Preparation of Cu2+/TA/HAP composite coating with anti-bacterial and osteogenic potential on 3D-printed porous Ti alloy scaffolds for orthopedic applications.

Because of stress shielding effects, traditional titanium (Ti) alloy scaffolds have a high elastic modulus, which might promote looseness and bone disintegration surrounding the implant, increasing the likelihood of a second surgery. In contrast, 3D-printed porous Ti alloy scaffolds can reduce the scaffold weight while enhancing biocompatibility. Further, these scaffolds' porous nature allows bone tissue ingrowth as well as strong pore connectivity, which can improve nutrient absorption. Nevertheless, bare Ti alloy implants may fail because of inadequate bone integration; hence, adding a coating on the implant surface is an effective technique for improving implant stability. In this study, a composite coating comprising hydroxyapatite (HAP), chitosan (CS), tannic acid (TA) and copper ions (Cu2+) (Cu2+/TA/HAP composite coating) was prepared on the surface of 3D printed porous Ti alloy scaffolds using electrophoretic deposition. Using the standard plate count method, Live/Dead bacteria staining assay, FITC Phalloidin and 4',6-diamidino-2-phenylindole staining assay, and live/dead staining of cells we determined that the composite coating has better antibacterial properties and cytocompatibility as well as lower cytotoxicity. The Alkaline Phosphatase assay revealed that the coating results showed good osteogenesis potential. Overall, the composite coatings produced in this investigation give new potential for the application of Ti alloys in clinics.

Morphological, cellular, and molecular basis of brain infection in COVID-19 patients.

Although increasing evidence confirms neuropsychiatric manifestations associated mainly with severe COVID-19 infection, long-term neuropsychiatric dysfunction (recently characterized as part of "long COVID-19" syndrome) has been frequently observed after mild infection. We show the spectrum of cerebral impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, ranging from long-term alterations in mildly infected individuals (orbitofrontal cortical atrophy, neurocognitive impairment, excessive fatigue and anxiety symptoms) to severe acute damage confirmed in brain tissue samples extracted from the orbitofrontal region (via endonasal transethmoidal access) from individuals who died of COVID-19. In an independent cohort of 26 individuals who died of COVID-19, we used histopathological signs of brain damage as a guide for possible SARS-CoV-2 brain infection and found that among the 5 individuals who exhibited those signs, all of them had genetic material of the virus in the brain. Brain tissue samples from these five patients also exhibited foci of SARS-CoV-2 infection and replication, particularly in astrocytes. Supporting the hypothesis of astrocyte infection, neural stem cell-derived human astrocytes in vitro are susceptible to SARS-CoV-2 infection through a noncanonical mechanism that involves spike-NRP1 interaction. SARS-CoV-2-infected astrocytes manifested changes in energy metabolism and in key proteins and metabolites used to fuel neurons, as well as in the biogenesis of neurotransmitters. Moreover, human astrocyte infection elicits a secretory phenotype that reduces neuronal viability. Our data support the model in which SARS-CoV-2 reaches the brain, infects astrocytes, and consequently, leads to neuronal death or dysfunction. These deregulated processes could contribute to the structural and functional alterations seen in the brains of COVID-19 patients.

SARS-CoV-2 productively infects primary human immune system cells in vitro and in COVID-19 patients.

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is associated with a hyperinflammatory state and lymphocytopenia, a hallmark that appears as both signature and prognosis of disease severity outcome. Although cytokine storm and a sustained inflammatory state are commonly associated with immune cell depletion, it is still unclear whether direct SARS-CoV-2 infection of immune cells could also play a role in this scenario by harboring viral replication. We found that monocytes, as well as both B and T lymphocytes, were susceptible to SARS-CoV-2 infection in vitro, accumulating double-stranded RNA consistent with viral RNA replication and ultimately leading to expressive T cell apoptosis. In addition, flow cytometry and immunofluorescence analysis revealed that SARS-CoV-2 was frequently detected in monocytes and B lymphocytes from coronavirus disease 2019 (COVID-19) patients. The rates of SARS-CoV-2-infected monocytes in peripheral blood mononuclear cells from COVID-19 patients increased over time from symptom onset, with SARS-CoV-2-positive monocytes, B cells, and CD4+ T lymphocytes also detected in postmortem lung tissue. These results indicated that SARS-CoV-2 infection of blood-circulating leukocytes in COVID-19 patients might have important implications for disease pathogenesis and progression, immune dysfunction, and virus spread within the host.

SARS-Cov-2 pneumonia phenotyping on imaging exams of patients submitted to minimally invasive autopsy.

Background: Correlation between pathology and imaging of the new SARS-Cov-2 disease (COVID-19) is scarce. This study aimed to characterize SARS-Cov-2 pneumonia on imaging of patients submitted to minimally invasive autopsy (MIA). Methods: This unicentric retrospective observational study included 46 consecutive patients with confirmed COVID-19 who underwent MIA. All clinical chest images were reviewed and classified for the presence and grade of viral pneumonia, as well as disease evolution. On CT, phenotypes were described as consistent with mild, moderate, or severe viral pneumonia, with or without radiological signs of organizing pneumonia (OP). In severe pneumonia, CT could also be classified as diffuse progressive OP or radiological diffuse alveolar damage (DAD). Specific features on CT were noted, including fibroproliferative signs that could indicate potential or initial fibrosis. Results: MIA showed a heterogeneous panel of alterations, with a high prevalence of OP and acute fibrinous and organizing pneumonia (AFOP). Also, signs of interstitial fibrosis corresponded to the most prevalent pathological feature. Initial chest radiography (CXR) findings were mainly consistent with moderate or severe viral pneumonia. Most patients showed stability or improvement (reduction of opacities) on imaging. CTs were performed on 15 patients. Consolidations were found in most patients, frequently showing features consistent with an OP phenotype. Fibroproliferative changes were also prevalent on CT. Conclusions: In this study, SARS-Cov-2 pneumonia showed heterogeneous radiological and pathological patterns. Signs of organization and potential or initial fibrosis were prevalent on both imaging and pathology. Imaging phenotyping may help to predict post-infection fibrosing interstitial pneumonitis in COVID-19.

Xiaoai Jiedu Prescription-containing Serum Enhances Lethal Effect of NK Cells on Colon Cancer Cells / 中国实验方剂学杂志

ObjectiveTo explore the influence of Xiaoai Jiedu prescription （XJP）-containing serum on natural killer （NK） cells′ lethal effect on colon cancer cells and the molecular mechanism. MethodXJP-containing serum （0.1%， 0.5%， 1%， 5%， 10%） was used to treat HCT-116 cells and NK-92MI cells respectively for 24 h， and methyl thiazolyl tetrazolium （MTT） assay was employed to detect cell proliferation. Then， low-concentration （0.1%， 0.5%， 1%） XJP-containing serum was selected to treat co-cultured HCT-116 cells and NK-92MI cells for 24 h and calcein acetoxymethyl ester/propidium iodide （Calcein-AM/PI） was applied to detect the killing effect of NK cells on colon cancer cells. Flow cytometry was used to detect apoptosis of colon cancer cells， Western blot the expression of apoptosis-related proteins and signal transducer and activator of transcription 4 （STAT4） pathway-related proteins， and enzyme-linked immunosorbent assay （ELISA） the secretion of interferon （IFN）-γ. ResultHigh-concentration （5%， 10%） XJP-containing serum inhibited the proliferation of HCT-116 and NK-92MI cells （P<0.01）， while low-concentration （0.1%， 0.5%， 1%） XJP-containing serum had no obvious influence on cell proliferation compared with the blank group. As compared with the blank group， low-concentration XJP-containing serum enhanced the killing activity of NK cells against colon cancer cells in a concentration-dependent manner （P<0.01）， and induced apoptosis of colon cancer cells （P<0.01）. Moreover， XJP-containing serum （0.1%， 0.5%， 1%） down-regulated the expression of B-cell lymphoma 2 （Bcl-2） and B-cell lymphoma-extra large （Bcl-xl）， and up-regulated the expression of Bcl-2-associated X （Bax） compared with the blank group （P<0.05， P<0.01）. Compared with the co-culture group， XJP-containing serum （0.1%， 0.5%， 1%） increased the expression of p-STAT4 and IFN-γ （P<0.05）. ELISA result showed that XJP-containing serum （0.1%， 0.5%， 1%） raised IFN-γ secretion （P<0.01）. ConclusionXJP-containing serum can enhance the activity of NK cells to kill colon cancer cells. The mechanism is the likelihood that it activates STAT4 pathway， increases IFN-γ secretion by NK cells， down-regulates the expression of Bcl-xl and Bcl-2， and up-regulates the expression of Bax， thereby promoting the apoptosis of colon cancer cells.

Development of an Anterior Foot Drop Ankle Foot Orthosis with Adjustable Stiffness / 医用生物力学

Objective For patients with foot drop gait, to design a kind of anterior ankle foot orthosis (AFO) with adjustable stiffness, so as to restore natural gait of the ankle by limiting the patients’ unusual plantar flexion to the optimum extent. Methods The minimum orthodontic moment of 10 foot drop male patients was measured by self-made experimental equipment, which could be used to select optimum material modulus of the AFO. The relationship between elastic modulus and different filling structures and filling ratio parameters was studied by tensile test. A typical patient with foot drop was selected, and the anterior AFO fitting the shape of patient’s foot was quickly made by three-dimensional (3D) printing with foot geometric data and specific filling material, filling structure and filling rate. The kinematics and surface electromyography (sEMG) of plantar flexors were tested under barefoot and wearing two kinds of AFOs, so as to verify the effect of the AFO on plantar flexion. The effectiveness of the limitation and the degree of preservation of ankle valgus and plantar flexion were discussed. Results The minimum corrective torque required for 10 male patients with foot drop was 2.16 N·m. Compared with the rigid AFO, the range of motion (ROM) of plantar flexion and valgus increased by 67.8% and 88.6% respectively with the flexible AFO. The activation of the muscles responsible for plantar flexion (soleus, medial head of gastrocnemius and lateral head of gastrocnemius) also decreased by 38.3%, 46.6% and 55.8%. Conclusions This AFO with adjustable stiffness can be used for orthosis customization of patients with foot drop, providing more effective and long-term orthosis function and potential.

An Intelligent Arch Diagnostic Method Based on Principal Component Analysis of Plantar Pressure Distribution / 医用生物力学

Objective According to clinical demand of quantification evaluation on flat foot and high arch, an intelligent and rapid method to diagnose arch shape based on principal component analysis (PCA) of plantar pressure is proposed, and its clinic validity is tested. Methods Volunteers diagnozed as abnormal arch and healthy arch were included in this study, and a portable intelligent arch test system was designed and developed. By adopting thin-firm piezoresistive sensor array with 44 rows, 52 columns of sensing units, the system could collect plantar pressure distribution data from the subjects under static standing. Foot axis could be fitted automatically by using the self-programmed PCA, so that foot diagnosis was completed with diagnostic report. The plantar pressure results from the system were compared with those from the existing plantar pressure acquisition device, so as to verify precision of collected data. The accuracy of the diagnosis algorithm for flat foot, high arch and healthy foot was verified through comparison with clinical diagnosis. Results The result of the system had a good correlation with that of the existing plantar pressure acquisition device, the deviation of contact area acquired by the system was smaller than 3.2%, and the angle deviation of the fitted foot axis with clinically defined angel was less than 1°. The system was capable of making diagnosis on arch shape that was 92.6% consistent with the clinical diagnosis. Conclusions PCA is introduced to automatically fit foot axis to achieve the purpose of fast and accurate extraction of foot arch information. The method can be used to assist clinical diagnosis of flat foot and high arch foot, and contribute to quantative analysis on foot arch deformity and its pathogenesis study.

Effect of etomidate and dexamethasone on cortisol secretion in elderly patients undergoing general anesthesia / 中华麻醉学杂志

Objective:To evaluate the effects of dexamethasone and etomidate on cortisol secretion in elderly patients undergoing general anesthesia.Methods:One hundred and twenty-five elderly patients of either sex, aged 66-90 yr, of American Society of Anesthesiologists physical statusⅠ-Ⅲ, undergoing minor and medium elective surgeries under general anesthesia, were allocated into 4 groups using a random number table method: propofol and normal saline group (group PN, n=31), propofol and etomidate group (group PD, n=31), etomidate and normal saline group (group EN, n=33) and etomidate and dexamethasone group (group ED, n=30). In PN and EN groups, propofol (2 mg/kg) was used to induce and maintain anesthesia, and normal saline 2 ml and dexamethasone 0.1 mg/kg were intravenously injected, respectively, at 5 min before anesthesia induction.In PD and ED groups, etomidate (0.2 mg/kg) was used to induce and maintain anesthesia, and normal saline 2 ml and dexamethasone 0.1 mg/kg were intravenously injected, respectively, at 5 min before anesthesia induction.The serum cortisol concentrations were measured at 8: 00 after entering the operating room on the morning of operation (T 1), 1 h after the start of anesthesia (T 2), 2 h after the start of anesthesia (T 3), 8: 00 on the next day ofoperation (T 4) and 8: 00 on the 2nd day of operation (T 5). Blood glucose concentrations were measured at T 1-T 3, and the hypotension during the peri-anesthesia period, nausea and vomiting in post-anesthesia care unit, and nausea and vomiting scores were recorded at 24 h after operation. Results:A total of 122 patients completed the trial.Compared with PN group, the concentration of serum cortisol was significantly decreased at T 2-T 5, blood glucose concentrations were increased at T 2 and T 3 ( P<0.05), and no significant change was found in the incidence of hypotension, nausea and vomiting and nausea and vomiting scores in PD group ( P>0.05), and the concentration of serum cortisol was significantly decreased at T 2-T 4, the incidence of hypotension was decreased ( P<0.05), and no significant change was found in the blood glucose concentrations, incidence of nausea and vomiting or nausea and vomiting scores in EN group ( P>0.05). Compared with ED group, the serum cortisol concentration was significantly increased at T 2 and T 3, the incidence of hypotension was increased, the incidence of nausea and vomiting and nausea and vomiting scores were decreased ( P<0.05), and no significant change was found in the blood glucose concentrations in PD group ( P>0.05), and the serum cortisol concentration was significantly decreased at T 2 and T 3 and increased at T 4 and T 5, the serum cortisol concentration was decreased at T 2 and T 3, and no significant change was found in the incidence of hypotension, nausea and vomiting and nausea and vomiting scores in EN group ( P>0.05). Conclusions:Combination of etomidate and dexamethasone significantly enhances the duration and degree of inhibition of cortisol secretion in elderly patients than etomidate or dexamethasone alone.

Inflammasomes are activated in response to SARS-CoV-2 infection and are associated with COVID-19 severity in patients.

Severe cases of COVID-19 are characterized by a strong inflammatory process that may ultimately lead to organ failure and patient death. The NLRP3 inflammasome is a molecular platform that promotes inflammation via cleavage and activation of key inflammatory molecules including active caspase-1 (Casp1p20), IL-1ß, and IL-18. Although participation of the inflammasome in COVID-19 has been highly speculated, the inflammasome activation and participation in the outcome of the disease are unknown. Here we demonstrate that the NLRP3 inflammasome is activated in response to SARS-CoV-2 infection and is active in COVID-19 patients. Studying moderate and severe COVID-19 patients, we found active NLRP3 inflammasome in PBMCs and tissues of postmortem patients upon autopsy. Inflammasome-derived products such as Casp1p20 and IL-18 in the sera correlated with the markers of COVID-19 severity, including IL-6 and LDH. Moreover, higher levels of IL-18 and Casp1p20 are associated with disease severity and poor clinical outcome. Our results suggest that inflammasomes participate in the pathophysiology of the disease, indicating that these platforms might be a marker of disease severity and a potential therapeutic target for COVID-19.

Risk factors for complications of therapeutic endoscopy for upper gastrointestinal subepithelial lesions / 中南大学学报(医学版)

OBJECTIVES@#To study the risk factors for complications after endoscopic therapy for upper gastrointestinal subepithelial lesions (SELs).@*METHODS@#Retrospective analysis was performed on 184 patients in the Department of Gastroenterology in the Third Xiangya Hospital, Central South University after therapeutic endoscopy [endoscopic submucosal dissection (ESD), endoscopic full-thickness resection (EFR), endoscopic submucosal excavation (ESE), and submucosal tunneling endoscopic resection (STER)] for the upper gastrointestinal SELs from 2014-09-01 to 2019-09-30. The clinic data were collected and risk factors for postoperative complications were analyzed.@*RESULTS@#Among the 184 patients, 22 patients were in the complication group (including 3 cases of delayed bleeding, 2 cases of delayed perforation, and 17 cases of electrocoagulation syndrome) and 162 patients were in the non-complication group. There was no significant difference between the complication group and the non-complication group in gender, age over 70 year, basic diseases, lesion location, lesion invasion layers, pathological results, endoscopic therapy, and preventive closure of wounds (all @*CONCLUSIONS@#For the patients with upper gastrointestinal SELs after endoscopic minimally invasive therapy with the lesion diameter over 40 mm and the operative time over 120 minutes, it needs to highly alert to the occurrence of postoperative complications.

Correlation analysis of choriocapillary blood flow area, diameter of ellipsoid zone absence and visual recovery in idiopathic macular hole / 中华眼底病杂志

Objective:To observe the changes of choriocapillary blood flow area (CBFA) and diameter of ellipsoid zone absence (DEZA) of eyes with idiopathic macular hole (IMH) before and after surgery and its correlation with visual function.Methods:A prospective study. From May 2019 to January 2020, 23 IMH patients (IMH group and fellow eyes group) diagnosed in the Department of Opthalmology of The First Affiliated Hospital of Bengbu Medical College, and 30 age and gender-matched normal controls (30 eyes, control group) were included in this study. All patients were examined the best corrected visual acuity (BCVA) before and after surgery. The BCVA examination was performed using the international standard Snellen visual acuity chart, which was converted into logarithm of the minimum angle of resolution (logMAR) BCVA for record. CBFA and DEZA were obtained by optical coherence tomography angiography (OCTA). CBFA was measured on the choriocapillary with a circle of 1.0 mm radius centered in the fovea. DEZA was the diameter of ellipsoid zone absence horizontally. The differences of CBFA and logMAR BCVA in the three groups, and the changes of CBFA, DEZA, logMAR BCVA in IMH group before and after surgery were analyzed. The measurement data between the three groups were compared by one-way analysis of variance, and the independent samples t test was used for the comparison between the two groups. Pearson correlation analysis was used for the correlation between the index, multiple linear regression analysis were performed between postoperative visual acuity and preoperative parameters. Results:Before and 6 months after surgery, the logMAR BCVA in IMH group were 1.26±0.7 and 0.48±0.22, CBFA were 1.49±0.30 and 1.92±0.17 mm 2, DEZA were 1 080.22±576.98 and 433.78±423.04 μm, respectively. Compared with those before surgery, BCVA and CBFA were significantly improved, DEZA obviously decreased and the differences were statistically significant ( t=5.53, 7.77, 6.58; P<0.01). CBFA in IMH group was lower than fellow eyes group and control group, the difference was statistically significant ( F=14.13, P<0.01). After surgery, CBFA in IMH group increased similar to that of fellow eyes group ( t=4.32, P=0.37), but lower than that of control group with the significant difference ( t=4.07, P<0.01). The results of Pearson correlation analysis showed that logMAR BCVA and DEZA were positively correlated ( r=0.69, 0.75; P<0.01), CBFA and DEZA were negatively correlated ( r= -0.49, -0.89; P<0.05) before and after surgery. Multivariate linear regression analysis showed that the postoperative logMAR BCVA was positively correlated with DEZA ( t=2.32, P=0.02). Conclusions:After surgery, BCVA and CBFA of IMH eyes are significantly increased, DEZA is obviously reduced. Before and after surgery, logMAR BCVA is positively correlated with DEZA, and CBFA is negatively correlated with DEZA.

SARS-CoV-2-triggered neutrophil extracellular traps mediate COVID-19 pathology.

Severe COVID-19 patients develop acute respiratory distress syndrome that may progress to cytokine storm syndrome, organ dysfunction, and death. Considering that neutrophil extracellular traps (NETs) have been described as important mediators of tissue damage in inflammatory diseases, we investigated whether NETs would be involved in COVID-19 pathophysiology. A cohort of 32 hospitalized patients with a confirmed diagnosis of COVID-19 and healthy controls were enrolled. The concentration of NETs was augmented in plasma, tracheal aspirate, and lung autopsies tissues from COVID-19 patients, and their neutrophils released higher levels of NETs. Notably, we found that viable SARS-CoV-2 can directly induce the release of NETs by healthy neutrophils. Mechanistically, NETs triggered by SARS-CoV-2 depend on angiotensin-converting enzyme 2, serine protease, virus replication, and PAD-4. Finally, NETs released by SARS-CoV-2-activated neutrophils promote lung epithelial cell death in vitro. These results unravel a possible detrimental role of NETs in the pathophysiology of COVID-19. Therefore, the inhibition of NETs represents a potential therapeutic target for COVID-19.

Infection of human lymphomononuclear cells by SARS-CoV-2.

Although SARS-CoV-2 severe infection is associated with a hyperinflammatory state, lymphopenia is an immunological hallmark, and correlates with poor prognosis in COVID-19. However, it remains unknown if circulating human lymphocytes and monocytes are susceptible to SARS-CoV-2 infection. In this study, SARS-CoV-2 infection of human peripheral blood mononuclear cells (PBMCs) was investigated both in vitro and in vivo . We found that in vitro infection of whole PBMCs from healthy donors was productive of virus progeny. Results revealed that monocytes, as well as B and T lymphocytes, are susceptible to SARS-CoV-2 active infection and viral replication was indicated by detection of double-stranded RNA. Moreover, flow cytometry and immunofluorescence analysis revealed that SARS-CoV-2 was frequently detected in monocytes and B lymphocytes from COVID-19 patients, and less frequently in CD4 + T lymphocytes. The rates of SARS-CoV-2-infected monocytes in PBMCs from COVID-19 patients increased over time from symptom onset. Additionally, SARS-CoV-2-positive monocytes and B and CD4+T lymphocytes were detected by immunohistochemistry in post mortem lung tissue. SARS-CoV-2 infection of blood circulating leukocytes in COVID-19 patients may have important implications for disease pathogenesis, immune dysfunction, and virus spread within the host.

The characteristics of degree centrality and voxel-mirrored homotopic connectivity in patients with obsessive-compulsive disorder / 中华行为医学与脑科学杂志

Objective:To explore the functional connections of the whole brain and the two hemispheres in patients with obsessive-compulsive disorder (OCD).Methods:Twenty-six patients with obsessive-compulsive disorder(patients group) and thirty-seven healthy controls matched in gender, age and education(control group) were enrolled.All the participants accepted the resting-state functional magnetic resonance (rs-fMRI) scan.Based on DPABI and REST software, degree centrality (DC) and voxel - mirrored homotopic connectivity (VMHC) approaches were used to explore the pattern of functional connection in OCD.Results:Compared with the control group, the DC values in the right posterior cerebellar lobe(MNI: x, y, z=45, -87, -12), left precentral gyrus(MNI: x, y, z=-54, 9, 39), left inferior parietal lobule(MNI: x, y, z=-48, -51, 42), right anterior cingulate cortex(MNI: x, y, z=3, 18, 48) were significantly higher( t values were 5.75, 5.26, 5.28 and 5.16, respectively), and the DC values in the left inferior frontal gyrus(MNI: x, y, z=-36, 9, 30) were significantly lower( t value was -6.65) in patients group.The VMHC values in bilateral posterior cerebellar lobe(MNI: x, y, z=±51, -69, -33), bilateral inferior parietal lobule(MNI: x, y, z=±48, -51, 54), bilateral anterior cingulate cortex(MNI: x, y, z=±3, 21, 45)in patients group were significantly higher that those in control group( t values were 5.19, 5.19, 5.02, 5.02, 5.15 and 5.15, respectively). The DC and VMHC values in patients group were not significantly correlated with clinical symptoms(-0.23< r<0.19, P>0.05). Conclusion:OCD patients have abnormal connections between key brain network nodes and relevant brain regions, and functional connections have increased among multiple cerebral hemispheres.

Clinical evaluation of outcome of amniotic membrane transplantation combine with interferon eye drops for primary pterygium / 中华实验眼科杂志

Objective:To observe the clinical effect of the biological amniotic membrane transplantation combined with interferon α2b eye drops (interferon eye drops) in the treatment of primary pterygium.Methods:A randomized controlled clinical trial was used, 49 patients (55 eyes) of primary pterygium were selected in Beijing Tongren eye center from June to December, 2018, and all the subjects finished the follow up on time.The patients were randomly divided into two groups by random number table method, with 25 eyes of 23 patients in the experimental group and 30 eyes of 26 patients in the control group.The experimental group was treated with pterygium resection combined with amniotic membrane transplantation and interferon eye drops, while the control group was treated with pterygium resection combined with conjunctival autograft transplantation.Meanwhile the experimental group was treated with interferon eye drops on the 3rd day after surgery for 3 months.Follow up was done on the 3rd day, 7th day, 1st month, 3rd month and half a year after the surgery.The best corrected visual acuity (BCVA), heal of corneal epithelial defect and pterygium recurrence rate were observed.Written informed consent was obtained from each subject prior to entering the study cohort.The study protocol was approved by the Ethics Committee of Beijing Tongren Hospital (No.TRECKY2018-043).Results:At 6 months after surgery, there was no significant difference in number of eyes with decrease, stable or increase of BCVA between the two groups ( P=0.259); Cornea epithelium of one eye in each group was healed within 14 days, and the cornea epithelia were healed within 7 days in all rest cases of the two groups, and there was no significant difference in the healing time of corneal epithelium between the two groups ( P=1.000); At 6 months after the surgery, there was no true recurrence in the two groups, and there was no significant difference between the two groups of grade 1, 2 and 3 patients with conjunctival hyperplasia ( Z=0.461, P=0.497). There were three eyes (3/25, 12.0%) and two eyes (2/30, 6.7%) had fibrovascular tissue hyperplasia in the experimental group and control group, respectively, but fibrovasular tissue hyperplasia was only appeared at the junction of conjunctiva and graft, and did not reach the center of the and graft or the limbus of cornea. Conclusions:Compared with the traditional conjunctival autograft transplantation, amniotic membrane transplantation combined with interferon eye drops has no higher recurrence rate for the treatment of primary pterygium, while it is getting less damage to the healthy conjunctival tissue.

Identification of a novel mutation in the BCS1L gene causing Bj(o)rnstad syndrome / 中华皮肤科杂志

Objective To identify gene mutations in the BCS1L gene in a patient with Bj(o)rnstad syndrome mainly manifesting as congenital pili torti and sensorineural hearing loss.Methods Clinical data were collected and DNA was extracted from the peripheral blood of the patient and her parents.All the exons and their flanking sequences of the BCS1L gene were amplified by PCR followed by Sanger sequencing,and the sequencing results were compared with the normal sequences.A few hairs were collected from the patient,and examined by the scanning electron microscope.Results There were two mutations in BCS1L gene in the patient,i.e.,a heterozygous nonsense mutation in exon 4 and a heterozygous missense mutation in exon 8.The nonsense mutation in exon 4,which caused a change from CGA to TGA at position 144 and resulted in the substitution of arginine by termination codon (p.R144*),was a novel mutation in the BCS1L gene causing Bj(o)rnstad syndrome,and had never been repotted in the literature.The missense mutation in exon 8 led to a change from CGC to CAC at position 306 and resulted in the substitution of arginine by histidine (p.R306H).The patient's mother only carried a heterozygous mutation c.430 C＞T (p.R144*) in exon 4 of the BCS1L gene,and her father only carried a heterozygous mutation c.917 G＞A (p.R306H) in exon 8 of the BCS1L gene.Scanning electron microscopy showed that flats,grooves and longitudinal twisting irregu larly appeared at intervals on the surface of hair shafts.Conclusions A novel mutation in the BCS1L gene,which causes a change from CGA to TGA at position 144 in the BCS1L gene and results in a premature termination codon,is firstly reported in a patient with Bj(o)rnstad syndrome,and the compound heterozygous mutations c.430 C＞T and c.917 G＞A in the BCS1L gene are associated with the clinical manifestations of the patient.Genetic analvsis is helpful for the diagnosis of Bj(o)rnstad syndrome.

Efficacy of oxycodone for improvement of general anesthesia for laparoscopic cholecystectomy in elderly patients / 中华麻醉学杂志

Objective To evaluate the efficacy of oxycodone for improvement of general anesthesia for laparoscopic cholecystectomy in elderly patients.Methods A total of 160 patients of both sexes,aged 65-75 yr,with body mass index ＜30 kg/m2,of American Society of Anesthesiologists physical status Ⅰ-Ⅲ,scheduled for elective laparoscopic cholecystectomy,were divided into 2 groups (n =80 each) using a random number table method:general anesthesia group (group GA) and oxycodone + general anesthesia group (group OX+GA).Anesthesia induction:propofol was given by closed-loop infusion at the initial target plasma concentration of 2 μg/ml,the target bispectral index (BIS) value was set at 50,and 2 min later remifentanil was given by target-controlled infusion at the target plasma concentration of 4 ng/ml,and cisatracurium 0.2 mg/kg was intravenously injected when BIS value was decreased to 70.Laryngeal mask airways were inserted and the patients were mechanically ventilated when BIS value was decreased to 50 and TOF ratio was decreased to 25％,and end-tidal pressure of carbon dioxide was maintained at 35-45 mmHg.Anesthesia maintenance:propofol was given by closed-loop infusion,the target BIS value was set at 50,cisatracurium 0.1 mg/kg was intravenously injected when TOF ratio was increased to 10％;remifentanil was given by target-controlled infusion at the target plasma concentration of 4-6 ng/ml.Oxycodone 0.07 mg/kg was intravenously injected at 5 min before stretching internal organs.Before anesthesia,at 5 min after laryngeal mask airway placement,at skin incision and while stretching internal organs,analgesia nociception index value and perfusion index value were recorded,the development of intraoperative cardiovascular events,emergence time,time for removal of laryngeal mask airway,time of post-anesthesia care unit stay and development of nausea and vomiting and back and shoulder pain within 48 h after surgery were also recorded.Results Compared with group GA,the analgesia nociception index value and perfusion index value were significantly increased while stretching internal organs,and the incidence of intraoperative hypertension,tachycardia,and nausea and vomiting and back and shoulder pain within 48 h after surgery were decreased in group OX-GA (P＜0.05).Conclusion Oxycodone can inhibit nociceptive stimuli,is helpful in maintaining stable hemodynamics and reduces postoperative complications in elderly patients undergoing laparoscopic cholecystectomy under combined general anesthesia.

Demineralized cancellous bone seeded with allogeneic chondrocytes for repairing articular osteochondral defects in rabbits / 南方医科大学学报

<p><b>OBJECTIVE</b>To evaluate the effect of demineralized cancellous bone (DCB) seeded with allogeneic chondrocytes for repairing articular osteochondral defects in rabbits.</p><p><b>METHODS</b>Articular chondrocytes were isolated from a 1-month-old male New Zealand rabbit for primary culture. The passage 1 chondrocytes were seeded onto prepared rabbit DCB scaffold to construct tissue-engineered cartilage and cultured for 2 weeks. Full-thickness articular osteochondral defects (3 mm both in diameter and depth) were created on both sides of the femoral medial condyles in 30 New Zealand white rabbits (age 4- 5 months). In 20 of the rabbits, the defects were filled with the tissue-engineered cartilage on the right side (group A) and with DCB only on the left side (group B); the remaining 10 rabbits did not receive any implantation in the defects to serve as the control (group C). At 1, 3, and 6 months after the implantation, tissue samples were collected from the defects for macroscopic observation and histological examination with Toluidine blue (TB) and collagen type Ⅱ staining. The effect of defect repair using the tissue-engineered cartilage was assessed at 6 months based on the histological scores.</p><p><b>RESULTS</b>The prepared DCB had a spongy 3D structure with open and interconnected micropores of various sizes and showed good plasticity and mechanical strength. DCB began to degrade within 1 month after implantation and was totally absorbed at 3 months. At 6 months after implantation, the defects filled with the chondrocyte-seeded DCB were repaired mainly by hyaline-like cartilage tissues, which were well integrated to the adjacent cartilage without clear boundaries and difficult to recognize. The chondrocytes were located in the lacunate and arranged in vertical columns in the deep repaired tissue, where matrix proteoglycans and collagen type Ⅱ were distributed homogeneously close to the normal cartilage. The subchondral bone plate was reconstructed completely. The defects implanted with DCB only were filled with fibrocartilage tissue, as compared with fibrous tissue in the control defects. The histological scores in group A were significantly superior to those in group B and C ( < 0.05), but the scores for subchondral bone plate reconstruction were comparable between groups A and B at 6 months.</p><p><b>CONCLUSIONS</b>DCB is a good scaffold material for preparing tissue-engineered cartilage, and chondrocyte- seeded DCB can repair articular osteochondral defects by inducing the generation of hayline-like cartilage.</p>

Value of 18F-FDG PET/CT in evaluation of curative effect and progression-free survival on lymphoma / 国际肿瘤学杂志

Objective To evaluate the value of 18F-fluorodeoxyglucose (FDG) PET/CT in evaluation of curative effect and progression-free survival (PFS) for lymphoma patients.Methods The data of 85 lymphoma patients were retrospectively analyzed.Before and after 4-8 cycles standardized chemotherapy,the patients were evaluated with 18F-FDG PET/CT.The two-year PFS rate was compared.The value of 18F-FDG PET/CT in evaluation of curative effect and PFS for lymphoma patients received chemoradiotherapy was analyzed.Results The non Hodgkin lymphoma (NHL) was the common type,and the common pathogenic sites were head and neck lymph nodes,mediastinum and retroperitoneum.The majority of patients were accompanied with spleen enlargement and local lesions with high metabolism.The complete remission (CR) rate of Hodgkin lymphoma (HL)patients in PET/CT negative group was significantly higher than that in positive group (86.4％ vs.42.9％,P =0.038).The two-year PFS rates in PET/CT positive group and negative group were 42.9％ and 81.8％,and the difference was statistically significant (x2 =7.70,P =0.006).Thirty-five NHL patients achieved CR,13 achieved partial remission (PR),and 8 achieved stable disease (SD) or disease progression (PD).The two-year PFS rates in the CR group,PR group,SD or PD group were 89.7％,65.3％ and 19.4％ respectively,and the difference was statistically significant (x2 =12.41,P =0.002).PET/CT imaging had a strong PFS predictive effect on T cell lymphoma (TCL) patients (x2 =13.85,P =0.001) and diffuse large B cell lymphoma (DLBCL)patients (x2=13.51,P =0.001),and had no predictive effect on follicular lymphoma (FL) patients (x2 =4.63,P =0.099).Conclusion 18 F-FDG PET/CT can evaluate the curative effect of lymphoma effectively and early predict prognosis,and has great guiding significance in choosing therapeutic schedule.