OBJECTIVE: To analyze the expression of procollagen gene in fracture callus, and to search for the technique of in situ hybridization for undecalcified skeletal tissue. METHODS: In situ hybridization of procollagen gene expression was performed on the undecalcified cryosections of rat fracture callus at 7, 14, and 28 d. RESULTS: The hybridization signals achieved were clear and easy to be localized with high specificity. On the 7th day, the expressions of pro alpha1 (III) in fibroblasts and some chondrocyte-like cells were dominant; and at the end of second week high expression of type-II procollagen mRNA was observed in chondrocytes. At the end of fourth week, the cartilaginous callus was almost all replaced by woven bone tissue, and some type-I procollagen mRNA positive osteoblasts and hypertrophic chondrocytes were found scattering in the woven bone and remnants of cartilaginous callus. CONCLUSIONS: The modified method employed in this study is easier, quicker, and more sensitive with high specificity than the conventional tec hnique for in situ hybridization of procollagen gene expression of decalcified rat fracture callus. The phenomenon of shared phenotype expression, which was demonstrated among cells engaged in fracture healing, indicates an important approach to reveal the mechanism of the origin, differentiation, and orientation of cells.

Objective:To investigate the imaging follow-up value of discectomy and Modic changes caused by endolate fracture.Methods:Forty-six patients with end-plate fractures admitted to Changxing People′s Hospital during January to December 2016 were selected as subjects and followed up for 1 year. All patients underwent MRI examination to analyze the changes of Modic, disc degeneration and lumbar function recovery before and after follow-up.Results:A total of 230 lumbar intervertebral discs in 46 patients in this group had Modic changes. After 1 year′s follow-up, Modic changes occurred in 185 lumbar intervertebral discs in 46 patients. Modic changes occurred in L 5-S 1 [38.92%(72/185)] and L 4 - L 5 [40.0%(74/185)] segments. After 1 year′s follow-up, the rate of intervertebral disc 3-4 grade was higher than that before discharge [70.43%(162/230) vs. 60.43%(139/230)], the rate of intervertebral disc 6-8 grade was lower than that before discharge[8.70%(20/230) vs. 15.22%(35/230)], and the differences were statistically significant ( χ2 = 5.085, 4.646, P<0.05). After 1 year′s follow-up, the lumbar spine function score was significantly higher than that before discharge [(23.47 ± 2.86) scores vs. (9.15 ± 1.32) scores], and the difference was statistically significant ( P<0.05). Conclusions:Diffusion-weighted MR imaging has the characteristics of convenient operation, good repeatability and high accuracy. It is suitable for diagnosis and follow-up of disc degeneration and Modic change caused by endplate fracture. It is worthy of clinical promotion.

OBJECTIVE To systematically evaluate the safety of paroxetine in the treatment of pregnant patients with depression in the second and third trimesters of pregnancy， and provide reference for rational clinical use of it. METHODS Retrieved from Cochrane Library， PubMed， Embase， VIP， CNKI， Wanfang database and SinoMed database， by manual search， randomized controlled studies or observational studies were collected on depression patients who were given paroxetine vs. selective serotonin reuptake inhibitor （SSRI） in the second and third trimesters of pregnancy during the inception to Aug. 2022. Methodological qualities of the included studies were assessed by Cochrane Handbook 5.1.0 or Newcastle-Ottawa Scale （NOS）. Meta-analysis was performed with RevMan 5.4.1 software. RESULTS Finally， 9 observational studies were included， and all included studies were of high quality in NOS scale. Meta-analysis was performed on 8 cohort studies. Meta-analysis showed that the total incidence of adverse pregnancy outcomes of mothers and infants [RR＝0.99， 95%CI（0.89，1.10），P＝0.87]， total incidence of maternal adverse pregnancy outcomes [RR＝0.98， 95%CI （0.87，1.10）， P＝0.69] and premature birth [RR＝0.89， 95%CI （0.43， 1.83）， P＝0.75] in the second and third trimesters of pregnancy were lower than that with other SSRI， without statistical significance. The incidence of neonatal complications with paroxetine in the second and third trimesters of pregnancy was higher than that with other SSRI， but the difference was not statistically significant [RR＝1.02， 95%CI （0.82，1.29）， P＝0.84]. One study reported that the incidence of neonatal pulmonary hypertension in paroxetine group was higher than that in other SSRI group （0.4% vs. 0.3%）. CONCLUSIONS The safety of peroxetine in the second and third trimesters of pregnancy is comparable with that of other SSRI， but it is necessary to be alert to the occurrence of neonatal pulmonary hypertension.

OBJECTIVE To explore the way to re-use epidermal growth factor receptor-tyrosine kinase inhibitors （EGFR-TKI） in patients with EGFR-TKI-induced interstitial pneumonia （IP）， using osimertinib as an example. METHODS The IP treatment regimen and re-use of EGFR-TKI regimen in a patient who developed IP after the use of osimertinib were analyzed. And a literature review was made by combining the characteristics of the cases which reported in the literature and the characteristics of this case. RESULTS The patient’s IP symptoms due to treatment with osimertinib had resolved after treatment. The patient’s IP symptoms also did not worsen after using almonertinib in combination with hormones as re-use of EGFR-TKI regimen. However， almonertinib was discontinued as the patient experienced disease progression. The adverse reactions of IP needed to be dealt with in time， the EGFR-TKI should be discontinued and symptomatic treatment should be given. CONCLUSIONS EGFR-TKI targeted therapy could be re-selected by replacing EGFR-TKI， adjusting the dose of EGFR-TKI， and using hormones in combination. EGFR-TKI-induced adverse drug reactions of IP are rare， but need to be observed closely. If other EGFR-TKI is used， close monitoring of adverse reactions and curative effects are also required in order to adjust the patient’s treatment plan in time.