BACKGROUND:Previous studies have found that for postmenopausal osteoporosis patients,the Bushen Jianpi Formula can help regulate serum osteoclast-and osteoblast-related factors and intestinal flora levels,improve clinical symptoms of patients and further improve efficacy.OBJECTIVE:To investigate the effect of Bushen Jianpi Formula on bone metabolism and bone microarchitecture in ovariectomized rats.METHODS:Twenty-four female SD rats were randomly divided into four groups by random number table method:sham operation group(n=6)was subjected to periovarian fat removal,and bilateral ovariectomy was performed in model group(n=6),alendronate group(n=6),and Bushen Jianpi Formula group(n=6).Five days after modeling,the Bushen Jianpi Formula group was given Bushen Jianpi Formula by intragastric administration(once a day).The alendronate sodium group was given alendronate by intragastric administration(once a week).The sham operation group and model group were given an equal volume of normal saline by intragastric administration(once a day)for 12 consecutive weeks.After intragastric administration,serum levels of procollagen Ⅰ N-terminal peptide,β-isomerized C-terminal telopeptide of type Ⅰ collagen degradation product,and tumor necrosis factor α were detected.The distal femur microstructure was detected by Micro-CT.The femoral tissue morphology was observed by hematoxylin-eosin staining.The expression of type Ⅰ collagen and tumor necrosis factorα in the femur was detected by immunohistochemical staining.RESULTS AND CONCLUSION:(1)The serum ELISA test showed that compared with the sham operation group,the level of procollagen Ⅰ N-terminal peptide in the model group decreased(P＜0.05),and the levels of degradation products of β-isomerized C-terminal telopeptide of type Ⅰ collagen and tumor necrosis factor α increased(P＜0.05).Compared with the model group,the levels of the procollagen Ⅰ N-terminal peptide in the Bushen Jianpi Formula group and the alendronate sodium group increased(P＜0.05),and the levels of β-isomerized C-terminal telopeptide of type Ⅰ collagen degradation products and tumor necrosis factor α decreased(P＜0.05).(2)Micro-CT three-dimensional reconstruction showed that compared with the sham operation group,the number of bone trabeculae in the model group was significantly reduced,the continuity was worsened,and the gaps were increased.Both alendronate sodium and Bushen Jianpi Formula had a positive improvement effect on this phenomenon.(3)Hematoxylin-eosin staining showed that compared with the sham operation group,the number of bone trabeculae in the model group was reduced and the shape became thinner,and the network structure was destroyed.Compared with the model group,the number of bone trabeculae in the Bushen Jianpi Formula group and the alendronate sodium group increased,the shape became thicker,and the reticular structure was restored.(4)Immunohistochemical staining showed that compared with the sham operation group,the expression of type Ⅰ collagen was reduced and tumor necrosis factor α expression was increased in the model group.Compared with the model group,the expression of type Ⅰ collagen increased and the expression of tumor necrosis factor α decreased in the Bushen Jianpi Formula group and the alendronate sodium group.The results show that the Bushen Jianpi Formula can effectively improve bone metabolism and bone microstructure in ovariectomized rats.

Objective To evaluate the role of distortion product otoacoustic emissions (DPOAE) testing in evaluating early hearing loss among noise-exposed workers. Methods A total of 174 noise-exposed workers in a metal shipbuilding enterprise were selected as the research subjects by the convenience sampling method. Pure tone audiometry (PTA), DPOAE and the level of noise exposure were conducted on the workers. The rank correlation analysis was used to analyze the correlation between DPOAE amplitude and PTA threshold. The multilevel model was used to analyze the effects of gender, age, noise exposure intensity, cumulative noise exposure (CNE), hearing loss classification and PTA threshold on DPOAE results. Results At the frequencies of 0.50, 1.00, 2.00, 3.00, 4.00, 6.00 and 8.00 kHz, the DPOAE amplitude was negatively correlated with the PTA threshold (rank correlation coefficients were -0.12, -0.48, -0.47, -0.18, -0.23, -0.44, -0.19, respectively, all P<0.01). At the most frequencies, DPOAE amplitude was negatively correlated with age and CNE (all P<0.05). The results of multilevel model analysis showed that there were significant differences in DPOAE amplitudes at certain frequencies across gender, age, noise intensity, CNE, and hearing loss classification (all P<0.05). Significant differences in DPOAE responses were found among different CNE and hearing loss groups (all P<0.01). Conclusion DPOAE testing can objectively reflect the hearing status of noise-exposed workers and could be considered for inclusion in routine hearing monitoring to facilitate early detection of noise-induced hearing loss.

OBJECTIVE To investigate the mechanism of the inhibitory effect of total flavonoids from Taraxacum mongolicum on high-fat diet-induced obesity in mice through modulation of intestinal flora.METHODS Twenty-four C57BL/6J mice were randomly divided into blank group,model group and T.mongolicum total flavonoid group,with 8 mice in each group.Except for the blank group,the other 2 groups were given a high-fat diet,while T mongolicum total flavonoid group was given T.mongolicum total flavonoid[400 mg/(kg·d)]intragastrically,once a day,for 8 consecutive weeks.During the experiment,the food intake of each group of mice was recorded.After the last medication,the body mass,fat weight,blood lipid level and pathological changes of liver and epididymal fat in mice were evaluated to observe the effect of T.mongolicum total flavonoid on the treatment of obesity in mice.The changes in abundance and structure of intestinal flora in mice were detected by amplicon sequencing;the effects of T.mongolicum total flavonoids on fat metabolism related genes were analyzed by qPCR.RESULTS Compared with model group,the body weight of mice in T.mongolicum total flavonoids group was decreased significantly(P＜0.05);the levels of total lipid cholesterol,triglycerides,and LDL cholesterol were all decreased significantly(P＜0.01),and the level of HDL cholesterol was increased significantly(P＜0.01);the fat indexes of inguinal white adipose tissue and epididymal white adipose tissue were significantly reduced(P＜0.05);significant improvement in hepatocellular steatosis and adipose cytopathy were significantly improved;mRNA expressions of COX7A1 and COX8B were significantly upregulated(P＜0.05).The results of bacterial colony detection showed that compared with the model group,there was a rising trend in the diversity of the bacterial colony in T.mongolicum total flavonoids group,and the Sobs index characterization and β diversity were increased significantly(P＜0.05).Relative abundances of Blautia,norank_f_Ruminococcaceae,Bilophila,Alistipes,classified_f_Ruminococcaceae,Parabacteroides,norank_f_Desulfovibrionaceae,Anaerotruncus were significantly up-regulated(P＜0.05),while those of Faecalibaculum,Erysipelatoclostridium,GCA-900066575,Tuzzerella,Lactobacillus,norank_f_norank_o_RF39,achnospiraceae_FCS020_group were significantly down-regulated(P＜0.05).CONCLUSIONS T.mongolicum total flavonoids can reduce body mass,fat weight and blood lipid levels,and repair the pathological damage to liver and epididymal fat in obese mice,which is related to improving intestinal flora disorders caused by high-fat diet.

BACKGROUND:Previous studies have found that for postmenopausal osteoporosis patients,the Bushen Jianpi Formula can help regulate serum osteoclast-and osteoblast-related factors and intestinal flora levels,improve clinical symptoms of patients and further improve efficacy.OBJECTIVE:To investigate the effect of Bushen Jianpi Formula on bone metabolism and bone microarchitecture in ovariectomized rats.METHODS:Twenty-four female SD rats were randomly divided into four groups by random number table method:sham operation group(n=6)was subjected to periovarian fat removal,and bilateral ovariectomy was performed in model group(n=6),alendronate group(n=6),and Bushen Jianpi Formula group(n=6).Five days after modeling,the Bushen Jianpi Formula group was given Bushen Jianpi Formula by intragastric administration(once a day).The alendronate sodium group was given alendronate by intragastric administration(once a week).The sham operation group and model group were given an equal volume of normal saline by intragastric administration(once a day)for 12 consecutive weeks.After intragastric administration,serum levels of procollagen Ⅰ N-terminal peptide,β-isomerized C-terminal telopeptide of type Ⅰ collagen degradation product,and tumor necrosis factor α were detected.The distal femur microstructure was detected by Micro-CT.The femoral tissue morphology was observed by hematoxylin-eosin staining.The expression of type Ⅰ collagen and tumor necrosis factorα in the femur was detected by immunohistochemical staining.RESULTS AND CONCLUSION:(1)The serum ELISA test showed that compared with the sham operation group,the level of procollagen Ⅰ N-terminal peptide in the model group decreased(P＜0.05),and the levels of degradation products of β-isomerized C-terminal telopeptide of type Ⅰ collagen and tumor necrosis factor α increased(P＜0.05).Compared with the model group,the levels of the procollagen Ⅰ N-terminal peptide in the Bushen Jianpi Formula group and the alendronate sodium group increased(P＜0.05),and the levels of β-isomerized C-terminal telopeptide of type Ⅰ collagen degradation products and tumor necrosis factor α decreased(P＜0.05).(2)Micro-CT three-dimensional reconstruction showed that compared with the sham operation group,the number of bone trabeculae in the model group was significantly reduced,the continuity was worsened,and the gaps were increased.Both alendronate sodium and Bushen Jianpi Formula had a positive improvement effect on this phenomenon.(3)Hematoxylin-eosin staining showed that compared with the sham operation group,the number of bone trabeculae in the model group was reduced and the shape became thinner,and the network structure was destroyed.Compared with the model group,the number of bone trabeculae in the Bushen Jianpi Formula group and the alendronate sodium group increased,the shape became thicker,and the reticular structure was restored.(4)Immunohistochemical staining showed that compared with the sham operation group,the expression of type Ⅰ collagen was reduced and tumor necrosis factor α expression was increased in the model group.Compared with the model group,the expression of type Ⅰ collagen increased and the expression of tumor necrosis factor α decreased in the Bushen Jianpi Formula group and the alendronate sodium group.The results show that the Bushen Jianpi Formula can effectively improve bone metabolism and bone microstructure in ovariectomized rats.

Objective To explore the effect of oral neuromuscular training combined with intermittent theta burst stimulation(iTBS)on dysphagia of nasopharyngeal carcinoma patients after chemoradiotherapy.Methods Seventy-six nasopharyngeal carcinoma patients with dysphagia who received chemoradiotherapy in The Second Affiliated Hospital of Air Force Medical University from March 2021 to March 2022 were enrolled and divided into two groups by random number table methods.Control group received conventional swallowing training,and observation group received oral neuromuscular training combined with iTBS.The swallowing function was assessed by video fluoroscopic swallowing study(VFSS)and Rosenbek penetration aspiration scale(PAS)at the baseline and after treatment.The quality of life and treatment effect were compared between the two groups.Results After intervention,the PAS score was decreased and the Swallowing Quality-of-Life Questionnaire(SWAL-QOL)score was increased in both groups(P＜0.05),with significant differences between the two groups(P＜0.05).The treatment efficacy of dysphagia in the observation group was significantly higher than that in the control group(86.84%vs 44.74%,P＜0.05).Conclusion Oral neuromuscular training combined with iTBS can effectively ameliorate dysphagia and improve the quality of life of patients with nasopharyngeal carcinoma after chemoradiotherapy.

Aim To investigate the levels of a disintegrin and metalloprotease 10(ADAM-10)and soluble uro-kinase plasminogen activator receptor(suPAR)in the serum of hypertension patients with atherosclerosis and their relation-ship with the severity of disease.Methods From February 2021 to February 2023,125 hypertension patients with atherosclerosis who visited our hospital were collected as the study group,and 76 healthy people were collected as control group.The patients in the study group were grouped into mild group(n=40),moderate group(n=42)and severe group(n=43)according to the degree of atherosclerosis,after 60 days of treatment,the patients were grouped into a good prog-nosis group(n=74)and a poor prognosis group(n=51)based on their prognosis.Enzyme linked immunosorbent assay(ELISA)was applied to measure serum ADAM-10 and suPAR levels;Clinical data of patients with different prognosis were compared;Pearson method was applied to analyze the relationship between serum ADAM-10,suPAR levels and carotid in-tima-media thickness(IMT)in patients with hypertension and atherosclerosis;Multivariate Logistic regression was applied to analyze the influencing factors of poor prognosis in patients with hypertension and atherosclerosis;Receiver operating characteristic(ROC)curve was applied to evaluate the predictive value of ADAM-10 and suPAR alone and jointly for poor prognosis of hypertension with atherosclerosis.Results The levels of serum ADAM-10 and suPAR were significantly higher in the study group than those in control group(P＜0.05);The serum ADAM-10 and suPAR levels in moderate group and severe group were obviously higher than those in mild group(P＜0.05),while the serum ADAM-10 and suPAR levels were obviously higher in severe group than those in moderate group(P＜0.05);The serum ADAM-10 and suPAR levels,left and right IMT,systolic blood pressure,and diastolic blood pressure of patients with poor prognosis were signifi-cantly higher than those of patients with good prognosis(P＜0.05);Pearson correlation analysis showed that serum ADAM-10 and suPAR levels in patients with hypertension and atherosclerosis were positively correlated with systolic blood pres-sure,diastolic blood pressure and IMT(P＜0.001);Logistic regression analysis showed that the increased levels of systolic blood pressure,diastolic blood pressure,ADAM-10,suPAR and IMT were risk factors for poor prognosis of hypertension patients with atherosclerosis(P＜0.05);ROC curve analysis showed that the area under the curve(AUC)of serum AD-AM-10 and suPAR levels alone and jointly predicting poor prognosis of hypertension with atherosclerosis was 0.819,0.830 and 0.900,respectively,the combination of the two was superior to their individual predictions(Zcombination-AD AM-10=2.766,P=0.006;Zcombination-suPAR=2.602,P=0.009).Conclusion The levels of serum ADAM-10 and suPAR in patients with hypertension and atherosclerosis are significantly increased,and are positively correlated with the severity of atherosclero-sis.Both of them have a high predictive value for evaluating the prognosis of patients with hypertension and atherosclerosis.

Objective:To explore the mediating effect of self-regulation fatigue between acceptance of hearing impairment and work withdrawal behavior in young and middle-aged patients with sudden deafness, so as to provide reference for the formulation of intervention measures for job withdrawal behavior.Methods:A cross-sectional survey was conducted to facilitate the selection of 326 young and middle-aged patients with sudden deafness who were treated in the Department of Otolaryngology, Head and Neck Surgery in the First Affiliated Hospital and the Second Affiliated Hospital of Air Force Military Medical University of the Chinese PLA from February 2021 to January 2022. The survey was carried out by general information questionnaire, the Revised Acceptance Disability Scale, the Self-Regulatory Fatigue Scale, and the Work Withdrawal Behavior Scale. Structural equation model method was used to analyze the mediating effect.Results:The acceptance of hearing impairment score in young and middle-aged patients with sudden deafness was (59.82 ± 10.99) points, the self-regulation fatigue score was (60.38 ± 8.84) points, and the work withdrawal behavior score was (39.06 ± 6.51) points. Self-regulation fatigue was negatively correlated with acceptance of hearing impairment ( r=-0.541, P<0.01). Work withdrawal behavior was negatively correlated with acceptance of hearing impairment ( r=-0.488, P<0.01), and was positively correlated with self-regulation fatigue ( r=0.587, P<0.01). Self-regulation fatigue played a partial mediating effect between the acceptance of hearing impairment and work withdrawal in young and middle-aged patients with sudden deafness, and the mediating effect ratio was 56.30%. Conclusions:The acceptance of hearing impairment can not only directly affect the work withdrawal behavior of young and middle-aged patients with sudden deafness, but also indirectly affect their work withdrawal behavior through self-regulation fatigue. Medical staff should pay attention to the internal relationship between the acceptance of hearing impairment, self-regulation fatigue and work withdrawal behaviors, so as to improve the acceptance of hearing impairment of patients, relieve their self-regulation fatigue, and avoid the occurrence of work withdrawal behaviors.

Objective:To investigate the relationship between prolonged PR interval and carotid atherosclerosis(CAS)in middle-aged and elderly patients with type 2 diabetes mellitus(T2DM).Methods:A total of 537 middle-aged and elderly inpatients with T2DM in the Southern Branch of the Sixth People′s Hospital of Shanghai Jiaotong University from January 2019 to January 2021 were selected as the research objects. Color Doppler ultrasound was used to detect bilateral carotid artery intima-media thickness(CIMT). The subjects were divided into carotid atherosclerosis group(CAS group, n=352)and non-carotid atherosclerosis group(NCAS group, n=185). The difference in the PR interval of ECG between the two groups was compared. Pearson or Spearman rank correlation analysis was used for evaluating the correlation of PR interval and CAS lesions with various clinical index. The relationship between PR interval and CAS lesions was adopted by multivariate logistic regression analysis. Results:The average PR interval of middle-aged and elderly patients with T2DM was(164.57±23.02)ms. The average PR interval in CAS group was significantly higher than that in NCAS group [(169.76±24.28) vs (154.70±16.42)ms, P<0.01]. The results of multifactorial logistic regression analysis showed that age, low density lipoprotein-cholesterol, serum osteocalcin, and PR interval were independent factors influencing the development of CAS lesions in middle-aged and elderly patients with T2DM( OR=1.079, 1.936, 0.879, 1.039, respectively, P<0.05 or P<0.01)where each 1 ms increase in PR interval was associated with a 3.9% increase in the risk of CAS in middle-aged and elderly patients with T2DM( OR=1.039, 95% CI 1.006-1.073, P=0.020). Multivariate logistic regression analysis showed that middle-aged and elderly type 2 diabetic patients with PR interval≥158 ms were 4.072 times more likely to have CAS lesions than those with PR interval<158 ms( OR=4.072, 95% CI 1.417-11.702, P<0.01). Conclusion:The PR interval of electrocardiogram is correlated with CAS lesions in middle-aged and elderly patients with T2DM. Middle-aged and elderly type 2 diabetic patients with significantly prolonged PR interval should be reminded to screen for CAS lesions early.

Objective To explore the clinical phenotype and genetic variation of familial short stature. Method The clinical data of a familial short stature pedigree in Guangxi Zhuang autonomous region were retrospectively analyzed. The disease-causing gene was identified using targeted high-throughput sequencing combined with Sanger sequencing in May 2017. The related literature were searched and the relationship between the clinical phenotype and genotype of the ACAN gene mutation were summarized. Results The two patients were brothers, one was 9-year and 10-month old boy and the other was 7-year-old boy. Both of them had short stature. Their parents were non-consanguineous marriage and both were 150 cm in height, with. Their uncle and grandpa are also short stature. Gene sequencing revealed a novel heterozygous variation c.6193delC (p.Gln2065Serfs*27) in exon 12 of ACAN gene in both brothers, which were inherited from their father. No report of this mutation was found by searching literature and databases. A total of 11 related articles in English were retrieved. Totally (including our study) 32 patients in 41 families were reported to have the pathogenic variants of ACAN gene, including 4 variants from Chinese children, but no such reports were found in Chinese literatures. The most common clinical manifestation is idiopathic short stature, which is mostly familial but could also be sporadic. Some children also suffered from osteoarthritis, disc herniation or degeneration. Most of the children had advanced bone age, but some of them were normal or even lagged. Treatment of postponing puberty by growth hormone combined with gonadotropin-releasing hormone analogues can effectively improve final height. Conclusion Heterozygous mutation of ACAN gene can cause short stature in children and has significant familial genetic characteristics, and the clinical characteristics have no relationship with genotypes.

Objective:To study the origin traceability of anemarrhenae rhizoma from Bozhou and Hebei based on multi-element fingerprints technology , and establish a discrimination model .Methods:The contents of 48 elements were determined by using induc-tively coupled plasma mass spectrometry ( ICP-MS) for 44 samples of anemarrhenae rhizome from Bozhou and Hebei province .Princi-pal component analysis ( PCA) and orthogonal partial least squares discrimination analysis ( OPLS-DA) were applied in the data analy-sis to screen out the significant elements .And then Fisher linear discrimination analysis was used to determine the origin of anemarrhe-nae rhizoma and the discrimination models were developed .Results:Two discrimination models were developed by the discrimination a-nalysis of the whole model method with nine significant elements identified by PCA and OPLS -DA, and 100％correct classification and 95.5％cross validation were achieved by the models .Conclusion: It is a promising approach to classify the geographical origin of anemarrhenae rhizome based on multi-element fingerprints analysis combined with multivariate statistical analysis .The discrimination models are good enough to be applied in the origin traceability of anemarrhenae rhizome.