Skeletal muscle and bone marrow derived stromal cells: A comparison of tenocyte differentiation capabilities

This study investigated the comparative ability of bone marrow and skeletal muscle derived stromal cells (BMSCs and SMSCs) to express a tenocyte phenotype, and whether this expression could be augmented by growth and differentiation factor‐5 (GDF‐5). Tissue harvest was performed on the hind limbs of seven dogs. Stromal cells were isolated via serial expansion in culture. After four passages, tenogenesis was induced using either ascorbic acid alone or in conjunction with GDF‐5. CD44, tenomodulin, collagen I, and collagen III expression levels were compared for each culture condition at 7 and 14 days following induction. Immunohistochemistry (IHC) was performed to evaluate cell morphology and production of tenomodulin and collagen I. SMSCs and BMSCs were successfully isolated in culture. Following tenocytic induction, SMSCs demonstrated an increased mean relative expression of tenomodulin, collagen I, and collagen III at 14 days. BMSCs only showed increased mean relative expression of collagen I, and collagen III at 14 days. IHC revealed positive staining for tenomodulin and collagen I at 14 days for both cell types. The morphology of skeletal muscle derived stromal cells at 14 days had an organized appearance in contrast to the haphazard arrangement of the bone marrow derived cells. GDF‐5 did not affect gene expression, cell staining, or cell morphology significantly. Stromal cells from either bone marrow or skeletal muscle can be induced to increase expression of matrix genes; however, based on expression of tenomodulin and cell culture morphology SMSCs may be a more ideal candidate for tenocytic differentiation. © 2012 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 30:1710–1718, 2012     

Clinical analysis of osteonecrosis of the femoral head induced by steroids

Objective: To explore the clinical characteristics of osteonecrosis of the femoral head (ONFH) induced by steroids. Methods: From January 2000 to October 2009, 497 hips in 270 cases of ONFH induced by steroids were studied. A questionnaire was administered when the patients were admitted; the questions concerned the underlying disease, duration of steroid usage, total dosage of steroid, incubation period (time interval between commencement of steroid therapy and onset of pain), severity of pain, location of initial complaint, primary diagnosis, time lag from onset of pain to final diagnosis and physical signs when admitted. The correlations between pain and Association Research Circulation Osseous (ARCO) stage, bone marrow edema (BME) and lesion size were analyzed. Results: The median of time between commencing steroid medication and developing ONFH for the 269 cases was 18 months (range, 2–384 months). 78.82% cases presented with pain within three years of steroid initiation, only 10.41% patients first complained of pain six or more years after commencing steroid therapy. Fifty‐six cases (20.82%) were misdiagnosed, lumbar disorders being the most frequent misdiagnoses. 79.29% of symptomatic hips presented with abnormal physical tests. Of 420 symptomatic hips, 166 hips were type C1, 223 hips type C2; 299 hips had collapsed; and there was BME in 209 hips. Conclusion: Most patients with ONFH induced by steroids complained of pain within 3 years of commencing steroid therapy. Pain was associated with lesion size, collapse and BME. Atypical location of pain, failure to perform a physical examination and MRI findings were the main causes of misdiagnoses.     

Evaluation of vertical traction radiography for predicting the outcome of moderate to severe rigid scoliosis correction

Objective: To determine the efficacy of imaging patients in a state of traction (“traction imaging”) for selection of upper and lower vertebrae to undergo instrumentation (UIV and LIV, respectively) to correct moderate to severe, rigid scoliosis. Methods: Twenty‐seven patients aged 11–21 years (average, 15.5 years) who had been treated at our institution for scoliosis of the thoracic spine between 2004 and 2008 were retrospectively analyzed. All patients were treated with the third multiple hook‐screw and rod instrumentation system. Standardized radiographic measurements (anteroposterior, sagittal, bending, fulcrum, traction) were taken and Cobb's angles, apical vertebra translation (AVT), and traction‐stable vertebrae determined. Results: All patients were followed for 6–36 months (average, 14.7 months). The Cobb's angles under preoperative vertical traction correlated positively with those measured postoperatively in standing anteroposterior film (P < 0.01). Preoperative AVT under vertical traction was significantly different from that measured postoperatively in standing anteroposterior film (P < 0.01). The traction radiography‐determined UIV slant angles were significantly different from those preoperatively without traction and the postoperative values, whereas traction radiography‐determined LIV values were not significantly different from those found preoperatively without traction (P > 0.05). Conclusions: Traction radiographic imaging is an effective, feasible preoperative assessment for determining which vertebrae are stable, designing the surgical strategy and choosing the UIV and LIV for correcting moderate to severe, rigid scoliosis.     

Effect of estrogen on regression of vascular calcification in rats

Objective To investigate the effect of estrogen on regression of vascular calcification in rats induced by vitamin D3 plus nicotine. Methods Ninety?six female SD rats were divided randomly into control group (n=24) and calcification group (n=72). Vascular calcification of 72 rats was induced by vitamin D3 and nicotine (VDN). On the day 1, the VDN group rats were injected with vitamin D3(300 000 U/kg, i.m), and were intragastric administrated with nicotine (25 mg/kg), after 9 hours, another dosage of nicotine was given again. After 4 weeks, the VDN group rats were subdivided randomly into 4 groups: VDN group(n=16), Sham operation group (n=16), ovariotomy group (n=16), estrogen group(after ovariotomy, 17β ?estrogen was subcutaneously injected, 50 μg•kg-1•d-1, n=16). Results After 4 weeks,the VDN group showed obvious vascular calcification, and calcium content of the vessel wall was significantly higher than that of control group (P<0.01). Extensive calcification was witnessed on the aortic tunica media of the VDN group. After 12 and 8 weeks, the calcium content of the vessel wall in each subdivided groups was significantly lower than that at 4 weeks point(P<0.01), and the lowest calcinm content was in estrogen group, meanwhile the reduction of previously accumulated arterial calcium precipitate in each group was different. Conclusions It is a reversible process that vascular calcification induced by vitamin D plus nicotine in rats. Estrogen can promote the regression of vascular calcification.     

消毒供应中心租赁器械的风险管理

目的探讨消毒供应中心租赁手术器械风险管理模式,保障患者安全,控制医院感染。方法通过强有力的组织保障,注重管理细节,拟定制度流程,加强人员培训,建立可追溯系统等措施来构建风险管理模式。结果风险管理后,消毒供应中心工作质量、外来器械管理质量、人员培训考核得分以及临床医护人员满意度较风险管理前显著提高(均P<0.01)。结论严格的租赁器械风险综合管理是保障患者安全、降低医院感染的有效方法。     

家属培训对长期住院慢性精神分裂症患者康复的影响

目的探讨家属心理护理、生活技能培训在长期住院的慢性精神分裂症患者康复治疗中的作用。方法选取有家庭监护条件的长期住院的精神分裂症患者126例,将其随机分为干预组(66例)和对照组(60例)。干预组由心理咨询师对患者家属进行心理护理、生活技能培训,然后对患者实施假出院3个月。对照组患者仍住院治疗。实施前后采用护士用住院患者观察量表(NOS-IE)、自尊量表(SES)进行测试。结果干预后干预组NOSIE及SES评分显著优于对照组(P<0.01,P<0.05)。结论家属心理护理、生活技能培训用于长期住院的慢性精神分裂症患者,可使其社会能力、生活技能提高,激惹、抑郁等消极情绪减少;自尊水平提升。     

Evaluation of thymosin β4 in the regulation of epithelial-mesenchymal transformation in urothelial carcinoma

ObjectivesTo study the underlying alteration in the expression of epithelial markers involved in epithelial-mesenchymal transition (EMT), and elucidate the potential mechanism(s) for Tβ4-induced EMT-like phenotypic changes in bladder cancer cells.Materials and methodsAll tissue samples in this study were obtained from clinical patients of the Union Hospital of Tongji Medical College, and were confirmed by surgery and pathology. Of these, normal bladder tissues (control), primary urothelial carcinoma of different grades (Stage pTa, Stage pT3), bladder paracancerous tissues, accompanied with 2 bladder cancer cell lines (BIU-87 and T24), were divided into 6 groups. Quantitative RT-PCR, Western blotting, and immunohistochemical study of adhesion molecules Tβ4, ILK, E-cadherin, and β-catenin involved in EMT were carried out. A lentiviral gene transferring vector containing the RNA polymerase III-dependent U6 promoter to express short hairpin RNA (shRNA) directed against Tβ4 was also applied. In the present study, all agents were evaluated using commercial kits.ResultsA strong correlation between the expression levels of Tβ4, ILK, E-cadherin, and β-catenin was found in the bladder transitional cell carcinoma (TCC) patients. In the BIU-87 and T24 bladder cancer cells overexpressing Tβ4, which were accompanied by a loss of E-cadherin as well as a cytosolic accumulation of β-catenin, up-regulation of ILK was also revealed. The inhibition of the Tβ4 expression with lentiviral shRNA vector could raise EMT-like phenotypic changes, significantly depressed motility, and subsequent invasiveness of bladder cancer cells.ConclusionsOur results imply that the Tβ4 is likely to play a crucial role in EMT progression, and that inhibition of the Tβ4 expression or interactions with other genes should be novel therapeutic targets for bladder cancers with high invasive and metastatic potential.     

Prostatic calculi influence the antimicrobial efficacy in men with chronic bacterial prostatitis

We studied the efficacy of culture-specific antibiotic therapy for chronic bacterial prostatitis (CBP) patients with or without prostatic calculi. This study included 101 patients (21–62 years old) who met the consensus criteria for CBP (National Institutes of Health category II). According to the results of transrectal ultrasonography (TRUS), all patients were divided into two groups: Group 1, CBP with prostatic calculi, n=39; Group 2, CBP without prostatic calculi, n=62. All patients received optimal antimicrobial therapy for 4 weeks and followed up for a minimum of 3 months (range: 3–8 months). In addition to expressed prostatic secretions (EPS) and urine culture, all patients were asked to complete the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) and the subjective global assessment (SGA). The microbiological eradication rate at the end of treatment were 32/39 (82.1%) and 54/62 (87.1%), while the rates for continued eradication at the end of study were 17/39 (43.6%) and 45/62 (72.6%) in Group 1 and Group 2 (P<0.01), respectively. We observed a decrease in the total NIH-CPSI score median values from 24 to 19 in Group 1 and from 24 to 11 in Group 2. The pain subscore (P<0.01), urinary sunscore (P<0.05) and quality of life (QoL; P<0.05) as well as the total NIH-CPSI score (P<0.01) were significantly improved after antimicrobial treatment in Group 2 compared to Group 1. Response, defined as a decrease of the NIH-CPSI total score by at least 50%, was seen in Group 1 versus Group 2 in 38.5% and 58.1% (P<0.01), respectively. Our results showed that prostatic calculi influence the antimicrobial efficacy in men with CBP. There was a noticeable decrease in the cure rate of CBP patients with prostatic calculi due to relapse after antimicrobial therapy.     

Extralobar Pulmonary Sequestration Mimicking an Adrenal Tumor

Pulmonary sequestration is a rare cystic malformation composed of bronchopulmonary tissue that is discontinuous from the tracheobronchial tree and has an anomalous systemic blood supply. We present a case of a 40-y-old male who presented with an extralobar pulmonary sequestration and underwent a laparoscopic retroperitoneal mass excision. Preoperative imaging revealed a large 11.3-cm retroperitoneal tumor consisting of a multiloculated cystic lesion. The patient was discharged home, and at 3-mo follow-up no complaints were reported.