Etiology of adolescent idiopathic scoliosis (MS),a complicated three-dimensional spinal deformity with early-onset,receives continuous attention but remains unclear.To gain an insight into AIS pathogenesis,this review searched PubMed database up to June 2019,using key words or medical subject headings terms including "adolescent idiopathic scoliosis," "scoliosis," "pathogenesis,etiology," "generics,mesenchymal stem cells," and their combinations,summarized existing literatures and categorized the theories or hypothesis into nine aspects.These aspects include bone marrow mesenchymal stem cell studies,genetic studies,tissue analysis,spine biomechanics measurements,neurologic analysis,hormone studies,biochemical analysis,environmental factor analysis,and lifestyle explorations.These categories could be a guidance for further etiology or treatment researches to gain inspiration.

BackgroundNanotechnology is emerging as a promising tool to perform noninvasive therapy and optical imaging. However, nanomedicine may pose a potential risk of toxicity during in vivo applications. In this study, we aimed to investigate the potential toxicity of rare-earth nanoparticles (RENPs) using mice as models.

MethodsWe synthesized RENPs through a typical co-precipitation method. Institute of Cancer Research (ICR) mice were randomly divided into seven groups including a control group and six experimental groups (10 mice per group). ICR mice were intravenously injected with bare RENPs at a daily dose of 0, 0.5, 1.0, and 1.5 mg/kg for 7 days. To evaluate the toxicity of these nanoparticles in mice, magnetic resonance imaging (MRI) was performed to assess their uptake in mice. In addition, hematological and biochemical analyses were conducted to evaluate any impairment in the organ functions of ICR mice. The analysis of variance (ANOVA) followed by a one-way ANOVA test was used in this study. A repeated measures' analysis was used to determine any significant differences in white blood cell (WBC), alanine aminotransferase (ALT), and creatinine (CREA) levels at different evaluation times in each group.

ResultsWe demonstrated the successful synthesis of two different sizes (10 nm and 100 nm) of RENPs. Their physical properties were characterized by transmission electron microscopy and a 980 nm laser diode. Results of MRI study revealed the distribution and circulation of the RENPs in the liver. In addition, the hematological analysis found an increase of WBCs to (8.69 ± 0.85) × 10/L at the 28 day, which is indicative of inflammation in the mouse treated with 1.5 mg/kg NaYbF:Er nanoparticles. Furthermore, the biochemical analysis indicated increased levels of ALT ([64.20 ± 15.50] U/L) and CREA ([27.80 ± 3.56] μmol/L) at the 28 day, particularly those injected with 1.5 mg/kg NaYbF:Er nanoparticles. These results suggested the physiological and pathological damage caused by these nanoparticles to the organs and tissues of mice, especially to liver and kidney.

ConclusionThe use of bare RENPs may cause possible hepatotoxicity and nephritictoxicity in mice.

Objective To evaluate the effect of transcranial direct current stimulation (tDCS) on post-stroke dysphagia. Methods Cochrane Library (CENTRAL), Medline, EMBASE, CBMdisc, VIP, CNKI and WANFANG Digital Journals were searched to collect randomized controlled trials (RCTs) about transcranial direct current stimulation for post-stroke dysphagia until February 2018. Two researchers independently screened literature, extracted data and evaluated the quality of the included studies. Then, meta-analysis was performed using RevMan 5.3 software. Results A total of eight RCTs were screened, including 225 patients. Compared to the control group, tDCS was effective on post-stroke dysphagia (SMD=0.71, 95%CI: 0.32~1.10, P<0.001) with safety. Conclusion tDCS could improve swallowing function of post-stroke dysphagia. Due to the limited quantity and quality of the included studies, more high quality studies are needed.

BACKGROUNDLuminescent rare-earth-based nanoparticles have been increasingly used in nanomedicine due to their excellent physicochemical properties, such as biomedical imaging agents, drug carriers, and biomarkers. However, biological safety of the rare-earth-based nanomedicine is of great significance for future development in practical applications. In particular, biological effects of rare-earth nanoparticles on human's central nervous system are still unclear. This study aimed to investigate the potential toxicity of rare-earth nanoparticles in nervous system function in the case of continuous exposure.

METHODSAdult ICR mice were randomly divided into seven groups, including control group (receiving 0.9% normal saline) and six experimental groups (10 mice in each group). Luminescent rare-earth-based nanoparticles were synthesized by a reported co-precipitation method. Two different sizes of the nanoparticles were obtained, and then exposed to ICR mice through caudal vein injection at 0.5, 1.0, and 1.5 mg/kg body weight in each day for 7 days. Next, a Morris water maze test was employed to evaluate impaired behaviors of their spatial recognition memory. Finally, histopathological examination was implemented to study how the nanoparticles can affect the brain tissue of the ICR mice.

RESULTSTwo different sizes of rare-earth nanoparticles have been successfully obtained, and their physical properties including luminescence spectra and nanoparticle sizes have been characterized. In these experiments, the rare-earth nanoparticles were taken up in the mouse liver using the magnetic resonance imaging characterization. Most importantly, the experimental results of the Morris water maze tests and histopathological analysis clearly showed that rare-earth nanoparticles could induce toxicity on mouse brain and impair the behaviors of spatial recognition memory. Finally, the mechanism of adenosine triphosphate quenching by the rare-earth nanoparticles was provided to illustrate the toxicity on the mouse brain.

CONCLUSIONSThis study suggested that long-term exposure of high-dose bare rare-earth nanoparticles caused an obvious damage on the spatial recognition memory in the mice.

AIM: To observe thickness and morphological changes of bulbar conjunctiva pre- and post epidemic hemorrhagic conjunctivitis ( EHC ) therapy by optical coherence tomography ( OCT) .
METHODS: Observed morphological changes and measured the bulbar conjunctiva thicknesses of 29 cases (36 eyes) of incipient (1-2d) EHC patients, who were received and treated by department of ophthalmology, the Putuo Affiliated Hospital of Shanghai University of Traditional Chinese Medicine from May 2013 to December 2013, by OCT. Then measured the thickness again on 7, 14d after the therapy.
RESULTS: Among 29 patients (36 eyes), 7d after the EHC therapy, in 27 cured eyes, the full-thickness ( before 344. 00±59. 91μm, after 230. 19±22. 16μm, t=11. 75, P<0-01); epithelial thickness ( before 56. 52±6. 19μm, after 51. 37±5. 53μm, t=4. 61, P<0. 01); and stromal thickness (before 287. 11±60. 56μm, after 178. 81±20. 20μm, t=10. 69, P<0. 01) of patients' bulbar conjunctiva were thicker than values measured after therapy with significant difference. Significant difference was also found for full-thickness ( before 361. 39±65. 56μm, after 233. 44±22. 57μm, the difference was statistically significant, t=14. 45, P<0. 01);epithelial thickness ( before 55. 50±6. 72μm, after 46. 67±5-24μm, t=10. 06, P<0. 01) and stromal thickness ( before 305. 61±66. 02μm, after 186. 78±21. 82μm, t=13. 11, P<0-01 ) of patients' bulbar conjunctiva between values measured before and 14d after therapy.
CONCLUSION: The OCT is able to measure the thickness of bulbar conjunctiva in EHC patients. An significant increase was found in full, epithelial and stromal thickness of EHC patients' bulbar conjunctiva. With recovery from the disease, subepithelial fluid, interlaminar fluid and edema of the bulbar conjunctival stroma faded away firstly, which provide references for clinical therapies of the EHC.

Objective To observe the prognostic value of admission B-type natriuretic peptide (BNP) on outcome for patients with congestive heart failure (CHF).Methods Blood BNP levels,routine echocardiography and tissue Doppler image were obtained in 162 CHF patients [95 male,mean age:(71.8 ±3.7 ) years] at admission.Patients were divided into high BNP ( BNP ＞ 1500 ng/L,n =104) and low BNP (BNP≤ 1500 ng/L,n =58 ) groups.All patients were followed up for 2 years and clinical characteristics,echocardiography including Doppler image and cardiovascular events results were analyzed.Data were also compared between patients with ( n =48 ) or without ( n =107 ) cardiovascular events.Results Left ventricular ejection fractions (LVEF) was significantly lower [ (40.9 ±5.6)％ vs.(44.0 ±5.9)％,P ＜0.01 ] while the total cardiovascular events rate (49.1％ vs.21.0％,P ＜0.01 ) and cardiac mortality rate (25.5％ vs.9.0％,P＜0.01) were significantly higher in high BNP group than in low BNP group.BNP level at admission in event group was significantly higher than in event-free group [ (2875.4 ±325.7) ng/Lvs.(1136.9±298.6) ng/L,P＜0.000].BNP level was positively related to Tei-index (r=0.793,P＜0.001 ) and negatively correlated with LVEF ( r =-0.57,P ＜0.001 ).Multiple logistic regression analysis demonstrated that BNP,LVEF,Tei-index and β-blocker use were independent risk factors for cardiovascular events.The area under the ROC curve for predicting cardiovascular death within 2 years in event group by BNP was 0.795 (95％ CI 0.693 - 0.935,sensitivity:72.31％ and specificity:84.62％,cut-off BNP value:1910 ng/L).The event risk was 2.17 times higher in CHF patients with admission BNP ＞ 1910 ng/Lcompared CHF patients with admission BNP ≤ 1910 ng/L ( 95％ CI:1.852 - 2.954,P =0.000 ).Conclusion Admission BNP level,LVEF,Tei-index and β-blocker use are independent risk factors for cardiovascular events in patients with CHF.Patients with higher admission BNP level ( ＞ 1910 ng/L) is linked with worse prognosis in this patient cohort.

OBJECTIVETo evaluate the efficacy and complications of posterior hemivertebra resection with monosegmental fusion in the treatment of congenital scoliosis.

METHODSThirty consecutive cases of congenital scoliosis managed by posterior hemivertebra resection with monosegmental fusion of the two adjacent vertebra were investigated retrospectively. Radiographs were reviewed to determine the coronal curve magnitude and sagittal alignment preoperatively, postoperatively and at last follow-up. Operative reports and patient charts were reviewed to record any perioperative and late complications.

RESULTSThe total number of resected hemivertebra was 30. Mean operation time was 193.8 min with average blood loss of 369.0 ml. The segmental scoliosis was corrected from 36.4° to 4.9° with a correction rate of 86.5%, and segmental kyphosis (difference to normal segmental alignment) from 21.2° to 6.6° with a correction rate of 68.9%. The trunk shift was improved from 17.1 to 8.8 mm. The correction of the compensatory cranial and caudal curve were 74.9% and 75.1%. There were 1 delayed wound healing, 2 pedicle cutting and 1 rod breakages. Radiolucent gaps were found on the lateral view in 2 cases without any sign of implant failure and correction loss.

CONCLUSIONSPosterior hemivertebra resection with monosegmental fusion of the two adjacent vertebra allows for early intervention in very young children. Excellent correction in the frontal and sagittal planes can be obtained. And a short segment of fusion allows for normal growth in the unaffected parts of the spine. The most common complication is implant failure.

Adolescent ; Child ; Child, Preschool ; Female ; Follow-Up Studies ; Humans ; Male ; Postoperative Complications ; Retrospective Studies ; Scoliosis ; congenital ; surgery ; Spinal Fusion ; adverse effects ; methods ; Treatment Outcome

OBJECTIVEto evaluate the outcomes and complications of posterior vertebral column resection in the treatment of severe and fixed spinal deformities.

METHODSfrom January 2008 to January 2010, 15 consecutive cases (4 males, 11 females) of severe and fixed spinal deformities managed by single posterior vertebral column resection with transpedicular instrumentation were investigated retrospectively. The diagnosis included congenital scoliosis in 10 cases, adolescent idiopathic scoliosis in 1 case, congenital kyphosis in 3 cases, tuberculous kyphosis 1 case. Radiographs were measured to determine the regional coronal and sagittal curve magnitude, and the coronal and sagittal balance preoperatively, postoperatively and at the final follow-up. Operative reports and patient charts were reviewed to record operation time, intraoperative blood loss and complications.

RESULTSthe mean resected vertebrae was 1.8 (range, 1 - 5). The mean operation time was 331 min (range, 240 - 450 min) with an average blood loss of 1453 ml (range, 800 - 3000 ml). The average follow-up time was 13 months (range, 3 - 24 months). The regional scoliosis was corrected from 111° to 51°with a correction rate of 54.0%, and regional kyphosis from 104° to 39° with a correction rate of 62.5%. No obvious loss of correction was noted at the final follow-up. The coronal trunk shift improved from 19.5 mm preoperatively to 18.1 mm postoperatively and 12.4 mm at final follow-up. The sagittal balance improved from 20.0 mm preoperatively to -2.0 mm postoperatively and -1.1 mm at the final follow-up. Complications included partial pleural rupture requiring repair in 3 cases, transient muscle weakness of one lower limb after surgery but recovered completely at 6 month follow-up in 2 cases, and tightness of thorax after surgery in one case.

CONCLUSIONSposterior vertebral column resection is effective in treatment of severe and rigid spinal deformities. But it is a technique-demanding procedure with higher risks of major neurologic complications.

Adolescent ; Adult ; Child ; Female ; Follow-Up Studies ; Humans ; Kyphosis ; surgery ; Male ; Middle Aged ; Retrospective Studies ; Scoliosis ; surgery ; Spine ; surgery ; Treatment Outcome ; Young Adult