BACKGROUND:The anterior cruciate ligament has unique nonlinear mechanical properties under a complex physiological loading environment.Elastin is an important contributor to the mechanical properties of the anterior cruciate ligament,but its mechanical response to the anterior cruciate ligament under axial tension is not clear. OBJECTIVE:To quantitatively analyze the effect of elastin on the tensile mechanical response of the anterior cruciate ligament. METHODS:Elastase solution and control buffer were prepared.The porcine anterior cruciate ligament samples were prepared into small-size samples and randomly soaked in 0,0.1,1.0,2.0,5.0,and 10.0 U/mL elastase solution for 6 hours,and other small samples of the same size were soaked in 2 U/mL elastase solution for 0,1,3,6,9,and 12 hours.To determine suitable soaking conditions for elastin-targeted enzymes and verify the digestive effect,histological staining was used to compare the effects of enzyme treatment on tissue structure and composition.The ligament samples were randomly divided into elastase-treated group and PBS group,and immersed in 2 U/mL elastase solution and PBS buffer for 6 hours,respectively.A mechanical tensile test was performed before and after immersion. RESULTS AND CONCLUSION:(1)The biochemical results showed that being treated in 2 U/mL elastase solution for 6 hours could reduce the elastin content by 31.1%,and had no significant effect on other mechanical-related components in the tissue.(2)The histological results showed that elastase was able to penetrate the tissue,and the loose degree of tissue increased after treatment.(3)In the mechanical results before and after treatment,the mechanical properties of the PBS group decreased significantly,only the low-tension elastic modulus increased significantly and the initial length increased significantly in the elastase-treated group.(4)The intergroup comparison results showed that there was no significant difference between the two groups in pre-treatment,but the low-tension elastic modulus,initial slopes,saturated slopes,and initial length of the elastase-treated group after treatment were significantly higher than those in the PBS group.(5)These results suggest that elastin degradation significantly affects the biomechanical properties of the anterior cruciate ligament and further complements our understanding of the structure-function relationship of the anterior cruciate ligament.

Objective:To explore the value of Caprini risk assessment scale and serum D-dimer in early prediction of postoperative lower extremities deep vein thrombosis (DVT) in patients with gastrointestinal malignant tumor.Methods:A total of 240 patients with gastrointestinal malignant tumors treated in Union Hospital of Tongji Medical College of Huazhong University of Science and Technology from Jan to Oct 2020 were analyzed retrospectively.Results:Caprini score was 4 in 8 cases, 5-7 in 217 cases, and 8 in 15 cases. Sixty-seven patients developed lower extremity DVT after operation. No patients with Caprini score of 4 had DVT, 57 cases (26.3%) with a score of 5-7 had DVT; 10 cases whose score were ≥8 points (66.7%) developed DVT. There was a higher incidence of lower extremity DVT in patients ≥8 points than those of 5-7 points after surgery ( P<0.01). The postoperative Caprini score of the DVT group was higher than that of the non-DVT group (6.37±1.01 vs. 5.80±0.94, t=4.108, P<0.001). D-dimer on the first day after operation in DVT group (4.08±2.27 vs. 2.01±1.04, t=7.715, P<0.001) and the level of serum D-dimer (2.93±1.81 vs. 2.30±1.21, t=2.631, P<0.001) on day 3 was higher than that in the non-DVT group. According to the ROC curve, the best cut-off value for serum D-dimer to predict lower extremity DVT on the first postoperative day was 2.84 mg/L, the sensitivity was 70.1%, the specificity was 87.3%, and the area under the curve (AUC) was 0.815. The best cut-off value of D-dimer for predicting lower limb DVT on day 3 after surgery was 1.67 mg/L, sensitivity was 85.1%, specificity was 34.7%, and AUC was 0.611. Conclusions:Patients with gastrointestinal malignant tumors have a high incidence of postoperative lower extremity DVT. When the serum D-dimer exceeds 2.84 mg/L on the first postoperative day, the likelihood of postoperative lower extremity DVT is higher.

Objective:The study was to explore the nipple-areola complex(NAC) blood supply model in Chinese breasts based on dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and to provide the blood supply knowledge for mammaplasty.Methods:Breast DCE-MRI images of breasts without masses in 245 patients from March 2012 to October 2019 in Tongji Hospital, Tongji Medical College, Huazhong University of Science & Technology were included retrospectively. The breast vessels images were obtained by image subtraction in the Siemens workstation. Axial, coronal and sagittal maximum intensity projection(MIP) images were evaluated, and all vessels supplying the nipple-areola complex were identified by 3D MIP images. Blood supply to the NAC was classified into 9 zones, and vessels of each zone were counted and analyzed. The maximum distance from the vessel to the skin surface of the breast was measured. SPSS 19.0 software was used for statistical analysis. The chi-square test was used to check for significant differences in the distribution of zones between the left breasts and the right breasts. The mean, standard deviation and 95% confidence interval of the distance between vessels and skin were calculated. Using ANOVA to compare the distance between vessels and skin of zones. P<0.05 was statistically significant. Results:There were 490 breasts in 245 DCE-MRI images, of which 97 breasts were found to have masses in 97 DCE-MRI images. The remaining 393 were normal breasts as study subjects. The patients’ ages ranged from 23 to 72 years, with a mean of 43.7 years. 637 source vessels (311 left, 326 right) were identified in 393 breasts (200 left, 193 right). Of the 637 vessels, 269 (42.2%) were in the superomedial zone and 180 (28.3%) were in the superolateral zone. The proportions of vessels in zone medial (57, 8.9%), inferior (37, 5.8%), central (30, 4.7%), inferomedial (25, 3.9%), inferolateral (25, 3.9%), superior (11, 1.7%) and lateral (3, 0.5%) were less than 10%, respectively. The chi-square test showed no significant difference in the distribution of zones ( χ2 =6.4, P=0.602) between the left breasts and the right breasts. Except for the central zone, the mean of maximum distance from the vessels to the skin surface was 0.91 cm, with a 95% confidence interval of 0.86 cm to 0.96 cm. Conclusions:DCE-MRI can clearly show the blood supply to the NAC. Superomedial or superolateral source vessels supplying the NAC were predominant, and the vessels run at a subcutaneous depth of about 1 cm.

Objective:The study was to explore the nipple-areola complex(NAC) blood supply model in Chinese breasts based on dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and to provide the blood supply knowledge for mammaplasty.Methods:Breast DCE-MRI images of breasts without masses in 245 patients from March 2012 to October 2019 in Tongji Hospital, Tongji Medical College, Huazhong University of Science & Technology were included retrospectively. The breast vessels images were obtained by image subtraction in the Siemens workstation. Axial, coronal and sagittal maximum intensity projection(MIP) images were evaluated, and all vessels supplying the nipple-areola complex were identified by 3D MIP images. Blood supply to the NAC was classified into 9 zones, and vessels of each zone were counted and analyzed. The maximum distance from the vessel to the skin surface of the breast was measured. SPSS 19.0 software was used for statistical analysis. The chi-square test was used to check for significant differences in the distribution of zones between the left breasts and the right breasts. The mean, standard deviation and 95% confidence interval of the distance between vessels and skin were calculated. Using ANOVA to compare the distance between vessels and skin of zones. P<0.05 was statistically significant. Results:There were 490 breasts in 245 DCE-MRI images, of which 97 breasts were found to have masses in 97 DCE-MRI images. The remaining 393 were normal breasts as study subjects. The patients’ ages ranged from 23 to 72 years, with a mean of 43.7 years. 637 source vessels (311 left, 326 right) were identified in 393 breasts (200 left, 193 right). Of the 637 vessels, 269 (42.2%) were in the superomedial zone and 180 (28.3%) were in the superolateral zone. The proportions of vessels in zone medial (57, 8.9%), inferior (37, 5.8%), central (30, 4.7%), inferomedial (25, 3.9%), inferolateral (25, 3.9%), superior (11, 1.7%) and lateral (3, 0.5%) were less than 10%, respectively. The chi-square test showed no significant difference in the distribution of zones ( χ2 =6.4, P=0.602) between the left breasts and the right breasts. Except for the central zone, the mean of maximum distance from the vessels to the skin surface was 0.91 cm, with a 95% confidence interval of 0.86 cm to 0.96 cm. Conclusions:DCE-MRI can clearly show the blood supply to the NAC. Superomedial or superolateral source vessels supplying the NAC were predominant, and the vessels run at a subcutaneous depth of about 1 cm.

Objective:To investigate the mediating and moderating effects of resilience on frailty and depression in the community-dwelling old adults.Methods:Totally 871 community-dwelling old adults chosen from different communities were investigated by the geriatric depression scale, Tilburg frailty indicator and 10-item Connor-Davidson resilience scale.SPSS 22.0 and AMOS 24.0 were used for data analysis, including descriptive analysis, correlation analysis, structural equation modeling and hierarchical regression analysis.Results:(1)The score of frailty (3.72±2.89)was positively correlated with the score of depression (2.63±2.57, r=0.16-0.58, P<0.01). The score of resilience(28.24±6.80) was negatively correlated with the score of frailty and depression ( r=-0.10~-0.49, both P<0.01), and frailty predicted 35% of the total variation of depression in the elderly.(2)The mediating effect of resilience was significant and the indirect effect was 0.10, accounting for 12.66% of the total variance.(3) Resilience moderated the relationship between frailty and depression ( β=-0.12, t=-4.11, R2=0.41, P<0.001). The frailty of old adults with lower resilience played a stronger predictive role in depression (simple slope=0.50, t=14.73, R2=0.01, P<0.001). Conclusion:There is a close relationship between frailty and depression in the community-dwelling older adults, and resilience plays both mediating and moderating role in the relationship.

A splicing mutation in VPS4B can cause dentin dysplasia type I (DD-I), a hereditary autosomal-dominant disorder characterized by rootless teeth, the etiology of which is genetically heterogeneous. In our study, dental follicle cells (DFCs) were isolated and cultured from a patient with DD-I and compared with those from an age-matched, healthy control. In a previous study, this DD-I patient was confirmed to have a loss-of-function splicing mutation in VPS4B (IVS7 + 46C > G). The results from this study showed that the isolated DFCs were vimentin-positive and CK14-negative, indicating that the isolated cells were derived from the mesenchyme. DFCs harboring the VPS4B mutation had a significantly higher proliferation rate from day 3 to day 8 than control DFCs, indicating that VPS4B is involved in cell proliferation. The cells were then replenished with osteogenic medium to investigate how the VPS4B mutation affected osteogenic differentiation. Induction of osteogenesis, detected by alizarin red and alkaline phosphatase staining in vitro, was decreased in the DFCs from the DD-I patient compared to the control DFCs. Furthermore, we also found that the VPS4B mutation in the DD-I patient downregulated the expression of osteoblast-related genes, such as ALP, BSP, OCN, RUNX2, and their encoded proteins. These outcomes confirmed that the DD-I-associated VPS4B mutation could decrease the capacity of DFCs to differentiate during the mineralization process and may also impair physiological root formation and bone remodeling. This might provide valuable insights and implications for exploring the pathological mechanisms underlying DD-I root development.
ATPases Associated with Diverse Cellular Activities ; genetics ; Case-Control Studies ; Cell Differentiation ; genetics ; Cells, Cultured ; Dental Sac ; cytology ; Dentin Dysplasia ; genetics ; pathology ; physiopathology ; Endosomal Sorting Complexes Required for Transport ; genetics ; Humans ; Mutation ; genetics ; Osteogenesis ; genetics ; RNA Splicing ; genetics

Cognitive impairment is one of the three primary symptoms of schizophrenic patients and shows important value in early detection and warning for high-risk individuals. To study the specifics of electroencephalogram (EEG) in patients with schizophrenia under the cognitive load, we collected EEG signals from 17 schizophrenic patients and 19 healthy controls, extracted signals of each band based on wavelet transform, calculated the characteristics of nonlinear dynamic and functional brain networks, and automatically classified the two groups of people by using a machine learning algorithm. Experimental results indicated that the correlation dimension and sample entropy showed significant differences in α, β, θ, and γ rhythm of the Fp1 and Fp2 electrodes between groups under the cognitive load. These results implied that the functional disruptions in the frontal lobe might be the important factors of cognitive impairments in schizophrenic patients. Further results of the automatic classification analysis indicated that the combination of nonlinear dynamics and functional brain network properties as the input characteristics of the classifier showed the best performance, with the accuracy of 76.77%, sensitivity of 72.09%, and specificity of 80.36%. The results of this study demonstrated that the combination of nonlinear dynamics and function brain network properties may be potential biomarkers for early screening and auxiliary diagnosis of schizophrenia.

Objective:This study aimed to explore the use of magnetic resonance imaging (MRI) to measure breast volume and gland volume to guide reconstruction of breast reconstruction with silicone gel prothesis following nipple-sparing mastectomy (NSM).Methods:According to the inclusion criteria, the breast cancer patients admitted to Wuhan Tongji Hospital from September 2018 to June 2019 were selected to undergo breast reconstruction with prosthesis after NSM. Preoperative MRI were used to measure distance from the tumor to the nipple-areola complex and the skin, and estimate the volume of breast and mammary gland. The data of breast volume measured by MRI, gland volume measured by MRI, volume of prosthesis and specimen weight were compared. The data were analyzed using Prism 8.0 software. The paired student t-test was used to compare the difference of two groups. P< 0.05 was considered statistically significant. Linear regression models were used to obtain coefficient of determination ( R2), and R2>0.8 was considered statistically significant. Results:A total of 15 breast cancer patients, aged 28-45 years, with a mean of 35.5 years, were included. There were 13 cases unilateral and 2 cases bilateral. The clinical stages of stage 0, Ⅰ and Ⅱ were 8, 5 and 2 patients, respectively. The average distance o from tumor to nipple-areola complex was (3.1±0.8) cm. One patient suffered postoperative bleeding and was promptly reoperated through the original incision, and the patient recovered well after surgery. All patients felt sensory disturbance of the nipple and areola. There was no complication such as infection, seroma, capsular contracture, prosthesis rupture, and prosthesis shift. At 4-12 months postoperative follow-up, all breasts were basically symmetrical and no tumor recurrence or metastasis occurred, which satisfied the patients. The mean values of the volume of prosthesis, specimen weight, breast volume measured by MRI and gland volume measured by MRI were (471.10±45.60) ml, (244.60±29.14) ml, (243.60±31.16) g, (244.30±16.63) ml. There was significant difference between the breast volume measured by MRI and the specimen weight ( t=10.37, P<0.001), while no statistical difference was found between gland volume measured by MRI and specimen weight ( t=0.20, P=0.847). Similarly, there was significant difference between the breast volume measured by MRI and the volume of prosthesis ( t=5.19, P<0.001), while no statistical difference was found between gland volume measured by MRI and the volume of prosthesis ( t=1.74, P=0.104). The coefficient of determination between gland volume measured by MRI and specimen weight ( R2=0.98) was higher than that of breast volume measured by MRI ( R2=0.82). Similarly, the coefficient of determination between gland volume measured by MRI and the volume of prosthesis ( R2=0.71) was higher than that of breast volume measured by MRI ( R2=0.54). Conclusions:Preoperative MRI can provide guidance to breast reconstruction with silicone gel prothesis following nipple-sparing mastectomy in breast cancer. The gland volume measured by MRI is closer to the specimen weight and the volume of prosthesis than the breast volume measured by MRI.

Objective:This study aimed to explore the use of magnetic resonance imaging (MRI) to measure breast volume and gland volume to guide reconstruction of breast reconstruction with silicone gel prothesis following nipple-sparing mastectomy (NSM).Methods:According to the inclusion criteria, the breast cancer patients admitted to Wuhan Tongji Hospital from September 2018 to June 2019 were selected to undergo breast reconstruction with prosthesis after NSM. Preoperative MRI were used to measure distance from the tumor to the nipple-areola complex and the skin, and estimate the volume of breast and mammary gland. The data of breast volume measured by MRI, gland volume measured by MRI, volume of prosthesis and specimen weight were compared. The data were analyzed using Prism 8.0 software. The paired student t-test was used to compare the difference of two groups. P< 0.05 was considered statistically significant. Linear regression models were used to obtain coefficient of determination ( R2), and R2>0.8 was considered statistically significant. Results:A total of 15 breast cancer patients, aged 28-45 years, with a mean of 35.5 years, were included. There were 13 cases unilateral and 2 cases bilateral. The clinical stages of stage 0, Ⅰ and Ⅱ were 8, 5 and 2 patients, respectively. The average distance o from tumor to nipple-areola complex was (3.1±0.8) cm. One patient suffered postoperative bleeding and was promptly reoperated through the original incision, and the patient recovered well after surgery. All patients felt sensory disturbance of the nipple and areola. There was no complication such as infection, seroma, capsular contracture, prosthesis rupture, and prosthesis shift. At 4-12 months postoperative follow-up, all breasts were basically symmetrical and no tumor recurrence or metastasis occurred, which satisfied the patients. The mean values of the volume of prosthesis, specimen weight, breast volume measured by MRI and gland volume measured by MRI were (471.10±45.60) ml, (244.60±29.14) ml, (243.60±31.16) g, (244.30±16.63) ml. There was significant difference between the breast volume measured by MRI and the specimen weight ( t=10.37, P<0.001), while no statistical difference was found between gland volume measured by MRI and specimen weight ( t=0.20, P=0.847). Similarly, there was significant difference between the breast volume measured by MRI and the volume of prosthesis ( t=5.19, P<0.001), while no statistical difference was found between gland volume measured by MRI and the volume of prosthesis ( t=1.74, P=0.104). The coefficient of determination between gland volume measured by MRI and specimen weight ( R2=0.98) was higher than that of breast volume measured by MRI ( R2=0.82). Similarly, the coefficient of determination between gland volume measured by MRI and the volume of prosthesis ( R2=0.71) was higher than that of breast volume measured by MRI ( R2=0.54). Conclusions:Preoperative MRI can provide guidance to breast reconstruction with silicone gel prothesis following nipple-sparing mastectomy in breast cancer. The gland volume measured by MRI is closer to the specimen weight and the volume of prosthesis than the breast volume measured by MRI.

Objective To investigate the resilience characteristics of the elderly disabled,and the effects of individual,family and social factors on resilience.Methods A total of 138 disabled older adults from four districts of Chengdu City were investigated by 10 items Connor-Davidson resilience scale (CDRISC-10),the automatic thoughts questionnaire (ATQ),self esteem scale (SES),revised eysenck personnality questionnaire short scale for chinese(EPQ-RSC) and self-made population sociology questionnaire.Totally 194 community-dwelling older adults without disabilities,as a comparative population,were included in the analysis.Results Compared with the community-dwelling elderly without disability (35.58 ± 5.75,18.13±3.48,18.43±3.08),the scores of resilience(21.38±7.71),strength(10.50±4.08) and hardiness (10.88±4.07) of the elderly disabled were significantly lower(t=-19.56,-17.81,-18.34,P＜0.01).There were no significant differences in the resilience scores of the elderly disabled in terms of gender,urban and rural sources,marital status,education,disability level and family atmosphere.However,there were significant differences in age,disability causes,disability type and family economic conditions (age:thardiess =2.18,P＜0.05.disability causes:tresilience =-2.75,tstrength =-2.22,thardiness =-2.68,P＜0.05.disability type:Fhardiness =2.60,P＜ 0.05.family economic conditions:Fresilience =5.45,Fstrength =4.78,Fhardiness =5.21,P＜0.01).The resilience,automatic thoughts,self-esteem and personality were significant correlation with each other(r=-0.16-0.65,P＜0.05).After controlling age,disability causes,disability type and family economic conditions,self esteem(β=0.291,P＜0.01),extraversion (β=0.287,P＜0.01) and neuroticism (β=-0.254,P＜0.05) were important influential factors of resilience,explained 32.0％ variance in resilience.Conclusion It may be an important way to improve resilience level of the elderly disabled by enhancing their selfesteem,promoting their psychological adjustment and strengthening their emotional management.