Contrast-enhanced ultrasound and contrast-enhanced computed tomography for differentiating mass-forming pancreatitis from pancreatic ductal adenocarcinoma: a meta-analysis / 中华医学杂志(英文版)

BACKGROUND@#Patients with mass-forming pancreatitis (MFP) or pancreatic ductal adenocarcinoma (PDAC) presented similar clinical symptoms, but required different treatment approaches and had different survival outcomes. This meta-analysis aimed to compare the diagnostic performance of contrast-enhanced ultrasound (CEUS) and contrast-enhanced computed tomography (CECT) in differentiating MFP from PDAC.@*METHODS@#A literature search was performed in the PubMed, EMBASE (Ovid), Cochrane Library (CENTRAL), China National Knowledge Infrastructure (CNKI), Weipu (VIP), and WanFang databases to identify original studies published from inception to August 20, 2021. Studies reporting the diagnostic performances of CEUS and CECT for differentiating MFP from PDAC were included. The meta-analysis was performed with Stata 15.0 software. The outcomes included the pooled sensitivity, specificity, positive likelihood ratio (+LR), negative likelihood ratio (-LR), diagnostic odds ratio (DOR), and summary receiver operating characteristic (SROC) curves of CEUS and CECT. Meta-regression was conducted to investigate heterogeneity. Bayesian network meta-analysis was conducted to indirectly compare the overall diagnostic performance.@*RESULTS@#Twenty-six studies with 2115 pancreatic masses were included. The pooled sensitivity and specificity of CEUS for MFP were 82% (95% confidence interval [CI], 73%-88%; I2  = 0.00%) and 95% (95% CI, 90%-97%; I2  = 63.44%), respectively; the overall +LR, -LR, and DOR values were 15.12 (95% CI, 7.61-30.01), 0.19 (95% CI, 0.13-0.29), and 78.91 (95% CI, 30.94-201.27), respectively; and the area under the SROC curve (AUC) was 0.90 (95% CI, 0.87-92). However, the overall sensitivity and specificity of CECT were 81% (95% CI, 75-85%; I2  = 66.37%) and 94% (95% CI, 90-96%; I2  = 74.87%); the overall +LR, -LR, and DOR values were 12.91 (95% CI, 7.86-21.20), 0.21 (95% CI, 0.16-0.27), and 62.53 (95% CI, 34.45-113.51), respectively; and, the SROC AUC was 0.92 (95% CI, 0.90-0.94). The overall diagnostic accuracy of CEUS was comparable to that of CECT for the differential diagnosis of MFP and PDAC (relative DOR 1.26, 95% CI [0.42-3.83], P  > 0.05).@*CONCLUSIONS@#CEUS and CECT have comparable diagnostic performance for differentiating MFP from PDAC, and should be considered as mutually complementary diagnostic tools for suspected focal pancreatic lesions.

The effect of transcranial magnetic stimulation combined with sertraline on post-stroke depression / 中国医师进修杂志

Objective:To explore the effect of transcranial magnetic stimulation (TMS) combined with sertraline on post-stroke depression (PSD).Methods:A total of 94 PSD patients admitted Zibo Fifth People's Hospital from June 2018 to June 2020 were selected as the research objects, and they were divided into observation group (47 cases) and control group (47 cases) according the treatment methods. The control group was treated with TMS, and the observation group was treated with TMS combined with sertraline. After treatment of 12 weeks, the clinical effects, neurological function scores, serological indicators, cognitive function and incidence of adverse reactions of the two groups were evaluated and compared.Results:The total effective rate in the observation group was higher than that in the control group: 91.49% (43/47) vs. 72.34% (34/47), the difference was statistically significant (χ 2 = 5.82, P<0.05). After treatment, the scores of National Institutes of Health Stroke Scale(NIHSS) and Hamilton′s Depression Scale -17 (HAMD-17) in the observation group were lower than those in the control group: (5.45 ± 1.97) scores vs. (7.89 ± 2.18) scores, (8.18 ± 2.34) scores vs. (10.27 ± 2.97) scores; the scores of Glasgow Coma Scale (GCS) in the observation group were higher than those in the control group: (26.23 ± 3.18) scores vs. (23.42 ± 2.90) scores, the differences were statistically significant ( P<0.01). After treatment, the level of C-reactive protein (CRP) in the observation group was lower than that in the control group: (8.28 ± 2.78) mg/L vs. (10.76 ± 2.99) mg/L; the level of 5-hydroxytryptamine (5-HT) in the observation group was higher than that in the control group: (196.12 ± 20.71) μmol/L vs. (177.98 ± 19.94) μmol/L, the differences were statistically significant ( P<0.01). After treatment, the scores of cognitive function screening scale (CASI) in the observation group, including attention, orientation, memory, fluency of thinking and language expression were higher than those in the control group ( P<0.05). The incidence of adverse reactions in the two groups had no significant difference ( P>0.05). Conclusions:TMS combined with sertraline has a good effect on PSD, which can improve neurological function, serological indicators and cognitive function, with low adverse reactions.

High-resolution MRI features in patients with ischemic stroke caused by vertebral artery dissection / 中华放射学杂志

Objective:To explore high-resolution MRI (HR-MRI) characteristics in patients with ischemic stroke caused by vertebral artery dissection.Methods:A total of 47 patients with suspected vertebral artery dissection in the First People′s Hospital of Lianyungang, Kangda College, Nanjing Medical University from June 2015 to June 2020 were consecutively enrolled. All patients underwent routine MRI before HR-MRI, and three-dimensional arterial spin labeling (3D-ASL) was performed in those with negative MR. Patients with posterior circulation infarction on MRI and ischemic hypoperfusion on 3D-ASL were included in the ischemic stroke group, while patients with negative plain MRI and normal 3D-ASL were included in the normal group. The clinical characteristics and HR-MRI imaging characteristics between the two groups were compared using t-test or χ 2 test, while the correlations of quantitative data or ranked data were analyzed by Pearson or Spearman test. Results:There were 27 patients in the ischemic stroke group and 20 patients in the normal group, and there were no significant differences in clinical characteristics such as gender, age, site of onset, history of hypertension, hyperlipidemia, and history of diabetes between the two groups ( P>0.05). Basilar artery lateral deviation classification (χ2 =7.013, P=0.030), basilar lateral bend angle (140°±19° vs. 137°±15°, t=2.231, P<0.026), minimum bending angle of vertebral basilar artery (131°±27° vs. 90°±13°, t=42.630, P<0.001), the minimum bending angle of vertebrobasilar artery ≤ 90° distribution (3 cases vs. 21 cases, χ2=15.240, P<0.001) and effective lumen index (0.33±0.10 vs. 0.17±0.09, t=35.934, P<0.001) of normal group and ischemic stroke group showed statistically significant differences. Among them, the minimum bending angle of the vertebrobasilar artery was negatively correlated with posterior circulation ischemic hypoperfusion ( r=-0.621, P<0.001), and the effective lumen index was negatively correlated with posterior circulation ischemic stroke ( r =-0.713, P<0.001). However, the location of the dissection, the distribution of hematoma, the shape of the lumen and the enhancement type were not statistically significant between the normal group and ischemic stroke group ( P>0.05). Conclusion:HR-MRI shows that the lateral deviation of the basilar artery of grade 3, the minimum bending angle of the vertebrobasilar artery less than 90°, and small effective lumen index are related to posterior circulation stroke caused by vertebral artery dissection, which may help for the proper formulation of clinical treatment plan.

The research of brain glioma therapy for nude mouse using transgenic human umbilical cord mesenchymal stem cells overexpressing TRAIL / 中国输血杂志

【Objective】 To explore the establishment methods of transgenic human umbilical cord mesenchymal stem cells (hUC-MSCs) overexpressing tumor necrosis factor(TNF)-related apoptosis-inducing ligand (TRAIL) based on the transposons, and attempt to apply it on the nude mice mode with glioma. 【Methods】 PiggyBac transposon system specially designed by us was used to prepare non-targeting and Her2-targeting hUC-MSCs that can stably express TRAIL through puromycin screening. The glioma cells expressing firefly luciferase (U87MG-LUC) were injected into the skull of the immunodeficient mice (BALB/c-nu/nu) with 1×106 cells per mouse. After 7 days of injection, the mice transplanted with U87MG were detected with a small animal living imager to determine the size and location of the tumors in skull. Then we injected the glioma-transplantation nude mouse with two kinds of transgenic hUC-MSCs expressing TRAIL (named as untarget-TRAIL and target-TRAIL, respectively), or the non-transgenic hUC-MSCs (all 1×106 cells per mouse) or PBS (named as WT-MSCs and PBS for negative control) respectively, and then monitored the changes of tumor signals by a small animal living imager every week for 3~4 weeks. 【Results】 After six passages to expand the cells, the both transgenic cell lines can stably express TRAIL gene. Their ratio of green fluorescent protein (GFP) positive cells can reach 93%-97%, and the positive ratio of their MSC-specific surface markers still maintained normal (CD34+, CD45+, and HLA-DR+ all <0.1%, CD90>99%, CD73>88%, and CD105 >60%). The median survival time (d) of U87MG-transplanted nude mice in the groups of untarget-TRAIL, target-TRAIL, WT-MSCs, and PBS was 41 vs 39 vs 24 vs 23(P<0.05). 【Conclusion】 The transgenic hUC-MSCs overexpressing TRAIL gene can significantly prolong the survival time of nude mice with brain glioma.

Analysis of clinical features and genetic variants in a child with creatine deficiency syndrome / 中华医学遗传学杂志

OBJECTIVE@#To explore the clinical features and genetic basis for a patient diagnosed with creatine deficiency syndrome (CDS).@*METHODS@#The patient was subjected to whole exome sequencing (WES). Candidate variant was verified by Sanger sequencing. The level of creatine was determined by using a magnetic resonance spectrum (MRS) method.@*RESULTS@#The patient presented with development delay and poor response to stimuli. No obvious abnormality was found with his muscle tone and strength of his limbs. Borderline EEG was detected. MRI showed abnormal development of the white matter and dysplasia of corpus callosum. Urine organic acid screening has shown increased glycerin-3-phosphate. WES revealed that the patient has carried compound heterozygous variants of the GAMT gene, namely c.412C>T and IVS4-1G>A, which were respectively derived from his mother and father. MRS showed reduced creatine in bilateral basal ganglia. Functional study of the splicing site suggested that the IVS4-1G>A variant has resulted skipping of exon 5 upon splicing.@*CONCLUSION@#The compound variants of the GAMT gene probably underlay the disease in this child. Above finding has enriched the spectrum of GAMT gene variants.

Overexpression of p21 Has Inhibitory Effect on Human Hematopoiesis by Blocking Generation of CD43＋ Cells via Cell-Cycle Regulation

Background and Objectives@#p21, an important member of the Cip/Kip family, is involved in inhibitory effects of RUNX1b overexpression during the early stage of human hematopoiesis. @*Methods@#and Results: We established a human embryonic stem cell (hESC) line with inducible expression of p21 (p21/hESCs). Overexpression of p21 did not influence either mesoderm induction or emergence of CD34＋ cells, but it significantly decreased the production of CD43＋ cells and changed the expression profile of hematopoiesis-related factors, leading to the negative effects of p21 on hematopoiesis. @*Conclusions@#In RUNX1b/hESC co-cultures when RUNX1b was induced from D0, perturbation of the cell cycle caused by upregulation of p21 probably prevented the appearance of CD43＋ cells, but not CD34＋ cells. The mechanisms via which CD34＋ cells are blocked by RUNX1b overexpression remain to be elucidated.

Analysis of risk factors for the rupture of small intracranial aneurysms by four?dimensional CT angiography / 中华放射学杂志

Objective Electrocardiographic (ECG) gated 4?dimensional CT angiography (4D?CTA) was performed to analyze the morphological characteristic differences between ruptured and unruptured intracranial aneurysms less than 5 mm to predict the rupture risk of small intracranial aneurysms. Methods A total of 118 patients with intracranial aneurysms less than 5 mm who underwent 4D?CTA examinations in our hospital from May 2014 to May 2017 were retrospectively analyzed. The whole study population was divided into ruptured group and unruptured group. Seventy?two patients were in the ruptured group and 46 patients were in the unruptured group. Original scanning data were reconstructed to produce 20 data sets of cardiac cycles with 5% time intervals. In addition, 20 groups of images and dynamic graphs were generated using three?dimensional software. We concluded the convex was point of impulse if small bubble or small pointed convex could be found in continuous three or more images at the same location. The morphological characteristics and clinical features of the two groups of aneurysms were firstly analyzed by univariate analysis, and then the meaningful indicators were analyzed by logistic regression, and the optimal diagnostic cutoff values were calculated using ROC curves. Results Univariate analysis showed that women, smoking history, location of aneurysm at the bifurcation, pulsation point, aspect ratio (AR) and size ratio (SR) were statistically significant different between the two groups of small aneurysms (P<0.05), but age, hypertension, type 2 diabetes, family history, history of multiple aneurysms, history of drinking, location, size, neck and tumor height had no significant differences between the two groups (P>0.05). Multivariate regression analysis showed that pulsation point (odds ratio=8.843, 95% confidence interval: 2.800—27.925) and large SR value (odds ratio=4.484, 95% confidence interval: 1.094—18.385) were independent risk factors for the aneurismal rupture. when the SR value was greater than 1.65, the area under the ROC curve was 0.832, the sensitivity to diagnose the risk of small aneurysm rupture was 76%, and the specificity is 70%. Conclusion The occurrence of pulsation point and SR value greater than 1.65 are independent predictors of the risk of intracranial aneurysm rupture less than 5 mm.

Evaluation of Hemodynamics of Posterior Circulation Distal Ischemia with Perfusion-weighted MR Imaging / 实用医学杂志

Objective To explore the way to evaluate hemodynamics of posterior circulation distal ischemia with PWI. Methods Thirty-two patients with vertebral basilar artery severe stenosis were reviewed and compared with thirty normal persons. Information and data of PWI and MRA were collected and analyzed. Following parameters were observed, index of vascular stenosis, collateral vessels, cerebral blood flow (rCBF), cerebral blood volume (rCBV), and mean transit time (rMTT). Results All the patients had at least one vertebral basilar artery with more than 70% stenosis. There were 17 cases with severe vertebral artery stenosis , 20 cases with severe basal artery stenosis , 8 cases with severe superior cerebellar artery stenosis , 17 cases with posterior cerebral artery stenosis , 22 cases with after the traffic artery open , 11 cases with soft meningeal arteries show and 12 cases with small artery show. The ratio of ROI with frontal white matter was lower than the rCBF and rCBV in the country group. MTT value was extended and P value of the parameters in both groups was less than 0.05, reflecting the statistical difference. Conclusions PWI combined with MRA can effectively evaluate the posterior circulation distal ischemia area and tissue perfusion , as well as the hemodynamic status of ischemia area.

Different managements of complete rupture of the deltoid ligament associated with supination-external rotation ankle fracture / 中华创伤骨科杂志

Objective To investigate the clinical outcomes of different managements of complete rupture of the deltoid ligament associated with supination-external rotation ankle fracture.Methods From January 2010 to June 2014,33 cases of complete rupture of the deltoid ligament associated with supination-external rotation ankle fracture were treated with open reduction and internal fixation.According to the different managements of the complete rupture of the deltoid ligament,the patients were divided into 4 groups:9 cases in the non-repair group,7 cases in the superficial layer repair group,9 cases in the deep layer repair group,and 8 cases in the complete repair group.All the patients took anteroposterior,lateral and gravity stress radiographs preoperatively and postoperatively.The 4 groups were compatible in preoperative general data (P ＞ 0.05).The 4 groups were compared in terms of operation time,medial clear space and American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score.Results All the patients were followed up for 6 to 18 months (average,13.7 months).All wounds healed at the first stage without any infection.All fractures united primarily after 3 to 9 months (average,4.7 months).The operation time for the superficial layer repair group was significantly longer than for the non-repair group,but significantly shorter than for the deep layer repair and the complete repair groups (P ＜ 0.05).In gravity stress radiographs,there was no significant difference in medial clear space among the 4 groups (P ＞ 0.05),but there were significant differences before and after operation in the 4 groups (P ＜ 0.05).The postoperative AOFAS ankle-hindfoot score in the repair groups was significantly higher than in the non-repair group and the superficial layer repair group(P ＜ 0.05).Conclusion To achieve satisfactory outcomes for patients with complete rupture of the deltoid ligament associated with supination-external rotation ankle fractures,anatomic open reduction and rigid internal fixation is necessary,and repair of the deltoid ligament,especially its superficial layer,is a valuable contribution.

Correlations between quality of life and sagittal parameters in ankylosing spondylitis after kyphosis correction / 中华骨科杂志

Objective To explore the impact of the ratio between pelvic tilt (PT) and sacral slope (SS) on the life quality of patients with ankylosing spndylitis (AS) after kyphosis correction. Methods From November 2008 to May 2011, 33 AS pa?tients were reviewed, including 31 males and 2 females, aged from 19 to 58 years old (average, 36 years old). The thoracolumbar kyphosis angle was 35.23° ± 13.98° (range, 15.12°-74.37° ) and the lumbar lordosis angle was 8.68° ± 18.27° (range,-23.70°-62.15°). The Scoliosis Research Society (SRS)?22 questionnaire was used to evaluate the quality of life and the Oswestry disability index (ODI) was used to evaluate the condition of pain. The pelvic incidence (PI), PT, SS, sagittal vertical axis (SVA) and osteoto?my angle were obtained from standing lateral full?spine radiographs. The correlations were analyzed from the subjective grading and the sagittal parameters in AS patients. Results The osteotomy site was in L1 (5 cases, 21.00°-54.59° , average 32.59° ± 13.44° ), L2 (19 cases, 28.63°-66.24° , average 37.89° ± 9.26° ), L3 (9 cases, 31.78°-60.90° , average 47.05° ± 9.20° ), respectively. The range of osteotomy angle was 39.59°±10.82° (range, 21.00°-66.24°). The subjective grading and spino?pelvic parameters were improved significantly after operation except PI, only postoperative PT/SS (0.93±0.65) and ODI standing (0.60±0.75)(r=0.681, P<0.05), osteotomy angle (39.59°±10.82°) and satisfaction of management (3.33±0.49)(r=0.478, P<0.05)had correlation with the subjective grading. Conclusion Compared with the change of PT, SS and SVA, the change of PT/SS is more closely related to the quality of life after operation in AS patients with kyphosis, which should be pay attention to by surgeon when designing operative schemes.

Surgical treatment in degenerative scoliosis / 中华外科杂志

Degenerative scoliosis is one of the important reasons of low back pain in middle-aged and elderly. The surgical treatment has been gradually paid more attention to in recent years. Pain and the quality of life are the key points of the surgical treatment. In addition to neurogenic compression,clinical symptoms and health-related quality of life are also closely related to the three-dimensional deformity of spine. Researchers try to employ different classifications of degenerative scoliosis to guide personalizedly surgical treatment. In the future,osteoporosis and complications may be the research highlights in the surgical treatment of degenerative scoliosis.

Urotensin II promotes monocyte chemoattractant protein-1 expression in aortic adventitial fibroblasts of rat / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Urotensin II (UII), a potent vasoconstrictive peptide, is able to stimulate phenotypic differentiation of adventitial fibroblasts. This study aimed to determine the effect of UII on monocyte chemoattractant protein-1 (MCP-1) expression in rat aortic adventitial fibroblasts, so as to explore possible mechanisms in the development of vascular inflammation.</p><p><b>METHODS</b>Growth-arrested adventitial fibroblasts were incubated in serum-free medium with UII (10(-10)-10(-7) mol/L) and inhibitors of signal transduction pathways for 1 to 24 hours. MCP-1 mRNA and protein expression and secretion were determined by RT-PCR, Western blotting analysis and enzyme-linked immunosorbent assay (ELISA), respectively.</p><p><b>RESULTS</b>UII dose- and time-dependently promoted MCP-1 mRNA and protein expression and secretion in cells, with maximal effect at 10(-8) mol/L at 3 hours for mRNA expression, 24 hours for protein expression in the cells, and 12 hours for protein secretion from the cells. Furthermore, the UII effects were significantly inhibited by treatment with its receptor antagonist SB710411, Rho kinase inhibitor Y27632, protein kinase C (PKC) inhibitor H7, mitogen-activated protein kinase inhibitor PD98059, calcineurin inhibitor cyclosporine A, and the Ca(2+)channel blocker nicardipine.</p><p><b>CONCLUSION</b>UII may stimulate MCP-1 expression in rat aortic adventitial fibroblasts through its receptor and Rho kinase, PKC, mitogen-activated protein kinase, calcineurin and Ca(2+) channel signal transduction, thus contributing to adventitial inflammation.</p>

Association of polymorphism of V4 and T2 locus alleles in ADAM33 gene with asthma susceptibility / 中国医师杂志

Objective To verify the association of a disintegrin and metalloproteinase domain 33 (ADAM33) polymorphisms in childhood asthma susceptibility and severity in patients with moderate and severe asthma.Methods A total of 144 controls and 110 asthmatic patients were recruited for this hospitalbased case-control study.Two polymorphic sites (V4,T2) were genotyped using the polymerase chain reaction-restriction fragment length polymorphism method.The gene-gene interactions were analyzed with the multifactor dimensionality reduction (MDR) software.Results The allele frequencies of three SNPs (V4,T2) of ADAM33 in childhood asthma group were significantly higher than control group (P ＜ 0.01,OR =2.36 ～ 2.96,95％ CI:1.56-1.78 ～ 3.56-4.94).For the SNPs V4,GC genotype frequencies of both moderate and severe groups were significantly higher from the control group (P ＜ 0.05) ; the CC genotype frequencies in severe group were significantly higher than control group (P ＜ 0.05) ; the genotype GA of T2 locus in severe group and AA genotype frequencies in moderate group were significantly higher than control group (P ＜0.01 ～0.05) ; there were no significant differences for both allele and genotype frequencies of S2 locus between the childhood asthma and control group (P ＞ 0.05).By MDR analysis,the best interaction model was the four-factor model that the V4,T2 genotypes were the subgroup to predict asthma risk.Conclusions Our results highlight the role of ADAM33 as a susceptibility gene for childhood asthma,and the interactions among ADAM33 V4 and T2 are also associated with childhood asthma.

Analysis on correlation of radiographic parameters and quality of life before and after kyphosis correction in ankylosing spondylitis / 中华骨科杂志

ObjectiveTo investigate the correlation of radiographic parameters and health-related quality of life(HRQOL) instruments before and after thoracolumbar kyphosis correction in ankylosing spondylitis (AS) kyphosis.MethodsThirty-eight AS patients with fixed thoracolumbar kyphosis were treated with pedicle subtraction osteotomies(PSO) in our hospital from January 2004 to March 2010.Pre- and post-operative radiological parameters,Cobb T1-S1,pelvic incidence(PI),pelvic tilt (PT),sacral slope (SS),and sagittal vertical axis(SVA) were measured.The Oswestry disability index(ODI) and scoliosis research society-22(SRS-22) questionnaire were used to evaluate the clinical results.Statistical correlation analysis was made to determine correlation between radiographic parameters and overall or partial specific scores of HRQOL instruments.ResultsThe life quality and related radiological spino-pelvic parameters were improved significantly after operation.Preoperatively,Cobb T1-S1,PT,SS,and SVA had partial correlation with ODI walking score and ODI standing score; postoperatively,only PT and SS had partial correlation with ODI.ConclusionPelvic positional parameters are the key parameters for upright activities,and making pelvis in a neutral position is the ultimate goal of surgery.

Analysis of neurological complications of spinal osteotomy for thoracolumbar and lumbar kyphosis in ankylosing spondylitis / 中华骨科杂志

Objective To analyze cause and preventative measures of neurological complications of spinal osteotomy for thoracolumbar and lumbar kyphosis in ankylosing spondylitis.Methods Data of 126 patients with kyphosis caused by ankylosing spondylitis,who had undergone spinal osteotomy in our hospital from January 2006 to January 2012,were retrospectively analyzed.Among them,18 patients developed neurological complications after spinal osteotomy,including 15 males and 3 females,aged from 25 to 56 years.The average preoperative Cobb angle of these patients was 76.3°.According to American Spinal Injury Association (ASIA) classification,all patients were rated as grade E.Results All 18 patients were followed up for 6 to 49 months (average,35 months).The postoperative Cobb angle ranged from 19° to 38° (average,27°).The average Cobb angle was corrected 49.3°.Neurological complications included spinal cord injury (3 cases) and nerve root injury (15 cases).The reasons of spinal cord injury consisted of sagittal migration of vertebra,spinal stenosis due to operation and iatrogenic cervical spine fracture and dislocation.The reasons of nerve root injury included compression injury (2 cases),malposition of screw (1 case) and excessive drag of nerve root during osteotomy (12 cases).Conclusion Nerve injury is one of the most serious complications of spinal osteotomy in the treatment of kyphosis in ankylosing spondylitis.The incidence of the neurological complications could be obviously reduced by fully decompressing,making patients in a proper surgical position,recognizing the pathological nature of ankylosing spondylitis and avoiding sagittal migration of osteotomy part.

Clinical study on the prevention of recurrent laryngeal nerve injury during thyroid surgery / 中国综合临床

Objective To explore the measures to prevent recurrent laryngeal nerve (RLN)injury during thyroid surgery.Methods The clinical data of 223 patients undergone thyroid surgery were retrospectively analyzed.Among the 223 surgeries,69 sides were undergone regional protection act of RLN and 191 sides were performed RLN exposure.Results There were 2 cases of RLN injury from the regional protection operation of RLN,including 1 case of temporary nerve injury which could be resulted from surgery clamp and 1 case of permanent nerve injury which might be caused by mistaking ligation during surgery.There was only 1 case of temporary nerve injury in RLN exposure procedure which was probably caused by the postoperative nerve edema and was recovered 2 months after the operation.The total RLN injury rate was 1.35％.Conclusion For benign thyroid lesions and non-dorsal lesions or during partial excision of the gland,the regional protection of RLN is helpful to prevent RLN injury.In cases with dorsal lesions of thyroid or contralateral RLN injury,or during lobe subtotal resection,lobe resection and reoperation,exposing RLN to prevent injury is necessary.Taking different approaches based on the profiles of lesions and surgical procedures to prevent RLN injury can significantly reduce the risk of RLN injury.

Effects of Huangqi Guizhi Wuwu Decoction given by different administration methods on rats with frostbite and the mechanism / 中西医结合学报

To establish a rat model of frostbite and to evaluate the effects of different administration methods of Huangqi Guizhi Wuwu Decoction (HGWD), a compound traditional Chinese herbal medicine for warming meridians to disperse cold, on rats with frostbite.

Experimental study on culture of human mesenchymal stem cells from cord blood using autologous serum / 生物医学工程学杂志

In this study, we collected human umbilical cord blood and separated the autologous serum and clear cells. Then the human mesenchymal stem cells were cultured with the use of autologous serum and fetal serum, respectively. By identifing surface markers with flow cytometry and testing the osteogenic, adipogenic and cardiomyocytes differentiation capacity of the cells, we affirmed that the cultured cells are mesenchymal stem cells. Among 21 cases of umbilical cord blood, 11 cases using fetal bovine serum and 15 cases using autologous successfully cultured mesenchymal stem cells from umbilical cord blood. The UCB-MSCs did not express CD34 and CD45, but they expressed CD29, CD44 and CD105, and they were successfully induced into osteogenic cells, adipogenic cells and cardiomyocytic-like cells. All of these suggest that using autologous serum to culture UCB-MSCs is better than using fetal bovine serum, and the autologous serum cultured UCB-MSCs can also be induced into osteogenic cells, adipogenic cells cardiomycyote-like cells.

Effect of carbonated hydroxyapatite cement for filling vertebral body on the vertebral heights and pain in patients with osteoporotic vertebral compression fractures / 中国组织工程研究

BACKGROUND: Carbonated hydroxyapatite cement (CHC) s a new kind of biomaterial for bone defect, which is made of powder and fluid, and can be mixed to be pasty to repair various bone defects.OBJECTIVE: To observe the improvement of vertebrae height and pain in patients with osteoporosis vertebral compression fracture (VCF) after vertebroplasty by using a new kind of bone graft biomaterial, taking CHC as the filling material to reinforce the vertebral body.DESIGN: A contrast observation trial taking patients as subjects.SETTING: Department of Orthopaedics, General Hospital of Chinese PLA.PARTICIPANTS: Totally 34 patients with thoracic or lumbar osteoporosis VCF who received the treatment in the Department of Orthopaedics, General Hospital of Chinese PLA between October 2000 and August 2003. Inclusive criteria: ①Definite diagnosis by CT; ② Informed consents were obtained from the patients. Exclusive criteria: The patients with osteoporosis vertebral compression fractures who suffered vertebral posterior wall fracture. There were 6 males and 28 females, and they were aged (72±13)years; Among the patients, 27 were diagnosed as postmenopausal osteoporosis, 1 as cortical hormone-induced osteoporosis and 6 male patients weresenile osteoporosis.METHODS: ①All the patients were randomly divided into two groups: Experimental group (n =23) and control group (n=11). All the patients were performed percutaneous operation with local anesthenia. All cases were performed percutaneous operation under local anesthesia. Under the C-arm monitored, one side pedicle puncture was performed to enter the anterior column of the involved VCF. Patients of the experimental group were filled with CHC. Patients of control group were filled with polymethyl Methacrylate (PMMA) with the same way. ② Referred to McGill-Melzack scoring. Among the scale 0-100 mm (0 was no pain, 100 was acute pain), the value indicated the painful intensity and mental assault degree. ＜ 30 scores indicated good, 30-40 basically satisfied and ≥ 50 poor .③ Referred to the method from Lee et al, the preoperative height (A1) and postoperative height (A2) of compression fracture position of VCF were measured according to the lateral X-ray film. At the same time, the upper vertebral height (A3) and the inferior vertebral height (A4) were measured at the same position. The original height (A) of the involved vertebra was calculated as (A)= (A3+A4)/2,and the preoperative vertebral compression rate =(A-A1 )/A, the postoperative vertebral compression rate =(A-A2)/A, the restoring rate = (the preoperative vertebral compression rate-the postoperative vertebral compression rate)/the preoperative vertebral compression rate. ④ The wounds of the patients were observed after operation. The levels of blood routine, serum calcium and serum phosphorus were detected before, one day and one week after operation. MAIN OUTCOME MEASURES: ① Preoperative and postoperative VAS scoring. ② The vertebral compression rate and restoring rate. ③ Wounds were observed after operation. The blood routine, the serum calcium and serum phosphorus were detected before, one day and one week after operation.RESULTS: Totally 34 patients were involved in the result analysis. ①The preoperative visual analogue scale (VAS) score of experimental group were (91.5±21.7) points, and the postoperative ones were (44.5±27.2) points. The difference of VAS score reduced gradually along with the postoperative time. There was no difference of VAS score between experimental group and the control group 4 weeks after operation. ② The biocompatibility of CHC in the vertebral body was fine. The vertebral compression rate of experimental group was recovered from (43.1±21.4)％ preoperatively to (27.3± 18.5)％ postoperatively. The rate of restored heights was (27.3±18.5)％. ③ All patients obtained Ⅰ stage wound healing, and none of them had infection, inflammatory secretion and nervous symptom. There were no differences in blood routine test, serum calcium, serum phosphorus between patients in two groups. One case filled by PMMA and two cases filled by CHC presented leakage, and none had nervous symptom.CONCLUSION: As the filling materials for vertebropalsty, CHC can restore the vertebral heights and relieve pain safely and effectively, however, its efficacy to relieve pain is not significant as PMMA in the short term.

Research and implementation of picture archiving and communication system (PACS) based on B/S mode / 生物医学工程学杂志

In this paper, with B/S application and architecture, an integrated solution of PACS is designed, and the function and application of each part of PACS based on the architecture is introduced. The PACS based on this mode is safe, stable, easy to manage and upgrade and convenient for use in telemedicine.