Objective To investigate the clinical effect of posterior pedicle screw fixation combined with anterior decompression and fusion for the treatment of thoracolumbar burst fractures.Methods The clinical data of 53 patients underwent posterior pedicle screw fixation and anterior decompression and fusion were retrospectively analyzed.The vertebral height,Cobb angle,vertebral tube volume,the Frankel gradient and Fugl -Meyer score were recorded and compared before and after treatment.Results 49 patients were followed up.At the last time of follow -up,the vertebral height,Cobb angle,vertebral tube volume all significantly improved (t =24.047,P <0.001;t =21.815,P <0.001;t =31.699,P <0.001).The Frankel gradient before treatment was:A 6 cases,B 18 cases,C 15 cases,D 10 cases,E 4 cases.After treatment,it came to 3 cases,8 cases,11 cases,17 cases,10 cases,respectively.There was significant difference before and after treatment (Z =2.997,P =0.003).There was significant difference in Fugl -Meyer score before and after treatment[(74.65 ±8.42)points,(90.26 ±9.17)points,respectively,P <0.001 ].Conclusion There is excellent effect on posterior pedicle screw fixation followed by anterior decompression and fusion for the treatment of thoracolumbar burst fractures.It is good for the recovery of motion and spinal function.

etabolic response to radiotherapy may predict the prognosis of paitents with locally advanced NPC. The prognosis is poor for patients with high FDG uptake before and after radiotherapy or SUV max-NSUV max-P .

Rectal cancer is one of the common cancers which poses a threat to the health of mankind. In recent years. Multi-modality treatment strategies for locally advanced rectal cancer improve the treatment efficiency. Accurate prediction of the treatment response after the neoadjuvant chemoradiotherapy (CRT) can guide more suitable treatment strategy. MERCURY study proved the prognostic value of post-CRT standard morphologic MRI(T2-weighted) assessment of tumor regression grade(TRG), and MRI assessment of circumferential resection margin can guide the definitive surgery. Compared with standard morphologic MRI (T2-weighted), functional MRI, including diffusion weighted imaging (DWI) and dynamic contrast enhanced (DCE) MRI, has shown more promising results for the prediction of therapeutic response in rectal cancer. The addition of diffusion-weighted images to T2-weighted images improves the accuracy of restaging examinations for determination of complete pathologic responders. DCE can reflect the tumor micro-vascular environment, and the change of perfusion in response to treatment. These images have the potential to improve the accuracy of therapeutic response in rectal cancer.
Chemoradiotherapy ; statistics & numerical data ; Contrast Media ; Diffusion Magnetic Resonance Imaging ; statistics & numerical data ; Humans ; Magnetic Resonance Imaging ; methods ; statistics & numerical data ; Margins of Excision ; Neoadjuvant Therapy ; statistics & numerical data ; Neoplasm Staging ; instrumentation ; methods ; statistics & numerical data ; Prognosis ; Rectal Neoplasms ; blood supply ; diagnostic imaging ; pathology

Objective:To analyze the distribution characteristics of plasma renin concentration (PRC) in patients with aldosterone-producing adenoma (APA) and its impact on diagnosis.Methods:In this retrospective case series, clinical data from 200 patients with APA (80 men and 120 women; mean age 45.6 years) in the First Affiliated Hospital of Chongqing Medical University from November 2013 to January 2022 were evaluated. PRC was determined by automated chemiluminescence immunoassay. The distribution characteristics of PRC were analyzed, and 8.2 mU/L was used as the low renin cutoff to evaluate whether renin was suppressed.Results:The median PRC was 1.6 mU/L (range, 0.4-41.5 mU/L). There were 116 patients with APA with PRC of ≤2 mU/L, 41 patients with 28.2 mU/L) in 8.0% (16/200) of the patients with APA. And PRC was not suppressed in 2.5% (5/200) of the patients with APA, resulting in a primary aldosteronism negative screening outcome.Conclusions:Although most patients with APA have low PRC, there are a small number (8%) of patients whose PRC has not been fully suppressed, which can lead to missed diagnoses during primary aldosteronism screening. While primary aldosteronism is highly suspected, further investigations are required to determine the diagnosis, even if PRC is not fully suppressed at screening.

N-methyladenosine (mA), a ubiquitous RNA modification, is installed by METTL3-METTL14 complex. The structure of the heterodimeric complex between the methyltransferase domains (MTDs) of METTL3 and METTL14 has been previously determined. However, the MTDs alone possess no enzymatic activity. Here we present the solution structure for the zinc finger domain (ZFD) of METTL3, the inclusion of which fulfills the methyltransferase activity of METTL3-METTL14. We show that the ZFD specifically binds to an RNA containing 5'-GGACU-3' consensus sequence, but does not to one without. The ZFD thus serves as the target recognition domain, a structural feature previously shown for DNA methyltransferases, and cooperates with the MTDs of METTL3-METTL14 for catalysis. However, the interaction between the ZFD and the specific RNA is extremely weak, with the binding affinity at several hundred micromolar under physiological conditions. The ZFD contains two CCCH-type zinc fingers connected by an anti-parallel β-sheet. Mutational analysis and NMR titrations have mapped the functional interface to a contiguous surface. As a division of labor, the RNA-binding interface comprises basic residues from zinc finger 1 and hydrophobic residues from β-sheet and zinc finger 2. Further we show that the linker between the ZFD and MTD of METTL3 is flexible but partially folded, which may permit the cooperation between the two domains during catalysis. Together, the structural characterization of METTL3 ZFD paves the way to elucidate the atomic details of the entire process of RNA mA modification.