BACKGROUND:Liuwei Dihuang Wan takes"three tonifying and three reducing effects"as its compatibility feature to nourish yin and tonify the kidneys,while Zuogui Wan takes"seeking yin in yang"as its compatibility feature to nourish yin and tonify the kidneys by promoting yang.Both of them belong to the same method of nourishing yin and tonifying the kidneys,and have better curative effects at the symptomatic and cellular molecular levels. OBJECTIVE:To observe the effects of Liuwei Dihuang Wan and Zuogui Wan in bone metabolism,and to explore their mechanism of action in the osteoprotegerin(OPG)/receptor activator of nuclear factor-κB ligand(RANKL)osteoblastic pathway. METHODS:Thirty-two Sprague-Dawley rats were randomized into model,Liuwei Dihuang Wan,Zuogui Wan,and sham operation group,with eight rats in each group.Osteoporosis models were prepared using removal of both ovaries in the first three groups.Starting at 30 days postoperatively,rats in the Liuwei Dihuang Wan group were gavaged with Liuwei Dihuang Wan 1.125 g/kg/d;rats in the Zuoqui Wan group were gavaged with Zuogui Wan 2.25 g/kg/d;and rats in the sham operation group and the model group were gavaged with saline 10 mL/kg/d.After 12 weeks of gavage,the rat tibia was taken to measure bone mineral density.The serum levels of estrogen,bone alkaline phosphatase,and cAMP/cGMP were measured using ELISA,and the expression of OPG/RANKL in the femur was detected using western blot. RESULTS AND CONCLUSION:Compared with the sham operation group,the model group showed a decrease in bone mineral density and levels of estrogen and bone alkaline phosphatase(P＜0.05)and an increase in cAMP/cGMP level(P＜0.05).Compared with the model group,the Liuwei Dihuang Wan group and the Zuogui Wan group significantly increased bone mineral density(P＜0.05)and bone alkaline phosphatase levels(P＜0.05);the Zuogui Wan group significantly decreased cAMP/cGMP levels(P＜0.05)and upregulated OPG expression(P＜0.05);the Liuwei Dihuang Wan group upregulated OPG expression and downregulated RANKL expression(P＜0.05);and both groups were unable to significantly increase estrogen levels(P＞0.05).To conclude,Zuogui Wan,which seeks yin from yang,can effectively increase the expression of OPG but cannot downregulate the expression of RANKL.However,Liuwei Dihuang Wan,which has three tonifying and three reducing effects,can bidirectionally regulate the expression of OPG and RANKL.This result suggests that Liuwei Dihuang Wan can significantly inhibit osteoclastic function compared with Zuogui Wan,and further research is needed to verify this conclusion.

BACKGROUND:Studies have reported that alendronate intake significantly increases bone mineral density in patients with osteoporosis. OBJECTIVE:To analyze and compare the changes in metabolites before and after alendronate intervention in ovariectomized rats by chromatography-mass spectrometry,and to further explore the specific mechanism and target of alendronate in the treatment of osteoporosis. METHODS:A total of 36 female Sprague-Dawley rats were randomly divided into model group,alendronate sodium group and sham operation group.The osteoporosis model was established by ovariectomy in the first two groups.Four weeks after modeling,the rats in the alendronate group were intragastrically given alendronate sodium,while those in the sham operation group and model group were given equal volume of normal saline.After 12 weeks of continuous gavage,the metabolites of the lumbar spine were analyzed by chromatography-mass spectrometry,and the common differential metabolites were obtained,which were analyzed by bioinformatics such as Kyoto Gene and Genome Encyclopedia pathway. RESULTS AND CONCLUSION:Totally 17 different metabolites were obtained in the three groups.The enrichment analysis of the Kyoto Encyclopedia of Genes and Genomes showed that alendronate sodium could regulate unsaturated fatty acid biosynthesis,linoleic acid metabolism and other pathways to protect ovariectomized rats.These results indicate that alendronate sodium may exert its anti-osteoporosis effect by interfering with unsaturated fatty acid bioanabolism and linoleic acid metabolism,so as to achieve the purpose of preventing osteoporosis

The objective of this study was to develop a rapid and precise detection technique for por-cine Senecavirus A(SVA)employing reverse transcription recombinase polymerase amplification(RT-RAA)in conjunction with CRISPR Cas13a technology.Additionally,the study aimed to opti-mize the assay's reaction conditions to enhance amplification efficiency.Eight RT-RAA primer sets were designed based on the conserved gene sequence of porcine SVA,and a series of reaction condi-tions were evaluated to refine the RT-RAA reaction system.Subsequently,CRISPR-derived RNA(crRNA)sequences were developed and selected to construct the RT-RAA-CRISPR reaction sys-tem.The method's specificity was determined by examining six prevalent porcine pathogenic nucleic acids,while its sensitivity was assessed using SVA cRNA standards quantified by digital PCR.The method's stability and the consistency of clinical sample analysis were also evaluated.The findings revealed that the optimized RT-RAA and CRISPR reaction systems exhibited the highest amplifi-cation efficiency at a reaction temperature of 37 ℃.Among the eight crRNAs,five were identified as exhibiting the strongest detection signals.The formulated RT-RAA-CRISPR Cas13a method demonstrated exceptional specificity,showing no cross-reactivity with other common porcine disea-ses,including ASFV,PRRSV,PEDV,PCV2,CSFV,and PRV.The method achieved high sensitivi-ty,detecting as low as 0.86 copies/μL of SVA,and exhibited stable fluorescence output,robust re-producibility,and the ability to complete clinical sample analysis within 50 minutes.Consistency e-valuation with six positive and 58 negative samples indicated 100％agreement in outcomes.These results substantiate that the study successfully established a rapid and specific RT-RAA-CRISPR Cas13a detection method for the on-site identification of porcine Senecavirus A,demonstrating high specificity and sensitivity,and holds promise for application in SVA monitoring and control initia-tives.

The objective of this study was to develop a rapid and precise detection technique for por-cine Senecavirus A(SVA)employing reverse transcription recombinase polymerase amplification(RT-RAA)in conjunction with CRISPR Cas13a technology.Additionally,the study aimed to opti-mize the assay's reaction conditions to enhance amplification efficiency.Eight RT-RAA primer sets were designed based on the conserved gene sequence of porcine SVA,and a series of reaction condi-tions were evaluated to refine the RT-RAA reaction system.Subsequently,CRISPR-derived RNA(crRNA)sequences were developed and selected to construct the RT-RAA-CRISPR reaction sys-tem.The method's specificity was determined by examining six prevalent porcine pathogenic nucleic acids,while its sensitivity was assessed using SVA cRNA standards quantified by digital PCR.The method's stability and the consistency of clinical sample analysis were also evaluated.The findings revealed that the optimized RT-RAA and CRISPR reaction systems exhibited the highest amplifi-cation efficiency at a reaction temperature of 37 ℃.Among the eight crRNAs,five were identified as exhibiting the strongest detection signals.The formulated RT-RAA-CRISPR Cas13a method demonstrated exceptional specificity,showing no cross-reactivity with other common porcine disea-ses,including ASFV,PRRSV,PEDV,PCV2,CSFV,and PRV.The method achieved high sensitivi-ty,detecting as low as 0.86 copies/μL of SVA,and exhibited stable fluorescence output,robust re-producibility,and the ability to complete clinical sample analysis within 50 minutes.Consistency e-valuation with six positive and 58 negative samples indicated 100％agreement in outcomes.These results substantiate that the study successfully established a rapid and specific RT-RAA-CRISPR Cas13a detection method for the on-site identification of porcine Senecavirus A,demonstrating high specificity and sensitivity,and holds promise for application in SVA monitoring and control initia-tives.

The timely use of screening tools to assess the palliative care needs of emergency patients can provide decision-making basis for patient referral and help patients receive palliative care in a timely manner.This paper reviews the palliative care needs screening tools for emergency patients at home and abroad,describes their development methods,scoring criteria and application status,compares and analyzes their characteristics and shortcomings.It aims to provide references for the localized development and application of palliative care needs screening tools in emergency patients.

Objective:To conduct the visual analysis of emergency palliative care based on the Web of Science database.Methods:The literature on emergency palliative care collected from 2012 to 2022 was systematically searched in the Web of Science core collection. CiteSpace software was used for visual analysis.Results:A total of 630 articles were included, and the number of publications was on the rise. The country with the highest number of publications was the United States, with 8 out of the top 10 institutions in terms of publication volume coming from the United States. The author with the highest number of publications was Grudzen. The top 10 journals in terms of citation frequency were mostly specialized journals on palliative care and first aid. The results of keyword analysis showed that a total of 15 clustering labels and 20 emergent words were output, reflecting the changes of key research objects, main research types and areas of concern.Conclusions:At present, nursing research in this field is in the development stage in China. We can draw on the practical experience of foreign countries to further explore the emergency palliative care model and service system based on China's national conditions.

BACKGROUND:The mechanisms and targets of alendronate in the treatment of osteoporosis still need to be investigated in depth. OBJECTIVE:To investigate the mechanism by which alendronate regulates bone metabolism in rats with osteoporosis and to perform a bioinformatics analysis of differentially expressed proteins. METHODS:Female Sprague-Dawley rats were randomly divided into three groups(n=12 per group):model group,alendronate group and sham-operated group.Animal models of osteoporosis were prepared using ovariectomy in the model and alendronate groups.At 4 weeks after modeling,rats in the alendronate group were gavaged with alendronate;the other two groups were given the equal volume of normal saline.After 12 weeks of continuous gavage,the bone mineral density of the tibia was measured and the lumbar spine of the rats was taken for proteomic analysis using Tandem mass tag-liquid chromatography-tandem mass spectrometry technique to identify differentially expressed proteins for gene ontology,Kyoto Encyclopedia of Genes and Genomes pathway and protein-protein interaction analysis. RESULTS AND CONCLUSION:There were 32 up-regulated proteins and 51 down-regulated proteins identified between the alendronate group and model group.Gene ontology enrichment analysis showed that the differentially expressed proteins were mainly involved in molecular functions,such as binding and catalytic activity,and in biological processes,such as cellular process and metabolic process.Kyoto Encylopedia of Genes and Genomes enrichment analysis showed that the differentially expressed proteins in the alendronate group and model group were mainly involved in the biosynthesis of pantothenate and coenzyme A.Protein-protein interaction analysis indicated that among the differentially expressed proteins in the alendronate group and model group,Hspa1l,Enpp3,Unc45a,Myh9 and Cant1 were located at the nodes of the protein-protein interaction network and were closely related to bone metabolism.Overall,these findings indicate that alendronate may regulate bone metabolism in the rat model of osteoporosis by regulating the expression of differentially expressed proteins and biosynthesis of pantothenate and coenzyme A.

Objective To summarize the experience of endovascular embolization for the treatment of posterior circulation aneurysms. Methods The clinical and follow-up data of 65 patients with posterior circulation aneurysm treated with endovascular embolization in Jiangmen Central Hospital, Guangdong Province were analyzed retrospectively. Results A total of 65 patients with posterior circulation aneurysm received endovascular embolization in Jiangmen Central Hospital, including 30 females (46.2％) and 35 males (53.8％). Their age ranged from 37 to 76 years old(mean 57.3 ± 10.25).Ruptured aneurysms were found in 57 cases (87.7％) and unruptured aneurysms were found in 8 cases (12.3％). Parent arteries:22 (33.8％) in vertebral artery,23 (35.4％) in basilar artery,3 (9.2％) in posterior cerebral artery,2 (3.1％) in superior cerebellar artery, 2 (3.1％) in anterior inferior cerebellar artery, and 10 (15.4％) in posterior inferior cerebellar artery. Hunt-Hess grade:gradeⅠin 15 cases,gradeⅡin 29 cases,gradeⅢin 11 cases, grade Ⅳ in 6 cases, and grade Ⅴ in 4 cases. Twenty-one patients (32.3％) were treated with coil embolization alone,29 (44.6％) were treated with stent-assisted coil embolization, 6 (9.2％) were treated with stenting alone, and 9 (13.8％) were treated with parent artery embolization. Immediate angiography after surgery revealed that 54 patients (83.1％) were completely embolized, and 11 (16.9％) were not embolized completely. Three patients (4.6％) complicated with cerebral infarction, 2 (3.1％) had intraoperative rupture,2 had respiratory disturbance(3.1％),1 (1.5％) had hoarseness, and 1 had vitreous hemorrhage (1.5％).At discharge,the modified Glasgow outcome scale assessment showed that 53 patients (81.5％) had excellent outcome,5 (7.7％) had good outcome, and 7 (10.8％) had poor outcome. Of the patients with poor outcome, 2 (3.1％) died. Thirty-four patients (52.3％) were followed up by angiography, of whom 6 (17.6％) recurred, and 1 died of complicated cerebral infarction. Conclusion Although endovascular treatment of posterior circulation aneurysms is difficult, flexible selection of endovascular treatment may achieve good therapeutic effect.

Objective To study the effects and mechanism of Xuling-Jiangu formula on bone mineral density in the osteoporosis model rats.Methods According to the random number table method,50 SD female rats were randomly divided into the sham group,the model group,the low dose group of Xuling-Jiangu formula group,the medium dose group and the high dose of group.In addition to the sham group,the other groups were osteoporosis model.After 30 days,low dose group received intragastric Xuling-Jiangu formula solution 7.5 g/kg;medium dose group and high dose group received 15 and 30 g/kg,respectively.And the sham group and the model group received normal saline 10 ml/kg.After 12 weeks treatment,the bone mineral density of the left tibia was measured by double energy X ray.Estrone,osteocalcin in serum had been detected by Enzyme linked immunosorbent assay (ELISA).The mRNA expression of osteoprotegerin (OPG),receptor activator of nuclear factor κB ligand (RANKL) in lumbar were measured by quantitative real-time PCR.Results The bone mineral density (0.215 ± 0.010 g/cm2,0.222 ± 0.013 g/cm2 vs.0.196 ± 0.016 g/cm2) of the Xuling-Jiangu formula group were significantly higher than that of the model group (P＜0.01 or P＜0.05).The estrone in low,middle and high dose groups showed an upward trend,but there was no significant difference compared with the model group.The OC (87.0 ± 8.9 ng/L vs.100.5 ± 16.8 ng/L) of high dose group was significantly lower than that of the model group (P＜0.05).Compare with the model group,OPG mRNA level (0.97 ± 0.23 vs.0.78 ± 0.17) in high dose group increased (P＜0.05),the RANKL mRNA level decreased significantly (1.12 ± 0.17,0.97 ± 0.38,1.04 ± 0.29 vs.1.31 ± 0.18) in three Xuling-Jiangu formula groups (P＜0.05).Conclusions The bone mineral density of rats with osteoporosis can be improved by treating Xuling-Jiangu formula.It may be related to the increase of mRNA expression of OPG,and the reduction of RANKL.

Objective To study the effects ofXuling-Jiangu formula on bone mineral density and the bone biomechanic in the osteoporosis model rats.Methods According to the random number table method, 40 SD female rats were randomly divided into the caltrate D group, theXuling-Jianguformula group, the model group and the sham group,10 rats each group. In addition to the sham group, the other groups were osteoporosis model. After 30 days, the Caltrate D group received intragastric caltrate D mixed suspension 0.126 g/kg; the Xuling-Jiangu formula group receivedXuling-Jianguformula solution 15 g/kg, and the sham group and the model group received normal saline 10 ml/kg. After 12 weeks treatment, detection of left tibia bone mineral density andthree-point bending method was used for biomechanical testing.Results The mineral density of the Xuling-Jiangu formula group (0.244 ± 0.022 g/cm2,0.195 ± 0.017 g/cm2vs. 0.223 ± 0.013 g/cm2) were significantly higher than the model group and caltrate D group (P<0.01); compared with the model group, the bone biomechanictests in theXuling-Jiangu formula group (0.072 ± 0.036 kN vs.0.041 ± 0.015 kN; 843.754 ± 428.722 N/mm2vs. 482.084 ± 176.646 N/mm2) were significantly higher (P<0.05).ConclusionXuling-Jiangu formula canimprove the bone mineral density and the bone lbiomechanic of osteoporosis rats.