Bone marrow mesenchymal stem cells protect myocardial ischemia-reperfusion injury by inducing regulatory T cells in mice / 中华急诊医学杂志

Objective:To investigate the protective effect and mechanism of bone marrow-derived mesenchymal stem cell (BM-MSC) on myocardial ischemia-reperfusion injury (MIRI) in mice.Methods:Twenty four C57 MIRI mice were randomly(random number) divided into four groups: SO group, RI group, MSC+RI group, and MSC + RI+ PC61 group. The ratio of Treg were detected by flow cytometry. Serum levels of CK, TNI, BNP, IL-10 and TGF-β were measured by ELISA. The histological changes of myocardium were observed by HE staining. The number of cardiomyocyte apoptosis was measured by TUNEL staining, and the area ratio of myocardial infarction were determined by TTC staining. One-way ANOVA was used to analyze the data.Results:In the MSC + RI group, the ratio of Treg and the levels of IL-10 and TGF-β were the highest, while CK, TNI and BNP were the lowest ( P<0.01) .The number of myocardial apoptotic cells, infarct size and tissue fibrosis were the least ( P<0.01) . Conclusions:MSC can induce the production of Treg, increase the release of anti-inflammatory cytokines IL-10 and TGF-β, and reduce the inflammatory injury after myocardial ischemia-reperfusion.

Characteristics and clinical significance of wideband tympanometry of otitis media with effusion in young children / 中华耳鼻咽喉头颈外科杂志

Objective: To study the characteristics of wideband tympanometry(WBT) and its application value in the diagnosis of otitis media with effusion(OME) in young children. Methods: We compared wideband acoustic energy absorbance(EA) under peak pressure in young children with OME(190 ears) and healthy control subjects(121 ears) from Ninth People's Hospital of Shanghai Jiaotong University School of Medicine between January 2018 and June 2020. Both groups were divided into three groups, 1-6 months, 7-36 months and 37-72 months. SPSS 20.0 statistical software was used to analyze and compare the EA parameters between OME children of different months and the control group. Receiver operating characteristic (ROC)curve was used to analyze the diagnostic value of WBT in young children with OME. Results: There were significant differences in EA among three OME groups from 500 Hz to 2 000 Hz(P<0.05).Compared with the control groups, EA of 1-6 m OME group decreased significantly below 4 000 Hz(P<0.05), EA of 7-36 m OME group decreased significantly at 545-1 600 Hz(P<0.05), EA of 37-72 m OME group decreased significantly above 545 Hz(P<0.05).ROC curve indicated that EA at 1 000 Hz had the greatest diagnostic value (AUC was 0.890), followed by 1 500 Hz and the range of 500-2 000 Hz (AUC was 0.883 and 0.881, respectively).EA at 1 000 Hz with a cutoff value of 0.55 had the best diagnostic sensitivity of 90.8%, which was higher than conventional tympanometry (85.8%). The maximum AUC (0.932) could be obtained by combining EA, peak pressure and admittance amplitude of 226 Hz tympanometry as predictors. Conclusions: EA is significantly decreased in young children with OME. Compared with the conventional single frequency tympanometry, WBT is more accurate in the diagnosis of OME in young children, and the prediction accuracy would be better if combined with 226 Hz tympanometry.

Analysis of the effect of surgical treatment of periprosthetic femoral fractures after hip replacement / 中国骨伤

OBJECTIVE@#To analyze and compare the clinical efficacy of different types of surgical treatment of periprosthetic femoral fracture(PFF) after hip arthroplasty (HA).@*METHODS@#From September 2010 to September 2016, 47 patients (47 hips) with periprosthetic fractures after total hip arthroplasty were retrospectively analyzed, including 13 males and 34 females. According to Vancouver classification, there were 2 patients with type AG, 17 patients with type B1, 19 patients with type B2, 7 patients with type B3 and 2 patients with type C. The age of patients ranged from 56 to 94 (71.5±8.3) years. After admission, nutritional risk screening (NRS2002) was used to assess the nutritionalstatus of the patients. Eighteen patients (38%) had malnutrition risk (NRS>3 points). After admission, the patients were given corresponding surgical treatment according to different types. Intraoperative blood loss was recorded. Harris score was used to evaluate the hip function. VAS pain score was performed on admission and after operation.@*RESULTS@#All the 47 patients were followed up for 19 to 62 (34±11) months. The Harris scores were (41.8±12.1) and (89.0±2.6) respectively before and 1 year after operation, and the difference was statistically significant (@*CONCLUSION@#The treatment of hip periprosthetic fracture patients should be based on the general situation of patients, imaging data, intraoperative correction classification, etc. to develop individualized treatment plan in line with patients. For patients with preoperative malnutrition risk, preoperative nutritional intervention may reduce intraoperative bleeding.

Effect of electro-nape-acupuncture on hearing in patients with refractory flat descending idiopathic sudden sensorineural hearing loss / 中国针灸

OBJECTIVE@#To compare the therapeutic effect of electro-nape-acupuncture (ENA) combined with hyperbaric oxygen therapy (HBOT) and single HBOT on refractory flat descending idiopathic sudden sensorineural hearing loss (ISSNHL).@*METHODS@#A total of 78 patients were randomized into an ENA combined with HBOT (ENA+HBOT) group and a HBOT group, 39 cases in each one. Patients in both groups were treated with oral extract of ginkgo biloba leaves and mecobalamin tablets. On the basis of the conventional medication treatment, HBOT was adopt in the HBOT group. On the basis of the treatment in the HBOT group, electro-nape-acupuncture was applied at Fengchi (GB 20), Gongxue (Extra), Zhongzhu (TE 3), Waiguan (TE 5) and Yifeng (TE 17), Tinggong (SI 19), Tinghui (GB 2) and the vertigo-auditory area of affected side in the ENA+HBOT group. Pulse acupuncture instrument was connected at Fengchi (GB 20) and Gongxue (Extra) for 30 min (with continuous wave, 2 Hz in frequency), the needles were retained for another 30 min after electroaupuncture. The treatment was given once a day, 6 times a week for 4 weeks in both groups. Before the treatment and 2,4 weeks into the treatment, the average auditory threshold, the scores of tinnitus handicap inventory (THI) and dizziness handicap inventory (DHI) were observed, and the therapeutic effect was evaluated in both groups.@*RESULTS@#Compared before treatment, the average auditory threshold, the scores of THI and DHI of 2,4 weeks into the treatment were decreased in both groups (0.05).@*CONCLUSION@#Electro-nape- acupuncture can improve the mean auditory threshold and the symptoms of tinnitus and dizziness in patients with refractory flat descending idiopathic sudden sensorineural hearing loss.

End-stage renal disease and pulmonary hypertension / 中南大学学报(医学版)

Pulmonary hypertension (PH) is a common complication in patients with end-stage renal disease (ESRD), especially in patients with hemodialysis (HD). Poor prognosis can eventually lead to right heart failure and even death. PH is an independent risk factor for increased mortality in ESRD patients. We should pay attention to these patients in clinic for early detection, prevention and treatment. The pathogenesis of PH in ESRD patients is still unclear so far, which might be related to the increase of pulmonary vascular resistance, pulmonary blood flow, and pulmonary arterial wedge pressure. In addition, the presence of risk factors can promote the development of PH, such as chronic hypoxia, vascular calcification, and inflammation.

The role of GPRC6A in prostate cancer cell on proliferation and apoptosis / 医学研究生学报

Objective　The incidence of prostate cancer (PCa) is increasing year by year in China. G protein coupled receptor family C,group 6,member A (GPRC6A ) is a susceptible gene of PCa found in recent years. To investigate therole of GPRC6A and extracellular signal-regulated kinase (ERK) mediated by GPRC6A in the proliferation and apoptosis of PCaLncapC4-2 cells, and provide new ideas for targeted therapy of PCa.　Methods　The experiment was divided into the LncapC4-2 PCDH group (only the empty vector pCDH was transfected), the LncapC4-2 GPRC6A group (only the pCDH-GPRC6A was transfected) and the LncapC4-2 GPRC6A + U0126 group (pCDH-GPRC6A was transfected and treated with U0126). The proliferation of LncapC4-2 cells was detected by using CCK8 kit. The changes of cell cycle and apoptosis were detected using flow cytometry. Cell cycle and apoptosis-related proteins were evaluated by Western blot.　Results　The result ofWestern blots showed the expression ofGPRC6A and P-ERK in LncapC4-2 GPRC6A group washigher than that in LncapC4-2 PCDH group(P<0.05), and the expression of P-ERKin LncapC4-2 GPRC6A + U0126 group was evidently lower than that in LncapC4-2 GPRC6A group(P<0.05). The result of CCK8 tests showed the cell proliferation ability in LncapC4-2 GPRC6A group was higher than that in LncapC4-2 PCDH group, and the proliferation ability in LncapC4-2 GPRC6A + U0126 group was lower than that in LncapC4-2 GPRC6A group, and there was statistical difference between two groups(P<0.05).Flow cytometry results showed the ratio of G1/（G2+S）in LncapC4-2 GPRC6A groupwas evidently lower than that in LncapC4-2 PCDH group(P<0.05), and the ratio of G1/(G2+S)in LncapC4-2 GPRC6A + U0126 group was evidently higher than that in LncapC4-2 GPRC6A group(P<0.05). Western blot results showed that the expression of CyclinD1 were evidently increased in LncapC4-2 GPRC6A group(0.88±0.04) compared to LncapC4-2 PCDH group(0.66±0.02, P<0.05), the expression CyclinD1 wasevidently reduced in LncapC4-2 GPRC6A +U0126 group(0.71±0.02) compared with LncapC4-2 GPRC6A group (P<0.05). The ratio of apoptosis in LncapC4-2 GPRC6Agroup(3.64%) was evidently reduced than that in LncapC4-2 PCDH group(9.00%) and in LncapC4-2 GPRC6A +U0126 group(19.57%, P<0.05). Meanwhile, western blot results showed that the expression of BCL2 was increased and the expression of Cleaved-caspase3 was lower in LncapC4-2 GPRC6A group compared to LncapC4-2 PCDH group (P<0.05). The expression of BCL2 was reduced and the expression of Cleaved-caspase3 was increased in LncapC4-2 GPRC6A +U0126 group compared with LncapC4-2 GPRC6A group (P<0.05).　Conclusion　GPRC6A may be promote the proliferation and inhibit apoptosis of PCa cells through ERK signaling pathway, thus to be involved in the development of PCa .

Differential expression of microRNAs related to apoptosis in human osteoblasts induced by sodium fluoride / 中国组织工程研究

BACKGROUND: Long-term excessive intake of fluoride, especially through drinking water, can cause chronic fluorosis of bone. The disease can lead to bone damage and deformity, and is difficult to recover.Unfortunately, we have not developed a noninvasive or minimally invasive method for its early diagnosis. OBJECTIVE: To observe the expression of apoptosis-related miRNAs under the action of excessive fluorine in human osteoblasts. METHODS: The fluorine model was established in the human osteoblasts by cultured with 20 and 40 mg/L sodium fluoride for 24 and 48 hours, respectively. The expression levels of apoptosis-related miRNAs were determined by PCR array. RESULTS AND CONCLUSION: After 24-hour treatment of sodium fluoride, 48 kinds of miRNAs were upregulated and 4 ones were down-regulated in the osteoblasts. After 48-hour treatment of sodium fluoride, 21 kinds of miRNAs were upregulated and 2 ones were down-regulated. It showed that nine up-regulated miRNAs and one down-regulated miRNA were same in two periods. The 10 miRNAs are selected for target gene analysis on bioinformatics software that refer to the effect of anti-apoptosis and pro-apoptosis, which is of great significance for the early identification of skeletal fluorosis.

Serum HMGB1 Levels and Its Clinical Significance in Patients with Idiopathic Pulmonary Arterial Hypertension / 中山大学学报(医学科学版)

[Objective]To estimate the clinical value of serum high mobility group box 1(HMGB1) as a biomarker of idiopathic pulmonary arterial hypertension (IPAH).[Methods]This study included 33 patients with IPAH that were confirmed by right heart catheter in the Second Xiangya Hospital, Central South University from May 2011 to April 2015. 8 patients with IPAH were followed up for 6 months during treating with PAH-specific pharmacotherapies. All the subjects ' clinical data were collected,HMGB1 levels were determined by enzyme linked immunosorbent assay(ELISA).[Results]Serum HMGB1 levels (ng/mL) were significantly increased in patients with IPAH compared with the control group(14.8 ± 2.4 vs. 3.8 ± 1.2, P<0.001);The serum HMGB1 levels were significant?ly positive correlation with mean pulmonary arterial pressure(MPAP) and pulmonary vascular resistauce (PVR) ( r=0.864, P<0.001; r=0.460,P=0.002) in the patients with IPAH. After treating with PAH-specific pharmacotherapies for 6 month, HMGB1 levels(ng/mL) were significantly decreased(15.9±5.3 vs 11.1±2.5,P=0.021)along with the patients'MPAP(62.3±9.7 vs 54.0±8.7,mmHg)and 6-min walk distances(m)improved(368±69 vs 401±55,P<0.001).[Conclusions]Our study suggested that serum HMGB1 may be used as a biomarker of treatment response to targeted therapy, and it will be used as a biomarker in the follow-up evaluation of patients with IPAH.

Analysis of influencing factors of recrudescence after endovascular embolization of posterior communicating artery aneurysms / 中国脑血管病杂志

Objective To investigate the risk factors for influencing recrudescence after endovascular embolization of posterior communicating artery aneurysms.Methods From January 2014 to December 2014,71 consecutive patients (a total of 74 aneurysms) with posterior communicating artery aneurysm treated with endovascular treatment at the Department of Neurosurgery,Yijishan Hosptial of Wannan Medical College were enrolled retrospectively.The aneurysms were calculated as the number of cases (n=74).The aneurysms were divided into two groups according to whether they had recrudescence or not,including recurrent group (n=18) and non-recurrent group (n=56).The differences of the clinical data and aneurysm characteristics between the two groups were compared.Multivariate logistic regression was used to analyze the risk factors for recrudescence after endovascular embolization of posterior communicating artery aneurysms.Results Of the 74 patients with aneurysm,51 were treated with simple coil embolization and 23 were treated with stent-assisted coil embolization.All the coils were released satisfactorily.There were significant difference in the size of aneurysms and Raymond grade between the two groups (all P0.05).After variable selection,the Raymond grade was referred to Raymond gradeⅠ.Multivariate logistic regression analysis showed that the non-stent-assisted coil embolization (OR,4.789,95%CI 1.207-19.009,P=0.026),Raymond grade Ⅱ (OR,12.326,95%CI 3.838-39.592,P<0.01),Raymond grade Ⅲ (OR,36.884,95%CI 2.892-470.454,P=0.005) were the independent risk factors for recrudescence after embolization of posterior communicating artery aneurysms.Conclusion Non-stent-assisted coil embolization,Raymond Ⅱ and Ⅲ may cause recrudescence of posterior communicating artery aneurysms.

Application of Navien catheter in intracranial aneurysm embolization / 中国脑血管病杂志

Objective To investigate the application technology and effect of Navien catheter in intracranial aneurysms embolization.Methods The clinical data of 15 patients with intracranial aneurysm treated with Navien catheter in Department of Neurosurgery of Yijishan Hospital Affiliated to Wannan Medical College from March to December 2016 were analyzed retrospectively. The extracranial segments of internal carotid arteries were seriously tortuous in all patients. The coaxial system was used during procedure. Whether the Navien catheter could be smoothly placed into the target artery or not was observed,and the coils or stent-assisted coils were used to embolize the intracranial aneurysms in the corresponding positions. The immediate embolization results were assessed by the Raymond grading. The intraoperative and postoperative complications were observed and the patients were followed up by imaging.Results All 15 patients had abnormal tortuosity of extracranial segments of internal carotid arteries. The Navien catheter was able to smoothly pass through the tortuous vessels and reach the desired position. The stent-assisted coil embolization was used in 9 patients,and the coil embolization was used in 6 patients. The success rate of the coil and stent placement technology was 100%. The stents were all accurately put in place without shift. According to the Raymond grading,the immediate embolization rate of aneurysms showed that 15 patients achieved Raymond gradeⅠ. One case developed internal carotid spasm during the procedure. The patient was improved after giving papaverine. Others did not have intraoperative complications,such as cerebral vasospasm,vascular dissection,in-stent thrombosis,and intraoperative aneurysm rupture. Five patients were followed up for 3 to 6 months with digital subtraction angiography (DSA). There was no recurrence of aneurysm and no in-stent stenosis and shift,No rebleeding or cerebral ischemia was observed.Conclusion Forpatients with severely tortuous in extracranial segments of internal carotid artery,using the Navien catheter may overcome artery tortuosity and other unfavorable factors of the patients and successfully reach the target vessel position,enable the embolization of intracranial aneurysms to be completed successfully.

Expression and clinical significance of ribosomal protein L6 in prostate cancer / 天津医药

Objective To explore the expression of ribosomal protein L6 (RPL6) in prostate cancer and its clinical sig-nificance. Methods RT-qPCR and Western blot assay were used to measure the mRNA transcription and protein expres-sion levels of RPL6 in prostate cancer tissues (n=80) and adjacent non-cancerous tissues (n=62). The relationship between RPL6 mRNA expression level and clinicopathological factors of prostate cancer was statistically analyzed. Results The mRNA and protein expression levels of RPL6 were significantly higher in prostate cancer tissues compared with those of non-cancerous tissues (P0.05). Kaplan-Meier survival analysis of biochemical recurrence (BCR)-free survival time showed the significantly lower recurrent rate in patients with high RPL 6 mRNA expression(χ2=4.530,P=0.033). Conclusion The elevated expression of RPL6 may play a role in the development of prostate cancer, and which can be used as a tumor marker to assess the prognosis of prostate cancer.

Efficacy analysis of endovascular treatment of ruptured aneurysm of fetal posterior communicating artery / 中国脑血管病杂志

Objective To investigate the feasibility and effectiveness of endovascular treatment of posterior communicating artery aneurysm (PcoAA)in keeping the fetal posterior cerebral artery (FPCA) patency. Methods Form January 2014 to December 2015,14 patients with ruptured PcoAA enrolled retrospectively were treated with endovascular embolization. Six of them were treated with simple coil embolization,3 with stent-assisted coil embolization,3 with double catheter-assisted coil embolization,1 with stent-assisted coil embolization + double catheter technique,and 1 with Y-stent in Yijishan Hospital, Wannan Medical College. The immediate embolization rate of PcoAA (using Raymond grade),prognosis of the patients (the modified Rankin scale score at 6 months after procedure),complications,and imaging follow-up results were analyzed. Results The success rate of coil and stenting was 100% . All the stents were accurately released in place without displacement. The immediate Raymond grading of the aneurysms displayed that Raymond grade Ⅰ was in 8 cases,Raymond grade Ⅱ was in 4 cases,and Raymond grade Ⅲ was in 2 cases. All FPCA were kept patent. A coil protruded into internal carotid artery in one case during the procedure. Others did not have any complications,such as intraoperative cerebral vasospasm,in-stent thrombosis,and rupture. All 14 patients were followed up for 3 -24 months after procedure. Two had recurrence. Both were aneurysms embolized with coils only. No rebleeding and ischemic complications were observed. The modified Rankin scale scores in 13 cases were 0 -2 at 6 months after procedure,1 was 4. Conclusions Endovascular embolization for the treatment of PcoAA and keeping FPCA patency are safe and feasible. A variety of endovascular treatment modalities are necessary in order to keep FPCA patency.

Efficient Expression and Purification of Recombinant Human Enteropeptidase Light Chain in Esherichia coli

Human enterokinase (synonym: enteropeptidase, EC 3.4.21.9) light chain (hEKL) gene was designed and artificially synthesized with built-in codon blas towards Escherichia coli codon preference. The synthetic hEKL gene was cloned into prokaryotic expression vector pMAL-s and transferred into the expression strain E. coli BL21 (DE3). Recombinant hEKL protein with a maltose binding protein (MBP) tag was expressed at high levels in soluble form, which yielded about 42% of the total cellular protein. The target protein was then purified to the homogeneity (> 95%) by affinity chromatography. The peptide substrate GST-Melittin with enterokinase recognition site was completely cleaved by the purified MBP-hEKL at the molar ratio of 1:5000 (enzyme:substrate). Tricine SDS-PAGE analysis showed that the activity of MBP-hEKL was approximately seven times that of bovine enterokinase catalytic subunit (EKMaxTM, Invitrogen). From 1 L flask culture, 206 mg pure active MBP-hEKL was with specific activity of 1.4×104 U/mg.

Everolimus combined with all-trans retinoid acid reverses drug resistance in acute promyelocytic leukemia NB4-R1 cells / 浙江大学学报·医学版

<p><b>OBJECTIVE</b>To investigate the effect of everolimus(RAD001)combined with all-trans retinoid acid(ATRA) on drug resistance of ATRA-resistance acute promyelocytic leukemia(APL) cell line NB4-R1 and its molecular mechanism.</p><p><b>METHODS</b>APL NB4-R1 cells were treated with different concentrations of RAD001(1 nmol/L, 10 nmol/L and 100 nmol/L) with ATRA(1μmol/L) for 24, 48 and 72 h, respectively. The differentiation of NB4-R1 cells was analyzed by flow cytometry with CD11b staining and nitro blue tetrozolium(NBT) reduction test. Cell cycle was detected by cell cycle staining kit and apoptosis was detected by flow cytometry with Annexin V/PI staining. Protein expressions of LC-3II, PML-RARα, P-P70S6K and P-4E-BP1 were determined by Western blotting.</p><p><b>RESULTS</b>RAD001 combined with ATRA significantly induced NB4-R1 cells differentiation, but RAD001 or ATRA alone did not enhance NB4-R1 differentiation. The co-treatment induced accumulation of cells in G1 phase and decreased the proportion of cells in S phase. The combined treatment had no effect on cell apoptosis. The differentiation rate of NB4-R1 cells in 100 nmol/L RAD001, 1μmol/L ATRA, RAD001 combined with ATRA and control groups was(2.29±0.57)%,(17.06±2.65)%,(54.47±4.91)% and(2.54±0.53)%, respectively; the proportion of cells in G1 phase was(35.20±11.97)%,(33.54±6.25)%,(53.70±8.73)% and(27.40±6.01)%, respectively; cells apoptosis rate was(2.30±0.14)%,(2.25±0.21)%,(2.40±0.28)% and(1.95±0.07)%, respectively. The combination of RAD001 with ATRA significantly inhibited mTOR signaling downstream proteins P-P70S6K, P-4E-BP1 and enhanced autophagy-related protein LC3-II and Beclin 1. The co-treatment also induced degradation of fusion protein PML-RARα.</p><p><b>CONCLUSION</b>RAD001 combined with ATRA can induce cell differentiation, inhibit cell cycle, resulting the reverse of drug resistance in NB4-R1 cells, which is associated with increase of autophagy level and degradation of PML-RARα.</p>

An preliminarily experimental study of bone mineral density mediated by new tuberculosis-controlled release composite / 中国医师杂志

Objective To investigate bone mineral density ( BMD ) after filling in the bone scaffolds with anti-tuberculosis controlled-release microspheres, and provide experimental basis for decrease of the side effects of anti-tuberculosis therapy after spinal surgery.Methods The bone densitometer was used to observe the changes of bone mineral density before and after the infusion with the artificial allograft bone (Group A), the controlled release complex of the RFP controlled-release microspheres-artificial allograft bone (Group B), and RFP-artificial allograft bone complex (Group C), respectively.Results BMDs of three groups before perfusion were not different significantly [Group A:(0.191 ±0.018)g/cm2;Group B:(0.186 ±0.016)g/cm2;Group C:(0.189 ±0.018)g/cm2;P >0.05].BMDs of three groups after perfusion were not different significantly [Group A:(0.191 ±0.018)g/cm2;Group B:(0.179 ±0.023)g/cm2;Group C:(0.185 ±0.021)g/cm2;P >0.05].Conclusions RFP microspheres using ultrasonic vibration method and the porous bone were prepared to controlled-release anti-tuberculosis complex .BMD of three groups after perfusion were not influenced obviously .

Treatment of thoracolumbar deformity with transpedicular eggshell technique / 中国骨伤

<p><b>OBJECTIVE</b>To evaluate the clinical effects of transpedicular eggshell technique in treating thoracolumbar deformity.</p><p><b>METHODS</b>From December 2008 to December 2011,36 patients with thoracolumbar deformity were treated with transpedicular eggshell technique. There were 20 males and 16 females with an average age of 45 years old (ranged from 20 to 58). Among them, 5 cases were congenital hemivertebrae deformity, 12 cases were secondary to tuberculotic deformity, 14 cases were post-traumatic deformity with pain, 5 cases were ankylosing spondylitis. Low back pain, living ability, scoliotic Cobb angle were analyzed according to VAS scoring, Oswestry Disability Index (ODI), radiological examination.</p><p><b>RESULTS</b>Average operative time was 245 min and average bleeding was 1 900 ml in 36 patients. All patients were followed up more than 1 year and obtained bone fusion at 1 year after operation. Preoperative,postoperative at 1 week and 1 year, VAS scoring was 7.2 +/- 1.4, 2.5 +/- 1.0, 1.8 +/- 0.5, respectively; ODI was (72.50 +/- 10.80)%, (42.50 +/- 11.10)%, (22.50 +/- 7.90)%, respectively; kyphosis Cobb angle was (76.31 +/- 2.52) degrees, (23.66 +/- 1.16) degrees, (23.67 +/- 1.16) degrees, respectively; lumbar scoliosis Cobb angle was (71.86 +/- 4.02) degrees, (30.81 +/- 2.33) degrees, (30.82 +/- 2.32) degrees, respectively. Postoperative at 1 week and 1 year,above data had obviously improved than that of preoperative (P < 0.05); and there was no significant difference in Cobb angle between postoperative at 1 week and postoperative at 1 year (P > 0.05).</p><p><b>CONCLUSION</b>Treatment of thoracolumbar deformity with transpedicular eggshell technique could obtain effective correcting and clinical results.</p>

Significance detecting hscTnT in patients with non ST-elevation acute coronary syndrome / 心血管康复医学杂志

Objective: To study change of serum high sensitive cardiac troponin T (hscTnT) concentration in coronary circulation of patients with non ST-elevation acute coronary syndrome (NSTE-ACS). Methods: The subjects were all selected from our hospital, including 46 NSTE-ACS patients （NSTE-ACS group）, 42 patients with stable angina pectoris (SAP group) and 30 cases with negative coronary angiography results（healthy control group）The hscTnT concentrations in coronary venous sinus, coronary artery (CA) and peripheral serum were measured in three groups respectively. The results were compared and analyzed. Results: Compared with healthy control group, the hscTnT concentrations in coronary venous sinus, CA and peripheral venous serum all significantly increased in NSTE-ACS group and SAP group, P<0.01 all. Compared with hscTnT levels in CA and peripheral venous serum, there was significant increase in coronary venous sinus [(0.9657±0.5863) μg/L vs. (0.9562±0.7853) μg/L vs. (1.3018±1.1024) μg/L, P<0.05] in NSTE-ACS group. Conclusion: The serum hscTnT concentrations in peripheral vein, coronary artery and coronary venous sinus all significantly increase in NSTE-ACS patients, especially in coronary venous sinus.

Routine use of a transanastomotic stent is unnecessary for hepatojejunostomy in liver transplantation / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The use of transanastomotic stents for Roux-en-Y hepatojejunostomy (RYHJ) in liver transplantation (LT) remains controversial. The aim of this retrospective study was to assess the role of transanastomotic stent for RYHJ in LT.</p><p><b>METHODS</b>RYHJ for biliary reconstruction in LT was performed in 52 patients. Twenty-five patients had bile duct reconstruction by RYHJ with transanastomotic stents (S group), while 27 patients underwent the same procedure without transanastomotic stents (non-S group). The two groups were compared in terms of post-LT biliary complications and survival.</p><p><b>RESULTS</b>The incidences of bile leakage, anastomotic stricture, non-anastomotic stricture, biliary sludge/lithiasis and biliary infection were 12% (3/25), 9.5% (2/21), 23.5% (4/17), 11.8% (2/17), and 24% (6/25), respectively in the S group, and 0, 0, 20.0% (5/25), 10.0% (2/20), and 16.7% (4/24), respectively in the non-S group. One and three year survival rates were 48.0% (12/25) and 34.0% (8/23), respectively, in the S group and 57.7% (15/26) and 38.9% (7/18), respectively, in the non-S group. There was no significant difference between the two groups in terms of the incidence of various biliary complications and survival (P > 0.05).</p><p><b>CONCLUSION</b>The routine use of transanastomotic stents is not necessary for RYHJ for biliary reconstruction in LT.</p>

Symptomatic osteonecrosis of the femoral head after adult orthotopic liver transplantation / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>With the increase of survival in liver transplantation recipients, more patients are at a high risk of developing osteonecrosis, especially in the femoral head, due to immunosuppressive treatment. The purpose of this study was to report the incidence, possible risk factors, and outcome of symptomatic osteonecrosis of the femoral head (ONFH) in adult patients with current immunosuppressive agents and individual protocol after liver transplantation in China.</p><p><b>METHODS</b>A retrospective analysis was performed on 226 adult patients who underwent orthotopic liver transplantation (OLT) at a single liver transplantation institution between January 2004 and December 2008. The posttransplant survival time (or pre-retransplantation survival time) of all the patients were more than 24 months. The possible pre- and post-transplantation risk factors of symptomatic ONFH were investigated and the curative effects of the treatment were also reported.</p><p><b>RESULTS</b>The incidence of ONFH was 1.33% in patients after OLT. ONFH occurred at a mean of (14 ± 6) months (range, 10 - 21 months) after transplantation. Male patients more often presented with osteonecrosis as a complication than female patients. The patients with lower pre-transplantation total bilirubin and direct bilirubin levels (P < 0.05). There was no difference in the cumulative dose of corticosteroids or tacrolimus between the patients with or without symptomatic ONFH. Patients were treated either pharmacologically or surgically. All patients showed a nice curative effect without major complications during the 18 - 63 months post-treatment follow up.</p><p><b>CONCLUSIONS</b>The symptomatic ONFH does not occur commonly after adult OLT in the current individual immunosuppressive protocol in China.</p>

Experimental study of the correlation of telomerase and intramedullary scar after spinal cord injury in rats / 中华外科杂志

<p><b>OBJECTIVE</b>To detect the expression of telomerase in glial scar and its correlation with glial scar.</p><p><b>METHODS</b>There were 120 Sprague Dawley rats were randomly divided into non-interference group of telomerase, interference group of telomerase and control group. Non-interference group and interference group were for spinal cord injury, which adopted Allen's Weight Dropping to make molding; control group was for sham operation to open the vertebral plate and expose spinal marrow, in which spinal cord injury would not be caused. The expression of telomerase and glial fibrillary acidic profein (GFAP) was detected by PCR-ELISA and Western blot, and the formation of glial scar was observed by immunofluorescence on the 1st, 3rd, 5th, 7th, 14th, 28th, 42 th and 56th day after the spinal injury, and analyzed its relativity.</p><p><b>RESULTS</b>The expression of telomerase in non-interference group was (0.180 ± 0.004 - 1.217 ± 0.072), which was significantly higher than those in interference group (0.028 ± 0.007 - 0.092 ± 0.004, χ(2) = 28.753 - 37.518, P < 0.05) and control group (0.072 ± 0.007 - 0.075 ± 0.004, χ(2) = 18.618 - 41.093, P < 0.05) at all the time, with statistical significance. The expression of GFAP in non-interference group was (1.98 ± 0.15 - 19.40 ± 0.55) which was significantly higher than those in interference group (1.10 ± 0.13 - 16.64 ± 1.02, χ(2) = 14.538 - 37.366, P < 0.05) and control group (0.44 ± 0.05 - 0.48 ± 0.04, χ(2) = 16.733 - 34.041, P < 0.05) at all the time, with statistical significance. The expression of GFAP showed a linear correlation with that of telomerase in non-interference group, and with statistical differences (r = 0.755, P < 0.01). The expression of telomerase in interference group and control group were always negative. Glial scar observed by immunofluorescence in non-interference group was heavier than that in interference group, and control group showed no formation of glial scar.</p><p><b>CONCLUSIONS</b>Telomerase shows a dynamic expression in glial scar and has positive correlational linear relationship with GFAP which shows the formation of glial scar. And the telomerase may be an important factor in promoting the formation of glial scar.</p>