[Objective]To investigate whether syrinx should by treated before correction in patients with scoliosis complicated by syringomyelia without neurologic impairment. [Method]Thirty-five cases were divided into experimental group(group A,without preoperative surgical intervention to syrinx,15 cases)and control group(group B,with preoperative surgical intervention,20 cases) randomly. The coronal plane Cobb's angle,the length of syrinx,the position of syrinx,the biggest diameter of syrinx and S/C ratio were measured and compared between 2 groups.[Result]There was no significant difference in the correction rate and loss rate between two groups.The postoperative syrinx index(biggest diameter of syrinx,syrinx length and S/C ratio) was significantly smaller than that of preoperation(P

Pi.Au-Pt alloy does not resist the growth and adhesion of the bacteria, but Au-Pd does.

Objective To set up and validate three-dimensional finite element model (FEM) of Lenke 1 BN idiopathic scoliosis based on CT images, for building ideal digitization platform for further biomechanical study. Methods An 18-year-old female Lenke 1 BN idiopathic scoliosis patient was selected as volunteer for current study. CT transverse scanning in supine position was done from T1 to caudal end in 1mm layer interval. All CT images were imported into Mimics 10.01 to form qualified AIS three-dimensional geometric model after geometry clean, including all thoraco-lumbar-sacral vertebrae and thoracic cage, which was further delivered to Hypher Mesh 7.0 to build 3d finite element AIS model by mesh partition and quality control. A variety of material parameters were given to different mesh according to references. Validation verification was done by left and right Bending test and erect-supine test. Results 1 )A complete three-dimensional finite element model of Lenke 1 BN idiopathic scoliosis was built successfully, in consist of 341 228 nodes,1 409 929 tetrahedron elements, 163 132 shell elements, 715 cable elements and 149 rod elements. 2)The convex bending Cobb's angles of PT, MT and L curve on X-ray films and finite element simulation were 14°,26° ,8° and 15° ,24°,6° respectively. The error of finite element simulation was 8.3%. 3)Erect Cobb's angles of PT, MT and L were 37°, 50°, 24° and 33°, 51°, 24° on X-ray films and by finite element simulation.Supine Cobb's angles of PT, MT and L were 29°, 43°, 22° and 27°, 42°, 22° on X-ray films and by finite element simulation. The average error of finite element simulation was 3.9%. Conclusion Lenke 1 BN idiopathic scoliosis FEM is intact, reliable and effective for further biomechanical simulation study.

Objective To investigate the effect of posterior operation for thoracolumbar burst fractures combined with dislocation. Methods The study involved 22 patients with thoracolumbar burst fractures combined with dislocation admitted into our hospital from October 2005 to March 2008. There were 17 males and 5 females at age range of 18-56 years. The fractures were located at T12-L2. The fractured vertebrae lost its height by 1/4 to 3/4 of the normal height. The upper vertebral dislocation ex-tent was from 25% to 50%. All operations were accomplished within two weeks after injury. The patients were randomly divided into two groups, ie, Group Ⅰ (implanted with 4 pedicle screws in upper and lower vertebrae adjacent to the fractured vertebrae) and Group Ⅱ (implanted with 6 pedicle screws in 2 upper and 1 lower vertebrae adjacent to the fractured vertebrae). The operation time, volume of blood loss, ky-photic angle, neurological function and Low Back Outcome Score (LBOS) were compared between two groups. Results All patients were followed up for 12-36 months. The duration of operation in Group Ⅱ was longer than Group Ⅰ (P < 0.05), with no increase of intraoperative blood loss. Group ⅡI was su-perior to Group Ⅰ in aspects of correction rate, correction loss and implant failure rate (P < 0.05). There was no statistical difference in aspects of neurological function recovery and low back outcome score be-tween two groups. Conclusion Fixation with three vertebrae and six pedicle screws through posterior approach is an effective, feasible and safe procedure for treatment of thoracolumbar burst fractures com-bined with dislocation.

Objective To explore the relationship between Nestin expression level and prognosis in osteosarcoma,and to provide a new idea for treatment.Methods Thirty patient with osteosarcoma who had received treatment were included this study according to the criteria.HE staining was applied to evaluate the response to chemotherapy,meanwhile immunohistochemistry was applied to evaluate Nestin expression levels before and after chemotherapy.Kaplan Meier survival curve was drawn to analyze the outcomes.Results The response of chemotherapy was good in 17 patients and poor in 13.24 cases were strongly positive in Nestin staining,five were weakly positive,and one was negative.The expression level of Nestin in osteosarcona was correlated to the chemotherapy response and prognosis (P ＜ 0.05),while higher level of Nestin expression referred to poorer response of chemotherapy and lower overall survival rate.Conclusions The expression level of Nestin in osteosarcoma tissue is associated with the effect of chemotherapy and prognosis;higher expression level of Nestin indicates poorer prognosis and efficacy of chemotherapy.

Objective To explore the correlative factors that affected the early clinical efficacy of surgical management of lumbar disc herniation.Method 208 cases of lumbar disc herniation were recruited since December 2007.The details of their therapy in different periods were compared and analyzed.Result The aggressive discectomy was the most powerful factor related to the better early clinical outcome.The patients with preoperative JOA score ＞ 17 were associated to the poor clinical outcome.The patients with postoperative JOA score ≥ 25 on 3 month and ≥ 24 on 1 year after operations were associated to better early clinlcal outcome.Conclusion The pre- and post-operative JOA score and aggressive discectomy were the factors affected the clinical outcome.

Objective:To assess the influence of different surface treatment on the adhesion of the zirconia-veneering ceramic systems.Methods:28 zirconia specimens were divided into 4 groups(n =7) and treated by non-treatment(group A,the control),sandblaste(group B),hot-etching(group C) and sandblaste + hot-etching(group D).2 specimens randomly selected from each group were examined under SEM and XRD for the observation of surface structure.The veneering porcelain was layered on the remaining specimens of the 4 groups (n =5),then the shear strength of the interface was tested by a universal testing machine.Data were statistically analyzed by SPSS 13.0 software.Results:Different degrees of micro pore structure was observed on the zircomia surface of the 4 groups by SEM observation.The XRD analysis showed that all specimens emerged monoclinic phase.The shear bond strength of group A,B,C and D was (15.96 ± 3.44) MPa,(20.58 ± 2.21) MPa,(26.28 4-2.86) MPa and (22.51 ± 1.94) MPa respectively.group A vs group B,C and D,P ＜ 0.05;group C vs group A,B and D,P ＜ 0.05.Conclusion:The surface treatment of sandblaste,hot-etching and sandblasted + hot-etching can improve the shear bond strength of the zirconia-veneering ceramic systems,and the hotetching method is the most effective.

Objective:To explore the effect of self-management capability cluster intervention on clinical compliance and treatment outcome in patients with end-stage renal disease undergoing hemodialysis.Methods:A total of 88 patients undergoing hemodialysis in dialysis center from June to December 2019 were randomly divided into intervention group (44 cases) and control group (40 cases) according to odd-even number method. Patients in both groups were treated with hemodialysis and basic treatment, and patients in intervention group were treated with self-management capability cluster intervention. The self-management ability, dialysis compliance and related complications were compared between the two groups before and after intervention. The data were statistically analyzed by SPSS 26.0 software. Independent sample t-test was used for intergroup comparison, and paired t-test was used for intragroup comparison. Results:There was no significant difference in self-management ability at baseline between intervention group and control group ( P>0.05). After 6 months, the total score of self-management ability ((68.61±10.16), (55.12±9.29)) and emotional processing ((13.42±2.89), (11.04±2.46)), executive self-care ((21.67±4.87), (16.71±3.59)), problem solving ((16.61±3.22), (12.03±4.61)), partnership ((14.26±3.64), (10.88±3.29)) were higher than those in the control group, and the differences were statistically significant ( t=7.112, 3.764, 4.739, 5.515, 5.834, all P<0.05). The total score of self-management behavior and the scores of four dimensions in the intervention group were significantly higher than those in the control group ( t=13.413, 5.432, 8.114, 1.910, 4.127, all P<0.05). There were significant differences between the intervention group and the control group in jumping behavior (9.09%, 22.50%) , shortening behavior (11.36%, 30.00%) , hyperkalemia (15.91%, 55.00%), heart failure (11.36%, 37.50%) and arteriovenous fistula occlusion (4.55%, 10.00%) ( χ2=4.095, 5.206, 17.571, 8.843, 5.127, all P<0.05). There were significant differences between the intervention group and the control group in urea clearance index, anemia improvement, blood phosphorus, parathyroid hormone level ( t=3.830, 4.558, -3.720, 6.481, all P<0.05). Conclusion:Self-management capability cluster intervention can improve the clinical compliance and treatment outcome in patients with end-stage renal disease undergoing hemodialysis.

OBJECTIVETo assess the clinical value of the diagnostic laparoscopy in choosing treatment strategies for patients with gastric cancer.

METHODSRetrospective analysis was performed on clinical and pathological data collected from 2 023 patients undergoing gastric cancer surgery in the Zhongshan Hospital of Fudan University from 2009 to 2014. All the patients were diagnosed as gastric cancer by endoscopic biopsy and staged by imaging examination before surgery. During the diagnostic laparoscopy procedure, a small periumbilical incision was made and a pneumoperitoneum with COunder 10-15 mmHg was established through a port. A 10 mm trocar was put in, and the camera was inserted. Two 5 mm trocars were put in two ports which located in midclavicular line two fingers under the left and right costal margin and then the instruments were inserted. A thorough inspection included ascites, the abdominal cavity, liver, diaphragm, spleen, greater omentum, colon, small intestine, mesentery, adnexa (female) and pelvic floor. If the tumor located at the posterior part of the stomach, the gastrocolic ligament was opened in order to look for carcinomatosis in the omental bursa. The accuracy rate of diagnostic laparoscopy in diagnosing adjacent organ invasion and intra-abdominal metastasis was calculated, and the rate of adjusting treatment plans after diagnostic laparoscopy was also calculated.

RESULTSThere were 52.7%(1 067/2 023) of patients underwent diagnostic laparoscopy. The accuracy rate of diagnostic laparoscopy in evaluating adjacent organ invasion and intra-abdominal metastasis were 98.3%(1 049/1 067) and 98.1%(1 047/1 067) respectively. Besides, 14 patients with stage T4b and 32 with intra-abdominal metastasis, which were missed by imaging examination, were diagnosed by diagnostic laparoscopy. The treatment plans of 9.3% (99/1 067) of patients were changed after diagnostic laparoscopy, and 65 (6.1%) cases of non-therapeutic laparotomy were avoided. However, 18 cases of adjacent organ invasion and 20 cases of intra-abdominal metastasis were still missed by diagnostic laparoscopy, and 12 cases received non-therapeutic laparotomy.

CONCLUSIONDiagnostic laparoscopy has considerable value in assessing adjacent organ invasion and intra-abdominal metastasis and has great clinical significance in making precise treatment plans.

Abdominal Neoplasms ; diagnostic imaging ; secondary ; Digestive System ; pathology ; Digestive System Surgical Procedures ; methods ; Female ; Humans ; Laparoscopes ; Laparoscopy ; instrumentation ; methods ; statistics & numerical data ; Laparotomy ; statistics & numerical data ; Male ; Neoplasm Invasiveness ; diagnostic imaging ; Patient Care Planning ; statistics & numerical data ; Retrospective Studies ; Stomach Neoplasms ; diagnostic imaging ; surgery ; Surgical Instruments ; Unnecessary Procedures ; statistics & numerical data

Ubiquitination is one of the most major post-translational modifications playing important role in regulation of intra-cellular proteins' stability, degradation, localization and biological activity. However, these proteins are difficult to be detected due to their low abundance, short half-life. In this study, ubiquitin-binding domains (UBDs) were constructed to purify the ubiquitinated proteins from Hep3B cells. Ubiquitinated proteins and sites were detected by LC-MS/MS. A total of 1 900 potential ubiquitinated proteins were identified. Among them, 158 ubiquitinated sites were identified, belonging to 102 proteins. Bioinformatics analysis revealed that the enriched pathways of ubiquitinated proteins were closely related to tumor occurrence and development. The dysfunction of ubiquitin-proteasome has a high correlation with cell signaling and extracellular matrix changing in tumor cells.