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Osteonecrosis of the femoral head （ONFH） is a painful and debilitating disease caused by impaired blood supply to the femoral head and cellular and tissue degeneration， leading to gradual destruction of the bone structure and progressive collapse of the femoral head. The main pathological mechanism of ONFH is the disruption of the balance between bone absorption and the reconstruction of new bone， resulting from microcirculation damage and decreased cellular tissue ability. This imbalance leads to biomechanical changes and accelerates the pathological progression of ONFH. In the early stages， clinical manifestations may not be obvious， mainly presenting as pain or discomfort in the hip or groin area， which can be relieved after rest. In the later stage of the disease， pain intensifies， and limb shortening， lower limb weakness， difficulty walking， or limping may occur. Currently， western medicine commonly uses osteogenic agents， anticoagulants， and artificial joint replacement for treatment， but there are also many issues such as prosthesis loosening and infection. Research has shown that traditional Chinese medicine （TCM） treatment of ONFH takes a holistic approach and employs multi-functional， multi-target， and multi-system Chinese medicine therapies， ensuring the safety and effectiveness of the treatment. The osteoprotegerin （OPG）/receptor activator of nuclear factor-κB （RANK）/RANK ligand （RANKL） signaling pathway plays a crucial role in maintaining the dynamic balance of bone remodeling. TCM treatments utilize this pathway to promote apoptosis of osteoclasts， reduce bone resorption， and accelerate bone formation， thereby playing an important role in the prevention and treatment of ONFH. This paper reviewed the role of OPG/RANK/RANKL signaling pathway and related cytokine expression in ONFH by reviewing relevant literature in China and abroad and research status of Chinese medicinal monomers， Chinese medicinal formulations， and combinations with physical therapy in increasing osteoblast secretion， promoting OPG expression， enhancing cytokine expression levels， and inhibiting osteoclast activity for the prevention and treatment of ONFH. This paper is expected to provide new ideas and directions for TCM in the prevention and treatment of ONFH.
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Tumor biomarkers have multiple characteristics, including noninvasive, repeatable analysis and real-time monitoring, and they have important application value in early diagnosis and prognosis monitoring of hepatocellular carcinoma (HCC). In recent years, the researches on tumor markers of HCC have developed rapidly. There are not only traditional serological tumor markers, such as alpha fetoprotein, des-gamma carboxy prothrombin, Golgi protein 73, glypican-3, etc., but also new emerging "liquid biopsy" tumor markers, such as circulating tumor cells, circulating tumor DNA etc. Further study on the correlation between tumor biomarkers and HCC can provide reference for the treatment and prognosis evaluation of HCC.
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Objective To study the early diagnostic value of high-sensitivity cardiac troponin Ⅰ(hs-cTnI) and soluble growth stimulating gene 2 protein (soluble suppression of tumorigenicity 2,sST2) in myocardial injury of acute organophosphorus pesticide poisoning (AOPP).Methods Totally 168 AOPP patients hospitalized from March 2014 to October 2018 were divided into the mild group (n=45),moderate group (n=55) and severe group (n=68).Another 30 healthy persons were served as the control group.The levels of cTnI,hs-cTnI,N-terminal B-type natriuretic peptide(NT-proBNP) and sST2 were detected at 4 h and 12 h after admission.SPSS 21.0 was used for statistical analysis.The measurement data were expressed by mean±standard deviation,two groups were compared by LSD-t test,and the multigroup comparison was made by single factor analysis of variance (ANOVA).The correlation analysis by Spearman correlation test (P＜0.05).Results At 1 h after admission,the hs-cTnI of AOPP patients with different degrees of poisoning was higher than that of control group,and that of severe group was higher than that of mild to moderate group.Comparison between groups was statistically significant (P＜0.05).However,there was no significant difference in the cTnI level (P＞0.05).At 4 h and 12 h after admission,the levels of cTnI and hs-cTnI increased with the increase of poisoning degree and the extension of time,and their level at 12 h after admission were significantly higher than those at 4 h after admission,with statistically significant difference between the two groups (P＜0.05).At 1 h after admission,the level of sST2 in the poisoned patients was higher than that in the control group,and the level in the severe group was higher than that in the mild to moderate groups.At 4 h and 12 h after admission,the level of sST2 was increased significantly,especially in the severe group.The level of sST2 at 12 h after admission was significantly higher than that at 4 h after admission (P＜0.05).The concentration of NT-proBNP was in normal range 1 h after admission,increased gradually at 12 h after admission,and the level of NT-proBNP in the severe group was significantly higher than that in the other groups (P＜0.05),and comparison between the groups was significantly different (P＜0.05).The correlation analysis showed that there was a positive correlation between hs-TnI and sST2 in AOPP patients (r=0.776,P＜0.01).hs-TnI and sST2 was positively correlated with the severity of AOPP (r=0.958,P＜0.01;r=0.844,P＜0.01).That is,the more severe the patient,the higher the concentration of hs-TnI and sST2,and the more serious myocardial injury.Conclusions Early detection ofhs-cTnI and sST2 levels in AOPP patients can identify early myocardial damage and objectively evaluate the extent of myocardial damage.
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OBJECTIVE:To observe therapeutic efficacy and safety of Shensong yangxin capsules in the treatment of brainsten hemorrhage complicated with cerebrocardiac syndrome(CCS)accompanied by arrhythmia. METHODS:Medical information of 98 patients with brainstem hemorrhage complicated with CCS arrhythmia were analyzed retrospectively and divided into control group (49 cases)and observation group(49 cases)according to drug use. Control group was given routine treatment as mannitol and pi-racetam. Observation group was additionally given Shensong yangxin capsules 1.2 g orally or via nasal feeding,3 times a day,on the basis of control group. Treatment course of 2 groups lasted for 4 weeks. Clinical efficacies of 2 groups were observed as well as the levels of catecholamine [norepinephrine(NE),epinephrine(E),dopamine(DA)],ET-1 and NO,the occurrence of ADR be-fore and after treatment. RESULTS:Total response rate of observation group was significantly higher than that of control group (75.5% vs. 46.93%),with statistical significance(P0.05). 3 and 7 d after treatment,the levels of NE,E,DA,ET-1 and NO in 2 groups were significantly lower than before,and the observation group was significantly lower than the control group,with statisti-cal significance(P0.05). CONCLU-SIONS:Based on routine treatment,Shensong yangxin capsules shows significant therapeutic efficacy for CCS,can reduce levels of catecholamine and doesn't increase the occurrence of ADR.
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The method of quantitative nuclear magnetic resonance spectroscopy (qNMR) for determination of epigoitrin in Radix Isatidis was established based on solid phase extraction (SPE).The twice ultrasonic extraction method using pure water was used for fully extracting epigoitrin in sample, and then the extraction was enriched and concentrated by poly-Sery MCX SPE cartridge.The effect of sample pretreatment and qNMR experimental conditions was investigated.The qNMR experiment conditions were selected using DMSO as solvent, calibrated 2,3,5-triiodobenzoate as internal standard, and P1(pulse width)=14.1 μs, d1(pulse delay time)=5 s, NS(number of scan)=256.The .1H-NMR peaks of δ 5.365-5.399 (H-7b, d, 1H) of epigoitrin were chosen as the quantitative peaks.Method validation was performed including precision (intra-day precision RSD was 0.5%, and the inter-day precision was 0.8%), linearity (correlation coefficient r>0.9991), LOD (0.05 mg/g, standard curve method) and LOQ (0.19 mg/g, S/N≥150).The recoveries of the SPE-qNMR were 97.4%-101.7%.The result showed that the method was stable, accurate and reliable.With this method the epigoitrin in a real Radix Isatidis was determined to be <0.19-1.26 mg/g.SPE combining with qNMR could extend the application field of qNMR, especially in the detection of low-content component in complex samples.
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AIM To investigate the effects of safflower yellow on myocardial injury in patients with severe sepsis.METHODS Using prospective research methods,ninety-two patients with severe sepsis treated in our hospital from Jan.2013 to Mar.2016 were divided equally into two groups:control group (routine treatment) and observation group (routine treatment + safflower yellow).In addition,6 and 72 hours after the treatment,heart-type fatty acid binding protein (H-FABP),creatine kinase (CK) and creatine kinase isoenzyme (CK-MB) of patients were detected,and the changes of left ventricular ejection fraction (LVEF) and sequential organ failure assessment (SOFA) scores were observed;length of ICU stay,cumulative incidence of major adverse cardiac events (MACE) and 28-day survival also were recorded at the same time.RESULTS In admission,there were no differences in the levels of H-FABP,CK,CK-MB and LVEF,SOFA scores between the two groups.After 6 hours treatment,the levels of H-FABP,CK,CK-MB and SOFA score in the observation group were lower than those in the control group;the two groups had higher levels of H-FABP,CK and CK-MB than those before the treatment,SOFA score was lower than that before the treatment;After 72 hours treatment,H-FABP,CK,CK-MB and SOFA score were lower than those after 6 hours treatment;SOFA score in the observation group was lower than that in the control group;there were no differences in H-FABP,CK and CK-MB between the two groups.The observation group had a lower cumulative incidence of MACE than the control group.There was no statistical difference in LVEF and length of ICU stay after the treatment between the two groups.The observation group had a higher 28-day survival than the control group,the difference was statistically significant (76.08％,35/46 vs 54.35％,25/46;x2 =4.529,P =0.033).The level of serum H-FABP in severe sepsis patients was negatively correlated with LVEF (r =-0.270,P =0.009).CONCLUSION Therapeutic effects of safflower yellow on myocardial injury in patients with severe sepsis is superior to routine treatment with the improvement of the prognosis of patients to a certain extent.
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Objective To study the effects of main ingredients from microemulsion extract of Compound Longqincao in vitro on anti-influenza virus H1N1 activity; To analyze effects of main ingredients from microemulsion extract on influenza virus inhibition rate.Methods Uniform design was used to conduct the experiment. MTT method was used to detect the effect rate (ER) of anti-influenza virus H1N1 on A549 cells. Setting ER as the index, Minitab17 software was used to establish mathematical model to come up with regression equations of all factors. The effects of ingredients on ER were analyzed and the efficient composition ratio of the optimum anti-influenza virus H1N1 was chosen.ResultsIn the compound compatibility, baicalin showed the most obvious antivirus activity, and licorice glycosides had certain inhibition effects on pathological changes of cells. Five ingredients had coordinative or controlled relation with ER. When per milliliter liquids containing licorice glycosides, baicalin, leucine, aspartic acid, glutamic acid was 13.94μg, 49.44μg, 0.23 mg, 1.25 mg, and 2.50 mg, ER was the best. ER was 85.34%±4.72% after verification.ConclusionThe optimized combination of main ingredients from microemulsion extract of Compound Longqincaocan better play a role in anti-influenza virus H1N1.
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Objective To investigate the emotional memory changes in patients with thalamic infarction on different laterals and explore the impact of different emotional valence pictures on the thalamic infarction(TI) patients' memory.Methods 28 patients with thalamic infarction (TI group)and 28 patients who were hospitalized without TI during the same period (control group) were given emotional memory test,a test where they use their emotional memory to evaluate and recognize pictures with different emotional valence,including positive,neutral,and negative valence.Results (1) At the stage of evaluating emotional images,there were no significant difference between patients with TI and control group in positive evaluation (P＞0.05).Compared with control group (neutral(12.96±1.62),negative(13.57±1.37),respectively),neutral and negative recognition scores for emotional pictures of patients with TI (neutral (10.79±2.07),negative (10.96±2.05),respectively) were decreased significantly (positive t =-4.5 and negative t=-5.6,both P＜0.05).(2)At the stage of emotional images memorizing tests,TI group's total scores on re-accessing total emotional pictures were significantly lower than those in control group ((36.14 ± 3.24) vs(41.89 ± 3.43) respectively)) (t=-6.44,P＜0.05).Compared with control group (positive (14.04± 1.29),neutral (13.68±1.56)),patients with TI (positive (10.93± 1.96),neutral(11.25± 1.67)) were decreased significantly in the emotional pictures memorizing tests (t=-7.00,5.61,P＜0.05).But there were no difference in negative stimulus between the two groups (P＞0.05).(3)The score of emotional pictures recognition in patients with LTI (34.43 ± 3.48) were decreased significantly than that in patients with RTI (37.86± 1.83) (t =3.26,P＜ 0.05).The score in recognizing neutral valence images in patients with LTI(10.43± 1.55) were significantly decreased than those in RTI (12.07± 1.38) (t=2.95,P＜0.05).Conclusion Patients with TI may rely on different neural mechanisms to affect the different valence of the emotional memory loop process.The emotional memory impairment in patients with TI at different sides is different.The left thalamus has a greater influence on memory.
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Objective To investigate the emotional memory changes in patients with thalamic infarction on different laterals and explore the impact of different emotional valence pictures on the thalamic infarction(TI) patients' memory.Methods 28 patients with thalamic infarction (TI group)and 28 patients who were hospitalized without TI during the same period (control group) were given emotional memory test,a test where they use their emotional memory to evaluate and recognize pictures with different emotional valence,including positive,neutral,and negative valence.Results (1) At the stage of evaluating emotional images,there were no significant difference between patients with TI and control group in positive evaluation (P＞0.05).Compared with control group (neutral(12.96±1.62),negative(13.57±1.37),respectively),neutral and negative recognition scores for emotional pictures of patients with TI (neutral (10.79±2.07),negative (10.96±2.05),respectively) were decreased significantly (positive t =-4.5 and negative t=-5.6,both P＜0.05).(2)At the stage of emotional images memorizing tests,TI group's total scores on re-accessing total emotional pictures were significantly lower than those in control group ((36.14 ± 3.24) vs(41.89 ± 3.43) respectively)) (t=-6.44,P＜0.05).Compared with control group (positive (14.04± 1.29),neutral (13.68±1.56)),patients with TI (positive (10.93± 1.96),neutral(11.25± 1.67)) were decreased significantly in the emotional pictures memorizing tests (t=-7.00,5.61,P＜0.05).But there were no difference in negative stimulus between the two groups (P＞0.05).(3)The score of emotional pictures recognition in patients with LTI (34.43 ± 3.48) were decreased significantly than that in patients with RTI (37.86± 1.83) (t =3.26,P＜ 0.05).The score in recognizing neutral valence images in patients with LTI(10.43± 1.55) were significantly decreased than those in RTI (12.07± 1.38) (t=2.95,P＜0.05).Conclusion Patients with TI may rely on different neural mechanisms to affect the different valence of the emotional memory loop process.The emotional memory impairment in patients with TI at different sides is different.The left thalamus has a greater influence on memory.
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Aim To investigate the regulatory effects of baicalin on apoptosis induced by virus H1 N1 in hu-man pulmonary carcinoma cell A549 . Methods The chips were used to screen the RNA samples in virus-in-fected A549 cells. Differentially expressed genes were selected in the pathway of apoptosis. The mRNA ex-pressions of caspase-3 and -8 were verified by Real-Time PCR. Results With the DNA microarray, the functions of differentially expressed genes involved in apoptosis biological pathways were analyzed by Kyoto Encyclopedia of Genes and Genomes ( KEGG ) Path-way databases. caspase-3, -7, -8, -10, TRAIL, MYD88 , IL1 A and IL1 B were up-regulated in virus-in-fected group. Oseltamivir could down-regulate gene ex-pressions of caspase-3 ,-4 and-8 . High-dose of baica-lin could down-regulate gene expressions of caspase-3 ,-4,-6 and -8. Except gene expressions of above, low-dose of baicalin could also down-regulate gene expres-sions of IL1RAP and Cn. Real-Time PCR experiments showed that baicalin could significantly decrease mR-NA expression of caspase-3 , -4 , -6 , -8 , IL1 RAP and Cn ( P < 0. 01 ) , compared with the virus-infected group. The results also figured that the interference ef-ficacy of low-dose baicalin was better than that of high-doses. As expected, real-time PCR data were in good agreement with the microarray assay. Conclusions Baicalin can be detected in their suppression effect of caspase-3,-4,-6, and -8 mRNA expression, so it re-sists against the apoptosis to fight against influenza vi-rus in vitro.
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Objective To study the relationship between copeptin,ischemia modified albumin (IMA) and the degree of myocardial injury in patients with acute carbon monoxide poisoning (ACOP).Methods A total of 110 ACOP patients with different degree of poisoning were selected as poisoning group and included mild poisoning 22 cases (mild group),moderate poisoning 50 cases (moderate group),severe poisoning 38 cases (severe group),and 30 healthy subjects were selected as control group.The cardiac troponin Ⅰ (cTnⅠ),IMA,copeptin level was detected at 2 h,7 d after admission in poisoning group and at admission in control group.According to with or without complications,poisoning group was divided into complications group (26 cases) and non-complications group (84 cases).cTnⅠ,IMA,copeptin level was compared among groups.Results At 2 h after admission,IMA was decreased and copeptin was increased in mild,moderate,severe group[(62.50 ± 2.17),(59.04 ± 3.10),(56.01 ± 8.85) kU/L and (2.82 ± 0.73),(7.31 ±0.95),(13.08 ± 1.96) μg/L],there was statistical difference compared with control group [(67.23 ± 1.40) kU/L and (0.87 ±0.19) μg/L](P＜0.05),and there was significant difference between moderate group and mild group,severe group and mild group,moderate group (P ＜ 0.05);there was no statistical difference in cTnⅠ among groups.At 7 d after admission,there was no significant difference in IMA,copeptin among groups (P ＞ 0.05) ; cTnⅠ was increased in mild,moderate,severe group [(1.80 ± 0.17),(2.34 ±0.46),(2.60 ±0.54) μg/L],and there was statistical difference compared with control group [(1.27 ±0.28) μg/L] (P ＜0.05),and there was significant difference between moderate group and mild group,severe group and mild group,moderate group (P＜ 0.05).IMA,copeptin at 2 h,7 d after admission in complications group was higher than that in non-complications group [(54.62 ± 1.53) kU/L vs.(57.89 ± 4.02) kU/L,(60.65 ± 3.61) kU/L vs.(66.84 ± 1.78) kU/L and (13.88 ± 1.45) μ g/L vs.(6.99 ± 3.39) μ g/L,(6.65 ± 1.82) μ g/L vs.(2.47 ± 0.61) μ g/L](P＜ 0.05).cTnⅠ at 7 d after admission in complications group was higher than that in non-complications group [(3.10 ± 0.22) μ g/L vs.(1.87 ± 0.27) μ g/L] (P ＜ 0.05).Correlation analysis showed that copeptin was negatively correlated with IMA in patients with different degree of poisoning (r =-0.560,P ＜ 0.01).Conclusions The combined detection of IMA and copeptin has important clinical value to the early diagnosis and prognosis in evaluating the prognosis of ACOP myocardial injury.There is important guidance for early clinical drug application.
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Objective To investigate the clinical value of copeptin and ischemia modified albumin combined determination in the early diagnosis and clinical significance in myocardial damage of acute organic phosphorus pesticide poisoning .Methods Eighty‐six cases of AOPP patients were divided into two groups :the myocardial injury group (50 cases) and non myocardial injury group (36 cases) ;30 healthy people were selected as the control group .3 mL of venous blood were collected for all subjects involved within one hour in admission ,and their cTnI ,IMA and copeptin levels were detected .Results Compared with the control group ,the copep‐tin levels of non myocardial injury group and myocardial injury group were elevated and there was significant difference (P< 0 .05) ;the difference between myocardial injury group and non myocardial injury groups was also significantly different (P< 0 .05) .Among them ,the comparison between severe and mild to moderate group revealed that the IMA and copeptin levels reduced obviously ,there was significant difference (P< 0 .05) ;in myocardial injury group ,the IMA and copeptin levels of patients in different poisoning de‐gree were negatively correlated .Conclusion Early determination of IMA and copeptin level has important significance in the early diagnosis of myocardial injury in patients with poisoning in AOPP ,and could provide guidance for clinical medication .
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Objective To study the value of copeptin and APACHE Ⅱ used for assessing acute paraquat poisoning (APP). Methods One hundred and twenty six APP patients were divided into survival group (n = 58) and death group (n = 68), with clinical death as the endpoint of observation. 3 mL blood was obtained from each subject at 2 h , 24 h and 7 d after admission for detecting the levels of copeptin , and APACHE Ⅱ scores were recorded at the same time. Results There was significant difference in dosages of paraquat taken in the death group and the survival group , but the differences were significant in the rescue time , the first time for hemoperfusion and the times for hemoperfusion. 2 h after admission , the death group and survival group had significant difference in elevated copeptin but no significant difference in scores by APACHE Ⅱ. 24 h after admission copeptin decreased to normal level in the survival group but maintained at a higher level in the death group, while the scores by APACHE Ⅱ had insignificant difference between two groups. 7 d after admission, copeptin kept at a higher level and the scores by APACHE Ⅱwere significantly increased in the death group , with significant differences compared to the survival group. The oral doses of pesticides the patients took were positively correlated with copeptin level and scores by APACHE Ⅱ. Conclusion Repeated detection of copeptin and APACHE Ⅱ score are of clinical importance for the assessment of prognosis of APP patients and reasonable distribution of medical resources.
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ObjectiveTo provide decision-making information support for recognizing research trends, selecting frontier science and technology, shaping reasonable science and technology distribution, a visualization analysis was applied to the international liver stem cell research. Methods Based on bibliometric method and visualization analysis tools, various fields including publication years, countries of publications, journals and organizations were analyzed exhaustively on publications of international liver stem cells which were searched in Science Citation Index Expanded (SCIE).In addition, details on main subjects, evolution and research fronts were presented in this paper. Results 1092 publications were searched in SCIE,which were growing rapidly since 2000.The production of China is far behind United States of America and Japan. Publications were distributed in concentrated journals but involved multidisciplinary. Liver stem cells research evolution basically experienced identification,sources,basic application. Research fronts include cell identifications, liver regeneration, cell differentiation, expression of exogenous genes,etc. Conclusion China should increase the liver stem cell funding, strengthen cooperation with the top institutes, independent innovation, leading liver stem cells research from basic research to clinical research.
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In this paper a new super-resolution image reconstruction algorithm was proposed. With the improvement of the classical projection onto convex sets (POCS) algorithm, as ground work, and with the combined use of POCS and wavelet fusion, a high resolution CT image was restored by using a group of low resolution CT images. The experimental results showed: the proposed algorithm improves the ability of fusing different information, the detail of the image is more prominent, and the image quality is better.