of 3.37%, with annual rates ranging from 1.50% to 5.31%. Among culture-positive corneas, 178 (70.92%) yielded bacteria alone, 72 (28.68%) yielded fungi alone, and 1 (0.40%) yielded both bacteria and fungi. Candida spp. and Aspergillus spp. were the predominant fungal isolates. Gram-negative bacteria were more frequently isolated than Gram-positive bacteria. The most common bacterial isolates were Acinetobacter baumannii, Staphylococcus epidermidis, Stenotrophomonas maltophilia, Enterococcus faecium, and Pseudomonas fluorescens. MDROs accounted for 75.47% of bacterial isolates, predominantly Acinetobacter baumannii, Staphylococcus epidermidis, and Enterococcus faecium, and demonstrated an increasing trend over the study period. Donor corneas procured through the Hospital Cornea Retrieval Program (HCRP) had a higher culture positivity rate than those obtained through Organ Procurement Organization (OPO) (P<0.000 1). Among culture-positive donor corneas, the proportion of fungal culture-positive corneas was significantly higher in the HCRP group than in the OPO group (P=0.001 5), whereas the proportion of MDROs among bacterial culture-positive corneas was significantly higher in the OPO group than that in the HCRP group (P=0.005 2). ConclusionsThe overall culture positivity rate of donor corneas from the Eye Bank of Guangdong Province is relatively low, indicating that the risk of microbial contamination is controlled. However, pathogen profiles and antimicrobial resistance patterns varies by procurement source. Ongoing microbiological and antimicrobial resistance surveillance, together with optimized donor risk assessment and timely reporting of culture results, may further improve eye bank quality management and help inform strategies for preventing post-keratoplasty infections.
5.Comprehensive application of fingerprint studies, content determination, and chemometrics to identify geo-markers of Chuanxiong Rhizoma.
Meng-Yuan WU ; Cheng PENG ; Chun-Wang MENG ; Juan-Ru LIU ; Qin-Mei ZHOU ; Ou DAI ; Liang XIONG
China Journal of Chinese Materia Medica 2025;50(1):152-171
This study established a high performance liquid chromatography(HPLC) fingerprint of Chuanxiong Rhizoma from different producing areas and screened its potential differential components for producing areas by chemometrics. Furthermore, the content of the above differential components in Chuanxiong Rhizoma from different producing areas was measured and compared. Then, the geoherbalism markers(geo-markers) that can be used to distinguish Dao-di and non-Dao-di Chuanxiong Rhizoma were excavated by chemometrics. In fingerprint studies, a total of 27 common peaks were determined, and the fingerprint similarity for 37 batches of Chuanxiong Rhizoma samples from different producing areas was above 0.968. The orthogonal partial least squares-discriminant analysis(OPLS-DA) was capable of distinguishing Chuanxiong Rhizoma from Sichuan and from three other provinces, as well as Dao-di Chuanxiong Rhizoma(from Dujiangyan) and non-Dao-di Chuanxiong Rhizoma(from other producing areas) in Sichuan province. Meanwhile, 14 potential differential components in Chuanxiong Rhizoma from different provinces and 16 potential differential components in Chuanxiong Rhizoma from different producing areas in Sichuan were screened by the variable importance in projection(VIP) analysis under OPLS-DA. The reference standards were used to identify 10 potential differential components in the common peaks, and subsequent content determination verified that the content of the above 10 potential differential components was different among different producing areas. Then, the OPLS-DA and VIP analysis were performed with the content of the 10 potential differential components as variables. The results showed that Z-ligustilide, chlorogenic acid, and the ratio of butylidenephthalide/senkyunolide A were the geo-markers that can distinguish Chuanxiong Rhizoma from Sichuan and Chuanxiong Rhizoma from Shaanxi, Hebei, and Jiangxi, while Z-ligustilide, n-butylphthalide, and the ratios of Z-ligustilide/senkyunolide A and butylidenephthalide/senkyunolide A were the geo-markers that can distinguish Dao-di Chuanxiong Rhizoma(from Dujiangyan) and non-Dao-di Chuanxiong Rhizoma(from other producing areas) in Sichuan province. This study elucidated the differences in material basis of Dao-di and non-Dao-di Chuanxiong Rhizoma based on fingerprinting and content determination combined with chemometrics, which provides a reference for the study of material basis of Dao-di traditional Chinese medicine.
Drugs, Chinese Herbal/chemistry*
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Rhizome/chemistry*
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Chromatography, High Pressure Liquid/methods*
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Chemometrics/methods*
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Quality Control
6.The influence of in vitro aggregation of apheresis platelets on their quality
Huizhong LIU ; Huaheng LI ; Dawei CHEN ; Daixiao OU ; Huibin ZHONG ; Yue ZHANG ; Huaqin LIANG
Chinese Journal of Blood Transfusion 2025;38(12):1742-1746
Objective: To study the impact of disaggregation on the quality of in vitro aggregated apheresis platelets. Methods: The apheresis platelets collected from Guangzhou Blood Center served as the study samples. The in vitro aggregated apheresis platelets after successful disaggregation were designated as the experimental group (referred to as the aggregation group), and apheresis platelets without in vitro aggregation during collection served as the control group. The product volume, platelet content, residual white blood cells, red blood cell contamination, pH value, CD62p expression rate, platelet morphology score and thromboelastography of both groups were respectively detected. Results: The routine quality control indicators such as product volume, platelet content, residual white blood cells, red blood cell contamination, and pH value of both groups all met the quality requirements. There were statistically significant differences in pH value (7.180 vs 7.071) between the two groups (P<0.05). There was no significant difference in product volume, platelet content, residual white blood cells, and red blood cell contamination between the two groups (P>0.05). The CD62p expression rate of the aggregation group was higher than that of the control group (42.386% vs 17.310%, P<0.05), while the cell morphology score of the aggregation group was lower than that of the control group (132.066 vs 141.166, P<0.05). No statistically significant differences were found in thromboelastography parameters (R-CK, K-CK, α angle, MA-CK, CI-CK) between the two groups (P>0.05). Conclusion: After the disaggregation of in vitro-aggregated apheresis platelets, the quality indicators met the national quality requirements. Although the expression rate of CD62p increased and the cell morphology score decreased, there were no statistically significant differences in the thromboelastography parameters between the two groups. This indicates that although some platelet activation occurred, it did not affect the hemostatic function of the platelets.
7.Research on Targeted Screening of Diflorasone Components in Health Products Using Feature Ion Guided Strategy Combined with High-Resolution Mass Spectrometry
Shuo-Jun OU ; Yin-Yin LIN ; Hai-Tao ZHANG ; Jian-Bin CEN ; Zhi-Yuan WANG ; Xin-Dong GUO ; Jia-Jun ZHANG ; Zhi-Sen LIANG ; Guang-Feng ZENG
Chinese Journal of Analytical Chemistry 2025;53(8):1320-1330,中插88-中插92
A method for determination and targeted screening of diflorasone components in health products using ultra performance liquid chromatography-quadrupole time of flight mass spectrometry(UPLC-Q-TOF/MS)was established.Four representative diflorasone and esters(diflorasone,diflorasone diacetate,diflorasone-17-propionate,and diflorasone-21-propionate)were selected to optimize the pretreatment conditions,and 10 mL of extraction solvent dosage,15 min of extraction time and 5 g of salting-out agent as the optimal conditions were selected by response surface methodology.The results showed that the four analytes exhibited good linearity within the concentration range of 2.0?100 μg/L with the chromatographic peak area,and the correlation coefficients(R2)were all greater than 0.9990,while the results of recovery and relative standard deviation could satisfy the requirements of determination.The common characteristic ions of diflorasone and esters werem/z121 andm/z335,and their specific structures were obtained by analyzing the cleavage pathway based on the optimized determination conditions.A targeted screening method for other esters of diflorasone based on characteristic ions guidance strategy was established.This method had many advantages such as high efficiency,high sensitivity and good reproducibility,and could be used for targeted screening of diflorasone and esters in health products.The developed characteristic ion guided strategy could be employed to construct mass spectral databases for various glucocorticoids,enabling comprehensive targeted screening across a broad range of compounds.
8.Study on Clinical Characteristics and Distribution of Traditional Chinese Medicine Syndrome Types in Patients with Colorectal Polyps and Their Relationship with Anxiety and Depression
Zhiqing LI ; Zeying OU ; Yueming GU ; Minlian LIANG ; Jinhui YANG ; Xinlei MA
Journal of Guangzhou University of Traditional Chinese Medicine 2025;42(1):18-25
Objective To investigate the clinical characteristics,distribution of traditional Chinese medicine(TCM)syndrome types,and the anxiety and depression status in patients with colorectal polyps.Methods From January 2022 to December 2023,a total of 200 cases of patients with colorectal polyps(polyp group)and 100 patients without intestinal abnormalities(non-polyp group)under colonoscope who received colonoscopy or treatment at the Endoscopy Center of Dongguan Hospital,Guangzhou University of Chinese Medicine were enrolled.The relevant medical information of the patients in the two groups were collected,and then TCM syndrome differentiation of patients with colorectal polyps were carried out,the general infromation including gender,age,body mass index(BMI),smoking history and alcohol-intake history was recorded,and Hospital Anxiety and Depression Scale(HAD)score was calculated for assessing their anxiety and depression status.Results(1)The investigation of clinical characteristics showed that between the polyp group and the non-polyp group,the differences in the general information of gender,age,BMI,smoking history and alcohol-intake history were statistically significant(P<0.05 or P<0.01).As for the gender,the polyp group was predominated by the male(63.5%),while the non-polyp group was predominated by the female(58.0%),indicating that male patients were more likely to suffer from colorectal polyps.In terms of the age,the age group of 51-60 years old accounted for a higher percentage(36.0%)in the polyp group,while the age group of 41-50 years old accounted for a higher percentage(38.0%)in the non-polyp group,indicating that the polyp group had an elder average age than the non-polyp group.In addition,the percentages of patients with obesity(BMI≥28.0 kg/m2),smoking history,and alcohol-intake history in the polyp group were higher than those in the non-polyp group.(2)The analysis of features of colorectal polyps showed that the polyps were mostly seen in the left colon,accounting for 53.5%in the polyp group;adenomatous polyps accounted for 57.0%of all polyps;the size of colorectal polyps was usually less than one centimeter,accounting for 81.5%of all polyps;single colorectal polyps accounted for 45.5%,and multiple colorectal polyps accounted for 54.5%,indicating that colorectal polyps were usually multiple.(3)Among the 200 patients with colorectal polyps,there were 93 cases of syndrome of stagnation dampness due to spleen deficiency(46.5%),59 cases of dampness-heat in large intestine syndrome(29.5%),27 cases of liver depression and qi stagnation syndrome(13.5%),and 21 cases of dampness and blood stasis obstruction syndrome(10.5%).There were no statistically significant differences in the distribution of TCM syndrome types among colorectal polyp patients with different genders,ages,BMIs and alcohol consumption(P>0.05).The difference in the distribution of TCM syndrome types among colorectal polyp patients with or without smoking history was statistically significant(P<0.05).No statistically significant differences were shown in the distribution of TCM syndrome types among the colorectal polyp patients with various foci,number of polyps,and pathological types(P>0.05).The difference in the distribution of TCM syndrome types in colorectal polyp patients with different polyp sizes was statistically significant(P<0.05).In the patients with the polyp size
9.Observation on the Therapeutic Effect of Internal and External Application of Osteoking in Treating Knee Osteoarthritis of Cold-Damp Blockage Type
Yixiao XIONG ; Qindai LIU ; Linhan BAI ; Sheng HUA ; Zuyu TANG ; Ke LIU ; Liang OU ; Jianjun KUANG
Journal of Guangzhou University of Traditional Chinese Medicine 2025;42(2):298-308
Objective To observe the clinical efficacy of oral use combined with targeted transdermal delivery of Osteoking in treating knee osteoarthritis(KOA)of cold-damp blockage type.Methods A total of 120 patients with KOA of cold-damp blockage type who admitted to Hunan Provincial Hospital of Integrated Traditional Chinese And West Medicine from September 2022 to September 2023 were randomly divided into the control group,oral use group,transdermal delivery group and combination group according to the random number table method,with 30 cases in each group.The control group was treated with Celecoxib Capsule orally,the oral use group was treated with Osteoking orally,the transdermal delivery group was treated with Osteoking by targeted transdermal delivery,and the combination group was treated with oral use combined with targeted transdermal delivery of Osteoking.One course of treatment covered 12 days,and all of the four groups were treated for two continuous courses.Before and after treatment,the scores of traditional Chinese medicine(TCM)syndrome,Visual Analogue Scale(VAS)for pain,Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC)for joint function,36-Item Short Form Health Survey(SF-36)for quality of life(QOL),as well as the levels of serum interleukin 1β(IL-1β),interleukin 6(IL-6),and tumor necrosis factor α(TNF-α)were observed in the patients of each group.After treatment,the clinical efficacy and safety of patients in each group were evaluated.Results(1)After two courses of treatment,the total effective rate of the combination group was 96.67%(29/30),which was higher than those of the control group[73.33%(22/30)],oral use group and transdermal delivery group[both being 70.00%(21/30)],and the difference was statistically significant(P<0.05).However,no statistically significant difference of the total effective rate was presented among the control group,oral use group,and transdermal delivery group(P>0.05).(2)After treatment,the scores of TCM syndrome,VAS for pain and WOMAC for joint function in the four groups were decreased compared with those before treatment(P<0.01).The intergroup comparison showed that the scores of TCM syndrome,VAS for pain and WOMAC in the combination group were lower than those in the other three groups(P<0.05),while no statistically significant difference of the scores of TCM syndrome,VAS for pain and WOMAC were presented among the control group,oral use group,and transdermal delivery group(P>0.05).(3)After treatment,the QOL scores of the eight dimensions of SF-36 such as physical functioning(PF),bodily pain(BP),general health(GH),vitality(VT),role-physical(RP),social functioning(SF),role-emotional(RE),and mental health(MH)in the four groups were significantly increased compared with those before treatment(P<0.01).The intergroup comparison showed that the scores of each dimension of SF-36 in the combination group were significantly higher than those in the other three groups(P<0.05),while no statistically significant difference of the dimension score of SF-36 was presented among the control group,oral use group,and transdermal delivery group(P>0.05).(4)After treatment,the levels of serum inflammatory factors of IL-1β,IL-6,and TNF-α in the four groups were decreased compared with those before treatment(P<0.01).The intergroup comparison showed that the decrease of serum levels of inflammatory factors in the combination group were significantly superior to those in the other three groups(P<0.05),and the decrease in the control group and oral use group were all superior to those in the transdermal delivery group(P<0.05),while the difference between the control group and oral use group was not statistically significant(P>0.05).(5)During the trial,no serious adverse reactions were found in the patients of four groups,which is of high safety.Conclusion Oral use combined with targeted transdermal delivery of Osteoking is effective on improving the joint pain,joint function and QOL of patients with KOA of cold-damp blockage type,and can speed up the rehabilitation of patients.Its therapeutic mechanism may be related to the decrease of the expression level of inflammatory factors.
10.Rauch-Steindl Syndrome Caused by NSD2 Mutation:A Case Report and Follow-up of Growth Hormone Therapy
Qun ZENG ; Siqi HUANG ; Hui OU ; Xiaojuan LI ; Liyang LIANG
Journal of Sun Yat-sen University(Medical Sciences) 2025;46(4):714-720
[Objective]To analyze the clinical characteristics,efficacy of growth hormone(GH)therapy,and follow-up of a child with Rauch-Steindl syndrome(RAUST)caused by NSD2 gene mutation,aiming to enhance pediatricians'understanding of this disorder.[Methods]We summarized the clinical features,gene test results,outcomes of GH therapy,and follow-up data of a child with RAUST syndrome caused by NSD2 mutation admitted to the Pediatric Endocrinology Department of Sun Yat-sen Memorial Hospital in April 2017,and then conducted a comparative analysis with relevant literature.[Results]The 2.9-year-old boy at initial visit was born prematurely at 36 weeks of gestation,with a birth weight of 1.7 kg and a body length of 42.0 cm.Clinical manifestations included intrauterine growth retardation,delayed language and motor development,extreme short stature(82.0 cm,-3.7 SD),emaciation,and distinctive facial features(triangular face,narrow jaw,prominent forehead,arched eyebrows,sparse eyebrows,high anterior hairline,crowded dentition),accompanied by bilateral cryptorchidism.Bone age was delayed by 1.4 years.Karyotyping and chromosomal microarray analysis were normal.GH therapy initiated at 3.8 years old yielded annual growth rates of 4.9-6.6 cm/year.When the treatment was discontinued at the age of 8.0,the boy's height was 113.7 cm(-3.0 SD),with subsequent decline in growth velocity.Whole exome sequencing in July 2024 identified a frameshift variant c.4028del(p.Pro1343Glnfs*49)in NSD2,which was confirmed as de novo pathogenic variation by parental Sanger sequencing.[Conclusions]This study reports the clinical features of RAUST syndrome caused by NSD2 mutation and explores the long-term efficacy of GH therapy.The findings contribute to a better understanding of this rare syndrome and further optimize its diagnosis and management.

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