Emphasis on biomaterial research in bone defect repair of osteoporotic fracture / 中华创伤杂志

Osteoporosis results in decreased bone mass,impaired bone strength and bone microstructure,and thus can easily cause bone fracture.Osteoporosis is one of the common diseases troubling the aging people.Due to the decreased activity of osteoblasts as well as impaired osteogenic differentiation of mesenchymal stem cells,the repair of bone defects accompanied with osteoporosis is very limited.It is a promising way to enhance the healing effect of such bone defect through implanting biomaterials with improved physical and chemical properties as well as elevated bioactivities,since it can mediate the activities of osteogenesis related cells in situ.The author summarizes the popular methods for the modification of biomaterials used for repairing bone defect caused by osteoporotic fractures and provides a prospect in this field,with the aim to provide a reference for the treatment of osteoporotic fractures.

Where are the theca cells from: the mechanism of theca cells derivation and differentiation / 中华医学杂志(英文版)

Mammalian follicles are composed of oocytes, granulosa cells, and theca cells. Theca cells form in the secondary follicles, maintaining follicular structural integrity and secreting steroid hormones. Two main sources of theca cells exist: Wilms tumor 1 positive (Wt1) cells native to the ovary and Gli1 mesenchymal cells migrated from the mesonephros. Normal folliculogenesis is a process where oocytes, granulosa cells, and theca cells constantly interact with and support each other through autocrine and paracrine mechanisms. The proliferation and differentiation of theca cells are regulated by oocyte-derived factors, including growth development factor 9 and bone morphogenetic protein 15, and granulosa cell-derived factors, including desert hedgehog, Indian hedgehog, kit ligand, insulin-like growth factor 1, as well as hormones such as insulin and growth hormones. Current research on the origin of theca cells is limited. Identifying the origin of theca cells will help us to systematically elaborate the mechanisms of follicular formation and development.

Emphasis on biomaterial research in bone defect repair of osteoporotic fracture / 中华创伤杂志

Osteoporosis results in decreased bone mass, impaired bone strength and bone microstructure, and thus can easily cause bone fracture. Osteoporosis is one of the common diseases troubling the aging people. Due to the decreased activity of osteoblasts as well as impaired osteogenic differentiation of mesenchymal stem cells, the repair of bone defects accompanied with osteoporosis is very limited. It is a promising way to enhance the healing effect of such bone defect through implanting biomaterials with improved physical and chemical properties as well as elevated bioactivities, since it can mediate the activities of osteogenesis related cells in situ. The author summarizes the popular methods for the modification of biomaterials used for repairing bone defect caused by osteoporotic fractures and provides a prospect in this field, with the aim to provide a reference for the treatment of osteoporotic fractures.

Performance verification of diluted thrombin time assay for detecting Dabigatran level in plasma / 临床检验杂志

Objective To evaluate the performance of diluted thrombin time (dTT) assay for detecting Dabigatran levels and observe whether this assay may meet the requirements of clinical laboratory.Methods According to EP15-A2,EP6-A,EP7-A and C-24 documents of the Clinical and Laboratory Standards Institute (CLSI),the precision,trueness,analytical measurement range,carryover rate and anti-biological interference of dTT assay were evaluated and the stability of specimen for dTT assay was observed.Results Both the within-day and between-day coefficient of variation (CV) of dTT assay for detecting Dabigatran levels were consistent with manufacturer's stated CV.Compared with target values of Dabigatran,the relative bias of 3 levels of proficiency test materials from College of American Pathologists (CAP) were less than 10％.The results meet linear verification when Dabigatran concentration was between 30.92 and 249.13 ng/mL.The carryover rate was-0.84％.There was no interference for Dabigatran levels by dTT assay for detecting Dabigatran when Hb≤3 g/L,triglyceride≤873 mg/dL,heparin≤2.2 IU/mL and FDP≤29 mg/L.The results of stability showed that plasma specimens for dTT could not be stored at room temperature more than 4 hours,at 4 ℃ more than 4 days,at-20 ℃ exceed 1 month,while at-80℃ the plasma specimens could be stored at least 6 months for dTT assay.Conclusion The precision,trueness,analytical measurement range,carryover rate,anti-biological interference of dTT assay may meet the requirement of clinical laboratory.The stability of the specimen can fulfill the clinical requirements.

Obstructive Sleep Apnea Syndrome is Associated with Metabolic Syndrome among Adolescents and Youth in Beijing: data from Beijing Child and Adolescent Metabolic Syndrome Study / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Obstructive sleep apnea (OSA) syndrome has a negative impact on the health of millions of adolescents and youth. The aim of this study was to evaluate the associations of OSA syndrome with obesity and cardiometabolic risk factors among adolescents and youth at risk for metabolic syndrome (MS).</p><p><b>METHODS</b>A total of 558 subjects aged 14-28 years were recruited from the Beijing Child and Adolescent Metabolic Syndrome Study. Each underwent a 2-h oral glucose tolerance test (OGTT), echocardiography, and liver ultrasonography. Anthropometric measures, blood levels of glucose, lipids, and liver enzymes were assessed. Subjects with high or low risk for OSA were identified by Berlin Questionnaire (BQ).</p><p><b>RESULTS</b>Among the subjects in obesity, 33.7% of whom were likely to have OSA by BQ. Subjects with high risk for OSA had higher neck and waist circumference and fat mass percentage compared to those with low risk for OSA (P < 0.001). Moreover, significant differences in levels of lipids, glucose after OGTT, and liver enzymes, as well as echocardiographic parameters were found between the two groups with high or low risk for OSA (P < 0.05). The rates of nonalcoholic fatty liver disease (71.0% vs. 24.2%), MS (38.9% vs. 7.0%), and its components in high-risk group were significantly higher than in low-risk group.</p><p><b>CONCLUSIONS</b>The prevalence of OSA by BQ was high in obese adolescents and youth. A high risk for OSA indicates a high cardiometabolic risk. Mechanisms mediating the observed associations require further investigation.</p>

Impact of surgery and epirubicin intravesical chemotherapy on peripheral blood dendritic cell subsets in patients with superficial urothelial carcinoma of the bladder / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Superficial urothelial carcinoma (SUC) of the bladder is a common urinary tract tumor in China. There is a high recurrence rate of this tumor even after surgery and intravesical instillation. Previous reports have described a suppression of the immune system in cancer patients. Dendritic cells (DCs) play a pivotal role in the induction of an effective antitumor immune response. The aim of this study was to investigate the effects of surgery and epirubicin intravesical chemotherapy (IC) on peripheral blood DCs in subsets of patients with bladder SUC.</p><p><b>METHODS</b>A total of 66 SUC patients and 38 healthy controls were enrolled in this study. All the patients had undergone transurethral resection (TUR) of their cancer and adjunctive IC after tumor removal. The patients were divided into a non-recurrence group (n = 40) and a recurrence group (n = 26) based on the presence or absence of tumor recurrence. Blood samples were taken preoperatively (PreOP), on postoperative days (POD) 1 and 7, and at postoperative month (POM) 3. Flow cytometric analysis was used for the determination and quantitation of the surface markers CD80 and CD86 in circulating DC subsets.</p><p><b>RESULTS</b>The preoperative percentages of myeloid dendritic cells (mDCs) and expression of CD80 and CD86 were impaired in SUC patients compared to healthy controls (P < 0.05). The percentages of mDCs and these surface markers decreased significantly on POD 1 and increased on POD 7, remaining higher than the preoperative values in POM 3 (P < 0.05). The percentages of mDCs, and CD80 and CD86 in the non-recurrence group on PreOP, POD 7, and POM 3 were higher than those in recurrence group.</p><p><b>CONCLUSIONS</b>Surgical removal of SUC and adjunctive IC were associated with improved circulating mDC counts and function. Persistent depression of mDC counts and function after treatment in recurrence patients indicated lower antitumor immunity that may lead to tumor recurrence.</p>

Functional recovery following traumatic spinal cord injury mediated by a unique polymer scaffold seeded with neural stem cells and Schwann cells / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The most important objective of transplant studies in the injured spinal cord has been to provide a favorable environment for axonal growth. Moreover, the continuing discovery of new grafts is providing new potentially interesting transplant candidates. Our purpose was to observe the morphological and functional repair effects of the co-transplantation of neural stem cell (NSC), Schwann cells (SCs) and poly lactide-co-glycolide acid (PLGA) on the spinal cord injury of rats.</p><p><b>METHODS</b>A scaffold of PLGA was fabricated. NSCs and SCs were cultured, with the NSCs labeled with 5-bromodeoxyuridine, and the complex of NSC/PLGA or NSC + SCs/PLGA were constructed. Thirty-six Wistar rats were randomly divided into three groups: group A (transplantation of PLGA), group B (transplantation of NSC/PLGA) and group C (transplantation of NSC + SCs/PLGA). The 3 mm length of the right hemicord was removed under the microscope in all rats. The PLGA or the complex of PLGA-cells were implanted into the injury site. Basso-Beattie-Bresnahan (BBB) locomotion scores, motor and somatosensory evoked potential of lower limbs were examined to learn the rehabilitation of sensory and motor function at 4 weeks, 8 weeks, 12 weeks and 24 weeks after injury. All the recovered spinal cord injury (SCI) tissues were observed with HE staining, immunohistochemistry, and transelectronmicroscopy to identify the survival, migration and differentiation of the transplanted cells and the regeneration of neural fibres at 4 weeks, 8 weeks, 12 weeks and 24 weeks after injury.</p><p><b>RESULTS</b>(1) From 4 weeks to 24 weeks after injury, the BBB locomotion scores of cell-transplanted groups were better than those of the non-cell-transplanted group, especially group C (P < 0.05). The amplitudes of the somatosensory evoked potential (SEP) and motor-evoked potential (MEP) were improved after injury in groups B and C, but the amplitude of SEP and MEP at 4 weeks was lower than that at 12 weeks and 24 weeks after injury. Compared with group B, the amplitude of SEP and MEP in group C was improved. The amplitude of SEP and MEP was not improved after injury in group A. (2) HE staining revealed the volume of the scaffold decreased and the number of cells in the scaffold increased. Newly-grown capillaries also could be seen. Immunohistochemistry staining showed the transplanted NSCs could survive and migrate until 24 weeks and they could differentiate into neurons and oligodendrocytes. The regenerated axons were observed in the scaffold-cell complex with transelectronmicroscopy. The above manifestations were more extensive in group C.</p><p><b>CONCLUSIONS</b>The transplanted NSC can survive and migrate in the spinal cord of rats up to 24 weeks after injury, and they can differentiate into various neural cells. Co-transplantation of cells/PLGA can promote the functional recovery of the injured spinal cord. The effect of co-transplanting NSC + SCs/PLGA is better than transplanting NSC/PLGA alone.</p>

Clinical selection of endovascular stenting and carotid endarterectomy in treatment of carotid artery stenosis / 中华外科杂志

<p><b>OBJECTIVE</b>To explore reasonable clinical decision in treating carotid artery stenosis under different conditions.</p><p><b>METHODS</b>The data of 133 carotid artery stenosis patients were retrospectively analyzed. Of the patients, 46 cases were treated with carotid angioplasty and stenting (CAS), 87 patients received carotid endarterectomy (CEA). The length of hospital stay and National Institutes of Health Stroke Scale (NIHSS) grade before and after treatment in both groups were observed; the forward flow were assessed by digital subtraction angiography (DSA) before and after treatment; the degree of carotid artery stenosis were determined by using ultrasound during 3 to 24 months after treatment in both groups; the cumulative incidence of major cardiovascular events was concentrated, including appearance of death, stroke or myocardial infarction during 30 days after CAS and CEA and death or homonymy stroke during 31 days to 2 years.</p><p><b>RESULTS</b>Significant difference was found in hospital stay and when NIHSS exceed 20 after treatment between the two groups (P < 0.05); there was no significant difference in the forward flow before and after treatment in both groups; the carotid artery stenosis had been improved significantly after the operation in both groups; the cumulative incidence of major cardiovascular events in CEA group was significantly higher than in CAS group in 30 days after the operation (P < 0.05), but no statistical difference in 31 days to 2 years after the operation.</p><p><b>CONCLUSIONS</b>CAS and CEA has equivalent effects in treating carotid artery stenosis, and should be selected according to the location of stenosis, etiological factors and the condition of opposite carotid artery.</p>