Efficacy of intramedullary and extramedullary decompression and lavage therapy under microscope for treatment of chronic cervical spinal cord injury / 南方医科大学学报

<p><b>OBJECTIVE</b>To analyze the clinical effect of spinal cord decompression and lavage therapy on chronic cervical spinal cord injury and explore the possible mechanism.</p><p><b>METHODS</b>Fifty-seven patients with chronic cervical spinal cord injury treated in our hospital from January, 2008 to January, 2015 were enrolled, including 17 with multilevel cervical disc herniation, 25 with long segmental ossification of the posterior longitudinal ligament, 13 with hypertrophy or calcification of neck ligamentum flavum, and 2 with old cervical fractures. Open-door spinal canal laminoplasty via a posterior approach and decompression in simple extramedullary decompression was performed in 31 cases (group A), and open-door spinal cord incision decompression via a posterior approach, saline irrigation, and spinal canal laminoplasty in intramedullary decompression was performed in 26 cases (group B). The pre-operative cerebrospinal fluid in group B patients was collected to examine the inflammatory factors. All the patients were followed up and evaluated for pre- and postoperative JOA scores to calculate the improvement rate with regular examinations by X-ray, CT or MRI.</p><p><b>RESULTS</b>Imaging examinations 2 weeks after the operation showed obvious relief of the primary lesion in both groups, and the improvement of high signals was better in group B than in group A. The mean improvement rate at 12 months after the operation was 52.33% in group A and 61.52% in group B (P<0.05), and the mean JOA score was significantly higher in group B than in group A (14.80∓1.51 vs 13.58∓0.56; P<0.05). Cerebrospinal fluid leakage occurred in 3 cases, epidural hematoma in 2 cases, internal fixation loosening in 1 case in group A; portal shaft fracture and internal fixation loosening occurred in 1 case in group B. Postoperative recovery time was shorter in group B and entered the platform phase in 3 months. The inflammatory factors IFN-γ, IL-17F, IL-6 and sCD40L were all significantly higher than the normal levels after spinal cord injury, and the increment of IL-6 was the most conspicuous (P<0.05).</p><p><b>CONCLUSION</b>Intramedullary and extramedullary decompression can achieve better outcomes than extramedullary decompression in patients with chronic cervical cord injury. This may be related not only to relieving adhesions and secondary compression by cutting the dura under the microscope, but also to removal of local inflammatory factors.</p>

microRNA-181b promotes migration and invasion of osteosarcoma cells by targeting N-myc downstream regulated gene 2 / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the effects of miR-181b on the migration and invasion of osteosarcoma cells.</p><p><b>METHODS</b>Three cultured osteosarcoma cell lines and MG-63 cells transfected with miR-181b inhibitor were examined for miR-181b expression using qRT-PCR analysis. The cell migration and invasion of the transfected cells were assessed with Transwell assay. The targets of miR-181b were predicted using a miRNA target prediction software and the results were verified with luciferase reporter assay. The target protein expression in osteosarcoma cells lines was determined by Western blotting, and the cell migration and invasion changes following inhibition of miR-181b or its target protein were assessed using Transwell assay.</p><p><b>RESULTS</b>All the 3 osteosarcoma cells lines showed significantly up-regulated miR-181b expression. Inhibition of miR-181b expression obviously suppressed the migration and invasion of MG-63 cells. Based on luciferase reporter assay, N-myc downstream regulated gene 2 (NDRG2) was identified as the direct target gene of miR-181b, and inhibition of NDRG2 expression significantly reversed the effect of miR-181b on cell migration and invasion in MG-63 cells.</p><p><b>CONCLUSION</b>miR-181b is over-expressed in osteosarcoma cells, and inhibition of miR-181b, which directly targets NDRG2, can suppress the migration and invasion of osteosarcoma cells.</p>

Contrast-enhanced ultrasound imaging features of diabetic foot ulcers / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate contrast-enhanced ultrasound imaging features of diabetic foot ulcers.</p><p><b>METHODS</b>Sixteen patients with diabetic foot ulcers underwent conventional and contrast-enhanced ultrasound examinations, and the features of contrast-enhanced ultrasound imaging were analyzed. Pathological examination was also carried out in some cases.</p><p><b>RESULTS</b>Contrast-enhanced ultrasound showed slow enhancement in the artery phase in the 16 ulcers after administration of SonoVue. The mean time of initial enhancement was 30.02 ± 2.35 s, and the mean time for the occurrence of peak enhancement was 37.54 ± 4.13 s. In 5 cases a homogeneous enhancement pattern was clearly displayed, and in the other 11 cases, a pattern of homogenous peripheral enhancement with non-enhanced patches within the ulcers was found. Contrast-enhanced ultrasound showed a greater ulcerous area than conventional ultrasound.</p><p><b>CONCLUSION</b>Contrast-enhanced ultrasound is a valuable means for evaluating the ulcerous area and the treatment efficacy for diabetic foot ulcers.</p>

The change of angiotensin II production and its receptor expression during wound healing: possible role of angiotensin II in wound healing / 中华整形外科杂志

<p><b>OBJECTIVE</b>This study was undertaken to observe the change in the local level of angiotensin II (Ang II) and the expression of its corresponding receptors AT1 and AT2 during wound healing, and explore the possible role of Ang II in wound healing .</p><p><b>METHODS</b>A model of full-thickness cutaneous wound was developed on the back of C57/BL6 mice. Specimens were taken from the wound of each mouse on the day 0, 1, 3, 5, 7, 9, 11, 13 and 15 after wounding. The change in the generation of Ang II in wounded tissue during the healing process was detected with ELISA. The proliferation and the apoptosis of cells were detected by bromodeoxyuridine (Brdu) and terminal deoxynucleotidyl transferase mediated deoxyuridine triphosphate nick end labeling (TUNEL) method in wounded skin during the healing process, respectively. The cellular localization and the mRNA level change of Ang II receptors in wounded tissue during healing were detected with immunostaining and RT-PCR.</p><p><b>RESULTS</b>Ang II produced in wounded skin was increased in the first 7 days to reach the peak, and then gradually decreased during wound healing. BrdU labeling index was increased gradually in the first 7 days to reach the peak, and then gradually decreased during wound healing. The number of TUNEL-positive cells was increased slowly in the first 7 days after wounding. The increase in the number of TUNEL-positive cells was more markedly after epithelization of the wound. In normal mice, AT1 and AT2 receptor were found positively expressed in the whole epidermal layer, while positive expression was only found in the endothelial cells of the capillary vessels within the dermal layer, and positive expression was also found in appendages of the skin, i. e. hair follicle, sweat gland and sebaceous gland respectively. Positive staining signal of both AT1 and AT2 receptors were increased in the first 7 days to reach the peak, then gradually decreased. Expression of AT2R was increased again following the epithelization of wound. The result of RT-PCR showed that the expression of both AT1 and AT2 receptors was detectable, and AT1 receptor was increased in the first 7 days to the peak, and then gradually decreased during wound healing, while AT2 receptor expression reached its peak value on day 7, then gradually decreased, and increased again following the epithelization of wound.</p><p><b>CONCLUSIONS</b>These results indicate that Ang II participate in wound repair and related to remolding in the late stage of wound healing through the change in production of angiotensin II and expression of AT1 and AT2 receptors. AT1 receptor might be closely associated with cell proliferation, while AT2 receptor might play a role in cell apoptosis and remolding during wound healing.</p>

Application of titanium mesh in anterior cervical subtotal corpectomy with locking plate for cervical spondylotic myelopathy / 南方医科大学学报

<p><b>OBJECTIVE</b>To evaluate the clinical effect of titanium mesh in anterior cervical subtotal subcorpectomy with locking plate for treatment of cervical spondylotic myelopathy.</p><p><b>METHODS</b>Thirty-eight patients with cervical spondylotic myelopathy were treated with anterior cervical subtotal corpectomy using titanium mesh and locking plate. The JOA score of the patients were assessed before and after the operation, and the pre- and postoperative lateral cervical radiographs were taken to observe the instability of the titanium mesh, dynamic plates and changes of the cervical curvature.</p><p><b>RESULTS</b>The patients were followed up for 12-18 months. Radiographic cervical fusion was achieved in 12-16 months (36 cases) or 18 months (2 cases) postoperatively. The degree of Jordosis was improved and the height of the anterior spinal column and physical curvature were effectively maintained after the operation. The titanium mesh and locking plate showed no signs of loosening and the JOA scores was significantly improved after the operation (P<0.05).</p><p><b>CONCLUSION</b>Titanium mesh in anterior cervical subtotal corpectomy with locking plate allows effective treatment of cervical spondylotic myelopathy, but the indications of this procedure must be carefully evaluated. The long-term effect of this approach still needs verification by further follow-up data.</p>