Effectiveness and safety of celecoxib combined with diacerein in the treatment of senile degenerative knee osteoarthritis: study protocol for a randomized controlled trial / 中国组织工程研究

BACKGROUND:The non-steroidal anti-inflammatory drug celecoxib,used for the treatment of senile degenerative knee osteoarthritis,has a rapid onset of action and few side effects.However,it cannot prevent the occurrence and development of knee osteoarthritis.Celecoxib withdrawal is likely to induce a rebound increase in inflammation that may aggravate symptoms.Diacerein is a drug used to improve articular cartilage metabolism.It can delay the progression of senile degenerative knee osteoarthritis,but has a slow onset of action.Whether combined treatment with celecoxib and diacerein provides complimentary actions to achieve a better therapeutic effect on senile degenerative knee osteoarthritis remains unclear.Whether combined treatment with celecoxib and diacerein provides complimentary actions to achieve a better therapeutic effect on senile degenerative knee osteoarthritis remains unclear.OBJECTIVE:To investigate the effectiveness and safety of celecoxib combined with diacerein in the treatment of senile degenerative knee osteoarthritis.METHODS:This is a prospective,single-center,randomized controlled trial.Three hundred patients with senile degenerative knee osteoarthritis who receive treatment at the Department of Orthopedics,Second Affiliated Hospital of Nanjing Medical University,China will be randomly assigned to celecoxib (200 mg,once a day,orally),diacerein (50 mg,twice a day,orally),and ccelecoxib+diacerein (celecoxib 200 mg,once a day,orally and diacerein 50 mg,twice a day,orally) groups,with 100 patients in each group.Patients in each group will be treated for 12 successive weeks,and a 36-week follow-up will be performed.The primary outcome measure of this study is the 20-meter walk pain visual analogue scale score before and 1,4,12,24,and 36 weeks after treatment.The secondary outcome measures of this study include osteoarthritis index and X-ray image findings of the knee before and 1,4,12,24,and 36 weeks after treatment,as well as the incidence of adverse events at 1,4,12,24,and 36 weeks after treatment.This study was approved by the Ethics Committee of the Second Affiliated Hospital of Nanjing Medical University,China (approval No.(2017)KY-091).The study protocol will be performed in strict accordance with the Declaration ofHelsinki formulated by the World Medical Association.Written informed consent of the study protocol and procedure will be obtained from each patient.Participant recruitment will begin in January 2018.Sample and data collection will begin in January 2018 and end in December 2018.Outcome measures will be analyzed in January 2020.The trial will end in February 2020.Results will be disseminated through presentations at scientific meetings and/or by publication in a peer-reviewed journal.This trial was registered with the Chinese Clinical Trial Registry (registration No.ChiCTR-IOR-17013867).DISCUSSION:Results from this study will help to determine whether celecoxib and diacerein complement each other to produce a long-acting,safe,reliable,and rapid-onset analgesic effect in patients with senile degenerative knee osteoarthritis.

Intracytoplasmic Sperm Injection Fertilization Rate Does Not Depend on the Proportion of Round-headed Sperm, Small-acrosomal Sperm, or Morphologically Normal Sperm in Patients with Partial Globozoospermia / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Generally, intracytoplasmic sperm injection (ICSI) may be the preferable method to treat partial globozoospermia, but whether there exist some correlations between ICSI fertilization rate and the proportion of round-headed sperm or morphologically normal sperm remains open. This study was to explore the correlation between ICSI fertilization rate and the sperm morphology in patients with partial globozoospermia.</p><p><b>METHODS</b>Thirty-four patients diagnosed with partial globozoospermia accepted the following assisted fertilization treatments - 2 cases accepted in-vitro fertilization (IVF) alone, 26 cases accepted ICSI alone, and 6 accepted split IVF/ICSI. Detailed morphological characteristics were described using Diff-Quik rapid staining. Sixty cases accepting IVF or ICSI treatment in our reproductive center were considered as the control group after being matched by relevant criteria. Fertilization rate, embryo quality, embryo implantation rate and clinical pregnancy rate were calculated.</p><p><b>RESULTS</b>Besides very high proportion of round-headed sperm, partial globozoospermia also showed very high proportion of small-acrosomal sperm and very low proportion of morphologically normal sperm. Fertilization rate of IVF (IVF alone plus split IVF) was very low in partial globozoospermia (25.4% ± 17.4%), but ICSI (ICSI alone plus split ICSI) achieved satisfying fertilization rate compared with the control group (66.2% ± 22.5% vs. 68.8% ± 29.4%, P > 0.05). In patients with partial globozoospermia, there were no correlations between ICSI fertilization rate and the proportion of round-headed sperm, small-acrosomal sperm, or morphologically normal sperm.</p><p><b>CONCLUSIONS</b>There was high proportion of small-acrosomal sperm in partial globozoospermia. For patients with partial globozoospermia, ICSI is more preferable than IVF. ICSI fertilization rate does not depend on the proportion of round-headed sperm, small-acrosomal sperm, or morphologically normal sperm.</p>

Three-dimensional cultures of human endometrial cells on Matrigel mimic in vivo morphology / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The regulation of endometrial physiology and morphogenesis by the paracrine effectors has been well established using in vivo studies. A more complete understanding of the endometrial function has been delayed due, in part, to a lack of appropriate culture models. In this study, we aimed to simulate the in vivo three-dimensional (3-D) growth pattern of endometrial cells using a 3-D in vitro culture system.</p><p><b>METHODS</b>Isolated endometrial epithelial cells, stromal cells and RL95-2 cells were seeded into culture chambers coated with the extracellular matrix Matrigel and observed using light microscopy. Fluorescence staining and immunohistochemistry were used to assess the morphology.</p><p><b>RESULTS</b>Depending on the culture conditions, epithelial cells and RL95-2 cells formed multicellular structures on Matrigel; stromal cells remained individually distinguishable or grew together to form 3-D lattice-like structures.</p><p><b>CONCLUSIONS</b>Matrigel provided a good microenvironment for culturing endometrial cells. The cells cultured in the Matrigel-coated chambers closely resembled those seen in vivo.</p>

Pathological characteristics of sudden death caused by coronary thrombosis / 法医学杂志

OBJECTIVE@#To explore medico-legal characteristics of sudden death caused by coronary heart disease combined with coronary thrombosis.@*METHODS@#Ninety-six cases of sudden death caused by coronary heart disease were collected and divided into two groups: thrombus positive and thrombus negative groups. The time onset, induction and pathological features of coronary artery disease were analyzed.@*RESULTS@#Two groups showed man-dominant population. There were no statistical significant differences in season, circadian rhythm and induction factor. The thrombus positive group (age < 40) showed a higher disease incidence. Heart weight and degree of coronary stenosis were lower in thrombus positive group. However, there was no statistical difference in the number of atherosclerotic coronary arteries (> or = 2), the length of coronary lesions and myocardial infarct. But thrombosis positive group showed lower tendency.@*CONCLUSION@#Two groups are man-dominant population and similar induction factor, lesion position, mechanism of death. But thrombus positive group appeared more in a younger population and the degree of coronary stenosis is milder than thrombus negative group. Forensic pathologists should pay more attention to these characteristics in death investigation.

Effects of vitamin A on the immune function of intestinal mucosa lymphocytes in mice / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study the effects of vitamin A on the development of T lymphocytes in peripheral blood and small intestine and on the cytokine response of intestinal mucosa in mice.</p><p><b>METHODS</b>Twenty young mice were randomly fed with forage containing vitamin A 250 or 4 IU/g (n=10 each). Three weeks later, the levels of CD4+ CD25+ T subsets in peripheral blood and intestinal mucosa were measured by flow cytometry. The levels of cytokines IFN-γ, IL-4, IL-17 and IL-23 in stool were measured using ELISA.</p><p><b>RESULTS</b>The levels of CD4+ CD25+ T subsets in peripheral blood and intestinal mucosa in the 250 IU/g vitamin A group were significantly higher than those in the 4 IU/g vitamin A group (P<0.05). The IL-4 level in stool increased, in contrast, the IL-23 level in stool decreased significantly in the 250 IU/g vitamin A group when compared with the 4 IU/g vitamin A group (P<0.05).</p><p><b>CONCLUSIONS</b>vitamin A may promote the development of CD4+ CD25+ T lymphocytes in peripheral blood and small intestine. Moreover, it may be involved in intestinal mucosa-associated immune response by regulating cytokines IL-4 and IL-23.</p>