Implantation of beta-tricalcium phosphate combined with osteoblast-specific peptides for alveolar bone preservation in extraction sockets / 中国组织工程研究

BACKGROUND: Previous findings show that osteoblast-specific peptides can promote the repair and regeneration of skull defects in rabbits, and β-tricalcium phosphate (β-TCP) is used as a scaffold to carry osteoblast-specific polypeptides. Both of them not only complement each other, but also fully exert dual effects of osteoinduction and bone conduction. OBJECTIVE: To investigate the effect of osteoblast-specific peptide on the preservation of the anterior tooth extraction site in rabbits, and to study the effect on the alveolar bone remodeling. METHODS: Twenty-seven New Zealand white rabbits were randomly divided into three groups (n=9 per group), and the right mandibular incisors were removed to establish the animal models of tooth extraction. β-TCP/osteoblast-specific peptide compounds were implanted in the experimental group, and pure β-TCP meal was implanted into the material group. The blank control group had no implantation. Three rabbits from each group were scarified at 4, 8 and 12 postoperative weeks, and tissue samples were prepared for gross observation, histomorphology measurements, and radiographic measurements of extraction socket healing. RESULTS AND CONCLUSION: (1) Imaging results showed that the relative length of residual alveolar bone after modeling was ranked as follows: the experimental group > the material group > the blank control group, and the difference was statistically significant among groups (P < 0.05). Cone-beam CT findings in the three groups changed as time went on. At 4 and 8 postoperative weeks, the implanted materials in the experimental and material groups gradually degraded; the bone mass in the experimental group was significantly higher than that in the material and blank control groups. At 12 postoperative weeks, the experimental group had basically completed the reconstruction of tooth socket, but there were still some bone defects in the material and blank control groups. (2) Histomorphological findings showed that at 4 postoperative weeks, the experimental group exhibited obvious bone deposition lines, and the bone trabecula was widened; in the material and blank control groups, the new bone was less. At 8 postoperative weeks, a small amount of undegraded scaffold was found in the experimental group, with mature lamellar bone, the amount of new bone tissues in the material group increased and osteoblasts were obviously detected in the blank control group. At 12 postoperative weeks, the bone remodeling in the extraction socket of the experimental group was basically completed; in the material group, there were still a small amount of scaffold materials and dense plate-like new bone; and in the blank control group, the new bone tended to be mature, and there was obvious lamellar structure. To conclude, osteoblast-specific peptides can effectively preserve the length of the residual alveolar bone after tooth extraction, promote the formation of new bone, and have the function of preserving the tooth extraction site.

A rare case of B-lymphoproliferative disorder with villous lymphocytes harboring t(8;14)(q24;q32) translocation / 医学前沿

Splenic lymphoma with villous lymphocytes (SLVL) or splenic marginal zone lymphoma with circulating villous lymphocytes is rare, and prolymphocytic transformation of SLVL is rarer. At present, only one case of SLVL with t(8;14)(q24;q32) translocation has been reported. In this study, we report a case of B-lymphoproliferative disorder with villous lymphocytes harboring t(8;14)(q24;q32) chromosome translocation that we inclined to SLVL with a prolymphocytic transformation. A 73-year-old female showed marked hepatosplenomegaly and high lymphocytosis (lymphocytes > 200 × 10/L). The abnormal lymphocytes had short coarse villi and round nuclei with prominent nucleoli. The immunophenotypes showed CD19, CD20, HLA-DR, CD22, CD5, Kappa, CD25, CD71, Lambda, CD7, CD10, CD23, CD34, CD33, CD13, CD14, CD117, CD64, CD103, and CD11c. The karyotype showed complex abnormality: 46XX,+ 3,-10, t(8;14)(q24; q32)[11]/46XX[9]. The cytoplasmic projection, immunological characteristics, and trisomy 3 chromosome abnormality supported the diagnosis of SLVL. However, the presence of prominent nucleoli and high lymphocytosis suggested prolymphocytic transformation, probably as a result of t(8,14) chromosome translocation. In this report, we described an unusual case of B-lymphoproliferative disorder with villous lymphocytes harboring t(8;14)(q24;q32) translocation, which could provide help in the diagnosis and differential diagnosis of B-lymphocytic proliferative diseases.

Meta-analysis on effect of Shenfu injection in treating angina pectoris / 中国中药杂志

To systematically evaluate the efficiency and safety of Shenfu injection in treating patients with angina pectoris. Retrievals were made in Embase, Pubmed, Cochrane Library, Clinical Trials.gov, CNKI, CBM, VIP and Wanfang (before September 2015) for randomized or semi-randomized controlled trials reporting data of Shenfu injection in the adjuvant treatment of angina pectoris. The quality of included trials was evaluated according to tool evaluation at cochrane.org. STATA version 12.0 was applied for Meta analysis after quality assessment of included studies. Finally, a total of 17 studies, including 16 randomized controlled trials (RCTs) and 1 controlled clinical trial (CCT) involving 1 309 patients, met the inclusion criteria, of which 659 patients received Shenfu injection treatment. Meta-analysis results showed that Shenfu injection treatment group significantly improved angina pectoris symptoms (OR=3.38, 95%CI： 2.47-4.64, P=0.000) and ischemic ST-T changes in electrocardiogram (OR=3.30, 95%CI： 2.22-4.90, P=0.000), compared with control group. In the Meta-regression analysis, the average age of patients was positively correlated with the improved clinical (β=0.17) and electrocardiogram (β=1.15) efficacies. Major complication rate of Shenfu injection was 3.4%, and no serious adverse events were reported. Current clinical evidence in this study proved that Shenfu injection could significantly improve clinical symptoms and ECG ischemic changes for angina pectoris patients, with a good safety.

Research Advances in Mechanism of Bioactive Tanshinones in Salviae Miltiorrhiae Regulating Angiogenesis / 浙江中医药大学学报

[Objective]To explore the mechanism of bioactive tanshinones in Salviae Miltiorrhiae regulating angiogenesis and lay the foundation for the prevention and treatment of cancer, atherosclerosis, ischemic heart disease and other angiogenesis-related diseases. [Method]Based on angiogenesis mechanisms, infer to recent 10 years of articles from home and abroad, analyze and summarize the angiogenesis regulatory mechanisms of various bioactive ingredients in Danshen on endothelial cells, in vitro tumour cells and in vivo xenograft tumor. [Result] Among various bioactive ingredients of Salvia, Salvianolic acid B, Tanshinone IIA, Cryptotanshinone, Dihydrotanshinone I can promote or inhibit angiogenesis. Furthermore, Salvianolic acid B and Tanshinone IIA are considered to be the most important bioactive ingredients in Danshen and exhibit a dual angiogenic regulating activity through regulating various approaches, such as pro-angiogenic factors, MMPs, HIF-1α, the PI3K/AKT/eNOS signal pathway and so on. [Conclusion]Various bioactive ingredients of Salvia can serve as a regulator of angiogenesis, and it may provide new ideas for the prevention of angiogenesis-related diseases.

Inhibitory effect of cryptotanshinone on angiogenesis and Wnt/β-catenin signaling pathway in human umbilical vein endothelial cells / 中国结合医学杂志

<p><b>OBJECTIVE</b>To investigate the anti-angiogenic effect of cryptotanshinone (CPT) on human umbilical vein endothelial cells (HUVECs) and the effect of CPT on Wnt/β-catenin signaling pathway.</p><p><b>METHODS</b>HUVECs were incubated with 0, 2.5, 5, 10, and 20 μ mol/L CPT for detecting cell viability with dimethyl thiazolyl-2,5-diphenyltetrazolium bromide (MTT) assay. Then, HUVECs were incubated with 0, 2.5, 5, and 10 μ mol/L CPT for detecting endothelial cell migration, invasion, and tubular-like structure formation with wound healing, transwell invasion and matrigel tube formation assays, respectively. To gain insight into CPT-mediated signaling, the effects of CPT on T-cell factor/lymphocyte enhancer factor (TCF/LEF) transcription factors were detected by the Dual-luciferase reporter assay. Next, the nuclear expression of β-catenin was evaluated using Western blot and immunochemistry. Finally, vascular endothelial growth factor (VEGF) and cyclin D1, downstream proteins of the Wnt pathway were examined with Western blot.</p><p><b>RESULTS</b>CPT dose-dependently suppressed endothelial cell viability, migration, invasion, and tubular-like structure formation. In particular, CPT blocked β-catenindependent transcription in HUVECs in a dose-dependent manner. In Western bolt, 10 μ mol/L CPT decreased expression of β-catenin in nucleus of HUVECs (P<0.01). In immunohistochemistry, β-catenin was more potent in response to LiCl (an activator of the pathway) treatment. However, the signals were weaker in the nucleus of the CPT (10 μ mol/L) group, compared to the positive control. Also, VEGF and cyclin D1 were both eliminated by CPT in 5 and 10 μ mol/L doses (P<0.05).</p><p><b>CONCLUSION</b>Our study supported the role of CPT as an angiogenic inhibitor, which may impact on the Wnt/β-catenin signaling pathway.</p>

Tubularized incised plate urethroplasty for hypospadias (a report of 35 cases) / 中华男科学杂志

<p><b>OBJECTIVE</b>To evaluate the clinical effects of tubularized incised plate urethroplasty for hypospadias.</p><p><b>METHODS</b>Thirty-five children aged 1 to 12 years with hypospadias were included in this study, 5 cases of them were glans type, 27 cases penis type, and 3 cases penoscrotal type. Hypospadias was treated by one-stage tubularized incised plate urethroplasty. Incised plate in the middle line loosened the urethral plate, and the microsurgery technique was applied during the suture.</p><p><b>RESULTS</b>The appearance and function of the new urinary meatus was satisfactory. Thirty cases were successfully corrected with no urethral fistula and stricture. Two cases with urethral fistula and 3 cases with urinary meatus stricture were corrected by re-operation. Follow-up investigations were carried out in 32 patients.</p><p><b>CONCLUSION</b>The urethral plate, close to normal urethral tissues, has an abundant blood supply and satisfactory elasticity. Tubularized incised plate urethroplasty is an ideal method for stage-one correction of hypospadias.</p>

Causes of 100 cases of dispute over malpractice in Nantong and preventive measures / 中华医院管理杂志

An assortment and analysis was made into the distribution of 100 cases of dispute over medical malpractice taken up by the Association the author works with across various levels of medical institutions and different disciplinary specialties as well as the results of arbitration. The leading causes of dispute on the part of physicians were misdiagnosis, missed diagnosis, and delayed treatment; inappropriateness in the selection of indications of operation, operational procedures and postoperative observation and handling; irrational use of drugs and adverse drug reactions; poor performance of the duty to provide necessary information; and improper medical records. The preventive measures put forward for guarding against medical malpractice included: ①taking strict precautions against misdiagnosis and missed diagnosis; ②ensuring the quality of operations; ③putting under strict control the indications and ways of drug use; ④properly performing the duty to provide necessary information and respecting patients right of informed consent; ⑤reinforcing management of medical institutions at the grassroots and perfecting various rules and regulations.