BACKGROUND:Osteoblasts are the main cell types responsible for bone formation and remodeling,and the normal performance of their function is precisely regulated by various signaling pathways.Among them,the bone morphogenetic protein and Wnt signaling pathways play a key role in osteogenesis. OBJECTIVE:To review the role of bone morphogenetic protein/Wnt signaling pathway in the regulation of osteoblast function and analyze its changes in different physiological and pathological conditions in order to further reveal the molecular mechanism of bone formation and remodeling. METHODS:The Chinese and English search terms"BMP signaling pathway,Wnt signaling pathway,and osteogenesis"were searched in CNKI,Wanfang,and PubMed databases for original researches published from the inception to June 2023.Totally 61 articles were finally selected for analysis and summary.Using the method of the literature review,the studies of the bone morphogenetic protein/Wnt signaling pathway in regulating osteogenesis were sorted out and analyzed. RESULTS AND CONCLUSION:(1)Bone morphogenetic protein and Wnt signaling pathways play important roles in the differentiation,proliferation,and maturation of osteoblasts.Bone morphogenetic protein signaling pathway mainly regulates the expression of osteogenesis-related genes through the activation of Smad protein.Smad protein enters the nucleus and regulates the expression of genes related to osteogenesis.Different Wnt signaling pathway from bone morphogenetic protein mainly depends on the activation of β-catenin to exert its biological effects.(2)The regulatory effect of bone morphogenetic protein/Wnt signaling pathway will be affected by many factors in different physiological and pathological states.Growth factors,hormones,and mechanical stress can affect the activity of bone morphogenetic protein/Wnt signaling pathway to some extent.(3)Bone morphogenetic protein/Wnt signaling pathway interacts with other signaling pathways in the regulation of osteogenesis,and they together constitute a complex regulatory network.(4)Chinese medicine and natural compounds can promote bone health by regulating signaling pathways,providing new possibilities for treating bone diseases.(5)Future studies can further explore the interaction of bone morphogenetic protein/Wnt signaling pathway and other signaling pathways and its changes in different physiological and pathological conditions,resolve the key nodes and regulation mechanism in the complex network,to provide more precise targets for the treatment of bone-related diseases,and also provide new ideas to reveal the molecular mechanism of bone formation and remodeling.

BACKGROUND:The occurrence and development of osteoarthritis is strongly associated with immune abnormalities,and the importance of various immune cells and immune mediators in the pathogenesis of osteoarthritis has been continuously elucidated. OBJECTIVE:To review the role of immune cells and related cytokines in osteoarthritis disease,and provide new ideas for future research and prevention of osteoarthritis. METHODS:Taking"osteoarthritis,knee,macrophages,T cells,B cells,natural killer cells,dendritic cells,cytokines,inflammatory factors,immune cells"as search terms,relevant published literature was searched on CNKI,WanFang,VIP,PubMed and Web of Science databases.After reading the title and abstract for preliminary screening,98 articles were selected for review after reading the full text again. RESULTS AND CONCLUSION:In the past,it was believed that the pathogenesis of osteoarthritis was associated with cartilage wear.In recent years,studies have suggested that osteoarthritis is a chronic inflammatory state in which immune cells are widely involved.With the in-depth study of the pathogenesis of osteoarthritis,scholars believe that the pathogenesis of osteoarthritis is driven by early innate immune response,which will gradually catalyze degenerative changes and eventually lead to changes in the joint microenvironment.Various immune cells and cytokines are the key factors affecting the repair of osteoarthritis.Macrophages and natural killer cells participate in synovial inflammatory reaction,and T cell immune reaction participates in the degradation of osteoarthritis cartilage and aggravates the condition of osteoarthritis.Interleukin-1β secreted by immune cells,interleukin-6,tumor necrosis factor α,interleukin-17 and interleukin-37 play an important role in the pathophysiology of osteoarthritis,among which interleukin-1β is the most important inflammatory factor causing articular cartilage damage.Assessing immunological risk factors at the early stage of osteoarthritis can effectively treat the disease at an early stage,which can significantly reduce disability,morbidity and costs associated with osteoarthritis.At present,the immunomodulatory effect of stem cells and their derived secretions and biomaterials on the treatment of osteoarthritis has been confirmed in different experimental models,but there is still a lot of research to be done before they are used in clinical practice.With the discovery of new therapeutic targets,targeted treatment will bring new hope for the repair of clinical osteoarthritis.

Objective To monitor the susceptibility of clinical isolates to antimicrobial agents in tertiary hospitals in major regions of China in 2022.Methods Clinical isolates from 58 hospitals in China were tested for antimicrobial susceptibility using a unified protocol based on disc diffusion method or automated testing systems.Results were interpreted using the 2022 Clinical &Laboratory Standards Institute(CLSI)breakpoints.Results A total of 318 013 clinical isolates were collected from January 1,2022 to December 31,2022,of which 29.5％were gram-positive and 70.5％were gram-negative.The prevalence of methicillin-resistant strains in Staphylococcus aureus,Staphylococcus epidermidis and other coagulase-negative Staphylococcus species(excluding Staphylococcus pseudintermedius and Staphylococcus schleiferi)was 28.3％,76.7％and 77.9％,respectively.Overall,94.0％of MRSA strains were susceptible to trimethoprim-sulfamethoxazole and 90.8％of MRSE strains were susceptible to rifampicin.No vancomycin-resistant strains were found.Enterococcus faecalis showed significantly lower resistance rates to most antimicrobial agents tested than Enterococcus faecium.A few vancomycin-resistant strains were identified in both E.faecalis and E.faecium.The prevalence of penicillin-susceptible Streptococcus pneumoniae was 94.2％in the isolates from children and 95.7％in the isolates from adults.The resistance rate to carbapenems was lower than 13.1％in most Enterobacterales species except for Klebsiella,21.7％-23.1％of which were resistant to carbapenems.Most Enterobacterales isolates were highly susceptible to tigecycline,colistin and polymyxin B,with resistance rates ranging from 0.1％to 13.3％.The prevalence of meropenem-resistant strains decreased from 23.5％in 2019 to 18.0％in 2022 in Pseudomonas aeruginosa,and decreased from 79.0％in 2019 to 72.5％in 2022 in Acinetobacter baumannii.Conclusions The resistance of clinical isolates to the commonly used antimicrobial agents is still increasing in tertiary hospitals.However,the prevalence of important carbapenem-resistant organisms such as carbapenem-resistant K.pneumoniae,P.aeruginosa,and A.baumannii showed a downward trend in recent years.This finding suggests that the strategy of combining antimicrobial resistance surveillance with multidisciplinary concerted action works well in curbing the spread of resistant bacteria.

Objective:To analyze the impact of the construction of county medical community led by a traditional Chinese medicine (TCM)hospital on the service capacity of township hospitals, in order to provide empirical evidence for deepening the reform of medical communities, improving the service capacity of township hospitals, and promoting the development of TCM services.Methods:Taking the county medical community led by the TCM Hospital in Mengcheng County, Anhui Province as the research object, and using the structure-process-outcome model to analyze the organizational conditions and the key measures for improving the service capacity of township hospitals, and evaluate the changes in service capacity of township hospitals before and after the construction of the medical community. In August 2023, a semi-structured in-depth interview method was used to interview six key informants on the implementation process, mechanism, and impact of the construction of county medical community on the service capacity improvement of township hospitals. The interview data was analyzed using a thematic framework method. At the same time, based on the Service Capacity of Township Health Centers (2022 Edition), a survey questionnaire was designed and 4 township hospitals was randomly selected to investigate their service capacity in 2015 (before the construction of the county medical community) and 2022 (after the construction of the county medical community), and descriptive analysis was conducted on the questionnaire data. Results:Mengcheng County has established a leading group and council for the construction of the county medical community, which was responsible for coordinating and promoting the construction of the medical community. The county-level leading hospital has gained greater autonomy to promote the optimal allocation of medical resources. Through the analysis of interview data, five key themes for enhancing the service capabilities of township hospitals have been identified: resource allocation and unified management, service integration and path optimization, technical assistance and capacity training, institutional construction and quality control, continuous improvement and regular assessment. The average qualification rate of the service capacity of each township hospital has increased from 71.50% in 2015 to 90.50% in 2022, and the average excellence rate has increased from 46.50% to 72.50%. In 2015, the three indicators related to TCM services, including TCM medical services, TCM health management, and TCM management, did not reach level A in all township hospitals. In 2022, they all reached level A.Conclusions:Through structural optimization and process improvement in the construction of county medical communities, the service capabilities of township hospitals can be enhanced, and TCM hospitals as leading units can effectively improve the chronic disease prevention and health management capabilities of township hospitals.

【Objective】 To investigate the effects of 450 nm diode blue laser on the morphological changes and thermal damage of renal pelvis under different conditions. 【Methods】 An ex vivo study was conducted on a fresh porcine pelvis model (7 cm×5 cm×3 cm). The laser fiber was fixed on the mechanical arm perpendicular to the renal pelvis tissue, and the distance between them was 1-2 mm. The renal pelvis tissue was incised at a speed of 1-2 mm/s and power of 5-30 W. After the incised tissue was fixed in formalin (4%), the morphology, depth, width and coagulation thickness were observed with naked eyes and a microscope. 【Results】 The different powers had different vaporization and incision effects. When the operating distance was 2 mm, the speed was 2 mm/s and power was 5 W, the vaporization depth, width and coagulation thickness were approximately 0 9 mm, 0.25 mm and 0.35 mm, respectively. With the increase of power, the vaporization width and depth increased, and the coagulation thickness was 0.35-0.50 mm. When the power was more than 10 W, the renal pelvis tissue was easily penetrated. When the laser power was 20 W, the section of the renal pelvis showed an irregular shape of vaporization. When the operating distance was 1 mm, the whole renal pelvis tissue was easily vaporized. When it was 2 mm, a wide and safe energy treatment window was produced. 【Conclusion】 The 450 nm diode blue laser can vaporize and incise renal pelvis tissue safely and effectively, with high precision and little thermal damage. It is expected to be a new surgical tool in the treatment of renal pelvis lesions.

Objective:To compare the early and mid-term results of hybrid coronary revascularization (HCR) and minimally invasive multivessel coronary artery bypass grafting (MICS-CABG) in coronary artery disease patients with low left ventricular ejection fraction and non diabetes mellitus, and to explore the indication of HCR and MICS-CABG.Methods:A retrospective cohort analysis of HCR and MICS-CABG cases with preoperative left ventricular ejection fraction less than 0.40, and without diabetes mellitus were conducted in Xijing Hospital from January 2015 to December 2019. 36 cases in HCR group and 17 cases in MICS group were included in this study. For HCR procedure, minimally invasive left internal mammary artery(LIMA) to the left anterior descending artery (LAD) bypass surgery were performed, and followed by percutaneous coronary intervention (PCI) to treat non LAD lesion 1 to 4 weeks later. MICS-CABG procedure was performed through left anterior small thoracotomy minimally invasive direct coronary artery bypass grafting for multiple diseased vessels.Results:The preoperative SYNTAX score in MICS group was significantly higher than that in HCR group ( P<0.05). There was no perioperative death in both groups. Troponin I, postoperative drainage volume, blood transfusion volume and ventilator ventilation time in MICS group were significantly higher than those in HCR group ( P<0.05). After 12 months follow-up, no patient died in both groups. Furthermore, all LIMA grafts were patency. The stenosis rate of drug-eluting stents in HCR group was similar to that of great saphenous vein grafts in MICS group. LVEF and left ventricular end diastolic diameter of both groups were significantly improved 12 months after operation ( P<0.05). Conclusion:HCR and MICS-CABG are minimally invasive and safe treatment for multivessel coronary artery disease patients with low ejection fraction and non diabetese mellitus. The early and mid-term therapeutic effects are satisfactory. If coronary artery lesions other than LAD are suitable for PCI, HCR should be the preferred treatment.

OsRhoGDI2 was isolated as a putative partner of Rho protein family member OsRacD from rice panicles by yeast two-hybrid, but its function remains unknown. In order to identify the function of OsRhoGDI2, OsRhoGDI2 knockout mutants were created by CRISPR/Cas9 technology. The results showed that two different homozygous mutants were obtained in T0 generation, and eight kinds homozygous mutants were identified in T1 generation. Sequence analysis revealed that the base substitution or base deletion occurred near the editing targets of the gene in knockout rice, and it could be expected that the truncated OsRhoGDI2 proteins lacking the RhoGDI conserved domain would be generated. Phenotype analysis showed that the OsRhoGDI2 knockout rice plants were significantly lower than the control plants. Statistical analysis confirmed that the significant decrease of plant height was due to the shortening of the second and third internodes, suggesting that OsRhoGDI2 gene may be related with rice height control.
CRISPR-Cas Systems ; Genes, Plant ; genetics ; Oryza ; genetics ; growth & development ; Plants, Genetically Modified ; rho Guanine Nucleotide Dissociation Inhibitor beta ; genetics

OBJECTIVE:To provide reference for clinical rational drug use. METHODS:The drug sales amount,DDDs, DDC and major pharmaceutical enterprises in 273 sample hospitals of Yangtze River basin in 2014 were statistically analyzed. RE-SULTS:The growth of consumption sum slowed down gradually. The anti-infective drugs,cardiovascular drugs and nervous sys-tem drugs occupied the medical mainstream market. Top 3 drugs in the list of consumption sum in consecutive 4 quarters were monosialotetrahexosylganglioside,thymic peptide and lansoprazole. Nearly half of top 15 drugs were auxiliary drugs;Chinese pat-ent medicines grew increasingly and appeared in the list. The sales enterprises were mainly domestic enterprises,which concentrat-ed in Sichuan,Chongqing,Jiangsu province,and other places. CONCLUSIONS:The structure of drug use in sample hospitals is basically consistent with the spectrum of disease in China. However,there is deviation between auxiliary drug use and international guide,and the rationality of clinical drug use needs to be improved.

Objective To evaluate the clinical effects of thoracic close drainage with thin drainage tube assisted to thick drainage tube after video-assisted thoracic surgery(VATS)lobectomy. Methods We ret-rospectively reviewed 89 patients received VATS lobectomy in Chinese PLA General Hospital from January 2014 to September 2014. The patients with non-small cell lung cancer were divided into two groups:treatment group (50 patients)and control group(39 patients). Treatment group took thin tube assisted to thick tube of thoracic close drainage and control group took general thoracic closed drainage tube. We studied the operation time,the bleeding of operation,the number of lymph node dissection,time of first activity out of bed,the hospitalization time of post-operation,post-operative complications,the days of post-operative drainage,drainage volume,the effect of drainage,the VAS evaluation score of post-operative pain in the two groups. Results Compared with control group,there was no statistical significance in the differences of the time of operation[(2. 58 ± 0. 57)h vs(2. 57 ± 0. 50)h;t = 0. 127,P = 0. 681],bleeding of operation[(108. 00 ± 52. 84)ml vs(114. 10 ± 107. 18)ml;t = 0. 352,P = 0. 334],the number of lymph node dissection[(14. 20 ± 5. 95)vs(11. 21 ± 4. 71);t = 2. 576,P = 0. 068)],the staying time of drainage[(5. 66 ± 2. 53)d vs(5. 82 ± 2. 02)d;t =0. 324,P = 0. 219],the postoperative drainage volume[(1 141. 76 ± 819. 26)ml vs(1 022. 95 ± 464. 84) ml;t = 0. 889,P = 0. 367]and the occurrences of the post-operative complications(8. 00% vs 10. 25% ;χ2 =1. 750,P = 0. 726). There was statistical significance in the differences of the post-operative time of off-bed [(11. 28 ± 8. 78)h vs(13. 97 ± 7. 83)h;t = 4. 027,P = 0. 045],the time from surgery to discharge [(8. 36 ± 2. 63)d vs(9. 56 ± 2. 89)d;t = 2. 952,P = 0. 043]and the drainage effect(costophrenic angle sharp:72. 0% vs 46. 2% ;χ2 = 5. 329,P = 0. 017). In the two groups,there were statistical significance differences in scores of VAS for the 24 to 72 hours resting and coughing of post-operation:24 h[(2. 78 ± 1. 13)vs(3. 74 ± 1. 68);t = 3. 226,P < 0. 001)],48 h[(1. 98 ± 0. 59)vs(3. 33 ± 1. 72);t = 5. 189,P <0. 001)],72 h[(1. 94 ± 0. 55)vs(3. 15 ± 1. 60);t = 5. 010,P < 0. 001)],coughing[(3. 64 ± 1. 23)vs (5. 33 ± 1. 95);t = 5. 005,P < 0. 001)]. Conclusion The thin drainage tube assisted to thick drainage tube for thoracic close drainage make the drainage more effective,release the pain,shorten the hopital stay;moreo-ver,it is simple and safe for operation and easy to popularize with high modified value.