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Objective:To investigate the clinical features of patients with coexisting connective tissue disease (CTD) and sarcoisosis and to avoid misdiagnosis and mistreatment.Methods:To analyze the clinical manifestations, laboratory data, imaging and pathological features of patients with CTD combined with sarcoidosis in Peking Union Medical College Hospital from January 1985 to December 2021.Results:There were 17 patients with CTD(including 10 SS, 2 DM, 2 PBC, 1 SLE, 1 RA and 1 UCTD), combined with sarcoidosis, with a mean age of (55±10) years old and the ratio of male-to-female was 1:16. Eight patients were diagnosed as CTD before sarcoidosis, while 3 patients after sarcoidosis. The other 6 patients were diagnosed with the two diseases almost simultaneously. Lymphadenopathy(12/17), pulmonary nodules (8/17), subcutaneous nodules (4/17), rash (4/17) and blurred vision (1/17) were the main manifestations of patients with the onset of nodular disease. Nine patients were treated based on the presentation of sardoisis and 5 patients for CTD; 3 patients were treated for both diseases at the same time. All 17 patients discharged with improvement after treatment.Conclusion:When sarcoidosis do coexists with CTD, occult CTD might occur. It is important to investigate specific manifestations including pathological features of sarcoidosis and differentiate it from CTD.
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Objective:To analyze the diagnostic value of Michigan nerve screening Scale (MNSI), pain, touch and temperature detection combined with vibratory perception threshold (VPT) in diabetic peripheral neuropathy (DPN).Methods:A total of 500 patients with type 2 diabetes mellitus (T2DM) who received inpatient treatment in Xinhua Hospital Chongming Branch Affiliated of Shanghai Jiao Tong University School of Medicine from January to December 2018 were selected. Sixty four patients with DPN were enrolled in the DPN group, and the remaining 436 patients were enrolled in the no-DPN group. The clinical data and the results of MNSI scale, pain, touch and temperature detection thresholds and VPT of the two groups were compared. Receiver operating characteristic (ROC) curve was drawn to analyze the clinical value of single and combined examination indicators in the diagnosis of DPN.Results:MNSI symptom questionnaire score and MNSI physical examination score in DPN group were higher than those in no-DPN group: (3.00 ± 1.35) scores vs. (1.69 ± 0.52) scores, (1.57 ± 0.50) scores vs. (1.01 ± 0.24) scores; the proportion of touch regression, pain regression and temperature regression was significantly higher than that in no-DPN group; and the levels of VPT in the DPN group was higher than that in the no-DPN group: (26.34 ± 5.03) V vs. (17.97 ± 6.82) V, there were statistical differences ( P<0.01). When the single index was diagnosed, the area under the curve (AUC) value of VPT was the highest (0.825), and significantly higher than the pain, touch and temperature detection ( P<0.01). The AUC value of VPT + MNSI in combined diagnosis was the highest (0.738), and the sensitivity and specificity of DPN diagnosis were 51.56% and 96.10%, respectively. Conclusions:Compared with MNSI scale score, sensory detection such as pain, touch and temperature, VPT has the best diagnostic efficiency for DPN, while combined with MNSI, the specificity can be further improved, but the sensitivity decreases, which is worthy of clinical attention.
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Three sesquiterpenoids and nine iridoids were isolated from the roots and rhizomes of Valeriana jatamansi by various chromatographic methods. Their structures were identified by physicochemical properties, NMR and MS data. Among them, valeriananoid G (1) was a new patchoulol-type sesquiterpenoid, and compound 3 was isolated from the genus Valeriana for the first time. Compounds 3 and 10 exhibited significant inhibitory effects on nitric oxide production induced by lipopolysaccharide in RAW 264.7 macrophages, with IC50 values of 19.00 and 3.66 μmol·L-1, respectively. In addition, compounds 4, 6 and 12 showed anti-influenza virus activity with IC50 values of 51.75, 51.40 and 102.08 μmol·L-1, respectively.
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Aim To study the protective effect of fluoxetine hydrochloride on brain tissues of rats with simulated high altitude cerebral edema(HACE)and its mechanism.Methods The optimal dosage and time of fluoxetine hydrochloride were determined by the hypoxia tolerance test of mice under normal pressure.The rat model of brain edema at high altitude was established by large-scale low-pressure oxygen chamber.HE staining was used to observe the pathological changes of brain tissues in rats.Microplate reader was used to detect the corresponding indexes of oxidative stress such as malondialdehyde(MDA)level and superoxide dismutase(SOD)activity.The expressions of hypoxia-related proteins HIF-1α,VEGF,MMP-9,AQP4 and SERT were detected by Western blot.Results Compared with the hypoxia model group,after the intervention of fluoxetine hydrochloride,the survival time of mice was prolonged,and the middle dose of fluoxetine(14 mg·kg-1)had the best effect,with an extension rate of 17.78%.The pathological damage of brain was improved,the water content of brain decreased,and the permeability of blood-brain barrier decreased.MDA content in rat brain decreased and SOD activity increased.Western blot results showed that HIF-1α,VEGF,MMP-9,AQP4,SERT protein were significantly down-regulated.Conclusions Fluoxetine has protective effect on rats with brain edema at high altitude,and its mechanism may be related to improving oxidative stress,activating HIF-1α/VEGF/MMP-9 signaling pathway and affecting the expression of SERT protein.SERT may be a potential target for treating brain edema at high altitude.
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Objective:To analyze the risk factors of patients with ankylosing spondylitis (AS) combined with premature coronary atherosclerotic heart disease (PCAD).Methods:A total of 74 patients with AS and coronary atherosclerotic heart disease (CAD) in Peking Union Medical College Hospital from January 1983 to July 2021 were enrolled. According to the age of onset of coronary heart disease, the 74 patients were divided into PCAD group and NPCAD (non-premature coronary heart disease) group. T test and Chi square test were used to analyze the data of the two groups, the risk factors for AS-PCAD were analyzed by multivariate Logistic regression. Results:① There were 37 cases in the PCAD group and 37 cases in the NPCAD group. In the PCAD group, there were 28 men and 9 women; wherease all were men in the NPCAD group. The difference was statistically significant ( χ2=10.25, P=0.001). ② Compared with the NPCAD group, the age of AS-PCAD group was younger [(23±10) years vs (29±12) years, t=-2.28, P=0.026], and the course from AS to CAD was shorter [(25±10) years vs (34±13) years, t=-3.00, P=0.004], hemoglobin (Hb) level was lower [(122±23) g/L vs(132±18) g/L, t=2.10, P=0.039], rate of anemia was higher [38.5%(14/37) vs 16.2%(6/37), χ2=4.39, P=0.037]. Proportion of increased C-reactive protein (CRP) was higher [65.5%(19/29) vs 35.5%(11/31), χ2=5.41, P=0.019]. ③ Juvenile onset AS (JoAS)[ OR(95% CI)=3.45(1.31, 9.10), P=0.012] and high levels of CRP [ OR (95% CI)=3.68 (1.44, 9.40), P=0.006] might berisk factors of AS-PCAD by multiple logisctic regression analysis. Conclusion:Patients with AS have a higher probability of PCAD, especially in those patients with JoAS, persistent inflammation and anemia. It is necessary to be alert to the risk of PCAD and early screening.
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When this paper was first published the following ethical statement was omitted in error: The experiment was conducted in accordance with the welfare and ethical principles of experimental animals and the laws and regulations of experimental animals. Treat animals kindly, respect animal life, no maltreatment and brutality against animals, and take the least painful method to deal with animals. The authors would like to apologise for any inconvenience caused. DOI of original article: https://doi.org/10.1016/j.chmed.2019.03.005
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Objective@#To investigate the prevalence of metabolic syndrome in adults in Shanghai Chongming area and to analyze the relationship between metabolic syndrome and chronic kidney disease.@*Methods@#A total of 7 679 residents aged 30 years and over in Chongming District of Shanghai were randomly sampled and investigated by questionnaires, physical examinations, and laboratory examinations. The metabolic syndrome was diagnosed by the diagnostic criteria of metabolic syndrome according to the Chinese Guidelines for the Prevention and Treatment of Type 2 Diabetes in 2017. According to the criteria of the International Society of Nephrology Working Group on Improving the Overall Prognosis of Kidney Diseases, estimated glomerular filration rate (eGFR)<60 ml·min-1·(1.73 m2)-1 was diagnosed as chronic kidney disease.@*Results@#The prevalence of metabolic syndrome was 38.61% in the total population. The prevalence of metabolic syndrome was 47.06% in males and 34.71% in females. Urinary albumin-creatinine ratio (ACR), eGFR, age, smoking, waist circumference, blood glucose, blood pressure, high density lipoprotein-cholesterol and triglyceride in metabolic syndrome group were significantly higher than those in non- metabolic syndrome group. With the increase of metabolic components, eGFR decreased, and ACR increased. According to logistic regression analysis, age, male, hyperglycemia, hypertension, hypertriglyceride were risk factors for eGFR. Male, hypertension, hyperglycemia, hypertriglyceride, central obesity, smoking history, lower education level were risk factors for ACR.@*Conclusion@#The number of metabolic components is related to renal damage. Male, hypertension, hyperglycemia, hypertriglyceride are risk factors for early renal damage.
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Objective To investigate the prevalence of metabolic syndrome in adults in Shanghai Chongming area and to analyze the relationship between metabolic syndrome and chronic kidney disease. Methods A total of 7679 residents aged 30 years and over in Chongming District of Shanghai were randomly sampled and investigated by questionnaires, physical examinations, and laboratory examinations. The metabolic syndrome was diagnosed by the diagnostic criteria of metabolic syndrome according to the Chinese Guidelines for the Prevention and Treatment of Type 2 Diabetes in 2017. According to the criteria of the International Society of Nephrology Working Group on Improving the Overall Prognosis of Kidney Diseases, estimated glomerular filration rate (eGFR)<60 ml?min-1?(1.73 m2)-1 was diagnosed as chronic kidney disease. Results The prevalence of metabolic syndrome was 38. 61％ in the total population. The prevalence of metabolic syndrome was 47. 06％ in males and 34. 71％ in females. Urinary albumin-creatinine ratio (ACR), eGFR, age, smoking, waist circumference, blood glucose, blood pressure, high density lipoprotein-cholesterol and triglyceride in metabolic syndrome group were significantly higher than those in non-metabolic syndrome group. With the increase of metabolic components, eGFR decreased, and ACR increased. According to logistic regression analysis, age, male, hyperglycemia, hypertension, hypertriglyceride were risk factors for eGFR. Male, hypertension, hyperglycemia, hypertriglyceride, central obesity, smoking history, lower education level were risk factors for ACR. Conclusion The number of metabolic components is related to renal damage. Male, hypertension, hyperglycemia, hypertriglyceride are risk factors for early renal damage.
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Objective To investigate the optimal HbA1Cthreshold to be used for the diagnosis of diabetes mellitus in Chongming rural area,and further to evaluate the optimal HbA1Ccutoff values in different age stratifications and body mass index classifications.Methods Data from 9,981 individuals aged greater than 40 years who participated in a population-based cross-sectional survey in Shanghai,China,were analyzed.A 2 h 75 g oral glucose tolerance test(OGTT)value was used to diagnose diabetes.The performance of HbA1Cwas evaluated against the results of the OGTTs by using receiver operating characteristic(ROC)curve analysis.Results At the optimal HbA1C cutoff point of 6.15%for newly diagnosed diabetes, sensitivity was 69.73%, and specificity was 89.71%.The optimal HbA1Ccutoff points for diabetes were 6.05%in subject with age less than 60 years(sensitivity was 72.88%, and specificity was 90.25%),and 6.25%in subjects with age≥60 years(sensitivity was 70.89%,and specificity was 92.34%).The optimal HbA1Ccutoff points for diabetes were 6.05% in normal-weight(with sensitivity 70.94%,and specificity 89.93%),6.25%in overweight(with sensitivity 70.21%,and specificity 90.32%), and 6.35% in obese population(with sensitivity 72.33%, and specificity 92.75%).Conclusion An HbA1C threshold of 6.15%was highly specific for detecting undiagnosed diabetes.The HbA1Cdiagnosis cutoff point can be affected by age and overweight/obesity status.
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Objective T o prom ote the further research on body stature estim ation and the innovative ap-plications based on the distances betw een the anatom ical landm arks on body torso surface. Methods A specification for the collection of distances betw een the anatom ical landm arks on body torso surface w as established. T he data of 933 cases of adult population in Y angtze R iver D elta region w ere collected. M ultiple linear regression m ethod w as used to statistical analyse and establish the regression equation of stature estim ation. Results A regression equation about 5 variables including gender (x1), cervical verte-brae-coccyx line (x2), sterna-pubis line (x3), distance betw een acrom ion and iliospinale anterius (x4) and shoulder breadth (x5), and stature (y) w as established, y=105.406+5.414 x1+0.436 x2+0.286 x3+0.225 x4+0.193 x5. Conclusion T he m ethod is suitable for the rapid, sim ple and accurate estim ation of stature for the forensic experts.
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OBJECTIVES@#To promote the further research on body stature estimation and the innovative applications based on the distances between the anatomical landmarks on body torso surface.@*METHODS@#A specification for the collection of distances between the anatomical landmarks on body torso surface was established. The data of 933 cases of adult population in Yangtze River Delta region were collected. Multiple linear regression method was used to statistical analyse and establish the regression equation of stature estimation.@*RESULTS@#A regression equation about 5 variables including gender （x₁）, cervical vertebrae-coccyx line （x₂）, sterna-pubis line （x₃）, distance between acromion and iliospinale anterius （x₄） and shoulder breadth （x₅）, and stature （y） was established, y=105.406+5.414 x₁+0.436 x₂+0.286 x₃+0.225 x₄+ 0.193 x₅.@*CONCLUSIONS@#The method is suitable for the rapid, simple and accurate estimation of stature for the forensic experts.
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Adult , Female , Humans , Male , Body Height , Bone and Bones/anatomy & histology , Cervical Vertebrae/anatomy & histology , Forensic Anthropology/methods , Linear Models , Regression Analysis , Torso/anatomy & histologyABSTRACT
Purpose To investigate the pathological morphology and diagnostic parameters in the high-grade primary neuroendocrine carcinoma (NECa) of the uterus.Methods The clinical manifestations,pathological morphology,and immunohistochemical features of 25 uterine high-grade primary NECa cases were analyzed,and the relevant literatures were reviewed.Results The age of the 25 patients ranged from 24 to 72 years (mean age,44 years).Clinically,most of them complained of the vaginal bleeding or occupying lesions.84％ cases displayed typical neuroendocrine architectures histologically,and neurosecretory granules were observed in the electron microscopy examination.The nucleus of the small-cell type and large-cell type NECa were typical.Additionally,the mitosis number was more than 20/10 HPF in 64％ cases,10 to 20/10 HPF in 28％ cases,and less than 10/10 HPF in 8％ cases.Furthermore,highgrade NECa was often accompanied with apoptosis (72％) and necrosis (92％).The diagnosis included 13 cases of small-cell carcinoma,5 cases of combined small-cell carcinoma (1 with cervical intraepithelial neoplasia 3,1 with squamous cell carcinoma,and 1 with adenocarcinoma),4 cases of large-cell NECa,and 3 cases of combined large-cell NECa (2 with squamous cell carcinoma,and 1 with adenocarcinoma).The neuroendocrine markers were positive with Syn (96％),CgA (70.5％) and CD56 (78.6％).76.9％ cases demonstrated CKpan positivity,with small foci or linetype of cytoplasmic immunostaining.The proliferation index of Ki-67 was ranged from 60％ to 90％.In this study,13 patients received the uterus excision with adjuvant chemotherapy,and 5 cases died within 2 years.Conclusion High-grade NECa of the uterus is rare,and the terminology is similar to that of the digestive tract and lung.Yet,the diagnostic parameters are slightly different to some extent.The therapy is the surgical resection followed by adjuvant chemotherapy.
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Objective To solve the problems of flushing fluid overflow pollution in urinary endoscopy surgery and specimen run-off in flushing fluid.Methods An intraoperative specimen collector was designed and developed.Totally 212 patients were enrolled and divided into the experimental group (n=106) and the control group (n=106).Effects of application were evaluated by comparing contamination rate due to flushing fluid leakage,degree of patient comfort and degree of nursing satisfaction.Results Contamination rate due to flushing fluid leakage in the experimental group was significantly lower than that in the control group(P＜0.05).Degree of patient comfort and degree of nursing satisfaction in the experimental group were significantly better than those in the control group (P＜0.05).Conclusion The application of intraoperative specimen collector in urinary endoscopy surgery can effectively reduce pollution of staff and environment in operating room,improve retention rate of surgical specimen,increase patient comfort and satisfaction,and guarantee the success of the surgery.
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Objective To solve the problems of flushing fluid overflow pollution in urinary endoscopy surgery and specimen run-off in flushing fluid.Methods An intraoperative specimen collector was designed and developed.Totally 212 patients were enrolled and divided into the experimental group (n=106) and the control group (n=106).Effects of application were evaluated by comparing contamination rate due to flushing fluid leakage,degree of patient comfort and degree of nursing satisfaction.Results Contamination rate due to flushing fluid leakage in the experimental group was significantly lower than that in the control group(P＜0.05).Degree of patient comfort and degree of nursing satisfaction in the experimental group were significantly better than those in the control group (P＜0.05).Conclusion The application of intraoperative specimen collector in urinary endoscopy surgery can effectively reduce pollution of staff and environment in operating room,improve retention rate of surgical specimen,increase patient comfort and satisfaction,and guarantee the success of the surgery.
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[Summary] Propylthiouracil-induced anti-neutrophil cytoplasmic antibodies ( ANCA ) positive vasculitis ( APV) is an autoimmune diseases with multi-system damage. Its basic pathological lesions are characterized by necrotizing vasculitis. We present a case of propylthiouracil-induced APV, with regard to its pathogenesis, clinical manifestation, diagnosis, treatment, and outcomes for futher understanding this disease.
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Objective To investigate the relationship between cystatin C (CysC) and severity of the disease and changes of renal function in patients with acute cerebral infarction .Methods A total of 84 patients with acute cerebral infarction (study group) and 84 healthy individuals (control group) were enrolled and serum CysC levels were detected ,and its relationship with the degree of neurological impairment was analysed .500 mL/d (group A) and 375 mL/d (B group) 20% mannitol treatment were used ,and changes of serum CysC levels and renal function before treatment and 5 days and 14 days after treatment were analyzed .Results Serum CysC levels in patients with large ,medium and small infarcts were significantly higher than that in the control group (P0 .05) .Conclusion CysC might be closely related with the severity of acute cerebral infarction ,which could be more useful for monitoring renal function of patients with cerebral infarction than Cr and BUN .
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Objective To discuss the correlationship between the diagnosis of surgical pathology and the signs of malignancy which is both displayed by breast conventional mammography and amplificatory mammography with partial compression.Methods 65 cases with breast cancer were examined by both breast conventional mammography and amplificatory mammography with partial compression.The results of the two methods were analyzed.Results In all 65 cases of breast cancer,the comparison between breast conventional mammography and amplificatory mammography with partial compression could provide 16/60 cases in the X-ray signs of malignancy,which were in accordance with pathological examination results,19/41cases in the occurrence of calcification,13/37 cases in ductal calcification,0/4 cases in mixed type calcification,18/46 and 14/59 cases in the occurrence of lobulation and spicule signs.Conclusion Amplificatory mammography with partial compression can provide better insight in breast cancer than conventional mammography,especially in the region of dense shadow,small calcification and dense breast lesions,amplificatory mammography with partial compression can provide higher accuracy in diagnosis,especially for early breast cancer.
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OBJECTIVE@#To study the correlation between age and general morphology of transverse section of cartilago costalis and its forensic significance.@*METHODS@#Eighty-six corpses' cartilago costalis from the routine postmortem examination were collected and the morphological features of their transverse section were observed.@*RESULTS@#With the increased age, there were regular changes in the color, structure, and material of the general morphology of transverse section of cartilago costalis. But the changes were not affected by gender.@*CONCLUSION@#The good correlation between general morphology of transverse section of cartilago costalis and age can be used to estimate age of the deceased rapidly.
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Humans , Age Factors , Autopsy , Cadaver , Cartilage/pathologyABSTRACT
Objective To observe the level of reduced glutathione(GSH) and oxidized glutathione(GSSG)in a mouse bone cell line MC3T3-E1 cells exposed to fluoride.Methods MTT method was used to detect cell viability of M C3T3-E1 cells exposed to varying concentrations and periods of fluoride [F-concentration:0(control),0.5,1.0,2.0,4.0,8.0,12.0,20.0 mg/L; F-periods:1,2,4 and 10 days].The Xevo TQ MS was employed to test the levels of GSH,GSSG and glutamine (Gln).Results The MC3T3-E1 cell viability was significantly higher in the 2 mg/L group(0.57 ± 0.05) 1 day after the exposure compared to the respective control(0.49 ± 0.03,P ＜0.01); conversely,cell viability was markedly lower in the 8 mg/L(0.49 ± 0.07) and 12 mg/L(0.47 ± 0.09)groups 4 days after the exposure in comparison to the control(0.63 ± 0.06,P ＜ 0.05 or P ＜ 0.01).The cell viability in the 8 mg/L group(1.52 ± 0.29) 10 days after the exposure was significantly higher than that in the control group (0.86 ± 0.23,P ＜ 0.01),however,the value in the 20.0 mg/L group (0.54 ± 0.07) was significantly lower(P ＜0.01).The level of cell GSH decreased significantly in the 20 mg/L groups 2 days[(13.92 ± 4.63)μmol/L]and 10 days [(0.53 ± 0.30)μmol/L]after exposure compared to the respective comtrols [(26.42 ± 3.67),(24.85 ± 5.68)μmol/L,all P ＜ 0.01].The level of cell GSSG markedly increased in the 2 mg/L group 2 days [(1.12 ± 0.62)μ mol/L]and the 8 mg/L group 4 days [(2.13 ± 0.62)μ mol/L]after exposure compared to the controls[(0.55 ± 0.22),(1.46 ± 0.46)μmol/L,all P ＜ 0.05].The similar change was observed in the 8 mg/L group[(2.97 ± 1.30)μmol/L] 10 days after exposure compared to the control [(1.35 ± 0.50)μmol/L,P ＜ 0.05].The level of Glndecreased significantly in the 2 mg/L group[ (62.80 ± 17.4l)μ mol/L] 4 days and in the 8 and 20 mg/L groups 10 days[ (122.26 ± 19.51), (19.38 ± 8.11)μmol/L] after exposure compared to the controls [ (83.28 ±14.32), ( 147.15± 16.95) μmol/L , all P ＜ 0.05 or P ＜ 0.01 ]. Conclusions Fluoride exposure can significantly promote the changes of GSH, GSSG and Gln levels in the osteoblast, thus affecting the intracellular redox equilibrium.
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<p><b>OBJECTIVE</b>To observe the effects of Fuzheng Huayu Capsule (FHC) on the liver function, HBV DNA quantization, the ratio of transforming growth factor-beta1/bone morphogenetic protein-7 (TGF-beta1/ BMP-7) of peripheral blood mononuclear cells (PBMCs), HBV DNA YMDD variation, and the liver tissue pathology of chronic viral hepatitis B fibrosis patients of Gan-Shen insufficiency blood-stasis obstruction syndrome (GSIBSOS) on the basis of antiviral treatment by lamivudine.</p><p><b>METHODS</b>Eighty chronic viral hepatitis B fibrosis patients of GSBSOS were randomly assigned to two groups. Patients in the control group (43 cases) were treated with lamivudine alone, while those in the treatment group (37 cases) were treated with lamivudine + FHC. The treatment period lasted for 6 months. By the end of treatment lamivudine was continually given to all patients, and patients were followed up for 6 months. Before and after treatment, liver tissue pathology was examined by liver biopsy. The serum HBV DNA quantization, the ratio of TGF-beta1/BMP-7 were determined by fluorescence quantitative polymerase chain reaction (PCR). HBV DNA YMDD variation was tested by the end of follow-ups.</p><p><b>RESULTS</b>Better effects were obtained in decreasing the levels of ALT, AST, and HBV DNA after 6 months of treatment in the two groups, with statistical difference when compared with before treatment in the same group, but with no statistical difference between the two groups. At the end of the 6th month follow-up, YMDD variation occurred in 9 cases of the control group and in 5 cases of the treatment group, with statistical difference between the two groups (P < 0.05). FHC could significantly reduce the ratio of TGF-beta1/BMP-7, significantly lower in the treatment group (0.09 vs 0.25, P < 0.05). In the aspect of liver tissue pathological changes, the rates of inflammatory activity over G3 and fibrosis degree S3 in the treatment group were significantly lower than those in the control group (P < 0.05).</p><p><b>CONCLUSIONS</b>On the basis antiviral treatment of lamivudine for chronic viral hepatitis B fibrosis patients of BSOS, additional application of FHC could lower the HBV DNA YMDD variation, improve the hepatic inflammation and fibrosis, and exert anti-fibrosis by decreasing the ratio of TGF-beta1/BMP-7.</p>