10.3969/j.issn.2095-4344.2013.26.003

BACKGROUND:Majority of patients appeared different degrees of hip joint bursitis and gradual y developed into femoral head necrosis in the early rehabilitation process of severe acute respiratory syndrome. OBJECTIVE:To analyze various causes of the severe acute respiratory syndrome sequela, and to review the treatment method of femoral head necrosis. METHODS:The PubMed database, China Journal Ful-text database (CNKI), VIP database and Wanfang database were retrieved by the first author with computer for the related articles from January 1997 to August 2012. The key words of“infectious atypical pneumonia, sequela, femoral head necrosis, bone ischemia, etiology, infectious atypical pneumonia virus, conservative treatment, operation treatment, total hip replacement”in English and Chinese were put in the title and abstract to search articles. A total of 872 articles were screened out after primary retrieval, and eventual y 56 articles were included for review. RESULTS AND CONCLUSION:Severe acute respiratory syndrome sequela, femoral head necrosis, was related with the dose and duration of hormone, patient’s sensitivity to hormone, using method, the secretion of leptin and bone calcitonin, and also infectious atypical pneumonia virus. The femoral head necrosis caused by the above factors can be treated with conservative treatment to slow down the process of femoral head necrosis and delay prosthesis replacement. Eventual y, most of the patients wil receive surgical method. For the treatment of advanced severe acute respiratory syndrome sequelae femoral head necrosis, prosthesis replacement can get the best effect.

BACKGROUND: Tendon transplantation is limited by deficiency of donor tendon or immunological rejection. With the development of cell culture and transplantation techniques and biomaterial science, tissue-engineered tendon, a novel ideal tendon substitute, can be used to repair tendon defect. OBJECTIVE: To summarize the research course and novel advances of tissue-engineered tendon. RETRIEVAL STRATEGY: A computer-based online search of PubMed database was undertaken to identify related English articles published between January 1994 and December 2007 with keywords "tissue engineering, artificial biocompatible tendon". In addition, we searched Wanfang database for related Chinese articles dated from January 1994 to December 2007 with the same keywords in Chinese. Eighty articles were collected from the above-mentioned databases, including 55 Chinese and 25 English. Only ①original articles with reliable argument, ②articles with clear viewpoints, and ③articles strongly correlated with the objective of the article were selected. Eight articles with unrelated content and 40 repetitive studies were excluded. LITERATURE EVALUATION: Thirty-two articles accorded with the inclusive criteria were included, including 10 animal experiments and in vivo, ex vivo and cytology experiments, 12 review articles, comments and lectures, and 10 clinical studies. DATA SYNTHESIS: Tendon injury not treated promptly may result in limb disturbance. Tissue-engineered tendons can repair the appearance and rebuilt the function of injured tendon, and serve as permanent substitutes. Currently, although tissue engineering is developing rapidly, there are still many problems in clinical application. Firstly, seed cells cannot only be harvested from autologous tenocytes. Secondly, how to improve materials to become ideal three-dimensional scaffold material for constructing organ, and how to simulate body environment to construct tendon tissue in vitro are still uncertain. CONCLUSION: Using bioreactor to simulate body environment to construct tissue-engineered tendon is future research focus.

Objective To discuss and observe the clinical effect of intervertebral pedicle internal fixation and debride?ment combined with bone graft through posterior approach/trans-intervertebral space approach on the treatment of uni/multi-segmental lumbosacral vertebral tuberculosis (TB). Methods A cohort of 37 patients, with single or multiple segmental ver?tebral destruction due to TB, were treated by trans-intervertebral debridement, posterior pedicle screw system internal fixa?tion and intervertebral bone graft. All patients underwent X-ray,CT and MRI examination to observe the combination treat?ment effect. Results Most patients (n=34) enjoyed primary healing, in which include only 4 cases that presented symptom of nerve root stretch injury during operation but all recovered after 3 months. Other 3 patients underwent secondary healing due to sinus but two were rectifying with anti-TB therapy and wound dressing. The other 1 case suffered from sinus tract was healed through second debridement and rectifying therapy. X-ray, CT and MR at 6 months after operation indicated that all patients present great graft osseous fusion, good recovering of height of vertebral body without kyphosis deformity nor internal fixation loosening nor screw breakage. Conclusion Intervertebral pedicle internal fixation and debridement combined with bone graft through posterior approach/trans-intervertebral space approach is with minimum invasion but good graft fusion ef?fects, harder fixation and satisfactory clinical effects in the treatment of uni/multi-segmental lumbosacral vertebral tuberculosis.

BACKGROUND:Lots of bone graft materials such as autologous iliac bone, autologous rib, titanium mesh plus alograft are available in the treatment of bone defects after spinal tuberculosis debridement. OBJECTIVE: To compare the fixation effect of different kinds of bone graft materialsvia pedicle approach fixation for treatment of thoracic spinal tuberculosis. METHODS: Totaly 40 patients with thoracic spinal tuberculosis were enroled, including 18 patients accompanied with paraplegia and 15 patients accompanied with kyphosis deformity. Both of them were subjected to by standard anti-tuberculosis treatment for 2-4 weeks and consequent posterior pedicle screw fixation combined with debridement/bone grafting fusion. They were grouped by the variables of bone graft materials: autologous iliac bone, autologous rib, titanium mesh plus alograft groups. Al patients were folowed up for 24 months. The lesion healing, bone graft fusion, rehabilitation of paraplegia, correction of kyphosis and incidence of adverse reaction were observed. RESULTS AND CONCLUSION: The time of bone graft fusion in the autologous iliac bone group was shorter than that in the autologous rib and titanium mesh plus alograft groups (P < 0.05), and there was no significant difference between autologous rib and titanium mesh plus alograft groups. No adverse phenomenons such as grafts and titanium mesh faling off, fracture and displacement, nonunion and pseudarthrosis, tuberculosis recurrence were found in these three groups. After the symptomatic therapy for 3-6 months, the muscle strength of patients with paraplegia and spinal kyphosis deformity basically recovered, spinal kyphosis deformity was basically corrected. These results demonstrate that the treatment effect of autologous iliac bone is the best; however, the treatment effect of autologous rib is as good as the titanium mesh plus allograft.

OBJECTIVEAcute respiratory distress syndrome (ARDS) is usually diagnosed on the basis of clinical manifestations. However, a sensitive and effective biochemical index is important for early diagnosis of ARDS. It has been confirmed that macrophage migration inhibitory factor (MIF) expression is increased in patients with ARDS (adults and children). The present study aimed to investigate the expression and pathogenic role of MIF in children with ARDS by determining the serum level of MIF and expression of MIF in lung tissues.

METHODSTotally 18 children with ARDS, who were diagnosed in the department of pediatrics, the People's Hospital of Nanhai District, and 8 healthy children (control) were enrolled into the study. The serum level of MIF in ARDS children and normal children were measured by using enzyme-linked immunosorbent assay (ELISA). Peripheral blood mononuclear cell (PBMC) MIF expression was determined by flow-cytometry. The expression of MIF mRNA and protein in lung tissues were detected by using double-staining immunohistochemistry and in situ hybridization.

RESULTS(1) The serum level of MIF and PBMC MIF expression were (2040 +/- 146) microg/L and (8.98 +/- 2.76)%, respectively in ARDS children, which were significantly higher than those in the healthy children [(53 +/- 31) microg/L and (0.97 +/- 0.28)%, (P < 0.01)]. (2) In situ hybridization and immunohistochemistry showed that the number of KP(1)(+) cells and the percentages of MIF(+) expressed cells and MIF mRNA expressed cells were (229 +/- 87)/mm(2), (31.4 +/- 7.8)% and (34.71 +/- 8.91)%, respectively in the bronchoalveolar lavage fluid of ARDS children, which were significantly higher than those in the healthy children [(11 +/- 6)/mm(2), (1.9 +/- 0.8)% and (1.17 +/- 0.16)%, P < 0.01)]. (3) The number of KP(1)(+) cells and the percentages of MIF(+) expressed cells and MIF mRNA expressed cells were (319 +/- 129)/mm(2), (41.7 +/- 11.6)% and (45.13 +/- 13.2)% in ARDS lungs interstitium, which were significantly higher than those in the healthy children [(11 +/- 6)/mm(2), (1.9 +/- 0.8)% and (1.40 +/- 0.25)%, (P < 0.01)].

CONCLUSIONSThe level of MIF increased in serum and lung interstitium in ARDS children. Macrophage infiltration was demonstrated in lung interstitium and bronchoalveolar lavage fluid of ARDS children, MIF was expressed and significantly associated with the number of macrophage, which suggest that MIF plays an important role in the pathogenesis of ARDS. The level of MIF expression and macrophage infiltration can be regarded as a sensitive and effective biochemical index in the early diagnosis of ARDS.

Biomarkers ; blood ; metabolism ; Bronchoalveolar Lavage Fluid ; cytology ; Child ; Child, Preschool ; Early Diagnosis ; Enzyme-Linked Immunosorbent Assay ; Female ; Flow Cytometry ; Humans ; Immunohistochemistry ; In Situ Hybridization ; Infant ; Leukocytes, Mononuclear ; metabolism ; Lung ; cytology ; metabolism ; pathology ; Macrophage Migration-Inhibitory Factors ; blood ; genetics ; metabolism ; Macrophages ; metabolism ; pathology ; Male ; RNA, Messenger ; metabolism ; Respiratory Distress Syndrome, Adult ; blood ; diagnosis ; metabolism ; pathology

OBJECTIVE: To screen potential plasma protein biomarkers for the progression of cervical precancerous lesions into cervical carcinoma and analyze their functions. METHODS: Plasma samples obtained from healthy control subjects, patients with low-grade squamous intraepithelial lesion (LSIL), high-grade squamous intraepithelial lesion (HSIL), cervical cancer (CC), and patients with CC after treatment were enriched for low-abundance proteins for liquid chromatography-tandem mass spectrometry (LC-MS/MS) analysis. The MS data of the samples were analyzed using Discoverer 2.2 software, and the differential proteins (peptide coverage ≥20%, unique peptides≥2) were screened by comparison of LSIL, HSIL and CC groups against the control group followed by verification using target proteomics technology. Protein function enrichment and coexpression analyses were carried out to explore the role of the differentially expressed proteins as potential biomarkers and their pathological mechanisms. RESULTS: Compared with the control group, both LSIL group and HSIL group showed 9 differential proteins; 5 differentially expressed proteins were identified in CC group. The proteins ORM2 and HPR showed obvious differential expressions in LSIL and HSIL groups compared with the control group, and could serve as potential biomarkers for the progression of cervical carcinoma. The expression of F9 increased consistently with the lesion progression from LSIL to HSIL and CC, suggesting its value as a potential biomarker for the progression of cervical cancer. CFI and AFM protein levels were obviously decreased in treated patients with CC compared with the patients before treatment, indicating their predictive value for the therapeutic efficacy. Protein function enrichment analysis showed that all these differentially expressed proteins were associated with the complement system and the coagulation cascades pathway. CONCLUSIONS We identified 5 new protein biomarkers (F9, CFI, AFM, HPR, and ORM2) for cervical precancerous lesions and for prognostic evaluation of CC, and combined detection of these biomarkers may help in the evaluation of the development and progression of CC and also in improving the diagnostic sensitivity and specificity of cervical lesions.
Antigens, Neoplasm ; blood ; Biomarkers, Tumor ; blood ; Carrier Proteins ; blood ; Case-Control Studies ; Cervical Intraepithelial Neoplasia ; blood ; diagnosis ; Chromatography, Liquid ; Complement Factor I ; analysis ; Early Detection of Cancer ; Female ; Glycoproteins ; blood ; Haptoglobins ; Humans ; Neoplasm Proteins ; blood ; Orosomucoid ; analysis ; Precancerous Conditions ; blood ; diagnosis ; Serum Albumin, Human ; Tandem Mass Spectrometry ; Uterine Cervical Neoplasms ; blood ; diagnosis

OBJECTIVE: To screen new serum metabolic biomarkers for different drug resistance profiles of pulmonary tuberculosis (TB) and explore their mechanisms and functions. METHODS: We collected serum samples from TB patients with drug sensitivity (DS), monoresistance to isoniazid (MR-INH), monoresistance to rifampin (MR-RFP), multidrug resistance (MDR), and polyresistance (PR). The metabolites in the serum samples were extracted by oscillatory and deproteinization for LC-MS/MS analysis, and the results were normalized by Pareto-scaling method and analyzed using Metaboanalyst 4.0 software to identify the differential metabolites. The differential metabolites were characterized by function enrichment and co-expression analysis to explore their function and possible pathological mechanisms. RESULTS: Compared with the DS group, 286 abnormally expressed metabolites were identified in MR-INH group, 362 in MR-RPF group, 277 in MDR group and 1208 in PR group by LC-MS/MS analysis. Acetylagmatine ( < 0.05), aminopentol ( < 0.05), and tetracosanyl oleate ( < 0.05) in MR-INH group; Ala His Pro Thr ( < 0.001) and glycinoprenol-9 ( < 0.05) in MR-RFP group; trimethylamine ( < 0.05), penaresidin A ( < 0.05), and verazine ( < 0.05) in MDR group; and PIP (18:1(11Z)/ 18:3(6Z, 9Z, 12Z)) ( < 0.001), Pro Arg Trp Tyr ( < 0.001), N-methyldioctylamine ( < 0.001), and phytolaccoside E ( < 0.05) in PR group all showed significant differential expressions. Significant differential expressions of phthalic acid mono-2-ethylhexyl ester ( < 0.05) and eicosanoyl-EA ( < 0.05) were found in all the drug resistant groups as compared with DS group. CONCLUSIONS Acetylagmatine, aminopentol, tetracosanyl oleate, Ala His Pro Thr, glycinoprenol-9, trimethylamine, penaresidin A, verazine, PIP(18:1(11Z)/18:3(6Z, 9Z, 12Z)), Pro Arg Trp Tyr, N-methyldioctylamine, phytolaccoside E, phthalic acid mono-2-ethylhexyl ester, and eicosanoyl-EA are potentially new biomarkers that indicate monoresistance, multi-drug resistance and polyresistance of Mycobacterium tuberculosis. The combined use of these biomarkers potentially allows for assessment of drug resistance in TB and enhances the diagnostic sensitivity and specificity.
Biomarkers ; Chromatography, Liquid ; Humans ; Tandem Mass Spectrometry ; Tuberculosis, Multidrug-Resistant ; Tuberculosis, Pulmonary

Objective To develop a novel transcatheter tricuspid valve replacement device and test its performance. Methods The transcatheter tricuspid valve stent consisted of double-layer self-expanding nitinol stent, biotissue-derived bovine pericardial leaflets, and PTFE woven. The delivery system, mainly consisting of a handle control unit and a delivery sheath, was sent to the correct position via right atrium or jugular vein. The sheath had a visualization feature, and the handle control unit could realize the functions of stable release and partial recovery of the interventional valve. In addition, this study performed animal survival experiments on the basis of in vitro experiments. A large-white pig was used as the experimental animal. Cardiopulmonary bypass was established through median thoracotomy, then the right atrium was opened, and the interventional valve was released under direct vision without cardiac arrest. Approximately 1 month after interventional valve implantation, the maneuverability and stability of the interventional tricuspid device were evaluated by autopsy. Results Through the animal experiment, the interventional valve was successfully released, and the anchoring was satisfactory. Postoperative transthoracic echocardiography showed that the interventional valve opened and closed well, the flow rate of tricuspid valve was 0.6 m/s, and there was no obvious tricuspid regurgitation. One month after the operation, we dissected the large-white pig and found the interventional valve was not deformed or displaced, the leaflets were well aligned, and there was thrombus attachment in the groove between the inner and outer layers of the interventional valve. Conclusion Animal experiment shows that the novel device can stably and firmly attach to the tricuspid annulus, with good anchoring effect, and effectively reduce paravalvular leakage.