BACKGROUND:Biphasic calcium phosphates, consisting of hydroxyapatite and beta-tricalcium phosphate, have been extensively applied as bone graft substitutes due to their similarity with the mineral portion of nature bone. They have been proved to have excellent biocompatibility, bioactivity and osteoconductivity. In recent years, many studies have il ustrated biphasic calcium phosphates perform osteoinductivity both in vitro and in vivo, which is expected to become a good choice for bone graft substitutes. However, the critical factors triggering the osteoinduction process and mechanism of this phenomenon are stil indistinct.
OBJECTIVE:To review the influencing factors and mechanism related to the osteoinductivity of biphasic calcium phosphates.
METHODS:The Ovid Medline database and PubMed database (1985-01/2013-01) were used to search the related articles about the osteoinductive property of biphasic calcium phosphates. The key words were“bone graft substitutes, biphasic calcium phosphates, osteoinduction”. Articles concerning the osteoinductive property of biphasic calcium phosphates were included. The articles that published recently or in the high-impact journals were preferred, and articles with repetitive contents were ruled out. Then 34 articles were suitable for further analysis.
RESULTS AND CONCLUSION:The chemical composition of biphasic calcium phosphates influences the rate of degradation/resorption as wel as bioactivity, which in turn has an influence on the osteoinductivity;the physical properties also play important roles in osteoinductivity by affecting the absorption of bone morphogenetic proteins, vascularization, tissue invasion, microenvironment, and more importantly, triggering the undifferentiated stem cells into osteogenic lineage. What’s more, the species of animals, the implantation-site and the implant size are also critical for osteoinduction. Therefore, through the further study on the influencing factors and mechanism of osteoinduction, biphasic calcium phosphates with stable osteoinductivity, as a promising bone graft substitute, could be synthesized for clinical applications.

Objective To explore TCM syndrome and treatment regular for AIDS dementia complex (ADC). Methods Through literature retrieval, the review of medical records and clinical investigation, expert questionnaires survey was carried out. Results The recovery rate of complete questionnaires in the 1st survey was 88.89%. The agreement rate, the arithmetical mean, the weight coefficient, the mean level and the rank sum of the concept, clinical features, diagnostic criteria, syndrome differentiation and treatment of insufficiency of kidney essence, nursing, period of treatment and curative effect standard were more than others, CV<0.076. The agreement rate, the arithmetical mean, the weight coefficient, the mean level and the rank sum of the etiology and pathogenesis, syndrome differentiation and treatment of deficiency of heart and liver yin were smaller, and CV was within 0.168–0.234. The recovery rate of complete questionnaires in the 2nd survey was 96.00%. The agreement rate, the arithmetical mean, the weight coefficient, the mean level and the rank sum of the etiology and pathogenesis, syndrome differentiation and treatment of deficiency of kidney and liver were more than the 1st survey, and CV was within 0.065–0.106, which was smaller than the 1st survey. The agreement rate, the arithmetical mean, the weight coefficient, the mean level and the rank sum of syndrome differentiation and treatment of deficiency of kidney and liver were smaller, and CV was 0.156. The weight coefficient of the 1st and 2nd survey were within 0.072–0.087, 0.071–0.089. The questionnaire reliability of the 1st and 2nd survey were 0.916 and 0.886 respectively. The half reliability of the 1st and 2nd survey were 0.81 and 0.79 respectively. Conclusion TCM syndrome and treatment regular for ADC is preliminarily formed.

Objective To study the relationship between different syndromes of AIDS dementia complex (ADC) and different disease severity, age, CD4+ T cell count and infection. Methods Totally 186 patients with ADC were classified into different syndrome types, and the distribution in different degree of disease, different age, different CD4+T cell count and different routes of infection was analyzed. Results There were 48, 51, 15, 37 and 35 cases of deficiency of kidney and marrow, yin deficiency of liver and kidney, deficiency of heart and spleen, syndrome of phlegm obstruction, syndrome of qi deficiency and blood stasis, respectively. Moderate and severe degrees with yin deficiency of liver and kidney were more common. There was statistical significance in the distribution of different syndromes in different degree of disease (χ2=82.495, P=0.000). Deficiency of kidney and marrow, yin deficiency of liver and kidney were more common in different age groups. The distribution of the syndrome types in different age groups was statistically significant (χ2=72.710, P=0.000), the patients were mainly in two age groups of>50–60 years old and>60 years old. The distribution of the syndrom types in diffenrent CD4+T cell count stratum was statistically significant (χ2=66.778, P=0.000). Blood pathway infection mainly included deficiency of kidney and marrow and syndrome of qi deficiency and blood stasis, sexual pathogens mainly yin deficiency of liver and kidney. Conclusion CD4+T cells layers, age group, progression of disease and transmission way are the influencing factors of syndrom type.

Objecve To observe the clinical effect and safety of the Chinese medicine syndrome differentiation combined with HAART for the ADC(acquried immune deficiency syndrom dementia complex). Methods A total of 80 patients with ADC were divided into the treatment group and control group based on random number table, 40 in each group. The patients in the control group were treated by highly active anti-retrovital therapy (HAART). The patients in the treatment group were treated with TCM treatment on the based of the control group. Both groups received the treatment for 3 months.These outcomes were measured: TCM syndrome integral, mini mental state examination(MMSE), daily behavior scale(ADL), change of clinical stage, and adverse reactions. Results The effect rate of treatment group was 82.5%, which was significant higher than 65% of the control group (χ2=8.115,P=0.024). After the treatment, the ADL integral of the treatment group (37.69 ± 5.31vs.33.67 ± 5.16;t=2.528,P=0.021) was significantly higher than that before the treatment; and the ADL integral of the control group(36.96 ± 5.52vs.34.54 ± 4.98;t=2.747,P=0.027) was significantly higher than that before the treatment.But there was no significant difference between the two groups after the treatment (t=2.003,P=0.139). After the treatment, the MMSE integral of the treatment group (24.76 ± 4.43 vs.19.97 ± 5.46;t=1.006,P=0.013) was significantly higher than that before the treatment; the MMSE integral of the control group(24.65 ± 4.36 vs. 20.11 ± 4.87;t=1.035,P=0.014) was significantly higher than that before the treatment. But there was no significant difference between the two groups after the treatment (t=0.953, P=0.347).There was no significant difference between the two groups in the clinical stage change (phase1χ2=1.231,P=0.954; phase2χ2=2.726,P=1.053). There was no adverse reaction in the two groups during the treatment.Conclusions The Traditional Chinese medcine combined with HAART was better than HAART alonein the treatment of ADC.

COVID-19 has swept globally and Pakistan is no exception.To investigate the initial introductions and transmissions of the SARS-CoV-2 in Pakistan,we performed the largest genomic epidemiology study of COVID-19 in Pakistan and generated 150 complete SARS-CoV-2 genome sequences from samples collected from March 16 to June 1,2020.We identified a total of 347 mutated positions,31 of which were over-represented in Pakistan.Meanwhile,we found over 1000 intra-host single-nucleotide variants(iSNVs).Several of them occurred concurrently,indicating possible interactions among them or coevolution.Some of the high-frequency iSNVs in Pakistan were not observed in the global population,suggesting strong purifying selections.The genomic epidemiology revealed five distinctive spreading clusters.The largest cluster consisted of 74 viruses which were derived from different geographic locations of Pakistan and formed a deep hierarchical structure,indicating an extensive and persistent nation-wide transmission of the virus that was probably attributed to a signature mutation(G8371T in ORF 1ab)of this cluster.Further-more,28 putative international introductions were identified,several of which are consistent with the epidemiological investigations.In all,this study has inferred the possible pathways of introduc-tions and transmissions of SARS-CoV-2 in Pakistan,which could aid ongoing and future viral surveillance and COVID-19 control.