Abstract:Objective To observe the expression of SRY(sex determining region Y)-box 9 (SOX9) and collagen type Ⅱalpha 1 (COL2A1) in human cervical intervertebral disc nucleus pulposus (NP) tissues of various degeneration degrees, so as to discuss the role of their expression during cervical intervertebral disc degeneration(CIDD). Methods Totally 36 human cervical intervertebral disc specimens and their pre-operation MRI findings were obtained from surgical patients or patients with cervical trauma, and they were classified into five grades according to the Miyazaki grading system. The expression of SOX9 and COL2A1 was examined by fluorescence quantitative RT-PCR, Western blotting analysis and immunohistochemistry staining. The relationship between SOX9, COL2A1 expression and the degrees of CIDD was analyzed, and the relationship between SOX9 and COL2A1 was also discussed. Results Both SOX9 and COL2A1 were expressed in NP tissues, with SOX9 seen in the nucleus and COL2A1 in the extracellular matrix. The expression of SOX9 and COL2A1 mRNA and protein gradually decreased as Miyazaki Ⅰprogressed to Miyazaki Ⅴ.We also found a linear relationship between COL2A1 (Y) and SOX9 (X) expression: Y=0.923X-0.059 (P<0.001). Conclusion The expression of SOX9 and COL2A1 mRNA decrease with the increase of CIDD severity, with SOX9 and COL2A1 mRNA having a similar decreasing tendency. SOX9 positively regulate COL2A1 expression, indicating that changes of SOX9 and COL2A1 gene might be one of the molecular mechanisms of CIDD.

Abstract:Objective To compare the efficiencies of two methods (serum and non-serum) in inducing mouse embryonic stem cell differentiation into definitive endoderm cells. Methods The serum and non-serum methods were used to induce differentiation of mouse embryonic stem cells into definitive endoderm cells. Fluorescence activated cell sorter (FACS) was used to analyze the inducing time and efficiency of definitive endoderm using their surface protein marks (Cxcr4, c-Kit and E-cadherin). Meanwhile, RT-PCR was used to analyze the gene profile of definitive endoderm induced by the two methods. Real-time PCR was used to analyze the gene expression in definitive endoderm during the induction course in the non-serum group. The Cxcr4 and c-Kit double positive definitive endoderm cells were sorted by flow cytometry and gene profile was characterized by RT-PCR. Results Definitive endoderm cells were induced from mouse embryonic stem cells by both serum and non-serum methods. However, the efficiency of non-serum group (74.19%) was higher than that in the serum group, and the induction outcome reached a climax at the 4^th day of induction. Conclusion We have established a highly efficient method to induce differentiation of mouse embryonic stem cells into definitive endoderm, which lays a foundation for further differentiation into liver and pancreatic cells.

Abstract:Objective To investigate the effects of hypoxic conditioned medium (HCM) of cerebral cortex cells on the proliferation of neural stem cells (NSCs) and to discuss the role of phosphoinositide 3-kinase (PI3-K) and c-Jun N-terminal kinase (JNK) signal pathways in the process. Methods The cerebral cortex cells of newborn SD rats (within 24 h after birth) were primarily cultured for 5 days, the cells were then cultured under 4% O₂, 1% O₂ or normal oxygen for 6 h, and the cultured media were collected as the HCM and normoxic conditioned medium (NCM). The specific inhibitors of PI3-K and JNK (LY294002 and SP600125) were added into the conditioned medium to culture NSCs. And then immunofluorescence staining was performed to identify NSCs in the neurospheres. The proliferation efficiency(number of neurospheres) and speed (diameter of neurospheres) were used to analyze the effects of hypoxic conditioned media on the proliferation of NSCs. Results The proliferation efficiencies of 4% HCM and NCM groups were significantly higher than that of 1% HCM group(P<0.01), and there was no significant difference between former two groups. The proliferation speed of two HCM groups was significantly faster than that of the NCM group(P<0.01), with the speed of 4% HCM group being the fastest one. The two inhibitors inhibited both the proliferation efficiency and speed of NSCs in the 4% HCM group(P<0.01), and the inhibitory effect of LY294002 was more prominent after 24 h. Conclusion 4% HCM of cerebral cortex cells can promote the proliferation speed of NSCs, and PI3-K pathway may play an important role in it.

Abstract:Objective To investigate the protective effect of Jinlida granules on hippocampus of diabetic rats. Methods Diabetic models were induced by high-fat diet and intraperitoneal injection of streptozotocin(STZ) in SD rats. The study was divided into diabetic model group, Jinlida granule groups(0.75, 1.5,and 3.0 g/kg), α-lipoic acid group and insulin group. Healthy rats served as normal controls. Rats were tested in Morris water maze after 8 weeks of treatment, and then the hippocampus tissues were taken from each group and were subjected to TUNEL assay and transmission electron microscopy (TEM) observation. The activities of superoxide dismutase (SOD), glutathione (GSH), myeloperoxidase (MPO), and the contents of malondialdehyde (MDA) were all examined. Results The diabetic rats developed studying and memory disorders 8 weeks after establishment. Except for those in the low-dose Jinlida group, rats in other treatment groups had improved studying and memory functions to different extents. Compared with normal control group, rats in the model group had more apoptotic neurons in the hippocampal CA1 area, prominent ultrastructure damage, significantly decreased SOD and GSH activities (P<0.05), and significantly increased MPO activity and MDA level (P<0.05). Compared with the model group, rats in all the treatment groups had decreased apoptosis and less ultrastructure damage；and rats in high-dose Jinlida group, α-lipoic acid group and insulin group had significantly increased SOD and GSH activities and significantly decreased MPO activity in the hippocampal CA1 area (P<0.05); and the high-dose Jinlida granule group had a similar effect to α-lipoic acid group. Conclusion Jinlida granule can protect the hippocampus of diabetic rats.

Abstract:Objective To investigate the mechanism by which wild-type PTEN gene reversing multi-drug resistance (MDR) in human leukemia K562/ADM cells resistant to adriamycin (ADM). Methods The recombinant adenovirus containing green fluorescent protein and PTEN (Ad-PTEN-GFP)or empty vector (Ad-GFP) was transducted into K562/ADM cells resistant to ADM. The transduction efficiency was assessed by flow cytometry (FCM). Then the cells were treated with different concentrations of ADM, cytarabine (Ara-C) or arsenic trioxide(As₂O₃) 3 days after transduction. The proliferation of K562/ADM cells was examined by MTT assay, the apoptosis rate was assessed by FCM, and the IC₅₀ of different drugs was used to calculate the drug resistance reversal fold (RF), so as to observe the effect of PTEN on reversing MDR of the 3 drugs. PTEN, NF-κB, MDR1, MDR-associated protein (MRP) and apoptosis related genes (Bcl-2, Bcl-xL, Bax) were detected by fluorescence quantitative PCR. PTEN, Akt, p-Akt and NF-κB protein levels were detected by Western blotting analysis. Results The proliferation inhibition rate and apoptosis rate of cells in Ad-PTEN-GFP plus chemotherapeutic groups were significantly higher than those Ad-GFP plus chemotherapeutic groups at 3 days after infection (MOI=200) (P<0.05). PTEN transduction promoted the sensitivity of K562/ADM cells to ADM, Ara-C and As₂O₃, with the RF being 3.80, 2.65 and 2.64 folds, respectively. K562/ADM cells in Ad-PTEN-GFP group had lower p-Akt and NF-κB (P65) protein levels and lower NF-κB, MDR1, Bcl-2 and Bcl-xL mRNA levels, and up-regulated Bax mRNA level compared with those in Ad-GFP group. Conclusion Wild-type PTEN gene may reverse drug resistance via inhibiting Akt pathway and regulating its downstream signaling molecules, such as NF-κB, MDR1, Bcl-2 and Bax.

Abstract:Objective To investigate the apoptosis in hepatocellular carcinoma cells induced by NF-κB silencing combined with matrine (MT) and the expression of related molecules. Methods The recombinant eukaryotic expression plasmid NF-κB/P65 siRNA was constructed and transfected into HepG2 cells. RT-PCR was used to detect the efficiency of the constructed RNAi in silencing NF-κB/P65, and the steadily transfected clones of NF-κB/P65 RNAi were selected. The cultured HepG2 cells was randomly divided into four groups: control group, MT group (1.5 g/L), steadily transfected group and combination group(steadily transfected cells+MT). The apoptosis of carcinoma cells was analyzed by flow cytometry; expression of NF-κB/P65, CD95(Fas), Smac, and Survivin mRNA and protein in carcinoma cells was examined by RT-PCR and Western blotting analysis. Results The expression of NF-κB/P65, CD95(Fas), Smac, and Survivin mRNA and protein in MT group was significantly increased compared with that in the control group (P<0.05). The expression of CD95 and Smac in the steadily transfected group was significantly higher than that in the control group(P<0.05), and the expression of NF-κB/P65 and Survivin was significantly suppressed compared with the control group and the MT group(P<0.05). The expression of CD95 and Smac in the combination group was significantly increased compared with that in the other three groups(P<0.05), and the expression of NF-κB/P65 and Survivin was significantly lower than that in the MT group(P<0.05). The apoptosis rates of the HepG2 cells in the control group, MT group, steadily transfected group, and combination group were 3.21%, 6.25%, 11.82%, and 21.06%, respectively, with significant difference found between different groups(P<0.05). Conclusion The apoptosis in hepatocellular carcinoma cells induced by NF-κB RNAi combined with matrine may be related to increased CD95 and Smac expression and decreased NF-κB/P65 and Survivin expression.

Abstract:Objective To investigate the expression of arginase-2 (Arg-2) in hepatocellular carcinoma (HCC) tissues and to discuss its clinicopathological significance. Methods Totally 113 HCC samples and corresponding adjacent liver tissues were collected. Among them 29 cases were characterized by the presence of dysplastic nodules (DN). Another 12 samples of normal liver tissues were collected as controls. Western blotting analysis was used to detect the Arg-2 protein expression in 15 HCC samples, corresponding adjacent liver tissues and 12 control samples. Immunohistochemical staining was performed to detect the Arg-2 expression in 113 HCC samples, corresponding adjacent liver tissues and DN samples. The correlation of Arg-2 expression with clinicopathological features of HCC was analyzed. Results Western blotting analysis revealed no Arg-2 expression in adjacent liver tissues and normal liver tissues, while the expression was significantly increased in HCC tissues (P<0.01). Immunohistochemical staining showed that Arg-2 was expressed in the cytoplasm of HCC cells, with a positive rate of 77.0% (87/113). Arg-2 expression was found to be correlated with the histological grades of HCC tissue (P<0.05). Arg-2 was not expressed in low-grade DN; its positive rate was 14.3% (2/14) in the high-grade DN and 66.7% (8/12) in well-differentiated HCC (P<0.05). Conclusion Arg-2 is highly expressed in the HCC tissues and its expression is associated with histological grades of HCC, and it may be involved in the development and progression of HCC. Detecting Arg-2 expression may help to differentiate HCC from DN.

Abstract:Objective To optimize the process of making cell blocks by residual pleural and peritoneal effusions, and to explore its value in pathological diagnosis. Methods Totally 150 residual pleural and peritoneal effusion specimens of thinprep cytologic test (TCT) were evenly divided into 3 groups according to cytopathological diagnosis. Specimens in the three groups were processed by direct centrifugal method, egg white as the bracket method and cell block test method. The detection rate of malignant cells, distribution status and morphological features of cells on the cellular sections were compared between the three different methods, and the immunohistochemical staining results were compared between the cell block and tissue block. Results The TCT yielded a detection rate of malignant cells of 31.3% (47/150), and examination of the cell block in this study yielded a detection rate of 40.7% (61/150), with the rates of direct centrifugal method, egg white as the bracket method and cell block test method being 26.0%(13/50), 46.0%(23/50) and 50.0%(25/50), respectively. The detection rates of malignant cells in egg white as the bracket method and cell block test method groups were significantly higher than that in the direct centrifugation method (P<0.05); in addition, the former two groups also had better cell aggregation and distribution. The immunohistochemical staining results of cell blocks were also similar to those of tissue blocks. Conclusion The cell blocks processed by egg white as the bracket method and cell block test method can improve the detection rate of malignant cells in residual pleural and peritoneal effusion, and the blocks can be used for immunocytochemistry staining.

Abstract:Objective To study whether botulinum toxin type A (BTX-A) can inhibit the spontaneous and acetylcholine (ACh)- or substance P (SP)-induced contraction of rat lower esophageal sphincter in vitro, and to discuss the related mechanism. Methods The lower esophagus muscle strips were taken from Sprague-Dawley rats and were randomly divided into control group, BTX-A group, ACh group, ACh+BTX-A group, ACh+Atropine group, SP group, SP+APTL-SP group and SP+BTX-A group. The contractile graph of the muscle strips was recorded by physiological experimental system Biolap-420E. Results BTX-A significantly decreased the spontaneous contractile tension and amplitude in the lower esophageal sphincter(P<0.05). ACh significantly enhanced the contractile tension and amplitude in the lower esophageal sphincter (P<0.01), which could be significantly inhibited by both BTX-A and Atropine (P<0.01). SP significantly enhanced the contractile tension in the lower esophageal sphincter (P<0.01), which could be significantly inhibited by both BTX-A and APTL-SP (P<0.01). Conclusion ACh and SP can enhance the spontaneous contractility of lower esophageal sphincter. BTX-A can inhibit ACh- and SP-induced enhancement of lower esophageal sphincter contraction.

Abstract:Objective To study whether stabilizing microtubules can decrease myocardial ischaemic-reperfusion injury. Methods (1) The isolated rat hearts were divided into four groups (n=15): control group, ischemic group, ischemic+0.1 μmol/L Taxol group, and ischemic+1 μmol/L Taxol group. All the groups were given a 15-min equilibration and then followed by different treatments: control group, 50 min normoxic superfusion; ischemia group, 20 min normoxic superfusion plus 30 min ischemia; and Taxol groups, 20 min normoxic superfusion plus 30 min ischemia, plus 0.1 or 1 μmol/L Taxol throughout 50-min superfusion period. Arrthymias scores were assessed and compared between different groups; the structure of the microtubules was observed and its breakage score was obtained. (2) The isolated rat hearts were divided into 3 groups (n=8): normal control group, ischemic/reperfusion (I/R) group, and 1 μmol/L Taxol group. The I/R group was Langendorff-perfused; the left anterior descending branch was ligated for 30 min and reperfused for 120 min. The Taxol group received 1 μmol/L Taxol and other treatments were similar to the I/R group. Evans blue perfusion was used to observe the infarct size of each group. Results Stabilizing microtubules with Taxol (0.1 μmol/L or 1 μmol/L) reduced ischaemic ventricular arrhythmia in a dose-dependent fashion (P<0.05); it also significantly reduced arrhythmia scores and the incidence of ventricular tachycardia (P<0.05). Taxol at 0.1 μmol/L greatly decreased microtubule breakage score, and at 1 μmol/L significantly reduced the infarct size compared with the control group (P<0.05). Conclusion Stabilizing microtubules can reduce myocardial ischaemic-reperfusion injury.

Abstract:Objective To evaluate the performance of the Chinese system for cardiac operative risk evaluation (SinoSCORE) in predicting the in-hospital mortality and postoperative complications in patients undergoing cardiac valve surgery. Methods The clinical data of patients undergoing valve surgery in Changhai Hospital between 2005 and 2011 were retrospectively analyzed. SinoSCORE was used to calculate the in-hospital mortality risk. The relationship of SinoSCORE result with postoperative complications (low cardiac output syndrome, renal failure, lung infection, application of intra-aortic balloon pump \[IABP\] , prolonged ventilation, prolonged postoperative ICU stay and reoperation) was verified. Discrimination degree of the model was tested by determining the area under the receiver operating characteristic (ROC) curve, and calibration of the model was evaluated by Hosmer-Lemeshow goodness-of-fit test. The optimal cut-off points for postoperative complications, which could be well predicted by SinoSCORE, were obtained by Youden index. Results The mean age of the 3 407 enrolled patients was (49.2±13.3) years. The area under ROC was 0.754 (95%CI: 0.701-0.806), indicating good discrimination power of the model in predicting in-hospital mortality. The overall in-hospital mortality was 3.05%(104/3 407). The predicted in-hospital mortality by SinoSCORE was (3.1±0.1)%. Hosmer-Lemeshow calibration test yielded χ²=9.454，P=0.490, suggesting a high calibration ability of the model. The areas under ROC of low cardiac output syndrome, renal failure, and application of IABP were 0.708, 0.711, and 0.718, respectively, suggesting that SinoSCORE had a satisfactory performance in predicting post-operative low cardiac output syndrome, renal failure, and application of IABP. And the optimal cut-off points for the above three complications predicted by SinoSCORE were 5.5, 7.5, and 6.0, respectively. Conclusion SinoSCORE has a better performance in predicting the in-hospital mortality risk in Chinese patients undergoing valve surgery, and it can better predict post-operative low cardiac output syndrome, renal failure, and application of IABP.

Abstract:Objective To analyze the glycemic control and other metabolic profiles in outpatients with type 2 diabetes mellitus (T2DM) who were only taking oral antidiabetic drugs (OADs). Methods The clinical data and laboratory findings (past 3 months) of 374 T2DM outpatients who were followed up in our hospital were collected by questionnaire survey. The participants were grouped by the types of OADs they were taking (single drug group, two drug group, and three or more drug group). The relationship of the control status of each parameter with complications or/and other metabolic abnormalities was analyzed. Results The mean glycosylated hemoglobin A_1c (HbA_1c) of these patients was (7.46±1.22)%, with 40.64% of them achieving the recommended glycemic target (HbA_1c<7.0%). Participants with body mass index (BMI) less than 24 kg/m² achieved better glycemic control compared with those with BMI more than 24 kg/m²(P<0.05). Sulphonylureas and biguanides were the most commonly used options, accounting for 51.35% in the two drug group and 71.09% in the three or more drug group. The proportion of participants with poorly controlled glycemic status (HbA_1c≥8.0%) in the three or more drug group (34.12%) was significantly higher than that of participants in the other two groups (20.86%, P=0.005). Logistic regression analysis indicated that the long course of disease (OR=1.64), high BMI (OR=1.60) and the more comorbidities and complications (OR=1.60) were the risk factors of poor glycemic control (all P<0.01), and age was a protective factor for glycemic control (OR=0.695, P<0.01). Conclusion The status of blood glucose control in the outpatients of our hospital is not satisfactory, which is due to factors such as “therapeutic inertia”. When multidrug therapy fails to achieve the recommended glycemic targets, the treatment strategy should be adjusted promptly.

Abstract:Objective To conduct a metabolic analysis of the intracellular metabolism in baicalein-treated Candida albicans, so as to search for possible biomarkers and to discuss the mechanism of baicalein. Methods GC-MS analysis was used to obtain the metabolic fingerprint of C. albicans before and after treatment with baicalein, and multivariate statistical analysis was used to identify the differences in intracellular metabolites between the treated and control groups, so as to search for the possible biomarkers and discuss the possible relevant metabolic pathways. Results and conclusion Twenty metabolites were screened out and selected as potential biomarkers, and they were primarily involved in oxidative stress, citrate cycle, lipid metabolism and amino acid metabolism.

Abstract:Objective To distinguish Rhizoma curcuma of different origins using headspace-gas chromatography/mass spectrometry (HS-GC/MS) combined with principal components analysis (PCA) and hierarchical cluster analysis (HCA), so as to help the quality control of Rhizoma curcuma. Methods HP-5 capillary column (30 m×0.32 mm, 0.25 μm) was used under the following condition: inlet temperature: 250℃, initial column temperature: 50℃ maintained for 3 min, then increasing to 150℃ at 20℃/min and to 200℃ at 2℃/min, maintained for 10 min, with the split ratio being 101. The carrier gas was helium, with flow rate being 1.0 mL/min, hadspace vials regional temperature being 90℃, vials heating equilibration time being 30 min, and injection volume being 1.5 mL. The effect of extract separation conditions, temperature of the vial and equilibrium time on the extraction volatile components of Rhizoma curcuma were observed. Results PCA could distinguish 18 common peaks of 15 batches of Rhizoma curcuma from Sichuan, Guangxi and Yunnan, and it was confirmed that β-elemene, camphene, β-pinene, p-menth-1-en-8-ol, eucalyptol, and cycloisolongifolene, 8,9-dehydro-9-formyl were the main components to cause differences in Rhizoma curcuma of different origins. Conclusion We have established a method combining HS-GC/MS with PCA and HCA to distinguish Rhizoma curcuma of different origins, and we have also identified the major characteristic components of Rhizoma curcuma of different origins.

Abstract:Objective To develop a quantitative analysis of multi-components with single marker (QAMS) and validate its accuracy and feasibility for simultaneously determining 3-n-butylphthalide (b), sedenenolide (sen), and sedanolide (san) in celery seed extracts (CSE). Methods Three main effective components,3-n-butylphthalide, sedenenolide, and sedanolide,were selected as analytes for evaluating the quality of CSE. The relative correction factors (RCF, f) of 3-n-butylthalide to the other two thalides were calculated: f_b/sen=0.226, f_b/san =0.702. The external standard method was used to determine the title compounds in 6 batches of CSE and the results were compared with those of QAMS. Results The RSD of RCF calculated by different instruments was between 4.4%-6.7%. The RSD of RCF calculated by the same instrument with different chromatographic columns was between 2.3%-3.6%. The established RCF had a good reproducibility. The quantitative results of three thalides determined by external standard method and QAMS method were not significantly different. Conclusion The present method can serve as a new mode to determine multi-components in CSE when standard substances are unavailable.

Abstract:Objective To construct a lentiviral vector carrying mouse aquaporin-1 (AQP1) gene and use it for infecting Schwann cells of C57BL/6 mouse, so as to provide AQP1+Schwann cells for further studying the relationship of AQP1 with peripheral nerve system injury edema.Methods Mouse AQP1 gene was inserted into lentiviral vector pCDH-CMV-MCS-EF1-copGFP, and the products were confirmed by PCR and sequencing analysis. pCDH-CMV-MCS-EF1-copGFP-AQP1 and the virus packaging plasmids psPAX2 and pMD were cotransducted into 293T cells to prepare lentivirus-AQP1, and the latter was used to infect C57BL/6 mouse Schwann cells in vitro. The expression of AQP1 mRNA and protein was detected by quantitative real-time PCR and Western blotting analysis in infected mouse Schwann cells. Results PCR and sequencing revealed that the pCDH-CMV-MCS-EF1-copGFP-AQP1 plasmids were successfully constructed. The expression of AQP1 mRNA and protein in Schwann cells was significantly increased than that in cells infected with control lentiviruses (P<0.05). Conclusion We have successfully constructed a recombinant lentivirus carrying AQP1 gene, which can be used to infect mouse Schwann cells, leading to increase of AQP1 mRNA and protein expression.

Abstract:Objective To quantitatively evaluate the efficacy of a novel continuous irrigation sheath in improving the vision of flexible cystoscopy under hematuria using an in vitro bladder model. Methods An in vitro bladder model was designed for simulating flexible cystoscopy under hematuria. According to the presence of continuous hemorrhage the experiment was divided into the static experiment and the dynamic experiment. The experiment was divided into three groups according to three levels of the irrigation condition during flexible cystoscopy: no irrigation (Group 1), continuous irrigation without an outflow of water (Group 2), and continuous irrigation with an outflow of water (Group 3). The vision field of flexible cystoscopy and vision precision of flexible cystoscopy images were recorded at 30, 60, 90 and 120 s. Results The vision field and precision of flexible cystoscopy images were greatly different between the 3 groups in both the static and the dynamic experiments. Compared with Group 1, the vision field and precision were significantly improved in Group 2 and 3 in both the static and the dynamic experiments(P<0.01). The vision precision of Group 3 was significantly better than that in Group 2 in both the static and the dynamic experiments(P<0.05,P<0.01), and the vision field of Group 3 was also significantly better than that in Group 2 in the dynamic experiments (P<0.05). Conclusion The novel continuous irrigation sheath can effectively improve the vision field and precision of flexible cystoscopy.

Abstract:microRNAs (miRNAs) are involved in a number of biological processes, including cell differentiation, apoptosis, tumorigenesis, and metastasis. A group of miRNAs including miR-210, miR-32, and miR-17-92 cluster are up-regulated in renal cell carcinoma (RCC) tissues, and others including miR-141 and miR-200c are down-regulated. The mechanisms responsible for the aberrant expression might be related to cellular microenviroments and loss of chromosome. Up-regulated miR-155 together with down-regulated miR-141 can be used for discriminating RCC from non-malignant renal tissues. miR-203 and miR-424 are over-expressed in clear cell RCC compared to papillary RCC. Over-expression of miR-32 is associated with poor outcome of ccRCC patients. miR-21 and miR-106b are involved in the process of RCC invasion and metastasis. It is of great clinical significance to understand the mechanism miRNA regulation and the roles of miRNAs in molecular typing, early diagnosis and prognosis prediction.

Abstract:Objective To explore the clinical efficacies of transpedicular lumbar wedge resection osteotomy for correction of kyphosis in ankylosing spondylitis. Methods From January 2005 to March 2010,32 patients with ankylosing spondylitis kyphotic deformity received one stage posterior transpedicular wedge osteotomy and internal fixation, with 27 receiving single-level ones and 5 receiving two-level ones. All patients underwent X-ray examination of the total spine to obtain radiographic parameters and were asked to accomplish simplified Chinese scoliosis research society-22 (SRS-22) questionnaire to assess quality of health before and after operation. Results The mean operation time was (260±42) min and the mean blood loss was (1 360±282) mL in the patients. The patients were followed up for a mean of (31±8) months (range: 24-76 months) and there were no neurological complications and pseudarthrosis. The chin-brow vertical angle (CBVA), global thoraco-lumber kyphosis angle (TLKA), thoracolumbar kyphosis angle (TKA) and lumber lordosis angle (LLA) were (65.9±11.6)°, (78.2±15.9)°, (38.9±10.3)°, and (-14.6±17.3)° before operation and (11.7±4.7)°,(38.9±10.3)°,(1.3±7.8)°, and (26.2±5.6)° after operation, respectively; and significant differences were found for each parameter (P<0.01).The body height and the sagittal imbalance distance were improved from (135.4±15.2) cm and (37.2±11.3) cm before operation to (166.2±9.6) cm and (12.7±7.7) cm after operation, respectively. The average SRS-22 score increased from (1.8±0.4) before operation to (4.0±0.6) after operation, showing a satisfactory outcome. Conclusion Transpedicular lumbar wedge resection osteotomy is a safe and effective method for treatment of the ankylosing spondylitis kyphosis．

Abstract:Objective To study the effects of levocarnitine on recombinant human erythropoietin (rhEPO)dose and microinflammatory state in maintenance hemodialysis patients. Methods Totally 326 maintenance hemodialysis patients were randomly divided into 2 groups: the treatment group (n=163) and the control group (n=163). The age, gender, course of disease, and conventional treatments were similar in the 2 groups. To maintain the hemoglobin (HB) within 110-120 g/L and hematocrit (HCT) at 33%-35%, the treatment group was given levocarnitine and rhEPO, and the control group was given rhEPO only. The weekly dose of rhEPO (IU/kg) and the erythropoietin response index (ERI) were calculated and compared between the two groups 8 months later. Meanwhile, the serum high-sensitivity C-reactive protein (hs-CRP) was monitored in the 2 groups before and after 8 months. Results The weekly dose of rhEPO required for the treatment group was significantly lower than that required for the control group (\[106±20\] IU/kg vs \[141±23\] IU/kg, P<0.05); the treatment group also had significantly lower ERI compared with the control group (\[0.93±0.11\] IU·L·kg^-1·g^-1 vs \[1.35±0.29\] IU·L·kg^-1·g^-1, P<0.05). Serum hs-CRP level in the treatment group was significantly decreased 8 months after treatment (\[5.21±3.20\] mg/L vs \[10.33±2.54\] mg/L,P<0.05), and it was also significantly lower than that in the control group after the treatment (\[5.21±3.20\] mg/L vs \[9.93±2.12\] mg/L, P<0.05). Serum hs-CRP levels were not changed significantly in the control group before and after the treatment. Conclusion Levocarnitine can reduce the dose of rhEPO in MHD patients, which might be associated with improvements of the microinflammation and erythropoietin resistance in MHD patients.

Abstract:【Abstract】Objective To Investigate the clinical manifestations, diagnosis and treatment of pulmonary sequestration. Methods 30 patients with pulmonary sequestration confirmed by histopathological studies were analyzed and related literatures were reviewed. Results Among these patients, 25 were intralobar type and 5 were extralobar type. All patients with intralobar type had symptoms of cough, expectoration, fever and hemoptysis while 5 patients with extralobar type were asymptomatic. 20 patients were diagnosed preoperatively by chest radiography, plain CT scan, enhanced CT scan or CT angiography. Operation was performed in all the patients, with successfully recovery after operation, and no relapse was found. Conclusions The clinical manifestations of pulmonary sequestration are nonspecific. Although invasive, Selective arteriography was gold standard for pulmonary sequestration. Noninvasive angiography including enhanced CT scan, CT angiography have become important supplements to selective arteriography. Surgery is the optimal treatment, while the effectiveness of interventional therapy needs further investigations.

Abstract:The disease of hypophosphatemic osteomalacia is clinically rare and easy to be misdiagnosed. It refers to a metabolic bone disease in which bone matrix can not be mineralized in the normal way due to hypophosphatemia. One case report of adult-onset sporadic hypophosphatemic osteomalacia ever misdiagnosed as spondyloarthropathy and related literature were studied. We should master the diagnosis and differential diagnosis of hypophosphatemic osteomalacia to improve the clinic diagnosis and treatment level.

Abstract:患者一例，女性，42岁，在我院门诊行“硅凝胶假体植入隆乳术”后8个月突发左侧乳腺肿胀畸形，保守治疗后不见好转，遂于术后第11个月行手术探查，术中发现左侧胸大肌下形成包膜，包膜内另有一层较厚包膜包绕乳腺假体表面，形成“双包膜”，两层包膜间有大量陈旧血性液体及血清样粘液；手术中清理积液并将原假体清洗后放回胸大肌下，手术后7个月再次发现左侧乳房肿胀变形、局部发硬明显，再次行探查手术，手术中去除胸大肌下坚韧包膜，移除假体，术后诊断：隆乳术后继发左乳纤维包膜挛缩，现随访10个月无异常。整个治疗过程中患者血压，尤其是舒张压偏高，第三次手术前控制良好。经验及教训：血肿是隆乳术后早期并发症。该患者隆乳术后8个月才出现迟发性血肿，较为罕见。经验教训：如B超CT等提示隆乳继发血肿出血量较少，早期可以行静脉应用止血药物，外部加压包扎等保守疗法。但在积血量较多时，如不能及时在B超引导下进行穿刺引流，那么血肿内很快就会形成血凝块，机化后很难吸收，刺激原包膜继续增生肥厚并导致后期的“双包膜形成”及包膜挛缩。这时，就应该及时进行手术探查，止血、清理血凝块、彻底松解包膜；原置放假体应早期取出，包膜松解的同期仍坚持植入假体者强烈建议更换假体，以除去假体因素可能引发的包膜挛缩。

Abstract: