[Re-evaluation of systematic reviews of acupuncture and moxibustion for childhood autism].

OBJECTIVE: To re-evaluate the systematic review/Meta-analysis of acupuncture and moxibustion for childhood autism (CA), aiming to provide decision-making basis for clinical diagnosis and treatment. METHODS: The systematic review and/or Meta-analysis of acupuncture and moxibustion for CA were searched in PubMed, EMbase, Cochrane Library, SinoMed, CNKI and Wanfang databases. The retrieval time was from the database establishment to May 5th, 2022. PRISMA (preferred reporting items for systematic reviews and Meta-analyses) was used to evaluate the report quality, and AMSTAR 2 (a measurement tool to assess systematic reviews 2) was used to evaluate the methodological quality, bubble map was used to construct the evidence map and GRADE was used to evaluate the quality of evidence. RESULTS: A total of 9 systematic reviews were included. The PRISMA scores ranged from 13 to 26. The report quality was low, and there was a serious lack in the aspects of program and registration, search, other analysis and funding. The main problems in methodology included not making prespecified protocol, incomplete retrieval strategy, not providing a list of excluded literatures, and incomplete explanation on heterogeneity analysis and bias risk. The evidence map showed that 6 conclusions were valid, 2 conclusions were possible valid and 1 conclusion was uncertain valid. The overall quality of evidence was low, and the main factors leading to the downgrade were limitations, followed by inconsistency, imprecision and publication bias. CONCLUSION: Acupuncture and moxibustion has a certain effect for CA, but the quality of reporting, methodology and evidence in included literature need to be improved. It is suggested to perform high-quality and standardized research in the future to provide evidence-based basis.

External fixator combined with three different fixation methods of fibula for treatment of extra-articular open fractures of distal tibia and fibula: a retrospective study.

BACKGROUND: To compare the efficacy of three different fixation methods of fibula combined with external fixation of tibia for the treatment of extra-articular open fractures of distal tibia and fibula. METHODS: From January 2017 to July 2019, 91 cases of open fractures of distal tibia and fibula were treated with external fixator, and the fibula was fixed with non-fixation (group A, n = 35), plate-screw (group B, n = 30) and Kirschner wire (group C, n = 26). The operation time, intraoperative blood loss, surgical and implants costs, fracture healing time, postoperative complications, and American Orthopaedic Foot and Ankle surgery (AOFAS) scores were compared among the groups. RESULTS: Four patients were lost to follow-up, and 87 patients were followed up for 5-35 months (average, 14.2 months). The operation time of group C (114.92 ± 36.09 min) was shorter than that of group A (142.27 ± 47.05 min) and group B (184.00 ± 48.56 min) (P < 0.05). There was no difference in intraoperative blood loss among the three groups (P > 0.05). The surgical and implants costs in group C (5.24 ± 1.21, thousand dollars) is lower than that in group A (6.48 ± 1.11, thousand dollars) and group B (9.37 ± 2.16, thousand dollars) (P < 0.05). The fracture healing time of group C (5.67 ± 1.42 months) was significantly less than that of group A (6.90 ± 1.33 months) and group B (6.70 ± 1.12 months) (P < 0.05). The postoperative complications such as fractures delayed union and nonunion in group C (2 cases, 8.00%) is less than that in group A (13 cases, 39.39%) and group B (11cases, 37.93%) (P < 0.05). The wound infection and needle-tract infection did not differ among the three groups (P > 0.05). The excellent or good rate of ankle function was 69.70% in group A, 72.41% in group B and 84.00% in group C, with no statistical difference among the three groups (P > 0.05). CONCLUSION: Compared with simple external fixator fixation and external fixator combined with plate-screw osteosynthesis, external fixator combined with K-wire intramedullary fixation shortens the operative time and fracture healing time, reduced costs and complications of fracture healing, while the blood loss, infection complications and ankle function recovery showed no difference with the other two groups. External fixator combined with plate-screw osteosynthesis had no advantage in treating extra-articular open fractures of distal tibia and fibula when compared with simple external fixation.

Assessment on the Self-Discharge Behavior of Lithium-Sulfur Batteries with LiNO3-Possessing Electrolytes.

It is generally understood that the reduction of nitrate on the metallic Li surface aids in the formation of a solid-electrolyte interphase. LiNO3 is, therefore, frequently used as an electrolyte additive to help suppress the polysulfide redox shuttle in lithium-sulfur (Li-S) batteries. Although LiNO3 enables cycling of cells with considerably improved Coulombic efficiency and cyclic performance, the self-discharge behavior has largely been neglected. We present in this work a basic but systematic study to assess self-discharge of Li-S batteries with electrolytes possessing LiNO3. Comparative electrochemical tests and interfacial analysis reveal that the redox shuttle is fast enough to cause cells to self-discharge at a relatively rapid rate with limited concentration of the LiNO3 additive. Despite the capacity loss of a full-charged cell under rest for one day can be controlled to 2% with LiNO3 concentration as high as 0.5 M, the development of a practically viable Li-S technology looks like a daunting challenge. Further increasing LiNO3 would potentially cause more irreversible reduction of LiNO3 on the cathode during the first discharge. Therefore, a possible pathway for a long shelf life and low self-discharge is offered as well by the synergic protection of the separator and stabilization of the Li anode surface. The cell using a nanosized Al2O3-coated microporous membrane and a LiNO3-possessing electrolyte exhibits an extremely suppressed self-discharge, providing an alternative perspective for the practical use of Li-S batteries.

[A clinical analysis of treatment with recombinant human thrombopoietin combined with large doses of dexamethasone in primary immune thrombocytopenia].

OBJECTIVE: To study the efficacy and safety of recombinant human thrombopoietin (rhTPO) combined with dexamethasone as front line regimen in patients with primary immune thrombocytopenia (ITP). METHODS: This study was a prospective, randomized, controlled trial. A total of 59 primary ITP patients were enrolled at the First Affiliated Hospital, Xinjiang Medical University from June 2013 to February 2015. All subjects were randomized into study group (30 cases) and control group (29 cases). The study group was scheduled to receive high-dose dexamethasone (40 mg intravenously d1-4) combined with rhTPO (300 U·kg(-1)·d(-1) subcutaneously d1-14). Once absolute platelet count reached >50 × 10(9)/L, rhTPO stopped. Patients in control group were just administrated with high-dose dexamethasone (40 mg intravenously d1-4). Efficacy and adverse reactions were evaluated. RESULTS: The short-term (15 days) and mid-term (3 months) response rates in the study group were 83.3% (25/30) and 76.7% (23/30) respectively, which were both significantly better than those in the control group [51.7% (15/29) and 20.7% (6/29) respectively] (P<0.01). In the study group and control group, the median time platelet count reached 100 × 10(9)/L was 6.0 and 6.8 days respectively. In the study group, the time of TPO usage was (6.1 ± 1.7) days. The incidence of adverse reactions in both groups was comparable and slight. The most common TPO related adverse events included knee ache and fatigue, which accounted for 6.7% (2/30) in the study group. CONCLUSIONS: Recombinant human TPO combined with dexamethasone as front line treatment for primary ITP shows significant advantages in both short-term and mid-term responses with less and manageable adverse reactions. This may provide a new method to treat patients with primary ITP.

[Progress on cell infiltration in electrospun scaffold].

OBJECTIVE: To introduce the research progress on the technique of improving cell infiltration in electrospun scaffold. METHODS: The recent original articles about improving cell infiltration in electrospun scaffold were extensively reviewed and analyzed. RESULTS: The technique includes regulation of the electrospun parameters, modification of electrospun scaffold, and dynamic culture of scaffold-cells composite etc. The effect is limited and most of them need further optimization. CONCLUSION: Cell infiltration in electrospun scaffold is of great significance in tissue engineering application. The relatively high compressed density and small pore size have become the bottleneck problem that prevents cell infiltration and tissue ingrowth into the scaffold. The combination of different techniques will be more effective to overcome this problem.

[Effect of rolling compression loading bioreactor on chondrogenesis of rabbit bone marrow mesenchymal stem cells with different loading parameters].

OBJECTIVE: To explore the effect of rolling compression loading bioreactor on chondrogenesis of rabbit bone marrow mesenchymal stem cells (BMSCs) with different loading parameters. METHODS: BMSCs were isolated from New Zealand rabbits, aged 2.5 months. BMSCs at passage 3 were used to prepare BMSCs-agarose gels (4 mm in diameter and height, respectively). Samples were divided into 8 groups: 10% (group A1), 20% (group A2), and 30% (group A3) compression groups (0.4 Hz, 3 h/d) and 20 minutes (group B1), 3 hours (group B2), and 12 hours (group B3) rolling time groups and static culture (control groups). The living cell rate, the collagen type II and Aggrecan gene expressions, and glycosaminoglycan (GAG) content were determined, and histological staining was done at 24 hours, 7 days, 14 days, and 21 days after culture. RESULTS: At 14 and 21 days, the living cell rates of groups A1 and A2 were significantly higher than that of group A3 (P < 0.05), groups B1 and B2 were significantly higher than group B3 (P < 0.05). Collagen type II and Aggrecan gene expressions of the experimental groups at each time point were significantly higher than those of the control groups (P < 0.05); at 14 and 21 days, collagen type II and Aggrecan gene expressions of groups A1 and A2 were significantly higher than those of group A3, and groups B1 and B2 were also significantly higher than group B3 (P < 0.05). At 14 and 21 days, the GAG contents of groups A1 and A2 were significantly higher than those of group A3 (P < 0.05); groups B1 and B2 were also significantly higher than group B3 (P < 0.05). At 21 days, toluidine blue staining showed that obvious blue-staining and even cartilage lacunae were seen in groups A2 and B2, but light and quite rare blue-staining in groups A1, A3, B1, and B3. CONCLUSION: The rolling compression loading bioreactor has great promotion effect on chondrogenesis of rabbit BMSCs with rolling parameters of 0.4 Hz, 3 hours, and 20% compression.

Fabrication of PU/PEGMA crosslinked hybrid scaffolds by in situ UV photopolymerization favoring human endothelial cells growth for vascular tissue engineering.

Poly(ethylene glycol) methacrylate (PEGMA) was introduced into a polyurethane (PU) solution in order to prepare electrospun scaffold with improving the biocompatibility by electrospinning technology for potential application as small diameter vascular scaffolds. Crosslinked electrospun PU/PEGMA hybrid nanofibers were fabricated by a reactive electrospinning process with N,N'-methylenebisacrylamide as crosslinker and benzophenone as photoinitiator. The photoinduced polymerization and crosslinking reaction took place simultaneously during the electrospinning process. The electrospinning solutions with various weight ratios of PU/PEGMA were successfully electrospun. No significant difference in the scaffold morphology was found by SEM when PEGMA content was <20 wt%. The crosslinked fibrous scaffolds of PU/PEGMA exhibited higher mechanical strength than the pure PU scaffold. The hydrophilicity of scaffolds was controlled by varying the PU/PEGMA weight ratio. The tissue compatibility of electrospun nanofibrous scaffolds were tested using human umbilical vein endothelial cells (HUVECs). Cell morphology and cell proliferation were measured by SEM, fluorescence microscopy and thiazolyl blue assay (MTT) after 1, 3, 7 days of culture. The results indicated that the cell morphology and proliferation on the crosslinked PU/PEGMA scaffolds were better than that on the pure PU scaffold. Furthermore, the appropriate hydrophilic surface with water contact angle in the range of 55-75° was favorable of improvement the HUVECs adhesion and proliferation. Cells seeded on the crosslinked PU/PEGMA (80/20) scaffolds infiltrated into the scaffolds after 7 days of growth. These results indicated the crosslinked electrospun PU/PEGMA nanofibrous scaffolds were potential substitutes for artificial vascular scaffolds.

[Effect of collagen type II on redifferentiation of dedifferentiated rabbit chondrocytes].

OBJECTIVE: Collagen type II is a characteristic molecular of chondrocyte. With continuous subculture of chondrocytes, they progressively lose the ability to express collagen type II. To observe the effect of collagen type II on redifferentiation of dedifferentiated rabbit chondrocytes so as to lay a experimental foundation for use of chondrocytes in cartilage tissue engineering. METHODS: Cartilage was harvested under sterile conditions from tibio-femoral joints of 7-month-old New Zealand white rabbit. The rabbit articular chondrocytes were subcultured in vitro to the 7th generation (named P1-P7). Dedifferentiated rabbit chondrocytes were chosen by RT-PCR, real-time PCR, and 1, 9-dimethylmethylene blue (DMMB) assay. Then dedifferentiated rabbit chondrocytes were treated with various concentrations (0, 0.5%, 1.0%, and 1.5%) of exogenous collagen type II. The redifferentiation of dedifferentiated chondrocytes was measured by RT-PCR and real-time PCR, and the glycosaminoglycan content was determined by DMMB assay. RESULTS: The glycosaminoglycan content of P1-P7 chondrocytes were (12.20 +/- 0.17), (11.20 +/- 0.24), (11.18 +/- 0.16), (10.89 +/- 0.50), (8.73 +/- 0.19), (9.39 +/- 0.32), and (8.18 +/- 0.20) microg, respectively, showing no significant difference (P > 0.05) among P2, P3, and P4, and showing significant differences (P < 0.05) among other generations. The mRNA of collagen type I, collagen type II, and aggrecan expressed at P4-P7, showing no significant difference in the mRNA expression of collagen type I (P > 0.05) and significant differences in the mRNA expressions of collagen type II and aggrecan (P < 0.05) among P4-P7. The glycosaminoglycan content at concentrations of 0, 0.5%, 1.0%, and 1.5% were (8.20 +/- 0.16), (14.61 +/- 0.33), (13.93 +/- 0.25), and (19.59 +/- 0.46) microg, showing significant differences among different concentrations (P < 0.05). With exogenous collagen type II concentrations increased, the mRNA expressions of collagen type II and aggrecan gene were up-regulated gradually, but collagen type I gene was down-regulated, showing significant differences (P < 0.05). CONCLUSION: Collagen type II can promote redifferentiation and activation of dedifferentiated rabbit chondrocytes.

Culturing functional cartilage tissue under a novel bionic mechanical condition.

Bioreactor, which is used for in vitro construction of tissue-engineered cartilage, has been extensively studied by researchers. The growth and development of articular cartilage tissue are affected by biomechanical and biochemical factors, especially mechanical condition. Kinds of mechanical conditions including compressive and shear force, fluid flow, hydrostatic pressure, and tissue deformation, were developed in the past years. However, most mechanical conditions of improved bioreactor involve only one or two external force, which is merely partial for engineering cartilage tissue. No bioreactor which can simulate a normal articular cartilage in terms of structure and function has been reported. Consequently, simulation of bionic mechanical environment of a normal articular cartilage is considered to be the optimal environment for culturing the functional articular cartilage in vitro. Based upon this purpose, we designed a rolling-compression loading bioreactor. It could provide cultures with multi-mechanical stimulations and sufficiently mimic the complex mechanical environment of a normal articular cartilage. We propose that this comprehensive rolling-compression loading bioreactor can enhance the cultivation of functional cartilage constructs in vitro.

Treating lumbar spinal canal stenosis by injecting insoluble particles.

Lumbar spinal stenosis is a common indication for surgical intervention. Although traditional "open" surgical decompression or minimally invasive decompression are well proven and successful, its inherent approach morbidity cannot be avoided (massive trauma, spondylolisthesis, nerve root adhesion, dural laceration). Many studies on wear-mediated osteolysis have demonstrated that wear debris can initiate the release of cytokines and other inflammatory mediators, which stimulates increased osteoclastic activity and focal bone resorption at the bone-implant interface. Therefore we hypothesize that the decompression can be achieved by injecting insoluble particles into the epidural space, initiating the surrounding biological reaction and focal bone resorption. If the hypothesis is verified, spinal canal stenosis will be treated nonsurgically and furthermore a new nonsurgical bone resection technique will be invented.

Effect of recombinant human basic fibroblast growth factor on angiogenesis during mandible fracture healing in rabbits.

OBJECTIVE: To investigate the effect of recombinant human basic fibroblast growth factor (rhbFGF) on angiogenesis during mandible fracture healing in rabbit. METHODS: Fifty adult white rabbits were used for animal model and randomly divided into a control group (25 rabbits) and an experimental group (25 rabbits). The membranous complex of rhbFGF and bovine type I collagen was prepared and implanted into the rabbit mandible fracture site under periosteum. The animals were sacrificed on 7, 14, 28, 56 and 84 days respectively after operation and the whole mandibles were harvested. The expression of factor VIII related antigen (F8-RA) in callus was examined with immunohistochemical staining. RESULTS: The amounts of microvascular formation in calluses in the rhbFGF-treating group on days 7, 14, 28 and 56 were more than those of the control group (P<0.01). CONCLUSIONS: The results indicated that rhbFGF could stimulate microvascular formation during mandible fracture healing in rabbits.

[Preparation and osteogenic activity of combining calcium phosphate cement with bone morphogenetic protein composite as a bone graft material].

OBJECTIVES: To construct new type of bone graft material by combining calcium phosphate cement (CPC) with bone morphogenetic protein (BMP), and then to detect its osteogenic activity. METHODS: The surface of CPC and CPC/BMP composite were observed by scanning electron microscope (SEM). CPC and CPC/BMP pellets were separately implanted into the thigh muscle pouches of mice. Samples obtained at different times were tested by histological analysis, SEM, organic substance detection, and alkaline phosphatase (ALP) measurement to observe the induced ectopic bone formation. RESULTS: Under SEM, the CPC and CPC/BMP composite was found to consist primarily of platy crystals, granular crystals and some small rod-like crystals with micropores about 10-50 microm in size. BMP about 1-5 microm in size was seen like micro globules distributing evenly in the micropores. Newly formed cartilage or bone was not found in the CPC group. In the CPC/BMP group, mesenchymal cells were proliferated and abundant cartilage was found in one week. Woven bone appeared at 2 weeks. New bone formation increased with bone marrow at 4 weeks. At 8 weeks, the implanted CPC/BMP became heterogeneous and a lot of collapsed granules were observed. At the end of 16 weeks, mature lamellar bone appeared and the volume of the implanted CPC/BMP became smaller. One week after implantation, the ALP increased evidently in the CPC/BMP groups and reached the highest level at the 4th week, which was about 168 U/L. The content of organic substance in specimens increased from 22% to 39% by the end of the 16th week, showing the continuous calcification and formation of new bone. SEM also showed that the CPC/BMP composite had good potentiality of ectopic bone induction, and the new bone formed accompanied by the slow degradation of the material. CONCLUSION: The results of this study suggested that the CPC/BMP composite could be used as material for bone graft substitute.