Advances of SHP2 modulators in the cancer immunotherapy / 药学学报

Src homology phosphotyrosyl phosphatase 2 (SHP2) is a protein tyrosine phosphatase encoded by PTPN11, which catalyzes the dephosphorylation of protein tyrosine. As a convergence node, SHP2 mediates multiple signaling pathways such as rat sarcoma (RAS)-rapidly accelerated fibrosarcoma (RAF)-mitogen-activated extracellular signal-regulated kinase (MEK)-extracellular regulated protein kinases (ERK), phosphatidylinositol 3-kinase (PI3K)-serine/threonine kinase (AKT), janus kinase (JAK)-signal transducer and activator of transcription (STAT) and programmed death-1 (PD-1)/programmed cell death-ligand 1 (PD-L1). It can not only regulate the growth and proliferation of tumor cells, but also mediate the immune escape of tumor cells by influencing the tumor microenvironment. Given its dual biological functions in tumor immune regulation, SHP2 is a promising target for cancer immunotherapy. To date, several SHP2 allosteric inhibitors have been advanced into clinical trials for tumor immunotherapy with single or combination therapeutic strategies. Additionally, SHP2 activators also showed therapeutic potential in the field of tumor immune modulation. In this paper, we reviewed the dual function of SHP2 in both tumor and immune cells. Besides, the challenges and prospects of SHP2 modulators in cancer immunotherapy were also briefly discussed, aiming to explore new horizon of SHP2 modulators for tumor immunotherapy.

Analysis of tuberculosis epidemiological characteristics and drug resistance among the floating population in Beijing in 2019 / 中华流行病学杂志

Objective: To analyze the epidemic characteristics and drug resistance of pulmonary tuberculosis among the floating population in Beijing and to provide a scientific basis for formulating strategies for the prevention and control of tuberculosis among the floating population. Methods: Data of tuberculosis patients who were positive for Mycobacterium tuberculosis culture was collected from 16 districts and one municipal institution of tuberculosis control and prevention in Beijing in 2019. The strain samples were tested for drug sensitivity by the proportional method. According to household registration location, patients were divided into the floating population and Beijing registration. SPSS 19.0 software analyzed tuberculosis patients' epidemic characteristics and drug resistance in the floating population. Results: In 2019, there were 1 171 culture-positive tuberculosis patients in Beijing, among the floating population, 593 (50.64%) patients were identified, with a male-to-female sex ratio of 2.2∶1 (409∶184). Compared to patients under household registration as Beijing residents, a higher proportion of young adults aged 20-39 years (65.09%,386/593) were noticed, with 55.65% (330/593) reported from the urban areas and 96.80% (574/593) were reported the first time. The differences were statistically significant (all P<0.05). After completing the drug sensitivity test, 37 cases were with multiple drug-resistant tuberculosis, accounting for 6.24% (37/593). The rates of isoniazid resistance (42.11%,8/19) and multidrug resistance (21.05%,4/19) in floating population patients after retreatment were significantly higher than those in newly treated patients (11.67%, 67/574 and 5.75%, 33/574), and the differences were statistically significant (all P<0.05). Conclusions: Most patients with tuberculosis in the floating population in Beijing in 2019 were young males aged 20-39 years. The reporting areas were urban areas and the newly treated patients mainly. The patients with tuberculosis in the re-treated floating population were more likely to suffer from multidrug and drug resistance, which should be taken as the key population for prevention and control.

Mechanism of Jinqi Jiangtang Tablets in treatment of pancreatic β cell dysfunction based on network pharmacology and molecular docking technology / 中国中药杂志

The present study investigated the therapeutic efficacy and potential mechanism of Jinqi Jiangtang Tablets(JQJT) on pancreatic β cell dysfunction based on network pharmacology and molecular docking technology. TCMSP platform was used to retrieve the chemical components and targets of the three Chinese herbal medicines of JQJT. The genes were converted to gene symbol by the UniProt, and its intersection with targets related to pancreatic β cell function in GeneCards and CTD databases was obtained. The drugs, active components and common targets were imported into Cytoscape 3.8.2 to plot the drug-component-target network. The main effective components and targets were obtained by software analysis. The drug targets and targets related to pancreatic β cell function were imported separately into the STRING platform for the construction of protein-protein interaction(PPI) networks. The two PPI networks were merged by Cytoscape 3.8.2 and the key targets were obtained by plug-in CytoNCA. The targets obtained from drug-component-target network and PPI networks were imported into DAVID for GO analysis and KEGG enrichment analysis. AutoDock was used to carry out molecular docking of main active components and core targets and Pymol was used to plot the molecular docking diagram. The results showed that there were 371 active components and 203 targets related to JQJT and 2 523 targets related to pancreatic β cell damage, covering 136 common targets. The results revealed core targets(such as PTGS2, PTGS1, NOS2, ESR1 and RXRA) and effective key components(such as quercetin, kaempferol, luteolin, β-carotene and β-sitosterol). KEGG enrichment analysis indicated that apoptosis, inflammation, and other signaling pathways were mainly involved. Molecular docking results showed that the main active components could spontaneously bind to the targets. This study preliminarily revealed the mechanism of JQJT in improving pancreatic β cell damage through multi-component, multi-target and multi-pathway, and provided a theoretical basis for JQJT in the treatment of pancreatic β cell dysfunction.

Systematic review of Chuankezhi injection for treating acute exacerbation of chronic obstructive pulmonary disease / 中国中药杂志

To evaluate the inflammatory factors, the pulmonary function, the efficiency and the safety of Chuankezhi injection for treating acute exacerbation of chronic obstructive pulmonary disease (AECOPD). The randomized controlled trials (RCTs) on Chuankezhi injection for treating AECOPD were collected from 7 databases (PubMed, CNKI, et al) between inception to November 2016. Two reviewers independently screened literature and extracted the data according to the inclusion and exclusion criteria, and assessed methodological quality of included studies according to the criteria from Cochrane Reviewer's Handbook 5.3. Then, Meta-analysis was conducted by using RevMan 5.3 software. A total of 13 RCTs involving 1 016 patients were included. Meta-analysis results indicated that Chuankezhi group was superior to the control group in the clinical effectiveness [RR=1.15, 95% CI(1.06, 1.23), P=0.000 3], improved pulmonary functions including forced expiratory volume in one second (FEV1) [MD=0.21, 95% CI (0.15, 0.27), P<0.000 01], forced vital capacity (FVC) [MD=0.36, 95% CI（0.15, 0.56）, P=0.000 6], the first seconds breathing volume percentage of forced vital capacity (FEV1/FVC) [MD=6.85, 95% CI（4.68, 9.02）, P<0.000 01] and decreased the level of inflammatory factors including interleukin-6 (IL-6) [MD=-6.35, 95% CI (-8.23, -4.47), P<0.000 01], IL-8 [MD = -2.00, 95% CI ( -3.13, 0.87), P=0.000 5], tumor necrosis factor-α (TNF-α) [ MD=-2.79, 95% CI (-4.61,-0.97), P=0.003]. Besides, there were no frequently happened or serious adverse reactions observed in Chuankezhi group. The results showed that Chuankezhi injection could improve the efficiency and the pulmonary function, reduce inflammation for AECOPD with a high safety on the basis of routine symptomatic treatment. However, due to limited quantity and quality of the included studies, the conclusion above should be further verified by conducting more high quality RCTs.

Baicalin alleviated rheumatoid arthritis synovitis of SD rats through TLR2-NF-κB pathway / 中国药理学通报

Aim To evaluate the effects of different doses of baicalin on rheumatoid arthritis (RA) in SD rats and explore the possible mechanism.Methods Firstly,the model of RA in SD rats was prepared and the hind foot swelling was measured;HE staining was used to observe the pathological changes of the knee joint synovial tissue;RT-qPCR was adopted to determine the mRNA expressions of TLR2 and MyD88 in synovial tissue;Western blot was used to determine the protein expressions of TLR2,MyD88 and NF-κB p65 aher intragastric administration of different doses of baicalin solution.Results Compared with the model,baicalin (60 and 30 mg · kg-1) could inhibit the proliferation of fibroblasts and inflammatory damages in synovial tissue,significantly cut down mRNA expressions of TLR2 and MyD88 (P ＜ 0.05) and markedly reduce protein expressions of TLR2,MyD88 and NF-κB p65 (P ＜ 0.01).Conclusion Baicalin has good effects on RA,which may be realized by inhibiting the activation of TLR2-NF-κB signaling pathway.

Posterior selective thoracic fusion in adolescent idiopathic scoliosis patients: a comparison of all pedicle screws versus hybrid instrumentation / 中国医学科学杂志(英文版)

<p><b>OBJECTIVE</b>To analyze the influence of segmental pedicle screws versus hybrid instrumentation on the correction results in adolescent idiopathic scoliosis patients undergoing posterior selective thoracic fusion,</p><p><b>METHODS</b>By reviewing the medical records and roentgenograms of adolescent idiopathic scoliosis patients who underwent selective thoracic fusion from February 2000 to January 2007 in our hospital, the patients were divided into 2 groups according to different instrumentation fashions: Group A was hook-screw-rod (hybrid) internal fixation type, Group B was screw-rod (all pedicle screws) internal fixation type, and the screws were used in every segment on the concave side of the thoracic curve. The parameters of the scoliosis were measured and the correction results were analyzed,</p><p><b>RESULTS</b>Totally, 48 patients (7 males, 41 females) were included, with an average age of 14.4 years old and a mean follow-up time of 12.3 months. Thirty and 18 patients were assigned to group A and group B, respectively. The mean preoperative coronal Cobb angles of the thoracic curve were 48.8 degrees and 47.4 degrees, respectively. After surgery, they were corrected to 13.7 degrees and 6.8 degrees, respectively. At final follow-up, they were 17.0 degrees and 9.5 degrees, with an average correction rate of 64.6% and 79.0%, respectively, and the correction rate of group B was significantly higher than that of group A (P = 0.003). The mean preoperative coronal Cobb angles of the lumbar curve were 32.6 degrees and 35.2 degrees, respectively. After surgery, they were corrected to 8.6 degrees and 8.3 degrees, respectively. At final follow-up, they were 10.3 degrees and 11.1 degrees, with an average correction rate of 66.8% and 69.9%, respectively, and the correction rate of group B was significantly higher than that of group A (P = 0.003). The correction loss of the thoracic curve and lumbar curve in the 2 groups were 3.1 degrees and 1.8 degrees, 2.4 degrees and 2.4 degrees, respectively. No significant difference was noted (both P > 0.05). The decompensation rate at final follow-up in these 2 groups were 4% (1/25) and 7.1% (1/14) respectively, with no significant difference (P > 0.05).</p><p><b>CONCLUSIONS</b>Both all pedicle screws and hybrid instrumentation can offer good correction results of the thoracic curve and lumbar curve in posterior selective thoracic fusion in patients with adolescent idiopathic scoliosis. While with all pedicle screws, the correction results of the thoracic curve and lumbar curve are both better than those with hybrid instrumentation without increased decompensation rate.</p>

Risk factors for skin necrosis around incision after total knee arthroplasty / 中华外科杂志

<p><b>OBJECTIVES</b>To analyze the risk factors of skin necrosis around incision after total knee arthroplasty, and explore measures for prevention and treatment.</p><p><b>METHODS</b>From January 2003 to November 2005, skin necrosis around incision occurred to 15 out of the 382 cases (494 knees) treated by total knee arthroplasty. The data of the 15 cases were analyzed. Preoperative hospital for special surgery knee score (HSS) was 60 points on average.</p><p><b>RESULTS</b>All wound were healed after debridement. However, the recover time was over 3 weeks longer than the healing time by first intention. Extensor weakness with anterior knee pain appeared among 9 patients, and 6 months later, the symptoms improved obviously. At two years follow-up, the average range of motion was 92 degrees, and the average HSS improved to 86. There were no secondary infection and deformity in the group.</p><p><b>CONCLUSIONS</b>It is the key to prevent skin necrosis around incision during total knee arthroplasty that surgeons must accurately grasp technique of minimally invasive surgery for total knee arthroplasty. To acquire satisfactory outcome, it is imperative to perform debridement as soon as possible while the skin necrosis happens. At the same time, it is important to persist in doing adequate functional exercises throughout the period of treatment.</p>

Perioperative management in hemophilic arthropathy / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate the clinical results and improve perioperative management in patients with hemophilic arthropathy.</p><p><b>METHODS</b>From May 2002 to March 2007, 20 patients with hemophilic arthropathy were admitted. Fourteen patients (20 knees) were performed total knee arthroplasty, and 6 patients (8 hips) were performed total hip arthroplasty, while 2 patients were performed ankle arthrodesis. The average preoperative HSS score, hip Harris score and ankle AOFAS score were 83, 89 and 78 points respectively.</p><p><b>RESULTS</b>All patients had been followed up, and the mean time was 27.3 months. The average postoperative knee HSS score increased to 83 points, and hip Harris score increased to 89 points, while the AOFAS score increased to 78 points. Delayed bleeding and deep venous thrombosis and late infection with loose prosthesis occurred in one case respectively.</p><p><b>CONCLUSIONS</b>Arthroplasty and arthrodesis are promising for severe hemophilic arthropathy to obtain pain relief and functional improvement Correct perioperative management is the key to successful treatment in hemophilic arthropathy.</p>

Video-assisted thoracoscopic correction and fusion of scoliosis / 中国医学科学杂志(英文版)

<p><b>OBJECTIVE</b>To evaluate the operative technique and preliminary results of video-assisted thoracoscopic anterior correction and fusion of scoliosis.</p><p><b>METHODS</b>Eleven cases underwent thoracoscopic anterior correction and fusion of scoliosis from March 2003 to April 2005 in our hospital were reviewed. They were all females with an average age of 13.1 years old. Of which, 9 cases were idiopathic scoliosis, 1 case was congenital scoliosis, and 1 case was Marfan syndrome scoliosis. The coronal Cobb angle and apical vertebral translation before and after surgery as well as at final follow-up were measured. The operation time, blood loss during operation, and peri-operative complications were recorded. Results The mean operation time was 6.4 hours, mean instrumented vertebrae were 6.4 segments, and mean blood loss during operation was 364 mL. The coronal Cobb angles of the thoracic curve before and after surgery were 45.5 degrees and 15.4 degrees respectively, with an average correction rate of 65.4%. The lumbar curve was corrected from 28.4 degrees lation to 11.8 degrees, with an average simultaneous correction rate of 57.2%. All of the patients were followed up regularly with an average time of 21.4 months. At the final follow-up, the coronal Cobb angles of the thoracic and lumbar curves were 19.0 degrees and 20.1 degrees, with a 3.6 degrees and 8.3 degrees loss of correction, respectively. The apical vertebral translation was improved from 32.3 mm to 10.5 mm for the thoracic curve, and from 13.1 mm to 8.2 mm for the lumbar curve. There were 6 cases with peri-operative complications, including 1 case of thoracic effusion, 1 case of chylothorax, 1 case of locking plug loosing, 2 cases of aggravation of the unfused lumbar curve (1 case also with thoracolumbar kyphosis), and 1 case with a screw tip causing a contour deformity of the aorta. And 4 of them underwent revision surgery.</p><p><b>CONCLUSIONS</b>Video-assisted thoracoscopic anterior correction and fusion of scoliosis has good correction capability, less intraoperative bleeding, and favorable cosmetic effect for mild and moderate thoracic scoliosis, but with higher rates of correction loss of the lumbar curve and peri-operative complications. A surgeon should be cautious to perform this technique. ders</p>

Two-dimensional gel electrophoresis profiles of human normal prostate cells successfully established by 2-DE coupled with laser capture microdissection / 中华男科学杂志

<p><b>OBJECTIVE</b>To establish a technological system of proteomics research for displaying the full-scale protein expression spectrum of the prostate cells.</p><p><b>METHODS</b>We obtained the epithelial cells from normal prostate tissues by laser capture microdissection (LCM) technology, extracted the proteins from them and established two-dimensional gel electrophoresis (2-DE) profiles of the proteins by immobilized pH gradient (IPG) two-dimensional electrophoresis. Then protein spot detection and matching were performed with the scanner and the ImageMaster 2D Elite analysis software. With the help of the Ettanspotter and digester, protein spots that matched well across the gels were extracted, digested and further identified by assisted laser desorption/ionization time of flight mass spectrometry (MALDI-TOF-MS).</p><p><b>RESULTS</b>The 2-DE profiles of prostate cells were established, and one protein spot from normal prostate cells identified successfully.</p><p><b>CONCLUSION</b>The 2-DE profiles of normal prostate cells have good reproducibility. We have tentatively established the proteomics research technology of normal prostate cells and demonstrated the feasibility of proteomics research with the model of human normal prostate cells.</p>

Comparative analysis of pedicle screw versus hybrid instrumentation in posterior spinal correction of adolescent idiopathic scoliosis / 中华外科杂志

<p><b>OBJECTIVE</b>To compare the effect of posterior correction and fusion between segmental pedicle screw instrumentation with hybrid constructs in adolescent idiopathic scoliosis (AIS).</p><p><b>METHODS</b>Study the clinical data of 40 AIS patients retrospectively. They were underwent posterior fusion and be distributed into two group, group A was hybrid instrumentation (20 cases) and group B was pedicle screw instrumentation (20 cases). Compared therapy effect, operative time, intraoperative blood loss.</p><p><b>RESULTS</b>The average major curve correction was 82.4% in the screw group and 71.8% in the hybrid group (P = 0.004). After one to three years follow-up, major curve correction was 77.0% and 62.5% respectively (P = 0.001). Average apical vertebral derotation showed 63% correction in the screw group and 32% in the hybrid group (P = 0.001). There was no statistical significance between two group in thoracic sagittal correction, the lowest instrumented vertebra below the lower end vertebra, trunk shift, operative time, and average estimated blood loss. There were no neurologic complications related to hybrid or pedicle screw instrumentation.</p><p><b>CONCLUSION</b>Pedicle screw instrumentation was significantly better than hybrid constructs.</p>

Analysis of the correction results of the adolescent idiopathic scoliosis patients with a proximal thoracic curve / 中华外科杂志

<p><b>OBJECTIVE</b>To analyze the correction results of the adolescent idiopathic scoliosis patients with a proximal thoracic (PT) curve.</p><p><b>METHODS</b>There were 13 cases of double thoracic curve (PUMC IIa) and 13 cases of triple curve (PUMC IIIa 11 cases, IIIb 2 case). The upper instrumented vertebra were at T(3) or above (fusion level including PT curve, Group A) in 18 cases, and at T(4) or T(5) (PT curve not fused, Group B) in 8 cases. Reviewing the medical records and radiographs of 26 adolescent idiopathic scoliosis patients with a proximal thoracic curve that underwent corrective surgery, the changes of the curve and the shoulder balance were analyzed.</p><p><b>RESULTS</b>The coronal Cobb angles of the PT curve and the main thoracic (MT) curve before operation were 45.3 degrees and 61.2 degrees in group A, 35.6 degrees and 58.9 degrees in group B. After operation, they were corrected to 24.2 degrees and 20.1 degrees , 26.4 degrees and 20.3 degrees , respectively. The correction rates of the PT curve and MT curve were 48.2% and 68.7%, 24.5% and 66.3%, respectively. The correction rates of the PT curve of group A was significantly better than group B (P = 0.006), but for the MT curve, the difference was not significant (P = 0.694). The incidence of radiographic shoulder height (RSH) over than 10 mm (shoulder imbalance) after operation in group B was higher than group A significantly (P = 0.038). The incidence rate of shoulder imbalance after operation of the patients with a left higher shoulder or balance shoulder was significantly higher than that of the patients with a right higher shoulder (P = 0.015).</p><p><b>CONCLUSIONS</b>Fusing the PT in patients with a left shoulder not lower than right side will make better coronal correction results of the PT curve and reduce the incidence of postoperative shoulder imbalance.</p>

Expression of collagen type I in the articular processes of apex from adolescent idiopathic scoliosis patients / 中国医学科学院学报

<p><b>OBJECTIVE</b>To investigate the characteristic of the expression of collagen type I in the articular processes of apex from adolescent idiopathic scoliosis (AIS) patients.</p><p><b>METHODS</b>The apical processes of 11 AIS patients were collected. The techniques of HE staining and In-cell Western were adopted in this research. We studied the pathological changes of the apical processes and collected and cultured the osteoblast from the apical processes on both sides in vitro separately. After cell identification, we compared the secretion of collagen type I in the osteoblast from concave side to that of convex side.</p><p><b>RESULTS</b>The cartilages of the apical processes showed some signs of regression. The secretion of collagen type I of the osteoblast in vitro from the concave side of the apical articular process was significantly higher than that from the convex side (P < 0.05).</p><p><b>CONCLUSION</b>Significant difference of the gene expression of the osteoblasts from the apical process exists between the concave side and the convex side.</p>

Reoperative treatment of lumbar disc herniation / 中国医学科学院学报

<p><b>OBJECTIVE</b>To explore the causes, methods and outcomes of reoperative treatment after lumbar disc surgery.</p><p><b>METHODS</b>Nine hundred and twenty eight patients with lumbar disc herniation were treated surgically from January 1995 to January 2004, of whom 43 patients (4.6%) underwent reoperation due to persistent pain or recurrence of symptoms. Forty patients were followed up from 3 months to 84 months (mean 30 months).</p><p><b>RESULTS</b>According to Macnab's criteria, outcomes were excellent in 11 cases (27.5%), good in 16 cases (40%), fair in 8 cases (20%), and poor in 5 cases (12.5%).</p><p><b>CONCLUSIONS</b>The major causes of reoperation after lumbar disc surgery included incomplete removal of herniating discs and recurrent disc herniation of primary interspace, secondary lumbar canal stenosis, and adhesion of nerve roots. Prior to primary surgical treatment of lumbar disc herniation, operative indications must be strictly accurate, surgical methods should be correctly selected, and improved and refined surgical skills should be guaranteed. Satisfactory outcomes can be gained with reoperation for patients who still requiring treatment.</p>

The expression of hypoxia inducible factor-1,2 alpha in sporadic clear cell renal cell carcinoma and their relationships to the mutations of von Hippel-Lindau gene / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate the expression of hypoxia inducible factor (HIF)-1alpha, 2alpha in sporadic clear cell renal cell carcinoma and their relationships to the mutations of von Hippel-Lindau (VHL) gene.</p><p><b>METHODS</b>Mutations of VHL gene, expression of HIF-1alpha and 2alpha were detected by polymerase chain reaction (PCR), direct DNA sequencing and immunohistochemistry in 77 cases of Chinese sporadic clear cell renal cell carcinoma (CCRCC). The stage was pT(1)N(0)M(0)in 55 patients (71%), pT(2)N(0)M(0) in 7 patients (9%), pT(3)N(0)M(0) in 14 patients (18%), and pT(4)N(0)M(0) in 1 patient (1%). The classification according to the tumor nuclear grading system showed 15 carcinomas (19%) of tumor nuclear grade 1, 56 (73%) of tumor nuclear grade 2 and 6 (8%) of tumor nuclear grade 3.</p><p><b>RESULTS</b>None of the VHL gene mutations were found in all the normal tissue specimens. VHL gene mutations were detected in 40 (52%) cases of CCRCC. The positive rate of HIF-2alpha (81%) was higher than that of HIF-1alpha (66%) (chi(2) = 23.310, P < 0.01); The positive rate of HIF-1alpha and HIF-2alpha in the cases of mutations (98% and 93% respectively) was higher than that of them in non-mutations (32% and 68% respectively) (chi(2) = 36.386, 7.617, P < 0.01); The correlation between HIF-1alpha and VHL gene mutations was closer than that between HIF-2alpha and VHL gene mutations (partial correlation coefficiency was 4.481 and 2.027 respectively, P < 0.01). The expression of HIF-1alpha and 2alpha in different pathological grade and stage of CCRCC showed no significant difference (P > 0.05).</p><p><b>CONCLUSIONS</b>Our study suggests that VHL gene mutations are frequent in sporadic CCRCC, and the high expression of HIF-1alpha and 2alpha are found in the group of VHL mutations. However, we have not found significant correlation between the expression of HIF-1alpha and 2alpha and pathological grade and stage of CCRCC in our study.</p>

Minimally-invasive surgical treatment of cervical radiculomyelopathy / 中华外科杂志

<p><b>OBJECTIVE</b>To discuss the effect of the posterior minimally-invasive surgical treatment of root type cervical spondylotic myelopathy.</p><p><b>METHODS</b>A posterior minimally-invasive operation was given to 32 nerve root type cervical spondylotic myelopathy patients, and the clinical result was followed.</p><p><b>RESULTS</b>An operation of enlargement of intervertebral foramen and disc excision was given for 14 young patients whose ligamentum flavum incrassated a little and the disc was soft. An operation of enlargement of intervertebral foramen only was given for 18 old patients whose ligamentum flavum incrassated much with ossification, and the disc was tenacious. All the patients' sign of nerve root was improved after operation. Twenty-eight patients were followed up 3 to 16 months, and there were no obstacle of neck movement and recurrence of clinical sign.</p><p><b>CONCLUSION</b>This method for the posterior minimally-invasive neurosurgical operations of cervical spondylotic myelopathy is safe, simple and effective. By this operation, we can removal most of the herniative cervical disk and decompression for the nerve root and get good stable of spondylopathy.</p>

Clinic effect of alendronate sodium treatment in osteoporosis patients with hip fracture / 中华外科杂志

<p><b>OBJECTIVE</b>To assess efficacy and safety of alendronate sodium treatment in osteoporosis patients with hip fracture.</p><p><b>METHODS</b>One year randomized, double-blind clinical trial was carried out in 77 osteoporosis patients with hip fracture. The bone mineral density (BMD) in lumbar spine (L(2 - 4)), femoral neck (Neck), Wards triangle (Wards) and great trochanter (Troch) was measured by dual energy x-ray absorptiometer (DEXA).</p><p><b>RESULTS</b>In our study, alendronate sodium induced marked increases in BMD of the L(2 - 4) (7.0% +/- 13.0%), Neck (7.3% +/- 11.1%), Wards (4.6% +/- 5.9%), Troch (4.5% +/- 3.2%) (mean +/- s) versus decreases of 2.0% +/- 4.5%, -0.9% +/- 6.9%, 3.6% +/- 4.9% and 1.14% +/- 6.0% with placebo (P < 0.05). Blood Ca, P, ALP, BGP and Urine Pyd/C were no significant difference between before and after therapy. There were usually mild and transient side-effect, such as gastrointestinal symptoms.</p><p><b>CONCLUSION</b>Alendronate is an efficacy and safety drug in treatment of osteoporosis.</p>

Selective thoracic fusion in adolescent idiopathic scoliosis / 中华外科杂志

<p><b>OBJECTIVE</b>To define the criteria of selective thoracic fusion in adolescent idiopathic scoliosis patients.</p><p><b>METHODS</b>By reviewing the roentgenograms of adolescent idiopathic scoliosis patients undergoing selective thoracic fusion, the curve type, Cobb angle, apical rotation and translation, trunk shift, and thoracolumbar kyphosis were measured and analyzed.</p><p><b>RESULTS</b>There were 12 King type II patients (PUMC type: IIb1 9, IIc3 3). The coronal Cobb angle of thoracic curve before and after surgery were 54.0 degrees and 19.0 degrees respectively, and the average correction rate was 62.7%. The coronal Cobb angle of lumbar curve before and after surgery were 34.6 degrees and 12.5 degrees respectively, and the average spontaneous correction rate was 64.7%. At the final follow-up, the coronal Cobb angle of thoracic and lumbar curve was 18.8 degrees and 15.9 degrees respectively. There was no significant change in the coronal Cobb angle, apical vertebral translation and rotation compared with that after surgery. 1 patient had 12 degrees of thoracolumbar kyphosis after surgery, no progression was noted at the final follow-up. There was no trunk decompensation or deterioration of the lumbar curve. In this group, 3.5 levels were saved compared with fusing both the thoracic and lumbar curves.</p><p><b>CONCLUSION</b>Selective thoracic fusion can be safely and effectively performed in patients with a moderate and flexible lumbar curves, which can save more mobile segments to maintain a good coronal and sagittal balance.</p>

The correlation between preoperative pulmonary function and postoperative pulmonary complications in the surgical treatment of scoliosis / 中华外科杂志

<p><b>OBJECTIVES</b>To evaluate the incidence of immediate postoperative pulmonary complications and their correlation to preoperative pulmonary function tests (PFTs), preoperative pulmonary symptoms and surgical approaches.</p><p><b>METHODS</b>The case records of 298 patients, who underwent anterior or posterior fusion, were reviewed. Preoperative PFTs were recorded and abnormal PFTs were defined as forced vital capacity (FVC) is less than 80% of FVC predicted. Preoperative pulmonary symptoms (breathless on exertion) were noted, and postoperative pulmonary complications were defined when the presence of atelectasis, infiltrates, pneumothorax, hemothorax, pneumonia or requirement of postoperative ventilatory support was noted.</p><p><b>RESULTS</b>The mean age of this group was 16.4 years (range from 6-62 years). The average coronal Cobb angle was 73.26 degrees (range from 45 degrees-141 degrees ). Of all the patients, 115 patients had normal preoperative PFTs, the other 183 cases had abnormal PFTs. Nineteen cases of all the patients were found with postoperative pulmonary complications including postoperative ventilatory support in 6 cases, atelectasis in 4 cases, infiltration in 2 cases, pneumothorax in 3 cases, pneumonia in 3 cases and hypoxemia in 1 case. The incidence of postoperative pulmonary complication was 6.4% in all the patients, while 18.99% in the 79 patients with thoracotomy and 1.85% in the 216 patients without. The correlation between postoperative pulmonary complications and the surgical approach was statistically significant (P=0.0000). When the patients were classified into 3 groups: 60%< FVCR <80%, 40%< FVCR <60%, FVCR <40%, the incidence of postoperative pulmonary complications were 2.72% (3/110), 7.40% (4/54) and 31.6% (6/19) respectively, which showed an increasing complication incidence. In the 115 patients with normal PFTs, 3 patients had preoperative pulmonary symptoms (2.68%), while 14 of the 183 patients with abnormal PFTs had preoperative pulmonary symptoms (7.65%). The correlation between presence of preoperative respiratory symptoms and abnormal results on PFTs was statistically significant (P=0.01). No significant correlation was found between preoperative respiratory symptoms and postoperative pulmonary complications (P=0.52).</p><p><b>CONCLUSIONS</b>The incidence of postoperative pulmonary complications increases with the deterioration of PFTs. The posterior procedure has a very low incidence of postoperative pulmonary possibility of complications, but a transthoracic procedure increases the complications significantly. Preoperative respiratory symptoms usually predict abnormal results of PFTs but have no correlation with postoperative pulmonary complication.</p>

Expression and significance of clusterin in normal prostate, benign prostate hyperplasia and prostate cancer / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the expression and significance of Clusterin in normal prostate, benign prostate hyperplasia (BPH) and prostate cancer.</p><p><b>METHODS</b>Clusterin expression in samples of 12 normal prostate, 15 BPH, and 56 prostate cancer were studied by immunohistochemical stain.</p><p><b>RESULTS</b>Of 83 cases, 67 are positive or weak positive (81%). The rate of positive or weak positive for normal prostate, BPH and prostate cancer was 17% (2/12), 73% (11/15), and 96% (54/56) respectively. The expression level of Clusterin in prostate cancer was much higher than in normal prostate (t = 8.82, P < 0.01). BPH (t = 7.63, P < 0.01) was related positively with pathological grade (r = 0.649, P < 0.01) and stage (r = 0.609, P < 0.01) of prostate cancer.</p><p><b>CONCLUSION</b>Clusterin may play an important role in the biological characteristics of prostate cancer by the anti-apoptosis pathway.</p>