Objective To compare the clinical outcomes of selective thoracic spinal fusion in adolescent idiopathic scoliosis using either iliac bone or autologous rib combined with allografts. Methods A retrospective study was made in 84 cases of idiopathic thoracic scoliosis, who were operated on with posterior instrumentation of CD, CDH or TSRH from 1999 to 2000. These patients were divided into two groups. In Group A, 34 patients, who were 12 to 20 years with a mean age of 14.5 years with a mean Cobb angle 56?(range, 40? to 82?), received autologous iliac bone grafting, and no thoracoplasty were performed. In group B 50 patients, who were 13 to 19 years with a mean age of 15.4 years with a mean Cobb angle of 54? (range, 38? to 80?), had allograft bone grafting combined with the ribs from thoracoplasty. The patients were followed up for at least 2 years with an average of 3.4 years regarding the clinical and radiographic outcomes. Results For group A, an average of 73.2% correction rate was achieved, and average 10% loss of correction and 3% of pseudoarthrosis was recorded at 2 year follow-up. The incidence of donor site morbidity was 26%, which included deep infection, hematoma, delayed healing of incision and continuous pain. For group B, an average of correction rate was 70.4% with 9% average loss of correction and 2% of pseudoarthrosis at 2 year follow-up. The complications related to thoracoplasty consisted of intraoperative tear of parietal pleural, pneumothorax, effusive pleuritis, and chest pain. Conclusion The clinical outcomes are comparable between the group of iliac bone grafing and the group of rib grafing associated with allografts in terms of fusion rate and loss of correction. If chose appropriately, allografts plus autologous rib harvested from thoracoplasty will be a good alternative to iliac crest regarding its safety, efficacy and reliability.

[Objective] To evaluate the surgical techniques and its clinical results of CDH Legacy in the treatment of scoliosis.[Method]Nine patients(7 female and 2 male)with scoliosis instrumented with posterior CDH Legacy system were recruited for this retrospective study.The etiological classification of scoliosis were idiopathic for 7,congenital for 1,neurofibromatosis(NFl)for 1.The average age was 13.5 years(ranged 11～18 years).The average preoperative Cobb's angle was 54?(ranged 48?～68?).Seven AIS and one CS patients received one stage posterior CDH Legacy instrumentation;the NFl patients received one stage anterior epiphysiodesis and second stage posterior CDH Legacy instrumentation.[Result]There was no death,no infection and no neurological complication.No intra-operative fracture,no dura matter or pleuml laceration occurred.Superior Mesenteric Artery Syndrome occurred in one patients and recovered with conservative treatment.Posterior Cobb's angle averaged 20? with correction rate of 63%.The duration of follow-up averaged 23 months(ranged 20～30 months).Surgical time averaged 260 min(ranged 210～300 min)and mean EBL was 700 ml(300～1 000 ml).Bony fusions were achieved in all patients and no coronal or sagittal plane decompensation occurred.The loss of correction at last follow-up was 4? with 7.4% loss of correction rate.[Conclusion]The clinical results of CDH Legacy are as good as the other three generation implants,its advantage lies in lower profile,solid inter-locking,versatile implants and handy manipulation.

0.05). No death, pseudoarthrosis, or implantation failure occurred. Conclusions One-row portal pattern is suitable for patients with long-segment deformity and short anteroposterior thoracic diameter, while double-row portal pattern is suitable for patients with short-segment deformity and long anteroposterior thoracic diameter.

Objective To evaluate the expression of Survivin,PTEN in tongue squamous cell carcinoma (TSCC) and the correlation with vascular endothelial growth factor (VEGF) and its clinical significance.Methods The expression of Survivin,PTEN and VEGF of 72 TSCC samples and 15 normal tongue mucosa (NTM) samples were detected by immunohistochemical method.Results The positive expression rate of Survivin,PTEN and VEGF in TSCC were 66.7％(48/72),61.1％(44/72),70.8％(51/72)respectively,while the positive expression rate in NTM were 0,100.0％ (15/15),0.There were statistical significance between the rate in TSCC and NTM respectively (P ＜0.01 ).The expression of Survivin and VEGF in TSCC were positively correlated with TNM stage,histological grade and lymph node metastasis (P＜ 0.05 or ＜ 0.01 ),while the expression of PTEN had negative correlation with them (P＜ 0.05 or ＜ 0.01 ).The expression of Survivin was positively correlated with VEGF expression in TSCC (r=0.6482,P＜0.01),while the expression of PTEN was negatively correleted with VEGF expression (r =-0.4027,P ＜0.01).Conclusions The expression of Survivin and PTEN in TSCC are associated with tumor occurrence and development closely,and are both significantly correlated with VEGF.Joint detection of Survivin,PTEN and VEGF have important reference value in clinical diagnosis,metastasis and prognosis of TSCC.

[Objective]To determine a surgical plan for the treatment of scoliosis. [Methods]A consecutive series of scoliosis patients were admitted from Oct. 1,2007 to Feb. 29,2008. The preliminary operation programs (including diagnosis,operative approach,upper instrumented vertebra,lowest instrumented vertebra,whether to need selective fusion of main thoracic curve and multiple operations) were formulated by the attending physicians.Preliminary operation programs were decided on by a symposium. A comparison was made between the two kinds of programs.[Results]Data from 143 consecutive scoliosis patients were reviewed. The average age at the time of operation was 16.1 years (2-49 years) and the average curve was 56.9? (range,15?~115? ). There were 6 spine surgeons involved in the study. The accepted programs formulated by the symposium occurred in 46 (32.2%) cases. One of these cases was changed in surgical approach and need selective fusion of main thoracic curve,19 in upper instrumented vertebra and 29 in lower instrumented vertebra. There were no changes in diagnosis and need multistage operations. Operation programs were difficult to formulated in patients aged less than 20,with Cobb's angle≤70?and thoracic curve patterns. [Conclusion]Preoperative symposium for treatment of idiopathic scoliosis influenced the preliminary operation programs in 32.2%. Sympoium appears to have a significant role in drawing up a more perfect operation program.

Recently,the progress in employing transplanting stem cells to cure injured retina is very fast and has been continuously yielding exciting results.Various sources are used in the studies,including retina-derived cells such as M?ller cells and ciliary body cells,and non-retina-derived cells such as embryonic stem cells and brain-derived stem cells.This review briefly discusses the recent progress of these studies.

Objective To observe the safety and efficacy of the posterior spinal instrumentation (PSI) with preserving of the intraspinal rib head in neurologically intact patients with scoliosis secondary to Neurofibromatosis type 1 (NF1).Methods The clinical and radiographic data of nine NF1 scoliosis patients with rib head protrusion into the spinal canal,who had undergone PSI from August 1998 to March 2012,were retrospectively investigated.The average age of these patients (4 males,5 females) was 15.4±7.6 years,and their neurological status all were Frankel grade E preoperatively.The intraspinal rib head was not resected in all patients intraoperatively.The following parameters,including the magnitude of rib head penetration into the spinal canal (MRPC),the angle between the bilateral rib (ABR),the angle between the dislocated rib and the posterior vertebral wall (ARV),the coronal Cobb angle and the sagittal Cobb angle,were measured before and after surgery.Results The follow-up period was 0.5 to 4.8 years.The average MRPC decreased from preoperative 32.8％±9.9％ to postoperative 16.8％±15.2％ (P=0.026); the average ARV increased from preoperative 34.7°±16.4° to postoperative 47.8°±17.5° (P=0.001); the average ABR decreased from preoperative 83.0°±19.5° to postoperative 67.9°±13.3° (P=0.009); the average coronal Cobb angle decreased from preoperative 70.7° ±17.7° to 35.4°±17.0° immediately after operation (P=0.000) and the sagittal Cobb angle decreased from preoperative 59.7°±17.6° to 24.7°±10.8° immediately after operation (P=0.001).The coronal Cobb angle and sagittal Cobb angle had no significant change during follow-up period.The neurological status was Frankel grade E in all patients immediately after operation and at final follow-up.Conclusion For NF1 scoliosis patients with rib head penetration into the spinal canal without impingement of the spinal cord and neurological deficits,the deformity can be corrected safely and effectively without resecting the intraspinal rib head.

ObjectiveTo investigate the protective effect of astragalosideⅣ pretreatment against liver ischemia/reperfusion (I/R) injury in mice.MethodsSixty male C57BL/6 mice were randomized into four groups (15 mice in each group):group A:sham surgery with saline injection,group B:sham surgery with astragalosideⅣ injection,group C:I/R group with saline injection,group D:I/R and astragalosideⅣ injection.Mice were pretreated by daily intraperitoneal injection of saline or astragalosideⅣ (24 mg · kg-1 · d-1 ) for one week.The mouse partial liver model of I/R injury was established,and samples were collected at the 24 h after the I/R injury.Serum ALT and AST levels were determined,the histologic changes were observed by H&E staining under the light microscopy,whereas the nuclear factor (NF)-κB was assessed with Western blotting.Serum IL-1β,IL-6,and TNF-α levels were measured by enzyme-linked immunosorbent assay (ELISA). ResultsSerum ALT and AST levels significantly decreased and the histological damage was significantly alleviated in astragalosideⅣ treated I/R group as compared with saline I/R group [ AST:C:(4290± 292) U/L vs.D:(2373± 416) U/L t =0.844 ; ALT:C:(4146±500) U/L vs.D:(2318±289) U/L t =7.08 P ＜0.05].In comparison with group 3,astragalosideⅣ reduced NF-κB nuclear expression.ELISA showed astragalosideⅣ significantly inhibit the levels of IL-1 β,IL-6,and TNF-α in the serum (IL-1β:t =10.04;IL-6:t =6.281;TNF-α:t =6.817; P ＜0.05).ConclusionsPretreatment with astragaloside Ⅳ effectively protect against liver ischemia/reperfusion injury in mice.

Objective To study whether the uremic toxins accumulated long-term in uremia patients may be involved in oxidation of protein by forming advanced oxidative protein products (AOPPs). Methods Malonylaldehyde (MDA), hippuric acid (HA) and p-cresol were used as the representatives of uremic toxins. Human albumin serum (HSA), plasma specimens from normal or uremia patients were incubated respectively with MDA (10 retool/L), HA (20 mmol/L) and p-cresol (10 retool/L) or PBS (20 retool/L, pH 7.4, as control groups) at 37℃ for 30 minutes or 24 hours, respectively. Those indices such as AOPPs, protein thiol groups (Pt-SH) and dityrosine were used as biomarkers of protein injury. High performance liquid chromatography (HPLC) was employed to identify the aggregation and cross-links of modified proteins. Results AOPPs levels in all groups containing poison compounds were significantly increased by 121.5%(P<0.05) compared to that in control groups. Uremic toxins also resulted in over 14.7% loss in Pt-SH (P< 0.05) and 119.2% increment in dityrosine, respectively (P<0.05). Meanwhile, the formation of HMW-AOPPs in a time-dependent manner was observed by HPLC and cross-linked protein levels were significantly increased by 148.45%～333.3% in comparison with control groups. Conclusion Uremic toxins can directly mediate the damage of proteins by inducing the formation of HMW- AOPPs in a time-dependent manner, which is also one of the mechanism of AOPPs production in vivo besides the activation of the myeloperoxidase-H2O2-Cl pathway.

Objective To investigate the gender difference in the smile aesthetic features in aged Han Chinese with normal occlusion and its clinical significance.Methods Fifty-six aged Han Chinese (male:28,female:28,aged 60-66 years)with normal occlusion were included in this study.Smiling images of the resting-position and mandibular postural position were obtained in an anteriorposterior view.The CoSmileMAA1.0 software was used to evaluate the indices associated with the smile-aesthetic features,and its clinical significance was analyzed.Results Significant differences were noted in the nasal ala width,upper lip length,lip clearance,angle oris width in resting-position/ smiling position together with the changes of lip clearance,angle oris width,distance of inferior margin of upper lip to cutting edge of the maxillary incisor teeth,distance of superior border of lower lip to cutting edge of the maxillary incisor teeth,smile line ratio and type of smile (all P＜0.05).When the subjects were smiling,the changes of lip clearance was greater in females than in males [(10.7±1.9)mm vs.(11.3±1.6)mm,P＜0.05],the changes of angle oris width was greater in males than in females [(14.1±1.6)mm vs.(13.4±1.3)mm,P＜0.05],and the smile line ratio was less in males than in females [(0.9±0.2) vs.(1.1±0.5),P＜0.05],which indicate that the females had more attractive smile in aged Han Chinese with normal occlusion than males.The type of smile was mainly high smile in elderly females and median smile in elderly males [53.6％ (15 cases) and 60.7％ (17 cases),x2 =6.43,P＜0.05].Conclusions Significant gender difference is noted in the smile-aesthetic features in aged Han Chinese with normal occlusion.Modulation of maxillary incisor teeth length and smile line ratio can contribute to the aesthetic appearance of smiling.