Objective To investigate therapeutical methods on lumbar disc herniation with posterior edge separation of the vertebral body. Methods Different methods were applied to 31 patients, including 24 males and 7 females whose ages ranged from 18 to 61 years. Except that 2 patients with mild lumbar pain were treated with conservative therapy, the other 29 patients were treated with operation. The operations were made according to the relationship between compressive hernia and vertebral canal. For instance, for cases that the herniated mixtures were lateral, decompression with fenestration or amplified fenestration was applied to the trouble side; for cases that mixtures were central or paracentral, the same treatment was applied to both sides; and posterior lumbar interbody fusion(PLIF) or transforaminal lumbar interbody fusion (TLIF) was applied to those that the mixtures occupied most part of the front canal. Results The follow-up studies were made for all the patients for 1 to 4 years with an average period of 2.6 years. For the two patients treated with conservative therapy, one was fully recovered and the other, who took no effect from former therapy, was finally recruited after decompression with fenestration on the trouble side. Among the patients who were treated with operation, those with lateral herniated mixtures received significant effect, while only 60% of those with central or paracentral mixtures recovered (the unrecovered or even worsened patients after operation finally recruited by PLIF), and for those with mixtures occupying most part of the front canal, satisfactory effect were achieved. Conclusion Operation treatment should be applied to patients as early as possible when conservative therapy has no obvious effect. Different operation methods should be taken according to the relationship between compressive hernia and vertebral canal: 1) Decompression with fenestration or amplified fenestration on the trouble side be applied to those with lateral herniated mixtures; 2) Decompression with fenestration on both sides be applied to those with paracentral mixtures but no lateral crypt narrowness, and PLIF or TLIF to those with central mixtures or lateral crypt narrowness; 3) PLIF or TLIF be applied to those with mixtures occupying most part of the front canal.

Objective To analyze and compare clinical application of two types of clavicular hook plates. Methods From September 2000 to October 2003, 33 cases with acromioclavicular joint dislocation (Tossy Ⅲ) or distal clavicle fractures (Neer Ⅱ) were treated with insertion type (AO/ASIF) or knuckle-protruded type (WALDEMAR LINK) clavicular hook plates. The former one was used in 18 cases and the latter one in 15. Results In insertion type group, the average operation time was 28 minutes, with average incision length for 7.6 cm. All the cases got good reduction and fixation without any subluxation, except for one case suffering from impingement of the shoulder joint. In knuckle-protruded type group, the average operation time was 40 minutes, with an average incision length for 9.8 cm. After operation, one case lost hooking-up, one had born shoulder joint impingement, while another two suffered from skin pain at acromion caused by hook tip for a long time. Except for one case losing hooking-up, all cases of both groups achieved good recovery of function of shoulder joint and won satisfactory reduction without any redislocation after the implants being taken out. Conclusion Because of the advantages like convenient manipulation, short operation time, minor incisions and less potential complications, the insertion type clavicular hook plate is more suitable for cases with Tossy Ⅲ or Neer Ⅱ fractures.

A quantitative nuclear magnetic resonance spectroscopic ( qNMR) method was established for the simultaneous determination of resveratrol and polydatin in Polygonum Cuspidatum traditional Chinese herb cuts and granule. The 2_step ultrasonic extraction method using 80% alcohol and acetone was used for fully extracting these two components in samples before qNMR determination. The qNMR experimental conditions were investigated and deuterated dimethyl sulphoxide_deuterium oxide (10∶1, V/V) was selected as solvent, the pulse delay time was 5 s, the scan number was 32, 2,3,5_triiodobenzoate was used as internal standard which was calibrated with primary standard substance of potassium hydrogen phthalate. The 1 H_NMR peaks atδ6. 388-6. 391 ( d, 2H) of resveratrol and δ 6. 322-6. 330 ( t, 1H) of polydatin were chosen as the quantitative peaks. Method validation was performed in terms of precision ( RSD<0. 6%), linearity (correlative constants R2>0. 999), limit of detection (0. 23 g/L for resveratrol and 0. 24 g/L for polydatin) and limit of quantitation ( resveratrol 0. 69 g/L, polydatin 1. 57 g/L), recovery ( resveratrol 97. 7% -103 . 5%, RSD=2 . 4%, polydatin 94 . 5%-99 . 2%, RSD=1 . 6%, including the sample extraction and preparaton process) . The results showed the reliability of qNMR for traditional Chinese medicine assay. The resveratrol and polydatin in Polygonum Cuspidatum real cuts and granule samples were experimental determined as 3. 57-5. 69 mg/g and 12. 73-24. 07 mg/g, respectively.

Low shear stress is a component of the tumor microenvironment in vivo and plays a key role in regulating cancer cell migration and invasion. The integrin, as a mechano-sensors mediating and integrating mechanical and chemical signals, induce the adhesion between cells and extracellular matrix (ECM). The purpose of this study is to investigate the effect of low shear stress (1.4 dyn/cm2)on the migration of HepG2 cells and the expression of integrin. Scratch wound migration assay was performed to examine the effect of low shear stress on the migration of HepG2 cells at 0 h, 1 h, 2 h and 4 h, respectively. F-actin staining was used to detect the expression of F-actin in HepG2 cells treated with low shear stress at 2 h and 4 h. Western blot analysis was carried out to determine the effect of low shear stress on the expression of integrin at different durations. The results showed that the migrated distance of HepG2 cells and the expression of F-actin increased significantly compared with the controls. The integrin alpha subunits showed a different time-dependent expression, suggesting that various subunits of integrin exhibit different effects in low shear stress regulating cancer cells migration.
Actins ; physiology ; Cell Movement ; Extracellular Matrix ; physiology ; Hep G2 Cells ; Humans ; Integrins ; physiology ; Stress, Mechanical

Objective To observe the treatment of transolecranon fracture-dislocation using combined anterior and posterior approach.Methods From September 2010 to October 2014,6 patients (4 males and 2 females) with transolecranon fracture-dislocation were treated via the combined anterior and posterior approach at our department.Their average age was 42.5 years (from 25 to 63 years).One case had open injury (Gustilo-Anderson type I) and 5 closed injury.Six cases were associated with coronoid process fracture and 5 with radial head fracture.Bone union was assessed by elbow anterioposterior and lateral radiographs.The elbow function was assessed at the last follow-up according to the Broberg-Morrey functional rating indexes.Results All the 6 patients achieved primary incision healing with no early complications.They were followed up for an average period of 14 months (from 9 to 22 months).All fractures healed 6 months post-operation.At the last follow-up,the average elbow flexion range was 127° (from 90° to 145°) and the average rotation range was 112°(from 80° to 150°).The mean Broberg and Morrey functional score was 89 points (from 74 to 96 points).Two cases were excellent,3 good,and one moderate.No implant failure,heterotopic ossification or elbow instability was observed at the last follow-up.Conclusion In treatment of transolecranon fracture-dislocation,combined anterior and posterior approach provides clear vision which benefits anatomical reduction and stable fixation.Also it allows early mobilization of the elbow and leads to good short-term results.

Objective:To investigate the relationship between the expression of serum exsomal miRNA-155-5p (miR-155-5p) and prognosis in patients with esophageal squamous cell carcinoma (ESCC).Methods:A total of 336 samples from ESCC patients in Fujian Provincial Cancer Hospital from October 2014 to December 2015 were collected. The relative expression levels of serum exsomal miR-155-5p were detected by using real-time fluorescent quantitative polymerase chain reaction (qRT-PCR). Cut-off value of the expression levels of serum exsomal miR-155-5p was determined by using X-tile software. Based on the optimal cut-off value, patients were divided into miR-155-5p low expression group and miR-155-5p high expression group. The survival curve was drawn by using Kaplan-Meier method and Cox proportional hazards regression model was used to make survival analysis.Results:The cut-off value of serum exsomal miR-155-5p expression level was 2.340. According to the cut-off value, patients were divided into miR-155-5p low expression group (<2.340) of 51 cases and miR-155-5p high expression group (≥2.340) of 285 cases. There were no statistical differences in age ( χ2 = 0.020, P = 0.887), gender ( χ2 = 0.283, P = 0.595), tumor location ( χ2 = 0.063, P = 0.977), differentiation grade ( P = 0.474), clinical staging ( χ2 = 3.996, P = 0.136) and surgery treatment ( χ2 = 0.941, P = 0.332) of patients in both groups. ESCC patients in serum exsomal miR-155-5p high expression had a higher risk of death compared with patients in miR-155-5p low expression group ( HR = 1.763, 95% CI 1.049-2.961, P = 0.032). Conclusion:The high expression level of serum exsomal miR-155-5p is associated with poor prognosis in ESCC patients and it could be used as a prognostic new marker in ESCC patients.

Ribosomes are abundant,large RNA-protein complexes that are the sites of all protein synthesis in cells.Defects in ribosomal proteins(RPs),including proteoforms arising from genetic variations,alternative splicing of RNA transcripts,post-translational modifications and alterations of protein expression level,have been linked to a diverse range of diseases,including cancer and aging.Comprehensive character-ization of ribosomal proteoforms is challenging but important for the discovery of potential disease biomarkers or protein targets.In the present work,using E.coli 70S RPs as an example,we first developed a top-down proteomics approach on a Waters Synapt G2 Si mass spectrometry(MS)system,and then applied it to the HeLa 80S ribosome.The results were complemented by a bottom-up approach.In total,50 out of 55 RPs were identified using the top-down approach.Among these,more than 30 RPs were found to have their N-terminal methionine removed.Additional modifications such as methylation,acetylation,and hydroxylation were also observed,and the modification sites were identified by bottom-up MS.In a HeLa 80S ribosomal sample,we identified 98 ribosomal proteoforms,among which multiple truncated 80S ribosomal proteoforms were observed,the type of information which is often overlooked by bottom-up experiments.Although their relevance to diseases is not yet known,the integration of top-down and bottom-up proteomics approaches paves the way for the discovery of proteoform-specific disease biomarkers or targets.

Coronavirus disease 2019 (COVID-19) outbreak started in December 2019 that caused difficulties for clinical work. Practical work experience in our spinal outpatient and emergency department during the COVID-19 pandemic is summarized in this article, with combined evidence-based medical evidence to explore a standardized process of diagnosis and treatment for spinal diseases. Outpatient reservation, continuous screening, triage, and isolation, first consultation accountability system, pandemic reporting system, and online revisit were strictly followed. We hope that our experience in prevention and control of COVID-19 can help spine surgeons globally in stopping the spread of COVID-19. Spine surgeons should collaborate with infection control specialists to avoid cross-infection in hospitals and optimize treatment.

Objective To evaluate the clinical effects of autologous osteochondral transplantation for talar lesions after anterolateral tibial osteotomy.Methods Between October 2011 and June 2015,10 patients with osteochondral lesions on the lateral talar dome underwent autologous osteochondra] transplantation after anterolateral tibial osteotomy.All donor grafts were harvested from the lateral femoral condyle of the ipsilateral knee.They were 6 men and 4 women,aged from 25 to 54 years(average 35.8 years).According to Hepple classification,7 patients belonged to stage Ⅴ and 3 to stage Ⅳ.The lesion areas ranged from 110 mm2 to 247 mm2,averaging 178.6 mm2;the lesion depths ranged from 6 mm to 11 mm,averaging 7.8 mm.The ankle function and pain were assessed according to American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score and visual analogue scale (VAS) preoperatively and postoperatively.Results The 8 patients were followed up for an average of 31.6 months (from 18 to 51 months).All the patients achieved bone union 6 weeks after operation and were free of infection,malunion or hardware failure.The average AOFAS and VAS scores were improved from preoperative 65.5 and 6.9 to 91.3 and 1.3 at the last follow-up,respectively.Four cases were rated as excellent and 4 as good.Conclusions Anterolateral tibial osteotomy can provide excellent exposure of the lateral talar lesions for autologous osteochondral transplantation without problems related to the osteotomy itself.Also it may lead to good functional recovery in a short term.

Objective:To study the effect of insulin intraperitoneal administration combined with dietary intervention on glycemic regulation in in KKAy mice with spontaneous type 2 diabetes.Methods:An animal model of type 2 diabetes was established, and healthy C57BL/6J mice were selected as the normal control group and healthy KKAy mice as the non-disease group. The successfully modeled KKAy mice were randomly divided into the subcutaneous group, the intraperitoneal group, and the untreated group. The non-disease group was given a maintenance diet, and all other groups were fed a high-fat, high-sugar diet. The daily feeding time was from 08:00 to 20:00, with one feeding at a 4-hour interval, for a total of four times. The subcutaneous and intraperitoneal groups were given subcutaneous and intraperitoneal insulin injections before feeding, and recombinant glargine insulin injection (subcutaneous group: 0.125 IU/g; intraperitoneal group: 0.250 IU/g) was injected before the first feeding, and biosynthetic human insulin injection (subcutaneous group: 0.075 IU/g; intraperitoneal group: 0.125 IU/g) was injected after a 0.5 h interval; the rest 3 times before feeding, the biosynthetic human insulin injection (subcutaneous group: 0.075 IU/g; intraperitoneal group: 0.125 IU/g) was injected for 4 weeks. The dietary intake, body mass, fasting blood glucose, and 1 and 2 h postprandial blood glucose of mice in each group were tested regularly, and an oral glucose tolerance test was performed.Results:The total dietary intake of mice in the intraperitoneal group was lower than that in the subcutaneous group. Compared with the initial body mass, the body mass of the mice in the subcutaneous and intraperitoneal groups decreased by 5.05 and 3.59 g at week 4, respectively. The changes of fasting blood glucose in the subcutaneous and intraperitoneal groups ranged from 5.4 to 9.4 and 5.4 to 6.4 mmol/L, respectively, and the changes of 1 h postprandial blood glucose ranged from 4.6 to 12.3 and 5.7 to 8.9 mmol/L, respectively, and the changes of 2 h postprandial blood glucose ranged from 2.5 to 9.8 and 3.8 to 7.1 mmol/L, respectively. For the glucose tolerance index, the intraperitoneal group showed improvement at all time points, and the subcutaneous group showed a decrease at all time points except for 0 and 60 min.Conclusions:In combination with dietary intervention, insulin intraperitoneal injection was more effective in controlling blood glucose in KKAy mice with spontaneous type 2 diabetes compared with subcutaneous insulin injection, and had a significant improvement in glucose tolerance.