BACKGROUND:Bone formation is a dynamic process, and osteoclasts and osteoblasts are involved in this dynamic process. Semaphorins were found first as axonal growth cone guidance molecules, which express in many different tissues and regulate many physiological processes. Recently, Semaphorins are confirmed to play an important role in the regulation of osteoclasts and osteoblasts. OBJECTIVE:To summarize the role of Semaphorins in bone homeostasis. METHODS: A computer-based search of PubMed and Web of Science was performed for articles related to the effect of Semaphorins in regulation of bone metabolism published from June 1993 to January 2014 using the keywords of “semaphorin, sema”. Irrelevant articles or duplicate content articles were excluded, and finaly 48 articles were reviewed. RESULTS AND CONCLUSION:Semaphorins act as a new class of regulatory molecules in the aspect of bone cytobiology. Studies have show semaphorins are actively involved in bone remodeling through some special mechanisms, and semaphorin proteins are crucial for bone homeostasis, which provides a new method and therapeutic target for the treatment of osteoporosis, bone sclerosis, osteolysis adjacent to joint prosthesis and other bone diseases.

OBJECTIVE: To investigate the effect of perioperative dexamethasone on nausea, vomiting and pain after unilateral total knee arthroplasty and to evaluate its safety. METHODS: From February 2014 to June 2016, 100 patients with unilateral advanced osteoarthritis treated by total knee arthroplasty were divided into two groups: 50 patients in dexamethasone group including 27 males and 23 females, aged (72.30±7.02) years, were given intravenous drip of dexamethasone 10 mg before operation; 50 patients in saline group, including 26 males and 24 females, aged (71.30±6.08) years, were given the same amount of saline at the corresponding time. The VAS scores of pain at rest and at 45 degrees of knee flexion were recorded at 2, 4, 6, 8, 12, 24, 36 and 48 h after operation. Vomiting, antiemetic drugs and opioids were recorded at 0 to 24 h and 24 to 48 h after operation. The side effects and complications were recorded. RESULTS: All the 100 patients were followed up for an average of 14.5 months. VAS score of pain at rest in dexamethasone group was lower than that in saline group at 8, 24 and 48 h after operation (<0.05); VAS score of dexamethasone group at 45 degrees after knee flexion was lower than that of saline group at 8 and 48 h after operation(<0.05); VAS score of dexamethasone group at rest and 45 degrees after knee flexion was lower than that of saline group(<0.05). The dosage of opioids and total opioids in dexamethasone group was lower than that in saline group at 0 to 24 h, 24 to 48 h after operation (<0.05). The proportion of nausea and vomiting occurred at 0 to 24 h and 24 to 48 h after operation, and the proportion of antiemetic required at 0 to 24 h after operation had statistical significance between two groups(<0.05). The total antiemetic dosage of dexamethasone group was less than that of saline group(<0.05). As of the last follow-up, no complications such as infection, gastrointestinal ulcer and bleeding occurred in the two groups. CONCLUSIONS Preoperative systemic application of dexamethasone can effectively reduce pain and nausea and vomiting after TKA without increasing postoperative complications.
Aged ; Arthroplasty, Replacement, Knee ; Dexamethasone ; Female ; Humans ; Male ; Nausea ; Pain, Postoperative ; Vomiting

OBJECTIVETo explore the characteristics, diagnosis and treatment on traumatic dislocation.

METHODSFrom April 2000 to August 2010, 12 patients with acute traumatic dislocation of superior tibiofibular joint were treated including 10 males and 2 females with an average age of 30.6 years old ranging from 18 to 60 years. According to Ogden classification, 8 cases were the anterolateral dislocation, 2 were posterior-medial dislocation, and 2 were upward dislocation. All patients had swelling in lateral-inferior of knee, fibular head prominent, fibular head pain, floating feeling in head of fibula. One case was treated by conservative treatment, and the remaining 11 cases by surgical treatment.

RESULTSAll patients were followed-up for 10 months to 3 years (means 18 months). Evaluation by Lysholm scoring,the total scores were 95.08 +/- 2.02, involving limbing 4.92 +/- 0.28, support 4.92 +/- 0.28, interlocking 15.00 +/- 0.00, instability 24.58 +/- 0.79, pain 22.50 +/- 1.24, swell 8.50 +/- 0.90, climbing stairs 9.75 +/- 0.62, squatting 4.92 +/- 0.28; 11 cases achieved excellent results and 1 good. Nerve functional recovered. X-ray was no longer dislocation.

CONCLUSIONThe diagnosis of traumatic dislocation is easy misseddiagnosis, surgery is the main treatment method, the prognosis is good.

Adolescent ; Adult ; Arthrography ; Female ; Fibula ; Humans ; Joint Dislocations ; diagnostic imaging ; therapy ; Joints ; injuries ; Male ; Middle Aged ; Tibia ; Tomography, X-Ray Computed ; Treatment Outcome ; Young Adult

Objective （ ） To explore the feasibility of using generalized estimating equation GEE to analyze the influencing - （ ） factors of high frequency hearing loss HFHL among noise exposed workers in an air conditioner manufacturing enterprise. Methods - The noise exposed workers in an air conditioner manufacturing industry who had been tested for pure tone hearing threshold twice or more from 2015 to 2019 were selected as the research subjects using the judgment sampling method. Data ， ， ， ， ， （ ） such as age length of service gender smoking alcohol consumption body mass index BMI and HFHL were collected. The Results influencing factors of HFHL were analyzed using the GEE. The detection rates of HFHL from 2015 to 2019 were ， ， ， ， ， 22.2% 23.8% 24.2% 24.1% and 20.9% respectively. Among them the detection rate of HFHL in 2019 was lower than that （ P ） ， ， in 2017 and 2018 all <0.001 . The GEE analysis results showed that the risks of HFHL in 2015 2016 2017 and 2018 were （ P ）， higher than that in 2019 all <0.01 regardless of interaction effects and after adjusting for confounding factors such as ， ［OR（ CI）］ （ - duration of noise exposure smoking and BMI. The odds ratios and 95% confidence intervals 95% were 1.19 1.07 ）， （ - ）， （ - ） （ - ）， 1.33 1.26 1.13 1.39 1.30 1.18 1.43 and 1.27 1.15 1.39 respectively. The risk of HFHL was higher in males than in （P ）， OR（ CI） （ - ） ， （P ）， OR females <0.01 and 95% was 3.78 3.00 4.77 . The older the age the higher the risk of HFHL <0.01 and （ CI） （ - ） Conclusion - 95% was 1.07 1.05 1.09 . The influencing factors of HFHL among noise exposed workers in the air conditioner industry are age and gender. GEE can be used to analyze the factors influencing the longitudinal data of HFHL in workers with noise exposure.

OBJECTIVETo investigate the safety and efficacy of decitabine combined with CAG regimen in the treat-ment of newly diagnosed elderly patients with acute myeloid leukemia(AML).

METHODSFourty-nine patients with newly diagnosed acute myeloid leukemia (except M3) who were admitted to our hospital were selected. All the patients were older than 50 years old, and allogeneic hematopoietic stem cell transplantation could not be performed for various reasons. Decitabine-based chemotherapy regimens were used during induction therapy including single decitabine therapy(DAC), decitabine combined with CAG regimen(DAC-CAG) and decitabine combined with HAAG regimen(DAC-HAAG). Most of patients continued to use the original treatment after complete remission, while others were given the standard "3+7" regimen chemotherapy. A total of 2-4 courses of treatment was conducted in the majority of patients.

RESULTSAll of the 49 patients completed the induction therapy, in which 26 cases achieved complete remission(CR), 7 cases achieved partial remission(PR) and no response(NR) existed in 16 cases. The complete remission and the overall response rate(ORR) were 53% and 67% respectively. The overall response rate of DAC group, DAC-CAG group and DAC-HAAG group were 17%, 77% and 63% respectively. 14 patients were infected and 1 patients died of pulmonary infection during the induction therapy. The median number of suspended red blood cells and platelet infused were 9 units and 69 units respectively. Neutrophil recovery time was 15.1 days while the platelet recovery time was 20.1 days during the induction therapy. The mean follow-up time was 21 months. Overall survival(OS) was 75% at 6 months, 30% at 1 year, and 26% at 2 year, while disease-free survival(DFS) was 83% at 3 months, 54% at 1 year, and 47% at 2 year. The induction therapy could reach CR that was an independent prognostic factor, however, the initial white blood cell count, platelet count, age, chemotherapy regimen, prognostic stratification and whether complical by pnenmonia during chemotherapy were not independent prognostic factors.

CONCLUSIONThe induction efficacy of decitabine combined with chemotherapy is superior to that of decitabine alone. The outcome of induction chemotherapy is an independent prognostic factor, however, the high white blood cell count, poor karyotype, complications and AML with myelodysplasia-related changes do not affect long-term survival. DAC-CAG regimen is effective and have relatively few adverse reactions in AML. It is suitable for the patients who are ineligible for conventional chemotherapy.

Aged ; Antineoplastic Combined Chemotherapy Protocols ; Azacitidine ; analogs & derivatives ; Cytarabine ; Decitabine ; Humans ; Induction Chemotherapy ; Leukemia, Myeloid, Acute ; Middle Aged ; Remission Induction ; Treatment Outcome

ObjectiveTo study the expression of CLAUDIN-11 in the testis tissue of non-obstructive azoospermia (NOA) patients with different severities and investigate its clinical significance.

METHODSSixty-two NOA patients were divided into a hypospermatogenesis (HS) group (n = 30) and a Sertoli cell only syndrome (SCO) group (n =32). The expression of CLAUDIN-11 in the testicular tissue of the patients was detected by immunohistochemistry, that of CLAUDIN-11 mRNA determined by real-time fluorescence quantitative polymerase chain reaction (RT-qPCR), and the levels of serum reproductive hormones measured by chemiluminescent immunoassay.

RESULTSImmunohistochemistry showed that the expression of CLAUDIN-11 was mainly in the cytoplasm of the Sertoli cells around the seminiferous tubule wall in the HS group, but diffusely distributed in the membrane of the Sertoli cells in the SCO group. RT-qPCR revealed a significantly lower expression of CLAUDIN-11 mRNA in the HS than in the SCO group (0.008 ± 0.001 vs 0.013 ± 0.002, t = 10.616, P<0.01). The level of serum luteotropic hormone (LH) was also markedly lower in the HS than in the SCO group (［3.62 ± 1.34］ vs ［4.96 ± 3.10］ IU/L, P<0.05) and so was that of follicle-stimulating hormone (FSH) (［5.36 ± 2.80］ vs ［10.65 ± 9.18］ IU/L, P<0.05).

CONCLUSIONSThe up-regulated expression of CLAUDIN-11 in Sertoli cells may play an important role in the development and progression of spermatogenic dysfunction in NOA patients.

Azoospermia ; genetics ; metabolism ; Claudins ; metabolism ; Follicle Stimulating Hormone ; metabolism ; Humans ; Male ; Oligospermia ; genetics ; metabolism ; RNA, Messenger ; metabolism ; Seminiferous Tubules ; metabolism ; Sertoli Cell-Only Syndrome ; genetics ; metabolism ; Sertoli Cells ; metabolism ; Spermatogenesis ; Testis ; metabolism

Ferroptosis is a form of iron-dependent regulated cell death. Evidence of its existence and the effects of its inhibitors on subarachnoid hemorrhage (SAH) is still lacking. In the present study, we found that liproxstatin-1 protected HT22 cells against hemin-induced injury by protecting mitochondrial functions and ameliorating lipid peroxidation. In in vivo experiments, we demonstrated the presence of characteristic shrunken mitochondria in ipsilateral cortical neurons after SAH. Moreover, liproxstatin-1 attenuated the neurological deficits and brain edema, reduced neuronal cell death, and restored the redox equilibrium after SAH. The inhibition of ferroptosis by liproxstatin-1 was associated with the preservation of glutathione peroxidase 4 and the downregulation of acyl-CoA synthetase long-chain family member 4 as well as cyclooxygenase 2. In addition, liproxstatin-1 decreased the activation of microglia and the release of IL-6, IL-1β, and TNF-α. These data enhance our understanding of cell death after SAH and shed light on future preclinical studies.