Objective:To analyze the X-ray imaging characteristics of calcaneus in adult patients with osteoarticular diseases and its impact on disease diagnosis.Methods:Totally 78 patients (156 ankle joints) with osteoarticular diseases admitted to the Affiliated Hospital of Jining Medical University from June 2019 to June 2022 were selected as research subjects, including 72 cases of osteoarthritis and 6 cases of Kashin-Beck disease. Another 50 volunteers who underwent health examination in this hospital during the same period were selected as control group, all of them underwent calcaneal X-ray examination. Receiver operating characteristic (ROC) curve was used to analyze the diagnostic efficacy of calcaneal X-ray parameters in predicting adult osteoarticular diseases.Results:Among 72 patients with osteoarthritis, 63 cases (87.50%) showed joint surface sclerosis in the calcaneal X-ray changes. Forty-seven cases (65.28%) had narrowing of the subtalar joint space; 14 cases showed disappearance of the subtalar joint space, accounting for 19.44%. Among the 6 patients with Kashin-Beck disease, the X-ray changes of the calcaneus showed joint surface sclerosis in 6 cases, narrowing of the subtalar joint space in 4 cases, and disappearance of the subtalar joint space in 2 cases. The length, height, Bohler angle, Gissane angle, and inclination angle of the calcaneus in patients with Kashin-Beck disease were all smaller than those in the osteoarthritis group and the control group, the height to length ratio of the calcaneus was higher than that in the osteoarthritis group and the control group, and the difference was statistically significant ( P < 0.05). The length, height, Bohler angle, Gissane angle, and inclination angle of the calcaneus in patients of the osteoarthritis group were all smaller than those in the control group, and the height to length ratio of the calcaneus was higher than that in control group, and the difference was statistically significant ( P < 0.05). ROC curve analysis showed that the sensitivity of Bohler angle, Gissane angle, and the height to length ratio of the calcaneus in predicting osteoarticular diseases (72 patients with osteoarthritis) were 92.5%, 87.6% and 80.4%, respectively, with specificity of 73.0%, 68.8% and 63.1%, respectively. Conclusion:The calcaneal X-ray manifestations of adult patients with osteoarticular diseases vary greatly, among which Bohler angle, Gissane angle, and height to length ratio of the calcaneus have certain accuracy in diagnosis of osteoarthritis.

Aim To explore the correlation between residual lipoprotein cholesterol(RLP-C)and the occurrence and severity of peripheral arterial disease(PAD)in patients with type 2 diabetes mellitus(T2DM).Meth-ods 392 T2DM patients with complete data who attended the Department of Endocrinology and the Department of Cardio-vascular Medicine of People's Hospital of Henan University of Traditional Chinese Medicine from May 2022 to December 2022 were selected and classified into PAD group(n=203)and non-PAD group(n=189).General clinical data were collected between the groups,the difference of RLP-C level was compared between the two groups,the correlation between RLP-C and PAD was examined by using univariate and multivariate Logistic regression analysis,and ROC curve was plotted to analyze the predictive value of RLP-C for PAD.Results Compared with non-PAD group,RLP-C level was significantly higher in PAD group(P＜0.001);RLP-C was positively correlated with the severity of PAD(r=0.443,P＜0.001);Multifactorial Logistic regression analysis revealed that RLP-C was a major risk factor for the development of PAD in T2DM(P＜0.001);The area under the curve(AUC)of RLP-C level prediction for T2DM combined with PAD was 0.860(95％CI:0.824～0.896,P＜0.001);The optimal RLP-C threshold for predicting the development of PAD was 0.67 mmol/L.Conclusion RLP-C level was positively associated with the occurrence and severity of PAD in patients with T2DM,and RLP-C was an independent risk factor for the development of PAD.In addition,RLP-C＞0.67 mmol/L increased the risk of PAD in T2DM patients.

Objective:To observe the effects of repetitive transcranial magnetic stimulation combined with divergent shock wave on muscle spasm in patients with traumatic spinal cord injury,and to explore a new clinical treatment method for the disease. Method:Fifity-nine patients with traumatic spinal cord injury with muscle spasm from January 2017 to June 2021 were selected and randomly divided into the observation group(n=30)and the control group(n=29)with the method of random number table.The patients in the observation group received repeated transcranial magnet-ic stimulation combined with divergent shock wave therapy,while the patients in the control group received ba-clofen treatment.Both groups received conventional rehabilitation therapy,including exercise therapy,acupunc-ture and massage.The treatment time was 8 weeks.The modified Ashworth score,Barthel index and SF-36 score of the patients in the observation group and the control group were compared before and after treatment. Result:After treatment,the effective rate of the observation group was 86.67％,which was significantly high-er than that of the control group(P＜0.05).The total score of Barthel index and SF-36 score of the two groups were significantly increased compared with those before treatment(P＜0.05).The Barthel index and SF-36 score in the observation group were significantly higher than those in the control group(P＜0.05). Conclusion:Repetitive transcranial magnetic stimulation combined with divergent shock wave can effectively im-prove the symptoms of muscle spasm in patients with traumatic spinal cord injury and can fully improve their ability of daily life and quality of life,which has achieved good clinical efficacy.

OBJECTIVES: To investigate the mechanism of comorbidity between non-alcoholic fatty liver disease (NAFLD) and atherosclerosis (AS) based on metabolomics and network pharmacology. METHODS: Six ApoE^－/－ mice were fed with a high-fat diet for 16 weeks as a comorbid model of NAFLD and AS (model group). Normal diet was given to 6 wildtype C57BL/6J mice (control group). Serum samples were taken from both groups for a non-targeted metabolomics assay to identify differential metabolites. Network pharmacology was applied to explore the possible mechanistic effects of differential metabolites on AS and NAFLD. An in vitro comorbid cell model was constructed using NCTC1469 cells and RAW264.7 macrophage. Cellular lipid accumulation, cell viability, morphology and function of mitochondria were detected with oil red O staining, CCK-8 assay, transmission electron microscopy and JC-1 staining, respectively. RESULTS: A total of 85 differential metabolites associated with comorbidity of NAFLD and AS were identified. The top 20 differential metabolites were subjected to network pharmacology analysis, which showed that the core targets of differential metabolites related to AS and NAFLD were STAT3, EGFR, MAPK14, PPARG, NFKB1, PTGS2, ESR1, PPARA, PTPN1 and SCD. The Kyoto Encyclopedia of Genes and Genomes showed the top 10 signaling pathways were PPAR signaling pathway, AGE-RAGE signaling pathway in diabetic complications, alcoholic liver disease, prolactin signaling pathway, insulin resistance, TNF signaling pathway, hepatitis B, the relax in signaling pathway, IL-17 signaling pathway and NAFLD. Experimental validation showed that lipid metabolism-related genes PPARG, PPARA, PTPN1, and SCD were significantly changed in hepatocyte models, and steatotic hepatocytes affected the expression of macrophage inflammation-related genes STAT3, NFKB1 and PTGS2; steatotic hepatocytes promoted the formation of foam cells and exacerbated the accumulation of lipids in foam cells; the disrupted morphology, impaired function, and increased reactive oxygen species production were observed in steatotic hepatocyte mitochondria, while the formation of foam cells aggravated mitochondrial damage. CONCLUSIONS Abnormal lipid metabolism and inflammatory response are distinctive features of comorbid AS and NAFLD. Hepatocyte steatosis causes mitochondrial damage, which leads to mitochondrial dysfunction, increased reactive oxygen species and activation of macrophage inflammatory response, resulting in the acceleration of AS development.
Animals ; Mice ; Non-alcoholic Fatty Liver Disease/metabolism* ; Cyclooxygenase 2/metabolism* ; PPAR gamma/metabolism* ; Reactive Oxygen Species/metabolism* ; Mice, Inbred C57BL ; Hepatocytes ; Macrophages/metabolism* ; Liver

OBJECTIVE To establish the quality evaluation method of Polyporus formula granules, and to comprehensive evaluate the quality uniformity and stability of products from different manufacturers. METHODS The fingerprint of Polyporus formula granules was determined by HPLC. Shim-pack GIST C18-AQ(4.6 mm×150 mm, 3 μm) was used, mobile phase was acetonitrile-water with gradient elution, volume flow rate was 1.0 mL·min-1, detection wavelength was 350 nm (0-3 min) and 250 nm(3-35 min), column temperature was 30℃. HPLC fingerprints of Polyporus formula granules from different manufacturers were established, common peaks were identified, similarities were evaluated and cluster analysis were performed. HPLC was used to determine the contents of 4 active ingredients, and the quality of 16 batches of samples was analyzed and evaluated. RESULTS The established HPLC fingerprint of Polyporus formula granules defined 14 common peaks and identified 6 common components. They were peak 2(uridine), peak 4(guanosine), peak 6(adenosine), peak 12(polyporusteron B), peak 13(polyporusteron A), peak 14(polyporusteron C). The similarity of 16 batches of samples were 0.609-0.982, and could be clustered into 2 categories by cluster analysis. Guanosine, adenosine, polyporusteron B and polyporusteron A all showed good linear relationships(r ≥ 0.999 7), RSDs of instrument precision, stability and reproducibility tests were <3%. The average recoveries were 98.22%, 99.32%, 99.56%, 99.15%, RSD<3%(n=6). The contents of guanosine, adenosine, polyporusteron B, polyporusteron A in 16 batches of samples were 6.326-28.006, 13.392-44.058, 10.324-30.335, 9.270-26.964 μg·g-1.CONCLUSION There is considerable quality difference among different manufacturers. The established fingerprint combine with the compound determination can comprehensively and accurately evaluate the internal quality of Polyporus formula granules, and provide a basis for the overall improvement of the quality.

Objective:To analyze the advantages of the impact of physical activity management under medical supervision on body components and healthy physical fitness.Methods:A total of 106 healthy adults who participated in physical activity management activities in the Health Management Center of Sichuan Academy of Medical Sciences & Sichuan Provincial People′s Hospital from April 1 st 2020 to May 31 th 2021 were enrolled. The subjects were equally divided into a medical supervision group and a self-supervision group with random number table. Both groups performed a 8-week physical activity intervention, followed by the model of “a combination of online home physical activity with offline team exercise, and team exercise interaction with individual physical activity guidance”, while health education was provided and wearable devices were worn to collect exercise data. The medical supervision group completed the set number of exercises under the supervision of the team, with on-site exercise guidance. They were required to participate in weekly one-to-one on-site instruction. The self-management group carried out exercises and participated in weekly one-to-one instruction in accordance according to their own will with online feedback. During the study, 6 cases withdrew, and 52 cases in the supervision group and 48 in the self-management group were obtained. The t and Wilcoxon tests were used to compare the body components and physical fitness of the two groups before and after intervention. Results:The amount of exercise in the supervision group was significantly higher than that in self-management group (1 359 vs 615), and there was no significant differences in exercise intensity (mean heart rate, maximum heart rate and exercise duration) between the two groups (all P>0.05). After the intervention, the body weight, body mass index (BMI), percent body fat, subcutaneous fat area and strength fitness of the supervision group were significantly lower than those before the intervention [(55.36±6.37) vs (56.11±6.33) kg, (21.48±2.85) vs (21.73±2.47) kg/m 2, (27.38±5.34) % vs (28.53±4.99) %, (119.56±48.45) vs (128.70±50.10) cm 2, (24.48±6.37) vs (26.07±5.29) kg], while the cardiorespiratory endurance, flexibility fitness and agility fitness were significantly higher [(33.57±5.06) vs (30.32±4.59) ml·kg -1·min -1, (14.71±7.51) vs (10.54±7.54) cm, (0.44±0.08) vs (0.48±0.05) s] (all P<0.05). After the intervention, the body weight, muscle mass and lean body mass in self-management group were all significantly higher than those before the intervention [(56.83±8.09) vs (56.45±8.22) kg, (38.28±3.19) vs (38.24±5.17) kg; (40.80±4.16) vs (40.32±4.95) kg], and agility fitness was significantly lower [(0.64±0.39) vs (0.49±0.05) s] (all P<0.05). It was also found that improvements regarding the following three indicators were more significant in the supervision group: visceral fat, balance and agility fitness (all P<0.05). Conclusions:Physical activity intervention under medical supervision can significantly improve the body components and physical fitness in healthy adults, as well as exercise compliance and validity.

Objective:To explore the effectiveness of the Exowalk gait training robot in improving the walking ability of stroke survivors.Methods:Forty stroke survivors were randomly divided into a control group and an experimental group, each of 20. In their rehabilitation, the control group was given routine walking training, while the experimental group′s training was assisted with the Exowalk robot. Both groups trained for 60 minutes a day, five days a week for four weeks. Before as well as after 2 and 4 weeks of training functional ambulatory categories (FACs), the Berg balance scale (BBS), the 6-minute walking test (6MWT), the 10-minute walking test (10MWT), the Rivermead mobility index and an exercise index were used to evaluate those in both groups.Results:After 2 weeks significant improvement was observed in the average FAC, BBS, 6MWT and 10MWT results of both groups, without significant differences between them. After 4 weeks there was still no significant difference in the groups′ average BBS scores. However, the average FAC rating in the experimental group had improved significantly while there was no significant increase in the control group′s average score.Conclusions:The Exowalk robot can help to improve the balance and walking ability of hemiplegic stroke survivors.

Objective: To understand the epidemiological and clinical features of patients with hemorrhagic fever and renal syndrome (HFRS) in Shenzhen, and to accumulate experience in the diagnosis and treatment of HFRS in this area. Methods: A retrospective analysis was conducted by collecting the clinical data from 46 patients who were confirmed with HFRS and admitted to the Department of Infectious Diseases of Shenzhen People's Hospital from January 2015 to December 2018. The demographic characteristics, epidemiological, clinical manifestations, examinations, treatments and prognosis, and other characteristics were analyzed. Results: All the 46 patients with HFRS were residens in Shenzhen, with a male-to-female ratio of 6.67∶1.00(40∶6), aged (40.18 ± 15.63) years old, and 38 patients (82.61%) aged 23-45 years old. There were 41 patients (89.13%) with a history of HFRS epidemiology, and there were mice in their houses or workplaces. The houses of 39 patients (84.78%) were rented, and 34 patients(87.18%) rented their houses in urban villages. There were morbidity throughout the year, and 33 patients (71.74%) were ill from January to June. In clinical classification, 44 cases (95.65%) were mild, 2 cases (4.35%) were medium, and there were no severe or critical cases. The clinical manifestations were that all patients were hospitalized due to fever mainly with hyperthermia. Thirty-nine patients (84.78%) were presented with systemic aches, headaches, low back pain and eyelid pain, and 28 patients (60.87%) had skin and mucous membrane hyperemia flushing. Clinical stages showed that all patients had pyretogenesis stage and polyuria stage, including pyretogenesis stage [(7.34 ± 6.82) d], polyuria stage [(9.94 ± 5.77) d], only 4.35% (2/46) patients with hypotension shock stage, all patients did not have oliguric stage. On the next day of admission, the number of white blood cells in 46 patients was (8.17 ± 3.19) × 10⁹/L, and 38 cases (82.61%) in the normal range; platelet was (61.92 ± 32.53) × 10⁹/L, and 42 cases (91.30%) were decreased; the procalcitonin was (1.62 ± 0.38) ng/ml, and 41 cases (89.13%) were increased; C-reactive protein was (74.33 ± 30.48) mg/L, and 46 patients (100.00%) were elevated; creatinine was (176.25 ± 55.15) μmol/L, and 19 cases (41.30%) were increased. Abnormal liver function was manifested by increased enzymology, alanine aminotransferase was (137.58 ± 46.76) U/L, and aspartate aminotransferase was (129.82 ± 40.29) U/L. All patients were positive for Hantavirus IgM. B-ultrasound results showed that in 58.70% (27/46) patients, both kidneys were plump and the parenchymal echo was enhanced. Liver injury occurred in 39 patients (84.78%) and sinus bradycardia in 2 patients (4.35%). All the 46 patients were clinically cured. Conclusion The epidemiological characteristics of patients with HFRS in Shenzhen are typical, the clinical manifestations are mild, and the curative effect and prognosis are good.

To examine the efficacy and safety for metformin in treating antipsychotic-induced dyslipidemia.
 Methods: Two randomized placebo-controlled trials were included in the analysis. A total of 201 schizophrenia patients with dyslipidemia after treatment with an antipsychotic were collected, and the patients were divided into two groups: a 1 000 mg/d metformin group (n=103) and a placebo group (n=98). The clinical symptoms and metabolic indicators such as body weight, blood glucose, and blood lipids were assessed at baseline, the 12th week and the 24th week after treatment respectively.
 Results: After metformin treatment, the mean difference in the low-density lipoprotein cholesterol (LDL-C) value between the metformin group and the placebo group was from 0.16 mmol/L at baseline to -0.86 mmol/L at the end of the 24th week, which was decreased by 1.02 mmol/L 
(P<0.01). At the 24th week, the LDL-C was more than 3.37 mmol/L in 25.3% patients in the metformin group, which was significantly lower than that in the placebo group (64.8%) (P<0.01). Compared with the placebo group, there were significant changes in the weight, body mass index (BMI), insulin, insulin resistance index, total cholesterol and triglyceride, and high-density lipoprotein cholesterol (HDL-C) in the metformin group (all P<0.05). The treatment effects on weight and insulin resistance appeared at the 12th week and further improved at the 24th week, but the effects on improving dyslipidemia only significantly occurred at the end of the 24th week.
 Conclusion: The metformin treatment is effective in improving antipsychotic-induced dyslipidemia and insulin resistance, and the effect to reduce the antipsychotic-induced insulin resistance appears earlier than the effect to improve dyslipidemia.
Antipsychotic Agents ; adverse effects ; Blood Glucose ; Diabetes Mellitus, Type 2 ; Double-Blind Method ; Dyslipidemias ; chemically induced ; drug therapy ; Humans ; Hypoglycemic Agents ; Metformin ; therapeutic use

Objective To observe the effect of drug edible of herbal medicine granule on vascular endothelial function in patients with coronary heart disease(CHD).Methods A total of 200 cases featuring with cardiovascular blood stasis were chosen from patients who were diagnosed with CHD in Zhengzhou hospital of traditional Chinese medicine from January 2015 to January 2016.All cases were divided into observation group(n=98)and control group(n=102).The observation group was given Xin bao drug edible of herbal medicine granule and conventional drugs,and the control group was given conventional drugs.After 8 weeks of observation,the levels of endothelin(ET-1),nitric oxide(NO)and angiotensin Ⅱ(AngⅡ)were measured by enzyme-linked immunosorbent assay(ELISA).The serum levels of total cholesterol(TC),triglyceride(TG),low density lipoprotein(LDL),and TCM clinical symptom score were compared between the two groups.Results The level of TC of the control group was decreased after treatment(P<0.05);the levels of TC,TG and LDL in the observation group were lower than those in the control group(P<0.05).After treatment,the levels of NO,ET-1,Ang-Ⅱ and FMD in the observation group were significantly different from those before treatment(P<0.05).The levels of NO and FMD in the observation group were higher than those in the control group,and the levels of ET-1 and Ang-Ⅱ were lower than those in the control group(P<0.05).After treatment,the scores of TCM clinical symptoms in the observation group were lower than those before treatment(P<0.05).Compared with the control group,the total score of palpitations,the times of shortness of breath and clinical symptoms were lower than those in the observation group(P<0.05).Conclusion Xin bao drug edible of herbal medicine granule could relieve coronary heart disease blood stasis type of patients with vascular tension,reduce its endothelial cell damage and improve its clinical symptoms.