Clinical Observation on 96 Cases of Primary Osteoporosis Treated with Kidney-Tonifying and Bone-Strengthening Mixture

Objective: To objectively evaluate the therapeutic effect and safety of Mixture for Nourishing Kidney and 96 patients in the treatment group were treated with Mixture for Nourishing Kidney and Strengthening Bone in the blank group were given no drug in half a year. Observation and determination were conducted on bone mineral density (BMD), clinical symptoms, bone gla protein (BGP), pyridinoline (PYD), estradiol (E2),testosterone (T), blood urea nitrogen (BUN), transaminase and routine test on blood and urine. Result: The comprehensive effect in the treatment group was remarkably superior to that in the control group. Conclusion:The safe and reliable Chinese drug can enhance BMD, promote osteogenesis and inhibit bone absorption,hence treating osteoporosis with marked effect.

Hyperglycemia induces protein nonenzymeatic glycosylation in brain neurons of diabetic rats at early stage

BACKGROUND： Protein nonenzymatic glycosylation is supposed to be one of mechanisms for chronic complications development in diabetes mellitus, and therefore, might play an important role in the neuronal degeneration. OBJECTIVE： To study the protein nonenzymatic glycosylation in brain neurons of diabetic rats, and to analyze the pathway of neuronal degeneration at the early stage of hyperglymecia. DESIGN： Randomized controlled animal experiment. SETTING： Department of Endocrinology, First hospital Affiliated to General Hospital of Chinese PLA and Beijing Laboratory for Brain Aging, Xuanwu Hospital Affiliated to Capital Medical University. MATERIALS： Thirty-five male Wistar rats （grade Ⅱ ）, aged 3 months old, and 11 male purebred Kunming mice （grade Ⅲ） without special pathogen, aged 3 months old, were provided by the Animal Room of Capital Medical University. METHODS： This experiment was carried out in the Beijing Laboratory for Brain Aging, Xuanwu Hospital Affiliated to Capital Medical University in 1998. The rats in the diabetic model group were intraperitoneally injected into 10 g/L STZ according to 60 mg/kg to establish rat models of diabetes mellitus. The blood glucose and body mass of rats in each group were determined respectively at 1, 2 and 3 months after modeling. The antibodies of advanced glycosylation end products （AGEs） of bovine serum albumin （anti-BSA） were self-prepared： ①The antigen of AGEs-BSA was prepared.②Eleven male Kuming mice （grade Ⅱ） of 3 months old without special pathogen were selected to inoculate AGEs-BSA. ③The animals were immunized. ④Primary purification and detection of poly-antibodies of AGEs： the AGEs were performed immtmohistochemical examination at 1 month after diabetic modeling by ELISA method. MAIN OUTCOME MEASURES： ① Detection results of blood glucose and body mass of rats in two groups at different time points. ②Determination of polyclonal antibody titer of AGEs-BSA. ③Changes in immtmohistochemical image of AGEs in brain tissue of rats in two groups. RESULTS： Thirteen rats in the diabetic model group and fifteen rats in the normal model group entered the stage of final analysis. ①Changes of blood glucose and body mass： At 1, 2 and 3 months after modeling, the blood glucose of rats in the diabetic model group were respectively（28.8 ± 2.8）, （23.1 ± 5.5）, （25.4 ± 5.1） mmol/L, which were significantly higher than those in the normal control group [（6.2± 0.9）, （6.1 ± 0.8）, （6.1±0.7） mmol/L, P 〈 0.01]; At 1, 2 and 3 months after modeling, the body mass of rats in the diabetic model group were respectively （250.1 ± 52.2）, （263.8± 50.0）, （261.5 ± 42.6） g, which were significantly lower than those in the normal control group [（422.6±36.2）, （462.6±39.0）, （485.0±28.8） g, P 〈 0.01]. ②Determination of antibody titer of immune serum： The mice were treated by AGEs-BSA of different concentrations twice. After that, the titer of AGEs -BSA was determined, and the results of which indicated that a higher absorbance existed at 1： 1 000. ③Determination of antigen concentration： The final titer of antibody in the abdominal dropsy was determined, and the results of which suggested that there was a much higher absorbance in the AGEs-BSA at the concentration of 5 - 50 mg/L. ④Determination of antibody titer in abdominal dropsy： The antibody titer in abdominal dropsy was detected by ELISA method with antigen at 20 mg/L, which indicated that the maximum absorbance （1.265 ±0.039） existed at 1 ： 4 000, and very larger absorbance （0.982±0.067） at 1 ： 20 000. The polyclonal antibody of AGEs-BSA was successfully prepared. ⑤Immtmohistochemical detection results： The immtmohistochemical staining of AGEs showed there were positive neurons in the first month in the diabetic model group, whereas it was not significant in the normal control group. The positive substances were found mainly in the cytoplasm. CONCLUSION： Hyperglycemia at the early stage of diabetes mellitus （1 month after modeling） can lead to protein nonenzymeatic glycosylation in brain neurons, and no obvious reactions mentioned above are found in the normal control group. It suggests that the degenerative changes of tissue structure of central nervous system are related with protein nonenzymeatic glycosylation caused by hyperglycemia.

Correlation between Helicobacter pylori infection and atherothrombotic stroke

Previous studies have demonstrated that Helicobacterpylori infection is associated with coronary atherosclerotic heart disease, but the correlation between Helicobacterpylori infection and ischemic stroke remains unclear. The present study assessed the effects of Helicobacter pylori infection on atherothrombotic stroke. This study included 115 individuals with atherothrombotic stroke, all of whom were patients receiving treatment at the Department of Neurology, Aerospace Central Hospital （Aerospace Clinical Medical College Affiliated to Peking University） in China, from March 2006 to July 2009. In addition, 131 controls without the history of cardiovascular disease, cerebrovascular disease or atherothrombosis were also enrolled in the study. Results show that the Helicobacterpylori-lgG positive rate was greater in the atherothrombotic stroke patients than in the controls, but the difference was not statistically significant （67.8% vs. 61.8%, OR = 1.301,95%C/： 0.769-2.203, P = 0.327）. After correction for potential risk factors for Helicobacter pylori infection and known risk factors for ischemic stroke, no significant difference was detected between them （OR = 1.278, 95%C1： 0.667-2.449, P = 0.459）. These results indicate that there is no specific correlation between Helicobacterpylori infection and atherothrombotic stroke. This finding requires further verification in large-sample prospective studies.

The Relevance between Symptoms and Magnetic Resonance Imaging Analysis of the Hippocampus of Depressed Patients Given Electro-acupuncture Combined with Fluoxetine Intervention - A Randomized,Controlled Trial

Objective： To probe the relevance between depressive symptoms and hippocampal volume and its metabolites detected by magnetic resonance imaging （MRI） in depressed patients who were given electro- acupuncture （EA） combined with Fluoxetine before and after treatment. Methods： A randomized, controlled trial was conducted. A total of 75 cases of mild or moderate depression were randomly assigned to two groups： the EA group which received EA combined with Fluoxetine; the Fluoxetine group which received Fluoxetine only as the control. The 17-item Hamilton Scale for Depression （HAMD） was used to assess the depression level. The relevance between the changes of the hippocampal volume and its metabolites, including N-acetyl aspartate （NAA）/creatine （Cr） and choline containing compounds （Cho）/Cr, and the reduction rate of the HAMD score before and after treatment of the two groups were analyzed. Results： At the end of the treatment, the therapeutic response rates were not statistically different between the two groups （73.53% for the Fluoxetine group and 83.33% for the EA group, respectively）. Compared to that of the Fluoxetine group, a significant difference was shown in the EA group in the reduction rate of the HAMD scores （P〈0.05）. There was a negative correlation between the therapeutic effect and the HAMD scores before treatment in both groups of patients. There was no significant difference in the hippocampal volume before and after treatment. The NAA/Cr ratio of both groups increased after treatment, with the EA group increasing more. There was a negative correlation between the rate of change of the NAA/Cr after treatment and the HAMD scores before treatment in the two groups. In the Fluoxetine group, the Cho/Cr ratio showed no significant difference before and after treatment, which had no relevance with the HAMD scores before treatment either. Meanwhile, in the EA group, the Cho/Cr ratio showed a significant difference before and after treatment, which also had a positive relevance with the HAMD scores before treatment. Conclusions： There was a significant improvement in the hippocampal metabolites in depressed patients who treated by EA combined with Fluoxetine. Those differences showed relevance with the HAMD scores before treatment.

Radiological Characteristics and Anatomical Risk Factors in the Evaluation of Hallux Valgus in Chinese Adults

Background：There are no unified theories as to the anatomical changes that occur with hallux valgus,we investigated the radiological characteristics and anatomical risk factors for hallux valgus deformity in Chinese adults.Methods：We reviewed 141 patients with hallux valgus （206 feet; 15 males,126 females; mean age,58.5 years）.These patients attended Peking University People＇s Hospital from April 2008 to March 2014.All feet had intact radiological data,obtained using the Centricity RIS/PACS system.We measured hallux valgus angle （HVA）,1-2 intermetatarsal angle （IMA）,proximal articular set angle （PASA）,distal articular set angle,hallux interphalangeal angle,metatarsocuneiform angle,size of the medial eminence of the distal first metatarsal,tibial sesamoid position,and joint congruity of the first metatarsophalangeal joint （MTPJ）.Results：We found positive correlations between the HVA and IMA （r =0.279,P 〈 0.01） and HVA and PASA （r =0.358,P 〈 0.01）,but not for IMA and PASA （P 〉 0.05）.Feet were divided into three groups based on HVA severity.IMA （P 〈 0.05） and PASA （P 〈 0.05） in the mild group were significantly lower than that in the moderate and severe groups,with no significant difference determined for IMA or PASA between the moderate and severe groups （P 〉 0.05）.Feet were then grouped based on the shape of the first metatarsal head.Using this grouping,HVA was significant higher in the rounded shape （19.92°） than in a flat shape （17.66°）.The size of the medial eminence of the distal first metatarsal was positively correlated with HVA （r =0.185,P 〈 0.01）.The medial eminence in the moderate and severe groups was significantly larger than that in the mild group; moderate and severe groups were not significantly different.Conclusions：PASA enlargement is an adaptive change during early hallux valgus formation,and decompensation leads to subdislocation in the first MTPJ.A rounded first metatarsal head would thus predispose a foot to hallux valgus.Furthermore,bone proliferation at the medial eminence may also lead to early hallux valgus development.

A Pilot Study on the Correlation of Tongue Manifestation with the Site of Cerebral Infarction in Patients with Stroke

Objective：To discuss the correlation of tongue manifestation with the site of cerebral infarction in patients with acute cerebral infarction.Methods：From March 2008 to February 2009,200 cases of hospitalized patients with first unilateral cerebral infarction were chosen in the Department of Neurology,Xuanwu Hospital.The correlation of different tongue color,fur texture,fur color with the site of cerebral Infarction was analyzed.Results：The site of cerebral infarction in patients were compared between different tongue color by Chisquare test（P=0.314）,and further correspondence analysis demonstrated that there was correlation between red tongue and cortical-subcortical infarction group.The site of cerebral infarction in patients were compared between thick fur group and thin fur group,cortical-subcortical infarction occurred more frequently in the former（P=0.0008）.The site of cerebral infarction in patients were compared between dry fur group,moist fur group and smooth fur group,correspondence analysis demonstrated there was correlation between dry fur and cortical-subcortical group.The site of cerebral infarction in the patients were compared between white fur group,white-yellow fur group and yellow fur group（P=0.010）,and correspondence analysis demonstrated there was correlation between white fur and brainstem infarction;white-yellow fur has relationship with cortical infarction;subcortical infarction was weakly related with white-yellow fur;there was closer relationship between yellow fur and cortical-subcortical infarction.Conclusion：The change of tongue manifestation was associated with the site of cerebral infarction in patients,providing a new combining site for diagnosing cerebrovascular diseases by integrative medicine.

The recommendations of Chinese Parkinson’s disease and movement disorder society consensus on therapeutic management of Parkinson’s disease

Background:Parkinson’s disease(PD)is a chronic,progressive and debilitating disease,which affects over 2.5 million people in China.PD is characterized clinically by resting tremor,muscular rigidity,bradykinesia and postural instability.As the disease progresses,additional complications can arise such as non-motor and neurobehavioral symptoms.Pharmacological treatment and surgical intervention for PD have been implemented in China.Until 10 years ago,there was lack of standardization for the management of PD in different regions and among different physicians,leading to different treatment levels in different regions and different physicians.Since then,the Chinese Parkinson’s Disease and Movement Disorder Society have published three versions of guidelines for the management of PD in China,in 2006,2009 and 2014,respectively.Correspondingly,the overall level of treatment for PD in China improved.Objectives:To update the treatment guidelines based on current foreign and domestic practice guidelines and clinical evidence,and to improve the treatment options available to physicians in the management of PD.Summary:A variety of treatment recommendations in the treatment guidelines have been proposed,including physical activity and disease-modifying medication,which should be initiated at the early-stage of the disease.The principles of dosage titration should be followed to avoid acute adverse reactions to the drugs,to achieve a satisfactory clinical effect with a low dose and to reduce the incidence of long-term motor complications.Moreover,different treatment strategies should be considered at different stages of the disease.Importantly,treatment guidelines and personalized treatments should be valued equally.A set of treatment recommendations has been developed to assist physicians to improve and optimize clinical outcomes for patients with PD in China.

Efficacy and safety of Liangxue Jiedu decoction for the treatment of progressive psoriasis vulgaris: a multicenter, randomized, controlled study

OBJECTIVE: To determine the clinical efficacy and safety of Liangxue Jiedu decoction(LJD) for the treatment of progressive psoriasis vulgaris and to provide the basis for the development of a standardized treatment protocol for psoriasis vulgaris.METHODS: In this multicenter, randomized, controlled study, patients with blood-heat type psoriasis were randomly assigned to receive either Chinese herbal medicine(LJD;treatment group) or Western Medicine(cetirizine hydrochloride, vitamin C, and vitamin B complex;control group). Psoriasis Area and Severity Index(PASI) scores were calculated in addition to the number of patients who achieved ≥ 50% or ≥ 75% improvement in PASI score from baseline. The change in symptoms of Chinese medicine(color of rash, burning sensation,itchiness, severity of irritation, and anger) was evaluated and safety was assessed as adverse events and laboratory analysis. t test, independent sample non-parametric test and χ2 test were used to analyze the results.RESULTS: A total of 238 participants were included in the study [treatment group, n = 122(PP analysis117);control group, n = 116(PP analysis 104)]. LJD treatment was associated with a significant improvement in skin lesions and symptoms com-pared with Western Medicine treatment. At the end of the 8-week treatment period, 23.77%(PP analysis 24.79%) of patients in the treatment group had achieved PASI75 and 57.38%(PP analysis 58.97%)had achieved PASI50;the corresponding figures in the control group were 9.48%(9.62%) and 25.00%(25.00%), respectively. The between-group differences were statistically significant(P < 0.05).CONCLUSION: Treatment of psoriasis vulgaris of the blood-heat type using LJD was associated with significantly better outcomes compared with those achieved using standard Western Medicine.

The current surgical treatment of pancreatic neuroendocrine neoplasms in China: a national wide cross-sectional study

Objective:The aim of this study is to investigate the current status of the diagnosis and treatment of patients with pancreatic neuroendocrine neoplasms(pNENs)undergoing surgery in China.Methods:This is a multicenter cross-sectional study performed in China.Data from patients with pNENs undergoing surgery at 33 high-volume medical centers,where the number of pancreatectomies exceeds 20 cases per year,were collected and analyzed between March 1,2016 and February 28,2017.Results:In total,392 patients with pNENs were enrolled.The male to female ratio was 1.4.The majority of patients were aged between 40 and 70 years.65.6%of the patients had non-functional tumors.Among those with functional tumors,the percentages of insulinomas,gastrinomas,glucagonomas,and vasoactive intestinal peptide-secreting tumors were 94.8%,1.5%,2.2%,and 1.5%,respectively.Multidisciplinary team(MDT)discussion was conducted for 39.0%of the patients.Minimally invasive surgery was performed on 31.1%of the 392 patients.The incidence of grade B/C pancreatic fistula formation was 4.4%.A total of 89.0%of the surgeries achieved R0 resection,and 41.6%of the tumors were well differentiated.Lymph node metastasis was present in 8.9%of the patients.The percentages of patients with grades G1,G2,and G3 disease were 49.2%,45.7%,and 5.1%,respectively.Conclusion:This multicenter cross-sectional study systematically presents the current status of the diagnosis and treatment of patients with pNENs undergoing surgery in China.MDT consultation for pNENs has not been widely implemented in China.Although the incidence of surgical complications is relatively low,minimally invasive procedures should be further promoted.This study shows us how to improve the outcomes of these patients.