Decellularized extracellular matrix (dECM) has been widely used as a scaffold for regenerative medicine due to its high biomimetic and excellent biocompatibility. As a functional polymer material with high water content and controlled fluidity, hydrogel is very promising for some minimally invasive surgery in clinical practice. In recent years, with the rapid development of hydrogel theory and technology, dECM hydrogel has gradually become a research hotspot in the field of regenerative medicine. In this paper, the related researches in recent years are reviewed regarding the preparation of dECM hydrogel and its preclinical application. The future clinical use is also prospected.
ObjectiveTo investigate the positive rates of virulence genes ply, lytA and nanA in Streptococcus pneumoniae (SP) strains isolated from different sources and the pathogenesis.MethodsA total of 147 and 24 strains of SP were isolated from sputum and blood samples of hospitalized children in Tongji Hospital of Wuhan from 2015 to 2016, respectively. Such strains of SP were analyzed by automated microbial analyzer VITEK Compact-2 and confirmed by its specific gene pbp2B using regular polymerase chain reaction (PCR) method. Then PCR method was used to detect the carriers of the virulence genes ply, lytA and nanA, and calculated the fatality and hospitalization days of patients.ResultsPositive rates of virulence genes ply, lytA and nanA were 95.9%, 96.6% and 88.4% respectively for 147 strains isolated from sputum, and were 100.0%, 100.0% and 79.2% respectively for those from blood. Between the 147 children with pneumonia and 24 children with septicemia, there was no statistically significant difference in fatality [ 8.3% (2/24) vs. 0.7% (1/147), P=0.052], but there was a significant difference in length of hospital stay [(14.2±2.4) vs. (6.4±1.5) d; t=21.303, P<0.001].ConclusionsThe positive rate of SP virulence gene nanA is lower than those of ply and lytA. The positive rates of SP virulence genes ply, lytA and nanA are similar from different sources. Significant difference may be found for hospitalization days among different types of SP infections.
ObjectiveTo explore value of ultrasound real-time elastography (RTE) technology for identification of benign and malignant solid thyroid nodules.MethodsA retrospective analysis was performed on 125 patients with thyroid nodules who underwent ultrasound RTE in this hospital from February 2018 to August 2019. All patients underwent RTE on the basis of conventional ultrasound. The ultrasound elasticity contrast index (ECI) was used as the evaluation index and the pathological examination result was used as the gold standard. The receiver operating characteristic (ROC) curve analysis was used to evaluate the value of ECI in the identification of benign and malignant solid thyroid nodules. Logistic regression analysis was used to analyze the influencing factors of ECI.ResultsAmong the 125 patients with solid thyroid nodules, 51 were malignant nodules, 74 were benign nodules. The ECI value of patients with benign thyroid nodules was lower than that of patients with malignant nodules (2.71±0.83 versus 3.42±1.14, t=–4.030, P<0.001). The result of ROC analysis showed that the cutoff value of ECI to distinguish benign and malignant solid thyroid nodules was 3.07, area under curve of ROC was 0.806 [95%CI (0.717, 0.894), P<0.001], sensitivity was 80.3%, specificity was 70.4%. The multivariate logistic regression analysis showed that the thyroid nodules with diffuse lesions, calcification, and maximum nodule diameter ≥1 cm were the risk factors for elevated ECI values (P<0.05). For the solid thyroid nodules without diffuse lesions, without calcification, and maximum nodule diameter <1 cm, ECI had the higher sensitivity, specificity, accuracy, and positive predictive value for the differential diagnosis of benign and malignant thyroid nodules (all exceed 80%), but these indexes were lower (under 60%) for the differential diagnosis of solid thyroid nodules with diffuse diseases, with calcification, and maximum nodule diameter ≥1 cm.ConclusionsECI obtained by ultrasound RTE can be used to differentiate solid thyroid nodules from benign ones. The presence or absence of diffuse lesions, calcification, and maximum nodule diameter are the influencing factors for ECI to differentiate solid thyroid nodules. In clinical diagnosis, it should be paid attention to the comprehensive analysis of the above factors.
Objective To investigate the diagnostic efficacy of silkworm larvae plasma (SLP) colorimetry in the accurate diagnosis of periprosthetic joint infection (PJI). Methods Ninety healthy male New Zealand white rabbits were used for knee arthroplasty with Swanson prosthesis. Then they were randomly divided into 3 groups according to different pathogenic bacteria: group A (Staphylococcus aureus group), group B (Staphylococcus epidermidis group) and group C (Escherichia coli group), with 30 rats in each group. The PJI model was prepared by knee injection with 1 mL of pathogenic bacteria of different concentrations. Samples were taken before inoculation and at 7, 14, and 21 days after inoculation, and based on the 2018 PJI Philadelphia International Consensus diagnostic criteria, the success rate of modeling among 3 groups of experimental animals was determined. The sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic efficiency of SLP colorimetry were calculated. Results At 21 days after inoculation, 26, 18, and 23 rabbits in groups A, B, and C were diagnosed as infection, respectively. The success rates of modeling were 86.7%, 60.0%, and 76.7%, respectively, showing no significant difference among the 3 groups (χ2=5.724, P=0.073). The results of PJI colorimetry showed that 1 false-positive animal (specificity 75.0%) appeared in group A at 7 days, and the specificity of SLP increased to 100.0% over time (on 14 and 21 days); on 14 and 21 days, another animal appeared false-negative results (sensitivity decreased from 100.0% to 96.2%). One false-positive animal appeared in group B at 7 days (specificity 91.7%), the specificity returned to 100.0% over time; 1 and 4 false-negative animals appeared at 14 and 21 days, respectively (sensitivity 94.4% and 83.3%, respectively). In group C, two false-positive animals (specificity 71.4%) were found at 7 days, and then returned to 100.0%. The diagnostic efficiency of groups A and C was very high at 21 days (96.7% and 100.0%), even for the low virulence Staphylococcus epidermidis in group B, the diagnostic efficiency could be maintained at 90.0% (21 days), and the overall diagnostic efficiency was very good (95.6%). Conclusion SLP colorimetry has high sensitivity, specificity, and diagnostic efficiency in the diagnosis of PJI, which is a potential diagnostic method.
In recent years, wearable devices grew up gradually and developed increasingly. Aiming at the problems of skin sensibility and the change of electrode impedance of Ag/AgCl electrode in the process of long-term electrocardiogram (ECG) signal monitoring and acquisition, this paper discussed in detail a new sensor technology–fabric electrode, which is used for ECG signal acquisition. First, the concept and advantages of fabric electrode were introduced, and then the common substrate materials and conductive materials for fabric electrode were discussed and evaluated. Next, we analyzed the advantages and disadvantages from the aspect of textile structure, putting forward the evaluation system of fabric electrode. Finally, the deficiencies of fabric electrode were analyzed, and the development prospects and directions were prospected.
The human spine injury and various lumbar spine diseases caused by vibration have attracted extensive attention at home and abroad. To explore the biomechanical characteristics of different approaches for lumbar interbody fusion surgery combined with an interspinous internal fixator, device for intervertebral assisted motion (DIAM), finite element models of anterior lumbar interbody fusion (ALIF), transforaminal lumbar interbody fusion (TLIF) and lateral lumbar interbody fusion (LLIF) are created by simulating clinical operation based on a three-dimensional finite element model of normal human whole lumbar spine. The fusion level is at L4–L5, and the DIAM is implanted between spinous process of L4 and L5. Transient dynamic analysis is conducted on the ALIF, TLIF and LLIF models, respectively, to compute and compare their stress responses to an axial cyclic load. The results show that compared with those in ALIF and TILF models, contact forces between endplate and cage are higher in LLIF model, where the von-Mises stress in endplate and DIAM is lower. This implies that the LLIF have a better biomechanical performance under vibration. After bony fusion between vertebrae, the endplate and DIAM stresses for all the three surgical models are decreased. It is expected that this study can provide references for selection of surgical approaches in the fusion surgery and vibration protection for the postsurgical lumbar spine.
Cartilage with limited self-repairing ability is a kind of tissue with relatively hypocellular structure, low nerve distribution and vascular nutrient. Cartilage tissue engineering provides a new therapeutic idea for cartilage injured cartilage repairing in clinical practice. Electrospinning fibrous scaffold with three-dimensional structure like extracellular matrix is suitable for cell growth and bioactive factor loading for cartilage tissue engineering. This paper introduces studies of the application of electrospinning technology in repairing damaged cartilage by simulating highly hierarchical structures and mechanical features from the aspects of composition optimization, structure optimization and multi-technology combination.
Objective To investigate the correlation between RUNX3 expression and human gastric cancer, as well as its clinically pathologic features. Methods Such databases as PubMed, EMbase, VIP, WanFang Data and CBM were searched from their inception to February 28th, 2013 to collect case-control studies about the correlation between RUNX3 expression and human gastric cancer, as well as its clinically pathologic features, and the relevant references of the included literature were also retrieved. Two reviewers independently screened the literature according to the inclusion and exclusion criteria, extracted the data, and assessed the methodological quality. Then meta-analysis was conducted using RevMan 5.0 software. Results A total of 6 case-control studies were included, which included 405 cases in the gastric cancer group and 185 cases in the normal gastric mucosa group. The results of meta-analysis showed that, RUNX3 expression was lower in the gastric cancer group than the normal gastric mucosa group, with a significant difference (OR=0.07, 95%CI 0.04 to 0.12, Plt;0.000 01); it was also lower in the subgroup of gastric cancer accompanied with lymph node metastasis than that without lymph node metastasis (OR=0.37, 95%CI 0.23 to 0.61, Plt;0.000 1); but it was higher in the subgroup of gastric cancer that had infiltrated into serosa than that had not, with a significant difference (OR=3.92, 95%CI 2.29 to 6.71, Plt;0.000 01); and it was also higher in the subgroup of well differentiated gastric cancer that the moderately and poorly differentiated, with a significant difference (OR=0.36, 95%CI 0.22 to 0.58, Plt;0.000 1). Conclusion RUNX3 expression is notably correlated to gastric cancer and its clinically pathologic features. For the quantity and quality limitation of the included studies, this conclusion still needs to be further proved by performing more high quality studies.
Objective To investigate the quality of randomized controlled trials (RCTs) involving Danhong Injection for angina of coronary heart disease, and to provide references for improving the quality of clinical research on Chinese medicine (CM) injection. Methods The RCTs published from 2002 to July 2010 about Danhong Injection for angina of coronary heart disease were searched. The methodological quality of the literatures was evaluated according to the methods recommended by the Cochrane Collaboration, and the reporting quality was assessed by means of the Jadad scale and the CONSORT checklist. Results A total of 104 RCTs were included. The assessment result of Jadad scale showed: nine RCTs (8.7%) scored two, 87 (83.6%) scored one, and the other 8 (7.7%) scored zero. According to the standard of CONSORT, only 1 RCT (0.96%) described the random method; no literatures explained how to execute randomization and use placebo control; 3 RCTs (2.9%) reported endpoint outcome; 1 (0.96%) RCT performed single blind; 2 (1.9%) RCTs performed double blind; 54 (51%) RCTs calculated statistic values; 5 (4.8%) RCTs reported follow-up; no RCT reported equivalent results or negative results; 74 (71.2%) RCTs reported adverse events; no RCTs conducted sample size estimation, intention-to-treat analyses and stratified analyses; no RCTs were multicenter trials; and no RCTs recorded the accreditation and the informed consent. Conclusion The quality of RCTs about Danhong Injection for angina of coronary heart disease is still low in methodological aspects such as randomization, estimation of sample size, statistic methods, reporting of follow-up and non-follow-up, and adverse reactions, which has influences on the real evaluation of the effect of Danhong Inection. It is suggested that the future RCTs on CM injection should be conducted with references of CONSORT statement, that a clinical mode of integration of disease and syndrome should be applied according to the treatment theory based on syndrome differentiation, and that more attention should be paid to the clinical observation on adverse reactions of CM injection, so as to be helpful for safe medication and patients’ right protection.
ObjectiveTo bioinformatically analyze the gene chip data of chondrocytes from osteoarthritis patients from the Gene Expression Omnibus (GEO) database, and explore the molecular mechanisms of osteoarthritis.MethodsWe searched the GEO database (up to April 23rd, 2021) for data of chondrocytes and gene expression profiling in human knee osteoarthritis via the key words of “osteoarthritis OR cartilage OR chondrocyte*”. Then, we selected the samples by our inclusion criteria. The data were normalized before analysis. After differentially expressed genes were identified, Gene Ontology, Kyoto Encyclopedia of Genes and Genomes, Search Tool for the Retrival of Interacting Genes/Proteinsm, R language, Perl language, Cytoscape software, and DAVID database were used to perform differentially expressed gene analysis, functional annotation, and enrichment analysis.ResultsThe differentially expressed genes were mostly enriched in cell components and some extracellular regions, which participated in cell division, mitosis, cell proliferation and inflammatory response mainly via the regulation of protein kinase activity. The differentially expressed genes were mainly involved in the cell proliferation signaling pathway, mitogen-activated protein kinase signaling pathway, oocyte meiosis, cell cycle and so on.ConclusionsMultiple signaling pathways are involved in the changes of chondrocytes in human knee osteoarthritis, mainly about cell cycle and protein metabolism genes/pathways. Inflammatory factors and cytokines may be the most important links in the pathogenesis of osteoarthritis.