Correlative Factors Research of Tibial Shaft Fracture with Ipsilateral Posterior Malleolar Crack Fractures

Background:Missed diagnosis rate of spiral tibia shaft fracture with posterior malleolus crack fracture(PMCF)is high in the clinical.However,the mechanism and related factors of fracture are still unclear.Moreover,PMCF has been observed in other types of tibial shaft fractures.Objective:To explore the correlative factors of tibial shaft fracture with ipsilateral PMCF,decrease the rate of clinical missed diagnosis,strengthen the effective fixation of PMCF,and reduce the incidence of traumatic arthritis.Methods:From September 2014 to May 2019,we collected 137 tibiofibular fracture.Only 68 cases involved in ankle joint CT examination and were retrospectively analyzed.The patients were divided into posterior malleolus group(30 cases)and non-posterior malleolus group(38 cases)according to whether come up PMCF or not.The posterior malleolus group contained 24 males and 6 females,27-77(47.57±11.79)years old,the non-posterior malleolus group contained 23 males and 15 females,18-85(48.71±13.84)years old.The gender,age,location,fibula fracture and tibial shaft fracture classification were observed for univariate and multivariate analysis.Results:The probability of PMCF was higher with right tibial shaft fracture(OR=3.6995%CI:1.13-12.08 P<0.05);the probability of PMCF following distal fibular fracture was higher than that without fibular fracture(OR=11.3695%CI:1.72-75.05 P<0.05);the probability of PMCF with type A tibial shaft fracture was higher than type C(OR=4.8295%CI:1.19-19.58 P<0.05).Conclusion:Right type A tibial shaft fracture accompanied by distal fibular fracture are very important factors related to PMCF,which needs highly attention to avoid clinical missed diagnosis.

Effect of Chinese Herbal Medicine for Nourishing Yin,Supplementing Qi,and Activating Blood on the Th1/Th2 Immune Balance in Peripheral Blood in Patients with Primary Sjogren's Syndrome

Objective： To observe the effect of Chinese herbal medicine for nourishing yin, supplementing qi, and activating blood on the expression of interferen- γ （IFN-γ,）/interleukin-4 （IL-4） in peripheral blood and disease activity in primary Sjogren＇s syndrome （pSS） patients, and to study the relationship between the immune balance of Th1/Th2 and the disease activity. Methods： A total of 66 pSS patients were randomized with tossing coins method into two groups： the integrative therapy group （34 cases） and the control group （32 cases）; and 28 healthy subjects were taken as the normal group. The integrative therapy group was treated by Chinese herbal medicines for nourishing yin, supplementing qi, and activating blood combined with hydroxychloroquine sulfate tablets and the control group was treated with hydroxychloroquine sulfate tablets. The treatment course was 3 months for both groups. The levels of serum immunoglobulin G （IgG）, erythrocyte sedimentation rate （ESR）, IFN-γand IL-4 in peripheral blood were measured before and after treatment. Results： Compared with the normal group, the levels of IgG, ESR, IFN- γ and IL-4 were significantly increased in pSS patients （P〈0.05）. Remarkably, after 3 months of treatment, these levels were dramatically decreased in both the integrative therapy group and the control group, although still higher than the normal group. The levels of IgG, ESR, IFN- and IL-4 in the integrative therapy group were lower than the control group and the same group before treatment （P〈0.05）. The ratio of IFN-γ/IL-4 also significantly decreased after treatment. Moreover, the level of IFN- γ, and the ratio of IFN- γ/IL-4 in the integrative theraphy group were significantly lower than the control group （P〈0.05）. For all patients the ratio of IFN-γ/IL-4 before and after treatment was positive correlated with the levels of IgG and ESR. Conclusion： Chinese herbal medicine for nourishing yin, supplementing qi, and activating blood can alleviate the disease activity of pSS by regulating the immune balance of Th1/Th2.

Effect of Chinese Herbal Medicines for Nourishing Yin,Supplementing Qi,and Activating Blood on Reproductive Endocrine Activity and Immune Functions in Patients with Primary Sjogren's Syndrome

ABSTRACT Objective： To investigate the effect of Chinese herbal medicines for nourishing yin, supplementing qi, and activating blood on the reproductive endocrine-immune network and its mechanisms in patients with primary Sjogren＇s syndrome （pSS）. Methods： Seventy pSS patients were randomly assigned to two groups using a randomized digital table： the integrative therapy group （36 cases） and the control group （34 cases）. Thirty healthy subjects were taken as a normal group. The control group was treated with hydroxychloroquine sulfate tablets alone, and the integrative therapy group was treated by Chinese herbal medicines for nourishing yin, supplementing qi, and activating blood combined with hydroxychloroquine sulfate tablets. The treatment course was 6 months for both groups. Before and after treatment, serum estradiol （E2）, testosterone （T）, luteinizing hormone （LH）, prolactin （PRL） by radioimmunoassay and immunoglobulin （IgG） by immunodiffusion, erythrocyte sedimentation rate （ESR） by Westergren, interferon-γ （IFN-γ） and interleukin-4 （IL-4） by enzyme linked immunosorbent assay were determined. Results： E2 and T levels in all patients were lower than those of normal subjects before treatment （P〈0.05） and were increased significantly after 6-month treatment （P〈0.05）. ESR, FSH, LH, IgG, IFN - γ, IL - 4 and ratios of E2/T, and IFN --γ/IL in the patients were higher than those of normal subjects before the treatments （P〈0.05）, and were reduced significantly after the treatments （P〈0.05）. The T and IFN -γ levels and E2/T ratio in the patients treated with integrative therapy were reduced significantly compared with the control group （P〈0.05）. However, the PRL levels before and after treatment were not significantly changed in the two groups （P〉0.05）. The ratios of E2/T and IFN -γ/IL-4, and levels of IgG and ESR were positively correlated before and after treatment （P〈0.05）. Conclusions： The ratios of E2/T and IFN - γ/ IL-4 might be used as indicators of pSS activity. Chinese herbal medicines for nourishing yin, supplementing qi, and activating blood combined with Western medicine could improve the therapeutic effect by regulating the reproductive endocrine-immune network in pSS patients.

Association of Chinese Medicine Constitution Susceptibility to Diabetic Nephropathy and Transforming Growth Factor-β1(T869C)Gene Polymorphism

Objective：To explore the association of Chinese medicine constitution susceptibility to diabetic nephropathy（DN） and transforming growth factor（TGF）-β1（T869C） gene polymorphism.Methods：TGF-β1 gene polymorphism detected with polymerase chain reaction-restriction fragment length polymorphism（PCRRFLP） was screened for 180 DN cases and 180 type 2 diabetic mellitus（T2DM） cases without combined DN. Patients with DN were surveyed epidemiologically with constitution in the Chinese medicine questionnaire （CCMQ）.Binary logistic regression analysis was utilized to study the correlation between nine types of Chinese medicine constitution and TGF-β1（T869C） gene polymorphisms.Results：The DN group has a higher frequency of TGF-β1（T869C） gene polymorphism than the T2DM group,and CC/CT genotypes than the T2DM group[CC,CT,TT（DN group）：88,87,5（cases） versus（T2DM group） 71,73,36（cases）,P0.05].The phlegm-dampness constitution,damp-heat constitution,and blood stasis constitution have correlations with TGF-β1 （T869C） gene polymorphism.Conclusion：Chinese medicine constitutions were associated with TGF-β1（T869C） gene polymorphism,a potential predictor of susceptibility to DN in T2DM patients.

Progress of Research in Treatment of Hyperlipidemia by Monomer or Compound Recipe of Chinese Herbal Medicine

Hyperlipidemia （HLP） is the No.1 risk factor for patients with atherosclerosis （AS） and is directly related to the occurrence of coronary artery disease （CAD） and cerebrovascular disease. Therefore, prevention and treatment of AS is of great importance and of practical significance in controlling the incidence and mortality of CAD. With its peculiar syndrome-dependent therapy, traditional Chinese medicine （TCM） has accumulated abundant practical experiences in this field and good clinical effects have been achieved. Chinese herbal medicine, with its particularly unique advantages and high potentials yet to be tapped, displays its huge strength in HLP prevention and treatment. The progress of studies concerning prevention and treatment of HLP by Chinese herbal medicines, in the form of monomers or compound recipes, is reviewed in this paper.

Focus on Effects of Chinese Medicine on Improving Anxiety-Depression and Quality of Life of Patients with Primary Sjogren’s Syndrome

Primary Sjogren’s syndrome(pSS)is a chronic autoimmune disease with a long duration of illness,for which there is no cure.Patients often suffer from anxiety and depression due to various reasons,exhibiting a decline in their quality of life.Chinese medicine(CM)has certain advantages in the treatment of pSS,which not only helps relieve clinical symptoms and improve treatment outcomes,but also reduces anxiety and depression and improves the quality of life.Therefore,CM should be considered as early as possible given its effectiveness and synergistic effects in treating p SS.

Changes of Intestinal Microecology in Patients with Primary Sjogren’s Syndrome after Therapy of Yangyin Yiqi Huoxue Recipe(养阴益气活血方)

Objective: To explore the change of intestinal microecology in patients with primary Sjogren’s syndrome(p SS) and correlation with disease activity, and also discuss the therapy effect of Yangyin Yiqi Huoxue Recipe(养阴益气活血方, YYHD). Methods: Sixteen p SS patients were enrolled in the present study, who received 3-month treatment of YYHR, 200 mL orally twice daily. Their pre-and post-test ESSDAI scores, erythrocyte sedimentation rate(ESR) and serum immunoglobulin G(IgG) levels were measured respectively. The 16 Sr DNA metagenomic sequencing was used to detect and analyze the abundance and diversity of intestinal bacteria flora and the proportion of bacteria at the levels of phylum, family, and genus, in comparision with those of 6 healthy subjects in the control group. Results: The abundance and diversity of intestinal bacteria flora in pSS patients were lower than those of healthy subjects(P<0.05). After the treatment with YYHD, patients’ ESSDAI score and levels of IgG and ESR have decreased significantly(P<0.05). At the phylum level, the proportions of Actinobacteria, Firmicutes, Fusobacteria and Proteobacteria have reduced sharply, while the proportions of Bacteroidetes, Teneriquetes and Candidate-division-TM7 have increased significantly by treatment(all P<0.05). At the classification level, such treatment has caused a significant decrease in the proportions of Bacteroidaceae, Ruminococcaceae, Veillonellaceae, and Enterobacteriacea(all P<0.05), but a significant increase in the proportion of Lachnospiraceae(P<0.05). At the genus level, the treatment has significantly decreased the proportions of Bifidobacterium, Bacteroides, Escherichia-Shigella, Faecalibacterium and Prevotella(all P<0.05), but significantly increased the proportion of Clostridia(P<0.05), close to the levels of healthy subjects(P>0.05). Conclusions: There exists an imbalance of intestinal microecology in p SS patients, which can be improved through the treatment with YYHD. Besides, such treatment can also improve the disease activity and adjust the diversity of intestinal bacteria flora, the composition and the abundance of intestinal flora.

Interventional Value of Total Flavonoids from Rhizoma Drynariae on Cathepsin K,a Potential Target of Osteoporosis

Osteoporosis,the sixth most common disease in the world,is bringing increasingly serious harm to people＇s health.Cathepsin K,which plays an important role in bone resorption,is a potential target in the treatment of osteoporosis.Total flavonoids,the active ingredients in Rhizoma Drynariae,have shown obvious therapeutic effect on osteoporosis.In previous studies,it was presumed that the mechanism for the therapeutic effect was through inhibiting the expression of Cathepsin K.However,there are still no detailed reports on some key issues such as the specific inhibitory results of total flavonoids on Cathepsin K and the pathway of inhibition and so on.Based on previous studies on total flavonoids from Rhizoma Drynariae,the pathway for the effect of total flavonoids inhibiting Cathepsin K and their interventional value on Cathepsin K were analyzed in this paper, so as to explore the interventional feasibility and value of total flavonoids in Rhizoma Drynariae on Cathepsin K.

Effects of Panax Notoginseng Saponins on Proliferation and Differentiation in NIH3T3 Cells

Objective： To investigate the effects of Panax notoginseng saponins （PNS） on the proliferation and differentiation in NIH3T3 cells. Methods： NIH3T3 cells were treated by various concentrations of PNS 0, 0.05, 0.10, 0.20, and 0.40 g/L. The vitality and proliferation potential of cells were detected by 3-（4,5-dimethylthiazol- 2-yl）-2, 5-diphenyltetrazolium bromide （MTT） assay, the alkaline phosphatase （ALP） activity was measured by p-nitrophenyl phosphate （pNPP） assay, and the mineralization formation ability was tested for the cellular differentiation toward osteoblast, as well as the expression level of phosphorylated extrecellular signal-regulated kinasel/2（P-ERK1/2）, extracellular signal-regulated kinasel/2 （ERK1/2） protein kinase was analyzed by Western blot with total cell lysate of NIH3T3 cells treated by PNS. Results： Both MTT and pNPP assay showed that optical density （OD） values were increased in response to PNS treatment at a dose-dependent pattern. The mineralization formation ability was enhanced in PNS-treated NIH3T3 cells compared with untreated cells. Meanwhile, the expression level of P-ERK1/2 protein kinase was up-regulated in PNS-treated NIH3T3 cells, while, the expression level of ERK1/2 protein kinase revealed no obvious difference with or without PNS treated cells. Conclusion： PNS could pay a role to promote the proliferation and differentiation in NIH3T3 cells by means of up-regulation of P-ERK1/2 protein kinase.

Xiyanping injection therapy for children with mild hand foot and mouth disease:a randomized controlled trial

OBJECTIVE: To evaluate the clinical effects of Xiyan-ping injection intervention in pediatric patients with mild hand foot and mouth disease(HFMD).METHODS: A total of 329 patients were stratified and block-randomized for symptomatic treatment of HFMD and assigned to one of the following groups: Western Medicine(group A, n = 103), Xiyanping injection(group B, n = 109), or Xiyanping injection and symptomatic treatment using Western Medicine(group C, n = 117). During the trial, fever,rash, ulcers of the mouth were observed among participants in each group before and after treatment, and conversion rates from mild to severe HFMD were measured.RESULTS: After 3-7 days' treatment, no significant differences in the conversion rates from mild to severe HFMD were observed among the three groups(P > 0.05). There was a significantly low number of patients with the onset time of antifebrile effect,vanished time of hand and foot rashes and cumulative time for the ulcers in the mouth vanished,among the three groups(P < 0.05, P < 0.01). The onset time of antifebrile effect of patients in groups B and C were markedly shorter compared with those in group A(P < 0.05, P < 0.01); there was no statically significant difference observed between groups B and C(P > 0.05). No significant differences were observed in the time for body temperature recovery among the three groups(P > 0.05). There were no significant differences in adverse effects among the three groups(P > 0.05).CONCLUSION: Xiyanping injection together with use of Western Medicine is most effective for symptomatic treatment of mild HFMD. No severe adverse reactions were observed.