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Background Steriod-induced osteonecrosis of femoral head (SIONFH) cystic degeneration have a "double-edged sword" effect. The method of activating blood and dredging collate is effective in the treatment of early SIONFH, but its regulatory effect on bone resorption/angiogenesis/osteogenic protein in cystic degeneration remains unclear. Objective To investigate the effect of activating blood and dredging collate method on serum bone resorption/angiogenesis/osteogenic protein in patients with cystic degeneration of SIONFH. Methods Sixty patients with SIONFH admitted to the Hip Joint Research Center of Guangzhou University of Traditional Chinese Medicine from January 2019 to January 2021 were included as the study subjects and divided into the control group and treatment group according to random number table method, with 30 cases in each group. Another 30 volunteers with normal physical examination in hospital at the same period and no history of hormone use were selected as the normal group. The treatment group was treated with Huoxuetongluo capsule (2 g/time, 3 times/day) and calcium carbonate (600 mg/time, 1 time/day), the control group was treated with the same amount of calcium carbonate, and the course of treatment of both groups was 12 months, simultaneously limiting weight-bearing on the affected limb. Fasting serum was collected, and the expression levels of nuclear factor κB receptor activating factor ligand (RANKL), platelet-derived growth factor-BB (PDGF-BB), vascular endothelial growth factor A (VEGFA), osteoprotegerin (OPG) and cadherin-associated protein (CTNNB1) in serum were detected by enzyme-linked immunosorbent assay. The patients were followed up twice at the 6th and 12th month after discharge, and the collapse of femoral head was defined as the end event. Hip pain visual analogue score (VAS), hip function (Harris) score and necrotic area score were used to evaluate the efficacy. Results Baseline RANKL, PDGF-BB, OPG and CTNNB1 levels were compared among the three groups, and the differences were statistically significant (P

The study aimed to determine the potential anti-diabetic activities of the hydrolysates of camel milk proteins (CMPH). Camel milk proteins were hydrolyzed independently by using 11 proteases, and their anti-diabetic activities were analyzed by in vitro, and in vivo. The results showed that CMPH-Flavourzyme exhibited the best α-glucosidase and dipeptidyl peptidase-IV inhibitory activity, while CMPH-Papain exhibited the highest α-amylase inhibitory activity, and best proliferative effect on streptozotocin-induced NIT-1 cells in vitro. Furthermore, CMPH-Papain exhibited the most effect in decreasing the serum levels of fasting blood glucose, oral glucose tolerance test, pro-inflammatory factors (IL-1β, IL-6) and triglyceride, as well as increasing insulin levels on in vivo streptozotocin-induced diabetic mice. Peptides identification followed with molecular docking and network pharmacology analysis also found the potential anti-diabetic peptides from CMPH-Flavourzyme and CMPH-Papain. Our results indicated the type of protease used for the treatment significantly influences the anti-diabetic activities of the resulting CMPH.

ImportanceDelayed graft function (DGF) is a risk factor for acute rejection and graft failure after kidney transplant. Previous studies have suggested that dexmedetomidine may be renoprotective, but whether the use of dexmedetomidine would improve kidney allograft function is unknown.ObjectiveTo investigate the effects of perioperative dexmedetomidine on DGF following a donation-after-cardiac-death (DCD) kidney transplant.Design, setting, and participantsThis single-center, double-blind, placebo-controlled randomized clinical trial was conducted at The First Affiliated Hospital of Soochow University in Suzhou, China. Adults (18 years or older) who were scheduled for DCD kidney transplant were enrolled between September 1, 2019, and January 28, 2021, and then randomized to receive either dexmedetomidine or normal saline (placebo). One-year postoperative outcomes were recorded. All analyses were based on the modified intention-to-treat population.InterventionsPatients who were randomized to the dexmedetomidine group received a 24-hour perioperative dexmedetomidine intravenous infusion (0.4 μg/kg/h intraoperatively and 0.1 μg/kg/h postoperatively). Patients who were randomized to the normal saline group received an intravenous infusion of the placebo with the same dose regimen as the dexmedetomidine.Main outcomes and measuresThe primary outcome was the incidence of DGF, defined as the need for dialysis in the first posttransplant week. The prespecified secondary outcomes were in-hospital repeated dialysis in the first posttransplant week, in-hospital acute rejection, and serum creatinine, serum cystatin C, estimated glomerular filtration rate, need for dialysis, and patient survival on posttransplant day 30.ResultsOf the 114 patients enrolled, 111 completed the study (mean [SD] age, 43.4 [10.8] years; 64 male patients [57.7%]), of whom 56 were randomized to the dexmedetomidine group and 55 to the normal saline group. Dexmedetomidine infusion compared with normal saline reduced the incidence of DGF (17.9% vs 34.5%; odds ratio [OR], 0.41; 95% CI, 0.17-0.98; P = .04) and repeated dialysis (12.5% vs 30.9%; OR, 0.32; 95% CI, 0.13-0.88; P = .02, which was not statistically significant after multiple testing corrections), without significant effect on other secondary outcomes. Dexmedetomidine vs normal saline infusion led to a higher median (IQR) creatinine clearance rate on postoperative days 1 (9.9 [4.9-21.2] mL/min vs 7.9 [2.0-10.4] mL/min) and 2 (29.6 [9.7-67.4] mL/min vs 14.6 [3.8-45.1] mL/min) as well as increased median (IQR) urine output on postoperative days 2 (106.5 [66.3-175.6] mL/h vs 82.9 [27.1-141.9] mL/h) and 7 (126.1 [98.0-151.3] mL/h vs 107.0 [82.5-137.5] mL/h) and at hospital discharge discharge (110.4 [92.8-121.9] mL/h vs 97.1 [77.5-113.8] mL/h). Three patients (5.5%) from the normal saline group developed allograft failure by the post hoc 1-year follow-up visit.Conclusions and relevanceThis randomized clinical trial found that 24-hour perioperative dexmedetomidine decreased the incidence of DGF after DCD kidney transplant. The findings support the use of dexmedetomidine in kidney transplants.Trial registrationChinese Clinical Trial Registry Identifier: ChiCTR1900025493.