Application and development of orthognathic surgery in treatment of syndromic craniosynostosis / 中国修复重建外科杂志

OBJECTIVE@#To summarize the application and recent development of orthognathic surgery in treating syndromic craniosynostosis.@*METHODS@#The related literature at home and abroad in recent years was extensively reviewed, and the indications, routine procedures, and protocols of orthognathic surgery in the treatment of syndromic craniosynostosis were summarized and analyzed.@*RESULTS@#Craniosynostosis is a common congenital craniofacial malformation. Syndromic craniosynostosis usually involves premature fusion of multiple cranial sutures and is associated with other deformities. Orthognathic surgery is the necessary and effective means to improve the midfacial hypoplasia and malocclusion. Le Fort I osteotomy combined with sagittal split ramus osteotomy are the common surgical options. Orthognathic surgery should combine with craniofacial surgery and neurosurgery, and a comprehensive long-term evaluation should be conducted to determine the best treatment plan.@*CONCLUSION@#Orthognathic surgery plays an important role in the comprehensive diagnosis and treatment of syndromic craniosynostosis. The development of digital technology will further promote the application and development of orthognathic surgery in the treatment of syndromic craniosynostosis.

Cyasterone inhibits IL-1β-mediated apoptosis and inflammation via the NF-κB and MAPK signaling pathways in rat chondrocytes and ameliorates osteoarthritisin vivo / 中国天然药物

Osteoarthritis is a prevalent global joint disease, which is characterized by inflammatory reaction and cartilage degradation. Cyasterone, a sterone derived from the roots of Cyathula officinalis Kuan, exerts protective effect against several inflammation-related diseases. However, its effect on osteoarthritis remains unclear. The current study was designed to investigate the potential anti-osteoarthritis activity of cyasterone. Primary chondrocytes isolated from rats induced by interleukin (IL)-1β and a rat model stimulated by monosodium iodoacetate (MIA) were used for in vitro and in vivo experiments, respectively. The results of in vitro experiments showed that cyasterone apparently counteracted chondrocyte apoptosis, increased the expression of collagen II and aggrecan, and restrained the production of the inflammatory factors inducible nitric oxide synthase (iNOS), cyclooxygenase-2 (COX-2), a disintegrin and metalloproteinase with thrombospondin motifs-5 (ADAMTS-5), metalloproteinase-3 (MMP-3), and metalloproteinase-13 (MMP-13) induced by IL-1β in chondrocytes. Furthermore, cyasterone ameliorated the inflammation and degenerative progression of osteoarthritis potentially by regulating the nuclear factor kappa B (NF-κB) and mitogen-activated protein kinase (MAPK) pathways. For in vivo experiments, cyasterone significantly alleviated the inflammatory response and cartilage destruction of rats induced by monosodium iodoacetate, where dexamethasone was used as the positive control. Overall, this study laid a theoretical foundation for developing cyasterone as an effective agent for the alleviation of osteoarthritis.

Analysis on the dilemma and strategy of healthcare and prevention integration based on incentive compatibility / 中华医院管理杂志

Integration of healthcare and prevention is key path to achieving the pattern of " macro healthcare, macro health". However, it is hard at present to fully integrate healthcare and prevention in China, mostly due to the lack of effective incentive compatibility strategies. Based on the incentive compatibility theory, this study proposed a multi-level principal-agent chain of healthcare and prevention integration. Taking the incentive transmission among stakeholders in the principal-agent chain as the analysis framework, the dilemma and causes of incentive incompatibility of healthcare and prevention integration were studied.Combined with the proctice of healthcare and prevention integration in Sanming city, the incentive compatibility strategies of healthcare and prevention integration were proposed at the level of government, medical institutions, medical staff, public health staff and residents. These strategies refer to coordinating the use of medical insurance funds and public health funds, strengthening organization management as well as assessment and incentive, rewarding health promotion management points, and setting up health science popularization teams.

High Expression of Bone Marrow VEGF in Patients with Acute Leukemia and Its Correlation with Prognosis / 中国实验血液学杂志

OBJECTIVE@#To detect the level of vascular endothelial growth factor (VEGF) in bone marrow of patients with non-M3 acute leukemia (AL), and estimate its relationship with prognosis.@*METHODS@#From January 2016 to December 2019, 114 patients with AL in department of Hematology, Wuwei People's Hospital were selected as study group, and 25 healthy volunteers were enrolled as control group. The concentration of VEGF in bone marrow was detected by ELISA. The patients were divided into high and low concentration group according to the level of VEGF. The overall survival (OS) and event-free survival (EFS) were compared among different groups.@*RESULTS@#The level of VEGF in patients with AL was significantly higher than that in the control group. The median OS and EFS in the low concentration group was 34.5 and 32 months, respectively, while, in the high concentration group was 30 and 26 months, respectively. The differences between the two groups were statistically significant (P=0.010). There were significant differences in OS rate (P=0.035) and EFS rate (P=0.026) between low and high concentration group. Multivariate analysis showed that high VEGF concentration was an independent risk factor affecting OS (HR=2.619, 95%CI 1.070-6.406, P=0.035) and EFS (HR=2.221, 95%CI 1.074-4.552, P=0.031) in AL patients.@*CONCLUSION@#VEGF highly expresses in the bone marrow of patients with AL at initial diagnosis and relapse, and shows adverse effects on the prognosis.

Regulation Effect of Myeloid Leukemia No.1 Chinese Herb Medicine Prescription Combined with Chemotherapy on Th17 Cells in Bone Marrow of Patients with Acute Myeloid Leukemia / 中国实验血液学杂志

OBJECTIVE@#To explore the regulation effect of myeloid leukemia No.1 Chinese herb medicine prescription combined with chemotherapy on Th17 cells in bone marrow fluid of AML patients, so as to provide guidance for improving AML treatment effect and patients' long-term survival.@*METHODS@#Seventy patients with AML who were hospitalized in Department of Hematology, Wuwei People's Hospital from April 2017 to August 2019 were selected and enrolled in AML group, 25 healthy volunteers were selected and enrolled in control group; then according to therapeutic regimen, AML patients were divided into 2 groups: combined therapy group (myeloid leukemia NO.1 Chinese herb medicine prescription combined with chemotherapy) and non-combined therapy group (chemotherapy alone). Flow cytometry was used to detect the ratio of CD3@*RESULTS@#The ratio of CD3@*CONCLUSION@#Th17 cells expression in bone marrow of newly diagnoses and relapsed AML patients significantly increase, and decrease significantly after treatment. Myeloid leukemia No.1 Chinese herb prescription combined with chemotherapy can significantly increase the CR rate and reduce the RL rate for AML.

The review of common external birth defects / 中华整形外科杂志

Birth defects is one of the most important problems of human society. External birth defect is one of the major research fields of plastic surgery. This kind of disorders damages the body image of patients in mild or severe way, affects severely the social confidence of the patients themselves and their families. we summarized the research progress of the common external birth defects (the incidence top 10) from the aspects of pathogenesis, prevention, treatments and so on, in order to provide reference materials to the prevention and treatment of them.

Short-term outcome of complex coronary lesions treated by excimer laser coronary atherectomy / 中国介入心脏病学杂志

Objective To investigate the feasibility, safety and efficacy of excimer laser coronary atherectomy used in complex lesions, including in-stent restenosis, non-crossable or nonexpandable lesions, heavily calcified lesions without successful wire-exchange and saphenous vein grafts lesions. Methods From Jul 24, 2017 to Aug 24, 2018, 22 cases with 24 lesions were treated with excimer laser coronary atherectomy in Peking University People's Hospital, combined with or without IVUS/OCT, rotational atherectomy or other percutaneous coronary intervention instrument, and with or without stent implantation. Results The procedural success rate was 23/24. There was no complications in all cases. Drug-eluting stents were implanted in 19/24 of lesions. There were no major advent cardiovascular events, including death, acute ST-segment-elevation myocardia and pericardial tamponade recorded. Conclusions Excimer laser coronary atherectomy used in complex lesions is feasible, safe and efficient with satisfactory in-hospital short-term outcome.

Application Value of Combined Detection of Urinary Amino Acid Metabolite and Tumor Specific Growth Factor in Evaluation of Curative Efficacy for Acute Leukemia / 中国实验血液学杂志

OBJECTIVE@#To investigate the clinical importance of combined detection of urinary amino acid metabolite --urinary tyrosine (UT) and tumor specific growth factor (TSGF) in the disease observation and curative effect evaluation of acute leukemia（AL）.@*METHODS@#In 87 cases of AL, the UT and TSGF levels were detected by using chemical chromogenic method and continuous monitoring method respectively. The 2 indicators of each treatment group were statistically analyzed and compared with that of 50 healthy control group.@*RESULTS@#In 87 AL patients, the levels of UT and TSGF after treatment were significantly lower than those before treatment (P0.05).@*CONCLUSION@#UT and TSGF levels are related with the metabolism of tumor cells in AL patients. UT level can be used to predict the recurrence of patients with CR. The combined dynamical monitoring of these 2 indicators can be used as the indexes for observation of AL status, evaluation of therapeutic efficacy, prediction of prognosis and relapse of AL.

Changes of facial volume maintenance rate after single autologous fat grafted for repaired progressive facial hemiatrophy / 中华医学美学美容杂志

Objective To measure the change of facial volume maintenance rate after autologous fat grafted for repaired progressive facial hemiatrophy by using three-dimensional digital technology.Methods 3D scanner was used to acquire facial data in 10 patients with progressive facial hemiatrophy before operation;Mimics 17.0 software was used to reconstruce patients' facial 3D model and to calculate the volume of facial tissue defect;autologous fat was grafted to repair facial deformity.The facial volume maintenance rate was calculated in all the patients 3 months and 6 months after operation.Results We had performed facial 3D data acquisition and facial repaired with autologus fat grafted in 10 patients;patients' facial morphology was improved.The mean facial volume maintenance rate was (35.80±3.44)％ in 3 months and (27.82±3.80)％ 6 months after surgery.Conclusions The mean facial volume maintenance rate in postoperative 3 months is inferior to that in 6 months in single autologous fat grafted for repairing progressive facial hemiatrophy.

Surgery-first approach for Angle class Ⅲ malocclusion: clinical retrospective analysis of 185 cases / 中华整形外科杂志

Objective@#The purpose of this study was to explore the surgery-first approach in sequential combined orthodontic-orthognathic treatment to shorten total treatment duration and improve the clinical outcome.@*Methods@#This study included 185 patients with Angle classⅢ malocclusion. The patients were divided into 3 different types according to cephalometry analyses and facial features. ①Type Ⅰ: mandibular prognathism or asymmetry mandibular prognathism; ②Type Ⅱ: mandibular prognathism and maxillary retrusion; ③ Type Ⅲ: mild Angle′s Class Ⅲ malocclusion, cross bite in anterior teeth, or normal overlap and overbite relation with midfacial hypoplasia. All of patients received surgery first approach therapy. The surgical procedures were chosen according to different malformation types. Type Ⅰ was treated with the sagittal split ramus osteotomy (SSRO). Type Ⅱ was treated by Le Fort Ⅰmaxillary osteotomy combined with SSRO. Type Ⅲ underwent anterior subapical osteotomy combined pyriform aperture augmentation with biomaterials as well as maxillary anterior orthodontics. All patients received postoperative rapid orthodontic treatment for 6-12 month after 2 weeks of operation. Using the straight arch wire techniques and the class Ⅲ intermaxillary traction, we removed the overcrowding upper and lower teeth, the compensatory axial tilt of teeth, and the deviation of the dental arch and maintained the neutral relationship of the molar. The mandible Hawley retaining devices were used during the maintaining stage.@*Results@#The cases in study acquired satisfactory clinical outcome, which included the shortened overall treatment duration, the significantly improved facial features, the corrected occlusion relationship, and the restored function of mastication and temporomandibular joint. There were some complications as follows: intraoperative fracture (6 cases, 3.24%), the inferior alveolar nerve bundle injury (2 cases, 1.1%), and temporary open-bite that diminished by inter-maxillary elastic distraction one month after operation (19 cases, 10%). All cases in this study accepted postoperative orthodontic treatment. Follow-up time ranged from 6 months to 5 years. The cephalometric analysis results of 126 cases who had complete image data and over 6 months of follow-up showed that hard and soft tissue indexes were restored to normal range after combined orthognathic-orthodontic treatment. The stability of the maxillary and occlusive relationship of SFA(surgery-first approach) was similar to that of the COS(conventional orthodontics-first system) [relapse ratio=(T2-T1)/(T1-T0)×100%]. Over six months of follow-up , SNB and ANB showed that the average relapse ratio were 22% and 19.8%, whereas the relapse angle are less than 2°.@*Conclusions@#The Surgery-first approach could be used to treat most patients with Angle skeletal Class Ⅲ malocclusion, but the indications and the surgical procedures should be noticed and chosen.

Double support technique in malar reduction surgery / 中华整形外科杂志

Objective@#To present a new method for correction of prominent malar complex via intraoral approach by double support technique osteotomy which can provide a stable support.@*Methods@#According to the anatomical characteristics of malar complex and relevant masseter muscle, we designed a malar reduction technique including anterior and posterior support. The reduction procedure entailed an L-shaped osteotomy ofthemalarbody and oblique osteotomy of malar arch. On the basis of prominence degree, bone fragment was moved inward and upward to form double support, which could reduce malar and zygomatic arch effectively.@*Results@#A total of 76 patients subjected to double support technique for malar reduction between January 2015 and January 2017 were retrospectively reviewed.The follow-up period ranged from 10 to 12 months. All patients were satisfied with aesthetic outcomes without major complications, such as facial nerve damage or bone ununion.@*Conclusions@#Double support technique is an effective method to correct malar prominence andreduce the zygomatic complex which can prevent saggy cheek and bony malunion.

Revision surgery for malar reduction: causes and treatment strategies / 中华医学美学美容杂志

Objective To discuss the correlation between initial malar reduction procedures and the method of revision procedures and the personalized treatment strategies for the second deformity of postoperative prominent malar complex.Methods From January 2003 to December 2017,27 patients underwent personalized revision surgery of malar reduction according to the different second deformity of malar complex.The surgical technique included the double support malar reduction technique,orthotopic malar osteotomy technique,malar bone grinding surgery,and autogenous bone transplantation.Results A total of 27 patients subjected to revision surgery for malar reduction between November 2006 and December 2017 were retrospectively reviewed.22 patients were satisfied with aesthetic outcomes after the first revision procedure,while 5 patients were satisfied after 2 or 3 procedures follow-up for 10 to 12 months.Conclusions The incidence of complications after malar reduction is related to the first surgical method.According to the unsatisfactory results,it can be repaired individually to obtain a better clinical repair effect.

Clinical efficacy of nasolabial groove flap/offside ala nasi groove flap on nasal deformity of Tessier 3 cleft / 中华医学美学美容杂志

Objective To find a method to repair nasal deformity of Tessier 3 cleft.Methods Five Tessier 3 cleft patients were treated from June 2010 to June 2015 in our department.Nasolabial groove flap or nasolabial groove flap accompanied by offside ala nasi groove flap were performed to correct the nasal deformity according to the defect of the ala.Results Two cases were treated with simple nasolabial groove glap,and 3 cases were treated with nasolabial groove flap accompanied by offside ala nasi groove flap.All the flaps survived with incisions of donor sites healed primarily.The color,texture and thickness of the flaps were similar to those of recipient sites after 1 year follow up.The scar in donor site was concealed and not obvious.The results showed good healing and good appearance,and the symmetry between the nostrils also seemed to be acceptable.Conclusions Nasolabial groove flap and nasolabial groove flap accompanied by offside ala nasi groove flap are good methods to correct nasal deformity of Tessier 3 cleft.The offside ala can be reduced at the same time and the symmetry between the nostrils can be achieved more easily.The operation is easily performed,the scar is acceptable and the results are good.

Discussion on the Dilemma and Countermeasure of Medical Ethics Education on Medical Targeted-area Student / 中国医学伦理学

Starting from the characteristics of medical targeted-area student,the cultivation should not only strengthen the general medical knowledge,but also the ethics education.Based on this,this paper pointed out the dilemma of the students in the educational subject,educational object and educational process.Also,it put forward the countermeasures:enhancing the cognition,perfecting the curriculum system,intensifying the resources of teachers,optimizing the content of courses and innovating the teaching methods.

Therapeutic effect of anterior subapical osteotomy combined with postoperative orthodontic treatment for bimaxillary protrusion based on surgery-first approach / 中华整形外科杂志

Objective@#To invesigate the therapeutic effect of anterior subapical osteotomy combined with postoperative orthodontic treatment for bimaxillary protrusion based on surgery-first approach(SFA).@*Methods@#From April 2015 to April 2016, 22 adult patients with bimaxillary protrusion were treated with bimaxillary anterior subapical osteotomy without peroperative orthodontic treatment. Digital computer-aided technology was used for preoperative design and dental model simulation surgery. Then the occlusal guide plate was made for intraoperative built-up of temporary occlusion. Two weeks after orthognathic surgery, a short-term orthodontic treatment was carried out to improve the occlusion. Cephalometric analysis was done to evaluate the treatment effects. 19 cephalometric parameters about hard and soft tissues were measured and compared in all cases before and after SFA combined treatments. All data were statistically analyzed by SPSS software package.@*Results@#Primary healing was achieved in all the 22 cases without any infection or necrosis of bone and dental pulp. During the follow-up period of 6-12 months, all the patients were satisfied with the profile contour. The cephalometric parameters of hard and soft tissues changed remarkably. U1E-McN and L1E-McN set back (-10.5±4.9) mm and (-8.0± 6.9) mm respectively. Upper and lower lip set back obviously. SNA decreased from (82.5±2.8) to (77.9±2.3) degrees on average. SNB decreased from (79.1±5.4) to (74.6±3.8) degrees on average. Upper and lower lip protrusion decreased obviously. TUL-E line decreased from the mean value of (2.7±2.7) mm to (0.5±3.2) mm and TLL-E line from (5.2±4.0) mm to (1.4±2.7) mm. The aesthetic contours were remarkably improved.@*Conclusions@#Anterior subapical osteotomy combined with postoperative orthodontic treatment based on SFA could correct adult bimaxillary protrusion effectively with normal occlusion, satisfactory soft tissue aesthetic profile.

Clinical Analysis of 84 Cases of Erythrodermic Psoriasis and 121 Cases of Other Types of Erythroderma from 2010-2015 / 华中科技大学学报（医学）（英德文版）

Erythroderma with complicated etiology is one of the severe skin diseases and has high mortality,of which the incidence was 0.5％-1.5％ in skin diseases.Erythrodermic psoriasis (EP) is the commonest type of erythroderma.In addition,there are drug-induced erythroderma,erythroderma secondary to preexisting dermatoses,malignancy-related erythroderma,and idiopathic erythroderma of unknown etiology.Erythroderma of different etiologies has various clinical manifestations,resulting in relevant curative effects and outcomes.In this article,we retrospectively investigated 205 erythroderma patients about clinical symptoms,auxiliary examination and treatments,and evaluated the efficacy and prognosis.There were 84 cases of EP among 205 patients,10 cases of erythroderma caused by specific drugs,77 cases of erythroderma secondary to preexisting dermatoses (excluding psoriasis),7 cases of erythroderma patients suffering from malignancy and 27 cases with unknown causes.We concluded that the etiology of male patients in different age groups had significant difference.The incidence of EP was the highest among all types.The EP was commonly accompanied with hypoproteinemia,and changed into psoriasis vulgaris after treatment.Drug-induced erythroderma was commonly accompanied with fever,and mostly cured by systematic steroid therapy.For erythroderma secondary to preexisting der matoses,the original dermatoses must be actively treated to achieve a satisfying prognosis.Erythroderma with malignancy or unknown causes had long-term duration,poor response to the treatment,and high potential to relapse.Therefore,clarifying the etiology,providing an appropiate and individual regimen,and regular follow-up are crucial for the successful treatment of erythroderma with unknown causes.

Effect of modified postural drainage for treating pulmonary infection of senile patients with gastric cancer / 中国实用护理杂志

Objective To explore clinical effect of modified postural drainage for treating pulmonary infection of senile patients with gastric cancer.Methods 107 cases of patients with gastric cancer were randomly divided into two groups:control group (n =53) and treatment group (n =54),which were respectively treated by routine postoperative therapy and nursing measures and modified postural drainage based on these routine measures,and compared daily amount of expectoration sputum,positive cases of sputum culture,restore time of postoperative blood test,postoperative fever time,cases of pulmonary infection on the postoperative tenth day and length of stay.Results Daily amount of expectoration sputum of patients in treatment group was significantly higher than that of control group [(185.7 ± 23.7) ml vs.(99.7 ± 17.6) ml] (P ＜ 0.05).However,restore time of postoperative characters of blood test [white blood cell count (2.9±0.9) d vs (5.0±0.7)d,C-reaction protein (35±0.7)d vs.(7.4±0.6) d],postoperative fever time [(1.9±0.5) d vs.(3.6±1.4) d],cases of atelectasis (5 cases vs.19 cases) and length of stay [(1.9±0.5) d vs.(3.6±1.4) d] were respectively significantly less than those of control group (P ＜ 0.05).Conclusions Modified postural drainage could effectively prevent postoperative atelectasis and pulmonary infection,significantly reduced incidence of postoperative atelectasis of senile patients with gastric cancer operation,and so it was worthy of clinical application.

Effects of different cryopreservation methods on the ultrastructure and viability of amniotic membrane / 中国组织工程研究

BACKGROUND: There are currently many cryopreservation methods for the aminotic membrane, which have varying effects on the ultrastructure and biological activity of amniotic membrane, but on no one is effective. OBJECTIVE: To compare the effects of different cryopreservation methods on the ultrastructure and viability of aminotic membrane and to seek the ideal cryopreservation method. METHODS: Aminotic membrane separated from the fresh placenta was preserved respectively with deep-frozen cryopreservation and vitrification, and everyway was run for 3 and 6 months. Fresh aminotic membrane was used as control. The ultrastructure of aminotic membrane was observed by transmission electron microscopy, and the viability of aminotic membrane was assessed by microcomputer analysis system for biological oxygen consumption, and immunohistochemical staining combined with image analysis system was used for lactate dehydrogenase activity. RESULTS AND CONCLUSION:After 3 and 6 months of crypreservation, the damage to the ultrastructure of aminotic membrane by vitreous cryopreservation was slighter than that of amniotic membrane cryopreserved at-80℃. Compared with the fresh aminotic membrane, the gray value of lactate dehydrogenase and partial pressure of oxygen were significantly decreased in the cryopreserved aminotic membrane by deep-frozen cryopreservation at 3 and 6 months (P < 0.05) and by vitreous cryopreservation at 6 months (P < 0.05), but there was no statisticaly significant difference in the change rate of oxygen partial pressure and the gray value of lactate dehydrogenase between the fresh aminotic membrane and the cryopreserved aminotic membrane by vitreous cryopreservation at 3 months. The present study led to the conclusion that vitreous cryopreservation protocol alows to not only maintain the integrity of AM, but also to preserve the viability of the cels. So the vitreous cryopreservation is superior to the deep-frozen cryopreservation for cryopreservation of aminotic membrane.

The highly expressed secreted phosphoprotein 1 gene in prostate cancer metastasis: a microarray-based bioinformatic analysis / 中华男科学杂志

<p><b>OBJECTIVE</b>To investigate the composition, function, and regulatory mechanisms of the secreted phosphoprotein 1 (SPP1) gene in metastatic prostate cancer.</p><p><b>METHODS</b>We obtained the data about the whole genomic expression profiles on prostate cancer metastasis from the GEO database, and performed data-mining and bioinformatic analysis using BRB-Array Tools and such softwares as Protparam, MotifScan, SignalP 4.0, TMHMM, NetPhos2.0, PredictProtein, GO, KEGG, and STRING.</p><p><b>RESULTS</b>Totally, 73 co-expressed differential genes in prostate cancer metastasis were identified, 21 up-regulated and 52 down-regulated (P <0.01). Bioinformatic analysis indicated that the highly expressed SPP1 gene encoded 314 amino acids and contained 2 N-glycosylation sites, 8 casein kinase II phosphorylation sites and 3 protein kinase C phosphorylation sites, playing essential roles in extracellular matrix (ECM) binding, ossification, osteoblast differentiation, cell adhesion, PI3K-Akt signaling pathway, focal adhesion, Toll-like receptor signaling pathway, and ECM-receptor interaction.</p><p><b>CONCLUSION</b>The bioinformatic method showed a high efficiency in analyzing microarray data and revealing internal biological information. SPP1 may play an important role in prostate cancer metastasis and become a novel biomarker for the diagnosis of prostate cancer metastasis and a new target for its treatment.</p>

Effects of diterpene phenol extract of Rosmarinus officinalis on TGFbeta1 and mRNA expressions of its signaling pathway molecules in the lung tissue of pulmonary fibrosis rats / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To investigate the regulative mechanism of the diterpene phenol extract of Rosmarinus Officinalis (DERO) on the imbalance of collagen metabolism of the lung tissue in pulmonary fibrosis rats.</p><p><b>METHODS</b>Fifty healthy Sprague-Dawley rats were randomly divided into the normal saline group (NS), the bleomycin-induced lung injury group (BLM), the low dose DERO group (at the daily dose of 50 mg/kg), the moderate dose DERO group (at the daily dose of 100 mg/kg), and the high dose DERO group (at the daily dose of 200 mg/kg), 10 in each group (abbreviated as DERO 1, 2, 3, respectively). The pulmonary fibrosis rat model was prepared by disposable intratracheal instillation of bleomycin. DERO was administered by gastrogavage as intervention during the repairing process of lung injury. On the morning of the 29th day, the rats' lung tissue was extracted. The karyocyte number, collagen protein, type I collagen (collagen I) and transforming growth factor-beta type II receptor (TGFbetaR II), Smad4 mRNA expressions were semi-quantitatively determined using tissue microarray, HE staining, collagen fiber dyeing, immunohistochemical assay, and in situ hybridization. Using real-time fluorescent quantification RT-PCR, the mRNA expression of transforming growth factor-beta1 (TGF-beta1) were detected.</p><p><b>RESULTS</b>Compared with the NS group, the collagen deposition of the lung tissue was obvious and the inflammatory infiltration was more severe in the BLM group (P < 0.05, P < 0.01). There was no statistical difference in the aforesaid 4 indices between the DERO1 group and the BLM group (P > 0.05). The collagen deposition and the inflammatory infiltration were obviously alleviated in the DERO2 and DERO3 groups (P < 0.05, P < 0.01). Compared with the NS group, the mRNA expressions of collagen-I, TGF-beta1 R II, Smad4, and TGF-beta1 were obviously up-regulated in the BLM group (P < 0.05, P < 0.01). Compared with the BLM group, the aforesaid four indices were not statistically changed in the DERO1 group (P > 0.05). But the mRNA expressions of collagen-I, TGF-beta1 R II, Smad4, and TGF-beta1 were obviously downregulated in the DERO2 and DERO3 groups (P < 0.05, P < 0.01). But the down-regulation of Smad4 expression was not obvious in the DERO2 and the DERO3 groups (P > 0.05). Compared with the DERO1 group, the mRNA expressions of collagen-I, TGF-beta1, R II, TGFbeta1 were all obviously lower in the DERO2 and the DERO3 groups (P < 0.05). But there was no statistical difference in the aforesaid 4 indices between the DERO2 group and the DERO3 group (P > 0.05).</p><p><b>CONCLUSIONS</b>DERO could regulate imbalanced collagen metabolism of pulmonary fibrosis. It could inhibit excessive deposition of collagen fibers, especially excessive deposition of collagen- I. Its mechanisms might be realized by inhibiting up-regulation of TGF-beta1 and TGFbetaR II mRNA expressions, thus interfering the activation of TGF-beta-Smad signaling pathway on target genes, especially on type I procollagen target gene.</p>