Sports medicine is often associated with soft tissue injuries,with tendon and ligament injuries being the most common sports injuries accounting for 30％-40％of all injuries.Mesenchymal stem cell exosomes have the ability to escape phagocytosis and realize long-term circulation,and can also be used as drug carriers of biological materials.The use of exosomes derived from mesenchymal stem cells for cell-free treatment of soft tissue injury is the current research direction in sports medicine.In this paper,the origin of exosomes in soft tissue regeneration is summarized,with emphasis on the biological mechanism of exosomes in soft tissue injury and the progress of diagnosis and treatment related to biomaterial.

Objective To quantify the mean fat fraction(FF)values of hip abductor muscles using the MR least squares estimation method of iterative water-fat separation(IDEAL-IQ)technique and to analyze the correlation between muscle fat infiltration and cartilage damage in hip osteoarthritis(HOA),age and gender.Methods Ninety-five patients with clinical symptoms of hip joint(HOA group)and volunteers(control group)underwent MRI conventional sequence and IDEAL-IQ sequence scans of the hip joint were selected.Hip cartilage damage was graded based on conventional MRI sequences(mild HOA group and severe HOA group),and the FF values of hip abductor muscles were measured for each group.ANOVA analysis and Pearson correlation tests were used to compare the differences between the groups and correlation analyses were performed.Results The FF values of hip abductor muscles in the mild HOA group and severe HOA group were significantly higher than those in the control group,with statistically significant differences(P＜0.05).There were correlations between the FF values of hip abductor muscles and the degree of HOA cartilage damage,age and gender(r=0.677,0.566,0.311).Conclusion The IDEAL-IQ technique can be used for quantitative research on muscle fat infiltration,and fat infiltration in hip abductor muscles is an important risk factor for HOA cartilage damage.

Sports medicine is often associated with soft tissue injuries,with tendon and ligament injuries being the most common sports injuries accounting for 30％-40％of all injuries.Mesenchymal stem cell exosomes have the ability to escape phagocytosis and realize long-term circulation,and can also be used as drug carriers of biological materials.The use of exosomes derived from mesenchymal stem cells for cell-free treatment of soft tissue injury is the current research direction in sports medicine.In this paper,the origin of exosomes in soft tissue regeneration is summarized,with emphasis on the biological mechanism of exosomes in soft tissue injury and the progress of diagnosis and treatment related to biomaterial.

Objective To quantify the mean fat fraction(FF)values of hip abductor muscles using the MR least squares estimation method of iterative water-fat separation(IDEAL-IQ)technique and to analyze the correlation between muscle fat infiltration and cartilage damage in hip osteoarthritis(HOA),age and gender.Methods Ninety-five patients with clinical symptoms of hip joint(HOA group)and volunteers(control group)underwent MRI conventional sequence and IDEAL-IQ sequence scans of the hip joint were selected.Hip cartilage damage was graded based on conventional MRI sequences(mild HOA group and severe HOA group),and the FF values of hip abductor muscles were measured for each group.ANOVA analysis and Pearson correlation tests were used to compare the differences between the groups and correlation analyses were performed.Results The FF values of hip abductor muscles in the mild HOA group and severe HOA group were significantly higher than those in the control group,with statistically significant differences(P＜0.05).There were correlations between the FF values of hip abductor muscles and the degree of HOA cartilage damage,age and gender(r=0.677,0.566,0.311).Conclusion The IDEAL-IQ technique can be used for quantitative research on muscle fat infiltration,and fat infiltration in hip abductor muscles is an important risk factor for HOA cartilage damage.

Entinostat plus exemestane in hormone receptor-positive (HR+) advanced breast cancer (ABC) previously showed encouraging outcomes. This multicenter phase 3 trial evaluated the efficacy and safety of entinostat plus exemestane in Chinese patients with HR + ABC that relapsed/progressed after ≥1 endocrine therapy. Patients were randomized (2:1) to oral exemestane 25 mg/day plus entinostat (n = 235) or placebo (n = 119) 5 mg/week in 28-day cycles. The primary endpoint was the independent radiographic committee (IRC)-assessed progression-free survival (PFS). The median age was 52 (range, 28-75) years and 222 (62.7%) patients were postmenopausal. CDK4/6 inhibitors and fulvestrant were previously used in 23 (6.5%) and 92 (26.0%) patients, respectively. The baseline characteristics were comparable between the entinostat and placebo groups. The median PFS was 6.32 (95% CI, 5.30-9.11) and 3.72 (95% CI, 1.91-5.49) months in the entinostat and placebo groups (HR, 0.76; 95% CI, 0.58-0.98; P = 0.046), respectively. Grade ≥3 adverse events (AEs) occurred in 154 (65.5%) patients in the entinostat group versus 23 (19.3%) in the placebo group, and the most common grade ≥3 treatment-related AEs were neutropenia [103 (43.8%)], thrombocytopenia [20 (8.5%)], and leucopenia [15 (6.4%)]. Entinostat plus exemestane significantly improved PFS compared with exemestane, with generally manageable toxicities in HR + ABC (ClinicalTrials.gov #NCT03538171).

Objective:To observe the clinical features of eyes in children with methylmalonic acidemia (MMA).Methods:A retrospective clinical case study. From June 2019 to June 2022, 13 children with MMA visited on the Department of Ophthalmology of Henan Children's Hospital were included in the study. The anterior segment and fundus were examined under surface or general anesthesia. Best corrected visual acuity (BCVA) and refraction were performed in 9 cases; fluorescein fundus angiography (FFA) was performed in 3 cases; flash electroretinogram (FERG) was performed in 6 cases; flash visual evoked potential (FVEP) was detected in 6 cases; optical coherence tomography (OCT) was performed in 3 cases.Results:Among the 13 pediatric patients with methylmalonic acidemia, 6 cases were male and 7 cases were female. The average age at first visit was 45 months. All cases suffered from hyperhomocysteinemia; 9 cases were with epilepsy; 2 cases were with infantile spasms; 11 cases were with stunting, 13 cases were with repeated pulmonary infection during growth period; 4 cases were with hydrocephalus; 1 cases was with hypertension and renal insufficiency. Genetic dectection results of 8 cases were recorded, MMACHC:c.609G>A:p.W203* mutation site was found in all cases. One case was accompanied by corneal ulcer. There were 10 cases with nystagmus, 4 cases with macular degeneration, 3 cases with hyperopic refractive error and esotropia. Nine cases underwent BCVA examination, BCVA was light perception-0.6. In OCT, 2 cases of 3 cases showed retinal thinning and photoreceptor cell layer atrophy in the macular area. In FFA, 2 cases of 3 cases showed circular transparent fluorescence in the macular area. Five cases of 6 cases who with FVEP had different degrees of P100 peak time delay and decreased amplitude, and 4 cases of 6 cases with FERG had decrease of a and b wave in light and dark adaptation. Conclusions:The clinical phenotypes of eyes in children with MMA are various and the severity was different; most of them are accompanied by nystagmus, and the fundus lesions are common in the characteristic bovine eye like macular region. Those with macular disease have severe visual impairment.

Objective:To observe any effect of dry needling of myofascial trigger points on substance P and synaptophysin expression in the spinal dorsal horn.Methods:Sixty-four Sprague-Dawley rats were randomly divided into a control group ( n=16) and a model group ( n=48). Myofascial trigger points were induced in the model group by a blunt strike and eccentric running. That group was then randomly divided into a no-treatment group ( n=15), a massage group ( n=16), and a dry needling group (16 rats). The rats in the two treatment groups received 4 weeks of dry needling or Chinese massage. Pressure pain thresholds were recorded before the experiment and after the 4 weeks. The content of substance P and synaptophysin in the spinal dorsal horn were measured using immunoblotting and immunohistochemistry. Results:After the treatment 14 rats (93%) in the model group had trigger points, significantly higher than the 8 rats (50%) in the massage group and the 7 rats (44%) in the dry needling group. After treatment, the average pressure pain thresholds of the no-treatment and massage groups was significantly lower than the control group′s average, while the difference between the dry needling group and the control group was not significant. The average pressure pain threshold had improved significantly in the no-treatment group, the massage group and the dry needling group, and the averages of the massage group and the dry needling group were significantly higher than that of the no-treatment group. The level of substance P was significantly higher in the no-treatment group than in the other three groups and the ratio of substance P to Glyceraldehyde 3-phosphate dehydrogenase (GAPDH)was significantly higher. The substance P: GAPDH ratio of the massage group was significantly higher than that of the control group.Conclusions:Dry needling and massage are effective in relieving myofascial pain, at least in rats. Both can reduce the content of substance P in the spinal dorsal horn.

Osteoarthritis (OA) is a common degenerative disease. Its most significant pathological change is destruction of articular cartilage and the main clinical symptoms are pain and dysfunction of joints. Recent studies have shown that the expression of non-coding RNA (ncRNA) in chondrocytes can abnormally up-regulate or down-regulate and alter the activities of chondrocytes like their proliferation, migration and apoptosis, thus leading to the occurrence and development of osteoarthritis. Exosomes are extracellular vesicles with a diameter of 40-100 nm, which are secreted in intercellular fluid, act as medium of intercellular communication. They protect ncRNA, protein, lipid and other bioactive materials from enzymatic degradation by encapsulating them and transferring to sibling chondrocytes, due to their good tissue permeability. They can also improve communication between cells and regulate the activities of chondrocytes. Thus, exosomes behave like gene carriers. The ncRNA carried by exosomes can supplement or adsorb the abnormal ncRNA in chondrocytes, so as to regulate the activity of chondrocytes, and is therefore considered as a possible candidate with capabilities to repair cartilages. In this study we reviewed existing literatures related to the roles and effects of exosome miRNA, lncRNA and circRNA on osteoarthritis. We also reviewed the pathogenesis of exosome ncRNA in osteoarthritis.

Objective:To investigate the correlation between UGT1A1 polymorphisms and the irinotecan plus S-1 regimen-induced toxicities in Chinese advanced esophageal squamous cell carcinoma (ESCC) patients.Methods:A total of 46 recurrent or metastatic ESCC patients selected from ESWN 01 trial were randomly assigned to irinotecan plus S-1 group [intravenous infusion of irinotecan (160 mg/m 2) on day 1 and oral S-1 (80-120 mg) on days 1-10, repeated every 14 days]. Peripheral venous blood at baseline was collected and genomic DNA was extracted. The genetic polymorphisms of UGT1A1*6 and UGT1A1*28 were analyzed by polymerase chain reaction (PCR) amplification. Irinotecan plus S-1 regimen-induced toxicities of patients with different UGT1A1 polymorphisms were observed. The correlation between UGT1A1 polymorphisms and the adverse effects was analyzed. Results:Among the 46 patients, the numbers of UGT1A1*6 wild type genotype (GG), mutant heterozygote (GA) and mutant homozygote (AA) were 30, 15 and 1, while those with UGT1A1*28 wild type genotype (TA6/6), mutant heterozygote (TA6/7) and mutant homozygote (TA7/7) were 36, 8 and 2, respectively. Only one patient with UGT1A1*6 AA genotype occurred grade 3 diarrhea, while one of the 2 patients with UGT1A1*28 TA7/7 genotype occurred grade 4 diarrhea. No neutropenia was observed in the patient with UGT1A1*6 AA genotype, however, both of the two patients with UGT1A1*28 TA7/7 genotype occurred grade 3-4 neutropenia. Patients with UGT1A1*28 genetic polymorphism (TA 6/7 or TA7/7) had a higher response rate compared with wild-type TA6/6 carriers. (55.6% versus 26.5%).Conclusions:The homozygous genotype of UGT1A1*6 AA and UGT1A1*28 TA7/7 are rare (<5%) in Chinese ESCC population. Not all homozygous AA and TA7/7 carriers occur severe dose limited toxicities (DLT) when treated with irinotecan (160 mg/m 2) plus S-1 regimen for 2 weeks. However, it′s still necessary torigorously observe the occurrence of severe diarrhea and neutropenia in patients with UGT1A1*6 AA and UGT1A1*28 TA7/7 and adjust the dose timely.

Objective:To investigate the correlation between UGT1A1 polymorphisms and the irinotecan plus S-1 regimen-induced toxicities in Chinese advanced esophageal squamous cell carcinoma (ESCC) patients.Methods:A total of 46 recurrent or metastatic ESCC patients selected from ESWN 01 trial were randomly assigned to irinotecan plus S-1 group [intravenous infusion of irinotecan (160 mg/m 2) on day 1 and oral S-1 (80-120 mg) on days 1-10, repeated every 14 days]. Peripheral venous blood at baseline was collected and genomic DNA was extracted. The genetic polymorphisms of UGT1A1*6 and UGT1A1*28 were analyzed by polymerase chain reaction (PCR) amplification. Irinotecan plus S-1 regimen-induced toxicities of patients with different UGT1A1 polymorphisms were observed. The correlation between UGT1A1 polymorphisms and the adverse effects was analyzed. Results:Among the 46 patients, the numbers of UGT1A1*6 wild type genotype (GG), mutant heterozygote (GA) and mutant homozygote (AA) were 30, 15 and 1, while those with UGT1A1*28 wild type genotype (TA6/6), mutant heterozygote (TA6/7) and mutant homozygote (TA7/7) were 36, 8 and 2, respectively. Only one patient with UGT1A1*6 AA genotype occurred grade 3 diarrhea, while one of the 2 patients with UGT1A1*28 TA7/7 genotype occurred grade 4 diarrhea. No neutropenia was observed in the patient with UGT1A1*6 AA genotype, however, both of the two patients with UGT1A1*28 TA7/7 genotype occurred grade 3-4 neutropenia. Patients with UGT1A1*28 genetic polymorphism (TA 6/7 or TA7/7) had a higher response rate compared with wild-type TA6/6 carriers. (55.6% versus 26.5%).Conclusions:The homozygous genotype of UGT1A1*6 AA and UGT1A1*28 TA7/7 are rare (<5%) in Chinese ESCC population. Not all homozygous AA and TA7/7 carriers occur severe dose limited toxicities (DLT) when treated with irinotecan (160 mg/m 2) plus S-1 regimen for 2 weeks. However, it′s still necessary torigorously observe the occurrence of severe diarrhea and neutropenia in patients with UGT1A1*6 AA and UGT1A1*28 TA7/7 and adjust the dose timely.