Objective To investigate the correlation between surgical outcomes and body mass index (BMI) in patients with lumbar disc herniation. Methods 448 patients who underwent operative treatment for lumbar disc herniation were followed-up consecutively. The height and body weight of each patient was measured and recorded preoperatively. The BMI was calculated by the following formula, BMI=weight/height2 (kg/m2). The patients were asigned into three groups (normal group, BMI 28) based on the BMI. A questionnaire evaluation form was designed according to the 60 indexes put forward by North American Spine Association and the authors' clinical experiences. The post-operative signs and symptoms, living and working ability of the patients were evaluated by the questionnaire. Results Among the total 448 patients, none was lost for follow-up and all the patients were followed-up for average 2.48 (2.08-5.16) years. The improvement rate of the normal group was significantly higher than that of the obese group(P 0.05). The post-operative working ability of the patients in the normal group recovered more quickly than that of the patients in obese group (P 0.05). The remission rate, the post-operative pain and numbness between the male and the female were significantly different(P

OBJECTIVEChanges in the osteogenesis of diabetic rat bone marrow mesenchymal stem cells (BMSCs) by the regulation of Lnk/stem cell factor (SCF)-cKit signaling were investigated.

METHODSBMSCs were isolated from diabetic rats and identified by immunocytochemical staining. These cells were divided into the control group (untransfected group), negative control group (transfected with control plasmid), and RNA interference group (transfected with Lnk-targeting RNA interference plasmid). Western blot was performed to analyze the effect of interference. The BMSCs were induced for osteogenic differentiation under diabetic conditions, and Western blot was used to examine the expressions of Lnf, SCF, and cKit in Lnk/SCF-cKit signaling and osteogenic proteins alkaline phosphatase (ALP), osteocalcin (OCN), and collagen type I al (ColIal).

RESULTSIsolated cells expressed CD₄₄ and CD₉₀ but not CD₁₁b or CD₄₅. This phenomenon was characteristic of BMSCs. Compared with other diabetic BMSCs, cells in the RNA interference group expressed low Lnk but high SCF and cKit (P < 0.05). Thereafter, 28 days after induction of osteogenic differentiation, cells in the RNA interference group expressed low Lnk but high SCF, cKit, ALP, OCN, and ColIal compared with other diabetic BMSCs (P < 0.05).

CONCLUSIONThe inhibition of Lnk expression and activation of SCF-cKit pathway may improve the osteogenic differentiation of BMSCs under diabetic conditions.

Alkaline Phosphatase ; Animals ; Bone Marrow Cells ; Cell Differentiation ; Cells, Cultured ; Diabetes Mellitus, Experimental ; Hematopoietic Stem Cells ; Mesenchymal Stromal Cells ; Osteocalcin ; Osteogenesis ; RNA Interference ; Rats ; Signal Transduction ; Stem Cell Factor ; Transfection

Objective To evaluate the safety, feasibility and efficacy of CT-guided percutaneous hollow screw fixation in the treatment of patients with sacroiliac complex injury. Methods Forty-five patients (at age range of 15-58 years) with sacroiliac complex injuries including 20 males and 25 females were enrolled in this study. There were 28 traffic injuries and 17 fall injuries. Fourteen patients with sacral fractures ( 15 patients with Dennis type Ⅰ fractures and nine with Dennis type Ⅱ fractures), 12 with sacroiliac joint dislocation, six with sacral fracture combined with sacroiliac joint dislocation and nine with sacroiliac joint complex injury. All patients were treated by CT-guided percutaneous hollow screw fixation. The functional exercise was performed early after operation. Results Seventy-two hollow screws were installed in 45 patients, with the operation time for 21-68 minutes ( average 37 minutes) and the operative blood loss for 30-75 ml. Of all, 38 patients were followed up for 6-26 months. According to the Majeed functional criteria, the score of the patients was 72-96 points (average 90. 3 points ), which showed that the results were excellent in 33 patients and good in two, with excellence rate of 92%. No iatrogenic nerve injury, incision infection or screw fracture were detected. Conclusion CT-guided percutaneous hollow screw fixation takes advantages of precise direction, stable fixation and safe operation and hence is one of safe and effective methods for treatment of sacroiliac complex injury.

Background and purpose:Many studies indicate that nonsteroidal anti-inflammatory drugs(NSAIDs) may inhibit cancer growth.However,the molecular mechanisms may involve different pathway and still remain unclear.The aim of this experiment was to investigate the influence of aspisol against breast cancer lines,including MDA-MB-231(estrogen receptor-negative),MCF-7(estrogen receptor-positive),and reveal the potential signaling pathway mechanism of aspisol effect on breast cancer lines.Methods:MDA-MB-231 and MCF-7 human breast cancer cell lines were treated with aspisol in vitro.Cell proliferation was evaluated by MTT assay and rate of apoptosis were determined by flow cytometry.Extracellular signal regulated kinase(ERK),phosphor-ERK(P-ERK) protein expressed in breast cancer cell lines were analyzed by Western blot.Results:①The results of MTT assay demonstrated that the growth of MDA-MB-231,MCF-7 cells were inhibited by aspisol in a time-and dose-dependent fashion(P0.05).Conclusions:aspisol inhibits proliferation and induces apoptosis not only in ER-positive but also in ER-negative breast cancer cells.The mechanism may relate to ERK signal pathway.

Objective To evaluate effect of construction with dual plates via olecranon osteotomy approach in treatment of type C distal humeral fractures.Methods The study involved 19 patients with type C distal humeral fractures treated by olecranon osteotomy and double plate fixation between July 2008 and April 2010,including 11 males and 8 females at a mean age of 49.2 years (range,27-71 years).Fractures were causes by traffic accidents in 10 patients,tumble in seven and fall from height in two.According to Association for Osteosynthesis/Orthopaedic Trauma Association (AO/OTA) classification,there were nine patients with type C2 and 10 with type C3 fractures.Besides,two patients were complicated by ulnar nerve injuries and one by radial nerve injury.Results Primary wound healing was achieved in all patients after operation.All patients were followed up for average 15.9 months (range,12-20 months).X-ray films revealed that both fracture and olecranon osteotomy sites were healed in average 12 weeks (range,8-18 weeks).No fixation failure,myositis ossificans,malunion,delayed union or disunion occurred during the follow-up.Average Mayo elbow performance score (MEPS) was 94.8 points (range,75-100 points) at the last follow-up,which showed excellent results in 14 patients,good in three,and fair in two,with excellence rate of 90％.Conclusions Double plate fixation via olecranon osteotomy gains advantages of solid fixation and early functional exercise in treatment of comminuted intercondylar fractures of humerus.Moreover,postoperative outcome is satisfactory.

Objective:To compare the analgesic effects of naborphine and desorine after surgery for supracondylar fracture of humerus in children.Methods:Eighty-seven children with supracondylar fracture of humerus who received surgical treatment in Zhoushan Hospital of Traditional Chinese Medicine between January 2019 and January 2020 were included in this study. They were randomly assigned to receive postoperative analgesia either with dezocine (control group, n = 44) or naborphine (observation group, n = 43). The postoperative agitation score, postanesthetic recovery score, postoperative visual analogue scale score, and adverse reactions were determined between the two groups. Results:The heart rate and mean arterial pressure at the time of extubation were (102 ± 7) beats/min and (83 ± 6) mmHg respectively in the observation group, which were significantly lower than those in the control group [(115 ± 8) beats/min, (92 ± 7) mmHg, t = 6.214, 8.283, P < 0.05]. In the observation group, the postoperative agitation score was (4.45 ± 0.34) points, (5.02 ± 0.38) points, and (3.65 ± 0.39) points, at the time of spontaneous eye opening, at the time of extubation and at 30 minutes after extubation respectively, which were significantly lower than those in the control group [(5.31 ± 0.48) points, (5.75 ± 0.35) points, (4.12 ± 0.37) points, t = 6.392, 7.194, 7.382, all P < 0.05]. At 30 min, 3 h and 6 h after surgery, the visual analogue scale scores in the observation group were significantly lower than those in the control group ( t = 5.345, 6.124, 7.553, P < 0.05). The time to return to spontaneous breathing, the time to spontaneous eye opening and the time to extubation in the observation group were (7.32 ± 4.17) min, (11.65 ± 3.32) min, (12.13 ± 2.41) min, respectively, which were significantly shorter than those in the control group [(10.34 ± 4.15) min, (14.43 ± 3.18) min, (15.16 ± 2.23) min, t = 7.216, 5.382, 7.319, all P < 0.05]. The incidence of adverse reactions in the observation group was significantly lower than that in the control group [6.97% (3/43) vs. 27.27% (12/44), χ2 = 6.280, P < 0.05]. Conclusion:Naborphine for analgesia after surgery for supracondylar fracture of humerus in children can effectively reduce the incidence of agitation during the recovery period, enhance postoperative analgesic effect, and lower the incidence of reverse reactions.

Objective To investigate the surgical strategies for management of unstable fractures of intertrochanteric lateral wall.Methods From July 2012 to June 2014,50 patients with unstable fractures of intertrochanteric lateral wall received osteosynthesis with proximal femoral nail anti-rotation.They were 37 men and 13 women,with an average age of 65.6 years (range,from 42 to 87 years).According to our morphology classification,25 patients belonged to type Ⅰ (comminuted fracture of lateral wall),4 to type Ⅱ (split fracture of lateral wall with loss of medial support),21 to type Ⅲ (comminuted fracture of lateral wall and subtrochanteric part with loss of medial support).The fractures were managed differently according to our classification.Type Ⅰ were treated by intramedullary fixation with compression screws to reconstruct the lateral wall,type Ⅱ by intramedullary fixation after reconstruction of the lateral wall lby cables,and type Ⅲ by intramedullary fixation after optimal reduction of the coronal plane and neck-shaft angle because the lateral wall could not be reconstructed.Results The 50 patients obtained an average follow-up of 17 months (range,from 5 to 24 months).No deep infection or wound dehiscence happened.Deep vein thrombosis occurred in 2 patients.No nonunion,cutout of the sliding screw,or coxa vara occurred.The operation time,blood loss,time of weight loading after operation and time of union increased with our increased classification.One patient died from a heart disease 5 months after operation.Functional outcome of the other 49 patient was assessed by Harris hip score one year after operation.Forty patients were excellent,6 good and 3 fair,giving an excellent to good rate of 93.9％.Conclusion Unstable fractures of intertrochanteric lateral wall should be treated using different surgical strategies based on the morphology classification system.

AIM: To investigate the expression of microRNA-625-3p ( miR-625-3p) in colorectal carcinoma ( CRC) and its underlying mechanism .METHODS:Quantitative real-time PCR was employed to detect the levels of miR-625-3p expression in different CRC cell lines , CRC tissues and pair-matched adjacent normal tissues .The relationships be-tween the expression levels of miR-625-3p and the patients’clinicopathological parameters were estimated .The effects of miR-625-3p on the apoptosis and the cell mitotic cycle of CRC cells were analyzed with propidium iodide staining and flow cytometry.The effect of miR-625-3p on the apoptosis-related proteins was analyzed by Western blot .RESULTS: The ex-pression level of miR-625-3p in the CRC tissues was higher than that in the pair-matched adjacent normal tissues ( P <0.05).The expression of miR-625-3p in the CRC tumor tissues was significantly correlated with the tumor infiltrative depth , TNM stage and distant metastasis (P<0.05).The expression levels of miR-625-3p in CRC SW620 cells were higher than that in SW480 cells.The CRC cell mitotic cycle was significantly inhibited and cell apoptosis was significantly promoted when the expression of miR-625-3p was inhibited (P<0.05).The expression of Bax protein didn’t change and the expres-sion of Bcl-2 protein increased after miR-625-3p mimics were transfected into CRC SW620 cells(P<0.05).CONCLU-SION:miR-625-3p may be a promising approach for the treatment of CRC by promoting cell proliferation and inhibiting apoptosis .

Objective To evaluate the specificity and sensitivity of a Hove]hepatitis C virus NS3 antigen detection immunoassay and the potential application of this assay in clinical diagnosis.Methods Samples from 77 healthy flubjects,173 anti-HCV-positive pailents and 3708 patients infected with other type of hepatitis were tested with the HCV NS3 antigen assay,some HCV NS3 antigen positive samples were validated witll HCV-RNA.neutralization and immunodot assays.Twenty.five sequential samples from 11 HCV NS3 antigen positive patients were subjected to kinetic studv.Results Forty-eight(1.3%)of 3708 antiHCV negative samples were positive for HCV NS3 antigen.Among them,44 of 3030 samples from patients only infected with HBV were HCV NS3 antigen-positive,4 of the 445 samples from patients infected with other type hepatitis were HCV NS,antigen-positive.In addition.42(24.3%)of 173 anti-HCV positive samplea were HCV NS3 antigen-positive and all 77 samples from healthy subjects were negative to HCV NS3 antigen assay.Of 15 HCV NSl antigen-positive samples,9(60%)were HCV-RNA positive.The neutralization and positive percentage of immunodot assay for 23 HCV NS3 antigen-positive sera were 87.0%(20/23)and 69.6%(16/23) respectively.Of the 25 sequential samples from 11 HCV NS3 antigen positive patients,there was a negative correlation between the A values and the duration of test.and there were correlations among their HCV NS3 antigen.HCV.RNA and anti-HCV;In addition,the anti-HCV antibodies of two sera were detected while their A values of HCV NS3 antigen decreased gradually.Conclusion The HCV NS3 antigen detection assay showed perfect specificity and higher sensitivity,it will be useful in routine laboratories test in developing countfies for earlier diagnosis of HCV infection.

Objective: To investigate the effects of 25-hydroxyvitamin D3[25(OH) D3,D3] on NLRP3 inflammasome activation and inflammatory response of bone marrow mesenchymal stem cells (BMSCs) from diabetic rats. Methods: BMSCs were isolated from diabetic rats and identified by immunocytochemical staining. The cells were divided into diabetic control group (without D3 treatment),low concentration group(treated with 1 × 10-5 mmol /L of D3),intermediate concentration group(treated with 1 × 10-4 mmol /L of D3),and high concentration group(treated with 1 × 10-3 mmol /L of D3) (n = 10),BMSCs from normal rats were used as the normal control group(without D3 treatment). Inflammation-related proteins including NLRP3 in BMSCs were examined by western blot analysis. Results: The cultured cells expressed biomarkers of BMSCs. VDR expression in normal control,diabetic control and low concentration groups was less than that in intermediate concentration and high concentration groups(P ＜ 0. 05). Compared with all diabetc groups,normal control group expressed less NF-κB,NLRP3,ASC,Caspase-1,IL-1β,IL-18 and IL-6(P ＜ 0. 05). Additionally,diabetic control and low concentration groups showed stronger expression of NF-κB,NLRP3,ASC,Caspase-1,IL-1β,IL-18 and IL-6 than intermediate concentration and high concentration groups(P ＜ 0. 05). Conclusion: 25-(OH)2-D3 can inhibit the activation of NLRP3 in BMSCs and suppress the inflammatory response of BMSCs from the diabetic rats.