Comparison of clinical outcomes and complications between endoscopic and minimally invasive transforaminal lumbar interbody fusion for lumbar degenerative diseases: a systematic review and meta-analysis.

OBJECTIVE: This study compares the efficacy and complications of endoscopic transforaminal lumbar fusion (Endo-TLIF) and minimally invasive transforaminal lumbar fusion (MIS-TLIF) in treating lumbar degenerative diseases. It aims to provide reference data for clinical decision-making. METHODS: We identified randomized controlled studies and non-randomized controlled studies on Endo-TLIF and MIS-TLIF for treating lumbar degenerative diseases based on specific inclusion and exclusion criteria. Data were managed with Endnote X9 software and meta-analyzed using Revman 5.3 software. Extracted outcomes included lower back VAS score, lower extremity pain VAS score, low back pain ODI score, complication rate, fusion rate, time to surgery, blood loss, and length of hospital stay. RESULTS: ① Thirteen high-quality studies were included in this meta-analysis, totaling 1015 patients-493 in the Endo-TLIF group and 522 in the MIS-TLIF group. ② Meta-analysis results revealed no significant differences in preoperative, postoperative 6-month, and final follow-up waist VAS scores, lower limb pain VAS score, ODI index, complications, and fusion rate between the two groups (P > 0.05). The MIS-TLIF group had a shorter operative time (MD = 29.13, 95% CI 10.86, 47.39, P = 0.002) than the Endo-TLIF group. However, the Endo-TLIF group had less blood loss (MD = - 76.75, 95% CI - 111.59, - 41.90, P < 0.0001), a shorter hospital stay (MD = - 2.15, 95% CI - 2.95, - 1.34, P < 0.00001), and lower lumbar VAS scores both immediately postoperative (≤ 2 week) (MD = - 1.12, 95% CI - 1.53, - 0.71, P < 0.00001) compared to the MIS-TLIF group. CONCLUSION: Meta-analysis results indicated that Endo-TLIF is similar to MIS-TLIF in terms of long-term clinical outcomes, fusion rates, and complication rates. Although MIS-TLIF has a shorter operation time, Endo-TLIF can significantly reduce blood loss and hospital stay duration. Endo-TLIF offers the advantages of less surgical trauma, reduced blood loss, faster recovery, and early alleviation of postoperative back pain.

Construction of TRAF6 ubiquitin site 331 mutant colorectal cancer cell stable line and its effect on biological behavior of colorectal cancer cells / 中华肿瘤杂志

Objective: To investigate the effect of ubiquitin mutation at position 331 of tumor necrosis factor receptor related factor 6 (TRAF6) on the biological characteristics of colorectal cancer cells and its mechanism. Methods: lentivirus wild type (pCDH-3×FLAG-TRAF6) and mutation (pCDH-3×FLAG-TRAF6-331mut) of TRAF6 gene expression plasmid with green fluorescent protein tag were used to infect colorectal cancer cells SW480 and HCT116, respectively. The infection was observed by fluorescence microscope, and the expressions of TRAF6 and TRAF6-331mut in cells was detected by western blot. Cell counting kit-8 (CCK-8) and plate cloning test were used to detect the proliferation ability of colorectal cancer cells in TRAF6 group and TRAF6-331mut group, cell scratch test to detect cell migration, Transwell chamber test to detect cell migration and invasion, immunoprecipitation to detect the ubiquitination of TRAF6 and TRAF6-331mut with ubiquitinof lysine binding sites K48 and K63. Western blot was used to detect the effects of TRAF6 and TRAF6-331mut over expression on the nuclear factor kappa-B (NF-κB) and mitogen activated protein kinase mitogen-activated protein kinase (MAPK)/activating protein-1(AP-1) signal pathway. Results: The successful infection of colorectal cancer cells was observed under fluorescence microscope. Western blot detection showed that TRAF6 and TRAF6-331mut were successfully expressed in colorectal cancer cells. The results of CCK-8 assay showed that on the fourth day, the absorbance values of HCT116 and SW480 cells in TRAF6-331mut group were 1.89±0.39 and 1.88±0.24 respectively, which were lower than those in TRAF6 group (2.09±0.12 and 2.17±0.45, P=0.036 and P=0.011, respectively). The results of plate colony formation assay showed that the number of clones of HCT116 and SW480 cells in TRAF6-331mut group was 120±14 and 85±14 respectively, which was lower than those in TRAF6 group (190±21 and 125±13, P=0.001 and P=0.002, respectively). The results of cell scratch test showed that after 48 hours, the percentage of wound healing distance of HCT116 and SW480 cells in TRAF6-331mut group was (31±12)% and (33±14)%, respectively, which was lower than those in TRAF6 group [(43±13)% and (43±7)%, P=0.005 and 0.009, respectively]. The results of Transwell migration assay showed that the migration numbers of HCT116 and SW480 cells in TRAF6-331mut group were significantly lower than those in TRAF6 group (P<0.001 and P<0.002, respectively). The results of Transwell invasion assay showed that the number of membrane penetration of HCT116 and SW480 cells in TRAF6-331mut group was significantly lower than those in TRAF6 group (P=0.008 and P=0.009, respectively). The results of immunoprecipitation detection showed that the ubiquitin protein of K48 chain pulled by TRAF6-331mut was lower than that of wild type TRAF6 in 293T cells co-transfected with K48 (0.57±0.19), and the ubiquitin protein of K63 chain pulled down by TRAF6-331mut in 293T cells co-transfected with K63 was lower than that of wild type TRAF6 (0.89±0.08, P<0.001). Western blot assay showed that the protein expression levels of NF-κB, p-NF-κB and p-AP-1 in TRAF6-331mut-HCT116 cells were 0.63±0.08, 0.42±0.08 and 0.60±0.07 respectively, which were lower than those in TRAF6-HCT116 cells (P=0.002, P<0.001 and P<0.001, respectively). The expression level of AP-1 protein in TRAF6-HCT116 cells was 0.89±0.06, compared with that in TRAF6-HCT116 cells. The difference was not statistically significant (P>0.05). The protein expression levels of NF-κB, p-NF-κB and p-AP-1 in TRAF6-331mut-SW480 cells were 0.50±0.06, 0.51±0.04, 0.48±0.02, respectively, which were lower than those in TRAF6-SW480 cells (all P<0.001). There was no significant difference in AP-1 protein expression between TRAF6-331mut-SW480 cells and TRAF6-SW480 cells. Conclusion: The ubiquitin site mutation of TRAF6 gene at 331 may prevent the binding of TRAF6 and ubiquitin lysine sites K48 and K63, and then affect the expressions of proteins related to downstream NF-κB and MAPK/AP-1 signal pathways, and inhibit the proliferation, migration and invasion of colorectal cancer cells.

Effect of Nucleolin on Lymphoma Proliferation by Regulating Thymidine Kinase 1 / 中国实验血液学杂志

OBJECTIVE@#To investigate the mechanism of nucleolin (NCL) involved in lymphoma proliferation by regulating thymidine kinase 1 (TK1).@*METHODS@#Twenty-three patients with diffuse large B-cell lymphoma (DLBCL) were selected and divided into initial treatment group (14 cases) and relapsed/refractory group (9 cases). Serum TK1 and C23 protein in peripheral blood mononuclear cells were detected. Cell models of CA46-NCL-KD (CA46-NCL-knockdown) and CA46-NCL-KNC (CA46-NCL-knockdown negative control) were established by lentivirus vector mediated transfection in Burkitt lymphoma cell line CA46. The half maximal inhibitory concentration (IC50) of CA46-NCL-KD, CA46-NCL-KNC, and CA46 to adriamycin were detected by cell proliferation assay (MTS). The expression of NCL mRNA and protein in CA46-NCL-KD and CA46-NCL-KNC cells were dectected by Q-PCR and Western blot, respectively. The cell cycle of CA46-NCL-KD, CA46-NCL-KNC, and CA46 cells were detected by flow cytometry. The expression of TK1 protein in CA46-NCL-KD and CA46-NCL-KNC cells was detected by an enhanced chemiluminescence (ECL) dot blot assay.@*RESULTS@#The level of serum TK1 in the initial treatment group was 0.43(0-30-1.01) pmol/L, which was lower than 10.56(2.19-14.99) pmol/L in the relapsed/refractory group (P<0-01), and the relative expression level of NCL protein in peripheral blood was also significantly lower. The IC50 of CA46-C23-KD cells to adriamycin was (0.147±0.02) μg/ml, which was significantly lower than (0.301±0.04) μg/ml of CA46-C23-KNC cells and (0.338±0.05) μg/ml of CA46 cells (P<0.05). Compared with CA46-NCL-KNC cells, the expression of NCL mRNA and protein, TK1 protein decreased in CA46-NCL-KD cells, and the proportion of S phase and G2/M phase also decreased, while G0/G1 phase increased in cell cycle.@*CONCLUSION@#The increased expression of NCL in DLBCL and CA46 cells indicates low sensitivity to drug. NCL may participate in regulation of lymphoma proliferation by affecting TK1 expression, thereby affecting the drug sensitivity.

Biosynthesis and Metabolism of Garlic Odor Compounds in Cultivated Chinese Chives (Allium tuberosum) and Wild Chinese Chives (Allium hookeri).

Chinese chives is a popular herb vegetable and medicine in Asian countries. Southwest China is one of the centers of origin, and the mountainous areas in this region are rich in wild germplasm. In this study, we collected four samples of germplasm from different altitudes: a land race of cultivated Chinese chives (Allium tuberosum), wide-leaf chives and extra-wide-leaf chives (Allium hookeri), and ovoid-leaf chives (Allium funckiaefolium). Leaf metabolites were detected and compared between A. tuberosum and A. hookeri. A total of 158 differentially accumulated metabolites (DAM) were identified by Gas Chromatography-Mass Spectrometry (GC-MS) and Liquid Chromatography-Mass Spectrometry (LC-MS), among which there was a wide range of garlic odor compounds, free amino acids, and sugars. A. hookeri contains a higher content of fructose, garlic odor compounds, and amino acids than A. tuberosum, which is supported by the higher expression level of biosynthetic genes revealed by transcriptome analysis. A. hookeri accumulates the same garlic odor compound precursors that A. tuberosum does (mainly methiin and alliin). We isolated full-length gene sequences of phytochelatin synthase (PCS), γ-glutamyltranspeptidases (GGT), flavin-containing monooxygenase (FMO), and alliinase (ALN). These sequences showed closer relations in phylogenetic analysis between A. hookeri and A. tuberosum (with sequence identities ranging from 86% to 90%) than with Allium cepa or Allium sativum (which had a lower sequence identity ranging from 76% to 88%). Among these assayed genes, ALN, the critical gene controlling the conversion of odorless precursors into odor compounds, was undetected in leaves, bulbs, and roots of A. tuberosum, which could account for its weaker garlic smell. Moreover, we identified a distinct FMO1 gene in extra-wide-leaf A. hookeri that is due to a CDS-deletion and frameshift mutation. These results above reveal the molecular and metabolomic basis of impressive strong odor in wild Chinese chives.

GRP78 facilitates M2 macrophage polarization and tumour progression.

This study investigated the regulation of GRP78 in tumour-associated macrophage polarization in lung cancer. First, our results showed that GRP78 was upregulated in macrophages during M2 polarization and in a conditioned medium derived from lung cancer cells. Next, we found that knocking down GRP78 in macrophages promoted M1 differentiation and suppressed M2 polarization via the Janus kinase/signal transducer and activator of transcription signalling. Moreover, conditioned medium from GRP78- or insulin-like growth factor 1-knockdown macrophages attenuated the survival, proliferation, and migration of lung cancer cells, while conditioned medium from GRP78-overexpressing macrophages had the opposite effects. Additionally, GRP78 knockdown reduced both the secretion of insulin-like growth factor 1 and the phosphorylation of the insulin-like growth factor 1 receptor. Interestingly, insulin-like growth factor 1 neutralization downregulated GRP78 and suppressed GRP78 overexpression-induced M2 polarization. Mechanistically, insulin-like growth factor 1 treatment induced the translocation of GRP78 to the plasma membrane and promoted its association with the insulin-like growth factor 1 receptor. Finally, IGF-1 blockade and knockdown as well as GRP78 knockdown in macrophages inhibited M2 macrophage-induced survival, proliferation, and migration of lung cancer cells both in vitro and in vivo.

The dissection of R genes and locus Pc5.1 in Phytophthora capsici infection provides a novel view of disease resistance in peppers.

BACKGROUND: Phytophthora capsici root rot (PRR) is a disastrous disease in peppers (Capsicum spp.) caused by soilborne oomycete with typical symptoms of necrosis and constriction at the basal stem and consequent plant wilting. Most studies on the QTL mapping of P. capsici resistance suggested a consensus broad-spectrum QTL on chromosome 5 named Pc.5.1 regardless of P. capsici isolates and resistant resources. In addition, all these reports proposed NBS-ARC domain genes as candidate genes controlling resistance. RESULTS: We screened out 10 PRR-resistant resources from 160 Capsicum germplasm and inspected the response of locus Pc.5.1 and NBS-ARC genes during P. capsici infection by comparing the root transcriptomes of resistant pepper 305R and susceptible pepper 372S. To dissect the structure of Pc.5.1, we anchored genetic markers onto pepper genomic sequence and made an extended Pc5.1 (Ext-Pc5.1) located at 8.35 Mb-38.13 Mb on chromosome 5 which covered all Pc5.1 reported in publications. A total of 571 NBS-ARC genes were mined from the genome of pepper CM334 and 34 genes were significantly affected by P. capsici infection in either 305R or 372S. Only 5 inducible NBS-ARC genes had LRR domains and none of them was positioned at Ext-Pc5.1. Ext-Pc5.1 did show strong response to P. capsici infection and there were a total of 44 differentially expressed genes (DEGs), but no candidate genes proposed by previous publications was included. Snakin-1 (SN1), a well-known antimicrobial peptide gene located at Pc5.1, was significantly decreased in 372S but not in 305R. Moreover, there was an impressive upregulation of sugar pathway genes in 305R, which was confirmed by metabolite analysis of roots. The biological processes of histone methylation, histone phosphorylation, DNA methylation, and nucleosome assembly were strongly activated in 305R but not in 372S, indicating an epigenetic-related defense mechanism. CONCLUSIONS: Those NBS-ARC genes that were suggested to contribute to Pc5.1 in previous publications did not show any significant response in P. capsici infection and there were no significant differences of these genes in transcription levels between 305R and 372S. Other pathogen defense-related genes like SN1 might account for Pc5.1. Our study also proposed the important role of sugar and epigenetic regulation in the defense against P. capsici.

Reversible SUMOylation of FHY1 Regulates Phytochrome A Signaling in Arabidopsis.

In response to far-red light (FR), FAR-RED ELONGATED HYPOCOTYL 1 (FHY1) transports the photoactivated phytochrome A (phyA), the primary FR photoreceptor, into the nucleus, where it initiates FR signaling in plants. Light promotes the 26S proteasome-mediated degradation of FHY1, which desensitizes FR signaling, but the underlying regulatory mechanism remains largely unknown. Here, we show that reversible SUMOylation of FHY1 tightly regulates this process. Lysine K32 (K32) and K103 are major SUMOylation sites of FHY1. We found that FR exposure promotes the SUMOylation of FHY1, which accelerates its degradation. Furthermore, we discovered that ARABIDOPSIS SUMO PROTEASE 1 (ASP1) interacts with FHY1 in the nucleus under FR and facilitates its deSUMOylation. FHY1 was strongly SUMOylated and its protein level was decreased in the asp1-1 loss-of-function mutant compared with that in the wild type under FR. Consistently, asp1-1 seedlings exhibited a decreased sensitivity to FR, suggesting that ASP1 plays an important role in the maintenance of proper FHY1 levels under FR. Genetic analysis further revealed that ASP1 regulates FR signaling through an FHY1- and phyA-dependent pathway. Interestingly, We found that continuous FR inhibits ASP1 accumulation, perhaps contributing to the desensitization of FR signaling. Taken together, these results indicate that FR-induced SUMOylation and ASP1-dependent deSUMOylation of FHY1 represent a key regulatory mechanism that fine-tunes FR signaling.

Analysis of Clinical Characteristics of Acute B Lymphoblastic Leukemia with EP300-ZNF384 Fusion Gene Positive / 中国实验血液学杂志

OBJECTIVE@#To investigate the clinical manifestations and laboratory features of B-ALL patients with EP300-ZNF384 fusion gene positive, so as to improve the understanding of this subtype disease.@*METHODS@#The clinical data of 3 B-ALL patients with EP300-ZNF384 fusion gene positive admitted in Department of Hematology, the first medical center of Chinese PLA general hospital from February 2017 to February 2018 were collected and analyzed retrospectively. The clinical and laboratory characteristics as well as the therapentic outcome in B-ALL patients with EP300-ZNF384 fusion gene positive were analyzed.@*RESULTS@#The fusion gene of EP300-ZNF384 was detected in 8.1%(3/37) of B-ALL patients. All cases showed the normal karyotype and aberrant CD13 and/or CD33 expression for immunophenotype. 3 patients were sensitive to traditional chemotherapy.@*CONCLUSION@#The B-ALL with EEP300-ZNF384 fusion gene positive may be a subgroup of B-ALL with a uniqe clinical characteristis and laboatorial features. EP300-ZNF384 positive patients show a good response to conventional chemotherapy, suggesting a favorable prognosis.

Research Progress of Pulmonary Epithelioid Hemangioendothelioma / 中国肺癌杂志

Epithelioid hemangioendothelioma (EHE) is a rare vascular neoplasm that develops from vascular endothelial cells. It has been reported to occur many sites of body, but the most common EHE presentations are soft tissue (limbs), bone, liver and lung. Compared with other pulmonary tumors, pulmonary epithelioid hemangioendothelioma (P-EHE) is relatively rare. According to a literature review, more than 100 cases have been described all over the world. Due to the low incidence of P-EHE, lack of specificity in clinical symptoms and radiological findings, it is often misdiagnosed. Meanwhile, many patients do not receive appropriate treatment, resulting in poor prognosis in some cases. Histology and immunohistochemical methods are essential for diagnosis. However, there is no established standard treatment for P-EHE, because of the rarity of the disease. When the lesions are small and limited in number, surgical is the best treatment, achieving the purpose of diagnosis and treatment at the same time. This article tries to present the etiopathogenesis, clinical manifestations, diagnosis, treatment and prognosis of P-EHE.
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Study of TLRs recognition in the immune response post tumor chemotherapy / 中国免疫学杂志

Toll like receptor ( TLRs) is a highly conserved transmembrane protein expressed in epithelial cells and immune cells,which is a kind of important receptor to identify the damage associated molecular patterns (DAMPs). TLRs and DAMP produced by tumor cells after chemotherapy combine to produce the corresponding biological effects via MyD88 dependent and independent path-ways. At present,the research application of TLRs identifying DAMP clinically is mainly focused on promoting the release of the DAMP and enhancing the expression of TLRs to strengthen the immune effect of chemotherapy drugs.

Effects of placental cord drainage in the third stage of labour: A meta-analysis.

Observational studies have demonstrated that placental cord drainage can shorten the length of the third stage of labour and reduce blood loss during vaginal deliveries. The aim of our work was to evaluate the existing evidence for the effectiveness of placental cord drainage in the third stage of labour. PubMed, Embase, the Cochrane Library, Web of Science, Google Scholar and 50 journals were searched up to the 4th of June, 2017. Randomized controlled trials comparing placental cord drainage with no cord drainage in the third stage of labour during vaginal delivery were included. Nine studies with 2653 participants were included. Compared with clamping the umbilical cord, umbilical cord drainage during the third stage of labour shortened the third-stage duration by 2.28 minutes (95% confidence interval (CI), -3.22 to -1.33), but did not reduce the amount of blood loss (-31.99 mL, -86.08 to 22.09). For women with normal vaginal deliveries, the incidence of postpartum haemorrhage was reduced by 3%. Placental cord drainage is a simple and non-invasive procedure that should be considered after delayed cord clamping. Further studies about the physiological processes and effects of placental cord drainage in additional circumstances are needed.

Misoprostol for medical treatment of missed abortion: a systematic review and network meta-analysis.

The efficacy and safety of misoprostol alone for missed abortion varied with different regimens. To evaluate existing evidence for the medical management of missed abortion using misoprostol, we undertook a comprehensive review and meta-analysis. The electronic literature search was conducted using PubMed, the Cochrane Library, Embase, EBSCOhost Online Research Databases, Springer Link, ScienceDirect, Web of Science, Ovid Medline and Google Scholar. 18 studies of 1802 participants were included in our analysis. Compared with vaginal misoprostol of 800 ug or sublingual misoprostol of 600 ug, lower-dose regimens (200 ug or 400 ug) by any route of administration tend to be significantly less effective in producing abortion within about 24 hours. In terms of efficacy, the most effective treatment was sublingual misoprostol of 600 ug and the least effective was oral misoprostol of 400 ug. In terms of tolerability, vaginal misoprostol of 400 ug was reported with fewer side effects and sublingual misoprostol of 600 ug was reported with more side effects. Misoprostol is a non-invasive, effective medical method for completion of abortion in missed abortion. Sublingual misoprostol of 600 ug or vaginal misoprostol of 800 ug may be a good choice for the first dose. The ideal dose and medication interval of misoprostol however needs to be further researched.

Oxidized low-density lipoprotein modulates differentiation of murine memory CD8T cell subpopulations / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate effect of oxidized low-density lipoprotein (ox-LDL) on memory CD8T cell subpopulation differentiation in mice with autoimmune diabetes.</p><p><b>METHODS</b>Cultured splenic CD8T cells from pre-diabetic NOD mice isolated with magnetic beads were treated with 30 µg/mL ox-LDL and 10 U/mL interleukin-2 (IL-2) for 24 h and the control cells were treated with IL-2 only. Flow cytometry was used to determine the percentage of splenic CD8IFN-γT cells, expressions of CD8, CD44 and CD62L on the T cells, and the activation of T cell factor-1 (TCF-1) and STAT-3. The CD127memory T cells were purified and transplanted into the pre-diabetic NOD mice via the tail vein, and the blood glucose was recorded weekly and survival time of the mice was monitored.</p><p><b>RESULTS</b>Treatment with ox-LDL significantly reduced islet β cell-specific cytotoxic CD8T cells as compared with the control group [(0.7∓0.03)% vs (2.7∓0.14)%, P<0.01]. The percentage of effector memory CD8T cells (Tem) in the total memory CD8T cells was reduced [(10.3∓0.71)% vs (30.3∓1.36)%, P<0.01] and that of stem cell-like memory T cells was significantly increased [(72.3∓3.8)% vs (55.1∓2.61)%, P<0.05] following ox-LDL treatment, which also resulted in significantly decreased activation of TCF-1 [(14.5∓0.82)% vs (34.2∓1.23)%, P<0.01] and pSTAT-3 [(3.3∓0.12)% vs (22.1∓1.1)%, P<0.01]. Transplantation of ox-LDL-treated memory T cells in pre-diabetic NOD mice obviously inhibited the increase of blood glucose and prolonged the survival time of the mice (P<0.05).</p><p><b>CONCLUSION</b>Ox-LDL decreases the activation of transcriptional factors TCF-1 and phosphorylation of STAT-3, inhibits the formation of effector memory CD8T cells with long-term cytotoxicity, but promote the generation of stem cell-like memory CD8T cells, which result in suppression of islet β cell-specific effector cytotoxic CD8T cell differentiation to lessen autoimmune injury to the islet β cells.</p>

Effects of Virtual Reality on Balance and Activities of Daily Living in Patients with Parkinson's Disease:A Meta-Analysis / 中国康复理论与实践

@#Objective To evaluate the effects of virtual reality on balance and activities of daily living in patients with Parkinson's dis-ease.Methods Randomized controlled trials(RCTs)about virtual reality for balance and activities of daily living in patients with Parkin-son's disease were electronically searched in PubMed,Web of Science,EBSCO,Cochrane Library,Science Direct,Wanfang Data,VIP Data-base and China National Knowledge Infrastructure (CNKI) from the date of establishment to July, 2017. Data were analyzed with Rev-Man5.3 software.Results A total of nine RCTs were included.Virtual reality significantly improved the ability of dynamic balance(WMD=1.6,95%CI[0.75,2.46],P=0.0002)and activities of daily living(SMD=0.41,95%CI[0.01,0.80],P=0.04).However,the results of sensitivi-ty organization test(SMD=-0.18,95%CI[-0.65,0.28],P=0.44)and walking ability(WMD=-1.18,95%CI[-2.38,0.02],P=0.05)were not statistically significant.Conclusion Virtual reality can improve the balance function and activities of daily living of patients with Parkin-son's disease,however,the effects on sensitivity organization and walking ability still need further study.

Nine issues about clinical application of thoracolumbar injury classification and severity score / 中华创伤骨科杂志

Spinal fractures are a big challenge to orthopedists.Thoracolumbar Injury Classification and Severity Score (TLICS),a newly developed evaluation system for thoracolumbar fractures,has proved to be valid and reliable in the last decade.However,there have still been many problems in the clinical application of TLICS in China.We discussed nine issues about the clinical application of TLICS in this article,hoping to promote better understanding and application of TLICS in Chinese spinal surgeons in their daily practice.

Nine issues about clinical application of thoracolumbar injury classification and severity score / 中华创伤骨科杂志

Spinal fractures are a big challenge to orthopedists.Thoracolumbar Injury Classification and Severity Score (TLICS),a newly developed evaluation system for thoracolumbar fractures,has proved to be valid and reliable in the last decade.However,there have still been many problems in the clinical application of TLICS in China.We discussed nine issues about the clinical application of TLICS in this article,hoping to promote better understanding and application of TLICS in Chinese spinal surgeons in their daily practice.

Case-control study on effect of anterolateral and posterolateral approaches on early postoperative hip abductor strength in total hip arthroplasty / 中国骨伤

<p><b>OBJECTIVE</b>To compare the difference of early postoperative hip abductor strength and function between improved Gibson anterolateral approach (group A) and conventional Gibson posterolateral approach (group B) in patients who had underwent total hip arthroplasty (THA).</p><p><b>METHODS</b>Among 149 patients performing total hip arthroplasty,130 patients were followed up and were randomly divided into two groups (19 unqualified cases were excluded). Group A included 65 cases who underwent anterolateral approach, and the other group included 65 cases who underwent posterolateral approach. In the group A, male:female = 26:39,with an average age of (72.5 ± 8.3) years old, BMI of (24.7 ± 3.7) kg/m², and hip abductor strength of (1.08 ± 0.49) N · m/kg. In the group B, male:female = 30:35, with an average age of (71.6 ± 7.1) years old, BMI of (25.5 ± 3.9) kg/m², and hip abductor strength of (1.05 ± 0.51) N · m/kg. In the age-related control group, male:female = 33:32, with an average age of (73.1 ± 7.5) years old, BMI of (24.2 ± 3.8) kg/m², and hip abductor strength of (1.17 ± 0.53) N · m/kg. The age, BMI, hip abductor strength, anatomy of surgical approach, hip abduction angles and Harris score in all patients were evaluated at the day before surgery and at 1, 2, 3, 6, and 12 months after surgery. All preoperative clinical data (age, BMI and abductor strength of the uninjured side limb ) of these cases had no significant differences.</p><p><b>RESULTS</b>At 1, 2, 3, 6, and 12 months after surgery, the hip abductor strength in group A were (0.53 ± 0.13), (0.66 ± 0.21), (0.85 ± 0.15), (0.95 ± 0.19), (1.03 ± 0.13) N · m/kg respectively, while in group B were (0.46 ± 0.14), (0.57 ± 0.18), (0.78 ± 0.12), (0.85 ± 0.18), (0.98 ± 0.14) N · m/ kg respectively.The differences between the two groups at the 6th months after operation were significant; the hip abduction angles in group A were (25.35 ± 4.31)°, (36.53 ± 5.13)°, (48.07 ± 1.62)°, (61.53 ± 1.77)°, (68.62 ± 3.16)°,while in group B were (23.47 ± 2.41)°, (33.42 ± 4.23)°, (46.64 ± 2.51)°, (60.96 ± 1.75)°, (67.47 ± 4.36)°. The differences between the two groups at the 3rd month after operation were significant. Harris score in the group A were 72.23 ± 2.57, 79.36 ± 3.91, 84.75 ± 3.17, 88.63 ± 2.16, 95.21 ± 1.37 repectively ; while in the group B were 71.58 ± 3.62, 78.96 ± 2.21, 83.97 ± 3.57, 87.92 ± 2.94, 94.83 ± 1.62 respectively. There were no significant differences between them.</p><p><b>CONCLUSION</b>Owing to less muscles interrupted, the THA with improved Gibson anterolateral approach offers a better improvement in earlier hip abductor strength and abduction angle compared with the conventional surgery.</p>

Efficacy of sublingual immunotherapy in children with allergic rhinitis / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To evaluate the efficacy of sublingual immunotherapy with dermatophagoides farina drops on children with allergic rhinitis.@*METHOD@#This was retrospective study analyzing the efficacy of dermatophaguides farinae drops SLIT in 110 patients (aged 4-14 years old) with house dust mites induced allergic rhinitis (without asthma). All the patients were divided into the SLIT group (n = 60) and drug group (n = 50). Patients in SLIT group received sublingual immunotherapy combined with symptomatic medication, and patients in drug group only received symptomatic medication. We recorded and evaluated the total nasal symptom scores (TNSS), total medication scores (TMS) and visual analogue scale (VAS) of the 2 groups at three time points, before the treatment, and the treatment for 1-year and 2-year.@*RESULT@#After 1-year and 2-year treatment, compared with drug group, TMS, TNSS and VAS in SLIT group decreased significantly (P < 0.01). When compared with baseline, we got the similar result as compared with drug group. Besides, the TMS of drug group increased significantly after treatment (P < 0.01). And no significant difference was observed in TNSS and VAS. In addition, there was significant difference in the Proportion of patients withdrawing symptomatic medication in SLIT group and drug group (68.33%,16.00%, respectively; P < 0.01). There were 4 local adverse reactions occurred during the treatment and no serious adverse events occurred.@*CONCLUSION@#Sublingual immunotherapy with Dermatophagoides farinae drops showed significant clinical efficacy in children with allergic rhinitis comparing with pharmacotherapy.

PTEN inhibits the proliferation of neural stem cells via the antagonism of PI3K/Akt signaling pathway / 西安交通大学学报(医学版)

ABSTRACT:Objective To explore the role of PTEN in the suppression of neural stem cells so as to clarify whether neural stem cell proliferation can be promoted by regulating the PI3K-Akt/PTEN expression level. Methods We removed the hippocampus from neonatal 24 h Kunming mice,isolated and cultured the generation of neural stem cells,which were then identified by immunofluorescence test.We randomly grouped the cultured neural stem cells into normal group,ischemia model group,hypoxia group (hypoxia + ischemia model group),Lip2000 group (hypoxia+ ischemia model group + Lip2000 null transfection group,PTEN transfection group (hypoxia +ischemia model group+Ad5-PTEN transfection group),and PTEN interference group (hypoxia+ ischemia model group+Lip2000+PTENsiRNA interference group).We detected the proliferation of neural stem cells in the groups at different time points,and PTEN protein expression of neural stem cells in each group after PTEN transfection, and the effect on iconic protein on Akt-PI3K signaling pathway.Results (1 )Nestin identification of the neural stem cells was tested by immunofluorescence.We observed green bright and typical cell spheroids under fluorescence microscope;the clear structure could be seen within spheroids.(2)We determined the proliferation of neural stem cells at different time points by MTT.After 36 h of culture,the neural stem cells had obvious proliferation in the hypoxia group and Lip2000 group compared with the model group, the PTEN transfection group and PTEN interference group (P 0.05);(4)After PTEN plasmid transfection,there were no apparent changes in the total Akt and bad in the groups,but compared with the normal group,PI3K,p-Akt,and p-bad expressions in model group and PTEN gene transfection group reduced (P <0.05),with the more obvious changes in the PTEN transfection group.PI3K,p-Akt,and p-bad expressions in the hypoxia group, Lip2000 group and PTEN interference group increased (P < 0.05 ). Conclusion Hypoxia contributes to promoting the proliferation of neural stem cells,and the inhibition of PTEN on PI3K/Akt might be the key factor for blocked proliferation of adult neural stem cells.

Complications of percutaneous kyphoplasty non-related with bone leakage in treating osteoporotic thoracolumbar vertebral compression fractures / 中国骨伤

<p><b>OBJECTIVE</b>To analyze the complications of percutaneous kyphoplasty except bone leakge for the treatment of osteoporotic thoracolumbar vertebral compression fractures.</p><p><b>METHODS</b>From October 2008 to October 2012,178 patients with 224 osteoporotic vertebral compression fractures were treated with percutaneous kyphoplasty under local anethsia. There were 72 males and 106 females,ranging in age from 58 to 92 years old,with an average of 75.3 years,including 93 thoracic vertebrae and 131 lumbar vertebrae. The complications except bone cement leakage were analyzed during operation and after operation.</p><p><b>RESULTS</b>All operations were successful and all patients were followed up from 12 to 60 months with an average of 26.2 months. No death was found. Bone cement leakage occurred in 27 cases, about 15.1% in 178 cases; and complications except bone cement leakage occurred in 15 cases. There was 1 case with cardiac arrest,was completely recovery by cardiopulmonary resuscitation (CPR) immediately; and 1 case with temporary absence of breathing,was recovery after treatment. There were 3 cases with fall of blood pressure and slower of heart rate; 1 case with intestinal obstruction; 2 cases with local hematoma and 1 case with intercostal neuralgia. Vertebral body fractures of 2 cases were split by bone cement and the fractures of adjacent body occurred in 4 cases.</p><p><b>CONCLUSION</b>It's uncommon complication except bone cement leakge in treatment of osteoporotic thoracolumbar vertebral compression fractures with percutaneous kyphoplasty. The complication of cardiopulmonary system is a high risk in surgery; and cytotoxicity of bone cement,nervous reflex,fat embolism and alteration of intravertebral pressure may be main reasons.</p>