Effects of human umbilical cord mesenchymal stem cells exosomes on hippocampal microglia polarization and neuronal apoptosis in depressed model mice / 中华行为医学与脑科学杂志

Objective:To investigate the effects of human umbilical cord mesenchymal stem cells exosomes (hucMSC-Exo) on depression-like behavior and polarization dynamic transition of hippocampal microglia in chronic unpredictable mild stress(CUMS) mice.Methods:The hucMSC was isolated, cultured, and the 5th generation hucMSC-Exo was extracted by ultracentrifugation and identified.Biological markers of CD9 and CD63 of hucMSC-Exo were detected by Western blot.A total of 12 SPF grade male C57BL/6J mice were randomly selected to establish depression model by CUMS method at the same time, and relevant behavioral experiments, including opening field test (OFT) and forced swimming test (FST) were used to detect changes of depression-like behavior in CUMS mice. After modeling, 12 mice were randomly divided into two groups, with 6 mice in each group. One group of mice was the exosome treatment group (CUMS+ Exo group) after stereotactic brain injection of hucMSC-Exo in the hippocampus, and the other group was the CUMS group. The expression of inflammatory signals in the hippocampus of mice in both groups were detected by micro PET/CT scanning technique. The proportion of M2-type microglia and M1-type microglia in the hippocampus of mice was detected by tissue immunofluorescence. β3-tubulin immunofluorescence staining was used to detect the length changes of neuronal axons in the depressed cell model constructed with corticosterone (CORT). EdU staining was used to detect neuronal proliferation. TUNEL staining was used to observe the apoptosis of neurons in the hippocampus of mice.Statistical analysis was conducted by GraphPad 8.0 software, and t-test was used for inter group comparison. Results:Under the electron microscope, hucMSC-Exo showed typical " double-layer cup-like" small vesicle-like changes and the particle diameter was about 100 nm.Western blot confirmed the expression of lconic proteins of CD9 and CD63. In the micro PET/CT scans, the uptake of [18F]DPA-714 in the CUMS+ Exo group was lower than that of the CUMS group, and the difference was statistically significant ((0.91±0.02)g/mL, (0.81±0.05)g/mL, t=4.54, P=0.001 1). In the opening field test, the percentage of central path length ((3.40±0.44)%, (5.17±0.90)%, t=4.33, P=0.001 5) and the time spent on the central path ((7.04±0.60)s, (10.22±1.41)s, t=6.02, P=0.000 1) in CUMS+ Exo group were higher than those in CUMS group, while the total distances of the two groups were not statistically significant ( t=0.48, P>0.05). In the forced swimming test, the immobility time in the CUMS+ Exo group was less than that in the CUMS group ((152.33±7.28) s, (133.50±4.32) s, t=5.45, P=0.000 3). In tissue immunofluorescence experiments, compared with the CUMS group, the proportion of M2-type microglia of hippocampus in the CUMS+ Exo group((0.33±0.04), (0.59±0.12), t=5.11, P=0.000 5)increased and the proportion of M1-type microglia ((0.56±0.06), (0.41±0.03), t=5.15, P=0.000 4) decreased in the CUMS+ Exo group. β3-tubulin-labeled immunofluorescence results showed an increase of neuronal axon length in the CORT+ Exo group compared with that in the CORT group((3.99±0.99) μm, (6.76±1.11) μm, t=6.10, P=0.000 1). The results of cell proliferation test showed an increase of proliferation rate in the CORT+ Exo group compared with that in the CORT group((0.74±0.07), (0.64±0.03), t=3.32, P=0.001 8). In the TUNEL staining experiment, the apoptosis rate of neurons in the hippocampal region of mice in the CUMS+ Exo group was lower than that of CUMS group ((0.24±0.04), (0.39±0.04), t=6.11, P=0.000 1). Conclusion:hucMSC-Exo can promote the conversion of M1 polarized microglia to M2 type microglia to alleviate depression-like behavior and reduce neuronal apoptosis in CUMS mice.

Short-term effectiveness of transverse antecubital incision for failed closed reduction of Gartland type Ⅲ supracondylar humerus fractures in children / 中国修复重建外科杂志

OBJECTIVE@#To investigate the short-term effectiveness of transverse antecubital incision in the treatment of failed closed reduction of Gartland type Ⅲ supracondylar humeral fractures (SHFs) in children.@*METHODS@#Between July 2020 and April 2022, 20 children with Gartland type Ⅲ SHFs who failed in closed reduction were treated with internal and external condylar crossing Kirschner wire fixation through transverse antecubital incision. There were 9 boys and 11 girls with an average age of 3.1 years (range, 1.1-6.0 years). The causes of injuries were fall in 12 cases and fall from height in 8 cases. The time from admission to operation ranged from 7 to 18 hours, with an average of 12.4 hours. The healing of the incision and the occurrence of complications such as nerve injury and cubitus varus were observed after operation; the elbow flexion and extension range of motion after removing the gypsum, after removing the Kirschner wire, and at last follow-up were recorded and compared, as well as the elbow flexion and extension and forearm rotation range of motion at last follow-up between healthy and affected sides; the Baumann angle was measured on the X-ray film, and the fracture healing was observed. At last follow-up, the effectiveness was evaluated according to the Flynn elbow function evaluation criteria.@*RESULTS@#All incisions healed by first intention, and there was no skin necrosis, scar contracture, ulnar nerve injury, and cubitus varus. Postoperative pain occurred in the radial-dorsal thumb in 2 cases. The gypsum was removed and elbow flexion and extension exercises were started at 2-4 weeks (mean, 2.7 weeks) after operation, and the Kirschner wire was removed at 4-5 weeks (mean, 4.3 weeks). All the 20 patients were followed up 6-16 months, with an average of 12.4 months. The fracture healing time was 4-5 weeks, with an average of 4.5 weeks, and there was no complication such as delayed healing and myositis ossificans. The flexion and extension range of motion of the elbow joint gradually improved after operation, and there were significant differences between the time after removing the gypsum, after removing the Kirschner wire, and at last follow-up ( P<0.017). There was no significant difference in the flexion and extension of the elbow joint and the forearm rotation range of motion between the healthy and affected sides at last follow-up ( P>0.05). There was no significant difference in Baumann angle between the time of immediate after operation, after removing the Kirschner wire, and at last follow-up ( P>0.05). According to Flynn elbow function evaluation standard, 16 cases were excellent and 4 cases were good, the excellent and good rate was 100%.@*CONCLUSION@#The treatment of Gartland type Ⅲ SHFs in children with failed closed reduction by internal and external condylar crossing Kirschner wire fixation through transverse antecubital incision has the advantages of complete soft tissue hinge behind the fracture for easy reduction and wire fixation, small incision, less complications, fast fracture healing, early functional recovery, reliable reduction and fixation, and can obtain satisfactory results.

Response inhibition and emotional responding in attention-deficit/hyperactivity disorder with comorbid disruptive, impulse-control, and conduct disorders / 南方医科大学学报

OBJECTIVE@#To characterize the traits of neuropsychological functioning deficits in patients with attention-deficit/ hyperactivity disorder (ADHD) with comorbid disruptive, impulse-control, and conduct disorders (DICCD).@*METHODS@#Twenty out-patients with ADHD, 20 with ADHD with comorbid DICCD, and 20 with DICCD, all aged 6-16 years, were enrolled in this study, with 20 healthy subjects matched for age, gender and IQ serving as the healthy controls. The patients were diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Revision (DSM-5). All the subjects were assessed with Golden Stroop test and emotional Stroop test to evaluate their response inhibition and emotional responding.@*RESULTS@#In Golden Stroop test, the interference scores (IGs) of errors and reaction time both differed significantly among the groups ( < 0.05), and were the highest in patients with ADHD only. In emotional Stroop test, the mean reaction time (MRT) showed significant differences among the groups ( < 0.05); the MRT of positive- congruent trials in ADHD with comorbid DICCD group was shorter than that in ADHD group but longer than that in group DICCD; the MRT in the 3 case groups were all longer than that in the control group. The MRT of both positive-incongruent trials and negative-congruent trials in ADHD with comorbid DICCD group and DICCD group was shorter than that in ADHD group but longer than that in the control group. The MRT of negative- incongruent trials in DICCD group was shorter than that in ADHD group and ADHD with comorbid DICCD group but longer than that in the control group.@*CONCLUSIONS@#The response inhibition deficit and abnormal emotional responding are the core symptoms of ADHD. Bias emotional stimuli may render response inhibitory dysfunction in patients with DICCD with callous-unemotional traits of emotional responding disorder, especially in dealing with negative emotional trials, while the comorbidity of ADHD and DICCD tends to have the emotional response trait of DICCD.

Fear memory and heart rate and blood pressure during conditioned fear in rats with hippocampal lesion or fimbria-fornix transection / 中华行为医学与脑科学杂志

Objective To investigate the effects of dorsal hippocampal lesions (DH) or fimbria-fornix transection (FF) on the learning and memory of conditioned fear and the heart rate and blood pressure in rats.Methods Nineteen male adult Wistar rats were used in this experiment.They were implanted telemetry sensors in their abdominal aortas.Two week later,six of the rats were subjected to permanent NMDA-induced neurotoxic lesions to the dorsal hippocampus (DH) and seven for the fimbria-fornix transection (FF)through stereotactic brain surgery,the left six were treated with saline as the control (Sham).All rats were subjected to a conditioned fear experiment.Meanwhile,changes in heart rate and blood pressure were measured.Results There was no significant difference in heart rate and blood pressure among the rats with the hippocampal operation or fimbria-fornix transection.In the acquisition of conditioned fear,there were significant difference in freezing time among the three group in both inter-trial-interval (ITI) and conditioned stimulus (CS) process (all P＜0.05).The freezing time of the FF group showed significantly lower than that of the Sham group (P＜0.05).There was no significant difference in heart rate and blood pressure among the three group(P＞0.05).In the test of conditioned contextual fear memory,the freezing time percentage in the FF group ((0.31±0.16) ％) significantly lower than that in the Sham group ((2.78± 1.23) ％) (P＜0.05)at the first 3 min of the test.There was a significant difference in heart rate among the three group.The heart rate of FF group ((436.42± 10.16) times/min) was significantly lower than that of the Sham group ((472.48±4.43) times/min,P＜0.01) and the DH group ((469.94 ±7.36)times/min,P＜0.01).In the test of conditioned tone fear memory.The freezing time percentage in FF group ((18.78±6.29) ％) was significantly lower than that in the Sham ((51.77±9.33)％,P＜0.01) and DH group ((59.19±8.13)％,P＜0.01),but the freezing time percentage between the later two groups had no difference (P=0.52).The synchronous telemetry measurement showed there was no significant difference both in the heart rate and the blood pressure among the groups (all P＞0.05) during the conditioned tone test.Conclusion The dorsal hippocampal lesions and fimbria-fornix transection in rats can significantly reduce the learning and memory ability in conditioned fear and scene fear in rats,and the effect of fimbria-fornix transection is more obvious.The decrease in,fear memory is not synchronously reflected in heart rate and blood pressure in rats.

Effects of postnatal enriched environment on schizophrenia-related behaviors induced by early prena-tal polynosinic-polycytidylic acid immune challenge in adult mice offspring / 中华行为医学与脑科学杂志

Objective To investigate if the positive postnatal environment could modify the schizo-phrenia-related behaviors caused by early maternal immune activation,and the interaction of this two pre-and postnatal factors.Methods The pregnant mice were randomly divided into experimental and control groups.The experimental groups were injected with polynosinic-polycytidylic acid(Poly I : C)(5mg/kg),via intra-venous route,at gestational day 9.The control groups were injected with the same volume of normal saline (NS)at the same gestational day.All offspring were housed in groups of littermates until postnatal day (PND)21 when they were weaned.Between PND22-PND60,offspring were divided into dull or enriched en-vironment(DE or EE)groups by sex and treatment.Different toys were put into the cages of enriched envi-ronment group every week,such as running wheels,climbing materials,swings and rollers.The dull environ-ment(DE)groups were kept the normal housing environment only with sawdust.At PND60,behavioral tests were conducted,such as prepulse inhibition(PPI),open field test,novel object/location recognition,social interaction test,as well as water maze test,were conducted to evaluate the performance of all offspring.After behavioral tests,all offspring were killed and the hippocampus were dissected.The western blot was used to analyze the expression of myelin basic protein in the hippocampus.Results (1)The percentage of PPI with early maternal immune activation of Poly I : C were significantly reduced when compared with control groups (female offspring:F=28.12,P<0.001;male offspring:F=14.76,P<0.01),suggesting the schizophrenia-like behavioral deficit in the offspring induced by early prenatal Poly I : C challenge.(2)In open field test,early maternal immune activation increased the moved distance and speed of the offspring compared with the con-trol groups(female offspring:distances,F=5.10,P<0.05,speed:F=5.19,P<0.05;male offspring:distances:F=6.76,P<0.05,velocity:F=6.85,P<0.05,vs each corresponding control).(3)Enriched environment in-creased the social interaction time of offspring with strange mouse in the social interaction test(female off-spring:EE group(101.30±6.83)s,DE group(76.50±5.59)s,F=9.41,P<0.01;male offspring:EE group(98. 52±6.82)s,DE group(75.82±3.95)s,F=7.95,P<0.01).(4)Enriched environment decreased the time for offspring to find the platform in water maze test(P<0.05).(5)The expression of myelin basic protein in hip-pocampus in offspring which received early maternal immune activation by Poly I : C was lower than that in the control groups(P<0.05).Conclusion The postnatal enriched environment increased the social interac-tion and the learning abilities of the offspring with early maternal immune activation by Poly I : C in water maze,and even more improved the perseveration behavior of the offspring induced by the early maternal im-mune activation.

Delay aversion test between the male children with obsessive-compulsive disorder and ones with attention-deficit/hyperactivity disorder / 中国心理卫生杂志

Objective:To clarify the characteristics and differences between obsessive-compulsive disorder (OCD)and attention-deficit/hyperactivity disorder (ADHD)in male children.Methods:Forty boys with OCD and 40 boys with ADHD were selected from out-patient department,and 40 normal boys matched with age,gender and IQ were recruited as the controls.Patients'diagnosis was made according to the International Statistical Classifica-tion of Diseases and Related Health Problems,Tenth Revision (ICD-10).The choice delay tasks (CDT1 /2)were assessed respectively for the measurements of normal or high ecological validity of delay aversion.In CDT1 /2, waiting time and scores of the tasks were indicators reflecting the delay aversion.Results:The scores of CDTs were higher in children with OCD than in the controls [CDT1,(30.9 ±3.2)vs.(27.6 ±3.8);CDT2,(31.3 ±4.4)vs. (28.5 ±4.9);P <0.01].The scores of CDTs were lower in children with ADHD than in the controls [CDT1, [(25.0 ±4.3)vs.(27.6 ±3.8)];CDT2,[(26.2 ±4.6)vs.(28.5 ±4.9);P <0.001].Conclusion:The results in-dicate that the children with OCD have a trend to choose the task with longer waiting time and higher score,and the children with ADHD trend to choose the task with shorter waiting time and lower score.The results suggest that the pathogenesis of hyperactivity/impulse control may be different between OCD and ADHD in delay aversion.

Response inhibition and fine-motor coordination in male children with Tourette syndrome comorbid attention-deficit/hyperactivity disorder / 中国心理卫生杂志

Objective:To explore the differences and similarities of the neuropsychological functioning defi-cits in children between Tourette syndrome (TS)and attention-deficit/hyperactivity disorder (ADHD). Methods:Thirty boys with TS-only,36 with TS-plus-ADHD,36 with ADHD were selected from out-patient department,and 50 normal boys (NC)matched with gender,age and IQ were recruited as the controls. Patients'diagnosis was made according to the International Statistical Classification of Diseases and Related Health Problems,Tenth Revision (ICD-10). They were assessed with the Stroop Color-Word Interference Test (Stroop)and Purdue Pegboard Test (Purdue)to evaluate the response inhibition and fine-motor coordination respectively. Results:The Stroop scores were higher in children with ADHD than in other groups (P0. 05 ). All Purdue scores were higher in children with disease than in normal children (P<0. 05 ). Conclusion:The results indicate that the response inhibition deficit may be found in children with ADHD,but not in those with TS-only and TS-plus-ADHD. The neural compensatory mechanism may be re-sponsible for the response inhibition function in children with TS whilst the fine-motor coordination deficit was as-sociated with the disease groups.

Clinical analysis of reconstruction of thumb or finger by free second-toe transfer and one stage appearance remodeling / 中华显微外科杂志

Objective To explore the effects of reconstruction and shaping of thumb or finger defects by free second-toe transfer and one stage appearance remodeling.Methods From October,2007 to August,2013,128 thumb or finger Ⅴ degree defect of 109 cases were reconstruct with free second-toe transfer,and one stage shape remodeling at the same time.Among them,20 fingers by nail bed expand one stage; 23 fingers were nail bed expand added on toe pulp splayed resection on both sides; 29 fingers were added on embedded the philp island flap of great toe to the section of plantar side narrow part in the second digit,19 fingers were added on embedded the abdominal phil chamfered-edge-shape flap to that narrow part in the second digit,and 37 fingers added on toe pulp resection and embedded the philp island flap of great toe to that narrow part.Results All reconstructed thumb or fingers survived and appearance were good.The nail shape of reconstructed thumb or fingers were improved obviously,the shape of narrow part in middle segment was recovered satisfactorily.Seventy-nine cases (72.5％) were followed-up from 3 months to 5 years,and the other 30 cases (27.5％) were lost.The function of the reconstructed thumb or finger and hand feeling was ideal recovered.There were no claudication,no pain and no other sequelaes for donor foot.According to the Standard on Approval of Reconstructed Thumb and Finger Functional Assessment of Chinese Medical Association,43 cases excellent,26 cases good,10 cases approve.The rate of excellent and good was 87％.Conclusion Second-toe transfer and shape remodeling is a good method of thumb or finger reconstructing.The appearance of the thumb reconstruction can be improved obviously.Preoperative carefully design and the combination of the above several kinds of operation,for draw up an personalized surgical program is necessary.

Design and clinical application of “exclamation mark” shaped pedicle flaps / 中华创伤杂志

Objective To investigate effects of pedicle processing methods on the survival and appearance of the pedicle flaps. Methods The study involved 17 patients with soft tissue defects of extremities treated with the “exclamation mark” shaped pedicle flaps from October 2009 to January 2011.The traditional pedicled rotation flaps was designed to be a tennis racket-like shape,then the rotational pedicle was designed to small round tension reduction flap and pedicled rotation flaps,which contributed to formation of the “exclamation mark” shaped pedicle flaps.The soft tissue defects was located at the upper extremity in three patients and at lower extremity in 14,with defect areas of 4.0 cm× 7.2 cm-5.8 cm × 14.0 cm.There used two superficial radial nerve vasotrophic flaps,one ulnar artery supra-carpal cutaneous flap,eight sural neurocutaneous vasotrophic flaps and six saphenous nerve vasotrophic flaps.Results All flaps survived at Ⅰ stage except that one flap had partial distal necrosis postoperatively,which was cured after dress change.The follow-up ranged from six months to one year,which showed unobvious swelling of the survived flaps and good appearance of the rotation point of the pedicle. Conclusion The “ex(c)lamation mark” shaped pedicle flaps can reduce entrapment of the distal pedicle,promote venous drainage,improve survival and modify the appearance of the flaps.

The study of magnetic resonance spectrum about sensitive brain structure of the first episode depression / 中华行为医学与脑科学杂志

Objective To explore the brain's metabolism about the hippocampus, anterior cingulate and thalamus of first episode depressive patients. Methods Using proton magnetic resonance spectroscopy and 1 HMRS analyzing technology to detect multiple metabolic indices of the hippocampus, anterior cingulate and thalamus of 20 patients and 20 healthy persons, including N-acetylaspartate ( NAA), choline ( Cho ), myoinositol ( MI ), creatine(Cr). Results The ratios of MI/Cr of the bilateral thalamus of the depressive patients group decreased ( Left (0.23 ±0.13) ,(0.25 ±0.09), t=2.25, P=0.03,Right(0.33 ±0.15,0.34 ±0.04), t=2.42, P=0.02).The ratios of NAA/Cr and Cho/Cr of the bilateral hippocampus of the depressive patients group were both lower (NAA/Cr: Left t=3.06, P=0.004,Right t=3.54, P=0.001. Cho/Cr: Left t=2.94, P=0.006,Right t=4.02,P=0.001 ). The ratios of Cho/Cr and MI/Cr of the anterior cingulate of the depressive patients group were both significantly higher (NAA/Cr: t=3.12, P=0. 003;Cho/Cr: t=2.62, P=0.01). Conclusion The metabolic abnormalities of hippocampus, anterior cingulate and thalamus maybe constitute the nervous biochemical basis of first episode depression.

A Report of X-ray Manifestations of the Hereditary Multiple Osteochondroma:21 Patients in 5 Pedigree / 实用放射学杂志

Objective To investigate the X-ray and clinic manifestations of hereditary multiple osteochondroma(HMO).Methods Five patients with HMO clinically and pathologically confirmed and 63 persons in their pedigree were studied.Results Of 63 cases inquired in this study,there were 21 patients with hereditary multiple exostosis,including 16 men and 5 women.In 5 cases confirmed pathologically,4 patients had hereditary history of pedigree and the members of three generation in 1 patient with HMO had no the history of pedigree.Conclusion HMO has the remarkable sex difference and the typical inherited trend including the location of exostosis.HMO has inherited character of skipping generation.