Observational study on perioperative outcomes of pelvic exenteration / 中华胃肠外科杂志

Objective: To investigate the surgical indications and perioperative clinical outcomes of pelvic exenteration (PE) for locally advanced, recurrent pelvic malignancies and complex pelvic fistulas. Methods: This was a descriptive study.The indications for performing PE were: (1) locally advanced, recurrent pelvic malignancy or complex pelvic fistula diagnosed preoperatively by imaging and pathological examination of a biopsy; (2)preoperative agreement by a multi-disciplinary team that non-surgical and conventional surgical treatment had failed and PE was required; and (3) findings on intraoperative exploration confirming this conclusion.Contraindications to this surgical procedure comprised cardiac and respiratory dysfunction, poor nutritional status,and mental state too poor to tolerate the procedure.Clinical data of 141 patients who met the above criteria, had undergone PE in the Sixth Affiliated Hospital of Sun Yat-sen University from January 2018 to September 2022, had complete perioperative clinical data, and had given written informed consent to the procedure were collected,and the operation,relevant perioperative variables, postoperative pathological findings (curative resection), and early postoperative complications were analyzed. Results: Of the 141 included patients, 43 (30.5%) had primary malignancies, 61 (43.3%) recurrent malignancies, 28 (19.9%) complex fistulas after radical resection of malignancies,and nine (6.4%)complex fistulas caused by benign disease. There were 79 cases (56.0%) of gastrointestinal tumors, 30 cases (21.3%) of reproductive tumors, 16 cases (11.3%) of urinary tumors, and 7 cases (5.0%) of other tumors such mesenchymal tissue tumors. Among the 104 patients with primary and recurrent malignancies, 15 patients with severe complications of pelvic perineum of advanced tumors were planned to undergo palliative PE surgery for symptom relief after preoperative assessment of multidisciplinary team; the other 89 patients were evaluated for radical PE surgery. All surgeries were successfully completed. Total PE was performed on 73 patients (51.8%),anterior PE on 22 (15.6%),and posterior PE in 46 (32.6%). The median operative time was 576 (453,679) minutes, median intraoperative blood loss 500 (200, 1 200) ml, and median hospital stay 17 (13.0,30.5)days.There were no intraoperative deaths. Of the 89 patients evaluated for radical PE surgery, the radical R0 resection was achieved in 64 (71.9%) of them, R1 resection in 23 (25.8%), and R2 resection in two (2.2%). One or more postoperative complications occurred in 85 cases (60.3%), 32 (22.7%)of which were Clavien-Dindo grade III and above.One patient (0.7%)died during the perioperative period. Conclusion: PE is a valid option for treating locally advanced or recurrent pelvic malignancies and complex pelvic fistulas.

Application of two phacoemulsification modes in cataract surgery with different hard nuclear / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To compare the clinical efficacy of the Balanced energy system versus the conventional torsional ultrasound system in phacoemulsification surgeries for cataracts with varying nuclear hardness.METHODS: In this study, 120 patients(122 eyes)with age-related cataracts scheduled for surgery between November 2021 and November 2022 at our hospital were randomly divided into two groups: 58 patients(59 eyes)in the experimental group underwent surgery using the Balanced energy system, while 62 patients(63 eyes)in the control group were treated with the conventional torsional ultrasound system. Intraoperative cumulative dissipated energy(CDE), case time(CT), aspiration time(AST), and estimated fluid used(EFU)were recorded. Patients were followed-up for 3mo to examine and record the best-corrected visual acuity(BCVA)and corneal endothelial cell density(ECD), and to calculate the rate of endothelial cell loss.RESULTS: Comparing the intraoperative parameters between the two groups, there was no significant difference in CT(P>0.05), but the CDE, AST and EFU of the patients in the experimental group were lower than those of the control group(P<0.05), and the CDE of patients with grade III nuclear hardness in the experimental group was lower than the control group(P<0.05), CDE, AST and EFU in patients with grade IV nuclear hardness were lower than those in the control group(P<0.05). After 3mo of follow-up, BCVA in both groups improved significantly, and the experimental group recovered faster than the control group. At 3mo after surgery, the ECD of the two groups of patients was reduced compared with that before surgery(P<0.01), but there were no significant differences in ECD and endothelial cell loss rates between the experimental and control groups before and at 3mo after surgery(P>0.05). In grade IV nuclear hardness cataracts, the rate of endothelial cell loss in the experimental group was significantly lower than that in the control group(4.63%±4.10% vs. 6.63%±4.49%, P<0.01).CONCLUSION: The Balanced energy system and the conventional torsional ultrasound system both show high safety and efficiency in phacoemulsification of cataracts with different nuclear hardness. However, the former demonstrates substantial advantages in cases with dense nuclei, offering lower ultrasound energy, shorter aspiration and infusion times, and reduced volume of infusion fluid.

Bioactive peptides from scorpion venoms: therapeutic scaffolds and pharmacological tools / 中国天然药物

Evolution and natural selection have endowed animal venoms, including scorpion venoms, with a wide range of pharmacological properties. Consequently, scorpions, their venoms, and/or their body parts have been used since time immemorial in traditional medicines, especially in Africa and Asia. With respect to their pharmacological potential, bioactive peptides from scorpion venoms have become an important source of scientific research. With the rapid increase in the characterization of various components from scorpion venoms, a large number of peptides are identified with an aim of combating a myriad of emerging global health problems. Moreover, some scorpion venom-derived peptides have been established as potential scaffolds helpful for drug development. In this review, we summarize the promising scorpion venoms-derived peptides as drug candidates. Accordingly, we highlight the data and knowledge needed for continuous characterization and development of additional natural peptides from scorpion venoms, as potential drugs that can treat related diseases.

Integrative analysis of prognostic long non-coding RNAs with copy number variation in bladder cancer / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

Copy number variations (CNVs), which can affect the role of long non-coding RNAs (lncRNAs), are important genetic changes seen in some malignant tumors. We analyzed lncRNAs with CNV to explore the relationship between lncRNAs and prognosis in bladder cancer (BLCA). Messenger RNA (mRNA) expression levels, DNA methylation, and DNA copy number data of 408 BLCA patients were subjected to integrative bioinformatics analysis. Cluster analysis was performed to obtain different subtypes and differently expressed lncRNAs and coding genes. Weighted gene co-expression network analysis (WGCNA) was performed to identify the co-expression gene and lncRNA modules. CNV-associated lncRNA data and their influence on cancer prognosis were assessed with Kaplan-Meier survival curve. Multi-omics integration analysis revealed five prognostic lncRNAs with CNV, namely

Claudin 14/15 play important roles in early wallerian degeneration after rat sciatic nerve injury / 中华创伤杂志(英文版)

PURPOSE@#Wallerian degeneration (WD) is an antegrade degenerative process distal to peripheral nerve injury. Numerous genes are differentially regulated in response to the process. However, the underlying mechanism is unclear, especially the early response. We aimed at investigating the effects of sciatic nerve injury on WD via CLDN 14/15 interactions in vivo and in vitro.@*METHODS@#Using the methods of molecular biology and bioinformatics analysis, we investigated the molecular mechanism by which claudin 14/15 participate in WD. Our previous study showed that claudins 14 and 15 trigger the early signal flow and pathway in damaged sciatic nerves. Here, we report the effects of the interaction between claudin 14 and claudin 15 on nerve degeneration and regeneration during early WD.@*RESULTS@#It was found that claudin 14/15 were upregulated in the sciatic nerve in WD. Claudin 14/15 promoted Schwann cell proliferation, migration and anti-apoptosis in vitro. PKCα, NT3, NF2, and bFGF were significantly upregulated in transfected Schwann cells. Moreover, the expression levels of the β-catenin, p-AKT/AKT, p-c-jun/c-jun, and p-ERK/ERK signaling pathways were also significantly altered.@*CONCLUSION@#Claudin 14/15 affect Schwann cell proliferation, migration, and anti-apoptosis via the β-catenin, p-AKT/AKT, p-c-jun/c-jun, and p-ERK/ERK pathways in vitro and in vivo. The results of this study may help elucidate the molecular mechanisms of the tight junction signaling pathway underlying peripheral nerve degeneration.

Effects of sperm DNA fragmentation index on semen parameters and pregnancy outcomes in intrauterine insemination / 中华男科学杂志

Objective@#To analyze the correlation of the sperm DNA fragmentation index (DFI) level with semen parameters and pregnancy outcomes of artificial insemination of the husband (AIH) in the cycle of intrauterine insemination (IUI).@*METHODS@#We collected the clinical data on 777 cases of IUI, including female clinical indicators, male semen parameters, sperm DFI and pregnancy outcomes. According to the DFI level, we divided the patients into three groups: DFI < 15%, 15% ≤ DFI < 30% and DFI ≥ 30%.@*RESULTS@#The sperm DFI level was significantly elevated with the increased age of the males (P = 0.002) and closely related to the total number of motile sperm (P = 0.002) and total sperm motility (P = 0.000) before treatment, as well as to sperm concentration (P = 0.000), total sperm motility (P = 0.001) and total number of progressively motile sperm (P = 0.000) after density gradient centrifugation. The rate of clinical pregnancy was decreased in the DFI ≥ 30% group. There were no statistically significant differences between sperm DFI and the rates of clinical pregnancy and abortion.@*CONCLUSIONS@#Male age significantly affects the sperm DFI level. Sperm DFI is closely related to sperm motility and total number of progressively motile sperm, but not to the rates of clinical pregnancy and abortion in patients undergoing IUI. IUI can be used as an effective method of assisted reproduction for male infertility./.

Regulation of RDN on Th1/ILC1 cell imbalance in HFMD patients caused by EV71 infection / 中国天然药物

Enterovirus 71 (EV71) infection is more likely to cause hand, foot and mouth disease (HFMD) in children, which can lead to neurogenic complications and higher mortality. As a commonly used clinical medicine, Reduning injection (RDN) helps to shorten the symptoms of patients with HFMD and facilitate the early recovery of children. However, the regulatory mechanism of RDN on the HFMD immune system disorder caused by EV71 remains to be discussed. This study collected detailed treatment data of 56 children with HFMD who entered the affiliated Children's Hospital of Nanjing Medical University during 2019. Retrospective analysis of clinical data showed that the symptoms of the RDN treatment group were improved compared with the untreated group. To explore its mechanism, the relevant detection indicators were detected by flow cytometry, enzyme-linked immunosorbent assay and real-time quantitative PCR. It was found that the number and function of innate immune (ILCs) and adaptive immunity (Th1, Th2 and secreted cytokines) were reduced, suggesting that RDN plays a role by regulating cellular immunity. The in vitro differentiation inhibition test further confirmed that RDN affected Th1 differentiation by inhibiting the expression of transcription factors on the basis of Th1 cell differentiation in vitro.

The relationship between serum and seminal plasma vitamin D and male reproductive function / 医学研究生学报

Objective Male infertility accounts for 40 to 50% of the total number of infertility in the world. Among many factors that cause male infertility, vitamin D is considered to be directly related to male fertility. The purpose of this study was to explore the relationship between serum and seminal plasma vitamin D and male reproductive function, and provide a more comprehensive research direction for studying the specific mechanism of vitamin D on male reproduction. Methods A total of 198 infertile males, receiving andrological examination from June 2017 to January 2018 in the Center for Reproductive Medicine, Jinling Hospital (Nanjing, China) was included in our study. Serum and seminal plasma vitamin D levels were measured by electrochemiluminescence immunoassay (ECLIA) kits. The associations between vitamin D and biomarkers of male reproduction were analyzed. Results Serum 25(OH) vitamin D level [26.17(19.61-31.99)ng/mL] was in positive relation with semen volume[3.8(3.1-4.8)ng/mL] (r=0.229,P=0.003). Seminal plasma 25(OH) vitamin D level was not related to serum 25(OH) vitamin D level, but in negative relation with sperm concentration(r=0.174,P=0.016) and positive relation with semen volume(r=0.271,P=0.0001). Serum 25(OH) vitamin D level was in positive relation with seminal plasma fructose concentration(r=0.256,P=0.002), total fructose content (r=0.310,P=0.0002) and total zinc content(r=0.26,P=0.002). The level of serum and seminal plasma vitamin D leve was not related to serum anti-Mullerian hormone(AMH), seminal plasma AMH, serum inhibin (INH B) and seminal plasma INH B(P>0.05). Conclusion Vitamin D is associated with affiliated gland function. The seminal vesicles and prostate produced by semen may be the main source of vitamin D in the male reproductive system.

Correlation between follicular fluid sRAGE level and ovarian responsiveness in non-PCOS patients undergoing controlled ovarian hyperstimulation / 南方医科大学学报

OBJECTIVE@#To investigate the correlation between soluble receptor for advanced glycation end products (sRAGE) level in the follicular fluid and ovarian responsiveness in non-PCOS patients undergoing controlled ovarian hyperstimulation.@*METHODS@#Ninety non-PCOS patients underwent IVF/ICSI using a short-acting long protocol for ovarian stimulation with a GnRH agonist. For each patient, the level of sRAGE in the follicular fluid was measured by enzyme linked immunosorbent assay (ELISA), and the data including the clinical baseline state, hormone level, number of oocytes obtained and the fertilization rate were collected.@*RESULTS@#Follicular fluid sRAGE level showed significant negative correlations with basal FSH level (=0.0036) and Gn dose ( 15) than in cases with oocytes obtained within the range of the target numbers (7-15) and below the target number (< 7) ( < 0.0001 and =0.0012, respectively).@*CONCLUSIONS@#Follicular fluid sRAGE level can reflect ovarian reserve function in non-PCOS patients, the number of oocytes obtained and the fertilization rate, and can thus predict ovarian responsiveness during controlled hyperstimulation in nonPCOS patients.

Effect on sperm quality of asthenospermia and oligospermia treated with grain-moxibustion combined with medicine therapy / 中国针灸

OBJECTIVE@#To observe the clinical effect of grain-moxibustion combined with medicine therapy for asthenospermia and oligospermia.@*METHODS@#A tatal of 60 patients were randomized into an observation group (30 cases) and a control group (30 cases) according to 1︰1 ratio. In the control group, vitamin E capsules were taken orally one capsule each time, twice a day, and pills 6 g each time, three times a day for a total of 3 months. In the observation group, grain-moxibustion was applied at Guanyuan (CV 4)，Shenshu (BL 23) and Zusanli (ST 36) based on the control group, once a week for 3 months, with a total of 12 times. The sperm concentration and sperm progressive motility were measured by automatic sperm quality analysis system in the two groups, and the clinical effects were compared. Sperm DNA fragmentation index (DFI) in the observation group was measured by sperm nucleus chromosome structure assay (SCSA).@*RESULTS@#①The sperm concentrations and sperm progressive motilities after 1-month, 2-month and 3-month of treatment were increased compared with those before treatment in the two groups (<0.01), and they were increased with time. In the two groups, 2-month and 1-month of treatment, 3-month and 2-month of treatment were compared, the sperm concentrations and sperm progressive motilities were significantly increased (<0.01). The sperm concentrations after 1-month, 2-month and 3-month of treatment in the observation group were higher than those in the control group (<0.01), the sperm progressive motility after 3-month of treatment in the observation group was higher than that in the control group (<0.05). ②After 3-month of treatment，the DFI in the observation group was significantly reduced compared with that before treatment (<0.01). ③The total effective rate in the observation group after 3-month of treatment was 86.7% (26/30), which was superior to 63.3% (19/30) in the control group (<0.05).@*CONCLUSION@#Grain-moxibustion combined with medicine therapy can improve sperm concentration and sperm progressive motility, enhance the integrity of sperm DNA.

Repairing effect of wheat-grain moxibustion on thin-type endometrium in rats / 中国针灸

OBJECTIVE@#To observe the repairing effects of estrogen and wheat-grain moxibustion on thin-type endometrium in rats and to explore its possible mechanism.@*METHODS@#Forty healthy SPF-grade adult female SD rats were randomly divided into a normal group, a model group, an estrogen group and a moxibustion group according to random number table method, 10 rats in each group. The model of thin-type endometrium was established during estrous period in all the groups except for the normal group. No intervention was given in the normal group. The intragastric administration of 2 mL of 0.9% sodium chloride solution was applied the next day after modeling in the model group. The intragastric administration of 2 mL of estradiol was given the next day after modeling in the estrogen group. The wheat-grain moxibustion was given at "Guanyuan" (CV 4) and "Shenshu" (BL 23) the next day after modeling in the moxibustion group, 7 moxa cones for each acupoint. The treatment in 3 groups was given once a day. After three estrous cycles, the samples were collected during estrous period; the thickness and morphology of endometrium were observed by HE staining; the expressions of vimentin, keratin and vascular endothelial growth factor (VEGF) in endometrium tissue were detected by immunohistochemistry; the expressions of HOXA10 and LIF in endometrium tissue were detected by Western blot.@*RESULTS@#The endometrial thickness in the model group was significantly thinner than that in the normal group (0.05). The expressions of keratin, vimentin and VEGF in endometrium in the model group were significantly lower than those in the normal group (0.05). The expressions of HOXA10 and LIF in endometrium in the model group were significantly lower than those in the normal group (<0.01); compared with the model group, the expressions of HOXA10 and LIF in endometrium in the estrogen group and moxibustion group were significantly increased (<0.05).@*CONCLUSION@#The wheat-grain moxibustion could up-regulate the expressions of keratin, vimentin and VEGF in endometrium to improve the endometrial thickness; in addition, it could increase the levels of factors related to endometrial receptivity including HOXA10, LIF, which improves endometrial receptivity and play a repair role.

Immunosuppressive Effect of Exosomes from Mesenchymal Stromal Cells in Defined Medium on Experimental Colitis

BACKGROUND AND OBJECTIVES: The exosomes released by mesenchymal stromal cells (MSCs) in classical FBS-containing media have been demonstrated as an alternative, cell-free therapy in various diseases including inflammatory bowel disease (IBD). It has been found that the function of exosomes is affected by culture condition. We previously developed a serum-free, xeno-free and chemically defined medium, and umbilical cord-derived MSCs in this medium retained the immunosuppressive capability.METHODS: In this study, we evaluated the immunosuppressive function of exosomes from MSCs (MSC-Exo) in defined medium and their therapeutic effect on treating colitis.RESULTS AND CONCLUSIONS: In vitro studies indicated that MSC-Exo reduced the concentration of pro-inflammatory cytokines IFN-γ, TNF-α and IL-1β, and increased the secretion of anti-inflammatory cytokines TGF-β1 and IL-10, but no significant change of inhibitory effect on peripheral blood mononuclear cells proliferation was shown. In vivo experimental colitis showed that administration of MSC-Exo was able to significantly ameliorate the disease activity index score, weight loss, colon shortening, and the histological colitis score through up-regulation anti-inflammatory responses and down-regulation of inflammatory responses. Moreover, the use of MSC-Exo (200 μg) led to an improved therapeutic efficacy when compared with MSCs at a dose of 1×10⁶ cells. Our findings indicate that the exosomes from MSCs in defined medium possess a certain degree of immunosuppressive effect in vitro and exhibit a therapeutic capability in a mouse model of DSS-induced colitis through suppressing inflammation mechanism.

Effect of Tongxinluo Treated Conditioned Medium of Cardiac Microvascular Endothelial Cells on Rats' Embryo Cardiomyocyte Apoptosis / 中国循环杂志

Objective: To explore the effect of impaired cardiac microvascular endothelial cells on rat's embryo cardiomyocyte apoptosis and the impact of Tongxinluo in such process. Methods: 3 kinds conditioned medium of cardiac microvascular endothelial cells were prepared. ① normal rat's cardiac microvascular endothelial cell (RCMECs) conditioned medium, ②homocysteine induced impaired RCMECs conditioned medium and ③ Tongxinluo treated RCMECs conditioned medium. Rat's embryo H9c2 cardiomyocytes were divided into 4 groups:① Control group, cells were cultured in DMEM without serum, ② N-CM group, cells were cultured in RCMECs conditioned medium, ③ H-CM group, cells were cultured in homocysteine induced impaired RCMECs conditioned medium and ④ T-CM group, cells were cultured in Tongxinluo treated RCMECs conditioned medium. Cell mitochondrial membrane potential (MMP) was detected by JC-1 agent, ROS level was examined by flow cytometry, cardiomyocytes apoptosis was measured by live cell imaging system, expression levels of cytochrome C (Cyt-C), cysteinyl aspartate specific proteinase-3 (Caspase-3), Bcl-2 associated X protein (Bax) and B-cell leukemia/lymphoma 2 protein (Bcl-2) were detected by Western blot analysis. Results: MMP, expression levels of ROS, Cyt-C and cardiomyocyte apoptosis were similar between Control group and N-CM group, P>0.05. Compared with N-CM group, H-CM group had decreased MMP, increased ROS and cardiomyocyte apoptosis, up-regulated expressions of Cyt-C, Caspase-3 and Bax, all P<0.01. Compared with H-CM group, T-CM group had increased MMP, decreased ROS and cardiomyocyte apoptosis, down regulated expressions of Cyt-C, Caspase-3 and Bax, all P<0.05; while up-regulated expression of Bcl-2, P<0.01. Conclusion: Conditioned medium of impaired cardiac microvascular endothelial cells may induce cardiomyocyte apoptosis and such process could be inhibited by Tongxinluo.

Index weight analysis of long-term care insurance disability rating scale / 中国卫生政策研究

Objective:To establish index weight system of the disability rating scale for the long-term care in-surance. Methods:On the basis of the index system of disability rating scale constructed by Delphi method,the im-portance of each index of the scale was evaluated and its weight was calculated by analytic hierarchy process. Re-sults:The weights of the 4 first-class indicators in the long-term care insurance disability rating scale were as follows:sensory perception was 0.2408,basic activities of daily living was 0.5899,cognitive ability was 0.1204, emotional& behavior was 0.0489;and the weights of 22 second-class indicators were calculated simultaneously. Conclusions:The determination of the index weight further improves the system of disability rating system,and provides reference for the development of long-term care insurance system.

Protective effects and possible mechanism of 12-O-tetradecanoylophorbol-13-decano-ate against acute intestinal radiation injury of mice / 军事医学

Objective To investigate the effect of 12-O-tetradecanoylophorbol-13-decanoate(TPD)on protection against acute intestinal radiation injury of mice and the possible mechanism.Methods Twenty female BALB/c mice aged 6-8 weeks were divided by random number table method into the control group and TPD groups(25,50,and 100 μg/kg). A radiation-damaged model of mice was irradiated by 10 Gy 60Co γ-rays,while the TPD groups were pretreated for 3 d with caudal vein injection before irradiation.The survival time of 20 days and the number of crypts at 3.5 days after irradiation were detected.Rat intestinal epithelial cells(IEC-6)were treated with 1 nmol/L TPD for 12 h before irradiation with 10 Gy 60Co γ-rays,and CCK-8 was used to detect the capability of cell proliferation at 0,1,2,3 and 4 d after irradiation. Results The mice in the control group survived for an average of 4.2 days,compared to 10 days in the optimal TPD group (100 μg/kg).The average number of crypts in the control group and the best TPD group was 11.0 ±1.3 and 35.1 ±1.9 respectively.The proliferation activity of IEC-6 was measured for four consecutive days.The average D value of the TPD groups was significantly higher than that of control.Conclusion TPD has a protective effect against acute intestinal radiation injury, and its protective mechanism may be achieved by promoting intestinal crypt cell proliferation and increasing the number of crypts in the intestine.

Precise-surgical-opening intramedullary nail insertion in treating unstable femoral intertrochanteric fractures with closed-reposition difficulty / 中国骨伤

<p><b>OBJECTIVE</b>To compare clinical efficacy of repositioning with precise-surgical-opening intramedullary nail insertion and traditional repositioning in treating unstable femoral intertrochanteric fractures with closed-reposition difficulty.</p><p><b>METHODS</b>Clinical data of 58 patients with unstable femoral intertrochanteric fractures after closed-reposition difficulty (AO 31A2.2-3.3) were retrospective analyzed. Among them, 32 patients were treated with first open intramedullary nail and then reduction operation(modified reductuon group) including 9 males and 23 females with an average age of (80.9±11.1) years old ranging from 46 to 99 years old; and 26 patients were treated by traditional reduction(traditional reduction group) including 7 males and 19 females with an average of(78.1±13.9) years old ranging from 41 to 89 years old. The time of operation, the amount of bleeding, the length of hospital stay, the first weight-bearing time and the time of fracture healing, postoperative complications and Harris hip score were evaluated and compared between the two groups.</p><p><b>RESULTS</b>All patients were followed up for 12 to 24 months with an average of 17.3 months. The operative time(3.612, 0.008 2) nd the blood loss(3.389, 0.007 5) in the modified reduction group were lower than those in the traditional reduction group. There were no significant differences in hospitalization time(0.851, 0.392), fracture healing time(0.640, 0.531), and the first loading time(0.845, 0.411) between two groups. There was no significant difference in the Harris score between two groups(χ²=0.66, 0.831>0.05).</p><p><b>CONCLUSIONS</b>Traditional repositioning requires a repositioning of the fracture bone and a correct opening reaming before the insertion and fixture of the intramedullary nail, which is a complicated operation in unstable femoral intertrochanteric fractures after closed-reposition difficulty. On the other hand, the new method implements the insertion of the intramedullary nail before the repositioning of the fracture bone, greatly simplifying the operation procedure, shortening the total operation time and reducing the amount of intraoperative blood loss.</p>

Preliminary study of bone marrow mesenchymal stem cell-derived exo-somes in repair of spinal cord injury in rats / 中国病理生理杂志

AIM:To study the influence of bone marrow mesenchymol stem cell-drived exosomes(BMSC-exo-somes)on hindlimb activity,and the numbers of reactive astrocytes and residual neurons in spinal cord injury(SCI)rats. METHODS:BMSCs were cultured using the whole bone marrow adherent culture method and surface markers CD 90 and CD34 were verified by flow cytometry.Exosomes were isolated by ultracentrifugation and the morphology of exosomes was observed under transmission electron microscope.The protein markers CD63 and CD9 were verified by Western blot.After exosomes were applied to SCI rats,the Basso,Beattie and Bresnahan locomotor rating scale score,the Nissl staining of the lesion site,and the numbers of reactive astrocytes and residual neurons were assessed at various time points.RESULTS:Transmission electron microscopic observation revealed the presence of saucer -shaped vesicles.BMSC-exosomes were found to express high levels of CD63 and CD9.Compared with injury group,significant improvement of hindlimb activity scores from day 14 after injury in treatment group was observed(P<0.05),and less reactive astrocytes and more residual neu-rons from day 7 after injury were also observed(P<0.05).CONCLUSION:BMSC-exosomes inhibit reactive astrocytes and death of neurons,and improve hindlimb activity in the rats after SCI.

Effects of bacterial lipopolysaccharide on the mineralization and differentiation of periodontal ligament stem cells / 医学研究生学报

Objective Periodontal tissue engineering has shown a highlight prospect in the treatment of periodontitis,but the related clinical experiments have not achieved the predetermined goal. In this study,we analyzed the reasons for the limited clinical efficacy of periodontal tissue engineering. Methods We primarily cultured the periodontal tissue from the young permanent teeth extracted for or-thodontic treatment,isolated periodontal ligament stem cells (PDLSCs),and transplanted the well-grown third-generation PDLSCs onto the fluorapatite-polycaprolactone (FA-PCL) nanofiber scaffolds and PCL nanofiber scaffolds. We randomly divided the cells into groups A (cultured with 10 ng/mL porphyromonas gingivalis lipopo-lysaccharide (Pg-LPS)+FA-PCL),B (cultured with 10 ng/mL PG-LPS+PCL),C (cultured with 10 μg/mL PG-LPS+FA-PCL),D (cultured with 10 μg/mL PG-LPS+PCL),E (cultured with FA-PCL),and F (cultured with PCL),and observed their proliferation,differentiation and mineralization. Results The PDLSCs adhered and grew well after transplanted onto the nanofiber scaffolds and their proliferation significantly increased in groups A and B but decreased in C and D as compared with E and F. At 7 days,the expres-sions of ALP and mineralization-related genes runx2 and SPP1 in the PDLSCs were significantly higher in group E than in the other five groups (P<0.05),but higher groups A and C than in B and D as well as in A than in C. At 28 days,alizarin red and Von Kossa stai-ning showed a higher positivity in group E than in the other five groups,but higher groups A and C than in B and D as well as in A than in C. Conclusion The inflammatory environment not only affects the proliferation of PDLSCs,but also inhibits their differentiation and mineralization. The FA-PCL scaffold can reduce the cytotoxic effect of PG-LPS.

The application of frozen-thawed blastocyst transfer in patients with diminished ovarian reserve / 医学研究生学报

Objective The embryonic development is usually observed for 5-6 days during the process of embryo culture in most embryonic laboratories.The article aimed to explore the application of D 6+D7 frozen-thawed blastocyst transfer in patients with di -minished ovarian reserve(DOR). Methods Retrospective analysis was conducted on 285 patients with DOR who were treated with in-vitro fertilization and embryo transfer (IVF-ET) in our center from 2015 to 2017.Frozen embryos were harvested from the natural cycle , mini-stimulation protocol, ovulation induction during the luteal phase , followed by frozen-thawed embryo transfer with a total of 442 cycles. The frozen embryos were divided into cleavage embryo group and blas -tocyst group according to different life stages , and comparison was made in general data and pregnancy outcome between the two groups .The blastocyst transfer group was subdivided into Day 5 group and Day6+Day7 group followed by the comparison of different pregnancy outcome between the two groups . Results Patients with DOR were treated with frozen-thawed blastocyst transfer with 291 cycles in cleavage embryo group and 151 cycles in blastocyst group.The implantation rate, clinical pregnancy rate, and ongoing pregnancy rate of blastocyst group were significantly higher than those of cleavage embryo group ( 44.62％ vs 22.46％, 50.33％ vs 33.33％, 37.75％ vs 21.65％, P<0.05) and the abortion rate of blastocyst group was significantly lower than that of cleavage embryo group (35.05％ vs 25％, P<0.05).As to the frozen blastocyst transplantation cycle , the number of D5 blastocysts was 69, and D6+D7 blastocyst was 76. The embryo planting rate, clinical pregnancy rate, continued pregnancy rate and abortion rate of D 6+D7 group were higher than those of D5 group(39.74％ vs 50％, 44.93％ vs 55.26％, 34.78％ vs 39.47％, 22.58％ vs 28.57％), but the difference was of no statistical significance(P>0.05). Conclusion In patients with DOR, the transplanted blastocyst can significantly improve the pregnancy out -come, increase the clinical pregnancy rate and reduce the abortion rate .The embryo planting rate and clinical pregnancy rate of the transplanted D6+D7 blastocyst were higher than those of D 5 blastocyst, but the difference was not statistically significant .The abortion rate was also increased.Therefore, when the number of embryos is limited, patients with DOR may consider transplanting D 6+D7 high-quality blastocysts in order to get a certain clinical pregnancy rate .

Electroacupuncture and transplantation of bone marrow mesenchymal stem cells for thin endometrium / 医学研究生学报

Objective Thin endometrium affects embryo implantation and the existing clinical options are rather limited for its treatment.This paper aims to investigate the effects of electroacupuncture (EA) and bone marrow mesenchymal stem cell (BMSC) transplantation in the treatment of thin endometrium and their possible mechanisms.Methods Fifty adult female SD rats were randomly divided into five groups of equal number:normal control,model control,BMSC,EA,and BMSC+EA,and the thin endometrial model was established by intrauterine injection of 95％ ethanol in the estrous cycle in the latter three groups of animals.The model controis were injected with PBS solution,the rats of the BMSC group injected with stem cell suspension,those of the EA group treated by daily electroacupuncture at the acupoints of Guan Yuan,Sanyinjiao and Zigong from the second day after modeling,and those of the BMSC+EA group treated by both injection of stem cell suspension and daily electroacupuncture.At the fourth estrous cycle after modeling,endometrial tissues were collected from the rats for observation of their morphological changes by HE staining,measurement of the endometrial thickness,count of the vascular glands,and determination of the expressions of vimentin and cytokeratin by immunohistochemistry and those of LIF and HOXA10 by Western blot.Results Compared with the model controls,the rats of the BMSC,EA,and BMSC+EA groups showed significant thickening of the endometrium (P＜0.05) and the endometrial thickness of the BMSC+EA group was the closest to that of the normal control.The numbers of endometrial blood vessels and vascular glands were remarkably increased in the three treatment groups as compared with the model controls (P＜0.01),with complete and regenerated endometrial tissues.The expressions of vimentin and cytokeratin were the highest in the normal control,the lowest in the model control group,and increased sequentially in the EA,BMSC and BMSC+EA groups (P＜0.05).The expression of LIF and HOXA10 were significantly higher in the BMSC,EA and BMSC+EA groups than in the model control (P＜0.01),the highest in the BMSC+EA group,which was closest to that of the normal control (P＜0.05).Conclusion Bone marrow mesenchymal stem cell transplantation and electroacupuncture can both promote the regeneration and repair of thin endometrium in rats,and the combination of two strategies produces an even better effect.