Growing attention on the toxicity of Chinese herbal medicine: a bibliometric analysis from 2013 to 2022.

Introduction: Despite the clinical value of Chinese herbal medicine (CHM), restricted comprehension of its toxicity limits the secure and efficacious application. Previous studies primarily focused on exploring specific toxicities within CHM, without providing an overview of CHM's toxicity. The absence of a quantitative assessment of focal points renders the future research trajectory ambiguous. Therefore, this study aimed to reveal research trends and areas of concern for the past decade. Methods: A cross-sectional study was conducted on publications related to CHM and toxicity over the past decade from Web of Science Core Collection database. The characteristics of the publication included publication year, journal, institution, funding, keywords, and citation counts were recorded. Co-occurrence analysis and trend topic analysis based on bibliometric analysis were conducted on keywords and citations. Results: A total of 3,225 publications were analyzed. Number of annal publications increased over the years, with the highest number observed in 2022 (n = 475). The Journal of Ethnopharmacology published the most publications (n = 425). The most frequently used toxicity classifications in keywords were hepatotoxicity (n = 119) or drug-induced liver injury (n = 48), and nephrotoxicity (n = 40). Co-occurrence analysis revealed relatively loose connections between CHM and toxicity, and their derivatives. Keywords emerging from trend topic analysis for the past 3 years (2019-2022) included ferroptosis, NLRP3 inflammasome, machine learning, network pharmacology, traditional uses, and pharmacology. Conclusion: Concerns about the toxicity of CHM have increased in the past decade. However, there remains insufficient studies that directly explore the intersection of CHM and toxicity. Hepatotoxicity and nephrotoxicity, as the most concerned toxicity classifications associated with CHM, warrant more in-depth investigations. Apoptosis was the most concerned toxicological mechanism. As a recent increase in attention, exploring the mechanisms of ferroptosis in nephrotoxicity and NLRP3 inflammasome in hepatotoxicity could provide valuable insights. Machine learning and network pharmacology are potential methods for future studies.

Flavonoid glycosides from the nectar of Camellia reticulata Lindl.

The nectar of Camellia reticulata Lindl. contains sugar, amino acids and other nutritional components, suggesting that it could be developed for food and food additives. To understand the effects of the nectar on human health, we investigated its chemical constituents. Two new flavonoid glycosides, cameretiins A and B (1 and 2), and two known flavonoid glycosides, kaempferol 3-O-(2''-O-E-p-coumaroyl)-ß-D-glucopyranoside (3) and tiliroside (4) were obtained from the nectar of Camellia reticulata Lindl. Their structures were determined based on analysis of their spectroscopic data and by comparison with 1D NMR spectroscopic data of known compounds reported in the literature. Compounds (1-4) were first isolated from the nectar of Camellia reticulata Lindl.

Electro-activation of O2 on MnO2/graphite felt for efficient oxidation of water contaminants under room condition.

The activation of oxygen (O2) under room condition is highly desirable for oxidative removal of organic pollutants in water. Herein, we report a graphite felt (GF)-supported α-MnO2 catalyst which is active for activating O2 with assistance of an anodic electric field. The electro-assisted catalytic wet air oxidation (ECWAO) process on MnO2/GF is able to rapidly degrade a variety of dyes, pharmaceutics and personal care products (PPCPs) under room condition. The congo red, basic fuchsin, neutral red and methylene blue are completely mineralized in 160 min, and the bisphenol A, triclosan and ciprofloxacin are mineralized by 89.9%, 81.5% and 65.4%, respectively, in 300 min. Mechanistic study indicates a surface-catalyzed non-free radical pathway for the oxidation of organic pollutants by O2 in the ECWAO process. The oxygen vacancies on MnO2 are identified as the catalytically active sites, at which oxygen atom is transferred from O2 to organic molecule through chemisorbed oxygen species. The anodic electric field assists such an oxygen transfer pathway by activating the complex of chemisorbed oxygen species and organic molecule through electro-oxidation reaction. The ECWAO process on MnO2/GF electrode exhibits a great potential for practical wastewater treatment under room condition.

Male density, a signal for population self-regulation in Alligator sinensis.

The regulation of population density is suggested to be indirect and occurs with a time-lag effect, as well as being female centred. Herein, we present a quantitative analysis on the precise, timely and male-dominated self-regulation of Chinese alligator ( Alligator sinensis) populations. Analysis of 31 years of data revealed gender differences in regulation patterns. Population dynamics were restricted by male density rather than population density, and population growth was halted (birth rate = 0) when male density exceeded 83.14 individuals per hectare, until some males were removed, especially adult males. This rapid and accurate response supports the notions of intrinsic mechanisms and population-wide regulation response. Furthermore, density stress affected mating success rather than parental care to juveniles, i.e. females avoided unnecessary reproduction costs, which may represent an evolutionary advantage. Our findings highlighted the importance of further studies on related physiological mechanisms that focus on four characteristics: quantity breeds quality, gender differences, male density thresholds and nonlinearity.

Effects of Population Bottleneck and Balancing Selection on the Chinese Alligator Are Revealed by Locus-Specific Characterization of MHC Genes.

Chinese alligator (Alligator sinensis) is an endangered freshwater crocodilian endemic to China, which experienced a severe bottleneck about 30 years ago. In this study, we developed locus-specific primers to investigate the polymorphism of 3 major histocompatibility complex (MHC) loci in 3 Chinese alligator populations, in combination with 6 neutral microsatellite markers as a contrast. We found the genetic trace for the bottleneck effect on the endangered Chinese alligator: the low allelic diversity (2 alleles at each locus), the low nucleotide substitution rate (no more than 0.009) at all sites, the deviation from Hardy-Weinberg Equilibrium/heterozygote deficiency, and the significant Tajima's D values, indicating the MHC class I and class II loci being at different stages of bottleneck. We also obtained 3 pieces of evidence for balancing selection on this severely bottlenecked reptile: an obvious excess of nonsynonymous substitutions over synonymous at the antigen-binding positions, the mean synonymous substitution rate of MHC exons significantly higher than mean nucleotide substitution rate of introns, and the differentiation coefficient F ST of MHC loci significantly lower than that of microsatellite loci. Consequently, we emphasize that the Chinese alligator holds a pretty low adaptive ability and requires scientific conservation strategies to ensure the long-term population development.

Clinical outcomes associated with evolving treatment modalities and radiation techniques for base-of-tongue carcinoma: thirty years of institutional experience.

Curative treatment for base-of-tongue squamous cell carcinoma (BOT SCC) has evolved over time; however, comparative outcomes analysis for various treatment strategies is lacking. The authors reviewed the evolution of treatment modality and radiotherapy (RT) technique for 231 consecutive BOT SCC patients at our institution between 1981 and 2011. Treatment modalities included definitive chemoradiotherapy (chemoRT) (42%), definitive RT (33%), surgery followed by RT (20%), and surgery alone (5%). RT techniques included external beam plus interstitial brachytherapy (EBRT + IB) (37%), conventional EBRT (29%), intensity-modulated radiation therapy ± simultaneous integrated boost (IMRT ± SIB) (34%). Clinical characteristics and outcomes were stratified by modality or RT technique. Treatment modality evolved from definitive RT (1980s-1990s) to definitive chemoRT (1990s-2000s). RT technique evolved from EBRT + IB (1980s-1990s) to conventional EBRT (1990s-2000s) to IMRT + SIB (2000s). With median alive follow-up of 6 years (0.3-28 years), the 5-year LC, LRC, and OS rates were 80%, 73%, and 51%. There was no difference in distribution of gender, age, stage among treatment modalities. Definitive chemoRT had improved LRC (HR 1.6) and OS (HR 1.7) compared to definitive RT. IMRT + SIB had improved LRC (HR 3.2), DFS (HR 3.4), and OS (HR 3.0) compared to conventional EBRT. Over the past 30 years, BOT SCC treatment has undergone major paradigm shifts that incorporate nonsurgical functional preservation, concurrent chemotherapy, and advanced RT techniques. Excellent locoregional control and survival outcomes are associated with accelerated IMRT with chemotherapy.

Silver nanoparticles and growth factors incorporated hydroxyapatite coatings on metallic implant surfaces for enhancement of osteoinductivity and antibacterial properties.

Research on incorporation of both growth factors and silver (Ag) into hydroxyapatite (HA) coatings on metallic implant surfaces for enhancing osteoinductivity and antibacterial properties is a challenging work. Generally, Ag nanoparticles are easy to agglomerate and lead to a large increase in local Ag concentration, which could potentially affect cell activity. On the other hand, growth factors immobilization requires mild processing conditions so as to maintain their activities. In this study, bone morphology protein-2 (BMP-2) and Ag nanoparticle contained HA coatings were prepared on Ti surfaces by combining electrochemical deposition (ED) of Ag and electrostatic immobilization of BMP-2. During the ED process, chitosan (CS) was selected as the stabilizing agent to chelate Ag ions and generate Ag nanoparticles that are uniformly distributed in the coatings. CS also reduces Ag toxicity while retaining its antibacterial activity. Afterwards, a BMP/heparin solution was absorbed on the CS/Ag/HA coatings. Consequently, BMP-2 was immobilized on the coatings by the electrostatic attraction between CS, heparin, and BMP-2. Sustained release of BMP-2 and Ag ions from HA coatings was successfully demonstrated for a long period. Results of antibacterial tests indicate that the CS/Ag/HA coatings have high antibacterial properties against both Staphylococcus epidermidis and Escherichia coli. Osteoblasts (OB) culture reveals that the CS/Ag/HA coatings exhibit good biocompatibility. Bone marrow stromal cells (BMSCs) culture indicates that the BMP/CS/Ag/HA coatings have good osteoinductivity and promote the differentiation of BMSCs. Ti bars with BMP/CS/Ag/HA coatings were implanted into the femur of rabbits to evaluate the osteoinductivity of the coatings. Results indicate that BMP/CS/Ag/HA coatings favor bone formation in vivo. In summary, this study presents a convenient and effective method for the incorporation of growth factors and antibacterial agents into HA coatings. This method can be utilized to modify a variety of metallic implant surfaces.

Genome analysis and signature discovery for diving and sensory properties of the endangered Chinese alligator.

Crocodilians are diving reptiles that can hold their breath under water for long periods of time and are crepuscular animals with excellent sensory abilities. They comprise a sister lineage of birds and have no sex chromosome. Here we report the genome sequence of the endangered Chinese alligator (Alligator sinensis) and describe its unique features. The next-generation sequencing generated 314 Gb of raw sequence, yielding a genome size of 2.3 Gb. A total of 22 200 genes were predicted in Alligator sinensis using a de novo, homology- and RNA-based combined model. The genetic basis of long-diving behavior includes duplication of the bicarbonate-binding hemoglobin gene, co-functioning of routine phosphate-binding and special bicarbonate-binding oxygen transport, and positively selected energy metabolism, ammonium bicarbonate excretion and cardiac muscle contraction. Further, we elucidated the robust Alligator sinensis sensory system, including a significantly expanded olfactory receptor repertoire, rapidly evolving nerve-related cellular components and visual perception, and positive selection of the night vision-related opsin and sound detection-associated otopetrin. We also discovered a well-developed immune system with a considerable number of lineage-specific antigen-presentation genes for adaptive immunity as well as expansion of the tripartite motif-containing C-type lectin and butyrophilin genes for innate immunity and expression of antibacterial peptides. Multifluorescence in situ hybridization showed that alligator chromosome 3, which encodes DMRT1, exhibits significant synteny with chicken chromosome Z. Finally, population history analysis indicated population admixture 0.60-1.05 million years ago, when the Qinghai-Tibetan Plateau was uplifted.

[Efficacy evaluation of treating cervical spondylopathy with the Discover artificial cervical disc prosthesis].

OBJECTIVE: To explore the clinical and radiological outcomes of Discover artificial cervical disc arthroplasty and the range of motion status on adjacent segments for cervical spondylosis causing radiculopathy or myelopathy. METHODS: A total of 18 consecutive patients underwent cervical arthroplasty with the Discover artificial cervical disc at our hospital. Clinical and radiological follow-ups were conducted. Their radiographic parameters of treatment and adjacent segments were evaluated at Month 1, 3, 6, 12, 18 post-operation. And the Japanese Orthopedic Association (JOA) score, visual analog scale (VAS) pain score and Odom's scale were recorded and analyzed. RESULTS: During follow-ups over an average of 15 months, there was no occurrence of vascular injury, severe complications or prosthesis displacement and loosening. The score of JOA was 7.2±1.8 at preoperation and 16.7±4.5 at postoperation. And the score of VAS was 8.15±1.65 at preoperation and 2.03±1.12 at postoperation. CONCLUSION: Discover artificial cervical disc arthroplasty is efficacious and the patients recover quickly. Targeted cervical segments may be stabilized and their physiological ranges of motion preserved.

[Minimally invasive percutaneous pedicle screw fixation for the treatment of thoracolumbar fractures and posterior ligamentous complex injuries].

OBJECTIVE: To evaluate the efficacy and safety of minimally invasive percutaneous pedicle screw for the management of neurologically intact patients with thoracolumbar burst fractures and posterior ligamentous complex injuries. METHODS: In the study, 35 patients were reviewed,including 20 males and 15 females, with an average age of 34.1 years (18 to 52), and the mean follow-up for 25.8 months (24 to 36). RESULTS: The duration of surgery was (95.8±12.3) minutes and intraoperative blood loss was (83.0±40.7) mL. There were no major perioperative complications, with the exception of 2 patients who developed a superficial wound infection. LKA and VBH were significantly improved immediately after surgery (P<0.001). No significant loss of correction was observed in all the patients(P>0.05). Screw misplacement was observed in 9/140 (6.4%) and no patient showed neurological deficit as a result of screw misplacement. CONCLUSION: The minimally invasive percutaneous pedicle screw has a good clinical outcome in the treatment of thoracolumbar burst fractures with posterior ligamentous complex injury, which could maintain the fracture reduction effectively, and minimize the iatrogenic soft tissue injury.

[Early treatment of large soft-tissue wounds with intermittent vacuum sealing drainage].

OBJECTIVE: To evaluate the early clinical efficacy of large soft-tissue wounds with intermittent vacuum sealing drainage. METHODS: From March 2009 to June 2010, the study group was comprised of 56 patients treated with intermittent vacuum sealing drainage. There were 47 males and 9 females with a mean age of 37.5 years (range: 16 - 65). Intermittent vacuum sealing drainage was immediately used after an emergency operation. The mean duration of treatment was 2.5 weeks (range: 1 - 4). The granulation status was observed and wound dressing changed weekly. RESULTS: Among them, all wound surfaces were dry and granulation tissues brightly red. There was no deep infection. The mean healing durations of intermittent and continuous vacuum sealing drainage groups were (32 ± 4.5) and (37 ± 7.5) days respectively. And there was no statistical difference (P > 0.05). CONCLUSION: Intermittent vacuum sealing drainage promotes a rapid and copious production of granulation tissue over soft tissue wound. The patient suffering is minimal and the dressings are easy to manage.

[Treatment of lumbar disc herniation by modified transforaminal lumbar interbody fusion with a pedicle screw system].

OBJECTIVE: To evaluate the outcomes of modified transforaminal lumbar interbody fusion in patients with lumbar disc herniation. METHODS: Forty-six cases of lumbar disc herniation were treated by modified transforaminal lumbar interbody fusion. There were 32 males and 14 females with a mean age of 47 years old (range: 27 - 65). The mean course of disease was 7.5 years (range: 4 - 18). Eighteen cases were of single-level lumbar disc herniation, including L3/4 (n = 5), L4/5 (n = 8) and L5/S1 (n = 5). There were 28 cases with lumbar degenerative diseases at other levels. Preoperatively, the score of visual analogue scale (VAS) was 8.9 ± 1.3 and the score of Oswestry disability index (ODI) was 57.3 ± 5.2. All patients received a normal conservative treatment for at least 3 months with no therapeutic effect at pre-operation. RESULTS: Forty-six cases had an average follow-up of 20 months (range: 12 - 20). The operative duration was an average of 160 minutes (range: 120 - 180). And the average volume of intra-operative blood loss was 550 ml (range: 400 - 800). There was no severe complication. The symptoms became stable after three months. At 3 months postoperatively, the score of VAS was 2.0 ± 0.4 and the score of ODI 15.2 ± 3.4. And there were significant differences between preoperative and postoperative values (P < 0.05). The improvement rates of postoperative VAS and ODI were (80.1 ± 4.7)% and (73.6 ± 2.8)% respectively. All patients achieved lumbar interbody bone fusion at 12 months post-operation with a fusion rate of 100%. For the therapeutic effect, 34 cases were regarded as excellent, 8 good and 4 fair with an excellent/good rate of 91.3%. All patients began to walk with orthosis after 3 days and resumed their jobs and normal lives after 3 months. CONCLUSION: Modified transforaminal lumbar interbody fusion is effective for the treatment of lumbar disc herniation. Making a detailed operative plan on the basis of preoperative images and symptoms is essential.

Molecular dynamics simulation of RGD peptide adsorption on titanium oxide surfaces.

Peptide Arg-Gly-Asp (RGD) sequence is a ubiquitous adhesive motif found in various bone extracellular matrix proteins and is crucial in the biomaterial surface/interface reaction. This study analyzed the adsorption of RGD on different titanium oxide surfaces with molecular dynamics simulation. The simulation results indicate that the RGD peptide binds strongly with anatase (001) and rutile (010). RGD conformation changes due to the variation of the backbone torsion angle in the middle of the RGD chain. Pair correlation function analysis indicates that the interaction of the RGD peptide and the titanium oxide results from hydrogen bonding and the groups in RGD play different roles during the adsorption process. This study provides useful information on how to design titanium surfaces in order to modulate peptide or protein adsorption.

[Surgical treatment of open fractures of the talus].

OBJECTIVE: To evaluate the long-term outcomes of surgical treatment of open fracture of talus. METHODS: Sixteen patients with displaced open fractures of the talus, including 3 cases of type 1, 8 of type 2, 2 of type 3A, 2 of type 3B, and 1 of type 3C according to the Gustilo-Anderson classification system, 15 males and 1 female, aged 37.5 (21 - 48), were treated with open reduction and stable internal fixation within 6 - 8 hours after injury, and followed up for 3.2 years (3 - 6 years). There were 7 cases of pure displaced talar neck or body fracture and 9 cases of fractures associated with an ipsilateral pilon, ankle, and calcaneus totally that included 2 cases of type 2, 3 of type 3, and 1 of type 4 according to the Hawkins classification system modified by Canale. RESULTS: The union rate was 81% (13/16) with the average union time of 4.5 months. Three cases failed to heal and developed osteomyelitis, of which 2 were treated with late talectomy because of septic nonunion. One case underwent amputation below-the-knee because of instability and pain. Osteonecrosis developed after seven of the nineteen closed fractures, whereas posttraumatic arthritis developed after all nineteen. Osteonecrosis developed in 11 (68%), and posttraumatic arthritis developed in 13 of the 16 cases (85%). The average American Orthopaedic Foot and Ankle Society score of these patients was 43.7 points. CONCLUSION: Open fractures of the talus has a low union rate, a higher osteonecrosis rate, and substantially higher reoperation and infection rates. Posttraumatic arthritis is a more common complication than osteonecrosis following operative treatment. Open reduction and internal fixation are recommended for the treatment of open fractures of talus.