Methods: This retrospective analysis included a total of 155 patients who underwent single-level lumbar fusion, with 81 patients in the traditional group and 74 patients in the Wiltse group (less paraspinal muscle damage). QCT was used to measure the volumetric BMD (vBMD), Hounsfield unit value, and cross-sectional area of the paraspinal muscles at the upper instrumented vertebrae (UIV), vertebrae one segment above the UIV (UIV+1), and the vertebrae one segment above the UIV+1 (UIV+2). Statistical analyses were performed. Results: No significant differences in general data were observed between the two groups (p>0.05). Strong correlations were noted between the preoperative and 1-week postoperative vBMD of each segment (p<0.01), with no significant difference between the two time points in both groups (p>0.05). Vertebral BMD loss was significantly higher in UIV+1 and UIV+2 in the traditional group than in the Wiltse group (−13.6%±19.1% vs. −4.2%±16.5%, −10.8%±20.3% vs. −0.9%±37.0%; p<0.05). However, no statistically significant difference was observed in the percent vBMD changes in the UIV segment between the two groups (37.7%±70.1% vs. 36.1%±78.7%, p>0.05). Conclusions QCT can reliably determine BMD in the instrumented spine after lumbar interbody fusion. With QCT, we found that reducing paraspinal muscle destruction through the Wiltse approach during surgery can help preserve the adjacent vertebral BMD; however, it does not help increase the BMD in the instrumented vertebrae.

A patient who suffered soft tissue defects of all 5 digits of left hand was referred to the Department of Hand and Foot Surgery, Affiliated Nanhua Hospital, University of South China in January 2020. A quadruple paddled posterior interosseous artery flaps was used to cover the defect in index, middle, ring and little fingers and a free hallux nail flap was used to repair the defect in thumb. Two years after operation, the appearance and texture of the flaps of all digits in the left hand were good. The function of the digits was good as well. There were slightly noticeable scars left in both the donor sites of left forearm and right foot.

OBJECTIVETo analyze the contents of harmful heavy metals, sulfur and trace elements from Paeoniae Radix Alba before and after sulfur-fumigated process.

METHODSamples were pretreated by wet digestion and then subjected to elements analysis by inductively coupled plasma-atomic emission spectrometry (ICP-AES).

RESULTThe contents of Cu and S elements were increased, while the content of Zn element was decreased in Paeoniae Radix Alba after sulfur-fumigated process compared with the samples dried in the sun. Moreover, heavy metallic elements, such as As and Hg, were detected in Paeoniae Radix Alba after sulfur-fumigated process.

CONCLUSIONSulfur fumigated process may cause residual of heavy metals and sulfur which are harmful to human body and change the contents of some trace elements.

Fumigation ; methods ; Humans ; Metals, Heavy ; analysis ; Paeonia ; chemistry ; Spectrophotometry, Atomic ; methods ; Sulfur ; analysis ; metabolism ; Trace Elements ; analysis

OBJECTIVETo develop a quick identification method for the sun-dried and sulfur-fumigated Angelicae Sinensis Radix used by Fourier transform infrared spectroscopy (FTIR) combined with second derivative infrared spectroscopy.

METHODThe alcoholic and aqueous extracts of sun-dried and sulfur-fumigated Angelicae Sinensis Radix were analyzed by using FTIR, the further analysis was used by second derivative infrared spectroscopy.

RESULTThere existed differences between their infrared spectra either extracted by ethanol or water, while the distinctions were more obvious after analyzing their alcoholic and aqueous extracts through high resolution of second derivative infrared spectroscopy. Infrared spectra showed that the absorption peaks of Angelicae Sinensis Radix were significantly reduced and a new absorption peak appeared after sulfur-fumigated process in alcoholic extracts, while both of them changed markedly in the "fingerprint region" ranging from 1 000 to 400 cm(-1) in aqueous extracts. Second derivative spectra showed that the absorption peaks of sulfur-fumigated Angelicae Sinensis Radix extracted by ethanol weakened and disappeared at about 3 578 cm(-1) and 3 541 cm(-1), while both of them differed significantly from each other ranging from 1 400 to 1 200 cm(-1) as well as 800 cm(-1) to 600 cm(-1), difference also existed between them extracted by water ranging from about 3 900 to 3 850 cm(-1) and 3 800 to 3 750 cm(-1).

CONCLUSIONThe FTIS method combined with second derivative can be utilized to distinguish sun-dried and sulfur-fumigated Angelicae Sinensis Radix efficiently, conveniently and accurately, and provide a basis for identification and quality control of Angelicae Sinensis Radix.

Angelica sinensis ; chemistry ; classification ; Spectroscopy, Fourier Transform Infrared ; methods ; Sulfur ; chemistry ; Sunlight

Objective:To master the epidemic status and characteristics of skeletal fluorosis in the coal-burning-borne fluorosis affected areas of Chongqing, and to provide a scientific basis for formulating accurate prevention and control strategy for elimination of coal-burning-borne fluorosis.Methods:Stratified sampling method was used to select the villages with mild, moderate and severe coal-burning-borne fluorosis in Wushan and Pengshui, respectively in January-November 2018. The number of villages surveyed in each area was determined by the proportion of 5% to 10% of the actual number of the diseased villages. To investigate the resident population, all the adults over 25 years old in the village were examined for skeletal fluorosis through clinical and X-ray examination, and were diagnosed according to the "Diagnostic Criteria of Endemic Skeletal Fluorosis" (WS 192-2008). The prevalence of skeletal fluorosis in different disease areas, different sexes, different ages (25 -, 35 -, 45 -, 55 -, ≥65 years old) were compared and analyzed. The number of cases of skeletal fluorosis in Chongqing was calculated according to the 2015 population survey data.Results:A total of 7 768 adults over 25 years old were investigated in 15 villages of 10 townships in 2 counties, and 478 people were diagnosed clinically as skeletal fluorosis, and the clinical detection rate was 6.15%. There were differences in the clinical diagnosis of skeletal fluorosis among different disease areas (χ 2 = 183.23, P < 0.01). There were significant differences among different age groups (χ 2 = 406.73, P < 0.01). But no difference was found among different sex groups (χ 2 = 0.32, P > 0.05). A total of 690 people were diagnosed as skeletal fluorisis by X-ray, the X-ray detection rate was 8.88%, and moderate and severe skeletal fluorosis detection rate was 4.20% (326/7 768). The X-ray diagnosis rates of skeletal fluorosis were different among different disease areas (χ 2 = 46.25, P < 0.01) and different age groups (χ 2 = 384.60, P < 0.01). There was no difference between different sexes groups(χ 2 = 1.77, P > 0.05). According to the different disense in Chongqing, there were about 48 770 cases of skeletal fluorosis diagnosed clinically and 72 630 cases diagnosed by X-ray. Conclusions:The more serious the disease area is, and the older the people's age is, the higher the prevalence of skeletal fluorosis will be. In the future, it is of great important to investigate the prevalence of skeletal fluorosis in coal-burning-borne fluorosis areas in Chongqing.

Objective To observe the efficacy of mannatide injection and nedaplatin injected in thoracic cavity in the treatment of malignant pleural effusion. Methods Ninety-four patients with malignant pleural effusion were randomly divided into two groups. The observation group of 48 patients were given mannatide injection and nedaplatin,and con-trol group of 46 patients were given only nedaplatin. Effectiveness and adverse reactions were observed after treatment. Results The effective rate was 85.4% in observation group, hihger than that in control group (69.6%)(P<0.05); The incidence rates of gastrointestinal tract and bone marrow and chest pain of observation group were 35.4%,22.9% and 18.8%. Compared with control group, the incidence of observation group had significantly lowered. There were signifi-cant differences between the two groups(P<0.05). Conclusion Mannatide injection combined with nedaplatin is more efficient and less adverse reaction for malignant pleural effusion, so it is worth popularizing.

Objective To investigate the effects and mechanisms of shRNA interfered with expression of leucine-rich repeat containing G-protein coupled receptor 5 (Lgr5) on the malignant behaviors of colorectal cancer stem cells (CSCs).Methods The experimental study was conducted.The CSCs expressing Lgr5+ were sorted by fluorescence activated cell sorting.Lgr5+ cells that were transfected with Lgr5-shRNA lentiviral vector and nontarget shRNA lentiviral vector were respectively allocated into the experimental group and control group.The percentage of Lgr5+ cells was analyzed by flow cytometery.The relative expression of Lgr5 mRNA was detected by fluorescence quantitative real-time polymerase chain reaction (qRT-PCR).The capacity of self-renewal was detected by sphere forming assay.The tumorigenesis in vitro and in vivo were respectively measured by colony formation assay and xenografting experiment.The mRNA expressions of stem cells related genes (Oct4,Sox2,Nanog,KLF4),CSCs genes (CD133,CD44,ALDH) and Wnt/β-catenin pathway key genes (Axin2,Wnt5a,Wnt3a,Fzd3,c-myc,VEGF,Ascl2,claudin-1) were detected by qRT-PCR.Measurement data with normal distribution were represented as-x±s.Comparison between groups was analyzed using the t test.Results (1)Transfection efficiency of shRNA lentiviral vector induced Lgr5 by flow cytometery was respectively 6.8％± 1.0％ in the experimental group and 92.7％±3.3％ in the control group,with a statistically significant difference (t =43.148,P＜0.05).The relative expression of Lgr5 mRNA measured by qPT-PCR was respectively 0.168±0.057 in the experimental group and 1.148±0.004 in the control group,with a statistically significant difference (t=28.778,P＜0.05).(2) The capacity of self-renewal was detected by sphere forming assay.The results of sphere forming assay:the number of spheres was 29±6 in the experimental group and 410± 10 in the control group,with a statistically significant difference (t =41.070,P＜0.05).The results of colony formation assay:the numbers of colonies in the experimental group and control group were respectively 72±4 and 412± 19,showing a statistically significant difference (t =31.433,P＜ 0.05).The results of tumorigenesis:the volumes of tumors in the experimental group and control group were respectively (81± 15)mm3 and (328±24)mm3,with a statistically significant difference (t=11.304,P＜0.05).(3) The effects of Lgr5 down-regulation on related genes,results of qRT-PCR detection:① The mRNA relative expressions of Oct4,Sox2,Nanog and KLF4 (stem cells related genes) were 0.377±0.093,0.662±0.104,3.591±0.300,0.425±0.091 in the experimental group and 1.957± 0.026,2.137±0.015,5.831±0.165,1.536±0.014 in the control group,with statistically significant differences (t=23.079,22.261,8.446,19.186,P＜0.05).② The mRNA relative expressions of CD133,CD44 and ALDH (CSCs genes) were 1.490±0.155,5.535±0.487,1.640±0.039 in the experimental group and 2.488± 0.061,9.908±0.332,5.718±0.292 in the control group,with statistically significant differences (t =8.170,9.667,27.849,P＜0.05).③The mRNA relative expressions of Axin2,Wnt5a,Wnt3a,Fzd3,c-myc,VEGF,Ascl2 and claudin-1 genes in the Wnt/β-catenin pathway were respectively 1.592±0.267,0.528±0.138,2.153±0.078,1.480±0.064,0.248±0.128,1.492±0.025,0.658±0.095,1.647±0.087 in the experimental group and 3.651±0.224,2.570±0.093,2.301±0.157,1.636±0.058,1.415±0.080,2.610±0.159,2.480±0.123,3.432±0.273 in the control group.There were statistically significant differences in the mRNA relative expressions of Axin2,Wnt5a,c-myc,VEGF,Ascl2 and claudin-1 genes between the 2 groups (t =7.316,15.332,12.649,12.320,14.831,9.063,P＜0.05),and no statistically significant difference in the mRNA relative expressions of Wnt3a and Fzd3 between the 2 groups (t =2.887,2.242,P＞0.05).Conclusion The malignant behaviors of colorectal CSCs are suppressed after shRNA lentivirus interfered with expression of Lrg5,and its mechanism is related to inhibiting activity of Wnt/β-catenin pathway.

OBJECTIVETo investigate the risk factors for congenital external malformation.

METHODSA 1:2 matched case-control study was conducted with 52 cases of congenital external malformation during perinantal period collected from surveillance in Baoan District of Shenzhen City from January to June in 2000.

RESULTSSimple and multiple conditional logistic regression analysis showed that the major risk factors for congenital external malformations during perinatal period were preterm labor (beta(k) = 1.4171, s(theta, beta(kappa)) = 0.4601, OR = 4.115), adverse mental stimulus (beta(kappa) = 2.1870, s(theta beta(kappa)) = 0.7873, OR = 8.909), taking medicine (beta(k) = 1.9178, s(theta beta(kappa)) = 0.8072, OR = 6.808) and exposure to hazardous chemicals during early pregnancy (beta(k) = 0.9602, s(theta beta(kappa)) = 0.4262, OR = 2.612).

CONCLUSIONSCongenital external malformation during perinatal period was caused by multiple risk factors and results of the study showed that environmental and mental factors were in obvious connection with its occurrence.

Case-Control Studies ; Congenital Abnormalities ; etiology ; Female ; Humans ; Male ; Multivariate Analysis ; Perinatal Care ; Pregnancy ; Risk Factors

Objective To investigate the effects of different foot strike patterns during running on Achilles tendon(AT)morphology and mechanical loading.Methods Fourteen habitual rearfoot strike runners and 14 habitual forefoot strike runners were recruited.Morphological characteristics(tendon length,cross-sectional area,and thickness)of the AT were collected using ultrasound imaging.The AT loading characteristics(plantar flexion moment,tendon force,load rate,impulse,and stress)of subjects wearing cushioned running shoes while running at a speed of 10 km/h were collected and calculated using a three-dimensional force measurement treadmill.Results Compared to habitual rearfoot strike runners,habitual forefoot strike runners showed a significant increase in peak plantar flexion moment of ankle joint,AT peak force,average loading rate,and peak loading rate(P<0.05).However,the differences in AT length,cross-sectional area,and thickness between the two groups were not statistically significant(P>0.05).Conclusions Long-term forefoot strike patterns can adaptively enhance the mechanical loading characteristics of the AT during repetitive stretch-shortening cycles.

Objective:To compare the efficacy of fusion and non-fusion hybrid operation with Dynesys system with the traditional fusion operation with rigid instrumentation in the patients with multi-segment lumbar degenerative disease.Methods:A total of 30 patients with multi-segment lumbar degenerative disease who were subjected to operation from January 2017 to October 2019 in Shenzhen People's Hospital were included in the study. There were 13 males and 17 females, age: 60.8±13.2 years, range: 25 to 83 years. 28 patients with two segments, 1 with three segments, and 1 with four segments. The patients were divided into two groups, i.e the hybrid operation group (13 cases, 9 males and 4 females, average age: 56.6 years, range: 25 to 83 years) versus the traditional fusion group (17 cases, 4 males and 13 females, average age: 63.9 years, range: 46 to 80 years). The main outcome measures were visual analogue scale (VAS), Oswestry disability index (ODI), range of motion (ROM), adjacent segment degeneration (ASD) and complications.Results:There were no statistically significant differences in operation data, such as operation time, intraoperative blood loss, postoperative drainage volume and length of hospitalization, between the two groups. There were no significant differences for ROM in the surgical segments between the two groups before operation (hybrid group and traditional group were 9.6°±4.9° vs. 8.9°±6.1°, t=0.341, P=0.736, respectively). However, after 12 months follow-up, the ROM disappeared in the traditional group and was partially preserved in the hybrid group, with statistically significant differences (hybrid group and traditional group were 5.4°±2.7° vs. 0°, t=9.104, P=0.001, respectively). There was a statistical difference in intervertebral disc height between the two groups at 12 months post-operation, though no statistical difference was found before operation (8.8±1.9 mm vs. 10.5±1.7 mm, t=2.927, P=0.006). There was no statistically significant difference in the intervertebral disc height of the upper adjacent vertebrae between the two groups before and after operation. There were statistically significant differences in ODI scores before operation (63.4%±11.0% vs. 71.3%±9.2%, t=2.146, P=0.041), and 12 months post-operation (17.2%±2.1% vs. 15.5%±2.3%, t=2.091, P=0.046), while no statistical difference was found in VAS scores. Conclusion:The fusion and non-fusion hybrid operation with Dynesys system has comparable clinical efficacy with the traditional fusion operation with rigid instrumentation in the treatment of multisegment lumbar degenerative disease. Meanwhile, the hybrid surgery can preserve the motion of surgical segments and provide a dynamic stability of the vertebral body. The hybrid surgery can be used as a new surgical method for multi-segment lumbar degenerative disease.