BACKGROUND: The biomechanical property(BP) of the bone is decided by its geometric structure and component material. Merely pursuing increase of the bone mineral density(BMD) might lead to deterioration of bone BP.However at present, some researohes on therapeutic action on osteoporosis emphasize excessively medical influence to BMD, and the change in the holistic BP of the bone in osteoporotic zone and its mechanism still need to investigate deeply.OBJECTIVE: To probe into the action and its mechanism of "the kidney tonifying compound of the Traditional Chinese Medical (TCM) "on BP of cortical bone in ovariectomized osteoporotic model rats.DESIGN: Completely randomized controlled experiment based on experimental animals.SETTING: Laboratory of Biomedical Engineering, Luoyang Hospital and Institute of Traditional Chinese Orthopedics and Traumatology in Henan Province.MATERIALS: The experiment was completed from November 2000 to July 2001 at Research Laboratory of Biomedical Engineering,Luoyang Institute of Traditional Chinese Orthopedics and Traumatology of Henan Province. The healthy Wistar female rats aged 10 months,weighing(350±20) g.METHODS: Fifty Whistar female rats aged 10 months were randomly divided into 5 groups: the normal, model, premarin-treated, xianling gubao-treated and migu capsule-treated with 10 in each group. The normal group was only given sham operation and the other four groups were ovariectomized. The rats after operation were fed normally for ninety days.Since the 91st day after operation,the rats had been given the medicines for 90 days and then killed. The thighbones were taken out,then BMD,femoral geometry sizes and BP were determined.MAIN OUTCOME MEASURES: ① The primary sequel was the comparison of the parameters of femoral BP. ② The secondary sequel was the changes in parameters of femoral geometric structure, area of cortical bone and BMD of every midsectional fomur.RESULTS: Femoral BP worsened significantly,its mechanical intensity reduced,its external diameter diminished,cortical bone area decreased and femoral BMD lowered in osteoporotic model rats. In comparison with the above,in "the kidney tonifying compound ofTCM " groups(migu capsule group and xianling gubao group) femoral BP raised significantly, its mechanical intensity advanced,its external diameter augmented,cortical bone area aggrandized and femoral BMD enhanced.CONCLUSION: "The kidney tonifying compound of TCM" can improve BP of the cortical bone(thighbone) in ovariectomized osteoporosis rats. Its primary mechanism of action is that the TCM compound prescription could enhance"the mechanism of biomechanical response and regulation"(MBRR) of macrostructure of cortical bone,consequently increase femoral external diameter,aggrandize cortical bone area and enhance BMD in ovariectomized rats.

Objective To cstimnate the diagnostic performance of computer tomography (CT) and magnetic resonance imaging (MRI) for detecting metastasis in pelvic lymph nodes with normal size in patients with bladder cancer.Methods hnaging of CT and MRI and clinical data of 118 patients who underwent radical cystectomy and pelvic lymphadenectomy were reviewed.The diagnostic efficacy of CT and MRI were analyzed when taking lymph nodes short axis diameter ≥0.3 cm and ≥ 1.0 cm respectively as diagnostic criterion of metastasis with corTelation of pathological results.Results 22.7％ (27/118) of patients were confirmed lymph nodes malignancies among 118 patients based on pathology.Totally 1 705 lymph nodes were detected in surgery and 119 of them were observed malignancy according to pathological presentation.The malignant nodes were mainly distributed in the perivesical (35.4％,41/119),internal iliac (12.6％,15/119),external iliac (30.3％,36/119),obturator region (21.0％,25/119) and presarcal region (1.7％,2/119).Imaging of CT and MRI showed that when taking nodes with ≥0.3 cm in maximum short-axis diameter (MSAD) as positive,the sensitivity (Se),specificity (Sp),and positive predictive values (PPV) were 16.0％,99.2％,54.2％ and 56.5％,99.2％,86.7％ respectively.While taking MSAD≥1.0 cm as malignant,the Se,Sp and PPV of CT and MRI were 6.2％,99.9％,83.3％ and 13％,100％,100％ respectively.When taking MSAD ≥0.3 cm as positive,the Se and PPV between CT and MR were statistically different(P ＜ 0.001 and P =0.036,respectively).When taking MSAD ≥ 1.0 cm as positive,there was no statistically difference (P =0.275 and 1.000,respectively).Conclusions The incidence of normal-sized lymph node metastasis was higher in patients with bladder cancer.At this phase the MRI evaluation was superior to that of CT.When the MSAD ≥ 1.0 cm,there was no significant difference between CT and MRI.

Objective:To explore the inhibitory effect of dihydroartemisinin (DHA ) on the growth of neuroblastoma cells,and to clarify the anti-tumor mechanism of DHA.Methods:The experiment was divided into blank control group and DHA groups (the final concentrations of DHA were 0.05, 0.50, 5.00 and 50.00μmol·L-1 ).The proliferation rates of neuroblastoma SH-SY5Y cells after treated with DHA were examined by MTT assay;the changes of cell cycle of SH-SY5Y cells after treated with DHA were examined by flow cytometry;the expression levels of cyclin D1 and caspase-3 proteins were detected by ELISA and Western blotting methods.Results:The proliferation of SH-SY5Y cells 24,48,and 72 h after treated with different concentrations of DHA were inhibited.Compared with blank control group,the proliferation rates of SH-SY5Y cells in 0.50,5.00 and 50.00μmol·L-1 DHA groups were significantly decreased (P<0.05 or P<0.01).The density of cells was decreased with the increasing of DHA concentration.Compared with blank control group,the percentage of SH-SY5Y cells at SubG1 phase in 50.00μmol·L-1 DHA group was increased (P<0.05),and the percentage of cells at G0/G1 phase was increased first then was decreased;otherwise, the percentages of cells at S and G2/M phase were decreased.Compared with blank control group,the expression level of cyclin D1 protein in 50.00μmol·L-1 DHA group was decreased (P<0.05),but the expression level of caspase-3 protein in 50.00μmol· L-1 DHA group was increased (P<0.05).Conclusion:DHA could inhibit the proliferation through arresting the cell cycle and inducing the apoptosis of neuroblastoma cells.

BACKGROUND:Due to the very limited ability of articular cartilage to repair itself,articular cartilage defects caused by natural degeneration or trauma often cannot be repaired on their own,which triggers or aggravates osteoarthritis and even leads to severe disability.Therefore,the repair treatment after articular cartilage injury has become an urgent clinical problem. OBJECTIVE:To summarize the hot research topics and development trends in the field of articular cartilage repair using bibliometric analysis. METHODS:Literature related to articular cartilage repair was searched from the Web of Science Core Collection from 2000 to 2023,and bibliometric and visualization analyses were carried out using VOSviewer,Citespeace and Bibliometrix R-package. RESULTS AND CONCLUSION:The annual publication volume in the field of articular cartilage repair shows an overall increasing trend,with the United States,China,and Germany being the top three countries in terms of publication volume,and the research institutions focus on universities and hospitals,with Harvard University,New York Hospital for Special Surgery,and Shanghai Jiao Tong University being the top three institutions in terms of publication volume.AMERICAN JOURNAL OF SPORTS MEDICINE is the journal that publishes the most research literature in the field,and BIOMATERIALS is the journal with the highest number of citations in the field."Injectable hydrogels for cartilage and bone tissue engineering"is the most cited document published in the last decade,and the author with the most publications is Madry Henning,an active author in the field.The active authors in this field have formed a number of stable research teams with each other,and the cooperation between different teams needs to be further strengthened.Intra-articular injections,high tibial osteotomies,hydrogels,drug delivery,inflammation,cartilage regeneration,and scaffolds are the current hot topics of research in this field,and the application of 3D printing technology,bio-inks,silk proteins,injectable hydrogels,and exosomes in articular cartilage repair may be the frontier of research in this field.Integrating various innovative technologies and methods for more effective,durable and functional cartilage tissue regeneration and repair,and facilitating the clinical translation of the relevant technologies and methods by conducting more high-quality clinical studies may be the future research trend in this field.

Objective:Objectives To investigate the predictive value of color Doppler flow imaging (CDFI) for the proteinuria following pyeloplasty for congenital ureteropelvic junction obstruction (UPJO) in children.Methods:We identified a series of 206 children with a mean age of (20.0±28.8) months (1-132 months), consisted of 171 males and 35 females, diagnosed with congenital UPJO accepted pyeloplasty from January 2014 to September 2018, the preoperative mean urinary Albumin/Creatinine Ratio (ACR) was (17.3±160.1) mg/mmol and the mean β2-microglobulin/Creatinine Ratio (β2-MG/Cr) was (135.6±383.8) μg/mmol, ultrasound showed a mean renal pelvis dilatation of (3.1±1.5) cm and a mean cortical thickness of (0.3±0.1) cm, and classified as grade Ⅰ-Ⅴ according to the blood flow distribution in renal by CDFI, these children were divided into three groups of increased, decreased and unchanged blood flow according to the postoperative CDFI within 1 week, the postoperative urinary protein and renal function indexes within 1 week and 2 years were retrospectively analysed among groups.Results:Within 1 week postoperatively, an increased, decreased and unchanged blood flow occurred in 113 (54.9%), 31(15.0%), 62(30.1%) children, respectively. Urinary ACR in above mentioned groups was (112.3±400.7), (16.1±29.3), (32.7±48.4) mg/mmol, β2-MG/Cr was (887.4±6061.0), (50.2±62.7), (51.9±57.8)μg/mmol, there were significant differences among groups ( P<0.01). Contralateral hydronephrosis occurred in 21(18.6%), 4(12.9%), 8(12.9%) children, urinary N-Acetyl-β-D-glucosaminidase (NAG) was (7.5±5.2), (7.0±5.4)、(5.7±4.5) U/L, these indexes showed no significant differences among groups. There was a positive correlation between the increased blood flow level and the decreased renal pelvis dilatation (Spearman’s correlation coefficient 0.2, P<0.01), ACR (Spearman’s correlation coefficient 0.4, P<0.01) and β2-MG/Cr (Spearman’s correlation coefficient 0.3, P<0.01). After a follow up of 2 years, 67 children were diagnosed with proteinuria in this series, 51 cases of them with an increased blood flow, which had significantly higher percentage than children with a decreased (4 cases, 12.9%) or unchanged blood flow (12 cases, 19.3%). Logistic multivariate analysis indicated that early postoperative (within 1 week) increased blood flow ( OR=1.9, 95% CI 1.5-2.6), contralateral hydronephrosis ( OR=2.2, 95% CI 1.1-4.8) and urinary NAG ( OR=1.1, 95% CI 1.0-1.1) were predictive of proteinuria, the increased blood flow was independent predictor of proteinuria (Ⅰ level increased: OR=1.9, 95% CI 1.5-2.6). Conclusions:The CDFI reveals good predictive value for the postoperative proteinuria, an early marked increased blood flow postoperatively indicated risk of proteinuria in the long term.

BACKGROUND: Accurate evaluation of lymph node metastasis in bladder cancer (BCa) is important for disease staging, treatment selection, and prognosis prediction. In this study, we aimed to evaluate the diagnostic accuracy of computed tomography (CT) and magnetic resonance imaging (MRI) for metastatic lymph nodes in BCa and establish criteria of imaging diagnosis. METHODS: We retrospectively assessed the imaging characteristics of 191 BCa patients who underwent radical cystectomy. The data regarding size, shape, density, and diffusion of the lymph nodes on CT and/or MRI were obtained and analyzed using Kruskal-Wallis test and χ test. The optimal cutoff value for the size of metastatic node was determined using the receiver operating characteristic (ROC) curve analysis. RESULTS: A total of 184 out of 3317 resected lymph nodes were diagnosed as metastatic lymph nodes. Among 82 imaging-detectable lymph nodes, 51 were confirmed to be positive for metastasis. The detection rate of metastatic nodes increased along with more advanced tumor stage (P < 0.001). Once the ratio of short- to long-axis diameter ≤ 0.4 or fatty hilum was observed in lymph nodes on imaging, it indicated non-metastases. Besides, lymph nodes with spiculate or obscure margin or necrosis indicated metastases. Furthermore, the short diameter of 6.8 mm was the optimal threshold to diagnose metastatic lymph node, with the area under ROC curve of 0.815. CONCLUSIONS The probability of metastatic nodes significantly increased with more advanced T stages. Once lymph nodes are detected on imaging, the characteristic signs should be paid attention to. The short diameter > 6.8 mm may indicate metastatic lymph nodes in BCa.
Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Lymph Node Excision ; Lymph Nodes ; pathology ; Lymphatic Metastasis ; diagnostic imaging ; pathology ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Neoplasm Staging ; Pelvic Neoplasms ; diagnostic imaging ; pathology ; secondary ; surgery ; Pelvis ; diagnostic imaging ; pathology ; Tomography, X-Ray Computed ; Urinary Bladder Neoplasms ; diagnostic imaging ; pathology ; surgery

Objective To summarize the characteristics and management of pregnancy complicated with aortic dissection, and to explore the reasonable diagnosis and treatment plan. Methods The clinical data of 10 patients of pregnancy complicated with aortic dissection in Wuhan Tongji Hospital from January 2011 to June 2017 were collected. Their age was 25.2 (21-29) years. Results In the 10 patients, the majority (8 patients) were primipara, and most of them were in the late stages of pregnancy (5 patients) and puerperal (4 patients). Among them, 1 patient had gestational hypertension, and the blood pressure of the left and right upper extremities was significantly abnormal (initial blood pressure: left upper limb blood pressure: 90/60 mm Hg, right upper limb blood pressure: 150/90 mm Hg). The major clinical manifestations were severe chest and back pain which happened suddenly, with D-dimmer and C-creative protein increased which may be associated with inflammatory reaction. All patients were diagnosed by thoracoabdominal aortic CTA, including 5 patients of Stanford type A dissection and 5 patients of Stanford type B dissection. In the 10 patients, 1 patient refused surgery and eventually died of aortic rupture with the death of fetus before birth. And the remaining 9 patients underwent surgical treatment, 3 patients of endovascular graft exclusion for thoracic aortic stent graft, 2 patients underwent Bentall operation, 1 patient with Bentall + total aortic arch replacement + vascular thoracic aortic stent graft, 1 patient with Bentall operation combined with endovascular graft exclusion for thoracic aortic stent graft, 1 patient with Bentall + coronary artery bypass grafting, 1 patient of thoracoabdominal aortic vascular replacement. Among them, 1 patient underwent endovascular graft exclusion for thoracic aortic stent graft died of severe postoperative infection, and the remaining 8 patients were discharged from hospital. Nine patients were single birth, among them 5 newborn patients had severe asphyxia, 4 patients had mild asphyxia. Finally, 3 neonates died of severe complications, and the remaining 6 survived. Conclusion The ratio of pregnancy with Stanford type A aortic dissection is far higher than in the general population, the possibility of fetal intrauterine asphyxia is larger, but through active and effective surgical and perioperative treatment, we can effectively save the life of mother and fetus.

BACKGROUND: LY01005 (Goserelin acetate sustained-release microsphere injection) is a modified gonadotropin-releasing hormone (GnRH) agonist injected monthly. This phase III trial study aimed to evaluated the efficacy and safety of LY01005 in Chinese patients with prostate cancer. METHODS: We conducted a randomized controlled, open-label, non-inferiority trial across 49 sites in China. This study included 290 patients with prostate cancer who received either LY01005 or goserelin implants every 28 days for three injections. The primary efficacy endpoints were the percentage of patients with testosterone suppression ≤50 ng/dL at day 29 and the cumulative probability of testosterone ≤50 ng/dL from day 29 to 85. Non-inferiority was prespecified at a margin of -10%. Secondary endpoints included significant castration (≤20 ng/dL), testosterone surge within 72 h following repeated dosing, and changes in luteinizing hormone, follicle-stimulating hormone, and prostate specific antigen levels. RESULTS: On day 29, in the LY01005 and goserelin implant groups, testosterone concentrations fell below medical-castration levels in 99.3% (142/143) and 100% (140/140) of patients, respectively, with a difference of -0.7% (95% confidence interval [CI], -3.9% to 2.0%) between the two groups. The cumulative probabilities of maintaining castration from days 29 to 85 were 99.3% and 97.8%, respectively, with a between-group difference of 1.5% (95% CI, -1.3% to 4.4%). Both results met the criterion for non-inferiority. Secondary endpoints were similar between groups. Both treatments were well-tolerated. LY01005 was associated with fewer injection-site reactions than the goserelin implant (0% vs . 1.4% [2/145]). CONCLUSION: LY01005 is as effective as goserelin implants in reducing testosterone to castration levels, with a similar safety profile. TRIAL REGISTRATION ClinicalTrials.gov, NCT04563936.
Humans ; Male ; Antineoplastic Agents, Hormonal/therapeutic use* ; East Asian People ; Gonadotropin-Releasing Hormone/agonists* ; Goserelin/therapeutic use* ; Prostate-Specific Antigen ; Prostatic Neoplasms/drug therapy* ; Testosterone