BACKGROUND:Recent studies have shown that research on naringin anti-osteoporosis mostly stays in in vitro and in vivo experiments.Understanding the mechanism of related signaling pathways and the expression of related proteins and some specific genes is an important way to deeply understand naringin anti-osteoporosis.At present,traditional Chinese medicine has been confirmed to have a significant role in anti-osteoporosis.Naringin is one of the main active ingredients in Rhizoma Drynariae.Its effectiveness and mechanism of action against osteoporosis have been gradually recognized by scholars,and its clinical and basic research has been gradually emphasized. OBJECTIVE:To analyze and summarize the research progress of naringin in anti-osteoporosis in vitro and in vivo,thereby providing some ideas for the next step to study its related mechanism of action. METHODS:The relevant literatures included in CNKI and PubMed database were searched with the Chinese search terms of"naringin,osteoporosis,traditional Chinese medicine compound,pathogenesis,signaling pathway,bone marrow mesenchymal stem cells,osteoblasts,osteoclasts"in Chinese and English,respectively.The corresponding criteria were established according to the research needs,and finally 69 articles were included for review. RESULTS AND CONCLUSION:Naringin blocks the increase in the number of osteoclasts and adipocytes,the decrease in the number of osteocytes and osteocalcin(+)cells induced by fructose-rich diet,and promotes the secretion of Sema3A from osteoblasts and osteocytes,thereby enhancing local bone formation and inhibiting osteoclast production by activating the Wnt/β-catenin pathway.Naringin is an important way to induce autophagy of osteoblasts,but autophagy-related proteins participate in osteoblast differentiation and bone formation.Lack of autophagy in osteoblasts reduces mineralization and leads to an imbalance in the number of osteoblasts and osteoclasts,which results in bone loss and decreased bone density.The composite scaffold loaded with naringin can be used as a necessary carrier for bone defect repair and has excellent bone repair properties.Naringin can also accelerate the growth of new bone tissue by increasing the local contents of bone morphogenetic protein 2 and vascular endothelial growth factor.Naringin can regulate bone metabolism and inhibit oxidative stress via ERK,PI3K/Akt and Wnt signaling pathways to improve osteoporosis,which can play a good role in preventing and controlling the disease.However,the depth and breadth of the relevant research is insufficient.Based on the mechanism of the current study,we should investigate the specific mechanisms by which naringin regulates different pathways and inter-pathway interactions in the future,which will be beneficial to the multifaceted development of naringin used in the treatment of osteoporosis..

Objective:To explore the effect of short-term training on pressure injury prevention cognition and nursing behavior of nurses in Operating Room.Methods:From July 2018 to September 2019, 36 nurses working in the Operating Room of the Affiliated Hospital of Hangzhou Normal University were selected as the research object by convenience sampling. The questionnaire was used to find out how they acquired knowledge about pressure injury before training. Then, the short-term training in pressure injury prevention lasting for 3 months was conducted. The nurses' mastery of knowledge and nursing skills on pressure injury prevention before and after training were compared. Using the convenience sampling method, 80 surgical patients who received treatment in the hospital from July to December 2018 were selected as the control group (before training) , and 80 surgical patients from April to September 2019 were selected as the observation group (after training) . The incidence of surgery-related pressure injury was compared between the two groups.Results:Before the training, the number of nurses who acquired knowledge about pressure injury through in-hospital learning accounted for 80.56% (29/36) , followed by the Internet, related books and nursing journals, accounting for 52.78% (19/36) and 44.44% (16 /36) and 44.44% (16/36) respectively. After short-term training, 36 nurses' mastery of pressure injury-related knowledge, pressure injury nursing behavior scores and total scores were higher than those before training, and the differences were statistically significant ( P<0.01) . The incidence of pressure injury in the observation group was lower than that in the control group, and the difference was statistically significant ( P<0.05) . Conclusions:Short-term training for nurses in Operating Room can effectively improve their awareness of pressure injury and nursing behavior, and reduce the incidence of pressure injury in surgical patients.

Objective:To investigate the incidence and risk factors of active human cytomegalovirus (HCMV) infection in patients with severe community-acquired pneumonia.Methods:Patients who required respiratory support and were diagnosed with severe community-acquired pneumonia in the respiratory intensive care unit (RICU) of the First Affiliated Hospital of Guangzhou Medical University from March 1, 2019 to June 1, 2020 were consecutively screened and divided into active HCMV infection group (20 cases) and non-active HCMV infection group (95 cases) based on whether a patient has active HCMV infection or not. Differences in demographic data, laboratory findings, and clinical outcomes were compared between the two groups. Moreover, logistic regression was applied to analyze risk factors for active HCMV infection.Results:The 20 of 115 patients with severe community-acquired pneumonia requiring respiratory support were confirmed to have active infection with HCMV, with a prevalence of active HCMV infection of 17.4%. The pneumonia severity index (PSI) and suppressor T lymphocytes (Ts) in active HCMV infection group were higher than that of the control group, and all the differences were statistically significant ( Z=2.432, P=0.015; Z=2.036, P=0.042); whereas lymphocytes, monocytes, blood lactate, and platelet levels were lower than those of the control group, and all the differences were statistically significant ( P < 0.05). Patients with active HCMV infection had a higher transfusion rate than the control group, and the differences were statistically significant (χ 2=3.941; P=0.047). Increasing levels of PSI and Ts percentage were independent risk factors for active HCMV infection ( OR=1.03, 95% CI: 1.01~1.05; OR=1.06, 95% CI: 1.00~1.11; P < 0.05). RICU length of stay, complication rates, and 90-day all-cause mortality were higher in the active HCMV infection group than the control group, and all the differences were statistically significant ( P < 0.05). Conclusions:Active HCMV infection is highly prevalent in patients with severe community-acquired pneumonia and associated with several adverse clinical outcomes, with PSI and Ts cell levels being independent risk factors.

Objective]To assess the effects and mechanism of triptolide(TPL)on cardiac remodeling in chronic heart failure (CHF)rats.[Methods]Thirty-two Wistar rats were divided into four groups of eight:Control group,isoprenaline(Iso)group,TPL group(Iso+TPL)and captopril group(Iso+Cap). CHF rat model was induced by Iso. In TPL and Cap group,TPL(20μg/kg·d)and Cap(15 mg/kg·d)were administrated to CHF rats for six weeks. Left ventricular internal diameter at end-diastole(LVIDd)and left ventricular internal diameter at end-systole (LVIDs)were detected. Histopathological changes of myocardial tissues of rats were evaluated byMasson staining and immunohistochemical staining of type Ⅰcollagen. Ventricular weight/body weight ratio(VW/BW), collagen volume fraction(CVF),perivascular collagen volume area(PVCA)of myocardial tissues were calculated. With real-time polymerase chain reaction and Western blot,the protein and mRNA levels of phosphatase and tensin homologue deleted on chromosome ten(PTEN)were detected.[Results]Compared to the Iso group,the levels of LVIDs,LVIDd,VW/BW,CVF and PVCA reduced in TPL and Cap group. TPL and Cap can alleviate the myocardial fibrosis in CHF rats. The expression of PTEN protein and mRNA increased markedly in the TPL or Cap treated group.[Conclusion]TPL can attenuate cardiac remodeling in Iso-induced CHF rats. The potential mechanism may be highly associated with the up-regulating of PTEN signaling pathway.

Objective To investigate the effects of different abstinent duration on brain functional network of heroin addicts at resting state.Methods Sixteen heroin addicts during protracted abstinence for 11-13 months (PA12 group) and twenty heroin addicts during protracted abstinence for 5-7 months (PA6 group) were recruited in the resting-state functional MRI study.Graph theoretical methods were applied to construct topological organization of whole brain network and nodes betweenness of the networks in all subjects,and the between-group differences were analyzed.The correlation of the node betweenness with the abstinence duration was conducted.Results There was no significant difference (P＞0.05) in the small world characteristic (γ≈1,λ》1) between two groups.Compared with the PA6 group,the PA12 group demonstrated significantly decreased nodal betweenness in regions of left parahippocampal gyrus,left precentral gyrus,and significantly enhanced nodal betweenness in regions of the left cuneus,left temporal and right middle occipital gyrus (all P＜0.05).Moreover,the betweenness of the left precentral gyrus (r =-0.52,P =0.001) and parahippocampal gyrus (r=-0.49,P=0.002) were negatively related with the abstinence duration,the betweenness of the right middle occipital was positively correlated with the abstinence duration (r=0.49,P=0.003).Conclusion The brain network small world topology of heroin addicts tend to be stable after 5-7 months of abstinence.Long-term abstinence may minimize the addicfs memory of drugs and potential drug seeking behavior,and recover addicts' visual spatial attention function.

BACKGROUND:Vertebral compression fractures are the most common vertebral fractures in the elderly patients with osteoporosis, and the correlation between the compression of anterior border of vertebral body and adjacent vertebral refractures is not clear.
OBJECTIVE:To establish a model of different compression of T12vertebral body with finite element method, and analyze the relationship between the compression of T12vertebral body and the stress of adjacent vertebral plate.
METHODS:Based on thoracolumbar CT data of normal adult volunteers, MIMICS/3-matic was imported. Through image segmentation, repair and three-dimensional mesh of accessto thoracic and lumbar T11-L1data, grid assigned material properties was imported to ABAQUS so as to establish ligament, joint and other small features and obtain realistic three-dimensional finite element model. The six degrees of freedom, including anteflexion, posterior extension, left and right flexion, left and right rotation, were loaded, to verify the validity of the normal model. With the frontier of vertebral body compression to 90%, 80%, 70%…10% of the nine states, MISES stressesof the T11andL1segment intervertebral disc endplate were extracted; the relationship curve of compression state and endplate stress was obtained.
RESULTS AND CONCLUSION:(1) The model was highly realistic and could reflect the actual stress state. (2) The stress value of T11vertebral body and L1vertebral body was positively correlated with the compression of T12vertebral body. Increased stress may lead to an increased likelihood of end plate fractures, which increases the risk of fractures in the adjacent vertebralbodies.

Objective To study the diagnostic value of contrast-enhanced CT patterns in focal hepatic lesions.Methods Contrast-enhanced CT patterns in 44 patients with focal hepatic lesions (54 foci) were retrospectively analysed.Results (1)78% of the hepatocellular carcinoma presented "rapid-filling and rapid-washout" feature.(2)All hepatic hemangioma presented "rapid-filling and slow-washout", progressive opacification from the periphery to center. (3)All cholangiocarcinoma presented "slow-filling and slow-washout" .(4)Metastatic hepatocarcinoma in 14 cases and hepatic abscesses in 5 cases were presented a enhanced ring around the lesion, metastatic hepatocarcinomas showed single ring,however, hepatic abscesses showed multi-ring. (5)Focal nodular hyperplasia in 3 cases and hepatic adenomas in 1 case presented "rapid-filling and slow-washout".Conclusion The contrast-enhanced patterns at spiral CT can fully reflect the blood supply of focal hepatic lesions, it has significant value in diagnosing focal hepatic lesions.

Objective To investigate the atypical appearances of small hepatocellular carcinoma(SHCC) with triple-phase spiral CT enhanced scan, and its correlation with the histopathology .Methods The atypical CT signs in triple-phase and histopathologic changes of SHCC confirmed pathologically in 30 cases (32 lesions) were analysed.Results 32 atypical lesions were found in 30 patients,of them,14 lesions were hypodense in hepatic arterial phase(HAP),portal venous phase(PVP) and delayed phase(DP).10 lesions enhanced markedly in the AP,while these lesions became isodense or slight hyperdense in the PVP and DP.8 lesions were enhanced as ring like or punctual shape in the AP,and constant enhancement in PVP and DP.Conclusion The atypical appearances are present in triple- phase spiral CT scan in SHCC,the pattern of blood supply and the base of histopathology are usually the cause of these findings .

Objective To investigate the features of the enhancement of SHCC at triple-phase spiral CT scanning and compare its sensitivity in different phase.Methods The pre- and post-contrast CT scanning of the entire liver in 70 patients with SHCC was carried out with a helical CT scanner. The contrast material was infused at a rate of 3ml/s, followed by sequential arterial-, portal- and equilibrium- phase scans of the liver. The number of the detected lesions was calculated in each phase, the characterization of lesions in each phase was observed.Results Of the 82 detected SHCC, the sensitivity in three phases was 92.68%, 70.73% and 73.17% respectively. The sensitivity increased significantly to 95% by combining the detection of three phases. Conclusion Triple-phase contrast enhanced spiral CT can fully demonstrate the patterns of SHCC and improve its detection rate.

Objective To study the CT findings of late onset intracranial hemorrhage in vitamin K(Vit K) deficiency.Methods 56 cases of late onset intracranial hemorrhage in Vit K deficiency proved clinically were presented.There were 42 male and 14 female,age ranging 28～60 days.Brain CT scans were obtained in all 56 cases. Results Subarachnoid hemorrage(SAH) in 33 cases,subdural hemorrage(SDH) in 32 cases,intracerebral hemorrage(ICH) in 19 cases and inraventricular hemorrage(IVH) in 8 cases were found.The hemorragic amount was ranged 2～150 ml.Simple hemorrage was demonstrated in 26 cases,and multiple mixed hemorrage in 30 cases.The cerebral edema was displaied in 16 cases.Conclusion SAH,SDH and multiple mixed hemorrage are common seen in the late onset intracranial hemorrage in Vit K deficiency.