OBJECTIVETo compare the clinical curative effect of thoracolumbar burst fracture treated by the posterior unilateral approach corpectomy fusion screw-rod fixation and anterior corpectomy bone fusion screw plate fixation.

METHODSFrom January 2008 to May 2014,36 cases of thoracolumbar burst fracture underwent operation of decompression, fusion, and internal fixation was retrospective analyzed. Among them, 16 patients were treated through posterior approach as posterior group, including 13 males and 3 females aged from 37 to 62 years old; 9 cases caused by falling injury, 3 cases by traffic accident injury,4 cases by heavy aboved;the injury segment was on T₁₂ in 2 cases, L₁ in 5 cases, L₂ in 7 cases, L₃ in 2 cases; according ASIA grade, 3 cases were grade A, 2 cases were grade B, 2 cases were grade C, 5 cases were grade D, 4 cases were grade E; the time between injury and operation ranged from 5 to 15 days. Other 20 patients were treated through anterior-lateral approach as anterior-lateral group, including 15 males and 5 females with age from 27 to 62 years old; 12 cases caused by falling injury, 4 cases by traffic accident injury, 4 cases by heavy aboved; the injury segment was on T₁₂ in 2 cases, L₁, in 7 cases, L₂ in 9 cases, L₃ in 2 cases; for ASIA grade: 4 cases were grade A, 2 cases were grade B, 4 cases were grade C, 6 cases were grade D, 4 cases were grade E; the time between injury and operation ranged from 4 to 12 days. The operation time, bleeding during operation and postoperative drainage volume were observed in two groups,and the changes of nerve function of ASIA grade, clinical efficacy,improved degree of thoracic and lumbar lordosis,and bony fusion were compared between two groups.

RESULTSAll patients were followed up from 12 to 24 months with an average of (15.8 ± 3.3) months. The operation time, bleeding during operation, and postoperative drainage volume had no significant different between two groups (P > 0.05). As compared with preoperative, ASIA grade of two groups at last follow-up had statistically significantly different (P < 0.01), the neural function of two groups after operation was recovered for different extent. The JOA score of two groups was compared between last follow-up and preoperative, the difference had statistically significant (P < 0.01), the two groups showed good clinical effect. The clinical results of ASIA grade, JOA score and RIS had no significant differences between two groups. All patients of two groups were obtained fusion. Thoracic and lumbar lordosis angle improvement degree had no significant difference between two groups ,it bad significant difference had statistical significance compared with preoperative, the two approaches could effectively restore the spinal sequence.

CONCLUSIONFor patients with thoracolumbar burst fracture just treated by anterior decompression and reconstruction of anterior column, according to the degree of operation performer' skill proficiency and the patient' condition to choose, but for patients must performed the spinal canal decompression anterior and posterior, the three column-reconstruction to required anterior-posterior approach, the posterior unilateral approach corpectomy fusion screw-rod fixation obviously shorten operation time, reduce the operation wound, it is worth the clinical promotion.

Adult ; Decompression, Surgical ; methods ; Female ; Humans ; Lumbar Vertebrae ; injuries ; surgery ; Male ; Middle Aged ; Pedicle Screws ; Reconstructive Surgical Procedures ; Retrospective Studies ; Spinal Fractures ; surgery ; Spinal Fusion ; methods ; Thoracic Vertebrae ; injuries ; surgery

Objective To screen serum proteomic marker of hepatic echinococcosis, establish a diagnotic model of serum protein fingerprint patterns, and evaluate its clinical application for hepatic echinococcosis. Methods Serum samples from 68 patients with hepatic echinococcosis matched with 73 controls composed of 33 patients with liver diseases other than hepatic echinococcosis and 40 healthy people were collected. All subjects were divided into training group (37) and testing group (67). Serum protein profiling of patients with hepatic echinococcosis and controls were detected using surface enhanced laser desorption/ionization time of flight mass spectrometry(SELDI-TOF-MS) and weak cation exchange protein chip(WCX2). Peak intensities were compared, in the training group, between 37 patients with hepatic echinococcosis and 37 controls, 5 patients with HCE and 5 patients with HAE, and 8 patients with hepatic echinococcosis before and after operation, respectively. ZJU-Protein Chip Data Analyze System(ZJU-PDAS) was used for data analysis and the model of serum protein fingerprint patterns was build by support vector machine (SVM). The sensitivity and specificity of the model for diagnosis of hepatic echinococcosis were verified by blind method on samples of testing group. Results There were nine different protein peak spectra between hepatic echinococcosis group and control group, of which eight protein peak spectra decreased in patient group, their relative molecular mass were 1044, 1047, 1073, 1075, 1338, 6453, 6649, 8714 m/z, respectively, while one protein peak spectrum(5651 m/z) increased(P < 0.05). The sensitivity,specificity, positive predictive and negative predictive value of the model validated by blind method were 77.4% (24/31), 66.7% (24/36), respectively. There were two different protein peak spectra between HCE group and HAE group, Their relative molecule mass were 8716 and 2751 m/z, respectively (P < 0.05). Six different proteins were detected from pre-operation group and post-operation group. Their relative molecular mass were 1297, 1505, 1525, 1534, 5921, 5941 m/z, respectively(P < 0.05). Conclusions It is a successful way to screen serum proteomic marker in patients with hepatic echinococcosis by SELDI-TOF-MS and Bio-informatics, and the marker has a potential clinical value in diagnosis and judging prognosis of hepatic echinococcosis.

Objective To evaluate the value of differential diagnosis on congenital biliary atresia(BA) and infantile hepatitis syndrome(IHS) by technetium-99m-diethyl-iminodiacetic acid(99Tcm-EHIDA)hepatobiliary scintigraphy with phenobarbitol sodium.Methods Fifty-eight infants with persistent jaundice were taken phenobarbitol sodium[5 mg/(kg?d)] ,bid ?7 d).Those who had not bowel and gallbladders radioactivity within 24 hours were diagnosed as the diagnostic criterion of BA.Those with bowel and gallbladders radioactivity within 24 hours were diagnosed as the diagnostic criterion of IHS,who then received 99Tcm-EHIDA hepatobiliary scintigraphy with single photon emission computed tomography(SPECT) instrument.The results of all children were analyzed and compared with pathology and clinical follow up results.Results 99Tcm-EHIDA hepatobiliary scintigraphy correctly diagnosed 24 infants with last diagnosis BA and 29 infants with last diagnosis IHS,5 neonates false positive in all 34 IHS patients.The sensitivity in the diagnosis of BA was 100%,the specificity and accuracy were 85.3% and 91.4%,restectively.The sensitivity was 85.3% in the diagnosis of IHS;the specificity and accuracy were 100% and 91.4%,respectively.Conclusions 99Tcm-EHIDA hepatobiliary scintigraphy with phenobarbitol sodium can accurately differentiate BA and HIS at early stage.

Objective To investigate the effects of autologous bone mesenchymal stem cells(MSC) transplantation on malignant arrhythmia induced by electrophysiological (EP) stimulation and cardiomyocyte ion channels remodeling in a mini-swine model of acute myocardial infarction (AMI). Methods Immediately after AMI(LAD occluded for 120 min),MSC(10×107,labeled by colloidal gold and cocultivated with 5-azacytidiRe,5-aga,n=12) or equal volume saline (n=10) were iniected through over-the-wire (OTW) balloon in LAD at distal over D1.EP stimulation is performed after 2 hours and 4 weeks in both groups to induce arrhythmia.The variance of heterogeneity of sodium currents(INa)and INa steady-state inactivation curves in different zones of infracted wall were investigated by patch clamp technology and the relationship between ionic channel and ventrieular arrhythmia is analyzed.Results EP induced malignant ventficular arrhythmia (VT) rate was similar (MSC 75% vs.saline 90%.P=0.455) at 2 hours post AMI and was significantly lower in MSC group(25% vs.80%,P=0.012) at 4 weeks post AMI.The Peak INa current densities of the Endo,Media and Epi were significantly lower in MSC group[(-14.04±3.82)pA/pF,(-29.26±5.70)pA/pF,(-12.43±3.04)pA/pF] compared those in saline group [(-9.71±3.38)pA/pF,(-18.98 ±4.05)pA/pF,(-8.47±3.34)pA/pF,all P<0.05].The IHa steady-state inactivation curves of the Epi,Endo and Media in mini-swine with VT in MSC group [(-126.2±10.9)mV,(-106.7±11.9)mV,(-105.4±11.0)mV] were similar as those in saline group with VT[(-129.1±10.9)mV,(-112.2±9.9)mV,(-109.7±9.2)mV,all P>0.05] while significantlylower compared to MSC group without VT[(-93.1±13.8)mV,(-95.2±15.5)mV,(-103.4±8.7)mV,all P<0.05].The multiple logistic regression analysis showed that INa current density (RR=1.449,95%CI 1.276-2.079,P=0.029) and INa steady-state inaetivation curves(RR=1.092,95%CI 1.008-1.917.P=0.012) were the independent factors for reduced VT.Conclusions Autologous MSC attenuated malignant ventricudar arrhythmia induced by EP at 4 weeks in nlini-swine with AMl which might due to altered eardiomyocyte ion channels remedcling induced by MSC.

The study was to explore the change of coagulation factor VIII and IX activities in the platelet suspension collected by platelet apheresis during storage at 22 degrees C. 18 samples of platelet concentrates were collected by the cs-3000 plus and stored at 22 degrees C and then FVIII: C, FIX: C activities were detected at 0, 12, 24, 48, 72, 96, 120 hours respectively by SYSMEX CA-1500. The results showed that FVIII: C activity was (100.51 + 44.02)% at 0 hour, and then decreased dramatically to 10% - 40% of primary level from 12 to 120 hours, while FIX: C activity was (120.93 +/- 20.50)% at 0 hour and decreased to 10% - 35% of primary level from 24 to 120 hours. In conclusion, FVIII and FIX in the platelet concentrates stored at 22 degrees C could keep their biological activities at physiologically high levels.
Blood Platelets ; Blood Preservation ; methods ; Factor IX ; metabolism ; Factor VIII ; metabolism ; Humans ; Platelet Transfusion ; Plateletpheresis ; methods

Objective To evaluate the effect of myocardial viability on left ventricular function after elective revascularization in patients with myocardial infarction by 99Tcm-MIBI and 18F-FDG dual-isotope simultaneous acquisition (DISA) myocardial perfusion-metabolic imaging. Methods Ninety-one patients clinically confirmed of myocardial infarction underwent DISA imaging. Based on the results of echocardiography, the patients were divided into heart failure group (group A) and normal cardiac function group (group B). After PCI, left ventricular function was measured by echocardiography in 1, 3 and 6 months. The t-test and χ2-test were used to compare the difference between the two groups using SPSS 13.0. Results The average number of diseased segments by myocardial perfusion imaging was 9.8±3.5 and 5.4±2.6 in groups A and B, respectively (t=6.87, P<0.01). The average number of diseased segments by myocardial metabolic imaging was 7.5±3.4 and 4.6±2.8 in groups A and B, respectively (t=4.46, P<0.01). There were 173 segments with viable myocardium (173/458: 37.8%) in group A and 188 segments with viable myocardium (188/307: 61.2%) in group B (χ2=40.61, P<0.001). The summed perfusion score (SPS), summed metabolism score (SMS) and summed difference score (SDS=SMS-SPS) were 28.43±11.86 vs 21.36±9.54, 20.17±8.52 vs 15.19±5.74 and 0.39±3.17 vs -12.72±4.55, respectively in groups A and B (t=3.15, P<0.01; t=3.32, P<0.01; t=15.59, P<0.01). The mean change of LVEF (ΔLVEF) and the mean change of left ventricular end-diastole dimension (ΔLVEDd) of the patients with more than 4 viable myocardial segments in group A were significantly more than those in group B( (12.81±2.62)% vs (5.90±1.91)%, t=16.33, P<0.001; (-13.13±4.20) mm vs (-7.75±2.31) mm, t=6.86, P<0.001). However, the ΔLVEF and ΔLVEDd of the patients with less than 4 viable myocardial segments in group A were significantly less than those in group B (t=3.25, P<0.01; t=4.92, P<0.001). Conclusion The amount of viable myocardium in infarct myocardium is an important factor for left ventricular function recovery after elective revascularization.

Objective :To study correlation between treadmill exercise test assessing myocardial ischemia and coronary stenosis .Methods :A total of 150 patients with stable angina pectoris in our hospital ,according to vascular stenosis by coronary CT were divided into group A (stenosis＜ 50%,n＝ 50) ,group B (stenosis 50% ～75%,n＝ 50) and group C (stenosis ＞75%,n＝50).Coronary stenotic rate and ST depression during exercise test were compared a-mong three groups.Spearman method was used to analyze correlation between treadmill exercise positive rate and coronary stenosis .Results :Compared with group B ,there were significant rise in coronary diameter stenotic rate [(63.64 ± 4.21)% vs.(66.71 ± 4.46)%] and vascular diameter of reference segment [(2.92 ± 0.23) mm vs.(3.03 ± 0.21) mm] in group C ,P＜0.05 or ＜0.01. Along with coronary stenosis aggravated ,there was significant re-duction in onset time of ST depression [(712.3 ± 202.7) s vs.(602.3 ± 210.4) s vs.(501.2 ± 236.1) s] ,and signif-icant rise in duration [ (425.4 ± 200.5) s vs.(520.8 ± 205.8) s vs.(603.4 ± 198.4) s] and treadmill exercise posi-tive rate (64.00% vs.82.00% vs .92.00%) ,in group A ,B ,C respectively ;and ST depression extent of group C was significantly higher than that of group A [(2.4 ± 1.1) mV vs.(1.9 ± 0.8) mV] ,P＜0.05 or ＜0.01. Spearman correlation analysis indicated that treadmill exercise positive rate (myocardial ischemia rate ) was not significantly correlated with coronary stenotic degree (r＝3.425 , P＝0.126).Conclusion :Although treadmill exercise test pos-sesses important significance in diagnosis of myocardial ischemia ,but coronary stenotic degree is not correlated with myocardial ischemic degree .which should raise clinical attention

OBJECTIVETo investigate the intracellular trafficking pathway of fusion protein epidermal growth factor-adenovirus early region 4 open reading frame 4 protein (EGF-E4orf4) internalized via epidermal growth factor (EGF) receptor and its affectivity on extracellular signal-regulated kinase (ERK) phosphorylation.

METHODSMDA-MB-231 and BGC823 cells were incubated with fluorescein isothiocyanate-EGF-E4orf4 or EGF at different time points. The specific molecular mark of early endosome or late lysosome was labeled by indirect immunofluorescence, and then colocalization staining was observed using confocal laser microscopy. The levels of ERK phosphorylation were detected by Western blot.

RESULTSThe fluorescent signal of fusion protein EGF-E4orf4 accumulated within the cells and congregated to the perinuclear region. A nucleus localization of the fusion protein was only at MDA-MB-231 cell. Colocalization of EGF-E4orf4 with early endosome/late lysosome was observed. EGF-E4orf4 stimulated ERK phosphorylation, which was most obvious 10 minutes after stimulation, and then gradually attenuated, which was similar to EGF stimulation but with a less decrease.

CONCLUSIONSInternalized EGF-E4orf4 can be slowly degraded via endosome-lysosome pathway. The action features of EGF-E4orf4 are remarkably different between MDA-MB-231 and BGC823 cells, which may help explain the differences in its anti-tumor potency and in the special selectivity toward different tumor cells.

Adenovirus E4 Proteins ; pharmacokinetics ; Cell Line, Tumor ; Epidermal Growth Factor ; pharmacokinetics ; Extracellular Signal-Regulated MAP Kinases ; metabolism ; Humans ; Phosphorylation ; drug effects ; Protein Transport ; Recombinant Fusion Proteins ; pharmacokinetics ; Viral Proteins ; pharmacokinetics

OBJECTIVETo explore the influence of conventional metal materials in oral cavity on brain magnetic resonance imaging (MRI).

METHODSFour kinds of metal materials (metal ligature wire, forging hard and slotless denture, casting nichrome denture, casting copper alloy denture) in oral cavity were scanned through MRI. FSE sequence T1 weighted imaging (FSE T1), EPI diffusion-weighted imaging (DWI) sequence of ordinary, Propeller DWI imaging were used.

RESULTSIn FSE T1 sequence, metal ligature wire and forging hard and slotless denture produced serious false image, casting nichrome denture produced moderate false image, casting copper alloy denture produced only little false image. In EPI DWI sequence, obvious magnetic-sensitive false image were produced in the dissection tissue of the brain by metal ligature wire. While in Propeller DWI sequence, magnetic-sensitive false image were greatly reduced and satisfactory images were formed.

CONCLUSIONDifferent metal materials in oral cavity have different influence on the MRI. The false images produced by different metal materials are closely related to the type of the material. Magnetic-sensitive false images can be eliminated by Propeller DWI technique.

Dental Materials ; Diffusion Magnetic Resonance Imaging ; Humans ; Magnetic Resonance Imaging

OBJECTIVE: Over-expression of thrombin in ovarian cancer cells is associated with poor prognosis. In this study, we investigated the role of thrombin in inducing epithelial-mesenchymal transition (EMT) in SKOV3 epithelial ovarian cancer cells. METHODS: After thrombin treatment SKOV3 cells were subjected to western blots, reverse-transcription PCR, and enzyme-linked immunosorbent assay to quantify EMT-related proteins, mRNA expression of SMAD2, DKK1, and sFRP1, and the secretion of matrix metalloproteinases (MMPs) and cytokines. Meanwhile, invasion ability was evaluated using transwell assays. RESULTS: The results indicated a dose- and time-dependent down-regulation of E-cadherin and upregulation of N-cadherin and vimentin in thrombin-treated SKOV3 cells, compared with the thrombin-free control group (p<0.05). There was a dose- and time-dependent increase in the levels of SMAD2 and DKK1 mRNAs and a decrease in the levels of sFRP1 mRNA in thrombin-treated SKOV3 cells compared to control cells (p<0.05). Thrombin-treated SKOV3 cells exhibited increased secretion of MMP-9, MMP-2, interleukin (IL)-8, and IL-6 and increased invasion compared to untreated cells (p<0.05). Thrombin altered the morphology of SKOV3 cells to a spindle-like phenotype. Addition of hirudin to thrombin-treated cells reversed the effects of thrombin. CONCLUSION: Thrombin induced EMT and promoted the invasion of SKOV3 cells, possibly via distinct signaling pathways. Hirudin inhibited the effects of thrombin, suggesting that anticoagulant therapy could be a novel therapeutic strategy for ovarian carcinoma.
Blotting, Western ; Cadherins ; Cytokines ; Down-Regulation ; Enzyme-Linked Immunosorbent Assay ; Epithelial-Mesenchymal Transition ; Hirudins ; Interleukin-6 ; Interleukins ; Matrix Metalloproteinases ; Neoplasms, Glandular and Epithelial ; Ovarian Neoplasms ; Phenotype ; Polymerase Chain Reaction ; Prognosis ; Proteins ; RNA, Messenger ; Thrombin ; Up-Regulation ; Vimentin