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Osteoporosis (OP) is a serious metabolic disease that, due to the increased number or function of osteoclasts, results in increased bone brittleness and, therefore, fragile fracture. Some recent studies report the importance of the transforming growth factor β (TGFβ) pathway in bone homeostasis. RepSox is a small molecule inhibitor of TGFβRI that has a wide range of potential application in clinical medicine, except OP. The aim of our study is to evaluate the effects of RepSox on the differentiation and bone resorption of osteoclasts in vitro and in vivo in an ovariectomy (OVX)-induced OP model. An initial analysis showed TGFβRI messenger RNA expression in both bone samples and bone cells. In the in vitro study, RepSox inhibited the receptor activator of nuclear factor κB ligand (RANKL)-induced osteoclast differentiation and bone resorption activity. Real-time polymerase chain reaction (PCR) analysis showed that RepSox suppressed osteoclastic marker gene expression in both dose-dependent and time-dependent manners. In addition, RepSox did not affect osteoblast differentiation, migration or osteoblastic-specific gene expression in vitro. Furthermore, western blot analysis indicated the underlying mechanisms of the RepSox suppression of osteoclastogenesis via the Smad3 and c-Jun N-terminal kinase/activator protein-1 (JNK/AP-1) signaling pathways. Finally, our animal experiments revealed that RepSox prevented OVX-induced bone loss in vivo. Together, our data suggest that RepSox regulates osteoclast differentiation, bone resorption, and OVX-induced OP via the suppression of the Smad3 and JNK/AP-1 pathways.

Rationale In 1891, Dr. Hermann Kummell, a German surgeon, described a clinical entity characterized by the development of progressive painful kyphosis following an asymptomatic period of months or years after a minor spinal trauma, leading to a gradual collapse of the vertebra and dynamic instability, ultimately progressing to kyphosis with prolonged back pain and/or paraparesis. To date, the main pathologic eliciting event remains unclear, and no standard treatment or single effective treatment are available for Kummell disease. Patient concerns A 74-year-old woman presented with severe back pain and numbness of both legs for approximately 2 months. Diagnoses According to the clinical symptoms and imaging examinations, the patient was diagnosed with stage III Kummell disease. Interventions The patient underwent titanium mesh bone grafting combined with pedicle screw internal fixation. Outcomes Postoperative kyphosis was corrected, and the vertebra was reconstructed. Lessons Kummell disease is not a rare complication of osteoporotic vertebral compression fractures, and treatment of each patient must be individualized. The application of titanium mesh bone grafting combined with pedicle screw internal fixation is an effective treatment option for stage III Kummell disease.

Major depressive disorder (MDD), one of the most frequently encountered forms of mental illness and a leading cause of disability worldwide, poses a major challenge to genetic analysis. To date, no robustly replicated genetic loci have been identified, despite analysis of more than 9,000 cases. Here, using low-coverage whole-genome sequencing of 5,303 Chinese women with recurrent MDD selected to reduce phenotypic heterogeneity, and 5,337 controls screened to exclude MDD, we identified, and subsequently replicated in an independent sample, two loci contributing to risk of MDD on chromosome 10: one near the SIRT1 gene (P = 2.53 × 10(-10)), the other in an intron of the LHPP gene (P = 6.45 × 10(-12)). Analysis of 4,509 cases with a severe subtype of MDD, melancholia, yielded an increased genetic signal at the SIRT1 locus. We attribute our success to the recruitment of relatively homogeneous cases with severe illness.

BACKGROUND: Years of education are inversely related to the prevalence of major depressive disorder (MDD), but the relationship between the clinical features of MDD and educational status is poorly understood. We investigated this in 1970 Chinese women with recurrent MDD identified in a clinical setting. METHODS: Clinical and demographic features were obtained from 1970 Han Chinese women with DSM-IV major depression between 30 and 60 years of age across China. Analysis of linear, logistic and multiple logistic regression models were used to determine the association between educational level and clinical features of MDD. RESULTS: Subjects with more years of education are more likely to have MDD, with an odds ratio of 1.14 for those with more than ten years. Low educational status is not associated with an increase in the number of episodes, nor with increased rates of co-morbidity with anxiety disorders. Education impacts differentially on the symptoms of depression: lower educational attainment is associated with more biological symptoms and increased suicidal ideation and plans to commit suicide. LIMITATIONS: Findings may not generalize to males or to other patient populations. Since the threshold for treatment seeking differs as a function of education there may an ascertainment bias in the sample. CONCLUSIONS: The relationship between symptoms of MDD and educational status in Chinese women is unexpectedly complex. Our findings are inconsistent with the simple hypothesis from European and US reports that low levels of educational attainment increase the risk and severity of MDD.

BACKGROUND: The relationship between major depressive disorder (MDD) and dysthymia, a form of chronic depression, is complex. The two conditions are highly comorbid and it is unclear whether they are two separate disease entities. We investigated the extent to which patients with dysthymia superimposed on major depression can be distinguished from those with recurrent MDD. METHODS: We examined the clinical features in 1970 Han Chinese women with MDD (DSM-IV) between 30 and 60 years of age across China. Logistic regression was used to determine the association between clinical features of MDD and dysthymia and between dysthymia and disorders comorbid with major depression. RESULTS: The 354 cases with dysthymia had more severe MDD than those without, with more episodes of MDD and greater co-morbidity for anxiety disorders. Patients with dysthymia had higher neuroticism scores and were more likely to have a family history of MDD. They were also more likely to have suffered serious life events. LIMITATIONS: Results were obtained in a clinically ascertained sample of Chinese women and may not generalize to community-acquired samples or to other populations. It is not possible to determine whether the associations represent causal relationships. CONCLUSIONS: The additional diagnosis of dysthymia in Chinese women with recurrent MDD defines a meaningful and potentially important subtype. We conclude that in some circumstances it is possible to distinguish double depression from recurrent MDD.

Background The relationship between age at onset (AAO) and major depression (MD) has been studied in US, European and Chinese populations. However, larger sample studies are needed to replicate and extend earlier findings. Methods We re-examined the relationship between AAO and the clinical features of recurrent MD in Han Chinese women by analyzing the phase I ( N =1848), phase II ( N =4169) and total combined data ( N =6017) from the CONVERGE project. Linear, logistic, multiple linear and multinomial logistic regression models were used to determine the association of AAO with continuous, binary and categorical variables. Results The effect size of the association between AAO and clinical features of MD was quite similar in the phase I and phase II samples. These results confirmed that MD patients with earlier AAO tended to suffer more severe, recurrent and chronic illness and cases of MD with earlier AAO showed increased neuroticism, greater family history and psychiatric comorbidity. In addition, we showed that earlier AAO of MD in Han Chinese women was associated with premenstrual symptoms, postnatal depression, a highly authoritarian or cold childhood parental rearing style and a reduced probability for having melancholia. Limitations Data were collected retrospectively through interview and recall bias may have affected the results. Conclusions MD with earlier AAO in Han Chinese women shows a distinct set of clinical features which are similar to those reported in Western populations.

Background Phobic fears are common in the general population and among individuals with major depression (MD). We know little about the prevalence, clinical correlates, and structure of phobic fears in Chinese women with MD. Methods We assessed 22 phobic fears in 6017 Han Chinese women with MD. We used exploratory factor analysis to examine the structure of these phobic fears. We examined the relationship between individual phobic fears and the severity of MD, neuroticism, comorbid panic disorder, generalized anxiety disorder and dysthymia using logistic regression models. Results The frequency of phobic fears ranged from 3.0% (eating in public) to 36.0% (snakes). Phobic fears were significantly associated with more severe MD, high neuroticism, and co-morbid panic disorder, generalized anxiety disorder and dysthymia. Our factor analysis suggested four underlying subgroups of phobic fears which differed in their clinical correlates, severity and patterns of comorbidity. Limitations Data were collected retrospectively through interview and recall bias may have affected the results. Conclusions Phobic fears are correlated with comorbid MD and more severe MD. These phobic fears clearly subdivide into four subgroups that differ meaningfully from each other.

Miniature mobile robots are very suitable for initiative reconnaissance and surveillance important targets of sensitive areas. However, miniaturization of robots will inevitably lead to lack of the power of locomotion. Throwable miniature robots can very kind to solve the above-mentioned problem. However, the crucial problem resulted from the small volume of miniature robots is the difficulty of packing locomotion, sensing, computing and power subsystems into constrained space. Some mechanical designs and control system of throwable miniature reconnaissance robot for indoor reconnaissance tasks were presented in the paper. Several experiments showed that the robot was useful for covert surveillance in confined spaces and can carry out reconnaissance missions by its own or by teleoperation. Moreover, experiments also showed that these mechanical designs and the control system of throwable miniature reconnaissance robot are reliable and practical.

Secret reconnaissance and surveillance in spatially constrained spot are demanded in many antiterrorism activities. The special applications require a kind of miniature mobile robot to function covertly in highly confined environments. Thrown deployment mode for robots could be adopted. However, the crucial problem coping with the impact resulted from thrown miniature mobile robots' falling to the ground, is the difficulty of designing anti-impact machine. This paper presents a kind of mechanical design for reinforcing miniature mobile robots' anti-impact capability so that miniature mobile robots (“BMS-2”) carry out reconnaissance and surveillance tasks in confined region by thrown deployment mode. The inflatable wheels with damping spring and damping lid are designed as the crucially damping devices for robots' anti-impact machine. Also the principle for design and the relatively auxiliary design are discussed. Finally, the finite element analysis and several experiments show that the anti-impact mechanical design of BMS-2 is useful for attenuating the impact resulting from robots' falling to the ground, when Miniature Mobile Robots are thrown for carrying out missions in confined spaces.

Secret surveillance in tightly constrained spaces is demanded in many military and civilian activities, such as cave-in enemy raids and indoor hostage rescue missions. These special applications require a kind of miniature mobile robot to function covertly in highly confined environments. However, the crucial problem resulted from the small volume of miniature robots is the difficulty of packing locomotion, sensing, computing and power subsystems into constrained space. This paper presents the mechanical design and the control system of a miniature autonomous surveillance robot ("BMS-1") for indoor reconnaissance tasks. Several experiments showed that BMS-1 was useful for covert surveillance in confined spaces and can carry out reconnaissance missions on its own or by teleoperation.