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Lung cancer (LC) is a malignant tumor with the highest incidence in the world, and its specific pathogenesis is still unclear. Circular RNAs (circRNAs) are a group of non-coding RNAs that play a key role in the development and progression of various cancers. The expression pattern and function of circRNAs in LC are still not completely distinct. In this study, it was aimed to study the expression and potential mechanism of circ-UBR1 in LC cells. Then it was found that circ-UBR1 was up-regulated in LC cells, and had microRNA (miR)-545-5p binding sites. Meanwhile, it was confirmed by dual-luciferase reporter assay that circ-UBR1 directly bound to miR-545-5p and then repressed its expression. MiR-545-5p was down-regulated in LC cells and refrained its expression by binding to the downstream target gene SSFA2. Knockdown circ-UBR1 or enhancive miR-545-5p repressed A549 cell proliferation, migration, and invasion, but accelerated apoptosis. After transfection with circ-UBR1 low expression vector, upregulation of SSFA2 apparently reversed the depression of reduced circ-UBR1 on cell proliferation, migration, and invasion, and the promotion of cell apoptosis. Further tumor xenograft experiments in nude mice also confirmed that knockdown of circ-UBR1 could increase the expression of miR-545-5p, but decrease the expression of SSFA2, thus alleviating the progression of LC in vivo. Therefore, these results fully indicate that circ-UBR1 promotes LC cell proliferation, migration, and invasion, but represses apoptosis via the circ-UBR1 axis, which may be a closely related marker and therapeutic target of LC.

The review is to explore the connection between gestational hypertension diseases (GHD) and small for gestational age (SGA) in twin pregnancies.According to the recommendations of PRISMA, relevant studies were systematically searched through PubMed, Web of Science, Cochrane Library, Embase from inception until January 16, 2022. Subgroup analysis was performed according to chorionicity and diagnostic criteria of SGA. Odds ratios (OR) were assessed to judge the link between GHD and SGA in twin pregnant women. A random-effect model was used to estimate the pooled hazard ratio when there was significant heterogeneity (ISeven articles containing 470 589 twin pregnant women were included. The increased risk of SGA was connected to the twin pregnancies complicated with GHD (OR = 1.57, 95% confidence interval [CI] = 1.10-2.24, p = 0.01). After subgroup analysis, the connection between SGA and GHD had no statistical significance (OR = 1.17, 95% CI = 0.95-1.44, p = 0.14) when the enrolled studies using the SGA diagnosis referred to singleton birth weight, but significant (OR = 2.14, 95% CI = 1.77-2.60, p0.001) in the group using the SGA diagnosis referred to twin birth weight. Stratified by chorionicity, SGA was relevant to GHD in the dichorionic (DC) group (OR = 1.68, 95% CI = 1.17-2.42, p = 0.005), while not in the monochorionic (MC) group (OR = 1.68, 95% CI = 0.93-3.03, p = 0.09). More future articles are warranted to confirm these outcomes.Our review demonstrated that GHD in DC twin pregnancies was related to an enlarged risk of SGA. Two SGA diagnosis references led to different results. Twin pregnancies complicated with GHD were at significantly higher risk of SGA when twin birth weight reference was used.

Background/Aim. Non-small-cell lung cancer (NSCLC) is the principal agent of cancer deaths globally. The goal of this study was to determine how circular RNA_0000518 (circ_0000518) regulates tumor progression. Materials/Methods. circ_0000518 was selected as a study target involved in NSCLC from GEO (Gene Expression Omnibus) database. circ_0000518 level was gauged by qRT-PCR. It was confirmed as circRNA by actinomycin D inhibition and RNase R assay. Subcellular localization of circ_0000518 was identified by FISH. Cell function was determined by CCK-8, Transwell, and western blot. Glutamine metabolic factors were detected by ELISA. The target regulation relationship between genes was clarified by dual-luciferase reporter assay. In vivo models were established to evaluate the impact of circ_0000518 on tumor growth. Immunohistochemical staining for Ki67, vimentin, and E-cadherin was used to detect cell proliferation and metastasis, respectively. Results. circ_0000518 expression was enhanced in NSCLC. si-circ_0000518 inhibited cell proliferation, invasion, and glutamine metabolism. circ_0000518 functioned as a molecular sponge for miR-330-3p, and inhibition of miR-330-3p in cells markedly reversed circ_0000518 interference-mediated antitumor effects. miR-330-3p interacted with 3 ′ -UTR of SLC1A5. miR-330-3p inhibitor-mediated protumor effect was remarkably reversed in cells after the knockdown of SLC1A5. circ_0000518 knockdown reduced glutamine, glutamate, and α-KG by targeting miR-330-3p. Intertumoral injection of circ_0000518 shRNA adeno-associated virus effectively halted xenograft tumor growth. Conclusion. The current study revealed that circ_0000518 may have a prooncogenic function in the formation and progression of NSCLC, which might be achieved through moderating the miR-330-3p/SLC1A5 axis.

The diagnosed COVID-19 cases revealed that the incubation periods (IP) varied a lot among patients. However, few studies had emphasized on the different clinical features and prognosis of patients with different IP. A total of 330 patients with laboratory-confirmed COVID-19 were enrolled and classified into immediate onset group(IP10 days, L group, 75 cases) based on IP. The difference of clinical characteristics and prognosis of the two groups were compared. There were more patients with fever in I group than in L group(P = 0.003), and counts of all the total lymphocytes, total T lymphocytes, CD4 + and CD8 + T lymphocytes were significantly different between the two groups(all P

Background: Cervical anastomotic leakage (CAL) is one of the most common complications that occur minimally invasive esophagectomy (MIE). It is associated with high postoperative mortality. Some risk factors still remained controversial and so accurate prediction of risk groups for CAL remained very difficult. This study aimed to identify the risk factors of CAL after McKeown MIE to predict the accuracy of the technique as early as possible. Material and Methods: A total of 129 patients with esophageal cancer who underwent McKeown MIE at the Department of Thoracic Surgery, the Fourth Hospital of Hebei Medical University, between January 2018 and June 2019 were retrospectively reviewed. Multivariate logistic regression analysis was used to identify the risk factors for CAL and receiver operating characteristic (ROC) curve analysis was used to predict the accuracy for each quantitative data variable and determine the cutoff value. Results: There were statistically significant differences between Group CAL and Group NCAL in FEV1 (p = 0.031), neoadjuvant chemotherapy (p = 0.001), intraoperative minimum PaCO2 (p = 0.002), and hospital stays (p 45.5 mmHg (p = 0.002) demonstrated good accuracy. Conclusion: FEV1, neoadjuvant chemotherapy, and intraoperative minimum PaCO2 in arterial blood gas (ABG) were considered as risk factors of CAL after McKeown MIE for esophageal cancer. Preoperative FEV1 45.5 mmHg in ABG showed good accuracy in predicting risk factors for CAL.

Background To investigate the value of contrast-enhanced CT (CECT)-derived imaging features in predicting lymphovascular invasion (LVI) status in esophageal squamous cell carcinoma (ESCC) patients. Methods One hundred and ninety-seven patients with postoperative pathologically confirmed esophageal squamous cell carcinoma treated in our hospital between January 2017 and January 2019 were enrolled in our study, including fifty-nine patients with LVI and one hundred and thirty-eight patients without LVI. The CECT-derived imaging features of all patients were analyzed. The CECT-derived imaging features were divided into quantitative features and qualitative features. The quantitative features consisted of the CT attenuation value of the tumor (CTVTumor), the CT attenuation value of the normal esophageal wall (CTVNormal), the CT attenuation value ratio of the tumor-to-normal esophageal wall (TNR), the CT attenuation value difference between the tumor and normal esophageal wall (ΔTN), the maximum thickness of the tumor measured by CECT (Thickness), the maximum length of the tumor measured by CECT (Length), and the gross tumor volume measured by CECT (GTV). The qualitative features consisted of an enhancement pattern, tumor margin, enlarged blood supply or drainage vessels to the tumor (EVFDT), and tumor necrosis. For the clinicopathological characteristics and CECT-derived imaging feature analysis, the chi-squared test was used for categorical variables, the Mann–Whitney U test was used for continuous variables with a nonnormal distribution, and the independent sample t-test was used for the continuous variables with a normal distribution. The trend test was used for ordinal variables. The association between LVI status and CECT-derived imaging features was analyzed by univariable logistic analysis, followed by multivariable logistic regression and receiver operating characteristic (ROC) curve analysis. Results The CTVTumor, TNR, ΔTN, Thickness, Length, and GTV in the group with LVI were higher than those in the group without LVI (P P Tumor, TNR, ΔTN and enhancement pattern, Thickness, Length, GTV, tumor margin, EVFDT, and tumor necrosis were associated with LVI status (P Conclusion The CECT-derived imaging features, including TNR, Thickness, tumor margin, and their combination, can be used as predictors of LVI status for patients with ESCC.

MicroRNAs (miRNAs) have been revealed to play a crucial role in oncogenesis of esophageal squamous cell carcinoma (ESCC). However, the biological role of miR-181a-5p in ESCC is currently less explored. The current study was designed to assess whether miR-181a-5p affects ESCC progression and further investigate relevant underlying mechanisms. Based on the data of GSE161533, GSE17351, GSE75241 and GSE67269 downloaded from GEO database, MAP2K1 (MEK1) was revealed to be one overlapping gene of the top 300 DGEs. Additionally, using the predicting software, miR-181a-5p was projected as the presumed target miRNA. Immunohistochemical staining and RT-qPCR research revealed that miR-181a-5p expression was decreased in human tumor tissues relative to surrounding peri-cancerous tissues. In an

The sensitivity and specificity of endoscopic ultrasound (EUS) for esophageal cancer are variable. The aim of the present study was to determine the accuracy of EUS for the T staging of esophageal cancer and to explore the factors that affect the accuracy.This was a retrospective study of patients with esophageal cancer who underwent EUS between January 2018 and September 2019 at the author's hospital. All patients underwent EUS, surgery, and pathological examination. The diagnostic value of ultrasound-based T (uT) staging was evaluated using the pathological T (pT) staging as the gold standard.Finally, 169 patients were included. Among the 169 patients, 37 were overstaged by EUS, 33 were understaged, and 99 were correctly staged. The overall accuracy of EUS was 58.6%. Sensitivity was low, at 0% to 70.8% depending upon the pT stage, but specificity was higher, at 71.0% to 100.0%, also depending upon the pT stage. The multivariable analysis revealed that highly differentiated tumors (odds ratio = 9.167, P = .041) and pT stage ≥T2 (odds ratio = 2.932, P = .004) were independent factors of accurate uT stage.The staging of esophageal cancer using EUS has low sensitivity but high specificity. Highly differentiated tumors and pT stage ≥2 tumors were associated with the accuracy of uT staging.

Video assisted thoracic surgery (VATS) is the main surgical method for lung cancer. The aim of this study was to analyze the reasons for conversion to thoracotomy in 83 cases among 1,350 consecutive cases who underwent video-assisted thoracic surgery (VATS) lobectomy by a single surgical team, in order to achieve a deeper understanding of the rules and the opportunity for conversion to thoracotomy in VATS lobectomy under normal conditions.The clinical data of 1,350 patients who underwent VATS lobectomy between September 21, 2009 and June 1, 2020, by a single surgical team in the Fifth Department of Thoracic Surgery of the Fourth Hospital of Hebei Medical University were retrospectively analyzed. There were 773 males and 577 females, aged 8-87 years, with a median age of 61.3 years, including 83 cases of benign diseases, 38 cases of lung metastases, and 1,229 cases of primary lung cancer. The cases with stage I, II and IIIa were 676, 323 and 230, respectively. The cases of left upper, left lower, right upper, right middle, right lower, right middle and upper and right middle and lower lobectomy were 301 (22.30%), 231 (17.11%), 378 (28.00%), 119 (8.81%), 262 (19.41%), 16 (1.19%) and 43 (3.19%), respectively.In the cohort of 1,350 consecutive patients with VATS lobectomy, 83 patients (6.15%) were converted to thoracotomy for different reasons. The conversion rate of benign lesions was significantly higher than that of malignant tumors (P0.05). The conversion rate in stage IIIa was significantly higher than that in stage I and II (P0.05). The conversion rate of combined lobectomy was significantly higher than that of single lobectomy (P=0.001). The conversion rate of left upper lobectomy was significantly higher than that of other single lobectomy (P0.001). The conversion rate of right middle lobectomy was significantly lower than that of other single lobectomy (P=0.049). The main reasons for conversion were vascular injury (38.55%), lymph node interference (26.51%) and dense adhesion in thoracic cavity (16.87%). In the conversion group, the total operation time was (236.99±66.50) min and the total blood loss was (395.85±306.38) mL. The operation time in patients converted to thoracotomy due to lymph node interference was (322.50±22.68) min, which was significantly longer than that in the other groups (P0.05). The intraoperative blood loss in patients converted to thoracotomy due to vascular injury was (560.94±361.84) mL, which was significantly higher than that in the other groups (P0.05). With the increase in surgical experience, the number of vascular injuries gradually decreased at the early stage, mid-stage and late stage (P=0.045).In VATS lobectomy, benign lung lesions and more advanced malignant tumors led to more surgical difficulties and higher conversion rate. The conversion rate was different in different lobectomy sites, with the highest in left upper lobectomy, and the lowest in right middle lobectomy. Vascular injury, lymph node interference and dense adhesion were the main reasons for conversion to thoracotomy, which led to prolonged operation time and increased blood loss. With the increasing number of surgical cases, the rate of conversion to thoracotomy in VATS lobectomy continues to decline, which may be mainly due to the more advanced treatment of pulmonary vessels.【中文题目：胸腔镜肺叶切除术中转开胸83例原因分析：单手术组连续1,350例手术总结】 【中文摘要：背景与目的 电视胸腔镜手术（video-assisted thoracic surgery, VATS）为肺癌治疗的主流术式，本研究旨在分析单手术组连续VATS肺叶切除术1,350例中转开胸83例的中转原因，以期对常态下胸腔镜肺叶切除术中转开胸的规律有更深层次的认识，并更好地把握中转开胸的手术时机。方法 回顾性分析2009年9月21日-2020年6月1日河北医科大学第四医院胸外科单手术组连续行胸腔镜肺叶切除术的1,350例患者资料。其中男性773例，女性577例，年龄8岁-87岁，中位年龄61.3岁。全组良性疾病83例，肺转移瘤38例，原发性肺癌1,229例，其中I期: 676例，II期: 323例，IIIa期: 230例。全组行左肺上叶切除术301例（22.30%），左肺下叶切除术231例（17.11%），右肺上叶切除术378例（28.00%），右肺中叶切除术119例（8.81%），右肺下叶切除术262例（19.41%），右肺中上叶切除术16例（1.19%），右肺中下叶切除术43例（3.19%）。结果 单手术组连续1,350例胸腔镜肺叶切除术患者中有83例（6.15%）因不同原因中转开胸。良性病变的中转开胸率高于恶性肿瘤（P0.05）；病理分期为IIIa期的中转开胸率明显高于I期、II期患者（P0.05）。联合肺叶切除术的中转开胸率明显高于单肺叶切除术（P=0.001）；左肺上叶切除术的中转开胸率显著高于其他单肺叶切除术（P0.001）；右肺中叶切除术的中转开胸率低于其他单肺叶切除术（P=0.049）。中转开胸主要原因为血管损伤（38.55%）、淋巴结干扰（26.51%）、胸腔致密粘连（16.87%）；中转开胸组总体手术时间为（236.99±66.50）min，总体失血量（395.85±306.38）mL。其中淋巴结干扰组患者手术时间（322.50±22.68）min，长于其他原因中转开胸组（P0.05）；血管损伤组术中出血量（560.94±361.84）mL，多于其他原因中转开胸组（P0.05）；随着时间的推移以及经验的积累，在手术前、中、后期血管损伤例数逐步下降（P0.05）。结论 在胸腔镜手术中，肺部良性病变和较晚期恶性肿瘤有较高的手术难度和中转率。不同肺叶切除术中转开胸率不同，左肺上叶切除术中转率较高，而右肺中叶切除术中转率较低。血管损伤、淋巴结干扰、胸腔致密粘连仍是常态下胸腔镜肺叶切除术中转开胸的主要原因。中转开胸会导致手术时间延长和手术出血量增加。随着手术例数的增加，胸腔镜肺叶切除术中转开胸率有持续下降趋势，其主要原因是肺血管的处理更加成熟。 】 【中文关键词：中转开胸；电视胸腔镜手术；肺叶切除术；出血】.

Esophageal squamous cell carcinoma (ESCC) is the predominant form with the highest incidence. We aimed to find metastasis-related differentially expressed long noncoding RNAs (lncRNAs), microRNAs (miRNAs), and messenger RNA (mRNAs) in ESCC. We first obtained the lncRNAs, miRNAs, and mRNAs profiles. The differentially expressed lncRNAs, miRNAs, and mRNAs were obtained, followed by the functional annotation. Then the interaction networks of miRNA-mRNA, lncRNA-mRNA coexpression, lncRNA-miRNA, and lncRNA-miRNA-mRNA were constructed. In addition, systematic expression pattern analysis of differentially expressed lncRNAs, miRNA, and mRNA in the normal, metastasis, and nonmetastasis was performed. Survivability of differentially expressed lncRNAs, miRNAs, and mRNA was analyzed. A total of 613 differentially expressed lncRNAs, 35 differentially expressed miRNAs, and 1586 differentially expressed mRNAs were obtained. Several interactions of H19-hsa-mir-222-chromobox 2 (CBX2), H19-hsa-mir-330-phosphoinositide-3-kinase regulatory subunit 4 (PIK3R4), KCNQ1 opposite strand/antisense transcript 1 (KCNQ1OT1)/CTB-89H12.4-hsa-mir-374a-vascular endothelial growth factor A (VEGFA), MALAT1/X inactive specific transcript (XIST)/XIST antisense RNA (TSIX)-hsa-mir-340-tumor necrosis factor receptor superfamily member 10A (NFRSF10A) were identified to play key roles in the metastasis of ESCC. In addition, KCNQ1OT1, TSIX, and XIST were significantly associated with the survival time of patients. In conclusion, our study may be helpful in understanding the pathological mechanism and providing new diagnostic and therapeutic biomarkers for ESCC.

This paper improves the accuracy of a mine robot’s positioning and mapping for rapid rescue. Specifically, we improved the FastSLAM algorithm inspired by the lion swarm optimization method. Through the division of labor between different individuals in the lion swarm optimization algorithm, the optimized particle set distribution after importance sampling in the FastSLAM algorithm is realized. The particles are distributed in a high likelihood area, thereby solving the problem of particle weight degradation. Meanwhile, the diversity of particles is increased since the foraging methods between individuals in the lion swarm algorithm are different so that improving the accuracy of the robot’s positioning and mapping. The experimental results confirmed the improvement of the algorithm and the accuracy of the robot.

This study aims to assess the early effects of operatively and nonoperatively managed vertebral compression fractures (VCFs) in elderly polytrauma patients. A multi-center retrospective cohort study of operative treatment [vertebroplasty (VP) or kyphoplasty (KP)] versus nonoperative treatment (bed rest). A total of 40 patients received operative treatment and 59 patients received nonoperative treatment. The mean length of hospital stay was 15.53 ± 6.994 days in the operative and 19.54 ± 12.012 days in the nonoperative group (P = 0.039). The incidence of complication was higher in the nonoperative group than the operative group (P = 0.009), especially the incidence of bed rest complication (P = 0.024). Mortality rate was not significant difference between two groups (P = 0.172). For VCFs in elderly polytrauma patients, VP or KP can reduce length of hospital stay and complications, especially bed rest complication compared with nonoperative treatment.

The aim of this study was to compare the efficacy between SBRT and surgery based on the Propensity-Matched Analysis.Publications on comparison SBRT and Surgery for early stage non- small cell lung cancer (NSCLC) from 2011 to 2017 were collected. Propensity score matching was used to achieve comparable treatment hazard ratios of the overall survival (OS), local control survival (LC), regional control survival (RC), loco-regional control survival (LRC), distant control survival (DC), disease-free survival (DFS), and progression-free survival (PFS) between SBRT and Surgery. The major outcomes measures were hazard ratios (HRs). Meta-analysis Revman 5.3 software was used to analyze the combined Pooled HRs using fixed- or random-effects models according to the heterogeneity.Eleven studies met our inclusion criteria. The LC, L-R C, DC, DFS and PFS rates of patients with early-stage lung cancer who were treated with SBRT are equal to surgical results. While, patients with surgery achieved superior OS compared with SBRT.In this study we carried out a meta-analysis, which controls the acceptable level of the efficacy in the propensity score to match patients. The surgery had obvious OS advantages in this meta-analysis. However, these conclusions would be proven by further studies incorporating comorbidity data, and outcomes from randomized control study. The final decision for the optimal treatment of a patient with early-stage NSCLC can be substantiated by a personalized treatment model.

Combination of tissue-engineered bone scaffolds with cell-adhesive, osteoconductive, or osteoinductive biomolecules is a critical strategy to improve their properties that significantly influence cellular behaviors, such as adhesion, proliferation, and differentiation, which is beneficial for critical-sized bone defects repairing. However, the traditional surface modification techniques, such as physical adsorption, coating, and plasma treatment, et al, have great limitations for immobilization of bioactive molecules due to undesirable controlled delivery performance or overly complex multistep procedures. In this study, we functionalized the chitosan/hydroxyapatite (CS/HA) biomimetic composite scaffold for controlled delivery of BMP2-derived peptide (P24) by the chemical grafting modification technique: firstly, P24 was conjugated with a thiolated chitosan, chitosan-4-thiobutylamidine (CS-TBA); secondly, the resultant CS-P24 was then combined with HA to prepare CS-P24/HA scaffolds. The effect of CS-P24/HA scaffolds on bone regeneration was evaluated, along with the underlying biological mechanisms responsible in vitro and in vivo. In vitro, the controlled and sustained release of bioactive P24 could last up to 90 days, furthermore, the release profiles of CS-5%P24/HA and CS-10%P24/HA were linear and could be fitted according to zero-order kinetic model (R2=0.9929; R2=0.9757); P24 on the scaffold significantly promoted cell adhesion, proliferation, osteodifferentiation, and mineralization with synergistic effects. Bone marrow stromal cells (BMSCs) revealed spindle-shaped surface morphology, indicating the CS-P24/HA scaffolds supported cell adhesion and possessed a high proliferation rate that varied according to the P24 concentration levels. Furthermore, mRNA levels for OCN, Runx2, and collagen I were significantly up-regulated on CS-P24/HA scaffolds compared with cells grown on CS/HA scaffolds in vitro (p < 0.05). Similarly, the BMSCs exhibited a higher ALP expression and calcium deposition level on CS-P24/HA scaffolds compared with CS/HA scaffolds (p < 0.05). In vivo, osteoinductive studies revealed a significantly higher ectopic osteogenesis level of CS-10%P24/HA scaffolds in rat dorsal muscle pockets compared with that of CS/HA scaffolds. Finally, CS-P24/HA scaffolds showed superior performance in the reconstruction of rat calvarial bone defects. This novel CS-P24/HA scaffold is deemed a strong potential candidate for the repair of bone defects in human bone tissue engineering.

Both of the osteogenic factor and the suitable delivery system in bone tissue engineering are essential for bone regeneration. In this study, we manufactured two kinds of composite vehicles for sustained release of rhBMP-2 and its derived synthetic oligopeptide (Peptide-24, abbreviated as P24) for osteogenesis and bone defect repair. The composite vehicle was based on cross-linked chitosan, nano-hydroxyapatite/collagen (nHAC), and poly (lactide-co-glycolide) acid microsphere. The physicochemical properties of the composite vehicles (abbreviated as CS/nHAC/PLGA-MS) were investigated. The rhBMP-2 and P24 release kinetics from the vehicles were examined and the secondary structure of rhBMP-2 and P24 after 28 days' release process was analyzed. In vitro cell proliferation, osteogenic differentiation and rat calvarial defect repair were evaluated. The results proved that the composite vehicle had favorable compressive strength, elastic modulus, the porosity, and the bulk density. The secondary structures of rhBMP-2 and P24 kept stability during microencapsulation and release process. P24 from the vehicle kept a geared-up release and rhBMP-2 from the vehicle kept a three-stage mode release process. The results of in vitro cell detection showed that the composite vehicle had good biocompatibility and osteoinduction. In vivo rat calvarial defect repair demonstrated that both groups of vehicles with rhBMP2 and P24 exhibited satisfied bone defect repair. This research showed that the composite vehicle could exhibit sustained release of osteogenic factors. CS/nHAC/PLGA-MS loading rhBMP-2 or P24 could be a novel and ideal scaffold for bone regeneration. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 105A: 1593-1606, 2017.

Objective: The aim of this study was to evaluate the effect of anti-osteoporosis treatment on radiological and functional results following anterior cervical discectomy and fusion (ACDF). Methods: Medical records of 59 patients (Mean age 68.1 years, 36 males and 23 females) who had ACDF surgery between January 2010 and December 2013 were retrospectively reviewed. Antiosteoporotic treatment group consisted of 31 patients and non-antiosteoporotic treatment group consisted of 28 patients. The height of intervertebral space (HIS), cervical alignment (CA), segmental angle (SA), and Visual Analogue Scale (VAS) were compared between the groups, preoperatively, postoperatively, and at final follow-up. Results: There were significant differences at final follow-up between the 2 groups in SA (p=0.03), HIS (p=0.03), and VAS (p=0.03) for upper limb pain, in favor of antiosteoporotic treatment. Conclusion: Anti-osteoporotic treatment appear to improve the radiological and functional results following following anterior cervical discectomy and fusion.

With the development of minimally invasive techniques, injectable materials have become one of the major hotspots in the biomaterial field. We have developed an injectable bone regeneration composite (IBRC) using calcium alginate hydrogel as matrix to carry nano-hydroxyapatite/collagen particles. In this work, we evaluated the homogeneity of IBRC by dry/wet weight ratio test. The results showed that the structural homogeneity was determined by controlling the molar ratios of trisodium phosphate to calcium sulfate rather than alginate concentration in the studied ranges. Pore sizes of wet IBRC samples were characterized by thermoporometry. The pore properties of dried IBRC were tested by mercury porosimetry. Average pore size and porosity of dried IBRC declined with increasing alginate concentration. In contrast, surprisingly, pore size of wet homogeneous IBRC increased with increasing alginate concentration. Meanwhile, the swelling ratio did not increase with varying alginate concentration, but the swelling degree increased with increasing alginate concentration. In vitro cell culture showed that IBRC had no obvious cytotoxic effect on the rat bone mesenchymal stem cells. The morphology and viability of cells were also related to MR value. IBRC had good histocompatibility with a mild short-term inflammatory response in rat dorsum muscle. In addition, the excellent ability of IBRC to promote bone healing was confirmed by 5-mm-diameter cranial defects using histological analysis and bone mineral density measurement.

Inspired from the sophisticated bilayer structures of natural dermis, here, we reported collagen/chitosan based two-compartment and bi-functional dermal scaffolds. Two functions refer to mediating rapid angiogenesis based on recombinant human vascular endothelial growth factor (rhVEGF) and antibacterial from gentamicin, which were encapsulated in PLGA microspheres. The gentamicin and rhVEGF encapsulated PLGA microspheres were further combined with collagen/chitosan mixtures in low (lower layer) and high (upper layer) concentrations, and molded to generate the two-compartment and bi-functional scaffolds. Based on morphology and pore structure analyses, it was found that the scaffold has a distinct double layered porous and connective structure with PLGA microspheres encapsulated. Statistical analysis indicated that the pores in the upper layer and in the lower layer have great variations in diameter, indicative of a two-compartment structure. The release profiles of gentamicin and rhVEGF exceeded 28 and 49 days, respectively. In vitro culture of mouse fibroblasts showed that the scaffold can facilitate cell adhesion and proliferation. Moreover, the scaffold can obviously inhibit proliferation of Staphylococcus aureus and Serratia marcescens, exhibiting its unique antibacterial effect. The two-compartment and bi-functional dermal scaffolds can be a promising candidate for skin regeneration.

The objective of the present study was to enhance the regeneration ability of an injectable bone regeneration composite (IBRC) by the controlled release of recombinant human bone morphogenetic protein-2 (rhBMP-2). The IBRC comprised nano-hydroxyapatite/collagen (nHAC) particles in an alginate hydrogel carrier. First, bovine serum albumin (BSA) as a model protein was released from IBRC to evaluate its release rules. The results suggested that IBRC is a good controlled release carrier for BSA in the range 5-75 µg/ml. In the in vitro study the rhBMP-2 released from IBRC was determined by an enzyme-linked immunosorbent assay specific for rhBMP-2. The bioactivity of the released rhBMP-2 was evaluated through differentiated function of marrow mesenchymal stem cells (MSCs), as measured by alkaline phosphatase activity. The results of an in vitro study confirmed that rhBMP-2 released continuously for 21 days, and its bioactivity was well preserved during this period. The bone formation ability was assessed using a rat calvarial defect model of critical size. Micro-computed tomography (micro-CT) and histological analysis demonstrated that the IBRC had good bone formation ability, which was promoted through rhBMP-2 released from IBRC/rhBMP-2. In vitro and in vivo studies suggested that the present system is a potential bone critical defect repair material for clinical applications.