LASS2/TMSG1 overexpression inhibits proliferation and promotes apoptosis of human lung cancer A549 cells possibly by upregulating ceramide and p38 MAPK to activate a signaling cascade / 南方医科大学学报

OBJECTIVE@#To investigate the effects of LASS2/TMSG1 gene overexpression on proliferation and apoptosis of human lung cancer A549 cells and explore the possible mechanism.@*METHODS@#We examined LASS2/TMSG1 expression level in a previously constructed A549 cell line overexpressing LASS2/TMSG1 using Western blotting. The proliferation and apoptosis of the cells were detected using colony-forming assay, CCK-8 assay, Hoechst/PI double staining and flow cytometry. Fourteen nude mice were randomized into 2 groups (n=7) to receive subcutaneous injection of A549 cells with or without LASS2/TMSG1 overexpression on the back of the neck, and the cell proliferation in vivo was observed. The expression levels of p38 MAPK protein and p-p38 MAPK protein in the xenografts were detected with Western blotting. ELISA was used to detect the levels of ceramide and p38 MAPK protein in cultured A549 cell supernatants and the xenografts in nude mice.@*RESULTS@#Compared with the negative control cells, A549 cells with LASS2/TMSG1 overexpression had significantly lowered proliferation ability in vitro with increased early apoptosis rate (P < 0.05), and showed obvious growth inhibition after inoculation in nude mice(P < 0.05). Western blotting showed that in both cultured A549 cells and the xenografts in nude mice, LASS2/TMSG1 gene overexpression significantly increased the expression levels of p38 MAPK protein and p-p38 MAPK protein (P < 0.05); the results of ELISA also revealed significantly increased levels of ceramide and p38 MAPK protein in the cell supernatant andxenografts as well (P < 0.05).@*CONCLUSION@#Overexpression of LASS2/TMSG1 gene can significantly inhibit the proliferation and promote early apoptosis of human lung cancer A549 cells both in vitro and in vivo possibly by upregulating the expressions of ceramide and p38 MAPK protein to activate a signal transduction cascade.

Finite element analysis of different intramedullary fixation methods for the treatment of senile pubic ramus fractures / 中国骨伤

OBJECTIVE@#To evaluate the biomechanical stability of elastic intramedullary nail in the treatment of pubic ramus fractures by finite element analysis, and to compare the stability of elastic intramedullary nail with cannulated screw intramedullary fixation.@*METHODS@#The CT data of the pelvis of a volunteer were selected, and the three-dimensional model of the pelvis was reconstructed by reverse engineering software and the fracture of the pubic ramus fractures was simulated by osteotomy. The hollow nail model, single elastic nail model and double elastic nailmodel were assembled with different implants respectively. The mesh division, material assignment loading and other steps were carried out in the ANSYS software, and then the calculation was submitted.@*RESULTS@#The overall displacement of the pelvis of the elastic nail model was smaller than that of the cannulated screw model, in which the double elastic nail model had the smallest overall displacement, but the cannulated screw model had the smallest plant displacement and the single elastic nail model had the largest plant displacement. Although the stress of cannulated screw was small, there was obvious stress concentration, the stress of elastic nail was large, but there was no obvious stress concentration, especially the stress distribution of double elastic nail was more uniform and the overall stress of pelvis was the smallest.@*CONCLUSION@#All the three fixation methods can effectively improve the stability of the anterior ring of the pelvis. Among them, there is no significant difference in the overall biomechanical propertiesof hollow nail fixation and double elastic nail fixation, which is better than that of single elastic nail fixation. Elastic nail fixation has the advantages of minimally invasive surgery and good biomechanical stability, so it can be used as a better surgical method for the treatment of pubic ramus fractures.

Molecular mechanism study of Shouhui Tongbian Capsules on promoting energy metabolism of gastrointestinal stromal cells / 中国中药杂志

Mechanism study was performed to explore how Shouhui Tongbian Capsules promotes energy metabolism of gastrointestinal stromal cells. In this study, gastrointestinal stromal cells line GIST-882 was used as the model to explore energy metabolism regulation effects of Shouhui Tongbian Capsules extract(10, 20, 50 and 100 μg·mL~(-1)) by measuring the cell proliferation, ATP level, mitochondrial membrane potential, and mitochondrial isocitrate dehydrogenase activity. Meanwhile, Western blot was used to detect the proteins expression of SCF/c-Kit and CDK2/cyclin A signaling pathways. Our results showed that Shouhui Tongbian Capsules promoted cell proliferation and increased ATP level of gastrointestinal stromal cells. In addition, Shouhui Tongbian Capsules obviously improved mitochondrial structural integrity, and increased mitochondrial membrane potential in GIST-882 cells. Mechanism study revealed that Shouhui Tongbian Capsules increased mitochondrial isocitrate dehydrogenase activity and up-regulated the proteins expression of SCF/c-Kit and CDK2/cyclin A signaling pathways. Collectively, our study indicated that Shouhui Tongbian Capsules promoted the energy metabolism for gastrointestinal stromal cells proliferation by activating mitochondrial isocitrate dehydrogenase to induce ATP production, as well as activating SCF/c-Kit and CDK2/cyclin A signaling pathways.

Therapeutic effect and mechanism of Shouhui Tongbian Capsules on slow transit constipation model mice / 中国中药杂志

Shouhui Tongbian Capsules was used to explore the therapeutic effect and potential mechanism on slow transit constipation model mice induced by loperamide hydrochloride. In the experiment, loperamide hydrochloride-induced ICR mice were used as the model of slow transit constipation. Fifty ICR mice were divided into the blank group, model group and high, medium and low dose groups of Shouhui Tongbian Capsules extract(100, 200 and 400 mg·kg~(-1)). The model group and the administration groups were then modeled using loperamide hydrochloride intragastrically to obtain slow transit constipation. After successful modeling, high, medium and low doses of drugs were given to each drug group by intragastric administration. After 14 days of administration, the first defecation time, 6 h defecation grain number, 6 h defecation wet weight and dry weight, black feces discharged within 6 h and the fecal water content were measured. Intestinal tissues were taken for c-Kit and SCF immunohistochemical sections to detect the expression of c-Kit and SCF in the blank group, model group and high, medium and low dose groups of the medicinal extract of Shouhui Tongbian Capsules. The tissue changes in the intestinal wall of mice were detected by HE staining. At the same time, partial intestinal tissues were taken to test the activity of ATP synthase and isocitrate dehydrogenase in intestinal tissues of mice. RESULTS:: showed that Shouhui Tongbian Capsules effectively improved the symptoms of slow transit constipation in ICR mice and promoted intestinal movement. Shouhui Tongbian Capsules obviously shortened the time of discharging black stool for the first time, improved the intestinal propulsion rate, increased the water content and amount of feces, and improved the constipation symptoms. Mechanism study revealed that Shouhui Tongbian Capsules increased ATP synthase activity and mitochondrial isocitrate dehydrogenase activity in intestinal tissue, and up-regulated c-Kit/SCF signaling pathway to promote interstitial Cajal cells proliferation, intestinal nerve transmission, intestinal motility and transport capacity.

Study on the mechanism of death related protein kinase 3 deficiency and inhibition of endoplasmic reticulum stress to alleviate vascular calcification / 中国综合临床

Objective:To investigate whether the deficiency of death associated protein kinases (DAPK) 3 can reduce vascular calcification by inhibiting endoplasmic reticulum stress.Methods:The method of prospective cohort study was used to observe and analyze the cell culture in vitro.Human aortic vascular smooth muscle cells (VSMC) were cultured in F10K Kaighn′s modified medium, and divided into calcified group and non-calcified group according to whether β-phosphoglycerin (10 mmol/L) was added into the medium.The cells in calcified group and non calcified group were divided into DAPK3 inhibition group and its control group, endoplasmic reticulum stress inhibition group and its control group, mitogen-activated protein kinase (MAPK) activation group and its control group, DAPK3 inhibition + AMP-activated protein kinase (AMPK) inhibition and blank control group, respectively. DAPK3 mRNA and protein concentration, calcium content, alkaline phosphatase, protein concentration of VSMC differentiation marker genes (SM22α, α-SMA), osteogenic differentiation transcription factor (Runχ2, bone morphogenetic protein-2, BMP-2), endoplasmic reticulum stress markers (AFT4, GRP78, GRP94 and CHOP) and p-PAMK protein expression were measured.Results:The mRNA level(highest value was 15.24±0.72 on the 14th day ) and protein level(highest value was 11.31±0.38 on the 14th day) of DAPK3 were significantly higher than those in non calcified cells(5.63±0.62, 2.59±0.33, respectively). The difference was statistically significant ( P< 0.001). In the calcified cells, calcium content (86.54±8.21) mmol/g in dapk3 deficient group was significantly lower than that in control group (194.63±8.54) mmol/g ( t=22.35, P<0.001), alkaline phosphatase activity was significantly decreased((96.27±10.28) IU/g vs.(224.67±10.94) IU/g, t=20.951, P<0.001), the expression of the VSMC differentiation marker genes (SM22α, α-SMA) were upregulated significantly (SM22α: (0.82±0.14) vs.(0.44±0.13), t=4.872, P=0.001; α-SMA: (0.95±0.18) vs.(0.56±0.13), t=4.303, P=0.002), the level of bone differentiation transcription factor (Runχ 2, BMP2) was significantly decreased (Runχ 2: (1.12±0.28) vs.(2.21±0.35), t=5.957, P<0.001; BMP2: (0.82±0.12 ) vs.(1.26±0.16), t=5.39, P<0.001), MAPK level was up-regulated (DAPK3 inhibited group 0.74±0.12 of calcified cells, 1.04±0.14 of non calcified cells, higher than the control group 0.44±0.10 of calcified cells, 0.78±0.12 of non calcified cells, t=4.704, P=0.001; t=3.454, P=0.006), and the inhibited calcium content of ESR calcified cells significantly reduced (after inhibition of AMPK pathway, cells transfected with shRNA group 150.21±11.98, cells transfected with shRNA group 83.21±12.12 were lower than those transfection blank control group 164.82±12.34, P<0.001). The activity of alkaline phosphatase was significantly reduced (226.54±16.57) IU/g protein in the shRNA group and (112.34±15.96) IU/g protein in the shRNA group were significantly lower than 242.32±16.32 in the blank control group, P<0.001); calcium content and ALP activity in the calcified MAPK cells were significantly reduced ( P<0.001). Conclusion:DAPK3 deficiency can inhibit endoplasmic reticulum stress through AMPK signaling pathway to slow down VSMC calcification.

Finite element simulation of femoral neck fracture in osteoporotic rats / 医学研究生学报

Objective There are few reports on the establishment of the finite element model of the rat femur in China, and even none on the finite element analysis of rat hip fracture. This study aimed to build a finite element model of osteoporotic rat proximal femoral fracture base on fracture mechanics. Methods We collected the CT imaging data on the femur of a healthy adult SD rat and established a preliminary three-dimensional finite element model of the rat femur. We also constructed a finite element model of femoral neck fracture in an osteoporotic rat by mesh generation, defining the material properties, setting interfacial properties and failure parameters, and loading. Then we measured the crack moment, von Mises, shear stress, stress, strains, displacement, and the starting point of fracture. Results The von Mises of stress showed that the crack moment was 0.109980s and the maximum stress and shear stress were mainly distributed on the medial inferior and lateral superior of the femoral neck when damage started, with the maximum stress of 367.9 Mpa and the maximum shear stress of 200.4 Mpa. The maximum strains was 1.2%, which was consistent with the routes of crack extension and extended from the medial inferior to the superior. The maximum displacement was 1.6 mm, mainly distributed on the proximal femoral, concentrated at the femoral head, and a displaced femoral neck model was simulated finally. Conclusion The finite element simulation model of femoral neck fracture in osteoporotic rats was successfully established, which can provide a new method for biomechanical studies in animal experiments.

Efficacy and safety of rotational atherectomy combined with drug eluting coronary in the treatment of severe coronary artery calcified lesions / 中国综合临床

Objective To investigate the efficacy and safety of rotational atherectomy(RA)combined with drug eluting stent(DES)implantation in the treatment of severe coronary artery calcification,and analyze key operation points.Methods The clinical data of sixty-two patients(68 lesions)treated with RA combined with DES from January 2014 to December 2015 were retrospectively analyzed,including the characteristics of operation,postoperative curative effect,complications,incidence of major adverse cardiovascular events(MACE) during hospitalization and follow-up period.Results A total of 75 rotary blur were used in the 62 cases,with an average of(1.18±0.27)per case,the blur diameter/target vessel diameter was(0.54±0.07),the success rate of RA was 98.4%(61/62);A toal of 103 DES were implanted in 61 patients,with an average of(1.67±0.55)per case,average length was(44.5 ± 11.8)mm,immediate DES success rate was 100%.After RA,target vessel diameter was(2.33± 0.52)mm,target vessel narrow degree was(29.6 ± 4.8)%,thrombolysis in myocardial infarction grade Ⅲ blood flow ratio was 66.2%,which have been significantly improved compared with preoperation((0.75±0.21)mm,(82.5±7.2)%,10.3%)(P<0.05),the target vascular lumen diameter and stenosis of target vessel continued to improve after DES((3.26 ± 0.43)mm,(8.7 ± 2.1)%,98.5%)(P<0.05);At 3 days after operation,the left ventricular ejection fraction was significantly higher than that before the operation((60.5±5.5)% vs.(56.8±4.7)%)(P<0.05).The incidence of complications associated with interventional procedures was 9.7%,in which 1 case with burr incarceration switched to coronary artery bypass grafting.The incidence of major adverse cardiovascular events incidence during hospitalization was 4.8%,the follow-up period was 9.0-22.0 months.The incidence of major adverse cardiovascular events incidence during follow-up was 8.2%.Conclusion DES implantation following RA in the treatment of severe coronary artery calcification can further improve blood flow and artery stenosis,medium-term efficacy is safe and reliable;standardized RA operation is the key to ensure the success of interventional therapy.

Relationship between two blood stasis syndromes and inflammatory factors in patients with acute coronary syndrome / 中国结合医学杂志

<p><b>OBJECTIVE</b>To investigate the relationship between inflammatory factors and two Chinese medicine (CM) syndrome types of qi stagnation and blood stasis (QSBS) and qi deficiency and blood stasis (QDBS) in patients with acute coronary syndrome (ACS).</p><p><b>METHODS</b>Sixty subjects with ACS, whose pathogenesis changes belongs to qi disturbance blood stasis syndrome, were divided into 2 groups: 30 in the QSBS group and 30 in the QDBS group. The comparative analysis on them was carried out through comparing general information, coronary angiography and inflammatory factors including intracellular adhesion molecule-1 (ICAM-1), chitinase-3-like protein 1 (YKL-40) and lipoprotein-associated phospholipase A2 (Lp-PLA2).</p><p><b>RESULTS</b>Compared with the QSBS group, Lp-PLA2 and YKL-40 levels in the QDBS group showed no-significant difference (P>0.05); ICAM-1 was significantly higher in the QDBS group than in the QSBS group in the pathological processes of qi disturbance and blood stasis syndrome of ACS (P<0.05).</p><p><b>CONCLUSIONS</b>Inflammatory factor ICAM-1 may be an objective basis for syndrome typing of QSBS and QDBS, which provides a research direction for standardization research of CM syndrome types.</p>

Application of Valpar 4 System in Rehabilitation of Hand Injury / 中国康复理论与实践

@# Objective To observe the effect of Valpar 4 system on hand injury. Methods 40 patients with hand injury were randomly divided into control group and observation group with 20 patients in each group. Routine treatment was applied in both groups while Valpar 4 system was added in the observation group. Then total active motion (TAM) of finger joints, Disability of Arm Shoulder and Hand (DASH), and Upper Extremity Function Test (UEFT) were carried out before, 2 weeks and 4 weeks after treatment. Results The TAM improved significantly in the control group 2 weeks after treatment (P<0.001). The TAM, DASH and UEFT improved significantly in the observation group (P<0.001), and the DASH and UEFT were better in the observation group than in the control group (P<0.001). 4 weeks after treatment, the TAM and UEFT improved significantly (P<0.001) in the control group, the TAM, DASH, UEFT significantly improved in the observation group (P<0.001), and were better in the observation group than in the control group (P<0.05). Conclusion Valpar 4 system can effectively improve the TAM of fingers, function of hands and upper limb, especially in terms of activities of daily living of upper limbs.

Association of atherosclerotic renal artery stenosis with major adverse cardiovascular events after acute myocardial infarction / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Patients with atherosclerotic renal artery stenosis (ARAS) are in substantial risk of cardiovascular adverse events. We investigated whether myocardial infarction patients with ARAS are in additional risk of cardiovascular events.</p><p><b>METHODS</b>In this retrospective study, 257 patients with type 1 myocardial infarction were enrolled. Median follow-up was 42 months. Composite endpoint events are analyzed by definitions of ARAS as ≥ 50% or ≥ 70% diameter stenosis.</p><p><b>RESULTS</b>Defining ARAS as ≥ 70% diameter stenosis, ARAS was a significant predictor for composite endpoint events including death, non-fatal myocardial infarction, ischaemic stroke and intracranial haemorrhage, rehospitalisation for cardiac failure (HR: 4.381; 95% CI: 1.770-10.842) by Cox regression analysis, but not for death. Diabetes mellitus was also a significant predictor for composite endpoint events (HR: 2.756; 95% CI: 1.295-5.863). However, defining ARAS ≥ 50% diameter stenosis, ARAS was no longer a significant predictor for composite endpoint events or death.</p><p><b>CONCLUSIONS</b>Although not associated with mortality, ARAS ≥ 70% is associated with major adverse cardiac events after acute myocardial infarction. For prognosis, ≥ 70% diameter stenosis is a more appropriate criteria for ARAS definition than ≥ 50% diameter stenosis.</p>

Impact of primary percutaneous coronary intervention on blood perfusion in nonculprit artery in patients with anterior ST elevation myocardial infarction / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Recent studies have demonstrated that epicardial flow in nonculprit arteries, which has been assumed to be normal, was slowed in the setting of ST-elevation myocardial infarction (STEMI). However, the impact of primary percutaneous coronary intervention (PCI) on blood perfusion in nonculprit arteries in patients with STEMI has not been clarified. The purpose of this study was to investigate the impact of primary PCI on blood perfusion in nonculprit arteries in patients with STEMI and correlated clinical factors.</p><p><b>METHODS</b>A total of 117 patients with anterior wall STEMI, the culprit artery being the left anterior descending artery (LAD), undergoing primary PCI (the study group) and 100 patients with normal coronary angiography (the control group) were enrolled. To observe the differences of corrected TIMI frame count (cTFC) and myocardial blush grade (MBG) before and after primary PCI in both culprit and nonculprit arteries, the left circumflex coronary artery (LCX), cTFC and MBG in the LAD and LCX were measured in the study group and control group. The study group was divided into three groups; reflow in the culprit artery group (the R group), no reflow in culprit artery group (the NR group), and no reflow in both the culprit artery and nonculprit artery group (the NRB group) according to MBG grade. The level of serum C-reactive protein (CRP), catecholamine, and fibroblast growth factor-21 (FGF21) were assayed. The clinical and angiographic characteristics were also analyzed.</p><p><b>RESULTS</b>cTFC (28.1 ± 24.3 vs. 20.3 ± 19.3, P < 0.05) and MBG in the LCX were different in the study group compared to the control group before primary PCI. cTFC (25.2 ± 22.3 vs. 28.1 ± 24.3, P < 0.05) and the MBG level in the LCX were improved after successful primary PCI, but were not recovered to the normal level. Patients with no reflow in the culprit artery had a higher incidence of no-reflow in the nonculprit artery (78% vs. 19%, P < 0.0001), and the levels of CRP ((3.29 ± 1.31) mg/dl vs. (2.51 ± 1.14) mg/dl vs. (2.93 ± 1.07) mg/dl, P < 0.05, respectively), catecholamine ((epinephrine (693.48 ± 89.78) pg/ml vs. (398.12 ± 93.28) pg/ml vs. (562.54 ± 96.22) pg/ml, P < 0.0001, respectively), and norepinephrine ((7012.43 ± 932.47) pg/ml vs. (4012.34 ± 814.16) pg/ml vs. (5549.03 ± 912.65) pg/ml, P < 0.0001, respectively)) in the NRB group were higher than those in the R group and NR group. The level of FGF21 ((0.299 ± 0.093) ng/ml vs. (0.612 ± 0.071) ng/ml vs. (0.428 ± 0.074) ng/ml, P < 0.0001 respectively) in the NRB group was lower than that in the R group and NR group.</p><p><b>CONCLUSIONS</b>The blood perfusion in the nonculprit artery may be impaired in patients with STEMI. Although nonculprit artery perfusion may be improved after successful primary PCI, it is still lower than that in the control group, and may be involved in inflammation and spasms.</p>

Preliminary clinical results of endoscopic assisted anterior lumbar interbody fusion / 中华外科杂志

<p><b>OBJECTIVE</b>To summarize the experiences of endoscopic assisted anterior lumbar interbody fusion (ALIF) with self-locking cage via retroperitoneal approach through small incision lateral to abdominal rectus.</p><p><b>METHODS</b>There were 47 cases of endoscopic assisted ALIF from April 2010 to April 2012 were reviewed retrospectively, including 28 male and 19 female patients whose age ranged from 39 to 65 years, averaged of (48 ± 11) years. Of 47 cases, 17 cases were founded instability in lumbar spine, 16 cases of discogenetic low back pain, 7 cases of degenerative spondylolithesis, and 7 cases of recurrent disc herniation. The level involved included 7 cases at L3-4 level, 33 cases at L4-5 level, 7 cases at L5-S1. X-ray and/or 3D CT scan were done in each patient at post-operative day 4, 1 month, 3 months, and 6 months. The height and angle of disc space, angle of lumbar lordosis (LL), pelvic incidence (PI), pelvic tilt (PT), and sacral slope (SS) were recorded and measured, as well as length of incision, operation time, blood loss, complications and ratio of bone graft fusion. The clinical outcomes were evaluated by Oswestry disability index (ODI) and visual analogue scale (VAS).</p><p><b>RESULTS</b>Average length of incision was (6.2 ± 0.8)cm (5.3-7.8 cm) , average blood loss was (81 ± 20)ml (50-150 ml) , mean operation time was (96 ± 10)minutes (65-122 minutes) . There were significant improvement of ODI(48% ± 10% vs. 14% ± 5%), the VAS of back pain(6.3 ± 1.1 vs.0.7 ± 0.7) and VAS of leg pain(3.4 ± 2.1 vs.0.6 ± 0.6) during preoperative and postoperation last follow-up (t = 20.78, 25.92 and 8.74, P = 0.000). The disc height of operative segments were all recovered significantly (F = 18.971, P = 0.000) postoperatively, from preoperative (10.3 ± 2.4)mm to postoperative (12.6 ± 2.1)mm. For complications, 5 cases had peritoneum tear, 19 cases had bone donor site pain, 14 cases had abdominal distension and 5 cases had lower limb paraesthesia, which were all treated with supportive managements. Bony intervertebral fusion was obtained in all cases in 6 months postoperatively.</p><p><b>CONCLUSIONS</b>The advantages of endoscopic assisted ALIF with self-locking cage via retroperitoneal approach are less damage, rapid recovery, and less blood loss. Comparing with traditional ALIF procedure, the view of operative field is also improved.</p>

The use of anterior cervical discectomy and fusion with self-locking cages to treat multi-segmental cervical myelopathy / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the use of anterior cervical discectomy and fusion with self-locking cages to treat multi-segmental cervical myelopathy.</p><p><b>METHODS</b>From April 2008 to March 2010, anterior cervical discectomy and fusion with self-locking cages were performed on 45 patients who suffered from multi-segmental cervical myelopathy, among of them there were 23 male and 22 female, aged from 32 to 67 years (average 53 years). Recording the Japanese Orthopedic Association (JOA) scores and SF-36 scores in the protocol time point, in order to investigate the clinical outcome, meanwhile, accumulating the pre-operation and postoperation X-ray films of cervical spine for measuring the height of intervertebral space, whole curvature of cervical spine and the rate of fusion by repeated measures analysis of variance.</p><p><b>RESULTS</b>The mean follow-up time was 28.4 months (24 - 35 months). JOA scores ascended from preoperative 6.5 ± 3.1 to postoperative 13.4 ± 1.7 (F = 17.84, P = 0.001), the 7 scores of SF-36 improved significantly after operation (t = 1.151 - 12.207, P < 0.05), but mental health not. The fineness rate was 91.1%. Height of disc space ascended from preoperative (5.5 ± 1.8) mm to postoperative (8.3 ± 0.8) mm (F = 11.71, P = 0.043), globle curvature of cervical spine ascended from preoperative 5° ± 7° to postoperative 10° ± 14° (F = 234.53, P = 0.000), the change of the two index was significantly, respectively. Fat necrosis in one case and hematoma in another case at the bone donor-site were found, both of the two cases were cured by physiotherapy. All of the 45 cases (111 segments) achieved bone fusion.</p><p><b>CONCLUSION</b>The use of anterior cervical discectomy and fusion with self-locking cages to treat multi-segmental cervical myelopathy possess many advantages as follows: satisfactory clinical outcome, minimally invasive, higher fusion rate, higher orthopaedic ability.</p>

Factors affecting adjacent segment degeneration after rigid lumbar internal fixation / 南方医科大学学报

<p><b>OBJECTIVE</b>To analyze the factors affecting the occurrence of adjacent segment degeneration (ASD) after lumbar internal fixation.</p><p><b>METHODS</b>The clinical data of 147 surgical patients with lumbar disc herniation, lumbar spinal stenosis and lumbar spodylolisthesis undergoing surgeries between January 2002 and July 2007 in our hospital were reviewed. The correlations of gender, range of fixation, position of fixation, and characteristic of the adjacent disc to the occurrence of ASD were analyzed.</p><p><b>RESULTS</b>The patients were followed up for a mean of 30-/+10 months (18-84 months). The incidence of ASD was 13.6% in these patients, occurring all at the cephalad adjacent segment. The presence of preoperative degeneration of the adjacent disc gave rise to increased risk of ASD following the surgery (chi(2)=6.272, P=0.012), and multivariate analysis indicated that preoperative adjacent disc degeneration was a risk factor for postoperative ASD (P=0.046), but gender, range of fusion and site of fusion were not the risk factors.</p><p><b>CONCLUSION</b>Presence of adjacent segment degeneration before the operation is associated with a significantly increased risk of postoperative ASD.</p>

Surgical treatment of short upper lip / 中华医学美学美容杂志

Objective In order to cure some patients with the following characteristics which appear only when smiling: elevation and shortening of the upper lip, a transverse furrow below the co-lumella, and increased exposure of the maxillary gums, we reported a new surgical procedure to cor-rect this deformities. Methods By means of a transfixion incision extended laterally along the vestibu-lar or the upper gingivolabial sulcus incision, part of the depressor septi and orbicularis muscle were excised, and extensive separation were made to lower the upper lip. Results 27 cases of short upper lip were treated. Among the total, the transfixion incisions were made in 9 cases, and the upper gingi-volabial sulcus incisions were made in 18 cases. These procedures achieved lowering the upper lip, lighting or disappearing the transverse furrow, and covering the exaggerated exposure of the gums when patients smiled. At the same time the rhinoplasties were done in 6 cases. Through the above-mentioned we were able to correct the deformities on rhino-gingivolabial part only when the faces moved, achieved some kind of beauty for patients, and obtained satisfactory results. Conclusions Some patients have added defects .that are exported only when they begin to make facial movements. The cause of these characteristics is hypertrophy of the depressor septi nasi muscles. We describe the technique that is not only to correct the defects but also to enhance the patient's smile. It is worth to recommend for clinical application.