BACKGROUND:The guinea pig is considered to be the most useful spontaneous model for evaluating primary osteoarthritis in humans because of its similar knee joint structure and close histopathologic features to those of humans. OBJECTIVE:To investigate the pathological process of spontaneous knee osteoarthritis in guinea pigs by analyzing the histopathology of the total knee joint of guinea pigs aged 1 to 18 months. METHODS:Eight healthy female Hartley guinea pigs in each age group of 1,6,10,14,16,and 18 months old were selected.The quadriceps femoris was taken for hematoxylin-eosin staining,and the total knee joint was stained with hematoxylin-eosin and toluidine blue.The histopathology of the cartilage,subchondral bone,synovium,meniscus,and muscles were observed under light microscope.Mankin's score and synovitis score were compared,and the correlation analysis was conducted. RESULTS AND CONCLUSION:As the guinea pig age increased,the Mankin's score increased(P<0.05),and the pathological score of synovitis also gradually increased(P<0.05),and there was a significant positive correlation between the two(r=0.641,P<0.001).The incidence rate of subchondral bone marrow lesion in 18-month-old guinea pigs was 50%,and the incidence of meniscus injury was 37.5%.In addition,osteophyte and narrowing of the joint space were observed,and only a few guinea pigs had inflammation in the quadriceps femoris.To conclude,guinea pigs develop significant cartilage defects,synovial inflammation,subchondral bone lesions,meniscus injury,osteophyte formation,and joint space narrowing as they age,all of which are similar to the pathological processes of primary knee osteoarthritis in humans,making it an ideal model of spontaneous knee osteoarthritis.

OBJECTIVE:To systematically evaluate the correlation between phase angle and sarcopenia and its diagnostic indexes.METHODS:The PubMed,EMbase,Cochrane Library,Web of Science,CNKI,WanFang Data,VIP and SinoMed databases were electronically searched to collect studies on the correlation between phase angle and sarcopenia and its diagnostic indexes from database inception to May 8,2024. Two reviewers independently screened literature,extracted data and assessed the risk of bias of the included studies. Meta-analysis was then performed using RevMan 5.3 and Stata 14.0 software. RESULTS:A total of 50 eligible articles were included. Meta-analysis results showed that compared with the non-sarcopenic population,the phase angle was significantly reduced in sarcopenic patients[standardized mean difference (SMD)=-0.99,95％ confidence interval (CI) (-1.09,-0.90),P<0.00001]. The results of subgroup analysis indicated that the difference of phase angle was more significant in patients with severe sarcopenia and Asian sarcopenia. Moreover,reduction in the phase angle was more obvious in patients with malignant tumors and respiratory diseases with sarcopenia. And skeletal muscle mass index (Pearson's r=0.565,P<0.00001),grip strength (Pearson's r=0.446,P<0.00001),and gait speed (Pearson's r=0.405,P<0.00001) all showed a moderate positive correlation with phase angle. However,appendicular skeletal muscle mass index showed a very weak positive correlation with phase angle (Pearson's r=0.139,P=0.02). CONCLUSION:Phase angle has a significant difference between sarcopenia and non-sarcopenia population,and it is correlated with the diagnostic indexes of sarcopenia to different extents. It suggests that phase angle has some clinical values in the objective diagnosis of sarcopenia. However,the results may be influenced by some factors such as sarcopenia severity and detection instruments of phase angle. Due to the limited quality and quantity of the included studies,more high-quality studies are needed to verify the above conclusion.

Objective To explore the molecular mechanisms of moxibustion in improving osteoporosis in rats using high-throughput micro-RNA(miRNA)sequencing analysis.Methods A total of 18 female Sprague-Dawley(SD)rats were randomly divided into an operation group(12 rats),which was subjected to ovariectomy to induce osteoporosis,and a sham operation control(SO)group(6 rats).The 12 osteoporosis model rats were randomly divided into a model(OVX)group and a moxibustion(MOX)group(6 rats per group),which were treated with once-daily moxibustion at the"Shenshu"(BL23)and"Guanyuan"(CV4)acupoints for 20 minutes each time,for 12 weeks.Micro-computed tomography(CT)scans of the rat femur were taken to analyze the trabecular bone thickness(Tb.Th),trabecular separation(Tb.Sp),and bone volume total volume(BV/TV)ratio of the trabecular bone.Hematoxylin and eosin staining was used for morphological observation of tibial tissues.Serum alkaline phosphatase(ALP)and osteocalcin(OCN)levels were measured using ELISA.Three randomly selected rats from each group were used for miRNA high-throughput sequencing to screen for differentially expressed miRNAs,which were subjected to functional enrichment analysis and target gene prediction.Results Micro-CT images showed that,compared with the OVX group,the MOX group had superior bone density,significant increases in the Tb.Th and BV/TV score,and a significant decrease in Tb.Sp(P＜0.05).ELISA indicated that,compared with the OVX group,the MOX group showed a significant decrease in serum ALP activity and a significant increase in serum OCN content(P＜0.05).The miRNA sequencing result showed that 34 miRNAs were commonly expressed between the OVX group and the intervention group,and 15 miRNAs were commonly expressed between the OVX group and the intervention group.KEGG pathway enrichment analysis showed that the differentially expressed genes were mainly enriched in signaling pathways involving MAPK,Ras,FoxO,TNF,and cancer-related microRNAs.For the top five most differentially expressed microRNAs,namely miR-153-5p,miR-201-5p,miR-449c-5p,miR-451-3p,and miR-153-3p,target gene predictions yielded 10 major targets:Ebf2,Rtn4,Fbxl3,Naa15,Vamp2,Daam1,Akap6,Camta1,Ptprz1,and Lamp1.Conclusions Acupuncture slowed the progression of osteoporosis,improved bone microstructure,and balanced bone metabolism in rats.This therapeutic effect may be achieved through regulation of the expression of microRNAs and their target genes;however,the underlying mechanism requires further exploration.

The advent of an aging society means that bone-related diseases impose a substantial burden on the general population and on healthcare systems,highlighting the need to find new treatment method.The occurrence and progression of such diseases are closely linked to inflammatory responses.Moxibustion,as a traditional external treatment in traditional Chinese medicine(TCM),is well-known for its anti-inflammatory and analgesic effects,and it has also demonstrated remarkable therapeutic efficacy for bone-related diseases.Here we review the impact of moxibustion on inflammatory responses associated with bone-related conditions.The anti-inflammatory mechanism of moxibustion in treating bone-related diseases involves mediating pro-inflammatory and anti-inflammatory factors and related mediators,and regulating signaling pathways(e.g.,nuclear factor-kappa B(NF-κB),Janus kinase(JAK)/signal transducer and activator of transcription(STAT),mitogen-activated protein kinase(MAPK),programmed death receptor-1(PD-1)/programmed death ligand-1(PD-L1),adenosine monophosphate-activated protein kinase(AMPK)/UNC-51 like autophagy activating kinase(ULK1)),the hypothalamic-pituitary-adrenal axis,the activation of immune cells,and autophagy.Despite these findings however,the anti-inflammatory mechanisms underlying moxibustion treatment for bone-related diseases remain poorly understood.Further research utilizing advanced technologies is needed to gain a more comprehensive understanding of the anti-inflammatory mechanisms involved in moxibustion therapy.This approach aims to facilitate better clinical applications and contribute to safeguarding human bone health.

OBJECTIVE:To systematically evaluate the correlation between phase angle and sarcopenia and its diagnostic indexes.METHODS:The PubMed,EMbase,Cochrane Library,Web of Science,CNKI,WanFang Data,VIP and SinoMed databases were electronically searched to collect studies on the correlation between phase angle and sarcopenia and its diagnostic indexes from database inception to May 8,2024. Two reviewers independently screened literature,extracted data and assessed the risk of bias of the included studies. Meta-analysis was then performed using RevMan 5.3 and Stata 14.0 software. RESULTS:A total of 50 eligible articles were included. Meta-analysis results showed that compared with the non-sarcopenic population,the phase angle was significantly reduced in sarcopenic patients[standardized mean difference (SMD)=-0.99,95％ confidence interval (CI) (-1.09,-0.90),P<0.00001]. The results of subgroup analysis indicated that the difference of phase angle was more significant in patients with severe sarcopenia and Asian sarcopenia. Moreover,reduction in the phase angle was more obvious in patients with malignant tumors and respiratory diseases with sarcopenia. And skeletal muscle mass index (Pearson's r=0.565,P<0.00001),grip strength (Pearson's r=0.446,P<0.00001),and gait speed (Pearson's r=0.405,P<0.00001) all showed a moderate positive correlation with phase angle. However,appendicular skeletal muscle mass index showed a very weak positive correlation with phase angle (Pearson's r=0.139,P=0.02). CONCLUSION:Phase angle has a significant difference between sarcopenia and non-sarcopenia population,and it is correlated with the diagnostic indexes of sarcopenia to different extents. It suggests that phase angle has some clinical values in the objective diagnosis of sarcopenia. However,the results may be influenced by some factors such as sarcopenia severity and detection instruments of phase angle. Due to the limited quality and quantity of the included studies,more high-quality studies are needed to verify the above conclusion.

Objective To explore the molecular mechanisms of moxibustion in improving osteoporosis in rats using high-throughput micro-RNA(miRNA)sequencing analysis.Methods A total of 18 female Sprague-Dawley(SD)rats were randomly divided into an operation group(12 rats),which was subjected to ovariectomy to induce osteoporosis,and a sham operation control(SO)group(6 rats).The 12 osteoporosis model rats were randomly divided into a model(OVX)group and a moxibustion(MOX)group(6 rats per group),which were treated with once-daily moxibustion at the"Shenshu"(BL23)and"Guanyuan"(CV4)acupoints for 20 minutes each time,for 12 weeks.Micro-computed tomography(CT)scans of the rat femur were taken to analyze the trabecular bone thickness(Tb.Th),trabecular separation(Tb.Sp),and bone volume total volume(BV/TV)ratio of the trabecular bone.Hematoxylin and eosin staining was used for morphological observation of tibial tissues.Serum alkaline phosphatase(ALP)and osteocalcin(OCN)levels were measured using ELISA.Three randomly selected rats from each group were used for miRNA high-throughput sequencing to screen for differentially expressed miRNAs,which were subjected to functional enrichment analysis and target gene prediction.Results Micro-CT images showed that,compared with the OVX group,the MOX group had superior bone density,significant increases in the Tb.Th and BV/TV score,and a significant decrease in Tb.Sp(P＜0.05).ELISA indicated that,compared with the OVX group,the MOX group showed a significant decrease in serum ALP activity and a significant increase in serum OCN content(P＜0.05).The miRNA sequencing result showed that 34 miRNAs were commonly expressed between the OVX group and the intervention group,and 15 miRNAs were commonly expressed between the OVX group and the intervention group.KEGG pathway enrichment analysis showed that the differentially expressed genes were mainly enriched in signaling pathways involving MAPK,Ras,FoxO,TNF,and cancer-related microRNAs.For the top five most differentially expressed microRNAs,namely miR-153-5p,miR-201-5p,miR-449c-5p,miR-451-3p,and miR-153-3p,target gene predictions yielded 10 major targets:Ebf2,Rtn4,Fbxl3,Naa15,Vamp2,Daam1,Akap6,Camta1,Ptprz1,and Lamp1.Conclusions Acupuncture slowed the progression of osteoporosis,improved bone microstructure,and balanced bone metabolism in rats.This therapeutic effect may be achieved through regulation of the expression of microRNAs and their target genes;however,the underlying mechanism requires further exploration.

The advent of an aging society means that bone-related diseases impose a substantial burden on the general population and on healthcare systems,highlighting the need to find new treatment method.The occurrence and progression of such diseases are closely linked to inflammatory responses.Moxibustion,as a traditional external treatment in traditional Chinese medicine(TCM),is well-known for its anti-inflammatory and analgesic effects,and it has also demonstrated remarkable therapeutic efficacy for bone-related diseases.Here we review the impact of moxibustion on inflammatory responses associated with bone-related conditions.The anti-inflammatory mechanism of moxibustion in treating bone-related diseases involves mediating pro-inflammatory and anti-inflammatory factors and related mediators,and regulating signaling pathways(e.g.,nuclear factor-kappa B(NF-κB),Janus kinase(JAK)/signal transducer and activator of transcription(STAT),mitogen-activated protein kinase(MAPK),programmed death receptor-1(PD-1)/programmed death ligand-1(PD-L1),adenosine monophosphate-activated protein kinase(AMPK)/UNC-51 like autophagy activating kinase(ULK1)),the hypothalamic-pituitary-adrenal axis,the activation of immune cells,and autophagy.Despite these findings however,the anti-inflammatory mechanisms underlying moxibustion treatment for bone-related diseases remain poorly understood.Further research utilizing advanced technologies is needed to gain a more comprehensive understanding of the anti-inflammatory mechanisms involved in moxibustion therapy.This approach aims to facilitate better clinical applications and contribute to safeguarding human bone health.

Chronic Urticaria(CU)is a common skin disease involving autoimmunity and allergies,which brings a heavy burden to patients and society.The theory of traditional Chinese medicine"the Lung is combined with the Large Intestine,and the symptoms of large intestine can be reflected from the skin"has long shown that there is a close physiological and pathological relationship between the function of the Large Intestine and the skin.With the modern advancement of the"gut-skin axis"theory,the correlation between gut microbiome and CU has gradually become an emerging focus of research.Adjusting the imbalance of gut microbiome would be a new trend in the clinical treatment of CU.Acupuncture has a beneficial effect of regulating the gut microbiome,and the definite curative effect on CU.Therefore,this article summarized the research progress between the gut microbiome and CU in recent years,in order to discuss the feasibility of acupuncture to treat CU by regulating the gut microbiome,and provide a new idea for the mechanism research of acupuncture in the treatment of CU from the perspective of"treating skin from intestine".

Objective:To compare the dosimetric parameters and plan complexity between newly-delicated HyperArc (HA) and conventional volumetric-modulated arc therapy (VMAT) in the treatment of brain metastases.Methods:For 26 patients with brain metastases, HA, conventional coplanar (Cop) and non-coplanar (Non-cop) VMAT plans with a prescription dose of 9 Gy 3fx or 6 Gy 5fx were generated. The dosimetric parameters for planning target volume (PTV), RTOG conformity index (RTOG CI), Paddick CI, homogeneity index (HI), gradient index (GI), maximum dose (D max) of brainstem and dose-volume parameters of brain-PTV(V 2Gy-V 26Gy) were statisticaly compared among these three approaches. In addition, the monitor unit (MU) and the plan complexity parameters (including MCSv and AlPO) were statistically compared. Results:To prevent missed targets during treatment, all plans were established with RTOG CI of greater than 1.1. For Paddick CI, HA provided significantly higher conformity (0.89±0.019) than Non-cop (0.87±0.036, P=0.001) and Cop (0.88±0.017, P=0.003) VMAT. For GI, the fastest dose fall-off was noted in HA (3.35±0.64), followed by conventional Non-cop VMAT of (3.70±0.80), and conventional Cop VMAT of (4.90±1.85)(all P<0.05). For the brainstem sparing, HA plan performed better than Non-cop plan[(604.14±531.61) cGy vs.(682.75±558.22) cGy, P<0.05)]. For normal brain tissue sparing, HA approach showed significant reduction than conventional Cop and Non-cop VMAT (both P<0.05). For MU, HA approach (2 872.60 ± 566.93) was significantly lower than those of Non-cop VMAT (3 771.28 ± 1 022.38, P<0.05) and Cop VMAT (4 494.08 ± 1 323.09, P<0.05). In terms of plan complexity, the MCSv of Cop plan was the lowest, indicating that the complexity was the highest ( P<0.05). The AlPO of HA was significantly higher than that of Non-cop VMAT ( P<0.05), suggesting that the complexity of HA plan was lower ( P<0.05). Conclusion:For the treatment of brain metastases, HA provides better conformity, more rapid dose fall-off, better sparing of brainstem and normal brain tissues and less plan complexity compared with conventional VMAT.

Objective:To help clinicians simplify the post-processing operations of structures by developing rapid processing software for target area and organs at risk structures based on ESAPI.Methods:SmartStructure script software was developed based on ESAPI, verified and evaluated in clinical work. 10 cases of rectal cancer receiving neoadjuvant radiotherapy, 10 breast cancer treated with postoperative radiotherapy, 10 cervical cancer receiving postoperative radiotherapy, 10 nasopharyngeal carcinoma receiving radical radiotherapy and 10 lung stereotactic body radiotherapy (SBRT) were selected, and different types of tumors had different post-processing operations of structures. In each case, three methods were used for post-processing of structures. In the control group (manual group), normal manual processing was employed. In the experimental group 1(SmaStru-N group), scripts without templates were utilized. In the experimental group 2(SmaStru-P group). scripts combined with templates were adopted. The processing time of the three methods was compared. Clinicians scored the scripting software from multiple aspects and compared the feeling scores of scripting software and manual operation.Results:All three methods can be normally applied in clinical settings. The error rate in the manual group was 7.0%, 3.0% in the SmaStru-N group 0% in the SmaStru-P group, respectively. Compared with the manual method, SmaStru-N shortened the processing time of target area and organs at risk by 60.9% and 93.3% for SmaStru-P. In addition, SmartStructure was superior to manual method in terms of using feeling scores. Clinicians gave lower score for the" applicability" and" simplicity" , and higher score on the" accuracy" and" efficiency" .Conclusions:Compared with conventional manual structure processing method, SmartStructure software can rapidly and accurately process all structures of the target area and organs at risk, and its advantages become more obvious with the increasing number of structures that need to be processed. SmartStructure software can meet clinical requirements, reduce the error rate, elevate processing speed, improve the working efficiency of clinicians, providing basis for the development of adaptive radiotherapy.