OBJECTIVE: To investigate the influence of posterior osteotomy on spinopelvic parameters in lumbar degenerative kyphosis (LDK) patients. METHODS: The clinical data of 21 patients with lumbar degenerative kyphosis who underwent osteotomy from January 2012 to December 2015 were retrospectively analyzed. There were 5 males and 16 females, aged from 55 to 76 years with an average of (66.24±5.13) years. All patients had taken preoperative and postoperative full length spinal X-ray, analyzing the spinopelvic parameters as thoracic kyphosis (TK), lumbar lordosis (LL), sagittal vertical axis (SVA), pelvic incidence (PI), pelvic tilt (PT) and sacral slope (SS). RESULTS: All operations were successful, the average operative time was 190 min (160 to 220 min) and intraoperative blood loss was 1 000 ml (800 to 1900 ml). Parameters of the patients between preoperative and period 1-year follow-up were as follows : preoperative TK increased from (31.67±21.13) ° to (34.67±11.60) °, LL corrected from (4.76±3.17) ° to (37.41±6.28) °, PT reduced from (33.94±5.01) ° to (20.12±5.36) °, and SS improved from (18.47±2.60) ° to (31.71±4.30) °, SVA restored from (13.24±3.60) cm to (2.82±1.33) cm. There were significant differences of spinopelvic parameters between preoperation and postoperation (<0.05). CONCLUSION Posterior osteotomy can effectively reconstruct the sagittal balance of spinopelvis in patients with lumbar degenerative kyphosis. The recovery of lumbar lordosis and sacral slope is closely related to the reconstruction of sagittal balance.

The characteristics of syndrome differentiation and the experience of professor were briefly introduced for the treatment of infertility of ovulation disturbance, including three aspects, named the thought of diagnosis and treatment, the therapeutic method and the acupoint prescription, as well as the clinical case report. Academically, professor is deeply influenced by professor , the acupuncture master of Xin'an school and Lingnan school. Regarding the treatment of gynecological diseases, the academic thought of professor - and - is contributed. Professor attaches the importance to the syndrome differentiation based on meridian and collateral, supplemented by the syndrome differentiation of , , and blood, cold and heat, as well as the deficiency and excess. In clinical treatment, the acupoints are selected specially from the conception vessel, the governor vessel, the thoroughfare vessel and the belt vessel. The extra meridians are equally important as the regular ones in the treatment, especially the belt vessel. Additionally, the treatment focuses on communicating the congenital with the acquired one, regulating the liver and benefiting the kidney, as well as adjusting the heart, the spleen and the stomach to ease the uterus. Simultaneously, the great consideration is paid to the menstruation regulation so as to promote pregnancy.

OBJECTIVE: To observe the effect of electroacupuncture (EA) combined with lifestyle control on hepatic fat status, hepatic enzymology, glycolipid metabolism and anthropological parameters in patients with obese nonalcoholic fatty liver disease(NAFLD). METHODS: A total of 90 patients with obese NAFLD were randomized into an observation group (45 cases, 4 cases dropped off) and a control group (45 cases, 1 case dropped off). Lifestyle control was implemented in the control group. On the basis of the treatment in the control group, acupuncture was applied at Zhongwan (CV 12), Quchi (LI 11), Shuifen (CV 9), Huaroumen (ST 24), Daheng (SP 15), Guanyuan (CV 4), Qihai (CV 6), etc. EA was provided at Huaroumen (ST 24) and Daheng (SP 15) with dilatational wave, 2 Hz/100 Hz in frequency, 30 min each time, once every other day, 3 times a week. The treatment for 12 weeks was required in both of the two groups. Hepatic fat status [controlled attenuation parameter (CAP) and liver stiffness measurement (LSM)], hepatic enzymology [alanine aminotransferase (ALT), aspartate aminotransferase (AST) and γ-glutamyl transferase (GGT)], glycolipid metabolism and insulin sensitivity [fasting plasma glucose (FPG), fasting serum lisulin (FINS), homeostasis model assessment of insulin resistance (HOMA-IR), total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C) and low density lipoprotein cholesterol (LDL-C)] and anthropological parameters [body weight (BW), body mass index (BMI), fat percentage (FP), waist circumference (WC), hip circumference (HC) and waist-to-hip ratio (WHR)] in the two groups were observed before and after treatment. RESULTS: ①Compared before treatment, hepatic CAP, LSM, serum ALT, AST and GGT after treatment were obviously reduced in the two groups (<0.05, <0.01). After treatment, CAP and ALT in the observation group were lower than the control group (<0.05). ②Compared before treatment, FINS, HOMA-IR, LDL-C, TC and TG after treatment were obviously reduced in the two groups (<0.05, <0.01),while the levels of HDL-C were increased (<0.05). Compared before treatment, FPG after treatment in the observation group was reduced (<0.05). Compared with the control group, FINS, HOMA-IR, TC and TG in the observation group were lower than those in the control group after treatment (<0.05). ③Compared before treatment, BW BMI, FP, WC, HC, WHR after treatment were obviously reduced in the two groups (<0.01). After treatment, WC and WHR in the observation group were lower than the control group (<0.05). CONCLUSION Electroacupuncture combined with lifestyle control can effectively treat obese nonalcoholic fatty liver disease, and present better therapeutic effect on hepatic fat status, glycolipid metabolism, insulin resistance, WC and WHR.

To evaluate the relationship of volumetric changes and endoleaks after endovascular aneurysm repair(EVAR)for abdominal aortic aneurysms(AAAs). We retrospectively evaluated the clinical and imaging data of 54 patients who had underwent EVAR within 1 month after their aneurysms were detected.All patients received abdominal and pelvic enhanced computed tomography(CTA)for two follow-up visits in Peking Union Medical College Hospital from July 2014 to February 2019.Three-dimensional volumes and maximum diameters on axial CT of the aortic aneurysms were calculated by dedicated semi-automated 3D segmentation software before surgery(V and D),in the 4 postoperative month(Vand D),and in the 12 postoperative month(Vand D),respectively.The presence or absence of endoleak for each patient with the V/V,V/V,and V/V were calculated to assess the significance of volume changes with respect to endoleaks and the correlation between volume changes and maximum diameter changes on axial CT images. Of the 54 patients,endoleaks were found in 11 patients at the first follow-up visit(4 months after surgery),among whom 8 patients were arranged a second follow-up visit(12 months after surgery),during which endoleaks were found in 5 patients.Fifteen of 43 non-leaked patients underwent a second CTA examination,which revealed endoleak in one case.Patients who did exhibit endoleaks[ =11,V/V=1.086(1.033,1.116)]showed significant increases in aneurysm volume when compared with those who did not exhbit endoleaks[ =43,V/V=1.019(0.970,1.065)]at the first follow-up visit(=-2.695,=0.007),although no significant difference was found with regard to volume changes between endoleaks(=6,V/V=1.1±0.2,V/V=1.0±0.1)and non-endoleaks(=17,V/V=1.0±0.1,V/V=1.0±0.1)at the second follow-up visit(=0.725,=0.476)as well as between these two follow-up visits(=-0.021,=0.984).V and D were moderately correlated with V and D,respectively(=0.5,<0.001)and strongly correlated with V and D,respectively(=0.8,<0.001).V and D were strongly correlated with V and D,respectively(=0.8,<0.001). The changes of aneurysm volume cannot reliably reflect the occurrence of endoleaks.The change of maximum axial diameter of aneurysm has certain correlation with the changes of aneurysm volume.

Objective To investigate the effects of smoking on chronic obstructive pulmonary disease(COPD) and respiratory symptoms. Methods A multi-stage, stratified cluster sampling strategy was used to select participants aged 40 or older in 5 surveillance points of Anhui Province. Questionnaires, body measurements and spirometry were used to collect data. Based on complex sampling design, Logistic regression model was conducted to analyze the effects of smoking on COPD and respiratory symptoms. Results The smokers who had smoked for ≥30 pack-years accounted for 13.9% (95% CI:10.3%-17.5%, P＜0.001) of the total population. And the smokers who had smoked for ≥40 years accounted for 8.5% (95% CI:6.7%-10.3%, P＜0.001) of the total population. On average, one smoker had smoked for 32.4 years (95% CI:31.2-33.5). Average daily cigarette consumption of daily smokers was 21.1 cigarettes (95% CI:19.6-22.7). As shown by multiple-variables Logistic regression analyses, the risk of COPD and respiratory symptoms increased with the increment of smoking pack-years and duration (all Ptrend <0.001). Conclusions Smoking was associated with COPD and respiratory symptoms. The risk of developing COPD and respiratory symptoms was greater with the increment of smoking pack-years and duration.

BACKGROUND: We examined changes in hepatitis B core-related antigen (HBcrAg) during the four sequential phases of chronic hepatitis B virus (HBV) infection: hepatitis B e antigen (HBeAg)-positive chronic infection (EPCI) and hepatitis (EPCH), followed by HBeAg-negative chronic infection (ENCI) and hepatitis (ENCH). We compared the performance of serum HBcrAg, hepatitis B surface antigen (HBsAg), and HBV DNA in predicting EPCH and ENCH. METHODS: We enrolled 492 consecutive patients: 49 with EPCI, 243 with EPCH, 101 with ENCI, and 99 with ENCH. HBcrAg was detected by chemiluminescent enzyme immunoassays. HBsAg and HBeAg were detected by chemiluminescent microparticle immunoassays. HBV DNA was detected by real-time PCR. Predictive performance of HBcrAg, HBsAg, and HBV DNA was evaluated using ROC curves. RESULTS: Areas under ROC curves (AUCs) of HBcrAg, HBsAg, and HBV DNA for predicting EPCH were 0.738, 0.812, and 0.717, respectively; optimal cutoffs were ≤1.43×105 kU/mL, ≤1.89×104 IU/mL, and ≤3.97×107 IU/mL, with sensitivities and specificities of 66.3% and 77.6%, 65.0% and 93.9%, and 60.5% and 79.6%, respectively. AUCs of HBcrAg, HBsAg, and HBV DNA for predicting ENCH were 0.887, 0.581, and 0.978, respectively; optimal cutoffs were >26.8 kU/mL, >2.29×102 IU/mL, and >8.75×103 IU/mL, with sensitivities and specificities of 72.7% and 95.1%, 86.9% and 39.6%, and 89.9% and 92.1%, respectively. CONCLUSIONS: HBsAg and HBV DNA were the best predictors of EPCH and ENCH, respectively. HBcrAg is an important surrogate marker for predicting EPCH and ENCH.
Area Under Curve ; Biomarkers ; DNA ; Hepatitis B e Antigens ; Hepatitis B Surface Antigens* ; Hepatitis B virus* ; Hepatitis B* ; Hepatitis B, Chronic ; Hepatitis* ; Hepatitis, Chronic* ; Humans ; Immunoassay ; Immunoenzyme Techniques ; Real-Time Polymerase Chain Reaction ; ROC Curve

PURPOSE: This study was undertaken to explore how miR-206 represses osteosarcoma (OS) development. MATERIALS AND METHODS: Expression levels of miR-206, PAX3, and MET mRNA were explored in paired OS and adjacent tissue specimens. A patient-derived OS cell line was established. miR-206 overexpression and knockdown were achieved by lentiviral transduction. PAX3 and MET overexpression were achieved by plasmid transfection. Treatment with hepatocyte growth factor (HGF) was utilized to activate c-Met receptor. Associations between miR-206 and PAX3 or MET mRNA in OS cells were verified by AGO2-RNA immunoprecipitation assay and miRNA pulldown assay. OS cell malignancy was evaluated in vitro by cell proliferation, metastasis, and apoptosis assays. PAX3 and MET gene expression in OS cells was assayed by RT-qPCR and Western blot. Activation of PI3K-AKT and MAPK-ERK in OS cells were assayed by evaluating Akt1 Ser473 phosphorylation and total threonine phosphorylation of Erk1/2, respectively. RESULTS: Expression levels of miR-206 were significantly decreased in OS tissue specimens, compared to adjacent counterparts, and were inversely correlated with expression of PAX3 and MET mRNA. miR-206 directly interacted with PAX3 and MET mRNA in OS cells. miR-206 overexpression significantly reduced PAX3 and MET gene expression in OS cells in vitro, resulting in significant decreases in Akt1 and Erk1/2 activation, cell proliferation, and metastasis, as well as increases in cell apoptosis, while miR-206 knockdown showed the opposite effects. The effects of miR-206 overexpression on OS cells were reversed by PAX3 or MET overexpression, but only partially attenuated by HGF treatment. CONCLUSION: miR-206 reduces OS cell malignancy in vitro by targeting PAX3 and MET gene expression.
Apoptosis ; Blotting, Western ; Cell Line ; Cell Proliferation ; Gene Expression ; Hepatocyte Growth Factor ; Immunoprecipitation ; In Vitro Techniques ; MicroRNAs ; Neoplasm Metastasis ; Osteosarcoma ; Phosphorylation ; Plasmids ; RNA, Messenger ; Threonine ; Transfection

AIM:To investigate the protective effect of zacopride (ZAC) on the pressure-overload left ventricular remodeling in the rats induced by coarctation of abdominal aorta.METHODS:Male Sprague-Dawley (SD) rats with pressure overload were induced by the coarctation of abdominal aorta.The model rats were intraperitoneally administered with ZAC, chloroquine (Chlor) , and zacopride+chlorquine (ZAC+Chlor).The study duration was 8 weeks.The cardiac structure and function were assessed by echocardiography.The heart weight/body weight (HW/BW) ratio and the left ventricular weight/body weight (LVW/BW) ratio were calculated.The changes of structure and shape in myocardial tissue were observed with HE staining.The ultrastructure of the myocytes was observed under transmission electron microscope.The inward rectifier potassium channel (IK1) protein expression was determined by Western blot.The mRNA expression of Kir2.1 was detected by RT-PCR.RESULTS:Compared with vehicle group, ZAC improved cardiac function, as indicated by the decreased left ventricular end-diastolic dimension (LVEDD) and left ventricular end systolic dimension (LVESD) (P<0.05) , and the increased left ventricular ejection fraction (LVEF) and left ventricular fractional shortening (LVFS) (P<0.01).The HW/BW and LVW/BW ratios were significantly decreased, and the cross-sectional area of the cardiomyocytes was significantly less in ZAC group than that in vehicle group (P<0.01).The ultrastructure of the myocytes was significantly improved.Chlor blocked the protective effect of zacopride on the pressure-overload left ventricular remodeling.The protein level ofmRNA expression of Kir2.1 in the cardiac tissues in ZAC group were significantly increased compared with vehicle group (P<0.01).CONCLUSION:ZAC significantly attenuates pressure overload-induced ventricular remodeling in rats.

A 56-year-old female patient was admitted to a hospital because of repeated fatigue, anorexia, fever for more than one year, recurrence for 2 months and sudden left limb twitch for 10 days. In 2017, patient was diagnosed with infective endocarditis, then underwent aortic valve replacement, valve biopsy showed Candida parapsilosis, she took medicine regularly after operation and withdrew medicine after three consecutive negative blood culture. Fever and multiple organ infarction occurred again in 2018, Candida parapsilosis was isolated again from blood culture, it is suggested that fungal endocarditis may be latent and recurrence in human body for a long time, exfoliation of vegetation may embolize various organs and lead to corresponding clinical manifestations, surgery combined with drug therapy and subsequent maintenance of antifungal therapy are extremely important to improve the prognosis of patients.

Objective To explore the homing of DiR labeled regulatory T cells ( Tregs) in human-ized heterologous liver tissue transplantation mouse model. Methods The fluorescence intensities of Tregs labeled with different concentrations of DiR dye and different incubation times were measured, and the cell viability was measured by 3-( 4, 5-dimethylthiazol-2-yl )-5-( 3-carboxymethoxyphenyl )-2-( 4-sulfophenyl )-2H-tetrazolium ( MTS) assay to determine the optimal incubation time and dye concentration. The effect of DiR dye on the function and phenotype of Tregs was verified by flow cytometry. The xenogeneic liver tissue transplantation mouse model was constructed and the immune system was reconstituted. Small animal fluores-cence imaging was performed at different time points after infusion of Tregs. Immunohistochemistry analysis was used to analyze immune reconstitution and lymphocyte distribution in vivo. One-way analysis of variance and Dunnett-t test were used to analyze the data. Results With the increase of DiR concentration and incu-bation time, the fluorescence intensity of Tregs increased and gradually weakened after reaching the peak at 3 d. The cell viability of the 5. 00 μg/ml and 20. 00 μg/ml groups was significantly lower than that of the control group (culture medium) at various time points (F=120.142-182.025, t=9.969-19.329, all P<0. 05) . After incubation for 30 min and 60 min, the activity of Tregs was also significantly lower than that of the control group (F=21.826-301.968, t=6.897-40.016, all P<0.05). Tregs were finally co-incubated with DiR dye at a concentration of 2.50 μg/ml for 5 min, which was used further in vivo experiments. The flow cytometry showed that DiR dye did not affect the phenotype or the function of Tregs. The small animal fluorescence imaging showed that Tregs could locate in the graft area of mouse model. Immunohistochemical analysis showed that Tregs could improve lymphocyte infiltration induced by immune reconstitution. Conclu-sion After labeling Tregs with DiR dye, the distribution of Tregs can be directly observed by fluorescence imaging, which is a promising imaging method for Tregs tracer.