BACKGROUND:Anticancer drugs-loaded magnetic nanopartides,as a novel targeting drug delivery system,are characterized by high drug loading dose,targeting location transport,heat effect of magnetic grains,and biological degradation.Thus,this system brings new hopes for chemical therapy with high efficiency and low toxic and side effects.OBJECTIVE:To observe in vitro toxic effects of complexing cis-diaminedichloroplatinum (CDDP)-loaded magnetic nanopartides on human nasopharyngeal carcinoma (NPC) CNE2 cells.DESIGN,TIME AND SETTING:The in vitro controlled study was performed at the Laboratory of Pharmacology,Northern Region,Sun Yet-sen University in March 2005.MATERIALS:CDDP was provided by Shandong Qilu Pharmaceutical factory.CDDP-loaded magnetic nanoparticles (CDDP-SAMNP),43-52 nm in particle diameter.Utilization rate of CDDP was about 65%.NPC CNE2 cell line was supplied by the Laboratory of Cell Pathology,Cancer Hospital,Sun Yat-sen University.METHODS:This study contained medication and control groups.The medication group was assigned to CDDP and CDDP-SAMNP groups.CDDP and CDDP-SAMNP were diluted by RPMI-1640 medium.Drug concentration was in accordance with CDDP content.The control group was divided into RPMI-1640 medium and SAMNP groups (adding ferroso-ferric oxide,magnetic nucleus concentration was 7 g/L,diluted by the medium).MAIN OUTCOME MEASURES:MTT assay was used to observe kill and wound rate of 1.89-11.34 mg/L CDDP and corresponding dose of CDDP-SAMNP on NPC CNE2 cells following 24 and 48 hours.Uptake of CDDP-SAMNP by CNE2 cells was investigated under a transmission electron microscope.RESULTS:SAMNP as the medium group had no effect on killing or wounding CNE2 cells (P＞0.05).With the increment of CDDP and CDDP-SAMNP dose,the kill and wound rate presented an obvious dose-effect relationship.At the same dose,the same medicine showed an increasing kill and wound rate with the extension of reaction time,presenting an obvious time-effect relationship.At 24 hours after reaction,the kill and wound rate of CDDP-SAMNP and CDDP were similar (P＞0.05).At 48 hours,at the dose from 1.89 to 5.04 mg/L,the kill and wound rate of CDDP-SAMNP was lower than that of CDDP (P＜0.05),but when increased to 6.93 mg/L,the kill and wound rate of CDDP-SAMNP was dose to that of CDDP.SAMNP and CDDP-SAMNP could be easily taken into CNE2 cells.CONCLUSION:Effect of CDDP-SAMNP on killing and wounding NPC CNE2 cells is close to that of cis-diaminedichloroplatinum at the same high dose.The active sources are the cis-diaminedichloroplatinum released from the nano-camers.The stability of modified CDDP-SAMNP has been increased and its therapy effect has not been influenced.

BACKGROUND:With the development of three-dimensional (3D) printing technology, 3D printed porous titanium scaffolds as bone substitutes have become a research hotspot. OBJECTIVE:To introduce and discuss the effects of each parameter of 3D printed porous titanium scaffolds on bone ingrowth, and to sum out the optimal parameters for bone ingrowth. METHODS:The first author retrieved PubMed, Springerlink and Medline databases with“three-dimensional (3D) printing, scaffold, titanium, bone ingrowth”as keywords for relevant articles published from 2006 to 2016. 125 articles were retrieved initial y, and final y 42 eligible articles were included for analysis. RESULTS AND CONCLUSION:Pore size, porosity, pore structures and surface modifications of 3D printed porous titanium scaffolds al make effects on bone ingrowth or osteoblasts in scaffolds. Scaffolds with appropriate pore size and porosity can promote the vascularization and provide adequate nutrition and oxygen supplement, to ensure high cel viability. Regulations of cel performances, such as cel attachment, proliferation and differentiation, are also affected by pore structures and nano-scale surface modification. Herein, a detailed combination of the parameters, as mentioned above, can create a better porous scaffold for better bone ingrowth. Hence, the high-stability interface between bone and scaffolds may be obtained through the parameter adjustment.

BACKGROUND: Epidural block(EB) is one of the effective and widely used remedies for lumbar disc herniation(LDH) . Animal experiments have been conducted to study the changes in the local tissue structure in the spinal canel after several treatments with EB.OBJECTIVE: To study the effect of EB for LDH on the local tissue structures in the spinal canel.DESIGN: A non-randomized and controlled clinical observation.PARTICIPANTS: Department of Pathology and Laboratory of Electron Microscope of an Affiliated Hospital of a University.SUBJECTS: Forty patients with LDP, who failed to respond to EB treatment and subsequently received discectomy in the Department of Orthopaedics,First Affiliated Hospital of Sun Yat-sen University from May 1992 to December 1997, were enrolled in this study, with 20 patients receiving discectomy but not EB treatment serving as the control group.METHODS: From the 60 cases, totally 120 specimens of yellow ligament and the disc tissues were obtained during discectomy for optical microscopical examination. A portion of the yellow ligament and the lumbar disc tissues were chosen from EB group(12 cases) and non-EB group(10 cases), respectively, for electron microscope examination(involving altogether 44specimens) . The changes in histology and ultrastructnres in the specimens were compared between the two groups.MAIN OUTCOME MEASURES: ① Main results: the reactive proliferation of the tunica adventitia and inflammatory reaction of the intervertebral disc and yellow ligament; ② Secondary results: changes in the ultrastructure of the anulus fibrosus, nucleus pulposus and yellow ligament.RESULTS: No significant difference was found between the two groups either in light microscopy or electron microscopy in the degree of smoothness and the inflammatory reaction of the cavosurface of the yellow ligament and the disc tissues, nor in the cellular ultrastructures and fibrous arrangement.CONCLUSION: There is no direct relationship between lumbar EB and epidural scar adhesion formation. EB does not affect the ultrastructures of the local tissues in the spinal canal, but care must be taken of the sterilization in the surgical procedure, as chronic inflammatory reaction in the yellow ligament and disc tissues can be present in some patients.

Objective To evaluate the effectiveness of mirror therapy in treating the upper limbs of patients with stroke.Methods The PUBMED,MEDLINE,EMbase,Cochrane Central Register of Controlled Trials (CENTRAL),ISI Web of Knowledge,OVID,CNKI,VIP and Wanfang Data databases were searched for reports of randomized controlled trials (RCTs) of mirror therapy in the treatment of the upper limbs of patients with stroke from the date of establishment of each database to April 2012.The bibliographies of the studies retrieved were also searched.Two independent researchers evaluated the included studies using the risk of bias provided by Cochrane Library.The extracted data were analyzed using RevMan 5.1 software and version 3.6 of the GRAED profiler.Results Reports of 9 trials were discovered.Meta-analysis showed that compared to the group that didn't have visual feedback,mirror therapy did not significantly increase Fugl-Meyer assessment (FMA) (Upper Limb) scores after 4 weeks of treatment compared with groups that did not have visual feedback.Mirror therapy also did not significantly increase average scores on the action research arm test (ARAT) after 6 weeks of treatment.Mirror therapy did,however,increase average Brunnstrom stage scores for the hand after 4 weeks of treatment and at a 6-month follow-up.Mirror therapy did not increase average scores on the modified Ashworth scale (MAS) after 4 weeks of treatment,but increased MAS scores were observed at a 6-month follow-up compared with a group which had no visual feedback.Mirror therapy increased functional independence measure (FIM) self-care scores after 4 weeks of treatment and at a 6-month follow-up,and it also increased modified Barthel index (MBI) scores after 4 weeks of treatment.In the GRADE system,the scores of Brunnstrom stages for the hand after 4 weeks of treatment were of moderate quality,but those scores and the MAS scores at the 6-month follow-up were of low quality.The FIM selfcare scores after 4 weeks and at the 6-month follow-up and the MBI scores measured after 4 weeks were of very low quality.Conclusion This evidence shows that mirror therapy can improve upper limb function and quality of daily life to some extent after stroke.However,because of the limitations of the previous studies such as poor quality,different end points,different rating scales and different courses of stroke,more high-quality,randomized,controlled trials with larger samples are needed to evaluate the effectiveness of mirror therapy in the rehabilitation of upper limb function after stroke.

Purpose: We investigated the effectiveness of intravesical botulinum toxin-A (BTX-A) injection therapy in patients with lower urinary tract dysfunction (LUTD) and upper urinary tract (UUT) deterioration and evaluated whether BTX-A injection therapy could substitute for augmentation uretero-enterocystoplasty (AUEC). Methods: Data from a prospective, single-center cohort from 2017–2021 were analyzed. Patients were divided into 2 treatment groups: AUEC and BTX-A (i.e., patients who declined AUEC). Bladder and UUT functions were assessed by comparing clinical information, urodynamic data, laboratory results, and imaging records. Results: In total, 121 patients were enrolled (BTX-A group: 41 patients; AUEC group: 80 patients). The BTX-A group showed a reduced maximum detrusor pressure and increases in the maximum bladder volume and bladder compliance (P<0.05). However, in follow-up evaluations, significantly smaller improvements (all P<0.05) in urodynamic parameters were found in the BTX-A group than in the AUEC group. Notably, there was no significant improvement in vesicoureteral reflux (VUR; P=0.66) or upper urinary tract dilatation (UUTD; P=0.75) in the BTX-A group, and no statistically significant difference in serum creatinine (Scr) levels or the estimated glomerular filtration rate (eGFR) was observed in the follow-up evaluations (all P>0.05). Both VUR and UUTD improved significantly in the AUEC group, and the Scr and eGFR levels significantly improved after AUEC relative to baseline levels (P<0.05). The reduction in the Scr level was significantly lower in the BTX-A group than in the AUEC group during 0–15 months of follow-up (Scr reduction differences, -1.36; P<0.01). Conclusions Although BTX-A injection therapy was effective for improving bladder function, BTX-A injections did not alleviate UUT deterioration in this study, particularly in patients with advanced-stage LUTD. Conversely, AUEC for LUTD has a well-established role in improving UUT function. Hence, BTX-A injection therapy should not replace AUEC to ameliorate UUT impairment and protect UUT function.

Purpose: To explore the effect of intravesical electrical stimulation (IVES) on urinary adenosine triphosphate (ATP) and nitric oxide (NO) in rats with detrusor underactivity (DU) induced by bilateral pelvic nerve crush (bPNC), and to determine the underlying peripheral mechanism. Methods: Twenty-four female Sprague-Dawley rats were equally divided into 3 groups: sham; bPNC; and IVES. Rats in the IVES group began to receive IVES treatment 10 days after bPNC (20 minutes per day for 14 consecutive days). After the 14th IVES, rat urine was collected and cystometry was performed. The serum creatinine, blood urea nitrogen, and urinary ATP and NO levels were measured, and a routine urinalysis was performed. Results: The maximum cystometric capacity (MCC), maximum changes in bladder pressure during filling (∆FP), and postvoid residual urine (PVR) in the IVES group were significantly lower than the bPNC group, and the maximum changes in bladder pressure during voiding (∆VP) was significantly higher than the bPNC group. Compared with the sham group, the MCC, ∆FP and PVR were significantly increased, and the maximum voiding pressure (MVP) and ∆VP were significantly decreased in the bPNC group. After bPNC, urinary ATP was significantly decreased, and urinary NO was significantly increased. In IVES-treated rats, urinary ATP was significantly higher than the bPNC group, and NO was significantly lower than the bPNC group. In addition, the ATP-to-NO ratio of the rats in the bPNC group was significantly lower than the sham and IVES groups. Correlation analysis showed that the ATP and NO were not correlated with the MCC, ∆FP, MVP, ∆VP, and PVR. Conclusions Promoting the release of urothelial ATP and inhibiting the release of urothelial NO may be one of the peripheral mechanisms underlying IVES in the treatment of DU. Specifically, IVES may shift the balance between excitation and inhibition toward excitation.

OBJECTIVETo investigate the epidemiological characteristics of lower back pain of truck drivers in plateau areas with an analysis of the causes and evaluated the effects of the protective measures.

METHODSThe self-reported lower back symptom was investigated by questionnaire in 1,132 male drivers in plateau areas. Vibration of the driver lumbar back was measured real time with or without wearing corset. Study the effect of the special corset for drivers and the massage on back by self-control design of big sample intervention experiments.

RESULTSThe prevalence of lower back pain of drivers in plateau areas was 86.1%. High level of its prevalence is due to many factors. Special corset for drivers and massage on back by themselves can reduce the degree of the pain.

CONCLUSIONDriving in plateau areas is a special occupational work with high level of prevalence of lower back pain which can be prevented.

Automobile Driving ; Humans ; Low Back Pain ; epidemiology ; etiology ; prevention & control ; Male ; Occupational Diseases ; etiology ; prevention & control ; Prevalence ; Surveys and Questionnaires

BACKGROUND: In the process of bone defect healing, the use of biological materials loaded with drugs for local defect intervention can accelerate the repair of the defect, which provides a new method for the local treatment of bone defects. OBJECTIVE: To introduce the local application of bone tissue engineering scaffolds loaded with bisphosphonates in bone defect repair and to summarize the effects of bone tissue engineering scaffolds as a drug delivery system on the bone defect healing. METHODS: The authors retrieved PubMed, Web of Science, Springerlink, Medline, WanFang and CNKI databases with "bisphosphonates, alendronate, zoledronate, bone defect, bone tissue engineering" as key words for relevant articles published from 2006 to 2018. Initially, 235 articles were retrieved, and finally 70 articles were selected for further analysis. RESULTS AND CONCLUSION: Bisphosphonate drug is an effective inhibitor of osteoclast dissolution. It can form a drug sustained release system on the local defect by being loaded to composite scaffolds, promote the formation of new bone and accelerate the healing of the defect. For the drug delivery system of bisphosphonates, suitable scaffold materials are crucial to the osteogenic effect of composite scaffolds in the defect area. At present, the carrier materials used for bisphosphonate-loaded composite scaffolds are mainly divided into organic materials and inorganic materials. Most polymeric organic materials can directly load bisphosphonates to form good drug sustained release in the local area and obviously exert their pro-osteogenic effects, while natural materials and most inorganic materials are often combined with other materials to form composite materials as carriers to optimize the carrier performance. Most studies have also confirmed that these composite materials loaded with bisphosphonates in the defect area exert osteogenic effect in the defect area.

Objective:Evaluate the influence of different pressure transmission media of urodynamic water filled catheter(WFC) and air charged catheter(ACC) on the pressure measurement results to determine whether they can be used interchangeably.Methods:The results of 2 147 patients who underwent urodynamic examination in our hospital from January 2014 to December 2020 were retrospectively analyzed. A total of 2 538 times of bladder manometry data were obtained, including 1 299 times in WFC group, 856 times in male and 443 times in female, aged 37(24, 50)years, course of disease 1.2(0.4, 5.0) years, 1 130 times in neurogenic bladder(NB)and 169 times in non-neurogenic bladder(N-NB); In ACC group, there were 1 239 times, 773 times for male and 466 times for female, with age of 37(24, 55)years, course of disease of 1.5(0.5, 6.0)years, 1 040 times for Nb and 199 times for N-NB. There was no significant difference in baseline data of general clinical data between the two groups. The intravesical pressure(Pves), intra-abdominal pressure(Pabd)and detrusor pressure(Pdet) of WFC and ACC patients during filling and urination were analyzed. For traumatic spinal cord injury(SCI) and idiopathic patients, the two sets of pressure measurement data were analyzed separately. Nonparametric test and Chi-square test were used to compare the Pves, Pabd, and Pdet recorded by the two manometry catheters before, at the end and after urination, the maximum detrusor pressure at DO(Pdet.max-DO), and the maximum detrusor pressure during spontaneous urination (Pdet. max) and the detrusor pressure (Pdet.Qmax) corresponding to the maximum urine flow rate, the maximum urethral pressure (MUP) and the maximum urethral closure pressure (MUCP) during resting urethral pressure profile, and the initial cough Pdet signal pattern (typeⅠ, typeⅡand typeⅢ).Results:Regardless of the cause, the Pabd values measured by ACC were significantly higher than WFC before filling, end filling and after voiding[18(10, 26)cmH 2O vs.15(11, 21)cmH 2O; 23(16, 31)cmH 2O vs. 20(14, 26)cmH 2O; 23(15, 31)cmH 2O vs.18(12, 24)cmH 2O], and Pdet were significantly lower than WFC[0(0, 0) cmH 2O vs. 0(0, 1)cmH 2O; 5(1, 13)cmH 2O vs. 9(4, 17)cmH 2O; 6(1, 12)cmH 2O vs. 7(3, 14)cmH 2O]. In the initial cough state, Pves and Pabd increase value were also significantly lower than that of WFC [22(12, 36)cmH 2O vs. 23(14, 38)cmH 2O; 20(10, 33)cmH 2O vs. 21(12, 36)cmH 2O]. The Pves measured by ACC was also significantly higher than WFC before filling and after voiding[18(10, 27)cmH 2O vs. 16(11, 21)cmH 2O; 30(22, 39)cmH 2O vs. 26(20, 36)cmH 2O]. Maximum urethral pressure (MUP) and maximum urethral closure pressure (MUCP) measured by ACC were significantly higher than WFC [91(69, 118)cmH 2O vs.81(64, 106)cmH 2O; 77(55, 103)cmH 2O vs. 68(48, 91)cmH 2O], and there were no significant differences in Pdet.max-DO、Pdet.max和Pdet.Qmax. For patients with traumatic SCI, the Pves measured by ACC was significantly higher than WFC before filling[15(10, 24)cmH 2O vs. 14(10, 20)cmH 2O], and only MUP was significantly higher than WFC in the measurement of urethral pressure[95(71, 119)cmH 2O vs. 85(65, 112)cmH 2O], and there were no significant differences in Pdet.max-DO, Pdet.max, Pdet.Qmax and MUCP. For idiopathic patients, Pves measured by ACC before filling and after urination were significantly higher than WFC[25(20, 29)cmH 2O vs. 18(11, 23)cmH 2O; 35(29, 44)cmH 2O vs. 28(20, 38)cmH 2O], while Pdet.max-DO, Pdet.max, Pdet.Q max, MUP and MUCP were not significantly different in different pressure measurement systems. For the comparison of the initial cough Pdet signal pattern, ACC is easier to detect type Ⅰ, and WFC is easier to detect type Ⅱ and type Ⅲ. Conclusions:Compared with WFC, ACC measured higher Pves and Pabd and lower Pdet in resting state, and lower Pves and Pabd in initial cough state. The pressure values and signal pattern measured by WFC and ACC are not completely consistent, so they cannot be used interchangeably.

Objective:To investigate the long-term efficacy and complications of augmentation uretero-enterocystoplasty (AUEC).Methods:The clinical data of 262 patients with lower urinary tract dysfunction who underwent AUEC at our center from January 2003 to June 2022 were analyzed retrospectively. There were 193 males and 69 females, the median age was 24 (4, 67) years, the median disease duration was 12.0 (0.2, 56.0) years and the preoperative creatinine was 91.5 (68.1, 140.0) μmol/L. 320 ureters had high-grade UUTD, 216 ureters had VUR, 14 of which had low-pressure reflux.The number of low-grade VUR ureter was 22 (10.2%) and the number of high-grade VUR ureter was 194 (89.8%). Video-urodynamics showed that the maximum bladder capacity was 102 (47, 209) ml, the maximum detrusor pressure was 33.0 (15.5, 50.5) cmH 2O, and the bladder compliance was 6.4 (3.0, 12.3) ml/cmH 2O. All patients underwent AUEC. The surgical method is to cut a segment of sigmoid colon, open the sigmoid colon along the mesenteric margin, fold and suture it into " U" or " S" shaped intestinal mesh according to the principle of " detubulization" . At the same time, perform ureteroplasty and replanting, and then anastomosis the intestinal mesh with the opened bladder flap to form an expanded new bladder. Follow-up was performed via outpatient clinic or telephone. The creatinine, maximum bladder capacity, maximum detrusor pressure, bladder compliance, ureteral reflux and upper urinary tract dilatation were compared preoperatively and postoperatively. The postoperative complications were also evaluated. Results:The median follow-up time was 57.4 (4, 151) months after surgery. At 1-3 months after surgery, the maximum bladder capacity and bladder compliance increased to 303.9% and 189.9% of the preoperative level, and the maximum detrusor pressure decreased to 63.6% of the preoperative level. At 6-10 years after surgery, the maximum bladder capacity and bladder compliance increased to 490.2% and 627.9% and the maximum detrusor pressure decreased to 25.8% of the preoperative level. The UUTD of the patients was significantly reduced after surgery. The number of the high grade UUTD decreased to 116 (116/398, 29.2%) at 1-3 months and 51 (51/274, 18.6%) at 4-6 months. At 6-10 years, the number of the high-grade UUTD decreased to 4 (4/76, 5.3%) ( P<0.001), which was significantly lower than that before operation. The VUR was significantly relieved after operation, and 393 ureters had no VUR at 1-3 months, accounting for 97.8% (393/402) of the total ureters. Sustained remission of VUR was observed during follow-up. 73 ureters had no VUR at 6-10 years, accounting for 96.1% (73/76) of total ureters ( P<0.001). Patients' creatinine decreased to 79.0 (65.0-128.2) μmol/L at 1-3 months postoperatively, with a downward trend but no statistical difference, and creatinine levels were not significantly elevated at any postoperative time point compared with preoperative levels ( P>0.05). Postoperative complications included metabolic acidosis in 26 cases (9.9%), vesicoureteral anastomosis stenosis in 15 cases (5.7%), recurrent urinary tract infection in 16 cases (6.1%), and urinary calculi in 20 cases (7.6%), and intestinal obstruction requiring laparotomy in 8 cases (3.1%), all of them could be improved after treatments. Conclusions:AUEC is a safe and effective method for treating high-grade VUR or VUR with impaired anti-reflux mechanism, high-grade UUTD or UUTD with ureteral or vesicoureteral junction obstruction, and all of the complications can be improved after treatment. This technique can increase the bladder capacity and compliance, reconstruct the anti-reflux mechanism, and release upper urinary tract obstruction. It may play an important role in stabilizing and protecting the residual renal function from further deterioration.