Value of hyperextension MRI of cervical vertebra in determining decompression therapy after reduction of reducible atlantoaxial dislocation / 中华创伤杂志

Objective@#To determine the value of hyperextension MRI evaluation in determining whether to perform decompression therapy after reduction of reducible atlantoaxial dislocation as well as assess the decompression effect.@*Methods@#A retrospective case series study was conducted to analyze 24 patients with atlantoaxial dislocation admitted to Honghui Hospital affiliated to Xi'an Jiaotong University from May 2015 to May 2017. There were 10 males and 14 females, aged 40-74 years, with an average age of 52 years. There were 14 patients with os odontoideum, four patients with odontoid fracture, and six patients with transverse atlantal ligament rupture. Hyperextension MRI was performed to assess spinal cord compression for all patients. Eight patients with anterior spinal cord compression (Group A) underwent posterior atlantoaxial arch decompression plus atlantoaxial internal fixation reduction and bone graft fusion; 16 patients without anterior compression of the spinal cord (Group B) underwent only atlantoaxial internal fixation reduction and bone graft fusion. Intraoperative and postoperative complications were recorded. Spinal cord compression index and improvement rate of spinal cord decompression were evaluated by routine cervical spine MRI. Japanese Orthopedic Association (JOA) score was used to evaluate the clinical effect.@*Results@#All patients were followed up for 3-24 months, with an average of 9.3 months. There was no nerve or vertebral artery injury during the operation, and no screw loosening occurred after surgery. The spinal cord compression index (0.37±0.18) in Group A at the last follow-up was significantly lower than that before operation (0.73±0.22) (P<0.05), while the index in Group B (0.19±0.20) at the last follow-up was also lower than that before operation (0.61±0.25) (P<0.05). The improvement rate of spinal cord decompression was 67.11% in Group A and 70.61% in Group B. The final JOA score of Group A was (13.29±3.68)points, which was significantly better than the preoperative JOA [(5.61±2.74)points] (P<0.05). The final JOA score in Group B [(14.13±3.45)points] was also significantly better than the preoperative JOA [(7.32±2.90)points] (P<0.05). Improvement rate of JOA was 57.31% in Group A and 59.91% in Group B.@*Conclusions@#Hyperextension MRI of cervical vertebra can effectively judge whether the anterior spinal cord is compressed after reduction of atlantoaxial dislocation. It has important clinical significance for decompression treatment during reduction and internal fixation of reducible atlantoaxial dislocation. At the same time, posterior atlantoaxial arch resection and decompression can effectively relieve the compression of the spinal cord after reduction of atlantoaxial dislocation.

Value of hyperextension MRI of cervical vertebra in determining decompression therapy after reduction of reducible atlantoaxial dislocation / 中华创伤杂志

Objective To determine the value of hyperextension MRI evaluation in determining whether to perform decompression therapy after reduction of reducible atlantoaxial dislocation as well as assess the decompression effect. Methods A retrospective case series study was conducted to analyze 24 patients with atlantoaxial dislocation admitted to Honghui Hospital affiliated to Xi'an Jiaotong University from May 2015 to May 2017. There were 10 males and 14 females, aged 40-74 years, with an average age of 52 years. There were 14 patients with os odontoideum, four patients with odontoid fracture, and six patients with transverse atlantal ligament rupture. Hyperextension MRI was performed to assess spinal cord compression for all patients. Eight patients with anterior spinal cord compression ( Group A ) underwent posterior atlantoaxial arch decompression plus atlantoaxial internal fixation reduction and bone graft fusion; 16 patients without anterior compression of the spinal cord ( Group B ) underwent only atlantoaxial internal fixation reduction and bone graft fusion. Intraoperative and postoperative complications were recorded. Spinal cord compression index and improvement rate of spinal cord decompression were evaluated by routine cervical spine MRI. Japanese Orthopedic Association ( JOA) score was used to evaluate the clinical effect. Results All patients were followed up for 3-24 months, with an average of 9. 3 months. There was no nerve or vertebral artery injury during the operation, and no screw loosening occurred after surgery. The spinal cord compression index (0. 37 ± 0. 18) in Group A at the last follow-up was significantly lower than that before operation (0. 73 ± 0. 22) (P<0. 05), while the index in Group B (0. 19 ± 0. 20) at the last follow-up was also lower than that before operation (0. 61 ± 0. 25) (P<0. 05). The improvement rate of spinal cord decompression was 67. 11％ in Group A and 70. 61％ in Group B. The final JOA score of Group A was ( 13. 29 ± 3. 68 ) points, which was significantlybetterthanthepreoperativeJOA[(5.61±2.74)points] (P <0.05). ThefinalJOA score in Group B [(14. 13 ± 3. 45) points] was also significantly better than the preoperative JOA [(7. 32 ± 2. 90)points] (P<0. 05). Improvement rate of JOA was 57. 31％ in Group A and 59. 91％in Group B. Conclusions Hyperextension MRI of cervical vertebra can effectively judge whether the anterior spinal cord is compressed after reduction of atlantoaxial dislocation. It has important clinical significance for decompression treatment during reduction and internal fixation of reducible atlantoaxial dislocation. At the same time, posterior atlantoaxial arch resection and decompression can effectively relieve the compression of the spinal cord after reduction of atlantoaxial dislocation.

Correlation between complements and risk factors for essential hypertension / 西安交通大学学报(医学版)

Objective To investigate the relationship of complements C3 and C4 with essential hypertension and its risk factors, homocysteine (HCY) and blood lipids.Methods We selected 20 healthy subjects for physical checkup as control group and 45 patients with hypertension as hypertension group.According to The Guidelines for Prevention and Treatment of Dyslipidemia in Chinese Adults, the hypertension group was divided into lipid regulating therapy group and non-lipid regulating therapy group.We determined the levels of complements C3 and C4, HCY, total cholesterol, low density lipoprotein and apolipoprotein.Pearson linear correlation regression analysis was used to analyze the correlation of the complements with HCY and blood lipid indexes.Results Complements C3 and C4 were significantly higher in the hypertension group than in the control group (P0.05) or to homocysteine (P=0.074, P=0.894).Conclusion Complements C3 and C4 are closely related to essential hypertension.Activation of the complement system is one of the important risk factors for hypertension.The lipid regulating therapy can significantly alleviate immune damage in patients with essential hypertension.Hyperhomocysteinemia is an independent risk factor for essential hypertension.

Novel completed biodegradable polymer sirolimus-eluting stent versus durable polymer sirolimus-eluting stent in de novo lesions: nine-month angiographic and three-year clinical outcomes of HOPE trial / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Drug-eluting stents (DES) with durable polymer have significantly reduced restenosis and target vessel revascularization compared with bare metal stents. Durable polymer has been linked with persistent inflammation of vessel wall and delayed endothelial healing that may increase the risk of late and very late stent thrombosis. This study sought to evaluate the efficacy and safety of HELIOS completed biodegradable polymer sirolimus-eluting stent (SES) in de novo coronary lesions.</p><p><b>METHODS</b>Totally, 287 patients with one or two de novo coronary lesions (lesion length ≤ 38 mm and reference vessel diameter 2.5-4.0 mm) were enrolled in the HOPE study, a prospective, multicenter, randomized, non-inferiority trial. Patients were randomized to treatment either with HELIOS completed biodegradable polymer SES (n = 142) or PARTNER durable polymer SES (n = 145). The primary endpoint was angiographic in-stent late lumen loss (LLL) at 9-month follow-up. The secondary endpoint included stent thrombosis and major adverse cardiac events including cardiac death, myocardial infarction (MI) and target lesion revascularization (TLR).</p><p><b>RESULTS</b>The 9-month in-stent LLL in the HELIOS group was similar to the PARTNER group, (0.16 ± 0.22) mm vs. (0.19 ± 0.30) mm (P = 0.28). The difference and 95% confidence interval were -0.03 (-0.09, 0.04), and the P value for non-inferiority <0.01. Major adverse cardiovascular event (MACE) occurred in 7.9% vs. 8.2%, MI in 2.4% vs. 3.0%, TLR in 5.5% vs. 3.0%, and stent thrombosis in 0 vs. 1.5%; and events were comparable between the HELIOS group and PARTNER group at three-year follow-up (all P > 0.05). The three-year cardiac death was lower in the HELIOS group, but with no significant difference, 0 vs. 3.0% (P = 0.12).</p><p><b>CONCLUSIONS</b>In the HOPE trial, the novel completed biodegradable polymer SES HELIOS was non-inferior to the durable polymer SES PARTNER with respect to nine-month in-stent LLL in de novo coronary lesions. The incidence of other clinical endpoints was low for both of the stents in three-year follow-up.</p>

Diclofenac inhibits Kv1.3 and Kir2.1 expressions in human macrophages and affects the membrane potential and foam cell formation / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the effect of diclofenac on the expression of Kv1.3 and Kir2.1 channels in human macrophages and the membrane potential and foaming process of the macrophages.</p><p><b>METHODS</b>The effect of diclofenac on the expression of Kv1.3 and Kir2.1 channels in cultured human monocyte-derived macrophages was investigated using real-time RT-PCR and Western blotting, and its effect on the membrane potential was analyzed with optical mapping of the membrane potential with voltage-sensitive dyes. The ratio of cholesterol ester (CE) in the macrophages following intake of oxidized low-density lipoprotein (OxLDL) was analyzed by an enzymatic fluorometric method.</p><p><b>RESULTS</b>The expression of Kv1.3 and Kir2.1 channels in the macrophages were down-regulated by diclofenac (1.5 µmol/L and 15 µmol/L). Compared with those in the control group, Kv1.3 mRNA expression was reduced by over 80% and 90% (P<0.05), and Kir2.1 mRNA by over 20% and 30% (P>0.05), respectively; both their protein expression was reduced by over 10% and 60% with a dose- dependent effect (P<0.05). Diclofenac at the two doses dose-dependently reduced the surface fluorescence intensity of the macrophage, and the membrane potential was decreased by 28% and 54%, respectively (P<0.05). Incubation of the macrophages with 30 mg/L OxLDL for 60 h caused an obvious enlargement of the cell volume and deposition of numerous lipid granules in cytoplasm, resulting also in a CE/TC ratio over 50% (P<0.05). Diclofenac at 1.5 and 15 µmol/L both significantly decreased the CE/TC ratio to (23.624∓3.34)% and (13.601∓2.916)% (P<0.05), respectively, but this effect did not show a dose-response relationship (P>0.05).</p><p><b>CONCLUSION</b>Diclofenac can significant down-regulate the expression of Kv1.3 and Kir2.1 channels in human macrophages, lower their membrane potential and inhibit the process of foam cell formation.</p>

Biomechanical effect of bone cement volume and distribution on lumbar vertebral body with osteoporotic fracture / 中华骨科杂志

Objective To evaluate biomechanical effect of bone cement distribution on lumbar vertebral body with osteoporotic fracture.Methods Forty nine lumbar vertebrae (L1-L5) specimens were collected from 12 old cadavers.After exerting axial pressure load on every specimen,the initial intensity and stiffness were measured,and then vertebral body crush fracture models were established.According to zones where bone cement was injected in vertebrae,the specimens were divided into one control group and six experimental groups:A,B,C,D,E,F groups,i.e.unilateral anterior 2/3 group,unilateral posterior 2/3 group,unilateral whole group,bilateral anterior 2/3 group,bilateral posterior 2/3 group,and bilateral whole group,respectively,including 7 specimens in each group.In A,B,C groups,unipedicular balloon kyphoplasty was done,while in D,E,F groups,bipedicular balloon kyphoplasty was done.Then the maximum compressive strength and stiffness were measured.Results After percutaneous kyphoplasty,the maximum strength in all experimental groups was significantly greater than that in the control group.There were no significant differences in strength between A and B groups,between C,D and E groups.For the maximum strength,the results of comparison were:F group ＞ C group,D and C groups ＞ A and B groups.Except for F group,the stiffness in other 5 experimental groups was significantly lower than its initial value.There were no significant differences in stiffness between A,B,and C groups,between D and E groups.However,the stiffness in F group was greater than those in D and E groups,and it was greater in bilateral groups than those in unilateral groups.Conclusion Bone cement distribution in lumbar vertebral body can affect biomechanical property of vertebral body,and the bilateral distribution can cause better biomechanical effect than unilateral distribution.The ideal distribution zone of bone cement is in the anterior 2/3 of the vertebral body.

Analysis in short-term clinical benefit of percutaneous kyphoplasty for treating osteolytic tumor of thoracic lumbar vertebrae / 肿瘤研究与临床

ObjectiveTo evaluate the relief of pain and daily activities in patients with osteolytic tumor of thoracic lumbar vertebrae by percutaneous kyphoplasty (PKP).MethodsA retrospective study was conducted to review 35 cases of osteolytic tumor of vertebrae treated with PKP.All patients had a refractories back pain while CT and MRI showed osteolytic changes in their vertebrae. The operation involved percutaneously inserting inflatable vertebral body and creating a cavity filled with bone cement.The visual analogue scales (VAS),WHO standards for pain relief and owestry disability index (ODI) were recorded after the procedures.The change of height in abnormal vertebrae and status of postoperative leakage of PMMA were also recorded.These data were followed up after 1 day,1 month and 6 months and analyzed via t student test.ResultsThe total 35 operations were done successfully.All patients got a conspicuous pain relief at 24 h after operation,and no spinal injury or compression was found.The X-ray showed that the vertebrates treated were filled well by cerment.There were significant differences at pain levels[(7.52±0.81)vs(4.31±0.32)],locomotor activity scales (ODI) [(69.45±0.87) vs (54.45±0.85)] and the height of vertebral bodies [(2.0±0.5) mm vs (2.7±0.4) mm] before and after operation (t value was -7.34,-5.32 and -3.36,respectively,P ＜ 0.05).At 6 months,follow up studies showed that clinic therapeutic effects were stabled for odynolysis and locomotor activity scales.The rates of pain relief in 24 h,1 month and 6 months were 80.0 ％ (28/35),85.7 ％ (30/35),82.8 ％ (29/35),respectively.ConclusionPKP is a single safe and effective way to treat osteolytic tumor of thoracic lumbar vertebrae.It can simply,quickly,and effectively relief the pain caused by osteolytic spinal tumor,recover height of the abnormal vertebra,and improve patient's life quality safely with less complications.

Identification of a novel KCNH2 mutation in a family with congenital long QT syndrome and prediction of the secondary structure of its encoding protein / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To identify the gene mutation in a Chinese family with congenital long QT syndrome (LQTS) and predict the changes of the secondary structure of the protein.</p><p><b>METHODS</b>Polymerase chain reaction and DNA sequencing were used to screen for KCNH2 mutation in the proband. After the mutation was identified, KCNH2 gene of the family members was screened by multiplex PCR with site-specific primers. Network analysis software was used to predict the secondary structure of the KCNH2 protein.</p><p><b>RESULTS</b>A novel heterozygous missense mutation of F463L(GenBank accession no.EU218526) located at the transmembrane domain S2 of KCNH2 was detected. The mutation did not result in the change of the transmembrane domain, but altered the hydrophobicity and secondary structure of the protein.</p><p><b>CONCLUSION</b>The novel mutation identified in this study has enriched the GenBank data of ion channel gene mutation in LQTS. The changes of the secondary structure caused by the gene mutation were analyzed by Mfold and TMHMM software, which may help to understand LQTS.</p>

Effect of ABCA1-V771M polymorphism on plasma lipid levels and its relationship with coronary atherosclerotic heart disease / 西安交通大学学报·英文版

Objective: To explore the risk association of ABCA1-V771M polymorphism with coronary heart disease (CHD) in Han nationality in Northwest of China. Methods With case-control study, ABCA1-V771M polymorphism was detected in 204 unrelated Han nationality people in Northwest of China, and all the subjects by coronary angiography were grouped into 106 cases and 98 controls. The genotypes and alleles frequency distribution of ABCA1-V771M polymorphisms were analyzed by PCR-RFLP analysis, and the clinical statistics of serum lipids were compared and its effects of ABCA1-V771M polymorphism on the plasma lipid levels and coronary atherosclerotic heart disease were analyzed. Results: The genotypic frequencies of ABCA1-V771M polymorphism matched well under Hardy-Weinberg equilibrium (P>0.05), V and M allelic frequencies were 33.3% and 66.7%. In comparison with VV+VM genotype carriers, MM genotypes carriers had much lower plasma levels of HDL-C (P0.05). Conclusion: ABCA1-V771M polymorphism was not only associated with the plasma levels of HDL-C and TG, but also related to the susceptibility and severity of coronary atherosclerotic heart disease. Moreover, M771 allele appeared to be atherogenic among Han population in Northwest of China.

Effect of ABCA1-V771M polymorphism on plasma lipid levels and its relationship with coronary atherosclerotic heart disease / 药物分析学报

Objective To explore the risk association of ABCA1-V771M polymorphism with coronary heart disease (CHD) in Hart nationality in Northwest of China. Methods With case-control study, ABCA1-V771M polymorphism was detected in 204 unrelated Hart nationality people in Northwest of China, and all the subjects by coronary angiography were grouped into 106 cases and 98 controls. The genotypes and alleles frequency distribution of ABCA1-V771M polymorphisms were analyzed by PCR-RFLP analysis, and the clinical statistics of serum lipids were compared and its effects of ABCA1-V771M polymorphism on the plasma lipid levels and coronary atherosclerotic heart disease were analyzed. Results The genotypic frequencies of ABCA1-V771M polymorphism matched well under Hardy-Weinberg equilibrium (P>0.05), V and M allelic frequencies were 33.3% and 66.7%. In comparison with VV+VM genotype carriers, MM genotypes carriers had much lower plasma levels of HDL-C (P<0. 001) and much higher plasma levels of TG (P<0. 05). M allelic frequency in CHD group was significantly higher than V allelic frequency (P<0. 05). M allele was related with more severity of atherosclerosis in the coronary artery than V allele (P<0.05). However, there was no obvious difference in the incidence of AMI among carriers with three genotypes of ABCA1-V771M polymorphism (P>0.05). Conclusion ABCA1-V771M polymorphism was not only associated with the plasma levels of HDL-C and TG, but also related to the susceptibility and severity of coronary atheroselerotic heart disease. Moreover, M771 allele appeared to be atherogenie among Han population in Northwest of China.

Unilateral vesus bilateral minimally invasive transforaminal fixation in lumbar interbody fusion / 中国矫形外科杂志

0.05).Operation time in group A was shorter than that in group B,with significant difference(P0.05).No postoperative complication was found in two groups.[Conclusion]Unilateral TLIE technique has achieved satisfying postoperative effect compared with bilateral TLIF,with a good prospect in clinical application.

Effects of pulse pressure on coronary artery disease / 西安交通大学学报(医学版)

Objective To study the effects of pulse pressure (PP) on coronary artery disease. Methods High and low systolic blood pressure (SBP), diastolic blood pressure (DBP) and pulse pressure (PP) were measured in 221 cases with coronary heart disease diagnosed by coronary artery radiography, and the differences of coronary artery count, score, and clinic features were analyzed. Results ① Compared with low SBP group \[81mmHg)) were older in age, with higher percentage of females and lower incidence of unstable angina pectoris(UA) and acute myocardial infarction(AMI). ② Compared with low PP group(

A compare of hindlimbs locomotor function recovery after spinal cord injury in rats / 西安交通大学学报(医学版)

Objective To contrast the different scale rule of hindlimbs locomotor function recovery after the rat spinal cord was injured.Methods A total of 40 rats were divided into 3 groups: normal group,spinal cord injury group(SCI)(Modified Allen method),and control group(CON)(only T_(10) laminectomy).To observe nerve functional recovery of hindlimbs after operation in 1w,2w,3w,4w,6w respectively.Score standard: Inclined plane method,Modified Tarlov grading,BBB scale and recording results.Results To contrast SCI group and control group,critical angle in incline plane test was decreased in 6 weeks(P0.05);in convalescence stage(from 1w to 6w),the degree of every one of BBB scales was distinguished(P