Injectable bone tissue engineering scaffold material has a certain form and mechanical strength.It can be loaded with seed cells for injection to the defected site of bone tissue in the form of fluid.After that,structural recovery and functional reconstruction are achieved,and the new bone is formed ultimately.This material has the characteristics of small trauma and good plasticity.It can repair the irregular bone defects and well associate with growth factor,which is the ideal method for repairing bone tissue defects up to now.Among the various injectable bone tissue engineering materials,bioceramic materials,polymer materials,etc.have been proved to have a high biological compatibility and good mechanical properties.That makes these materials become the focus of current research in bone tissue engineering materials.In this paper,the development and application of bioceramic materials,polymer materials,bioceramics and polymer composites were reviewed.

The gene fragment encoding the egg-shell precursor protein of Schistosoma japonicum was amplified with RT-PCR by using PCR primer designed according to the 423 bp cDNA fragment of the Philippine strain of S.japonicum, the corresponding mDNA fragment of Chinese strain as template and then the 5' and 3' ends of this gene cDNA were amplified with 5' RACE and 3' RACE by using a series of primers designed according to the result of sequencing. Result of sequence analysis showed that this fragment, named as Sj423, contained a complete open reading frame (ORF) of gene encoding the egg-shell precursor protein of S.japonicum.(Chinese strain). As demonstrated by sequencing analysis. No intron could be detected in this gene fragment. This gene was subsequently expressed in E.coli after cloning into the expression vector pET28c(+). The molecular mass of the expressed product of this gene was 20.9 kDa as revealed by SDS-PAGE analysis, and Western blot analysis showed that the recombinant protein expressed could react well with the rabbit antiserum against the worm antigen of S.japonicum;indicating the good antigenicity of this expressed product.

Objective:To explore the depression of patients with systemic lupus erythematosus (SLE) during the coronavirus disease 2019 (COVID-19) pandemic.Methods:Patients with SLE and healthy subjects(control group) from August 16, 2020 to September 2, 2020 in Urumqi, Xinjiang were collected. The depression and sleep quality were assessed by Self rating Depression Scale (SDS) and Pittsburgh sleep quality index (PSQI). The nonparametric data were represented by median (quartile spacing), and the rank sum test was used to compare the continuous variables between the two groups. Pearson correlation test was used for continuous variables, and Spearman correlation test was used for rank variables or classified variables. Statistical product and service solutions.Results:The prevalence rate of depression in the SLE group (41.9%) was significantly higher than that in healthy control group (32.1%). The difference was statistically significant ( χ2= 10.312, P<0.01). The prevalence rate of poor sleep in the SLE group (31.8%) was significantly higher than that in healthy control group (21.6%). The difference was statistically significant( χ2=3.885, P=0.049). The total score of VAS ( OR=1.366, P<0.01) , PSQI( OR=1.198, P<0.01) were the risk factor of depression in patients with SLE. Conclusion:SLE patients have a higher prevalence of depression during pandemic quarantinee-period, pain and poor sleep quality are risk factors. We need to pay attention to the psychological status of SLE patients.

Objective To evaluate the efficacy and safety of donepezil in the treatment of cognitive dysfunction caused by radiation-induced encephalopathy.Methods A total of fifty-five patients with radiation-induced cognitive impairment were divided into treatment group with extra donepezil 5-10 mg/d combined with conventional therapy and control group with conventional treatment for 16 weeks.The cognitive function was assessed according to Montreal cognitive assessment (MoCA) and mini-mental state examination (MMSE) before and 16 weeks after treatment.Results After 16 weeks of treatment,the patients in treatment group displayed significantly greater improvement in cognitive function.In treatment group,the scores of patients after donepezil therapy in MoCA and MMSE were obviously higher than the control group (t =5.40,3.88,P ＜ 0.01).The scores in the visual space and executive function,naming,attention,abstract thinking,delayed memories also had improved,which suggested the statistically significant difference(t=-3.55,-3.08,-3.21,-2.58,-3.65,P＜0.05).The scores of control group unchanged accordingly.Conclusions Donepezil combined with conventional treatment was signally effective in the therapy of cognitive dysfunction caused by radiation-induced encephalopathy.

Objective To explore the effects of the Chinese medicine, modified Erchen decoction, on the serum lipid spectrum of ApoE-/-mice, and to explore its possible anti-atherosclerotic mechanism.Methods Forty-four male 7-8-week old ApoE-/-mice were used in this experiment.ApoE-/-mouse models of atherosclerosis were generated by high-cholesterol diet for 4 weeks.And then, they were given simvastatin or modified Erchen decoction by gavage.The body weight of mice was recorded every week, The mice were sacrificed after treated with the drugs for 8 weeks continuously, and the plasma lipid was determined by enzymatic method.The aortic valves and arches were stained with oil red O to depict atherosclerotic plaques and liver structural changes of the mice were examined by pathology.Results Modified Erchen decoction lowered plasma lipid ( including TCHOL and LDL-C ) significantly ( P<0.01 ) .The body weight was increased in the mice of all groups, but it was more pronounced in the mice of model group than in the blank and modified Erchen decoction groups.The serum CHOL and LDL-C levels were significantly lowered in the modified Erchen decoction group (P<0.01).The area of atherosclerotic plaques in the aortic wall was significantly reduced in the mice of modified Erchen decoction group as shown by oil red O staining.The pathological changes of hepatocytes were less severe and the structure of hepatic lobules was better preserved in the mice of modified Erchen decoction group.Conclusions The Chinese medicin modified Erchen decoction can effectively reduce serum lipids, regulate lipid metabolism, and ameliorate the process of atherosclerosis in ApoE-/-mice.

Objective To evaluate the efficacy of pregabalin on painful radiation-induced brachial plexus injury.Methods A total of forty-five patients with painful radiation-induced brachial plexus injury were assigned to treatment group with pregabalin 150-600 mg/d combined with conventional therapy, and to control group with conventional treatment for 12 weeks.The visual analogue scale (VAS) and neuropathic pain symptom inventory (NPSI) were evaluated.The response rate (proportion of subjects with at least a 30％ to 50％ reduction in visual analogue scale) was evaluated as the primary endpoint.Results The response rate of the pregabalin group(36.4％) was significantly higher than that of the control group (9.1％) (x2 =4.98, P ＜ 0.05).Although hospital anxiety and depression level, clinical global impression of change, and clinical global impression of change (CGIC) did not differ significantly between pregabalin group and control group (P ＞ 0.05), improvements in neuropathic pain symptom inventory (NPSI), patient global impression of change (PGIC) and the sleep interference score(t =-6.62,-5.65,-6.16, P ＜ 0.05)suggested some utility in the management of radiation-induced brachial plexus.Conclusions Pregabalin treatment combined with conventional treatment exerts efficacy on patients with painful radiation-induced brachial plexus and patients are well tolerated.

OBJECTIVE: To determine the effect of ulinastatin on plasma thromboxane B(2) and deep vein thrombosis(DVT) in elderly patients after hip joint replacement. METHODS: Eighty ASAI-IIpatients aged 65-81 years undergoing hip joint replacement were randomly divided into 4 groups (n=20): Group U1 (ulinastatin 5 000 U/kg);Group U2 (ulinastatin 10 000 U/kg); Group U3 (ulinastatin 20 000 U/kg); and Group C (the same volume of saline as control).The blood samples were collected at 5 time points: preoperation (T(1)), immediately after the operation (T(2)), 1 d (T(3)), 2 d (T(4)) and 3 d after the operation (T(5)), respectively. Thromboxane B(2) was detected, and DVT was also examined through color Doppler ultrasonography 3 d after the operation. RESULTS: Compared with T(1), the level of thromboxane B(2) significantly increased in Group C at T(2)-5, in Group U1 at T(2-4), in Group U2 and U3 at T(2) (P<0.01). Compared with Group C, the concentration of thromboxane B(2) decreased in Group U1 at T(2-3), in Group U2 and U3 at T(2-4) (P<0.01). Compared with Group U1, thromboxane B(2) significantly decreased in Group U2 and U3 at T(2-4) (P<0.01).The incidence rate of DVT was 40% in Group C, 10% in Group U1. There was no incidence of DVT in the Group U2 and U3 (P>0.05). CONCLUSION Ulinastatin can inhibit blood thromboxane B(2) level in dose dependent manner and prevent DVT in elderly patients after hip joint replacement.
Aged ; Aged, 80 and over ; Arthroplasty, Replacement, Hip ; adverse effects ; Female ; Glycoproteins ; therapeutic use ; Hip Fractures ; surgery ; Humans ; Male ; Thromboxane B2 ; blood ; Trypsin Inhibitors ; therapeutic use ; Ultrasonography ; Venous Thrombosis ; diagnostic imaging ; etiology ; prevention & control

Objective:By retrospectively analyzing 6 cases of IgG4-related membranous nephropathy (IgG4-MN), combined with literature review, to explore the clinical and renal pathological characteristics of the disease, and improve clinicians' understanding of the disease.Methods:The data of six patients with biopsy-proven IgG4-MN in the nephrology center of our hospital during April 2017 to January 2021 were collected. At the same time, we reviewed the literature systematically and summarized the clinicopathological characteristics.Results:Six male patients with the age ranged fom 55 to 75 years old were described. Urine protein level was (3.1±2.1) g/24 h, 3 cases (50%) showed nephrotic syndrome and 4 cases (67%) had elevated serum creatinine. The median creatinine level was (103±24) μmol/L. Six cases (100%) had elevated serum immunoglobulin (Ig)E level, and 4 cases (67%) had elevated IgG4. M-type phospholipase A2 receptor (PLA2R) was positive in 1 case (17%) and tubulointerstitial nephritis (TIN) was present in 6 cases. The review of the literature suggested that a total of 49 cases with IgG4-MN were reported, including 6 cases in this report. There were 40 males (40/46, 87%), with a age range of (61±12) years old, 32 cases (32/49, 65%) showed nephrotic syndrome range proteinuria, and the proportion of serum IgG and IgG4 increase was 61%(20/33) and 88% (36/41), respectively, 13 cases (13/15, 87%) had elevated serum IgE level, 47% (14/30) had low-complement C3 and 44%(12/27) had low-complement C4 level. The main organs involved were pancreas (15/37) and lymph nodes (16/37). Renal pathology showed TIN in 74%(36/49). Electron dense deposition was mainly subepithelial deposits. 7%(2/28) were positive for anti-PLA2R antibody in serum, 17%(3/18) were positive for PLA2R in kidney tissue, 6%(1/18) were suspected positive for PLA2R in kidney tissue, and 8%(1/12) were dual positive in blood and kidney tissue.Conclusion:IgG4-MN usually presents with nephrotic range proteinuria or nephrotic syndrome in middle-aged and elderly patients. Most of them are complicated with TIN and other organ involvement. A certain proportion of patients are PLA2R positive in IgG4-MN, and whether it is primary or secondary MN needs further study.

Objective To explore the effect of controlled low central venous pressure(CLCVP)on venous congestion and postoperative acute kidney injury(AKI)in cardiac surgery under cardiopulmonary bypass(CPB).Methods A total of 137 patients scheduled for elective cardiac surgery under general anes-thesia with CPB were selected,including 73 males and 64 females,aged 18 to 70 years,with a BMI of 20 to 28 kg/m2,and ASA physical status Ⅱ or Ⅲ.The patients were randomly assigned into two groups:the controlled low central venous pressure group(group CL,n=68)and the control group(group C,n=69).In group CL,CLCVP was applied by pumping nitroglycerin to reduce CVP to below 10 mmHg after 20 minutes of CPB cessation until the end of surgery.If necessary,norepinephrine was applied to maintain MAP≥65 mmHg.Patients in group C received standardized anesthesia management.Urine samples were collected before anesthesia induction and 12 hours postoperatively to detect the concentration of kidney injury molecule-1(KIM-1).Urine samples were also collected before anesthesia induction and 2 hours postopera-tively to detect the concentration of neutrophil gelatinase-associated lipocalin(NGAL).Cumulative time a-bove 10,12,16,and 20 mmHg and time-weighted average CVP were used to assess venous congestion.The occurrence of postoperative AKI,stage 2 or above AKI,renal replacement therapy(CRRT),postoperative low cardiac output syndrome(LCOS),acute kidney injury following cardiac surgery(AKICS)score when arriving in ICU,in-hospital mortality,ICU stay,and postoperative hospital stay were recorded.Results Compared with group C,the cumulative time of CVP above 10,12,16,and 20 mmHg after CPB in group CL was significantly shorter,and the time-weighted average CVP was significantly lower(P＜0.05).AKI occurred in 9 patients(13.2%)in group CL and 15 patients(21.7%)in group C postoperatively,and there was no significant difference between the two groups.One case(1.5%)of stage 2 or above AKI oc-curred in group CL and 2 patients(2.9%)in group C,with one patient in group C requiring CRRT.Com-pared with group C,the concentrations of KIM-1 at 12 hours postoperatively and NGAL at 2 hours postoper-atively were significantly lower in group CL(P＜0.05).There were no statistically significant differences between the two groups in LCOS,AKICS score,in-hospital mortality,ICU stay,and postoperative hospital stay.Conclusion Controlled low central venous pressure in cardiac surgery under cardiopulmonary bypass can reduce venous congestion and decrease the occurrence of postoperative renal injury,thereby exerting a certain renal protective effect.

Objective:To explore the value of detecting plasma donor-derived free DNA (dd-cfDNA) fraction in distinguishing antibody mediated-rejection (ABMR) and T cell-mediated rejection (TCMR) of renal allografts.Methods:Patients with acute rejection confirmed by allograft biopsy in the First Affiliated Hospital of Medical College of Zhejiang University from December 1, 2017 to July 18, 2019 were retrospectively included. Based on pathological classification of Banff renal allograft rejection in 2017, the patients were divided into ABMR group and TCMR group, and the latter was subdivided into TCMR Ⅰ subgroup and TCMR Ⅱ subgroup. The second generation sequencing and target region capture were used to detect candidates' peripheral blood dd-cfDNA. The demographic and clinicopathological data of the two groups were compared. The receiver operating characteristic curve (ROC) was used to evaluate the differential value of plasma dd-cfDNA and serum creatinine levels in two kinds of acute renal allograft rejection.Results:A total of 60 patients with acute rejection of renal transplantation were enrolled in this study, including 42 patients in TCMR group and 18 patients in ABMR group. The plasma dd-cfDNA percentage (%) in the ABMR group was significantly higher than that in the TCMR group [2.33(1.19, 4.30)% vs 0.98(0.50, 1.82)%, P=0.001]. The absolute value of dd-cfDNA in ABMR group was obviously higher than that in TCMR group [0.94(0.60, 2.27) ng/ml vs 0.43(0.20, 0.96) ng/ml, P=0.003]. ROC analysis to discriminate TCMR from ABMR showed that, the area under the curve ( AUC) of dd-cfDNA% was 0.76(95% CI 0.64-0.88), when the threshold was 1.11%, the sensitivity and specificity were 88.89% and 59.52%, respectively; the AUC of absolute value of dd-cfDNA was 0.74(95% CI 0.61-0.86), when the threshold was 0.53 ng/ml, the sensitivity was 88.89% and the specificity was 54.76%. TCMR subgroups were further analyzed, there was no significant difference between TCMR subgroups on the absolute value and percentage of dd-cfDNA (both P>0.05); dd-cfDNA% in ABMR group was apparently higher than that in TCMRⅠ subgroups ( P=0.008) and TCMRⅡsubgroup ( P=0.030). The absolute value of dd-cfDNA in ABMR group was significantly higher than that in TCMRⅠsubgroups ( P=0.003). Conclusion:Plasma dd-cfDNA level may help to distinguish between ABMR and TCMR rejection.