Transrectal ultrasound examination of prostate cancer guided by fusion imaging of multiparametric MRI and TRUS: avoiding unnecessary mpMRI-guided targeted biopsy / 亚洲男科学杂志(英文版)

The purpose of this study was to explore transrectal ultrasound (TRUS) findings of prostate cancer (PCa) guided by multiparametric magnetic resonance imaging (mpMRI) and to improve the Prostate Imaging Reporting and Data System (PI-RADS) system for avoiding unnecessary mpMRI-guided targeted biopsy (TB). From January 2018 to October 2019, fusion mpMRI and TRUS-guided biopsies were performed in 162 consecutive patients. The study included 188 suspicious lesions on mpMRI in 156 patients, all of whom underwent mpMRI-TRUS fusion imaging-guided TB and 12-core transperineal systematic biopsy (SB). Univariate analyses were performed to investigate the relationship between TRUS features and PCa. Then, logistic regression analysis with generalized estimating equations was performed to determine the independent predictors of PCa and obtain the fitted probability of PCa. The detection rates of PCa based on TB alone, SB alone, and combined SB and TB were 55.9% (105 of 188), 52.6% (82 of 156), and 62.8% (98 of 156), respectively. The significant predictors of PCa on TRUS were hypoechogenicity (odds ratio [OR]: 9.595, P = 0.002), taller-than-wide shape (OR: 3.539, P = 0.022), asymmetric vascular structures (OR: 3.728, P = 0.031), close proximity to capsule (OR: 3.473, P = 0.040), and irregular margins (OR: 3.843, P = 0.041). We propose subgrouping PI-RADS score 3 into categories 3a, 3b, 3c, and 3d based on different numbers of TRUS predictors, as the creation of PI-RADS 3a (no suspicious ultrasound features) could avoid 16.7% of mpMRI-guided TBs. Risk stratification of PCa with mpMRI-TRUS fusion imaging-directed ultrasound features could avoid unnecessary mpMRI-TBs.

Factors Influencing Senior Nursing Students’ COVID-19 Psychological Distress: A Cross-sectional Study / 기본간호학회지

Purpose@#The purpose of this study was to examine the relationship between coronavirus disease 2019 (COVID-19)-related knowledge, preventive behaviors, risk perception, nursing professional values, and COVID-19 psychological distress among nursing students, and to identify factors associated with senior nursing students’ COVID-19 psychological distress. @*Methods@#This descriptive cross-sectional study included fourth-year nursing students (n=183). Data were collected using a structured questionnaire between May and June 2022. Data were analyzed using descriptive statistics, the independent t-test, one-way analysis of variance, the Scheffé test, Pearson’s correlation coefficients, and multiple linear regression analysis, using SPSS version 27.0 for Windows. @*Results@#COVID-19 risk perception (β=.39, p<.001) had the strongest association with COVID-19-related psychological distress, followed by COVID-19 knowledge (β=.37, p<.001), major satisfaction (β=-.19, p=.004), and COVID-19 preventive behavior (β=-.16, p=.023). These variables accounted for approximately 27% of the variance in COVID-19-related psychological distress. @*Conclusion@#Nursing educators should work to develop interventions to reduce nursing students’ COVID-19-related psychological distress and should consider COVID-19 knowledge, COVID-19 risk perception, and COVID-19 preventive behavior. Furthermore, plans should be developed to enhance students’ satisfaction with the nursing major by improving the clinical practicum suited to their needs.

Research progress on regulatory mechanism of long non-coding RNA CYTOR in human cancer / 中国药理学通报

Cancer is difficult to cure because of its heterogeneity, drug resistance and easy recurrence and metastasis. Revealing the molecular mechanism of cancer genesis and development, identifying new diagnostic markers and molecular therapeutic targets are undoubtedly effective strategies to solve the problems of early diagnosis, treatment and improvement of prognosis of cancer patients. More and more studies have shown that long non-coding RNA (IncRNA) is specifically expressed in human cancer and is a key regulator of cancer occurrence and development. Cytoskeleton regulator RNA (CYTOR) is a carcinogenic lncRNA found in recent years. CYTOR is highly expressed in many types of cancer and regulates the development of cancer through a variety of pathways, which may be an effective biomarker for early cancer diagnosis, molecular targeted therapy and prognosis assessment. This paper reviews the molecular regulatory mechanism and related biological characteristics of CYTOR in human cancer, in order to provide new scientific reference for clinical cancer diagnosis and treatment.

Circadian rhythm and health: dialogue between traditional Chinese medicine and modern medicine / 中国中药杂志

Circadian rhythm refers to the daily rhythmic variations in an organism. The irregular lifestyles of modern humans have led to a high incidence of chronic diseases, highlighting an inseparable relationship between disrupted circadian rhythm and disease development. TCM has long discussed rhythmic variations, with records dating back to the Yellow Emperor's Inner Canon(Huang Di Nei Jing), which laid a rich theoretical foundation for the research on circadian rhythm. Modern medical research has provided a more comprehensive explanation of its molecular mechanisms. This article integrated the current understanding of circadian rhythm in both Chinese and western medicine, emphasizing the crucial relationship between rhythm regulation and disease treatment. By highlighting the interdisciplinary nature of the two fields, it offers new directions for exploring the field of chronomedicine.

Added value of shear-wave elastography in the prediction of extracapsular extension and seminal vesicle invasion before radical prostatectomy / 亚洲男科学杂志(英文版)

The purpose of this study was to analyze the value of transrectal shear-wave elastography (SWE) in combination with multivariable tools for predicting adverse pathological features before radical prostatectomy (RP). Preoperative clinicopathological variables, multiparametric magnetic resonance imaging (mp-MRI) manifestations, and the maximum elastic value of the prostate (Emax) on SWE were retrospectively collected. The accuracy of SWE for predicting adverse pathological features was evaluated based on postoperative pathology, and parameters with statistical significance were selected. The diagnostic performance of various models, including preoperative clinicopathological variables (model 1), preoperative clinicopathological variables + mp-MRI (model 2), and preoperative clinicopathological variables + mp-MRI + SWE (model 3), was evaluated with area under the receiver operator characteristic curve (AUC) analysis. Emax was significantly higher in prostate cancer with extracapsular extension (ECE) or seminal vesicle invasion (SVI) with both P < 0.001. The optimal cutoff Emax values for ECE and SVI were 60.45 kPa and 81.55 kPa, respectively. Inclusion of mp-MRI and SWE improved discrimination by clinical models for ECE (model 2 vs model 1, P = 0.031; model 3 vs model 1, P = 0.002; model 3 vs model 2, P = 0.018) and SVI (model 2 vs model 1, P = 0.147; model 3 vs model 1, P = 0.037; model 3 vs model 2, P = 0.134). SWE is valuable for identifying patients at high risk of adverse pathology.

Comparison of clinical effects of corneal topography-guided FS-LASIK and TICL implantation for myopia with moderate to high astigmatism / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To explore the clinical efficacy of the myopic with moderate to high astigmatism correction between corneal topography-guided femtosecond laser in situ keratomileusis(FS-LAISK)and Toric implantable collamer lens(TICL).METHODS: A total of 60 patients(115 eyes)with moderate to high astigmatism in myopia(115 eyes)from June 2019 to June 2021 and treated in the refractive center of Heyuan Aier Eye Hospital were enrolled in the study, then were divided into Group A and Group B according to the operations they would accept. There were 32 patients(62 eyes)in the Group A treated with corneal topography-guided FS-LASIK and 28 patients(53 eyes)in the Group B treated with TICL implantation. Uncorrected visual acuity(UCVA), best corrected visual acuity(BCVA), spherical diopter and residual astigmatism were recorded preoperatively and postoperatively at 3mo, surgical safety and efficacy were evaluated, and the Alpins vector analysis was used to evaluate the astigmatism.RESULTS: The postoperative at 3mo, there were no differences in the safety index(1.163±0.167 vs 1.136±0.194)and the efficacy index(1.145±0.159 vs 1.123±0.196)between the patients of the two groups(P&#x003E;0.05). However, the astigmatism vector analysis showed that there were statistically differences in the index of success index [0.125(0.091, 0.200)vs 0.200(0.167, 0.250)], the correction index [1.000(0.902, 1.066)vs 0.834(0.783, 0.869)] and the flattening index [1.000(0.922, 1.079)vs 0.835(0.795, 0.870)](P&#x003C;0.01).CONCLUSION:Corneal topography-guided FS-LASIK and TICL implantation were effective and safe in correcting myopia with moderate to high astigmatism, and corneal topography-guided FS-LASIK perform better than TICL implantation for the astigmatism correction.

Synchronous tele-ultrasonography is helpful for a naive operator to perform high-quality thyroid ultrasound examinations

Purpose@#This study investigated the value of synchronous tele-ultrasonography (TUS) for naive operators in thyroid ultrasonography (US) examinations. @*Methods@#Ninety-seven patients were included in this prospective, parallel-controlled trial. Thyroid scanning and diagnosis were completed by resident A independently, resident B with guidance from a US expert through synchronous TUS, and an on-site US expert. The on-site expert’s findings constituted the reference standard. Two other off-site US experts analyzed all data in a blind manner. Inter-operator consistency between the two residents and the on-site US expert for thyroid size measurements, nodule measurements, nodule features, American College of Radiology (ACR) Thyroid Imaging Reporting and Data System (TI-RADS) categories, and image quality was compared. Two questionnaires were completed to evaluate the clinical benefit. @*Results@#Resident B detected more nodules consistent with the on-site expert than resident A did (89.4% vs. 56.5%, P0.75), while resident A achieved lower consistency in ACR TI-RADS categories, composition, echogenicity, margin, echogenic foci, and vascularity (all ICCs 0.40-0.75). Residents A and B had excellent consistency in target nodule measurements (all ICCs >0.75). Resident B achieved better performance than resident A for gray values, time gain compensation, depth, color Doppler adjustment, and the visibility of key information (all P<0.05). Furthermore, 61.9% (60/97) of patients accepted synchronous TUS, and 59.8% (58/97) patients were willing to pay for it. @*Conclusion@#Synchronous TUS can help inexperienced residents achieve comparable thyroid diagnostic capability to a US expert.

Molecular Mechanism of Long Non-coding RNA NEAT1 in DiabetesMellitus and Its Complications / 中国生物化学与分子生物学报

Diabetes is a clinical syndrome caused by a variety of factors. It often causes multiple systemdamage, leading to chronic progressive lesions of the eye, kidney, blood vessels, heart, nerves and otherorgans. At present, its etiology and pathogenesis are not fully clarified, and there is a lack of effectivecure. Further exploration of the molecular regulatory mechanisms that drive diabetes and itscomplications, identifying specific biomarkers and molecular therapeutic targets, is undoubtedly aneffective strategy to prevent the onset and development of diabetes and improve the quality of life ofpatients. Long non-coding RNA (lncRNA) is an important regulator of body normal activity and diseasedevelopment. Abnormal expression and mutation are one of the main causes of diabetes and many otherdiseases. Nuclear paraspeckle assembly transcript 1 (NEAT1) is a newly discovered lncRNA molecule inrecent years. It has attracted much attention because of its important regulatory role and diverse biologicaleffects in diabetes and its complications. This article summarizes the molecular regulation mechanism andrelated biological functions of lncRNA NEAT1 in diabetes and its complications in order to provide a newscientific reference for early prevention, diagnosis and molecular targeted therapy of diabetes.

基于网络 ? ? 学探讨 ? 脾补肾活血方治疗 缺血性 ? 中的作用机 / 中国药理学通报

Aim To explore the mechanism of Danshen decoction in the treatment of colon cancer using network pharmacology and molecular docking.Methods The active components and corresponding target proteins of Salvia miltiorrhiza, Santalum album and Amo-mum villosum in Danshen decoction were screened based on Traditional Chinese Medicine Systems Pharmacology database and analysis platform.The targets of colon cancer were searched by using Genecards database, and the common targets were selected.The network diagram of traditional Chinese medicine-active components-target-disease was constructed by using Cytoscape 3.7.0.The protein protein interaction network of common targets was constructed by using STRING database.The gene ontology(GO)and Kyoto Encyclopedia of Genes and Gnomes(KEGG)enrichment analysis were carried out based on R4.0.2.The important targets in the key pathways and the important active components in the network diagram of traditional Chinese medicine-active ingredients-target-disease network were selected for Surflex Dock.Results A total of 78 active components, 142 targets, 3 239 colon cancer targets, 105 overlapping targets and 69 corresponding active components were screened out.KEGG analysis showed that the key signaling pathway was PI3K/AKT.Luteolin and Tanshinone IIA with high correlation were selected to dock with protein kinase B(AKT1).Both active components had hydrogen bonding with AKT1.Conclusions Danshen decoction plays a positive role in colon cancer treatment.The mechanism may be related to the regulation of PI3K/AKT signaling pathway.

Orlistat induces ferroptosis-like cell death of lung cancer cells / 医学前沿

Aberrant de novo lipid synthesis is involved in the progression and treatment resistance of many types of cancers, including lung cancer; however, targeting the lipogenetic pathways for cancer therapy remains an unmet clinical need. In this study, we tested the anticancer activity of orlistat, an FDA-approved anti-obesity drug, in human and mouse cancer cells in vitro and in vivo, and we found that orlistat, as a single agent, inhibited the proliferation and viabilities of lung cancer cells and induced ferroptosis-like cell death in vitro. Mechanistically, we found that orlistat reduced the expression of GPX4, a central ferroptosis regulator, and induced lipid peroxidation. In addition, we systemically analyzed the genome-wide gene expression changes affected by orlistat treatment using RNA-seq and identified FAF2, a molecule regulating the lipid droplet homeostasis, as a novel target of orlistat. Moreover, in a mouse xenograft model, orlistat significantly inhibited tumor growth and reduced the tumor volumes compared with vehicle control (P < 0.05). Our study showed a novel mechanism of the anticancer activity of orlistat and provided the rationale for repurposing this drug for the treatment of lung cancer and other types of cancer.

Factors of direct breastfeeding at hospital discharge in preterm infants / 国际儿科学杂志

Direct breastfeeding at discharged of premature infants is a complicated process.Direct breastfeeding at discharge can not only reflect the level of medical institutions, but also determine the duration and quality of breastfeeding for premature infants after discharge.This article mainly expounds the influencing factors and corresponding intervention measures of direct breastfeeding of premature infants discharged from neonatal intensive care unit at three aspects: mothers of premature infants, premature infants and health care institutions.International lactation consultants are recommended for NICU to accurately identify and deal with the factors affecting direct breastfeeding disorders of premature infants at discharge.We should promote multidisciplinary cooperation and develop diversified breastfeeding support programs for hospitalized premature infants, so as to improve the direct breastfeeding rate of premature infants.

Effect of histone H3Ser10 phophorylation on oocyte meiotic in porcine / 医学研究生学报

ObjectiveThe mechanism of histone phosphorylation modification in oocyte meiosis is less studied. This study is designed to investigate the pattern of histone H3 phophorylation and regulation of maturation process in the porcine oocytes.MethodsThe histone H3Ser10 (H3S10) phosphorylation expression was examined on the porcine oocyte meiotic process. The porcine cumulus oocyte complexes (COCs) were divided into four groups, one group was cultured as control group, and the other 3 groups were supplemented with 5, 10, and 30 μmol/L ZM447439, and cultured in vitro for 27 h, respectively, 5, 10, and 30 μmol/L ZM4474349 treatment group. The proportion of each meiotic stage was counted. The phosphorylation pattern of histone H3S10 and the expression level of protein kinase Aurora B were detected at the porcine oocytes.ResultsCompared with histone H3S10 phosphorylation level of oocyte GVBD phase, the MI and AI phases were significantly increased (P<0.05), and H3S10 phosphorylation level of AI phase was remarkedly higher than that of MII phase (P<0.05). Compared with the control group, the proportion of oocytes at the GVBD phase in the 10 and 30 μmol/L ZM4447439 treatment group [(32.14±0.51)%, (95.34±0.59)%]was higher than that of the control group [(2.56±0.03)%, P<0.05], the proportion of oocytes at the MI phase [(66.88±0.13)%, (4.66±0.04)%] significantly decreased than that of the control group [(87.42±0.14)%, P<0.05], and the proportion of oocytes at the AI stage [(1.01±0.03)%, (0.000±0.00)%] significantly decreased compared with the control group[(10.02 ± 0.21)%, P<0.05]. Compared with the control group (0), oocytes H3S10 dephosphorylation modification ratio in the 10 μmol/L and 30 μmol/L ZM4474349 treatment group [(35.2±0.39)%, (95.4±0.65)%]significantly increased (P<0.05). Compared with the control group, the relative expression level of Aurora B in the 10 and 30 μmol/L ZM4447439 treatment group was significantly reduced (P<0.05).ConclusionHstone H3S10 phosphorylation plays arolein the maturation of mammalian oocytes. AuroraB kinase inhibitors (ZM447439) treatment can reduce H3S10 phosphorylation and Aurora B expression level and lead to oocytesmaturation disorder.

Utilizing databases to study the expression of FAM83C in gastric cancer and its clinical significance / 医学研究生学报

ObjectiveAs the pathogenesis of gastric cancer remains unclear, this paper aims to investigate the expression of FAM83C in gastric cancer tissues, to analyze the relationship between the expression difference and clinicopathological features and prognosis, and to further explore the mutation sites and methylation of FAM83C in gastric cancer.MethodsData mining of FAM83C was conducted by TCGA database and Oncomine database to analyze the expression of FAM83C in gastric cancer and other multiple types of cancer. The relationship between the expression of FAM83C and the clinicopathological characteristics of gastric cancer was analyzed by LinkedOmics database. The effect of FAM83C expression on the prognosis of patients with gastric cancer was analyzed by Kaplan Meier Plotter database. The mutation sites and methylation of FAM83C in gastric cancer was analyzed by cBioportal database and MethHC database. The protein network interacting with FAM83C was analyzed by String database.ResultsThere were 56 studies on FAM83C expression differences in the Oncomine database with statistical significance (P<0.05), among which 46 studies suggested that FAM83C was highly expressed in a variety of cancer tissues, and its high expression in gastric cancer was statistically significant (P=0.000733). Meanwhile, the analysis of 637 gastric cancer samples in the TCGA database showed that FAM83C was highly expressed in all kinds of gastric cancer tissues (P<0.05). The differences between FAM83C expression level and patients' age (P=0.0344) and T stage (P=0.034) were statistically significant (P<0.05). The group with high FAM83C expression had shorter survival time and worse prognosis, and the difference was statistically significant (P=0.0071). FAM83C mutations in gastric cancer include missense mutation, frame-shift mutation and splicing mutation. The methylation level of FAM83C gene promoter region in gastric cancer was significantly higher than that in normal gastric tissue (P<0.005). The proteins interacting with FAM83C include SLCO5A1, AKR7A3, MMP24, EIF6 and ARL11, etc., and may participate in the cellular function process together.ConclusionFAM83C is highly expressed in gastric cancer. In addition, its expression level has a certain correlation with the degree of malignancy and poor prognosis of gastric cancer, which is manifested in the characteristics of proto-oncogenes to a certain extent, and is expected to become a new target for clinical diagnosis and treatment of gastric cancer.

CXCL11 induces pancreatic cancer cell invasion and epithelial-mesenchymal transition in vitro through activation of NF-κB pathway / 西安交通大学学报(医学版)

Objective: To investigate the important role of NF-κB pathway in CXCL11-induced invasion and epithelial-mesenchymal transition (EMT) of pancreatic cancer cell line Panc-1. Methods: Panc-1 cultured in vitro was harvested and divided into control group, CXCL11 group, and BAY 11-7082 group (NF-κB inhibitor). Transwell invasion assay was applied to analyze the invasive ability of tumor cells in different groups. The expressions of p65, P-p65, E-cadherin, N-cadherin, and Vimentin were determined by Western blot. The intracellular localization of p65 was detected by immunofluorescence staining. Results: CXCL11 significantly induced the invasion of Panc-1 cells, promoted p65 nuclear translocation of Panc-1 cells, upregulated the expressions of P-p65, N-cadherin and Vimentin, and downregulated the expression of E-cadherin. Furthermore, the inhibition of NF-κB pathway obviously abrogated CXCL11-induced invasion of Panc-1 cells and enhanced the p65 nuclear translocation. Conclusion: CXCL11 induces epithelial-mesenchymal transition and enhances invasion of pancreatic cancer cells through the activation of NF-κB pathway.

Combination of hyaluronic acid and bone marrow mesenchymal stem cells promotes cardiac function after myocardial infarction / 中国组织工程研究

BACKGROUND: The poor retention and survival of donor cells implanted into the myocardium limit the efficacy of cell therapy for myocardial infarction. Embedding cells in natural or synthetic biomaterials is a strategy to address this issue. OBJECTIVE: To explore the effects of bone marrow mesenchymal stem cells (BMSCs) encapsulated in hyaluronic acid (HA) hydrogel on cardiac function after myocardial infarction. METHODS:BMSCs from male Sprague-Dawley rats were isolated and cultured,and then HA-encapsulated BMSCs were cultured in vitro in the three-dimensional manner. A model of myocardial infarction was made by cutting the anterior descending artery of female Sprague-Dawley rats. After 1 week, the model rats were screened by ultrasonic testing and then eligible ones were randomly divided into four groups: PBS group (n=8), HA group (n=8), BMSCs group (n=29), and HA-encapsulated BMSCs group (n=29). At 1 week after modeling, the model rats underwent the secondary thoracotomy and the implants were injected into the marginal zone and infarcted region in corresponding groups. The survival rate and apoptosis of implanted cells were examined at post-injection day 1, week 1 and week 2 by RT-PCR and TUNEL respectively. At post-injection week 4, changes of cardiac microstructure and function were evaluated by histological examination and echocardiography. RESULTS AND CONCLUSION: Compared with the BMSCs group, HA hydrogel significantly enhanced the survival rate and reduced the apoptotic rate of BMSCs at post-injection day 1 and week 2 (both P < 0.05). At post-injection week 4, the HA+BMSCs combined treatment yielded the best recovery of cardiac function (P < 0.05). To conclude, HA hydrogel can act as a vehicle for BMSCs delivery and improve the beneficial effects of implanted BMSCs in early myocardial repair(within 2 weeks after infarction)via enhancing cell retention and survival.

Organization moclel of the German national cohort and its enlightenments / 中华医学图书情报杂志

Objective To promote the effective management of population cohort data and to provide the beneficial reference for the cohort data management model in our country. Methods After a description of the German national cohort program with an international impact, its organizational model, data types and data management were sum-marized and analyzed, its research target and plan were outlined, its data collection and processing, integration and storage, quality protection and control were studied. Results Multisource data classification management prohibited the application for data and sharing of data use in tested subjects when they were using the data. Conclusion Data standards should be unified, multisource data classification storage should be implemented, the data analysis should be widened and deepened, the right of tested subjects should be made clear, and the data sharing procedure should be standardized in our country according to the inadequate domestic cohort research and the enlightenments of the German national cohort.

Targeting tumor-associated macrophages by anti-tumor Chinese materia medica / 中国结合医学杂志

Tumor-associated macrophages (TAMs) play a key role in all stages of tumorigenesis and tumor progression. TAMs secrete different kinds of cytokines, chemokines, and enzymes to affect the progression, metastasis, and resistance to therapy depending on their state of reprogramming. Therapeutic benefit in targeting TAMs suggests that macrophages are attractive targets for cancer treatment. Chinese materia medica (CMM) is an important approach for treating cancer in China and in the Asian region. According to the theory of Chinese medicine (CM) and its practice, some prescriptions of CM regulate the body's internal environment possibly including the remodeling the tumor microenvironment (TME). Here we briefly summarize the pivotal effects of TAMs in shaping the TME and promoting tumorigenesis, invasion, metastasis and immunosuppression. Furthermore, we illustrate the effects and mechanisms of CMM targeting TAMs in antitumor therapy. Finally, we reveal the CMM's dual-regulatory and multi-targeting functions on regulating TAMs, and hopefully, provide the theoretical basis for CMM clinical practice related to cancer therapy.

Effects and safety assessment of methylprednisolone on postoperative nausea and vomiting and pain after total knee arthroplasty / 中国组织工程研究

BACKGROUND:At present, dexamethasone has been widely used in the perioperative period of major surgery in the orthopedics for reducing postoperative pain and nausea and vomiting, but the study on the application of methylprednisolone to reducing postoperative nausea and vomiting and pain after unilateral total knee arthroplasty is rarely reported.OBJECTIVE:To evaluate the effects and safety assessment of the application of methylprednisolone on postoperative nausea and vomiting and pain after unilateral total knee arthroplasty. METHODS:A total of 86 patients undergoing unilateral total knee arthroplasty were randomly assigned to two groups. Patients in the methylprednisolone group were given methylprednisolone 40 mg in intravenous drip within 24 hours during and after replacement. Patients in the control group were given an equal volume of saline in intravenous drip at the same time. The incidence of postoperative nausea and vomiting was observed and recorded at 0-6 hours, 6-24 hours, 24-48 hours, and 48-72 hours after surgery, as wel as the total incidence was recorded in both groups. Pain visual analogue scale (VAS) score at 6, 24, 48 and 72 hours after replacement, and knee joint scoring system (KSS) score at 3 days after replacement were recorded. C-reactive protein and fasting blood glucose were determined. The occurrence of adverse reactions postoperatively was recorded in 6-month fol ow-up in both groups. RESULTS AND CONCLUSION:(1) The total incidence rate of postoperative nausea and vomiting during 0-72 hours after surgery, and incidence rates of nausea and vomiting at 6 and 24 hours were significantly lower in the methylprednisolone group than in the control group (P0.05). (5) The surgical incision was found to heal in 3-month fol ow-up and no postoperative infection occurred in both groups. (6) Results show that methylprednisolone can obviously reduce postoperative nausea and vomiting and pain in unilateral total knee arthroplasty, and did not increase the incidence of postoperative infection.

Insulin promotes the osteogenic differentiation of umbilical cord mesenchymal stem cells / 中国组织工程研究

BACKGROUND: How to effectively and rapidly induce the osteogenic differentiation of human umbilical cord mesenchymal stem cells is the focus of the current stem cell research. Increasing evidence has demonstrated some growth factors, such as bone morphogenetic protein-2, have important effects on the transdifferentiation of umbilical cord mesenchymal stem cels into osteoblasts in vitro. However, widespread use of growth factors is limited because of high cost. Insulin is widely used in the cell culture and induction, but there is no report about the effect of insulin on the osteogenic differentiation of human umbilical cord mesenchymal stem cells. OBJECTIVE:To observe the effect of insulin on osteogenic differentiation of human umbilical cord mesenchymal stem cels and to explore the feasibility of human umbilical cord mesenchymal stem cell transplantation in the treatment of diabetic delayed fracture healing. METHODS:The passage 3 human umbilical cord mesenchymal stem cells were inoculated in two flasks, denoted as experimental group and control group. The insulin (10-7mmol/L) was added to the experimental group but not to the control group. The proliferative capacity of human umbilical cord mesenchymal stem cels was evaluated by cell count kit-8 and alkaline phosphatase activity. The osteogenic differentiation capacity of human umbilical cord mesenchymal stem cells was evaluated by measuring the protein and mRNA expressions of type I colagen as well as osteocalcin mRNA level. RESULTS AND CONCLUSION: After 1-2 weeks of induction, compared with the control group, insulin could significantly increase the number of human umbilical cord mesenchymal stem cells in the experimental group, the activity of alkaline phosphatase and expressions of type I collagen osteocalcin mRNA (P< 0.05). These data indicate that insulin can promote the proliferation and osteogenic differentiation of human umbilical cord mesenchymal stem cells.

Intra-articular and intravenous injection of tranexamic acid effectively reduces blood loss after total knee arthroplasty / 中国组织工程研究

BACKGROUND: Studies have shown that tranexamic acid can effectively reduce postoperative blood loss in patients with total knee arthroplasty. There are many means to inject tranexamic acid (intra-articular injection, intravenous injection and their combination). Which is the best way has no conclusion. OBJECTIVE: To explore whether all three ways (intra-articular injection, intravenous injection and their combination) to inject tranexamic acid can all effectively reduce the bleeding after total knee arthroplasty. METHODS:103 patients undergoing unilateral total knee arthroplasty from December 2014 to December 2015 were enrolled in this study. The patients were allocated into four groups according to injection way. In the intra-articular injection group, 2 000 mg of tranexamic acid was given through the intra-articular injection after incision suture. In the intravenous injection group, 1 000 mg of tranexamic acid was given through the intravenous injection at 15 minutes before the use of tourniquet. In the combined modality therapy group, above methods were used. In the blank control group, tranexamic acid was not given. RESULTS AND CONCLUSION:(1) Total blood loss and blood transfusion rate were less in the intra-articular injection group and combined modality therapy group than in the intravenous injection group (P 0.05). The blood transfusion rate was 0% in the intra-articular injection group and combined modality therapy group. (2) Adverse reaction: deep vein thrombosis, pulmonary embolism, wound infection, hematoma or gangrene was not observed in al groups. (3) Results confirmed that intra-articular combined with intravenous injection can reduce effectively postoperative blood loss and the effect is better than separate administration.