A novel fluffy PLGA/HA composite scaffold for bone defect repair.

Treatment of bone defects remains crucial challenge for successful bone healing, which arouses great interests in designing and fabricating ideal biomaterials. In this regard, the present study focuses on developing a novel fluffy scaffold of poly Lactide-co-glycolide (PLGA) composites with hydroxyapatite (HA) scaffold used in bone defect repair in rabbits. This fluffy PLGA/HA composite scaffold was fabricated by using multi-electro-spinning combined with biomineralization technology. In vitro analysis of human bone marrow mesenchymal stem cells (BMSCs) seeded onto fluffy PLGA/HA composite scaffold showed their ability to adhere, proliferate and cell viability. Transplant of fluffy PLGA/HA composite scaffold in a rabbit model showed a significant increase in mineralized tissue production compared to conventional and fluffy PLGA/HA composite scaffold. These findings are promising for fluffy PLGA/HA composite scaffolds used in bone defects.

Strategies towards PM2.5 attainment for non-compliant cities in China: A case study.

The northern part of the Yangtze River Delta (YRD) region in China suffers from high concentrations of fine particular matter (PM2.5) during the past years yet received much less attention compared to the other parts of the YRD region. In this study, we integrated observational data, control policies and strategies, and air quality simulations to develop PM2.5 attainment demonstration by year 2030 for the city of Bengbu, which represents a typical non-compliant city in the northern YRD region. In 2018, the annual average PM2.5 concentration in Bengbu was 51.8 µg/m3, which was 48 % higher than the standard of 35 µg/m3 set by the National Ambient Air Quality Standards (NAAQS). Different future emission scenarios were developed for year 2025 as mid-term and year 2030 as long-term. Integrated meteorology and air quality modeling system together with monitoring data was applied to predict the air quality under the future emission scenarios. Results show that when a conservative emission reduction ratio of 40 % was assumed for surrounding regions, the annual average PM2.5 concentration in Bengbu could meet the target value by 2030, in which case emissions of SO2, NOx, PM2.5, VOCs, and NH3 need to be reduced by 70.6 %, 43.5 %, 47.2 %, 33.4 %, and 47.5 %, respectively. PM2.5 concentration in Bengbu is not only controlled by local emission reductions but also affected by emission reductions of surrounding regions as well as contribution from long-range transport. More attentions need to be paid to the control of VOCs emissions in the near future to avoid increase of ozone concentrations while reducing PM2.5. Our results provide scientific support for the local government to formulate future air pollution prevention and control strategies, sub-regional joint-control among surrounding cities, as well as trans-regional joint-control between the north China and the YRD region.

Chinese Cretaceous larva exposes a southern Californian living fossil (Insecta, Coleoptera, Eucnemidae).

Palaeoxenus sinensis Chang, Muona & Teräväinen sp. nov. (Coleoptera, Eucnemidae) is described on the basis of a Cretaceous larva found from the Yixian Formation in Huangbanjigou, Liaoning Province, China. The only previously known member of this clade is a southern Californian endemic, Dohrn's elegant eucnemid beetle (Palaeoxenus dohrni), a species that develops in conifers, especially the incense cedar (Calocedrus decurrens). The new find proves that the highly specialized main eucnemid lineages had evolved 123 Mya, before the main radiation of the angiosperms and probably as an adaptation to development in gymnosperms.

Xenoimplantation of an extracellular-matrix-derived, biphasic, cell-scaffold construct for repairing a large femoral-head high-load-bearing osteochondral defect in a canine model.

This study was aimed to develop an ECM-derived biphasic scaffold and to investigate its regeneration potential loaded with BM-MSCs in repair of large, high-load-bearing osteochondral defects of the canine femoral head. The scaffolds were fabricated using cartilage and bone ECM as a cartilage and bone layer, respectively. Osteochondral constructs were fabricated using induced BM-MSCs and the scaffold. Osteochondral defects (11 mm diameter × 10 mm depth) were created on femoral heads of canine and treated with the constructs. The repaired tissue was evaluated for gross morphology, radiography, histological, biomechanics at 3 and 6 months after implantation. Radiography revealed that femoral heads slightly collapsed at 3 months and severely collapsed at 6 months. Histology revealed that some defects in femoral heads were repaired, but with fibrous tissue or fibrocartilage, and femoral heads with different degrees of collapse. The bone volume fraction was lower for subchondral bone than normal femoral bone at 3 and 6 months. Rigidity was lower in repaired subchondral bone than normal femoral bone at 6 months. The ECM-derived, biphasic scaffold combined with induced BM-MSCs did not successfully repair large, high-load-bearing osteochondral defects of the canine femoral head. However, the experience can help improve the technique of scaffold fabrication and vascularization.

Severe anemia and melena caused by pyeloduodenal fistula due to renal stone-associated squamous cell carcinoma.

Pyeloduodenal fistula is a rare condition and its association with malignancy is even rarer. Herein we report the case of a 66-year-old man who was admitted to the hospital with a three-month history of intermittent melena and a more than 20-year history of right-side renal stones. Computed tomography showed a heterogeneous right renal mass with a staghorn stone that had invaded the duodenum and caused an internal fistula. An upper gastrointestinal series showed pyeloduodenal fistula. The patient underwent an exploratory operation and a biopsy was taken at the peripelvic region. Pathological examination verified the existence of squamous cell carcinoma. To our knowledge, this is the first case of pyeloduodenal fistula associated with renal stones, squamous cell carcinoma and upper urinary tract calculus presenting on melena. We report on the features of this rare entity but also review and summarize the etiology, diagnosis and treatment options that can be extrapolated from the existing literature.

Sustained release silicon from 3D bioprinting scaffold using silk/gelatin inks to promote osteogenesis.

Repairing extensive bone defects that cannot self-heal has been a clinical challenge. The construction of scaffolds with osteogenic activity through tissue engineering can provide an effective strategy for bone regeneration. This study utilized gelatin, silk fibroin, and Si3N4 as scaffold materials to prepare silicon-functionalized biomacromolecules composite scaffolds using three-dimensional printing (3DP) technology. This system delivered positive outcomes when Si3N4 levels were 1 % (1SNS). The results showed that the scaffold had a porous reticular structure with a pore size of 600-700 µm. The Si3N4 nanoparticles were distributed uniformly in the scaffold. The scaffold could release Si ions for up to 28 days. In vitro experiments showed that the scaffold had good cytocompatibility, promoting the osteogenic differentiation of mesenchymal stem cells (MSCs). In vivo experiments on bone defects in rats showed that the 1SNS group facilitated bone regeneration. Therefore, the composite scaffold system showed potential for application in bone tissue engineering.

Identification of Fungal Pathogens to Control Postharvest Passion Fruit (Passiflora edulis) Decays and Multi-Omics Comparative Pathway Analysis Reveals Purple Is More Resistant to Pathogens than a Yellow Cultivar.

Production of passion fruit (Passiflora edulis) is restricted by postharvest decay, which limits the storage period. We isolated, identified, and characterized fungal pathogens causing decay in two passion fruit cultivars during two fruit seasons in China. Morphological characteristics and nucleotide sequences of ITS-rDNA regions identified eighteen isolates, which were pathogenic on yellow and purple fruit. Fusarium kyushuense, Fusarium concentricum, Colletotrichum truncatum, and Alternaria alternata were the most aggressive species. Visible inspections and comparative analysis of the disease incidences demonstrated that wounded and non-wounded yellow fruit were more susceptible to the pathogens than the purple fruit. Purple cultivar showed higher expression levels of defense-related genes through expression and metabolic profiling, as well as significantly higher levels of their biosynthesis pathways. We also found fungi with potential beneficial features for the quality of fruits. Our transcriptomic and metabolomics data provide a basis to identify potential targets to improve the pathogen resistance of the susceptible yellow cultivar. The identified fungi and affected features of the fruit of both cultivars provide important information for the control of pathogens in passion fruit industry and postharvest storage.

Signaling pathways in the mechanism underlying active ingredients of Chinese medicine in the treatment of osteoarthritis / 中国组织工程研究

BACKGROUND:Osteoarthritis is a chronic degenerative disease of skeletal muscle,and the incidence of osteoarthritis is increasing yearly,but its pathogenesis is not clear.The commonly used drugs for osteoarthritis include non-steroidal anti-inflammatory drugs and glucocorticoid.Adverse drug reactions to these drugs can reduce patient compliance and ultimately affect the efficacy of treatment.Active ingredients in Chinese medicine are closely scrutinized for their safety and other characteristics. OBJECTIVE:Through reviewing the research progress in the effect of active ingredients of traditional Chinese medicine on osteoarthritis-related signaling pathways,to provide ideas and theoretical basis for the research,development,and application of new drugs in the prevention and treatment of osteoarthritis. METHODS:CNKI,WanFang,VIP,PubMed,and GeenMedical were searched for relevant literature in the last 10 years.The key words were"OA,osteoarthritis,traditional Chinese medicine,active ingredients of traditional Chinese medicine,chondrocyte,inflammation,signal pathways,mechanism"in Chinese and English.We excluded the irrelevant repetitive and older literature,and finally included 63 articles for further review. RESULTS AND CONCLUSION:The active ingredients of traditional Chinese medicine regulate the levels of inflammatory factors,promote the proliferation and differentiation of chondrocytes,regulate the apoptosis of chondrocytes,and delay the degeneration of chondrocytes through Wnt/β-catenin,NK-ΚB,P38 MAPK,PI3K/AKT,JAK2/STAT3 and other signaling pathways,thus slowing the progression of osteoarthritis.

Cryptogenic Multifocal Ulcerous Stenosing Enteritis Treated by Integrated Traditional Chinese and Western Medicine： A Case Report / 中医杂志

Cryptogenic multifocal ulcerous stenosing enteritis（CMUSE） is a rare and difficult disease characte-rized by chronic recurrent intestinal obstruction and gastrointestinal bleeding caused by multiple ulcers and strictures of the small intestine. There is still a lack of mature and systematic guidance for the treatment of the disease. This paper reported a case of CMUSE mainly manifested as fatigue， abdominal distention， and edema of both lower limbs ， who is treated by integrated traditional Chinese and western medicine. In western medicine treatment， hormone and symptomatic treatment are mainly used. In traditional Chinese medicine treatment， the method of fortifying spleen and reinforcing healthy qi is taken as the basis； during the active stage of the disease， the method of moving qi and removing stagnation， clearing and removing dampness and heat， astringing and engendering flesh should be combined with， while during the remission stage， it is advised to unite with the method of diffusing lung and moving water， regulating and harmonizing zang-fu （脏腑） organs； simultaneously， replenishing qi and invigorating blood can be used throughout the treatment， and attach importance to the maintenance therapy of the traditional Chinese medicine immunomo-dulatory agent Tripterygium glycosides. After more than 2 years of treatment， the patient's clinical symptoms were significantly relieved， and all indicators basically restored to normal， having a stable condition.

Synthesis and antibacterial activities of phosphonate derivatives containing aminothiazoloxime fragment / 药学学报

Based on the principle of molecular hybridization, fifteen compounds were designed and synthesized through the combination of aminothiazoloxime and phosphonate fragment. The results showed that these compounds had better inhibitory effects on the tested bacteria. In particular, the activities of compounds Ⅲf and Ⅲi against S. aureus, E. coli, methicillin-resistant S. aureus (MRSA) and fluoroquinolone-resistant E. coli (FREC) were the most significant, the minimal inhibitory concentration (MIC) of Ⅲf was 1, 8, 4, 16 μg·mL-1 respectively, and the MIC of Ⅲi was 4, 4, 16, 8 μg·mL-1 respectively, which were slightly lower than that of the control drug oxacillin, and their anti-E. coli, MRSA and FREC activities were superior to that of the control drug oxacillin. Their activities to S. aureus were close to that of oxacillin, and to E. coli, MRSA and FREC were superior to that of oxacillin, which is worthy of further study.

JCAD deficiency attenuates activation of hepatic stellate cells and cholestatic fibrosis

Background/Aims@#Cholestatic liver diseases including primary biliary cholangitis (PBC) are associated with active hepatic fibrogenesis, which ultimately progresses to cirrhosis. Activated hepatic stellate cells (HSCs) are the main fibrogenic effectors in response to cholangiocyte damage. JCAD regulates cell proliferation and malignant transformation in nonalcoholic steatoheaptitis-associated hepatocellular carcinoma (NASH-HCC). However, its participation in cholestatic fibrosis has not been explored yet. @*Methods@#Serial sections of liver tissue of PBC patients were stained with immunofluorescence. Hepatic fibrosis was induced by bile duct ligation (BDL) in wild-type (WT), global JCAD knockout mice (JCAD-KO) and HSC-specific JCAD knockout mice (HSC-JCAD-KO), and evaluated by histopathology and biochemical tests. In situ-activated HSCs isolated from BDL mice were used to determine effects of JCAD on HSC activation. @*Results@#In consistence with staining of liver sections from PBC patients, immunofluorescent staining revealed that JCAD expression was identified in smooth muscle α-actin (α-SMA)-positive fibroblast-like cells and was significantly up-regulated in WT mice with BDL. JCAD deficiency remarkably ameliorated BDL-induced hepatic injury and fibrosis, as documented by liver hydroxyproline content, when compared to WT mice with BDL. Histopathologically, collagen deposition was dramatically reduced in both JCAD-KO and HSC-JCAD-KO mice compared to WT mice, as visualized by Trichrome staining and semi-quantitative scores. Moreover, JCAD deprivation significantly attenuated in situ HSC activation and reduced expression of fibrotic genes after BDL. @*Conclusions@#JCAD deficiency effectively suppressed hepatic fibrosis induced by BDL in mice, and the underlying mechanisms are largely through suppressed Hippo-YAP signaling activity in HSCs.

Expert consensus on the diagnosis and treatment of osteoporotic proximal humeral fracture with integrated traditional Chinese and Western medicine (version 2024) / 中华创伤杂志

Osteoporotic proximal humeral fracture (OPHF) is one of the common osteoporotic fractures in the aged, with an incidence only lower than vertebral compression fracture, hip fracture, and distal radius fracture. OPHF, secondary to osteoporosis and characterized by poor bone quality, comminuted fracture pattern, slow healing, and severely impaired shoulder joint function, poses a big challenge to the current clinical diagnosis and treatment. In the field of diagnosis, treatment, and rehabilitation of OPHF, traditional Chinese and Western medicine have accumulated rich experience and evidence from evidence-based medicine and achieved favorable outcomes. However, there is still a lack of guidance from a relevant consensus as to how to integrate the advantages of the two medical systems and achieve the integrated diagnosis and treatment. To promote the diagnosis and treatment of OPHF with integrated traditional Chinese and Western medicine, relevant experts from Orthopedic Expert Committee of Geriatric Branch of Chinese Association of Gerontology and Geriatrics, Youth Osteoporosis Group of Orthopedic Branch of Chinese Medical Association, Osteoporosis Group of Orthopedic Surgeon Branch of Chinese Medical Doctor Association, and Osteoporosis Committee of Shanghai Association of Integrated Traditional Chinese and Western Medicine have been organized to formulate Expert consensus on the diagnosis and treatment of osteoporotic proximal humeral fracture with integrated traditional Chinese and Western medicine ( version 2024) by searching related literatures and based on the evidences from evidence-based medicine. This consensus consists of 13 recommendations about the diagnosis, treatment and rehabilitation of OPHF with integrated traditional Chinese medicine and Western medicine, aimed at standardizing, systematizing, and personalizing the diagnosis and treatment of OPHF with integrated traditional Chinse and Western medicine to improve the patients ′ function.

[Preparation and characterization of oriented scaffolds derived from cartilage extracellular matrix and silk fibroin].

OBJECTIVE: This study aims to prepare oriented scaffolds derived from a cartilage extracellular matrix (CECM) and silk fibroin (SF) and use to investigate their physicochemical property in cartilage tissue engineering. METHODS: Oriented SF-CECM scaffolds were prepared from 6% mixed slurry (CECM：SF=1：1) through modified temperature gradient-guided thermal-induced phase separation, followed by freeze drying. The SF-CECM scaffolds were evaluated by scanning electron microscopy (SEM) and histological staining analyses and determination of porosity, water absorption, and compressive elastic modulus of the materials. RESULTS: The SEM image showed that the SF-CECM scaffolds contained homogeneous reticular porous structures in the cross-section and vertical tubular structures in the longitudinal sections. Histological staining showed that cells were completely removed, and the hybrid scaffolds retained proteogly can and collagen. The composition of the scaffold was similar to that of natural cartilage. The porosity, water absorption rate, and vertical compressive elastic modulus of the scaffolds were 95.733%±1.010%, 94.309%±1.302%, and (65.40±4.09) kPa, respectively. CONCLUSIONS: The fabricated SF-CECM scaffolds exhibit satisfactory physicochemical and biomechanical properties and thus could be an ideal scaffold in cartilage tissue engineering.

Lactate dehydrogenase inhibitor alleviates LPS/D-Gal-induced acute liver injury in mice / 中国药理学通报

Aim To investigate the effect of lactate dehydrogenase inhibitor on LPS/D-Gal-induced acute liver injury in mice. Methods BALB/ C mice were divided into four groups:solvent control group, lactate dehydrogenase inhibitor NHI-2 group, lipopolysaccharide(LPS)/ D-galactosamine(D-Gal)group and LPS/D-Gal+NHI-2 group. To induce acute liver injury, mice were injected intraperitoneally with LPS(10 μg·kg-1)and D-Gal(700 mg·kg-1), NHI-2 was intraperitoneally injected 30 min before LPS/D-Gal exposure. Liver tissue and serum were harvested 1.5 or 6 h after LPS/D-Gal exposure, serum lactate, serum aspartate aminotransferase(ALT), serum alanine aminotransferase(AST), serum tumor necrosis factor alpha(TNF-α)liver malondialdehyde(MDA)and liver caspase-3/8/9 levels were determined. HE staining was used to evaluate the degree of liver injury. TUNEL staining was used to evaluate hepatocyte apoptosis. Survival curve was used to record survival situation of tested mice. Results Serum lactate level of model mice was significantly reduced after treatment with NHI-2. Compared with LPS/D-Gal group, level of serum TNF-α showed no significant difference, but serum ALT and AST level of LPS/D-Gal+NHI-2 group significantly decreased, injury of liver structure was remarkably attenuated, level of MDA and activity of caspase-3/8/9 in liver were significantly down-regulated, and the number of TUNEL-positive cells was significantly reduced. Treatment with NHI-2 also significantly improved the survival rate of LPS/D-Gal-insulted mice. Conclusion Lactate dehydrogenase inhibitor alleviates LPS/D-Gal-induced acute liver injury in mice.

Research progress of olfactory dysfunction in Parkinson′s disease / 中国医师杂志

Parkinson′s disease (PD) is the second most common neurodegenerative disease in middle-aged and elderly people. In addition to motor symptoms, PD also has many non motor symptoms, such as dysosmia, constipation, cognitive impairment, etc. Among them, dysosmia is a common non motor symptom of early Parkinson′s disease. Research has confirmed that olfactory dysfunction (OD) can appear before the typical clinical symptoms of PD, which is of great significance to the diagnosis and treatment of diseases. However, at present, the pathogenesis of OD is still unclear, and the inspection methods have not been unified, and there is no complete cure. This article reviews the latest research progress of dysosmia in Parkinson′s disease.

Role of TRPM2 in sevoflurane anesthesia-induced necroptosis in hippocampal neurons of aged rats / 中华麻醉学杂志

Objective:To evaluate the role of transient receptor potential melastatin2 (TRPM2) in sevoflurane anesthesia-induced necroptosis in hippocampal neurons of aged rats.Methods:Sixty SPF-grade healthy male Sprague-Dawley rats, aged 22 months, weighing 550-600 g, were divided into 3 groups ( n=20 each) using a random number table method: control group (group C), sevoflurane anesthesia group (group M) and sevoflurane anesthesia+ TRPM2 inhibitor group (group M+ A). M and M+ A groups inhaled 2% sevoflurane for 5 h. In group M+ A, TRPM2 inhibitor ACA 20 mg/kg was intraperitoneally injected at 1 h before sevoflurane inhalation, and the equal volume of dimethyl sulfoxide was intraperitoneally injected in group C and group M. Morris water maze test was performed at 1 day after sevoflurane anesthesia. The escape latency, times of crossing the original platform and time spent in the original platform quadrant were collected. The expression of TRPM2 and necroptosis-related proteins (mixed lineage kinase domain-like protein [MLKL], receptor-interacting protein kinase-1 [RIPK1], phosphorylated MLKL [p-MLKL], and phosphorylated RIPK1 [p-RIPK1]) was detected by Western blot. The cytosolic Ca 2+ concentration in and necroptosis rate of hippocampal neurons were determined by flow cytometry. Results:Compared with group C, the escape latency was significantly prolonged, the times of crossing the original platform were decreased and the time spent in the original platform quadrant was shortened, the expression of TRPM2, MLKL, RIPK1, p-MLKL and p-RIPK1 was up-regulated, and the cytosolic Ca 2+ concentrations in hippocampal neurons and necroptosis rate of hippocampal neurons were increased in group M and group M+ A ( P<0.05). Compared with group M, the escape latency was significantly shortened, the times of crossing the original platform were increased, and the time spent in the original platform quadrant was prolonged, the expression of TRPM2, MLKL, RIPK1, p-MLKL and p-RIPK1 was down-regulated, and the cytosolic Ca 2+ concentrations in hippocampal neurons and necroptosis rate of hippocampal neurons were decreased in group M+ A ( P<0.05). Conclusions:Hippocampal TRPM2 is involved in the process of sevoflurane anesthesia-induced necroptosis in hippocampal neurons of aged rats.

Changes of thickness and area of ligamenta flavum after lateral lumbar interbody fusion / 中华骨科杂志

Objective:To investigate the changes of thickness and area of the ligamentum flavum after lateral lumbar interbody fusion (LLIF) for lumbar degenerative diseases.Methods:From 2019 to 2021, a total of 54 patients with lumbar degenerative diseases who underwent LLIF combined with percutaneous pedicle screw internal fixation were retrospectively analyzed. There were 9 males and 45 females, aged 59.46±6.91 years (range, 45-76 years), followed up for 14.69±6.87 months (range, 12-33 months). The disc height (DH), midsagittal canal diameter (CD), dural sac axial cross-sectional area (DCSA), ligamentum flavum area (LFA) and ligamentum flavum thickness (LFT) before and after surgery and at the last follow-up were evaluated and compared. Pearson correlation analysis was used to assess the relationship between the amount of change in the DCSA and LFA in the immediate postoperative period and at the last follow-up, as well as the correlation between the two and the amount of change in the DH. The data of patients at the last follow-up of 12 months after operation were extracted. Pearson correlation was used to evaluate the changes in DCSA and LFA at the last follow-up and the visual analogue scale (VAS) of low back pain and leg pain and Oswestry disability index (ODI) at 1 year after surgery.Results:All patients were followed up for 14.69±6.87 months (range, 12-33 months). The differences in DH ( F=354.93, P<0.001), sagittal CD ( F=44.78, P<0.001) and DCSA ( F=130.97, P<0.001) before, immediately after surgery and at the last follow-up were statistically significant. The DH, sagittal CD, and DCSA immediate after surgery and last follow-up were higher than those before surgery ( P<0.05). The differences in LFA ( F=51.59, P<0.001) and bilateral LFT ( F=53.49, P<0.001; F=50.53, P<0.001) before and after surgery and at the last follow-up were statistically significant, and both LFA and bilateral LFT at immediate after surgery and last follow-up were smaller than those before surgery ( P<0.05). Pearson correlation analysis showed that the change of DH immediately after surgery was moderately correlated with the change of DCSA ( r=0.57, P<0.001), and was strongly correlated with the change of LFA ( r=0.65, P<0.001). The change of DH at the last follow-up was moderately correlated with the change of DCSA ( r=0.43, P<0.001), and was weakly correlated with the change of LFA ( r=0.25, P=0.042). The differences in VAS-leg ( F=199.51, P<0.001), VAS-low back ( F=233.90, P<0.001), and ODI ( F=199.17, P<0.001) were statistically significant in patients before operation, 3 months after operation and 12 months after operation. There was no correlation between the changes of DCSA and LFA at the last follow-up and the changes of VAS and ODI at 1 year after operation ( P>0.05). Conclusion:LFA and LFT decrease and DCSA increase in patients with lumbar degenerative diseases after LLIF. LFA and LFT gradually decrease with time, and VAS and ODI are significantly improved compared with those before surgery. The DH loss caused by a certain degree of cage subsidence after surgery does not affect the clinical efficacy. There is no correlation between the improvement of DCSA and LFA and the improvement of clinical symptoms.

Emodin Ameliorates High Glucose-Induced Podocyte Apoptosis via Regulating AMPK/mTOR-Mediated Autophagy Signaling Pathway / 中国结合医学杂志

OBJECTIVE@#To investigate the effect of emodin on high glucose (HG)-induced podocyte apoptosis and whether the potential anti-apoptotic mechanism of emodin is related to induction of adenosine-monophosphate-activated protein kinase (AMPK)/mammalian target of rapamycin (mTOR)-mediated autophagy in podocytes (MPC5 cells) in vitro.@*METHODS@#MPC5 cells were treated with different concentrations of HG (2.5, 5, 10, 20, 40, 80 and 160 mmol/L), emodin (2, 4, 8 µ mol/L), or HG (40 mmol/L) and emodin (4 µ mol/L) with or without rapamycin (Rap, 100 nmol/L) and compound C (10 µ mol/L). The viability and apoptosis of MPC5 cells were detected using cell counting kit-8 (CCK-8) assay and flow cytometry analysis, respectively. The expression levels of cleaved caspase-3, autophagy marker light chain 3 (LC3) I/II, and AMPK/mTOR signaling pathway-related proteins were determined by Western blot. The changes of morphology and RFP-LC3 fluorescence were observed under microscopy.@*RESULTS@#HG at 20, 40, 80 and 160 mmol/L dose-dependently induced cell apoptosis in MPC5 cells, whereas emodin (4 µ mol/L) significantly ameliorated HG-induced cell apoptosis and caspase-3 cleavage (P<0.01). Emodin (4 µ mol/L) significantly increased LC3-II protein expression levels and induced RFP-LC3-containing punctate structures in MPC5 cells (P<0.01). Furthermore, the protective effects of emodin were mimicked by rapamycin (100 nmol/L). Moreover, emodin increased the phosphorylation of AMPK and suppressed the phosphorylation of mTOR. The AMPK inhibitor compound C (10 µ mol/L) reversed emodin-induced autophagy activation.@*CONCLUSION@#Emodin ameliorated HG-induced apoptosis of MPC5 cells in vitro that involved induction of autophagy through the AMPK/mTOR signaling pathway, which might provide a potential therapeutic option for diabetic nephropathy.

Chinese expert consensus on the diagnosis and treatment of osteoporotic periarticular fracture of the shoulder in the elderly (version 2023) / 中华创伤杂志

Periarticular fracture of the shoulder is a common type of fractures in the elderly. Postoperative adverse events such as internal fixation failure, humeral head ischemic necrosis and upper limb dysfunction occur frequently, which seriously endangers the exercise and health of the elderly. Compared with the fracture with normal bone mass, the osteoporotic periarticular fracture of the shoulder is complicated with slow healing and poor rehabilitation, so the clinical management becomes more difficult. At present, there is no targeted guideline or consensus for this type of fracture in China. In such context, experts from Youth Osteoporosis Group of Chinese Orthopedic Association, Orthopedic Expert Committee of Geriatrics Branch of Chinese Association of Gerontology and Geriatrics, Osteoporosis Group of Youth Committee of Chinese Association of Orthopedic Surgeons and Osteoporosis Committee of Shanghai Association of Chinese Integrative Medicine developed the Chinese expert consensus on the diagnosis and treatment of osteoporotic periarticular fracture of the shoulder in the elderly ( version 2023). Nine recommendations were put forward from the aspects of diagnosis, treatment strategies and rehabilitation of osteoporotic periarticular fracture of the shoulder, hoping to promote the standardized, systematic and personalized diagnosis and treatment concept and improve functional outcomes and quality of life in elderly patients with osteoporotic periarticular fracture of the shoulder.

Minimizing complications during surgical management of cervical cancer / 中国医师杂志

Radical hysterectomy combined with pelvic lymphadenectomy is the mainstream management for early-stage cervical cancer. However, the high radicality of such procedures is accompanied by high risk for complications. How to reduce the complications while ensuring the extent of surgical resection represents a dilemma faced by gynecological oncologists. Besides surgical techniques, multiple aspects during patient management should be involved in the measures for preventing surgery-associated complications in cervical cancer patients. By strictly grasping the surgical indications, being familiar with the use of instruments, paying attention to the application of surgical operation details and skills, strengthening postoperative management, and paying attention to the learning curve of surgeons, the incidence of surgical injury can be controlled at a low level.