中药黄芪对骨代谢的影响及相关基础研究进展

黄芪(Astragali Radix)为豆科黄芪属植物蒙古黄芪或膜荚黄芪的干燥根。始载于东汉末年的《神农本草经》,具有2000多年的药用史,在《本草纲目》中被列为上品,认为黄芪具有补气升阳、利水消肿、固表止汗、托疮生肌等功效。黄芪化学成分包括:葡聚糖、杂多糖等多糖成分;黄芪苷I、II、III和大豆皂苷等多种皂苷;天冬氨酸、丝氨酸等多种氨基酸;多种微量元素及叶酸、亚油酸、甾醇类等。目前对黄芪的化学成分研究多集中在黄芪多糖、黄芪皂苷或其有效单体成分。现代药理学研究表明,黄芪具抗肿瘤、免疫调节、心血管保护、保肝、改善神经系统功能、抗骨质疏松等生物活性,其中,黄芪对骨细胞代谢具有一定的调节作用。通过对近年来黄芪对骨代谢的影响及相关基础研究的文献汇总,发现黄芪甲苷等黄芪提取物及黄芪制剂大多通过对成骨细胞的促进及破骨细胞的抑制进行骨代谢的调节,亦有通过促进类骨素的分泌、激素水平的调节进行调控,本文综述了黄芪甲苷等黄芪提取物及黄芪制剂对骨代谢的基础、动物模型及临床3个方面近十年的研究内容进行综述,为研究中药黄芪对骨细胞代谢影响提供些许帮助并为防治骨质疏松症提供思路与参考。     

左、右半结肠癌骨转移病理特征及预后分析

目的:比较左半结肠癌（LSCC）和右半结肠癌（RSCC）骨转移的病理特征和临床预后差异。方法:对漯河市中心医院2007年1月至2015年12月收治的103例结肠癌骨转移病例资料进行回顾性分析，据解剖位置将64例纳入LSCC组，39例纳入RSCC组，对比分析其病理学特征,绘制并分析生存曲线,筛选预后因素。结果:RSCC骨转移相对LSCC表现为:CA199 阳性率高、年龄大、分化程度更差、分期更晚、预后更差。单因素分析结果示原发肿瘤位置、TNM分期、LDH水平、ALP水平是影响结肠癌骨转移3年生存的相关因素。Logistic多因素回归分析显示原发肿瘤位置、TNM分期、ALP水平是结肠癌骨转移的独立危险因素。结论:左、右半结肠癌在病理特点、临床表现、生物学行为、生存预后等方面存在差异，本文为区分左、右半结肠癌骨转移的不同病理特征及预后评价提供了依据。     

MicroRNA-301b-3p accelerates the growth of gastric cancer cells by targeting zinc finger and BTB domain containing 4

MicroRNAs (miRNAs) have been found to be aberrantly expressed and exert essential roles in the tumorigenesis and progression of gastric cancer (GC). miR-301b-3p has been recognized as a cancer-related miRNA in lung cancer, bladder cancer and hepatocellular carcinoma. However, the function of miR-301b-3p in GC progression and its underlying mechanism have not been studied yet. In this study, we found that miR-301b-3p expression was up-regulated in GC tissues compared to adjacent noncancerous tissues. Furthermore, the elevated levels of miR-301b-3p were detected in GC cell lines (SGC-7901, AGS, MKN-45 and MGC-803) as compared with GES-1 cells. Interestingly, GC tissues from patients with tumor size ≥ 5 cm and advanced tumor stages showed obvious higher levels of miR-301b-3p compared to matched controls. Functionally, miR-301b-3p knockdown prominently inhibited cell proliferation, and induced cell cycle arrest at G1 phase and apoptosis in MGC-803 cells. Meanwhile, ectopic expression of miR-301b-3p conversely regulated these biological behaviors of MKN-45 cells. Next, we found that miR-301b-3p knockdown increased, whereas miR-301b-3p overexpression reduced the expression of zinc finger and BTB domain containing 4 (ZBTB4) in GC cells. Accordingly, luciferase reporter assay identified ZBTB4 as a direct target of miR-301b-3p. ZBTB4 overexpression markedly restrained the growth of MGC-803 cells. More importantly, ZBTB4 silencing partially reversed miR-301b-3p knockdown-induced tumor suppressive effects on MGC-803 cells. In conclusion, we firstly revealed that miR-301-3p was highly expressed in GC and contributed to tumor progression via attenuating ZBTB4, which might provide a novel molecular-targeted strategy for GC treatment.     

Comparison of survival rate and crestal bone loss of narrow diameter dental implants versus regular dental implants: A systematic review and meta‐analysis

The aim of the present study was to establish survival rates, as well as crestal bone loss (CBL) of narrow diameter implants (NDI), compared to regular diameter implants (RDI). The current review followed the Enhancing the QUAlity and Transparency Of health Research guidelines and Preferred Reporting Items for Systematic Reviews and Meta‐Analyses statement. We searched main databases (MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, and Cochrane Oral Health Group Trials Register) for articles addressing the focused question up to and including May 2018. Meta‐analyses were conducted for CBL and survival rates. Qualitatively, three clinical studies showed comparable CBL and survival rates between NDI and RDI at follow up. Only one study showed increased CBL around NDI compared to RDI. The overall weighted mean difference (WMD) for CBL (WMD = .06, 95% confidence interval [CI] = ‐.38‐.51, P=.76) and risk difference for survival rate (risk difference = .88, 95% CI = .22‐3.50, P=.85) were not significant between the NDI and RDI groups at follow up. NDI and RDI showed comparable CBL and survival rates. However, the findings of the present study should be interpreted with caution due to significant heterogeneity and the low number of included studies. Further randomized, controlled trials should be performed in order to obtain strong conclusions.     

A case review of a patient experience of photopheresis using a peripherally inserted central catheter

Extracorporeal photopheresis (ECP) is a cell based immunomodulatory therapy in which the patient is attached intravenously to a cell separating machine. During ECP a patient's blood is collected via either a central venous access device (CVAD) or a peripherally inserted 16G arterial venous fistula needle in either one or both antecubital fossa. However, patients presenting for ECP with GVHD repeatedly present a challenge to the ECP team due to poor venous access resulting from previous therapies and skin changes. The use of peripherally inserted central venous catheters (PICCs) offers an alternative route of vascular access for this cohort of patients. Here we present a case report of a patient successfully treated with ECP following the insertion of a PICC line.