BACKGROUND: There are numerous inducers used in inducing bone marrow mesenchymal stem cells (BMMSCs) differentiate into neuron-like cells, however, due to poisonous, most chemical inducers can not be used in human.OBJECTIVE: To investigate the effect of ligustrazine on differentiation of rat BMMSCs into neuron-like cells in vitro, and to search for the optimal inductive concentration.METHODS: After SD rats were anesthetized, bone marrow was obtained from the femoral and tibial bones, centrifuged, and the supernatant was discarded. The extracted cells were cultured in L-DMEM supplemented with 15% fetal bovine serum. The expression of CD44 and CD45 of the 5~(th) passage of BMMSCs were identified by immunocytochemical technique. Serum-free L-DMEM medium contains 1.00, 1.25 and 1.50 g/L ligustrazine concentrations were used to induce the 5~(th) passage of BMMSCs in vitro. Morphology changes of BMMSCs were observed under an inverted phase microscope. Expression of nestin, neuron-specific enolase and glial fibrillary acidic protein were identified by immunocytochemical technique, and the expression ratio of neuron-like cells' surface antigens induced by different concentrations of ligustrazine were compared.RESULTS AND CONCLUSION: ①Most primarily cultured BMMSCs adhered to the wall at 3 days after culture, which proliferated faster after passaged, and the 5~(th) passage of cells were mostly purified into BMMSCs, spread radially or vortex-likely. ②The 5~(th) passage of BMMSCs was positive expressed (98.02±0.81)% CD44, but negative for CD45. ③Neuron-like cells with prominence and bifurcation could be seen after induction. The immunocytochemical method showed that nestin and neuron-specific enolase in most induced cells were positive expressed, especially received a highest ration of neuron-specific enolase expressing in the induced group with 1.25 g/L concentration of ligustrazine. It revealed that ligustrazine can induce BMMSCs differentiated into neuron-like cells, and 1.25 g/L is the optimal inductive concentration.

OBJECTIVE: To investigate the in vivo possibility of osteogenesis and angiogenesis of tissue-engineered periosteum in rabbits.METHODS: The marrow mesenchymal stem cells (MSCs) derived from New Zealand rabbits were adhered to small intestinal submucosa (SIS) to fabricate the tissue-engineered periosteum. Totally 12 New Zealand rabbits were received critical bone defect in bilateral radii to prepare models. The tissue-engineered periosteum was randomly implanted in one side of bone defect,and the other side was treated by SIS. At 4 weeks after operation, the angiogenesis of tissue engineered bone was detected by Tetracycline fluorescence microscopy and formaldehyde-ink perfusion method; simultaneously, the new bone formation was firmed by haematoxylin-eosin staining.RESULTS: Animals showed normal daily behaviors and non-infection wounds healing. The gross observation showed that bone defects in the experimental side were bridged with newly formed bone; while the defects of the control side were remained empty.Tetracycline fluorescence microscopy and hisotological examination could confirm the new bone tissue formation in the experimental side. The ink staining in new bone specimens suggested that there were abundant of neovasculization in tissue-engineered bone.CONCLUSION: Tissue-engineered periosteum can form new bone in allogenic rabbits and can be vascularized by some inherent mechanism for new bone tissue survivor.

Animals ; Caenorhabditis elegans ; metabolism ; radiation effects ; Caenorhabditis elegans Proteins ; genetics ; metabolism ; Light ; Lysine ; analogs & derivatives ; genetics ; metabolism ; Promoter Regions, Genetic ; Protein Transport ; RNA, Transfer ; genetics ; metabolism ; Tumor Necrosis Factor Ligand Superfamily Member 14 ; metabolism

Objective To investigate the changes and their significance of glutamate-aspartate transporter (GLAST) and glutamate transporter-1 (GLT-1) expressions in glial cells following spinal cord injury (SCI) in adult rats.Methods Twenty-five healthy female adult SD rats were randomly divided into control group (5 rats) and experimental group (20 rats).The contusive spinal cord injury models were prepared at T10 segment in the rats in the experimental group according to the modified Allen's method.At days 1,3,7 and 14 following SCI,five rats were sacrificed by cardiac perfusion and the spinal cord segments adjacent to the epicenter of injury were obtained at each time point after the neurological function of hind limbs was assessed using the modified Tarlov scale.Changes of GLAST and GLT-1 expressions were detected semi-quantitatively using immunofluorescence and computer image analysis system (IPP 6.0).Results (1) Single immunofluorescence:Moderate GLAST expression was found in the control group.The GLAST expression was increased slightly at day 1 after SCI,decreased progressively at days 3 and 7 after SCI,and increased slightly at day 14 after SCI.The GLAST expression in experimental group was significantly lower than those in control group at days 3,7 and 14 after SCI (P ＜ 0.05).Moderate GLT-1 expression was detected in the control group.The expression of GLT-1 was increased slightly at day 1 after SCI,decreased to the lowest at day 3 after SCI,and increased slightly at days 7 and 14 after SCI.The GLT-1 expression in experimental group was significantly lower than those in control group at days 3,7 and 14 after SCI (P ＜0.05).(2) Double immunofluorescence:GLAST expression was found on astrocytes in the control group.The GLAST expression in experimental group was decreased at day 1 after SCI,further decreased progressively at days 3 and 7 after SCI,and started to recover at day 14 after SCI.The coexpressions of GLAST and glial fibrillary acidic protein (GFAP) in experimental group were significantly lower than those in the control group at days 3 and 7 after SCI (P ＜ 0.05).The expression of GLAST was found on microglial cells in the control group.The expression of GLAST in experimental group was increased obviously at day 1 after SCI and increased progressively at days 3-14 after SCI.The coexpressions of GLAST and OX-42 in experimental group were significantly than those in the control group at days 3,7 and 14 after SCI (P ＜ 0.05).(3) Double immunofluorescence:GLT-1 expression was found on astrocytes in the control group.The GLT-1 expression was decreased at day 1 after SCI,further decreased progressively at days 3 and 7 after SCI,and started to recover at day 14 after SCI.The coexpressions of GLT-1 and GFAP were significantly lower than those in the control group at days 3 and 7 after SCI (P ＜ 0.05).The GLT-1 expression was found on microglial cells in the control group.The GLT-1 expression was increased obviously at day 1 after SCI and increased progressively at days 3-14 after SCI.The coexpressions of GLT-1 and OX-42 were significantly higher than those in the control group at days 1,3,7 and 14 after SCI (P ＜ 0.05).Conclusion The glutamate transporters GLAST and GLT-1 show different expression patterns in astrocytes and microglia following SCI in rats,which may be correlated with the roles of different glial cells in repair of spinal cord injury.

Objective: To summarize the measures and experience of treatment in mass extremely severe burn patients. Methods: The clinical data and treatment of 8 extremely severe burn patients in August 2 Kunshan factory aluminum dust explosion accident who were admitted in the 100th Hospital of PLA on August 2nd, 2014, were retrospectively analyzed. There were 4 males and 4 females, aging 22-45 (34±7) years, with total burn area of 55%-98% [(89±15)%] total body surface area (TBSA) and full-thickness burn area of 45%-97% [(80±21)%] TBSA. All the 8 patients were accompanied with severe shock, inhalation injury, and blast injury. According to the requirements of former PLA General Logistics Department and Nanjing Military Command, a treatment team was set up including a special medical unit and a special care unit, with Chai Jiake from the First Affiliated Hospital of PLA General Hospital as the team leader, Zheng Qingyi from the 175th Hospital of PLA (the Affiliated Dongnan Hospital of Xiamen University) as the deputy leader, the 100th Hospital of PLA as the treatment base, and burn care, respiratory, nephrology, nursing specialists from the First Affiliated Hospital of PLA General Hospital, and the burn care experts and nursing staff from the 180th Hospital of PLA, 118th Hospital of PLA, 98th Hospital of PLA, and 175th Hospital of PLA, and nurses from the 85th Hospital of PLA, 455th Hospital of PLA, 101th Hospital of PLA, 113th Hospital of PLA as team members. Treatment strategies were adopted as unified coordination by the superior, unified responsibility of team leader, division of labor and cooperation between team members, and multidisciplinary cooperation led by department of burns. With exception of one patient who received deep vein catheterization before admission, the other 7 patients were treated with deep vein catheterization 0.5 to 3.0 hours after admission to correct hypovolemic shock as soon as possible. Eight patients received tracheotomy, and 7 patients were treated with mechanical ventilation by ventilator in protective ventilation strategy with low tide volume and low volume pressure to assist breathing. Fiberoptic bronchoscopy was done one to three times for all the 8 patients to confirm airway injuries and healing status. Escharectomy and Meek dermatoplasty in the extremities of all the 8 patients were performed 3 to 6 days after injury for the first time. Escharectomy, microskin grafting, and covering of large pieces of allogeneic skin on the trunks of 4 patients were performed 11 to 16 days after injury for the second time. The broad-spectrum antibiotics were uniformly used at first time of anti-infective therapy, and then the antibiotics species were adjusted in time. The balance of internal environment was maintained and the visceral functions were protected. One special care unit was on responsibility of only one patient. Psychological intervention was performed on admission. The rehabilitative treatment was started at early stage and in company with the whole treatment. Results: Acute renal injury occurred in 5 patients within 36 hours after injury and their renal function was restored to normal 4 days after injury due to active adjustment of fluid resuscitation program. No pulmonary complications, such as severe pulmonary infection and ventilator-associated pneumonia, occurred in the survived patients. One of the 8 patients died, and the other 7 patients were cured successfully. The wounds were basically healed in 2 patients in 26 or 27 days by 2 or 3 times of operation, and in 5 patients by 4 or 5 times of operation. The basic wound healing time was 26-64 (48±15) days for all the 7 patients. Conclusions Treatment strategies of unified coordination by the superior, unified responsibility of team leader, division of labor and cooperation between team members, and multidisciplinary cooperation led by department of burns are the bases to successful treatment. Correcting shock as soon as possible is the prerequisite and closing wound as soon as possible is the key to successful treatment. Comprehensive treatment measures, such as maintaining and regulating the function of viscera, improving the body immunity, and preventing and treating the complications, are the important components to successful treatment. It is emphasized that in the treatment of mass extremely severe burn patients, specialist burn treatment should always be in the dominant position, and other related disciplines may play a part in auxiliary function.

Objective:To analyze germline genetic testing in Chinese high-to very-high-risk non-metastatic prostate cancer patients.Methods:This study included 249 Chinese patients with high- to very-high-risk non-metastatic prostate cancer for germline genetic testing, in Fudan University Shanghai Cancer Center, West China Hospital and Cancer Center of Sun Yat-sen University, from January 2018 to December 2022. High risk and very-high risk are termed according to National Comprehensive Cancer Network (NCCN) Prostate Cancer Guideline (2022 V1). The mean age of the patients was (66.7±9.2) years old and median PSA level was 28.50 (ranging 2.43 - 1481.11) ng/ml. Within these 249 patients, 84 (33.7%) were T 1-2, 98 (39.3%) were T 3-4, while 67 (26.9%) were unclear in T stage. Additionally, 51 patients (20.5%) were classified into International Society of Urological Pathology(ISUP) grade group 1-3 group and 198 patients (79.5%) were in ISUP 4-5 group. Focusing on 16 genetic susceptibility genes for prostate cancer, we interpret the germline genetic testing data in accordance with the American College of Medical Genetics and Genomics and the Association for Molecular Pathology (ACMG/AMP) guideline, clarify the germline pathogenic mutation rate and elucidate the clinicopathological characteristics of germline pathogenic mutation carriers. Results:Among Chinese high-to very-high-risk non-metastatic prostate cancer patients, 7.2% (18/249) had germline pathogenic mutations. Patients with mutations had a significantly higher proportion of first-degree relatives with a history of malignancy than those without mutations (50% vs. 13%, P<0.001), but there was no difference in age of onset [(68.2±9.3)years vs. (66.6±9.2) years], PSA level (median: 40.68 ng/ml vs. 28.00 ng/ml), T stage [T 3-4: 38.9%(7/18)vs. 39.4%(91/231)] and ISUP grade [group 4-5: 88.9%(16/18) vs. 78.8%(182/231)]. Germline pathogenic mutations were observed in BRCA2 (7 patients, 38.9%), MSH2 (3 patients, 16.7%), PALB2 (2 patients, 11.1%), ATM (2 patients, 11.1%), RAD51C (1 patient, 5.6%), PMS2 (1 patient, 5.6%), MSH6 (1 patient, 5.6%) and HOXB13 (1 patient, 5.6%). By comparing with normal controls of East-Asian population, germline pathogenic mutations in BRCA2 ( OR=11.1, 95% CI 4.8-25.6, P<0.001) and MSH2 ( OR= 43.5, 95% CI 8.5-200.0, P<0.001) can significantly increase the risk of developing high- to very-high-risk prostate cancer in Chinese males. Conclusions:This study identified a germline pathogenic mutation rate of 7.2% in 249 Chinese patients with high- or very-high-risk non-metastatic prostate cancer. Carrying germline BRCA2 or MSH2 pathogenic mutations can significantly increase the risk of high- or very-high-risk prostate cancer in Chinese men.

Objective:To investigate the imaging and electrophysiological characteristics, surgical methods and efficacies of preschoolers with refractory temporal lobe epilepsy.Methods:A retrospective data study was conducted on 27 patients with refractory temporal lobe epilepsy accepted surgical treatment in our hospital from June 2014 to January 2019. By combined with clinical manifestations, preoperative epileptogenic zones were evaluated by imaging data, such as MR imaging, MR spectroscopy and positron emission tomography-CT, and interictal and ictal video-electroencephalogram (VEEG) data. During the surgery, cortical electroencephalography (ECoG) and deep electrode monitoring were used to monitor and locate the abnormal discharge areas to guide the surgical excision of epileptic zone. Engel grading was used to evaluate the efficacy after surgery.Results:All children had typical clinical manifestations of temporal lobe epilepsy; abnormal signal images were found in one side of the temporal lobe and the hippocampus in MR imaging; epileptic discharges were originated from one side frontotemporal region in interictal and ictal VEEG. Obviously persistent or paroxysmal spike waves, spike waves and slow spikes and spike composite waves were intraoperatively discovered by ECoG and depth electrode electroencephalography in the temporal lobe. All patients accepted standard anterior temporal lobectomy+lesion resection+peripheral abnormal discharge resection of the temporal lobe cortex; partial insular lobe was excised and frontal cortex was performed low power thermal coagulation in two patients. Follow-up was performed for 6 months; Engel grading I was reported in 22 patients (81.5%), Engel grading II in 3 patients (11.1%), and Engel grading III in 2 patients (7.4%).Conclusion:Early surgery and moderate extension of resection under intraoperative ECoG and deep electrode monitoring are the key factors to improve the surgical efficacy of preschoolers with refractory temporal lobe epilepsy.

Objective:To compare the efficacy and safety of low-dose and standard-dose radiotherapy (LD-RT vs. SD-RT) in the treatment of oropharyngeal cancer patients with positive human papillomavirus (HPV). Methods:All comparative studies of low-dose versus standard-dose radiotherapy in the treatment of HPV-positive oropharyngeal cancer were searched from PubMed, Web of Science, Cochrane Library, EMbase, Chinese Biomedical Literature Database (CBM), CNKI, Chongqing VIP, and Wanfang databases from January 1, 2000 to February 9, 2023. According to the inclusion and exclusion criteria, the data were strictly screened, and the RevMan 5.4 software was used for meta-analysis.Results:A total of 8 studies were included. The pooled results showed that the overall survival (OS) and progression-free survival (PFS) of patients in the LD-RT group were similar to those in the SD-RT group ( HR=0.83, 95% CI=0.59-1.18, P=0.31; HR=0.97, 95% CI=0.53-1.78, P=0.92), but the rate of percutaneous endoscopic gastrostomy (PEG) insertion was significantly reduced ( RR=0.45, 95% CI=0.28-0.72, P=0.001). Conclusion:LD-RT yields similar efficacy and lower rate of PEG insertion compared with SD-RT in HPV-positive oropharyngeal neoplasm patients.

Objective To observe the effect of in situ needle fenestration thoracic endovascular aortic repair(TEVAR)for treating aortic dissection(AD)involving aortic arch.Methods Data of 16 patients with AD involving aortic arch who underwent in situ needle fenestration TEVAR for reconstruction of aortic arch branches were retrospectively analyzed,and the number of fenestration,technical success rate and TEVAR related complications were recorded.Regular follow-up was conducted after TEVAR,the repair of dissection and the patency of fenestrated branch blood vessels were evaluated,the endoleak was assessed,and the survival of patients were recorded.Results The main aortic stent was successfully implanted in all 16 cases.Among them,4 received triple fenestration stent implantation in zones Z0,Z1 and Z2,6 received double fenestration stent implantation in zones Z1 and Z2,2 received double fenestration stent implantation in zones Z0 and Z1 and 4 received single fenestration stent implantation in zone Z2.The success rate of brachiocephalic trunk(BCT)fenestration was 83.33%(5/6).Left common carotid artery(LCCA)-right common carotid artery bypass was performed in 1 case without successful fenestration.The success rate of LCCA fenestration was 100%(12/12).The success rate of left subclavian artery(LSA)fenestration was 87.50%(14/16),2 cases with not successful fenestration were treated with axillar-axillary artery artificial vascular bypass.The technical success rate of intervention was 100%(16/16).Type Ⅰa endoleak occurred in 1 case during TEVAR process and improved after embolization with spring coil.One patient died of pericardial tamponade at the end of TEVAR.Fifteen patients were followed up for a median follow-up time of 20 months.During this period,transient ischemic attack and local small dissection at the proximal beginning of the main stent occurred each in 1 case,which improved after no special treatment.Type Ⅰ endoleak occurred in 1 case,type Ⅲ endoleak occurred in 2 cases,all improved after proximal fenestrated membrane stent implantation or spring coil embolization treatment.One case died of coronary heart disease.Conclusion In situ needle fenestration TEVAR was effective and safe for treating AD involving aortic arch.

[Abstract] Objective: To explore the mechanism of glucose transport protein-1(Glut-1) promoting the migration of osteosarcoma MG63 cells through Wnt/β-catenin pathway. Methods: RNA interference recombinant adenovirus targeting Glut-1 gene (Ad-Glut-siRNA) and control recombinant adenovirus (Ad-GFP) were constructed and transfected into MG63 cells to silence Glut-1 gene expression. The cell migration ability of Blank group, Ad-AFP group, Ad-Glut-siRNA group and AZD2858 (inhibitor of GSK-3) group were detected by Transwell chamber migration assay. Immunofluorescence assay was used to detect the expression of E-cadherin and vimentin in each group and the nuclear translocation of β-catenin. The expression of MMP-2 and MMP-9 in each group and FZD7, β-catenin, Dsh protein in Blank group, Ad-AFP group, Ad-Glut-siRNA group were detected by Western blotting assay. Results: The migration ability of MG63 cells was significantly decreased (P<0.05) after Glut-1 gene silencing, which was restored afterAZD2858 treatment (P <0.05). Compared with Blank group and Ad-GFP group, the E-cadherin level in MG63 cells in Ad-Glut-siRNA group was significantly increased (P<0.05), while the expressions of vimentin, MMP-2, MMP-9, FZD7, β-catenin and Dsh protein were significantly reduced (all P<0.05). Compared with Ad-Glut-siRNA group, E-cadherin expression of AZD2858 group was significantly reduced, while the expressions of vimentin, MMP-2, MMP-9 were significantly up-regulated (P<0.05). Conclusion: The high expression of Glut-1 gene is closely related to the invasion and metastasis of MG63 cells. The possible mechanism is that the high expression of Glut-1 leads to the activation of Wnt/β-catenin pathway, which leads to the decrease of EMT-related protein E-cadherin, and the increase of vimentin and MMP-2, MMP-9, and further promotes the migration of MG63 cells.