Strong halo-femoral traction with wide posterior spinal release and three dimensional spinal correction for the treatment of severe adolescent idiopathic scoliosis / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Many investigators advocate anterior release combined with halo-femoral traction and posterior fusion when treating stiff thoracic curves in patient with adolescent idiopathic scoliosis (AIS). But the anterior operations often induce severe complications. Some surgeons choose posterior-only surgery with halo-femoral traction, posterior wide release and correction. But to the best of our knowledge, there are only rare prospective studies on these posterior-only surgeries for AIS patients who have a rigid curve more than 80° and flexibility less than 35%.</p><p><b>METHODS</b>Sixty-four AIS patients were recruited from September 2006 to June 2009. All patients had rigid curves and underwent spinal correction. They were randomly divided into group A (combined anteroposterior surgery) and group B (posterior-only surgery). Images and scoliosis research society-22 questionnaire (SRS-22) scores were performed pre- and post-operation and during follow-up visits. The operation time, blood loss, hospital days, and hospital charges were compared between the two groups.</p><p><b>RESULTS</b>These patients were followed for an average of 37.5 months (range, 24 - 65 months). No serious complications were observed. There were no significant differences between the two groups in gender, age, preoperative radiographic data, or preoperative SRS-22 score. The average operation time, blood loss, hospital days and hospital charges in group B were less than those in group A. The SRS-22 score in group B was better than in group A at post-operation and at final follow-up.</p><p><b>CONCLUSIONS</b>In AIS with a rigid curve more than 80° and flexibility less than 35%, strong halo-femoral traction with wide posterior spinal release and three dimensional spinal correction can provide better SRS-22 scores, comparable curve correction, shorter operation time, less blood loss, shorter hospital stays and lower charges when compared to combined anterior and posterior surgery.</p>

Effect of adenovirus-mediated tissue factor pathway inhibitor gene transfer on apoptosis of rat vascular smooth muscle cells / 中华心血管病杂志

<p><b>OBJECTIVE</b>Previous studies showed potential role of tissue factor pathway inhibitor (TFPI) on attenuating restenosis, we investigated the effect of TFPI gene transfer on vascular smooth muscle cells (VSMCs) apoptosis.</p><p><b>METHODS</b>Human TFPI recombinant adenovirus or LacZ recombinant adenovirus or PBS were transferred to rat aortic VSMCs respectively in vitro. RT-PCR was used to detect the expression of exogenous TFPI gene. VSMCs were examined by cell counting and MTT. Apoptosis of VSMCs was detected by flow cytometry, TUNEL and electron microscope at different time after gene transfer.</p><p><b>RESULTS</b>mRNA expression of TFPI was detected in VSMCs at the 3rd day after gene transfer. Cell numbers and absorbance value in Ad-TFPI group were similar as those in Ad-LacZ and PBS groups at the 1st, 3rd and 5th day but significantly lower at the 7th day (P<0.05) after gene transfer. The apoptosis rates in Ad-TFPI group tested by flow cytometry were all significant higher than those in Ad-lacZ groups at each time point. The positive rates in Ad-TFPI group determined by TUNEL were significant higher than those in Ad-LacZ groups at 3rd (10.82% +/- 1.57% vs. 3.46% +/- 0.93%), 5th and 7th (16.95% +/- 2.01% vs. 5.11% +/- 1.29%, all P<0.05) day post gene transfer. Electron microscope evidenced cell contracting, cytoplasm condensing, lightly swelled mitochondria, nucleus pyknosis and apoptotic body formation after gene transfer in Ad-TFPI group which were not shown in cells of LacZ and PBS groups.</p><p><b>CONCLUSION</b>TFPI gene transfer could induce apoptosis in rat VSMCs which might be one of the mechanisms responsible for its beneficial effect on restenosis inhibition after angioplasty.</p>

Experimental study on cyclosporine A impairing the rat myocardial tissue / 中国地方病学杂志

Objective To observe the impairment of different doses of cyclosporine A (CsA) to the rat myocardial tissue to offer scientific evidence for the long-term safe application of CsA in heart transplantation. Methods Eighty-four female Wistar rats, each weighing of (200 ± 25)g, were randomly divided into 12 groups. On days 7,14,21 after a constant peritoneal injection of CsA(0,5,10,15 mg/kg) and 1 ml physiological saline in control group, the rats were put to death, the rat myocardial tissue taken, to observe the pathologic and structural changes of the tissue cells under light microscope and electron microscope. The contents of rat myocardium tissue malondialdehyde(MDA) and superoxide dismutase(SOD) were measured;cardiomyocyte apoptosis was detected and accounted, apoptosis index(AI) was measured with the method of TUNEL. Results Small dose of CsA(5 mg/kg)had no obvious effects on cardiac tissue, in CsA groups of 10 mg/kg and 15 mg/kg, under the light microscope, there appeared edema, degeneration and necrosis of myocardium, part of cardiac myocyte had different level cavity;under the electron microscope, there appeared mitochondria damage, nucleus shrinkage and chromatic margination, part of cardiac myocyte had focus cavity. There was dilated endoplasic reticulum in the sarcoplasm. The effects of different time and dose on MDA content of rat myocardium tissue had statistical significance (F = 6.37,10.15, both P < 0.05). Interaction between time and dose existed statistical significance (F=7.14, P< 0.05). The MDA contents of CsA group of 10 mg/kg and 15 mg/kg were [(2.29 ± 0.18), (3.10 ± 0.45), (2.57± 0.37)nmol/L] and [(3.09±0.63), (3.32 ±0.52), (3.34 ± 0.29)nmol/L] on days 7,14,21 after a constant peritoneal injection of CsA, which were obviously higher than the control group [(1.98 ± 0.20), (2.04 ± 0.52), (1.99 ± 0.26) nmol/L, all P < 0.05], respectively. The effects of different time and dose on SOD activity of rat myocardium tissue had statistical significance(F = 8.43,11.69, both P < 0.05). Interaction between time and dose existed statistical significance(F = 9.86, P < 0.05). The SOD activity of CsA groups of 10 mg/kg and 15 mg/kg were (15.95 ± 1.00), (12.74 ± 1.31), (14.01 ± 0.81)nmol/L and (13.04 ± 1.01), (14.68 ± 0.81), (14.01 ± 0.63)nmol/L on days 7,14,21 after a constant peritoneal injection of CsA, which were obviously higher than the control group [(10.38 ± 0.80), (9.73 ± 0.58), (10.20 ± 0.26)nmol/L, all P < 0.05], respectively. Apoptosis nucleus appeared huffy or brown under the light microscope. The effects of different time and dose on AI of rat myocardium tissue had statistical significance (F = 10.02,20.46, both P < 0.05). Interaction between time and dose existed statistical significance (F = 15.73,P < 0.05). The AI of CsA groups of 10 mg/kg and 15 mg/kg were (6.91 ± 0.70)%, (11.10 ± 2.05)%,(19.81 ± 5.00)% and (11.02 ±2.02)%,(15.51 ± 1.31)%,(33.40±6.60)% on days 7,14,21 after a constant peritoneal injection of CsA, which were obviously higher than the control group [(4.40 ± 0.13)%, (4.60± 1.20)%, (5.20 ± 1.10), all P < 0.05] and CsA group of 5 mg/kg [(4.60 ± 0.10)%, (5.00±2.11)%, (5.43± 1.11)%, all P < 0.05], respectively. Conclusion Small dose of CsA has no obvious effects on cardiac tissue, but large dosage can induce myocyte apoptosis and damage by causing oxidative stress;after implantation, attention should be paid to cardiac impairment due to constant large dosage of CsA.

Analysis on the prevalence of hypertension in patients with Keshan disease in Fuyu County, Heilongjiang Province / 中国地方病学杂志

Objective To explore the reasons why patients with Keshan disesse complicated with hypertension and their interaction in Fuyu County, Heilongjiang Province. Methods Fifty-three patients with Keshan disease were investigated in January, April and July in 2007. Blood pressure was measured and the risk factors of hypertension were investigated. According to the diagnostic criteria of hypertension, patients were divided into hypertension group and non-hypertension group, and then the risk factors of hypertension, as well as the course of Keshan disease, were compared between the two groups. The risk factors include age, gender, family history of hypertension, salt intake in diet, smoking, drinking and obesity. Results The age of hypertension group[(57.83±8.89)years] was significantly higher than that of non-hypertension group [(51.53 ± 9.43)years, t = 2.3630, P < 0.05) ;while the course of Keshan disease in non-hypertension group [(31.63 ± 8.66)years] was notably longer than that in hypertension group [(25.08±11.41)years, t = 2.0224, P < 0.05] ;No statistically significant difference in gender, family history of hypertension, salt intake in diet, smoking, drinking and obesity was observed between the two groups(χ2 = 0.0072,0.1779,0.0029,0.1555,0.119,0.7679, all P > 0.05). Conclusions Age might be an important factor in patients with Keshan disease accompanied by hypertension, and the role of other risk factors of hypertension should not be overlooked;whether Keshan disease and hypertension can affect each other needs further investigation.

Evaluation on self-treatment of patients with chronic Keshan disease in Fuyu County, Heilongjiang Province / 中国地方病学杂志

Objective To evaluate the self-treatment effectiveness on patients with ehwnic Keshan disease.Methods Twenty patients with chronic Keshan disease were selected from individuals with Keshan disease in Fuyu County,Heilongjiang Province.They were trained three times every three months of self management including pathogenetic condition education,general guidance,drug therapy,and they also taught how to adiust the doBe of drug according to their illness.Major symptom score,heart rate(HR),ultrasoundcardiogram (UCG)index and cardiac functional grading of these patients at basehne,after 3 months and 6 months of treatment were compared.Results The 20 patients rated their main symptoms score as(15.03 ±6.77)before self- treatrnent,and significantly decreased to(7.25±4.82)and(6.70±4.90)after 3 and 6 months treatment(P<0.01); the heart rate(HR) was (76.40±12.06) beats per minute(bpm)before self-treatment,and dramatically decreased to (69.95±12.63),(67.15±9.76)bpm after 3 and 6 months treatment(P<0.01).As for UCG detecting index,left atrial diameter(Lad)aIld left ventricular end-diastolic diameter(LVEDd)Was(37.85 ±5.23)nun and(52.49± 9.38)mm separately before self-treatment,and notablely decreased to(36.77 ±5.63),(52.15 ±9.24)mm,and (35.29±5.50),(50.81±8.88)mm respectirely after 3 and 6 months of treatment(P<0.01 or<0.05);left ventricuIar ejection fractiOII(LVEF)markedly increased(P<0.05),from(55.15±15.80)%at baseline to(57.35± 12.51)%at 3 months and(60.30±13.42)%at 6 months;there were no significant differences in mitral flow E/A ratio changes before and after treatment(P>0.05);compared with prior to the treatment.cardiac function grading was significantly better aftertreatmentfor 3 months(T=36.0,P<0.05),but not after 6 months(T=17.5,P> 0.05).Conclusions The patients'serf-treatment is effective,which we recommend to uphold and widespread.