S1 posterior edge inlet view for placement of percutaneous sacroiliac screws / 中华创伤骨科杂志

Objective:To evaluate the significance of S1 posterior edge inlet view for placement of percutaneous sacroiliac screws.Methods:1. CT data of the pelvis were collected from 134 normal adults and introduced into Mimics Medical 21.0 system. Anatomical parameters of sacral vertebrae were measured and analyzed to observe the anatomical disparities between the anterior and posterior edges of S1 vertebral body. A mathematical model was established using the data acquired. 2. Manual placement of sacroiliac screws was performed using a conventional S1 posterior edge inlet view on the pelvic specimens from 5 adult cadavers in simulation of actual surgical situations. After placement, the inlet views from both the S1 anterior and posterior edges were taken to observe the imaging differences and to check if the screws had pierced the sacral canal. 3. A retrospective study was conducted of the 11 patients with posterior pelvic ring fracture who had been treated at Department of Orthopaedics, Tongji Hospital from January 2019 to October 2020. Their fractures were fixated by percutaneous sacroiliac screws under the guidance of a C-arm X-ray machine. The manual placement of the screws was guided intraoperatively by the inlet views from both the S1 anterior and posterior edges to secure a safe placement. Pelvic CT examinations were performed to check any screw dislocation.Results:1. CT measurements in the normal adults showed that the angle of S1 anterior edge inlet view (20.71°±11.89°) was smaller than that of S1 posterior edge inlet view (41.99°±11.67°) and the width of S1 upper end plate [(32.22±3.41) mm] greater than that of S1 lower end plate [(20.10±3.28) mm], showing significant disparities in anatomy between the anterior and posterior edges of S1 vertebral body ( P<0.05). 2. In 2 of the 5 cadaveric specimens, imaging differences were observed between the inlet views of the anterior and posterior edges of S1 and the screws pierced out of the sacral canal. 3. Satisfactory closed reduction was achieved in all the 11 patients. A total of 17 screws were placed, with 12 ones into S1 and 5 ones into S2. Operation time ranged from 84 to 141 min (average, 114.4 min), fluoroscopy frequency from 69 to 101 times (average, 89.6 times), and intraoperative blood loss from 110 to 463 mL(average, 296.6 mL). No screw dislocation was observed on postoperative CT. Conclusion:As there is a difference between the inlet views of the anterior and posterior edges of S1 vertebral body, the inlet view of the posterior edge of S1 can display the posterior edge of S1 more clearly so as to improve the safety of placement of percutaneous sacroiliac screws.

Matrine suppresses stemness of hepatocellular carcinoma cells by regulating β-catenin signaling pathway / 南方医科大学学报

OBJECTIVE@#To explore the effects of matrine on the proliferation, tumor cell stemness, β-catenin transcriptional activity and AKT/GSK3β/β-catenin signaling pathway in human hepatocellular carcinoma (HCC) HepG2 and Huh7 cells.@*METHODS@#The proliferation and colony formation ability of HepG2 and Huh7 cells treated with 200, 400, and 800 μg/mL matrine were evaluated with MTT assay and colony formation assay, respectively. Real-time quantitative PCR was performed to detect the mRNA expressions of CD90, epithelial cell adhesion molecule (EpCAM) and CD133, and dual-luciferase assay was used to detect the transcriptional activity of β-catenin in the treated cells. The effects of matrine on the expressions of protein kinase B (AKT), P-AKT, GSK-3β, P-GSK-3β, P-β-catenin and β-catenin proteins in the Wnt/β-catenin signaling pathway were assessed using Western blotting.@*RESULTS@#Matrine inhibited the proliferation of the two HCC cell lines in a time- and concentration-dependent manner. The half-inhibitory concentrations of matrine were 2369, 1565 and 909.1 μg/mL at 24, 48 and 72 h in HepG2 cells, respectively, and were 1355, 781.8, and 612.8 μg/mL in Huh7 cells, respectively. Matrine concentrationdependently suppressed colony formation of the HCC cells, producing significant inhibitory effects at 400 μg/mL < 0.01) and 800 μg/mL < 0.001) in HepG2 cells and at 200 μg/mL < 0.05), 400 μg/mL < 0.01), and 800 μg/mL < 0.001) in Huh7 cells. Matrine at 400 and 800 μg/mL significantly inhibited the mRNA expression of CD90, EpCAM and CD133 and the transcriptional level of β-catenin in both HepG2 and Huh7 cells < 0.05 or 0.01). Matrine at 400 and 800 μg/mL also significantly decreased the protein levels of β-catenin, P-AKT and P-GSK-3β and increased the phosphorylation level of β-catenin in both of the cell lines.@*CONCLUSIONS@#Matrine inhibits the proliferation, colony formation, and the expressions of tumor stem cell markers CD90, EpCAM and CD133 in both HepG2 and Huh7 cells probably by inhibiting Wnt/β-catenin signaling pathway and the transcriptional activity ofβ-catenin.

Application of the cortical bone packing in external auditory bony canal and attic reconstruction in tympanoplasty with mastoid obliteration / 中国耳鼻咽喉头颈外科

OBJECTIVE To explore the application value of the cortical bone packing in external auditory bony canal and attic reconstruction in tympanoplasty.METHODS A total of 30 patients admitted during the period of middle ear cholesteatoma patients in our hospital from March 2014 to March 2016,were randomly divided to observation group and control group,the radical mastoidectomy with canal wall down was adopted in the control group,the radical mastoidectomy with canal wall down combined with bone autograft in the external auditory meatus and bony powder mastoid obliteration in observation group,the postoperative out-come between two groups were compared.RESULTS There was no significant difference between the speech frequency average air bone conduction and air conduction threshold before the treatment in two groups.There was significant difference between the speech frequency average air bone conduction and air conduction threshold after the treatment(P＜0.05),the air conduction threshold significantly reduced,the patients in the observation group were significantly lower than the control group,there was no recurrence of cholesteatoma in two groups of patients before and after the treatment during follow-up period;the dry ear time in observation group was significantly lower than that of the control group,and dry ear the incidence was significantly higher than that of the control group,the difference is statistically significant(t=2.758,4.865,P＜0.05).CONCLUSION Radical mastoidectomy with canal wall down combined with the cortical bone packing in external auditory bony canal and attic reconstruction,can effectively presesre the patient hearing,it should be recommended.

Determination of serum carbamazepine concentration and metabonomic analysis in rats / 南方医科大学学报

<p><b>OBJECTIVE</b>To study the effects of carbamazepine on serum metabolic profiles in rats using nuclear magnetic resonance (NMR) spectroscopy.</p><p><b>METHODS</b>Twenty-four healthy male Wistar rats were randomized into 4 groups (n=6) for daily intragastric administration of high-, medium- or low-dose carbamazepine or distilled water (control) for 7 days. Blood samples were collected from the abdominal aortic under anesthesia after the treatment to determine serum carbamazepine concentration using high-performance liquid chromatography. ¹H nuclear magnetic resonance (¹H NMR) spectra were acquired for pattern recognition analysis. Histopathological changes of the renal and liver tissues of the rats were also examined.</p><p><b>RESULTS</b>Steady-state blood concentration of carbamazepine in high-, medium- and low-dose groups were 14.64 ± 1.41, 8.54 ± 1.19, and 4.56 ± 0.64 µg/ml, respectively. Slight liver swelling was found in high-dose group, but none of the groups showed renal pathologies. Compared with the control group, the high-dose carbamazepine group showed lowered serum concentrations of 1,3-diaminopropane, deoxycorticosterone, 7-dehydrocholesterol, betaine, beta-alanine, L-cystathionine, 4-methyl-2-oxovaleric acid, and creatine with increased levels of saccharides, lactate, succinic acid, acetyl phosphate, and adipic acid. Principal component analysis revealed significant differences of the metabolites between carbamazepine-treated groups and the control group. The metabolic profiles showed no differences in the kinds of metabolites although the concentrations of the metabolites varied between the carbamazepine groups.</p><p><b>CONCLUSIONS</b>Carbamazepine significantly affects metabolism in normal rats. This finding provides evidence for clinical drug monitoring and drug safety of carbamazepine. NMR technique has important values for pharmacodynamic and toxicological evaluation of drugs.</p>

Half circle external fixation for the treatment of open tibial fibular fractures / 中国骨伤

<p><b>OBJECTIVE</b>To explore the effect of half circle external fixation for the treatment of open tibial fractures.</p><p><b>METHODS</b>From March 2005 to March 2011, 94 patients with open tibiofibula fractures were treated by closed manipulative or Kirschner-wire poking reduction with half circle groove external fixation including 63 males and 31 females with an average age of 39 years old ranging from 17 to 65 years old. Among these patients, 5 cases were cross shaped fractures, 19 were oblique form and spiral fractures, 70 cases were comminuted fractures. According to the fracture Gustilo classification, 49 cases were type IIIA, 45 were type IIIB. The incidence of wound infection, fracture healing time were observed. The function was evaluated according to the Johner-Wruhs standard.</p><p><b>RESULTS</b>All patients were followed up for 14 to 63 months (averaged 29 months). The wound healing time was from 16 to 39 weeks (means 21.4 weeks). No fracture nonunion, osteomyelitis and calf compartment syndrome occurred. The wounds of 81 cases were healed at the first period,deep wound infection occurred in 2 cases. According to the function Johner-Wruhs evaluation criteria:the result was excellent in 52 cases, good in 37 cases, fair in 5 cases.</p><p><b>CONCLUSION</b>Closed manipulative or Kirschner-wire poking reduction and half circle groove external fixation can reduce the infection rate of open tibiofibula fractures. For open tibiofibula comminuted fractures, after the half circle groove external fixation for 3 to 6 weeks, a middle Kirschner-wire was removed according to fracture end healing situation to make fixation dynamic and promote fracture healing.</p>

On the right side of the amygdala salivary glands ectopic case report / 临床耳鼻咽喉头颈外科杂志

The patient complained of recurrent sore throat for 2 years, who was diagnosed parapharyngeal abscess or tonsillitis for four times during June 16, 2012 to April 16, 2013. Special physical examination: left or right lateral pharyngeal wall is slightly elevated. Routine blood test showed increasing white blood cells and neutrophils. Oropharyngeal CT showed right lateral pharyngeal wall swelling and abscess formation? Repeated puncture showed no obvious purulent secretions. Symptoms were improved after anti-inflammatory treatment, but it recurrently happened later. Bilateral tonsillectomy was performed under general anesthesia on April 29, 2013. Pathological report (May 6, 2013) showed: (left) chronic tonsillitis with lymphoid hyperplasia; chronic inflammation in (right) tonsil tissue, and salivary gland tissue is also observed, considering as the hyperplasia of ectopic salivary gland tissue and interstitial lymphocytic oinfiltration.

Clinical observation on treatment of allergic rhinitis using endoscopic more nasal structures orthopedic surgery combined with steroid nasal spray / 中国医师进修杂志

Objective To expore the clinical therapeutic effect of allergic rhinitis using endoscopic more nasal structures orthopedic surgery combined with steroid nasal spray. Methods Sixty allergic rhinitis patients accompanied by deviation of nasal septum, middle turbinate lesions, or/and inferior turbinate lesions, were divided into two groups: observation group with 30 cases, applying endoscopic more nasal structures orthopedic surgery combined with steroid nasal spray (mometasone furoate nasal spray) during perioperative period; control group with 30 patients, only applying steroid nasal spray (mometasone furoate nasal spray). Long-term effect was compared between two groups. Results Sixty cases were followed up for 1 year. The total effective rate was 90.0%(27/30) in observation group,22 cases of significant effect, 36.7% (11/30) in control group,3 cases of significant effect. The total effective rate had significant difference between two groups (P＜0.01). Conclusion Using endoscopic more nasal structures orthopedic surgery combined with steroid nasal spray (mometasone furoate nasal spray) to treat allergic rhinitis has good long-term effect.

Primary malignant bone neoplasm: a case report of dedifferentiated chondrosarcoma in the rib and review of the literature / 癌症

Dedifferentiated chondrosarcoma (DDCS) is a rare but highly malignant primary bone neoplasm, which is resistant to radiotherapy and chemotherapy. There remains uncertainly as to the best treatment of this disease and how to improve its prognosis. In this paper we reported a case of DDCS and reviewed the related literatures in order to provide references to throw a light on the histogenesis, diagnosis and therapy of this disease.

High-performance capillary electrophoresis for determining caffeic acid content in compound Yinhuangjiedu decoction / 南方医科大学学报

<p><b>OBJECTIVE</b>To establish a method for determining the content of caffeic acid in compound Yinhuangjiedu decoction using high-performance capillary electrophoresis (HPCE).</p><p><b>METHODS</b>The optimized HPCE for determining caffeic acid content utilized a fused-silica capillary tube (75 microm x 60 cm, effective length of 53 cm) with 20 mmol/L borate as the running buffer (pH=9.18), a constant voltage of 12 kV, a sampling time of 5 s at 25 degrees celsius, and UV detection wavelength at 313 nm.</p><p><b>RESULTS</b>The linear range of caffeic acid was 20-100 microg/ml.</p><p><b>CONCLUSION</b>HPCE is simple, rapid, and sensitive for quality control of the compound Yinhuangjiedu decoction.</p>

Pharmacokinetic study of polydatin in Beagle dogs / 南方医科大学学报

<p><b>OBJECTIVE</b>To establish a method for detecting plasma polydatin using high-performance liquid chromatography (HPLC) and investigate the pharmacokinetics of polydatin in Beagle dogs.</p><p><b>METHODS</b>HPLC-based detection of polydatin was performed on a Hypersil-BDS C18 column with a mobile phase of methanol and water (35:65) at the flow rate of 1.0 ml/min and the detection wavelength of 290 nm. The pharmacokinetic parameters of polydatin were calculated by non-compartment model statistics.</p><p><b>RESULTS</b>The standard curve was linear within the range of 0.21-21.0 microg/ml (correlation coefficient of 0.9995, n=5). The average recovery was 90% with a relative standard deviation no more than 8.0%. The limit of detection of the method was 0.1 microg/ml. The pharmacokinetic parameters of polydatin at 3 doses were obtained, with T((1/2)); of 89.95-/+19.96 min, 152.15-/+55.82 min, and 202.36-/+66.75 min, and AUC0-infinity of 300.14-/+51.33 g.min.ml(-1), 751.72-/+173.97 g.min.ml(-1) and 1521.12-/+310.02 microg.min.ml(-1), respectively.</p><p><b>CONCLUSION</b>The method we established allows effective detection of polydatin, whose pharmacokinetics conforms to the two-compartment model.</p>

Pathological and ultramicrostructural changes of tissues in a patient with severe acute respiratory syndrome / 中华病理学杂志

<p><b>OBJECTIVE</b>To study the morphological, ultramicrostructural and pathological changes of tissues from a patient with severe acute respiratory syndrome (SARS).</p><p><b>METHODS</b>One autopsy case of diagnosed SARS was investigated. Lung puncture was performed immediately after the patient died, and the autopsy was done after 12 h. The specimens from lymph nodes, spleen, small intestine, colon and bone marrow were studied by immunohistochemical technique. The antibodies used included CD20, CD45RO (UCHL-1), CD4, CD8, CD68 and CD34.</p><p><b>RESULTS</b>The principal lesions of the SARS case consisted of acute lobular intrastitial pneumonia, hyaloid membranes of pulmonic alveoli and hyperplasia and shedding of alveolar epithelium of. Virus-like inclusions occasionally contained cytoplasm of the alveolar epithelium, which were positive by histochemical staining. The adjacent blood-vessels were changed by hyperplasia and enlargement. The structures of lymph nodes and spleen were damaged with lymph follicles depletion and splenic nodules atrophy. The specific changes included reduction of lymphocytes and hyperplasia of histiocytes, depletion of the follicles of small intestine and colon wall, decreased hyperplasia of the bone marrow and increased number of the megakaryocyte. Meanwhile, in the immunohistochemical study, CD(20)(+) B cells were fully expressed in lymph nodes and spleen, and the CD45RO (UCHL-1)(+) T cells were scatteredly expressed. The number of CD4(+) help T cell was markedly decreased, while the number of CD8+ poisonal T cells increased, and the ratio of the former and latter was no more than 0.5. Under the electronic microscopy observation, virus-like particles with 80 - 160 nm diameter and halo or garland envelope were found in mononuclear macrophage and cytoplasm of alveolar epithelium.</p><p><b>CONCLUSION</b>The specific lesions of SARS consist of lobular intrastitial pneumonia with the formation of hyaline membranes of lung, haemorrhage, necrosis, inflammation of blood vessels and the damages of extralung lymphohemopioetic system. The damages were very similar to the pathological features of tissues infected by human immunodeficiency virus, in which numbers of T cells decreased and CD(4)(+) T cell/CD(8)(+) T cell ratio was no more than 0.5. According to the virus-like particles found in lung of the SARS case, it is considered that these virus-like particles may be a new kind of coronavirus which caused the "atypical pneumonia".</p>