Objective To develop a new method, the bone marrow stromal cells (BMSCs)-mediated tissue engineering technique combined with mosaicplasty, for repair of osteochondral defects and integration of gaps. Methods BMSCs from 12 Chinese goats were cultured and proliferated in vitro. Prior to the BMSCs harvest, osteochondral defects, 5 mm in diameter and 3 mm in depth, were created in the femoral medial condyles of both the goat's hind limbs. When the mosaicplasty (osteochondral autograft transplantation) was performed, the BMSCs, which had been harvested and compounded with hyaluronic acid, were injected into the gaps between the osteochondral autografts in the left hind limb. The right hind limb which only received osteochondral autograft transplantation without BMSCs served as a control. At four, eight and 16 weeks post-operatively, samples of the repaired defects were harvested and assessed by histological evaluation, immunohistochemical analysis and glycosaminoglycan (GAG) quantification. In both groups 16 weeks post-operatively, the GAG quantification was analyzed by one-way ANOVA and least significant difference (LSD) method. Results At all the time points, the cartilage autografts in both groups survived as hyaline cartilage and presented no significant difference from the surrounding native cartilage. In the group filled with BMSCs compound, the gaps were replaced by regenerated hyaline cartilage and disappeared; however, in the control group, the osteochondral autografts were still distinct from the surrounding normal cartilage, though the gaps were replaced by fibrous tissue or fibrous cartilage. Immunohistochemical analysis of typeⅡcollagen showed positive staining in the matrix of transplanted and regenerated cartilage. The Alcian blue method also confirmed a significantly less GAG content in the regenerated tissue in gaps in the control group than in the treatment group and in the normal cartilage. Conclusion Since tissue engineering combined with mosaicplasty can promote gap integration and cartilage healing, the method can be an ideal way for osteochondral defect repair.

Objective To evaluate the value of ultrasound in diagnosing congenital digestive tract abnormalities and abdominal wall defects.Methods The OB ultrasound examinations of 136 cases with digestive tract abnormalities and 41 cases of abdominal wall defects were analyzed , those cases came from Alta Bates Perinatal Diagnostic center , Oakland, California USA during 5 years recently.Results In 136 cases of digestive tract abnormalities, 9 cases were esophageal atresia, 19 cases were duodenal atresia, 12 cases were jejunal atresia, 68 cases were echogenic bowel, 19 cases were meconium peritonitis, 9 cases were diaphragmatic hernia. In 41 cases of abdominal wall defects, 11 cases were gastroschisis, 18 cases were omphalocele, 12 cases were amniotic band syndrome. Each type had its special image feature,which is correlated to errors in embryonic developments. Conclusion Many digestive tract abnormalities and abdominal wall defects can be readily detected and diagnosed by ultrasound . Ultrasound is valuable in diagnosing fetal congenital digestive tract abnormalities and abdominal wall defects.

INTRODUCTIONA few electrocardiographic criteria have been described to identify the infarct-related artery in inferior myocardial infarction. The aim of this study was to devise an arithmetic score to further improve the diagnostic accuracy.

MATERIALS AND METHODSFrom 2004 to 2006, 78 patients who underwent primary angioplasty for inferior myocardial infarction within 6 hours from symptom onset were recruited for electrocardiographic and angiographic analysis.

RESULTSThe mean age of patients was 65 ± 12 years with male predominance (74%). Less ST depression in lead I and aVL, and more prominent ST depression in lead V1-3 were observed in left circumflex artery (LCX) than right coronary artery (RCA) occlusions. In addition, more prominent ST depression in lead I and ST elevation in V1 were found in proximal RCA than distal RCA occlusions. Based on the findings, the Jeopardised Inferior Myocardium (JIM) score was constructed and defi ned as [II-V3/III+V1- I]. The sensitivity and specificity of JIM score ≤0.5 to predict proximal RCA occlusions; 0.5 <JIM score ≤1.5 to predict distal RCA occlusions; and JIM score >1.5 to predict LCX occlusions were 58% and 85%, 69% and 68%, and 79% and 94%, respectively. The accuracy of prediction is slightly better than the 2 previously reported criteria.

CONCLUSIONBy taking into account more leads, the JIM score is capable of identifying the infarct-related artery with an improved diagnostic accuracy.

Aged ; Algorithms ; Coronary Angiography ; Coronary Occlusion ; diagnosis ; Coronary Vessels ; pathology ; Electrocardiography ; methods ; Female ; Humans ; Inferior Wall Myocardial Infarction ; diagnosis ; Male ; Middle Aged ; Predictive Value of Tests ; Sensitivity and Specificity

INTRODUCTION: Polypharmacy and inappropriate prescribing are associated with negative health outcomes in the elderly. Several prescribing tools have been developed to assess medication appropriateness. Explicit (criteria-based) tools often do not take into account patients' preferences and comorbidities, and have little room for individualised clinical judgement. METHODS: A cross-sectional observational study was conducted in 243 elderly patients admitted to the Geriatric Medicine service in a Singapore tertiary hospital over one month. We incorporated an implicit (judgement-based) tool developed by Scott et al into a mnemonic, 'S-I-R-E', to assess medication appropriateness: S = symptoms ('Have symptoms resolved?'), I = indication ('Is there a valid indication?'), R = risks ('Do risks outweigh benefits?') and E = end of life ('Is there short life expectancy limiting clinical benefit?'). RESULTS: Inappropriate prescribing was present in 27.6% of patients. The most common reason for inappropriateness of medications was lack of valid indication (62.2%), followed by high risk-benefit ratio (20.7%). The most common medications that lacked valid indication were supplements and proton pump inhibitors. Polypharmacy was found in 93% of patients and was significantly associated with inappropriate prescribing (p = 0.047). CONCLUSION Inappropriate prescribing and polpharmacy are highly prevalent in the hospitalised elderly. The 'S-I-R-E' mnemonic can be used as a memory aid and practical framework to guide appropriate prescribing in the elderly.

Aim To study the effect of sodium pyruvate on apoptosis and autophagy of HT22 in mouse hippocampal neuronal cells under hypoxia conditions. Methods HT22 cells were incubated with different concentrations of sodium pyruvate to detect their cellular activity by MTS; iron staining was used to further observe the effect of sodium pyruvate on HT22 cells in mitochondrial metabolism; lysosomal staining was applied to detect the lysosomal changes of sodium pyruvate on HT22 cells; Western blot was used to detect the expression of Bcl-2, Bax and LC3-II/LC3- I proteins. Results To verify whether sodium pyruvate exerted neuroprotective effects on mouse hippocampal HT22 cells through affecting mitochondrial apoptosis and autophagy pathways, which were improved by administration of sodium pyruvate. Conclusions Sodium pyruvate administration under hypoxic conditions can reduce the neuroprotective effect of hypoxic injury by reducing apoptosis and activating autophagy in HT22 cells.

COVID-19 has been prevalent for three years. The virulence of SARS-CoV-2 is weaken as it mutates continuously. However, elderly patients, especially those with underlying diseases, are still at high risk of developing severe infections. With the continuous study of the molecular structure and pathogenic mechanism of SARS-CoV-2, antiviral drugs for COVID-19 have been successively marketed, and these anti-SARS-CoV-2 drugs can effectively reduce the severe rate and mortality of elderly patients. This article reviews the mechanism, clinical medication regimens, drug interactions and adverse reactions of five small molecule antiviral drugs currently approved for marketing in China, so as to provide advice for the clinical rational use of anti-SARS-CoV-2 in the elderly.