Effect of N-cadherin on Chondrogenic Differentiation of Bone Marrow-Derived Mesenchymal Stem Cells through Wnt Signaling Pathway.

This study aimed to compare and analyze the effect of N-cadherin on chondrogenic differentiation of bone marrow-derived mesenchymal stem cells (BMSCs) and to explore the related mechanism, so as to provide a novel theoretical basis for the clinical work of articular cartilage injury regeneration and repair. For this purpose, the experimental animals were clean grade SD rats (aged 5-6 weeks, weighing 180-250g). Alcian blue staining was carried out to observe the induced chondrogenesis following N-cadherin inhibition. The specific role of N-cadherin in the Wnt signaling pathway and chondrogenic differentiation of BMSCs was detected by Western blot; while the effect of N-cadherin on the molecular level changes of ß-catenin in the cytoplasm was evaluated by fluorescence quantitative real-time PCR (qRT-PCR). In addition, immunoprecipitation (IP) was used for the verification of the interaction between N-cadherin and ß-catenin. Results showed that under the light microscope, 90% of the BMSCs at the third generation, 90% of the cells were fused. Alcian blue staining showed that the green staining area in the BMP2 induction group was large and dense, while that in the N-cadherin inhibition group and blank control group was small and sparse. Western blot revealed that N-cadherin and SOX9 were significantly developed in the BMP2 induction group, but Wnt3a was not significantly developed. While in the N-cadherin inhibition group, the development of Wnt3a was obvious, yet without evident development of N-cadherin and SOX9. The qRT-PCR indicated that the relative mRNA expression of Wnt3a was significantly increased in the N-cadherin inhibition group (P<0.05). However, no obvious difference was observed in the mRNA expression of ß-catenin between the BMP2 induction group and the N-cadherin inhibition group (P>0.05). Western blot indicated that in the BMP2 induction group; there existed the development of ß-catenin, significant development of phos-GSK-3ß and total GSK-3ß, but no obvious development of Wnt3a. In the N-cadherin inhibition group, there was significantly enhanced development of Wnt3a and ß-catenin than that before, blurred development of phos-GSK-3ß than that before, and also obvious development of total GSK-3ß with little change from before. N-cadherin promoted the expression of ß-catenin mostly in the cell membrane, but only a few in the cytoplasm and nucleus. Additionally, verification by IP showed that N-cadherin and ß-catenin were developed on N-cadherin and ß-catenin bands, suggesting an interaction between N-cadherin and ß-catenin. According to these results, N-cadherin can ultimately promote chondrogenic differentiation of BMSCs by inhibiting the Wnt signaling pathway.

Relationship between patients in hospital affects recovery from total knee arthroplasty (TKA)-A prospective study.

BACKGROUND: The interaction between patients is rather important source of information about surgery and recovery. Patients always prefer particularly to compare themselves with others of relatively similar ability, opinion and situation. Exploration of patients' dyads, however, is rare and needs further elaboration as to the significance of fellow patients. This study was designed to determine in whether and how preoperative assignment affects TKA's results. METHODS: We assessed early post-operative outcomes in a cohort of 520 TKA patients. Preoperative, and postoperative outcome measures at 6-months following TKA were analyzed and compared between patients who were hospitalized with a roommate whose surgical status was either similar (preoperative) or dissimilar (postoperative) and whose type of surgery was either similar (TKA) or dissimilar (THA). Mean scores, and postoperative change in scores were calculated. Outcome measures evaluated included WOMAC, SF-36, patient affiliation, preoperative anxiety, expectation and analgesic consumption, length of hospital stay. RESULTS: patients were more willing to have serious conversations with roommates whose surgical status was dissimilar (postoperative) and whose type of surgery was similar (TKA). And their SF-36 and WOMAC scores to be significantly improved better. Besides, they were released from hospital more quickly and showed significantly less preoperative anxiety. CONCLUSIONS: We recommend implementation of an assignment policy that patients prior to TKA should be assigned into a postoperative roommate undergoing TKA as well.

Potent growth-inhibitory effect of TRAIL therapy mediated by double-regulated oncolytic adenovirus on osteosarcoma.

Osteosarcoma (OS) severely threatens the health of young people and understanding on the molecular mechanisms of OS etiology enables gene therapy to become an effective therapeutic modality. However, insufficient expression level of genes using existing vectors limits the clinical application of gene therapy for OS. To solve the problem, we developed an oncolytic adenoviral vector, OAT, which can selectively and efficiently replicate in OS cells to enhance the expression of transferred genes. We demonstrated that OAT-mediated TRAIL expression is significantly elevated after infection of OS cells than replication-incompetent Ad5 vector. Increased antitumor capacity was observed in OS cells after OAT-TRAIL treatment both in vitro and in vivo. In normal cells, adenoviral replication, TRAIL expression and growth-inhibiting effect were quite limited when OAT-TRAIL was administrated, showing a high biosafety of this oncolytic adenoviral vector. Collectively, we generated an efficient and promising expression vector for OS gene therapy.

Portal Setup: the Key Point in the Learning Curve for Hip Arthroscopy Technique.

OBJECTIVE: To analyze the learning curve experience of hip arthroscopy based on patient demographics, surgical time, portal setup time, and postoperative complications and to find the key point in the learning curve. METHODS: From May 2016 to February 2019, a prospective study on the learning curve experience of hip arthroscopy was performed in our hospital. We evaluated the first 50 consecutive hip arthroscopy procedures performed by a single surgeon. There were nine females and 41 males with a mean age of 30.8 years. We divide the patients into early group and late group according to the date of their operation, with each group including 25 patients. Data on patient demographics, types of procedure, surgical time, portal setup time, and postoperative complications were collected. Functional scores were assessed with the modified Harris Hip Score (mHHS). RESULTS: Patients were followed up for 16.4 months on average (range, 13-27 months). The early group of patients had a mean age of 35.2 years and the late group a mean age of 26.5 years. The most common procedures performed for the early group were debridement (17 patients, 68%), and in the late group, most patients underwent labral repair (18 patients, 72%). Mean total surgical time was 168 min for the early group and 143 min for the late group, and there was no statistically significant difference between two groups. The portal setup time in the early group and late group was 40.2 ± 12.4 min and 18.5 ± 6.2 min, respectively (P < 0.001), and the portal setup time was significantly longer in the early group. Further analysis of the learning curve of portal setup showed that the average portal setup time was not statistically significant changed after 30 cases. There were six complications including iatrogenic cartilage injury and iatrogenic labrum injury in the early group and five complications including perineal crush injury and nerve stretch injury in the late group. The functional score of patients in the late group was significantly higher than that in the early group during follow-up. CONCLUSION: The steep learning curve of hip arthroscopy is mainly caused by the challenge of portal setup and portalrelated complications were more common in the early group than in the late group. Surgical time is not an effective indicator for evaluating progress on the learning curve of hip arthroscopy.

Structural Characteristics and Antioxidant Activity Analysis of Polysaccharides from Pinelliae Rhizoma and Its Processed Products Before and After Hydrolysis （Enzymolysis） by Sugar Spectrum / 中国实验方剂学杂志

ObjectiveThe glycosidic linkage structural characteristics of polysaccharides from Pinelliae Rhizoma（PR） and its processed products were analyzed by sugar spectrum， high performance thin layer chromatography（HPTLC）， fluorescence-assisted carbohydrate gel electrophoresis（PACE） based on partial acid hydrolysis and specific glycosidase hydrolysis， and the antioxidant activities of polysaccharides before and after hydrolysis（enzymolysis） were compared. MethodPolysaccharides from PR and its processed products were extracted by ultrasound extraction， starch was hydrolyzed by α-amylase， and small molecules below 3 kDa were removed by ultrafiltration. The purified polysaccharides were prepared by hydrolysis of acid and five different specific glycosidases， and the hydrolysates were analyzed by HPTLC and PACE. The antioxidant capacity of polysaccharides was analyzed by 2，2′-azino-bis（3-ethylbenzthiazoline-6-sulfonic acid）（ABTS） and 2，2-diphenyl-1-picrylhydrazyl（DPPH） free radical scavenging experiment before and after different hydrolysis. ResultThrough HPTLC and PACE analysis， it was found that polysaccharides from PR and its processed products could be hydrolyzed by β-galactosidase， β-mannase， cellulase and pectinase， but hardly hydrolyzed by glucanase， indicating that the polysaccharides contained β-galactopyranoside bond， β-1，4-mannoside bond， β-1，4-glucoside bond and α-1，4-galacturonic acid glycosidic bond. In vitro antioxidant experiments showed that the ABTS radical scavenging capacity of the polysaccharides from PR and its processed products was weakened after acid hydrolysis and pectinase enzymatic hydrolysis， while the ABTS radical scavenging capacity was enhanced after enzymatic hydrolysis with cellulase， β-galactosidase， and β-mannase. And after different hydrolysis， the DPPH free radical scavenging capacity of polysaccharides from PR and its processed products was all significantly enhanced. ConclusionThe glycosidic linkage structural characteristics of polysaccharides from PR and its processed products was analyzed by sugar spectrum in this paper， and the relationship between glycosidic bond types and their antioxidant activity was clarified through in vitro antioxidant experiments， which is beneficial for further elucidating the material basis of the related efficacy of PR and its processed products， and providing new ideas and methods for analyzing the structural characteristics of polysaccharides in Chinese medicines.

Efficacy comparison of botulinum toxin A injection and extraocular muscle surgery in the treatment of large angle acute acquired concomitant esotropia / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To explore the variance in efficacy between botulinum toxin A(BTA)injection and extraocular muscle surgery in managing large-angle(≥+60 PD)acute acquired concomitant esotropia(AACE).METHODS: A retrospective analysis was conducted on clinical data of 60 patients with AACE treated at our hospital from June 2020 to December 2022. Patients were divided into three groups based on different treatments: 2.5 IU BTA injection group(14 cases), 5.0 IU BTA injection group(29 cases), and surgical group(17 cases). Follow-up was conducted for 6 mo after treatment to observe the degree of strabismus after the correction of refractive error, visual function, treatment effectiveness, and occurrence of complications after BTA injection.RESULTS: At 6 mo post-treatment, the degree of strabismus in the surgical group and the 5.0 IU BTA injection group was lower than that in the 2.5 IU BTA injection group(P&#x003C;0.017). However, there was no significant difference in the degree of strabismus between the surgical group and the 5.0 IU BTA injection group(P&#x003E;0.017). The effective rate of the 5.0 IU BTA injection group was higher than that of the 2.5 IU BTA injection group(86% vs 43%, P&#x003C;0.017). There was no difference in visual function among the three groups(P&#x003E;0.05). The incidence of complications after treatment was not significantly different between the 2.5 IU BTA injection group and the 5.0 IU BTA injection group(43% vs 52%, P&#x003E;0.05).CONCLUSION: For AACE patients with esotropia degree ≥+60 PD, bilateral medial rectus injection of 5.0 IU BTA can yield outcomes comparable to traditional extraocular muscle surgery, with the advantages of minimal trauma and simple and convenient operation.

Effect of dementia on postoperative complications in older patients with hip fractures / 中国组织工程研究

BACKGROUND:The number of hip fracture patients with dementia is increasing with an aging population,posing challenges for surgical treatment. OBJECTIVE:To determine the effect of dementia on postoperative complications in older patients with hip fractures. METHODS:Patients aged over 60 years old with hip fractures from 2000 to 2019 at Chinese PLA General Hospital were included.Dementia patients with a preexisting diagnosis of dementia at admission were identified.Each dementia patient was matched,for age±5 years,gender,and fracture type with 10 non-dementia patients.The differences in postoperative complications were compared between the two groups,including pneumonia,respiratory failure,gastrointestinal bleeding,urinary tract infection,surgical site infection,deep venous thrombosis,pulmonary embolism,angina pectoris,arrhythmia,heart failure,myocardial infarction,stroke,and death.The impact of dementia on major complications was evaluated using multivariate conditional logistic regression. RESULTS AND CONCLUSION:A total of 2 887 patients were included,of whom 125(4.3%)were dementia patients and matched with 1 243 non-dementia patients.The average age of dementia patients was(80.6±7.4)years;64.8%were female;53.6%were intertrochanteric fractures,and 46.4%were femoral neck fractures.Major complications occurred in 25(20.0%)patients with dementia and 123(9.9%)patients without dementia(P<0.01).The risk of major complications was 200.0 per 1 000 persons(95%CI,139.3-278.6)in dementia patients and 99.0 per 1 000 persons(95%CI,83.6-116.9)in non-dementia patients.Multivariate conditional logistic regression showed that a 2-fold risk of major postoperative complications after hip fracture surgery was found in dementia patients than in those without dementia(adjusted OR,2.11;95%CI,1.08-4.10).The results show that dementia is an independent risk factor for postoperative complications in elderly patients with hip fractures.Appropriate preoperative risk assessment and corresponding preventive and therapeutic measures should be given to this vulnerable population to mitigate postoperative complications.

Levels and diagnostic value of TOP2A and ERBB2 in peripheral blood mononuclear cells of patients with early colorectal cancer / 国际肿瘤学杂志

Objective:To investigate the levels and diagnostic value of topoisomerase Ⅱα (TOP2A) and human epidermal growth factor receptor 2 (ERBB2) in early colorectal cancer (CRC) .Methods:Ninty-three early CRC patients (CRC group) admitted to Shijiazhuang Hospital of Traditional Chinese Medicine were selected for the study from January 2019 to April 2022, and 93 healthy subjects during the same period were selected as the healthy group, and 93 colorectal polyps patients diagnosed and treated in the same period were selected as the colorectal polyp group. TOP2A and ERBB2 mRNA levels in peripheral blood mononuclear cell (PBMC) and serum carcinoembryonic antigen (CEA) level were detected and compared in each group. The value of TOP2A, ERBB2 mRNA and serum CEA level in the diagnosis of early CRC were evaluated by using receiver operating characteristic (ROC) curve. The relationship between TOP2A and ERBB2 levels and clinicopathological features of early CRC patients was analyzed.Results:There were statistically significant differences in the PBMC TOP2A (1.04±0.35 vs. 1.72±0.57 vs. 2.83±0.71, F=246.73, P<0.001), ERBB2 mRNA (1.01±0.34 vs. 1.64±0.55 vs. 2.75±0.71, F=234.80, P<0.001) levels and serum CEA levels (1.29±0.52 vs. 1.93±0.64 vs. 3.17±0.81, F=190.78, P<0.001) in healthy group, colorectal polyp group and CRC group. Compared with the healthy group and colorectal polyp group, the levels of TOP2A and ERBB2 mRNA in PBMC and serum CEA level in CRC group were significantly increased (all P<0.05) ; Compared with the healthy group, the levels of TOP2A and ERBB2 mRNA in PBMC and serum CEA level in the colorectal polyp group were increased (all P<0.05). The ROC curve showed that the area under curve (AUC) of TOP2A and ERBB2 mRNA levels in PBMC and serum CEA level for the diagnosis of early CRC were 0.85, 0.85 and 0.84, respectively, and the AUC for the combined diagnosis of early CRC was 0.96, which was higher than that of TOP2A, ERBB2 and CEA alone ( Z=2.92, P=0.004; Z=3.16, P=0.002; Z=2.86, P=0.005). The combination of the three diagnosed early CRC with a sensitivity of 94.64% and a specificity of 85.96%. There were statistically significant differences in PBMC TOP2A and ERBB2 mRNA levels in early CRC patients with different differentiation degrees ( χ2=6.21, P=0.013; χ2=10.49, P=0.001) . Conclusion:The expression levels of TOP2A, ERBB2 mRNA in PBMC in CRC patients are higher. The combination of TOP2A, ERBB2 mRNA levels in PBMC and serum CEA level may be more helpful for clinical diagnosis of early CRC.

Reconstruction of soft tissue defects in distal segment of dorsal fingers with a perforator(joint branch) flap of proper palmar digital artery combined with dorsal metacarpal artery flap / 中华显微外科杂志

Objective:To explore the surgical procedure and effect of reconstruction of soft tissue defects in the distal segment of dorsal finger with a perforator(joint branch) flap of proper palmar digital artery combined with a dorsal metacarpal artery flap.Methods:From January 2019 to June 2022, 9 patients with soft tissue defects in distal dorsal finger, mostly with avulsion at the extensor tendon insertion point, were treated in Department of Hand and Foot Microsurgery, the Affiliated Hospital of Qingdao University. The defect areas were 1.0 cm×1.0 cm-2.5 cm×2.0 cm. Steel wires were used to reconstruct the extensor tendon insertion point. The defects were reconstructed by a perforator(joint) flap of proximal phalanx artery and a dorsal metacarpal artery flap was used to repair the donor site for proximal flap. Postoperative follow-up and evaluation included flap survival, flap appearance, scars and function of interphalangeal and metacarpophalangeal joints, through outpatient clinical, WeChat and so on.Results:The flap of digital artery perforator (joint branch) and the fasciocutaneous flap of dorsal metacarpal artery all survived. One flap of the digital artery perforator(joint branch) appeared purple and tension blisters after surgery. The stitches of the pedicle of the flap were partially dismantled at 36-48 hours after surgery. The flap was then turned to ruddy in colour 7 days after surgery. The wounds of the distal finger joint and nail bed healed well without redness and infection. The postoperative follow-up lasted for 5 to 12 months, 9 months in average. The appearance, colour and texture of the skin at distal finger were similar to those at the dorsal proximal finger and dorsal palm. Sensation recovered well, all flaps exceeding S 3. The two-point resolution (TPD) was 8-10 mm, with an average of 9.5 mm. According to the Evaluation Standard of Upper Limb Partial Functional of Hand Surgery of Chinese Medical Association, 5 cases were in excellent and 4 in good. Conclusion:The perforator(joint branch) flap of proper palmar digital artery combined with a dorsal metacarpal artery flap is simple and safe treatment. It has a fast functional recovery with an aesthetic appearance in reconstruction of the soft tissue defect in distal segment of dorsal finger.

Investigation on knowledge, attitude and practice on e-cigarette use among college students in Guiyang City / 预防医学

Objective @#To investigate the knowledge, attitude and practice on e-cigarette use among college students in Guiyang City, so as to provide insights into tobacco control health education among colleges and universities. Methods College students were sampled from full-time colleges and universities in Guiyang City using a multi-stage stratified cluster sampling method from March to May in 2022. Students' knowledge, attitude and practice on e-cigarette use were collected using a questionnaire designed based on the 2019 China National Youth Tobacco Survey Questionnaire, and factors affecting the attempt to use e-cigarette were identified using a multivariable logistic regression model. @* Methods@# College students were sampled from full-time colleges and universities in Guiyang City using a multi-stage stratified cluster sampling method from March to May in 2022. Students' knowledge, attitude and practice on e-cigarette use were collected using a questionnaire designed based on the 2019 China National Youth Tobacco Survey Questionnaire, and factors affecting the attempt to use e-cigarette were identified using a multivariable logistic regression model. @* Results @#Totally 2 800 questionnaires were recovered, including 2 694 valid questionnaires, with an effective recovery rate of 96.21%. The respondents included 687 males (25.50%) and 2 007 females (74.50%). The total score of knowledge on e-cigarette use was (2.95±1.02) points, and there were low proportions of knowing that e-cigarettes contained hazardous substances, including nicotine and tar (59.06%) and knowing that e-cigarette use may cause diseases (53.27%). The total score of attitudes towards e-cigarette use was (5.09±2.36) points, and 93.50% of respondents did not use e-cigarettes given by companions. There were 132 students with attempts to use e-cigarettes (4.90%), and there were 29 current e-cigarette users (1.08%). Multivariable logistic regression analysis identified age of 20 years and lower (OR=0.438, 95%CI: 0.267-0.719), living in rural areas (OR=0.458, 95%CI: 0.264-0.794), thinking that e-cigarettes are addictive (OR=0.449, 95%CI: 0.217-0.928), and thinking that e-cigarette smoking is harmful (OR=0.263, 95%CI: 0.131-0.527) as factors protecting from e-cigarette use, and monthly living expenses of more than 2 000 Yuan (OR=2.995, 95%CI: 1.135-7.902), cigarette smoking (OR=19.826, 95%CI: 11.385-34.527), and using companions' e-cigarettes (OR=9.141, 95%CI: 5.534-15.101) and thinking that people around me support my use of e-cigarettes (OR=2.673, 95%CI: 1.426-5.013) were risk factors for e-cigarette use among college students. @* Conclusions @#There is a low awareness rate of e-cigarette use among college students in Guiyang City, and the majority oppose e-cigarette use, with a low proportion of attempt to use e-cigarettes. Age, source of students, monthly living expenses, e-cigarette smoking, knowledge on e-cigarette use and use of companions' e-cigarettes may affect the attempt to use e-cigarettes.

Anti-Alzheimer's Disease Effect of Polysaccharides from Zanthoxyli Pericarpium and Analysis of Its Structural Characteristics by Sugar Spectrum / 中国实验方剂学杂志

ObjectiveThe therapeutic effect of polysaccharides from Zanthoxyli Pericarpium on Alzheimer's disease（AD） was evaluated through establishing a mouse model of AD， and the structural characteristics of the polysaccharides was analyzed by sugar spectrum. MethodThe AD model of mice with rapid aging was established by intraperitoneal injection of D-galactose combined with gavage of aluminum trichloride， and the learning and memory ability of mice was evaluated by Morris water maze test， the histopathological status of brain and neuronal damage were observed by hematoxylin-eosin（HE） staining and Nissl staining. After hydrolysis of polysaccharides from Zanthoxyli Pericarpium with acid and different glycosidases， the characteristics of hydrolysates were analyzed by high performance thin layer chromatography（HPTLC） and fluorescence assisted carbohydrate gel electrophoresis（PACE）. HPTLC chromatography was performed on a silica gel 60 plate with sampling volume of 5 μL， developing solvent of ethyl acetate-glacial acetic acid-water（2∶2∶1）， developing twice， aniline-diphenylamine-phosphoric acid solution as chromogenic agent， and heating at 105 ℃ for 10 min， and then observed under sunlight. PACE experimental conditions were 34% separation gel and 8% concentration gel， electrophoresis buffer was 0.1 mol·L-1 tris（hydroxymethyl） aminomethane（Tris）-boric acid buffer（pH 8.2）. Electrophoresis was carried out at 0 ℃ and the loading amount was 3-6 μL. The sample ran to the front of the gel with a constant current of 15 mA， and imaged under ultraviolet 365 nm. ResultThe results of Morris water maze test showed that polysaccharides from Zanthoxyli Pericarpium significantly improved the learning and memory ability of AD model mice， shortened the escape latency， and significantly increased the number of crossing and the residence time in the target quadrant. The results of histopathological experiments showed that polysaccharides from Zanthoxyli Pericarpium could improve the pathological conditions and neuronal damage in the CA1 and CA3 regions of hippocampus of AD mice， and the number of Nissl corpuscles was significantly increased. The results of sugar spectrum analysis showed that the results of HPTLC and PACE analysis were basically consistent， polysaccharides from Zanthoxyli Pericarpium could be mainly hydrolyzed into small molecular sugars by cellulase and pectinase， indicating that they mainly contained β-1，4-glucosidic bond and α-1，4-galacturonic acid glycosidic bond， and could be slightly hydrolyzed by glucanase， β-galactosidase and β-mannase， indicating that they contained only a small amount of α-1，6-glucosidic bond， β-galactosidic bond， β-1，4-mannosidic bond. ConclusionPolysaccharides from Zanthoxyli Pericarpium has obvious therapeutic effect on AD mice， and its structure mainly contains β-1，4-glucosidic bond and α-1，4-galacturonic acid glycosidic bond， which can provide a reference for the structural analysis of traditional Chinese medicine polysaccharides.

Meta-integration of qualitative research on exercise promoting and hindering factors in patients with chronic kidney disease / 中国实用护理杂志

Objective:To systematically evaluate the factors that promote and hinder exercise in patients with chronic kidney disease, and to provide reference for exercise intervention.Methods:The Cochrane Library,Web of Science, PubMed, Embase, CNKI, Wanfang, VIP and China Biomedical Literature Database were searched for qualitative researches on the promoting and hindering factors of exercise in patients with chronic kidney disease.The retrieval period was from the establishment of the database to January 2022. Qualitative Research Authenticity Evaluation Tool (version 2016) from JBI Evidence-Based Health Care Center was used to evaluate the quality of the literatures, and Meta-integration was used to analyze the results.Results:A total of 10 articles were included and 60 results were extracted, which were grouped into 8 new categories and integrated into 2 results:the promoting factors included personal exercise motivation,exercise self-efficacy stimulation,physical and psychological benefits and good social support;the hindering factors included disease and treatment factors,low exercise self-efficacy,fear of exercise risk and weak social support.Conclusions:Exercise of patients with chronic kidney disease is affected by many factors, so we should deeply understand the actual situation of patients,pay attention to the core factors affecting exercise, and improve the health of patients.

SSBP1 mutation-induced autosomal dominant optic atrophy with chronic renal insufficiency: a case report and literature review / 中华实用儿科临床杂志

The data of a patient with autosomal dominant optic atrophy (ADOA) and chronic renal insufficiency caused by SSBP1 gene mutation in the Children′s Hospital Affiliated to Zhengzhou University in July 2021 was analyzed retrospectively.Literature was reviewed.The patient was a 10-year-old girl, who visited the hospital due to " growth retardation for the past 3 years and elevated serum creatinine (Scr) for the past 2 years" . On admission, the patient′s height was 130 cm (<10 th percentile of the same sex of healthy age) and her weight was 22 kg (<3 rd precentile of the same sex of healthy age). Lab examination showed that the level of blood urea nitrogen (BUN) was 16.3 mmol/L, Scr was 115.4 μmol/L, and the estimated glomerular filtration rate was 41 mL/(min·1.73 m 2). The patient was complicated with metabolic acidosis and mild anemia.Imaging findings showed small volume of both kidneys, increased background parenchymal enhancement, scattered spot-like hyperechoes and unclear boundary between the cortex and medulla.Additionally, the patient had a history of optic atrophy.Both the father and mother of the patient had no related phenotypes.The genetic test of the patient showed that c. 320G>A (p.R107Q) was a heterozygous missense mutation, which was spontaneous.A total of 5 English papers were retrieved.There were 8 kinds of SSBP1 gene mutations reported, including 7 heterozygous missense mutations [c.320G>A (p.Arg107Gln), c.119G>T (p.Gly40Val), c.331G>C (p.Glu111Gln), c.184A>G (p.Asn62Asp), c.113G>A (p.Arg38Gln), c.422G>A (p.Ser141Asn), c.79G>A (p.Glu27Lys)] and 1 homozygous mutation [c.394A>G (p.Ile132Val)]. Studies have established that almost all patients carrying SSBP1 mutations have manifestations of eye involvement, and that some patients are complicated with progressive deterioration of renal function, sensorineural deafness, growth retardation, and hypothyroidism.It suggests that SSBP1 gene mutation can cause ADOA.For patients with optic atrophy, whether they are complicated with hearing loss and growth retardation, renal morphology and renal function evaluation are recommended.Early genetic examination is helpful for diagnosis and treatment.

How Job Stress and Psychological Adaptation Predicting Interpersonal Needs Among Female Migrant Manufacturing Workers in China: A Structural Equation Model

Background@#This study aimed to explore relationships between job stress and psychological adaptation and how they related to interpersonal needs through mood states among female migrant manufacturing workers. @*Methods@#A cross-sectional survey was conducted in 16 factories in Shenzhen, China. Sociodemographic, job stress, psychological adaptation and other psychological information of was collected. Structural equation modeling was performed to delineate the internal relationship between variables. @*Results@#The hypothetical structural equation model exhibited acceptable model fit among female migrant manufacturing workers (χ2 = 11.635, df = 2, χ2/df = 5.82, p = 0.003, RMSEA = 0.090, CFI = 0.972, SRMR = 0.020). Job stress was directly associated with mood states and interpersonal needs; Psychological adaptation was directly associated with mood states and indirectly associated with interpersonal needs; Bootstrapping tests demonstrated mediation effect of mood states in the way from psychological adaptation to interpersonal needs. @*Conclusion@#Female migrant manufacturing workers who suffered stress from job and the process of psychological adaptation may have worse mood states and workers with worse mood states are more likely to develop unmet interpersonal needs, a proximal factor of suicidal ideation.

Ibrutinib in treatment of steroid-resistant chronic graft-versus-host disease: report of 3 cases and review of literature / 白血病·淋巴瘤

Objective:To investigate the clinical characteristics of steroid-resistant chronic graft-versus-host disease (cGVHD) patients and the therapeutic effect of ibrutinib.Methods:The clinical data of 3 steroid-resistant cGVHD patients treated with ibrutinib after allogeneic hematopoietic stem cell transplantation in the First Affiliated Hospital of Soochow University from December 2017 to March 2018 were retrospectively analyzed, and the literature was reviewed.Results:All 3 patients had different degrees of skin and oral cGVHD. One patient's oral symptom improved after the application of prednisone, and the skin symptom was better after oral ibrutinib; one patient's oral symptom improved after oral ibrutinib, but skin symptom did not improve significantly; one patient's skin symptom did not improve significantly. None of the 3 patients presented with adverse reactions such as hemorrhage, infection and cytopenia.Conclusions:Ibrutinib has a certain effect on the improvement of symptoms in steroid-resistant cGVHD patients.

Curative Effect of Lenvatinib Combined with Locoregional Therapy on PD-L1-positive Hepatocellular Carcinoma Patients with Type Ⅰ-Ⅲ Portal Vein Tumor Thrombus According to Cheng's Classification / 肿瘤防治研究

Objective To compare curative effect between lenvatinib combined with locoregional therapy and locoregional therapy on PD-L1-positive hepatocellular carcinoma patients with type Ⅰ-Ⅲ portal vein tumor thrombus according to Cheng's classification. Methods The patients in lenvatinib combined with locoregional therapy group received orally-administered lenvatinib at a dose of 12 mg qd for patients≥60 kg or 8 mg qd for patients < 60 kg. The locoregional therapy group only received locoregional therapy. We retrospectively analyzed the clinical data and prognosis of two groups. Results The CR+PR were 78.1% and 53.6% in the combination group and locoregional therapy group, respectively (P < 0.05). The response rate, disease control rate and overall survival of the combination group were higher than those in the locoregional therapy group (P < 0.05). Conclusion The curative effect and overall survival of lenvatinib combined with locoregional therapy is better than locoregional therapy on PD-L1-positive hepatocellular carcinoma patients with type Ⅰ-Ⅲ portal vein tumor thrombus according to Cheng's classification.

The application and insight of single-stage posterior total en bloc spondylectomy treatment on L 5 vertebrae spine tumors / 中华骨科杂志

Objective:To investigate the feasibility and technical points of single posterior total spine resection for L 5 vertebrae tumors, evaluate the effectiveness and safety of the technique, and propose a comprehensive treatment model for L 5 tumors on this basis. Methods:A retrospective analysis was performed on the data of 13 patients with L 5 vertebrae tumor who were treated by total en bloc spondylectomy (TES) through single-stage posterior approach from January 2014 to September 2021, including 4 males and 9 females. The age range was 21-65 years, with an average age of 33.85±14.24 years. Imaging examination showed isolated tumors of L 5 vertebrae without other metastases. All patients were treated with a single posterior L 5 vertebrae tumor TES by adjusting the curvature of lumbar lordosis, and the lumbar nerve root was fully dissociated. The vertebra with tumor was removed entirely and lumbar stability reconstruction via a pedicle screw system. Various parameters, including operative time, blood loss, complications, preoperative and postoperative spine sagittal parameters, Japanese Orthopaedic Association scores (JOAs), tumor control and outcome, were listed and analyzed. Results:Preoperative pathological diagnosis of 13 patients was mainly primary bone tumor including giant cell tumor in 7 cases, and invasive hemangioma, epithelioid hemangioma, aneurysmal bone cyst, chordoma, plasma cell myeloma and bone metastasis of breast cancer in 1 case. The mean operative time was 333.23±99.48 min (range 175-480 min), and the mean intraoperative blood loss was 1 407.69±676.49 ml (range 300-2 800 ml). There were no serious perioperative complications during the perioperative period. The mean follow-up was 54.92±19.29 months (range 28-84 months). JOAs improved from 13.85±3.86 points before operation to 24.31±2.16 points at 6 months after operation, and the difference was statistically significant ( t=8.19, P<0.001). Postoperative delayed wound healing occurred in 2 case. 2 patients showed numbness of the left lower limb, and 1 patient had slightly reduced plantar flexion movement. Conclusion:Single posterior TES is a good surgical method for the treatment of isolated L 5 vertebrae tumors. Although this technique is difficult, it can reduce surgical wounds and postoperative complications and good functional and oncology prognosis can be achieved.

Arthroscopic treatment for patients with borderline developmental dysplasia of the hip and cam-type femoroacetabular impingement syndrome / 中华骨科杂志

Objective:To evaluate the clinical outcomes of patients with borderline developmental dysplasia of the hip (BDDH) and cam-type femoroacetabular impingement syndrome (FAIS) after hip arthroscopy.Methods:Data were retrospectively reviewed for patients with BDDH and cam-type FAIS who underwent hip arthroscopy surgery from June 2017 to December 2019. A total of 32 patients were enrolled, with a mean age of 36.13±8.67 years (range, 20-50 years), including 15 males and 17 females. The preoperative lateral center-edge angle was 22.3°±1.6° (range 20.1°-24.7°), while the preoperative α angle was 64.1°±4.6° (range, 56.0°-69.8°). All patients were treated with arthroscopic limited acetabular plasty, labral repair, femoral osteoplasty, and capsular plication after excluding from external hip diseases by ultrasound-guided hip blocking test. The visual analogue scale (VAS), modified Harris Hip Scores (mHHS) and International Hip Outcome Tool-12 (iHOT-12) scores were used to evaluate the clinical effects.Results:All patients were followed up, and the mean follow-up time was 2.5±0.8 years (range, 2.0-4.7 years). The VAS score decreased from 6.07±1.56 to 1.96±0.92 at 1 year and to 1.86±1.01 at 2 years after operation ( F=112.64, P<0.001); the mHHS score increased from 53.87±13.04 to 86.12±8.64 at 1 year and to 88.71±8.15 at 2 years after operation ( F=101.70, P<0.001); the iHOT-12 score was improved from 40.00±7.33 to 76.27±9.50 at 1 year and to 78.67±10.31 at 2 years after operation ( F=134.91, P<0.001). The α angle improved to 40.27°±4.52° (range, 34.8°-49.7°) with significant difference ( t=9.24, P<0.001). Conclusion:Hip arthroscopy can achieve satisfied short-term outcomes in treating BDDH and cam-type FAIS with few complications and less trauma.

Prognosis-related Factors of Colorectal Cancer Patients with Positive PD-L1 Expression in Liver Metastases After Hepatectomy / 肿瘤防治研究

Objective To evaluate the prognosis-related factors of colorectal cancer patients with positive PD-L1 expression in liver metastases after hepatectomy. Methods We reviewed retrospectively the clinical data of 68 colorectal cancer patients with positive PD-L1 expression in liver metastases receiving personalized comprehensive treatment which was mainly consisted of surgical resection. We observed the results and prognosis after surgical resection and analyzed related factors. Results Univariate analysis showed that no radiotherapy, N stage, RAS mutation status, T stage, dMMR, Duck stage, disease free interval from primary to metastases≤12 months and largest hepatic tumor diameter > 5 cm had obvious significance (all P < 0.05). Multivariate logistic analysis regression revealed that without dMMR (P=0.012), Duck A stage (P=0.000), disease free interval from primary to metastases > 12 months (P=0.020) and largest hepatic tumor diameter < 5 cm (P=0.006) were independent protective factors for the prognosis of colorectal cancer patients with positive PD-L1 expression in liver metastases after surgical resection. Conclusion Personalized comprehensive treatment which is mainly consisted of surgical resection still has a good effect on colorectal cancer patients with positive PD-L1 expression in liver metastases after hepatectomy. Without dMMR, Duck A stage, disease free interval from primary to metastases > 12 months and largest hepatic tumor diameter ≤5cm are independent protective factors for patients' prognosis.

Biomechanical study on different high-strength sutures and suture site for repairing posterior root tear of the medial meniscus / 中国骨伤

OBJECTIVE@#To compare biomechanical characteristic of different high-strength sutures and suture sites for repairing posterior root tear of the medial meniscus with modified Mason-Allen technique.@*METHODS@#Forty-eight specimen of medial meniscus of knee joint from fresh porcine (female, aged from 5 to 9 months with an average of 7 months) were chosen and established experimental model. The samples were divided into red zone fixation group and red-white zone fixation group according to suture sites, 24 in each group; and then were randomly divided into 3 subgroups which 8 in each group, and fixed with Ethibond suture, Ultrabraid suture and FiberWire suture, respectively. Biomechanical tests were performedon universal electromagnetic and mechanical testing machine. Each specimen was underwent 1 000 cyclic tests on the first time, then pull out test until failure. The maximum failure load, yield load, stiffness and displacement were analyzed.@*RESULTS@#All specimen were successfully completed biomechanical tests. The failure mode of Ethibond group was caused by suture fracture; 6 cases of Ultrabraid suture group was caused by suture fracture which belong to red zone fixation group, 10 cases were caused by suture pull out, which 2 cases belong to red zone fixation group, 8 cases belong to red-white zone fixation group;8 cases of FiberWire group was caused by suture pull-out. Biomechanical test showed that:(1)In terms of suture strength, comparison of the maximum failure load, yield load and stiffness showed that Ethibond suture group