BACKGROUND:Surgical accuracy is a key to surgical success.The traditional positioning method mainly depends on surgeons' experience,which is too subjective to cause screw misplacement.Three-dimensional (3D) printing technology-assisted pedicle screw placement can make individualized surgical scheme,most importantly,it is accurate and simple showing promising application prospect.OBJECTIVE:To design an individualized pedicle guide plate with 3D printing and to simulate screw placement in vitro,and to explore its feasibility in vertebral pedicle screw placement.METHODS:Lumbar spine CT data of 11 patients with degenerative lumbar spine were selected from April 2016 to July 2016 at Hebei General Hospital,and 3D reconstruction of L1,L3 and L5 vertebrae of each case was performed.Pre-experiment was conducted based on one patient's lumbar CT data:according to the principle of screw placement,the screw position and orientation were designed to prepare the best pedicle guide plate model.Afterwards,the screw placement in vitro was simulated,and was then cut by chainsaw to verify the accuracy of screw placement.RESULTS AND CONCLUSION:(1) A total of 30 pedicle guide plates were used,and 60 screws were inserted in the patients,and the placement process was successful.The guide plates adhered well,none appeared with screw perforating the pedicle cortex,and the screw position was accurate and reliable.(2) There were no significant changes in the transverse section and sagtial section angles of the left and right pedicle screws before and after placement (P ＞ 0.05).(3) These results suggest that the 3D-printed individualized pedicle guide plate holds a good accuracy of placement,which can be applied in the vertebral pedicle screw placement,but further clinical trials are needed.

The study was aimed to investigate the effect of IL-2 on the acquired immune response of naive T cells, and to explore the influence of IL-2 on suppressor of cytokine signaling 3 (SOCS-3) expression of naive T cells, as well as to elucidate the role of SOCS-3 on antigen specific immune response in vitro. Naive DO11.10 T cells were pre-stimulated with IL-2 (50 U/ml), and stimulated with OVA(323 - 329) antigen after removing IL-2, then the proliferation of naive DO11.10 T cells was detected. Naive DO11.10 T cells were stimulated with IL-2 (50 U/ml), and SOCS-3 expression was detected by real-time PCR. Naive DO11.10 T cells were stimulated with OVA(323 - 329) antigen, and SOCS-3 expression was detected by means of (3)H-TdR. The results showed that after IL-2 pre-stimulation, the proliferation of naive DO11.10 T cells decreased significantly when stimulated with OVA(323 - 329) antigen; SOCS-3 expression of naive DO11.10 T cells was up-regulated significantly after IL-2 stimulation, the up-regulation began obviously at 4 hours and reached peak at 6 hours. SOCS-3 expression on naive DO11.10 T cells was down-regulated markedly after OVA(323 - 329) antigen stimulation, the expression level of SOCS-3 was lowest on day 2 and returned to normal on day 4 after stimulation. It is concluded that the antigen specific immune response of naive DO11.10 T cells is inhibited after pre-stimulation with IL-2, which may be mediated by SOCS-3.
Animals ; Gene Expression ; Humans ; Interleukin-2 ; immunology ; pharmacology ; Mice ; Suppressor of Cytokine Signaling 3 Protein ; Suppressor of Cytokine Signaling Proteins ; immunology ; metabolism ; T-Lymphocytes ; immunology

Objective:To evaluate the feasibility of using bedside ultrasound and serum biomarkers for the prediction of sepsis-induced myocardial dysfunction(SIMD)and mortality in septic shock patients.Methods:The patients diagnosed as septic shock were enrolled in the study from January 2019 to July 2021 in PICU at Shanghai Children′s Medical Center Affiliated to Shanghai Jiaotong University School of Medicine.Bedside ultrasound results were recorded at day 1, 2, 3, 7 and 10.Blood samples were collected at the same time, markers of myocardial injury were detected, and prognosis was recorded at 28 days.According to the left ventricular ejection fraction (LVEF), children with septic shock were divided into SIMD group and non-SIMD group.Those with LVEF <50% or decreased by ≥10% from baseline level were defined as SIMD.Differences in cardiac ultrasound parameters and biomarkers between two groups were compared.Logistic regression analysis was performed to determine the independent risk factors for SIMD and the independent risk factors for death at 28 days after septic shock.The area under the receiver operating characteristic curve (AUC) was used to evaluate the efficacy of different indicators in predicting SIMD and the death outcome of children with septic shock on 28 days.Results:A total of 57 children were enrolled, including 28 cases in SIMD group and 29 cases in non-SIMD group.Univariate analysis showed that there were statistically significant differences in pediatric critical illness score, N-terminal B-type natriuretic peptide(NT-proBNP), LVEF and left ventricular short axis shortening rate between two groups ( P<0.05). Logistic analysis demonstrated that LVEF( OR=0.890, 95% CI 0.818-0.969, P=0.007)and NT-proBNP ( OR=1.000, 95% CI 1.000-1.000, P=0.015)could independently predict SIMD.There were 42 cases in survival group and 15 in non-survival group according to the prognosis on 28 days.Univariate analysis showed that there were significant differences in pediatric risk mortality score Ⅲ, pediatric sequential organ failure assessment, cardiac troponin I, and mitral annular plane systolic excursion(MAPSE)( P<0.05). Logistic analysis showed that only MAPSE independently predicted mortality( OR=85.670, 95% CI 1.685-4 356.736, P=0.026). Compared with MAPSE(AUC=0.727), MAPSE combined with pediatric risk mortality score Ⅲ, pediatric sequential organ failure assessment, cardiac troponin I(AUC=0.926) could be better to predict the 28 days prognosis of patients with septic shock on 28 days. Conclusion:NT-proBNP increases significantly in the early stage of SIMD.MAPSE shows no difference between SIMD and non-SIMD patients.MAPSE is correlated with the prognosis of patient with septic shock.

BACKGROUNDThe association between vulnerability of plaque assessed with intravascular ultrasound (IVUS) and plasma levels of fibrinolytic biomarkers was determined in patients with acute coronary syndrome (ACS). However, few data are available on the relationship between the levels of tissue type plasminogen activator (t-PA) and virtual histological intravascular ultrasound (VH-IVUS) signs of plaque instability.

METHODSEighty-nine patients with ACS were enrolled in the study. Blood was collected to measure t-PA levels by liquid phase bead flow cytometry. Eighty-nine nonbifurcate lesions (identified by coronary angiography and ECG) were investigated using IVUS before catheterization. IVUS radiofrequency data obtained with a 20 MHz catheter were analyzed with IVUS virtual histological software. The areas of plaque and media were calculated and lesions were classified into two groups: VH-IVUS derived thin cap fibroatheroma (VH-TCFA) and non-VH-TCFA plaque.

RESULTSPlasma t-PA level in the patients with TCFA was significantly lower than that with non-TCFA ((1489+/-715) pg/ml vs (2163+/-1004) pg/ml). Decreased plasma levels of t-PA were associated with plaque vulnerability. Plasma levels of t-PA correlated negatively with plaque plus media and necrotic core in plaque in patients with ACS.

CONCLUSIONSt-PA is an independent risk factor and a powerful predictor of vulnerable plaques. Decreased levels of t-PA may reflect instability of atherosclerotic plaques and might therefore serve as noninvasive determinants of those at high risk for consequent adverse events.

Acute Coronary Syndrome ; blood ; pathology ; Aged ; Coronary Artery Disease ; pathology ; Coronary Vessels ; pathology ; Female ; Humans ; Male ; Middle Aged ; Tissue Plasminogen Activator ; blood ; Ultrasonography, Interventional

This study was aimed to explore the expression of microRNA-21 (miR-21) in multiple myeloma (MM), and its correlation with plasma β2-microglobulin (β2-MG) and staging of MM by Durie-Salmon (D-S) classification. The expression level of miR-21 in bone marrow mono-nuclear cells (BMMNC) of 43 patients with MM and 20 healthy individuals was examined by real-time polymerase chain reaction (real-time PCR), and the correlations among the expression level of miR-21 and related clinical pathologic features, plasma β2-MG and staging of MM by D-S classification were analyzed. The results showed that the expression of miR-21 in BMMNC of MM patients was obviously higher than that in normal controls (P < 0.05). The expression of miR-21 in BMMNC of relapsed/refractory MM patients was obviously higher than that in newly diagnosed MM patients. The expression of miR-21 in MM patients decreased after chemical therapy, especially in effective group (P < 0.05), there was no significant change of miR-21 expression level in ineffective/progressive group before and after chemical therapy (P > 0.05). The expression of miR-21 was related with staging of MM and plasma β2-MG level. It is concluded that the expression levels of miR-21 in BMMNC of MM patients are significantly higher than in normal bone marrow, these data indicated that miR-21 may play an important role in the development of MM. Super expression of miR-21 is positively correlated with level of plasma β2-MG and staging of MM by D-S classification.
Adult ; Aged ; Case-Control Studies ; Female ; Humans ; Male ; MicroRNAs ; metabolism ; Middle Aged ; Multiple Myeloma ; metabolism ; pathology ; beta 2-Microglobulin ; blood

Objective To investigate the effect of 4-hydroxytamoxifen on the expression of pituitary tumor transforming gene (PTTG) in GH3 prolactinoma cells. Methods RT-PCR and Western blotting were employed to detect the expressions of PTTG mRNA and protein in human GH3 prolaetinoma cells. Different concentrations of estradiol (E2) or 4-hydroxytamoxifen (OHTam) were addedl into the hormone-depleted medium, and the viable cell number and expression levels of PTTG mRNA and protein were measured. Results The growth of OH3 prolaetinoma cells was significantly inhibited in hormone-depleted medium. E2 at a concentration of 1×10<'-8> mol/L obviously promoted the cell growth, the effect of which was inhibited by the application of OHTam (1×10<'-6> mol/L) to cause slowed cell growth. The expressions of PTTG at both the mRNA and protein levels were detected in detected in untreated GH3 prolactinoma cells, and OHTam at the concentration of 1×10<'-6> mol/L significantly inhibited their expressions. Conclusion The growth of GH3 cells is estrogen-dependant and can be inhibited by estrogen antagonist OHTam, which also results in reduced expression of PTTG gene in the cells.

OBJECTIVETo investigate the influencing factors on cerebral stroke in Zhangwu county, Liaoning province, a region with high hypertension prevalence rate.

METHODSBy cluster sampling method, 5208 adults ( > 18y. ) from 11 villages of 6 towns were registered. General information, common risk factors of cerebral stroke about these persons was recorded. Blood pressure together with several biochemistry indicators was determined. Data were analyzed by SPSS 10.0 software.

RESULTSStandardized prevalence of cerebral stroke in this region was 3.10%, and the difference between males and females was significant. Prevalence rate was increasing with age. Multiple-factor analysis revealed that the incidence rate of cerebral stroke was related to high blood pressure, high diastolic pressure, pulse pressure, age, high-density lipoprotein cholesterol (HDL-C) and low-DL-C (LDL-C) level with OR values of 95% CI as 2.958 (1.783-4.907), 2.803 (1.934-4.062), 1.154 (1.056-1.261), 1.080 (1.063-1.097), 0.390 (0.235-0.647) and 1.422 (1.008-2.006) respectively.

CONCLUSIONHigh blood pressure, in particular high diastolic pressure, pulse pressure and LDL-C level were main risk factors of cerebral stroke in Zhangwu countryside. However, HDL-C level was a protective factor. No new risk factors were discovered.

Adult ; Aged ; Blood Pressure ; physiology ; China ; epidemiology ; Cholesterol, HDL ; blood ; Cholesterol, LDL ; blood ; Female ; Humans ; Hypertension ; complications ; epidemiology ; Male ; Middle Aged ; Risk Factors ; Stroke ; blood ; epidemiology ; etiology ; Young Adult

We report the effects of biventricular pacing in a patient with hypertrophic obstructive cardiomyopathy (HOCM) refractory to medical therapy. A 58-year-old man with HOCM had suffered from dyspnea, chest pain and palpitation for 5 years. Cardiac catheterization showed a left ventricular outflow tract (LVOT) gradient of 80 mmHg. He refused septal myomectomy and the septal ablation was not available. Based on intraoperative pressure measurements, he was implanted with biventricular pacing and LVOT gradient decreased to 10 mmHg. During the follow-up period of 6 months, the patient's symptoms were markedly improved. Biventricular pacing may be an alternative therapy for patients with HOCM.
Cardiac Resynchronization Therapy ; methods ; Cardiomyopathy, Hypertrophic ; diagnostic imaging ; pathology ; therapy ; Coronary Angiography ; Electrocardiography ; Humans ; Male ; Middle Aged

Hyperpolarization-activated cyclic nucleotide-gated (HCN) channels are confirmed to be expressed in bladder interstitial Cajal-like cells (ICC-LCs), but little is known about their possible role in cystitis-associated bladder dysfunction. The present study aimed to determine the functional role of HCN channels in regulating bladder function under inflammatory conditions. Sixty female wild-type C57BL/6J mice and sixty female HCN1-knockout mice were randomly assigned to experimental and control groups, respectively. Cyclophosphamide (CYP)-induced cystitis models were successfully established in these mice. CYP treatment significantly enhanced HCN channel protein expression and I(h) density and significantly altered bladder HCN1 channel regulatory proteins. Carbachol (CCH) and forskolin (FSK) exerted significant effects on bladder ICC-LC [Ca²⁺]i in CYP-treated wild-type (WT) mice, and HCN1 channel ablation significantly decreased the effects of CCH and FSK on bladder ICC-LC [Ca²⁺]i in both naive and CYP-treated mice. CYP treatment significantly potentiated the spontaneous contractions and CCH (0.001-10 µM)-induced phasic contractions of detrusor strips, and HCN1 channel deletion significantly abated such effects. Finally, we demonstrated that the development of CYP-induced bladder overactivity was reversed in HCN1 -/- mice. Taken together, our results suggest that CYP-induced enhancements of HCN1 channel expression and function in bladder ICC-LCs are essential for cystitis-associated bladder hyperactivity development, indicating that the HCN1 channel may be a novel therapeutic target for managing bladder hyperactivity.
Animals ; Carbachol ; Colforsin ; Cyclophosphamide ; Cystitis ; Female ; Humans ; Hyperpolarization-Activated Cyclic Nucleotide-Gated Channels* ; Mice* ; Telocytes* ; Up-Regulation* ; Urinary Bladder*

This study was aimed to explore the expression of B cell-activating factor of TNF family (BAFF) and B cell lymphoma/leukemia-2 (BCL-2) in bone marrow mononuclear cells (BMMNC) of multiple myeloma (MM) and the significance of BAFF and BCL-2 for occurrence, development and prognosis of MM. The bone marrow of 40 cases of MM and 10 healthy persons was collected, the mononuclear cells (MNC) were isolated, the expression of BAFF and BCL-2 mRNA in BMMNC was detected by real-time PCR; the plasma was simultaneously collected and the β2-MG level was determined; the clinical staging of MM patients was performed according to Durie-Salmon (D-S) staging criterion. The results indicated that the expression level of BAFF and BCL-2 mRNA in MM patients increased, as compared with normal controls, the difference was statistical significant (p < 0.05); the expression level of BAFF and BCL-2 mRNA in plateau stage after treatment obviously decreased. The expression level of BAFF and BCL-2 mRNA in relapsed/refractory MM patients was significantly higher than that in normal controls and patients reached plateau stage (p < 0.05), there was no statistically significant difference between newly diagnosed and relapsed/refractory MM patients (p > 0.05). The expression of BAFF and BCL-2 mRNA related with D-S staging and β2-MG level. It is concluded that the expression levels of BAFF and BCL-2 mRNA increase, moreover the expression levels of BAFF and BCL-2 mRNA in newly diagnosed and relapsed/refractory MM patients are higher than those in patients reached plateau stage, which suggest the BAFF and BCL-2 may be involved in occurrence and development of MM; the relation of expression level of BAFF and BCL-2 mRNA to MM load is positive, which indicates the expression level of BAFF and BCL-2 mRNA may be a new indicator for evaluating the prognosis of MM patients.
Adult ; Aged ; B-Cell Activating Factor ; genetics ; metabolism ; Case-Control Studies ; Female ; Humans ; Lymphoma, B-Cell ; genetics ; Male ; Middle Aged ; Multiple Myeloma ; diagnosis ; genetics ; Prognosis ; Proto-Oncogene Proteins c-bcl-2 ; genetics ; metabolism ; RNA, Messenger ; genetics