Mechanism and experimental verification of jiawei duhuo jisheng mixture in treatment of knee osteoarthritis based on network pharmacology / 中国药理学通报

Aim To explore and verify the possible mechanism of Jiawei Duhuo Jisheng Mixture(JDJM)in the treatment on Knee Osteoarthritis(KOA)via using network pharmacology and animal experiment. Methods The ingredients of JDJM and relevant targets were collected from TCMSP and BATMAN-TCM database. The KOA-related targets were collected from GeneCard, OMIM and GEO databases. The common targets were acquired by intersecting ingredients-related and KOA-related targets, and then the Ingredient-Disease-Target Network and PPI network were constructed by Cytoscape 3.7.2 software and STRING platform. GO and KEGG enrichment analysis were performed based on Metascape database. Finally, the key targets and relevant mechanism were validated via animal experiment. Results In the network pharmacology study, 180 active ingredients related to treatment on KOA by JDJM were collected, and 152 common targets were confirmed. PPI network analysis showed that AKT1 might be the key targets of JDJM in the treatment on KOA. GO and KEGG enrichment analysis revealed that the key target mainly concentrated on inflammatory response and apoptosis. Animal experiment confirmed that JDJM could improve lesion in KOA rabbits, and suppress the expression levels of IL-1β, TNF-α, Caspase 3 and BAX in serum and articular fluid. AKT1 expression(including mRNA and protein)in articular cartilage was also down-regulated. Conclusions Based on the results of network pharmacology and animal experiment, JDJM may relieve KOA severity by anti-inflammatory and anti-apoptotic effects through a variety of molecular signaling pathways.

Effect of down-regulation of let-7c/g on triggering a double-negative feedback loop and promoting restenosis / 中华医学杂志(英文版)

BACKGROUND@#Excessive proliferation and migration of vascular smooth muscle cells (VSMCs) are the main causes of restenosis (RS) in diabetic lower extremity arterial disease (LEAD). However, the relevant pathogenic mechanisms are poorly understood.@*METHODS@#In this study, we introduced a "two-step injury protocol" rat RS model, which started with the induction of atherosclerosis (AS) and was followed by percutaneous transluminal angioplasty (PTA). Hematoxylin-eosin (HE) staining and immunohistochemistry staining were used to verify the form of RS. Two-step transfection was performed, with the first transfection of Lin28a followed by a second transfection of let-7c and let-7g, to explore the possible mechanism by which Lin28a exerted effects. 5-ethynyl-2΄-deoxyuridine (EdU) and Transwell assay were performed to evaluate the ability of proliferation and migration of VSMCs. Western blotting and quantitative real-time polymerase chain reaction (qRT-PCR) were performed to detect the expression of Lin28a protein and let-7 family members.@*RESULTS@#Using a combination of in vitro and in vivo experiments, we discovered that let-7c, let-7g, and microRNA98 (miR98) were downstream targets of Lin28a. More importantly, decreased expression of let-7c/let-7g increased Lin28a, leading to further inhibition of let-7c/let-7g. We also found an increased level of let-7d in the RS pathological condition, suggesting that it may function as a protective regulator of the Lin28a/let-7 loop by inhibiting the proliferation and migration of VSMCs.@*CONCLUSION@#These findings indicated the presence of a double-negative feedback loop consisting of Lin28a and let-7c/let-7g, which may be responsible for the vicious behavior of VSMCs in RS.

Genetic Analysis and Prenatal Diagnosis of a Family with Hereditary Spherocytosis Caused by a Novel Compound Heterozygous Mutation of SPTB Gene / 中国实验血液学杂志

OBJECTIVE@#To investigate the clinical and genetic characteristics of a family with hereditary spherocytosis (HS), to clarify the cause of the disease, and to provide the basis for genetic counseling and prenatal diagnosis.@*METHODS@#The clinical data of proband and his parents were collected, and HS-related pathogenic genovariation of the proband was detected by high throughput sequencing. Suspected pathogenic mutation sites were verified by PCR-Sanger sequencing, and the fetus were conceived by a proband mother underwent prenatal diagnosis.@*RESULTS@#Clinical manifestations of the proband showed moderate anemia, mild splenomegaly, and jaundice (an indirect increase of bilirubin). The gene detection showed that the proband showed compound heterozygous mutations of SPTB gene c. 6095T > C (p.Leu2032Pro) and c. 6224A > G (p.Glu2075Gly), which was inherited from the asymptomatic mother and father, respectively. Both mutations were detected rarely in the common population. Prenatal diagnosis revealed that the fetus inherited a mutant gene of the mother.@*CONCLUSION@#The compound heterozygous mutations of SPTB genes c.6095T>C (p.Leu2032Pro) and c.6224A>G (p.Glu2075Gly) were the causes of the family disease, which provides a basis for family genetic counseling and prenatal diagnosis. This report is the first one found in the HGMD,1000G and EXAC database, which provides an addition to the mutation profile of the SPTB gene.

Similarities and differences between D3 lymphadenectomy and complete mesocolic excision of right hemicolonectomy / 中华胃肠外科杂志

D3 lymphadenectomy and complete mesocolic excision (CME) for colon cancer, which have been introduced to China for more than 10 years, are two major surgical principles worldwide. However, there are still many different opinions and misunderstandings about the core principles of D3 and CME, especially the similarities and differences between them. However, few articles have been published to discuss these issues specifically. Domestic scholars' understandings about D3 lymphadenectomy and CME for right hemicolectomy are quite different. Two different concepts including "D3/CME" and "D3+CME" have become mainstream views. The former equate D3 with CME and the latter seems to regard them as totally different principles. There is no consensus on which one is more reasonable. Therefore, this article aims to discuss the similarities and differences between D3 and CME for right hemicolectomy in perspectives of the theoretical background, surgical principles, extent of surgery and oncological outcomes. We believed that D3 and CME do not belong to the same concept, and that the scope of CME surgery for right-sided colon cancer is greater than and includes the scope of D3 surgery, and that D3 and CME are not complementary.

Association Between Homocysteine Level and Methylenetetrahydrofolate Reductase Gene Polymorphisms in Type 2 Diabetes Accompanied by Dyslipidemia / 中国医学科学杂志(英文版)

Objective To investigate the association between total homocysteine (tHcy) level in plasma and methylenetetrahydrofolate reductase (MTHFR) C677T and A1298C genetic polymorphisms in a Chinese Han nationality population with type 2 diabetes mellitus (T2DM) accompanied by dyslipidemia. Methods This case-control study enrolled T2DM patients with dyslipidemia and without dyslipidemia respectively. Sanger dideoxy-mediated chain-termination method was used to detect the gene polymorphisms of MTHFR C677T and A1298C. Plasma tHcy and lipid levels were measured as well. The genotype frequency and allele frequency between the dyslipidemia and non-dyslipidemia groups were compared by using Chi-square test. Plasma tHcy level of T2DM patients who carried the different genotypes was compared by Student's t test. Results Finally, 82 T2DM patients with dyslipidemia and 94 ones without dyslipidemia were included in this study. There was a significant correlation between tHcy level and MTHFR C677T gene polymorphism in T2DM patients (t=2.27, P=0.02). Moreover, the plasma tHcy level in the dyslipidemia patients who carried MTHFR 677 TT genotype was significantly higher than that in those with CT+CC genotype (13.62±6.97 vs. 10.95±3.62 μmol/L, t=2.20, P=0.03); while for patients without dyslipidemia, comparison of the tHcy level between those who carried the above two alleles showed no significantly difference (13.34±6.03 vs. 12.04±5.09 μmol/L, t=1.08, P=0.29). Conclusion MTHFR 677TT genotype might associate with higher tHcy level in T2DM patients with dyslipidemia.

Neuroligins Differentially Mediate Subtype-Specific Synapse Formation in Pyramidal Neurons and Interneurons / 神经科学通报·英文版

Neuroligins (NLs) are postsynaptic cell-adhesion proteins that play important roles in synapse formation and the excitatory-inhibitory balance. They have been associated with autism in both human genetic and animal model studies, and affect synaptic connections and synaptic plasticity in several brain regions. Yet current research mainly focuses on pyramidal neurons, while the function of NLs in interneurons remains to be understood. To explore the functional difference among NLs in the subtype-specific synapse formation of both pyramidal neurons and interneurons, we performed viral-mediated shRNA knockdown of NLs in cultured rat cortical neurons and examined the synapses in the two major types of neurons. Our results showed that in both types of neurons, NL1 and NL3 were involved in excitatory synapse formation, and NL2 in GABAergic synapse formation. Interestingly, NL1 affected GABAergic synapse formation more specifically than NL3, and NL2 affected excitatory synapse density preferentially in pyramidal neurons. In summary, our results demonstrated that different NLs play distinct roles in regulating the development and balance of excitatory and inhibitory synapses in pyramidal neurons and interneurons.

Application of High Resolution Melting Curve Analysis in Detection of SLC4A1 Gene Mutation in Patients with Hereditary Spherocytosis / 中国实验血液学杂志

OBJECTIVE@#To investigate the feasibility and clinical significance of high resolution melting(HRM) curve analysis to detect SLC4A1 gene D38A and K56E mutations in the patients with hereditary spherocytosis(HS).@*METHODS@#Peripheral blood was collected from 23 cases of HS for routine tests and their genomic DNA was extracted by routine technique. Specific primers of mutation sites D38A and K56E of SLC4A1 gene were designed. The HRM method was used to analyze all the samples, and then the results of HRM were verified with DNA sequencing technology.@*RESULTS@#Among 23 specimens of HS patients, 6 cases of heterozygous mutant gene were detected by HRM technology, including 3 cases of D38A mutation and 3 cases of K56E mutation, which were confirmed by DNA sequencing.@*CONCLUSION@#The HRM technology can correctly detect 2 common mutation sites including D38A and K56E in SLC4A1 gene in an efficient, fast, and reliable way, which not only can be used for clinical diagnosis, but also expected to be a new method for clinical researchers to define gene mutation spectrum in HS patients.

Rapid screening of c.166A>G in SLC4A1 gene by high-resolution melting analysis / 中华检验医学杂志

Objective To explore the feasibility of a high-resolution melting(HRM)method for rapid screening of SLC4A1 mutation.Methods Two hereditary spherocytosis(HS)with a c.166A >G heterozygous mutation of SLC4A1 confirmed by DNA sequencing and thirty healthy controls were selected for the study.The HRM primer was designed by Primer Premier 6.0 software.All of these samples were detected by LightCycler?480 and analyzed by HRM.Results The HRM analysis was able to detect the c.166A>G heterozygous mutation of SLC4A1 effectively, and the specificity and sensitivity were both 100%.Conclusions The HRM analysis was appropriate for the detection of c.166A>G in SLC4A1.It was an efficient,accurate and cost-effective molecular diagnosis method.

The relationship between hereditaryspherocytosis and protein 4.2 / 医学研究生学报

Hereditary spherocytosis (HS) is a common hereditary hemolytic disease. The molecular pathogenesis of HS involves gene mutations, which lead to deficiency or absence of erythrocyte membrane proteins. Five major pathogenic genes of SPTA1, SPTB, ANK1, SLC4A1 and EPB42 had been found, and they encode α-spectrin, β-spectrin, ankyrin, band 3 and protein 4.2 respectively. There are many reports about gene mutations of EPB42, which cause deficiency or absence of protein 4.2 abroad. However, few scholars study the correlation between HS and protein 4.2 in China. This review describe the advances of the relationship between HS and protein 4.2 in detail.

Pilot study on reference interval of serum lipoprotein-associated phospholipase A2 activity in healthy adults of Changsha area, China / 临床检验杂志

Objective To investigate the level of serum lipoprotein-associated phospholipase A2(Lp-PLA2) activity in healthy adults of Changsha area and establish the reference interval of serum Lp-PLA2activity. Methods A total of 424 healthy adults (175 males and 249 females) were classified into five groups by different age, including 20 to 29, 30 to 39, 40 to 49, 50 to 59 and over 60 years old group. Serum Lp-PLA2activity was measured by continuous-monitoring assay. According to the requirements of Clinical and Laboratory Standards Institute (CLSI) C28-A3, the reference interval of Lp-PLA2activity was established by nonparametric method.Results The levels of serum Lp-PLA2activities in both males and females showed normal distribution. The average of Lp-PLA2activity was (478± 135)U/L in 175 males and (402±116)U/L in 249 females with statistically significant difference (t＝6.184, P＜0.01). Z test result showed Z＞Z?, so the reference intervals of males and females were established respectively. There was no statistical difference of Lp-PLA2activities among the varied groups of males (F＝1.259, P＝0.288), but there were statistical differences among the varied groups of females (F＝9.341, P＜0.01). The females of the age over 40 years old showed higher activities than those of age under 40 years old (t＝5.732,P＜0.01). However, there was no statistical significance of serum Lp-PLA2activities in the females between the two groups of the age under 40 and the three groups of age over 40. Therefore, the reference intervals of serum Lp-PLA2activities in healthy adults were established as followed: 217-761 U/L for males, 168-566 U/L for the females of 20 to 39 years old and 203-702 U/L for the fe-males of 40 to 86 years old. Conclusion The reference interval of serum Lp-PLA2activity in physical examination of healthy adults in Changsha area was established.

Progress of the treatment of diabetic nephropathy / 中国综合临床

The treatment of diabetic nephropathy (DN) currently extent to control the occurrence and development of it and delay renal failure on a certain stage.However,the effect is not satisfactory.Some traditional hypoglycemic,antihypertensive,lipid and anticoagulant drugs in DN patients with renal protective effect.And some have been in clinical use of drugs such as vitamin D,aldose reductase inhibitors,tripterygium wilfordii glycoside has proved to have the effect of the slow progress in DN,could be used more widely.For new drugs,such as renin inhibitors,phosphodiesterase inhibitors and methyl bartholomew sauron,while partialy was confirmed in a role in the treatment of DN,but before the clinical promotion,its effectiveness and safety still need further study to verify.

The effects of low calcium dialysate on bone mineral density in old patients under maintenance hemodialysis with low turnover renal osteodystrophy / 中华老年医学杂志

Objective To study the effects of low calcium dialysate on bone mineral density (BMD) in old patients with low turnover renal osteodystrophy under maintenance hemodialysis.Methods Totally 72 elderly patients aged≥ 60 years under MHD for 6 months or more with parathyroid hormone(iPTH)＜100 ng/L were selected and randomly divided into treatment group(n=36,calcium 1.25 mmol/L in dialysate)and a control group(n =36,calcium 1.5 mmol/L in dialysate),for 12 months of treatment.The changes of albumin-corrected calcium and phosphorus,calciumphosphorus product,iPTH level,bone mineral density,and other indicators as well as related adverse events were observed before and 12 months after the study.Results There was no statistically significant difference in general conditions and the correlated laboratory examinations between the two groups before and after treatment (P ＞ 0.05).After dialytic treatments with dialysate containing calcium 1.25 mmol/L for 12 months,the therapy group versus pre-therapy and control group showed statistically significant decrease in parameters of mean arterial pressure(MAP) [(88.6 ± 9.2) vs.(92.6±10.4)and(93.7±8.8)mmHg],serum calcium[(2.4±0.1)vs.(2.6±0.3)and(2.6±0.2)mmol/L,t =5.061,5.074],phosphorus[(2.0±0.2)vs.(2.1 ±0.2)and(2.1±0.3)mmol/L,t=2.276,2.271],calcium-phosphorus product[(4.7 ± 0.5) vs.(5.3 ± 0.6) and (5.4 ± 0.7) mmol2 / L2,t =4.682,4.627](all P＜0.05),and showed statistically significant increase in parameters of iPTH levels[(132.6 ±37.8) vs.(71.3 ± 11.48) and (69.7 ± 16.0) ng/L;t value 8.824 and 9.048,respectively],bone mineral density values(Lumbar:0.8±0.9 vs.-1.2±1.1 and-1.2±1.1;t value 2.170 and 2.170,respectivly.Femoral neck:-0.8± 1.0 vs.1.3±1.2 and-1.3±1.3;t value 2.258 and 2.243,respectively) (all P＜0.05).In the control group after 12 months of treatment with calcium 1.5mmol/L dialysate,there was no significant difference in related parameters (P＞ 0.05).There was no significant difference in the adverse reactions between study and control groups (P ＞ 0.05).Conclusions The low calcium dialysate(calcium 1.25 mmol/L)used in elderly patients with iPTH＜100 ng/L under MHD can effectively improve the excessive depression of parathyroid function and the decreased BMD,and better control the albumin corrected calcium,phosphorus,calcium-phosphorus product level,and has a good security.

Effect of autophagy inhibitor 3-methyladenine on phenotype transformation and proliferation of pulmonary arterial smooth muscle cells / 实用医学杂志

Objective To evaluate the effect of autophagy inhibitor 3-methyladenine (3-MA) on phenotype transformation and proliferation of rat pulmonary arterial smooth muscle cells (PASMCs).Methods Cultured PASMCs were treated with different concentrations of 3-MA (low-dose group,2.0 mmol/L;middle-dose group,4.0 mmol/L;high-dose group,8.0 mmol/L;control group,0 mmol/L).The protein expression of LC3 Ⅱ,OPN and Vimentin was detected by Western blotting.Cell proliferation was detected by MTT assay.Results The autophagy of PASMCs was decreased with the increase of the concentration of 3-MA.Compared with the control group,significantly down-regulated protein expression of LC3 Ⅱ,OPN and Vimentin was observed in 3-MA-treated cells,with significantly lower proliferation activity.Conclusion The autophagy inhibitor 3-MA significantly down-regulated the expression of LC3 Ⅱ,OPN and Vimentin in PASMCs,with inhibiting the proliferation of PASMCs.

Epidemic situation and control strategy of major food-borne parasitic dis-eases in Guangxi Zhuang Autonomous Region / 中国血吸虫病防治杂志

Food-borne parasitic diseases have become a public health problem for social economy and health care. In this pa-per,the epidemic situation of major food-borne parasitic diseases in Guangxi Zhuang Autonomous Region,such as toxoplasmo-sis and clonorchiasis,are reviewed,and the countermeasures of prevention and control are put forward.

Analysis of a family with congenital dysfibrinogenemia caused by an Arg275His mutation in the gamma chain of fibrinogen / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To explore the clinical phenotype of a family affected with congenital dysfibrinogenemia and potential mutations underlying the disease.</p><p><b>METHODS</b>Coagulation testing and hepatorenal function testing were conducted on 18 individuals from three generations. Plasma fibrinogen was extracted and analyzed with SDS-PAGE electrophoresis. All of the exons and flanking sequences of fibrinogen FGA, FGB, FGG genes were analyzed by PCR, and the products were subjected to Sanger sequencing.</p><p><b>RESULTS</b>Hepatorenal function, prothrombin time and activated partial thromboplastin time of the proband were all normal. However, his thrombin time was significantly prolonged. Fibrinogen activity was decreased, while the concentration of antigen was in the normal range. The results of his mother, brother, and nephew were similar. DNA sequencing has confirmed that the proband, his mother, brother, and nephew have all carried a g.5877G>A mutation in the exon 8 of the FGG gene, which resulted in replacement of arginine (Arg) by histidine (His) at position 275.</p><p><b>CONCLUSION</b>The Arg275His mutation of the fibrinogen gamma chain probably underlies the pathogenesis of congenital dysfibrinogenemia in this family.</p>

Bone mineral density change in patients with hyperthyroidism after 131I therapy: a Meta-analysis / 中华核医学与分子影像杂志

Objective To review the influence of 131I therapy on bone mineral density (BMD) in patients with hyperthyroidism.Methods Published articles of prospective randomized controlled study,clinical controlled study or case-control study on BMD change in patients with hyperthyroidism after 131I therapy were selected from PubMed,the Excerpta Media Database (Embase),Cochrane library,Chinese Journal Full-text Database,Wanfang Database,Vip Database and Chinese Biomedical Literature Database.Data from the date of database establishment to October 2015 were all reviewed.The languages were restricted to English and Chinese.Meta-analysis was performed with RevMan 5.3.Results Thirteen trials with a total of 668 hyperthyroidism patients were included.The meta-analysis showed that BMD of the lumbar spine,hip joint,femoral neck and osteocalcin were significantly improved after 131I therapy.The weighted mean difference (WMD) for BMD of the lumbar spine was 0.07 (95％ CI:0.04-0.11),P=0.O00 2;that of the hip joint and the femoral neck was 0.13(95％ CI:0.09-0.16) and 0.05(95％ CI:0.03-0.06),respectively(both P＜0.01).The standardized mean difference (SMD) of osteocalcin was-1.20(95％ CI:-1.43--0.97) with P＜0.01.Furthermore,the improvements were time dependent within the 2 years' follow-up.Conclusions 131I therapy improves the BMD and osteocalcin in patients with hyperthyroidism in a time dependent manner within 2 years' follow-up.

Effect of serum of patients with obstructive jaundice on myogenic differentiation of human pulmona-ry microvascular endothelial cells / 中华麻醉学杂志

Objective To evaluate the effects of the serum of patients with obstructive jaundice on myogenic differentiation of human pulmonary microvascular endothelial cells (PMVECs). Methods Hu?man PMVECs were isolated and then subcultured. The cultured PMVECs were incubated with the serum of patients with obstructive jaundice or with the serum of healthy volunteers. At 24, 48 and 72 h of incubation (T1?3), the inverted microscope was used to observe the morphology of primary PMVECs. The expression of muscular proteins ( alpha?smooth muscle actin [α?SMA ] , smooth muscle?mysion heavy chain [ SM?MHC] , capolnin) in PMVECs was detected using Western blot analysis. Results The expression of cal?ponin andα?SMA was negative, and a few SM?MHC proteins were expressed when PMVECs were incubated with the serum of healthy volunteers; the expression of calponin, α?SMA and SM?MHC was positive when PMVECs were incubated with the serum of patients with obstructive jaundice. Compared with the serum of healthy volunteers, the expression of SM?MHC was significantly up?regulated when PMVECs were incubated with the serum of patients with obstructive jaundice (P<0.05). The expression of calponin, α?SMA and SM?MHC was significantly up?regulated at T2,3 compared with that at T1 , and at T3 compared with that at T2 when PMVECs were incubated with the serum of patients with obstructive jaundice ( P<0.05) . Conclusion The serum of patients with obstructive jaundice promotes myogenic differentiation of human PMVECs, which is probably one of the mechanisms underlying intrapulmonary microvascular dilatation.

Clinical observation of cognitive impairment after traumatic brain injury treated with acupuncture and cognitive training / 中国针灸

<p><b>OBJECTIVE</b>To observe the clinical efficacy on cognitive impairment after traumatic brain injury (TBD treated with acupuncture and cognitive training.</p><p><b>METHODS</b>Sixty patients were randomized into an observation group and a control group, 30 cases in each one, and 5 cases of them were dropped out due to the earlier discharge. Finally, there were 28 cases in the observation group and 27 cases in the control group. In the control group, the cognitive training and conventional treatment were applied. In the observation group, on the basis of the treatment as the control group, acupuncture was applied to Baihui (GV 20), Fengchi (GB 20), Geshu (BL 17) and Fenglong (ST 40), once a day, for 4 weeks totally. The mini-mental state examination (MMSE) and Montreal cognitive assessment (MoCA) were adopted to evaluate the cognitive function in the patients of post-TBI cognitive impairment.</p><p><b>RESULTS</b>(1) After treatment, the total score in MMSE and the score of each item were increased significantly as compared with those before treatment in the two groups (all P<0. 05). Except for the score of immediate recall, the score in MMSE and the score of each of the other items were increased significantly in the observation group as compared with those in the control group after treatment (all P<0. 05). (2)After treatment, the total score in MoCA and the score of each item were increased significantly as compared with those before treatment in the two groups (all P<. 05). Except for the score of nomenclature item, the total score in MoCA and the score of each of the other items were increased significantly in the observation group as compared with those in the control group after treatment (all P<0. 05).</p><p><b>CONCLUSION</b>Both the simple cognitive training and the combined therapy of acupuncture and cognitive training improve MMSE and MoCA scores and relieve the cognitive impairment induced by TBI. But the combined therapy achieves the much better efficacy.</p>

A Clinical Study on Acupuncture and Moxibution Combined with Cognitive Training in Treating Cognitive Impairment after Traumatic Brain Injury / 中国中医药信息杂志

Objective To observe the clinical efficacy of acupuncture and moxibustion combined with cognitive training in treating cognitive impairment after traumatic brain injury (TBI). MethodsSixty patients were recruited into the study and randomly divided into the control group and the treatment group according to the MINIMIZE software. Patients in the control group were treated with cognitive training and regular treatment. Besides the traditional treatment, patients in the treatment group were additionally treated with acupuncture and moxibution. The treatment lasted four weeks. Mini-Mental State Examination (MMSE) and Loewenstein Occupational Therapy Cognitive Assessment (LOTCA) were applied to evaluate the patients’ cognitive function before and after the treatment.Results In the end, there were 27 patients in the control group and 28 patients in the treatment group, because 5 patients withdrew from the study. After treatment, scores of MMSE, LOTCA and their sub-items in the control group and the treatment group increased significantly (P<0.05), and the scores in the treatment group were higher than the control group (P<0.05).Conclusion Combination of acupuncture, moxibution, and cognitive training could help patients after TBI to increase the scores of MMSE and LOTCA, and improve the cognitive impairment caused by TBI. Its therapeutic effect is superior than the pure cognitive training.

Efficacy and safety of vitamin D3 in patients with diabetic nephropathy: a meta-analysis of randomized controlled trials / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Several studies found that vitamin D3 might alter glucose metabolism, protect kidney from injury and even proposed the mechanisms. But results from previous studies have been conflicting. The aim of this study was to evaluate the efficacy and safety of vitamin D3 in patients with diabetic nephropathy. The underlying mechanism of vitamin D3 decreasing proteinuria is also discussed.</p><p><b>METHODS</b>We conducted a search of English and Chinese articles using database of Pubmed, Embase, Sinomed, CNKI, Wanfang and clinical trial register centers, for randomized controlled trials of vitamin D3 in diabetic nephropathy patients. Two reviewers performed independently. Meta-analysis was used when studies were homogeneous enough.</p><p><b>RESULTS</b>Twenty studies, including 1 497 patients with diabetic nephropathy, were involved in this systemic review. Vitamin D3-treated patients with diabetic nephropathy had a statistically significant reduction in 24-hour proteinuria (weighted mean difference -0.44, 95% CI -0.54 to -0.34, Z = 8.80, P < 0.000 01) and urine albumin/creatine ratio (standardized mean difference -0.29, 95% CI -0.48 to -0.10, Z = 2.96, P = 0.003). But vitamin D3 supplementation did not significantly reduce blood pressure and hemoglobin A1c compared with control group. The potential mechanisms about the renal protection of vitamin D3, including the inhibition of rennin-angiotensin system, the protection of kidney from inflammation, fibrosis and the structure change of kidney are discussed. In addition, vitamin D3 did not significantly increase the incidence of adverse effects, including total adverse effects, gastrointestinal adverse effects and fluctuation of blood pressure.</p><p><b>CONCLUSIONS</b>Vitamin D3 can ameliorate proteinuria and protect kidney from injury in patients with diabetic nephropathy. This renoprotective effect is independent of blood pressure and glucose reduction. And it does not increase any adverse effects than control, even in combination therapy with angiotensin converting enzyme inhibitors/angiotensin receptor blockers. But due to the limited randomized controlled trials of high quality, more clinical researches should be taken in the future.</p>