BACKGROUND:Titanium mesh is a new type of bone graft supports used for the treatment of spine, especial y the cervical spine disorders at home and abroad in recent years. But, at present, how to improve the cervical lordosis curvature during anterior surgery is the difficulty for the treatment of cervical spondylotic myelopathy.
OBJECTIVE:To observe the effect of straight titanium mesh and individual designed titanium mesh used in the bone graft fusion and internal fixation on the recovery of cervical curvature and Japanese Orthopaedic Association score during anterior cervical subtotal vertebrectomy in the patients with cervical spondylotic myelopathy.
METHODS:Forty-three patients with cervical spondylotic myelopathy treated with surgical indications of subtotal vertebrectomy and decompression internal fixation were included, and the patients were divided into two groups according to different internal fixation methods. There were 15 cases in the individual designed titanium mesh group and 28 cases in the straight titanium mesh group. The preoperative anteroposterior X-ray films of the cervical spine of al the patients were as the blank control group. The clinical data of the patients in two groups were retrospectively analyzed, and the postoperative Japanese Orthopaedic Association score, cervical curvature, intervertebral angles and intervertebral height were compared.
RESULTS AND CONCLUSION:The cervical lordosis angle and the intervertebral angle of surgery segment in the individual designed titanium mesh group were improved when compared with those in the straight titanium mesh group and the blank control group (P<0.01), and the straight titanium mesh group was better than the blank control group (P<0.05). The intervertebral height of surgery segment in the individual designed titanium mesh group and the straight titanium mesh group was increased for 3.69 mm and 3.22 mm respectively when compared with that in the blank control group, and there was significant difference between individual designed titanium mesh group and the straight titanium mesh group (P>0.05). There was no significant difference in Japanese Orthopaedic Association score between individual designed titanium mesh group and the straight titanium mesh group (P>0.05). During subtotal vertebrectomy for the treatment of cervical spondylotic myelopathy, cutting titanium mesh into trapezoidal shape to simulate the normal disc shape of former high to low can effectively restore the physiological curvature of cervical spine and the intervertebral height of surgery segment.

Objective Based on the teeth in vitro skull specimen to investigate the feasibility and accuracy of CARE kV CT scan for reducing radiation dose. Methods Of eight fixed and preserved skull teeth were scanned repeatedly in groups of A, B, C. In expose factors of 100 kVp/150 mAs in conventional scanning of group A, open CARE Dose 4D scan of group B and CARE kV scan of group C. We assessed the radiation dose in the group A, B and C, the average CT values of the images, noise, SNR, CNR and subjective ratings. Results Three groups of actual scan tube current, tube voltage and radiation dose were statistically significant (P < 0.05). Compared with group A, the radiation dose in the group B was reduced by about 13.76% and 26.61%reduced in the C group. The average CT values of the images and the noise SNR, CNR and subjective ratings hasd no significant difference (P > 0.05). Conclusion CARE kV technology based on the use specimens tooth can reduce the radiation dose, protect image quality, and be consistent to the reports of previous researches.

Objective To study the clinical,pathological and genetic features of myofibrillar myopathy caused by BAG3 gene mutation.Methods The clinical features and pathological findings of a patient with myofibrillar myopathy were analyzed.Genomic DNA of the patient was extracted from peripheral blood and the next generation sequencing was performed to explore the mutation of genes about myopathies.Results The patient presented with nine-year-old onset myopathy characterized by progressive difficulty for squatting,rigid spine and muscle atrophy in the limbs symmetrically.Peripheral neurogenic damages were found on electromyography.On muscle biopsy,myogenic and neurogenic damages with rimmed vacuoles appeared,and the deposited materials were positive for sarcoglycan,dystrophin-R and dystrophin-C.There was a reported heterozygous mutation in the exons of the BAG3 gene (c.626C ＞ T).Conclusion There is no specificity of clinical manifestation in myofibrillar myopathy,and the diagnosis of this disease mainly depends on muscle biopsy and genetic screening.

OBJECTIVETo investigate the changes in circulating bone marrow stem cells in pregnant rabbits after AMI (AMI) and their relationship with estradiol.

METHODSThree groups of rabbits were used, namely pregnancy and AMI group, AMI group without pregnancy, and sham operation group with pregnancy. The ratio of CD90(+) cells in the peripheral blood was determined with flow cytometry in all the rabbits, and serum estradiol level measured. Four weeks after AMI, hemodynamic measurements were carried out. The morphological changes of the myocardial tissues were examined with ImageJ 1.31.

RESULTS AND CONCLUSIONFour weeks after AMI, the two pregnancy groups showed a higher Left ventricular end systolic pressure(LVESP) and+dp/dtmax, lower left ventricular end-diastolic pressure (LVEDP) and -dp/dtmax and high levels of CD90(+) cells in peripheral blood than AMI group without pregnancy (P<0.01). The ratio of circulating CD90(+) cells increased gradually with gestational age and peaked at the end stage of pregnancy. After delivery the circulating CD90+ cell ratio decreased sharply, showing a significant correlation with serum estradiol level (r=0.725, P<0.01). Four weeks after AMI, the pregnancy group had smaller myocardial infarction (MI) volume than the non-pregnant group (22.17+/-6.34% vs 38.86+/-5.97%, P<0.05). Circulating bone marrow stem cells increased during pregnancy with gestational age and peaked at the end stage of pregnancy. Ten days after delivery, the stem cells resumed basically the normal level. The proportion of circulating bone marrow stem cells was significantly correlated with the level of serum estradiol during pregnancy, and mobilization of the bone marrow stem cells induced by acute ischemic event in pregnant rabbits was advanced. 4 weeks after AMI, the pregnant rabbits showed better heart contraction and diastolic function than the non-pregnant ones.

Animals ; Bone Marrow Cells ; cytology ; Estradiol ; blood ; Female ; Hematopoietic Stem Cells ; cytology ; Myocardial Contraction ; Myocardial Infarction ; blood ; physiopathology ; Pregnancy ; Pregnancy Complications, Cardiovascular ; blood ; Rabbits ; Thy-1 Antigens ; blood ; Time Factors

Objective: To investigate the response to neoadjuvant chemotherapy (NAC) among different molecular subtypes of breast cancers using molecular classification with Ki-67 (ER+ PR+ HER2+ Ki-67) or without Ki-67 (ER+ PR+ HER2). Methods: One hundred and twenty-seven cases of invasive breast cancer confirmed by core needle biopsy before NAC were collected from January 2007 to December 2009 and diagnosed at West China Hospital, Sichuan University. The cases were classified into different molecular subtypes using molecular classifications with or without Ki-67. Their clinical and pathological response to NAC was evaluated and compared. Results: The different subtypes using both molecular classifications showed significant difference in clinical response(with Ki-67: χ²=22.40, P<0.01; without Ki-67: χ²=9.202, P=0.027)but not pathological(P>0.05) response to NAC. By multivariate analysis, Ki-67 was predictive for a clinical complete response (P=0.041) and clinical overall response (P<0.01); also Ki-67 was the only clinicopathological factor predictive of pathological response(P=0.041). Conclusion The molecular classification with Ki-67 is better to predict breast cancers responsiveness to NAC than the molecular classification without Ki-67.

Objective To elucidate the association of genetic polymorphisms of key molecules in JAK/STAT signaling pathway with susceptibility of hepatocellular carcinoma (HCC).Methods A total of 367 HCC patients and 367 healthy controls were recruited in this sex- and age-matched case-control study.Genetic polymorphisms of IL-6 (rs1800796,-572C＞G),STAT3 (rs744166,+ 26312T＞C; rs3816769,+ 42240T＞C; rs6503695,+ 40980T＞C),EGFR (rs11543848,+ 142530A＞G),and mTOR (rs7211818,+ 170278A＞G; rs9674559,+ 196983A＞G; rs11653499,+65678G＞A) were genotyped using a mass spectrometry method.Odds ratio (OR) and 95％ confidence interval (CI) were calculated.Results Genotype frequency of the 8 polymorphisms of IL-6,STAT3,EGFR,and mTOR were not significantly different between the patients with HCC and the controls.When stratified by sex,the female subjects who carried STAT3 +26312CC,+ 42240CC,or + 40980CC had a decreased risk of HCC when compared to those who carried TT allele (OR=0.192,95％CI:0.047-0.784; OR=0.180,95％CI:0.045-0.725;OR=0.198,95％ CI:0.049-0.806,respectively).When compared with AA genotype on the site of EGFR + 142530,the (AG+ GG) genotype reduced the risk of HCC in women (OR=0.422,95％CI:0.179-0.994).Conclusion The polymorphisms of IL-6 (rs1800796) and mTOR (rs7211818,rs9674559,and rs11653499) were not associated with the HCC susceptibility.Those carrying CC allele in three loci (rs744166,rs3816769,and rs6503695) of STAT3 and (AG + GG) in rs11543848 of EGFR had a decreased risk of HCC in women.However,these results need to be validated using larger sample size.

Objective To discuss the different clinical features and prognosis of single cerebral venous thrombosis (CVT) and multiple CVT. Methods The site and the number of vein and thrombosed sinuses of 136 patients with CVT were summarized. The patients were divided into 2 groups according to the numbers of thrombosed sinuses. The clinical features and outcome of the patients with single CVT were analyzed in comparison with those with multiple CVT by univariate analysis. Results In 44 patients (32.4%), only 1 cerebral sinus was involved. In 92 patients (67.6%), 2 or more cerebral veins and sinuses were involved (2 sinuses in 45, 3 sinuses in 35, 4 sinuses in 9, 5 sinuses in 3). The lateral sinus and the sigmoid sinus were the most frequent thrombosed sinuses which were found in 86.8% of patients; the followings were superior sagittal sinus (58.1%), straight sinus (18.4%) , deep venous system (7.4%), and cortical veins (2.9%). Mean ages were significantly older but the short-term prognosis was better in the group of patients with single CVT in comparison with those in the group of patients with multiple CVT. The patients with multiple CVT also presented more serious intracranial hypertension, more frequent parenchymal lesions and systematic thrombotic events than those with single CVT (P＜0.05). Conclusion In most CVT patients, 2 or more veins and sinuses are involved and thromboses most commonly implicate the lateral sinus and the superior sagittal sinus. Patients with multiple CVT usually present higher intracranial pressure, more serious clinical course, worse outcome and higher incidence of systematic venous thrombotic events in comparison with patients with single CVT. And the multiple sinus thrombosis is more likely to cause venous infarctions and intracranial hemorrhage than the single one.

OBJECTIVETo study the distribution of human papillomavirus (HPV) subtypes in nasal inverted papilloma (NIP), and to evaluate the relationship between HPV and NIP.

METHODSTwenty-one HPV subtypes were detected in paraffin-embedded tissues of 101 cases of NIP by flow through hybridization and gene chip (HybriMax), 24 cases of normal nasal mucosa were used as controls.

RESULTSHPV positive rates of NIP were 64.36% (65/101). Benign NIP group, NIP with atypical hyperplasia group, NIP with cancerous group of HPV positive rates were 59.7% (46/77), 81.8% (18/22) and 50% (1/2) respectively. The control group was negative (0/24). The comparison between NIP group and control group was statistically significant (chi(2) = 32.178, P < 0.05). Benign NIP group and NIP with atypical hyperplasia group were compared, but no statistically significance (chi(2) = 3.649, P = 0.056) was found. The constituent ratio of benign NIP group and NIP with atypical hyperplasia group in high, low-risk HPV subtypes infections was compared, a statistically significance (chi(2) = 10.412, P < 0.05) was found.

CONCLUSIONSThe occurrence of NIP was related with HPV infection. High-risk HPV subtype infections or multiple infections will prompt benign NIP to NIP with atypical hyperplasia. Understanding the distribution of HPV subtypes in the NIP is helpful to predict the clinical behavior.

Adult ; Aged ; Case-Control Studies ; Female ; Humans ; Male ; Middle Aged ; Nose Neoplasms ; pathology ; virology ; Papilloma, Inverted ; pathology ; virology ; Papillomaviridae ; classification ; Papillomavirus Infections ; pathology

BACKGROUNDChronic hepatitis B virus (HBV) infection is the major cause of hepatocellular carcinoma (HCC). Some HBV mutants and dysregulation of phosphatase and tensin homolog (PTEN) may promote the development of HCC synergistically. We aimed to test the effects of PTEN genetic polymorphisms and their interactions with important HBV mutations on the development of HCC in HBV-infected subjects.

METHODSQuantitative polymerase chain reaction was applied to genotype PTEN polymorphisms (rs1234220, rs2299939, rs1234213) in 1012 healthy controls, 302 natural clearance subjects, and 2011 chronic HBV-infected subjects including 1021 HCC patients. HBV mutations were determined by sequencing. The associations of PTEN polymorphisms and their interactions with HBV mutations with HCC risk were assessed using multivariate logistic regression analysis.

RESULTSRs1234220 C allele was significantly associated with HCC risk compared to healthy controls (adjusted odds ratio [AOR] = 1.35, 95% confidence interval [CI] = 1.07-1.69) and HCC-free HBV-infected subjects (AOR = 1.27, 95% CI = 1.01-1.57). rs1234220 C allele was significantly associated with increased frequencies of HCC-risk A1652G, C1673T, and C1730G mutations in genotype B HBV-infected subjects. Rs2299939 GT genotype was inversely associated with HCC risk in HBV-infected patients (AOR = 0.75, 95% CI = 0.62-0.92). The interaction of rs2299939 variant genotypes (GT+TT) with A3054T mutation significantly increased HCC risk (AOR = 2.41, 95% CI = 1.08-5.35); whereas its interaction with C3116T mutation significantly reduced HCC risk (AOR = 0.34, 95% CI = 0.18-0.66). These significant effects were only evident in males after stratification.

CONCLUSIONSPTEN polymorphisms and their interactions with HBV mutations may contribute to hepatocarcinogenesis in males. The host-virus interactions are important in identifying HBV-infected subjects who are more likely to develop HCC.

Carcinoma, Hepatocellular ; enzymology ; genetics ; DNA Mutational Analysis ; Genetic Predisposition to Disease ; genetics ; Genotype ; Humans ; Liver Neoplasms ; enzymology ; genetics ; Microfilament Proteins ; genetics ; Mutation ; PTEN Phosphohydrolase ; genetics ; Phosphoric Monoester Hydrolases ; genetics ; Polymorphism, Genetic ; genetics ; Tensins

Objective The loop electrosurgical excision procedure (LEEP) is a major option for the treatment of cervical in-traepithelial neoplastic (CIN) lesions,but reports are rarely seen on the consistency of the result of post-LEEP pathology with that of preoperative biopsy as well as on the postoperative pathological upgrading of related factors. This study analyzes the consistency of the result of preoperative biopsy with that of post-LEEP pathology for CIN lesions and the risk factors for residual and/or recurrence after LEEP. Methods A retrospective study was conducted on 1 089 patients with CIN lesions treated by LEEP in our hospital from May 2014 to A-pril 2017. All the patients underwent liquid-based thin-layer cytology (TCT) and vaginoscopic biopsy preoperatively,followed by analysis of the results of TCT,the consistency of the result of preoperative bi-opsy with that of post-LEEP pathology,and the risk factors for residu- al and/or recurrence after LEEP. Results Preoperative biopsy showed 447 cases of low-grade squamous intraepithelial lesion (LSIL),among which TCT revealed 85 cases negative for intraepithelial lesion and malignancy (NILM),with a false negative rate of LSIL of 19.0%. Of the 645 cases of high-grade squamous intraepithelial lesion (HSIL) revealed by preoperative biopsy,TCT manifes-ted 95 cases of NILM,with a false negative rate of HSIL of 14.7%,which was significantly lower than that of LSIL (P<0.05). Preop-erative biopsy showed 447 cases of LSIL,among which post-LEEP pathology manifested 316 cases of LSIL (70.69%) and 51 cases of HSIL (11.4%). Of the 635 cases of HSIL revealed by preoperative biopsy,post-LEEP pathology exhibited 4 cases (0.63%) of inva-sive cervical cancer (ICC). Multivariate analysis showed the risk factors for pathological upgrading after LEEP were sexual partners >2 (OR=0.139,95% CI: 0.034-0.561) and LSIL in TCT (OR=0.111,95% CI: 0.040-0.310) (P<0.05) and those for postopera-tive recurrence included positive incision margin (OR=2.970,95% CI: 1.010-8.733) and persistent human papilloma virus (HPV) infection (OR=5.446,95% CI: 3.109-9.540). Preoperative HPV16 infection was correlated with lesion residual and/or recurrence after LEEP (P<0.05). Conclusion LEEP can significantly improve the diagnosis rate of HSIL in low-grade CIN patients with high risk factors. The risk factors for lesion residual and/or recurrence after LEEP include HPV16 infection,lesion involvement of the inci-sion margin,and persistent HPV infection.