BACKGROUND:The traditional percutaneous pedicle screw fixation for thoracolumbar fractures has a lot of shortcomings,such as restoring the vertebral height.The combination of hyperextension traction-elastic compression and internal percutaneous pedicle screw fixation provides a new treatment strategy.OBJECTIVE:To observe and compare the biomechanical properties of the traditional percutaneous transpedicular screw fixation and hyperextension traction-elastic compression combined with percutaneous pedicle screw fixation in the treatment of thoracolumbar fractures.METHODS:Clinical data of 40 patients with simple vertebral compression fractures undergoing traditional percutaneous pedicle screw fixation (control group) or hyperextension traction-elastic compression combined with percutaneous pedicle screw fixation (treatment group) were analyzed retrospectively,and none had neurologic signs or symptoms.The operation time,intraoperative radiant volume,intraoperative blood loss,hospitalization time or complications were compared between two groups.The sagittal Cobb angle and percentage of anterior height in vertebral body were measured at baseline and different time points after internal fixation.The pain and symptom improvement were evaluated by Visual Analogue Scale and Oswestry Disability Index.RESULTS AND CONCLUSION:All patients were followed up for 12 months.(1) There were no significant differences in the operation time,intraoperative radiation volume,intraoperative blood loss,hospitalization time and complications between two groups (P ＞ 0.05).(2) The sagittal Cobb angle,percentage of anterior height in vertebral body,Visual Analogue Scale and Oswestry Disability Index scores after internal fixation were significantly superior to those before internal fixation in both two groups (P ＜ 0.05).(3) The sagittal Cobb angle and percentage of anterior height in vertebral body in the treatment group were significantly superior to those in the control group at 24 hours,6 and 12 months postoperatively (P ＜ 0.05).(4) The Visual Analogue Scale and Oswestry Disability Index scores in the treatment group were significantly superior to those in the control group at 12 months postoperatively (P ＜ 0.05).(5) These results indicate that hyperextension traction-elastic compression combined with percutaneous pedicle screw fixation exerts remarkable effect on restoring the vertebral height and effectiveness compared with the traditional percutaneous pedicle screw fixation.

A perfect clinical trial must nave a solid study design, strict conduction, complete quality control, non-interference of statistical result, and acceptable risk-benefit ratio. To reach the target, the quality control (QC) should be performed from the study design to conduction, from the analysis to conclusion. We discuss the relationship between data management and biostatistics from the statistical point of view, and emphasize the importance of the statistical concept and methods in the improvement of data quality in clinical data management.

AIM:To investigate the roles of maspin in the biological behaviors of non-small-cell lung cancer A549 cells.METHODS:Full-length coding region of maspin was amplified by PCR from human normal breast tissue and cloned into MSCV vector .Virus supernatants was produced by Phoenix A packaging system , and target cell line was infec-ted with the virus supernatants .The transfected cells were screened with puromycin .The cell line with maspin over-expres-sion was identified by real-time PCR and Western blot.Cell growth, migration and invasion were investigated by xCelli-gence system .RESULTS:Maspin over-expression vector was successfully constructed .The cell line with maspin over-ex-pression was established .No difference of the growth between A 549-control cells and A549-maspin cells was observed .The migration and invasion were quite different between A 549-control cells and A549-maspin cells.The expression level of inte-grin β1 in A549-maspin cells was decreased compared with A 549-control cells .CONCLUSION:Maspin has no effect on the growth of A549 cells.Maspin suppresses the migration and invasion of A 549 cells, in which integrin β1 is involved.

Objective To analyze the distribution of tophus in ankle and tarsal joints by multislice spiral computed tomography (MSCT)and to explore the pathogenesis of gout.Methods 34 patients with a documented diagnosis of gout underwent CT examina-tion of bilateral ankle and tarsal joints,and 55 ankle and tarsal joints were observed tophus.The sites of tophus deposition were cate-gorized into groups of ligament,tendon and joint in order to record and analyze.Results The tophus were showed at the anterior talofibular ligament (n=38),the medial ligament (the site of talus and calcaneus)(n=30)and the interosseous talocalcaneal liga-ment (n=29)(P <0.05)in the group of ligament;at achilles tendon (n= 18),followed by tibialis posterior tendon (n= 7)(P <0.05)in the group of tendon;at articulations intercuneiformes (n=1 5)and inferior tibiofibular articulation (n= 10)(P <0.05 )in the group of joint.Conclusion In ankle and tarsal joints,tophus is commonly deposited at the anterior talofibular ligament,at the achilles tendon and the articulationes intercuneiformes.

refer to the cases with pression caused by both posterior and anterior matters, the posterior-anterior surgery is better.

Objective To make a comparison between the plain radiograph, CT, and MR findings of gouty arthritis and to analyse the relationship between clinical data and imaging findings. Methods Fifty-four joints of 33 patients with a confirmed diagnosis of gouty arthritis were included in this study. In the morning, the blood uric acid level of patients was tested before meal. In the afternoon, their clinical data were recorded and joints were examinated by plain radiography, CT, and MRI. The imaging findings were evaluated by tophi, bone erosion, soft tissue swelling, hydrarthrosis, synovial thickness, and bone oedema. The data was analyzed by Chi-square test, indepentdent-samples t test, and logistic regression. Results The Chi-square test was utilized to evaluate number of joints with tophi(CT>plain radiography, MR>plain radiography, P<0. 01), soft tissue swelling (MR>CT>plain radiography, P<0. 01), hydrarthrosis(MR>CT, P<0. 01). In addition, 35 joints had bone oedema and 50 joints had synovial thickness. The course of disease(tophi positive group vs tophi negative group, P<0. 01) was analyzed by indepentdent-samples t test. The tophi's causative agents including bone erosion and course of disease were analysed by logistic regression(P<0. 01). Conclusions MRI is superior to CT and plain radiography on the early diagnosis of gout. Tophi and bone erosion may not affect the blood uric acid level. With the progression of disease, the probability of tophi formation increases. The relationship between the formation of tophi and bone erosion may be interpromotied.

Objective To analyze the mammographic findings of triple-negative breast cancer [TNBC,which is estrogen receptor (ER) negative,progesterone receptor (PR) negative,and human epidermal growth factor receptor 2 ( HER2 ) negative ] and triple-positive breast cancer ( TPBC,which is ER positive,PR positive,and HER2 positive ),and to evaluate the relationship of immunohistochemologic receptor status and mammographic findings.MethodsThe immunohistochemistry results of 631 cases with breast cancers were reviewed,including 117 cases of TNBC and 44 cases of TPBC.All of the patients took mammography at initial diagnosis.We retrospectively evaluated the visibility,morphology,distribution and size of the lesion (masses and calcifications) and breast density on mammography of TNBC,and compared them with those of TPBC.The age onset and tumor sizes of TNBC and TPBC were compared by using Chi-square test and t test.ResultsThe visibility rate of TNBC and TPBC on mammography were 88.0％(103/117) and 90.9％ (40/44),and the difference between them was insignificant ( x2 =0.055,P ＞0.05).TNBC was more frequently associated with merely a mass (56/103) than TPBC (12/40) (x2 =6.860,P＜0.01 ),and the mean diameter of the mass of TNBC [ ( 2.6 ± 1.4 ) cm ] was larger than that of TPBC [(2.0 ± 0.6) cm](t =2.087,P ＜ 0.05). TNBC were less frequently associated with microcalcifications (37/103) than TPBC ( 24/40 ) ( x2 =7.423,P ＜ 0.01 ).Mammographic density and lesion visibility were similar between the two different immunophenotypes of breast cancers.The mean age of TNBC (52±9) was more than that of TPBC (48 ±8) (t =2.759,P ＜0.01).Infiltrating ductal carcinoma was the main pathologic type of both groups.Basal-like breast cancer accounted for 49％ (57/117 ) of TNBC while none happened in TPBC.ConclusionsTNBC shows merely a mass with indistinct margins,lager size and is less associated with microcalcifications.These mammographic features might be useful in diagnosing triple negative breast cancer.

BACKGROUND:Different anesthesia methods significantly impact mean arterial pressure, systolic and diastolic blood pressure, arterial blood pH and blood viscosity, but what kind of anesthesia method is more suitable for preparation of animal model does not reach an agreement. OBJECTIVE: To compare the effectiveness of local anesthesia and general anesthesia for preparation of rabbit intervertebral disc degeneration model in procession of percutaneous acupuncture rotary cut. METHODS:A total of 48 New Zealand white rabbits were randomly divided into the local anesthesia group and the general anesthesia group. The local anesthesia group was anesthetized with 0.5% lidocaine. The general anesthesia group was intraperitoneally injected with 3% sodium pentobarbital (30 mg/kg). In the two groups, models of intervertebral disc degeneration were established by minimally invasive percutaneous acupuncture rotary cut at L4/5, L5/6 levels. Modeling time was observed in both groups. Disc degeneration was evaluated by the gross observation, MRI detection, and histopathological examination at 4, 8, 12, and 16 weeks after modeling. RESULTS AND CONCLUSION: (1) General observation: the nucleus pulposus gradually with darker color and elasticity reduced in two groups after modeling. (2) MRI T2-weighted image results showed no significant changes in disc signal intensity at early stage, but the signal strength showed a decreasing trend with time. (3) Disc degeneration was evaluated according to Pfirrmann grading. Disc degeneration was gradually increased with time in two groups (P< 0.05), but there was no significant difference at postoperative time points in both groups (P > 0.05). (4) Masson staining showed that different degrees of annulus irregular arrangement appear in the two groups 8 and 12 weeks after modeling, but the structure was still intact. 16 weeks later, annulus disorganized, or even breakage in the two groups; no significant difference was detected between the two groups. (5) Safranin O staining showed that nucleus pulposus cells were not significantly reduced in the two groups at 4 weeks, but were significantly reduced at 16 weeks. (6) The average modeling time of local anesthesia group [(15.24±2.67) minutes] was significantly shorter than that in the general anesthesia group [(25.64±6.85) minutes] (P < 0.05). These results indicate that intervertebral disc degeneration model can be successfully established by minimally invasive percutaneous acupuncture rotary cut by using local anesthesia and general anesthesia; however, local anesthesia has a shorter operating time and simple anesthetic procedure. The efficacy was identical between the two methods.

BACKGROUND:The Herbal Compound formula Yaotu Granules for lumbar disc degeneration has achieved satisfactory efficacy, but the underlying mechanism remains unclear. OBJECTIVE: To explore the possible molecular mechanisms ofYaotu Granules for lumbar disc degeneration based on transcriptome sequencing (RNA-seq). METHODS: Ten New Zealand white rabbits were randomly divided into control and experimental groups (n=5 per group), followed by intragastric injection of 20 mL of normal saline and 20 mL of water decoction of Yaotu Granules, respectively, twice daily for consecutive 1 week. The different drug serums were prepared using serum samples obtained from the common carotid artery at 2 hours after the last injection. Human nucleus pulposus cells were cultured in DMEM containing 10% different drug serums to observe the cellular morphology in each group. The cell viability was detected by trypan blue staining. The passage 3 human nucleus pulposus cells were pretreated for 48 hours, the mRNA level was detected using RNA-seq, and the differentially expressed mRNA was screened by RNA-seq. Subsequently, the differential gene expression, Gene Ontology (GO) enrichment analysis and Pathway enrichment analysis were performed. RESULTS AND CONCLUSION: In the experimental group, there were round or fusiform cells with abundant cytoplasm and clear nuclei that showed smooth surface and complete nuclear membrane; elongated rough endoplasmic reticulum arranged regularly, and less mitochondrion, scattered lysosomes and filaments were visible in the cytoplasm. In the control group, spindle and polygonal cells were found, and the large nuclei with 2 or 3 nucleoli and slightly rough surface were observed; there were mildly dilated endoplasmic reticulum, and few mitochondria with incomplete membrane. The adherent rate, generation time and cell viability of passage 1, 2 and 3 cells in the experimental group were significantly better than those in the control group (P < 0.05). Sequencing results found that there were 464 differentially expressed genes including 143 upregulated, and 321 downregulated genes. GO analysis revealed that the differentiated genes were mainly concentrated on cell regulation and metabolism. Pathway analysis found that mainly differentiated genes focused on the metabolism related pathways. These findings suggest that the differentially expressed gene profile of Yaotu Granules for lumbar disc degeneration is obtained by RNA-seq technology.Yaotu Granules mainly upregulate extracellular matrix metabolism-related genes and downregulate polysaccharide synthesis related genes in the prevention and treatment of lumbar disc degeneration, which provides basis for further research.

BACKGROUND: Bushen Huoxue Tongluo Capsule, a well-known traditional prescription, exhibits remarkable treatment outcomes in knee osteoarthritis, but the underlying mechanism is not fully understood. OBJECTIVE: To explore the regulatory effect of Bushen Huoxue Tongluo Capsule on miR-27a of synovial cells in Sprague-Dawley rats with knee osteoarthritis. METHODS: The model of knee osteoarthritis was established in 120 Sprague-Dawley rats using Hulth method, and then these rat models were randomized into four groups, followed by given75 mg/kg normal saline (blank control group), 34 (low-dose group), 75 (medium-dose group) and 140 (high-dose group) mg/kg Bushen Huoxue Tongluo Capsule aqueous solvent via gavage according to body mass, respectively, twice daily, for consecutive 2 courses (15 days as a course) with 2 days in between. The synovium and cartilages were removed after each course, and the expression of miR-27a in the knee joint synovium and chondrocytes was determined by real-time quantitative PCR. RESULTS AND CONCLUSION: Gross observation found that the degeneration of synovium and cartilage in the Bushen Huoxue Tongluo Capsule groups was milder than that in the blank control group. Real-time PCR revealed that there was an increasing trend in the expression of miRNA-27a in the synovium and cartilage in each group, especially in the high-dose group, and there was a significant difference between groups (P < 0.05). Our findings show that Bushen Huoxue Tongluo Capsule can suppress the reduced expression of miRNA-27a in the synovium and chondrocytes in rats with knee osteoarthritis, further alleviating knee degeneration and protecting the knee from damage.