Mechanism of Tongbi Jiangu Prescription in Treatment of Knee Osteoarthritis Based on Network Pharmacology and Molecular Docking / 中国实验方剂学杂志

ObjectiveTo explore the mechanism of Tongbi Jiangu prescription （TBJG） in the treatment of knee osteoarthritis （KOA） based on network pharmacology and molecular docking，and further verify it by cell experiments. MethodThe active components and the corresponding targets of TBJG were screened out according to the traditional Chinese medicine systems pharmacology database and analysis platform（TCMSP）. The targets of KOA were obtained from GeneCards，online mendelian inheritance in man（OMIM）， and DrugBank. The common targets of active components of TBJG and KOA were the targets of TBJG against KOA. The active component-target network and protein-protein interaction （PPI） network were constructed by Cytoscape 3.7.2. STRING was used for PPI network analysis. DAVID was used for gene ontology （GO） and Kyoto encyclopedia of genes and genomes （KEGG） enrichment analyses. Key targets and core active components were selected for molecular docking by AutoDock. The results of network pharmacology were verified by cell experiments and the pharmacodynamic responses were observed. ResultThe prediction of network pharmacology showed that there were 111 active components of TBJG in the treatment of KOA. The core active components were quercetin，kaempferol， and β-sitosterol，and the key targets were interleukin-1β（IL-1β）， matrix metalloproteinase-3 （MMP-3），and tumor necrosis factor-α （TNF-α）. Biological processes （BP） in GO analysis mainly involved inflammatory response，response to lipopolysaccharide，apoptosis signaling pathway，and regulation of DNA activity in binding transcription factor. Cellular components （CC） included plasma membrane protein complex，RNA polymerase Ⅱ transcription factor complex，membrane raft，and serine/threonine protein kinase complex. Molecular functions （MF） were mainly enriched in cytokine receptor binding，nuclear receptor activity，protein domain specific binding，serine hydrolase activity，chemokine receptor binding，and activity of nitric oxide synthase regulator. As revealed by the KEGG analysis， the relevant signaling pathways were nuclear factor（NF）-κB， Janus kinase（JAK）/signal transducer and activator of transcription（STAT）， and Wnt signaling pathways. Molecular docking results showed that the core active components had good binding activities with key targets. The experimental results showed that TBJG could down-regulate IL-1β， MMP-3，TNF-α， and NF-κB p65 expression levels （P<0.05），and up-regulated NF-κB inhibitor（IκB）-α（P<0.05）. ConclusionThe mechanism of TBJG in the treatment of KOA lies in the application of active components such as quercetin，kaempferol， and β-sitosterol with IL-1β，MMP-3， and TNF-α as key targets through the NF-κB，JAK/STAT， and Wnt signaling pathways.

Treatment of senile lumbar spinal stenosis by unilateral approach and bilateral decompression with large channel endoscopy / 中国骨伤

OBJECTIVE@#To evaluate clinical effect of unilateral approach and bilateral decompression via large channel endoscopic system for the treatment of lumbar spinal stenosis.@*METHODS@#The clinical data of 32 patients with lumbar spinal tenosis treated by unilateral approach and bilateral decompression via large channel endoscopy from February 2018 to February 2019 were retrospectively analyzed. There were 18 males and 14 females, aged 65 to 84 years old with an average of (70.6± 8.4) years. The course of disease was from 1 to 12 years. All 32 cases were accompanied by numbness or pain in the lower limbs, of which 28 cases were accompanied by intermittent claudication. Narrow segments were L@*RESULTS@#All the patients were followed up for 12-24 (17.68±2.43) months and all operations were successfully completed with the operation time of 70-160(85.64±11.94) min. Spinal dural tear occurred in 1 case during the operation, and sensory disturbance in the other side of lower limb in a short period of time occurred in 2 cases, all improved after corresponding treatment. Postoperative imaging showed that the spinal canal was significantly enlarged and the nerve root was fully released. Before operation and 3 days, 3 months, 1 year after operation, VAS scores of low back pain were 4.62 ±1.41, 2.73 ±1.35, 1.21 ±1.17, 1.11 ±0.34, respectively;VAS scores of leg pain were 6.83 ± 1.71, 3.10±1.50, 1.08±0.19, 0.89±0.24, respectively. VAS scores of low back pain and leg pain each time point after operation were obvious improved (@*CONCLUSION@#It is a safe and effective way to treat lumbar spinal stenosis with unilateral approach and bilateral decompression via large channel endoscopic system. It has the advantages of sufficient decompression, less trauma, fast recovery, high safety and low incidence of postoperative complications. It can minimize the damage to the stable structure of the lumbar spine and is an ideal minimally invasive operation for the treatment of lumbar spinal stenosis.

Interpretation of Expert consensus on Shujin Jianyao Pills in clinical practice / 中国中药杂志

Shujin Jianyao Pills is a kind of concentrated honey pills made of 13 Chinese herbal medicines, such as Cibotii Rhizoma, Rosae Laevigatae Fructus, and Spatholobi Caulis. It has the effects in tonifying liver and kidney, strengthening muscles and bones, removing wind and dampness, activating collaterals and relieving pain. Under the leadership of the Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences and Wangjing Hospital of China Academy of Chinese Medical Sciences, the Expert consensus on clinical application of Shujin Jianyao Pills was developed by 22 universities, scientific research institutes and hospitals. This consensus formed 1 recommendation and 9 consensus suggestions, which were based on evidence and oriented to clinical practice. The expert consensus had a new understanding of the indications of Shujin Jianyao Pills, especially the applicable Western medicine diseases, the advantages and characteristics of treatment, the time of intervention, the applicable syndromes, the precautions and contraindications of medication. The indications were detailed and expressed as the combination of disease, symptom and syndrome. And it filled in the gaps of package inserts in applicable syndrome and special population medication in the process of drug use. The expert consensus showed the optimization of precautions and contraindications, and more detailed description of drug safety. Therefore, it provides guidance and reference for clinicians to use Shujin Jianyao Pills rationally.

Expert consensus on Shujin Jianyao Pills in clinical practice / 中国中药杂志

Shujin Jianyao Pills is a Chinese patent medicine, with anti-inflammation, analgesic and anti-osteoporotic effects. Based on a questionnaire investigation of clinicians and a systematic review of study literatures on Shujin Jianyao Pills, the international clinical practice guidelines development method was adopted to analyze the optimal available evidences and expert experiences in the "evidence-based, consensus-based and experience-based" principles. Expert consensus on Shujin Jianyao Pills in clinical practice(GS/CACM267-2019) was developed by more than 30 multidisciplinary experts nationwide with the aim to guide and standardize the rational use of Shujin Jianyao Pills among clinicians and improve the clinical efficacy and safety. The expert consensus adopted the internationally recognized recommendation criteria for classification of evidence--GRADE. Expert consensus was formed by the nominal group method. Six main considerations were quality of evidence, curative effect, safety, economical efficiency, patient acceptability and other factors. If there were sufficient evidences, a "recommendation" was given, and GRADE grid voting rule was adopted. If there wasn't sufficient evidence, a "consensus opinion" was formed, and the majority counting rule. According to the indication, usage and do-sage, drug use for special population and safety of Shujin Jianyao Pills, one recommendation and nine consensus opinions were put forward. By means of expert meetings and correspondence, a nationwide consultations and peer reviews were conducted. This consensus is applicable to clinicians in hospitals and grass-roots health services, and provides guidance and reference for the rational use of Shujin Jianyao Pills.

Preparation instructions for Experts consensus statement on Cheezheng Xiaotong Tiegao in clinical practice / 中国中药杂志

As a topical plaster developed by modern pharmaceutical technology based on traditional Tibetan medicine,Cheezheng Xiaotong Tiegao has functions of promoting blood circulation,relieving swelling and relieving pain. Since its introduction in 1993,it has been widely used in the treatment of various types of acute and chronic musculoskeletal pain and various types of spinal,joint and soft tissue diseases. In order to better standardize the clinical application and improve the clinical efficacy of Cheezheng Xiaotong Tiegao,the research and development work of the Experts consensus statement on Cheezheng Xiaotong Tiegao in clinical practice was officially launched on October 19,2017,upon approval from China Association of Chinese Medicine. In this paper,main R&D process and related technical links for the experts consensus on Cheezheng Xiaotong Tiegao would be summarized,which will help the various medical workers understand,master and apply more accurately,and also provide reference for the development of experts consensus on clinical application of other topical Chinese medicines.

The therapeutic effects of Yougui pill on knee osteoarthritis and the expression of Wnt signal pathway related factors in rats / 中国应用生理学杂志

OBJECTIVES@#To observe the effects of Yougui pill (Traditional Chinese Medicine) on the related factors of Wnt signal pathway of rats with knee osteoarthritis (KOA), and explore its protective mechanism.@*METHODS@#Sixty SPF SD rats were randomly divided into the sham-operative group, model group, glucosamine sulfate group, high-dose, middle-dose, low-dose of Yougui pill treated group (=10). KOA model was established by modified Hulth method for six weeks. The rats in the high, middle and low-dose of Yougui pill group were treated with Yougui pills at the doses of 20,10 and 5 g/kg respectively by gastrogavage once a day for 8 weeks, while equal volume of normal saline was given to those in the sham and model control group and an equal volume of glucosamine sulfate (1.7 g/kg·d) was given to those in glucosamine sulfate group for 8 weeks. The knee joint was removed after the last dose of drug. The pathological changes of cartilaginous tissues were observed under a microscope. The mRNA levels of Dickkopf homolog 1(DKK1), Wnt induced secreted protein 1(WISP1), Wnt1, low density lipoprotein receptor related protein 5(LRP5) and beta -catenin in rats cartilaginous tissues were analyzed by using RT-PCR method, and the protein contents of DKK1, WISP1, Wnt1, LRP5 and beta-catenin in cartilaginous tissues were detected by Western blot.@*RESULTS@#Compared with the sham group, the articular cartilage was severely damaged, the Mankin score was increased significantly (<0. 05), the mRNA and protein expression levels of DKK1 in cartilaginous tissue were markedly decreased(<0.05), while those of WISP, Wnt1, LRP5 and beta-catenin were increased significantly in model group(<0.05). Compared with model group, the articular cartilage lesions was light (<0.05), the Mankin Score was decreased significantly(<0.05), and the mRNA and protein levels of DKK1 in cartilaginous tissue were increased(<0.05), while those of WISP, Wnt1, LRP5 and beta-catenin were decreased in Yougui pill high-dose group and glucosamine sulfate group (<0.05).@*CONCLUSIONS@#Yougui pill has protective effects on the KOA by inhibiting the expressions of WISP, Wnt1, LRP5, beta-catenin and increasing the expression of DKK1 cytokine in the Wnt signaling pathway.

Long non-coding RNA for metabolism of bone tissue / 中国骨伤

The mechanism of metabolism of bone and cartilage are one of focus of orthopedic knowledge, and its clinical and basic study plays an important role in preventing and treating osteoporosis, degeneration of bone and joint, bone tumor. At present, the mechanism of metabolism of bone and cartilage studied from protein, signal pathway to mRNA transcription factor regulation. As a new regulatory factor for non-coding proteins, long non-coding RNA(LncRNA) participates in physiological and pathological process. In recent years, a large number of researche showed that LncRNA plays an important role in metabolism of bone and cartilage, and proved LncRNA participates in development and conversion of bone metabolism. With the exposure of function chennel and target of LncRNA, the key role of LncRNA in bone metabolism were proved constantly. The paper concluded biological characteristics of LncRNA, function and target spot of LncRNA in bone and cratilage metabolism, and in further state gene regulatory mechanism of bone and cartilage metabolism, explore diagnosis and treatment, provide new thought and treatment target for bone metabolism.

Clinical Application Status of TCM for Prevention and Treatment of Osteonecrosis of Femoral Head / 中国中医药信息杂志

Osteonecrosis of the femoral head (ONFH) is a common refractory disease in orthopedics, and the rate of disability is very high, and its pathogenesis is unknown. TCM has unique advantages in the prevention and treatment of ONFH, and it has gradually received attention. This article reviewed the clinical application status of TCM for prevention and treatment of ONFH in recent years from ONFH's TCM name, etiology, pathogenesis, syndrome differentiation, and clinical treatment, with a purpose to provide a reference for the clinical treatment of ONFH.

Chemical constituents of Gendarussa vulgaris / 中草药

Objective To study the chemical constituents of Gendarussa vulgaris. Methods The chemical constituents were isolated and purified with silica column chromatography and gel chromatography, etc. Their structures were identified by physico- chemical properties and various spectroscopic methods including NMR spectrum, MS, UV, etc. Results A total of 16 compounds were isolated and elucidated as daucosterol (1), 6″-O-acetylisavitexin (2), 9,10-dihydroxy-4,7-megastigmadien-3-one (3), 22E,24R-ergosta- 7,22-diene-3β,5α,6β,9α-tetraol (4), isorhamnetin (5), quercetin (6), eleutheroside E (7), gusanlung A (8), gusanlung B (9), betulin (10), isovitexin-2″-O-rhamnoside (11), isovitexin (12), genkwanin (13), apigenin (14), quercetin 3-O-β-D-glucuronide (15), and 2-(4-hydroxy-3-methoxyphenyl)-3-(2-hydroxy-5-methoxyphe-nyl)-3-oxo-1-propanol (16). Conclusion Compounds 3, 5, 11, 12 and 15 are isolated from G. vulgaris for the first time. Compound 2, 4, 13, and 16 are isolated from the plant of genus for the first time.

Concepts, characteristics and values of precision medicine in the field of orthopedics / 中国组织工程研究

BACKGROUND: Precision medicine pays attention to the depth characteristics of the disease and the high precision of the treatment, and is a precise and accurate personalized approach of the diagnosis and treatment of the disease. In recent years, it has gradually become the hotspot of the medical field. As a new concept of medicine and medical model, its value in clinical treatment of orthopedics has been gradually highlighted. OBJECTIVE: To summarize the current status and progress of precision medicine in the field of orthopedics.METHODS: A computer-based search of PubMed and CNKI databases was performed for literatures about application and prospect of precision medicine in the field of orthopedics in and outside China published within the past 10 years using the keywords of "precision medicine, Orthopedics, bone, 3D printing, computer assisted navigation, minimal invasive, gene". RESULTS AND CONCLUSION: (1) In the study on the prevention and treatment of the disease of orthopedics, 3D printing technology, computer assisted navigation technology, precision minimally invasive orthopedic technology, and gene research are four effective way to achieve precise and personalized healthcare. (2) The appearance of precision medicine, a novel medicinal model, enriches the treatment of the disease in the field of orthopedics and enhances the curative efficacy of the disease. Precision medicine brings the new dawn to the patient and provides some new clues for medical workers and researchers engaged in the clinical and basic research of the disease in the field of orthopedics.

Precision medicine of osteonecrosis of the femoral head: concepts and patterns / 中国组织工程研究

BACKGROUND: In recent years, precision medicine has become a hot topic in the medical field. The application of precision medicine to osteonecrosis of the femoral head is wider than before. OBJECTIVE: To summarize the current status and progress of precision medicine to osteonecrosis of the femoral head. METHODS: A computer-based search of PubMed and CNKI databases was performed for literatures about application and prospect of precision medicine for osteonecrosis of the femoral head in and outside China published within the past 10 years using the keywords of "precision medicine, osteonecrosis of the femoral head, three dimensional (3D) printing, computer assisted navigation, minimal invasive, gene" in English and Chinese. RESULTS AND CONCLUSION: (1) In the study on the prevention and treatment of osteonecrosis of the femoral head, 3D printing technology, computer assisted navigation technology, precision minimally invasive orthopedic technology, research and treatment of gene are four effective ways to achieve precise and personalized healthcare. (2) The appearance of precision medicine, a novel medicinal model, enriches the treatment of osteonecrosis of the femoral head and enhances the curative efficacy of the disease. It brings the new dawn to the patient and provides some new clues for medical workers and researchers engaged in the clinical and basic researches of osteonecrosis of the femoral head.

The Observation on the Effect of Q-Switching Nd:YAG Treatment in Pigmented Dermatoses and Influence for Melanin Metabolism / 昆明医科大学学报

Objective To observe the effect of Q-Switching Nd:YAG treatment in pigmented dermatoses and its influence for melanin metabolism. Methods 114 patients with pigmented dermatoses in our hospital from October 2015 to August 2016 were selected as the study object,and were randomly divided into the control group (57 cases) and the observation group (57 cases).The control group were treated with intense pulsed light therapy while the observation group were treated with Q-Switching Nd:YAG treatment on the treatment of control group. Then the total effective rates,recurrence rates,adverse reaction rates,skin lesion scores and serum melanin metabolism related indexes before and after the treatment of two groups were analyzed and compared. Results Clinically, the total effective rates of observation group were higher than those of control group ( <0.05)and the recurrence rate of observation group was lower than that of control group ( <0.05) .The adverse reaction rates of two groups were compared and the differences were not statistically significant ( >0.05) .The skin lesion scores and serum melanin metabolism related indexes of two groups before the treatment were compared and the differences were not statistically significant (>0.05) .The serum melanin metabolism related indexes of two groups after the treatment were all better than those of control group ( <0.05) . Conclusion The clinical effect of Q-Switching Nd:YAG treatment in the patients with pigmented dermatoses is better, and it has the active influence for the melanin metabolism,so it has higher clinical value in the treatment of pigmented dermatoses.

Chemical constituents from Gnaphlium affine / 中草药

Objective: To investigate the chemical constituents from the stems of Gnaphlium affine. Methods: The constituents were isolated and purified by silica gel, Sephadex LH-20 column chromatography, and preparative TLC. The structures were identified on the basis of spectral data and physiochemical characteristics. Results: Fifteen compounds were isolated from 70% ethanol extracts of G. affine and identified as 3-methoxyphenol1-O-α-L-rhamnopyranosyl-(1→6)-O-β- D-glucopyranoside (1), 3', 5-dihydroxy-2-(4- hydroxybenzyl)-3-methoxybibenzyl (2), physcion (3), aldehyde (4), luteolin-4'-O-β-D-glucoside (5), faradiol 3-O-palmitate (6), betulinic acid (7), anabellamide (8), 4-O-D-glucopyranosyl-p-coumaric acid methyl ester (9), valene-1 (10)-ene-8, 11-diol (10), longumoside A (11), grossamiade K (12), quercetin-3-O-rutin-7-O-glucoside (13), luteolin-7-O-β-D-glucopyranosyl-(1→6)-[(6'''- O-caffeoylquinic)-β-D-glucopyranoside] (14), and isoverbascoside (15). Conclusion: Compounds 2 and 11 are reported from the plants in Gnaphalium L. for the first time. Compounds 2, 3, 6, 8, 13, and 14 are isolated from this plant material for the first time.

Chemical constituents of whole plant of Oxalis pes-caprae L / 中国药学杂志

OBJECTIVE: To study the chemical constituents of Oxalis pes-caprae L. METHODS: The chemical constituents were isolated and purified with silica column chromatography and gel chromatography, etc. Their structures were identified by physicochemical properties and various spectroscopic methods including NMR spectrum, MS, UV, etc. RESUTLS: Twelve compounds were isolated from the ethyl acetate part, among which 10 compounds were elucidated as daucosterol(1), β-sitosterol(2), vitexin(3), isovitexin(4), acacetin(5), robinin(6), β-tocopherol(7), tartaric acid(8), vanillic acid(9), and luteolin(10). CONCLUSION: All compounds are isolated from Oxalis pes-caprae L. for the first time.

Chemical constituents of Arisaema rhizomatum / 中国药学杂志

OBJECTIVE: To investigate the chemical constituents of Arisaema rhizomatum.

In vitro and in vivo antioxidant properties of the total flavonoids from Lithocarpus polystachyus Rehd / 中国药学杂志

OBJECTIVE: To examine the antioxidant properties of the total flavonoids from Lithocarpus polystachyus Rehd (TFL) in vitro and in vivo. METHODS: The TFL was obtained by ultrasound-assisted extraction with 70% ethanol and purified with D-101 macroreticular resin. DPPH, ABTS, reducing power and ORAC of TFL were analyzed for antioxidant activity in vitro, with VC and rutin as control. Acute liver injury mice model was induced with carbon tetrachloride (CCl4), the effect of TFL on the superoxide dismutase (SOD), catalase (CAT), glutathione (GSH) and malondialdehyde (MDA) levels were examined. RESULT: At 1 mg·mL-1 of TFL, the DPPH and ABTS radicals-scavenging activities was 81.25% and 85.54% respectively, while the reducing power was slightly lower than that of VC but higher than that of rutin. In the concentration of 1%, 2% and 3%, the value of ORAC was 47.86, 65.43 and 81.9 μmol TE·g-1 respectively. In mice with CCl4-induced actute liver injury model, TFL at the concentration of 100, 200 and 400 mg·mL-1 significantly decreased the MDA content, and increased the activities of SOD, CAT and GSH. CONCLUSION: The total flavonoids from Lithocarpus polystachyus Rehd. have a strong antioxidant effect.

Flavonoid constituents of whole plant of Kummerowia striata / 中国药学杂志

OBJECTIVE: To study the chemical constituents of Kummerowia striata. METHODS: The chemical constituents were isolated and purified with silica column chromatography, gel chromatography, etc. Their structures were identified by physicochem-ical properties and various spectroscopic methods including NMR spectrum, MS, UV, etc. RESULTS: Fourteen compounds were isolated and elucidated as quercetin-3-O-α-L-rhao pyranoside(1), kaempferol-3-O-α-L-rhamopyra noside(2), apigenin(3), quercetin(4), quercetin-3-O-β-D-galactopyranside(5), luteolin-7-O-β-D-glucoside (6), luteolin(7), campherol-3-O-D-sophoroside(8), isoorientin (9), orientin(10), apigenin-7-O-β-D-glucuronide methylester(11), 7-hydroxy-4′-methoxy isoflavone(12), tricin(13), and tricin-7-O-β-D-glucopyranoside(14). CONCLUSION: Compounds 1, 2, 5, 6, 8, 9, and 10-14 are isolated from Kummerowia striata for the first time.

Study on impact of ethanol extracts from Sedum sarmentosum in inhibiting STAT-3 signaling and inducing apoptosis of human hepatocellular carcinoma cell line HepG2 / 中国中药杂志

<p><b>OBJECTIVE</b>To investigate the impact of ethanol extracts from Sedum sarmentosum (ESB) on STAT-3 signaling and its probable molecular mechanism in inducing apoptosis.</p><p><b>METHOD</b>MTT assay was used to detect the impact of ESB on HepG2 cell proliferation. FITC-Annexin V-FITC /PI double-labeling were used to investigate the impact on hepatoma carcinoma cell apoptosis. Western blot analysis was used to test the expression levels of cell apoptosis-related proteins Caspase-3, Caspase-9, PARP, P-STAT-3 (Tyr705) , STAT-3, Bcl-2, Mcl-1.</p><p><b>RESULT</b>ESB could notably inhibit proliferation of HepG2 cells, and induce HepG2 cell apoptosis, with the dose-dependent inhibitory effect. In addition, ESB could inhibit STAT-3 signaling, down-regulate Mcl-1 and Bcl-2 expressions, and induce degradation/activation of apoptosis-related proteins Caspase-3 and Caspase-9 and PARP degradation in a dose-dependent manner.</p><p><b>CONCLUSION</b>ESB inhibits HepG2 cell proliferation and induces apoptosis by inhibiting STAT-3 signaling and Mcl-1 and Bcl-2 expressions.</p>

Update of research on minimally invasive treatment of lumbar disc herniation / 中国骨伤

There has been rapid progress in endoscopy-and imaging technology-based minimally invasive surgery for the treatment of lumbar disc herniation (LDH). It is advategeous over conventional surgery in that it not only reduces surgical trauma but relieves sufferings of patients. However, endoscopy-and imaging technology-based minimally invasive surgery cannot completely replace traditional surgery at present because of its limited indications. How to expand the indications and solve the practical problem of lumbar reconstruction remains to be the direction of future breakthrough. This article is a summary of the progress and current situation of minimally invasive percutaneous and endoscopic techniques for the treatment of LDH.

Research progress of gene therapy in the treatment of non-traumatic osteonecrosis of femoral head / 中国骨伤

There are many methods of conservative treatment for early non-traumatic osteonecrosis of femoral head, but still lack of a mature and effective treatment. Gene therapy is a new treatment method for non-traumatic osteonecrosis of femoral head in recent years. This article showed that the non-traumatic osteonecrosis of femoral head related to progress and problems on pathogenesy, molecular biology foundation, exogenous theoretical gene,carrier selection and so on, discussed some problems and countermeasure and future applications.