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Self-organized blastoids from extended pluripotent stem (EPS) cells possess enormous potential for investigating postimplantation embryo development and related diseases. However, the limited ability of postimplantation development of EPS-blastoids hinders its further application. In this study, single-cell transcriptomic analysis indicated that the "trophectoderm (TE)-like structure" of EPS-blastoids was primarily composed of primitive endoderm (PrE)-related cells instead of TE-related cells. We further identified PrE-like cells in EPS cell culture that contribute to the blastoid formation with TE-like structure. Inhibition of PrE cell differentiation by inhibiting MEK signaling or knockout of Gata6 in EPS cells markedly suppressed EPS-blastoid formation. Furthermore, we demonstrated that blastocyst-like structures reconstituted by combining the EPS-derived bilineage embryo-like structure (BLES) with either tetraploid embryos or tetraploid TE cells could implant normally and develop into live fetuses. In summary, our study reveals that TE improvement is critical for constructing a functional embryo using stem cells in vitro.
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Pregnancy , Female , Animals , Mice , Tetraploidy , Blastocyst , Embryo, Mammalian , Cell Differentiation , Embryonic DevelopmentABSTRACT
Objective:To investigate the clinical efficacy of oblique lateral interbody fusion (OLIF) combined with lateral plate (LP) fixation and posterior lumbar interbody fusion (PLIF) combined with pedicle screw fixation in the treatment of adjacent segment disease (ASDis).Methods:Data of 21 ASDis patients treated with OLIF-LP from August 2016 to October 2019 were selected, including 9 males and 12 females; age was 59.3±7.0 years (range, 46-71 years). Target segments: L 2, 3 1 cases (4.8%), L 3, 4 16 cases (76.2%), L 4, 5 4 cases (19.1%). Twenty-one ASDis patients matched with age, sex and surgical segment and treated with PLIF were selected as the control group. The operation time, intraoperative bleeding, postoperative hospital stay, visual analogua scale (VAS), Oswestry disability index (ODI), disc height (DH), intervertebral foramen height (IFH) and lumbar lordosis (LL) were compared between the groups were tested by t-test. VAS score, ODI, DH, IFH and LL were compared within the group by ANOVA, and Bonferroni's test was used for pairwise comparison. Results:All of 42 patients were followed up for 23.7 ±7.4 months (range, 12-36 months). The operation time (97.6 ± 18.0 min) and interpretative bleeding (38.5±62.7 ml) in OLIF-LP group were significantly lower than those in PLIF group (operation time 154.6±42.4 min) and interpretative bleeding (288.6±55.3 ml). There were significant differences between two groups ( t=5.66, P<0.001; t=8.23, P<0.001); the postoperative hospital stay 4.4±1.3 d in OLIF-LP group was longer than that in PLIF group 5.1±1.2 d, but there was no significant difference ( t=1.93, P=0.061); VAS score in OLIF-LP group at 1 month and 3 months after operation (1.6 ± 0.9 points, 1.4 ± 0.8 points), and the ODI index (29.4%±4.7%) after one month operation was improved better than that of PLIF group ( t=2.48, P=0.017; t=2.35, P=0.024; t=2.28, P=0.029), but there was no significant difference between the 12 months after operation of two groups ( t=0.99, P=0.329; t=0.86, P=0.395). The immediately after operation, 3 months after operation and 12 months after operation of DH, IFH and LL in the two groups were significantly improved compared with those before operation ( P<0.05). The immediately after operation, 3 months after operation and 12 months after operation of DH and IFH in the OLIF-LP group were better than those in the PLIF group ( P<0.05), while LL had no significant difference ( P>0.05). There were 2 cases (9.52%) in each group with cage sinking, but no clinical symptoms occurred. In the OLIF-LP group, there was no injury of blood vessels, nerves or abdominal organs during operation, and 2 patients had transient lower limb pain after operation; In the PLIF group, 2 cases (9.52%) of dural rupture were repaired during operation, and no cerebrospinal fluid leakage occurred after operation; Postoperative lower limb pain was aggravated in 3 cases, and improved after dehydration, anti-inflammatory and analgesic treatment; 2 cases of incision exudation healed after symptomatic treatment. Conclusion:OLIF combined with LP fixation has the same clinical effect as PLIF in the treatment of lumbar ASDis, but OLIF combined with LP fixation has more advantages in surgical trauma, postoperative recovery and related complications.
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Objective@#To explore the effects and correlation of gross motor intervention on social skills of autistic children. To provide new ideas for rehabilitation intervention of autistic children s social ability.@*Methods@#Recruiting 23 autistic children through WeChat in Nanchang, randomly divided into experimental groups (n=13) and control group (n=10). The experimental group underwent 6 weeks of large muscle exercise intervention, in the control group, Test of Gross Motor Development 3 (TGMD3), Social Responsiveness Scale(SRS) and the Autism Social Skills Scale (ASSS) examined changes in social skills, and analyze the relationship between sports and social ability.@*Results@#TGMD-3 score in the intervention group before intervention was (34.31±9.79) and increased significantly after intervention (59.77±13.92)(t=-15.28, P<0.01). There was no statistical significance before and after experiment in the control group (P>0.05). The scores of SRS and ASSS in the experimental group were (96.77±15.79, 97.31±29.22) before the intervention, and (82.92±15.86, 117.62±24.93) after the intervention, and the differences were statistically significant(t=4.55, -5.61, P<0.01). The difference between the SRS and ASSS scores of the control group before and after experiment was not statistically significant(P>0.05). Both the TGMD-3 score and the object manipulation score were related to the SRS total score (r=-0.49, -0.45) and ASSS total score(r=0.54, 0.51)(P<0.05).@*Conclusion@#Gross motor intervention can improve the motor and social skills of children with autism, and there is a positive correlation between motor ability and social skills in children with autism.
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Objective@#To understand the concern of freshmen with different characteristics on sexual knowledge in Sichuan province and to provide evidence for comprenensive sex education in colleges.@*Methods@#A survey was conducted among 2 532 freshmen from 13 universities in Sichuan Province in September 2018. Attention to specific sexual knowledge among students with different characteristics was analyzed.@*Results@#Sexual knowledge that the freshmen concerned included partner communication (39.25%~55.10%), STD and AIDS (37.78%~44.85%) and gender equality (33.33%~43.34%). Logistic regression results showed that male students payed more attention to partner communication(OR=0.77,95%CI=0.65-0.91), masturbation (OR=0.36，95%CI=0.27-0.47) and sexual minorities (OR=0.61,95%CI=0.41-0.90), while female students payed more attention to gender equality (OR=1.31,95%CI=1.10-1.57), sexual harassment and violence (OR=1.65,95%CI=1.37-1.98). Rural students pay. more attention to partner communication (OR=0.79,95%CI=0.65-0.94), while urban students pay. more attention to masturbation (OR=1.50,95%CI=1.08-2.08), sexual harassment and sexual violence (OR=1.30,95%CI=1.07-1.58). Students who had sex were more concerned about contraception and unwanted pregnancy than those who had not (OR=0.53,95%CI=0.39-0.72). Sexual minority students were more concerned about topic of sexual minorities than heterosexual students (OR=3.50,95%CI=2.30-5.33).@*Conclusion@#College freshmen with different characteristics varied in their concern on sexual knowledge, which is related to their needs. It is suggested that schools set up comprehensive education courses according to the needs of students, the content of sex education knowledge can be focused, and carry out comprehensive and targeted sex education.
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Objective:To detect the changes of serum complement factors C3 and C4 in diabetic retinopathy (DR) patients, and to explore their role in the occurrence and development of DR.Methods:A cases-controlled study was carried out.Total of 195 patients with DR diagnosed in the First Affiliated Hospital of Harbin Medical University from December 2017 to December 2018 were selected as the DR group, 150 patients with type 2 diabetes were included as the diabetes group, and 281 simple age-related cataract or strabismus patients were collected at the same time and served as control group.Fasting venous blood was collected and serum was isolated.The concentration of C3 and C4 in serum was determined by immunoturbidimetry.The contents of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were determined by rate method, and the contents of total cholesterol and triglyceride were determined by enzyme method.Pearson linear correlation analysis was used to evaluate the correlation between serum complement factors and clinical parameters.Stepwise regression analysis was used to evaluate the influencing factors of complement factor C3 and C4 expression.This study adhered to the tenets of the Declaration of Helsinki and was approved by the Ethical Committee Review Board of the First Affiliated Hospital of Harbin Medical University(No.2016-81500711).Results:The concentration of serum complement factor C3 in the diabetes group was (1 154.0±177.4)mg/L, which was significantly higher than (1 077.3±177.0)mg/L in the DR group and (1 072.0±184.3)mg/L in the control group, the differences were statistically significant (all at P<0.05); The concentration of serum complement factor C4 in the DR group was (287.5±83.5)mg/L, which was significantly higher than (257.5±70.1)mg/L in the diabetes group and (263.7±77.2)mg/L in the control group, the differences were statistically significant (all at P<0.05). The correlation analysis results showed that the expression level of complement factor C3 was weakly positively correlated with total cholesterol and triglyceride in the diabetes and DR groups (diabetes group: r=0.250, P<0.05; r=0.205, P<0.05.DR group: r=0.308, P<0.01; r=0.213, P<0.01); The expression level of complement factor C4 was weakly positively correlated with total cholesterol and triglyceride in the DR group ( r=0.235, P=0.002; r=0.247, P=0.001). Multiple regression analysis showed that total cholesterol and triglyceride were the influencing factors of serum C3 and C4 expression in the DR group. Conclusions:Complement factors may participate in the pathological process of DR and serum complement factors C3 and C4 are affected by serum total cholesterol and triglyceride in DR patients.
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Posterior capsule opacification (PCO) is the most common complication of extracapsular cataract extraction and intraocular lens implantation in the long-term.After cataract surgery, the content of growth factor in aqueous humor increased, which induced excessive hyperplasia, migration and fibrosis of lens epithelial cells (LECs), resulting in posterior capsular opacity and decreased vision.PI3K/AKT/MTOR signaling pathway is an important pathway regulating cell growth, cell cycle, protein and ribosome synthesis, which plays a crucial role in the occurrence and development of PCO.The mammalian target of rapamycin (mTOR) is a key site for regulating the protein expression in the downstream of PI3K/AKT signaling pathway.The application of mTOR inhibitor to interfere with the signaling pathway and affect the biological function of LECs is expected to provide a new idea for the prevention and treatment of PCO.This paper described the research progress of the role of mTOR signaling pathway and mTOR inhibitors in the occurrence and development of PCO.
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Objective To construct a dual-luciferase reporter gene vector and validate the targeting relation ship between miR-299 and the COL4A3 gene,laying a foundation for the study on the effect of miR-299 in the chondrogenic differentiation of stem cells by regulating the COL4A3 gene.Methods This study was made from March,2018 to December,2018.Firstly,the potential binding sites between miR-299 and COL4A3-3'UTR were pre dicted using bioinformatics.Then,the wild and mutant COL4A3-3'UTR sequences were amplified by PCR and cloned into psiCHECK-2 plasmid to construct corresponding recombinant vectors.The vectors were validated by enzyme digestion and gene sequencing.Finally,the cells were resuscitated,amplified,transfected and divided into 4 groups:COL4A3-WT+miR-299/NC group,COL4A3-WT+miR-299-inhibitor/NC-inhibitor group,COL4A3-MUT+miR-299/NC group and COL4A3-MUT+miR-299-inhibitor/NC-inhibitor group.Each group contains 3 holes,respectively.Luciferase activity in each group was determined using a dual-luciferase assay kit.The statistical analysis was conducted and differences between groups were compared by t test.Probabilities lower than 5％(P＜0.05) were considered statistically significant.Results Enzyme digestion and DNA sequencing showed that the dual-luciferase reporter gene vector of psiCHECK-2-COL4A3 was constructed successfully.Luciferase assay demonstrated that in wild COL4A3 gene,luciferase activity reduced in the miR-299 transfection group (The average R/F value was 59.38％) compared with the NC group (The average R/F value was 100.00％),with a statistical significant difference (P＜0.05).In wild COL4A3 gene treated with inhibitor,luciferase activity increased in the miR-299-inhibitor group (The average R/F value was 153.98％) compared with the NC-inhibitor group (The average R/F value was 100.00％),with a statistical significant difference (P＜0.05).In mutant COL4A3 gene treated with inhibitor,no obvious statistical differences in luciferase activity were found between miR-299 transfection group (The average R/F value was 102.09％),miR-299-inhibitor group (The average R/F value was 108.51％) and NC group (The average R/F value was 104.70％),NC-inhibitor group (The average R/F value was 105.13％) and/9＞0.05.Conclusion The dual-luciferase reporter gene vector of the 3'UTR of the COL4A3 gene is constructed successfully.In addition,dual-luciferase assay further verifies the authenticity of miR-299 directly targeting the 3'UTR of the COL4A3 gene.
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Objective To investigate the efficacy and accuracy of 3D printing individualized navigation templates used in shoulder hemi-arthroplasty (HA).Methods We collected 9 adult cadaveric specimens of 18 shoulders with no obvious deformities or defects.After CT scanning was conducted on bilateral shoulders,the raw CT data in DICOM format were imported into software Mimics 10.01 and Imageware 12.0 to reconstruct 3D shoulder models.The retroversion angles and heights of bilateral humeral heads were measured to design individualized navigational templates using software Geomagic Studio 12.0.Rapid prototyping (RP) technique was used to manufacture the individualized navigation templates which were then used to assist shoulder HA in cadaveric specimens.CT scanning was performed postoperatively to measure the retroversion angle and height of the prosthesis implanted for comparison with the preoperative measurements.Results Before shoulder replacement in the 9 cadaveric specimens,respectively,the heights of left and right humeral heads averaged 300.0 ± 11.6 mm and 300.0 ± 11.4 mm,and the retroversion angles 15.6°±4.9° and 15.9°± 4.9°.After the replacement,the heights of left and right humeral heads averaged 300.0 ± 11.3 mm and 300.0 ± 11.7 mm,respectively,and the retroversion angles 15.7° ± 4.9° and 15.8° ± 5.2°,respectively.There were no significant differences between the left and right sides in the pre-or post-operative heights or retroversion angles of the humeral head (P ＞ 0.05).There were no significant differences either between preand post-operation in the heights or retroversion angles of the left and right humeral heads (P ＞ 0.05).The mean errors for the preoperative and postoperative heights and retroversion angles of the humeral heads were 1.44 ± 0.96 mm and 0.25° ± 0.15°,respectively.Conclusion Individualized navigation templates 3D printed can be used to assist effective and accurate shoulder HA because they are designed and manufactured according to accurate measurements of retroversion angles and heights of the humeral heads which are acquired by computer preoperatively.
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Objective To characterize the spinal motion of 6 degrees of freedom (6DOF) under the fulcrum bending in Lenke type 1 adolescent idiopathic scoliosis (AIS) patients using 3D image volume fusion technique.Methods Ten volunteers with Lenke type 1 AIS were examined by the Gemstone Spectral Imaging to obtain their T1-S1 vertebral morphological data in the supine position and fulcrum bending position.With the computer software,images of 2 different positions were fused with the 3D image to obtain in vivo kinematics data of each vertebral body in the target area.Results In the apical vertebrae (AV) region,the main range of motion in the fulcrum bending position ranged from-2.57°± 0.95° to-1.37°± 0.65°,showing significant differences between segments (P ＜ 0.05);along the vertical axis the coupling rotation ranged from-2.71° ± 0.48° to-1.27° ± 0.49°;along the coronal axis,the coupling flexion and extension ranged from 0.19° ± 0.85° to 1.51° ± 0.42°.In the upper end vertebrae (UEV) area,the main ROM ranged from-2.20° ± 1.13° to-1.91° ± 0.76°,showing no significant differences between the 3 segments (P ＞ 0.05);along the vertical axis,coupling rotation ranged from 0.18°±0.47° to 1.35°±0.52°;along the coronal axis,coupling flexion and extension ranged from 1.62° ± 0.41° to 2.07° ± 0.37°.In the lower end vertebrae (LEV) region,the main movement ranged from-0.79°± 0.63° to 0.73°± 1.09°,showing significant differences between the 3 segments (P ＜ 0.05);along the vertical axis,the coupling rotation ranged from-1.62°± 1.05° to-0.60°± 0.60°;along the coronal axis,the coupling flexion extension ranged from -1.41° ± 0.87° to-0.75° ± 0.66°.Conclusionts In the fulcrum bending position,Lenke type 1 AIS shows a unique motion and coupling mechanism in the spine.The coupling rotational movement in the UEV region is at the same side as the lateral flexion movement.The coupling rotational motion in the AV and LEV regions is opposite the lateral flexion movement.
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Background:Gastrointestinal dysmotility is commonly seen in individuals exposed to acute plateau hypoxia. Its pathogenic mechanism is still not clear and intervention study is rarely performed. Aims:To investigate the influence of plateau hypoxia on small intestinal motility of rats,its possible mechanism,and the intervention effect of raw Atractylodes macrocephala. Methods:Seventy Wistar rats were randomly divided into 7 groups:control group,two high altitude model groups(3 500 m and 5 000 m),trimebutine and raw Atractylodes macrocephala groups at 3 500 m or 5 000 m altitude. Rats in six experiment groups were placed in a hypobaric chamber mimicking 3 500 m or 5 000 m altitude and given trimebutine/ raw Atractylodes macrocephala/ saline intragastrically for 3 days. Then all the rats were lavaged with 2 mL ink and sacrificed 30 minutes later. The propulsion rate of ink in small intestine was measured,the pathological changes of small intestine tissue were examined,and the expression of 5-HT4 receptor was determined by immunohistochemistry. Results:Compared with control group,the propulsion rate of small intestine and immunopositive area of 5-HT4 receptor were reduced in model group at 3 500 m altitude,while those in model group at 5 000 m altitude were increased(P ﹤0. 05). Moderate-to-severe mucosal injury was observed in two model groups. In model rats treated with raw Atractylodes macrocephala,the abnormalities in small intestine propulsion and 5-HT4 receptor induced by high altitude(3 500 m and 5 000 m)returned to the control level(P ﹤ 0. 05),and the mucosal injury ameliorated simultaneously. Efficacy of raw Atractylodes macrocephala was prior to trimebutine,a positive control. Conclusions:Acute plateau hypoxia may induce small intestine dysmotility with diverse manifestations,and altitude is a crucial determinant in this process. Raw Atractylodes macrocephala can exert therapeutic effect on this dysmotility by modulating 5-HT4 receptor,and it is also effective in repairing mucosal injury.
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This study was aimed to explore pharmacological effects of epimedium pubescen flavonoid (EPF) on biomechanical properties among ovariectomized rats. Sixty female Sprague-Dawley (SD) rats (aged 2-month-old) were randomly divided into six groups (n = 10), which were the sham control group (Group A), the model group (GroupB), the standard group (Group C), the treated 1 group (Group D), the treated 2 group (Group E), and the treated 3 group (Group F). Except the sham control group (Group A), rats in other groups had been ovariectomized. All rats were given the same feedstuff. Meanwhile, Group C was given calcium 75 mg·kg-1 combined with VitD3 21 IU·kg-1 by gastrogavage every day for 4 months; Group D was given EPF 75 mg·kg-1; Group E was given EPF 150 mg·kg-1;Group F was given EPF 300 mg·kg-1. At the end of the 4th month, all rats were sacrificed. Bones, which included tibia, femur and humerus of both sides and all lumbar vertebra bodies, had been taken out. Measurement was made on the elastic modulus, maximum loading capability, maximum stress, potential energy of deformation, and structural rigidity of biomechanical properties of the fourth lumbar vertebra body (LV4); the maximum loading capability, bone break load, potential energy of deformation, structural rigidity of the structural dynamics properties of the femur com-pact bone; the elastic modulus, maximum stress, maximum inherent strain, bone break stress, and bone break strain of the mechanical properties of a material of the femur compact bone in the experimental rats. The results showed that compared with Group B, the elastic modulus, maximum loading capability, maximum stress, potential energy of deformation, and structural rigidity of LV4; the maximum loading capability, bone break load, potential energy of de-formation, structural rigidity of the structural dynamics properties of the femur compact bone; the elastic modulus, maximum stress, maximum inherent strain, and bone break strain of the mechanical properties of a material of the fe-mur compact bone were obviously increased in Group A, D, E and F (P< 0.05). Group C had increasing tendency. There were no statistical differences among Group A, C, D, E and F. Group D, E, and F had increased with EPF dose-dependently. However, there were no statistical differences among them. There were no statistical differences on bone break strain of the mechanical properties of a material of the femur compact bone among Group A, C, D, E, and F. It showed that ovariectomization reduced the biomechanical properties of vertebra bodies, structural dynamics properties of the femur compact bone, and the mechanical properties of a material of the femur compact bone. The application of EPF can effectively prevent and treat the decreasing of biomechanical properties of ovariectomized rats, so as to keep them in a relatively higher level.
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BACKGROUND:Active surgical treatments are preferred for elderly hip fractures. Individual fixation method is chosen according to fracture site, type, age and whether there are basic diseases in internal medicine, which plays an important role in the successful treatment of elderly hip fractures. OBJECTIVE:To explore the effects of optimized surgical treatment on osteoporotic hip fracture in the elderly. METHODS: Totally 176 patients with osteoporotic hip fracture were treated by different methods between January 2000 and January 2012, including 63 males and 113 females, with a mean age of (76.7±6.3) years. Out of the 84 cases of interchanteric fracture, seven cases were treated with conservative methods, 34 cases were treated with dynamic hip screw internal fixation, 18 cases were treated with cannulated screw internal fixation, seven cases were treated with anatomical plate internal fixation, 12 cases were treated with bipolar femoral placement, and six cases were treated with total hip arthroplasty. Out of the 92 cases with femoral neck fractures, 40 cases were treated with bipolar femoral placement, 37 cases were treated with total hip arthroplasty and 15 cases were treated with cannulated screw internal fixation. Modified Harris hip function scores were used to evaluate the therapeutic effects of different treatment methods. Complications were observed. RESULTS AND CONCLUSION:Seventy-six cases of interchanteric fractures and 85 cases of femoral neck fractures were fol owed-up for 8-26 months with an average of (5.7±1.3) months. Three cases suffered from post-operative infection, and one case died due to cardio-pulmonary failure in 10 days after operation. Both intraoperation and postoperative complications included femoral head cutting, intraoperative fracture, internal fixation and prosthetic loosening, postoperative fracture, avascular necrosis of femoral head, coxa vara, legs shorten, and delayed fracture healing. The incidence rates of complications in patients undergoing bipolar femoral placement and total hip arthroplasty were significantly lower than those treated with conservative methods, dynamic hip screw internal fixation, cannulated screw internal fixation, and anatomical plate internal fixation (P0.05). No significant differences were found in the incidence rate of complications and Harris scores between patients treated with bipolar femoral placement and total hip arthroplasty (P>0.05). These findings indicate that the treatment of osteoporotic hip fracture in the elderly can achieve satisfactory results if the comprehensive therapies are given. Bipolar femoral placement and total hip arthroplasty are preferred for elderly femoral neck fractures.
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ObjectiveTo explore the efficacy and safety of bone marrow mesenchymal stem cells (BMSC)in treatment of aplastic anemia(AA). MethodsTwenty-two patients with aplastic anemia were enrolled with median age of 31 (12-70) years old,including 11 severe aplastic anemia (SAA),and 3 of whom were cyclosporine and anti-thymocyte globulin-resistant. BMSC were isolated from bone marrow of healthy donors and cultured.The third to fifth generation cells were administered intravenously in 1×106/kg to patients once or twice a week.After infusion,complete blood count,bone marrow aspiration,bone marrow biopsy,flow cytometry analysis of lymphocyte subsets of CD3+ CD4+ and CD3+ CD8+ and clinical symptoms were involved in outcome measurement.ResultsAll patients finished 16-time median (5-83 times) infusions of BMSC with 13-month median (2-33 months) treatment course and 23-month median (2-34 months) follow-up.The total response rate was 72.7 ％(16/22), including one patient with essential cure, 9 with remission, 3 with remarkably improvement and 3 with transfusion interval extension.Two of three front-line immunosuppressiveresistant SAA patients achieved remission. Ten of 14 patients recovered from inverted ratio of CD4+/C8+ cells after BMSC treatment. There were no treatment-related side effects observed in the course of treatment.ConclusionBMSC are effective and safe for the treatment of AA in our preliminary study and they deserve further research with larger-scale and long-term clinical trials.
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Objective To explore the effect of prevention of hemorrhagic cystitis (HC) after hematopoietic stem cell transplantation (HSCT) with hyperhydration, forced diuresis and alkalinizing plus infusion mesna. Methods 32 cases of patients receiving HSCT were included in this study. 2 cases of severe aplastic anemia (SAA) received total body irradiation (TBI)+cyclophosphamide(CTX)(TBI-CTX) regimen,and the remaining 30 patients were using the classic busulfan+CTX (BU+CTX) regimen. All patients were treated with mesna combined with hydration, forced diuresis and alkalization to prevent HC. Ganciclovir and acyclovir were used to prevent cytomegalovirus (CMV) and other viral infections and monitor CMV-IgM levels of the blood. Encourage patients to urinate every hour, testing urine pH value and the calculation of urine output, every 6 h review and testing of urine routine,central venous pressure (CVP), each of 8 h of serum electrolytes. Results Only 1 patient at 6 months after transplantation appeared delayed grade Ⅱ HC after hydration, alkalization, diuretic, hemostatic, anti-graft-versus-host disease (GVHD), and ganciclovir antiviral therapy. The HC patients cured at 35 d. The remaining patients did not suffer HC. Adverse effects such as acid-base balance disturbance did not appear clear. Conclusion Mesna joint hydration, forced diuresis and alkalization was effective and safe to prevent HC.
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Objective To investigate the treatment effects of dahuang gancao decoction on lung Injury complicated by acute necrotizing pancreatitis and explore its mechanism. Methods 90 Wistar rats were randomly divided into 3 groups, namely sham-operated group (SO), ANP group (ANP), dahuang gancao decoction treatment group (DG). 4% sodium taurocholate was injected into the pancreatic duct to induce ANP. Dahuang gancao decoction(0.25 g/ml) 0.6 ml/100 g weight was gavaged in the DG group, the same volume of normal saline was gavaged in the SO and ANP group, which was repeated 12 h later. After 6 h, 12 h, 24 h, all rats were sacrificed, pancreas and lung tissues were harvested to observe the pathological changes and the pathological changes were scored. IL-6, IL-10, TNF-α levels of serum and lung tissue were measured,and the changes of toll-like receptor 4 (TLR4) expression in lung tissue was determined by immunohistochemical method. Results 12 h after ANP induction, the serum levels of IL-6 in SO, ANP, DG group were (14.4±4.0)pg/ml, (171.4 ±41.3)pg/ml, (156.9 ±34.7)pg/ml; the serum levels of IL-10 were (13.7 ±4.5)pg/ml, (120.5 ±23.7)pg/ml, (148.3 ±44.4)pg/ml; the serum levels of TNF-α were (22.4 ±4.7)pg/ml, (261.3 ±51.4)pg/ml, (235.3 ±45.9)pg/ml; the lung tissue levels of IL-6 were (257.3 ±55.9)pg/ml,(2578.3 ±403.0)pg/ml,(2370.0 ±491.0)pg/ml; the lung tissue levels of IL-10 were (80.8 ±20. 8)pg/g, (642.0 ± 107.3)pg/g, (695.3 ± 151.7) pg/g, the lung tissue levels of TNF-α were (207.6 ±98.6)pg/g, (1769.1 ±635.6) pg/g, (1401.1 ±450.5) pg/g; the pancreas pathological scores were 0, 7.00 ±1.33, 6.30 ± 0.95; the lung pathological scores were 0, 6.30 ± 1.42, 5.60 ± 0.97; the expressions of TLR4in lung tissue were 0.09 ± 0. 03, 0.59 ± 0. 09, 0. 52 ± 0. 08. The values in the ANP and DG groups were significantly higher than those in SO group (P < 0. 01 ); except for IL-10, all values in the DG groups were significantly lower than those in ANP group (P < 0.05); there was a positive association between lung and pancreas scores (r =0.807, P<0.01), and lung score was positively associated with the expression of TLR4(r = 0.519, P < 0.01 ). Conclusions Dahuang ganeao decoction may quickly improve lung injury complivated by ANP. The mechanism may involve inhibiting the expression of TLR4 and down-regulating the expression of IL-6, TNF-α, up-regulating the. Expression of IL-10.
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BACKGROUND: Differentiation of bone marrow mesenchymal stem calls(BMSCs) is associated with their microenvironment. After acute myocardial infarction (AMI), the necrosis of cardiomyocytes caused activation of complement, generation of free radical, and secretion of various cell factors. As a result, the ingredients of patients' serum also changed, so does the changes will influence the differentiation of BMSCs into cardiomyocytes? And what influence it will be? OBJECTIVE: To investigative effects of AMI rat serum on the differentiation of BMSCs into cardiomyocytes. DESIGN, TIME AND SETTING: The in vitro controlled cytology experiment was performed at the Laboratory of Center for Stem cells and Tissue Engineering, Sun Yat-sen University from September in 2005 to June in 2006. MATERIALS: SPF Sprague Dawley rats, weighing 50-80 g, aged 3-4 weeks, were used for culture of BMSCs, and SpragueDawley rats, weighing 200-300 g, aged 6-8 weeks, were used for making AMI models. METHODS: BMSCs were isolated and cultured with the adherent method. After making AMI rat models by deligating anterior descending of the left coronary artery, the serum were collected and centrifuged from AMI and normal rats. Then the passage 3 of BMSCs were divided into six groups, non-induction group, 5-azacytidine (5-aza) group, 5-aza plus serum from AMI rat group, 5-aza plus serum from normal rat group, serum from AMI rat group, and serum from normal rat group. MAIN OUTCOME MEASURES: Morphology changes in rat BMSCs after induction; Expression of cardiac troponin T of BMSCs after induction; Expression of GATA-4 and desmin mRNA of BMSCs after induction. RESULTS: After being induced by 5-aza and two kinds of serum, some cells became elongated and thinner. Two to three weeks after induction, some cells had a ball-like or rod-like appearance, and connection were formed between adjacent cells. It showed that some BMSC have differentiated into cardiac like cells. The expression of cardiac troponin T, GATA-4 and desmin were positive in cells differentiated from BMSCs. The troponin T expression in control group and simple serum induction group were negative, but GATA-4 and desmin expressed weakly. CONCLUSION: Serum from AMI rat cannot induce BMSCs to differentiate into cardiomyocytes alone, but it promotes BMSCs induced by 5-aza differentiating into cardiomyocytes and facilitates the differentiated calls into mature.
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BACKGROUND: Thoracolumbar burst fracture Dennis type B does not have significant damage in the intervertebral discs of the inferior vertebral body. To reduce fusion segment and remain normal intercalated disc, single discectomy (damaged vertebral body and supervisor vertebral body) is proposed, but because of the damage to the vertebral body, implanted screw is easy to loose following excising partial vertebral body, even cannot be fixed. However, it is still unknown whether implanted screw in the inferior vertebral body of the damaged vertebral body was stabilized using two segment discectomy with fixation.OBJECTIVE: To analyze the feasibility of single segmental spinal interbody fusion with bisegment fixation for thoracolumbar burst fracture type B.DESIGN, TIME AND SETTING: The randomized controlled in vitro study was conducted at the Laboratory of Biomechanics, Southern Medical University from June 2007 to June 2008.MATERIALS: A total of 20 fresh freezing 7-9 months pig samples (T_(13)?L_3 segment) were used, comprising 10 integral samples and 10 L_1 type B thoracolumbar burst fracture samples prepared by pre-injury and weight dropping technique.METHODS: Pig fresh thoracolumbar specimens from T_(13)?L_3 were collected to create models of type B thoracolumbar burst fracture. There were 4 groups in this study. Ten of them were selected as intact group (n=10) (fresh pig T_(13)?L_3 segment). T_1 vertebral endplate pre-injury and weight dropping technique and incremental trauma approach were used. Denis' type B burst fracture was produced, and ten of them were selected as unstable group (n=10). Firstly, unstable group was decompressed by discectomy and semivertebraectomy in upper half of the vertebral body, single level was fused with iliac and U-FRONT anterior thoracolumbar system were placed between T_(14) and L_2, as single discectomy with fixation group (n=10). Then lower disc of injury vertebra discectomy and vertebraectomy, fused with iliac U-FRONT anterior thoracolumbar system were placed between T_(14) and L_2, as two segment discectomy with fixation group (n=10). The bone graft was longer 1 mm than the bone graft region.MAIN OUTCOME MEASURES: The flexion, extension, right/left lateral bending, and right/left axial rotation range of motion (ROM) of T_(14)?L_2 were measured in each group on the spinal three-motional test machine at 10 N穖.RESULTS: The flexion, extension, right/left lateral bending, and right/left axial rotation were not stable in the unstable group.ROM was significantly increased in the unstable group compared with the intact group (P< 0.01). The primary stability was significantly elevated in the single discectomy with fixation and two segment discectomy with fixation groups. The flexion, extension, right/left lateral bending, and right/left axial rotation ROM were significantly reduced in the single discectomy with fixation and two segment discectomy with fixation groups compared with the unstable group (P < 0.05). The flexion, extension, right/left lateral bending ROM was significantly decreased in the two groups compared with the intact group, but axial rotation ROM was significantly increased (P< 0.05). Axial rotation ROM was smaller in the single discectomy with fixation group compared with the two segment discectomy with fixation group (P < 0.05).CONCLUSION: Single segmental spinal interbody fusion with bisegment fixation for thoracolumbar burst fracture type B had a good immediate stability in flexion, extension, lateral bending motion. Compared with traditional partial corpectomy L_1 between the caudal and cranial endplate of the adjacent vertebrae with bisegmental fixation, it had a better immediate stability in axial rotation.
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Background:Personality characters will influence the future career planning and development of medical students.Therefore,it will be important in the field of medical education to survey their personalities.Study design:The personality questionnaire was developed according to the Big-Five characters.The content validity and consistent reliability were assessed.A total of 124 undergraduate medical students participated in this 44-item self-evaluation about their personalities.Results:The inter-item consistency reliabilities of the 44-items of Big-Five personality questionnaire were analyzed and discordant items were deleted(Crobach's Alpha from 0.484~0.782 before selection to 0.67~0.82 after selection).The content validity of this five dimensions ranged from 0.8 to 0.9(P
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Academia-industry collaboration is defined as the cooperation between both sides,utilizing the capitals and pathways of the industrial side as well as the faculties and facilities of the academic side to push the products to the market with cost minimization as well as profit or utility maximization.All the group members share the results to attain the double win.The six key steps to establish this collaboration include creating the cooperation platform,signing related agreements,constructing related hard and software,setting a company for operation,performing experiment,licensing,patent or technique transfer,products marketing as well as sharing profits.Several issues should be known while this collaboration established in the biomedical field,especially about the ethics of human studies.The influencing factors of its effectiveness would be analyzed in the present paper.