Baveno VII - Renewing consensus in portal hypertension: personalized care for portal hypertension / 中华肝脏病杂志

The Baveno VII workshop held in October 2021 was featured by the subject of personalized care in portal hypertension. The workshop focused on the following 9 topics including: the relevance and indications for measuring the hepatic venous pressure gradient as a gold standard; the use of non-invasive tools for the diagnosis of compensated advanced chronic liver disease and clinically significant portal hypertension; the impact of etiological and of non-etiological therapies in the course of cirrhosis; the prevention of the first episode of decompensation; the management of the acute bleeding episode; the prevention of further decompensation; as well as the diagnosis and management of splanchnic vein thrombosis and other vascular disorders of the liver. This essay provides a compilation and summary of recommendations regarding the abovementioned topics, and presents the most recent research proceedings and the corresponding consensus to our readers.

Role of BET Bromodomain in Hematopoietic Differentiation from hESCs / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To explore the role of bromodomain and extra terminal (BET) bromodomain in hematopoietic differentiation from human enbryonic stem cells (hESC).</p><p><b>METHODS</b>The effect of BET hematopoietic inhibitor I-BET151 on hematopoietic differentiation from hESC was detected by using a monolayer hematopoietic defferentiation model, immunofluorescence, flow cytometry and real-time PCR; moreover the role of I-BET151 in process of hematopoietic differentiation was explored by adding I-BET151 in different differentiation stages.</p><p><b>RESULTS</b>The analysis results of immunofluorescence, flow cytometry and real-time PCR showed that I-BET 151 significantly inhibited the generation of CD43 positive hematopoietic stem and progenitor cells (HSPCs). It was found that the addition of I-BET 151 in different stages, including APLNR lateral plate mesoderm production, CD34CD31 hemogenic endothelium (HEP) generation and endothelial-to-hematopoietic transition, significantly suppressed the generation of CD43 positive hematopoietic progenitor cells.</p><p><b>CONCLUSION</b>I-BET 151 inhibites hematopoietic differentiation from hESCs at several stages, suggesting that the BET bromodomain plays important roles in multiple stages of hematopoietic differentiation from hESCs.</p>

The effect of the thoracic cage on the vertebral axial rotation of adolescent idiopathic scoliosis: a biomechanical study / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the effect of the rib cage on the vertebral axial rotation of adolescent idiopathic scoliosis under axial load condition.</p><p><b>METHODS</b>Three dimensional finite element model of adolescent idiopathic scoliosis included and excluded thoracic cage was built based on the data of computer tomography. The model was imported into the preprocessor of the ANSYS 8.0 software for assigning boundary and loading conditions. Then the axial loading condition was simulated after entering the solution modular. The magnitude and direction of each vertebral axial rotation of the scoliotic spine were read and analyzed in the postprocessor of the ANSYS software.</p><p><b>RESULTS</b>The rib cage had a significant influence on the axial rotation of the vertebra above the structural curve and had no influence on the axial rotation of the lumbar and sacral vertebra. The effect of the thoracic cage on the axial rotation of the apical vertebra was limited. Under different loading conditions, the apical vertebra of both models rotated in the same direction. The magnitude of the vertebral rotation of both models has no statistical significance.</p><p><b>CONCLUSIONS</b>Adolescent idiopathic scoliosis can lead to the anatomical changes of the vertebra and the thoracic cage. The corresponding changes of biomechanical features of the scoliotic spine and rib cage would occur. The deformed thoracic cage could not maintain the rotation stability as the normal one.</p>

Combined pedicle subtraction osteotomy and polysegmental closing wedge osteotomy for correction of the severe thoracolumbar kyphotic deformity in ankylosing spondylitis / 中华外科杂志

<p><b>OBJECTIVE</b>To study retrospectively the efficacy and complications of combined pedicle subtraction osteotomy (PSO) and polysegmental closing wedge osteotomy for correction of the severe rigid thoracolumbar kyphotic deformity in ankylosing spondylitis (AS).</p><p><b>METHODS</b>A total of 8 consecutive male patients with AS and severe thoracolumbar kyphotic deformity (mean age 32 years, range 28 - 46) were involved in this study from August 2004 to June 2007. The average preoperative Cobb angle of thoracic spine (T(1)-T(12)) was 96 degrees (range, 80 degrees - 112 degrees ), the mean preoperative angle of lumbar lordosis (L(1)-S(1)) was 10 degrees (5 degrees - 15 degrees ). The mean chin-brow angle was 47 degrees (range, 40 degrees - 58 degrees ). The average gaze angle was 43 degrees (range, 32 degrees - 50 degrees ). After preoperative assessment, single-level PSO was performed in L(3) vertebrae and two-level polysegmental closing wedge osteotomy was performed in thoracolumbar vertebrae (T(12)-L(1), L(1-2)). Radiographic and clinical results and complications were assessed.</p><p><b>RESULTS</b>The surgical time was (298.1 +/- 20.7) minutes and blood loss during the procedure was (1588.8 +/- 171.6) ml. The follow-up period was (11.5 +/- 7.7) months. The postoperative angle and the amount of correction of the thoracic and lumbar spine were 76.1 degrees +/- 9.6 degrees , 20.3 degrees +/- 1.1 degrees and 48.4 degrees +/- 4.7 degrees , 38.4 degrees +/- 4.7 degrees respectively. The postoperative chin-brow and gaze angle was 16.5 degrees +/- 4.6 degrees and 73.0 degrees +/- 5.2 degrees , respectively. The amount of correction for sagittal balance was (12.3 +/- 1.6) cm. No nerve, vascular injury, stress fracture and coronal decompensation occurred in the patients.</p><p><b>CONCLUSIONS</b>Combined PSO and polysegmental closing wedge osteotomy by posterior approach only is safe and effective for correction of the severe rigid thoracolumbar kyphotic deformity in AS. The visual field is significantly improved after surgery.</p>

Development of a water tank for X-ray dose measurement in stereotactic radiotherapy (X-knife) / 中国医疗器械杂志

This paper presents a novel x-ray dose testing water tank used for the stereotactic radiation therapy system, including its constitution, structure and the method of using it. The water tank has a simple structure of inner and outer sleeves which are connected through a drowned pump and a water pipe in order to control the water level of the tank. The water tank featuring autoregulation and easy use is worthy of clinical application and popularization.

Research advance in effectiveness of bracing for adolescent idiopathic scoliosis / 上海第二医科大学学报

The role of bracing for adolescent idiopathic scoliosis,which came into application in 1960's,has long been controversial.There are various brace instrument with different reported effectiveness.In this paper,we summarize the research findings and main views in the effectiveness of bracing for adolescent idiopathic scoliosis in the past ten years,and explore the possible causes leading to the different results.Besides,we are trying to point out the research trend,in hope of drawing a scientific conclusion on the effectiveness of bracing treatment in the near future.

Application and advance of finite element method in spinal biomechanics / 上海第二医科大学学报

As a novel research tool in the field of the spinal biomechanics, the finite element method (FEM) complements and verifies the traditional research methods, which has been attached increasingly greater importance. In this paper, we briefly introduce the achievement made in the field of spinal biomechanics by FEM in the past decade, summarize the physiological and pathological behaviors of various spinal anatomical parts described by FEM, and present the basic view of using FEM to optimize the surgery instrument design.

In vitro vasculogenesis and angiogenesis of mouse embryonic stem cells / 中国医学科学院学报

<p><b>OBJECTIVE</b>To explore an optional condition to induce mouse embryonic stem (ES) cells to differentiate into endothelial cells and to establish in vitro models of vasculogenesis and angiogenesis.</p><p><b>METHODS</b>Mouse ES cells were cultured in differentiation medium containing a cocktail of vascular endothelial growth factor (VEGF), basic fibroblast growth factor (bFGF), interleukin-6 (IL-6) and erythropoietin (EPO) in 1% methylcellulose to induce formation of embryoid bodies (EBs). At day 11, EBs were harvested and suspended in rat-tail collagen type I with the same cocktail of cytokines cultured for three additional days. The differentiation of ES cells into endothelial cells, processes of vasculogenesis and angiogenesis were examined using immunostaining of EBs slices and whole-mount immunocytochemistry of EBs with monoclonal antibodies (mAbs) against platelet endothelial cell adhesion molecule-1 (PECAM-1) and alpha-smooth muscle actin (SMA).</p><p><b>RESULTS</b>Under appropriate culture conditions; ES cells spontaneously differentiated and formed EBs containing vascular structures and tubular channels, which were positive for PECAM-1 co-differentiated with smooth muscle. When not treated with angiogenic growth factors, PECAM-1-positive cells could not organize into vascular structures of 11-day-old EBs. In the presence of angiogenic factors 11-day old EBs embedded into type I collagen, and rapidly developed an endothelial networks. Whole-mount immunocytochemistry of collagen gel with anti-PECAM-1 antibody showed the formation of primary vascular structures sprouting from EBs. Quantitative analysis revealed that 100 microg/ml thalidomide significantly reduced the number and length of EBs endothelial sprouting.</p><p><b>CONCLUSIONS</b>Mouse ES cells can differentiate into endothelial cells combined with smooth muscle differentiation during EBs formation and further develop endothelial outgrowths after EBs embedded into collagen, which respectively recapitulate vasculogenesis, angiogenesis, and arteriogenesis processes in vivo. The models provide a useful tool to investigate vasculogenesis, angiogenesis, and arteriogenesis mechanisms and evaluate the effects of angiogenic and angiostatic agents.</p>