Objective To explore the feasibility and efficacy of posterior minimally invasive scoliosis surgery in Lenke 5C adolescent idiopathic scoliosis (AIS).Methods From November 2012 to March 2014,a total of 16 patients underwent posterior minimally invasive scoliosis surgery assisted by O-arm three-dimensional CT navigation were included.There were 14 female and 2 male,with an average age of (16.7± 1.6) years (ranged from 14 to 18 years).The mean Cobb angles of lumbar and thoracic curve were 48.7°±5.6°and 24.1°±5.4°,respectively.Results 16 patients were successfully completed the operation,the average operation time was (246±89) min,the average intraoperative blood loss was (192± 105) ml,and the fusion level was 4.9±0.5 on average.A total of 155 screws were inserted in the 16 patients,with a mean implant density of 98.9％±4.9％.All the patients were followed up for (26.4±3.9) months on average.The following radiographic parameters were evaluated before surgery,immediately after surgery and at the last follow-up:curve magnitude,apical vertebral translation (AVT),apical vertebral rotation (AVR),trunk shift,thoracic kyphosis (TK),thoracolumbar kyphosis (TLK),lumbar lordosis (LL) and sagittal vertical axis (SVA).The accuracy of pedicle screw placement was assessed according to postoperative CT scans.SRS-22 scores and complications were also recorded during the follow-up.Immediately after surgery,the correction rate of main lumbar curve was 80.1％±8.3％,and thoracic curve was 59.3％±8.7％,and a obvious improvement was noted in terms of AVT,AVR,trunk shift and TLK.At the last follow-up,except the increase of SVA from (-27.6± 19.5) mm to (-12.3±6.6) mm,no obvious changes of AVT,AVR,trunk shift,TK,TLK and LL were observed during the follow-up.According to CT evaluation,the satisfactory rate of pedicle screw placement was 94.2％,while the perforation rate was 5.8％ (9/155).Fusion across the facet joint were satisfactory.In SRS-22 assessment,the mean scores of functional,pain,self-image,mental state and satisfaction were (4.3 ± 0.5) points,(4.7 ± 0.6) points,(4.2 ± 0.7) points,(4.2 ± 0.5)points and (4.4 ± 0.6) points.No wound infection,implant failure and neurologic complications were found after surgery.Conclusion Wiltse approach assisted by O-arm three-dimensional CT navigation has the characteristics of small injury,less bleeding,high accuracy placement of pedicle screws and high self-satisfaction of patients.It is a feasible,safe and effective way to treat Lenke 5C AIS.

Objective To investigate the natural evolution of postoperative distal adding-on in Lenke 1A and 2A adoles-cent idiopathic scoliosis(AIS)patients,and to explore the risk factors for the progression of distal adding-on.Methods From Ju-ly 2006 to July 2012,a total of 197 AIS patients with Lenke 1A or 2A curves underwent posterior selective thoracic instrumenta-tion and fusion surgery.Among which,44 patients(22.3%)with postoperative distal adding-on were recruited in this study.There were 39 female and 5 male,with an average age of(15.0±2.1)years.The mean Cobb angle of main thoracic curve was 49.3°±9.3°. The first postoperative radiograph indicating distal adding-on and the last follow-up radiograph were compared:make the measure-ment of the disc angle below lowest instrumented vertebra(LIV),and the distance between the vertebra below LIV(LIV+1)and cen-tral sacral vertical line(CSVL).Distal adding-on could be classified into progressive group and non-progressive group according to its natural evolution during follow-up.If the disc angle increased> 5°or the LIV+1-CSVL distance increased>5 mm,the pa-tients were assigned into progressive group; Otherwise, the patients were assigned into non-progressive group. Using Student T test, χ2test or Fisher exact test, the predicted risk factors for progression were screened for further Logistic regression. Results Among the 44 patients enrolled in the study,17 patients(38.6%)had progressive adding-on while 27 patients(61.4%)had non-progressive adding-on.The Risser sign was significantly lower in progressive group than non-progressive group(t=4.399,P<0.001). Besides,more patients had LIV proximal to substantially stable vertebra(SSV)in progressive group than non-progressive group (Fisher exact test value=18.142,P<0.001).The improvement of shoulder imbalance was significantly better in progressive group than non-progressive group(t=3.011, P=0.002). According to Logistic regression, the low Risser sign and LIV proximal to SSV were independent risk factors for progression of distal adding-on.Moreover,the self-image domain of SRS-22 Scores was remark-ably lower in progressive group than non-progressive group(t=2.321,P=0.014).Conclusion Distal adding-on could be classi-fied into progressive group(40%)and non-progressive group(60%)according to its natural evolution.The risk factor for its progres-sion included skeletal immaturity and LIV proximal to SSV.Moreover,the progression of distal adding-on might compensate for the shoulder imbalance during follow-up.

Objective To evaluate the bioequivalence of domestic and imported terazosin hydrochloride tablets after single oral dose .Methods It was a single center ,randomized ,open ,cross-over trail design ,21 subjects were fasting oral adminis-tered of 2 mg domestic and imported terazosin hydrochloride tablets in different periods ,venous blood 4 ml were collected in different time points before and 60 h after administration ,plasma concentration of terazosin was determined by LC-MS/MS . Results The main pharmacokinetic parameters of domestic and imported terazosin hydrochloride tablets were as follows :t1/2 :(13.2± 2.39)hvs(12.5±1.93)h,tmax :(1.01±0.83)hvs(1.08±0.69)h,Cmax :(40.1±10.6)ng/mlvs(37.3± 9 .57) ng/ml;AUC0- ∞ :(428 ± 82 .1) ng · h/ml vs (426 ± 85 .2) ng · h/ml .The relative bioavailability of domestic terazosin hydrochloride tablets was (101 .2 ± 14 .7)% .90% CI of domestic and imported terazosin hydrochloride tablets AUC0-t and Cmax geometric mean ratio fell between 80% -125% .Conclusion The domestic tablets are bioequivalent to the imported tablets .

Objective To optimize the extraction process of collagen from the jellyfish (Nemopilema nomurai) and explore its characters. Methods The collagen was extracted with acetic acid and pepsin from jellyfish. The crude jellyfish collagen was purified by salting out and ultrafiltration. The purified collagen was characterized and analyzed by XRD (X-ray diffraction), UV (ultraviolet spectroscopy) and FTIR (fourier transform infrared spectroscopy). Results The purity of jellyfish collagen was 97%, the yield was 33% (dry weight). The jellyfish collagen maintained its triple helix structure during the extraction and purification process. Jellyfish collagen conformed to the characteristics of type I collagen according to amino acid composition and gel electrophoresis analysis. The jellyfish collagen exhibited a good solubility under the conditions of pH 3–5 and less than 0.9 mol/L of NaCl. Conclusion The extracted jellyfish collagen exhibited similar characteristics with bovine type I collagen and was a potential new source of collagen.