BACKGROUND:Multiple observational studies have suggested a potential association between telomere length and musculoskeletal diseases.However,the underlying mechanisms remain unclear. OBJECTIVE:To investigate the genetic causal relationship between telomere length and musculoskeletal diseases using two-sample Mendelian randomization analysis. METHODS:Genome-wide association study summary data of telomere length were obtained from the UK Biobank.Genome-wide association study summary data of 10 common musculoskeletal diseases(osteonecrosis,osteomyelitis,osteoporosis,rheumatoid arthritis,low back pain,spinal stenosis,gout,scapulohumeral periarthritis,ankylosing spondylitis and deep venous thrombosis of lower limbs)were obtained from the FinnGen consortium.Inverse variance weighting,Mendelian randomization-Egger and weighted median methods were used to evaluate the causal relationship between telomere length and 10 musculoskeletal diseases.Inverse variance weighting was the primary Mendelian randomization analysis method,and sensitivity analysis was performed to explore the robustness of the results. RESULTS AND CONCLUSION:(1)Inverse variance-weighted results indicated a negative causal relationship between genetically predicted telomere length and rheumatoid arthritis(odds ratio=0.78,95%confidence interval:0.64-0.95,P=0.015)and osteonecrosis(odds ratio=0.56,95%confidence interval:0.36-0.90,P=0.016).No causal relationship was found between telomere length and the other eight musculoskeletal diseases(all P>0.05).(2)Sensitivity analysis affirmed the robustness of these causal relationships,and Mendelian randomization-Egger intercept analysis found no evidence of potential horizontal pleiotropy(all P>0.05).(3)This Mendelian randomized study supports that telomere length has protective effects against rheumatoid arthritis and osteonecrosis.However,more basic and clinical research will be needed to support our findings in the future.

Objective To investigate the clinical effect of superficial temporal artery-middle cerebral artery anastomosis(STA-MCA)in the treatment of patients with occlusive cerebrovascular disease.Methods A total of 74 patients with occlusive cerebrovascular disease admitted to our hospital were included and divided into the observation group and control group according to the random number table method,with 37 cases in each group.Patients in the control group received conservative treatment,and patients in the observation group received STA-MCA.After 3 months of follow-up,the cerebral blood flow indexes(including cerebral blood flow of anterior cerebral artery,and peak time)before treatment and 3rd day,1st month and 3rd month after treatment were observed,the modified Rankin scores before treatment and 3rd day and 1 month after treatment were recorded,and the revascularization and occurrence of complications after treatment were recorded.Results At 1 month and 3 months after treatment,the cerebral blood flow of anterior cerebral artery in the two groups increased and the peak time was shortened,and the cerebral blood flow of anterior cerebral artery in the observation group was higher than that in the control group,and the peak time was shorter than that in the control group,with statistically significant differences(P<0.05).The modified Rankin scores of the two groups 1 month after treatment were lower compared with those before treatment,and the modified Rankin score of the observation group was lower than that of the control group,with statistically significant differences(P<0.05).At 1 month after treatment,the proportions of patients with grades 0 and 1 of vascular reconstruction in the observation group were lower than those in the control group,and the proportions of patients with grades 2 and 3 were higher than those in the control group,with statistical significant differences(P<0.05).At 3 months after treatment,the proportions of patients with grades 0 and 1 of vascular reconstruction in the observation group were lower than those in the control group,and the proportion of patients with grade 3 of vascular reconstruction was higher than that in the control group,with statistically significant differences(P<0.05).There was no statistically significant difference in the total incidence of complications after treatment between the two groups(P>0.05).Conclusion STA-MCA has a good clinical effect in the treatment of patients with occlusive cerebrovascular disease,which is conducive to improving the cerebral blood flow indexes and promoting the recovery of neurological function and vascular reconstruction,with safety and reliability.

This study aims to acetylate Rehmannia glutinosa polysaccharides by acetic anhydride method, optimize process parameters and evaluate their antioxidant activity. With the degree of substitution(D_s) as a criterion, the effects of reaction time, acetic anhydride-to-polysaccharides ratio and temperature were investigated. Process parameters were optimized by single-factor experiment and response surface methodology. The infrared spectroscopy(IR) and scanning electron microscopy(SEM) proved the successful acetylation and were employed to preliminarily analyze the structural characteristics of acetylated derivatives. The results showed that the D_s was 0.327 under the optimal technological conditions, including m(acetic anhydride):m(R. glutinosa polysaccharides)=2.70, reaction time 3.0 h and temperature 48 ℃. Further, the antioxidant properties of acetylated derivatives were investigated in vitro and acetylation was found effective to improve the antioxidant activity of R. glutinosa polysaccharides. This study provides a reference for the further development and application of R. glutinosa polysaccharides.
Acetylation ; Antioxidants/pharmacology* ; Polysaccharides/pharmacology* ; Rehmannia/chemistry*

Osteoarthritis (OA) is a prevalent degenerative joint disease characterized by cartilage loss and accounts for a major source of pain and disability worldwide. However, effective strategies for cartilage repair are lacking, and patients with advanced OA usually need joint replacement. Better comprehending OA pathogenesis may lead to transformative therapeutics. Recently studies have reported that exosomes act as a new means of cell-to-cell communication by delivering multiple bioactive molecules to create a particular microenvironment that tunes cartilage behavior. Specifically, exosome cargos, such as noncoding RNAs (ncRNAs) and proteins, play a crucial role in OA progression by regulating the proliferation, apoptosis, autophagy, and inflammatory response of joint cells, rendering them promising candidates for OA monitoring and treatment. This review systematically summarizes the current insight regarding the biogenesis and function of exosomes and their potential as therapeutic tools targeting cell-to-cell communication in OA, suggesting new realms to improve OA management.
Apoptosis ; Cartilage/pathology* ; Cartilage, Articular/metabolism* ; Cell Communication ; Chondrocytes/metabolism* ; Exosomes/pathology* ; Humans ; Osteoarthritis/therapy*

Objective To analyze the status of quality indicators(QI) on specimen acceptability and establish preliminary qual ity specification.Methods Web based External Quality Assessment system was used to collect data of laboratories partici pated in "Medical quality control indicators in clinical laboratory" from 2015 to 2017,including once in 2015 and 2017 and twice in 2016.Rate and sigma scales were used to evaluate incorrect sample type,incorrect sample container,incorrect fill level and anticoagulant sample clotted.The 25th percentile (P25) and 75th percentile (P75) of the distribution of each QI were employed to establish the high,medium and low specification.Results 5 346,7 593,5 950 and 6 874 laboratories sub mitted the survey results respectively.The P50 of biochemistry (except incorrect fill level),immunology and microbiology reach to 6σ.The P50 of clinical laboratory is 4 to 6σ except for incorrect sample container.There is no significant change of the continuous survey results.Based on results in 2017 to establish the quality specification,the P25 and P75 of the four QIs is 0 and 0.084 4 ％,0 and 0.047 6 ％,0 and 0.114 2 ％,0 and 0.078 4 ％,respectively.Conclusion According to the results of the survey,most laboratories had a faire performance in biochemistry,immunology and microbiology,and clinical laboratory needs to be strengthened.Laboratories should strengthen the laboratory information system construction to ensure the actual and reliable data collection,and make a long time monitoring to achieve a better quality.

OBJECTIVETo explore a new method for finite element modeling to achieve material property assignment based on in situ CT gray value in simulated osteotomies for deformities.

METHODSA CT scan dataset of the lower limb of a patient with extorsion deformity was obtained for three-dimensional reconstruction using Mimics software and preparing a solid model. In the CAD software, the parameters for osteotomy simulation were defined including the navigation axis, rotation angle and reference plane. The tibia model was imported to the FEA pre-processing software for meshing procedure and then exported to Mimics. All the segments of the tibia meshed model were assigned uneven material properties based on the relationship between CT gray values and material properties in the Mimics software. Finally, all the segments of the tibia model, reference axis and reference plane were assembled in the pre-processing software to form a full finite element model of a corrected tibia, which was submitted to resolver for biomechanical analysis.

RESULTSThe tibia model established using our modeling method had inhomogeneous material properties based on CT gray values, and was available for finite element analysis for the simulation of osteotomy.

CONCLUSIONSThe proposed finite element modeling method, which retains the accuracy of the material property assignment based on CT gray value, can solve the reposition problem commonly seen in modeling via the routine method of property assignment and provides an efficient, flexible and accurate computational biomechanical analysis method for orthopedic surgery.

Finite Element Analysis ; Humans ; Models, Anatomic ; Osteotomy ; Software ; Tibia ; pathology ; Tomography, X-Ray Computed

Objective To analyze biomechanical properties of cervical spine after anterior cervical discectomy and fusion (ACDF) and total disc replacement (TDR) surgery. Methods Twelve cadaveric cervical spines (C2-T1) were adopted, and the motion and load distributions of the cervical segments under intact state and after ACDF and TDR surgery were tested using a three-dimensional (3D) optoelectronics measurement system. All the tests were carried out with displacement control in directions of flexion (Flex), extension (Ext), left bending (LB), right bending (RB), left rotation (LR) and right rotation (RR). Motion characteristics of the normal cervical spine and the implant were also discussed. Results In TDR-treated specimens, range of motion (ROM) was well preserved and could restore to the normal ROM distributions, especially in Flex/Ext and LR/RR direction. While in ACDF-treated specimens, ROM presented a large decrease as much as to 73.41% under the same condition compared with TDR, and ROM distributions were also changed obviously in other motions for the segments. Significant changes of ROM in LB/RB direction occurred in both TDR and ACDF group, which were up to 45.92% and 108.06%, respectively. The experimental data indicated that the normal motion of cervical spines was a 3D coupled motion, especially in LB/RB direction, where a 35% rotation around X-axis existed. The cervical spine could recover close to normal coupled motion after TDR surgery. Conclusions TDR surgery can restore the physiological motion of cervical spines more close to the normal state, especially in Flex/Ext and LR/RR direction. The study provides a theoretical basis and quantitative reference for TDR and ACDF surgery in clinic.

Eighteen compounds were isolated by a combination of various chromatographic techniques including column chromatography over macroporous resin, MCI gel, silica gel, and sephadex LH-20 and reversed-phase HPLC. Their structures were elucidated by spectroscopic data analysis as adinoside A (1), stryspinoside (2), benzyl alcohol beta-glucopyranoside (3), benzyl 2-o-beta-D-glucopyranosyl-2,6-dihydroxybenzoate (4) , gentisic acid 2-O-beta-D-glucopyranoside (5), eugenyl beta-D-glucopyranoside (6) , eugenyl-P-xylopyranosyl-(1-->6)-beta-glucopyranoside (7), (-)-lyoniresinol 9-O-fP-D-glucopyranoside (8) , (+)-lyoniresinol 9-O-beta-D-glucopyranoside (9) , apigenin-7-O-L-rhamnopyranoside (10), luteolin-3 '-O-L-rhamnoside (11) , ursolic acid (12) , beta-sitosteryl-3beta-glucopyranoside-6'-O-palmitate (13), abscisic acid (14), guanosine (15), 5-methyluracil (16), trans-cinnamic acid (17), and 4-hydroxybenzaldehyde(18). These compounds were obtained from this plant for the first time.
Benzaldehydes ; analysis ; Flowers ; chemistry ; Gentisates ; analysis ; Glucosides ; analysis ; Hydroxybenzoates ; analysis ; Lonicera ; chemistry ; Luteolin ; analysis ; Thymine ; analysis ; Triterpenes ; analysis

OBJECTIVETo evaluate the learning curve of complete mesocolic excision(CME) for colon cancer.

METHODSClinical data of 75 cases in whom CME was performed by a group of surgeons in the Department of Gastrointestinal Surgery, Peking University People's Hospital from November 2009 to June 2011 were reviewed. The patients were divided into three groups(groups A, B, C, 25 cases in each group) by operative chronologic sequence.

RESULTSThere were no significant differences in age, sex, preoperative staging, cancer location, operation history of abdomen, ASA among the three groups(P>0.05). The operative time in group A was (205.4 ± 53.2) min and decreased to (180.4 ± 29.7) min in group B and (169.8 ± 41.3) min in group C (P<0.05). The postoperative hospital stay decreased from (17.8 ± 10.9) d in group A to(12.9 ± 4.1) d in group B and(11.0 ± 3.5) d in group C(P<0.05). The postoperative complication rate decreased from 32%(8/25) in group A and 36%(9/25) to 8%(2/25) in group C. The specimen quality was superior in group C compared to group A (WEST grade C above were 20 and 11 respectively, P<0.05). There were no significant differences in intraoperative bleeding, time to first flatus, postoperative fasting time, number of retrieved lymph nodes among the three groups(P>0.05).

CONCLUSIONFrom the learning curve of CME, surgeons can learn CME skill after performing 25 cases.

Adult ; Aged ; Aged, 80 and over ; Colectomy ; education ; methods ; Colonic Neoplasms ; surgery ; Female ; Humans ; Learning Curve ; Male ; Mesocolon ; surgery ; Middle Aged ; Retrospective Studies ; Young Adult

To enhance the DNA immunogencity of PRRSV ORF5 gene, CpG sequence and the universal helper T cell antigen epitope (PADRE) sequence were inserted between the decoy epitope and the neutralizing epitope. At the same time, site-mutations were introduced at N33 and N51 to diminish the coverage effect to epitope B from the polysaccharides. Subsequently, the modified ORF5 gene (MORF5) and PRRSV ORF6 gene were cloned into the eukaryotic expression vector pcDNA3.0 under the control of two CMV promoters, respectively. With indirect immunofluorescence assay and Western-blot the expression in vitro of the two genes was confirmed, then six-week-old Balb/C mouse were immunized with the modified expression plasmid pcDNA-M5A-6A. The non-modified expression plasmid pcDNA-5A-6A, the blank eukaryotic expression plasmid pcDNA3.0, living attenuated vaccine and inactivated vaccine were used as controls. The PRRSV specific neutralizing antibodies and the T cell proliferation response were elevated with virus neutralization assay and MTf method. Results indicate that the modified plasmid pcDNA-M5A-6A can elicit not only higher titer of neutralizing antibodies in a rapid time, but also more vigorous T cell proliferation response compared with the non-modified plasmid pcDNA-5A-6A and commercial vaccines, indicating that DNA vaccine pcDNA-M5A-6A maybe a promising candidate for PRRS prevention.
Animals ; Antibodies, Neutralizing ; immunology ; Antibodies, Viral ; blood ; immunology ; Binding Sites ; genetics ; Blotting, Western ; CHO Cells ; Cell Proliferation ; Cricetinae ; Cricetulus ; Female ; Glycosylation ; Mice ; Mice, Inbred BALB C ; Mutation ; Open Reading Frames ; genetics ; Porcine Reproductive and Respiratory Syndrome ; immunology ; prevention & control ; Porcine respiratory and reproductive syndrome virus ; genetics ; immunology ; metabolism ; Swine ; virology ; T-Lymphocytes ; cytology ; immunology ; metabolism ; Vaccines, DNA ; administration & dosage ; immunology ; Viral Proteins ; genetics ; immunology ; metabolism ; Viral Vaccines ; administration & dosage ; immunology