BACKGROUND:Many previous retrospective smal-sample studies analyzed the short-term effects using pedicle screw placement to repair thoracolumbar fracture. Conclusions are relatively thin. Simultaneously, screw placement in the injured vertebra can further stabilize the vertebral body, and reduce screw and rod breakage and loss of correction. OBJECTIVE:To evaluate the long-term effects of pedicle screw placement fixation through the injured vertebra in the repair of thoracolumbar fracture. METHODS: From February 2010 to February 2012, 36 patients with thoracolumbar fracture, who were treated in the Department of Orthopedics, Guangzhou Panyu District Second People’s Hospital, were selected. They were treated by vertebral pedicle screw placement fixation. Height ratio of preoperative injured vertebral leading edge was averagely 36%. Kyphosis angle (Cobb angle) was 25°. Sagittal diameter of the center of the vertebral canal was 60%. Nerve function was classified according to Frankel classification: grade A, 2 cases; grade B, 6 cases; grade C, 10 cases; grade D, 9 cases; grade E, 9 cases. The height ratio of injured vertebra, kyphosis angle (Cobb angle), sagittal diameter of the center of the vertebral canal and Frankel classification of nerve function were compared before and after treatment. RESULTS AND CONCLUSION: The postoperative folow-up was 3-3.5 years. Pain was obviously aleviated postoperatively in 36 patients. Average height ratio of injured vertebra was 95%. Kyphosis angle (Cobb angle) was 3.5°. Sagittal diameter of the center of the vertebral canal was 96%. Significant difference was found in the above indexes before and after treatment (P < 0.05). Postoperative neurologic recovery: grade A in 1 case, grade B in 2 cases, grade C in 3 cases, grade D in 4 cases, and grade E in 26 cases. Postoperative fractures were reset. Complications such as breakage, loosing or correction loss were not found. These findings suggest that pedicle screw placement fixation through the injured vertebra in the repair of thoracolumbar fracture can make a satisfactory reduction, enhance the pressure stability of the spine, reduce the internal fixation of fracture and vertebral height loss, and have good long-term effects, indicating that the implant and host have good biocompatibility.

Objective To investigate the effect of AP-2α on the chemoresistance to oxaliplatin of colorectal carcinoma cell and its related mechanism.Methods Plasmid of GV102-AP-2α-RNAi (experimental group) and control plasmid GV102-NC (negative control group) were transfected into HCT-116 using Lipofectamine 2000 respectively.The AP-2α expression levels of mRNA and protein of experimental group,control group and HCT-116 blank group were detected by qRT-PCR and Western blot.Cell proliferation assay was performed using the CCK-8 and the apoptosis assays were preformed with Annexin V-PE Apoptosis Kit.Results The AP-2α expression levels of mRNA and protein both decreased after transfection of AP-2α-RNAi plasmid,moreover,the effect produced by subsequence 1 was the most significant.After treatment by oxaliplatin,AP-2α protein levels increased with time while mRNA did not change significantly.Western blot results suggested that the level of AP-2α protein in experimental group which was maintained in oxaliplatin was lower than the negative control group.CCK-8 results suggested that cell proliferation ability was significantly higher for the experimental group maintained in oxaliplatin [(88±3) ％] than the negative control group maintained in oxaliplatin [(57±3) ％] and the blank group maintained in oxaliplatin [(73t4) ％].Flow cytometry showed that the apoptosis rate of the experimental group maintained in oxaliplatin [(15.07±1.20) ％] was lower than the control group maintained in oxaliplatin [(24.93±0.90) ％] and the blank group maintained in oxaliplatin [(23.71±1.32) ％].Conclusion AP-2α may be related to the sensitivity of colon cancer cells to oxaliplatin.

Objective To compare the image quality, radiation dose and diagnostic accuracy on film-screen, digital radiography (DR) and computed radiography (CR) mammography. Methods Three different kinds of mammography machines (film-screen, DR and CR) were tested to make sure they were qualified and comparable. Radiographies were taken on Mammo-152 phantom and ACR phantom using filmscreen, DR and CR systems with the same radiation dose. Next, radiographies were taken on two phantoms using DR and CR systems with classic mode or AEC and the radiation dose was recorded. The images were numbered and scored by eight independent experienced radiologists under the same reading condition according to ACR method. Statistics was performed with the randomized complete-block design variance analysis. The diagnostic accuracy of three kinds of mammography methods were compared with Kappa test in clinical cases who had pathologic results. Results The spacial resolution of film-screen system was the highest (7.0-8.0 Lp/mm) and that of CR was the lowest (2.5 Lp/mm). When the radiation dose was increased (27. 0%-30. 0% ), the resolution was improved with DR ( +11. 0% ) but almost no change with CR ( +1.5%). The radiation dose of DR was the lowest on ACR phantom. The delineation of mass was better on film-screen than on CR, but the delineation of fibers and speck was better on CR. When the radiation dose of CR was increased (25. 0% ), the delineation of fibers and speck on CR was similar to that on DR and the delineation of mass was similar to that on film-screen. There was a good correlation between the mammography diagnosis and pathological results (film-screen is 50/56, DR is 83/90 and CR is 61/69,P < 0. 01 and Kappa value > 0. 75) . The diagnostic accuracy of three mammography systems had no statistical difference [film-screen 89. 3% (50/56), DR 92. 2% (83/90) and CR 88. 4% (61/69),Pearson X 2=0. 722 ,P =0. 697]. Conclusion Film/screen system has the highest space resolution and DR has the lowest radiation dose. Three mammography systems have the same diagnostic accuracy for breast disease.

Objective To compare the operative and conservative treatments for senile dens fractures of Anderson-D Alonzo type Ⅱ or Ⅲ using Meta-analysis.Methods A literature search was conducted in PubMed,Embase,Web of Science,Cochrane Library,Wanfang Data and CNKI for studies on senile dens fractures of Anderson-D Alonzo type Ⅱ or Ⅲ from the earliest records through June 2016.The relative studies identified were screened by 2 independent authors.The quality of these articles was evaluated using modified Newcastle-Ottawa scale,and the meta-analysis was conducted using Review Manager 5.3.Results A total of 22 articles were brought into this Meta-analysis.The union rate was significantly higher in the operative group than in the conservative group[OR =0.30,95％ CI(0.20,0.44),P ＜ 0.001];the mortality in the operative group was significantly lower than in the conservative group[OR =0.61,95％ CI (0.39,0.96),P=0.03];the complication rate was similar in both groups[OR=1.09,95％ CI(0.76,1.57),P ＜ 0.46].The heterogeneity of all the 3 indexes was low.In the subgroup analysis,the union rate was significantly higher in posterior operations than in anterior operations or conservative treatments (P ＜ 0.05).Conclusion For the elderly patients with dens fracture of type Ⅱ or Ⅲ who can tolerate surgery,operative treatment may be more suitable because it can lead to much better prognosis.

Objective To analyze the influence of Absidia corymbifera on cell activity of human umbilical vein endothelial cells (HUVEC) as well as the related mechanism. Methods Time course analy sis of the influence of A. corymbifera on cell viability of HUVEC was determined by cell counting after Trypan blue staining. Apoptosis of HUVEC induced by A. corymbifera was observed under fluorescence microscope after treatment with apoptosis detection kit. Time course analysis of HUVEC apoptosis induced by A. corymbifera was detected by flow cytometry quantitatively. Effect of caspase-3 inhibitor on A. corymbifera associated apoptosis was also evaluated at the same time. Activation of caspase-3 inside HUVEC was detected by Western blot. Results A. corymbifera inhibited cell viability of HUVEC in a time-dependent manner by Trypan blue staining. After 12 hours' co-culture, A. corymbifera began to show suppression on cell viability (P =0. 001 ). Fluorescence microscope observation revealed A. corymbifera induced apoptosis of HUVEC instead of necrosis. Flow cytometry analysis showed A. corymbifera induced apoptosis of HUVEC in a time-dependent manner. A. corymbifera began to show obvious effect on apoptosis after 12 h co-culture (P =0.0036). Moreover, A. corymbifera-associated apoptosis was almost abrogated completely by caspase-3 inhibitor. Western blot analysis demonstrated that A. corymbifera triggered the activation of caspase-3 inside HUVEC in a timedependent fashion. Conclusion A. corymbifera induces apoptosis of HUVEC in vitro. Such apoptotic signal is transmitted through caspase cascade reaction.

Objective To investigate the screening significance of transcranial Doppler (TCD) for patients with patent foramen ovale ( PFO) induced cerebral embolism and to improve the treatment aiming at the causes.Methods Thirty-six patients of less than 60 years old with unknown-cause cerebral embolism and transient ischemic attack were enrolled.Besides conventional examination,the 24 h Holter,transthoracic echocariiography,carotid artery Doppler ultrasonography (CAU),routine TCD,TCD foaming test,transesophageal echocardiography (TEE),CT angiography (CTA) of head and neck,ultrasonography of vein in bilateral lower limbs were examined in all patients.Results All the patients showed no atrial fibrillation.No structural heart disease and intracardiac occupying lesion were shown in transthoracic echocardiography.No carotid stenosis was shown in carotid artery Doppler ultrasonography.Routine TCD showed no intracranial artery stenosis.No thrombus was found in ultrasonography of deep veins in bilateral lower limbs.CTA of head and neck showed everything was normal.Fourteen patients were observed with right-to-left shunt in heart by TCD foaming test,including 10 cases with microbubble signals(MBS) in 10 s,and 4 cases with MBS after Valsalva maneuver.Among 14 patients,12 patients were proved PFO by TEE.Conclusions PFO is one of the causes of cardiogenic cerebral embolism.TCD is accurate and reliable for the screening of PFO.

Objective To investigate the impact of miR-200c overexpression on colon cancer cell proliferation ability and the related mechanism.Methods MicroRNAs which may combined with the transcription factor AP-2α were screened and forecasted by the bioinformatics database,while its eukaryotic expression plasmids and specific inhibitor were synthesized.Plasmids PEZX-miR-200c,PEZX-NC,pmirGLO-AP-2α3'UTR,pmir-GLO and the specific inhibitors miR-67-inhibtor,miR-200c-inhibitor were transfected in vitro into colon cancer HCT-116 and SW480 cells and the HEK293T cell by Lipofectamine2000.The expression of AP-2α mRNA and protein in colon cancer cells was analyzed by qRT-PCR,Westem blot and immunocytochemical staining.CCK-8 assay and flow cytometry were adopted to observe the effect of miR-200c on colon cancer cells proliferation and apoptosis.Dual-Luciferase assay experiments were performed to observe the relative luciferase activity induced by miR-200c.Results The proliferation activity was significantly decreased in anti-miR-200c/SW480 group,while in PEZX-miR-200c/HCT-116 group,it was higher than that in PEZX-NC/HCT-116 group.The apoptosis ability was significantly increased in anti-miR-200c/SW480 group [(78±0.7) ％ vs (66±1.1) ％,P ＜ 0.05].The expression of AP-2o both in mRNA and protein levels was decreased in PEZX-miR-200c/HCT-116 group,while the protein level was increased in Anti-miR-200c/SW480 group.The relative luciferase activity inhibited by miR-200c was decreased in HEK-293T cells transfected with PEZX-miR-200c and pmir-GLO-AP-2α3' UTR (0.51±0.09 vs 0.98±0.04,P ＜ 0.01).Conclusion MicroRNA-200c could promote cell proliferation ability by targeting transcriptional factor AP-2α in human colorectal cancer cells.

Objective To evaluate the significance of tumor markers CEA and CA15-3,and biochemical markers of bone turnover (total procol]agen type Ⅰ amino-terminal propeptide (TP I NP),β-isomerized carboxyterminal propeptide (β-CTx),ALP and PTH) in the diagnosis of bone metastasis from breast cancer.Methods A total of 78 patients (all females) with mean age (56.72 ± 10.76) years,who were diagnosed with breast cancer,were included in this study.The patients were divided into two groups based on radionuclide bone imaging:with bone metastasis (n =32) and without bone metastasis (n =46).The serum concentrations of CEA,CA15-3,TP I NP,[β-CTx,PTH,ALP were measured.Gleason scores were evaluated.The diagnostic value was evaluated by ROC curve.The two groups were compared using two-sample t test.The correlations between bone metastasis and tumor markers,bone metastasis and biochemical markers of bone turnover were analyzed with Pearson correlation and logistic analysis.Results The serum levels of CEA,CA15-3,TPINP,β-CTx,PTH and ALP were significantly higher in the group with bone metastasis than those in the group without bone metastasis (t:4.16-7.56,all P ＜ 0.05).For the diagnosis of bone metastasis from breast cancer,the AUC of CEA,CA15-3,TPINP,[β-CTx,PTH and ALP was 0.815,0.887,0.869,0.852,0.844,0.731,respectively.Using the cut-off values of 4.18 μg/L for CEA,0.04 U/L for CA15-3,49.70 μg/L for TP I NP,0.47 pg/L for β-CTx,54.90 ng/L for PTH and 49.90 U/L for ALP,the sensitivities were 56.3％ (18/32),75.0％ (24/32),78.1％ (25/32),81.3％ (26/32),78.1％ (25/32),68.8％ (22/32) and the specificities were 80.4％ (37/46),84.8％ (39/46),76.1％ (35/46),78.3％ (36/46),69.6％ (32/46),58.7％ (27/46),respectively.CEA,CA15-3,TPINP,β-CTx,PTH,ALP and Gleason score were positively correlated with the presence of bone metastasis (r:0.267-0.636,all P ＜ 0.05).CEA,CA15-3,TP I NP,β-CTx,PTH and Gleason score were independent predictors for bone metastasis of breast cancer (odds ratios:2.45,3.44,1.24,1.54,1.11,2.22,all P ＜0.05).The total coincidence rate of regression model was 81.3％ (26/32) in patients with bone metastasis.Conclusions The diagnostic values of CEA,CA15-3,TP I NP,β-CTx and PTH are comparable.Combined use of these parameters may be helpful for the early diagnosis of bone metastasis from breast cancer.

Objective:To research the effect of lumbar spinal nerve block combined with ultrashort wave on the pain and biomechanics of lumbar back muscle of patients biomechanics with lumbar disc.Methods:98 patients with lumbar disc herniation in our hospital from February 2014 to August 2016,according to the lottery method divided into control group and research group.The control group was treated with Lumbar spinal nerve block.The research group was based on the control group treated with ultrashort wave,clinical curative effect,changes of the visual analogue scale (VAS),60 ° /s angular velocity,120° /s average apical power (AP),peak torque (PT),lumbar dorsiflexion / dorsal flexion (F/E),serum levels of substance P (SP),β-endorphin (β-EP),interleukin-6 (IL-6),tumor necrosis factor-α (TNF-α) before and after treatment,and adverse reactions were compared between two groups.Results:The total effective rate of research group was95.91％,which was significant higher than that of the control group,the difference was statistically significant (P＜0.05).After treatment,The VAS,F/E,serum levels of SP,IL-6 and TNF-α of two groups were significantly lower than those before treatment,the above indicators of research group were significantly lower than those of the control group.The AP,PT and serum levels of β-EP between two groups were significantly higher than those before treatment,the above indicators of research group were significantly higher than those of the control group (P＜0.05).No statistical difference was found in the incidence of adverse effects between the two groups (P＞0.05).Conclusion:Umbar spinal nerve block combined with ultrashort wave was more effective than lumbar paravertebral nerve block treatment alone in the treatment of lumbar disc herniation,it could effectively relieve the pain and improve the low back muscle biological mechanics performance and reduce the inflammatory response.

Objective To evaluate the clinical efficacy of intra-articular injection of ozone in collagen-induced arthritis (CIA) rats and to assess its effects on serum receptor activator of nuclear factor κB ligand (RANKL) and osteoprotegerin (OPG) levels. Methods Forty weight age malched Wistar rats were randomly divided into normal control group (normal group), the CIA model group (CIA group), ozone (O 3 group), and methotrexate (MTX group). In addition to the normal control group, Freund's complete adjuvant and bovine type Ⅱ collagen were injected to establish the rat model of CIA. After the model was sucessfully developed, double ankle injection concentration ozone group of 40 μg/ml of O3 each 1 ml, 1 times a week, a total of injection for 3 weeks for the experimenal group. MTX group of 0.9 mg/kg was injected 1 times a week for 3 weeks for the MTX group. Degree of foot swelling was measured, and radiographic assessment of arthritis index (AI) score was performed. One week after treatment, angular vein blood was collected for the rats after the intervention, flow multi-factor detection technology was used to test each rat. T test or Wilcoxon rank test was used to compare the difference between groups. Results ① After 3 week administration with O3, dcgree of foot swelling, and AI of the O3 group was reduced significanly than the CIA group during the same period (foot swelling degree: O3 group: (4.21±0.14) ml, CIA group (9.12±0.17) ml, T=64.08, P=0.00; AI O3 group: [(2.97± 0.18) ml, CIA group: 5.76 ±0.13, T=37.24, P=0.00], and X-ray showed joint damage was alleviated. ② The serum level of RANKL in the CIA group was significantly higher than of the normal group [CIA model group 1890.70(797.03, 10571.94)], normal group [74.46(29.21, 95.37), T=43, P=0.005] during the same period; The serum level of RANKL in the O3 group was significantly lower than the CIA group [O3 group 28.09 (14.11, 207.30), CIA group 1890.70 (797.03, 10571.94), T=39, P<0.05]; RANKL level of the Ozone group when compared with MTX group, was not statistically significantly difference (T=52, P>0.05).③Serum RANKL/OPG of the CIA group was significantly higher than that of the normal group during this period, the difference was statistically significant [CIA group 250.68(42.33, 2959.78), normal group 4.32(3.16,5.30), T=36, P<0.01);The serum level of RANKL/OPG in the O3 group was significantly lower than the CIA group [O3 treatment group 5.10 (3.38, 6.64), CIA group 250.68 (42,33, 2959.78), T=36, P<0.01]; There was no statistically significant difference of the serum RANKL/OPG between the O3 group and the MTX group (T=62.5, P>0.05). Conclusion Intra-articular injection of concentration of 40 μg/ml of O3 can reduce RA rat joint swelling degree, which may relate to the mechanism that O3 can lower levels of serum RANKL and RANKL/OPG ratio, reduce osteoclast formation and activation.