Comparative transcriptomic analysis reveals the molecular changes of acute pancreatitis in experimental models

BACKGROUND Acute pancreatitis(AP)encompasses a spectrum of pancreatic inflammatory conditions,ranging from mild inflammation to severe pancreatic necrosis and multisystem organ failure.Given the challenges associated with obtaining human pancreatic samples,research on AP predominantly relies on animal models.In this study,we aimed to elucidate the fundamental molecular mechanisms underlying AP using various AP models.AIM To investigate the shared molecular changes underlying the development of AP across varying severity levels.METHODS AP was induced in animal models through treatment with caerulein alone or in combination with lipopolysaccharide(LPS).Additionally,using Ptf1αto drive the specific expression of the hM3 promoter in pancreatic acinar cells transgenic C57BL/6J-hM3/Ptf1α(cre)mice were administered Clozapine N-oxide to induce AP.Subsequently,we conducted RNA sequencing of pancreatic tissues and validated the expression of significantly different genes using the Gene Expression Omnibus(GEO)database.RESULTS Caerulein-induced AP showed severe inflammation and edema,which were exacerbated when combined with LPS and accompanied by partial pancreatic tissue necrosis.Compared with the control group,RNA sequencing analysis revealed 880 significantly differentially expressed genes in the caerulein model and 885 in the caerulein combined with the LPS model.Kyoto Encyclopedia of Genes and Genomes enrichment analysis and Gene Set Enrichment Analysis indicated substantial enrichment of the TLR and NOD-like receptor signaling pathway,TLR signaling pathway,and NF-κB signaling pathway,alongside elevated levels of apoptosis-related pathways,such as apoptosis,P53 pathway,and phagosome pathway.The significantly elevated genes in the TLR and NOD-like receptor signaling pathways,as well as in the apoptosis pathway,were validated through quantitative real-time PCR experiments in animal models.Validation from the GEO database revealed that only MYD88 concurred in both mouse pancreatic tissue and human AP peripheral blood,while TLR1,TLR7,RIPK3,and OAS2 genes exhibited marked elevation in human AP.The genes TUBA1A and GADD45A played significant roles in apoptosis within human AP.The transgenic mouse model hM3/Ptf1α(cre)successfully validated significant differential genes in the TLR and NOD-like receptor signaling pathways as well as the apoptosis pathway,indicating that these pathways represent shared pathological processes in AP across different models.CONCLUSION The TLR and NOD receptor signaling pathways play crucial roles in the inflammatory progression of AP,notably the MYD88 gene.Apoptosis holds a central position in the necrotic processes of AP,with TUBA1A and GADD45A genes exhibiting prominence in human AP.

Comparison of Three Experimental Models for Rat Osteoarthritis Induction

Background: Osteoarthritis is a slowly progressive and debilitating disease with high prevalence in adult population. Knee is one of the joints most affected by this disorder. There are several models for animals’ osteoarthritis induction, however it is not identified any paper that compares these techniques. The present study was aimed to define the most appropriate model for rats osteoarthritis induction. Material and Methods: 40 Wistar rats were distributed into 4 groups of 10 animals each: normality group (NG);meniscectomy group (MG);quinolone group (QG) and iodoacetate group (IG). Radiographic images of the rat’s knees were analyzed as well as the amount of chondrocytes in the epiphyseal and articular cartilage. Results: In the radiographic analysis, there was a low correlation between the raters. Regarding the amount of chondrocytes in the epiphyseal cartilage, it was noticed that the IG and QG groups had fewer chondrocytes than NG, in contrast to MG that reported similar results to normality (p > 0.05). There was no significant difference between IG and QG groups (p > 0.05). Regarding the amount of chondrocytes in articular cartilage, it was noticed that the IG group showed fewer chondrocytes than NG (p 0.05). There was no significant difference between QG and MG groups (p > 0.05). Conclusion: Intraarticular injection of iodoacetate in rats is the model with greatest effect on reduction of chondrocytes amount.

Evidence for a role of mitogen-activated protein kinases in the treatment of experimental acute pancreatitis

Acute pancreatitis(AP) is an inflammatory disease characterized by acute inflammation and necrosis of the pancreatic parenchyma. AP is often associated with organ failure, sepsis, and high mortality. The pathogenesis of AP is still not well understood. In recent years several papers have highlighted the cellular and molecular events of acute pancreatitis. Pancreatitis is initiated by activation of digestive enzymes within the acinar cells that are involved in autodigestion of the gland, followed by a massive infiltration of neutrophils and macrophages and release of inflammatory mediators, responsible for the local and systemic inflammatory response. The hallmark of AP is parenchymal cell necrosis that represents the cause of the high morbidity and mortality, so that new potential therapeutic approaches are indispensable for the treatment of patients at high risk of complications. However, not all factors that determine the onset and course of the disease have been explained. Aim of this article is to review the role of mitogen-activated protein kinases in pathogenesis of acute pancreatitis.

Effects of Rebixiao Granules (热痹消颗粒剂) on Blood Uric Acid in Patients with Repeatedly Attacking Acute Gouty Arthritis

Objective: To observe the clinical effect of Rebixiao granule (热痹消颗粒剂, RBXG) in treating repeatedly attacking acute gouty arthritis and through experimental study on blood uric acid to explore RBXG's therapeutic mechanism. Methods: Ninety repeatedly attacking acute gouty arthritis patients were divided into the treated group ( n =60) and control group ( n =30). The treated group was treated with RBXG, and the control group was treated with Futalin tablets (diclofenac sodium). The baseline treatment including good rest, low purine diet, sufficient water drinking and urine alkalization, etc. was then given to both groups. Hypoxanthine 600 mg/kg and niacin 100 mg/kg was applied to hyperuricemic mice by gastrogavage to establish the animal models. Results: The clinical effective rate of the treated group was 95.0% and that of the control 90.0%. Good therapeutic effects were won, insignificant difference ( P >0.05)was shown between the two groups. However, the cure rate of the treated group was 26.7% while that of the control group was 10.0%, with significant difference ( P <0.01) shown between them. The treated group had its blood uric acid lowered, which was significantly different ( P <0.05) from that of the control group. The animal experiment indicated that all the three groups treated with different dosages of RBXG, as well as the Ash bark and Smilax glabra rhizome groups had their blood uric acid content reduced in the hyperuricemic mice. Conclusion: RBXG has a quicker initiation and better treatment effects than sole anti-inflammatory and analgesic agents on the treatment of repeatedly attacking acute gouty arthritis, showing no obvious toxic or adverse reactions and therefore good for long-term administration and likely to be a safe TCM preparation to control the symptoms and reduce the onsets of repeatedly attacking of acute gouty arthritis. The animal experiment shows that both the compound preparation and part of the single ingredients in the recipe have the function of reducing blood uric acid. However, the compound recipe has better therapeutic effects, proving to be superior to single drugs.

Bilateral nephromegaly and arthritis: A rare presentation of acute lymphoblastic leukemia

A 2.5 years old boy presented with fever, intermittent small joint arthritis of hands and feet, bilateral nephromegaly with normal hemogram and uric acid level. Bone marrow aspiration revealed pre-B acute lymphoblastic leukemia without leukemic infiltration of kidneys. Leukemia should be suspected in any patient with arthritis and nephromegaly.

Comment on "p38 MAPK inhibition alleviates experimental acute pancreatitis in mice"

To the Editor：I read with great interest the article by Cao et al[1] re- porting a potential therapeutic utility of p38 inhibitors for acute pancreatitis. Using a preclinical mouse model where acute pancreatitis was induced by administra- tion of cerulein （a cholecystokinin analog derived from the tree frog Litoria caerulea）, the authors reported that the p38 MAPK inhibitor SB203580, administered intra- peritoneally before and after the first administration of cerulein, relieved signs associated with acute pancreatitis, including decreased HSP60 and HSP70 expression, and serum IL-6, amylase and lipase activities. Although the study remains descriptive and pharmacodynamic aspects were not examined in depth, it still has a merit as it undoubtedly provides a basis for further investigation into the potential utility of targeting p38 signaling for acute pancreatitis, a common serious condition that can be life-threatening.

The correctional modification of inflammatory response at the experimental acute pancreatitis

This study investigated the effects of the L-17 compound of the group of substituted 5R1, 6H2-1,3,4- thiadiazine-2-amines on the possibility of inflammatory reaction evolvement correction in experimental acute pancreatitis. The study was based upon recent clinical and experimental work which demonstrated the role of local and systemic inflammatory reactions in pancreatonecrosis. Pancreatonecrosis modeling in rats was performed in accordance with the author’s modification of ligation model of acute pancreatitis. The biochemical and hematological analysis were performed in all groups at day 1. For microscopic analysis, five histological slices of each animal were analyzed. The main group, consisting of 15 animals with the average body weight 223 g each, got intraperitoneal injection of L-17 compound, dozed 40 mg/kg in an hour after surgery of pancreatitis formation. Later on, a 40 mg/kg doze of L-17 compound was repeatedly injected as often as once every 24 hours. Already during the 1st day of the experiment, no leucopenia was observed and the signs of proliferative inflammation were detected. Later, at the background of L-17 compound introduction (5th day of the experiment) the necrosis area got surrounded by demarcation bank, and further on (by the 7th day) had been entirely replaced by granulation tissue. Thus, the application of L-17 compound in experimental acute pan-creatitis results in replacement of destructive purulent inflammation by exudative-proliferative one, prevents lympho- and monocytopenia development, minimizes amylase and pancreatic ferments level during the first day of development of the disease and cuts down the lethality rate as result of pancreatonecrosis complications twofold.

Effect of Simiao Liangxue Granule on Acute Gouty Arthritis in Rats

[Objectives]To study the anti-inflammatory effect of Simiao Liangxue granule on the rats with acute gouty arthritis(AGA).[Methods]A total of 60 male SD rats were randomly divided into 6 groups with 10 rats in each group.The rats in the colchicine group were intragastrically administered with 0.65 mg/kg colchicine,and the rats in low,medium and high dose groups of Simiao Liangxue granule were intragastrically administered with Simiao Liangxue granule with mass concentration of 0.4,0.8 and 1.6 g/kg,respectively.The rats in the normal control group and the model group were given the same amount of normal saline for 7 d,and the acute gouty arthritis model was prepared 1 h after administration on the 5th d.At the end of the experiment,the degree of joint swelling and joint inflammation index,the content of interleukin-1β,tumor necrosis factor-a and cyclooxygenase-2 in articular cartilage,and the content of interleukin-8,NO and UA in serum of rats were measured,and the histomorphological observation was performed.[Results]Compared with the normal control group,the joints of rats were swollen to different degrees,the inflammation score was significantly increased,and the content of IL-1β,TNF-αand COX-2 in the soft tissue of the joints was significantly increased in each group(P<0.05);compared with the model group,the joint swelling degree and inflammation score of rats in the colchicine group and Simiao Liangxue granule group were significantly decreased,the content of IL-1β,TNF-αand COX-2 in the joint soft tissue was also significantly decreased(P<0.05),and the indexes of each dose group of Simiao Liangxue granule were similar to those of the colchicine group;compared with the normal control group,the content of IL-8,NO and UA in the joint soft tissue of rats was significantly increased in each group(P<0.05);compared with the model group,the content of all indexes in joint soft tissue of rats in normal control group,colchicine group and Simiao Liangxue granule group were significantly decreased(P<0.05);the content of various indexes in the joint soft tissue of rats in the low and medium dose groups of Simiao Liangxue granule was higher than that in the colchicine group,and decreased significantly with the increase of the dose of Simiao Liangxue granule(P<0.05);the inflammatory index decreased significantly with the increase of the dose of Simiao Liangxue granule(P<0.05);the inflammation and degeneration in each dose group of Simiao Liangxue granule were milder than those in the model group,and the symptoms were relieved to some extent with the increase of dose(P<0.05).[Conclusions]Simiao Liangxue granule has the effect of anti-inflammation and detumescence,and its mechanism may be related to the content of factors that reduce inflammation including IL-1β,TNF-α,C0X-2,IL-8,NO and UA.

A network pharmacology approach to explore action mechanisms of Si Miao decoction for treating acute gouty arthritis

Objective:To Find the core targets and drug action mechanism of Si Miao decoction for the treatment of acute gouty arthritis.Methods:Through the TCMSP database,the chemical composition of all the drugs in Si Miao decoction was obtained.The Perl script was compiled and the UniProt database was searched to determine the corresponding target of the chemical composition.Then,the disease databases such as OMIM,DisGeNET,and GeneCards were searched in order to determine acute gouty arthritis Related targets.Finally,screen common targets for drugs and diseases,use the STRING database and Cytoscape software to build a network control map of drugs-chemical components-targets-disease.Use R language software to screen common targets and find the four best The core targets of San for the treatment of acute gouty arthritis.The GO and KEGG analysis of the core targets were performed to clarify the core targets and mechanism of Si Miao decoction for the treatment of gout.Results:There are 64 effective chemical components in Si Miao decoction,197 genetic targets,600 disease targets,and 58 common targets.It is predicted that IL6,VEGFA,IL1B,JUN,PTGS2,and CCL2 may be treated by Si Miao decoction for gout The core target of arthritis.GO enrichment analysis identified 85 entries,of which biological processes mainly included the regulation of cytokine activity,protease activation,nucleic acid expression,etc.;KEGG pathway enrichment analysis identified 135 signaling pathways,of which signaling pathways involved the IL-17 signaling pathway,TNF signaling pathway,Th17 cell differentiation and other pathways.Conclusion:Si Miao decoction acts on acute gouty arthritis by regulating the occurrence of inflammation,and has significant anti-inflammatory and immune effects.The formula is rigorous and scientific,and it is worthy of clinical application.

Study on anti-inflammatory mechanism and effects of Flemingia Roxb.exAit extract intervene acute gouty arthritis in rats

Objective:To investigate the effect and anti-inflammatory mechanism the effect of Flemingia Roxb.exAit extract on acute gouty arthritis.Methods:Sixty SD rats were randomly divided into 6 groups by weight,control and model group,(100、150、200 mg/kg)of Flemingia Roxb.exAit extract group and colchicine group.The rats of each group were given by intragastric for 7 days of continuous administration,meanwhile,there were given 0.9%NaCl solution instead as control and model group.The acute gouty arthritis model was constructed through right ankle joint cavity injection of sodium urate crystal solutionon day 5 after 1 h,but rats in the negative control group were injected with 0.9%NaCl solution into the articular cavity of the right foot.The general condition of rats and the degree of joint swelling,and the gait was observed after constructed model.To detected the joint fluid IL-1β、TNF-α、IL-6 indicators,and the expression of NLRP3,Caspase-1 protein in ankle joint tissue for 2 hours after the last administration.Results:Groups of Flemingia Roxb.exAit extract could markedly reduce the joint swelling on acute gouty arthritis rat model,improve gait in a dose-dependent manner,high dose group of Flemingia Roxb.exAit extract did particularly well(Pjoint swelling<0.01;Pgait<0.05),close to the therapeutic effect colchicine group.Further mechanism studies show that the joint fluid IL-1β、TNF-α、IL-6 level was reduced by Flemingia Roxb.exAit extract group,the expressions of NLRP3、Caspase-1 protein of Flemingia Roxb.exAit extract group was decreased observbly than model group,but the most obvious is that high dose group as well as colchicine group(PNALP3<0.01;PCaspase-1<0.01).Conclusion:Flemingia Roxb.exAit extract has the effect of treating acute gouty arthritis and its mechanism may be related toinhibiting NLRP3 inflammasome activation and inhibiting inflammatory response.

Structural Changes in Vertebrae of Mice Based on Experimental Model of Rheumatoid Arthritis

Studies have shown that autoimmunity causes pathogenesis of more than 100 diseases. Among these diseases, approximately 1-2% of the world’s population has rheumatoid arthritis disease, which is a chronic disease that affects 45 out of every 3000 people who have autoimmune diseases. The aim of this research is to address the possible treatment of rheumatoid arthritis disease by comparing and contrasting the effectiveness and influence that treatments have on treating the disease. This study will be conducted by inducing the following treatments: ibuprofen and Boigor-10 on model animal subjects (mice) to determine the outcomes of the treatment. We will assess the outcomes by investigate the structural changes on vertebrae and joints of these subjects and the clinical manifestation score of each treatment. We hypothesize that these treatments will improve the treatment of rheumatoid arthritis disease. Furthermore, we hope that this research contributes to further understanding autoimmune disease and promotes proper treatment of the disease.

Experimental and clinical evidence of antioxidant therapy in acute pancreatitis

Oxidative stress has been shown to play an important role in the pathogenesis of acute pancreatitis (AP). Antioxidants, alone or in combination with conventional therapy, should improve oxidative-stress-induced organ damage and therefore accelerate the rate of recovery. In recent years, substantial amounts of data about the efficiency of antioxidants against oxidative damage have been obtained from experiments with rodents. Some of these antioxidants have been found beneficial in the treatment of AP in humans; however, at present there is insufficient clinical data to support the benefits of antioxidants, alone or in combination with conven-tional therapy, in the management of AP in humans. Conflicting results obtained from experimental animals and humans may represent distinct pathophysiological mechanisms mediating tissue injury in different species. Further detailed studies should be done to clarify the exact mechanisms of tissue injury in human AP. Herein I tried to review the existing experimental and clinical studies on AP in order to determine the efficiency of antioxidants. The use of antioxidant enriched nutrition is a potential direction of clinical research in AP given the lack of clues about the efficiency and safety of antioxidant usage in patients with AP.

Efficacy and safety of Huzhang Granule,a compound Chinese herbal medicine,for acute gouty arthritis:A double-blind,randomized controlled trial

Background:Acute gouty arthritis(AGA)is an inflammatory joint disease with a high prevalence.Typical medical interventions,including nonsteroidal anti-inflammatory drugs,colchicine and glucocorticoids,can have serious adverse reactions.Huzhang Granule(HZG),a compound Chinese herbal medicine,has been used to treat AGA for more than 30 years with satisfactory effects and no significant adverse reactions.However,the efficacy and safety of HZG in AGA patients remains unknown.Objective:The present investigation was designed to examine the efficacy and safety profile of HZG in managing AGA patients.Design,setting,participants and interventions:The current study was conducted as a noninferiority,randomized controlled clinical trial on 180 eligible enrolled participants.Participants were randomly assigned into the HZG and etoricoxib groups.Treatments were administered for 5 d,during which the HZG group received HZG and placebo etoricoxib,while the etoricoxib group received etoricoxib and placebo HZG in the same ratio(1:1).Main outcome measures:The primary outcome was pain experienced by the patient in the gout-afflicted joint from days 2 to 5 of the treatment window.The pain level was measured via a visual analogue scale,ranging from 0 mm to 100 mm.The secondary outcomes comprised joint tenderness and swelling,reduction of inflammatory biomarkers,and the patient’s and investigator’s global evaluations of therapeutic response.Results:The mean reduction in pain was-51.22 mm(95%confidence interval[CI],[-53.42,-49.03]mm)for the HZG and-52.00 mm(95%CI,[-54.06,-49.94]mm)for the etoricoxib groups.The mean difference between the two groups was 0.78 mm(95%CI,[-2.25,3.81]mm).All additional efficacy endpoints,covering decreased inflammation and pain relief,yielded compelling proof of noninferiority.Patients in the HZG group exhibited a comparatively lower rate of adverse events compared to those in the etoricoxib group(4.44%vs 13.33%;P≤0.05).Conclusion:HZG and etoricoxib groups demonstrated similar levels of analgesic effectiveness.The safety and efficacy of HZG indicates that it can be used as a potential therapeutic option for treating AGA.

An autopsy case of acute pancreatitis with a high serum IgG4 complicated by amyloidosis and rheumatoid arthritis

We report an autopsy case of acute pancreatitis with a high serum IgG4 concentration complicated by systemic amyloid A amyloidosis and rheumatoid arthritis (RA). The patient was a 42-year-old Japanese female with a 22-year history of rheumatoid arthritis. She was diagnosed with myasthenia gravis when she was 31-year old. At the onset of pancreatitis, the patient was anti-nuclear antibody-positive,and had high serum gamma globulin and IgG4 levels.Dexamethasone and conventional therapy induced clinical remission and significantly decreased the serum IgG4 and gamma globulin. However, despite the decreased disease parameters, the patient developed a bleeding pseudocyst and died of cardiac failure. In the autopsy examination, it was determined that pancreatitis was probably caused by ischemia due to vascular obstruction caused by amyloid deposition in the pancreas. Even though acute pancreatitis is a rare complication in RA patients, we speculate that an autoimmune pancreatitis-related mechanism and ischemia due to vascular obstruction by amyloid deposition might be attributable to a single source that leads to acute pancreatitis in our particular case.

Insulin is necessary for the hypertrophic effect of cholecystokinin-octapeptide following acute necrotizing experimental pancreatitis

AIM: In previous experiments we have demonstrated that by administering low doses of cholecystokinin-octapeptide (CCK-8), the process of regeneration following L-arginine (Arg)-induced pancreatitis is accelerated. In rats that were also diabetic (induced by streptozotocin, STZ), pancreatic regeneration was not observed. The aim of this study was to deduce whether the administration of exogenous insulin could in fact restore the hypertrophic effect of CCK-8 in diabetic-pancreatitic rats.METHODS: Male Wistar rats were used for the experiments.Diabetes mellitus was induced by administering 60 mg/kg body mass of STZ intraperitoneally (i.p.), then, on d 8, pancreatitis was induced by 200 mg/100 g body mass Argi.p. twice at an interval of 1 h. The animals were injected subcutaneously twice daily (at 7 a.m. and 7 p.m.) with 1 μglkg of CCK-8 and/or 2 IU mixed insulin (300 g/L shortaction and 700 g/L intermediate-action insulin) for 14 d after pancreatitis induction. Following this the animals were killed and the serum amylase, glucose and insulin levels as well as the plasma glucagon levels, the pancreatic mass/body mass ratio (pm/bm), the pancreatic contents of DNA, protein, amylase, lipase and trypsinogen were measured. Pancreatic tissue samples were examined by light microscopy on paraffin-embedded sections.RESULTS: In the diabetic-pancreatitic rats treatment with insulin and CCK-8 significantly elevated pw/bm and the pancreatic contents of protein, amylase and lipase vs the rats receiving only CCK-8 treatment. CCK-8 administered in combination with insulin also elevated the number of acinar cells with mitotic activities, whereas CCK-8 alone had no effect on laboratory parameters or the mitotic activities in diabetic-pancreatitic rats.CONCLUSION: Despite the hypertrophic effect of CCK-8 being absent following acute pancreatitis in diabetic-rats,the simultaneous administration of exogenous insulin restored this effect. Our results clearly demonstrate that insulin is necessary for the hypertrophic effect of low-doses of CCK-8 following acute pancreatitis.

Randomized and Controlled Clinical Study of Modified Prescriptions of Simiao Pill(四妙丸) in the Treatment of Acute Gouty Arthritis

Objective： To investigate the compatibility of a modified prescription of Simiao Pill （四妙丸） in the treatment of acute gouty arthritis and to verify the clinical efficacy and safety of the drug through a clinical trial. Methods： A randomized and controlled clinical trial was designed based on clinical epidemiological principles. A total of 107 patients with acute gouty arthritis were enrolled and randomly assigned to four groups. The first group （Group Ⅰ ） included 27 patients taking gout prescription Ⅰ ; the second group （Group Ⅱ ） included 27 patients taking gout prescription Ⅱ ; the third group （Group Ⅲ） included 28 patients taking gout prescription Ⅲ; and the fourth group （control group） included 25 patients taking indomethacin and Benzobromarone as a control group. The duration of the treatment in all 4 groups was two weeks. After the treatment, the index of blood uric acid, blood leukocyte count, score of clinical symptoms, etc. were observed and measured. Results： The total clinical effective rate of the three different modified prescriptions of the Simiao Pill was above 96%, significantly superior to that of the control group （68%, P〈0.05）. In terms of the improvement of main symptoms, the scores of four symptoms in all TCM treatment and control groups decreased after treatment, with statistically significant differences （P〈0.05）. Moreover, the scores markedly fell more so in the three Chinese herb groups than in the control group, and especially in Group Ⅲ （P〈0.05）. There was a statistically significant difference in blood uric acid values before and after the treatment in the same group but no significant inter-group difference was seen. Conclusion： The modified prescriptions, based on the clinical research, clinical experience and traditional Chinese medicine theory, did show a better effect than Western medicine in this clinical study. Moreover, the prescriptions were precise, with the herbs inexpensive and readily available. The patients had good compliance with less adverse reactions noted. The modified prescription has a favorable prospect for future development and is worthy of further blind trials with larger samples. KEY WORDS Simiao Pill, acute gouty arthritis, randomized and controlled, clinical research

Effect of Triptolide on Expression of Receptor Activator of Nuclear Factor-κB Ligand in Rat Adjuvant Induced Arthritis

The effect of triptolide （TP） on the expression of receptor activator of nuclear factor-κB ligand （RANKL） and osteoprotegerin （OPG） was explored in rat adjuvant induced arthritis （AA）. AA was induced in Wistar rats. Arthritis rats were treated with TP and methotrexate （MTX） at the onset （day 9） of arthritis. On the peak of arthritis （day 24）, the expression of RANKL and OPG protein in the joints and RANKL mRNA in peripheral blood mononuclear cells （PBMC） was detected. TNF-α and IL-1β levels in peripheral blood were determined. Bone erosion scores were also evaluated. The results showed that bone erosion scores in TP and MTX groups were lower than in AA group （.P〈0.01） ; The expression levels of RANKL in the synovium （P〈0.01） and bone （P〈0.05）, and OPG level in synovium （P〈0.05） were lower in TP group than in AA group （P〈0.05）. In TP group, the expression levels of RANKL mRNA and TNF-α, IL-1β in PBMC were lower than in AA group （all P〈0.01）. It was concluded that TP could inhibit rat adjuvant arthritis bone erosion by suppressing the expression of RANKL.

Comparative Study on Treatment of Acute Gouty Arthritis by Electroacupuncture with Different Frequency

Objective： To study the therapeutic effect of treatment of acute gouty arthritis （AGA） respectively by electroacupuncture （EA） with different frequency and oral intake of Western medicine. Methods： Seventy-two patients of AGA were randomly assigned into three groups, 24 in each group. Group A was treated with EA 100 Hz; Group B with EA 2 Hz; and Group C with Western medicine. The analgesic effect, initiating time and sustaining time of analgesia were observed and the level of serum uric acid was measured before and after treatment. Results： The initiating time of analgesia was shorter while the sustaining time of analgesia was longer in Group A and B than those in Group C （all P〈0.01）. The efficacy of analgesia was higher in Group B than that in Group A , and a better effect was shown in Group B in reducing serum uric acid level than that in Group A （P〈0.01）, which was near that in Group C （P〉0.05）. Conclusion： EA is an effective treatment for AGA, and low frequency （2 Hz） EA showed a better efficacy.

Differences in Acute Phase Reactants between Gout and Pseudogout

Objectives: To define clinical differences in the acute phase response and serum acute phase reactants between gout, pseudogout and crystal-induced arthritis in the presence of non-articular infections (CAI). Patients and Methods: Eleven patients with definite gout, 12 patients with pseudogout and 5 patients with CIA were included in the study. Results: The erythrocyte sedimentation rate (ESR) was significantly different between gout (68.2 ± 49.9 mm/Hr) and CIA (113.8 ± 37.2 mm/Hr) but not between gout and pseudogout (83.9 ± 45.6 mm/Hr) or between pseudogout and CIA. The C-reactive protein (CRP) was significantly increased between gout (10.1 ± 7.9 mg/dL) and pseudogout (18.9 ± 9.8 mg/dL), gout and CIA (36.5 ± 12.4 mg/dL) as well as between pseudogout and CIA. The peripheral white cell count was significantly different between gout (9.27 ± 3.7 k/μL) and CIA (16.5 ± 6.8 k/μL), and between pseudogout (8.9 ± 3.2 k/μL) and CIA. Conclusions: Measurement of ESR and CRP are helpful in crystal-induced arthritis. The CRP has more discriminating utility than the ESR in distinguishing between gout, pseudogout and CIA. Peripheral wbc is most useful for differentiating crystal-induced arthritis from CIA.

Research Progress and Analysis of Moxibustion in Prevention and Treatment of Acute Infectious Diseases

To introduce and evaluate current research progress of moxibustion in the prevention and treatment of acute infectious diseases,related literature in CNKI,Wanfang Data,and SinoMed was retrieved and analyzed by the present study.Results showed abundant studies on the mechanism of action of moxibustion in the prevention and treatment of acute infectious diseases with remarkable clinical efficacy.The present study also summarizes the commonly-occurring problems and found out the deficiencies in existing studies in hope of providing more reference for further research.