Recent advances in the knowledge of the mechanism of reflux hypersensitivity.

Reflux hypersensitivity (RH) is a subtype of gastroesophageal reflux disease. The Rome IV criteria separated RH from the original nonerosive reflux disease subgroup and classified it as a new functional oesophageal disease. Recently, the pathogenesis of RH has become the focus of research. According to the latest research reports, upregulation of acid-sensitive receptors, distribution of calcitonin gene-related peptide-positive nerve fibres, and psychiatric comorbidity have key roles in the pathogenesis of RH. This work reviews the latest findings regarding RH mechanisms.

Serum Levels of 25-hydroxyvitamin D and Functional Outcome in Older Patients with Hip Fracture.

The aim was to assess prognostic value of serum 25-hydroxyvitamin D (25[OH] D) levels in older Chinese patients with hip fracture. From June, 2012 to February, 2014, older patients with hip fracture were included. Serum 25(OH) D levels were measured at admission. The functional evaluation at the time of discharge was performed by the Barthel Index. In the 66 patients with an unfavorable outcome, serum 25(OH) D levels were lower compared with those with a favorable outcome. In multivariate analyses, there was an increased risk of unfavorable outcome associated with serum 25(OH) D levels ≤ 20 ng/ml (OR 5.25, 95% CI: 3.12-8.16). Our data supported an association between serum 25[OH] D levels at admission and short-term prognosis in Chinese older patients with hip fracture.

IL-1beta sensitizes rat intervertebral disc cells to Fas ligand mediated apoptosis in vitro.

AIM: To determine the apoptotic effect of recombinant rat Fas Ligand on rat intervertebral disc cells pre-treated with IL-1beta in vitro, and the expression of Fas in cultured rat intervertebral disc cells. METHODS: Cells were isolated from the inner annulus fibrosus and transition zones of lumbar discs from Sprague-Dawley rats. The cells were grown in monolayer and divided in 5 treatment groups. IL-1beta (10 ng/mL), FasL (5, 20 ng/mL) with/without IL-1beta (10 ng/mL) pre-treatment was respectively added in Dulbeccoos modified Eagleos medium and Hamos F-12 medium with 1% fetal bovine serum. After 32 h, the cells were stained with annexin V-FITC and propidium iodide to evaluate apoptosis using flow cytometry and to analysis transcription of Fas using RT-PCR. RESULTS: Compared with control group, FasL (20 ng/mL), IL-1beta (10 ng/mL)+FasL (5 ng/mL), and IL-1beta (10 ng/mL)+FasL (20 ng/mL) induced significant apoptosis of the disc cells (P<0.01). Apoptosis was also induced by FasL 5 ng/mL (P<0.05); whereas, apoptosis was not induced by IL-1beta (10 ng/mL) (P>0.05). IL-1beta (10 ng/mL) enhanced the apoptosis-inducing effects of FasL (5 ng/mL) and FasL (20 ng/mL) in disc cells. Fas gene transcription in all groups and Fas expression in the 5 treatment groups were approximately 1.2-2.1-fold greater than control group (respectively, P<0.05). Additionally, Fas expression in FasL with IL-1beta pre-treatment groups were significantly up-regulated than in FasL groups (P<0.01). CONCLUSION: The results of this study showed disc cells pre-treated with IL-1beta increased apoptotic rate in response to FasL in vitro and provided insights to understand Fas/FasL system-mediated apoptosis in disc cells which would be enhanced due to inflammation factor in degenerative disc.

[Percutaneous vertebroplasty with EH composite material: an experiment study].

OBJECTIVE: To investigate the appropriate ratio of liquid/powder and use of radiopaque agent in EH composite material for percutaneous vertebroplasty (PVP). METHODS: (1) EH composite material was divided into 6 groups. The material without contrast with the liquid/powder ratios 8:9, 8:8, and 8:7 was classifieds as groups I, II, and III; and the EH composite material with the liquid/powder ratios 8:9, 8:8, and 8:7 and with the addition of 20% barium sulfate by weight was classified as the groups IV, V, and VI. The curing temperature was measured. The bone cement of different groups was made into cylinders to be X-rayed to observe the opacity. Universal tester was used to examine the strength and stiffness. (2) The vertebrae (T8 approximately L5) were isolated from the cadaver of an elder female patient with osteoporosis. Universal tester was used to examine the strength and stiffness of the vertebral bodies (VBs). Osteoporotic vertebral compression fracture (OVCF) model was made. PVP procedure was mimicked by puncturing through the bilateral pedicle of vertebral arch into the anterior 1/3 of the vertebral bodies and the EH composite materials of the groups II and V were injected into the VBs Then the temperatures of the geometric center (CT) and spinal canal posterior wall (PT) of the VBs were measured in a water bath with the temperature of 37 degrees C. Twenty-four hours later the vertebrae underwent X-ray examination to observe the opacity and underwent examination of strength and stiffness with universal tester. RESULTS: (1) The sticking periods (?) of the groups IV, V, and VI were significantly longer than those of the corresponding groups I, II, and III respectively by about 60 s, and the highest temperature of the groups IV, V, and VI were significantly lower than those of the corresponding groups I, II, and III respectively. Addition1 of barium sulfate increased the opacity of the bone cement, but did nor significantly influence the strength of the bone cement. The properties of the group V was the best. (2) The bone cement was easy to be injected into the VBs. The peak PT was not beyond 50 degrees C. After the injection of the bone cement of the groups II, the strength and stiffness of the VB were (1501.6 +/- 5.0) N/mm and (285.6 +/-) N/mm, both significantly higher than those before the injection [(547.5 +/- 3.1) N/mm and (104.1 +/- 1.3) N/mm]; and after the injection of the bone cement of the groups V, the strength and stiffness of the VB were (1355.0 +/- 4.5) N/mm and (257.7 +/- 1.9), both significantly higher than those before the injection [(543.8 +/- 2.7) N/mm and (103.4 +/- 1.1) N/mm]. The opacity of the VBs injected with the bone cement of the group V was better than those injected with the bone cement of the group II. CONCLUSION: The EH (8/8) with 20% barium sulfate is a proper and effective filling material for the treatment of OVCF.