BACKGROUND:Some studies have showed that the accuracy and surgery outcome of the percutaneous pedicle screw implantation was superior to open surgery, but the relationship between the angle of pedicle screws and screw stability is stil unclear in previous studies. OBJECTIVE:To investigate the effect of different angles of implanted screws on the stability of pedicle screw. METHODS:A total of 30 vertebral specimens of adult pigs were selected and screws were implanted respectively according to different coronal and sagittal angles. The maximum pul-out strength of screws from each specimen was tested by machine. Load-displacement curves were drew and statistical y analyzed. RESULTS AND CONCLUSION:The maximum pul-out strength and maximum energy of screw with 10° and 15° coronal and sagittal angles implantation were significantly better than those of 0° angle group (P<0.05). When the stress exceeded the maximum pul-out strength, the pul-out strength of screw decreased gradual y. The curves in coronal and sagittal 10° and 15° angle groups was similar, and the slope was better than 0° angle group (P<0.05). These results confirm that the angle of the implanted screw provides effective assistance to the stability of percutaneous pedicle screw. After the looseness of the screws, the pul out strength shows a steady downward trend.

Objective To explore the role of ultrasound-guided core needle biopsy in diagnosis and treatment of thyroid nodules.Methods 778 cases undergoing ultrasound-guided core needle biopsy in our department from Jan.2012 to Dec.2014 were retrospectively analyzed,and the sensitivity,specificity and accuracy were calculated.Results All the patients were operated successfully.Except for 21 nodules undiagnosed,16.4％ (124/757) were histologically diagnosed as malignant and 83.6％ (633/757) were benign.15 samples of the 124 malignant nodules were less than 10 millimeter in diameter.The sensitivity,specificity and accuracy were 100％,94.8％ and 95.6％,respectively.Of the ultrasound features,blood flow,boundary,internal situation and calcification were statistically significant between benign and malignant nodules,but not so between the groups of different greatest dimentions.Conclusion Ultrasound-guided core needle biopsy is safe and effective for obtaining thyroid nodule tissue,and it is helpful for diagnosis of thyroid diseases.

[ ABSTRACT] AIM:To investigate the effects of sinapic acid ( SA) on the proliferation and apoptosis of rat vas-cular smooth muscle cells (VSMCs) induced by high glucose (HG).METHODS:Cultured A7r5 cells were randomly di-vided and treated as indicated.The cell viability was determined by MTT assay.DNA synthesis was measured by BrdU as-say.Cell cycle progression and cell apoptotic rate were determined by flow cytometry analysis.The levels of reactive oxygen species (ROS) were detected by ELISA.The protein levels of cyclin D1, P21, P27, phosphorylated protein kinase C (p-PKC), p-P38 andβ-actin were evaluated by Western blot.RESULTS:Compared with control group, the viability of A7r5 cells was significantly enhanced, the DNA synthesis was increased, the cell cycle progression was promoted, the levels of ROS were elevated, the cell apoptotic rate was reduced, the protein expression of P21 and P27 was decreased, and the pro-tein levels of cyclin D1, p-PKC and p-P38 were increased in HG group (all P<0.05).These effects were reversed by SA (0.1, 1 and 10 μmol/L) treatment in a dose-dependent manner (all P<0.05).Both P38 inhibitor SB203580 and PKC inhibitor chelerythrine significantly inhibit HG-induced PKC/P38 activation and cell viability ( P <0.05).CONCLU-SION:SA inhibits HG-induced VSMCs proliferation and promotes cell apoptosis via reducing PKC/P38 activation.

Glaucoma is a group of diseases which can threaten and damage the optic nerve and its visual pathway, leading to visual impairment as a result. Glaucomatous optic neuropathy is a chronic disease accompanied by apoptosis of retinal ganglion cells ( RGCs ) , visual field defect and cupping of optic nerve head. The gold standard in functional glaucoma evaluation is standard automated perimetry ( SAP) , but it is often limited to the subjective feelings of the patients. Still, visual electrophysiological techniques cannot replace the conventional inspection, but with its rapid development, it has provided a new strategy for the early diagnosis of glaucoma as a supplement because it can show changes in amplitude and latency before visual field defect. Here we review three special electroretinograms and multifocal focal visually evoked potentials in the early diagnosis of glaucoma.

Objective:To evaluate the effects of amelogenin(AML)on the migration,adhesion and proliferation of periodontal liga-ment stem cells(PDLSCs).Methods:PDLSCs were cultured with AML at 0.25,50 amd 100 μg/ml respectively.The migration, adhesion and proliferation of the cells were examined by wound healing migration assay,transwell migration assay,attachment assay, MTT assay and cell counting,respectively.Results:AML induced the migration of PDLSCs in a dose-dependent manner(P <0.05), increased the adhesion and proliferation of PDLSCs(P <0.05).Conclusion:AML may promote the migration,adhesion and prolifer-ation of PDLSCs.

Objective To observe the effect of medication compliance and self-efficacy of schizophrenia patients with diabetes by continuing self-management education. Methods A total of 60 patients with schizophrenia with diabetes diagnostic criteria were divided into experimental group (30 cases) and control group (30 cases) by the admission number, 2 groups received conventional drug treatment, the control group received general preaching health education pattern, were each issued a health education manual, with schizophrenia and diabetes health knowledge division, the test group on the basis of the continuation of the implementation of self-management education, followed up 12 months after discharge, compared 2 groups of patients with medication compliance and recurrence rate, with General Perceived Self-Efficacy Scale (GSES) assessment level of 2 groups of patients with self-efficacy, fasting blood glucose (FPG) was determined by automatic biochemical analyzer, 2 hours postprandial blood glucose (2 hPBG). Results Six months after discharge, 82.1%(23/28) cases were complete compliance, 14.3%(4/28) cases of partial compliance, 3.6%(1/28) cases of non-compliance, 55.2%(16/29)cases of the control group complete compliance, 27.6%(8/29) cases of partial compliance, 17.2%(5/29) cases of non-compliance, the differences between two groups were statistically significant (χ2=37.41, P<0.05). The 12 month test group of full compliance discharged 75.0%(21/28) cases, 14.3%(4/28) cases of partial compliance, 10.7%(3/28) cases of non-compliance, 31.0%(9/29) cases of the control group complete compliance, 31.0%(9/29) cases of partial compliance, 37.9%(11/29) cases of non-compliance, the test group compliance was higher than the control group (χ2=11.27, P<0.05). The score after 6 months and 12 months respectively for the test group general self-efficacy scored 35.32 ± 2.02, 34.18 ± 1.77, control group scored 24.03 ± 3.04, 22.48 ± 2.01, the differences between two groups were statistically significant (t=16.445, 23.304, P<0.01). After 6 months in test group FPG and 2 hPBG were (5.71 ± 1.05), (9.46 ± 1.37) mmol/L, control group were (7.79 ± 1.05),(12.28 ± 2.07) mmol/L, the differences between two groups were statistically significant (t=7.483, 6.023, P<0.01). 12 months after discharge in test group FPG and 2 hPBG respectively (5.89±1.13), (9.68±1.09) mmol/L, control group (9.14±1.19), (13.17±1.42) mmol/L, test group FPG and 2 hPBG were lower than the control group (t=10.550, 7.431, P<0.01). After 6 months and 12 months, the recurrence rate of experimental group were 7.1% (2/28) and 24.1% (7/29) respectively, and control group were 14.3%(4/28) and 44.8%(13/29), the recurrence rate of experimental group was lower than the control group, there was significant difference between 2 groups (χ2=4.326, 6.225, P< 0.05 or 0.01). Conclusions Self-management education can improve the medication compliance and self-efficacy, improve mental symptoms and sugar metabolism, and reduce the recurrence rate.

Objective:To clone swine leukocyte antigen,class II,DO alpha (SLA-DOA) gene from Banna mini-pig inbred line (BMI) and detect its mRNA expression level in 19 important tissues.Methods:The complete eDNA sequence of SLA-DOA gene was cloned by RT-PCR method from BMI and the mRNA expression pattern in BMI important tissues was examined by semi-quantative RT-PCR method.Nucleotide and protein sequences of SIA-DOA were used to carry out bioinformatics analysis and construct the phylogenetic tree.Results:The eDNA length of BMI SLA-DOA was 1 079 bp,which encoded a protein of 250 amino acids with molecular weight (Mw) 27.81 kD,and isoelectric point (pI) 6.48.Genome structure analysis showed it localized to Sus scrofa chromosomes 7 and consisted of four exons and three introns.Semi-quantitative expression analysis showed that SLA-DOA gene expressed highly in the lymph nodes and stomach;weakly in the heart,skin and duodenum and none in other 14 tissues.Functional bioinformatics analysis indicated that SLA-DOA protein contained one signal poptide,one transmembrane region,three conserved domains,four O-GlcNAc glycosylation sites,18 potential phosphorylation sites and to be located in the cytoplasm with 94.1％ certainty.Phylogenetic analysis demonstrated that BMI (pig) had the closest relationship with cattle.Conclusion:This study have successfully cloned the SLA-DOA gene of Banna mini-pig inbred line,performed bioinformatics analysis and tissue expression profile analysis.It will provide a basis for the studies of BMI xenotransplantation.

Objective:To discuss the etiology, clinical manifestations and renal pathological features of acute interstitial nephritis (AIN) in children.Methods:The etiology, clinical manifestations, pathological characteristics, clinical effects and outcome of the children with AIN diagnosed by renal biopsy from January 2010 to December 2019 in Nanjing Jinling Hospital were analyzed retrospectively. The Kaplan-Meier method was used to evaluate the kidney survival rate. Cox regression model was built to analyze the risk factors for developing end-stage renal disease (ESRD) at baseline in AIN children.Results:A total of 51 children with AIN were diagnosed by renal biopsy, including 36 males and 15 females. The age was (12.94±2.55) years old (2-17 years old). The clinical manifestations of AIN in children were various and lack of specificity. Only 2 cases (3.92%) had triad. All of the 51 children with AIN showed acute renal injury (AKI), accompanied by increased serum creatinine and decreased estimated glomerular filtration rate. The stage of AKI was mainly stageⅢ(33 cases, 64.71%). Infection was the main cause (38 cases, 74.51%) and drug factor was the second cause (27 cases, 52.94%) in children with AIN. Nonsteroidal antiinflammatory drugs (NSAIDs) were the main inducers of drug-induced AIN (18 cases, 35.29%). The interstitial inflammatory cell infiltration or interstitial edema was found in 51 children. The infiltration of inflammatory cells was mainly mononuclear cells (46 cases, 90.20%). After 4 weeks of treatment, 32 cases (62.75%), 11 cases (21.57%) and 8 cases (15.69%) showed complete, partial and no recovery of renal function, respectively. After 12 weeks of treatment, 49 cases (96.08%), 0 cases (0) and 2 cases (3.92%) showed complete, partial and no recovery of renal function, respectively. After an average follow-up of 4.0(2.0-15.0) months, 2 case (3.92%) patients developed ESRD. The cumulative survival rates of ESRD at 1 year and 2 years after renal biopsy both were 100%, and renal survival rates at 5 years and 10 years were 96.55% and 72.41%, respectively. Multivariate Cox regression analysis results showed that N-acetyl-β-D-glucosidase (NAG) enzyme level>17.6 U/g·cr ( HR=15.729, 95% CI 1.045-15.977, P=0.042) and IgM deposition in renal tissue ( HR=7.523, 95% CI 1.142-9.541, P=0.033) were independent risk factors for developing ESRD in AIN children. Conclusions:AKI is the main clinical manifestation of AIN in children. The characteritic of renal pathology in AIN is tubulointerstitial lesions. After active treatment, most of the patients have a good prognosis. Prevention of infection and rational use of drugs are the key to reduce the incidence rate of AIN in children. The N-acetyl-β-D-glucosidase enzyme level>17.6 U/g·cr and IgM deposition in renal tissue are independent risk factors for developing ESRD in AIN children.

Objective To apply the prosthesis and orthosis to improve the walking ability of patients after meningomyelocele.Methods A case was reported.Results and Conclusion After wearing prosthesis and orthosis combined with physical therapy for 3 weeks,She could walk 1000 m with only one hand crutch and the speed reached to 36 m/min.

ObjectiveTo investigate the application of intraoperative Computed Tomograph (CT) using in surgery for complex acetabular fractures.MethodsFrom June 2008 to December 2010,14 patients (9 males,5 females; with the mean age of 45.1 years; range,28-62 years) with complex acetabular fractures were operated using intraoperative CT.Preoperative radiotherapy and CT scan were adopted to evaluate the fractures.Three dimensional reconstruction based on CT scan was used to mimic surgery.The surgery approach and the type of internal fixators were noted.Intraoperative C-arm and CT scan were used to evaluate the fractures reduction respectively.Decision of additional reduction was made by surgeons according to above mentioned methods respectively and the results were noted.Comparing to preoperative design,the change of surgery plan were noted.Overall time,frequency and radiation dose of intraoperative CT scan were also noted.ResultsAll patients in this study received average 2.7 times of intraoperative CT scan.Mean time of CT scan was 40.4 min and the overall dose of radiation was 47.2 mGy.Decision of additional reduction was made in 3 cases according to C-arm radiography and 4 cases according to CT scan (above mentioned 3 cases were included).The change of surgery plan was made in one case.In postoperative radiography evaluation according to Matta's score system,anatomical reduction were achieved in 8 cases,imperfect reduction in 3 cases and poor reduction in 3 cases.ConclusionIntraoperative CT scan increases the radiation time and dose of patients dramatically.When used to evaluate fracture reduction intraoperatively,it can't take the advantage of traditional C-arm radiography.When delicate preoperative plan is made with radiography and three dimensional reconstruction based on CT data,the efficiency of intraoperative CT scan for complex acetabular fractures are to be discussed.