Imaging study on thoracic and lumbar physiological curvature in adolescent idiopathic scoliosis / 中国骨伤

OBJECTIVE@#To observe the alteration of thoracic and lumbar physiological curvature in adolescent idiopathic scoliosis(AIS) and the difference of physiological curvature between different types of scoliosis.@*METHODS@#A retrospective analysis was conducted on 305 adolescent patients taken full spine X-ray in our hospital from January 2017 to December 2021. The patients were divided into normal group and scoliosis group. The normal group was composed of 179 patients, 79 males and 100 females, aged 10 to 18 years old with an average of (12.84±2.10) years old, with cobb agle less than 10 degrees. The scoliosis group was composed of 126 patients, 33 males and 93 females, aged 10 to 18 years old with an average of (13.92±2.20) years old. The gender, age, Risser sign, thoracic kyphosis(TK) and lumbar lordosis(LL) in 2 groups were compared, and the TK and LL were also compared between different genders, different degrees of scoliosis and different segments of scoliosis.@*RESULTS@#The female ratio(P=0.001) and age (P<0.001) in scoliosis group were higher than them in normal group; the ratio of low-grade ossification was higher in normal group than in scoliosis group(P=0.038). TK was significantly smaller in scoliosis group than in normal group(P<0.001), but there was no significant difference in LL between the 2 groups(P=0.147). There were no significant difference in TK and LL between male and female. The TK was significantly bigger in mild AIS patients than in moderate AIS patients(P<0.05), but there was no significant difference in LL between mild and moderate patients(P>0.05). The TK and LL in different segments scoliosis were not found significant difference.@*CONCLUSION@#The physiological curvature of thoracic and lumbar spine is independent of gender. The thoracic physiological curvature becomes smaller in AIS patients, but lumbar curvature remains unchanged. The thoracic physiological curvature in mild AIS patients is greater than that in moderate AIS patients, but the lumbar curvature is almost unchanged between mild and moderate scoliosis and is similar with that in normal adolescent. The alteration of thoracic and lumbar physiological curvature in AIS patients may be related to relative anterior spinal overgrowth, and the specific detailed mechanism needs to be further studied.

Correlation analysis of Cobb angle and linear spinous process angle in adolescent idiopathic scoliosis / 中国骨伤

OBJECTIVE@#To analyze the correlation between Cobb angle and spinous process angle (SPA) on X-ray film and body surface in patients with mild to moderate adolescent idiopathic scoliosis(AIS). To explore the possibility of linear SPA to assess scoliosis.@*METHODS@#Retrospective study for correlation of Cobb angle and linear SPA on X-ray film. AIS patients treated and taken full spine anteroposterior X-ray from January 2019 to December 2021 were analyzed correlation of Cobb angle and linear SPA on X-ray film. Prospective study for correlation of Cobb angle and body linear SPA. AIS patients treated and taken full spine anteroposterior X-ray from December 1 to December 9 this year were analyzed correlation of Cobb angle and body linear SPA.@*RESULTS@#A total of 113 AIS patients with age an average of (14.02±2.16) years old(ranged from 10 to 18 years old) were recruited in retrospective study, involving 26 males and 87 females;there were 71 patients with mild AIS and 42 patients with moderate AIS. Cobb angle in AIS patients was significantly inversely associated with SPA(r=-0.564, P<0.001), the linear regression equation was:Cobb angle=169.444-0.878×SPA. Cobb angles in patients with mild scoliosis were significantly and inversely associated with SPA(r=-0.269, P=0.012), the linear regression equation was:Cobb angle=46.832-0.185×SPA. Cobb angles in patients with moderate scoliosis were also clearly correlated with SPA(r=-0.417, P=0.003), the linear regression equation was:Cobb angle=113.889-0.516×SPA. Thirty-eight patients were recruited in prospective study. The mean Cobb angle and body linear SPA were(18.70±6.98)°, ranged from 11.3° to 36.0° and (170.34±4.57)°, ranged from 162.1° to 177.7° respectively. There was significantly negative correlation(r=-0.651, P<0.001), the linear regression equation is:Cobb angle=187.91-0.99×SPA.@*CONCLUSION@#Linear SPA on X-ray film or on the body was significantly negatively correlated with Cobb angles, but the regression equation fits poorly, so it's not suitable for diagnosis of scoliosis;however, linear SPA is appropriate for self-controlled assessment of scoliotic therapy or for dynamic assessment of spinal flexibility.

Value of 18F-FDG PET/CT combined with tumor markers ProGRP and NSE in diagnosis and differential diagnosis of stageⅠA small cell lung cancer / 中华核医学与分子影像杂志

Objective:To explore the value of 18F-FDG PET/CT combined with pro-gastrin-releasing peptide (ProGRP) and neuron-specific enolase (NSE) in diagnosis and differential diagnosis of stageⅠA small cell lung cancer (SCLC). Methods:From June 2017 to October 2021, 113 patients (75 males, 38 females; age 32-79 years) with stageⅠA lung cancer (70 with adenocarcinoma, 25 with squamous cell carcinoma, 18 with SCLC; patients with adenocarcinoma and squamous cell carcinoma were combined into non-SCLC (NSCLC) group) and 30 patients with benign pulmonary nodule (21 males, 9 females; age 37-77 years) from the Affiliated Qingdao Central Hospital of Qingdao University were retrospectively analyzed. All patients were examined by 18F-FDG PET/CT and serum tumor markers associated with lung cancer. Differences of the clinical, imaging and tumor markers data among different groups were analyzed by χ2 test, Fisher exact test and Kruskal-Wallis rank sum test. Independent risk factors were analyzed by logistic regression analysis and ROC curve analysis was used to analyze the value of different predictive factors in diagnosis and differential diagnosis of SCLC. Results:There were significant differences in SUV max, lobulation sign, spiculation sign, calcification, pleural traction sign, ProGRP, NSE and carcinoembryonic antigen (CEA) among SCLC, NSCLC and benign nodules groups ( H values: 14.06-20.54, χ2 values: 8.16-14.95, all P<0.05), in which lobulation sign of SCLC was more than that of benign nodules (12/18 vs 26.7%(8/30); χ2=7.41, P=0.007), spiculation sign (2/18 vs 51.6%(49/95); χ2=10.01, P=0.002) and pleural traction sign (1/18 vs 35.8%(34/95); χ2=6.47, P=0.011) were less than those of NSCLC, SUV max was higher than that of benign nodules (7.4(5.8, 9.0) vs 2.3(1.4, 5.1); H=51.82, P<0.001), ProGRP was higher than that of NSCLC and benign nodules (64.0(40.1, 84.8) vs 38.7(26.9, 47.6), 36.7(29.1, 40.5) ng/L; H values: 36.13, 43.96, P values: 0.002, 0.001) and NSE was higher than that of benign nodules (12.4(10.9, 14.5) vs 7.4(5.4, 11.8) μg/L; H=40.53, P=0.001). When differentiated SCLC from NSCLC, spiculation sign (odds ratio ( OR)=0.043, 95% CI: 0.004-0.450, P=0.009) and ProGRP ( OR=1.083, 95% CI: 1.035-1.133, P<0.001) were independent risk factors for SCLC, and the AUC of the two factors combination was 0.875, with the sensitivity and specificity of 14/18 and 84.2%(80/95). When differentiated SCLC from benign nodules, SUV max( OR=2.706, 95% CI: 1.099-6.662, P=0.030), ProGRP ( OR=1.165, 95% CI: 1.009-1.344, P=0.038) and NSE ( OR=1.639, 95% CI: 1.016-2.645, P=0.043) were independent risk factors for SCLC, and the AUC of the three factors combination was 0.985, with the sensitivity and specificity of 17/18 and 96.7%(29/30). Conclusion:18F-FDG PET/CT combined with tumor markers ProGRP and NSE is helpful to improve the diagnosis and differential diagnosis of stage ⅠA SCLC.

Application of electronic portal imaging device in postoperative intensity modulated radiotherapy of rectal cancer / 医疗卫生装备

Objective To measure and analyze the set-up errors of postoperative intensity modulated radiation therapy of rectal cancer (PIMRTRC)with electronic portal imaging device (EPID),and to provide theoretical foundation for clinical realizing of accurate PIMRTRC.Methods Totally 30 patients after rectal carcinoma resection underwent sagittal and coronal photographing with EPID before the first time of therapy and one time per week during the treatment course.The obtained images were compared with DRR images in treatment planning system to get the setup errors at X(left-right),Y(head-foot) and Z (front-back)directions,and the extending margins of CTV and PTV in postoperative intensity modulated radiation therapy were calculated.EPID was used for setup correction,and SPSS 19.0 was involved in to execute statistical analysis. Results The linear displacement had the mean values plus/minus standard deviation at X, Y and Z directions before and after error correction being(-1.392 4±3.670 9)mm vs(-0.816 5±2.670 5)mm,(0.969 7±4.076 1)mm vs(0.418 2±2.911 4)mm, and(0.704 4±1.805 6)mm vs(0.471 7±1.641 3)mm respectively;the extending margin had the values being 7 mm vs 5 mm, 6 mm vs 4 mm, and 4 mm vs 3 mm respectively.Conclusion EPID ensures the correctness and accuracy in postoperative intensity modulated radiotherapy of rectal cancer,which makes target area gifted with maximized dose,the surrounding tissue and organs at risk protected adequately,and provides theoretical support for extending CTV margin.[Chinese Medical Equip-ment Journal,2018,39(5):59-63]

Neoflavonoids and their pharmacological activities in Dalbergia genus / 中国中药杂志

Neoflavonoids are a kind of characteristic components in the Dalbergia genus. Based on the previous researches, 59 neoflavonoids have been obtained from the Dalbergia genus. According to their molecular skeleton, the neoflavonoids can be divided intodalbergiphenols, dalbergiones, dalbergins, benzophenones and other types. Modern research shows that neoflavonoids displayed a variety of pharmacological activities, such as anti-osteoporosis, anti-inflammatory, antitumor, anti-androgen, anti-allergic, antioxidation etc. This paper reviewed neoflavonoids and their pharmacological functions, which could provide the valuable reference for comprehensive utilization and new drug development in the Dalbergia genus.

Expression and significance of P-glycoprotein in triple negative breast cancer / 国际外科学杂志

Objective To investigate the expression and significance of P-glycoprotein in triple negative breast cancer (TNBC).Methods One hundred and seventy-one cases of breast invasive ductal carcinoma in our hospital were retrospectively analyzed.According to the expression of ER,PR,Her2,we categorized those paitents into triple negative breast cancer group (58 cases) and non triple negative breast cancer group (113 cases).The different expression of P-glycoprotein was detected by immunohistochemieal technology in two groups.We analyzed the relationship between the expression of P-glycoprotein and clinical and pathological features in TNBC,and investigated the effect of P-gp on the rate of recurrence and metastasis in 3 years.Results (1) The expression of P-gp in TN BC was significantly higher than that of NTNBC (53.45％ vs 37.17％) (P ＜ 0.05).(2) The expression of P-gp in TNBC was associated with TNM stage,histological grade,lymph node status and vascular invasion (P ＜ 0.05),but not with age and size of the tumor (P ＞ 0.05).(3) The rate of recurrence and metastasis in positive expression of P-gp in TNBC was 58.06％,which was significantly higher than negative expression of P-gp in TNBC (44.44％),but no statistically significant was found(P ＞ 0.05).Survival analysis showed that P-glycoprotein expression had no relationshiop to 3-year cumulative survival rate (P =0.161 ＞ 0.05).Conclusions The positive expression of P-gp in TNBC is associated with drug resistance and metastasis,but has no obvious significance to recurrence and metastasis,so as to 3-year cumulative survival rate.

Breast-conserving surgery for early-stage breast cancer guided by intra-operative ultrasound / 国际外科学杂志

Objective To evaluate the feasibility of intra-operative ultrasound guide in breast conservative-surgery and its effect on positive margin rate and breast tissue volume.Methods Fifty-five cases of invasive breast cancer staged T1-2N0-1 were randomly assigned to palpation-guided group(control group) 26 cases and ultrasound-guided group(experiment group) 29 cases.Before and during operation,high-frequency ultrasound was used to guide the resection of breast cancer with 1 cm margin in experiment group.The resection margin positive rate deteced by tissue section frozen biopsy and resected breast tissue volume were compared between experiment and control group.Results The clinicopathologic features were accordant between two groups.The margin positive rate and near-margin positive rate in experiment group were 0 and 3.45％ respectively,slightly lower than that of control group 3.85％ and 15.38％,but with no statistical significance (P ＞ 0.05).The same situation occurred at the re-exision rate.The resected breast tissue volume in experiment group (32.40 ± 10.93) cm3 was lower than that of control group (55.11 ± 12.88) cm3,and with statistical significance (P ＜ 0.01).Conclusions Intra-operative ultrasound guide could reduce the margin positive rate and unnecessary resected brcast tissue volume in breast conservative-surgery,and improve cosmetic effect.

Role and mechanism of macrophage in the occurrence and development of tumor / 国际外科学杂志

Macrophages,as an important member of innate immune system,constitute a major component of the microenvironment of tumours,and play an important role in the occurrence and development of tumor.According to particular phenotypes and functions,macrophages can be divided into M1 macrophages and M2 macrophages.In the research of breast cancer,lung cancer,gynecological malignancies,researchers have found that tumor-associated macrophage has the similar phenotype and function of M2 macrophages.Tumor-associated macrophage can promote the formation of new blood vessels and lymphatic vessels in tumor tissue,thus contributing to the occurrence and development of tumor.The relation between tumor-associated macrophage and poor prognosis was also be found.The tumor microenvironment can affect the phenotype and function of macrophages,such as TGF,IL-10 and PGE-2.This paper reviewed the role and mechanism of macrophages in the tumorigenesis.