BACKGROUND:Wnt signal pathway is involved in the regulation of bone marrow mesenchymal stem cells differentiating into osteoblasts, promotes osteoblasts proliferation and differentiation, inhibits programmed death of osteoblasts, and indirectly affects the function of osteoclasts.
OBJECTIVE:To summarize the relationship between Wnt/β-catenin signal pathway and bone disease.
METHODS:A computer-based online search was performed to find papers published between January 2000 and January 2014 in CNKI database and Elsevier database. The key words were“Wnt/β-catenin, osteoblasts, bone marrow mesenchymal stem cells, osteoarthritis, chondrocytes”in Chinese. Documents concerning the effects of Wnt/β-catenin signal pathway on osteoblasts and bone disease were included.
RESULTS AND CONCLUSION:Wnt signaling pathway is consisted of Wnt/β-catenin signal pathway (Wnt typical signal pathway), Wnt/Ca2+signal pathway and Wnt/planar cellpolarity signal pathway. Wnt signaling pathway is one of the most important regulatory systems that plays a key role in modulating the differentiation, proliferation and programmed celldeath of osteoblasts, osteoclasts and chondrocytes. The role of Wnt signal pathway in patients with rheumatoid arthritis is mediated by osteoblasts. The inhibitory factor of Wnt signal pathway in osteoblasts is upregulated, which reduces the ratio of osteoprotegerin/receptor activating factor ligand, promotes the osteoclasts differentiation and immaturation. The researches addressing the components and effect of Wnt signal pathway are important for the special treatment of bone diseases and the prevention of osteoporosis or other bone diseases.

Objective To investigate the protective effect of ginsenoside Rb1 and Re on injury of the neonate rat cardiomyocyte induced by aconitine alkaloids.Methods The influence of aconitine and ginsenoside Rb1,Re together in neonate rat cardiomyocyte was observed respectively.The influence of these components in neonate rat cardiomyocyte was examined by myocard zymogram.The expression of Ca2+ channel gene Cav1.2 mRNA of neonate rat cardiomyocyte after treatment was observed by RT-PCR.Results The ginsenoside Rb1 and Re were able to decrease the release of AST and LDH,reverse Cav1.2 mRNA abundance induced by aconitine.Conclusion The ginsenoside Rb1 and Re which together with aconitine can alleviate the side effects and boost up the therapeutic effects of aconitine.The action mechanism may be relation with that the ginsenoside Rb1 and Re can decrease injuries of the neonate rat cardiomyocytes and abundant expression of Cav1.2 mRNA induced by aconitine.

Objective To compare the surgical effects of transurethal enucleation of prostate (TUEP)with transurethal resection of prostate (TURP) by a retrospective analysis of clinical data.Methods The patients in this study were divided into the groups of TUEP (enrolled in 2010 and 2011,n =77) and TURP (enrolled in 2009,n =27) with prostate larger than 60 g and smaller than 60 g respectively.Comparisons were made between the two groups in operation time,blood loss volume and weight of resected prostate.Results In the group of patients with prostate larger than 60 g,there was no significant difference in prostate weight ((88.5 ± 9.2) g vs.(107.0 ± 15.30) g,P =0.255),operation time ((91.5 ± 8.8) min vs.(118.3 ± 20.2)min,P =0.083),and weight of resected prostate ((48.0 ± 4.6) g vs.(58.4 ± 5.4) g,P =0.32) between the TUEP (53 patients) and the TURP (12 patients) groups.There was significant difference in blood loss ((110.0 ± 16.4) ml vs.(193.3 ± 22.3) ml,P =0.011) between the two groups.In the group of patients with prostate smaller than 60 g,there was no significant difference in prostate weight ((43.1 ± 3.2) g vs.(36.8 ± 3.4) g,P =0.072),operation time ((62.7 ±6.8) min vs.(69.3 ±6.2) min,P =0.431),blood loss ((56 ± 5) ml vs.(110±20) ml,P=0.082),and weight of resected prostate ((26.3 ±2.4) g vs.(23.6 ±2.1) g,P =0.291) between the TUEP (24 patients) and the TURP (15 patients) groups.Conclusion Compared with TURP,TUEP has the advantages of less blood loss in the treatment of patients with prostate larger than 60 g.With the improvement of surgeon' s experience and development of operation techniques,TURP will be replaced by TUEP.In the treatment of patients with prostate smaller than 60 g,the operation modality can be chosen by the surgeon based on his experience and proficiency.

Objective To investigate factors influencing the quality of life (QOL) of cancer patients with bone metastases. Methods Eighty-two cancer patients with hone metastasis were investigated.A questionnaire designed according to European Organization for Treatment of Cancer quality of life questionnaire ( EORTC QLQ-C30),Monroe Dunaway Anderson symptom inventory-Chinese edition (MADSI-C) and hospital anxiety and depression scale (HADS) standards was used to collect the information. Results The average total standardized QOL score of these cancer patients was 53.28±19.20.Among the function subscales,social function got the lowest average score (47.54),while among the symptom subscales fatigue got the highest average score (56.65).According to the MDASI-C,the most serious symptom burdens were fatigue,distress and pain; working and walking experienced the most interference.The symptom burdens correlated significantly with the QOL results.Twenty-four of the patients (29.3％) had been diagnosed with anxiety,and 17 (20.7％) were diagnosed with depression.Anxiety and depression continued to be significantly associated with overall QOL and its various dimensions. Conclusions The results　show that the burden of fatigue and pain,as well as of anxiety and depression are significantly associated with impaired QOL among cancer patients with bone metastasis.Work (housework) and walking were the most severely affected activities.Psychological rehabilitation should be focused on the comprehensive treatment of patients with bone　metastasis along with other appropriate rehabilitation strategies to enhance their overall functioning,relieve their　symptoms and improve their QOL.

Objective To investigate the fatigue experience of the community-dwelling frail elderly to establish the conceptual model.Methods Grounded theory was adopted.With MAXQDA v10.4.15.1for 3 levels coding,the conceptual model of fatigue experience of community-dwelling frail elderly people was structured through constant comparison and in-depth analysis.Results Multi-response,selfmanagement,safe and belonging,hitting rock bottom,accepting and transferring formed the conceptual model.Conclusions Based on the conceptual model,nurses should pay more attention to concern about the fatigue experience of community-dwelling frail elderly people,and probe different assessment methods to enrich comprehensive geriatric assessment (CGA),then improve the community health service level and the quality of elderly people's life.

Objective To investigate serum amino acid spectrum in patients with acute stroke in response to different nutritional support strategies and its effects on neurological function.Methods A total of 60 cases of acute stroke with dysphagia were randomly distributed into two groups:enteral nutrition group (30 cases) and control group (30 cases) using simple randomized design.Serum amino acid spectrum,hemoglobin,total protein,albumin,prealbumin,immunoglobulins,complement,and infection rate were assessed at three time points:within 48 hours,(7 ± 1) days and (14 ± 1) days after admission,and neurological deficit and activities of daily living are scored according to National Institutes of Health Stroke Scale (NIHSS) and Barthel Index (BI).Results (7 ± 1),(14 ± 1) days after admission,serum amino acid spectrum,hemoglobin,total protein,albumin,prealbumin,immunoglobulins,complement,and neurological deficit scores of enteral nutrition group patients were significantly better than those of non-enteral nutrition control group; and infection rate was lower than that of control group.Follow-up for a month,3 months,NIHSS of enteral nutrition group patients (9.0 ± 1.4,7.9 ± 1.3) were significantly better than nonenteral nutrition control group(11.1 ± 1.5,10.6 ± 1.4,F =46.042,P ＜ 0.05).While BI score seemed to be not insignificant different between enteral nutrition group (50.1 ± 1.8,52.0 ± 2.4) and control group (49.0±2.1,51.3 ±2.8,F=2.707,P＞0.05).Conclusion For patients suffering acute stroke with dysphagia,enteral nutrition support could reduce infectious complications,improve short-term neurological function and long-term prognosis by improving serum amino acids level and thus the whole body' s nutritional status.

Objective:To explore the impact of clinical pharmacists involved in the treatment team on the reasonable drug use rate in medical orders. Methods:Totally 782 medical records including hypertension and 1-3 kinds of hypertension associated diseases in our hospital from January 2011 to December 2011 were used as the pre-intervention group, and 1 061 ones with the same conditions from September 2012 to August 2013 were used as the post-intervention group. The patients of the two groups were divided into 8 dis-ease subgroups, clinical pharmacists performed timely intervention on the medical orders in the post-intervention group, and the rational drug use rate between the two groups was compared. Results:In hypertension, hypertension associated coronary heart disease, hyper-tension with heart failure and hypertension with diabetes subgroups,the difference in the rational drug use proportion before and after the intervention was statistically significant(P<0. 01), in hypertension with coronary heart disease and heart failure, hypertension associ-ated coronary heart disease and diabetes, hypertension with heart failure and diabetes subgroup, the difference in the rational drug use proportion before and after the intervention was statistically significant(P<0. 05), while in hypertension with coronary heart disease, heart failure and diabetes subgroups, the difference was not statistically significant(P>0. 05). After the medical records in the 8 sub-groups were aggregated, the difference in the rational drug use proportion before and after the intervention was statistically significant( P<0. 01). Conclusion:Clinical pharmacists should involve in the clinical treatment to intervene irrational drug use,which can signifi-cantly improve the medical record rationality, avoid the health risks as much as possible and ensure the medication safety and treatment effectiveness for patients.

Objective: To establish the quality control standard of Xiangshapingwei Pills (Rhizoma Atracylodis Pericarpium Citri Reticulatae Cortex Magnoliae Officinalis Radix Aucklandiae etc.)Methods: Rhizoma Atractylodis , Radix Auklandiae, Cortex Magnoliae Officinalis, Pericarpium Citri Reticulatae in Xingshapingwei Pills were identified by TLC. The content of hesperidin in Xiangshapingwei Pills was determined by RP HPLC with C 18 reversed phase column, mobile phase (methanol∶water∶acetic acid=30∶65∶5),detection wavelength at 283nm and flow rate 1.0mL?min -1 .Results: Hesperidin showed a good linear relationship at a rang of 0.8～4.0?g. r = 0.9993 . The average recovery was 96.7%, and RSD was 2.42%.Conclusion: The method is accurate and quick, and can be used for the quality control of Xiangshapingwei Pills.

Objective To study the effects of enteral immunonutrition on immune function in patients with multiple trauma. Method A total of 32 patients with multiple trauma admitted to general ICU in ChangZheng hospital, Shanghai from March 2007 to May 2008 were randomly (random number) divided into two groups,enteral immunonutrition group (EIN group, n = 16)and the general formula enteral nutrition group (EN group, n = 16).Two groups of patients on the third day after injury began to accept the EIN and the general formula EN which respectively support at least 14 days. The patients peripheral blood lymphocyte count (TLC), immunoglobulin (IgG,IgM, IgA) ,and T-lymphocyte subsets (CD3, CD4, CD8, CD4/CD8) were detected on the day of the group formation, the seventh and the fortteenth day of the nutritional support. Results TLC, IgG, IgM, IgA, CD4 and CD4/CD8 ratio were significantly higher in EIN Group on the 7th and 14th day than that on the first day ( P ＜0.05), and extended with the EIN and sustained increase. All immunization indicators of EN group on the 7th day were no significant changes compared with the day of the group formation, and on the 14 th day TLC, IgG, IgM,IgA, CD4 and CD4/CD8 ratio were significantly higher than that on the day of the group formation ( P ＜ 0.05),but were significantly lower than that in the EIN group on the 14th day ( P ＜ 0.05). Conclusions Compared with the general formula EN, EIN is more helpful to restore and increase the humoral and cellular immune function in early post-multitraumatic phase.

Objective:To prepare the production of TIGIT-Fc fusion protein using H22 cells stably integrated the gene by lentivirus vector , and to explore the immunoregulatory effect on macrophages by TIGIT-Fc.Methods: TIGIT-Fc fusion gene were constructed by molecular cloning.The fusion gene was then subcloned to plasmids contained the secretion signaling peptide .The secrected TIGIT-Fc fusion gene was inserted into the lentivirus backbone vector.The purified lentivirus vector was the used to infect the murine H22 cell line.TIGIT-Fc protein was purified by protein A column from the ascites of H 22-injected C57BL/6 mice.Macrophages stimulated by lipopolysaccharide ( LPS ) was challenged to TIGIT-Fc treatment or control.Cytokine levels was then detected by ELISA.Results: TIGIT-Fc protein was purified from the ascites of H 22-injected mice.PVR was upregulated in LPS-treated macrophages.IL-10 level was upregulated in TIGIT-Fc treated macrophages.Conclusion: TIGIT-Fc promotes the mature macrophages to secrete anti-inflammatory cytokine IL-10.