组织工程半月板：种子细胞和理化因素

BACKGROUND: As meniscectomy may result in various adverse reactions, tissue-engineered meniscus is expected to be used for meniscus repair. Seed cell selection and optimal physicochemical stimuli are crucial for the construction of tissue-engineered meniscus. OBJECTIVE:To overview the seed cells for the tissue-engineered meniscus construction and the research progress of physicochemical factors. METHODS: The first author retrieved the CNKI and Medline databases using the keywords of “meniscus, tissue engineering, seed cells, physical and chemical factors” in English and Chinese, respectively, to retrieve articles related to the seed cells and physicochemical factors of the tissue-engineered meniscus construction. Irrelative and repetitive articles were excluded, and 49 eligible articles were enrolled for analysis. RESULTS AND CONCLUSION:The seed cells must maintain their phenotype and synthetic ability after physicochemical stimulation in combination with scaffolds, to achieve the reproducibility of tissue-engineered meniscus. Most of cytokines can be used for promoting the proliferation and differentiation of chondrocytes, but the underlying mechanisms were little known. Their application in the meniscus tissue engineering needs to be studied in depth. Currently it is urgent to improve physicochemical stimuli in order to construct the tissue-engineered meniscus. The shear force does harm to chondrocyte phenotype, and dynamic compression loading has been proved to enhance Ca+ and glycosaminoglycan release. The fibrous cartilage stimulated by shear force and other factors may be helpful for constructing the tissue-engineered meniscus. An elaborated randomized controlled trial and the long-term quantitative analysis are of importance to assess the research results. 中国组织工程研究杂志出版内容重点：组织构建;骨细胞;软骨细胞;细胞培养;成纤维细胞;血管内皮细胞;骨质疏松;组织工程     

运动员Lisfranc损伤的诊疗策略及研究进展

BACKGROUND: Lisfranc injury is a concealed or low-energy damage in the athletic population. The optimal treatment strategies for Lisfranc injury in the athletes, especially for high-level or professional athletes, remain controversial. Improvement and development in treatment for Lisfranc injury are ongoing. OBJECTIVE: To summarize the diagnostic and therapeutic strategies and problems in surgery in Lisfranc injuries in the athletic population. METHODS: A computer-based online search was conducted in PubMed and Web of science databases from June 1909 to June 2014 to screen the relevant articles regarding the diagnostic and therapeutic strategies for Lisfranc injury using the key words “Lisfranc, injury, athletes”. The irrelevant and duplicate articles were excluded, and finally 43 articles were reviewed. RESULTS AND CONCLUSION: With the improvement and development in the therapeutic methods for Lisfranc injury, suture button fixation and bioabsorbable screw technology, as novel treatment strategies, have the potential to help restore and/or preserve stability at the tarsometatarsal joints, to avoid the potential risk for internal fixation irritation or the need for removal of hardware after fixation. However, more multi-center, prospective, randomized controlled clinical trials are required for seeking the optimal treatment for Lisfranc injury. For the athletes with Lisfranc injury, the best treatment option, removal timing of internal fixation devices, and the proper postoperative function exercise performed according the conditions of patients are vital for restoring the professional sports level. 中国组织工程研究杂志出版内容重点：组织构建;骨细胞;软骨细胞;细胞培养;成纤维细胞;血管内皮细胞;骨质疏松;组织工程     

中医疗法与透明质酸治疗膝骨性关节炎有效性的网状Meta分析

BACKGROUND: Comparative study results between the efficacies of traditional Chinese medicine (TCM) therapy with Western medicine therapy in the treatment of knee osteoarthritis remain controversial. Currently, meta-analysis studies mainly focus on comparison of the efficacy between TCM and Western medicine, but lack investigations among TCM therapies. It makes us difficult to fully understand the efficacy of TCM therapy for knee osteoarthritis. OBJECTIVE: To compare the efficacies of TCM therapy with intra-articular injection of hyaluronic acid for knee osteoarthritis using a network Meta-analysis method. METHODS:PubMed, The Cochrane Library (tissue 10, 2015), EMbase, CNKI, CBM, VIP, Wangfang databases were searched up to October 20, 2015 for relevant randomized controlled trials addressing the efficacies of TCM therapy versus intra-articular injection of hyaluronic acid for knee osteoarthritis. Two reviewers independently selected the studies, extracted information, and assessed the quality of included trials. Data extraction from eligible studies was pooled and meta-analyzed using Stata12.0 and WinBUGS1.4.3 softwares. Odd ratios with their 95% confidence interval were estimated as effect size between treatments. RESULTS AND CONCLUSION: A total of 59 randomized controlled trials involving 6 155 patients with knee osteoarthritis and 12 treatment strategies were included. The results of network meta-analysis showed that TCM comprehensive therapy was superior to the TCM monotherapy and intra-articular injection of hyaluronic acid. Among these therapies, the efficacy of needle scalpel combined with acupuncture is optimal. TCM comprehensive therapies may be the best choice to treat patients with knee osteoarthritis of Kellgren-Lawrence II-III. More large-scale and well-designed randomized controlled trials are still warranted due to the limitation of the present study. 中国组织工程研究杂志出版内容重点：组织构建;骨细胞;软骨细胞;细胞培养;成纤维细胞;血管内皮细胞;骨质疏松;组织工程     

蛋白质组学在医学研究中的应用与进展

BACKGROUND: Studies on the proteomics contribute not only to exploring the laws governing life activities, but also to elucidating the pathogenesis of a variety of diseases to find the treatment strategies. OBJECTIVE: To summarize the application of proteomics in the plateau medical research. METHODS: A computer-based online search was conducted in PubMed and Wanfang databases from 1995 to 2015 to screen the relevant literatures using the key words “proteomics, medical research, plateau medicine” in English and Chinese, respectively. A total of approximately 200 English and 60 Chinese relevant literatures were selected and the 59 eligible literatures were included after screening finally. RESULTS AND CONCLUSION: Currently, the human genome has been decoded through the studies on exploring the proteomics changes under the pathological conditions and the underlying mechanisms. Construction of physiological and pathological mapping based on the human proteome contributes to revealing the novel treatment targets, diagnostic markers, and drugs for the prevention and treatment of diseases. Proteomics has become the frontier and hot research field both at home and abroad, including all the proteins expressed in the tissue, cell or organism, and becomes a bridge between the genome and clinical application. 中国组织工程研究杂志出版内容重点：组织构建;骨细胞;软骨细胞;细胞培养;成纤维细胞;血管内皮细胞;骨质疏松;组织工程     

少肌症对骨骼肌的影响、分子机制及其防治

BACKGROUND: There is an urgent need to explore the loss of skeletal muscle mass during aging (sarcopenia), and its molecular mechanisms of action, and prevention and treatment strategies. OBJECTIVE: To summarize the latest progress in molecular mechanisms of sarcopenia, and to provide a fundamental for promoting functional recovery and regeneration of skeletal muscle. METHODS: A computer-based online search was conducted in PubMed and Wanfang databases from 2005 to 2015 to screen the relevant literatures using Chinese and English key words “sarcopenia, skeletal muscle, mechanism, therapy”, respectively. Consequently, 31 eligible literatures were collected, summarized, and analyzed. RESULTS AND CONCLUSION:Sarcopenia is closely correlated with oxidative stress caused by mitochondrial respiratory failure, inhibition of activating factors for regulating satellite cells, reduction in insulin secretion, decreased sensitivity, protein synthesis, and low protein diet. There are common features and molecular mechanisms in sarcopenia and disuse muscle atrophy. Further exploration of exercise and diet strategies for the treatment of sarcopenia is required. 中国组织工程研究杂志出版内容重点：组织构建;骨细胞;软骨细胞;细胞培养;成纤维细胞;血管内皮细胞;骨质疏松;组织工程     

构建组织工程半月板的相关基础研究

BACKGROUND: The meniscus injury is one of the most common sports injuries of knee joint. The treatment after injury is always a difficult problem in the clinic. Researchers have been trying to apply the method of using tissue-engineering to solve the problem of meniscus repair after injury. OBJECTIVE: To summarize tissue-engineered meniscus-related basic research. METHODS: The first author retrieved China National Knowledge Infrastructure and Medline for literatures on tissue-engineered meniscus. The key words were “meniscus, tissue engineering, basic research”. Articles with unrelated objective and repeated articles were excluded. Finally, 35 articles were included.  RESULTS AND CONCLUSION: There was some controversy about the classification of the cell of the meniscus. The outer tissue of the meniscus is mainly composed of the fibrous cartilage cells and the extracellular matrix. The inner tissue of the meniscus is mainly composed of a small atypical class of cartilage cells. The biomechanical properties of the meniscus can be properly adjusted when it is subjected to external pressure. The lateral meniscus is assumed to bear all the pressure of the outer part of the knee joint during knee flexion, but the medial meniscus is assumed to bear 50% of the medial part of the knee joint. The etiology and pathophysiology of meniscus injury are not the same, which is highly dependent on the age of onset of the patient. However, in each age group, right knee meniscus injury was the majority. The way of surgical repair of the meniscus tear can be divided into the technology from inside to outside, and that from outside to inside, total internal repair under arthroscopy and open repair technology. 中国组织工程研究杂志出版内容重点：组织构建;骨细胞;软骨细胞;细胞培养;成纤维细胞;血管内皮细胞;骨质疏松;组织工程     

关节镜下保留残端重建前交叉韧带与不保留残端重建的Meta分析

BACKGROUND: There are controversies about preserving the remnant in the anterior cruciate ligament reconstruction procedure because of its uncertain therapeutic effects. OBJECTIVE:To compare the efficacy and safety of preserving-remnant with removing-remnant for arthroscopic anterior cruciate ligament reconstruction using a meta-analysis. METHODS: A computer-based online search was conducted in PubMed, Embase, the Cochrane Library, CDSR, CBM, and CNKI databases by using the English key words of “anterior cruciate ligament AND remnant (OR stump) AND randomized controlled trial (RCT) OR quasi-RCT” and the Chinese key words of “anterior cruciate ligament reconstruction, preserving-remnant, removing-remnant” to screen the relevant articles published from 1995 to July 2015. Meta-analysis was performed using Review Manager 5.3 software. RESULTS AND CONCLUSION:A total of 13 randomized controlled trials were included. The meta-analysis results showed that there were no statistically significant differences in KT1000/2000 scores (OR=-0.28, 95%CI: -0.76-0.20, P=0.25), the good rate of synoveal coverage (OR =-0.30, 95%CI: -0.30-0.90, P=0.32), and the incidence of cyclops leions (OR=0.87, 95%CI: 0.63-2.90, P=0.44). Postoperative Lysholm scores (OR=2.45, 95%CI: 0.52-4.39, P=0.01), proprioceptive function (OR=-1.72, 95%CI: -3.32 to 0.13, P=0.03), tunnel enlargement (OR=-0.66, 95%CI: -1.08 to -0.23, P=0.002) in preserving-remnant were superior to removing-remnant for arthroscopic anterior cruciate ligament reconstruction. These results suggest that both preserving-remnant and removing-remnant for arthroscopic anterior cruciate ligament reconstruction can obtain satisfactory antero-posterior stability of the knee. Preserving-remnant exhibits superiority in post-operative scores of the knee, proprioceptive function, tunnel enlargement. Further high-quality randomized controlled trials are warranted because of some low-quality studies and the existing biases. 中国组织工程研究杂志出版内容重点：组织构建;骨细胞;软骨细胞;细胞培养;成纤维细胞;血管内皮细胞;骨质疏松;组织工程     

血管化鹿茸软骨组织与骨组织修复

BACKGROUND:Deer antlers are the only known mammalian organ that can regenerate periodically, and its cartilage is rich in blood vessels. Study on deer antler vascularized cartilage can uncover the antler biological characteristics and is of vital significance for bone repair and regenerative medicine. OBJECTIVE:To review the distribution of blood vessels in antler cartilage tissue, the generating process and mechanism of blood vessels, cytokines influncing angiogenesis, and to analyze the features of deer antler models in bone tissue engineering, providing medical reference for bone repair. METHODS: A computer-based online search of PubMed and CNKI databases was performed using the keywords of “deer antler, bone tissue engineering, vascularized cartilage” in English and Chinese, respectively. Articles concerning antler histology, morphology, antler cartilage and vascularized cartilage and bone tissue engineering were enrolled and repetitive studies and irrelevant articles were excluded. RESULTS AND CONCLUSION: Fifty-one eligible articles were selected finally. Deer antler is a kind of periodic regenerative bone, and antler cartilage is different from normal cartilage that is rich in blood vessels with the growth speed of 2.7 cm/day. Scholars have studied the vascularization of antler cartilage tissue, and obtained some achievements. Exploring the distribution of antler blood vessels in cartilage tissue, the generating process and mechanism of antler blood vessels, the cytokines acting on antler angiogenesis, as well as analyzing the advantages of deer antler model for bone tissue engineering provide a reference for tissue-engineered cartilage vascularization. 中国组织工程研究杂志出版内容重点：组织构建;骨细胞;软骨细胞;细胞培养;成纤维细胞;血管内皮细胞;骨质疏松;组织工程     

生长因子对骨骼肌损伤与修复的作用

BACKGROUND: Growth factors involved in the regulation of cellular processes play an important role in the wound healing and tissue regeneration. OBJECTIVE:To elaborate the role of a variety of cellular processes involving growth factors in the repair of skeletal muscle injury, and to provide the references for the treatment and rehabilitation strategies, and the synthesis of biomaterials with growth factor for the skeletal muscle after injury. METHODS: A computer-based online search was conducted in PubMed, Mendeley, Google Scholar, and CNKI databases from 1995 to November 2015 to screen the relevant literatures using the keywords “skeletal muscle, damage repair, insulin-like growth factor, epidermal growth factor, growth factor”. Data screening, processing, and summary were performed. RESULTS AND CONCLUSION: Fifty-one eligible literatures were included. Exercise training promotes the repair and regeneration of the injured skeletal muscle cells and the recovery of the function by activating satellite cells in the sarcolemma and basement membrane to produce the numerous myoblasts. The repair involves the complex biological process regulated by growth factors. Exogenous growth factors up-regulate the mRNA expression of endogenous growth factors, stimulate the proliferation of the myoblasts, accelerate the fusion between myotubes and muscle fibers, promote the repair of skeletal muscle injury, inhibit the formation of scars, thereby enhancing the healing quality. 中国组织工程研究杂志出版内容重点：组织构建;骨细胞;软骨细胞;细胞培养;成纤维细胞;血管内皮细胞;骨质疏松;组织工程     

转化生长因子β信号与肌肉调控

BACKGROUND: Transforming growth factor-β signaling widely existing in cells mediates cell growth, proliferation, migration, differentiation, and apoptosis. The activation of transforming growth factor-β signaling can result in muscular dystrophy. However, there have been some contradictions regarding the effects of the transforming growth factor-β signaling on muscular dystrophy. OBJECTIVE: To summarize the latest progress in the effects of the transforming growth factor-β signaling on muscle mass and function regulation to provide the solutions for the treatment of muscular dystrophy. METHODS: A computer-based online search was conducted in PubMed and Wanfang databases from 2005 to 2015 to screen the relevant literatures using Chinese and English key words “transforming growth factor-β, muscle, regulation mechanism, treatment”. A total of 102 literatures were retrieved, and 22 eligible literatures were included, summarized, and analyzed. RESULTS AND CONCLUSION: The activation of transforming growth factor-β signaling as a common cause of most muscle disorders promotes the activation of muscle satellite cells, differentiation of myocytes, myoblast infusion, the expression of muscle-specific proteins, and the inhibition of collagen synthesis, which facilitates muscular fibrosis and scar formation. Transforming growth factor-β signaling is involved in Duchenne muscular dystrophy, spinal scoliosis, type I diabetes induced skeletal muscle regenerative disorders, myocardial and cardiac remodeling. The inhibition of transforming growth factor-β signaling may result in incomplete muscle recovery. 中国组织工程研究杂志出版内容重点：组织构建;骨细胞;软骨细胞;细胞培养;成纤维细胞;血管内皮细胞;骨质疏松;组织工程     

Renal dysplasia and asplenia in two sibs

A family is reported in which two sibs, one male and the other female, both died within 24 hours of birth with enlarged polycystic kidneys. Postmortem histology in the second child showed gross renal dysplasia. In both children the pancreas was enlarged, nodular and cystic but the liver appeared macroscopically normal. In the second child, histological examination confirmed pancreatic fibrosis with cystic dilation of ducts, but showed portal fibrosis with bile duct proliferation in the liver.
This combination of findings is very reminiscent of those in a girl and her brother reported by Ivemark et al. (1959). The children reported here also showed absence or hypoplasia of the spleen, cardiac anomalies and other features of the Ivemark syndrome (Ivemark 1955), a quite different, usually sporadic, congenital disorder. It is suggested that the children described here have a distinct lethal congenital disorder, probably inherited in an autosomal recessive manner.     

Schizophrenia in a North Swedish geographical isolate, 1900–1977. Epidemiology, genetics and biochemistry

Over 200 schizophrenic patients belonging to three major and interrelated pedigree complexes have been investigated over the past 30 years in a North Swedish geographically isolated population, presently numbering about 6,000. An intensive investigation of a number of biochemical correlates and genetic markers in a few selected families belonging to one of the major pedigrees has indicated new strategies for the current research program.
Schizophrenia, as defined operationally, is significantly associated with decreased activities of two enzymes (1) blood platelet monoamine oxidase, (2) plasma dopamine-β-hydroxylase, and (3) with the genetic marker Gc² (group specific antigen). Both enzymes are subject to genetic variation. A positive score for linkage between schizophrenia and low plasma DBH activity has been calculated, but, so far, available data are insufficient for discrimination between linkage and partial contribution of genetically controlled low plasma DBH to the pathogenesis of the disease. Alternatively, both mechanisms could be involved.
As a model for continued research, schizophrenia is explained as based on a double dominant-recessive genotype (Aabb), representing a vulnerability which in about 50 % of cases develops into clinical schizophrenia. It is suggested that the dominant mutation (A) operates on or affects MAO activity, and that the recessive genotype (bb) is instrumental in low variates of DBH activity and very likely such variates within the normal range of physiological variation. Moreover, it is suggested that the combined effects of MAO- and DBH-reduced efficiency on the metabolism of e.g. dopamine could be an essential pathogenic mechanism for the schizophrenic illness which is segregating in this population.     

What will studies of Fulani individuals naturally exposed to malaria teach us about protective immunity to malaria?

There are an estimated over 200 million yearly cases of malaria worldwide. Despite concerted international effort to combat the disease, it still causes approximately half a million deaths every year, the majority of which are young children with Plasmodium falciparum infection in sub-Saharan Africa. Successes are largely attributed to malaria prevention strategies, such as insecticide-treated mosquito nets and indoor spraying, as well as improved access to existing treatments. One important hurdle to new approaches for the treatment and prevention of malaria is our limited understanding of the biology of Plasmodium infection and its complex interaction with the immune system of its human host. Therefore, the elimination of malaria in Africa not only relies on existing tools to reduce malaria burden, but also requires fundamental research to develop innovative approaches. Here, we summarize our discoveries from investigations of ethnic groups of West Africa who have different susceptibility to malaria.     

The universal muscular chain reaction,muscle spasm,Torsions, ruptures and extravasations. Chameleons of pathology and some manifestations of simple muscular disorders

Most bodily functions require the coordinated actions of complementary and supplementary paired muscle groups. Where this essential muscular cooperation is lacking, hollow organs may burst and others become literally screwed up, giving rise to many similar spastic diseases such as Torticollis, Twisted ovarian cyst, Torsion of the Testis, Volvulus of the intestines, Varicose Veins, Megacolon, Aortamegaly, Scoliosis, Erb's Palsy, Peyronie's Disease, Main-en-Griffe, Undescended Foot (Pes Cavus), Talipes, Strabismus. Spasm is “panenepidemic” and unclassified examples of Torsion Dystonia and Dyskinesia really are as common as debt and taxes.     

The dominant diseases of modernized societies as omega-3 essential fatty acid deficiency syndrome: Substrate beriberi

About 1900, modern food selection and processing caused widespread $\text{epidemics}$ of the B vitamin deficiency diseases of beriberi and pellagra which, for genetic reasons, often expressed as different diseases ranging from bowel and heart disease to dermatoses and psychoses. But the B vitamins merely help convert essential fatty acids (EFA) into the prostaglandin (PG) tissue regulators and it now turns out that, through hydrogenation, milling and selection of w3-poor southern foods, we have also been systematically depleting, by as much as 90%, a newly discovered trace Nordic EFA (w3) of special importance to primates and sole precursor of the PG3(4) series, even as a concurrent fiber deficiency increases body demand for EFA. Since substrate EFA is processed by many B vitamin catalysts, an EFA deficiency will mimic a $\text{panh}$ypovitaminosis B, i.e., a mixture of $\text{substrate}$ beriberi and $\text{substrate}$ pellagra resembling vitamin beriberi and pellagra but exhibiting as even more diverse $\text{endemic}$ disease. This would consitute a second stage of the Modern Malnutrition and explain why some workers now hold the dominant diseases of modermized societies to be new, nutritionally based, pellagraform yet lipid-related and to range, once again, from heart disease to psychosis. It is an assumption that our dominant diseases are unrelated to each other or are merely revealed by our diagnostic acumen and therapeutic success; and that hydrogenating millions of tons of food oils annually, to destroy the rancidity producing w3-EFA, is safe for $\text{primates}$. Extensive beriberiform disease is reported here in 32 typical cases taken from medical practice which responds strikingly to linseed oil supplements (60% w3-EFA) in confirmation of identical results in Capuchins.     

Hypo- und Hypermagnesämie aus kardiologischer Sicht

Zusammenfassung Eine Reihe pathologischer Zustände bedingen Magnesiummangel. Zustände mit Hypermagnesämie sind ebenfalls bekannt, doch wesentlich seltener. Für den Kardiologen beachtenswert ist, daß unter Therapie mit bestimmten Diuretica bei Herzinsuffizienz, bei Herzinfarkt, Kardiomyopathie, Digitalisintoxikation und bestimmten Herzrhythmusstörungen Hypomagnesämie beobachtet wurde. Leider kann in der klinischen Routine nur ein extracelluläres Magnesiumdefizit durch Serumbestimmungen gemessen werden; über Magnesiummangel einzelner Organe kann nichts ausgesagt werden. Hinweise für Magnesiummangel geben aber neben der Messung des Serumspiegels Anamnese, klinischer Befund, bestimmte EKG-Veränderungen wie auch evtl. Hypokalämie, ein Zustand, bei dem sich oft — besonders bei Aldosteronismus — parallele Veränderungen zeigten.Tierexperimente deuten darauf hin, daß infarktähnliche Läsionen unter Magnesiummangel entstehen, doch ob Herzinfarkt beim Menschen durch Magnesiummangel ausgelöst werden kann, ist noch ungeklärt. In Leichenherzen zeigte sich im Infarktgebiet neben Calciumakkumulation signifikanter Magnesiumverlust, wobei unklar blieb, ob sich Ursache oder Folge des Infarktes widerspiegelten. Falls ein ursächlicher Zusammenhang besteht, ist er im Myokardstoffwechsel selbst zu suchen, wie bei der Alkoholkardiomyopathie, wo myokardialer Magnesiummangel zumindest als pathogenetischer Teilfaktor anerkannt wird. Andererseits versucht man aber auch Beziehungen zwischen Atherosklerose, Blutgerinnung und Hypomagnesämie herzustellen, in der Meinung, daß Magnesiummangel auch über den coronaren Pathomechanismus des Herzinfarktes wirken könnte. Sicher scheint, daß gewisse EKG-Veränderungen und Herzrhythmusstörungen durch einen irritierten Magnesiumhaushalt bedingt sein können, da sie bei Gabe bzw. Entzug von Magnesium verschwinden. Daß Magnesiummangel die Glykosidtoleranz verringert, wird tierexperimentell bestätigt. Unter Hypomagnesämie bewirkt Acetylstrophanthidin eher und länger Rhythmusstörungen als ohne, außerdem lassen diese sich durch Magnesiumgaben eliminieren. Da in gewissen Fällen spontane und digitalisinduzierte Herzrythmusstörungen durch Magnesiuminjektionen beseitigt wurden, scheint Magnesium als Therapeuticum angebracht. Einsatz verschiedener Magnesiumsalze bei Angina pectoris, degenerativen Herzerkrankungen und Herzinsuffizienz ohne geprüften und offensichtlich gestörten Magnesiumhaushalt ist fragwürdig, weil keine eindeutigen klinischen Erfolgsbeweise vorliegen. Immerhin mag es aber larvierte, durch Serumbestimmungen nicht erfaßbare Mangelzustände geben. Allgemein erscheint es aus kardiologischer Sicht ratsam, den Magnesiumhaushalt zu überwachen und in entsprechenden Fällen auszugleichen, um möglichen Myokardläsionen oder fatalen Herzrhythmusstörungen entgegenzuwirken.     

Environmental risk factors and their role in the management of atopic dermatitis

Introduction: The etiology of atopic dermatitis (AD) is multifactorial with interaction between genetics, immune and environmental factors.

Areas covered: We review the role of prenatal exposures, irritants and pruritogens, pathogens, climate factors, including temperature, humidity, ultraviolet radiation, outdoor and indoor air pollutants, tobacco smoke exposure, water hardness, urban vs. rural living, diet, breastfeeding, probiotics and prebiotics on AD.

Expert commentary: The increased global prevalence of AD cannot be attributed to genetics alone, suggesting that evolving environmental exposures may trigger and/or flare disease in predisposed individuals. There is a complex interplay between different environmental factors, including individual use of personal care products and exposure to climate, pollution, food and other exogenous factors. Understanding these complex risk factors is crucial to developing targeted interventions to prevent the disease in millions. Moreover, patients require counseling on optimal regimens for minimization of exposure to irritants and pruritogens and other harmful exposures.     

Class II HLA in Georgia Caucasus Tbilisi Georgians and their Mediterranean ancestry: The Usko Mediterranean languages

Georgia (or Sakartvelo in its own language) is a South Caucasus Mts. country with its easternmost part is enigmatically named Iberia, like the Iberian Peninsula, which may refer to rivers “Kura” and “Ebro” or their valleys respectively. Most of their inhabitants speak Georgian which is included within Dene-Caucasian group and Usko-Mediterranean subgroup of languages. The latter includes Basque, Berber, ancient Iberian-Tartessian, Etruscan, Hittite, Minoan Lineal A and others. In the present paper, HLA class II -DRB1 and -DQB1 alleles has been studied and extended haplotypes calculated. Most frequent haplotypes are also of Mediterranean origin (i. e.: (A*02-B*51)-DRB1*11:01-DQB1*03:01, (A*02-B*51)-DRB1*13:01-DQB1*06:03, or (A*24-B*35)-DRB1*01:01-DQB1*05:01) and DA genetic distances show that closest world populations to Georgians are Mediterraneans. Georgians also show common extended haplotypes ((A*02-B*51)-DRB1*11:01-DQB1*03:01, (A*02-B*13)-DRB1*07:01-DQB1*02:01 and (A*03-B*35)-DRB1*11:01-DQB1*03:01) with Svan people, a secluded population in North Georgia mountains. We can conclude that Georgians belong to a very old Mediterranean substratum according to both linguistics (Usko Mediterranean languages) and HLA genetics.     

'Very sore nights and days': the child's experience of illness in early modern England, c.1580-1720

Sick children were ubiquitous in early modern England, and yet they have received very little attention from historians. Taking the elusive perspective of the child, this article explores the physical, emotional, and spiritual experience of illness in England between approximately 1580 and 1720. What was it like being ill and suffering pain? How did the young respond emotionally to the anticipation of death? It is argued that children’s experiences were characterised by profound ambivalence: illness could be terrifying and distressing, but also a source of emotional and spiritual fulfilment and joy. This interpretation challenges the common assumption amongst medical historians that the experiences of early modern patients were utterly miserable. It also sheds light on children’s emotional feelings for their parents, a subject often overlooked in the historiography of childhood. The primary sources used in this article include diaries, autobiographies, letters, the biographies of pious children, printed possession cases, doctors’ casebooks, and theological treatises concerning the afterlife.