BACKGROUND: The development of hip joint in children with developmental dislocation of the hip (DDH) has been evaluated by X-ray plain film, which mainly presents Shen Tong's line continuity and epiphyseal nucleus position. There is still a lack of quantitative and objective evaluation methods. OBJECTIVE: To evaluate the rotation center and dislocation degree in DDH children by using three-dimensional (3D) computed tomography (CT).METHODS: Preoperative 3D CT was performed for 16 unilateral DDH from December 2010 to December 2014 in Tongji Hospital of Huazhong University of Science and Technology, with 4 males and 12 females, at the mean age of (4.42±2.59) years. There were 10 cases on the left side and 6 cases on the right side. 3D digital models were constructed by analysis. The 3D coordinate system was established with reverse engineering software. In 3D coordinatesystem, using inverse solution method of sphere fitting engineering, the rotation center of the acetabulum, the rotationalcenter of the femoral head, and the radius of ossification were constructed. Ossific radius ratio and dislocation lengthwere calculated. RESULTS AND CONCLUSION: (1) The acetabulum has the same point as the rotation center with the head of femur,and no significant difference in X, Y, and Z coordinates was detected (Px > 0.05, Py > 0.05, Pz > 0.05). However, it is notthe same condition in ipsilateral acetabular rotation center and femoral head rotation center, showing significant differences (Px=0.052, Py < 0.05, Pz < 0.05). (2) There were no significant differences in ossific radius between the healthy and affected sides (P > 0.05). The ossific radius was (21.37±4.42) mm and (20.14±3.14) mm on the healthy and affected sides of the femoral head (P < 0.05). (3) There was no significant difference in ossific radius ratio between healthy and affected sides (0.544±0.069 and 0.522±0.088; P > 0.05). (4) The dislocation length was 8.64-35.28 mm, mean (19.47±7.84) mm. (5) These findings suggest that 3D CT reconstruction can construct 3D digital models of DDHchildren. Thus, the accurate rotation center of the hip can be identified so as to precisely measure the dislocation length.

Objective To analyze the value of two-dimensional ultrasound diagnosis of medullary thyroid carcinoma.Methods The two-dimensional ultrasonographic manifestations of 18 nodules in 13 medullary thyroid carcinoma patients pathologically confirmed were analyzed retrospectively.Results In 18 nodules of medullary thyroid carcinoma,18 nodules were hypoechoic,13 nodules were irregular shaped,14 nodules had unclear boundaries,15 nodules with an aspect ratio less than 1,13 nodules had calcifications and 9 patients had neck lymphatic enlargement.Conclusion Medullary thyroid carcinoma has some two-dimensional ultrasonographic manifestations:hypoechoic nodules,no obvious envelope with coarse calcification and widely distributed,and tiny calcified nodules of hypoechoic,round,non-calcified with an aspect ratio greater than 1 and the diameter less than 10 mm should be wary of medullary thyroid carcinoma.

Objective To study the effects of Shuanghuanglian Oral Solution (only for children) on general condition, body weight, food intake, growth and development, blood routine and pathologic changes of SD weanling rats; To provide experimental references for clinical safe medication.Methods SD weanling rats were randomly divided into control group,Shuanghuanglian (only for children) Oral Solution low-, medium- and high-dose group according to body mass, with 30 rats in each group. Each administration group was given corresponding amount of Shuanghuanglian Oral Solution (only for children) concentrated ointment for gavage, once a day, for 33 d. The toxicity of the rats during dosing period and recovery period (medicine withdrawal 25 d) was observed.Results There were no significant differences in general condition, individual development, organ mass and coefficient, and internal fixation and pathological findings of rats in administration groups during dosing period and recovery period. The body mass and food intake of female and male rats in the Shuanghuanglian Oral Solution high-dose group were lower than those in the control group. The blood routine test during dosing period showed that the lymphocyte ratio of female rats and male rats in Shuanghuanglian Oral Solution high-dose group decreased significantly, neutrophil ratio increased significantly, and then returned to normal level in recovery period.Conclusion Shuanghuanglian Oral Solution (only for children) concentrated ointment has no toxic effect on the whole body organs and tissues of juvenile rats, and the safety is good.

Objective To study the anatomic characteristics of Zuckerkandl's tubercle (ZT) and its clinical relevance as an anatomic landmark of the recurrent laryngeal nerve (RLN) in thyroid surgery.Methods This study involved 147 (106 with benign thyroid diseases and 41 with malignancies) patients who underwent thyroidectomy.ZT was measured and classified based on the Pelizzo classification.The relationship between ZT and the RLN and the relationship between the RLN and the inferior thyroid artery were recognized and classified.Results 233 (107 left and 126 right) thyroid gland lobes were dissected and ZT was identified in most patients (left in 93.5％ and right in 96.0％).The distribution of ZT according to grade was as follows:Grade 0,left 16.0％ and right 13.2％ ; Grade Ⅰ,left 32.0％ and right 27.3％ ; Grade Ⅱ,left 46.0％ and right 44.6％ ; Grade Ⅲ,left 6.0％ and right 14.9％.There was no significant difference on classification between the left-sided and right-sided ZTs.In terms of the relationship between the ZT and the RLN,it was classified as follows:Type A,left 92.9％ and right 93.3％ ; Type B:left 0 and right 0; Type C:left 7.1％ and right 6.7％.Similarly,there was no significant difference between the left sided and the right sided.The ZT grade was correlated with the course of the RLN:the higher the ZT grade was (that is,the greater the size of the ZT),the more often was the course of RLN behind the back of the ZT; the lower the ZT grade (that is,the smaller the size of the ZT),the more often was the course of RLN running by the lateral of the ZT.Considering the incidence of being dangerous type of RLN,the right sided (19.0％) was higher than the left sided (8.3％).The relationship between the ZT and the RLN does not relate to RLN course across the inferior thyroid artery.Conclusions As an important anatomic landmark,the ZT is essential for locating and dissecting the RLN during thyroid surgery,and its classification is a guide to RLN dissection and preservation.

Biomarkers ; Humans ; Indium ; Occupational Exposure

Objective To evaluate the feasibility of methylene blue as a method in lymphatic mapping and the effect factors of SLNB identification rate. Methods The results of SLNB in 276 patients with clinical stage T-T2N0M0 breast eaneer were analyzed to evaluate the effect factors of identification rate and false-neg-ative rate of SLNB. Results The identification of SLN was carried out using methylene blne . When the mapping time of SLN and lymphatic were controlled in 20～30 minutes, the SLN could be visualized easily. SLN was successfully identified in 246 of 276 patients (89.1%) ,423 SLNs were retrieved(1～4). The SLN accurately predicted the status of the axilla in 226 of 246 patients (77.3%) yielding a FNR(false negative rate)of 8.1% (20/246) ,false positive rate of0, and an accuracy of 91.9% (226/241). For the identified rate of SLN, the clinical stage of T2N0M0 disease was higher than the clinical stage of T1N0M0 disease (P=0.046,P<0.05), Upper outer quadrant and lower outer quadrant were higher than other evidently (P<0.0010). SLNs were easily retrieved in those cases aged above 50 years than below 50 years (P<0.001).In the view of false-negative rate of SLNB, the FNR rate in patients of 50 years old was less than older ones (P=0.037, P<0.05). No significant correlation was found between the stage of TMN, the expression of ER and PR, histologic status and FNR. Conclusion When SLNB was performed using methylene blue, we found age, clinical stage of TMN, the location of tumor had relationship with the identified rate of SLN. Ag-ing and location of tumor may adversely affect FNR of SLNB.

Objective To investigate the protective effects of Angelicae Sinensis Radix and Angelicae Sinensis Radix polysaccharides on immune function injury induced by X rays in SD rats. Methods Forty SD rats were randomly divided into control group, model group, Angelicae Sinensis Radix Decoction group, Angelicae Sinensis Radix polysaccharide group and positive medicine group. After routine feeding for 14 day, each administration group was given relevant medicine for gavage, while control group and model group were given the same amount of distilled water for gavage, once a day for 7 d. From the 8th day, except for the control group, the rats in the rest of groups were subjected to whole-body X ray irradiation, continuous exposure to 2 d; the total absorbed dose was 6 Gy. The rats were killed by femoral artery after irradiate 3 d. The WBC count, RBC, HGB, and PLT in peripheral blood were observed by blood routine test; the number of nucleated cells in the bone marrow was observed by nucleated cell count method; the pathological changes of spleen were observed by HE staining under microscope; the contents of IFN-γ and IL-4 in serum were detected by ELISA. Results Compared with the control group, the spleen index WBC, number of bone marrow nucleated cells and serum contents of IL-4 and IFN-γ in model group was significantly lower (P<0.05), The contents of RBC and HGB increased (P<0.05). Compared with the model group, WBC, number of bone marrow nucleated cells, and the contents of IL-4 and IFN-γ in serum of each administration group increased significantly (P<0.05); RBC and HGB decreased significantly (P<0.05). Conclusion Angelicae Sinensis Radix and Angelicae Sinensis Radix polysaccharides have protective effects on the immune function injure induced by X ray in SD rats.

Objective:To evaluate the efficacy between pedicle screws combined with vertebroplasty (PSV) and pedicle screws combined with intermediate screws (PSIS) for the treatment of osteoporotic thoracolumbar fracture (OTLF).Methods:PubMed, Cochrane Library, Web of Science, CNKI, VIP and Wanfang database were searched for all randomized controlled trial (RCT) or case-control trial (CCT) studies that comparing PSV and PSIS for the treatment of OTLF. Two reviewers independently screened the studies in the light of the inclusion and exclusion criteria, extracted data and evaluated the quality of the included studies. The Meta-analysis was performed using the RevMan 5.4 software. The subjects were divided into PSV group and PSIS group according to different treatment methods. Operation time, intraoperative blood loss, postoperative incision infection rate, postoperative short-, mid- and long-term visual analogue scale (VAS) score, postoperative short- and mid-term Oswestry disability index (ODI), hospitalization time, postoperative short-, mid- and long-term Cobb angle, postoperative short-, mid- and long-term anterior vertebral height ratio (VBH) and implant failure rate were compared between the two groups.Results:A total of 12 studies were enrolled for review, involving 870 subjects (433 in PSV group and 437 in PSIS group). The results showed insignificant difference between the two groups in operation time ( WMD=7.07, 95% CI -4.00, 18.13, P>0.05), intraoperative blood loss ( WMD=0.62, 95% CI -7.19, 8.43, P>0.05), postoperative incision infection rate ( OR=0.65, 95% CI 0.10, 4.08, P>0.05), postoperative short-term Cobb angle ( WMD=-0.19, 95% CI -0.43, 0.05, P>0.05) and postoperative short-term VBH ( WMD=0.91, 95% CI -1.30, 3.13, P>0.05). However, there was significant difference between the two groups in postoperative short-term VAS score ( WMD=-0.59, 95% CI -1.02, -0.15, P<0.05), mid-term VAS score ( WMD=-0.41, 95% CI -0.65, -0.16, P<0.05), long-term VAS score ( WMD=-0.51, 95% CI -0.59, -0.43, P<0.05), postoperative short-term ODI ( WMD=-6.26, 95% CI -9.65, -2.87, P<0.05), postoperative mid-term ODI ( WMD=-2.44, 95% CI -3.43, -1.45, P<0.05), hospitalization time ( WMD=-2.65, 95% CI -4.61, -0.68, P<0.05), postoperative mid-term Cobb angle ( WMD=-1.40, 95% CI -2.41, -0.39, P<0.05), postoperative long-term Cobb angle ( WMD=-1.06, 95% CI -1.59, -0.52, P<0.05), postoperative mid-term VBH ( WMD=3.06, 95% CI 1.31, 4.81, P<0.05), postoperative long-term VBH ( WMD=4.11, 95% CI 2.44, 5.77, P<0.05) and implant failure rate ( OR=2.06, 95% CI 0.11, 0.59, P<0.05). Conclusion:Compared with PSIS, PSV can not reduce the operation time, intraoperative blood loss and incision infection in the treatment of OTLF, but it can significantly relieve pain, improve function, decrease reduce hospitalization time, help to maintain Cobb angle and anterior vertebral height after operation, and reduce implant failure rate.

Objective:To compare the efficacy of percutaneous vertebroplasty (PVP) in the treatment of osteoporotic lumbar compression fracture (OLCF) via the approach through midpoint transverse process-transition zone of articular process and the unilateral transpedicular approach.Methods:A prospective cohort study was conducted to analyze the clinical data of 794 patients with OLCF treated in Honghui Hospital affiliated to Xi′an Jiaotong University School of Medicine from January 2017 to December 2019. The patients were divided into transitional-zone puncture group (400 patients, 400 vertebrae) and pedicle puncture group (394 patients, 394 vertebrae) according to the envelope method. The transitional-zone puncture group was treated with PVP via the approach through midpoint transverse process-transition zone of articular process, and the pedicle puncture group was treated with PVP via the unilateral transpedicular approach. The operation time and radiation dose were documented. The visual analogue score (VAS) and Oswestry dysfunction index (ODI) were evaluated before operation and at 1 day, 3 months, 1 year after operation. The cement distribution and the incidence of complications such as cement leakage, re-fracture of the injured vertebra, spinal cord nerve injury and facet joint injury were detected.Results:The patients were composed of 270 males and 524 females, at the age of 68.9-78.5 years [(73.7±4.8)years]. All patients were followed up for 12-14 months [(13.4±0.8)months]. The operation time and radiation dose in transitional-zone puncture group were reduced compared with pedicle puncture group ( P<0.01). There was no significant difference in VAS and ODI between the two groups before operation (all P>0.05). The VAS between transitional-zone puncture group [(2.1±0.9)points, (2.3±1.1)points, (2.7±1.3)points] and pedicle puncture group [(2.3±0.7)points, (2.5±0.9)points, (2.9±1.1)points] was obviously reduced from that before operation (all P<0.01), significantly different at 1 day, 3 months, 1 year after operation ( P<0.05 or 0.01). The ODI between transitional-zone puncture group (14.3±1.8, 13.6±3.4, 11.3±4.4) and pedicle puncture group (25.5±5.7, 20.7±6.3, 20.6±6.9) was significantly different at 1 day, 3 months, 1 year after operation (all P<0.01), and all were obviously reduced from that before operation (all P<0.01). With regard to the cement distribution, the number of bilaterally cemented vertebrae in transitional-zone puncture group (324) was more than that in pedicle puncture group (94) ( P<0.01). The incidence of cement leakage, re-fracture of the injured vertebra and facet joint injury was 8.25%(22/400), 0.00%(0/400) and 3.25%(13/400) in transitional-zone puncture group, significantly different from 20.81%(82/394), 2.03%(8/394) and 9.90%(39/394) in pedicle puncture group ( P<0.05 or 0.01). There was no significant difference in spinal cord nerve injury between the two groups ( P>0.05). Conclusion:For OLCF, PVP via the approach through the midpoint transverse process-transition zone of articular process and the unilateral transpedicular approach are both effective, but the former has advantages of shorter operation time, smaller radiation dose, greater dispersion of bone cement and lower incidence of cement leakage, re-fracture of the injured vertebra and facet joint injury.

Objective To investigate the effects of cholesterol-lowering probiotics, DM9054 com-bined with 86066, on the intestinal mucosal barrier and gut microbiota in mice with nonalcoholic fatty liver disease ( NAFLD) induced by high-fat diet and the possible mechanisms. Methods Twenty-four male mice deficient in the low-density lipoprotein receptor gene ( Ldlr- / - mice ) were randomly divided into three groups including control, NAFLD model and probiotic intervention groups. Mice in the three groups were given normal chow diet+normal saline, high-fat diet ( HFD)+normal saline, and HFD+cholesterol-lowering probiotics, respectively. The mouse model of NAFLD was established by feeding mice with high-fat diet (45％ of calories derived from fat diet) for 12 weeks. qPCR was performed to measure the expression of liv-er and intestinal inflammatory genes and liver cholesterol synthesis genes. Western blot assay was used to de-tect the expression of intestinal tight junction proteins and HMG-CoA reductase ( HMGCR ) . Pathological changes in tissues were evaluated by HE staining. Features of gut microbiota were analyzed by 16S rRNA gene sequencing. Results Cholesterol-lowering probiotics intervention attenuated HFD-induced hepatic steatosis, inflammatory responses and obesity and decreased the synthesis of liver cholesterol (P<0. 05). Moreover, inhibited gut inflammatory responses and improved intestinal barrier function were detected in the probiotic intervention group (P<0. 05). The composition of gut microbiota in mice of the probiotic intervention group was different from that of the model group, but similar to that of the control group. Con-clusions Cholesterol-lowering probiotics might attenuate NAFLD in mice through reducing liver cholesterol synthesis, alleviating liver and intestinal inflammation, improving intestinal mucosal barrier function and reg-ulating intestinal microbiota.