Evaluation of the relationship between endolymphatic hydrops and hearing loss in Meniere's disease based on three-dimensional real inversion recovery sequence

Abstract Objectives: The degree of endolymphatic hydrops in Meniere's disease may be related to hearing loss. However, the results of prior studies have been inconsistent. We aimed to investigate the relationship between endolymphatic hydrops and hearing loss characteristics in Meniere's disease. Methods: This study included 54 patients (62 ears) with Meniere's disease. Patients underwent three-dimensional real inversion recovery sequences for magnetic resonance imaging and puretone audiometry. Endolymphatic hydrops were assessed according to Gurkov's criteria (2011). Correlations between different degrees of endolymphatic hydrops and pure-tone audiometry, as well as staging, were analysed. Results: Pure tone audiometry and staging were higher for vestibular endolymphatic hydrops complicated by cochlear ones than isolated cochlear or vestibular hydrops (both p<0.05). There was no significant correlation between vestibular endolymphatic hydrops and pure-tonal audiometry or staging (all p > 0.05). The degree of hydrops in the middle turn was correlated with the mid-frequency hearing threshold (p<0.05). The degree of cochlear hydrops was correlated with the audiometry, low-frequency hearing thresholds, mid-frequency hearing thresholds and staging (p<0.01). Conclusion: The types and sites of endolymphatic hydrops based on a 3D-real inversion recovery sequence can be used to indicate the degree of hearing loss in patients with Meniere's disease. Level of evidence: Level III.

Downregulated miR-181a alleviates H2O2-induced oxidative stress and cellular senescence by targeting PDIA6 in human foreskin fibroblasts

Abstract Background Oxidative stress is strongly associated with cellular senescence. Numerous studies have indicated that microRNAs (miRNAs) play a critical part in cellular senescence. MiR-181a was reported to induce cellular senescence, however, the potential mechanism of miR-181a in hydrogen peroxide (H2O2)-induced cellular senescence remains obscure. Objective The aim of this study is to investigate the role and regulatory mechanism of miR-181a in H2O2-induced cellular senescence. Methods Human foreskin fibroblasts (HFF) transfected with miR-181a inhibitor/miR-NC with or without H2O2 treatment were divided into four groups: control + miR-NC/miR-181a inhibitor, H2O2 + miR-NC/miR-181a inhibitor. CCK-8 assay was utilized to evaluate the viability of HFF. RT-qPCR was used to measure the expression of miR-181a and its target genes. Protein levels of protein disulfide isomerase family A member 6 (PDIA6) and senescence markers were assessed by western blotting. Senescence-associated β-galactosidase (SA-β-gal) staining was applied for detecting SA-β-gal activity. The activities of SOD, GPx, and CAT were detected by corresponding assay kits. The binding relation between PDIA6 and miR-181a was identified by luciferase reporter assay. Results MiR-181a inhibition suppressed H2O2-induced oxidative stress and cellular senescence in HFF. PDIA6 was targeted by miR-181a and lowly expressed in H2O2-treated HFF. Knocking down PDIA6 reversed miR-181a inhibition-mediated suppressive impact on H2O2-induced oxidative stress and cellular senescence in HFF. Study limitations Signaling pathways that might be mediated by miR-181a/PDIA6 axis were not investigated. Conclusion Downregulated miR-181a attenuates H2O2-induced oxidative stress and cellular senescence in HFF by targeting PDIA6.

Probability of premature mortality due to four chronic diseases in Jiangmen City from 2012 to 2021 / 预防医学

Objective@#To investigate the mortality of malignant tumors, diabetes, cardio-cerebrovascular diseases and chronic respiratory diseases and trends in probability of premature mortality due to these four chronic diseases in Jiangmen City, Guangdong Province from 2012 to 2021, so as to provide the evidence for perfecting the chronic disease control strategy. @*Methods@#The mortality of malignant tumors, diabetes, cardio-cerebrovascular diseases and chronic respiratory diseases among household registered residents in Jiangmen City from 2012 to 2021 were collected from the Guangdong Provincial Population Death Information Registration Management System, and the crude mortality, standardized mortality by the population of the Fifth National Population Census in China in 2000 and probability of premature mortality were calculated. The trends in mortality and probability of premature mortality were analyzed using average annual percent change (AAPC), and whether achieving the targets for the probability of premature mortality due to four chronic diseases in 2025 and 2030 were evaluated.@*Results@#A total of 226 012 deaths occurred due to four chronic diseases in Jiangmen City from 2012 to 2021, and the overall crude mortality and standardized mortality rates were 569.22/105 and 283.29/105, with a reduction in the probability of premature mortality from 15.04% to 12.05% (AAPC=-2.403%, Z=-7.603, P<0.001). The probability of premature mortality due to four chronic diseases decreased from 19.21% to 16.38% in males, and from 10.42% to 7.58% in females (AAPC=-1.893% and -3.085%, Z=-5.262 and -9.811, both P<0.001). The probability of premature mortality due to diabetes appeared a tendency towards a rise (AAPC=2.317%, Z=2.548, P=0.034), and the probability of premature mortality due to cardio-cerebrovascular diseases showed a tendency towards a decline (AAPC=-4.826%, Z=-13.590, P<0.001), while no significant changing trend was seen in the probability of premature mortality due to malignant tumors or chronic respiratory diseases (AAPC=-0.751% and -2.461%, Z=-1.532 and -1.730, P=0.125 and 0.122). The predicted probability of premature mortality due to four chronic diseases was 10.92% in 2025 and 9.66% in 2030 in Jiangmen City, which were both lower than the target (11.21% and 9.81%). @*Conclusions@#The probability of premature mortality due to four chronic diseases appeared a tendency towards a decline in Jiangmen City from 2012 to 2021, which can reach the target in 2025 and 2030. Males should be given a high priority for interventions of chronic diseases, and diabetes control should be reinforced.

Aß promotes CD38 expression in senescent microglia in Alzheimer's disease

BACKGROUND: In Alzheimer's disease (AD), the neuroinflammatory response mediated by the activation of senescent microglia is closely related to energy dysmetabolism. However, the mechanism underlying the interaction between the energy metabolism of aging microglia and neuroinflammation remains unclear. METHODS: We used biochemical methods, enzyme-linked immunosorbent assay (ELISA), immunofluorescence, and western blot to determine the effects and mechanism of CD38 knockdown on energy metabolism and neuroinflammation in Aß1-40 injured BV2 cells. Using AD model mice, we detected CD38 enzyme activity, energy metabolism factors (ATP, NAD +, and NAD +/NADH), and neuroinflammatory factors (IL-1ß, IL-6, and TNF-α) following the addition of CD38 inhibitor. Using a combination of biochemical analysis and behavioral testing, we analyzed the effects of the CD38 inhibitor on energy metabolism disorder, the neuroinflammatory response, and the cognition of AD mice. RESULTS: Following Aß1-40 injury, SA-ß-Gal positive cells and senescence-related proteins P16 and P21 increased in BV2 cells, while energy-related molecules (ATP, NAD +, and NAD +/NADH) and mitochondrial function (mitochondrial ROS and MMP) decreased. Further studies showed that CD38 knockdown could improve Aß1-40-induced BV2 cells energy dysmetabolism and reduce the levels of IL-1ß, IL-6, and TNF-α. In vivo results showed an increase in senile plaque deposition and microglial activation in the hippocampus and cortex of 34-week-old APP/PS1 mice. Following treatment with the CD38 inhibitor, senile plaque deposition decreased, the number of Iba1 +BV2 cells increased, the energy metabolism disorder was improved, the proinflammatory cytokines were reduced, and the spatial learning ability was improved. CONCLUSIONS: Our results confirm that senescent microglia appeared in the brain of 34-week-old APP/PS1 mice, and that Aß1-40 can induce senescence of BV2 cells. The expression of CD38 increases in senescent BV2 cells, resulting in energy metabolism disorder. Therefore, reducing CD38 expression can effectively improve energy metabolism disorder and reduce proinflammatory cytokines. Following intervention with the CD38 inhibitor in APP/PS1 mice, the energy metabolism disorder was improved in the hippocampus and cortex, the level of proinflammatory cytokines was reduced, and cognitive impairment was improved.

Effect evaluation of supplementary food nutrition package for infants aged 6-24 months in rural areas of Hainan / 中国热带医学

@#Abstract: Objective To analyze the effect of nutrition package on the nutritional status and prevalence of children in rural areas of Hainan Province, and provide scientific basis and suggestions for further improving the nutritional and health status of children in this region. Methods　Four cities and counties were randomly selected as the intervention group, and four cities and counties matched with the intervention group in terms of population, economy, social culture, maternal and child health work foundation of township health centers, physical nutrition and health status were selected as the control group.With the combination of monitoring and prospective cohort study, infants in the intervention group and the control group were studied from June 1, 2020, and they were intervened for 12 months with supplementary food nutrition package. Before and after intervention, the nutrition and health status of infants aged 6-24 months in the intervention group and the control group were investigated to evaluate the nutritional and health effects of supplementary food nutrition package for infants aged 6-24 months in rural Hainan Province. Results　A total of 999 infants were investigated, including 427 in the intervention group and 572 in the control group. After 12 months of nutritional intervention, there was no significant difference in weight-for-age Z-score (WAZ) and height-for-age Z-score (HAZ) and weight-for-height Z-score (WHZ) between the intervention group and the control group (P>0.05). The rate of emaciation of the intervention group was 1.64%, which was significantly lower than 3.67% of the control group (P<0.05). There were no significant differences in the rate of growth retardation (2.81% and 3.32%, respectively) and underweight (0.47% and 1.92%, respectively) between the intervention group and the control group (P>0.05). The rate of respiratory infection and diarrhea in the intervention group were 9.13% and 1.17%, which were significantly lower than corresponding 23.25% and 3.15% in the control group (P<0.05). The hemoglobin of the intervention group and the control group were 117.24 g/L and 114.51 g/L respectively, and the rates of anemia were 11.11% and 22.84% respectively, the differences were statistically significant (P<0.05). Conclusions　The intervention of nutrition package in rural areas of Hainan Province has achieved the expected results, and supplementary food nutrition package has reduced the incidence of malnutrition and respiratory infection and diarrhea in recent two weeks in infants and anemia to a certain extent. We should attach great importance to the supplementary nutrition package for right-age children and promote the growth and health of children in rural areas through supplementary nutrition package, and continuously improve the nutrition and health level of children in Hainan Province.

Efficacy and safety of tolperisone versus baclofen among Chinese patients with spasticity associated with spinal cord injury: a non-randomized retrospective study

There are many medications available to treat spasticity, but the tolerability of medications is the main issue for choosing the best treatment. The objectives of this study were to compare the efficacy and adverse effects of tolperisone compared to baclofen among patients with spasticity associated with spinal cord injury. Patients received baclofen plus physical therapy (BAF+PT, n=135) or tolperisone plus physical therapy (TOL+PT, n=116), or physical therapy alone (PT, n=180). The modified Ashworth scale score, the modified Medical Research Council score, the Barthel Index score, and the Disability Assessment scale score were improved (P<0.05 for all) in all the patients at the end of 6 weeks compared to before interventions. After 6 weeks, the overall coefficient of efficacy of the intervention(s) in the BAF+PT, TOL+PT, and PT groups were 1.15, 0.45, and 0.05, respectively. The patients of the BAF+PT group reported asthenia, drowsiness, and sleepiness and those of the TOL+PT group reported dyspepsia and epigastric pain as adverse effects. When comparing drug interventions to physical therapy alone, both baclofen plus physical therapy and tolperisone plus physical therapy played a significant role in the improvement of daily activities of patients. Nonetheless, baclofen plus physical therapy was tentatively effective. Tolperisone plus physical therapy was slightly effective. In addition, baclofen caused adverse effects related to the sedative manifestation (Level of Evidence: III; Technical Efficacy Stage: 4).

Clinical outcomes of transforaminal lumbar interbody fusion for patients with lumbar spinal stenosis and diffuse idiopathic skeletal hyperostosis / 中华骨科杂志

Objective:To evaluate the outcomes of transforaminal lumbar interbody fusion (TLIF) for patients with lumbar spinal stenosis (LSS) and diffuse idiopathic skeletal hyperostosis (DISH).Methods:This study recruited 33 patients (15 male and 18 female) with LSS and DISH who underwent TLIF surgery from January 2010 to July 2018. The mean age was 65.1±11.2 years old and the instrumented segments averaged 1.45±0.42 levels. Another group of LSS patients without DISH were well matched to the DISH group at a 1∶1 ratio in terms of age, sex, and instrumented levels. Lumbar lordosis, local lordosis as well as lowerlumbarlordosis were measured on X-ray taken before and after surgery. According to Pfirrmann's classification, the degree of preoperative disc degeneration was evaluated on preoperative MRI, and the incidence of postoperative fusion cage subsidence was recorded during follow-up. Oswestry disability index (ODI) was used to evaluate the lumbar function and visual analogue scale(VAS) scores for low back pain and leg pain were used to evaluate the quality of life.Results:There were no significant difference between two groups in terms of age, bone mineral density, operative time, postoperative bleeding volume, fusion levels and postoperative follow-up time. Compared with the non-DISH group (3.20±0.95), the DISH group had higher degeneration disc according to Pfirrmann's classification (3.82±0.64) ( t=3.109, P=0.002), lower lumbar lordosis(37.4°±8.5° vs. 45.2°±12.2°, t=3.013, P=0.003), and lower lower lumbar lordosis (18.3°±3.9° vs. 21.9°±5.4°, t=3.104, P=0.002). After TLIF surgery, lumbar lordosis was significantly improved in both groups. During follow-up, notable correction loss was noted in DISH group in terms of lumbar lordosis (43.6°±9.7° vs. 50.1°±10.2°, t=2.652, P=0.010), lower lumbar lordosis (19.1°±4.7° vs. 22.9°±5.2°, t=2.540, P=0.013) as well as local lumbar lordosis (17.4°±6.5° vs. 22.7°±7.2°, t=3.138, P=0.002). Moreover, these above value in the DISH group were significantly lower than those in the non-DISH group. At the latest follow-up, 12 patients in the DISH group were identified with cage subsidence, which were significantly higher than in the non-DISH group (36.3% vs. 12.1%, χ2=5.280, P=0.022). Till the latest follow-up, both groups had considerable improvement of the ODI score, back pain and leg pain VAS score. However, the back pain VAS scores in the DISH group were significantly higher than that in the non-DISH group ( t=2.862, P=0.005). Conclusion:Compared with LSS patients without DISH, LSS patients with DISH are more likely to have cage subsidence and loss of correction of lumbar lordosis angle after TLIF surgery. Moreover, the VAS score of low back pain in LSS patients with DISH was lower than those without DISH.

Determinants of the delay in case finding, treatment, and diagnosis among students tuberculosis patients in Guiyang from 2014 to 2020 / 中国学校卫生

Objective@#To analyze factors affecting the delay in the case finding, treatment and diagnosis of tuberculosis among students during 2014-2020，and to provide a reference for the prevention and control measures of tuberculosis among students in Guiyang City.@*Methods@#The medical cases of students with tuberculosis from 2014 to 2020 recorded by "China Disease Prevention and Control Information System" were collected and trend of delays in the detection, treatment, and diagnosis of students with tuberculosis were analyzed, and χ 2 test and multivariate Logistic regression were used to analyze influencing factors.@*Results@#From 2014 to 2020, the rate of delay in the case finding, treatment, and diagnosis of tuberculosis among students in Guiyang showed a relatively stable trend. From 2014 to 2020, Guiyang City reported a total of 1 323 valid cases, the median number of case finding was 16 days,and 48.75% of student TB patients were delayed; the median number of treatment was 11 days, the delay rate of treatment was 43.46%; the median number of diagnosis was 0 day, the diagnosis delay rate was 11.87%. The results of multivariate Logistic regression analysis showed that the floating population was a risk factor for delay in case finding ( OR =1.45), the classification of the source of patients as "other" ( OR =0.19), the level of the first diagnosed unit was county ( OR =0.44), and the type of the first diagnosed unit was general hospital ( OR =0.58) were the protective factors for the delayed case finding of tuberculosis in students( P <0.05). Female ( OR =1.32) and floating population ( OR =1.38) were risk factors for delayed treatment. Floating population ( OR =1.51), rural areas ( OR =4.30), urban fringe ( OR =2.76),non severe patients ( OR =5.99) were risk factors for delayed diagnosis,females ( OR =0.65), ethnic minorities ( OR =0.38), college degree ( OR =0.53), and the first diagnosis unit wae a specialist hospital ( OR =0.22) were protective factors for delayed diagnosis of tuberculosis in students ( P <0.05).@*Conclusion@#The rates of tuberculosis case finding and treatment delay among students are common, which warrants targeted prevention and control measures to reduce the incidence of student delays and reduce the risk of tuberculosis cluster epidemics in schools.

Prevalence and trend of low vision among primary and secondary school students in Wuhan from 2019 to 2020 / 中国学校卫生

Objective@#To provide a largescale assessment the prevalence of poor vision in 2020 among children and adolescents in Wuhan City, Hubei province and to provide basis for healthy vision promotion.@*Methods@#This crosssectional epidemiological study was conducted among 156 783 students, who lived in Wuhan during the COVID-19 period participated the vision screening through the online applet designed by Wuhan Center for Adolescent Poor Vision Prevetion and Control under the guidance of their guardians between June 19 and July 6, 2020. The demographic information and daily hours spent on various activities in the past week were investigated. The corresponding visual acuity data of students in 2019 before the COVID-19 outbreak was extracted from school vision monitoring records for each semester, which was measured by the experienced eye care professionals.@*Results@#The detection rate of poor vision (51.04%) in 2020 was significantly higher than that in 2019(43.04%)( χ 2=68 944.95, P <0.01). After adjustment for covariates, the odds ratio and 95% confidence interval for poor vision were 1.17(1.13-1.20), 1.07(1.04-1.10), 0.67 (0.65-0.69) and 0.62(0.60-0.64) in students with online class time, recreational screen time, indoor and outdoor activity time in the highest tertile, compared with the lowest tertile groups.@*Conclusion@#Increased rate of poor vision among primary and secondary schoool students deserves further concern. It is necessary to strengthen intervention of eyesight protection. Policies and programs aimed at improving opportunities for physical activities and decreasing multiple screen behaviors should be given priority.

Evaluation of the sealing ability of different root canal sealers: a combined SEM and micro-CT study

Abstract Objective: The purpose of this study was to analyze the ability of multiple compounds to seal the dental tubules using scanning electron microscopy (SEM) and micro-computed tomogra-phy (micro-CT). Material and Methods: Twenty-four single-root human mandibular premolars were selected and instrumented with nickel-titanium rotary file and the final file size was #40/06. They were then randomly allocated into 2 groups, and all samples were filled with single cone gutta-percha (#40/06) and one of the tested sealers (AH Plus and EndoSequence BC sealers). All specimens were scanned using micro-CT and then three from each group were randomly selected for SEM analysis. Results: According to SEM, both root canal sealers showed sufficient adaptation to dentin along the whole length of the root canal, though the coronal sections presented superior sealing than the apical sections. Micro porosity analyses revealed that the volume of closed pores and the surface of closed pores had the largest values in the coronal sections, followed by the middle and the apical sections for both sealants (p<0.05). However, no significant difference was observed for those two parameters between AH Plus and EndoSequence BC sealers in any of the three sections (p>0.05), whereas they were larger in the apical section when the AH Plus sealer was used. Conclusions: By using the single cone technique, neither EndoSequence or AH Plus pro-vides a porosity-free root canal filling. The EndoSequence BC sealer may have similar sealing abilities regarding the whole root canal as the AH Plus sealer. A better sealing effect could be obtained in the coronal and middle sections of a root canal than the apical part by using the tested sealers.

Understanding Qi Running in the Meridians as Interstitial Fluid Flowing via Interstitial Space of Low Hydraulic Resistance / 中国结合医学杂志

Qi, blood and the meridians are fundamental concepts in Chinese medicine (CM), which are components of the human body and maintain physiological function. Pathological changes of qi, blood and meridians may lead to discomfort and disease. Treatment with acupuncture or herbal medicine aims to regulate qi and blood so as to recover normal function of the meridians. This paper explores the nature of qi as well as compares and correlates them with the structures of the human body. We propose a conceptualization of qi as being similar to the interstitial fluid, and the meridians as being similar to interstitial space of low hydraulic resistance in the body. Hence, qi running in the meridians can be understood as interstitial fluid flowing via interstitial space of low hydraulic resistance.

LW-AFC and its active components ameliorate corticosterone-induced long-term potentiation impairment in mice / 中国药理学与毒理学杂志

OBJECTIVE LW- AFC is extracted from the classical traditional Chinese medicinal prescription-Liuwei Dihuang Decoction. Previous studies have showed that LW-AFC could improve learning & memory ability in amny animal models. In this study, we focused on evaluating the effect of several main active components from LW-AFC (B-B; loganin, LOG; morroniside, MOR; paeoniflorin, PF and stachyose, STA) on LTP. METHODS In vivo recording of LTP was used in this study to evaluate the effects of LW-AFC and it's active components on coticorsterone (Cort) induced LTP impairment. RESULTS The results showed that LW-AFC could ameliorate Cort-induced LTP impairment. The effect of LW-AFC was abolished when the immune function was inhibited. Single administration (ig, ip, icv) of any of the components had no effect on Cort-induced LTP impairment. Consecutively intragastric admin?istration or intraperitoneal injections (chronic administration) of B-B, LOG, MOR or PF for 7 d showed protective effect on Cort-induced LTP impairment. Intragastric administration of STA for 7 d protected LTP from impairment induced by Cort, while there was little improving effect when STA was administrated via intraperitoneal injection. In addition, when the intestinal microbiota was disrupted by applying the antibiotic cocktail, STA showed little protective effect against Cort. CONCLUSION In conclusion, LW-AFC and it' s components showed positive effects against cort induced LTP impairment, it seems that all displayed protective effects via indirectly, immune modulation might be the common pathway for all components; the exact pathways are different in each component, B-B, LOG, MOR and PF could be absorbed into the bloods tream and then modulate the peripheral immune function, while STA could not be absorbed and modulates the immune function via modulating intestinal microbiota. Further studies are needed to invesgate the underlying mechanisms and the synergetic effects of all components.

Cut-off Values of Diagnostic Indices to Detect Iron Deficiency in Chinese Breast-fed Infants / 生物医学与环境科学（英文）

Iron deficiency anemia is one of the most prevalent nutritional deficiency worldwide. The commonly used cut-off values for identifying iron deficiency are extrapolated from older children and may not be suitable for infants. Therefore, our study aimed to establish appropriate cut-off values for the evaluation of iron status in Chinese infants. Pregnant women who delivered at ⋝37 gestational weeks with normal iron status were recruited. Later, infants with normal birth weight and who were breastfed in the first 4 months were selected. Blood samples were collected to assess hemoglobin, serum ferritin, soluble transferrin receptor, mean corpuscular volume and free erythrocyte protoporphyrin. Cut-offs of all iron indices were determined as the limit of 95% confidence interval.

Peroxisome proliferator-activated receptor γ and regulation of adaptive thermogenesis / 国际药学研究杂志

Adaptive thermogenesis is an important manner to keep homeostasis of energy metabolism by non-shivering thermogenesis(NS). In addition to brown adipose tissue, the beige adipose tissue induced by cold stimulation in subcutaneous white adipose tissue (WAT) also proceeds NS in mice. Regulating NS to increase excess energy expense of the body may be a safe and effective method for the treatment of obesity, insulin resistance and the disorder of energy metabolism. Peroxisome proliferator-activated receptor γ(PPARγ) is an important transcription factor whose activator can induce the production of adipose tissue cell in pharmacological doses. This paper reviewes the function of PPARγ in adaptive thermogenesis and analyzes the possible mechanism of selective modulation of PPARγ. It may become the theoretical basis of a new generation of insulin sensitizing agent.

Hybrid constructs versus all pedicle screw instrumentation for treatment of thoracic scoliosis secondary to Chiari malformation in adolescents / 中华骨科杂志

Objective To compare the clinical and radiological outcomes between hybrid and total pedicle screw instrumentation in adolescents undergone posterior spinal fusion (PSF) for thoracic scoliosis secondary to Chiari malformation..Methods A total of 75 patients undergone PSF were included and divided into two groups:the all pedicle screw group (Group A,n=44) and the hybrid group (Group B,n=31).Patients were evaluated before surgery,immediately after surgery,and at the 2-year follow-up in radiographic changes in curve magnitude,apical vertebral translation (AVT),apical vertebral rotation (AVR),trunk shift,thoracic kyphosis (TK),lumbar lordosis (LL),and sagittal vertical axis (SVA).These parameters were further analyzed with respect to preoperative TK in both groups.Results After surgery,the average correction of the thoracic curve was 60.2％ and 51.3％ in Group A and B,respectively (t=2.372,P=0.023).The average lumbar curve correction was 61.7％ in Group A,representing a significant increase compared to Group B (51.1％,t=2.431,P=0.020).At the final follow-up,loss of the thoracic curve correction was less in Group A (0.3％) than in Group B (1.7％),however,there was no statistical significance (t=-0.468,P＞0.05).AVT of the thoracic curve improved in Group A from 25.0 mm to 6.9 mm,while in Group B it changed from 24.1 mm to 7.4 mm.For patients with a preoperative TK greater than 40°,the proximal junctional angle was found to be significantly larger in Group A (10.0 degrees versus 4.5 degrees,t=-2.031,P=0.052) by the final follow-up,along with a significantly increased incidence of proximal junctional kyphosis (20％ versus 9％).Conclusion Total pedicle screw instrumentation provided a significantly better correction of the major and minor curves than hybrid constructs for the operative treatment of thoracic scoliosis secondary to Chiari malformation.However,for patients with thoracic hyperkyphosis,all-screw instrumentation had a higher risk of adjacent level proximal kyphosis.

Correlation between the shifting of medulla oblongata and cerebellum and syrinx resolution after posterior fossa decompression in Chiari malformation / 中华外科杂志

<p><b>OBJECTIVES</b>To evaluate the changes of the position of medulla oblongata and cerebellum following posterior fossa decompression (PFD), and to investigate their influences on the prognosis of the syringomyelia in adolescents with Chiari malformation (CM).</p><p><b>METHODS</b>A retrospective review was performed on all CM patients between September 2006 and September 2011. A subset of 46 patients, including 25 male and 21 female patients, was finally enrolled according to the inclusion criteria. The initial age and duration of follow-up averaged 13.9 years (range, 10-17 years) and 13 months (range, 6-52 months), respectively. On mid-sagittal MRI, the following parameters were evaluated pre- and postoperatively (follow-up ≥ 6 months): the longitudinal and transverse position of bulbopontine sulcus, the fourth ventricle vertex, the lower extreme of cerebella tonsil, the cervico-medullary angle, the maximal syrinx/cord(S/C) ratio and the syrinx length. Changes in these parameters were analysed using the paired samples t test, and for these reaching statistical significances, an additional bivariate correlation analysis was performed to investigate their relation with syrinx resolution.</p><p><b>RESULTS</b>At the latest follow-up, upward shifting of the bulbopontine sulcus was observed in 31 patients(67.4%), with upward shifting of the lower extreme of cerebella tonsil presenting in 35 patients(76.0%). The maximal S/C ratio and the syrinx length were significantly improved postoperatively (t = 7.114 and 7.816, P = 0.000).Significant resolution of the syrinx was demonstrated in 40 patients(86.9%), and more specifically, the average improvement rates of the maximal S/C ratio and the syrinx length were 32% ± 30%and 43% ± 33%, respectively. In addition, the bivariate correlation analysis revealed that syrinx resolution was significantly correlated with the upward shifting of the bulbopontine sulcus (r = 0.332, P = 0.027) and lower extreme of cerebella (r = 0.298, P = 0.044) .</p><p><b>CONCLUSION</b>The upward shifting of the bulbopontine sulcus and the lower extreme of cerebella tonsil might be implicated in the mechanisms of postoperative syrinx resolution.</p>

System approaches reveal the molecular networks involved in neural stem cell differentiation

The self-renewal and multipotent potentials in neural stem cells (NSCs) maintain the normal physiological functions of central nervous system (CNS). The abnormal differentiation of NSCs would lead to CNS disorders. However, the mechanisms of how NSCs differentiate into astrocytes, oligodendrocytes (OLs) and neurons are still unclear, which is mainly due to the complexity of differentiation processes and the limitation of the cell separation method. In this study, we modeled the dynamics of neural cell interactions in a systemic approach by mining the high-throughput genomic and proteomic data, and identified 8615 genes that are involved in various biological processes and functions with significant changes during the differentiation processes. A total of 1559 genes are specifically expressed in neural cells, in which 242 genes are NSC specific, 215 are astrocyte specific, 551 are OL specific, and 563 are neuron specific. In addition, we proposed 57 transcriptional regulators specifically expressed in NSCs may play essential roles in the development courses. These findings provide more comprehensive analysis for better understanding the endogenous mechanisms of NSC fate determination.

Reduction of Insulin Resistance in HepG2 Cells by Knockdown of LITAF Expression in Human THP-1 Macrophages / 华中科技大学学报（医学）（英德文版）

The molecular mechanism by which obesity induces insulin resistance is not completely understood.The aim of this study was to determine how lipopolysaccharide-induced tumor necrosis-α factor (LITAF) influenced obesity-induced insulin resistance using a cellular co-culture system.The cells were divided into 3 groups:palmitic acid (PA) stimulation group,LITAF small interfering RNA (siRNA) group and untreated (NC) group.The LITAF siRNA was used for knockdown of LITAF expression in human THP-1 macrophages.The expression levels of LITAF,IRS-2,IRS-2Tyr465,PI3K,and GLUT2 in each group were measured by using quantitative reverse transcriptase real-time polymerase chain reaction and Western blotting.The expression of LITAF was much higher in the PA group than in the siRNA and NC groups (*P＜0.05); meanwhile,the expression of IRS-2,IRS-2Tyr465,PI3K,and GLUT2 was much lower in the PA group than in the NC group (*P＜0.05); however,IRS-2,IRS-2Tyr465,PI3K,and GLUT2 had much higher expression in the siRNA group than in the PA group (*P＜0.05).It is concluded that PA can induce insulin resistance in liver cells and knockdown of LITAF expression can reduce insulin resistance in liver cells,suggesting LITAF may regulate the insulin signal transduction pathway involved in obesity-induced insulin resistance.

Association of SUMO4 Met55Val Variation with Increased Insulin Resistance in Newly Diagnosed Type 2 Diabetes in a Chinese Population / 华中科技大学学报（医学）（英德文版）

SUMO4 Met55Val variation was shown to be related to type 2 diabetes susceptibility and the vascular complications in Asian people.To further examine the related mechanisms,this study was designed to evaluate the association of SUMO4 Met55Val polymorphism with insulin resistance and βcell function in newly diagnosed type 2 diabetic patients in a Chinese population.Four hundred and twenty seven newly diagnosed type 2 diabetic patients were selected for SUMO4 Met55Val polymorphism genotype analysis.All subjects underwent a 75-g oral glucose tolerance test (OGTT) to estimate the insulin sensitivity and β cell function.Anthropometrics and a metabolic profile were used for phenotyping analysis.The results showed that the SUMO4 Met55Val polymorphism was associated with higher insulin resistance (P＜0.001) and lower insulin sensitivity (P＜0.001).Patients with GG genotype had higher levels of plasma glucose,insulin and C peptide.Insulin sensitivity index (ISI) was closely correlated with body mass index (BMI) in patients with GG genotype in comparison to the counterparts with AG or AA genotype (r=-0.504 vs.r=-0.430 vs.r=-0.340).Multiple regression linear analysis showed that SUMO4 Met55Val polymorphism was an independent determinant for insulin sensitivity (P=0.001),which,along with triglyceride,BMI and sex,could account for 20.1％ of the variation in ISI.The result remained the same after adjusting for BMI and sex.No association was found between SUMO4 Met55Val polymorphism and β cell function (all P＞0.05).It was concluded that SUMO4Met55Val variant was associated with increased insulin resistance in Chinese patients with newly diagnosed type 2 diabetes.

Wave Intensity Analysis of Carotid Artery: A Noninvasive Technique for Assessing Hemodynamic Changes of Hyperthyroid Patients / 华中科技大学学报（医学）（英德文版）

This study examined the wave intensity (WI) of the carotid artery in patients with hyperthyroid in order to assess the hemodynamic changes of hyperthyroid patients. A total of 86 hyperthyroid patients without cardiac morphological changes and arrhythmia, and 80 healthy control subjects were enrolled in the study. Right common carotid artery (RCCA) was selected for ultrasonic imaging to obtain WI indices, including amplitude of the peak during early systole (W1), amplitude of the peak during late systole (W2), area of the negative wave during mid-systole (NA), interval between R wave of electrocardiogram and W1 (R-1 st), interval between W1 and W2 (1 st-2nd). The levels of serum thyroid hormones, consisting of free triiodothyronine (FT3), free thyroxin (FT4) and thyroid stimulating hormone (TSH), were measured in hyperthyroid patients. Echocardiographic indices including left ventricular ejection fraction (LVEF) and left ventricular fraction shortening (LVFS) were determined in each subject. The results showed that the WI, W2, NA, and (lst-2nd×HR) in hyperthyroid patients were significantly higher than those in healthy controls. There was no significant difference in LVEF and LVFS between the two groups. FT3 was correlated with WI, W2, NA,(lst-2nd×HR), pulse pressure (PP) and heart rate (HR) in hyperthyroid patients. Several abnormal waves on WI curves were present in 19 hyperthyroid patients during mid-systole. It was concluded that WI technique may prove a real-time, noninvasive, sensitive and convenient tool for assessing the cardiac function and hemodynamic alterations in hyperthyroid patients.