BACKGROUND:The distribution of the necrotic area plays an important role in hip preservation treatment.At present,there are few studies on whether the difference in the three-dimensional spatial distribution of osteonecrosis of the femoral head affects the clinical outcome of fibular support. OBJECTIVE:To explore the relationship between the spatial distribution and clinical outcome at the sites of osteonecrosis of the femoral head and fibular support using CT three-dimensional reconstruction so as to provide a basis for optimizing the applicable conditions of fibular support and improving the hip preservation effect of fibular support. METHODS:Eighty patients with osteonecrosis of the femoral head who were treated with fibular support for hip preservation from January 2010 to January 2021 were selected as the study subjects according to the inclusion criteria.They were followed up for at least 2 years.According to the clinical outcome,the patients were divided into the successful hip preservation group(n=55)and the failure hip preservation group(n=25).3D reconstruction was performed according to the preoperative and postoperative CT images of the patients.According to the three-column theory,the femoral head was divided into outer nine areas,middle nine areas and inner nine areas(L1-9,C1-9,and M1-9)to explore the spatial distribution of necrotic area of the femoral head and fibular support area and its relationship with clinical outcome. RESULTS AND CONCLUSION:(1)Before operation,the necrotic area of the femoral head was mainly distributed in L1,L2,L4,L5,C1,C2,C4,and C5(the upper and middle part of the anterior part of the outer ninth area and the middle part of the middle ninth area).After operation,the fibular support area was mainly distributed in L5,L6,C5,and C6(the middle and lower part of the outer ninth area and the middle and lower part of the middle ninth area).(2)There were significant differences in the distribution of osteonecrosis of the femoral head between the successful hip preservation group and the failure hip preservation group in L8(the posterior middle part of the outer ninth area),C3(the anterior lower part of the middle ninth area),C6(the lower middle part of the middle part of the inner ninth area)and M2(the anterior middle part of the inner ninth area)(P<0.05).There was a significant difference in the distribution of fibular support in L5 and L6(middle and lower part of outer nine)(P<0.05).Among them,the L8 region could be used as an independent predictor of hip preservation failure in fibular support surgery.The area under the curve of the L8 single factor prediction model was 0.698[95%CI(0.575,0.822)];the sensitivity was 76%,and the specificity was 63.6%.(3)It turns out,when the necrotic area involves L8,C3,C6,and M2,especially L8,the failure of fibular support may increase,and when the fibular support involves L5 and L6,the effect of hip preservation is often not ideal.

BACKGROUND:Bone has bioelectric effects.However,bone defects can lead to loss of endogenous bioelectricity in bone.The implantation of bone tissue engineering scaffolds with bioelectric effect into bone defects will replenish the missing electrical signals and accelerate the repair of bone defects. OBJECTIVE:To introduce the bioelectric effect of bone tissue and expound the repair effect of electrical stimulation on bone defects,summarize the research progress of bioelectric effect applied to bone tissue engineering,in order to provide new ideas for the research of bone tissue engineering. METHODS:Relevant articles were searched on CNKI,WanFang,PubMed,Web of Science and ScienceDirect databases,using"bioelectrical effect,bioelectrical materials,electrical stimulation,bone tissue engineering,bone scaffold,bone defect,bone repair,osteogenesis"as the English and Chinese search terms.Finally,87 articles were included for analysis. RESULTS AND CONCLUSION:(1)Bioelectrical effect combined with ex vivo electrical stimulation to design bone tissue engineering scaffolds is an ideal and feasible approach,and the main materials involved include metallic materials,graphene materials,natural bio-derived materials,and synthetic biomaterial.At present,the most widely used conductive material is graphene material,which benefits from its super conductivity,large specific surface area,good biocompatibility with cells and bones,and excellent mechanical properties.(2)Graphene materials are mainly introduced into the scaffold as modified materials to enhance the conductivity of the overall scaffold,while its large surface area and rich functional groups can promote the loading and release of bioactive substances.(3)However,there are still some major challenges to overcome for bioelectrically effective bone tissue engineering scaffolds:not only electrical conductivity but also the overall performance of the bracket needs to be considered;lack of uniform,standardized preparation of bioelectrically effective bone tissue engineering scaffolds;extracorporeal electrical stimulation intervention systems are not yet mature enough;lack of individualized guidance on stent selection to enable the selection and design of the most appropriate stent for patients with different pathologies.(4)When designing conductive scaffolds,researchers have to deeply consider the comprehensive effects of the scaffolds,such as biocompatibility,mechanical properties,and biodegradability.This combination of properties can be achieved by combining multiple materials.(5)Beyond that,clinical translation should be the ultimate consideration for conductive stent design.On the basis of evaluating the safe current threshold for electrical stimulation to act on the human body and facilitate the repair of bone defects,animal experiments as well as basic experiments are designed and then applied to the clinic to achieve the ultimate goal of applying bioelectrical effect bone tissue engineering scaffolds in the clinic.

Objective:To investigate epidemic status of avian influenza virus (AIV) in live poultry market (LPM) and evaluate its potential public health threat and develop control measures in Nanchang city.Methods:Forty-seven LPM in 10 counties/districts of Nanchang city were selected as surveillance sites by using cluster random sampling. Poultry swabs and environmental samples were obtained from LPM. Real time RT-PCR was used for AIV typing and subtyping. Excel 2016, SPSS 24.0 and Prism Version 7 (GraphPad) software were used for statistical analysis.Results:Total of 9 248 poultry swabs and environmental samples were collected. 1 525 specimens(16.49%) were positive for AIV. H7 and H9 were the dominant subtypes, and H9 positive rate was highest (17.44%). Sewage (21.46%) and throat swabs (20.46%) had higher positive rates than the other types of samples. Chicken and duck were dominant hosts for AIV, the corresponding positive rates were 22.80% and 13.95%. The positive rates of Honggutan district, Anyi county and Xinjian district were 25.52%, 24.31% and 22.35%, which were higher than that of the other counties/districts. Each county/district had its unique subtype composition of AIV.Conclusions:The coexistence of H7, H9 and other subtypes of AIV in LMP was identified in Nanchang city. Continuing active surveillance and comprehensive control measures should be taken to reduce the potential risk of human infection.

Objective: To develop the chimeric antibodies against neuraminidase (NA) of H7N9 and to identify their biological activity and function. Methods: The genes of variable regions of the light chain (VL) and heavy chain (VH) obtained by mouse hybridoma technology were cloned respectively into the expression VH and VL vectors bearing human-derived Cγ1, and Cκ1 and co-transfected into 293T cells. The chimeric antibodies were purified and their functions were investigated. Results: Two chimeric antibodies, 1E2 and 3E3 against neuraminidase (NA) of H7N9 were obtained. Both antibodies recognized similar antigenic epitopes. MAb 1E2 and 3E3 could prevent the infectivity with H7N9 and H11N9 virus and reduce their size of viral plaque. Conclusions The chimeric antibodies specific for N9 could prevent the infection of N9 subtype influenza virus as well as the NAI-resistant mutants and could be a potential immunotherapy approach for H7N9 treatment.

Objective To evaluate the effect of the different Child-Pugh classification on the recurrence and survival of hepatocellular carcinoma (HCC) recipients after liver transplantation. Methods Clinical data of 125 HCC recipients undergoing liver transplantation were retrospectively analyzed. The 3-year disease-free survival (DFS) and overall survival (OS) rates were calculated by Kaplan-Meier survival curve. The independent risk factors probably affecting the recurrence and survival of HCC recipients after liver transplantation were identified by using Cox's proportional hazards regression model. Results The median follow-up time was 25.6 months. The 3-year DFS and OS rates were 68.4% and 65.7% for all patients. The 3-year DFS and OS rates in 113 patients with Child-Pugh class A/B HCC were 68.6% and 66.2%, whereas 66.7% and 65.6% for 12 patients with Child-Pugh class C HCC with no statistical significance (all P>0.05). Cox's proportional hazards regression model demonstrated that vascular invasion (P=0.001)and the number of tumors>3 (P=0.025) were the independent risk factors for the postoperative recurrence of HCC in recipients undergoing liver transplantation. Alpha fetoprotein (AFP)>400μg/L (P=0.035), vascular invasion (P=0.031) and number of tumors>3 (P=0.008) were the independent risk factors affecting the survival of HCC patients. Conclusions The postoperative prognosis does not significantly differ between Child-Pugh class C and A/B HCC patients after liver transplantation. AFP, vascular invasion and number of tumors are the risk factors affecting the clinical prognosis of HCC patients after liver transplantation. Liver transplantation is an efficacious treatment for HCC patients with Child-Pugh class C.

CD8+T cells are critical immune cells protecting the body against infection and cancer. Long-lived memory CD8+T cells formed in a prior infection can reproduce to mount a faster and stronger im-mune response at a second encounter with the cognate antigen. The activation, clonal expansion and re-sponse of T cells are energetically demanding processes tightly coupled in cellular metabolism. Meanwhile, changes in cellular metabolism could also affect the development of memory T cells following acute infection. In this review, we discussed the current understanding of the mechanism by which glycometabolic pathways manipulate the differentiation of memory CD8+T cells in order to provide reference for improving vaccine de-velopment and cancer treatment.

Influenza vaccination is the most effective means to prevent and control influenza epi-demics, and the universal influenza vaccine which can induce broad and long-term protective effect is still in its infancy. Up to date, several broad neutralizing antibodies that can antagonize a variety of influenza A vi-ruses have been identified, and the crystal structure of the antibody and HA complex reveals at least three highly conserved epitopes. Deep insights into the molecular mechanism of the interactions between neutrali-zing antibodies and virus antigen can elicit a new strategy not only for rational design of universal influenza vaccines, but also for the development of antibody-based therapeutics against influenza virus. In this paper, advances in research of universal neutralizing antibodies and vaccines for Influenza A virus are reviewed.

Based on the analysis of survey results and random interviews on medical students , this paper dis-cussed from the perspective of medical students under the present situation of doctor -patient relationship:satisfied with prescriptions basic medical quality , but there are still a large room to improve;to cure medical ethics appraisal is higher , but still need to strengthen medical ethics education; the parties are still lack of trust in the prescrip-tions;the doctor-patient relationship nervous .And put forward the following countermeasures on how to relieve the strain on the doctor -patient relationship , strengthening medical ethics education , strengthen the study and practice of doctor-patient communication , pay attention to legal consciousness propaganda and training , use media power to improve direction of publit opinion .

Objective To observe the effects of stromal cell-derived-factor-1(SDF-1) on the function of endotheli?al progenitor cells(EPCs)of peripheral blood in patients with diabetes, and to discuss the effects of PI3K/AKT signaling path?way on the role of SDF-1 in EPCs. Methods The peripheral blood samples (30 mL) were collected in 10 diabetes patients (DM group) and 10 healthy controls (HC group). (1) The 100μg/L SDF-1 was added in intervention group. EGM-2MV was added in non-intervention group. The Boyden chamber and in vitro angiogenesis kit were used to analyze the migration and in vitro angiogenesis of EPCs. (2) Cultured EPCs were divided into blank control group, 1μg/L SDF-1 group, 10μg/L SDF-1 group, 100μg/L SDF-1 group, pure AMD3100 group and 100μg/L SDF-1+AMD3100 group. AKT protein expression lev?els of endothelial progenitor cells were detected by Western blot assay in each group. Results (1) Without intervention with SDF-1, EPCs’migration and angiogenesis ability were lower in DM group than those in HC group. After intervention with SDF-1, the migration and angiogenesis ability were enhanced in two groups, but the increased level was higher in DM group than that of HC group. (2) Under the same concentration, AKT protein expression level was significantly lower in DM group than that in HC group (P<0.01). AKT protein expression levels were increased with the increased levels of SDF-1 in DM group and HC group (P<0.05). AKT protein expression was significantly lower in 100μg/L SDF-1+AMD3100 group than that of 100μg/L SDF-1 group (P<0.05). Conclusion SDF-1 can increase the chemotactic migration and angiogenesis ability of EPCs in peripheral blood, especially for patients with diabetes. The effects of SDF-1 on EPCs were related to the PI3K/AKT signaling pathway.

Objective In this study ,to explore the relationship between the renal blood flow PI ,and the AKI was caused by CPB .Methods 14 cases with heart disease were accepted .The renal aorta and renal segmental artery PI of all cases were monitored by the CDFI at the preoperative and postoperative 1 h ,2 h ,4 h ,8 h ,16 h ,24 h .The renal blood urea nitrogen (Urea) ,uric acid (UA) ,creatinine (Crea) ,were detected at the same time .All datas for statistical analysis .Results The renal aorta PI was higher at the postoperative 1 h ,2 h ,4 h ,8 h ,16 h than that at the preoperative .The renal segmental artery PI was higher at the postoperative 1 h ,2 h ,4 h ,16 h than that at the preoperative .The renal blood flow PI was positively correlated with Urea ,UA and Crea .Conclu-sion The renal aorta ,renal segmental artery PI was positively correlated with Urea ,UA and Crea after CPB .The PI may be seen as an evaluation index to assess AKI after CPB .