BACKGROUND: The use of bone graft materials can promote bone fusion and enhance the stability of the spine during the spinal fusion. OBJECTIVE: To investigate the effect of autologous bone marrow mesenchymal stem cel s with hydroxyapatite/ tricalcium phosphate in the spinal fusion. METHODS: A retrospective analysis of clinical data of 64 patients with spinal fusion was carried out, and these patients were divided into two groups (n=32 per group): control group undergoing autogenous iliac bone grafting and observation group undergoing autologous bone marrow mesenchymal stem cel s combined with hydroxyapatite/tricalcium phosphate. Al patients were fol owed up for 12 months, and their recovery conditions about low back pain, spinal fusion and vertebral reset were assessed. RESULTS AND CONCLUSION: The low-back outcome scale scores and excel ent rate, Lenke grading and Cobb angle had insignificant differences between the two groups after treatment (P > 0.05). No infection, inflammation and skin irritation occurred in the two groups. The coagulation function, renal function and inflammatory factor levels were at normal levels in al the patients, and there was no difference between the two groups (P > 0.05). These findings indicate that autologous bone marrow mesenchymal stem cel s combined with hydroxyapatite/tricalcium phosphate can achieve clinical outcomes equivalent to the autologous iliac bone grafting.

Objective To observe the effect of short-term treatment with metfbrmin on psychological distress and metabolic feature in patients with polycystic ovary syndrome(PCOS).Methods Ninety women were diagnosed as cases of PCOS based on the 2003 Rotterdam criteria.These patients were divided into three groups:group A,consisted of 26 subjects treated with mefformin only; group B,36 cases treated with metformin plus Dane-35 ; and group C,28 cases treated with placebo and Dane-35.The treatment was carried out for 3 months.Clinical and metabolic parameters were observed.The psychological distress was evaluated by the hospital anxiety and depression scale(HAD scale).Results Compared with group C,patients in group A and B showed significantly lower body mass index(BMI),waist circumference (WC),waist-hip ratio (WHR),serum fasting insulin,homeostasis model assessment for insulin resistance (HOMA-IR),total cholesterol (TC),triglyceride (TG),low density lipoproteincholesterol(LDL-C) levels as well as anxiety and depression scores,but higher high density lipoprotein-cholesterol (HDL-C) levels (all P＜0.05).Compared with group A,patients in Group B had significantly higher WC,WHR,and LDL-C levels(all P＜O.05).No significant differences in BMI,TG,HDL-C,anxiety and depression scores were found between group A and B (all P＞0.05).In group A,a positive correlation was found between the changes of metabolic feature (BMI,WHR,and HOMA-IR) and the changes of anxiety and depression scores (all P ＜0.05).Conclusion Short-term treatment with metformin will benefit patients with polycystic ovary syndrome,regarding psychological distress and metabolic features.

Objective To prepare,characterize glycyrrhetinic acid lysinate,and study the solubilization and inhibitory action antitumor activity of glycyrrhetinic acid lysinate on cell proliferation of colorectal cancer cell line HCT-8. Methods Glycyrrhetinic acid lysinate was prepared by co-grinding glycyrrhetinic acid with lysine in 1∶1 molar mixture for 10 hours. Characterization of glycyrrhetinic acid lysinate was achieved by X-ray powder diffraction, infrared spectroscopy, and ultraviolet spectrum techniques.HPLC method was used to study the solubilization of glycyrrhetinic acid lysinate.The MTT method was used to assay the inhibitory action of glycyrrhetinic acid lysinate on cell proliferation. Results The solubility of glycyrrhetinic acid lysinate was enhanced 260 folds,compared with glycyrrhetinicacid in water. The inhibitory cell proliferation action on HCT-8 of glycyrrhetinic acid lysinate was 7 times higher than that of glycyrrhetinic acid. Conclusion The satisfactory water solubility and antitumor activity of glycyrrhetinic acid lysinate will be potentially useful for its application as a new pharmaceutical formulation in cancer treatment in the future.

Objective To compare the efficacy of self-made bone cement spacers containing vancomycin(vancomycin spacer)and Link infection-treating spacers(Link type spacer)for chronic infection after total hip arthroplasty(HTA)and investigate the choice of spacers for the two-stage revision of infection.Methods The study included 26 patients with infection combined with HTA,aged 32-82 years(mean 69.5 years).In the first stage,after complete debridement and removal of infected prostheses,the vancomycin spacers were implanted in 14 patients,while the Link type spacers were implanted in the rest 12 patients.Two weeks of intravenous administration of antibiotics and then six weeks of oral administration of antibiotics were done postoperatively.White blood cells(WBCs),erythrocyte sedimentation rate(ESR)and C-reactive protein(CRP)were measured periodically after operation.THA revision was performed in the second stage.Clinical outcomes were evaluated according to the pre-and post-operative Harris hip score.Results All patients obtained primary healing of incision after complete debridement,removal of prostheses and implant of the vancomycin spacers or the Link type spacers.Two-stage revision surgery was performed at 3-11.5 months after the one-stage surgery(mean 5.2 months).The follow-up ranging from 12 to 33 months(mean 20.8 months)manifested no signs of reinfection.The mean Harris hip score was increased from 27.9 points before one-stage operation to 52.9 points before two-stage operation,and 83.6 points at the latest follow-up(P＜0.05)One of 12 vancomycin spacers was broken before the revision surgery,as was free from the Link spacers.Conclusions(Ⅰ)Two-stage revision is an effective method in the treatment of infection after HTA because of high eradication rate of infection,effective pain relief and good postoperative functional result.(2)The vancomycin spacers and the Link type spacers can both effectively control infection and restore part of limb function.(3)The Link type spacers take advantages of simple in operation and the function improvement of the limbs during the intermittent period of treatment,but disadvantages of the catheters being prone to block,limited slow release of antibiotics and high cost of treatment.Thereby,the Link type spacer is suitable for the patients with relatively strong constitution,little serious infection,or high requirement of limb functions at the interval of two operations.

Aim To investigate the effect of genistein on apoptosis in triple-negative breast cancer MDA-MB-231 cells and the underlying mechanisms.Methods MTT assay was used to detect the inhibition rate on breast cancer MDA-MB-231 cells of genistein.Hoechst 33258 staining was applied to determine the effect of genistein on morphology of MDA-MB-231 cells.qRT-PCR was employed to detect the mRNA expression of EGFR in MDA-MB-231 cells.Western blot was utilized to determine the expression of Bcl-2, Bax, caspase-3, EGFR, Akt, and p-Akt.The expressions of Akt and p-Akt proteins in breast cancer MDA-MB-231 cells were detected after treated with Akt activator insulin, genistein and in combination with insulin.Results Genistein inhibited the viability of breast cancer MDA-MB-231 cells in a time-dependent manner.The results of Hoechst 33258 staining showed a typical apoptotic morphological changes of MDA-MB-231 cells after treatment of genistein for 36 h.qRT-PCR showed that the mRNA expression of EGFR in MDA-MB-231 cells decreased after treated with genistein for 36 h.The expression levels of Bcl-2, EGFR, Akt, p-Akt, ERK, p-ERK were significantly down-regulated(P<0.01) compared with control.While, the expression of Bax, caspase-3 was significantly up-regulated (P<0.01).It was observed that p-Akt was significantly activated after the treatment of Akt activator insulin (P<0.01), however, significantly down-regulated (P<0.01) when treated with genistein.Conclusion Genistein could inhibit the growth of triple-negative breast cancer MDA-MB-231 cells and induce apoptosis, which probably involves regulating EGFR/PI3K/Akt signaling pathway.

Objective To investigate the associations of a single-nucleotide polymorphisms (SNPs) in the interleukin (IL)-6 gene with the migraine of a Han Chinese northeastern population.Methods We collected 252 patients of the migraine attack,who were diagnosed at People' s Hospital of Liaoning Province from March 2012 to June 2013,all being Han nationality in the northeast of China.At the same time,we collected 270 healthy people over the same period who had health examination or were healthy workers of People' s Hospital of Liaoning Province.We used polymerase chain reaction and gene sequencing to analyze the genotype and allele frequencies of the-572G/C (rs1800796) IL-6 polymorphisms between migraine cases (n =252;including migraine without aura (MO) group (n =168) and migraine with aura group (n =84);the male group (n =109) and the female group (n =143)) and control group (n =270;the male group (n =116) and the female group (n =152)),as well as analyzed the genotype and allele frequencies distribution between the subgroups.Results We found higher frequencies of the distribution of the C/C genotype and the C allele of the-572G/C polymorphism in migraine cases than in control group (32.54％ (82/252) vs 19.63％ (53/270),x2 =12.061,P =0.002;55.56％ (280/504) vs 45.37％ (245/540),x2 =10.818,P =0.001),higher distribution frequencies of the C/C genotype and the C allele in female group (21.83％ (55/252) vs 12.59％ (34/270),x2 =10.187,P =0.006;33.73％ (170/504) vs 26.48％ (143/540),x2 =10.073,P =0.002).Between MO group and controls,these distribution frequencies had statistically significant difference (24.60％ (62/252) vs 19.63％ (53/270),x2 =18.172,P=0.000;39.88％ (201/504) vs 45.37％ (245/540),x2 =17.307,P=0.000).After correction by conditional Logistic regression,the frequency distribution difference of the C/C genotype between the migraine cases and controls remained statistically significant (OR =22.861,95％ CI 5.218-27.098,P =0.023).Conclusion Our data indicate that the SNPs of the IL-6 are associated with migaine and the C/C genotype increases the migraine susceptibility in a Han Chinese northeastern population.

Objective To explore the influencing factors on short -term efficacy of intravenous thrombolysis with rt -PA.Methods The clinical data of the 95 acute ischemic stroke(AIS)patients who received thrombolytic therapy were analyze.Multivariate logistic regression analysis was used to determine the possible influencing factors. Results Fifty -six(58.95%)patients had favourable outcomes after thrombolytic therapy for 24 hours.Multivariate logistic regression analysis indicated that diabetes(OR =3.933,95% CI 1.199 ~12.897)and TOAST classification (OR =1.448,95% CI 1.032 ~2.032 )were the independent predictors of short -term outcome.Conclusion Diabetes and TOAST classification are the major influencing factors of short -term efficacy after intravenous thrombolysis with rt -PA.It should pay attention screening patients for intravenous thrombolysis therapy and predicting the efficacy of thrombolysis.

Objective To investigate the sleep quality of older adults in Shaoxing City and to examine its influencing factors. Methods Based on a cross-sectional questionnaire survey, a cluster sampling method was adopted to collect participants. Five villages were chosen randomly from 20 in the Yuecheng district of Shaoxing. The respondents were adults aged more than 60 years in the 5 villages. In total,1 303 adults participated,including 603 men and 700 women,and the average age was(70.99±7.38). The information related to sociodemographic factors,health status,sleep characteristics,and behavioral and lifestyle factors were collected.A chi-square test and variance analysis were used to compare sleep quality and sleep duration among participants. An ordinal regression model was adopted to examine the factors influencing sleep quality. Results One hundred and ninety-six (15.0%) older adults reported that sleep quality was always bad during the past year, 180(13.8%)reported that sleep quality was bad occasionally, and 927(71.1%)reported that sleep quality was good every day.The average sleep duration of participants was(6.64±1.38)h per night,and sleep durations for older adults who reported that sleep quality was always bad, bad occasionally, and good every day were (4.21 ± 1.13) h, (6.12 ± 1.40) h, and (7.26 ± 1.39) h, respectively,and older adults with poor sleeping quality had a shorter sleep duration(F=421.828,P<0.001). Being a woman, more than 80 years old, not working, and taking sleeping pills were risk factors for poor sleep quality with ORs (95% CI) of 1.492 (1.132-1.964), 1.564 (1.108-2.206), 1.331 (1.015-1.747), and 14.614(7.164-29.844),respectively.Conclusions Elderly individuals in Shaoxing had poor sleep quality. The sleep quality of those who were women, were oldest and took sleeping pills is cause for concern. Encouraging them to engage in work may improve their sleeping status.

Objective To explore the CT dominant phase and optimal classification model in differenting clear cell renal cell carcinoma (ccRCC) from fat‐poor angiomyolipoma (fpAML) through quantitative multiple‐phase CT radiomic features analysis. Methods Clinical and imaging data of 195 cases pathologically confirmed ccRCC (n=131) and fpAML (n=64) were retrospectively studied. All the patients underwent non‐contrast enhanced CT scans and dynamic multi‐phase (corticomedullary phase, medullary phase and excretion phase) contrast‐enhanced CT scans. Regions of interest (ROIs) were manually delineated based on the selected image slices with the maximal diameter of the lesion using ITK‐SNAP software, followed by the acquisition of candidate CT radiomic feature sets from each phase with statistically significant differences by using Mann‐Whitney U test. Then, using the synthetic minority oversampling technique (SMOTE), 232 classification models which are composed of 29 different feature selection algorithms (top 10 features were chosen by the backward elimination method) and 8 different classifiers were constructed. Employing the 5‐fold cross‐validation method, the performance of each classification models for each phase was evaluated using accuracy (ACC), sensitivity (SEN), specificity (SPE) and area under receiver operating characteristic curve (AUC), to acquire dominant CT phases and the optimal classification models for distingushing ccRCC and fpAML, along with the key imaging radiomic features. Results In this study, the mean maximal diameter of ccRCC and fpAML lesions were (3.9±1.4) cm, and (3.5±1.7) cm, respectively, and there was no statistically significant difference in the size of the tumor between two groups (P>0.05). From 102 initial imaging feature sets, the total number of candidate imaging feature sets (P<0.05) were:non‐enhanced phase (n=26), corticomedullary phase (n=71), medullary phase (n=68), excretion phase (n=62). Among the 232 classification models through different combination of classifiers and feature selectors, the amount of classification models which achieved the maximum of AUC value (AUCmax) from different CT phases were: non‐enhanced phase (n=106, 45.7%), corticomedullary phase (n=94, 40.5%), medullary phase (n=23, 9.9%), excretion phase (n=9, 3.9%). Imaging features from non‐enhanced phase and corticomedullary phase yielded higher performance compared with medullary phase and excretion phase, with the corresponding optimal prediction models were SVM‐fisher_score (AUC: 0.897, ACC: 83%, SEN: 84%, SPE:80%) and Logistic Regression‐RFS (AUC: 0.891, ACC: 83%, SEN: 81%, SPE: 89%), respectively. Conclusions The quantitative imaging features from non‐enhanced and corticomedullary phase have better performance among proposed classification models than that from medullary phase and excretion phase. Furthermore, it is feasible to acquire proper combination of feature selection and classifiers to achieve high performance in identifying ccRCC and fpAML.

Objective To study the value of transcranial Doppler (TCD) combined with digital subtraction angiography (DSA) in the evaluation of intracranial vessels in patients with cerebral watershed infarction.Methods The clinical and imaging data of 97 patients with cerebral watershed infarction,admitted to our hospital from June 2008 to June 2011,were retrospectively analyzed.All patients underwent TCD and DSA examination.Comparative analysis of TCD and DSA for intracranial stenosis diagnosis and compensatory collateral circulation in these patients was performed,and the advantages and disadvantages of TCD and DSA in these cases were compared.Results Eight hundred and seventy-three intracranial vessels of the 97 patients were analyzed.TCD and DSA showed no significant differences in evaluation of vascular stenosis or occlusion (P=0.503).As to the collateral circulation,no significant differences between TCD and DSA were shown in the evaluation of anterior communicating artery compensatory (P=0.754),while TCD was more sensitive than DSA in the evaluation of ophthalmic artery compensatory (P=0.039),and DSA was more sensitive in evaluating the posterior communicating artery and pial artery compensatory (P=0.035 and P=0.000).The internal watershed infarction and cortical watershed infarction had significant differences in intracranial vascular stenosis or occlusion and collateral circulation (x2=9.762,P=0.002; x2=24.708,P=0.000).Conclusion Combining TCD and DSA can contribute to judge the intracranial vascular lesions and collateral circulation correctly.