Synovium is the target organ of rheumatoid arthritis.The excessive proliferation of synovial cells and insufficient apoptosis lead to synovial hyperplasia,which in turn causes damage to the surrounding tissues of the joint and bone destruction."Yang transforming qi and yin forming elements"is derived from Su Wen and is a highly summarized description of the functions of yin and yang,which runs through the entire course of the disease.This article elucidated the theoretical connotation of"yang transforming qi and yin forming elements"and its connection with synovial hyperplasia,proposing that the insufficiency of"yang transforming qi"is the root of synovial hyperplasia,while the excess of"yin forming elements"is the manifestation of synovial hyperplasia.Based on this,it put forward that"assisting yang qi as the priority,and according to the bias of pathogenic factors of yin,supplementing the method of reducing yin forming elements"is an important principle for treating this disease,which could provide new ideas for the treatment of the disease.

Objective To explore the mechanism of Quhan Zhufeng Mixture on proliferation and apoptosis of rheumatoid arthritis fibroblast-like synoviocyte(RA-FLS)based on NDRG2/JAK2/STAT3 signaling pathway.Methods RA-FLS cells were cultured in vitro,and were divided into ① blank serum group,methotrexate group,Quhan Zhufeng Mixture low-,medium-and high-dosage groups;② blank serum group,AG490 group,Quhan Zhufeng Mixture low-,medium-and high-dosage groups.Different concentrations of drug-containing serum were used to intervene cells.Cell proliferation was detected by CCK-8 method,apoptosis was detected by flow cytometry,and mRNA expressions of Bax,Bcl-2,Caspace-3,Caspace-9,N-myc downstream regulatory gene 2(NDRG2),Janus kinase 2(JAK2)and signal transduction and transcription activator 3(STAT3)were detected by RT-qPCR,Western blot was used to detect the protein expressions of Bax,Bcl-2,Caspace-3,Caspace-9,NDRG2,JAK2,STAT3,p-JAK2 and p-STAT3 in cells.Results Compared with the blank serum group,cell survival rate in methotrexate group,Quhan Zhufeng Mixture all dosage groups significantly decreased(P<0.01),the apoptosis rate significantly increased(P<0.01),the mRNA and protein expressions of Bax and Caspase-9 significantly increased(P<0.05,P<0.01),while the mRNA and protein expression of Bcl-2 significantly decreased(P<0.01),and Caspase-3 mRNA and protein expression in methotrexate group and Quhan Zhufeng Mixture medium-and high-dosage groups significantly increased(P<0.01).Compared with the blank serum group,the mRNA and protein expression of NDRG2 significantly increased in Quhan Zhufeng Mixture all dosage groups(P<0.05,P<0.01),the mRNA and protein expressions of JAK2 and STAT3 were significantly reduced in AG490 group and Quhan Zhufeng Mixture medium-and high-dosage groups(P<0.05,P<0.01),and the expressions of p-JAK2 and p-STAT3 proteins were significantly reduced(P<0.01).Conclusion Quhan Zhufeng Mixture can regulate the proliferation and apoptosis of RA-FLS by regulating the activity of NDRG2/JAK2/STAT3 signaling pathway,playing a role in treating rheumatoid arthritis.

Objective To investigate the expression and clinical significance of serum Golgi protein 73 (GP73) and SMAD family member 2 (SMAD2)in endometriosis. Methods From March 2022 to September 2023,175 patients with endometriosis who visited Xinjiang Military Region General Hospital were collected as the observation group. According to the staging of endometriosis,patients were separated into mild group (stage Ⅰ,n=61),moderate group (stage Ⅱ,n=52 ) and severe group (stage Ⅲ-Ⅳ,n=62). The healthy group comprised 55 healthy individuals who underwent medical examinations from December 2020 to December 2022 at Xinjiang Military Region General Hospital. ELISA was applied to detect serum GP73 and SMAD2 levels,the general data of the observation group and the control group were compared. Logistic regression was used to analyze the relevant factors affecting the occurrence of endometriosis,the Pearson method was applied to investigate the correlation between serum GP73 and SMAD2 levels in patients with endometriosis.ROC curves were used to assess the diagnostic value of serum GP73,SMAD2 levels and their combination in patients with EMT. Results The presence or absence of dysmenorrhea and irregular menstruation was compared between the two groups,and the differences were statistically significant (x2=17.633,39.268,all P<0.001). Serum GP73 (73.68±19.23 ng/ml),SMAD2 (42.27±9.61 mg/L) expression levels in the observation group were higher than those in the control group (58.61±13.27 ng/ml,35.26±6.37 mg/L),and the differences were statistically significant (t=8.327,7.845,all P<0.05). GP73 (59.79±17.26,73.73±18.17,87.29±22.05ng/ml) and SMAD2 (35.18±7.39,39.97±9.45,51.17±11.96mg/L) increased sequentially in the mild,moderate and severe groups,and the differences were statistical significance (F=31.067,42.866,all P<0.05). Pearson analysis showed serum GP73 levels were positively correlated with SMAD2 levels in EMT patients (r=0.427,P<0.001).Multifactorial Logistic regression analysis showed that irregular menstruation,dysmenorrhea,serum GP73[OR(95％CI):2.035 (1.208～3.428)],SMAD2[OR(95％CI):1.972 (1.284～3.029)]levels were risk factors for the development of EMT in patients (all P<0.05). The AUC(95％CI) for the combined diagnosis of EMT by serum GP73 and SMAD2 was 0.821 (0.776～0.861),which was higher than that of serum GP73 and SMAD2 alone[0.763 (0.714～0.807),0.708 (0.656～0.756)],respectively,and the differences were statistically significant (Z=3.121,4.346,all P<0.05). Conclusion Elevated serum GP73 and SMAD2 levels in EMT patients are all related to the extent of the patient's condition and have some diagnostic value for EMT.

Objective To establish an animal model of osteoporosis combined with liver cirrhosis and conduct preliminary investigation into the effect of liver cirrhosis on bone loss in mice and the underlying mechanisms.Methods The experimental animals were 25 6-week-old female C57BL/6 mice with a body weight of approximately 20-22 g.A comorbidity model of liver cirrhosis and osteoporosis was established in the mice by ovariectomy combined with carbon tetrachloride(CCl4)induction.The mice were randomly assigned to 4 groups(n=5 in each group),including a control group,a liver cirrhosis group,an osteoporosis group,and a cirrhosis and osteoporosis comorbidity group.Pathological changes in the liver were observed via HE staining,Sirius Red staining,and serum liver function indicators.Bone mass and morphological changes were assessed using micro-CT and HE staining.ELISA,Western blot,and immunohistochemistry were performed to assess the expression of insulin-like growth factor-1(IGF-1)in serum and liver tissues.An additional IGF-1 intervention group was established to investigate the potential role of IGF-1 in the comorbidity of liver cirrhosis and osteoporosis,and changes in bone mass and morphology were analyzed via micro-CT and HE staining.Results Compared with the control and osteoporosis groups,the liver cirrhosis and cirrhosis-osteoporosis comorbidity groups exhibited significant inflammatory cell infiltration and collagen fiber deposition in liver tissues,along with markedly increased serum levels of alanine aminotransferase(ALT),aspartate aminotransferase(AST),and total bilirubin(TBIL)(P＜0.05).According to the Micro-CT and HE staining results,the cirrhosis-osteoporosis comorbidity group showed reduced bone mass and decreased trabecular numbers in the distal femur compared to those in the osteoporosis group,with the differences being statistically significant(P＜0.05).ELISA,Western blot,and immunohistochemistry demonstrated significantly reduced expression of IGF-1 in the liver and serum of the cirrhosis-osteoporosis comorbidity group(P＜0.05).Notably,exogenous IGF-1 treatment restored bone mass in mice with liver cirrhosis combined with osteoporosis(P＜0.05).Conclusion Through ovariectomy combined with CCl4 induction,a mouse model of liver cirrhosis combined with osteoporosis was successfully established.IGF-1 may serve as a potential molecular mechanism and therapeutic target mediating the liver cirrhosis-osteoporosis comorbidity.

Objective To investigate the expression and clinical significance of serum Golgi protein 73 (GP73) and SMAD family member 2 (SMAD2)in endometriosis. Methods From March 2022 to September 2023,175 patients with endometriosis who visited Xinjiang Military Region General Hospital were collected as the observation group. According to the staging of endometriosis,patients were separated into mild group (stage Ⅰ,n=61),moderate group (stage Ⅱ,n=52 ) and severe group (stage Ⅲ-Ⅳ,n=62). The healthy group comprised 55 healthy individuals who underwent medical examinations from December 2020 to December 2022 at Xinjiang Military Region General Hospital. ELISA was applied to detect serum GP73 and SMAD2 levels,the general data of the observation group and the control group were compared. Logistic regression was used to analyze the relevant factors affecting the occurrence of endometriosis,the Pearson method was applied to investigate the correlation between serum GP73 and SMAD2 levels in patients with endometriosis.ROC curves were used to assess the diagnostic value of serum GP73,SMAD2 levels and their combination in patients with EMT. Results The presence or absence of dysmenorrhea and irregular menstruation was compared between the two groups,and the differences were statistically significant (x2=17.633,39.268,all P<0.001). Serum GP73 (73.68±19.23 ng/ml),SMAD2 (42.27±9.61 mg/L) expression levels in the observation group were higher than those in the control group (58.61±13.27 ng/ml,35.26±6.37 mg/L),and the differences were statistically significant (t=8.327,7.845,all P<0.05). GP73 (59.79±17.26,73.73±18.17,87.29±22.05ng/ml) and SMAD2 (35.18±7.39,39.97±9.45,51.17±11.96mg/L) increased sequentially in the mild,moderate and severe groups,and the differences were statistical significance (F=31.067,42.866,all P<0.05). Pearson analysis showed serum GP73 levels were positively correlated with SMAD2 levels in EMT patients (r=0.427,P<0.001).Multifactorial Logistic regression analysis showed that irregular menstruation,dysmenorrhea,serum GP73[OR(95％CI):2.035 (1.208～3.428)],SMAD2[OR(95％CI):1.972 (1.284～3.029)]levels were risk factors for the development of EMT in patients (all P<0.05). The AUC(95％CI) for the combined diagnosis of EMT by serum GP73 and SMAD2 was 0.821 (0.776～0.861),which was higher than that of serum GP73 and SMAD2 alone[0.763 (0.714～0.807),0.708 (0.656～0.756)],respectively,and the differences were statistically significant (Z=3.121,4.346,all P<0.05). Conclusion Elevated serum GP73 and SMAD2 levels in EMT patients are all related to the extent of the patient's condition and have some diagnostic value for EMT.

Synovium is the target organ of rheumatoid arthritis.The excessive proliferation of synovial cells and insufficient apoptosis lead to synovial hyperplasia,which in turn causes damage to the surrounding tissues of the joint and bone destruction."Yang transforming qi and yin forming elements"is derived from Su Wen and is a highly summarized description of the functions of yin and yang,which runs through the entire course of the disease.This article elucidated the theoretical connotation of"yang transforming qi and yin forming elements"and its connection with synovial hyperplasia,proposing that the insufficiency of"yang transforming qi"is the root of synovial hyperplasia,while the excess of"yin forming elements"is the manifestation of synovial hyperplasia.Based on this,it put forward that"assisting yang qi as the priority,and according to the bias of pathogenic factors of yin,supplementing the method of reducing yin forming elements"is an important principle for treating this disease,which could provide new ideas for the treatment of the disease.