1.Mechanism and Combination Therapy of Berberine in Treatment of Nonalcoholic Fatty liver Disease:A Review
Xiaojie WANG ; Heng ZHANG ; Sutong LIU ; Lihui ZHANG ; Wenxia ZHAO
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(5):269-281
Nonalcoholic fatty liver disease(NAFLD) is the most common chronic liver disease in the world. Because of its complex pathogenesis, high clinical prevalence and large population, it poses a great threat and challenge to public health in the world. Therefore, active intervention measures are needed. Currently, western medicine is effective in reducing weight, reducing liver fat content, improving glucose-lipid metabolism and insulin resistance. However, for patients with NAFLD-related fibrosis and cirrhosis, there is still a lack of sufficient histological evidence to support its benefits, and randomized controlled trials are still needed to clarify. Lifestyle intervention is an important cornerstone for the treatment of NAFLD, but there are many problems such as poor implementation and low compliance of patients, and the clinical efficacy is not ideal. Traditional Chinese medicine(TCM) has the significant advantages of multiple pathways and multiple targets. Berberine, the active ingredient of TCM, can interfere with the production of NAFLD from multiple pathways, including increasing energy consumption, weight loss, improving glucose-lipid metabolism, improving insulin resistance, anti-inflammatory, anti-oxidation, regulating intestinal flora, restoring bile acid homeostasis, anti-fibrosis and so on, which can play a positive role in the treatment of NAFLD. At the same time, it was found that the combination of BBR with Chinese and western medicines had significant advantages in promoting drug absorption, improving oral bioavailability, increasing the highest biological distribution in the liver, enhancing the overall therapeutic effect of NAFLD, and reducing adverse drug reactions, which could provide reference for clinical medication.
2.Study on the protective efect and mechanism of paeoniflorin on palmitic acid-induced HepG2 cells
Tong LIU ; Shanzheng LI ; Cheng ZHOU ; Sutong LIU ; Lihui ZHANG ; Wenxia ZHAO
Journal of Clinical Hepatology 2025;41(3):499-505
ObjectiveTo investigate the role and mechanism of action of paeoniflorin (PF) in protecting HepG2 cells induced by palmitic acid (PA). MethodsHepG2 cells were stimulated with PA at a concentration of 250 μmol/L to establish a NAFLD model. Compound C at a concentration of 10 μmol/L was used as an inhibitor, and PF at a concentration of 25 μmol/L was used for intervention. The experiment was divided into normal group (CON group) treated with complete culture medium, model group (MOD group) treated with PA, PF treatment group (MOD+PF group) treated with PA and PF, model+inhibitor group (MOD+COM group) treated with PA and Compound C, and model+inhibitor+PF group (MOD+COM+PF group) treated with PA, Compound C, and PF. Kits were used to measure lipid deposition indicators, liver function parameters, oxidative stress indicators, and inflammation indicators; oil red O staining was used to observe lipid deposition; Western Blot was used to measure the protein expression levels of AMPK, SIRT1, PGC-1α, mTOR, Beclin-1, LC3, and P62 in cells. The one-way analysis of variance was used for comparison of quantitative data between groups, while the Tukey’s test was used for comparison between two groups. ResultsCompared with the MOD group, PF improved the levels of TC and TG (P<0.05), reduced the levels of ALT, AST, CRP, TNF-α, IL-1β, and IL-6 (P<0.05), increased the activity of SOD and CAT and the level of GSH, and reduced the level of MDA in cells (all P<0.05). Oil red O staining showed that PF alleviated lipid deposition in cells. Western blot results showed that compared with the MOD group, PF increased the protein expression levels of p-AMPK, SIRT1, PGC-1α, LC3Ⅱ/LC3Ⅰ, and Beclin-1 and reduced the protein expression levels of p-mTOR and P62 (all P<0.05). ConclusionPF can inhibit PA-induced oxidative stress and inflammatory response in HepG2 cells, improve lipid deposition, and promote autophagy via the AMPK/SIRT1/PGC-1α/mTOR signaling pathway.
3.Clinical Effect of Xiaozhi Hugan Capsules in Treatment of Patients with Non-alcoholic Steatohepatitis and Its Impact on Serum IL-6 and MCP-1
Xiaoyan LIU ; Suping MA ; Qingliang MA ; Chunxiao LI ; Lihui ZHANG ; Huaxin CHEN ; Wenxia ZHAO
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(12):185-192
ObjectiveTo observe the clinical effect of Xiaozhi Hugan capsules in treating patients with non-alcoholic steatohepatitis (NASH) combined with phlegm-dampness and blood stasis syndrome and its effects on serum interleukin-6 (IL-6) and monocyte chemoattractant protein-1 (MCP-1). MethodsA total of 124 patients with NASH combined with phlegm-dampness and blood stasis syndrome who were admitted to the Department of Spleen, Stomach, and Hepatobiliary Diseases, the First Affiliated Hospital of Henan University of Chinese Medicine from July 2020 to December 2022 were selected. According to the random number table method, patients were randomly divided into an observation group (62 cases) and a control group (62 cases). The treatment duration was 6 months. The observation group received Xiaozhi Hugan capsules orally, while the control group received polyene phosphatidylcholine capsules. The efficacy indicators included alanine aminotransferase (ALT), aspartate aminotransferase (AST), controlled attenuation parameter (CAP), liver stiffness measurement (LSM), traditional Chinese medicine (TCM) syndrome scores (discomfort/dull pain/distending pain in liver region, fatigue, etc.), body mass index (BMI), waist-to-height ratio (WHtR), high-density lipoprotein cholesterol (HDL-C), total cholesterol (TC), triglycerides (TG), homeostatic model assessment for insulin resistance (HOMA-IR) [including fasting blood glucose (FBG) and fasting insulin level (INS)], free fatty acids (FFA), IL-6, and MCP-1. Adverse drug reactions were recorded. ResultsAfter treatment, the total effective rate in the observation group was 92.3% (48/52), while that in the control group was 75.5% (39/49). The total effective rate in the observation group was higher than that in the control group (χ2=5.339, P<0.05). After treatment, the TCM syndrome scores in both groups were significantly reduced (P<0.05), and the post-treatment scores in the observation group were better than those in the control group (P<0.05). After treatment, the levels of ALT, AST, TC, FFA, fasting insulin (FINS), HOMA-IR, MCP-1, IL-6, CAP, LSM, BMI, and WHtR were decreased (P<0.05) significantly in both groups, and the observation group showed superior improvement in the above indicators compared to the control group (P<0.05). The observation group exhibited significant reductions in TG and FBG (P<0.05) and an increase in HDL-C (P<0.05), while no significant changes were observed in the control group. The observation group was superior to the control group after treatment (P<0.05). No severe adverse reactions occurred in either group during the treatment. ConclusionXiaozhi Hugan capsules have significant clinical efficacy in treating patients with NASH combined with phlegm-dampness and blood stasis syndrome. It reduces hepatic steatosis, lowers liver stiffness, inhibits the expression of serum inflammatory factors, and alleviates liver inflammation. No obvious adverse reactions occur, suggesting it is suitable for clinical application.
4.Clinical Effect of Xiaozhi Hugan Capsules in Treatment of Patients with Non-alcoholic Steatohepatitis and Its Impact on Serum IL-6 and MCP-1
Xiaoyan LIU ; Suping MA ; Qingliang MA ; Chunxiao LI ; Lihui ZHANG ; Huaxin CHEN ; Wenxia ZHAO
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(12):185-192
ObjectiveTo observe the clinical effect of Xiaozhi Hugan capsules in treating patients with non-alcoholic steatohepatitis (NASH) combined with phlegm-dampness and blood stasis syndrome and its effects on serum interleukin-6 (IL-6) and monocyte chemoattractant protein-1 (MCP-1). MethodsA total of 124 patients with NASH combined with phlegm-dampness and blood stasis syndrome who were admitted to the Department of Spleen, Stomach, and Hepatobiliary Diseases, the First Affiliated Hospital of Henan University of Chinese Medicine from July 2020 to December 2022 were selected. According to the random number table method, patients were randomly divided into an observation group (62 cases) and a control group (62 cases). The treatment duration was 6 months. The observation group received Xiaozhi Hugan capsules orally, while the control group received polyene phosphatidylcholine capsules. The efficacy indicators included alanine aminotransferase (ALT), aspartate aminotransferase (AST), controlled attenuation parameter (CAP), liver stiffness measurement (LSM), traditional Chinese medicine (TCM) syndrome scores (discomfort/dull pain/distending pain in liver region, fatigue, etc.), body mass index (BMI), waist-to-height ratio (WHtR), high-density lipoprotein cholesterol (HDL-C), total cholesterol (TC), triglycerides (TG), homeostatic model assessment for insulin resistance (HOMA-IR) [including fasting blood glucose (FBG) and fasting insulin level (INS)], free fatty acids (FFA), IL-6, and MCP-1. Adverse drug reactions were recorded. ResultsAfter treatment, the total effective rate in the observation group was 92.3% (48/52), while that in the control group was 75.5% (39/49). The total effective rate in the observation group was higher than that in the control group (χ2=5.339, P<0.05). After treatment, the TCM syndrome scores in both groups were significantly reduced (P<0.05), and the post-treatment scores in the observation group were better than those in the control group (P<0.05). After treatment, the levels of ALT, AST, TC, FFA, fasting insulin (FINS), HOMA-IR, MCP-1, IL-6, CAP, LSM, BMI, and WHtR were decreased (P<0.05) significantly in both groups, and the observation group showed superior improvement in the above indicators compared to the control group (P<0.05). The observation group exhibited significant reductions in TG and FBG (P<0.05) and an increase in HDL-C (P<0.05), while no significant changes were observed in the control group. The observation group was superior to the control group after treatment (P<0.05). No severe adverse reactions occurred in either group during the treatment. ConclusionXiaozhi Hugan capsules have significant clinical efficacy in treating patients with NASH combined with phlegm-dampness and blood stasis syndrome. It reduces hepatic steatosis, lowers liver stiffness, inhibits the expression of serum inflammatory factors, and alleviates liver inflammation. No obvious adverse reactions occur, suggesting it is suitable for clinical application.
5.Association between serum creatinine/cystatin C ratio and nonalcoholic fatty liver disease in adults
Qizhen ZHANG ; Sutong LIU ; Lihui ZHANG ; Yajie GUAN ; Junjiao XU ; Wenxia ZHAO ; Minghao LIU
Journal of Clinical Hepatology 2025;41(6):1083-1089
ObjectiveTo investigate the association between serum creatinine/cystatin C ratio (CCR) and nonalcoholic fatty liver disease (NAFLD) based on the NHANES database, and to evaluate the potential significance of CCR as an indicator reflecting the metabolic status of the body. MethodsBased on the data from the NHANES database in 1999 — 2004, a total of 4 217 participants were enrolled and divided into NAFLD group with 1 726 participants and non-NAFLD group with 2 491 participants. CCR was compared between the two groups, and the association between CCR and NAFLD was analyzed. The Wilcoxon rank-sum test was used for comparison of continuous data between two groups, and the chi-square test was used for comparison of categorical data between two groups. The multivariate logistic regression model was used to investigate the association between CCR and NAFLD; CCR was divided into 4 groups based on quartiles, and odds ratio (OR) and 95% confidence interval (CI) in the regression model was calculated with the first quartile as reference. In addition, the restricted cubic spline analysis was used to investigate whether there was a non-linear relationship between CCR and NAFLD, and interaction items were introduced into the Logistic regression model to perform an interaction analysis. Subgroup analyses were performed based on the stratification of variables to investigate the difference in the association between CCR and NAFLD in different populations. ResultsThe non-NAFLD group had a significantly higher CCR than the NAFLD group (Z=-4.76,P<0.01). The Logistic regression analysis showed that in model 1 without adjustment of variables, CCR was negatively associated with NAFLD (OR=0.993,95%CI:0.989 — 0.996,P<0.01), and in model 3 with adjustment of all variables, CCR was still negatively associated with NAFLD (OR=0.986,95%CI:0.981 — 0.991,P<0.01). The analysis of CCR based on quartiles showed a significant association between the increase in CCR and the reduction in the risk of NAFLD. In model 3, compared with the individuals with the lowest quartile of CCR, the individuals with the highest quartile of CCR had a significantly lower risk of NAFLD (OR=0.426,95%CI:0.316 — 0.574,P<0.01). Further interaction and subgroup analyses showed that the interaction between CCR and age/sex had a statistical significance (Pinteraction<0.01 and Pinteraction=0.04). The subgroup analysis based on age showed a more significant association between CCR and NAFLD in the middle-aged population (≤60 years) (OR=0.982,95%CI:0.976 — 0.987), and the subgroup analysis based on sex showed a stronger association between CCR and NAFLD in women (OR=0.979,95%CI:0.972 — 0.986). ConclusionThis study shows a significant negative association between CCR and NAFLD, and such association is more significant in middle-aged individuals and women.
6.Clinical Study on Treatment of Non-alcoholic Steatohepatitis Patients with Dyslipidemia by Dizhuo Huayu Prescription with Catgut Embedding Therapy
Xiaoyan LIU ; Dongfang SHANG ; Lihui ZHANG ; Chenlu ZHAO ; Siying WANG ; Huaxin CHEN ; Wenxia ZHAO
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(20):152-159
ObjectiveTo observe the clinical efficacy and safety of Dizhuo Huayu prescription combined with catgut embedding therapy in patients with nonalcoholic steatohepatitis (NASH) and dyslipidemia and explore the effect of the combined therapy on inflammatory cytokines interleukin (IL)-18 and IL-1β. MethodsA total of 82 patients with NASH and dyslipidemia from the Gastroenterology Department of the First Affiliated Hospital of Henan University of Chinese Medicine were randomly divided into a control group and a treatment group, with 41 patients in each group. The control group received Polyene Polyenylphosphatidylcholine Capsules, while the treatment group received Dizhuo Huayu prescription granules combined with catgut embedding. The treatment duration was 24 weeks for both groups. At weeks 0, 12, and 24, the traditional Chinese medicine (TCM) syndrome score, body mass index (BMI), liver fat content assessed by Fibroscan (CAP value), the level of alanine transaminase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transferase (GGT), total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and free fatty acid (FFA), and the expression of inflammatory cytokines IL-18 and IL-1β in serum were observed. Adverse reactions in both groups were recorded. ResultsA comparison of the comprehensive therapeutic effects between the two groups after 24 weeks of treatment revealed that the total effective rate was 62.16% (23/37) in the control group and 85.71% (30/35) in the treatment group, with a statistically significant difference (χ2 = 5.14, P<0.05). At weeks 12 and 24 after treatment, the TCM syndrome score, BMI, CAP value, TC, TG, LDL-C, and FFA were all significantly lower in both groups compared to pre-treatment levels, while the HDL-C level significantly increased (P<0.05). The effect was better at week 24 (P<0.05) than at week 12 (P<0.05), and the treatment group showed better outcomes than the control group at weeks 12 and 24 after treatment (P<0.05). After 24 weeks of treatment, both groups exhibited significant reductions in IL-18 and IL-1β levels (P<0.05). The treatment group demonstrated superior efficacy compared to the control group after treatment (P<0.05). Both groups experienced decreases in ALT, AST, and GGT levels after treatment (P<0.05). However, there were no statistically significant differences between the 12-week and 24-week post-treatment values within each group, nor were there significant differences between the two groups. No significant adverse reactions were observed in both groups. ConclusionThe Dizhuo Huayu prescription combined with catgut embedding therapy is safe and effective in treating patients with NASH and dyslipidemia, exhibiting hepatoprotective, anti-inflammatory, lipid-regulating, and weight-reducing effects.
7.Clinical efficacy and safety of intravenous colistin sulfate monotherapy versus combination with nebulized inhalation for pulmonary infections caused by carbapenem-resistant gram-negative bacilli: a multicenter retrospective cohort study.
Danyang PENG ; Fan ZHANG ; Ying LIU ; Yanqiu GAO ; Lanjuan XU ; Xiaohui LI ; Suping GUO ; Lihui WANG ; Lin GUO ; Yonghai FENG ; Chao QIN ; Huaibin HAN ; Xisheng ZHENG ; Faming HE ; Xiaozhao LI ; Bingyu QIN ; Huanzhang SHAO
Chinese Critical Care Medicine 2025;37(9):829-834
OBJECTIVE:
To compare the efficacy and safety of intravenous colistin sulfate combined with nebulized inhalation versus intravenous monotherapy for pulmonary infections caused by carbapenem-resistant organism (CRO).
METHODS:
A multicenter retrospective cohort study was conducted. Clinical data were collected from patients admitted to the intensive care unit (ICU) of 10 tertiary class-A hospitals in Henan Province between July 2021 and May 2023, who received colistin sulfate for CRO pulmonary infections. Data included baseline characteristics, inflammatory markers [white blood cell count (WBC), neutrophil count (NEU), procalcitonin (PCT), C-reactive protein (CRP)], renal function indicators [serum creatinine (SCr), blood urea nitrogen (BUN)], life support measures, anti-infection regimens, clinical efficacy, microbiological clearance rate, and prognostic outcomes. Patients were divided into two groups: intravenous group (colistin sulfate monotherapy via intravenous infusion) and combination group ((intravenous infusion combined with nebulized inhalation of colistin sulfate). Changes in parameters before and after treatment were analyzed.
RESULTS:
A total of 137 patients with CRO pulmonary infections were enrolled, including 89 in the intravenous group and 48 in the combination group. Baseline characteristics, life support measures, daily colistin dose, and combination regimens (most commonly colistin sulfate plus carbapenems in both groups) showed no significant differences between two groups. The combination group exhibited higher clinical efficacy [77.1% (37/48) vs. 59.6% (52/89)] and microbiological clearance rate [60.4% (29/48) vs. 39.3% (35/89)], both P < 0.05. Pre-treatment inflammatory and renal parameters showed no significant differences between two groups. Post-treatment, the combination group showed significantly lower WBC and CRP [WBC (×109/L): 8.2±0.5 vs. 10.9±0.6, CRP (mg/L): 14.0 (5.7, 26.6) vs. 52.1 (24.4, 109.6), both P < 0.05], whereas NEU, PCT, SCr, and BUN levels showed no significant between two groups. ICU length of stay was shorter in the combination group [days: 16 (10, 25) vs. 21 (14, 29), P < 0.05], although mechanical ventilation duration and total hospitalization showed no significant differences between two groups.
CONCLUSIONS
Intravenous colistin sulfate combined with nebulized inhalation improved clinical efficacy and microbiological clearance in CRO pulmonary infections with an acceptable safety profile.
Humans
;
Colistin/therapeutic use*
;
Retrospective Studies
;
Administration, Inhalation
;
Anti-Bacterial Agents/therapeutic use*
;
Carbapenems/pharmacology*
;
Male
;
Female
;
Middle Aged
;
Gram-Negative Bacteria/drug effects*
;
Aged
;
Treatment Outcome
;
Respiratory Tract Infections/drug therapy*
8.Value of body roundness index in predicting the risk of metabolic dysfunction-associated fatty liver disease
Qizhen ZHANG ; Sutong LIU ; Lihui ZHANG ; Minghao LIU
Journal of Clinical Hepatology 2025;41(10):2054-2061
ObjectiveTo investigate the association between body roundness index (BRI) and the risk of metabolic dysfunction-associated fatty liver disease (MAFLD) based on the National Health and Nutrition Examination Survey (NHANES) database, as well as the clinical value of BRI as a noninvasive tool for risk prediction. MethodsBased on the NHANES data in 2015—2020, the 4 573 individuals were divided into MAFLD group with 2 508 individuals and non-MAFLD group with 2 065 individuals, and BRI was calculated for each individual. In order to ensure data quality and reduce the impact of abnormal values on analytical results, the boxplot method was used to remove abnormal levels of BRI and improve the robustness of data. The Wilcoxon rank-sum test was used for comparison of continuous data between two groups, and the chi-square test was used for comparison of categorical data between two groups. The multivariate Logistic regression model was established to investigate the association between BRI and MAFLD. BRI was divided into four groups based on quantiles, and with the first quantile (Q1) as reference, odds ratio (OR) and 95% confidence interval (CI) were calculated for the other three models. Restricted cubic spline was used to investigate the dose-effect relationship between BRI and MAFLD. The receiver operating characteristic (ROC) curve was plotted and the area under the ROC curve (AUC) was calculated to assess the efficacy of BRI in the diagnosis of MAFLD. The decision curve analysis was used to investigate the potential clinical value of the model in clinical practice. The interaction analysis and the subgroup analysis were performed to investigate the difference in the association between BRI and MAFLD between different populations. The Lasso regression analysis was conducted for the screening and analysis of characteristic variables. ResultsCompared with the non-MAFLD group, the MAFLD group had a significantly higher BRI (Z=36.29, P<0.001). After adjustment for the variables including age, sex, ethnicity, educational level, the proportion of individuals with poor income, marital status, smoking, hypertension, diabetes, alanine aminotransferase, aspartate aminotransferase, gamma-glutamyl transpeptidase, and high-density lipoprotein cholesterol, the fully adjusted Logistic regression model showed that BRI was significantly positively associated with the risk of MAFLD (OR=2.53, 95%CI: 2.28 — 2.80, P<0.001). In addition, the highest BRI quartile (Q4) group had a significantly higher risk of MAFLD than the lowest quartile (Q1) group (OR=83.45, 95%CI: 51.87 — 134.26, P<0.001). The restricted cubic spline analysis further confirmed the significant nonlinear association between BRI and MAFLD (P for nonlinear<0.001). The interaction analysis and the subgroup analysis showed that the interaction between hypertension and BRI had statistical significance (P for interaction=0.003), and compared with the individuals without hypertension, the individuals with hypertension had a stronger association between BRI and MAFLD (OR=1.60, 95%CI: 1.23 — 2.08, P<0.001). The ROC curve analysis showed that the fully adjusted model based on BRI had a strong discriminatory ability in differentiating MAFLD from non-MAFLD, with an AUC of 0.887 (95%CI: 0.877 — 0.896). The decision curve analysis showed that the fully adjusted model had good net benefits within the risk threshold of 0.10 — 0.75, which was commonly used in clinical practice. The model based on the key variables identified by the Lasso regression analysis had an AUC of 0.882 (95%CI: 0.872 — 0.892), which confirmed the robustness of the prediction results. ConclusionThere is a significant positive correlation between BRI and the risk of MAFLD, with a stronger association observed in the hypertensive population. As a body index reflecting abdominal obesity and visceral fat accumulation, BRI shows promising application prospects in the risk assessment of MAFLD.
9.Expert consensus on digital intraoral scanning technology
Jie YOU ; Wenjuan YAN ; Liting LIN ; Wen-Zhen GU ; Yarong HOU ; Wei XIAO ; Hui YAO ; Yaner LI ; Lihui MA ; Ruini ZHAO ; Junqi QIU ; Jianzhang LIU ; Yi ZHOU
Journal of Prevention and Treatment for Stomatological Diseases 2024;32(8):569-577
Digital intraoral scanning is a hot topic in the field of oral digital technology.In recent years,digital intra-oral scanning has gradually become the mainstream technology in orthodontics,prosthodontics,and implant dentistry.The precision of digital intraoral scanning and the accuracy and stitching of data collection are the keys to the success of the impression.However,the operators are less familiar with the intraoral scanning characteristics,imaging process-ing,operator scanning method,oral tissue specificity of the scanned object,and restoration design.Thus far,no unified standard and consensus on digital intraoral scanning technology has been achieved at home or abroad.To deal with the problems encountered in oral scanning and improve the quality of digital scanning,we collected common expert opin-ions and sought to expound the causes of scanning errors and countermeasures by summarizing the existing evidence.We also describe the scanning strategies under different oral impression requirements.The expert consensus is that due to various factors affecting the accuracy of digital intraoral scanning and the reproducibility of scanned images,adopting the correct scanning trajectory can shorten clinical operation time and improve scanning accuracy.The scanning trajec-tories mainly include the E-shaped,segmented,and S-shaped methods.When performing fixed denture restoration,it is recommended to first scan the abutment and adjacent teeth.When performing fixed denture restoration,it is recommend-ed to scan the abutment and adjacent teeth first.Then the cavity in the abutment area is excavated.Lastly,the cavity gap was scanned after completing the abutment preparation.This method not only meets clinical needs but also achieves the most reliable accuracy.When performing full denture restoration in edentulous jaws,setting markers on the mucosal tissue at the bottom of the alveolar ridge,simultaneously capturing images of the vestibular area,using different types of scanning paths such as Z-shaped,S-shaped,buccal-palatal and palatal-buccal pathways,segmented scanning of dental arches,and other strategies can reduce scanning errors and improve image stitching and overlap.For implant restora-tion,when a single crown restoration is supported by implants and a small span upper structure restoration,it is recom-mended to first pre-scan the required dental arch.Then the cavity in the abutment area is excavated.Lastly,scanning the cavity gap after installing the implant scanning rod.When repairing a bone level implant crown,an improved indi-rect scanning method can be used.The scanning process includes three steps:First,the temporary restoration,adjacent teeth,and gingival tissue in the mouth are scanned;second,the entire dental arch is scanned after installing a standard scanning rod on the implant;and third,the temporary restoration outside the mouth is scanned to obtain the three-di-mensional shape of the gingival contour of the implant neck,thereby increasing the stability of soft tissue scanning around the implant and improving scanning restoration.For dental implant fixed bridge repair with missing teeth,the mobility of the mucosa increases the difficulty of scanning,making it difficult for scanners to distinguish scanning rods of the same shape and size,which can easily cause image stacking errors.Higher accuracy of digital implant impres-sions can be achieved by changing the geometric shape of the scanning rods to change the optical curvature radius.The consensus confirms that as the range of scanned dental arches and the number of data concatenations increases,the scanning accuracy decreases accordingly,especially when performing full mouth implant restoration impressions.The difficulty of image stitching processing can easily be increased by the presence of unstable and uneven mucosal mor-phology inside the mouth and the lack of relatively obvious and fixed reference objects,which results in insufficient ac-curacy.When designing restorations of this type,it is advisable to carefully choose digital intraoral scanning methods to obtain model data.It is not recommended to use digital impressions when there are more than five missing teeth.
10.Effect of fisetin against venous thrombosis in rats and its mechanism
Lihui LONG ; Shuang WEI ; Qing LIU ; Yang YAO ; Juanni DONG ; Yuanyuan CHANG ; Enhui WEN
Journal of Xi'an Jiaotong University(Medical Sciences) 2024;45(3):383-387
Objective To analyze the effect of fisetin against venous thrombosis in rats.Methods Seventy SD rats were randomly divided into the following groups:sham-operation group,model group,fisetin 45 mg/kg,15 mg/kg,5 mg/kg groups,and aspirin group(47 mg/kg).The corresponding medication was administered by gavage once a day consecutively(the sham-operation group and the model group were given 0.5%carboxymethyl cellulose sodium solution with 10 mL/kg,respectively)for 7 consecutive days.One hour after the last administration,the rats were anesthetized,the lower part of the intersection of inferior vena cava and left renal vein was ligated with silk thread(no ligation in the sham-operation group),and the abdominal wall was sutured.Two hours later,the abdominal cavity was reopened,the other venous branches 1.5 cm away from the ligation site were closed with the artery clamp,and blood was collected from the abdominal aorta.The anticoagulant ratio of 3.8%sodium citrate∶whole blood was 1∶9.The venous thrombus 1 cm down from the ligation point of the intersection of inferior vena cava and left renal vein was cut and the thrombus was separated.The residual blood was dried with filter paper,weighed and recorded.Plasma was taken after anticoagulant blood centrifugation.The levels of plasma antithrombin-Ⅲ(AT-Ⅲ),protease C(PC),plasminogen(PLG),and plasminogen activator inhibitor(PAI-1)were detected by ELISA kits.Results Compared with the model group,the weight of thrombus in fisetin 45 mg/kg group and aspirin 47 mg/kg group decreased(P<0.01).The content of AT-Ⅲ in three fisetin groups increased(all P<0.05).The content of PC in fisetin 45 mg/kg increased(P<0.05).The content of PLG and PAI-1 in fisetin 45 mg/kg group decreased(both P<0.05).Conclusion Fisetin has the effect against venous thrombosis in vivo,and the effect is related to the upregulation of AT-Ⅲ and PC and the downregulation of PLG and PAI-1.


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