1.Comparison of awakening effects of enriched environmental quantitative stimulation and conventional rehabilitation on patients with consciousness disorder after traumatic brain injury
Kehong LIU ; Tianhua DONG ; Chun HAN ; Wei ZHOU ; Xiaoyang WANG ; Xiaohua HU
Chinese Journal of Trauma 2024;40(2):111-117
Objective:To compare the awakening effects of enriched environmental quantitative stimulation and conventional rehabilitation on patients with consciousness disorder after traumatic brain injury (TBI).Methods:A retrospective cohort study was conducted to analyze the clinical data of 60 patients with consciousness disorder after TBI admitted to Hospital of Zhejiang Provincial Armed Police Corps from October 2021 to October 2022, including 38 males and 22 females, aged 26-72 years [(41.6±13.2)years]. The injury was located at the frontal and temporal lobe in 37 patients, at the brain stem in 9, and at the thalamus in 14. The types of injury included cerebral contusion and laceration in 36 patients and intracerebral hematomas in 24 patients. The Glasgow Coma Scale (GCS) score on admission was 5-8 points in 11 patients, 9-12 in 34, and 13-15 in 15. Disease course was (19.2±5.4)days. A total of 30 patients received conventional rehabilitation treatment (conventional rehabilitation group) and 30 patients received enriched environmental quantitative stimulation on the basis of conventional rehabilitation treatment, which lasted 4 cycles in 28 days (quantitative stimulation group). The Coma Recovery Scale-Revised (CRS-R) score, Activities of Daily Living (ADL) score, and brainwave α/δ ratio (ADR) before treatment and at the second and fourth treatment cycles were compared between the two groups. The incidence of complications at the end of the fourth treatment cycle and the rate of favorable outcome of Glasgow Outcome Scale (GOS) at the last follow-up were compared between the two groups.Results:All the patients were followed up for 6-12 months [(8.3±2.5)months]. There were no significant differences in CRS-R score, ADL score, or brainwave ADR between the two groups before treatment ( P>0.05). At the second treatment cycle, they were (13.03±0.73)points, (14.83±0.95)points and 0.35±0.11 respectively in the quantitative stimulation group, which were all higher than those in the conventional rehabilitation group [(11.18±0.14)points, (8.74±0.43)points and 0.29±0.09 respectively] ( P<0.05). At the fourth treatment cycle, they were (17.83±0.23)points, (52.93±10.75)points and 0.44±0.11 respectively in the quantitative stimulation group, which were all higher than those in the conventional rehabilitation group [(13.67±0.35)points, (40.56±7.15)points and 0.37±0.07 respectively] ( P<0.05). The CRS-R score, ADL score, and brainwave ADR at the second treatment cycle were significantly higher than those before treatment, and they were even higher at the fourth treatment cycle than those at the second treatment cycle ( P<0.05). At the end of the fourth treatment cycle, the incidence of complications in the quantitative stimulation group was 13.3% (4/30), which was lower than that of the conventional rehabilitation group [36.7% (11/30)] ( P<0.05). At the last follow-up, the favorable outcome rate of GOS was 80.0% (24/30) in the quantitative stimulation group, which was superior to 66.7% (20/30) in the conventional rehabilitation group ( P<0.05). Conclusion:Compared with the conventional rehabilitation treatment, enriched environmental quantitative stimulation for patients with consciousness disorder after TBI achieves enhanced consciousness level, activity of daily life and electroencephal reactivity, together with decreased incidence of complications and improved prognosis.
2.Progress and prospect of biological treatment for rotator cuff injury repair.
Zhengbo YIN ; Zhian CHEN ; Ni YIN ; Yifei ZHU ; Bihuan ZHANG ; Tianhua ZHOU ; Hongbo TAN ; Yongqing XU
Chinese Journal of Reparative and Reconstructive Surgery 2023;37(9):1169-1176
OBJECTIVE:
To review the research progress in biotherapy of rotator cuff injury in recent years, in order to provide help for clinical decision-making of rotator cuff injury treatment.
METHODS:
The literature related to biotherapy of rotator cuff injury at home and abroad in recent years was widely reviewed, and the mechanism and efficacy of biotherapy for rotator cuff injury were summarized from the aspects of platelet-rich plasma (PRP), growth factors, stem cells, and exosomes.
RESULTS:
In order to relieve patients' pain, improve upper limb function, and improve quality of life, the treatment of rotator cuff injury experienced an important change from conservative treatment to open surgery to arthroscopic rotator cuff repair. Arthroscopic rotator cuff repair plus a variety of biotherapy methods have become the mainstream of clinical treatment. All kinds of biotherapy methods have ideal mid- and long-term effectiveness in the repair of rotator cuff injury. The biotherapy method to promote the healing of rotator cuff injury is controversial and needs to be further studied.
CONCLUSION
All kinds of biotherapy methods show a good effect on the repair of rotator cuff injury. It will be an important research direction to further develop new biotherapy technology and verify its effectiveness.
Humans
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Rotator Cuff Injuries/therapy*
;
Quality of Life
;
Arthroplasty
;
Exosomes
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Neurosurgical Procedures
3.Clinical prospects and research strategies of long non-coding RNA encoding micropeptides.
Xinyi WANG ; Zhen ZHANG ; Chengyu SHI ; Ying WANG ; Tianhua ZHOU ; Aifu LIN
Journal of Zhejiang University. Medical sciences 2023;52(4):397-405
Long non-coding RNAs (lncRNAs) which are usually thought to have no protein coding ability, are widely involved in cell proliferation, signal transduction and other biological activities. However, recent studies have suggested that short open reading frames (sORFs) of some lncRNAs can encode small functional peptides (micropeptides). These micropeptides appear to play important roles in calcium homeostasis, embryonic development and tumorigenesis, suggesting their potential as therapeutic targets and diagnostic biomarkers. Currently, bioinformatic tools as well as experimental methods such as ribosome mapping and in vitro translation are applied to predict the coding potential of lncRNAs. Furthermore, mass spectrometry, specific antibodies and epitope tags are used for validating the expression of micropeptides. Here, we review the physiological and pathological functions of recently identified micropeptides as well as research strategies for predicting the coding potential of lncRNAs to facilitate the further research of lncRNA encoded micropeptides.
Female
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Pregnancy
;
Humans
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RNA, Long Noncoding/genetics*
;
Research Design
;
Antibodies
;
Carcinogenesis
;
Micropeptides
4.Progress on RNA-based therapeutics for genetic diseases.
Ting LUO ; Chunxiao HUO ; Tianhua ZHOU ; Shanshan XIE
Journal of Zhejiang University. Medical sciences 2023;52(4):406-416
RNA therapeutics inhibit the expression of specific proteins/RNAs by targeting complementary sequences of corresponding genes or encode proteins for the synthesis desired genes to treat genetic diseases. RNA-based therapeutics are categorized as oligonucleotide drugs (antisense oligonucleotides, small interfering RNA, RNA aptamers), and mRNA drugs. The antisense oligonucleotides and small interfering RNA for treatment of genetic diseases have been approved by the FDA in the United States, while RNA aptamers and mRNA drugs are still in clinical trials. Chemical modifications can be applied to RNA drugs, such as pseudouridine modification of mRNA, to reduce immunogenicity and improve the efficacy. The secure and effective delivery systems such as lipid-based nanoparticles, extracellular vesicles, and virus-like particles are under development to address stability, specificity, and safety issues of RNA drugs. This article provides an overview of the specific molecular mechanisms of eleven RNA drugs currently used for treating genetic diseases, and discusses the research progress of chemical modifications and delivery systems of RNA drugs.
Aptamers, Nucleotide
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RNA, Small Interfering/therapeutic use*
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RNA, Messenger
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Oligonucleotides, Antisense/therapeutic use*
5.ORP8 acts as a lipophagy receptor to mediate lipid droplet turnover.
Maomao PU ; Wenhui ZHENG ; Hongtao ZHANG ; Wei WAN ; Chao PENG ; Xuebo CHEN ; Xinchang LIU ; Zizhen XU ; Tianhua ZHOU ; Qiming SUN ; Dante NECULAI ; Wei LIU
Protein & Cell 2023;14(9):653-667
Lipophagy, the selective engulfment of lipid droplets (LDs) by autophagosomes for lysosomal degradation, is critical to lipid and energy homeostasis. Here we show that the lipid transfer protein ORP8 is located on LDs and mediates the encapsulation of LDs by autophagosomal membranes. This function of ORP8 is independent of its lipid transporter activity and is achieved through direct interaction with phagophore-anchored LC3/GABARAPs. Upon lipophagy induction, ORP8 has increased localization on LDs and is phosphorylated by AMPK, thereby enhancing its affinity for LC3/GABARAPs. Deletion of ORP8 or interruption of ORP8-LC3/GABARAP interaction results in accumulation of LDs and increased intracellular triglyceride. Overexpression of ORP8 alleviates LD and triglyceride deposition in the liver of ob/ob mice, and Osbpl8-/- mice exhibit liver lipid clearance defects. Our results suggest that ORP8 is a lipophagy receptor that plays a key role in cellular lipid metabolism.
Animals
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Mice
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Lipid Droplets
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Autophagy
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Autophagosomes
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Homeostasis
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Triglycerides
6.Progresses on RNA-based therapeutics for genetic diseases.
Ting LUO ; Chunxiao HUO ; Tianhua ZHOU ; Shanshan XIE
Journal of Zhejiang University. Medical sciences 2023;():1-11
RNA therapeutics inhibit the expression of specific proteins/RNAs by targeting complementary sequences of corresponding genes, or synthesize proteins encoded by the desired genes to treat genetic diseases. RNA-based therapeutics are categorized as oligonucleotide drugs (antisense oligonucleotides, small interfering RNA, RNA aptamers), and mRNA drugs. The antisense oligonucleotides and small interfering RNA for treatment of genetic diseases have been approved by the FDA in the United State, while RNA aptamers and mRNA drugs are still in clinical trials. Chemical modifications are applied to RNA drugs, such as pseudouridine modification of mRNA, to reduce immunogenicity and improve the efficacy. The secure and effective delivery systems like lipid-based nanoparticles, extracellular vesicles, and virus-like particles are under development to address stability, specificity, and safety issues of RNA drugs. This article provides an overview of the specific molecular mechanisms of 11 RNA drugs currently used for treating genetic diseases, and discusses the research progress of chemical modifications and delivery systems of RNA drugs.
7.Efficacy and Safety of Pulse Magnetic Therapy System in Insomnia Disorder: A Multicenter, Randomized, Double-Blind, Placebo-Controlled Trial
Jiwu LIAO ; Sisi WANG ; Borong ZHOU ; Wei LIANG ; Ping MA ; Min LIN ; Weisen LIN ; Congrui LI ; Xiaotao ZHANG ; Hongyao LI ; Yin CUI ; Jiajia HU ; Yuanyi QIN ; Yanhua DENG ; Aibing FU ; Tianhua ZHU ; Shanlian ZHANG ; Yunhong QU ; Lu XING ; Wumei LI ; Fei FENG ; Xinping YAO ; Guimei ZHANG ; Jiyang PAN
Psychiatry Investigation 2023;20(6):559-566
Objective:
This study’s objective is to assess the efficacy and safety of Pulsed Magnetic Therapy System (PMTS) in improving insomnia disorder.
Methods:
Participants with insomnia disorder were randomly assigned to receive either PMTS or sham treatment for four weeks (n= 153; PMTS: 76, sham: 77). Primary outcomes are the Insomnia Severity Index (ISI) scores at week 0 (baseline), 1, 2, 3, 4 (treatment), and 5 (follow-up). Secondary outcomes are the Pittsburgh Sleep Quality Index at baseline and week 4, and weekly sleep diary-derived values for sleep latency, sleep efficiency, real sleep time, waking after sleep onset, and sleep duration.
Results:
The ISI scores of the PMTS group and the sham group were 7.13±0.50, 11.07±0.51 at week 4, respectively. There was a significant group×time interaction for ISI (F3.214, 485.271=24.25, p<0.001, ηp 2=0.138). Only the PMTS group experienced continuous improvement throughout the study; in contrast, the sham group only experienced a modest improvement after the first week of therapy. At the end of the treatment and one week after it, the response of the PMTS group were 69.7% (95% confidence interval [CI]: 58.6%–79.0%), 75.0% (95% CI: 64.1%–83.4%), respectively, which were higher than the response of the sham group (p<0.001). For each of the secondary outcomes, similar group×time interactions were discovered. The effects of the treatment persisted for at least a week.
Conclusion
PMTS is safe and effective in improving insomnia disorders.
8.Macrophage-evading and tumor-specific apoptosis inducing nanoparticles for targeted cancer therapy.
Zimo LIU ; Xuefei ZHOU ; Qi LI ; Youqing SHEN ; Tianhua ZHOU ; Xiangrui LIU
Acta Pharmaceutica Sinica B 2023;13(1):327-343
Extended circulation of anticancer nanodrugs in blood stream is essential for their clinical applications. However, administered nanoparticles are rapidly sequestered and cleared by cells of the mononuclear phagocyte system (MPS). In this study, we developed a biomimetic nanosystem that is able to efficiently escape MPS and target tumor tissues. The fabricated nanoparticles (TM-CQ/NPs) were coated with fibroblast cell membrane expressing tumor necrosis factor (TNF)-related apoptosis inducing ligand (TRAIL). Coating with this functionalized membrane reduced the endocytosis of nanoparticles by macrophages, but increased the nanoparticle uptake in tumor cells. Importantly, this membrane coating specifically induced tumor cell apoptosis via the interaction of TRAIL and its cognate death receptors. Meanwhile, the encapsulated chloroquine (CQ) further suppressed the uptake of nanoparticles by macrophages, and synergized with TRAIL to induce tumor cell apoptosis. The vigorous antitumor efficacy in two mice tumor models confirmed our nanosystem was an effective approach to address the MPS challenge for cancer therapy. Together, our TM-CQ/NPs nanosystem provides a feasible approach to precisely target tumor tissues and improve anticancer efficacy.
9.Staged treatment of chronic hematogenous osteomyelitis of long bone by induced membrane technique in adults
Xijiao ZHANG ; Yongqing XU ; Tianhua ZHOU ; Hu ZHANG ; Xiaoqing HE ; Xingyu CHEN ; Muguo SONG ; Xiaoyong YANG ; Zhenghua YUE ; Yi CUI ; Jian SHI
Chinese Journal of Orthopaedic Trauma 2022;24(10):892-897
Objective:To investigate the clinical efficacy of induced membrane technique in the staged treatment of adult chronic hematogenous osteomyelitis (CHOM) of long bone.Methods:The clinical data were retrospectively analyzed of the 22 adult patients with CHOM of long bone who had been admitted to the 920th Hospital, Joint Logistics Support Force of PLA from January 2016 to December 2019. There were 18 males and 4 females, aged from 16 to 56 years (average, 31.81 years). Their disease duration ranged from 0.6 to 42.0 years, averaging 18.4 years. By the Cierny-Mader anatomical classification, 4 cases were type Ⅰ, 6 cases Type Ⅲ, and 12 cases type Ⅳ. In the first stage, the bone defects were filled with antibiotic bone cement after thorough debridement. In the second stage when the infection had been controlled, the bone defects were repaired with bone grafts after removal of the bone cement. Bone healing time and complications were followed up. The treatment effects were evaluated by comparisons of the infection control indexes [including clinical manifestations like local redness, swelling, pus, and pain, and blood white blood cell count, C-Reactive protein (CRP), and erythrocyte sedimentation rate (ESR) as well] before the primary surgery, before the secondary surgery and at the last follow-up.Results:The volumes of the bone defects after stage-one debridement ranged from 54 cm 3 to 176 cm 3 (mean, 90.9 cm 3). All patients were followed up for 20 to 51 months (mean, 30.1 months) after surgery. All bone defects healed after 4 to 11 months (mean, 6.6 months). Postoperatively, infection developed at the bone extraction site of the posterior superior iliac spine in 3 cases and pain was observed at the donor site in one case, but the conditions were relieved after symptomatic treatment. Fracture and plate breakage occurred at the bone defect site in one case who had fallen down 7 months after operation, but responded to reoperation. The last follow-up revealed such symptoms as redness, swelling and pus discharge in none of the patients. The white blood cell count [(5.70 ± 1.57) × 10 9/L and (5.65 ± 1.58) × 10 9/L], CRP [(7.56 ± 2.57) mg/L and (7.25 ± 3.83) mg/L] and ESR [(9.64 ± 2.90) mm/h and (10.55 ± 5.23) mm/h] before the secondary surgery and at the last follow-up were significantly lower than those before the primary surgery [(8.24 ± 2.18) × 10 9/L, (49.54 ± 19.56) mg/L, and (42.68 ± 13.77) mm/h] (all P < 0.05). However, there were no significant differences between the indexes before the secondary surgery and at the last follow-up ( P > 0.05). Conclusion:In the staged treatment of adult CHOM of long bone, the induced membrane technique can effectively control infection, achieve repair of bone defects, and reduce complications.
10.Low-intensity pulsed ultrasound ameliorates angiotensin II-induced cardiac fibrosis by alleviating inflammation via a caveolin-1-dependent pathway.
Kun ZHAO ; Jing ZHANG ; Tianhua XU ; Chuanxi YANG ; Liqing WENG ; Tingting WU ; Xiaoguang WU ; Jiaming MIAO ; Xiasheng GUO ; Juan TU ; Dong ZHANG ; Bin ZHOU ; Wei SUN ; Xiangqing KONG
Journal of Zhejiang University. Science. B 2021;22(10):818-838
OBJECTIVES:
Cardiac hypertrophy and fibrosis are major pathological manifestations observed in left ventricular remodeling induced by angiotensin II (AngII). Low-intensity pulsed ultrasound (LIPUS) has been reported to ameliorate cardiac dysfunction and myocardial fibrosis in myocardial infarction (MI) through mechano-transduction and its downstream pathways. In this study, we aimed to investigate whether LIPUS could exert a protective effect by ameliorating AngII-induced cardiac hypertrophy and fibrosis and if so, to further elucidate the underlying molecular mechanisms.
METHODS:
We used AngII to mimic animal and cell culture models of cardiac hypertrophy and fibrosis. LIPUS irradiation was applied in vivo for 20 min every 2 d from one week before mini-pump implantation to four weeks after mini-pump implantation, and in vitro for 20 min on each of two occasions 6 h apart. Cardiac hypertrophy and fibrosis levels were then evaluated by echocardiographic, histopathological, and molecular biological methods.
RESULTS:
Our results showed that LIPUS could ameliorate left ventricular remodeling in vivo and cardiac fibrosis in vitro by reducing AngII-induced release of inflammatory cytokines, but the protective effects on cardiac hypertrophy were limited in vitro. Given that LIPUS increased the expression of caveolin-1 in response to mechanical stimulation, we inhibited caveolin-1 activity with pyrazolopyrimidine 2 (pp2) in vivo and in vitro. LIPUS-induced downregulation of inflammation was reversed and the anti-fibrotic effects of LIPUS were absent.
CONCLUSIONS
These results indicated that LIPUS could ameliorate AngII-induced cardiac fibrosis by alleviating inflammation via a caveolin-1-dependent pathway, providing new insights for the development of novel therapeutic apparatus in clinical practice.