Strontium-containing mesoporous bioactive glass nanoparticles loaded with bisphosphonates ameliorate bone loss in ovariectomized mice / 中国组织工程研究

BACKGROUND:Inhibition of osteoclast activity by bisphosphonates slows the progression of osteoporosis.However,serious complications of bisphosphonates,such as osteonecrosis of the jaw and atypical femur fracture,limit the clinical application of bisphosphonates.Effective alternative therapies need to be sought to improve existing clinical dilemmas. OBJECTIVE:To prepare strontium-containing mesoporous bioactive glass nanoparticles loaded with bisphosphonates(BPS@Sr-MBG)and analyze its activity against bone loss. METHODS:Strontium-containing mesoporous bioactive glass nanoparticles(Sr-MBG)were prepared by sol-gel method and added to alendronate saturated solution for the preparation of BPS@Sr-MBG.(1)Cell experiment:Mouse bone marrow macrophages were inoculated in 96-well plates and supplemented with ɑ-MEM complete culture medium containing macrophage colony stimulating factor and activator-ligand of nuclear factor κB receptor for osteoclast induced differentiation experiment.Meanwhile,they were cultured in three groups.The blank group was added with PBS.The control group was added with bisphosphonate,and the experimental group was added with BPS@Sr-MBG.After 5 days of culture,the differentiation of osteoclasts was observed by F-actin ring staining.(2)Animal experiments:Twenty-four female C57/BL mice were randomly divided into four groups with six mice in each group.Except sham operation group,ovariectomy group,BPS group and BPS@Sr-MBG group were used to construct osteoporosis model.One week after model establishment,mice in BPS group and BPS@Sr-MBG group were intraperitoneally injected with bisphosphonate solution and BPS@Sr-MBG solution,respectively.Mice in the sham operation group and ovariectomy group were intraperitoneally injected with PBS once a week.After 8 weeks of continuous injection,mouse femurs were taken for Micro-CT scanning and hematoxylin-eosin staining. RESULTS AND CONCLUSION:(1)Cell experiment:F-actin ring-formation staining demonstrated that compared with blank group,the area proportion and number of osteoclasts in the control group were decreased(P<0.01).Compared with the control group,the area proportion of osteoclasts and the number of osteoclasts in the experimental group were decreased(P<0.01).(2)Animal experiments:Micro-CT scanning results of femur showed that compared with the sham operation group,bone density,trabecular bone volume fraction,trabecular thickness and trabecular number of mice in the ovariectomy group were decreased(P<0.05,P<0.01),while trabecular distance and structural model index were increased(P<0.01).Compared with the ovariectomy group,the above bone parameters in the BPS group and BPS@Sr-MBG group were significantly improved(P<0.01),and the improvement in the BPS@Sr-MBG group was more obvious.The Micro-CT scanning results were further confirmed by hematoxylin-eosin staining of the femur.(3)The results show that BPS@Sr-MBG can exert anti-osteoporosis activity through anti-osteoclastic effect and promoting bone formation.

Refined logistics management in hospitals based on information system / 现代医院

Logistics informatization is importantfor promoting the high-quality development of public hospitals.It is a driving force for innovating hospital logistics management and an important practice of"green hospitals"and"smart hospitals".The logistics information system can effectively integrate people,machines,materials,and events of hospitals to achieve data-driven scientific management and improve service and management efficiency.By analyzing the current status of logistics manage-ment in the Sun Yat-sen University Cancer Center,this article proposes a transformation path to and management ideas for hospi-tal refined logistics management based on the information system,expecting to provide an insight into future information construc-tion and hospital logistics management development.

Factor analysis of secondary intraocular hypertension after intravitreal dexamethasone implantation in patients with diabetic macular edema / 中华眼底病杂志

Objective:To observe and analyze the risk factors of secondary intraocular hypertension in diabetic macular edema (DME) patients after treatment with dexamethasone vitreous cavity implant (DEX).Methods:A retrospective observational study. A total of 352 patients with type 2 diabetes mellitus (T2DM) secondary macular edema diagnosed by ophthalmic examination and treated with DEX in Department of Ophthalmology of Harbin 242 Hospital from January 2016 to March 2022 were included in the study. Among them, 221 were males and 131 were females, with the mean age of (55.56±8.09) years. There were 194 patients with disseminated macular edema, 158 patients with cystoid macular edema. All patients underwent vitreous cavity implantation of DEX. Intraocular pressure (IOP) was measured once a month for 3 months after treatment, with IOP over than 25 mm Hg (1 mm Hg=0.133 kPa) or higher than 10 mm Hg from baseline as secondary intraocular hypertension. The relevant clinical data were collected, and the risk factors of secondary intraocular hypertension in DME patients after DEX treatment were analyzed by binary logistic regression.Results:Among 352 patients, 116 patients (32.95%, 116/352) were in the intraocular hypertension. Among them, 29 patients (25.00%, 29/116), 69 patients (59.48%, 69/116) and 18 patients (15.52%, 18/116) occurred intraocular hypertension at 1, 2 and 3 months after treatment, respectively. Compared with the normal IOP group, the IOP in the intraocular hypertension group increased significantly at 1, 2 and 3 months after treatment, with statistical significance ( t=10.771, 21.116, 13.761; P<0.001). Compared with normal IOP group, the patients in the intraocular hypertension group had younger age ( t=6.967), longer duration of diabetes ( t=5.950), longer axial length (AL) ( t=14.989), higher proportion of DME grade 3 ( Z=6.284), higher proportion of DEX implantation in pars plana ( χ2=23.275), and higher HbA1c level ( t=10.764), the differences were statistically significant ( P<0.05). Logistic regression analysis showed that longer AL [odds ratio ( OR)=1.428, 95% confidence interval ( CI) 1.054-1.934], DEX implantation in pars plana ( OR=1.358, 95% CI 1.063-1.735), and higher HbA1c ( OR=1.702, 95% CI 1.225-2.366) were the risk factors for secondary intraocular hypertension in DME patients after DEX treatment ( P<0.05), older age was a protective factor ( OR=0.548, 95% CI 0.380-0.789, P<0.05). Conclusions:Long AL, DEX implantation in pars plana and high HbA1c are the risk factors for secondary intraocular hypertension after DEX treatment in DME patients, older age is a protective factor.

Differences of clinical features and surgical efficacy between the elderly and the middle-aged and young patients with meningiomas in the central cortex area / 中华神经医学杂志

Objective:To explore the differences of clinical features and surgical efficacy between the elderly and the middle-aged and young patients with meningiomas in the central cortex area.Methods:Forty-three elderly patients with meningiomas in the central cortex area (≥60 years old) and 63 middle-aged and young patients with meningiomas in the central cortex area (18-59 years old), accepted surgery in Department of Neurosurgery, Guangdong 999 Brain Hospital from January 2011 to December 2020, were chosen. The differences of symptom, gross tumor volume, peritumoral edema degrees, intraoperative blood loss, tumor resection degrees, complications, and hospital stays between the 2 groups were analyzed.Results:The elderly patients had significantly higher proportion of preoperative muscle strength decline, lower proportion of preoperative headache, larger preoperative tumor volume, more severe peritumoral edema degrees before and after surgery, small volume of intraoperative blood loss, and longer hospital stays compared with the middle-aged and young patients ( P<0.05). However, no significant differences in distributions of tumor resection Simpson grades, proportion of new neurological dysfunction, incidence of postoperative complications, and proportions of reoperations and tumor recurrence were noted between the 2 groups ( P>0.05). Significant difference in distributions of peritumoral edema degrees among patients with different WHO grades was noted in the elderly group ( P<0.05), and significant difference in distribution of peritumoral edema degrees among patients with different tumor volumes was noted in the middle-aged and young group ( P<0.05). Conclusions:Although differences in clinical characteristics exist between the elderly and the middle-aged and young patients with meningiomas in the central cortex area, no significant difference in surgical efficacy is noted between the 2 groups. The peritumoral edema degree in the elderly patients is related to tumor pathological grades, while that in middle-aged and young patients is related to tumor volumes.

The Ameliorative Effects of Isorhynchophylline on Morphine Dependence Are Mediated Through the Microbiota-Gut-Brain Axis.

Morphine abuse is a global public health problem. Increasing evidence has shown that gut microbiota dysbiosis plays an important role in several central nervous system diseases. However, whether there is an association between gut microbiota and morphine dependence remains unclear. In this study, the effects of isorhynchophylline on morphine dependence were evaluated based on the microbiota-gut-brain axis (MGBA). The results showed that isorhynchophylline could reverse the changes in alpha and beta diversity, composition, and richness of the intestinal flora occurring in morphine-dependent zebrafish, as well as the morphine-induced changes in the expression of MGBA-related genes in BV2 cells and the brain and intestine of zebrafish. Based on the results, we then used antibiotics to evaluate whether disrupting the gut microbiota would affect morphine addiction in zebrafish. The results showed that the antibiotic-induced intestinal floral imbalance changed the behavior of morphine-dependent zebrafish, the characteristics of the zebrafish intestinal flora, and the expression of MGBA-related genes in the zebrafish brain and intestine. Importantly, we also show that, following antibiotic administration, the ameliorative effects of isorhynchophylline on morphine addiction were lost. Together, our results indicate that the gut microbiota interacts with the brain, and dysbiosis of the intestinal flora may affect the efficacy of isorhynchophylline in the body. Our findings provide a novel framework for understanding the mechanisms of morphine addiction through the MGBA and may provide new therapeutic strategies for the use of Chinese medicines in the prevention of drug addiction.

Diagnostic Performance of Shear Wave Elastography in the Noninvasive Evaluation of Liver Inflammation of Chronic Hepatitis B Patients.

ABSTRACT: In the current study, we sought to delineate the elastographic characteristics and further compare the diagnostic performance of various shear wave elastography modalities in hepatitis B virus patients whose liver fibrosis stage was less than F2 by liver biopsy. We retrospectively studied the clinical and imaging data of chronic hepatitis B virus patients who underwent liver biopsy at our hospital between January 2017 and October 2017. Totally, 102 patients were eligible for the study. The mean Young modulus of sound touch elastography (STE) and sound touch quantify (STQ) gradually increased as inflammation grade of the liver rose from G0 to G3. Spearman rank correlation analysis revealed that the mean Young modulus of STE and STQ significantly correlated with hepatic inflammation grade (r = 0.341, P < 0.05). The area under the receiver operating characteristic curve (AUC) was the highest for the mean Young modulus of STE (AUC = 0.740; P = 0.015) followed by that of STQ (AUC = 0.684; P = 0.063) for G ≥ 2 hepatic inflammation and the AUC was the highest for the mean Young modulus of STE (AUC = 0.920; P = 0.000) followed by that of STQ (AUC = 0.910; P = 0.000) for G ≥ 3 hepatic inflammation. The current study demonstrated that the mean Young modulus of STE and STQ could serve as a useful diagnostic marker for hepatic inflammation of hepatitis B virus patients with no apparent liver fibrosis.

Antibiotic-Driven Gut Microbiome Disorder Alters the Effects of Sinomenine on Morphine-Dependent Zebrafish.

Morphine is one of the most severely abused drugs in the world. Previous research on morphine addiction has focused on the central nervous system (CNS). Studies have shown that a two-way regulation of the brain and gut microbiota (GM), suggesting a link between GM and CNS disease. However, the functional mechanism underlying the relationship between intestinal flora and morphine dependence is unclear. In this study, the effect of sinomenine on morphine addiction was evaluated based on the microbiota-gut-brain axis (MGBA). The results show that the GM plays an important role in morphine dependence. Morphine treatment induced zebrafish conditional position preference (CPP), and significantly changed zebrafish GM characteristics and the expression of MGBA-related genes in the zebrafish brain and intestine. Importantly, sinomenine, an alkaloid with a similar structure to morphine, can reverse these morphine-induced changes. Subsequently, morphine-dependent CPP training was performed after antibiotic administration. After antibiotic treatment, zebrafish CPP behavior, the composition and proportions of the zebrafish GM, and the expression of MGBA-related genes in zebrafish were changed. More interestingly, sinomenine was no longer effective in treating morphine dependence, indicating that antibiotic-driven intestinal flora imbalance alters the efficacy of sinomenine on morphine-dependent zebrafish. This study confirms that the MGBA is bidirectionally regulated, highlighting the key role of the GM in the formation and treatment of morphine dependence, and may provide new treatment strategies for using traditional Chinese medicine to treat drug addiction.

[Microsurgical resection of lumbar intraspinal tumors through paraspinal approach using percutaneous tubular retractor system].

OBJECTIVE: To evaluate the clinical outcomes and operative techniques of microsurgical resection of lumbar intraspinal tumors through paraspinal approach by percutaneous tubular retractor system. METHODS: A retrospective study was conducted to analyze 21 patients with lumbar intraspinal tumors between November 2011 and February 2014, including Schwannoma (n = 19) and meningioma (n = 2) without lumbar instability on preoperative images. The length of tumors was 0.6-2.0 cm. Tracheal intubation anesthesia was performed prior to microsurgery using percutaneous tubular retractor system through paraspinal approach. Operative duration, blood loss volume, postoperative wound pain duration and hospital stay were analyzed. Creatine phosphokinase (CPK-MM) level was recorded at 1 day preoperatively, 1 day, 3 days and 5 days postoperatively. The scores of Japanese Orthopedic Association (JOA) and visual analog scale (VAS) were analyzed at 1 day preoperatively, 1, 3, 5 days and 6 months postoperatively to evaluate the function status of spinal cord. Computed tomography ( CT) three-dimensional reconstruction of lumbar vertebrae was performed at 1 week postoperatively. Magnetic resonance imaging ( MRI) plain scan and enhanced scan of lumbar vertebrae were conducted preoperatively, 1 week and 6 months postoperatively. RESULTS: Complete removal of tumors was achieved in all patients without the injuries of spinal cord or nerve root. Postoperative scores of JOA and VAS improved versus preoperative ones (P < 0.05). Level of CPK-MM increased 1 day postoperatively and declined to preoperative level at 5 days postoperatively. And th difference was not statistically significant (P < 0.05). Neither residual tumor nor tumor recurrence was detected by MRI plain and enhanced scans. No postoperative spinal instability was identified by CT three-dimensional reconstruction. And no spinal deformity occurred during a follow-up period of 6-28 months. CONCLUSION: Microsurgical resection of lumbar intraspinal tumors using percutaneous tubular retractor system through paraspinal approach minimizes the injuries of paraspinal muscles, facet joint, spinous process and ligaments. This technique offers the advantages of mini-invasiveness, shorter hospital stay, rapid recovery and preserved postoperative spinal stability.

Guide to Home Rehabilitation of Elderly Patients with Stroke in the Convalescent Stage / 国际中医中药杂志

Due to the limitation of length of stay, hospital costs, medical conditions, and other restrictions, the time in the hospital for rehabilitation therapy is limited for patients with stroke in the convalescent stage. They need to continue rehabilitation treatment at home after being discharged from hospital. The provision of rehabilitation for stroke patients is one of professional courses in community care. Community nurses guide for home-based rehabilitation through a variety of guidance methods plays a positive role in improving the quality of life of the patients.