Study on the growth curve of uncorrected visual acuity of children and adolescents with relative safe refractive range / 中国学校卫生

Objective@#To analyze the distribution of uncorrected visual acuity in children and adolescents aged 3-18 years with relative safe refractive range, and to develop the growth curve and reference range of uncorrected visual acuity in children and adolescents of different ages, so as to provide reference for formulating the referral threshold for myopia screening practice.@*Methods@#Using cluster sampling method, 9 146 children and adolescents aged 3-18 years old in Shanghai were selected for uncorrected visual acuity, cycloplegic refraction, slit lamp and other ophthalmic examinations, and the percentiles and growth curve of uncorrected visual acuity of children and adolescents in the relative safe refractive range were fitted by LMS method. Besides, the area under the ROC curve and the sensitivity and specificity of different cut-off values were analyzed.@*Results@#The uncorrected visual acuity was skewed, with a median of 4.8. There were 4 675 individuals with safe refraction, the median of uncorrected visual acuity in which was 4.9. The LMS curve showed that the uncorrected visual acuity increased with age in the lower age group, and gradually stabilized to the best level at the age of 6-10. P 50 was 4.8 in 3-4 years old, 4.9 in 5-8 years old, 5.0 in 9 years old and above. The area under ROC curve of uncorrected visual acuity predicting refractive abnormality increased with age, with the lowest value of 0.55(95%CI=0.50-0.61) at 3 years old and the highest value of 0.95 (95%CI=0.94-0.96) at 12-18 years old. The Youden index was the highest for P25 at 3-6 years old, and the highest for P 10 at 7 years old and above. With the increase of the cut off value, the sensitivity increased and the specificity decreased.@*Conclusion@#The uncorrected visual acuity increases gradually with age, and reaches the best level after 6-10 years old. The screening effect of uncorrected visual acuity predicting refractive abnormality increased with age. It is suggested that the referral threshold of children and adolescents with abnormal uncorrected visual acuity should be set according to their ages, and P 25-P 75 can be selected according to the screening purposes.

Expert consensus on rehabilitation strategies for traumatic spinal cord injury / 中华创伤杂志

TSCI have dyskinesia and sensory disturbance that can cause various life-threaten complications. The patients with traumatic spinal cord injury (TSCI), seriously affecting the quality of life of patients. Based on the epidemiology of TSCI and domestic and foreign literatures as well as expert investigations, this expert consensus reviews the definition, injury classification, rehabilitation assessment, rehabilitation strategies and rehabilitation measures of TSCI so as to provide early standardized rehabilitation treatment methods for TSCI.

Warming needling combined with decoction for arteriosclerosis obliterans with stasis / 中国针灸

<p><b>OBJECTIVE</b>To observe the effect difference of warming needling combined with decoction and ciloprost for arteriosclerosis obliterans (ASO) with stasis.</p><p><b>METHODS</b>A total of 96 ASO patients with stasis were randomly assigned into a combination group and a western medication group, 48 cases in each group. Anti-hypertension, glucose-lowering and lipid lowering therapies were applied in the two groups. Ciloprost was prescribed orally in the western medication group, twice a day, 100 mg a time. The main acupoints in the combination group were Sanyinjiao (SP 6), Yinlingquan (SP 9), Zusanli (ST 36), Guanyuan (CV 4), and Xuehai (SP 10), matched with Yanglingquan (GB 34) and Weizhong (BL 40). Warming needling was used at Sanyinjiao (SP 6), Zusanli (ST 36), Xuehai (SP 10) and Guanyuan (CV 4), 5 times a week, once a day, 20 min a time. At the same time, self-made decoction was applied in the combination group, 1 dose a day, twice a day. All the treatment was given for continuous 3 courses, 1 month as a course. The indexes were the symptom scores for cool limb skin, sour swelling, numbness, pain, abnormal complexion, ankle brachial index (ABI) and blood biochemical indexes, including fasting blood-glucose (FPG), triacylglycerol (TG), cholesterol total (TC), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), glutamic-pyruvic transaminase (ALT), glutamic-oxalacetic transaminase (AST), serum creatinine (Scr) and blood urea nitrogen (BUN). The adverse reactions were recorded. The clinical effect was evaluated. Two-month follow-up was carried out.</p><p><b>RESULTS</b>After treatment, the symptom scores for cool limb skin, sour swelling, numbness, pain, abnormal complexion and total score decreased in the two groups (all <0.05), with better results in the combination group (all <0.05). The bilateral ABI were higher than those before treatment in the two groups (all <0.05), with better results in the combination group (both <0.05). The FPG, TG, TC, HDL-C, LDL-C, ALT, AST, Scr, BUN before and after treatment had no statistical significance in the two groups (all >0.05). There was no adverse reaction on acupuncture and moxibustion. The total effective rate of the combination group was 95.8% (46/48), which was better than 91.7% (44/48) of the western medication group (<0.05). The recurrence and aggravation rate in the combination group was 8.7% (4/46), which was lower than 18.2% (8/44) in the western medication group (<0.05).</p><p><b>CONCLUSION</b>Warming needling combined with decoction for ASO are better than simple oral ciloprost, with safety.</p>

Analyzing Risk Factors that were Associated with Loss of Correction Curvature after Short-segment Restoration and Fixation in Cases Who had Single-segment Thoracolumbar Fracture / 现代生物医学进展

Objective:To analyze risk factors that were associated with loss of correction curvature after short-segment restoration and fixation in cases who had single-segment thoracolumbar fracture.Methods:87 Cases who had experienced single-segment thoracolumbar fracture and had underwent short-segment restoration and fixation in our department from Jan 2008 to Jan 2011,and had complete follow-up imaging were included.Cobb angles were measured on lateral thoracolumbar X-ray preoperatively,postoperatively and before removal of internal fixation.And these included the angle formed by vertebras that located above and below injured vertebrae (α angle),superior endplate of injured vertebrae and its superior vertebrae (β angle),inferior endplate of injured vertebrae and its inferior vertebrae (γ angle),inferior and superior endplate of injured vertebrae (δ angle).T-test was used to analyze these angles and their changes.And correlation analysis was used to analyze relationships between α angle change and other risk factors.Results:When compared with preoperative angles,the mean α angle,β angle,γ angle and δ angle were all significantly increased (p＜0.05) after the operation.The mean α angle and δ angle before the removal of internal fixation were both significantly smaller than those after the operation (p＜0.05),and the mean change ofα angle was-2.85 degrees.After the correlation analysis,we found significant correlations between the change ofα angle and postoperative correction curvature(-0.342,p=0.026),injured region in endplate(0.374,p=0.015),and change of the δ angle(0.231,p=0.041).Conclusion:There was significant loss in the correction curvature before the removal of internal fixation.And the loss was significantly associated with postoperative correction curvature,injured region in endplate,and change of the δ angle.

Finite element analysis of different motion states of vertebral pedicle screw fixation in thoracolumbar fractures / 医学研究生学报

Objective Construct the finite element model of vertebral pedicle screw fixation in thoracolumbar fractures can obtain the intuitive systematic mechanical effects under different motion conditions, it has a very important significance to the patients' rehabilitation, evaluation of system stability and prognosis.In this study, the biomechanical effects of different motion states of thoracic and lumbar spine fracture models were analyzed by the finite element analysis method.Methods We selected 1 orthopedic health volunteers from Nanjing General Hospital of Nanjing Military Region in June 2014, established the finite element model by the CT scan data of the healthy volunteer, used the geometric cutting method for fracture simulation and replacement, assembled posterior orthopedic internal fixation system of vertebral pedicle screw, simulated the different motion states and obtained the stress nephogram and displacement graph of the nail-stick system..Results For the six-nail and two-rod internal fixation system of posterior nail-stick system which set nails through injured vertebrae, we used the finite element operation method to simulate the biomechanical characteristics of different modes of motion in space, it combined by the movement of six directions(flexion, dorsiflexion, left side bend, right side bend, left twist, right twist).The maximum stress(94.99±1.72MPa) and the maximum displacement(0.1854±0.0052mm) and the of the dorsiflexion were significantly lower than that of flexion[(126.82±5.56)MPa、(0.2502±0.0050)mm]、left side bend[(152.18±9.13)Mpa、(0.3172±0.0048)mm]、right side bend[(159.58±13.54)Mpa、(0.3315±0.0051)mm](P<0.05).Conclusion The method of finite element analysis can obtain clear and intuitive biomechanical data, which provides effective evidence for the evaluation of surgical efficacy, the development of postoperative rehabilitation methods and the evaluation of the stability of thoracolumbar spinal system.

The CT and MRI manifestations and clinical features of 8 cases of juxtaglomerular cell tumor / 中华放射学杂志

Objective To explore the CT and MRI manifestations and clinical features of juxtaglomerular cell tumor (JGCT). Methods A retrospective analysis the data of eight JGCT patients who resected by surgery and comfirmed by histopathology. Seven cases were examined by CT before operation, five of whom underwent CT scan and dynamic enhanced scan, two of whom underwent CT scan, and all of the eight underwent MRI scan and dynamic enhanced scan. The clinical manifestations of patients were also observed, whether they have hypertension and reduced blood potassium, recorded the results of lying and standing test, and collected the segmental renal vein blood to detect the renin levels. Meanwhile, the CT and MRI manifestations were also recorded. Results (1) We found that all of the eight patients appeared hypertension, and hypokalemia were found among five cases. Seven patients proceeded the lying and standing test, six of whom the plasma renin activity (PRA) were elevate in erect position, and the levels of angiotensin Ⅱand aldosterone (ALD) were rised among all of the seven cases in erect position. Four patients were collected the segmental renal vein blood, and one of whom has positive result of the renin activity. (2) The tumors of all the eight cases were single, the border was clear, and the average size was 2.7 cm (range 1.9 to 3.8 cm). The CT scan results showed there's no calcification or pseudocapsule were detected, four cases showed homogeneous iso-density, one case with slightly high density, another one showed low density with dotty high density and one case with low density. The dynamic enhanced CT scan showed that four cases performed continuous enhancement from cortical to medullary phase, and no obvious enhancement was found in one case. The T2WI results of MRI scan showed six cases had pseudocapsule, 6 cases had heterogeneous signal (4 cases with patchy low signal and 2 cases with patchy high signal), and 2 cases had homogeneous signal (one case with iso-high signal and another with high signal). The T1WI results showed two cases performed low signal, anther two cases showed iso-signal, and four cases with heterogeneous signal. The DWI results showed all of the 8 lesions with homo-or peripheral high signal. The dynamic enhanced MRI scan results showed seven cases performed gradual enhancement, and the border of another case became clear on delay phase. Conclusions JGCT has specific clinical and imaging features, and the combination will help make a correct diagnosis.

Clinical study of the electroacupuncture combined with thunder-fire moxibustion in treatment of degenerative knee osteoarthritis with cold-damp stagnation / 中国针灸

<p><b>OBJECTIVE</b>To observe the clinical effect of early degenerative knee osteoarthritis with cold-damp stagnation treated with electroacupuncture (EA) combined with thunder-fire moxibustion and simple EA.</p><p><b>METHODS</b>Eighty cases were randomly assigned into a combination group and an EA group,40 cases in each one. Twenty-five min EA was used in the EA group mainly atpoints,Neixiyan(EX-LE 4),Zusanli(ST 36),Dubi(ST 35),Yanglingquan(GB 34),Yinlingquan(SP 9) and Liangqiu(ST 34) after(arrival),once a day. Based on EA at the same acupoints as the EA group,thunder-fire moxibustion was applied atpoints,Dubi(ST 35)and Liangqiu(ST 34) by means of 20-minute suspended moxibustion,once a day. Ten-day treatment was seen as one course,and continuous 2 courses were applied. The indices were observed before and after treatment including visual analogue scale(VAS) score,Lequesne index score,Lysholm score of knee joint,serum C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR). Clinical effects were also evaluated and 6-month follow-up was implemented to show the recurrence rate.</p><p><b>RESULTS</b>After treatment the total effective rate of the combination group was 95.0%(38/40),which was better than 82.5%(33/40) of the EA group(<0.05).The Lequesne index score,VAS score,serum CRP and ESR apparently decreased compared with those before treatment in the two groups(all<0.05),and the four indices in the combination group were obviously lower than those in the EA group(all<0.05). As for the Lysholm knee joint score,the good rates of the two groups enhanced after treatment(both<0.05),and the result of the combination group was superior to that of the EA group[87.5%(35/40) vs 72.5%(29/40),<0.05]. At 6-month follow-up,the recurrence rate of the combination group was lower than that of the EA group[26.7%(4/15) vs 100.0%(9/9),<0.05].</p><p><b>CONCLUSIONS</b>EA combined with thunder-fire moxibustion achieve good effect for degenerative knee osteoarthritis with cold-damp stagnation. The combination therapy have advantages in effect duration compared with simple EA.</p>

Influences different functional groups on the biological characteristics of the osteosarcoma Saos-2 cell line / 医学研究生学报

Objective Microenvironment plays important roles in the proliferation , viability, and apoptosis of tumor cells. This study was to investigate the effects of different functional groups on the biological characteristics of the osteosarcoma Saos -2 cell line in vitro. Methods Using self-assembled monolayers of alkanethiols on gold , we prepared different terminal chemical groups , including methyl (-CH3 ) , amino (-NH2 ) , hydroxyl (-OH) , and carboxyl (-COOH ) .We determined the similar density of different functional groups by contact angle measurement and x-ray photoelectron spectroscopy , and observed the effects of different functional groups on the adhesion , proliferation, viability, and apoptosis of the osteosarcoma Saos-2 cells by fluorescence microscopy , CCK-8 as-say, flow cytometry, and scan electron microscopy (SEM). Results The surface of -COOH and -NH2 promoted the adhesion and proliferation of the of the Saos-2 cells, with a good compatibility , while that of -CH3 was unfavorable for their adhesion and proliferation and even increased their apoptosis . The promoting effects of the functional groups on the adhesion and proliferation of the cells were listed in the following order: -COOH ≥ -NH2 >-OH -CH3 , while their toxicity and apoptosis-increasing effect ranked as -CH3 -OH >-NH2 >-COOH. Conclusion The-CH3 group inhibits the adhesion and proliferation and promotes the apoptosis of Saos-2 cells, which has provided some evidence for the surface design of biomaterials.

Design and application of silver needle-knife / 中国针灸

A silver needle-knife which has the dual function of silver needle and needle-knife is designed. The main components of this silver needle-knife are approximately 50% silver and approximately 50% nichrome. The silver needle-knife is composed of five parts, including needle-knife tail, spiral handle; steering handle, needle-knife body and needle-knife edge. It converges the advantages of needle-knife and silver needle, which can cut loose of diseased tissue and peel adhesion of lesions, but also be heated with moxa cone and thermal therapeutic instrument, and connect with electroacupuncture apparatus. It has the function of warming channel and removing coldness, dispelling wind and eliminating dampness, resolving spasm and relieving pain, dredging the channel and so on. Due to the spiral handle and the steering handle, the operation is easier, which reduces the blindness of cutting and increase the safety. It is mainly used for soft tissue injury, rheumatism and rheumatoid arthritis, as well as degenerative diseases of spine and joint, and it has obvious efficacy on some internal medical diseases.

Short-term effectiveness of pedicle fixation at the fractured vertebra via paravertebral intermuscular ap-proach for thoracolumbar fractures / 医学研究生学报

Objective Pedode foxatoon at the level of fracture vetebral technology is widely used in rebuilding spnal fracture recently.The purpose of minimally invasive surgery for thoracolumbar fractures is to reduce the injury , fix segments, and rebuild the stability of the spine .This study aimed to investigate the short-term clinical effect of pedicle fixation at the fractured vertebra via the pa-ravertebral intermuscular approach for the treatment of thoracolumbar fractures . Methods We treated 24 cases of thoracolumbar fracture by pedicle fixation at the fractured vertebra via the paravertebral intermuscular approach , rebuilt spinal stability , and corrected kyphotic deformity .We evaluated the improvement of pain symptoms and life quality using The Visual Analogue Scale ( VAS) and The MOS 36-Item Short-Form Health Survey (SF-36), and assessed the corrected status of vertebral height loss and kyphotic deformity by radiographic measurement .All the patients were followed up for over 12 months. Results The VAS score of the patients was signifi-cantly higher while the SF-36 score remarkably lower before surgery than the scores in 12 months which were ([7.65 ±0.13] -[1.54 ±0.07], P<0.05) and ([90.21 ±2.02]-[117.21 ±1.02], P<0.05).Imaging evaluation showed desirable correction of the reduced height of the injured vertebrae and kyphotic deformity . Conclusion Pedicle fixation at the fractured vertebra via the pa-ravertebral intermuscular approach , with its advantages of minimal invasiveness and fewer segments of fixation , can effectively correct vertebral height reduction and kyphotic deformity .

Application of chitosan and its derivatives in cartilage tissue engineering / 中国组织工程研究

BACKGROUND:Chitosan and its derivatives have become one of the most active research topics in the field of tissue-engineered scaffold material substitute for cartilage owing to their porous structure, ease of chemical modification, and high affinity to in vivo macromolecules. OBJECTIVE:To summarize chitosan and its derivatives in terms of design, modification and its application in tissue engineering. METHODS:A computer-based search of CNKI and PubMed databases was performed for papers on application of chitosan and its derivatives in cartilage tissue engineering published from January 1990 to January 2015 with the key words“chitosan;chitosan derivatives;scaffold;tissue engineering;cartilage”in Chinese and English. RESULTS AND CONCLUSION:Chitosan is a natural polymer from renewable resources, modification of chitosan has been found to be necessary for its advanced tissue engineering applications. The modification of chitosan can be divided into two categories including chemical modification and physical blending, which improve its biological properties such as biocompatibility and biodegradability. Recent studies have suggested that chondrocytes maintained round morphology and preserved synthesis of cel-specific extracel ular matrix molecules on chitosan substrates in vitro and chitosan scaffolds seeded with chondrocytes showed partial repair of cartilage defects in vitro. Chitosan and its derivatives are promising candidates as a supporting material for tissue engineering applications.

Cervical disc replacement and anterior interbody fusion in the repair of middle-aged patients with cervical spondylosis:cervical function and range of motion / 中国组织工程研究

BACKGROUND:The development of spinal non-fusion technology promoted movement function protection of adjacent segment and operating segment. In the treatment of cervical spondylosis surgery, non-fusion technology has been widely carried out. For middle-aged patients with cervical spondylosis, the demand for spinal joint movement function is high. Non-fusion technology can improve the postoperative quality of life and slow down the risk of adjacent segment degeneration. OBJECTIVE:To evaluate the clinical efficacy of anterior cervical different implant materials (fusion or non-fusion) in the treatment of single segment of the intervertebral disc degeneration of cervical spondylosis in middle-aged patients. METHODS:This study enrol ed 10 cases of single segmental radiculopathy and cervical myelopathy after cervical intervertebral disc replacement from June 2011 to June 2013. Simultaneously, 10 cases were randomly selected from patients with anterior interbody fusion as the control group. Before treatment, at 1 and 3 months, and 1 year after treatment, changes in range of motion of cervical vertebra were observed using imaging results. Therapeutic effects were assessed using Japanese Orthopaedic Association Scores, Visual Analog Scale and The Neek Disability Index in both groups. RESULTS AND CONCLUSION:Al patients did not suffer from incision fat liquefaction, infection and delayed healing, and had finished fol ow-up for more than 1 year. Results revealed that Japanese Orthopaedic Association Scores and Visual Analog Scale scores were improved at 1 and 3 months, and 1 year after treatment (P0.05). In the analysis of range of motion of cervical vertebra and The Neek Disability Index, there were significant advantages in non-fusion treatment group (P<0.05). For middle-aged patients with cervical spondylosis, due to its life demand for neck mobility, the repair program of non-fusion cervical intervertebral disc replacement has a clear advantage.

The role of matrix metalloproteinases in intervertebral disc degeneration / 医学研究生学报

Intervertebral disc degeneration is one of the orthopedic common diseases , its complex physiopathological changes are regulated by many factors .The matrix metalloproteinases ( MMPs) and its regulatoryl factors play a very important role , and the factors that affect the role of MMPs in intervertebral disc degeneration interact with each other .So MMPs have gradually become one of the hot spot of intervertebral disc degeneration in recent years .In this paper , we first analyze the factors that cause the degeneration of intervertebral disc .Then we summarize the relationship between the expression of MMPs and the degeneration of intervertebral disc ac -cording to the different function of MMPs members in the family .Finally we state that MMPs can have an effect on the degeneration of intervertebral disc by the regulation of gene polymorphism and the related factors .

Silencing of KIF14 interferes with cell cycle progression and cytokinesis by blocking the p27(Kip1) ubiquitination pathway in hepatocellular carcinoma

Although it has been suggested that kinesin family member 14 (KIF14) has oncogenic potential in various cancers, including hepatocellular carcinoma (HCC), the molecular mechanism of this potential remains unknown. We aimed to elucidate the role of KIF14 in hepatocarcinogenesis by knocking down KIF14 in HCC cells that overexpressed KIF14. After KIF14 knockdown, changes in tumor cell growth, cell cycle and cytokinesis were examined. We also examined cell cycle regulatory molecules and upstream Skp1/Cul1/F-box (SCF) complex molecules. Knockdown of KIF14 resulted in suppression of cell proliferation and failure of cytokinesis, whereas KIF14 overexpression increased cell proliferation. In KIF14-silenced cells, the levels of cyclins E1, D1 and B1 were profoundly decreased compared with control cells. Of the cyclin-dependent kinase inhibitors, the p27Kip1 protein level specifically increased after KIF14 knockdown. The increase in p27Kip1 was not due to elevation of its mRNA level, but was due to inhibition of the proteasome-dependent degradation pathway. To explore the pathway upstream of this event, we measured the levels of SCF complex molecules, including Skp1, Skp2, Cul1, Roc1 and Cks1. The levels of Skp2 and its cofactor Cks1 decreased in the KIF14 knockdown cells where p27Kip1 accumulated. Overexpression of Skp2 in the KIF14 knockdown cells attenuated the failure of cytokinesis. On the basis of these results, we postulate that KIF14 knockdown downregulates the expression of Skp2 and Cks1, which target p27Kip1 for degradation by the 26S proteasome, leading to accumulation of p27Kip1. The downregulation of Skp2 and Cks1 also resulted in cytokinesis failure, which may inhibit tumor growth. To the best of our knowledge, this is the first report that has identified the molecular target and oncogenic effect of KIF14 in HCC.

Vacuum-sealing drainages based on biologicalversus synthetic dressings in wound healing of skin grafting / 中国组织工程研究

BACKGROUND:Vacuum-sealing drainage in wound skin grafting can close wound, reduce the leakage, promote granulation hyperplasia and improve skin new speed. OBJECTIVE:To compare the clinical effects of two kinds of wound surface dressings used in wound skin grafting. METHODS: Eighty patients who needed skin grafting for trauma were retrospectively studied and chosen from September 2010 to March 2012. They were divided into two groups: biomaterial group (dressings mainly made of luffa fibers) and synthetics group (seaweed polyvinyl alcohol foam). The vacuum-sealing drainage device and wound dressing were removed after 1 week treatment. The skin grafting coverage and wound healing time were recorded. RESULTS AND CONCLUSION:Al patients of two groups got effective skin grafting coverage rate, and no patient appeared with infection and nonunion. The skin grafting coverage and wound healing time of the biomaterial group significantly differed from the synthetics group (P< 0.05). These findings indicate that compared to the synthetic material group, the biomaterial group can be better for effective drainage, good circulation, bacteria inhibition and fast repair.

Effect of placenta polypeptide injection on the fracture healing time and the incidence of infection in patients with limb fractures / 重庆医学

Objective To explore the impact of placenta polypeptide injection on fracture healing time and the incidence of infec-tion in patients with limb fractures .Methods 138 cases with limb fractures admitted to our hospital from February 2010 to Febru-ary 2012 were randomly divided into two groups ,and each group had 69 patients .The control group was given conventional treat-ment while the observation group was given placenta polypeptide injection on the basis of the conventional treatment .The bone healing time and infection rates were observed .Results The limbs fracture healing time of observation group was significantly shorter than that of control group (P<0 .05) .The infection rate of observation group (1 .45% ) was significantly lower than that of control group (10 .14% ,P<0 .05) .Conclusion The placenta polypeptide injection for treatment of limb fractures can effectively decrease fracture healing time ,and significantly reduce the rate of infection .

Silver ion dressing effects on healing of chronic wound / 中国组织工程研究

BACKGROUND:Silver ion dressing can reduce tissue necrosis, accelerate the epithelial formation, relieve the patient’s pain during the treatment, and strengthen various growth factors for wound repair, which is based on the theory of wet healing theory. It has obvious advantages for chronic wound healing, such as anti-infection and promoting wound granulation and epithelial hyperplasia. OBJECTIVE:To observe the efficacy of silver ion dressing used in healing of chronic wound. METHODS:A total of 40 patients who had chronic wounds were selected from Tangshan Branch Hospital of Nanjing General Hospital of Nanjing Military Command. Al cases were divided into two groups. The treatment group was treated with silver ion dressing, and the control group was treated with routine dressing. Secretions extracted from wound were used for bacterial culture prior to and 7, 14, and 21 days after treatment. Healing condition and velocity were observed and wound pain was assessed using visual analog scale. RESULTS AND CONCLUSION: The detection rate of wound bacteria in the treatment group was significantly lower than that of the control group (P0.05). No adverse reaction occurred in the two groups. These findings indicate that silver ion dressing used in chronic wound healing can prevent infection and promote wound granulation or epithelial hyperplasia. It can effectively promote wound healing and has no bad reaction.

Old thoracolumbar fractures treated by opening osteotomy supplemented with autologous anterior strut grafting and internal fixation through posterior-lateral approach / 中华创伤骨科杂志

Objective To assess the radiographic and clinical outcomes of opening osteotomy supplemented with autologous anterior strut grafting and internal fixation through posterior-lateral approach in the treatment of unstable thoracolumbar fractures. MethodsFrom January 2008 through March 2010,a consecutive series of 13 thoracolumbar fractures were managed with opening osteotomy supplemented with autologous anterior strut grafting and internal fixation through posterior-lateral approach.They were 8 males and 5 females,aged from 20 to 58 years(median age,37.2 years).The fractures happened at T11 in 2 cases,at T12 in 3 cases,at L1 in 6 cases and at L2 in 2 cases.The autologous ilium was used for all the anterior strut grafts.The time from injury to surgery ranged from 21 days to 2 years (average,8 months).The mean heights of anterior and posterior borders of the vertebral body,the cobb angles and treatment-related complications were compared between preoperation and postoperation and the patients' satisfaction was assessed with the visual analogue scale(VAS).Statistical analyses were performed with the paried-sample t test. Results The patients were followed for 12 to 36 months (average,17 months).The latest follow-up radiographs were available for all patients.The mean heights of anterior and posterior borders of the vertebral body restored respectively from preoperative 21.02 ± 3.02 cm and 31.34 ± 5.18 cm to postoperative 31.88 ±3.46 cm and 33.75 ± 3.66 cm.The mean cobb angle was corrected from preoperative 28.46° ± 5.81° to postoperative 4.62° ± 3.48°.The mean VAS score decreased from preoperative 7.63 ± 0.72 to 1.39 ± 1.02 at the final follow-up.There were significant differences between preoperation and postoperation in the radiographic and clinical outcomes ( P ＜ 0.05).No mortality or major complications occurred involving large blood vessels or abdominal viscera or internal organs. Conclusion The opening osteotomy supplemented with autologous anterior strut grafting and internal fixation through posterior-lateral approach is safe and effective for old unstable thoracolumbar fractures.

Beclin 1 cleavage by caspase-3 inactivates autophagy and promotes apoptosis

Autophagy and apoptosis are both highly regulated biological processes that play essential roles in tissue homeostasis, development and diseases. Autophagy is also described as a mechanism of death pathways, however, the precise mechanism of how autophagy links to cell death remains to be fully understood. Beclin 1 is a dual regulator for both autophagy and apoptosis. In this study we found that Beclin 1 was a substrate of caspase-3 with two cleavage sites at positions 124 and 149, respectively. Furthermore, the autophagosome formation occurred, followed by the appearance of morphological hallmarks of apoptosis after staurosporine treatment. The cleavage products of Beclin 1 reduced autophagy and promoted apoptosis in HeLa cells and the cells in which Beclin 1 was stably knocked down by specific shRNA. In addition, the cleavage of Beclin 1 resulted in abrogating the interaction between Bcl-2 with Beclin 1, which could be blocked by z-VAD-fmk. Thus, our results suggest that the cleavage of Beclin 1 by caspase-3 may contribute to inactivate autophagy leading towards augmented apoptosis.

Spinal nonfusion interspinous U titanium alloy for early degenerative intervertebral disk protrusion and dynamic spinal stenosis:Mechanical properties of the lumbar vertebra / 中国组织工程研究

BACKGROUND:The new technique of spinal nonfusion is used for intervention of early spinal diseases. It can protect the spine motion function and treat the patients either. The interspinous U titanium alloy belongs to the new technique of spinal nonfusion. And this investigation will be a hot spot in the spinal nonfusion technique. OBJECTIVE:To explore the clinical mechanical property of spinal nonfusion interspinous U titanium alloy. DESIGN,TIME AND SETTING:Comparative observation. All patients were selected from the Department of Orthopaedics of Changhai Hospital between June 2006 and December 2007. PARTICIPANTS:A total of 28 patients with degenerative intervertebral disk protrusion and dynamic spinal stenosis,including 23 male and 5 female aged 41 to 58 years old. METHODS:All patients were randomly divided into two groups:intervertebral disectomy alone (n=20):affected segments were removed; implantation group (n=8):affected segments were removed and interspinous U titanium alloy was implanted following interspinous ligament. MAIN OUTCOME MEASURES:The height of the intervertebral space and vertebral canal area of the affected segment as well as JOA scores for lumbar vertebra postoperatively and during follow-up. RESULTS:All 28 patients were included in the final analysis. The height of the intervertebral space and vertebral canal area of the affected segment in implantation group were significantly increased compared with intervertebral disectomy alone group (P