ABSTRACT
Teprotumumab-trbw,a monoclonal antibody that acts on the insulin growth factor-Ⅰ receptor, was approved in 2020 for the treatment of thyroid-associated ophthalmopathy, but little is known about it in China. It is hoped to provide guidance for clinical use through the review of its molecular structure, pharmacokinetics, therapeutic mechanism, clinical research and safety. It inhibits immune inflammation by blocking thyroid-stimulating hormone receptor /insulin growth factor-Ⅰ receptor crosstalk signaling, so as to reduce the production of hyaluronic acid and inflammatory factors in response. It can also promote the apoptosis of retro-orbital fibroblasts/adipocytes and inhibit the expression of genes related to the synthesis of thyroid hormones, thereby significantly improving the clinical symptoms such as exophthalmos and diplopia. The common adverse reactions of Teprotumumab-trbw are muscle spasm, hyperglycemia, hearing loss and so on. Teprotumumab-trbw is effective and durable in the treatment of thyroid-associated ophthalmopathy, and patients with secondary treatment can also benefit from it, which provides a new way and hope for the treatment of thyroid-associated ophthalmopathy.
ABSTRACT
Shegan Mahuang Decoction has been used in clinical practice for thousands of years, and is a classical formula for treating asthma and other respiratory diseases, with the effects of ventilating lung, dispersing cold, and relieving cough and asthma. This paper summarized the history, clinical application and mechanism of Shegan Mahuang Decoction, and predicted its quality markers(Q-markers) based on the "five principles" of Q-markers. The results suggested that irisflorentin, tectoridin, tectorigenin, irigenin, ephedrine, pseudoephedrine, asarinin, methyleugenol, shionone, epifriedelanol, tussilagone, 6-gingerol, trigonelline, cavidine, schizandrin, and schizandrin B could be used as Q-markers of Shegan Mahuang Decoction, which provided a basis for the quality control and subsequent research and development of Shegan Mahuang Decoction.
Subject(s)
Humans , Ephedra sinica , Drugs, Chinese Herbal/pharmacology , Asthma/drug therapy , Lung , Cough/drug therapyABSTRACT
Thyroid-associated ophthalmopathy(TAO)is an organ-specific autoimmune disease, which will cause a series of symptoms to significantly reduce the health level and life quality of patients. The pathogenesis of TAO has not been fully clarified. At present, there is a lack of unified and mature treatment scheme of it. Indeed, T-helper 17 lymphocyte(Th17)cells, regulatory T(Treg)cells and their imbalance are closely related to the immunological pathogenesis of TAO. It is currently believed that the cytokines secreted by Th17 cells can not only promote the inflammatory response of TAO and the fibrosis of orbital connective tissue, but also inhibit the adipogenic differentiation of TAO orbital connective tissue. In addition, Treg cells mainly exert immunosuppressive effect on TAO and delay the disease progression. At the same time, there is a dynamic balance relationship between Th17 and Treg cells, the imbalance of Th17/Treg cells can trigger the occurrence and development of TAO. This paper mainly expounds the influence mechanism of Th17, Treg cells and their balance on TAO, and analyzes the reasons for the differences between different research results, so as to provide some reference for the study of the pathogenesis and clinical treatment of TAO.
ABSTRACT
OBJECTIVE@#To explore the therapeutic effect and safety of acupoint thread embedding therapy in treatment of simple obesity of stomach heat and damp obstruction.@*METHODS@#A total of 144 patients with simple obesity of stomach heat and damp obstruction were randomized into an acupoint thread embedding group (72 cases, 3 cases dropped off and 1 case removed) and a sham-embedding group (72 cases, 6 cases dropped off and 3 cases removed). On the base of the lifestyle adjustment, the acupoint thread embedding therapy with PGLA thread was applied to Tianshu (ST 25), Zhongwan (CV 12), Ganshu (BL 18), Shuidao (ST 28), etc. in the acupoint thread embedding group, while in the sham-embedding group, the acupoint selection and operation were all same as the acupoint thread embedding group, but without PGLA thread embedded. In either group, the treatment was given once every 2 weeks, consecutively for 12 weeks and the follow-up was conducted for 3 months after treatment. Separately, before and after treatment as well as in follow-up, the obesity indices (body mass index [BMI], waist circumference [WC], waist-to-hip ratio [WHR] and fat percentage [F%]) were observed in the two groups. Before and after treatment, the indices of blood glucose and insulin (fasting blood glucose [FBG], fasting insulin [FINS] and insulin resistance index [HOMA-IR]), adipocyte factor indices (adiponectin, leptin [LP] and serine protease inhibitor [Vaspin]) and inflammatory factor indices (tumor nercosis factor [TNF-α], interleukin-1β [IL-1β] and interleukin-6 [IL-6]) were observed separately in the two groups. The therapeutic effect and safety were compared between the two groups.@*RESULTS@#After treatment and in follow-up, except WC and WHR in the sham-embedding group, BMI, WC, WHR and F% were all reduced as compared with those before treatment in the two groups (P<0.01, P<0.05), and the values in the acupoint thread embedding group were lower than the sham-embedding group (P<0.01). After treatment, except FBG, LP and Vaspin in the sham-embedding group, FBG, FINS, HOMA-IR, LP and Vaspin were all reduced as compared with those before treatment in the two groups (P<0.01, P<0.05), and adiponectin was increased as compared with that before treatment (P<0.01, P<0.05); the improvements in the acupoint thread embedding group were more significant than the sham-embedding group (P<0.01). After treatment, the levels of serum TNF-α, IL-1β and IL-6 in the acupoint thread embedding group were reduced as compared with the values before treatment and those in the sham-embedding group separately (P<0.01). The total effective rate was 89.7% (61/68) in the acupoint thread embedding group, higher than 19.0% (12/63) in the sham-embedding group (P<0.01). There was no severe adverse reaction reported in the two groups.@*CONCLUSION@#Acupoint thread embedding therapy with PGLA thread can alleviate obesity, regulate glucose metabolism and adipocyte factors activity, improve insulin resistance and inhibit the expression of pro-inflammatory factors in the patients with simple obesity with stomach heat and damp obstruction, and this therapy presents a satisfactory safety in treatment.
Subject(s)
Humans , Acupuncture Points , Acupuncture Therapy , Body Mass Index , Hot Temperature , Obesity/therapy , StomachABSTRACT
Objective:To evaluate the efficacy of modified Xiaoji Baozhong granules combined with scraping in the treatment of abdominal obesity with gastric heat and dampness syndrome and its effect on adipocytokines. Method:One hundred and forty-four patients were randomly divided into the control group and the observation group， 72 cases in each group. The lifestyle adjustments were conducted in both groups. The observation group was given a comprehensive traditional Chinese medicine regimen of modified Xiaoji Baozhong granules combined with scraping. The control group was given modified Xiaoji Baozhong granules combined with scraping. The course of treatment was three months. The body mass index （BMI）， body fat percentage （FP）， waist circumference （WC）， waist to hip ratio （WHR）， obesity and abdominal fat thickness of the two groups were compared before and after treatment. The levels of fasting blood glucose （FBG）， insulin resistance index （HOMA-IR）， high density lipoprotein （HDL）， low density lipoprotein （LDL）， triglyceride （TG）， total cholesterol （TC）， adiponectin， leptin， resistin， endolipid and tumor necrosis factor-α （TNF-α） were compared between the two groups before and after treatment. The clinical efficacy and safety were evaluated. Result:After treatment， the BMI， FP， obesity， WC and WHR of the observation group were lower than those of the control group （<italic>P</italic><0.01）. After treatment， the abdominal wall fat thickness and intra-abdominal fat thickness of patients in the observation group were lower than those in the control group （<italic>P</italic><0.01）. The FBG， HOMA-IR， TG， TC and LDL of the observation group were lower than those of the control group （<italic>P</italic><0.01）， while the HDL level was higher than the control group （<italic>P</italic><0.01）. Adiponectin in the observation group was higher than the control group after treatment （<italic>P</italic><0.01）. The leptin， resistin， visfatin and TNF-α were lower than those in the control group （<italic>P</italic><0.01）. The total clinical efficacy rate of patients in the observation group was 88.24% （60/68）， which was better than 73.53% （50/68） in the control group （<italic>χ</italic><sup>2</sup>=4.755， <italic>P</italic><0.05）. Conclusion:In addition to lifestyle adjustments， modified Xiaoji Baozhong granules combined with scraping treatment can reduce the degree of obesity and fat thickness in patients with abdominal obesity， and regulate lipid， carbohydrate metabolism and adipocytokines， with a better clinical efficacy than simple scraping therapy and the safety in practice.
ABSTRACT
Objective:To investigate the effect of iron nanoparticles and melatonin on yield and quality of <italic>Fritillaria przewalskii</italic> and provide technical support for its domesticated cultivation. Method:Hundred grain weight was measured by conventional method；alkaloid content was detected according to protocols of the edition of 2020 <italic>Chinese Pharmacopoeia</italic>，chlorophyll，hydrogen peroxide，malondialdehyde，superoxide dismutase （SOD），peroxidase （POD） and catalase （CAT） were detected by spectrophotometric analysis，auxins，cytokinins，gibberellins，salicylic acid，jasmonic acid and abscisic acid were detected by ultra performance liquid chromatography tandem mass spectrometry analysis. Result:Zero-valent iron nanoparticles and melatonin significantly increased the hundred grain weight without affecting the quality. The effect of the two treatments on physiological and biochemical indexes in different stages were quite different，but the effects on content of endogenous hormones were basically the same. Correlation analysis showed that hundred grain weight was negatively correlated with malondialdehyde content，SOD activity and jasmonic acid content，but positively correlated with POD activity，salicylic acid content，gibberellins content，auxin content and abscisic acid content. The two treatments were separated effectively by principal component analysis，indicating that there were some differences in the mechanisms of growth promoting. The treatment of zero-valent iron nanoparticles mainly affected auxins，salicylic acid and abscisic acid. The treatment of melatonin mainly affected SOD，malondialdehyde and gibberellins. Conclusion:Zero-valent iron nanoparticles and melatonin can be used as a simple and practical technology to improve the stress resistance and yields of <italic>F. przewalskii</italic> in domesticated cultivation conditions.
ABSTRACT
Objective To investigate the association between single nucleotide polymorphism ( SNP) of proprotein convertase subtilisin/kexin type 9 ( PCSK9 ) rs2479409 and cognitive impairment .Methods In this population-based cohort study conducted in Rugao , Jiangsu province , China , a total of 1707 participants aged 70-84 years old were included.The cognitive impairment was assessed by Revised-Hasegawa Dementia Scale (HDS-R).Their SNPs rs2479409 of PCSK9 were examined.Results According the HDS-R, there were 789 cases in cognitive im-pairment group and 918 cases in control group .GG and AG were major genotype of rs 2479409.The distribution of allele frequency and genotype frequency of rs 2479409 was significantly different between cognitive impairment group and the control group ( P<0.05 ) .A allele was a protective factor for cognitive impairment , and risk of cognitive im-pairment increased by 1.66 folds in GG genotype compared with AA genotype GG genotype ( OR=1.66,95 %CI 1.16-2.36,P<0.01), the significance remained after adjusting for confounders (P<0.05).Conclusions SNP rs2479409 of PCSK9 gene is associated with cognitive impairment .
ABSTRACT
Objective To investigate the clinical efficacy of a needle knife in treating knee meniscus injury. Methods One hundred patients with knee meniscus injury (112 knee joints) were randomly allocated to treatment and control groups, 50 cases each. The treatment group received needle knife therapy and the control group, an injection of sodium hyaluronate injectio into knee joint cavity. The main clinical symptoms and signs around the knee joint were observed and the knee function score was recorded in the two groups before and after treatment. the clinical therapeutic effects were evaluated in the two groups. Results There were statistically significant differences in pre-/post-treatment main clinical symptom and sign index (pain score, swelling score, activity score and tenderness index score) difference values between the two groups (P<0.05). There were statistically significant differences in the main clinical symptom and sign index difference values at follow-up compared with before treatment between the two groups (P<0.05). There was a statistically significant differences in the knee function score after treatment and at follow-up compared with before treatment in the two groups (P<0.01,P<0.05). There was a statistically significant differences in the knee function score between the treatment and control groups after treatment and at follow-up (P<0.05). Post-treatment excellence rate and total efficacy rate were 94.0%and 100.0%, respectively, in the treatment group and 72.0%and 98.0%, respectively, in the control group. There was a statistically significant differences in post-treatment excellence rate between the two groups (P<0.05). Follow-up excellence rate and total efficacy rate were 96.0% and 100.0%, respectively, in the treatment group and 76.0% and 98.0%, respectively, in the control group. There was a statistically significant differences in follow-up excellence rate between the two groups (P<0.05). Conclusion Needle knife therapy is an effective way to treat knee meniscus injury.
ABSTRACT
ObjectiveTo observe andanalyze the clinical efficacy of needle knife treatment for knee meniscus injury from improving knee biomechanical balance and to provide a therapeutic basis and method for clinical practice.MethodOne hundred patients (112 knees) with knee meniscus injury meeting the inclusion criteria were allocated, in order of visits, to observation and control groups, 50 cases each. They were treated with a needle knife and an injection of sodium hyaluronate injectio into knee joint cavity, respectively. Changes in the indices were observed and assessed in the two groups by recording the plantar pressure analysis score and the knee function score before and after treatment and at follow-up. The clinical therapeutic effects were evaluated in the two groups.ResultThemaximum load, time integral difference value and load ratio around the knee joint decreased significantly in both observation and control groups after treatment and at follow-up (P<0.05). The regulating effect on knee joint force balance was better in theneedle knife group than in the control group (P<0.05). The improving effect on knee joint function was significantly better in the observation group than in the control group (P<0.01). The excellence rate was significantly higher in the observation groupthan in the control group after treatment and at follow-up (P<0.05).ConclusionNeedle knife treatment restores the function of the knee joint by loosing focal soft tissues around the knee joint, improving knee joint load imbalance and correcting the mechanical equilibrium around the knee joint in patient with knee meniscus injury. It has a definite curative effect on the disease.
ABSTRACT
Background Graves ophthalmopathy is generally considered to be an organ-speeifie autoimmune disease.It was reported that 99Tc-methylenediphosphonate (99Tc-M)P) has therapeutic effect on Graves ophthalmopathy,though the mechanism has not been completely delineated.Objective This study was to explore the effects of 99Tc-MDP on the proliferation of retrooeular fihrohlasts (RFs) hyaluronic acid (HA) synthesis,and the expression rate of human leucocyte antigen-DR (HLA-DR) and intercellular adhesion molecule-1 (ICAM-1) in cultured RFs.Methods Retroocular connective tissue was obtained from 2 eyes with Graves ophthalmopathy during the orbital decompression surgery.RFs were cultured with explant culture method in DMEM medium with 20％fetal bovine serum.The cells of 2-7 generations were used in the study.Interferon γ (IEN-γ),interleukin-1 (IL-1),tumor necrosis factor-α (TNF-α) was added in medium for 72 hours to stimulate the growth of the RFs,and then 10,100 and 1000 mg/L 99Tc-MDP was respectively used to co-culture the cells with IFN-γ,IL-1 or TNF-α.3H-TdR incorporation was used to detect the proliferation of RFs,and synthesis of HA,expression rate of HLA-DR and ICAM-1 in RFs were assayed by radio-immunoassay and flow cytometry,respeetively.Results Cultured cells showed the fibrous shape under the inverted microseope with the positive response for vimentin and absent response for cytokeratine.After addition of TNF-α,IFN-γ and IL-1,the proliferation value of RFs,HA level,the expression rate of HLA-DR and ICMA-1 in RFs was (4918.33±297.91) counts/min,(505.83±41.29)mg/L,(56.88±14.67)％ and (63.57± 14.11)％ respectively,showing significant differenee in comparison with normal control group(P＜0.01).However,after co-culture of ＞100 mg/L 99Tc-MDP with TNF-α,IFN-γ and IL-1,the proliferation value of RFs,HA level,the expressing rates of HLA-DR and ICMA-1 were significantly lower than those in the TNF-α,IFN-γ and IL-1 only culture groups(P＜0.01),but were still higher than those in the normal group.Conclusions 99Tc-MDP can suppress cytonike-induced activation and growth of RFs derived from Graves ophthalmopathy in vitro at a dosedependent manner.
ABSTRACT
Objective A group of patients who had undergone total hip arthroplasty were followed up radiologically to explore the effects of abduction angle, the anteversion angle and the height of the femoral head center on dislocation, because these measurements could be used as a basis to evaluate current practice and to seek improvements. Methods A series of 326 hip joints (318 patients) were followed up routinely. The average follow up period was 2.7 years. 10 was found to have dislocation. The abduction angle, the anteversion angle and the height of the femoral head center were measured. The results were statistically analyzed, with a P value less than 0.05 indicating significant difference. Results The abduction angle of 55?or larger was found to be associated with greater risk of dislocation, compared with the abduction angle of less than 55?. Meanwhile, cups with the femoral head center superior placement greater than 30 mm resulted in more dislocation, compared with those less than 30 mm. As an independent variable, the anteversion angle had no significant association with dislocation. Conclusions Based on the results of the current study, the abduction angle and the height of the femoral head center should be considered as prerequisites for maintaining hip stability and decreasing the risk of dislocation. We believe that hips with the abduction angle of less than 55?and the height of the femoral head center less than 30 mm can decrease the risk of dislocation.