PMMA bone cement is known to induce tissue inflammation around implants. A previous research group developed a novel material, enoxaparin sodium bone cement (ES-PMMA), which combines 40 g of PMMA bone cement with 8000 AxaIU of enoxaparin sodium. This innovative bone cement has demonstrated anti-inflammatory and immunomodulatory properties within the local tissue microenvironment. This study aimed to explore the underlying molecular mechanisms. RAW264.7 cells were treated with different bone cement extract mediums to observe macrophage polarization and the expression of inflammatory factors. RAW264.7 cells treated with different bone cement extract mediums were collected for lncRNA sequencing, and the sequencing results were analyzed using bioinformatics. The lncRNA NONMMUT104330.1-miR-709-DDX58 regulatory axis was constructed based on the competing endogenous RNA mechanism. Subsequently, lncRNA NONMMUT104330.1 in RAW264.7 cells was either knocked down or overexpressed to observe the inflammatory response of the cells. ES-PMMA bone cement induces M2 polarization of macrophages and increases the expression of anti-inflammatory factors. A bioinformatics analysis was conducted on the sequencing results to construct the lncRNA NONMMUT104330.1-miR-709-DDX58 regulatory axis. A dual-luciferase reporter gene assay was employed to verify the binding feasibility of the axis, and the results demonstrated that miR-709 could bind to the molecular sites of lncRNA NONMMUT104330.1 and DDX58, respectively. Knockout and overexpression experiments of lncRNA NONMMUT104330.1 demonstrated that the knockdown of lncRNA NONMMUT104330.1 induced M2 polarization in RAW264.7 cells, leading to a reduction in pro-inflammatory factor expression and an increase in anti-inflammatory factor expression. Conversely, upon overexpression of lncRNA NONMMUT104330.1, RAW264.7 cells were polarized to M1, resulting in elevated levels of pro-inflammatory factors. Enoxaparin sodium bone cement can induce M2 polarization of macrophages, thereby playing an anti-inflammatory immunomodulatory role. The lncRNA NONMMUT104330.1-miR-709-DDX58 axis may significantly contribute to this process. Not applicable.

2.This research investigates the impact of the EGCG-CSH/n-HA/CMC composite material on bone defect repair, emphasizing its influence on macrophage polarization and osteogenic differentiation of BMSCs. Comprehensive evaluations of the composite’s physical and chemical characteristics were performed. BMSC response to the material was tested in vitro for proliferation, migration, and osteogenic potential. An SD rat model was employed for in vivo assessments of bone repair efficacy. Both transcriptional and proteomic analyses were utilized to delineate the mechanisms influencing macrophage behavior and stem cell differentiation. The material maintained excellent structural integrity and significantly promoted BMSC functions critical to bone healing. In vivo results confirmed accelerated bone repair, and molecular analysis highlighted the role of macrophage M2 polarization, particularly through changes in the SIRPA gene and protein expression. EGCG-CSH/n-HA/CMC plays a significant role in enhancing bone repair, with implications for macrophage and BMSC function. Our findings suggest that targeting SIRPA may offer new therapeutic opportunities for bone regeneration.

Background: Lumbar fusion and internal fixation techniques have shown promise in treating lumbar disc herniation (LDH), yet the impact on lumbar function in young patients remains unclear. This study aimed to investigate the impact of lumbar fusion on lumbar function in young patients. Material/Methods: A retrospective analysis was conducted on 330 patients diagnosed with LDH admitted to our hospital. Patients were divided into 2 groups: a control group (n=264) that underwent a minimally invasive procedure with a keyhole lens, and a research group (n=66) that underwent lumbar fusion internal fixation. Clinical features and therapeutic outcomes were assessed using Oswestry Disability Index (ODI) and Japanese Orthopedic Association (JOA) Lumbar Scores before surgery and 12 months postoperatively. Additionally, intervertebral space height, degree of vertebral spondylolisthesis (grades I, II, and III), incidence of adverse effects, and treatment efficacy were measured pre-and post-surgically. Results: No significant difference in ODI and JOA scores was found between the groups before surgery (P>0.05). Postoperatively, the research group had lower ODI scores, higher JOA scores, and lower intervertebral space heights compared to the control group (P=0.001). While grade 1 and 2 spondylolisthesis showed slight improvement (P>0.05), a significant difference was observed in grade III spondylolisthesis between the 2 groups (P=0.001). Additionally, the research group had a lower incidence of adverse effects (P=0.049) and higher treatment efficacy, although the difference was not statistically significant (P>0.05). Conclusions: Lumbar fusion with internal fixation produced better postoperative outcomes and fewer adverse effects than minimally invasive procedures in young patients with lumbar disc herniation.

The dynamic coefficients (dynamic stiffness coefficient and dynamic damping coefficient) of gas foil bearings (GFBs) are important for transient dynamics calculation and stability analysis of the GFBs-rotor system. Although the perturbation method can be used to calculate the dynamic coefficients, it can only consider a single whirl ratio. Moreover, the whirl ratio is assumed and not practical. Therefore, this paper proposes an identification method of dynamic coefficients of GFBs by simulated excitation. Firstly, based on single journal-single GFB model considering gas-structure interaction by coupled fields, harmonic excitations were applied to the rotor to obtain the shaft orbit. Next, frequency response function method and equivalence coefficient method were used to identify dynamic coefficients. The former method is suitable for the case where response and excitation are same frequency, namely linear problem. The latter method is fit for the situation in which the response has multiple frequency components, namely nonlinear problem. Finally, examples were carried out, and the results from different methods were compared and analyzed. This research work lays a theoretical foundation for the design of the GFBs-rotor system.

Objective:Finite element method was used to analyze and evaluate the stress distribution and maximum extractive force during pedicle screw extraction under different bone mineral density (BMD) conditions, and to explore the minimum bone mineral density for safe implantation of pedicle screw internal fixation.Methods:Based on the unscanned lumbar CT data and standard pedicle screw parameters of a healthy male volunteer, a three-dimensional model of lumbar 1 vertebral body and pedicle screw was established. The vertebral bodies were divided into group A (BMD=120 mg/cm 3), group B (BMD=110 mg/cm 3), group C (BMD=100 mg/cm 3), group D (BMD=90 mg/cm 3), and group E (BMD=80 mg/cm 3) according to the BMD (QCT method). After the material assignment was completed according to the references, the axial pull-out force experiment was simulated to the five finite element models established. The screw stress distribution and the maximum axial pull-out force in each group were observed, and the measured indexes were compared and analyzed among different BMD. One-way analysis of variance was used for statistical analysis. Results:The maximum pull-out force of the finite element model in groups A-E was (1 834±78), (1 626±65), (1 441±55), (1 141±48) and (1 039±42) N, respectively, and there was statistically significant difference between the two groups ( F=3.413, P<0.05). When BMD decreased by 10 mg/cm 3, the maximum axial pulling force decreased by 11%, 23%, 43%, 51% respectively. The maximum principal strain of the screw appeared at the end of the screw, and the maximum stress of the screw moved gradually from the end to the head during pullout. Conclusion:The stability of pedicle screws decreases with the decrease of BMD. The maximum pull-out force began to decrease significantly from group D (BMD=90 mg/cm 3). Therefore, for patients requiring pedicle screw internal fixation, preoperative QCT method should be routinely used for BMD detection. When vertebral BMD is less than 90 mg/cm 3 (male≥70 years old, female≥60 years old), pedicle screw system alone is not recommended.

Chronic alcoholism has become a major public health problem. Long-term and excessive drinking can lead to a variety of diseases. Chronic ethanol exposure can induce neuroinflammation and anxiety-like behavior, and this may be induced through the Toll-like receptor 3/nuclear factor-κB (TLR3/NF-κB) pathway. Animal experiments were performed using healthy adult male C57BL/6 N mice given 10 % (m/V) or 20 % ethanol solution as the only choice of drinkable fluid for 60, 90 or 180 d. In cell culture experiments, H4 human glioma cells were treated with 100 mM ethanol for 2 d, with the TLR3 gene silenced by RNAi and NF-κB inhibited by ammonium pyrrolidine dithiocarbamate (PDTC, 10 μM). After treatment with ethanol solution for a specific time, the anxiety-like behavior of the mice was tested using the open field test and the elevated plus maze test. Western blotting was used to detect the expression of TLR3, TLR4, NF-κB, IL-1β, IL-6, and TNF-α in the mouse hippocampus and H4 cells. The expression of IL-1β, IL-6 and TNF-α in the supernatant of cell culture medium was detected by ELISA. The open field test showed a decrease in time spent in the central area, and the elevated plus maze test showed a decrease in activity time in the open arm region. These behavioral tests indicated that ethanol caused anxiety-like behavior in mice. The expression levels of TLR3, TLR4, NF-κB, IL-1β, IL-6, and TNF-α increased after ethanol exposure in both the hippocampus of mice and H4 cells. Silencing of the TLR3 gene by RNAi or inhibition of NF-κB by PDTC attenuated the ethanol-induced increase in the expression of inflammatory factors in H4 cells. These findings indicated that chronic ethanol exposure increases the expression of TLR3 and NF-κB and produces neuroinflammation and anxiety-like behavior in male C57BL/6 mice and that ethanol-induced neuroinflammation can be caused through the TLR3/NF-κB pathway.

目的 对比髌骨全切术(complete patellectomy,CP)和髌骨部分切除术(partial patellectomy,PP)治疗髌骨粉碎性骨折的远期疗效.方法 回顾性分析1980至2003年收治的髌骨粉碎性骨折患者41例,采用PP治疗21例,采用CP治疗20例.末次随访时进行相关膝关节评分并摄患膝X线片,评估患者患肢膝关节功能和影像学情况.结果 41例患者随访时间14.2～35.9年,末次随访时PP组患者髌骨上缘10 cm、20 cm处大腿周径分别为(42.95±3.58)cm和(58.14±2.39)cm,CP组患者髌骨上缘10 cm、20 cm处大腿周径分别为(42.95±3.18)cm和(59.05±3.33)cm,差异均无统计学意义(P>0.05).pp组患者AKS评分为(159.76±27.27)分,CP组为(157.00±25.20)分,差异无统计学意义(t=0.881,P=0.384).PP组患者Bostman评分为(24.38±2.85)分,CP组为(24.35±2.30)分,2组差异无统计学意义(t=0.038,P=0.970).PP组患者Lysholm评分为(70.10±13.37)分,CP组为(66.75±14.66)分,2组差异无统计学意义(t=0.764,P=0.449).PP组患者VAS评分为(2.29±1.68)分,CP组为(2.25±1.62)分,2组差异无统计学意义(t=0.069,P=0.945).双膝骨关节炎按照K-L分级标准,PP组重度关节炎5例,轻度16例;CP组重度关节炎7例,轻度13例,差异无统计学意义(P=0.747).结论 PP和CP两种术式对髌骨粉碎性骨折的远期疗效不存在显著差异;两种方法 治疗髌骨粉碎性骨折,患者远期术后功能评分较低.

目的 研究骨科损伤防控在骨盆骨折护理当中的临床效果.方法 骨盆骨折患者120例,采取随机建组的方式分为研究组和对照组,每组60例.研究组患者采用损伤防控理论进行护理,对照组患者采用骨科常规急诊护理,将2组患者病死率、骨折复位优良率、骨盆损伤量化评估体系(Majeed)功能评分及术后并发症发生率进行比较和分析.结果 研究组患者的病死率低于对照组,差异均有统计学意义(P＜0.05);骨折复位优良率、术后并发症发生率Majeed评分明显高于对照组患者,差异均有统计学意义(P＜0.05).结论 在骨盆骨折患者的护理中应用骨科损伤防控理论的临床效果较好,降低了患者的病死率,且并发症发生率明显降低,可加快患者术后康复并提高患者生活质量,值得在临床护理当中推广.

目的 比较切开复位内固定术和髌骨部分切除术治疗髌骨粉碎性骨折的远期疗效.方法 回顾性分析1980至2003年收治的髌骨粉碎性骨折患者46例,其中采用切开复位内固定术25例,采用髌骨部分切除术治疗21例,每次随访时,拍摄患肢正侧位X线评估患者骨折愈合情况,指导下一步康复计划;随访后期,X线片用于判断患者膝关节炎的进展情况.对患者进行AKS膝关节功能评分、膝关节Bostman评分、膝关节Lysholm评分和视觉模拟评分法(visual analogue scale,VAS),记录并评价患者术后功能和疼痛情况;评估患者股四头肌肌力,测量患者双腿伸直位时髌骨上缘近端10 cm和20 cm处大腿周径,间接反映双侧股四头肌肌力情况.结果 46例患者平均随访时间26.5年(14.2～35.9年),末次随访时各项数值差异均无统计学意义(P>0.05).结论 髌骨粉碎性骨折患者行切开复位内固定和髌骨部分切除术,两种术式远期疗效无明显差异.

目的 探讨单侧髌骨骨折合并膝关节韧带和半月板损伤的患者术后对双侧膝关节功能的远期影响.方法 回顾性分析2003年至2012年收治的单侧髌骨骨折合并膝关节交叉韧带和(或)半月板损伤患者39例,男26例,女13例;平均年龄(51.08±16.36)岁;左侧28例,右侧11例.记录患者末次随访时双侧股四头肌肌力、髌骨上缘近端10 cm、20 cm处大腿周径,进行相关膝关节评分并拍摄患膝X线片,评估患者患肢膝关节功能和影像学情况.结果 39例患者平均随访7～12年,末次随访时患者患侧髌骨上缘10 cm、20 cm处大腿周径分别为(41.82±5.31)cm和(56.87±3.23)cm,健侧髌骨上缘10 cm、20 cm处大腿周径分别为(43.74±4.83)cm和(57.38±3.84)cm,双侧比较两项数值差异均无统计学意义(P>0.05).所有患者双侧股四头肌肌力均为5级.患者患侧AKS评分为(155.54±20.14)分,健侧为(160.08±13.07)分,差异无统计学意义(t=1.181,P=0.241).患者患侧VAS评分为(3.31±1.98)分,健侧为(3.28±2.28)分,两侧对比差异无统计学意义(t=0.053,P=0.958).双膝骨关节炎按照K-L分级标准,患侧关节炎情况明显更重(P=0.037).结论 单侧髌骨骨折合并膝关节交叉韧带和(或)半月板损伤的患者术后,长期随访患侧股四头肌力量和膝关节功能可以恢复至与健侧相当的水准,但患侧膝关节退变更为明显.

OBJECTIVE:miR-199a-5p was increased during osteoblast differentiation, which may target and regulate TET2, a gene attracted a lot of attention in the osteoblast differentiation in the past few years. However, the role of miR-199a-5p in osteoblast differentiation by targeting TET2 is not established.METHODS:The correlation between miR-199a-5p and TET2 was verified through dual luciferase reporter assay, and their expressions in human bone marrow stromal cells (hBMSCs) during the osteoblast differentiation were detected. hBMSCs were transfected with TET2 siRNA, miR-199a-5p mimic or/and TET2 CRISPR activation plasmid., and then prepared for the induction of osteoblast differentiation, followed by alkaline phosphatase (ALP) and alizarin red staining, qRT-PCR and Western blotting. In vivo, ovariectomized (OVX) mice were injected with agomir-miR-199a-5p, antagomiR-199a-5p or/and TET2 siRNA to calculate the BMD and BV/TV ratio of mice, as well as to measure the expressions of osteogenesis-related genes in bone tissues.RESULTS:A gradual increase of miR-199a-5p was observed in hBMSCs during the induction of osteoblast differentiation, while TET2 expression was decreased. Besides, miR-199a-5p was reduced in the bone tissue of OVX mice, while TET2 was up-regulated. In addition, overexpression of miR-199a-5p and inhibition of TET2 augmented ALP activity in hBMSCs, with the enhanced calcification and the up-regulated expressions of Runx2, OSX and OCN, which also increased the quality of bone in OVX mice accompanying the enhancement BV/TV ratio, BMD and osteogenesis-related genes.CONCLUSION:MiR-199a-5p may promote the osteoblast differentiation and prevent OVX-induced osteoporosis by targeting TET2.

Objective This study was performed to investigate the efficacy and safety of percutaneous antegrade nailing with a reductor-T tape pin in the treatment of ipsilateral multisegmental femoral shaft fractures (IMFSFs). Methods Nineteen patients with IMFSFs underwent antegrade nailing with a reductor-T tape pin by percutaneous techniques. The operation time, reduction time, fluoroscopy time, blood loss, fracture union time, and complications were recorded. Results All 19 patients (100%) achieved technical success. The mean and median operation time were 62.42±16.27 and 60 (range, 40–105) minutes, respectively; the mean and median reduction time were 11.47±3.78 and 10 (range, 8–22) minutes, respectively; the mean and median fluoroscopy time were 16.63±6.10 and 15 (range, 10–35) s, respectively; and the mean and median blood loss were 185.26±62.75 and 180 (range, 110–350) mL, respectively. Additionally, all 19 patients (100%) achieved fracture union within a mean and median time of 3.95±1.75 and 3 (range, 3–9) months, respectively; most patients [n=14 (73.7%)] achieved fracture union within 3 months. No obvious complications occurred during the study. Conclusion Antegrade nailing with a reductor-T tape pin by a percutaneous technique is effective and well tolerated in patients with IMFSFs.

Objective To observe the biomechanical effects of enoxaparin sodium added to bone cement in different mixing modes.Methods The enoxaparin sodium for injection was mixed with polymethylmethacrylate (PMMA) bone cement according to different dosages and different mixing methods.Group A was used as blank control group without enoxaparin sodium.Groups B (8 000 AxaIU),C (16 000 AxaIU) and D (24 000 AxaIU) served as control groups in a powder mixture.Groups E(8 000 AxaIU),F (16 000 AxaIU) and G (24 000 AxaIU) served as experimental groups.The enoxaparin sodium for injection was dissolved and added to the PMMA bone cement.Under the environment of sterility,temperature (23 ± 1) ℃,relative humidity higher than 40％ (operating room environment),according to the international standard ISO5833:2002 "Implants for surgery-Acrylic resin cement" regulations,bone cement cylinder specimens and cuboid specimens were prepared.After measurement and X-ray irradiation,5 specimens of each group were selected,and the compressive strength,flexural strength and flexural modulus were measured on an electronic material universal testing machine.Results The compressive strength,flexural strength and flexural modulus in groups E,F and G were significantly lower than those in the control groups (t =12.731,41.646,3.128,P ＜ 0.05).The lowest values were (57.17±1.15) MPa,(67.93 ±0.55) MPa,and (19.2 ±0.114) GPa respectively.Conclusion The addition of enoxaparin sodium to PMMA bone cement in a liquid mixture can significantly reduce the biomechanical properties of bone cement.

Background: Chemokines play a key role in post-traumatic inflammation and secondary injury after spinal cord injury (SCI). CCL28, the chemokine CC-chemokine ligand 28, is involved in the epithelial and mucosal immunity. However, whether CCL28 participates in the physiopathologic processes after SCI remains unclear. Results: CCL28 is upregulated in the spinal cord after SCI. In addition, neutralizing antibodies against IL-1 beta or TNF-alpha, or treatment of ML120B, a selective inhibitor of IKK-beta, remarkably decrease CCL28 upregulation, suggesting that CCL28 upregulation relies on NF-kappa B pathway activated by IL-1 beta and TNF-alpha after SCI. Moreover, CD4(+)CD25(+)FOXP3(+) regulatory T (Treg) cells that express CCR10, a receptor of CCL28, are enriched in the spinal cord after SCI. We further demonstrate that the spinal cord recruits Treg cells through CCL28-CCR10 axis, which in turn function to suppress immune response and promote locomotor recovery after SCI. In contrast, neutralizing CCL28 or CCR10 reduces Treg cell recruitment and delays locomotor recovery. Methods: The neutralizing antibodies and recombinant CCL28 were injected intraspinally into the mice prior to SCI, which was established via hemitransection. RT-qPCR analysis was performed to determine transcript level, and Western blot analysis and ELISA assay were used to detect protein expression. Immune cells were analyzed by flow cytometry and visualized by immunofluorescence. The chemotaxis was assessed by in vitro transwell migration assay. The mouse locomotor activity was assessed via the Basso Mouse Scale (BMS) system. Conclusions: These results indicate that NF-kappa B pathway-regulated CCL28 production plays a protective role after SCI through recruiting CCR10-expressing and immunosuppressive Treg cells, and suggest that interfering CCL28-CCR10 axis might be of potential clinical benefit in improving SCI recovery.

Chronic ethanol (EtOH) exposure can cause intracellular Ca2+ overload by stimulating calcium channel receptors and trigger apoptosis of neurons. NCX3 may play a cytoprotective role in intracellular Ca2+ excretion. In this study, the effect of EtOH on NCX3 was analyzed by observing NCX3 expression in the hippocampus of chronic EtOH-exposed male C57BL/6 mice. Mice were divided into a control group, a 10% EtOH group, and a 20% EtOH group for 30, 60, and 90 days. Behavioral changes were observed using the Morris water maze. The protein and mRNA expressions of NCX3 and their distribution in the hippocampus were observed by western blotting, quantitative PCR, and immunohistochemistry staining. The results showed that EtOH exposure exerted a significant adverse effect on the spatial memory capacity of mice. Increased expression of calpain-1 and cleaved caspase-3 proteins indicated increased apoptosis. The expression of NCX3 in the hippocampus was downregulated after exposure to EtOH (except 10% EtOH for 30 days) and this inhibition was time and dose dependent with EtOH exposure. The level of p-Akt, which is an upstream regulation factor of NCX3, showed a trend similar to that of NCX3 protein. Chronic EtOH exposure reduced the expression of NCX3 in the hippocampus of male C57BL/6 mice, increasing intracellular calcium and apoptosis, resulting in spatial memory impairment in mice.

聚甲基丙烯酸甲酯骨水泥是一种常用的骨科材料,广泛应用于髋膝关节置换术、椎体成形术以及骨肿瘤、骨与关节感染的治疗.由于聚甲基丙烯酸甲酯骨水泥具有多孔隙的微观结构,使其具备复合药物的潜力[1].临床上现已广泛将复合抗生素的聚甲基丙烯酸甲酯骨水泥用于治疗骨与关节感染.近年来,抑制骨肿瘤和缓解骨质疏松的载药骨水泥也有人进行过研究[2-3].在关节置换或椎体成形术中,由于聚甲基丙烯酸甲酯骨水泥植入,局部血栓形成风险大大增加,甚至可能发生肺栓塞[4].为解决这一问题,笔者研发了"依诺肝素钠聚甲基丙烯酸甲酯骨水泥",以用于降低聚甲基丙烯酸甲酯骨水泥植入时操作局部血栓形成的风险.本研究旨在探讨依诺肝素钠聚甲基丙烯酸甲酯骨水泥能否起到一定的抗凝作用.

This manuscript reported a case of fatal arsenic poisoning. A woman with schizophrenia took arsenic-containing "pills," which consisted of arsenic trioxide and realgar (arsenic (II) sulfide) and wrapped with gauze. The victim consumed 1.09 and 0.819 g arsenic on two occasions, respectively, with the interval between the two doses of 3 days. The woman died on the sixth day after the first dose without any treatment. In this case, pathological examination revealed fat degeneration of the liver rather than hepatomegaly, a rare finding in acute arsenic poisoning. Arsenic in tissue samples was measured, the total arsenic and inorganic arsenic in blood, liver, and gastric wall was 10.2 mu g/mL (9.61 mu g/mL), 23.1 mu g/g (20.7 mu g/g), and 32.3 mu g/g (28.6 mu g/g), respectively.

Objective To evaluate the curative effect and surgical skills of intramedullary nailing(IMN)in the treatment of ipsilateral multisegmental femoral shaft fractures under the assistance of an reduction device by joystick techniques.Methods Twenty-four adult patients with ipsilateral multisegmental femoral shaft fractures,including 1 9 males and 5 females,were enrolled into this study.All the patients were treated with anterograde IMN by percutaneous and joystick techniques under the assistance of the special reduction device(T-tape pin redaction device).The operation time,reduction time,fluoroscopy time,and intra-operative blood loss were recorded.Follow-up was conducted to assess the healing of the fractures and the functional recovery of the affected limbs.Results All the 24 cases were achieved closed reduction under the assistance of an reduction device by joystick techniques,two patients of them needed kirschner wire for reduction.The average operative time,fracture reduction time,fluoroscopy time and blood loss were(61.4± 15.1)min,(11.5± 3.5)min,(16.3± 5.6)s and(183.8± 58.0)mL, respectively.All fractures healed well on an average of(4.5 ± 3.3)months.According to Friedman-Wyman classification 24 cases get good result.Conclusion The method that treated ipsilateral multisegmental femoral shaft fractures with anterograde IMN under the assistance of the T-pin redaction device by percutaneous techniques is a good choice with the advantages of less soft tissue trauma,less intra-operative blood loss,easy reduction,short operative time,high healing rate of bone fractures,less complications and excellent functional recovery,so it is worthy of popularizing in clinic.

It has been identified that chronic ethanol exposure damages the nervous system, particularly neurons. There is scientific evidence suggesting that neuronal loss caused by chronic ethanol exposure has an association with neuron apoptosis and intracellular calcium oscillation is one of the primary inducers of apoptosis. Therefore, the present study aimed to investigate the inductive effects of intracellular calcium oscillation on apoptosis in SK-N-SH human neuroblastoma cells and the protective effects of the N-methyl-D-aspartic acid receptor (NMDAR) antagonist, memantine, on SK-N-SH cell apoptosis caused by chronic ethanol exposure. SK-N-SH cells were treated with 100 mM ethanol and memantine (4 µM) for 2 days. Protein expression of NR1 was downregulated by RNA interference (RNAi). Apoptosis was detected by Annexin V/propidium iodide (PI) double-staining and flow cytometry and cell viability was detected using an MTS kit. Fluorescence dual wavelength spectrophotometry was used to determine the intracellular calcium concentration and the levels of NR1 and caspase-3 were detected using western blotting. NR1 mRNA levels were also detected using qPCR. It was found that chronic ethanol exposure reduced neuronal cell viability and caused apoptosis of SK-N-SH cells, and the extent of damage in SK-N-SH cells was associated with ethanol exposure concentration and time. In addition, chronic ethanol exposure increased the concentration of intracellular calcium in SK-N-SH cells by inducing the expression of NMDAR, resulting in apoptosis, and memantine treatment reduced ethanol-induced cell apoptosis. The results of the present study indicate that the application of memantine may provide a novel strategy for the treatment of alcoholic dementia.

目的 评价腓肠神经血管皮瓣联合rh-aFGF修复足跟区皮肤软组织缺损的有效性与安全性.方法 选择2015年6月至2017年6月足跟区皮肤软组织缺损42例,随机分为治疗组和对照组,每组21例.对照组行远端蒂腓肠神经营养血管皮瓣修复治疗,治疗组在对照组基础上对皮瓣及植皮区同时给予rh-aFGF预处理及术后换药.术后随访1个月,观察皮瓣存活情况、皮瓣移植后并发症及创面愈合情况.结果 治疗组皮瓣成活面积显著高于对照组[(98.4±12.8)％vs(89.4±13.7)％],受区完全愈合时间[(9.4±2.4)d vs(13.8±4.6)d]供区完全愈合时间[(11.4±4.2)d vs(16.7±6.8)d]显著短于对照组,2组比较差异有统计学意义(P<0.05).治疗组水肿评分、渗出评分、皮瓣暗紫评分分别为1.4±0.7,1.1±0.2,1.3±0.4,对照组三项评分则分比为2.6±0.3,2.2±0.3,2.8±0.6.治疗组评分明显低于对照组,差异有统计学意义(P<0.05).随访30 d内,治疗组发生感染的病例为1例,发生率为4.7％,对照组发生感染的病例为8例,感染率为28.5％,2组比较差异有统计学意义.随访30 d显示,治疗组感觉评分为(8.2±1.4)分,对照组为(5.2±1.3)分,2组比较差异有统计学意义(P=0.021).另外2组治疗过程均未发生明显的不良反应.结论 rh-aFGF预处理联合术后换药干预皮瓣及植皮区有利于皮瓣存活、减少皮瓣移植后并发症发生,促进皮瓣的愈合.