Objective To study the expression and its significance of bcl-2 associated death (bad) gene in human optic nerves from traumatic atrophic eyeballs. Methods The optic nerves from 8 normal human donor eyes and 31 traumatic atrophic eyes were studied by immunohistochemistry technique. Results Bad protein was positively expressed in the normal optic nerve myelin sheath and residual myelin portions of optic nerve tissues from traumatic atrophic eyes. The expression of bad protein in the residual portions of myelin sheath was stained significantly ber than that in normal optic nerves (P＜0.05)。The pathological durations for ocular atrophy was not co-related with the quantites of expression of bad protein. There was no significant difference between pathogenic causes of ocular atrophies and the quantites of bad expression (P＞0.05). Conclusion Bad might possess the function of promoting the optic nerve atrophy processes in traumatic atrophic eyes. (Chin J Ocul Fundus Dis, 2002, 18: 276-278)
Objective To assess the effectiveness and safety of laryngeal mask airway (LMA) and endotracheal tube (ETT) for airway management in pediatric general anesthesia. Methods Randomized controlled trials were collected through electronic searches of the PubMed, The Cochrane Library, EMbase, CBM, WanFang Data, VIP, CNKI from the date of establishment to November 2010. All the related data that matched the standards were abstracted by two reviewers independently. The quality of the included trials was evaluated according to the Cochrane Handbook 5.0. RevMan 5.0 software was used for meta-analysis of the complications, success of insertion on the first attempt and hemodynamic changes. Results A total of 39 trials involving 2 612 patients were included. The results of meta-analyses showed that LMA was superior to ETT in terms of less cough (RR=0.21, 95%CI 0.15 to 0.28, Plt;0.000 01), laryngospasm or bronchospasm (RR=0.37, 95%CI 0.18 to 0.77, P=0.008) and agitation (RR=0.14, 95%CI 0.09 to 0.22, Plt;0.000 01) during emergency. The incidence of postoperative sore throat (RR=0.32, 95%CI 0.19 to 0.55, Plt;0.000 1), hoarse voice (RR=0.09, 95%CI 0.03 to 0.27, Plt;0.000 1), nausea and vomiting (RR=0.46, 95%CI 0.26 to 0.80, P=0.006) was significantly lower in the LMA group. The hemodynamic changes during insertion and extraction of LMA were more stable than ETT, such as the heart rate changes in insertion, extraction and post-extraction period (SMD= –1.18, 95%CI –1.59 to –0.77, Plt;0.000 01; SMD= –1.29 95%CI –1.72 to –0.86, Plt;0.000 01; and SMD= –1.51 95%CI –2.15 to –0.87, Plt;0.000 01, respectively) and the MAP changes in insertion, extraction and post-extraction period (SMD= –1.21, 95%CI –1.39 to –1.02, Plt;0.000 01; SMD= –1.31, 95%CI –1.77 to –0.85, Plt;0.000 01; and SMD= –0.85, 95%CI –1.24 to –0.46, Plt;0.000 1, respectively); but no significant differences in postoperative regurgitation and aspiration (RR=3.00, 95%CI 0.62 to 14.61, P=0.17) and successful insertion on the first attempt (RR=0.99, 95%CI 0.94 to 1.05, P=0.84) were found between the LMA and ETT groups. Conclusion Current evidence indicates that the laryngeal mask airway is superior to endotracheal tube in terms of fewer complications during emergency and after operation as well as stable hemodynamic changes. So, it is a selective, safe and effective airway management for children.
ObjectiveTo study immunodepression effect of bone marrow-derived mesenchymal stem cell (BMSC) on acute asthmatic airway inflammation by galectin-1 (gal-1) in vivo.MethodsEighty-five female BALB/c mice were equally randomized into normal control group, asthmatic group, BMSC treatment group, gal-1 treatment group and BMSC and gal-1 inhibitor group. Ovalbumin (OVA) was used to establish acute asthmatic model. Total cell number and differential cell analysis in each group in bronchoalveolar lavage fluid (BALF) were determined. Furthermore, hematoxylin-eosin and periodic-acid Schiff staining was used to compare airway inflammation among five groups. Measurement of cytokines, including interleukin (IL) -4, IL-5 and gal-1 in BALF and OVA specific IgE (OVA-IgE) in serum were evaluated by enzyme linked immunosorbent assay. Moreover, dendritic cell (DC) in lung tissue was sorted by immunomagnetic beads and its MAPK signal pathway was analyzed by western blotting among five groups.ResultsAccumulation of inflammation cells, particularly eosinophils around airway and in BALF was evident in asthmatic mouse model, meanwhile hyperplasia of Goblet cell was also obvious in asthmatic group. BMSC engraftment or gal-1 infusion significantly reduced airway inflammation and hyperplasia of Goblet cell and the number of inflammation cells in BALF, especially eosinophils attenuated dramatically. However, there was no effect on airway inflammation and hyperplasia of Goblet Cell by simultaneous infusion BMSC engraftment and gal-1 inhibitor. Compared to normal control group, the level of IL-4, IL-5 in BALF and OVA-IgE in serum was increased remarkably in asthmatic group, but the level of gal-1 reduced obviously. Moreover, infusion of BMSC or gal-1 could mitigate the level of IL-4, IL-5 in BALF and OVA-IgE in serum and increase the level of gal-1 in asthmatic mouse. However, infusion with both BMSC and gal-1 inhibitor exerted no effect on cytokine and OVA-IgE in asthmatic mouse. DC was sorted by immunomagnetic beads and western blotting was used to detect the expression of MAPK signal pathway among five groups. The expression of ERK phosphorylation in asthmatic group was much lower than that in normal control group. On the contrary, the expression of p38 phosphorylation was much higher than that in normal control group. BMSC engraftment or gal-1 infusion significantly activated the ERK pathway and inhibited the p38 MARP pathway on asthmatic mouse DC. Nevertheless, the expression of ERK phosphorylation and p38 phosphorylation for group with BMSC and gal-1 inhibitor infusion was between the level of asthmatic group and normal control group.ConclusionsBMSC infusion alleviates airway inflammation in asthmatic mouse, especially weakens eosinophils infiltration, and the underlying mechanism might be protective effect of gal-1 secreted by BMSC which plays a role in lung tissue DC and regulates the DC expression of MAPK signal pathway.
ObjectiveTo explore the effects of concentrated growth factor (CGF) combined with mineralized collagen (MC) materials on the adhesion, proliferation, and differentiation of bone marrow mesenchymal stem cells (BMSCs) and their osteogenic effects in vivo, and to provide a theoretical basis for the combined application of CGF and MC materials in bone defect regeneration and repair.MethodsCGF was prepared from venous blood of healthy volunteers, and then CGF extracts (CGFe) were prepared. In vitro experiment: human BMSCs (hBMSCs) were divided into 4 groups. Groups A, B, and C were cultured with α-MEM medium [containing 10% fetal bovine serum (FBS) and 1% double antibody] containing 2%, 5%, and 10%CGFe, respectively; group D was cultured with α-MEM medium (containing 10%FBS and 1% double antibody) without CGFe. Scanning electron microscopy was used to observe the effect of CGFe on cell adhesion. Cell counting kit 8 (CCK-8) was used to detect the effect of CGFe on cell proliferation. After osteogenic induction, alkaline phosphatase (ALP) activity was detected and Western blot was performed to detect osteopontin (OPN) expression. In vivo experiment: Eighteen New Zealand big-eared rabbits were used to prepare circular bone defect models on the left and right mandibles, and implant CGF gel (prepared from autologous venous blood)+MC material (volume ratio 1∶1, experimental group) and simple MC material (control group), respectively. At 4, 8, and 12 weeks after operation, 6 rabbits were sacrificed respectively to obtain materials, and Micro-CT scanning was performed to observe the formation of new bone and material degradation in vivo.ResultsIn vitro experiments: Scanning electron microscopy showed that the cells of groups A, B, and C spread better on MC materials than group D, with more pseudopodia. CCK-8 method showed that different concentrations of CGFe could promote cell proliferation, and the absorbance (A) value of cells cultured for 2, 3, 5, and 7 days was in the order of group C>group B>group A>group D, the differences were significant (P<0.05). ALP activity test showed that its activity was proportional to the osteogenic induction time and CGFe concentration (P<0.05). Western blot analysis of osteogenic induction culture for 14 days showed that the relative expression of OPN protein in groups A, B, and C was significantly higher than that in group D, and the higher the CGFe concentration, the higher the relative expression of OPN protein (P<0.05). In vivo experiment: Micro-CT observation showed that the new bone formation and material degradation of the experimental group were better than those of the control group at 4, 8, and 12 weeks after operation. Quantitative detection showed that the volume of new bone volume, new bone volume fraction, trabeculae number, and trabecular thickness of the experimental group were significantly higher than those of the control group at each time point, the residual material volume, residual material volume fraction, and trabecular separation were significantly lower than those of the control group, all showing significant differences (P<0.05).ConclusionCGF can effectively promote the adhesion, proliferation, and osteogenic differentiation of BMSCs on MC materials, and 10%CGFe has the most significant effect. The combined application of CGF and MC material can significantly promote bone formation in vivo.
For refractory epilepsy requiring surgical treatment in clinic, precise preoperative positioning of the epileptogenic zone is the key to improving the success rate of clinical surgical treatment. Although the use of electrical stimulation to locate epileptogenic zone has been widely carried out in many medical centers, the preoperative implantation evaluation of stereoelectroencephalography (SEEG) and the interpretation of electrical stimulation induced EEG activity are still not perfect and rigorous. Especially, there are still technological limitations and unknown areas regarding electrode implantation mode, stimulation parameters design, and surgical prognosis correlation. In this paper, the clinical background, application status, technical progress and development trend of SEEG-based stereo-electric stimulation-induced cerebral electrical activity in the evaluation of refractory epilepsy are reviewed, and applications of this technology in clinical epileptogenic zone localization and cerebral cortical function evaluation are emphatically discussed. Additionally, the safety during both of high-frequency and low-frequency electrical stimulations which are commonly used in clinical evaluation of refractory epilepsy are also discussed.
Standardized residents training is a necessary way to cultivate qualified clinical physicians, and the teaching ability of their mentors will be a key factor affecting the quality of standardized residents training. In view of the problems existing in the current teachers training of standardized residents training, West China Hospital of Sichuan University has innovatively built a “coordination of six priorities” teachers training system to conduct hierarchical training for different types of mentors, in order to improve the quality and achieve homogenization of training. This article mainly elaborates on the problems in the current residents teachers training, the “coordination of six priorities” teachers training system of West China Hospital of Sichuan University, and the effect of the teachers training.
Objective To summarize the dynamic and synchronized changes between the hair cycle and dermal adipose tissue as well as the impact of dermal adipose tissue on hair growth, and to provide a new research idea for the clinical treatment of hair loss. MethodsAn extensive review of relevant literature both domestic and international was conducted, analyzing and summarizing the impact of dermal adipose precursor cells, mature dermal adipocytes, and the processes of adipogenesis in dermal adipose tissue on the transition of hair cycle phases. ResultsDermal adipose tissue is anatomically adjacent to hair follicles and closely related to the changes in the hair cycle. The proliferation and differentiation of dermal adipose precursor cells promote the transition of hair cycle from telogen to anagen, while mature adipocytes can accelerate the transition from anagen to catagen of the hair cycle by expressing signaling molecules, with adipogenesis in dermal adipose tissue and hair cycle transition signaling coexistence. ConclusionDermal adipose tissue affects the transition of the hair cycle and regulates hair growth by secreting various signaling molecules. However, the quantity and depth of existing literature are far from sufficient to fully elucidate its prominent role in regulating the hair cycle, and the specific regulatory mechanisms needs to be further studied.
ObjectiveTo systematically review studies investigating the rate of falls among Chinese elderly. MethodsThe CNKI, VIP, CBM, WanFang Data, EMbase, The Cochrane Library and PubMed databases were electronically searched to identify cross-sectional studies on the rate of falls in Chinese elderly published from January 1st, 2000 to December 31st, 2021. Two reviewers independently screened the literature, extracted data, and assessed the risk of bias of the included studies. Meta-analysis was then performed using Stata 16.0 software. Results A total of 54 cross-sectional studies, involving 111 098 cases were included. The results of meta-analysis showed that the rate of falls among Chinese elderly was 19.3% (95%CI 16.9% to 21.6%). Subgroup analyses showed that the fall rates were 16.1% and 21.9% for males and females, respectively. The rates for 60-69, 70-79, and >80 years age groups were 16.3%, 21.7%, and 27.3%, respectively. The rates for the North, South, East, Southwest, and Central parts of China were 16.6%, 17.9%, 18.7%, 22.0%, and 25.8%, respectively. For the urban and rural elderly, the rates were 16.4% and 23.1%, respectively. The rates for those with or without spouses were 24.2% and 26.8%, respectively, while for the solitary and non-solitary elderly were 21.1% and 17.8%, respectively. The rates for elderly with or without exercise habits were 22.1% and 27.1%, respectively. ConclusionThe rate of falls is high among Chinese elderly, especially among females, older individuals, those in Southwest China, rural individuals, those without spouse, solitary individuals and those without exercise habits.
Objective To summarize the research progress of scaphotrapeziotrapezoid osteoarthritis (STT OA) and its etiology and clinical treatment. Methods The domestic and foreign literature on STT OA in recent years was reviewed and the research progress was summarized. Results STT OA is a common OA, which is highly prevalent in postmenopausal women and diagnosed by wrist X-ray films. The current treatment methods include conservative treatment and surgery. Among them, the conservative treatment can relieve clinical symptoms, but the long-term effectiveness is not ideal. In surgical treatment, scaphoid arthrodesis can effectively relieve wrist pain, but it sacrifices part of the range of motion and grip strength of the wrist, and there is a risk of fusion failure. Distal scaphoid resection and trapezium resection have the advantages of short operation time, simple operation, less damage to the joint capsule and ligament, and shorter postoperative external fixation time, but they lead to changes in carpal bone alignment and dorsal intercalated segmental instability. Arthroplasty can provide pain relief while restoring grip strength and preserving wrist motion, but there is a risk of dislocation of the prosthesis. Conclusion At present, there is no gold standard for the STT OA treatment. The short-term effectiveness of arthroplasty and arthroscopic distal scaphoid resection are satisfactory, but the long-term effectiveness needs further study.
Objective To design customized titanium alloy lunate prosthesis, construct three-dimensional finite element model of wrist joint before and after replacement by finite element analysis, and observe the biomechanical changes of wrist joint after replacement, providing biomechanical basis for clinical application of prosthesis. Methods One fresh frozen human forearm was collected, and the maximum range of motions in flexion, extension, ulnar deviation, and radialis deviation tested by cortex motion capture system were 48.42°, 38.04°, 35.68°, and 26.41°, respectively. The wrist joint data was obtained by CT scan and imported into Mimics21.0 software and Magics21.0 software to construct a wrist joint three-dimensional model and design customized titanium alloy lunate prosthesis. Then Geomagic Studio 2017 software and Solidworks 2017 software were used to construct the three-dimensional finite element models of a normal wrist joint (normal model) and a wrist joint with lunate prosthesis after replacement (replacement model). The stress distribution and deformation of the wrist joint before and after replacement were analyzed for flexion at and 15°, 30°, 48.42°, extension at 15°, 30°, and 38.04°, ulnar deviation at 10°, 20°, and 35.68°, and radial deviation at 5°, 15°, and 26.41° by the ANSYS 17.0 finite element analysis software. And the stress distribution of lunate bone and lunate prosthesis were also observed. Results The three-dimensional finite element models of wrist joint before and after replacement were successfully constructed. At different range of motion of flexion, extension, ulnar deviation, and radial deviation, there were some differences in the number of nodes and units in the grid models. In the four directions of flexion, extension, ulnar deviation, and radial deviation, the maximum deformation of wrist joint in normal model and replacement model occurred in the radial side, and the values increased gradually with the increase of the range of motion. The maximum stress of the wrist joint increased gradually with the increase of the range of motion, and at maximum range of motion, the stress was concentrated on the proximal radius, showing an overall trend of moving from the radial wrist to the proximal radius. The maximum stress of normal lunate bone increased gradually with the increase of range of motion in different directions, and the stress position also changed. The maximum stress of lunate prosthesis was concentrated on the ulnar side of the prosthesis, which increased gradually with the increase of the range of motion in flexion, and decreased gradually with the increase of the range of motion in extension, ulnar deviation, and radialis deviation. The stress on prosthesis increased significantly when compared with that on normal lunate bone. Conclusion The customized titanium alloy lunate prosthesis does not change the wrist joint load transfer mode, which provided data support for the clinical application of the prosthesis.