Physical exercise suppresses hepatocellular carcinoma progression by alleviating hypoxia and attenuating cancer stemness through the Akt/GSK-3β/β-catenin pathway / 中西医结合学报

OBJECTIVE@#Physical exercise, a common non-drug intervention, is an important strategy in cancer treatment, including hepatocellular carcinoma (HCC). However, the mechanism remains largely unknown. Due to the importance of hypoxia and cancer stemness in the development of HCC, the present study investigated whether the anti-HCC effect of physical exercise is related to its suppression on hypoxia and cancer stemness.@*METHODS@#A physical exercise intervention of swimming (30 min/d, 5 d/week, for 4 weeks) was administered to BALB/c nude mice bearing subcutaneous human HCC tumor. The anti-HCC effect of swimming was assessed in vivo by tumor weight monitoring, hematoxylin and eosin (HE) staining, and immunohistochemistry (IHC) detection of proliferating cell nuclear antigen (PCNA) and Ki67. The expression of stemness transcription factors, including Nanog homeobox (NANOG), octamer-binding transcription factor 4 (OCT-4), v-Myc avian myelocytomatosis viral oncogene homolog (C-MYC) and hypoxia-inducible factor-1α (HIF-1α), was detected using real-time reverse transcription polymerase chain reaction. A hypoxia probe was used to explore the intratumoral hypoxia status. Western blot was used to detect the expression of HIF-1α and proteins related to protein kinase B (Akt)/glycogen synthase kinase-3β (GSK-3β)/β-catenin signaling pathway. The IHC analysis of platelet endothelial cell adhesion molecule-1 (CD31), and the immunofluorescence co-location of CD31 and desmin were used to analyze tumor blood perfusion. SMMC-7721 cells were treated with nude mice serum. The inhibition effect on cancer stemness in vitro was detected using suspension sphere experiments and the expression of stemness transcription factors. The hypoxia status was inferred by measuring the protein and mRNA levels of HIF-1α. Further, the expression of proteins related to Akt/GSK-3β/β-catenin signaling pathway was detected.@*RESULTS@#Swimming significantly reduced the body weight and tumor weight in nude mice bearing HCC tumor. HE staining and IHC results showed a lower necrotic area ratio as well as fewer PCNA or Ki67 positive cells in mice receiving the swimming intervention. Swimming potently alleviated the intratumoral hypoxia, attenuated the cancer stemness, and inhibited the Akt/GSK-3β/β-catenin signaling pathway. Additionally, the desmin+/CD31+ ratio, rather than the number of CD31+ vessels, was significantly increased in swimming-treated mice. In vitro experiments showed that treating cells with the serum from the swimming intervention mice significantly reduced the formation of SMMC-7721 cell suspension sphere, as well as the mRNA expression level of stemness transcription factors. Consistent with the in vivo results, HIF-1α and Akt/GSK-3β/β-catenin signaling pathway were also inhibited in cells treated with serum from swimming group.@*CONCLUSION@#Swimming alleviated hypoxia and attenuated cancer stemness in HCC, through suppression of the Akt/GSK-3β/β-catenin signaling pathway. The alleviation of intratumoral hypoxia was related to the increase in blood perfusion in the tumor. Please cite this article as: Xiao CL, Zhong ZP, Lü C, Guo BJ, Chen JJ, Zhao T, Yin ZF, Li B. Physical exercise suppresses hepatocellular carcinoma progression by alleviating hypoxia and attenuating cancer stemness through the Akt/GSK-3β/β-catenin pathway. J Integr Med. 2023; 21(2): 184-193.

Core muscle functional strength training for reducing the risk of low back pain in military recruits: An open-label randomized controlled trial / 中西医结合学报

BACKGROUND@#Core muscle functional strength training (CMFST) has been reported to reduce injuries to the lower extremity. However, no study has confirmed whether CMFST can reduce the risk of low back pain (LBP).@*OBJECTIVE@#This study identified the effects of CMFST on the incidence of LBP in military recruits.@*DESIGN, SETTING, PARTICIPANTS AND INTERVENTION@#We performed a prospective, open-label, randomized, controlled study in a population of young healthy male naval recruits from a Chinese basic combat training program. Participants were randomly assigned to either the core group or the control group. In additional to normal basic combat training, recruits in the core group underwent a CMFST program for 12 weeks, while recruits in the control group received no extra training.@*MAIN OUTCOME MEASURES@#At the beginning of the study and at the 12th week, the number of participants with LBP was counted, and lumbar muscle endurance was measured. In addition, when participants complained of LBP, they were assessed using the visual analog scale (VAS) and Roland Morris Disability Questionnaire (RMDQ).@*RESULTS@#A total of 588 participants were included in the final analysis (295 in the core group and 293 in the control group). The incidence of LBP in the control group was about twice that of the core group over the 12-week study (20.8% vs 10.8%, odds ratio: 2.161-2.159, P < 0.001). The core group had better lumbar muscle endurance at 12 weeks than the control group ([200.80 ± 92.98] s vs [147.00 ± 84.51] s, P < 0.01). There was no significant difference in VAS score between groups, but the core group had a significantly lower RMDQ score at week 12 than the control group (3.33 ± 0.58 vs 5.47 ± 4.41, P < 0.05).@*CONCLUSION@#This study demonstrated that the CMFST effectively reduced the incidence of LBP, improved lumbar muscle endurance, and relieved the dysfunction of LBP during basic military training.

Risk factors for pulmonary infection among stroke survivors with dysphagia / 中华物理医学与康复杂志

Objective:To analyze the risk factors for aspiration pneumonia among persons with post-stroke dysphagia.Methods:A total of 105 dysphagic stroke survivors were examined using videofluoroscopy. Those suffering from aspiration pneumonia constituted a pneumonia group, and the others were a non-pneumonia group. Univariate and multivariate logistic regression were conducted using data on nasal feeding, pharyngeal transit time (PTT), pharyngeal remnants, active coughing, diet adjustment and Rosenbek Penetration-aspiration Scale (PAS) scores to analyze the risk factors for aspiration pneumonia.Results:There were 29 in the pneumonia group and 76 in the non-pneumonia group. Significant age differences were observed between the two groups, and also significant differences in the location of the stroke, the course of the disease, the incidence of diabetes mellitus, nasal feeding, active coughing, PAS score, PTT, pharyngeal remnants and diet adjustment. But there were no significant differences in gender, Kubota drinking water grade, the incidence of hypertension or atrial fibrillation, or leukocyte count. Univariate analysis showed that stroke site, age≥65, type 2 diabetes, nasal feeding, active coughing, diet adjustment, a PAS score >6, prolonged PTT and pharyngeal residue were all significant predictors of pneumonia. Multivariate logistic analysis indicated that the incidence of pneumonia was significantly higher in patients with a brainstem or bilateral stroke than among those with unilateral stroke. Patients older than 64, with a PAS score >6, pharyngeal residue or prolonged PTT were at significantly greater risk of coming down with pneumonia, though active coughing was correlated with lower risk.Conclusions:Age >64, bilateral or brainstem stroke, a PAS score >6, prolonged pharyngeal transit time and pharynx remnants are independent risk factors for aspiration pneumonia among dysphagic stroke survivors, while active cough is a protective factor.

Aerobic exercise suppresses hepatocellular carcinoma by downregulating dynamin-related protein 1 through PI3K/AKT pathway / 中西医结合学报

OBJECTIVE@#Exercise, as a common non-drug intervention, is one of several lifestyle choices known to reduce the risk of cancer. Mitochondrial division has been reported to play a key role in the occurrence and transformation of hepatocellular carcinoma (HCC). This study investigated whether exercise could regulate the occurrence and development of HCC through mitosis.@*METHODS@#Bioinformatics technology was used to analyze the expression level of dynamin-related protein 1 (DRP1), a key protein of mitochondrial division. The effects of DRP1 and DRP1 inhibitor (mdivi-1) on the proliferation and migration of liver cancer cells BEL-7402 were observed using cell counting kit-8, plate colony formation, transwell cell migration, and scratch experiments. Enzyme-linked immunosorbent assay, Western blot and real-time polymerase chain reaction were used to detect the expression of DRP1 and its downstream phosphoinositide 3-kinase (PI3K)/protein kinase B (AKT) pathway. A treadmill exercise intervention was tested in a nude mouse human liver cancer subcutaneous tumor model expressing different levels of DRP1. The size and weight of subcutaneous tumors in mice were detected before and after exercise.@*RESULTS@#The expression of DRP1 in liver cancer tissues was significantly upregulated compared with normal liver tissues (P < 0.001). The proliferation rate and the migration of BEL-7402 cells in the DRP1 over-expression group were higher than that in the control group. The mdivi-1 group showed an inhibitory effect on the proliferation and migration of BEL-7402 cells at 50 μmol/L. Aerobic exercise was able to inhibit the expression of DRP1 and decrease the size and weight of subcutaneous tumors. Moreover, the expression of phosphorylated PI3K (p-PI3K) and phosphorylated AKT (p-AKT) decreased in the exercise group. However, exercise could not change p-PI3K and p-AKT levels after knocking down DRP1 or using mdivi-1 on subcutaneous tumor.@*CONCLUSION@#Aerobic exercise can suppress the development of tumors partially by regulating DRP1 through PI3K/AKT pathway.

Efficacy for combined injection of salvizanolic acid B with triamcinolone acetonide on the treatment of the soft palate with oral submucous fibrosis / 中南大学学报(医学版)

To evaluate therapeutic effect of combined injection of salvizanolic acid B with triamcinolone acetonide on the treatment of the soft palate with oral submucous fibrosis.
 Methods: Salvizanolic acid B combined with triamcinolone acetonide was consecutively applied once a week for 30 weeks for 33 patients with middle and later periods of oral submucous fibrosis. The response rate of color change in the soft palate and the increase of capillary vessels (determined by degree I-IV visual analog scale) were evaluated at the 12th, 24th, and 36th months after 30 weeks treatment.
 Results: Thirty-three patients were fulfilled the study without obvious adverse reactions and they were followed up for 24 months, while 31 patients were followed up for 36 months. The color change in the soft palatal mucus and the increase of capillary vessels at the 36th month follow-up after treatment were significantly better than those at the 12th month (P=0.004).
 Conclusion: Combined injection of salvizanolic acid B with triamcinolone acetonide in the treatment of the soft palate with oral submucous fibrosis is effective.

Clinical progress of wound management in venous leg ulcers / 中华全科医师杂志

Venous leg ulcer (VLU) is a disease of venous hypertension leading to open skin lesions of lower extremities, which is the terminal stage of chronic venous insufficiency. Considering the high prevalence and recurrence rate, VLU restrain daily activities, impair mental health and even contribute to social isolation of patients. Currently, surgery and compression therapy are wildly used to relieve symptoms and eliminate the etiological factors, however, ulcers remain unhealed even after these treatments in many cases. In this article, we review the clinical progress of treatment for VLU, including the debridement, antibiotics, ulcer dressing, negative pressure wound therapy and skin graft, to provide reference on the therapeutic strategy for different ulcer conditions.

Effect of ultrasound combined with SonoVue microbubbles on vascular permeability in hind limbs of rats / 上海交通大学学报（医学版）

Objective • To investigate the effect of 500 kHz pulsed ultrasound combined with SonoVue microbubbles on the vascular permeability of hind limbs in rats and the permeability dynamics for the duration. Methods • Eighty male Sprague Dawley rats were randomly divided into eight groups (n=10), including control group, only microbubble group (MB group), and microbubble combined with ultrasound groups (MB+US group). And MB+US groups classified into time subgroups according to the interval from the endpoint of ultrasound exposure to the injection of Evans blue (EB), included 2.5 min group, 5 min group, 10 min group, 20 min group, 30 min group and 60 min group. The change of vascular permeability was quantitively analyzed by detecting the content of EB after ultrasound irradiation. Meanwhile, four rats in each group were randomly selected. Two of them were performed hematoxylin-eosin (H-E) staining; and the rest of them underlied transmission electron microscope analysis. Results • The results of EB content detected from muscle samples demonstrated that the exposure of ultrasound in conjunction with microbubbles could alter the vascular permeability of hind limbs of rats. The optimal time window for extravasation was within 30 min after ultrasound exposure. And the permeability could return to the normal status 60 min after ultrasound irradiation. There was no apparent damage on arteries and muscles in the slices with H-E staining. From the observation of transmission electron microscope, the tight junctions between endothelial cells on the arterial wall were significantly widened in MB+US groups. Conclusion • The application of ultrasound with the frequency of 500 kHz combined with SonoVue microbubbles can reversibly change the vascular permeability of hind limbs in rats without obvious damage to the tissues.

Application of the modified split crest technique of piezosurgery in mandible molar area / 实用医学杂志

Objective To evaluate the therapeutic outcome of horizontal bone augmentation by using the modified split crest technique of piezosurgery in mandible molar area. Methods The present study reviewed the record of 15 patients from 2016 January to 2017 March in the department of oral implantology center of Stomato-logical Hospital of Southern Medical University,who underwent the modified split crest technique of piezosurgery in mandible molar area. Preoperative CBCT was performed to determine the bone thickness of the toothless alveo-lar crest of the mandibular posterior region,and the bone thickness was less than 3 mm. The modified split crest technique of piezosurgery was performed for the horizontal bone augmentation at mandibular posterior region. Meanwhile,GBR and the postoperative CBCT were performed to determine the bone width increments,followed with 1-week anti-inflammatory therapy postoperation. Three months after the operations,the bone width incre-ment was examined by CBCT. SPSS13.0 software was used to analyze the collected data. Results The modified split crest technique of piezosurgery in mandible molar area was successfully established,resulting in the mini-mal operative wounds and the slight postoperative reaction,without obvious infection. The postoperative crest width increase achieved 6.05 ± 0.65 mm. At 3 months after operation,the crest width increase reduced to(5.81 ± 0.61)mm. There were significant differences of the alveolar ridge thickness between the preoperative and post-operative patients(P<0.05). There were significant differences between the preoperative crest width and the 3 months after treatment(P<0.05). Conclusion Horizontal bone augmentation of the modified split crest tech-nique of piezosurgery was efficient,which could be performed in very narrow alveolar ridge,and which was rela-tively safe and accurate,with less trauma. No damage was observed to the soft tissue,and the cutting direction can be well controlled.

Clinical progress of compression therapy in treatment of venous leg ulcers / 中华全科医师杂志

Venous leg ulcers ( VLU) are open skin lesions of the lower extremities that occur in an area affected by venous hypertension .Due to the long healing time , high prevalence and recurrent rate , VLU always comes with a heavy economic burden that affects the quality of life of the patients .Currently, compression therapy is the main approach for treatment of VLU .However, which is the most effective device for compression therapy is still controversial .This article reviews the cutting-edge advances of the clinical compression therapy for VLU , which would provide a reference for clinicians to set an optimal strategy for VLU treatment.

Research progress on chemical compounds and pharmacological effects of Caesalpinia / 中国中药杂志

Consult literature, the chemical composition of the type of system Caesalpinia plants were summarized and discussed in detail its pharmacological effects. The genus contains major chemical components of high isoflavones, chalcones and diterpenoids, pharmacological effects inhibit melanin production, anti-inflammatory, antioxidant, antibacterial, immune regulation, and further research in this genus offer reference.

Effect of heating treatment on stability of two coumarins in Angelica dahurica and activity of tyrosinase / 中国中药杂志

To study the heating treatment of Angelica dahurica under different temperature and time conditions on the stability of coumarins and tyrosinase activity. HPLC method was used to determine the contents of imperatorin and isoimperatorin, and tyrosinase activity was assayed by measuring the oxidation rate of L-DOPA in vitro. After heated, the contents of imperatorin increased. Expect for being heated at 90 ℃ for 2 h, the content of isoimperatorin was higher than crude one. Before and after being heated, A. dahurica showed an activating effect on tyrosinase. In the same temperature and time conditions, the activation rate increased with the rise of concentration of tyrosinase extracts. Heating process for A. dahurica could change the contents of imperatorin and isoimperatorin, mainly increasing their concentrations.

Simultaneous determination of quercitrin, phloridzin and 3-hydroxyl phloridzin in leaves of Malus halliana by ultrasound-assisted ionic liquid-reversed phase liquid chromatography / 中国中药杂志

To establish a method for the simultaneous determination of phloridzin, 3-hydroxy phloridzin and quercitrin in leaves of Malus halliana by ultrasonic-assisted ionic liquid coupled with RP-HPLC. An Agilent TC-C₁₈ (4.6 mm×250 mm, 5 μm) column was used, with the mobile phase of acetonitrile and 1% phosphoric acid-water (20∶80) by gradient elution at the detection wavelength of 270 nm. The flow rate was 0.8 mL•min⁻¹, and chromatographic column temperature was controlled at the room temperature. Under the optimized conditions, the linear ranges for phloridzin, 3-hydroxy phloridzin and quercitrin were 0.9-112.5 μg (r = 0.999 6), 0.093 2-11.65 μg (r = 0.999 1) and 0.097 2-12.15 μg (r = 0.999 8), respectively. The average recoveries of the three constituents were 99.35%, 98.80% and 98.19%, respectively. The method was environmental friendly, rapid, accurate and highly reproducible, and so suitable for the quantitative analysis of phloridzin, 3-hydroxy phloridzin and quercitrin in leaves of M. halliana.

Clinical value of NT-proBNP and cTnI detection in the diagnosis and treatment of congestive heart failure / 国际检验医学杂志

Objective To investigate the clinical value of NT‐proBNP and cTnI detection in the diagnosis and treatment of con‐gestiveheartfailure.Methods 198patientswithcardiovascularwereastheresearchobjects,95caseswithHFwereasHFgroup, 103 caseswithout HF were as control group ,compared left ventricular ejection fraction (LVEF) and serum NT‐proBNP ,cTnI levels of patients ,and compared LVEF ,serum NT‐proBNP ,cTnI levels of patients with different cardiac functions ,analysed the correla‐tion between serum NT‐proBNP ,cTnI levels and LVEF in patients with HF ,and analysed the diagnosic value of NT‐proBNP ,cTnI combined detection and single detection on HF .Results LVEF and serum NT‐proBNP ,cTnI levels of the HF group were higher than those of the control group(P<0 .05) ,LVEF of the HFgroup decreased significantly when cardiac function classification in‐creased ,serum NT‐proBNP ,cTnI levels increased significantly ,there were statistically significant differences in the indices between the three groups(P<0 .05) ,serum NT‐proBNP ,cTnI was inversely related to the level of LVEF (r= -0 .536 ,-0 .328 ,P<0 .05);proBNP ,the specificity ,positive predictive value and accuracy in the diagnosis of HF byproBNP 、cTnI combined detection improved obviously than the single detection ,compared with cTnI the specificity ,accuracy rate ,there was difference significant(χ2 =4 .595 , 21 .648 ,P=0 .032 ,0 .000) .Conclusion It has important clinical value Serum NT‐proBNP ,cTnI levels detection for the diagnosis and judgment of HF .

Identification of Gardenia Based on cpDNA Barcoding / 中国中医药信息杂志

Objective To test and eva1uate the abi1ity of three potential chloroplast DNA (cpDNA) barcoding sequences;To find new methods to identify the species of gardenia. Methods Three cpDNA sequences were amplified and sequenced by universal primers of matK, rbcL and psbA. By comparing PCR amplification efficiency, length, intra-and inter-specific divergence, and barcoding gap, BLAST and DNA MAN were used to evaluate these loci. Results The amplification efficiency of 5 samples from 3 gardenia species was 100%. Analysis of the intra-and inter-specific divergence of matK among the sequences showed that barcoding gap was superior to psbA and rbcL, with higher identification efficiency. Conclusion Gardenia jasminoides Ellis can be better identified by matK sequence.

Analysis on comparison results of multiple automated hematology analyzers within same laboratory / 国际检验医学杂志

Objective To evaluate the consistency of the test results detected by multiple automated hematology analyzers .Meth-ods The EP9-A2 guideline of NCCLS ,Passing-Bablok regression analysis and t test were adopted to compare the detection results of hemoglobin(HGB) ,hematocrit (HCT) ,red blood cell count(RBC) ,white blood cell count (WBC) and platelet(PLT) in 115 samples from patients by 5 automated haematology analyzers of the Sysmex XE-2100 ,the Sysmex XT-1800i ,the Sysmex XS-1000i , the Mindray BC-5300 and ABX pentra80 .The Sysmex XE-2100 was used as the reference instrument .Results In the detection of all the compared items including HGB ,HCT ,RBC ,WBC and PLT ,these automated hematology analyzers exhibited very good cor-relation(r>0 .97) ,whereas the individual parameters in 3 automated hematology analyzers appeared the proportional systematic differences and /or constant systematic differences ,including HCT in the sysmex XT-1800i ,HCT and RBC in the sysmex XS-1000i and RBC in the ABX pentra 80 .Conclusion The Passing-Bablok regression analysis combined with t test may identify the system-atic differences of the comparative results of 2 automated haematology analyzers ,the consistency of the comparative results of the automated hematology analyzers can not be evaluated by the simple correlation coefficient .

Construction of Recombinant Plasmid of Human RIP3 Gene and Its Effects on the Death of Breast Cancer MCF7 Cells / 天津医药

Objective To construct the recombinant RIP3 over-expressed plasmids and transfect them in breast cancer MCF7 cells, and identify the expression and localization of fusion protein, as well as its effect on the death way of MCF7 cells. Methods The expression levels of RIP3 mRNA in four breast cancer cell lines and normal mammary epithelial cells were detected by reverse transcription polymerase chain reaction (RT-PCR). The RIP 3 coding sequence was amplified by polymerase chain reaction and subcloned into mCherry vector to construct recombinant plasmids. The plasmids were transfected into MCF7 cells by lentivirus after DNA sequencing, then screened by basticidin (4 mg/L) for 1 week. The efficiencies of RIP3 expression were validated by Western blotting assay. The death way of mCherry-RIP3-MCF7 cells was observed under the treatment of TNF-αand Z-VAD-FMK. Results The lowest expression of RIP3 mRNA was found in MCF7 cells. The sequencing results validated the well recombinant plasmids. The expression of mCherry-RIP3 fusion pro-tein with a molecular weight of 85 ku was detected by Western blot assay. The mCherry-RIP3 expression enhanced the sensi-tivity of MCF7 cells to TNF-αand Z-VAD-FMK induced cell death. Conclusion The recombinant RIP3 over-expressed plasmids were successfully constructed, and the stable MCF7 cells with ectopic RIP3 transfection were obtained. The mCher-ry-RIP3 fusion protein was expressed in the cytoplasm and was conformed to mediate TNF-αinduced necroptosis.

Selective anterior thoracolumbar/lumbar fusion and instrumentation in adolescent idiopathic scoliosis patients / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Selective anterior thoracolumbar/lumbar (TL/L) fusion and instrumentation in adolescent idiopathic scoliosis (AIS) patients with a structural major TL/L curve and a nonstructural minor thoracic curve is rarely reported. We investigate the correction results of these patients.</p><p><b>METHODS</b>By reviewing the medical records and roentgenograms of AIS patients undergone selective anterior TL/L fusion and instrumentation, Cobb angle, correction rate of the major and minor curves, coronal balance, lowest instrumented vertebra (LIV) tilt, coronal disc angle immediately below the LIV (LIVDA) and radiographic shoulder height (RSH) were measured and analyzed.</p><p><b>RESULTS</b>Forty patients were included. For the major TL/L curve, the mean coronal Cobb angle before and after operation were 43.9° and 8.7°, respectively, with an average correction rate of 80.2% (P = 0.000). While for the minor thoracic curve, the mean coronal Cobb angle before and after operation were 27.2° and 14.3°, respectively, with an average spontaneous correction rate of 47.4% (P = 0.000). At final follow-up, the coronal Cobb angles of the major and minor curves were 13.7° and 17.1°, respectively, with a mean correction loss of 5.0° and 2.9°, respectively. The coronal balance before and after operations was 13.2 mm and 11.5 mm, respectively. At the final follow-up, it turned to 5.6 mm, which was much better than that after operation (P = 0.001). The mean LIV tilt was 23.5° before operation, and was significantly improved after operation (8.3°, P = 0.000). At final follow-up, it was well maintained (10.6°). The LIVDA averaged 3.5° before operation, and aggravated to 5.5° after operation (P = 0.100) and 7.4° at final follow-up (P = 0.012), respectively. The RSH was 7.3 mm before operation, 5.6 mm after operation, and 2.2 mm at the final follow-up. The RSH at the final follow-up was significantly improved compared with that after operation (P = 0.002).</p><p><b>CONCLUSIONS</b>Selective anterior TL/L fusion and instrumentation can get good correction results of both curves, with good results of the coronal balance and RSH in AIS patients, while a larger LIVDA.</p>

Selective anterior thoracolumbar or lumbar fusion for adolescent idiopathic scoliosis / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate the outcomes of selective anterior thoracolumbar or lumbar (TL/L) fusion for adolescent idiopathic scoliosis (AIS) with PUMCIId1 curves (Lenke type 5).</p><p><b>METHODS</b>Thirty-five consecutive AIS patients (PUMC type IId1, Lenke type 5) with selective anterior TL/L fusion with single solid rod instrumentation were reviewed. The average follow-up was 36 months (range, 18 - 42 months). Standing anteroposterior and lateral radiographs were measured and analyzed.</p><p><b>RESULTS</b>The average preoperative Cobb angle of the TL/L curves was 45.6 degrees and corrected to 9.7 degrees postoperatively, with 79.7% curve correction. The thoracic curves decreased from 29.7 degrees preoperatively to 17.6 degrees postoperatively, with a spontaneous correction of 41.5%. There was an average 4.7 degrees and 2.5 degrees correction loss of the TL/L and the thoracic curves at the final follow-up respectively. Trunk shift deteriorated slightly from 14.0 mm preoperatively to 14.8 mm postoperatively, and improved significantly to 5.1 mm at the final follow-up. The lowest instrumented vertebra (LIV) tilt was significantly improved after surgery (from -21.8 degrees preoperatively to -1.5 degrees postoperatively) and well maintained at the final follow-up (-2.1 degrees). The coronal disc angle immediately above the upper instrumented vertebra (UIVDA) and below the LIV (LIVDA) averaged 0.5 degrees and 0.6 degrees respectively, and aggravated after surgery (0.9 degrees and 4.9 degrees, respectively). Both the UIVDA and LIVDA were significantly aggravated at the final follow-up (3.0 degrees and 7.8 degrees, respectively). The sagittal contours of T(5-12) and T(10)-L(2) were well maintained after surgery and at the final follow-up. The lumbar lordosis of L(1)-S(1) and the sagittal Cobb angle of the instrumented segments were reduced postoperatively and at the final follow-up. No pseudarthrosis or other complications were observed.</p><p><b>CONCLUSION</b>Selective anterior TL/L fusion with single solid rod instrumentation is effective and safe for AIS with PUMCIId1 (Lenke type 5) curves, above and below the fusion and larger residual thoracic curve in some cases need further evaluated.</p>

Effect of preemptive analgesia with flurbiprofen axetil on patient-controlled intravenous analgesia with tramadol in patients undergoing postburn plastic surgery / 南方医科大学学报

<p><b>OBJECTIVE</b>To observe the preemptive analgesic effect of flurbiprofen axetil for post-operative pain relief.</p><p><b>METHODS</b>Sixty ASA class I or II patients undergoing postburn plastic surgery were randomly assigned into two groups to receive intravenous administration of 100 mg flurbiprofen axetil (group F, n=30) and 10 ml intravenous saline (group C, n=30) 30 min before surgery. After the operation, all the patients received patient-controlled intravenous analgesia (PCIA) with tramadol for pain relief. The postoperative analgesic effect was assessed by visual analog scales (VAS) at 1, 2, 4, 8, 12 and 24 h after surgery, with tramadol requirements and the adverse effects were recorded.</p><p><b>RESULT</b>At 1, 2, 4, and 8 h after the operation, the patients in group F showed significantly lowered VAS scores as compared with the patients in group C (P<0.05). The requirement of tramadol was also significantly less in group F than in group C (182.9-/+37.4 vs 227.3-/+49.8 mg, P<0.05). No significant difference was found in the adverse effects between the two groups.</p><p><b>CONCLUSION</b>Flurbiprofen axetil can produce preemptive analgesia and reduce the tramadol dose during postoperative PCIA in patients undergoing postburn plastic operations.</p>