OBJECTIVETo investigate the causes and managements of postoperative neurological complications in pedicle screw internal fixation for the treatment of degenerative scoliosis (DS).

METHODSThe data of 325 patients with degenerative scoliosis underwent pedicle screw internal fixation was retrospectively analyzed from February 2000 to April 2013. There were 22 patients with postoperative neurological complications. Of them, 16 cases complicated with numbness or pain of lower limb and 6 cases with obvious sensation and motor function decreasing in lower limb. The patients were treated with trophic nerve, dehydration, glucocorticoids, reoperation according to the causes of disease. Postoperative at 3, 6 months and 1 year later, according to VAS scoring and muscule power improvement,the recovery of nerve injury was assessed.

RESULTSPostoperative at 3,6 months and 1 year later,VAS scoring of 16 patients with slightly nerve injury was 2.81 +/- 0.66, 1.94 +/- 0.77, 0.63 +/- 0.62, respectively, and the symptoms had obviously improved than 1 week after operation (P < 0.05). Postoperative at 3 months, among 6 patients with severe nerve injury,muscule power improved in 2 cases and no-improved in 4 cases, with VAS scoring of 4.83 +/- 1.17; postoperative at 6 months,muscule power still had not improved in 3 cases,with VAS scoring of 4.17 +/- 0.75; both of the VAS scoring had not significant difference than 1 week after operation (P > 0.05). One year later, there was no muscule power improvement in 2 cases,with VAS scoring of 3.00 +/- 1.26, there was significant difference than 1 week after operation (P < 0.05).

CONCLUSIONThe causes of postoperative neurological complication in internal fixation for the treatment of dengenerative scoliosis includes: dragging and torsion injury of spinal marrow and nerve root because of excessive orthopedic of scoliosis; inderect injury of nerve root because of malposition of pedicle screw; nerve functional impairment caused by spinal cord ischemia. Avoiding the above factors could decrease the complication and early discovery and treatment could decrease the adverse outcomes.

Aged ; Aged, 80 and over ; Bone Nails ; adverse effects ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Nervous System Diseases ; etiology ; Postoperative Complications ; etiology ; Retrospective Studies ; Scoliosis ; diagnostic imaging ; surgery ; Tomography, X-Ray Computed

BACKGROUND: How to deal with bone defect is a big problem to surgeons. In recent years, the development in the technology of molecular biology and tissue engineering provides broad prospect for the clinical treatment of bone defect, which is one of the important study directions in department of orthopedics. The transforming growth factor-beta 1(TGF-β1),one of the important factors in bone formation, plays an important role in bone metabolism and recovery.OBJECTIVE: To observe the therapeutic effects of bone defects with osteoblasts transfected . By TGF-β1 combining with biomimetic biodegradable polymer scaffolds.DESIGN: Randomized controlled trial.SETTING: Department of Orthopedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology.MATERIALS: Siderophilin, trypsin, 3H-proline and sirius red, etc.MATERIALS: The experiment was completed in Union Hospital, Tongji Medical College, Huazhong University of Science and Technology from March to August in 2003. Twenty healthy adult Sprague-Dawley(SD) rats of SPF grade, weighing 200-250 g, were provided by the Experimental Animal Center of Tongji Medical College.METHODS: The osteoblasts transfected by TGF-β1 gene, combining with poly-DL-lactic acid scaffolds modified with poly-L-lysine, were transplanted into rat tibia defect. Radiographs and histological analysis were performed to evaluate the repair effects.MAIN OUTCOME MEASURES: The X-ray evaluation and histology observation were performed at the 4th and 8th weeks after the operation.RESULTS: Totally 20 SD rats were included in result analysis without one rat missing. ①In the experiment group, X-ray image indicated callus formation, while histology observation showed osteoid tissue and new bone formation, and osteoblasts attached to the surface of the materials after 4 weeks. Eight weeks later, the defect was essentially repaired, and the bone density of new bone was similar to that of the autogenous bone. ②In the control group, there was no formation of callus and osteoid tissue, and few osteoblasts attached to the surface of the materials, and a lot of lymphocytes infiltrated and blood capillary grew in the lacune of materials after 4 weeks. Eight weeks later, the imbedded materials were substituted mostly by fibrous tissue.CONCLUSION: The ideal repair effect of bone defect can be obtained through the combination of molecular biology with tissue engineering.

Objective To compare the transfection rate of AAV2-EGFP and AAV2/1-EGFP to human skin fibroblast(HFB).Methods Two recombinant adeno-associated viruses(AAV) encoding enhanced green fluorescent protein(EGFP) were constructed and transfected to HFB at multiple of infection MOI ranging from 104 to 106.Twenty-four hours after the infection,the expression rates of EGFP on cultured HFB were assessed by flow cytometry and the transfected cells were observed under fluorescence microscope.The killing effect of the virus on the infected cells was assayed by MTT.Results The transfection efficiency of AAV2-EGFP was increased as MOI increased.When MOI was 104,the transfection efficiency of AAV2-EGFP was 7.68%?1.18%;When MOI was 105,that was 52.12%?1.59%;When MOI was 106,that showed no significant increase.However,the transfection efficiency of AAV2/1-EGFP showed no obvious changes at any MOI.Conclusion AAV2 is more efficient than AAV2/1 in transfecting HFB,but neither AAV has a high transfection efficiency.

Objective To explore the correlation of peritumoral brain edema( PTBE)size,histologi-cal grades and the expression rate of Ki-67 in gliomas. Methods The data and specimens about 74 cases of gliomas in People's Hospital of Xinjiang Uygur Autonomous Region during 2010-2013 were collected. All cases were confirmed by surgery and pathology. According to preoperative MRI,PTBE was graded. Immunohisto-chemical discriminate the expression of Ki-67. HE coloration distinguish the histological grades. Results In this study,90. 54%(67/74)patients occured PTBE,the incidence of PTBE inⅠ,Ⅱ,Ⅲ,Ⅳlevel of groups were 100%(3/3),78. 95%(15/19),83. 33%(15/18),100%(34/34). Ki-67 expression was positive in 75. 68%(56/74)patients,and the rates were 0,36. 84%(7/19),94. 44%(17/18),94. 12%(32/34) in Ⅰ,Ⅱ,Ⅲ,Ⅳ level of groups. The expression rate of Ki-67 was 57. 14%(4/7),60. 00%(6/10),and 80. 70%(46/57)in normal group,Ⅰ-level groups of PTBE,Ⅱ-level groups of PTBE. The result of Kruskal-Wallis H showed that the PTBE from different grades was statistically significant(H=11. 304,P=0. 010). The expression rate of Ki-67 in different grade gliomas was statistically significant(H=38. 530,P﹤0. 05), The difference of expression Ki-67 in gliomas of different PTBE was statistically significant( H=6. 478,P=0. 039). The result of Spearman rank correlation analysis showed that the PTBE level increased with the histo-logical grade up in gliomas(r=0. 385,P=0. 001). The expression rate of Ki-67 increased with the histologi-cal grade up in gliomas(r=0. 692,P﹤0. 05),and the expression rate of Ki-67 increased with the degree of PTBE up in glomas( r =0. 256,P =0. 028 ). Conclusion Accorrding to the PTBE size,the histological grades and proliferation ability of glioma can be judged pre-operation. Ki-67 can be used as the indicator of pro-liferation activity of tumor,and also be used as the important basis of histological grades.

Objective To explore clinical characteristics of severe pre-eclampsia and eclampsia complicated with reversible posterior leukoencephalopathy syndrome(RPLS).Methods Clinical data of 31 cases of severe pre-eclampsia and eclampsia complicated with RPLS were studied retrospectively.ResulIs These 31 cases with RPLS accounted for 48% of those with eclampsia,.and all presented with hypertension,headache and disturbalice of vision,24 cases with seizure episodes,19 cases with nausea and vomiting and 13 with continuous dysphoria after seizure.Neuroradiologic findings showed edema predominantly in the bilateral posterior cerebral white matter,especially in occipital-parietal lobe,with low density lesions in CT and long T1 and T2 signals in brain MRI. Conclusions Severe pre-eclampsia and eclampsia tended to complicate with RPLS,presenting severe hypertension,headache,disturbance of vision and recurrent seizure as major clinical manifestations.

Objective To study the effect of exogenous prostaglandin E 1 (PGE 1) on the superoxide dismutase(SOD) and nitric oxide(NO) levels in brain tissue of neonatal rats with hypoxic-ischemic brain damage(HIBD).Methods Sixty 7-day old newborn Wistar rats to establish HIBD models,intraperitoneally and subcutaneous injected PGE 1 and TMP,then the rats were killed after hypo- xia and ischemia for 48 hours.Take cerebral cortex of arteria carotis ligation side and made them into homogenate to detect SOD and NO levels in brain tissue.Results SOD level in HIBD group was lower,and NO level was higher than those of normal group(P

Animals ; Epithelial-Mesenchymal Transition ; Fibrosis ; Kidney ; pathology ; Kidney Tubules ; cytology ; Male ; Rats ; Rats, Sprague-Dawley ; Ureteral Obstruction ; pathology

BACKGROUNDBreast cancer is one of the most common malignancies in women and is highly resistant to chemotherapy. Due to its high tumour selectivity, 3-bromopyruvic acid (3-BrPA), a well-known inhibitor of energy metabolism has been proposed as a specific anticancer agent. The present study determined the effect of 3-BrPA on proliferation, cell cycle and apoptosis in the human breast cancer MCF-7 cell line and other antitumour mechanisms.

METHODSMCF-7 cells were treated with various concentrations of 3-BrPA for 1 - 4 days, and cell growth was measured by 3-(4, 5-dimethylthiazol-2-yl)-2, 5-diphenyl tetrazolium bromide assay. Marked morphological changes in MCF-7 cells after treatment with 3-BrPA were observed using transmission electron microscopy. The distributions of the cell cycle and apoptosis were analyzed by flow cytometry. Immunohistochemistry was used to indicate the changes in the expression of Bcl-2, c-Myc, and mutant p53.

RESULTS3-BrPA (25 microg/ml) significantly inhibited the proliferation of MCF-7 cells in a time-dependent manner. The MCF-7 cells exposed to 3-BrPA showed the typical morphological characteristics of apoptosis, including karyopycnosis, nuclear condensation and oversize cytoplasmic particles. In addition, flow cytometric assay also showed more apoptotic cells after 3-BrPA stimulation. The cells at the G0 and G1 phases were dramatically decreased while cells at the S and G2/M phases were increased in response to 3-BrPA treatment after 48 hours. Furthermore, 3-BrPA stimulation decreased the expressions of Bcl-2, c-Myc and mutant p53, which were strongly associated with the programmed cell death signal transduction pathway.

CONCLUSION3-BrPA inhibits proliferation, induces S phase and G2/M phase arrest, and promotes apoptosis in MCF-7 cells, which processes might be mediated by the downregulation of the expressions of Bcl-2, c-Myc and mutant p53.

Antineoplastic Agents ; chemistry ; pharmacology ; Apoptosis ; drug effects ; Breast Neoplasms ; Cell Cycle ; drug effects ; Cell Division ; drug effects ; Cell Line, Tumor ; Cell Proliferation ; drug effects ; Female ; Flow Cytometry ; G2 Phase ; drug effects ; Humans ; Immunohistochemistry ; Molecular Structure ; Pyruvates ; chemistry ; pharmacology ; S Phase ; drug effects

AIMTo elevate the encapsulation efficiency, decrease the burst release and improve the release of protein entrapped in poly (lactic-co-glycolic acid) (PLGA) microspheres. The bovine serum albumin (BSA) composite microspheres of alginate-chitosan-PLGA were prepared and the release characteristics of BSA from this composite microspheres were studied.

METHODSThe much smaller calcium alginate microcapsules were first prepared by a modified emulsification method in an isopropyl alcohol-washed way and coated with chitosan, then the alginate-chitosan microcapsules were further entrapped in PLGA to form the composite microspheres. The protein concentration was determined using a BCA protein assay kit. The release profiles were changed with various formulation factors.

RESULTSThe average diameter of the composite microcapsules was about 30 microm. Comparing with 60% to 70% of the conventional PLGA microspheres, the average encapsulation efficiency was more than 80%, and the burst releases in phosphate buffer solution of the composite microspheres decreased from 40% and 50% to 25% and further to 5% in saline solution.

CONCLUSIONThe novel composite microspheres were prepared, the drug encapsulation efficiency increased and the burst release decreased. The desired release profiles could be obtained by regulating the ratios of PLG and PLA in the composite microspheres.

Alginates ; chemistry ; Chitosan ; chemistry ; Drug Delivery Systems ; methods ; Lactic Acid ; chemistry ; Microspheres ; Particle Size ; Polyglycolic Acid ; chemistry ; Polymers ; chemistry ; Serum Albumin, Bovine ; chemistry

Biopsy ; Histological Techniques ; instrumentation ; methods ; Humans ; Indicators and Reagents ; Paraffin Embedding ; Ultrasonics