A novel mutation in COL1A1 causing osteogenesis imperfecta/hearing loss

Abstract Objectives: To screen the COL1A1 and COL1A2 gene mutation sites in a family with type I osteogenesis imperfecta (OI)/hearing loss and analyze the characteristics and recovery of hearing loss in patients with osteogenesis imperfecta. Methods: The basic clinical data of Ol proband and her parents were collected, and the COL1A1 and COL1A2 genes were detected in peripheral blood by PCR amplification and generation Sanger sequencing. Literature of stapedial surgery in patients with osteogenesis imperfecta was collected. Results: The heterozygous mutation of the 26 exon c.1922_1923 ins C in the Ol progenitor COL1A1 gene led to the amino acid frameshift mutation of p.Pro 601FS, which was not detected in the phenotypic parents. The homozygous of exon 28 c.1782>G in COL1A2 was detected in the proband and her parents, resulting in changes in the protein p.Pro 549Ala. Conclusion: The clinical symptoms of the Ol proband is caused by heterozygous mutation of the 26 exon c.1922_1923 ins C in COL1A1 gene. Stapedial surgery can provide short-term and long-term hearing benefits for Ol patients with hearing loss. Level of evidence: Level 4.

To compare the efficacy and incidence of severe hematological adverse events of flumatinib and imatinib in patients newly diagnosed with chronic phase chronic myeloid leukemia / 中华血液学杂志

Objective: To analyze and compare therapy responses, outcomes, and incidence of severe hematologic adverse events of flumatinib and imatinib in patients newly diagnosed with chronic phase chronic myeloid leukemia (CML) . Methods: Data of patients with chronic phase CML diagnosed between January 2006 and November 2022 from 76 centers, aged ≥18 years, and received initial flumatinib or imatinib therapy within 6 months after diagnosis in China were retrospectively interrogated. Propensity score matching (PSM) analysis was performed to reduce the bias of the initial TKI selection, and the therapy responses and outcomes of patients receiving initial flumatinib or imatinib therapy were compared. Results: A total of 4 833 adult patients with CML receiving initial imatinib (n=4 380) or flumatinib (n=453) therapy were included in the study. In the imatinib cohort, the median follow-up time was 54 [interquartile range (IQR), 31-85] months, and the 7-year cumulative incidences of CCyR, MMR, MR(4), and MR(4.5) were 95.2%, 88.4%, 78.3%, and 63.0%, respectively. The 7-year FFS, PFS, and OS rates were 71.8%, 93.0%, and 96.9%, respectively. With the median follow-up of 18 (IQR, 13-25) months in the flumatinib cohort, the 2-year cumulative incidences of CCyR, MMR, MR(4), and MR(4.5) were 95.4%, 86.5%, 58.4%, and 46.6%, respectively. The 2-year FFS, PFS, and OS rates were 80.1%, 95.0%, and 99.5%, respectively. The PSM analysis indicated that patients receiving initial flumatinib therapy had significantly higher cumulative incidences of CCyR, MMR, MR(4), and MR(4.5) and higher probabilities of FFS than those receiving the initial imatinib therapy (all P<0.001), whereas the PFS (P=0.230) and OS (P=0.268) were comparable between the two cohorts. The incidence of severe hematologic adverse events (grade≥Ⅲ) was comparable in the two cohorts. Conclusion: Patients receiving initial flumatinib therapy had higher cumulative incidences of therapy responses and higher probability of FFS than those receiving initial imatinib therapy, whereas the incidence of severe hematologic adverse events was comparable between the two cohorts.

Spatial epidemiological analysis of severe hand, foot and mouth disease in Guangxi, 2014-2018 / 中国热带医学

@#Abstract: Objective　To explore the spatial epidemiological characteristics of severe cases hand, foot and mouth disease (HFMD) in Guangxi, China, from 2014 to 2018, and to provide a basis for identifying the high-risk regions as well as the prevention and control of severe cases of HFMD in Guangxi. Methods　Spatial-temporal scanning analysis, global and local spatial autocorrelation analysis were used to analyze the spatial clustering of HFMD. The trend surface analysis was used to evaluate the spatial distribution trend of HFMD. Results　From 2014 to 2018, the incidence and severe case fatality rates of HFMD were 3.89/100 000 and 4.23%, respectively. Monte Carlo scanning analysis showed that the first cluster region was Cenxi City, the second cluster was mainly concentrated in northwest of Guangxi, and the aggregation time was mainly concentrated in April to May and August to October. The global spatial autocorrelation analysis showed that the severe HFMD was significant clustering distribution, and the Moran's I coefficients of the sever cases, severe morbidity and severe case fatality rate were 0.088, 0.118, 0.197, respectively (P<0.05). Local spatial autocorrelation analysis showed that hotspots of severe HFMD cases were concentrated in the southern Guangxi, mainly in Lingshan County. Anselin local Moran's I clustering and outlier analysis indicated that 5 high-high (H-H) clustering regions for fatality were Lingshan, Pubei, Zhongshan, Zhaoping and Pinggui County. There were 6 high-high (H-H) clustering regions for severe incidence rate, namely Lingshan, Qinnan, Lingyun, Youjiang, Bama Yao Autonomous and Pinggui County, and 1 high-low (H-L) clustering region, Cenxi County. The trend surface analysis showed that the overall number of severe cases of death decreased from east or west to the middle, and increased from north to middle, and then decreased to south. Conclusions　Severe HFMD cases in Guangxi have obvious spatial-temporal clustering, and the hop spots are mainly concentrated in southern Guangxi. The prevention and control of HFMD in areas with high incidence of severe cases should be strengthened to reduce the burden of HFMD cases.

Study on the diagnostic value of different posterior cruciate ligament index measurement methods for anterior cruciate ligament injury / 中国骨伤

OBJECTIVE@#To compare the posterior cruciate ligament(PCL) index with six different measurement methods, and analyze and verify its clinical diagnostic value in anterior cruciate ligament (ACL) injury.@*METHODS@#The Magnetic resonance imaging (MRI) data of 225 knee joints in our hospital from May 2018 to March 2022 were retrospectively analyzed, aged from 18 to 60 years old, with a median of 32 years old. On the sagittal MRI images of 114 patients with ACL injury and 111 patients with intact ACL, Measure the straight-line distance (A) between the femoral attachment point and the tibial attachment point of the PCL on the MRI sagittal image and the maximum vertical distance (B) between the straight line and the arcuate mark point of the PCL on the sagittal image, calculate the PCL index and evaluate the diagnostic value of the PCL index for ACL injury.@*RESULTS@#The PCL index of the ACL normal group and the ACL injury group were statistically described. There was no significant difference in PCL index 1, 2, 3 and 6 between the two groups(P>0.05). The difference of PCL index 4 and 5 between the two groups was statistically significant (P<0.001). This study only found that the PCL index 2, 6 in the ACL normal group had a negative correlation with the patient's age (correlation coefficient=-0.213, -0.819;P<0.05), and the PCL index 5 in the ACL injury group was significantly correlated with the patient's body mass index(BMI)had a negative correlation (correlation coefficient=-0.277, P<0.05).@*CONCLUSION@#The change of PCL index is helpful for the diagnosis of ACL injury, PCL index 4 and 5 can be used as effective reference indexes for diagnosing ACL injury in clinic.

Hepatic protective effects of Shenling Baizhu powder, a herbal compound, against inflammatory damage via TLR4/NLRP3 signalling pathway in rats with nonalcoholic fatty liver disease / 中西医结合学报

OBJECTIVE@#High-fat diet (HFD) and inflammation are two key contributors to nonalcoholic fatty liver disease (NAFLD). Shenling Baizhu powder (SLBZP), a classical herbal compound, has been successfully used to alleviate NAFLD. However, its specific mechanisms are not fully understood. In this study, we assessed the anti-NAFLD effect of SLBZP in vivo.@*METHODS@#Rats were fed an HFD with or without SLBZP or with probiotics. At the end of week 16, an echo magnetic resonance imaging (EchoMRI) body composition analyser was used to quantitatively analyse body composition; a micro-computed tomography (micro-CT) imaging system was used to evaluate whole body and liver fat; and the Moor full-field laser perfusion imager 2 was used to assess liver microcirculation, after which, all rats were sacrificed. Then, biochemical indicators in the blood and the ultrastructure of rat livers were evaluated. Protein expression related to the liver Toll-like receptor 4 (TLR4)/Nod-like receptor family pyrin domain-containing 3 (NLRP3) signalling pathway was assessed using Western blot analysis. Further, high-throughput screening of 29 related inflammatory factors in liver tissue was performed using a cytokine array.@*RESULTS@#SLBZP supplementation reduced body weight, serum free fatty acid, and insulin resistance index (P < 0.05). It also ameliorated liver microcirculation and ultrastructural abnormalities. EchoMRI and micro-CT quantitative analyses showed that treatment with SLBZP reduced fat mass and visceral fat (P < 0.05 and P < 0.01, respectively). In addition, SLBZP decreased the expression of lipopolysaccharide (LPS)-activated TLR4/NLRP3 signalling pathway-related proteins and altered the expression levels of some inflammatory cytokines in liver tissues.@*CONCLUSION@#SLBZP can inhibit NLRP3 inflammasome activation and interleukin-1β release by suppressing LPS-induced TLR4 expression in rats with HFD-induced NAFLD. Thus, SLBZP may be beneficial for the prevention and treatment of inflammatory damage and associated diseases.

Research progress of necroptosis on bone related diseases / 中国骨伤

As a new type of cell death, necroptosis is initiated by tumor necrosis factor receptor 1(TNFR1), and then activated receptor-interacting protein kinase 1(RIP1) and receptor-interacting protein kinase 3 (RIP3), following by the activation of mixed lineage kinase domain-like protein(MLKL) to deliver cell death signal. When necroptosis happens, damage associated molecular patterns (DAMPs) enter into extracellular area through the ruptured cytomembrane, followed by the disordered tissue hemeostasis. In recent years, many researches showed that necroptosis playimportant roles in a few bone related diseases, such as osteoporosis, osteonecrosis, osteosarcoma, etc. Thus, we try to briefly review the researches in this field.

Prognostic significance of low expression of B-cell translocation gene 1 (BTG1) in skin squamous cell carcinoma

Although the B-cell translocation gene 1 (BTG1) plays an important role in apoptosis and negatively regulatescell proliferation, BTG1 expression in skin squamous cell carcinoma (SCC) has not been reported. In this study,we wanted to investigate the significance of BTG1 expression in SCC and adjacent tissues. The expression ofBTG1 protein and mRNA in SCC tissues and adjacent tissues were detected by immunohistochemistrytechnique (IHC), Western blot and reverse transcriptase-polymerase chain reaction (RT-PCR). IHC stainingshowed that the positive expression rate of BTG1 protein in SCC tissues was 54.00%; and the positive rate was90.50% in the adjacent tissues. Western blot showed that the expression of BTG1 protein in SCC tissues wassignificantly lower than that in the adjacent tissues (P\0.05). RT-PCR showed that the positive rate of BTG1mRNA in SCC was 50.50%, which was significantly lower than that in adjacent tissues 89.00% (P\0.05).Both BTG1 mRNA and protein expression are related to tumor diameter, stage, tumor metastasis and thedegree of tumor differentiation in SCC. Patients exhibiting lower BTG1 protein expression in the SCC tissueshad a significantly shorter disease-specific survival rate. BTG1 protein expression, tumor diameter, tumors siteand stage were independent factors affecting the overall survival of postoperative patients. Further, BTG1overexpression inhibited A431 cell proliferation ability, while BTG silencing enhanced A431 cell proliferationability. The lower expression of BTG1 in SCC may be associated with the occurrence, development andprognosis of SCC.

Status of glycosylated hemoglobin and prediction of glycemic control among patients with insulin-treated type 2 diabetes in North China: a multicenter observational study / 中华医学杂志(英文版)

BACKGROUND@#Blood glucose control is closely related to type 2 diabetes mellitus (T2DM) prognosis. This multicenter study aimed to investigate blood glucose control among patients with insulin-treated T2DM in North China and explore the application value of combining an elastic network (EN) with a machine-learning algorithm to predict glycemic control.@*METHODS@#Basic information, biochemical indices, and diabetes-related data were collected via questionnaire from 2787 consecutive participants recruited from 27 centers in six cities between January 2016 and December 2017. An EN regression was used to address variable collinearity. Then, three common machine learning algorithms (random forest [RF], support vector machine [SVM], and back propagation artificial neural network [BP-ANN]) were used to simulate and predict blood glucose status. Additionally, a stepwise logistic regression was performed to compare the machine learning models.@*RESULTS@#The well-controlled blood glucose rate was 45.82% in North China. The multivariable analysis found that hypertension history, atherosclerotic cardiovascular disease history, exercise, and total cholesterol were protective factors in glycosylated hemoglobin (HbA1c) control, while central adiposity, family history, T2DM duration, complications, insulin dose, blood pressure, and hypertension were risk factors for elevated HbA1c. Before the dimensional reduction in the EN, the areas under the curve of RF, SVM, and BP were 0.73, 0.61, and 0.70, respectively, while these figures increased to 0.75, 0.72, and 0.72, respectively, after dimensional reduction. Moreover, the EN and machine learning models had higher sensitivity and accuracy than the logistic regression models (the sensitivity and accuracy of logistic were 0.52 and 0.56; RF: 0.79, 0.70; SVM: 0.84, 0.73; BP-ANN: 0.78, 0.73, respectively).@*CONCLUSIONS@#More than half of T2DM patients in North China had poor glycemic control and were at a higher risk of developing diabetic complications. The EN and machine learning algorithms are alternative choices, in addition to the traditional logistic model, for building predictive models of blood glucose control in patients with T2DM.

Multi-center Clinical Observation of Reyanning Mixture in Treatment of COVID-19 / 中国实验方剂学杂志

Objective:In the early stage, in vivo experiments of coronavirus infection and pulmonary syndrome syndrome combined with mouse model verified that Reyanning mixture has a significant therapeutic effect on human coronavirus disease-2019 (COVID-19). This study further evaluated the clinical efficacy of Reyanning mixture in the treatment of COVID-19, providing a basis for clinical medication. Method:Patients were collected from January 21, 2020 to February 24, 2020 in Xi'an No. 8 Hospital, Second Affiliated Hospital of Xi'an Jiaotong University, Yan'an Second People's Hospital and Songzi People's Hospital. 54 common-type patients who met the diagnostic criteria of COVID-19 were enrolled in this study,5 patients of them were not included in the statistical analysis because they did not meet the requirements, including 26 cases in the treatment group using Reyanning mixture on the basis of chemical drug treatment, and 23 cases in the control group receiving chemical drug treatment only. The symptom disappearance rates (throat dryness, throat pain, cough, fever, fatigue, chest tightness, runny nose, nasal congestion, headache), time to complete fever clearance (d), the nucleic acid conversion rate and time to recovery on chest CT were compared between two groups. Result:After treatment, except cough and fatigue, other symptoms disappeared in the treatment group, and the disappearance rate of symptoms such as dry throat, cough, fatigue, chest tightness and headache was statistically significant compared with the control group (P<0.05). The median time to complete fever clearance in the treatment group was 3 days, which was 2 days shorter than that in control group. The remission rate of chest CT was 88.46% (23/26) in the treatment group, which was higher than 73.91% (17/23) in control group. The negative conversion rate of viral nucleic acid detection was 96.15% (25/26) in treatment group, higher than 60.87% (14/23) in control group (P<0.01). Conclusion:Reyanning mixture can improve the clinical symptoms of COVID-19 patients, promote the improvement of chest CT. Can shorten the duration of fever.Can improve the novel coronavirus nucleic acid conversion rate, providing a basis for clinical treatment.

Effect of Shenling Baizhusan on mTORC1/STAT3 Pathway in Hepatocytes of Nonalcoholic Fatty Liver Disease Rats / 中国实验方剂学杂志

Objective::To observe the effect of Shenling Baizhusan(SBS)on the mammalian target of rapamycin complex 1 (mTORC1)/signal transducers and activators of transcription 3 (STAT3) pathway in liver hepatocyte of nonalcoholic fatty liver disease(NAFLD)rats induced by high fat diet, in order to reveal the mechanism of SBS against rat NAFLD from the perspective of inflammation. Method::Totally 80 SD rats were randomly divided into 4 groups, normal control group, model group, high-dose SBP group(30 g·kg-1), and low-dose SBS group(10 g·kg-1), with 20 rats in each group. The rats of NAFLD model were established by being fed with high-fat diets for 8 weeks, and the treatment groups were fed with high or low dose of SBS respectively. After treatment for 8 weeks, blood and liver samples of rats were collected. Alanine aminotransferase (ALT), aspartate aminotransferase(AST), total cholesterol (TC), triglyceride(TG), high-density lipoprotein cholesterol(HDL-C)and low-density lipoprotein cholesterol(LDL-C)levels in blood serum were detected with automatic biochemical analyzer. The liver tissues were observed by oil red O and hematoxylin-eosin (HE) staining. Hepatocytes were isolated by type Ⅳ collagenase perfusion in vitro. Tumor necrosis factor (TNF)-α, interleukin (IL)-1β, IL-5 and IL-6 in hepatocytes were detected by enzyme-linked immunosorbent assay (ELISA), and the relevant gene and proteins expressions of mTORC1 and STAT3 in hepatocytes were detected by Real-time fluorescent quantitative polymerase chain reaction (Real-time PCR) and Western blot detection respectively. Result::Compared with the normal control group, the serum levels of TG, TC, AST, ALT and LDL-C were increased significantly, the levels of TNF-α, IL-1β, IL-5 and IL-6 in hepatocytes were increased significantly, and the expression levels of mTORC1, STAT3 mRNA and proteins in hepatocytes were increased significantly(P<0.01). Compared with the model group, the hepatic lipid accumulation of the medicine intervention group was relieved significantly, the serum levels of AST, ALT, TG and LDL-C were decreased significantly, the expression levels of TNF-α, IL-1β, IL-5 and IL-6 of hepatocytes were decreased significantly, and the expressions of mTORC1, STAT3 mRNA and proteins in hepatocytes were decreased significantly(P<0.05, P<0.01). In the high-dose SBS group, the effects in improving the lipid accumulation and inhibiting the inflammatory reaction were better than those of the low-dose SBS group, and the expressions of mTORC1 and STAT3 genes and proteins in hepatocytes were significantly decreased (P<0.05, P<0.01). Conclusion::SBS can improve the fat metabolism disorder and reduce liver lipid accumulation and inflammatory reaction in NAFLD rats induced by high-fat diet. The mechanism may be correlated with the inhibition of mTORC1/STAT3 pathway relating to genes and protein expression in hepatocytes.

Effects of fatigue-predominant subhealth on mechanical and thermal pain sensitivity in mice / 中国药理学通报

Aim: To study the effects of the fatigue-predominant subhealth on mechanical and thermal pain sensitivity in mice. Methods: Kunming mice were randomly divided into two groups (n = 10); normal control group (control), fatigue-predominant subhealth model group (fatigue). The physiological behavior, rota-rod test and blood routine indexes were examined. The paw withdrawal mechanical threshold (PWMT) and the paw withdrawal thermal latency (PWTL) were measured in order to reflect the change of the mechanical and thermal pain sensitivity. Results: Compared to control group, the fur of model group was markedly pale, the time of rota-rod test was significantly lower (P < 0. 01), the data of blood cells was nearly the same, the outcome of PWMT was increased (P < 0. 01), and PWTL was decreased (P < 0. 01). Conclusions The fatigue-predominant subhealth reduces the mechanical pain sensitivity and increases the thermal pain sensitivity in mice.

Correlation between Asymptomatic Bacteriuria and Surgical Site Infection in Middle-aged and Elderly Patients Undergoing Open Hysterectomy / 中国医学科学院学报

Objective To explore the correlation between asymptomatic bacteriuria(AB)and surgical site infection(SSI)in middle-aged and elderly women undergoing open hysterectomy.Methods The clinical data of 1469 middle-aged and elderly women undergoing open hysterectomy in the Third Affiliated Hospital of Guizhou Medical University from June 2011 to August 2018 were retrospectively analyzed.Factors associated with SSI after operation were analyzed by univariate and multivariate regression models to identify the relationship of AB with SSI after open hysterectomy.Results Of these 1469 patients,101(6.88%)had SSI and 124 had AB[including 14 patients(11.29%)with infections].In addition,1345 patients had no AB,among whom 87(6.47%)had infections.Thus,the infection rate in patients with AB was significantly higher than that in patients without AB(=4.123,=0.042).Univariate analysis showed AB,history of diabetes mellitus,surgical procedure,length of stay(>15 d),season(summer and autumn),body mass index(≥25 kg/m ),nature of lesions(malignant tumors),ASA grade(>grade Ⅱ),incision length(≥10 cm),and operative time(≥3 h),bleeding volume(≥1000 ml),serum albumin concentration(grade Ⅱ)were risk factors for SSI in these patients(all <0.05). Conclusions AB is one of the risk factors for SSI in middle-aged and elderly women undergoing open hysterectomy.Screening and treatment of AB before surgery can reduce the risk of SSI.ASA grading shall be performed before surgery before corresponding preparation was offered.Effective control of blood glucose,improved surgical skills,and shorter operative time are helpful for lowering postoperative SSI.

Effect of Highvolume Platelet Reduction Therapy on White Blood Cell Count and Hemoglobin Level in Patients with Thrombocytosis / 中国实验血液学杂志

OBJECTIVE@#To explore the effect of high volume platelet reduction therapy on the white blood cell (WBC) count and hemoglobin (Hb) level in patients with thrombocytosis.@*METHODS@#Thirty-two plateletphoreses were performed for patients with thromocytosis by using ELP or MNC program of blood component isolator of COBE spectra continuous flow concentrifugation and the ACD-A preservation solution for blood as blood anticoagulant. In each treatment of patients, 2.5-3.0 tines total blood volume (TBV) were circulated, then the platelet suspension of 1/5-1/4 time TBV was prepared and collected.@*RESULTS@#A single plateletpheresis took (212.53±41.54) minutes in which (8 812.63±2087.15) ml blood were treated, and (798.84±190.77) ml platelet suspension was collected. In the suspension, the platelet count was 4 486.50 (3 058.50-5 279.50)×10/L, containing 3 455.50 (2 288.68-4 226.71)×10. WBC count was 13.79 (10.21-20.72)×10/L, containing 11.90(7.81-14.40)×10. Hemoglobin concentration was (3.28±1.25) g/L，containing (2.62 ± 1.17) g. Before and after plateletpheresis, the patients' platelet count was 1 263.00 (1 052.50-1 807.50)×10/L and (778.83±247.25)×10/L（Z=4.94, P＜0.01), WBC count was 9.96(6.44-14.01)×10/L and 8.59(5.37, 13.12)×10/L (Z=13.31, P＜0.05), Hemoglobin concentration was (112.63 ± 24.56)g/L and (109.55 ± 24.46)g/L (t=1.68，P＞0.05).@*CONCLUSION@#Using continuous flow centrifugation and blood component separating in plateletpheresis for the patients with thrombocytosis can obviously decrease the high ratio of platelets, and improve the effect of plateletpheresis. The high volume platelet reduction therapy can lead to decrease of WBC count to some alent, degree but WBC count still in the normal range, moreover not affect the hemoglobin level significantly.

Comparison of cryoballoon ablation for atrial fibrillation guided by real-time three-dimensional transesophageal echocardiography vs. contrast agent injection / 中华医学杂志(英文版)

BACKGROUND@#Pulmonary vein (PV) occlusion generally depends on repetitive contrast agent injection when cryoballoon ablation for atrial fibrillation (AF). The present study was to compare the effect of cryoballoon ablation for AF guided by transesophageal echocardiography (TEE) vs. contrast agent injection.@*METHODS@#Eighty patients with paroxysmal AF (PAF) were enrolled in the study. About 40 patients underwent cryoballoon ablation without TEE (non-TEE group) and the other 40 underwent cryoballoon ablation with TEE for PV occlusion (TEE group). In the TEE group during the procedure, PVs were displayed in 3-dimensional images to guide the balloon to achieve PV occlusion. The patients were followed up at regularly scheduled visits every 2 months.@*RESULTS@#No differences were identified between the groups in regard to the procedure time and cryoablation time for each PV. The fluoroscopy time (6.7 ± 4.2 min vs. 17.9 ± 5.9 min, P < 0.05) and the amount of contrast agent (3.0 ± 5.1 mL vs.18.1 ± 3.4 mL, P < 0.05) in the TEE group were both less than the non-TEE group. At a mean of 13.0 ± 3.3 mon follow-up, success rates were similar between the TEE group and non-TEE group (77.5% vs. 80.0%, P = 0.88).@*CONCLUSIONS@#Cryoballoon ablation with TEE for occlusion of the PV is both safe and effective. Less fluoroscopy time and a lower contrast agent load can be achieved with the help of TEE for PV occlusion during procedure.

Biomechanical effects of interbody cage height on cervical spine / 医用生物力学

Objective To investigate the biomechanical effects of interbody cage height on cervical spine during anterior cervical discectomy and fusion (ACDF) surgery,so as to provide references for selection of interbody cage.Metheds The finite element model of normal cervical spine (C2-7) was built and validated,and the cages with different height (5,6,7,8 mm) were implanted into C5-6 disc (cage 5,6,7,8 model).All the models were loaded with pure moment of 1.5 N · m to produce flexion,extension,lateral bending and axial rotation motions on cervical spine,and the effects of cage height on range of motion (ROM),facet joint stress,intervertebral pressure in cervical spine were investigated.Results The intervertebral angle at the fusion segment increased by 0.68° with per 1 mm-increase in height.The ROM in C5-6 after cage implantation was smaller than 0.44°.The influence of cage height on ROM in C4-5 was greater than that in C6-7,and the changes of ROM in non-fusion segments were smaller than 7.3％.The cage height variation had a smaller impact on the facet joint stress and intervertebral pressure.The stresses in the capsular ligament,cage and screw-plate system increased gradually with the increase of cage height,and the stresses in cage 6,7,8 models were much higher than those in cage 5 model.Conclusions For patients who need implanting fusion cage,the cage height should be 0-1 mm greater than the original intervertebral space height.

Biomechanical effects of interbody cage height on cervical spine / 医用生物力学

Objective To investigate the biomechanical effects of interbody cage height on cervical spine during anterior cervical discectomy and fusion (ACDF) surgery,so as to provide references for selection of interbody cage.Metheds The finite element model of normal cervical spine (C2-7) was built and validated,and the cages with different height (5,6,7,8 mm) were implanted into C5-6 disc (cage 5,6,7,8 model).All the models were loaded with pure moment of 1.5 N · m to produce flexion,extension,lateral bending and axial rotation motions on cervical spine,and the effects of cage height on range of motion (ROM),facet joint stress,intervertebral pressure in cervical spine were investigated.Results The intervertebral angle at the fusion segment increased by 0.68° with per 1 mm-increase in height.The ROM in C5-6 after cage implantation was smaller than 0.44°.The influence of cage height on ROM in C4-5 was greater than that in C6-7,and the changes of ROM in non-fusion segments were smaller than 7.3％.The cage height variation had a smaller impact on the facet joint stress and intervertebral pressure.The stresses in the capsular ligament,cage and screw-plate system increased gradually with the increase of cage height,and the stresses in cage 6,7,8 models were much higher than those in cage 5 model.Conclusions For patients who need implanting fusion cage,the cage height should be 0-1 mm greater than the original intervertebral space height.

Biomechanical effects of interbody cage height on cervical spine / 医用生物力学

Objective To investigate the biomechanical effects of interbody cage height on cervical spine during anterior cervical discectomy and fusion (ACDF) surgery, so as to provide references for selection of interbody cage. Methods The finite element model of normal cervical spine (C2-7) was built and validated, and the cages with different height (5, 6, 7, 8 mm) were implanted into C5-6 disc (cage5, 6, 7, 8 model). All the models were loaded with pure moment of 1.5 N•m to produce flexion, extension, blending and axial torsion motions on the cervical spine, and the effects of cage height on range of motion (ROM), facet joint stress, intervertebral pressure in cervical spine were investigated. Results The intervertebral angle at the fusion segment increased by 0.68°with per 1 mm-increase of height. The ROM at C5-6 after cage implantation was less than 0.44°. The influence of cage height on ROM in C4-5 was greater than that in C6-7, and the changes of ROM in non-fusion segments were less than 7.3%. The cage height variation had a smaller impact on the facet joint stress and intervertebral pressure. The stresses in the capsular ligament, cage and screw-plate system increased gradually with the increase of cage height, and these stresses in the cage6, 7, 8 models were much higher than those in the cage5 model. Conclusions For patients who need implanting fusion cage, the cage height should be 0-1 mm greater than the original intervertebral space height.

Postoperative analgesia of Ropivacaine combined Dexmedetomidine for transversus abdominis plane block in laparoscopic surgery / 中国内镜杂志

Objective To observe the effect of postoperative analgesia of Ropivacaine combined Dexmedetomidine for transversus abdominis plane (TAP) block in laparoscopic surgery. Methods 60 patients underwent selective laparoscopic hernia repair were randomly divided into two groups: Ropivacine plus Dexmedetomidine group (Rpd group): Dexmedetomidine 1.0 μg/kg + 0.4% Ropivacine 30 ml was injected into bilateral TAP, and Ropivacine group (R group): saline 1 ml+0.4% Ropivacine 30 ml was injected into bilateral TAP. Blood pressure and heart rate on beginning of the surgery, 1 h during surgery and leaving the operating room, VAS of immediate postoperative period, 4 h, 6 h, 8 h, 12 h, 24 h after the surgery, analgesic duration and incidence of nausea and vomiting of the two groups were recorded. Results Two groups have no difference in blood pressure and heart rate in all time points (P > 0.05), VAS score of 6 h, 8 h, 12 h after surgery in Rpd group were lower than in R group (P < 0.05), and VAS score of postoperative period, 4 h, 24 h after the surgery had no difference between the two groups (P > 0.05). Sensory block duration in Rpd group was longer than in R group (P < 0.05). Incidence of nausea and vomiting of the two groups had no difference in two groups (P > 0.05). Conclusions Ropivacaine combined Dexmedetomidine for Transversus Abdominis Plane block in laparoscopy patients can significantly prolong the analgesic duration.

Postoperative analgesia of Ropivacaine combined Dexmedetomidine for transversus abdominis plane block in laparoscopic surgery / 中国内镜杂志

Objective To observe the effect of postoperative analgesia of Ropivacaine combined Dexmedetomidine for transversus abdominis plane (TAP) block in laparoscopic surgery. Methods 60 patients underwent selective laparoscopic hernia repair were randomly divided into two groups: Ropivacine plus Dexmedetomidine group (Rpd group): Dexmedetomidine 1.0 μg/kg + 0.4% Ropivacine 30 ml was injected into bilateral TAP, and Ropivacine group (R group): saline 1 ml+0.4% Ropivacine 30 ml was injected into bilateral TAP. Blood pressure and heart rate on beginning of the surgery, 1 h during surgery and leaving the operating room, VAS of immediate postoperative period, 4 h, 6 h, 8 h, 12 h, 24 h after the surgery, analgesic duration and incidence of nausea and vomiting of the two groups were recorded. Results Two groups have no difference in blood pressure and heart rate in all time points (P > 0.05), VAS score of 6 h, 8 h, 12 h after surgery in Rpd group were lower than in R group (P < 0.05), and VAS score of postoperative period, 4 h, 24 h after the surgery had no difference between the two groups (P > 0.05). Sensory block duration in Rpd group was longer than in R group (P < 0.05). Incidence of nausea and vomiting of the two groups had no difference in two groups (P > 0.05). Conclusions Ropivacaine combined Dexmedetomidine for Transversus Abdominis Plane block in laparoscopy patients can significantly prolong the analgesic duration.

Biological Effects of Chlamydiaphage phiCPG1 Capsid Protein Vp1 on Chlamydia Trachomatis In Vitro and In Vivo / 华中科技大学学报（医学）（英德文版）

The researches on chlamydia in recent years show that chlamydia bacteriophage may be a potential and effective means to solve the clinical infection of chlamydia trachomatis (Ct).We investigated the biological effect of chlamydiaphage phiCPG1 capsid protein Vp1 on Ct both in McCoy cells and genital tract of mice.Different concentrations of Vp1 were co-incubated with Ct E serotype strain in McCoy cells.Female BALB/c mice were used to establish Ct E strain-induced urogenital infection model.They were randomly divided into five groups and given different treatments on the fifth day after Ct inoculation.Animals in groups 1 and 2 were given 30 μL different concentrations of Vp1 in the genital tract respectively,those in group 3 were intramuscularly injected with 30 μL Vp1,those in the infected group did not receive any intervention,and those in the control group received 30 μL PBS in the genital tract.The vaginal discharge was collected to identify the live chlamydia by cell culture and gene fragment by real time PCR different days after infection.Inhibition rate of 100 μg/mL and 50 μg/mL Vpl proteins against Ct E strain in the McCoy cell cultures was 91％ and 79％ respectively,The number of intracellular Ct inclusion in the McCoy cells co-cultured with vaginal discharge of group 1 and group 2 was less than in the infected group,and that in group 1 was less than in group 2,on the 7th day after Ct inoculation.Real-time PCR showed that chlamydia concentration of the vaginal discharge in group 2 was lower than in the infected group,and that in group 1 was lower than in group 2 on the 10th day.It was suggested that Vp1 capsid proteins had inhibitory effect on the proliferation of Ct serovar E strain in cell culture and mouse genital tract.