Network pharmacology identification and in vivo validation of key pharmacological pathways of Qin Jiao for gout and arthritis.

Context: Gout is a chronic disease that imposes a huge financial and health burden on patients, which might diminish quality of life. Qin Jiao, a perennial herb found in northwestern China and Japan, is commonly used for treating various ailments.Objective: This study investigates the effects of Qin Jiao on gout and joint inflammation and elucidates its potential mechanism for gouty arthritis.Materials and methods: Study 1, a literature review was conducted using PubMed, Web of Science, and CNKI to assess the applications of Qin Jiao in arthritis treatment. Study 2 was performed to discover the component targets and gouty disease targets via TCMSP, OMIM, GeneCards and DRUGBANK, and network pharmacology analysis. Study 3, male Sprague-Dawley (SD) rats were divided into normal, model, colchicine, Qin Jiao low-dose (QJL), and Qin Jiao high-dose group (QJH), oral gavage for 40 d. Serum, synovial fluid, and synovial membrane tissue were collected to measure the expression levels of IL-1ß, IL-6, and STAT3.Results: The research also identified potential targets and pharmacological pathways of Qin Jiao for gout treatment. In vivo study demonstrated Qin Jiao can reduce IL-1ß levels in serum and ankle flushing fluid. ELISA analysis confirmed that Qin Jiao significantly reduces the protein expression of IL-6 and STAT3.Discussion and conclusion: Qin Jiao exerts anti-inflammatory effects on gouty arthritis by modulating the IL-6/STAT3 pathway. This study provides a biological basis for the use of Qin Jiao in treating arthritis-related diseases and offers experimental evidence for potential future drug development.

Misdiagnosis of primary dumbbell chordoma of the cervical spine.

AIM: This study aimed to analyze the clinical characteristics and outcomes of patients with primary dumbbell chordoma of the cervical spine and to summarize the causes of misdiagnosis. METHODS: The clinical data of patients were retrospectively collected. The diagnostic process, surgical procedures, and outcomes were analyzed, then the difference was compared between dumbbell and non-dumbbell chordomas of the cervical spine. RESULTS: This study included six patients with primary dumbbell chordoma (one male and five females) with a mean age of 32.2 ± 24.5 years (range: 5-61 years). Five cases with no computed tomography (CT) examination before the first operation were misdiagnosed, and on magnetic resonance imaging (MRI), primary dumbbell chordoma showed the following specific features: extensive invasion of the surrounding soft tissues with an obscure boundary (≥5 cm), intervertebral disc sparing, and hemorrhagic necrosis, furthermore, the CT features included atypical destructive vertebral lesions, minimal intralesional calcification, and neural foraminal enlargement. After comparison with non-dumbbell chordomas, it show statistical difference (p < 0.05) in terms of calcification, foramen enlargement, FNA, misdiagnosis rate but with different recurrent rate. CONCLUSION: Primary dumbbell chordomas of the cervical spine can easily be misdiagnosed as neurogenic tumors. Preoperative CT-guided fine-needle aspiration puncture biopsy helps make an accurate diagnosis. Gross total excision with postoperative radiotherapy has been proven effective in reducing the recurrence rate.

Ramulus Mori (Sangzhi) alkaloids tablets for diabetes mellitus: A regulatory perspective.

The reform of the review and approval system for Traditional Chinese Medicine (TCM) continues to advance with the introduction of a new registration classification and the establishment of a review and approval evidence system. This new registration process established a novel review and approval evidence system, which combines the TCM theory, human use experience and clinical trials. Ramulus Mori (Sangzhi) alkaloids Tablets are a brand new drug. It is the first botanical natural hypoglycemic drug, and a new model of TCM review and approval evidence system has gradually been developed through contemporary research. In this paper, we discuss the registration process of new Chinese medicine drugs under the "three integrated review and approval system", retrace the development process of Mulberry alkaloid tablets, and discuss the opportunities and challenges encountered under the "three integrated" evidence system to provide feasible strategies and reference models for the development of Chinese medicine and the development of botanical drugs in the world.

Investigation of cullin-3 gene expression changes in people with colorectal cancer and polyps in China.

Colorectal cancer (CRC) is one of the most common fatal malignancies caused by environmental and genetic factors. Considering the increasing frequency of CRC worldwide, especially in China, the importance of research on CRC is more widely defined. A recent study focused on molecular pathways involved in colon cancer carcinogenesis to improve cancer diagnosis and treatment to identify new biomarkers. Colon cancer is the result of dysplasia in primary growths of the intestine, known as polyps. These early growths are unknown and different in terms of morphology, molecular mechanisms, and the ability to cause colon cancer. This study aims to investigate the expression level of the CUL3 gene in polyps and colorectal cancer. This cross-sectional study collected 300 colorectal tissue biopsy samples, including 40 tumor tissue samples, 73 precancerous lesions with their adjacent tissue, and 31 normal tissue samples. The expression of the CUL3 gene was investigated by the Real-time PCR method. There was no significant difference in CUL3 mRNA expression between polyp tissues and their adjacent samples (p = 0.41). Our results showed no statistically significant difference in CUL3 gene expression between tumor tissues and their adjacent thermal samples (p = 0.78) and between tumor and polyp groups (p = 0.53). CUL3 may play an essential role in regulating cancer and CRC progression by stimulating the proteasomal degradation of various tumor suppressors or oncogenes. Studies on the effective substrates of CUL3 in colorectal cancer are essential.

[Visual analysis of exosomes in traditional Chinese medicine research and application status based on CiteSpace knowledge map].

In this study, CiteSpace was used to conduct bibliometric statistics and visualization of the research papers on the exosomes in traditional Chinese medicine(TCM) and application status in CNKI, Wanfang, VIP, and Web of Science. The authors, research institutions, and keywords of the relevant papers were analyzed to summarize the research status, hotspots, and development trends of TCM application of exosomes, thereby providing references for future research. A total of 340 Chinese papers and 9 English papers were included. In Chinese papers, GUO Hai-dong is the author with the largest amount of research papers, and his research interest is the mechanism of electroacupuncture in promoting functional recovery after sciatic nerve injury by regulating the release of exosomes. Shanghai University of Traditional Chinese Medicine is the research institution with the largest amount of papers, followed by Nanjing University of Chinese Medicine and Hunan University of Chinese Medicine. There was less cooperation among these research institutions, and cooperation between teams and agencies should be strengthened. The overall volume of publications in English was comparatively small, and the connections between the authors were weak. The publishing organizations were mostly distributed in medical schools, hospitals, comprehensive universities, and the cooperation between institutions was scattered. The main keywords in Chinese papers include microRNA, mesenchymal stem cells, bone marrow mesenchymal stem cells, mechanism of action, and extracellular vesicles. The research of exosomes in TCM is increasing in recent years. The research hotspot is that exosomes can both serve as biomarkers for the diagnosis and prognosis of certain diseases in TCM and drug carriers of Chinese medicine for targeted treatment of diseases. Keyword prominence suggested that exosomes derived from osteoblasts and macrophages in the treatment of diseases might still be a future research trend.

Radiofrequency ablation in gross total excision of cervical chordoma: ideas and technique.

PURPOSE: To use radiofrequency ablation (RFA) in the resection of C4 cervical chordoma with a giant paravertebral tumor mass to achieve tumor-free exposed margins and perform a gross total excision. METHODS: A gross total excision using combined posterior and anterior approaches was performed. In the posterior stage, the C4 posterior arch was removed and the C4/C5 nerve roots and vertebral artery were released from the tumor. In the anterior stage, the giant soft mass of tumor from C3 to C6 was treated with RFA to make it shrink and solidify visually to achieve tumor-free exposed margins before resecting the tumor. Finally, a gross total excision was performed followed by the implantation of titanium plate and mesh filled with allograft bone. RESULTS: A gross total excision was performed with tumor-free exposed margins and radiotherapy. The patient survived more than 5 years without recurrence. CONCLUSIONS: RFA can help achieve tumor-free exposed margins. A gross total excision combined with RFA can improve the local relapse-free survival of patients with cervical chordoma. These slides can be retrieved under Electronic Supplementary Material.

Effects of small molecules water that may retard kidney stone formation.

PURPOSE: Water intake is important for preventing kidney stones. Small molecules water is a more active restructured water under magnetic field. Here, we studied the relation between small molecules water and crystal formation in the rat kidney. MATERIALS: The small molecules water was prepared by a water machine providing a 0.8-T magnetic field. Calcium oxalate crystals were induced by 0.75% EG (ethylene glycol) in male Sprague-Dawley rats by drinking small molecules water and plain water for up to 6 weeks, respectively. Urinary ions were assayed. Osteopontin mRNA expression and urinary LDH were detected. Crystals were observed using a light microscope and a polarizing microscope. RESULTS: A significantly reduced urinary calcium and phosphorus excretion occurred in the 2nd and the 4th week after treatment of small molecules water. Crystals were initially detected in 40% of the experimental rats in the small molecules water group at the 6th week, later than the control group in which crystals were detected in 60% of rats at the 4th week. After 6 weeks of treatment, crystals were observed to form in renal cortex, medulla and papilla in the control group, whereas only to form in renal medulla and papilla in the small molecules water group. OPN mRNA expression significantly increased earlier in the 2nd week after treatment of the small molecules water compared to the control (P = 0.016). CONCLUSIONS: Small molecules water may retard crystal formation, reduce urinary calcium and phosphorus excretion and promote earlier OPN mRNA expression in the rat kidney.

Risk factors and the surgery affection of respiratory complication and its mortality after acute traumatic cervical spinal cord injury.

The aim of this study is to estimate the risk factors of both respiratory complication (RC) and mortality after acute traumatic cervical spinal cord injury (TCSCI). Between July 2005 and July 2015, in 181 patients (142 males and 39 females; mean age 41.0 years) with acute TCSCI, we compared the difference and odds ratio in RC group (n = 73) with that of non-RC group (n = 108), and also death group (n = 15) and survival group (n = 166). We collected injury-related information after half a year of injury, which is as follows: the causes of injury, time of surgery, ICU (intensive care unit) days, ventilator days, ASIA (American Spinal Injury Association) classification, neurological injury, CIPS (Clinical Pulmonary Infection Score), and BMI (body mass index). Besides these, we gathered the general information such as age, gender, smoking history, and use of steroids. The study compared perioperative parameters; surgery-related and instrumentation- and graft-related complication rates; clinical parameters; patient satisfaction; and radiologic parameters. Variations like gender (odds ratio [OR] = 1.269, 95% confidence interval [CI] [0.609-2.646]), smoking history (OR = 2.902, 95% CI [1.564-5.385]), AIS grade (grade A) (OR = 6.439, 95% CI [3.334-12.434]), neurological level (C1-C4) (OR = 2.714, 95% CI [1.458-5.066]), and steroid use (OR = 2.983, 95% CI [1.276-6.969]) have a facilitated effect on RC. When we estimated surgery-related affection, only the time of surgery and anterior approach compared with posterior has significant difference in RC (P < .05). Between death and survival group, the aspect of age, non-surgical, CPIS, AIS grade, and BMI have statistically significant difference. Survival analysis reveals significant difference in aforementioned groups. In patients suffering from acute TCSCI, those who are old, have long smoking history, complete spinal cord injury, C1-C4, high CPIS, and fat have high incidence of RC and mortality.

One-year clinical study of NeuroRegen scaffold implantation following scar resection in complete chronic spinal cord injury patients.

The objective of this clinical study was to assess the safety and feasibility of the collagen scaffold, NeuroRegen scaffold, one year after scar tissue resection and implantation. Scar tissue is a physical and chemical barrier that prevents neural regeneration. However, identification of scar tissue is still a major challenge. In this study, the nerve electrophysiology method was used to distinguish scar tissue from normal neural tissue, and then different lengths of scars ranging from 0.5-4.5 cm were surgically resected in five complete chronic spinal cord injury (SCI) patients. The NeuroRegen scaffold along with autologous bone marrow mononuclear cells (BMMCs), which have been proven to promote neural regeneration and SCI recovery in animal models, were transplanted into the gap in the spinal cord following scar tissue resection. No obvious adverse effects related to scar resection or NeuroRegen scaffold transplantation were observed immediately after surgery or at the 12-month follow-up. In addition, patients showed partially autonomic nervous function improvement, and the recovery of somatosensory evoked potentials (SSEP) from the lower limbs was also detected. The results indicate that scar resection and NeuroRegen scaffold transplantation could be a promising clinical approach to treating SCI.

Knowledge, attitudes and practice of desalinated water among professionals in health and water departments in Shengsi, China: a qualitative study.

Desalination has been considered as an essential way to solve water stress all over the world. Most of previous studies focused on its environmental impacts, energy consumption and desalination technologies rather than human health. However, the safety of desalinated water remains unclear. This study was undertaken to investigate the knowledge, attitude and practice (KAP) of the residents in an island county in eastern China to desalinated water. Seventeen people working in medical and water industries were recruited, and focus group discussion and in-depth interview were conducted among them. Our results showed that the majority of people interviewed knew the definition and local supply pattern of desalinated water, while some of them showed some concern about the safety and nutrition of desalinated water. Current drinking water standard has no specific item for desalination, so we strongly suggest issuing a standard for desalinated water.