Objective To study the effects of Guizhi Shaoyao Zhimu Decoction on factors related to bone destruction and bone protection in rats with collagen-induced arthritis(CIA)based on osteopro-tegerin(OPG)/receptor activator of NF-κB ligand(RANKL)/receptor activator of NF-κB(RANK)signaling pathway.Methods According to the body weight,60 female Wistar rats were randomly di-vided into the following six groups:the normal group,the model group,the Triperygium wilfordii mul-tiglucoside group(0.01 g/kg),the Guizhi Shaoyao Zhimu Decoction low-dose group(8.6 g/kg),the Guizhi Shaoyao Zhimu Decoction medium-dose group(17.2 g/kg),and the Guizhi Shaoyao Zhimu Decoction high-dose group(34.4 g/kg)(n=10 rats per group).The rats in all groups except for the normal group were given 100 μg bovine type Ⅱ collagen on the 1st and 8th days to establish the CIA model,and was injected into the left foot sole and tail root of the rats.After the successful modeling,the rats were treated by gavage for 4 weeks.The general state,body weight,and arthritis index(AI)score of rats were recorded,and the contents of RANKL and OPG in rat serum were determined by enzyme-linked immunosorbent assay.The mRNA and protein expressions of RANKL,RANK,and OPG in the ankle joint were determined through real-time PCR and Western blotting,respectively.Results Com-pared with the normal group,the general state of the model group was poor,the toe swelling was obvious,the AI score was increased,the serum RANKL content was increased,the serum OPG content was de-creased,and the mRNA and protein expressions of RANKL and RANK in the ankle joint were increased(P＜0.05).Compared with the model group,the degree of toe swelling and the AI score of rats in the Guizhi Shaoyao Zhimu Decoction low-,medium-,and high-dose groups were decreased,the serum RANKL content was decreased,the serum OPG content was increased,the mRNA and protein expres-sions of RANKL and RANK in the ankle joint were decreased,the mRNA and protein expressions of OPG were increased,and the RANKL/OPG ratio of the ankle joint was decreased(P＜0.05).Conclusion Guizhi Shaoyao Zhimu Decoction can improve the destruction of joint bone in CIA rats,and its mecha-nism of action may be related to reducing RANKL level,reducing RANKL/OPG ratio,and regulating bone balance.

Objective:To construct a nomogram model for predicting frailty in elderly hypertensive patients, and to evaluate the discrimination and consistency of the model.Methods:A total of 317 patients with essential hypertension who were admitted to Hebei Eighth People′s Hospital from February 2021 to June 2022 were taken, they were divided into modeling group (190 cases) and verification group (127 cases) according to the proportion of 6∶4, the patients in the modeling group were divided into the asthenic group (45 cases) and the non asthenic group (145 cases) according to whether the patients in the modeling group had asthenia. The nomograph model was constructed based on the results of Logistic analysis.Results:The age, obesity or overweight ratio, diabetes ratio and systolic blood pressure in the frail group were significantly higher than those in the non-frail group: (76.25 ± 3.64)years vs.(70.44 ± 3.82) years, 51.11%(23/45) vs. 24.83%(36/145), 46.67%(21/45) vs. 17.24%(25/145), (156.46 ± 18.64) mmHg (1 mmHg = 0.133 kPa) vs. (143.25 ± 12.38) mmHg, and the mini-nutrition assessment summary form (MNA-SF) score was significantly lower than that in the non-frail group: (11.45 ± 2.06) scores vs. (13.12 ± 1.22) scores, there were statistical differences ( P<0.05). Logistic results showed that age, body mass index, diabetes, and systolic blood pressure were the risk factors for frailty ( P<0.05). The receiver operating characteristic (ROC) curve evaluation showed that the area under the curve (AUC) in the modeling group was 0.998, and AUC in the validation group was 0.954. The Hosmer-Lemeshow goodness of fit test showed: modeling group χ2 = 6.18, P = 0.627; validation group χ2 = 6.58, P = 0.582. Conclusions:The nomogram prediction model of frailty risk in elderly hypertensive patients has good consistency and differentiation

OBJECTIVE To investigate the effects of β-sitosterol on the function of rheumatoid arthritis （RA） fibroblastic synoviocytes MH7A cells and its mechanism. METHODS Network pharmacology was adopted to screen the targets of β-sitosterol and the targets for the treatment of RA. After the intersection of them， topological analysis was performed to find the most critical target in the treatment of RA. MH7A cells were treated with different concentrations （0， 5， 10， 20， 40 μmol/L） of β-sitosterol， and CCK-8 was used to assay cell viability for screening the optimal concentration of β-sitosterol. MH7A cells were induced by 10 ng/mL TNF-α in vitro and treated with β-sitosterol （the optimum concentration）. CCK-8 and EdU were used to detect the ability of cell proliferation. Scratch experiment and Transwell invasion assay were used to analyze cell migration and invasion. The levels of interleukin-1β （IL-1β） and IL-6 in cell supernatant were detected by enzyme-linked immunosorbent assay （ELISA）. The mRNA and protein expressions of peroxisome proliferator-activated receptor α （PPARα） were measured by qRT-PCR and Western blot， respectively. The siRNA targeting PPARα was transfected into MH7A cells， and the effects of β-sitosterol on cell proliferation， migration， invasion， the secretion of inflammatory factors and the expression of PPARα after PPARα knockdown were detected by the above experimental methods. RESULTS PPARα was the most critical target of β-sitosterol in the treatment of RA. The optimal concentration of β-sitosterol was 20 μmol/L. Compared with model group， β-sitosterol decreased the viability of MH7A cells， and the number of proliferating cells also decreased significantly （P＜0.05）； the cell migration rate and the number of cell invasion decreased significantly （P＜0.05）. The levels of IL-1β and IL-6 were also significantly decreased （P＜0.05）， and the mRNA 15 and protein expression levels of PPARα were significantly increased （P＜0.05）. Compared with negative control small interfering RNA group， after PPARα knockdown， the cell viability increased by about 35.6% （P＜0.05）， the number of cell proliferation， the cell migration rate and the number of cell invasion increased significantly （P＜0.05）， and the levels of IL-1β and IL-6 also increased significantly （P＜0.05）. CONCLUSIONS β-sitosterol could effectively inhibit the proliferation， migration， invasion and secretion of inflammatory factors in MH7A cells， the mechanism of which may be associated with activating PPARα pathway.

Objective:To explore the effect of anticoagulation risk assessment combined with list management in patients with venous thrombosis.Methods:From September 2019 to September 2021, 104 patients with venous thrombosis who were diagnosed and treated in Nanshi Hospital of Nanyang were selected by convenient sampling. The patients were divided into observation group and control group by random number table method, with 52 cases in each group. The observation group was given anticoagulation risk assessment combined with list management, while the control group was given routine nursing. The incidence of bleeding, Self-rating Depression Scale (SDS) score, Self-rating Anxiety Scale (SAS) score and nursing satisfaction were compared between the two groups.Results:The incidence of bleeding of patients in the observation group was 5.77% (3/52), and the subcutaneous ecchymosis rate was 7.69% (4/52), which was lower than 26.92% (14/52) and 34.62% (18/52) of the control group, respectively, with statistically significant differences (χ 2=8.508, 11.299; P<0.05). After intervention, the SDS score and SAS score of the observation group were (38.52±8.52) and (47.58±7.69) respectively, which were statistically lower than (52.06±10.39) and (57.52±10.47) of the control group, respectively ( t=7.267, 5.518; P<0.05). The nursing satisfaction of the observation group was 94.23% (49/52), which was higher than 75.00% (39/52) of the control group, and the difference was statistically significant (χ 2=7.386, P<0.05) . Conclusions:Anticoagulation risk assessment combined with list management in patients with venous thrombosis is conducive to reducing the incidence of bleeding and relieving the anxiety and depression of patients.

Objective:To investigate the clinical manifestation and management strategy of intraparotid facial nerve schwannoma.Methods:The clinical data of 12 patients with parotid schwannoma treated in Henan Cancer Hospital from January 2009 to January 2019 were analyzed retrospectively, including 5 males and 7 females, aged from 23 to 72 years. All the 12 patients complained of a mass in the parotid region, of whom 4 patients had local discomfort and pain, and 6 patients had varying degrees of pain during palpation. Ultrasound examination showed solid mass in parotid region in 8 cases and mixed mass in 4 cases. The treatment methods, the relationship between tumor and facial nerve, the modes of treatments and the nerve functions before and after operation were analyzed and summarized with House-Brackmann grade.Results:All 12 patients received surgical treatment: 8 patients underwent tumor resection plus partial or total superficial parotidectomy, 1 patient underwent tumor resection and total parotidectomy, and 3 patients underwent tumor resection, with 1 patient in whom tumor could not be removed completely due to tumor extention to the skull base. In 9 cases, the tumor occurred in the trunk or main branch of the facial nerve, and there was no facial nerve injury occurred after surgery; in 1 case, the tumor occurred in the terminal branch of the facial nerve, and part of the severe small branches of adhesion were cut off during the operation; in 1 case, the total trunk of the facial nerve was not found and the broken end of the nerve could not be found during the operation, so the nerve transplantation was not performed. In 1 case, nerve grafting was performed after nerve transection because it was impossible to separate the trunk of the facial nerve from the tumor during the operation. Preoperatively, House-Brackmann grade (H-B)Ⅰfacial nerve function was shown in 10 patients, H-BⅡ in 1 patient and H-B Ⅴin 1 patient. Postoperatively, the facial nerve function recovered to H-B Ⅰfor 7 patients, H-B Ⅱfor 2 patients, H-B Ⅲ for 1 patient, grade Ⅳ for 1 patient with nerve transplantation, and H-B Ⅴfor 1 patient with a revised surgery due to tumor recurrence.Conclusions:The intraparotid facial nerve schwannoma is rare, and it is easy to be misdiagnosed before operation. Surgery is a main treatment for intraparotid facial nerve schwannoma. Attention should be paid to the protection of facial nerve during operation.

Objective To observe the effect of the method of warming kidney and dredging collaterals on the clinical effect and the content of urine C5b-9 in patients with idiopathic membranous nephropathy with spleen kidney yang deficiency and blood stasis. Methods A total of 60 idiopathic membranous nephropathy patients with spleen kidney yang deficiency and blood stasis type were randomly divided into the conventional western medicine treatment group (control group), Jingui-Shenqi pill and Taohong-Siwu decoction plus conventional western medicine treatment group (treatment group), 30 cases in each group. The Scr was detected by deproteinized alkaline picric acid method, and BUN was detected by rate method, and serum albumin (ALb) was detected by bromocresol green dye binding method, and 24 hours urinary protein was measured by pyrogallol red colorimetry, and the double antibody sandwich ELISA method was used for detection of urinary C5b-9. Results The Jingui-Shenqi pill combined with Taohong-Siwu decoction plus conventional western medicine treatment has obvious curative effect on patients. The total effective rate was 83.3 in the treatment group (25/30), and the control group was 60％ (18/30). After treatment, the Alb (33.5 ± 7.95 g/L vs. 28.8 ± 6.10 g/L, t=2.569) in the treatment groupwas significantly higher than that in the conventional treatment group (P<0.01). While the 24 h urine protein (2.40 ± 0.92 g/24 h vs.3.60 ± 2.3 g/24 h, t=2.653), the contents of C5b-9 in urine(42.5 ± 17.50 ng/mg vs.71 ± 25.2 ng/mg, t=5.088) in the treatment group were significantly lower than those in the conventional treatment group (P<0.01). Conclusions The method of warming kidney and dredging collaterals can improve the clinical symptoms, improve serum albumin level, reduce the 24 hour urine protein and urinary C5b-9 content of idiopathic membranous nephropathy of spleen and kidney yang deficiency and blood stasis type.

Objective To explore the molecular mechanism of Yishen Huoxue prescription in delaying the development of renal fibrosis by regulating the microRNA-126/vascular endothelial growth factor-Notch (miR-126/VEGF-Notch) signaling pathway. Methods Ninety male Sprague-Dawley (SD) rats were randomly divided into sham operation group (sham group), unilateral ureteral obstruction (UUO) model group, losartan group (50 mg·kg-1·d-1) and high, medium and low doses Yishen Huoxue prescription group (25.2, 12.6, 6.3 mL/kg). Each treatment group began to administer drugs by gavage on the day when UUO modeling was finished until the end of the experiment. Left renal tissues of rats were harvested after 7, 14 and 21 days postoperatively. The pathological changes of renal tissue were observed after hematoxylin and eosin (HE) and Masson staining under the microscope, and the renal fibrosis score was calculated. The mRNA expressions of renal tissues miR-126, VEGFA, vascular endothelial growth factor receptor-2 (VEGFR-2), Notch1 were detected by reverse transcription-polymerase chain reaction (RT-PCR). Results① Pathology results: the kidney tissue of sham group was normal. In UUO model group, renal tubules expanded and inflammatory cells in renal interstitium increased; renal tubulointerstitial fibrosis could be seen 7 days after operation, and the degree of fibrosis was gradually increased with time. The renal fibrosis score at each time point after operation in UUO model group was significantly higher than that in sham group. Compared with UUO model group, each treatment group were improved the degree of renal swelling and atrophy of renal parenchyma; the score of renal fibrosis were significantly decreased in the middle and high doses Yishen Huoxue prescription group and losartan group at the 7th day after operation (1.00±1.00, 0.91±0.58, 1.01±0.58 vs. 2.00±0.00,all P < 0.01); but there was no significant difference between low dose Yishen Huoxue prescription group and UUO model group. ② RT-PCR results: Compared with sham group, the mRNA expressions of miR-126, VEGFA, VEGFR-2 and Notch1 in renal tissues were significantly increased at each time point after operation in UUO model group. Compared with the UUO model group, the mRNA expressions of miR-126, VEGFA, VEGFR-2 and Notch1 in renal tissue of 7 days postoperatively in the middle and high doses Yishen Huoxue prescription group and the losartan group were significantly increased [miR-126(2-ΔΔCt):0.465±0.067, 0.639±0.092, 0.404±0.069 vs. 0.132±0.021; VEGFA(2-ΔΔCt): 0.024±0.005, 0.027±0.007, 0.023±0.006 vs. 0.014±0.006; VEGFR-2(2-ΔΔCt):0.021±0.007, 0.023±0.008, 0.019±0.007 vs. 0.012±0.004; Notch1(2-ΔΔCt):0.017±0.004, 0.020±0.005, 0.018±0.005 vs. 0.007±0.004; all P < 0.05]; compared with the losartan group, the mRNA expressions of each index in the middle and high doses Yishen Huoxue prescription group were increased at all the time points, but there was no significant difference between them (all P > 0.05). There was no significant difference in mRNA expression of each index between low dose Yishen Huoxue prescription group and UUO model group. Conclusions The medium and high doses of Yishen Huoxue prescription can effectively antagonize renal fibrosis. Yishen Huoxue prescription may use up-regulation the signaling pathways of miR-126/VEGF-Notch to mediate renal microvascular newly born, eventually to improve renal microvascular damage and delay the development of renal fibrosis progression.

With the rapid development of instrument technology , Raman spectrometer has become one of the fastest growing type of instrument in the molecular spectroscopy . In recent years , Raman spectrometer gradually emerging in the application in the domain of biology and medicine , Raman spectroscopy technology appears new development constantly in the rapid identification and classification of microorganisms because of its rapid , efficient, sensitive, noninvasive, repeatability and other unique advantages.This article describes its application in the rapid detection of bacteria , viruses and other microorganisms , and also prospects for the application of Raman spectroscopy in future clinical work .

As a novel,label-free and non-invasive detection modality,terahertz(THz,1THz=1012 Hz)spectroscopy has been widely used in various areas.For instance,in the biomedical field,it has great potentials to provide real-time scanning of living cells and tissues due to its unique advantages.Significant achievements have been reached in cell detection, related to bacterial identification, cancer cell characterization and blood cell detection.In tissue detection, the THz spectroscopy can be used to provide real-time scanning of living tissues and fast diagnosis.Furthermore, a single system which integrated THz spectroscopy and THz imaging would be able to collect information more sensitive and comprehensive. However,the clinical adaption of THz spectroscopy is still a controversial issue attributed to some intrinsic limitations and technical bottlenecks.In this article, both the application of THz spectroscopy in cell and tissue detection and the existing challenges and strategies to accelerate clinical applications were reviewed comprehensively.