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 partially purify the toxic factor secreted by A. corymbifera and to analyze the mechanism of A. corymbifera-induced human umbilical vein endothelial cell (HUVEC) apoptosis. Methods Glycoprotein secreted by A. corymbifera was purified by Con A Lectin chromatography. The influence of different protein fractions on HUVEC apoptosis was determined by flow eytometer. Both denaturing and nondenaturing deglycosylation of purified glycoprotein was performed and the ability of the protein moiety and carbohydrate moiety to induce HUVEC apoptosis was evaluated respectively. Activation of related caspases during A. corymbifera-induced apoptosis was analyzed by Western blot. The role of caspase-8 and -9 in HUVEC apoptosis was investigated using caspase inhibitors. Caspase inhibitors were used to stop the suppression of HUVEC viability by XTT assay. Results Flow cytometric analysis shows the total protein as well as the glycoprotein fraction of A. corymbifera may induce HUVEC apoptosis in a dose dependent manner. In contrast, similar activity was not observed in the non-glycoprotein fraction. Neither deglycosylated protein nor carbohydrate moiety is able to induce HUVEC apoptosis alone. In the apoptotic signaling pathway, caspase9, caspase-3 and cytochrome C were activated significantly, except caspase-8. Moreover, caspase-9 inhibitor, instead of caspase-8 inhibitor, completely abrogates A. corymbifera-induced HUVEC apoptosis. Caspase9 and caspase-3 inhibitors completely waived the suppression of HUVEC viability by A. corymbifera. Conclusion Glycoprotein secreted by A. corymbifera is associated with HUVEC apoptosis. Intact glycoprotein is essential for the apoptotic progress. Intrinsic apoptotic signaling pathway mediates A. corymbifera-induced HUVEC apoptosis.

Objective To develop an overall health risk model and to evaluate its convergent validity and reliability.Methods Health examination results of 230 adults from a public institution were collected by using Chinese Health Risk Appraisal Questionnaire V1.0 (CHRAQ V1.0).An CHRAQ V1.0-based overall health risk model was then developed,which included 34 items.Kolmogorov-Smirnov was used to test normal distribution of the data.Pearson correlation coefficient and Spearman correlation coefficient were used to evaluate parallel validity of the model.Crane Bach coefficient,Spearman-Brown coefficient and test-retest reliability were calculated to evaluated the reliability of the model.Results In this study,212 valid questionnaires (92.17％) were received.The average score of the newly developed overall health risk model was 41.96 ± 9.69,and its kurtosis coefficient and coefficient of skewness were 2.105 and 0.862,respectively.In Kolmogorov-Smirnov,the data were normally distributed (Z =1.073,P =0.199).The correlation coefficient of positive rate of all objective examinations with model scores was 0.774 (P ＜ 0.05).The Cronbach's alpha coefficient,Spearman-Brown coefficient and test-retest reliability of the model were 0.652,0.784 and 0.841,respectively (P ＜ 0.05).Conclusion In this investigation,our newly developed overall health risk model shows good validity and reliability and application prospect in the field of health management.

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 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 clinical significance of the 3D-CTA (three-dimensional computed tomography angiography)assisted design of finger reconstruction the second toe.Methods Between June 2010 and January 2013,five patients with finger defect received 3D-CTA assisted finger reconstruction surgeries using the second toe.Preoperative ipsilateral foot and hand 3D-CTAs were conducted and the 3D digital models were analyzed.The accurate positions and adjacent relations of vessels in both donor and recipient site were precisely marked and then the calibers of the vessels were measured.Four cases received thumb reconstructions and 1 case received little finger reconstruction.All of these surgeries were second-stage.According to Gu Yudong's classification of finger defect:second degree 2 cases,third degree 2 cases,five degree 1 case(little finger).Results With the help of 3D-CTA,five patients in this group had no vascular crisis,and all fingers survived successfully.With 4-12 months' follow-up,the algesthesia and thalposis of the reconstructed fingers gained good recoveries.The two-point discrimination was 5-10 mm.Tthe range of flexion of interphalangeal joint was 10 °-30 °.The range of flexion of the metacarpophalangeal joints was 35 °-80 °.And all patients restored walking and bearing functions with 3 months after surgeries.Conclusion The 3D-CTA reconstruction based digital model of ipsilateral foot and hand can objectively reflect the real situation of the vessels in both donor sites and recipient sites (exist of variations,routes and the calibers of the vessels),thus improve the success rate of surgery.

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.