Combination use of core decompression for osteonecrosis of the femoral head: A systematic review and meta-analysis using Forest and Funnel Plots

Problem statement. Core decompression (CD) is a very significant process of dealing in the treatment of femoral head necrosis. And CD combined with bone marrow mesenchymal stem cell transplantation has been widely used in clinical practice, but its effectiveness is controversial. This study is carried out to observe its efficacy and outcomes. Objective. This study evaluated the efficacy and safety of CD combined with bone marrow stem cells in the treatment of femoral head necrosis by systematic review and meta-analysis. Methodology. PubMed, The Cochrane Library, Embase, CNKI, Google Scholar and MEDLINE, etc. databases were searched for clinical randomized controlled trials (RCTs) comparing core decompression combined with autologous bone marrow mesenchymal stem cells versus core decompression alone in the treatment of femoral head necrosis. The retrieval period is from the establishment of each database to May 20, 2021. After literature was extracted and literature quality was evaluated, meta-analysis was conducted by using RevMan5.3 software. Results. A total of 420 osteonecrosis of the femoral head 452 patients' data were collected from all studies. Compared with the core decompression alone group, the CD combined with bone marrow stem cell showed marked reduction in the Visual analog scale (VAS), enhanced Harris hip score (HHS) at 12 months and 24 months, slowed down the progression of the disease, decreased the number of hips conversed to total hip arthroplasty (THA) in the future. Conclusion. Core decompression therapy is a very effective and safe treatment process used for ONFH. Moreover, CD combined autologous bone marrow stem cell transplantation can improve the survival rate of the necrotic head, reduce hip pain and delay the disease progression, the rate of THA postoperatively.

Cardiac amyloidosis: diagnostic challenges and recent advancement in the treatment of transthyretin amyloidosis (ATTR)

ABSTRACT ATTR-CA is an under-reported cause of congestive heart failure (CHF) and cardiac arrhythmias. Heightened clinical suspicion along with a multimodal investigative approach is often required in diagnosing this potentially fatal condition. Tafamidis and inotersen have shown promising results in terms of progression-free survival by ameliorating CHF symptoms and peripheral neuropathies in clinical trials. In this case series of five patients, we present three wild-type cardiac amyloidosis (ATTRwt-CA), one familial cardiac amyloidosis (ATTRm-CA) and one primary cardiac (AL-CA). The diagnostic modality was different for each patient. ATTRwt-CA, ATTRm-CA and AL-CA patients received tafamidis, inotersen and chemotherapy with bone marrow stem-cell transplantation, respectively.

Exosomal MicroRNA-1257 from Bone Marrow Stem Cells (BMSCs) Suppresses Cell Proliferation and Induces Cell Apoptosis in Ovarian Cancer

The role of bone marrow stem cell (BMSC)-derived exosomal microRNA-1257 (miR-1257) in ovarian cancer (OC) was explored in this research. BMSCs were cultured and the exosomes (exo) were isolated from BMSCs. OC cells were co-cultured with BMSC-exo or BMSC-exo transfected with miR-1257 inhibitor. Cell apoptosis was analyzed by flow cytometry, cell proliferative ability was tested by MTT assay, and apoptotic protein Bax and anti-apoptotic proteins Bcl-2 were assessed by Western blot. MiR-1257 was downregulated in OC cells and tissues, which was closely related to the poor prognosis. The co-culture of BMSC-exo with OC cells upregulated the transcription level of miR-1257, inhibited cell proliferation, and enhanced apoptosis. After silencing of miR-1257, the effects of BMSC-exo on apoptosis and proliferation were eliminated, Bax expression increased, and Bcl-2 level decreased. MiR-1257 from BMSC-exo inhibits the progression of OC.

The Combination of bFGF and Hydrocortisone is a Better Alternative Compared to 5-Azacytidine for Cardiomyogenic Differentiation of Bone Marrow and Adipose Stem Cells

Stem cells can be differentiated into cardiomyocytes by induction with 5-azacytidine (5-aza) but its carcinogenicity is of concern for future translational application. Alternatively, growth factors and hormones such as basic fibroblast growth factor (bFGF) and hydrocortisone have been reported to act as a therapeutic inducer for cardiomyocytes differentiation. In this study, we aim to investigate the ability of bFGF and hydrocortisone in combination to stimulate the differentiation of mesenchymal stem cells (MSC) into cardiomyocytes lineage. Sheep adipose tissue stem cell (ATSC) and bone marrow stem cell (BMSC) were isolated, cultured and induced with the three groups of induction factors; 5-aza alone, the combination of hydrocortisone and bFGF and all three factors in combination for cardiomyogenic differentiation. Morphological, protein and functional ability of both ATSC and BMSC were observed and analysed to confirm cardiomyocyte differentiation. Viability of BMSC and ATSC in each treated group was significantly higher (P < 0.05) on both cells after treated with 10 nM of bFGF and 50 μM of hydrocortisone. Cardiomyocyte proteins; α-Sarcomeric actin (αSA) and Phospolamban (Plb) was detected in both ATSC and BMSC exposed to induction factors but not in the control negative group. Both ATSC and BMSC without induction factors showed only minute cell number possesses αSA and Plb. Calcium ion (Ca2+) spark was observed in primary heart cells. Similarly, Ca2+ spark was also detected in induced ATSC and BMSC, proving some functionality of induced cells. In conclusion, bFGF and hydrocortisone are safer induction factor compared to the currently used 5-aza as both showed higher viability after induction, therefore more cells are available for future use in cardiac tissue engineering.

Case of Acute B cell Lymphoblastic Leukaemia in HIV-infected patient with chronic hepatitis C

Purpose. To observe clinical course of acute B cell lymphoblastic leukaemia and HIV infection combination from the point of view of current treatment conceptions for thus patients.Materials and methods. A clinical case of acute B cell lymphoblastic leukaemia in HIV-infected patient is presented.Results and discussion. 39-year old HIV-infected male with acute B cell lymphoblastic leukaemia received chemotherapy with the ALL-2009 regimen simultaneously with anti-retroviral therapy accompanied by severe leukopenia complicated with pneumonia by the force of strong comorbidity resulting to lethal outcome.Summary. Nowadays acute B cell lymphoblastic leukaemia and HIV infection combination that predestine poor prognosis in the accordance of special infection and immune status within the comorbidity of the patients, what demands to establish particular guidelines for chemotherapy, target therapy, maintenance treatment and bone marrow stem cell transplantation to improve efficiency of therapeutic influence at the course of heamoblastosis, so as HIV infection.