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BACKGROUND:Hydroxyapatite is the main inorganic component of bone tissue.The polymer has the structure and function of a biomimetic extracellular matrix.The composites of hydroxyapatite and polymer have been widely studied. OBJECTIVE:To summarize the research status of hydroxyapatite composite polymer materials for bone tissue repair. METHODS:The articles collected in PubMed,Web of Science,CNKI and WanFang databases were searched from January 2010 to April 2023.The Chinese and English search terms were"hydroxyapatite,polymer,composites,degradability,bone defect,bone repair".Finally,75 articles were included for review. RESULTS AND CONCLUSION:Polymers often used in composite with hydroxyapatite for bone tissue repair include natural polymers(collagen,chitosan,alginate,serine protein,cellulose,hyaluronic acid,and polyhydroxybutyrate)and synthetic polymers[polylactic acid,polylactic acid-hydroxyacetic acid copolymer,poly(has-lactide),poly(amino acid)and poly(vinyl alcohol)].The mechanical properties and osteoinductivity of hydroxyapatite/polymer composites were improved compared with pure hydroxyapatite.Hydroxyapatite composite with polymers can be made into porous scaffolds,hydrogels,and coatings for bone repair.Hydroxyapatite/polymer composites can accelerate bone reconstruction with a slow release of loaded drugs and cytokines due to their bionic extracellular matrix structure and function.Based on the diversity of causes of bone defects and the fact that bone repair is a complex continuous process involving multiple biological factors and proteins,repair materials with mechanical properties matching bone tissue,degradation processes synchronized with bone repair,and efficient osteogenesis and vascularization need to be further investigated.
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OBJECTIVE To study the improvement effect of total flavonoids from Rosa multiflora root on vascular injury in rheumatoid arthritis （RA） model rats and its potential mechanism. METHODS Female Wistar rats were randomly divided into normal control group， model group， aspirin group （positive control， 30 mg/kg）， low-dose and high-dose groups of total flavonoids from R. multiflora root （4.15， 8.30 g/kg， by crude drug）， with 10 rats in each group. Except for the normal control group， the RA model was induced in other groups by collagen induction and high-fat diet. After 14 days of modeling， they were given corresponding drug solution/0.5% sodium carboxymethyl cellulose solution intragastrically， once a day， for 36 consecutive days. The total body score， arthritis index （AI） and swollen joint count （SJC） of the rats were evaluated regularly. After the last medication， serum levels of interleukin-6 （IL-6）， intercellular adhesion molecule-1 （ICAM-1） and vascular cell adhesion molecule- 1 （VCAM-1） were determined. The pathological morphological changes in the vascular tissue of thoracic aorta were observed； the protein expression of Toll-like receptor 4 （TLR4） and the protein phosphorylation levels of Janus kinase 2 （JAK2） and signal transduction and activator of transcription 3 （STAT3） in vascular tissue of thoracic aorta were measured. RESULTS Compared with the normal control group， serum levels of IL-6， ICAM-1 and VCAM-1， protein expression of TLR4， and the protein phosphorylation levels of JAK2 and STAT3 in vascular tissue of thoracic aorta were increased significantly in model group （P＜ 0.01）. The atherosclerotic plaque （atheroma）， cholesterol crystal， lymphocyte infiltration and a small number of unbroken foam cell aggregation could be seen in the vascular tissue of thoracic aorta. Compared with the model group， total body score （except for the low-dose group）， AI and SJC were decreased significantly in groups of total flavonoids from R. multiflora root on the 28th day （P＜0.05 or P＜0.01）； total body score，AI and SJC were decreased significantly in low-dose group of total flavonoids from R. multiflora root on the 49th day （P＜0.05 or P＜0.01）； the other quantitative indicators in serum and vascular tissue were significantly reversed in groups of total flavonoids from R. multiflora root （P＜0.05 or P＜0.01）， and pathological damage of vascular tissue was significantly relieved. CONCLUSIONS Total flavonoids from R. multiflora root can significantly improve vascular injury in RA model rats， and its mechanism may be related to reducing the protein expression of TLR4 in vascular tissue and inhibiting the activation of IL-6/JAK2/ STAT3 signaling pathway.
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Background Fine particulate matter (PM2.5) is a serious air pollutant associated with elevated levels of C-reactive protein (CRP), an inflammatory indicator. Objective To assess the potential impacts of long-term exposure to PM2.5 on CRP levels based on previous epidemiological studies. Methods PubMed, Embase, Web of Science, CNKI, and Wanfang databases were searched to screen the cohort studies published from January 1, 2000 to January 1, 2022 on the effects of long-term exposure to PM2.5 on CRP levels. "Fine Particulate Matter", "PM2.5", "Particulate Air Pollutants", "Ambient Particulate Matter", "CRP", "C-reactive Protein", and "High Sensitivity C-reactive Protein" in English or Chinese were the key words used in the search. The percentage change in CRP level per 10 μg·m−3 increase in PM2.5 concentration in each study was extracted, followed by meta-analysis, subgroup analysis, and sensitivity analysis. Results A total of 1241 articles were retrieved, and 7 articles were included. Random-effects models were used to merge the included data, and it was found that the percentage of CRP level increased by 10.41% (95%CI: 2.24%-18.57%, P<0.05), when PM2.5 concentration increased by 10 μg·m−3, І2=84.2%. The subgroup analysis conducted with grouping based on the annual mean concentration of PM2.5 long-term exposure showed that the intra-group heterogeneity was significantly reduced in the <15 μg·m−3 and the 15- μg·m−3 groups, and the subgroup forest analysis showed differences between the two groups. The results of sensitivity analysis showed that there was a high degree of heterogeneity among the 7 studies, and the 2 papers with the highest annual average PM2.5 concentration were the sources of heterogeneity. The Egger test and the funnel plot indicated that no obvious publication bias was found. Conclusion Long-term exposure to PM2.5 can raise levels of CRP in human body.
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Inherited metabolic disorders, also known as congenital metabolic diseases, refer to a group of diseases that cause a series of clinical symptoms due to gene mutations, such as enzyme deficiency, dysfunction of cell membrane or receptor deficiency, resulting in biochemical metabolic disorders, accumulation of intermediate or bypass metabolites, or lack of final metabolites. Inherited metabolic disordersoften occur in childhood, progressively aggravating, irreversible nervous system damage, and even death. Tandem mass spectrometry (MS/MS) has been widely used in newborn screening abroad and in China. This technology not only expands the screening spectrum of newborn screening, but also improves the screening efficiency, specificity and sensitivity, which opens up a new field for disease screening. With deepening the understanding of the mechanism of inherited metabolic disorders and mass spectrometry technology, its clinical application becomes more significant in diseases screening and diagnosing.
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Objective To observe and analyze the expression of programmed cell death 4 (PDCD4) gene and apoptosis inhibitor Livin in triple negative breast cancer (TNBC) tissues and its relationship with prognosis.Methods One hundred cases of TNBC tumor tissue,50 cases of adjacent carcinoma tissue,50 cases of normal breast tissue were selected as the research data.The immunohistochemical technique was applied to detect and compare the expression positive rates of PDCD4 and Livin protein in three kinds of tissues.The patients were followed up.The overall survival (OS) and the progression free survival (PFS) were observed and compared.Results The expression positive rate of PDCD4 in TNBC tissue was significantly lower than that in adjacent carcinoma tissue or normal breast tissue,the differences were statistically significant (x2=26.613,32.000,P＜0.05).The expression was correlated with the clinical pathological features of tumor size,lymph node metastasis,clinical stage,axillary lymph node metastasis and cancer embolus (x2=26.936,13.210,22.774,27.463,5.803,P＜0.05);the expression positive rate of Livin protein in TNBC tissue was significantly higher than that in adjacent carcinoma tissue or normal breast tissue and the expression positive rate of Livin protein in adjacent carcinoma tissue was significantly higher than that in normal breast tissue,the differences were statistically significant (x2 =14.614,57.353,19.048,P＜0.05).The expression was correlated with the clinical pathological features of lymph node metastasis,clinical stage,axillary lymph node metastasis and cancer embolus (x2 =10.788,6.160,27.350,8.914,P＜0.05);OS,PFS in the patients with PDCD4 negative expression were significantly lower than those in the patients with PDCD4positive expression.OS,PFS in the patients with Livin positive expression were significantly lower than those in the patients with Livin negative expression,the above differences were statistically significant (x2 =23.931,19.163,22.649,17.213,P＜0.05).OS in the TNBC patients was correlated with age (RR=1.405),clinical stage (RR =2.897),tumor diameter (RR=2.722),axillary lymph node metastasis (RR=2.516),vascular invasion (RR=3.020),PDCD4 Expression (RR=1.752) and Livin expression (RR=2.051) (P＜0.05).PFS in the patients was correlated with clinical stage (RR =2.756),axillary lymph node metastasis (RR =2.437),PDCD4 expression (RR =1.649) and Livin expression (RR=1.804) (P＜0.05).Conclusion The PDCD4 low expression and Livin protein over-expression exist in TNBC tissues.Their abnormal expressions are correlated with the clinicopathological features of tumor and the prognosis of patient,and could be used as the auxiliary indexes in evaluation of progression and prognosis of TNBC.
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Objective To investigate the application value of three-dimensional shear wave elastography( 3D-SWE) in diagnosis of malignant and benign breast masses . Methods Sixty-seven patients with total 96 masses diagnosed by ultrasound and verified with surgical pathological analysis were selected . The masses were divided into benign group ( 54 masses ) and malignant group ( 42 masses ) . The quantitative diagnosis was performed using two-dimensional shear wave elastography ( 2D-SWE) and 3D-SWE to evaluate the hardness of the masses . Receiver operating characteristic ( ROC ) curves of 2D-SWE and 3D-SWE were drawn to calculate the sensibility and specificity in diagnosis of breast masses . The qualitative diagnosis was performed according to the elastic color image classification to classify the elastic images of the lesions into type Ⅰ - Ⅳ . Results The quantitative diagnosis:① There were significant differences in Emean ,Emax and SD on planes of 2D-SWE and three orthogonal planes of 3D-SWE between the two groups ( P <0 .05) ;② There was no significant difference in Emean ,Emax and SD of two groups between 2D-SWE and 3D-SWE ( P > 0 .05) ;③ Emean ,Emax and SD on planes of 2D-SWE and three orthogonal planes of 3D- SWE both exhibited high diagnostic performance . However , there was no significant difference in Emean ,Emax and SD between 2D-SWE and 3D-SWE ( P >0 .05) . The qualitative diagnosis of elastic color mode:type Ⅰ and type Ⅱ account for most planes of 2D-SWE and three orthogonal planes of 3D-SWE in benign masses ,while type Ⅲ and type Ⅳ account for most in malignant masses . Among the malignant group ,type Ⅲ on the 3D-SWE coronal planes was significantly more than other three types ( P < 0 .05) .Conclusions For quantitative diagnosis ,2D-SWE and 3D-SWE are both beneficial to differentiate benign from malignant masses ,but there is no difference in diagnostic efficacy ;for qualitative diagnosis ,3D-SWE can provide more diagnostic information than 2D-SWE ,especially on the coronal planes of 3D-SWE .
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Objective To evaluate the clinical and radiographic outcomes of locking plate plus endosteal fibular allograft augmentation for unstable proximal humeral fractures with comminuted medial column.Methods We retrospectively analyzed the 48 patients who had been treated by locking plate plus endosteal fibular allograft augmentation and fully followed up for unstable proximal humeral fractures with comminuted medial column between June 2014 and March 2016.They were 12 men and 36 women,with an average age of 64.3 years (from 33 to 87 years).By the Neer classification,7 cases were two-part fractures,21 three-part fractures and 20 four-part fractures.Postoperative assessments included Constant-Murley scores,shoulder scores of Quick Disabilities of the Arm,Shoulder and Hand (Quick DASH),Short Form Health Survey (SF12),humeral head height loss,change in humeral neck shaft angle,postoperative complications and revision rate.Results Their follow-ups averaged 16.7 months (from 12 to 30 months).Their final follow-ups showed a mean Constant score of 83.3 (from 67 to 98),a mean DASH shoulder score of 18.9 (from 6.6 to 49.9),and a mean SF12 of 82.8 (from 56 to 98).Postoperatively,the humeral head height loss averaged 1.2 mm (from 0.1 to 3.4 mm) and the neck-shaft angle 3.1° (from 0.1° to 9.1°).Complications happened in 5 cases (10.4％):loss of reduction in one and screw penetration out of the articular surface in 4.Conclusion Locking plate along with endosteal fibular strut allograft augmentation is a promising technique for the treatment of proximal humeral fractures with comminuted medial column because fibular strut allograft may enhance mechanical stability of the humeral head,maintain fracture reduction,reduce humeral head height loss and complications to ensure good clinical outcomes.
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Objective We studied the EHD2 expression level in NSCLC and its association with clinicopathological features and prognosis.Methods The EHD2 expression level in NSCLC was measured by Western blot in 4 pairs fresh tissues and immunohistochemistry on 91 parffin-embedded slices.These experiments were used to explore the relationship of EHD2 and Ki-67 in the clinical parameters,as well as the relationship with EHD2 and prognosis.Results Western blot showed EHD2 expression level was low in 4 pairs NSCLC tissues.The results by immunohistochemistry showed that the expression of EHD2 was higher in well-differentiated NSCLC tissues than that in poor-differentiated tissues,which was opposite to the Ki-67 expression.Statistical methods revealed that EHD2 protein in NSCLC was significantly correlated with histological grade,pTNM staging,tumor size,lymph node metastasis as well as Ki-67.Low EHD2 expression was correlated with poor prognosis.Conclusions The abnormal expression of EHD2 might be closely related to the initiation and progress of NSCLC.EHD2 might be an indicator of the prognosis of NSCLC,which could be a potential target for NSCLC therapy.
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Objective to investigate the role of Pim‐3 and NF‐κB in the development and progression of infiltrating ductal carcinoma of the breast .Methods Here ,we used immunohistochemistry to detect expression of Pim‐3 and NF‐κB in 75 samples of infiltrating ductal breast carcinoma ,21 samples of intraductal breast carcinoma and 30 normal breast tissues .The relationship of their expression ,as well as their correlation with clinicopathological features and patient survival were assessed .Results In con‐trast ,both Pim‐3 and NF‐κB were more commonly detected in infiltrating ductal carcinoma than in intraductal carcinoma and normal tissue .In the infiltrating ductal carcinoma ,the positive expression rate of Pim‐3 was 77 .3% ,and that of NF‐κB was 68 .0% ;in duc‐tal carcinoma of the breast ,the positive expression rate of Pim‐3 was 52 .4% ,and that of NF‐κB was 42 .9% ;in the normal breast tissue ,the positive expression rate of Pim‐3 was 23 .3% ,and that of NF‐κB was 16 .7% ;the positive expression rate of Pim‐3 was correlated with tumor size ,histological grade ,and clinicopathological stage ;and that of NF‐κB was correlated with tumor size ,histo‐logical grade ,lymph node metastasis of breast cancer .Spearman rank correlation analysis revealed a positive correlation between Pim‐3 expression and NF‐κB expression in infiltrating breast cancer (r=0 .243) .Conclusion Our results demonstrate that Pim‐3 and NF‐κB play a role in the initiation and development of breast cancer ,thus ,these proteins may serve as useful diagnostic and prognostic markers of invasive breast cancer .
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Objective To explore the effectiveness of using somatosensory evoked potentials (SEPs) combined with event-related potentials (ERPs) to predict the prognosis of comatose patients in neurologic intensive care units (N-ICU).Methods A prospective cohort study was conducted in 53 comatose patients enrolled from the Department of Neurology,Xuanwu Hospital of Capital Medical University from January 2011 to June 2014.Short-latency somatosensory evoked potentials (SLSEP),middle-latency somatosensory evoked potentials (MLSEP),N100,and mismatch negative (MMN) were recorded in these comatose patients in N-ICU within one week after coma onset.All patients were evaluated with Glasgow Outcome Scale (GOS) in 3 months after onset.GOS grades 3 to 5 were considered the good outcome; while GOS grades 1 and 2 were considered poor.SLSEP,MLSEP,N100 and MMN were also recorded in 30 healthy controls.The consistency between SLSEP,MLSEP,N100,MMN,and prognosis,as well as the prognostic authenticity of SLSEP,MLSEP,N100 and MMN were analyzed.Results The amplitude was smaller and the latency became longer in comatose patients,compared with healthy controls.The latency of N20,N60,N100 and MMN in patients with good outcome was (21.73 ±2.91) ms,(68.67 ±7.60) ms,(114.81 ±21.60) ms and (194.10 ±55.31) ms,respectively.And the latency of N20,N60,N100 and MMN in patients with poor outcome was (20.74 ±2.05) ms,(64.20 ±5.29) ms,(109.74 ±21.30) ms and (181.00 ± 50.32) ms,respectively.The consistency between poor outcome and absence of evoked potentials for N20,N60,N100 and MMN was satisfactory (x2 =14.60,10.59,14.46,18.12 respectively,all P ＜ 0.05).When combined SEPs with ERPs,the sensitivity was 85.2％,specificity was 74.2％,and general correct rate was 86.8％,respectively,for good outcome; the sensitivity was 74.2％,specificity was 85.2％,and general correct rate was 86.8％,respectively,for poor outcome.Conclusions The bilateral absence of N20 has a good power for predicting the poor outcome in comatose patients,while the bilateral existence of N60,N100 and MMN has a good power for predicting the good outcome.The combined use of SEPs and ERPs in evaluating and predicting the outcomes in comatose patients is suggested.
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ObjectiveTo discuss the expression of VEGF and COX-2 in breast cancer and their correlation with Clinical relationships.MethodsWith Elivision immunohistochemistry,the expression of VEGF and COX-2 was evaluated in 60 samples with primary breast cancer,and it was determined that the correlation of their expression and the clinical features including age,tumor size,clinical TNM staging,pathological grading,armpit lymph node metastasis and prognosis. ResultsThe expression of VEGF had close correlation with tumor size, the clinical TNM staging, pathological grading, and armpit lymph node metastasis (P ＜0.05),but had no correlation with age.The expression of COX-2 had close correlation with the clinical TNM staging pathological grading, and armpit lymph node metastasis (P ＜0.05), but had no correlation with age and tumor size. The expression of VEGF had positive correlation with that of COX-2 (r =0.2615, P ＜0.05);In the death group, the expression of VEGF and COX-2 was significantly higher than the survival group (P ＜0.05).ConclusionThe up-regulated expression of VEGF and COX-2 closely correlated with tumor take place, evolution, metastasis and soake of breast carcinoma. The expression of COX-2 had positive correlation with that of VEGF.Combined detection would be helpful in screening the patients of breast cancer with high risks of recurrence and metastasis, judge the prognosis, so it is good for further treatment.
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OBJECTIVE:To observe the effects of felodipine on blood vessel endothelial function in patients with benign prostatic hyperplasia(BPH) complicating essential hypertension(EH).METHODS:Fifty five patients with BPH complicating EH were assigned to receive 5mg felodipine orally qd for 6 weeks,with levels of endothelin-1(ET-1),nitrous oxide(NO) and von Wilebrand factor(vWF),brachial artery flow-mediated dilatation(FMD) function,the maximum urine flow rate,the average urine flow rate and International Prostate Symptom Score(I-PSS) determined before and after treatment.Meanwhile levels of ET-1,NO and vWF and FMD in 37 normal healthy males were determined.RESULTS:In the treatment group compared with normal control group there were significant differences in levels of ET-1,NO and vWF and FMD(P0.05).There were significant differences in ET-1,NO and vWF levels and FMD after treatment as compared with before treatment(P