Objective To explore the differences in autophagic expression levels between hypertrophic scar (HS) tissue and normal skin tissue,and further investigate the relationship between hypertrophic scar formation and autophagy protein expression through the rabbit ear hypertrophic scar model.Methods 30 patients with hypertrophic scar were collected.One hypertrophic scar tissue and one normal skin tissue were harvested.The relative expressions of LC3,P62 and Beclin-1 in each tissue specimen were detected by immunohistochemistry and Western blot.Western blot was used to detect the autophagic-associated protein LC3 (MAPLC3),P62 and Beclin-1 in the hypertrophic scar tissue of rabbit ear and the corresponding normal tissue of rabbit ears at 4 weeks,8 weeks,12 weeks,and 24 weeks,and further explore their clinical significance.Results In vivo,the expression of hypertrophic scar tissue protein LC3 and Beclin-1 was significantly stronger than that in normal skin tissue (P ＜ 0.05).The expression of P62 was significantly weaker than that in normal skin tissue (P ＜ 0.05).In animal experiments,during the process of HS formation,the protein expression of LC3 gradually increased,while the protein expression of P62 gradually decreased;the protein expression of Beclin-1 was higher than that of normal rabbit ears tissue,with statistically significant differences (P ＜ 0.05).Conclusions The expression of LC3 and Beclin-1 in human hypertrophic scar tissues is higher than that in normal tissues.While the expression of P62 is lower than that in normal tissues.That is,the expression of autophagy in human hypertrophic scar tissue showed an upward trend in a certain period of time,and was significantly higher than that in normal tissue.

Objective: To compare the curative effects between our self-designed flexible vertebroplasty device and the conventional straight bone cement injector in the treatment of osteoporotic thoracic compression fractures. Methods: A retrospective case-control study was conducted to analyze the clinical data of 140 patients with osteoporotic thoracic compression fracture who had been admitted to Department of Spine Surgery, Xi’an Honghui Hospital from June 2016 to January 2017. They were 61 males and 79 females, aged from 55 to 88 years (average, 70.3 years). Their fractured vertebrae distributed from T5 to T12. Our self-designed flexible vertebroplasty device was used in 67 of them (group A) while the conventional straight bone cement injector in the other 73 patients (group B). The 2 groups were compared in terms of operative time, amount of bone cement injected, distribution ratio of bone cement on the contralateral side, bone cement leakage, and visual analogue scale (VAS), anterior height ratio of the fractured vertebra and kyphosis cobb angle at 1 d, 1 and 2 years after operation. Results: The 2 groups were comparable due to their insignificant differences in preoperative general data (P>0.05). All the patients were followed up for more than 2 years, with an average of 26.7 months. There were no significant differences between the 2 groups in operation time (28.1±4.2 min versus 26.3±3.2 min) or in bone cement leakage [34.3%(23/67) versus 17.8%(13/73)] (P>0.05). However, group A was significantly higher than group B in amount of bone cement injection (5.6±1.2 mL versus 4.9±1.1 mL) and in distribution ratio of bone cement on the contralateral side (71.5%±11.3% versus 65.7%±12.9%), significantly lower than group B in VAS at 1 and 2 years after operation (2.8±0.7 and 3.0±0.9 versus 3.1±0.8 and 3.4±0.8) and in kyphosis cobb angle at 1 and 2 years after operation (25.2°±5.2° and 26.8°±5.5° versus 27.7°±4.9° and 29.1°±1.6°), and significantly higher than group B in anterior height ratio of the fractured vertebra at 1 and 2 years after operation (39.2%±8.1% and 37.1%±7.2% versus 35.4%±7.8% and 33.2%±8.4%) (all P< 0.05). There were no significant differences between the 2 groups in VAS, anterior height ratio of the fractured vertebra or kyphosis cobb angle at one day after operation (P>0.05). Conclusions Compared with the conventional straight bone cement injector, our self-designed flexible vertebroplasty device can lead to better contralateral distribution of bone cement, more effective maintenance of the height of injured vertebra, and better long-term analgesic effect in the treatment of osteoporotic thoracic compression fractures.

Objective: To compare the efficacy of unilateral and bilateral percutaneous kyphoplasty (PKP) for thoracolumbar osteoporotic vertebral compression fractures (OVCFs). Methods: A retrospective case control study was conducted to analyze the clinical data of 234 OVCFs patients admitted to Honghui Hospital affiliated to Xi'an Jiaotong University Medical College from June 2014 to January 2016. There were 95 males and 139 females, aged 60-89 years, with an average age of 68.3 years. The fractured segments included T₁₁ in 45 patients, T₁₂ in 65 patients, L₁ in 72 patients, and L₂ in 52 patients. A total of 116 patients were treated with PKP through unilateral puncture of transverse process and superior articular process (unilateral group), and 118 patients were treated with PKP through bilateral puncture of Magerl (bilateral group). The operation time, radiation exposure, bone cement injection and leakage were compared between the two groups. Visual analogue scale (VAS) and Oswestry dysfunction index (ODI) were used to evaluate the clinical efficacy and life quality improvement. The distribution of bone cement was observed by CT. The complications were recorded. Results: All patients were followed up for 25-36 months, with an average of 27 months. The operation time of unilateral group [(19.6±5.3)minutes] was significantly shorter than that of bilateral group [(35.6±8.9)minutes]; the radiation exposure [(0.65±0.22)mSv] was lower than that of bilateral group [(1.69±0.58)mSv]; the bone cement injection [(5.3±0.8)ml] was less than that of bilateral group [(6.5±1.3)ml] (P<0.05). The postoperative X-ray showed that 10 patients (8.6%) in the unilateral group and 22 patients (18.6%) in the bilateral group (P<0.05) were found with bone segment leakage, although without clinical symptoms. The postoperative VAS and ODI of the two groups were significantly improved than before operation (P<0.01), and there was no significant difference between the two groups (P>0.05). Bone cement was mainly distributed in the front and middle of the vertebral body (A2, B1, C2, D1) in the unilateral group and in the front 2/3 of the vertebral body (A, B, C, D) in the bilateral group. There were in total 10 patients with cerebrospinal fluid during intraoperative puncture, including two patients in the unilateral group and eight patients in the bilateral group (P>0.05). The puncture direction was adjusted during the operation, and there was no neurological damage after the operation. There were 16 patients with local pain caused by small joint injury, including two patients in unilateral group and 14 patients in bilateral group (P<0.05). The pain was relieved one month after physical treatment. A total of 30 patients had vertebral fracture again, including 18 in unilateral group and 12 in bilateral group (P>0.05), all of whom were treated with PKP again. Conclusion Compared with Magerl bilateral approach, PKP for OVCFs has the advantages of shorter operation time, less radiation exposure, low leakage rate of bone cement and good distribution of bone cement.

Objective: To analyze the differentially expressed microRNA (miRNA) and their target genes in peripheral blood and bone tissue of postmenopausal osteoporosis (PMOP), and provide basis for the study of pathogenesis as well as biomarkers identification of PMOP. Methods: Two miRNA datasets of PMOP from the public platform NCBI-GEO DataSets were obtained, including GSE64433 (the miRNA expression profile of peripheral blood samples, including 23 PMOP patients and 25 controls) and GSE74209 (the miRNA expression profile of the femoral neck bone tissue sample, including six PMOP patients and six controls). R/Bioconductor was performed for data analysis and differentially expressed miRNA screening, and miRNAs with fold change>2 & P<0.05 between osteoporosis and controls were selected as differentially expressed miRNA. The miRNA target gene prediction was performed by combining TargetScan, miRDB and miRTarBase databases. The miRNA-target gene regulatory network was constructed and analyzed by Cytoscape. Results: There were 224 differentially expressed miRNAs (75 up-regulated miRNAs and 149 down-regulated miRNAs) in the peripheral blood samples of PMOP group (GSE64433 dataset) and 132 differentially expressed miRNAs (58 up-regulated miRNAs and 74 down-regulated miRNAs) in the femoral neck bone tissue of PMOP group (GSE74209 dataset). We combined the results from the two datasets and obtained 8 miRNAs down-regulated in both datasets, and the 8 miRNAs regulated a total of 327 target genes, and 10 of these target genes were co-regulated by two miRNAs. Conclusions The core miRNAs and the target genes regulated by multiple miRNAs in the regulatory network may play important roles in the pathogenesis of PMOP and have potential application values as molecular biomarkers of disease. These findings are meaningful for the studies of PMOP pathogenesis, biomarkers screening and prevention of osteoporotic fractures.

Objective: To explore the safety and effectiveness of a novel percutaneous self-expanding forceful reduction screw system in the treatment of thoracolumbar fracture with severe vertebral height loss. Methods: Thirty-eight patients of thoracolumbar fracture with more than 50%vertebral height loss were treated with the novel percutaneous self-expanding forceful reduction screw between March 2014 and June 2015. The screw system is a single plane screw with a reduction angle of 0,3,6,9 degrees. During the operation, the fracture vertebral body was automatically restored during the locking process of the top cap. All the patients were single vertebral fractures. Percutaneous screw fixation and reduction was used in the operation. Two groups of screws were used to fix the two adjacent vertebrae of the injured vertebra and to restore the injured vertebral body, without fusion treatment. The vertebral body index (VBI), height of the anterior margin of fractured vertebra (HAMFV), vertebral body angle (VBA), bisegmental Cobb angle (BCA), visual analog scale (VAS) and Oswestry disability index (ODI) of the patients before and after operation, 6 months after operation, and at the end of the follow-up were compared. The scoring results were compared using a t test. Results: The operation was completed successfully in 38 cases. A total of 152 screws were placed. The accuracy rate of CT evaluation was 98.7%. The average operation time was 90.7±21.9 min, and the average intraoperative bleeding amount was 89.2±31.9 ml. The patients' preoperative VBI, HAMFV, VBA, BCA, VAS and ODI scores were 0.38±0.07, 0.38±0.06, 25.45°±4.54°, 18.66°±8.57°, 7.76±1.02, and 44.58%±2.33%, respectively. The postoperative measurements were 0.93±0.03, 0.95±0.02, 3.71°± 1.35°, 5.84°±6.80 °, 4.29±1.16 and 24.37%±1.88%. At the last follow-up, the measurements were 0.92±0.03, 0.94±0.02, 3.89° ±1.31°,6.05°±7.00°, 1.71±0.65 and 5.95%±2.67%. There was significant difference between the preoperative and postoperative data, as well as the preoperative and the last follow-up data (P<0.05). Conclusion In the treatment of thoracolumbar fractures with severe loss of vertebral height, the novel percutaneous self-expanding forceful reduction screw system has achieved satisfactory vertebral height restoration and kyphosis correction.

Two patients with primary hypertrophic osteoarthropathy (PHO) and their available healthy family members were studied.All exons of the SLCO2A1 and HPGD gene and adjacent exonintron sequences were amplified by PCR and subsequently sequenced.To assess the damaging effects of missense mutations in silico,the online database,PolyPhen-2 and SIFT were used.We identified two homozygous mutations in SLCO2A1 gene:one was c.1106G＞A (p.G369D) in exon 9,the other was c.611C＞T (p.S204L) in exon 4.No HPGD mutation was found in the affected individuals.The two mutation were predicted in silico by the bioinformatic tools.Our study further supports the role of mutations in the SLCO2A1 gene in the pathogenesis of PHO.Identification of the genotype in PHO may not only help the clinical diagnosis of PHO but also help the interpretation of genetic information for prenatal diagnosis and genetic counseling.

Objective To investigate the infection status, serotype distribution, drug sensitivity and molecular characteristics of diarrheagenic Escherichia coli (DEC) in patients with diarrhea in Guangdong Province. Methods Fecal samples were collected, cultured and isolated by traditional methods. Suspected Escherichia coli isolates were confirmed by multiplex PCR used for detecting specific virulence genes and bio-chemical methods. Positive strains were serotyped, characterized for drug sensitivity and analyzed by pulsed-field gel electrophoresis ( PFGE). Results The total positive rate of DEC in patients with diarrhea was 6.26%. The positive rates of enteropathogenic Escherichia coli (EPEC), enterotoxigenic Escherichia coli (ETEC), enterohemorrhagic Escherichia coli (EHEC), enteroadherent Escherichia coli (EAEC) and en-teroinvasive Escherichia coli (EIEC) were 2. 47% , 1. 54% , 1. 32% , 0. 62% and 0. 09% , respectively, with infections primarily in children aged 0-<7 years. The total seropositive rate was 52. 54% , with EHEC accounting for 15. 00% . DEC showed high sensitivity to imipenem, ciprofloxacin, ceftazidime and cefo-taxime. The multidrug resistance rate of DEC was 58. 45% , with EPEC being the most serious for multidrug resistance. PFGE results showed that ETEC, EHEC, EPEC and EAEC had a high degree of polymorphism. Conclusion EPEC is the predominant type of DEC circulating in Guangdong Province. Third-generation cephalosporins are the first drugs of choice for treating infections in children. Ciprofloxacin can be used to treat adults. The problem of multiple drug resistance of DEC is severe and efforts to monitor DEC infections and drug resistance should be strengthened.

Objective To observe the effect of retinal hemorrhage on the treatment of retinopathy of prematurity (ROP) by laser photocoagulation.Methods Retrospective case analysis.Screening and diagnosis of 134 eyes in 67 patients with ROP in Zone IⅡ Stage 3+ were included in the study.Among them,32 patients were male and 35 patients were female.The average birth gestational age was 27.80 ± 2.55 weeks.The average birth weight was 1060± 320 g.All children underwent binocular indirect ophthalmoscopy and RetCam Ⅲ.Of the 134 eyes,38 eyes (28％) with anterior,ridge or vitreous hemorrhage (group A);96 eyes (72％) without hemorrhage.Retinal avascular photocoagulation was performed within 72 hours after diagnosis by intravenous sedative combined with ocular surface anesthesia with 810 nm laser.Follow-up was performed at 1,4,8 and 12 weeks after treatment,and then every 6 months thereafter.The same equipment and methods before treatment were used to examine and document the regression and progression of ROP.The number of eyes with lesions after photocoagulation in the two groups was compared by x2 test.The t-test was used to compare the gestational age and birth weight.Results Among 134 eyes,lesions completely resolved in 125 eyes (93.3％),progressed in 9 eyes (6.7％).In group A,7 eyes were progressive (18.4％).In group B,2 eyes were progressive (2.1％).There was a statistically significant difference in the number of eyes with lesions after laser treatment in group A and B (x2=9.14,P=0.003).There was no significant difference in birth gestational age and birth weight (t=0.85,0.25;P=0.40,0.80).Conclusion The laser photocoagulation is safe and effective in the treatment of ROP.The preretinal,ridge or vitreous hemorrhage is related to the progression of the lesion after laser photocoagulation.

Objective To analyze the serotype distribution and antibiotic resistance characteristics of Salmonella strains isolated in Guangdong province for better understanding the condition of Salmonella infection in patients with diarrhea.Methods Fecal samples collected from patients with diarrhea in Guangdong province were used to isolate Salmonella strains.Biochemical analysis was performed to identify these isolated strains.Serotyping and antimicrobial susceptibility testing were carried out for further analysis of the isolated Salmonella strains.Results The rate of Salmonella infection was 7.64％in 2015, and the male to female patient ratio was 1.52∶1.A total of 2 377 patients of all age groups were positive for Salmonella infection and the patients aged 0-6 years accounted for 81.74％.The isolation rate of Salmonella strains in the summer and autumn was higher than that in the winter and spring (10.73％ vs 4.24％;X2=463.77, P<0.01).The Salmonella isolation rates in different areas were as follows: 16.82％ in Zhuhai, 15.85％ in Heyuan, 11.81％ in Yangjiang, 10.68％ in Jiangmen, 8.49％ in Zhongshan, 8.07％ in Maoming, 8.05％ in Jieyang, 7.35％ in Shaoguan, 6.97％ in Foshan, 6.03％ in Dongguan, 5.48％ in Guangzhou and 0.00％ in Zhanjiang.And the differences between different regions were statistically significant (X2=367.67, P<0.01).The 2 377 isolated Salmonella strains were classified into 108 serotypes except for oneSalmonella strain that could not be classified.The top four predominant serotypes were 4,5,12:i:-, Salmonella enteritidis,Salmonella stanley and Salmonella typhimurium.Most Salmonella strains were sensitive to imipenem, azithromycin, ceftazidime, cefotaxime and trimethoprim/sulfamethoxazole, but multidrug resistance was common among those strains.Conclusion Salmonella serotypes of 4,5,12:i:-and Salmonella enteritidis are the predominant pathogens causing human Salmonella infections in Guangdong province.Ceftazidime and cefotaximeare are preferred in the treatment of Salmonella infections.Surveillance for drug resistance in Salmonella should be strengthened as multidrug resistant strains have become a serious problem in Guangdong province.

ObjectiveTo predict the target genes of miRNA associated with hsa_circRNA_102802 and hsa_circRNA_104597 using bioinformatics methods,and analyse the biological process and signaling pathway.MethodsTargetscan,miranda and mirbase three online database were used to predict target genes of miRNAs which are complementary to circRNAs.Target genes of miRNAs prediction results were taken their intersection of three online database,then take their collection as total target genes of miRNAs.The results were analyzed by gene ontology(GO) and KEGG pathway analysis using FunNet.Results199 target genes of has_miR_204_5p,has_miR_809,has_miR_520_5p,has_miR_423_5p,has_miR_617 and has_miR_877_5p were gotten from the intersection of 3 databases;and 410 targets of has_miR_659_3p,has_miR_9_5p,has_miR_661,has_miR_576_3p,has_miR_548d_5p,has_miR_548a_5p,has_miR_548b_5p,has_miR_876_5p and has_miR_744_5p were gotten from the intersection of 3 databases.GO analysis showed that Target genes involved in diverse biological processes including central nervous system,such as cortex development,axon guidance and extension,synaptic transmission,as well as the process of learning and memory (P<0.05).Enriched pathways were also revealed target genes involved in the signal path including the axon guidance,glutamic acid synapses,Wnt signaling pathway,ErbB signaling pathway,mTOR signaling pathway and VEGF signaling pathway,which connect closeiy with depression.hsa_circRNA_102802 and hsa_circRNA_104597 may play an important role in depression.Conclusionshsa_circRNA_102802 and hsa_circRNA_104597 may be associated with the pathologenesis of depression disorder.