Objective To investigate the consistency of M RI detecting posterior ligamentous complex (PLC) injury associated with thoracolumbar factures.Methods MRI data of 170 cases of thoracolumbar fractures were reviewed retrospectively.Each case underwent MRI around one week postinjury.MRI data were analyzed and compared by three physicians respectively to discuss the consistency in MRI detection of PLC injury and the severity of PLC injury.Results Kappa coefficient was 0.846 between observer 1 and 2,0.768 between observer 1 and 3,and 0.793 between observer 2 and 3.Interobserver reliability was high and overall Kappa coefficient was 0.803.Severity of PLC injury was interrelated with spinal cord nerve injury (P ＜ 0.05).Conclusions Accurate detection of PLC injury in thoracolumbar fractures is beneficial to clear the mechanical stability of the spine.MRI detection of PLC injury is of high consistency and hence deserves wide use.

Objective To investigate the damage sequence of posterior ligamentous complex (PLC) and its clinical significance in thoracolumbar fracture.Methods Data of 132 patients with spinal fracture evaluated with X-rays,CT and short-tau inversion-recovery (STIR) sequences in MRI were collected prospectively.Fracture morphology was classified using the AO classification.PLC components including interspinous ligament (ISL),supraspinous ligament (SSL),ligamentum flavum (LF) and facet capsules (FC) were assessed and classified as intact,edema,or tear.ISL edema was further subdivided depending on the extension (＞ 50％ or ≤50％).Correlation between MRI signal and AO progressive scale of morphological damage was analyzed.Results AO type A1/A2 fracture associated with only FC distraction.AO type A3 fracture showed additional ISL tear,usually less than 50％,with neither LF nor SSL tear.AO type B1 fracture showed FC distraction,ISL edema or disruption,and low rate of SSL/LF tear,but B2 fracture increased the rate of SSL/LF tear.AO type C fracture showed facet fracture or dislocation and ISL,SSL as well as LF tear.High correlation was found between AO progressive scale and MRI signal (P ＜ 0.01).Conclusions MRI study can well display the PLC damage and damage sequence.MRI correlates with AO progressive scale of morphological damage,which shows a progressive orderly rupture sequence among different PLC components as traumatic forces increase.

Objective:To analyze the main active ingredients and mechanisms of action of clinically commonly used traditional Chinese medicine for anti-hepatic fibrosis based on network pharmacology.Methods:The traditional Chinese medicine system pharmacology analysis platform (TCMSP) and Swiss Target Prediction were employed to obtain the active ingredients and potential targets of 21 clinically commonly used traditional Chinese medicines. The GEO database was used to analyze the differential genes of liver fibrosis that resulted from hepatitis B virus (HBV) infection, alcoholic liver disease, and non-alcoholic fatty liver disease.The therapeutic targets of traditional Chinese medicine were predicted by combining the key genes for the production and reversal of the extracellular matrix in liver fibrosis. The "drug-therapeutic target pathway" network was constructed using Cytoscape software to analyze the anti-fibrosis ingredients and mechanisms of action of traditional Chinese medicine. The effects of core ingredients were investigated in vitro on macrophages (THP-1) and hepatic stellate cells (LX2). The data were initially examined for normality and homogeneity of variance, and then a t-test was used to compare the data between the two groups. The one-way ANOVA method was used for multi- ingredient comparisons.Results:The 21 traditional Chinese medicines contained 355 monomer compounds, which corresponded to 315 recognized drug targets. The results showed that 57 genes were anti-fibrotic therapeutic targets based on the key links between liver fibrosis occurrence and regression.The results of the "drug-target-pathway network" association analysis showed that quercetin and kaempferol were the most core anti-liver fibrosis ingredients of various traditional Chinese medicine compounds, which mainly improved HBV, alcoholic liver disease, and non-alcoholic fatty liver disease and fibrosis progression by regulating and controlling PI3K-Akt, AGE-RAGE, MAPK, TNF, and IL-17 signaling pathways core genes such as TNF, AKT1, MMP9, BCL2, CCL2, CASP3, CXCL8, RELA, MYC, and STAT1. Cellular experiments showed that quercetin had a stronger ability to inhibit the release of proinflammatory factors IL-1β, IL-6, and TNF-α from inflammatory THP-1 cells than kaempferol. In contrast, kaempferol had markedly reduced the chemokine CCL2. Quercetin and kaempferol significantly inhibited THP-1-mediated LX2 cell proliferation, which was accompanied by significant decreases in α-SMA, collagen IA, and TGF-β, as well as increases in CASP3 and cleaved-CASP3, indicating both had a synergistic effect.Conclusion:Quercetin and kaempferol are the basic forms of traditional Chinese medicine compounds for liver fibrosis treatment, and it serve as a reference for the subsequent research and development of multi-target anti-hepatic fibrosis drugs.

Cystic fibrosis (CF) is a rare autosomal recessive disease with only one pathogenic gene cystic fibrosis transmembrane conductance regulator (CFTR). To identify the potential pathogenic mutations in a Chinese patient with CF, we conducted Sanger sequencing on the genomic DNA of the patient and his parents and detected all 27 coding exons of CFTR and their flanking intronic regions. The patient is a compound heterozygote of c.2909G > A, p.Gly970Asp in exon 18 and c.1210-3C > G in cis with a poly-T of 5T (T5) sequence, 3 bp upstream in intron 9. The splicing effect of c.1210-3C > G was verified via minigene assay in vitro, indicating that wild-type plasmid containing c.1210-3C together with T7 sequence produced a normal transcript and partial exon 10-skipping-transcript, whereas mutant plasmid containing c.1210-3G in cis with T5 sequence caused almost all mRNA to skip exon 10. Overall, c.1210-3C > G, the newly identified pathogenic mutation in our patient, in combination with T5 sequence in cis, affects the CFTR gene splicing and produces nearly no normal transcript in vitro. Moreover, this patient carries a p.Gly970Asp mutation, thus confirming the high-frequency of this mutation in Chinese patients with CF.
China ; Cystic Fibrosis/genetics* ; Cystic Fibrosis Transmembrane Conductance Regulator/genetics* ; Humans ; Mutation ; Poly T ; RNA, Messenger/genetics*