Objective To compare the surgical outcomes of the sequence of screw and rod placement for Lenke type 5C adolescent idiopathic scoliosis(AIS).Methods Lenke type 5C AIS patients who underwent posterior orthopedic fusion and fixation in our hospital from Jan.2013 to Dec.2020 were recruited.Based on surgical sequences,22 cases were assigned to bilateral group(after bilateral screw placement,orthopedics was performed on the convex side and then on the concave side),and 20 cases were assigned to convex group(screws placed on the convex side and performed orthopedics,followed by the concave side).The operation-related indicators(including operation time),imaging parameters,quality of life scores were compared between the 2 groups before and 2 years after surgery.Complications of the 2 groups were analyzed.Results The operation time in the bilateral group was significantly longer than that in the convex group([232.8±13.1]min vs[198.4±16.5]min,P＜0.01).At the last follow-up 2 years after operation,the Cobb angle and its correction rate in the convex group were better than those in the bilateral group([8.0±2.3]° vs[9.9±3.2]°,P=0.03;[81.9±5.4]%vs[77.8±5.8]%,P=0.02).The rate of pedicle screw breach rate was 5.4%(17/312)in the bilateral group and 1.4%(4/280)in the convex group,with significant difference(P＜0.01).At the last follow-up 2 years after operation,the treatment satisfaction of quality of life assessment of the bilateral group was 4.61±1.38,and that of the convex group was 4.50±1.44,but there was no significant difference between the 2 groups(P＞0.05).There were no abnormal electrophysiological monitoring or operation-related complications in the 2 groups.Conclusion For Lenke type 5C AIS,the convex side of pedicle screw placement and orthopedics followed by concave side of pedicle screw placement and orthopedics can achieve better surgical effect.

The tendon-bone interface is where the tendons or ligaments are connected with the bones. A spectrum of injuries may happen to the "soft-to-hard" tissue interface, including those to the rotator cuff-bone and cruciate ligament-bone interfaces, which are often precipitated by a combination of degenerative changes on the tendon-bone interface and acute or chronic injuries, thus severely impairing the patients′ motor function. In recent years, with the deepening of the interdisciplinary researches in biomechanics, mechanobiology, and sports medicine, the role of mechanical factors in the repair of tendon-bone interface injuries has attracted more and more attention and becomes a focus of the edge-cutting researches on the tendon-bone interface injuries. To this end, the authors proposed the concept of "tendon-bone interface mechanomedicine" based on an overview of the relevant researches at home and abroad. The mechanical properties of the tendon-bone interface and the effects of mechanical stimuli on its biological behavior were elucidated from the four aspects: biomechanics, mechanobiology, mechanodiagnostics, and mechanotherapy, aiming to explore the diagnostic and therapeutic strategies for tendon-bone interface injuries from the angle of mechanics and provide new perspectives and methodologies for the field of tendon-bone interface injury repair.

Objective:To investigate the expressions of apoptosis-related factors survivin, p53 and human epidermal growth factor receptor 2 (HER2) in breast cancer tissues and their prognostic value.Methods:A total of 131 patients undergoing radical mastectomy for breast cancer who were admitted to Tangshan Maternal and Child Health Care Hospital from February 2015 to January 2019 were selected as the research subjects. During the operation, the cancer tissues and adjacent tissues (normal tissues >3 cm from the tumor margin) were collected from the patients. Expressions of survivin, p53 and HER2 in cancer tissues and adjacent tissues of patients were detected by using immunohistochemistry. The prognoses of patients were recorded after the follow-up for 3 years; the recurrence, metastasis and death treated as the poor prognosis, the rest prognoses of patients were treated as the good prognosis group. The difference of clinicopathological characteristics between the poor prognosis group and the good prognosis group was compared. Multivariate logistic regression was used to analyze risk factors for prognosis of breast cancer patients. The result of prognosis of breast cancer was taken as the golden standard. The receiver operating characteristic (ROC) curve was used to analyze the value of survivin pasitive, p53 pasitive, HER2 pasitive alone, the combination of both and the combination of the there in the judgement of poor prognosis of breast cancer.Results:The positive expression rates of survivin [49.6% (65/131) vs. 7.6% (10/131)], p53 [60.3% (79/131) vs. 13.0% (17/131)] and HER2 [79.4% (104/131) vs. 16.8% (22/131)] in cancer tissues were higher than those in adjacent tissues (all P<0.001). A total of 131 breast cancer patients were followed up for 3 years without any loss of follow-up, and the follow-up rate was 100%. Within the follow-up for 3 years, there were 15 (11.5%) cases of recurrence, 8 (6.1%) cases of metastasis, and 10 (7.6%) cases of death, the incidence of poor prognosis was 25.2% (33/131); and the remaining 98 cases had good prognosis. The proportions of patients with TNM stage Ⅲ, lymph node metastasis, poorly differentiated histology, tumor diameter ≥3 cm, survivin, p53, and HER2 positive expressions in the poor prognosis group were higher than those in the good prognosis group (all P<0.05). Multivariate logistic regression analysis showed that TNM stage Ⅲ [ OR = 5.323 (95% CI 2.190-12.936)], lymph node metastasis [ OR = 4.773 (95% CI 1.964-11.600)], tumor diameter ≥3 cm [ OR = 3.582(95% CI 1.474-8.706)], positive survivin [ OR = 2.740 (95% CI 1.127-6.659)], positive p53 [ OR = 3.271 (95% CI 1.346-7.949)], and positive HER2 [ OR = 3.873 (95% CI 1.594-9.412)] were independent risk factors for prognosis of breast cancer (all P<0.001). The ROC curve results showed that the area under the curve (AUC) values of survivin positive, p53 positive,HER2 positive, and the combination of any two were more than 0.80 (all P<0.001); the AUC of the combination of the three was 0.944 (95% CI 0.890-0.977) ( P<0.001). Conclusions:The expressions of survivin, p53, and HER2 are highly expressed in breast cancer tissues. The expressions of the three can be used to judge the prognosis of breast cancer patients, and the combination of the three has a higher judgement value.

Previous studies suggest that the reduction of SMAD3 (mothers against decapentaplegic homolog 3) has a great impact on tumor development, but its exact pathological function remains unclear. In this study, we found that the protein level of SMAD3 was greatly reduced in human-grade IV glioblastoma tissues, in which LAMP2A (lysosome-associated membrane protein type 2A) was significantly up-regulated. LAMP2A is a key rate-limiting protein of chaperone-mediated autophagy (CMA), a lysosome pathway of protein degradation that is activated in glioma. We carefully analyzed the amino-acid sequence of SMAD3 and found that it contained a pentapeptide motif biochemically related to KFERQ, which has been proposed to be a targeting sequence for CMA. In vitro, we confirmed that SMAD3 was degraded in either serum-free or KFERQ motif deleted condition, which was regulated by LAMP2A and interacted with HSC70 (heat shock cognate 71 kDa protein). Using isolated lysosomes, amino-acid residues 75 and 128 of SMAD3 were found to be of importance for this process, which affected the CMA pathway in which SMAD3 was involved. Similarly, down-regulating SMAD3 or up-regulating LAMP2A in cultured glioma cells enhanced their proliferation and invasion. Taken together, these results suggest that excessive activation of CMA regulates glioma cell growth by promoting the degradation of SMAD3. Therefore, targeting the SMAD3-LAMP2A-mediated CMA-lysosome pathway may be a promising approach in anti-cancer therapy.

Objective:To investigate the characteristics of senile neurodegenerative diseases (NDDs) inpatients in south China, especially in Guangdong province, and explore the influencing factors for their medical expenses.Methods:The medical records of 7231 patients with NDDs≥65 years were collected in the electronic health database of our hospital from January 2010 to December 2019, including gender, age, admission ways, chief complaints, length of hospital stays and medical expenses. On the basis of median of the medical expenses (21 345 yuan) of these patients, they were divided into low cost (<21 345 yuan) group and high cost (≥21 345 yuan) group. Univariate Logistic analysis and multivariate Logistic regression analysis were conducted to screen the influencing factors for medical expenses and the independent influencing factors.Results:(1) The main age group of geriatric inpatients with NDDs were 70-79 years (40.96%); the admission source was mainly outpatient (56.70%), and length of hospital stays of a large percent of patients (44.50%) were 8-14 d. (2) From 2010 to 2019, the number of hospitalized geriatric patients with NDDs showed an increasing trend year by year, the overall trend of length of hospital stays was shortened, and the medical expenses showed gradual increase; the causes of hospitalization, percentages of patients caused by infection, abnormal blood pressure and water-electrolyte metabolism disturbances showed decreased trend, percentages of patients caused by heart diseases, cerebrovascular accidents and mental-psychological diseases showed increased trend, and the proportions of patients caused by fracture/trauma/wound injuries were generally stable. The proportion of patients returning home and mortality rate after hospital discharge were declined, and the proportion of patients returning to other medical or community institutions was increased. (3) Living in ICU, length of hospital stays, diabetes, nosocomial infection, chronic kidney disease, urinary tract infection, tumble, body mass index, and anticholinergic drugs were independent risk factors influencing the medical expenses ( P<0.05). Conclusions:An aging trend is noted in patients with NDDs; the number of hospitalized patients and medical expenses increase year by year, and the length of hospital stays gradually decreases. In view of the many factors that influence the medical expenses of this disease, it is suggested to develop the corresponding standardized treatment plan for the main influencing factors in clinical practice.

BACKGROUND: Greater tuberosity of humerus, as the attachment point of rotator cuff, plays a vital role in shoulder.Neer and AO classification for proximal humeral fractures have been accepted extensively. However, the classification for single greater tuberosity fractures of the proximal humerus is little reported, and its fixation method remains controversial.OBJECTIVE: To explore the curative efficacy of the double-row suture anchors under arthroscopy for avulsion-type greater tuberosity fractures (Mutch type Ⅰ) METHODS: Clinical data of 24 patients with avulsion-type greater tuberosity fractures (Mutch type Ⅰ) undergoing double-row suture anchors under arthroscopy were analyzed retrospectively. The displacement distance of the greater tuberosity of humerus was measured on CT before and after fixation. The shoulder joint was evaluated by Constant-Murley Score and the University of California, Los Angeles score at baseline, 1, 3, 6 and 12 months postoperatively. Besides, the visual analogue scale scores were detected at baseline and 12 months postoperatively.RESULTS AND CONCLUSION: (1) Double-row suture anchors effectively improved the displacement of greater tuberosity and rotator cuff injury. (2) The patients accompanied by rotator cuff injury accounted for 79.16%. (3) The Constant-Murley Score and the University of California, Los Angeles scores were significantly improved at each time point (P < 0.05). The visual analogue scale scores after fixation were significantly superior to those before fixation (P < 0.05). (4) These results suggest that the double-row suture anchors under arthroscopy can effectively improve the displacement of greater tuberosity and alleviate the pain. Moreover, it is conductive for early recovery of the shoulder function with little trauma, so it is a good choice for avulsion-type greater tuberosity fractures (Mutch type Ⅰ).

Nowadays, normal humidifier is used to heat and humidify the gas before sending to ventilator tube. A new type of ventilator which offers both breathing tube with heater and humidifier is incorporate. In the light of this, patients already bought ventilator still confront this problem. Therefore, this paper mainly introduces a new manufactural method which is controlling the temperature and humidity of gas sent by breathing machine online by a temperature controller which consist of Silica gel hotline and microcomputer. As a matter of fact, the controller is adaptable in various types of breathing tube and can accurately control the humidity and temperature of gas sent into bodies.
Equipment Design ; Humans ; Humidity ; Temperature ; Ventilators, Mechanical

BACKGROUND:Liver regeneration is the key factor influencing the prognosis of living donor liver transplantation. There has not been the research on special miRNA of liver regeneration after living donor liver transplantation. OBJECTIVE:To analyze the variation of miRNAs expression profile after rat reduced-size liver transplantation at certain time point, select and verify target miRNA which can provide targeting intervention strategies in liver regeneration after rat reduced-size liver transplantation and provide theoretical evidence for liver regeneration after living donor liver transplantation.METHODS:The reduced-size liver transplantation models were established. miRNAs microarray was used to detect miRNA expression. In differentialy expressed microRNAs, real-time quantitative PCR was utilized to detect target miRNAs. The credibility of miRNAs microarray results was verified. RESULTS AND CONCLUSION:Compared with rat liver tissue in the sham operation group, 11 miRNAs up-regulated in reduced-size liver transplantation, including let-7b-5p, let-7c-5p, miR-101a-3p, miR-103-3p, miR-130a-3p, miR-142-5p, miR-186-5p, miR-199a-3p, miR-21-5p, 221-3p and miR-34a-5p. Four miRNAs were down-regulated, including miR-26b-5p, miR-150-5p, miR-19a-3p and rno-miR-146-5p. PCR test further verified that miR-221-3p and miR-199a-3p expression changes approximated the chip results at 24, 48 hours and 1 week, indicating that results of miRNA microarray were believable. These results verified that it exists variation of miRNAs expression profile after rat reduced-size liver transplantation, which picked out and verified the target miRNAs.

Objective To investigate the expression of PTTG and VEGF-C in laryngeal carcinoma and the effect of angiogene-sis .Methods Immunohistochemistry was used to detect the expression of PTTG 、VEGF-C and LMVD in 60 cases of laryngeal car-cinoma and 32 cases of para-carcinoma tissue .D2 40 positive products was used to locate lymphatic endothelial cell cytoplasm and cell membrane ,and count lymphatic microvessel density (LMVD) .Results The expression of PTTG and VEGF-C in laryngeal car-cinoma was significantly higher than that in para-carcinoma tissue(P<0 .05) .In laryngeal carcinoma ,the expression of PTTG and VEGF-C were associated with differentiation ,lymph node metastasis and clinical stage(P<0 .05) ,but independent of clinical classi-fication ,smoking history ,tumor′size ,sex and gender(P>0 .05) .The expression of LMVD in laryngeal carcinoma was significantly higher than that in para-carcinoma tissue(P<0 .05) .The expression of LMVD was associated with lymph node metastasis (P<0 .05) ,but independent of differentiation ,clinical classification ,clinical stage smoking history ,tumor′size ,sex and gender ( P>0 .05) .A significantly positive relation was found between PTTG and VEGF-C(P<0 .05) .And there were positive relation between PTTG and LMVD、VEGF-C and LMVD(P<0 .05) .Conclusion PTTG and VEGF-C might play an important role in the carcino-genesis and development of laryngeal carcinoma .PTTG and VEGF-C could be a prognostic factor of colorectal cancer and a new tar-get of gene therapy .

A total of 52 patients with chronic lateral epicondylitis were randomly assigned into platelet-rich plasma (PRP) (n =28) or corticosteroid (n =24) group.The visual analog pain scale (VAS) and Mayo elbow score had no significant difference between two groups within 1 week post-treatment.However,VAS and Mayo elbow score improved more significantly in PRP group versus corticosteroid group at Month 1 and 6 post-treatment (P ＜ 0.05).The PRP trigger point injection treatment of elbow lateral epicondylitis achieved clinical outcomes and it was superior to glucocorticoid treatment.