Objective To outline the classification of spinal tuberculosis based on MRI findings (Southern Medical University classification,SMU classification) and explore its use in the diagnosis,surgical protocols.Methods The MRI data from 230 cases with spinal tuberculosis were analyzed retrospectively.Our classification system was based on clinical and radiological criteria (abscess formation,disc degeneration,vertebral collapse,kyphosis,sagittal index,instability and neurological problems).The surgical strategies were made according with this classification.Results Two hundred and thirty cases with spinal tuberculosis were classified into the 5 types.There were signal change type (type Ⅰ) in 28 cases,abscess formation type (type Ⅱ) in 39,vertebral collapse type (type Ⅲ) in 78,canal compression type (type Ⅳ) in 46 and kyphosis type (type Ⅴ) in 39 respectively.In type I lesion,25 patients had been followed up.Twenty patients were treated medically.Recurrence of tuberculosis was found in 2 cases.Surgical meticulous debridements were done in 5 cases without recurrence.In type Ⅱa lesion,6 patients were treated medically.The other 6 patients underwent surgical meticulous debridement with recurrence occurred in one patient.There was no difference between medical and surgical treatment regarding outcomes in patients with type Ⅰ and Ⅱa lesion.In type Ⅱb-Ⅴ,surgical treatments were carried out according to the pathological changes.There was no difference between medical and surgical treatment regarding outcomes in the patients with type Ⅱb-Ⅴ.Conclusion The SMU classification helps in differentiating the various manifestations of spinal tuberculosis and appears to correlate with the surgical treatment of spinal tuberculosis.We believe that this new classification system can be used as a practical guide in the treatment of spinal tuberculosis.

ObjectiveTo assess left ventricular twist and untwist in rabbit models with diastolic heart failure(DHF) and systolic heart failure(SHF) by speckle tracking imaging(STI).Methods Thirtythree male New Zealand rabbits were divided into three groups:one group was used to establish DHF model by suprarenal abdominal aortic constriction(n = 12) and the other was used to establish SHF model by abdominal aortic constriction subdiaphragmly above celiac artery origin(n = 11),another was control group established by sham operation(n = 10).After two weeks,left ventricular twist-related parameters were measured.by STE.Finallly,left ventricular catheterization and myocardial pathological examination were performed.Results Compared with control group,peak twist angle (Ptw) and peak twisting velocity(PTV)remained unchanged in DHF group (P ＞ 0.05) and decreased in SHF group (P ＜ 0.05).Isovolumic untwisting rate (IUR) decreased,untwisting half-time(UHT) was prolonged,time to peak twist (tPtw) and peak untwisting velocity (tPUTV) were delayed in SHF and DHF groups.In additon,Peak untwisting velocity(PUTV) decreased in SHF group,but increased in DHF group (P ＜0.05).Ptw correlated correlated positively with LVEF,+ dp/dtmax significantly in both groups (DHF group:r = 0.897,P =0.002; r = 0.719,P = 0.044;SHF group:r = 0.727,P = 0.041; r = 0.780,P = 0.022).A significantly positive correlation was observed between PUTV and - dp/dtmax Tau,LVEDP(r = 0.801,P = 0.017; r =0.814,P = 0.014; r = 0.875,P = 0.004) in SHF group.Conclusions STI is useful in evaluating left ventricular twist and untwist in rabbit model of DHF and SHF.

AIM: To investigate the role of Forkhead box M 1 ( FoxM1 ) and B-cell leukemia/lymphoma-2 (Bcl-2) in the pathogenesis of acute myeloid leukemia (AML).METHODS:RT-qPCR and immunofluorescence analysis were used to determine the expression of FoxM 1 at mRNA and protein levels in AML-de novo patients, AML-complete re-mission (CR) patients, AML-refractoriness and relapse (RR) patients and healthy controls.HL60 cells and K562 cells were transfected with FoxM1 siRNA.The cell proliferation was detected by cell proliferation assay and colony formation as-say on soft agar, and the cell apoptosis was determined by flow cytometry .The expression of FoxM1 and Bcl-2 at mRNA and protein levels was detected by RT-qPCR and Western blotting .The activity of bcl-2 promoter was examined by lucifer-ase reporter assay with FoxM1 targetting.RESULTS:FoxM1 expression level in the AML-de novo patients was significant-ly higher than that in the healthy controls .As compared with the AML-de novo patients, FoxM1 expression in the AML-CR patients was reduced , and the FoxM1 expression level was the highest in the AML-RR patients .FoxM1 expression was in-hibited in the HL60 cells and K562 cells transfected with FoxM1 siRNA.Transfection with FoxM1 siRNA in the HL60 cells and K562 cells inhibited the proliferation as compared with NC siRNA transfection , and impaired the colony formation abili-ty.On the contrary , transfection with FoxM1 siRNA promoted the cell apoptosis .FoxM1 regulated bcl-2 expression posi-tively.CONCLUSION:FoxM1 promotes the development of AML by regulating bcl-2 expression.Silencing of FoxM1 ex-pression suppresses cell proliferation and promotes cell apoptosis .FoxM1 is a potential target for AML treatment .

Objective To observe the effect of ultrasound-guided injection of botulinum toxin type A (BTX-A) combined with orthosis training for the treatment of lower limb spasticity for children with cerebral palsy.Methods Fifty-four patients with spastic cerebral palsy were randomly divided into an observation group and a control group using a random number table.Patients in the control group were given conventional rehabilitation training,while those in the observation group were additionally given ultrasound-guided BTX-A injection,followed by daily knee-ankle-foot orthosis rehabilitation training 24 h after the injection.Before and 6 weeks after treatment the lower limb function of the 2 groups was evaluated using the modified Ashworth scale (MAS) and the gross motor function measure (GMFM).Adductor angles,popliteal angles and motor ranges of the ankle joint were also measured and compared.Results After 6 weeks the average MAS scores were lower than before treatment in both observation[(1.26±0.63) vs (3.07±0.68)] and control group [(2.56±0.71) vs (2.89±0.64).And in both groups the average GMFM scores,adductor angles and popliteal angles,as well as range of motion of the ankle were all much better than before treatment.The observation group,however,improved significantly more than the control group(P ＜ 0.05).Conclusion Ultrasound-guided injection of BTX-A can effectively alleviate spasticity of lower extremity for children with cerebral palsy with accurate positioning,obvious curative effect and less adverse reactions.Knee-ankle-foot orthosis rehabilitation training after the injection can further alleviate spasticity and improve the motor function of the limbs.

AIM:To study whether inhibition of forkhead box protein M1(FoxM1) sensitizes leukemia K562 cells to homoharringtonine ( HHT ) .METHODS: K562 cells were incubated with HHT at different concentrations ( 0μmol/L, 0.015 μmol/L, 0.030μmol/L and 0.045μmol/L) for different time (0 h, 24 h, 48 h and 72 h).The mRNA and protein levels of FoxM1 were detected by real-time PCR and Western blot.FoxM1 siRNA was transfected into K562 cells with 0.015μmol/L HHT after 6 h.After 72 h incubation, the cell proliferation was detected by cell counting and soft agar assay, and the proportion of apoptotic K562 cells was determined by flow cytometry.The expression of c-Myc and Sp1 were detected by real-time PCR and Western blot.RESULTS:FoxM1 expression was reduced time-dependently and dose-dependently, suggesting that HHT mediated the downregulation of FoxM1 in K562 cells.In K562 cells, treatment with FoxM1 siRNA and HHT inhibited the cell proliferation and promoted the apoptosis significantly.Therefore, inhibition of FoxM1 sensitized leukemia K562 cells to HHT.The expression of c-Myc and Sp1 was positively regulated by FoxM1. CONCLUSION:HHT inhibits Forkhead box protein M1 expression in K562 cells.Inhibition of FoxM1 sensitizes K562 cells to HHT.

Nerve agent not only inhibit acetylcholinesterase ( AChE) at an early stage, but also induce prolonged and progressive neuroinflammation and delayed neurodegeneration.Recently, the US National Institute of Health ( NIH) has sponsored some major programs of toxic mechanisms and treatment of nerve agents, which aims at the development of quick and effective treatment to acute intoxication and delayed effect.The experimentally effective new antidotes mainly include AChE-targeting drugs, broad-spectrum reactivators and scavengers, antiinflamatory and nerve protection drugs.

BACKGROUND:In recent years, many manufacturing techniques have been recently developed for soft tissue engineering scaffolds. Especialy additive manufacturing with a unique material accumulated forming principle can be feasible and reliable to manufacture the highly precise scaffolds with gradient structures and multi-materials for large soft tissue defect repairing.
OBJECTIVE:To summarize scaffolds manufacturing technologies in the soft tissue engineering applications developed in recent years and to predict the direction of development.
METHODS: A retrieval was performed for the literature about the manufacturing methods of soft tissue scaffolds using key words of “additive manufacturing, microfabrication, vascular tissue engineering, muscle tissue engineering, cartilage tissue engineering, stereolithography, 3D printing, biodegradable hydrogel” in English and Chinese, which were published between January 2010 and September 2013 in PubMed Database and China National Knowledge Infrastructure (CNKI) Database.
RESULTS AND CONCLUSION:For large soft tissue defects repairing, structure design of the scaffolds has been shifted from a simple planar structure to a more complex three-dimensional structure, and integration of scaffold structure, materials and cels, and growth factors during the manufacturing procedure can be used to obtain the resolution of vascularization. Additive manufacturings become one of the most promising approaches for the ideal soft tissue scaffolds with gradient and complex structure and multi-materials. In particular, the hydrogel/cellcomposite scaffolds fabrication, a hot but promising approach to develop the soft tissue engineering wil be made progress by the accurate principles and processes of the hydrogel additive manufacturing combined with the introduction of living cels and growth factors.

The simulator testing in vitro and computational simulation of the artificial knee joint wear are important methods to evaluate the wear performance of the prosthesis in vitro and to predict the clinical performance of knee joint products. Based on the method of literature search, this paper compares the mechanical and kinematic loading input curves carried out by Chinese scholars in recent years, standard curves, and Chinese measurement curves of two typical movements of gait. Data of vitro simulator test and computational simulation model are compared, summarized, and analyzed. The results show that the measured data of motion and load cannot be directly used as the loading conditions for the simulator wear test and computational simulation. The mechanics and kinematics data of Chinese people are different from the international standards. The domestic artificial knee joint in vitro simulator wear test methods are similar but the results of different test institutions are somewhat different. The computation wear prediction research is basically synchronized with foreign countries, but the problem that the calculated wear results are lower than that in vitro test is still unsolved. The artificial knee joint wear performance evaluation system based on Chinese knee joint mechanics and kinematics data is the forward direction of the research.

Objective To investigate the effects of mefformin on the differentiation of osteoclastas well as relative mechanism.Methods Raw264.7 cells from the murine macrophage cell line was used.Receptor activator of NF-κB ligand (RANKL) was used to stimulate osteoclast differentiation from Raw264.7 cells.Osteoclast differentiation was assessed by tartrate-resistant acid phosphatase (TRAP) and actin fluorescence staining and counting the TRAP-positive cells after exposure to different concentrations of mefformin (0 μmol/L,400 μmol/L,800 μmol/L and 1000 μmol/L) or rapamicin (100 nmol/L) in the presence of 50 ng/ml RANKL for 5 days.Bone-resorbing activity was evaluated by BD BioCoatTM OsteologicTM Bone Cell Culture System.The expression of osteoclast-specific genes like TRAP,capthesin K,calcitonin receptor (CTR) and matrix metalloproteinase (MMP-9) was evaluated by RT-PCR.The expression of tumor necrosis factor-α(TNF-ct) S6K1Thr389,S6 Ser235/236,4E-BP1Thr37/46 and c-Fos protein was evaluated by ELISA kit and Western blot analysis,respectively.Results Mefformin dose-dependently inhibited RANKL-stimulated osteoclasts differentiation in Raw264.7 cell culture,as manifested by decrease of TRAP-positive multinucleated cells and pit erosion area,down-regulation of TRAP,cathepsin K,CTR and MMP-9 mRNA and reduction of TNF-α and c-Fos protein expression.Further study revealed that RANKL activated mTOR complex 1(mTORC1) signaling,while mefformin impaired RANKL-stimulated mTORC1 signaling.Rapamycin,an mTORCl-specific inhibitor and immunosuppressive macrolides could also prevent RANKL-induced osteoclast differentiation and bone resorption in vitro.Conclusion Mefformin inhibits osteoclastogenesis in vitro,which may due to reduction of TNF-α and c-Fos protein expression,and mTORC1 signaling is involved in this process.

Objective To investigate changes in gait level of patients after hip replacement, the variation trend of bone mineral density (BMD) around the prothesis was studied, so as to reveal the influence pattern of gait level at postoperative initial and long-term stages on bone reomodeling. Methods Based on adaptive bone remodeling theory, the finite element model of femer-prosthesis was developed. The BMD distribution was calculated using the initial and long-term gait level after hip replacement as the remodeling parameters. Gruen method was applied to quantify the BMD changes. Results At the postoperative initial stage, obvious variations existed in constant gait group and changing gait group. The maximum difference occurred in low gait group, resulting in the decrease of BMD by 41% in greater trochanter region. The improvement of gait level would promote the enhancement of BMD in proximal and middle region of the prosthesis, resulting in the increase of BMD by 47%. Long-term gait recovery would promote BMD recovery in middle and end region of prosthesis, with BMD increase by 2%-9%. Conclusions The research findings provide guidance for rehabilitation process of patients after hip replacement.