Effects of Gardenia jasminoides extracts on cognition and innate immune response in an adult Drosophila model of Alzheimer's disease / 中国天然药物

Herbal extracts have been extensively used worldwide for their application on memory improvement, especially among aged and memory-deficit populations. In the present study, the memory loss induced by human Abeta protein over-expression in fruitfly Alzheimer's disease (AD) model was rescued by multiple extracts from Gardenia jasminoides. Three extracts that rich with gardenia yellow, geniposide, and gardenoside components showed distinct rescue effect on memory loss. Further investigation on adding gardenoside into a formula of Ganoderma lucidum, Panax notoginseng and Panax ginseng (GPP) also support its therapeutic effects on memory improvement. Interestingly, the application of GPP and gardenoside did not alter the accumulation of Abeta proteins but suppressed the expression of immune-related genes in the brain. These results revealed the importance and relevancy of anti-inflammation process and the underlying mechanisms on rescuing memory deficits, suggesting the potential therapeutic use of the improved GPP formulation in improving cognition in defined population in the future.

Chemical constituents from inflorescences of Tilia amurensis / 中草药

Objective: To study the chemical constituents from the inflorescences of Tilia amurensis. Methods: The chemical constituents were separated and purified by silica gel, Sephadex LH-20, ODS column chromatographies, and preparative HPLC. Their structures were determined by physicochemical properties and spectral data. Results: Fourteen compounds were isolated from the ethyl acetate fraction of 70% ethanol extract in the inflorescences of T. amurensis, and identified as linarin (1), soquercitrin (2), quercetin (3), astragalin (4), tiliroside (5), 5, 7, 4'-trihydroxy-3'-methoxy isoflavone (6), orobol (7), quercetin-3-O-α-L- arabinopyranoside (8), friedelin (9), β-sitosterol (10), protocatechuic acid (11), theophylline (12), caffeine (13), and palm alcohol (14). Conclusion: Compounds 1-5, 7, 8, and 10-12 are isolated from this plant for the first time, and compound 7 is found in the plants of Tilia Linn. for the first time.

Risk factors of thoracic curve decompensation after anterior selective fusion in adolescent idiopathic scoliosis with major thoracolumbar or lumbar curve / 中华外科杂志

<p><b>OBJECTIVES</b>To investigate the incidence of thoracic curve decompensation or proximal adding-on phenomenon after anterior selective fusion of thoracolumbar or lumbar curve in Lenke type 5 adolescent idiopathic scoliosis (AIS), and to identify its risk factors.</p><p><b>METHODS</b>From June 2001 to December 2008, 130 Lenke type 5 AIS patients with a Cobb angle of 40° - 73° treated with anterior selective thoracolumbar or lumbar fusion, and with a minimum 2-year postoperative regular follow-up were recruited in this study. The average age, Cobb angle and Risser sign of all patients was 14.8 ± 1.6 years, 46° ± 6° of major thoracolumbar or lumbar curve (TL or L), 25° ± 7° of proximal thoracic curve and 0-5, respectively. The patients were grouped according to the relationship between the upper instrumented vertebrae (UIV) and the upper end vertebrae (UEV), the patients' Risser sign and the relationship between UIV and C(7) plumb line (C(7)PL). The radiographic data of the patients were compared between patients with and without proximal adding-on by using t test, and the incidence of proximal adding-on was analyzed in terms of determination of UIV and Risser sign to identify the risk factors of this phenomenon by using Fisher's exact test.</p><p><b>RESULTS</b>Eleven patients were identified with proximal adding-on, thus the incidence of it was 8.5%. At last follow-up postoperatively, the average Cobb angle of TL or L and proximal thoracic curve was 9° ± 4° and 11° ± 5°, respectively. Moreover, the incidence of adding-on in Rissex sign grade 0 to 1 (3/8) was higher than that of grade 2 to 3 (12.1%) and grade 4 to 5 (4.5%). In addition, the incidence of adding-on in UIV lower than UEV group (20.6%) was obviously higher than that of UIV higher than or equal to UEV group (4.2%). The incidence of adding-on for patients with C(7)PL falls away from UIV (19.5%) were obviously higher than that of patients with C(7)PL falls between the pedicle and lateral margin of UIV (3.6%) and between bilateral pedicles of UIV (3.0%). Each group showed significant difference for the incidence of adding-on by Fisher's exact test (P < 0.05).</p><p><b>CONCLUSIONS</b>There exists the risk of proximal thoracic curve decompensation, with a not low rate, after anterior selective fusion for major TL or L curve AIS. The determination of UIV relative to UEV and the skeletal maturity of the patient are the two factors closely associated with the presence of such a phenomenon.</p>

Early outcome of vertical expandable prosthetic titanium rib technique in treating early-onset scoliosis / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the early outcome of vertical expandable prosthetic titanium rib (VEPTR) technique in treating early-onset scoliosis.</p><p><b>METHODS</b>This study recruited 11 early-onset scoliosis patients (8 boys and 3 girls) who received VEPTR treatment from December 2006 to July 2011 with a minimum follow-up of 12 months. The average age at initial surgery was (7 ± 3) years (range, 3.1 to 9.8 years). VEPTR device, either rib to rib or rib to lumbar, was implanted at initial surgery. During the regular post-operative follow-ups, expansion surgeries were scheduled at an interval of 6 to 12 months. Measurements of primary curve magnitude, apical vertebral translation, thoracic height and T(1)-S(1) height were performed on radiographs, and were compared between those of preoperatively, postoperatively, and at latest follow-up through paired-t tests.</p><p><b>RESULTS</b>All patients had a mean follow-up of (32 ± 11) months. Totally 41 surgeries were performed, averagely 3.7 surgeries per patient; and 30 expansion surgeries were carried out, averagely 2.7 surgeries per patient. The average interval for each expansion surgery was 8 months. From preoperatively to latest follow-up, the Cobb angle of primary curves was averagely corrected from 78° ± 18° to 55° ± 11° (t = 4.931, P < 0.05), and apical vertebral translation and thoracic kyphosis displayed slight improvement. Average thoracic height increased from (13.3 ± 2.0) cm to (17.2 ± 2.4) cm (t = 8.365, P < 0.001), and average T(1)-S(1) height from (24.4 ± 3.8) cm to (32.5 ± 5.3) cm (t = 9.080, P < 0.001). After initial surgery with VEPTR instrumented, gains in thoracic height and T(1)-S(1) height per expansion surgery averaged (0.8 ± 0.3) cm and (1.8 ± 0.4) cm, respectively. Eight complications occurred in 6 patients, including rib cradle dislodgements, displayed infection, intraoperative pleura rupture and loosening of lumbar pedicle screws.</p><p><b>CONCLUSIONS</b>VEPTR technique proves to be an effective way of preventing curve progression in early-onset scoliosis patients while allowing growth of spine and chest. Yet, indications for such a technique need to be strictly selected because of the relatively high complication rate.</p>

Long term outcome of video-assisted thoracoscopic surgery for thoracic adolescent idiopathic scoliosis / 中华外科杂志

<p><b>OBJECTIVE</b>To study the long term outcomes and complications of video-assisted thoracoscopic surgery (VATS) in correcting thoracic adolescent idiopathic scoliosis (T-AIS) with more than five-year follow-up.</p><p><b>METHODS</b>The T-AIS patients underwent corrective surgery by VATS between June 2002 and December 2006 and experienced more than five-year follow-up were retrospectively reviewed. Nine female patients with T-AIS were recruited with a mean age of 14.3 years (range 11 - 16 years) at operation. Radiological parameters including thoracic and lumbar curves, thoracic kyphosis (T(5)-T(12)), sagittal alignment of the thoracolumbar junction (T(10)-L(2)) and lumbar lordosis (T(12)-S(1)) were measured on the X-rays taken preoperatively, 3 months, 2 year postoperatively and at latest follow-up. Complications occurred after operation and during follow-up were retrieved. The Chinese edition SRS-22 was finished by patients at the latest follow-up. Repeated-measures analysis of variance and paired t test were used for statistical analysis.</p><p><b>RESULTS</b>The patients were followed for a mean of 6.2 years (5 - 7.5 years) after VATS. The mean thoracic curve was corrected from 51° ± 8° preoperatively to 20° ± 8° at 3 months post-operation, and 21° ± 12° and 25° ± 13° at 2 year post-operation and latest follow-up, respectively. During the follow-up, no significant changes were observed regarding to coronal and sagittal radiological parameters (P > 0.05). Rod breakage occurred in 1 patient and Adding on was found in another one patient 2 year post-operation. Revision surgery was not needed for the solid fusion achieved and lack of correction loss. The mean score of SRS-22 at final follow-up was 4.3 ± 0.3, with high score in most of the domains.</p><p><b>CONCLUSIONS</b>Loss of curve correction and implant-related complication are found in VATS-treated T-AIS patients at the long-term follow-up. Although the patients show high scores in SRS-22, which indicated higher functional outcome and satisfaction to the operation, special care should be taken for applying VATS to T-AIS patients for the concern of long-term complication.</p>

A comparative study on the surgical outcomes of spinal fusion in adolescent idiopathic scoliosis patients with or without triradiate cartilages closed / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the effect of potential spinal growth on the posterior-only spinal instrumentation of adolescent idiopathic scoliosis (AIS).</p><p><b>METHODS</b>From June 2003 to October 2007, 40 patients received posterior-only spinal instrumentation. Group of open triradiate cartilage (Group A) included 16 female AIS patients with mean age of 11.8, and group of closed triradiate cartilages (Group B) covered 24 female AIS patients with mean age of 13.7. The mean preoperative Cobb angles of Group A and B were 53.3° and 49.6° respectively, and the mean kyphosis in the sagittal plane was 27.7° and 27.8° respectively.</p><p><b>RESULTS</b>The post-operative Cobb angles were 22.2° (Group A) vs. 20.7° (Group B) (P = 0.34) with correction rate of 58.3% (Group A) vs. 57.7% (Group B) (P = 0.83). The mean Cobb angles at final follow-up were 24.8° (Group A) vs. 21.1° (Group B) (P = 0.05) with the correction loss of 5.3% (Group A) vs. 1.0% (Group B) (P = 0.01). In the sagittal plane, the average post-operative kyphosis was 22.5° (Group A) vs. 23.9° (Group B) (P = 0.49) with correction of 5.2° (Group A) vs. 3.9°(Group B) (P = 0.63). The mean kyphosis at final follow-up was 20.8°(Group A) vs. 24.7°(Group B) (P = 0.04) with the correction loss of -1.7° (Group A) vs. 0.8°(Group B) (P = 0.01). Group A showed obvious correction loss in the coronal plane and decrease of kyphosis in the sagittal plane. Adding on phenomenon was found in 2 cases with Lenke type I with selected fusion in Group A, but not in Group B.</p><p><b>CONCLUSIONS</b>Although similar post-operative correction is found in AIS patients with OTRC or CTRC, the loss of correction and "adding on phenomenon" are more likely to happen in patients with OTRC.</p>

Effects of genistein and folic acid on neuronal membrane and mitochondrial membrane damaged by β-amyloid peptides 31-35 / 中华预防医学杂志

<p><b>OBJECTIVE</b>To observe the neuro-protective effects of genistein (Gen) and folic acid (FA) on neurons membrane and mitochondrial membrane damaged by β-amyloid peptides 31-35 (Aβ31-35).</p><p><b>METHODS</b>The primary cultured rat cerebral cortical neurons were randomly divided into DMEM (control), Aβ31-35 (25 µmol/L), Gen (Gen 27 µg/ml), FA (FA 40 µg/ml) and Gen + FA (Gen 27 µg/ml + FA 40 µg/ml). Gen and/or FA were added two hours before Aβ31-35 addition. After twenty four hours, MTT assay was performed to measure the viability of cultured neurons. Fluorescence polarization was performed to observe the neuron cell membrane fluidity. The mitochondrial membrane potential (MMP) was determined to investigate the alteration of mitochondrial structure and function of neurons by laser scanning confocal microscope and a flow cytometer was used to investigate the activation of mitochondrial permeability transition pore (MPTP). Each experiment was repeated three times.</p><p><b>RESULTS</b>Compared with group Aβ31-35 (0.845 ± 0.050, F = 4.931, P < 0.05), the absorbance was significantly higher in group Gen (0.982 ± 0.110, t = 3.523, P < 0.01), FA (0.947 ± 0.061, t = 2.745, P < 0.01) and Gen + FA (0.996 ± 0.090, t = 3.966, P < 0.01). The viscosity of cell neuron membrane in group Gen (1.75 ± 0.28, t = 2.085, P < 0.05), FA (1.66 ± 0.37, t = 2.357, P < 0.05) and Gen + FA (1.50 ± 0.20, t = 3.784, P < 0.05) was significantly lower than that in group Aβ31-35 (2.11 ± 0.44, F = 5.529, P < 0.01), which indicated the cell membrane fluidity was significantly higher in group Gen and/or FA than that in group Aβ31-35. MMP was significantly decreased by Aβ31-35 (3.364 ± 1.140, t = 3.949, P < 0.01) when comparing to control group (6.383 ± 1.683), while it was significantly increased by Gen (5.286 ± 1.792, t = 2.406, P < 0.05), FA (5.884 ± 2.022, t = 2.887, P < 0.01) and Gen + FA (6.120 ± 2.124, t = 3.304, P < 0.01) when comparing to group Aβ31-35 (F = 7.585, P < 0.01). MPTP was activated by Aβ31-35 and Gen and/or FA could reverse this progress.</p><p><b>CONCLUSION</b>Gen and/or FA could protect the neuronal and mitochondrial membrane from the impairment induced by Aβ31-35.</p>

Pulmonary dysfunction patterns in patients with Marfan and Marfanoid syndrome associated with scoliosis and the influencing factors / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the impairment pattern and the influencing factors of pulmonary function in patients with Marfan and Marfanoid syndrome associated scoliosis (MS).</p><p><b>METHODS</b>In this retrospective study, totally 25 MS patients (aged 11 - 20 years, 11 boys and 14 girls) who received posterior instrumentation and fusion (Group A) and 38 adolescent idiopathic scoliosis (AIS) patients (Group B) (aged 10 - 19 years, 11 boys and 27 girls) were included from February 1998 to September 2007. The curve pattern was matched in both groups. The preoperative pulmonary function test (PFTs) were compared in two groups. And the parameters influencing the preoperative pulmonary function were analyzed in group A.</p><p><b>RESULTS</b>In Group A, the Cobb angle of thoracic curve was negatively correlated with the percentage of predicted pulmonary volumes (VC%, FVC% and FEV1%) (r = -0.514, -0.503, -0.464, P < 0.05). And the reduction of lung function parameters (VC%, FVC%, FEV1% and MMEF%) was more severe in Group A than in Group B with compared magnitude of thoracic curve (P < 0.05). In Group A, the extent of impairment of pulmonary function in patients with the number of vertebrae involved ≥ 8 were more severe than those involved < 8 vertebrae (P < 0.05). However, there was no significant difference of deterioration of lung function between the higher apex (T₄₋₈) subgroup and lower apex (T₉₋₁₂) subgroup. And no correlation was found between thoracic kyphosis and the degrees of impairment of respiration function.</p><p><b>CONCLUSIONS</b>Patients with MS have mixed ventilation dysfunction, which is more severe than AIS patients with matched age and Cobb angle. The pulmonary dysfunction in MS patients can be influenced by the severity of thoracic curve and the number of involved vertebrae.</p>

Efficacy of preoperative Halo-femoral traction in the treatment of rigid idiopathic scoliosis / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate the efficacy of preoperative Halo-femoral traction in the treatment of rigid idiopathic scoliosis.</p><p><b>METHODS</b>Sixteen patients with rigid idiopathic scoliosis treated with Halo-femoral traction before posterior spine fusion from July 2003 through May 2006 were studied retrospectively. There were 4 male and 12 female, with a mean age of 16 years (range, 12-20 years). The coronal Cobb angles of coronal major curve and the thoracic kyphosis (T(5)-T(12)) were 111 degrees and 64 degrees, respectively. All the patients underwent preoperative Halo-femoral traction. After the maximum weight traction for 2-3 weeks, a posterior instrumentation and fusion was performed. The correction rate of coronal major curve on preoperative side bending film, on supine film after Halo-femoral traction and after surgery was compared.</p><p><b>RESULTS</b>The maximum traction weight averaged 19 kg. All patients had an at least 12-month follow-up. One patient experienced transient brachial plexus palsy and complete recovery was achieved after reducing the traction weight. No neurologic complication, death and respiratory failure occurred after surgery. In comparison to the correction rate of 18.7% on preoperative side bending film, the correction rate of coronal major curve after Halo-femoral traction increased by 13.2% (P < 0.05). The postoperative correction rate of coronal major curve and thoracic kyphosis was 48.6% and 51.9%, respectively. At the final follow-up, the coronal and sagittal correction loss averaged 2.0% and 5.8%, respectively.</p><p><b>CONCLUSIONS</b>Preoperative Halo-femoral traction combined with intraoperative posterior spinal release can significantly enhance the correction rate for rigid idiopathic scoliosis. However, the traction complications should be worthy of vigilance.</p>

Early outcome of one-stage posterior transpedicular hemi-vertebra resection in the treatment of children with congenital scoliosis / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate the early outcomes of children with congenital scoliosis treated by one-stage transpedicular hemi-vertebra resection.</p><p><b>METHODS</b>From July 2005 to June 2006, 27 consecutive cases of congenital scoliosis managed by one-stage transpedicular hemi-vertebra resection with instrumentation were investigated retrospectively. There were 11 girls and 16 boys, with a mean age of 5.5 years at surgery (range 1.3 - 10.0 years). Location of the hemi-vertebra was in the thoracic spine in 12 cases and in the lumbar spine in 15 cases. Radiographic evaluations were performed on the preoperative, postoperative, and latest follow-up standing posteroanterior and lateral radiographs.</p><p><b>RESULTS</b>The average operation time was 4 hours (range 3-6 hours), and the mean blood loss during operation was 750 ml (range 300 - 2200 ml). The mean fusion level was 2 to 7 segments, average 4.4 segments. The average follow-up period was 16 months (range 12 - 34 months). Mean Cobb angle of the total main curve was 40.0° before surgery, 12.6° after surgery, and 15.2° at latest follow-up. Mean Cobb angle of the segmental main curve was 35.6° before surgery, 11.6° after surgery, and 12.1° at latest follow-up. The trunk shift was improved from 16.5 mm before operation to that of 7.5 mm after the operation and 7.6 mm at the latest follow-up. Compensatory cranial curve improved from 19.4° before surgery to 8.9° after surgery, and compensatory caudal curve improved from 26.3° to 12.8°. The angle of segmental kyphosis was 26.4° before surgery and 14.6° after surgery in cases with thoracic hemivertebrae, and averaged 11.2° before surgery and 3.9° after surgery in cases with lumbar hemivertebrae. Peri-operative complications included two pedicle screws malpositioning and one case with pelvic tilt. There was no neurological complication.</p><p><b>CONCLUSION</b>One-stage transpedicular hemi-vertebra resection with instrumentation has a good capability of correcting deformity on the frontal and sagittal planes, which is available in children with middle or lower thoracic or lumbar hemivertebrae.</p>

The value of somatosensory evoked potential in the clinical evaluation of congenital scoliosis with and without intraspinal malformations / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the value of somatosensory evoked potential (SEP) in the diagnosis of congenital scoliosis (CS) with intraspinal malformation.</p><p><b>METHODS</b>From September 2001 to September 2007 posterior tibial nerve SEP were performed on 187 operatively treated CS patients. There were 85 male and 102 female, and the average age was 13.8 years (range from 30 to 22 years). Patients with intraspinal malformations were diagnosed by MRI. Absence of SEP waveforms, prolongation of peek latency or asymmetrical peek latency were defined as pathological change. The incidence of pathological SEP and clinical characteristics were compared between patients with and without intraspinal malformations.</p><p><b>RESULTS</b>Of 187 patients, intraspinal malformations were diagnosed in 32 patients (17.1%). The incidence of intraspinal malformations was higher in type III (30.8%) than in type I and II CS patients (P < 0.05). The mean Cobb angle of scoliosis in patients with intraspinal malformations was greater than without intraspinal malformations, but there was no difference in kyphosis between the two groups. The ratio of abnormal SEP in patients with intraspinal malformations was 75.0% (24/32), while it was 38.7% (60/155) in patients without intraspinal malformations, and it showed significant difference between the two groups (χ(2) = 4.70, P < 0.05).</p><p><b>CONCLUSIONS</b>SEP is a reliable tool for assessment of spinal cord function in patients with congenital scoliosis. It could be helpful for the diagnosis of intraspinal malformations, and also might provide an important reference for assessment and treatment of intraspinal malformations in congenital scoliosis.</p>

Characteristic of somatosensory evoked potentials in adolescent idiopathic scoliosis and relationship with Cobb angle / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the abnormality of somatosensory evoked potentials (SEPs) in adolescent idiopathic scoliosis (AIS) with different curve magnitudes, and to explore its effect on the etiopathogenesis of AIS.</p><p><b>METHODS</b>Posterior tibial nerve SEPs were evaluated on 489 young operative treated AIS patients with a Cobb angle >40 degrees and 45 age-matched healthy control individuals. Absence of SEPs waveforms, prolongation of peek latency or asymmetrical peek latency were defined as pathological change. Base on the control reference, the incidence of pathological SEPs was determined in AIS group. The association of abnormal SEPs and curve severity for AIS patients was also assessed.</p><p><b>RESULTS</b>Peek latency corrected for body height was slightly longer in AIS patients than in controls, however, with no significant difference. Inter side difference of latency was significantly larger in AIS patients. Abnormal SEPs were found in 166 of 489 AIS patients. Among these, 17 (10.2%) showed absent waveforms, 50 (30.1%) had unilateral latency prolongation, 38 (22.9%) had bilateral latency prolongation, and 120 (72.3%) showed significant inter side difference. Statistical analysis failed to show a correlation between abnormal SEPs and the curve severity of spinal deformity.</p><p><b>CONCLUSION</b>Disorder of somatosensory pathways does exist in a subgroup of AIS patients, and it might be a primary factor other than secondary change, and could play an import role in the etiopathogenesis of AIS.</p>

Study of relationship between position of the cerebellar tonsil and abnormal somatosensory evoked potentials in adolescent idiopathic scoliosis / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the abnormality of position of the cerebellar tonsil and somatosensory evoked potentials (SEP) in adolescent idiopathic scoliosis (AIS), and to explore its clinical significance.</p><p><b>METHODS</b>Sagittal magnetic resonance imaging (MRI) of hindbrain and posterior tibial nerve SEP (PTN-SEP) were performed on 171 young operative treated AIS patients. The PTN-SEP obtained from 45 age-matched healthy control individuals were considered as standard values. Tonsillar ectopia (TE) was defined as any inferior displacement of the tonsils. Absence of SEP waveforms, prolongation of peek latency or asymmetrical peek latency were defined as pathological change. The incidence of TE and pathological SEP was determined in all AIS patients. The association of TE and abnormal SEP for AIS patients was also assessed.</p><p><b>RESULTS</b>The incidence of TE and abnormal SEP in AIS patients was 36.8% (63/171) and 36.3% (62/171), respectively. It was shown the frequency of TE and abnormal SEP were not significantly different among AIS patients with different curve severity. Statistical analysis failed to show a correlation between TE and abnormal SEP.</p><p><b>CONCLUSIONS</b>TE and disorder of somatosensory pathways do exist in a subgroup of AIS patients. However, there is not a significant association between TE and abnormal somatosensory function. It is suggested that TE and disorder of somatosensory function might contributes to different etiopathogenesis of AIS.</p>

Neurotoxicity of beta-amyloid peptide 31-35 and 25-35 to cultured rat cortical neurons / 中华预防医学杂志

<p><b>OBJECTIVE</b>To compare the toxicity of mechanism beta amyloid peptide (Abeta) 25-35 and 31-35 to cultured rat cortical neurons.</p><p><b>METHODS</b>The primary rat cerebral cortical neurons of rat were cultured 48 hours and randomly divided into control, Abeta25-35 (25 micromol/L)and Abeta31-35 (25 micromol/L) treated groups. After twenty four hours culturing, the cells were collected MTT assay was performed to measure the viability of cultured neurons. The mitochondrial membrane potential was determined to investigate the alteration of mitochondrial structure and function of neurons by laser scanning confocal microscope. The DNA damage of neurons was measured by single cell gel electrophoresis. The expressions of Bcl-2, Bax and p53 gene were measured by reverse transcriptase polymerase chain reaction (RT-PCR). Each experiment was repeated three times.</p><p><b>RESULTS</b>The absorbance (0.746 +/- 0.071, 0.811 +/- 0.083) and fluorescence intensity (3.050 +/- 0.240, 2.806 +/- 0.203) of neurons in Abeta25-35 and 31-35 treated group were significantly lower (t(A) were 4.023 and 5.401, t(fluorescence intensity) were 9.524 and 7.589 respectively, P < 0.01) than those in control group (1.038 +/- 0.125 and 4.280 +/- 0.358 respectively). The percentage of comet cells (59.0%, 48.5%) and tail length (57.3 +/- 4.7, 54.2 +/- 6.8) microm in Abeta25-35 and 31-35 treated group were significantly higher (chi(2)(comet cell) were 99.397 and 137.071, t(tail length) were 19.058 and 29.173 respectively, P < 0.01) than those in control group (4.5% and (5.2 +/- 1.1) microm respectively). Compared with control group (Bax/Bcl-2 ratio 0.2090 +/- 0.0991, p53/beta-actin ratio 1.6560 +/- 0.0853), the Bax/Bcl-2 ratio (t value were 2.429 and 2.356 respectively, P < 0.05) and expressions of p53 (t value were 2.366 and 2.503 respectively, P < 0.05) gene were significantly increased (P < 0.05) in Abeta25-35 (Bax/Bcl-2 ratio 1.2774 +/- 0.0762, p53/beta-actin ratio 2.0284 +/- 0.2223) and Abeta31-35 (Bax/Bcl-2 ratio 1.0330 +/- 0.0683, p53/beta-actin ratio 1.9505 +/- 0.2725) treated group.</p><p><b>CONCLUSIONS</b>Neurotoxicity-induced by Abeta31-35 in cortical neurons is similar to that induced by Abeta25-35, which is possibly related to its direct neurotoxic and apoptotic effects to neurons.</p>

Radiologic analysis of factors predicting the surgical reduction of lumbar spondylolisthesis / 中华外科杂志

<p><b>OBJECTIVES</b>To find out the radiologic factors predicting the outcomes of reduction of lumbar spondylolisthesis.</p><p><b>METHODS</b>Forty two patients were treated with pedicle screw fixation with posterolateral fusion because of lumbar spondylolisthesis, with the average age of 56.0 years. There were 11 males and 31 females; 20 degenerative spondylolisthesis cases, and 22 isthmic spondylolisthesis cases; 1 L(3,4) case, 26 L(4,5) cases and 25 L(5)S(1) cases; 23 grade I patients and 19 grade II ones. All patients were taken the X-ray examination before operation and one week after operation. Measurements of slip ratio, percentage disc height, slip angle, lumbar lordosis angle and sacral slope angle were based on pre-operation X-rays. Measurements of the post-operation slip ratio were based on post-operation X-rays. Multivariate regression analysis was used to analysis the correlation between reduction ratio and pre-operation slip ratio, slip angle, percentage of disc height, lumbar lordosis angle and sacral slope angle.</p><p><b>RESULTS</b>The average pre-operation slip ratio was (22.5 +/- 10.6)%. The pre-operation percentage disc height was 0.23 +/- 0.10, the slip angle was 4.4 degrees +/- 5.4 degrees , the lumbar lordosis angle was 43 degrees +/- 13 degrees and the sacral slope angle was 34 degrees +/- 10 degrees . The reduction ratio was (63.2 +/- 27.9)%. No correlation was found among reduction ratio with pre-operation slip ratio, slip angle and sacral slope angle, but a positive correlation between reduction ratio and the pre-operation percentage of disc height (P < 0.05), a positive correlation between reduction ratio and the pre-operation lumbar lordosis angle (P < 0.05) was found.</p><p><b>CONCLUSION</b>The percentage disc height and the lumbar lordosis angle can predict the outcomes of reduction of lumbar spondylolisthesis.</p>

Misplacement patterns of the pedicle screws in surgical correction of patients with adolescent idiopathic scoliosis / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate and analyze the misplacement patterns of the pedicle screws in surgical correction of patients with adolescent idiopathic scoliosis.</p><p><b>METHODS</b>For this study, 70 consecutive cases of patients with adolescent idiopathic scoliosis treated by posterior instrumented spinal fusion with pedicle screws were investigated from July 2008 to September 2008. Postoperative CT scans were performed in all cases. The patients included 58 girls and 12 boys, with a mean age of 14.5 +/- 2.7 years at surgery (range 12 - 19 years). Pedicle screws were inserted using anatomic landmark with free hand technique. A number of parameters were measured using PacsClient software (PACS) on workstation, which included distances of the penetration of medial, lateral pedicle cortex and anterior vertebral cortex. The distance between edge of aorta and tip of screw should be measured if left pedicle screw penetrated lateral pedicle cortex or anterior vertebral cortex. Misplacement screws with > 2 mm of either pedicular cortex perforation and grievous screws with >4 mm of medial pedicle perforation or contour of aorta were defined. The influencing factors for misplacement screws were analyzed.</p><p><b>RESULTS</b>A total of 1030 pedicle screws were inserted, 773 in thoracic pedicle and 257 in lumbar pedicle. There were 108 (10.5%) misplacement screws, 35 of which penetrated lateral pedicle cortex, 56 of which penetrated medial pedicle cortex, 33 of which penetrated vertebral anterior cortex. Misplacement screw rate of apical vertebra, 5 segments above apical vertebra (AV-5s) and 4 segments below apical vertebra (AV + 4s) were higher than other levels. Most of grievous screws were placed in apical vertebra region.</p><p><b>CONCLUSIONS</b>The risk factors for misplacement screws included Cobb angle > 90 degrees and vertebrae rotation extent up to III-IV. Care should be exercised during pedicle screw instrumentation in the apical region of the main thoracic curve, AV-5s region and AV + 4s region.</p>

Spontaneous spinal epidural hematoma: early recognition and clinical evaluation / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate early recognition and clinical evaluation of spontaneous spinal epidural hematoma (SSEH) and to analyze the factors related to prognosis.</p><p><b>METHODS</b>Nine patients with SSEH were include in current study. There were 7 men and 2 women with a mean age of 45.4 years (range, 18-83 years). Etiological factors were noted in 9 patients, 3 with hypertension, 2 with angioma, 2 with laminar osteoblastoma, 1 with neuroblastoma, and 1 with thrombolysis treatment. Six patients presented with acute onset of neck or back pain. Two patients initially presented with incomplete paralysis. One patient emerged with ascending bilateral lower extremity weakness and loss of sensation after thrombolysis treatment. Neurologic deficit was four as Frankel A, two as Frankel B, one as Frankel C and two as Frankel D. Evacuation of the hematoma was carried out in eight patients. One patient of thrombolysis treatment was treated conservatively because of loss of optimum for operation.</p><p><b>RESULTS</b>Eight hematomas were located in thoracic region, one was found in the cervicothoracic region. Mean extension was 3.7 segments (range, 2-8 segments). One patient died of severe pulmonary infection 50 days postoperatively. The average follow-up observation was 7. 5 months. Evaluation of the neurological function showed that 2 patients being classified as Frankel B, 1 as Frankel D and 4 patients as Frankel E. There was no improvement of neurological function in 1 patient with conservative treatment.</p><p><b>CONCLUSIONS</b>The keys to the early diagnosis of SSEH are the characteristic of clinical symptoms, and the lesion site, the extent of the lesion demonstrated by MRI. The prognosis is worse for SSEH with etiological factor of hypertension. Early diagnosis and surgical treatment might get better results for SSEH resulting from tumour.</p>

Clinical evaluation of adolescent lumbar disc herniation misdiagnosed as idiopathic scoliosis / 中华外科杂志

<p><b>OBJECTIVE</b>To retrospectively review the clinical features and treatment strategy of lumbar disc herniation in adolescents initially misdiagnosed as idiopathic scoliosis.</p><p><b>METHODS</b>From 1998 to 2007, nineteen adolescents with lumbar disc herniation were admitted to our hospital. All of them presented a scoliotic curve as their first complaint. There were 10 males and 9 females with the age ranged from 14 to 20 years. The disc herniation located at L(4,5) in 10 patients, at L(5)S(1) in 7, and at L(4)-S(1) in 2. The Cobb angle ranged from 23 degrees to 38 degrees . The distance from the C(7) plumb line to the central sacral line averaged 4.7 cm. All the patients underwent conventional open discectomy, followed by a pelvic traction for 3 weeks. A cast fixation for one month was recommended for further correction of scoliosis if the curve improvement was not obvious.</p><p><b>RESULTS</b>Fourteen (73.7%) patients had a disc herniation at the convex side of lumbar curve, and 5 (26.3%) patients had a disc herniation at the concave side, which showed a marginal statistical correlation between the side of the disc herniation and the direction of lumbar curve (P = 0.07). Leg pain and numbness disappeared in the 19 patients after surgical decompression. After the pelvic traction for 3 weeks postoperatively, the Cobb angle reduced to 14 degrees, with the mean distance from the C(7) plumb line to the central sacral line of 2.2 cm. At a mean follow-up of 21 months, neither the recurrence of back pain and leg pain nor the loss of spontaneous scoliosis correction was found.</p><p><b>CONCLUSIONS</b>Care should be taken to the diagnosis of lumbar disc herniation in adolescents with spine deformity as their chief complaint. Satisfactory clinical results can be achieved by early diagnosis and proper treatment.</p>

The role of initial bone mineral status in predicting the early outcome of brace treatment in girls with adolescent idiopathic scoliosis / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate whether initial bone mineral status acts as a predictor factor in evaluating the early outcome of brace treatment in adolescent idiopathic scoliosis (AIS) girls.</p><p><b>METHODS</b>Seventy-seven girls with AIS, aged 10 - 15 years old, were included in this study. A standardized bracing protocol was performed in these girls, and the early outcomes of brace treatment were evaluated at over-1-year follow-up. Girls with a progressed scoliosis and those with a non-progressed scoliosis were identified. The associations between the outcome and the indices before bracing, including age, menstrual status, Risser grade, bone mineral density (BMD) status, curve magnitude and curve pattern were assessed using univariate analysis. A multiple Logistic stepwise regression was used to determine the risk factors in curve progression in AIS girls treated with brace treatment.</p><p><b>RESULTS</b>There were 16 girls (21%) with a progressed scoliosis and 61 girls (79%) with a non-progressed scoliosis, respectively. In the girls with a progressed scoliosis, higher ratios of subjects were found with pre-menarchal status (chi(2) = 9.628, P = 0.004), lower Risser grade (chi(2) = 4.565, P = 0.037), main thoracic scoliosis (chi(2) = 4.009, P = 0.045), a larger curve (chi(2) = 1.685, P = 0.194), as well as osteopenia (chi(2) = 3.828, P = 0.050), as compared with those with a non-progressed scoliosis. During brace treatment, besides pre-menarchal status, a larger Cobb angle, and a main thoracic scoliosis, osteopenia (OR = 5.362, P = 0.022) was identified as the risk factor in curve progression in AIS girls, as revealed by the multiple Logistic regression analysis.</p><p><b>CONCLUSIONS</b>Osteopenia might be an independent risk factor in the curve progression during brace treatment. The analysis of initial BMD status before bracing may help to predict the outcome of brace treatment.</p>

Study on correlation of soil nutrients and content of active constituents in root of Rumex gmelini / 中国中药杂志

<p><b>OBJECTIVE</b>To provide scientific basis for the selection of agrotype and property fertilization for Rumex gmelini cultivated in compliance with good agricultural practice (GAP).</p><p><b>METHOD</b>HPLC method was applied to determinate the content of seven active constituents (resveratrol, polydatin, chrysophanol 1-glucoside, nepodin, emodin, chrysophanol and physcion) of annual R. gmelini. And the correlation between soil nutrients and content of active constituents in the root of R. gmelini were analyzed by stepwise regression analysis.</p><p><b>RESULT</b>Seven regression equation were established. The statistic significance was found in three of them.</p><p><b>CONCLUSION</b>The soil with high total K level is not suitable for R. gmelini cultivation. But the higher available N, available P, available K level of soil is suitable.</p>