A network pharmacology approach to explore and validate the potential targets of ginsenoside on osteoporosis.

Background: Osteoporosis (OP) is determined as a chronic systemic bone disorder to increase the susceptibility to fracture. Ginsenosides have been found the anti-osteoporotic activity of in vivo and in vitro. However, its mechanism remains unknown.Methods: The potential mechanism of ginsenosides in anti-osteoporotic activity was identified by using network phamacology analysis. The active compounds of ginsenosides and their targets associated to OP were retrieved from Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform, Drug Bank, Pharmmapper, and Cytoscape. The Gene ontology (GO) enrichment analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis target genes were performed in String, Phenopedia, DisGeNET database, and Metascape software. The protein to protein interaction were created by String database and Cytoscape software. The molecular docking was used to investigate the interactions between active coumpounds and potential targets by utilizing SwissDock tool, UCSF Chimera, and Pymol software. Results: A total of eight important active ingredients and 17 potential targets related to OP treatment were subjected to analyze. GO analysis showed the anti-osteoporosis targets of ginsenoside mainly play a role in the response to steroid hormone. KEGG enrichment analysis indicated that ginsenoside treats OP by osteoblast differentiation signal pathway. Lastly, the molecular docking outcomes indicated that ginsenoside rh2 had a good binding ability with four target proteins IL1B, TNF, IFNG, and NFKBIA. Conclusion: IL1B, TNF, IFNG, and NFKBIA are the most important targets and osteoblast differentiation is the most valuable signaling pathways in ginsenoside for the treatment of OP, which might be beneficial to elucidate the mechanism concerned to the action of ginsenoside and might supply a better understanding of its anti-OP effects.

Risk and Prognostic Factors for Rupture of Intracranial Aneurysms During Endovascular Embolization.

OBJECTIVE: Intraoperative aneurysm rupture (IPR) always results in a poor prognosis for the patient. However, the risk factors of IPR are unclear. In this article, the risk factors are explored, a nomogram model for predicting IPR is established, and the prognostic factors for patients with IPR are analyzed. METHODS: A total of 549 patients with aneurysm, which were embolized from September 2011 to September 2015, were enrolled for analysis. Univariate and multivariate logistic regression were performed to explore the risk factors for IPR, and a nomogram was established. A nonparametric Mann-Whitney U test was performed to analyze prognostic factors for patients with IPR. RESULTS: Twenty-one patients (4.4%) experienced IPR. In univariate analysis, Hunt-Hess grade (P = 0.002), time from hospitalization to treatment (P = 0.08) and subarachnoid hemorrhage (SAH) to treatment (P = 0.08), aneurysm neck (P = 0.08), assistive technique (P = 0.03), and intraoperative cerebral vasospasm (P < 0.001) were significantly associated with IPR. In multivariate analysis, Hunt-Hess grade (odds ratio [OR], 8.177; 95% confidence interval [CI], 1.714-39.012; P = 0.008), aneurysm neck (OR, 5.629; 95% CI, 1.149-27.575; P = 0.033), assistive technique (OR, 1.393; 95% CI, 0.961-2.018; P = 0.080), and intraoperative cerebral vasospasm (OR, 4.280; 95% CI, 1.081-16.947; P = 0.038) were independent risk factors for IPR. Hydrocephalus (P = 0.069), history of SAH (P = 0.10), ≥2 SAH (P = 0.051), location of aneurysm (P = 0.09), and number of aneurysms (P = 0.025) were associated with the bad outcome. CONCLUSIONS: Hunt-Hess grading, aneurysm neck, intraoperative assistive technology, and vasospasm were independent risk factors for IPR. Hydrocephalus requiring surgical intervention, times of rupture, location of aneurysm, and the number of aneurysms were relevant to the prognosis of patients.

Comparison of nerve combing and percutaneous radiofrequency thermocoagulation in the treatment for idiopathic trigeminal neuralgia / Comparação entre neurólise interna e termocoagulação percutânea por radiofrequência no tratamento da neuralgia idiopática do trigêmeo

ABSTRACT INTRODUCTION: Idiopathic trigeminal neuralgia (ITN) is a common pain disease in elderly people. Many methods have been used to alleviate the pain of patients, but few studies in the literature have compared the effect of nerve combing and percutaneous radiofrequency thermocoagulation. OBJECTIVE: The purpose of this study was to describe and evaluate the clinical outcome of idiopathic trigeminal neuralgia after nerve combing (NC) and compare them with those obtained using percutaneous radiofrequency thermocoagulation (RF). METHODS: The study included 105 idiopathic trigeminal neuralgia patients with similar symptom, age and underlying disease, which were divided into two groups. One group was treated by nerve combing (50 patients), the other by RF (55 cases). All patients were considered medical failures prior to the surgeries. A questionnaire was used to assess the long-term outcomes: pain relief, recurrence, complication and need for additional treatment. RESULTS: The median duration of follow-up in both groups was 90 months. Satisfactory relief was noted in 41 patients (82%), 5 patients (10%) initially experienced pain relief, then recurred, and four patients (8%) were designated poor among the group NC. In the group RF, satisfactory relief was noted in 42 patients (76.4%). There were eight "pain free with recurrence patients (14.5%) and 5 poor cases (9.1%). No statistically significant differences existed in the outcomes between both groups (p > 0.05). Postoperative morbidity included dysesthesia, diplopia, partial facial nerve palsy, hearing loss, tinnitus, cerebrospinal fluid leak, meningitis and mortality. CONCLUSION: Nerve combing and RF are both satisfactory treatment strategies for patients with ITN. Because of the higher risk of sensory morbidity and surgical risk as open surgery, RF is preferred as the recommended procedure for patients with ITN.

Resumo Introdução: A neuralgia idiopática do trigêmeo (NIT) é uma condição dolorosa comum em idosos. Muitos métodos têm sido usados para aliviar a dor dos pacientes, mas poucos estudos na literatura compararam o efeito de neurólise interna e termocoagulação percutânea por radiofrequência. Objetivo: O objetivo desse estudo foi descrever e avaliar o desfecho clínico de pacientes com neuralgia idiopática do trigêmeo após neurólise interna (NI) e compará-los com os obtidos usando termocoagulação percutânea por radiofrequência (RF). Método: O estudo incluiu 105 pacientes com NIT com sintomas, idade e doenças de base semelhantes, que foram divididos em dois grupos. Um grupo foi tratado por neurólise interna (50 pacientes) e o outro por RF (55 casos). Todos os pacientes haviam sido considerados fracassos terapêuticos antes das cirurgias. Um questionário foi utilizado para avaliar os resultados a longo prazo: alívio da dor, recorrência, complicações e necessidade de tratamento adicional. Resultados: A duração média do acompanhamento foi de 90 meses em ambos os grupos. Alívio satisfatório foi observado em 41 pacientes (82%); cinco pacientes (10%) experimentaram alívio inicial da dor, porém seguido de recrudescimento, e quatro pacientes (8%) apresentaram desfecho desfavorável no grupo NI. No grupo de RF, alívio satisfatório foi observado em 42 pacientes (76,4%). Houve oito pacientes livres de dor, com recorrência ''LDR'' (14,5%) e cinco casos com desfecho desfavorável (9,1%). Não houve diferenças significantes nos resultados entre os dois grupos (p > 0,05). Morbidade pós-operatória incluiu disestesia, diplopia, paralisia parcial do nervo facial, perda auditiva, tinnitus, fístula liquórica, meningite e óbito. Conclusão: Neurólise interna e RF são estratégias satisfatórias de tratamento para os pacientes com NIT. Em decorrência da maior morbidade sensorial e maior risco cirúrgico em uma cirurgia aberta, a RF é o procedimento mais indicado para pacientes com NIT.

Comparison of nerve combing and percutaneous radiofrequency thermocoagulation in the treatment for idiopathic trigeminal neuralgia.

INTRODUCTION: Idiopathic trigeminal neuralgia (ITN) is a common pain disease in elderly people. Many methods have been used to alleviate the pain of patients, but few studies in the literature have compared the effect of nerve combing and percutaneous radiofrequency thermocoagulation. OBJECTIVE: The purpose of this study was to describe and evaluate the clinical outcome of idiopathic trigeminal neuralgia after nerve combing (NC) and compare them with those obtained using percutaneous radiofrequency thermocoagulation (RF). METHODS: The study included 105 idiopathic trigeminal neuralgia patients with similar symptom, age and underlying disease, which were divided into two groups. One group was treated by nerve combing (50 patients), the other by RF (55 cases). All patients were considered medical failures prior to the surgeries. A questionnaire was used to assess the long-term outcomes: pain relief, recurrence, complication and need for additional treatment. RESULTS: The median duration of follow-up in both groups was 90 months. Satisfactory relief was noted in 41 patients (82%), 5 patients (10%) initially experienced pain relief, then recurred, and four patients (8%) were designated poor among the group NC. In the group RF, satisfactory relief was noted in 42 patients (76.4%). There were eight "pain free with recurrence patients (14.5%) and 5 poor cases (9.1%). No statistically significant differences existed in the outcomes between both groups (p>0.05). Postoperative morbidity included dysesthesia, diplopia, partial facial nerve palsy, hearing loss, tinnitus, cerebrospinal fluid leak, meningitis and mortality. CONCLUSION: Nerve combing and RF are both satisfactory treatment strategies for patients with ITN. Because of the higher risk of sensory morbidity and surgical risk as open surgery, RF is preferred as the recommended procedure for patients with ITN.

Comparative Study of Endolymphatic Sac Decompression and Vestibular Neurectomy in Intractable Meniere's Disease.

To comparative study the clinical effect of endolymphatic sac decompression (ELSD) and vestibular neurectomy (VN) in intractable Meniere's disease (MD). The study included 30 MD intractable patients, 21 of which underwent ELSD and nine of which were treated by VN via retrosigmoid approach. Follow-up period ranged from 3 to 6 years. In 21 patients by ELSD, excellent vertigo control and good control were noted in 11 patients (52.4 %) and 4 patients (19.0 %), partial control in 4 and no control in 2 patients. All the 9 patients by VN, vertigo was excellent control. ELSD can improve hearing and tinnitus, but VN not. VN can achieve much better effect in improving vertigo in intractable MD patients. But relative to ELSD, it has much more disadvantages.

Surgical management of facial paralysis resulting from temporal bone fractures.

CONCLUSION: To achieve good facial reanimation in cases with facial paralysis resulting from temporal bone fractures, the ideal timing for surgical intervention is at least within 1 month of injury and an appropriate surgical approach should be selected depending on the site of facial nerve injury. OBJECTIVE: This paper aimed to address the ideal time for surgical intervention and the appropriate surgical approach for patients with facial paralysis resulting from temporal bone fractures. METHODS: We retrospectively investigated 60 patients with facial paralysis due to temporal bone fractures who underwent facial nerve decompression via different operative approaches within 1 month after trauma, of which 48 were surgically treated by the middle cranial fossa approach (80%), 8 by a pure transmastoid approach (13.3%), and four by a combined transmastoid and middle cranial fossa approach (6.7%). The House-Brackmann (H-B) grading system was used to evaluate the recovery of facial nerve function. RESULTS: The follow-up period for all the patients was 1 year. Among 60 patients who were surgically treated, 39 achieved grade I of facial nerve function, 18 achieved grade II, two achieved grade III, and one achieved grade IV according to the H-B grading system.