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In growing children, growth plate cartilage has limited self-repair ability upon fracture injury always leading to limb growth arrest. Interestingly, one type of fracture injuries within the growth plate achieve amazing self-healing, however, the mechanism is unclear. Using this type of fracture mouse model, we discovered the activation of Hedgehog (Hh) signaling in the injured growth plate, which could activate chondrocytes in growth plate and promote cartilage repair. Primary cilia are the central transduction mediator of Hh signaling. Notably, ciliary Hh-Smo-Gli signaling pathways were enriched in the growth plate during development. Moreover, chondrocytes in resting and proliferating zone were dynamically ciliated during growth plate repair. Furthermore, conditional deletion of the ciliary core gene Ift140 in cartilage disrupted cilia-mediated Hh signaling in growth plate. More importantly, activating ciliary Hh signaling by Smoothened agonist (SAG) significantly accelerated growth plate repair after injury. In sum, primary cilia mediate Hh signaling induced the activation of stem/progenitor chondrocytes and growth plate repair after fracture injury.
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Mice , Animals , Hedgehog Proteins/genetics , Receptors, G-Protein-Coupled/metabolism , Cilia/metabolism , Cartilage/metabolism , RegenerationABSTRACT
Tooth number abnormality is one of the most common dental developmental diseases, which includes both tooth agenesis and supernumerary teeth. Tooth development is regulated by numerous developmental signals, such as the well-known Wnt, BMP, FGF, Shh and Eda pathways, which mediate the ongoing complex interactions between epithelium and mesenchyme. Abnormal expression of these crutial signalling during this process may eventually lead to the development of anomalies in tooth number; however, the underlying mechanisms remain elusive. In this review, we summarized the major process of tooth development, the latest progress of mechanism studies and newly reported clinical investigations of tooth number abnormality. In addition, potential treatment approaches for tooth number abnormality based on developmental biology are also discussed. This review not only provides a reference for the diagnosis and treatment of tooth number abnormality in clinical practice but also facilitates the translation of basic research to the clinical application.
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Humans , Gene Expression Regulation, Developmental , Odontogenesis , Signal Transduction , Tooth/metabolismABSTRACT
Objective:To observe the anatomical characteristics of the semispinalis capitis plane (SCP) to provide a reference for clinically effective implementation of ultrasound-guided SCP block.Methods:Ultrasound scanning was performed in six certain districts of SCP in 30 healthy volunteers (60 sides). The key point was to examine and describe the anatomical characteristics of semispinalis capitis (SCA), deep space of SCA and structures within the space.Results:(1) Transverse scanning at the posterior arch of atlas revealed that the SCA was separated into medial and lateral head by an oblique thick septum; in the space between SCA and obliquus capitis inferior (SCA-OCI), the third occipital nerve (TON) and the greater occipital nerve (GON) were separated by a fascia.There was often a branch of occipital vein between them.The distance from TON to GON was (12.9±0.6) mm.(2) Transverse scanning at the lamina of axis revealed that the axial image of SCA and the structures in SCA-OCI space were similar to the results previously described in (1). The distance from TON to GON was (12.1±0.5) mm.(3) Sagittal scanning beside the spinous process of axis revealed that SCA was separated into superior and inferior belly by a septum which connected to the end of axis spinous process.(4) Sagittal scanning at the C 2, 3 facet joint revealed that in the space between OCI and C 2, 3 facet joint (OCI-C 2, 3) beneath SCA, there was no septum between TON and GON.The distance from TON to GON was (8.0±0.5) mm.(5) Transverse scanning at the lamina of C 4 revealed that in the space between SCA and semispinalis cervicis, the deep cervical artery and vein were observable except medial branch of C 4, and the characteristics of the short axis of the SCA belly were similar to the results previously described in (1). (6) Transverse scanning at the lamina of C 5 revealed that the view was similar to the results previously described in (5). The posterior branch of C 5 nerve was not found. Conclusions:SCP is rich in fascia, and blood vessels often pass through the deep surface space of SCA under ultrasound.The anatomical structure is complex, and there is individual variation.Grasping its ultrasonic anatomical characteristics is helpful in safely and effectively implementing ultrasound-guided SCP block.
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Objective:Based on the construction of benign organizational climate of tertiary public hospitals, this paper tries to understand the practical demands of hospital staff for the internal organizational climate.Methods:A seven-dimension organizational climate questionnaire for public hospitals was designed by literature review and Delphi expert survey method. On the basis of satisfying the reliability and validity test, Kano questionnaire analysis and Better-Worse coefficient analysis were combined to identify the key climate factors to improve the satisfaction of hospital staff.Results:28 climate indicators were divided into: 9 (32.1%) attractive requirements, 7 (25.0%) one-dimensional requirements, 4 (14.3%) hybrid requirements, 6 (21.4%) must-be requirements, and 2 (7.2%) indifference requirements.Conclusions:According to Kano model classification results and satisfaction influence matrix distribution results, Some suggestions are put forward for constructing benign organizational climate in hospitals from the aspects of constructing equitable system, popularizing democratic leadership, attaching importance to cultivating scientific research and improving humanistic care.
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Objective:To explore the effect of suspension exercise training (SET) on the lumbar function and balance ability of patients with thoracolumbar fracture and spinal cord injury.Methods:Totally 64 patients with thoracolumbar fracture and spinalcord injury were randomly divided into a control group and an observation group, each of 32. Both groups received pedicle screw reduction with internal fixation and spinal dome decompression, followed by routine post-operative rehabilitation. In addition, the observation group performed double bridge and single leg suspension training and pelvic lift training. Everyone′s walking ability, spinal nerve functionality and balance were evaluated 3 days after the operation and 2 months after the training. Stride frequency, stride length and walking speed were observed. American Spinal Injury Association (ASIA) nerve function classifications were assigned. The trajectory length, trajectory included area and movement deviation of each subject′s center of gravity (CG) was recorded.Results:The average stride frequency, step length and walking speed of the observation group had all improved significantly after the intervention, and were significantly better than the control group′s averages at that point. This was also true of the proportion in ASIA neurological function grade D (65.63%), CG trajectory length and area, and the Romberg rate of deviation along the X-axis and Y-axis of the CG.Conclusion:SET training after pedicle screw reduction and internal fixation and spinal dome decompression can significantly improve the spinal nerve functioning of persons after a thoracolumbar fracture with incomplete spinal cord injury. It enhances their balance and walking ability. Such therapy is worthy of clinical promotion and application.
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Objective:To observe the effect of carotid endarterectomy (CEA) on the patients with ischemic stroke, and to observe the effect on the function of nerve and blood coagulation.Methods:The patients who were treated with ischemic stroke in our hospital from February 2017 to December 2017 were selected as the research subjects. According to the treatment methods, the patients were divided into the carotid angioplasty stenting (CAS) group ( n=45) and the CEA treatment group ( n=45). The therapeutic effects of the two groups were observed, and the differences of coagulation function and quality of life between the two groups before and after treatment were compared. Results:The effective rate of treatment in the CEA treatment group was 97.78%, which was significantly higher than that of the CAS group (χ 2=4.939, P=0.026). The two groups had no difference in coagulation function before treatment. After the treatment, the levels of activated partial thromboplastin time (APTT), prothrombin time (PT), thrombin time (TT) and D-dimer (D-D) in the CEA group were lower than those in the CAS group ( t=22.801, 3.752, 6.039, 169.556, P<0.05). There was no difference in the quality of life between the two groups before treatment. After treatment, the quality of life of the CEA treatment group was higher than that of the CAS group ( P<0.05). The incidence of high perfusion syndrome, restenosis and hematoma in group CEA was lower than that in group CAS (χ 2=4.406, P=0.036). Conclusions:CEA has good therapeutic effect on patients with ischemic stroke. It can obviously improve the nerve function and coagulation function of patients, and has a good application value.
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Objective:To analysis the clinical characteristics of The clinical characteristics of using automated external defibrillation in the public place,To explore the feasibility and effectiveness of AED application in public places in China.Methods:From January 2014 to April 5, 2019, 54 cases of on-site emergency medical records of AED use in public places in China were analyzed retrospectively from three aspects: patient and AED user attributes, and AED clinical performance.Results:After field application of AED analysis, 54 patients did not have out of hospital cardiac arrest in 9 patients; cardiac arrest in 45 patients, cerebral resuscitation in 40 patients (88.9%), death in 5 patients (11.1%), one of them died in hospital. The accuracy of AED for defibrillation rhythm recognition and defibrillation recommendations was 100%. The success rate of shock to VF was 97.22%, and that of non pulse VT was 100%. The data shows that AEDs of different brands show clinical effectiveness in the core indicators of work. The operation level of the rescuer determines the critical time of AED shock, which is closely related to the prognosis of the patient ( P<0.05) . Conclusions:AED is reliable and effective in electric shock decision and performance.The overall efficiency of AED application can be improved by strengthening training, shortening the critical time of electric shock, rational configuration and effective management.
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Activation of osteoclasts during orthodontic tooth treatment is a prerequisite for alveolar bone resorption and tooth movement. However, the key regulatory molecules involved in osteoclastogenesis during this process remain unclear. Long noncoding RNAs (lncRNAs) are a newly identified class of functional RNAs that regulate cellular processes, such as gene expression and translation regulation. Recently, lncRNAs have been reported to be involved in osteogenesis and bone formation. However, as the most abundant noncoding RNAs in vivo, the potential regulatory role of lncRNAs in osteoclast formation and bone resorption urgently needs to be clarified. We recently found that the lncRNA Nron (long noncoding RNA repressor of the nuclear factor of activated T cells) is highly expressed in osteoclast precursors. Nron is downregulated during osteoclastogenesis and bone ageing. To further determine whether Nron regulates osteoclast activity during orthodontic treatment, osteoclastic Nron transgenic (Nron cTG) and osteoclastic knockout (Nron CKO) mouse models were generated. When Nron was overexpressed, the orthodontic tooth movement rate was reduced. In addition, the number of osteoclasts decreased, and the activity of osteoclasts was inhibited. Mechanistically, Nron controlled the maturation of osteoclasts by regulating NFATc1 nuclear translocation. In contrast, by deleting Nron specifically in osteoclasts, tooth movement speed increased in Nron CKO mice. These results indicate that lncRNAs could be potential targets to regulate osteoclastogenesis and orthodontic tooth movement speed in the clinic in the future.
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Animals , Mice , Bone Resorption , Genetics , Mice, Inbred C57BL , Osteoclasts , Osteogenesis , RANK Ligand , RNA, Long Noncoding , GeneticsABSTRACT
Pre-hospital rescue is key to the emergency medical system. Based on the current pre-hospital emergency standardized system construction in China, the authors explored the standardization of pre-hospital emergency system construction, command dispatch and emergency service quality control standardization, pre-hospital classification standardization, pre-hospital emergency service capacity standardization, pre-hospital emergency and intra-hospital emergency connection standardization, standardized training for pre-hospital emergency doctors and nurses. These efforts aim to achieve such rescue and transfer criteria for patients, as " vicinity, urgency, professional needs, and intension of both patients and their families" . Such criteria if met can further reduce emergency response time and shorten the emergency radius, hence improving emergency medical services.
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Objective@#To explore the cross classification of tibial plateau fractures combined with avulsion fracture of medial femoral condyle.@*Methods@#The 16 patients were retrospectively analysed as an observation group who had been treated at Department of Lower Limbs, Sichuan Orthopaedic Hospital for tibial plateau fracture and avulsion fracture of the medial condyle of the same femur from January 2015 to December 2018. They were 9 males and 7 females, aged from 27 to 78 years (average, 51.5 years). By the Schatzker classification, there were 2 cases of type Ⅰ, 8 cases of type Ⅱ, 3 cases of type Ⅲ and one case of type Ⅳ; by the cross classification, there were 10 cases of type Ⅰe, one case of type Ⅱe and 2 cases of type Ⅲe and 3 cases of type Ⅰv. The 332 patients were included as a control group who had been treated at the same department for simple tibial plateau fracture from January 2010 to December 2015. The imaging data of the 2 groups were compared to find out the charateristics of cross type distribution; the widened distance of the lateral tibial plateau, collapse depth of the tibial plateau, separation of avulsion fracture of medial femoral condyle, maximum clearance of the medial knee and eversion angle of the tibial plateau were investigated in the patients with cross types e and Ⅰv in the observation group.@*Results@#In the observation group, the widened distance of the lateral tibial plateau averaged 7.18 mm, the collapse depth of the tibial plateau 8.74 mm, the separation of avulsion fracture of medial femoral condyle 3.44 mm, the maximum clearance of the medial knee 7.77 mm, and the eversion angle of the tibial plateau 87.03°. There was a significant difference in the cross type distribution of tibial plateau fractures between the 2 groups (P=0.002). In the observation group, the average widened distance of the lateral tibial platea for the 13 type e patients (8.49±4.26 mm)was significantly larger than that for the 3 type Ⅰv patients (1.51±2.11 mm) (t=2.706, P=0.017).@*Conclusion@#The cross classification of tibial plateau fractures with avulsion fracture of mediall condyle of the same femur may result mainly in types e and type Ⅰv. The widened distance of lateral tibial plateau helps distinction between types e and type Ⅰv.
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Early brain injury (EBI) refers to the direct damage and secondary pathophysiological changes of brain tissue within 72 h after aneurysmal subarachnoid hemorrhage. Studies have shown that a variety of signaling pathways are involved in the mechanism of EBI, such as ecoxy chloropropane Kelch sample related protein-1 (Keap1)-nuclear factor E2 related factor 2 (Nrf2)-antioxidant response element (ARE) pathway, Toll-like receptor 4 (TLR4)/nuclear factor-κB pathway, phosphatidylinositol-3 kinase (PI3K)/protein kinase B (Akt) pathway. This article reviews the mechanisms of action of different signaling pathways involved in EBI.
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Objective To explore the cross classification of tibial plateau fractures combined with avulsion fracture of medial femoral condyle.Methods The 16 patients were retrospectively analysed as an observation group who had been treated at Department of Lower Limbs,Sichuan Orthopaedic Hospital for tibial plateau fracture and avulsion fracture of the medial condyle of the same femur from January 2015 to December 2018.They were 9 males and 7 females,aged from 27 to 78 years (average,51.5 years).By the Schatzker classification,there were 2 cases of type Ⅰ,8 cases of type Ⅱ,3 cases of type Ⅲ and one case of type Ⅳ;by the cross classification,there were 10 cases of type Ⅰe,one case of type Ⅱe and 2 cases of type Ⅲ e and 3 cases of type Ⅰv.The 332 patients were included as a control group who had been treated at the same department for simple tibial plateau fracture from January 2010 to December 2015.The imaging data of the 2 groups were compared to find out the charateristics of cross type distribution;the widened distance of the lateral tibial plateau,collapse depth of the tibial plateau,separation of avulsion fracture of medial femoral condyle,maximum clearance of the medial knee and eversion angle of the tibial plateau were investigated in the patients with cross types e and Ⅰv in the observation group.Results In the observation group,the widened distance of the lateral tibial plateau averaged 7.18 mm,the collapse depth of the tibial plateau 8.74 mm,the separation of avulsion fracture of medial femoral condyle 3.44 mm,the maximum clearance of the medial knee 7.77 mm,and the eversion angle of the tibia1 plateau 87.03°.There was a significant difference in the cross type distribution of tibial plateau fractures between the 2 groups (P =0.002).In the observation group,the average widened distance of the lateral tibial platea for the 13 type e patients (8.49 ± 4.26 mm)was significantly larger than that for the 3 type Ⅰv patients (1.51 ± 2.11 mm) (t =2.706,P =0.017) Conclusion The cross classification of tibial plateau fractures with avulsion fracture of mediall condyle of the same femur may result mainly in types e and type Ⅰv.The widened distance of lateral tibial plateau helps distinction between types e and type Ⅰv.
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Fractures are frequently occurring diseases that endanger human health. Crucial to fracture healing is cartilage formation, which provides a bone-regeneration environment. Cartilage consists of both chondrocytes and extracellular matrix (ECM). The ECM of cartilage includes collagens and various types of proteoglycans (PGs), which play important roles in maintaining primary stability in fracture healing. The PG form of dentin matrix protein 1 (DMP1-PG) is involved in maintaining the health of articular cartilage and bone. Our previous data have shown that DMP1-PG is richly expressed in the cartilaginous calluses of fracture sites. However, the possible significant role of DMP1-PG in chondrogenesis and fracture healing is unknown. To further detect the potential role of DMP1-PG in fracture repair, we established a mouse fracture model by using a glycosylation site mutant DMP1 mouse (S89G-DMP1 mouse). Upon inspection, fewer cartilaginous calluses and down-regulated expression levels of chondrogenesis genes were observed in the fracture sites of S89G-DMP1 mice. Given the deficiency of DMP1-PG, the impaired IL-6/JAK/STAT signaling pathway was observed to affect the chondrogenesis of fracture healing. Overall, these results suggest that DMP1-PG is an indispensable proteoglycan in chondrogenesis during fracture healing.
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Objective To observe the changes ofmacular structure and choroidal capillary blood flow density in patients with acute central serous chorioretinopathy (CSC).Methods Prospective cross-sectional study.A total of 24 eyes of 24 patients with monocular acute CSC (case group) diagnosed by clinical examination from Shanxi Eye Hospital during January and March 2018 were included in the study.The eyes (24 eyes) and contralateral eyes (24 eyes) of the patients in the case group were set to CSC group and contralateral eye group,respectively.Twenty-one eyes of 21 healthy volunteers with age and gender matching were selected as normal control group.The macular structure of the eyes were observed by OCT and OCT angiography (OCTA),and the blood vessel density of choroidal capillary layer in the circular area of the macular area with a radius of 1 mm was measured.The paired t-test was used to compare the differences in blood flow density in the choroidal capillaries between the three groups.Results The results of OCT showed that the serous neuroepithelial detachment in the macular area was observed in all eyes of the CSC group,with or without RPE detachment being 20 or 4 eyes,respectively.Of the 24 eyes in the contralateral eye group,13 eyes (54.2％) had thick choroidal RPE lesions (PPE).There was no abnormality in the retina and choroidal structure in the macular area of the normal control group.The results of OCTA showed that the blood flow density of choroidal capillaries in the CSC group,the contralateral eye group and the normal control group were 1.759 ± 0.132,1.924± 0.463,and 1.940± 0.033,respectively.Compared with the eyes of the contralateral eye group and the normal control group,the blood flow density of choroidal capillaries in the CSC group was significantly lower (t=6.611,6.474;P=0.000,0.000).There was no significant difference in the blood flow density of choroidal capillary layer between the contralateral eye group and the normal control group (t=1.328,P ＞ 0.05).In the contralateral eye group,there was no significant difference in the blood flow density of choroidal capillary layer between PPE eyes and no RPE eyes (t=0.806,P＞0.05).Conclusions There is 54.2％ of the contralateral eyes in the monocular acute CSC patients with PPE.The choroidal capillary layer blood flow density is lower than that of the contralateral and normal eyes.
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Early brain injury (EBI) refers to the direct damage and secondary pathophysiological changes of brain tissue within 72 h after aneurysmal subarachnoid hemorrhage.Studies have shown that a variety of signaling pathways are involved in the mechanism of EBI,such as ecoxy chloropropane Kelch sample related protein-1 (Keapl)-nuclear factor E2 related factor 2 (Nrf2)-antioxidant response element (ARE) pathway,Toll-like receptor 4 (TLR4)/nuclear factor-κB pathway,phosphatidylinositol-3 kinase (PI3K)/protein kinase B (Akt) pathway.This article reviews the mechanisms of action of different signaling pathways involved in EBI.
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Glioma is a central nervous system tumor,which originates neuroderm and expresses the high malignant degree.Due to the particularity of the usual location,it makes the treatment of glioma difficult to achieve the desired effect.Interferon is a kind of important cytokines,and it has some biological characteristics,such as inducing apoptosis,inhibiting of tumor growth,and pathological angiogenesis,regulating immune function and so on.Studies have shown that there are many key molecules in the interferon signaling pathways,and these molecules play an important role in the occurrence and development of glioma cell apoptosis.Explore the key molecules and its mechanism of action in the process of Interferon inducing glioma,which may provide new clinical strategies for diagnosis and treatment of glioma.
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Whether and how garlic-derived -allylmercaptocysteine (SAMC) inhibits hepatocellular carcinoma (HCC) is largely unknown. In the current study, the role of low-density lipoprotein receptor (LDLR)-related protein 6 (LRP6) in HCC progression and the anti-HCC mechanism of SAMC was examined in clinical sample, cell model and xenograft/orthotopic mouse models. We demonstrated that SAMC inhibited cell proliferation and tumorigenesis, while induced apoptosis of human HCC cells without influencing normal hepatocytes. SAMC directly interacted with Wnt-pathway co-receptor LRP6 on the cell membrane. LRP6 was frequently over-expressed in the tumor tissue of human HCC patients (66.7% of 48 patients) and its over-expression only correlated with the over-expression of -catenin, but not with age, gender, tumor size, stage and metastasis. Deficiency or over-expression of LRP6 in hepatoma cells could partly mimic or counteract the anti-tumor properties of SAMC, respectively. administration of SAMC significantly suppressed the growth of Huh-7 xenograft/orthotopic HCC tumor without causing undesirable side effects. In addition, stable down-regulation of LRP6 in Huh-7 facilitated the anti-HCC effects of SAMC. In conclusion, LRP6 can be a potential therapeutic target of HCC. SAMC is a promising specific anti-tumor agent for treating HCC subtypes with Wnt activation at the hepatoma cell surface.
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Objective To understand the status quo of our young doctors' doctor-patient communi-cation and related influencing factors. Methods Among the doctors under the age of 40 in various clinical departments, according to 30% proportion, we randomly selected 32 doctors, and combined with revised Liverpool communication skills assessment scale (LCSAS) and standardized patients (SP), the doctors' ability of doctor-patient communication was evaluated. Descriptive statistics, t test and variance analysis were per-formed by SPSS 21.0 lines. Results The average score of communication etiquette of young doctors was (2.00±0.15), and the average score of their communication skills was (1.74±0.29), and the average score of their communication technical ability was (3.74±0.39). The detection rate of communication etiquette, communication skills and communication skills evaluation (less than 2) was 33.3%, 81.5%, and 85.2%, respectively. Physicians and surgeons' scores in communication etiquette and communication skills dimen-sion had significant difference (P<0.05). Significant difference was found in different ages doctor communi-cation protocol (F=3.641, P=0.028), and 20 to 25 years old doctors' score in communication manners was significantly lower than other ages (P<0.05). There were significant differences in the scores of doctors of different title in communication etiquette (F=4.410, P=0.023), and the trainee doctors' communication etiquette score was significantly lower than the physician and surgeon (P<0.05). Conclusion The commu-nication skills of young doctors in our hospital are generally in the middle state, and their communication etiquette is good, communication skills are general. There are great individual differences. Hospital should begin from those whose communication ability are low, cultivate their biology-psychology-social medicine thinking mode of the doctor-patient relationship , help new employees complete the role transformation , emotion management, and professional commitment, and encourage patients to participate in the medical process, so as to improve the doctors' communication ability in all directions and at different levels.
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Invasion of glioma is a complex process with multiple steps and multiple factors,including the inhibition of tumor cell adhesion,the degradation of extracellular matrix,the promotion of tumor cells migration and angiogenesis.The abnormal activation of Wnt/β-catenin signaling pathway is closely related to the invasion of glioma.The study of Wnt/β-catenin pathway affecting invasion mechanism of glioma will provide new ideas and targets for the treatment of glioma.
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In mammals,there are two RNA-binding proteins,Musashi (Msi)1 and Msi2,constituting the Msi family.Msi2 is mainly distributed among neural,hematopoietic,gastrointestinal,pancreatic and epithelial stein cells.It is of great importance to maintain the balance between proliferation and differentiation of stem cells and regulate their growth and development.The changed expression of this protein will induce genesis and progression of malignant tumor through many kinds of signal pathways.Thus,Msi2 is trusted to provide a predictive mark and a therapeutic target for related tumors.