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    18 December 2019, Volume 23 Issue 35 Previous Issue    Next Issue
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    Association between vitamin D receptor gene polymorphism and semi-quantitative classification of thoracolumbar osteoporotic vertebral compression fractures
    Lu Qiuping1, Gui Yuchang2, Xu Jianwen2, Qin Haibiao3, Rao Yuansen1
    2019, 23 (35):  5577-5581.  doi: 10.3969/j.issn.2095-4344.1989
    Abstract ( 359 )   PDF (21064KB) ( 170 )   Save

    BACKGROUND: Vitamin D receptor gene plays a key role in regulating calcium and phosphorus metabolism and bone metabolism. There are no reports on its association with osteoporotic vertebral compression fractures.
    OBJECTIVE: To investigate the relationship between vitamin D receptor gene polymorphism and semi-quantitative classification of thoracolumbar osteoporotic vertebral compression fractures by restriction fragment length polymorphism polymerase chain reaction.
    METHODS: The study was in accordance with the ethical requirements of the First Affiliated Hospital of Guangxi University of Chinese Medicine, and all participants signed the informed consents. Sixty patients with thoracolumbar osteoporotic vertebral compression fractures were randomly selected. The standard lateral X-ray films of the whole spine were taken. The Genant semi-quantitative method was used to classify the fracture types. The serum of peripheral blood was collected, and the genotype of vitamin D receptor polymorphism was identified by DNA amplification, specific enzyme digestion and gel electrophoresis imaging. The correlation between the polymorphisms of the vitamin D receptor and the thoracolumbar osteoporotic vertebral compression fractures classification was analyzed by statistical methods.
    RESULTS AND CONCLUSION: (1) Vitamin D receptor gene BB type was detected in 0 case, Bb type in 28 cases and BB type in 32 cases.
    (2) Type II (moderate compression) and type III (severe compression) Bb vertebral fractures accounted for 87%, compared with Bb group accounted for 32%, the difference was significant (χ2=57.236, P < 0.01). (3) These results indicate that different genotypes of vitamin D receptor in thoracolumbar osteoporotic vertebral compression fractures patients are correlated with fracture types. The risk of moderate to severe compressive vertebral fractures in patients with Bb genotype is higher than that in patients with bb genotype.

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    Comparison of bone mineral density levels in women of different ages during middle and late pregnancies
    Huang Liqian, Kong Cunqing, Shu Wenbo, Zhou He, Lai Qiurong, Chen Run, Tang Cheng, Yang Yazhu,
    2019, 23 (35):  5582-5586.  doi: 10.3969/j.issn.2095-4344.1902
    Abstract ( 695 )   PDF (20431KB) ( 154 )   Save

    BACKGROUND: With the increasing awareness of eugenics and the opening up of the National Policy of Second Child, people pay more and more attention to health care during pregnancy, especially nutrition intake and bone health status during pregnancy.
    OBJECTIVE: To provide scientific and rational nutrition guidance for maternal health care and prevent bone mineral density from decreasing during pregnancy by comparing and analyzing the changes of bone mineral density in women of different ages and gestational periods.
    METHODS: Totally 531 pregnant women admitted to the hospital from June 2017 to April 2018 were selected. All participants were native residents of Guangxi Zhuang Autonomous Region, volunteered to the trial, and signed the informed consents. They were signed by pregnancy week and age. The bone mineral density of radius of pregnant women in each group was measured by ultrasound. Correlation analysis of age, pregnancy week and bone mineral density was conducted.
    RESULTS AND CONCLUSION: (1) There was no significant difference in the bone mineral density decrease between middle and late pregnant women (P > 0.05). (2) The speed of sound and T values of pregnant women of different ages had significant difference, and increased with age (P < 0.05). (3) The speed of sound and T values in the second trimester increased with age, and there was a significant difference (P < 0.05). There was no significant difference in the bone mineral density between the different age groups in the third trimester (P > 0.05). (4) These results indicate that bone mineral density changes should be regularly detected in the middle and late pregnancies, and the calcium deficiency and bone condition of pregnant women should be known in time. Nutritional intervention should be carried out in the early stage to ensure maternal bone health and normal fetal development.

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    Association of polymorphisms of klotho gene with primary osteoporosis in the elderly aging above 60 years old
    Ma Qiuhua, Wang Yunwen, Ma Hui, Qi Jie, Zhang Qingtan
    2019, 23 (35):  5587-5591.  doi: 10.3969/j.issn.2095-4344.1973
    Abstract ( 306 )   PDF (16797KB) ( 193 )   Save

    BACKGROUND: Klotho gene has been shown to be related to various diseases, such as osteoporosis, tumor, atherosclerosis and dyslipidemia.
    OBJECTIVE: To further testify the association of polymorphisms of klotho gene with primary osteoporosis in elderly (≥ 60 years old).
    METHODS: The study was in accordance with the ethical requirements of Binzhou Medical University Hospital, and the participants signed the informed consents. A total of 609 elderly Han patients were selected
    from Medical Examination Center and Division of Geriatrics of Binzhou Medical University Hospital. There were 303 osteoporotic patients, and 306 healthy controls. Genotypes of klotho G395A and F352V polymorphisms were analyzed by multiplex SNaPshot SNP reaction.
    RESULTS AND CONCLUSION: (1) The distribution frequency of GG genotype of klotho G395A in the control group was higher than that in the osteoporosis group (P < 0.05). (2) The distribution frequency of GG genotype of klotho G395A in the female osteoporosis group was lower than that in the control group (P < 0.05). (3) According to multivariate logistic regression analysis, the total bilirubin, age and body mass index were risk factors of primary osteoporosis. (4) In summary, the klotho loci G395A and F352V polymorphisms may be not the risk factors of osteoporosis in the Han elderly in this area. Total bilirubin, age and body mass index may be related to osteoporosis.

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    Diagnosis and treatment of early joint infection after anterior cruciate ligament reconstruction
    Wang Changbing1, 2, Lu Mingfeng2, He Lilei2, Xing Jisi2, Xu Ting2, Zhao Lilian2, Liu Xiaofang1
    2019, 23 (35):  5592-5599.  doi: 10.3969/j.issn.2095-4344.1980
    Abstract ( 464 )   PDF (29380KB) ( 120 )   Save

    BACKGROUND: Infection after anterior cruciate ligament reconstruction is a rare but serious complication. There is no unified standard for the diagnosis and treatment of infection after anterior cruciate ligament reconstruction.
    OBJECTIVE: To investigate the diagnosis and treatment method of joint infection after anterior cruciate ligament reconstruction.
    METHODS: The study was in accordance with the ethical requirements of Foshan Hospital of Traditional Chinese Medicine, and the patients signed the informed consents. Clinical data of 1 489 patients who underwent anterior cruciate ligament reconstruction were retrospectively analyzed. The clinical manifestations, laboratory examinations, treatment methods and clinical prognosis of highly suspected cases of postoperative infection were observed. The appropriate clinical diagnosis and treatment methods were summarized.
    RESULTS AND CONCLUSION: (1) Postoperative joint infections occurred in 38 cases. The clinical manifestations were fever or local surgical orifice ulceration with joint swelling and pain, local skin temperature elevation, high-sensitivity C-reactive protein and erythrocyte sedimentation rate elevation, and the decreased positive rate of bacterial culture. (2) The treatment included active intravenous antibiotic therapy and arthroscopic synovial membrane cleaning and catheter irrigation and drainage. (3) All cases were cured. The patients were followed up for 12 months. The joint movement and function were good. (4) To conclude, positive diagnosis and treatment of highly suspected cases of joint infection after anterior cruciate ligament reconstruction can achieve good prognosis.

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    Effects of ligustrazine on free radicals and enzyme metabolism after static postural load in rat models
    Xiao Kai1, Zhou Jianghong1, Gao Xinfeng1, Zhao Jingjing1, Fang Zhenhua1, Yang Lin2
    2019, 23 (35):  5600-5604.  doi: 10.3969/j.issn.2095-4344.1979
    Abstract ( 320 )   PDF (19543KB) ( 114 )   Save

    BACKGROUND: Ligustrazine has been shown to protect the rat skeletal muscle under state of disuse, and protect against skeletal muscle atrophy in denervated rats.
    OBJECTIVE: To investigate the effects of ligustrazine on different phases of free radicals and enzyme metabolism after static postural load in rats.
    METHODS: The study was approved by the Laboratory Animal Ethical Committee of Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology. Thirty-six SPF male Sprague-Dawley rats were randomized into control, model and ligustrazine groups. At 0.5 hour before experiment, the rats in the control and model groups were given 2 mL solvent via gavage, and ligustrazine group was given 2 mL ligustrazine solution. During the experiment, the rats in the control group received no load. The rats in the model and ligustrazine groups were fixed with the splint to maintain the static posture load, and the trunk part was fixed in the pre-made wooden box to maintain the straight state for 10 hours, to establish a static posture load rat model. The serum level of malonaldehyde, serum lactic dehydrogenase activity and Ca2+-ATPase activity in the soleus at different phases (2 , 5 , 8 and 10 hours) were detected.
    RESULTS AND CONCLUSION: (1) The serum level of malonaldehyde, serum lactic dehydrogenase activity and Ca2+-ATPase activity in the soleus did not change with time in the control group. Compared with 2 hours, in the model group, the serum level of malonaldehyde and serum lactic dehydrogenase activity were increased, and the Ca2+-ATPase activity was significantly decreased at 5, 8 and 10 hours (P < 0.05 or P < 0.01). Compared with 2 hours, in the ligustrazine group, the serum level of malonaldehyde and serum lactic dehydrogenase activity were decreased, and the Ca2+-ATPase activity was significantly increased at 5, 8 and 10 hours (P < 0.05 or P < 0.01). Compared with the control group at the same phase, the serum level of malonaldehyde and serum lactic dehydrogenase activity in the model group were increased, and the Ca2+-ATPase activity was significantly decreased (P < 0.01). Compared with the model group at the same phase (except 2 hours), the serum level of malonaldehyde and serum lactic dehydrogenase activity were significantly decreased in the ligustrazine group, and the Ca2+-ATPase activity was significantly increased (P < 0.01). (2) These results indicate that ligustrazine can significantly reduce the serum malonaldehyde content and serum lactic dehydrogenase activity caused by static postural load at different phases, and significantly increase the Ca2+-ATPase activity in the soleus, so as to alleviate the body injury caused by long-term static postural load.

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    Tranosseous suture bridge technique versus modified Mason-Allen technique repairs unilateral rotator cuff tears in rabbits 
    Kou Jinghao1, 2, Pu Jingsong1, Jiang Cheng1, Liu Tao2, Lei Xiaoyu2
    2019, 23 (35):  5605-5610.  doi: 10.3969/j.issn.2095-4344.1485
    Abstract ( 434 )   PDF (22836KB) ( 99 )   Save

    BACKGROUND: The modified Mason-Allen technique is commonly used for repairing rotator cuff tears in small animals, while the suture bridge technique is rarely reported.
    OBJECTIVE: To explore a new method for repairing rotator cuff injury in small animals.
    METHODS: The study was approved by the Experimental Animal Ethics Committee of North Sichuan Medical College. Forty-eight male New Zealand white rabbits were used to make rotator cuff injury models and randomly divided into control (repaired by Mason-Allen technique) and experimental (repaired by tranosseous suture bridge technique) groups. Sixteen animals were sacrificed at 4, 8, and 12 weeks, respectively, and the proximal humerus specimens were used for gross observation, histological examination, and modified maturity of tendon-bone healing score.
    RESULTS AND CONCLUSION: (1) Gross observation: there were two cases of fixation failure in the control group. (2) Histological examination: at 12 weeks after modeling, in the experimental group, the chondrocytes arranged regularly, and fibrocartilage arranged densely and regularly, which similar with columnar structure. The tendon-bone interface in the control group revealed scar healing mainly, and few chondrocytes and fibrocartilage that arranged in disorder were observed. (3) At 4, 8 and 12 weeks, the scores of tendon-bone healing in the experimental group were significantly better than those in the control group (P < 0.01). (4) These results indicate that compared with modified Mason-Allen technique, the transosseous suture bridge technique possesses higher maturity of tendon-bone healing score and lower fixation failure rate, and improves the rotator cuff tendon-bone healing rate, which is a better method to repair rotator cuff injury in animal models.

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    Effect of reduction of mechanical loading on subchondral bone and articular cartilage of early osteoarthritis in mice  
    Shao Yijie1, Jiang Huaye1, Gao Chao1, Luo Zongping2, Yang Huilin1
    2019, 23 (35):  5611-5618.  doi: 10.3969/j.issn.2095-4344.1432
    Abstract ( 359 )   PDF (28188KB) ( 125 )   Save

    BACKGROUND: Osteoarthritis has a high incidence in the world, but its underlying pathogenesis is still not thoroughly studied.
    OBJECTIVE: To investigate the effect of reduction of mechanical loading on subchondral bone and articular cartilage of early osteoarthritis in mice.
    METHODS: The study was approved by the Laboratory Animal Ethics Committee of the First Affiliated Hospital of Soochow University. Forty-eight male adult C57BL/6 mice (8 weeks old) were randomly divided into normal group, osteoarthritis model group, motor nerve transection+osteoarthritis model group, and motor nerve transection+sham group, 12 mice in each group. We simulated the reduction of mechanical loading in knee joint via tibial nerve combined with common peroneal nerve transection, which was performed at 1 week before the osteoarthritis induction. Six mice in each group were sacrificed at 4 and 8 weeks after modeling. The right knee joints of each group were collected for micro-CT scanning, histological staining, footprint analysis and muscle atrophy detection, respectively.
    RESULTS AND CONCLUSION: (1) The bone volume fraction in the motor nerve transection+osteoarthritis model group was lower than that in the osteoarthritis model group at 4 and 8 weeks after modeling (P < 0.05). There was no significant difference in the bone volume fraction between motor nerve transection+osteoarthritis model and motor nerve transection+sham groups (P > 0.05). The bone volume fraction in the motor nerve transection+osteoarthritis model group was increased significantly at 8 weeks compared with that at 4 weeks after modeling (P < 0.05). (2) The OARSI score in the motor nerve transection+osteoarthritis model group was lower than that in the osteoarthritis model group at 4 and 8 weeks (P < 0.05). OARSI score in the motor nerve transection+osteoarthritis model group at 8 weeks was higher than that at 4 weeks after modeling (P < 0.05). (3) Compared with the osteoarthritis model group, the hindfoot base widths in the motor nerve transection+osteoarthritis model group at 4 and 8 weeks were decreased significantly (P < 0.05), and the wet weights of the right tibial anterior muscle and the calf triceps muscle were decreased (P < 0.05). (4) These results indicate that reduction of mechanical loading in knee joint induced by peripheral motor nerve transection leads to bone loss of subchondral bone and reduction thickness of articular cartilage layer, suggesting that the appropriate joint mechanical loading plays an important role in maintaining the homeostasis of articular cartilage and subchondral bone.

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    Epidermal growth factor-like domain 7 promotes the repair and reconstruction of cerebral microcirculation in rat models of craniocerebral injury
    Xu Pengxiang1, Li Qiang1, Xu Qiongguan1, Luo Mengyanan2, Cheng Kai1, Xie Zhenming1, Fu Zhoufeng1
    2019, 23 (35):  5619-5625.  doi: 10.3969/j.issn.2095-4344.1491
    Abstract ( 336 )   PDF (5114KB) ( 100 )   Save

    BACKGROUND: Vascular endothelial cell damage is shown to be closely related to blood brain barrier function disorder after traumatic brain injury. Epidermal growth factor-like domain 7 (EGFL7) is an important factor to promote angiogenesis. Whether EGFL7 can promote traumatic brain injury repair by activating angiogenesis remains unknown.
    OBJECTIVE: To explore the mechanisms by which EGFL7 promotes angiogenesis after traumatic brain injury in rats. 
    METHODS: Forty-two healthy adult male rats were randomly divided into craniocerebral injury group (n=36, craniocerebral injury model was established by impacting rat dura mater with modified Feeney method) and sham group (n=6, only complete dura mater was exposed) and the rats were divided into six subgroups according to the sample time after injury: 1 hour, 6 hours, 24 hours, 3 days, 7 days and 14 days, 6 rats in each subgroup. The contusion lesion and the surrounding brain tissue were obtained after the neurological injury score was available. Another 18 rats were selected and randomized into three groups (n=6/group) to establish craniocerebral injury model. rAd-vector, rAd-EGFL7 and combined PI3K/Akt pathway inhibitor rAd-EGFL7+LY294002 was respectively injected into the ventricles of rats at 1 hour after injury. Samples were obtained at 12 hours later.
    RESULTS AND CONCLUSION: (1) RT-PCR, western blot assay and immumohistochemical staining results showed that the EGFL7 and CD34 were significantly up-regulated in rat brain after craniocerebral injury (P < 0.05). The expression of EGFL7 peaked on day 3 (P < 0.05), and the expression of CD34 had the same trend with EGFL7. The number of angiogenesis peaked on day 7. (2) After 12 hours of the rAd-EGFL7 microinjection in rat brain at 1 hour post-injury, the expression levels of EGFL7, CD34, pAkt and cyclin D1 were significantly up-regulated and the FOXO1 expression was significantly down-regulated (all P < 0.05). (3) Microinjection of rAd-EGFL7 and PI3K/Akt inhibitor in rat brain at 1 hour post-injury, the EGFL7 expression was not significantly changed, but the CD34 expression was significantly inhibited (P < 0.05), and the number of angiogenesis was significantly decreased (P < 0.05). (4) To conclude, up-regulated EGFL7 in the injured brain tissue may be related to angiogenesis after traumatic brain injury. Overexpression of the EGFL7 promotes the angiogenesis in the injured brain tissue through activating PI3K/Akt signaling.

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    Prourokinase combined with non-invasive delayed limb ischemic preconditioning in rat models of myocardial ischemia/reperfusion injury 
    Liu Zhiyuan1, Zhang Jinying2, Liu Jiangbo1, Zhao Xiaoning1, Liu Fei1, Li Gang1
    2019, 23 (35):  5626-5632.  doi: 10.3969/j.issn.2095-4344.1332
    Abstract ( 445 )   PDF (860KB) ( 202 )   Save

    BACKGROUND: Prourokinase has been shown to hold good thrombolysis, and improve reperfusion injury after acute myocardial infarction. Non-invasive delayed limb ischemic preconditioning is a protective reaction after repeated transient ischemic preconditioning.
    OBJECTIVE: To analyze the effect of prourokinase combined with non-invasive delayed limb ischemic preconditioning on myocardial ischemia/reperfusion injury in rats.
    METHODS: The study was approved by the Experimental Animal Ethics Committee of Zhengzhou University, approval number: 1811034. Forty Sprague-Dawley rats were randomly divided into model, prourokinase, non-invasive delayed limb ischemic preconditioning and combined groups (n=10/group). Before modeling, non-invasive delayed limb ischemic preconditioning and combined groups were given non-invasive delayed limb ischemic preconditioning preconditioning for 3 days, and prourokinase and combined groups were given intravenous injection of prourokinase. Myocardial ischemia/reperfusion injury models were prepared by surgical ligation. Before and after modeling, the levels of creatine kinase-isozyme, lactic dehydrogenase, plasminogen activator inhibitor-1 and tissue plasminogen activator in serum were detected. After modeling, hematoxylin-eosin staining was used to detect myocardial tissue damage. The levels of tumor necrosis factor-α, interleukin-6, superoxide dismutase and malondialdehyde in myocardial tissue were detected by kit. The expression levels of tyrosine kinase JAK2, p-JAK2, signal transducers and activators of transcription 3 (STAT3), p-STAT3, Caspase-3, Bax and Bcl-2 were detected by western blot assay.
    RESULTS AND CONCLUSION: (1) Compared with the model group, myocardial infarct size was significantly decreased in the prourokinase, non-invasive delayed limb ischemic preconditioning and combined groups (P < 0.05), and the myocardial infarct size in the combined group was significantly lower than that in the other groups (P < 0.05). (2) Compared with the model group, the levels of creatine kinase-isozyme, lactic dehydrogenase, tumor necrosis factor-α, interleukin-6 and malondialdehyde and plasminogen activator inhibitor-1 activity in the other three groups were significantly decreased (P < 0.05), especially in the combined group (P < 0.05). (3) Compared with the model group, the activities of tissue plasminogen activator and superoxide dismutase in the other three groups were significantly increased (P < 0.05), especially in the combined group (P < 0.05). (4) Compared with the model group, the apoptosis rate of myocardial tissue in the other three groups was significantly decreased (P < 0.05). The expression levels of Caspase-3 and Bax in myocardial tissue were significantly down-regulated (P < 0.05), especially in the combined group (P < 0.05). (5) The expression levels of Bcl-2, p-JAK2 and p-STAT3 in the other three groups were up-regulated significantly than in the model group (P < 0.05), especially in the combined group (P < 0.05). (6) These results suggest that prourokinase combined with non-invasive delayed limb ischemic preconditioning can improve myocardial ischemia/reperfusion injury and dysfunction, which may be related to JAK2/STAT3 signal pathway.

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    Expression Foxp3 and bone morphogenetic protein 7 in rat models of carotid artery balloon injury after treated by total glucosides of paeony
    Luo Tedan, Jiang Xin, Zhou Chongchong, Huang Baofeng, Li Peng
    2019, 23 (35):  5633-5637.  doi: 10.3969/j.issn.2095-4344.1940
    Abstract ( 380 )   PDF (19874KB) ( 125 )   Save

    BACKGROUND: Restenosis after percutaneous coronary affects the outcome of surgery. Total glucosides of paeony has been shown to regulate autoimmune response by several pathways, and can inhibit mononuclear macrophage secreting inflammatory cytokines, eliminate oxygen free radicals, affect cell proliferation and roles of anti-inflammation, analgesia and anti-stress.
    OBJECTIVE: To observe the changes in Foxp3 and bone morphogenetic protein 7 after carotid artery balloon injury in rats and the intervention of total glucosides of paeony.
    METHODS: The study was approved by the Laboratory Animal Ethical Committee of Shenzhen People’s Hospital. Thirty-six Sprague-Dawley rats were randomly divided into four groups: control group, balloon injury group, total glucosides of paeony group and total glucosides of paeony immersion group. The rats in the control group underwent sham surgery at 4 days after given normal saline via gavage, followed by 13 days of normal saline via gavage. The rats in the balloon injury group underwent left common carotid artery injured by ballooning at 4 days after given normal saline via gavage, followed by 13 days of normal saline via gavage. The rats in the total glucosides of paeony group received balloon injury at 4 days after given total glucosides of paeony via gavage, and then received 13 days of total glucosides of paeony via gavage. The rats in the total glucosides of paeony immersion group received balloon injury at 4 days after given normal saline via gavage, then the balloon was immersed in total glucosides of paeony diluent for 4 hours, and then subjected to 13 days of normal saline via gavage. At 14 days after surgery, the left common carotid artery samples were removed for hematoxylin-eosin staining to observe the changes of intima. The vessels were stained with hematoxylin-eosin. The expression levels of Foxp3 and bone morphogenetic protein 7 mRNA in injured vessels were detected by real-time RT-PCR.
    RESULTS AND CONCLUSION: (1) The area of intima and intima/tunica media area in the total glucosides of paeony immersion group were significantly less than those in the total glucosides of paeony group (P < 0.05), and significantly more than those in the control group (P < 0.05). (2) The order of the expression levels of Foxp3 and bone morphogenetic protein 7 mRNA was as follows: control group < balloon injury group < total glucosides of paeony group < total glucosides of paeony immersion group (P < 0.05). (3) These results suggest that total glucosides of paeony can regulate the expression of Foxp3 and bone morphogenetic protein 7 mRNA and the balance of inflammatory factors, inhibit the inflammatory reaction of injured vessels and may contribute to alleviating the restenosis of injured vessels. Local application of balloon immersed in total glucosides of paeony achieved better results than gavage in inhibiting the restenosis caused by inflammation.

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    Silencing of periosteal protein gene by shRNA inhibits angiogenesis in human osteosarcoma 
    Xu Chaojian, Zhang Long, Cheng Caitong, Feng Yi, Lü Jia, Sun Xiaojuan, Lü Zhi
    2019, 23 (35):  5638-5644.  doi: 10.3969/j.issn.2095-4344.1429
    Abstract ( 341 )   PDF (25899KB) ( 88 )   Save

    BACKGROUND: Periostin (POSTN) is an extracellular matrix protein that is upregulated in most tumor tissues and is associated with tumor migration, proliferation and angiogenesis. Vascular endothelial growth factor receptor 2 (VEGFR2/KDR) mainly regulates the occurrence and construction of blood vessels after combining with its ligand VEGF, but the interaction between KDR and POSTN in osteosarcoma is still unclear.
    OBJECTIVE: To investigate the effect of POSTN on the proliferation and angiogenesis of human osteosarcoma in vitro and in vivo and the underlying action mechanism.
    METHODS: In vitro study: The mRNA and protein levels of POSTN and KDR in human osteosarcoma clinical specimens were detected by qRT-PCR and western blot analysis. POSTN expression in three human osteosarcoma cell lines was detected by qRT-PCR. POSTN shRNA plasmids were transfected into Saos-2 cells and the sequence with the highest inhibition rate among the three targets was selected for subsequent experiments. Fluorescence quantity of cells was observed under fluorescence microscope, and the transfection efficiency was detected by qRT-PCR. In vivo study: twelve nude mice (Beijing Vital River Laboratory Animal Technology Co., Ltd., China) were randomly divided into an experimental group and a control group (n = 6/group). In the experimental group, Saos-2 cells transfected with pPLK-POSTN-shRNA were injected into the tibial medullary cavity of nude mice. In the control group, Saos-2 cells transfected with pPLK-Scramble-shRNA were identically injected. After 3 weeks of inoculation, angiogenesis was detected by in vivo imaging. After 5 weeks of inoculation, the removed tumor tissue was measured in volume and mass and then used for detecting the expression of POSTN, proliferating cell nuclear antigen, KDR and p-AKT protein by western blot analysis and the expression of endothelial cell adhesion molecule by immunohistochemical staining. This study was approved by Medical Ethics Committee, the Second Hospital of Shanxi Medical University of China (approval No. 2018002). 
    RESULTS AND CONCLUSION: (1) In vitro study: The mRNA and protein levels of POSTN and KDR in osteosarcoma tissues were higher than those in normal bone tissues (P < 0.01). POSTN expression in Saos-2 cells was higher than that in MG-63 and U2-OS cells. (2) In vivo study: the tumor volume and mass of the experimental group were lower than those of the control group (P < 0.05). Osteosarcoma angiogenesis in the experimental group was significantly lower than that in the control group (P < 0.05). POSTN, proliferating cell nuclear antigen, KDR and p-Akt as well as endothelial cell adhesion molecule protein levels in the experimental group were significantly lower than those in the control group (P < 0.05). (3) These results suggest that silencing POSTN gene can inhibit osteosarcoma angiogenesis, which may be related to the activation of KDR /PI3K/AKT pathway.

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    Changes of auditory function and mechanisms in tinnitus rats treated by Wuling Capsule
    Mo Binyu1, Wei Tao2, Li Jihui1, Feng Haiyan1, Chen Meiqiu1, Wei Yumei1
    2019, 23 (35):  5645-5651.  doi: 10.3969/j.issn.2095-4344.1951
    Abstract ( 597 )   PDF (29427KB) ( 133 )   Save

    BACKGROUND: There is no standard cure for tinnitus. Wuling Capsule is a pure Chinese medicine preparation extracted from Wuling Ginseng by modern biological technology. Its composition is Wuling powder, which has the functions of nourishing the heart and calming the nerves, nourishing the kidney and strengthening the brain.
    OBJECTIVE: To explore the effect of Wuling Capsule on the auditory function of tinnitus rats and its neuronal plasticity related genes in auditory central ultrastructure and auditory pathway.
    METHODS: Seventy-five SPF-level Wistar rats were selected. In addition to the normal group, the other groups of rats were prepared with tinnitus model. After successful modeling, the model group (n=15) and the normal group (n=15) were given normal saline, and the carbamazepine group (n=15) was given carbamazepine solution. The low- and high-dose Wuling Capsule groups were intragastrically administered with 40 and 80 g of Wuling Capsule for 4 weeks. The changes of drinking water inhibition rate Rb, open field behavioral changes, auditory brainstem response threshold, primary auditory cortical pathology, auditory cortex ultrastructural changes, auditory central neurotransmitter γ-aminobutyric acid, 5-hydroxytryptamine were observed in the cortex, cochlear nucleus, inferior colliculus and upper olive.
    RESULTS AND CONCLUSION: (1) The mean Rb in the high- and low-dose Wuling Capsule groups and the carbamazepine group in the conditioned reflex period (within 7 days) was significantly lower than that in the model group (P < 0.05). (2) On day 15 after modeling, the total stroke, average speed and erecting times in the model group and each drug-administered group were significantly lower than those in the normal control group, and the number of fecal pellets was significantly higher than that in the normal control group (P < 0.05). After the treatment, the total stroke, average speed and erecting times in the drug-administered groups were significantly higher than those in the model group, and the number of fecal pellets was significantly lower than that in the model group (P < 0.05). (3) Compared with the model group, the levels of γ-aminobutyric acid and 5-hydroxytryptamine in the hypothalamus were significantly increased (P < 0.05), and expression of cytoskeletal proteins in the auditory cortex, inferior colliculus and cochlear nucleus decreased in the low-and high-dose Wuling Capsule groups (P < 0.05). (4) These results indicate that Wuling Capsule significantly reduces the degree of neuronal damage in the auditory pathway of tinnitus rats, improves the ultrastructure of the auditory center, and lowers the auditory brainstem response threshold, thereby improving the auditory function of tinnitus rats and improving the anxiety and depression. The mechanism may be increasing the levels of γ-aminobutyric acid and 5-hydroxytryptamine in the hypothalamus and improving the expression of neuronal plasticity-related genes in the auditory pathway of tinnitus rats. The study was approved by the Ethical Committee of Liuzhou General Hospital, approval No. TRH58689.

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    Variables affecting the retained volume of adipose tissue after transplantation in rats
    Jia Daping, Ma Li, Wu Liangliang, Zhao Yu
    2019, 23 (35):  5652-5657.  doi: 10.3969/j.issn.2095-4344.1486
    Abstract ( 416 )   PDF (25742KB) ( 106 )   Save

    BACKGROUND: The high and unstable absorption rate after autologous granule fat transplantation limits its clinical application. In addition to the early establishment of blood supply, it is particularly important to find new ways to improve survival rate.
    OBJECTIVE: To investigate the effect of mechanical shearing and anti-apoptotic drug edaravone on the volume retention after autologous fat transplantation from the perspective of apoptosis.
    METHODS: The study was approved by the Laboratory Animal Ethics Committee of Anhui Medical University. Forty-two Sprague-Dawley male rats were randomly divided into three groups: A, B, and C. The rats were transplanted with fat by clinical autologous fat transplantation. Group A was the control group (n=6): the adipose tissue was given 130 times of basic shearing during operation; the B and C groups were given different variables of adipose tissue on the basis of group A. Group B was a mechanical shearing group with a total of 18 rats subdivided into subgroups B1, B2 and B3, which were given 230 times, 330 times and 430 mechanical shears, respectively. Group C was the edaravone group (n=18), subdivided into C1, C2 and C3 subgroups, respectively, given 0.1%, 0.2% and 1% concentration of edaravone, and then the adipose tissue was given 130 times of basic shearing. Graft specimens were taken immediately after operation and at 1, 4 and 8 weeks after transplantation, to observe and record the morphological features and volume of the specimens. The histological changes were observed under a light microscope after hematoxylin-eosin staining. The apoptosis ratio of fat cells in each group was detected by flow cytometry Annexin V/PI double staining.
    RESULTS AND CONCLUSION: (1) Compared with the control group, the group B: the proportion of apoptosis was increased significantly at immediately and 1 week after surgery, and the graft absorption rate was fast; at 4 and 8 weeks after operation, the volume of hematoxylin- eosin-stained adipocytes was different, the arrangement was disordered, and the graft retention volume was reduced. The graft retention volume was reduced (P < 0.05). C1 and C2 subgroups: the proportion of apoptosis in specimens was significantly decreased at immediately and 1 week after surgery. At 4 and 8 weeks after operation, the morphology of hematoxylin-eosin-stained adipocytes was more regular and volume was more consistent, more blood vessels were visible. The graft retention volume was significantly increased (P < 0.05). (2) There was no significant difference in the fat absorption rate between C3 subgroup and control group (P > 0.05). (3) To conclude, in autologous fat transplantation, mechanical shearing reduces the volume of fat retained after transplantation, and a certain concentration of anti-apoptotic drug edaravone can increase the retained volume of adipose tissue after transplantation.

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    Preoperative CT angiography and intraoperative X-ray image registration algorithm for thoracic aortic endovascular repair 
    Jia Ruiming1, Li Haoxuan1, Chen Yu2, Huang Xiaoyong2, Pu Xin2, Shu Lixia2
    2019, 23 (35):  5658-5663.  doi: 10.3969/j.issn.2095-4344.1901
    Abstract ( 541 )   PDF (1014KB) ( 106 )   Save

    BACKGROUND: Thoracic aortic endovascular repair is an important method for treating aortic dissection and thoracic aortic aneurysm. The success of the operation depends on whether the stent graft is placed in the correct position. However, when the stent is implanted, the aorta in the intraoperative X-ray image is invisible, so the operation is difficult and the risk is high. Registration of preoperative CT angiography and intraoperative X-ray images can help doctors place stents and increase success rates.
    OBJECTIVE: To propose a preoperative CT angiography and intraoperative X-ray image registration algorithm for thoracic aortic endovascular repair.
    METHODS: Firstly, digital reconstruction images of CT angiography and bone CT were performed under different virtual perspectives, and the two were superimposed to obtain a digital reconstruction image library under various angles of position and orientation for intraoperative X-ray images. Secondly, we proposed a deep neural network based on branch decoding structure. Using digital reconstruction image library training, the position and attitude parameters of intraoperative X-ray images could be estimated to obtain CT angiography and intraoperative X-ray images. The spatial positional relationship was obtained. Finally, according to the pose parameters of the X-ray image in the CT angiography coordinate system, the thoracic aorta image in the CT angiography was re-projected and superimposed into the intraoperative X-ray image to navigation assistance for the doctors.
    RESULTS AND CONCLUSION: (1) The experimental results show that the root mean square error of the proposed algorithm is reduced by 17% compared with the traditional algorithms of gradient correlation and mode strength. (2) In the dual-branch code structure network, the parameter estimation error is reduced to 30% of the network without branching structure in the digital reconstruction image test set. (3) In the experimental X-image experiment, the root mean square error is also reduced by 2%.

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    One-year evaluation of recombinant human tumor necrosis factor-alpha receptor II decrement combined with thalidomide increment in the treatment of active ankylosing spondylitis   
    Zhou Jin, Fu Lin, Zhou Zhen, Li Qiurong
    2019, 23 (35):  5664-5669.  doi: 10.3969/j.issn.2095-4344.1955
    Abstract ( 328 )   PDF (21452KB) ( 137 )   Save

    BACKGROUND: Tumor necrosis factor antagonist (such as, etanercept and adalimumab) is the optimal selection for treating active ankylosing spondylitis. However, these drugs are expensive, so it is urgent to search for a cheap and effective substitute. 
    OBJECTIVE: To investigate the 1-year follow-up of recombinant human tumor necrosis factor-α receptor II:IgG Fc fusion protein decrement combined with thalidomide increment in the treatment of active ankylosing spondylitis.
    METHODS: The study was approved by the Ethics Committee of the Second People’s Hospital of Yibin. Eighty-six patients of active ankylosing spondylitis were randomly divided into control and combination groups (n=43/group). All patients and their family signed the informed consents. Patients in both groups received subcutaneous injection of etanercept at 25 mg/time. Initial medication was twice/week, for 2 months. When the disease reached the clinical remission standard, the dose of etanercept would be decreased once every 2 months: at the beginning of the third month, we went from twice/week to once/week; at the beginning of the fifth month, it was reduced to once/10 days at the beginning of the seventh month, it was reduced to once/2 weeks. At the beginning of the ninth months, it was reduced to once/3 weeks; at the beginning of the eleventh months, it was reduced to once/4 weeks. After that, no reduction was found until the end of December. If each dose reduction aggravates the disease and does not meet the clinical remission criteria, the previous dose of etanercept should be readjusted. Patients in the combined group were also given thalidomide tablets once a day before bedtime. The initial dose was 25 mg/d, for 2 months. Thereafter, the dose was increased by 25 mg/d every two months until reaching 100 mg/d at the beginning of the seventh month. The duration of treatment was 12 months in both groups.
    RESULTS AND CONCLUSION: (1) Forty-three patients in the control group, 38 patients completed the 12-month course of treatment; 43 cases in the combination group, 40 patients completed the 12 months course of treatment. (2) From the end of the fourth month to the end of the twelfth month after treatment, Ankylosing Spondylitis Disease Activity Score-erythrocyte sedimentation rate/C-reactive protein score in the combination group was lower than that in the control group (P < 0.05 or P < 0.01). (3)The Appraisement of Spondyloarthritis International Society 20 compliance rate and Appraisement of Spondyloarthritis International Society 5/6 compliance rate of the combination group were higher than those of the control group (P < 0.05 or P < 0.01). (4) The clinical remission maintenance rate in the combination group was higher than that in the control group (χ2=8.527, P=0.003). (5) The total drug dosage of etanercept of each patient in the combination group was lower than that in the control group within 12 months (t=2.932, P=0.004). (6) There was no significant difference in the incidence of adverse reactions between two groups (χ2=0.174, P=0.677). (7) These results indicate that for the 12-month treatment of ankylosing spondylitis, in the scheme of prolonging the interval between the drugs of etanercept, a higher remission rate or a lower disease activity can be achieved, and the combination of thalidomide and isopropyl does not increase the adverse reactions of the drugs.

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    Sandwiched Moxibustion plus Bushen Quhan recipe for treating knee osteoarthritis: a randomized controlled trial 
    Zhong Qiusheng1, Xia Weichao1, Guo Meizhen1, Zhu Haiqing1, Zhong Cuiqiong1, Shao Jieqi1, He Xiaohong2, Chen Xiumin2
    2019, 23 (35):  5670-5675.  doi: 10.3969/j.issn.2095-4344.1333
    Abstract ( 425 )   PDF (26924KB) ( 127 )   Save

    BACKGROUND: Conservative treatment is a method for the early- and medium-term knee osteoarthritis. The concept of quality of life of patients has attracted much attention in the field of medicine.
    OBJECTIVE: To observe the clinical effect and quality of life in Sandwiched Moxibustion plus Bushen Quhan recipe for treating knee osteoarthritis.
    METHODS: One hundred patients of knee osteoarthritis were randomly divided into treatment group (n=50) and control group (n=50). The treatment group was given the Sandwiched Moxibustion plus Bushen Quhan recipe, and the control group was treated with loxoprofen sodium dispersible tablets and diacerein capsules. After 12 weeks of treatment, the Visual Analogue Scale score, Western Ontario and McMaster Universities Osteoarthritis Index and 36-Item Short Form Health Survey questionnaire were analyzed before and after treatment. The changes of total clinical efficacy and adverse reactions were observed. The study was approved by the Ethics Committee of Southern Medical University Affiliated Shilong People’s Hospital of Dongguan on May 11, 2017, approval number: 20170511.
    RESULTS and CONCLUSION: After 12 weeks of treatment: (1) The Visual Analogue Scale scores in the treatment group was decreased significantly compared with the control group (P < 0.05). (2) The joint pain, joint stiffness and total cores of Western Ontario and McMaster Universities Osteoarthritis Index in the treatment group were significantly lower than those in the control group (P < 0.05). The scores of 36-Item Short Form Health Survey questionnaire in the treatment group were significantly higher than those in the control group (P < 0.05). (3) There was no significant difference in the total effectiveness or adverse reaction between two groups (P > 0.05). (4) These results suggest that the Sandwiched Moxibustion plus Bushen Quhan recipe has the similar clinical efficacy with oral loxoprofen sodium dispersible tablets and diacerein capsules for treating knee osteoarthritis. The former possesses more obvious effects in reducing joint pain, joint stiffness and total cores of Western Ontario and McMaster Universities Osteoarthritis Index and significantly improves the quality of life of patients.

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    Evaluation of the effectiveness and safety of closed negative pressure drainage nursing system (PU suction cup type): a perspective, randomized, open, parallel controlled and non-inferiority trial 
    Yuan Yacui1, Liu Linna2, Liu Xiwen3, Li Yuejun1, Zhao Congying1, Han Lin1
    2019, 23 (35):  5676-5681.  doi: 10.3969/j.issn.2095-4344.1990
    Abstract ( 387 )   PDF (24237KB) ( 118 )   Save

    BACKGROUND: The closed negative pressure drainage nursing system (PU suction cup type) is a wound treatment device with continuous closed negative pressure drainage function developed on the basis of vacuum sealing drainage in recent years. Under the premise of correct use and effective drainage, it is convenient for medical personnel to monitor wound healing in real time compared with traditional dressing debridement, which can obviously reduce the application of large doses of antibacterial drugs and the number of dressing changes, thereby reducing treatment costs, shortening hospitalization time, and alleviating patient suffering.
    OBJECTIVE: To evaluate the clinical efficacy and safety of the closed-type negative pressure drainage nursing system (PU suction cup type), and to provide theoretical and data support for its clinical promotion and product application registration.
    METHODS: Totally 132 patients needing vacuum sealing drainage were randomly divided into trial group (closed suction drainage system record (PU suction type) and control group (the use of closed suction drainage kit (II-PU type)) (n=66/group). The therapeutic effect within 14 days was evaluated. The primary measurement outcome was the efficacy with 14 days. The secondary measurement outcomes were Visual Analog Scale score, operating satisfaction, physical properties, and safety evaluation indexes: incidence of adverse events/reactions, incidence of complications, and laboratory examination indexes.
    RESULTS AND CONCLUSION: (1) Effectiveness index: the effective rate of both groups was 100% within 14 days of treatment. Compared with before treatment, the Visual Analog Scale scores in the two groups were significantly decreased after treatment of (10±3) days (P < 0.05), and there was no significant difference between two groups. (2) Safety indicators: There were no significant differences in laboratory test indicators (blood routine, liver function, coagulation) before and after treatment. The two groups of product operation satisfaction, product physical properties could meet 100% of clinical use. No complications occurred in both groups. During the whole trial period, 9 (13.6%) of the 66 subjects in the trial group appeared with adverse events, and 10 (15.2%) of the 66 subjects in the control group had adverse events. (3) These results imply that the efficacy and safety of the closed negative pressure drainage material set (PU) for wound drainage are comparable to that of the control product, which is worthy of clinical promotion. The trial has been approved by the Ethical Committee of Tangdu Hospital of Air Force Medical University on September 13, 2016, approval No. 201609-10.

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    Medical nutrition treatment guideline for diabetic foot
    Society for Prevention and Control of Tissue Inflammation and Injury of Chinese Preventive Medicine Association; Society of Parenteral and Enteral Nutrition of Chinese Medical Association; Diabetic Foot Group, Committee of Peripheral Vascular Disease, China Society of Integrated Traditional Chinese and Western Medicine
    2019, 23 (35):  5682-5689.  doi: 10.3969/j.issn.2095-4344.1891
    Abstract ( 331 )   PDF (48220KB) ( 120 )   Save

    BACKGROUND: Diabetic foot is most serious and costly chronic complication of diabetes mellitus. Multidisciplinary comprehensive treatment should be advocated for its treatment. Among them, medical nutrition treatment should be paid enough attention.
    OBJECTIVE: By putting forward medical nutrition treatment suggestions, guiding clinical workers in the process of practice, scientific nutrition assessment and effective intervention, diabetic foot patients can benefit significantly through scientific medical nutrition treatment.
    METHODS: By referring to relevant international and domestic guidelines and literature, this paper puts forward suggestions for medical nutritional treatment on the evaluation of nutritional assessment scale, the purpose of nutritional therapy, dietary choice, energy requirements, macronutrient and micronutrient recommendations, follow-up and parenteral nutrition support for critical patients.
    RESULTS AND CONCLUSION: (1) For the assessment of nutritional status of diabetic foot patients, patient-generated global assessment and mini nutritional assessment are mainly used. In addition, Geriatric Nutritional Risk Index can also be used to assess the nutritional status of elderly patients. (2) To synthesize the relevant international and domestic guidelines and put forward the goal of medical nutrition treatment. (3) All kinds of dietary methods are helpful for patients’ weight control and blood sugar improvement. It is recommended that individualized dietary plans be formulated on the basis of various dietary methods and under the guidance of clinical nutritionists. (4) All diabetic foot patients should accept the individualized energy balance plan formulated after professional evaluation by clinical nutritionists, and adjust it in time according to the course of disease. (5) Based on the latest researches, three macronutrients intake requirements were proposed. (6) For patients with diabetic foot disease, specific micronutrients supplementation can promote their clinical benefits. (7) Medical nutrition treatment should pay more attention to the follow-up of patients with diabetic foot disease. (8) Specific medical nutrition treatment was suggested for patients with critical diabetic foot disease.

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    Features of animal models of osteonecrosis of the femoral head
    Ge Yingjie1, Cai Miaoxin1, Li Linpeng1, Chen Haoyan1, Pang Zhihui2, Fan Yueguang3
    2019, 23 (35):  5690-5696.  doi: 10.3969/j.issn.2095-4344.2000
    Abstract ( 391 )   PDF (45639KB) ( 114 )   Save

    BACKGROUND: The pathogenesis of femoral head necrosis has not been completely clarified. Due to the lack of experimental animal models that can reliably simulate the various stages of human femoral head necrosis, research in the prevention and treatment of osteonecrosis of the femoral head is hindered.
    OBJECTIVE: To summarize the construction methods of animal models of osteonecrosis of the femoral head, advantages and disadvantages of animal models, so as to provide basis and direction for the model improvement.
    METHODS: Keywords of “femoral head necrosis, animal model or osteonecrosis of femoral head, animal model” were used to search the databases of CNKI and PubMed. The articles related to establishing the animal models of osteonecrosis of the femoral head published between January 2000 and April 2019 were retrieved.
    RESULTS AND CONCLUSION: Fifty-one articles eligible for inclusion criteria were included. There are few studies on the establishment of the animal models of osteonecrosis of the femoral head, which mainly simulate the early pathological features of the disease, and unable to progress to the end stage of necrotic mechanical collapse. As the ideal animal model of femoral head necrosis is not yet to be found, the efficacy of new treatments cannot be evaluated, the animal model of femoral head necrosis remains to be a challenging that needs to be improved.

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    Relationship between miRNA and occurrence and development of chondrosarcoma
    Wang Jicheng1, 2, Liu Shizhang1, Zhao Song1, 2, Yi Zhi1
    2019, 23 (35):  5697-5702.  doi: 10.3969/j.issn.2095-4344.1437
    Abstract ( 279 )   PDF (32491KB) ( 127 )   Save

    BACKGROUND: Increasing evidence has shown that miRNA plays an important regulatory role in the pathological process of chondrosarcoma.
    OBJECTIVE: To analyze the correlation between miRNA and pathological process of chondrosarcoma, thus providing a new direction for studying the pathogenesis, diagnosis and treatment of chondrosarcoma.
    METHODS: A computer-based search of CNKI and PubMed databases was conducted for the articles concerning miRNA and chondrosarcoma published before March 2019. The keywords were “chondromasarcoma and miRNA” in Chinese and English, respectively. Finally, 69 eligible English articles were included for review.
    RESULTS AND CONCLUSION: (1) miRNA is closely related to the pathological development of chondrosarcoma. (2) miRNA abnormal expression is involved in the development, metastasis and prognosis of chondrosarcoma. (3) Abnormal expression of miRNA can be used as a biomarker for the diagnosis and prognosis of chondrosarcoma. (4) miRNA as a regulatory gene has broad application prospects in the biotherapy of chondrosarcoma.

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    Research progress of mechanism of protein glycosylation in the immune reaction under hypoxia
    Chen Yao, Zhao Min, Li Wenhua
    2019, 23 (35):  5703-5709.  doi: 10.3969/j.issn.2095-4344.1489
    Abstract ( 436 )   PDF (38661KB) ( 239 )   Save

    BACKGROUND: As one of the important post-translation modifications, the protein glycosylation inhere in the biosome extensively, and its synthetize process is influenced by the surroundings of the cells.
    OBJECTIVE: To summarize the study on the protein glycosylation with the immune reaction under hypoxia developed in the bacteria, virus and tumors infecting, so as to discuss the mechanism of the protein glycosylation with the immune reaction in the plateau hypoxia.
    METHODS: PubMed database between January 1988 and January 2019 was retrieved for relevant articles on the effect of glycosylation induced by bacteria, virus and tumors. The keywords were “protein glycosylation, immune reaction, hypoxia”. Finally 61 articles eligible for inclusion and exclusion criteria were included for result analysis.
    RESULTS AND CONCLUSION: In recent years, hypoxia has been shown to cause the changes of glycosylation in organism or cells, and moreover can change the biologic activity of protein. Protein glycosylation modification plays an important role in the virus infection, virus particle formation and immune escape. Lack of oxygen and increased sugar intake lead to glycolysis in the progress of tumor cells, and elevated blood glucose levels induce non-enzymatic glycosylation or saccharification, further resulting in the accumulation of advanced glycosylation product. Plateau environment of oxygen is the basis of airframe damage, can lead to a series of diseases, and whether glycosylation change is involved needs to be investigated in depth.

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    Meta-analysis of tripterygium glycosides combined with methotrexate in the treatment of rheumatoid arthritis
    Yin Cong, Chen Xin, Sun Hui, Yu Axiang, Yuan Lijun, Tong Zhibin, Cheng Yinjie, Tu Xing
    2019, 23 (35):  5710-5717.  doi: 10.3969/j.issn.2095-4344.1431
    Abstract ( 631 )   PDF (25048KB) ( 92 )   Save

    BACKGROUND: The efficacy of tripterygium glycosides is equal to the methotrexate in the treatment of rheumatoid arthritis, and the clinical efficacy of the combination of tripterygium glycosides and methotrexate is better.
    OBJECTIVE: To systematically evaluate the efficacy of tripterygium glycosides combined with methotrexate in the treatment of rheumatoid arthritis, so as to provide evidence-based reference for clinical practice.
    METHODS: PubMed, The Cochrane Library, CNKI, WanFang and SinoMed databases were searched from database establishment time to December 31, 2018. The clinical trial data of tripterygium glycosides combined with methotrexate (trial group) and methotrexate (control group) in the treatment of rheumatoid arthritis were collected. The Cochrane system was used to evaluate the quality of the literature. RevMan 5.3 software was used to conduct a meta-analysis of the overall effects of 10 studies.
    RESULTS AND CONCLUSION: (1) Meta-analysis results showed that: morning stiffness [SMD=−1.51, 95%CI (-2.31, −0.71), P=0.000 2], joint swollen and pain [SMD=−1.50, 95%CI (-2.66, −0.35), P=0.001], joint pressure pain [SMD=−1.28, 95%CI (-1.98, −0.57), P=0.000 4], joint swelling [SMD=−1.46, 95%CI (-2.48, −0.44), P=0.005], erythorcyte sedimentation rate [SMD=−1.86, 95%CI (-2.90, −0.83), P=0.000 4], C-reactive protein [SMD=−1.50, 95%CI (-2.40, −0.60), P=0.001], rheumatoid factor [SMD=−1.11, 95%CI (-1.96, −0.26), P=0.01], and incidence of adverse reaction [RR=0.67, 95%CI (0.48, 0.93), P=0.002] in the trial group was significantly lower than that in the control group. (2) The total effective rate in the trial group was significantly better than that in the control group [RR=1.23, 95%CI (1.13, 1.35), P < 0.000 01]. (3) These results indicate that tripterygium glycosides combined with methotrexate in the treatment of rheumatoid arthritis can elevate the efficiency, improve the various signs and symptoms associated with rheumatoid arthritis, reduce the side effects of drugs, and have good safety.

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    Systematic review and meta-analysis of effect of resistance exercise on glucose and lipid metabolism disorder in type 2 diabetes mellitus patients
    Liang Min1, Wang Hainiu2, Huang Peng2, Zhu Weihua2, Li Shunchang1
    2019, 23 (35):  5718-5726.  doi: 10.3969/j.issn.2095-4344.1482
    Abstract ( 516 )   PDF (27509KB) ( 180 )   Save

    BACKGROUND: Resistance exercise has been shown to be beneficial for improving glycolipid metabolism in patients with type 2 diabetes mellitus. But the mode, intensity and frequency of resistance exercise, as well as the effective combination with different other exercises need to be further explored and confirmed.
    OBJECTIVE: To evaluate the effect of resistance exercise on glucose and lipid metabolism disorder in type 2 diabetes mellitus.
    METHODS: Databases of PubMed, FMRS, EMbase, The Cochrane Library, and WanFang were searched to collect the randomized controlled trials (blank control, aerobic exercise and resistance exercise groups) concerning resistance exercise for treating type 2 diabetes mellitus. The retrieval time was set from inception to December 2018, and the references in the included articles were retroactively searched. According to the inclusion and exclusion criteria, two researchers screened the literature, extracted data, and assessed the quality. Meta-analysis was performed on RevMan 5.3 software.
    RESULTS AND CONCLUSION: (1) Eleven randomized controlled trials were included. The selective report and other risk bias were unclear, but the overall literature quality was on the above-average. (2) Meta-analysis results showed that the resistance exercise group significantly improved fasting blood glucose [SMD=0.84, 95%CI (0.39, 1.29), P=0.000 2], glycosylated hemoglobin [SMD=0.44, 95%CI (0.06, 0.81), P=0.02], triglyceride [SMD=0.55, 95%CI (0.07, 1.04), P=0.02], high-density lipoprotein cholesterol [SMD=-0.33, 95%CI (-0.53, -0.13), P=0.001], low-density lipoprotein cholesterol [SMD=0.49, 95%CI (-0.03, 1.01), P=0.06]. (3) The resistance exercise group was superior to the blank control group and showed no significant difference compared with the aerobic exercise group. (4) These results indicate that resistance exercise contribute to improving glucose and lipid metabolism in patients with type 2 diabetes mellitus and can be an important part of exercise therapy for diabetes mellitus.

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    Meta-analysis of the effect of aerobic exercise on mild cognitive impairment in the elderly
    Liu Dongqi1, Li Rongmei1, Zhang Meiqi1,Chen Yanyan1, Zhang Haiping2
    2019, 23 (35):  5727-5731.  doi: 10.3969/j.issn.2095-4344.1943
    Abstract ( 448 )   PDF (18027KB) ( 151 )   Save

    BACKGROUND: Preliminary study has shown that exercise can improve the cognitive function in senile dementia and patients with mild cognitive impairment.
    OBJECTIVE: To understand the effect of aerobic exercise on mild cognitive impairment in elderly people in China by meta-analysis.
    METHODS: The search strategies and inclusion and exclusion criteria were developed, and CNKI, CBMdisc, WanFang, VIP, PubMed, EBSCOhost and Cochrane library databases were searched to retrieve the randomized controlled trials concerning aerobic exercise in the elderly patients with mild cognitive impairment. Risk assessment of Cochrane bias was performed, valid information was selected and input, and meta-analysis was performed on RevMan 5.3 software.
    RESULTS AND CONCLUSION: Finally, nine articles were obtained, all of which were randomized controlled studies. Meta-analysis results showed that the mini-mental state examination score in the trial group was higher than that in the control group after aerobic exercise intervention [MD=1.51, 95%CI (0.54, 2.48), P < 0.01]. The Montreal Cognitive Assessment score in the trial group was higher than that in the control group [MD=2.90, 95%CI (1.92, 3.88), P < 0.000 01]. After 3 months of aerobic exercise intervention, the cognitive score in the trial group was higher than that in the control group [SMD=0.77, 95%CI (0.33, 1.20), P=0.000 6]. After 6 months of aerobic exercise intervention, the cognitive score in the trial group was higher than that in the control group [SMD=0.73, 95%CI (0.19, 1.28), P=0.008]. After several months of aerobic exercise intervention, the cognitive score in the trial group was higher than that in the control group [SMD=0.89, 95%CI (0.60, 1.18), P < 0.000 01]. In summary, long-term exercise can improve the cognitive function in the elderly, and this method is safe and feasible, and is easy to carry out in the elderly.

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    Similar effect of high-intensity interval training with moderate-intensity continuous training on body composition and cardiovascular health of obesity children
    Cao Meng1, Quan Minghui1, Zhuang Jie2
    2019, 23 (35):  5732-5740.  doi: 10.3969/j.issn.2095-4344.1344
    Abstract ( 528 )   PDF (32280KB) ( 224 )   Save

    BACKGROUND: High-intensity interval training intervention in obesity children is gradually increasing, but there remains inconformity within the literature regarding the most effective means for delivering a high-intensity interval training intervention. Childhood obesity is becoming a global health issues, and the identification of effective intervention strategies is imperative.
    OBJECTIVE: To perform a meta-analysis to compare the improvement effects between high-intensity interval training and moderate-intensity continuous training on body composition and cardiovascular health in obesity children, and to explore the optimal high-intensity interval training protocol.
    METHODS: Five databases (MEDLINE, PubMed, Web of Science, CNKI and Google Scholar) were searched for original research articles. A search of the literature was conducted using the key words about obesity and health. The effects of two training methods on body composition and cardiovascular health were compared.
    RESULTS AND CONCLUSION: A total of 295 subjects from 11 studies were identified. The pooled effect size on systolic blood pressure was -0.60 (95% CI: -1.02, -0.18, P=0.01) comparing high-intensity interval training to moderate-intensity continuous training. There was no significant difference between high-intensity interval training and moderate-intensity continuous training on other biomarkers. Elements of reference intervention include: running high-intensity interval training with 0.33 work rest ratio, work intensity ≥ 100% maximal aerobic speed, activity recovery (50% maximal aerobic speed), 6 bouts per session and two or three times weekly and more than 12 weeks. Compared with endurance training, high-intensity interval training has similar improvements on body composition and cardiovascular health of obesity children, and has more time-efficiency. It is possible to carry out exercise interventions for obesity students in the future. Further recommendations as to optimal exercise protocol are needed to improve the intervention effects.

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