ABSTRACT
OBJECTIVE：To stu dy the effect of psoralen on osteoporosis in postmenopausal rats and PI3K/Akt/mTOR signaling pathway. METHODS ：Totally 60 healthy female SD rats were randomly divided into normal group ，model group ，positive control group（0.09 mg/kg estradiol ），psoralen low-dose ，medium-dose and high-dose groups （22，44，88 mg/kg），with 10 rats in each group. Except for normal group ，the other groups were ovariectomized to establish Postmenopausal osteoporosis model. After 2 months of normal feeding after operation ，normal group and model group were given the constant volume of normal saline intragastrically，and administration groups were given the corresponding solution intragastrically ；the volume was 0.005 mL/g， once a day ，for consecutive 98 days. 24 h after last administration ，the BMD of femur and vertebra of right lower extremities in rats was determined. The contents of serum calcium ，osteocalcin and P1NP，the serum levels of BMP2 and VEGF were determined；mRNA and protein expression of PI3K，Akt and mTOR in femur tissue were detected.RESULTS ：Compared with normal group ，BMD of femur and vertebra ，serum contents of calcium ，osteocalcin，P1NP and serum levels of BMP 2，VEGF in model group were decreased significantly ，while the mRNA and protein expression of PI 3K，Akt and mTOR were increased significantly （P＜0.05 or P＜0.01）. Compared with model group ，BMD of femur and vertebra ，serum levels of calcium ， osteocalcin，P1NP and serum levels of BMP2（except for psoralen medium-dose group ），VEGF（except for psoralen medium-dose group）were increased significantly in psoralen medium-dose and high-dose groups ，positive control group ，while the mRNA expression（except for psoralen low-dose group ）and protein expression of PI 3K，Akt and mTOR in administration groups were decreased significantly （P＜0.05 or P＜0.01）；BMD of femur ，serum levels of calcium ，BMP2 and PI 3K protein expression in psoralen high-dose group were significantly higher than positive control group （P＜0.05），and mTOR mRNA expression in psoralen high-dose group was significantly lower than positive control group （P＜0.05）. CONCLUSIONS ：Psoralen can improve osteoporosis in postmenopausal rats ，the mechanism of which may b e associated with inhibiting PI 3K/Akt/mTOR signaling pathway.
ABSTRACT
OBJECTIVE： To systematically evaluate the difference of therapeutic efficacy of Xianling gubao capsules combined with routine therapy for postmenopausal osteoporosis （PMOP）. METHODS： Retrieved from Cochrane Library， PubMed， Embase， ClinicalTrials， CNKI， VIP， Wanfang database and CBM， clinical randomized controlled trials （RCTs） about Xianling gubao capsules combined with placebo and routine treatment （trial group） versus placebo and routine treatment or Xianling gubao capsules （control group） alone in the treatment of PMOP were collected. After literature screening and data extraction， the quality of included literatures were evaluated with Cochrane system evaluator manual 5.3 recommend bias risk evaluation tool. Bayesian Network Meta-analysis was performed with Stata 14.0 software and Bayesian Markov Chain Monte Carlo. RESULTS： A total of 16 RCTs were included， involving a total of 1 360 patients and 3 intervention measures as Xianling gubao capsules alone， Xianling gubao capsules combined with routine treatment， routine treatment. Results of Meta-analysis showed that in respect of improving total response rate， compared with routine treatment， Xianling gubao capsules combined with routine treatment [OR＝0.28，95％CI（0.12， 0.64），P＜0.05]could significantly improve total response rate； network Meta-analysis ranking showed that Xianling gubao capsules combined with routine treatment＞Xianling gubao capsules alone＞routine treatment. In terms of increasing bone mineral density （BMD）， compared with routine treatment， Xianling gubao capsules combined with routine treatment [OR＝0.45，95％CI（0.24， 0.84），P＜0.05] and Xianling gubao capsules alone [OR＝0.78， 95％CI（0.32， 0.84），P＜0.05] could significantly improve BMD； network Meta-analysis ranking showed that Xianling gubao capsules combined with routine treatment＞Xianling gubao capsules alone＞routine treatment. In the term of improving serum calcium level， compared with Xianling gubao capsules alone [OR＝4.76，95％CI（2.14， 10.59），P＜0.05] and routine treatment [OR＝0.45， 95％CI（0.21， 0.99），P＜0.05]， Xianling gubao capsules combined with routine treatment could significantly improve serum calcium level； network Meta-analysis ranking showed that Xianling gubao capsules combined with routine treatment＞routine treatment＞Xianling gubao capsules alone. In the term of improving serum phosphorus level， compared with Xianling gubao capsules alone， Xianling gubao capsules combined with routine treatment [OR＝2.85，95％CI（1.81， 4.48），P＜0.05] and routine treatment [OR＝2.93，95％CI（1.76， 4.86），P＜0.05] could significantly improve serum phosphorus level； network Meta-analysis ranking showed that routine treatment＞Xianling gubao capsules combined with routine treatment＞Xianling gubao capsules alone. CONCLUSIONS： Xianling gubao capsules combined with routine treatment can significantly improve therapeutic efficacy of PP patients， increase BMD and serum calcium level after treatment， but routine treatment is the best in improving serum phosphorous level.
ABSTRACT
BACKGROUND: The change of the axial angle of the lower limb is related to the occurrence and development of osteoarthritis.OBJECTIVE: To analyze the correlation between the change of lower limb power line and pain area in the knee osteoarthritis patients.METHODS: Totally 65 knee osteoarthritis patients were selected as pain group and 30 healthy people were selected as control group. All the participants took anteroposterior and lateral knee radiographs through PACS imaging systems to collect six imaging indexes, including install index, the degree of tibiofemoral joint subluxation, tibiofemoral inside and outside joint clearance ratio, femoral angle, tibial angle and tibiofemoral angle. Knee osteoarthritis patients in pain group were divided into two common clinical pain areas which were proparea and medial area.RESULTS AND CONCLUSION: (1) The insall index, the degree of tibiofemoral joint subluxation, tibiofemoral inside andoutside joint clearance ratio between knee osteoarthritis patients in pain group and people in healthy control group hadsignificant differences. There was no statistical significance in the femoral angle, tibial angle and tibiofemoral angle. (2) In terms of the comparison between proparea and medial area in knee osteoarthritis patients in pain group, tibiofemoral joint subluxation degree was statistically different. (3) These findings suggest that there was a higher patella in knee osteoarthritis patients who were in pain, more severe in the degree of tibiofemoral joint subluxation, and more limited in tibiofemoral inside and outside joint clearance ratio. The degree of tibiofemoral joint subluxation of proparea was more severe than medial area in pain group.
ABSTRACT
BACKGROUND: Heterotopic ossification (HO) is common following primary total hip arthroplasty (THA) in patients with ankylosing spondylitis (AS), which may cause certain influence on functional recovery.OBJECTIVE: To explore the risk factors for HO after primary THA in AS patients.METHODS: The clinical and radiological data from 87 patients (132 hips) with AS undergoing primary THA between June 2011 and December 2015 were retrospectively analyzed, and followed up for more than 6 months. The radiological information included preoperative and postoperative hip anteroposterior and lateral radiographs. The presence of HO surrounding the prosthesis was evaluated on the radiographs at the last follow-up and graded according to the Brooker classification. Risk factors for HO were divided into invariable factors (age, sex, course and with or without ankylosed hip) and variable factors (preoperative C-reactive protein level, preoperative erythrocyte sedimentation rate, intraoperative blood loss, operation time, prosthesis types and anesthesia methods) to determine the pertinent risk factors.RESULTS AND CONCLUSION: (1) Totally 43 hips (32.6%) were found to have developed into HO. (2) Invariable risk factors including male (P=0.029), preoperative ankylosed hip (P < 0.001), and course (P=0.029) increased the prevalence of HO. Among the variable risk factors, prolonged operation time (P=0.031) and general anesthesia (P=0.003)were associated with the increased occurrence of HO. Age, preoperative C-reactive protein level and erythrocyte sedimentation rate, intraoperative blood loss, and prosthesis types had no obvious correlation with HO. (3) These results suggest that to prevent the formation of HO following THA in AS, efforts to reduce the operation time and avoid general anesthesia should be considered.
ABSTRACT
Objective To study correlation between biochemical markers of bone metabolism and postmenopausal osteoporot-ic vertebral fractures.Methods The clinical data of 100 cases with postmenopausal osteoporotic were study retrospectively.Fifty patients were postmenopausal osteoporotic,the rests were postmenopausal osteoporotic vertebral fractures.Lumbar spine,hip BMD,serum P1NP,β-CTX,N-MID,25-(OH)VitD and Ca2 + were recorded.Results There was a significant difference among ser-um P1NP,β-CTX and 25-(OH)VitD(P 0.05).Conclusion Serum P1NP and 25-(OH)VitD could predict risk of postmenopausal osteoporotic vertebral fractures.Biochemical markers of bone metabolism combined with BMD could reduce postmenopausal osteoporosis fractures.
ABSTRACT
Objective To investigate risk factors for healthcare-associated infection (HAI) in patients with aneurysmal subarachnoid hemorrhage(aSAH)in the department of neurology of a hospital.Methods Clinical data of 47 patients with aSAH who were admitted to a hospital from January 2014 to January 2015 were retrospectively analyzed.Results Of 47 patients with aSAH,17 developed 19 times of HAI,HAI rate was 36.17%,case infection rate was 40.43%.The main infection site was lower respiratory tract (n = 17,89.47%),followed by urinary tract (n=2,10.53%);2 patients had both lower respiratory tract infection and urinary tract infection.17 patients were performed pathogenic detection,13 pathogenic isolates were isolated from 9 patients.Multivariate non-conditional logistic regression analysis revealed that risk factors for HAI in patients with aSAH were disturbance of consciousness (OR,24.878 [95%CI ,3.996 - 156.040])and intensive care unit admission(OR, 8.645 [95%CI ,1.419-52.670]).The prognosis of patients with HAI was poorer than those without HAI(Z =4.108,P < 0.001 ).Conclusion Patients with aSAH are at high risk of HAI,it is necessary to take targeted prevention and control measures for reducing the occurrence of HAI and promoting good prognosis.
ABSTRACT
BACKGROUND:Jumonji domain-containing histone demethylase (JMJD) can promote osteoblast differentiation, and estrogen-related receptor alpha (ERRα) can promote osteoblast differentiation and increase bone formation. However, little is reported on the association between postmenopausal osteoporosis andJMJD and ERRα. OBJECTIVE: To study the changes in the JMJD2 family expression in patients with postmenopausal osteoporosis. METHODS: Postmenopausal patients with osteoarthritis of the hip scheduled for total hip arthroplasty, aged 50-70 years, were enroled, including 10 postmenopausal osteoporosis patients (experimental group) and 10 patients with no postmenopausal osteoporosis (control group). During the arthroplasty, the cancelous bone specimens from the femoral head were colected. Then, immunohistochemistry and western blot assay were used to detect expression of histone demethylase (JMJD2A, JMJD2B), histone methylation (H3K9me3, H3K36me3) and ERRα. RESULTS AND CONCLUSION:In the experimental group, the expressions of JMJD2A, JMJD2B and ERRαwere from weakly positive to positive; these expressions were significantly lower in the experimental group than the control group (P < 0.05). The expressions of H3K9me3 and H3K36me3 were significantly higher in the experimental group than the control group (P < 0.05). These findings indicate that the expression of JMJD2A and JMJD2B is consistent with the expression of ERRα in the patients with postmenopausal osteoporosis, and JMJD is likely to serve as an antagonistic enzyme of osteoporosis.
ABSTRACT
BACKGROUND:Fracture healing is the coupling interaction of osteoblasts and osteoclasts that promotes bone growth, in which osteoblast-mediated bone resorption and osteoclasts-mediated bone reconstruction make the bone reconstruction in a dynamic equilibrium to promote bone growth. However, the majorities of the current studies focus on osteogenic or osteoclastic mechanism alone, and ignore the interaction mechanism between these two cels under co-existing conditions. OBJECTIVE:To investigate the effects of Kidney Chinese Herbs on osteoblasts and osteoclasts coupling of osteoprotegerin-receptor activator of nuclear factor kappaB ligand-receptor activator of nuclear factor kappaB and its mechanism of action in fracture treatment. METHODS: Mouse osteoblasts and osteoclasts were isolated and cultured in vitro to establish the mouse “osteoblast-osteoclast co-culture system” as a research platform. Then, Kidney Chinese Herbs at doses of 1.25, 2.5, 6.25 g/(kg?d) were given intragastricaly for 7 consecutive days. Mice in the blank control group were fed with the same volume of normal saline. RESULTS AND CONCLUSION:The alkaline phosphatase activity in osteoblasts co-cultured with osteoclasts was significantly higher than that in osteoblasts cultured alone at 24 hours of culture (P < 0.05). Real-time PCR showed that in the co-culture system, the expression of alkaline phosphatase, Runt related transcription factor 2 and osteoprotegerin were increased in a dose-dependent manner (P < 0.05). Western blot assay showed 6.25 g/(kg?d) Kidney Chinese Herbs could dramaticaly promote the expression of osteoprotegerin and receptor activator of nuclear factor kappaB ligand, but restrained the expression of receptor activator of nuclear factor kappaB (P < 0.05). These findings indicate that Kidney Chinese Herbs can dynamicaly regulate the osteoprotegerin-receptor activator of nuclear factor kappaB ligand-receptor activator signaling pathway, and has a positive effect to promote bone reconstruction and rehabilitation.
ABSTRACT
Objective:To investigate the competency of informed consent in new admitted schizophrenia pa-tients.Methods:Fifty-three patients who were consecutively admitted to the hospital and diagnosed as schizophrenia according to the International Statistical Classification of Diseases and Related Health Problems,Tenth Revision (ICD-10)were recruited and assessed in seventy-two hours.The competence of informed consent was assessed by the MacArthur Competence Assessment Tool-Treatment (MacCAT-T).The insight was assessed by the Insight and Treatment Attitude Questionnaire.The severity of illness was assessed by the Brief Psychiatric Rating Scale (BPRS).Correlations between the competence of informed consent and the factors mentioned above were discussed.Results:Forty-five (84.9%)patients had lower MacCAT-T scores,especially the scores of understand-ing dimension (1.58 ±1.85)and appreciation dimension (2.40 ±1.47).The competence of informed consent was significantly correlated with insight (r =0.73,P <0.01)but not correlated with age,education,duration of illness and BPRS scores.Logistic regression demonstrated that insight (OR =0.69)was a protective factor of competence of informed consent while thought disturbance (OR =1.39)was a risk factor.As to the involuntary admitted pa-tients,34.1% of them had competence of informed consent.Conclusion:The competence of informed consent in new admitted schizophrenia patients is widely impaired especially in understanding and appreciation dimension.The competence of informed consent is correlated with insight and thought disturbance.Voluntary or involuntary hospi-talization does not reflect the level of competence of informed consent.
ABSTRACT
Objective To explore the p27 gene expression and clinical significance in acute leukemia (AL).Methods RT-PCR was used for testing the mRNA levels of p27 gene in bone marrow mononuclear cell of 65 cases of newly diagnosed AL patients and 41 controls.The correlation between the p27 gene expression positive rate and age, sex, peripheral blood white blood cell count and extramedullary infiltration were analyzed simultaneously in AL patients.Results The positive rate of p27 gene expression (36.9 ％,24/65)was significantly lower in AL group than that in the control group (87.8 ％,36/41) (P ＜0.05),and which was lower than the control group (P ＜0.05) in the AML group (34.2 ％,13/38) and the ALL group (37.5 ％,9/24).However,comparing AML group with ALL group,the difference was not statistically significant (P ＞0.05).At the same time,compared the p27 gene expression positive rate of ≥ 14 years old group (52 cases) and ＜14 years old group (13 cases),and also compared in male group (34 cases) and in female group (31 cases),there was no statistically difference (P ＞0.05); Compared the p27 gene expression positive rate of peripheral blood white blood cell count ≥20×109/L group (31 cases) and ＜20×109/L group (34 cases),also compared with in extramedullary infiltration group (37 cases) and in no extramedullary infiltration group (28 cases),the relationship of p27 gene expression positive rate with peripheral blood white blood cell count as well as extramedullary infiltration was a negative correlation (r =-0.284,P ＜ 0.05,r =-0.300,P ＜ 0.05).Conclusion There is p27 mRNA expression deletion in AL patients,and the deletion is present in the AML and ALL at the same time.p27 mRNA expression is negatively correlated with peripheral blood white blood cell count or extramedullary infiltration,which might be one of the mechanisms of occurrence and development of AL.
ABSTRACT
Objective: To examine the correlation of symptomatic feature and exploratory eye movements in schizophrenia. Methods: The eye movements of 60 patients with schizophrenia and 30 healthy control subjects were measured by the eye-mark recorder (model IV, Japan) and symptom profiles of patients were assessed using the Positive and Negative Syndrome Scale (PANSS) . Pearson correlation analysis was performed to examine the relationship between five-factor scores of PANSS, positive symptoms, negative symptoms and exploratory eye movements respectively. Results: The differences of all indices of eye movements between schizophrenic groups and normal control group had statistical significance ( P
ABSTRACT
Objective To study the changes of plasma interleukin-13 (IL-13) in patients with acute cerebral stroke and its effects in the cerebral inflammatory reactions. Methods The levels of plasma IL-13 measured in 50 patients with acute cerebral infarction (CI group) and in 30 patients with cerebral hemorrhage (CH group) using enzyme-linked immunoabsordent assay(ELISA) were compared to the control A (with the risk factors of stroke) and control B (normal group).Results As compared with the controls (control A: 28.0?3.2; control B: 26.4?2.7), the levels of plasma IL-13(pg/ml) were increased in three periods in the CI group (37.6?6.2;45.2?10.1;41.3?8.3) and CH group (36.6?4.9;45.3?8.9,38.1?5.6) ( P