ABSTRACT
We used network pharmacology to predict the mechanism in the treatment of rheumatoid arthritis (RA) via modified Gan Cao Fu Zi Decoction (GCFZ), and validated the results of the analysis and explored the pharmacodynamic effects of GCFZ through animal experiments. Firstly, TCMID, SymMap, HERB, STITCH and GEO databases were utilized to obtain the target genes of GCFZ for the treatment of RA, which yielded a total of 1 250 differentially expressed genes for RA, 534 genes for GCFZ targets and 83 intersecting genes. Then functional enrichment analysis of the intersecting genes was performed through GO and KEGG databases, and the results revealed that GCFZ and its active ingredients mainly functioned through cytokine pathways, where chemokine signaling pathway and tumor necrosis factor (TNF) signaling pathway were enriched with a high number of genes. Cytoscape 3.8.0 software was used to construct the drug-target-disease network and screen key proteins, which included TNF, C-X-C chemokine ligand 8 (CXCL8), C-X-C chemokine ligand 10 (CXCL10), C-C chemokine ligand 5 (CCL5), C-X-C chemokine ligand 2 (CXCL2) and C-X-C chemokine receptor type 4 (CXCR4). The molecular docking technology was used to confirm the binding ability of the main active ingredients of GCFZ to the core proteins. Additionally, the therapeutic effects of GCFZ in low (4 g·kg-1), medium (8 g·kg-1) and high (16 g·kg-1) dose groups were investigated by constructing the collagen-induced arthritis (CIA) rat model. X-ray imaging approach, HE staining and Safranin O-Fast Green staining showed that GCFZ treatment significantly improved bone destruction, synovial hyperplasia and cartilage damage in CIA rats, while immunofluorescence results showed that GCFZ treatment could regulate the expression of TNF, CXCL8 and CCL5. In summary, our results indicate that GCFZ contains a variety of small molecule pharmacodynamic substances, which can exert therapeutic effects via multiple targets and pathways, and obviously reduce the symptoms of arthritis in CIA rats. This animal experiment of our research was approved by the Experimental Animal Management and Ethics Committee of Bengbu Medical College.
ABSTRACT
<p><b>OBJECTIVE</b>To evaluate the clinical effects of combined methods of minimally invasive percutaneous proximal humeral internal locking system (PHILOS) and injectable bone for the treatment of proximal humerus fractures in elderly patients.</p><p><b>METHODS</b>From January 2006 to January 2012, 80 patients with proximal humerus fractures were randomly divided into two groups (n = 40). The patients in the research group were treated with minimally invasive PHILOS fixation combined with injectable bone, including 20 males and 20 females, with an average age of (68.4 +/- 11.9) years; according to AO classification, 2 cases of type A1, 3 cases of type A2, 6 cases of type B1, 7 cases of type B2, 9 cases of type B3, 6 cases of type C1, 7 cases of type C2. The patients in the control group were treated with PHILOS fixation, including 18 males and 22 females, with an average age of (65.4 +/- 10.7) years; according to AO classification, 3 cases of type A1, 4 cases of type A2, 5 cases of type B1, 8 cases of type B2, 10 cases of type B3, 5 cases of type C, and 5 cases of type C2. The BMD, satisfactory rate, postoperative complications,bone healing time, Constant-Murley score in the two groups were reviewed and compared.</p><p><b>RESULTS</b>In the research group, no patients had necrosis of femoral head, 1 patient had shoulder varus, 1 patient had internal fixation loosening, 36 patients were satisfactory with the treatment results, BMD was (1.013 +/- 0.109) g/cm2, bone healing time averaged (12.00 +/- 3.79) weeks, and the Constant-Murley score was 97.2 +/- 4.6. In the control group, 3 patients had necrosis of femoral head, 5 patients had shoulder varus, 6 patients had internal fixation loosening, 32 patients were satisfactory with the treatment results, BMD was (0.812 +/- 0.089) g/cm2, bone healing time averaged (20.00 +/- 8.67) weeks,and the Constant-Murley score was 78.5 +/- 3.2. The results of BMD, satisfactory rate, postoperative complications, bone healing time, and Constant-Murley score in the research group were better than those of control group (P < 0.05).</p><p><b>CONCLUSION</b>PHILOS combined with injectable bone for the treatment of proximal humerus fractures in elderly patients has advantages of minimal wound, stable fixation, and earlier rehabilitation.</p>
Subject(s)
Aged , Female , Humans , Male , Middle Aged , Bone Plates , Fracture Fixation, Internal , Methods , Humerus , General Surgery , Injections , Retrospective Studies , Shoulder Fractures , General Surgery , Treatment OutcomeABSTRACT
<p><b>OBJECTIVE</b>To investigate the relationship between variable influence factors and postoperative 2 week hospital special surgery (HSS) of knee joint, thus offer the treatment suggestion to patients with osteoarthritis, and judge the comprehensive effective prognosis to the clinical patient.</p><p><b>METHODS</b>From March 2008 to August 2010, 72 patients with 72 knees were treated with TKA (treatment group), including 30 males and 42 females with a mean age of (71.9 +/- 6.2) years (ranged, 60 to 86 years). Twenty-two patients with HoldenIV OA treated by arthroscopy were in the control group, including 10 males and 12 females with a mean age of (70.5 +/- 5.9) years. The index including height, weight, BMI, muscle strength,knee joint HSS score and ROM were evaluated before operation and at 1st, 2nd weeks after operation.</p><p><b>RESULTS</b>The HSS knee score and ROMs of patients in the treatment group improved. The pre-operative ROM, HSS score, knee pain, continous passive motion (CPM) at different level (i.e.CPM initial angle) had a prominent positive correlation with HSS score in postoperative 2 weeks. The factors such as patients' age, height, weight, BMI, muscular strength, etc. had no obvious relevant to HSS score in postoperative 2 weeks.</p><p><b>CONCLUSION</b>The pre-operative HSS score, knee pain, knee ROM, perioperative severe complications, and postoperative CPM initial angle have a positive correlation with the postoperative effects.</p>