Seroprevalence of anti-HBs antibodies and the need for booster vaccination in children under 5 years of age born to HBsAg-negative mothers

Objective:To determine the proportion of HBV surface antigen(anti-HBs)antibody positive children under five years of age born to HBs Ag-negative mothers and to analyze the possible related factors following implementation of a hepatitis B vaccination program for infants in Indonesia 22 years ago.Methods:Blood samples were taken from children under five years of age born to HBsAg-negative mothers who have completed primary vaccination series.Anti-HBs antibodies were determined by using rapid test.Data of age,gender,nutritional status,vaccination timing or vaccination compliance,and booster vaccination were collected from vaccination card.Results:Ninety children were enrolled,consisting of 47 females and 43 males with a mean age of 2.3 years.Twenty two(24.4%)children received booster vaccine between 18 and 24 months and 55(61.1%)were anti-HBs positive.Among factors of age,gender,nutritional status,compliance to vaccination and booster vaccine,only administration of booster vaccine was significantly associated with anti-HBs status(OR 5.45,95%CI 1.45,20.52).Children who received booster vaccine at age of 18-24 months were 5.45 times more likely to be anti-HBs positive than that of children who did not receive booster vaccine.Conclusions:Booster vaccine rate is low among children under 5 years of age but is associated with anti-HBs positivity.Booster vaccination may be required to improve anti-HBs seropositivity.

藏红花对2型糖尿病患者的心脏保护作用:一项系统综述和meta分析

目的探讨藏红花作为潜在补充剂在2型糖尿病患者治疗过程中的心脏保护作用。方法应用系统综述和meta分析优先报告条目(PRISMA)指南对Pub Med、Science Direct、Cochrane Library、Web of Science、中国知网(CNKI)和中国生物医学文献数据库(CBM)检索到的文章进行分析,发表时间跨度为2015年1月15日至2023年3月20日。本研究仅纳入英文随机对照试验(RCTs)文献,研究对象为接受藏红花或安慰剂治疗2型糖尿病的成年患者。采用Review Manager 5.4软件进行meta分析。本研究在国际前瞻性系统综述注册数据库(PROSPERO)中注册,注册号为CRD42023443180。结果本研究纳入了7项RCTs,包括455例患者。数据显示,与安慰剂相比,藏红花治疗显著降低了2型糖尿病患者的肿瘤坏死因子(TNF-α,P=0.008)和空腹血糖(FBG,P=0.04)水平。藏红花与安慰剂的白细胞介素6(IL-6)、丙二醛(MDA)、高血清C反应蛋白(hs-CRP)、血脂、血压和体重指数水平(BMI)差异均无统计学意义(P>0.05)。结论藏红花治疗通过降低肿瘤坏死因子和空腹血糖水平对2型糖尿病患者具有心脏保护作用。然而,这种植物化学物质的潜在抗氧化、抗高血压和抗血脂异常作用有待进一步研究。

The Osteogenic Capacity of Human Amniotic Membrane Mesenchymal Stem Cell (hAMSC) and Potential for Application in Maxillofacial Bone Reconstruction <i>in Vitro</i>Study

Amniotic membrane of human placenta is a source of abundant mesenchymal stem cell (hAMSC) which makes it a potential source of allogeneic multipotent cell for bone healing. However, much has to be explored about its isolation procedure and the osteogenic differentiation potential. The aims of this study are to establish the procurement procedure of human amniotic membrane, the isolation and culture of hAMSC, the MSC phenotypic characterization, and the in vitro osteogenic differentiation of hAMSC. Results of the study are as follows. The quality of human amniotic membrane would be best if procured from Caesarean operation under highly aseptic condition to avoid fungal and bacterial contamination on the culture. Isolation procedure using modified Soncini protocol yielded large amount of MSC with high proliferative capacity in culture medium. Characterization of hAMSC showed that the majority of the target cells exhibited specific MSC markers (CD105 and CD90) with a small number of these cells expressing CD45, the marker of hematopoeitic cells. The in vitro osteogenic differentiation of hAMSC followed by Alizarin Red staining showed that osteoblastic differentiation was detected in a significantly high number of cells. This study concludes that hAMSCs isolated from human amniotic membrane have the capacity for in vitro osteogenesis which makes them be one of the potential allogeneic stem cells for application in maxillofacial bone reconstruction.

Adherence to iron supplementation amongst pregnant mothers in Surabaya, Indonesia: Perceived benefits, barriers and family support

Background:Anaemia during pregnancy is a major nutritional problem that can cause preterm delivery and low birth weight.Adherence to iron supplementation can prevent anaemia during pregnancy.However,adherence to iron supplementation remains a problem in many countries.Objective:This study aimed to identify the correlations of the perceived benefits and perceived barriers of and family support for iron supplementation with adherence to this practice amongst pregnant woman in Surabaya,Indonesia.Methods:A cross-sectional study was carried out on 102 pregnant women who attended check-ups at the Puskesmas and received iron supplementation.Data were collected using questionnaires.Results:Perceived benefits(r=0.334,P=0.001),perceived barriers(r=-0.294,P=0.003)and family support(r=0.263,P=0.008)were noted to be correlated with adherence to iron supplementation amongst pregnant woman in Surabaya,Indonesia.Conclusion:Perceived benefits,perceived barriers and family support are related to adherence to iron supplementation;thus,developing good perceptions and family support should be properly promoted.

Healing Mechanism and Osteogenic Capacity of Bovine Bone Mineral—Human Amniotic Mesenchymal Stem Celland Autogenous Bone Graft in Critical Size Mandibular Defect

Experiments on maxillofacial bone tissue engineering showed the promising result;however, its healing mechanisms and effectiveness had not been fully understood. The aim of this study is to compare the bone healing mechanism and osteogenic capacity between bovine bone mineral loaded with hAMSC and autogenous bone graft in the reconstruction of critical size mandibular bone defect. Critical size defects were made at the mandible of 45 New Zealand white rabbits reconstructed with BBM-hAMSC, BBM alone, and ABG, respectively. At the end of first, second, and twelfth weeks, five rabbits from each experimental week were sacrificed for histology and immunohistochemistry staining. Expressions of vascular endothelial growth factor (VEGF), bone mor-phogenic proteins-2 (BMP2), Runx2 and the amount of angiogenesis were analyzed in the first and second week groups, while expressions of Runx2, osteocalcin, collagen type-I fibres, trabecular area and bone incorporation were analyzed in the twelfth week groups. The result showed that expressions of VEGF, BMP2 and Runx2 as well as the amount of angiogenesis were higher in ABG compared with BBM-hAMSC group in the first and second weeks of healing. The result of twelfth week of healing showed that expressions of Runx2 and osteocalcin as well as the thickness of collagen type-I fibres were significantly higher in BBM-hAMSC compared to ABG group, while there was no statistically difference in trabecular area and bone incorporation between BBM-hAMSC and ABG group. This study concluded that early healing activities were higher in auto-genous bone graft than in BBM-hAMSC, while osteogenic activities in the late stage of healing were higher in BBM-hAMSC compared to autogenous bone graft. It was also concluded that the osteo-genic capacity of BBM-hAMSC was comparable to autogenous bone graft in the reconstruction of critical size defect in the mandible.

Study Biocompatibility and Osteogenic Differentiation Potential of Human Umbilical Cord Mesenchymal Stem Cells (hUCMSCs) with Gelatin Solvent

The human umbilical cord is a source of numerous Mesenchymal Stem Cells (MSCs), making it as a potential source of allogeneic multipotent cell for bone tissue engineering. The aims of this study were to find: 1) Human Umbilical Cord Mesenchymal Stem Cells (hUCMSCs) phenotypic characterization, 2) The in-vitro osteogenic differentiation potential of hUCMSCs, 3) The cytotoxicity of gelatin solvent to hUCMSCs using 3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyl tetrazolium bromide (MTT) assay. As a result, through characterization of hUCMSCs, the majority of target cells expressed specific MSCs markers, Cellular Differentiation (CD)73, smaller number of subpopulation expressed CD90 with only minimal subpopulation expressed CD105 and all negative MSCs markers. Osteoblastic differentiation was found in a significantly high number of cells when in vitro osteogenic differentiation of hUCMSCs with Alizarin Red staining was done. Biocompatibility analysis using the MTT assay showed that gelatin solvent and Alpha modification of minimum essential medium Eagle (α-MEM) was non-toxic for hUCMSCs in vitro. The study concluded that hUCMSCs isolated from human umbilical cord was capable of undergoing in vitro osteogenesis, indicating its potential as allogeneic stem cells for clinical application in bone tissue engineering.

Hypoxic Preconditioning Improved Neuroprotective Effect of Bone Marrow-Mesenchymal Stem Cells Transplantation in Acute Glaucoma Models

This study explored the novel strategy of hypoxic preconditioning of Bone Marrow Mesenchymal Stem Cells (BM-MSCs) before intra vitreal transplantation to improve neuroprotective effects of Retinal Ganglion Cells (RGCs) in Acute Glaucoma Models. The methods of this research were isolated mesenchymal stem cells from the bone marrow of adult wild-type Sprague-Dawley (SD) rats. BM-MSCs were cultured under normoxic or hypoxic (1% oxygen for 24 hours) conditions. Normoxic or hypoxic BM-MSCs were transplanted intravitreally 1 week after ocular hypertension induction by acutely increasing IOP to 100 - 120 mmHg for 60 minutes. Rats were killed 4 weeks after transplanted. Apoptosis was examined by tunnel assay and expression Brn3b (Brn3b = RGCs marker) by immunohistochemical analysis of the retina. Results showed that transplantation of hypoxic preconditioning BM-MSCs in acute glaucoma models resulted in a significant apoptosis decreasing (p < 0.05) and an significant increasing in RGCs (p < 0.05), as well as enhanced mor-phologic and functional benefits of stem cell therapy versus normoxic BM-MSCs transplantation. Conclusions: Hypoxic preconditioning enhances the capacity of BM-MSCs transplantation to improve neuroprotective effects of RGCs in Acute Glaucoma Models.

Mesenchymal stem cell secretome: A promising therapeutic strategy for erectile dysfunction?

Objective:The secretome,comprising bioactive chemicals released by mesenchymal stem cells(MSCs),holds therapeutic promise in regenerative medicine.This review aimed to explore the therapeutic potential of the MSC secretome in regenerative urology,particularly for treating erectile dysfunction(ED),and to provide an overview of preclinical and clinical research on MSCs in ED treatment and subsequently to highlight the rationales,mechanisms,preclinical investigations,and therapeutic potential of the MSC secretome in this context.Methods:The review incorporated an analysis of preclinical and clinical research involving MSCs in the treatment of ED.Subsequently,it delved into the existing knowledge regarding the MSC secretome,exploring its therapeutic potential.The methods included a comprehensive examination of relevant literature to discern the processes underlying the therapeutic efficacy of the MSC secretome.

Arthroscopic fixation of chronic bicruciate tibial avulsion fractures:A case report

A cruciate ligament avulsion is a much less common form of injury than a cruciate ligament tear.Simultaneous tibial avulsion fractures of both cruciate ligaments occur even more rarely.Over the last decades,many studies have described arthroscopic fixation of acute cruciate tibial avulsion fractures,but arthroscopic treatment in a late presenting patient has not been reported in the literature.This case report presents a 32-year-old female with a chronic tibial avulsion fracture of both anterior cruciate ligament and posterior cruciate ligament.Simultaneous fixation of both fractures was performed arthroscopically at week four post-injury.At one year of follow-up,the patient had demonstrated full knee range of motion and stable knee with no complaints,and achieved excellent clinical outcomes.Radiographs showed union of both fractures,and the patient had resumed high-impact exercises.

Ligation or Occlusion of the Internal Iliac Arteries for the Treatment of Placenta Accreta Spectrum:Why Is This Technique Still Performed?

Introduction The major complication of placenta accreta spectrum(PAS)disorder is massive bleeding;therefore,multiple vascular interventions have been described to prevent or treat pelvic bleeding.Ligature of the internal iliac arteries(IIAs)was published more than 130 years ago,and although research relating to the physiology of this procedure has demonstrated poor vascular control over the last few decades,2-this technique has evolved into an established technique known as endovascular IIA balloon occlusion.

Comparison of half-molar sodium lactate and mannitol to treat brain edema in severe traumatic brain injury:A systematic review

Purpose:Hypertonic fluids such as mannitol and half-molar sodium lactate are given to treat intracranial hypertension in patients with severe traumatic brain injury(TBI).In this study,sodium lactate was compared to mannitol in patients with TBI to investigate the efficacy in reducing intracranial pressure(ICP).Methods:This study was a systematic review with literature research on articles published in any year in the databases of PubMed,ScienceDirect,Asian Journal of Neurosurgery,and Cochrane Central Register of Controlled Trials.The keywords were"half-molar sodium lactate","mannitol","cerebral edema or brain swelling",and"severe traumatic brain injury".The inclusion criteria were(1)studies published in English,(2)randomized control trials or retrospective/prospective studies on TBI patients,and(3)therapies including half-molar sodium lactate and mannitol and(4)sufficient data such as mean difference(MD)and risk ratio(RR).Data analysis was conducted using Review Manager 5.3.Results:From 1499 studies,a total of 8 studies were eligible.Mannitol group reduced ICP of 0.65 times(MD 0.65;p=0.64)and improved cerebral perfusion pressure of 0.61 times(MD 0.61;p=0.88),better than the half-molar group of sodium lactate.But the half-molar group of sodium lactate maintained the mean arterial pressure level of 0.86 times,better than the mannitol group(MD 0.86;p=0.09).Conclusion:Half-molar sodium lactate is as effective as mannitol in reducing ICP in the early phase of brain injury,superior over mannitol in an extended period.It is able to prevent intracranial hypertension and give better brain tissue perfusion as well as more stable hemodynamics.Blood osmolarity is a concern as it increases serum sodium.

Schwannoma of the upper cervical spine-a case report

Upper cervical schwannoma is rare,and belongs to benign tumors that is usually asymptomatic.It accounted for only ten percent of schwannomas cases and mostly occurs in 40-50 years old patients.Aggressive and total resection is the treatment of choice for this tumor.Preoperative diagnosis is difficult,relying on clinical suspicion,and confirmed by surgical pathology.We report a 54-year-old male patient with chief complain of progressive weakness and numbness of his right arm for four months.He had a history of lymph node tumor in 2007 and excised in 2011.Neurological decrease was found on the right arm.The radiographic examination showed lytic lesion on the second,third,and fourth cervical spine.Computed tomography scan showed destruction extending to the first cervical vertebra.Capsulated extradural and extramedullary mass and compression to the spinal cord was found from the magnetic resonance imaging.Two-stage operation was performed.The first stage was posterior decompression with occipitocervical fusion and instrumentation,while the second was anterior decompression and iliac strut graft.Both operations performed using the surgical ultrasonic dissector.During three months'follow-up,it showed neurological improving.Neurological deficit appears when there is compression on the spinal cord.Total resection is the treatment of choice for these tumors.Preoperative imaging should be performed to exclude malignant tumor and found tumor extension.