Research progress of the application of mesenchymal stem cells in chronic inflammatory systemic diseases

Chronic inflammatory systemic diseases are the result of the body's immune imbalance, with a long course and recurring episodes. Immunosuppressants are the main treatment, but not all patients respond well to it. Being capable of both self-renewal and differentiation into multiple tissue cells and low immunogenicity, mesenchymal stem cell is a promising treatment for chronic inflammatory systemic diseases. In this article, we describe the research progress and clinical application of mesenchymal stem cells in chronic inflammatory systemic diseases and look for influencing factors and biomarkers that can predict the outcome of patient with mesenchymal stem cell transplantation.

Effects of Neoadjuvant Radiotherapy on Postoperative Complications in Rectal Cancer: A Meta-Analysis

Objective. Neoadjuvant radiotherapy (nRT) is an important treatment approach for rectal cancer. The relationship, however, between nRT and postoperative complications is still controversial. Here, we conducted a meta-analysis to evaluate such concerns. Methods. The electronic literature from 1983 to 2021 was searched in PubMed, Embase, and Web of Science. Postoperative complications after nRT were included in the meta-analysis. The pooled odds ratio (OR) was calculated by the random-effects model. Statistical analysis was conducted by Review Manager 5.3 and STATA 14. Results. A total of 23,723 patients from 49 studies were included in the meta-analysis. The pooled results showed that nRT increased the risk of anastomotic leakage (AL) compared to upfront surgery (OR = 1.23; 95% CI, 1.07–1.41; p = 0.004 ). Subgroup analysis suggested that both long-course (OR = 1.20, 95% CI 1.03–1.40; p = 0.02 ) and short-course radiotherapy (OR = 1.25, 95% CI, 1.02–1.53; p = 0.04 ) increased the incidence of AL. In addition, nRT was the main risk factor for wound infection and pelvic abscess. The pooled data in randomized controlled trials, however, indicated that nRT was not associated with AL (OR = 1.01; 95% CI 0.82–1.26; p = 0.91 ). Conclusions. nRT may increase the risk of AL, wound infection, and pelvic abscess compared to upfront surgery among patients with rectal cancer.

Preparation of Long-acting Somatostatin and GnRH Analogues and their Applications in Tumor Therapy

Hormonal drugs are essential treatment options for some hormone-dependent or hormone-sensitive tumors. The common dosage forms of hormonal drugs have a short half-life. Hence, frequent administration is needed, which results in poor patient compliance. Nevertheless, using drug delivery technology, somatostatin analogues (SSAs) and gonadotropin-releasing hormone (GnRH) analogues are prepared into long-acting formulations that can significantly prolong the action time of these drugs, reducing medication frequency and increasing patient compliance. Such drugs are advantageous when treating acromegaly, gastroenteropancreatic neuroendocrine tumors (GEP-NETs), breast cancer, prostate cancer, and other diseases having a relatively long course. SSAs and GnRH analogues are two typical hormonal drugs, the long-acting formulations of which are essential in clinical practice. This review summarized the preparation methods and clinical application of long-acting formulations in cancer. Further, the action mechanism and new research of SSAs and GnRH analogues were discussed, and suggestions related to the development of long-acting SSAs and GnRH analogues were provided.

What is the appropriate extended duration of antibiotic prophylaxis after two-stage revision for chronic PJI?

Aims To explore the effect of different durations of antibiotics after stage II reimplantation on the prognosis of two-stage revision for chronic periprosthetic joint infection (PJI). Methods This study involved a retrospective collection of patients who underwent two-stage revision for chronic PJI and continued to use extended antibiotic prophylaxis in two regional medical centres from January 2010 to June 2018. The patients were divided into a short (≤ one month) or a long (> one month) course of treatment based on the duration of antibiotics following stage II reimplantation. The difference in the infection control rate between the two groups was compared, and prognostic factors for recurrence were analyzed. Results A total of 105 patients with chronic PJI were enrolled: 64 patients in the short course group and 41 patients in the long course group. For 99 of the patients, the infection was under control during a follow-up period of at least 24 months after two-stage revision. For the short course group, the mean duration of antibiotic prophylaxis after stage II reimplantation was 20.17 days (SD 5.30) and the infection control rate was 95.3%; for the long course group these were 45.02 days (SD 15.03) and 92.7%, respectively. There was no significant difference in infection control rates between the two groups (p = 0.676). Cox regression analysis found that methicillin-resistant staphylococcus infection (p = 0.015) was an independent prognostic factor for recurrence. Conclusion After stage II reimplantation surgery of two-stage revision for chronic PJI, extended antibiotic prophylaxis for less than one month can achieve good infection control rate. Cite this article: Bone Joint Res 2021;10(12):790–796.

An Ounce of Prevention: Reducing Ageism Through the Lens of Public Health

Ageism is pervasive. The negative consequences of ageism are vast, and the literature on the effects of ageism on health and health care is extensive. The perpetrators of ageism are equally vast. While it may be tempting to believe that those who go into the fields of gerontology and geriatrics are free from these attitudes and behaviors, this is untrue. It is reasonable to suspect that future public health professionals, even those interested in gerontology, may also carry ageist ideas and practices into their professional careers. This research was developed to determine whether teaching about aging and ageism in a public health course could reduce ageism among students. Participants were students in a class on aging and public health. All students were graduate students in a Master of Public Health (MPH) program. Multiple assessments were used to assess ageism including the Framboni Scale of Ageism (FSA), a validated 29-question measure used to assess ageism, and the Succession, Identity, and Consumption (SIC) scale, another scale assessing ageism. Students were enrolled in an elective course on aging and public health, which was taught through the public health lens of disease prevention and health promotion. Health topics related to aging are discussed with an emphasis on prevention. The contributions older adults make, and the resulting improved health and well-being of self, others, and community are promoted. And the class participates in activities with a variety of community-dwelling older adults. Results show that ageism among students is reduced after the semester long course.

Incidence and Risk Factors of Dry Eye in Children and Adolescents With Diabetes Mellitus: A 3-Year Follow-Up Study

Purpose: To investigate the incidence and risk factors of dry eye in children with diabetes mellitus (DM) over a period of 3 years.Methods: Children and adolescents with DM (age: 3–14 years) from the Shanghai Children and Adolescent Diabetes Eye (SCADE) study cohort who did not have dry eye in January 2018 were followed-up for 3 years and re-examined in January 2021, and the incidence rate and risk factors for dry eye were calculated.Results: Forty children and adolescents with DM came for follow-up in 2021. Nine of them were diagnosed with dry eye, resulting in a 3-year incidence rate of 22.5% and an annual mean incidence rate of 7.5% for dry eye. Univariate regression analysis confirmed that decreased corneal sensation (OR [Odds Ratio] = 25.60; 95%CI [Confidence Interval] = 1.31~501.69; P = 0.03) was the risk factor for dry eye incidence. Long course of DM (OR = 1.80; 95%CI = 0.96~3.38; P = 0.07), eye pain (OR = 12.27; 95%CI = 0.65~231.48; P = 0.09), and dry eye in parents (OR = 15.99; 95%CI = 0.76~337.75; P = 0.08) may interfere with the incidence of dry eye in them.Conclusions: The incidence of dry eye in children and adolescents with DM is high.

Effect of long-haul transmeridian travel on recovery and performance in international level swimmers

This study holistically examined the effects of long-haul transmeridian travel (LHTT) on physiological, perceptual, sleep and performance markers in nine international level swimmers preparing for the 2019 FINA World Long Course Championships in Gwangju, South Korea. Baseline (BL) measurements were taken over two days during the week before a long-haul eastward flight across eight time-zones. Following the flight, measurements were taken over a six-day holding camp in Japan (C1-C6), and over four days at the competition venue in Gwangju before the Championships commenced (PR1-PR4). Salivary cortisol (sCort), immunoglobulin A (sIgA), alpha-amylase (sAA) concentrations and perceptual measures via the Liverpool John Moore's University Jetlag Questionnaire were assessed. Sleep was monitored using wrist activity monitors and self-report sleep diaries. Performance was assessed via squat jump (SJ), countermovement jump (CMJ) and a 4 × 100 m swim test. Participants perceived themselves to be significantly more fatigued and jet lagged than BL for five- and nine-days post-travel, respectively. Morning sCort decreased by 70% on C1 and remained significantly lower than BL until C6 ( p < 0.05). Sleep ratings improved significantly in comparison to BL from C5 onwards ( p < 0.05). Compared with BL, there was no significant change in swim performance or SJ height following travel; however, there was a 3.8 cm improvement ( p < 0.001) in CMJ height on C5. It took ten days for elite swimmers to perceive themselves recovered from jet lag following LHTT in an eastward direction across eight time-zones. LHTT did not negatively affect sleep or physical performance in the swimmers in comparison to BL.

P.158 Feeling Green

Background: Myeloid sarcoma (MS) is a rare solid tumour made of myeloblasts or immature myeloid cells in an extramedullary site or in bone, associated with systemic hematologic neoplasms. When they occur in the brain parenchyma, they can often be misdiagnosed. Methods: The authors report a case of a 4-year old boy 6 months out of remission from AML, presenting with a short history of headaches and vomiting, and found to have a heterogenous contrast-enhancing lesion in the right cerebellar hemisphere, with differential diagnosis of myeloid sarcoma, astrocytoma, medulloblastoma and ATRT. Preliminary diagnosis was made flow cytometry from an intraoperative biopsy. The patient had a long course of chemotherapy and radiation, but eventually died from the systemic burden of his AML. Results: The authors present a literature review on 178 published cases of CNS myeloid sarcomas, and their radiological presentation and the basis of immunohistochemical and pathological diagnosis is discussed. Conclusions: Diagnosis rests on a combination of immunohistochemistry and histopathology of biopsied tissue. Surgical resection is controversial, especially given the efficacy of chemotherapy and radiation, and prognosis remains unclear. As with all uncommon and rare clinical entities, further investigation is warranted to determine prognosis and optimal management of CNS myeloid sarcomas.