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Objective:To investigate the individual and combined effects of calf circumference and vitamin D levels on all-cause mortality risk in community-dwelling older adults based on the Chinese Longitudinal Healthy Longevity Survey.Methods:The calf circumference was measured in the baseline survey in 2012 and 2014.Low calf circumference was defined as <34 cm for men or 33 cm for women at screening.Vitamin D deficiency was defined as plasma 25-hydroxyvitamin D[25(OH)D]levels <50 nmol/L.All participants were followed up until 2018, when death outcomes and survival time were collected.Cox proportional hazard regression models were used to analyze the effects of calf circumference and 25(OH)D levels on the risk of all-cause mortality.Results:A total of 3 052 older adults were included in the analysis, of which 1 960(64.22%)had low calf circumference and 2 245(73.56%)had vitamin D deficiency.After 10 559.9 person-years of follow-up period, 1 312 death events were recorded.After adjusting for sociodemographic characteristics, physical activities, cognitive function, and multiple chronic diseases, calf circumference and 25(OH)D levels were negatively associated with the risk of all-cause mortality(both P<0.05). In the combined analysis, compared with the normal group, the risk of death was highest in the participants with both low calf circumference and vitamin D deficiency, which was higher than those with low calf circumference or vitamin D deficiency alone, with a hazard ratios( HR)(95% CI)of 2.51(1.81-3.45), 1.71(1.22-2.42)and 1.53(1.09-2.15), respectively.There was a significant additive interaction between low calf circumference and vitamin D deficiency on mortality(RERI>0). Conclusions:Low calf circumference and vitamin D deficiency are associated with higher mortality.Older adults with combined conditions had a even higher risk of death.Attention should be paid to joint screening and comprehensive intervention for older adults with both low calf circumference and vitamin D deficiency.
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Most foreign bodies are often discharged without obvious symptoms after swallowing, but some may be misdiagnosed and stay in the body, resulting in serious complications. Different diagnostic methods should be integrated to diagnose such patients. Once diagnosed, they should be treated as soon as possible if necessary. The authors reported a case of retention in the body for 6 years after swallowing a wooden chopstick, resulting in the insertion into the psoas muscle after duodenal perforation, complicated by abdominal abscess. During the operation, endoscopic assisted laparoscopic foreign body removal was performed, and the patient showed good prognsis, which provided references for the diagnosis and treatment of the disease.
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Epiphyseal plate injury in children is very common, which can be caused by fracture, infection, malignant tumors, iatrogenic injury or other causes.Growth arrest and angulation or rotation deformity after epiphyseal plate injury would seriously affect the physical and mental health of children.At present, the success rate of bone bridge resection combined with corresponding material filling is super low.The construction of bioactive epiphyseal cartilage using cartilage tissue engineering technology has become a new research direction for the treatment of epiphyseal plate injury in children.Therefore, this review focuses on the current research on the regeneration of epiphyseal cartilage from the perspective of 3 elements of tissue engineering: seed cells, growth factors, and tissue engineering scaffolds.
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Circadian rhythm is involved in the development and diseases of many tissues. However, as an essential environmental regulating factor, its effect on amelogenesis has not been fully elucidated. The present study aims to investigate the correlation between circadian rhythm and ameloblast differentiation and to explore the mechanism by which circadian genes regulate ameloblast differentiation. Circadian disruption models were constructed in mice for in vivo experiments. An ameloblast-lineage cell (ALC) line was used for in vitro studies. As essential molecules of the circadian system, Bmal1 and Per2 exhibited circadian expression in ALCs. Circadian disruption mice showed reduced amelogenin (AMELX) expression and enamel matrix secretion and downregulated expression of BMAL1, PER2, PPARγ, phosphorylated AKT1 and β-catenin, cytokeratin-14 and F-actin in ameloblasts. According to previous findings and our study, BMAL1 positively regulated PER2. Therefore, the present study focused on PER2-mediated ameloblast differentiation and enamel formation. Per2 knockdown decreased the expression of AMELX, PPARγ, phosphorylated AKT1 and β-catenin, promoted nuclear β-catenin accumulation, inhibited mineralization and altered the subcellular localization of E-cadherin in ALCs. Overexpression of PPARγ partially reversed the above results in Per2-knockdown ALCs. Furthermore, in in vivo experiments, the length of incisor eruption was significantly decreased in the circadian disturbance group compared to that in the control group, which was rescued by using a PPARγ agonist in circadian disturbance mice. In conclusion, through regulation of the PPARγ/AKT1/β-catenin signalling axis, PER2 played roles in amelogenin expression, cell junctions and arrangement, enamel matrix secretion and mineralization during ameloblast differentiation, which exert effects on enamel formation.
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Objective To understand the clinical outcomes of frozen embryo transfer and fresh embryo transfer.Methods A retrospective analysis was conducted on the clinical data of 870 cases receiving embryo transfer at the Reproductive Medical Center of Sun Yat-Sen Memorial Hospital from January 2013 to March 2014,including 577 cases of in vitro fertilization and fresh embryo transfer,118 cases of intracytoplasmic sperm injection and fresh embryo transfer and 175 cases of frozen thawed embryo transfer,to compare the clinical characteristics and outcomes between fresh embryo transfer group and frozen embryo transfer group (the patients who had received unsuccessful fresh embryo transfer).The frozen embryo transfer group was divided into pregnant subgroup and non pregnant subgroup to further comparison.Binary logistic regression analyses was performed to identify the influencing factors of pregnancy.Results The implantation rate and clinical pregnancy rate were significantly lower in frozen embryo transfer group than in fresh embryo transfer group (26.27％ vs.31.98％,P=0.01 and 47.43％ vs.65.18％,P＜0.001).The differences in abortion rate,biochemical pregnancy rate and fetal birth weight had no statistical significance between the two groups (P=0.63,P=0.17 and P=0.33).The difference in age between pregnant subgroup and non pregnant subgroup was statistical significant (30.69 ± 3.37 years vs.32.00 ± 5.09 years,P=0.03),but no significant differences were found in BMI,duration of infertility and basic endocrine between the two subgroups.Binary logistic regression analysis showed that receiving frozen embryo transfer or not (P＜0.001),wife's age (P＜0.001),BMI (P=0.011) and number of top quality embryos (P＜0.001) were influencing factors of pregnancy.Conclusion Lower implantation rate and clinical pregnancy rate was observed in the patients in frozen embryo transfer group,who had received unsuccessful fresh embryo transfer,but no increase of abortion rate,influence on fetal birth weight and adverse pregnancy outcome were observed.
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BACKGROUND:To construct a normal animal model of femoral head necrosis contributes to the research of the pathogenesis of femoral head necrosis, which can provide theoretical basis for the prevention and treatment of femoral head necrosis. OBJECTIVE:To research the experimental effect of lipopolysaccharide combined with dexamethasone injection in the induction of rabbit femoral head necrosis. METHODS:Thirty-six New Zealand white rabbits were randomly divided into model group (n=21) and control group (n=15). The rabbits in the model group were injected with 10μg/kg lipopolysaccharide daily and continuous for 2 days, and then injected with 25 mg/kg dexamethasone daily for 3 days continuously. The rabbits in the control group were injected with the normal saline at the same volume. RESULTS AND CONCLUSION:After 4 weeks, the X-ray film of the rabbit in the model group showed the joint gaps were widened, the density was increased, the articular subchondral bone mineral density was increased, the femoral head was flat, trabecular bone was fuzzy, the boundaries between subchondral bone and cancel ous bone was unclear, and the patchy high-density areas were observed in the femoral head with shortened femoral neck. The bone mineral density of partial femoral head was measured with dual-energy X-ray absorptiometry, and found that the bone mineral density of femoral head and the bone mineral content of the model group were significantly lower than those of the control group (P<0.05). Histological section observation showed that the bone cel lacuna was empty and shal ow, fat cel s were increased and vascular thrombosis was observed, meanwhile, the osteonecrosis rate and lacunae rate of the survival animals were significantly higher than those in the control group. Dexamethasone combined with lipopolysaccharide can effectively construct the model of steroid-induced avascular necrosis of the femoral head.
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BACKGROUND:There are various methods for the treatment of osteonecrosis of femoral head, but there is no satisfactory method to promote the repair of osteonecrosis of femoral head. In recent years, bone marrow mesenchymal stem cel transplantation for the treatment of osteonecrosis of femoral head has achieved certain effect. OBJECTIVE:To review the application progress and problems of bone marrow mesenchymal stem cel transplantation for the treatment of osteonecrosis of femoral head. METHODS:A computer-based online search was performed in PubMed database, Wanfang database and CNKI database for the related articles from 1999 to 2012. The articles on the isolation, culture, differentiation, labeling and in vivo tracing of bone marrow mesenchymal stem cel s were selected, as wel as the basic and clinical researches on bone marrow mesenchymal stem cel transplantation for the treatment of osteonecrosis of femoral head. A total of 39 articles were included for review. RESUTLS AND CONCLUSION:At present, the method for the isolation of bone marrow mesenchymal stem cel s includes adherence screening method, density gradient centrifugation, flow cytometry separation and magnetic activated cel sorting method;the commonly used method for cel labeling and tracing includes isotope tracing method, antigen labeling method, antigen labeling, fluorescent labeling and MRI contrast enhancer labeling method. The method for the treatment of osteonecrosis of femoral head with bone marrow mesenchymal stem cel s includes pith dril ing decompression combined with bone marrow mesenchymal stem cel injection and transplantation, intervention plus bone marrow mesenchymal stem cel transplantation, gene transfection combined with bone marrow mesenchymal stem cel transplantation and tissue engineering technology of bone marrow mesenchymal stem cel s. Although, the research on the bone marrow mesenchymal stem cel transplantation for the treatment of osteonecrosis of femoral head has achieved great progress, there are stil problems needed to be further solved.
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BACKGROUND:Animal death is a main influential factor for experimental results in establishment of animal models of steroid-induced necrosis of femoral head. OBJECTIVE:To observe models of femoral head necrosis established using lipopolysaccharide and dexamethasone so as to elevate success rate of model induction. METHODS:A total of 48 New Zealand white rabbits were equal y and randomly divided into model group, gentamicin group, gentamicin+lansoprazole group and control group. The first three groups were injected with lipopolysaccharide for 2 consecutive days via the ear vein, and then they were injected with dexamethasone via intramuscular injection in the buttocks for 3 consecutive days to establish models of femoral head necrosis. The rabbits of gentamicin group, gentamicin+lansoprazole group were intragastrical y administered gentamicin for 7 consecutive days after success model induction. Simultaneously, gentamicin+lansoprazole group received intramuscular injection with lansoprazole. Rabbits in the control group were only injected with saline. RESULTS AND CONCLUSION:Models were successful y established in the model, gentamicin, gentamicin+lansoprazole groups. Their conditions were best in the gentamicin+lansoprazole group. Mortalities in above-mentioned groups were 33.3%, 25%and 8.3%, respectively. Significant differences in the number of dead rabbits were detected in the model, gentamicin, gentamicin+lansoprazole and control groups (P<0.05). Results indicated that the combined use of gentamicin and lansoprazole can elevate survival rate of experimental animals during the establishment of rabbit models of steroid-induced necrosis of femoral head.