Chinese expert consensus on the diagnosis and treatment of osteoporotic periarticular fracture of the shoulder in the elderly (version 2023) / 中华创伤杂志

Periarticular fracture of the shoulder is a common type of fractures in the elderly. Postoperative adverse events such as internal fixation failure, humeral head ischemic necrosis and upper limb dysfunction occur frequently, which seriously endangers the exercise and health of the elderly. Compared with the fracture with normal bone mass, the osteoporotic periarticular fracture of the shoulder is complicated with slow healing and poor rehabilitation, so the clinical management becomes more difficult. At present, there is no targeted guideline or consensus for this type of fracture in China. In such context, experts from Youth Osteoporosis Group of Chinese Orthopedic Association, Orthopedic Expert Committee of Geriatrics Branch of Chinese Association of Gerontology and Geriatrics, Osteoporosis Group of Youth Committee of Chinese Association of Orthopedic Surgeons and Osteoporosis Committee of Shanghai Association of Chinese Integrative Medicine developed the Chinese expert consensus on the diagnosis and treatment of osteoporotic periarticular fracture of the shoulder in the elderly ( version 2023). Nine recommendations were put forward from the aspects of diagnosis, treatment strategies and rehabilitation of osteoporotic periarticular fracture of the shoulder, hoping to promote the standardized, systematic and personalized diagnosis and treatment concept and improve functional outcomes and quality of life in elderly patients with osteoporotic periarticular fracture of the shoulder.

Effect of electroacupuncture on neuronal apoptosis in rats with traumatic brain injury based on PI3K/Akt signaling pathway / 中国针灸

OBJECTIVE@#To observe the effect of electroacupuncture (EA) on neuronal apoptosis in rats with traumatic brain injury (TBI), and to explore the action mechanism of EA on improving the brain nerve function of TBI.@*METHODS@#A total of 88 6-week-old SD rats were randomly divided into a sham operation group, a model group, an EA group and a LY294002+EA group, 22 rats in each group. The TBI model on the left side was established by the improved Feeney's free fall method. After modeling for 24 h, the rats in the EA group and LY294002+EA group were treated with acupuncture at "Baihui" (GV 20) for 10 min and pricking acupuncture at "Shuigou" (GV 26) for 20 s; EA was applied at "Neiguan" (PC 6) and "Zusanli" (ST 36) on the right side (discontinuous wave, 2 Hz of frequency, 1 mA of intensity) for 10 min, once a day for 3 days. After 3 days of intervention, the TUNEL method was used to detect the level of neuron apoptosis in left cerebral cortex; the Western blot method was used to detect the expression of Akt, p-Akt, Bcl-2, Bax, Cyt-C and Caspase-9 in the left cerebral cortex.@*RESULTS@#After 3-day treatment, compared with the sham group, the number of neuronal apoptosis in the left cortex was increased in the model group (<0.01), and the expression of Bax, Cyt-C and Caspase-9 protein was increased (<0.01), and the expression of p-Akt/Akt, Bcl-2 was decreased (<0.01). Compared with the model group, the number of neuronal apoptosis in the left cortex was decreased in the EA group (<0.01), and the expression of Bax, Cyt-C and Caspase-9 was decreased (<0.01), and the expression of p-Akt/Akt and Bcl-2 was increased (<0.01). Compared with the LY294002+EA group, the number of neuronal apoptosis in the left cortex was decreased in the EA group (<0.01), and the expression of Bax, Caspase-9 and Cyt-C was decreased (<0.01, <0.05), and the expression of p-Akt/Akt and Bcl-2 was increased (<0.01).@*CONCLUSION@#EA could significantly reduce the neuronal apoptosis in rats with TBI, and its mechanism may be related to the activation of PI3K/Akt signaling pathway.

Impacts of electroacupuncture on neurological function and protein expressions of apoptosis-related Cyt-C and Caspase-9 in rats with traumatic brain injury / 中国针灸

OBJECTIVE@#To observe the impacts of electroacupuncture (EA) on neurological function, the pathological morphology in brain tissue, apoptosis level and the protein expressions of apoptosis-related cytochrome C (Cyt-C) and cysteine aspartic acid protease-9 (Caspase-9) in the rats with traumatic brain injury (TBI) and explore the potential mechanism of EA in treatment of TBI.@*METHODS@#A total of 70 clean-grade SD mice were randomized into a blank group (8 rats), a sham-operation group (8 rats), a model group (27 rats) and an EA group (27 rats). In terms of interventions of 3, 7 and 14 days, 3 subgroups were divided in the model group and the EA group successively, 9 rats in each subgroup. The modified Feeney free-fall percussion method was adopted to establish TBI models of rats. In the sham-operation group, only the skull was exposed and drilled and no free-fall percussion was exerted. One day after modeling, EA was given in the rats of EA group at "Shuigou" (GV 26), "Baihui" (GV 20) and "Neiguan" (PC 6) and "Zusanli" (ST 36) on the affected side, with intermittent wave, 2 Hz in frequency, once daily, 10 min each time, for 3, 7 and 14 days successively. Separately, on the day 3, 7 and 14 of intervention, the modified neurological severity scale (mNSS) was used to evaluate the degree of neurological function injury in the rats, HE staining and Nissl staining were to observe the pathological and morphological changes in brain tissue, TUNEL method was to observe the level of apoptosis in brain tissue and immunohistochemistry (IHC) method and Western blot were to determine the protein expressions of Cyt-C and Caspase-9 in brain tissue.@*RESULTS@#Compared with the sham-operation group, on the day 3, 7 and 14 of intervention, mNSS scores were increased obviously in the rats of the model group respectively (<0.01). Compared with the model group, on the day 3, 7 and 14 of intervention, mNSS scores were reduced in the rats of the EA group respectively (<0.05). On day 3 of intervention, in brain injury region of the rats in the model group and the EA group, gross tissue necrosis, nuclear fragmentation, consolidation and obvious vacuolar changes, reduced Nissl bodies and scattered arrangement were found. On day 7 and 14 of intervention, in the model group and the EA group, the new connective tissue filling and normal cells were visible and Nissl bodies increased. The overall repair and Nissl body quantity in the EA group were better than the model group. Compared with the sham-operation group, on day 3, 7 and 14 of intervention, the numbers of apoptotic cells were increased obviously in the model group (<0.01) and they were reduced in the EA group as compared with the model group (<0.05). Compared with the sham-operation group, on day 3, 7 and 14 of intervention, the protein expressions of Cyt-C and Caspase-9 in damaged brain tissue were all increased obviously in the model group (<0.01) and they were all reduced in the EA group as compared with the model group successively (<0.05).@*CONCLUSION@#Electroacupuncture remarkably improves the condition in the neurological function injury and reduces apoptosis degree in TBI model rats, which is likely related to the down-regulation of the protein expressions of Cyt-C and Caspase-9 in damaged brain tissue and further to bring the impacts on mitochondria mediated apoptosis process.

Effect of Tripteryginum wilfordii polyglycoside on Fas/FasL and p38 MAPK signaling pathway expression in ulcerative colitis rats / 中国药理学通报

Aim: To investigate the expression changes of Fas/FasL and its related signaling pathway p38 MAPK in ulcerative colitis(UC) rats and the effects of Tripterygium wilfordii polycoride (TWP). Methods: TNBS and ethanol enema method were adopted to build the UC rat model, and colon inflammation in rats was assessed; the differential expression of Fas/FasL was analyzed by expression profiling method, and verified by real-time PCR. Subsequently, pathway analysis in DAVID database showed that Fas/FasL might involve p38 MAPK signaling pathway in regulating UC inflammatory activities, and the related molecules in this signaling pathway were analyzed by the expression profiling method and verified by real-time PCR. Finally, the expression of the terminal inflammatory factors of the pathway were detected by RT-PCR and Western blot. Results: In UC rats, the gross morphological damage and histopathological injury scores significantly increased, which could be reduced by TWP. The trend of FasL was in consistent with that of MAPK14 (p38α), TNF-α and IL-1β in Fas/FasL system and the p38 MAPK signaling pathway, and the expression of them were up-regulated in inflammatory activity, which can be down-regulated by TWP. Conclusion: TWP can regulate the inflammatory activity of UC through Fas/FasL system and the p38 MAPK signaling pathway.

Efficacy of acupuncture combined with tropisetron in treating nausea and vomiting induced by car-boprost tromethamine in cesarean section / 中华麻醉学杂志

Objective To evaluate the efficacy of acupuncture combined with tropisetron in treating nausea and vomiting induced by carboprost tromethamine in cesarean section. Methods Sixty-six patients aged 22-40 yr who received carboprost tromethamine and developed nausea and vomiting during cesarean section under lumbar anesthesia, were randomly divided into 3 groups(n=22 each): acupuncture group (group A), tropisetron group(group T)and acupuncture+ tropisetron group(group AT). In group A, 09% normal saline 2 ml was intravenously injected immediately, acupuncture was given at Renzhong, Neiguan and Hegu acupoints with lifting thrusting twirling the acupuncture needle for 10 min. In group T, tropisetron 10 mg was intravenously injected immediately, the needle was placed on Renzhong, Neiguan and Hegu skin surface. In group AT, tropisetron 10 mg was intravenously injected immediately, acupunc-ture was given at Renzhong, Neiguan and Hegu acupoints with lifting thrusting twirling the acupuncture nee-dle for 10 min. The nausea and vomiting score was assessed before anesthesia induction(T0), when nause-a or vomiting occurred(T1)and at 1, 3, 5 and 15 min after acupuncture or administration(T1-5). The degree of patient′s satisfaction with therapeutic effect was recorded. Results Compared with group A, the nausea and vomiting scores were significantly decreased at T4, and the patient's satisfaction score was in-creased in group AT(P<005). Compared with group T, the nausea and vomiting scores were significantly decreased at T2-4and the patient's satisfaction score was increased in group AT(P <005). Conclusion Acupuncture combined with ondansetron can quickly and effectively relieve the nausea and vomiting induced by carboprost tromethamine during cesarean section.

Standardized investigation on medicinal nature of ethnomedicine / 中国中药杂志

This article recorded the analysis and comparison between the medicinal nature theory of traditional Chinese medicine(TCM) and ethnomedicine(EM). The vocabulary of "medicinal nature" was suggested to indicate the properties of ethnomedicine. Based on the influence of TCM medicinal nature theory on EM in China, the application of medicinal nature theory in EM was divided into 3 classes, and the standardizing principles for EM medicinal nature were proposed. It was suggested that medicinal quality, flavor, tendency, tropism, degree and efficiency can be used for the classification standard for EM medicinal nature.

Antihypertensive Effects of Extract from Flower Buds of Coreopsis tinctoria on Spontaneously Hypertensive Rats / 中草药·英文版

Objective: To provide experimental evidence for the antihypertensive activity of the flavonoids in flower buds of Coreopsis tinctoria (CT-F) and to investigate the underlying mechanism. Methods: The spontaneously hypertensive rats (SHRs) were divided into model, captopril (positive control), and CT-F groups, and the Wistar-Kyoto rats were set as control group, eight in each group. The blood pressure of SHRs, the activity of angiotensin II (Ang-II) in plasma, nitric oxide (NO), malondialdehyde (MDA) and thoracic aorta media thickness in SHRs were measured by tail-cuff method, radioimmunity method, nitrate reductase method, thibabituric acid (TBA) method, and the hematoxylin-eosin staining method. Q-PCR analysis was performed to determine the relative quantity of angiotensin-converting enzyme (ACE), ACEII, angiotensin type 1 receptor (AT1R), and TGF-β1 mRNA in left ventricle. Results: CT-F could lower the systolic blood pressure of SHRs dramatically (P < 0.01). The levels of MDA in serum and Ang II in plasma of SHRs treated with CT-F decreased markedly (P < 0.05, 0.01), the level of NO in serum increased significantly (P < 0.01). In addition, thoracic aorta media thickness in SHRs treated with CT-F was thinner than that of the model group (P < 0.05). The mRNA expression of ACE, AT1R, and TGF-β1 in left ventricle was markedly decreased (P < 0.05), while that of ACE II was increased (P < 0.05). Conclusion: CT-F is effective to lower the blood pressure of SHRs, and its antihypertensive effect is probably associated with lowering the oxidative stress by reducing MDA, ameliorating aorta remodeling, dilating vessel by increasing NO and decreasing Ang-II, and regulating the expression of rennin-angiotensin System-related various genes. © 2014 Tianjin Press of Chinese Herbal Medicines.

Effect on Softening Liver and Reducing Enzyme Mixed Agent in Prevention of CCl4-induced Liver Damage Rats / 世界科学技术-中医药现代化

This study was aimed to observe the effect of Softening Liver and Reducing Enzyme Mixed Agent (SLREXA) in the prevention of acute liver injury rats induced by carbon tetrachloride (CCl4). A total of 60 male SD rats were randomly divided into 6 groups, which were the SLREXA low-, middle-, high-dose group, glucurolactone group, normal group and model group. Intraperitoneal injection of CCl4 was used to induce acute liver injury rat mod-el. Intragastric administration of SLREXA was given to each Chinese medicine group. Intragastric administration of distilled water was given to the normal group and the model group. Intragastric administration of glucurolactone aque-ous solution was given to the glucurolactone group. On the 12th day of the experiment, after 16-hour fasting, rats were killed. Pathological changes in liver tissues were examined. Blood serum was determined for alanine aminotrans-ferase (ALT) and aspartate aminotransferase (AST). The liver homogenate was determined for superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), glutathione (GSH), catalase (CAT) and malondialdehyde (MDA) in liver tis-sues of rats. RT-PCR was used to detect the expression level of mRNA in liver heme oxygenase-1 (HO-1). The re-sults showed that in the microscopic examination of liver tissues, compared with the model group, different doses of SLREXA can alleviate pathological damages of liver in varying degrees. Levels of blood serum ALT and AST content in different doses of SLREXA groups and glucurolactone group were significantly lower than those of the model group (P < 0.05 or P < 0.01). Compared with the model group, contents of GSH-Px, GSH, SOD, CAT in the liver ho-mogenate were significantly increased, and MDA content was decreased significantly (P< 0.05 or P< 0.01) in differ-ent doses of SLREXA groups and glucurolactone group; compared with the model group, the HO-1 mRNA relative expression quantity in the normal group and each treatment group increased obviously, with statistical significance (P< 0.05 or P< 0.01). It was concluded that SLREXA can prevent CCl4-induced liver injury rats with definite thera-peutic effect.

Effects of Jiaweisinisan on gastric mucosal ultrastructure and brain-gut axis in a rat model of chronic psychological stress / 南方医科大学学报

<p><b>OBJECTIVE</b>To study the effect of Jiaweisinisan (JWSNS), a traditional Chinese herbal medicinal recipe, on gastric mucosal ultrastructure and brain-gut axis in rat models of chronic psychological stress and elucidate the mechanism of JWSNS for ameliorating stress-induced gastrointestinal dysfunction.</p><p><b>METHODS</b>Sixty rats were randomly assigned into normal control group, model group, 3 JWSNS groups (high, moderate, and small doses), and omeprazole group (n=10). Rat models of chronic psychological stress were established by random stressful stimulations, and following the corresponding interventions, plasma adrenocorticotropic hormone (ACTH) and cortisol (CORT) levels were detected using radioimmunoassay, and the mRNA expressions of gastrin receptor in the gastric tissue (GASR) and vasoactive intestinal peptide II receptor (VIPR2) in the jejunal tissue were examined using RT-PCR. Transmission electron microscopy was employed to examine the ultrastructural changes in the gastric mucosa tissue cells of the glandular stomach area and alterations in the intercellular junctions.</p><p><b>RESULTS</b>Electron microscopy revealed obvious damages in gastric mucosal epithelial cell organelles and nuclei in the model rats. These damages were ameliorated after treatments with JWSNS and omeprazole. Compared with the model group, the 3 JWSNS groups and omeprazole group all showed significantly lowered plasma ACTH and CORT levels, increased gastrin receptor mRNA expression and decreased jejunal VIPR2 mRNA expression (P<0.05 or 0.01).</p><p><b>CONCLUSION</b>JWSNS can obviously ameliorate the pathologies of the gastric mucosa cells, regulate the state of brain-gut axis, and modulate the gastric gastrin receptor and jejunal VIPR2 mRNA expressions in rats with chronic psychological stress.</p>

Multi-index determination and optimization of liquirtin separated from polyamide resin / 中国中药杂志

To optimize the separation process of liquirtin from glycyrrhiz by static, dynamic adsorption and desorption experiments on polyamide resin, with liquirtin, isoliquiritin and glycyrrhizic acid as the study index. The optimum process conditions were that the pH of solution was regulated to be 7.0, the concentration of liquirtin was 1.296 g x L(-1), the volume of loading buffer was 3 BV. After absorption, efforts shall be made to elute resin with water, 10%, 20%, 30% ethanol (3 BV for each), collect 20% ethanol eluted fraction, and recover solvents. The results showed lower contents of such impurities as isoliquiritin and isoliquiritin in extracts sepaprated under this process conditions, as well as an increase in purity of liquirtin from 4.86% to 88.5%. The method was simple and feasible, it could obtain a higher purity in extracts from liquirtin and provide basis for industrialized separation and preparation of liquirtin.

Experimental Study of Nerve Growth Factor of Sciatic Nerve of Rats with Diabetes Peripheral Neuropathy Accommodated by Electro-acupuncture / 中国康复理论与实践

@#Objective To explore the mechanism of the nerve growth factor (NGF) accommodated by electro-acupuncture in rats with diabetes peripheral neuropathy (DPN).MethodsThe rat DPN model was established with streptozotocin (STZ). The rats were randomly divided into the normal group, model group, western medicine group and electro-acupuncture group. The animals of the electrol-acupuncture group were treated with electrol-acupuncture on "Zusanli" and "Shenshu" after DPN model established. The nervous tissues of all animals were examined with the techniques of immunity and fluorescent quantitation PCR to detect the albumen and mRNA expression of NGF.ResultsThe albumen and mRNA expression of NGF of the animals in the model group, western medicine group and electro-acupuncture group were significantly lower than that in the normal group ( P<0.05～0.01), and the albumen and mRNA expression of NGF was up-regulation in the electro-acupuncture group after electro-acupuncture treatment and was significantly higher than that in the model group ( P<0.01).ConclusionElectro-acupuncture on "Zusanli" and "Shenshu" can up-regulate the albumen and mRNA expression of NGF, and improve reparation of the sciatic nerve in DPN animals.

Bibliometrics study on dominant diseases in modern acupuncture clinic / 中国针灸

<p><b>OBJECTIVE</b>To find out the dominant diseases in the clinic of modern acupuncture.</p><p><b>METHODS</b>By means of bibliometrics, clinical acupuncture study literatures from 1978 to 2004, searched from CBM database, were sorted and counted to show the different clinical utilizing quantities and developing trends of different disease groups in the acupuncture clinic.</p><p><b>RESULTS</b>Obviously dominant type: nervous system diseases; mature type: motor system diseases; developing type: 3 kind of diseases including psychosis; premature type: diseases related with surgery; steady type: 3 kind of diseases including digestive system diseases (diseases of liver and gallbladder are not included); pre-developing diseases: 5 kind of diseases including otorhinolaryngologic diseases.</p><p><b>CONCLUSION</b>Among all these types, obvious advantage type and mature type are the most distinguishing. Developing type has the most significant ascending trend. Premature type has relatively strong developing potentiality.</p>

Proteomic analysis of differentially expressed proteins in human hepatoma SMMC-7721 cells induced by Fufang Banmao capsule serum / 中国中药杂志

<p><b>OBJECTIVE</b>To investigate the effects of Fufang Banmao capusle on the proteome of SMMC-7721 cells and discover potential molecular mechanism of anti-cancer at molecular level.</p><p><b>METHOD</b>SMMC-7721 cells were treated by Fufang Banmao capusle serum prepared with serum pharmacological method; proteomic protocol involving 2-DE, image analysis and mass spectrometry were used to detect the proteins in cells influenced by Fufang Banmao capusle.</p><p><b>RESULT</b>Approximately 450 protein spots in SMMC-7721 cells were resolved and detected in 2-D gel maps from pH3-10L IEF. 47 protein plots varied over 2-fold quantitively between treated sample and control sample were uncovered. 13 differentially expressed proteins spots were further identified by MALDI-TOF-MS analysis and four of them were successfully identified. Annexin A5, heatshock 70 x 10(3) protein 8 was significantly up-regulated in treated sample compared with control sample, while Eukaryotic translation initiation factor 5A and Peroxiredoxin-2 was significantly down-regulated in treated sample.</p><p><b>CONCLUSION</b>4 differently expressed proteins associated with the proliferation, apoptosis, immunity of tumor were detected and they might provide clues for the coming research. The protocol of proteomics combined with serum pharmacological method is an effective platform to research complicated formulas in that it is capable of laying out many proteins associated with Fufang Banmao capusle.</p>

Drug distribution in gastric cancer and adjacent tissues by preoperative intraperitoneal chemotherapy with Co-fluorouracil liposome / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To examine the distribution of fluorouracil in gastric cancer (CA), lymph node (LN), normal gastric mucosa (NG), peritoneum (PE), greater omentum (GO) and lesser omentum (LO) by preoperative intraperitoneal chemotherapy with Co-fluorouracil liposome (Co 5-Fu), and offer an experimental basis for clinic practice.</p><p><b>METHODS</b>Ninety-six gastric cancer patients were divided into four groups: Co 5-Fu i.v. injection group (Co 5-Fu i.v.), Co 5-Fu intraperitoneal perfusion group (Co 5-Fu i.p.), 5-Fu i.v. injection group (5-Fu i.v.) and intraperitoneal perfusion group (5-Fu i.p.) given on day-2, day-1 and 60 minutes before operation. Fluorouracil concentration in all tissues collected during operation were examined by high performance liquid chromatography (HPLC).</p><p><b>RESULTS</b>The fluorouracil concentration in the tissues in Co 5-Fu i.p. group was significantly higher than that in Co 5-Fu i.v. or 5-Fu i.p. group (P < 0.05 or P < 0.01), and that in 5-Fu i.p. group was greatly higher than that at 5-Fu i.v. group (P < 0.01). In Co 5-Fu i.p. group, the concentration of drug in LN, CA, PE, NG, GO and LO decreased gradually with the former 3 tissues significantly higher than the latter 3 tissues (P < 0.01), and adjacent lymph node was the highest. In Co 5-Fu i.v. group, the ranking was LN, CA, NG, PE, GO and LO with the former 3 tissues significantly higher than the latter 3 tissues (P < 0.01) and showing tumor tissues higher than the other tissues (P < 0.01). In 5-Fu i.p. group, the ranking was PE, LN, CA, NG, GO and LO with the former 2 tissues significantly higher than the latter tissues (P < 0.01).</p><p><b>CONCLUSION</b>Co 5-Fu possesses drug targeting, slow release and long effect in gastric cancer tissues and adjacent lymph nodes. Preoperative chemotherapy with Co 5-Fu i.p. is more advantageous than 5-Fu given i.v. or 5-Fu i.p.</p>