The histopathological effects of reabsorbable polyethylene glycol hydrogel (Coseal) on epidural fibrosis in an experimental postlaminectomy model in rats

Background/aimTo investigate the histopathological effects of reabsorbable polyethylene glycol hydrogel (RPGH, Coseal) on epidural fibrosis (EF) following laminectomy in rats.Materials and methodsA total of 24 rats were equally divided into three groups. In the first group, no treatment was applied after laminectomy (control group, Group 1). In the second group, hemostasis was achieved after laminectomy, and 2 mm absorbable gelatin sponge soaked in saline was placed over the epidural space and the wound was closed (Group 2). In the third group, hemostasis was achieved following laminectomy, and 0.5 mL RPGH (Coseal, Group 3) was squeezed over the dura mater, and the wound was closed. A histopathological examination was undertaken to evaluate arachnoidal invasion and EF.ResultsThe results of EF in the Group 2 and Group 3 were significantly lower compared to the Group 1 (p = 0.023 and p = 0.002, respectively). No statistically significant difference was found between the Group 2 and Group 3 in terms of EF (p = 0.957). There was also no statistically significant difference between the mean arachnoidal invasion of the three groups (p > 0.171). However, the rate of arachnoidal invasion was the lowest in the Group 3.ConclusionIntraoperative Coseal, a polyethylene glycol polymer, tends to reduce the risk of epidural fibrosis, although this is not statistically significant.     

椎板切除模型大鼠局部应用绿原酸对硬膜外纤维化及硬脑膜粘连的影响

背景：椎板切除减压能起到有效的脊髓神经减压作用,但该操作也会发生硬膜外纤维增生并突入椎管,致医源性椎管狭窄,发生持续或复发的腰腿疼痛。绿原酸是金银花的有效药理成分之一,主要有抗炎等作用。 目的：观察局部应用绿原酸对椎板切除模型大鼠硬膜外纤维化及硬脑膜粘连的影响。 方法：选用72只健康成年Wistar大白鼠,制备椎板切除模型,随机分成3组(n=24)。绿原酸组皮肤缝合前椎板切除区域给绿原酸溶液2 mL/只;生理盐水组给予等量的生理盐水;空白对照组术后不做任何处理。各组大鼠均于造模后4周被处死,进行实验评估,包括大体评价、组织学分析、羟脯氨酸含量测定及白细胞介素6、转化生长因子β1的表达情况。 结果与结论：3组大白鼠均进入结果分析,解剖并取样。绿原酸组硬膜外胶原纤维增生较少,外观较为正常;生理盐水组和空白对照组硬膜外胶原纤维明显增多,外观可见明显纤维瘢痕组织。组织学评价显示,绿原酸组的组织染色切片中成纤维细胞的密度明显比其他两组的成纤维细胞密度低。绿原酸组硬膜外纤维瘢痕的羟脯氨酸含量显著低于生理盐水组和空白对照组(P < 0.01)。通过RT-PCR方法测得绿原酸组白细胞介素6 和转化生长因子β1的表达低于另外两组。提示椎板切除模型大鼠局部应用绿原酸可以抑制成纤维细胞增殖,同时可以降低白细胞介素6 和转化生长因子β1的表达,防止硬膜外瘢痕粘连。 中国组织工程研究杂志出版内容重点：肾移植;肝移植;移植;心脏移植;组织移植;皮肤移植;皮瓣移植;血管移植;器官移植;组织工程全文链接：     

羊膜预防硬膜外粘连的初步研究

目的：观察羊膜预防椎板切除术后硬膜外粘连的作用，寻求预防硬膜外粘连的有效材料和方法。方法：制备椎板切除模型兔60只，依术前随机分组，分别在硬膜外覆盖羊膜（AM组）、几丁糖膜（CHS组）、空白对照组不做任何覆盖（CON组）。于术后2、4、8、12周每组分别处死5只动物，对标本做大体解剖及组织学观察。结果：CON组暴露的硬膜发生广泛粘连，硬膜外腔几乎消失；AM组和CHS组硬膜外瘢痕稀少，硬膜表面光滑，硬膜外形成潜在腔隙，维持了硬膜外的有效空间：不同时间段三组间粘连度评分以AM组最低，CHS组次之，CON组最高，组间比较有显著性差异（P〈0．05）。结论：羊膜能预防硬膜外瘢痕向椎管内延伸，防止硬膜外粘连，是一种能有效预防硬膜外粘连的生物相容性材料；几丁糖膜亦显示了一定的预防硬膜外粘连作用。     

The influence of intrinsic coagulation pathway on blood platelets activation by oxidized cellulose

Oxidized cellulose is an effective hemostat that works naturally to aid in blood coagulation. The mechanism of its action is not very well understood. Little effect on blood coagulation, but a pronounce decrease in platelet count has been reported upon the addition of the oxidized cellulose to the whole blood. As a marker of platelet activation and aggregation we used serotonin release reaction and turbidity changes in time. We found that oxidized cellulose did not activate washed platelets reconstituted in plasma-free medium or plasma-free medium with fibrinogen; no reduction of platelet count was observed. Serotonin release in platelet-rich plasma incubated with oxidized cellulose started in the range from 5 to 10 min. Serotonin release from platelets reconstituted in plasma deficient in either coagulation factor V, VIII, IX, or XII was delayed. Blood platelets activation by oxidized cellulose requires calcium ions present in dispersion of oxidized cellulose. Factor XIII deficiency had no influence on blood platelets activation by oxidized cellulose. Our results clearly indicate the significance of intrinsic coagulation pathway activation on blood platelets activation by oxidized cellulose and so indirectly on the hemostyptic effect of oxidized cellulose.     

Micro-CT联合硬膜外造影在医用自交联透明质酸钠凝胶预防椎板切除后硬膜外粘连中的应用

背景：二维平面角度已证实医用自交联透明质酸钠凝胶能够在术后8周有效预防兔椎板切除后硬膜外粘连的发生。 目的：应用Micro-CT联合硬膜外造影技术观察和评估自交联透明质酸钠凝胶预防椎板切除后硬膜外粘连的可行性。 方法：将18只L₅椎板全切除的新西兰大白兔随机分组：对照组用生理盐水冲洗术区后关闭切口;HyaRegen/SPⅠ组用医用自交联透明质酸钠凝胶HyaRegen/SPⅠ 0.5 mL覆盖暴露硬脊膜后关闭切口;HyaRegen/SPⅡ组用医用自交联透明质酸钠凝胶HyaRegen/SPⅡ 0.5 mL覆盖暴露硬脊膜后关闭切口。 结果与结论：各组体感诱发电位潜伏期均无明显延长,3组间差异无显著性意义(P > 0.05)。Micro-CT联合硬膜外造影扫描并三维重建后显示,HyaRegen/SPⅠ组及HyaRegen/SPⅡ组对比剂能够顺利充盈硬膜外间隙,对照组对比剂充盈不顺畅,在术区局部形成多处充盈缺损。HyaRegen/SPⅠ组及HyaRegen/SPⅡ组术区硬脊膜外单位体积内对比剂充盈体积均高于对照组(P < 0.05),前2组间差异无显著性意义(P > 0.05)。对照组硬膜外粘连程度要远高于HyaRegen/SPⅠ组及HyaRegen/SPⅡ组(P < 0.05)。证实医用自交联透明质酸钠凝胶可有效预防兔椎板切除后硬膜外粘连的发生,应用Micro-CT联合硬膜外造影技术能有效观察和评估硬膜外粘连。     

The role of anakinra in the modulation of intestinal cell apoptosis and inflammatory response during ischemia/reperfusion

Background/aim Even though interleukin-1 receptor antagonist, IL-1Ra, is used in certain inflammatory diseases, its effect on ischemia-reperfusion injury is a current research topic. We aimed to investigate the protective effects of anakinra, an IL-1Ra, on the I/R induced intestinal injury.Materials and methods The rat model of intestinal ischemia-reperfusion was induced. Rats were randomized into 4 groups: (group 1) control group, (group 2) I/R group, (group 3 and 4) treatment groups (50 mg/kg and 100 mg/kg, respectively). Gene expressions of caspase-3, TNF-α, IL-1α, IL-6, and apoptotic cells in tissue samples were evaluated by PCR and TUNEL methods, respectively. Plasma levels of superoxide dismutase (SOD), catalase (CAT), and malondialdehyde (MDA) were studied by the ELISA method and tissue samples were examined histopathologically as well.Results Anakinra inhibited the expression of IL-1α, IL-6, and TNF-α and decreased the SOD, CAT, and MDA caused by ischemia-reperfusion injury in both treatment groups. Caspase-3 expression and TUNEL-positive cell number in treatment groups were also less. Histopathologically, anakinra better preserved the villous structure of the small intestine at a dose of 100 mg/kg than 50 mg/kg. Conclusion Anakinra decreased the intestinal damage caused by ischemia-reperfusion and a dose of 100 mg/kg was found to be histopathologically more effective.     

高龄全膝关节置换中全麻和硬膜外麻醉对凝血功能的影响

背景：在行全膝关节置换的高龄患者围手术期,维持正常的凝血功能至关重要。但多种因素会对患者的围手术期凝血功能产生影响,其中麻醉是一重要的因素。不同的麻醉方式会对患者的凝血功能产生不同的影响,临床需要积极的选择适当的麻醉方式以维持稳定的凝血功能。 目的：观察全麻和硬膜外麻醉在高龄全膝关节置换中的应用及对患者凝血功能的影响。 方法：回顾性分析山东省立集团东营医院2012年9月至2013年9月收治的135例行全膝关节置换高龄患者的临床资料,按照麻醉方式分为两组,对照组67例给予全身麻醉,观察组68例给予硬膜外麻醉。观察两组患者麻醉前、麻醉后6 h、置换后第1天清晨的凝血指标和D-二聚体水平变化,随访12个月检测两组深静脉血栓发生情况,并进行比较。 结果与结论：经统计和比较,两组患者在不同时间点的凝血功能各项指标差异均无显著性意义(P均 > 0.05);但两组患者的D-二聚体水平在麻醉后6 h以及置换后第1天清晨差异有显著性意义,观察组显著低于对照组(P均< 0.05);观察组和对照组的置换后深静脉血栓发生率分别为3%和21%,差异有显著性意义(P < 0.05)。表明在高龄全膝关节置换中对患者实施硬膜外麻醉可以获得更好的应用效果,维持稳定的凝血功能状态。中国组织工程研究杂志出版内容重点：人工关节;骨植入物;脊柱;骨折;内固定;数字化骨科;组织工程     

再生氧化纤维素在严重骨质疏松体外循环手术胸骨止血中的作用

背景：严重骨质疏松患者正中开胸胸骨出血较多,尤其是体外循环下手术存在凝血功能障碍,更加重了术中及术后出血。 目的：与常规胸骨止血材料骨蜡对比,观察再生氧化纤维素在减少严重骨质疏松患者体外循环术后胸骨出血和预防胸骨切口感染中的作用。 方法：84例行正中开胸体外循环心脏手术的严重骨质疏松患者,随机分成2组。再生氧化纤维素组胸骨创面及骨髓腔内填充覆盖再生氧化纤维素,对照组常规应用医用骨蜡。记录两组术后1 d引流量、总引流量、拔引流管时间、总输血量、切口拆线时间、术后持续发热时间、平均住院时间及术后胸骨切口愈合情况,出院随访6个月。 结果与结论：两组术后1 d引流量、总引流量、拔引流管时间、总输血量及平均住院时间差异有显著性意义(P < 0.05),再生氧化纤维素组更有优势。随访6个月中,再生氧化纤维素组未出现胸骨切口排出异物情况,对照组中有4例出现骨蜡排出。提示再生氧化纤维素可应用于严重骨质疏松患者体外循环后胸骨止血,近远期疗效确切,并在胸骨感染方面具有一定预防作用。     

医用自交联透明质酸钠凝胶预防兔腰椎板切除术后硬膜外粘连的实验研究

目的:通过大体观察、组织学观察及羟脯氨酸浓度分析,评估两种医用自交联透明质酸钠凝胶——HyaRegen/SPI和HyaRegen/SPII预防椎板切除术后硬膜外粘连的效果.方法:将Ls全椎板切除的新西兰兔36只随机分为3组(n=12).A组为对照组,术区生理盐水冲洗后关闭切口;B组和C组为实验组,分别在暴露出的硬膜外覆盖HyaRegen/SPI 0.5 ml和HyaRegen/SPII 0.5 ml后关闭切口.所有动物术后8周予以安乐死,完整切下脊柱节段(L4～6)进行如下评估.①对硬膜外粘连程度进行大体观察,并根据Rydell标准进行分级;②对标本进行组织学观察和评估;③取术区硬膜外背侧少量瘢痕组织行羟脯氨酸浓度分析.结果:大体观察发现,A组硬膜外粘连严重、无法完整分离,而B组及C组未见明显粘连,A组的粘连程度Rydell分级要远高于B组和C组(P＜0.05);组织学观察发现3组均在原椎扳切除术区形成大量新生骨,不同的是A组新生骨下可见广泛而致密的硬膜外粘连,脊髓向背侧牵拉,硬膜外间隙消失,而B组和C组新生骨下可见极少量瘢痕组织,硬脊膜表面光滑,未与周围组织形成粘连,硬膜外间隙存在,进行组织学评级后发现B组和C组之间差异无统计学意义(P＞0.05),分别与A组比较,差异均有统计学意义(P＜0.05);羟脯氨酸浓度分析结果显示B组、C组瘢痕组织中羟脯氨酸浓度要明显低于A组(P＜0.05).结论:两种医用自交联透明质酸钠凝胶(HyaRegen/SPI和HyaRegen/SPII)均能够在术后8周有效预防新西兰兔椎板切除术后硬膜外粘连的发生.     

医用自交联透明质酸钠凝胶预防兔硬膜外粘连的安全性研究

目的利用体感诱发电位及运动功能评分,评价医用自交联透明质酸钠凝胶预防椎板切除术后硬膜外粘连的安全性。方法将L5全椎板切除的新西兰兔24只随机分为4组,A组为对照组:术区生理盐水冲洗后关闭切口;B组、C组、D组均为实验组:均在术区硬脊膜暴露区覆盖医用自交联透明质酸钠凝胶,而覆盖剂量各不相同,分别为0.5、0.75和1.0ml。分别于麻醉后,椎板切除术后,闭合手术切口之后,术后8周这4个时间点进行体感诱发电位监测并记录潜伏期值。并分别于术前,术后1d,术后8周对各组动物进行后肢运动功能评分。结果麻醉后和椎板切除术后各组潜伏期值无统计学差异(P0.05)。在关闭切口后测定各组的潜伏期值显示:A组和B组潜伏期值均无延迟(P0.05),C组和D组潜伏期值出现明显延迟(P0.05)。在术后8周复测各组潜伏期值,均处于正常范围(P0.05)。运动功能评分结果:术前所有动物评分均正常。在术后1d,A组和B组动物的评分仍然正常,C组和D组的动物评分下降。在术后8周,各组动物的运动功能评分均再次正常。结论体感诱发电位是测定脊髓损伤的敏感指标;椎板切除术后局部覆盖预防粘连剂有剂量的要求,0.5ml的医用自交联透明质酸钠凝胶不会对该动物模型的脊髓的电生理功能及后肢运动功能产生影响。     

Bipolar plasma vaporization using plasma-cutting and plasma-loop electrodes versus cold-knife transurethral incision for the treatment of posterior urethral stricture: a prospective,randomized study

OBJECTIVE:Evaluate the efficiency and safety of bipolar plasma vaporization using plasma-cutting and plasma-loop electrodes for the treatment of posterior urethral stricture. Compare the outcomes following bipolar plasma vaporization with conventional cold-knife urethrotomy.METHODS:A randomized trial was performed to compare patient outcomes from the bipolar and cold-knife groups. All patients were assessed at 6 and 12 months postoperatively via urethrography and uroflowmetry. At the end of the first postoperative year, ureteroscopy was performed to evaluate the efficacy of the procedure. The mean follow-up time was 13.9 months (range: 12 to 21 months). If re-stenosis was not identified by both urethrography and ureteroscopy, the procedure was considered “successful”.RESULTS:Fifty-three male patients with posterior urethral strictures were selected and randomly divided into two groups: bipolar group (n=27) or cold-knife group (n=26). Patients in the bipolar group experienced a shorter operative time compared to the cold-knife group (23.45±7.64 hours vs 33.45±5.45 hours, respectively). The 12-month postoperative Qmax was faster in the bipolar group than in the cold-knife group (15.54±2.78 ml/sec vs 18.25±2.12 ml/sec, respectively). In the bipolar group, the recurrence-free rate was 81.5% at a mean follow-up time of 13.9 months. In the cold-knife group, the recurrence-free rate was 53.8%.CONCLUSIONS:The application of bipolar plasma-cutting and plasma-loop electrodes for the management of urethral stricture disease is a safe and reliable method that minimizes the morbidity of urethral stricture resection. The advantages include a lower recurrence rate and shorter operative time compared to the cold-knife technique.     

Effects of regular whey protein consumption on rat thyroid functions

Background/aimWe aimed to investigate whether there was a significant difference in TSH, T3, T4 values and histopathologically evaluated thyroid tissues between rats that received ısole hydrolyzed whey protein (IHWP) at different doses regularly and rats fed with only standard feed.Material & methodsTotal 24 rats were randomly divided into three groups with 8 rats in each group. First group were fed with standard feed for 12 weeks. Second group were given standard feed + daily 0.3 g/kg IHWP and rats in the third group standard feed + 0.5 g/kg IHWP for 12 weeks. Blood samples were collected from all rats before and after IHWP administration. All rats were then sacrificed, and thyroid tissues were histopathologically examined.ResultsInterfollicular connective tissue areas and TSH (0.35–4.90 µIU/L) were higher in the control group compared to 3 cc IHWP and 5 cc IHWP groups, while thyroid hormone T4 (0.7–1.48 ng/dL), and thyroid hormone synthesis parameters including intrafollicular colloid amount, follicular diameter, and epithelial height were significantly higher in 3 cc and 5 cc IHWP groups compared to the control.ConclusionWe think that regular daily use of IHWP may increase the synthesis of thyroid hormone due to its high amino acid content.     

Evaluation of hemostatic changes using thromboelastography after crystalloid or colloid fluid administration during major orthopedic surgery

The effects of Ringer lactate, 6% hydroxyethyl starch (130/0.4) or 4% succinylated gelatin solutions on perioperative coagulability were measured by thromboelastography (TEG). Seventy-five patients (ASA I-III) who were to undergo major orthopedic procedures performed under epidural anesthesia were included in the study. Patients were randomly divided into three groups of 25 each for the administration of maintenance fluids: group RL (Ringer lactate), group HES (6% hydroxyethyl starch 130/0.4), and group JEL (4% gelofusine solution). Blood samples were obtained during the perioperative period before epidural anesthesia (t1, baseline), at the end of the surgery (t2), and 24 h after the operation (t3). TEG data, reaction time (R), coagulation time (K), angle value (α), and maximum amplitude (MA) were recorded. TEG parameters changed from normal values in all patients. In group RL, R and K times decreased compared to perioperative values while the α angle and MA increased (P < 0.05). In group HES, R and K times increased, however, the α angle and MA decreased (P < 0.05). In group JEL, R time increased (P < 0.05), but K time, α angle and MA did not change significantly. In the present study, RL, 6% HES (130/0.4) and 4% JEL solutions caused changes in the coagulation system of all patients as measured by TEG, but these changes remained within normal limits.     

应用姜黄素预防大鼠椎板切除术后硬膜外粘连的实验研究

目的观察局部应用姜黄素预防椎板切除术后硬膜外粘连的效果。方法 36只SD大鼠随机分为3组,切除L1或L2椎板。术中各组分别以胶原蛋白海绵姜黄素（C组）、胶原蛋白海绵（B组）置于裸露的硬脊膜后,空白对照组（A组）不作治疗。术后第4周处死动物取材,分别作肉眼观察、羟脯氨酸（Hydroxyproline HOP）含量测定、胶原组织面积测定及成纤维细胞记数。结果 A组标本硬膜外瘢痕组织致密,与硬脊膜形成紧密粘连。C组无明显硬膜外粘连,HOP含量、胶原组织面积及成纤维细胞记数显著减少。B组HOP含量、胶原组织面积及成纤维细胞记数不同程度的减少,但不能避免硬膜外粘连的形成。结论局部应用姜黄素能够有效减少硬膜外瘢痕组织增生,避免椎板切除术后硬膜外瘢痕粘连。     

Plasma levels of soluble TGF β receptor type III: no apparent promise as a marker in acute pancreatitis

AimTo assess the potential of the soluble transforming growth factor β receptor type III (sTGFβrIII), a key regulator in TGFβ signaling, as a biomarker for diagnosis and stratification of patients with acute pancreatitis (AP).MethodsIn this small prospective pilot study, patients’ (N = 22) plasma samples were obtained at three time points: the first and fourth day of hospitalization and the day of hospital discharge. Healthy controls’ plasma (N = 25) was obtained at a single time point. Concentration of sTGFβrIII in plasma was determined by ELISA. Data were analyzed by fitting linear or linear mixed models.ResultsPlasma sTGFβrIII levels at presentation (day 1) were similar in AP patients and healthy participants, irrespectively of the disease severity. sTGFβrIII levels in patients were constant during hospital stay.ConclusionThese observations do not support further evaluation of plasma sTGFβrIII levels in this setting, but do not exclude a potential biological role of TGFβ and membrane-bound TGFβrIII in AP pathophysiology.

Acute pancreatitis (AP) is an inflammatory condition of the pancreas most commonly caused by bile stones or excessive alcohol use (1). It has a wide spectrum of presentations – from mild (most commonly) to life threatening – and may trigger a systemic inflammatory response that could lead to organ dysfunction. An accurate and timely diagnosis and risk stratification are critical for treatment and the optimization of follow-up. This might be of a particular interest in initially milder-to-moderate forms of the disease that could deteriorate over subsequent days (2). Risk stratification in AP is an ongoing challenge considering the limitations of current prognostic scores, which are predominantly based on clinical and radiological findings. Although certain biochemical indicators are essential for diagnosis (serum amylase and lipase), they are without or of limited predictive value (C-reactive protein [CRP], procalcitonin) (2,3). Some cytokines found in plasma, such as interleukin 6 or 8, show promise in severity discrimination, however, they are not routinely used in clinical practice for this indication (4,5).Transforming growth factor β (TGF β) is a pleiotropic cytokine involved in the regulation of vital cellular processes (eg, maturation and differentiation; cell homeostasis and/or death) (6) as well as in the pathophysiology of malignant diseases, inflammation, and autoimmunity (7-9). TGFβ mediates its signaling mainly through TGFβ receptor type III (TGFβrIII), a homodimeric co-receptor that facilitates signal transduction by promoting ligands to the type II TGFβ receptor without intrinsic kinase activity (6,8). Unlike other TGFβ receptors, it is abundantly expressed on almost every human cell type (8,10). TGFβrIII generates, possibly via ectodomain shedding, a soluble form of the receptor (sTGFβrIII) (11-13), a potent TGFβ neutralizing agent with a confirmed presence in plasma (14-17). The connection between TGF-β and inflammation is a complex one (6,18). It seemingly involves TGFβrIII, and might be context-dependent, similarly to the role of TGF-β in cancer formation and progression (16,19-22). Generally, TGFβ is a strong anti-inflammatory cytokine. Disruption of its signaling results in an increased T-cell response (23), and TGFβrIII has been implicated in Th 17 lymphocyte (CD4+ and CD8+) activation (20,24). In relation to AP specifically, TGFβrIII mRNA was found to be moderately increased in AP tissue samples (25). Taken together, it appears plausible to assume that the plasma levels of the soluble form – sTGFβrIII – might be a biochemical marker in AP. To investigate the feasibility of this hypothesis, we conducted a pilot study in patients with mild-to-moderate AP.     

The effects of water immersion and epidural analgesia on cellular immune response,neuroendocrine, and oxidative markers

Background/aim Water immersion and epidural analgesia are the most preferred pain relief methods during the labor process. Adverse effects related to these methods, impact on the labor, and perception of pain is well studied in the literature. We aimed to investigate the cord blood level of copeptin, total serum oxidant (TOS), antioxidant (TAS), interleukin (IL)-1, IL-6, and oxytocin after the labor with water immersion, epidural analgesia, and vaginal birth without pain relief. Materials and methodsThe study was conducted with 102 healthy pregnant women admitted to the obstetric delivery unit for noncomplicated term birth. Copeptin, oxytocin, TAS, TOS, IL-1, and IL-6 levels of cord blood and obstetric and neonatal results after vaginal birth were compared.Results The study included a total of 102 patients (group 1 = 30, group 2 = 30, and group 3 = 42). We found no significant difference between the three groups in terms of BMI, age, gravidity, parity, birth week, birth weight, interventional birth, perineal trauma, breastfeeding, duration of labor, oxytocin, IL-1 and IL-6 levels (p > 0.05). Neonatal intensive care unit (NICU) need, TAS, TOS, and copeptin levels were higher. Apgar scores were lower in the epidural group (p = 0.011, p = 0.036, p = 0.027, p < 0.001, and p < 0.001 respectively).Conclusion Epidural analgesia has deteriorated oxidative stress status and lower neonatal Apgar scores with higher NICU administration compared with water birth and vaginal birth without pain relief.     

Granulation tissue is altered after intramyocardial and intracoronary bone marrow-derived cell transfer for experimental acute myocardial infarction

BackgroundBone marrow-derived mononuclear cell (BMMC) treatment in acute myocardial infarction (AMI) has been shown to have a beneficial effect. Our objective was to study in detail the histopathological process after the cell therapy after intramyocardial (IM) or intracoronary (IC) administration of BMMCs following experimental AMI.MethodsTwenty-fours pigs were randomized to the IM group (n=8), the IC group (n=8), and the control group (n=8).After 90 min of transient occlusion of the circumflex coronary artery, BMMCs were injected either intramyocardially or by a transfemoral catheter into the circumflex coronary artery. Echocardiography was performed preoperatively, postoperatively, and after a 21-day recovery period. The heart biopsies were examined histopathologically. Volumetric ex vivo CT scan was performed to evaluate calcification of the infarcted myocardium.ResultsThe ejection fraction (EF) showed significant recovery in the IM group compared to the control group at Day 21 (P=.05). Despite beneficial histological changes in the infarction site in the IC group, compared to the control group, EF failed to recover. Reduction of collagen density that depicts scar formation was seen in both cell therapy groups compared to the control (P<.001). The number of mitotic cells was higher in the control group compared to the cell therapy groups (P<.001). The IC and IM groups differed significantly from each other in muscle-specific actin staining (P<.001) and smooth muscle actin staining (P<.004). The IM therapy group showed higher density for both stainings. Additionally, macrophage density was higher in the IC group compared to the IM and control groups (P<.002). Both cell therapy regimens substantially diminished tissue calcification; due to the large variation, the effect was not statistically significant.ConclusionBMMC therapy launches cellular changes that affect mostly the repair process in the granulation tissue. The cell transplantation method might have some effect on the magnitude of the effect.     

Transforming growth factor β2 is able to modify mRNA levels and release of luteinizing hormone-releasing hormone in a immortalized hypothalamic cell line (GT1-1)

On the basis of our previous observations which indicated that transforming growth factor β1 (TGFβ1) affects the gene expression and the release of luteinizing hormone-releasing hormone (LHRH) in GT1-1 cells, we have presently evaluated whether also TGFβ2 might be effective on these parameters. The data here reported show that also TGFβ2 is able to affect LHRH dynamics, and that this action presents a different kinetics than that reported by TGFβ1. In particular TGFβ2 is able to facilitate LHRH release and to decrease the mRNA levels of this decapeptide. The present data have also shown that, GT1-1 cells express the messengers for the two most important receptors of the TGFβ family, namely TGFβRI and TGFβRII and consequently represent a target for the action of the different isoforms of TGFβ. Since the two isoforms of TGFβ are produced and released from astrocytes, the present data add new support to the hypothesis that astrocytes participate in the control of LHRH secretion in a paracrine fashion.     

Reconstruction of epidural fat with engineered adipose tissue from adipose derived stem cells and PLGA in the rabbit dorsal laminectomy model

Epidural fibrosis resulted from epidural fat destruction following laminectomy operation is regarded as a main cause of failed back surgery syndrome, which represents one of the most common complications in spine surgery. Up to now, the effectiveness of currently available treatments to prevent such a syndrome is quite limited. In the present study, we aimed to restore epidural fat using adipose tissue engineered from adipose derived stem cells (ASCs) in a rabbit dorsal laminectomy model. ASCs isolated from subcutaneous fat were first expanded to passage 3, seeded on porous poly(lactic-co-glycolic acid, PLGA) scaffold and then adipogenically induced for 7 days in?vitro to form cell-scaffold complex. Laminectomy sites were created at T13-L1 level in each animal. The laminectomy defect was implanted either with cell-scaffold complex or PLGA scaffold alone. Non-treated defect was also included as a control. The animals were subjected to MRI evaluation at 1, 12 and 24 weeks post-surgery, and sacrificed at 24 weeks for gross and histological observation. It was demonstrated by MRI evaluation that scar tissue of coarse and high density was formed within laminectomy site in PLGA alone and non-treated groups as early as 12 weeks. However, the defect implanted with engineered adipose had formed a continuous linear adipose tissue regenerated along the spinal cord at 24 weeks. Histologically, a distinct area of adipose tissue just overlaying the dura mater could be identified in cell-scaffold complex treated group at 24 weeks post-operation. Regeneration of epidural fat was further confirmed by positive Oil Red O staining. As to the defect treated with PLGA alone or left untreated, either fine or dense scar tissue adhering to the dura mater was observed. Moreover, we could track the implanted ASCs labeled by magnetic nanoparticles within epidural area for as long as four weeks by MRI detection. Thus, adipose tissue engineered from ASCs exhibited great potential in restoration of epidural fat to prevent formation of epidural fibrosis.     

MicroRNA-29 mediates TGFβ1-induced extracellular matrix synthesis by targeting wnt/β-catenin pathway in human orbital fibroblasts

Purpose: Transforming growth factor β1 (TGFβ1) is very important in the synthesis and degradation of extracellular matrix (ECM) and also in the mediation of human orbital fibroblasts (OFs) proliferation. MicroRNA-29 (MiR-29) plays an important role in this process. In the present study, the effects of TGFβ1 on the expression of miR-29 and whether miR-29 is involved in pro-survival signaling pathways mediated by TGFβ1 were examined in human OFs. Methods: Detecting the influence of TGFβ1 on the expression of miR-29a/b/c by real-time PCR analysis. Using 3-(4, 5-Dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium bromide (MTT) to detecting the influence of miR-29 on the increased proliferation caused by TGF-β1 on the human orbital fibroblasts. Using soft agar assay to detecting the influence of miR-29 on the increased colony formation caused by TGF-β1 on the human orbital fibroblasts. Western blot was used to detect the specific mechanisin. Results: TGFβ1 treatment decreases the expression of miR-29 in OFs. In the cultured OFs, the value of optical density (OD) in the group treated with miR-29 is lower than that in the group treated without miR-29 (P < 0.05). In the cultured OFs, the ratio of colony formation in the group treated with miR-29 is lower than that in the group treated without miR-29 (P < 0.05). In OFs, miR-29 decreases the secretion of Wnt3a and activation of β-catenin whether the treatment of TGFβ1 was used or not. MiR-29 decreases expression of Collagen, type I, alpha 1 (COL1A1) through down-regulation of wnt/β-catenin pathway. Conclusions: In OFs TGFβ1 treatment decreases expression of miR-29 which can cause the inhibition of normal ability of TGFβ1. MiR-29 inhibits TGFβ1-induced proliferation of OFS cell and decreases colony formation of OFS cell after TGFβ1 treatment. MiR-29 Mediates TGFβ1-induced Extracellular matrix synthesis through activation of Wnt/β-catenin pathway in human OFs.