Adult ; Bone Neoplasms ; Humans ; Male ; Nose Neoplasms ; Osteoblastoma ; Skull Base Neoplasms

Pharmacogenomics is a discipline studying the influence of genetic differences on drug effectiveness .It promises to op-timize the effect of medicine and reduce side effects .It is one of the most effective ways to predict the drug reaction in human body by using pharmacogenomics , which can achieve the goal of precision medicine .With the rapid development of the genetical test technolo-gies, the in vitro individual genome testing projects with the properties of high throughput , and measurable and low cost are better to be applied in medical practice and guiding for making individualized medicine plan .The study elucidated the progress in single nucleotide polymorphism and its clinical application , and focused on the strategic effects of pharmacogenomics on individualized treatment and gene diversity for guiding medicine .

OBJECTIVE:To evaluate the efficacy and safety of tiotropium bromide in the treatment of COPD patients and pro-vide evidence-based reference for the clinical treatment. METHODS:PubMed,EMBase,Medline,Cochrane Library,CJFD,Wan-Fang and VIP database were retrieved to collect the randomized controlled trial(RCT)of tiotropium bromide(test group)vs. place-bo(control group)in the treatment of COPD. The data was extracted and the quality was evaluated by Rev Man 5.0 software. RE-SULTS:A total of 19 studies were included,involving 16 318 patients. Meta-analysis shows that the FEV1[MD=0.13,95%CI (0.12,0.14),P<0.001],FVC[MD=0.20,95%CI(0.20,0.25),P<0.001] in test group were higher than control group,SGRQ score [MD=-2.94,95%CI(-3.38,-2.49),P<0.001] and COPD exacerbation rate[RR=0.83,95%CI(0.77,0.90),P<0.001] in test group were lower than those in control group ,but the dry mouth rate was higher than that of control group[RR=2.07,95%CI(1.34, 3.20),P<0.001],there were significant differences in 2 groups . CONCLUSIONS:Tiotropium bromide has good efficacy in the treatment of COPD. However,it may cause dry mouth. Due to the methodological limitations of included studies,it remians to be further verified by large-sample and high-quality RCT.

BACKGROUND:The smal intestinal submucosa has good biocompatibility and biodegradability, and also contains a variety of growth factors that can significantly promote celladhesion, proliferation and differentiation. Currently, the smal intestinal submucosa has been widely used in bone and cartilage, blood vessels, skin, bladder, smooth muscle and pancreatic tissue repair, showing good performance as a tissue-engineered cellscaffold.
OBJECTIVE:To investigate the in vitro feasibility of tissue engineered periosteum constructed by porcine smal intestinal submucosa and osteoblasts differentiated from bone marrow mesenchymal stem cells.
METHODS:Bone marrow mesenchymal stem cells were harvested from 2-week-old healthy New Zealand rabbits by using adherent method, and then cells were cultured, induced, differentiated and identified in vitro. Fol owing induced differentiation and identification, the bone marrow mesenchymal stem cells were compounded with porcine smal intestinal submucosa to fabricate tissue engineered periosteum. The adhesion, growth, and proliferation of cells on the materials were observed.
RESULTS AND CONCLUSION:At 5 days after inoculation, the cells receiving osteogenic induction could quickly adhere and proliferate on the surface of porcine smal intestinal submucosa and be interconnected;at 10 days, the desmosomes formed among the cells, cellprocesses from osteoblasts were visible and attached to the smal intestine submucosa;at 15 days, cellproliferation and secretion of matrix appeared, and multi-layer membrane-like structure formed on the surface of the smal intestine submucosa. These findings indicate that after osteogenic induction, the bone marrow mesenchymal stem cells can be combined with porcine smal intestinal submucosa to construct a tissue engineered periosteum, which is hoped to be an ideal scaffold for tissue engineering.

Objective:To compare the therapeutic effects between sequential therapy of external-internal fixation and internal fixation alone in the treatment of high-energy pilon fracture.Methods:A total of 61 patients with high-energy pilon fracture were enrolled by our team for this retrospective analysis who had been treated from January 2015 to July 2017. They received sequential therapy of external-internal fixation (the sequential group) or internal fixation alone (the internal group). In the sequential group of 26 cases, there were 19 males and 7 females (aged from 18 to 65 years), 4 cases of type C1, 8 cases of type C2 and 14 cases of type C3 by the OTA classification, and 7 cases of closed injury and 19 cases of open injury. In the internal group of 35 cases, there were 25 males and 10 females (aged from 19 to 64 years), 6 cases of type C1, 13 cases of type C2 and 16 cases of type C3 by the OTA classification, and 21 cases of closed injury and 14 cases of open injury. The 2 groups were compared in terms of postoperative infection, fracture reduction, fracture union time, nonunion, American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, short form 36 health survey questionnaire (SF-36) and reduced range of motion between healthy and affected ankles.Results:There was no significant difference between the 2 groups in gender, age, fracture type, injury cause or follow-up time ( P>0.05), but a significant difference in soft tissue injury favoring the sequential group ( P=0.010). There were no significant differences between the 2 groups in postoperative infection rate [15.4% (4/26) versus 17.1% (6/35)], fracture reduction, fracture union time [(7.4±3.4) months versus (6.5±3.2) months], nonunion rate [7.7% (2/26) versus 8.6% (3/35)], AOFAS ankle-hindfoot score (71.7±29.4 versus 74.4±19.5), or SF-36 (83.1±9.9 versus 83.8±7.9) ( P>0.05). The reduced range of motion between healthy and affected ankles at 6 months postoperation in the sequential group (34.6°±7.2°) was significantly greater than that in the internal group (23.7°±5.1°) ( P<0.05), but there was no significant difference between the 2 groups in the reduced range of motion between healthy and affected ankles at 2 years postoperation (26.0°±11.1° versus 21.8°±11.3°) ( P>0.05). Conclusion:Although both sequential therapy of external-internal fixation and internal fixation alone can lead to fine clinical efficacy in the treatment of high-energy pilon fracture, the former may be more suitable for the patients with severe soft tissue injury.

AIM:To investigate the characteristics of Ets-1 and VEGF expression and distribution in the experimental diabetic rat retina.METHODS:Diabetes was induced by intraperitoneal injection of streptozotocin (STZ).At 4 weeks after STZ-injection,animals were sacrificed.Total proteins were isolated from retinas of experimental and control eyes and were assessed by Western blot analysis.Frozen cross sections of eyeballs with 14um thickness were used to perform double immunoffuorescence staining with anti-Ets-1 and anti-VEGF antibodies.RESULTS:Both Ets-1 and VEGF expression were up-regulaled in the diabetic retina,the distribution of Ets-1 and VEGF was identical to each other,and the two proteins were almostlocalized in all retinal layers.CONCLUSION:Ets-1 might contribute to the pathologic progress of the diabetic retina induced by VEGF.

AIM: To determine the involvement of Ets-1 in the pathological progress of the experimental diabetic retina. METHODS: Diabetes was induced by intraperitoneal injection of STZ. Total RNA and Total proteins were isolated from retinas of experimental and control eyes at 4 weeks after STZ-injection and were assessed by Northern blot analysis and Western blot analysis, respectively.RESULTS: Expression of both Ets-1 mRNA and Ets-1 protein was significantly increased in the experimental diabetic rat's retina after STZ-injection compared with the control group (P＜0.001).CONCLUSION: Our results indicated that Ets-1 was involved in the pathological progress of experimental diabetic retina.Further studies should be conducted to focus on the relationship between Ets-1 and VEGF in the diabetic retina.

Objective To determine the activities of 131I for treating differentiated thyroid carcinoma with diffuse pulmonary metastases ( DTC-DPM ) from the perspective of internal radiation dosimetry.Methods According to Medical Internal Radiation Dosimetry (MIRD) schema, the activity constraint,from which the whole bdy retention at 48 h should not exceed 2.96 GBq (2.96 GBq rule), was converted to dose-rate constraint(DRC) to lungs at 48 h ( DRCLU ·48 h ) in 131I therapy for DTC-DPM. Based on the assumption of DRCLU·48 h at 48 h in lung, the fractions of whole body activities ( F48 ), the effective half times of 131I in lungs ( TLL ) and the remainder of body ( TRB ) were 0.6-0.9, 20- 120 h, and 10- 20 h, respectively. The maximum safe activities of 131I for different human phantoms from the Organ Level Internal Dose Assessment (OLINDA) software were calculated. Results According to MIRD schema and 2.96 GBq rule, DRCLU ·48 h should not exceed 46.4 mGy/h in 131I therapy for DTC-DPM. Depending on varying F48 h,TLL and TRB, the maximum safe activities of 131I were 6.77-81.36, 5.29-56.20, 5.08-55.19 and 3.87-40. 52 GBq for the male adult, female adult, 15-year-old, and 10-year-old patients with DTC-DPM, respec tively. Conclusion Dosimetry-guided 131I therapy for DTC-DPM considers adequately the differences of 131I kinetics in individual patients and can adjust administered activities of 131I on the precondition of avoiding radiological pneumonitis and pulmonary fibrosis.

Objective To evaluate MRI diagnostic value for single lesion characteristics in the splenium of corpus callosum.Methods MRI features,clinical data,and parts of follow-up results of 9 cases with single lesion in the splenium of corpus callosum were analyzed retrospectively.Results (1)Clinical manifestations:headache and dizziness occurred in 4 cases,syncope in 3 cases,fever in 2 cases, physical activity barriers in 2 cases.(2)Clinical diagnosis:hypoglycemic encephalopathy were rescaned one month later in 3 cases, in which the previous lesion completely disappeared.Clinical experience of encephalitis were improved after treatment in 2 cases. Cerebral infarction,epilepsy,brain injury and degeneration were diagnosed respectively in each one case,in which lesion still existed after treatmented.(3)Image findings:despite the different clinical manifestations,image features of all cases were quite similar. Round or foliated like lesions of slightly long T1 and long T2 signals in the splenium of corpus callosum were presented in all cases. High signals on diffusion weighted imaging and low signals on the ADC were showed with same lesions,andno obvious enhancement after contract media injected was seen.Conclusion Single lesions in the splenium of corpus callosum are showed in many diseases. The image features of hypoglycemic encephalopathy or encephalitis have certain characteristics (single lesion is reversible).Accurate diagnosis need to combine with clinical data and medical history.

Objective:To study the effects of endothelial progenitor cells(EPCs)on the osteogenesis of bone marrow mesenchymal stem cell (BMSCs)sheet-implant complex.Methods:EPCs were added to the BMSC sheets,and the expression of osteogenesis-relat-ed genes was examined by real time PCR.Cell sheets were wrapped around implants to construct cell sheet-implant complexes and the complexes were subcutaneously transplanted into SCID mice.The complexes were harvested 8 weeks after operation and observed by micro-CT and histological examination.Results:The BMSC sheet with EPCs showed higher expression of Runx2,ALP,BMP2 and VEGF in the in vitro test;higher bone volume ratio,greater amount of new bone tissue and higher expression of Runx2 and BMP2 in the in vivo test.Conclusion:EPCs can improve the osteogenesis of BMSC sheet-implant complex.