Osteoporosis can be induced by various factors including prolonged glucocorticoid usage, diminished estrogen levels, secondary hyperparathyroidism, and alterations in the microenvironment of bone tissue. The bone metabolism imbalance(osteogenic-lipogenic imbalance) plays a crucial role in the development of osteoporosis. This imbalance is primarily driven by an increase in the differentiation of bone marrow mesenchymal stem cells into adipocytes and a decrease in their differentiation into osteoblasts, thus forming the core of the osteogenic-lipogenic imbalance observed in osteoporosis. The bone morphogenesis protein(BMP) plays a crucial role in the regulation of the osteogenic-lipid balance in osteoporosis. This regulatory function is accomplished through both the Smad-dependent and Smad-independent pathways. This review centers on the Smad-dependent and Smad-independent pathways facilitated by BMP, offering a comprehensive overview of the potential mechanisms through which BMP-2, 4, 6, 7, and 9 contribute to the regulation of osteogenesis and lipid metabolism in osteoporosis via these pathways. In order to present novel insights for the identification of efficacious targets for clinical anti-osteoporosis medications.

The internal organs and meridians were associated with Yin and Yang, five elements, six qi, and time and space, based on the holistic view of heaven, earth and human, according to Huangdi Neijing. The syndrome differentiation system of six meridians and Zang Fu meridians were established by Shanghan Zabing Lun, on the basis of the three Yin, three Yang, six meridians, and five Zang system in Huangdi Neijing. We put forward the concept of the six meridians syndrome differentiation system of circular motion, considering that the six meridians syndrome differentiation system actually implies the theory of circular motion. The syndrome differentiation system was constructed with the circular model of one qi circulating around the road, rising left and falling right, corresponding up and down, and maintaining conservation in the middle as the core, integrating Yin and Yang, five elements, six qi, Zang Fu and meridians, qi, blood and body fluid, and the integration of heaven, earth and human, focusing on "disease location and disease nature", taking classical prescriptions as the main treatments, and cooperating with external treatments such as acupuncture and moxibustion. We organically combined the circular motion with the syndrome differentiation of the six meridians, systematically interpreted the physiological bases, pathological changes, progressive patterns, and the treatments, based on syndrome differentiation, by inheriting the classical thinking mode of Hetu, Luoshu,Zhouyi, Huangdi Neijing, ShennongHerbal Classic, and Shanghan Zabing Lun.

Objective:To explore the difference of high-risk factors between early-onset and late-onset pre-eclampsia, and to further understand high-risk factors of pre-eclampsia.Methods:Clinical data of pre-eclampsia pregnant women in 160 medical institutions in China in 2018 were retrospectively analyzed, including 8 031 cases of early-onset pre-eclampsia and 12 969 cases of late-onset pre-eclampsia. The proportion of high-risk factors, different body mass index (BMI) and age stratification between early-onset group and late-onset group were compared.Results:(1) Univariate analysis of high-risk factors: the proportions of high-risk factors in early-onset group and late-onset group were compared, and the differences were statistically significant (all P<0.05). Among them, the proportions of primipara and multiple pregnancy in early-onset group were lower than those in late-onset group, while the proportions of pregnant women with advanced age, irregular antenatal examination, obesity, family history of hypertension, pre-eclampsia, diabetes, kidney diseases, immune system diseases and assisted reproductive technology were higher than those in late-onset group. (2) Hierarchical analysis of BMI: the proportion of pregnant women with BMI≥24 kg/m 2 in early-onset group [48.2% (2 828/5 872) vs 45.5% (4 177/9 181), respectively; P=0.001] and the proportion of pregnant women with BMI ≥28 kg/m 2 in early-onset group [19.5% (1 143/5 872) vs 18.0% (1 656/9 181), respectively; P=0.028] were significantly higher than those in late-onset group. (3) Age stratification analysis: the proportion of pregnant women aged 35-39 years in the early-onset group [21.8% (1 748/8 023) vs 17.5% (2 110/12 068), respectively; P<0.01], the proportion of pregnant women 40-44 years old [6.8% (544/8 023) vs 5.4% (648/12 068), respectively; P<0.01], and the proportion of pregnant women ≥45 years old [0.7% (58/8 023) vs 0.5% (57/12 068), respectively; P=0.021] were significantly higher than those in the late-onset group. (4) Multivariate analysis: advanced age (≥35 years old), multiple pregnancy, irregular antenatal examination or transfer from other hospitals, family history of hypertension (including paternal, maternal and parental lines), previous history of pre-eclampsia, kidney diseases, immune system diseases (systemic lupus erythematosus, antiphospholipid antibody syndrome) and assisted reproductive technology pregnancy were the risk factors affecting the severity of pre-eclampsia (all P<0.05). Conclusion:Pregnant women with high risk factors such as age ≥35 years old, BMI ≥24 kg/m 2 before pregnancy, family history of hypertension, history of pre-eclampsia, chronic kidney diseases, immune diseases (mainly including systemic lupus erythematosus and antiphospholipid syndrome) and assisted reproductive technology are more likely to have early-onset pre-eclampsia.

Models of acute and chronic liver injury in mice were established using carbon tetrachloride (CCl4) and ethanol to explore the protective effects of Ganoderma lucidum spore glycopeptide on liver injury.Different dosage of Ganoderma lucidum spore glycopeptide (65,130,260 mg/kg) were given by gavage.The liver index and the levels of serum aspartate transaminase (AST) and alanine transaminase (ALT) were determined.The contents of liver interleukin-6 (IL-6), tumor necrosis factor (TNF-α) and inducible nitric oxide synthase (iNOS) were tested by enzyme-linked immunosorbent assay (ELISA).The pathological injury of liver tissue was observed by HE staining.The results showed that Ganoderma lucidum spore glycopeptide could significantly reduce the liver index and the contents of serum AST and ALT in mice of acute and chronic liver injury.In mice of chronic liver injury induced by CCl4, Ganoderma lucidum spore glycopeptide could significantly decrease the contents of liver IL-6, TNF-α and iNOS, and alleviate the pathological damage of liver tissue.Results suggested that Ganoderma lucidum spore glycopeptide might reduce acute and chronic liver injury with anti-inflammatory effects in mice.

Objective: To explore the association between preeclampsia/eclampsia and maternal and fetal angiotensinogen SNPs. Methods: From January 2008 to October 2015, a case-parents/mother-control designed study was conducted among 347 preeclampsia/eclampsia cases and 700 controls to collect related information on their demographic characteristics and to detect the related angiotensinogen SNPs’ genotypes. Both log-linear and unconditional logistic regression methods were employed to investigate the genetic effects of maternal/fetal angiotensinogen SNPs on preeclampsia/eclampsia. Multivariate binary unconditional logistic regression model and covariance were used to analyze the relationship between BMI before pregnancy, weight gain during pregnancy and overweight and obesity in preschool children. Results: Both fetal angiotensinogen rs3789679 GA and AA genotype were associated with the reduced risks of preeclampsia/eclampsia, with ORs as 0.73 (95%CI: 0.55-0.96) and 0.62 (95%CI: 0.39-0.98), respectively. For fetal angiotensinogen rs2493132, individuals that carrying the TT genotype, presented a positive association with the risk of preeclampsia/eclampsia, with OR as 1.60 (95%CI: 1.08-2.37). However, these associations were not statistically significant after the correction of the false discovery rate. It was observed that fetal rs3789679 could reduce the risk of preeclampsia/eclampsia (OR=0.73, 95%CI: 0.55-0.96) under the dominant model (GA+AA/GG) while fetal rs2493132 increased the risk of preeclampsia/eclampsia (OR=1.66, 95%CI: 1.13-2.44) under the recessive model (TT/CC+CT). Maternal rs5051 presented an association with preeclampsia/eclampsia (OR=1.33, 95%CI: 1.01-1.76) under the dominant model (TC+CC/TT). Conclusions Results from the dominant model showed that both fetal rs3789679 GA and AA genotype reduced the risk of preeclampsia/eclampsia and maternal rs5051 TC while CC genotype increased the risk of preeclampsia/eclampsia. Fetal rs2493132 TT genotype seemed to be associated with the risk of preeclampsia/eclampsia under the recessive model.

Objective: To investigate the safety and efficacy of allogeneic CAR-T cells in the treatment of relapsed/refractory multiple myeloma (RRMM) . Methods: CAR-T cells were prepared from peripheral blood lymphocytes of HLA mismatch healthy donors. Median age was 55 (48-60) . Allogeneic cells were derived from 3 HLA haploidentical donors and 1 HLA completely mismatch unrelated donor. Four patients with RRMM were conditioned with FC regimen followed by CAR-T cell transfusion. They were infused into CART-19 (1×10⁷/kg on day 0) and (4.0-6.8) ×10⁷/kg CART-BCMA cells as split-dose infusions (40% on day 1 and 60% on day 2) . The adverse reactions and clinical efficacy were observed during follow-up after infusion, and the amplification and duration of CAR-T cells in vivo were monitored by PCR technique. Results: CAR-T cells were successfully infused in 3 of the 4 RRMM patients according to the study plan, and the infusion in one patient was delayed by 1 day due to high fever and elevated creatinine levels on day 3. The side effects included hematological and non-hematological toxicity, grade 3 hematological toxicity in 2 patients, grade 3 CRS in 1 one, grade 1 CRES in 1 one, prolonged APTT in 3 ones, tumor lysis syndrome in 1 one, mixed chimerism detected STR and clinical GVHD manifestation in 1 one. According to the efficacy criterias of IMWG, 2 patients acquired PR, 1 MR, and 1 SD respectively. Progression-free survival was 4 (3-5) weeks and overall survival was 63 (3-81) weeks. CAR T cells were amplified 2.2 (2-14) times in the patients with a median survival time of 10 (8-36) days. Conclusions Small sample studies suggested that GVHD may be present in the treatment of RRMM with allogeneic CAR-T cells. There were early clinical transient events after transfusion. Low amplification and short duration of CAR-T cells in vivo may be the main factors affecting the efficacy.

This paper was aimed to investigate the changes of pulses under different emotional states.Based on the emotional pulse theory of traditional Chinese medicine (TCM),with college students as the research object,through films to stimulate different emotional expressions (i.e.,calm,sad and happy) of college students,the pulse recordings of college students were acquired in this study.The time domain parameters of pulses of college students under three types of emotional states were extracted.The difference among three groups of time-domain parameters was calculated by nonparametric test.Based on the time-domain parameters,the Support Vector Machine (SVM) classifier was used to classify three types of emotional states.The results showed that there were significant differences in three groups of time domain parameters (h3/h1,t and As/(As+Ad)).And the average recognition rate of three types of emotion states was 74.25％ based on the time-domain parameters of the pulse recordings.It was concluded that the pulse parameters can provide objective reference for emotional changes.It can be used to identify emotional states.

This study introduced the application of a log-linear model in the hybrid design of case-parents triad/control-mother dyad.Data related to the association between cleft lip with palate (CLP) and methylenetetrahydrofolate reductase (MTHFR) gene A1298C diversity was analyzed.Log-linear model based on likelihood ratio tests (LRTs) was used to analyze the relationships between mother,offspring genotypes and CLP.Data from our study noticed that children of mothers carrying the CC genotype presented a lower risk of CLP,comparing with the children of mothers carrying the AA genotype,with S2=0.45 (95％CI:0.26-0.79).Offspring that carrying the AC genotype presented a lower risk of CLP,comparing with the offspring that carrying the AA genotype,with R1 =0.69 (95％CI:0.48-0.97).However,no other types of relationships were found.The power of hybrid design was greater than the case-parents study (0.86＞0.78).MTHFR A1298C polymorphism seemed to have played an important role in the etiology on both cleft lip and palate.Data from the hybrid design and the log-linear model could help researchers to explore the effects of genotypes from both mothers and the offspring.This study design would present stronger power than the regular case-parents studies thus suitable for studies on the etiology of diseases in early lives,as birth defects.

OBJECTIVETo establish the technical specifications of transbronchoscope whole lung lavage (TBWLL) and to compare the clinical efficacy between TBWLL and bronchoalveolar lavage (BAL) or whole lung lavage (WLL).

METHODSA total of 133 patients with pneumoconiosis admitted to Hunan Prevention and Treatment Institute for Occupational Diseases from 2009 to 2014 were divided into TBWLL group (n=43), BAL group (n=45), and WLL group (n=45). Patients in the TBWLL group received conventional BAL of both lungs under a fiber bronchoscope, as well as sedation and anesthesia; lavage was performed twice in each course. TBWLL was compared with the BAL and WLL in terms of lavage volume. The clinical symptoms, pulmonary function, and blood gas before and after treatment and the safety were evaluated.

RESULTSThe TBWLL group had significantly relieved cough and limitation of activity after lavage (P<0.05). Compared with the BAL group, the TBWLL group had significantly increased single lavage volumes and total lavage volume and a significantly shortened length of hospital stay (P<0.05). The three groups showed no significant short-term changes in clinical symptoms and pulmonary function after lavage. The TBWLL and WLL groups had a significantly lower incidence of postoperative complications than the BAL group (P<0.05).

CONCLUSIONTBWLL has good clinical efficacy, with the advantages of BAL and WLL, and is highly feasible, safe, and effective.

Bronchoalveolar Lavage ; Bronchoscopes ; Humans ; Lung ; physiopathology ; Pneumoconiosis ; therapy ; Therapeutic Irrigation ; methods

OBJECTIVETo analyze absentees due to injury among primary school pupils in Hubei, 2012-2013; and to provide theoretical basis for the prevention and control of injuries.

METHODSA total of 32 primary schools in Qianjiang city and Shayang county were sampled to conduct injury absenteeism surveillance, and the total number of students was 21 493. The surveillance contents included absent dates, genders, grades, initial or return absent, and the detailed absent reasons. The classification of injury was based on the 10th Revision of the international classification of diseases developed by WHO. Data from 2012-2013 school-year were extracted from the surveillance system for analysis. The total surveillance period was 182 days, of which the fall semester was 98 days and the spring semester was 84 days. The absenteeism rate and injury rate in different characteristics of primary school students were compared by χ² test, and the possible risk factors of injury were preliminary explored by calculating the RR (95% CI) value.

RESULTSThe total daily injury absenteeism rate was 8.26/100 100 during 2012-2013 school-year in 32 primary schools in Hubei province, which was higher in fall semester (9.16/100 000), Qianjiang area (9.63/100 000), rural primary schools (13.44/100 000), boys (9.57/100 000), 1-2 grades (10.41/100 000), and the differences were significant (P < 0.05). The total injury rate was 0.46%. Rural primary schools (RR = 2.32, 95% CI: 1.46-3.70), boys (RR = 1.88, 95% CI: 1.23-2.87), and 3-4 grades (RR = 1.85, 95% CI: 1.10-3.09) were identified as high-risk factors, while using city primary schools, girls, and 5-6 grades as references, respectively.

CONCLUSIONThe injury absenteeism rate and injury rate were more higher in rural primary schools, boys and low or middle grades in Hubei province during 2012 to 2013 school year, so monitoring and preventive measures should be focused on those students.

Absenteeism ; Adolescent ; Child ; Female ; Humans ; Male ; Risk Factors ; Rural Population ; Schools ; Sex Factors ; Students ; Wounds and Injuries