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BACKGROUND:Knee osteoarthritis is a common disease in middle-aged and elderly people.It is a kind of disease that seriously affects the quality of life of patients and even has the risk of disability.Therefore,the pathogenesis and treatment of knee osteoarthritis have become the focus of research.In Chinese medicine,knee osteoarthritis is often treated as"biness,"which is closely related to"biness"caused by blood stasis and blood vessels blocking collaterals in the theory of"blood stasis"in traditional Chinese medicine.Iron overload is a kind of pathological state caused by iron metabolism disorder,which highly coincides with the pathogenic characteristics and clinical manifestations of the"blood stasis"theory of traditional Chinese medicine,and is a risk factor that promotes the development of knee osteoarthritis. OBJECTIVE:Based on the"blood stasis"theory,to summarize the effects of iron overload on cartilage metabolism and subchondral bone reconstruction,to lay a new theoretical foundation for the treatment of knee osteoarthritis with traditional Chinese medicine,and to explore the therapeutic effect of traditional Chinese medicine for promoting blood circulation after interfering with bone tissue. METHODS:CNKI,WanFang database,PubMed and Web of Science databases were searched for relevant literature.The Chinese search terms were"ferroptosis,iron,iron overload,osteoarthritis,blood stasis"and the English search terms were"ferroptosis,iron,iron overload,osteoarthritis,TCM."In the end,76 articles were included for further review. RESULTS AND CONCLUSION:First of all,we explored the potential of the"blood stasis"theory in treating knee osteoarthritis,and found that"blood stasis"is a crucial part in the progress of knee osteoarthritis,indicating that the"blood stasis"theory is the key to the treatment of knee osteoarthritis in traditional Chinese medicine.Secondly,"blood stasis"and iron overload have a high degree of similarity in pathogenic factors,clinical manifestations,and pathogenic characteristics,suggesting the possibility of"blood stasis"theory in treating iron overload.This finding reminds us that iron overload may be an important mechanistic basis for the"blood stasis"theory in the treatment of knee osteoarthritis.The extracts of blood-activating drugs can relieve iron overload and treat knee osteoarthritis,but the specific mechanism is still unclear.Therefore,we believe that the relationship between"blood stasis"theory and iron overload and related mechanisms are important research directions for knee osteoarthritis in the future.The related mechanism of"blood stasis"theory to alleviate iron overload and then treat knee osteoarthritis also provides a theoretical basis for the modernization of traditional Chinese medicine,such as the development of new drugs and innovative usage,and has certain guiding significance for clinical practice.
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Objectives To investigate the epidemiology of high-risk human papillomavirus (HPV) infection and the common genotypes in Liaocheng city, Shandong province, China, and to evaluate the application value of high risk HPV detection in cervical cytology with different pathological conditions.Methods A total of 19 707 permanent female residents in Liaocheng were recruited who were married or had sexual life, aged from 18 to 70 years old.They were screened for cervical cancer by thinprep liquid-based cytology test (TCT) from January 2013 to January 2014.The screen positive rate was 4.24 ％ (837/19 707), and 785 volunteers aged from 21 to 65 years old were recalled.The xMAP bead-based hybridization and flowcytometry analysis were used for genotyping.The data were analyzed by comparison and description.Results According to TCT, among 785 cases, there were 478 cases of atypical squamous epithelium of unknown significance (ASCUS) and atypical glandular epithelium of unknown significance (AGCUS), 175 cases of low-grade squamous intraepithelial lesion (LISL), 127 cases of high-grade squamous intraepithelial lesion (HSIL), 5 cases of squamous cell carcinoma (SCC) and adenocarcinoma (ACC).The positive rate of high-risk HPV was 62.8 ％ (493/785).The risk age of infection was 26-30 years old (87.7 ％, 71/81) and 51-55 years old (79.7 ％, 51/64), while a low risk one was found in patients older than 55 years old (28.6 ％, 14/54).The top five high-risk subtypes of HPV were HPV16 (21.5 ％, 169/785), HPV52 (12.2 ％, 96/785), HPV58 (9.8 ％, 77/785), HPV33 (9.7 ％, 76/785), HPV18 (7.5 ％, 59/785).Single infection accounted for 45.0 ％ (353/785), while multi-infection for 17.8 ％ (140/785).98 cases were infected by two subtypes, 37 cases by three subtypes, 2 cases by four subtypes, 2 cases by five subtypes and 1 case by six subtypes.Conclusions Compared with pure cervical TCT screening, high-risk HPV infection detection is an effective method for cervical cancer screening, which can improve the specificity of cervical cancer screening and reduce the omission diagnostic rate.In Liaocheng, HPV subtypes 16, 52, 58, 33, 18 and multi-infection are more prevalent.Women belonging to 26-30 or 51-55 years old are identified as high-risk population.Screening is important for this group to discover early cervical lesions.