Effect of morphological changes in the sagittal plane of vertebrae and discs on degenerative kyphodeformity / 中国骨伤

OBJECTIVE@#To explore the effects of morphological changes such as vertebral wedge deformation and disc degeneration (collapse) on adult thoracolumbar/lumbar degenerative kyphosis(TL/LDK) deformity.@*METHODS@#A retrospective analysis of 32 patients with spinal TL/LDK deformity admitted from August 2015 to December 2020, including 8 males and 24 females, aged 48 to 75(60.3±12.4) years old. On the long-cassette standing upright lateral radiographs, the coronal Cobb angle, sagittal thoracic lumbar/lumbar kyphosis angle(KA) of spine were measured, and the height and wedge parameters of apex vertebral(AV) and two vertebrae(AV-1, AV-2, AV+1, AV+2) above and below AV and the intervertebrae and the intervertebral disc(AV-1D, AV-2D, AV+1D, AV+2D) were evaluated, involving anterior vertebral body height(AVH), posterior vertebral body height(PVH), vertebral wedge angle(VWA), ratio of vertebral wedging(RVW), anterior disc height(ADH), posterior disc height(PDH), disc wedge angle(DWA), ratio of disc wedging(RDW), and DWA/KA.@*RESULTS@#The average angle of kyphosis was (44.2±19.1)°. A significant decrease in anterior height of vertebral was observed compared to the posterior height of vertebral(P<0.005). There was no significant difference in anterior and posterior height of discs. The vertebral wedging ratio/contribution ratio:AV-2(14.98±10.95)%/(14.21±8.08)%, AV-1(21.08±12.39)%/(18.09±7.38)%, AV(26.94±11.94)%/(25.52±8.64)%, AV+1(24.19±8.42)%/(20.82±8.69)%, AV+2(20.56±7.80)%/(15.60±9.71)%, total contribution(94.23±22.25)%, the disc wedging ratio/contribution ratio:AV-2D(2.88±2.57)%/(5.27±4.11)%, AV-1D(1.98±1.41)%/(2.29±2.16)%, AV+1D(-5.54±3.75)%/(-0.57±0.46)%, AV+2D(-8.27±4.62)%/(-1.22±1.11)%, total contribution (5.77±4.79)%. And the contribution rate of AV was significantly higher than that of adjacent vertebral(P<0.05).@*CONCLUSION@#The vertebral body and intervertebral disc shape both have influence on thoracolumbar kyphosis. However, the contribution of vertebral morphometry to the angle of TL/LDK deformity is relatively more important than the disc. The contribution of the wedge change of the AV to the TL/LDK deformity is particularly significant.

Yixin Ningshen Tablet Alleviates Comorbidity of Myocardial Infarction and Depression by Enhancing Myocardial Energy Metabolism and Increasing Availability of Monoamine Neurotransmitter / 中国结合医学杂志

OBJECTIVE@#To investigate the therapeutic effect of Yixin Ningshen Tablet (YXNS) on comorbidity of myocardial infarction (MI) and depression in rats and explore the underlying mechanism.@*METHODS@#The Sprague-Dawley rats were randomly divided into 5 groups with 7 rats in each group according to their weights, including control, model, fluoxetine (FLXT, 10 mg/kg), low-dose YXNS (LYXNS, 100 mg/kg), and high-dose YXNS (HYXNS, 300 mg/kg) groups. All rats were pretreated with corresponding drugs for 12 weeks. The rat model of MI and depression was constructed by ligation of left anterior descending coronary artery and chronic mild stress stimulation. The echocardiography, sucrose preference test, open field test, and forced swim test were performed. Myocardial infarction (MI) area and myocardial apoptosis was also detected. Serum levels of interleukin (IL)-6, IL-1β, tumor necrosis factor-α (TNF-α), 5-hydroxytryptamine (5-HT), adrenocorticotrophic hormone (ACTH), corticosterone (CORT), and norepinephrine (NE) were determined by enzyme linked immunosorbent assay. The proteins of adenosine 5'-monophosphate -activated protein kinase (AMPK), p-AMPK, peroxisome proliferator-activated receptor gamma coactivator-1α (PGC-1α), and nuclear respiratory factor 1 (NRF1) in heart were detected by Western blot analysis. The expression levels of TNF-α, IL-6, indoleamine 2,3-dioxygenase (IDO1), kynurenine 3-monooxygenase (KMO), and kynureninase (KYNU) in hippocampus were detected by real-time quantitative polymerase chain reaction.@*RESULTS@#Compared with the model group, the cardiac function of rats treated with YXNS improved significantly (P<0.01). Meanwhile, YXNS effectively reduced MI size and cardiomyocytes apoptosis of rats (P<0.01 or P<0.05), promoted AMPK phosphorylation, and increased PGC-1α protein expression (P<0.01 or P<0.05). HYXNS significantly increased locomotor activity of rats, decreased the levels of TNF-α, IL-6 and IL-1β, and increased the serum levels of 5-HT, NE, ACTH, and CORT (all P<0.05). Moreover, HYXNS decreased the mRNA expressions of IDO1, KMO and KYNU (P<0.05).@*CONCLUSIONS@#YXNS can relieve MI by enhancing myocardial energy metabolism. Meanwhile, YXNS can alleviate depression by resisting inflammation and increasing availability of monoamine neurotransmitters. It may be used as a potential drug to treat comorbidity of MI and depression.

Quantifying peripapillary vessel density in type 2 diabetic patients without clinically detectable retinopathy using OCTA / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To quantify changes in peripapillary vessel density in patients with type 2 diabetic mellitus(DM)without clinical features of diabetic retinopathy(DR)by OCT angiography(OCTA). <p>METHODS:A retrospective clinical study. From January to December 2019, 38 type 2 DM patients without DR(38 eyes, NDR group)and 30 normal subjects(30 eyes, control group)in Eye Hospital of Wenzhou Medical University at Hangzhou were included in the study. The optic nerve head was scanned by OCTA with HD 4.5mm×4.5mm imaging scanning mode for all subjects.The software automatically divides the peripapillary region into 8 sectors, designated as nasal superior(NS), nasal inferior(NI), inferior nasal(IN), inferior tempo(IT), tempo inferior(TI), tempo superior(TS), superior tempo(ST)and superior nasal(SN). Radial peripapillary capillaries vessel density(ppVD)and peripapillary retinal nerve fiber layer(pRNFL)thickness of entire peripapillary area and each sector were measured. The discrepancy of ppVD and pRNFL thickness between the two groups was also analyzed. Pearson correlation analysis was used to analyze the correlation between ppVD and pRNFL in each quadrant of NDR group. <p>RESULTS:The mean ppVD value and NS,NI,IN,IT,TI,TS,ST and SN sector values were all significantly lower in NDR group compared to normal controls(all <i>P</i><0.05). The mean and each sector pRNFL thickness was reduced in NDR group compared with the control group, but the difference was not statistically significant(all <i>P</i>>0.05). Pearson correlation analysis showed that the significant positive correlation was found between ppVD and pRNFL thickness in TI, TS, SN, NS and NI sector(<i>r</i>=0.578, 0.427, 0.577, 0.397, 0.317; all <i>P</i><0.05). <p>CONCLUSION: Peripapillary vessel density has decreased in eyes of patients with type 2 DM before clinically detectable retinopathy and OCTA is helpful for early monitoring.

Correlation of mean platelet volume with diabetic macular edema in type 2 diabetic patients / 眼科新进展

Objective To investigate the relationship between mean platelet volume (MPV) and diabetic macular edema (DME) in type 2 diabetic patients.Methods The study included 4 patient groups:40 healthy control as group 1,40 diabetic patients without diabetic retinopathy(DR) as group 2,40 DR patients without DME as group 3,and 40 DR patients with DME as group 4.Then the collection of general information,fundus photograph and OCT were conducted for the measurement and comparison of serum levels of platelet parameters including platelet count (PLT),MPV,platelet distribution width (PDW) and plateletcrit (PCT).Results Significant differences were found in MPV and PDW among the four groups (all P ＜ 0.05),but there was no significant difference in PLT and PCT levels (all P ＜ 0.05).Furthermore,MPV and PDW level was (11.07 ± 1.06)fL and (13.57 ±2.25)fL in group 3,as well as (11.27 ±0.85)fL and (13.89 ± 1.76)fL in group 4,respectively,which were both significantly higher than those in group 1 [(10.41 ±0.63)fL and (11.93 ± 1.22)fL] as well as in group 2 [(10.38 ± 0.51) fL and (12.33 ± 1.28) fL] (all P ＜ 0.05).Both MPV and PDW levels of group 4 were higher than those of group 3,but there was no significant difference (P =0.254,0.388).As for males,MPV level was increased gradually in group 2 [(10.29 ±0.58)fL],group 3 [(10.67 ± 1.08)fL] and group 4 [(11.42 ±0.90) fL] (all P＜0.05),but there was no significant difference between group 1 [(10.27 ± 0.55)fL] and group 2.For females,MPV level was (11.37 ± 0.69) fL in group 3 and (11.13 ± 0.79) fL in group 4,both which were significantly higher than that in group 1 [(10.55 ± 0.70) fL] and group 2 [(10.42 ± 0.49) fL],respectively (all P ＜ 0.05),but there was no significant difference between group 3 and group 4 (P ＞ 0.05).Conclusion High MPV level may be an important risk factor for the development of DME in DR patients.Platelet parameter surveillance can aid in the monitoring of this disease.

Characteristics of near-infrared fundus autofluorescence at the leakage site in acute central serous chorioretinopathy / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To investigate the characteristics of near-infrared fundus autofluorescence(NIR-FAF)at the leakage site in acute central serous chorioretinopathy(CSC). <p>METHODS: Twenty-five eyes of the 25 patients diagnosed with acute CSC(mean age 44.52±6.17 years)were included in this retrospective study. Fundus fluorescein angiography and NIR-FAF imaging were performed using a confocal scanning laser ophthalmoscope. The imaging features of NIR-FAF at the leakage site were analyzed. <p>RESULTS: There were four patterns of NIR-FAF at the leakage site in acute CSC eyes: no NIR-FAF abnormal changes, hypoautofluorescence(hypo-AF), mottled autofluorescence(AF)and hyperautofluorescence(hyper-AF). Only 1 eye(4%)among 25 eyes of NIR-FAF imaging at the leakage site had no obvious abnormalities, while other 24 eyes(96%)had abnormal changes. Among them, 7 eyes had dot-like hypo-AF, 10 eyes had expanded hypo-AF, 5 eyes had expanded mottled AF and the remaining 2 eyes had expanded hyper-AF. All eyes had abnormal NIR-FAF corresponding to the area of the serous retinal detachment, including 17 eyes with hypo-AF and 8 eyes with mottled AF. <p>CONCLUSION: There are characteristic NIR-FAF changes at the leakage sites of acute CSC eyes. NIR-FAF photography can be used as a fast, effective and non-invasive method for the early detection of RPE abnormality in acute CSC.

Muscles reposition in correction of nasal deformity after unilateral cleft lip / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate the effective method for correction of nasal deformity after unilateral cleft lip.</p><p><b>METHODS</b>50 cases with secondary nasal deformity after unilateral cleft lip were retrospectively analyzed. All the patients underwent nasal and lip muscle reposition operation to restore the symmetry of nasal alar.</p><p><b>RESULTS</b>The nasal deformity was greatly improved in all the 50 cases. The malposition of nasal column and nasal alar was corrected. The symmetry was markedly improved. The measurement before and after operation showed significant difference ( P<0.05).</p><p><b>CONCLUSIONS</b>The reasons of secondary nasal deformity after unilateral cleft lip are complicated. The muscle reposition operation can effectively improve the deformity.</p>

A new modified forked flap and a reverse V shaped flap for secondary correction of bilateral cleft lip nasal deformities / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The columella, nasal tip, lip relationship in the bilateral cleft lip nasal deformity remains a great challenge for plastic surgeon. An esthetically satisfying result is difficult to obtain. A subset of patients with bilateral cleft lip nasal deformity still require columellar lengthening and nasal correction and philtrial construction. This study aimed to provide a new method based on the forked flap to improve the final appearance of these patients.</p><p><b>METHODS</b>A technique to correct this deformity is described. This consists of (1) a newly modified forked flap including the orbicularis oris muscle and nasalis muscle along the whole flap for columellar lengthening, (2) a reverse V shaped flap from the lower portion of the columella and the prolabium for normal size phitrum construction, (3) inserting the vermilion portion of the forked flap and advancing the nasal floor medially and anteriorly to lengthen and maintain the nasal septum side of the columella for proper tip positioning, (4) open rhinoplasty, allowing definitive repositioning of the lower lateral cartilages, (5) reconstruction of the orbicularis orismuscle as required, and (6) the flaring nostril floor advancing medially and constructing the sill.</p><p><b>RESULTS</b>This technique was applied to 15 cases of secondary bilateral cleft lip nasal deformity. All the flaps took without signs of partial necrosis. In all cases, the nasal tip was projected forward with adequate columella elongation, and the height of the prolabium was added with normal size philtrial dimensions.</p><p><b>CONCLUSIONS</b>This method makes maximum use of the tissue containing the scar in the lip and limits tissues in the lower portion of the columella and the prolabium for adequate columella elongation and reconstruction with normal size philtrial dimensions. It is a very reasonable and useful method in correction of secondary bilateral cleft lip nasal deformities.</p>

Correction of secondary deformity of unilateral cleft lip with refined anatomic repair in orbicularis oris muscle / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate the functional repair of secondary deformity of unilateral cleft lip.</p><p><b>METHODS</b>The nasal branch, nasolabial branch, and labial branch of orbicularis oris muscle were dissected and repositioned precisely to correct the secondary deformity of unilateral cleft lip.</p><p><b>RESULTS</b>96 patients were treated successfully with this method during Jan. 2005 to Oct. 2008. Good cosmetic and functional results were achieved. 85 cases were followed up for 3 months to 5 years with a satisfactory rate of 94.1% (80/85 cases).</p><p><b>CONCLUSIONS</b>The application of refined anatomy and precise reposition in orbicularis oris muscle is important to ensure therapeutic effect in patients with secondary deformity of unilateral cleft lip.</p>

Full face dermabrasion for acne scars / 中华整形外科杂志

<p><b>OBJECTIVE</b>Dermabrasion has been of great value in plastic surgery. Dermabrasion was developed for a specific indication; however, within a very short time, the concept of dermabrasion found wide applicability. This study was to investigate the application of dermabrasion in the treatment of acne scars.</p><p><b>METHODS</b>From Feb. 1996 to May 2004, a total of 110 patients with acne scar were treated with dermabrasion.</p><p><b>RESULTS</b>Postoperatively, the curative results were achieved in 45 cases; good results in 40 cases and effective results in 25 cases. The study revealed that the patients at 18-46 years of age have good results.</p><p><b>CONCLUSIONS</b>Dermabrasion is a good and safe technique to treat the scar of acne.</p>

Cleft lip nasal deformity corrected by an alar flap and the alar cartilage sling method / 中国医学科学院学报

<p><b>OBJECTIVE</b>To search an effective method to correct the secondary nasal deformity.</p><p><b>METHODS</b>The "spilth" tissue asymmetry to the another side on the cleft side alar is formed as a flap, which is used to drive up or reconstruct the nostril base (sill), readjust nostril size and shape. The cleft side alar cartilage lateral foot is disassociated, replaced and fixed into the normal place.</p><p><b>RESULTS</b>Nineteen patients were received this operation, their nasal alar, nostril, sill, on the two sides are symmetry, and the result is good.</p><p><b>CONCLUSIONS</b>The cleft side alar flap and alar cartilage sling procedure is effective to correct secondary cleft lip nasal deformity.</p>