OBJECTIVE To explore the effectiveness and possible mechanism of Shangke Lengtong Patch in treating knee osteo-arthritis with cold-dampness arthralgia obstruction.METHODS A total of 70 patients who met the inclusion criteria of knee osteoar-thritis with cold-dampness arthralgia obstruction in the Orthopedics Department of Affiliated Hospital of Nanjing University of Chinese Medicine from November to December 2024 were randomly divided into an experimental group and a control group,with 35 cases in each group.During the treatment,1 case dropped out of the experimental group,3 cases dropped out of the control group,and 1 case was discontinued.The experimental group was treated with Shangke Lengtong Patch,and the control group was treated with Compound Nanxing Zhitong Ointment.The WOMAC scores and TCM syndrome scores of the two groups before and after treatment were compared to comprehensively evaluate the clinical efficacy.The changes in the expression levels of CGRP,substance P,HMGB1,IL-1β,CX-CL12,and CXCR4 in the serum of the two groups were detected by ELISA.RESULTS After 3,7,and 14 d of treatment,the WOMAC scores and TCM syndrome scores of the two groups were significantly reduced(P<0.05,P<0.01),and the score of aggrava-ted cold in the experimental group was better than that in the control group at 7 d of treatment(P<0.05);after 14 d of treatment,the expression levels of CGRP,substance P,HMGB1,IL-1β,CXCL12,and CXCR4 in the serum of the two groups were significantly re-duced(P<0.05),and there was no statistical difference between the two groups.CONCLUSION Shangke Lengtong Patch can sig-nificantly relieve the pain symptoms of knee osteoarthritis patients with cold-dampness arthralgia obstruction and improve the joint func-tion of patients.It may improve synovial inflammation by inhibiting the HMGB1/CXCL12/CXCR4 pathway,thereby exerting a thera-peutic effect.

OBJECTIVE To explore the intervention mechanism of Shangke Lengtongtie on cold hyperalgesia in KOA mice based on the HMGB1/CXCL12/CXCR4 signaling axis.METHODS Monosodium iodoacetate(MIA)was used for the intra-articular injec-tion into the knee joint to establish mice model of knee osteoarthritis(KOA).Peripheral blood monocytes were extracted from mice,cultured,and then reinfused into the tail vein of the mice.Subsequently,in vivo animal imaging was used to observe the recruitment sites of these monocytes.The cold hyperalgesia threshold was measured at various time points in each group of mice.Hematoxylin and eosin(HE)staining was used to evaluate the level of synovial pathological changes.ELISA was employed to detect the expression of in-flammatory factors IL-1β,TNF-α,and pain mediators CGRP and Substance P in mouse serum.Western blot and qPCR methods were used to detect the protein and gene expression of cold hyperalgesia-related indicators such as TRPA1,TRPM8,HMGB1,CXCL12,CXCR4,Collagen Ⅰ,and Netrin-1 in synovial tissue,as well as DCC in dorsal root ganglia(DRG)tissue.RESULTS In vivo ima-ging showed that after the monocytes were reinfused into KOA mice,they were recruited to the knee joint area,with the HMGB1 group exhibiting a greater recruitment of circulating monocytes at the knee joint.Additionally,compared to the control group,the KOA group and HMGB1 group showed inflammatory pathological changes in the synovium,increased expression of serum inflammatory factors and pain mediators,reduced cold hyperalgesia threshold,and upregulated protein and gene expression of cold hyperalgesia-related indica-tors in synovial and DRG tissues.The changes were more significant in the HMGB1 group compared to the KOA group(P<0.05).Af-ter treatment with Shangke Lengtongtie or GL intervention,synovial inflammation was alleviated,serum inflammatory factors and pain mediators decreased,cold hyperalgesia threshold increased,and the upregulation of cold hyperalgesia-related indicator protein and gene expression levels was significantly reversed(P<0.05).CONCLUSION Shangke Lengtongtie exerts a beneficial effect on the mitigation of synovitis and cold hyperalgesia in KOA mice,a therapeutic mechanism that possibly mediated through the inhibition of the HMGB1/CXCL12/CXCR4 signaling axis.

OBJECTIVE To explore the intervention mechanism of Shangke Lengtongtie on cold hyperalgesia in KOA mice based on the HMGB1/CXCL12/CXCR4 signaling axis.METHODS Monosodium iodoacetate(MIA)was used for the intra-articular injec-tion into the knee joint to establish mice model of knee osteoarthritis(KOA).Peripheral blood monocytes were extracted from mice,cultured,and then reinfused into the tail vein of the mice.Subsequently,in vivo animal imaging was used to observe the recruitment sites of these monocytes.The cold hyperalgesia threshold was measured at various time points in each group of mice.Hematoxylin and eosin(HE)staining was used to evaluate the level of synovial pathological changes.ELISA was employed to detect the expression of in-flammatory factors IL-1β,TNF-α,and pain mediators CGRP and Substance P in mouse serum.Western blot and qPCR methods were used to detect the protein and gene expression of cold hyperalgesia-related indicators such as TRPA1,TRPM8,HMGB1,CXCL12,CXCR4,Collagen Ⅰ,and Netrin-1 in synovial tissue,as well as DCC in dorsal root ganglia(DRG)tissue.RESULTS In vivo ima-ging showed that after the monocytes were reinfused into KOA mice,they were recruited to the knee joint area,with the HMGB1 group exhibiting a greater recruitment of circulating monocytes at the knee joint.Additionally,compared to the control group,the KOA group and HMGB1 group showed inflammatory pathological changes in the synovium,increased expression of serum inflammatory factors and pain mediators,reduced cold hyperalgesia threshold,and upregulated protein and gene expression of cold hyperalgesia-related indica-tors in synovial and DRG tissues.The changes were more significant in the HMGB1 group compared to the KOA group(P<0.05).Af-ter treatment with Shangke Lengtongtie or GL intervention,synovial inflammation was alleviated,serum inflammatory factors and pain mediators decreased,cold hyperalgesia threshold increased,and the upregulation of cold hyperalgesia-related indicator protein and gene expression levels was significantly reversed(P<0.05).CONCLUSION Shangke Lengtongtie exerts a beneficial effect on the mitigation of synovitis and cold hyperalgesia in KOA mice,a therapeutic mechanism that possibly mediated through the inhibition of the HMGB1/CXCL12/CXCR4 signaling axis.

OBJECTIVE To explore the effectiveness and possible mechanism of Shangke Lengtong Patch in treating knee osteo-arthritis with cold-dampness arthralgia obstruction.METHODS A total of 70 patients who met the inclusion criteria of knee osteoar-thritis with cold-dampness arthralgia obstruction in the Orthopedics Department of Affiliated Hospital of Nanjing University of Chinese Medicine from November to December 2024 were randomly divided into an experimental group and a control group,with 35 cases in each group.During the treatment,1 case dropped out of the experimental group,3 cases dropped out of the control group,and 1 case was discontinued.The experimental group was treated with Shangke Lengtong Patch,and the control group was treated with Compound Nanxing Zhitong Ointment.The WOMAC scores and TCM syndrome scores of the two groups before and after treatment were compared to comprehensively evaluate the clinical efficacy.The changes in the expression levels of CGRP,substance P,HMGB1,IL-1β,CX-CL12,and CXCR4 in the serum of the two groups were detected by ELISA.RESULTS After 3,7,and 14 d of treatment,the WOMAC scores and TCM syndrome scores of the two groups were significantly reduced(P<0.05,P<0.01),and the score of aggrava-ted cold in the experimental group was better than that in the control group at 7 d of treatment(P<0.05);after 14 d of treatment,the expression levels of CGRP,substance P,HMGB1,IL-1β,CXCL12,and CXCR4 in the serum of the two groups were significantly re-duced(P<0.05),and there was no statistical difference between the two groups.CONCLUSION Shangke Lengtong Patch can sig-nificantly relieve the pain symptoms of knee osteoarthritis patients with cold-dampness arthralgia obstruction and improve the joint func-tion of patients.It may improve synovial inflammation by inhibiting the HMGB1/CXCL12/CXCR4 pathway,thereby exerting a thera-peutic effect.

Brain age prediction is of great significance to the in-depth understanding of individual neurodevelopment,early diagnosis of neuropsychiatric disorders,and formulation of personalized treatment plans. With the continuous advancement of deep learning,more and more researches focus on using such algorithms to predict brain age. Compared with traditional regression algorithms,deep learning which has the advantages of complex pattern learning,end-to-end learning and high adaptability can more accurately reveal the neuropathological mechanisms of neuropsychiatric disorders,and provide more precise tools for clinical assessment,assisted diagnosis and prognosis prediction. Herein the study reviews the recent advances in the application of deep learning algorithms in brain age prediction,introduces the achievements in deep learning model optimization,multimodal data inputs and interpretability studies for brain age prediction,discusses the methods for the establishment of integrated deep learning architectures and the future challenges of developing unified benchmarking,and provides an outlook on the application of deep learning in brain age prediction.

Brain age prediction is of great significance to the in-depth understanding of individual neurodevelopment,early diagnosis of neuropsychiatric disorders,and formulation of personalized treatment plans. With the continuous advancement of deep learning,more and more researches focus on using such algorithms to predict brain age. Compared with traditional regression algorithms,deep learning which has the advantages of complex pattern learning,end-to-end learning and high adaptability can more accurately reveal the neuropathological mechanisms of neuropsychiatric disorders,and provide more precise tools for clinical assessment,assisted diagnosis and prognosis prediction. Herein the study reviews the recent advances in the application of deep learning algorithms in brain age prediction,introduces the achievements in deep learning model optimization,multimodal data inputs and interpretability studies for brain age prediction,discusses the methods for the establishment of integrated deep learning architectures and the future challenges of developing unified benchmarking,and provides an outlook on the application of deep learning in brain age prediction.

The traditional diagnosis of neuropsychiatric disorders mainly depends on the subjective evaluation of specialists,neuropsychological test,biochemical examination and other methods,which lacks objective,accurate and intelligent biomarkers.With the rapid development of neuroimaging and artificial intelligence technology,unsupervised learning has been widely used in the auxiliary diagnosis of neuropsychiatric disorders for it has the advantages of independence of external labels,high model generalization,and automatic feature extraction.Compared with the traditional supervised learning methods,unsupervised learning is more capable of achieving objective,accurate and intelligent diagnosis of neuropsychiatric disorders.Herein an overview on the applications of unsupervised learning in the auxiliary diagnosis of neuropsychiatric disorders is provided,summarizing the findings of unsupervised learning in Alzheimer's disease,schizophrenia,major depressive disorder,and autism spectrum disorder,and discussing the research challenges such as insufficient image processing capability,small sample size,insufficient biochemical index data.The corporation with neural network,multi-site large sample size,and deep fusion of multidimensional data are the development trends of unsupervised learning method.

BACKGROUNDAs a novel device-based approach targeting the renal sympathetic nerves, percutaneous renal denervation (RDN) has been shown to be effective and safe for reducing blood pressure. However, while considerable data on RDN have been obtained from Western populations, there is limited findings from East Asian populations. The purpose of this study was to evaluate one-year outcomes of RDN for the treatment of resistant hypertension in Chinese patients.

METHODSBetween February and August 2012, 14 patients (mean age 39 ± 8 years, 10 males) with resistant hypertension underwent successful RDN at the Fuwai Hospital. All 14 patients were followed up at 1, 3, 6 and 12 months post-procedure. Blood pressure, use of antihypertensive agents, renal function, and complications were investigated.

RESULTSBaseline values included mean office blood pressure of 164/103 ± 14/10 mmHg, mean 3.9 ± 0.6 anti-hypertensive agents, and an estimated glomerular filtration rate of (79 ± 19) ml × min(-1)×1.73 m(-2). Office blood pressure after the procedure was reduced by -14/-10, -17/-11, -21/-12, and -24/-14 mmHg at 1, 3, 6, and 12 months respectively, and the reduction of the number of antihypertensive agents at the above corresponding time points was -1.3, -1.5, -1.7 and -1.8 respectively (all P < 0.001). The mean reduction of 24-hour ambulatory blood pressure was similar to the reduction of office blood pressure at the four corresponding time points. Renal function did not significantly change at any time point (all P > 0.05). No clinical complications were observed at 12-month follow-up.

CONCLUSIONThis study showed that RDN seems to be effective in reducing blood pressure of Chinese patients with resistant hypertension, with minimal adverse events at 12-month follow-up.

Adult ; Antihypertensive Agents ; therapeutic use ; Blood Pressure ; drug effects ; Female ; Glomerular Filtration Rate ; physiology ; Humans ; Hypertension ; drug therapy ; Male ; Middle Aged