Comparison of Clinical Characteristics and Outcomes of Pediatric and Adult Patients with Coronavirus Disease 2019 in Shenzhen, China / 生物医学与环境科学（英文）

Objective@#Here we aimed to investigate the difference in clinical characteristics and outcomes between pediatric and adult patients with COVID-19.@*Methods@#A total of 333 consecutive patients with laboratory-confirmed SARS-CoV-2 infection treated in the departments of Internal medicine of Shenzhen Third People's Hospital from January 11 @*Results@#Compared with adult patients, pediatric patients had a shorter time of symptom onset to hospitalization than adults [median time, 1 ( @*Conclusion@#Pediatric patients with COVID-19 had milder or less clinical symptoms, less evident pulmonary imaging changes, better prognosis, and shorter length of hospital stay.

Prognostic Analysis of 102 Patients with Synchronous Colorectal Cancer and Liver Metastases Treated with Simultaneous Resection / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The liver is the most common site for colorectal cancer (CRC) metastases. Their removal is a critical and challenging aspect of CRC treatment. We investigated the prognosis and risk factors of patients with CRC and liver metastases (CRCLM) who underwent simultaneous resections for both lesions.</p><p><b>METHODS</b>From January 2009 to August 2016, 102 patients with CRCLM received simultaneous resections of CRCLM at our hospital. We retrospectively analyzed their clinical data and analyzed their outcomes. Overall survival (OS) and disease-free survival (DFS) were examined by Kaplan-Meier and log-rank methods.</p><p><b>RESULTS</b>Median follow-up time was 22.7 months; no perioperative death or serious complications were observed. Median OS was 55.5 months; postoperative OS rates were 1-year: 93.8%, 3-year: 60.7%, and 5-year: 46.4%. Median DFS was 9.0 months; postoperative DFS rates were 1-year: 43.1%, 3-year: 23.0%, and 5-year 21.1%. Independent risk factors found in multivariate analysis included carcinoembryonic antigen ≥100 ng/ml, no adjuvant chemotherapy, tumor thrombus in liver metastases, and bilobar liver metastases for OS; age ≥60 years, no adjuvant chemotherapy, multiple metastases, and largest diameter ≥3 cm for DFS.</p><p><b>CONCLUSIONS</b>Simultaneous surgical resection is a safe and effective treatment for patients with synchronous CRCLM. The main prognostic factors are pathological characteristics of liver metastases and whether standard adjuvant chemotherapy is performed.</p>

Evaluation of eight different clinical staging systems associated with overall survival of chinese patients with hepatocellular carcinoma / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Hepatocellular carcinoma (HCC) is a common cancer in China, an area of high hepatitis B virus (HBV) infection. Although several staging systems are available, there is no consensus on the best classification to use because multiple factors, such as etiology, clinical treatment and populations could affect the survival of HCC patients.</p><p><b>METHODS</b>This study analyzed 743 HBV-related Chinese HCC patients who received surgery first and evaluated the predictive values of eight different commonly used staging systems in the clinic.</p><p><b>RESULTS</b>The overall 1-, 3-, 5-year survival rates and a median survival were 91.5%, 70.3%, 55.3% and 72 months respectively. Barcelona Clinic Liver Cancer (BCLC) staging systems had the best stratification ability and showed the lowest Akaike information criterion (AIC) values (2896.577), followed by tumor-node-metastasis 7 th (TNM 7 th ) (AIC = 2899.980), TNM 6 th (AIC = 2902.17), Japan integrated staging score (AIC = 2918.085), Tokyo (AIC = 2938.822), Cancer of the Liver Italian Program score (AIC = 2941.950), Chinese University Prognostic Index grade (AIC = 2962.027), and Okuda (AIC = 2979.389).</p><p><b>CONCLUSIONS</b>BCLC staging system is a better staging model for HBV infection patients with HCC in Chinese population among the eight currently used staging systems. These identifications afford a large group of Chinese HCC patients with HBV infection and could be helpful to design a new staging system for a certain population.</p>

Application value of Provider-Initiated HIV Testing and Counseling in dermatology / 中华男科学杂志

<p><b>OBJECTIVE</b>To explore the clinical application value of Provider-Initiated HIV Testing and Counseling (PITC) by analyzing the positive rate of HIV tests for people in need of PITC and that of routine HIV tests.</p><p><b>METHODS</b>We retrospectively analyzed the demographic and epidemiologic data about the patients seeking PITC services or undergoing routine HIV tests in Nanjing Drum Tower Hospital between January and December 2013.</p><p><b>RESULTS</b>The positive rate of initial HIV screening was 1.98% in the PITC group and 0.24% in the routine test group, while that of confirmed HIV was 0. 40% in the former and 0.07% in the latter, both with statistically significant differences between the two groups (P < 0.01). The positive rate of HIV was markedly higher in males than in females, particularly in the PITC group.</p><p><b>CONCLUSION</b>PITC has a high clinical value in HIV detection for targeted subjects and therefore deserves general application in dermatology.</p>

Effect of Fibulin-5 on cell proliferation and invasion in human gastric cancer patients

OBJECTIVES@#To explore the effect of Fibulin-5 expression on cell proliferation and invasion in human gastric cancer patients.@*METHODS@#Fibulin-5 expression was detected in 56 samples of surgically resected gastric cancer and paired noncancerous tissues using qRT-PCR and immunoblotting. Fibulin-5 was knocked down by Fibulin-5 shRNA in MGC-803 cells, then BrdU cell proliferation and transwell invasion assays were used to determine cell proliferation and invasion.@*RESULTS@#The level of Fibulin-5 mRNA in gastric cancer tissues was significantly higher as compared with that in normal tumor-adjacent tissues (P<0.05). Otherwise, the level of Fibulin-5 protein in cancer and noncancerous tissues was consistent with mRNA expression (P<0.05). Fibulin-5 protein expression in tumor tissues with poorly differentiated, lymph node metastasis and advanced TNM tumor stage was significantly higher (P<0.05, respectively). Fibulin-5 was obviously knocked down by Fibulin-5 shRNA (P<0.05), and Fibulin-5 knockdown significantly inhibited cell proliferation and invasion in MGC-803 cells (P<0.05, respectively).@*CONCLUSIONS@#The high-expression of Fibulin-5 is associated with the malignant clinicopathologic parameters in gastric cancer and Fibulin-5 knockdown inhibits cell proliferation and invasion in MGC-803 cells, suggesting Fibulin-5 may act as a key factor in the progression of gastric cancer.

Effect of total lumbar disc replacement on the treatment of discogenic low lumbar pain: preliminary outcomes / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Lumbar pedicle screw fixation and fusion are major procedures for treating discogenic low back pain (DLBP). However, due to its advantages of preserving the segmental motion and biomechanical simulation, artificial total lumbar disc replacement (TDR) is increasingly popular.</p><p><b>METHODS</b>From 2007 to 2010, 68 DLBP patients were enrolled. TDR were performed on 34 patients and the other 34 controls underwent the traditional fixation procedure. Qualitative and quantitative evaluations were followed including the changes in range of motion (ROM) and interpedicle height (IPH) at the posterior intervertebral body of operated level, in 6 and 12 months, and 3 years, postoperatively.</p><p><b>RESULTS</b>Qualitative results showed satisfying improvement in the two groups after 6 and 12 months, respectively, and the inter-group differences were significant (P > 0.05). The results of ROM and IPH have shown significant differences between the TDR and spinal fusion groups (P < 0.05).</p><p><b>CONCLUSION</b>With similar clinical improvements as the traditional spinal fusion method, TDR offered significantly better ROM and intervertebral foramen height.</p>

Effectiveness analysis on the physical activity and the health benefit of a community population based program / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To evaluate the community-based health promotion effect of physical activity.</p><p><b>METHODS</b>The residents aged 18 and above from two communities in Gongshu District of Hangzhou City, Zhejiang province, were randomly selected and recruited for the multi-strategy and comprehensive physical activity intervention. Questionnaire survey, physical check up and blood biochemistry were conducted.</p><p><b>RESULTS</b>After this two-year intervention, the time of the participant spent on weekly physical activity of moderate intensity increased from 464 min to 542 min (P<0.05), with an average increase of 78 min. Time spent in walking every week increased from 533 min to 678 min (P<0.05), with an average increase of 145 min. The body weight, waistline, blood pressure and heart rate all reduced significantly (P<0.05); the vital capacity increased significantly (P<0.05); and the related biochemical indicators were also improved.</p><p><b>CONCLUSION</b>Comprehensive and evidence-based physical activity interventions targeting community population can improve the levels of physical activity, related body measurement and biochemical indicators.</p>

Prognosis of hepatocellular carcinoma: a study of 832 cases / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To investigate the prognostic factors of hepatocellular carcinoma.</p><p><b>METHODS</b>The purpose of this study was to retrospectively analyze the surgical outcomes of hepatocellular carcinoma (HCC) in 832 patients who underwent hepatic resection between February 2002 and June 2010 in the Cancer Hospital of Chinese Academy of Medical Sciences. Post-resection prognostic factors were assessed using a univariate Kaplan-Meier analysis and a multivariate Cox proportional hazards model.</p><p><b>RESULTS</b>The overall 1-, 3- and 5-year survival rates were 92.0%, 70.2% and 53.6%, respectively. The disease free survival rates (DFS) were 90.2%, 61.5% and 40.5%, respectively. The univariate analysis showed that a better prognosis for overall survival (OS) was associated with asymptomatic presentation, small tumor, single lesion, high-grade histological differentiation, no vascular tumor embolus, negative serum alpha-fetoprotein (AFP), negative serum alkaline phosphatase (ALP), Child-Pugh class A, no ascites, no/mild cirrhosis, new surgical techniques, no blood transfusion, no regional lymph node metastasis, no major vascular invasion, and no extra-hepatic invasion. The multivariate analysis showed that asymptomatic presentation, small tumor, single lesion, no tumor embolus, negative serum alpha-fetoprotein (AFP), no regional lymph node metastasis, no major vascular invasion, no extra-hepatic invasion, no/mild cirrhosis, and surgical techniques are independent factors for a longer overall survival.</p><p><b>CONCLUSIONS</b>The prognosis of HCC after resection is influenced by a number of factors. Therefore, regularly screening and early diagnosis, applying surgical techniques to minimize the liver injury, and preventing the aggravation of cirrhosis are important measures to improve the overall survival of HCC patients. For those patients with high risk factors of recurrence, routine follow-up is one of the best methods to be recommended.</p>

Clinicopathological and prognostic analysis of primary clear cell carcinoma of the liver / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To investigate the clinicopathological features and prognostic factors of primary clear cell carcinoma of the liver (PCCCL).</p><p><b>METHODS</b>The clinical data of 41 PCCCL patients who underwent hepatic resection for PCCCL from October 1998 to June 2012 in our department were retrospectively analyzed. There were 31 male and 10 female patients. The median age was 56 years (range, 25 to 80 years), and the diagnosis was confirmed by postoperative pathological examination. The data of 106 well or moderately differentiated non-clear cell hepatocellular carcinoma (HCC) patients and 86 poorly differentiated non-clear cell HCC patients who underwent hepatic resection in the same period in our hospital in the same period were compared. The χ(2) test or Fischer's exact test, as appropriate, was used to compare group frequencies. Survival analysis was estimated by Kaplan-Meier method. Cox proportional hazards model was used in multivariate analysis.</p><p><b>RESULTS</b>The proportion of fibrous capsule formation in the PCCCL tumors (46%, 19/41) was significantly higher than that of the other two groups (P < 0.05), whereas the PCCCL group had a lower rate of intravascular tumor embolus (2/41) and vascular invasion (1/41) (P < 0.05). The median survival time of PCCCL group was 65 months, the 1-, 3-, 5-year survival rates for PCCCL patients were 90.2%, 67.4% and 42.0%, significantly better than that of poor differentiated NCCHCC group's (82.9%, 33.3%, 7.2%, P < 0.01). However, there were no statistic significant differences between PCCCL group and well or moderately differentiated NCCHCC group (84.7%, 55.7%, 34.4%, P > 0.05). Tumor capsule formation was an independent favorable prognostic factor. In contrast, preoperative serum α-fetoprotein (AFP) level and hepatitis B virus infection were independent unfavorable prognostic factors for PCCCL.</p><p><b>CONCLUSIONS</b>PCCCL is a rare, low degree malignant pathological subtype of HCC. Surgical resection may achieve favorable prognosis and even long-term survival.</p>

Surgical management of nodular hyperplasia tumor-like hepatic lesions: a study of 72 cases / 中华外科杂志

<p><b>OBJECTIVE</b>To explore and improve the diagnosis and treatment of benign hyperplasia tumor-like hepatic lesion.</p><p><b>METHODS</b>The clinical data of 72 patients who had undergone hepatic resection for benign non-cystic hepatic lesions between January 1987 and December 2010 were analyzed retrospectively. There were 46 male and 26 female patients. The median age was 49 years (ranging 15 to 72 years), and diagnosis were confirmed by postoperative pathological examination. Thirty-four cases had symptoms, such as abdominal discomfort in right upper quadrant, fever, fatigue. All the cases had undergone hepatic resection; totally 78 lesions were removed. The surgical procedure including hepatic lobectomy for 13 cases, hepatic segmentectomy for 19 cases and non-anatomy resection for 39 cases.</p><p><b>RESULTS</b>The finally diagnosis included focal nodular hyperplasia in 47 cases, adenomatous hyperplasia in 3 cases, hepatic dysplastic nodule in 3 cases, inflammatory pseudotumor in 3 cases, hepatic granuloma in 4 cases, nodular cirrhosis in 3 cases, hepatitis nodule in 6 cases, nodular regenerative hyperplasia in 1 case, lymphoid hyperplasia in 1 case. The postoperative complication rate was low (19.4%, 14/72). The follow-up period was 6 to 96 months. There was no mortality caused by lesion. One patient developed recurrence after 3 years.</p><p><b>CONCLUSIONS</b>It is suggested that symptomatic lesions, lesions when malignancy cannot be excluded, and lesions which have canceration tendency, just like adenomatous hyperplasia, dysplastic nodule, and nodular cirrhosis regenerative hyperplasia need surgical resection. Operation is not necessary for other nodular hyperplasia lesions if the diagnoses are identified.</p>

Subcutaneous implantation of benign thyroid tissue: a rare complication after thyroidectomy / 中华医学杂志(英文版)

Subcutaneous implantation of benign thyroid tissue is a rare complication of thyroid surgery. Here the authors report two cases of subcutaneous implantation of benign thyroid tissue following conventional thyroid surgery. The diagnosis and differential diagnosis of cervical subcutaneous thyroid tissue implantation, and their clinical pathological characteristics are retrospectively investigated. The mechanism of the implantation process is analyzed. The management of patient with cervical subcutaneous soft tissue implantation is also discussed.

The comparison of computer assisted minimally invasive spine surgery and traditional open treatment for thoracolumbar fractures / 中华外科杂志

<p><b>OBJECTIVE</b>To compare the clinical results between computer assisted minimally invasive spine surgery (CAMISS) and traditional open fixation surgery which used in thoracolumbar fractures.</p><p><b>METHODS</b>A prospective randomized controlled trial of patients who had undergone surgery for thoracolumbar fracture from January 2006 to March 2011 was performed. The patients were randomly divided into CAMISS group and traditional open treatment group (control group) by random number table. Clinical results were assessed by comparing the following parameters between patients who had undergone CAMISS or traditional open surgery: operative time, estimated blood loss, visual analogue scale (VAS) of the low back pain, the accuracy of pedicle screw, the status and the correction of kyphosis.</p><p><b>RESULTS</b>Forty-seven patients underwent CAMISS, and fifty patients underwent traditional open surgery. The follow-up periods were 3 - 50 months (mean 12 months). According to the preoperative data, the two groups did not differ with respect to age, gender, marriage, occupation, mechanism of injury, classification of fracture, preoperative VAS scores of the low back pain, preoperative functional spine unit (FSU) Cobb's angle and preoperative local angle of the fracture vertebral body (P > 0.05). Compare to the control group, the patients who got CAMISS had more accuracy of pedicle screw, less blood loss, short immobilized time, lower postoperative fever, and better VAS score of the low back pain (t = 2.162 - 8.736, P < 0.05). The improvement of FSU Cobb's angle and local angle of the fracture vertebral body were better at control group after operation (13.8° ± 6.8° vs. 10.9° ± 5.5°, 11.0° ± 6.0° vs. 7.7° ± 4.8°, t = 2.108 and 2.610, P < 0.05). But there was no significant difference of the FSU Cobb's angle, or local angle of the fracture vertebral body between the two groups at post-operation and follow-up (P > 0.05).</p><p><b>CONCLUSIONS</b>CAMISS has the characteristics of fewer traumas, less bleeding, faster recovery, high accuracy of pedicle screws. It has comparable vertebral deformity correction and fixation result of the traditional open operation.</p>

The effect of preoperative factors on the function of the cervical spine after cervical artificial disc replacement: a minimal 3 years follow-up / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate the effect of preoperative factors on the function of the cervical spine after Bryan artificial disc replacement.</p><p><b>METHODS</b>Fifty patients who underwent cervical disc replacement from December 2003 to January 2006 were investigated. The preoperative factors such as long course of disease, lose of motion or disc height at the operation level were evaluated for their effects on the motion of the operated disc and clinical results at the time of final follow-up. There were 35 males and 15 females. Thirty-nine patients received one-level disc replacement, 11 patients received two-level disc replacement. The age of patients was from 25 to 73 years, average was 49 years.</p><p><b>RESULTS</b>Until January 2009, 50 cases of all the 53 patient who got operation for more than 3 years were followed up. The follow up period was from 36.0 to 55.6 months, which showed a skewed distribution, with a median of 41.9 months. The patients, who got neural syndrome for more than 3 years, would have worse JOA recovery rate through the surgery compared with the patients who got neural syndrome less than 3 month. As for radiographic results, the preoperative range of movement (ROM) at the implanted disc spaces was 10.4 degrees +/- 5.0 degrees which had significant correlation with the most recent follow-up ROM which was 8.6 degrees +/- 4.8 degrees (r = 0.325, P < 0.05). The group which height ratio of the operative disc and the adjacent discs was less than 0.87 would have worse JOA recovery rate and range of motion at operated level at the most recent follow-up than the group more than 0.87 with statistical significance.</p><p><b>CONCLUSIONS</b>For the patients with cervical spondylosis or cervical disc herniation who get nervous syndrome for more than 3 years, will have worse JOA recovery rate through the surgery, so the patient should get the operation in time to achieve better improvement. When the operated level is severe degenerated, the motion of the replaced disc and the clinical results is dissatisfied at the time of final follow-up, so it is the relative contraindications for the cervical disc replacement.</p>

Diagnosis and treatment of parathyroid carcinoma: 9 cases report and literature review / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the diagnosis and surgical treatment of parathyroid carcinoma.</p><p><b>METHODS</b>The clinical data of 9 cases of parathyroid carcinoma treated from January 1967 to December 2009 was analyzed retrospectively with the review of related Chinese literatures.</p><p><b>RESULTS</b>Parathyroid carcinoma accounted for 8.9% (8/90) of all patients with primary hyperparathyroidism in our hospital, and the other one case was transferred from another hospital. Of the patients, 8 cases were found with primary hyperparathyroidism. Primary surgery was carried out with small incision: 5 patients underwent en bloc resection, among which, 3 cases received central lymph node dissection; 2 patients received simple parathyroidectomy; one case underwent palliative tumor resection. The case from another hospital received subtotal thyroidectomy. Considering preoperative, intraoperative data and frozen sections pathology, all patients were diagnosed as parathyroid carcinoma. Nine patients were followed-up for 1 - 14 years, no recurrence occurred, and the patient received palliative resection died from carcinoma two years after the operation. In previous Chinese literatures and this group, there were total 146 patients reported as parathyroid carcinoma. Those patients were diagnosed through routine histopathology, accounted for 1.8% - 11.5% of patients with primary hyperparathyroidism.</p><p><b>CONCLUSIONS</b>The diagnosis of parathyroid carcinoma is established according to severe hypercalcemia, clinical features, subset B-ultrasound and Tc(99m)-sestamibi scanning, intraoperative finding of adherence to close structures and histopathology. The initial surgical procedure of choice is en bloc resection of the tumor by minimally invasive small incision, including adjacent structures and ipsilateral thyroidectomy. The prognosis is favorable after the operation.</p>

Clinical and radiographic results of cervical artificial disc arthroplasty: over three years follow-up cohort study / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Theoretic advantages of cervical disc arthroplasty include preservation of normal motion and biomechanics in the cervical spine, and reduction of adjacent-segment degeneration. The clinical and radiographic effects of cervical disc arthroplasty in short term have been ascertained. The aim of this study is to research the data of mid-term results.</p><p><b>METHODS</b>In this prospective cohort study, 50 patients who underwent cervical disc arthroplasty from December 2003 to January 2006 were enrolled. There were 39 patients who received 1-level disc arthroplasty, and 11 patients received 2-level disc arthroplasty, with an average age of 50.9 years (range from 29 to 73). The median follow-up was 41.85 months (range from 36.00 - 55.63 months). Patients were followed prospectively with respect to their symptoms, neurologic signs, and radiographic results.</p><p><b>RESULTS</b>The median value of Japanese Orthopaedic Association (JOA) score was 14.0 before surgery, and 16.5 at the most recent follow-up (P < 0.01). The median value of the recovery rate of the JOA score was 92.2%. The preoperative range of motion (ROM) at the indexed level was (10.40 ± 4.97)°, which has significantly correlated with the most recent follow-up ROM which was (8.56 ± 4.76)° (P < 0.05, r = 0.33). The ROM at the operative level at the most recent follow-up was greater than the value at the 3-month follow-up of (7.52 ± 3.37)° (P < 0.05). The preoperative functional spinal unit (FSU) angulation was (-0.96 ± 6.52)°, which was not significantly correlated with that of the most recent follow-up value of (-2.65 ± 7.95)° (P < 0.01, r = 0.53). The preoperative endplate angulation was (2.61 ± 4.85)°, which had no significant correlation with that of the most recent follow-up value of (0.71 ± 6.41)° (P > 0.05).</p><p><b>CONCLUSIONS</b>The clinical and radiographic results of cervical disc arthroplasty are good in mid-term follow-up. The normal range of motion of the operated level and the biomechanics in the cervical spine are well preserved.</p>

Comparison of the clinical accuracy of cervical (C2-C7) pedicle screw insertion assisted by fluoroscopy, computed tomography-based navigation, and intraoperative three-dimensional C-arm navigation / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The complicated anatomy of the cervical spine and the variation among pedicles reduces the accuracy and increases the risk of neurovascular complications associated with screw implantation in this region. In this study, we compared the accuracy of cervical (C2-C7) pedicle screw fixation assisted by X-ray fluoroscopy, computed tomography (CT)-based navigation, or intraoperative three-dimensional (3D) C-arm navigation.</p><p><b>METHODS</b>This prospective cohort study was performed in 82 consecutive patients who underwent cervical pedicle screw fixation. The accuracy of screw insertion was assessed by postoperative CT scan with 3D reconstruction. The accuracy of screw insertion was assessed as: excellent (screw completely within pedicle); acceptable (≤ 1 mm screw outside pedicle cortex); poor (> 1 mm screw outside pedicle cortex).</p><p><b>RESULTS</b>A total of 145 screws were inserted in 24 patients who underwent C-arm fluoroscopy. Of these, 96 screws (66.2%) were excellent, 37 (25.5%) were acceptable, and 12 (8.3%) were poor. One hundred and fifty-nine screws were inserted in 29 patients in the CT-based navigation group. Among these, 141 (88.7%) were excellent, 14 (8.8%) were acceptable, and 4 (2.5%) were poor. A total of 140 screws were inserted in 29 patients in the intraoperative 3D C-arm navigation group, of which 127 (90.7%) were excellent, and 13 (9.3%) were acceptable. No severe or permanent neurovascular complications associated with screw insertion were observed in any patient.</p><p><b>CONCLUSIONS</b>CT-based and intraoperative 3D C-arm navigation were similarly accurate, and were both significantly more accurate than C-arm fluoroscopy for guiding cervical pedicle screw fixation. They were able to accurately guide the angle and depth of screw placement using visual 3D images. These two techniques are therefore preferable for high-risk cervical pedicle screw fixation. The ease and convenience of intraoperative 3D C-arm navigation suggests that it may replace virtual-fluoroscopy and CT-based navigation systems in future clinical applications.</p>

Study of pedicle screw placement assisted by intraoperative three-dimensional navigation in lumbar vertebrae with axial rotation / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate the effect of axial rotation of lumbar vertebrae on the accuracy of pedicle screw placement using the traditional method, as well as to assess the value of intraoperative three-dimensional (3D) navigation in improving the accuracy.</p><p><b>METHODS</b>Sixteen lumbar simulation models at different degrees of axial rotation (0°, 5°, 10° and 20°), with every four assigned with the same degree, were equally divided into two groups (traditional method group and intraoperative 3D navigation group). Random placement of pedicle screws was carried out, followed by CT scan postoperatively. Then the outer pedicle cortex contours were depicted from reconstructed sectional pedicle images using Photoshop. The accuracy of pedicle screw placement was evaluated by determining the interrelationship between screw trajectory and pedicle cortex (qualitative) and measuring the shortest distance from pedicle screw axis to outer cortex of the pedicle (quantitative).</p><p><b>RESULTS</b>Eighty pedicle screws were implanted respectively in each group. In traditional method group, statistical difference existed in the accuracy of pedicle screw placement at different axial rotational degrees (P < 0.05). With degrees increasing, the accuracy declined. The accuracy of intraoperative 3D navigation group was higher than traditional method group in vertebrae with axial rotation (P < 0.01). In qualitative evaluation, the accuracy of the two methods had statistical difference when the degree was 20°, and in quantitative evaluation, statistical difference existed in 5°, 10° and 20° of vertebral axial rotation.</p><p><b>CONCLUSIONS</b>Screw malposition can be caused by vertebral axial rotation in lumbar spine using traditional method. Accuracy of pedicle screw placement declines with the increase of axial rotational degrees. However, the accuracy can be improved by using intraoperative 3D navigation.</p>

The design, synthesis and anticancer activity of 4-heteroarylamino-3-cyanoquinolines as dual inhibitors of c-Src and iNOS / 药学学报

Because c-Src and iNOS are key regulatory enzymes in tumorigenesis, a new series of 4-heterocycle amine-3-quinolinecarbonitriles as potent dual inhibitors of both enzymes were designed, synthesized and evaluated as multiple targets agents in cancer therapy. All compounds were evaluated by two related enzyme inhibition assays and an anti-proliferation assay in vitro. The results showed that most compounds inhibited c-Src and iNOS well. The best compound 33 inhibited both enzymes with the IC50 values of 0.0484 micromol x L(-1) and 34.5 micromol x (-1), respectively. Some of the compounds also showed moderate anti-proliferation activities at 10 micromol x L(-1) against colon cancer HT-29 and liver cancer HepG2 cell lines.

Synthesis and anti-histamine release activity of phenyl tetrazole compounds / 药学学报

Ongoing effort to find novel antiasthmatic drugs led to the design and synthesis of a series of compounds bearing phenyl tetrazole group based on the SAR study. The important intermediate 3-(1H-tetrazol-5-yl) benzenamine was synthesized from m-nitroaniline via cyclization and hydrogenation. Followed by amidation, eight new target compounds were obtained. The structures of these compounds were confirmed with 1H NMR, ESI-MS and elemental analysis. Their non-specific and specific anti-histamine effects in the mast cell were determined. Compound NP03 could inhibit non-specific histamine release induced by compound 48/80 in mast cell of SD rats.

Synthesis and biological evaluation of 3-quinolinecarbonitrile-7-amide derivatives / 药学学报

A series of N-(3-cyano-6-methyl-4-anilinoquinoline-7-yl) amide derivatives 13a-13n have been synthesized, their structures were confirmed with 1H NMR, EI-MS, IR and elemental analysis. Antitumor activities of all the synthesized compounds in vitro were tested with MTT. Compound 13j showed better than or equal antitumor activity on Bosutinib and EKB-569.