Objective To analyse the quality of life in patients with severe acute respiratory syndrome (SARS) for 10 years. Methods Twenty-five SARS patients were collected as SARS group and 25 healthy persons were used as control group. There were no significant differences in general clinical data between two groups. The quality of life of the respondents was evaluated by the MOS item short form health survey (SF-36) including physiological function, physical pain, general health condition, energy, social function, emotional function and mental health. The pulmonary function indicators including forced vital capacity (FVC), one second forced expiratory volume (FEV1), one second rate (FEV1/FVC), total lung capacity (TLC), residual volume (RV), corrected breath diffusing capacity (TLCOc SB) and corrected dispersion rate TLCOc/VA were also compared between two groups. The correlation between each dimension score of pulmonary function indexes and quality of life were analyzed in SARS group. Data of hip and femoral head necrosis were detected by MRI scan in SARS group of patients. Results Total quality of life score was poor in 23 cases (92.0%), and moderate quality of life score in 2 cases (8.0%). The quality of life score was lower in SARS group than that of control group (P<0.01). Data of TLCOc SB was lower in SARS group than that of control group. The score of physiological function was positively correlated with FEV1 and FEV1/FVC. The score of physical pain was positively correlated with FEV1/FVC (P<0.05). There were no significant differences between quality of life score and pulmonary function indicators. There were 11 cases (44%) of avascular necrosis of femoral head, and 14 cases (56%) of non-avascular necrosis of femoral head in SARS group. The score of physiological function was lower in femoral head necrosis group than that of non necrosis group (P<0.05). ConclusionThe lower quality of life in patients with SARS is not only related with psychological factors but also related with physical factors. The damage of pulmonary function and (or) necrosis of femoral head affect the quality of life in patients with SARS, especially the physiological function.

Mesenchymal stem cells (MSCs), which are regarded as the promising option of cell replacement therapy, are able to regulate immune response after tissue damage caused by traumatic brain injury (TBI). Secondary neuroinflammation following the mechanical injury is the essential factor of neural cell necrosis and apoptosis, even after the intracranial pressure has returned to normal. Their immune environments caused by neuroinflammtary response determine the outcome and long-term behavior function of TBI in survivors directly. MSCs modulate macrophage/microglia, drive them to polarize into alternative M2-like cells through releasing soluble cytokines, such as prostaglandin E2 (PGE2), tumor necrosis factor-stimulated gene 6 protein (TSG-6), IL-1 and TGF-β, which limits the progression of inflammation and maintain micro-environment stable. Meanwhile, macrophage/microglia exerts significant effects in MSCs survival, proliferation, differentiation and activation. It provides a novel approach as a practical anti-inflammatory therapy in clinical treatment.

Objective To investigate the effect of statin on trabecular bone microstructure by using trabecular bone score (TBS), a new type of bone microstructure evaluation index. Methods A total of 253 middle and aged patients hospitalized in the First Affiliated Hospital of Nanjing Medical University between January 2014 and March 2016 were retrospectively analyzed. According to whether statin was used or not, patients were divided into two groups: 90 patients in the statin use group (statin was use for more than 1 year) and 163 in the control group (not taken any statin). Serum biochemical indicators, such as triacylglycerol, total cholesterol, high density lipoprotein cholesterol, low density lipoprotein cholesterol, alkaline phosphatase, fasting blood glucose and 25 hydroxy vitamin D, were compared between the two groups. Dual energy X-ray absorptiometry (DXA) was used to measure the bone mineral density (BMD) of lumbar spine and femoral neck. TBS was calculated with TBS iNsight? software, and the DXA image of lumbar spine were analyzed. Results Values of total cholesterol and low density lipoprotein cholesterol were significantly lower in statin group compared with those of control group (P<0.001), while no significant differences in other biochemical indicators between two groups (P>0.05). There was higher lumbar spine BMD statin group compared to that of control group (g/cm2:1.04 ± 0.19 vs. 0.96 ± 0.14, P<0.01). There was higher lumbar spine BMD and higher TBS (1.31±0.09 vs. 1.26±0.09, P<0.01) in statin group than that of control group. There was no difference in the femoral neck BMD between the two groups (P>0.05). Conclusion Statin increases lumbar spine BMD and improves trabecular bone microstructure in middle and aged people.

Objective To investigate the effects of fasudil on expressions of Bcl-2 and Bax in cerebral cortex of model rats with subarachnoid hemorrhage (SAH). Methods Thirty rats were divided into sham operation group, SAH group and SAH+fasudil group, 10 rats in each group. Double injection of blood into occipital cistern method was used for SAH model in SAH group and SAH+fasudil group. In the sham operation group, the blood injection was instead by normal saline. In the SAH+fasudil group, at 30 min after the second injection of blood, rats were administrated with intraperitoneal injection of fasudil at a dose of 3 mg/kg. The general situation, neurological score, TUNEL staining for cortex cell apoptosis, immune histochemical staining and Western blotting assay for Bcl-2 and Bax protein expression were compared 24 h after the operation between the three groups. Results Compared with the sham operation group, rats in SAH group and SAH +fasudil group appeared obvious neurological deficits. The neurological score was significantly lower in SAH group ( 2.68 ± 0.31) than that of sham operation group (5.00±0.00). The neurological score was significantly higher in SAH+fasudil group (3.27 ± 0.35) compared with that of SAH group (2.68 ± 0.31, P<0.05). There was obvious cell apoptosis in SAH group and SAH+fasudil group, and the apoptosis was less in SAH+fasudil group than that of SAH group (P<0.05). The level of Bcl-2 expression was significantly lower in SAH group than that of sham operation group, and Bax expression was significantly higher in SAH group than that of sham operation group (P<0.05). The level of Bcl-2 expression was significantly higher in SAH+fasudil group than that of SAH group, but Bax expression was significantly lower in SAH+fasudil group than that of SAH group (P<0.05). Conclusion Fasudil can improve the neurological damage in rats with SAH, which may be related with the regulation of apoptosis related proteins Bcl-2 and Bax.

Objective To investigate the effects of artesunate (Art) on cell proliferation, apoptosis, nuclear factor (NF)-κB and monocyte chemotactic protein 1 (MCP-1) expressions induced by high glucose in rat renal mesangial cells (HBZY-1), and the mechanism thereof. Methods HBZY-1 cells were cultured and divided into normal glucose group (5.6 mmol/L), high glucose group (25 mmol/L) and high glucose with different concentrations of Art (10 mg/L, 20 mg/L, 30 mg/L) groups. MTT assay was used to detect the cell proliferation after 48 h. The apoptotic rate was evaluated by flow cytometry with Annexin V-FITC/PI double stains. The protein levels of NF-κB and MCP-1 in the cell culture supernatant were determined using ELISA. Results High glucose induced apoptosis and proliferation in HBZY-1 cells, and the expressions of NF-κB and MCP-1 in the supernatant were also increased (P<0.05). After treatment with Art, the proliferation was obviously abolished, and the apoptosis was increased, and the expressions of NF-κB and MCP-1 in the supernatant were decreased in HBZY-1 cells. The effects of Art showed a dose-dependent manner (P<0.05). Conclusion Artesunate treatment can reverse the effect of high glucose in HBZY-1 cells in a dose-dependent manner, which may provide a new therapeutic strategy for diabetic nephropathy.

Objective To explore the difference of DNA methylation levels between normal Schwann cells (NSCs) and activated Schwann cells (ASCs) in rats. Methods The adult Wistar rats were received sciatic nerve ligation and fed for 7 days. The ASCs and NSCs were separated from ligated sciatic nerves and brachial plexus respectively. Immunocytochemical staining of S-100 antibody was used to identify the cells. The growth condition of cells was detected by CCK-8 method. Methylated DNA immunoprecipitation sequencing (MeDIP-Seq) was applied to filter the differentially methylated regions in ASCs and NSCs. The distribution of differentially methylated genes related with axonal regeneration in chromosome was analyzed, and Gene ontology(GO)and PATHWAY analysis were also conducted. Results High purity of ASCs and NSCs were obtained successfully, which were both positive for S-100 antibody. In the same culture condition, ASCs showed a faster proliferation than that of NSCs. A total of 177 176 differentially methylated regions were found by MeDIP-Seq. Among them, 1 097 were located in the promoter (≤1 kb), 1 136 in the promoter (1-2 kb) and 567 on the CpG. After functional annotation of differentially methylated genes, 214 differentially methylated genes related with axonal regeneration were found in ASCs and NSCs. Compared with NSCs, 191 genes were up-regulated and 23 genes were down-regulated in ASCs. These genes were located on different chromosomes, most of which on chromosome 12 (22 genes) and the least on chromosomes M (2 genes). GO analysis indicated that the differential methylated genes were involved in axon growth, axon formation, axon elongation and axon guidance. The MAPK, cell adhesion molecules, Ras signaling pathway may be related with the differential methylated genes. Conclusion The methylation levels between ASCs and NSCs are significantly different, which are probably related with axon regeneration.

Objective To review and analyze the clinical effect of combined posterior mini-invasive fixation with anterior debridement via small incision for the treatment of single segment lumbar vertebral tuberculosis. Methods Totally 31 cases with single segment lumbar tuberculosis (both borderline tuberculosis) without attachment involvement underwent one-stage anterior debridement, interbody fusion and posterior mini-invasive fixation from July 2010 to July 2015. Among these patients, 19 were male and 12 were female. The average age was (36.1±17.8) years old (ranged 21-61 years old). The average course of disease was 11(9, 12) months (ranged from 2 to 16 months). All were single segment involvement, and the involved segment was L2-3 in 7 cases, L3-4 in 10 cases, L4-5 in 6 cases, and L5-S1 in 8 cases. The clinical manifestations included lumbar back pain in 31 cases with an average pain visual analog score (VAS) of 7(6, 8) points. ASIA grade of spinal cord injury was E in 25 cases and D in 6 cases. Paravertebral abscess occurred in 22 cases and iliac fossa gravity abscess appeared in 9 cases. Kyphosis was observed in 12 cases and the average Cobb angle was 21° ± 6° . Quadruple anti-tuberculosis chemotherapy was used for at least 2 weeks preoperatively. Posterior mini-invasive fixation was fulfilled on prone position, including mini-invasive percutaneous screws in 18 cases and pedicle screw fixation via Wiltse approach in 13 cases. Posterior distraction and deformity correction were performed simultaneously for patients with kyphosis. Then the patients were changed to lateral position for anterior debridement, bone grafting and/or titanium mesh fusion. Results The average operation time was (204±54) min (ranged 160-240 min) in 31 patients, and the mean blood loss was (168±73) mL (ranged 100-300 mL). Delayed healing of anterior incision occurred in 1 case and the incision healed after two-week dressing of wound. The incision healed well in the rest 30 cases. No complications such as nerve function, blood vessel injury were found in patients. The VAS scores of the 3 days after operation were 1.3 ± 0.3 and 2.1 ± 1.4 in percutaneous group and Wiltse approach group, respectively, and the difference between them was statistically significant ( P<0.05). The VAS score of low back pain was 2(1, 3) points in all the 31 patients three months after operation, which was significantly lower than that before surgery (P<0.05). The six patients with neurological symptoms recovered to E grade after operation. The average Cobb angle correction was 15°±5° in 12 patients with kyphosis (P<0.05), which was significantly decreased compared with that before surgery (P<0.05). All patients were followed up for an average of (36.8 ± 9.3) months (ranged from 12 to 72 months). The clinical healing of tuberculosis was achieved at the final follow-up in all the 31 patients. No complications were observed, such as lumbar kyphosis, internal fixation loosening and breakage, dislocation and titanium mesh subsidence. Conclusion Mini-invasive posterior internal fixation and anterior debridement via small incision is effective for the treatment of single segment lumbar vertebral tuberculosis in lesion debridement and spine stability reconstruction by short segment fixation. This technique can reduce fused segments, surgical trauma of anterior approach and related complications.

Objective To study the relationship between microalbuminuria and cardiac diastolic function in patients with type 2 diabetes mellitus (T2DM) and nonalcoholic fatty liver disease (NAFLD). Methods A total of 262 patients with T2DM and NAFLD were included in this study. Patients were divided into normal group (n=106) and abnormal group (n=156) according to their cardiac diastolic function. Data of waist circumference (WC), low density lipoprotein cholesterol (LDL-C), triglyceride(TG), systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting blood glucose (FBG), fasting insulin level (FINS), insulin resistance index (HOMA-IR), glycosylated hemoglobin (HbA1c), glomerular filtration rate (GFR), C reactive protein (CRP), urinary microalbuminuria excretion rate (UAER), left ventricular myocardial quality index (LVWI) and liver fat content (LFC) were compared between two groups. All patients were divided into four groups according to data of UAER and GFR:group A[UAER<20μg/min and GFR≥90 mL/(min · 1.73 m2)], group B [UAER<20μg/min and GFR<90 mL/(min·1.73 m2)], group C [UAER≥20μg/min and GFR≥90 mL/(min·1.73 m2)], and group D [UAER≥20μg/min and GFR<90 mL/(min · 1.73 m2)]. The differences between the relevant indicators were analyzed between groups. Logistic regression analysis was used to compare UAER between normal group and abnormal group. Also the relationship between the related factors and cardiac diastolic function was compared between these two groups. Results For abnormal group, TG, SBP, HOMA-IR, CRP, UAER, LVWI and LFC were significantly higher, and GFR was significantly lower, than those of normal group (P<0.05). There were no significant differences in other indicators between two groups. Values of peak early/late diastolic filling velocity (E/A) showed a reduction trend in order in A, B,C and D groups (P<0.05). Values of LVWI showed a increasing trend in order in four groups (P<0.05). Values of LFC were significantly higher in C and D groups compared with those of A and B groups (P<0.05). There was no significant difference in LFC between A group and B group. The GFR<90 mL/(min·1.73 m2)was an independent risk factor for cardiac diastolic function in normal group of UAER, and higher UAER was an independent risk factor for cardiac diastolic function in the abnormal group of UAER. Conclusion There is obviously reduced cardiac diastolic function in patients with T2DM and NAFLD and microalbuminuria. When UAER≥20 μg/min, the higher UAER is an independent risk factor for reducing diastolic cardiac dysfunction.

The intervertebral disc disease is a group of clinical diseases with complex etiology, various clinical symptoms and poor conservative treatment effect. The traditional treatment methods include conservative treatment, local injection and open surgery. In recent years, minimally invasive spine surgery has made great progress and development, and its clinical effect has been fully affirmed. Coblation nucleoplasty (CN) has been mainly used in the treatment of contained disc herniation since it has been used in clinical treatment. Its application is not favorable because of narrow indications, uncertain clinical efficacy and other reasons. At present, the application of CN in the intervertebral disc diseases has been reported in many literatures, and its working principle, operation safety, indications and efficacy have been analyzed and extended. Those literatures play an important role in its clinical application. Therefore, in this paper, the application status of CN in the intervertebral disc diseases is reviewed.

Fibulin protein family has widely existed in the extracellular matrix, and plays an important role in maintain the stable of basement membrane, elastic fibers and loose connective tissue. Fibulin-5 (FBLN-5) is one of the members of the Fibulin protein family, which is essential to the structure function and cell mediated action. The lack of FBLN-5 will cause many diseases such as internal organ deformity. Current research suggests that changes of expression level of FBLN-5 are associated with the occurrence of tumors such as lung cancer, and also can influence the tumor proliferation, invasion and prognosis, thus may become a new molecular marker for cancer diagnosis. Therefore, in this review, we summarize and update biological characteristics and functions of FBLN-5, and its role in the development of tumor formation mechanism.