Osteoporosis （OP） and osteoarthritis （OA） are common bone diseases in clinic. OP is a systemic skeletal disease， and OA is a chronic degenerative joint disease with high prevalence and disability rates. With the advent of the aging population， the incidence rate of OA and OP is increasing year by year， and they have become common diseases of the elderly. The quality of life and physical and mental health of patients are severely affected by the above two bone diseases. Chinese medicine has a long history of treating bone diseases， with a good clinical effect on preventing and treating OP， OA， and other bone diseases with few side effects. It is one of the commonly used methods to treat bone diseases. Polysaccharides， as one of the active substances of Chinese medicine， have various pharmacological activities and a wide range of sources with low toxicity， and their effect cannot be ignored. The role of polysaccharides in the treatment of bone diseases has been deeply studied. It has been found that the mechanism of Chinese medicine polysaccharides in treating OP and OA involves multiple levels， targets， and pathways. Through the analysis and summary of the relevant literature on the mechanism of Chinese medicine polysaccharides in treating OP and OA， it was found that Chinese medicine polysaccharides mainly treated OP by regulating the bone dynamic balance between osteoblasts and osteoclasts and affecting bone marrow mesenchymal stem cells and bone microstructure. The mechanism of Chinese medicine polysaccharides in the treatment of OA is related to the regulation of chondrocyte growth， the increase in the proteoglycan and collagen content in the cartilage matrix， and the reduction of oxygen free radical content and inflammatory mediator level. This study aimed to further explore the internal relationship among mechanisms of Chinese medicine polysaccharides in the treatment of bone diseases， to provide relevant ideas for the study of Chinese medicine polysaccharides in the treatment of bone diseases.

Objective:To investigate the effect of hyperuricemia on acute kidney injury in sepsis patients.Methods:It is a retrospective cohort study of 459 adult sepsis patients who were admitted to the Department of Intensive Care Unit (ICU) of the First Affiliated Hospital of Guangxi Medical University from March 2014 to June 2019, and the Second Affiliated Hospital of Guangxi Medical University from January 2017 to June 2019. The patients were divided into the hyperuricemia group and the non-hyperuricemia group according to the first serum uric acid level within 24 h after ICU admission, and the incidence of AKI within 7 days after ICU admission was compared between the two groups. The effect of hyperuricemia on sepsis-associated AKI was analyzed by univariate analysis and binary logistic regression analysis.Results:Among the 459 sepsis patients, 81 patients (17.6%) had hyperuricemia, and 127 patients (27.7%) had AKI. The incidence of AKI in the hyperuricemia group and the non-hyperuricemia group were 60.5% (49/81) and 20.6% (78/378), respectively, which showed significantly statistical difference ( χ2=52.954, P<0.01). After adjusting for gender, associated diseases (diabetes, coronary heart disease), sequential organ failure score (SOFA) on the day of ICU admission, the use of diuretics within one week before and after ICU admission, invasive mechanical ventilation, basal renal function, lactic acid, and procalcitonin, binary logistic regression analysis showed that hyperuricemia was an independent risk factor for AKI in sepsis patients ( OR=5.091, 95% CI: 2.768-9.362, P<0.01); For every 1 mg/dL increase in serum uric acid in sepsis patients, the risk of developing AKI increased by 28.4% ( OR=1.284, 95% CI: 1.165-1.414, P<0.01). Conclusions:AKI is a common complication in sepsis patients admitted to ICU, and hyperuricemia is an independent risk factor for AKI in sepsis patients.

A total of 186 type 2 diabetic patients(DM group)and 72 healthy subjects(NDM group)were enrolled. Metabolic parameters and serum irisin levels were measured. The effects of intensity and time of the physical activity were evaluated. According to quartiles of plasma irisin levels,all subjects were divided into four groups and the prevalence of type 2 diabetes mellitus(T2DM) among four groups was compared. The relationship between plasma irisin level and physical activity in DM group was investigated. The results showed that plasma irisin levels were correlated negatively with the prevalence of T2DM(OR=0.984,95% CI 0.973~0.996);also negatively correlated with age(r=-0. 227, P=0. 029) and blood uric acid (r=-0. 225, P=0. 032) in the DM group. When corresponding exercise time was up to grade 4,the intensity of exercise would influence the irisin levels(χ2=7.319, P=0.025). After controlling for potential confounders such as age,metabolic parameters,intensity of work,timing of work,plasma irisin levels in DM group were correlated positively with the intensity of exercise (β=0.326, P=0.014) and negatively with corresponding exercise time(β=-0.454,P=0.001). These results suggest that the prevalence of T2DM decreases with the increase of plasma irisin level. Plasma irisin levels are increased after moderate intensity exercise(5~7 times weekly and 1h each time) or by short-term high-intensity exercise.

Objective To study the occurrence site characteristics of middle cerebral artery aneurysm (MCAA ) in volume CT digital subtraction angiograhy(VCTDSA) .Methods The image characteristics in 72 cases of MCAA from May 2009 to January 2011 were retrospectively analyzed ,according to the running of middle cerebral artery ,the occurrence sites of aneurysm were divided into four categories :M1 segment ,M2 bifurcation ,M2 distal and M3-M5 segment ,the aneurysm number was conducted the statistics and the image characteristics were analyzed ;two neuroradiologists adopted the double-blind method to measure the MCAA angle in bifurcation of M2 segment and compared it with the bifurcation angle in the normal middle cerebral artery ,the difference between them were statistically analyzed .Results (1)M1 segment aneurysms were 7 cases(9 .70% ) ,M2 bifurcation aneurysms were 58 ca-ses(80 .56% ) ,M2 distal aneurysms were 5 cases(6 .94% ) and M3-M5 segment aneurysms were 2 cases(2 .78% ) .(2)The angle in M2 bifurcation of the normal middle cerebral artery was(99 .30 ± 22 .96)° ,M2 bifurcation aneurysm angle was(139 .26 ± 27 .61)° , the difference between them showing statistical significance (P<0 .01) .(3)The difference between left and right of M 2 bifurcation angle in the normal middle cerebral artery had no statistical significance (P>0 .05) .(4)The M2 bifurcation angle in ruptured aneu-rysm was(133 .98 ± 30 .24)° ,which in unruptured aneurysms was(144 .53 ± 21 .81)° ,the difference between them had no statistical significance(P>0 .05) .Conclusion MCAA mainly occurred in M2 bifurcation .There is significant difference in M2 bifurcation an-gle between the aneurysm group and non-aneurysm group ,M2 bifurcation angle is increased ,the probability of aneurysm occurrence is increased .

AIM:To explore the effect of Toll-like receptor ( TLR) 2 and TLR4 in Mycobacterium bovis Bacil-lus Calmette-Guérin (BCG)-induced human proximal renal tubule epithelial cell (HK-2) injury.METHODS:HK-2 cells were stimulated by BCG, and the expression of TLR2, TLR4, chemokine (C-X3-C motif) ligand 1 (CX3CL1) and trans-forming growth factor beta 1 ( TGF-β1 ) was detected by quantitative real-time PCR and Western blotting .TLR2 monoclonal antibody and TLR4 inhibitor were used to treat the HK-2 cells 1 h before BCG stimulation.The expression of CX3CL1 and TGF-β1 was evaluated by quantitative real-time PCR and Western blotting .RESULTS: BCG increased the expression of TLR2, TLR4, CX3CL1 and TGF-β1 in the HK-2 cells.Additionally, the expression of CX3CL1 and TGF-β1 was inhibited partly by TLR2 monoclonal antibody or TLR4 inhibitor.CONCLUSION:BCG is able to increase the production of TLR 2, TLR4, CX3CL1 and TGF-β1 in the HK-2 cells.TLR2 and TLR4 signaling pathways play important roles in tubule epitheli-al cell injury induced by BCG .

BACKGROUND: Brain-awakening nasal sprayer is composed of many herbs,such as Chuanxiong and Shichangpu, which were regarded by "Shennong Bencaojing" as having the function of "preventing stroke in the brain".OBJECTIVE: To observe the changes of free radicals and nitric oxide synthase in rat brain following focal ischemic-reperfusional injury due to brain-awakening nasal sprayer intervention and compare with that due to classical nimodipine.DESIGN: A randomized controlled study.SETTING: Department of internal medicine of a hospital affiliated to a traditional Chinese medical university.MATERIALS: Seventy adult male Wistar rats of clean grade, were randomly divided into seven groups: brain-awakening nasal sprayer of higher dosage group, moderate dosage group, lower dosage group, nimodipine intraperitoneal injection group, physical saline nasal sprayer group, menstruum nasal sprayer group, and sham operation group with 10 rats in each.METHODS: Focal brain ischemia-reperfusion model was established by blocking the left cerebral middle artery in rats of all the groups except sham operation group. Three days before model establishment and during reperfusion, rats were given different dosages of brain-awakening nasal sprayer composed of Chuanxiongqin and Shichangpu of 5.4, 2.7, 1.08 mg/(kg · d) and 1.35, 0. 54, 0.27 g/(kg· d), respectively, three times a day; which was replaced by physical saline and menstruum nasal sprayer of 0. 18 mL/ (kg · d),three times a day in physical saline nasal sprayer group and menstruum nasal sprayer group; rats in nimodipine intraperitoneal injection group received intraperitoneal injection of nimodipine by 0. 8 mg/(kg · d) twice a day. Rats in sham operation group were routinely raised. The content of prodialdehyde, superoxide dismutase and nitric oxide synthase were measured with colorimetric method.MAIN OUTCOME MEASURES: ① The changes of prodialdehyde content, superoxide dismutase and nitric oxide synthase activity in rat brain following focal ischemic-reperfusional injury in groups of different dosage of brain-awakening nasal sprayer and other groups. ② Comparison between different dosage brain-awakening nasal sprayer intervention groups and nimodipine intraperitoneal injection group.RESULTS: Eight rats died during model establishment and the other 62 rats entered the results analysis. ① Content of prodialdehyde: It was significantly lower in higher dosage group and nimodipine intraperitoneal injection group than in physical saline nasal sprayer group [ (0.92 ± 0. 32), (0. 87 ± 0. 39)vs(1.35 ±0. 34) μmol/g, P ＜ 0.05], but there was no difference between higher dosage group and nimodipine intraperitoneal injection group. ② Activity of superoxide dismutase: It was obviously higher in higher dosage group and nimodipine intraperitoneal injection group than in physical saline nasal sprayer group[ (35.64 ± 11.67), (33.88 ± 7. 15) vs(20. 70 ± 3.88) NU/mg,P ＜ 0. 05 ], but no difference could be observed between higher dosage group and nimodipine intraperitoneal injection group. ③ Activity of nitric oxide synthase and superoxide dismutase: It was found obviously higher in higher dosage group and nimodipine intraperitoneal injection group than in physical saline nasal sprayer group[ (4.64 ± 1.22), (5.00 ± 1.10) vs (3.08 ± 1.12) mkat/g, P ＜ 0.05], but no difference could be observed between higher dosage group and nimodipine intraperitoneal injection group.④ The activity of nitric oxide synthase and superoxide dismutase slightly increased while prodialdehyde slightly decreased in moderate dosage group,lower dosage group and menstruum nasal sprayer group, which did not differ significantly from physical saline nasal sprayer group.CONCLUSION: Brain-awakening nasal sprayer intervention exerts multiple effects such as preventing lipo-peroxidation following brain ischemic- reperfusional injury, in addition to suppressing prodialdehyde production, attenuating injury induced by free radicals and increasing nitric oxide synthase activity, thereby playing a similar role to nimodipine in protecting against brain ischemic-reperfusionaldamage

Objective To determine how the pulmonary ligament affects the helical CT appearances of the lower thoracic disease on the basis of the anatomic findings. Methods Four cadavers were cut transversely, with the section thickness of 11.3-13.4 mm. 57 patients with the lower thoracic disease were scanned using Somatom Plus 4, with administration of intravenous contrast material. The correlation of the anatomic findings of the pulmonary ligament and the helical CT appearances of the lower thoracic disease was evaluated. Results On cadaver sections, the right pulmonary ligament attached the lower lobe of the right lung to the esophagus, while the left ligament attached the lower lobe of the left lung to the esophagus or the descending aorta. In 40 pleural effusion and 7 pneumothorax cases, the pulmonary ligament tethered the medial aspect of the collapsed lower lobe and limited the shift of the lower lobe. In 40 pleural effusions, the ligament divided the medial pleural space into an anterior and a posterior compartment. The ligament showed thickness due to the invasion of the lesions of lower lobe including 7 tumors and 3 inflammatory diseases. Conclusion The pulmonary ligament can affect the helical CT appearances of the lower thoracic disease, such as lobe collapse, pleural effusion and pneumothorax; while the intraparenchymal and mediastinal abnormality can extend into the pulmonary ligament.

[Objective] To explore the protective mechanism of Naoxing Nasal Spray (NNS) on ischemic cerebral injury. [Methods] Seventy Wistar rats were randomized into 7 groups: high-dose NNS group (group A), moderate-dose NNS group (group B), low-dose NNS group (group C), nimodipine group (group D), model group (group E), solvent control group (group F) and pseudo-operation group (group G). Rat models of ischemia/reperfusion were established by blocking left middle cerebral artery. Plasma levels of tumor necrosis factor a (TNF-?) and interleukin 1? (IL-1?), malondialdehyde (MDA) content, activities of superoxide dismustase (SOD), glutathione peroxidase (GSH-Px) and nitric oxide synthase (NOS) in brain homogenate were detected. [Results] NNS decreased the contents of MDA, TNF-? and IL-1?, and increased the activities of SOD, GSH-Px and NOS. [Conclusion] NNS has protective effect on ischemic cerebral injury by promoting the clearance of free radicals, inhibiting the release of inflammatory mediator and increasing the synthesis of NO and thus to reduce injury of free radicals, inhibit the local inflammatory reaction and improve cerebral blood perfusion.

ive] To observe the therapeutic effect of Naoxing Granule (NG) for acute ischemic stroke (AIS) and to explore its mechanism. [Methods] Single-blind controlled trial was applied. Two hundred cases of AIS were randomly allocated to Group A (n = 150, treated with NG) and Group B (n = 50, treated with nimodipine). Therapeutic effect of NG was observed and plasma free radical levels and the ratio of thromboxane A2 (TXA2) and prostaglandin 2 (PGI2) were detected. [Results] The total effective rate was 91.3%and 76.0% , and the remarkably effective rate was 62.0% and 46.0% in Group A and Group B respectively ( P

0.05) . NNS could decrease blood viscosity and hematocrit, inhibit the aggregation of erythrocytes and platelet and increase the activities of superoxide dismutase (SOD) and glutathione peroxidase (GSH -Px). [Conclusion] NNS has an effect on AIS, which is similar to nimodipine. Its therapeutic mechanism may be related to the relief of cerebral ischemia by improving blood rheology and cerebral blood flow and protecting brain cells from injury by eliminating free radicals.