BACKGROUND:The development of minimaly invasive technology significantly reduces the occurrence of surgical complications due to spinal metastases. Currently, the minimaly invasive treatment basicaly has three broad categories: vertebral cement augmentation, radiofrequency ablation combined with vertebroplasty, intraoperative radiotherapy combined with vertebroplasty. OBJECTIVE:To summarize the research progress of three kinds of minimaly invasive treatments for spinal metastases. METHODS:PubMed and Wanfang databases were searched using the keywords of spinal metastases, vertebroplasty, radiofrequency ablation, radiotherapy in English and Chinese, respectively. RESULTS AND CONCLUSION:Vertebral cement augmentation with good analgesic effect has been used widely, and the efficiency is up to 80%-90%. But its effect to kil tumors is very limited that is unable to control tumor growth. Radiofrequency ablation and radiation can kil the tumor, but cannot rebuild the vertebral stability. Therefore, the combination of different technologies can improve the therapeutic effect on spinal tumors. In recent years, intraoperative radiation and implantation of radioactive particles or radioactive bone cement have been developed as new technologies. However, there is no conclusion that these new technologies have better outcomes than the vertebral cement augmentation because of less reports and lack of long-term folow-up. Especialy in the metastatic patients with damaged vertebral posterior wal and tumors invaded into vertebral canal, the risk of nerve function damage caused by bone cement leakage is stil very high, even after many attempts. Above al, there is no a perfect minimaly invasive treatment for spinal metastases.

Objective To investigate whether or not extracorporeal shock wave (ESW) treatment is safe for treating low back pain caused by lumbar facet joint degeneration by observing its effects on the lumbar segment of the spinal cord.Methods Five adult dogs were used for this study.ESWs were focused on their right L_(4～5) facet joints. The energy output was set at 40% of the maximum output,and a total of 1000 shocks were delivered at a frequency of 120/min.Before and 3 days after the treatment,the somatosensory evoked potentials (SEPs) induced by stimulating the tibial nerve were recorded from the animals' scalps,and the motor function of their hind limbs was evaluated with Tarlov's scale.The animals were then sacrificed and the L_(4～5) segments of their spinal cords were taken for histopatho- logical observation,with the T_(12) segments taken as controls.Results Three days after ESW treatment,the left and the right hind limbs scored 5 and 4 on the Tarlov scale.The amplitude of SEPs decreased and their latency increased. Histopathological observation showed mild swelling of the L_(4～5) segment of the spinal cord with congested veins on the surface.Erythrocyte and leukocyte exudation as well as myelin sheath swelling in the spinal cord were also observed un- der the microscope,but with no demyelination.Conclusion ESW had some adverse effects on the spinal cord when focused on the facet joint.Further studies of the safety range of ESW energy and distance are needed.

Objective To investigate the effects of S100B on the expressions of dopamine receptors and the synthesis,metabolism of neurotransmitters dopamine,5-hydroxytryptamine which are related to the abnormal motor coordination of Parkinson's disease (PD).Methods The hS100B transgenic mice were established.The mice were divided into S100B transgenic group (TG,n =14),S100B knockout group (KG,n =14) and the non-transgenic control group (CG,n =14).The motor coordination ability of mice was measured by the Rota-rod test.The expressions of dopamine D1 receptor (D1DR),dopamine D2 receptor (D2DR),tyrosine hydroxylase (TH) and phosphorylated TH at Ser19,Ser31,Ser40 in brain tissue were detected by reverse transcription polymerase chain reaction and Western blotting.The levels of Tyr,levodopa,dopamine,homovanillic acid,Trp,5-hydroxytryptamine and 5-hydroxyindoleacetic acid in mesencephalon were measured by high performance liquid chromatography with fluorescence detection.Results Compared with CG,the motor coordination ability of mice (s) showed progressive decline in TG (3 months:4.60±0.30vs4.25±0.21,q =5.194;6 months:4.52±0.31 vs4.07±0.22,q =6.139;9 months:4.43 ± 0.25 vs 3.60 ± 0.18,q =13.484;all P ＜ 0.05),the expressions of D2DR mRNA and protein decreased (1.34 ± 0.13 vs 0.48 ± 0.07,q =21.578;1.05 ± 0.15 vs 0.69 ± 0.10,q =8.063,both P＜0.05) and phosphorylated TH at Serl9 and Ser40 increased (0.95 ±0.10 vs 1.14-0.13,q =4.972;0.94 ± 0.12 vs 1.17 ± 0.14,q=5.382,both P＜ 0.05),the levels of levodopa,dopamine and homovanillic acid were elevated (87.04 ± 11.77 vs 115.28 ± 16.80,q =4.764;56.66 ± 9.87 vs 72.96 ± 11.02,q=3.923;26.58 ± 8.11 vs 38.65 ± 6.67,q=3.981,all P＜ 0.05),the leve1 of 5-hydroxytryptamine was reduced (925.50 ± 74.26 vs 637.87 ± 56.76,q =11.084,P ＜ 0.05),the ratios of homovanillic acid/dopamine and 5-hydroxyindoleacetic acid/5-hydroxytryptamine increased (0.45 ± 0.05 vs 0.54±0.08,q =3.325;0.94±0.07 vs 1.42±0.12,q =12.367,both P＜0.05) in the brain of TG at the age of 9 months old.There was no significant difference of detection indexes between KG and CG.Conclusions S100B plays an important role in the development of PD and the brain-specific S100B transgenic mice can be used to investigate the function of S100B gene on the development of PD.

Objective To compare the surgical and functional outcomes of single-site (transumbilical two-port) intracorporeal purse-suturing (IP) and single-port extracorporeal knotting (EK) for laparoscopic pediatric inguinal hernia (PIH) repair.Methods Between June 2008 and December 2014,358 PIH children underwent lapamscopic inguinal herniorrhaphy,including 126 treated by single-site intracorporeal purse string stitching using a needle-holder (IP group),and 232 by single-port extracorporeal knotting using an inner two-hook needle with preperitoneal hydrodissection (EK group).Results In all patients laparoscopic procedures were completed successfully without conversion.The operating time in IP group was significantly longer than that in EK group [unilateral:(20.4 ± 2.1) min vs.(9.4 ± 1.3) min,t=-5.23,P＜0.01;bilateral:(31.3 ±2.9) min vs.(15.2±1.7) min,t=-4.22,P＜0.01)].The hospital stay were similar between the two groups [(2.35 ±0.25) d vs.(2.38 ±0.18) d,t =-0.062,P ＞ 0.05].Five cases had intraoperative hematoma in the IP group while none in the EK group.One each suffered from recurrence in IP group and EK group.Three postoperative hydroceles were seen in IP group and one in EK group.Subcutaneous knot granulomas were seen in two in EK group.Conclusions Both IP and EK laparoscopic procedures are safe and feasible.With the assistance of preperitoneal hydrodissection technique,single-port laparoscopic EK herniorraphy is superior to single-site IP repair in easy performance and shorter operation time.

The uracil in DNA comes from either the misincorporation of dUTP in place of dTTP or deamination of cytosine. In the latter case, it can result in a GC to AT transition mutation if the uracil is not removed before DNA replication. Base excision repair (BER) is a major pathway for removing DNA lesions arising from endogenous processes as well as those induced by exposure to exogenous chemicals or irradiation. BER is initiated by DNA glycosylases that excise aberrant bases from DNA by cleavage of the N-glycosidic bond linking to the base of its deoxyribose sugar. Uracil N-glycosylase (UNG) is the enzyme responsible for the first step in the BER pathway that specifically removes uracil from DNA. The UNG gene undergoes both temporal and spatial regulation mainly at the level of transcription. Normally cancer cells undergo over-proliferation and up-regulate their UNG during tumorigenesis. In this study we examine the correlation between UNG level and carcinogenesis, and explore the possibility of using UNG as a marker for cancer diagnosis. Human UNG gene was amplified from the total RNA of the human choriocarcinoma cell line, JEG-3, by RT-PCR. After purification, the 942bp full-length UNG cDNA coding sequence was digested with EcoR I and Sal I, and cloned into the digested pET-21 to construct a recombinant vector, pUNG. The UNG protein was expressed under the control of T7 promoter in E. coli BL21 (DE3) cells induced with IPTG. After ultrasonic treatment, the cell lysate and precipitate were analyzed by SDS-PAGE and a 39kD band was detected. The plasmid was serially diluted at appropriate concentrations and employed as standards in the subsequent quantification. Total RNAs were extracted from 18 pairs of clinical samples, each pair contains a sample of esophageal squamous cell carcinoma (ESCC) tissue and its surrounding normal esophageal epithelia. The copy numbers of UNG mRNA in these RNA samples were determined by real-time quantitative RT-PCR using a Lightcycler (Roche). UNG was present in 13 cases of ESCC (13/18, n = 18) but absent in all of the normal tissues. The results indicated that there was a correlation between high level of UNG expression and the carcinogenesis of ESCC.
Carcinoma, Squamous Cell ; genetics ; metabolism ; Cell Line, Tumor ; Cloning, Molecular ; Electrophoresis, Polyacrylamide Gel ; Esophageal Neoplasms ; genetics ; metabolism ; Humans ; In Vitro Techniques ; Reverse Transcriptase Polymerase Chain Reaction ; Uracil-DNA Glycosidase ; genetics ; metabolism

Animals ; Cattle ; Chickens ; Dogs ; Sheep ; Swine ; Yersinia enterocolitica ; classification ; isolation & purification

AIM: To compare the accuracy of intraocular lens(IOL)power calculations by using five formulas(Haigis, SRK-T, Hoffer Q, Holladay-1, SRK-Ⅱ)in eyes with long axial lengths in order to improve the accuracy of predicating IOL powers.METHODS: Fifty-one eyes of 51 cases of age-related cataract and with mild long axial(24.5mm27mm) were collected who`s optical biometry were performed by the Zeiss IOL Master500 before operation.They underwent regular phacoemulsification and posterior chamber IOL implantation.The actual postoperative refraction was measured with the methods of phoropter and subjective optometry 3mo after surgery.Then we compared the differences of the predicted and actual postoperative refraction of the five formulas in each group.RESULTS: In the mild axial lengths cases, the differences between SRK Ⅱ formula and the other four formulas were statistically significant (P<0.05), and the difference between Hoffer Q and SRK-T formula was statistically significant (P<0.05);there was no difference among the other formulas (P>0.05).In the moderate and severe long axial lengths cases, the differences between SRK Ⅱ formula and the other four formulas were statistically significant (P<0.05), and the difference between Hoffer Q and SRK-T formula, Hoffer Q and Haigis formula were statistically significant (P<0.05);there was no difference among the other formulas (P>0.05).The differences of all the five formulas between the two groups were statistically significant (P<0.05).CONCLUSION: In the mild axial lengths cases, Haigis, SRK-T, Hoffer Q, Holladay-1 performed well.In the moderate and severe long axial lengths cases, Haigis, SRK-T and Holladay-1 performed better than other formulas.The accuracy of all the five formulas decreases as the axial length getting longer.

ObjectiveTo identify the framework for assessing health related quality of life(HRQOL) of Kaschin-Beck disease(KBD),in order to reflect the impact of KBD on quality of life in patients with the disease.MethodsQualitative descriptive research was adopted.Semi-open ended questions were developed by using the World Health Organization(WHO) definitions of health and quality of life.Group interview and face to face interviews were conducted on 48 patients with KBD and 29 health care experts on KBD in Linyou and Yongshou counties,Shaanxi province,which were higher prevalence areas of KBD.Content template analysis was conducted and the template was based on the WHOQOL-100's framework.ResultsThe framework of HRQOL for KBD included four domains:physical activity,familial/social support,economic and psychological state.There were also eleven facets which were:pain and discomfort,physical function and activity limitation,diet and sleeping,social relationship,concerns of family responsibilities,social support,economic,housing and the surrounding environment,appearance concerns,mental health,and general state of health.The total entries were 69.ConclusionsThe framework for assessing HRQOL of KBD is established.The framework highlights the impact of KBD on the patients' quality of life with higher specificity.

Objective:To evaluate the curative effects of Masquelet technique and 3D printing in repair of Cierny-Mader type Ⅳ long bone osteomyelitis.Methods:A retrospective study was conducted of the 8 patients who had been treated at Department of Orthopaedics, The Third Affiliated Hospital to Peking University for Cierny-Mader type Ⅳ osteomyelitis of the lower extremity from June 2017 to December 2019. They were 6 males and 2 females, aged from 27 to 79 years (average, 54.6 years). The defects involved femoral shaft in 5 cases, femoral metaphysis in one, tibia shaft in one, and tibial metaphysis in one. The defect lengths ranged from 7.7 to 15.5 cm, averaging 10.2 cm. Stage one was local infection control and temporary stability reconstruction using Masquelet technique, stage two design and 3D printing of the prosthesis and stable pattern design, and stage three prosthesis implantation and rehabilitation. The ranges of motion of the knee and ankle were recoded postoperatively and the functions evaluated using the Johner-Wruhs scores.Results:The average follow-up time for the 8 patients was 12.6 months (from 6 to 18 months). The total treatment time from the first admission to the last discharge ranged from 62 to 125 days (average, 91.0 days), the time for stage one from 13 to 57 days (average, 28.7 days), that for stage two from 30 to 87 days(average, 48.3 d), and that for stage three from 28 to 84 days (average, 63.0 days). The infection was controlled and there was no recurrence, implant loosening or breakage. Seven patients were capable of full weight-bearing at 14.7 days (from 4 to 42 days) after surgery. One patient recovered full weight-bearing 6 months after surgery due to severe osteoporosis. Fine functional recovery was achieved in the 8 patients, with a range of motion from 0° to 100° for the knee and a range from 35° dorsal flexion to 40° toe flexion for the ankle. The Johner-Wruhs scores at the last follow-up showed 2 excellent, 5 good and one moderate cases.Conclusion:In repair of Cierny-Mader type Ⅳ long bone osteomyelitis, Masquelet technique and 3D printing can shorten the treatment process and allow for early recovery.

OBJECTIVETo explore the prophylactic effect of tissue inhibitor of matrix metalloproteinase (TIMP) on acute graft-versus-host disease (aGVHD) after allogeneic hematopoietic stem cell transplantation (allo-HSCT) in a murine model.

METHODSThe murine model of aGVHD after allo-HSCT was established by using female C57BL/b (H-2b) mouse as the donor, and male BALB/c (H-2b) as the recipient. After allo-HSCT, recipient mice were divided into 3 groups. For aGVHD prophylaxis group A was given TIMP (2 mg/d) , group B CsA (5 mg x kg(-1) x d (-1)) was given, and group C nothing. Physical signs, mean survival time (MST), peripheral blood counts and aGVHD histopathology were observed.

RESULTSMice in group C developed typical aGVHD and 100% of mortality, with a MST of 8 days, and those in group A and B had longer survival, the MST being (4.8 +/- 1.4) d and (4.3 +/- 0.9) d respectively, with no statistical difference in peripheral blood count between these two groups. Mice in group A showed less severe signs.

CONCLUSIONSTIMP markedly prolongs MST of allo-HSCT recipients, delays the onset of aGVHD signs, and has no adverse effect on hematopoiesis reconstitution.

Animals ; Female ; Graft vs Host Disease ; prevention & control ; Hematopoietic Stem Cell Transplantation ; adverse effects ; Male ; Mice ; Mice, Inbred BALB C ; Mice, Inbred C57BL ; Tissue Inhibitor of Metalloproteinases ; therapeutic use