Construction of a noninvasive diagnosis model for nonalcoholic steatohepatitis / 解放军医学杂志

[Abstract] Objective To establish a noninvasive diagnostic model consisting of clinical and laboratory indicators for predicting the occurrence of nonalcoholic steatohepatitis (NASH) with the model. Methods In this retrospective study, 111 liver biopsy-proven NASH patients and 343 non-NASH patients presented to the Fifth Medical Center of Chinese PLA General Hospital from January 2014 to July 2018 were enrolled and randomly divided into training group (n=364, including 85 NASH cases and 279 non-NASH cases) and validation group (n=90, including 26 NASH cases and 64 non-NASH cases). At the same time, 21 clinical and laboratory indicators, including age, gender, body mass index (BMI), biochemical and blood routine parameters, were tested and recorded. In the training group, univariate analysis and multivariate logistic regression analysis were used to screen out the independent predictors related to NASH, and to construct the noninvasive diagnostic model of NASH. The diagnostic performance of the model was tested in the validation group. Results In the training group, a noninvasive diagnostic model (NA-6) consisting of age, gamma glutamyltransferase (GGT), calcium, phosphorus, red blood cell and BMI was established to predict NASH and evaluate its severity. The area under the ROC curve (AUC) of NA-6 was 0.893, with 0.2 as the cut-off value, the diagnostic sensitivity was.

Accuracy of magnetic resonance imaging signal intensity ratio measurements in the evaluation of multifidus muscle injury and atrophy relative to that of histological examinations.

STUDY DESIGN: A matched-pairs animal study. OBJECTIVE: To confirm the accuracy of magnetic resonance imaging (MRI) as a means of evaluating edema and fat degeneration of the multifidus muscle by comparing measurements made using MRI with those made using histological examination. SUMMARY OF BACKGROUND DATA: MRI is considered a reliable means of evaluating multifidus muscle edema and fat degeneration. However, it is not clear whether its results are always consistent with histological findings. METHODS: Models of different degrees of multifidus injury were created at the L2-L3, L3-L4, and L4-L5 disc levels in 56 New Zealand white rabbits. These were divided into 4 groups and subjected to different processes: sham surgery, dissection and stripping of the multifidus, crushing of the muscle lasting 1 hour, and crushing of the muscle lasting 2 hours. Two rabbits per group were examined at each of the indicated points in time. Multifidus edema was assessed using fat-suppressed T2 signal intensity ratio of gross multifidus to psoas (T2R) on MRI bilaterally, wet weight and wet:dry weight ratio on the left side (edema-left), and visual edema score on the right side (edema-right). Muscle fat degeneration was detected bilaterally using the T1 signal intensity ratio of gross multifidus to psoas with MRI (T1R) and visual fat degeneration score (fat score) with histology. RESULTS: Pearson correlation coefficient analyses showed significant correlations (P < 0.001) between left T2R and edema-left (r = 0.927), right T2R and edema-right (r = 0.868), and T1R and fat score (r = 0.804). A paired t test demonstrated no significant differences between MRI measurements and histological changes (P = 0.999, 1.000, and 0.998). Bland-Altman plots also depicted good agreement between MRI measurements and histological changes (limits of agreement: left multifidus edema, ± 0.75; right multifidus edema, ± 1.01; fat degeneration, ± 1.23). CONCLUSION: The MRI technique is an accuracy means of evaluating multifidus muscle injury and atrophy.

Influencing of chronic low back pain on multifidus muscle atrophy / 中国骨伤

<p><b>OBJECTIVE</b>To identify the affect of chronic low back pain on multifidus muscle atrophy and fatty infiltration.</p><p><b>METHODS</b>From March 2010 to August 2013, a retrospective study were carried out in the department of orthopedics of patients with low back pain. Finally 31 cases were selected to this study including 19 males and 12 females with an average age of 36.4 years ranging from 23 to 55 years. The main symptoms of these patients were repeated back pain. Duration was more than 1 year. X-ray, CT, MRI showed no obvious abnormalities. The changes of net cross-sectional area of multifidus and T2 signal ratio of the same patient were measured at different time by MRI. VAS and Oswestry disability scores were recorded in two MRI examination. Correlation between these change of multifidus net area and T2 signal ratio in two times measurement and duration of low back pain, VAS, Oswestry disability scores were analyzed to find the affection of low back pain on paraspinal multifidus muscle.</p><p><b>RESULTS</b>The net multifidus cross-sectional area in same case by the second follow-up MRI is significantly smaller than that of the first follow-up, T2 signal ratio at second was significantly higher than that of the first (P < 0.05). The net cross sectional area of multifidus muscles reduced rate were positively correlated with VAS scores, duration and of Oswestry disabilitry scores (P < 0.001). The rate of increase in T2 signal ratio was not correlated with VAS scores,duration and the Oswestry disability scores (P > 0.05).</p><p><b>CONCLUSION</b>Chronic low back pain is one of the most important reasons of paraspinal multifidus muscle atrophy and fatty. The duration, VAS and Oswestry disability scores of chronic low back pain were positively correlated with the multifidus muscle atrophy.</p>

Case-control study on effects of two approaches on multifidus muscle injuries during lumbar interbody fusion of lumbar vertebrae / 中国骨伤

<p><b>OBJECTIVE</b>To study differences of multifidus muscle injury between Wiltse intermuscular approach and intramuscular stripping approach in one-level small incision transforaminal lumbar interbody fusion (TLIF) surgery.</p><p><b>METHODS</b>A total of 46 patients with unilateral lumbar degenerative disease underwent small incision TLIF from August 2009 to February 2011 by one group of surgeons at a single institution. The decompression side of all patients adopted intra-muscular stripping approach; for the non-decompression side, 22 patients adopted Wiltse intermuscular approach (group A),and 24 patients adopted intra-muscular striping approach (group B). In group A, there were 13 males and 9 females, ranging in age from 36 to 74 years old,averaged 52.7 +/- 9.2; 1 patient had disease in L3, 4 12 in L4,5 and 9 in L5S1. In group B,there were 11 males and 13 females,ranging in age from 32 tio 72 years old, averaged 51.8 +/- 8.7; two patients had disease in L3,4, 14 in L4,5, and 8 in L5S1. The following data were compared between the 2 groups: surgical time from skin incision to completion of pedicle screw placement, suturation time, blood loss. Clinical effects were evaluated by VAS score pre-operatively, as well as 1, 6 and 12 months post-operatively. At the latest follow-up, all the patients were evaluated by MRI. This enabled the cross-sectional area (CSA) of lean multifidus muscle, and the T2 signal intensity ratio of multifidus to psoas muscle, to be compared at the operative level.</p><p><b>RESULTS</b>There was no obvious difference in suturation time, but less surgical time from skin incision to completion of pedicle screw placement, less blood loss, less postoperative back pain in Wiltse intermuscular approach group. For the comparison between the two groups or paired comparison between sides in the Wiltse group, the reduction of lean CSA and increase in the multifidus:psoas T2 signal intensity ratio were all significant lower in Wiltse intermuscular approach group or side.</p><p><b>CONCLUSION</b>The Wiltse intermuscular approach is an easy way for pedicle screw placement, and caused less paraspinal muscle damage than intra-muscular stripping approach, and had positive effects on less back pain.</p>

An update of repairing spinal cord injury by olfactory ensheathing cells / 中国骨伤

The treatment of spinal cord injury is always a stubborn problem for neurosurgeons because nerve cell cannot regenerate and the glia scar can prevent the axonal regeneration. Olfactory ensheathing cells (OECs) is a kind of especial glia cell, which possesses the character of horizontal cell of central nervous system and schwann cell. Many foundational and clinical studies showed that the olfactory ensheathing cellscan promote axonal regeneration and prove axonal growth, some progress is made and this is bringing hope for treatment of spine injury.

Effect of Bromocriptine on the Activation of T Lymphocyte Stimulated by Phytohemagglutinin / 实用儿科临床杂志

Objective To study the effect of bromocriptine(BRC) on the activation of T lymphocyte stimulated by phytohemagglutinin(PHA).Methods After CD4+ T cell line Jurkat E6-1 cells were stimulated by PHA,prolactin(PRL) and BRC,respectively,the expression of linker for activation of T cells(LAT) and zeta-chain T cell receptor associated protein kinase 70 000(ZAP-70) mRNA of T lymphocytes were checked by RT-PCR.The expression of PRL mRNA of T lymphocytes was detected by Real time PCR.The expression of CD25(cluster of differentiation) as a marker of early activation on the surface of T lymphocytes was detected by flow cytometry,and the activation of nuclear factor-?B(NF-?B) was detected by luciferase reporter system.Results 1.BRC inhibited the expression of ZAP-70 as the common signal molecules both in the T lymphocyte activation pathway and PRL-prolactin-prolactin receptor(PRLR) signal transduction pathway,and decreased the expression of PRL mRNA produced by activation T lymphocytes.2.BRC enhanced the expression of LAT mRNA as another important signal molecular on the T lymphocytes and CD25 on the surface of the T lymphocytes.3.The activation of NF-?B of T lymphocytes was decreased.Conclusions BRC might inhibit the activation of T lymphocytes by inhibiting the expression of ZAP-70,the common signal molecules between T lymphocytes activation and PRL-PRL pathway,and PRL mRNA,the like-T lymphocyte growth factor.

Cloning and expression of dengue 2 virus NS1 gene in eukaryotic cells / 军事医学科学院院刊

Objective：To investigate the correct expression of dengue 2 virus 43 strain NS1 gene in transfected BHK-21 cell. Methods：The D2-43 DNA fragment coding for signal peptide plus NS1 protein was cloned between KpnⅠ site and EcoR Ⅰ site of expression plamid pcDNA3.1. The obtained recombinant vector pcDNA-NS1 was transfected into BHK-21 cells with electroporation technique. After selection by G418, resistant clones were screened by RT-PCR and Western blotting test. Results：The RT-PCR results of four in five randomly selected cell clones were positive. Western blotting test showed that NS1 gene could be expressed in BHK-21 cells. Conclusions：NS1 protein was capable of being expressed and appropriately processed in pcDNA-NS1 transfected BHK-21 cells. The present results suggest the feasibility of NS1-based DNA immunization.

Advance in research on dengue virus infection and replication / 军事医学科学院院刊

Dengue (DEN) virus is a member of the family flaviviridae which consists of a group of enveloped viruses with a single-stranded positive-sense RNA genome. DEN virus infection is initiated by the binding of envelope protein E to cellular receptor,followed by replication in cytoplasm which associated with a range of induced membrane structures. Further characterization of the DEN replication complex (RC) showed the involvement of NS1, NS2A, NS3, NS4A, and NS5 proteins as the viral replicase. The DEN virion maturation is associated with the cleavage of precursor of protein C by NS2B/NS3 protease and the glucosylase-mediated N-linked oligosaccharide trimming of prM, E protein. This review summarizes recent advance in research on DEN virus life cycle, emphasizing cellular receptor, RNA replication and virion assembly.