Tendon injuries often need surgical treatment, which enables to repair the structure and stability of the tendons to a certain extent, whereas it is difficult to restore to their normal strength. The primary reason is that the natural healing ability of tendons is limited and the functions of the repaired tendons cannot be restored completely. As further researches on tendon healing are conducted, biological technology provides a novel orientation for tendon repair. One of the research hotspots of tendon repair currently is to facilitate tendon healing using biological auxiliaries, including tendon stem /progenitor cells(TSPCs) and growth factors. The authors review the research progress in mechanism of TSPCs and growth factors accelerating tendon healing in order to provide a reference for the biological treatment of tendon injuries.

Objective:To study the effect of microglia depletion combined with bone marrow mesenchymal stem cells (BMSC) transplantation for spinal cord injury (SCI) repair.Methods:GFP-BMSCs were cultured, identified and detected for expression levels of growth factors. The effects of BMSCs ondorsal root ganglion (DRG) axon outgrowth were observed by the co-culture of BMSCs with DRGs. Mice were depleted of microglia by administrating the colony stimulating factor 1 receptor (CSF1R) inhibitor PLX3397. The spinal cords of these microglia-depleted mice were subjected to crush injury. BMSCs were transplanted into SCI area after microglia depletion. Mice were randomly divided into control group (SCI+BMSCs) and experimental group (PLX3397+SCI+BMSCs). Mice were sacrificed at corresponding time points after transplantation for observing the survival of transplanted BMSCs and the repair of spinal cord. BMS score was used for evaluation of motor function recovery.Results:BMSCs secreted a large number of neurotrophic factors and promoted the growth of DRG axons when co-cultured with DRGs. Depletion of microglia significantly improved the survival of transplanted BMSCs. Compared with BMSCs transplantation alone, the combined treatments slightly but non-significantly reduced the area of the lesion ( t=2.141, P=0.065). Immunofluorescence staining showed that both BMSC transplantation alone and the combined treatments did not cause the corticospinalaxons across the lesion and into distal spinal cord. BMS scores were (1.20±0.45), (3.20±0.45), (3.80±0.45), (4.20±0.45), and (4.60±0.55) points in control group at 1, 7, 14, 21 and 28 d after injury. The experimental groups were(0.60±0.55), (3.00±0.71), (3.80±0.84), (4.20±0.84), and (4.40±0.89) points, respectively. Conclusion:Depletion of microglia improves the survival of transplanted cells, depletion of microglia combined with BMSC transplantation did not result in a significant reduction in lesion area. At the same time, the damaged CST axons were notregenerated. Thus, combining cell transplantation with axon-promoting strategy may be necessary for SCI repair.

Objective:To explore the clinical effectiveness of arthroscopic treatment of tibial eminence avulsion fracture by four-point fixation with suture anchors.Methods:A retrospective analysis was performed of the 58 patients with tibial eminence avulsion fracture who had been treated by the same group of surgeons using four-point fixation technique with suture anchors under arthroscopy at Department of Sports Medicine, The Affiliated Hospital to Qingdao University from January 2015 to December 2018. They were 33 males and 25 females, with an average age of 18.4 years (from 14 to 32 years). By the modified Meyers-McKeever classification, 15 fractures were type Ⅱ, 19 type Ⅲ and 24 type Ⅳ. Recorded and compared were knee Lysholm scores, International Knee Documentation Committee (IKDC) scores and tibial eminence height between preoperation and one year postoperation; recorded at the last follow-up were range of knee motion and results of Lachman and pivot-shift tests.Results:The 58 patients were followed up for a mean of 20.7 months (from 12 to 33 months). Bony union was achieved in all patients within 12 weeks after operation. In this cohort, the Lysholm score (85.2±4.9) and IKDC score (86.2±4.3) at one year postoperation were significantly higher than the preoperative values (43.2±5.2 and 51.2±4.9), and the post-operative tibial eminence height [(9.1±1.2) mm] was significantly lower than the preoperative value [(12.6±1.2) mm] (all P<0.05). The correlation coefficients between the tibial eminence height and the Lysholm & IKDC scores at one year postoperation were -0.16 and -0.17, respectively. The last follow-up showed a 132°±5° range of knee motion for all patients, a positive result of pivot-shift test (grade Ⅱ) for 3 and a positive result of Lachman test (grade Ⅰ) for 2. Conclusion:Arthroscopic treatment of tibial eminence avulsion fracture by four-point fixation with suture anchors can lead to satisfactory effectiveness, showing advantages of minimal invasion, anatomic reduction, reliable fixation, and little impact on the epiphysis plate.

OBJECTIVES: To evaluate the value of thrombospond in Type I domain-containing 7A (THSD7A) and M-type phospholipase A2 receptor (PLA2R) in primary membranous nephropathy (PMN) and to explore the relationship between their antibody levels and prognosis. METHODS: Renal tissues in 128 patients with membranous nephropathy in the Second Xiangya Hospital of Central South University were collected from February 2015 to August 2017, including 108 patients with primary membranous nephropathy (PMN group) and 20 patients with secondary membranous nephropathy (SMN) (SMN group). Indirect immunofluorescence method was used to detect the expression of PLA2R antigen in kidney tissues,and the glomerular expression of THSD7A antigen was examined by immunohistochemistry and indirect immunofluorescence. The serum levels of anti-PLA2R antibodies and THSD7A antibodies were also detected by ELISA. According to the results of PMN examination,the patients were also divided into a PLA2R-related membranous nephropathy group and a THSD7A-related membranous nephropathy group. RESULTS: The positive rate of PLA2R in the renal tissues in the PMN group was higher than that in the SMN group (78% in the PMN group, 35% in the SMN group, <0.01),while the positive rate of anti-PLA2R antibody in the PMN group was also higher than that in the SMN group (50% in the PMN group, 25% in the SMN group, <0.05).The serum level of anti-PLA2R antibody was positively correlated with 24 h urine protein (=0.254, <0.05) and negatively correlated with serum albumin (=-0.236, <0.05). The expression of THSD7A was positive in glomeruli in 7 cases of the PMN group (6%) by immuno-histochemistry, and which was positive in 1case of the SMN group (5%).The serum levels of anti-THSD7A antibody in the PMN group were higher than those in the SMN group [(0.49±0.26) pg/mL in the PMN group,(0.34±0.27) pg/mL in the SMN group, <0.05]. There was no difference in the clinical characteristics between the PLA2R-related membranous nephropathy group and the THSD7A-related membranous nephropathy group. CONCLUSIONS PLA2R and THSD7A are the target antigen of PMN, and the associated autoantibodies are helpful for the differential diagnosis of PMN. The anti-PLA2R antibody levels can reflect the severity of the disease and evaluate the effect of treatment. The incidence of THSD7A membranous nephropathy is low, and monitoring the serum anti-THSD7A antibody levels can assess patients' condition and predict disease outcome.
Autoantibodies ; Glomerulonephritis, Membranous ; Humans ; Immunohistochemistry ; Receptors, Phospholipase A2 ; Thrombospondins

Objective:To establish a scientific and systematic department rotation examination and evaluation system adapted to the development of Pulmonary and Critical Care Medicine according to the clinical needs and the actual situation of the hospital.Methods:The literature analysis method and Delphi method were adopted to determine the index system after two rounds of consultation. The weight of the index was determined by the method of optimal sequence diagram.Results:The positive coefficients of the two rounds of consulting experts were 100% and 95.65%. The average value of the authoritative coefficients of the two consulting groups was 0.85. And the coordination coefficients of the two rounds of expert consultations were 0.513 and 0.516 respectively. Finally, five first-level indicators and 14 second-level indicators were established.Conclusion:The enthusiasm and coordination coefficient of experts are good, and the results are credible. The established index system can be used for standardized residency training assessment of residents in Department of Pulmonary and Critical Care Medicine.

OBJECTIVE: To investigate the differentially expressed microRNAs(miRNAs) in human embryonic lung fibroblast MRC-5 cells stimulated by transforming growth factor-β1(TGF-β1) using microarray chip, and screen for key genes and signaling pathways of fibroblast trans-differentiation. METHODS: The miRNA expression gene chip dataset GSE43992 on TGF-β1 stimulated MRC-5 cells were downloaded from high-throughput Gene Expression Omnibus(GEO) database of National Center for Biotechnology Information of the United States. The R language Limma package was used to screen the differentially expressed miRNAs. Corresponding target genes were predicted by miRWalk database performed by Gene Ontology(GO) functional enrichment analysis and Kyoto Encyclopedia of Genes and Genomes(KEGG) signaling pathway enrichment analysis. The protein-protein interaction(PPI) network was constructed by the search tool for the Retrieval of Interacting Genes database. RESULTS: A total of five differentially expressed miRNAs were identified, including four up-regulated miRNAs and one down-regulated miRNA; and 42 corresponding differentially expressed target genes were predicted. GO analysis indicated that the target genes were significantly enriched in collagen catabolic process, extracellular matrix organization, membrane organization, collagen fibril organization, and cellular response to amino acid stimulus. The results of KEGG pathway analysis showed that the signaling pathways corresponding to miRNAs and target genes were mainly concentrated in 18 signaling pathways, that were mainly related to the age-ethnic signaling pathways and protein digestion and absorption miRNAs in tumors and diabetic complications. The core genes transfected into the myofibroblasts by the three fibroblasts screened by the PPI network were threonine kinase 1, estrogen receptor 1 and β-catenin. CONCLUSION: Five differentially expressed miRNAs, 42 target genes, 18 signaling pathways, and 3 core genes related to TGF-β1-induced MRC-5 cell trans-differentiation were screened. It can provide new reference for the treatment and research of many diseases including pneumoconiosis and pulmonary fibrosis.

Objective To find out whether NOTCH receptors can serve as direct downstream targets of transforming growth factor β(TGF-β)/Smad4 signaling in endothelial cells.Methods Real-time PCR and Western blotting were performed to verify whether the expression of notch1 and notch4 was regulated by TGF-β pathway.Luciferase reporter assay was employed to investigate how the promoter of notch1 and notch4 was regulated by TGF-β.Then, ChIP assay was used confirm whether the promoter of notch1 and notch4 physically interacted with SMAD protein.Results TGF-β1 and bone morphogenetic protein 4 (BMP4) treatment increased the expression of both notch1 and notch4 at the transcriptional level.In addition, SMAD4 was physically associated with the SMAD binding sites on the notch4 promoter, which was largely enhanced under the treatment of TGF-β1 and BMP4.Importantly, TGF-β1 and BMP4 failed to transactivate notch4 in the absence of endogenous SMAD4 or the SMAD binding regions on the notch4 promoter.Conclusion The expression of NOTCH receptor can be directly up-regulated by SMAD4-mediated TGF-β/BMP signaling in cerebrovascular endothelial cells.

Objective To explore the employment values and the related factors of the patients with schizophrenia in the rehabilitation stage .Methods A total of 158 patients with schizophrenia were selected from March 2013 to May 2015 in our hospital for treatment rehabilitation program and agreed to participate in this study, using relevant questionnaire investigation .Results The employment values evaluation score in patients was (2.73 ±0.97), and its main influencing factors were the patient′s age, culture level, illness experience level , duration, employment, employment expectation , the quality of life, sense of self respect , protector, we are looking forward to your support, expert support, daily life ability, shame, always persuade at a rate of 75.2%. Conclusions The overall employment values level of patients with schizophrenia is not high , but the patient′s values of employment can be improved from the patient′s employment expectation , quality of life, sense of self-respect, protector, friend support, expert support, activity of daily life, disease shame and other measures .

BACKGROUND:Bacterial biofilm is the main cause of the infection of the prosthesis.In vitro experiments confirmed that hypertonic sodium chloride and ethanol can apparently promote the formation of staphylococcal biofilms. There are no reports on the effects of ethanol and hypertonic environment surrounding the prosthesis on the formation of biofilms.
OBJECTIVE: To evaluate the effects of different environment factors surrounding the prosthesis on the growth of Staphylococcus epidermidis and bacterial biofilm formation after replacement.
METHODS: White rabbit models infected with Staphylococcus epidermidis on the prosthesis were established, and were randomly divided into hypertonic sodium chloride, ethanol and control groups (n=15). The bacteria were injected with 0.1 mL 4% sodium chloride and 4% ethanol into the knee of rabbits in the hypertonic sodium chloride and ethanol groups. The rabbits were injected with 0.1 mL 0.9% sodium chloride in the control group. Three rabbits were sacrificed at 2, 4, 6, 8 and 16 days after inoculated with bacteria. Synovial fluid, prosthesis and tissue surrounding infection were obtained. Bacterium was cultured to extract total RNA. The ica operon transcription levels were detected in the gene levels. Adhesion of bacteria on the surface of the prosthesis was observed using a scanning electron microscope. Tissues surrounding the prosthesis were observed using hematoxylin-eosin staining.
RESULTS AND CONCLUSION:Histological examination revealed that inflammatory cel infiltration was observed in al the rabbits at 4 days after injection. Colony formation was found at 16 days after injection. At 6 days after injection, inflammatory cel infiltration was observed in the ethanol and control groups. Scanning electron microscope showed that compared with the control group, the bacteria adhered to the prosthetic surface became more in the hypertonic sodium chloride and ethanol groups at 6, 8 and 16 days (P < 0.05). At 6, 8 and 16 days, the expression of icaA mRNA was significantly higher in the hypertonic sodium chloride and ethanol groups than in the control group (P < 0.05). These data showed that the environment factors could affect the growth of Staphylococcus epidermidis and bacterial biofilm formation.