[Objective]To demonstrate the shift of the spinal cord to the concave side of the spinal canal in adolescent patients with idiopathic thoracic scoliosis,to investigate possible cause of the shift of the spinal cord and to explore its clinical relevance.[Method]Thirty-nine adolescents with idiopathic thoracic scoliosis were recruited in this study.Cobb's angle,relative apical translation and relative trunk shift of the major thoracic curves were recorded from standing posteroanterior roentgenography of the whole spine.The shift of the spinal cord was determined through the measurements of distance between the spinal cord and the medial walls of the pedicles on the convex and concave sides,which were performed in transverse magnetic resonance images of the spinal canal in the major thoracic curves(T5~12).The variations of the shift of the spinal cord were determined,and the relationships between the shift of the spinal cord at the apical region and Cobb's angle,and between that and the relative apical vertebral translation were analyzed.[Result]In the region of the major thoracic curves,the distance from the spinal cord to the pedicle on the convex side was significantly less than the distance to the pedicle on the concave side(P

Objective To evaluate the clinical diagnosis of gastric stromal tumors and the safety and feasibility with laparoscopic wedge resection.Methods The clinical data of diagnosis and treatment were retrospectively analyzed in 43 cases diagnosed as gastric stromal tumors by endoscopyic ultrasonography.Results Thirty-six cases were successful by laparoscopic surgery success rate being 83.7%.Endoscopic ultrasonography diagnosis rate was 69.0%.The positive rate of CD117 and CD34 in postoperative diagnosis of gastrointestinal stromal tumor wasl00%.The mean post-operative hospital stay was 5 days.Conclusion Endoscopyic ultrasonography can be selected as a main method for clinical diagnosis of gastric stromal tumors and laparoscopic resection was safe and feasible.

Objective To investigate the relationship between polymorphisms within the CETP gene, D442G,and natural longevity in the Uygur population. Methods 191 healthy individuals over 90 years old and 53 control individuals who died before their 75 years were recruited. The D442G polymorphism within CETP gene was genotyped by PCR-RFLP and PCR-Sequencing. Results There were no difference in the genotypes and alleles distribution of D442G polymorphisms within the CETP gene between longevity group and control group. Conclusions There were no the correlation between the D442G polymorphisms within CETP gene and natural longevity of Uygur population in Hetian. The difference of D442G polymorphism existed in not only races, but also regions where the same race dwelled.

Objective To investigate the relation ship between two polymorphisms within the CETP gene,TaqIB and I4O5V,and natural longevity in the Uygur population.Methods 191 healthy individuals over 90 years old and 53 control individuals who died before their 75 years were recruited.The polymorphisms within CETP gene,TaqIB and I4O5V,were genotyped by PCR-RFLP and PCR-Sequencing.Results There were no difference in the genotypes and alleles distribution of two polymorphisms within the CETP gene between longevity group and control group.Conclusions There was no correlation between the polymorphisms within CETP gene,TaqIB and I4O5V,and natural longevity of Uygur population in Hetian.

Objective To explore the feasibility and efficacy of posterior minimally invasive scoliosis surgery in Lenke 5C adolescent idiopathic scoliosis (AIS).Methods From November 2012 to March 2014,a total of 16 patients underwent posterior minimally invasive scoliosis surgery assisted by O-arm three-dimensional CT navigation were included.There were 14 female and 2 male,with an average age of (16.7± 1.6) years (ranged from 14 to 18 years).The mean Cobb angles of lumbar and thoracic curve were 48.7°±5.6°and 24.1°±5.4°,respectively.Results 16 patients were successfully completed the operation,the average operation time was (246±89) min,the average intraoperative blood loss was (192± 105) ml,and the fusion level was 4.9±0.5 on average.A total of 155 screws were inserted in the 16 patients,with a mean implant density of 98.9％±4.9％.All the patients were followed up for (26.4±3.9) months on average.The following radiographic parameters were evaluated before surgery,immediately after surgery and at the last follow-up:curve magnitude,apical vertebral translation (AVT),apical vertebral rotation (AVR),trunk shift,thoracic kyphosis (TK),thoracolumbar kyphosis (TLK),lumbar lordosis (LL) and sagittal vertical axis (SVA).The accuracy of pedicle screw placement was assessed according to postoperative CT scans.SRS-22 scores and complications were also recorded during the follow-up.Immediately after surgery,the correction rate of main lumbar curve was 80.1％±8.3％,and thoracic curve was 59.3％±8.7％,and a obvious improvement was noted in terms of AVT,AVR,trunk shift and TLK.At the last follow-up,except the increase of SVA from (-27.6± 19.5) mm to (-12.3±6.6) mm,no obvious changes of AVT,AVR,trunk shift,TK,TLK and LL were observed during the follow-up.According to CT evaluation,the satisfactory rate of pedicle screw placement was 94.2％,while the perforation rate was 5.8％ (9/155).Fusion across the facet joint were satisfactory.In SRS-22 assessment,the mean scores of functional,pain,self-image,mental state and satisfaction were (4.3 ± 0.5) points,(4.7 ± 0.6) points,(4.2 ± 0.7) points,(4.2 ± 0.5)points and (4.4 ± 0.6) points.No wound infection,implant failure and neurologic complications were found after surgery.Conclusion Wiltse approach assisted by O-arm three-dimensional CT navigation has the characteristics of small injury,less bleeding,high accuracy placement of pedicle screws and high self-satisfaction of patients.It is a feasible,safe and effective way to treat Lenke 5C AIS.

Objective To evaluate the changes in sagittal profiles and complications during treatment with growing rods (GRs) in hyperkyphotic early-onset scoliosis (EOS).Methods From December 2009 to December 2016,a total of 32 EOS patients who received growing rods treatment in our center,including 8 males and 24 females,were reviewed retrospectively.All the patients had minimum 2-year follow-up and over 2 lengthenings.Based on the reference value of thoracic kyphosis (TK) in T2-12 of normal children,the patients were categorized into an N group (20°≤TK≤50°,15 cases,4 males and 11 females) or K group (TK≥50°,17 cases,4 males and 13 females).The distribution of etiology was similar between the two groups.The average age was (6.2±2.0) years and (6.3±2.3) years respectively,curve flexibility was 34.6％± 10.4％ and 35.8％± 11.2％ before surgery.The precontoured rods were tunneled submuscularly,connecting proximal and distal anchors,and tandem or domino connectors.The rods were then locked after applying direct distraction that allowed appropriate elongation.The connectors were all placed under the deep fascia.Results The mean follow-up in the N and K groups was (5.5±1.9) years and (5.5±2.1) years,respectively.The distribution of proximal and distal anchors was similar between the two groups.The N and K groups,respectively,had an average number of lengthenings of 5.1±2.0 and 5.3±2.3,with mean lengthening intervals of (11.3±2.3) months and (10.9±1.9) months,respectively.In the N group,TK was decreased from 36.0°±9.4° to 30.6°±.8.3° after surgery,and to 32.2°±7.8° at the last follow-up,demonstrating it was maintained within the normal range.In the K group,TK was markedly reduced from 67.6°±11.6° to 41.7°±8.7° after the index surgery,with a correction rate of 38.3％± 14.6％,and the difference was statistically significant.And then it slightly increased to 46.5°±8.4° at the last follow-up,with correction loss of 7.1％±4.2％,and the difference was not statistically significant compared with the postoperatiom.The complication rate in the K group was significantly higher than in the N group (76.5％ vs.33.3％,P=0.031).The most common implant-and alignment-related complication in both groups was rod fracture (15.6％) and proximal junctional kyphosis (21.9％),respectively.The incidence of rod fracture in the N group and K group was 6.7％ and 23.5％,respectively.And the incidence of proximal junctional kyphosis was noted as 13.3％ and 29.4％ in the N group and K group,respectively.Proximal junctional angle (PJA) in the K group was greater than that in the N group preoperatively,postoperatively and at the last follow-up.Moreover,the increasing amount of PJA was significantly greater in the K group compared to the N group (1.6°± 1.0° vs.0.7°±0.8°).Four and seven complication events in the N and K groups,respectively,were evaluated with Grade Ⅰ.Four and seven complication events in the N and K groups,respectively,were classified as Grade Ⅱ A.Conclusion GRs can effectively restore the sagittal profile in hyperkyphotie EOS patients,but with a higher complication rate compared to the patients with normal kyphosis.

Objective To investigate the efficiency and safety of articulating spacer for severe infected knee arthroplasty in patients with medical comorbidities and local sinus tracts. Methods Ten consecutive patients with medical comorbidities (rheumatoid arthritis, diabetes mellitus, etc) or local sinus tracts,who were complicated with late infected TKA, were included in the study. All the patients underwent twostage revision using articulating spacers. All of the patients were debridement thoroughly and followed by implantation of an antibiotic-loaded cement articulated spacer. Two-stage revisions were not followed untill the infection were controlled. The hospital for special surgery (HSS) knee scoring system and range of motion were used to evaluate the outcomes. Results One patient underwent knee fusion because the infection was not controlled after first-stage surgery. The other 9 patients had no evidence of infection. The mean follow-up was 50 months (range, 24-90 months), no recurrent infection developed for these 9 patients. The mean modified HSS score had improved from 48 points (range, 32-63) before the resection surgery to 79 points (range,62-91) at the end of the spacer period. At the latest follow-up, the modified HSS score averaged 89 points (range, 74-95). The good and excellent rate was 0, 80% and 100%, respectively. The average range of motion had increased from 13°-70° preoperatively to 8°-93° prior to the revision. And at the latest follow-up, the range of motion averaged 3° to 110°. Conclusion The delayed two-stage revision using an articulating spacer is effective in the treatment of chronically infected TKA characterized by simple, good reproducible, high rate of infection control, better joint function after surgeries

Objective To investigate the application of 3D printing technique in the treatment of obsolete pelvic and acetabular fractures.Methods The clinical data of 23 patients with obsolete pelvic and acetabular fractures were retrospectively analyzed who had been surgically treated in our hospital from January 2006 through January 2016.3D printing technique was used in surgical planning in 11 of them,including 8 males and 3 females,with an average age of 33.8 ±4.9 years (3D group).The other 12 patients received conventional surgery without using 3D printing technique.They were 9 males and 3 females,with an average age of 34.8 ± 8.3 years (conventional group).The primary pelvic fractures in both groups were all type C according to the Tile classification system.The patients complicated with acetabular fracture in the 3D group and the conventional group were 10 and 11 cases respectively.The operative time,blood loss,blood transfusion.intraoperative fluoroscopy,visual analogue score (VAS) and Majeed score were compared between the 2 groups.Results The 2 groups were compatible in terms of preoperative general data (P ＞ 0.05).For the 3D group and the conventional group,operative time was 166.4± 24.2 min versus 222.5 ± 49.0 min.blood loss 2,063.6 ± 484.3 mL versus 2,700.0 ± 597.0 mL,blood transfusion 13.2 ± 3.2 U versus 17.6 ± 4.5 U,and intraoperative fluoroscopy 7.4 ± 1.3 times versus 11.7 ± 3.6 times.There were significant differences between the 2 groups in the above indexes (P ＜ 0.05).The 3D group and the conventional group obtained an average follow-up of 18.4 months and 21.7 months,respectively.The postoperative VAS scores were respectively 1.8 ±-0.9 points and 3.4 ± 1.0 points for the 2 groups,showing a significant between-group difference (P ＜0.05).The Majeed scores at the last follow-ups were respectively 85.7 ± 4.2 points and 84.9 ± 3.1 points for the 2 groups,showing no significant between-group difference (P ＞ 0.05).There were no such complications in the 3D group as iatrogenic nerve injury,vascular injury,nonunion or internal fixation failure.One patient in the conventional group suffered transient iatrogenic injury to the sciatic nerve.Conclusions 3D printing technique can provide helpful guidance for diagnosis and fracture classification preoperatively.It improves the patient's perioperative safety by benefiting intraoperative reduction,shortening operative time,and reducing intraoperative blood loss and intraoperative fluoroscopy.

OBJECTIVETo investigate the relationship between chronic pyelonephritis (CPN) and immune function, and the therapeutic mechanism of Yishenkang granule (YSKG).

METHODSOne hundred and twenty patients of CPN were divided into 3 groups randomly, the YSKG group (treated with YSKG), the control A group (treated with Sanjin tablet) and the control B group (treated with western medicine). Serum levels of immunoglobulin (Ig), complement 3 (C3), interleukin-2 (IL-2), peripheral T-lymphocyte subsets, and urinary secretory immunoglobulin A (sIgA) were determined before and after treatment with monoclonal antibody assay, agar diffusion method, radioimmunoassay (RIA), and radioimmuno-equilibrium method, and compared with normal control.

RESULTSThere were disorders of T-lymphocyte subsets in CPN, lowering of serum Ig, C3 and urinary sIgA, and increase of blood IL-2 (P < 0.05 or P < 0.01). These abnormalities could be normalized after YSKG treatment.

CONCLUSIONFunctional disorders of cellular and humoral immunity exist in CPN patients of chronic stage, YSKG could correct the immune functional disorder, control the recurrence of CPN effectively and alleviate the immunopathological damage.

Adult ; Chronic Disease ; Complement C3 ; metabolism ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Immunoglobulin G ; blood ; Interleukin-2 ; blood ; Male ; Middle Aged ; Pyelonephritis ; drug therapy ; immunology ; prevention & control ; T-Lymphocyte Subsets ; drug effects

Objective: To investigate the effects of Fufang Jiangzhi No. 3, a compound traditional Chinese herbal medicine, on cholesterol-bile acid metabolism in rabbits with hypercholesterolemia and to explore the mechanism. Methods: Twenty-four male New Zealand white rabbits were randomly assigned into normal control group, untreated group and Fufang Jiangzhi No. 3 group, with 8 rabbits in each group. Rabbits in the untreated group and Fufang Jiangzhi No. 3 group were fed high cholesterol diet to induce hypercholesterolemia. After 4-week treatment, serum total cholesterol and bile acid contents were assessed. Activity of cholesterol 7alpha-hydroxylase (CYP7A1) in liver tissues was measured by enzyme-linked immunosorbent assay. The expressions of CYP7A1, bile salt export pump (BSEP) and small heterodimer partner (SHP) mRNAs in liver tissues were observed by real-time fluorescent quantitative polymerase chain reaction. Results: Compared with the normal control group, serum total cholesterol and bile acid contents in the untreated group were increased (P<0.01). Activity of CYP7A1 and expression of CYP7A1 mRNA were decreased and expressions of BSEP and SHP mRNAs were increased in liver tissues in the untreated group as compared with the normal control group (P<0.01). Serum total cholesterol level, and expressions of BSEP and SHP mRNAs in the Fufang Jiangzhi No. 3 group were lower than those in the untreated group (P<0.01). The CYP7A1 activity and expression of CYP7A1 mRNA in the Fufang Jiangzhi No. 3 group were increased as compared with the untreated group (P<0.01), however, there was no significant difference in bile acid between the Fufang Jiangzhi No. 3 group and the untreated group. Conclusion: Fufang Jiangzhi No. 3 can up-regulate the expression of CYP7A1 mRNA, raise the activity of CYP7A1, and inhibit the expressions of BSEP and SHP mRNAs to regulate the metabolism of total cholesterol in rabbits.