Clinical efficacy of ultrasound-guided closed reduction for pediatric distal radius fracture / 中华实用儿科临床杂志

Objective:To compare the clinical efficacy of ultrasound-guided closed reduction and bare-handed reduction on pediatric distal radius fractures.Methods:Clinical data of 118 consecutive pediatric patients with distal radius fracture treated in the Wuhan Children′s Hospital, Tongji Medical College, Huazhong University of Science & Technology from April 2018 to August 2019 were retrospectively analyzed.Patients treated with bare-handed reduction and ultrasound-guided closed reduction were respectively classified into group Ⅰ (58 cases) and group Ⅱ (60 cases). Baseline characteristics, treatment duration, out-patient treatment cost, postoperative pain and the modified Mayo wrist function score during the follow-up visits between groups were compared by the t test.The success rate of initial reduction, reduction times, hospitalization rate and complication between 2 groups were compared by the Chi- square test.The number of postoperative imaging scans between 2 groups was compared by the Mann- Whitney U test. Results:There were no significant differences in out-patient treatment cost and hospitalization rate between 2 groups (all P>0.05). There were significant differences in the length of stay [ (166.2±54.8) min vs.(142.6±49.2) min], success rate of initial reductions [72.4%(42/58 cases ) vs.88.3%(53/60 cases)], incidence of repeated reductions (27.6% vs.1.7%) and the incidence of postoperative repeated imaging scans (20.7% vs.1.7%) between groupⅠ and group Ⅱ (all P<0.05). A total of 104 patients (88.1%) were successfully treated with closed reduction and followed up, with a rate of success reductions.Among them, success rate of closed reduction in group Ⅰ and Ⅱ were 86.2% and 90.0%, respectively.The mean time of fracture healing was 43 (34-56) days.There were no significant differences in fracture healing time and pain score between 2 groups(all P>0.05). The modified Mayo wrist score was significantly lower in group Ⅰ than that of group Ⅱ[(97.3±4.1) points vs.(98.8±2.9) points, P<0.05]. Seven patients in group Ⅰ suffered fracture re-displacement, including 6 cases within 1 case week and 1 within 2 weeks, and 4 cases admitted to the surgical ward for further management.Five patients in group Ⅱ had re-displacement within 1 week of plaster fixation, of which 2 cases admitted to the surgical ward for further management, which was comparable between groups( P>0.05). Conclusions:Both ultrasound-guided closed reduction and bare-handed reduction are effective on the treatment of pediatric distal radius fractures, showing low incidence of complications and satisfactory functional results.Owing to its higher success rate of initial reduction, lower frequency of postoperative ra-diography and shorter length of stay, ultrasound-guided closed reduction should be recommended.

Epidemiological characteristics, diagnosis, treatment and prognosis of gallbladder cancer in China: a report of 6 159 cases / 中华消化外科杂志

Objective:To investigate the epidemiological characteristics, diagnosis, treat-ment and prognosis of gallbladder cancer in China from 2010 to 2017.Methods:The single disease retrospective registration cohort study was conducted. Based on the concept of the real world study, the clinicopathological data, from multicenter retrospective clinical data database of gallbladder cancer of Chinese Research Group of Gallbladder Cancer (CRGGC), of 6 159 patients with gallbladder cancer who were admitted to 42 hospitals from January 2010 to December 2017 were collected. Observation indicators: (1) case resources; (2) age and sex distribution; (3) diagnosis; (4) surgical treatment and prognosis; (5) multimodality therapy and prognosis. The follow-up data of the 42 hospitals were collected and analyzed by the CRGGC. The main outcome indicator was the overall survival time from date of operation for surgical patients or date of diagnosis for non-surgical patients to the end of outcome event or the last follow-up. Measurement data with normal distribu-tion were represented as Mean±SD, and comparison between groups was conducted using the t test. Measurement data with skewed distribution were represented as M( Q1, Q3) or M(range), and com-parison between groups was conducted using the U test. Count data were described as absolute numbers or percentages, and comparison between groups was conducted using the chi-square test. Univariate analysis was performed using the Logistic forced regression model, and variables with P<0.1 in the univariate analysis were included for multivariate analysis. Multivariate analysis was performed using the Logistic stepwise regression model. The life table method was used to calculate survival rates and the Kaplan-Meier method was used to draw survival curves. Log-rank test was used for survival analysis. Results:(1) Case resources: of the 42 hospitals, there were 35 class A of tertiary hospitals and 7 class B of tertiary hospitals, 16 hospitals with high admission of gallbladder cancer and 26 hospitals with low admission of gallbladder cancer, respectively. Geographical distribution of the 42 hospitals: there were 9 hospitals in central China, 5 hospitals in northeast China, 22 hospitals in eastern China and 6 hospitals in western China. Geographical distribution of the 6 159 patients: there were 2 154 cases(34.973%) from central China, 705 cases(11.447%) from northeast China, 1 969 cases(31.969%) from eastern China and 1 331 cases(21.611%) from western China. The total average number of cases undergoing diagnosis and treatment in hospitals of the 6 159 patients was 18.3±4.5 per year, in which the average number of cases undergoing diagnosis and treatment in hospitals of 4 974 patients(80.760%) from hospitals with high admission of gallbladder cancer was 38.8±8.9 per year and the average number of cases undergoing diagnosis and treatment in hospitals of 1 185 patients(19.240%) from hospitals with low admission of gallbladder cancer was 5.7±1.9 per year. (2) Age and sex distribution: the age of 6 159 patients diagnosed as gallbladder cancer was 64(56,71) years, in which the age of 2 247 male patients(36.483%) diagnosed as gallbladder cancer was 64(58,71)years and the age of 3 912 female patients(63.517%) diagnosed as gallbladder cancer was 63(55,71)years. The sex ratio of female to male was 1.74:1. Of 6 159 patients, 3 886 cases(63.095%) were diagnosed as gallbladder cancer at 56 to 75 years old. There was a significant difference on age at diagnosis between male and female patients ( Z=-3.99, P<0.001). (3) Diagnosis: of 6 159 patients, 2 503 cases(40.640%) were initially diagnosed as gallbladder cancer and 3 656 cases(59.360%) were initially diagnosed as non-gallbladder cancer. There were 2 110 patients(34.259%) not undergoing surgical treatment, of which 200 cases(9.479%) were initially diagnosed as gallbladder cancer and 1 910 cases(90.521%) were initially diagnosed as non-gallbladder cancer. There were 4 049 patients(65.741%) undergoing surgical treatment, of which 2 303 cases(56.878%) were initially diagnosed as gallbladder cancer and 1 746 cases(43.122%) were initial diagnosed as non-gallbladder cancer. Of the 1 746 patients who were initially diagnosed as non-gallbladder cancer, there were 774 cases(19.116%) diagnosed as gallbladder cancer during operation and 972 cases(24.006%) diagnosed as gallbladder cancer after operation. Of 6 159 patients, there were 2 521 cases(40.932%), 2 335 cases(37.912%) and 1 114 cases(18.087%) undergoing ultrasound, computed tomography (CT) or magnetic resonance imaging (MRI) examination before initial diagnosis, respec-tively, and there were 3 259 cases(52.914%), 3 172 cases(51.502%) and 4 016 cases(65.205%) undergoing serum carcinoembryonic antigen, CA19-9 or CA125 examination before initially diagnosis, respectively. One patient may underwent multiple examinations. Results of univariate analysis showed that geographical distribution of hospitals (eastern China or western China), age ≥72 years, gallbladder cancer annual admission of hospitals, whether undergoing ultrasound, CT, MRI, serum carcinoembryonic antigen, CA19-9 or CA125 examination before initially diagnosis were related factors influencing initial diagnosis of gallbladder cancer patients ( odds ratio=1.45, 1.98, 0.69, 0.68, 2.43, 0.41, 1.63, 0.41, 0.39, 0.42, 95% confidence interval as 1.21-1.74, 1.64-2.40, 0.59-0.80, 0.60-0.78, 2.19-2.70, 0.37-0.45, 1.43-1.86, 0.37-0.45, 0.35-0.43, 0.38-0.47, P<0.05). Results of multivariate analysis showed that geographical distribution of hospitals (eastern China or western China), sex, age ≥72 years, gallbladder cancer annual admission of hospitals and cases undergoing ultrasound, CT, serum CA19-9 examination before initially diagnosis were indepen-dent influencing factors influencing initial diagnosis of gallbladder cancer patients ( odds ratio=1.36, 1.42, 0.89, 0.67, 1.85, 1.56, 1.57, 0.39, 95% confidence interval as 1.13-1.64, 1.16-1.73, 0.79-0.99, 0.57-0.78, 1.60-2.14, 1.38-1.77, 1.38-1.79, 0.35-0.43, P<0.05). (4) Surgical treatment and prognosis. Of the 4 049 patients undergoing surgical treatment, there were 2 447 cases(60.435%) with complete pathological staging data and follow-up data. Cases with pathological staging as stage 0, stage Ⅰ, stage Ⅱ, stage Ⅲa, stage Ⅲb, stage Ⅳa and stage Ⅳb were 85(3.474%), 201(8.214%), 71(2.902%), 890(36.371%), 382(15.611%), 33(1.348%) and 785(32.080%), respectively. The median follow-up time and median postoperative overall survival time of the 2 447 cases were 55.75 months (95% confidence interval as 52.78-58.35) and 23.46 months (95% confidence interval as 21.23-25.71), respectively. There was a significant difference in the overall survival between cases with pathological staging as stage 0, stage Ⅰ, stage Ⅱ, stage Ⅲa, stage Ⅲb, stage Ⅳa and stage Ⅳb ( χ2=512.47, P<0.001). Of the 4 049 patients undergoing surgical treatment, there were 2 988 cases(73.796%) with resectable tumor, 177 cases(4.371%) with unresectable tumor and 884 cases(21.833%) with tumor unassessable for resectabi-lity. Of the 2 988 cases with resectable tumor, there were 2 036 cases(68.139%) undergoing radical resection, 504 cases(16.867%) undergoing non-radical resection and 448 cases(14.994%) with operation unassessable for curative effect. Of the 2 447 cases with complete pathological staging data and follow-up data who underwent surgical treatment, there were 53 cases(2.166%) with unresectable tumor, 300 cases(12.260%) with resectable tumor and receiving non-radical resection, 1 441 cases(58.888%) with resectable tumor and receiving radical resection, 653 cases(26.686%) with resectable tumor and receiving operation unassessable for curative effect. There were 733 cases not undergoing surgical treatment with complete pathological staging data and follow-up data. There was a significant difference in the overall survival between cases not undergoing surgical treatment, cases undergoing surgical treatment for unresectable tumor, cases undergoing non-radical resection for resectable tumor and cases undergoing radical resection for resectable tumor ( χ2=121.04, P<0.001). (5) Multimodality therapy and prognosis: of 6 159 patients, there were 541 cases(8.784%) under-going postoperative adjuvant chemotherapy and advanced chemotherapy, 76 cases(1.234%) under-going radiotherapy. There were 1 170 advanced gallbladder cancer (pathological staging ≥stage Ⅲa) patients undergoing radical resection, including 126 cases(10.769%) with post-operative adjuvant chemotherapy and 1 044 cases(89.231%) without postoperative adjuvant chemo-therapy. There was no significant difference in the overall survival between cases with post-operative adjuvant chemotherapy and cases without postoperative adjuvant chemotherapy ( χ2=0.23, P=0.629). There were 658 patients with pathological staging as stage Ⅲa who underwent radical resection, including 66 cases(10.030%) with postoperative adjuvant chemotherapy and 592 cases(89.970%) without postoperative adjuvant chemotherapy. There was no significant difference in the overall survival between cases with postoperative adjuvant chemotherapy and cases without postoperative adjuvant chemotherapy ( χ2=0.05, P=0.817). There were 512 patients with pathological staging ≥stage Ⅲb who underwent radical resection, including 60 cases(11.719%) with postoperative adjuvant chemotherapy and 452 cases(88.281%) without postoperative adjuvant chemotherapy. There was no significant difference in the overall survival between cases with postoperative adjuvant chemo-therapy and cases without post-operative adjuvant chemo-therapy ( χ2=1.50, P=0.220). Conclusions:There are more women than men with gallbladder cancer in China and more than half of patients are diagnosed at the age of 56 to 75 years. Cases undergoing ultrasound, CT, serum CA19-9 examination before initial diagnosis are independent influencing factors influencing initial diagnosis of gallbladder cancer patients. Preoperative resectability evaluation can improve the therapy strategy and patient prognosis. Adjuvant chemotherapy for gallbladder cancer is not standardized and in low proportion in China.

Layers of interstitial fluid flow along a "slit-shaped" vascular adventitia / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

Interstitial fluid (ISF) flow through vascular adventitia has been discovered recently. However, its kinetic pattern was unclear. We used histological and topographical identification to observe ISF flow along venous vessels in rabbits. By magnetic resonance imaging (MRI) in live subjects, the inherent pathways of ISF flow from the ankle dermis through the legs, abdomen, and thorax were enhanced by paramagnetic contrast. By fluorescence stereomicroscopy and layer-by-layer dissection after the rabbits were sacrificed, the perivascular and adventitial connective tissues (PACTs) along the saphenous veins and inferior vena cava were found to be stained by sodium fluorescein from the ankle dermis, which coincided with the findings by MRI. The direction of ISF transport in a venous PACT pathway was the same as that of venous blood flow. By confocal microscopy and histological analysis, the stained PACT pathways were verified to be the fibrous connective tissues, consisting of longitudinally assembled fibers. Real-time observations by fluorescence stereomicroscopy revealed at least two types of spaces for ISF flow: one along adventitial fibers and another one between the vascular adventitia and its covering fascia. Using nanoparticles and surfactants, a PACT pathway was found to be accessible by a nanoparticle of <100 nm and contained two parts: a transport channel and an absorptive part. The calculated velocity of continuous ISF flow along fibers of the PACT pathway was 3.6‒15.6 mm/s. These data revealed that a PACT pathway was a "slit-shaped" porous biomaterial, comprising a longitudinal transport channel and an absorptive part for imbibition. The use of surfactants suggested that interfacial tension might play an essential role in layers of continuous ISF flow along vascular vessels. A hypothetical "gel pump" is proposed based on interfacial tension and interactions to regulate ISF flow. These experimental findings may inspire future studies to explore the physiological and pathophysiological functions of vascular ISF or interfacial fluid flow among interstitial connective tissues throughout the body.

Analysis of curative effect of Doppler ultrasound-guided management for vascular complications of Gartland type Ⅲ supracondylar fractures of the humerus in children / 中华实用儿科临床杂志

Objective:To investigate the curative effect of Doppler ultrasound-guided management of vascular injury of Gartland type Ⅲ supracondylar fractures of humerus in children.Methods:A prospective study on 18 children with vascular complications of pulseless Gartland type Ⅲ supracondylar humeral fracture who were admitted at Department of Pediatric Orthopedic Surgery, Wuhan Children′s Hospital from March 2017 to March 2018 was conducted.Among these children, 12 were male and 6 were female, with the age of 2.1-8.6 years (mean 4.4 years old), and 10 cases were injured on the left and 8 cases on the right.All patients were satisfied with closed reduction and internal fixation within 24 hours after injury.Before the operation, Doppler ultrasound was performed to determine the shape of brachial artery and it relationship with fracture.During reduction, Doppler ultrasound was used to assess brachial pulse and blood perfusion.Then, the brachial artery was assessed by palpable radial pulse and peripheral blood supply, and elbow joint function was evaluated with Mayo Elbow Performance Score and Flynn criteria.Results:Eighteen patients were followed up for 6 to 12 months (average 9 months) after operation.Before reduction, radial pulse disappeared and peripheral blood supply was good in 18 cases.Preoperative Doppler ultrasonography showed that the brachial artery was located in front of the proximal humerus fracture fragment.A proximal stream of the brachial artery was identified, but the distal blood vessels were compressed by the fragment.A stream of radial artery was identified in 5 patients with Doppler, and no stream was identified in 13 patients.After reduction, the peripheral blood supply of all the affected limbs was good, among which the peripheral blood supply, 1 case returned to normal after 5 minutes waiting.Specifically the palpable radial pulse was immediately restored in 14 patients.The palpable radial pulse did not restore but the peripheral blood supply was good in 4 cases.Intraoperative ultrasonography showed that brachial artery blood flow was good, and palpable radial pulse was restored between 3 to 5 weeks later.In patients with at average sixteen-week neurological follow-up, 5 patients had complete resolution of nerve palsy.No complications such as forearm compartment syndrome and elbow joint dysfunction occurred.Functional outcome as measured by Flynn criteria was excellent in 12 patients, good in 6 patients, the excellent and good rate was 100%.Functional outcome as measured by Mayo Elbow Performance Score was excellent in 17 patients, good in one patient, the excellent and good rate was 100%.Conclusion:Ultrasound-guided is a safe and reliable option to treat pulseless Gartland type Ⅲ supracondylar humeral fracture.

Incidence of chronic obstructive pulmonary disease and pneumoconiosis in different occupational positions among populations from jinchang cohort / 中华劳动卫生职业病杂志

Objective@#To investigate the incidence and rank of chronic obstructive pulmonary disease and pneumoconiosis to the workers in different occupational positions in Jinchang Cohort.@*Methods@#In January 2014, a cohort of follow-up population in jinchang city was taken as the research object, 17843 individuals among follow-up populations in Jinchang Cohort Study, removed the individuals with chronic obstructive pulmonary disease and pneumoconiosis before 2013, and counted the new incidence individuals diagnosed by the A-Class hospital in Grade III in Jinchang City, Gansu Province, as the investigation objects to investigate the incidence rate & rank of chronic obstructive pulmonary disease and pneumoconiosis. The statistical significance was tested by chi-square test.@*Results@#The 2-year incidence rate of Chronic Obstructive Pulmonary Disease and Pneumoconiosis in the population of Jinchang Cohort Study were 11.60‰, 13.51‰ for male and 8.46‰ for female. the ranks of 2-year incidence rates of chronic bronchitis, emphysema, pneumoconiosis and other phenotypes of chronic obstructive pulmonary disease were 7.06‰、3.42‰、0.84‰、0.34‰, respectively. Incidence rate of chronic bronchitis among administrators and executive staffs were 10.45‰; incidence rate of chronic bronchitis among service staffs were 10.45‰; incidence rate of pneumoconiosis among mining staffs were 3.44‰.@*Conclusion@#The first incidence rank of chronic obstructive pulmonary disease and pneumoconiosis in Jinchang cohort is chronic bronchitis, and the risk factors are smoking and occupational exposure.

Application of suction assisted closure to repair refractory ulcers of leukemia in children / 中华实用儿科临床杂志

Objective To investigate the effect of suction assisted closure (SAC) in treatment of children's leukemia with refractory ulcers.Methods The clinical data of 15 children who had leukemia associated with refractory ulcers from January 2013 to April 2017 in Department of Orthopedics,Wuhan Children's Hospital,Tongji Medical College of Huazhong University of Science & Technology were retrospectively analyzed.There were 8 males and 7 females,among whom 9 cases were acute non-lymphocytic leukemia and 6 cases were acute lymphoblastic leukemia.Patient's ages ranged from 2 to 9 years old with the mean age of 6.2 years.There were 5 cases of refractory ulcers located in the medial side of thigh and 4 cases in the perineum and around anus,3 cases in the ankle,2 cases in the crus and 1 case in the lateral side of thigh.The refractory ulceration area varied from 2 cm × 3 cm-7 cm × 5 cm,and the depth varied from 0.6-1.8 cm.All the 15 cases were cultured with secretions,including 7 cases of Staphylococcus aureus,4 cases of Escherichia coli,2 cases of Klebsiella pneumoniae,1 case of Pseudomonas aeruginosa,and 1 case with no bacteria detected.These children were transferred from Department of Hematology to Department of Orthopedics when there was no improvement in conventional therapy with the average treatment of 26 d (11-36 d).All of these children underwent SAC after thorough debridement.Secondary suturing of ulcers closure was performed or skin transplantation according to the recovery condition of ulcers.Results All the 15 patients of refractory ulcers achieved fresh granulation tissue after SAC treatment.Ten of them who had refractory ulcers could be sutured directly after once SAC treatment,and 5 cases who had refractory ulcers underwent SAC treatment again,in which 3 cases could be sutured directly,and the other 2 cases needed to reduce the wound area and autologous skin graft.All of these patients had refractory ulcers healed after SAC treatment,without any local or systemic complications.Conclusions SAC can bring the deep refractory ulcers into full drainage,protect the refractory ulcers against contamination,stimulate the growth of granulation tissue.SAC is a simple and effective method in treatment of children's leukemia with refractory ulcers.

Application of multi-slice spiral CT in the screening of coronary artery lesions in elderly patients with diabetes mellitus / 中华老年医学杂志

Objective To evaluate the clinical value of multi-slice spiral CT (MSCT)in the screening of coronary artery lesions in elderly patients with diabetes mellitus.Methods MSCT and coronary angiography(CAG)were performed in 136 elderly patients(68 patients with diabetes and 68 patients without diabetes).The number of diseased coronary segments and the plaque type (noncalcified,mixed and calcified)for each patient were determined.The characteristics of coronary lesions were compared between patients with and without diabetes.The sensitivity and specificity of MSCT were evaluated.Results More noncalcified and calcified plaques and few ermixed plaques were observed in patients with diabetes,compared with patients without diabetes(noncalcified plagues:10 cases or 14.7％ vs.4 cases or 5.9％;calcified plagues:47 cases or 69.1％ vs.39 cases or 57.4％)(P＜ 0.05).In addition,diabetic patients showed a significantly higher frequency of multivessel disease(P＜0.05).Furthermore,MSCT was able to clearly show stenosis and plaque type in the trunk and branches of the coronary artery,with a sensitivity of 91.0％,a specificity of 95.0％,a positive predictive value of 93％ and a negative predictive value of 96.0％.Conclusions Diabetes is associated with a higher risk of coronary artery disease.MSCT can effectively detect the characteristics of coronary artery disease in diabetic patients and is an effective,noninvasive,and safe screening method.

Feasibility of Transradial Percutaneous Coronary Intervention in Coronary Artery Disease Patients Elder Than 80 Years of Age / 中国循环杂志

Objective: To review the feasibility of transradial percutaneous coronary intervention (PCI) in coronary artery disease (CAD) patients elder than 80 years of age. Methods: A total of 661 CAD patients elder than 60 years with PCI in our hospital from 2013-12 to 2015-12 were enrolled and divided into 2 groups: Observation group, the patients with the mean age of (83.2±3.8, 80-92) years,n=76 and Control group, the patients with the mean age of (68.3±5.2, 60-79) years,n=585. Clinical features, coronary lesions, radial puncture failure rate, PCI success rate and intra-, post-operative complications were retrospectively analyzed and compared between 2 groups. Results: In Control group and Observation group, the patients from failed radial artery puncture changing to brachial artery puncture were 1.0% and 2.6%, from failed radial artery puncture changing to femoral artery puncture were 1.5% and 2.6% respectively; PCI success rates were 96.5% and 96.4%, operational times were (45.7±21.2) min and (47.6±18.5) min, the contrast agent used in coronary angiography (CAG) were (28.9±10.2) ml and (30.6±8.8) ml and in CAG+PCI were (150.4±35.7) ml and (155.6±28.2) ml, intra-operative cardiac events were 0.7% and 1.3%, post-operative vascular complications were 0.9% and 2.6%, post-operative hospital stay times were (5.7±1.9) days and (6.3±2.7) days respectively; the above differences had no statistic meaning. Conclusion: Transradial PCI is safe and feasible in elder CAD patients.

Effect of triple therapy and sequential therapy on eradication of Helicobacter pylori in long-term aspirin use / 中国生化药物杂志

Objective To analysis curative effect of triple therapy and sequential therapy for eradication of Helicobacter pylori in patients with long-term aspirin use.Methods 52 patients with long-term aspirin use who were diagnosed with helicobacter pylori infection were collected.All patients were divided into sequential group and triple group according to different drugs classified, each 26 cases in each group were given corresponding drug treatment, after the end of treatment, the serum pepsinogen, Hp-IgG antibody levels and Helicobacter pylori clearance rate were detected in all patients. Results After treatment, compared with the triple Group, in the sequential group, the levels of serum PG I and PG II were lower, and PGⅠ/PGⅡwas higher, and the differences were statistically significant (P<0.05);the serum Hp-IgG antibody levels were lower in the sequential group (P<0.05);the Hp clearance rate of patients in the sequential group was higher (P<0.05).Conclusion Compared with triple therapy, sequential therapy can lower serum PG, PG II and Hp-IgG levels, and improve the Hp clearance rate and clinical efficacy, have guiding significance to clinical.

Antiosteoporotic activity of lycopene in mature ovariectomized rats / 中国组织工程研究

BACKGROUND: A number of studies have suggested that lycopene is an antioxidant which is used to decrease the risk of age-related chronic diseases.OBJECTIVE: To establish a rat model of postmenopausal osteoporosis, and to investigate the effects of lycopene in preventing bone loss in ovatiectomized rat models of osteoporosis.METHODS: The 6-month-old female Wistar rats, SPF grade, which had never given birth, were divided into sham and ovatiectomized groups. The ovatiectomized rats were further sub-divided into four groups which were administered with corn oil orally as model group, lycopene (10 mg/kg, 20 mg/kg, daily) or treated by intraperitoneal injection with estradiol benzoate (25 mg/kg, twice).RESULTS AND CONCLUSION: After 12-week administration, as compared with the model group, the uterus weight of high-dose and low-dose lycopene groups significantly increased (P < 0.05); the Ca, P, superoxide dismutase levels, percent trabecular area,and trabecular number were obviously higher, and serum alkaline phosphatase, urine deoxypyridinoline, malondialdehyde,trabecular separation and number of osteoclasts were obviously lower in the lycopene groups than the model group (P < 0.05). The bone mass index, bone bio-mechanics and bone histomorphometry were better in the lycopene groups than the model group (P < 0.05). These findings indicate that lycopene has a definite antiosteoporotic effect on ovatiectomized rats.

Relationship between the +104T＞C polymorphism of GDF5 core promoter and spinal fusion / 中华骨科杂志

Objective To investigate the relationship between a functional single nucleotide polymorphisms(SNP) in the core promoter region of GDF5 gene(+104T＞c ;rs143383) and spinal fusion in Qingdao Han people. Methods This study included 201 patients who needed to be treated with spinal fusion and 200 healthy controls. They were all out of tuberculosis, tumor, infection, and long time of related medicine using. Their operation regions were similar, containing L4.5, C4.5, C5.6, and C6.7. The SNP was defined in all people, using PCR-restriction fragment length polymorphism (RFLP) and gene sequencing. The patients were followed-up 3,6, 12 months after operation. The conditions of bone graft fusion were carried out into different grades according to imaging. According to the common used fusion criterion, to analyze the relationship between this SNP and spinal fusion. Results The results obtained from PCR-RFLP were confirmed by gene sequencing. The patients and the healthy control all showed the SNP in this site. There were no relationship between the spinal fusion patients and the healthy control in the SNP (x2=0.304, P=0.859). But it showed correlation (x2=4.752, P=0.023) with fusing or not in the spine and the speed of fusion (x2=9.864, P=0.007)in Qingdao Han people. In the fusion group, the site rs143383 showed more C allele than the non-fusion group. T allele may affect the transcription of GDF5, thus reduce the expression of GDF5. Patients with the genotype TC+CC showed larger proportion stable fusion and faster speed than the patients with TT. Conclusion SNP in the core promoter region of GDF5 (+104T＞C) is associated with spinal fusion in Qingdao Han people. The allele C may be an important factor to promote spinal fusion. Detect the TT genotype early and intervene, the spinal fusion effect may be improved. Or, the genotype may be changed by gene technology,making the efficient fusion.

Clinical Observation of Fludarabine、 Intermediate-dose Ara-C and G-CSF in Treatment for Refractory or Relapsed Acute Myeloid Leukemia(26 Cases) / 中国基层医药

Objective To observe the therapeutic effects and side effects of FLAG regimen(fludarabine, Ara-C, and granulocyte-colony stimulating factor( C-CSF) for refractory or relapsed acute myeloid leukemia( AML). Methods Twenty-six AML were treated with fludarabine plus intermediate-dose Ara-C and G-CSF,of whom 15 cases belonged to refractory and 11 cases belonged to relapsed. Results After two courses of treatment, 14 cases were completely relieved (53. 8% ) and 5 cases were partially relieved (19.2% ). The overall effective rates was 73.1%. The main side effects were severe myelosuppression and non-hematological toxicity was mild. Conclusion FLAG regimen was very effective for refractory or relapsed acute myeloid leukemia and was well tolerated. The treatment-related mortality rate was low,so it provided a treatment choice for these patients.

Treatment of chronic posttraumatic thoracolumbar kyphosis by posterior pedicle subtraction osteotomy / 中华创伤杂志

Objective To retrospectively evaluate and analyze the clinical effect of posterior pedicle subtraction osteotomy in treating chronic, posttraumatic thoracolumbar kyphosis. Methods Nineteen patients (11 males and 8 females) with chronic, posttraumatic thoracolumbar kyphosis were corrected surgically. The patients were at age range of 29-61 years (mean 42 years). Preoperative kyphosis Cobb angle ranged from 31° to 63° (mean 47°) and trauma history ranged from 8 months to 63 months (mean 29 months). All patients were treated with pedicle subtraction osteotomy according to the size of Cobb angle, extent of spinal stenosis and source of compression. Results Sagittal alignment was improved to average 40.2°, with a correction rate of 85.8%. Two patients developed postoperative leakage of cerebrospinal fluid. Among them, one was combined with encephalic infection and cured with active treatment, and the other developed postoperative wound infection, which were treated conservatively with antibiotics and local wound care. There were no other severe complications. The average follow-up period was 15 months (range 6-41 months). At the last follow-up, clinical symptoms and neurological function were improved significantly. Neither loss of correction nor failure of internal fixators was observed. X-ray and dynamic X-ray films showed a 100% fusion in all patients. Conclusions The single-stage posterior pedicle subtraction osteotomy is a safe and effective procedure for correction of posttraumatic thoracolumbar kyphosis. It is possible and safe to obtain a correction within 55° on single segment by this technique.

Correlation between type Ⅰ collagen gene polymorphism and spinal fusion rate following autologous bone transplantation / 中国组织工程研究

BACKGROUND:Basic research demonstrated that type Ⅰ collagen exhibited prominent effect on osteogenesis,bone mass and bone fracture,which also participated in the bone fusion.However,few reports concerning the polymorphism of type Ⅰ collagen gene and spinal fusion.OBJECTIVE:To investigate the polymorphism of type Ⅰ collagen and to explore its relationship with the spinal fusion rate following metal implant or autogenous bone transplantation.METHODS:A total of 200 volunteers who need to receive spinal fusion in the Affiliated Hospital of Qingdao University Medical College were selected,including 102 cases received anterior cervical subcorpectomy combined with lilac bone implantation fusion following decompression,and 98 cases received posterior laminectomy for decompression combined with intertransverse process fusion.Meantime,223 normal adults were served as the control group.The peripheral blood was drawn-off and genomic DNA was extracted from white blood cells.The specific fragment which includes the objective gene was amplified by polymerase chain reaction (PCR),with length of 293 bp.The genotypes of Pcol2 site in type Ⅰ collagen were detected by PCR-restriction fragment length polymorphism (PCR-RFLP) method.The PCR product was digested with restriction endonuclease Eco311 and the result was observed by agarose gel electrophoresis.The G gene represented for the presence of the restriction endonuclease site,while the T gene for the absence of the restriction endonuclease site.The fusion rate of the bone graft was evaluated by x-ray film prior to and at months 3,6 and 12 after operation,and the results were compared by stages including quick (＜3 months),middle (3-6 months) and slow (6-12 months).RESULT AND CONCLUSION:There were the-1997G/T polymorphisms of the type Ⅰ collagen gene in 423 cases,including 166cases with GG,232 cases with GT,and 25 cases with TT,in addition,there was some correlation between the GG genotype and the lilac bone implantation fusion (P =0.004).The GG genotype accounted for 50% in the fast group,which was obviously greater than that of the middle and slow groups (33.3% and 16.7%,respectively).However,the-1997G/T polymorphisms had no correlation with the bone graft fusions inter transverse process of lumbar vertebra (P=0.831).The GG genotype in the-1997G/T polymophsim of the type Ⅰ collagen gene may be the essential factor which can promote the C-spine auto-ilium graft fusion.

Analysis of sperm morphology and semen quality of patients with varicocele in varying degrees / 中华内分泌外科杂志

Objective To evaluate the semen quality and sperm morphology in the patients with different grades of varicocele. Methods Semen from 121 patients with varicocele which were divided into three groups, gradel, grade Ⅱ and grade Ⅲ, were studied and those of 23 normal male were taken as the control. Semen analysis was performed with the methods described in the WHO manual and sperm morphology was evaluated by WHO cri-teria. Results A significant reduction of semen quality and sperm morphology and an increase of small oval head, tapering head and amorphous head sperm were found in patients with different grades of varicocele compa-ring with those of the control. There was no difference in routine analysis between different groups. A reducetion of normal morphology percentage in grade Ⅲ were found comparing with grade Ⅱ (P<0.01). An increase of a-morphous head sperm in grade Ⅲ was found comparing with that of sperm in grade Ⅱ (P <0.01). Canclusions The routine semen analysis can not distinguish seminal damage between different grades of varicocele, but the sperm morphology can reflect the sperm state. Therefore, the patients with varicocele should not only get routine semen analysis but also check the sperm morphology.

Effect of lycopene on bone mass and biomechanics in ovariectomized rats / 中国组织工程研究

AIM: Lycopene as an antioxidant can decrease the risk of age-related chronic diseases, such as cancer. In this study, we investigated the impact of lycopene on bone mineral density and bone biomechanics in experimental osteoporotic rats. METHODS: The experiment was performed at the Animal Experiment Center of the Affiliated Hospital of Qingdao University Medical College from July 2006 to November 2007. The lycopene was provided by the Xinjiang Zhixing Technology Invest Development Company, and diluted to certain concentration by corn oil. Fifty six-month-old SPF female Wistar rats were selected and divided into 5 groups (n=10) according to body mass: Sham operation and corn oil group (2 mL/d), ovariectomy (OVX) and corn oil group (2 mL/d), OVX and estradiol benzoate (EB) group (0.2 mg/kg, once a week), low and high lycopene groups (10 mg/kg, 20 mg/kg, once a day). Except the sham operation group, all rats underwent OVX to establish models of osteoporosis. Each group was administrated corresponding medicine for 12 weeks. RESULTS: Within 2 weeks postoperatively, 1 of sham operation group died and 2 of low lycopene group died. Finally, 47 rats were included in final analysis. ①The lumbar and femoral bone mineral density and maximum stress of ovariectomized rats were significantly lower than those of sham operation group (P

Clinical study of different surgical procedures for the treatment of lumbar spondylolisthesis:clinical analysis on 82 cases / 中国矫形外科杂志

[Objective]Through the analysis of 82 cases of spondylolisthesis treated with surgery,the different types of surgical procedures were evaluated.[Method]Patients with spondylolisthesis were divided into 4 groups based on their pathology and different surgical procedures were used accordingly.Group Ⅰ consisted of 18 patients with degenerative spondylolisthesis with back pain(3 cases)and isthmic spondylolisthesis(13 cases)and traumatic spondylolisthesis(2 cases)of Ⅰ degree;They were treated with posterior interlaminar and interspinous process fusion;Group Ⅱ consisted of 31 cases with degenerative spondylolisthesis(2 cases)and isthmic spondylolisthesis(23 patients)and traumatic spondylolisthesis(6 cases)of Ⅰ degree(11 cases)and Ⅱ degree(20 cases);They were treated with reduction of sliding vertebra and posterior interlaminar and interspinous process fusion;Group Ⅲ consisted of 19 cases with degenerative spondylolisthesis(2 cases)and isthmic spondylolistbesis(17 cases)of Ⅰ degree(2 cases),Ⅱ degree(13 cases)and Ⅲ degree(4 cases);They were treated with laminectomy and decompression,with reduction of sliding vertebra and transverse process fusion;Group Ⅳ consisted of 14 cases with isthmic spondylolisthesis of Ⅰ degree(1 case),Ⅱ degree(10 cases)and Ⅲ degree(3 cases);They were treated with laminectomy and decompression,with intervertebral body fusion,with reduction of sliding vertebra and transverse process fusion.[Result]In group Ⅰ,solid fusion were in 15 cases giving a fusion rate of 83%,0.03% rate of reduction,52.69% rate of improvement;In group Ⅱ,solid fusion were in 30 cases giving a fusion rate of 96%,56.20% rate of improvement,83% rate of reduction;In group Ⅲ,fusion rate,reduction rate and improvement rate reached 89%,90%,59.85% respectively;In group Ⅳ,the fusion rate,reduction rate and improvement rate were as high as 100%,92%,61.08% respectively.[Conclusion]Different operative methods have different operative indications.Operative methods differ from different patients.

Diagnosis and treatment of the posterior margin separation of lumbar vertebral epiphysis / 中国矫形外科杂志

[Objective]To study the pathogenesis,clinical manifestation and surgical treatment of the posterior margin separation of lumbar vertebral epiphysis.[Method]Sixteen patients suffering from the posterior margin separation of lumbar vertebral epiphysis were followed up.The clinical manifestation and radiologic examination were analyzed and results of surgical treatment were evaluated.[Result]The patients were usually young and manifested with the sign and symptom of lumbar disc herniation and/or lumbar stenosis.CT was helpful for the accurate diagnosis of this disease.The different surgical measures were taken for the treatment according to the type and range of protrusion.[Conclusion]The posterior margin separation of lumbar vertebral epiphysis were divided into three types:end plate separation and moving into posterior margin,Schmorl node and avulsion fracture.The good results can be obtained with surgery.

Effects of cartilage-derived growth factor on cultured rabbit chondrocytes / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the effect of cartilage-derived growth factor (CDGF) on cultured rabbit chondrocytes, and the relation between CDGF, insulin-like growth factor-I (IGF-I), and proliferation and metabolism of chondrocytes.</p><p><b>METHODS</b>CDGF was extracted from chicken xiphoid in our laboratory. Chondrocytes were isolated from 3-week-old New Zealand male rabbits, and cultured in Ham's F-12 medium containing 10% fetal calf serum. The chondrocyts of second generation were treated with CDGF and/or IGF-I of different concentrations. With chloramine T method and MTT method, we compared the content of hydroxyproline in Ham's F-12 medium and observed proliferation and energy synthesis of chondrocytes.</p><p><b>RESULTS</b>CDGF and IGF-I both stimulated the proliferation and synthesis of hydroxyproline of chondrocytes dose-dependently. The optimal concentration of CDGF was 16 ng/ml and 32 ng/ml respectively, and that of IGF-I was 30 ng/ml. There was obvious synergic effect between CDGF and IGF-I.</p><p><b>CONCLUSION</b>CDGF can stimulate the proliferation and collagen synthesis of chondrocytes and has synergistic effect with IGF-I.</p>

Experimental study on the change of osteoinductive potential of bone in ovariectomized rat / 中华老年医学杂志

Objective To exoplore the causes in healing difficulties of osteoporotic fracture, and to study the feasible approaches and methods for clinical treatment of osteoporotic fracture. Methods Forty female Sprague-Dawley rats, used as donor animals, were divided randomly into ovariectomized (OVX) group and control (CON) group, with each group of 20 animals. OVX group was subjected to bilateral ovariectomy and CON group was subjected to sham operation. Four months after surgery, the rats were sacrificed, and long bones of the extremities were harvested respectively for preparation of bone matrix gelatin (BMG) in terms of Urist's method. BMG implants obtained from OVX and CON rats were implanted into left and right femoral muscle pouches respectively of 17 female SD rats. The host rats were killed after 14-day feeding, and tissue block of BMG implants were removed for histologic study, alkaline phosphatase (ALP) activity, and calcium content (CA) determination, respectively. Results ALP activity of BMG tissue block from OVX group was (7.22? 2.59)U/g, and that from CON group was (12.01?6.18)U/g. Significant difference was found between the two groups (P