[Arthroscopic all-inside reconstruction for posterior cruciate ligament and popliteus tendon compared with popliteofibular ligament reconstruction: clinical outcome of minimum 2-year follow-up]

OBJECTIVE

To describe the clinical results of a one-stage operation for posterior cruciate ligament reconstruction and a posterolateral corner reconstruction of popliteus tendon reconstruction, compared with an open popliteofibular ligament reconstruction.

METHODS

Our study included 33 patients who had undergone posterior cruciate ligament reconstruction with use of an achilles tendon-bone allograft and posterolateral corner reconstruction with arthroscopic anatomical reconstruction of popliteus tendon or open reconstruction of popliteofibular ligament. The patients were assessed for knee instability with use of the dial test at 30° and 90°, together with posterior stress radiography and KT-1000 measurement.

RESULTS

The mean time of follow-up was more than 2 years. At the final follow-up evaluation, the tibial posterior translation as measured by stress radiography at 90° of knee flexion, the anterior-posterior translation as measured by KT-1000, and the external rotation of tibia as measured by dial test were reduced postoperatively (P<0.001) in both groups. Between the two groups, the preoperative tibial posterior translation as measured by stress radiography and the preoperative mean anterior-posterior translation as measured by KT-1000 in the popliteofibular ligament group were a little more than those in the popliteus tendon group (P=0.014, P<0.001). But the other comparisons were not significantly different (P>0.05). The final flexion losses were 3.33°±4.88° and 3.06°±3.38° for the two groups.

CONCLUSION

Combined with posterior cruciate ligament reconstruction, anatomical posterolateral corner reconstruction of the popliteus tendon and open reconstruction of popliteofibular ligament showed similar outcomes. This study demonstrated that both posterolateral corner reconstruction techniques were a reliable alternative method in addressing posterolateral corner and posterior cruciate ligament insufficiency of the knee.

Anisotropic Li intercalation in a Li(x)FePO4 nano-particle: a spectral smoothed boundary phase-field model

A spectral smoothed boundary phase-field model is implemented to study lithium (Li) intercalation in a LixFePO4 nano-particle immersed in a Li(+) rich electrolyte. It takes into account different physical processes on the particle surface, such as heterogeneous nucleation, Li flux and stress-free boundary conditions. We show the nucleation and growth of plate-like Li-rich crystallites along the (010) plane due to the high Li mobility along [001]. Since such plate-like crystallites, which are nucleated from (001) surfaces, align their phase boundaries along the (101) habit planes, a LixFePO4 nano-particle with prominent (010) and (001) surface facets and the longest axis length along [100] is proposed to exhibit great mechanical stability.

New role and molecular mechanism of Gadd45a in hepatic fibrosis

AIM: To investigate the role of Gadd45a in hepatic fibrosis and the transforming growth factor (TGF)-β/Smad signaling pathway.

METHODS: Wild-type male BALB/c mice were treated with CCl₄ to induce a model of chronic liver injury. Hepatic stellate cells (HSCs) were isolated from the liver of BALB/c mice and were treated with small interfering RNAs (siRNAs) targeting Gadd45a or the pcDNA3.1-Gadd45a recombinant plasmid. Cellular α-smooth muscle actin (α-SMA), β-actin, type I collagen, phospho-Smad2, phospho-Smad3, Smad2, Smad3, and Smad4 were detected by Western blots. The mRNA levels of α-SMA, β-actin, and type I collagen were determined by quantitative real-time (qRT)-PCR analyses. Reactive oxygen species production was monitored by flow cytometry using 2,7-dichlorodihydrofluorescein diacetate. Gadd45a, Gadd45b, anti-Gadd45g, type I collagen, and SMA local expression in liver tissue were measured by histologic and immunohistochemical analyses.

RESULTS: Significant downregulation of Gadd45a, but not Gadd45b or Gadd45g, accompanied by activation of the TGF-β/Smad signaling pathways was detected in fibrotic liver tissues of mice and isolated HSCs with chronic liver injury induced by CCl₄ treatment. Overexpression of Gadd45a reduced the expression of extracellular matrix proteins and α-SMA in HSCs, whereas transient knockdown of Gadd45a with siRNA reversed this process. Gadd45a inhibited the activity of a plasminogen activator inhibitor-1 promoter construct and (CAGA)₉ MLP-Luc, an artificial Smad3/4-specific reporter, as well as reduced the phosphorylation and nuclear translocation of Smad3. Gadd45a showed protective effects by scavenging reactive oxygen species and upregulating antioxidant enzymes.

CONCLUSION: Gadd45a may counteract hepatic fibrosis by regulating the activation of HSCs via the inhibition of TGF-β/Smad signaling.

Nanoparticles based on phenylalanine ethyl ester-alginate conjugate as vitamin B2 delivery system

Phenylalanine ethyl ester (PAE)-alginate (Alg) conjugate (PAE-Alg, PEA) was synthesized and formation of an amide bond between PAE and Alg was confirmed by Fourier transformed-infrared and (1)H nuclear magnetic resonance spectroscopy. The degree of PAE substitution was 3.5-4.7 (PAE group per hundred sugar residues of Alg) which was determined by elemental analysis. The critical aggregation concentration values determined for PEA conjugates PEA1, PEA2, and PEA3 were 0.20, 0.12, and 0.10 mg/ml, respectively. The particle size of PEA nanoparticles (PEA-NPs) decreased from 425 nm to 226 nm with the increasing degree of PAE substitution. Vitamin B2 (VB2), as a model nutrient, was encapsulated into the nanoparticles. The drug-loading content increased with increasing degree of PAE substitution. The maximum VB2 loading capacity and loading efficiency of PEA3 nanoparticles were 3.53 ± 0.03% and 91.48 ± 0.80%, respectively. The in vitro release behavior of VB2 from the PEA-NPs showed a biphasic release profile with an initial burst release of about 40-50% of VB2 in the first 10 h followed by a steady and continuous release phase for the following 50 h in PBS, pH 7.4. The human colorectal carcinoma cell line was used to investigate the cytotoxicity of PEA-NPs. Our results showed that various concentrations of nanoparticles did not cause significant cytotoxicity against cell lines at normal concentrations.

Radiotherapy Combined With Androgen Deprivation for Bone Oligometastases After Primary Curative Radiotherapy for Prostate Cancer: A Retrospective Study

To evaluate the effects and toxicity of radiotherapy (RT) combined with androgen deprivation (AD) for bone oligometastases after primary curative RT for prostate cancer (PCa).We retrospectively analyzed 30 consecutively treated PCa patients with bone oligometastases from April 2005 to July 2014. All patients underwent RT combined with AD for oligometastatic bones after curative RT for PCa. Measured outcomes included overall survival (OS) rate, local control (LC), progression-free survival (PFS), pain relief, and toxicities. Statistical analysis was performed with SPSS17.0.The median follow-up was 32.5 months (range, 0.6-50.3). The 3-year PFS and OS rates were 22.8% (95% CI, 13.4-37.5%) and 69% (95% CI, 51.7-81.1%), respectively. The number of bone oligometastases and RT schedule were found to be significantly associated with OS on univariate analysis (P < 0.05, respectively). The 3-year OS for patients with 1 and >1 metastases was 78.8% versus 42.2%, respectively (P = 0.037). The long-course RT was associated with better 3-year OS compared with short-course (76.4% vs 44.1%, P = 0.03). A total of 15 (83.3%, 15/18) patients achieved pain relief. No grade 3 toxicity was observed.Long-course RT combined with ADT was effective and well-tolerated in PCa patients with bone oligometastases after curative RT for PCa. Further randomized controlled trials are needed to corroborate the findings.

Solid-Liquid Self-Adaptive Polymeric Composite

A solid-liquid self-adaptive composite (SAC) is synthesized using a simple mixing-evaporation protocol, with poly(dimethylsiloxane) (PDMS) and poly(vinylidene fluoride) (PVDF) as active constituents. SAC exists as a porous solid containing a near equivalent distribution of the solid (PVDF)-liquid (PDMS) phases, with the liquid encapsulated and stabilized within a continuous solid network percolating throughout the structure. The pores, liquid, and solid phases form a complex hierarchical structure, which offers both mechanical robustness and a significant structural adaptability under external forces. SAC exhibits attractive self-healing properties during tension, and demonstrates reversible self-stiffening properties under compression with a maximum of 7-fold increase seen in the storage modulus. In a comparison to existing self-healing and self-stiffening materials, SAC offers distinct advantages in the ease of fabrication, high achievable storage modulus, and reversibility. Such materials could provide a new class of adaptive materials system with multifunctionality, tunability, and scale-up potentials.

Ultra-strong gel-spun ultra-high molecular weight polyethylene fibers filled with chitin nanocrystals

Ultra-high molecular weight polyethylene (UHMWPE)/chitin nanocrystals (CNC) and UHMWPE/acetylated chitin nanocrystals (ACNC) fibers were prepared.

Catalyst-controlled switch of regioselectivity in the asymmetric allylic alkylation of oxazolones with MBHCs

A catalyst-controlled switch of regioselectivity in asymmetric allylic alkylation of oxazolones with MBHCs was described.

Asymmetric dearomatization of phenols

This review summarizes the recent advances in the field of asymmetric dearomatization of phenols and their applications in the total synthesis of some complex natural products.

Chiral phosphoric acid catalyzed enantioselective 1,3-dipolar cycloaddition reaction of azlactones

The first chiral phosphoric acid catalyzed highly diastereo- and enantioselective 1,3-dipolar cycloaddition reaction of azlactones and methyleneindolinones was disclosed to yield 3,3′-pyrrolidonyl spirooxindole scaffolds.

High-dose chemotherapy combined with autologous peripheral blood stem cell transplantation in children with advanced malignant solid tumors: A retrospective analysis of 38 cases

The aim of the present study was to assess the toxicity and efficacy of autologous peripheral blood stem cell (APBSC) transplantation in children with advanced malignant solid tumors. The outcomes of 38 children with advanced malignant solid tumor, who were treated with high-dose chemotherapy and autologous peripheral blood stem cell transplantation in Beijing Tongren Hospital (Capital Medical University, Beijing, China) between September 2005 and November 2011, were retrospectively analyzed. The effects of treatment were evaluated according to the standard Bearman's criteria. The mean count of collected mononuclear cells and the cluster of differentiation 34⁺ cell count from 38 patients was 5.6±2.2×10⁸/kg and 3.8±2.6×10⁶/kg, respectively. From these 38 patients, the number of stem cells collected from 31 cases (81.6%) accorded with the transplantation standards. Three and 14 days after pretreatment in these 38 cases, there were 19 cases of grade I, 11 cases of grade II, five cases of grade III and three cases of grade IV (one case succumbed) adverse reaction. Following the treatment (23-40 days after pretreatment, during organ injury recovery), 37 cases obtained bone marrow reconstitution with a mean time of 12.3±3.1 days after APBSC reinfusion. The median survival time of the 37 patients was 49 months, and the survival rate at one, three and five years post-treatment was 91.9, 68.2 and 36.6%, respectively.

Local effects of human PCSK9 on the atherosclerotic lesion

Proprotein convertase subtilisin/kexin type 9 (PCSK9) promotes atherosclerosis by increasing low-density lipoprotein (LDL) cholesterol levels through degradation of hepatic LDL receptor (LDLR). Studies have described the systemic effects of PCSK9 on atherosclerosis, but whether PCSK9 has local and direct effects on the plaque is unknown. To study the local effect of human PCSK9 (hPCSK9) on atherosclerotic lesion composition, independently of changes in serum cholesterol levels, we generated chimeric mice expressing hPCSK9 exclusively from macrophages, using marrow from hPCSK9 transgenic (hPCSK9tg) mice transplanted into apoE(-/-) and LDLR(-/-) mice, which were then placed on a high-fat diet (HFD) for 8 weeks. We further characterized the effect of hPCSK9 expression on the inflammatory responses in the spleen and by mouse peritoneal macrophages (MPM) in vitro. We found that MPMs from transgenic mice express both murine (m) Pcsk9 and hPCSK9 and that the latter reduces macrophage LDLR and LRP1 surface levels. We detected hPCSK9 in the serum of mice transplanted with hPCSK9tg marrow, but did not influence lipid levels or atherosclerotic lesion size. However, marrow-derived PCSK9 progressively accumulated in lesions of apoE(-/-) recipient mice, while increasing the infiltration of Ly6C(hi) inflammatory monocytes by 32% compared with controls. Expression of hPCSK9 also increased CD11b- and Ly6C(hi) -positive cell numbers in spleens of apoE(-/-) mice. In vitro, expression of hPCSK9 in LPS-stimulated macrophages increased mRNA levels of the pro-inflammatory markers Tnf and Il1b (40% and 45%, respectively) and suppressed those of the anti-inflammatory markers Il10 and Arg1 (30% and 44%, respectively). All PCSK9 effects were LDLR-dependent, as PCSK9 protein was not detected in lesions of LDLR(-/-) recipient mice and did not affect macrophage or splenocyte inflammation. In conclusion, PCSK9 directly increases atherosclerotic lesion inflammation in an LDLR-dependent but cholesterol-independent mechanism, suggesting that therapeutic PCSK9 inhibition may have vascular benefits secondary to LDL reduction.

SERPINE1 rs1799768 polymorphism contributes to sepsis risk and mortality

INTRODUCTION

The present meta-analysis aimed to investigate whether there is an association between SERPINE1 rs1799768 polymorphism and sepsis risk and mortality.

MATERIALS AND METHODS

Published reports were searched in PubMed, PubMed Central, Gene, PubChem and Google Scholar. Odds ratios (ORs) and corresponding 95% confidence intervals (CIs) were assessed in a random-effects model.

RESULTS

The results of the overall meta-analysis indicated that an increased sepsis risk was evidently associated with SERPINE1 rs1799768 polymorphism (OR = 1.30; 95% CI 1.08-1.56; p = 0.006). When studies were stratified by ethnicity, no significant association was observed between SERPINE1 rs1799768 polymorphism and sepsis risk in the Asian group. As for the Caucasian population, overall OR was 1.24 (95% CI 1.02-1.51; p = 0.03). The results of the overall meta-analysis indicated that an increased sepsis mortality risk was evidently associated with SERPINE1 rs1799768 polymorphism (OR = 1.73; 95% CI 1.31-2.28; p < 0.0001). When studies were stratified by ethnicity, significant association was observed between SERPINE1 rs1799768 polymorphism and sepsis risk mortality in the Asian group and the Caucasian population.

CONCLUSIONS

In conclusion, the meta-analysis suggests that there are significant associations between SERPINE1 rs1799768 polymorphism and risk of sepsis and sepsis mortality.

Resveratrol attenuates the progress of liver fibrosis via the Akt/nuclear factor-κB pathways

Liver fibrosis is a wound-healing response to chronic liver injury that results in the accumulation of extracellular matrix proteins. It eventually leads to cirrhosis of the liver and liver failure, and it is a critical threat to the health and lives of patients with chronic liver diseases. No effective treatment is currently available. Resveratrol is a polyphenol with antioxidant, anti‑cancer and anti‑inflammatory properties. It has been reported that resveratrol prevents liver fibrosis, possibly by inhibiting NF‑κB activation. The present study investigated the mechanisms by which resveratrol prevented liver fibrosis, focusing on the possible involvement of the NF‑κB pathway. Mice with carbon tetrachloride (CCl4)‑induced liver fibrosis were treated with various concentrations of resveratrol. Serum levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST) and tumor necrosis factor (TNF)‑α were detected by ELISAs. Expression of α‑smooth muscle actin (α‑SMA), collagen I, inhibitor of NF‑κB (IκB) and NF‑κB were detected by western blot analysis. In addition, the present study examined the effects of resveratrol on the expression of fibrosis markers in LX‑2 cells. Western blot analysis was further used to detect the levels of Akt and phosphorylated Akt, as well as the nuclear levels of IκB, phosphorylated IκB and NF‑κB p65. The expression of α‑SMA in resveratrol‑treated LX‑2 cells was detected by immunofluorescence and flow cytometry, which demonstrated that resveratrol decreased the expression of α‑SMA in LX‑2 cells. Resveratrol also decreased CCl4‑induced upregulation of serum AST, ALT, TNF‑α, α‑SMA and collagen I. Finally, resveratrol prevented the activation of NF‑κB and Akt. The results of the present study therefore indicated that resveratrol attenuates liver fibrosis via the Akt/NF-κB pathways.

Comparison and improvement in primary airway fibroblast culture across different mammalian species

This study aims to establish rabbit, rat and human models of primary airway fibroblasts, improve existing culture methods of human, and provide alternatives to benign airway stenosis in vitro. We used conventional «tissue adherent method» to culture airway primary fibroblasts extracted from New Zealand rabbits, Sprague&mdash;Dawley (SD) rats and human subjects. To improve quality of this culture, we combined the «tissue adherent method» with « trypsinization", and compared the success rate of the two approaches. Cultures were examined using an inverted microscope, following hematoxylin&mdash;eosin and immunohistochemical staining. The different species were identified based on the total number of chromosomes. We successfully cultured primary airway fibroblasts isolated from three species. Human airway primary fibroblasts are more difficult to culture. The efficiency of culture is low, when using the «tissue adherent method». However, the rate of successful culture is improved when combined with the "trypsinization", and by using the «serum adherent, organizing tablet» technology. In conclusion, we demonstrate that primary airway fibroblasts from three mammalian species can be cultured successfully in vitro, for a reliable cellular model of benign airway stenosis. Culturing human primary airway fibroblasts is technically more challenging than the other two species. It is necessary to improve it.

Extravascular lung water monitoring of renal replacement therapy in lung water scavenging for septic acute kidney injury

This study aims to investigate the extravascular lung water index (EVLWI) in lung water scavenging of sepsis patients with acute kidney injury (AKI) by renal replacement therapy (RRT). 57 septic acute kidney injury patients with EVLWI > 7 ml/kg were selected and randomly divided into two groups: the treatment group with continued RRT for 24 h per day, the control group with RRT for ≤8 h per day. Fluid resuscitation and RRT were performed simultaneously. After fluid resuscitation, EVLWI, hemodynamics, oxygenation index, blood lactate, and intensive care unit (ICU) stay were determined. The values of EVLWI, pulmonary vascular permeability index (PVPI), and blood lactate decreased and the intrathoracic blood volume index (ITBVI) increased significantly at 24 h, 48 h and 72 h, after RRT, compared with those before RRT in the two groups (P < 0.05). The values of EVLWI at 48 h and 72 h after RRT in the treatment group were significantly lower than that in the control group (P < 0.05). The cardiac index (CI) at 48 h and 72 h after RRT in the treatment group was significantly higher than that before RRT (P < 0.05). The values of PVPI, ITBVI, CI, blood lactate, transcutaneous oxygen saturation pulse (SPO2), oxygenation index (PO2/FiO2) and arterial oxygen (PO2) before and 24 h, 48 h, and 72 h after RRT. The 28d mortality had no significant difference in the two groups (P > 0.05). The average ICU stay for the treatment group was significantly shorter than that of the control group (P < 0.05). EVLWI monitoring of septic patients with AKI in RRT time had clinical reference value.