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    18 November 2020, Volume 24 Issue 32 Previous Issue    Next Issue
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    Epidemiological distribution characteristics of 2 342 cases of hip fracture: a single center analysis
    Liu Zemin, Lü Xin, Liu Jinyuan, Wang Xiaohu
    2020, 24 (32):  5085-5091.  doi: 10.3969/j.issn.2095-4344.2853
    Abstract ( 349 )   PDF (592KB) ( 75 )   Save

    BACKGROUND: Early prevention of hip fracture can effectively reduce the risk of hip fracture in a high-risk population. Epidemiological studies can provide guidance for the clinical prevention and treatment of such patients.

    OBJECTIVE: To retrospectively analyze the epidemiological distribution characteristics of patients with hip fracture admitted to the Second Hospital of Shanxi Medical University from January 1, 2016 to December 31, 2018.

    METHODS: To collect the patient’s age, sex, fracture type, territorial, season for injury, causes, surgical procedure, intraoperative situation, blood clots, length of hospital stay, cost, and admission to operation time, body mass index, complications, SPSS 26.0 software was used for data processing to analyze the epidemiology of hip fracture distribution characteristics in 2342 patients.

    RESULTS AND CONCLUSION: The average age of patients with hip fracture was (73.90±13.43) years, and hip fracture mostly occurred in the 80-90 group, accounting for 29.97%. Hip fractures were common in winter, and there was a significant difference in the seasonal distribution of femoral neck and intertrochanteric fractures. Falls resulted in the most hip fractures, accounting for 88.13%. Among the 2 108 patients with hip fractures who underwent surgical treatment, hip replacement was the major choice for femoral neck fractures, accounting for 60.03%; intramedullary fixation was the main choice for intertrochanteric fractures, accounting for 92.04%. Among the 2097 patients with hip fracture who underwent color Doppler ultrasonography, 32.38% (679/2 097) of the patients had arteriovenous thrombosis of the lower extremities, and 28.71% (195/679) of the patients had inferior vena cava filter implantation. The average hospitalization time of patients with hip fracture was (10.49±7.06) days, and the average hospitalization cost was (4.63±3.14) thousand yuan. The average hospitalization cost, average blood loss and average operation time of femoral neck fractures were significantly less than those of intertrochanteric fractures. Patients with intertrochanteric fractures were generally thinner than those with femoral neck fractures. The 44.41% of patients with hip fracture had cardiovascular and cerebrovascular diseases. These results indicate that hip fractures are mainly developed in the older adults, especially in elderly women. With the increase of age, the proportion of intertrochanteric fractures increases gradually. Falls are the main cause of hip fractures in the older adults. Surgical treatment is the main choice for hip fracture. Preoperative blood preparation and perioperative thrombosis prevention can improve the prognosis of patients.

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    Effect of pterostilbene on oxidative stress induced apoptosis in chondrocytes
    Lin Yicai, Wu Zhengyuan, Luo Yingli, Yao Jun
    2020, 24 (32):  5092-5096.  doi: 10.3969/j.issn.2095-4344.2854
    Abstract ( 341 )   PDF (503KB) ( 93 )   Save

    BACKGROUND: A variety of antioxidants exhibit anti-arthritis effects by inhibiting the production of inflammatory factors. Pterostilbene is a powerful natural antioxidant; however, there is no report on its effect against oxidative stress in chondrocytes.

    OBJECTIVE: To investigate the effect of pterostilbene on oxidative stress induced apoptosis in human chondrocytes

    METHODS: Normal human articular chondrocytes were cultured in medium containing different concentrations of pterostilbene (7.8-       32 000 μg/L) for 24 continuous hours to determine the optimal concentration of pterostilbene. Normal human articular chondrocytes cultured in vitro were randomized into control group, pterostilbene group (treatment with 125 μg/L pterostilbene), hydrogen peroxide (H2O2) group (treatment with 0.2 mmol/L H2O2), and H2O2 plus pterostilbene group (pretreatment with 125 μg/L pterostilbene followed by continuous treatment in the medium containing 125 μg/L pterostilbene and 0.2 mmol/L H2O2). After treating for 24 hours, the cell proliferation rate was detected by MTT experiment, the cell morphology and number by hematoxylin-eosin staining, the cell activity was measured by FDA/PI staining, and the changes of proteoglycan content were observed by saffron O staining. The expression of chondrogenesis marker genes aggrecan and type II collagenase 1 was detected by RT-PCR. An approval for the study protocol was validated by the Ethic Committee of the First Affiliated Hospital of Guangxi Medical University with an approval No. 201805008.

    RESULTS AND CONCLUSION: The results of MTT assay showed that pterostilbene could significantly promote chondrocyte growth at 15.6-250 μg/L, especially at 125 μg/L. The results of hematoxylin-eosin staining and FDA/PI staining further showed that pterostilbene could inhibit H2O2-induced chondrocyte apoptosis, promote chondrocyte proliferation, and increase cell viability. The results of saffron O staining showed that pterostilbene promoted the secretion of proteoglycan by chondrocytes and inhibited the adverse effects of H2O2 on chondrocytes. The results of RT-PCR further revealed that pterostilbene could promote the expression of aggrecan and type II collagenase 1 genes in chondrocytes damaged by oxidative stress and improve the chondrocyte differentiation function. In conclusion, pterostilbene can promote chondrocyte proliferation and inhibit human articular chondrocyte apoptosis caused by oxidative stress.  

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    Expression of Shh and Ihh during the formation of intervertebral discs in mouse embryo
    Gong Tingting, Chen Jianquan
    2020, 24 (32):  5097-5101.  doi: 10.3969/j.issn.2095-4344.2855
    Abstract ( 490 )   PDF (491KB) ( 56 )   Save

    BACKGROUND: Studies have shown that Sonic Hedgehog (Shh) is expressed in mouse Notochordal cells, and India Hedgehog (Ihh) is mainly expressed in chondrocyte-like cells and end plates of mouse embryonic vertebral bodies. However, the expression of Shh and Ihh during the formation of intervertebral discs in mouse embryo is unclear.

    OBJECTIVE: To investigate the expression of Shh and Ihh during the formation of intervertebral discs in mouse embryo.

    METHODS: Male Shh-CreERT2, R26-mTmG/+ mice mated with female R26-mTmG/+ mice to obtain pregnant rats at different periods of pregnancy (E8.5, E11.5, E12.5, E14.5, E16.5, E18.5), followed by injection of 10 g/L tamoxifen at a dose of 10 μL/g. Intervertebral disc tissues were isolated from the mouse embryo at P0, followed by genotype identification. At the same time, male C57BL/6 mice mated with female C57BL/6 mice to obtain pregnant rats at different periods of pregnancy (E11.5, E12.5, E14.5, E16.5, E18.5), and the intervertebral disc tissues of mouse embryo were taken and analyzed. The expression of Shh and Ihh during the formation of intervertebral discs in mouse embryo was detected using immunofluorescence and immunohistochemistry, respectively. Implementation of animal experiments was approved by the Animal Ethics Committee of Soochow University.

    RESULTS AND CONCLUSION: Shh-CreERT2; R26-mTmG/+ mouse embryos were identified by PCR amplification. The results of immunofluorescent staining showed a gradual decrease in the expression of Shh in nucleus pulposus cells during the formation of intervertebral discs in mouse embryo. The results of immunohistochemical staining showed a gradual increase in expression of Ihh in nucleus pulposus cells during the formation of intervertebral discs in mouse embryo. In summary, Shh and Ihh are dynamically expressed during the formation of intervertebral discs in mouse embryo, and provide a basis for further research on the molecular mechanism of intervertebral disc degeneration. 

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    Expression of bone growth factor in rats with infectious bone defects after treatment with bone migration
    Guo Yande, Zeng Gaofeng, Wei Shoufeng, Zhang Qiong, Zhou Quan, Zhang Chuanyang, Zong Shaohui
    2020, 24 (32):  5102-5107.  doi: 10.3969/j.issn.2095-4344.2857
    Abstract ( 389 )   PDF (531KB) ( 49 )   Save

    BACKGROUND: Studies have shown that bone healing is a pathophysiological process that completes repair, regeneration and reconstruction in which multiple growth factors are involved. Insulin-like growth factors-1

    (IGF-1) and basic fibroblast growth factor (bFGF) are two important bone growth factors in the process of bone healing.

    OBJECTIVE: To investigate the expression of IGF and bFGF before and after bone migration in rats with infectious bone defects.

    METHODS: Thirty-six Sprague-Dawley rats were selected, and then each rat was made an infectious bone defect of 4 mm long at the lower end of tibia. After 2 weeks, the rats were randomly divided into two groups: an operation group and a control group. After debridement, stents were installed with no bone migration in the control group, and bone migration was performed in the operation group. X-ray observation was performed at the 2nd week after stenting. The healing of infectious bone defects and the expression of IGF and b-FGF in the two groups were detected by hematoxylin-eosin staining and enzyme-linked immunosorbent assay at the 2nd, 3rd and 4th weeks. The experimental protocol was approved by the Animal Experimental Ethics Committee of Guangxi Medical University (approval No. 201903036).

    RESULTS AND CONCLUSION: X-ray findings showed callus formation in the defect area at the 2nd week postoperatively, and no swelling in the surrounding soft tissue with good healing effects. Hematoxylin-eosin staining showed less fibrous tissues, more osteoblasts, denser trabeculae, and more mesenchymal cells and new capillaries in the operation group than the control group. Enzyme-linked immunosorbent assay findings showed that the expression of IGF-1 was significantly increased in the operation group compared with the control group in the 2nd and 3rd weeks postoperatively (P < 0.05); the expression of bFGF was significantly different from that in the control group at the 2nd week postoperatively (P < 0.05). In conclusion, IGF-1 and b-FGF is up-regulated in rats after bone migration, which suggests that the up-regulation of IGF-1 and bFGF may be one of the reasons for promoting the healing of infectious bone defects.

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    Mechanism of YKL-40 regulating apoptosis of rabbit osteoarthritis chondrocytes via PI3K/Akt signaling pathway
    Tian Shenglan, Wang Guoyan, Yang Yang
    2020, 24 (32):  5108-5113.  doi: 10.3969/j.issn.2095-4344.2856
    Abstract ( 388 )   PDF (562KB) ( 38 )   Save

    BACKGROUND: Due to the close relationship between the phosphatidylinositol 3-kinase (PI3K)/Akt signaling pathway and the physiological metabolism of bone tissue, human chitinase protein 40 (YKL-40) can regulate the PI3K/Akt signaling pathway related to breast cancer pathogenesis. Therefore, it is speculated that YKL-40 may regulate apoptosis in knee osteoarthritis (KOA) chondrocytes through the PI3K/Akt signaling pathway.

    OBJECTIVE: To study the mechanism by which YKL-40 regulates apoptosis in rabbit KOA chondrocyte s through the PI3K/Akt signaling pathway.

    METHODS: (1) New Zealand white rabbits were randomized into two groups. An animal model of KOA was made using anterior cruciate ligament dissection in the model group, whereas the right posterior knee joint capsule was cut but not dissected in the control group. Chondrocytes were extracted from the rabbits at 6 weeks after modeling. Hematoxylin-eosin staining and Mankin histological scoring of the cartilage tissue were performed, whereas immunohistochemical staining was used to detect type II collagen expression in chondrocytes. (2) The second-generation chondrocytes in the control group were used as normal control group, and those in the model group were further divided into four groups, followed by culture with high glucose DMEM medium containing 10% fetal bovine serum in KOA model group, 100 μg/L YKL-40 in KOA + YKL group,    50 µmol/L LY294002 in KOA + LY group, and 50 µmol/L LY294002 + 100 μg/L YKL-40 in KOA + YKL + LY group. The expression levels of collagen type II, matrix metalloproteinase 13, Akt, p-Akt, P53, Bcl-2 proteins in chondrocytes were detected by western blot.

    RESULTS AND CONCLUSION: Hematoxylin-eosin staining, Mankin histological score, and collagen type II immunohistochemical staining confirmed the successful construction of KOA animal model and successful chondrocyte culture. Compared with the normal control group, the collagen type II, Bcl-2, p-Akt protein expression levels in chondrocytes were significantly reduced in the KOA model group (P < 0.05), and matrix metalloproteinase 13 and P53 protein expression levels were significantly increased in the KOA model group (P < 0.05). Compared with the KOA model group, these indicators were significantly improved in the KOA + YKL group (P < 0.05), significantly worsened in the KOA + LY group (P < 0.05), and had no significant changes in the KOA + YKL + LY group (P > 0.05). However, there were significant differences between the KOA + YKL group and the KOA + LY group (P < 0.05). In addition, the expression level of p-Akt protein in chondrocytes had no difference among groups (P > 0.05). To conclude, YKL-40 can inhibit the apoptosis of KOA chondrocytes, accelerate the repair of KOA cartilage damage and delay the degeneration of cartilage by activating the PI3K/Akt signaling pathway. Therefore, YKL-40 can be used as a new target for clinical treatment of KOA.

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    Effect of parathyroid hormone on cartilage healing in a rabbit model of mandibular condylar fracture
    Xie Liuqin, Huang Zhicai, Wang Guangsu, Zhang Guoxing, Li-Du Chenhui, Li Xiao, Tang Zhenglong
    2020, 24 (32):  5114-5121.  doi: 10.3969/j.issn.2095-4344.2858
    Abstract ( 381 )   PDF (631KB) ( 140 )   Save

    BACKGROUND: A high fracture of the mandibular condyle is often accompanied by cartilage damage. At the same time, the muscle attached to the condyle is avulsed and becomes a free bone mass. How to speed up the concurrent healing of cartilage during bone healing has always been a clinical difficulty and challenge.

    OBJECTIVE: To investigate the effect of parathyroid hormone on the healing of condylar cartilage in rabbits with high condylar fracture after free reduction.

    METHODS: An experimental model of free reduction and fixation of condylar fracture was established in 48 New Zealand big-eared rabbits, which were randomly divided into experimental group and control group (n=20

    per group). The experimental group was injected with parathyroid hormone (20 μg/kg) subcutaneously every other day, and the control group was injected with 1 mL of normal saline. The animals were sacrificed at 1, 2, 3, and 4 weeks postoperatively. The mandible condyle was histologically observed. Immunohistochemistry staining and PCR were used to detect the expression of Sox9 and matrix metalloproteinase 13 in the condylar cartilage. The study protocol was approved by the Animal Experimental Ethics Committee of Guizhou Medical University (approval No. 1700456).

    RESULTS AND CONCLUSION: The results of safranine O-fast green staining and hematoxylin-eosin staining indicated that there were more chondrocytes and cartilage matrix deposition in the experimental group than the control group. In the immunohistochemistry, the average absorbance of Sox9 in the experimental group was significantly higher than that in the control group within 1-3 postoperative weeks (P < 0.05). The average absorbance of matrix metalloproteinase 13 in the experimental group was lower than that in the control group within 1-3 postoperative weeks (P < 0.05). The expression of Sox9 mRNA in the experimental group was significantly higher than that in the control group within 1-3 postoperative weeks, P < 0.05). The expression of matrix metalloproteinase 13 mRNA in the experimental group was significantly lower than that in the control group within 1-3 postoperative weeks (P < 0.05). These findings indicate that intermittent subcutaneous injection of parathyroid hormone can up-regulate the expression of Sox9, inhibit the expression of matrix metalloproteinase 13, promote the transformation of mesenchymal stem cells to cartilage, and accelerate the repair of cartilage damage.

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    Vacuum sealing drainage enhances wound healing by up-regulating collagen type I/III ratio in rats
    Zhao Xin, Shi Xin, Chen Bei, Cao Yanpeng, Chen Yaowu, Liu Xiaoren, He Yusheng, He Liyun, Li Xiying, Liu Jun
    2020, 24 (32):  5122-5127.  doi: 10.3969/j.issn.2095-4344.2859
    Abstract ( 328 )   PDF (634KB) ( 68 )   Save

    BACKGROUND: Vacuum sealing drainage can enhance acute and chronic wound healing. The ratio of collagen type I/III play a critical role in the structural stability of skin tissue and skin repair, but its change during vacuum sealing drainage accelerating wound healing remains unclear.

    OBJECTIVE: To observe the effect of vacuum sealing drainage on the ratio of collagen type I/III during wound healing and to explore the potential mechanism underlying acute wound repair in rats.

    METHODS: A full-thickness wound, with a diameter of 20 mm, was created on the back of healthy male rats. All model rats were then randomized into two groups: blank control and vacuum sealing drainage groups. The wound surface was photographed at three observational time points (1, 3, 7 days after operation), and wound closure rate was calculated and compared. The mRNA and protein expression levels of type I collagen and type III collagen and ratio of collagen type I/III were detected by RT-qPCR and immunohistochemistry. The structure of granulation tissue and length of re-epithelialization were histologically detected.

    RESULTS AND CONCLUSION: Compared with the blank control group, treatment with vacuum sealing drainage significantly increased the expression of type I collagen and type III collagen at mRNA and protein levels (P < 0.05), enhanced wound healing rate (P < 0.05) as well as increasing the ratio of collagen type I/III starting from the 3rd day after operation (P < 0.05). To conclude, the vacuum sealing drainage can accelerate wound healing by up-regulating the protein expression of type I collagen and type III collagen, the ratio of collagen type I/III and increasing wound tensile strength.

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    Association of HTRA1 and HAPLN1 gene polymorphism with intervertebral disc degeneration
    Yang Jinfeng, Ma Sanhui
    2020, 24 (32):  5128-5132.  doi: 10.3969/j.issn.2095-4344.2860
    Abstract ( 294 )   PDF (459KB) ( 31 )   Save

    BACKGROUND: Studies have found that single nucleotide polymorphism genotypes in the HTRA1 gene promoter region are associated with intervertebral disc degeneration, while HAPLN1 is associated with osteoarthritis caused by intervertebral disc degeneration.

    OBJECTIVE: To explore the role of human secretory serine protease HTRA1 and the key group of extracellular matrix HAPLN1 in the pathogenesis of intervertebral disc degeneration.

    METHODS: This study included 498 postmenopausal female subjects who underwent a physical examination at Dingzhou People’s Hospital from April 2015 to December 2018. TaqMan PCR was used to detect HTRA1 gene promoter rs11200638 single nucleotide polymorphism and HAPLN1 gene 5' flanking rs975563, intron 1 rs10942332, intron 2 rs179851 and intron 4 rs4703570 single nucleotide polymorphism in 498 postmenopausal Chinese women. The correlation between the HTRA1orHAPLN1 gene polymorphisms and the radiographic features of spinal disc degeneration was analyzed. The trial has been approved by the Ethics Committee of Dingzhou People’s Hospital.

    RESULTS AND CONCLUSION: Among the 498 subjects with the HTRA1 gene rs11200638 single nucleotide polymorphism, 178 were GG homozygotes, 222 were GA heterozygotes, and 98 were AA homozygotes. We compared the parameters of intervertebral disc degeneration in subjects with at least one G allele (GG+GA, n=400) and without G allele (AA, n=98). In HTRA1 gene rs11200638 single nucleotide polymorphism, the score on intervertebral space stenosis in the subjects with GG+GA allele genome was lower than that in the subjects with AA allele (P < 0.001). With the increase of the score on intervertebral space stenosis, the proportion of the subjects with AA alleles increased (P ≤ 0.001). Among the 498 subjects with single nucleotide polymorphisms of the HAPLN1 gene, 137 were homozygous for TT, 230 were heterozygous for CT, and 131 were homozygous for CC. Intervertebral disc degeneration parameters of CC+TT allele (n=361) and TT allele (n=137) were compared. In the HAPLN1 gene, there was a significant difference between the CC+TT and TT alleles of the rs179851 single nucleotide polymorphism in osteophyte formation and intervertebral space stenosis (P < 0.01). Among the HAPLN1 gene rs179851 single nucleotide polymorphisms, the proportion of subjects with TT alleles and intervertebral space stenosis ≥ 6 points increased (P < 0.05). With an increase in osteophyte formation score, the proportion of subjects with TT allele increased (P < 0.001). These results reveal that HTRA1 and HAPLN1 genetic variations at specific genetic loci are associated with intervertebral disc degeneration.

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    Endoscopic unilateral versus bilateral decompression effects on lumbar disc herniation with contralateral symptoms

    Wang Qiuan, Yuan Feng, Wu Jibin, Sun Maji, Wu Dongying, Meng Qiang, Guo Kaijin
    2020, 24 (32):  5133-5137.  doi: 10.3969/j.issn.2095-4344.2861
    Abstract ( 350 )   PDF (549KB) ( 73 )   Save

    BACKGROUND: Lumbar disc herniation is mostly accompanied by ipsilateral compression symptoms caused by the pressure of herniated portion on the ipsilateral nerve root. Rare cases are reported to present with contralateral compression symptoms. So there is currently no specific classification and nomenclature for this type of lumbar

    disc herniation, which is referred to as lumbar disc herniation with contralateral symptoms in this article.

    OBJECTIVE: To investigate the efficacy of endoscopic lumbar nucleus pulposus removal for unilateral versus bilateral decompression in patients with lumbar disc herniation presenting with contralateral symptoms.  

    METHODS: Forty patients with contralateral symptomatic lumbar disc herniation who underwent endoscopic lumbar nucleus pulposus surgery from January 2015 to December 2018 were enrolled in enrolled for retrospective analysis. According to the different decompression methods, the patients were randomly divided into an ipsilateral decompression group (n=20) and a bilateral decompression group (n=20). The visual analogue scale (VAS) and Japanese Orthopedics Association (JOA) scores of the lumbar and lower extremities before and at 3, 6, and 12 months after surgery were recorded. Clinical efficacy was evaluated by the modified Macnab standard at 12 months after surgery. Dynamic X-rays of the lumbar spine were used to evaluate lumbar stability.

    RESULTS AND CONCLUSION: All the 40 patients were followed up for 12-20 months, with an average of 16 months. There were no complications such as dural sac tear and intervertebral space infection in the two groups. The pain in the lower back and lower extremities were significantly relieved in both groups. The postoperative JOA score was significantly higher than that before surgery; and the postoperative VAS scores of the waist and lower extremities were significantly lower than those before surgery (P < 0.05). The VAS and JOA scores in the bilateral decompression group were significantly superior to those in the unilateral decompression group (P < 0.05). The improved Macnab evaluation at 12 months after surgery showed that the excellent and good rate was 70% in the unilateral decompression group, and 95% in the bilateral decompression group, with significant difference between two groups (P < 0.05). Lumbar spine dynamic X-rays at 12 months after surgery showed no lumbar instability or slippage in the two groups. For patients with lumbar disc herniation presenting with contralateral symptoms who underwent percutaneous transforaminal lumbar nucleus pulposus removal, pain symptoms eased off after treatment with two decompression methods, but the bilateral decompression had better postoperative recovery compared with the unilateral decompression.

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    Passive training improves the recovery of skeletal muscle structure and function in rats with denervated muscle atrophy
    Wang Shiyang, Sun Huizhe, Yan Nan, Wang Xiaojie, Zhang Hongxin, Guan Lili, Li Fenjie, Wang Zhengdong
    2020, 24 (32):  5138-5144.  doi: 10.3969/j.issn.2095-4344.2862
    Abstract ( 446 )   PDF (578KB) ( 58 )   Save

    BACKGROUND: Inflammatory cells or inflammatory factors participate in the proliferation and differentiation of skeletal muscle satellite cells after denervation injury, and play an important role in the pathological process of skeletal muscle denervation.

    OBJECTIVE: To study the effects of passive training on skeletal muscle structure, function and expression of Actin and inflammatory factors in rats with denervated muscle atrophy.

    METHODS: Thirty Sprague-Dawley rats were randomly divided into sham operation group, model group and training group. In the model group and the training group, the sciatic nerve was exposed and cut off the sciatic nerve, while the sciatic nerve in the sham operation group was exposed but not cut off. Two months after modeling, rats in the training group underwent passive rehabilitation training with self-made drum for 2 months, and then the degree of muscle atrophy and motor function were evaluated by muscle wet weight ratio and Basso, Beattie and Bresnahan score. The muscle fiber fine structure and cross-sectional area were observed by hematoxylin-eosin staining, and the expression of Actin, tumor necrosis factor-α, interleukin-6 and interleukin-1β in each group was detected by immunohistochemical staining. The study protocol was approved by the Laboratory Animal Welfare Ethics Committee of Shenyang Medical College with the approval No. SYYXY2015010601.

    RESULTS AND CONCLUSION: The Basso, Beattie and Bresnahan score of the training group was higher than that of the model group. The wet weight ratio of the training group was higher than that of the model group; however, the cross-sectional area of the muscle fibers was lower than that of the model group (P < 0.001, P < 0.05). The expression of Actin in the training group was higher than that in the model group (P < 0.001), and the expression levels of tumor necrosis factor-α, interleukin-6 and interleukin-1β in the training group were lower than those in the model group (P < 0.001 or P < 0.05). To conclude, passive training can help to recover the muscle structure and function of denervated muscles, reduce the levels of inflammatory factors, prevent further muscle atrophy, and improve skeletal muscle strength.

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    Effect of “Lumbar Three Needles” on expression of oxidative stress factors in rats with multifidus muscles injury
    Bai Zhenjun, Liu Tong, Wang Zirun, Zhang Huiyu, Xu Peng
    2020, 24 (32):  5145-5150.  doi: 10.3969/j.issn.2095-4344.2863
    Abstract ( 372 )   PDF (747KB) ( 32 )   Save

    BACKGROUND: Posterior lumbar spine surgery is currently the main surgical approach for many surgical operations such as discectomy and spinal canal decompression. However, 10%-40% of patients with posterior lumbar spine surgery can have low back pain and related dysfunctions soon after surgery, which is related to excessive stretching or blunt injury to the paraspinal muscles such as the multifidus muscle during the operation.

    OBJECTIVE: To explore the effect of “Lumbar Three Needles” on the expression of oxidative stress factors, including malondialdehyde, reactive oxygen species, superoxide dismutase, glutathione peroxidase and phosphorylated protein kinase B, in rats with multifidus muscles injury.

    METHODS: Twenty-four male Sprague-Dawley rats were randomly divided into control group, model group and “Lumbar Three Needles” group, with 8 rats in each group. An animal model of multifidus muscles injury was made by intramuscular injection of 0.5% bupivacaine hydrochloride in the model and treatment groups in control and “Lumbar Three Needles” group, while normal saline was injected in the control group. No acupuncture intervention was given in the control group and model group, while Dachangshu, Shenshu and Weizhong acupoints were electroacupunctured in the “Lumbar Three Needles” group. Needles were then stimulated electrically using a Han's Acupoint Nerve Stimulator with density wave, frequency of 2 Hz/10 Hz and continuous current of 1 mA for 20 minutes, once daily for 7 days in total. The multifidus muscle was stained with hematoxylin-eosin staining to observe morphological changes, and kits were used to observe the expression of malondialdehyde, reactive oxygen species, superoxide dismutase, and glutathione peroxidase, while western blot was applied to observe the expression of phosphorylated protein kinase B. The study protocol was approved by the Animal Ethic Committee of Guangdong Second Traditional Chinese Medicine Hospital with an approval No. 048617.

    RESULTS AND CONCLUSION: Hematoxylin-eosin staining results indicated that the muscle fibers were partially fixed in the model group and there were still a lot of macrophages after 7 days of intervention. Compared with the model group, more newborn muscle fibers and fewer macrophages could be seen in the “Lumbar Three Needles” group. After intervention, the cross-sectional area of the multifidus muscles in the “Lumbar Three Needles” group was significantly bigger than that in the model group (P < 0.01). The expression levels of malondialdehyde and reactive oxygen species in the model group were significantly increased compared with the control group (P < 0.01) and “Lumbar Three Needles” group (P < 0.01). The expression of superoxide dismutase, glutathione peroxidase and phosphorylated protein kinase B in the “Lumbar Three Needles” group was significantly higher than that in the model group (P < 0.01 or P < 0.05). Therefore, “Lumbar Three Needles” can significantly decrease the oxidative stress level after multifidus muscle injury, which may be related to the improvement of phosphorylated protein kinase B.  

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    Effect of Electroacupuncture at Zusanli and Futu acupoints on expression of apoptosis factor Caspase-3 in spinal cord injury rats
    Wei Weibing, Zhou Binbin, Zhang Hongsheng, Yang Yu, Cui Junwu, Li Zhenxing
    2020, 24 (32):  5151-5157.  doi: 10.3969/j.issn.2095-4344.2864
    Abstract ( 361 )   PDF (743KB) ( 53 )   Save

    BACKGROUND: Traditional Chinese medicine has proposed the theory of “treatment for flaccidity aims at Yangming meridian” in the Internal Canon of Medicine. However, there have been relatively few reports on electroacupuncture at the stomach channel of Foot Yangming in the treatment of spinal cord injury.

    OBJECTIVE: To investigate the effect of electroacupuncture stimulation of Zusanli and Futu on Caspase-3 expression in injured segments of spinal cord injury rats.

    METHODS: Sixty-four Sprague-Dawley female rats, SPF grade, were randomly divided into four groups, i.e., control group, pre-labeling group, post-injury labeling group and electroacupuncture group, with 16 rats in each group. The control group and the pre-labeling group were intraperitoneally given Brdu (50 mg/kg) for 10 days before the operation. The control group was given a bite to remove the lamina on the 11th day, which did not damage the spinal cord. A model of spinal cord injury was made in the pre-labeling group on the 11th day. The post-injury labeling group and the electroacupuncture group were injected intraperitoneally with Brdu for 10 days after the spinal cord injury was made, and the post-injury labeling group was not treated. The electroacupuncture group started electroacupuncture at Zusanli and Futu acupoints on the 3rd day after the model was established. Spinal cord specimens were taken at 3, 10, 17, and 24 days after injury in each group, and the changes in the number of neurons were observed by hematoxylin-eosin staining. The expression of Brdu positive cells was observed by immunohistochemistry. The changes in Caspase-3 mRNA and protein expression were detected by qRT-PCR and western blot, respectively. The study protocol was approved by the Animal Ethic Committee of Guangxi Medical University, with an approval No. 201712001.

    RESULTS AND CONCLUSION: The expression of Caspase-3 mRNA and protein after spinal cord injury was higher than that of the control group without spinal cord injury, and the number of neurons after spinal cord injury was significantly lower than that of the control group. With the passage of time, the mRNA and protein expression of Caspase-3 gene in the pre-labeling, post-injury labeling and electroacupuncture groups increased first and then decreased, while the Caspase-3 expression in the electroacupuncture group decreased significantly, which was significantly different from that in the pre-labeling and post-injury labeling groups (P < 0.05). Hematoxylin-eosin staining results showed that the number of neurons in the electroacupuncture group was significantly higher than that in pre-labeling and post-injury labeling groups, and gradually approached the number of neurons in the control group on the 24th day. Immunohistochemical results showed that the positive protein expression in the electroacupuncture group increased first and then decreased, reaching the highest on the 17th day and the lowest on the 24th day. The overall positive protein expression was significantly higher than that in the other groups (P < 0.05). To conclude, electroacupuncture stimulation of Zusanli and Futu acupoints can reduce the expression of Caspase-3 mRNA and protein, reduce the apoptosis of nerve cells, and promote the number of neurons, thus promoting the regeneration and repair of nerve cells.

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    Preparing an adult mouse model of functional dyspepsia
    Yu Jing, Pang Jiayu, Jia Ziye, Wu Xiaoguang
    2020, 24 (32):  5158-5161.  doi: 10.3969/j.issn.2095-4344.2805
    Abstract ( 375 )   PDF (545KB) ( 37 )   Save

    BACKGROUND: A suitable rat model of functional dyspepsia is a reliable animal model for subsequent clinical treatment and drug research.

    OBJECTIVE: To prepare a model of functional dyspepsia in adult mice using a combined multi-factor method.

    METHODS: Sixty Kunming mice were randomly divided into a blank control group and a model group, with 30 mice in each group. The mice in the blank control group were orally administered 0.2 mL of a 2% sucrose solution for 8 continuous days. Based on the classic iodoacetamide modeling method combined with daily feeding, the model group was subjected to force swimming in a water tank for 20 minutes, and 1 hour later, the mice were orally administered 5.7 g/kg L-arginine solution for 5 days, followed by oral administration of cold rhubarb decoction 2.9g/gk for another 3 days. The behavioral and pathological changes under light microscope were observed to determine the modeling effect. The study protocol was approved by the Animal Ethic Committee of Chengde Medical College, No. CDMULAC-20191113-011.

    RESULTS AND CONCLUSION: Compared with the control group, the model group showed a reduction in hair color, arch back and body mass, and the intestinal propulsion rate and gastric emptying rate both had a downtrend. Intestinal tissue sections showed mild damage under the light microscope. Therefore, the combined multi-factor modeling method used in in the adult mice can successfully prepare the functional dyspepsia model. Moreover, the animal model prepared by this method has no obvious organic lesions, such as necrosis and erosion, indicating that this is a feasible method to prepare the adult mouse model of functional dyspepsia.  

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    Variation of Fas/Fasl pathway in limb ischemia-reperfusion lung injury rats after etomidate post-treatment
    Zou Haibo, Sun Xiaofeng
    2020, 24 (32):  5162-5167.  doi: 10.3969/j.issn.2095-4344.2865
    Abstract ( 407 )   PDF (632KB) ( 28 )   Save

    BACKGROUND: To date, it has been confirmed that etomidate pre-treatment can reduce the damage of remote organs caused by limb ischemia-reperfusion, but whether etomidate post-treatment has protective effect on remote organs and its mechanism has been rarely reported.

    OBJECTIVE: To investigate the influence of etomidate post-treatment on limb ischemia-reperfusion lung injury.

    METHODS: A rat model of limb ischemia-reperfusion lung injury was prepared by clamping the bilateral femoral arteries for 2 hours and reperfusion for 3 hours. After 2 hours of limb ischemia, I/R group experienced the process of limb ischemia-reperfusion; I/R+ETO group, I/R+Dex 0.2 group, I/R+Dex 0.5 group and I/R+Dex 1.0 group, besides the model of limb ischemia-reperfusion, were injected with etomidate 1.0 mg/kg and dexamethasone 0.2, 0.5 and 1.0 mg/kg respectively through tail vein. At 3 hours of reperfusion, blood samples were extracted from the carotid artery, blood gas analysis was performed and the partial pressure of blood oxygen (PaO2) was recorded. The pathological changes were detected by immunohistochemistry. Apoptotic index was detected by Hoechst 33258 staining and wet/dry weight ratio was detected. Fas protein and Fasl mRNA of lung tissue were detected by western blot and RT-PCR respectively. Tumor necrosis factor-α and interleukin-1β levels were detected by ELISA.

    RESULTS AND CONCLUSION: Compared with the I/R group, PaO2 increased (P < 0.05), Apoptotic index, wet/dry weight ratio, Fas and FasL mRNA, tumor necrosis factor-α and interleukin-1β decreased in the I/R+ETO group, and the number of apoptotic lesions decreased in the I/R+ETO group (P < 0.05). Compared with the I/R+ETO group, the change of each index was not statistically significant in the I/R+Dex 0.5 group (P > 0.05). To conclude, etomidate post-treatment can reduce lung injury caused by limb ischemia-reperfusion in rats, and its mechanism may be related to the down-regulation of Fas/FasL. In the statistical point of view, etomidate 1.0 mg/kg has the potency intensity of reducing lung injury, almost equivalent to dexamethasone 0.5 mg/kg.

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    Time for preparing a mouse model of autoimmune premature ovarian failure
    Tian Haiqing, Zhang Yunian, Zhang Hejiang, Fan Yinglu, La Xiaolin
    2020, 24 (32):  5168-5172.  doi: 10.3969/j.issn.2095-4344.2866
    Abstract ( 440 )   PDF (718KB) ( 48 )   Save

    BACKGROUND: Studies have confirmed that anti-zona zona antibodies can accelerate the destruction and depletion of oocytes, thereby causing premature ovarian failure.

    OBJECTIVE: To investigate the time of establishing autoimmune premature ovarian failure model in BALB/c mice induced by zona pellucida 3 peptides.

    METHODS: Thirty healthy female BALB/c mice (7-8 weeks) were randomly divided into immune experimental group (20 mice) and the control group (10 mice). In the experimental group, the mice were given immunization injection starting at 0 week, 0.15 mL of immune reagent injected into the soles at both sides and the lower

    abdomen. The vaginal exfoliated cell smears were observed every morning to observe the changes in the estrous cycle of the mice. After 2 weeks of injection, 0.15 mL of immune enhancement agent was injected subcutaneously into the same site. On the first day of weeks 4 and 6, the immune agent or immune enhancement agent was injected alternatively. Blood samples were collected before each injection and the serum sex hormone level was measured by enzyme-linked immunosorbent assay. Finally, ovarian tissue and uterus morphology were observed.

    RESULTS AND CONCLUSION: There was no difference in serum follicle stimulating hormone and estrogen levels between the first immunization injection and 2 weeks after the injection. The serum estrogen level in the experimental group was significantly lower than that in the control group at 4 weeks after injection. The serum estrogen level of the experimental group was significantly lower than that of the control group at 6 weeks after injection (P < 0.05), and meanwhile the serum follicle stimulating hormone level was significantly higher than that of the control group (P < 0.01). The degree of ovarian interstitial fibrosis in the experimental group was more obvious than that in the control group. The ovarian volume decreased and the uterus atrophied in the experimental group. The number of primitive follicles, primary follicles and secondary follicles in mice was significantly lower in the experimental group than the control group, and the number of atresia follicles was significantly higher than the control group (P < 0.05). Therefore, 75 μg of zona pellucida 3 peptides can be used to establish an autoimmune premature ovarian failure disease model in BALB/c mice, and a good modelling effect can be achieved at 6 weeks after immunization.

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    Comparing tumor suspension injection and tissue explant to establish rabbit VX2 subcutaneous tumor model
    Liu Ya, Feng Shuang, Yi Cuo, Yu Yanlan, Liu Zheng
    2020, 24 (32):  5173-5178.  doi: 10.3969/j.issn.2095-4344.2867
    Abstract ( 423 )   PDF (462KB) ( 47 )   Save

    BACKGROUND: There are many methods to establish VX2 subcutaneous tumor model, and the existing modeling methods have their own advantages and disadvantages. To meet the needs of tumor experiments on animals, the method of establishing an animal tumor model with high-quality and high-efficiency is necessary.

    OBJECTIVE: To explore more simple and efficient way of modeling, provide rabbit VX2 subcutaneous tumor

    experiment with large quantities of high-quality animal models by comparing different methods to establish rabbit VX2 subcutaneous tumor model.

    METHODS: Sixty-six male New Zealand white rabbits were enrolled. Two of the 66 rabbits were used to prepare VX2 tumor-bearing rabbits, and tumor tissues were taken from the tumor-bearing rabbits to prepare tumor tissue blocks and tumor tissue suspensions. There were two groups in the experiment. In tumor tissue suspension group (n=20), the rabbits were injected with 0.15 mL of tissue suspension on the medial side of bilateral hind limbs after anesthesia; in tumor tissue block group (n=20), tumor tissue blocks were implanted subcutaneously on the medial side of bilateral hind limbs after anesthesia. Two tumor-bearing rabbits from each group were subjected to the corresponding vaccination methods, each passed for five generations. Tumor inoculation time in the two groups was record and compared. The tumor size and growth were observed by ultrasound with 2-D and CDFI mode. Tumor-take rate and serial passage of tumor tissues were observed and compared between the two groups. The experimental protocol was approved by the Animal Experiment Ethics Committee of the Army Medical University of PLA (approval No. AMUWE2020016)

    RESULTS AND CONCLUSION: The tumor inoculation time in the tissue suspension group [(75.70±11.16) s] was significant shortened compared with that in the tissue block group [(100.80±9.21) s; P=0.00]. The tumor-take rate was significantly higher in the tissue suspension group than the tissue block group (95% vs. 60%; P < 0.05). The tumor size was significantly larger in the tissue suspension group than the tissue block group (P < 0.05). The rate of tumor tissue series passage was significantly higher in the tissue suspension group than the tissue block group (95% vs. 65%; P < 0.05). Therefore, tissue suspension method for making the model of rabbit VX2 subcutaneous tumor is simpler and more efficient compared with the tissue block method.

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    Hippocampal astrocytes in juvenile rats with persistent epilepsy: the role of cannabinoid receptor type 2 in regulating MAPK pathway
    Cao Qingjun, Yang Fenghua, Wang Hua
    2020, 24 (32):  5179-5185.  doi: 10.3969/j.issn.2095-4344.2868
    Abstract ( 442 )   PDF (526KB) ( 57 )   Save

    BACKGROUND: Astrocyte proliferation is an important morphological change in epilepsy. Proliferated glial cells can produce cytokines, and in turn activates JAK/STAT signal transduction to promote glial cell proliferation, which affects the occurrence and recurrence of epilepsy. Astrocytes and signal transduction pathways interact with each other to play a role in the pathogenesis of epilepsy.

    OBJECTIVE: To investigate the effect of cannabinoid receptor type 2 (CB2R) on the activation of ERK, p38, and JNK proteins in astrocytes and MAPK pathways in juvenile rats with persistent epilepsy.

    METHODS: Forty healthy male Sprague-Dawley rats (18-21 days old) were randomly divided into four groups: normal control group, epilepsy model group, CB2R agonist JWH133 group, CB2R antagonist AM630 group. The normal control group was given only normal saline. In the other groups, rats were intraperitoneally injected with lithium chloride and pilocarpine to establish epilepsy models, and different interventions were performed. Twenty-four hours after the onset of epilepsy, brain tissues were taken. Co-expression of GFAP and p-ERK, p-p38, and p-JNK in hippocampal tissue was detected by immunofluorescence. Real-time PCR was used to detect the expression of GFAP mRNA in hippocampal tissue.

    RESULTS AND CONCLUSION: The co-expression of GFAP/p-ERK and GFAP/p-p38 was significantly higher in the epilepsy model group than the normal control group (P < 0.05), significantly lower in the JWH133 group than the epilepsy model group (P < 0.05), and significantly higher in the AM630 group than the JWH133 group (P < 0.05). The co-expression of GFAP/p-JNK was significantly lower in the epilepsy model group than in normal control group (P < 0.05), significantly higher in the JWH133 group than the epilepsy model group (P < 0.05), and significantly lower in the AM630 group than the JWH133 group (P < 0.05). The mRNA expression of GFAP was significantly decreased in the epilepsy model group compared with the normal control group (P < 0.05), significantly increased in the JWH133 group compared with the epilepsy model group (P < 0.05), and significantly reduced in the AM630 group compared with the JWH133 group (P < 0.05). Therefore, CB2R can regulate the expression of ERK, p38, JNK proteins in the MAPK pathway, thereby affecting astrocytes in the hippocampus of juvenile rats with persistent epilepsy.

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    Effect of chronic cerebral hypoperfusion on expression of Occludin and Claudin-2 in rat ileum mucosa
    Li Siyu, Wang Qingsong
    2020, 24 (32):  5186-5191.  doi: 10.3969/j.issn.2095-4344.2869
    Abstract ( 302 )   PDF (672KB) ( 102 )   Save

    BACKGROUND: Previous studies have found that chronic cerebral hypoperfusion can cause changes in the intestinal mucosal barrier in rats, and Occludin and Claudin are important components of the intestinal mucosal barrier.

    OBJECTIVE: To explore the effect of chronic cerebral hypoperfusion on the ileum mucosal barrier.

    METHODS: Twenty male Sprague-Dawley rats were randomly divided into sham operation (sham) group and chronic cerebral hypoperfusion model group. Animal model of chronic cerebral hypoperfusion was built by permanent bilateral common carotid artery ligation. The bilateral common carotid arteries of the sham group were isolated without ligation. The animals were killed at 4 weeks after operation, and their ileums were isolated for morphological observation and pathological scoring using hematoxylin-eosin staining. Apoptosis in the ileum cells was detected using TUNEL. Western blot was used to detect the expression of Claudin-2 and Occludin. immunohistochemical staining was used to detect the expression of Occludin. The study protocol was approved by the Animal Experiment Ethics Committee of General Hospital of Western Theater Command.

    RESULTS AND CONCLUSION: Compared with the sham group, hematoxylin-eosin staining showed that the ileum in the model group did not develop obvious injury with no higher pathological scores (P > 0.05). Western blot results indicated that compared with the sham group, the expression of claudin-2 was increased in the ileum tissue of the rats with chronic cerebral hypoperfusion, while the expression of Occludin was decreased (P < 0.05). TUNEL fluorescence staining showed that the apoptotic rate in the model group was significantly increased compared with the sham group (P < 0.05). Immunohistochemical results showed that the expression of Occludin in the ileum tissue of the chronic cerebral hypoperfusion group was significantly reduced (P < 0.05). These findings indicate that chronic cerebral hypoperfusion may damage the intestinal mucosal barrier by downregulating Occludin expression and upregulating Claudin-2 expression.

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    The competitive situation of liver tissue engineering based on patent analysis
    Wang Tingting, Zhang Ting, Xu Dongzi, Ouyang Zhaolian
    2020, 24 (32):  5192-5197.  doi: 10.3969/j.issn.2095-4344.2870
    Abstract ( 395 )   PDF (501KB) ( 63 )   Save

    BACKGROUND: China is a country with high incidence of liver disease. Liver tissue engineering, which is still in the stage of exploration, has brought a new hope for treatment.

    OBJECTIVE: To provide advices and references for the development and innovation of liver tissue

    engineering based on patent analysis.

    METHODS: The number and development tendency, as well as the technology birthplace, target market, applicants, inventors and technical fields of patents in the field of liver tissue engineering in nearly 20 years were analyzed in this study. The keywords for full-text search included tissue engineering, tissue regenerate/repair, and hepatic/liver. The retrieval deadline was December 28, 2018.

    RESULTS AND CONCLUSION: There is a rapid development in the field of the global liver tissue engineering. The compound growth rate in the past 10 years is 8.64%, of which invention patents account for 84.93%. China is the main technology birthplace; however, the number of tripartite patents of China is far less than that of the United States and Japan. China and the United States are the two most high-profile target markets in the field of liver tissue engineering, but the applicants are mostly from native instead of international. Meanwhile, there are 8 Chinese application institutions and 14 Chinese inventors ranking among the top 20 in the world in this field. In conclusion, liver tissue engineering has developed rapidly in China, but the lack of core technology is still an important issue. Therefore, we must improve our innovation capabilities and explore core technologies continuously to enhance our international competitiveness.

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    An analysis of pathogenic bacteria infection in 422 kidney transplant recipients
    Guo Juan, Zheng Shan, Xie Hui, Hu Yahui
    2020, 24 (32):  5198-5202.  doi: 10.3969/j.issn.2095-4344.2806
    Abstract ( 399 )   PDF (454KB) ( 43 )   Save

    BACKGROUND: In this study, we investigated the types and characteristics of bacterial infections in kidney transplant recipients, and analyzed the distribution of pathogenic bacteria for nosocomial infections and the changes in bacterial resistance after kidney transplantation, with the attempt to provide accurate and effective

    measures for prevention and treatment of bacterial infection and achieve the rational clinical use of antimicrobial drugs for kidney transplant recipients.

    OBJECTIVE: To investigate the epidemiological characteristics of nosocomial infection in renal transplant recipients.

    METHODS: A total of 422 patients with pathogenic bacteria infection after kidney transplantation in the Center of Kidney Transplantation, Zhengzhou People’s Hospital were investigated from August 2014 to August 2019, including specimen types, distribution of pathogenic bacteria and drug resistance of pathogens. The implementation of this study complied with the relevant ethical requirements of Zhengzhou People’s Hospital.

    RESULTS AND CONCLUSION: Positive specimens of pathogenic bacteria infection after kidney transplantation were from sputum, urine and peripheral blood mainly. Of the 422 strains of pathogenic bacteria, 274 strains (64.9%) were gram-negative, 75 strains (17.8%) were gram-positive and 73 strains (17.3%) were fungi. Among them, gram-negative bacteria were isolated from Klebsiella pneumoniae, Acinetobacter and Escherichia coli. Staphylococcus aureus, Enterococcus faecium and Staphylococcus epidermidis had higher isolation rate of gram-positive bacteria. The resistance rate of gram-negative bacteria to most antimicrobial agents was high. The gram-positive bacteria tested had different degrees of resistance to the other antimicrobial agents besides being completely sensitive to vancomycin, teicoplanin and linezolid. To conclude, gram-negative bacteria are the main pathogenic bacteria in kidney transplantation recipients. Most of the pathogenic bacteria are highly resistant to many antibiotics, and some of them have developed multiple resistance. We should strengthen the supervision of drug resistance of recipients after kidney transplantation and rationally use antibiotics.

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    Wnt/beta-catenin signaling pathway: multiple roles in osteosarcoma, bone remodeling and angiogenesis
    Liu Chang, Song Keguan
    2020, 24 (32):  5213-5220.  doi: 10.3969/j.issn.2095-4344.2871
    Abstract ( 391 )   PDF (647KB) ( 89 )   Save

    BACKGROUND: The Wnt/β-catenin signaling pathway plays a key role in osteosarcoma tumorigenesis and bone remodeling, and its roles in angiogenesis and immune surveillance are the two key mechanisms of metastatic dissemination.

    OBJECTIVE: To review the role of Wnt/β-catenin pathway in the occurrence and development of osteosarcoma and its regulatory role in specific microenvironment.

    METHODS: PubMed database was searched for relevant articles on the relationship between Wnt/β-catenin pathway and bone tumors using the search terms of “Wnt/β-catenin; bone tumors.” The search time for publications was from 2000 to 2020.

    RESULTS AND CONCLUSION: The typical Wnt/β-catenin signaling pathway plays an important role in the growth and metastasis of osteosarcoma by directly acting on osteosarcoma cells and indirectly regulating cell activity in osteosarcoma. The Wnt/β-catenin pathway also participates in the hijacking of the bone tumor microenvironment by osteosarcoma cells, promotes the regulation of extracellular matrix, makes the tumor cells invasive, induces immune tolerance and angiogenesis in tumor cells, and eventually augments metastatic spread. In addition, the typical Wnt signaling pathway abnormally activated in osteosarcoma cells seems to be closely related to cell proliferation, induction of epithelial-mesenchymal transition-like processes, acquisition of osteosarcoma-promoting tumor cell stem cell characteristics, and metastatic spread.

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    Recent advances and applications of Kartogenin in cartilage regeneration and repair
    Lu Junxu, Wang Yuanbo, Hu Yanuan, Yang Biaobing
    2020, 24 (32):  5221-5227.  doi: 10.3969/j.issn.2095-4344.2809
    Abstract ( 539 )   PDF (594KB) ( 58 )   Save

    BACKGROUND: Cartilage defects due to cartilage lesions such as osteoarthritis are difficult to

    self-regenerate. How to promote cartilage regeneration and restore smooth wound surface is a hot topic in recent years.

    OBJECTIVE: To review the general concept, mechanism and effect of Kartogenin as well as the current clinical models, providing new ideas for the regeneration and repair of damaged cartilage.

    METHODS: WanFang, CNKI, and PubMed were retrieved for studies on Kartogenin combined with tissue engineering in the field of cartilage regeneration and repair published from January 2010 to January 2020. The keywords were “Kartogenin, cartilage regeneration, chondrogenesis, chondroprotection” in English and “Kartogenin, cartilage regeneration and repair, cartilage protection, tissue engineering" in Chinese. After initial screening by reading titles and abstracts, irrelevant literature was excluded and finally 55 articles were included for result analysis according to the inclusion criteria and exclusion criteria.

    RESULTS AND CONCLUSION: As a newly discovered small molecule, Kartogenin has better stability, lower immunogenicity and easy availability. In addition, Kartogenin plays a synergistic role with growth factors in cartilage regeneration and has great potential in cartilage formation and cartilage protection. Through in vitro experiments or animal experiments, it has been proved that Kartogenin plays a positive role in promoting cartilage generation, osteoarthritis treatment, repair of tendon and bone injury, and wound healing, and helps to protect the degeneration of cartilage and healing of rotator cuff injury. With more basic research and clinical trials on Kartogenin, a breakthrough in cartilage regeneration and repair will be made in the near future.

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    Application and mechanism of virtual reality technology in post-stroke rehabilitation of the hemiplegic upper limb
    Cai Danxian, Zeng Qing, He Longlong, Huang Guozhi
    2020, 24 (32):  5228-5235.  doi: 10.3969/j.issn.2095-4344.2872
    Abstract ( 562 )   PDF (604KB) ( 338 )   Save

    BACKGROUND: Virtual reality is an important assistive technology of upper limb motor function rehabilitation in recent years. The possible mechanism has become one of the research hotspots in the field of neural rehabilitation.

    OBJECTIVE: To summarize the application status and possible mechanism of virtual reality technology in post-stroke functional rehabilitation of the hemiplegic upper limb, as well as its future development.

    METHODS: We searched the articles in PubMed, Web of Science, WanFang and CNKI with the keywords of “stroke; brain hemorrhage; brain infarction; virtual reality; upper limb; hand; motor function; rehabilitation; neurorehabilitation; mechanism” in English and Chinese, respectively. The search time was from June 2000 to December 2019. Eventually, 102 articles that met the criteria were recruited.

    RESULTS AND CONCLUSION: Combined with conventional rehabilitation, virtual reality can significantly improve the motor function of the hemiplegic upper limb in post-stroke patients, and do better in improving patients’ compliance and saving labor cost than conventional training. However, there is insufficient clinical evidence to prove that virtual reality training alone is superior to conventional rehabilitation. The training effect may be affected by different factors in different stages of post-stroke patients. Virtual reality training may activate sensorimotor center by visual feedback and achieve motor recovery through improving cortical reorganization. Due to the imperfection of current theoretical models, further researches are expected.

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    Semantic memory impairment and neuroregulation in patients with mild cognitive impairment
    Li Ying, Guan Hantian, Zhou Yu
    2020, 24 (32):  5236-5242.  doi: 10.3969/j.issn.2095-4344.2789
    Abstract ( 562 )   PDF (635KB) ( 474 )   Save

    BACKGROUND: Alzheimer’s disease is a progressive neurological degenerative disease characterized by cognitive decline. Cognitive decline can make the elderly gradually losing their self-care ability, which eventually affects daily life and activities. Mild cognitive impairment is a precursor state of Alzheimer’s disease, and to diagnose and treat mild cognitive impairment as soon as possible has great significance in preventing the development of Alzheimer’s disease.

    OBJECTIVE: To summarize the development and future prospects of the assessment and treatment of semantic memory disorders due to mild cognitive impairment.

    METHODS: A computer-based retrieval of PubMed, Web of Science, CNKI, and WanFang was performed for related studies on the evaluation and treatment of mild cognitive impairment in semantic memory. The keywords were “mild cognitive impairment, semantic memory impairment, semantic memory deficit” in English and Chinese, respectively. The retrieval time was from January 2009 to November 2019.

    RESULTS AND CONCLUSION: Semantic memory disorder is one of the main clinical symptoms of mild cognitive impairment, and has certain specificity. At present, there are different types of memory scales that can be used as neurophysiological measures of semantic memory disorder due to mild cognitive impairment. The temporal lobe, frontal lobe, and premotor region may participate in the semantic memory loop. Targeted semantic memory neurophysiology and auxiliary examinations, and targeted semantic memory rehabilitation training can be helpful for early identification of the occurrence and transformation of mild cognitive impairment.

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    Prospects for 3D printing in the treatment of cerebral aneurysm
    Zhang Yaochun, Zheng Lifang, Liu Rong
    2020, 24 (32):  5243-5248.  doi: 10.3969/j.issn.2095-4344.2712
    Abstract ( 339 )   PDF (608KB) ( 133 )   Save

    BACKGROUND: Interventional treatment can also be used as a palliative treatment for patients who cannot be surgically removed. However, the positioning of the lesion at the beginning of the operation or the catheter during the interventional treatment can only be accurately and clearly displayed through the two-dimensional image, and is related to the operator’s own experience and understanding of the image. The 3D printing model is a physical model with high simulation and individualized features, and has the advantages of individualization and precision in the medical field. It is currently widely used in orthopedics, oral and maxillofacial surgery, but the application in the treatment of craniocerebral aneurysms is rarely reported.

    OBJECTIVE: To summarize the classification and treatment status of cerebral aneurysms, and to prospect the application prospect of 3D printing technology in the treatment of cerebral aneurysms.

    METHODS: The authors retrieved CNKI, WanFang, PubMed, and EI database. The search terms were “cerebral aneurysm, clinical classification, treatment, 3D printing”. A total of 96 relevant literatures were retrieved, and 51 articles were summarized according to the inclusion and exclusion criteria. Specifically, it included the classification of cerebral aneurysms, craniotomy and interventional therapy, and the application status of 3D printing technology.

    RESULTS AND CONCLUSION: At present, the treatment methods of cerebral aneurysms commonly used in clinical practice have their own advantages and limitations. In this case, 3D visualization and 3D printing technology are proposed, which is an important supplement for the clinical treatment of patients with cerebral aneurysms. It can display organ anatomy and spatial structure more intuitively and accurately through operations such as enlargement, rotation and transparency. At the same time, it can accurately locate the aneurysm site, calculate the aneurysm size and volume, and define the aneurysm morphology. This is significant in preoperative diagnosis, planning of surgery, precise operation during surgery, and improvement of surgical success rate for the brain aneurysm. Simultaneously, the solid model of 3D printing is also widely used in the aspects of disease communication and training of resident surgical operations. By summarizing the research progress of 3D printing technology in the treatment of cerebral aneurysms, we have a clearer understanding of the application of 3D visualization and 3D printing technology. Whether it is combined with fluid mechanics for hemodynamic research or refined treatment based on existing treatment schemes, it has promoted the development of clinical research.

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    Chinese expert consensus on the diagnosis and treatment of postoperative brain injury in adult cardiac surgery
    Cerebral Protection in Cardiac Intensive Care Group, Neural Regeneration and Repair Committee, Chinese Research Hospital Association, Neural Intensive Nursing and Rehabilitation Group, Neural Regeneration and Repair Committee, Chinese Research Hospital Association
    2020, 24 (32):  5203-5212.  doi: 10.3969/j.issn.2095-4344.2808
    Abstract ( 447 )   PDF (635KB) ( 46 )   Save

    BACKGROUND: Brain injury, as a serious complication of adult cardiac surgery, has an increasing incidence, which is one of the most important factors leading to poor prognosis in cardiac surgery patients except for heart failure.

    OBJECTIVE: To establish the relevant standards for the diagnosis and treatment of postoperative complications so as to reduce the neurological complications, such as stroke, after cardiac surgery in adults.

    METHODS: To decrease the incidence of brain injury and reduce the neurological complications after cardiac surgery in adults, experts from cardiology and cardiosurgery, neurology and neurosurgery, intensive care unit, cardiopulmonary bypass, anesthesia and emergency have been organized to write the consensus by Cardiac Intensive Brain Care Group and Neurocritical Care and Rehabilitation Group which is belonging to the Neural Regeneration and Repair Committee of Chinese Association of Research Hospitals. Relevant domestic

    and foreign guidelines have been referred to, and also combined with the actual situation in China. The consensus was written based on manifestation, risk factors, non-drug protection strategies, intraoperative neuromonitoring, and drug protection strategies. The writing purpose of this consensus is to promote the rehabilitation of patients' cerebral nerve function. During this period, the draft has been discussed many times by the writing team before the final edition. We hope that it will be helpful to guide the clinical practice.

    RESULTS AND CONCLUSION: To reduce the incidence of brain injuries and neurological complications after cardiac surgery in adults, several personalized, patient-centric approaches are needed to manage those risk factors for alterable brain injury, including the prevention of intraoperative embolism, management of blood pressure, blood sugar and body temperature, and drug treatment for postoperative neuro-inflammatory reactions, with the aim of improving surgical effect and patients’ quality of life. However, high-quality, results-oriented, randomized controlled trials to further provide evidence for management strategies of brain injury are needed.

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