A Shift from Efficiency to Adaptability: Recent Progress in Biomimetic Interactive Soft Robotics in Wet Environments.

Research field of soft robotics develops exponentially since it opens up many imaginations, such as human-interactive robot, wearable robots, and transformable robots in unpredictable environments. Wet environments such as sea and in vivo represent dynamic and unstructured environments that adaptive soft robots can reach their potentials. Recent progresses in soft hybridized robotics performing tasks underwater herald a diversity of interactive soft robotics in wet environments. Here, the development of soft robots in wet environments is reviewed. The authors recapitulate biomimetic inspirations, recent advances in soft matter materials, representative fabrication techniques, system integration, and exemplary functions for underwater soft robots. The authors consider the key challenges the field faces in engineering material, software, and hardware that can bring highly intelligent soft robots into real world.

Regulatory Mechanisms of the Ihh/PTHrP Signaling Pathway in Fibrochondrocytes in Entheses of Pig Achilles Tendon.

This study is aimed at exploring the effect of stress stimulation on the proliferation and differentiation of fibrochondrocytes in entheses mediated via the Indian hedgehog (Ihh)/parathyroid hormone-related protein (PTHrP) signaling pathway. Differential stress stimulation on fibrochondrocytes in entheses was imposed. Gene expression and protein levels of signaling molecules including collagen type I (Col I), Col II, Col X, Ihh, and PTHrP in the cytoplasm of fibrochondrocytes were detected. Ihh signal blocking group was set up using Ihh signaling pathway-specific blocking agent cyclopamine. PTHrP enhancement group was set up using PTHrP reagent. Ihh/PTHrP double intervention group, as well as control group, was included to study the regulatory mechanisms of the Ihh/PTHrP signaling pathway in fibrochondrocytes. Under low cyclic stress tensile (CTS), PTHrP, Col I, and Col II gene expression and protein synthesis increased. Under high CTS, Ihh and Col X gene expression and protein synthesis increased. Blocking Ihh signaling with cyclopamine resulted in reduced PTHrP gene expression and protein synthesis and increased Col X gene expression and protein synthesis. Ihh and PTHrP coregulate fibrochondrocyte proliferation and differentiation in entheses through negative feedback regulation. Fibrochondrocyte is affected by the CTS. This phenomenon is regulated by stress stimulation through the Ihh/PTHrP signaling pathway.

Worldwide research productivity in the field of spine surgery: a 10-year bibliometric analysis.

PURPOSE: Bibliometrics is increasingly used to assess the quantity and quality of scientific research output in many research fields worldwide. However, the bibliometric studies in the field of spine surgery are scarce. This study aimed to evaluate the worldwide research productivity in the field of spine surgery using bibliometric methods and to provide an insight into the spine research for surgeons and researchers. METHODS: Articles published between 2004 and 2013 were retrieved using the Scopus database in 5 spine journals, including Spine, European Spine Journal, The Spine Journal, Journal of Neurosurgery: Spine, and Journal of Spinal Disorders and Techniques. The number of articles, trend of publications, countries' contribution and h-index, authorship, subspecialty, funding source, journal pattern, institutions, and top cited articles were analyzed. RESULTS: A total of 13,115 publications were identified in the database of Scopus from 2004 to 2013. The time trend of the number of articles showed a significant increase of 1.9-fold between 2004 and 2013 (p = 0.000). The largest number of articles in the field of spine surgery was from United States (39.17%), followed by Japan (10.74%) and China (8.62%). United States also have the highest h-index (106), followed by Canada (60) and United Kingdom (54). China (p = 0.000) and South Korea (p = 0.000) have a significantly increasing trend of contribution proportion to the world spine production over time in years, but h-index was still low (39 and 38, respectively). Spine published the highest number of articles (45.44%), followed by European Spine Journal (21.43%) and Journal of Neurosurgery: Spine (13.32%). The most productive institutions were University of California, San Francisco (1.98%), followed by Thomas Jefferson University (1.61%) and University of Toronto (1.41%). CONCLUSIONS: There has a rapid increase of scientific research productivity in the field of spine surgery during the past 10 years. United States has special contributions to the body of spine publications. China and South Korea have increasing contributions to the field of spine surgery.

Gemcitabine for the treatment of patients with osteosarcoma.

BACKGROUND: Patients with recurrent or refractory osteosarcoma are considered to have a very poor prognosis, and new regimens are needed to improve the prognosis in this setting. Gemcitabine, a nucleoside antimetabolite, is an analog of deoxycytidine which mainly inhibits DNA synthesis through interfering with DNA chain elongation and depleting deoxynucleotide stores, resulting in gemcitabine-induced cell death. Here we performed a systemic analysis to evaluate gemcitabine based chemotherapy as salvage treatment for patients with recurrent or refractory osteosarcoma. METHODS: Clinical studies evaluating the impact of gemcitabine based regimens on response and safety for patients with osteosarcoma were identified by using a predefined search strategy. Pooled response rates (RRs) of treatment were calculated. RESULTS: In gemcitabine based regimens, 4 clinical studies which included 66 patients with recurrent or refractory osteosarcoma were considered eligible for inclusion. Systemic analysis suggested that, in all patients, pooled RR was 12.1% (8/66) in gemcitabine based regimens. Major adverse effects were hematologic toxicity, including grade 3 or 4 anemia, leucopenia and thrombocytopenia in gemcitabine based treatment. No treatment related death occurred in gemcitabine based treatment. CONCLUSION: This systemic analysis suggests that gemcitabine based regimens are associated with mild activity with good tolerability in treating patients with recurrent or refractory osteosarcoma.

Impact of vascular endothelial growth factor expression on overall survival in patients with osteosarcoma: a meta-analysis.

Osteosarcoma is the most common primary malignant bone tumor of childhood. Vascular endothelial growth factor (VEGF) expression has been implicated in tumor development and progression of osteosarcoma, but previous studies investigating the impact of VEGF expression on overall survival in patients with osteosarcoma report conflicting findings. A meta-analysis of published studies was performed. The pooled hazard ratio (HR) with its 95% confidence interval (95% CI) was used to assess the impact of VEGF expression on overall survival in patients with osteosarcoma. Nine studies with a total of 432 osteosarcoma patients were included into this meta-analysis. There was no between-study heterogeneity among those nine studies (I (2) = 0.0%). Overall, high VEGF expression was obviously associated with poorer overall survival (HR = 1.68, 95% CI 1.33-2.12, P < 0.001). Sensitivity analysis performed by excluding single study in turns showed the pooled estimate was stable. Egger's test also did not suggest evidence for publication bias (P = 0.216). Therefore, this meta-analysis suggests that VEGF expression has an important impact on overall survival in patients with osteosarcoma and high VEGF expression is associated with poorer overall survival.

Serum EGF and NGF levels of patients with brain injury and limb fracture.

OBJECTIVE: To explore the expression and significance of human epidermal growth factor (EGF) and nerve growth factor (NGF) in patients with knee osteoarthritis. METHODS: RT-PCR and enzyme-linked immunosorbent assay were used to measure the serum EGF and NGF expression levels of patients with limb fracture and brain trauma injurry after 1 d, 3 d, 7 d, 14 d and the relationship between them was analyzed. The level was compared among the simple fracture group, traumatic brain injury group and the normal control group, with 40 cases in each group. RESULTS: The serum NGF levels were significantly different among three groups. Serum NGF, EGF mRNA and protein levels gradually decreased with the increasing injury time in the limb fracture combined with brain injury group, traumatic brain injury group, the simple fracture group and the health control group (P<0.05). CONCLUSIONS: The serum of NGF, EGF levels significantly increased when limb fracture combined with brain injury, so EGF and NGF may be involved in the process of fracture healing.

[Efficacy of double-door laminoplasty combined with hydroxyapatite artificial bone grafting for cervical spinal stenotic myelopathy].

OBJECTIVE: To evaluate the effects of double-door laminoplasty and hydroxyapatite artificial bone grafting in the treatment of cervical spinal stenotic myelopathy. METHODS: Twelve cases of cervical spinal stenotic myelopathy underwent expansive double-door laminoplasty of the cervical spine and hydroxyapatite artificial bone grafting. The clinical outcome of the patients and the operative procedures were assessed. RESULTS: The 5-year follow-up showed significantly alleviated clinical symptoms and improved physical signs in all the patients except for 1 patient who responded poorly to the surgery. CONCLUSIONS: Expansive double-door laminoplasty of the cervical spine in combination with hydroxyapatite artificial bone grafting is safe and effective for treating cervical spinal stenotic myelopathy. Hydroxyapatite artificial bone possesses good biological compatibility and osteoconduction, and is applicable in the laminoplasty procedures as an ideal bone graft material.

[Suppression of neutrophil immune function in rabbit models of hemorrhagic shock complicated by intra-abdominal hypertension].

OBJECTIVE: To investigate the effects of hemorrhagic shock and intra-abdominal hypertension (IAH) on inflammatory responses of peripheral circulating neutrophils such as intracellular cytokine production, phagocytic capacity and expression of nuclear factor (NF)- kappaB. METHODS: Twenty-four rabbits were divided equally into 4 groups including a hemorrhagic shock (HS) group complicated by abdominal compartment syndrome (ACS) (Group A), a HS group (Group B), a ACS group (Group C) and a normal control group (Group D). Intracellular interleukin (IL)-8 production in the peripheral neutrophils were measured in the rabbits by flow cytometry, phagocytic function of the neutrophils evaluated by a chemiluminescence method and the NF-kappaB expression detected by immunocytochemistry before, immediately and 4 h after the traumatization. RESULTS: Four hours after the trauma, decreased intracellular IL-8 production and impaired phagocytic function of the peripheral neutrophils were observed in Group A along with suppressed NF-kappaB expression. But in Group B and Group C, the intracellular IL-8 production, phagocytic function and expression of NF-kappaB returned to the normal levels 4 hours after the trauma following the early-stage changes. In Group D, no significant changes occurred during the observation. CONCLUSIONS: Responsiveness and function of the neutrophils to the stimuli by endotoxin are suppressed by the sequential second-hit of IAH after hemorrhagic shock, which may contribute to the occurrence of sepsis in ACS.