Osteoporosis complicated with fracture is a common and severe condition. This paper summarizes present advances and new concepts in its treatment. Since the secondary osteoporosis will likely develop after fracture treatment with immobilization, more and more bone mass will get lost in addition to primary osteoporosis. A vicious cycle will be established and influence the fracture healing. Therefore, the key to the treatment is to block the vicious cycle to stop or decrease the bone loss. As a routine measure, to do exercises and weight- bearing activities as early as possible is as important as to take medicines for osteoporosis treatment. Stable internal fixation and prosthetic replacement should be firstly chosen for treatment of most fractures. In drug treatment, calcitonin, bisphosphonate (alendronate), HRT (Livial), vitamins D2 and D3, and calcium are indicated.

Objective To study the properties of stress relaxation of the middle and lower cervical vertebrae, and to evaluate the effects of laminotomy and anterior diskectomy and spinal fusion (ASF) on the properties . Methods The dynamic responses of stress relaxation of six intact and post operative fresh human cadaveric cervical vertebrae were measured in vitro. Results Under the condition of the constant strain, the functional equations and the curves of stress relaxation of the six intact and post operative fresh human cadaveric cervical vertebrae were obtained. The Gex(t)(the ratio of the ensuing instant stress to the original stress) of the post operative ones was significantly bigger than that of the intact ones; The Gex(t) of the laminotomic ones was significantly bigger than that of the ones having undergone the anterior discectomy and spinal fusion(ASF). Conclusion Either in flexion or in extension, cervical vertebrae have the similar behaviors of stress relaxation. The laminotomy and anterior discectomy and spinal fusion (ASF) all reduce the stress relaxation effect of the cervical vertebrae, but ASF is more significant.

BACKGROUND:The development of spinal non-fusion technology promoted movement function protection of adjacent segment and operating segment. In the treatment of cervical spondylosis surgery, non-fusion technology has been widely carried out. For middle-aged patients with cervical spondylosis, the demand for spinal joint movement function is high. Non-fusion technology can improve the postoperative quality of life and slow down the risk of adjacent segment degeneration. OBJECTIVE:To evaluate the clinical efficacy of anterior cervical different implant materials (fusion or non-fusion) in the treatment of single segment of the intervertebral disc degeneration of cervical spondylosis in middle-aged patients. METHODS:This study enrol ed 10 cases of single segmental radiculopathy and cervical myelopathy after cervical intervertebral disc replacement from June 2011 to June 2013. Simultaneously, 10 cases were randomly selected from patients with anterior interbody fusion as the control group. Before treatment, at 1 and 3 months, and 1 year after treatment, changes in range of motion of cervical vertebra were observed using imaging results. Therapeutic effects were assessed using Japanese Orthopaedic Association Scores, Visual Analog Scale and The Neek Disability Index in both groups. RESULTS AND CONCLUSION:Al patients did not suffer from incision fat liquefaction, infection and delayed healing, and had finished fol ow-up for more than 1 year. Results revealed that Japanese Orthopaedic Association Scores and Visual Analog Scale scores were improved at 1 and 3 months, and 1 year after treatment (P<0.05), and no significant difference was detected between the two groups (P>0.05). In the analysis of range of motion of cervical vertebra and The Neek Disability Index, there were significant advantages in non-fusion treatment group (P<0.05). For middle-aged patients with cervical spondylosis, due to its life demand for neck mobility, the repair program of non-fusion cervical intervertebral disc replacement has a clear advantage.

Objective　To study the feasibility of constructing tissue engineered cartilage by differentiated rabbit bone marrow mesenchymal stem cells(MSC) cultured in vitro and in vivo. Methods　The MSC were isolated from the nucleated cells fraction of autologous bone marrow by density gradient centrifuge, and then induced into chondrogenic differentiation by adding dexamethasone, transforming growth factor-β1(TGF-β1) and ascorbic acid in vitro. After 3 weeks, some cells turned to round shape and secreted metachromatic matrix. The cartilaginoid grafts composed of chondrogenic MSC. Bovine type Ⅰ collagen and human fibrin were cultured within the chondrogenic medium for 2 weeks in vitro or transplanted subcutaneously adjacent to the knee joint for 3 weeks in vivo. Results　The most cells in the grafts were degenerated and disappeared after cultured in vitro. But the residual cells were survival and secreted metachromatic staining proteoglycan with toluidine blue, which was characteristic cartilage matrix. The grafts developed into matured cartilage tissue assessed by histological examination after 3 weeks of transplantation in vivo. Conclusion　MSC can be used as functional cells to constructing tissue engineered cartilage.

Objective　To observe the effect of repairing the articular cartilage defects with tissue-engineered cartilaginous grafts in rabbits. 　Methods　 A total of 60 rabbits were divided into the cartilage graft group, the pure carrier control group and the blank control group. In the cartilage graft group, the bone marrow mesenchymal stem cells (MSCs) of the rabbits were obtained by isolating and culturing the bone marrow aspirates in vitro. The culture system that facilitates the chondrogenous differentiation of MSCs in rabbits was established. The tissue engineering cartilaginous graft was composed of chondrogenetic MSCs, bovine type Ⅰ collagen and human fibrin. Then transplantations of the cartilaginous grafts were performed to repair articular cartilage defects in rabbits. 　Results　Hyaloid cartilage was formed within the defects repaired with the grafts at 12 weeks after transplantation by analyzing the content of type Ⅱ collagen and metachromatism. In the control groups, the fibrous cartilage repair was observed first, then the fibrous tissues and bone repairs were found. 　Conclusions　 The cartilaginous graft through tissue engineering is a promising graft for repairing articular cartilage defects.

Objective To promote the clinical practice of bone morphogenetic proteins (BMP) coated prosthesis in order to improve its biological fixation. Methods There were 12 healthy mongrels, weighted from 20 to 25 kg. They were randomly divided into 3 groups according to the scarified time. The bilateral femurs were adopted as the graft areas, and 4 kinds of implant were transplanted into each femur randomly. The transplant consisted of porous-coated anatomic(PCA group), PCA combined with BMP (BMP group), PCA combined with hydroxyapatite(Composite group), and polish PCA combined with HA (HA group). The femurs of the mongrels were retrieved at the 4th, 8th and 12th week respectively. Bone ingrowth and shear strength between the interfaces of the bone-implant were studied, using X-ray, soft X-ray, fluorescence tag, non-decalcification ground section, computer-aided image analysis, and histological examinations. Results By gross observation, the composite for the group of PCA with BMP was the most stable in all the experimental groups. All implants showed good histocompatibility, the bone ingrowth on the implant surface appeared earlier in the BMP group than any others, and so did the maturation of new bone. At 4th week, the percent of new bone formation in the BMP group was 26.58%?4.56%, which was also much higher than PCA group (18.28%?2.46%), Composite group (17.23%?2.11%), and HA group(16.89%?3.13%) through the means of non-decalcified ground section and computer aided image analysis, and the difference was of statistical significance(P0.05). Conclusion The composite of BMP to the PCA is effective and feasible procedure, which could increase biological fixation of the interfaces between the bone and implant. Furthermore, HA coating is also an effective method of prosthesis surface treatment in order to improve bone ingrowth and enhance the interface shear strength, and the technique of HA coating is an essential factor in processing the prosthesis.

Objective: To explore the effect of voluntary teaching for medical students on cardio-pulmonary resuscitation training for middle school students,and to provide a reference for education of first aid among primary and middle school students. Methods: A total of 196 students from four classes in the first grade of a middle school were selected by convenient sampling method and divided into experimental group and control group according to the class. After the two groups of students were trained in unified theory, the students in the control group were trained by the medical staff in the hospital, and the students in the experimental group were trained by the volunteers of the medical students who had been strictly trained and assessed. After the training was finished, questionnaires were sent out to investigate the effect of training. Results: Before the training, there was no significant difference in the theoretical scores between the two groups (t=1.18，P=0.24). After training, the theoretical and skill scores of the experimental group were(11.43±1.53)(5.68±1.80), that of the control group were(11.35±1.77)(5.30±1.76), and there was no significant difference between the experimental group and the control group(t=0.34，1.48，P>0.05). Conclusion The application of voluntary teaching in the training of middle school students’ cardiopulmonary resuscitation can improve the popularization rate of cardiopulmonary resuscitation, save medical resources effectively, and improve the practical ability of medical students.

Objective　By observing the effect of adenosine pretreatment on BBB permeability and AQP4 expression in the brain around the infarct area，the protective effect of adenosine pretreatment on brain and its possible mechanism were discussed from the perspective of BBB. Methods　SD （Sprague Dewley） rats were randomly divided into control group （F Group），model group （IR group） and adenosine preconditioning group （AP group）. Each group was further divided into 4 subgroups：6 h，24 h，48 h and 72 h groups. Brain water content was measured by dry wet weight method；BBB permeability was analyzed by Evans blue （EB） permeation method；AQP4 protein expression was detected by immunohistochemistry at different time points. Results　①The brain water content in AP group was significantly lower than that in IR group （P<0.05）. ②The amount of EB exudation in IR group and AP group was significantly higher than that in F group，the difference was statistically significant （P<0.05）；the EB exudation volume of AP group was significantly lower than that of IR group，but higher than that of F group，with significant difference（P<0.05）. ③AQP4 expression in IR group and AP group was higher than that in F group（P<0.05）；AQP4 expression in AP group was significantly lower than that in IR group（P<0.05）. ④Compared with IR group and AP group，EB exudation reached the peak at 48 h，then decreased but still higher than the normal level，AQP4 expression also reached the peak at 48 h；the BBB permeability of brain tissue around the infarcted area was significantly positively correlated with the change of AQP4 expression （r=0.898，P<0.001）. Conclusion　Adenosine preconditioning can improve the permeability of blood-brain barrier and protect the brain，which may be achieved by reducing the expression of AQP4 protein.

BACKGROUND: Lung adenocarcinoma (LUAD) is a major subtype of lung cancer, and its treatment and diagnosis remain a hot research topic. Targeting protein for Xenopus kinesin-like protein 2 (TPX2) is highly expressed in a variety of cancer cells and may be associated with the progression of LUAD. This study aimed to investigate the effect of TPX2 on the malignant progression of LUAD cells and the regulatory mechanisms. METHODS: The expression of gene TPX2 in LUAD tissues from The Cancer Genome Atlas (TCGA) database was analyzed by bioinformatics analysis techniques. Quantitative real-time polymerase chain reaction (qRT-PCR) was used to detect the expression levels of TPX2 and miR-218-5p in human lung normal cell lines and human LUAD cell lines. Western blot was used to detect TPX2 protein expression in cell lines and its effect on the expression of key proteins in the p53 signaling pathway. The relationship between TPX2 and miR-218-5p was predicted using bioinformatics and verified by dual luciferase reporter gene assay. Cell counting kit-8 (CCK-8) assay, cell clone formation, cell scratching, Transwell assay, and flow cytometry were used to detect the effects of miR-218-5p and TPX2 on LUAD cell function. RESULTS: TPX2 was significantly overexpressed in LUAD cells, and knockdown of TPX2 inhibited LUAD cell proliferation, migration, and invasion, promoted apoptosis and induced G2/M phase block, and promoted the expression of key proteins in the p53 signaling pathway. miR-218-5p, an upstream regulator of TPX2, could inhibit its expression. Overexpression of miR-218-5p eliminated the malignant development caused by high expression of TPX2, inhibited the malignant processes of LUAD cells such as proliferation and migration as well as promoted the p53 signaling pathway. CONCLUSIONS miR-218-5p targets and inhibits TPX2 expression and exerts an inhibitory effect on the malignant progression of LUAD cells via p53.
Humans ; Lung Neoplasms/genetics* ; Tumor Suppressor Protein p53/genetics* ; Adenocarcinoma of Lung/genetics* ; Adenocarcinoma/genetics* ; Cell Proliferation/genetics* ; MicroRNAs/genetics* ; Cell Movement/genetics* ; Gene Expression Regulation, Neoplastic ; Cell Line, Tumor ; Microtubule-Associated Proteins/genetics* ; Cell Cycle Proteins/genetics*

Hyperhomocysteinemia (HHcy) is considered to be an independent risk factor for cardiovascular diseases, but the molecular mechanisms underlying its pathogenesis are not fully understood. Endothelial dysfunction is a key initiating factor in the pathogenesis of atherosclerosis, which is commonly observed in almost all HHcy-induced vascular diseases. HHcy promotes oxidative stress, inhibits nitric oxide production, suppresses hydrogen sulfide signaling pathway, promotes endothelial mesenchymal transition, activates coagulation pathways, and promotes protein N-homocysteination and cellular hypomethylation, all of which can cause endothelial dysfunction. This article reviews the specific links between HHcy and endothelial dysfunction, and highlights recent evidence that endothelial mesenchymal transition contributes to HHcy-induced vascular damage, with a hope to provide new ideas for the clinical treatment of HHcy-related vascular diseases.
Humans ; Atherosclerosis ; Cardiovascular Diseases ; Endothelium, Vascular ; Homocysteine/metabolism* ; Hyperhomocysteinemia/complications* ; Oxidative Stress ; Risk Factors