Steroid-induced avascular necrosis of femoral head（SANFH） is a bone and joint disease caused by prolonged and excessive steroid use. Its typical pathological features involve progressive circulatory disorders in the blood supply system of femoral head， leading to osteocyte apoptosis and bone tissue necrosis. As the disease progresses， it ultimately results in structural collapse and necrotic lesions of the femoral head， severely affecting patients' limb function and quality of life. Glucocorticoids mediate pathological damage through dual mechanisms， on the one hand， they disrupt the dynamic equilibrium between bone formation and resorption by suppressing osteoblast differentiation activity and activating osteoclastogenesis， on the other hand， they induce lipid metabolism disorders， inhibit angiogenesis， and impair endothelial cell function， thereby triggering microcirculatory disorders. Epimedii Folium and its active components exhibit multidimensional regulatory effects in SANFH prevention and treatment. Literature review reveals that it is rich in multiple active ingredients， primarily including total flavonoids of Epimedii Folium， icaritin， icariin， kaempferol， icariside Ⅱ， etc. These compounds exert multiple pharmacological effects（regulating bone metabolic homeostasis， modulating angiogenesis， correcting lipid metabolism disorders， and controlling cellular autophagy processes） through multiple signaling pathways， including Wnt/β-catenin， transforming growth factor（TGF）-β/bone morphogenetic protein（BMP）/Smad， mitogen-activated protein kinase（MAPK）， phosphoinositide 3-kinase/protein kinase B（PI3K/Akt）， osteoprotegerin/receptor activator of nuclear transcription factor-κB ligand/receptor activator of nuclear transcription factor-κB（OPG/RANKL/RANK）， etc. Based on existing research findings， this paper systematically elucidates the intervention mechanisms of active components in Epimedii Folium on key pathological processes of SANFH through the above pathways. It also deeply analyzes their regulatory roles in key nodes of different signaling pathways， aiming to provide valuable references for future clinical treatment and experimental research.

The aim of this study is to explore the protective mechanism of Jiedu Tongluo Tiaogan decoction(JTTD)on islet cells of type 2 diabetic SD rats based on autophagy regulation.8-week-old SD male mice were fed with high-fat diet for 4 weeks and then induced with a single intraper-itoneal injection of streptozotocin 40 mg/kg.The Chinese medicine group was given the low(1.5 g·kg-1·d-1),medium(4.5 g·kg-1·d-1)and high(13.5 g·kg-1·d-1)doses of JTTD,and the western medicine group was given metformin hydrochloride(0.15 g·kg-1·d-1).Fasting blood glucose(FBG),glycated serum protein(GSP),triglycerides(TG),cholesterol(CHO),high-densi-ty lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),free fat(FFA)were measured.Moreover,the fasting serum insulin was determined by ELISA method and insulin resistance index(HOMA-IR)was calculated,glucose tolerance test was performed.The pancreatic tissues of SD mice were stained with HE,and the expression of Beclin-1 and LC3 were checked by immunohistochemistry,the expression of Beclin-1,LC3 and P62 was determined by Western blot,the expression of Beclin-1 and LC3RNA was determined by RT-PCR.The results showed that both the JTTD group and metformin hydrochloride group had better hypoglycemic and lipid-lowering effects(P＜0.05,P＜0.01).HE staining of pancreatic tissues showed that disorganized structure,unclear boundary,irregular arrangement,less cytoplasm,and lighter cytoplasmic staining or vacuo-lation in the islets in the JTTD group and metformin hydrochloride group were improved.In terms of autophagy regulation,immunohistochemistry,Western blot and RT-PCR,compared with the model group,the expression of Beclin-1 and LC3 mRNA was significantly increased(P＜0.01)and the level of p62 protein was decreased(P＜0.05,P＜0.01)in the JTTD group and metformin hydrochloride group.In conclusion,the JTTD can alleviate the trend of weight loss and improve ex-cessive drinking effectively in type 2 diabetic mellitus SD mice,as well as have better effects on im-proving glucose and lipid metabolism,moreover,it can alleviate the damage of pancreatic his-topathological structure and protect islet cells,which may be achieved by regulating the level of au-tophagy.

Objective:To evaluate the value of plasma aldosterone concentration (PAC)/renin concentration (PRC) ratio (ARR) combined with aldosterone, renin, and sodium/potassium ratio in the diagnosis of primary aldosteronism (PA).Methods:From January 2017 to October 2019, 105 patients were admitted to our hospital and diagnosed as PA and essential hypertension (EH) by clinical manifestations, laboratory examination and surgical pathological biopsy.The optimum cut-off point of ARR, PRC, PAC, plasma sodium-potassium ratio were determined by the Receiver Operating Characteristic (ROC). The sensitivity, specificity and Youden index at the optimum cut-off point were calculated in a separate test. By means of diagnostic test, the best cut-off points of ARR were tested in series with the best cut-off points of PRC, PAC and serum sodium/potassium ratio, respectively, and their specificity were calculated.Results:The area under the AUC of supine ARR was greater than that of vertical ARR (0.966 vs 0.946, Z= 1.380, P= 0.168), but there was no statistical difference. The optimum cut-off point of supine ARR was 28.64(pg/ml)/(pg/ml), with a sensitivity of 92.4% and specificity of 90.5%. The sensitivity of the combined PRC test was 79.0% and the specificity was 94.3%. The sensitivity of the combined PAC test was 65.7% and the specificity was 95.2%. The sensitivity of the combined serum sodium/potassium ratio was 50.5% and the specificity was 96.2%. The optimal cut-off of vertical ARR was 22.10 (pg/ml)/(pg/ml), with 91.4% specificity and 85.7% specificity. The sensitivity of vertical ARR combined with PRC was 78.1%, specificity was 89.5%. The sensitivity of combined PAC was 74.3%, specificity was 92.4%, and the sensitivity of combined sodium/potassium ratio was 50.5%, specificity was 95.2%. Conclusions:There was little difference in the diagnostic performance of PA between vertical and supine ARR values. The specificity of PA screening by ARR alone was high, and the specificity and accuracy of PA diagnosis could be improved by combining PRC, PAC and sodium/potassium ratio.

Adult ; Cell Cycle Proteins/genetics* ; Codon, Nonsense/genetics* ; Consanguinity ; Humans ; Infertility, Male/genetics* ; Male ; Oligospermia/genetics* ; Pedigree ; Spermatogenesis/genetics*

Objective To investigate the role of motility of Oddi's sphincter in pigment gallbladder stone formation in the model of guinea pigs.Methods Thirty-four general adult male Hartley guinea pigs were divided randomly into two groups.Control group (10 guinea pigs)and pigment stone groups (24 guinea pigs,which were divided into 4 subgroups with 6 guinea pigs each according to the time they were sacrificed),fed with pigment lithogenic diet.After 3,6,9 and 12 weeks later,Oddi's sphincter manometry and myoelectric activity record were obtained by multifunctional physiograph at each stage.Results The incidence of pigment gallstone formation was 0,0,16.7％ and 66.7％ in 3w,6w,9w and 12w group,respectively.The frequency of myoelectric activity decreased apparently in the 3w group(P ＜ 0.05).The amplitude of myoelectric activity had the tendency of decreasing but not statistically significant.The motility frequency of Oddi's sphincter decreased greatly in the 9w group (P ＜ 0.05).The basal pressure of Oddi's sphincter and common bile duct increased markedly in the 12w group [from (25 ± 8) mmHg (1 mmHg =0.133 kPa) to (41 ± 12) mmHg and from (22 ± 8) mmHg to (39 ± 12) mmHg,P ＜ 0.05)].Conclusions Pigment lithogenic diet may induce dysfunction of Oddi's sphincter.The disturbance of Oddi's sphincter motility may play a role in pigment gallstone formation.

OBJECTIVETo determine the major factors affecting the conversion efficiency of naringin-HP-beta-CD that was enzymed to prepare naringenin were determined and select the process condition with high conversion efficiency, stable and suitable for industrial production.

METHODThe dropping method was used to prepare naringin-HP-beta-CD, which was hydrolyzed by snailase to obtain naringenin. With the bioconversion rate as the index, the effects of pH value, temperature, reaction time, dosage of enzyme and concentration of naringin-HP-beta-CD on conversion rate of naringenin were detected for the purpose of optimizing the preparation condition. the conversion efficiency of naringin-HP-beta-CD was verified by scanning calorimetry, and the Hydrolysis product was identified by H-NMR, and 13C-NMR.

RESULTThe optimum enzymolysis of naringin-HP-beta-CD with snailase was 98.4% under the conditions of 37 degrees C, a pH 5.0 acetic acid- sodium acetate buffer solution for 12 hours. The substrate concentration was 30 g x L(-1) and the weight ratio of enzyme and substrate was 3: 5. Under the optimum enzymolysis condition, the conversion rate of naringin-HP-beta-CD was higher than naringin that was not entrapped with HP-beta-CD, with 272.25 reaction product relative molecules. The structure of naringenin was confirmed by the analysis of 1H-NMR and 13C-NMR.

CONCLUSIONNaringin which is entrapped with HP-beta-CD to prepare naringenin can significantly improve the conversion efficiency by shortening the reaction time, increasing the concentration of the substrate and reducing the amount of enzyme. Therefore, the process is stable and it was suitable for industrialization.

2-Hydroxypropyl-beta-cyclodextrin ; Flavanones ; chemistry ; isolation & purification ; Hydrolysis ; Solubility ; beta-Cyclodextrins ; chemistry

OBJECTIVETo evaluate the short-term results of humeral head replacement for the treatment of four-part proximal humeral fractures or fracture-dislocations.

METHODSTwenty-five patients (11 male and 14 female)with four-part proximal humeral fractures or fracture-dislocations underwent humeral head replacement. The average age was 68.2 years (ranging from 56 to 77 years). All cases were followed up and evaluated the clinical results including pain, function and range of motion of shoulder with Neer scoring system.

RESULTSThe follow-up ranged from 12 to 40 months with an average time of 29.3 months. No prosthesis loosening, prosthesis dislocation, postoperative infection, nerve injury or periprosthesis fractures occurred. The results were excellent in 8 cases, good in 11 cases and fair in 6 cases. The excellent and good rate was 76% according to Neer scoring system.

CONCLUSIONReplacement of humeral head prosthesis could attain good short-term results for four-part proximal humeral fractures or fracture-dislocations. The key to improve the postoperative results is meticulous surgical techniques and appropriate correct consecutive physical therapy.

Aged ; Arthroplasty, Replacement ; methods ; Female ; Humans ; Joint Prosthesis ; Male ; Middle Aged ; Shoulder Dislocation ; surgery ; Shoulder Fractures ; surgery ; Treatment Outcome