Based on the pathogenesis of “tendon off-position and joint subluxation”， combined with modern ana-tomy and biomechanics， the characteristic manifestations of “tendon off-position” and “joint subluxation” of the knee and the intrinsic connection between them are clarified. Through sorting out the relationship between “tendon off-position and joint subluxation” and knee osteoarthritis （KOA） in modern research， it is believed that “tendon off-position and joint subluxation” is the key mechanism for the occurrence and development of KOA， and accordingly， it is proposed to take the diet as the guide， use bone manipulation for external diagnosis and treatment， use traditional Chinese medicine decoction for internal treatment， and use Daoyin exercise throughout the whole process as the strategy for KOA's comprehensive traditional Chinese medicine treatment to improve the clinical effectiveness.

Wound healing is a complex process of biological integration in which the adverse conditions such as excessive inflammatory reactions, cell proliferation and migration disorders, and cellular secretion impairment can lead to refractory wounds. Characterized by complex etiology, protracted condition, and high morbidity and recurrence rate, refractory wounds severely impair patients′ physical and mental health. In clinical practice, refractory wounds are primarily treated with surgical debridement and skin transplantation, but there still exist problems such as large surgical wounds, prolonged recovery time, and high recurrence rate. In recent years, owing to the multipotent differentiation, immunomodulatory, and paracrine functions of stem cells, cell-assisted lipotransfer (CAL) technique, which involves intra-body injection of a mixture of autologous adipose-derived stem cells (ADSCs) and granular fat for refractory wound repair, has demonstrated promising application prospects. It is of great significance in its clinical application to clarify the mechanism of effects of CAL technique in refractory wound repair. The authors reviewed the research progress in the mechanism of effects of CAL technique in repairing refractory wounds to provide references for the research and treatment of refractory wounds.

Objective:To explore the clinical outcome of early endoscopic realignment with flexible cystoscope for pelvic fracture urethral injury.Methods:We retrospectively collected and analyzed the clinical data of patients with pelvic fracture urethral injuries in ER of Beijing Jishuitan Hospital from March 2018 to June 2022.Seventy-six male patients with PFUI were reviewed and 60 patients were included due to the integrity of data collected. The patients were divided into early endoscopic realignment (EER) group and suprapubic cystostomy (SC) group according to the acute management. There were 33 patients and 27 patients in EER group and SC group, respectively. The age of the patients were (42.2±13.8)years and (44.1±15.0) years in EER group and SC group, respectively. The causes of the injuries were car accident, falling and crush, the percentage of the patients were 60.6%(20 cases), 33.3%(11 cases), 6.1%(2 cases) and 55.6%(15 cases), 44.4%(12 cases), 0 in EER group and SC group, respectively. The difference between two groups was statistically insignificant. The procedure of EER began with a cystostomy guided by B ultrasound, then an antegrade cystoscopy was performed through the cystostomy while negociating the bladder neck to the proximal side of injured urethra. A ureteral stent was inserted into the broken urethra and retrieved by a forceps through retrograde urethroscopy with another flexible cystoscope. We inserted a guidewire into the ureteral stent before removing it and placed a 16F urethral catheter along the guidewire. We analyzed the difference between two groups including the incidence, the length and the management of urethral stricture and the complexity of urethroplasty if needed. The simple urethroplasty was defined as performing anastomosis after dissection of the bulbar urethral and removing the scar tissue, while the procedure was defined as complex urethroplasty if ancillary procedures, such as separating the corporal bodies and partial pubectomy, was needed.Results:The EER group and SC group had 33 patients and 27 patients, respectively. The mean operation time of EER was (24.5±7.0)minutes and there was no intra-operative complications. Postoperatively, 4 cases of bleeding and 2 cases of UTI were found, which were successfully treated by conservative managements. Twenty-eight out of 33 patients(84.8%) in EER group developed urethral stricture and the mean length of it was (3.10±1.20)cm. However, all patients in SC group developed urethral stricture (100.0%) with the mean stricture length of (3.83±1.18)cm. The difference between two groups in term of the length of stricture was statistically significant ( P=0.026). 24 patients(85.7%) in EER group were treated by urethroplsty, 2 patients(7.1%) with endoscopic urethrotomy and 2 patients (7.1%) with dilation. All were treated with urethroplasty but 2 patients with endoscopic in SC group. In EER group, 8 strictures (33.3%)finished with simple urethroplasty and 16 strictures (66.7%) with complex urethroplasty.While in SC group, 6 strictures(24.0%) completed with simple urethroplasty and 19 strictures (76.0%)with complex urethroplasty. The complexity of urethroplasty performed in EER group was not statistically significant when compared with it in SC group( P=0.538). Conclusions:The procedure of EER with flexible cystoscope is reliable and safe. Most patients with formed urethral stricture after PFUI would be treated with urethroplasty. EER can reduce the urethral stricture formation and may decrease the need of the ancillary procedures during the urethroplasties if needed.

The adipose-derived stem cell exosomes are subcellular structures of adipose stem cells. They are nano-sized membrane vesicles that can transport various cell components and act on target cells by paracrine, and they play an important role in the exchanges of substance and information between cells. Scar healing is the commonest way of healing after skin tissue injury. Pathological scar can not only cause movement dysfunction, but also lead to deformity, which affects the appearance of patients and brings life and mental pressure to the patients. In recent years, many researches have shown that the adipose-derived stem cell exosomes contain a variety of bioactive molecules, which play an important role in reducing scar formation and scar-free wound healing, by affecting the proliferation and migration of fibroblasts and the composition of extracellular matrix. This article reviewed the recent literature on the roles and mechanisms of adipose-derived stem cell exosomes in scar formation, and prospected the future application and development of adipose-derived stem cell exosomes in scar treatment.

Objective To investigate the effect of low-dose arsenious acid solution (As(III)) combined with total particulate matter (TPM) from cigarette smoke on cellular oxidative stress in human lung cancer cell line A549 cells. Methods A549 cells were divided into four groups: negative control group (0.75% DMSO), low dose As(III) group (0.88% μg/mL, 75% DMSO), cigarette smoke TPM group (75 μg/mL), and combined exposure group (75 μg/mL TPM, 0.88 μg/mL As (III)). After 24 hours' exposure, the superoxide dismutase (SOD) level in cell culture medium and intracellular 8-hydroxy-2-deoxyguanosine (8-OHdG) content were detected by ELISA, and intracellular reactive oxygen species (ROS) level was detected by fluorescent probe DCFH-DA. 2×2 factorial design was used to evaluate the interaction. Results Compared with the control group, the level of SOD in the combined exposure group was significantly increased (P<0.05). In addition, the ROS content in the combined exposure group and TPM alone group was significantly increased (P<0.05). The levels of 8-OHdG in the combined exposure group and low-dose As(III) treated group were significantly higher than those in the control group(P<0.05). The results of the factorial analysis showed that low-dose As(III) and TPM had interaction on SOD levels, ROS and 8-OHdG contents in A549 cells. The effects on SOD and ROS were synergistic, while the effect on 8-OHdG was antagonistic. Conclusion Low-dose arsenious acid solution As(III) and TPM in cigarette smoke have interaction on oxidative stress in A549 cells.

BACKGROUND: The association between heart rate and 1-year clinical outcomes in heart failure (HF) patients with atrial fibrillation (AF), and whether this association depends on left ventricular ejection fraction (LVEF), are unclear. We investigated the relationship between discharge heart rate and 1-year clinical outcomes after discharge among hospitalized HF patients with AF, and further explored this association that differ by LVEF level. METHODS: In this analysis, we enrolled 1760 hospitalized HF patients with AF from the China Patient-centered Evaluative Assessment of Cardiac Events Prospective Heart Failure study from August 2016 to May 2018. Patients were categorized into three groups with low (<65 beats per minute [bpm]), moderate (65-85 bpm), and high (≥86 bpm) heart rate measured at discharge. Cox proportional hazard models were employed to explore the association between heart rate and 1-year primary outcome, which was defined as a composite outcome of all-cause death and HF rehospitalization. RESULTS: Among 1760 patients, 723 (41.1%) were women, the median age was 69 (interquartile range [IQR]: 60-77) years, median discharge heart rate was 75 (IQR: 69-84) bpm, and 934 (53.1%) had an LVEF <50%. During 1-year follow-up, a total of 792 (45.0%) individuals died or had at least one HF hospitalization. After adjusting for demographic characteristics, smoking status, medical history, anthropometric characteristics, and medications used at discharge, the groups with low (hazard ratio [HR]: 1.32, 95% confidence interval [CI]: 1.05-1.68, P = 0.020) and high (HR: 1.34, 95% CI: 1.07-1.67, P = 0.009) heart rate were associated with a higher risk of 1-year primary outcome compared with the moderate group. A significant interaction between discharge heart rate and LVEF for the primary outcome was observed (P for interaction was 0.045). Among the patients with LVEF ≥50%, only those with high heart rate were associated with a higher risk of primary outcome compared with the group with moderate heart rate (HR: 1.38, 95% CI: 1.01-1.89, P = 0.046), whereas there was no difference between the groups with low and moderate heart rate. Among the patients with LVEF <50%, only those with low heart rate were associated with a higher risk of primary outcome compared with the group with moderate heart rate (HR: 1.46, 95% CI: 1.09-1.96, P = 0.012), whereas there was no difference between the groups with high and moderate heart rate. CONCLUSIONS: Among the overall HF patients with AF, both low (<65 bpm) and high (≥86 bpm) heart rates were associated with poorer outcomes as compared with moderate (65-85 bpm) heart rate. Among patients with LVEF ≥50%, only a high heart rate was associated with higher risk; while among those with LVEF <50%, only a low heart rate was associated with higher risk as compared with the group with moderate heart rate. TRAIL REGISTRATION Clinicaltrials.gov; NCT02878811.
Aged ; Atrial Fibrillation ; Female ; Heart Failure ; Heart Rate ; Humans ; Male ; Middle Aged ; Patient Discharge ; Prospective Studies ; Stroke Volume ; Ventricular Function, Left

In order to understand the current development of cell transformation assay (CTA) and its application in the evaluation of cigarette smoke carcinogenesis, the relevant literatures were analyzed and combed from these two aspects. CTA can evaluate the carcinogenicity of various genotoxic and non-genotoxic carcinogens in a short period of time, and has a strong consistency with the results of animal carcinogenic test. After malignant transformation, the cells show changes in cell morphology, immortalization of cells, disappearance of cell-cell contact inhibition, and the ability to form tumors when injected into animals. The identification methods of transformed cells include transformed cell focus count, agglutination test, soft agar culture and inoculation of nude mice, etc. At present, BALB/c 3T3 cells, Bhas 42 cells and SHE cells are the most widely used cells for CTA. Cigarette smoke is a complex aerosol containing a variety of non-genetic carcinogenic chemicals. Cell transformation tests are often used as an in vitro alternative method to evaluate the carcinogenic effects of cigarette smoke, which is different from the short-term genetic toxicity test. It simulates the long-term state of human smoking induced malignant transformation of cells, through the long-term exposure of cells for several decades, which is closer to the occurrence of cancer caused by human smoking. Therefore, CTA can evaluate the carcinogenicity of cigarette smoke and other tobacco products.

OBJECTIVETo assess the value of G-banded karyotyping in combination with multiplex ligation-dependent probe amplification (MLPA) as a tool for the detection of chromosomal abnormalities in fetuses with congenital heart defects.

METHODSThe combined method was used to analyze 104 fetuses with heart malformations identified by ultrasonography. Abnormal findings were confirmed with chromosomal microarray analysis (CMA).

RESULTSNineteen (18%) fetuses were found to harbor chromosomal aberrations by G-banded karyotyping and MLPA. For 93 cases, CMA has detected abnormalities in 14 cases including 10 pathogenic copy number variations (CNVs) and 4 CNVs of uncertain significance (VOUS). MLPA was able to detect all of the pathogenic CNVs and 1 VOUS CNV.

CONCLUSIONCombined use of G-banded karyotyping and MLPA is a rapid, low-cost and effective method to detect chromosomal abnormalities in fetuses with various heart malformations.

Chromosome Aberrations ; Chromosome Banding ; Chromosome Disorders ; diagnosis ; genetics ; DNA Copy Number Variations ; Female ; Fetal Diseases ; diagnosis ; genetics ; Genetic Testing ; methods ; Heart Defects, Congenital ; diagnosis ; genetics ; Humans ; Karyotyping ; methods ; Multiplex Polymerase Chain Reaction ; methods ; Pregnancy ; Prenatal Diagnosis ; methods ; Reproducibility of Results ; Sensitivity and Specificity

We have assessed the relationships between immune trait (antibody titers of Sheep red blood cell, SRBC; Avian influenza, AI; Newcastle disease, ND) and varieties of MHC B-LBHII Gene in local chicken breeds (Wenshang Barred chicken, LH; Laiwu Black chicken, LWH; and Jining Bairi chicken, BR). We selected 300 chickens randomly from the three indigenous chicken populations. The variations of MHC B-L BII gene were detected by directly DNA sequencing and polymerase chain reaction-single strand conformation polymorphism (PCR-SSCP). The results indicated that there were about 19-22 nucleotide mutations in the three local breeds, which could affect 16-18 amino acid variations. Another results indicated that there was significantly relationship between seven to eight SNPs of the MHC B-LBII region and some immune traits (P < 0.05 or P < 0.01). Both locus G97A and locus T138A were found in the three species, which were significantly related to the antibodies of SRBC, ND and AI antibody titers (P < 0.05). Among them, the locus G97A was significantly associated with ND antibody titers (P < 0.05) in BR chicken, with SRBC antibody titers (P < 0.05) in LWH chicken, and with H9 antibody titers (P < 0.05) in LH chicken. Furthermore, locus T138A was significantly associated with H9 antibody titers in BR and LH chickens (P < 0.05). All those results suggest relationships among the different varieties of MHC B-LBII and immune traits in the three local breeds.
Animals ; Base Sequence ; Breeding ; Chickens ; genetics ; immunology ; Major Histocompatibility Complex ; genetics ; Polymerase Chain Reaction ; Polymorphism, Single Nucleotide ; Polymorphism, Single-Stranded Conformational ; Sequence Analysis, DNA

OBJECTIVETo use array comparative genomic hybridization (array-CGH) and multiplex ligation-dependent probe amplification (MLPA) to detect unbalanced rearrangements in 4 cases suspected to have chromosome disease but were undetected with conventional karyotype analysis, and to assess the applicability of array-CGH and MLPA for detection of unbalanced translocation.

METHODSGenomic DNA was extracted with standard procedures. All cases were analyzed by array-CGH and subtelomeric MLPA.

RESULTSAll of the cases were identified to have unbalanced translocations by array-CGH analysis, among which 3 were consistent with subtelomeric MLPA analysis. For the remaining one, its chromosomal abnormality was not detected by MLPA as the imbalance has occurred outside of target regions.

CONCLUSIONBoth array-CGH and MLPA techniques can complement conventional karyotyping for detecting unbalanced translocations. The combination features both high resolution and efficiency for clinical use.

Adult ; Child ; Chromosome Deletion ; Chromosome Duplication ; Comparative Genomic Hybridization ; Humans ; Infant ; Karyotyping ; Male ; Multiplex Polymerase Chain Reaction ; Phenotype ; Translocation, Genetic