Objective To analyze the characteristics of pattern elements and the distribution of patterns of femoral head necrosis, hip osteoarthritis, and hip rheumatoid arthritis, in order to provide a theoretical basis for the "different diseases with the same pattern" of chronic bone diseases. Methods A cross-sectional survey was conducted to select patients with femoral head necrosis Association Research Circulation Osseous Ⅰ-Ⅱ stages, hip osteoarthritis Kellgren & Lawrence Ⅰ-Ⅱ stages, and acute or subacute hip rheumatoid arthritis who visited the Minimally Invasive Arthrology Department, Traumatology Department, and Rheumatology and Immunology Department of Beijing University of Chinese Medicine Third Affiliated Hospital from June 2020 to June 2022. The " case report form - traditional Chinese medicine pattern manifestation scale" previously developed by our team was used to collect the pattern manifestations, which were included into an Excel 2020 spreadsheet to establish a database. SPSS 20.0 software was used for factor analysis and cluster analysis to extract pattern element information, such as disease nature and location, in order to summarize the characteristics of pattern elements, the distribution of patterns, and the similarities and differences of the three kinds of early hip joint diseases.Results A total of 410 patients were included, including 150 patients with femoral head necrosis, 160 patients with hip osteoarthritis, and 100 patients with hip rheumatoid arthritis. The pattern elements of the disease nature of femoral head necrosis include phlegm (dampness), blood stasis, yang deficiency, essence deficiency, and qi deficiency. The pattern types were initially divided into four categories: syndrome of meridian obstruction (43.33％), syndrome of phlegm and blood stasis blocking collaterals (38.00％), syndrome of liver and kidney deficiency (12.00％), and syndrome of kidney essence deficiency (6.67％). The pattern elements of the disease nature of hip osteoarthritis include phlegm (dampness), blood stasis, qi deficiency, essence deficiency, yang deficiency, and cold (dampness). The pattern types were preliminarily divided into five categories: syndrome of spleen and kidney deficiency (37.50％), syndrome of meridian obstruction (26.87％), syndrome of cold and dampness obstruction (18.75％), syndrome of phlegm and blood stasis obstruction (9.38％), and syndrome of liver and kidney deficiency (7.50％). The pattern elements of the disease nature of hip rheumatoid arthritis include phlegm (dampness), blood stasis, qi deficiency, yin and yang deficiency, cold (dampness), and essence deficiency. The pattern types were preliminarily divided into four categories: syndrome of phlegm and blood stasis obstruction (34.00％), syndrome of cold and dampness obstruction (28.00％), syndrome of blood stasis blocking collaterals (23.00％), and syndrome of liver and kidney deficiency (15.00％). Overall, the top five pattern manifestations of the three kinds of hip joint diseases were hip joint pain (96.59％), tenderness (93.90％), fixed pain (87.56％), heavy joints (85.37％), and sourness of lower limbs (75.37％). The pattern elements of the disease nature include phlegm (dampness), blood stasis, qi deficiency, etc. The pattern types were preliminarily divided into five categories: syndrome of phlegm stasis blocking collaterals (33.17％), syndrome of meridian obstruction (31.95％), syndrome of cold dampness obstruction (21.46％), syndrome of liver and kidney deficiency (7.32％), and syndrome of spleen and kidney deficiency (6.10％). There were 21 similar pattern manifestations in the three kinds of early hip joint diseases, with blood stasis and spleen deficiency being the main pattern.Conclusion The common pattern characteristics of three kinds of early hip joint diseases are spleen deficiency and blood stasis. In addition, femoral head necrosis is accompanied with phlegm-dampness pattern, hip osteoarthritis is accompanied with kidney deficiency and phlegm-dampness pattern, hip rheumatoid arthritis is accompanied with kidney deficiency and cold-dampness pattern.

Objective:To evaluate the effect of lipoxin A4 on lipopolysaccharide (LPS)-induced activation of microglia and role of silent information regulator sirtuin 1 (SIRT1)/NF-κB signaling pathway.Methods:This experiment was performed in two parts.PartⅠ The well-growth BV2 microglia were divided into 4 groups ( n=30 each) using a random number table method: control group (group C), LXA4 group (group LXA4), LPS group (group LPS) and LPS+ LXA4 group (group LLI). PartⅡ The well-growth BV2 microglia were divided into 2 groups ( n=30 each) using a random number table method: LPS+ LXA4 group (group LL2) and LPS+ LXA4+ SIRT1 inhibitor EX527 group (group LLE). Cells in group C were commonly cultured without any treatment. In LXA4 group and LPS group, LXA4 (final concentration 100 nmol/L) and LPS (final concentration 100 ng/ml) were added respectively, and then the cells were incubated for 24 h. In LL1 group and LL2 group, LXA4 (final concentration 100 nmol/L) was added at 1 h before treatment with LPS, and the other treatments were similar to those previously described in LPS group. EX527 (final concentration of 5 μmol/L) was added at 30 min before treatment with LXA4, and the other treatments were similar to those previously described in LL2 group.The expression of inducible nitricoxide synthase (iNOS), CD32, arginine synthase 1 (Arg-1), CD206, interleuckin-1β (IL-1β), IL-6, tumor necrosis factor-α (TNF-α) and IL-10 mRNA was detected by real-time polymerase chain reaction. The concentrations of IL-1β, IL-6, TNF-α and IL-10 in the supernatant were measured using enzyme-linked immunosorbent assay. The content of ROS was detected by DCFH-DA. The activity of SOD was measured by WST-8 assay. The expression of NADPH oxidase 2 (NOX2), superoxide dismutase 1 (SOD1), heme oxygenase-1 (HO-1), SIRT1 and acetylated NF-κB p65 was detected by Western blot. Results:Compared with group C, the expression of iNOS, CD32, IL-1β, IL-6 and TNF-α mRNA was significantly up-regulated, the concentrations of IL-1β, IL-6 and TNF-α in the supernatant were increased ( P<0.05), no significant change was found in the expression of Arg-1, CD206 and IL-10 mRNA and IL-10 concentrations in the supernatant, the expression of NOX2 and HO-1 was up-regulated, SOD1 expression was down-regulated, the activity of SOD was decreased, the content of ROS was increased, the expression of SIRT1 was down-regulated, and the expression of acetylated NF-κB p65 was up-regulated in group LPS ( P<0.05). Compared with group LPS, the expression of iNOS, CD32, IL-1β, IL-6 and TNF-α mRNA was significantly down-regulated, the expression of Arg-1, CD206 and IL-10 mRNA was up-regulated, concentrations of IL-1β, IL-6 and TNF-α in the supernatant were decreased, the concentration of IL-10 was increased, the expression of NOX2 was down-regulated, the expression of HO-1 and SOD1 was up-regulated, the activity of SOD was increased, the content of ROS was decreased, the expression of SIRT1 was up-regulated, and the expression of acetylated NF-κB p65 was down-regulated in group LL1 ( P<0.05). Compared with group LL2, the concentrations of IL-1β, IL-6 and TNF-α in the supernatant were significantly increased, the activity of SOD was decreased, the content of ROS was increased ( P<0.05), and no significant change was found in the IL-10 concentration in the supernatant in group LLE ( P>0.05). Conclusions:LXA 4 can inhibit LPS-induced polarization of microglia to M1 phenotype, and the mechanism may be related to enhancement of SIRT1 activity and inhibition of NF-κB transcriptional activity.

OBJECTIVE： To analyze the formulation regularity of Chinese patent medicine for knee osteoarthritis （KOA）， and to provide reference for the clinical standard use of Chinese patent medicine for KOA and the research and development of new drugs. METHODS： Chinese Pharmacopoeia （2015 edition， part Ⅰ），National Drug Reimbursement List （2017 edition）， National Essential Drug List （2017 edition）， Chinese Materia Medica Preparation （1992 version）， Compilation of National Standard for Chinese Patent Medicines （2002 edition）， Handbook of Rational Application of Chinese Patent Medicines in Surgery and Orthopedics （2010 edition） were searched to collect the type and formulation of Chinese patent medicines for “KOA”， “osteoarthritis”， “Bi syndrome”， “promoting blood circulation and removing blood stasis， dispelling wind and removing dampness， tonifying liver and kidney”. Supplementary the type and formulations of Chinese patent medicines for KOA by questionaire survey of clinial experts. The types， properties， meridian tropism， frequency and combination of medicinal materials used in Chinese patent medicine formulations were counted by using TCM inheritance auxiliary platform software V 2.5. The association rules and entropy clustering method were used to analyze the formulation regularity. RESULTS： A total of 190 Chinese patent medicines were collected， involving 289 TCM. With the top 10 used frequency being Angelica sinensis （75 times）， Boswellia carterii （55 times）， Carthamus tinctorius （53 times）， Commiphora myrrha （51 times）， Achyranthes bidentata （49 times）， Notopterygium incisum （47 times）， Angelica pubescens （45 times）， Saposhnikovia divaricata （45 times）， Angelica dahurica （39 times）， Ligusticum chuanxiong （39 times）. Medicinal material were mainly Xinwen in properties field and mainly liver meridian and spleen meridian in meridian entry field. Top 5 frequency of medicinal material combinations were C. myrrha-B. carterii， B. carterii-A. sinensis， A. sinensis-N. incisum， A. bidentata-A. sinensis， L. chuanxiong-A. sinensis. 14 core medicinal material combinations and 7 new developed formulations were concluded. CONCLUSIONS： This study analyzed the formulation regularity of Chinese patent medicines for KOA with the help of TCM inheritance auxiliary platform software V 2.5， which can provide reference for clinical differentiation of symptoms and signs and research and development of related new medicines related to KOA.

Objective To observe the effects of obesity on dose-response curve of rocuronium in female patients and calculate ED9 5 of rocuronium.Methods Eighty female patients,aged 18-45 years, falling into ASA grade Ⅰ or Ⅱ,schedualed for elective surgery under general anesthesia,undergoing surgery less than 1.5 h,were included in the study.The patients with body mass index of 20-25 kg/m2 as group N were randomized to divided group N1,group N2,group N3 and group N4.Anoth-er 40 patients with body mass index of 30-35 kg/m2 as group B were randomized to divided group B1, group B2,group B3 and group B4.When the first twitch height of TOF (T1)was 100%,groups N1-N4 and groups B1-B4 patients were injected rocuronium 0.075,0.1,0.1 5,0.3 mg/kg respectively. The first dose of rocuronium in each group,T1 maximum inhibition degree and onset time were re-corded.The relationship between probit-transformed depression of T1 and the logarithm dose of rocu-ronium was analyzed by linear regression.ED50 and ED9 5 of rocuronium in obese and normal body weight patients were calculated.Results Dose-response curve equation of each group were Y1 =3.464X1 -2.23 and Y2 = 3.843X2 - 2.750 respectively(P < 0.05 ).The ED50 and ED9 5 (95% CI)of rocuronium were 0.122 (0.092-0.1 65 )mg/kg and 0.324 (0.242-0.433 )mg/kg in group N,and were 0.103 (0.078-0.133)mg/kg and 0.25 1 (0.1 93-0.326)mg/kg in group B.Conclusion Obesity significantly affects the dose-response curve of young women and can enhance the sensitivity of them to the rocuronium.The ED9 5 of obese patients is 0.25 1 mg/kg.

OBJECTIVETo observe the effect of Huogu II formula compatible with different channel ushering drugs on the homing of bone marrow stem cells of osteonecrosis of the femoral head (ONFH) induced by liquid nitrogen freezing in rabbits and discuss the mechanism for preventing and treating ONFH.

METHODThe ONFH model was established by liquid nitrogen freezing of 84 rabbits. They were randomly assigned to the model group and the Huogu II formula group and groups of Huogu II formula combining with Achyranthis Bidentatae Radix, Asari Radix et Rhizoma, Angelicae Pubescentis Radix, Platycodonis Radix. The remaining 14 rabbits were sham-operated. During the course of ONFH modeling, all of the rabbits were subcutaneously injected with recombinant human granulocyte colony-stimulating factor (rhG-CSF)(30 microg x kg(-1) x d(-1), for consecutively 7 days). Meanwhile, normal saline and decoction of the formulae were orally administrated respectively. WBC was counted in peripheral blood before and after the injection of rhG-CSF. HE stainings at the 2nd and the 4th weeks after the modeling were adopted to observe histopathological changes, vascular morphology was observed by ink perfusion, BrdU and SDF-1 were determined by immunohistochemical assay in femoral heads of the left hind leg.

RESULTCompared with the sham-operated group, the Huogu II formula group showed decrease in the ratio of empty lacuna and increase in vessel area, number of BrdU positive cells and SDF-1 level. In comparison with the model group, the Achyranthis Bidentatae Radix group displayed decreasing empty lacuna ratio and increasing vessel area at the 4th week and increasing SDF-1 at the 2nd week; the Platycodonis Radix group revealed a notably increasing empty lacuna ratio and a sharp decrease in the number of BrdU positive cells at 4th week; Asari Radix et Rhizoma and Angelicae Dubescentis Radix groups showed no remarkable change.

CONCLUSIONHuogu II formula can promote the directional homing of bone marrow stem cell to the necrosis area. Channel ushering drug achyranthes can further boost above effects of Huogu II formula.

Animals ; Bone Marrow Cells ; cytology ; Bromodeoxyuridine ; metabolism ; Chemokine CXCL12 ; metabolism ; Disease Models, Animal ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Femur Head Necrosis ; blood ; drug therapy ; metabolism ; pathology ; Gene Expression Regulation ; drug effects ; Humans ; Leukocyte Count ; Male ; Rabbits ; Stem Cells ; cytology ; drug effects

OBJECTIVETo learn the effects of coptis in treating neonatal jaundice and to find the index that guides the clinical administration of the medicine.

METHODClinical data of 412 cases of neonatal jaundice were studied retrospectively, and univariate and multivariate analysis were made to the factors affecting the incidence according to the Cox model which led to the establishment of the predictive equation. According to the regression coefficients, the relative risk, wald value, the coptis effects were evaluated on the incidence of neonatal jaundice.

RESULTSingle-factor Cox model analysis shows that there are five main factors affecting the incidence of neonatal jaundice, Multivariate Cox model analysis indicates that the five main factors are also independent factors that affect the incidence, the roles of which, ranking from minor to major are, in turn, age, applied coptis, ethnic, G6PD deficiency and cesarean section. Among them, the regression coefficient is -0.259, relative risk 0.772, wald value 6.832. It sugguests that coptis may reduce the incidence of neonatal jaundice, and that it is a protective factor. The prediction equation, by regression coefficients, which has been used to establish the incidence of neonatal jaundice, is as following: h(t, x) = h0 (t) exp (- 0.022 x2 - 0.494x3 + 0.344x8 + 0.226x9 - 0.259x10).

CONCLUSIONCoptis is one of the important factors that affect the occurrence of neonatal jaundice, and it has a protective effect in preventing neonatal jaundice from occurrence.

Coptis ; chemistry ; Drugs, Chinese Herbal ; administration & dosage ; adverse effects ; Female ; Humans ; Infant, Newborn ; Jaundice, Neonatal ; drug therapy ; Male ; Proportional Hazards Models ; Retrospective Studies

Objective To study the mechanism of killing and apoptosis-inducing effects of Capparis spinosa alkaloid (CSA) on human hepatocarcinoma cell line HepG2. Methods The killing effect of CSA on human hepatocarcinoma cell line HepG2 was studied by MTT method. Morphological observation of HepG2 cells was carried out by fluorescence microscope. Results The CSA had obvious cytotoxicity on the HepG2 in a dose-dependent manner and its IC50 value was 142.82 ?g/mL. The HepG2 cells showed the characteristic morphologic changes of apoptosis by the function of CSA and the apoptosis percentage is higher than that of the natural one. The progress of cells cycle from S phase to G2 phase had been blocked by CSA. The intracellular Ca2+ level had been increased by the function of CSA, which was positively related with drug concentration. Conclusion CSA has obviously killing and apoptosis-inducing effects on human hepatocarcinoma cell line HepG2 and calcium overload might also be invovled in these events.