BACKGROUND:Autophagy is the celular process of lysosomal pathway processing by endogenous substrates, which exists in the body cels and has been considered as type II programmed cel death. Autophagy may be a protective or balancing mechanism of normal chondrocytes. OBJECTIVE:To discuss the latest research progress in autophagy and cartilage damage aiming to better understanding the role of autophagy in cartilage damage and repair. METHODS:A computer-based search of CNKI, Wanfang database and PubMed database was performed for articles relevant to autophagy and cartilage damage published in recent 20 years with the key words of autophagy, cartilage, chondrocytes, beclin1, LC3 in Chinese and English. RESULTS AND CONCLUSION: Intra-articular chondrocytes can response to the changes in the microenvironment so as to adjust the extracelular matrix metabolism and maintain the biological function of articular cartilage. Hypoxic environment in which chondrocytes eixt is an important factor to causes autophagy. Autophagy is a normal balance or protection mechanism of chondrocytes. Studies on the correlation of autophagy with cartilage damage have made considerable progress in recent years, but stil in its infancy. Atg discovery at the molecular level deepens the understanding of autophagy, but the induction of cartilage autophagy pathway, signal transduction, and their effects on the survival of chondrocytes are not clear yet, which need further studies.

BACKGROUND:With deep understanding of the concept of biological fixation, more and more physicians choose interlocking intramedulary nail in the repair of femoral shaft fracture. Compared with traditional extramedulary plate, the superiority of the interlocking intramedulary nail has not been reported at present. Randomized controled clinical study is less, and lacks of systematic evaluation.
OBJECTIVE:The results of meta-analysis were used to compare the therapeutic effects of interlocking intramedulary nail and steel plate for femoral shaft fractures.
METHODS: We retrieved the MEDLINE, Embase, PubMed, Cochrane library, CNKI, Wanfang database, and Vip database from 2000 to 2015 by computer to colect randomized controled study on interlocking intramedulary nail and extramedulary plate for treatment of femoral shaft fractures. We screened the literatures that met the inclusion criteria, were strict quality evaluation of the selection. Excelent and good rate, operation time, intraoperative blood loss, hospitalization time, recovery time of knee joint function reaching 135°, knee joint function recovery time of the second operation to remove the internal fixation for reaching 135°, postoperative drainage volume, fracture healing time, nonunion or delayed union, internal fixation loosening, postoperative infection, and osteomyelitis were considered as the evaluation index of meta-analysis. Meta-analysis was performed with RevMan 5.2 software from the Cochrane Colaboration.
RESULTS AND CONCLUSION:Finaly 10 Chinese articles were included, including 915 patients with femoral shaft fractures. The results of meta-analysis showed that compared with extramedulary plate, interlocking intramedulary nails for femoral shaft fractures could effectively reduce the amount of blood loss, postoperative drainage, shorten operation time, hospitalization time, fracture healing time, reduce the incidence of postoperative infection, and obtain recovery of knee joint function. These results suggest that interlocking intramedulary nail for treating femoral shaft fractures has certain advantages. The interlocking intramedulary nail can be firstly selected in the permit of patient’s economic conditions and hospital conditions.

[Objective]To evaluate the effect of massive bioactive bone substitute in repairing large animals bone defect and to know its degrading rate.[Method]The massive Polylevolactic acid?collage calcium phosphate(PLLA?cTCP) carrieres by rapid forming technology was making,and then compounding rhBMP-2 and carrieres in a ratio of 3mg rhBMP-2 to one carrier was compounded to prepare the massive bioactive bone substitutes for dogs bone defect.Then the massive bone substitutes were implanted into 2.0cm dogss radius defects in the experiment group,and the massive carriers were implanted into in the control group.The repairing effect was evaluated by radiography,histology and biomechanics,and the degrading rate of the substitues was calculated in an image analysis apparatus.[Result]Radiographically,in the experiment group,the defects were connected by callus in all dogs in 12 weeks postoperatively;in 24 weeks,the callus rebuilt well.But in the control group,there was no callus formed in 24 weeks postoperatively,and the defects were not repaired.Histologically,in 12 weeks postoperatively,the outer layer of the callus in the experiment groups was lamellar bone and the center were trabecular bone,myeloid tissue and partial degrading carrier;in 24 weeks,the lamellar bone was more compact,trabecular bone decreased,myeloid tissue increased,and the carrier degraded more.In the control group,in 12 weeks postoperatively,the fibrous tissue wrapped and infiltrated into carrier,at the same time,part of the carrier degraded;in 24 weeks,the carrier was divided up by fibrous tissue and degraded more.The degrading rate of the carder in 12 weeks in the experiment group was 43.2%,in the control group was 35.7%,in 24 weeks 58.4% and 45.4%.Biomechanics,in 24 weeks after postoperation,the radius strength in the experiment group was superior to that in the normal bone.[Conclusion]The massive bioactive bone substitutes have satisfactory repairing effect on the radius bone defects of the large animal,but its degrading rate needs improving.

Mesenchymal stem cells (MSCs), which are regarded as the promising option of cell replacement therapy, are able to regulate immune response after tissue damage caused by traumatic brain injury (TBI). Secondary neuroinflammation following the mechanical injury is the essential factor of neural cell necrosis and apoptosis, even after the intracranial pressure has returned to normal. Their immune environments caused by neuroinflammtary response determine the outcome and long-term behavior function of TBI in survivors directly. MSCs modulate macrophage/microglia, drive them to polarize into alternative M2-like cells through releasing soluble cytokines, such as prostaglandin E2 (PGE2), tumor necrosis factor-stimulated gene 6 protein (TSG-6), IL-1 and TGF-β, which limits the progression of inflammation and maintain micro-environment stable. Meanwhile, macrophage/microglia exerts significant effects in MSCs survival, proliferation, differentiation and activation. It provides a novel approach as a practical anti-inflammatory therapy in clinical treatment.

Objective To investigate the effects of DNA methylation on the expression of lympho-cyte activation gene 3 (lag3) in different human T cell lines.Methods A quantitative PCR and a flow cy-tometry analysis were performed to measure the expression of lag3 gene in various T cell lines at mRNA and protein levels.The distribution of CpG sites within the promoter and body of lag3 gene was detected to locate the potential regulatory region(s) (CpG island and CpG island shore).The levels of DNA methylation in each cell line were analyzed.The T cell lines were demethylated with 5-Aza-2′-deoxycytidine (5-Aza-2′-dc) for further investigation on the changes of lag3 gene expression and DNA methylation.Results Jurkat E6-1 cells showed the highest expression level of lag3 gene as compared with J.CaM1.6 and CEM cells.Hyperm-ethylated CpG islands were detected in cells of each cell line.The methylation levels of CpG island shore in J.CaM1.6 and CEM cells were higher than that in Jurkat E6-1 cells.Treatment of J.CaM1.6 and CEM cells with 5-Aza-2′-dc significantly promoted the expression of lag3 gene at mRNA and protein levels as well as the demethylation of CpG island shore.No significant differences with the expression of lag3 gene and the methylation of CpG island were observed in Jurkat E6-1 cells with or without 5-Aza-2′-dc stimulation.Con-clusion Methylation and demethylation of CpG island shore played important roles in regulating the tran-scription of lag3 gene.

Objective To discuss the effect of mesenchymal stem cells (MSCs) in modulating immune responses in a rat renal transplantation model.Methods An in vivo trial of cytology was performed in one centre from March to December in 2008.Wistar rat donors and Lewis rat recipients in a renal transplantation model were randomly divided into 4 groups:MSCs (low dose,1 × 106 )therapy,MSCs (high dose,1 × 107) therapy,CsA monotherapy,and no therapy.Biochemistry methods were used to detect the levels of creatinine in serum.The survival time,renal grafting function and pathological changes of transplanted renal tissues were observed.Results Animal survival was significantly prolonged by MSCs (high dose) therapy and CsA monotherapy as compared with the no therapy group (both P＜0.01).Animal survival in the MSCs (low dose) therapy group was prolonged as compared with no therapy group (P＜0.01),but shortened as compared with MSCs (high dose) therapy group (P＜0.05) and CsA monotherapy group (P＜0.05).The MSCs (high dose) therapy and CsA therapy groups showed no special changes in histology,hut the control group showed acute rejection.Conclusion MSCs down-regulated immune responses,reduced production of some inflammatory mediators,preserved graft function in the initial stage after transplantation,and prolonged animal survival,and these effects were the same as those of CsA therapy with 1 × 107/day.

OBJECTIVEThis study aims to evaluate the influence of different bone types on the stress distribution in tooth implant-supported fixed partial prostheses by using finite element (FE) analysis.

METHODSFour FE models of mandibular arch containing one implant splinted to the mandibular second premolar were built according to bone types I, II, III, and IV. Dynamic loads of 250 N were applied to the buccal and lingual cusps of the prostheses in different directions to simulate the masticatory cycle. The maximum Von Mises stresses were calculated using the FE analysis software.

RESULTSThe maximum Von Mises stresses of the cortical bones were 89.229, 91.860, 125.840, and 158.420 MPa, increasing from type I to type IV, respectively. The maximum Von Mises stresses of the trabecular bone were 58.584, 43.645, 21.688, and 18.249 MPa, decreasing from type I to type IV, respectively. During the process of dynamic loading, the maximum Von Mises stresses of the cortical and trabecular bones followed the order buccal to tongue loading>tongue to buccal loading>vertical loading.

CONCLUSIONThe results showed that bone type significantly influenced the stress distribution in bones, and that for tooth implant-supported fixed partial prostheses, bone types I and II were a better choice than bone types III and IV. More caution should be exercised when restoring missing teeth using tooth implant-supported fixed partial prostheses in softer bone regions.

Bicuspid ; Bone and Bones ; chemistry ; Dental Implants ; Dental Prosthesis, Implant-Supported ; Dental Stress Analysis ; Denture, Partial, Fixed ; Finite Element Analysis ; Humans ; Stress, Mechanical

SUMMARY Herewereportedapatientwithwarfarin-inducedautoimmunehepatitis(AIH),andex-plored new concerns for the pharmaceutical care of warfarin.A 57-year-old woman was admitted to hospi-tal for repeated anorexia,abdominal pain and abnormal liver function.She received prosthetic heart valve replacement because of rheumatic heart disease,and had started warfarin medication since 2 years before.Her liver function was elevated with highest alanine aminotransferase 861 U/L, aspertate aminotransferase 604 U/L,and total bilirubin 1 06.7 μmol/L.Her anticoagulant therapy was switched to low molecular weight heparin and the liver function returned to normal.The liver function was elevated when she started to take warfarin again.The patient was then on liver protection therapy,and warfarin was stopped again for the liver biopsy for diagnosis reason.Through medication consultation and evalua-tion,pharmacists were invited to work together with the physicians and helped to differentiate the reason for abnormal liver function, and provided therapeutic suggestions. Also the pharmacists gained experiences in the treatment of AIH,and discovered a new and severe adverse drug reaction for warfarin. In treating this case,the pharmacists’active involvement into the treatment and evaluation of the effect on the patient reflected the advantage and importance of the multidisciplinary cooperation for pharmacists and physicians when complex diseases are faced.

BACKGROUND:At present, a large number of studies have confirmed that reconstruction plate compared to Kirschner wire in the treatment of clavicular fracture showed good effects, but there is no precise report on the specific advantages at present. Clinical randomized controled study is less, and lacks of systematic evaluation. OBJECTIVE:To systematicaly evaluate the efficacy and safety of the treatment of the clavicle fractures with the reconstruction plate and the Kirschner wire by using a meta-analysis. METHODS: We retrieved the MEDLINE, Embase, PubMed, Cochrane library, CNKI, Wanfang database and VIP database from 2008 to 2015 by computer to colect al controled study relevant to reconstruction plate and Kirschner wire in the treatment of clavicle fracture, and screened the literatures that met the inclusion criteria. Al literatures were analyzed in strict quality evaluation. Excelent rate, delayed healing of incision, malunion, postoperative infection, loosening of internal fixation, postoperative fracture displacement, operation time, intraoperative bleeding volume and fracture healing time were selected as the evaluation indexes of a meta-analysis. Meta-analysis was performed with RevMan 5.2 software from the Cochrane Colaboration. RESULTS AND CONCLUSION:Finaly 12 Chinese articles published from 2008 to 2014 were included, with 911 patients. Meta-analysis results showed that compared with Kirschner wire, the reconstruction plate has a certain advantage in improving the excelent and good rate, shortening the delayed wound healing and reducing deformity healing, reducing postoperative infection, preventing the loosening of internal fixation and avoiding postoperative fracture displacement. However, the two surgical methods in the treatment of clavicular fracture were not significant in operation time, intraoperative blood loss and fracture healing time. These results suggest that compared with the Kirschner wire, reconstruction plate fixation for treatment of clavicular fracture had better curative effect. The reconstruction plate can be firstly selected in the permit of patient economic conditions and hospital conditions. Due to the limited sample size in this study, the multicenter, large-sample and long-term clinical randomized controled studies with more strict design are needed to increase the reliability of the evidence.

BACKGROUND:Now a lot of studies have confirmed that in contrast with the dynamic hip screw, the proximal femoral nail anti-rotation has a better therapeutic effect on the treatment of intertrochanteric fractures in the elderly, but there is no definite conclusion on the specific superiority at present. OBJECTIVE:To compare the curative effects of proximal femoral nail anti-rotation and dynamic hip screw in repair of intertrochanteric fracture using a meta-analysis. METHODS: We searched VIP database, Wanfang database, PubMed database and Embase database from 2011 to 2015, and colected randomized controled trials on proximal femoral nail anti-rotation and dynamic hip screw in repair of intertrochanteric fracture. Operation time, intraoperative blood loss, hospital stays, fracture healing time, Harris score, length of incision, bed time walking after the operation were used as evaluation indexes of meta analysis. Data were analyzed using RevMan 5.3 software. RESULTS AND CONCLUSION:In the end, we used 9 literatures, which contained 858 patients of intertrochanteric fractures in the elderly. The time of publication was from 2011 to 2015, and al of them were published in Chinese. The results of Meta-analysis showed that, compared with dynamic hip screw, proximal femoral nail anti-rotation in the treatment of intertrochanteric fractures in the elderly could effectively reduce operation time, blood loss, hospital stays, fracture healing time, length of incision and the time of walking after the operation was earlier, and it could obtain better recovery of hip function. We can point out that compared with dynamic hip screw, proximal femoral nail anti-rotation has certain advantages in the treatment of intertrochanteric fractures in the elderly. In some conditions, the patients and the hospitals can give priority to choose the proximal femoral nail anti-rotation in the treatment of intertrochanteric fractures in the elderly.