Split spinal cord malformation(SSCM) is a rare neurological abnormality that spinal cord was separated in the sagittal plane.Based on the tissue element and type of thecal shvac,SSCM is classified into Ⅰ,Ⅱ and mixed type.Congenital spinal deformity(CSD) is caused by the vertebral body formed or segmented obstacles.CSD can be divided into 3 types:Ⅰ,Ⅱ and mixed type.Both of SSCM and CSD are diagnosed depending on clinical symptoms,X rays,computed tomography (CT),magnetic resonance imaging(MRI) and other examine.Genitourinary and cardiac ultrasound should be performed at the same time.Progression of spinal deformity and nerve injury are accompanied with the growth process of children with CSD and SSCM.Early surgery can avoid further injury of nervous system,prevent spinal deformity progress and obtain good correction.Segmental tissue removal,tethered cord release and spinal deformity correction are generally consisted into an individual operative plan at present.Traditional surgical option included 2 steps:tissue removal and tethered cord release are conducted at Ⅰ phase surgery;then conducted the spinal deformity correction at Ⅱ phase.However,some reports suggested that completed the process of tissue removal,tethered cord release and spinal deformity correction at one surgery also obtain a satisfied effictiveness.The aim of this research is to review and discuss the diagnosis of the SSCM with CSD and evaluate the treatment effectiveness of Ⅰ phase surgery instead of the traditional surgical option.

Hemivertebra (HV) is a congenital spinal abnormality due to a defection of formation of one side vertebral.It is divided into 3 types according to whether it fusion with adjacent vertebral : fully segmented, semi-segmented and incarcerated.HV deformity is diagnosed depending on clinical symptoms, X rays, CT and other examine.Preoperative magnetic resonance imaging of the spine, genitourinary and cardiac ultrasound should be performed at the same time.Congenital scoliosis due to HV especially fully segmented is nonresponsive to bracing,operative treatment is the mainstay of care.The 3 basic operations are fusion in situ, convex growth arrest (epiphysiodesis), and HV resection.The single posterior approach or combined anterior and posterior approach of HV resection with instrumentation is the main method now.

Tethered cord syndrome is a severe and congenital disease. Resecting the diseased ilium terminal(FT), eystis, lipoma is the main treatment for the disease, relieving the injury to the eonus medullaris. Why the FT is diseased and thickened? Is it necessary to eut internal FT or external FT? What is the injury mechanism of the low-positional or normal positional oonus medullaris? To study the component and structure of the conus medullaris and FT may give definite answers.

Objective To study the effects of dietary estrogens genistein(GS)and zearalenone(ZEA)on apoptosis in-duced by estrogen depletion in PEO4cells.Methods The monolayer ovarian cancer cell line PEO4cells were cultured in DMEM medium containing10%bovine serum.Before the addition of the testing compounds the cells were washed in phosphate-buffered saline and the medium was displaced with a phenol red-free DMEM medium containing5%dextral charcoal-stripped FBS and the cells were cultured for5days in order to exhaust the estrogen stored in the cells,and then cells were divided into5groups,including solvent control group,estrogen control group,anti-estrogen control group and2experimental groups.After treatment the apoptotic features of the cells were observed by cellular morphology,DNA fragmentation and location and height of cell hypodiploid were indicated by flow cytometry.Results The typical characteristics of apoptosis in PEO4cells were observed after estrogen deletion and then disappeared following exposure of the PEO4cells to32?10 -9 mol/L and96?10 -9 mol/L ZEA for72hrs.32?10 -6 mol/L and96?10 -6 mol/L GS could significantly aggravate apoptosis in PEO4cells.Conclusion Zearalenone is a kind of mycoestrogen that has estrogenic activity to inhibit apoptosis in PEO4cells.Genistein is a kind of phytoestrogen that has anti-estrogen activity(tamoxifen-like)to promote apoptosis in PEO4cells with the high doses range.

[Objective]To analyze clinical features,evaluate diagnostic procedures and discuss the different forms of therapy for each case of split cord malformation(SCM).[Method]A series of 48 patients had a follow-up period of 0.5~9 years,29 males and 19 females,aged 7 days to 14 years,were evaluated retrospectively.They suffered from back midline abnormalities,neurological deficits of lower limbs and bladder dysfunction.At first they were cut filum terminale and then excised the fibrous or bony spur finally treated scoliosis.The radiologieal procedures used for the diagnosis of SCM were spinal X-ray,ultrasound,CT scan and MRI.[Result]In all of the 48 patients with tethered cord,there were 28 cases with dysplasia of lower limbs and feet,13 cases with urination and defecation dysfunction,14 cases with only dorsal-lumbar abnormalities,26 cases with scoliosis and kyphosis,14 with myelomeningocele,15 with syringomyelia and 12 with intraspinal lipomas.There were 27 cases suffering from type Ⅰ SCM,18 type Ⅱ SCM and 3 composite type SCM according to Pang.The most frequent location of the spur was at the lumbar level(38 cases),the less frequent in thoracic regions(6 cases)and exceptionally rare below S_1(2 cases),in the cervical regions(1 case),the thoralumbar(1 case).After operation,28 cases were improved,3 cases were cured and 3 cases were inefficacy.[Conclusion]The most frequent syndrome of SCM patients is lower limbs dysplasia and dorsal-lumbar abnormalities.The patients are most suffered from tethered cord and spinal deformities.To improve diagnosis of SCM,tethered cord and other deformities,the patients should be routinely evaluated by MRI and X-ray of the whole spine,sometimes could be evaluated by ultrasound and CT scan.SCM cases should be early treated by first cutting filium terminal and then excising fibrous or bony spur and hemivertebra.

Objective:To evaluate the feasibility of fine-needle aspiration cytology (FNAC) in diagnosing vascular abnormality in oral and maxillofacial region.Methods: The method of retrospective study was used.The data from the patients who underwent FNAC from 2011 to 2014 in Department of Oral and Maxillofacial Surgery, Peking University School of Stomatology were collected.All the included patients were divided into surgery group and non-surgery group.The patients in surgery group underwent lesion resection and the postoperative pathological results were gained.The patients in non-surgery group underwent periodical sclerotherapy.The accuracy of FNAC was identified by histopathologic diagnosis in surgery group and the effect of sclerotherapy in non-surgery group.Results: In this study, 93 patients were involved, including 51 males and 42 females.The median age was 2.5 years.Among them, 67 cases were judged as vascular abnormality by FNAC, and 63 cases were in consistent with final diagnosis and 4 cases were not.Among the other 26 cases which were diagnosed as other diseases by FNAC, 5 cases were accorded with final diagnosis.Therefore, the sensitivity of FNAC on diagnosis of vascular abnormity was 93% and its specificity was 84%.Among them, there were 29 cases in the surgery group and 64 cases in the non-surgery group.FNAC results were in consistent with the postoperative pathological results in 20 cases in surgery group (69%), and not consistent with pathological results in 9 cases.The pathological diagnoses included vascular malformations (3 cases), neurofibromas (2 cases), hamartoma (1 case), sebaceous cyst (1 case), adenolymphoma (1 case), and descriptive diagnosis (1 case).In non-surgery group, FNAC results were in consistent with the clinical effect of sclerotherapy in 61 cases (95%).There were 3 misdiagnosed cases.The coincident rate between the result of FNAC and that of pathological or clinical diagnosis was 86%.Conclusion: FNAC is a feasible and minimal invasive method to diagnose vascular abnormality in oral and maxillofacial region.

Objective The filum terminale(FT)plays an important role in the pathophysiology of tethered cord syndrome(TCS).The study on morphology and structure of fetus FF can provide reference standard for diagnosis of TCS.Methods Ten fresh human aborted fetuses had their fila measured and removed.Transversal and longitudi nal sections of the middle,and distal thirds of FF were submitted to light microscopy analysis with four different techniques.Results The bulk of the Frr is composed of 1～5μm thick spring like longitudinal bundles of colla gen separated by 5～30μm layer intervals and 1～5μm intervals in the layer,although a small quantity of eapillar ies and other elements may be present.Collagen bundles can also be found between layers and bundles.Abundant longitudinally oriented elastic fibers ale found inside or between collagen bundles.Conclusion A complex tridi mensional structure composed by ordered arrangement of spring like fibers and small quantity of capillaries should e licit considerable elastic properties to the FI".Tts alternation of structure and element maybe involved in TCS closely.

Objective: To explore the mechanisms of the effect of isoflavone in reducing prostate cancer incidence throught studying the effects of isoflavone on apoptosis in PC-3 cell. Methods: Prostate cancer cell PC-3 was grown in RPMI 1640 medium supplemented with 10% bovine serum and 10 000 U/ml of penicillin/streptomycin in an incubator maintained at 5% CO 2 95% air and 100% humidity at 37 ℃. The respective test compound was added in fresh medium and the control cell received only the vehicle (MDSO). Apoptosis of PC-3 cells was analyzed by cell morphology under light microscope, agarose gel electrophoresis and flow cytometry. Results: Exposure of PC-3 cell to 50 ?mol/L GS, 75 ?mol/L DA and 75 ?mol/L GL after 72 h, the cell morphology indicated typical features commonly used to define apoptosis; agarose gel electrophoresis demonstrated laddered electrophoretic profiles of oligonucleosomal DNA fragments indicative of apoptosis, and flow cytometric analysis revealed a hyperdiploid population in the tested cells. Conclusion: Isoflavones could induce apoptosis in prostate cancer cells PC-3 and it may be the main cause of their role in cancer inhibition.

Objective:To explore the feasibility of the application of optical coherence tomography (OCT) in the diagnosis of congenital pseudarthrosis of tibia (CPT) in children.Methods:Ten children with neurofibromatosis type Ⅰ (NF1) and CPT were treated in the Third Affiliated Hospital of Zhengzhou University from January 2016 to December 2019, and enrolled as the experimental group.The bone tissue samples were collected and subjected to OCT scanning after intraoperative observation and evaluation, and were contrasted with conventional histological examination.During the same period, the bone tissues of 5 non-NF1 and non-CPT induced-labor fetuses were collected as the control group for the above examination, and the bone tissue examination results of the experimental group and the control group were compared as well.Results:Compared with the bone tissues of the control group, that of the experimental group displayed thickening trabecular bone, part of trabecular bone fusion, disordered arrangement, proliferation and fatification of interstitial fibrous tissue.OCT scan can directly show the nerves and blood vessels in the bone tissue, scattered in adipose tissue.OCT scan showed that the bone tissues of the control group were neatly arranged, with dense and regular shadows.The bone tissues of the experimental group could be observed with strong refraction, loose arrangement, and disordered bone fractures, fibrous ossification, scattered nerves, blood vessels, and increased vacuolar fat cells.Conclusions:OCT can quickly and clearly scan the freshly isolated tissues and directly display the internal structure of the tissues.It is highly compatible with routine pathological examinations and can be an effective supplement to the pathological diagnosis of children with CPT and retain samples for subsequent genetic studies.

Objective To explore the treatment method and clinical effect of congenital scoliosis caused by lumbosacral spine deformity in children.Methods From October 2000 to October 2015,a consecutive series of 21 congenital scoliosis due to lumbosacral spine deformity were treated in Department of Pediatric Orthopedics,the Third Affiliated Hospital of Zhengzhou University,including 12 male and 9 female,and the age was (63.1±47.3) months(3-144 months).The hemivertebrae,bone bridge,and the mixed type were found in 18 cases,2 cases,and 1 case,respectively.Hemivertebraes were on the left in 10 cases,on the right in 9 cases;involved L5 in 8 cases,S1 in 6 cases,multiple vertebrae malformation in 4 cases,wedged-shaped vertebrae involved L5 associated with contralateral bar in 1 case,unilateral unsegmented bar from L4 to S1 in 1 case,from L2 to L5 in 1 case.There were 4 cases combining with thoracic hemivertebrae,3 cases with ribs fusion and contralateral bar,16 cases(76%) with spinal cord malformations,3 cases(17%) with urinary system malformations,no congenital heart malformation.All the 21 patients were operated with one-stage posterior approach.Compared the scoliosis Cobb angle,trunk shift,operative time,blood loss volume,and complications among preoperation,post-operation and final follow-up.Results In this study,operative time was (278.9±83.1) min,blood loss volume was (355.3±249.0) mL,follow-up was (5.1±2.7) years.There were 18 cases operated with pedicle screw fixation,aged (72.9±44.1) months(16-144 months),operative time was (296.2±74.2) min,blood loss volume was(422.1±238.2) mL;the mean coronal Cobb angle of malformation area at preoperation,post operation and the final follow-up were(27.3±10.2)°,(11.0±5.9)°,(9.8±4.2)°,while the correction rate of post-operation and the final follow-up were 59.7%,64.1%.There were 3 cases operated by hemivenebra resection without pedicle screw fixation,aged 7.7 months(3-15 months),operative time was 168.3 min,blood loss volume was 103.3 mL.The mean coronal Cobb angle of malformation area at preoperation,post-operation and the final follow-up were 26.0°,13.6°,12.5°,while the correction rate of post-operation and the final follow-up were 47.7%,51.9%.The follow-up period was (5.1±2.7) years.The coronal Cobb angle of lumbosacral curve at preo-peration,post-operation and the final follow-up were (27.7±10.0)°,(11.3±5.4)°,(10.0±5.0)°,compared with preoperation,the differences of post-operation and the final follow-up were statistically significant (t=6.600,7.230,all P<0.05),with the correction rate of 59.2%,63.9%;the compensatory head side Cobb angle were(25.0±12.8)°,(11.9±8.2)°,(10.3±6.9)°,compared with preoperation,the differences of post-operation and the final follow-up were statistically significant (t=3.934,4.626,all P<0.05),with the correction rate of 52.4%,58.8%.Trunk shift was significantly improved.One case appeared fracture fixation rods breakage after 9 years,1 case appeared iliac screw breakage after 2 years but no complication such as infection,nerve injury.Conclusions The formation of obstacles and vertebral segmentation defects will lead to lumbosacral spine deformity,and scoliosis.Early one-stage posterior hemivertebra resection,breakage the bone bridge combined with pedicle screw fixation can obtain satisfactory clinical outcome.