Expression levels of plasma lncRNA MALAT1,LincRNA-p21 and GAS5 in patients with multiple myeloma and chronic lymphocytic leukemia and their diagnostic significances / 吉林大学学报(医学版)

Objective:To explore the differences of the relative expression levels of plasma long chain non encoding RNA(lncRNA)MALAT1,LincRNA-p21 and GAS5 in the patients with multiple myeloma(MM)and chronic lymphocytic leukemia(CLL),and to clarify their significances in the differential diagnosis of MM and CLL. Methods:A total of 60 cases of MM patients(MM group),60 cases of CLL patients(CLL roup)and 60 healthy persons after physical examinations(control group)were selected as the subjects.The plasma levels of lncRNA MALAT,LincRNA-p21 and GAS5 of the subjects in three groups were detected and compared.Results:The relative expression levels of lncRNA MALAT1 and GAS5 in plasma of the patients in MM group were significantly higher than those in the other two groups(P<0.05);the relative expression level of LincRNA-p21 in plasma of the patients in CLL group was significantly lower than those in the other two groups(P<0.05).The area under receiver operating characteristic curve(ROC)(AUC)of plasma LincRNA-p21 in the diagnosis of CLL was 0.850, its 95% confidence interval(CI)was 0.780-0.921. The AUC of plasma lncRNA MALAT1 and GAS5 in the diagnosis of MM were 0.898 and 0.815;their 95% CI were 0.836-0.959 and 0.740-0.890,respectively.The AUC of plasma lncRNA MALAT1,LincRNA-p21 and GAS5 in the differential diagnosis of CLL and MM were 0.878,0.778 and 0.805,and their 95% CI were 0.814 - 0.942,0.691 - 0.865 and 0.727 - 0.882, respectively.Conclusion:The incidence of MM is related with the high expressions of lncRNA MALAT1 and GAS5 in plasma and the incidence of CLL is related with the low expression of LincRNA-p21 in plasma. The relative expression levels of the above lncRNA can be used as the auxiliary indexes in the diagnosis of MM and CLL.

The effect of single anterior approach for pinching cervical spondylotic myelopathy / 中华骨科杂志

Objective To investigate effect of single anterior decompression and fusion for pinching cervical spondylosis myelopathy.Methods 82 patients with pinching cervical spondylosis myelopathy,treated with single anterior decompression and fusion,were analyzed,including 43 males and 39 females,with an average age of 54.4 years (range,33-79 years).Occupying rate,anterior occupying rate and posterior occupying rate were measured on pre- and post-operative midsagittal MRIs.Multiple regression analysis was performed between preoperative occupying rate,intervertebral space height,postoperative imaging changes and neural function recovery.Results All patients were followed up for an average of 25.8 months (range,9-72 months).Significant differences were found between pre- and postoperative Japanese Orthopaedic Association (JOA) scores,anterior occupying rate,posterior occupying rate,and intervertebral space height,respectively.Pre- and post-operative posterior occupying rate was averagely 29.0％±10.5％ and 19.9％+11.6％,respectively,and improvement rate of posterior occupying rate was 9.0％±6.1％.Regression analysis found that preoperative intervertebral space height did not relate to posterior occupying rate,while preoperative posterior occupying rate related to improvement rate of posterior occupying rate.JOA scores improved significantly after operation in patients with preoperative posterior occupying rate between 20％ and 40％.However,the decompression results were poor in patients with preoperative posterior occupying rate ≥40％.Conclusion Anterior decompression and fusion can achieve satisfactory results in patients with pinching cervical spondylotic myelopathy.For patients with preoperative posterior occupying rate between 20％ and 40％,the decompression results are better.

Cervical corpectomy with preserved posterior vertebral wall for cervical spondylotic myelopathy: a randomized control clinical study.

STUDY DESIGN: Cervical corpectomy with preserved posterior vertebral wall (CPW) had been performed by the senior author (Y.W.) since 1999. A prospective study had been conducted to evaluate the efficacy of CPW since 2001. OBJECTIVE: To validate the clinical outcome of CPW against conventional corpectomy (CC). SUMMARY OF BACKGROUND DATA: Anterior surgical managements of cervical spondylotic myelopathy (CSM) include discectomy and corpectomy. Both have significant disadvantages, including low fusion rates and residual symptoms. A procedure incorporating multilevel discectomy, corpectomy with preserved posterior vertebral wall, autograft and plating was described. By keeping the posterior vertebral wall (PW), infringement of the vein plexus and spinal canal was avoided and more fusion site was available. METHODS: From March 2001 to March 2004, 178 cases of CSM were randomized to undergo CPW (n = 89) or CC (n = 89). Arthrodesis was done with autogenous iliac bone graft or titanium cage supplemented with anterior self-lock plates in both groups. Operation time, blood loss, days of hospitalization, the numbers and types of complications, and preoperative and postoperative JOA scores were recorded. Fusion rate, segmental lordosis, and disc height were assessed by roentgenography. Three-dimensional reconstructions of CT scan were used to confirm fusion evidence. RESULTS: Average operation time and blood loss decreased significantly in the CPW group (98.06 +/- 19.42 minutes, and 131.69 +/- 62.41 mL) as compared with those in the CC group (108.45 +/- 22.35 minutes, and 181.57 +/- 82.10 mL) (P < 0.05). There were 2 cases of epidural bleeding and 1 case of CSF leak in the CC group. Other complications were minor. JOA improvement scores were similar in both groups. Roentgenograms showed that the fusion rate was 100% at 6 months postoperatively in both groups. CT scans showed that PW fused with grafts and bone dust in cages. Improvement in segmental lordosis and disc height was similar in both groups. CONCLUSION: CPW is a feasible procedure for anterior decompression and fusion, with safety, complete decompression, and high fusion rate, as long as indicative patients are selected.

Segmental anterior cervical decompression with fusion for treating multilevel cervical myelopathy: Comparison of fusion rates among three methods / 中国组织工程研究

BACKGROUND:As a traditional treatment for multilevel cervical myelopathy,nterior long-segmental decompression has the shortcomings of great operative trauma,high difficulty,low fusion rate,etc.,which can affect the postoperative efficacy.OBJ ECTIVE:To evaluate the clinical effects of three different anterior surgeries on multilevel cervical myelopathy.DESIGN:A comparative observation.SETTING:Department of Orthopaedics,Changzheog Hospital,the Second Military Medical University of Chinese PLA.PARTICIPANTS:Thirty-six patients with multilevel cervical myelopathy of 3 consecutive segments,who were surgically treated,were selected from the Department of Orthopaedics,Changzheng Hospital,the Second Military Medical University of Chinese PLA from June 1999 to June 2003,including 25 males and 11 females,35-62 years of age,the disease course ranged from 3 to 26 months. According to the clinical manifestations and imaging esults,they were diagnosed as multilevel cervical myelopathy,and they were not suffering from consecutive ossification of posterior longitudinal ligament and ossification of ligamenta flava. Informed contents were obtained from all the patients and their relatives.METHODS:All the patients were grafted with utologous bone. Autologous ilium or cancellous bone excluding vertebral body was filled into titan net or Cage,which were made of titan and characterized by high intensity,tolerance to decay,good biocompatibility,etc. According to the operative manner,the patients were divided into 3 groups:① two-level corpectomy with fusion group(long-segmental decompression group,n =11):There were 4 cases grafted with long-titan net,and 7 cases grafted with autologous iliac bone. Sub-total two-level corpectomy with fusion was performed. ②segmental decompression group(n =16):including 12 cases of titan net+cage graft,4 cases of autologous bone+cage graft. One-level decompression and sub-total single corpectomy with fusion were performed. ③three-level decompression group(n =9):Only discectomy without corpectomy was performed. After complete decompression,3cages were used to fill artificial bone or grafted with autologous bone.MAIN OUTCOME MEASURES:Cervical anteroposterior and lateral radiographies,flexion and extension radiograph were reexamined within 1 week and at 3,6 and 12 months postoperatively. The neurological function was assessed using the Japanese Orthopaedic Association(JOA) scoring method preoperatively and 3 months postoperatively. The total score was 17 points,the higher the score,the better the neurological function. The duration of operation,perioperative bleeding amount,length of stay,cost of hospitalization,graft fusion at 3 months postoperatively,improved JOA score at 3 months postoperatively were recorded in the three groups. The occurrence of postoperative complications was observed by means of return visit.RESULTS:All the 36 patients with multilevel cervical myelopathy were involved in the analysis of results. The mean duration of operation,mean perioperative bleeding amount and mean length of stay in the segmental-decompression group and three-level decompression group were obviously fewer or shorter than those in the long-segmental decompression group(P ＜ 0.05),and the average cost of hospitalization was obviously higher than that in the long-segmental decompression group(P ＜ 0.05). The postoperative improved JOA score and graft fusion rate were close among the groups(P ＞ 0.05).CONCLUSION:Segmental anterior cervical decompression is a recommendable technique for multilevel cervical myelopathy by comprehensively considering the fusion rate,recovery of neurological function,duration of operation,perioperative bleeding and length of stay.

Progress in treatment of systemic inflammatory response syndrome and multiple organ dysfunction syn- drome / 第二军医大学学报

The treatment of systemic inflammatory response syndrome (SIRS) and multiple organ dysfunction syndrome (MODS) is difficult in ICU. In addition to traditional methods, immunologic therapy has been used recently to treat SIRS and MODS through adjusting inflammatory responses and redressing abnormal responses. This article reviews the progress in treatment of SIRS and MODS,including blocking inflammatory activation, modifying the activation of inflammation, giving gene therapy and combination therapy of TCM and western medicine.