Validation of the IMPEDE VTE score for prediction of venous thromboembolism in Chinese patients with multiple myeloma: A single-center retrospective cohort study.

Multiple myeloma (MM) significantly increases the risk of venous thromboembolism (VTE) within 6 months of treatment initiation. The IMPEDE VTE score is a VTE risk prediction model which is recently incorporated into the National Comprehensive Cancer Network (NCCN) guidelines, but it lacks validation among Asians, including Chinese MM patients. We performed a retrospective chart review of 405 Chinese with newly diagnosed MM who started therapy at Beijing Jishuitan Hospital between April 2013 to October 2022. The 6-month cumulative incidence of VTE was 3.8 % (95 % CI:1.6-7.6), 8.6 % (95 % CI: 5.3-21.9) and 40.5 % (95 % CI: 24.9-55.7) in the low-, intermediate- and high-risk groups (P < 0.001), respectively. The C-statistic of the IMPEDE VTE scores for predicting VTE within 6 months of treatment initiation was 0.74 (95 % CI: 0.65-0.83). Of note, in this single-center cohort study, we propose that the anticoagulant LMWH may be more effective than the antiplatelet aspirin in potentially preventing VTE in newly diagnosed MM patients. Our findings suggest that the IMPEDE VTE score is a valid evidence-based risk stratification tool in Chinese patients with newly diagnosed MM.

The efficacy and safety of intravenous sucrose iron therapy for recurrent iron deficiency anemia / 中华血液学杂志

Objective: To evaluate the efficacy and safety of intravenous iron supplementation in patients with recurrent iron deficiency anemia (IDA) . Methods: This retrospective analysis of 90 patients with recurrent IDA from May 2012 to December 2021 was conducted, comparing the efficacy and safety of the intravenous iron therapy group and the oral iron therapy group. Results: Among the 90 patients with recurrent IDA, 20 were males and 70 were females, with a median age of 40 (range: 14-85) years. A total of 60 patients received intravenous iron supplementation and 30 received oral iron supplementation. The hematologic response rates in the intravenous iron group were significantly higher than those in the oral iron group at 4 and 8 weeks after treatment [80.0% (48/60) vs 3.3% (1/30) and 96.7% (58/60) vs 46.7% (14/30), all P<0.001, respectively]. The median increase in hemoglobin levels was also significantly higher in the intravenous iron group than in the oral iron group [38 (4, 66) g/L vs 7 (1, 22) g/L at week 4 and 44.5 (18, 80) g/L vs 19 (3, 53) g/L at week 8, all P<0.001]. The intravenous iron group had a significantly higher proportion of patients who achieved normal hemoglobin levels than the oral iron group (55.0% vs 0 and 90% vs 43.3%, all P<0.001, respectively). Iron metabolism indicators were tested before and after 8 weeks of treatment in 26 and 7 patients in the intravenous and oral iron groups, respectively. The median increase in serum ferritin (SF) levels in the intravenous iron group 8 weeks after treatment was 113.7 (49.7, 413.5) μg/L, and 54% (14/26) of these patients had SF levels of ≥100 μg/L, which was significantly higher than the median increase in SF levels in the oral iron group [14.0 (5.8, 84.2) μg/L, t=4.760, P<0.001] and the proportion of patients with SF levels of ≥100 μg/L (P=0.013). The incidence of adverse reactions was 3.3% (2/60) in the intravenous iron group, which was significantly lower than that in the oral iron group [20.0% (6/30), P=0.015]. Conclusion: Intravenous iron supplementation is more effective for hematologic response, faster hemoglobin increase, and higher iron storage replenishment rates compared with oral iron supplementation in patients with recurrent IDA, and it is well tolerated by patients.

Quality regulatory issues and suggestions for the Lonicerae Japonicae Flos with property of drug and food homologous substance / 国际中医中药杂志

In the context of the national strategy of promoting the research and development of food and drug homologous substances, it is necessary to study the regulatory model of food and drug homologous substances as food. Medicinal and food homologous substances are regulated as "Chinese medicinal materials" or "Chinese decoction pieces" in the drug category, and as "food and drug homologous substances", "agricultural products" or "traditional Chinese medicine healthy food" in the food category. Drug supervision focuses on quality, while food supervision focuses on safety, and it is worth exploring whether there is a blind spot in the supervision of food and drug substances completely based on the food concept. In this paper, Lonicerae Japonicae Flos, as drug and food homologous substance, is selected as the research object, and its quality regulation status is investigated by reviewing the relevant laws and regulations and standards on food, analyzing the quality information and test results of the samples, and analyzing the necessity of quality regulation when serving as food, in order to provide a basis and reference for the way food substances are regulated.

Clinical study of intra-articular injection of autologous PRP combined with Tongbi San fumigation in the treatment of early knee osteoarthritis / 国际中医中药杂志

Objective:To evaluate the efficacy of intra-articular injection of autologous platelet-rich plasma (PRP) combined with Tongbi Powder fumigation in the treatment of early knee osteoarthritis (KOA).Methods:Randomized controlled trial. Totally 160 patients with KOA in Tai'an Second Hospital of Traditional Chinese Medicine were enrolled between March 2021 and March 2022. According to random number table method, they were divided into two groups, with 80 cases in each group. The control group was given routine treatment, while observation group was given intra-articular injection of autologous PRP combined with Tongbi Powder fumigation. All were treated for 3 weeks. The knee function was evaluated by Western Ontario and McMaster University (WOMAC) osteoarthritis index. The activities of daily living were evaluated by Lysholm knee scale (LKS). The pain degree was evaluated by VAS. The levels of interleukin-1β (IL-1β) and tumor necrosis factor-α (TNF-α) were detected by ELISA. The adverse reactions during treatment were observed and recorded. The clinical efficacy was evaluated.Results:The total effective rate of the observation group was 95.0% (76/80), and that of the control group was 77.5% (62/80), with statistical significance ( χ2=10.33, P<0.01). At 1, 3 and 6 months after treatment, the WOMAC score of the observation group was lower than that of the control group ( F=15.63, P<0.01), the LKS score was higher than that of the control group ( F=55.23, P<0.01), and the VAS score was lower than that of the control group ( F=11.93, P<0.01). After treatment, the observation group IL-1β [(51.75±2.74)μg/L vs. (63.38±3.31) μg/L, t=24.21], TNF- α [(10.58±1.25) μg/L vs. (11.62±1.84) μg/L, t=4.18] were lower than those in the control group ( P<0.01). The incidence of adverse reactions was 10.0% (8/80) in the observation group and 7.5% (6/80) in the control group, without statistical significance ( χ2=0.31, P=0.576). Conclusion:Intra-articular injection of autologous PRP combined with Tongbi San fumigation can effectively improve knee function and activities of living ability, relieve pain symptoms, reduce inflammatory response and improve clinical curative effect in early KOA.

Huanglian Jiedutang Alleviates Liver Injury in Septic Mice by Inducing Autophagy / 中国实验方剂学杂志

ObjectiveTo explore effect of Huanglian Jiedutang （HLJDT） on autophagy-related protein expression in septic mice with liver injury induced by cecal ligation and puncture （CLP）. MethodSixty eight-week-old C57BL/6 mice were randomly divided into four groups， namely， the sham operation group， model group， and low- （1.44 g∙kg-1） and high-dose （2.88 g∙kg-1） HLJDT groups， with 15 in each group. The septic model was established by CLP after the last administration of HLJDT for three successive days. The survival rate of mice with 24 h was observed. The mice were sacrificed 12 h after operation for collecting the serum and liver tissue. The levels of serum interleukin-6 （IL-6）， tumor necrosis factor-α （TNF-α）， and interleukin-1β （IL-1β） were detected by enzyme-linked immunosorbent assay （ELISA）， and the levels of alanine aminotransferase （ALT） and aspartate aminotransferase （AST） in serum by biochemical method. The pathological changes in liver tissue were observed by hematoxylin-eosin （HE） staining， and the apoptosis index （AI） of hepatocytes by TdT-mediated dUTP-biotin nick end-labeling （TUNEL）. The expression levels of protein high-mobility group box 1 protein （HMGB1）， Beclin1， and microtubule-associated protein 1 light chain 3 （LC3）-Ⅱ/Ⅰ in the liver tissue were assayed by Western blot. ResultCompared with the sham operation group， the model group showed reduced survival rate at 12 and 24 h， elevated IL-6， TNF-α， and IL-1β levels， enhanced AST and ALT activities （P<0.05）， hepatocyte swelling， inflammatory cell infiltration， and apoptosis， and up-regulated HMGB1 （P<0.05）， Beclin1， and LC3-Ⅱ/Ⅰ （P<0.05）. Compared with the model group， each medication group exhibited increased survival rate at 12 and 24 h， lowered IL-6 and TNF-α levels， weakened AST and ALT activities （P<0.05）， alleviated liver injury and apoptosis （P<0.05）， down-regulated HMGB1 expression （ P<0.05）， and up-regulated Beclin1 and LC3-Ⅱ/Ⅰ （P<0.05）. ConclusionHLJDT alleviates the liver injury of septic mice possibly by inducing autophagy and inhibiting apoptosis.

Discussion on the essential thought of Ma's warm moxibustion technique for "unblocking fu-organs" / 中国针灸

"Unblocking fu organs" is one of the essential principles of Ma's warm moxibustion technique, characterized as "dredging" and "harmonizing" for either deficiency or excess condition. Under the guidance of this therapeutic thought, the acupoints for moxibustion are mainly selected from the middle and lower parts of the body. Regarding the therapeutic approach, the acupoint prescription for moxibustion should be formed in line with warming and promoting circulation of fu organs; the moxibustion degree should be specially considered, in which, the mild moxibustion is recommended to induce promoting action; and the systematic moxibustion technique should be the root for dredging fu organs and regulating zang organs. Ma's mild moxibustion technique stresses on removing the obstruction of fu organs and emphasizes promoting the qi activity of sanjiao (triple energizer) and regulating the balance of five zang organs.

Total Ginsenoside Extract from Panax ginseng Enhances Neural Stem Cell Proliferation and Neuronal Differentiation by Inactivating GSK-3β / 中国结合医学杂志

OBJECTIVE@#To study the effects of total ginsenosides (TG) extract from Panax ginseng on neural stem cell (NSC) proliferation and differentiation and their underlying mechanisms.@*METHODS@#The migration of NSCs after treatment with various concentrations of TG extract (50, 100, or 200 µ g/mL) were monitored. The proliferation of NSCs was examined by a combination of cell counting kit-8 and neurosphere assays. NSC differentiation mediated by TG extract was evaluated by Western blotting and immunofluorescence staining to monitor the expression of nestin and microtubule associated protein 2 (MAP2). The GSK-3β/β-catenin pathway in TG-treated NSCs was examined by Western blot assay. The NSCs with constitutively active GSK-3β mutant were made by adenovirus-mediated gene transfection, then the proliferation and differentiation of NSCs mediated by TG were further verified.@*RESULTS@#TG treatment significantly enhanced NSC migration (P<0.01 or P<0.05) and increased the proliferation of NSCs (P<0.01 or P<0.05). TG mediation also significantly upregulated MAP2 expression but downregulated nestin expression (P<0.01 or P<0.05). TG extract also significantly induced GSK-3β phosphorylation at Ser9, leading to GSK-3β inactivation and, consequently, the activation of the GSK-3β/β-catenin pathway (P<0.01 or P<0.05). In addition, constitutive activation of GSK-3β in NSCs by the transfection of GSK-3β S9A mutant was found to significantly suppress TG-mediated NSC proliferation and differentiation (P<0.01 or P<0.05).@*CONCLUSION@#TG promoted NSC proliferation and neuronal differentiation by inactivating GSK-3β.

Effective Dose Coefficients for Intakes of Uranium Via Contaminated Wounds for Reference Adults.

ABSTRACT: Effective dose coefficients for intakes of uranium radionuclides via contaminated wounds have been calculated for reference adults following the procedures in the ICRP 103 series. The number of transformations in each source region for all members of the radioactive series from time of intake to 50 y post intake are calculated by coupling the NCRP 156 wound model to the ICRP 137 systemic models and ICRP 100 human alimentary tract model. Together with the ICRP 107 nuclear decay data for dosimetric calculations, the ICRP 133 specific absorbed fractions are implemented to calculate the radiation-weighted S coefficient deposited in each target organ or tissue from each transformation in each source region. Effective dose coefficients for different categories of intake materials via contaminated wounds are calculated for the three major uranium isotopes-238U, 235U, and 234U. Originating from the combined effects of the new absorbed fractions, biokinetic and dosimetric models, the new coefficients are generally reduced by a percentage of 23-28% as compared to the old ones. The new dose coefficients benefit the assessment of internal exposures for intakes of uranium via contaminated wounds in actual applications.

Research on inheritance of Professor WANG Jie's Experience in Treatment of Frequent Ventricular Premature Complexes Based on Inheritance Support System of Traditional Chinese Medicine / 中国实验方剂学杂志

Objective:With the aid of the Inheritance Support System of Traditional Chinese Medicine V2.5 （TCMISS V2.5），to study the experience and prescription rules of professor WANG Jie in the treatment of frequent ventricular premature complexes，and inherit his clinical experience in diagnosis and treatment. Method:Professor WANG Jie's medical records and prescriptions for frequent ventricular premature complexes from 2016 to 2020 were collected and sorted out. Improved mutual information method，association rules，complex system entropy clustering，and unsupervised entropy hierarchical clustering were used to analyze the nature and flavor，channel tropism，concerted application rules，pair and combination of herbs for statistics， association rules analysis and discovery of new prescriptions. Result:A total of 122 prescriptions of professor WANG Jie on the treatment of frequent ventricular premature complexes were collected. 110 herbs，mostly with pungent and sweet flavors，were mainly on spleen channel and also on heart，kidney，liver，lung，and stomach channels. Cinnamomi Ramulus，Paeoniae Alba Radix<italic>，</italic>Os Draconis<italic>，</italic>Ostreae Concha<italic>， </italic>Glycyrrhizae Radix<italic>，</italic>and Jujubae Fructus<italic> </italic>had the highest frequency in use. The high-frequency herbal pair was Cinnamomi Ramulus-Paeoniae Alba Radix（116 times， accounting for 95.08%），the commonly used corner drugs were Cinnamomi Ramulus<italic>-</italic>Os Draconis<italic>-</italic>Ostreae Concha<italic> </italic>（108 times，88.52%），Cinnamomi Ramulus<italic>-</italic>Paeoniae Alba Radix<italic>-</italic>Ostreae Concha （106 times， 86.89%），Cinnamomi Ramulus<italic>-</italic>Paeoniae Alba Radix<italic>-</italic>Os Draconis （106 times，86.89%）. Commonly used herbal pair was<italic> </italic>Aucklandiae Radix-Amomi Villosi Fructus. The core prescription herbs included Cinnamomi Ramulus<italic>-</italic>Paeoniae Alba Radix<italic>-</italic>Os Draconis<italic>-</italic>Ostreae Concha<italic>-</italic>Glycyrrhizae Radix<italic>-</italic>Jujubae Fructus<italic>-</italic>Zingiberis Recens Rhizoma<italic>-</italic>Achyranthis Bidentatae Radix<italic>-</italic>Codonopsis Radix<italic>-</italic>Astragali Seu Hedysari Radix<italic>-</italic>Cistanches Herba-Poria<italic>-</italic>Ziziphi Spinosae Semen. Conclusion:Professor WANG Jie's prescription for the treatment of frequent ventricular premature complexes is Guizhi Jia Longgu Mulitang，and the main herbs are Cinnamomi Ramulus，Paeoniae Alba Radix，Os Draconis，Ostreae Concha，Glycyrrhizae Radix，and Jujubae Fructus. The final prescription could be adjusted according to the diseases and symptoms of patients.

Transcriptome analysis to identify genes involved in the biosynthesis of aconitines in Aconitum pendulum / 药学学报

italic>Aconitum pendulum is a Tibetan medicine that is rich in bioactive compounds such as aconitine-type C19-diterpenoid alkaloids. To investigate the key enzymes in the aconitine biosynthesis pathway, roots, leaves and flowers of Aconitum pendulum were subjected to a high-throughput transcriptomic sequencing analysis by Illumina HiSeqTM2000. Trinity de novo assembly yielded 47 264 unigenes with an average length of 1 140 bp and N50 of 1 678 bp, of which 30 231 unigenes (63.96%) were annotated. In the KEGG database, 542 unigenes were implicated in 17 secondary metabolic pathways; the analysis showed that 44 genes encoded 20 key enzymes in the diterpene skeleton of aconitine biosynthesis and 12 BAHD acyltransferase genes were related to the acetylation modification, with differential expression among three organs. For example, ApTPS8 was the only committed enzyme in the upstream aconitine biosynthetic pathway. The high expression level of ApTPS8 in root indicated that it is the main tissue for the production of precursors of diterpene alkaloids. Consistent with the accumulation of aconitine, we propose that ApBAHD1/2/8 is involved in the biosynthesis of 2-hydroxyaconitine, dehydrated 14-benzoylaconitine, 8-O-methyl-14-benzoylaconine, benzoyldeoxyaconitine and benzoylaconitine, and ApBAHD10 is involved in the biosynthesis of acontine, lucidusculine, 14-O-acetylneoline and 14-O-acetylvirescenin. Comparative transcriptome analysis of A. pendulum and A. carmichaeli indicates significant gene loss in the family of diterpene synthases and acyltransferases in A. pendulum, which is in accordance with the significantly fewer type and quantity of aconitine compounds in this species. Therefore, A. pendulum has proved to be an ideal material for the study of the aconitine biosynthesis pathway. This work provides basic scientific data for further study of aconitine biosynthesis, the discussion of molecular mechanisms of toxicity, and the synthesis of genuine medicinal materials.

Effect of acupoint application of / 中国针灸

OBJECTIVE@#To compare the effect between acupoint application of @*METHODS@#A total of 62 KOA patients with knee swelling after knee arthroscopy were randomly divided into an observation group and a control group, 31 cases in each group. In the control group, cold compress was adopted after surgery, 3 times a day. On the basis of the treatment as the control group, acupoint application of @*RESULTS@#The VAS scores 3, 5 and 7 days into treatment were lower than those before treatment in the two groups (@*CONCLUSION@#Acupoint application of

Effect of cotton-moxibustion on chronic eczema and quality of life / 中国针灸

OBJECTIVE@#To compare the therapeutic effect between cotton-moxibustion and compound flumetasone ointment, and observe the effect on quality of life in patients with chronic eczema.@*METHODS@#A total of 66 patients with chronic eczema were randomized into an observation group (33 cases, 2 cases dropped off) and a control group (33 cases, 2 cases dropped off). In the observation group, cotton-moxibustion was adopted on target skin lesion, once a day, 3 cones a time. In the control group, external application of compound flumetasone ointment was given twice a day. The treatment for 3 weeks was required in the both groups. Before treatment and 1,2,3 weeks into treatment, scores of visual analogue scale (VAS), eczema area and severity index (EASI) and dermatology life quality index (DLQI) were observed, and the recurrence rate was evaluated in the follow-up one month after treatment.@*RESULTS@#Compared before treatment, the VAS scores of 1,2,3 weeks into treatment, the EASI and DLQI scores of 2,3 weeks into treatment were decreased in the both groups (@*CONCLUSION@#Cotton-moxibustion can effectively improve the pruritus symptom, skin lesion and quality of life in the patients with chronic eczema, the therapeutic effect is superior to the external application of compound flumetasone ointment.

Isolation and identification of phosphatolytic bacteria in Paris polyphylla var. yunnanensis / 中国中药杂志

The wild resources of Paris polyphylla var. yunnanensis, a secondary endangered medicinal plant, are severely scarce. Introduction and cultivation can alleviate market demand. To screen phosphatolytic bacteria in the rhizosphere soil of P. polyphylla var. yunnanensis and provide data support for the development of high-efficiency microbial fertilizer, in this study, the dilution plate coating method was used to isolate and screen the phosphorus solubilizing bacteria with the ability of mineralizing organic phosphorus from the rhizosphere soil of wild and transplanted varieties of P. polyphylla var. yunnanensis in 10 different locations in Yunnan, Sichuan and Guizhou. After separation and purification, the phosphatolytic capacity was analyzed by qualitative and quantitative analysis. Combined with physiological and biochemical experiments, the strains were identified using 16 S rDNA sequencing analysis. Forty one strains were selected from the rhizosphere soil of P. polyphylla var. yunnanensis from 10 different habitats. Among them, 21 strains were obtained from the rhizosphere soil of the wild variety P. polyphylla var. yunnanensis and 20 strains were obtained from the rhizosphere soil of the transplanted variety. And significance analysis found that 41 organophosphate solubilizing strains had significant differences in their ability to solubilize phosphorus. The amount of phosphate solubilizing was 0.08-67.61 mg·L~(-1), the pH value was between 4.27 and 6.82. The phosphatolytic amount of strain Y3-5 was 67.61 mg·L~(-1), and the phosphorus increase amount was 57.57 mg·L~(-1). All 41 strains were identified as Gram-positive Bacillus. Combining physiological characteristic and phylogenetic trees, Bacillus mobilis Y3-5 was finally selected as the candidate rhizosphere phosphatolytic bacteria of P. polyphylla var. yunnanensis. The distribution of phosphorus solubilizing bacteria in the rhizosphere soil of P. polyphylla var. yunnanensis was different, and there were significant diffe-rences in phosphorus solubility. Organophosphate-dissolving strain Y3-5 is expected to be a candidate strain of P. polyphylla var. yunnanensis microbial fertilizer.

Preliminary study of medication rule of syndrome differentiation treatment for optic atrophy by TCM master Pin-zheng Liao based on data mining / 中草药

Objective: To dig out and analyze the medication rule of optic atrophy treatment by TCM master Pin-zheng Liao using the Traditional Chinese Medicine Inheritance Support System, and summarize and explore its potential new prescription. Methods: A total of 90 TCM prescriptions for the treatment of optic atrophy by Pin-zheng Liao were collected. Based on frequency statistics, association rule, entropy clustering method rule analysis and other data mining methods, the law and characteristics of drugs were excavated. Results: A total of 113 herbs were included in 90 prescriptions, the most frequently used Chinese herbs were Lycium barbarum, Ganoderma lucidum, etc. Tonic drugs were used the most, the medicated herbs were usually sweet and peace, the Chinese herbs which belong to the liver channel were the most in channel tropism drugs. Seventeen combinations of commonly used drugs were obtained by association rule analysis. Based on entropy clustering method rule analysis, 10 potential new prescriptions were obtained. Conclusion: TCM master Pin-zheng Liao believes that optic atrophy is closely related to liver, spleen and idney. Blood stasis and vein obstruction is the main pathogenesis of the disease. The drugs with effects of activating blood circulation and dredging the meridians, tonifying liver and kidney were recommended for the treating.

Preliminary study of traditional Chinese medicine for preventing COVID-19 based on data mining / 中草药

To dig out and analyze the drug rule of COVID-19 prevention prescriptions from provinces and cities by using Traditional Chinese Medicine Inheritance Support System, summarize and explore its potential new prescription. The Chinese medicine prevention programs for COVID-19 were collected and searched from the official website of the Health Commission and State Administration Medicine of Traditional Chinese Medicine of the country and provinces, autonomous regions, and municipalities. TCM prevention programs in 17 provinces including Heilongjiang, Beijing, Tianjin, Hebei, Henan, Jiangxi, Sichuan, Hubei, and Hunan, etc were received. A total of 82 herbs were included in 64 prescriptions, the most frequently used Chinese herbs were Astragalus membranaceus, Lonicera japonica, etc. Tonifying deficiency drugs with sweet and warm natures were used the most, the Chinese herbs distributed in the lung channel was the most in channel tropism drugs. Analysis by association rule, eight combinations of commonly used drugs were obtained. Based on entropy clustering method rule analysis, seven potential new prescriptions were obtained. Tonifying deficiency drugs are often used in various places to prevent COVID-19, focusing on the lung, spleen and stomach. Although the specific details are different, they all reflect the preventive thinking of traditional Chinese medicine.

Discussion on registry study of acupuncture-moxibustion for malignant pleural effusion / 中国针灸

Malignant pleural effusion (MPE) is one of the common complications of tumor. Acupuncture-moxibustion therapy has several advantages for treatment of MPE. Acupuncture is regarded as a complex individualized intervention, and its characteristics of TCM is difficult to be reflected by strict randomized controlled trials. The registry study provides more possibilities for the data collection of individualized diagnosis and treatment under the guidance of the overall concept and syndrome differentiation, and is more suitable for data management and collection of large samples and multi-center trials in the real-world study. It has become an opportunity to carry out real-world study of acupuncture for MPE. There are many challenges in the registry study of acupuncture for MPE. However, it is of great significance to collect real-world data of acupuncture for MPE to improve the clinical effect of MPE and provide a new clinical research method for acupuncture in tumors and related complications.

Effect of Zhongyi paste on inflammatory pain in mice by regulation of the extracellular regulated protein kinases 1/2– cyclooxygenase-2–prostaglandin E2 pathway

Background@#Zhongyi paste is a traditional Chinese medicine herbal paste that is externally applied to reduce inflammation and relieve pain. @*Methods@#An acute foot swelling inflammation model in C57BL/6J mice was established by carrageenan-induced pathogenesis. Zhongyi paste raised the pain threshold and also reduced the degree of swelling in mice with carrageenan-induced foot swelling. @*Results@#Analysis indicated that serum tumor necrosis factor-alpha, interleukin-1 beta, and prostaglandin E2 (PGE2) cytokine levels and PGE2levels in the paw tissue of the mice were decreased by Zhongyi paste treatment. The quantitative polymerase chain reaction and western blot results showed that Zhongyi paste downregulated the mRNA and protein expression of extracellular signal-regulated kinase 1/2 (ERK1/2), and cyclooxygenase-2 (COX-2), and also downregulated the mRNA expression of PGE2 . At the same time, the Zhongyi paste exerted a stronger effect as an external drug than that of indomethacin, which is an oral drug, and voltaren, which is an externally applied drug. @*Conclusions@#Our results indicated that Zhongyi paste is a very effective drug to reduce inflammatory swelling of the foot, and its mechanism of action is related to regulation of the ERK1/2–COX-2–PGE2 pathway.

Design of a mini-infrared moxibustion instrument based on carbon fiber / 中国针灸

A mini-infrared moxibustion instrument was developed on the base of carbon fiber heating film. This new type moxibustion instrument integrated the moxibusiton technique of TCM with modern technology. It is composed of a power module, an infrared generator module, a temperature sensor, a display screen and a main control panel. The carbon fiber is adopted as the material for infrared generator, which produces infrared rays in the range of the life light wave (from 8 to 15 μm), characterized as precise control of temperature, small gradient and wide range of temperature adjustment. The users can adjust the temperature and time of moxibustion by themselves. The instrument is small in size, light in weight, easy to carry and charge as well as comfortable and safe in application. It can be fixed directly at the required region without the posture restriction and be used whenever needed. Using PowerLab multichannel physiological recorder, the temperature carve is detected at different setting temperatures. The results show that the temperature is increased rapidly and stable.

Analysis the causes of endplate injury in oblique lateral interbody fusion / 中华骨科杂志

Objective:To investigate the characteristics and causes of endplate injury in the oblique lateral interbody fusion for the treatment of lumbar diseases, and summarize the precaution of endplate injury.Methods:Thirty-five cases of endplate injury were observed, which were originally treated with oblique lateral interbody fusion with or without pedicle screw fixation from October 2014 to December 2017. There were 7 males and 28 females, and the age ranged from 51 to 78 years old (averagely 62.8±8.13 years). There were 2 cases of lumbar disc degeneration, 10 cases of lumbar canal stenosis, 17 cases of lumbar degenerative spondylolisthesis, 2 cases of lumbar spondylolysis with or without spondylolisthesis, and 4 cases of lumbar degenerative scoliosis. Lesion sites contained L 3,4 in 2 cases, L 4,5 in 21 cases, L 2-4 in 3 cases, L 3-5 in 4 cases, L 2-5 in 3 cases and L 1-5 in 2 cases. Preoperative bone mineral density examination revealed there were 7 cases of T>-1 SD, 24 cases of -2.5 SD<T<-1 SD and 4 cases of T<-2.5 SD. There were 5 cases of high iliac crest. There were 25 cases of single segment, 5 cases of double segment, 3 cases of three segments, and 2 cases of four segments. Endplate injury occurred in all cases, and a total of 40 endplates occurred in 39 intervertebral spaces, of which the upper and lower endplates of 1 intervertebral space were injured, and the rest were single endplate injuries. There were 35 cases of upper endplate injury, 5 cases of lower endplate injury and 3 cases combined with vertebral fracture. The cage location where the endplate injury occurred: 3 cases in zone Ⅰ-Ⅱ, 31 cases in zone Ⅱ-Ⅲ and 5 cases in zone Ⅲ-Ⅳ. The main observation indicators were Visual Analog Scale (VAS) for low back pain, Oswestry disability index (ODI), intervertebral space height, and position of cage. Results:The reasons for endplate injury were: osteopenia or osteoporosis 28 cases, improper surgical steps 9 cases, high iliac crest 5 cases, endplate anatomical morphology variation 5 cases, obvious stenosis of the intervertebral space 4 cases, large cage 3 cases and mixed factors 12 cases. The follow-up time was 18.5±8.1 months. There was no pedicle screw loosen during the follow-up. There were 3 cases of lateral displacement of cage, including 1 case of Stand-alone OLIF, 2 cases of OLIF combined with pedicle screw fixation. In all cases, different degrees of cage subsidence occurred. Among them, 7 cases of Stand-alone OLIF were supplemented with posterior pedicle screw fixation. The intervertebral height of diseased segment was well restored postoperatively, which was statistically significant compared with preoperative. But there was significant loss during the follow-up, and the difference was statistically significant at the last follow-up. The low back pain VAS score was from 6.6±2.2 preoperative to 1.3±0.74 at the last follow-up, which was statistically different. The ODI was from 36.3%±7.4% preoperative to 9.6%±3.5% at the last follow-up, which was statistically different. Except 3 cases, the remaining had well interbody fusion, with the fusion rate of 91.4%.Conclusion:The incidence of endplate injury during oblique lateral interbody fusion is high. The reasons of endplate injury include both the patient's factors and the surgical factors. Endplate injury is closely related to the decreased intervertebral space height during the follow-up period, as well as the settlement or displacement of cage. Some cases may require reoperation. The prevention of endplate injury should be strengthened. Once it occurs, timely and effective treatment should be taken, and follow-up should be done closely.

Ursolic Acid Prevents Retinoic Acid-Induced Bone Loss in Rats / 中国结合医学杂志

OBJECTIVE@#To examine the effects of ursolic acid (UA) on mitigating retinoic acid (RA)-induced osteoporosis in rats.@*METHODS@#Fifty female Sprague-Dawley rats were randomly divided into the control group (n=10) and the osteoporosis group (n=40). The 40 osteoporosis rats were induced by 75 mg/(kg•d) RA once daily for 2 weeks, and then were randomly assigned to vehicle control (model), low-, middle-, and high-dose UA [(UA-L, UA-M, UA-H; 30, 60, 120 mg/(kg•d), respectively] groups (10 rats each). UA were administered once daily to the rats from the 3rd weeks for up to 4 weeks by gavage. Bone turnover markers [serum alkaline phosphatase (ALP), osteocalcin (OCN), urine deoxypyridinoline (DPD)] and other parameters, including serum calcium (S-Ca), serum phosphorus (S-P), urine calcium (U-Ca), urine phosphorus (U-P), and bone mineral density (BMD) of the femur, 4th lumbar vertebra and tibia, bone biomechanical properties and trabecular microarchitecture, were measured.@*RESULTS@#The osteoporosis in rats was successfully induced by RA. Compared with the model group, UA-M and UA-H significantly reversed the RA-induced changes in S-P, U-Ca, U-P, ALP, OCN and urine DPD ratio and markedly enhanced the BMD of right femur, 4th lumbar vertebra and tibia (Plt;0.05 or Plt;0.01). Further, biomechanical test and microcomputed tomography evaluation also showed that UA-H drastically improved biomechanical properties and trabecular microarchitecture (Plt;0.05 or Plt;0.01).@*CONCLUSION@#UA could promote bone formation, increase osteoblastic activity and reduce osteoclastic activity in rats, indicating that UA might be a potential therapeutic of RA-induced acute osteoporosis.