Network Meta-analysis of oral Chinese patent medicine in treatment of knee osteoarthritis / 中国中药杂志

To evaluate the efficacy and safety of Chinese patent medicine in the treatment of knee osteoarthritis(KOA) with network Meta-analysis, and provide evidence-based medicine evidences for clinical practice. PubMed, Cochrane Library, EMbase, CNKI, Wanfang, VIP and CBM were used to search for clinical randomized controlled trials(RCTs) on Chinese patent medicines for treatment of knee osteoarthritis, with a time limit from the establishment of each database to March 2020. The bias risk assessment tool recommended by Cochrane was used to evaluate the quality of the included RCTs. The network Meta-analysis was performed by Stata 14.0 software. A total of 5 788 patients in 58 RCTs were included, involving 9 kinds of Chinese patent medicines. The results of the network Meta-analysis indicated that in terms of total effective rate, the top three optimal medication regimens were Jinwu Gutong Capsules + Amino Acid Glucose(AAG), Xianling Gubao + AAG and Biqi Capsules; the top three interventions to reduce the VAS score were Panlongqi Tablets > Xianling Gubao + AAG > Xianling Gubao + non steroidal anti-inflammatory drugs(NSAIDs); the top three interventions to reduce the total score of WOMAC were Jintiange Capsules+NSAIDs> Jinwu Gutong Capsules + AAG > Biqi Capsules + NSAIDs; the top three medication schemes with better curative effect to reduce Lequesnse index were Xianling Gubao + NSAIDs > Biqi Capsules + NSAIDs > Jintiange Capsules + NSAIDs; the top three interventions to reduce TNF-α level Xianling Gubao + AAG > Jintiange Capsules > Jintiange Capsules + AAG=Jinwu Gutong Capsules + AAG. In terms of safety, the top five interventions with the least adverse reactions were Biqi Capsules > Jinwu Gutong Capsules > Biqi Capsules + NSAIDs > Xianling Gubao + NSAIDs > Jintiange Capsules. The combined application of Chinese patent medicine and NSADIs or AAG can improve the clinical treatment effect and reduce adverse reactions in KOA patients.

Research progress on mechanism of active components of Chinese materia medica in treatment of osteoporosis based on signaling pathway / 中草药

Osteoporosis is a systemic skeletal disease that causes a huge medical burden on patients and society. Drug treatment is the main intervention for anti-osteoporosis, but objectively existing adverse reactions reduce the patient's compliance and affect the effect of medication. Traditional Chinese medicine has good curative effect and safety in the prevention and treatment of osteoporosis, but its mechanism of action needs to be further studied. The pathway regulates the progress of osteoporosis and is one of the main targets for osteoporosis pathological mechanism and pharmacological research. In recent years, an increasing number of studies have been made on the regulatory mechanism of osteoporosis signaling pathways by active ingredients of Chinese materia medica. Recent research results on the active components of Chinese materia medica interfering with biological signaling pathways was reviewed in this article, in order to provide ideas for new drug development, basic research, and clinical applications for osteoporosis.

Antipyretic and anti-inflammatory activities of Thais luteostoma extracts and underlying mechanisms / 中国天然药物

Thais luteostoma has been utilized as a crude drug whose shell and soft tissue have been widely used for the treatment of heat syndrome in China for thousands of years. The present study was designed to investigate the antipyretic and anti-inflammatory activities of T. luteostoma. T. luteostoma was divided into shell (TLSH) and soft tissue (TLST) samples in the present study. The rat model of yeast-induced fever was used to investigate their antipyretic effects; and the rat model of hind paw edema induced by carrageenan was utilized to study their anti-inflammatory activities, and at the same time, the concentration variations of the central neurotransmitter [prostaglandin E2 (PGE2) and cyclic adenosine monophosphate (cAMP)], inflammatory mediators [tumor necrosis factor (TNFα), interleukin-1β (IL-1), interleukin-2 (IL-2) and interleukin-6 (IL-6)] and ion (Na(+) and Ca(2+)) were also tested. The results showed that TLSH and TLST extracts significantly inhibited yeast-induced pyrexia in rats (P < 0.05), and exhibited more lasting effects as compared to aspirin, and TLSH had the better antipyretic activity than TLST, and that TLSH and TLST could significantly prevent against carrageenan induced paw edema in rats (P < 0.05); and markedly reduced levels of PGE2, cAMP, TNFα, IL-1β, IL-2, IL-6, and Na(+)/Ca(2+). In fever model, TLST could significantly reduce the levels of PGE2 (P < 0.01) in rats' homogenate and TNFα (P < 0.05), IL-1β (P < 0.01) in the plasma than TLSH, whereas TLSH could reduce the content of IL-2 (P < 0.01) and IL-6 (P < 0.01) in plasma and increase the content of Ca(2+) (P < 0.01) in plasma and homogenate more significantly than TLST. In conclusion, T. luteostoma extract has antipyretic and anti-inflammatory activities, which may be mediated through the suppression of production of PGE2, cAMP, Na(+)/Ca(2+), TNFα, IL-1β, IL-2, and IL-6.

One stage anterior debridement, bone fusion and internal fixation for the treatment of lumbosacral tuberculosis / 中国骨伤

<p><b>OBJECTIVE</b>To explore the clinical effect of the anterior debridement,bone fusion, single screw-rod fixation for the treatment of lumbosacral tuberculosis.</p><p><b>METHODS</b>From March 2005 to February 2011,18 patients with lumbosacral (L3-S1) tuberculosis (including 13 males and 5 females with an average age of 38.5 years old ranging from 24 to 61 years) were treated with removing focus completely, large piece of iliac bone strut grafting, single screw-rod vertebral lateral anterior internal fixation through anterior extraperitoneal approach. The process segment was L3,4 in 2 cases, L4,5 in 5, L4 in 2, L5S1 in 6, L4-S1 in 3. All patients were routinely treated with antituberculous druy for 12-18 months after operation, erythrocyte sedimentation rate and liver function, X-ray films, CT examination, were statedly rechecked, and condition of antituberculosis treatment and bone grafting fusion were detected.</p><p><b>RESULTS</b>Intraoperative focus were exposed clearly, debrided thoroughly. There were no large blood vessels, nerves, ureteral injury and other serious complications during operation. All patients were followed up form 6 to 42 months with an average of 13 months. Internal fixations were not loosening,breaking; bone of grafting was not displacement and obtained good healing; erythrocyte sedimentation rate and C-reactive protein were normal; tuberculosis lesions were not recurrence.</p><p><b>CONCLUSION</b>Through anterior extraperitoneal approach to remove focus, bone fusion, single screw-rod fixation in treating lumbosacral tuberculosis can complete cut lesion and rebuild the stability of lumbosacral vertebrae,in this area with a single screw and rod fixation is a feasible method.</p>

Chemical constituents from root barks of Ginkgo biloba (I) / 中草药

Objective: To study the chemical constituents from the root barks of Ginkgo biloba. Methods: The constituents were isolated by column chromatography and their structures were elucidated by physicochemical properties and spectroscopic analyses. Results: Thirteen compounds were isolated including four fatty acids, palmitinic acid (1), stearic acid (2), behenic acid (3), and lignoceric acid (4); one fatty alcohol, 1-heptacosanol (5); two sterides, β-sitosterol (6) and daucosterol (7); two flavonoids, genkwanin (8) and apigenin (9); and four ginkgolides, bilobalide (10), ginkgolide A (11), ginkgolide B (12), and ginkgolide C (13). Conclusion: Among them, compounds 3-5 are isolated from this plant for the first time. The results are helpful for the comprehensive utilization of the resources of the root barks of G. biloba.

Management of complicated midface deficiencies with external distraction / 中华整形外科杂志

<p><b>OBJECTIVE</b>To treat complicated midface deficiencies with external distraction device.</p><p><b>METHODS</b>Four patients (one with acquired midface hypoplasia, two with Crouzon syndrome and one with Parry Romberg) with severe midface deficiencies underwent external distraction osteogenesis. After Le Fort III or Le Fort III plus I osteotomies were performed, the external distraction devices were activated on the 7th postoperative day with a rate of 1 mm per day. The distraction devices were removed after consolidation for 3 months.</p><p><b>RESULTS</b>All patients completed the distraction treatment. The distraction distance ranged from 10 to 14 mm. The appearance of all patients was significantly improved.</p><p><b>CONCLUSIONS</b>External distraction osteogenesis provides an effectively treatment for patients with severe and complicated midface deficiencies.</p>