0.05);but the difference on every other items in CSQ was significant(P

Objective:To investigate the clinical effect of local and systemic zoledronic acid in the treatment of giant cell tumor of bone.Methods:The clinical data of 42 patients with giant cell tumor of bone who were treated in the Department of Joint and Sports Medicine Surgery of Shandong Provincial Third Hospital from January 2000 to January 2017 were retrospectively analyzed. According to whether zoledronic acid was used during and after operation, the patients were divided into zoledronic acid group ( n=21) and non zoledronic acid group ( n=21). The perioperative indexes, pain visual analogue scale (VAS), international Musculoskeletal Tumor Society (MSTS) score of lower extremity function, adverse reactions and the postoperative recurrence were compared between the two groups. Results:The operative time of zoledronic acid group and non zoledronic acid group were (158.4±20.5) min and (169.5±19.5) min, the intraoperative bleeding volume were (236.3±9.7) ml and (228.2±16.5) ml, the postoperative drainage volume were (163.3±7.4) ml and (161.4±9.3) ml, and the healing time of incision were (13.8±2.1) d and (14.0±2.0) d, respectively, with no significant difference ( t=-1.798, P=0.080; t=1.936, P=0.062; t=0.733, P=0.468; t=-0.290, P=0.774). The preoperative VAS scores of zoledronic acid group and non zoledronic acid group were 6.54±1.76 and 6.72±1.51 respectively, the MSTS scores were 13.56±2.35 and 12.79±1.98 respectively, and the differences were not statistically significant ( t=-0.356, P=0.724; t=1.148, P=0.258). The VAS scores of the two groups were 1.32±0.31 and 1.92±0.19 at 4 weeks after operation, 0.93±0.29 and 1.47±0.38 at 3 months after operation respectively, and the differences were statistically significant ( t=-7.562, P<0.001; t=-5.177, P<0.001). The VAS scores of the two groups were 0.31±0.12 and 0.35±0.23 at the last follow-up, with no significant difference ( t=0.707, P=0.485). The MSTS scores of zoledronic acid group and non zoledronic acid group were 24.89±3.86 and 21.82±2.95 at 4 weeks after operation, 26.78±2.57 and 24.62±2.62 at 3 months after operation respectively, and the differences were statistically significant ( t=2.896, P=0.006; t=2.697, P=0.010). The MSTS scores of the two groups were 27.31±2.21 and 26.69±2.93 at the last follow-up, with no significant difference ( t=0.774, P=0.443). The postoperative recurrence time of the two groups was (9.79±2.58) months and (7.31±1.73) months respectively, and the difference was statistically significant ( t=3.659, P=0.001). There was no significant difference in recurrence Campanacci grade and recurrence tumor location between the two groups ( U=7.000, P=0.860; χ2=1.062, P>0.999). The occurrence rates of fever in zoledronic acid group and non zoledronic acid group were 23.81% (5/21) and 4.76% (1/21), the occurrence rates of myalgia were 19.05% (4/21) and 4.76% (1/21), the incidences of influenza like symptoms were 14.29% (3/21) and 0 (0/21), the occurrence rates of gastrointestinal reaction were 9.52% (2/21) and 4.76 (1/21), and the differences were not statistically significant ( χ2=1.750, P=0.186; χ2=0.980, P=0.341; χ2=1.436, P=0.231; χ2<0.001, P>0.999). All the patients had no serious adverse reactions such as liver and kidney function damage and mandible necrosis. Conclusion:Local and systemic application of zoledronic acid in the treatment of giant cell tumor of bone can improve the early postoperative pain and limb function, delay the recurrence time, and can be used as an auxiliary treatment of giant cell tumor of bone.

Objective Our previous studies established that microRNA (miR)-451 from human umbilical cord mesenchymal stem cell-derived exosomes (hUC-MSC-Exos) alleviates acute lung injury (ALI). This study aims to elucidate the mechanisms by which miR-451 in hUC-MSC-Exos reduces ALI by modulating macrophage autophagy. Methods Exosomes were isolated from hUC-MSCs. Severe burn-induced ALI rat models were treated with hUC-MSC-Exos carrying the miR-451 inhibitor. Hematoxylin-eosin staining evaluated inflammatory injury. Enzyme-linked immunosorbnent assay measured lipopolysaccharide (LPS),tumor necrosis factor-α,and interleukin-1β levels. qRT-PCR detected miR-451 and tuberous sclerosis complex 1 (TSC1) expressions. The regulatory role of miR-451 on TSC1 was determined using a dual-luciferase reporter system. Western blotting determined TSC1 and proteins related to the mammalian target of rapamycin (mTOR) pathway and autophagy. Immunofluorescence analysis was conducted to examine exosomes phagocytosis in alveolar macrophages and autophagy level. Results hUC-MSC-Exos with miR-451 inhibitor reduced burn-induced ALI and promoted macrophage autophagy. MiR-451 could be transferred from hUC-MSCs to alveolar macrophages via exosomes and directly targeted TSC1. Inhibiting miR-451 in hUC-MSC-Exos elevated TSC1 expression and inactivated the mTOR pathway in alveolar macrophages. Silencing TSC1 activated mTOR signaling and inhibited autophagy,while TSC1 knockdown reversed the autophagy from the miR-451 inhibitor-induced. Conclusion miR-451 from hUC-MSC exosomes improves ALI by suppressing alveolar macrophage autophagy through modulation of the TSC1/mTOR pathway,providing a potential therapeutic strategy for ALI.

BACKGROUND:How to provide sufficient skin resources for scar plastic surgery and repair of extensive deep burn patients while avoiding the re-proliferation of scar tissue in the surgical area has always been an important topic in burn and wound repair research. OBJECTIVE:To observe the clinical application effects of artificial dermis combined with autologous scar epidermis in the repair of scar after extensive burns. METHODS:Retrospective analysis was performed on 73 patients with scar hyperplasia and contracture deformity after extensive burns in Bengbu Third People's Hospital Affiliated to Bengbu Medical College from January 2021 to January 2023.The patients were divided into three groups according to the treatment method:Group A(n=21,artificial dermis combined with autologous scar epidermis transplantation was used for treatment),group B(n=27,scar epidermis was transplanted after scar release in the functional site),and group C(n=25,functional site scar release after transplantation of thick skin treatment).Skin survival and infection at the receiving site,wound healing time at the receiving site and the donor site were recorded in the three groups.The scar status and functional recovery of the recipient area and donor area were evaluated by the Vancouver Scar Scale and activities of daily living. RESULTS AND CONCLUSION:(1)The skin infection rate was lower in group B than that in groups A and C(P<0.05).The survival grade was higher in group B than that in groups A and C(P<0.05).(2)The wound healing time at the receiving site was longer in group A than that in groups B and C(P<0.05).The wound healing time at the receiving site was longer in group C than that in group B(P<0.05).The wound healing time at the donor site was longer in group C than that in groups A and B(P<0.05).(3)Vancouver Scar Scale score was higher in group B than that in groups A and C at 12 months postoperatively(P<0.05).Vancouver Scar Scale score was higher in group C than that in groups A and B at 6 and 12 months postoperatively(P<0.05).The excellent grade of activities of daily living in groups A and C was significantly higher than that of group B at 12 months postoperatively(P<0.05).(4)The results showed that the application of artificial dermis combined with autologous scar epidermis composite transplantation in the treatment of scar contracture after extensive burn could not only achieve the same effect as that of intermediate-thickness skin,but also avoid postoperative scar re-hyperplasia at the donor site and shorten the time of complete wound healing at the donor site.Compared with scar epidermal transplantation,this treatment has obvious advantages.

Objective:To observe the clinical effect of ablative fractional CO 2 laser in the treatment of hypertrophic scar in children after burn. Methods:The clinical data of patients with post-burn hypertrophic scar in children who met the inclusion and exclusion criteria in the Cosmetic Clinic and Burn Clinic of the Third People’s Hospital of Bengbu City Affiliated to Bengbu Medical College from January 2019 to March 2021 were collected, and a retrospective study was conducted. All patients were divided into laser group and control group, and laser group was further divided into 1-2 times subgroups and 3-4 times subgroups. The laser group received ablative fractional CO 2 laser treatment 1-4 times on the basis of conventional anti-scar treatment (pressure therapy and topical silicone drugs), and the treatment interval was 1-3 months; the control group only received conventional anti-scar treatment. The color, blood vessel distribution, thickness and softness of scar were scored by Vancouver Scar Scale (VSS), before treatment and 2 months after treatment In the laser group, and at 3 and 6 months in the control group, respectively. The degree of pruritus of the scar was scored with Visual Analogue Scale (VAS). The patient’s satisfaction evaluation is graded as four levels: very satisfied, relatively satisfied, generally satisfied, and dissatisfied. All data were analyzed by SPSS 19.0 software with paired t-test, Wilcoxon rank-sum test or chi-square test according to the type and nature of the data. Results:A total of 103 patients with hypertrophic scars were included, with a total of 134 scars, including 58 males and 45 females; the age was (3.9±3.0) years, range 0-11 years old; the scar area accounted for 4.2%±3.1% of the body surface area; the course of scar was (3.6±2.2) months. There were 72 patients (94 scars) in the laser group, including 29 patients (37 scars) in the 1-2 times subgroup and 43 (57 scars) in the 3-4 times subgroup; 31 patients in the control group(40 scars). (1) Vascular distribution, softness and overall score assessed by VSS in 1-2 times subgroup after treatments were significantly lower than those before treatment ( P<0.05). The thickness, blood vessel distribution, softness and overall score assessed by VSS in 3-4 times subgroup after treatments were significantly lower than those before treatment ( P<0.05). The improvement degree of scar after treatment in each group was different. Compared with the control group, the improvement degree in the 1-2 times subgroup and the 3-4 times subgroup was more obvious ( P<0.05). The improvement degree in the 3-4 times subgroup was better than that in the 1-2 times subgroups ( P<0.05). (2) Compared with before treatment, the VSS scores of scars after laser treatment in different parts were significantly different except for the thickness scores of face and neck, trunk, and upper limbs group ( P<0.05). (3) The degree of pruritus was assessed by VAS method. The pruritus score of the 1-2 times subgroups and 3-4 times subgroups before treatment was (4.86±1.35) points, (4.97±0.93) points, and the pruritus score 2 months after treatment was (1.93±0.99) points, (1.90±0.83) points, the pruritus score improved significantly after treatment, and the difference was statistically significant ( P<0.01). The pruritus scores of the control group at 3 months and 6 months were (4.83±0.82) points and (4.22±0.66) points, and the scores at 6 months were slightly improved compared with those at 3 months, and the difference was statistically significant ( P<0.01). (4) In the laser group, 5 patients (6.9%) had pigmentation after the first treatment, and then gradually subsided; 7 patients (9.7%) had blisters after the second treatment, which healed after dressing change. In the control group, 3 cases (9.7%) had erosions, and the erosions improved after adjusting the pressure appropriately. (5) The overall satisfaction of patients in the laser group was higher than that in the control group [100% (72/72) vs. 80.6% (25/31), P<0.05]. Conclusions:Fractional CO 2 laser has a good effect on the treatment of hypertrophic scars in early childhood burns. It can effectively inhibit scar hyperplasia and improve the degree of itching in patients. The satisfaction of both doctors and patients is high.

Objective:To observe the clinical effect of ablative fractional CO 2 laser in the treatment of hypertrophic scar in children after burn. Methods:The clinical data of patients with post-burn hypertrophic scar in children who met the inclusion and exclusion criteria in the Cosmetic Clinic and Burn Clinic of the Third People’s Hospital of Bengbu City Affiliated to Bengbu Medical College from January 2019 to March 2021 were collected, and a retrospective study was conducted. All patients were divided into laser group and control group, and laser group was further divided into 1-2 times subgroups and 3-4 times subgroups. The laser group received ablative fractional CO 2 laser treatment 1-4 times on the basis of conventional anti-scar treatment (pressure therapy and topical silicone drugs), and the treatment interval was 1-3 months; the control group only received conventional anti-scar treatment. The color, blood vessel distribution, thickness and softness of scar were scored by Vancouver Scar Scale (VSS), before treatment and 2 months after treatment In the laser group, and at 3 and 6 months in the control group, respectively. The degree of pruritus of the scar was scored with Visual Analogue Scale (VAS). The patient’s satisfaction evaluation is graded as four levels: very satisfied, relatively satisfied, generally satisfied, and dissatisfied. All data were analyzed by SPSS 19.0 software with paired t-test, Wilcoxon rank-sum test or chi-square test according to the type and nature of the data. Results:A total of 103 patients with hypertrophic scars were included, with a total of 134 scars, including 58 males and 45 females; the age was (3.9±3.0) years, range 0-11 years old; the scar area accounted for 4.2%±3.1% of the body surface area; the course of scar was (3.6±2.2) months. There were 72 patients (94 scars) in the laser group, including 29 patients (37 scars) in the 1-2 times subgroup and 43 (57 scars) in the 3-4 times subgroup; 31 patients in the control group(40 scars). (1) Vascular distribution, softness and overall score assessed by VSS in 1-2 times subgroup after treatments were significantly lower than those before treatment ( P<0.05). The thickness, blood vessel distribution, softness and overall score assessed by VSS in 3-4 times subgroup after treatments were significantly lower than those before treatment ( P<0.05). The improvement degree of scar after treatment in each group was different. Compared with the control group, the improvement degree in the 1-2 times subgroup and the 3-4 times subgroup was more obvious ( P<0.05). The improvement degree in the 3-4 times subgroup was better than that in the 1-2 times subgroups ( P<0.05). (2) Compared with before treatment, the VSS scores of scars after laser treatment in different parts were significantly different except for the thickness scores of face and neck, trunk, and upper limbs group ( P<0.05). (3) The degree of pruritus was assessed by VAS method. The pruritus score of the 1-2 times subgroups and 3-4 times subgroups before treatment was (4.86±1.35) points, (4.97±0.93) points, and the pruritus score 2 months after treatment was (1.93±0.99) points, (1.90±0.83) points, the pruritus score improved significantly after treatment, and the difference was statistically significant ( P<0.01). The pruritus scores of the control group at 3 months and 6 months were (4.83±0.82) points and (4.22±0.66) points, and the scores at 6 months were slightly improved compared with those at 3 months, and the difference was statistically significant ( P<0.01). (4) In the laser group, 5 patients (6.9%) had pigmentation after the first treatment, and then gradually subsided; 7 patients (9.7%) had blisters after the second treatment, which healed after dressing change. In the control group, 3 cases (9.7%) had erosions, and the erosions improved after adjusting the pressure appropriately. (5) The overall satisfaction of patients in the laser group was higher than that in the control group [100% (72/72) vs. 80.6% (25/31), P<0.05]. Conclusions:Fractional CO 2 laser has a good effect on the treatment of hypertrophic scars in early childhood burns. It can effectively inhibit scar hyperplasia and improve the degree of itching in patients. The satisfaction of both doctors and patients is high.

To explore the protective effect of rosiglitazone (RGZ) on hepatic ischemia reperfusion injury (HIRI) and the underlying mechanisms.
 Methods: A rat model of ischemia-reperfusion injury was established by clamping the left and middle lobe of liver with noninvasive vascular clamp. A total of 30 Sprague-Dawley rats were randomly divided into a sham group, an HIRI group, and a RGZ group (10 rats in each group). Two hours after reperfusion, serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) activities, lactate dehydrogenase (LDH) level, malondialdehyde (MDA) content and catalase (CAT), glutathione peroxidase (GPx) and superoxide dismutase (SOD) activities were examined. HE staining was used to observe liver pathological morphology. The liver peroxisome proliferators-activated receptor γ (PPAR-γ), p-PPAR-γ, nuclear factor related factor 2 (Nrf-2), antioxidant response element (ARE), heme oxygenase 1 (HO-1) and quinone oxidoreductase-1 (NQO-1) were detected by Western blot.
 Results: Compared with the HIRI group, the levels of ALT, AST, LDH and MDA in the RGZ group were significantly decreased (all P<0.05), while the levels of Nrf-2, ARE, HO-1 and NQO-1 in the RGZ group were significantly increased. The hepatic swelling, necrosis and pathological damage were decreased (all P<0.05). In addition, there was no difference in the level of PPAR-γ between the 2 groups (P>0.05).
 Conclusion: PPAR-γ agonist RGZ can attenuate HIRI, which may be related to activating Nrf2/ARE signaling pathway and enhancement of antioxidant ability.
Alanine Transaminase ; blood ; Animals ; Aspartate Aminotransferases ; blood ; Catalase ; blood ; Disease Models, Animal ; Glutathione Peroxidase ; blood ; L-Lactate Dehydrogenase ; blood ; Ligation ; Liver ; blood supply ; metabolism ; Malondialdehyde ; blood ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Reperfusion Injury ; blood ; etiology ; prevention & control ; Rosiglitazone ; Superoxide Dismutase ; blood ; Thiazolidinediones ; therapeutic use

Mitochondrial dysfunctions play major roles in ageing. How mitochondrial stresses invoke downstream responses and how specificity of the signaling is achieved, however, remains unclear. We have previously discovered that the RNA component of Telomerase TERC is imported into mitochondria, processed to a shorter form TERC-53, and then exported back to the cytosol. Cytosolic TERC-53 levels respond to mitochondrial functions, but have no direct effect on these functions, suggesting that cytosolic TERC-53 functions downstream of mitochondria as a signal of mitochondrial functions. Here, we show that cytosolic TERC-53 plays a regulatory role on cellular senescence and is involved in cognition decline in 10 months old mice, independent of its telomerase function. Manipulation of cytosolic TERC-53 levels affects cellular senescence and cognition decline in 10 months old mouse hippocampi without affecting telomerase activity, and most importantly, affects cellular senescence in terc cells. These findings uncover a senescence-related regulatory pathway with a non-coding RNA as the signal in mammals.

OBJECTIVE：To study the effects of augmented renal clearance （ARC）on blood trough concentration of patients receiving high-dose regimen of teicoplanin. METHODS ：Patients who received high-dose regimen of teicoplanin in the ICU were prospectively collected from the Affiliated Suzhou Hospital of Nanjing Medical University/Suzhou Municipal Hospital during Jul. 2018-Jun. 2020. They were divided into ARC group and normal renal function group according to corrected creatinine clearance. The dosage regimen of teicoplanin in the two groups were loading dose of 600 mg，q12 h×3 doses，maintenance dose of 6-10 mg/kg，qd，and the dosage was adjusted in combination with creatinine clearance rate and blood trough concentration. The trough concentration of blood samples which were collected 30 min before the 4th and 8th-10th dosage of teicoplanin were determined by HPLC. Trough concentration ，clinical efficacy ，Gram-positive bacterial clearance rate and the occurrence of ADR were compared between 2 groups. RESULTS ：A total of 56 patients were included and divided into ARC group （18 cases）and normal renal function group （38 cases）. ARC group had younger age （P＜0.001）and lower serum albumin level （P＝0.025）than normal renal function group. The trough concentrations before administration of the 4th and 8th-10th dosage in ARC group were lower than normal renal function group （P＝0.034；P＝0.035）. The trough concentrations in the ARC group and normal renal function group before 8th-10th dosage were all higher than 30 min before the 4th dosage （P＝0.003；P＜0.001）. The clinical efficacy rate and the clearance rate of Gram-positive bacteria in ARC group were 77.8％ and 76.2％，which were lower than those of the normal renal function group ，but there was no statistical difference （P＝0.195；P＝0.223）. There was no liver function damage ，hemocytopenia and allergic reaction in both groups ，but in the normal renal function group ，the causal relationship between acute renal damage and teicoplanin was assessed as “very likely ”in one patient. CONCLUSIONS ：ARC patients are younger ，most of them have hypoproteinemia，and the blood trough concentrations of teicoplanin in high-dose regimen are significantly lower than those of normal renal function patients. For critical ill ARC patients ，it is advisable to increase the loading dose of teicoplanin to make the trough concentration reach the target concentration range quickly.