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The acute combination fractures of the atlas and axis in adults have a higher rate of neurological injury and early death compared with atlas or axial fractures alone. Currently, the diagnosis and treatment choices of acute combination fractures of the atlas and axis in adults are controversial because of the lack of standards for implementation. Non-operative treatments have a high incidence of bone nonunion and complications, while surgeries may easily lead to the injury of the vertebral artery, spinal cord and nerve root. At present, there are no evidence-based Chinese guidelines for the diagnosis and treatment of acute combination fractures of the atlas and axis in adults. To provide orthopedic surgeons with the most up-to-date and effective information in treating acute combination fractures of the atlas and axis in adults, the Spinal Trauma Group of Orthopedic Branch of Chinese Medical Doctor Association organized experts in the field of spinal trauma to develop the Evidence-based guideline for clinical diagnosis and treatment of acute combination fractures of the atlas and axis in adults ( version 2023) by referring to the "Management of acute combination fractures of the atlas and axis in adults" published by American Association of Neurological Surgeons (AANS)/Congress of Neurological Surgeons (CNS) in 2013 and the relevant Chinese and English literatures. Ten recommendations were made concerning the radiological diagnosis, stability judgment, treatment rules, treatment options and complications based on medical evidence, aiming to provide a reference for the diagnosis and treatment of acute combination fractures of the atlas and axis in adults.
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Ankylosing spondylitis (AS) combined with spinal fractures with thoracic and lumbar fracture as the most common type shows characteristics of unstable fracture, high incidence of nerve injury, high mortality and high disability rate. The diagnosis may be missed because it is mostly caused by low-energy injury, when spinal rigidity and osteoporosis have a great impact on the accuracy of imaging examination. At the same time, the treatment choices are controversial, with no relevant specifications. Non-operative treatments can easily lead to bone nonunion, pseudoarthrosis and delayed nerve injury, while surgeries may be failed due to internal fixation failure. At present, there are no evidence-based guidelines for the diagnosis and treatment of AS combined with thoracic and lumbar fracture. In this context, the Spinal Trauma Academic Group of Orthopedics Branch of Chinese Medical Doctor Association organized experts to formulate the Clinical guideline for the diagnosis and treatment of adult ankylosing spondylitis combined with thoracolumbar fracture ( version 2023) by following the principles of evidence-based medicine and systematically review related literatures. Ten recommendations on the diagnosis, imaging evaluation, classification and treatment of AS combined with thoracic and lumbar fracture were put forward, aiming to standardize the clinical diagnosis and treatment of such disorder.
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The mechanisms underlying exercise-induced neuroprotective effects after traumatic brain injury (TBI) remained elusive, and there is a lack of effective treatments for TBI. In this study, we investigated the effects of an integrative approach of exercise and Yisaipu (TNFR-IgG fusion protein, TNF inhibitor) in a mouse TBI model. Male C57BL/6J mice were randomly assigned to a sedentary group or a group that followed a voluntary exercise regimen. The effects of 6-week prophylactic preconditioning exercise (PE) alone or in combination with post-TBI Yisaipu treatment on moderate TBI associated deficits were examined. The results showed that combined treatments of PE and post-TBI Yisaipu were superior to single treatments on reducing sensorimotor and gait dysfunctions in mice. These functional improvements were accompanied by reduced systemic inflammation largely via decreased serum TNF-α, boosted autophagic flux, and mitigated lesion volume after TBI. Given these neuroprotective effects, composite approaches such as a combination of exercise and TNF inhibitor may be a promising strategy for facilitating functional recovery from TBI and are worth further investigation.
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Animals , Male , Mice , Brain Injuries, Traumatic/pathology , Disease Models, Animal , Mice, Inbred C57BL , Neuroprotective Agents/pharmacology , Recovery of Function , Tumor Necrosis Factor InhibitorsABSTRACT
According to the pathological characteristics of symptomatic chronic thoracic and lumbar osteoporotic vertebral fracture (SCOVF), the different clinical treatment methods are selected, including vertebral augmentation, anterior-posterior fixation and fusion, posterior decompression fixation and fusion, and posterior correction osteotomy. However, there is still a lack of a unified understanding on how to choose appropriate treatment method for SCOVF. In order to reflect the new treatment concept and the evidence-based medicine progress of SCOVF in a timely manner and standardize its treatment, the clinical guideline for surgical treatment of SCOVF is formulated in compliance with the principle of scientificity, practicability and advancement and based on the level of evidence-based medicine.
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During pandemic of corona virus disease 2019 (COVID-19), emergency orthopedic trauma is commonly seen. It is particularly important to ensure the emergency treatment quality of orthopedic trauma but avoid cross-infection between doctors and patients. The double-buffered diagnosis and treatment mode refers to the model of patients first undergoing medical observation in the comprehensive buffer ward and the inpatient buffer rooms of various disciplines after admission to confirm the exclusion of COVID-19 and then receiving specialist diagnosis and treatment. The authors summarize the experiences of using the double-buffered diagnosis and treatment model in the Department of Orthopedics, Renmin Hospital of Wuhan University during the prevention and control of COVID-19 pandemic so as to provide a reference for treatment of orthopedic patients.
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PURPOSE: Effective biomarkers and models are needed to improve the prognostic prospects of clear cell renal cell carcinoma (ccRCC). The purpose of this work was to identify DNA methylation biomarkers and to evaluate the utility of DNA methylation analysis for ccRCC prognosis. MATERIALS AND METHODS: An overview of genome-wide methylation of ccRCC tissues derived from The Cancer Genome Atlas (TCGA) database was download for analysis. DNA methylation signatures were identified using Cox regression methods. The potential clinical significance of methylation biomarkers acting as a novel prognostic markers was analyzed using the Kaplan-Meier method and receiver operating characteristic (ROC) curves. RESULTS: This study analyzed data for 215 patients with information on 23171 DNA methylation sites and identified a two-DNA methylation signature (cg18034859, cg24199834) with the help of a step-wise multivariable Cox regression model. The area under the curve of ROCs for the two-DNA methylation signature was 0.819. The study samples were stratified into low- and high-risk classifications based on an optimal threshold, and the two groups showed markedly different survival rates. Moreover, the two-DNA methylation marker was suitable for patients of varying ages, sex, stages (I and IV), and histologic grade (G2). CONCLUSION: The two-DNA methylation signature was deemed to be a potential novel prognostic biomarker of use in increasing the accuracy of predicting overall survival of ccRCC patients.
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Humans , Biomarkers , Carcinoma, Renal Cell , Classification , DNA Methylation , Genome , Methods , Methylation , Prognosis , ROC Curve , Survival RateABSTRACT
Objective To investigate the acceptance of HPV self-sampling mode in cervical cancer screening population and explore its feasibility. Methods From March 5 to 15, 2018, researchers investigated women who participated in cervical cancer screening organized by Beijing Shunyi Women＇s and Children＇s Hospital in the form of questionnaires. Questionnaires were conducted on their acceptance status and the factors that affect the self-sampling experience. The specific contents of the questionnaires were as follows: (1) the experience of using self-sampling included operability, comfortable, sample time-consuming, bleeding or not after sampling; (2) psychological changes after self-sampling, including the willingness to accept self-sampling again, the worrying problems during self-sampling process. According to whether or not have operating video guidance, the self-sampling experience and psychological changes after self-sampling were compared. Results (1) There were 1 375 women participated in the questionnaire survey, and 86.55% (1 190/1 375) of them thought the self-sampling was convenient, 78.40% (1 078/1 375) thought it was not uncomfortable, 88.58% (1 218/1 375) thought the sampling time was fast (less than 5 minutes), 94.04% (1 293/1 375) self-sampling without bleeding; and 83.27% (1 145/1 375) were willing to self-sampling for cervical cancer screening again, 85.82% (1 180/1 375) were afraid of inaccurate sampling. (2) Among the 1 375 women, 1 202 were in the video guidance group and 173 were in the non-guidance group. The self-sampling experience of women in video guidance group was better than those of non-guidance group in operability, comfortable, sampling time-consuming and bleeding after sampling. The proportion of women who willing to self-sampling again was higher than that of non-guidance group (86.69% vs 59.54%, respectively). The proportion of women who worried operating incorrectly was lower than that of non-guidance group (11.23% vs 32.37%, respectively). The differences were significant (all P<0.05). Conclusions Self-sampling for HPV testing in cervical cancer screening is easy to operate and has little discomfort complaint. It is feasible in cervical cancer screening. Operational video guidance during the screening process could effectively improve the women＇s experience and willingness to self-sampling again in the future.
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2-[3-hydroxy-1-adamantyl]-2-oxoacetic acid [IV], a key intermediate of saxagliptin for type 2 diabetes mellitus [T2DM], was prepared from 1-adamantanecarboxylic acid[I] via oxidation by potassium permanganate[KMnO4] to afford 3-hydroxy-1-adamantanecarboxylic acid [II], which was treated with a one-pot method to give 1-acetyl-3-hydroxyadamantane [III] followed by oxidation. Some key steps were optimized and the overall yield was about 51%
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<p><b>OBJECTIVE</b>To investigate the effect of BIX01294 (BIX), a methyltransferase inhibitor, on the migration and decidualization of the stromal cells in mouse uterus.</p><p><b>METHODS</b>Mouse endometrial stromal cells were isolated and cultured from the uterus of pregnant mice on day 3.5 of gestation. The migration and decidualization of mouse endometrial stromal cells treated with BIX at different concentrations were observed with wound healing assay and real-time PCR.</p><p><b>RESULTS</b>The migration distance of mouse endometrial stromal cells increased as the BIX concentration increased within the range below 15 µmol/L. Compared with the control cells, the cells treated with BIX (15 µmol/L) showed significantly increased migration distances, but increasing BIX concentration to 20 µmol/L did not further increase the cell migration distance and began to cause cell death. Compared with the control cells, the BIX-treated stromal cells exhibited significantly down-regulated expression of Ehmt2 mRNA, and 15 µmol/L BIX caused inhibition of decidualization in the stromal cells.</p><p><b>CONCLUSION</b>Within a defined concentration range, BIX promotes the migration and inhibits decidualization of mouse uterine stromal cells by inhibiting the expression of Ehmt2 mRNA.</p>
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Objective To investigate the effect of double filtration plasmapheresis (DFPP) upon the removal of donor specific antibody (DSA) in highly sensitized recipients with renal transplantation. Methods Four highly sensitized recipients undergoing renal transplantation received 7 cycles of DFPP. Luminex technology was adopted to monitor the changes of DSA. Clinical efficacy, incidence of acute rejection and adverse reactions were observed. Results After DFPP, the DSA MFI [1036 (0-4113)] was significantly declined than that before treatment [6446 (2999-12905), Z= -2.503, P=0.012]. No hyperacute rejections occurred in four highly sensitized recipients undergoing renal transplantation.Acute rejection was noted in one case, which was mitigated by postoperative DFPP and adjustment of immunosuppressive agents. During postoperative follow-up, the function of transplant kidney was normal and no rejection reactions occurred. The level of albumin was decreased after DFPP. Conclusions DFPP can effectively remove the DSA in the recipients.It is an efficacious and safe approach to prevent the incidence of acute rejections in highly sensitized recipients after renal transplantation.
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<p><b>OBJECTIVE</b>To detect the expression of FABP7 in the placenta of pregnant mice and in HTR-8/Svneo cells.</p><p><b>METHODS</b>Real-time PCR and immunofluorescence were used to detect FABP7 mRNA and protein expressions in the uterine and placental tissue of pregnant mice at different days of gestation. FABP7 expression was also detected in cultured HTR-8/Svneo cells using immunofluorescence assay. The mice were treated with E, Por their combination for 6 and 24 h and Fabp7 mRNA level in the uterus was detected with real-time PCR.</p><p><b>RESULTS</b>At 7.5-10.5 days of gestation, the pregnant mice showed positive expressions of Fabp7 mRNA in the uterus and placenta, and FABP7 protein was detected in the decidualized cells and trophoblast giant cells. The expressions of FABP7 were detected at both the mRNA and protein levels in cultured HTR-8/Svneo cells. In mice treated with P4 alone or with E+Pfor 6 and 24 h, the expression level of Fabp7 mRNA was upregulated in the uterus. Fabp7 upregulation was observed in mice at 24 h following Etreatment but not at 6 h.</p><p><b>CONCLUSION</b>FABP7 is expressed in trophoblast giant cells and decidual cells in the placental tissue of mice and in cultured HTR-8/Svneo cells, suggesting the involvement of FABP7 in placental development and in maintenance of pregnancy. Eand Pcan regulate the expression of FABP7 in mouse uterus.</p>
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<p><b>OBJECTIVE</b>To investigate the relationship of gene polymorphisms of inflammattion related cytokines with incidence of diffuse large B-cell lymphoma(DLBCL) in Gansu Han population.</p><p><b>METHODS</b>The gene polymorphism of inflammation-related cytokines were detected by high-resolution melting(HRM) curve.</p><p><b>RESULTS</b>The homozygous CC genotype carrying IL-1RA rs4251961 gene locus was related with the risk of DLBCL in comparison with homozygous TT, the OR was 0.83 of homozygous CC, 95% CI=0.697-0.997,P<0.05), while the C allele of IL-1RA rs4251961 gene locus significantly correlated with the high incidence of diffuse large B-cell lymphoma compared with T allele(OR=8.83, 95% CI=1.909-40.813,P<0.01).</p><p><b>CONCLUSION</b>The minor allele C of IL-1RA rs4251961 gene locus significantly relates with the susceptibility to DLBCL.</p>
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OBJECTIVE: To explore the relationship among occupational stress,job satisfaction and psychological capital in oil workers,to analyze the role of psychological capital in mediating occupational stress and job satisfaction. METHODS: By cluster random sampling method,1 837 oil workers in western Liaoning area were chosen as study subjects. The EffortReward Imbalance,Minnesota Satisfaction Questionnaire and Psy Cap Questionnaire( PCQ-24) were used to investigate their occupational stress, job satisfaction and psychological capital. RESULTS: The average score of oil workers in occupational stress was( 66. 17 ± 6. 78),and the score of job satisfaction was( 68. 13 ± 14. 03),the score of psychological capital was( 96. 65 ± 20. 36). Internal investment,return on dimension of occupational stress and psychological capital and job satisfaction was positively correlated [the correlation coefficient( r) was 0. 09,0. 25,0. 62,respectively,P <0. 05]. The external dimensions and job satisfaction was negatively correlated( r =- 0. 27,P < 0. 05). Occupational stress and psychological capital had direct prediction on job satisfaction( P < 0. 05). Psychological capital on the mediation effect of occupational stress and job satisfaction was 0. 34,29. 11 % of the total effect. CONCLUSION: Occupational stress and job satisfaction was partially mediated by psychological capital. Adjusting the psychological capital can reduce the occupational stress and affect job satisfaction of oil workers.
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Saxagliptin,a novel antihyperglycemic agent belonging to dipeptidyl peptidase-4(DPP-4)inhibitor,was devel?oped by Bristol-Myers Squibb and AstraZeneca. It has the merit of obvious hypoglycemic activity,less side effect,good treatment com?pliance and remarkably high safety,and is widely applied to treatment of type 2 diabetes. In this paper,we review the synthetic meth?ods of the key intermediate(S)-N-Boc-3-hydroxyadamantylglycine(compound 3)as well as its two important compounds 3-hydroxy-1-acetyladamantane(1)and 2-(3-hydroxy-1-adamant-yl)-2-oxoacetic acid(2)and briefly discuss their advantages and disadvantages.
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The anaerobic granular sludge from an Internal Circulation (IC) reactor of a paper mill wastewater treatment plant were seeded in an Anammox upflow anaerobic sludge blanket reactor. After 185 days operation, the reactor was finally started up by increasing the influent ammonium and nitrite concentrations to 224 mg/L and 255 mg/L, respectively, with volumetric nitrogen removal rate increasing to 3.76 kg/(m3·d). The physicochemical characteristics of the cultivated Anammox granules were observed by scanning electron microscope, transmission electron microscope and Fourier Transform infrared spectroscopy (FTIR). Results suggested that during the start-up course, the granular sludge initially disintegrated and then re-aggregated. FTIR spectra results revealed that the Anammox granular sludge contained abundant functional groups, indicating that it may also possess good adsorption properties. The ecological structure of the granular sludge, analyzed by the metagenomic sequencing methods, suggested that the relative abundance of the dominant bacterial community in the seeding sludge, i.e., Proteobacteria, Firmicutes, Bacteroidetes, significantly reduced, while Planctomycetes which contains anaerobic ammonium oxidation bacteria remarkably increased from 1.59% to 23.24% in the Anammox granules.
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Ammonia , Chemistry , Bacteria , Bioreactors , Nitrogen , Chemistry , Sewage , Microbiology , Waste Disposal, Fluid , Methods , Wastewater , ChemistryABSTRACT
BACKGROUND:Since cannulated screw has been applied to femoral neck fracture, it is not uncommon that the screw wear penetrates or refunds. What factors affect the stability of cannulated screw for treatment of femoral neck fractures in adults remains unclear. ＜br> OBJECTIVE:To explore factors related to internal fixation failure by cannulated screws in treatment of adult femoral neck fracture and improve the stability of the adult femoral neck fracture by cannulated screws. ＜br> METHODS:A total of 92 adult patients of femoral neck fracture were treated by cannulated screws in our department between June 2007 and June 2011. Their data were retrospectively analyzed. According to clinical information and fol ow-ups, we selected factors such as age, gender, Garden type of fracture, preoperative skeletal traction, timing of surgery, Garden index, standards of pedicle screws, pedicle screw shapes, partial weight bearing time and postoperative complications, which may affect the success rate of cannulated screws for ＜br> treating femoral neck fracture. The selected factors were then grouped and assigned, after unrelated factors were excluded by one-way χ2 analysis, multiariable Logistic regression analysis was performed. ＜br> RESULTS AND CONCLUSION:The involved 92 patients were fol owed up for 18-72 months. According to Harris assessment criteria, hip function was excellent in 28 cases, good in 25 cases, fair in 17 cases, and poor in 22 cases at the final fol ow-up, the excellent and good rate was 58%. Radiographic results showed that, the patients were divided into two groups according to the presence of the displacement, GardenⅠ (n=22) and GardenⅡ (n=29) as a group, and Garden Ⅲ (n=25) and Garden Ⅳ (n=16) as the other group, the fixation failure rate was 12%and 39%, respectively. In normol and abnormal Garden Index groups, the fixation failure rate was 16%and 59%, respectively. In nail position standards and non-attainment standards groups, the fixation failure rate was 19%and 70%, respectively. In the complication and non-complication groups, the fixation failure rate was 14%and 55%, respectively. These factor groups showed significant differences (P＜0.05). Multiariable Logistic regression analysis showed that, Garden type of fracture, Garden index, standards of pedicle screws, and postoperative complications are the risk factors for internal fixation failure using cannulated screws in treatment of the adult femoral neck fracture.
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Objective To investigate the surgical techniques and clinical efficacy of cannulated screws combined with transposition of cuboid periosteal flap pedicled with fascia and lateral tarsal artery in the treatment of talus neck fractures.Methods From March 2008 to June 2011,12 cases with talus neck fractures were treated with cannulated screws combined with transposition of cuboid periosteal flap pedicled with fascia and lateral tarsal artery.External fixation in functional position for 12-14 weeks,and the load time was determined by X-ray fracture healing.Functional results were assessed according to AOFAS (American Orthopaedic Foot and Ankle Society) score at last follow-up.Results Twelve cases were followed up for an average of 24 months (12 to 48 months).One case of skin flap necrosis healed by dressing.All the fractures healed,and the mean healing time was 20 weeks (16 to 24 weeks).AOFAS ankle and hindfoot mean postoperative score was 82.5 (ranging from 55 to 96) points.Among them 4 cases were excellent,good in 5 cases,fair in 3 cases.Two cases presented with mild posttraumatic subtalar arthritis and pain relief after oral anti-inflammatory analgesic.One case with avascular necrosis of talus body,and X-ray displayed sclerosis of talus body,but no collapse,and the patient was told to reduce weight and regularly followed up.Conclusion The application of cannulated screws combined with transposition of cuboid periosteal flap pedicled with fascia and lateral tarsal artery for the treatment of talus neck fractures is an effective treatment,which can improves the blood supply of the talus body and reduces the occurrence of avascular necrosis of the talus.
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Objective To design and identify small interfering RNA (siRNA) targeting tumor necrosis factor‐α (TNF‐α) ex‐pression ,siRNAs were electroporated into synovial cells of Human to screen those which can effectively suppress TNF‐α expres‐sion .Methods Three TNF‐α specific double stranded siRNA were designed targeting different regions of TNF‐α mRNA(compared with negative control group) .RT‐PCR and Elisa were applied to detect TNF‐α ,mRNA expression and the secretion of TNF‐α in cell supernatant ,respectively .Results Two of the three customized TNF‐α siRNA could inhibit the expression of TNF‐α mRNA in synovial cells of Human (P< 0 .01) .At the same time ,the secretion of TNF‐α decreased in cell supernatant ,the difference was sig‐nificant statistically compared with the control group(P< 0 .01) .Conclusion TNF‐α siRNA can be successfully designed and syn‐thesized ,which can specifically and effectively suppress TNF‐α mRNA expression .
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A practical approach to the synthesis of the A, B and C-ring subunit of cyclopamine has been developed. This synthetic tactic highlights the utility of mandelate acetal-mediated resolution of the fused ring ketone (±)-4 and IBX-mediated oxidation cascades from 12 to 9. The availability of advanced intermediates from enantiomerically pure (+)-4 and 2 could provide efficient access to biologically active and structurally diverse C-nor-D-homo-steroidal alkaloids such as cyclopamine.
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Chemistry Techniques, Synthetic , Methods , Molecular Structure , Organic Chemistry Phenomena , Stereoisomerism , Steroids , Chemistry , Veratrum Alkaloids , ChemistryABSTRACT
<p><b>OBJECTIVE</b>To explore the pathogenesis of tumors by blocking the normal differentiation process of stem cells.</p><p><b>METHODS</b>Bone marrow mesenchymal stem cells (BMSCs) from rats were isolated, cultured and purified by whole bone marrow adherence method. The rat BMSCs were induced to differentiate into adipocytes with dexamethasone, insulin and indomethacin. Blockage of the differentiation process was induced by 3-methylcholanthrene (3-MC).</p><p><b>RESULTS</b>The differentiation experiment showed that at 30 days after the induction, oil red O staining-positive cells occurred with increased intracytolasmic lipid droplets, characteristic for adipocytes. The differentiation blockage experiment showed that at 30 days after induction, the deposits of oil red O staining-cytoplasmic lipid droplets was significantly reduced, indicating that the blocked cells were adipocytes, but not fully differentiated. Morphological identification showed that cell contact inhibition disappeared, abnormal cell nuclei, increased number of micronucleus aberration and karyotype abnormalities, indicating that malignant transformation of the stem cells occurred after the differentiation blockage.</p><p><b>CONCLUSIONS</b>The results of this study show a blockage of the differentiation of that stem cells at the intermediate phase, and a tendency of malignant transformation of the stem cells. The results of our study provide new evidence that cancer stem cells may be originated by suppression of stem cell differentiation.</p>