Dermatomyositis with kidney neoplasm: two cases report and literature review / 中华泌尿外科杂志

Objective:To investigate the clinical characteristics, diagnosis and treatment of dermatomyositis with kidney neoplasm.Methods:The data of two patients with dermatomyositis complicated with kidney neoplasm in Tongji Hospital from January to February 2022 were retrospectively analyzed. The first case was a 55-year-old female, who was admitted with the chief complaints of recurrent erythema of upper extremities for 2 months and facial erythema for 1 month. Physical examination: erythema can be seen on upper limbs and face, no tenderness or percussion pain in kidney area. Myositis enzyme profile test showed that anti-Mi-2 antibody and anti-SSA /Ro-52 antibody were positive. Contrast CT showed nodular uneven enhancement in the right kidney with a size of 50 mm×41 mm. The second case was a 58-year-old female, who was admitted with the chief complaints of kidney occupying for a month. Physical examination: flaky erythema on face, no tenderness or percussion pain in kidney area. Myositis enzyme profile test showed that anti-Ro-52 antibody and anti-MDA5 antibody were positive. Contrast CT showed a significantly uneven enhanced mass with a size of about 50 mm×41 mm on left kidney. Both patients were diagnosed with kidney neoplasm before surgery and underwent laparoscopic partial nephrectomy in Tongji Hospital.Results:Both patients received regular oral prednisone after surgery. The pathological presentation of case 1 was papillary renal cell carcinoma, the facial erythema subsided 1 month after surgery, and there was no tumor recurrence for 13 months. The pathological presentation of case 2 was clear cell renal cell carcinoma, facial erythema subsided 2 weeks after surgery, and there was no tumor recurrence for 12 months.Conclusions:The diagnosis of dermatomyositis should be combined with clinical manifestations and laboratory examination, and the possibility of malignant tumor should be excluded due to the high likelihood of concomitant malignancy. For patients with dermatomyositis with kidney neoplasm, the main treatment is still surgery, and supplemented with glucocorticoid therapy.

Research progress in 2023 ASCO-GU prostate cancer / 现代泌尿外科杂志

The 2023 American Society of Clinical Oncology Genitourinary Cancers Symposium unveiled numerous research advances which provide meaningful insights into the selection of treatment regimens of prostate cancer. Precision multi-treatment based on patients’ characteristics has become the predominant approach, including the use of a three-drug combination therapy for metastatic hormone-sensitive prostate cancer, and poly adenosine diphosphate ribose polymerase inhibitor therapy for metastatic castration-resistant prostate cancer. Nuclear medicine therapy and radiotherapy are also receiving significant attention. Integrated nuclear medicine diagnosis and therapy show immense potential for non-metastatic castration-resistant prostate cancer. Additionally, for localized prostate cancer, stereotactic body radiotherapy is a preferred alternative to surgery. This article sheds light on several key studies presented at the conference, focuses on prostate cancer treatment at different stages, and intends to enhance the therapeutic outcome for prostate cancer patients.

Implication practice of “Internet Plus” new technology in chronic diseases management in community / 公共卫生与预防医学

Objective  To introduce and evaluate the practice of “Internet Plus” new technology for health management of chronic diseases in community in Yichang, and to provide reference for chronic disease patients' health management in community. Methods  Data of hypertensive patients were collected from the national basic public health service system, the big data intelligent sorting system for chronic disease patients in Yichang City, and the basic public health service system in urban areas in Yichang from 2016 to 2020. Data on the discovery, sorting and filing, standardized management rate and blood pressure control of urban hypertension patients were analyzed. The application effect of “Internet Plus” new technology in chronic disease community health management was evaluated. Results  From 2016 to 2020, 15 934 patients with hypertension were found and their health records were established through big and intelligent data in Yichang City, accounting for 93.54% (15 934 / 17 035) of the total. The rate of standardized management in each district increased year by year, with an increase of 8.71% in 2020 compared with 2016, and the difference was statistically significant (χ2=1273.30, P2=867.14, P<0.001). Conclusion  Data exchange and sharing among medical institutions at all levels can strengthen the health management of chronic diseases in the community. The “Internet Plus” new technology, integrating the Internet, big data, cloud computing and intelligent terminal technology, can effectively improve the detection, management and treatment rate of chronic diseases, and provide a new direction for the health management of chronic diseases.

Contribution and Regulation of Forkhead Transcription Factor O1 during the Renal Fibrosis / 中国生物化学与分子生物学报

Chronic kidney disease (CKD) has become a chronic disease that cannot be ignored all over the world. Renal fibrosis is the final result and key pathological features of CKD. The whole process of renal fibrosis is associated with the repair and healing of kidney damage, and this long-term chronic stimulation promotes the renal fibrosis to the kidney failure, it is characterized by continuous activation of myofibroblasts and excessive production and deposition of extracellular matrix. Renal fibrosis is a synergistic process mediated by a variety of signaling pathways, and TGF-β / Smad and Wnt / β-catenin signaling pathways are two of the most classic ones. FoxO1 is an important transcription factor in the human body, which is expressed in a variety of cell types and plays an important role in a variety of cell life activities. Current researches have shown that FoxO1 plays an important role in renal fibrosis. FoxO1 regulates the occurrence and development of renal fibrosis through various signaling pathways such as STAT, SIRT1, Wnt / β-catenin, PI-3K / Akt. For example, FoxO1 / STAT regulates TIF and renal tubule apoptosis, SIRT1 / FoxO1 regulates oxidative stress response and lipotoxicity, FoxO1 / β-catenin inhibits the Wnt / β-catenin signaling pathway. In addition, some related studies suggest that FoxO1 / Smad may play a role in renal fibrosis. The contribution and regulation of FoxO1 in the renal fibrosis are reviewed here in order to further clarify the pathogenesis of renal fibrosis, which may bring new clues and prospects for the treatment of CKD.

Analysis of the efficacy of a modified posteromedial approach for Klammer III posterior Pilon fractures / 中华创伤杂志(英文版)

PURPOSE@#To analyze the curative effect and technical points of a modified posteromedial approach in the treatment of Klammer III posterior Pilon fracture.@*METHODS@#A retrospective analysis of patients with Klammer III posterior Pilon fractures were conducted in our department from January 2018 to December 2019. Before the surgery, the patients were fully relieved of swelling and pain, and a comprehensive examination was carried out. The posteromedial approach exposed the posterior and medial fracture block of the distal tibia. According to the fracture of external malleolus, it is determined whether to combine a lateral incision and protect tendons and vascular nerves by a retractor, and then perform a fracture reduction and internal fixation. Postoperatively, the patients were treated with analgesia, detumescence, anticoagulation and rehabilitation exercise. The American orthopaedic foot and ankle society (AOFAS) score and visual analogue score were recorded at regular follow-up after surgery. A t-test was used for the comparison of the preoperative and final AOFAS score.@*RESULTS@#There were 7 male and 13 female (n = 20) included in the study, aged 22 to 88 years (average age 54.2 years). The injury mechanisms were falling from a height (n = 7), traffic accident (n = 6), walking injury (n = 2) and heavy injury (n = 5). The postoperative follow-up duration was 12-24 months (mean 16.95 months). The AOFAS score of the 20 patients before and after surgery were compared. The preoperative AOFAS score was 38.90 ± 3.91, and the final AOFAS score was 80.55 ± 4.20, (p < 0.001). The mean final visual analogue scores at rest, active and weight-bearing walking were 0.30, 0.85 and 1.70, respectively. One patient reported poor postoperative wound healing and required a return to hospital for debridement and anti-infection treatment.@*CONCLUSION@#In the treatment of Klammer III posterior Pilon fractures, the modified posteromedial approach can fully expose the fracture block and the collapsed articular surface of the medial malleolus, achieve good reduction and internal fixation with limited injury of the tendon and vascular nerves, and have a better prognosis.

Examination of Ureaplasma urealyticum and Mycoplasma hominis in 4082 Chinese patients

The objective of this study was to analyze the infection rate and drug resistance of Ureaplasma urealyticum (UU) and Mycoplasma hominis (MH) in the genitourinary tract of Chinese patients. From December 2018 to June 2019, vaginal secretion or urinary secretion of outpatients in our hospital were selected for culture and drug sensitivity analysis of Ureaplasma urealyticum and Mycoplasma hominis. In 4082 Chinese samples, 1567 Mycoplasma were detected, a detection rate of 38.39%, among which 1366 cases were UU single positive, accounting for 33.47%, 15 cases were MH single positive, accounting for 0.36%, 186 cases were UU and MH mixed positive, accounting for 4.56%. The most affected age groups were 21-30 years and 31-40 years, accounting for 19.09 and 15.05%, respectively. The results of drug sensitivity showed that doxycycline, minocycline, josamycin, clarithromycin, and roxithromycin were more sensitive to mycoplasma infection. The distribution of Ureaplasma urealyticum and Mycoplasma hominis in the human genitourinary system and their sensitivity to antibiotics is different for sex and age groups.

Advances in olfactory ensheathing cells for the treatment of spinal cord injury / 中国骨伤

Spinal cord injury is a highly disabled neurological disease, and there is still a lack of effective treatments. Studies have proved that olfactory ensheathing cells are one of the ideal seed cells for promoting nerve regeneration after spinal cord injury. Olfactory ensheathing cells can promote axonal germination and elongation through secretion, interaction with astrocytes, regulation of inflammatory reaction, migration characteristics, myelination, anti-oxidation, lipid regulation and other channels. Thus olfactory ensheathing cells play the role of neuroprotection and nerve repair. In recent years, some studies have used bioengineering, tissue engineering, reprogramming and other technologies to enhance the efficacy of olfactoryensheathing cells from different aspects, thereby providing new therapeutic strategies for optimizing the cell therapy of spinal cord injury. This article will summarize the mechanism of olfactory ensheathing cells in repairing spinal cord injury, and review the progress of optimizing strategy of olfactory ensheathing cells in treating spinal cord injury recently, so as to provide new research ideas for the further developing the repair potential of olfactory ensheathing cells and optimize the cell therapy effect of spinal cord injury.

Combination of Probiotics and Salvia miltiorrhiza Polysaccharide Alleviates Hepatic Steatosis via Gut Microbiota Modulation and Insulin Resistance Improvement in High Fat-Induced NAFLD Mice

Background@#Nonalcoholic fatty liver disease (NAFLD) increases the risk of hepatocellular carcinoma, which is currently the leading cause of obesity-related cancer deaths in middle-aged men. @*Methods@#Probiotics with lipid-lowering function were screened from the fecal microbiota of healthy adults. Polysaccharide from different sources was screened for improving insulin resistance. The combination of probiotics and Salvia miltiorrhiza polysaccharide (LBM) was investigated for alleviating hepatic steatosis. @*Results@#First, Bifidobacterium bifidum V (BbV) and Lactobacillus plantarum X (LpX) were obtained from the fecal microbiota of healthy adults. Second, to improve insulin resistance, a Salvia miltiorrhiza Bunge polysaccharide showing good performance in reducing insulin resistance was obtained. The liver total cholesterol (TC) and total triglyceride (TG) levels and the serum levels of free fatty acid, alanine transaminase, aspartate transaminase, low density lipoprotein cholesterol, TG, and TC can be significantly reduced through supplementation with LpX-BbV (LB) in NAFLD mice. Interestingly, the function of the probiotic LB can be enhanced by S. miltiorrhiza Bunge polysaccharide. Furthermore, the gut microbiota was modulated by LpX-BbV+S. miltiorrhiza Bunge polysaccharide (LBM). The lipopolysaccharide concentration of the LBM group was decreased by 73.6% compared to the NAFLD group. Ultimately, the mRNA concentrations of the proinflammatory cytokines (tumor necrosis factor α, interleukin 1β [IL-1β], and IL-6) decreased with LB and LBM treatment. @*Conclusion@#The results of this this study indicate that the LBM combination can be used as a therapeutic for ameliorating NAFLD via modulating the gut microbiota and improving insulin resistance.

Neural pathway between the nucleus accumbens and the rostral ventrolateral medulla in a rat model of anorexia nervosa / 南方医科大学学报

OBJECTIVE@#To investigate the potential neural pathway connecting the nucleus accumbens (NAc) and the rostral ventrolateral medulla (RVLM), and whether the pathway participates in the regulation of cardiovascular function in a model rat of anorexia nervosa (AN).@*METHODS@#Rat models of AN were established by allowing voluntary activity in a running wheel with restricted feeding, with the rats having free access to normal chow without exercise as the control group. FluoroGold (FG) retrograde tracing method and multi-channel simultaneous recording technique were used to explore the possible pathway between the NAc and the RVLM.@*RESULTS@#The rats in AN group exhibited significantly reduced systolic blood pressure (SBP), mean arterial pressure (MAP) and heart rate (HR) with significantly increased discharge frequency of RVLM neurons in comparison with the control rats. After the injection of FG into the RVLM, retrograde labeled neurons were observed in the NAc of the rats in both the normal control and AN groups. In both groups, SBP and HR were significantly decreased in response to 400 μA electrical stimulation of the NAc accompanied by an obvious increase in the discharge frequency of the RVLM neurons; the diastolic blood pressure (DBP) and MAP were significantly lower in AN model rats than in the normal rats in response to the stimulation.@*CONCLUSIONS@#We successfully established a rat model of AN via hyperactivity and restricted feeding and confirm the presence of a neural pathway connecting the NAc and the RVLM. This pathway might participate in the regulation of cardiovascular function in AN model rats.

Effects of L-Arginine and α / 中国医学科学院学报

Kidney is one of the important organs of the body.With both excretory and endocrine functions,it plays a vital role in regulating the normal physiological state.As a precursor of the nitric oxide(NO)synthesis

Cultivation, screening, identification and transplantation of Muse cell from human umbilical cord-derived for spinal cord injury in rats / 中国骨伤

OBJECTIVE@#To investigate multilineage-differentiating stress-enduring (Muse) by immunomagnetic bead screening from Wharton's jelly mesenchymal stromal cells(WJ-MSCs), and explore transplantation of Muse cell for safety and effectivensess of sub acute cord injury in rats.@*METHODS@#Donated Wharton's Jelly-mesenchymal stromal cells (WJ-MSCs) were successfully derived from a human umbilical cord by a series of procedures namely physical isolation of Wharton's Jelly from cord membrane, collagenase and trypsin treatment and density gradient centrifugation. Magnetic activated cell sorting was performed to specifically select SSEA3+ Muse cells, and flow cytometry and immunocytochemistry were used to identify further. In vivo, spinal cord contusion injury model in rats was induced by NYU-III impactor, and were randomly divided and equally into four groups, namely group A (sham), group B (control), group C (Non-Muse cells transplantation) and group D (Muse cells transplantation). Laminectomy was conducted in group A but no spinal cord contusion injury. Laminectomy and cord injury were performed in group B, C and D, 10 g trip rod was freely falling down from 12.5 mm. Two weeks later, group B, C and D were received PBS injection, Non-Muse cells transplantation and Muse cells transplantation respectively, four-point injection were performed in each cord with totally 4×10⁵ cells. BBB scores were evaluated on 1 day, 1, 2, 3, 4, 5 and 6 week after injury. Four weeks after cell transplantation, the rats were sacrificed, and immunohistochemistry were carried out to observe survival, migration and differentiation of the injected cells.@*RESULTS@#The expression of CD105, CD90 and CD73 were over 99.5% in the derived WJ-MSCs population, but CD45 and CD14 were lower than 0.5%, positive rate of SSEA3+ was 1.46% under flow cytometer, However, after MACS sorting, the percentage of 92.0% Muse cells expressed SSEA3 and CD105, and immunohistochemistry results of SSEA3 showed typically membrane morphology with special processes. In vivo, BBB scores was 21 in group A at different time points. One-way ANOVA and LSD analysis showed that BBB scores in group C and D were significantly higher than that in group B (=0.004, 0.002), but there was no significantly difference between group C and D. Further intra-group paired t test showed that BBB score was significantly higher at 4 weeks than that 3 weeks in group C (=0.005). However, in group D, BBB scores were significantly higher at 4 and 6 week than those at 3 and 5 weeks, values were 0.005 and 0.016 respectively. Immunohistochemistry results showed that both Muse cells and Non-Muse cells could survive for 4 weeks in rats and they migrated from the four-point injection to injury site. But there showed more Muse cells survival than Non-Muse cells in the cord.@*CONCLUSIONS@#Immunomagnetic bead screening is efficient to select large number of purified SSEA3+ Muse cells. Muse cells could survive and target-migrate in injured cord to improve BBB scores continuously. Muse cells are a novel kind of seed cells in the spinal cord injury treatment.

Comparison of the effect of navigation template assisted spinal pedicle fixation and traditional pedicle screw fixation:a Meta-analysis / 中国骨伤

OBJECTIVE@#To systematically evaluate the efficacy of rapid prototyping drill navigation template-assisted pedicle screw fixation and traditional anatomic landmark-based fixation in the treatment of spinal disease by accessing and searching some relevant literatures home and abroad.@*METHODS@#Randomized Controlled Trials (RCTs) and prospective case-control studies or retrospective case-control studies about rapid prototyping drill templates-assisted pedicle screw fixation and traditional anatomic landmark-based fixation for the treatment of spinal disease were searched electronically in PubMed, The Cochrane Library(Issue 5, 2017), Clinical Trial, Google Scholar, Web of Science, CNKI, Wanfang database and VIP database before June 2017. According to the inclusion and exclusion criteria, two researchers independently screened the literatures, and extracted the data. The methodological quality of randomized controlled trials were evaluated by the Cochrane Handbook, and prospective case-control studies and retrospective case-control studies were evaluated by the NOS scale. The outcomes were analyzed using RevMan 5.3 software provided by the Cochrane information management system.@*RESULTS@#A total of 7 articles were included, including 2 RCTs, 1 prospective case-control study and 4 retrospective case-control studies. A total of 237 patients were implanted with 1 688 pedicle screws, including 898 screws in the navigation template group, 790 screws in the conventional method group. Meta-analysis results showed that there was significant difference in the excellent rate of screw implantation between navigation template group and conventional method group [OR=5.05, 95% CI(3.13, 8.16), <0.000 01], there was significant difference in operative time, intraoperative blood loss for thoracolumbar surgery [WMD=-27.19, 95% CI(-38.21, -16.17), <0.000 01; WMD=-100.82, 95% CI(-182.26, -19.37), =0.02].@*CONCLUSIONS@#Compared with traditional pedicle screw fixation, navigation template spine pedicle screw fixation has better clinical effect, which can improve the excellent rate of screw placement, reduce the operation time and intraoperative bleeding.

CT assisted morphological study of lumbar endplate / 中国骨伤

OBJECTIVE@#To study and measure the anatomic structure of lumbar vertebral endplate structure in healthy adults by computed tomography(CT) technique in order to provide a useful guidance for the optimal design and clinical application of lumbar prostheses.@*METHODS@#Sixty healthy adults (male and female equals) were recruited for full-waist CT scan after signing the informed consent form in the imaging department of the Second Affiliated Hospital of Xi'an Jiaotong University. The scanning data was imported into the computer aided software Mimics 16.0 for 3D reconstruction and measurement. The acquisition indexes included median sagittal diameter, maximum coronal diameter, concavity depth, median sagittal depression angle, coronal depression angle and so on. Finally, the collected data were statistically analyzed by the statistical software.@*RESULTS@#The median sagittal diameter and the maximum coronal diameter of the upper and lower endplates were not only different between the different sexes(0.05), but had a little change from L₁ to L₅, fluctuating from 1.5 to 2.0 mm and from 2.2 to 3.9 mm, respectively. In the same sequence, the concavity depth of lower endplate in males was greater than that of upper endplate, and the difference was statistically significant(0.05). Sagittal concavity angle and coronal concavity angle of upper and lower endplates changed slightly with the increase of vertebral order, and there was no gender difference in sagittal and coronal concavity angle of most vertebral sequences (>0.05). Statistics showed that the largest concavity near the caudal lumbar endplate was located on the dorsal side of the endplate plane.@*CONCLUSIONS@#The anatomical structure of the lumbar endplate is very complicated. It is important to master the anatomical parameters of the endplate and make full use of CT before operation for the development and clinical application of the lumbar prosthesis.

Evaluation of renal function in congenital spinal deformities patients with urinary malformations / 西安交通大学学报(医学版)

Objective To evaluate renal function in congenital spinal deformities patients with urinary malformations.Methods We prospectively enrolled patients diagnosed with congenital spinal deformities combined with urinary malformation as well as age- and weight-matched healthy individuals and divided them into three groups:renal malformations group,urinary tract malformations group,and healthy control group.Serum creatinine,blood urea,blood uric acid,serum cystatin C,and estimate glomerular filtration rate(eGFR)level were used to evaluate general renal function.Urinary microalbumin(mALB),urinary alpha-1-microglobulin(α1-MG), beta-2-microglobulin(β2-MG),and N-acetyl-beta-D-glucosaminidase(NAG)level were determined to evaluate early renal function.Results We enrolled totally 16 patients with renal malformations,14 patients with urinary tract malformations group,and 20 healthy individuals as controls.The concentration of serum creatinine,blood urea, blood uric acid,serum cystatin C,and the value of eGFR in the three groups were within normal reference values, with no significant difference(P＞0.05).There were significant differences in the urinary levels of mALB,α1-MG and NAG in the three groups(P＜0.05),but not for the concentration of β2-MG(P＞0.05).Urinary levels of mALB and NAG were significantly higher in renal malformations group than in urinary tract malformations group (P＜0.05),but not for the concentration of α1-MG(P＞ 0.05).Conclusion Early renal function impairment occurs in congenital spinal deformities children with urinary malformation.Moreover,it appears more severe in patients with renal malformations than in those with urinary tract malformations.

Rapid prototyping navigation template assisted cervical screw implantation:a review / 中国骨伤

The cervical screw fixation has been used widely in the clinic setting due to the high fusion rate, immediate fixation of the surgical segment and good correction of the deformity. However, owing to the variation of anatomical structures and the narrow pedicle screws, it's rather difficult to implant the screws through traditional methods. The perforation rate of the screw is high, which can cause serious complications such as neurovascular injury. In recent years, rapid prototyping navigation templates have been reported in the appilication to assist cervical screw placement for improving the accuracy of screw placement. In this paper, we reviewed and summarized published literatures about navigation template assisted cervical screw implantation in the past 20 years, systematically introduced the methods of producing and using of navigation templates, the development of design concept and the status of application in cervical spine surgery. To date, relevant clinical and cadaveric studies confirm that the use of rapid prototyping navigation template assisted cervical screw placement in cervical surgery can reduce screw perforation rate, intraoperative ionizing radiation injury and operation time, which is worth applying in the clinical practice. However, specific clinical effects of different design types of navigation templates are not well summarized. As a result, more clinical and cadaveric studies comparing the accuracy and safety of navigation templates of different design types are needed to help clinicians select the appropriate navigation template for surgery.

Depressant effect of Lithium on apoptosis of nerve cells of adult rats after spinal cord injury / 中国骨伤

<p><b>OBJECTIVE</b>To study whether lithium agent produces neuroprotective effect by inhibiting the nerve cell apoptosis of rats after spinal cord injury.</p><p><b>METHODS</b>Forty-two male SD rats weighing 200 to 250 g were randomly divided into 3 groups: blank control group(=6) without surgery, normal saline(NS) group(=18) with intraperitoneal injection of NS (40 mg/kg); and Lithium chloride (Licl) group (=18) with intraperitoneal injection of Licl (40 mg/kg). After Allen method modeling, Licl group started intraperitoneal injection of Licl solution (40 mg·kg⁻¹·d⁻¹) within 15 min after operation to the second week. NS group, during the same interval, was injected with a same amount of NS. Postoperative 3, 7, 14 d, BBB scores in each group were measured;the expression of Bcl-2 and Bax protein were observed by immunohistochemisty staining;TUNEL staining was used to observe the nerve cell apoptosis.</p><p><b>RESULTS</b>The BBB scores in blank control group were 21. Postoperative 7, 14 d, BBB scores of Licl group were higher than that of NS group(<0.05). As for the Bcl-2 protein expression, black control group has a level of 0.081±0.003;7 d and 14 d postoperatively, the level in Licl group was 0.151±0.003, 0.163±0.003 and in NS group, 0.143±0.003, 0.154±0.002, respectively. Licl group showed significantly increased Bcl-2 protein expression(<0.05). As for the Bax protein expression, black control group showed a level of 0.071±0.003; 7 d and 14 d postoperatively, the level in Licl group was 0.121±0.002, 0.106±0.002 and in NS group was 0.126±0.001, 0.120±0.002, respectively. The Bax protein expression is significantly inhibited in the Licl group(<0.05). In nerve cell apoptosis by TUNEL staining, the positive cells were fewer in the black control group with apoptosis index (AI) of 1.98±0.19;while 7d and 14d postoperatively, the AI of Licl group was 13.12±0.69, 4.29±1.00 and of NS group, 18.26±0.87, 5.48±0.70, respectively. Licl group showed significant inhibition of the cell apoptosis(<0.05).</p><p><b>CONCLUSIONS</b>Licl can promote the Bcl-2 protein expression and inhibit the Bax proteins expression in nerve cells of rat after SCI, thereby playing a role in the inhibition of nerve cell apoptosis. This may be one of the mechanisms that Licl can promote the recovery of motor function of rats after SCI.</p>

CT assisted goat lumbar vertebrae anatomical measurement and comparison with human lumbar vertebrae / 中国骨伤

<p><b>OBJECTIVE</b>To study the anatomical measurement of goat lumbar vertebrae and to compare with human lumbar vertebrae, so as to build the foundation for establishing animal models of lumbar prosthesis.</p><p><b>METHODS</b>The anatomical parameters of the vertebral body, pedicle and intervertebral disc in the fresh lumbar vertebrae of Boer goat and the lumbar vertebrae of healthy adults were collected by computer aided software Mimics16.0, and the anatomical characteristics of the two lumbar vertebrae were compared with the statistical software.</p><p><b>RESULTS</b>The anterior vertebral body height(VBHa) of goat lumbar was less than the middle vertebral body height(VBHm), which was less than the posterior vertebral body height(VBHp), and the maximum values were (38.7±2.9), (40.1±2.6) and (40.7±2.7) mm respectively. Its endplate width was greater than its depth, with the whole shaped like a heart or a kidney. The cranial endplate of goats was convex while the caudal endplate was depressed and the depression was small, with a maximum value of (1.6±0.6) mm. The pedicle height of goats increased from L₁1 to L̀ with the maximum of (30.5±1.9) mm; its pedicle width and angle increased firstly and then decreased with the increase of vertebra level and the minimum values were (6.7±0.4) mm and(45.9±2.6)° respectively. The anterior intervertebral disc height was larger than the middle which was larger than the posterior and all varied slightly with the changes of intervertebral spaces; the height and width of intervertebral foramen separately waved at (12.9±0.3) to (14.3±1.0) mm and (5.7±1.0) to (6.7±0.9) mm. The comparative results showed that the vertebral body height, pedicle height and angle of goats were greater than those of humans (<0.05) while the width and depth of the endplate, the intervertebral disc height, and etc. were significantly smaller than those of humans (<0.05). In addition, some structures, such as the height of pedicle and intervertebral disc, also showed different changing laws with the increase of vertebra level.</p><p><b>CONCLUSIONS</b>Although there are similarities in goat lumbar spine in some aspects, such as endplate and foramen foramen, there are still many differences in many aspects. Understanding the anatomical characteristics of goat lumbar vertebrae and the difference between goat and human is of great guiding significance for the research of goat prosthesis and related technology.</p>

Clinical effects of high frequency repeated transcranial magnetic stimulation therapy on dyskinesia in patients with incomplete spinal cord injury:a Meta-analysis / 中国骨伤

<p><b>OBJECTIVE</b>To systematically evaluate the clinical effect of high frequency repeated transcranial magnetic stimulation(HF rTMS)therapy on dyskinesia in patients with incomplete spinal cord injury.</p><p><b>METHODS</b>Randomized controlled trials(RCTs) about HF rTMS therapy on patients with motor incomplete spinal cord injury were searched electronically in PubMed, Google scholar, Cochrane library, Clinical trial, Medline, Web of science, CNKI, VIP, and Wanfang database before October 2016. Two reviewers independently screened the literatures according to the inclusion and exclusion criteria, as well as extracted the data and assessed the methodological quality. The observed outcomes included ASIA motor score, ASIA lower extremities motor score(LEMS), Modified Ashworth score (MAS), Ten-meter walking test (10MWT) and Walking index for SCI II(WISCI II), and the outcomes were analyzed using RevMan5.2 software provided by the Cochrane information management system.</p><p><b>RESULTS</b>Five RCTs involved 103 patients were included, and 61 patients(experimental group) accepted real rTMS and physical rehabilitation care for SCI, 51 patients(control group) accepted only physical rehabilitation care. There were significant differences in ASIA motor score, LEMS and 10MWT between two groups after HF rTMS therapy (statistics were=2.96,=0.003;=3.04,=0.002;=2.16,=0.03; respectively). When stimulating the leg motor cortex, there was significant difference in MAS between two groups(=2.79,=0.005), and when stimulating the vertex, there was no significant difference(=0.09,=0.93). There was no significant difference in WISCI IIscore after HF rTMS therapy between two groups(=0.90,=0.37).</p><p><b>CONCLUSIONS</b>HF rTMS can raise motor score in patients with incomplete spinal cord injury, improve the spasticity of the lower extremities, and increase the motor ability.</p>

Validity study of Coda Motion Analysis System for measuring cervical lateral flexion in normal adults / 中国骨伤

OBJECTIVE@#To investigate the validity of Coda Motion Analysis System for measuring cervical lateral flexion in normal adults in order to explore a new measuring tool for clinical and research practice.@*METHODS@#A total of 43 participants were involved in the study. Cervical range of lateral flexion were measured with Coda Motion Analysis System and "gold standard" X-ray simultaneously. The validity and agreement were assessed using the scatter diagram, the Pearson correlation coefficient and limits of agreement.@*RESULTS@#Cervical range of lateral flexion measured by Coda Motion Analysis System had no statistical differences with those measured by X-ray(>0.05). The Coda Motion Analysis System demonstrated a very good linear relation with the X-ray measurements in cervical range of right lateral flexion, left flexion and total lateral flexion, and the Pearson correlation coefficients were 0.72, 0.85 and 0.90 respectively.@*CONCLUSIONS@#Coda Motion Analysis System showed good validity for measuring cervical lateral flexion in normal adults. Because the reliability of Coda Motion Analysis System was established previously, the results of this study suggest that the system has the potential to be used to measure cervical lateral flexion in clinical and research practice.

Meta analysis of clinical effects between intramedullary nail and volar plate internal fixation for distal radius fractures / 中国骨伤

<p><b>OBJECTIVE</b>To evaluate curative effects of intramedullary nail and volar plate internal fixation for distal radius fractures.</p><p><b>METHODS</b>The studies concerning about randomized controlled trial of intramedullary nail and volar plate internal fixation for distal radius fractures from create database to May, 2016 were searched from PubMed, Cochrane Library, Web of Science, CNKI, Wan Fang data and VIP. Information was screen and taken out according to inclusion and exclusion criteria, quality of literature was evaluated according to Cochrane Handbook evaluating system. Meta analysis was performed by RevMan 5.2 software. Postoperative grip strength, clinical effects(results of flexion and extension, pronation, supination, deflection of ulnar and radialis) , imaging evaluation (ulnar variance, radial height, volar tilting angle and radial inclination) and the incidence of postoperative complications were analyzed.</p><p><b>RESULTS</b>Totally 6 RCT including 370 patients were chosen. According to the Meta analysis, there were no statistical differences in extension[MD=5.63, 95%CI(-7.01, 18.27),=0.38], flexion[MD=3.10, 95%CI(-0.67, 6.86),=0.11], pronation[MD=2.58, 95%CI(-0.49, 5.65),=0.10], supination[MD=0.82, 95%CI(-1.89, 3.54),=0.55], radial deviation[MD=-5.16, 95%CI(-14.42, 4.11),=0.28], ulnar deviation[MD=0.19, 95%CI(-2.39, 2.77),=0.88], ulnar variance[MD=-0.01, 95%CI(-0.43, 0.42),=0.97], ulnar inclination[MD=-0.31, 95%CI(-1.37, 0.73),=0.56], radial height[MD=-0.27, 95%CI(-0.98, 0.44),=0.45], radial inclination[MD=0.29, 95%CI(-0.41, 0.99),=0.42] and the incidence of postoperative complications[RR=0.71, 95%CI(0.46, 1.09),=0.12] between intramedullary nail and volar plate internal fixation.</p><p><b>CONCLUSIONS</b>Compared with volar plate internal fixation, intramedullary nail has the same effect in grip strength, clinical effect, but could not reduce the occurrence of postoperative complications. However, a large number of prospective randomized controlled study should be carried out to prove clinical effect of intramedullary nail for distal radius fractures.</p>