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Objective@#To quantify the serum levels of apoptosis-related molecules M30 and M65 in the patients with primary biliary cholangitis (PBC) and analyze their clinical significance for PBC. @*Methods@#A total of 79 patients with PBC and 40 healthy individuals were involved in this study from January 2017 to April 2019. The levels of serum M30 and M65 were measured by enzyme-linked immunosorbent assay (ELISA) and the ratio of M30/M65 was calculated. The parameters of liver function were tested by automatic biochemical analyzer. ALT, AST and GGT were determined by rate method, ALP was assayed by the method of NPP substrate-AMP buffer and T-Bil was determined by oxidation method. Autoantibodies including AMA-M2, anti-GP210 and anti-SP100 were detected by automated multiplexed bead-based and immunoblotting assays. The correlation of M30, M65 and M30/M65 ratio with liver function items were analyzed by spearman assay. The levels of M30, M65 and M30/M65 ratio were analyzed by ROC curve to evaluate their values in PBC screening. @*Results@#M65 level in PBC group was significantly higher than that in control group (P＜0.001) with statistically significant difference and M30/M65 ratio was significantly lower than that in control group with statistically significant difference (P＜0.001). There was no significant difference for the level of M30 between the two groups (P=0.641). Among the PBC patients, 18 were anti-GP210-positive and 17 were anti-SP100-positive. In anti-GP210 positive group the levels of M30 and M65 were significantly higher than those in the negative group (P values were 0.002 and 0.001 respectively). In anti-SP100 positive group the level of M65 was significantly higher than that in the negative group (P=0.027) and M30/M65 ratio was significantly lower than that in negative group with statistically significant difference (P=0.005). Spearman correlation analysis showed that the levels of M30 and M65 were positively correlated with ALT, AST and T-Bil (P＜0.05). The cut off values of M30 and M65 were 63.62 U/L and 155.37 U/L and M30/M65 was 0.32, respectively. The screening sensitivities were 63.30%, 89.10% and 93.30%, and the specificities were 51.60%, 90.00% and 75.00%, respectively. @*Conclusion@#The level of M65 in the serum of PBC patients significantly increased and M30/M65 ratio significantly decreased, which could be used as a promising serum marker of laboratory for PBC screening.
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Objective@#To investigate the IL-10+CD19+ regulatory B cells (Breg) in peripheral blood of patients with rheumatoid arthritis (RA), and analyze the correlation between the expression of IL-10+CD19+ Breg cells and disease severity. @*Methods@#A total of 40 patients with active RA and 30 healthy individuals (healthy controls, HC) were involved in this study. The peripheral blood mononuclear cells (PBMC) were isolated. The isolated PBMC were co-cultured with CpG oligodeoxynucleotide 2006 (CpG ODN 2006) and phorbol myristate acetate (PMA) in vitro. Flow cytometry was employed to analyze the expression of Breg before and after stimulation. The correlations of Breg expression with ESR, CRP and DAS28 were analyzed. @*Results@#Before stimulation in vitro, the expression of Breg in PBMC of RA group and HC group were 1.92%(1.58%, 2.56%) and 2.04%(1.73%, 2.93%) respectively. There was no significant difference between the two groups (P=0.258). After induction in vitro, the expression of Breg of RA group [13.00%(9.75%, 14.85%)] was significantly higher than that of HC group [9.12%(6.83%, 10.22%)], P＜0.001. Spearman correlation analysis showed that Breg expression was negatively correlated with DAS28 (P=0.002), but not with ESR and CRP (P＞0.05). @*Conclusion@#The expression of Breg was significantly increased after stimulation in vitro and negatively correlated with DAS28, which indicated Breg may play important regulatory roles in pathogenesis and development of RA.
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Objective To investigate the clinical effect of anterior controllable antedisplacement and fusion (ACAF) for the treatment of ossification of the posterior longitudinal ligament (OPLL) of the cervical spine.Methods The data of 45 cases with cervical posterior longitudinal ligament ossification treated by ACAF from March 2017 to October 2017 were retrospectively analyzed,including 25 males and 20 females,age 45-68 years,average 57.5 years.There were 18 cases involving C3 vertebral body,30 cases involving C4 vertebral body,40 cases involving C5 vertebral body,34 cases involving C6 vertebral body,and 7 cases involving C7 vertebral body.The function of the neural function was evaluated by the Japanese Orthopaedic Association (JOA) scoring system at preoperation and latest follow-up.The curvature of the cervical spine was measured on the lateral X-ray film of the cervical spine,the maximum occupying ratio of the spinal canal was measured on the cross section of the CT scan,and compression of the cervical spinal cord was evaluated by the cervical MRI.Results Patients were followed up for 3 to 6 months (average,3.9 months).The improvement of neurological function was obtained in all the patients.The JOA score improvement rate at the latest follow-up was 71.3％±9.6％.The cervical lordosis was improved from preoperative 4.5°±3.8° to 10.3°±4.8° at the latest follow-up.The canal stenosis ratio was decreased from preoperative 54.3％±8.2％ to 12.5％±5.3％ at the latest follow-up.MRI showed that the cervical spinal cord was adequately decompressed in situ.No specific complications were identified that were associated with this technique.Conclusion The present study elaborates the surgical tips and demonstrates the satisfactory outcome of ACAF for the treatment of OPLL.This novel technique has the potential to serve as an alternative surgical technique for the treatment of cervical OPLL.
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AIM To establish an HPLC method for the simultaneous content determination of five constituents in Jiangzhi Granules (Salviae miltiorrhizae Radix et Rhizoma,Polygoni cuspidati Rhizoma et Radix,Artemisiae scopariae Herba,etc.).METHODS The analysis of methanol extract of this drug was performed on a 30 ℃ thermostatic Hanbon-C18 column (4.6 mm × 250 mm,5 μm),with the mobile phase comprising of acetonitrile (A) 0.1％ phosphoric acid (B) flowing at 1.0 mL/min in a gradient elution manner,and the detection wavelengths were set at 286 nm (0-30,40-50 min) and 203 nm (30-40 min).RESULTS Gypenoside A,chlorogenic acid,polydatin,salvianolic acid B and emodin showed good linear relationships within the ranges of 0.176-2.46,0.056-0.84,0.36-5.40,0.192-2.88 and 0.12-1.80 μg (r ＞0.999 0),respectively,whose average recoveries were 97.17％-102.59％ with the RSDs of 1.9％-2.9％.CONCLUSION This accurate and simple method can be used for the quality control of Jiangzhi Granules.
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Objective To investigate the pathogenesis of diseases with antineutrophil cytoplasmic antibody (ANCA)and its diagnostic value in primary small vessel vasculitis.Methods 57 patients with serum ANCA positive were involved in this study,and ELISA was employed to assay anti-MPO.Patients with ANCA positive,anti-MPO positive and/or anti-PR3 positive were involved in group A.Patients with ANCA positive,anti-MPO negative and anti-PR3 negative were involved in group B.X2 was used to analyze the differences between the two groups.Results The etiology of 57 ANCA positive patients included primary small vessel vasculitis (20 cases,35.1%),non inflam-matory connective tissue disease(19 cases,33.3%),non connective tissue disease(18 cases,31.6%).A group of primary small vessel vasculitis accounted for 58.6%,which was significantly higher than 10.7% of the B group (χ2 =14.354,P<0.01);while the B group of non inflammatory connective tissue disease accounted for 50%,which was significantly higher than 17.2%of the A group (χ2 =6.879,P<0.01).Conclusion ANCA should be found in many kinds of diseases,so combined detection of anti-MPO and anti-PR3 should be employed to improve the diag-nosis specificity in primary small vessel vasculitis.Furthermore,non vessel vasculitis connective tissue disease should be excluded in patients with ANCA positive,anti-MPO and anti-PR3 negative.
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BACKGROUND:Zinc-modified calcium silicate (CaSiO3) bioceramics coating on the titanium surface prepared in preliminary experiments has good chemical stability and antibacterial property. OBJECTIVE:To observe the effects of zinc-modified CaSiO3 bioceramics coating on osteointegration. METHODS:MC3T3-E1 cels were respectively cultured on the titanium with zinc-modified CaSiO3 bioceramics coating (experiment group), titanium with CaSiO3 bioceramics coating (control group) and pure titanium (blank control group). Then, cel adhesion, proliferation, calcification rate and the expression of type I colagen and osteocalcin were detected. The implant materials mentioned above were respectively inserted into the femurs of New Zealand white rabbits, and after 1.5 months, the osteoproliferation and osteointegration between the implants and the host were tested. RESULTS AND CONCLUSION:In vitro experiment: The number of adhesive cels at 12 hours after co-culture was significantly increased in the experimental group compared with the control group and blank control group (P < 0.05). At 14 days after co-culture, cel proliferation ability and ability of calcium nodule formation in the experiment group were significantly better than those in the other groups (P < 0.05). At 21 days after co-culture, there was no significant difference in the expression of type I colagen, but the expression of osteocalcin in the experiment group was higher than that in the control group and blank control group (P < 0.05).In vivo experiment: In the experiment group, a large amount of bone substances were detected, the coating materials directly contacted with the bone interface, new bone tissues and little fibrous tissues were observed at the interface. In contrast, there was a small amount of bone hyperplasia in the control group and almost no bone hyperplase in the blank control group. Moreover, a small part of the implant directly contacted with the bone interface and the most part was separated from bone trabeculae by fibrous tissues. These findings indicate that zinc-modified CaSiO3 bioceramics coating can enhance the ability of osteointegration between titanium implants and the host.
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BACKGROUND:Tissue-engineered bone has been considered to be a promising candidate for the repair and reconstruction of load-bearing large segmental bone defects. Currently, the studies on the application of tissue-engineered bone mainly focus on cel-scaffold or cytokine-scaffold constructs, which haveshed light upon the repair of large segmental bone defects. OBJECTIVE:Toestablish simple and convenient tissue engineering of anatomicaly shaped tibial bone defect models using three-dimensional rapid prototyping technology to manufacture rabbit tibia biomimetic artificial bone scaffolds. METHODS:Three-dimensional electronic models were constructed using Mimic software. Hydroxyapatite/polycaprolactonescaffolds were manufactured by fused deposition modeling equipment. Fifty rabbits aged 6 months were randomly divided into three groups: blank control(n=3), control(n=6) and experimental groups(n=6), respectively. Tibial defects ranged 1.2 cmweremade in al groups. No treatment was given in blank control group. The bone defects in control and experimental groups were repaired with autogenous osteotomized bone and anatomicaltissue-engineered bone, respectively, and fixed with plates and screws. RESULTS AND CONCLUSION:(1) Rabbit tibial bone measurements:tibiallengthwas (93.77±0.59)mm, tibiofibular transverse diameter(8.36±0.13)mm, sagittal diameter(5.97±0.12)mm, average thickness of bone cortex(1.20±0.10)mm, average diameter of the medulary cavity(4.30±0.06)mm. Anglebetween the connection line of the midpoints of superior and inferior articular surfaces at the side of tibial bone models and the connection lineof the midpoints of superior and inferior intersecting surfaces at the side of osteotomized bone modelswasα=(5.97±0.13)°.(2) X-ray in bone defects: at postoperative 4 and 12 weeks, no obvious displacement and angulated deformity were found in bone grafts, suggesting the good bone defect repair.(3) Histological examination: at postoperative 4 weeks, bone scaffolds were filed with new bone in the experimental group. Furthermore, considerably increased new bone formation and mineralization were observed at postoperative 12 weeks.(4) General observation: no obvious displacement and angulated deformity occurredin bone defect grafts at postoperative 4 and 12 weeks. These findings suggest that rabbit anatomical models of large segmental tibial bone defects with good stability were constructed using three-dimensional prototyping technology, which may simulate the structure and function of bone tissue and be used for guiding the new bone regeneration.
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Objective To characterize the medial femoral circumflex artery based on three-dimensional computed tomographic angiography (3DCTA) so as to provide anatomical aids for diagnosis and treatment of hip injuries.Methods To do this research the 3DCTA data of 103 patients (206 hips) were collected who underwent 3DCTA from March 2012 to June 2014 for examination of the pelvis and lower extremities.They were 55 men (mean age,54.7 ± 15.9 years) and 48 women (50.0 ± 16.1 years).① The origin and course of the medial femoral circumflex artery was observed.② The length of the artery trunk was measured.The distances between the origin(A) of the artery to the main anatomical marks [the peak of greater trochanter (B),the inward peak of lesser trochanter (C),and the crosspoint (D) of the femoral artery and the pubic edge or the acetabulum inlet edge] were measured.Comparisons of the measurements were conducted between genders.③ The distance between point A and point E,the starting point of the femoral profound artery,was measured.Comparisons of the measurements were conducted between genders.Results 2.9％ (3/103) of the subjects had their bilateral medial femoral circumflex arteries originate from the femoral artery,94.2％ (97/103) had their bilateral medial femoral circumflex arteries originate from the femoral profound artery,and 2.9％ (3/103) had one medial femoral circumflex artery originate from the femoral artery and the other from the femoral profound artery.1.9％ (4/206),76.7％ (158/206) and 21.3％ (44/206) of the subjects had the artery of screw type,of circuitous type and of straight type,respectively.The artery trunk goes posteriorly and medially after it is issued,divides into branches along the course,continues to go around the back of the femoral neck,and finally goes to the outward and upper direction.There were no statistical differences between males and females regarding length of the artery trunk,or distances between points AB,AC,AD or AE (P ＞ 0.05).Conclusion Since 3DCTA can clearly demonstrate the origin,course and anatomical morphology of the medial femoral circumflex artery,it can be used to provide anatomical aids for clinical evaluation and treatment of hip injury.
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Objective To explore the intervention effects of trichostatin A ( TSA ) on specialization of rat bone marrow mesenchymal stem cells ( MSCs ) .Methods The rat MSCs were isolated, cultured and purified by the whole bone marrow adherent method in vitro, with morphological observation.The third generation of MSCs were selected, directional induced to osteoblasts, and divided into the TSA low dose group (0.1μmol/L), middle dose group (1μmol/L) , the high dose group (10μmol/L) according to different drug concentrations, seting up blank control group at the same time.MSCs proliferation and cell growth curve of each group were drawn by MMT, the activity of alkaliphosphatase ( ALP) was detected, and the levels of corebinding factor α1 (Cbfα1), basic fibroblast growth factor (bFGF) and insulin-like growth factors-1 (IGF-1) mRNA were detected by RT-PCR. Results The trend of MSCs growth curves in each groups were similar, compared with control group, the growth curve of TSA low dose group had no significant change, the TSA middle dose and high dose significantly promoted the proliferation of MSCs (P<0.05).Compared with control group, ALP activity of TSA low-, middle-and high-dose group were significantly higher at 4th,5th,6th(P<0.05).The expression levels of Cbfα1, bFGF and IGF-1mRNA were significantly higher than those of control group, respectively (P<0.05).Conclusion TSA can significantly promote the rat bone marrow mesenchymal stem cells to differentiate into osteoblast, which is possibly associated with up-regulation of Cbfα1, bFGF and IGF-1mRNA level.
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<p><b>BACKGROUND</b>Bone grafting is commonly used to repair bone defects. As the porosity of the graft scaffold increases, bone formation increases, but the strength decreases. Early attempts to engineer materials were not able to resolve this problem. In recent years, nanomaterials have demonstrated the unique ability to improve the material strength and toughness while stimulating new bone formation. In our previous studies, we synthesized a nano-scale material by reinforcing a porous β-tricalcium phosphate (β-TCP) ceramic scaffold with Na2O-MgO-P2O5-CaO bioglass (β-TCP/BG). However, the in vivo effects of the β-TCP/BG scaffold on bone repair remain unknown.</p><p><b>METHODS</b>We investigated the efficacy of β-TCP/BG scaffolds compared to autografts in a canine tibiofibula defect model. The tibiofibula defects were created in the right legs of 12 dogs, which were randomly assigned to either the scaffold group or the autograft group (six dogs per group). Radiographic evaluation was performed at 0, 4, 8, and 12 weeks post-surgery. The involved tibias were extracted at 12 weeks and were tested to failure via a three-point bending. After the biomechanical analysis, specimens were subsequently processed for scanning electron microscopy analysis and histological evaluations.</p><p><b>RESULTS</b>Radiographic evaluation at 12 weeks post-operation revealed many newly formed osseous calluses and bony unions in both groups. Both the maximum force and break force in the scaffold group (n = 6) were comparable to those in the autograft group (n = 6, P > 0.05), suggesting that the tissue-engineered bone repair achieved similar biomechanical properties to autograft bone repair. At 12 weeks post-operation, obvious new bone and blood vessel formations were observed in the artificial bone of the experimental group.</p><p><b>CONCLUSIONS</b>The results demonstrated that new bone formation and high bone strength were achieved in the β-TCP/BG scaffold group, and suggested that the β-TCP/BG scaffold could be used as a synthetic alternative to autografts for the repair of bone defects.</p>
Subject(s)
Animals , Dogs , Female , Autografts , Bone Substitutes , Chemistry , Ceramics , Fibula , Wounds and Injuries , General Surgery , Hydroxyapatites , Chemistry , Tibia , Wounds and Injuries , General Surgery , Tissue Engineering , Methods , Tissue Scaffolds , ChemistryABSTRACT
The outcome of patients with malignant middle cerebral artery infarction (mMCAI) is very poor.The mortality of conservative medical treatment is as high as 80％.Several randomized controlled trials published in recent years have shown that hemicraniectomy can significantly reduce the mortality of mMCAI.It is a life-saving therapeutic measure for patients,even if so in patients older than 60 years of age.
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Objective To investigate the immune tolerance in animal models of primary biliary cirrhosis (PBC) by determining the cell proliferation and activation induced cell death (AICD).Methods C57BL/6 mice were injected with 5 mg/kg of polyI:C to develope PBC models. The lymphocytes and CD4~+ T cells were separated from spleens and livers 16 weeks later and were stimulated by M2, conA and anti-CD3 for cell proliferation and AICD. Expression of apoptosis related genes and proteins were detected by real time polymerase chain reaction (PCR) and Western blotting, respectively. Results ① The lymphocyte proliferation was 0.1988 ± 0.0111 in blank controls and 0. 2068±0. 0115 in PBS treated mice with no significant difference (P>0.05). However, an abundant lymphocyte proliferation was found in PBC mice (0. 358 ± 0. 022), which was higher than that in controls and PBS treated mice. The proliferation of lymphocyte from liver was greater than that from spleen in PBC mice (P<0.01). ② The apoptotic rate in blank controls (74.70%±4.58%) and PBS treated mice (74.20%±4.44%) was higher than that in PBC mice (44.85%±6.47%,P<0.01),but no difference was found between blank controls and PBS treated mice (P>0.05). Furthermore, the apoptosis rate of T cells from livers were significantly lower than that from spleens in PBC mice (P<0.01). ③ The expressions of FasL and tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) in PBC mice were lower than those in PBS treated mice (P<0. 01), but there was no change in expression of Fas was found. ④ The expression of Fas-associated death domain-like interleukin-1-β-converting enzyme-inhibitory protein (FLIP_L) in PBC mice was higher than that in blank controls. Moreover, the expression of FLIP_L in livers was higher than that in spleens in PBC mice (P<0. 01). Conclusios The elevated expression of FLIP_L may inhibit AICD. Besides, the decreased expressions of FasL and TRAIL may also help in the enhancement of the anti-apoptotic ability in lymphocytes and in the aggravation of portal area inflammation.
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Objective To discuss indications,operation method and clinical outcome of posterior short-segment pedicle fixation at the injured level for treatment of thoracolumbar spine fractures.Methods A total of 38 patients with thoracolumbar spine fractures were equally randomized to Group A(treated with classic short-segment pedicle screw fixation)and Group B(treated with short-segment pedicle screw fixation at the injured level)based on fixation methods(19 patients per group).Preoperative and postoperative JOA score,segmental lordosis(Cobb' s angle),R value(anterior fractured vertebral body height/mean normal vertebral body height×100%),VSA score and internal fixation condition were assessed and compared clinically.Results All patients were followed up for 6-37 months(mean 20.5 months),which showed no statistical difference upon Frankel scores of two operation modes,while the segmental lordosis,VAS score and R value in Group B were than those in Group A.There occurred nuts loosening in one patient and screw bending in one in Group A.There was no implant breakage,loosening or emersion in Group B.Conclusion Posterior short-segmental fixation at the injured level is an adequate and effective procedure for compression fractures and mild to moderate burst fractures of the thoracolumbar spine.
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Objective To evaluate neurofunctional and radiographic results of transpedicular screw fixation reduction and anterior column fixation with use of screw-red system in treatment of multiple segment lumbar pedicle and vertebral body fractures combined with spondylolisthesis. Methods A consecutive series of 12 patients with unstable multiple segment lumbar pedicle fracture, vertebral body fracture, spondylolisthesis and neurologic deficit were managed with posterior transpedicular screw fixation including fractured pedicle and anterior screw-rod fixation instrumentation from January 2002 to December 2007. Results Patients were followed up for 24-30 months (mean 26 months). All the patients with incomplete neurologic deficits got improvement by at least one Frankel grade. Transpedicular screw brought satisfactory reduction. At the time of the latest follow-up, no screw breakage occurred. Con-clusions Excellent reduction of unstable multiple segment lumbar pedicle fractures combined with spon-dylolisthesis can attain better reduction and maintenance by means of selective pedicle screw fixation via fractured pedicle and anterior screw-rod instrument.
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Craniocervical unstability may cause severe motor and respiratory compromise due to recurrent upper spinal cord and/or brain stem impingement.In recent years,by improving internal fixation materials and surgical techniques,the methods of surgical treatment of craniocervical unstability has made great progress.With the appearance of these new surgery and internal fixation methods,the successful rate and safety of the operation obviously increased and the complications was reduced greatly.We reviewed the surgery methods for craniocervical unstability in this article.