BACKGROUND:Current basic and clinical research have showed that increases in bone resorption and bone loss accur earlier after spinal cord injury (SCI) than disuse atrophy, revealing that other mechanisms are involved in the pathogenesis of the SCI-induced osteoporosis (SIO).
OBJECTIVE:To introduce the current lab and clinical research progress in SIO focusing on the functional changes of two major neurotransmitters in the spinal cord, including dopamine (DA), 5-hydroxytryptamine (5-HT) and their receptors, as well as their regulatory functions on bone metabolism, aiming at finding a new treatment strategy for SIO.
METHODS:A computer-based online search in PubMed and Embase databases was conducted for clinical and basic research related to SIO published from January 1967 to August 2016, using the keywords of“spinal cord injury;osteoporosis;dopamine;serotonin;5-hydroxytryptamine”in English. Irrelevant, poorly related and repetitive studies were excluded, and finally 41 eligible articles were included.
RESULTS AND CONCLUSION:DA and 5-HT are major neurotransmitters in the central nervous system, both involving in the regulation of bone remodeling. After SCI, loss of innervation and descending neurotransmitters especially DA, 5-HT and subsequent deregulation of their receptors are responsible for the onset of post-traumatic bone loss. The above research progress, in combination with the emerging clinical and lab investigations targeting 5-HT, DA and their receptors for improving neural functions after SCI, provides possible therapeutic pathways for SIO.

OBJECTIVE:To establish a method for the content determination of matrine,sophocarpine,emodin,rhein,chloro-genic acid,sarkosaponin a,aloe-emodin in Kuhuang injection.METHODS:UPLC-MS/MS was adopted. The determination was per-formed on Phenomenex Kenetix C18 column with mobile phase consisted of methanol-0.1% formic acid(gradient elution)at the flow rate of 0.5 mL/min. The column temperature was set at 20 ℃,and injector temperature was set at 10 ℃. The equilibrium time was 4 min and sample size was 5 μL. Ionization mode was electrospray ionization with spray voltage of 5500 V and -4500 V,at-omizing air pressure of 4.14×105 Pa,heater pressure of 4.48×105 Pa,curtain air of 1.72×105 Pa and ion source temperature of 600 ℃. The work mode was multiple reaction monitoring mode. RESULTS:The linear range were 1.25-80.0 ng/mL for matrine (r=0.9993),1.10-70.0 ng/mL for sophocarpine(r=0.9995),0.16-10.5 ng/mL for emodin(r=0.9993),2.61-168 ng/mL for rhe-in (r=0.9993),1.50-96.0 ng/mL for chlorogenic acid (r=0.9993),1.48-94.5 ng/mL for sarkosaponin a (r=0.9996) and 6.11-391 ng/mL for aloe-emodin(r=0.9991). The limits of quantification were 0.061,0.109,0.041,1.313,0.500,0.492,3.055 ng/mL,limits of detection were 0.025,0.054,0.016,0.656,0.150,0.148,1.528 ng/mL. RSDs of precision,stability and reproducibility tests were all no more than 3%. The recoveries of them were 95.45%-99.45%(RSD=1.43%,n=6),97.50%-101.00%(RSD=1.50%,n=6),95.67%-101.73%(RSD=2.85%,n=6),97.17%-100.57%(RSD=1.16%,n=6),95.19%-98.90%(RSD=1.71%, n=6),95.38%-103.85%(RSD=3.39%,n=6),95.50%-101.17%(RSD=1.20%,n=6),respectively. CONCLUSIONS:The method is simple,effective,accurate,reliable and suitable for simultaneous determination for 7 components in Kuhuang injection.

Objective Toanalyzethealterationsofplasmaglucocerebrosidase(GBA),protein phosphatase 2A (PP2A)and its degradation product ceramide in patients with ischemic stroke. Methods Atotalof45inpatientswithischemicstrokeattheDepartmentofNeurology,theAffiliated Hospital of Logistics College of the CAPF were enrolled from May to September 2013,and 45 age-and sex-matched healthy subjects at the Physical Examination Center collected at the same time period were used as a control group. Blood samples of the patients and healthy subjects were obtained,anticoagulated, and the plasma was separated. H50 protein chip and laser matrix-assisted laser desorption/ionization top of flymassspectrometrywereusedtotestthelevelsofplasmaceramide.Results TheplasmaGBAand PP2A activities in patients with ischemic stroke were significantly lower than those of the control group;the GBA activities of the ischemic stroke group and the control group were 2 . 4 ± 0 . 8 and 3 . 1 ± 1 . 4 U/L respectively. There was significant difference (P<0. 05);the PP2A activities of the two groups were 6. 5 ± 2. 8 and 14. 5 ± 4. 7 U/L respectively (P<0. 01). The relative level of the plasma ceramide in patients with ischemic stroke was 1. 9 ± 0. 7,and it was significantly lower than 12. 2 ± 5. 0 of the control group (P<0.01).Conclusion ThedecreasedlevelsofplasmaGBAandPP2Aactivitiesaswellasthe ceramide in patients with ischemic stroke suggested that the abnormal phosphorylation of synuclein in the blood of patients with stroke.

Objective Toanalyzethechangesofplasmaphosphorylatedα-synuclein(α-Syn)level andα-Synphosphorylationrateinpatientswithischemicstroke.Methods Theclinicaldataof45 patients with acute stroke admitted to the Department of Neurology,the Affiliated Hospital of Logistics University of People′s Armed Force Police from May 2013 to September 2013 were analyzed retrospectively, and the age and sex matched 45 healthy subjects were recruited as a control group at the same time. The plasma phosphorylatedα-Syn level was measured by a double-antibody sandwich enzyme-linked immunosorbent assay (ELISA),besides,the gene-recombinated α-Syn was added into plasma,and the phosphorylated α-Syn accountingforthetotalratioofα-Synwascalculated.Results Theplasmaphosphorylatedα-Synlevelof patients with ischemic stroke was significantly higher than that of the control group (0. 0472 ± 0.0042μmol/L vs. 0. 0312 ± 0. 0043μmol/L). The plasma α-Syn phosphorylation rate of patients with ischemic stroke was higher than that of the control group (0. 1170 ± 0. 0176 vs. 0. 0364 ± 0. 0098μmol/(100μmol ·h ). Receiver operating characteristic (ROC )curve analysis showed that the specificity and sensitivity of the plasma phosphorylatedα-Syn concentration changes in determining ischemic stroke were 0. 88 and 0. 81 respectively. The area under curve (AUC)was 0. 91 and the cut-off value was 0. 060 mol/L;AUC 95%confidence interval (CI)was 0. 889 to 0. 961;the specificity and sensitivity of the plasma α-Syn phosphorylation rate changes in determining ischemic stroke were 0. 84 and 0. 81 respectively,AUC was 0.90andthecut-offvaluewas0.055mol/L;AUC95%CIwas0.898to0.971.Conclusion Theplasma phosphorylated α-Syn level and plasma α-Syn phosphorylation rate in patients with ischemic stroke were higher than those of the normal control group.

Objective To investigate the characteristics of persisters isolated from the chronic infected patients and clarify the relationship between the infection time and persistence as well as antibiotic drugs,so as to provide scientific basis for clinical effective measures to prevent,control and treatment of persister-associated chronic infection.Methods The tolerant ability of the 41 persisters (4 strains of Escherichiacoli,23 strains of Klebsiellapneumoniae,8 strains of Pseudomonasaeruginosa and 6 strains of Staphylococcusaureus)under differet kind and concentration of antibiotics and nutritional deficiencies cindi-tions were detected.In addition,analysis of the homologous strains isolated from the same patients with different infection time was performed.Results The study found that with the increase of concentration of antibiotics,the proportion of persis-ters would gradually decrease.The tolerance ability of the same persister strain to different antibiotics was dissimilar,and different species persisters also had various tolerance ability to the same kind of antibiotics.Persisters were more able to withstand the lack of nutrition.What’s more,there is no significant difference between the resistant ability of the homolo-gous strains isolated from the same patients with different infection time (P>0.05).Conclusion Persisters have different a-bility to stand the kill of different kinds and concentration of antibiotics and they can even be completely removed when ex-posed to sufficiently high concentrations of antibiotic.

Objective To investigate the compatibility and room light' s influence on Kuhuang injection diluted by 5%glucose,10% glucose, and fructose for injection within 48 hours at room temperature. Methods Kuhuang injections( high or low dosage) were diluted by 3 solutions at room temperature and were divided into light-exposed group and light-screening group. Stability were then studied by changes of appearance, pH value, particulates, contents of matrine and sophocarpine in the solutions. Results The Kuhuang injection solution remained clear within 48 hours, showing no obvious turbidity, sedimentation or change of appearance ( deep yellow clear solution ) . The pH of the low concentration group with 10% glucose injection exposed to room light in creased significantly at 6 h,which was less stable than the light-screening group.The particulate content was acceptable according to regulation. The Kuhuang injection compatibility solution with fructose injection changed into weak acidic pH, and the particulate content did not meet regulation criteria in the high concentration group. The contents of matrine did not change, while the contents of sophocarpine decreased in each group.Sophocarpine seemed more stable in the light-screening group than in the light-exposed group. Conclusion The fructose injection was not suitable as the solvent for Kuhuang injection.The solutions are more stable if protected from light, and should be used as early as possible to reduce the degradation of some effective components.

Tumor-associated macrophages (TAMs) are the predominant immune cells in the tumor microenvironment (TME). They have been shown to play an important immunosuppressive role in the development of TME and promote tumor immune escape, growth and metastasis. It is a current research hotspot to regulate the functional polarization of TAMs through trained immunity (metabolic reprogramming, epigenetic remodeling) to affect the occurrence and development of tumors. Therefore, in-depth research in this field not only presents a more comprehensive perspective on the pathogenesis of immune-mediated diseases, but also can provide new strategies for clinical anti-tumor immunotherapy. This paper outlines the origin of TAMs and the phenotypes and mechanisms of TAMs polarization, discusses the mechanisms by which metabolic reprogramming and epigenetic remodeling regulate TAMs, summarizes the regulation of TAMs activation and polarization by them, and provides an overview of the progress in TAMs at the current stage of clinical practice, hoping to provide reference for the development of new immunoprevention and treatment strategies.

Objective To identify the main compositions of urinary calculi found in pediatric patients who had the history of exposing to infant formula milk powder contaminated with melamine and try to find out the urinary calculus formation mechanism in these patients.Methods Sixteen patients were studied.These infant patients with urinary calculi due to consumption of melamine tainted milk powder had been admitted to hospital from June,2008 to August,2008.The components of the urinary calculi were separated by liquid chromatograph,and identified by electrospray ionization mass spectrometry,electron bombard ionization mass spectrometry,Fourier transform infrared spectroscopy,and quantitatively determined by liquid chromatograph.Results The main chemical components of the urinary ealculi were melamine and uric acid.The molar ratio of uric acid tO melamine was 2:1.Conclusion The main urinary calculus formation mechanism in infant patients who exposed to the inrant formula milk powder contaminated with melamine is melamine and uric acid formed indissoluble complex.

Bone graft materials have mixed effects of bone repair in the field of oral maxillofacial surgery. The qualitative analyses performed by previous studies imply that autogenous odontogenic materials and autogenous bone have similar effects on bone repair in clinical jaw bone transplantation. This retrospective systematic assessment and network metaanalysis aimed to analyze the best effect of clinical application of autogenous odontogenic materials and autogenous, allogeneic, and xenogeneic bone grafts in bone defect repair. A systematic review was performed by searching the PubMed, Cochrane Library, and other journal databases using selected keywords and Medical Subject Headings search terms. 10 Papers (n = 466) that met the inclusion criteria were selected. The assessment of heterogeneity did not reveal any overall statistical difference or heterogeneity (P = 0.051 [ 0.05), whereas the comparison between autogenous and allogeneic bone grafts revealed local heterogeneity (P = 0.071 0.1). Risk of bias revealed nine unclear studies and one high-risk study. The overall consistency was good (P = 0.065 [ 0.05), and the local inconsistency test did not reveal any inconsistency. The publication bias was good. The confidence regarding the ranking of bone graft materials after GRADE classification was moderate. The effects on bone repair in the descending order were as follows: autogenous odontogenic materials, xenogeneic bone, autogenous bone, and allogeneic bone. This result indicates that the autogenous odontogenic materials displayed stronger effects on bone repair compared to other bone graft materials. Autogenous odontogenic materials have broad development prospects in oral maxillofacial surgery.

Objective: To analyze the failure patterns of locoregional recurrence (LRR) and investigate the range of radiotherapy in T_1-2N₁ breast cancer patients undergoing modified radical mastectomy. Methods: From September 1997 to April 2015, 2472 women with T_1-2N₁ breast cancer after modified radical mastectomy without neoadjuvant systemic therapy were treated in our hospital. 1898 patients who did not undergo adjuvant radiotherapy were included in this study. The distribution of accumulated LRR was analyzed. The LR and RR rates were estimated by the Kaplan-Meier method, and the prognostic factors were identified in univariate analyses with Log-rank test. Multivariate analysis was performed using Cox logistic regression analysis. Results: With a median follow-up of 71.3 months (range 1.1-194.6), 164 patients had LRR, including supraclavicular/infraclavicular lymph nodes in 106(65%), chest wall in 69(42%), axilla in 39(24%) and internal mammary lymph nodes (IMNs) in 19 patients (12%). In multivariate analysis, age (>45 years vs.≤45 years), tumor location (other quadrants vs. inner quadrant), T stage (T₁ vs. T₂), the number of positive axillary lymph nodes (1 vs. 2-3), hormone receptor status (positive vs. negative) were significant prognostic factors for both LR and RR. Conclusions In patients with T_1-2N₁ breast cancer after modified radical mastectomy, the most common LRR site is supraclavicular/infraclavicular nodal region, followed by chest wall. The axillary or IMN recurrence is rare. The prognostic factors for LR and RR are similar, which indicates that supraclavicular/infraclavicular and chest wall irradiation should be considered for postmastectomy radiotherapy.