XinHua Hospital

About: XinHua Hospital is a healthcare organization based out in Shanghai, China. It is known for research contribution in the topics: Medicine & Biology. The organization has 908 authors who have published 596 publications receiving 11785 citations.

The biological effects of individual-level PM(2.5) exposure on systemic immunity and inflammatory response in traffic policemen.

Abstract: Background Ambient fine-particle particulate matter (PM 2.5 ) exposure is associated with the decline in pulmonary function, prevalence of coronary heart disease and incidence of myocardial infarction. The study is to observe the effects of ambient PM 2.5 on the cardiovascular system and to explore the potential inflammatory and immune mechanisms. Methods The subjects included 110 traffic policemen in Shanghai, China, who were aged 25–55 years. Two-times continuous 24 h individual-level PM 2.5 measurements were performed in winter and summer, respectively. The inflammatory marker (high-sensitivity C-reactive protein, hs-CRP), immune parameters (IgA, IgG, IgM and IgE) and lymphocyte profiles (CD4 T cells, CD8 T cells, CD4/CD8 T cells) were measured in blood. The associations between individual-level PM 2.5 and inflammatory marker and immune parameters were analysed by multiple linear regression. Results The average concentration of 24 h personal PM 2.5 for participants was 116.98 μg/m 3 and 86.48 μg/m 3 in winter and summer, respectively. In the main analysis, PM 2.5 exposure is associated with the increases in hs-CRP of 1.1%, IgG of 6.7%, IgM of 11.2% and IgE of 3.3% in participants, and decreases in IgA of 4.7% and CD8 of 0.7%, whereas we found no statistical association in CD4 T cells and CD4/CD8 T cells. In the adjusted model, the results showed that the increase of PM 2.5 was associated with the changes of inflammatory markers and immune markers both in winter and summer. Conclusions Traffic policeman have been a high-risk group suffering inflammatory response or immune injury because of the high exposure to PM 2.5 . These findings provided new insight into the mechanisms linking ambient PM 2.5 and inflammatory and immune response.

Thoracolumbar fractures in patients with multiple injuries: diagnosis and treatment-a review of 147 cases.

Abstract: Background: The initial evaluation and treatment of patients with multiple injuries are challenging. However, little is known about thoracolumbar fractures in patients with multiple injuries. We aimed to determine the incidence of missed injuries of the thoracolumbar spine in patients with multiple injuries, to examine the reasons for the delay in diagnosis, and to study the selection of treatment options in the management and timing of surgical intervention. Methods: One hundred forty-seven consecutive patients with acute thoracolumbar fractures and multiple trauma at the authors' hospital between 1988 and 1997 were retrospectively reviewed. The incidence of missed injuries of the thoracolumbar spine and the reasons for the delay in diagnosis were determined. All these patients were observed for a minimum of 3 years after surgery, except four who died during their hospital stay. Results: Delayed diagnosis of thoracolumbar fractures was made in 28 patients (19%). There was an increased incidence of pulmonary complications (p 0.05) were noted between the groups, the surgical patients had highly significantly less pain compared with the nonoperative patients (p 0.05). Neither the severity of injury nor the timing of surgery had any significant effect on the recovery rate (p > 0.05). Conclusion: Patients with blunt trauma caused by high-energy impact injuries are much more likely to have thoracolumbar fractures even if injuries elsewhere have been noted. Further radiographic studies of the thoracolumbar spine should be performed if there is any question related to a thorough and systematic examination. Choice of treatment options of thoracolumbar fractures in patients with multiple injuries is not different from that in patients with no associated injuries to other systems. Appropriate timing of thoracolumbar fracture fixation in patients with multiple injuries should not be dependent on a rigid protocol.

Remodeling of the spinal canal after thoracolumbar burst fractures.

Abstract: Thirty-one patients with thoracolumbar burst fractures, seven untreated, 16 treated nonoperatively, and eight treated operatively, were analyzed retrospectively and followed up for 3 to 7 years. The initial and final degrees of neurologic deficit and the stenotic ratio of the spinal canal were recorded. Stenotic ratio significantly decreased from the first examination (range, 12.3%-74.5%; average, 26.2%) to the final followup (range, 5.4%-46.5%; average, 19.2%), but there were no differences of the percentage of remodeling between patients who were untreated and those treated nonoperatively and operatively. The recovery rate was highly significantly related to the stenotic ratio at first examination. Nonoperative management may be considered for treatment of patients who are neurologically intact or only slightly impaired with thoracolumbar burst fractures.

Growth hormone synergizes with BMP9 in osteogenic differentiation by activating the JAK/STAT/IGF1 pathway in murine multilineage cells.

Abstract: Growth hormone (GH) is usually released by somatotrophs in the anterior pituitary in response to the GH-releasing hormone and plays an important role in skeleton development and postnatal growth. However, it is unclear if extrapituitary GH exerts any effect on murine multilineage cells (MMCs). MMCs are multipotent progenitors that give rise to several lineages, including bone, cartilage, and fat. We have identified bone morphogenic protein 9 (BMP9) as one of the most osteogenic BMPs in MMCs by regulating a distinct set of downstream mediators. In this study, we find that GH is one of the most significantly upregulated genes by BMP9 in mouse MMCs through expression-profiling analysis. We confirm that GH is a direct early target of and upregulated by BMP9 signaling. Exogenous GH synergizes with BMP9 on inducing early and late osteogenic markers in MMCs. Furthermore, BMP9 and GH costimulation leads to a significant expansion of growth plate in cultured limb explants. Although GH alone does not induce de novo bone formation in an ectopic bone formation model, BMP9 and GH costimulated MMCs form more mature bone, which can be inhibited by silencing GH expression. The synergistic osteogenic activity between BMP9 and GH can be significantly blunted by JAK/STAT inhibitors, leading to a decrease in GH-regulated insulin-like growth factor 1 (IGF1) expression in MMCs. Our results strongly suggest that BMP9 may effectively regulate extrapituitary GH expression in MMCs. Thus, it is conceivable that the BMP9-GH-IGF axis may be exploited as an innovative strategy to enhance osteogenesis in regenerative medicine.

Multicentre, randomized comparison of two-stent and provisional stenting techniques in patients with complex coronary bifurcation lesions: the DEFINITION II trial

Abstract: Aim The present study aimed to assess the benefits of two-stent techniques for patients with DEFINITION criteria-defined complex coronary bifurcation lesions Methods and results In total, 653 patients with complex bifurcation lesions at 49 international centres were randomly assigned to undergo the systematic two-stent technique (two-stent group) or provisional stenting (provisional group) The primary endpoint was the composite of target lesion failure (TLF) at the 1-year follow-up, including cardiac death, target vessel myocardial infarction (TVMI), and clinically driven target lesion revascularization (TLR) The safety endpoint was definite or probable stent thrombosis At the 1-year follow-up, TLF occurred in 37 (114%) and 20 (61%) patients in the provisional and two-stent groups, respectively [778%: double-kissing crush; hazard ratio (HR) 052, 95% confidence interval (CI) 030-090; P = 0019], largely driven by increased TVMI (71%, HR 043, 95% CI 020-090; P = 0025) and clinically driven TLR (55%, HR 043, 95% CI 019-100; P = 0049) in the provisional group At the 1 year after indexed procedures, the incidence of cardiac death was 25% in the provisional group, non-significant to 21% in the two-stent group (HR 086, 95% CI 031-237; P = 0772) Conclusion For DEFINITION criteria-defined complex coronary bifurcation lesions, the systematic two-stent approach was associated with a significant improvement in clinical outcomes compared with the provisional stenting approach Further study is urgently warranted to identify the mechanisms contributing to the increased rate of TVMI after provisional stenting Study registration http://wwwclinicaltrialscom; Identifier: NCT02284750