Osteoporosis is a prevalent skeletal condition characterized by reduced bone mass and strength, leading to increased fragility. Buqi-Tongluo (BQTL) decoction, a traditional Chinese medicine (TCM) prescription, has yet to be fully evaluated for its potential in treating bone diseases such as osteoporosis. To investigate the mechanism by which BQTL decoction inhibits osteoclast differentiation in vitro and validate these findings through in vivo experiments. We employed MTS assays to assess the potential proliferative or toxic effects of BQTL on bone marrow macrophages (BMMs) at various concentrations. TRAcP experiments were conducted to examine BQTL's impact on osteoclast differentiation. RT-PCR and Western blot analyses were utilized to evaluate the relative expression levels of osteoclast-specific genes and proteins under BQTL stimulation. Finally, in vivo experiments were performed using an osteoporosis model to further validate the in vitro findings. This study revealed that BQTL suppressed receptor activator of NF-κB ligand (RANKL)-induced osteoclastogenesis and osteoclast resorption activity in vitro in a dose-dependent manner without observable cytotoxicity. The inhibitory effects of BQTL on osteoclast formation and function were attributed to the downregulation of NFATc1 and c-fos activity, primarily through attenuation of the MAPK, NF-κB, and Calcineurin signaling pathways. BQTL's inhibitory capacity was further examined in vivo using an ovariectomized (OVX) rat model, demonstrating a strong protective effect against bone loss. BQTL may serve as an effective therapeutic TCM for the treatment of postmenopausal osteoporosis and the alleviation of bone loss induced by estrogen deficiency and related conditions.
Animals ; NFATC Transcription Factors/genetics* ; Drugs, Chinese Herbal/pharmacology* ; Ovariectomy ; Osteoclasts/metabolism* ; Female ; Osteogenesis/drug effects* ; Rats, Sprague-Dawley ; Rats ; NF-kappa B/genetics* ; Osteoporosis/genetics* ; Signal Transduction/drug effects* ; Bone Resorption/genetics* ; Cell Differentiation/drug effects* ; Humans ; RANK Ligand/metabolism* ; Mitogen-Activated Protein Kinases/genetics* ; Transcription Factors

Ponatinib is a multi-target tyrosine kinase inhibitor (TKI) indicated as second-line therapy for chronic myeloid leukemia and Philadelphia chromosome-positive acute lymphoblastic leukemia. It is the first BCR-ABL kinase inhibitor that targets ABL-T315I, and is effective for patients who have received multiple treatments or lack sensitivity to first or second-generation TKIs. However, the cardiovascular toxicities of ponatinib are frequent and serious. The common cardiovascular adverse events of ponatinib are arterial occlusive events, hypertension, myocardial infarction, etc. The mechanisms of these events might be related to platelet dysfunction, vascular endothelial dysfunction, and myocardial injury. Once adverse cardiovascular events occur in the treatment of ponatinib, dose reduction and even therapy discontinuation are common measures, which might hinder the tumor therapeutic effect in patients. Intervention measures can be formulated according to the "ABCDE" method to reduce the risk of cardiovascular toxicity of ponatinib.

Ponatinib is a multi-target tyrosine kinase inhibitor (TKI) indicated as second-line therapy for chronic myeloid leukemia and Philadelphia chromosome-positive acute lymphoblastic leukemia. It is the first BCR-ABL kinase inhibitor that targets ABL-T315I, and is effective for patients who have received multiple treatments or lack sensitivity to first or second-generation TKIs. However, the cardiovascular toxicities of ponatinib are frequent and serious. The common cardiovascular adverse events of ponatinib are arterial occlusive events, hypertension, myocardial infarction, etc. The mechanisms of these events might be related to platelet dysfunction, vascular endothelial dysfunction, and myocardial injury. Once adverse cardiovascular events occur in the treatment of ponatinib, dose reduction and even therapy discontinuation are common measures, which might hinder the tumor therapeutic effect in patients. Intervention measures can be formulated according to the "ABCDE" method to reduce the risk of cardiovascular toxicity of ponatinib.

Objective To systematically review the efficacy of different artificial liver support systems in the treatment of acute-on-chronic liver failure (ACLF) using a network Meta-analysis. Methods PubMed, Embase, the Cochrane library, Clinical Trial, CNKI, SinoMed, and Wanfang Data were searched for randomized controlled trials (RCTs) on different artificial liver support systems in the treatment of ACLF. Literature screening, data extraction, and method ological quality assessment were performed according to inclusion and exclusion criteria, and Stata15.1 software and R4.1.0 software were used to perform a network Meta-analysis. Results A total of 14 RCTs were included, with 1141 patients in total. The network meta-analysis showed different intervention methods had no significant difference in reducing mortality rate based on cross comparison (all P > 0.05). The probability ranking diagram showed that plasma exchange (PE) showed the best effect in reducing 30-day mortality rate, followed by extracorporeal liver assist device (ELAD), fractionated plasma separation and adsorption with Prometheus system, molecular adsorbent recirculating system (MARS), Biologic-DT liver dialysis device, and PE+MARS. PE showed the best effect in reducing 90-day mortality rate, followed by Prometheus, ELAD, and MARS. Biologic-DT showed the best effect in improving hepatic encephalopathy, followed by MARS, PE+MARS, and ELAD. Patients undergoing ELAD had the lowest risk of bleeding, and compared with standard medical treatment, Biologic-DT might increase the risk of bleeding [risk ratio=1.9×10 8 , 95% confidence interval: (4.6-6.2)×10 27 ]. Conclusion PE might be the best option for reducing 30- and 90-day mortality rates in ACLF patients. Biologic-DT has a better effect in improving hepatic encephalopathy, but it may increase the risk of bleeding.

Objective:To retrospectively evaluate the clinical effect of mitral valve repair for rheumatic mitral stenosis.Methods:We retropectively analyze the clinical datd of 50 rheumatic mitral disease patients undergoing mitral valve repair from January 2016 to March 2019, the clinical outcome was compaired with those of patients undergoing mitral valve replacement. The operation time, cardiopulmonary bypass time, blood loss, ICU time, hospital stay, and postoperative cardiac function were analyzed, and followed up for 2 years to assess mitral regurgitation, cardiac function, and complication rates.Results:The time of cardiopulmonary bypass and ascending aorta occlusion in the valve repair group were longer than those in the valve replacement group ( P<0.05), and the postoperative ventilator assistance time, ICU stay time, and hospital stay were shorter than those in the valve replacement group ( P<0.05). After 2 years of follow-up, no patients died in the two groups. The rehospitalization rate in the valve repair group was lower than that in the replacement group ( P<0.05), and there was no significant difference in the reoperation rate between the groups ( P>0.05); There was 1 case (2%) of moderate mitral valve regurgitation in the mitral valve repair group, no moderate or severe mitral valve stenosis, no paravalvular leakage in the mitral valve replacement group, and no significant difference between the two groups ( P>0.05). The left ventricular end-diastolic diameter and left ventricular ejection fraction in the mitral valve repair group were significantly better than those in the mitral valve replacement group ( P<0.05). Conclusion:Mitral valve repair is effective in treating rheumatic mitral stenosis. It is beneficial to protect heart function, reduce postoperative anticoagulation complications, and does not increase the rate of reoperation. It is a safe, effective and feasible treatment.

Objective: To observe the clinical efficacy and safety of Q-modulated laser combined with compound repair of oligosaccharides in the treatment of melasma. Methods: From January 2017 to December 2018, 90 patients with chloasma were divided into Q-switched laser treatment group (control group) and Q-switched laser combined repair oligopeptide treatment group (experimental group) according to random number table method. In the experimental group, the interval between microneedle introduction of oligopeptide and Q-switched laser therapy was 2 weeks, and the treatment was carried out alternately. Each treatment lasted for 4 months, with a total of 8 treatments completed. The control group was treated with Q-switched laser only. Each patient was treated four times, once a month for four months. All patients were evaluated before treatment and 1 month after treatment. Evaluation indicators: (1) Macular severity index (MASI), calculating its decline rate, analyzing the improvement of chloasma; (2) Applying Visia skin analyzer to evaluate the characteristic count of brown spots, calculating its decline rate; (3) Doctors Subjectively Evaluate Patient Pigmentation Legacy; (4) Patient self-evaluation. Measuring data were tested by t-test and counting data by Chi square test. Results: All subjects completed the treatment. Most of the chloasma in the two groups improved significantly after treatment. In the control group, the MASI decreased by 75.61%, 1 case of inefficiency, 13 cases of improvement, 28 cases of marked improvement and 3 cases of recovery. In the experimental group, the MASI decreased by 85.25%, 0 cases of inefficiency, 6 cases of improvement, 27 cases of significant improvement and 12 cases of recovery. Comparing the improvement of the two groups, the experimental group was better than the control group, the difference was statistically significant (χ²=9.00, P=0.03). After treatment, the number of chloasma brown spots in the two groups improved significantly. In the control group, the decrease rate of chloasma brown spots was (1.59 ± 1.33)% and in the trial experiment was (3.45± 1.54)%. The experimental group was better than the control group, and the difference between the two groups was statistically significant (P=0.01). The overall evaluation of therapeutic effect by doctors showed that 95.56% (43/45) of the patients in the experimental group had clearance rate greater than 75%, which was better than 86.67% (39/45) of the control group. There was a significant difference between the two groups (P<0.05). The self-evaluation result showed that the improvement rate of the experimental group was 66.67% (30/45) which was more than 75%, which was better than 37.78% (17/45) of the control group. The difference was statistically significant (P=0.04). Conclusions Q-switched laser combined with compound repair oligopeptide can effectively treat chloasma with less adverse reactions.

The knowledge of endocrine metabolic diseases represented by type 2 diabetes mellitus is highly specialized, complicated, and has many clinical guidelines. In this context, team based learning teaching combined with case teaching based on evidence-based medicine was applied in the actual class teaching. The class was divided into several groups and the students were encouraged to discuss and study from each other with the guidance of teachers. Consequently, students' learning interests and spirit of team-work were greatly enhanced, the way of thinking using evidence-based medicine and their ability to solve the practical clinical problems were also improved.

Objective:To explore the association between rheumatoid arthritis(RA)and two polymorphisms of interleukin-17(IL-17F)rs763780 and rs2397084.Methods: A systematic search of relevant studies was conducted in China National Knowledge Infrastructure,Wanfang Chinese Periodical Database,China Biology Medical Literature Database,Pubmed,Embase and Web of Science.Results: A total of 5 case-control studies including 1 174 RA cases and 966 health controls for rs763780 and 985 RA cases and 766 health controls for rs2397084 were included in this Meta-analysis.The results showed that rs763780 was significantly associated with increased susceptibility to RA(C vs.T:OR=1.74,95%CI=1.01-2.98,P=0.04;CC vs.TT:OR=3.17,95%CI=1.21-8.35,P=0.02;CT vs.TT:OR=1.80,95%CI=1.21-2.66,P=0.004;CC+CT vs.TT:OR=1.96,95%CI=1.35-2.83,P<0.001;CC vs.CT+ TT:OR=2.97,95%CI=1.13-2.66,P=0.03).In subgroup analysis based on ethnicity,rs763780 was positively correlated with RA in Europeans.No significant association was found between rs2397084 and RA.Conclusion: The present study revealed that IL-17F rs763780 polymorphism is a risk factor of RA,while the association of rs2397084 with RA remains uncertain.

OBJECTIVE:To systematically review the effectiveness and safety of Yinzhihuang oral liquid in the adjuvant treat-ment of neonatal jaundice,and provide evidence-based reference for clinical treatment. METHODS:Retrieved from CJFD,VIP Da-tabase,Wanfang Database,Medline and EMBase,randomized controlled trials(RCT)about the effectiveness of Yinzhihuang oral liquid(test group)based on the canventional treatment(control group)in the adjuvant treatment of neonatal jaundice were collect-ed,and Meta-analysis was performed by using Rev Man 5.2 software after data extracting and quality evaluating by modified Jadad. RESULTS:Totally 12 RCTs were enrolled,involving 1585 patients. Results of Meta-analysis showed total effective rate [OR=0.19,95%CI(0.12,0.30),P<0.001],serum total bilirubin levels [MD=-40.78,95%CI(-42.68,-38.89),P<0.001] and time of bilirubin decreased to normal [MD=-2.56,95%CI(-2.72,-2.40),P<0.001] in test group were significantly better than control group,the differences were statistically significant between 2 groups;3 reports of adverse reactions showed scme children had vomiting and mild diarrhea,they were improved after symptomatic treatment,and it did not affect the treatment. CONCLU-SIONS:The effectiveness of Yinzhihuang oral liquid is good in the adjuvant treatment of neonatal jaundice,with mild adverse reac-tions.

OBJECTIVE:Tosystematically evaluate the efficacy of Yixinshu capsule in the adjuvant treatmentof angina pecto-ris,and provide evidence-based reference for clinical treatment. METHODS:Retrieved from CJFD,VIP Database,Wanfang Data-base,Medline and EMBase,randomized controlled trials(RCT)about the efficacyof Yixinshu capsule(test group)versus other drugs (control group) in the adjuvant treatment of angina pectoris were collected. Meta-analysis was performed bu using Rev Man 5.2 software after data extraction and quality evaluation by modified Jadad. RESULTS:Totally 11 RCTs were enrolled,involving 1 827 pa-tients. Results of Meta-analysis showed the total effective rate of angina pectoris improvement [OR=0.30,95%CI(0.23,0.40),P<0.001] and electrocardiogram improvement [OR=0.52,95%CI(0.41,0.66),P<0.001] in test group were significantly higher than control group,there was significant difference between 2 groups. CONCLUSIONS:Yixinshu is effective for the adjuvant treatment of angina pectoris.