Correlation between spatial inclination of Blumensaat line and anterior cruciate ligament injury based on EOS biplanar 3D imaging system / 中国骨伤

OBJECTIVE@#To explore correlation between femoral mechanical axis and Blumensaat line (FMBL) angle of knee joint (angle between Blumensaat line and femoral mechanical axis), α angle (angle between Blumensaat line and axis of distal femur in sagittal plane) on EOS biplane imaging and non-contact anterior cruciate ligament(ACL) injury, and evaluate angle for its accuracy in predicting the populations prone to non-contact ACL injury.@*METHODS@#From February 2018 to October 2020, EOS imaging and clinical data from 88 patients (176 knees) with unilateral non-contact ACL injury were retrospectively analyzed, including 53 males and 35 females, aged from 18 to 45 years old with an average of (30.3±6.2) years old, 48 patients on the left side and 40 patients on the right side. The patients were divided into ACL-affected group and ACL-health group according to side of ACL injuries, and 51 patients (51 knees) with non-ACL identified from EOS database were included in normal control group, including 28 males and 23 females, aged from 20 to 44 years old with an average of (31.6±5.5) years old, 26 patients on the left side and 25 patients on the right side. Full-length EOS imaging of skeleton extremitatis inferioris among three groups were reconstructed to 3D images of skeletal system with EOS software, and then FMBL angle and α angle were measured on the images. Univariate binary Logistic regression analysis was performed to determine the influence of the univariate(FMBL angle or α angle) on ACL status(normal or torn). And the angle cutoff value for univariate was selected based on receiver operating characteristics curve (ROC) to got the best accuracy.@*RESULTS@#There was no statistically significant difference in age, gender and side distribution between ACL-injured group and normal control group(P>0.05). Statistical analyses (one-way ANOVA) indicated no significant difference in FMBL angle between ACL-injured knee group (32.8±2.3)° and ACL-injured contralateral knee group(32.5±2.3)°(P>0.05), but the values between two groups were significantly lower than that in normal control group (37.0±2.0)°(P<0.001). There was no statistically significant difference in α angle among three groups (P>0.05). Univariate binary Logistic regression analysis demonstrated that FMBL angle was risk factor for non-contact ACL injury[OR=0.433, 95%CI(0.330, 0.569), P<0.001]. The area under ROC curve for FMBL angle was 0.909[95%CI(0.861, 0.958), P<0.001], and the sensitivity and specificity were 70.5% and 98.0% respectively, cut-off value was 33.7°.@*CONCLUSION@#FMBL angle formed by Blumensaat line and femoral mechanical axis is one of the risk factors for non-contact ACL injury and has good predictive accuracy. The general population with FMBL angle below 33.7° may be increased risk for ACL injury.

Mechanism of Taohong Siwu Decoction in treating soft tissue injury based on UPLC-Q-TOF-MS,network pharmacology and experimental verification / 中国中药杂志

To explore the action mechanism of Taohong Siwu Decoction(THSWD) in the treatment of soft tissue injury(STI) based on UPLC-Q-TOF-MS technique, network pharmacology and experimental verification method. UPLC-Q-TOF-MS technique was used to identify the chemical constituents of THSWD. The active ingredients and predicted target proteins of THSWD were screened out through TCMSP database. Cytoscape software was used to construct the active component-target-pathway network, and STRING database was used for protein interaction analysis. GeneCards and CTD databases were used to screen out relevant targets of STI. GO function and KEGG pathway enrichment analysis were performed through DAVID database. The rat model of STI was constructed, and Western blot was used to verify the effect of THSWD on key targets of relevant pathways. The results showed 40 active ingredients in THSWD, and 141 potential targets and 20 targets of STI. Target enrichment analysis of the active components produced 128 KEGG pathways, which were mainly concentrated in amino acid synthesis and metabolism, disease signaling pathways, apoptosis, inflammation and other relevant pathways. Western blot showed that THSWD intervention could significantly decrease PTGS2, CASP3, NFKB1, p-CASP3 and p-NFKB1, while enhancing the expression of TP53 protein in the STI samples of rats. According to the results of UPLC-Q-TOF-MS, network pharmacology and experimental verification, active ingredients in THSWD may play anti-inflammatory and antioxidant effects in NF-κB signaling pathway and apoptotic pathway, thus playing a role in the treatment of STI.

Simulation accuracy of cortical bone fracture based on different types of strain criterion / 中国组织工程研究

BACKGROUND: Cortical bone crack caused by accident or other external factors is one of the main causes of fracture, so the mechanism of crack formation and propagation for cortical bone under different loads should be understood primarily to avoid fracture. Bone specimens may be destructed in experiments, which can lead to a difficulty to observe the interior mechanical state of bone structure before and after fracture. Therefore, it is important to find a finite element method that can accurately simulate the processes of cortical bone crack formation, propagation, and fracture. Current simulations mainly use the principal strain or the equivalent strain to determine the mechanical state of the element in the finite element model and to perform fracture simulation, but there are few studies on the simulation accuracy when using these two types of strains. OBJECTIVE: To testify the simulation accuracy of cortical bone fracture with the principal strain and the equivalent strain. METHODS: The principal strain and the equivalent strain were applied to perform the three-point bending simulation, and the simulation results were compared with the experimental results to determine which strain was more accurate. RESULTS AND CONCLUSION: (1) The failure time of the cortical bone simulated by the principal strain was significantly later than that obtained by the equivalent strain. (2) Compared with the experimental results, it was found that the simulation results obtained by equivalent strain were closer to the experimental results. (3) Therefore, simulating cortical bone crack and fracture using the equivalent strain is accurate.

Novel coronavirus pneumonia related liver injury: etiological analysis and treatment strategy / 中华肝脏病杂志

The outbreak of novel coronavirus pneumonia(NCP) caused by 2019 novel coronavirus has become a global public health challenge. Some patients accompany with liver function damage in addition to the main typical respiratory symptom. Here we analyzed the clinical features, susceptible population, potential causes and therapeutic strategies of NCP related liver injury.

Introduction of EOS imaging system and its current research status in evaluating clinical value of lower limb force line / 中国骨伤

The principle and technical background of EOS imaging system are introduced. Combining with the publicity of this technology and the existing literature reports, it is known that low dose EOS technology can reduce radiation dose by 5 to 10 times in the course of examination, and micro dose EOS can even reduce radiation dose by 45 times. The image quality is only high or low; the system has EOS 2D and 3D workstations, which can help clinicians to measure and evaluate coronal and sagittal force lines of lower limbs easily. The tilt and torsion of limbs can be measured three-dimensional after three-dimensional model reconstruction in the three-dimensional workstation. Using these results, preoperative evaluation can be carried out. It is helpful for clinicians to evaluate and improve preoperative planning and post-operative measurement and evaluation of surgical effect. In terms of measurement accuracy, a large number of literatures reported that the accuracy of EOS 2D measurement is comparable to that of general radiology measurement, while the accuracy of EOS 3D reconstruction measurement is comparable to that of CT and MRI. Based on the technical characteristics and advantages of EOS, this paper reviews the literature reports and research progress of EOS in evaluating the accuracy of lower limb alignment.

Analysis of factors associated with postoperative shoulder balance in Lenke Type 1 adolescent idiopathic scoliosis / 中华外科杂志

<p><b>OBJECTIVE</b>To study the factors associated with postoperative shoulder balance in Lenke Type 1 adolescent idiopathic scoliosis (AIS) patients with preoperative right-elevated shoulder after posterior thoracic fusion.</p><p><b>METHODS</b>A total of 34 Lenke Type 1 AIS patients were recruited between October 2006 to October 2008. There were 8 boys and 26 girls with an average age of 15.1 years (range, 12 - 19 years). Posterior thoracic fusion was performed in all the patients. There were 23 cases proximally fused to T4 and 11 cases fused to T5. Pearson's correlation analysis was made between radiographic shoulder height (RSH) at the latest follow-up and preoperative T1 tilt, clavicle angle (CA), coracoids process height (CPH), apical vertebral translation (AVT), RSH, coronal and bending proximal/main thoracic curve (PT and MT) Cobb angle, curve flexibility as well as correction ratio of the MT curve.</p><p><b>RESULTS</b>All patients presented right-elevated shoulder preoperatively, with an mean RSH of (-15.9 ± 5.8) mm. At the latest follow-up, PT curve correction was 44% ± 16%, and MT curve correction was 70% ± 10%. Of the 34 patients with an average postoperative RSH of (0.4 ± 7.9) mm, 32 patients had balanced shoulders, and only 2 patients had mild shoulder imbalance with left-elevated shoulder. The RSH at the latest follow-up was found to be negatively correlated with PT curve flexibility (r = -0.682, P < 0.01), but positively correlated with bending PT Cobb angle (r = 0.642, P < 0.01) and correction ratio of the MT curve (r = 0.557, P < 0.01). No significant correlations were found between RSH at the latest follow-up and preoperative T1 tilt, CA, CPH, AVT, RSH, coronal PT and MT Cobb angle, bending Cobb angle as well as flexibility of MT curve (P > 0.05).</p><p><b>CONCLUSIONS</b>For the Lenke Type 1 AIS patients with preoperative right-elevated shoulder, proximal fusion to T4 or T5 could improve shoulder balance significantly. However, the low PT curve flexibility and overcorrection of MT curve may be associated with postoperative shoulder imbalance in such patients.</p>

Characteristics of fundus autofluorescence and fundus fluorescein angiography in syphilitic posterior uveitis / 中华实验眼科杂志

Background The fundus autofluorescence (FAF)can reflect the function of retinal pigment epithelium(RPE) cell.As an invasive examination,it has been extensive used in retina disease,but there has not any report in syphilitic posterior uveitis.Objective This study was to characterize and contrast the FAF and fundus fluorescein angiography (FFA),indocyanine green angiography (ICGA) findings in patients with syphilitic posterior uveitis.Methods A retrospective series of cases observational study was designed.The clinical data of 27 eyes from 18 patients with syphilitic posterior uveitis were included in Shanghai First People's Hospital from 2010 May to 2012 October,and all the patients were diagnosed by serologic and ophthalmic tests.The patients were assigned to acute stage group(with the course ＜2 months)and chronic stage group(with the course ≥ 2 months).FFA,ICGA and FAF were performed respectively on all the patients,and the examination results were compared and analyzed.Results In the affected eyes with syphilitic posterior uveitis,the FFA image showed a retinal vasculitis sign and mottle-like fluorescence appearance in posterior pole and equator zone,and some affected eyes exhibited edema of optic disc and macula.Hypoautofluorescence zone was seen in the acute stage group and cystoid macular edema was found in the chronic stage group.ICGA presented with a wider damage of RPE,especially in the later phase of ICGA.A confluent of hyperautofluorescence with hypoautofluorescence in the posterior fundus,punctiform hyperautofluorescence as well as hypoautofluorescence in papillitis and macular edema were found on the FAF image.Conclusions The pathological basis of syphilitic posterior uveitis is retinal vasculitis and papillitis.ICGA indicates the damage of choroid membranes and RPE,and FAF reflects a metabolism disorder of RPE in the acute stage and atrophy and loss of RPE in the chronic stage.FAF is helpful for the diagnosis of syphilitic posterior uveitis as an assistant index.

Long term outcome of video-assisted thoracoscopic surgery for thoracic adolescent idiopathic scoliosis / 中华外科杂志

<p><b>OBJECTIVE</b>To study the long term outcomes and complications of video-assisted thoracoscopic surgery (VATS) in correcting thoracic adolescent idiopathic scoliosis (T-AIS) with more than five-year follow-up.</p><p><b>METHODS</b>The T-AIS patients underwent corrective surgery by VATS between June 2002 and December 2006 and experienced more than five-year follow-up were retrospectively reviewed. Nine female patients with T-AIS were recruited with a mean age of 14.3 years (range 11 - 16 years) at operation. Radiological parameters including thoracic and lumbar curves, thoracic kyphosis (T(5)-T(12)), sagittal alignment of the thoracolumbar junction (T(10)-L(2)) and lumbar lordosis (T(12)-S(1)) were measured on the X-rays taken preoperatively, 3 months, 2 year postoperatively and at latest follow-up. Complications occurred after operation and during follow-up were retrieved. The Chinese edition SRS-22 was finished by patients at the latest follow-up. Repeated-measures analysis of variance and paired t test were used for statistical analysis.</p><p><b>RESULTS</b>The patients were followed for a mean of 6.2 years (5 - 7.5 years) after VATS. The mean thoracic curve was corrected from 51° ± 8° preoperatively to 20° ± 8° at 3 months post-operation, and 21° ± 12° and 25° ± 13° at 2 year post-operation and latest follow-up, respectively. During the follow-up, no significant changes were observed regarding to coronal and sagittal radiological parameters (P > 0.05). Rod breakage occurred in 1 patient and Adding on was found in another one patient 2 year post-operation. Revision surgery was not needed for the solid fusion achieved and lack of correction loss. The mean score of SRS-22 at final follow-up was 4.3 ± 0.3, with high score in most of the domains.</p><p><b>CONCLUSIONS</b>Loss of curve correction and implant-related complication are found in VATS-treated T-AIS patients at the long-term follow-up. Although the patients show high scores in SRS-22, which indicated higher functional outcome and satisfaction to the operation, special care should be taken for applying VATS to T-AIS patients for the concern of long-term complication.</p>

Evaluation of visual functional and morphology change in young patients with idiopathic choroidal neovascularization / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Idiopathic choroidal neovascularization (ICNV) is an uncommon disorder affecting primarily individuals younger than the age of 50 years. In CNV patients, no apparent cause can be determined. This study aimed to evaluate the functional and morphological change of the retina with ICNV in young adults.</p><p><b>METHODS</b>In this retrospective study, 32 eyes of 32 patients with subfoveal or juxta/extra foveal ICNV had been admitted into the Shanghai First People's Hospital from January 2009 to July 2010. The functional changes were evaluated using the best corrected visual acuity (BCVA) and the microperimetry in the macular area. The morphology changes were evaluated using optical coherence tomography (OCT), the color fundus photography and the fluorescein angiography.</p><p><b>RESULTS</b>Seventeen patients with juxta/extra foveal and 15 subfoveal CNV were investigated. The mean logarithm of the minimum angle of resolution (LogMAR) BCVA was 0.39, the mean central retinal thickness (CRT) was 334 µm, and the mean sensitivity (MS) was 11.8 decibels (dB). In the subfoveal group, there was a strong correlation between CRT and BCVA (r = -0.675, F = 2.167, P < 0.01); as well as that between CRT and MS (r = -0.681, F = 22.91, P < 0.01). While in the juxta/extra foveal CNV group, the correlation of CRT and BCVA was not significant (r = -0.071, F = 1.018, P > 0.05); neither was the correlation of CRT and MS (r = -0.142, F = 36.54, P > 0.05). The microperimetry (MP-1) test revealed 17 (53%) patients with stable fixation, 9 (28%) with relatively unstable and 6 (19%) with unstable fixation. Fixation stability correlated positively with sensitivity in the central 2° diameter area (r = 0.380, F = 3.213, P < 0.05) and the duration of symptoms (r = 0.401, F = 7.933, P < 0.05).</p><p><b>CONCLUSIONS</b>ICNV was associated with reduced total MS, unstable fixation and eccentric fixation. These findings emphasized functional change in ICNV is beyond the BCVA and regular morphology change, which provided additional information of functional evaluation in clinical practice.</p>

Anterior endoscopic release/posterior spinal instrumentation for severe and rigid thoracic adolescent idiopathic scoliosis / 中华外科杂志

<p><b>OBJECTIVES</b>To compare the results of spinal correction for severe and rigid thoracic adolescent idiopathic scoliosis (T-AIS) by combined anterior endoscopic release/posterior hybrid constructs of proximal hooks and distal pedicle screws spinal fusion (APSF) and an all-pedicle screw construct posterior-only spinal fusion (PSSF).</p><p><b>METHODS</b>T-AIS patients with curves ≥ 70° and flexibility ≤ 50% who underwent APSF from November 2001 to December 2008 were retrospectively reviewed (APSF group). In addition, the patients treated by PSSF with comparable curve severity and flexibility were selected as control (PSSF group). All patients had a minimum 2-year follow-up. The thoracic curve and kyphosis were measured on standing long-cassette posteroanterior and lateral radiographs of entire spine taken at pre-operation, post-operation and last follow-up. The radiographic parameters, fusion levels, implant density and complications were compared between two groups.</p><p><b>RESULTS</b>There were 18 patients treated with APSF and 27 with PSSF, with mean age of (15.9 ± 2.1) years and (15.8 ± 2.9) years, respectively. In patients treated with APSF, the mean thoracic curve was 87° ± 12° with 58% ± 13% correction after operation; while in those treated with PSSF, the mean thoracic curve was 79° ± 8° with 59% ± 8% correction after operation. The number of levels fused was 12.7 ± 1.2 and 12.8 ± 1.4, while the implant density was 48% ± 5% and 61% ± 6% in APSF group and PSSF group, respectively. Patients treated with APSF and PSSF were followed by (4.5 ± 0.6) years and (2.8 ± 0.7) years, with a mean loss of correction of 4.4° and 1.9° at final follow-up. Despite the significant higher implant density found in PSSF (t = 6.123, P < 0.001), there were no statistically significant differences between the groups for gender, age, number of levels fused, preoperative coronal/sagittal Cobb measurements, coronal curve flexibility, or amount of postoperative coronal Cobb correction.</p><p><b>CONCLUSIONS</b>In patients with severe and rigid T-AIS, PSSF could achieve same curve correction as an APSF by increasing implant density. In treating scoliosis patients with high risk of having loss of curve correction, implant complications or pseudarthrosis, APSF is recommended to achieve solid spinal fusion.</p>

A comparative study on the surgical outcomes of spinal fusion in adolescent idiopathic scoliosis patients with or without triradiate cartilages closed / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the effect of potential spinal growth on the posterior-only spinal instrumentation of adolescent idiopathic scoliosis (AIS).</p><p><b>METHODS</b>From June 2003 to October 2007, 40 patients received posterior-only spinal instrumentation. Group of open triradiate cartilage (Group A) included 16 female AIS patients with mean age of 11.8, and group of closed triradiate cartilages (Group B) covered 24 female AIS patients with mean age of 13.7. The mean preoperative Cobb angles of Group A and B were 53.3° and 49.6° respectively, and the mean kyphosis in the sagittal plane was 27.7° and 27.8° respectively.</p><p><b>RESULTS</b>The post-operative Cobb angles were 22.2° (Group A) vs. 20.7° (Group B) (P = 0.34) with correction rate of 58.3% (Group A) vs. 57.7% (Group B) (P = 0.83). The mean Cobb angles at final follow-up were 24.8° (Group A) vs. 21.1° (Group B) (P = 0.05) with the correction loss of 5.3% (Group A) vs. 1.0% (Group B) (P = 0.01). In the sagittal plane, the average post-operative kyphosis was 22.5° (Group A) vs. 23.9° (Group B) (P = 0.49) with correction of 5.2° (Group A) vs. 3.9°(Group B) (P = 0.63). The mean kyphosis at final follow-up was 20.8°(Group A) vs. 24.7°(Group B) (P = 0.04) with the correction loss of -1.7° (Group A) vs. 0.8°(Group B) (P = 0.01). Group A showed obvious correction loss in the coronal plane and decrease of kyphosis in the sagittal plane. Adding on phenomenon was found in 2 cases with Lenke type I with selected fusion in Group A, but not in Group B.</p><p><b>CONCLUSIONS</b>Although similar post-operative correction is found in AIS patients with OTRC or CTRC, the loss of correction and "adding on phenomenon" are more likely to happen in patients with OTRC.</p>

A preliminary study of melatonin signaling transduction pathway in BMSCs from adolescent idiopathic scoliosis patients / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the melatonin signaling transduction pathway in BMSCs from adolescent idiopathic scoliosis patients.</p><p><b>METHODS</b>Twenty-four volunteers aged 12 - 18 years were divided into two groups: AIS group was 15 and control group was 9. The human bone marrow anticoagulated by heparin was obtained from anterior superior iliac spine, and the BMSCs were isolated by density gradient centrifuge from the mononuclear cells, and then were cultivated and serial subcultivated in vitro. P3 cultures were analyzed by the flow cytometry to determine the surface antigens. P3 BMSCs were used to detect the melatonin signaling transduction pathway. The cellular cAMP was elevated using forskolin, and then the BMSCs were treated with melatonin to inhibit the cellular cAMP levels.</p><p><b>RESULTS</b>Mononuclear cells were cultivated and subcultivated to P3 culture in vitro, which were analyzed by the flow cytometry, and demonstrated that the expanded mononuclear cells expressed mesenchymal cell markers. The basal cAMP levels of the two groups were very low, after the stimulation of forskolin, cellular cAMP levels increased rapidly in all the patients, but after the stimulation of melatonin at physiological dose or even at pharmacological dose, there was no statistical difference of the inhibition of cAMP between AIS group and control (P > 0.05).</p><p><b>CONCLUSION</b>Melatonin signaling transduction pathway may be normal in BMSCs from AIS patients.</p>

Effects of acupuncture-drug compound anesthesia on perioperative inflammatory factors in patients undergoing cardiac surgery / 中国针灸

<p><b>OBJECTIVE</b>To explore the effect of acupuncture-drug compound anesthesia on immune function in patients with extracorporeal circulation undergoing cardiac surgery.</p><p><b>METHODS</b>Thirty cases undergoing cardiac surgery which included atrial septal defect neoplasty, ventricular septal defect neoplasty, mitral valve replacement and pulmonary valve coarctotomy were randomly divided into group A and group B, 15 cases in each group. Group A was given general anesthesia plus acupuncture at Neiguan (PC 6), Lieque (LU 7) and Yunmen (LU 2), and group B was given simple general anesthesia. Tumor necrosis factor-alpha (TNF-alpha), interleukin-2 (IL-2) and interleukin-10 (IL-10) levels before and after surgery were compared.</p><p><b>RESULTS</b>The level of TNF-alpha was increased and the levels of IL-2 and IL-10 in the serum were decreased in both groups after extracorporeal circulation for 2 h and 24 h, and the ranges of all changes were more less in group A (all P < 0.05).</p><p><b>CONCLUSION</b>Compared with simple general anesthesia, acupuncture-drug compound anesthesia can improve immune suppression partially in the perioperative periods under the same conditions of controlling anesthesia degree.</p>

Thoracic scoliosis following anterior and posterior instrumentation and fusion / 中华外科杂志

<p><b>OBJECTIVES</b>To quantify the changes of the spatial relations between the vertebral body and the thoracic aorta in main right thoracic adolescent idiopathic scoliosis (AIS) following anterior and posterior instrumentation and fusion.</p><p><b>METHODS</b>Twenty-nine patients with main right thoracic AIS were divided into 2 groups. Group A included 13 females and 1 male with an average age of 14.3 years old and average main thoracic Cobb angle of 44.9 degrees, these patients underwent mini-incision thoracic anterior spinal fusion. Group B included 12 females and 3 males with an average age of 14.2 years old and average main thoracic Cobb angle of 46.4 degrees, all of them were treated with posterior spinal fusion. Patients underwent CT scanning from T5 to T12 Pre-and post-operatively. Five parameters pertaining to the spatial relations between the vertebral body and the thoracic aorta including the angle for safety screw placement (gamma), the angle of the aorta relative to the vertebral body (beta), vertebral rotation angle (gamma), distance from the aorta to the closest point of the vertebral body cortex (a) and distance from the posterior wall of the aorta to the anterior edge of the left rib head (b) were analyzed and were correlated with the curve correction.</p><p><b>RESULTS</b>In Group A, the alpha angle and 3 angle increased while gamma decreased after curve correction, and significant difference were found at T8 and T9 levels (P < 0.05); the a value decreased and b value increased after curve correction and reached significant difference at T9 (P < 0.05). No significant change of these parameters was found in Group B post-operatively. In Group A, the increment of alpha angle, beta angle and b value show great correlation with the decrement of gamma angle (P < 0.01). At the periapical the increment of alpha angle, beta angle and b value show great correlation with decrement of apical vertebral translation, while decrement of a value show great correlation with increment of kyphosis from T5 to T12 (P < 0.01).</p><p><b>CONCLUSIONS</b>Under anterior instrumentation and correction, the aorta moved anteromedially toward vertebral body on CT scanning. The factors contributing to the aorta shifting included releasing of aorta from vertebrae, vertebral derotation and curve correction.</p>

The value of parameters in predicting the growth peak height velocity of the adolescent idiopathic scoliosis girls: a histomorphological study on iliac crest cartilage / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate the value of some parameters in predicting of growth peak height velocity (PHV) of the girls with adolescent idiopathic scoliosis (AIS) by histomorphological studying on iliac crest cartilage.</p><p><b>METHODS</b>Iliac crest cartilages were harvested during posterior surgery from girls with AIS. The samples were then paraffin embedded after stored in formalin solid over 24 hours, sectioned vertical to the calcification at the thickness of 5 microm, and stained with Hematoxylin and Eosin. The histological grading of the proliferating activity of it was observed under the microscope. Parameters included chronologic age, menarche status, wrist skeletal age, digital skeletal age, elbow epiphysis and Risser sign were recorded. The histological grading data were compared with these parameters in terms of their accuracy in the prediction of PHV of the scoliosis.</p><p><b>RESULTS</b>The specimens of 53 AIS patients with an average age 14.0 years were stained successfully. The proliferating activity of the iliac crest cartilage decreased when the AIS girl was over 13.0 years of chronologic age, 14.0 years of wrist skeletal age, post menarche or Risser sign was no less than grade 3.</p><p><b>CONCLUSIONS</b>All the parameters evaluated can be used to show the end of PHV. Three parameters, including 11 years old of chronologic age, 12 years of the wrist skeletal age, unfusion of the elbow epiphysis and the thelarche, can be used in predicting the beginning of PHV.</p>

Comparative study on precision of vertebral screw insertion for idiopathic thoracic scoliosis between by thoracoscopy and by mini anterior thoracotomy / 中华外科杂志

<p><b>OBJECTIVE</b>To compare the precision of the vertebral screw insertion in treating idiopathic thoracic scoliosis by thoracoscopy with that by mini anterior thoracotomy.</p><p><b>METHODS</b>Ten patients with an average Cobb angle of 52.9 degrees were operated thoracoscopically (group A), and twenty-one patients with an average Cobb angle of 45.4 degrees were operated by mini anterior thoracotomy (group B). In order to determine the accuracy of screw placement, several parameters were measured postoperatively on each instrumented level of CT scan, including the entry point and entry direction of screw, the relationships between the screw tip and aorta as well as spinal canal. The safety of screw placement was determined at the position of screw to the vertebral canal and the aorta, and the results of CT analysis were designated as; D, the screw tip was distant from the aorta (> or = 1 mm); A, the screw tip was adjacent to the aorta (< 1 mm); C, the screw tip was felt to be against the aorta and creating contour deformity. The screw which had a bi-cortical purchase but was distant from the aorta and vertebral canal was defined as a satisfied screw.</p><p><b>RESULTS</b>73 screws were inserted into patients of Group A, and 162 into patients in Group B. Parameters measured on CT image and X-ray showed no difference between these two groups (P > 0.05). There is no difference (P > 0.05) between A and B group of percentages in D (89.0% vs. 80.2%), in bi-cortical purchase (89.0% vs. 87.0%), and in satisfaction of screw placement (74.0% vs. 66.0%).</p><p><b>CONCLUSION</b>Thoracoscopic and mini-open thoracotomic anterior correction are safe and effective to correct idiopathic right thoracic scoliosis with satisfied correction. Vertebral screws placed by both techniques have the same satisfied accuracy, safety, bi-cortical purchase and the satisfaction rate either in total screws or in the corresponding area.</p>

Computerized tomographic study about the effect of neurocentral cartilage on the etio-pathogenesis of adolescent idiopathic scoliosis / 中华外科杂志

<p><b>OBJECTIVE</b>To analysis the potential effect of neurocentral cartilage (NCC) on the etiology of adolescent idiopathic scoliosis (AIS).</p><p><b>METHODS</b>Thirty patients with AIS (Group A) and 30 control subject with normal spine (Group B) were included in this study. The age is matched. Both groups were divided into two subgroups according to the age and each subgroup has 15 patients. The younger patients were put into subgroup A1, B1 and the older patients put into subgroup A2, B2. Computed tomography (CT) scanning was carried and the pedicle length, the angle composed by pedicle and vertebral midline (alpha) and the angle composed by NCC and vertebral midline (beta) at periapical vertebrae (T7-T10) were analyzed.</p><p><b>RESULTS</b>The pedicle length showed no significant difference between group A and group B or between subgroup A1 and A2 or between B1 and B2. In each subgroup, no significant difference was found in alpha angle or beta angle between left side and right side (concave side and convex side).</p><p><b>CONCLUSIONS</b>No significant pedicle growth has been found during pubertal both in AIS and normal patients. Few affect of neurocentral cartilage on the etiology of AIS has been found, which might because of low growth activity of NCC during puberty.</p>

Effect of medroxyprogesterone acetate on proliferation and apoptosis of human colorectal cancer cells / 第二军医大学学报

Objective: To investigate the effects of medroxyprogesterone acetate (MPA) on the proliferation and apoptosis of human colorectal cancer cells. Methods: Human colorectal cancer cell line LS174T was treated with different concentrations of MPA(12.5,25,50 and 100 μmol/L ) for 120 h. The inhibitory effect of MPA was measured with MTT method; the cell cycle, cell apoptosis, and cell surface Fas expression were analyzed with flow cytometry. Results: MPA had significant inhibitory effect on the growth of LS174T human colon cancer cells. Cell growth was found to be arrested in G1 phase and cells in S phase and G2/M phase were decreased. The natural apoptosis rate and the apoptosis rates at MPA 12.5 and 25 μmol/L were 4.8%, 15.1% and 25.6%, respectively. Cell surface Fas expression in cancer cells increased after treated with MPA. Conclusion: MPA has significant inhibitory effect on the growth of human colon cancer cells, which may be related to Fas expression upregulation on cancer cell surface and G1 phase arrest.

Growth inhibition and apoptosis of human colon cancer cells induced by vitamin E succinate / 第二军医大学学报

Objective: To investigate the growth inhibition and apoptosis induction effect of vitamin E succinate (VES) on human colon cancer cells and to analyze the modulation of apoptosis-mediator Fas expression in this process. Methods: Human colon cancer cell line LS174T was treated with VES for 12 h, 24 h and 48 h at the concentrations of 5 mg/L, 10 mg/L and 20mg/L. 1-(4,5-dimethylthiazo-2-yl)-3,5-diphenylformazan (MTT) assay was employed to detect the inhibitory effect of VES on the growth of colon cancer cells. Flow cytometry was then used to analyze the cell cycle of the colon cancer cells after being treated with VES and the apoptotic rate was calculated at the same time. To find out whether the Fas protein expression was modulated in this process, Western blotting assay and flow cytometry were used to detect the Fas protein level in whole cell lystates and on cell surface. Results: VES exhibited a significant inhibitory effect on the growth of human colon cancer cells in a doseand time-dependent manner. After being treated with VES at 5 mg/L, 10 mg/L and 20 mg/L for 48 h, the apoptotic rate of LS174T cells rose from 0.90% to 15.9%, 46.7% and 64.5%, respectively. Fas neutralizing antibody can significantly block VES-induced apoptosis. After the administration of VES, total Fas protein in whole-cell extracts increased in a dose-dependent manner. The flow cytometry showed that the mean fluorescence intensity rose from 5.43 to 9.88, 13.21 and 18.0 after being treated with VES. Conclusion: VES can induce significant growth inhibition and apoptosis in human colon cancer cells. The modulation of Fas expression is one of the mechanisms involved in this process and may be related to the upregulation of Fas molecule on the cancer cell surface.

Growth inhibition and apoptosis of human colon cancer cells induced by vitamin E succinate / 第二军医大学学报

Objective: To investigate the growth inhibition and apoptosis induction effect of vitamin E succinate (VES) on human colon cancer cells and to analyze the modulation of apoptosis-mediator Fas expression in this process. Methods: Human colon cancer cell line LS174T was treated with VES for 12 h, 24 h and 48 h at the concentrations of 5 mg/L, 10 mg/L and 20mg/L. 1-(4,5-dimethylthiazo-2-yl)-3,5-diphenylformazan (MTT) assay was employed to detect the inhibitory effect of VES on the growth of colon cancer cells. Flow cytometry was then used to analyze the cell cycle of the colon cancer cells after being treated with VES and the apoptotic rate was calculated at the same time. To find out whether the Fas protein expression was modulated in this process, Western blotting assay and flow cytometry were used to detect the Fas protein level in whole cell lystates and on cell surface. Results: VES exhibited a significant inhibitory effect on the growth of human colon cancer cells in a doseand time-dependent manner. After being treated with VES at 5 mg/L, 10 mg/L and 20 mg/L for 48 h, the apoptotic rate of LS174T cells rose from 0.90% to 15.9%, 46.7% and 64.5%, respectively. Fas neutralizing antibody can significantly block VES-induced apoptosis. After the administration of VES, total Fas protein in whole-cell extracts increased in a dose-dependent manner. The flow cytometry showed that the mean fluorescence intensity rose from 5.43 to 9.88, 13.21 and 18.0 after being treated with VES. Conclusion: VES can induce significant growth inhibition and apoptosis in human colon cancer cells. The modulation of Fas expression is one of the mechanisms involved in this process and may be related to the upregulation of Fas molecule on the cancer cell surface.