Mental health status and its influencing factors in middle school students under the regular prevention and control of COVID-19 / 四川精神卫生

ObjectiveTo analyze the mental health status and its influencing factors in middle school students under the regular prevention and control of COVID-19， so as to provide references for the intervention and management of their mental health problems. MethodsFrom March 7 to 21， 2021， a stratified random sampling method was used to select 19 352 students from 17 schools in 3 districts and 9 counties of Linyi City， Shandong Province. Basic data were collected through a self-designed questionnaire. All students completed the Symptom Checklist 90 （SCL-90） to assess their mental health status. Then the factors affecting the mental health status of middle school students were screened using independent sample t-test， one-way ANOVA test and multiple stepwise regression analysis. Results① A total of 6 350 （32.81%） middle school students were found to have mental health problems. ② Each SCL-90 factor score and total average score yielded statistical difference among middle school students of different genders， relationships with classmate， closeness to friends， concerns about the epidemic， and pressure exerted by schoolwork （P<0.01）. Each SCL-90 factor score and total average score of middle school students were significant different in terms of the hours of smartphone usage for recreation per day， sleep duration per night in hours and exercise frequency （P<0.01）. ③ Multiple stepwise regression analysis denoted that female gender， poor relationship with classmate， no close friend and long hours of smartphone usage for recreation were the risk factors for mental health of middle school students （β=0.096， 0.183， 0.064， 0.232， P<0.01）. ConclusionThe prevalence rate of mild mental health problems is quite high among middle school students under the regular epidemic prevention and control. Additionally， female gender， poor relationship with classmate， no close friend and long hours of smartphone usage for recreation have a negative impact on middle school students' mental health.

Performance evaluation of automated magnetic beads extraction method for the measurement of catecholamine metabolites analyzed by liquid chromatography tandem mass spectrometry / 中华检验医学杂志

Objective:To evaluate the performance of magnetic beads extraction method (MGE) for the measurement of catecholamine metabolites by liquid chromatography tandem mass spectrometry.Methods:This is a methodological evaluation study. The linearity, limit of quantitation, recovery, precision, and matrix effect of catecholamine metabolites 3-methoxyepinephrine (MN), 3-methoxynorepinephrine (NMN) and 3-methoxytyramine (3-MT) extracted by MGE method were evaluated according to CLSI C62-A. Consensus of method development and validation of liquid chromatography-tandem mass spectrometry in clinical laboratories and other guidelines, 132 clinical residual plasma samples were collected and extracted by automated MGE and traditional solid phase extraction (SPE) method to compare the harmonization of the two extraction methods.Results:The linearity of MN, NMN and 3-MT extracted by automated MGE was>0.99, and the LOQ for MN, NMN and 3-MT were 0.033 5 nmol/L, 0.054 7 nmol/L and 0.011 0 nmol/L, respectively. The repeatability of MN, NMN and 3-MT were 1.3%-5.1%, 2.2%-5.6% and 1.7%-7.1%, respectively. The total imprecision in the laboratory were 1.5%-8.2%, 2.2%-7.7%, 2.1%-11.2%. Although the absolute recovery is low, the average relative recoveries of MN, NMN and 3-MT were 91.5%-108.5%, 92.0%-108.6%, and 89.3%-104.1%, respectively, and the percentage deviation from the expected concentration was within 15%. After isotope internal standard correction, the relative matrix effect is close to 100%, which can compensate for the potential matrix effect. The results of MGE and SPE of MN, NMN and 3-MT showeda good correlation (correlation coefficient r>0.99). The average relative deviations of MN, NMN and 3-MT were 0.2%, -1.4% and 1.0%, respectively. Conclusion:The automatic MGE method hasa good performance in extracting catecholamine metabolites, and is expected to be used in high-throughput analysis of samples in clinical in the future.

Effects of morning blood pressure on vascular endothelial function and chronic inflammatory response in the elderly / 中国医师杂志

Objectives:To investigate the effects of morning blood pressure on vascular endothelial function and chronic inflammatory response in the elderly.Methods:349 elderly people aged ≥60 who underwent 24-hour ambulatory blood pressure monitoring in Gaomi Municipal Hospital from April 2018 to October 2019 were selected to detect brachial artery flow mediated vasodilation (FMD) and chronic inflammatory factors [high-sensitivity C-reactive protein (hsCRP), tumor necrosis factor-α (TNF-α) and interleukin (IL)-17] levels. According to the results of 24-hour ambulatory blood pressure monitoring, the subjects were divided into normal blood pressure group ( n=108), simple morning hypertension group ( n=114) and hypertension group ( n=127). The clinical data, 24-hour ambulatory blood pressure parameters, vascular endothelial function and inflammatory factors of the three groups were compared. The correlation between 24-hour ambulatory blood pressure parameters and FMD and inflammatory factors was analyzed by partial correlation. Results:Compared with the normal blood pressure group, the simple morning hypertension group and the hypertension group had lower FMD (all P<0.05), higher serum hsCRP and TNF-α , IL-17 levels (all P<0.05). Compared with the simple morning hypertension group, the hypertension group had lower FMD ( P<0.05), higher serum hsCRP, TNF-α and IL-17 levels (all P<0.05). After controlling for age, sex, smoking history, drinking history, total cholesterol, triglycerides, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, fasting blood glucose and 24 h average blood pressure, the morning systolic blood pressure was negatively correlated with FMD ( P<0.05), and positively correlated with serum hsCRP and TNF-α and IL-17 levels (all P<0.05); the morning diastolic blood pressure was negatively correlated with FMD ( P<0.05) and positively correlated with serum hsCRP and TNF-α levels (all P<0.05). Conclusions:Morning blood pressure level is closely related to vascular endothelial function and chronic inflammation level, and is independent of 24-hour average blood pressure. The increase of morning blood pressure may be an important risk factor for endothelial dysfunction and chronic inflammation in the elderly.

Four-dimensional space events of fracture healing / 中国组织工程研究

BACKGROUND: Fracture fixation and surgical procedures have a very important impact on the final outcome of fracture healing, but the adverse outcome of fracture healing is the result of the combined action of surgical procedures and a series of four-dimensional space events. OBJECTIVE: To explore the four-dimensional space events in fracture healing. METHODS: China National Knowledge Infrastructure and Medline were retrieved, with the key words of “fracture healing, femoral fracture, stress shielding, fracture and blood flow” in Chinese and English. Retrieval of relatively macroscopic factual descriptions corresponds to the four-dimensional space events of fracture healing process, including logically supported and refuted evidence. Combined with literature review, the main four-dimensional space events after fracture fixation were analyzed. RESULTS AND CONCLUSION: The main four-dimensional space events after fracture fixation include blood flow tides, mechanical and biological impulses, grinding disc effect of small gap in hard tissue, stress shielding effect and four-dimensional space drift effect of internal fixation material. Fractures and surgical trauma are accompanied by months of super-compensatory blood flow tides, so there is no ischemia in the macro-level after fracture surgery, but the grinding disc effect will occur in the small gap of hard tissue under unstable condition, resulting in contusion injury and micro-ischemia in the fracture gap. Stress shielding effect caused by too strong fixation is an important reason for refracture after internal fixation removal and bone atrophy and thinning after internal fixation. The small axial drift of plate fixation screw may have important theoretical significance. It has “intelligent” axial dynamic effect, which can make the stress shared by plate gradually decrease with the healing of fracture. Discussing the four-dimensional space events of fracture healing will provide basic logic for the regulation of fracture healing and distraction osteogenesis.

The relationship between physical activity and incident hypertension in rural Chinese / 中华预防医学杂志

Objective@#To investigate the relationship between physical activity (PA) and the risk of incident hypertension among population in rural areas of China.@*Methods@#The Community Intervention of Metabolic Syndrome in China & Chinese Family Health Study (CIMIC) was conducted in 2007-2008. Data on PA, smoking, drinking, blood pressure and other variables were obtained at baseline. Then the follow-up study of incident hypertension was performed during 2012-2015. A total of 41 457 participants aged ≥18 years and free from hypertension at baseline were included in the final analyses. PA was calculated as metabolic equivalent (MET) for each participant. Cox proportional hazard models were used to explore the relationship of PA with incident hypertension according to the quartiles of PA.@*Results@#A total of 6 780 participants developed hypertension during an average follow up of 5.8 years. The annual incidence of hypertension was 2.80%. Compared to participants in the first quartile of PA, HR (95%CI) of incident hypertension decreased with the level of PA of 0.92 (0.86, 0.99), 0.72 (0.67, 0.77) and 0.70 (0.65, 0.75) for the 2nd, 3rd and 4th quartile, respectively (Ptrend<0.001). In subgroup analyses, compared to the first quartile, hazards of hypertension among normotensive participants (systolic blood pressure less than 120 mmHg (1 mmHg=0.133 kPa) and diastolic blood pressure less than 80 mm Hg) in the 2nd, 3rd and 4th quartile were 0.82 (0.70, 0.95), 0.73 (0.63, 0.85) and 0.78 (0.67, 0.90), respectively (Ptrend=0.002). Among participants with prehypertension (systolic blood pressure from 120 to 139 mmHg and/or diastolic blood pressure from 80 to 89 mmHg), similar trend for the relationship of PA and incident hypertension was also found with HR (95%CI) of 0.94 (0.87, 1.01), 0.71 (0.65, 0.77) and 0.66 (0.61, 0.71) for the 2nd, 3rd and 4th quartile, respectively (Ptrend<0.001).@*Conclusion@#There was linear trend association between PA and incident hypertension. Increased PA in daily life may be a protective factor against hypertension.

Expression level of Dickkopf-1 protein in bone mesenchymal stem cells in Type 2 diabetic rats and its relationship with osteogenic activity / 中南大学学报(医学版)

To examine the growth activity and osteogenic differentiation of bone mesenchymal stem cells (BMSCs) in rats with Type 2 diabetes mellitus (T2DM) as well as the expression level of Dickkopf-1 (DKK-1) in bone marrow, and to explore the relationship between the osteogenic activity of BMSCs and the expression of DKK-1.
 Methods: The BMSCs were isolated from T2DM rats and were cultured in vitro. The BMSCs were divided into a T2DM group and a control group. The proliferation of BMSCs was detected by cell counting kit-8 (CCK8). Apoptosis rate was detected by annexin V- fluorescein isothiocyanate (FITC)/propidium iodide (PI) double staining. In the osteogenic induction phase, the expression level of alkaline phosphatase (ALP) in BMSCs was detected by ALP staining and ALP activity assay kit. The osteogenic differentiation of BMSCs was analyzed by alizarin red staining and mineralized nodule quantification. In addition, the expression of Runx2 and DKK-1 in BMSCs was detected by qRT-PCR.
 Results: Compared with the control group, the proliferation of BMSCs was decreased and the apoptosis was increased in the T2DM group (both P<0.01). In the osteogenic induction process of BMSCs, the expression of ALP significantly decreased, the formation of calcium nodules reduced, and the expression of osteoblast transcription factor Runx2 was down-regulated in the T2DM group compared with those in the control group (all P<0.01). The levels of DKK-1 protein and mRNA were up-regulated in the T2DM group, which were higher than those in the control group (both P<0.01). The levels of DKK-1 protein and mRNA were related to the increase of Runx2 (both P<0.01).
 Conclusion: The growth activity of BMSCs and the potential of osteogenic differentiation are attenuated in the T2DM rats, which may be related to the increase of DKK-1 expression in BMSCs.

Association between morning surge of systolic blood pressure and white matter lesions in elderly hypertensive patients / 中华老年心脑血管病杂志

Objective To study the association between morning surge (MS) of systolic blood pressure (SBP) and white matter lesions in elderly essential hypertensive (EH) patients.Methods Three hundred and thirty-seven elderly EH patients from Zhangqiu of Shandong Province were divided into MS group (n=150) and non-MS group (n=187).Their 24 h ambulatory SBP was monitored.Their white matter hyperintensity (WMH) was assessed according to their brain MRI.Results The total WMH,periventricular WMH,and deep WMH were significantly higher in MS group than in non-MS group (P＜0.01).The MS of SBP was positively related with the total WMH,periventricular WMH,and deep WMH (r=0.561,r=0.563,r=0.283,P＜0.01),and was an independent risk factor for total WMH,periventricular WMH,and deep WMH after adjustment for confunders (r=0.479,r=0.486,r=0.208,P＜0.01).Conclusion MS of SBP is an independently risk factor for WMH in elderly EH patients.

Effect of telmisartan combined with rosuvastatin on white matter lesion in elderly hypertensive patients / 中华老年心脑血管病杂志

Objective To study the effect of telmisartan combined with rosuvastatin on white matter lesion (WML) in elderly hypertensive patients.Metheds Three hundred and twenty-nine elderly patients with mild-moderate essential hypertension (EH) were divided into control group (n=167) and combined treatment group (n=162).The patients in control group were treated with telmisartan (40 mg/d) and those in combined treatment group were treated with telmisartan plus rosuvastatin (10 mg/d).Their white matter hyperintensivity (WMH),periventricular white matter hyperintensity (PWMH),and deep white matter hyperintensity (DWMH) were measured by head MRI.Results The total WMH,PWMH and DWMH were significantly higher in two groups in the third and fifth years than at the baseline (P＜0.05).The growth rate of total WMH,PWMH and DWMH was significantly lower in combined treatment group than in control group in the third and fifth years (P＜0.05).Conclusion Telmisartan combined with rosuvastatin plays an important role in stablizing blood pressure,regulating blood lipids,and delaying WML.

Effect of empty-nest on variability of self-measured blood pressure at home in elderly hypertensive patients / 中华老年心脑血管病杂志

Objective To study the effect of empty-nest (EN) on the variability of HBPV in elderly hypertensive patients.Methods 457 elderly essential hypertensive patients admitted to our hospi tal were divided into non EN group (A group,n =183),EN couple group (B group,n =150),and EN single group (C group,n=124).They underwent 7-day HBPV,their BPV was detected,their loneliness and depressive symptoms were assessed according to the UCLA-LS and GDS.Results The variability of self-measured DPB and SBP,UCLA-LS and GDS score were significantly higher in B and C groups than in A group (P＜0.05).The variability of SBP,UCLA-LS and GDS score were significantly higher in C group than in B group (46.06±7.98 vs 38.95±8.11;7.67±2.58 vs 6.48±2.60,P＜0.05).Partial correlation analysis showed that the variability of SBP and DBP was positively related with the UCLA-LS and GDS score (P＜0.05).The variability of SBP was significantly higher in B and C groups than in A group after adjustment of confounding factors (P=0.000).Conclusion EN,an independent influencing factor for the variability of blood pressure in elderly hypertensive patients,is related with their loneliness and depression.

Effect of masked hypertension and white coat hypertension on vascular elasticity and endothelial function in elderly patients / 中华老年心脑血管病杂志

Objective To study the effect of masked hypertension (MH) and white coat hypertension (WCH) on vascular elasticity and endothelial function in elderly patients.Methods Four hundred and eighty-seven elderly patients who underwent physical examination in our our hospital were divided into normotension group (n=128),WCH group (n=115),MH group (n=112) and hypertension group (n=132) according to their diagnostic office blood pressure and 24 h ambulatory blood pressure.The brachial artery FMD,serum NO and endothelin-1 (ET-1) levels,and cfPWV were measured.Results The FMD and serum NO level were significantly lower while the serum ET-1 level and cfPWV were significantly higher in WCH group,MH group and hypertension group than in normotension group (P＜0.05).The FMD and serum NO level were significantly higher while the serum ET-1 and cfPWV were significantly lower in WCH group and MH group than in hypertension group (P＜ 0.05).Multivariate linear stepwise regression analysis showed that WCH,MH and hypertension were the independent influencing factors for FMD,serum NO and ET-1 level and cfPWV with normotension used as reference after adjustment of confounding factors (P＜0.01).Conclusion MH and WCH are the risk factors for the decreased vascular elasticity and endothelial dysfunction in elderly patients.

Life quality of Chinese patients with chronic Keshan disease and its influencing factors / 中华地方病学杂志

Objective To explore health-related quality of life (HRQOL) in patients with chronic Keshan disease in China and the influence factors.Methods According to the Diagnosis of Keshan Disease (WS/T 210-2011),146 patients with chronic Keshan disease were selected from the follow-up chronic Keshan disease patients with standard treatment in Shandong.The HRQOL was assessed in those patients by use of the Chinese version of SF-36.Correlation analysis and multiple linear regression were used to analyse the influence factors of HRQOL.Results All dimension scores were significantly lower than those of general population (t =-5.12--13.13,all P ＜ 0.01).There were significant differences in Role-Physical dimensions (RP,F =47.09,P ＜ 0.01) and Physiological Function dimension (PF,F =31.49,P ＜ 0.01) between patient groups with different severity of left ventricular ejectio,n fraction (LVEF),RP dimension (F =8.47,P ＜ 0.01) and Vitality dimension (VT,F =11.29,P ＜ 0.01) in patients varies with left ventricular end-diastolic dimension (LVEDD).The scores of some dimensions were correlated with age,family income,course of disease,LVEF and LVEDD,heart function grading,labor ability (r =-0.49-0.36,P ＜ 0.05 or ＜ 0.01).The multivariate linear regression analysis indicated that the influencing factors of physiological status were NYHA cardiac function classification,course of disease,family income and body mass index (BMI).The influencing factor of mental health states was NYHA cardiac function classification.The influencing factors of the total HRQOL score were NYHA cardiac function classification,course of disease and family income.Conclusions The HRQOL of patients with chronic Keshan disease is significantly declined as compared with the general population and the lowest is RP.NYHA functional class,course of disease and family income are relative dominant predictor of patients HRQOL among all variables.

Reducing visit-to-visit variability in systolic blood pressure for improving the progression of carotid atherosclerosis and endothelial dysfunction in patients with hypertension management

Visit-to-visit variability [VVV] in blood pressure [BP] creates challenges to hypertension control and was independent associated with increased all-cause mortality in hypertensive patients. The major goal of the present study was to investigate the association of VVV in systolic [S]BP with progression of carotid atherosclerosis and endothelial dysfunction in on-treated hypertensive patients. Overall, 356 hypertensive patients were enrolled and completed the trial. Clinic BP was measured at base-line and at 3 monthly thereafter. Carotid artery ultrasound and endothelial function were evaluated at baseline and annually follow-up visit. VVV in BP was assessed by standard deviation [SD] and coefficient of variation [CV] of serial follow-up BP measurements. The patients were divided into low, middle, and high group by tertile of SD in SBP. Decrease percentage of maximum intima-media thickness [IMT] and stiffness index beta and increase percent-age of brachial flow-mediated dilation [FMD] and nitric oxide [NO] in lower groups were significant greater than in higher groups [P < 0.05]. Change percentage of stiffness index beta and endothelin-1 positively, and change percentage of FMD and NO negatively correlated with SD, CV, maximum, and delta of SBP [P < 0.05]. SD and CV of SBP were risk factors for change percentage of IMT, stiffness index beta, FMD, NO, and endothelin-1 independently of other influential factors, such as age, and mean SBP. Excessive VVV in SBP maybe increase carotid atherosclerosis and impair endothelial function in on-treated hypertensive patients. Reducing VVV in SBP is benefit for patients with hypertension management

Impaired fracture healing and change of advanced glycation end products in vivo in type 2 diabetes rats / 中国组织工程研究

BACKGROUND:Increasing attention has been paid on the role of advanced glycation end products in bone tissue. Glucose metabolic disorder is one of the main reasons for the increase of advanced glycation end products. OBJECTIVE:To observe the change of advanced glycation end products expressed in type 2 diabetes rats, and to investigate the relationship between impaired fracture healing and change of advanced glycation end products expression in vivo. METHODS:Thirty Sprague-Dawley rats were randomly and equal y divided into two groups:control group (normal feeding) and experimental group (high fat and sucrosum diet feeding to establish type 2 diabetes model). After diabetes models were established, the model of distraction osteogenesis in the left tibiae of al the rats was produced. Distraction was given 0.3 mm per day and continued for 14 days. RESULTS AND CONCLUSION:After the traction was complete, cal us formation in distraction gap was obviously reduced in experimental group compared with control group by X-ray examination. The array of microcolumn formation was disordered and the area of primary matrix front was catachromasis by histology examination. The enzyme-linked immunosorbent assay results showed that, the level of advanced glycation end products was obviously elevated (P<0.01) while osteocalcin was obviously reduced (P<0.01) in experimental group in comparison with control group. The formation of distraction cal us was impaired in the process of fracture healing and blood of type 2 diabetes rats. The increase of advanced glycation end products may be one of the reasons that cause impaired fracture healing in diabetic rats.

Effect of cognitive-behavioral therapy on the quality of life of dderly depression patients with chronic pain / 中华行为医学与脑科学杂志

Objective To explore the influence of cognitive-behavioral therapy on the quality of life of elderly depression patients with chronic pain.Methods 60 patients were divided into the cognitive-behavioral therapy(CBT) group and non-cognitive-behavioral therapy(N-CBT) group,30 cases in each group.The patients in CBT group were treated with cognitive-behavioral therapy combined with mirtazapine,and the patients in N-CBT group were treated with mirtazapine only.Before treating and after the 4th week and 12th week,depression,anxiety and chronic pain were assessed respectively with Hamilton Depression Scale ( HAMD),Hamilton Anxiety Scale (HAMA),and Visual Analogue Scales (VAS),the quality of life was assessed with the WHO Quality of Life ( WHO.QOL-100).No significant different scores of HAMD,HAMA,VAS and WHOQOL-100 existed between two groups before treatment.Results Depression,anxiety and chronic pain were significantly related to the life quality of elderly depression patients with chronic pain ( r =-0.506 ～ -0.676,P ＜ 0.01 ).At the end of the 12th treating week,the scores of HAMD(36.82 ±7.93),HAMA(8.26 ±3.13),VAS(4.35 ±0.52) and WHOQOL100 ( respectively ( 65.71 ± 17.29 ),( 92.36 ± 13.55 ),( 77.91 ± 12.26 ),( 78.33 ± 12.81 ),( 81.79 ± 12.43 ),( 18.95 ± 11.91 ),( 19.98 ± 11.56 ) ) were significantly different from those before treatment in CBT group,and the change of each indicator score was significantly greater in CBT group than those in N-CBT group ( t =3.020 ～9.761,P＜ 0.01 ).Conclusion Cognitive-behavioral therapy can effectively improve the life quality of the elderly depression patients with chronic pain.

Suspension-assisted training of motor function for patients with cerebral infarction / 中华物理医学与康复杂志

Objective o observe the therapeutic effects of suspension-assisted functional rehabilitation training of motor function for patients with cerebral infarction. Methods Ninety-six patients with cerebral infarction were divided randomly into a treatment group and a control group. All patients were given routine medical treatment and routine limb movement therapy. Those in the treatment group also used an electrically-driven suspension device to aid in their functional rehabilitation training. The patients were assessed with a simplified Fugl-Meyer Motor Functional Assessment (S-FMMFA), and using the Postural Assessment Scale for stroke patients ( PASS), the Barthel Index (BI) and the 6-minute walking distance test before and after treatment and at a 6-month foliowup. Results The average S-FMMFA, PASS, BI and the 6-minute walk results in the treatment group were all significantly better than those in the control group. Conclusions Suspension-assisted training can significantly help improve limb movement function and ADL performance in cerebral infarction patients.

Expression of PPARγ and Cbfα1 mRNA in bone marrow cells in Type 2 diabetic rats and its correlation with impaired fracture healing / 中南大学学报(医学版)

Objective To investigate the relationship between impaired fracture healing and the expression of peroxisome proliferator activated-receptor gamma (PPARγ) and core binding factor alpha 1 (Cbfα1) mRNA in the bone marrow of Type 2 diabetic rats.Methods Thirty male Sprague-Dawley rats were divided into a control group (n=15, normal diet) and an experiment group (n=20, high fat and sucrosum diet). After 8 weeks, one eyeball was culled for blood collection. The experiment group was intraperitoneally injected with streptozotocin and the control group received citrate buffer. After another 2 weeks, the other eyeball was culled again to collect blood. The model of distraction osteogenesis in the left tibias of the rats was established. After 14 days, we sacrificed all the rats and collected the blood and left tibias. Both femurs were harvested with germ free. We observed the callus formation in the distraction gap by X-ray and the formation of primary matrix front and microcolumn by histological examination. We observed adipocytes in adjacent bone marrow of left tibia and computed the percentage of adipocytes accounting for the area of bone cavity. We measured the expression of PPARγ and Cbfα1 mRNA in femurs marrow by RT-PCR.Results In the experimental rats, the level of triglyceride was obviously elevated (P＜0.01), so was the total cholesterol (P＜0.05), while the level of fasting blood glucose and serum insulin did not obviously differ (P＞0.05) after 8 weeks. The level of fasting blood glucose and triglyceride was obviously elevated (P＜0.01), and so was the total cholesterol (P＜0.05), while the level of serum insulin was not obviously different in the experiment group after 10 and 12 weeks. Callus formation in the distraction gap was obviously diminished by X-ray in the experimental rats. The array of microcolumn formation was disordered and the area of primary matrix front was catachromasis in the controls by histology examination. The number of adipocytes in both the bone marrow and the percentage of adipocyte accounting for the area of bone cavity increased (P＜0.01) in the experiment group. In the experiment group, the expression of PPARγ mRNA was up-regulated (P＜0.05) while Cbfα1 mRNA was down-regulated (P＜0.05) in double femur marrow. Conclusion Increased expression of PPARγ mRNA and decreased expression of Cbfα1 mRNA in the bone marrow may cause impaired fracture healing in rats with Type 2 diabetes.

Associations of age-related expression changes of peroxisome proliferator-activated receptor gamma and core binding factor alpha 1 in bone marrow cells with age-related fracture healing impaimont in rats / 中国组织工程研究

BACKGROUND: It was reported that the reason why the fracture healing become more and more difficult with the increasing age may be associated with the varied gene regulation of bone marrow mesenchymal stem cells differentiation into osteoblast and lipoblast. However, the exact mechanism under it remains poorly understood.OBJECTIVE: To explore the association of the age-related changes on expression of peroxisome proliferator-activated receptor γ (PPARγ) and core binding α1 (Cbfα1) with the age-relatad fracture healing impairment, we studied the expression changes of PPARγ and Cbfα1 during aging fracture healing.DESIGN, TIME AND SETTING: A randomized control animal trial was performed in the Third Xiangya Hospital of Central South University between October 2007 and Febuary 2008. MATERIALS: Six male SD rats of 3 months and the other six of 23 months, randomly-selected, were divided into two groups: the old experiment group (23 months) and the young control group (3 months). METHODS: Transverse osteotomies on the middle-upper parts of left tibiae were performed to the rats, with the self-made extemal mini-fixator implanted there simultaneously. Tractions were taken twice a day (0.2 mm/d) for 14 days from day 2 till day 15 post operation. On day 15 post operation, rats were sacrificed to harvest left tibea samples. MAIN OUTCOME MEASURES: Both imaging examination and histological observation were performed to the fractures of rats. The PPARγ and Cbfα1 expression were detected with reverse transcription-polymerase chain reaction (RT-PCR) technique. RESULTS: All samples were involved in the results analyses. The imaging examination showed that many osteotylus generated between the broken ends of fractures in the young control group; that the bone formation of the young control group was much better than that of the old experiment group. The histological observation showed that large amounts of osteotylus growth occurred to every animal in the young control group and their membrane bone formation was remarkable; comparatively, the osteotylus growth in the old group was weakened dramatically, and only fibrous joints were seen. The RT-PCR detection showed that differences of significance existed in both PPARγ and Cbfα1 mRNA expressions between the two groups, with the much higher Cbfol mRNA expression in the bone marrow of rats in the young group and the much higher PPARy mRNA expression in the bone marrow of rats in the old group.CONCLUSION: Rats of different ages show different fracture healing abilities, i.e. the higher ages, the lower fracture healing abilities. In addition, expressions of PPARγ and Cbfα1 in the bone marrow of rats alter with the increasing age, which indicates that there are certain associations between the changed expression level of the two factors and the fracture healing impartment.

Recombinant human fibroblastic growth factor-2 with soluble tumor necrosis factor receptor-1 facilitates fracture repair in rats with type 2 diabetes mellitus / 中国组织工程研究

BACKGROUND: It has been reported that type 1 diabetes mellitus can result in impairments of bone regeneration and repair, and local injection of fibroblastic growth factor-2 (FGF-2) can obviously promote fracture healing, but its effect on type 2 diabetes mellitus is still unclear.OBJECTIVE: To observe the effects of recombinant human fibroblastic growth factor-2 (rhFGF-2) combined with soluble tumor necrosis factor receptor-1 (sTNF-R1) on impaired bone regeneration and repair in type 2 diabetes mellitus.DESTGN: A randomized controlled trial.SETTING: Department of Orthopaedics, the Third Xiangya Hospital of Central South University.MATERIALS: Twenty male Zucker diabetic fatty rats (ZDF/Gemi-fa/fa), 10 weeks of age, were purchased from Charles River Laboratory. rhFGF-2 was obtained from Orquest Incorporation; sTNF-R1 protein (PEG-r-metHu-sTNF-R1) was provided by Amgen Incorporation.METHODS: This experiment was finished in the central lab of the Third Xiangya Hospital of Central South University from September to November in 2006. ①Grouping: The 20 rats were randomly assigned into treated group (n =10)and control group (n =10). ② Experimental methods: All rats were examined for body mass, blood glucose, glycosuria and glycosemia. One week later, all the rats underwent the standard DO protocol, including placement of the external fixators and osteotomies to the left tibia. Distraction was initiated in the following morning (one day latency) at 0.2 mm b.I.d. (0.4 mm per day) and continued for 14 days. During surgery, all the rats received an injection of either rhFGF-2(25 mg/kg) for the treated group, or physiological saline (25 mg/kg) for the control group, into the hematoma of the osteotomic gap. The sTNF-R1 (8 mg/kg) or the same. Amount of saline was subcutaneously injected into the treated and control rats respectively every other day for 14 days. Evaluation: The serum biochemical indexes, amount of bone formation and number of proliferative cells in the distraction gaps were determined.MAIN OUTCOME MEASURES: Biochemical indexes, amount of bone formation and number of proliferative cells in the distraction gaps.RESULTS: All the 20 rats were involved in the final analysis of results. ①The blood glucose, glucosuria, ketonuria,serum levels of insulin and osteocalcin were not obviously different between the treated group and control group (P ＞0.05). ② The area and density of mineralization of the distraction gaps, and the endosteal and peristeal new bone formation in the treated group were all obviously higher than those in the control group (P ＜ 0.05-0.01). The number and percentage of the positive cells of proliferating cell nuclear antigen (PCNA) in the distraction gaps were obviously higher in the treated group than in the control group (P ＜ 0.05-0.01).CONCLUSION: The local application of rhFGF-2 combined with sTNF-R1 can enhance bone formation by increasing the proliferation during distraction osteogenesis in ZDF rats. The combination of rhFGF-2 and sTNF-R1 may be an effective treatment for type 2 diabetic patients with fracture healing problem.

Investigation on Essential Hypertension in the Elderly in Rural and Urban Areas of Jinan / 中国慢性病预防与控制

Objective To investigate the current condition of essential hypertension in the elderly aged over 60 yrs in rural and urban areas in Jinan. Methods 2 626 subjects aged over 60 years in rural and urban of Jinan were involved and were examined. The investigation was based on the unified questionnaire. The contents of questionnaire mainly included the history, treatment and control of hypertension. Results Prevalence of hypertension and rate of treatment in the male elderly in urban were 64.1% and 61.5% , respectively, and were higher than those in rural (56.9% and 38.3%, respectively). The treatment rate in female was higher in urban (60.8%) than in rural (43.1%) (P

Exchange of reamed intramedullary nailing for aseptic femoral shaft nonunion / 中华创伤骨科杂志

Medical literature was searched for articles concerning “femoral nonunion”and “exchange nailing”on Medline to evaluate the successful rate of the primary operation. Because of wide use of locking intramedullary nailing in recent years, the successful rate of the primary operation with exchange of ream ed intramedullary nailing for aseptic femoral shaft nonunion tends to decrease s ignificantly. Only reaming and exchange for nailing of a larger diameter can not completely resolve the problem of instability, and excessive reaming may result in new instability. The effective length of nail-bone contact should be emphas ized.