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2021 Volume 46 Issue 2  Published: 2021-02-28
    Basic Research
  • Mei-Ling Luo , Bo-Tao Tan , Lu Pan , Ya-Min Wu , Yuan Liu , Le-Hua Yu
    doi: 10.11855/j.issn.0577-7402.2021.02.01

    Objective To observe the effect of increasing brain cortical neuronal activity in mice on axon remyelination and motor function recovery after mild spinal cord contusion injury by chemical genetics technology (DREADDs). Methods 33 C57/BL male adult mice accepted stereotactic injection of adeno-associated virus with activated receptor [AAV-hM3D(Gq)-mCitrine] into the right cerebral cortex. Then all of the mice were randomly divided into three groups: sham group (n=11), SCI group (n=11) and activated group (n=11). SCI spinal cord injury model was established in SCI group and activation group. Two weeks later, activation group was intraperitoneally injected with 1 mg/(kg·d) clozapine N-oxide (CNO) to activate the electrical activity of cortical neurons. Sham group and SCI group were intraperitoneally injected with the same amount of normal saline once a day for 4 weeks. Animals were perfused at last, using immunofluorescence to observe the results of infection of virus, the expression of cellular Fos (cFos) within neurons and myelin basic protein (MBP) in dorsal corticospinal tract; transmission electron microscopy to show the result of axonal myelination; BMS scale and irregular horizontal ladders were used to evaluate the motor function of mice. Results Immunofluorescence microscopy confirmed successful transfection of virus into neurons at mice motor cortex, and there was no statistical significance of number of neurons infected by GFP labled adeno-associated virus between the three groups. Neuronal cFos fluorescence intensity at the transfection site in activated group was significantly higher than that in SCI group(P<0.001); MBP fluorescence intensity in the spinal cord injury center in activated group and sham group were significantly higher than that in SCI group (P<0.001). The G-ration value in activated group was apparently lower than that in SCI group (P<0.001). For the BMS score, there was no statistical significance between activated group and SCI group; the evaluation of irregular horizontal ladders found that after 2 weeks intraperitoneal injection, the error rate in activated group and SCI group decrease, and the error rate in activated group was significantly lower than that in SCI group (P<0.001); after 4 weeks intraperitoneal injection, the error rate in activated group and SCI group continued to decline, and the error rate in activated group was significantly lower than that in SCI group (P<0.001). Conclusion Using DREADDs strategies to improve the neuronal activity of cerebral cortical neurons can effectively promote the axon remyelination and the recovery of motor function after mild spinal cord contusion injury in mice.

  • Basic Research
  • Jian Wu , Meng-Meng Li , Ji-Wei Hao , Ling-Chao Meng , Qing-Hong Zhang , Yi-Qing Hao
    doi: 10.11855/j.issn.0577-7402.2021.02.02

    Objective To investigate the gender difference of cognitive function in neonatal rats treated with sevoflurane. Methods Eighty two postnatal 7-day (P7) SD rats were randomly divided into control group and sevoflurane treated group, then divided into the following subgroups according to gender: female control group, male control group, female sevoflurane treated group, and male sevoflurane treated group. After inhaling air or 4% sevoflurane for 4 hours, the levels of serum cortisone and estradiol (E2) were detected by ELISA, and the expressions of Ki-67 and neuronal core antigen (NeuN) in hippocampus were detected by immunohistochemistry. The open field experiment was performed with rat P21 and Morris water maze experiment was performed with rat P35 to explore the effects of sevoflurane exposure on the spatial cognitive function in different gender of rats. Results ELISA reveled that, compared with the control group, the serum cortisone level in sevoflurane treated group was significantly higher [(11.60±1.41) ng/ml vs. (7.93±1.58) ng/ml, P<0.05], while the serum E2 level showed no significantly different [(35.0±8.25) pmol/L vs. (34.2±9.73) pmol/L, P>0.05]; and no significant difference existed in the levels of cortisone and E2 between different genders (P>0.05). Immunohistochemistry showed that the number of Ki-67 and NeuN positive cells in hippocampal CA1 and dentate gyrus (DG) decreased significantly in sevoflurane treated group than those in control group(P<0.05). Also, no significant difference existed in the expression of hippocampal neurons between different genders (P>0.05).Morris water maze test showed that no significant difference was found among female rats (P>0.05); compared with male control group, the platform latency and moving distance of male sevoflurane treated group were significantly prolonged at the forth and fifth day of acquired training (P<0.01 or P<0.05). At the second day of counterpoint training, the platform latency and movement distance of rats in male sevoflurane treated group were significantly prolonged (P<0.05). In counterpoint exploration training, the platform latency of rats in male sevoflurane treated group was significantly prolonged (P<0.01), and the time spent in the target quadrant reduced significantly (P=0.031). Conclusions Sevoflurane treatment has a great influence on the serum cortisone level of postnatal rats, may inhibit the proliferation of hippocampal neural stem cells and neurogenesis. The learning ability of male rats decreased after adulthood, but no obvious effect on female rats.

  • Clinical Research
  • Nan Che , Wen-Bo Qi , Zhao-Ting Yang , Yan-Hua Xuan
    doi: 10.11855/j.issn.0577-7402.2021.02.03

    Objective To investigate the effect and mechanism of B7-H4 expression on the prognosis of patients with gastric cancer. Methods The databases of Gene Expression Profiling Interactive Analysis (GEPIA), UALCAN and Kaplan-Meier Plotter were used to analyze the expression of B7-H4 in gastric cancer tissues and its relationship with the prognosis of gastric cancer patients. Immunohistochemistry staining was performed to observe the expression of B7-H4 protein in gastric cancer tissues and analyze its correlation with clinicopathological characteristics, cell cycle regulatory proteins, microvessel density (MVD), stemness-related proteins, and PI3K/Akt/NF-κB signaling pathway proteins. Immunofluorescence and Western blotting were used to detect the expressions of B7-H4 and stemness-related proteins in gastric cancer cells. Oncomine database was employed to analyze the correlation between B7-H4 and the expressions of PI3K and Akt mRNA in gastric cancer tissues. Results The expression level of B7-H4 was higher in gastric cancer tissues than in normal tissues, and its expression was significantly related to tumor differentiation, pT staging, lymph node metastasis, distant metastasis and clinical staging (P<0.05), and indicated a poor prognosis in gastric cancer. The expression of B7-H4 was positively correlated with the expressions of cell cycle regulatory protein p16 (r=0.250, P<0.001) and stemness-related proteins LSD1 (r=0.331, P<0.001), SOX9 (r=0.176, P=0.018) and CD133 (r=0.434, P<0.001). The MVD was significantly higher in B7-H4 positive tissue than in B7-H4 negative tissue (P=0.019). Furthermore, B7-H4 was co-expressed with stemness-related proteins LSD1, SOX9, and CD133 in gastric cancer cell lines, and the expression of B7-H4 was positively correlated with the expressions of p-PI3K-p85 (r=0.269, P<0.001), p-Akt-Ser473 (r=0.282, P<0.01), p-Akt-Thr308 (r=0.214, P=0.005) and NF-κB p65 (r=0.157, P=0.034). The expression of B7-H4 in gastric cancer tissue was positively correlated with the expressions of PI3K mRNA (r=0.403, P<0.001) and Akt mRNA (r=0.351, P<0.001). Conclusion B7-H4 can promote gastric cancer progression and is closely related to poor prognosis, and the mechanism may be related to the regulation of gastric cancer stemness via PI3K/Akt/NF-κB.

  • Clinical Research
  • Dan-Ni Wang , Li-Dian Hua , Zhi-Guo Pan , Qiang Wen , Lei Su
    doi: 10.11855/j.issn.0577-7402.2021.02.04

    Objective To explore the relationship of body mass index (BMI) to short-term and long-term clinical outcomes in patients with sepsis. Methods To retrospectively analyze 5571 clinical data of sepsis patients in the Beth Israel Deaconess Medical Center (Boston, MA, USA) registered from 2001 to 2012 in the Medical Information Market Intensive Care (MIMIC-Ⅲ) database. Cox proportional hazards regression model was used to assess the relationship between BMI and 30-day and 1-year mortality. Results Patients were divided into four groups according to BMI: underweight 336 cases (6.0%); normal weight 1752 cases (31.4%);overweight 1563 cases (28.1%); and obesity 1920 cases (34.5%). The 30-day mortality of the patients mentioned above were 42.3%, 36.6%, 32.2% and 29.6%, respectively (P<0.001), the 1-year mortality were 64.6%, 56.8%, 52.5% and 46.7%, respectively (P<0.001), and in-hospital mortality were 35.4%, 34.3%, 31.6% and 29.9%, respectively (P=0.018). The Cox proportional hazards regression analysis confirmed that, compared to the patients with normal weight, the 30-day and 1-year risk of death increased by 13% and 24%, respectively, in underweight patients; decreased by 17% and 14%, respectively, in overweight patients; and decreased by 22% and 21%, respectively, in obese patients. Conclusion The 30-day and 1-year survival rate is higher in overweight or obese sepsis patients than in those sepsis patients with underweight and normal weight after admission to the intensive care unit.

  • Clinical Research
  • Xiao-Dong Yan , Jun Lin , Jian Zhang , Jun-Nan Xu , Zhi-Jia Liu , Xin Hong , Chang-Qin Chen , Tao Yu , Qiang Wang
    doi: 10.11855/j.issn.0577-7402.2021.02.05

    Objective To investigate the efficacy and safety of antithymocyte globulin (ATG) in the immune induction of deceased donor renal re-transplantation. Methods The clinical data of 20 renal re-transplantation patients treated with ATG from June 2017 to November 2020, were retrospectively studied. The safety was assessed with T lymphocyte subsets, pulmonary infection, and bone marrow suppression. The efficacy was assessed with acute rejection (AR) and delayed graft function (DGF). Results The study contained 15 males and 5 females. The average age was 45.7 (25-71) years; 6 patients were positive for prestored antibody and 14 negative antibody; 17 patients received a second transplantation, 3 did a third transplantation. T lymphocytes decreased more than 70% in average induced by ATG on the 1st day after surgery and gradually recovered to 50% of the amount on the 3rd day after surgery (P<0.01). Two weeks after surgery, the number of T lymphocytes recovered to the pretransplant level. NK cells showed a continuous decline (P<0.01). There were 5 patients (25.0%) who suffered AR, 1 patient (5.0%) did DGF, 7 patients(35.0%) presented with pulmonary infection, 5 patients (25.0%) presented with bone marrow suppression, and no ATG allergic reaction cases. The median follow-up period was 17.6 (6-53) months. During the follow-up period, 19 patients (95.0%) survived with allograft and 1 (5.0%) died. Conclusions ATG can significantly suppress the activation and proliferation of T cells, reduce the incidence of AR, and improve the short-term functional recovery of allograft with kidney re-transplantation. ATG induction does not increase the incidence of infection, and the clinical safety of ATG application is reliable.

  • Clinical Research
  • Qian Zhou , Shuang Tang , Kai-Ya Zhao , Xin Li , Peng-Chao Wu , Xiao-Kui Tang
    doi: 10.11855/j.issn.0577-7402.2021.02.06

    Objective To analyze the clinical characteristics of myositis autoantibody detection in the diagnosis of interstitial lung disease (ILD), and explore the diagnosis and treatment of ILD with the help of clinical manifestations combined with antibody results. Methods Sixty-three patients of ILD accurately diagnosed with the help of myositis autoantibody detection were collected retrospectively and divided into three groups: anti-synthetase syndrome associated interstitial lung disease group(ASS-ILD group, n=22), polymyositis/dermatomyositis associated interstitial lung disease group (PM/DM-ILD group, n=18) and interstitial pneumonia with autoimmune features group (IPAF group, n=23). Their clinical characteristics, treatment and prognosis were analyzed and compared. Results The positive rates of Raynaud's phenomenon, joint symptoms, mechanic's hand and anti-ARS antibodies in ASS-ILD group were higher than those in IPAF group (P<0.0167). Compared with PM/DM-ILD group, ASS-ILD group had higher positive rates of Raynaud's phenomenon, cough, dyspnea, respiratory system symptoms as the first manifestation, anti-ARS antibodies but lower positive rates of fever, muscle symptoms, skin/muscle symptoms as the first manifestation (P<0.0167).Compared with IPAF group, PM/DM-ILD group had higher positive rates of muscle symptoms, skin symptoms, skin/muscle symptoms as the first manifestation, anti-ARS antibodies and anti-MDA5 antibody but lower positivity rates of respiratory system symptoms as the first manifestation (P<0.0167). In this study, chest radiological findings of all patients were mainly nonspecific interstitial pneumonia (NSIP). The abnormality in pulmonary functions manifested mainly as diffusion disturbance and restrictive ventilatory dysfunction. 87.3% of all patients were treated with glucocorticoid combined with immunosuppressants. After treatment, 81.0% of these patients showed improvement or stability, while 19.0% showed deterioration or death. The difference in prognosis between the three groups was not statistically significant (P>0.05). Conclusion The detection of myositis autoantibody should be paid more attention in ILD patients. Diagnosis, classification, treatment and prognosis evaluation of ILD could be made with the help of myositis autoantibodies.

  • Clinical Research
  • Rui Chen , Ying Zhao , Jing An , Lin Zeng , Gang Xue , Hong-Ru Song , Yu-Tuo Zhang
    doi: 10.11855/j.issn.0577-7402.2021.02.07

    Objective To investigate the distribution of inhaled allergens and analyze the related risk factors among allergic rhinitis (AR) patients in Zhangjiakou area. Methods Serum specific IgE antibody of inhaled allergens was detected in 532 suspected AR patients in the Department of Otolaryngology, Head and Neck Surgery of the First Affiliated Hospital of Hebei North University form April 2019 to August 2020. A total of 245 family members of outpatient and inpatient patients (except family members of respiratory department, dermatology department and otolaryngology department) in the same period were selected as the control group. AR questionnaire survey was conducted in the AR patients and control group, and the survey results were statistically analyzed. Results Of the 532 patients with suspected allergic rhinitis, 388 (72.9%) were positive for at least one allergen. The top three positivity rates of inhalation allergens were mugwort (89.9%), common ragweed (44.1%) and cat epithelium(21.4%) among the AR patients. In the single allergen positive patients, the mudwort has a much higher positive detection rate(86.0%). The positive degree of allergens was mainly distributed in class 2, class 3 and class 6 of mugwort, in class 1 of house dust and house dust mite, and in class 2 of other allergens. There were statistically significant differences in the allergen positive rate of AR patients in different months, regions and ages (P<0.05). The allergen positivity rate from July to September was significantly higher than that in other months, in bar-upper region was significantly higher than that in bar-lower region, and the positive rate of allergen gradually declined with the increase of age. The differences of allergens in ragweed, cat epithelium, house dust, house dust mite and streptomyces alternaria between genders of AR patients were statistically significant (P<0.05). Multivariate logistic analysis showed that previous allergies, parents with allergic rhinitis, history of asthma, secondhand smoke exposure, staying up late, age 3-24 years old were AR high-risk factors (OR>1), regular physical exercise was an effective protective factor for AR (OR<1). Conclusions The most common inhalation allergens in Zhangjiakou area are mugwort and common ragweed. The distribution of allergens is correlated with the month, region, and gender and age of the patients. Previous allergies, history of asthma, parents having allergic rhinitis, age and so on are risk factors for AR.

  • Clinical Research
  • Da-Yuan Gong , Ren-Jie Ya , Xiao-Ping Xie , Yao-Ming Chang , Sheng-Quan Liu , Jun-Xiang Bao
    doi: 10.11855/j.issn.0577-7402.2021.02.08

    Objective To analyze the risk factors inducing hyperuricemia (HUA) in helicopter pilots and put forward the corresponding intervention measures. Methods A total of 190 male helicopter pilots, aged 20-50 years and with more than 100 hours of flight time, were recruited from April to October 2020 in a flight brigade. A self-designed questionnaire was used, by which the basic information of subjects were collected including eating habits, physical exercise, smoking and drinking, exposure to noise and vibration at work, mood, disease, work performance, sleep status, genetic factors, and so on. At the same time, 28 SPF grade 6-week-old male C57BL/6J mice were randomly divided into 7 groups (4 each): control group, noise group, noise + vitamin C (Vit C)group, noise + multivitamin (Multi Vit) group, noise + hyperbaric oxygen (HBO) group, noise + HBO + Vit C group, and noise +HBO + Multi Vit group. After continuous intervention for 7 days, Multiskan Ascent was used to detect the uric acid (UA) level in mice sera. Results Finally, 186 subjects, aged 22-50 years and with (1378±569) hours of flight time, were included in present study. Of whom 17 (9.14%) were self-reported with HUA (HUA group) and 169 (9.14%) were with normal uric acid (NUA group).No significant difference existed between the two groups in age, height, body mass index and the proportion of hyperglycemia. The proportions of hyperlipidemia and fatty liver were significantly higher in HUA group (17.6% and 29.4%, respectively) than those in NUA group (4.7% and 10.1%, respectively) with statistically significant difference (P<0.05). The scores of noise exposure and vibration exposure were significantly higher in HUA group [(22.942±3.960) and (16.351±3.552), respectively] than those in NUA group [(19.413±4.086) and (13.323±3.476), respectively] with statistically significant difference (P<0.05); there was no significant difference between the two groups (P>0.05) in the other 8 dimensions. Noise and vibration exposure were closely related to the occurrence of HUA. Among them, strong noise and long daily exposure, great influence on emotion, the poor effect and low use frequency of protective measures would significantly increase the risk of HUA; Long daily exposure and great influence on emotion of vibration would also increase the risk of HUA. Compared with the control group, the serum UA level in noise group increased significantly [(38.710±10.201) μmol/L vs. (191.935±9.542) μmol/L] with significant difference (P<0.05); The serum UA levels in noise + Vit C group [(127.419±5.349) μmol/L], noise + Multi Vit group [(111.290±7.030) μmol/L], noise + HBO group [(53.226±11.518) μmol/L], noise + HBO + Vit C group [(61.290±7.213) μmol/L] and noise + HBO + Multi Vit group[(69.355±13.968) μmol/L] were all lower significantly than that in noise group (P<0.05). The UA levels in noise + Vit C group, noise + Multi Vit group, noise + HBO + Vit C group and noise + HBO + Multi Vit group were still higher than that in control group(P<0.05), while there was no significant difference between noise + HBO group and control group (P>0.05). Conclusions HUA in helicopter pilots is related to noise and vibration exposure in working environment. Hyperbaric oxygen and dietary vitamin supplementation can effectively reduce the increase of serum uric acid level caused by noise exposure.

  • Clinical Research
  • Yi Wei , Jun-Ren Nong , Qiu-Long Wu , Guo-Ping Lu
    doi: 10.11855/j.issn.0577-7402.2021.02.09

    Objective To investigate the expression and significance of human neutrophil lipocalin (HNL) and neutrophil CD64 (nCD64) in prostatic fluid of chronic prostatitis patients with different infection degrees. Methods One hundred and seventy-eight patients with chronic prostatitis admitted to the Affiliated Ethnic Hospital of Guangxi Medical University from February 2017 to October 2019 were selected as the research objects. According to whether they were infected with bacteria, the patients were divided into chronic prostatitis/chronic pelvic pain syndromes group (CP/CPPS group, n=40) and chronic bacterial prostatitis group (CBP group, n=138). According to National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI)score, CBP group was divided into mild group (n=65), moderate group (n=46) and severe group (n=27), and another 40 healthy people were selected as control group. Age, body mass index (BMI), course of disease, white blood cell (WBC), and NIH-CPSI score were recorded and analyzed. The expression level of HNL in prostatic fluid was detected by enzyme linked immunosorbent assay (ELISA). The expression level of nCD64 in prostatic fluid was detected by flow cytometry. Pearson correlation was used to analyze the correlation between both HNL and NCD64 levels and NIH-CPSI score in the CBP group. Logistic regression analysis was used to analyze the influencing factors of CBP and CP/CPPS. ROC curve was used to evaluate the diagnostic value of HNL and nCD64 for CBP. Results Compared with the control group, WBC, HNL and nCD64 levels in CP/CPPS group, CBP group and its subgroups were significantly increased (P<0.05), while the CBP group was higher than CP/CPPS group, and the CBP subgroup increased with the increase of infection degree, and the difference between the groups was statistically significant (P<0.05). There was no significant difference in NIH-CPSI score between CP/CPPS group and CBP group (P>0.05), but NIH-CPSI score of moderate group was higher than that of mild group, and that of severe group was higher than that of moderate group and mild group(P<0.05). Pearson correlation analysis showed that the levels of HNL and nCD64 in prostatic fluid of CBP group were significantly positively correlated with NIH-CPSI score (r=0.897, P<0.001; r=0.919, P<0.001). Multivariate logistic regression analysis showed that bacterial infection, HNL, and nCD64 were independent risk factors for CBP (P<0.05). Other pathogen infections, urinary dysfunction, neuroendocrine abnormalities, abnormal immune response, and pelvis related diseases were independent risk factors for CP/CPPS (P<0.05). ROC curve analysis showed that HNL and nCD64 in prostatic fluid had higher diagnostic value for the occurrence of CBP, area under the ROC curve (AUC) was 0.837 and 0.899 respectively, and the best critical values were 165.36 μg/L and 4078.28/cells respectively. The combination of the two (HNL and nCD64) had higher diagnostic value, with AUC of 0.949. Conclusion The levels of HNL and nCD64 in prostatic fluid of patients with chronic prostatitis increased with the aggravation of the bacterial infection, showing a positive correlation, and the combined monitoring of HNL and nCD64 is of reference value for clinical diagnosis and the judgment of infection degree.

  • Clinical Research
  • Wen-Jie Qian , Yue Chen , Yun-Ting Wang , Zi-Yu Ren , Xun Wu , Wei Ren
    doi: 10.11855/j.issn.0577-7402.2021.02.10

    Objective To investigate the correlation between the ratio of serum non-high-density lipoprotein cholesterol/high-density lipoprotein cholesterol (Non-HDL-C/HDL-C) and microalbuminuria in patients with type 2 diabetes mellitus(T2DM). Methods A total of 576 patients with T2DM hospitalized in the Endocrinology Department of the First Affiliated Hospital of Chongqing Medical University from 2017 to 2019 were included in present study (373 males and 203 females, aged 59±11.8 years). The clinical data of patients were collected including: age, height, weight, history of smoking, duration of diabetes, glycosylated hemoglobin (HbA1c), comorbidities, medication status, blood lipid level, etc. The values of non-high-density lipoprotein cholesterol (Non-HDL-C) and the ratio of Non-HDL-C and HDL-C (Non-HDL-C/HDL-C) were then calculated. Depending on whether they have microalbuminuria and diabetic retinopathy, patients were divided into groups for comparative statistical analysis, the binary logistic regression model was used to analyze the influencing factors of microalbuminuria and diabetic retinopathy. Finally, the receiver operating characteristic curve (ROC) was adopted to analyze the predictive value of Non-HDL-C/HDL-C for microalbuminuria. Results The age, course of disease, systolic blood pressure, diastolic blood pressure, creatinine, total cholesterol (TC), triglyceride (TG), Non-HDL-C, Non-HDL-C/HDL-C, hypertension and the use of angiotensin-converting enzyme inhibitor (ACEI)/angiotensin receptor blocker (ARB) hypotensive drugs were all higher, but the HDL-C was lower in microalbuminuria group than those in non-proteinuria group with statistically significant differences (P<0.05). The course of disease longer and the proportion of hypertension is higher in retinopathy group than those in non-nephropathy group, with statistically significant differences (P<0.05). The logistic regression analysis revealed that high systolic blood pressure, high creatinine level, and high Non-HDL-C/HDL-C ratio were the influencing factors for the occurrence of microalbuminuria (P<0.05). The area under the ROC curve (AUC) of combined systolic blood pressure, creatinine level and Non-HDL-C/HDL-C to predict microalbuminuria is 0.774. Conclusions A large Non-HDL-C/HDL-C ratio is a risk factor for occurrence of microalbuminuria in patients with T2DM. Combined detection of systolic blood pressure, creatinine level and Non-HDL-C/HDL-C has a high predictive value for microalbuminuria, so is worthy of clinical reference.

  • Review
  • Peng Li , Qiong Bu , Guo-Ding Cao , Peng Liu , Wan-Shun Fang , Jun Liu , Jun Liu , Xu-Sheng Li
    doi: 10.11855/j.issn.0577-7402.2021.02.11

    Bone injury is the most common type of war wound, and different from ordinary open bone injury. The war wound bone injury caused by high-energy weapons has the characteristics of deep bleeding site, coagulation dysfunction, multi bacteria infection and large bone defect area, so it is difficult to be treated in battlefield. Mesoporous silica is a new type of inorganic nano biomaterial, which is widely used in bleeding treatment and bone tissue engineering due to its high specific surface area, large porosity and easy modification. Compared with the traditional materials for the treatment of traumatic bone injury, mesoporous silica has the advantages of local sustained hemostasis, broad-spectrum, sustained-release and strong mechanical support. Its main research direction is the composite and multifunctional materials. The surface functionalized mesoporous silica has the functions of hemostasis and infectious bone defect repair. However, there are still some problems such as unclear biological distribution in vivo and hepatorenal toxicity in large doses of mesoporous silica materials; in terms of preparation technology, there are still some problems such as unclear selection of pore size and shape of materials for promoting bone formation. Based on the actual needs of the treatment of war-induced bone injuries, the multifunctional, easy-to-use and portable properties of new mesoporous silica materials are reviewed in this paper.

  • Review
  • Zhi-Lin Sha , Shao-Hua Song , Guo-Shan Ding
    doi: 10.11855/j.issn.0577-7402.2021.02.12

    As a crucial microelement of human body, iron is involved in many important physiological processes. Serum ferritin (SF) is the main form of protein for iron storage, and regulates the storage and metabolism of iron. Although detection of ferritin has been applied for clinical use for a long time, some biological properties of ferritin still remain controversial, including its tissue origin, secretory pathway, interactions with receptors and cellular effects. Although many researches paid attention to the relationship between the changes of ferritin and liver diseases, the cut-off points of ferritin used varies in different studies, which hinders the consistency analysis of the results of different studies. It is urgent to explore and establish uniform standard for the parameter of ferritin, so as to better elucidate the iron status in the body reflected by changes in ferritin. This paper reviews the in vivo metabolic process of iron, the structural composition and pathophysiological function of ferritin, and the relationship between SF and liver diseases for providing guidance for future research.

  • Review
  • Chun-Yan Zhang , Yu-Xin Yan , Jie Liang , Menggen Si-Li-Mu , Yue-Hong Ma
    doi: 10.11855/j.issn.0577-7402.2021.02.13

    Long non-conding RNA (lncRNA) is a group of RNA with a length of more than 200 nt and no function of coding protein, and plays a physiological function at the level of heredity, transcription and post transcription. LncRNA can regulate multiple signal pathways. For example, hepatic fibrosis-associated lncRNA1 (LFAR1) promotes the activation of hepatic stellate cells(HSC) through transforming growth factor-β (TGF-β) signal pathway in the progress of liver fibrosis; HOX transcript antisense intergenic RNA (Hotair) promotes the activation of HSC as ceRNA; lncRNA-p21 inhibits the activation of HSC as ceRNA;maternally expressed gene 8 (MEG8) can inhibit the activation of HSC in hepatic cell by inhibiting Notch pathway. With more and more people's understanding of the function of lncRNA in liver fibrosis, it is expected to become a new target in the early diagnosis, prognosis judgment and treatment of fibrosis. This article reviews the research progress of lncRNA in liver fibrosis..

  • Review
  • Meng-Jie Li , Li-Na Zhang , Ying-Hui Shang , Han-Chang Huang , Feng-Xue Lao
    doi: 10.11855/j.issn.0577-7402.2021.02.14

    Alzheimer's disease (AD) is one of the common chronic neurodegenerative diseases, and characterized mainly by the deposition of amyloid β-protein (Aβ), hyperphosphorylation of tau protein, and neuronal and synaptic loss. Currently approved drugs can only alleviate the symptoms and cannot completely cure the disease. Stem cells have specific abilities of self-renewal, proliferation, differentiation and reprogramming. In particular, the induced pluripotent stem cells (iPSCs) developed in recent years have provided a new research strategy for the treatment of AD. The combination of iPSCs technology with gene editing,3D-like organs, and biomaterial scaffolds has resulted in a new approach to the recognition and treatment of AD. This review mainly summarizes the latest applications of iPSCs in AD, including the application of disease modeling in the research of pathogenesis of AD and early biomarker detection, the combination of iPSCs and 3D scaffold in cell therapy, and the application of iPSCs in high-throughput drug screening.

  • Review
  • Jing-Mei Luo , Zhong-Ce Yang , Li Pan , Li-Hua Zhang
    doi: 10.11855/j.issn.0577-7402.2021.02.15

    Immune checkpoint inhibitors (ICIs) are new anticancer agents in recent years, and are monoclonal autoantibodies specifically targeting T cell inhibitory receptors, may enhance the anti-tumor effect by blocking negative regulatory factors that inhibit T cell function. ICIs can generate peculiar immunotoxicity, called immune-related adverse events (irAEs), which can potentially affect many tissues, the most frequent toxic reactions to endocrine system include hypophysitis, thyroid dysfunction, adrenal insufficiency, and autoimmune diabetes mellitus. The treatment process of such adverse reactions has been further elaborated in present review through the introduction of the endocrine irAEs induced by ICIs in immunotherapy, aiming to provide clinicians with ideas for the treatment of endocrine irAEs.

  • Review
  • Jian-Xin Gao , Tan-Shi Li
    doi: 10.11855/j.issn.0577-7402.2021.02.16

    Heat stroke is the most severe form of heat-related illness, characterized by an elevated core body temperature(> 40 ℃) and an altered level of central nervous system dysfunction. The primary goal of treatment for heat stroke is to lower core body temperature, and evidence suggests that timely cooling promotes survival with limited sequelae. Intravascular cooling technique is a new cooling technique gradually applied in intensive care medicine in recent years, which can directly cool or rewarm blood, and can provide a larger cooling rate than traditional cooling methods. The focus of this article is to review the research progress of intravascular cooling technique on clinical application, and discuss the feasibility and safety of intravascular temperature management for heat stroke.