Objective To observe whether Nogo-66 can inhibit the neurite outgrowth during the neuronal differentiation of the neural stem cells (NSCs) and remove such an inhibitory effect by the small interfering RNA (siRNA) mediated knockdown of the Nogo66 receptor (NgR). Methods NSCs derived from the rat spinal cord were collected, and were cultured by the suspension culture in vitro. NSCs were transfected by siRNA to knock downtheexpression of NgR. Immunofluorescence and Western blot were used to assess the knockdown efficiency. NSCs were divided into four groups and differentiated in the medium containing 10% FBS. In the control group, no intervention was applied to NSCs; in the Nogo-P4 group, NSCs were differentiated in the presence of Nogo-P4 (active segment of Nogo-66); in the siRNA group, NSCs were transfected by siRNA to knock down NgR before they were differentiated; in the siRNA and Nogo-P4 group, NSCs were transfected by siRNA to knock down NgR before they were differentiated in presence of Nogo-P4. The differentiated neurons were labeled by immunofluorescence, and the neurite length was measured by the ImagePro Plus 5.0 software. The differentiation of the neurite length was compared in each group. Results The suspension-cultured cells became the nerve bulb, which could positively expresses Nestin by immunofluorescence. At 1 week of the differentiation in the medium containing 10% FBS, the positively-labeled neuron specific enolase, the glial fibrillary acidic protein, and the myelin basic protein were observed. Both immunofluorescence and Western blot approved that the expression of NgR was knocked down by transfection of siRNA at 24 hours after the transfection. The knockdown efficiency was 90.35%±3.10%. The neurite length was 97.80±6.97 μm, 80.54±6.75 μm,92.14±7.27 μm, and 94.01±8.37 μm in the control group, the Nogo-P4 group, the siRNA group, and the siRNA and Nogo-P4 group, respectively. The Nogo-P4 group had a significant difference when compared with the otherthree groups (Plt;0.01), and the other three groups had no significant difference when compared with each other（Pgt;0.05）. ConclusionNogo-66 can inhibit the neuronal neurite outgrowth during the differentiation ofNSCs. Such an inhibitory effect can be removed by the siRNA mediated knockdown of NgR.
Objective To assess the effectiveness of xuezhikang for treating diabetic kidney disease. Methods We searched the Cochrane Central Register of Controlled Trials (Issue 3, 2008), MEDLINE (1980 to September 2008), EMbase (1980 to September 2008), CBMdisc (1990 to September 2008), and CNKI (1994 to September 2008). We also hand searched relevant journals and conference proceedings. Randomized controlled trials (RCTs) in which xuezhikang was used to treat diabetic kidney disease were collected. Then we screened the retrieved studies according to predefined inclusion and exclusion criteria, evaluated the quality of included studies, and performed metaanalyses by using The Cochrane Collaboration’s RevMan 4.2 software. Results Nine RCTs were included. Meta-analyses showed that xuezhikang was superior to routine treatment in decreasing 24-hour urinary protein (WMD –0.87, 95%CI –1.34 to –0.41), microalbuminuria (WMD –115.39, 95%CI –127.63 to –103.15), and urinary albumin excretion rate (WMD – 65.46, 95%CI –68.87 to –62.12); but xuezhikang had similar effects in reducing serum creatinine compared with routine treatment (WMD –5.42, 95%CI –11.06 to 0.21). Moreover, xuezhikang was more effective in regulating blood lipids, including TC (WMD –1.71, 95%CI –2.39 to –1.03), TG (WMD –0.96, 95%CI –1.46 to –0.46), LDL-C (WMD –1.01, 95%CI –1.64 to –0.38), and HDL-C (WMD 0.22, 95%CI 0.09 to 0.36). Xuezhikang was not superior to routine treatment in improving fasting blood sugar (WMD -0.01, 95%CI -0.49 to 0.47), but was more effective in improving 2 h-BS (WMD –1.10, 95%CI –1.35 to –0.85) and HbA1c (WMD –0.41, 95%CI –0.56 to –0.27). No significant adverse effects or allergic reactions were reported. Conclusions The evidence currently available shows that xuezhikang may decrease 24-hour urinary protein, microalbuminuria, serum creatinine, regulate blood lipids, and adjust blood glucose. Due to a high risk of selection bias and detection bias in the included studies, the evidence is insufficient to determine the effect of xuezhikang. Further large-scale trials are required to define the role of xuezhikang in the treatment of diabetic kidney disease.
【摘要】 目的 觀察依托咪酯乳劑復合舒芬太尼用于全麻下喉罩置入的血流動力學變化。 方法 選擇2009年4月-2010年2月間，46例需全麻手術、適合使用喉罩，美國麻醉醫師協會（ASA）Ⅰ～Ⅱ級，年齡18～60歲的患者，隨機分為兩組:依托咪酯乳劑組（E組）23 例，靜脈推注咪達唑侖0.05 mg/kg，依托咪酯乳劑0.3 mg/kg；依托咪酯乳劑+舒芬太尼組（ES組）23 例，靜脈推注咪達唑侖0.05 mg/kg，依托咪酯乳劑0.15 mg/kg，加舒芬太尼0.5 mg/kg，誘導后置入喉罩，記錄患者誘導前、用藥后1 min、喉罩置入后1 min的心率（HR）、平均動脈壓（MAP）以及評估喉罩置入條件的6項指標（張口困難分級、置入喉罩困難分級、舌咽反射、干咳干嘔反射、肢動反應及喉痙攣分級），同時記錄呼吸暫停時間。 結果 ES組能提供更好的喉罩置入條件，且能減少舌咽反射和肢體反應， 更能保證喉罩置入時血流動力學的穩定。 結論 依托咪酯乳劑復合舒芬太尼能為全麻喉罩置入時提供更好的條件，且能保證更好的血流動力學穩定。【Abstract】 Objective To investigate the hemodynamics changes when etomidate combined with sufentanil was applied for laryngeal mask airway insertion under the general anaesthesia. Methods From April 2009 to February 2010, 46 patients requiring general anesthesia using laryngeal mask airway (LMA) (American Society of Anesthesiologists (ASA)Ⅰ-Ⅱ) aged 18-60 were randomly divided into two groups: 23 in etomidate emulsion group (group E) underwent the intravenous injection with midazolm (0.3 mg/kg) and etomidate (0.05 mg/kg); 23 in etomidate emulsion + sufentanil group (group ES) underwent the intravenous injection with etomidate (0.15 mg/kg), midazolm (0.05 mg/kg), and sufentanil 0.5 mg/kg. The patients were evaluated by six indexes of LMA insertion (mouth opening, swallowing reflex, cough reflex,vomiting reflex, body motion, and laryngospasm classification). After the anesthesia induction, LMA was inserted. The blood pressure (BP), heart rate (HR), and mean arterial pressure (MAP) were recorded before anesthesia induction one minute after the injection and one minute after LMA insertion. Meanwhile, the apnea time was recorded. Results Compared with group E, group ES offered better anesthesia for LMA insertion, less swallowing reflex and body motion, and more stable haemodynamics. Conclusion Etomidate combined with sufentanil provides good condition for LMA insertion under the general anaesthesia with steady haemodynamics.
Objective
To summarize the role of cellular senescence and senescent secretary phenotype in the intervertebral disc (IVD) degeneration.
Methods
Relevant articles that discussed the roles of cellular senescence in the IVD degeneration were extensively reviewed, and retrospective and comprehensive analysis was performed. The senescent phenomenon during IVD degeneration, senescent secretary phenotype of the disc cells, senescent pathways within the IVD microenvironment, as well as the anti-senescent approaches for IVD regeneration were systematically reviewed.
Results
During aging and degeneration, IVD cells gradually and/or prematurely undergo senescence by activating p53-p21-retinoblastoma (RB) or p16INK4A-RB senescent pathways. The accumulation of senescent cells not only decreases the self-renewal ability of IVD, but also deteriorates the disc microenvironment by producing more inflammatory cytokines and matrix degrading enzymes. More specific senescent biomarkers are required to fully understand the phenotype change of senescent disc cells during IVD degeneration. Molecular analysis of the senescent disc cells and their intracellular signaling pathways are needed to get a safer and more efficient anti-senescence strategy for IVD regeneration.
Conclusion
Cellular senescence is an important mechanism by which IVD cells decrease viability and degenerate biological behaviors, which provide a new thinking to understand the pathogenesis of IVD degeneration.
Objective To evaluate the clinical effect of the eyelid reconstruction using hard palate mucosa graft after resection of malignant tumor of eyelid. Methods From January 1998 to October2003, 18 cases of malignant tumor of eyelid underwent the eyelid reconstruction with local flap grafting and hard palate mucosa autotransplantation. Of 18 cases, there were 10 males and 8 females, aging from 35 to 67 years. The defect was caused by basal cell carcinoma of eyelid in 10 cases, by carcinoma of meibomian glands in 6 cases and by squamous cell carcinoma of eyelid in 2 cases, including 12 cases of complete eyelid defect and 6 cases of 2/3 eyelid defect. Results The appearance and function of the eyelid in all cases were almost normal after the eyelid reconstruction with hard palate mucosa autotransplantation in replacing posterior layer of eyelid. The complete eyelid closure and no entropion were observed in all cases. The infection and contracture of the graft, immunologic rejection were not observed in allcases during the followup period of 6 to 48 months. Conclusion The eyelid reconstruction using autotransplantation with hard palate mucosa in replacing posterior layer of eyelid was easy-to-operate and has satisfactory clinical effect. The hard palate mucosa as substitute of tarsus is superior to the traditional substitute.
Objective To introduce the research of nucleus pulposus cells for treating intervertebral disc degeneration. Methods The original articles in recent years about nucleus pulposus cells for treating intervertebral disc degeneration were extensively reviewed, and retrospective and comprehensive analysis was performed. Results Nucleus pulposus cells are not only simply a remnant of embryonic notochordal cells, but have also an important influence on the well-being of the whole disc. The biological treatment strategies aim to regenerate the disc by either trying to improve the micro-enviroment within the disc or to increase the popoulation of the nucleus pulposus, which includes transplanting mesenchymal stem cellsto differentiate into nucleus-l ike cells in the degenerated intervertebral disc. Conclusion Nucleus pulposus cells or ucleus pulposus l ike cells based cell transplantation methods prove to be a promising and real istic approach for the intervertebral disc regeneration.
Objective
To summarize the effectiveness of F-shaped screw fixation technique in treatment of Pauwels type Ⅲ femoral neck fractures.
Methods
Between January 2013 and December 2016, 43 patients with Pauwels type Ⅲ femoral neck fractures were treated with F-shaped screw fixation technique. There were 32 males and 11 females with an average age of 38.9 years (range, 20-55 years). The fractures located on the left side in 21 patients and on the right side in 22 patients. The cause of injury included traffic accident in 19 patients and falling from height in 24 patients. There were 25 patients of Garden type Ⅲ and 18 of Garden type Ⅳ. The time from injury to operation was 2-3 days (mean, 2.2 days). These data were recorded, including operative time, fluoroscopy time, postoperative hospital stay, quality of reduction, postoperative complications (nonunion, varus deformity, femoral neck shortening, avascular necrosis of femoral head, screws back-out), and Harris scores.
Results
The operative time was 28-45 minutes (mean, 37.5 minutes). The fluoroscopy time was 13-20 seconds (mean, 14.7 seconds). The postoperative hospital stay was 2-3 days (mean, 2.7 days). All incisions healed by first intention. All patients were followed up 18–58 months with an average of 38.7 months. All patients have anatomical reduction of fractures. Fracture healing occurred in 42 patients; the union time was 3-5 months with an average of 3.6 months. Nonunion occurred in 1 patient who was treated with total hip arthroplasty. Of the 42 patients with fracture healing, 11 cases had a femoral neck shortening, 9 cases had varus deformity, 3 cases had avascular necrosis of femoral head, and 8 cases had screws back-out. There was no significant difference in complication incidences between Garden type Ⅲ fractures and Garden type Ⅳ fractures (P>0.05).
Conclusion
Treatment of femoral neck fractures by using the F-shaped screw fixation technique, can achieve satisfactory effectiveness with less postoperative complication.
Objective To evaluate the clinical efficiency of fresh amniotic membrane transplantation in treatment of stenosis of conjunctival sac. MethodsThirty cases (30 eyes) of stenosis of conjunctival sac were treated with fresh amniotic membrane transplantation. Amniotic membrane was obtained under sterile conditions after elective cesarean delivery. The woman’s serum was negative for HBsAg, syphilis, and human immunodeficiency virus. The placenta was first washedfree of blood clots with sterile saline. Under sterile conditions, the inner amniotic membrane was separated from the chorion by blunt dissection, and was cleaned of blood with the sterile saline again. The membrane was then flattened onto a surgidrape adhesive paper with the epithelium surface up. The paper with the adherent amniotic membrane was then cut into 5 cm×8 cm pieces, and then rinsed in solution containing 4×106 U/L of gentamycin and stored at 4℃. It could bestored for 12 hours after preparation. The-adhesiotomy was performed firstly. The separation between the conjunctiva and scar tissue should be complete and wide enough to reach to the orbital margin. The adhesiectomy was taken secondly. The scar tissues were removed completely. The fresh amniotic membrane was flattened onto the conjunctival defect with epithelium side up. The fresh amniotic membranewas 10 mm more than the conjunctival defect by trimming off the excess portion.This fashioned membrane was then secured to surrounding conjunctival edge with continuous 7-0 nylon sutures. The necessary mattress suture of inferior conjunctival fornix via skin next to the inferior orbital margin was performed simultaneously. The retrobular implantation of the an artificial globe made of hydroxyapatite was performed on some patients with sunken eye. Correction of traumatic ptosis was performed on a few patients.Results The operation ofreconstruction of partial conjunctival sac for 30 cases was successful. All amniotic membrane grafts were alive. The cosmetic result was complete favorable. The infection and contracture of the graft, immunologic rejection and amniotic lysis were not observedin all cases during the follow-up period of 13-18 months.Conclusion Fresh amniotic membrane transplantation can be used in reconstruction of the partial conjunctival sac effectively and can be popularized in thelocal hospital in China because the amniotic membrane can be obtained easily.
Objective To explore the effects of intraperitoneal chemotherapy with fluorouracil (FU) on the growth and metastasis of tumor cells in carbon dioxide (CO2) pneumoperitoneum. Methods Fifty male H-22 mice of clean grade were selected and randomly assigned into 5 groups in each group with 10: simple implantation group, pneumoperitoneum group, pneumoperitoneum and NS group, pneumoperitoneum and low concentration (5.0 g/L) of FU group and pneumoperitoneum and high concentration (10.0 g/L) of FU group. All mice were executed after 11 days to observe the weight and the implantation of tumor in abdominal wall. Then the expressions of proliferating cell nuclear antigen (PCNA) and vascular endothelial growth factor (VEGF) were detected by immunohistochemistry. Results The tumor weight was significantly higher in pneumoperitoneum and high concentration of FU group compared with other groups except pneumoperitoneum and low concentration of FU group (P＜0.05, P＜0.01 ). The inhibition rate of tumor was 64.5% in pneumoperitoneum and high concentration of FU group. The diameter of portsite implantation nodus was significantly bigger in pneumoperitoneum and NS group compared with pneumoperitoneum and low concentration of FU group and pneumoperitoneum and high concentration of FU group (P＜0.01). The expressions of PCNA and VEGF of ascites and portsite implantation nodus were significantly different in every group, respectively (P＜0.05, P＜0.01). Conclusion There is inhibitive effect of intraperitoneal chemotherapy with high concentration of FU on the growth and metastasis of S-180 tumor cells in CO2 pneumoperitoneum, which may be associated with downregulation of PCNA and VEGF expressions.
Objective To evaluate the effectiveness and safety of nedaplatin combined with chemotherapy versus cisplatin combined with chemotherapy for advanced non-small cell lung cancer (NSCLC). Methods The randomized controlled trials (RCTs) on nedaplatin combined with chemotherapy versus cisplatin combined with chemotherapy for advanced NSCLC were searched in The Cochrane Library, PubMed, EMbase, CBM, VIP and WanFang Data from the date of their establishment to January 2012. According to the inclusion and exclusion criteria, two reviewers independently screened the studies, extracted the data and assessed the quality. Then RevMan 5.0 software was used for meta-analysis. Results A total of 15 RCTs involving 1 076 patients were included. The results of meta-analysis showed that, compared with the cisplatin combined with chemotherapy, nedaplatin combined with chemotherapy could reduce the risks of nausea and vomiting (RR=0.56, 95%CI 0.48 to 0.65, Plt;0.000 01), decrease the risk of renal function impairment (RR=0.47, 95%CI 0.30 to 0.74, P=0.001), but increase the risk of thrombocytopenia (RR=1.59, 95%CI 1.20 to 2.11, P=0.001). There were no significant differences between the two groups in objective response rate (ORR) (RR=1.09, 95%CI 0.92 to 1.29, P=0.03), leukopenia (RR=1.05, 95%CI 0.92 to 1.19, P=0.50), and hemoglobin reduction (RR=0.92, 95%CI 0.80 to 1.07, P=0.30). Conclusion Compared with cisplatin combined with chemotherapy for advanced NSCLC patients, nedaplatin in combination with chemotherapy can significantly reduce the risks of nausea, vomiting and renal function impairment. Although the ORRs are similar in the two groups, nedaplatin combined with chemotherapy can cause a higher risk of thrombocytopenia. For the quality restriction and possible publication bias of the included studies, more high quality RCTs are required to further verify this conclusion.
