Guidelines for management of pediatric acute hyperextension spinal cord injury / 中华创伤杂志(英文版)

Pediatric acute hyperextension spinal cord injury (SCI) named as PAHSCI by us, is a special type of thoracolumbar SCI without radiographic abnormality and highly related to back-bend in dance training, which has been increasingly reported. At present, it has become the leading cause of SCI in children, and brings a heavy social and economic burden. Both domestic and foreign academic institutions and dance education organizations lack a correct understanding of PAHSCI and relevant standards, specifications or guidelines. In order to provide standardized guidance, the expert team formulated this guideline based on the principles of science and practicability, starting from the diagnosis, differential diagnosis, etiology, admission evaluation, treatment, complications and prevention. This guideline puts forward 23 recommendations for 14 related issues.

Guideline for diagnosis and treatment of spine trauma in the epidemic of COVID-19 / 中华创伤杂志(英文版)

Outbreak of COVID-19 is ongoing all over the world. Spine trauma is one of the most common types of trauma and will probably be encountered during the fight against COVID-19 and resumption of work and production. Patients with unstable spine fractures or continuous deterioration of neurological function require emergency surgery. The COVID-19 epidemic has brought tremendous challenges to the diagnosis and treatment of such patients. To coordinate the diagnosis and treatment of infectious disease prevention and spine trauma so as to formulate a rigorous diagnosis and treatment plan and to reduce the disability and mortality of the disease, multidisciplinary collaboration is needed. This expert consensus is formulated in order to (1) prevent and control the epidemic, (2) diagnose and treat patients with spine trauma reasonably, and (3) reduce the risk of cross-infection between patients and medical personnel during the treatment.

Investigation on Anti-liver Cancer Potential and Compatibility Characteristics of Fufang Biejia Ruangan Pian from Network Perspective / 中国实验方剂学杂志

Objective:To explore the anti-liver cancer potential of Fufang Biejia Ruangan Pian （FBRP） and its compatibility characteristics from a network perspective， so as to provide a theoretical basis for the clinical repositioning of FBRP. Method:Three self-pairs of cancer and para-cancerous tissue samples were collected from three patients with primary liver cancer， and the whole genome expression profiling chip was used to detect the differential genes related to the development and progression of liver cancer. After collecting the phenotype-related genes and the candidate targets of the corresponding prescriptions of FBRP from The Encyclopedia of Traditional Chinese Medicine （ETCM） and Integrative Pharmacology-based Research Platform of Traditional Chinese Medicine （TCMIP） V2.0， the "differentially expressed genes related to liver cancer development-candidate targets of FBRP efficacy substance group" interaction network was constructed according to the interaction information between the above-mentioned differentially expressed genes related to liver cancer and the candidate targets of the FBRP efficacy group， and then the major network nodes were screened. After that， the enrichment analysis of the pathway was performed in order to explore the biological basis of various pharmacological efficacy groups of FBRP， including Xiaozheng Sanjie group （Trionycis Carapax and Curcumae Rhizoma）， Buxue Huoxue group （Paeoniae Radix Rubra， Angelicae Sinensis Radix and Notoginseng Radix et Rhizoma）， Yiqi Jianpi group （Codonopsis Radix and Astragali Radix）， Yuyin Yanggan group （Placenta Hominis and Cordyceps） and Qingre Jiedu group （Isatidis Radix and Forsythiae Fructus）. Result:The major network targets of the five efficacy groups may be involved into several common pathways but also associated with some special pathological processes. Those common pathways mainly contained the regulation of nervous system， the balance of immune-inflammatory system， the regulation of energy metabolism of various substances and cancer-related pathways， while the point was also reflected by the follows：①The regulating effects of Xiaozheng Sanjie group and Yiqi Jianpi group were summarized as promoting Qi circulation and relieving depression and replenishing Qi-blood， benefiting spirit. Buxue Huoxue group may also participate in the regulation of promoting Qi circulation and relieving depression and Yuyin Yanggan group may participate in the regulation of replenishing Qi-blood and benefiting spirit. ②The regulatory effects of the Xiaozheng Sanjie group and the Yuyin Yanggan group were summarized as essence， Qi and blood supplement. Buxue Huoxue group focused on the improvement of the immune-circulatory system. Qingre Jiedu group mainly regulated the balance of immune-inflammatory system by acting on T cell receptor signaling pathway. ③Yiqi Jianpi group was demonstrated to show the effects on various material and energy metabolisms. Yuyin Yanggan group exerted effects on lipid metabolism， carbohydrate metabolism， protein metabolism and hormone metabolism. Qingre Jiedu group was also involved into metabolism of nucleotide and hormone. ④In the aspect of alleviating the pathological changes of cancer， the regulatory effects of the five efficacy groups on cell cycle and other functions could be summarized as dispelling pathogenic factors. ⑤The whole prescription focused on the anti-liver cancer potential of FBRP as a whole， while each efficacy group emphasized that each efficacy group had its own functional characteristics. The two network analysis models complemented and verified each other. Conclusion:FBRP has the anti-hepatoma potential. By revealing the biological connotation of its efficacy and the rationality of the compatibility， the regulation mechanism of FBRP to correct the imbalance network of inflammation and cancer in liver is clarified， which can provide the possibility and biological basis for FBRP to increase the clinical indications for the prevention and treatment of liver cancer.

Study on the value of des-γ-carboxy-prothrombin combined with enhanced CT in predicting microvascular invasion of hepatocellular carcinoma / 中国实用外科杂志

OBJECTIVE: To explore the predictive value of preoperative enhanced CT combined with des-γ-carboxy-prothrombin(DCP) level for microvascular invasion(MVI) of hepatocellular carcinoma(HCC).METHODS: The clinicaldata of 105 cases of HCC diagnosed by pathology after surgical resection from January 1,2016 to March 1,2019 in thethe Affiliated Hospital of Southwest Medical University were analyzed retrospectively. According to the pathologicalresults,they were divided into two groups: experimental group(with MVI): 30 cases,control group(without MVI): 75 cases,using univariate and multivariate logistic regression analysis to predict influencing factors of MVI in HCC. Thereceiver working curve(ROC curve)was used to evaluate the predictive value of DCP combined with enhanced CT forMVI in HCC.RESULTS: Univariate analysis showed that serum DCP level(t=4.667,P<0.001),tumor size(t=9.427,P<0.001),capsule type(χ~2=18.456,P<0.001) and pathological type(χ~2=11.914,P=0.003) were risk factors for MVI in HCC,with statistically significant differences(P<0.05). Multivariate logistic regression analysis showed that tumor size(OR=12.610,P=0.001),capsule type(OR=14.363,P=0.008) and serum DCP level(OR=19.254,P=0.014)were independentrisk factors of MVI in HCC,with statistically significant differences(P<0.05). ROC curve analysis showed that thesensitivity,specificity and area under the curve(AUC) of serum DCP and enhanced CT model for predicting MVI in HCCwere 90.0%,74.7% and 0.856,respectively.CONCLUSION: Preoperative serum DCP level combined with enhanced CThelps predict MVI in HCC.

Efficacy and safety of triplecombination therapy with paclitaxel, cisplatin and TS-1 in patients with advanced gastric cancer / 肿瘤

Objective: To evaluate the efficacy and safety of triplecombination therapy with paclitaxel, cisplatin (intra-abdominal administration) and TS-1 in patients with advanced gastric cancer. Methods: Fifty eligible inpatients with advanced gastric cancer were recruited between January 2008 and January 2011 and treated with triple-combination therapy with paclitaxel (intravenous administration), cisplatin (intra-abdominal administration) and TS-1 (oral administration). The short-term response and adverse reactions were evaluated. The average follow-up time was 11.4 months. The PFS (progression-free survival) and OS (overall survival) were calculated. Results: Of 50 patients, 5 patients achieved complete response and 23 patients achieved partial response, and the objective response rate was 56%. The median PFS was 6.0 months (95% confidence interval: 3.4-8.6 months) and the median OS was 13.0 months (95% confidence interval: 7.9-18.1 months). The major adverse reactions were gastrointestinal reactions, hematologic toxicities and fatigue. Most of these adverse reactions were grades II Grades II adverse reactions were observed in three patients (one had serious vomiting, two had liver dysfunction). The bowel obstruction was relieved after two cycles of chemotherapy in 2 patients who had incomplete bowel obstruction before chemotherapy, and the chemotherapy-associated bowel obstruction after two cycles of chemotherapy occurred in another patient who had no bowel obstruction before chemotherapy. Conclusion: The triple combination therapy with paclitaxel, cisplatin and TS-1 demonstrates benefits in short-term response and the survival for patients with advanced gastric cancer, and it is also well-tolerated. © 2012 by Tumor.

The effect of fluorine on proliferation of osteoblast through extra cellular signal-regulated protein kinase signaling pathway / 中国地方病学杂志

ObjectiveTo study the effect of fluorine on proliferation of osteoblast through extra cellular signal-regulated protein kinase(ERK) signaling pathway.MethodsMouse osteoblasts(MC3T3-E1) were cultured in vitro with different concentrations of fluoride for 24 and 48 h (the concentrations of Fˉ were 0,200,400,600,1000,2000,4000,8000,10 000 μmol/L,respectively).The optimum concentration for promotion of cell proliferation was determined by methylthiophene tetrazolium(MTT) assay.According to the optimum concentration,the cells were randomly divided into three groups:control group (0 μmol/L Fˉ); fluorine group (400 μmol/L Fˉ); fluorine and MAPK inhibitor PD98059 group(400 μ mol/L Fˉ + 10 μ mmol/L PD98059).Cell cycle was detected by flow cytometry after 48 h culture.The expression of P-ERK protein was determined by Western blotting and immunofluorescence.ResultsThe optimum concentration of fluorine for proliferation of osteoblasts was 400 μ mol/L.Compared with the control group[(76.12 ± 10.08)％,(2.06 ± 0.31)％],the number of cells in G0/G1 phase[(63.04 ± 8.12)％] reduced and the number of cells in S phase[(9.13 ± 2.08)％] increased in fluorine group (all P ＜ 0.05) ; but the number of cells in G0/G1 phase [(92.11 ± 9.01 ) ％] in fluorine and mitogen-activated protein kinases (MAPK) inhibitor PD98059 group was significantly increased(P ＜ 0.05 ).Western blotting results showed that:compared with the control group[(100.00 ± 0.00)％],the expression of P-ERK protein in fluorine group[(131.24 ± 13.88)％] was significantly higher(P ＜ 0.05 ),but the expression of P-ERK protein in fluorine and MAPK inhibitor PD98059 group [(91.33 ± 9.68 )％] was not significantly changed(P ＞ 0.05).The results of immunofluorescence were similar to that of Western blotting.ConclusionsFluorine at the concentration of 400 μmol/L can promote the proliferation of osteoblasts.ERK signaling pathway has played a key role in the proliferation of osteoblasts.

Effects of subdiaphragmatic cardiac compression on cardiac arrest during liver transplantation / 中华医学杂志(英文版)

Cardiac arrest during upper abdominal surgery such as liver transplantation is a rare but very severe complication. Traditional external cardiac compression has been the mainstay of basic life support in general circumstances. Subdiaphragmatic cardiac compression (SDCC), with no incision in the diaphragm, may be a more effective measure. This maneuver can provide more effective and timely cardiac compression via the already open abdomen in surgery and not add extra trauma. This method can provide a quicker and more effective means of circulation support for intraoperative cardiac arrest patients without adding new injuries. Five cases are reported and all the patients had return of spontaneous circulation (ROSC). This is the first report of the SDCC method.

Adhesion, proliferation and osteodifferentiation of bone mesenchymal stem cells on PLGA-ASP-PEG tri-bolck polymer scaffolds / 中国骨伤

<p><b>OBJECTIVE</b>To explore the adhesion,proliferation and osteodifferentiation of bone mesenchymal stem cells (BMSCs)on the prepared lactic acid/glycolic acid/asparagic acid-co-polyethylene glycol(PLGA-[ASP-PEG])tri-block polymer scaffolds.</p><p><b>METHODS</b>Modified PLGA with polyethylene glycol (PEG) and asparagic acid(ASP)that has many liga nds,and then the synthesis PLGA-[ASP-PEG] tri-block polymer material was prepared. BMSCs were cultured in PLGA-[ASP-PEG] polymer material and poly lactic acid-co-glycolic acid(PLGA)were used as control group. Precipitation method, MUT assay and total cellular protein detection were used to test the adhersion and proliferation of BMSCs. After the third generation of BMSCs was cultured on PLGA-[ASP-PEG] tri-block polymer scaffolds for 14 day and 28 day with osteogenic supplements,the osteodifferentiation of MSCs were observed through alkaline phosphatase(ALP) staining and calcium tubercle staining.</p><p><b>RESULTS</b>BMSCs grew adherent to the surface of PLGA-[ASP-PEG] polymer scaffolds and the number of BMSCs was much higher than that of PLGA. The precipitation method suggested that adhesion and proliferation of BMSCs on the surface of PLGA-[ASP-PEG] was much higher than the control group (P < 0.05). MTU assay showed that after BMSCs were cultured for 20 days,the absorbance A of PLGA-[ASP-PEG] polymer scaffolds and PLGA were 1.336 and 0.780 respectively. Total cellular protein could image the adhersion and proliferation of BMSCs indirectly. After BMSCs were cultured for 12 days,the total cellular protein of PLGA-[ASP-PEG] and PLGA were 66.44 microg/pore and 41.23 microg/pore respectively. PLGA-[ASP-PEG] polymer scaffolds had well biocompatibility and cell adhersion. The positive results with ALP staining and calcium tubercle staining in both groups indicated tri-block polymer scaffold and its degradations had no effect on osteodifferentiation.</p><p><b>CONCLUSION</b>PLGA-[ASP-PEG]could improve the adhesion and proliferation of seed cells on bone-matrixmaterial, maintain the morphous of seed cells and had no obvious effect on cell osteodifferentiation.</p>

Effect of autocontrol micromotion intramedullary interlocking nail on fracture healing: an experimental study / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>To investigate the effect of autocontrol micromotion locking nail (AMLN) on experimental fracture healing and its mechanism.</p><p><b>METHODS</b>16 goats undergoing both sides of transverse osteotomy of the femoral shafts were fixed intramedullary with AMLN and Gross-Kempf (GK) nail, respectively. The follow-up time was 7, 14, 28 and 56 days. Roentgenographic, biomechanical, histological, scanning electromicroscopic and biochemical analyses were done.</p><p><b>RESULTS</b>(1) The strength of anticompression, antiflexion and antitorsion in the fractural end in the AMLN-fixed group was higher than that of GK nail-fixed group; whereas, the rate of stress shelter in the fractured end decreased significantly (P<0.01). (2) The content of the total collagen, insoluble collagen, calcium and phosphate in the AMLN-fixed group was higher than that in the GK nail-fixed group (P<0.05). (3) Histological observation and quantitative analysis of calluses revealed that AMLN could promote the growth of bridge calluses and periosteum calluses. Hence the fracture healing and remolding process achieved early, which was much better than traditional GK nail fixation. (P<0.05). (4) 7-14 days postoperation, the calluses of AMLN-fixed group was flourish and camellarly arranged and the collagen fibril formed constantly in the absorption lacuna of bone trabecula. 28-56 days postoperation, the collagen fibril was flourish around the absorption lacuna and was parallel to the bone's longitudinal axis. Active bony absorption and formation were seen, so was remolding and rebuilding. Haversian system was intact and the bony structural net was very tenacious because of the deposition of calcium salt. None of the above findings was observed in the GK nail-fixed group.</p><p><b>CONCLUSIONS</b>The design of AMLN accords well with the plastic fixation theory. As the geometry ametabolic system constituted by the intramedullary fixation instruments and the proximal and distal end of the fracture is very firm and stable, the disturbance to the physical stress distributed in the fractural end is light. The generation and conduct of the intermittent physical stress between the fractural parts could reach the balance between stress conduct and stress protection. The feature that the healing and remolding take place at the same time speeds up the fractural healing process.</p>

Adhesion and Proliferation of Bone Mesenchymal Stem Cells with PLGA-[ASP-PEG] Polymer Scaffolds / 中国生物工程杂志

Objectives: To investigate the effects of adhesion and proliferation of bone mesenchymal stem cells (BMSCs) in the surface of lactic acid/glycolic acid/asparagic acid-co-polyethylene glycol PLGA-[ASP-PEG] tri-block polymer scaffolds, try to find a new biomaterial to induce seed cells in vitro for bone tissue engineering. Methods: Modified PLGA with polyethylene glycol (PEG) and asparagic acid (ASP) that has many ligands, and synthesis PLGA-[ASP-PEG] polymer material. BMSCs were cultured in PLGA-[ASP-PEG] polymer material and PLGA used as control group. Through precipitation method, MTT assay and total cellular protein detection to test the adhersion and proliferation of BMSCs. Scanning electron microscope is used to observe cells appearance. Results: BMSCs on the surface of PLGA-[ASP-PEG] polymer scaffolds are adherention to the culture flask, the number of cells is much higher than PLGA’s. The precipitation method suggest that adhesion and proliferation of BMSCs on the surface of PLGA-[ASP-PEG] is much higher than the control group(P

Effects of type I collagen on adhesion,proliferation and osteogenic differentiation of rabbit bone marrow stromai cells on PLGA-[ASP-PEG]scaffolds / 中华创伤骨科杂志

Objective To explore the effects of surface modification of PLGA-[ASP-PEG] scaffold with typeⅠcollagen on the adhesion,proliferation and osteogenic differentiation of rabbit bone marrow stromal cells (BMSCs).Methods After PLGA-[ASP-PEG] materials were modified with typeⅠcollagen chemically,the collagen was coated onto the materials physically.The BMSCs obtained from rabbits were cultured on the modified PLGA-[ ASP-PEG] and on the unmodified PLGA-[ ASP-PEG] as control.The adhesion and proliferation behavior of the cells was analyzed and the expressions of osteogenie marker alkaline phosphatase,osteocalcin,osteopontin,typeⅠcollagen and core binding factor al were also detected.Results X-ray photoelectron spectrometry(XPS) confirmed that TypeⅠcollagen was grafted onto the surface of PLGA-[ASP-PEG] successfully and the collagen content on the materials modified chemically and physically was significantly increased.The abilities of adhesion and proliferation and the expressions of osteogenie makers of the BMSCs were significantly greater than those in the control group(P＜0.05).Conclusion Since Type collagen I can improve the biocompatibility of PLGA- [ASP-PEG] scaffold materials,it can be used as a new way to optimize scaffolds in tissue engineering.