Objective:To discuss the effect of angiotensin(1-7)[Ang(1-7)]on high-turnover bone disease in the uremic rats,and to clarify its possible mechanism.Methods:Thirty SD rats were randomly divided into sham operation group(n=6)and experimental group(n=24).The rats in experimental group underwent 5/6 nephrectomy(Platt method)+high-phosphorus(P)diet[1.2％P,1.0％calcium(Ca)]to establish the model of uremic high-turnover bone disease.The successfully modeled rats were then randomly divided into model group,Ang(1-7)group,angiotensin-converting enzyme 2(ACE2)activator dimethylacetamide amidoxime(DIZE)group,and Mas receptor antagonist group(A779 group),with 6 rats in each group.The levels of Ca,P,blood creatinine(Scr),blood urea nitrogen(BUN),and 24 h urinary protein(UP)in serum of the rats in various groups were detected by automatic biochemical analyzer at 12 and 18 weeks after operation;immunofluorescence staining was used to detect the levels of intact parathyroid hormone(iPTH)in the rats in various groups;ELISA method was used to detect the levels of osteocalcin(OC),type Ⅰ collagen N-terminal peptide(NTX),and tartrate-resistant acid phosphatase(TRAP)-5b in serum of the rats in various groups;high-resolution micro-CT scan was used to detect the bone density(BMD),tissue mineral density(TMD),trabecular thickness(Tb.Th),and trabecular separation(Tb.Sp)in femur tissue of the rats in various groups;Von Kossa staining and Giemsa staining were used to observe the pathomorphology of cortical bone and trabecular bone of the rats in various groups,and the trabecular bone volume(TBV)was calculated;fluorescence microscope was used to detect the mineral apposition rates(MAR)of the rats in vanious groups,and the osteoblast index(OBI)and osteoclast index(OCI)of the rats in various groups were calculated.Results:At 12 and 18 weeks after operation,compared with sham operation group,the weights of the rats in model group,Ang(1-7)group,DIZE group,and A779 group were decreased(P＜0.05).At 12 and 18 weeks after operation,compared with sham operation group,the levels of 24 h UP,Scr,and BUN in serum of the rats in model group,Ang(1-7)group,DIZE group,and A779 group were increased(P＜0.05);at 18 weeks after operation,compared with model group,the levels of 24 h UP and Scr in serum of the rats in Ang(1-7)group and DIZZ group were decreased(P＜0.05),and the levels of 24 h UP,Scr and BUN in serum of the rats in A779 group were increased(P＜0.05).The successful establishment of the uremic high-turnover bone disease model was confirmed.At 12 and 18 weeks after operation,compared with sham operation group,the serum iPTH,P,OC,NTX,and TRAP-5b levels ofthe rats in model group,Ang(1-7)group,DIZE group,and A779 group were all significantly increased(P＜0.05);at 18 weeks after operation,compared with model group,the serum NTX and TRAP-5b levels of the rats in Ang(1-7)group and DIZE group were decreased(P＜0.05),while the serum iPTH,P,NTX and TRAP-5b levels in A779 group were increased(P＜0.05).The high-resolution micro-CT scan results showed that compared with sham operation group,the values of femur BMD and TMD of the rats in model group,Ang(1-7)group,DIZE group,and A779 group were all significantly decreased(P＜0.05);compared with model group,the values of femur BMD and TMD of the rats in Ang(1-7)group and DIZE group were increased(P＜0.05),while the values of BMD and TMD of the rats in A779 group were decreased(P＜0.05).Compared with sham operation group,the femur Tb.Th of the rats in model group was decreased(P＜0.05),and the Tb.Sp was increased(P＜0.05);the femur Tb.Th of the rats in Ang(1-7)group and DIZE group were increased(P＜0.05),and the Tb.Sp was decreased(P＜0.05).Compared with model group,the femur Tb.Th of the rats in A779 group was decreased(P＜0.05),and the Tb.Sp was increased(P＜0.05).The bone pathological examination results showed that compared with sham operation group,the femur TBV of the rats in model group,Ang(1-7)group,DIZZ group and A779 group were decreased(P＜0.05),and MAR,OBI and OCI were increased(P＜0.05);compared with model group,the OBI and OCI of the rats in Ang(1-7)group and DIZE group were decreased(P＜0.05),and TBV was increased(P＜0.05),while the OBI and OCI of the rats in A779 group were increased(P＜0.05),and TBV was decreased(P＜0.05).Conclusion:The ACE2/Ang(1-7)/Mas axis improves high-turnover bone disease in the uremic rats.

Objective To explore the potential therapeutic targets and mechanisms of Shujinxi External Granules in the treatment of osteoarthritis(OA).Methods The chemical constituents and targets of Shujinxi External Granules were collected from TCMSP,TCMIP,TCMID and HERB databases,and the target genes related to OA were obtained from GEO database.Screening the overlapping targets,Cytoscape software was used to construct the"Shujinxi External Granules-compounds-OA-targets"and protein-protein interaction(PPI)networks.Gene Ontology(GO)analysis and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway enrichment analysis were performed on the overlapping targets through DAVID database,and the compounds and proteins with the highest degree values were selected for molecular docking by using AutoDock Vina.Results There were 85 components and 915 targets were found in Shujinxi External Granules.The 4 383 targets of OA were obtained,and 248 overlapping targets were screened out between Shujinxi External Granules and OA.The key target proteins were epidermal growth factor receptor(EGFR),cyclin-dependent kinase 1(CDK1),matrix metalloproteinase 9(MMP9),and the key compounds were N-trans-feruloyltyramine,palmatine,balanophonin,aurantiamide acetate,Saroaspidin A,luteolin,schizandrin,rhynchophylline,rhynchophylline A,kaempferol,1-piperoylpiperidine.A total of 489 biological processes,162 cellular components and 87 molecular functions were obtained by using GO functional enrichment analysis,and 100 signaling pathways related to the therapeutic of Shujinxi External Granules were obtained by using KEGG pathway enrichment analysis.The molecular docking results showed that N-trans-feruloyltyramine,1-piperonoylpiperidine and rhynchophylline A had good binding ability to the key targets EGFR,CDK1 and MMP9,respectively.Conclusion The Shujinxi External Granules may bind to the key targets EGFR,CDK1,and MMP9 in the pathways in cancer,hypoxia-inducible factor 1(HIF-1)and calcium signaling pathway through the key active components,such as N-trans-feruloyltyramine,rhynchophylline A,and 1-piperoylpiperidine,to exert the therapeutic effects on OA.

Chronic obstructive pulmonary disease (COPD) and pulmonary hypertension (PH) are both chronic progressive respiratory diseases that cannot be completely cured. COPD is characterized by irreversible airflow limitation, chronic airway inflammation, and gradual decline in lung function, whereas PH is characterized by pulmonary vasoconstriction, remodeling, and infiltration of inflammatory cells. These diseases have similar pathological features, such as vascular hyperplasia, arteriolar contraction, and inflammatory infiltration. Despite these well-documented observations, the exact mechanisms underlying the occurrence and development of COPD and PH remain unclear. Evidence that mitochondrial dynamics imbalance is one major factor in the development of COPD and PH. Mitochondrial dynamics is precisely regulated by mitochondrial fusion proteins and fission proteins. When mitochondrial dynamics equilibrium is disrupted, it causes mitochondrial and even cell morphological dysfunction. Mitochondrial dynamics participates in various pathological processes for heart and lung disease. Mitochondrial dynamics may be different in the early and late stages of COPD and PH. In the early stages of the disease, mitochondrial fusion increases, inhibiting fission, and thereby compensatorily increasing adenosine triphosphate (ATP) production. With the development of the disease, mitochondria decompensation causes excessive fission. Mitochondrial dynamics is involved in the development of COPD and PH in a spatiotemporal manner. Based on this understanding, treatment strategies for mitochondrial dynamics abnormalities may be different at different stages of COPD and PH disease. This article will provide new ideas for the potential treatment of related diseases.
Humans ; Mitochondrial Dynamics/physiology* ; Pulmonary Disease, Chronic Obstructive/metabolism* ; Hypertension, Pulmonary/metabolism* ; Mitochondria/metabolism* ; Animals

Objective To systematically evaluate the rumination in stroke patients and identify the influencing factors.Methods A mixed-methods systematic review was carried out by searching databases,such as CNKI,WanFang Data,VIP,CBM,PubMed,Web of Science,the Cochrane Library,Embase and Scopus databases,from the inception to 27th October,2023,for literature on the influencing factors of rumination in stroke patients.The researchers evaluated quality of the literature according to the mixed methods appraisal tool developed by McGill University of Canada.Then the data were collected,analysed and integrated using the convergent integration method proposed by the JBI Evidence-Based Health Care Research Centre of Australia.Results A total of 22 studies were included with an involvement of 4 949 patients.Then a total of 45 research topics were extracted and grouped into 8 categories.The influence factors of rumination were integrated,including individual factors,external support and coping strategies.Conclusions Stroke patients have different levels of rumination.Individual factors may affect rumination in patients.Harmonious interpersonal relationships and positive thinking with coping strategies can promote deliberate rumination.However,the effects of age,place of residence and household income on rumination in stroke patients are required to be further explored.

Objective:To analyze the case fatality rate of HIV/AIDS cases and influencing factors in Jingzhou.Methods:The data were retrieved from HIV/AIDS Comprehensive Response Information System and the cases diagnosed with HIV/AIDS in Jingzhou during 1996-2021 and aged 15 years or older were selected for the study. The death curve was drawn with Kaplan-Meier method, and Cox proportional-hazards model was used to identify influencing factors for death.Results:A total of 3 304 HIV/AIDS cases were followed up for 16 091.5 person-years, and 893 cases died, with a case fatality rate of 5.5/100 person-years. The cumulative case fatality rates of 1, 5 and 10 years were 15.4%, 25.0% and 34.6% respectively, the cumulative case fatality rates of 1, 5 and 10 years were 6.9%, 14.4% and 23.7% in the cases with access to antiretroviral therapy (ART), and 68.0%, 90.1% and 98.7% in the cases without access to ART. The results of Cox proportional hazards regression model showed that the risk for death was higher in those without access to ART than in those with access to ART (a HR=9.85, 95% CI: 8.19-11.85). The risk factors for death in those with access to ART included being men (a HR=1.64, 95% CI: 1.29-2.08), age ≥60 years old at diagnosis (a HR=3.52, 95% CI: 2.38-5.20), being infected by injecting drug use/others (a HR=2.38, 95% CI:1.30-4.34), being detected by medical institution (a HR=1.53, 95% CI: 1.11-2.11), CD4 +T lymphocytes(CD4) counts <50 cells/μl (a HR=2.58, 95% CI: 1.87-3.58). The protective factor for death was high education level (high school and technical secondary school: a HR=0.64,95% CI:0.46-0.90; college and above: a HR=0.42, 95% CI: 0.24-0.73). The risk factors for HIV/AIDS death in those without access to ART included older age at diagnosis (30-44 years old: a HR=2.32, 95% CI: 1.40-3.84; 45-59 years old:a HR=2.61, 95% CI: 1.59-4.27; ≥60 years old: a HR=3.31, 95% CI: 2.01-5.47), lower CD4 counts (<50 cells/μl: a HR=10.47, 95% CI: 6.47-16.56; 50-199 cells/μl: a HR=2.31, 95% CI: 1.08-4.94; 200-349 cells/μl: a HR=2.35, 95% CI: 1.46-3.79). Conclusions:The case fatality rate of HIV/AIDS was relatively high in Jingzhou from 1996 to 2021, the first CD4 counts, ART and age at diagnosis were the major factors affecting HIV/AIDS death, "Expanding testing" and "prompt treatment upon diagnosis" should be continued and enhanced to improve the efficacy of ART and HIV/AIDS case survival.

Objective:To analyze the ultrasound characteristics of small bowel volvulus among adults and to investigate the value of ultrasound in the diagnosis of small bowel volvulus.Methods:Totally 34 adults with small bowel volvulus confirmed by clinical diagnosis or surgery and who underwent ultrasound examination at Peking Union Medical College Hospital from August 2017 to October 2022 were enrolled, including 19 males and 15 females, aged (55.0±21.8) years (range: 19 to 94 years). The clinical characteristics, CT images and ultrasound images of the patients were retrospectively reviewed, and the ultra, sound features of small bowel volvulus and its diagnostic efficacy were analyzed.Results:Abdominal pain was the typical clinical symptom of all patients. Other symptoms included 21 cases of abdominal distension, 19 cases of nausea and vomiting, and 13 cases of cessation of passage of stool or flatus. Eight patients had signs of peritonitis and 22 patients had abnormal bowel sounds. Twenty patients had a history of abdominal surgery. Twenty-seven patients underwent surgery for intestinal obstruction, and the remaining 7 patients improved after conservative treatment. All cases were evaluated by ultrasound, 11 cases showed a “whirl sign” and were diagnosed as small bowel volvulus, the diagnostic accuracy rate was 32.4% (11/34), ultrasound simultaneously diagnosed intestinal obstruction in 21 cases, 17 cases of abdominal effusion, 4 cases of intestinal wall thickening, 2 cases of abdominal mass, 1 case of intussusception, 1 case of right sided inguinal hernia. CT and ultrasound had a consistent positive discovery in 88.2% (30/34) of all the patients.Conclusion:Ultrasound is valuable in the diagnosis of small bowel volvulus and the evaluation of complications.

Objective:To analyze the ultrasound characteristics of small bowel volvulus among adults and to investigate the value of ultrasound in the diagnosis of small bowel volvulus.Methods:Totally 34 adults with small bowel volvulus confirmed by clinical diagnosis or surgery and who underwent ultrasound examination at Peking Union Medical College Hospital from August 2017 to October 2022 were enrolled, including 19 males and 15 females, aged (55.0±21.8) years (range: 19 to 94 years). The clinical characteristics, CT images and ultrasound images of the patients were retrospectively reviewed, and the ultra, sound features of small bowel volvulus and its diagnostic efficacy were analyzed.Results:Abdominal pain was the typical clinical symptom of all patients. Other symptoms included 21 cases of abdominal distension, 19 cases of nausea and vomiting, and 13 cases of cessation of passage of stool or flatus. Eight patients had signs of peritonitis and 22 patients had abnormal bowel sounds. Twenty patients had a history of abdominal surgery. Twenty-seven patients underwent surgery for intestinal obstruction, and the remaining 7 patients improved after conservative treatment. All cases were evaluated by ultrasound, 11 cases showed a “whirl sign” and were diagnosed as small bowel volvulus, the diagnostic accuracy rate was 32.4% (11/34), ultrasound simultaneously diagnosed intestinal obstruction in 21 cases, 17 cases of abdominal effusion, 4 cases of intestinal wall thickening, 2 cases of abdominal mass, 1 case of intussusception, 1 case of right sided inguinal hernia. CT and ultrasound had a consistent positive discovery in 88.2% (30/34) of all the patients.Conclusion:Ultrasound is valuable in the diagnosis of small bowel volvulus and the evaluation of complications.

Objective:To compare the difference of chemical compositions of single decoction and mixed decoction of Gypsum Fibrosum - Anemarrhenae Rhizoma medicinal pair with different proportion.Methods:The Ultra Performance Liquid Chromatography (UPLC) and Ion Chromatography (IC) fingerprints of each sample were collected, and the independent sample t-test on the ratio of "peak area/weight" value of common peaks which was from the single decoction and mixed decoction samples was performed through SPSS 26.0.Results:In the UPLC fingerprint, there was significant difference in the "peak area/weight" values of peak 1, peak 2, peak 3, peak 6 and peak 13 between mixed decoction and single decoction with different compatibility ratios (1:1, 3:2, 2:1, 5:2, 3:1)( P<0.05), while peak 5 and peak 11 were without significant difference ( P>0.05). When the compatibility ratio of Gypsum Fibrosum and Anemarrhenae Rhizoma was 1:1, 3:2, 5:2, 3:1, there was significant difference in the "peak area/weight" values of peak 7 (neomangiferin) ( P<0.05). In the IC fingerprint, there was significant difference in the "peak area/weight" values of peak 1 between mixed decoction and single decoction with different compatibility ratios (1:1, 3:2, 2:1, 5:2, 3:1) ( P<0.05), while there was no significant difference in peak 5 (calcium ion) ( P>0.05). Conclusion:There are differences in the chemical component content of Gypsum Fibrosum-Anemarrhenae Rhizoma medicinal pair for single decoction and mixed decoction.

Background::Familial hypercholesterolemia (FH) is underrecognized, and its association with coronary artery disease (CAD) remains limited, especially in China. We aimed to investigate the prevalence of FH and its relationship with CAD in a large Chinese cohort.Methods::FH was defined using the Make Early Diagnosis to Prevent Early Death (MEDPED) criteria. The crude and age-sex standardized prevalence of FH were calculated based on surveys of the Prediction for Atherosclerotic Cardiovascular Disease Risk in China (China-PAR) project during 2007-2008. The associations of FH with incident CAD and its major subtypes were estimated with the cohort-stratified multivariate Cox proportional hazard models based on the data from the baseline to the last follow-up (2018-2020).Results::Among 98,885 included participants, 190 participants were defined as FH. Crude and age-sex standardized prevalence and 95% confidence interval (CI) of FH were 0.19% (0.17%–0.22%) and 0.13% (0.10%–0.16%), respectively. The prevalence varied across age groups and peaked in the group of 60–<70 years (0.28%), and the peak prevalence (0.18%) in males was earlier, yet lower than the peak crude prevalence in females (0.41%). During a mean follow-up of 10.7 years, 2493 cases of incident CAD were identified. After multivariate adjustment, FH patients had a 2.03-fold greater risk of developing CAD compared to non-FH participants.Conclusions::The prevalence of FH was estimated to be 0.19% in the participants, and it was associated with an elevated risk of incident CAD. Our study suggests that early screening of FH has certain public health significance for the prevention of CAD.

Background::Familial hypercholesterolemia (FH) is underrecognized, and its association with coronary artery disease (CAD) remains limited, especially in China. We aimed to investigate the prevalence of FH and its relationship with CAD in a large Chinese cohort.Methods::FH was defined using the Make Early Diagnosis to Prevent Early Death (MEDPED) criteria. The crude and age-sex standardized prevalence of FH were calculated based on surveys of the Prediction for Atherosclerotic Cardiovascular Disease Risk in China (China-PAR) project during 2007-2008. The associations of FH with incident CAD and its major subtypes were estimated with the cohort-stratified multivariate Cox proportional hazard models based on the data from the baseline to the last follow-up (2018-2020).Results::Among 98,885 included participants, 190 participants were defined as FH. Crude and age-sex standardized prevalence and 95% confidence interval (CI) of FH were 0.19% (0.17%–0.22%) and 0.13% (0.10%–0.16%), respectively. The prevalence varied across age groups and peaked in the group of 60–<70 years (0.28%), and the peak prevalence (0.18%) in males was earlier, yet lower than the peak crude prevalence in females (0.41%). During a mean follow-up of 10.7 years, 2493 cases of incident CAD were identified. After multivariate adjustment, FH patients had a 2.03-fold greater risk of developing CAD compared to non-FH participants.Conclusions::The prevalence of FH was estimated to be 0.19% in the participants, and it was associated with an elevated risk of incident CAD. Our study suggests that early screening of FH has certain public health significance for the prevention of CAD.