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Situational factors might help explain why most vertebral fractures occur in older people without a previous osteoporosis diagnosis. After adjusting for predisposing risk factors, the activity before the fall, type of fall, and falling direction remained as strong determinants of fall-related vertebral fractures in older men and women. INTRODUCTION: A matched case-control study was conducted to investigate the effects of situational factors, in addition to predisposing factors, on clinical vertebral fractures in older men and women in Taiwan. METHODS: Cases were community-dwelling individuals aged ≥ 65 years who visited emergency departments (EDs) of two university-affiliated hospitals due to a fall and had a primary diagnosis of a vertebral fracture during a 1-year period in 2017. Five control patients per case, matched by the time of falling, gender, and age, who sought care in the same ED due to a fall resulting in a soft tissue injury were selected. A total of 64 men (age range: 65 ~ 99 years) and 194 women (age range: 65 ~ 100 years), diagnosed with a vertebral fracture, participated in the study. RESULTS: Multivariable logistic models were conducted separately for men and women. Results suggested that the following factors were significantly associated with an increased risk of vertebral fractures in men: a low educational level (adjusted odds ratio [OR] = 1.95; 95% confidence interval (CI), 1.02 ~ 3.71), asthma (OR = 2.96; 95% CI, 1.35 ~ 6.92), depression (OR = 4.31; 95% CI, 1.03 ~ 17.5), toileting (OR = 2.30; 95% CI, 1.04 ~ 4.94), slipping (OR = 5.27; 95% CI, 1.80 ~ 15.4), stepping down (OR = 3.99; 95% CI, 1.40 ~ 11.4), sudden leg weakness (OR = 3.73; 95% CI, 1.13 ~ 12.4), and falling backwards (OR = 3.78; 95% CI, 1.83 ~ 7.80); and in women: a fracture history (OR = 2.00; 95% CI, 1.07 ~ 3.76), osteoporosis (OR = 1.94; 95% CI, 1.15 ~ 3.49), getting in/out of the bed/chair (OR = 1.90; 95% CI, 1.07 ~ 3.39), stepping down (OR = 2.10; 95% CI, 1.17 ~ 3.77), and falling backwards (OR = 4.00; 95% CI, 2.39 ~ 6.68) and sideways (OR = 2.61; 95% CI, 1.38 ~ 4.96). CONCLUSIONS: The combination of predisposing and situational risk factors may display a more comprehensive risk profile for the occurrence of VFs, and thus, interventions that add both types of risk factors may result in greater risk reduction of VFs, although those specifically targeted at situational risk factors during falls are limited and their effectiveness and efficiency remained to be explored.

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OBJECTIVE: Recent studies have suggested that long noncoding RNAs (lncRNAs) are involved in various tumors. The present research was designed to examine the prognostic values of a newly identified lncRNA, lncRNA LEF1-AS1 (LEF1-AS1), in esophageal squamous cell carcinoma (ESCC). PATIENTS AND METHODS: The relative levels of LEF1-AS1 in ESCC tissues and normal esophageal tissues were examined by applying quantitative Real Time-Polymerase Chain Reaction (qRT-PCR). The relations between LEF1-AS1 expressions and clinical factors were analyzed by conducting the Chi-square test. The Kaplan-Meier assay was used for assays of the overall survival (OS) and disease-free survival (DFS) dates. Univariate and multivariate analyses were applied for the identification of the independent prognostic factors for ESCC. RESULTS: We showed that LEF1-AS1 was distinctly upregulated in ESCC tissues compared with the matched normal tissues (p < 0.01). Higher levels of LEF1-AS1 were associated with lymph nodes metastasis (p = 0.009) and clinical stage (p = 0.008). Clinical investigation revealed that ESCC patients with high LEF1-AS1 level showed a significant shorter 5-year OS (p = 0.0028) and DFS (p = 0.0025). Multivariate analyses confirmed LEF1-AS1 as an independent prognostic parameter indicating unfavorable clinical prognosis for ESCC patients. CONCLUSIONS: The present study suggested that LEF1-AS1 could be a novel ESCC-related lncRNA involved in the clinical progression of ESCC, which may be used as a potential predictor.

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OBJECTIVE: To explore the effects of recombinant human growth hormone (rHGH) on the survival of the mouse slender narrow pedicle flap and the expressions of vascular endothelial growth factor (VEGF) and classification determinant 34 (CD34). MATERIALS AND METHODS: A total of 20 BALB/c mice were randomly divided into the experimental group (n=10) and control group (n=10). The flaps were transplanted for mice in two groups respectively. 6 h after the operation, the mice in the experimental group were administrated with rHGH via local subcutaneous injection, while the mice in the control group were injected with the same amount of normal saline. The laser Doppler was used to measure the sub-flap blood flow rates before the operation, and 3 days, 7 days and 14 days after the operation, respectively; the flap necrosis and survival areas of mice in two groups were measured respectively, and the survival rate of the flap was calculated 14 days after the operation. Afterwards, the flaps of mice in two groups were exfoliated and the shape and structure of flap tissues were tested by the hematoxylin-eosin (HE) staining. Reverse transcription-polymerase chain reaction (RT-PCR) and Western blot were used to test the levels of mRNA and protein of VEGF and CD34 in the flap tissues. RESULTS: The flaps of mice in the control group mainly exhibited the black or grayish-black and lost the elasticity with the hard texture, while those in the experimental group were ruddy in color with favorable elasticity. The survival rate of flaps of mice in the experimental group was significantly higher than that in the control group (83.61 ± 12.56% vs. 46.25 ± 9.70%) and the necrosis area of flaps of mice in the experimental group was significantly smaller than that in the control group (1.32 ± 0.16 vs. 4.13 ± 0.35, p < 0.05). There were no statistical differences in the blood flow rates of mouse flap both before the operation and three days after the operation between two groups (p > 0.05), while the blood flow rates of mouse flap both 7 days and 3 days after the operation in the experimental group were higher than those in the control group (p > 0.05). Compared with those in the control group, the levels of VEGF and CD34 were significantly increased, but the levels of the inflammatory factors of the interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) were significantly decreased (p < 0.05). CONCLUSIONS: rHGH plays an active role in the survival of the flap through promoting the angiogenesis and inhibiting inflammatory reaction.

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OBJECTIVE: To investigate the improvement effect of adipose-derived stem cells on neovascularization in an ischemic flap in diabetes mellitus (DM), and to explore the mechanism of hypoxia-inducible factor 1α (HIF-1α)/vascular endothelial growth factor (VEGF) pathway. MATERIALS AND METHODS: A total of 60 male Sprague-Dawley (SD) rats were divided into control group, model group, and adipose-derived stem cells (ADSCs) group. The survival rate of the flap and the number of new blood vessels were measured. The content of VEGF was determined by enzyme-linked immunosorbent assay (ELISA) kit. Then, the expressions of HIF-1α and VEGF in each group were measured by immunohistochemistry. Reverse transcriptase polymerase chain reaction (RT-PCR) method and Western blotting assay were used to detect the mRNA and protein expression of HIF-1α and VEGF in each group. RESULTS: Compared with control group, the flap survival rate of model group was decreased significantly, and the number of new blood vessels was also decreased significantly. Compared with model group, the flap survival rate of ADSCs group was increased significantly, and the number of new blood vessels was also increased significantly. The results of ELISA showed that compared with control group, the level of VEGF in model group was lower than that in model group, and the level of VEGF in the ADSC group was significantly higher than that in the model group. IHC results showed that both HIF-1α and VEGF proteins were decreased significantly in model group, whereas the expression of HIF-1α and VEGF in the ADSCs group was increased significantly. The results of RT-PCR and the Western blotting showed the mRNA and protein expressions in model group were all decreased, while those in ADSCs group were significantly increased (p < 0.05). CONCLUSIONS: ADSCs can improve the neovascularization of diabetic ischemic skin by regulating the HIF-1α/VEGF pathway.

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OBJECTIVE: Spinal tuberculosis, though destructive, can be cured in many patients by chemotherapy, though surgery is often necessary for decompression and deformity correction. Our aim of this study was to investigate the clinical efficacy of posterior debridement joint graft fixation therapy for lumbar vertebral fractures in patients with spinal tuberculosis with a compression fracture. PATIENTS AND METHODS: We prospectively included 48 patients diagnosed with spinal tuberculosis and lumbar compression fracture in our hospital from June 2010 to June 2013. The patients were randomly divided into observation group (n = 27) and control group (n = 21). The patients in the control group underwent an anterior debridement joint bone fixation therapy, whereas, the patients in the observation group underwent one stage posterior debridement joint bone fixation therapy. The patients in the both groups were followed-up for about 2 years and the postoperative complications were recorded and analyzed. RESULTS: Incision length, operative time and blood loss in patients of the observation group were significantly lower than the control group (p < 0.05). The kyphosis Cobb's angle was found to be reduced in a time-dependent manner in both groups, however, patients in the observation group achieved a significant reduction than the control (p < 0.05). The ASIA grade of few patients in the observation group significantly (p < 0.05) improved to class E from D at the time of the end of follow-up. The patients under the class 'excellent' and 'good' of Kirkaldy-Willis criteria were significantly (p < 05) higher in the observation group (92.6%) than the control group (85.7%). Also, the patients in the Bridwell grade I and II in the observation group (88.9%) were significantly (p < 0.05) higher in comparison with control group (81%). The prevalence of postoperative complications was significantly lower in the observation group (18.5%) when compared with the control group (28.6%). CONCLUSIONS: Our results indicate that one-stage posterior debridement joint bone fixation therapy is an effective and safe procedure for patients with spinal tuberculosis and lumbar compression; this method is worthy of clinical application.

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One of the rapidly prevailing neurological disorders affecting thousands of people per year is spinal cord injury (SCI). Though, great research has been made in recent past to understand thoroughly the molecular bases of the diseases, no fully restorative treatments for SCI are available. However, various rehabilitative, cellular and molecular therapies are being tested in animal models. Some of them have shown promising results. So, the present review shall enlighten all these latest developments in the field of spinal cord injury repair. The review shall discuss latest upcoming areas being focused for the management of SCI patients like stem cell therapy approach, cell-based approaches, combination therapeutic approaches, neuronal plasticity and possible use of omega-3 fatty acids in SCI repair.

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BACKGROUND: Gold(III) porphyrin 1a is a new class of anticancer drug, which inhibits cell proliferation of wide range of human cancer cell lines and induces apoptosis in human nasopharyngeal carcinoma cells. However, the underlying signalling mechanism by which gold(III) porphyrin 1a modifies the intracellular apoptosis pathways in tumour cells has not been explained in detail in neuroblastoma cells. METHODS: Cell proliferation and apoptosis were determined by measuring 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) and Annexin V binding, respectively. Western blot assay was used to detect proteins involved in apoptotic and Akt pathways. In vivo tumour growth was assessed by inoculating tumour cells to nude mice subcutaneously, and gold(III) porphyrin 1a was administrated intravenously. RESULTS: This study assessed the antitumour effect and mechanism of gold(III) porphyrin 1a on neuroblastoma in vitro and in vivo. Gold(III) porphyrin 1a displayed a growth inhibition and induction of apoptosis in neuroblastoma cells effectively in vitro, which was accompanied with release of cytochrome c and Smac/DIABLO and caspases activation. Further studies indicated that gold(III) porphyrin 1a inhibited X-linked inhibitor of apoptosis (XIAP). However, we found that gold(III) porphyrin 1a can induce a survival signal, Akt activation within minutes and could last for at least 24 h. To further confirm association between activation of Akt and the effectiveness of gold(III) porphyrin 1a, neuroblastoma cells were treated with API-2, an Akt-specific inhibitor. API-2 sensitised cells to gold(III) porphyrin 1a-induced apoptosis and growth inhibition. CONCLUSION: These results suggested that Akt may be considered as a molecular 'brake' that neuroblastoma cells rely on to slow down gold(III) porphyrin 1a-induced apoptosis and antiproliferation. Gold(III) porphyrin 1a is a mitochondrial apoptotic stimulus but also activates Akt, suggesting an involvement of Akt in mediating the effectiveness to growth inhibition and apoptosis by gold(III) porphyrin 1a and that inhibition of Akt can enhance the anticancer activity of gold(III) porphyrin 1a in neuroblastoma.

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AIMS/HYPOTHESIS: Betacellulin, a member of the epidermal growth factor family, is expressed in the pancreas and is thought to regulate differentiation of beta cells during development. The aim of the present study was to investigate the effects of exogenous betacellulin on the development of the mouse embryonic pancreas. MATERIALS AND METHODS: We used an in vitro culture model system based on the isolation and culture of the dorsal embryonic pancreas from day 11.5 embryos. Cultures were treated for up to 10 days with 10 ng/ml betacellulin and then analysed for changes in the expression of pancreatic exocrine, endocrine and ductal markers. RESULTS: Pancreases developed in culture and expressed the full complement of exocrine (both acinar and ductal) and endocrine cell types. Betacellulin enhanced branching morphogenesis and the proliferation of mesenchyme, increased Pdx1 and insulin production and inhibited the production of the exocrine cell marker amylase and the endocrine hormone glucagon. CONCLUSIONS/INTERPRETATION: These results suggest betacellulin has distinct and separate effects on exocrine, endocrine and ductal differentiation. In the future, betacellulin could perhaps be utilised to increase the production of beta cells from embryonic pancreatic tissue for therapeutic transplantation.

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Selective amidation of simple hydrocarbons with pre-isolated and in-situ formed iminoiodanes catalyzed by ruthenium complexes [Ru(III)(Me(3)tacn)(CF(3)CO(2))(3).H(2)O] (2b, Me(3)tacn = N,N', N"-trimethyl-1,4,7-triazacyclononane) and cis-[Ru(II)(6, 6'-Cl(2)bpy)(2)Cl(2)] (3, 6,6'-Cl(2)bpy = 6,6'-dichloro-2, 2'-bipyridine) was investigated. With PhI=NTs as nitrogen source, both catalysts efficiently promote the amidation of adamantane, cyclohexene, ethylbenzene, cumene, indan, tetralin, and diphenylmethane to afford N-substituted sulfonamides in 80-93% yields with high selectivity. Competitive amidations of para-substituted ethylbenzenes and kinetic isotope effect for the amidation of cyclohexene/cyclohexene-d(10) suggest that the amidation processes probably proceed via the hydrogen abstraction by a reactive Ru=NTs species to form a carboradical intermediate. The amidation with PhI(OAc)(2)/TsNH(2) gave results comparable to those obtained with PhI=NTs. Extension of the "PhI(OAc)(2)/TsNH(2) + catalyst 2b or 3" protocol to MeSO(2)NH(2) and PhCONH(2) with ethylbenzene as substrate produced the corresponding N-substituted amides in up to 89% yield.