BACKGROUND:Bone cement used in the vertebroplasty treatment of osteoporotic vertebral compression fractures is nonabsorbable and has stronger intensity than normal bone tissue, which can cause further fractures of adjacent segments. OBJECTIVE:To investigate the short-term effect of vertebroplasty with artificial bone in the treatment of osteoporotic thoracolumbar fractures. METHODS:A total of 21 patients with osteoporotic vertebral compression fractures were enrol ed, including 7 males and 14 females, aged 61-89 years old. Al the patients were subjected to vertebroplasty with calcium sulfate injection. Visual analog scale and Oswestry Disability Index assessment were used before and at 0, 24, 48 weeks after treatment;meanwhile, X-ray and CT were used to observe the fil ing and leakage of artificial bone. RESULTS AND CONCLUSION:After treatment, al the patients showed improvements in the scores of visual analog scale and Oswestry Disability Index (P<0.01). X-rays and CT scans showed that there were three cases of leakage but without spinal cord and nerve compressions. After 3 months, most of the artificial bone was absorbed. These findings indicate that vertebroplasty with artificial bone can ease pain and improve living conditions of patients with osteoporotic vertebral compression fractures.

AIM:To investigate the role of SDF-1? in migrating of bone marrow stromal cells to the injured areas. METHODS:Ischemic brain lesion model was created in rats by permanent middle cerebral artery occlusion (MCAO). 48 SD rats were divided randomly into 2 groups. Group 1:phosphate buffered saline (PBS 1 mL) for control (n=25); Group 2:BMSCs (2?106) were injected intravenously at 24 h after MCAO (n=24). After propagated in BMSCs,Ad5/F35 GFP (green fluorescent protein) was infected to BMSCs. The expression of SDF-1? (stromal cell-derived factor-1?) mRNA in the penrumbral tissue was assayed by real-time quantitative PCR. The expression of CXCR4 on MSCs was detected by flow cytometry. Confocal microscopy was used to detect the GFP-labeled MSCs migration. RESULTS:Ad5/F35 GFP signals was observed in almost infected BMSCs. The expressions of SDF-1? mRNA in the thalamus and hippocampus of the ischemic brains were peaked at 3rd day after stroke,followed by a decrease at 14th day post-ischemia. The expression of SDF-1? mRNA in the cortex of the ischemic brains was peaked at 7th day post-ischemia,still at high level at 14th day post-ischemia. The median percentage of surface CXCR4 expression in BMSCs was 14%. GFP labeled BMSCs were detected in the origination of the middle cerebral artery (olfactory area) at 6 h,after 3 days in the prenumbra tissue such as thalamus,and in the cortex more labeled cells were found after 14 d post-ischemia.CONCLUSION:BMSCs can pass through the blood brain barrier of ischemic rats. Its mechanism might be associated with the expression of SDF-1? in the ischemic brain.

Objective To investigate the effect of tigecycline on serum procalcitonin and its efficacy in the treatment of elderly chronic obstructive pulmonary disease (COPD) and nosocomial infection. Methods 82 elderly patients with COPD with nosocomial infection were selected and randomly divided into two groups with 41 cases of each group, the control group received routine treatment combined with cefoperazone and sulbactam, and the experimental group received routine treatment combined with tigecycline, 2 weeks for a course of treatment. The serum inflammatory factors and laboratory related indexes, clinical efficacy and bacterial clearance were compared after the treatment. Results Compared with control group, the levels of serum high-sensitivity C-reactive protein (hs-CRP), interluekin 6(IL-6) and tumor necrosis factorα(TNF-α) were significantly lower, and the serum levels of PCT and NO were lower(P < 0.05). The total efficacy of experimental group was 90.24%, which was higher than 70.73% in control group (P<0.05). The bacterial clearance rate in the control group was 63.42%, which was lower than the experimental group of 87.80% (P < 0.05). Conclusion Tigecycline in the treatment of COPD and nosocomial infection in elderly patients is curative effective and it can reduce the serum levels of PCT, NO and inflammatory factors with high safety.

Objective To compare the changes of plasma lipid indexes and coronary artery atherosclerotic plaque in TaqI B genotypes in CHD patients with impaired glucose tolerance (IGT) before and after statin therapy. Methods A total of 196 CHD with IGT and 160 controls were included. The changes of plasma lipid indexes and coronary artery atherosclerotic plaque in TaqI B genotypes were analyzed before and after Rosovastatin therapy. Sequenom Mass ARRAY platform was used to detect the CETP TaqI B SNPs. Results The genotype frequency of the B1B1, B1B2 and B2B2 in CHD with IGT group was 35.7%, 48.0% and 16.3% respectively, while in control group was 31.3%, 53.1% and 15.6% respectively. HDL-C, PA and MLA levels increased after Rosuvastatin therapy, while LDL-C, TG, TCH, Lpa, PA, EEMA and PB levels decreased. Conclusions CETP gene polymorphisms TaqI B would have association with the effects of Rosuvastatin therapy in the CHD with IGT.

[Objective] To investigate the effects of preconditioning with low concentration of hydrogen peroxide (H2O2) on oxidative stress-induced BMSC apoptosis.[Methods] In vitro separation,purification,culture,and amplification of bone marrow mesenchymal stem cells were performed.BMSC were insulted with 0,50,100,200,300,400,500 μmol/L H2O2 and the effect of different consentration of H2O2 on BMSC was detected by Flow cytometry (FCM).And then cells were preconditioned with different consentraion of H2O2.(FCM) was used to determine the protective role of H2O2 preconditioning on BMSC apoptosis,BMSC chromatin distribution changes were observed by Hoechst33324;BMSC Caspase-3 and Bcl-2 gene changes were detected by RT-PCR.[Results] Analysis of BMSC apoptosis by flow cytometry showed that H2O2 induced BMSC apoptosis in a dose-dependent manner,and pretreatment of the cells with low concentration of H2O2 prevented subsequent stimulation with high H2O2.RT-PCR results showed that preconditioning with low concentration of H2O2 reduced the BMSC Caspase-3 gene expression but increased Bcl-2 gene expression.[Conclusion] Preconditioning with low concentration of H2O2 has an adaptive role in BMSC,and its mechanism may be related to inhibit abnormal gene expression of Caspase-3 and increase the gene expression of Bcl-2.

Objectives To evaluate the effects of enteral nutrition(EN)and parenteral nutrition(PN)support in critically ill surgical patients. Methods 80 patients who could not eat were randomized into two groups:one group receivedEN,the other group received PN. The nutrition parameters including nitrogen balance, serum levels of albumin, prealbumin, transferrin and retinal-binding protein,immunity function parameters including immunoglobulin A, immunoglobulin G,immunoglobulin M,and natural kill cell activity, and patients'tolerability parameters including glutamic-oxalacetic transaminase, glutarmic-pyruvic transaminase, blood urea nitrogen and creatinine,and plasma glucose were compared. Results After 10 days'therapy,the two groups all turned from negative nitrogen balance to positive nitrogen balance. The nutrition parameters and immunity function parameters increased significantly in both groups and the latter in group EN increased more. For tolerability parameters, blood sugar in group PN increased obviously and no change in EN group. ConclusionsBoth EN and PN play a rde in nutrition support and elevation of immunity function. Patients tolerate well. EN has better effects on elevation of immunity function and patients tolerate better compared with PN.

ObjectiveTo explore the clinical feature of severe hand, foot and mouth disease (HFMD) in pediatric patients, and to observe the hemodynamic changes in those with acute pulmonary edema.Methods A prospective observation study was conducted. Thirty-five severe HFMD pediatric patients with acute pulmonary edema admitted to the intensive care unit (ICU) and Department of Pediatric of First People's Hospital of Foshan from May 2008 to September 2014 were enrolled. The clinical features were thoroughly investigated. Hemodynamic data were monitored by pulse-indicated continuous cardiac output (PiCCO) in 5 cases, and the changes in PiCCO parameters were observed at ICU admission (0 hour), and 24, 48, 96 hours after treatment.Results Thirty-five patients who met the diagnostic standard of severe HFMD were enrolled, including 22 male and 13 female, aged from 7 months to 4 years. Six patients were younger than 1 year, 13 1-2 years, 12 2-3 years, and 4 patients 3-4 years old. The most common time of occurrence of pulmonary edema was 3-4 days after the onset of the disease. Fever and central nervous system symptoms were found in all the patients, and examination of the cerebral spinal fluid (CSF) revealed non-bacterial inflammatory changes. PiCCO results showed a tendency of lowering of heart rate (HR), systemic vascular resistance index (SVRI), and extravascular lung water index (EVLWI) after the treatment, and the values obtained at 96 hours were significantly lower than those at 0 hour [HR (bpm): 119.0±14.7 vs. 200.8±19.7, SVRI (kPa·s·L-1·m-2):148.9±14.6 vs. 209.6±58.7, EVLWI (mL/kg): 10.5±1.9 vs. 34.8±10.8,P< 0.05 orP< 0.01], global end-diastolic volume index (GEDVI) was also gradually decreased without significant differences among all the time points, together with a tendency of increase in stroke volume index (SI) and cardiac index (CI). The values of the parameters at 96 hours were significantly higher than those at 0 hour [SI (mL/m2): 38.5±6.5 vs. 17.4±2.8, CI (mL·s-1·m-2): 75.0±8.0 vs. 55.5±8.5, bothP< 0.01]. Left atrium was found to be enlarged, and left ventricular systolic function decreased in two patients by cardiac ultrasonic. Four out of 35 patients died, and functional disability of extremities was found in 1 patient. Other patients were cured and discharged without any sequelae.Conclusions Severe HFMD complicated by acute pulmonary edema is a perilous condition in children, accompanied commonly by pathologic changes in central nervous system and systolic dysfunction of left ventricle. According to the results with PiCCO monitoring, HFMD patients suffering from acute pulmonary edema may be of cardiac origin in addition to neurogenic origin.

Objective To investigate the distribution of pathogens and their drug resistance in elderly patients with community-acquired pneumonia. Methods A total of 222 elderly patients with community-acquired pneumonia admitted to our hospital from February 2017 to January 2018 were enrolled in this study.Lower respiratory tract secretions or morning sputum were collected by using the sterile culture method. According to the clinical microbiological examination procedures ,pathogenic bacteria were cultured and identified. The pathogenic bacteria strains and the drug resistance were analyzed. Results The bacteria examination rate of the patients was 100.0% (222/222 patients) , and the rate of positive cultures was 64.9% (144/222 ).216 strains of pathogenic bacteria were identified ,and 75 strains(34.7% )were Gram-positive bacteria ,of which the most common pathogenic bacteria were Staphylococcus aureus ,Streptococcus pneumoniae and Staphylococcus epidermidis. And 127 strains(58.8% )were Gram-negative bacteria ,of which the most common pathogenic bacteria were Klebsiella pneumoniae ,patina Pseudomonas ,Escherichia coli ,Stenotrophomonas maltophilia and Haemophilus influenza. The drug susceptibility test showed that Gram-positive bacteria were sensitive to nitrofurantoin ,cotrimoxazole ,vancomycin and teicoplanin ,and Gram-negative bacteria were sensitive to piperacillin ,tazobactam ,cefepime ,amikacin ,levofloxacin and imipenem cilastatin. Conclusions The pathogenic bacteria are mainly Gram-negative bacteria in the elderly patients with community-acquired pneumonia ,but the majority of pathogenic bacteria have higher resistance to antibacterial drugs. The analyses of distribution of pathogens and their drug resistance are of great significance for the reasonable selection of antimicrobial agents and for the obvious decrease of lung infection and mortality rate.

OBJECTIVETo study the association of methylenetetrahydrofolate reductase (MTHFR) gene C677T mutation and plasma homocysteine (Hcy) levels with hyperlipidemia.

METHODSBlood samples were collected from 1591 adults for detecting MTHFR gene C677T polymorphism with polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP), plasma Hcy levels with enzymatic cycling method, and blood lipid levels as well. The patients were divided according to the lipid levels into hyperlipidemia group (n=694) and healthy control group (n=897) and the differences in MTHFR gene C677T polymorphisms and plasma Hcy levels were compared.

RESULTSThe hyperlipidemia group and healthy control group showed no significant differences in CC, CT, or TT genotype frequencies or C and T allele frequencies of MTHFR C677T gene, and had comparable plasma Hcy levels (P>0.05). Patients with 3 different MTHFR C677T genotypes had significant differences in plasma Hcy levels (P<0.01) but not in blood lipid levels (P>0.05). Pairwise comparison indicated a significantly higher plasma Hcy level in TT genotype than in CC and CT genotypes (P<0.01), and the latter two genotypes showed no significant difference (P>0.05).

CONCLUSIONMTHFR C677T polymorphisms and plasma Hcy levels are closely related but neither of them is associated with hyperlipidemia. The TT genotype is associated with a significantly higher plasma Hcy level than CC and CT genotypes.

Adult ; Gene Frequency ; Genotype ; Homocysteine ; blood ; Humans ; Hyperlipidemias ; blood ; genetics ; Methylenetetrahydrofolate Reductase (NADPH2) ; genetics ; Mutation ; Polymerase Chain Reaction ; Polymorphism, Genetic ; Polymorphism, Restriction Fragment Length

Objective:To investigate the clinical outcomes and complication of posterior surgery for Scheuermann kyphosis fusing to different distal fusion levels.Methods:From January 2012 to December 2017, a consecutive cohort of 34 patients who were treated with posterior spinal instrumented correction and satisfied the inclusion criteria were retrospectively reviewed, including 29 males and 5 females, aged 17.1±4.3 years (range, 12-30 years). All of the patients had a minimum follow-up of 2 years. According to the distal fusion level, patients were divided into 2 groups. Group sagittal stable vertebra (SSV) (22 cases) included patients whose lowest instrumented vertebra (LIV) was SSV; Group SSV-1 (12 cases) included patients who had a LIV one level above the SSV. Radiographic parameters including global kyphosis (GK), lumbar lordosis (LL), sagittal vertical axis (SVA), pelvic incidence (PI), pelvic tilt (PT), and sacral slope (SS) were measured in the standing radiographs before and after operation and at the latest follow up. Intraoperative and postoperative complications were recorded. The Scoliosis Research Society-22 questionnaire (SRS-22) were conducted at pre-operation and the final follow up to evaluate the clinical outcomes. The sagittal radiographic parameters and the incidence of distal junctional kyphosis (DJK) were compared between the two groups.Results:There were no significant differences in terms of age, sex, radiographic measurements and scores of SRS-22 between two groups preoperatively ( P>0.05). The correction rates of GK in the SSV group and the SSV-1 group were 42.8%±7.6% and 43.2%±8.4% ( t=0.151, P=0.881) respectively. While the correction rates loss were 1.2%±5.2% and 3.9%±7.2% ( t=0.767, P=0.449) at the latest follow up. No significant difference was observed in terms of other radiographic parameters ( P>0.05). During the postoperative follow up period, 3 patients (16.7%) in SSV group and 2 patients (13.6%) in SSV-1 group developed DJK. The incidence of DJK did not show any significant difference between two groups ( χ2=0.057, P=0.812). At the final follow-up, the function scores of SRS-22 in SSV-1 group (4.1±0.6) was significantly higher than SSV group (3.7±0.5) ( t=2.300, P=0.028) and there was no significant difference in the rest of the domain ( P>0.05). Conclusion:Compared with stopping at SSV, fusion to SSV-1 could achieve comparable curve correction with the preservation of more lumbar motility. Moreover, it would not increase the risk of DJK. As a result, we recommend selecting SSV-1 as the ideal LIV for SK patients.