Regulation of chondrocyte autophagy by acupotomy to promote chondrocyte homeostasis in osteoarthritis / 中国组织工程研究

BACKGROUND:Acupotomy is an effective method for the clinical treatment of osteoarthritis,with affirmed clinical outcomes,but the specific mechanisms remain unclear OBJECTIVE:To investigate the role of acupotomy in modulating chondrocyte autophagy to promote chondrocyte homeostasis in osteoarthritis. METHODS:Twenty-eight New Zealand rabbits were randomly divided into control group,osteoarthritis group,acupotomy group,and hyaluronic acid group,with seven rabbits in each group.The knee osteoarthritis rabbit model was prepared using the Videman method in the latter three groups.After modeling,the control group and osteoarthritis group received no interventions.The acupotomy group received acupotomy treatment 15 minutes per time,once a week,while the hyaluronic acid group received intra-articular injection of hyaluronic acid once a week,with a continuous treatment duration of 5 weeks.The day after the final intervention,knee joint macrostructure was observed using DR imaging,chondrocyte ultrastructure was examined through transmission electron microscopy,apoptosis of chondrocytes was assessed using Tunel staining,and western blot analysis was used to detect the expression of proteins related to the PI3K/Akt/mTOR pathway. RESULTS AND CONCLUSION:The DR imaging results revealed that the osteoarthritis group exhibited narrowed knee joint spaces and the formation of periarticular osteophytes,while the hyaluronic acid group and acupotomy group showed widened knee joint spaces with a reduction in periarticular osteophytes.Transmission electron microscopy results demonstrated a decreased number of autophagosomes in chondrocytes in the osteoarthritis group,along with nuclear shrinkage,nuclear membrane rupture,incomplete organelle morphology,and a clear tendency towards cell death.In contrast,both the hyaluronic acid group and acupotomy group exhibited a significant increase in autophagosomes,intact nuclear membranes,and a well-preserved cellular state.Tunel staining results indicated a considerable decrease in the number of apoptotic cells in the hyaluronic acid group and acupotomy group compared with the osteoarthritis group.Western blot results revealed that,compared with the control group,the expression levels of Beclin1,Cath D,and LC3II/LC3I were significantly decreased in the osteoarthritis group(P<0.05),while the expression levels of p-Akt/Akt and p-mTOR/mTOR were significantly increased(P<0.05);compared with the osteoarthritis group,the expression levels of Beclin1,Cath D,and LC3II/LC3I were significantly increased in both the hyaluronic acid group and acupotomy group(P<0.05),while the expression levels of p-Akt/Akt and p-mTOR/mTOR were significantly decreased(P<0.05).To conclude,acupotomy intervention can modulate the PI3K/Akt/mTOR signaling pathway to enhance the autophagic level in chondrocytes,thereby maintaining chondrocyte homeostasis.This ultimately leads to a slowdown in cartilage degeneration.

Impact of CSVD combined with cerebral large artery atherosclerosis on cognitive function in patients with advanced age / 中华老年心脑血管病杂志

Objective To evaluate the impact of overall burden of cerebral small vessel disease(CSVD)combined with intracranial large artery atherosclerosis(ICAS)on cognitive function in very old patients.Methods A total of 178 advanced elderly patients admitted to Department of General Medicine of Wuhan Central Hospital between January 2013 and December 2022 were re-cruited in this retrospective study.According to the results of Montreal Cognitive Assessment Scale,they were divided into dementia group(n=83)and non-dementia group(n=95).All pa-tients underwent brain MRI imaging,MRI susceptibility weighted imaging and cerebral angiogra-phy.Based on these imaging findings of MRI,the effect of total burden score of CSVD and athero-sclerosis on cognition were evaluated.The volumes of 14 different gyri in the left and right brain were measured in the patients with CSVD burden score ≤2 and those ≥3.Results There were significantly more patients with numbers of microbleeding foci＞10 and lacunar foci ≥5 in the dementia group than the non-dementia group(P＜0.01).But,no statistical difference was seen in intracranial and extracranial arterial stenosis between the two groups(P＞0.05).The volumes of left and right anterior cingulate gyrus,left and right paracingulate cortex,right hippocampus,left parahippocampal gyrus,right transverse temporal gyrus and left inferior temporal gyrus were no-tably smaller in the CSVD score ≥3 group than the CSVD ≤2 group(1723.444 vs 1867.167,1590.167 vs 1595.670,1481.466 vs 1509.540,1543.831 vs 1585.505,1038.345 vs 1305.831,1220.525 vs 1392.352,P＜0.05).Conclusion Cognitive function in the advanced elderly is mainly affected by the burden of CSVD,and atherosclerotic stenosis of large arteries is not the main fac-tor affecting cognitive function.The total burden of CSVD is correlated with atrophy of some gyri.

Effect of echocardiography-guided percutaneous intramyocardial septal radiofrequency ablation on the Lown classification in patients with hypertrophic obstructive cardiomyopathy / 中华超声影像学杂志

Objective:To investigate the effect of percutaneous intramyocardial septal radiofrequency ablation (PIMSRA) guided by echocardiography on the Lown classification of ventricular arrhythmias in patients with hypertrophic obstructive cardiomyopathy (HOCM).Methods:A total of 85 patients with HOCM who received PIMSRA treatment at Xijing Hospital of Air Force Military Medical University from May 2017 to October 2019 were retrospectively selected. All patients underwent 24-hour Holter examinations before and 1 year after PIMSRA to obtain parameters related to Lown classification. The changes in Lown grades after PIMSRA were analyzed. The patients were divided into improved group and unimproved group according to whether there was significant improvement in Lowen′s grades, and the difference of the parameters related were compared. The influencing factors of the changes in Lown classification were analyzed.Results:Compared with before PIMSRA, there was a significant improvement in the Lown classification after PIMSRA ( P=0.001). The patients with Lown grade Ⅰ increased significantly ( P=0.001), and the patients with grade Ⅲ decreased significantly ( P=0.005). There were no significant changes in patients with Lown grades 0, Ⅱ, and Ⅳ (all P>0.05). The proportion of patients with family history of hypertrophic cardiomyopathy (HCM), the baseline Lown classes, the reduction rate of the maximum left ventricular wall thickness and the reduction rate of the provocative left ventricular outflow tract gradient (LVOTG) were higher in the improved group than the unimproved group (all P<0.05). Multivariate Logistic regression results showed that HCM family history ( OR=3.95, 95% CI=1.34-11.64, P=0.013), baseline Lown classes ( OR=2.01, 95% CI=1.25-3.22, P=0.004) and the reduction rate of the provocative LVOTG gradient ( OR=1.02, 95% CI=1.00-1.04, P=0.041) were independent factors of postoperative Lown classification improvement. Conclusions:The Lown classes of HOCM patients after PIMSRA is significantly improved.HCM family history, the baseline Lown classes, and the reduction rate of postoperative provocative LVOTG are independent influencing factors for the improvement of Lown grade.

Development of Traditional Chinese Medicine in Serbia / 国际中医中药杂志

Serbia is a parliamentary republic country in Southeast Europe. It implements a health security system with social insurance as the mainstay and social assistance as a supplement. Ischemic heart disease, stroke and Alzheimer’s disease are the major causes of death, and the mortality rates of cardiomyopathy and chronic kidney disease are increasing. Serbia has relevant legislation on traditional medicine. Acupuncture, as the main form of Traditional Chinese Medicine (TCM), has been introduced to Serbia in an early stage. Acupuncture was recognized as a legal medical method in 2005, and then the corresponding educational institutions of TCM were established soon. However, the limitation of acupuncture treatment application, difficulty in access to Chinese medicine, and undeveloped of TCM education system, all of them restrict the development of TCM in Serbia. It is recommended to improve the development and dissemination of Chinese medicine in Serbia, like to increase the promotion of acupuncture, pay attention to the Chinese medicine for preventive health care, and strengthen TCM education.

Research progress on cardiac rehabilitation in patients with implanted cardiac defibrillator / 生物医学工程学杂志

Implantable cardioverter defibrillator (ICD) is the most effective measure to prevent sudden cardiac death. However, ICD patients frequently have problems such as decline of exercise tolerance and quality of life, anxiety and depression after operation, which require cardiac rehabilitation (CR). A considerable amount of studies have proved that CR is an effective secondary prevention measure for patients with cardiovascular disease. Its safety and effectiveness have been supported by evidence-based medicine research, which can prevent the recurrence of cardiovascular events, reduce the readmisson rate, and promote healthy behavior and active lifestyle formation of patients, so as to improve the quality of life of patients. This review mainly summarized the necessity, safety, exercise program and economic benefits of CR in ICD patients.

A meta-analysis of oral preparation of ginkgo biloba in treating vascular dementia / 国际中医中药杂志

Objective To systematically evaluate the efficacy and safety of oral preparation of ginkgo biloba in treating vascular dementia (VD).Methods A fully literature search was conducted in CNKI,Wanfang,Sinomed,VIP databases,PubMed,Embase,the Cochrane Library and Clinical Trails with the deadline of October,2018 for randomly controlled trials of oral preparation of ginkgo biloba for vascular dementia.After assessing the quality of literatures included,RevMan5.3 software was used to analyze the extracted data.Results A total of 17 studies which including 1 326 patients were involved.The results of meta-analysis showed that:compared with the western medicine group,oral ginkgo biloba preparation combined with western medicine group was much better in the MMSE assessment [MD=2.89,95％ CI (2.06,-3.72),P=0.000 1],there was no significant difference between the western medicine group and the pure oral ginkgo biloba group in the ADL assessment [MD=-3.00,95％ CI (-4.69,-1.30),P=0.000 5] and overall clinical status assessment [RR=1.29,95％ CI (1.20,1.39),P＜0.000 01],the efficacy of the pure oral ginkgo biloba group and western medicine group was similar in the ADL assessment [MD=-0.93,95％ CI (-3.48,1.63),P=0.48].Conclusions Based on the meta-analysis,oral preparation of ginkgo biloba combinedwithwestemmedicinehas certain advantages compared with conventional western medicine treatment alone,but a large number of large-sample and high-quality trials are requiredtofurther prove and review its effect

Frailty progress and related factors in the elderly living in community: a prospective study / 中华流行病学杂志

Objective: To investigate frailty progress status and related factors in the elderly living in communities. Methods: A cohort of elderly people aged 65 and over in Pingyi community of Dujiangyan, Sichuan province, was established. Face-to-face questionnaire survey was conducted by trained interviewers. The frailty status, cognitive function, nutrition status and other functions of the subjects surveyed were evaluated at baseline survey and during follow-up. The socio-demographic and clinical characteristics of the subjects surveyed were assessed at baseline survey. Binary logistic regressions were used to identify factors associated with frailty progress. Results: A total of 653 elderly people were surveyed in January 2014, and 507 elderly people were followed up while 146 elderly people terminated further follow-up in January 2017. The prevalence rates of frailty and pre-frailty at baseline survey were 11.2% (n=57) and 26.2% (n=133), respectively. After 3 years, 205 subjects (40.4%) surveyed experienced frailty progress, 276 (54.5%) remained to be in frailty state at baseline survey, and 26 (5.1%) had improvement. Disability (OR=8.27, 95%CI: 1.62-42.26), visual problem (OR=2.02, 95%CI: 1.27-3.22), cognitive impairment (OR=1.94, 95%CI: 1.08-3.48), poor self-rated health (OR=1.89, 95%CI: 1.07-3.31), chronic pain (OR=1.57, 95%CI: 1.03-2.40) and older age (OR=1.12, 95%CI: 1.08-1.17) were independently associated with the progress of frailty. In contract, overweight was a protective factor (OR=0.54, 95%CI: 0.34-0.85). Conclusions: Frailty is a dynamic syndrome affected by several socio-demographic factors and geriatric factors. The results of the study can be used in the prevention of frailty progress in the elderly in communities.

Frailty progress and related factors in the elderly living in community: a prospective study / 中华流行病学杂志

Objective To investigate frailty progress status and related factors in the elderly living in communities.Methods A cohort of elderly people aged 65 and over in Pingyi community of Dujiangyan,Sichuan province,was established.Face-to-face questionnaire survey was conducted by trained interviewers.The frailty status,cognitive function,nutrition status and other functions of the subjects surveyed were evaluated at baseline survey and during follow-up.The socio-demographic and clinical characteristics of the subjects surveyed were assessed at baseline survey.Binary logistic regressions were used to identify factors associated with frailty progress.Results A total of 653 elderly people were surveyed in January 2014,and 507 elderly people were followed up while 146 elderly people terminated further follow-up in January 2017.The prevalence rates of frailty and pre-frailty at baseline survey were 11.2％ (n=57) and 26.2％ (n=133),respectively.After 3 years,205 subjects (40.4％) surveyed experienced frailty progress,276 (54.5％) remained to be in frailty state at baseline survey,and 26 (5.1％) had improvement.Disability (OR=8.27,95％CI:1.62-42.26),visual problem (OR=2.02,95％CI:1.27-3.22),cognitive impairment (OR=1.94,95％CI:1.08-3.48),poor self-rated health (OR=1.89,95％ CI:1.07-3.31),chronic pain (OR=1.57,95％ CI:1.03-2.40) and older age (OR =1.12,95％CI:1.08-1.17) were independently associated with the progress of frailty.In contract,overweight was a protective factor (OR=0.54,95％CI:0.34-0.85).Conclusions Frailty is a dynamic syndrome affected by several socio-demographic factors and geriatric factors.The results of the study can be used in the prevention of frailty progress in the elderly in communities.

Effect of frailty syndrome on falls in Chinese elderly diabetics in the communities: a prospective cohort study / 中华流行病学杂志

Objective: To explore the relationship between frailty syndrome and falls in the elderly diabetics, in the communities. Methods: A three-year cohort study involving 653 community-dwelling adults who were over 65 years of age and participated in the Survey of Disease, Psychological and Social Needs in Dujiangyan Pingyi Community. Diabetic patients would include those who self-reported as having histories of diabetes or on anti-hyperglycemic therapies. Frailty, functional and other geriatric status were assessed respectively. Falls was defined as having had multiple falls or at least one event but with injury. Results: The highest prevalence of falls was found in the group of frail diabetic group (62.5%). Data showed that baseline frailty was associated with falls in both diabetic and non-diabetic groups but the odds ratio in the diabetic group was higher than that of the non-diabetic group (OR=3.87, 95%CI: 1.45-10.28 vs. OR=6.68, 95%CI: 1.14-38.99). Conclusion: Frailty could be used as a strong clinical predictor to prevent falls, for the elderly diabetic Chinese living in the communities.

Effect of frailty syndrome on falls in Chinese elderly diabetics in the communities: a prospective cohort study / 中华流行病学杂志

Objective To explore the relationship between frailty syndrome and falls in the elderly diabetics,in the communities.Methods A three-year cohort study involving 653 community-dwelling adults who were over 65 years of age and participated in the Survey of Disease,Psychological and Social Needs in Dujiangyan Pingyi Community.Diabetic patients would include those who self-reported as having histories of diabetes or on anti-hyperglycemic therapies.Frailty,functional and other geriatric status were assessed respectively.Falls was defined as having had multiple falls or at least one event but with injury.Results The highest prevalence of falls was found in the group of frail diabetic group (62.5％).Data showed that baseline frailty was associated with falls in both diabetic and non-diabetic groups but the odds ratio in the diabetic group was higher than that of the non-diabetic group (OR=3.87,95％ CI:1.45-10.28 vs.OR=6.68,95％ CI:1.14-38.99).Conclusion Frailty could be used as a strong clinical predictor to prevent falls,for the elderly diabetic Chinese living in the communities.

Study on in vitro Antibacterial Effect of Extracts from Miao Medicine Rubus multibracteatus Leaves / 中国药房

OBJECTIVE:To investigate in vitro antibacterial effect of extracts from Miao medicine Rubus multibracteatus leaves. METHODS:The aqueous extract and 80% ethanol extracts from R. multibracteatus leaves were used to prepare solution with mass concentration of 200 mg/mL. Using ampicillin and fluconazol as positive control (50 mg/mL),cup plate method was used to determine antibacterial effects of the extracts from R. multibracteatus leaves to Staphylococcus aureus,Staphylococcus epi-dermidis,Escherichia coli,Shigella dysenteriae,Proteus vulgaris,Candida albicans and Cryptococcus neoformans. The petroleum ether,acetic ether and n-butyl alcohol were used to extract 80% ethanol extracts in turns. After obtaining relevant extracts (50 mg/mL),cup plate method was used to investigate antibacterial effects of them to above 7 bacterial strains. The parts with antibacte-rial effects and bacterial strains sensitive to drug were screened. Micro-broth dilution method and agar culture medium plate method were used to determine minimum inhibitory concentration(MIC)and minimum bactericidal concentration(MBC). RESULTS:The aqueous extract of R. multibracteatus leaves almost had no inhibitory effect while 80% ethanol extract showed different degrees of antibacterial effect to tested bacterial strains,and it also had higher activity against 5 bacterial stains than 2 fungus. The ethyl ace-tate and n-butyl alcohol fractions of 80% ethanol extracts showed good effect while the petroleum ether and water layer fractions had no antibacterial effect,and all the fractions of 80% ethanol extracts showed no inhibitory effect on fungus. To 5 bacterial stains,MIC and MBC of 80% ethanol extract were 6.25-12.5,12.5-25 mg/mL,those of ethyl acetate fractions were 3.13,6.25 mg/mL and those of n-butyl alcohol fraction were 3.13-6.25,6.25-12.5 mg/mL,respectively. CONCLUSIONS:80% ethanol ex-tract of Miao medicine R. multibracteatus leaves and its ethyl acetate and n-butyl alcohol fractions have obvious in vitro antibacteri-al effect to bacteria.

Evaluating the left ventricular diastolic function of diabetes mellitus patients using dual-gate Doppler / 生物医学工程学杂志

To evaluate the value of left ventricular diastolic function in type 2 diabetes mellitus (DM) using dual-gate Doppler and relative factors, we included 50 non-obesity and hypertension-free DM patients into the controlled group in the study along with 48 age-and-gender-matched healthy volunteer subjects. The peak early diastolic velocity (E), peak later diastolic velocity (A), deceleration time (DT), anterior mitral annulus diastolic peak velocity (e') , isovolumic relaxation time (IVRT), E/A, E/e', Tei index and T(E-e), were measured with dual-gate Doppler. 20 subjects were randomly selected for repetitive analysis. Study showed statistical difference in E/A, DT, e', E/e', IVRT, Tei index and T(E-e), between the two groups (P < 0.05). Linear regression analysis showed positive correlation between T(E-e), and IVRT, course of DM patients and T(E-e), (Beta = 0.295, P = 0.020), and HbA1c control level and T(E-e), (Beta = 0.399, P = 0.010). Repeated analysis showed good reproducibility for both within and between groups. Dual-gate Doppler has clinical value in evaluating left ventricular diastolic function in type 2 diabetes mellitus patients. The course of type 2 diabetes mellitus patients and HbA(1C) control level were both closely related with left ventricular diastolic function.

Value of three-dimensional speckle tracking imaging for quantitative assessment of global left ventricular systolic function in patients with coronary heart disease / 中华超声影像学杂志

Objective To explore the accuracy of three dimensional speckle tracking imaging (3D-STI) in quantitative coronary evaluation of (CHD) patients' left ventricular global systolic function.Methods Sixty-eight CHD patients were divided into three groups according to the coronary artery angiography (CAG) results:32 cases in severe stenosis group,23 cases in moderate stenosis group,and 13 cases in mild stenosis group.Thirty gender-age-matched healthy subjects(control group) were enrolled in this study.All patients underwent 2D-echocardiography and real-time three-dimensional echocardiography (3DE).The global longitudinal strain(GLS),global radial strain(GRS),global circumferential strain(GCS),global area strain (GAS),global area strain rate (GASrate) and 3D global LV strain (3D-Strain) were analyzed using 3D-STI.Correlation between strain measurements and left ventricular ejection fraction (LVEF) by simpson method,3D-LVEF by 3DE were assessed using linear regression analysis.Results All 3D-STI parameters in the severe stenosis group were significant decreased compared with the other groups.GLS,GRS,GCS,GAS,3D-Strain of moderate stenosis group shown more significant decrease than both mild stenosis group and control group (P ＜ 0.05).Strong correlations were demonstrated in all 3D-STI parameters between 3D-LVEF and LVEF.The strongest correlation was observed between GAS with 3D-LVEF in severe stenosis group(r =-0.910,P ＜0.05).Intraobserver and interobserver reliability of GAS was better than other parameters.Conclusions Global strain of 3D-STI can quantitatively evaluate the global LV function in CHD patients,and GAS is more sensitive and reproducible than other parameters.

Community-based Rehabilitation Nursing of Osteoporosis (review) / 中国康复理论与实践

@# Osteoporosis is a common problem of the elderly. It is important to carry out community-based rehabilitation, care and education to prevent and treat osteoporosis.