Objective To evaluate the clinical efficacy of vertebroplasty using vertebral pedicle screw technique combined with calcium sulfate cement injection in the treatment of thoracolumbar vertebrae fractures.Methods Twenty-eight patients with thoracolumbar vertebrae fractures admitted in our department in recent 2 years were enrolled in this study,including 21 cases of type A,3 cases of type B,and 4 cases of type C.All patients were fixed with vertebral pedicle screw,and then verteplasty was performed using calcium sulfate cement injection.Results All patients were followed up for an average time of 16 months.Within the follow-up,there was no complication noted,such as loosening or breakage of internal fixation,chronical lumbar back pain,and loss of effected vertebral height.Artificial bones injected into vertebrae were absorbed in about 3 months.Conclusion Vertebroplasty using vertebral pedicle screw technique combined with calcium sulfate cement injection is an effective and safe procedure for thoracolumbar vertebrae fractures,which renders it possible to bear weight early and to maintain corrected vertebral height postoperatively.

Objective To evaluate the value of three-dimensional color power angiography(3D-CPA) in the differential diagnosis of benign and malignant breast tumors.Methods 3D-CPA vascular parameters were collected and analyzed in 121 breast solid lesions (63 malignant,58 benign) in the 114 female patients.The diagnostic performances of each parameter were compared by receiver operating characteristic (ROC)cure.Results The parameters of intra-tumor flow index (FI1),flow index of shells with outside thickness of 3mm surrounding the breast tumors(FI2 ) and the ratio of FI2 and FI1 (G2) in malignant group were significantly higher than those in benign group( P ＜0.05,respectively).Analysis of the areas under ROC curve showed that the areas under FI2 curve was the largest.No significant difference( P ＞0.05) was found between the area under FI2 curve and the area under G2 curve.Comparing the area under FI2 curve to that under FI1,there was significant differences ( P ＜ 0.05).Taking FI2 ≥ 27.385 as the critical value,the sensitivity and specificity for the diagnosis of malignant breast tumors were 88.9％ and 81.0％,and the positive and negative predictive values were 83.6％ and 87.0％ respectively.Conclusions The sensitivity and specificity of 3D-CPA parameter FI2 in the diagnosis of malignant breast tumors were higher than others,FI2 with the optimal critical value of ≥27.385 could help to identify malignant from benign breast tumors.

OBJECTIVE:To explore the genome-wide methylation differences between coronary heart disease (CHD) patients and healthy volunteers,and to investigate the relationsip of DNA methylation with CHD from epigenetics. METHODS:In case-control study,subjects were divided into CHD group(50 cases)and health control group(50 cases). DNA of 2 groups were sequenced with methylated DNA immunoprecipitation sequencing technology. The genome-wide methylation differences were analyzed and compared between 2 groups. RESULTS:The number of methylation peak in CHD group was higher than health group,with statistical signfi-cance(P<0.05). The methylation peak mainly distributed in 5'UTR,Intron functional elements. The number of reads in AQP1,SHB and other gene promoters in CHD group were lower than health group,and its methylation level decreased. The number of reads in GRK5 and serveal gene promoters on chrX in CHD group were higher than helath group,and its methylation level increased,with sta-tistical significance(P<0.01). CONCLUSIONS:The genome-wide methylation level of CHD patients are higher than those of healthy volunteers. The occurence of CHD is possibly associated with the change of methylation level of related gene promoters.

Objective To investigate clinical effect of surgical repair and reconstruction of traumatic floating shoulder injuries (FSI). Methods Sixteen patients with FSI were treated with open re-duction and reconstructive internal plate fixation. Of all, one patient was with transverse clavicle fracture, six with oblique clavicle fracture and nine with comminuted clavicle fracture. There was one patient with type Ⅰ scapula fracture, three with type Ⅱ, four with type Ⅲ, six with type Ⅳ and two with type Ⅴ. The combined injuries included rib fracture plus hemopneumothorax in six patients, traumatic moist lung in two, craniocerebral injuries in two, hepatic and splenic rupture in two and brachial plexus damage in one. The average time from primary injury to operation was seven days (3-21 days). Results Fifteen out of 16 patients were followed up for 6-28 months (average 11 months). All patients obtained bone u-nion, without infection, loosening or breakage of internal fixation. According to Herscvici evaluation standard of function, the shoulder joint outcome was rated as excellent in 11 patients, good in three and fair in one, with excellence rate of 93%. Conclusion The surgical repair and reconstruction of FSI can, to a greatest extent, recover the anatomical structure and stability around the shoulder joint and shorten the immobilization period of joint, which is beneficial to functional restoration of the joint and de-crease of occurrence of complications.

BACKGROUND:The most effective method for the treatment of acetabular fracture is open reduction and internal fixation, however, this treatment for some special types of acetabular fracture cannot get satisfactory prognosis, and is prone to complications, such as traumatic coxarthrosis and avascular necrosis of femoral head. OBJECTIVE:To evaluate the curative effect of open reduction and internal fixation and total hip arthroplasty in the treatment of special acetabular fracture. METHODS:Twelve cases of acetabular fracture were included, including seven cases of traffic accident wound, three cases of crush injury, and two cases of fal ing injury. The type of bone fracture:two cases of posterior wal fracture, two cases of posterior column and posterior wal fracture, one case of T shaped fracture, five cases of transverse and posterior wal fracture, and two cases of acetabular roof sexual fracture. Complications:one case was femoral head centric dislocation, five cases were latter dislocation, and three cases were caput femoris fractures. Before injury, three cases had coxarthrosis, and two cases were avascular necrosis of femoral head. Al the cases were treated with open reduction internal fixation and total hip arthroplasty, of which nine cases were treated with biological prosthesis, and three cases were treated with bone cement prosthesis. The time from hospitalization to surgery was 3-15 days, and average was 6 days. The patients were fol owed-up once every 2 months in 1 year after replacement, and the Harris score was used to evaluate the hip function recovery. RESULTS AND CONCLUSION:No surgical site and deep wound infection, joint dislocation, lower limb deep vein thrombosis, and death were found in these 12 cases. Among them, 11 cases were fol owed-up for a longtime;the fol ow-up was lasted for 6-82 months. The acetabular fracture was healed at 6-16 months after reduction without prosthesis loosening and sinking. The hip function was evaluated during final fol ow-up according to the Harris score:excellent in eight cases, good in two cases, poor in one case, and the excellent and good rate was 91%. Open reduction internal fixation and one-stage total hip arthroplasty can avoid long-term bed, get out of bed as soon as possible, and reduce complications, thus reconstruct the hip joint painlessly and good functional y.

BACKGROUND: Thoracolumbar fracture is most common seen in spinal fractures. The paraspinal muscle is subjected to extensive detachment and traction in traditional posterior approach, so the muscular ischemia and denervation lead to muscle atrophy further inducing intractable low back pain. Thereafter, minimally invasive spinal surgery becomes more and more popular.OBJECTIVE: To investigate the clinical efficacy of pedicle screw fixation through Wiltse approach combined with injectable calcium sulfate bone cement for single-level thoracolumbar fracture.METHODS: Clinical data of 52 patients with single-level thoracolumbar fracture without nerve injury were analyzed retrospectively, and were then assigned to observation (n=28) and control groups (n=24) according to the treatment method. The patients in the observation group were treated with pedicle screw fixation through Wiltse approach plus implanted with injectable calcium sulfate bone cement, and those in the control group were subjected to pedicle screw fixation through posterior approach plus implanted with injectable calcium sulfate bone cement. The operation time, blood loss and hospitalization time were compared between two groups. The low back pain was observed at baseline, 1 week and 3 months postoperatively, and the percentage of anterior vertebral height revealed on X-ray was observed at baseline, before ambulation, and during last follow-up. Moreover, the complications, loosening and rupture of the screws were recorded.RESULTS AND CONCLUSION: (1) All patients were followed up, and the follow-up time was 16-24 months. (2) The operation time, blood loss and hospitalization time in the observation group were significantly less than those in the control group (P < 0.05). (3) The postoperative visual analogue scale scores in the two groups were significantly lower than those before surgery, and the scores showed significant differences between two groups (P < 0.05). (4) The percentage of anterior vertebral height before ambulation and during last follow-up in the two groups was significantly improved, and the percentage showed significant difference between two groups at each time point (P < 0.05). (5) These findings suggest that based on strict indications, the pedicle screw fixation through Wiltse approach combined with injectable calcium sulfate bone cement is safe for single-level thoracolumbar fracture, which restores the anterior vertebral height rapidly, alleviates pain and exhibits satisfactory long-term efficacy. Furthermore, it holds shorter operation time and less blood loss than the traditional approach.

Objective To discuss the feasibility and reproducibility of left ventricular volume and function of patients with left atrial remodeling and left ventricular remodeling by 3-dimensional echocardiography HeartModel (3D-HM).Methods Three-dimensional images of 156 subjects were collected under HMACQ imaging mode.They were assigned into three groups:① control group (group A,n =70);② group of left ventricular remodeling after,acute myocardial infarction (group B,n =17);③group of hypertension left atrial remodeling (group C,n =69).3D-HM method was used for quantifying left ventricular end-diastolic volume (LVEDV),left ventricular end-systolic volume (LVESV),left atrial end-systolic volume (LAESV) and left ventricular ejection fraction (LVEF),and the results were compared with conventional 3D-manual results.The reproducibility of the 3D-HM method within one group and among different groups was evaluated.Results There was a significant difference in all the parameters measured with the 3D-HM method in different groups(P ＜0.05).LVEDV,LVESV,and LAESV in group B were higher than those in group A and group C(P ＜0.05),and LVEF was lower than that in group A and group C(P ＜0.05),LAESV of group C was higher than that of group A(P ＜0.05).The difference in the measurements of LVEDV and LVESV between the two methods was greatest in group B compared with group C and group A(P ＜0.05).In group C,the measured value difference of LAESV between two methods was greater than that of group A (P =0.03).There was closer correlation among LVEDV,LVESV,LAESV and LVEF measured values of 3D-HM method as well as measured values of the 3D-manual method (r =0.94,0.97,0.91 and 0.90).The data post-processing time of 3D-HM was significantly shorter than that of 3D-manual (P ＜0.05).The inter-observer and intra-observer difference of measured values of 3D-HM method had no statistical significance (P ＞0.05).Conclusions 3D-HM is a fast and feasible technique with high reproducibility for quantifying the left ventricular volume and function in patients with left atrial remodeling and left ventricular remodeling.

BACKGROUND:Percutaneous pedicle screw fixation has been applied in the treatment of thoracolumbar fracture,and has achieved satisfactory clinical efficacy.Injectable calcium sulfate holds good biocompatibility,degradability and fast curing.OBJECTIVE:To explore the clinical efficacy of percutaneous pedicle screw fixation combined with calcium sulfate cement for single-level thoracolumbar fracture.METHODS:Clinical data of 40 patients with single-level thoracolumbar fracture without nerve injury were analyzed retrospectively.All fractured vertebrae were compressed more than 30％ and at least one pedicle was complete.All patients were treated with percutaneous pedicle screw fixation combined with calcium sulfate cement.The Visual Analog Scale and Oswestry Disability Index scores were recorded at baseline,3 months postoperatively and last follow-up;the height of the fractured vertebra body and sagittal Cobb angle were measured on X-ray;the patient's satisfaction and healing rate were recorded.RESULTS AND CONCLUSION:(1) The Oswestry Disability Index at 3 months postoperatively and last follow-up was 16.3％ and 4.4％,respectively.Compared with baseline,the Cobb angle and Visual Analog Scale scores were significantly reduced,and height of the fractured vertebra body was significantly increased after surgery (P ＜ 0.01).(3) The healing rate at last follow-up was 95％,nonunion was not found,and the patients' satisfaction reached 95％.(4) The loss of vertebral height and Cobb angle was found at last follow-up compared with 3 months postoperatively,but had no significant difference (P ＞ 0.05).(5) These results indicate that percutaneous pedicle screw fixation combined with calcium sulfate cement is safe and reliable for single-level thoraclumbar fracture,which not only restores the vertebral height and relieves pain,but also has satisfactory long-term curative efficacy and high healing rate.

Cholangiocarcinoma is a malignant tumor originating from the epithelial cells of the bile duct, and its incidence and mortality rates keep increasing year by year. Unknown pathogenesis of this disease has led to the difficulties in early diagnosis and treatment. With the development of genetic engineering and bioinformatics, more and more studies have found that long non-coding RNA (lncRNA) is closely associated with the pathophysiological process of cholangiocarcinoma. This article summarizes the research advances in the role of lncRNA in mediating the biological behaviors of cell proliferation, apoptosis, metastasis, invasion, epithelial-mesenchymal transition, and drug resistance in cholangiocarcinoma, as well as the association of lncRNA with clinical features and prognosis.

Hepatic ischemia-reperfusion injury is one of the most important factors affecting the prognosis of clinical hepatic surgery. Studies have shown that microRNAs can participate in the process of hepatic ischemia-reperfusion injury through multiple pathways. This article reviews the biosynthesis and function of microRNAs and the mechanisms of action of microRNAs in the regulation of hepatic ischemia-reperfusion injury through energy metabolism, apoptosis, autophagy, oxidative stress, and cellular inflammation. It is pointed out that the treatment targeting microRNAs has a promising future in the treatment of hepatic ischemia-reperfusion injury, and further studies are needed in the future.