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Background: Frailty is a geriatric syndrome, and a common negative consequence of aging, which shares some obvious characteristics as cognitive impairment. Preventing and relieving frailty may reduce the possibility of developing cognitive impairment. Objective: This study aimed to investigate frailty prevalence and its correlation with cognitive function in elderly surgical inpatients. Methods: We enrolled a random sample of elderly surgical inpatients from Jingzhou from June 2020 to August 2020. We used a self-made registration sheet to collect their demographic data (gender, age, nationality, educational level and monthly income), and used the FRAIL Scale to assess the prevalence of frailty, and used the Mini-Mental State Examination (MMSE) to assess cognitive function. We used multiple linear regression analysis to explore the correlation between frailty level and demographic data, then Pearson correlation analysis was performed to analyze the correlation between frailty and cognitive function. Results: In the 143 elderly surgical inpatients, prevalence of frail was seen in 29 (20.3%), and pre-frail state was found in 64 (44.8%). Only 50 (34.9%) were in healthy state. Cognitive impairment was seen in 28 (19.5%). Pearson correlation analysis showed that the frail scoring was correlated with cognitive function in elderly surgical inpatients (r = -0.378, P < 0.05). Conclusion: The prevalence of frailty is high in elderly surgical inpatients, which is closely related to age and gender. Elderly surgical inpatients have high cognitive impairment, and frailty appears strongly associated with cognitive status. The findings suggest that attention should be paid to the frailty and cognitive function in the elderly surgical inpatients by pro-vision of effective interventions.

Vasculogenesis (de novo formation of vessels) induced by endothelial progenitor cells (EPCs) is requisite for vascularized bone regeneration. However, there exist few available options for promoting vasculogenesis within artificial bone grafts except for exogenous EPC transplantation, which suffers from the source of EPC, safety, cost, and time concerns in clinical applications. This study aimed at endogenous EPC recruitment for vascularized bone regeneration by using a bioinspired EPC-induced graft. The EPC-induced graft was created by immobilizing two bioactive peptides, WKYMVm and YIGSR, on the surface of poly(ε-caprolactone) (PCL)/poliglecaprone (PGC) nanofibrous scaffolds via a polyglycolic acid (PGA)-binding peptide sequence. Remarkable immobilization efficacy of WKYMVm and YIGSR peptides and their sustained release (over 14 days) from scaffolds were observed. In vivo and in vitro studies showed robust recruitment of EPCs, which subsequently contributed to early vasculogenesis and ultimate bone regeneration. The dual-peptide-functionalized nanofibrous scaffolds proposed in this study provide a promising therapeutic strategy for vasculogenesis in bone defect repair.

Angiogenesis is essential for successful bone defect repair. In normal tissue repair, the physiological inflammatory response is the main regulator of angiogenesis through the activity of macrophages and the cytokines secreted by them. In particular, M2 macrophages which secrete high levels of PDGF-BB are typically considered to promote angiogenesis. A hexapeptide [WKYMVm, (Trp-Lys-Tyr-Met-Val-D-Met-NH2)] has been reported to modulate inflammatory activities. However, the underlying mechanisms by which WKYMVm regulates macrophages remain unclear. In this study, the possible involvement by which WKYMVm induces the polarization of macrophages and affects their behaviors was evaluated. In vitro results showed that macrophages were induced to an M2 rather than M1 phenotype and the M2 phenotype was enhanced by WKYMVm through activation of the JAK1/STAT6 signaling pathway. It was also found that WKYMVm played an important role in the PDGF-BB production increase and proangiogenic abilities in M2 macrophages. Consistent with the results in vitro, the elevated M2/M0 ratio induced by WKYMVm enhanced the formation of new blood vessels in a femoral defect mouse model. In summary, these findings suggest that WKYMVm could be a promising alternative strategy for angiogenesis in bone repair by inducing M2 macrophage polarization.

Background. The number of patients with musculoskeletal pain, which seriously affects people’s quality of life, has increased. Traditional Chinese exercises are accepted and practiced to strengthen the body. Objective. This study aims to explore the efficacy of traditional Chinese exercises for the treatment of musculoskeletal pain. Methods. A comprehensive search of randomized controlled trials (RCTs) related to traditional Chinese exercises on patients with musculoskeletal pain was completed using PubMed, SinoMed, CNKI, VIP, and Wanfang Med Online databases. All RCTs published until February 2021 were considered. Two researchers independently screened the literature according to the predesigned inclusion and exclusion criteria, and data was extracted and assessed for their risk of bias via the Cochrane collaboration tool. Meta-analysis was performed using RevMan5.2 and Rx64 4.0.2 software. Results. A total of 45 RCT studies with 3178 patients were included. Traditional Chinese exercises were able to effectively alleviate patients with musculoskeletal pain (MD = −1.54, 95% confidence interval (−1.88, −1.19), P

Background: When the multicystic vesicles (precursor of exosomes) are formed in cells, there are two results. One is to be decomposed by lysosomes and the other one is to become exosomes which are transported out through transmembrane. On the other hand, M2 macrophages can promote the formation of local vascularization and provide necessary support for the repair of bone defects. In order to provide a new idea for the treatment of bone defects, the purpose of our study is to investigate the effect of WKYMVm peptide on the secretion of exosomes from murine bone marrow-derived MSCs （mBMSCs） and the effect of exosomes on the polarization of M2 macrophages. Methods: WKYMVm peptide was used to activate the Formyl Peptide Receptor 2 (FPR2) pathway in mBMSCs. At first, we used CCK-8 kit to detect the cytotoxic effect of WKYMVm Peptide on mBMSCs. Secondly, we used western blotting and Quantitative real-time Polymerase Chain Reaction （Qrt-PCR） to detect the expression of Interferon Stimulated Gene 15 （ISG15） and Transcription Factor EB （TFEB） in mBMSCs. Thirdly, we used exosomes extraction kit and western blotting to detect the content of exosomes secreted by mBMSCs. Finally, we used the immunofluorescence and western blotting to count the number of M2 macrophages polarization.Results: We firstly found that WKYMVm peptide had no toxic effect on mBMSCs at the concentration of 1μmol/L. Secondly, we found that when the FPR2 pathway was activated by WKYMVm peptide in mBMSCs, the expression of ISG15 and TFEB were decreased, leaded to the secretion of exosomes increased. Finally, we proved that the exosomes secreted by mBMSCs could promote the polarization of M2 macrophages. Moreover, all these effects can be blocked by WRWWWW (WRW4) peptide, an inhibitor of FPR2 pathway.Conclusion: Our findings demonstrated the potential value of WKYMVm peptide in promoting the secretion of exosomes by mBMSCs and eventually leading to M2 macrophages polarization. We believed that our study could provide a research basis for the clinical treatment of bone defects.

To investigate the effects of three-dimensional (3D) printed Ti6Al4V-4Cu alloy on inflammation and osteogenic gene expression in mouse bone marrow mesenchymal stem cells (BMSCs) and mouse mononuclear macrophage line RAW264.7.Ti6Al4V and Ti6Al4V-4Cu alloys were prepared by selective laser melting, and the extracts of the two materials were prepared according to the biological evaluation standard of medical devices. The effects of two kinds of extracts on the proliferation of mouse BMSCs and mouse RAW264.7 cells were detected by cell counting kit 8 method. After co-cultured with mouse BMSCs for 3 days, the expression of osteogenesis- related genes [collagen type Ⅰ (Col-Ⅰ), alkaline phosphatase (ALP), Runx family transcription factor 2 (Runx-2), osteoprotegerin (OPG), and osteopontin (OPN)] were detected by real-time fluorescence quantitative PCR. After co-cultured with mouse RAW264.7 cells for 1 day, the expressions of inflammation-related genes [interleukin 4 (IL-4) and nitric oxide synthase 2 (iNOS)] were detected by real-time fluorescence quantitative PCR, and the supernatants of the two groups were collected to detect the secretion of vascular endothelial growth factor a (VEGF-a) and bone morphogenetic protein 2 (BMP-2) by ELISA. The osteogenic conditioned medium were prepared with the supernatants of the two groups and co-cultured with BMSCs for 3 days. The expressions of osteogenesis-related genes (Col-Ⅰ, ALP, Runx-2, OPG, and OPN) were detected by real-time fluorescence quantitative PCR.Compared with Ti6Al4V alloy extract, Ti6Al4V-4Cu alloy extract had no obvious effect on the proliferation of BMSCs and RAW264.7 cells, but it could promote the expression of OPG mRNA in BMSCs, reduce the expression of iNOS mRNA in RAW264.7 cells, and promote the expression of IL-4 mRNA. It could also promote the secretions of VEGF-a and BMP-2 in RAW264.7 cells. Ti6Al4V-4Cu osteogenic conditioned medium could promote the expressions of Col-Ⅰ, ALP, Runx-2, OPG, and OPN mRNAs in BMSCs. The differences were all significant (3D printed Ti6Al4V-4Cu alloy can promote RAW264.7 cells to secret VEGF-a and BMP-2 by releasing copper ions, thus promoting osteogenesis through bone immune regulation, which lays a theoretical foundation for the application of metal prosthesis.探究 3D 打印 Ti6Al4V-4Cu 合金对小鼠 BMSCs 及小鼠单核巨噬细胞系 RAW264.7 炎症及成骨基因表达的影响。.通过选择性激光熔融技术制备 Ti6Al4V 与 Ti6Al4V-4Cu 合金，依据医疗器械生物学评价标准制备两种材料浸提液。通过细胞计数试剂盒 8 法检测两种浸提液对小鼠 BMSCs、小鼠 RAW264.7 细胞增殖的影响。两种浸提液与小鼠 BMSCs 共培养 3 d 后，通过实时荧光定量 PCR 法检测成骨相关基因Ⅰ型胶原（collagen type Ⅰ，Col-Ⅰ）、ALP、Runx 家族转录因子 2（Runx family transcription factor 2，Runx-2）、骨保护素（osteoprotegerin，OPG）、骨桥蛋白（osteopontin，OPN）mRNA 的表达；与小鼠 RAW264.7 共培养 1 d 后，通过实时荧光定量 PCR 法检测炎症相关基因 IL-4、一氧化氮合成酶 2（nitric oxide synthase 2，iNOS）mRNA 的表达，并收集两组上清液通过 ELISA 法检测其中 VEGF-a、BMP-2 的分泌量。将两组上清液制备成成骨条件培养基，与 BMSCs 共培养 3 d，实时荧光定量 PCR 法检测成骨相关基因 Col-Ⅰ、ALP、Runx-2、OPG、OPN mRNA 的表达。.与 Ti6Al4V 合金浸提液比较，Ti6Al4V-4Cu 合金浸提液对 BMSCs 及小鼠 RAW264.7 细胞的增殖影响不明显；但是可促进 BMSCs OPG mRNA 的表达，减少小鼠 RAW264.7 细胞炎症相关基因 iNOS mRNA 的表达、促进抑炎因子 IL-4 mRNA 的表达，还可促进小鼠 RAW264.7 细胞分泌 VEGF-a 及 BMP-2，而 Ti6Al4V-4Cu 成骨条件培养基又可促进 BMSCs 成骨相关基因 Col-Ⅰ、ALP、Runx-2、OPG、OPN mRNA 的表达，上述指标差异均有统计学意义（3D 打印 Ti6Al4V-4Cu 合金通过释放铜离子，促进 RAW264.7 细胞分泌 VEGF-a 及 BMP-2，从而通过骨免疫调节促进成骨发生，为金属假体的应用奠定了理论基础。.

The balance between bone formation and bone resorption is closely related to bone homeostasis. Osteoclasts, originating from the monocyte/macrophage lineage, are the only cell type possessing bone resorption ability. Osteoclast overactivity is thought to be the major reason underlying osteoclast‐related osteolytic problems, such as Paget's disease, aseptic loosening of prostheses and inflammatory osteolysis; therefore, disruption of osteoclastogenesis is considered a crucial treatment option for these issues. WKYMVm, a synthetic peptide, which is a potent FPR2 agonist, exerts an immunoregulatory effect. This peptide inhibits the production of inflammatory cytokines, such as (IL)‐1β and TNF‐α, thus regulating inflammation. However, there are only few reports on the role of WKYMVm and FPR2 in osteoclast cytology. In the current study, we found that WKYMVm negatively regulates RANKL‐ and lipopolysaccharide (LPS)‐induced osteoclast differentiation and maturation in vitro and alleviates LPS‐induced osteolysis in animal models. WKYMVm down‐regulated the expression of osteoclast marker genes and resorption activity. Furthermore, WKYMVm inhibited osteoclastogenesis directly through reducing the phosphorylation of STAT3 and NF‐kB and indirectly through the CD9/gp130/STAT3 pathway. In conclusion, our findings demonstrated the potential medicinal value of WKYMVm for the treatment of inflammatory osteolysis.

Studies have demonstrated that scaffolds, a component of bone tissue engineering, play an indispensable role in bone repair. However, these scaffolds involving ex-vivo cultivated cells seeded have disadvantages in clinical practice, such as limited autologous cells, time-consuming cell expansion procedures, low survival rate and immune-rejection issues. To overcome these disadvantages, recent focus has been placed on the design of functionalized cell-free scaffolds, instead of cell-seeded scaffolds, that can reduplicate the natural self-healing events of bone fractures, such as inflammation, cell recruitment, vascularization, and osteogenic differentiation. New approaches and applications in tissue engineering and regenerative medicine continue to drive the development of functionalized cell-free scaffolds for bone repair. In this review, the self-healing processes were highlighted, and approaches for the functionalization were summarized. Also, ongoing efforts and breakthroughs in the field of functionalization for bone defect repair were discussed. Finally, a brief summery and new perspectives for functionalization strategies were presented to provide guidelines for further efforts in the design of bioinspired cell-free scaffolds.

A new series of sulfonated poly(p-phenylene-co-aryl ether ketone)s (s, m, I-SPP-co-PAEKs) microblock polymers containing different hydrophobic units with precisely defined lengths have been prepared via the nickel (0) catalyzed coupling copolymerization and characterized to act as proton exchange membranes. By controlling the length and chemical structure of the hydrophobic units in the copolymers, these novel microblock polymers can exhibit well-developed nanophase morphologies and large length-scale of the ionic channels, resulting in the improvement of the proton conductivity in both the wet and dry state. Moreover, the membrane I-SPP-co-PAEK 1.80 with the largest hydrophobic micro-block length shows high proton conductivity, excellent dimensional stability, low glass-transition temperature (Tg), good oxidative stability and superior cell performance. (C) 2015 Elsevier B.V. All rights reserved.

A series of new nation composite membranes have been prepared by the self-assembly of microporous organic polymer networks (mopns) and nation. x-ray photoelectron spectroscopy (xps) and scanning electron microscopy (sem) reveal that mopns and nation membranes have good miscibility affording homogeneous composite membranes nafion-mopn-x. compared with the recast nation membrane, nafion-mopn-x composite membranes show excellent thermal and mechanical properties, good dimensional stability, low methanol permeability, and proper proton conductivity. also, the passive direct methanol fuel cell (dmfc) of nafion-mopn-3 membrane presents a maximum power density of 21.5 mw cm(-2) at 25 degrees c. these results show the introduction of mopns can improve the interface compatibility and lessen the cavity problem between fillers and polymeric matrix during chemical blend. therefore, it casts a new light on developing stable polymer electrolyte membranes (pems) for fuel cell application. (c) 2014 elsevier b.v. all rights reserved

OBJECTIVES: To explore the microendoscopic discectomy technique and inclusion criteria for the treatment of recurrent lumbar disc herniation and to supply feasible criteria and technical notes to avoid complications and to increase the therapeutic effect. METHODS: A consecutive series of 25 patients who underwent posterior microendoscopic discectomy for recurrent lumbar disc herniation were included. The inclusion criteria were as follows: no severe pain in the lumbar region, no lumbar instability observed by flexion-extension radiography and no intervertebral discitis or endplate damage observed by magnetic resonance imaging. All patients were diagnosed by clinical manifestations and imaging examinations. RESULTS: Follow-up visits were carried out in all cases. Complications, such as nerve injuries, were not observed. The follow-up outcomes were graded using the MacNab criteria. A grade of excellent was given to 12 patients, good to 12 patients and fair to 1 patient. A grade of excellent or good occurred in 96% of cases. One patient relapsed 3 months after surgery and then underwent lumbar interbody fusion and inner fixation. The numerical rating scale of preoperative leg pain was 7.4± 1.5, whereas it decreased to 2.1±0.8 at 7 days after surgery. The preoperative Oswestry disability index of lumbar function was 57.5±10.0, whereas it was 26.0±8.5 at 7 days after surgery. CONCLUSION: In these cases, microendoscopic discectomy was able to achieve satisfactory clinical results. Furthermore, it has advantages over other methods because of its smaller incision, reduced bleeding and more efficient recovery.

A new series of cardo poly(arylene ether sulfone/nitrile)s FSPES-x with perfluoroalkyl sulfonic acid groups have been successfully prepared by the perfluorosulfonic acid lactone ring-opening reaction without using any metal or base catalysts. These materials have been characterized by IR, NMR and TGA. The results indicate that this simple and metal-free method of preparation is highly efficient for controlling both the degree of perfluorosulfonation and the position of the sulfonate group and no side reactions such as crosslinking is observed. The FSPES-x membranes (IEC = 1.17–1.64 m equiv g−1) show the desired characteristics such as good film-forming ability, excellent thermal and mechanical properties, low methanol permeability, high conductivity (up to 0.083 S cm−1 at room temperature), as well as appropriate cell performance compared to Nafion®117. With these properties, such fluorinated sulfonic acid side-chain-type polymers are promising PEM materials for application in fuel cells.

A series of sulfonated poly( p -phenylene- co -aryl ether ketone)s (SPP- co -PAEK) have been designed as membrane materials for direct methanol fuel cell (DMFC) applications. The materials for such membranes have been prepared via the nickel (0) catalyzed coupling copolymerization of 2,5-dichloro-3-sulfobenzophenone and 2,6-bis(4-(4-chlorobenzoyl)phenoxy)benzonitrile. The SPP- co -PAEK membranes show the desired characteristics such as excellent thermal and mechanical properties, good oxidative stability, low methanol permeability and well-defined micro-phase separation. With an ion exchange capacity (IEC) ranging from 1.90 to 2.59 mequiv g −1 , these membranes display comparable proton conductivity (0.085–0.170 S cm −1 ) to Nafion @ 117 when fully hydrated at 80 °C. In addition, the passive direct methanol fuel cell with SPP- co -PAEK CN 1.86 (IEC = 1.90 mequiv g −1 ) membrane presents a maximum power density of 24.5 mW cm −2 at 25 °C, which is comparable to the value of Nafion @ 117 (24.3 mW cm −2 ).

We report a new hydroxyl functionalized microporous organic polymer (MOPOH) based on the polymerization of catechol with terephthalaldehyde using phenolic resin-inspired chemistry. This catechol-decorated material, with surface area of 874 m2 g−1 and micro, mesopores, facilitates the immobilization and dispersion of Pd nanoparticles (NPs) on the polymer matrix. The surface area of the created composite (Pd@MOPOH) decreases to 419 m2 g−1 and the pore size distribution is narrowly distributed at 1.54 nm due to the filling of mesopores. The CO2 capture capacities for MOPOH and Pd@MOPOH at 273 K and 1 bar are 13.4 and 9.2 wt%, respectively. The resultant Pd NPs are crystalline and uniform with a mean diameter of 4.8 nm. The well-dispersed Pd@MOPOH exhibits excellent catalytic activity toward the model reduction of 4-nitrophenol into 4-aminophenol. Significantly, nearly no Pd leaching is detected during the catalytic cycles, showing active and durable nature of the heterogeneous nanocatalyst.

We previously demonstrated that the utilization of an electrospun scaffold could boost functional outputs of transplanted islets. In this study, we aim to develop a drug-eluting scaffold with a payload of pioglitazone to simultaneously rein in hyperglycemia and recoup lost renal functions in diabetic mice that underwent islet transplantation. The in vivo proliferation of islets was measured by a non-invasive bio-imaging technology whereas the blood insulin, blood glucose and renal proteins were assayed. The local stimulation of transplanted islets by pioglitazone saw an accelerated in vivo proliferation without apoptosis caused by the drug-eluting scaffold. In addition, pioglitazone contributed to an increased secretion of insulin and C-peptide 2, giving rise to an accelerated rein-in of hyperglycemia and enhanced tolerance of sudden oral glucose challenge. Moreover, the accelerated decrease of blood creatinine, urine creatinine and blood urea nitrogen suggested that pioglitazone contributed to the recovery of renal functions compromised by diabetes. Our bioengineering strategy effectively ameliorated hyperglycemia and associated nephrotic disorders, and shed a new light on an engineering approach to combat diabetes.

Transpedicular closing wedge osteotomy (CWO) has become popular in correcting thoracic and lumbar kyphotic deformity (TLKD). Our study aims to evaluate the efficacy of CWO in treating TLKD of different etiologies. CWO was performed on 25 patients with thoracic and lumbar kyphosis, of whom 10 had ankylosing spondylitis, 10 had post-traumatic thoracolumbar fractures, and 5 had tuberculosis. Mean follow-up period was 24 months. Pre- and postoperative kyphotic Cobb angles and the horizontal distance between C7 and S1 in the lateral view were measured. Back pain and disability were assessed by visual analog score (VAS) and oswestry disability index (ODI). Postoperative complications were also recorded. Kyphotic deformity was successfully corrected, and 100 % osteotomic site fusion was obtained in all cases. Average operative duration was 255.6 min and blood loss was 1,675.6 ml. Average correction angels were 37.6°. The horizontal distance between C7 and S1 was 88.28 mm before the operation and 20.84 mm after the operation. Pre- and postoperative mean VAS of back pain in all cases was 7.6 and 2.6 respectively. Pre- and postoperative mean ODI was 61.8 and 27.32 receptively. Six complications were registered in six patients. Pedicle subtraction osteotomy is an effective and safe surgical method to correct thoracic and lumbar kyphosis of different etiologies.

Congenital partial anterior arch defect of the atlas is extremely rare. It could be found as an incidental radiological finding or patients can present with neurological deficit after head or neck trauma.To describe an extremely rare presentation of anterior midline cleft at the atlas and congenital posterior atlanto-occipital fusion with symptomatic anterior atlantoaxial subluxation. This report includes a feasible hypothesis for the development of this anomaly on the basis of previous hypotheses and surgical findings.A 46-year-old female presented with a 6-day history of right limbs numb and left upper and lower extremities paraparesis (Frankel D). Radiographs of the cervical spine showed anterior atlantoaxial subluxation with congenital posterior atlanto-occipital fusion. Computed tomography subsequently revealed partial midline absence of the anterior arch of the atlas and the odontoid tip ahead of the anterior arch of the atlas. Magnetic resonance imaging showed that the cervical dura was compressed by the remnant of anterior arch of the atlas. The patient underwent Gardner-Wells tong traction and surgery of occipitocervical fusion with autogenous iliac bone graft because she had definite neurological symptom and congenital posterior atlanto-occipital fusion.Atlantoaxial reduction was confirmed with fluoroscopic X-ray evaluation by bed, her neurological deficit was resolved from Frankel D to E, and numb of right limbs completely disappeared 6 days postoperation. No instability has been observed during 2-year follow-up.We describe the association between compressive myelopathy and congenital defect of the anterior arch of the atlas with symptomatic anterior atlantoaxial subluxation. Both computed tomography and magnetic resonance image were required to demonstrate the bony configuration and cord compression. And Gardner-Wells tong traction and surgery of occipitocervical fusion with autogenous iliac bone graft were effective as a treatment for this compressive myelopathy caused by the remnant of anterior arch of the atlas.

China is a country with a high tuberculosis (TB) burden. Spinal TB is one reason for the resurgence of TB in China. The objective of this study was to investigate the clinical and epidemiological features of patients with spinal TB in a teaching hospital of Southwest China. The study group comprised 967 patients with spinal TB who were admitted to the authors' institution from 1999 to 2013. Demographic characteristics, prevalence of symptoms and clinical manifestations, prevalence of multidrug resistance and extensive drug resistance of spinal TB, management and outcome, and incidence of complications were recorded and analyzed. The patients included 473 women and 494 men with a mean age of 35.86±15.68 years. The most common presentation of spinal TB was back pain, followed by night sweats and fever. The thoracic spine was the most commonly involved level, followed by the lumbar spine and cervical spine. The incidence of neurological involvement in spinal TB is 33.3%. Noncontiguous spinal TB was seen in 3.41% of cases. The incidence of concomitant pulmonary TB was 14.37%. A total of 740 patients were successfully treated with surgery and anti-TB drugs. No mortality was related to spinal TB. Spinal TB increased every year from 1999 to 2013 in Southwest China. Back pain is the most common clinical symptom, and the thoracic spine is the vertebral body most often involved. The most commonly used first- and second-line anti-TB drugs are isoniazid and levofloxacin, respectively. [ Orthopedics. 2016; 39(5):e838–e843.]

Objective: The aim of the present study was to evaluate the effect of tissue-engineered constructs on repair of large segmental bone defects in goats. Methods: Allogenic demineralized bone matrix (aDBM) was seeded with autologous marrow stromal cells (aMSC) for seven days to construct DBM–MSC grafts prior to implantation. 24 goats were randomly divided into three groups (eight in each). In each group, 3 cm diaphyseal femoral defects were created unilaterally, and subsequently filled with the DBM-MSC grafts, DBM alone and an untreated control, respectively. Radiological analysis and biomechanical evaluation were performed at 12 and 24 weeks after operation. Results: Obvious increases in radiological scoring and biomechanical strength were found in the DBM-MSC group when compared to the DBM group. X-ray examination showed excellent bone healing in the DBM-MSC group, whereas only partial bone repair was seen in the DBM group, and no healing in untreated controls. Histologically, a tendency to bone regeneration and remodeling was far more obvious for the DBM-MSC group than the DBM only and untreated controls. Conclusion: Our results strongly suggest that transplantation of bone MSC within a DBM could have advantages for the bone repair of large segmental defects.

Background This study was aimed to investigate the clinical outcome of lumbosacral tuberculosis treatment by one-stage radical debridement with bone allograft reconstruction and anterior instrumentation via a retroperitoneal approach. Methods We retrospectively analyzed a series of 43 patients with lumbosacral tuberculosis in whom the lumbosacral junction was exposed via an anterior midline retroperitoneal approach. After radical debridement, two parallel tricortical iliac crest bone allografts were placed to reconstruct the anterior column, and then anterior fixation was performed. Results The mean follow-up period was 34 months (range, 24–91 months), during which no obvious loss of correction was observed. No case experienced recurrence, tuberculous peritonitis, erectile dysfunction, or retrograde ejaculation. Conclusions The midline retroperitoneal approach provides direct and safe access to lesions of lumbosacral tuberculosis. Two parallel structural iliac crest allografts and anterior instrumentation effectively stabilize the lumbosacral junction.

China ranks second among the 22 countries with the highest burden of tuberculosis. The goals of this study were to evaluate the clinical outcomes of treatment of skipped multisegmental spinal tuberculosis and to investigate the selection strategy for the optimal procedure based on focal characteristics. From March 1999 to December 2013, 24 patients with skipped multisegmental spinal tuberculosis were enrolled in this study. Ten patients underwent an anterior procedure (anterior group). Four patients underwent a combined anterior and posterior procedure (combined anterior and posterior group). Ten patients underwent a posterior procedure (posterior group). All patients were evaluated according to clinical presentation and radiographic, computed tomography, and magnetic resonance imaging findings. The focal tissues of all patients underwent drug susceptibility testing. The patients underwent clinical and radiologic follow-up an average of 18.6 months post-operatively. The cohort included 13 male and 11 female patients (age range, 15–69 years). The patients showed significant improvement in deformity and neurologic deficits. All patients had graft union 6 to 12 months postoperatively. No patient had surgical complications. Postoperative recurrence occurred in 1 patient in the combined anterior and posterior group. Two patients had strains that were resistant to at least 1 anti-tuberculosis drug. One patient had multidrug-resistant strains. All 24 patients had achieved cure at final follow-up. This study showed that the 3 procedures can safely and effectively achieve nerve decompression, graft fusion, and kyphosis correction. The procedure should be chosen according to the patient's general condition, focal characteristics, and type of complication, and the surgeon's experience. [ Orthopedics. 2016; 39(1):e19–e25.]

This study was designed to investigate the effect of different concentrations of rifampicin on osteogenic differentiation and proliferation of mesenchymal stem cells (MSCs) in human bone marrow. Rifampicin treatment at 0, 4, 8, 16, 32, 64, and 128 mg/mL was applied throughout the whole process, from stromal cells purified from human bone marrow to differentiated bone cells. The effect of rifampicin on MSC proliferation was determined using the MTT assay. The effect of rifampicin on the expressions of type I collagen (COL1A1), osteopontin/bone Gla protein (OPN/BGP), and alkaline phosphatase (ALP) in human osteoblast cells were determined by real-time polymerase chain reaction, and the expressions of COL1A1, OPN/BGP, and the runt-related transcription factor (RUNX2) were determined by Western blot. Results showed that the proliferation of MSCs was significantly inhibited when the rifampicin concentration exceeded 32 mg/mL. In addition, increased rifampicin concentrations inhibited the formation of calcium nodules, OPN/BGP, and COL1A1 in osteoblasts after 28 days of induction. The RNA expressions of OPN/BGP, COL1A1, and ALP were significantly downregulated compared to those of the control group in osteoblasts after induction. The protein expressions of RUNX2, COL1A1, and OPN/BGP were also significantly downregulated compared to those of the control group after induction. In conclusion, rifampicin at exorbitant concentration exerts adverse effects on the proliferation of MSCs in human bone marrow and the differentiation of osteoblasts.

Study design Retrospective study. Objective To evaluate the clinical outcomes of 4 different procedures for the treatment of adjacent multisegmental spinal tuberculosis (AMSST) and to investigate the selection strategy of the optimal procedure with respect to focal characteristics. Summary of background data Because of the lack of support of the anterior columns of multiple segments, AMSST is thought to confer high risks for the development of kyphosis and paraplegia. However, there are few reports regarding the clinical outcomes of the surgical treatment for AMSST have been investigated. Methods From August 1999 to June 2010, 48 patients with AMSST were enrolled in this study. Seven patients (A group) underwent a single-stage anterior operation. Eighteen patients (AP group) underwent a single-stage posterior and anterior combined operation. Eighteen patients (P group) underwent a single-stage posterior operation. Five patients (DP group) underwent computed tomography-guided drainage and local chemotherapy combined with a 2-stage posterior operation. The patients were followed up clinically and radiologically for an average of 29.6 months. Results The cohort consisted of 29 males and 19 females, aged 4 to 54 years. The patients exhibited significant improvements in deformity and neurological deficits. Graft union was achieved in all patients 5 to 12 months postoperatively. Surgery-related complications were noted in 1 and 2 patients in the AP and P groups, respectively. Postoperative recurrence occurred in 1 and 2 patients in the AP and P groups, respectively. All 48 patients had been cured at the final follow-up. Conclusion This study demonstrated that the 4 procedures can safely and effectively achieve nerve decompression, graft fusion, and kyphosis correction. Individualized procedures should be chosen according to the patient's general condition, focal characteristic, type of complication, and surgeon's experience. Level of evidence 3.

Angiogenesis and osteogenesis are essential for healing bone injuries, especially those related to critically sized bone defect (CSBD). Bone tissue engineering is a promising method for repairing bone defect, but the inherently poor nutrient supply and the slow osteogenesis of large size defect are two obstacles. This leads to an urgent need to understand how to orchestrate angiogenesis and osteogenesis for promoting bone defect healing. In this article, poly-L-lysine-coated vascular endothelial growth factor/alginate controlled releasing microspheres (VEGF-AG-PLL) were fabricated in tissue-engineered bone (TEB), and then the composite was implanted into the CSBD of goat femurs. Dynamic intramedullary rod was utilized to fixate the femur and produce an analogous physiological axial compression. We found that VEGF released in early stage not only promoted angiogenesis, but also brought benefit to osteogenesis. Meanwhile, in early stage physiological axial compression could regulate angiogenesis and facilitate VEGF release from the composite. In later stage, compression could accelerate reconstruction of TEB. In conclusion, this study demonstrated that the collaborative application of VEGF and compression could accelerate the reconstruction of TEB; thus, providing a new strategy for clinically repairing large bone defect in future.

Copyright: © 2014 He Q. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. The extreme lateral interbody fusion (XLIF) was first introduced by Pimenta in 2001 [1] and developed in 2003. It is a minimally invasive, lateral, transpsoas approach for lumbar interbody fusion and is an alternative approach to anterior lumbar interbody fusion (ALIF) [2]. The XLIF approach minimizes anterior approach related complications such as vascular and visceral injury, without the need for an access surgeon [3], furthermore, it bears the several advantages to this approach, including less tissue dissection, smaller incisions, decreased operative time, blood loss, shorter hospital stay, reduced postoperative pain, enhanced fusion rates, and the ability to place instrumentation through the same incision [4].

A simple, rapid, and specific method for Hg(II) detection has been proposed based on the fluorescence change ofN-acetyl-L-cysteine-capped CdTe quantum dots (QDs). The presence of Hg(II) ions could quench the fluorescence of QDs at 565 nm and meanwhile produce new peak in 700–860 nm wavelength range. The linear response range is 20–430 nM with the detection limit at 8.0 nM Hg(II). It was found that the position of the new peak was irrelevant to the size of QDs. Furthermore, the mechanism of the quenching of QDs fluorescence by Hg(II) and the appearance of new peak in near-infrared area were also discussed and deduced through ultraviolet absorption spectrum, fluorescence spectrum, and X-ray photoelectron spectrum.

Distributed Generalized Assignment Problem (D-GAP) is very popular in scalable multi-agent systems. However, existing algorithms are not effective or efficient in large scale or highly dynamic domains due to the limited communication and computation resource. In this paper, we present a novel approach to address this issue. To reduce communication, we propose a decentralized model for agents to jointly search for optimized solutions. Considering the complexity of D-GAP in a massive multi-agent system, agents cannot perform the optimal search based on their local views, we propose a heuristic algorithm. By inferring knowledge from their previous communicated searches, agents are able to predict how to deploy their future similar searches more efficiently. If an agent can solve some parts of D-GAP well, similar searches will be sent to it. By taking the advantage of the accumulation effect to agents' local knowledge, agents can independently make simple decisions with highly reliable performance and limited communication overheads. Finally, we present a simulation to demonstrate the feasibility and efficiency of our algorithm.

As the development of internet of things (IOT), massive sensors have been deployed as the public infrastructure. However, there is a bottleneck in state of the art IOT applications, which require sensors to response on abstract and complex requests similar to human natural languages. On the contrary, since sensors' service directories are unable to map their services on how users' abstract queries can be performed, sensors can only response to low-level queries with accurate and complete descriptions. To handle this challenge, in this paper, we proposed a novel ontology based method to improve sensor systems' reasoning. The key lies on any abstract terminologies can be understood by searching their ontologies descriptions. Therefore, by utilizing ontologies, abstract queries can be hierarchically decomposed into several simple queries handled by single sensors. Moreover, ontologies also imply the logical relations on the feedbacks from each single queries, and the answer can be carried out based on the equations and sensor outputs.

Drug-resistant tuberculosis is a major public-health concern globally and can be difficult to manage clinically. Spinal tuberculosis is the most common manifestation of extrapulmonary tuberculosis. However, there have been few reports on the topic of drug-resistant spinal tuberculosis. The aim of this study was to investigate the clinical characteristics and drug susceptibility patterns and the outcomes of management with a combination of surgery and individualised chemotherapy, for drug-resistant spinal tuberculosis.We retrospectively analysed 35 patients with drug-resistant tuberculous spondylitis. After surgery, individualised chemotherapy was tailored for each patient according to the drug-resistance profile and previous history of chemotherapy. The patients were followed up clinically and radiologically for an average period of 35.8 months.Among 35 drug-resistant spinal tuberculosis cases, 13 were retreatment cases. Twelve were multi-drug resistant tuberculosis (MDR-TB), and 23 were non-MDR-TB. The patients with MDR-TB and non-MDR-TB had undergone previous chemotherapy for an average of 14.50 ± 2.00 (0-60) months and 4.56 ± 1.54 (0-74) months, respectively. A total of 32 cases underwent open operations, and the other three had percutaneous drainage and local chemotherapy. Patients received individualised chemotherapy for an average of 23.6 months postoperatively. Local recurrence was observed in six patients. Thirty-three patients had been cured at the final follow-up, and the other two were still receiving chemotherapy.Drug-resistant tuberculous spondylitis is mainly acquired through previous irregular chemotherapy and the spreading of drug-resistant strains. Management with a combination of surgery and individualised chemotherapy is feasible in the treatment of severe complications and the prevention of acquired drug resistance.

Both the antero-posterior and anterior approaches have been used for treating L5-S1 vertebral tuberculosis. However, no studies have compared the efficacy of the two methods in treating the disease.The antero-posterior (AP group, 14 cases) and anterior (A group, 13 cases) approaches were performed on L5-S1 vertebral tuberculosis cases who were followed up for average of 25 months. Clinical and radiographic data were obtained from and compared between groups.Average operative time, blood loss and pre-operative, post-operative and last follow-up of lumbo-sacral angles for groups AP and A were 497 min vs 190 min, 980 ml vs 410 ml, 22.3° vs 20.6°, 29.8° vs 25.7° and 28.3° vs 23.6°, respectively. Averaged visual analogue scale (VAS) scores in groups AP and A, respectively, were 6.5 vs 6.0 points before surgery and 3.0 vs 2.8 points after surgery. Mean ODI scores were 60.2 vs 63.0 points before and 30.0 vs 28.5 points after the operation for groups AP and A, respectively. Six cases in the AP group and five in the A group who exhibited neurological symptoms recovered to American Spinal Injury Association (ASIA) grade E. The average hospitalisations of groups AP and A lasted for 21 and 15 days, respectively. Bony fusion was achieved in both groups, with an average fusion time of five and four months, respectively.Both the antero-posterior and anterior approaches can effectively heal L5-S1 vertebral tuberculosis, but the average surgical time, blood loss and hospital stay following the anterior approach are prominently less than those following the antero-posterior approach.

This study sought to producte alginate sodium microsphere for controlled release bovine serum albumin(BSA) and to investigate the protein release profile of the BSA-alginate sodium microsphere in vitro, which threw some light on the angiogenesis of tissue engineering bone with vascular endothelial growth factor (VEGF) controlled release under stress. The BSA-alginate sodium microsphere was fabricated with W/O emulsification and ion cross-linking method using alginate sodium. The appearance, microsphere diameter and envelopment rate were detected, and the release characteristics of the BSA-alginate sodium microsphere in vitro was investigated. The alginate microsphere was found to be spherical in shape and evenly distributed. Its mean grain diameter was determined to be 230 +/- 60 microm, carrying capacity 80.3 microg/mg and envelopment rate 61%. Smooth controlled release in BSA-alginate sodium microsphere was shown to last more than 2 weeks. Alginate sodium proved an excellent biodegradable material for protein or polypeptide controlled release. The emulsification and ion cross-linking method was noted to be simple; it was propitious to the structural and functional stablility of protein or polypeptide, thus leading to the prolonged efficacious time of the microsphere.

To immortalize human articular chondrocytes (HACs) using gene transfection and to maintain stable phenotype of transformed HACs after induction.HACs were transfected with the retroviral vector pLXSN encoding human papillomavirus 16E7 (HPV16E7), and the transformed clones were sorted and proliferated. Karyotype analysis, clone forming tests and nude mice tumor forming tests were applied to check the characteristics of the transformation. Type II collagen of transformed chondrocytes was inducted with free serum medium (FSM) supplemented with nutridoma-sp and ascorbate.Immortalized HACs were isolated with fifty passages achieved. The HPV16E7 transformed cells were confirmed to be benign. Induction of FSM with nutridoma-sp and ascorbate promoted type II collagen of transformed chondrocytes to the high levels of normal chondrocytes.HACs transformed with HPV16E7 survive for long periods in vitro, and type II collagen can maintain stability after induction.

We designed and fabricated a new structure of PIN MOS imaging sensor. The result shows that its responsivity is high and its junction capacitance is small which is in good agreement with the theoretical analysis.

The aim of this experiment is to find proper cell carrier for skin tissue engineering.Various concentration of fibroblasts were seeded onto HA-ECM and cultured in vitro. The performance of cells' growth, array, adhesion and collagen secretion on HA-ECM was observed with light microscope and transmission electron microscope.The fusiform fibroblasts oriented radiantly or longitudinally and closely packed onto the HA-ECM, they attached firmly and proliferated to confluence on the stromal surface of HA-ECM.The optimal cell concentration is 3.5 x 10(6)/ml, HA-ECM is ideal carrier for fibroblasts because of its excellent scaffold and diffusion characteristics. Futhermore, it has the bioactive molecules such as fibronectin and laminin which play an important role in fibroblasts attachment and proliferation on HA-ECM.

To repair rabbit tendon defects with tissue engineering method.The third passage of fetal skin fibroblast cells was labeled with 5-bromo-2' deoxyuridine (Brdu) and then seeded on human amnion extracellular matrix (HA-ECM). Using 1 cm-long-Achilles tendon defects as repairing models in the experimental group, tendon defects were core bridged with polydioxanone (PDS) and then capsulated with the complex of fibroblasts-HA-ECM. In the control group I, defective tendons were sutured with PDS following the former procedure and capsulated with HA-ECM (without fibroblasts). In the control group II, only PDS was applied to connect the defective tendons. Gross examination, light microscopy, scanning electronmicroscopy and biomechanical measurement of the repaired tendons were respectively performed at postoperative 1, 2, 3 month as well as immunohistochemical examination.The optimal cell concentration for seeding fibroblasts was 3.5 x 10(6) cells/ml. Cells grew well and radiated or paralleled on HA-ECM. Immunohistochemistry showed that the labeled seed fibroblasts played an important role in tendonization. The results of light microscopy, electron microscopy, and biomechanical assessment suggested that the rate and quality of tendonization in the experimental group was superior to those of the control group I and II. The tensile strength in the experimental group was the greatest, the next was in the control group I, and the worst in the control group II (P0.05).HA-ECM is the excellent carrier for fibroblasts. Fibroblasts-HA-ECM complex has the capability to repair tendon defect and to tendonize with rapid rate and good performance three months after operation. Its tensile strength is 81.8% of that of normal tendon.