BACKGROUND:Previous studies have confirmed that drug-containing serum with low concentration of assemble flavone of rhizome drynaria (AFDR) promotes osteogentic differentiation of ciliary neurotrophic factor (CNTF)-modified myoblasts, but the underlying mechanism remains unclear.
OBJECTIVE:To observe the influence of mitogen-activated protein kinase (MAPK) inhibitor in the process of AFDR promoting the osteogentic differentiation of myoblasts.
METHODS:Transfected-CNTF myoblasts were preprocessed prior to osteogentic induction. Changes of alkaline phosphatase specific activities were detected in blank serum, AFDR drug serum and p38 pathway inhibitor SB203580 groups. mRNA and protein expression levels of core binding factor a1 and alkaline phosphatase were detected by real-time PCR and western blot, respectively.
RESULTS AND CONCLUSION:Real-time PCR showed that the mRNA expression levels of core binding factor a1 and alkaline phosphatase in the AFDR group were the highest;while p38 inhibitor SB203580 significantly downregulated the above levels. Western blot findings showed that a significant reduction in the protein expression levels of core binding factor a1 and alkaline phosphatase after p38 inhibitor SB203580 addition. These results suggest that p38 pathway inhibitor can downregulate osteogenesis-related gene and protein expressions, and thus AFDR promoting the osteogentic differentiation of CNTF-modified myoblasts probably through activating p38 MAPK signaling pathway.

【Objective】 To evaluate the application value of artificial intelligence mixed reality (AI-MR) technology in the planning of ultrasound-guided percutaneous nephrolithotomy (PCNL) for special types of complex upper urinary stones. 【Methods】 The prospective single-center, single-arm clinical study involved 15 patients with complex upper urinary stones undergoing ultrasound-guided PCNL during Aug.2022 and May 2023, including 9 male and 6 female, 3 cases of pelvic ectopic kidney stones, 5 cases of horseshoe kidney stones, 3 cases of renal stones combined with spinal deformity, and 4 cases of transplant kidney stones.Based on preoperative computed tomography urography (CTU) data, digital three-dimensional reconstruction was performed, and AI-MR was used to project surgery-related three-dimensional images in real space to obtain "perspective" information of the surgical area.This facilitated preoperative design and planning, including target calyx, number of channels, and auxiliary measures.The compliance of target calyx and number of channels, stone clearance rate, total operation time, time required to establish the percutaneous renal channel, decrease in hemoglobin level, surgical complications, and postoperative hospital stay were analyzed. 【Results】 All 15 patients underwent preoperative planning using AI-MR and successfully completed one-stage ultrasound-guided PCNL.Based on the preoperative planning, we utilized S-PCNL alone or combined with Needle-perc or antegrade/retrograde FURS/RIRS.Among all patients, 4 underwent single-channel S-PCNL, 3 multi-channel S-PCNL, and 8 S-PCNL combined with Needle-perc or FURS.The compliance of target calyx and number of channels was 86.7%, the one-stage stone clearance rate was 80.0%, the average time for establishing the channel was (2.3±0.3) minutes, the average total operation time was (61.5±12.2) minutes, the mean decrease in hemoglobin level was (9.6±1.2) g/L, and the average postoperative hospital stay was (4.6±0.5) days.There were no Clavien-Dindo grade ≥Ⅱ complications, such as blood transfusion, organ injury, or urosepsis. 【Conclusion】 Before surgery, AI-MR can be used to quantitatively analyze imaging data for patients with special types of complex upper urinary stones,which can achieve three-dimensional fluoroscopy effects, formulate surgical plans, optimize puncture paths, effectively avoid the risk of damage to surrounding organs, reduce complications, shorten treatment cycle and improve the first-stage stone clearance rate.