Osteoporosis is a prevalent skeletal condition characterized by reduced bone mass and strength, leading to increased fragility. Buqi-Tongluo (BQTL) decoction, a traditional Chinese medicine (TCM) prescription, has yet to be fully evaluated for its potential in treating bone diseases such as osteoporosis. To investigate the mechanism by which BQTL decoction inhibits osteoclast differentiation in vitro and validate these findings through in vivo experiments. We employed MTS assays to assess the potential proliferative or toxic effects of BQTL on bone marrow macrophages (BMMs) at various concentrations. TRAcP experiments were conducted to examine BQTL's impact on osteoclast differentiation. RT-PCR and Western blot analyses were utilized to evaluate the relative expression levels of osteoclast-specific genes and proteins under BQTL stimulation. Finally, in vivo experiments were performed using an osteoporosis model to further validate the in vitro findings. This study revealed that BQTL suppressed receptor activator of NF-κB ligand (RANKL)-induced osteoclastogenesis and osteoclast resorption activity in vitro in a dose-dependent manner without observable cytotoxicity. The inhibitory effects of BQTL on osteoclast formation and function were attributed to the downregulation of NFATc1 and c-fos activity, primarily through attenuation of the MAPK, NF-κB, and Calcineurin signaling pathways. BQTL's inhibitory capacity was further examined in vivo using an ovariectomized (OVX) rat model, demonstrating a strong protective effect against bone loss. BQTL may serve as an effective therapeutic TCM for the treatment of postmenopausal osteoporosis and the alleviation of bone loss induced by estrogen deficiency and related conditions.
Animals ; NFATC Transcription Factors/genetics* ; Drugs, Chinese Herbal/pharmacology* ; Ovariectomy ; Osteoclasts/metabolism* ; Female ; Osteogenesis/drug effects* ; Rats, Sprague-Dawley ; Rats ; NF-kappa B/genetics* ; Osteoporosis/genetics* ; Signal Transduction/drug effects* ; Bone Resorption/genetics* ; Cell Differentiation/drug effects* ; Humans ; RANK Ligand/metabolism* ; Mitogen-Activated Protein Kinases/genetics* ; Transcription Factors

Objective To compare the intestinal injury induced by different intensities of waveshock in rats exposed to extremely cold environment and to preliminarily explore the characteristics of the injury.Methods Sixty healthy male SD rats(2 months old,weighing 200～250 g)were randomly divided into 6 groups(n=10):blank control group,low-temperature control group,5.0 MPa shock control group,and low-temperature+4.0,4.5 and 5.0 MPa shock groups.The rats in the experimental groups were pre-treated in a-10℃low-temperature environment for 30 min and then subjected to intestinal injury by using BST-I biological shock tube with different driving pressures.At 3,8,and 24 h after injury,the serum levels of IL-6,TNF-α,intestinal fatty acid binding protein(I-FABP),and diamine oxidase(DAO)were detected,and the survival of rats within 24 h was recorded.At 24 h after injury,the rats were anesthetized and dissected,the characteristics of intestinal injury were observed,and pathological examination was performed.The differences of intestinal injury were compared among the 6 groups to explore the characteristics of intestinal injuries after different intensities of shockwave in rats after exposure to extremely cold environment.Results Compared with the blank control group,the other 5 groups exhibited different severities of intestinal injury,and the rats in the low-temperature+different shock groups were more prone to intestinal edema and trauma.The mortality rate was significantly increased in the low-temperature+5.0 MPa shock group(P<0.05).Pathological and serological studies found that dual effects of very cold environment and blast injury resulted in intestinal mucosal hemorrhage,edema,and disintegration of lamina propria in the experimental rats.The indicators of intestinal mucosal injury and intestinal inflammatory factors were also significantly increased when compared with the blank control group,and significant differences were among the groups with increment of shock intensity(P<0.05).Conclusion Exposure to very cold environment combined with abdominal blast injury increases mortality rate in rats,manifested by elevated serological indicators and intestinal inflammatory factors,as well as varying severities of intestinal wall edema and submucosal bleeding.Furthermore,the severity of the injury is positively related to the impact intensity,with worsened as the impact intensity increasing.

Objective To explore the relationship between minimal residual disease(MRD)on the 19th day(D19)and prognosis of children with acute B-lymphoblastic leukemia(B-ALL),as well as the correlation with related biological changes.Methods A total of 88 children with B-ALL newly diagnosed in this hospital from April 2016 to April 2020 who met the enrollment conditions were analyzed for induction therapy D19 MRD,overall survival(OS)rate,event-free survival(EFS)rate,chromosome karyotype,fusion gene and mu-tation gene.MRD≥ 0.01％was considered positive,and they were divided into MRD positive group and MRD negative group.The characteristics of OS rate,EFS rate,immunophenotype and molecular biology/cytogenet-ics were compared between the two groups over a period of 3 years.Results The 3-year OS rate and EFS rate of 88 pediatric patients were 92.0％and 86.4％,respectively.The rates of OS rate and EFS rate in MRD posi-tive group were lower than those in MRD negative group,with statistical significance(P＜0.05).The detec-tion rate of CD10 in MRD positive group was lower than that in MRD negative group,and the difference was statistically significant(P＜0.05).Thirty-two patients(36.4％)detected 8 types of 35 fusion genes.The de-tection rates of BCR-ABL1 and E2A-PBX1 in MRD positive group were higher than those in MRD negative group,and the differences were statistically significant(P＜0.05).Among 48 cases(54.5％)of pediatric pa-tients,41 types of 91 mutated genes were detected,and the remaining mutated genes were less than 5 cases.Abnormal karyotype was detected in 18 cases(20.5％),and no mitotic phase was detected in 17 cases.There was no difference in MRD between normal and abnormal karyotype.Binary Logistic regression analysis showed that BCR-ABL1 and E2A-PBX1 were prognostic factors of children with B-ALL.Conclusion The positive D19 MRD is the influential factor of adverse OS and EFS in children with B-ALL.Both E2A-PBX1 and BCR-ABL1 have adverse effects on the prognosis of children with B-ALL.

Objective To explore the application value of metagenomic next-generation sequen-cing(mNGS)technology in the diagnosis of spinal tuberculosis.Methods A total of 129 patients with suspected spinal tuberculosis admitted from January 2021 to January 2023 were selected as study subjects.Lesion tissue samples were collected intraoperatively and subjected to conventional microbio-logical testing(CMT),Mycobacterium tuberculosis DNA(MTB-DNA)amplification testing,and mNGS testing.The diagnostic efficacy of different testing methods was compared using results of com-prehensive clinical diagnosis as the gold standard.Results Among 129 patients,101(78.29％)were confirmed to have spinal tuberculosis,and 28(21.71％)had other spinal infections.Using clinical results as the diagnostic gold standard,the sensitivity of mNGS was 94.06％(95/101),and specificity was 89.29％(25/28);the sensitivity of MTB-DNA amplification was 90.10％(91/101),and specificity was 89.29％(25/28);the sensitivity of CMT was 86.14％(87/101),and specifici-ty was 85.71％(24/28).Compared with MTB-DNA amplification and CMT,mNGS showed the highest consistency with clinical results,and its consistency in detecting different lesion sites was also optimal,with statistically significant differences(P＜0.05).Conclusion mNGS testing has high diagnostic value for spinal tuberculosis and can provide a reference for clinical diagnosis,thereby guiding clinical decision-making.

BACKGROUND:Epigenetics,as an important regulation mode of gene expression network,has been proved to play an important role in the occurrence and development of aortic aneurysm mediated by vascular smooth muscle cell remodeling. OBJECTIVE:To review the epigenetic regulation mechanism underlying vascular smooth muscle cell remodeling during the occurrence and progression of aortic aneurysm. METHODS:Related articles published from 1970 to 2022 were retrieved from PubMed,Web of Science and CNKI databases.The keywords were"Aortic aneurysm,Vascular smooth muscle,Smooth muscle cells,Epigenetic,DNA methylation,Histone modification,Non coding RNA"in English and Chinese.Ultimately,we included 71 articles for review. RESULTS AND CONCLUSION:Epigenetic modification can influence the occurrence and progression of aortic aneurysm by targeting vascular smooth muscle cell remodeling and extracellular matrix degradation.Targeted epigenetic modification can play a key role in aortic aneurysm treatment,delaying the disease and improving the prognosis.Epigenetic related enzymes,such as DNA methylesterases and histone-modifying enzymes,can influence the progression of aortic aneurysm by regulating vascular smooth muscle cell remodeling,including cell proliferation,migration and apoptosis,and can be used as targets for drug therapy.The research of epigenetic modification on aortic aneurysm is still in the basic research stage and some epigenetic modification mechanisms have not yet been explored.With the development of medical research,targeted epigenetic modification is expected to achieve new breakthroughs in the treatment of aortic aneurysm and clinical transformation.

Objective To investigate the impact of anti-reflux modified duodenal exclusion surgery on glucose metabolism in rats with type 2 diabetes mellitus (T2DM), and to elucidate the role of the duodenum in maintaining glucose homeostasis. MethodsForty male Sprague-Dawley rats aged 5 weeks were fed a high-fat diet and induced with T2DM using low-dose streptozotocin. Thirty-six rats that met the T2DM model criteria were randomly divided into three groups: the simple duodenal exclusion surgery group (DE group), the anti-reflux modified duodenal exclusion group (MDE group), and the sham operation group (SO group), with 12 rats in each group. Gastroenterography was performed 4 weeks after surgery, and the body weight, fasting blood glucose levels, and serum glucagon-like peptide-1 (GLP-1) concentrations were measured before surgery and at 1, 2, 4, and 8 weeks post-surgery. Eight weeks post-surgery, the rats were euthanized, and a 1 cm segment of the biliopancreatic loop was collected from each group for pathological sectioning and HE staining to observe the intestinal mucosal villus length under an optical microscope. Results Gastroenterography showed that there was significant reflux of the contrast agent into the duodenal lumen in the DE group, while no reflux was observed in the MDE group. At one week post-surgery, the body weights of rats in all three groups significantly decreased compared to before surgery (P<0.05), and then the body weights of all groups increased over time, with no significant differences between the groups (P>0.05). Compared with the SO group, the fasting blood glucose levels in the MDE and DE groups significantly decreased at all time points post-surgery (P<0.05), while GLP-1 concentrations significantly increased (P<0.05). The fasting blood glucose levels in the MDE group were lower than those in the DE group at all time points post-surgery (P<0.05), but there were no significant differences in serum GLP-1 concentrations between the MDE and DE groups (P>0.05). Regarding intestinal mucosal morphology, the villus lengths of the biliopancreatic loops in the MDE group were significantly shorter than those in the DE and SO groups (P<0.05). Conclusion Anti-reflux modified duodenal exclusion surgery effectively improves glucose metabolism in T2DM rats by preventing the reflux of chyme into the diverted duodenum, thereby enhancing its hypoglycemic effect.

Background::Hypothermia therapy has been suggested to attenuate myocardial necrosis; however, the clinical implementation as a valid therapeutic strategy has failed, and new approaches are needed to translate into clinical applications. This study aimed to assess the feasibility, safety, and efficacy of a novel selective intracoronary hypothermia (SICH) device in mitigating myocardial reperfusion injury.Methods::This study comprised two phases. The first phase of the SICH was performed in a normal porcine model for 30 minutes ( n = 5) to evaluate its feasibility. The second phase was conducted in a porcine myocardial infarction (MI) model of myocardial ischemia/reperfusion which was performed by balloon occlusion of the left anterior descending coronary artery for 60 minutes and maintained for 42 days. Pigs in the hypothermia group ( n = 8) received hypothermia intervention onset reperfusion for 30 minutes and controls ( n = 8) received no intervention. All animals were followed for 42 days. Cardiac magnetic resonance analysis (five and 42 days post-MI) and a series of biomarkers/histological studies were performed. Results::The average time to lower temperatures to a steady state was 4.8 ± 0.8 s. SICH had no impact on blood pressure or heart rate and was safely performed without complications by using a 3.9 F catheter. Interleukin-6 (IL-6), tumor necrosis factor-α, C-reactive protein (CRP), and brain natriuretic peptide (BNP) were lower at 60 min post perfusion in pigs that underwent SICH as compared with the control group. On day 5 post MI/R, edema, intramyocardial hemorrhage, and microvascular obstruction were reduced in the hypothermia group. On day 42 post MI/R, the infarct size, IL-6, CRP, BNP, and matrix metalloproteinase-9 were reduced, and the ejection fraction was improved in pigs that underwent SICH.Conclusions::The SICH device safely and effectively reduced the infarct size and improved heart function in a pig model of MI/R. These beneficial effects indicate the clinical potential of SICH for treatment of myocardial reperfusion injury.

Objective To investigate the safety and clinical effect of prophylactic ileostomy using right lower abdominal specimen extraction incision in laparoscopic rectal low anterior resection and its impact on ileos-tomy closure.Methods A retrospective analysis was conducted on 127 patients who underwent laparoscopic low anterior resection of rectal cancer combined with prophylactic ileostomy in Department of General Surgery in our hospital from January 2020 to December 2023.Patients were divided into observation group(n=60)and control group(n=67)based on whether with prophylactic ileostomy using the right lower abdominal specimen extraction incision or not.Relevant data and clinical data of ileostomy closure were compared between the two groups.Results(1)There was no significant difference in baseline clinical data between the two groups(P>0.05).(2)In terms of operation time,pain score within three days after surgery and postoperative first exhaust time,the observation group was better than the control group,showing statistical difference(P<0.05).In the observation group,the average length of the incision was longer than that in the control group,and it was significantly different between the two groups(P<0.05).There was no significant difference between the two groups in terms of blood loss,post-operative feeding time and postoperative hospital stay(P>0.05).(3)There was no significant difference between the two groups in postoperative and ostomy-related complication S(P>0.05).(4)The observation group was better than the control group in terms of postoperative pain score and postoperative first exhaust time,indicating statistical significance(P<0.05).There were no significant differences in surgical time,abdominal adhesion,blood loss,postoperative hospital stay and postoperative complications between the two groups(P>0.05).Conclusion The patients undergoing laparoscopic rectal low anterior resection who needs prophylactic ileostomy using right lower abdominal specimen extraction incision can improve the appearance of the incision,shorten operation time,reduce postoperative pain of the patients but does not increase postoperative complications and the difficulty of ileostomy closure.It is safe and feasible,which worthy for clinical promotion.

Objective:To study the efficacy of Alteplase in repairing T-lymphocyte mediated brain tissue immunoinflammatory damage after acute ischemic stroke(AIS).Methods:A total of 100 patients with AIS admitted to Hengshui People's Hospital from June 2022 to June 2023 were selected,and divided into regular group and Alteplase group,with 50 cases in each group,after enroll-ment,the regular group received routine intervention treatment,while the Ateplase group received thrombolytic therapy with Ateplase.Compared changes in neurological function,cerebrovascular reserve function,cerebral hemodynamics,T lymphocytes mediated brain tissue immunoinflammatory damage indicators CD4+T cell subsets[pro-inflammatory cells(Th1,Th17),anti-inflammatory cells(Th2,Treg cells)]and related cytokines levels between two groups of patients,and evaluated clinical efficacy and prognosis.Results:After treatment,NIHSS score of Alteplase group was lower than that of regular group[(6.57±0.79)points vs(9.34±1.23)points,t=13.400,P<0.05].CVR and BHI of cerebral vascular reserve in Alteplase group were higher than those in regular group[(34.54±4.35)%vs(29.89±2.31)%,1.00±0.23 vs 0.92±0.08,t=6.676,2.323,P<0.05],PI was lower than that of regular group(0.60±0.07 vs 0.72±0.08,t=7.982,P<0.05).Cerebral hemodynamic CBF of Alteplase group was higher than that of regular group[(49.89±9.76)ml/(100 g/min)vs(40.34±7.86)ml/(100 g/min),t=5.389,P<0.05].MTT and TTP were shorter than those in regular group[(6.45±0.78)s vs(9.78±1.02)s,(24.45±2.16)s vs(26.78±3.25)s,t=18.340,4.222,P<0.05].Proportion of Th1 and Th17 cells and levels of IFN-γ and IL-17 in Ateplase group were lower than those in regular group[(3.27±0.59)%vs(5.64±0.52)%,(2.34±0.25)%vs(4.35±0.38)%,(3.24±0.45)pg/ml vs(4.90±0.65)pg/ml,(10.23±1.43)pg/ml vs(14.35±2.14)pg/ml,t=21.310,31.250,14.850,11.320,P<0.05),proportion of Th2 and Treg cells and levels of IL-4 and TGF-β were higher than those in regular group[(8.75±0.54)%vs(7.02±0.37)%,(7.24±2.13)%vs(5.88±1.67)%,(13.24±2.16)pg/ml vs(10.26±1.29)pg/ml,(90.32±9.02)pg/ml vs(81.45±8.97)pg/ml,t=18.690,3.553,8.375,4.930,P<0.05].Total effective rate and good prognosis rate of Alteplase group were higher than those of regular group(94.00%vs 80.00%,80.00%vs 62.00%,χ2=4.332,3.934,P<0.05).Conclu-sion:In treatment of AIS,Alteplase has effect of repairing the immune inflammation injury of brain tissue mediated by T lymphocytes,alleviating brain injury,improving cerebrovascular reserve function and nerve function,and the prognosis is good.

Objective:To explore the types of pre-diagnosis symptom clusters in patients with acute coronary syndrome (ACS) and identify bridge symptoms between symptom clusters.Methods:From May to October 2023, convenience sampling was used to select 243 ACS patients who visited Shanxi Provincial People's Hospital as participants. The General Information Questionnaire and Chinese version of the McSweeney Acute and Prodromal Myocardial Infarction Symptoms Survey were used for the survey. Exploratory factors were used to analyze symptom clusters, while network analysis was used to identify bridge symptoms between symptom clusters. A total of 243 questionnaires were distributed, and 230 valid questionnaires were collected, with a valid response rate of 94.7% (230/243) .Results:Before diagnosis, ACS patients had four symptom clusters, namely typical chest symptom cluster, typical shoulder and back symptom cluster, fatigue related symptom cluster, and cardiopulmonary symptom cluster. In symptom network analysis, fatigue and anxiety were bridge symptoms between symptom clusters, with fatigue having the highest expected impact coefficient ( rbei=0.387 3), followed by close centrality ( rbc=0.024 2). The bridge mediation ( rbb=35.000) and close centrality ( rbc=0.024 8) of anxiety were the highest. Conclusions:Fatigue and anxiety are bridge symptoms in ACS patients, connecting different symptom clusters. Identifying bridge symptoms is beneficial for improving the efficiency and accuracy of symptom management. Research needs to consider patient heterogeneity and conduct subgroup studies on symptom clusters to further explore the practical significance of core and bridge symptoms in clinical practice.