Effect of p-Stat3 on invasion of human gastric cancer cells / 临床与实验病理学杂志

Purpose To investigate the expression of signal transduction and activator 3 (Stat3) ,and phosphorylated Stat3 (p-Stat3) in human gastric cancer cell lines MGC-803 and BGC-823,and to explore the role of p-Stat3 in the invasion and migration of gastric cancer. Methods The expressed Stat3 and p-Stat3 in gastric cancer MGC-803 and BGC-823 cells were investigated by flow cytometry,and the migration and invasion abilities of cancer cells were observed using scratch test and in vitro Transwell test. Results Flow cytometry showed that the expression of Stat3 in MGC-803 and BGC-823 cells was basically unchanged before and after IL-6 stimulation (10 ng/mL) ,and the activated p-Stat3,however,was significantly higher after IL-6 stimulation. The activated p-Stat3 in BGC-823 cells was higher than that of MGC-803 cells (P < 0. 001) . The results of scratch tests showed that the scar healing area of BGC-823 cells was significantly larger than that of MGC-803 cells after 48 h (P = 0. 031) . Transwell cell experiments showed that the number of penetrating cells from BGC-823 cell line were significantly greater than those from MGC-803 cell line (P < 0. 001) . Conclusion Over activated p-Stat3 enhances the invasion and migration of MGC-803 and BGC-823 gastric cancer cells.

The Bidirectional Effects of Arsenic on miRNA-21: A Systematic Review and Meta-analysis / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>Arsenic is a metalloid environmental carcinogen involved in the occurrence and development of many cancers. miRNA-21 plays a crucial role in arsenic-induced carcinogenesis. We aimed to elucidate the mechanism by which miRNA-21 influences arsenic-induced cancer.</p><p><b>METHODS</b>We used meta-analysis of published studies to determine how arsenic induces cancerous cells through miRNA-21.</p><p><b>RESULTS</b>Low-dose arsenic exposure (⪕ 5 μmol/L) can increase miRNA-21 and phosphorylated signal transducter and activator of transcription 3 (pSTAT3) expression, and decrease programmed cell death protein 4 (PDCD4) and protein sprouty homolog 1 (Spry1) expression. High-dose arsenic exposure (> 5 μmol/L), can increase miRNA-21 expression, and decrease Spry1 and E-cadherin expression. Short-term arsenic exposure (⪕ 24 h) can increase miRNA-21 and pSTAT3 expression, and decrease PDCD4 expression. Moreover, long-term arsenic exposure (> 24 h) can increase the miRNA-21, STAT3, and pSTAT3 expression, and decrease PDCD4 expression. We found that activation of miRNA-21 and pSTAT3 were most pronounced following long-term arsenic exposure at low doses, and the effects on PDCD4 expression were most pronounced following short-term arsenic exposure at low doses. miRNA-21 inhibitors increased the expression of tumor suppressor genes PDCD4, PTEN, and Spry1 and miRNA-21-mimics suppressed the expression of these tumor suppressor genes.</p><p><b>CONCLUSION</b>Arsenic can cause cancer by activating miRNA-21 and inhibiting the expression of PDCD4, PTEN, and Spry1.</p>

Grape Seed Procyanidin Extract Reduces Arsenic-Induced Renal Inflammatory Injury in Male Mice / 生物医学与环境科学（英文）

The aim of the present study is to evaluate the ability and mechanism by which grape seed procyanidin extract (GSPE) relieves arsenic trioxide (As2O3)-induced renal inflammatory injury. Therefore, male Kunming mice were treated with As2O3 and/or GSPE by gavage for 5 weeks. Mice were then sacrificed and inflammatory cytokines of kidneys were examined by ELISA, whereas the expression levels of molecules involved in the nuclear factor (NF)-κB signaling pathway were evaluated by both qRT-PCR and Western blot. Our results indicate that GSPE prevents As2O3-mediated renal inflammatory injury by inhibiting activation of the NF-κB signaling pathway and inflammatory cytokine production, while promoting expression of anti-inflammatory cytokines.

Grape Seed Proanthocyanidin Extract Alleviates Arsenic-induced Oxidative Reproductive Toxicity in Male Mice / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To determine the ability of grape seed proanthocyanidin extract (GSPE) in alleviating arsenic-induced reproductive toxicity.</p><p><b>METHODS</b>Sixty male Kunming mice received the following treatments by gavage: normal saline solution (control); arsenic trioxide (ATO; 4 mg/kg); GSPE (400 mg/kg); ATO+GSPE (100 mg/kg); ATO+GSPE (200 mg/kg) and ATO+GSPE (400 mg/kg). Thereafter, the mice were sacrificed and weighed, and the testis was examined for pathological changes. Nuclear factor (erythroid-derived 2)-like 2 (Nrf2), heme oxygenase 1 (HO1), glutathione S-transferase (GST), NAD(P)H dehydrogenase, and quinone 1 (NQO1) expression in the testis was detected by real-time PCR. Superoxide dismutase (SOD), glutathione (GSH), total antioxidative capability (T-AOC), malondialdehyde (MDA), 8-hydroxydeoxyguanosine (8-OHdG), and reproductive indexes were analyzed.</p><p><b>RESULTS</b>ATO-treated mice showed a significantly decreased sperm count and testis somatic index and activity levels of SOD, GSH, and T-AOC than control group. Compared to the ATO-treated group, ATO +GSPE group showed recovery of the measured parameters. Mice treated with ATO+high-dose GSPE showed the highest level of mRNA expression of Nrf2, HO, NQO1, and GST.</p><p><b>CONCLUSION</b>GSPE alleviates oxidative stress damage in mouse testis by activating Nrf2 signaling, thus counteracting arsenic-induced reproductive toxicity.</p>

Epidemic features of dyslipidemia among Uygur, Kazakh, and Han adults in Xinjiang, China in 2010 / 中华预防医学杂志

<p><b>OBJECTIVE</b>To investigate the prevalence of dyslipidemia among the Uyghur, Kazakh, and Han adults in Xinjiang Region and to analyze the features of distribution.</p><p><b>METHODS</b>3625 Uygur residents, 1773 males and 1852 females, aged (42.89 ± 15.95) years old, 4148 Kazakh residents, 1649 males and 2499 females, aged (44.14 ± 13.27) years old, and 3733 Han residents, 1563 males and 2170 females, aged (49.66 ± 12.24) years old, were selected by stratified cluster random sampling method in year 2010, 11 506 adults in total. Questionnaire and physical examination were conducted, including fasting venous blood samples to test the levels of triglyceride (TG), total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), and high density lipoprotein cholesterol (HDL-C).</p><p><b>RESULTS</b>The levels of TG, TC, HDL-C and LDL-C were separately (1.31 ± 1.03), (4.44 ± 1.20), (1.41 ± 0.62), and (2.44 ± 0.81) mmol/L in the Uygur adults; separately (1.24 ± 0.99), (4.55 ± 1.31), (1.41 ± 0.62), and (2.40 ± 0.87) mmol/L in the Kazakh adults; and (1.62 ± 1.34), (4.60 ± 1.10), (1.16 ± 0.68), and (2.23 ± 0.93) mmol/L in the Han adults, respectively. The general prevalence of dyslipidemia in the Uygur, Kazakh, and Han adults were 42.4% (1537/3625), 31.6% (1311/4148), and 30.2% (1127/3733) respectively; while the age-standardized prevalence were separately 42.4%, 31.8%, and 28.2%. The prevalence of dyslipidemia in the Uygur adults was significantly higher than it of the Kazakh and Han adults, with statistical significance (χ(2) = 179.87, P < 0.01). The standardized prevalence of dyslipidemia in the Uygur males was 52.6%, significantly higher than it of the Kazakh and Han males (35.4% and 33.2%), with statistical significance (χ(2) = 159.19, P < 0.01). The prevalence of hypertriglyceridemia among the Han adults was 17.3%, which was significantly higher than it among the Uyghur and Kazakh adults (χ(2) = 172.55, P < 0.01). The prevalence of hypercholesterolemia in Kazakh (6.9%) was higher than it in Uygur (5.2%), with statistical significance (χ(2) = 10.20, P < 0.01). The prevalence of low HDL-C hyperlipidemia in the above 3 ethnic were 33.6%, 20.8% and 11.1%, respectively; while Uygur was the highest (χ(2) = 552.82, P < 0.01), followed by Kazakh, which was higher than Han (χ(2) = 138.01, P < 0.01). There was no significant difference in the prevalence of high LDL-C hyperlipidemia among the adults of the 3 ethnics.</p><p><b>CONCLUSION</b>The prevalence of dyslipidemia among the Uygur, Kazakh, and Han adults in Xinjiang were all higher than the national average prevalence, the distribution of dyslipidemia varied with ethnicity, age and sex.</p>

Epidemiological study on overweight and obesity among rural adult residents in Hazakh and Uygur population in Xinjiang province, 2010 / 中华预防医学杂志

<p><b>OBJECTIVE</b>To investigate the prevalence and distribution features of overweight, obesity and abdominal obesity among rural adult residents in Hazakh and Uygur population in Xinjiang province, 2010.</p><p><b>METHODS</b>Questionnaire-based survey and physical examination were conducted towards the 8611 subjects selected from Hazakh and Uygur residents aged over 18 years old in Yili Xinyuan County and Kashi Jiashi County in Xinjiang province by stratified cluster random sampling method; and thereby the results were analyzed and compared between the two ethnic populations.</p><p><b>RESULTS</b>The prevalence of overweight in Hazakh(male: 29.5% (612/2078) and female: 26.4% (789/2991)) was higher than that in Uygur(male: 25.5% (440/1728) and female: 21.9% (397/1814)). The difference showed statistical significance (male: χ(2) = 7.50, female: χ(2) = 12.27, P < 0.01). The prevalence was higher in males than in females among the same ethic population (Hazakh: χ(2) = 5.79, Uygur: χ(2) = 6.28, P < 0.05). The prevalence of obesity in Hazakh(male:18.2% (379/2078) and female:18.1% (540/2991)) was higher than that in Uygur(male: 9.4% (163/1728) and female: 13.2% (240/1814)). The difference showed statistical significance (male: χ(2) = 59.90, female: χ(2) = 19.32, P < 0.01). The female prevalence was higher than male in Uygur (χ(2) = 12.66, P < 0.01); however, there was no statistically significant difference in the prevalence stratified by gender in Hazakh. The prevalence of abdominal obesity in Hazakh(male: 57.0% (1185/2078) and female: 60.2% (1801/2991)) was higher than that in Uygur(male: 46.9% (811/1728) and female: 59.5% (1080/1814)). The difference showed statistical significance (male: χ(2) = 38.54, P < 0.01; female: χ(2) = 0.216, P > 0.05). And the female prevalence was both higher than male in the two ethic populations (Hazakh: χ(2) = 5.15, P < 0.05; Uygur: χ(2) = 56.50, P < 0.01).</p><p><b>CONCLUSION</b>The prevalence abdominal obesity among rural adult residents in Hazakh and Uygur population was much higher than the average level nationwide in China. Hazakh had a higher prevalence of overweight and obesity than Uygur.</p>

Analysis of ribs and intraspinal anomalies in congenital scoliosis / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the incidences and characteristics of the ribs and intraspinal abnormalities in surgical patients with congenital scoliosis.</p><p><b>METHODS</b>We conducted a retrospective study of the medical records and spine radiographs of 118 patients underwent surgical treatment between January 2010 and March 2011 with congenital scoliosis. The average age was 14 years (3-50 years).Fifty-two were male and 66 were female patients. The rib and intraspinal abnormalities were compared in different vertebral anomalies. Pearson's χ(2) test were used to analyze the incidence of anomalies of the ribs and vertebrae, as well as intraspinal anomalies.</p><p><b>RESULTS</b>A total of 57 (48.3%) patients were found to have intraspinal abnormalities.Split cord deformities were identified to be the most common intraspinal anomaly (32.2%), followed by syringomyelia (21.2%).Sixty-nine patients (58.5%) had rib anomalies, which occurring on the concavity of the scoliosis was most frequent. The patients with mixed deformity and failure of segment were found to have a higher incidence of rib anomaly than those with failure formation (χ(2) = 14.05, P < 0.01). The patients with multiple level malformations were found to have significantly higher incidence of rib anomaly than those with single level malformation (χ(2) = 27.50, P < 0.01).Intraspinal anomalies occurred in 42 of 69 patients (60.9%) with rib anomalies and 15 of 49 patients (30.6%) without rib anomalies in congenital scoliosis. The occurrence of intraspinal malformation has significant difference with or without rib anomalies in congenital scoliosis (χ(2) = 10.5, P < 0.01).</p><p><b>CONCLUSIONS</b>The intraspinal malformation is common in patients with mixed defects and failures of segmentation. The rib anomalies occurring on the concavity of the scoliosis is most frequent. The incidence of intraspinal anomaly is significant higher in the patients with rib anomalies than those without rib anomalies. Both the occurrence and type of rib anomaly, combined with vertebral deformity are helpful in forecasting the occurrence of intraspinal abnormalis.</p>

Epidemiological study on overweight and obesity among rural adult residents in Hazakh, Uygur and Han populations in Xinjiang / 中华流行病学杂志

<p><b>OBJECTIVE</b>To investigate the prevalence and distribution of overweight, obesity and abdominal obesity among rural adult residents in Kazakh, Uygur and Han populations from Xinjiang and to provide the theory gist for prevention and cure on obesity in different ethnic groups.</p><p><b>METHODS</b>Questionnaire-based survey and physical examination on 11 377 samples were conducted according to stratified cluster random samplings in Kazakh, Uygur and Han residents aged 18 years in Xinjiang. Prevalence rates on overweight, obesity and abdominal obesity between the three ethnic populations were analyzed and compared.</p><p><b>RESULTS</b>The rates of overweight were 27.8%, 24.5% and 40.3% in kazakh, Uygur and Han populations, with the prevalence rates of obesity as 17.9%, 11.5% and 13.7%. However, the rates of abdominal obesity were 58.0%, 53.9% and 59.9%, respectively. The rates of overweight and abdominal obesity were the highest in Han population but the prevalence of obesity was the highest in Kazakh (P < 0.01). All the prevalence of overweight among the three ethnic populations and the rate of abdominal obesity in Han population were higher in males (P < 0.05) while the prevalence of obesity in the three ethnic populations and the rate of abdominal obesity in Uygur were diametrically opposite (P < 0.01). The prevalence rates of overweight, obesity and abdominal obesity all had an increasing trend in the three ethnic populations and the prevalence of abdominal obesity of all age groups was higher than the rates of overweight and obesity in the same age group.</p><p><b>CONCLUSION</b>The prevalence rates of obesity and abdominal obesity in Kazakh and Uygur populations among rural adult residents were much higher in Xinjiang, so as the rate of overweight in the Hans. All the prevalence rates were different in ethnicities, age groups and sex. The prevalence rate of abdominal obesity was higher than the average data gathered from the nation.</p>

Analysis of clinical results and complications of growing rod technique for congenital scoliosis / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate clinical outcomes of growing rod technique in treating young children with congenital scoliosis.</p><p><b>METHODS</b>From August 2002 to October 2009, 34 patients with congenital scoliosis underwent growing rod procedures including 12 male and 22 female patients. Four patients underwent posterior correction surgeries with single growing rod (single growing rod group), 30 patients underwent posterior correction surgeries with dual growing rod(dual growing rod group). The average age at initial surgery was 6.9(2-13) years. Five patients with severe rigid deformity or kyphosis had an osteotomy at apex vertebra with short segmental fusion followed by dual growing rod technique. The analysis included age at initial surgery and final fusion (if applicable), number and frequency of lengthenings, and complications. Radiographic evaluation including scoliosis, trunk translation, length of T1-S1, thoracic kyphosis and lumbar lordosis was conducted.</p><p><b>RESULTS</b>The follow-up was 40.5 (24-110) months. In single growing rod group, the mean scoliosis Cobb angle improved from 80.9°to 59.5°after initial surgery and was 65.3°at the latest follow-up. T1-S1 length increased from average 24.3 cm to 26.0 cm after initial surgery, and to 31.1 cm at latest follow-up with an increase of 1.05 cm per year. The space available for lung ratio(SAL) in patients with thoracic curves improved from 0.81 to 0.92 at the latest follow-up. Three patients reached final fusion. Four complications occurred in 3 of the 4 patients. In dual growing rod group, the mean scoliosis Cobb angle improved from 72° ± 22°to 35 ± 14° after initial surgery and was 35 ± 17°at the last follow-up or post-final fusion. T1-S1 length increased from (25 ± 5) cm to (29 ± 5)cm after initial surgery and to (33 ± 5)cm at latest follow-up with an average T1-S1 length increase of 1.49 cm per year. The SAL in patients with thoracic curves improved from 0.84 ± 0.08 to 0.96 ± 0.06 at the latest follow-up. Three patients reached final fusion. Complications occurred in 7 of the 30 patients, and they had a total of 13 complications.</p><p><b>CONCLUSIONS</b>Growing rod technique is a safe and effective choice for young children of long, complex congenital scoliosis. It maintains correction achieved at initial surgery while allowing spinal growth to continue. Implants-related complications remain the biggest challenge.</p>

Roles of preoperative arterial blood gas tests in the surgical treatment of scoliosis with moderate or severe pulmonary dysfunction / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>It has been stated that preoperative pulmonary function tests are essential to assess the surgical risk in patients with scoliosis. Arterial blood gas tests have also been used to evaluate pulmonary function before scoliotic surgery. However, few studies have been reported. The aim of this study was to investigate the roles of preoperative arterial blood gas tests in the surgical treatment of scoliosis with moderate or severe pulmonary dysfunction.</p><p><b>METHODS</b>This study involved scoliotic patients with moderate or severe pulmonary dysfunction (forced vital capacity < 60%) who underwent surgical treatment between January 2002 and April 2010. A total of 73 scoliotic patients (23 males and 50 females) with moderate or severe pulmonary dysfunction were included. The average age of the patients was 16.53 years (ranged 10 - 44). The demographic distribution, medical records, and radiographs of all patients were collected. All patients received arterial blood gas tests and pulmonary function tests before surgery. The arterial blood gas tests included five parameters: partial pressure of arterial oxygen, partial pressure of arterial carbon dioxide, alveolar-arterial oxygen tension gradient, pH, and standard bases excess. The pulmonary function tests included three parameters: forced expiratory volume in 1 second ratio, forced vital capacity ratio, and peak expiratory flow ratio. All five parameters of the arterial blood gas tests were compared between the two groups with or without postoperative pulmonary complications by variance analysis. Similarly, all three parameters of the pulmonary function tests were compared.</p><p><b>RESULTS</b>The average coronal Cobb angle before surgery was 97.42° (range, 50° - 180°). A total of 15 (20.5%) patients had postoperative pulmonary complications, including hypoxemia in 5 cases (33.3%), increased requirement for postoperative ventilatory support in 4 (26.7%), pneumonia in 2 (13.3%), atelectasis in 2 (13.3%), pneumothorax in 1 (6.7%), and hydrothorax in 1 (6.7%). No significant differences in demographic characteristics or perioperative factors (P > 0.05) existed between the two groups with or without postoperative pulmonary complications. According to the variance analysis, there were no statistically significant differences in any parameter of the arterial blood gas tests between the two groups.</p><p><b>CONCLUSIONS</b>No significant correlation between the results of the preoperative arterial blood gas tests and postoperative pulmonary complications existed in scoliotic patients with moderate or severe pulmonary dysfunction. However, the postoperative complications tended to increase with the decrease of partial pressure of arterial oxygen in the arterial blood gas tests.</p>

The epidemic situation of metabolic syndrome among the Uygur in Kashgar of Xinjiang in 2010 / 中华预防医学杂志

<p><b>OBJECTIVE</b>To analyze the prevalence and risk factors of metabolic syndrome (MS) in Xinjiang Uygur adults.</p><p><b>METHODS</b>With cluster random sampling, investigations including questionnaire, physical examination and blood testing were performed among 3442 Uygur adults among in Kashgar of Xinjiang on November 2010. Prevalence of MS in groups with different characteristics were calculated and non-conditional logistic regression analysis were used to analyze the risk factors.</p><p><b>RESULTS</b>The prevalence of MS was 21.2% (728/3442), and the age-adjusted prevalence was 18.5%. The prevalence among males and females was 14.5% (245/1694) (age-adjusted prevalence 12.7%) and 27.6% (483/1748) (age-adjusted prevalence 24.4%) respectively (P < 0.05). The prevalence of MS among 18 to 24 years old and 65 years old and above were 4.3% (21/490) and 28.9% (109/377) respectively. The prevalence of MS increased with age (χ(2) = 204.13, P < 0.05). The prevalence of low blood HDL-C, central obesity, hypertension, hypertriglyceridemia and hyperglycemia was 57.5% (1978/3442), 44.5% (1531/3442), 27.5% (948/3442), 20.2% (696/3442) and 8.6% (297/3442) respectively. Compared to age group 18 - 24, the risk of MS occurrence was higher in age group 25 - 34, 35 - 44, 45 - 54, 55 - 64 and 65 years-old above, the according OR (95%CI) values were 2.29 (1.38 - 3.81), 6.91 (4.31 - 11.09), 10.81 (6.72 - 17.40), 12.52 (7.74 - 20.26) and 10.20 (6.20 - 16.78), respectively. Smoking also increased the risk of MS (OR = 2.35, 95%CI: 1.64 - 3.37).</p><p><b>CONCLUSION</b>The prevalence of MS in Xinjiang Uygur was in high level; The prevalence of MS is higher in female than in male; The risk factors of MS included female, age and smoking.</p>

The efficacy of one-stage posterior correction surgery for scoliotic patients with little symptomatic syringomyelia / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the safety and effectiveness of one-stage posterior correction of scoliosis associated with little symptomatic syringomyelia.</p><p><b>METHODS</b>A total of 19 cases diagnosed as scoliosis with little symptomatic syringomyelia between January 2003 and November 2010 were included in this study (study group), the patients underwent one-stage posterior correction and instrumentation without neurosurgery for the syringomyelia. At the same time, 9 cases with severe symptomatic syringomyelia were included as the control group, the patients underwent neurosurgery before scoliosis correction, including suboccipital decompression and syrinx shunting. All patients underwent posterior pedicle screw or screw-hook hybrid instrumentation. The preoperative, postoperative and the last follow-up of the Cobb angle of the coronal main curve and thoracic kyphosis were measured. Also, the preoperative and postoperative of the apical vertebra translation, apical vertebra rotation and trunk shift were measured by the same person. The perioperative and the last follow-up complications of neurological injury were recorded. The surgical outcome and postoperative complications between the 2 groups were compared with the t student and chi-square statistics methods.</p><p><b>RESULTS</b>There were no significant differences in gender, age, the location, length and diameter of the syringomyelia of the 2 groups (P > 0.05). The follow-up period ranged from 6 to 45 months, with a mean of 28.6 months. The average preoperative Cobb angles of coronal main curves of the 2 groups were 71° ± 23° and 68° ± 19°, the postoperative Cobb angles were 27° ± 20° and 25° ± 16°, and the last follow-up Cobb angles were 29° ± 17° and 32° ± 20°. The coronal correction rate was 66% ± 19% in the study group and 65% ± 21% in the control group (t = 0.136, P = 0.893). There was no significant difference at the last follow-up(t = 0.210, P = 0.837). The average preoperative Cobb angles of thoracic kyphosis of the 2 groups were 35° ± 18° and 32° ± 19°, the postoperative Cobb angles were 25° ± 10° and 23° ± 9°, and the last follow-up Cobb angles were 24° ± 4° and 28° ± 8°. The mean sagittal correction rate of the 2 groups were 50% ± 58% and 57% ± 53% (t = -0.303, P = 0.764). There was also no significant difference at the last follow-up time (t = 0.769, P = 0.490). There were no significant difference, in terms of the postoperative of the apical vertebra translation, apical vertebra rotation and trunk shift between the 2 groups (P > 0.05). One case in the study group complicated with a pedicle screw breaking the anterior cortex of the vertebra and one in the control group complicated with a hook loosening, postoperatively. At the last follow-up time, the neurological symptoms of the 2 groups got no aggravating.</p><p><b>CONCLUSION</b>One-stage posterior correction of scoliosis associated with little symptomatic syringomyelia may be effective and safe.</p>

Comparison of initial efficacy between single and dual growing rods in treatment of early onset scoliosis / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Initial results for the use of single and dual growing rod techniques in the treatment of early onset scoliosis (EOS) has been seldom documented. The aim of this research was to investigate the initial efficacy of single and dual growing rods in treatment of EOS.</p><p><b>METHODS</b>A retrospective study of 25 early onset scoliosis cases treated with growing rod technique between November 2002 and May 2010 was performed, including six cases in the single growing rod group and 19 cases in the dual growing rod group. Operation time, intra-operative bleeding, correction rate, changes in C7-S1 distance, and incidence of complications of the first operation were compared for the two techniques.</p><p><b>RESULTS</b>The average post-operative follow-up duration was 31.9 months. There was no statistical difference observed between operation time, intra-operative bleeding, and complication incidence between the single and dual growing rod groups. In addition, no statistical difference was observed in the pre-operative coronal Cobb's angle (P > 0.05), or in the pre-operative sagittal Cobb's angle between both groups (P > 0.05). The correction rate of the dual growing rod group was significantly superior to that of the single growing rod group in the coronal plane (P < 0.01), but not in the sagittal plane (P > 0.05). The C7-S1 distance in the dual growing rod group was significantly larger than that in the single growing rod group (P < 0.05).</p><p><b>CONCLUSIONS</b>The growing rod technique is an effective option for surgical treatment of EOS. The dual growing rod technique shows relative superiority in the correction outcome as compared to the single growing rod technique.</p>

The surgery treatment of scoliosis associated with tethered cord / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate the safety and effectiveness of correction of scoliosis associated with tethered cord without releasing it.</p><p><b>METHODS</b>Twenty-two cases diagnosed as scoliosis with tethered cord between December 2005 and January 2011 were investigated retrospectively in the study. There were 8 males and 14 females. The age was from 6 to 51 years, averaged 17.7 years. There were 7 patients with clinical symptoms before surgery. All the patients underwent posterior deformity correction and instrumentation by pedicle screws directly without releasing the tethered cord. Spinal cord monitoring was conducted in all the cases. The preoperative and postoperative Cobb angle of the coronal main curve and thoracic kyphosis were measured. Also, the preoperative and postoperative values of the apical vertebra translation, apical vertebra rotation and trunk shift were measured by the same person. The incidence of perioperative complications were recorded.</p><p><b>RESULTS</b>A total of 20 patients were followed up. The follow-up time was from 6 to 52 months, mean 23.5 months. The average Cobb angle of the coronal main curve were 68° ± 20° before surgery and 38° ± 21° after surgery with a mean correction of 48.1%. The difference was significant (t = 13.9, P < 0.05). The mean kyphosis was 65° ± 18° preoperatively and 28° ± 11° postoperatively, with a correction of 56.7%. The difference was also significant (t = 8.81, P < 0.05). The preoperative values of the apical vertebra translation, apical vertebra rotation and trunk shift were (5.4 ± 2.5) cm, 2.3° ± 0.6° and (2.0 ± 1.8) cm, respectively, which were corrected to (3.2 ± 1.8) cm, 1.2° ± 0.5° and (1.5 ± 1.1) cm after the surgery. Compared to the preoperative values, the difference were significant in the apical vertebra translation (t = 5.69, P < 0.05) and apical vertebra rotation (t = 10.07, P < 0.05). However, there was no difference in trunk shift. Postoperative complications occurred in 3 patients, including transient numbness of the lower extremity in 1 patient and hydrothorax in 2 patients. No neurological and instrumentation complications occurred during the follow-ups. Patients with clinical symptoms before surgery got no serious during the surgery and follow-ups.</p><p><b>CONCLUSIONS</b>If there are no symptoms of tethering in scoliosis patients with tethered cord, the corrective surgeries may be safe and effective when spinal cord monitoring conducted without spinal cord untethering. But more cases are needed to confirm it.</p>

The efficacy and complications of posterior hemivertebra resection with monosegmental fusion for congenital scoliosis / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate the efficacy and complications of posterior hemivertebra resection with monosegmental fusion in the treatment of congenital scoliosis.</p><p><b>METHODS</b>Thirty consecutive cases of congenital scoliosis managed by posterior hemivertebra resection with monosegmental fusion of the two adjacent vertebra were investigated retrospectively. Radiographs were reviewed to determine the coronal curve magnitude and sagittal alignment preoperatively, postoperatively and at last follow-up. Operative reports and patient charts were reviewed to record any perioperative and late complications.</p><p><b>RESULTS</b>The total number of resected hemivertebra was 30. Mean operation time was 193.8 min with average blood loss of 369.0 ml. The segmental scoliosis was corrected from 36.4° to 4.9° with a correction rate of 86.5%, and segmental kyphosis (difference to normal segmental alignment) from 21.2° to 6.6° with a correction rate of 68.9%. The trunk shift was improved from 17.1 to 8.8 mm. The correction of the compensatory cranial and caudal curve were 74.9% and 75.1%. There were 1 delayed wound healing, 2 pedicle cutting and 1 rod breakages. Radiolucent gaps were found on the lateral view in 2 cases without any sign of implant failure and correction loss.</p><p><b>CONCLUSIONS</b>Posterior hemivertebra resection with monosegmental fusion of the two adjacent vertebra allows for early intervention in very young children. Excellent correction in the frontal and sagittal planes can be obtained. And a short segment of fusion allows for normal growth in the unaffected parts of the spine. The most common complication is implant failure.</p>

Expression of chondromodulin-1 in the adult degenerative intervertebral disc / 中华外科杂志

<p><b>OBJECTIVES</b>To investigate the expression of chondromodulin-1 (ChM-I) in human adult degenerative intervertebral disc (IVD) cells and the relationship between ChM-I expression and disc degeneration.</p><p><b>METHODS</b>Three degenerated disc specimens obtained from patients in the treatment of disc degenerative disease from March to April 2009 were used for cell culture. ChM-I expression in IVD cells was examined by RT-PCR and Western blot. The effect of basic fibroblast growth factor (bFGF) on the expression of ChM-I was assessed by real-time PCR and Western blot. From October 2008 to October 2009, 26 human IVD tissues were obtained from patients in the surgical treatment of disc degenerative disease at different stage of degeneration according to MRI. Six IVD tissues removed from patients with metastatic spinal tumor were used as normal control. The expression of ChM-I determined by immunohistochemical analysis was correlated with MRI degeneration grade.</p><p><b>RESULTS</b>RT-PCR and Western blot examination showed that ChM-I was expressed in both adult degenerative anulus fibrosus and nucleus pulposus cells. The mRNA and protein expression of ChM-I were both down-regulated by administration of bFGF with dose-dependent way (P < 0.05). Immunohistochemical analysis showed the percent of ChM-I immunopositive cells in the control group was 0.12 ± 0.03, and the number increased significantly in the advanced degeneration group (P < 0.05).</p><p><b>CONCLUSIONS</b>The current results demonstrate that IVD cells express ChM-I. Administration of bFGF down-regulates the expression of ChM-I. The expression of ChM-I is correlated with the degree of IVD degeneration which means it may involve in the process of IVD degeneration.</p>

Radiological evaluation of intervertebral angles on short-segment fusion of degenerative lumbar scoliosis / 中华外科杂志

<p><b>OBJECTIVE</b>To analyze the radiological change of intervertebral angles after the short-segment fusion of degenerative lumbar scoliosis.</p><p><b>METHODS</b>From January 2001 to May 2007, 28 patients (mean age 62 years old) with degenerative lumbar scoliosis, including 6 male and 22 female, were reviewed retrospectively. The average vertebra number in the lumbar curve were 4.8, ranging from 3 to 6. All the patients underwent posterior decompressive laminotomy, pedicle screw fixation, and posterolateral fusion. The fusion levels were within the curve in all the cases (mean 3.3 vertebrae), without exceeding the end vertebrae. All the patients took standing lumbar antero-posterior and sagittal radiological images pre and post-surgery and upon follow up. The coronal scoliosis Cobb angle, anterior and sagittal intervertebral angles of upper adjacent segment of proximal fused vertebra were measured. The following aspects were also evaluated such as bone graft fusion and complications.</p><p><b>RESULTS</b>Follow up period of 25-97 months, average 50 months; post-operative scoliosis Cobb angle average correction rate was 33.7%, final follow up average correction loss was 3.7 degrees , pre-operative and final follow up results compared with post-operative indicated significant difference (P < 0.05); final follow-up antero-posterior proximal upper fusion segment intervertebral angle compared with pre-operative and postoperative presenting significant difference (P < 0.05). Upon final follow up, all cases did not present pseudo-arthrosis or internal instrumentation related complications.</p><p><b>CONCLUSION</b>For degenerative lumbar scoliosis, short-segment fusion can produce limited correction on antero-posterior proximal upper fusion segment intervertebral angle and cannot stop its aggravation.</p>

Postoperative disc wedging in adolescent idiopathic thoracolumbar/lumbar scoliosis: a comparison of anterior and posterior approaches / 中国医学科学杂志(英文版)

<p><b>OBJECTIVE</b>To evaluate the different influences of anterior and posterior correction and fusion approaches upon disc wedging in adolescent idiopathic thoracolumbar/lumbar scoliosis.</p><p><b>METHODS</b>The retrospective study was conducted with the medical records and radiographs of adolescent idiopathic thoracolumbar/lumbar scoliosis patients that underwent anterior (group A) or posterior (group B) correction and fusion surgery from December 1998 to May 2008. The correction of the main curve and changes of the disc wedging were analyzed.</p><p><b>RESULTS</b>Fifty-three patients were included, 26 in group A and 27 in group B. The mean coronal Cobb angles of the main curve in group A and group B were significantly corrected after surgery (P < 0.05), with an average correction rate of 75.2% and 88.2%, respectively. Upon final follow-up, the coronal Cobb angles of the two groups were 18.90 +/- 11.1 degrees and 7.70 +/- 5.6 degrees, respectively, with an average correction loss of 6.8 degrees +/- 6.5 degrees and 2.7 degrees +/- 3.3 degrees, respectively. The coronal Cobb angle after operation and at final follow-up, and the correction rate were significantly better in group B than those in group A (P < 0.05), while the coronal Cobb angle loss in group A was greater than that in group B (P < 0.05). The disc wedging before operation, after operation, and at final follow-up were 3.2 degrees +/- 3.0 degrees, 5.7 degrees +/- 3.0 degrees, and 8.6 degrees +/- 4.4 degrees in group A, and 2.4 degrees +/- 3.2 degrees, 3.3 degrees +/- 3.4 degrees, and 3.7 degrees +/- 3.6 degrees in group B, respectively. Postoperative disc wedging was significantly larger compared with preoperative measurements in group A (P < 0.05), but not in group B (P > 0.05). The difference between disc wedging at final follow-up and that after surgery was significant in group A (P < 0.05), but not in group B (P > 0.05). Between the two groups, group A had larger disc angles after operation and at final follow-up (P < 0.05), and a greater loss of disc angle (P < 0.05).</p><p><b>CONCLUSION</b>For adolescent idiopathic thoracolumbar/lumbar scoliosis, posterior approach using all pedicle screws might produce a better result in terms of disc wedging compared with anterior approach.</p>

Primary effect of dual growing rod technique for the treatment of severe scoliosis in young children / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Treatment of rapidly progressing scoliosis in young children is a challenge for spine surgeons. Some surgeons had begun to use dual growing rod technique for treatment of rapidly progressing scoliosis in young children and had achieved acceptable results. The aim of this study was to determine the primary results and complications of this new technique in China.</p><p><b>METHODS</b>Eleven children suffering from rapidly progressing scoliosis were treated with dual growing rod technique between November 2004 and March 2009 at Peking Union Medical College Hospital (PUMCH). There were 10 females and 1 male in the group with Risser sign of 0 grade. The mean age at initial surgery was 6.1 years (range, 2.1-10.9 years). Ten patients were diagnosed as congenital scoliosis and 1 patient neuromuscular scoliosis. All the patients had 1-4 lengthening procedures (mean, 1.8 procedures) after the initial surgeries. The radiographic results of all the patients were investigated.</p><p><b>RESULTS</b>The coronal Cobb angle of scoliosis improved from (67.64+/-11.43) degrees to (34.64+/-8.26) degrees after initial surgery with the correction rate observed at (47.15+/-16.48)%. The coronal trunk shift improved from (2.00+/-1.73) cm to (1.49+/-1.31) cm after initial surgery. The T1-S1 height increased from (25.47+/-6.16) cm to (28.84+/-5.69) cm after initial surgery. The coronal Cobb angle of scoliosis was (36.82+/-11.76) degrees and the coronal trunk shift was (1.11+/-1.29) cm after the most recent lengthening procedure with the most recent correction rate observed at (44.73+/-19.43)%. The T1-S1 height was (31.29+/-4.50) cm after the most recent lengthening procedure with an average T1-S1 length increase of 1.6 (range, 1.0-2.7) cm per year during the lengthening period. The sagittal balance was maintained. Five of the total patients (45.5%) had complications including: hook displacement, pedical screw loosening, and broken rod. We performed revision surgeries with simultaneous lengthening procedures in all 5 cases with satisfactory results.</p><p><b>CONCLUSIONS</b>The dual growing rod technique was useful in the management of rapidly progressing scoliosis in young children. This technique could control severe scoliosis, allow for spinal growth, and maintain the coronal and sagittal balance. But the technique has high complications requiring strict and regular follow-up.</p>

Clinical features of adolescent idiopathic scoliosis with thoracolumbar kyphosis and its surgical treatment / 中华外科杂志

<p><b>OBJECTIVE</b>To summarize the clinical features and evaluate the surgical results of adolescent idiopathic scoliosis (AIS) with thoracolumbar kyphosis.</p><p><b>METHODS</b>Four hundred and thirteen AIS patients were retrospectively reviewed between January 2001 and January 2007. Among them, 10 patients had thoracolumbar kyphosis, including 2 males and 8 females. The average age at surgery was 14.3 years old. There were 3 PUMC type IIb2, 4 PUMC IIc3, 1 PUMCIId2, 2 PUMC IIIb. Eight patients underwent posterior correction and spinal fusion with instrumentation, 2 patients underwent anterior release, posterior correction and spinal fusion with instrumentation. By reviewing the roentgenograms of patients, the curve type, Cobb angle, flexibility, apical rotation and translation, coronal and sagittal trunk shift and thoracolumbar kyphosis were measured and analyzed.</p><p><b>RESULTS</b>Eight patients had double curves and 2 patients had triple curves. Among them, the Cobb angles of thoracolumbar or lumbar curve were larger than 45 degrees in 7 patients, the flexibility index was less than 70% in 6 patients, the apical vertebral rotation was larger than II degrees in 9 patients and the apical vertebral translation was larger than 2 cm in all patients. All the surgical treatment strategy and fusion level followed the criteria of PUMC classification. The coronal Cobb angles of thoracic curve before and after surgery were 71.7 degrees and 37.4 degrees respectively, and the average correction rate was 47.8%. The coronal Cobb angles of thoracolumbar or lumbar curve before and after surgery were 65.0 degrees and 27.8 degrees respectively, and the average correction rate was 57.2%. The Cobb angles of thoracolumbar kyphosis before and after surgery were 35.5 degrees and 4.2 degrees respectively, and the average correction rate was 88.2%. No trunk decompensation was noted at final follow-up. All patients were followed-up from 12 to 72 months; the average follow up was 23.1 months.</p><p><b>CONCLUSIONS</b>AIS patients with thoracolumbar kyphosis usually have double or triple curves. In these patients, thoracolumbar curves or lumbar curves are severe and have obvious rotatory deformity. Thoracolumbar curve or lumbar curve should be fused in idiopathic scoliosis patients with thoracolumbar kyphosis to avoid trunk decompensation or junctional kyphosis. By using criteria of PUMC classification, these patients can be well identified and corresponding fusion level can be followed as well.</p>