Progress in diagnosis and treatment of acute injury to the anterior talofibular ligament

Injury to the anterior talofibular ligament(ATFL)is a common acute injury of the lateral foot ligament.Untimely and improper treatment significantly affects the quality of life and rehabilitation progress of patients.The purpose of this paper is to review the anatomy and the current methods of diagnosis and treatment of acute injury to the ATFL.The clinical manifestations of acute injury to the ATFL include pain,swelling,and dysfunction.At present,non-surgical treatment is the first choice for acute injury of the ATFL.The standard treatment strategy involves the“peace and love”principle.After initial treatment in the acute phase,personalized rehabilitation training programs can be followed.These may involve proprioception training,muscle training,and functional exercise to restore limb coordination and muscle strength.Static stretching and other techniques to loosen joints,acupuncture,moxibustion massage,and other traditional medical treatments can relieve pain,restore range of motion,and prevent joint stiffness.If the non-surgical treatment is not ideal or fails,surgical treatment is feasible.Currently,arthroscopic anatomical repair or anatomical reconstruction surgery is commonly used in clinical practice.Although open Broström surgery provides good results,the modified arthroscopic Broström surgery has many advantages,such as less trauma,rapid pain relief,rapid postoperative recovery,and fewer complications,and is more popular with patients.In general,when treating acute injury to the ATFL,treatment management and methods should be timely and reasonably arranged according to the specific injury scenario and attention should be paid to the timely combination of multiple therapies to achieve the best treatment results.

Pathogenesis,clinical manifestations,diagnosis,and treatment progress of achalasia of cardia

Achalasia cardia,type of esophageal dynamic disorder,is a relatively rare primary motor esophageal disease characterized by the functional loss of plexus ganglion cells in the distal esophagus and lower esophageal sphincter.Loss of function of the distal and lower esophageal sphincter ganglion cells is the main cause of achalasia cardia,and is more likely to occur in the elderly.Histological changes in the esophageal mucosa are considered pathogenic;however,studies have found that inflammation and genetic changes at the molecular level may also cause achalasia cardia,resulting in dysphagia,reflux,aspiration,retrosternal pain,and weight loss.Currently,the treatment options for achalasia focus on reducing the resting pressure of the lower esophageal sphincter,helping to empty the esophagus and relieve symptoms.Treatment measures include botulinum toxin injection,inflatable dilation,stent insertion,and surgical myotomy(open or laparoscopic).Surgical procedures are often subject to controversy owing to concerns about safety and effectiveness,particularly in older patients.Herein,we review clinical epidemiological and experimental data to determine the prevalence,pathogenesis,clinical presentation,diagnostic criteria,and treatment options for achalasia to support its clinical management.

长链非编码RNA SNHG16在消化系统肿瘤中作用机制研究进展

长链非编码RNA小核仁RNA宿主基因16(long non-coding RNA small nucleolar RNA host gene 16,LncRNA SNHG16),是小核仁RNA宿主基因家族的成员,主要位于细胞质中.研究表明SNHG16在前列腺癌、乳腺癌、膀胱癌、胃癌、结肠癌等多种恶性肿瘤中异常高表达.通过多种途径调控肿瘤细胞增殖、侵袭、迁移和凋亡等.本文主要总结了SNHG16在消化系统恶性肿瘤中的作用,包括SNHG16的异常表达、分子功能、调控网络以及相关临床特征,为肿瘤的早期诊断和早期治疗提供新思路.

Synergistic effects of three traditional herbs green tea,mulberry leaf and corn silk on glucose uptake level of L6 myoblasts and the hypoglycemic mechanism

Background:Green tea,mulberry leaf and corn silk are traditional herbs used in the prevention and treatment of diabetes in China for a long time,but their synergistic hypoglycemic effects and mechanisms remain unclear.Methods:The effective components of green tea,mulberry leaf and corn silk were extracted and enriched.Mixture design of experiments was used to study the influences of different combinations on the cell viability and glucose uptake level of L6 myoblasts,so as to determine the optimal synergistic hypoglycemic combination.The possible hypoglycemic mechanism of the optimal synergistic combination was explored by cytotoxicity assay,glucose uptake assay,and western blot.Results:Three polyphenol enrichment fractions of the herbs,30%ethanol elution fraction of green tea(GT),50%ethanol elution fraction of mulberry leaf(ML)and 60%ethanol elution fraction of corn silk(CS)were obtained.The antioxidant activities of GT-30%,ML-50%and CS-60%were superior to those of crude extracts,and showed strong potential inα-amylase andα-glucosidase inhibition activities.The optimal synergistic combination of crude extracts G7(crude extract of green tea:crude extract of mulberry leaf:crude extract of corn silk=1:5:3),polyphenol enrichment fractions R3(GT-30%:ML-50%:CS-60%=1:7:1)and monomers X2(epigallocatechin gallate:morusin:formononetin=3:1:2)were selected,respectively.G7,R3,and X2 showed promoting effects on the cell viability and glucose uptake of L6 myoblasts within the detected concentration range.In addition,G7,R3,and X2 could increase the expression levels of p-PI3K/PI3K and p-Akt/Akt in L6 myoblasts,and promote the translocation of Glut4,but G7 and R3 showed more significant effects.Conclusion:The synergistic hypoglycemic effects of green tea,mulberry leaf and corn silk had the characteristics of multiple-components and multiple-targets with p-PI3K/PI3K,p-Akt/Akt and the translocation of Glut4 signal pathways involved.The three traditional herbs might have the potential to be combined used for the prevention and treatment of diabetes based on the synergistic hypoglycemic effects.

促进大肠癌血管新生相关因素研究进展

大肠癌(colorectal cancer,CRC)是胃肠道常见的恶性肿瘤,占全球男性和女性恶性肿瘤约10%和9.4%,每年因大肠癌死亡的患者可达70万人,每年新增患者数约为140万人,呈逐年增加趋势.血管新生参与多种生理病理过程,是很多疾病(肿瘤、局部缺血、动脉粥样硬化、炎症性疾病等)以及创口愈合、组织再生的重要病理学标志.血管新生在CRC的发生、发展与转移中发挥重要作用.对于促进大肠癌血管新生相关因素的研究有利于寻找或者研发更有效的抑制CRC血管新生的药物,从而达到抗肿瘤的效果.本文就肿瘤相关血管新生、促CRC血管新生因素、结论三个方面进行综述,为我们更好地认识血管新生在CRC发病过程中的作用提供理论依据.

Ent-11α-Hydroxy-15-oxo-kaur-16-en-19-oic-acid Inhibits Growth of Human Lung Cancer A549 Cells by Arresting Cell Cycle and Triggering Apoptosis

Objective： To examine the apoptotic effect of ent-llα-hydroxy-15-oxo-kaur-16-en-19-oic-acid （5F）, a compound isolated from Pteris semipinnata L （PsL）, in human lung cancer A549 cells. Methods： A549 cells were treated with 5F （0-80 lag/ml） for different time periods. Cytotoxicity was examined using a Ml-I- method. Cell cycle was examined using propidium iodide staining. Apoptosis was examined using Hoechst 33258 staining, enzyme-linked immunosorbent assay （ELISA） and caspase-3 activity analysis. Expression of representative apoptosis-related proteins was evaluated by Western blot analysis. Reactive oxygen species （ROS） level was measured using standard protocols. Potential interaction of 5F with cisplatin was also examined. Results： 5F inhibited the proliferation of A549 cells in a concentration- and time-dependent manner. 5F increased the accumulation of cells in sub-G1 phase and arrested the cells in the G2 phase. Exposure to 5F induced morphological changes and DNA fragmentation that are characteristic of apoptosis. The expression of p21 was increased. 5F exposure also increased Bax expression, release of cytochrome c and apoptosis inducing factor （AIF）, and activation of caspase-3. 5F significantly sensitized the cells to cisplatin toxicity. Interestingly, treatment with 5F did not increase ROS, but reduced ROS production induced by cisplatin. Conclusion： 5F could inhibit the proliferation of A549 cells by arresting the cells in G2 phase and by inducing mitochondrial-mediated apoptosis.

Participation of local exosomes of acupoints in the initiation of acupuncture analgesic effect

Objective: To investigate the local initiation role of local exosomes of acupoints in acupuncture analgesic effect.Methods: Thirty-two rats with adjuvant arthritis were randomly divided into model group(Group CFA),model + electroacupuncture group(Group EA), model + antagonist + electroacupuncture group(Group GW4869 + EA), and model + dimethyl sulfoxide + electroacupuncture group(Group DMSO + EA), with 8 rats in each group. The model rat s of adjuvant arthritis were prepared by intradermal injection of 0.1 mL of Freund’s adjuvant complete into the metatarsal of the right posterior foot to induce inflammation.No intervention was given in Group CFA, while electroacupuncture was performed in the other three groups at 'Zúsānlǐ(足三里 ST 36, bilaterally)' and 'Huántiào(环跳 GB 30, bilaterally)' of the rats with the following electroacupuncture parameters: dilatational wave with a frequency of 2/10 Hz, an intensity of 5/10/15(0.76/1.53/2.3 mA), a duration of 30 min, and an intensity increasing every 10 min. In Group DMSO + EA, DMSO(with a concentration of 0.2%, 50μL/acupoint) was injected at bilateral 'ST 36' of the model rats one hour before electroacupuncture, while GW4869(with a concentration of 3 mg/mL,50μL/acupoint) was injected at bilateral ST 36 of the model rats one hour before electroacupuncture in Group GW4869 + EA. The paw withdrawal latency(PWL) was used as the therapeutic effect index.Results: The PWL of rats in each group at Hour 24 after modeling was significantly lower than that before modeling, indicating that the models were successfully established. After the electroacupuncture treatment, the PWL of rats showed an increasing trend in all groups. The PWL of Group GW4869 + EA(6.74 ±1.09)s was lower than that of Group EA(7.72 ±1.54)s on Day 1 after injection, but the difference was not statistically significant(P> 0.05). The PWL values of Group GW4869 + EA(7.72 ±0.70)s,(7.87 ± 0.58)s were significantly lower than those of Group EA(9.96 士 0.94)s,(9.66 ±0.96)s(both P< 0.05)on Days 2 and 3 after injection, and the differences were statistically significant.Conclusion: It was preliminarily found that acupuncture analgesic effect was significantly reduced after local exosomes of acupoints were blocked, indicating that local exosomes of acupoints may be involved in the initiation process of acupuncture effect.

Exosome Is an Important Novel Way of Acupuncture Information Transmission

As a physical stimulation of the body surface,the process of transmitting acupuncture information from acupoints to target organs through meridians and collaterals is complex,and network regulation is the most basic mode of acupuncture.Exosomes are membrane vesicles formed by various types of cells and secreted to the extracellular matrix through a series of regulation.We speculate that exosomes and their carriers,as important carriers of communication among neurons,endocrine cells,and immune cells,may play an important role in the process of acupuncture information transmission.Exosome in the acupoint area is an important interactive form of transformation from physical information to chemical information.Circulating exosome is an important means of delivery for acupuncture to play an important role in the network regulation.The structure and information molecules of exosomes are the important material bases for acupuncture effect.Through experimental research,it was found that acupuncture can regulate the release of exosome and may have a certain relationship with acupuncture effect.Therefore,exosome may play an important role in the process of acupuncture information transmission,which is an important new way of acupuncture information transmission.