Objective To evaluate the effectiveness and safety of one stage posterior vertebral osteotomy for correction of severe and rigid congenital scoliosis associated with Ⅰ, Ⅱ type of diastematomyelia.Methods According to the diastematomyelia packet,52 patients were divided into type Ⅰ group performed with mediastinum resection combined with spinal osteotomy, group Ⅱ without treatment of diastematomyelia direct spinal osteotomy.Group Ⅲ spinal osteotomy directly without diastematomyelia.Results The mean operation time was (548.6±113.2) min,the average amount of bleeding was (3 728.6±1 436.5) ml.In group Ⅰ,the mean operation time was (608.6± 123.2) min, significantly longer than those of group Ⅱ ((521.3 ±102.4) min,t=2.787,P＜0.01).In group Ⅰ the average amount of bleeding was (5 018.3 ±2 174.2) ml, significant more than that of group Ⅱ((2 615.3± 1 132.8) ml,t=5.182,P＜0.01).Patients with preoperative Cobb angle measurement for (95.2± 14.3) degrees, postoperative for (35.2± 14.8) degrees, follow-up of 2 years for (37.6± 16.1) degrees, group Ⅰ included preoperative (92.3 ± 12.8) degrees, postoperative (32.6 ± 15.8)degrees, 2 years later (35.8 ± 17.2) degrees;group Ⅱ before operation (99.2 ± 17.3) degrees, postoperative (37.3±14.3)degrees, 2 years later (40.2± 15.3) degrees.The postoperative Cobb angle correction rate and correction loss rate showed no significant difference between two groups (P ＞0.05), a posterior spinal osteotomy for the treatment of type Ⅰ and type Ⅱ with diastematomyelia severe rigid congenital scoliosis has good correction effect.This group of patients, the complication rate was 21.2％ (11/52);where in Ⅰ group the incidence rate of 36.4％ (8/22) was significantly higher than that of Ⅱ group 10.0％ (3/30) (P =0.021).Conclusion One stage posterior vertebral osteotomy for severe rigid with diastematomyelia of congenital scoliosis with the feasibility, effectiveness and safety, patients with type Ⅰ diastematomyelia should first bony mediastinum resection, Ⅱ type of diastematomyelia there is no need for treatment of diastematomyelia.

BACKGROUND:Sufentanil exerts protective effects on tissues, but its roles in the repair of nervous system injury and the underlying mechanism are stil unknown.
OBJECTIVE:To explore the protective effect of sufentanil preconditioning in the repair of spinal cord injuries and the underlying mechanism.
METHODS:Mouse models of spinal cord injuries were prepared through clipping spinal cord fol owed by intraperitoneal injection of 3 and 6μg/kg sufentanil, respectively.
RESULTS AND CONCLUISON:(1) Western blotting, ELISA and TUNEL assays showed that 6μg/kg sufentanil significantly down-regulated the protein expression levels of TLR4, nuclear factor-κBp65, cleaved-caspase 3, tumor necrosis factor-αand interlenkin-1βin the spinal cord of mice (P<0.05);at the same time, the number of apoptotic neurons was significantly decreased (P<0.05). (2) Furthermore, high-dose sufentanil preconditioning significantly ameliorated the recovery of limb function at 14 days after injury (P<0.05). (3) These results administrate that the neuroprotection provided by 6μg/kg sufentanil preconditioning for spinal cord injuries in mice maybe related to the TLR4/nuclear factor-κB signaling pathway inactivation.

Purpose To investigate the diameter change of dorsal root ganglion (DRG) in lumbar disc herniation using three-dimensional MR neurography. Materials and Methods Sixty-ifve patients with lumbar disc herniation and 30 healthy volunteers were selected. Bilateral DRG diameter was measured using MR three-dimensional constructive interference steady state (3D-CISS) sequence at the level of L3-S1 in the control group and at the level of herniation disc in patient group including central and lateral subgroups. The relationship between the sagittal index and DRG diameter at the level of herniation disc was analyzed. Results In the control group, the DRG diameters increased from the level of L3 to S1. The DRG diameters of the central subgroup were bigger than those of the control group (t=-2.485--2.253, P<0.05). The DRG diameters of the lateral subgroup were bigger on the diseased side than the contralateral side (t=1.956-2.432, P<0.05). The DRG diameters of the contralateral side in lateral subgroup were slightly bigger than those of control group without statistical signiifcance (t=-1.248--0.981, P>0.05). The sagittal index was not correlated with DRG diameter. Conclusion 3D-CISS sequence clearly demonstrates morphological changes of lumbosacral nerve root and measures its diameter.

Objective To investigate the aggressive signs of benign spinal lesions appearing on medical imaging and their impact on diagnosis.Methods 139 cases of benign spinal lesions with aggressive signs confirmed by pathology of needle aspiration or surgery were reviewed,including 18 cases of osteoblastoma(OB),12 cases of aneurysmal bone cyst(ABC),14 cases of osteoenchondroma (OC),19 cases of Langerhans cell histiocytosis (LCH),15 cases of hemangioma (HA),34 cases of tuberculous spondylitis (TS),and 27 cases of pyogenic spondylitis (PS).All patients underwent radiography,119 cases CT plain scan,75 cases MRI scan,and 57 cases performed all the three imaging modalities.The aggressive signs,including bulging of posterior margin of the vertebral body,pathological compression fractures,ill-defined boundary,abnormal soft tissue mass,bone marrow and soft tissue edema were showed.The benign and malignant misdiagnosis rate,the consistent rate of diagnosis with pathology were statistically analysed.Results Bulging of posterior margin of the vertebral body were found in 2 cases of OB,1 case ABC,3 cases LCH,1 case OC,6 cases HA,6 cases TS,2 cases PS.Pathological compression fracture were found in 6 cases of OB,10 cases ABC,16 cases LCH,4 cases HA,21 cases TS,16 cases PS.Ill defined boundary were found in 3 cases of OB,8 cases HA,34 cases TS,27 cases PS.The abnormal soft tissue around spine were found in 6 cases of OB,2 cases ABC,15 cases LCH,10 cases TS,15 cases PS.Bone marrow and soft tissue edema were found in 5 cases of OB,4 cases ABC,10 cases LCH,4 cases HA,30 cases TS,27 cases PS.For benign and malignant misdiagnosis rate,MRI was better than CT(P＜ 0.05).For accuracy of the consistent rate with pathology,CT was better than MRI(P＜0.05).The integrated application of the three imaging methods could significantly improve diagnostic accuracy (P＜0.05).Conclusion The imaging features benign spinal lesions are various,which may be associated with aggressive signs.A comprehensive method combined with three kinds of imaging methods,is a simple and feasible way to avoid the misdiagnosis.

Objective To evaluate a protocol of early treatment for dogs suffering from open abdominal injury and seawater immersion. Methods A canine model of open abdominal injury was made with 30 adult health dogs. After 2 hours seawater immersion, the dogs were divided into two groups: treatment group( n =18) and control group(untreated group, n =18). The changes of survival rate, body liquid metabolism and hemodynamics were observed respectively. Results The survival rate significantly increased from 0 in control group to 94 4% in treatment group. The disorder of hemodynamics and body liquid metabolism was improved significantly, P

Objective To compare dose distribution in gamma knife radiotherapy plan, conformal radiotherapy(CRT)plan and intensity modulated radiotherapy(MRT)plan for patients with small mass in lung, and evaluate their characters. Methods Fourteen patients with small mass in lung participated in the study. Gamma knife radiotherapy plan(plan 1), CRT plan(plan 2)and IMRT plan(plan 3)were made for each mass. The planning target volume(PTV)and the dose include 95% PTV were consistent.Conformal index(CI), homogeneity index(HI), lung V5 ,V10 ,V20 ,V30 and the max dose of esophagus and spinal cord were analyzed. Paired samples t-test was used for comparison between each two plans. Results The CI of the plan 1,2 and 3 were 0. 58,0. 46 and 0. 63, respectively. CI of the plan 1 ＞ that of the plan 2 (t= -3.95,P =0.000),plan 3 ＞ plan 2(t = -6.01 ,P =0.000),plan 1 =plan 3(t =1.64,P =0.116);HI of the plan 1,2 and 3 were 1.66,1.10 and 1.07 respectively. HI of the plan 1 ＞ plan 2 ,plan 1 ＞ plan 3(t= -20.52,21.41 respectively, both P=0. 000),plan 2 = plan 3(t= -1.08,P=0.294). The wholelung V5 ,V10 ,V20 and V30 were 10.0% ,5.6% ,2. 4% and 1.2%, respectively, in plan 1 ;20. 2% ,13. 4%,6. 9% ,3.0%, respectively, in plan 3; and 26. 5%, 18. 0%, 11.4% and 4. 6%, respectively, in plan 2.The V5, V10, V20 and V 30 of the plan 1 ＜ in plan 2(t = 9. 68,8. 41,5. 45,5. 14, all P = 0. 000), the V5,V10,V20 and V30 of the plan 1 ＜ in plan 3(t=7.58,8.95,6. 15,4.78, respectively, all P=0.000),the V5 ,V10, V20andV30 oftheplan2 ＞ inplan3(t =9. 71,5. 91,4. 13,3.91, respectively, allP =0.000).The max dose of esophagus in plan 1 ,2 and 3 were 24.93 ± 21.54, 31.90 ± 18. 75, 29. 19 ± 23.09 Gy,respectively, plan 1 ＜ plan 2(t = -2. 71 ,P=0.013),plan 1 = plan 3(t = - 1.49,P =0. 152),plan 2 =plan 3(t = 1.35, P = 0. 193). The max dose of spinal cord in plan 1,2 and 3 were 12.07 ± 10. 67,17.70 ±11.35 and 8.92 :± 10. 04 Gy, respectively, plan 2 ＞ plan 1 ＞plan 3(t = -2. 38,2. 29,4. 83,P=0. 1027,0.033,0.000);All three plans of each mass meet the needs that the max dose of the esophagus≤60 Gy and the max dose of spinal cord ≤40 Gy. Conclusions The dose of the normal lung was lower, but the HI and the max dose of spinal cord were higher in Gamma knife radiotherapy plan than those in the CRT and the IMRT plan of the small mass in lung.

Objective To explore MSCT optimal examination time window for patients with occult rib fracture, and provide objective evidence for forensic injury. Methods Totally 105 cases with chest trauma were retrospectively analysed. They were examined in the first week after trauma and re-examined in different time windows by MSCT. The quantities of occult rib fractures in the first examination were compared to those in re-examinations. Results The quantities of occult rib fractures at different inspection time windows were mostly different. There was no statistically significant between the quantities of rib fractures in the first week and the second week, the first week and the sixth week later, the fourth week and the fifth to sixth weeks (P>0.05). There was statistically significant between the quantities of rib fractures in the first week and the thrid to sixth weeks, the second week and the third to sixth weeks, the third week and the fourth to sixth weeks (P<0.05). Conclusion The result of the study imply that the fourth to sixth week is the optimal time window of MSCT examination in the occult rib fracture.

Objective To observe the value of three-dimensional constructive interference in steady state (3D-CISS) sequence for displaying anterolateral ligament (ALL) of knee joint.Methods MR scans of right knee joint were performed on 30 healthy volunteers,and the protocol included axial and coronal fat saturation proton density weighted imaging (FS-PDWI) and 3D-CISS sequence.MRP and CPR (reconstructive angles including 0°,30°,60°,90°,120°,150° and 180°) images were generated from of 3D-CISS sequence.The visibility rates of the femoral part,meniscal part,tibial part,meniscal insertion,femoral footprint and tibial footprint of ALL were compared among different protocols.Results The visibility rates of tibial footprint and femoral footprint of ALL on 3D-CISS CPR images were both 96.67％ (29/30),and on 3D-CISS MPR images were both 93.33％ (28/30),all of them were higher than those on FS-PDWI images (all P＜0.017).The visibility rates of tibial part,meniscal part and meniscal insertion of ALL on 3D-CISS CPR images were 96.67％ (29/30),83.33％ (25/30) and 83.33％ (25/30),respectively,and all of them were higher than those on FS-PDWI images (all P＜0.05).There was no statistical difference of visibility rate of femoral part between 3D-CISS CPR images and FS-PDWI images (P=0.095).Conclusion 3D-CISS sequence with CPR can significantly enhance the ability to identify ALL.

Objective The aims of this study were to explore effects of Wogonin on proliferation,apoptosis and the PI3K/Akt signaling pathway in human osteosarcoma MG-63 cells. Methods MG-63 cells were treated with different concentrations of Wogo-nin(0,50,100 and 200 μmol/L)for 24,48 and 72 h,MTT assay was used to determine the cell proliferation,and the rates of apoptosis of MG-63 cells were assessed by the flow cytometry;Cell scratch assay was used to detect cell migration and TEM to detect morpho-logical changes of MG-63 cells;Western blot were employed to examine the expression of COX-2,Caspase-3 and P-Akt protein in MG-63 cells. Results Wogonin significantly inhibited proliferation of MG-63 cells in a dose-or time-dependent manner,and this effect was positively correlated with drug concentration and duration of action(P<0. 05). The apoptotic rate of MG-63 cells was positively correlated to the concentrations of Wogonin. Their differences were statistically significant(P<0. 05). Wogonin also signifi-cantly inhibited the migration of MG-63 cells in a dose-dependent manner(P<0. 05). Wogonin significantly down-regulated the levels of COX-2 and p-Akt protein expression and significantly up-regulated the level of caspase-3 protein expression in MG-63 cells when compared to the negative control group(P<0. 05). Conclusion Wogonin can inhibit the proliferation of MG-63 cells and promote apoptosis,which may be related to down-regulation of PI3K/Akt signaling pathway.

Objective:To explore the value of quantitative parameters of dynamic contrast-enhanced MRI(DCE-MRI) in evaluating the biological behavior of soft tissue tumors.Methods:The clinical data of 69 patients with soft tissue tumors confirmed by pathology in the Affiliated Hospital of Qingdao University from January 2017 to December 2019 were analyzed retrospectively, including 29 benign tumors and 40 malignant tumors. All patients were examined by routine MRI and DCE-MRI before the operation. The DCE-MRI parameters including volume transfer constant (K trans), rate constant (K ep) and extracellular space volume fraction (V e) were acquired by post-processing software analysis. Microvessel density (MVD) and Ki-67 labeling index (Ki-67 LI) were detected using immunohistoche mical method. Spearman correlation test was used to analyze the correlation between DCE-MRI quantitative parameters and MVD and Ki-67 LI.Independent sample t-test or Mann-Whitney U test was used to compare the difference of parameters between benign and malignant group, and the receiver operating characteristic (ROC) curves were performed to evaluate the diagnostic value. Results:There was positive correlation between K trans, K ep and MVD ( r=0.633, 0.727, P<0.0l), and positive correlation between K trans, K ep and Ki-67 LI ( r=0.557, 0.612, P<0.01). There was no correlation between V e and MVD, Ki-67 LI ( P>0.05). The K trans, K ep, MVD and Ki-67 LI in the malignant group were higher than those in the benign group, and the differences were significant ( P<0.05).There was no significant difference in V e value between malignant group and benign group. When K trans value of 0.169/min was used, the sensitivity, specificity and area under the ROC curve (AUC) for differentiating benign and malignant soft tissue tumors were 84.6%, 85.8% and 0.859, respectively. When K ep value of 0.367/min was used, the sensitivity, specificity and AUC were 92.3%, 83.3% and 0.846, respectively. Conclusion:The DCE-MRI quantitative parameters K trans and K ep can be used to evaluate the biological behavior of soft tissue tumors.