同种异体骨 Cage 在经椎间孔腰椎椎间融合手术中的应用

目的评估同种异体骨 Cage 在经椎间孔腰椎椎间融合术（transforaminal lumbar interbody fusion，TLIF）术后的融合效果。方法回顾分析 2015 年 1 月—2017 年 1 月使用同种异体骨 Cage 行 TLIF 的 30 例患者（38 个节段）临床资料。男 25 例，女 5 例；年龄 44～72 岁，平均 56.9 岁。腰椎间盘突出症 20 例，腰椎滑脱 7 例，腰椎管狭窄 3 例。手术节段：单节段 22 例，L_3、4 4 例，L_4、5 13 例，L₅、S₁ 5 例；双节段 8 例，L_4、5～L₅、S₁ 6 例，L_3、4～L_4、5 2 例。病程 6～36 个月，平均 12 个月。术前，术后 3、6 个月及末次随访时采用疼痛视觉模拟评分（VAS）、Oswestry 功能障碍指数（ODI）和日本骨科协会（JOA）评分评估临床疗效；术后 3、6 个月摄正侧位 X 线片及行 CT 三维重建评估融合率；术前及术后 3 d、3 个月、6 个月分别摄腰椎正侧位 X 线片测量椎间隙高度。 结果手术时间 2.1～4.3 h，平均 3.1 h；术中出血量 150～820 mL，平均 407.5 mL。30 例均获随访，随访时间 8～25 个月，平均 16.4 个月。1 例术后 6 个月出现 Cage 下缘碎裂，不伴 Cage 移动，无神经症状；其余患者均无 Cage 脱出、位移、碎裂等情况发生。所有患者均无局部或全身变态反应或感染征象，随访期间无神经压迫、受损症状。30 例患者术后各时间点 VAS 评分、ODI 评分及 JOA 评分均较术前显著改善（P<0.05）；术后 6 个月及末次随访时显著优于术后 3 个月（P<0.05）；术后 6 个月和末次随访间比较差异无统计学意义（P>0.05）。X 线片及 CT 三维重建示，术后 3、6 个月及末次随访时的融合率分别为 55.3%（21/38）、92.1%（35/38）、100%（38/38）。术后 3 d、3 个月、6 个月及末次随访时椎间隙高度均较术前显著改善（P<0.05）；末次随访时与术后 3 d 比较椎间隙高度有所丢失，差异有统计学意义（P<0.05）。 结论同种异体骨 Cage 在腰椎 TLIF 术后可提供早期稳定性和较高融合率。     

TP53 and EGFR Mutational Status in Thymoma: A Genetic Sequencing Study

Background and objective: Thymoma is a rare malignant tumor that usually with an indolent presentation, which was falsely assumed to be benign previously. The tumor suppressor P53 (TP53) and EGFR gene mutate most frequently in human cancers. We tried to investigate the presence of TP53 and EGFR mutations among thymoma patients referred to an Indonesian referral respiratory hospital and to discuss its potential role in thymoma management and prognosis. Material and methods: Surgically resected tumor tissues were collected from thymoma patients and then underwent genomic analysis. PCR was performed on the extracted Paraffinized  DNA to amplify exon 6 of TP53 and exons 18, 19, and 21 of EGFR. The evaluation of mutational status was done using direct sequencing and sequence analysis of purified PCR products. Results: Among 27 collected samples, TP53 exon 6 mutation, namely  missense mutation and nonsense mutation, was observed in two samples (7.4%). EGFR exon 18 mutation, namely E709K and nonsense mutation, was found in 2 samples (7.4%). An intronic mutation in EGFR exon 19 (3.7%) and exon 21 (3.7%) was observed in one sample. Conclusion: TP53 and EGFR mutations were not most frequent, so it seems that these genes are not involved in the pathogenesis of thymoma in Indonesian patients. Nevertheless, we found two samples with a significant mutation in p53 and EGFR genes, suggesting further research on thymoma prognostification and targeted therapy.     

Analysis of the correlation between P27 expression and Helicobacter pylori infection in gastric cancer

We aimed to explore the correlation between P27 expression and Helicobacter pylori (H. pylori) infection in gastric cancer, so as to provide evidence for understanding the pathogenesis of gastric cancer caused by H. pylori infection. A total of 82 samples of gastric cancer tissues and 56 samples of tumor-adjacent normal tissues collected from the gastrectomy were enrolled in this study. Then, 14C-urease breathing test was carried out to evaluate the infection of H. pylori in gastric cancer tissues, the expression of P27 in the tissue samples was detected by the immunohistochemistry staining, and the correlation between the H. pylori infection and P27 expression in gastric cancer was analyzed. Of 82 gastric cancer patients, there were 53 patients with H. pylori infection (64.63%). Among the patients with highly or moderately differentiated gastric cancer, the expression of P27 was much higher than that of patients with poorly differentiated gastric cancer (p < 0.01). Besides, comparison of the P27 expression between males and females, among different age groups, tumor sizes, TNM stages, tumor infiltration degrees, or lymph node metastasis, showed no significant differences (p > 0.05). Analysis of the correlation revealed that P27 expression was negatively correlated with the infection of H. pylori (p < 0.01). Multifactorial logistics regression analysis indicated that tumor differentiation was a risk factor of P27-positive expression in gastric cancer tissues (p < 0.01). In addition, P27 expression in the gastric cancer tissues was lower than that in the tumor-adjacent normal tissues (p < 0.01). In gastric cancer patients, expression of P27 is correlated with H. pylori infection which, via downregulating P27, can cause the cancerization of gastric mucosa, and P27, for its role in the development and progression of gastric cancer, is a potential auxiliary indicator for clinical diagnosis whether gastric cancer is complicated with H. pylori infection. So, P27 is a key indicator for diagnosis, treatment, and prognostic evaluation of disease in the advanced stage.     

Inhibition of urinary bladder cancer cell proliferation by silibinin

Silibinin, a natural compound extracted from milk thistle, has demonstrated antitumor properties in urinary bladder cancer cells; however, the role of TP53 gene in these effects is unclear. In order to better understand the molecular and antiproliferative mechanisms of this compound, urinary bladder cancer cells with different TP53 gene status, RT4 (low-grade tumor, wild TP53 gene), 5637 (high-grade tumor, Grade 2, mutated TP53 gene), and T24 (high-grade tumor, Grade 3, mutated TP53 gene) were treated with several concentrations of silibinin (1, 5, 10, 50, 100, and 150 μM). Cytotoxicity, prooxidant effect, morphological changes, cell migration, cell cycle progression, global methylation profile, and relative expression of HOXB3, c-MYC, PLK1, SMAD4, SRC, HAT, HDAC, and RASSF1A genes were evaluated. The silibinin presented cytotoxic and prooxidant effects in the three cell lines. In mutated TP53 cells, significant interference in cell migration and cell cycle arrest at the G2/M phase was observed. Additionally, silibinin induced global DNA hypomethylation in the highest grade tumor cells. For wild-type TP53 cells, a sub-G1 apoptotic population was present. Furthermore, there was modulation of gene expression responsible for cell growth (SMAD and c-MYC), migration (SRC), cell cycle kinetics (PLK1), angiogenesis (HOXB3), and of genes associated with epigenetic events such as DNA acetylation (HAT) and deacetylation (HDAC). In conclusion, the silibinin inhibited the urinary bladder tumor cell proliferation independently of TP53 status; however, cell cycle effects, gene expression changes, and alteration of cell migration are dependent on TP53 status. © 2020 Wiley Periodicals, Inc.     

膝关节自体软骨细胞移植术后康复的研究进展

目的总结膝关节自体软骨细胞移植术（autologous chondrocyte implantation，ACI）术后康复的研究进展。方法查阅近年来国内外 ACI 术后康复相关的基础及临床研究，并进行总结分析。结果研究表明，ACI 术后移植物成熟分为 4 个阶段：增生期（术后 0～6 周）、过渡期（术后 6～12 周）、重塑期（术后 12～26 周）、成熟期（术后 26 周～2 年）。为了避免早期移植物损伤，适当刺激移植物和骨骼的整合过程，更快恢复关节功能，临床需针对术后不同阶段移植物的生物力学特性设计康复锻炼方案，主要体现在术后负重、运动范围、康复训练方式的过渡和调整。结论膝关节 ACI 术后应科学地逐步增加负重和运动范围，在不同阶段可借助相应的康复锻炼手段。但目前相关研究的证据等级较低，仍需更高质量、更大样本量的随机对照试验，进一步探讨完善康复方案。     

Transurethral instillation with fusion protein MrpH.FimH induces protective innate immune responses against uropathogenic Escherichia coli and Proteus mirabilis

Urinary tract infections (UTIs) are among the most common infections in human. Innate immunity recognizes pathogen‐associated molecular patterns (PAMPs) by Toll‐like receptors (TLRs) to activate responses against pathogens. Recently, we demonstrated that MrpH.FimH fusion protein consisting of MrpH from Proteus mirabilis and FimH from Uropathogenic Escherichia coli (UPEC) results in the higher immunogenicity and protection, as compared with FimH and MrpH alone. In this study, we evaluated the innate immunity and adjuvant properties induced by fusion MrpH.FimH through in vitro and in vivo methods. FimH and MrpH.FimH were able to induce significantly higher IL‐8 and IL‐6 responses than untreated or MrpH alone in cell lines tested. The neutrophil count was significantly higher in the fusion group than other groups. After 6 h, IL‐8 and IL‐6 production reached a peak, with a significant decline at 24 h post‐instillation in both bladder and kidney tissues. Mice instilled with the fusion and challenged with UPEC or P. mirabilis showed a significant decrease in the number of bacteria in bladder and kidney compared to control mice. The results of these studies demonstrate that the use of recombinant fusion protein encoding TLR‐4 ligand represents an effective vaccination strategy that does not require the use of a commercial adjuvant. Furthermore, MrpH.FimH was presented as a promising vaccine candidate against UTIs caused by UPEC and P. mirabilis.     

CYTED Network to develop an immunogen compatible with integrated management strategies for tick control in cattle

INCOGARR is a thematic network recently approved to be financially supported by the Ibero-American Program of Science and Technology for Development (CYTED). The objectives of this Network are the design and evaluation of an efficient and feasible anti-tick vaccine candidate from the technical and economical points of view and also sharing experiences in the immunological control of ticks as part of an Integrated Control Program. The Network consists of seven laboratories and one company from six countries. The first meeting of the Network took place with the representation of each laboratory involved. In the meeting, general and specific objectives and activities of the Network were discussed and it was a very nice example of international collaboration to address an unsolved worldwide topic on tick control in which laboratories with different competencies and expertise join their efforts in a common goal.     

The time course of psychological stress as revealed by event-related potentials

Psychological stress is common in everyday life and is believed to affect emotion, cognition and health. Previous brain imaging studies have been able to identify the brain regions involved in the stress response. However, our understanding of the temporal neurological response to psychological stress is limited. The present work aims to investigate the time course of psychological stress induced by a mental arithmetic task, utilizing event-related potentials (ERPs). The elicitation of stress was verified by self-reports of stress and increases in salivary cortisol levels. The subjective and physiological data showed that the stress-elicitation paradigm successfully induced a mild-to-moderate level of psychological stress. The electrophysiological data showed that the amplitude of occipital N1 was more negative in the control task than in the stress task, and the latency of frontal P2 was shorter in the stress task than in the control task. Our results provide electrophysiological evidence that psychological stress occurs primarily at the early stage of cognitive processing.