Relationship Between Intestinal Flora and Bone and Joint Diseases and Regulation of Traditional Chinese Medicine： A Review / 中国实验方剂学杂志

Intestinal flora is the largest microbial community in human body， which consists of more than 1 000 species. Its structure and metabolites change dynamically with the age， diet and intestinal environment of the host. Study shows that the intestinal microbes play a pivotal role in regulating human physiological and pathological processes， and intestinal flora imbalance may be the key factors affecting the occurrence and development of bone and joint diseases， including osteoporosis， osteoarthritis， rheumatoid arthritis and gouty arthritis. At present， calcitonin， estrogen， nonsteroidal anti-inflammatory drugs， immunosuppressants， xanthine oxidase inhibitors and other western drugs are mostly used to treat the above diseases. However， long-term use of western drugs leads to poor compliance and obvious gastrointestinal adverse reactions among patients. Traditional Chinese medicine （TCM） predominates in the treatment of bone and joint diseases due to its low price， high efficacy and slight side effects， with the advantages of multi-targets， multi-mechanism and multi-levels. In recent years， many scholars have carried out experiments and clinical studies on the treatment of bone and joint diseases by TCMs on the basis of the liver and kidney theory such as "tonifying liver and kidney and strengthening muscles and bones". Gratifying results have been achieved. However， the mechanism of action has not been fully clarified. Intestinal flora becomes a hot spot in medical research， and a close relationship between intestinal flora and bone and joint diseases has been unveiled. Relevant literature in China and abroad showed that TCM has a significant effect on the treatment of bone and joint diseases by regulating intestinal flora. In this paper， the relationship between intestinal flora and bone and joint diseases was summarized and the intervention of TCM active ingredients and compounds on intestinal flora was reviewed to facilitate the prevention and treatment of bone and joint diseases by TCM.

Comparison of clinical effect of two different Kirschner wire fixations after closed reduction on supracondylar fracture of humerus in children with GartlandⅡand Ⅲ / 中国骨伤

OBJECTIVE@#To compare clinical effect of Kirschner wire radial sector fixation and bilateral ulnar radial cross fixation in treating supracondylar fracture of humerus in children after closed reduction.@*METHODS@#From March 2017 to December 2018, 60 children with supracondylar fracture of humerus treated with closed reduction and Kirschner wire fixation were analyzed retrospectively, and divided into two groups according to different needling methods. Thirty patients in radial three needles fan fixation group (group A), including 19 males and 11 females, aged from 2 to 10 years old with an average of (5.00±2.10) years old, 21 patients were typeⅡ and 9 patients were typeⅢ according to Gartland classification. Thirty patients in cross fixationwith 3 needles on both ulnar and radial side group(group B), including 22 males and 8 females, aged from 1 to 9 years old with an average of(5.13±2.08) years old, 19 patients were typeⅡand 11 patients were typeⅢ. Healing time of fracture, postoperative complications, elbow flexion and extension activity, forearm rotation activity recovery, elbow carrying angle and angle loss after operation between two groups were observed and compared. Mayo Elbow function score at the final following up was used to evaluate clinical efficacy.@*RESULTS@#All patients were followed up, while there were no significant difference in follow-up time and fracture healing time between two groups (@*CONCLUSION@#Closed reduction and Kirschner wire at the early stage of fracture has advantages of less trauma, easy reduction, stable fixation, and early functional exercise. The risk of iatrogenic ulnar nerve injury caused by fan-shaped fixation of three radial needles is less than that of cross fixation of three radial needles.

A prospective study on the association between body mass index and all-cause mortality in type 2 diabetic patients / 中华疾病控制杂志

Objective The aim is to investigate the association between body mass index (BMI) and risk of all-cause mortality among patients with type 2 diabetes. Methods A total of 17 638 patients with type 2 diabetes registered in the management of National Basic Public Health Services in two areas of southern and northern Jiangsu were recruited. Cox proportional risk regression model was used to calculate the hazard ratio(HR) value and 95% confidence interval (95% CI) of different BMI groups in the follow-up period. Results The subjects were followed up for a total of 77 451 person-years with an average duration of 4.39 years, and 1 274 patients died during the follow-up period. The number of death in low weight group (BMI<18.5 kg/m2), normal weight group (18.5 kg/m2≤BMI<24 kg/m2), overweight (24 kg/m2≤BMI<28 kg/m2) and obese group (BMI≥28 kg/m2) were 39, 575, 484 and 176 respectively.The corresponding mortalities were 15.6%, 9.5%, 6.2% and 5.1%, respectively. Compared to normal weight group, the adjusted HR of all-cause mortality in low weight, overweight and obese group were 1.66 (95% CI: 1.20-2.30), 0.68 (95% CI: 0.61-0.77), 0.58 (95% CI: 0.48-0.68), respectively. Conclusions Low-weight patients have the highest risk of all-cause mortality compared with normal counterparts, while both overweight and obese people have a lower risk of death. Overweight and obesity may reduce the risk of all-cause mortality in type 2 diabetic patients.

Different level of fasting blood glucose and cardiovascular risk factors clustering among population of Jiangsu Province / 中华疾病控制杂志

Objective To analyze the clustering of major cardiovascular risk factors among population with different level of fasting blood glucose (FBG) in Jiangsu provincial communities. Methods A population-based screening project was conducted during 2015-2017, with 83 522 residents aged 35-75 years from 6 areas included in the study. Prevalence and the clustering of four cardiovascular risk factors (hypertension, obesity, dyslipidemia and smoking) were analyzed. Binary Logistic regression analysis was performed to explore the relationship between FBG and cardiovascular risk factor clustering. Results The prevalence of diabetes was 18.9% among adults aged 35-75 years in Jiangsu province, and 41.4% of them were aware of their disease. Among undiagnosed population, the odd ratios (OR) of cardiovascular risk factors clustering in impaired fasting glucose (IFG) and hyperglycemia group was 1.29 (OR=1.29，95% CI:1.24-1.36，P<0.001) and 1.99 (OR=1.99，95% CI:1.89-2.08，P<0.001), compared with normal FBG group. The control rate of FBG was 15.5% among diagnosed cases. There was no difference in the risk clustering between diabetes patient with and without control of FBG. Conclusions Hyperglycemia and IFG increase the risk of cardiovascular risk factor clustering. Comprehensive interventions should be served as an important role to keep blood glucose at a normal level in high-risk population.

Vitamin D receptor genetic polymorphisms and tuberculosis among Chinese Han ethnic group / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>In epidemiological studies, tuberculosis (TB) appears intimately with vitamin D insufficiency whereas its relationship with vitamin D receptor (VDR) polymorphism caused by radical difference remains unspecified. This study aimed to investigate the relationship between vitamin D genetic polymorphism and tuberculosis in Han ethnic group.</p><p><b>METHODS</b>Meta-analysis was adopted in the synthetic quantitative analysis of documents home and abroad on the relationship between vitamin D genetic polymorphisms and tuberculosis, which were openly published during June 2000 to January 2010. Random effect model and fixed effect model analyses were used to calculate the incorporated odds ratio (OR) based on the heterogeneity test data.</p><p><b>RESULTS</b>A total of 6 eligible studies were included in this analysis. The FokI-ff genotype showed a significant marginal association (Fixed effect model: OR 1.91, 95%CI 1.44-2.52; Random effect model: OR 1.91, 95%CI 0.94-3.88), yet TaqI polymorphisms was not significantly related to TB.</p><p><b>CONCLUSION</b>The interaction between FoKI genotype polymorphism and TB observed demonstrates that vitamin D deficiency might exist as a risk factor during the development of TB in Han ethnic group and more evidences needed to validate the conclusion.</p>

Advancement in the research of mechanism of endogenous cellular injury in visceral complications as complications after severe burn / 中华烧伤杂志

It is of great importance to know the endogenous mechanism in burn-induced organ injuries, not only for the understanding of pathophysiological processes after burn, but also for guiding the clinical treatment. Recent studies have widened and deepened our scope and understanding of secondary injuries to various organs. However, a unanimous understanding of molecular pathway involved in all burn-induced organ injuries has not been attained. Relatively, the mechanism of endogenous cellular injuries as a result of burn injury could be regarded as a common one to explain the causation of cellular injury, and to guide the prevention and treatment for the burn-induced complications using cytoprotection strategy. This review summarized four aspects of the mechanism of endogenous cellular injuries, including cellular injuries induced by ischemic/hypoxic-oxidative stress, excessive inflammatory factors released by inflammatory cells, immunosuppression caused by suppression of function of adaptive immune cells, and dysfunction of important supportive cells of various organs.

Effect of hydrogen-rich saline on blood pressure and antioxidant ability of lung tissue in scalded rats following delayed resuscitation / 中华烧伤杂志

<p><b>OBJECTIVE</b>To study the effect of hydrogen-rich saline on blood pressure and antioxidant ability of lung tissue in scalded rats following delayed resuscitation.</p><p><b>METHODS</b>The hydrogen-rich saline was prepared (hydrogen-saturated normal saline with hydrogen concentration of 0.6 mmol/L). Twenty SD rats were divided into hydrogen-rich saline group (HS) and normal saline group (NS) according to the random number table, with 10 rats in each group. All the rats were subjected to 30% total body surface area (TBSA) full-thickness scald. Rats in HS and NS groups were infused with hydrogen-rich saline or normal saline with one half of the total fluid replacement volume as calculated according to the Parkland formula (4 mL×kg(-1)×%TBSA(-1)) at post scald hour (PSH) 7 and one-quarter of the volume at PSH 9 and 17 respectively. The general condition of rats during the experiment was observed. The systolic pressure of rats was measured at PSH 6 and 24. All rats were sacrificed at PSH 24 to collect lung tissue for detecting superoxide dismutase (SOD) inhibition ratio and malondialdehyde (MDA) level. Data were processed with t test.</p><p><b>RESULTS</b>All rats survived through the experiment. The systolic pressure of rats in HS group and NS group was respectively (87 ± 4) mm Hg (1 mm Hg = 0.133 kPa) and (86 ± 5) mm Hg at PSH 6, and the values were close (t = 0.213, P = 0.834); however the systolic pressure at 24 h was higher in HS group than in NS group [(124 ± 7) mm Hg vs. (115 ± 6) mm Hg, t = 2.958, P = 0.008]. SOD inhibition ratio of lung tissue in HS group [(0.465 ± 0.014)%] was higher than that in NS group [(0.358 ± 0.021)%, t = 11.767, P = 0.000]. MDA level of lung tissue in HS group [(922 ± 196) pmol/mg] was lower than that in NS group [(1118 ± 212) pmol/mg, t = -2.142, P = 0.046].</p><p><b>CONCLUSIONS</b>Delayed resuscitation for scalded rats with hydrogen-rich saline is helpful in the recovery of systolic pressure, and it can ameliorate lung tissue injury caused by reperfusion through enhancing the effect of antioxidase.</p>

Transarterial oily chemoembolization combined with interstitial laser thermotherapy for treatment of hepatocellular carcinoma / 南方医科大学学报

<p><b>OBJECTIVE</b>To evaluate the therapeutic effects and adverse effects of transarterial oily chemoembolization combined with interstitial laser thermotherapy (TOCE+ILT) in the treatment of hepatocellular carcinoma.</p><p><b>METHODS</b>Totally 120 patients with hepatocellular carcinoma were randomized into two groups and received interventions with TOCE+ILT or TOCE combined with percutaneous ethanol injection (TOCE+PEI). The treatment was repeated when necessary until the tumor was completely ablated, after which the therapeutic effects were evaluated and the patients were the followed up for observing long-term clinical outcome.</p><p><b>RESULTS</b>Of the 120 patients enrolled in this observation, 105 were followed up for two years (54 in TOCE+ILT group and 51 in TOCE+PEI group). The complete tumor necrosis rate of TOCE+ILT group was significantly higher than that of the TOCE+PEI group (84.8% vs 73.9%,Chi(2)=4.405, P=0.036), and TOCE+ILT was associated with a significantly higher negative conversion rate of AFP positivity (77.8% vs 56.1%, Chi(2)=4.592, P=0.032). The 1-year survival rate were similar between two groups, but the 2-year survival rate was significantly higher in patients with TOCE+ILT (79.6% vs 60.8%, Chi(2)=4.477, P=0.034). The hepatic function was comparable between the two groups before treatment, and 1 week after treatment, the ALT level in patients undergoing TOCE+ILT was significantly lower than that in patients with TOCE+PEI (95.90-/+56.06 U/L vs 116.31-/+45.27 U/L, t=2.04, P=0.043). Post-embolization syndrome was observed in the patients in two groups, but no severe adverse events were found.</p><p><b>CONCLUSION</b>TOCE+ILT has good therapeutic effects and mild side effects in the treatment of hepatocellular carcinoma.</p>

The diagnosis and therapy of intractable upper gastrointestinal hemorrhage caused by hepatic arterioportal vein fistulas in hepatocellular carcinoma / 中华放射学杂志

Objective To investigate the hemodynamics of increasing portal venous pressure(PVP) in hepatocellular carcinoma patients complicated with hepatic arterioportal vein fistulas (HAPVF)and the diagnosis and therapy of intractable upper gastrointestinal hemorrhage caused by HAPVF.Methods One hundred and fifteen cases of hepatocellular carcinoma with upper gastrointestinal hemorrhage were checked by hepatic arteriography and were treated through orifices embolization in cases with severe HAPCF by coils and/or ethanol. Results Twenty-six out of 31 patients suffering intractable upper gastrointestinal hemorrhage have severe HAPVF(the main stem of portal veins are visible).However,there are only 15 patients with light HAPVF among the 84 patients who have mild upper gastrointestinal hemorrhage (the main stem of portal veins are invisible).After the embolization,all of the 26 patients who have severe HAPVF stopped bleeding.Among them,the main stem of hepatic arteries are occluded in 2 patients. Conclusion The existence of severe HAPVF should be taken into consideration when intractable upper gastrointestinal hemorrhage occurs in hepatocellular carcinoma patients,and it can be diagnosed through hepatic artery DSA.Orifice embolization is the most effective method for such kind of hemorrhage.