Erxian Decoction-induced serum exosomes slowed bone marrow mesenchymal stem cell senescence through mitophagy.

OBJECTIVE: Erxian Decoction (EXD) is traditionally employed in the treatment of menopausal syndromes, although its underlying mechanisms remain largely undefined. Given that the senescence of bone marrow mesenchymal stem cells (BMSCs) is intertwined with organismal aging and associated diseases, this study endeavored to elucidate the influence of EXD on aging BMSCs and uncover the mechanisms through which EXD impedes BMSC senescence. METHODS: Initially, we probed the anti-senescent mechanisms of EXD on BMSCs via network pharmacology. We subsequently isolated and identified exosomes from the serum of EXD-fed rats (EXD-Exos) and administered these to H2 O2 -induced aging BMSC. Assays were conducted to assess BMSC senescence indicators and markers pertinent to mitochondrial autophagy. Treatments with mitophagy inhibitors and activators were then employed to substantiate our findings. RESULTS: Protein-protein interaction (PPI) network analyses spotlighted AKT1, TP53, TNF, JUN, VEGFA, IL6, CASP3 and EGFR as focal targets. Gene Ontology and Kyoto Encylcopedia of Genes and Genomes pathway analyses underscored oxidative stress, mitophagy and cell proliferation as pivotal processes. Our cellular assays ascertained that EXD-Exos mitigated H2 O2 -induced senescence phenotypes in BMSCs. Moreover, EXD-Exos ameliorated disrupted mitophagy in BMSCs, as evidenced by enhanced cellular membrane potential and diminished reactive oxygen species levels. Intriguingly, EXD-Exos also preserved the osteogenic differentiation potential of BMSCs while curtailing their adipogenic propensity. CONCLUSION: Our findings compellingly suggest that EXD counteracts BMSC senescence by fostering mitophagy.

Feasibility analysis of high pitch cervical spine CT in uncooperative patients with acute cervical spine trauma: An initial experience.

Cervical computed tomography (CT) often suffers from examination failure in uncooperative patients with acute cervical spinal trauma. Therefore, this study aimed to evaluate the feasibility of using high-pitch cervical CT (HP-CT) in such populations. A total of 95 patients with acute neck/head-neck trauma who underwent HP-CT (n = 29) or standard cervical CT (SD-CT, n = 66) from October 2020 to June 2021 were included in this study. Differences in patient characteristics between the HP-CT group and the SD-CT group were firstly compared. Then, the objective image quality based on the mean score of the signal-to-noise ratio (SNR)/contrast noise ratio (CNR) was evaluated, while double-blind five-point scoring was adopted for the subjective evaluation. Finally, radiation doses in HP-CT and SD-CT were compared. Furthermore, the Student t test and/or Mann-Whitney U test were performed to analyze differences in patient characteristics, image quality, and radiation dose between the two regimes. A total of 17 cases of cervical spine fractures were found in 95 patients, including 6 cases in the HP-CT group and 11 cases in the SD-CT group. The average age of patients who received HP-CT was higher than that of those who received SD-CT, and the scan time using HP-CT was shorter than that SD-CT. The differences were statistically significant (both, P < .05). In addition, there was no significant difference between HP-CT and SD-CT in terms of sex, body mass index, field of view (FOV), and scan length (all P > .05). The SNR/CNR at the middle and upper neck was not significantly different between HP-CT and SD-CT (all P > .05). However, the SNR/CNR at the lower neck in HP-CT was lower than that in SD-CT (all P < .05). There was no significant difference in the subjective scores between HP-CT and SD-CT images in both the soft tissue and bone window (P = .129 and 0.649, respectively). The radiation dose in HP-CT was lower than that in SD-CT (all P < .05). With a scan time reduction of 73%, radiation dose reduction of 10%, and similar image quality, high-pitch cervical CT was of feasibility to evaluate cervical spine injury in uncooperative patients with acute cervical spine trauma.

Highly thermal stable RNase A@PbS/ZnS quantum dots as NIR-IIb image contrast for visualizing temporal changes of microvasculature remodeling in flap.

Surgeons face great challenges in acquiring high-performance imaging because fluorescence probes with desired thermal stability remains rare. Here, hybrid lead sulfide/zinc sulfide quantum dots (PbS/ZnS QDs) nanostructures emitting in the long-wavelength end of the second near-infrared (NIR-IIb) window were synthesized and conjugated with Ribonuclease-A (RNase A). Such formed RNase A@PbS/ZnS QDs exhibited strong NIR IIb fluorescence and thermal stability, as supported by the photoluminescent emission assessment at different temperatures. This will allow the RNase A@PbS/ZnS QDs to provide stable fluorescence signals for long-time intraoperative imaging navigation, despite often happened, undesirable thermal accumulation in vivo. Compared to NIR-IIa fluorescence imaging, NIR-IIb vascular fluorescence imaging achieved larger penetration depth, higher signal/background ratios and nearly zero endogenous tissue autofluorescence. Moreover, these QDs illustrate the reliability during the real-time and long-time precise assessment of flap perfusion by clearly visualizing microvasculature map. These findings contribute to intraoperative imaging navigation with higher precision and lower risk.

[Clinical application of new three-dimensional honeycomb guide in percutaneous cannulated screw fixation of femoral neck fracture].

OBJECTIVE: To design a new type of three-dimensional honeycomb guide for percutaneous cannulated screw placement in femoral neck fracture and evaluate its effectiveness. METHODS: The clinical data of 40 patients with femoral neck fracture who met the selection criteria between June 2019 and December 2020 were retrospectively analyzed. According to different intraoperative positioning methods, they were divided into control group (20 cases, free hand positioning screws) and study group (20 cases, new guide assisted positioning screws). There was no significant difference in gender, age, side, cause of injury, Garden classification, and time from injury to operation between the two groups ( P>0.05). The operation time, fluoroscopy times, guide needle puncture times, and fracture healing time of the two groups were recorded. The hip function was evaluated by Harris score at last follow-up. At immediate after operation, the following imaging indexes were used to evaluate the accuracy of screw implantation distribution: screw spacing, screw coverage area, distance from screw to cervical cortex, parallelism between screws, and screw to cervical axial deviation. RESULTS: All operations were successfully completed, and the guide needle did not penetrate the femoral neck cortex. There was no significant difference in operation time and fluoroscopy times between the two groups ( P>0.05); the guide needle puncture times in the study group was significantly less than that in the control group ( t=8.209, P=0.000). Imaging detection at immediate after operation showed that the screw spacing and screw coverage area in the study group were significantly greater than those in the control group ( P<0.05); the distance from screw to cervical cortex, parallelism between screws, and screw to cervical axial deviation were significantly smaller than those in the control group ( P<0.05). All patients were followed up 7-25 months, with an average of 19.3 months. There was no significant difference in follow-up time between the two groups ( t=-0.349, P=0.729). There were 2 cases of fracture nonunion in the control group and 1 case in the study group, and the other fractures completely healed. One case of osteonecrosis of the femoral head occurred in the control group. During the follow-up, there was no complication such as vascular and nerve injury, venous thrombosis, screw penetration, withdrawal, breakage, and refracture, etc. There was no significant difference in fracture healing time and Harris score at last follow-up between the two groups ( P>0.05). CONCLUSION: The new three-dimensional honeycomb guide has the advantages of simple structure and convenient use. It can reduce the puncture times of the guide needle and effectively improve the accuracy distribution of cannulated screw implantation.

Interactive effects of polymethyl methacrylate (PMMA) microplastics and salinity variation on a marine diatom Phaeodactylum tricornutum.

Until now, knowledge about the interactive effects of microplastics and environmental factors on primary producers is quite limited. In this work, a marine diatom (Phaeodactylum tricornutum) was exposed to polymethyl methacrylate (PMMA) microplastics at different salinities (25, 35, and 45‰) for 10 days in order to study their interactive effects. Results showed that growth of P. tricornutum was negatively affected by PMMA microplastics and salinity variation with a minimum EC50 value of 91.75 mg L-1. Photosynthetic activity of P. tricornutum was also inhibited by the two factors, and their interactive effects on chlorophyll fluorescence parameters (Fv/Fm and ΦPSII) were significant. In the algal cells, soluble protein accumulated, activities of two antioxidant enzymes changed, and malondialdehyde (MDA) content increased when this diatom was exposed to the microplastics at different salinities. These data would help to evaluate the risks of microplastics to primary producers under different environmental factors.

Cultivation of Chlorella sorokiniana in a bubble-column bioreactor coupled with cooking cocoon wastewater treatment: effects of initial cell density and aeration rate.

Previous studies have documented that Chlorella sorokiniana could grow well on cooking cocoon wastewater (CCW) with a maximum biomass of 0.49 g/L. In order to further enhance the biomass production and nutrient removals, a bubble-column bioreactor was designed and performed to cultivate C. sorokiniana in CCW, and two main cultivation parameters were investigated in this work. Results showed that a maximum algal biomass, specific growth rate, and biomass productivity of 2.83 g/L, 0.854 d-1, and 476.25 g/L/d, respectively, were achieved when this alga was cultivated in the bioreactor with an initial cell density of 0.8 g/L and an aeration rate of 3.34 L air/L culture/min; meanwhile, removal efficiencies of ammonium, total nitrogen, total phosphorus, and chemical oxygen demand reached 97.96, 85.66, 97.96, and 86.43%, respectively, which were significantly higher than that obtained in our previous studies. Moreover, chemical compositions in the algal cells varied with the changes of cultivation conditions (i.e., initial cell density and aeration rate). Thus, it is concluded that (1) the bubble-column bioreactor was suitable for cultivation of C. sorokiniana coupled with the CCW treatment and (2) initial cell density and aeration rate affected the biomass production, nutrient removals and chemical compositions of this alga.

Feprazone Ameliorates TNF-α-Induced Loss of Aggrecan via Inhibition of the SOX-4/ADAMTS-5 Signaling Pathway.

Background: Arthritis is a cartilage degenerative disease that is mainly induced by the degradation of the cartilage extracellular matrix (ECM), which is found to be regulated by the expression level of a disintegrin and metalloproteinase with thrombospondin motifs 5 (ADAMT-5), an enzyme degrading Aggrecans in the ECM. Feprazone is a classic nonsteroidal anti-inflammatory drug with promising efficacy in arthritis. The present study aims to investigate the protective effect of Feprazone on the degraded Aggrecan in the human chondrocytes induced with tumor necrosis factor-α (TNF-α) and to clarify the underlying mechanism. Methods: To investigate the effect of Feprazone, the CHON-001 chondrocytes were stimulated with TNF-α (10 ng/mL) in the presence or absence of Feprazone (3, 6 µM) for 24 h. Mitochondrial membrane potential was evaluated using the Rhodamine 123 assay. The gene expressions of interleukin-1ß (IL-1ß), interleukin-8 (IL-8), monocyte chemotactic protein 1 (MCP-1), and ADAMTS-5 in the treated chondrocytes were detected using real-time quantitative polymerase chain reaction (qRT-PCR), and the protein levels of these targets were determined using enzyme-linked immunosorbent assay (ELISA). SOX-4 was knocked down by transfecting the siRNA into the chondrocytes. Western blot analysis was utilized to evaluate the expression levels of SOX-4, Aggrecan, and protein kinase C (PKCα). Results: First, the reduced mitochondrial membrane potential (ΔΨm) and secretion of proinflammatory factors (IL-1ß, IL-8, and MCP-1) induced by TNF-α were significantly reversed by treatment with Feprazone. Second, the expression of Aggrecan was significantly decreased by stimulation with TNF-α via upregulation of ADAMTS-5 but was dramatically reversed by the introduction of Feprazone. Third, we found that TNF-α elevated the expression of ADAMTS-5 by upregulating SOX-4, which was observed to be related to the activation of PKCα. Lastly, the elevated expression of SOX-4 induced by TNF-α was significantly reversed by Feprazone. Conclusions: Feprazone might ameliorate TNF-α-induced loss of Aggrecan via the inhibition of the SOX-4/ADAMTS-5 signaling pathway.

Oxidative stress responses caused by dimethyl phthalate (DMP) and diethyl phthalate (DEP) in a marine diatom Phaeodactylum tricornutum.

A marine diatom (Phaeodactylum tricornutum) was exposed to different concentrations of dimethyl phthalate (DMP) and diethyl phthalate (DEP) for 96 h within a batch-culture system to investigate their toxicities. Results showed that P. tricornutum could remove DMP and DEP effectively with removal rates of 0.20-0.30 and 0.14-0.21 mg L-1 h-1, respectively. In addition, DMP and DEP significantly inhibited the photosynthesis and chlorophyll a biosynthesis of P. tricornutum with 96-h EC50 values of 390.5 mg L-1 and 74.0 mg L-1, respectively. Results of reactive oxygen species (ROS) level suggested that the two PAEs could induce excessive ROS production in the diatom. Moreover, activities of antioxidant enzymes (i.e., SOD and POD) in the diatom increased with the increase of DMP and DEP concentrations. The results will help to understand the toxic mechanisms of PAEs, and provide strong evidences for evaluating their ecological risks in the marine environment.

A feasibility study of using silkworm larvae as a novel in vivo model to evaluate the biotoxicity of ionic liquids.

Ionic liquids (ILs) have been reported to be a potential water and soil pollutant, whose toxicity has gained much attention in recent years. In this work, silkworm larvae were used as a novel in vivo model to assess the biotoxicity of ILs, which were performed by three steps. The first step was to determine the susceptibility of different silkworm strains to ILs. Data showed that Jingsong×haoyue was the most susceptible one among three silkworm strains (Jingsong×haoyue, P50, and Yi16) for evaluating the biological effects of ILs. The second step was to compare the toxicity of ILs with different structures using the larvae of Jingsong×haoyue. It was found that three representative ILs, 1-octyl-3-methylimidazole chloride ([C8mim]Cl), N-octyl-3-methylpyridine chloride ([C8mpy]Cl), and 1-octyl-3-methylimidazole tetrafluoroborate ([C8mim]BF4), had significant toxic effects on the growth and development of the larvae with 24 h median lethal concentration (24 h-LC50) values of 112.3, 156.3, and 68.9 µg g-1, respectively, indicating that the types of anions and cations had impacts on the toxicity of ILs. The last step was targeted at investigating responses of the larvae to the exposure of ILs. It was observed that remarkable physiological and biochemical responses occurred in different tissues of the larvae. For example, activities of superoxide dismutase (SOD), catalase (CAT), and peroxidase (POD) in different tissues increased significantly to form an active protective mechanism for alleviating the toxic effects of ILs. Additionally, an increase of malondialdehyde (MDA) contents was found in the larvae. The data suggested that ILs could induce lipid peroxidation and cellular damage, which may be the main reason for toxicity of ILs to the larvae. Therefore, silkworm larvae could be used as a susceptible and reliable in vivo model to evaluate the toxicity of ILs, and the results are helpful to reveal their toxic mechanism to insects.

[Analysis of hemostatic effect of intra-articular injection of tranexamic acid after minimally invasive unicompartmental knee arthroplasty].

OBJECTIVE: To investigate the effect of intra-articular injection of tranexamic acid on blood loss and blood transfusion rate after minimally invasive unicompartmental knee arthroplasty. METHODS: From January 2015 to September 2017, 90 patients underwent minimally invasive unicompartmental knee arthroplasty were divided into tranexamic acid group and control group, 45 cases in each group. In the tranexamic acid group, there were 22 males and 23 females, aged 62 to 69 (66.1±2.4) years;in the control group, 20 males and 25 females, aged 63 to 71(68.5±5.2) years. The amount of bleeding in the drainage ball at 48 hours after operation was recorded, and the blood transfusion rate and hematocrit level duringthe perioperative period were recorded. The factors influencing perioperative blood loss included gender, age and body mass index (BMI). RESULTS: All patients were followed up for 12.5 to 28.3 (22.8±7.9) months. During the follow-up, the wounds of the two groups healed well, and no deep vein thrombosis and pulmonary embolism occurred. There was no significant difference in postoperative blood loss between the tranexamic acid group and the control group. The postoperative bleeding volume in the tranexamic acid group was (110.0±52.1) ml, and that in the control group was (123.0±64.5) ml (P=0.39). There was no blood transfusion in the two groups. CONCLUSION: Intra articular injection of tranexamic acid can not significantly reduce the postoperative blood loss in patients with minimally invasive unicompartment.

Unicondylar knee arthroplasty versus total knee arthroplasty in adults with isolated medial osteoarthritis: A matched study protocol.

BACKGROUND: The choice between unicondylar knee arthroplasty (UKA) and total knee arthroplasty (TKA) is likely to have long-term implications for patient-reported health outcomes. However, high-quality studies that compare the outcomes of TKA and UKA and their effects are still lacking in the literature. Thus, the aim of the present study was to compare the UKA and TKA techniques with regard to functional outcomes and perioperative complications in patients who had isolated medial osteoarthritis. METHODS: This was a retrospective, single-center, matched-controlled study performed with approval of our hospital (Kunshan hospital of Traditional Chinese Medicine affiliated to Nanjing University of Traditional Chinese Medicine), with the ethics number KZY2020-37. To reduce the effect of selection bias and potential confounding in this observational study, a 1:1 matching algorithm was applied. The groups were split by sex, age to within 6 years, and body mass index within 5 kg/m. Thus, we retrospectively reviewed the records of 240 consecutively enrolled patients who underwent UKA and 240 patients who underwent TKA from January 2013 to June 2015 from the database of our institution. Written informed consent was obtained from all subjects participating in the trial. Clinical outcomes included range of motion, Short Form 12 score, new Knee Society Score, Western Ontario and McMaster Universities Arthritis Index, and the complications. The outcome measures were evaluated by a physiotherapist and were assessed preoperatively and postoperatively at 6 months and 2 years. The mean follow-up time was 3 years. CONCLUSION: We hypothesized that there was no significant difference between the 2 groups in terms of postoperative outcomes. TRIAL REGISTRATION: Our study was registered in Research Registry (researchregistry5828).

[Antero-medial incision of knee joint for the treatment of intercondylar fracture of femur].

OBJECTIVE: To explore the clinical effect of antero-medial incision of knee joint in treating intercondylar fracture of femur. METHODS: From September 2012 to March 2015, 24 patients with intercondylar fracture of femur were selected, including 17 males and 7 females, aged from 20 to 65 years old with an average of(38.3±9.5) years old. Among them, 12 cases were caused by traffic accident, 8 cases were caused by falling injury and 4 cases were caused by falling down. All patients were closed fractures. The time from injury to hospital was from 30 min to 8 h with an average of(2.2±0.3) h. According to AO classification, 4 cases were type B1, 3 type B2, 2 type B3, 5 type C1, 6 type C2 and 4 type C3. All patients were treated with antero-medial incision of knee joint. Operative time, blood loss and postoperative complications were observed and recovery of keen function was evaluated by Kolmert scoring. RESULTS: All patients were followed-up from 6 to 12 months with average of (9.0±1.7) months. Operative time ranged from 50 to 90 min with an average of (70.0±8.2) min; blood loss ranged from 90 to 400 ml with an average of (180±36) ml; negative pressure flow was from 30 to 90 ml, with an average of (50.0±7.1) ml. All fracture were healed at stage I without loosening of internal fixator, fracture nonunion, and deep vein thrombosis. According to Kolmert scoring, 16 patients got excellent result, 5 patients good and 3 fair. CONCLUSIONS: Antero-medial incision of knee joint in treating intercondylar fracture of femur, which has advantages of good fracture reduction, less injury of soft tissue and simple operation, could obtain good clinical results.