Objective To investigate the change rule of T1ρ value in the process of lumbar intervertebral disc degeneration(IVDD)based on Pfirrmann grading by Meta-analysis.Methods PubMed,EMBASE,Cochrane Library,CNKI,Wanfang Data,VIP and Sinomed were searched to collect studies on quantitative assessment of IVDD using T1ρ imaging technology.The retrieval time limit was from the establishment of the database to December 20,2022.Meta-analysis was performed using RevMan 5.4 and Stata 14.0 software.Results A total of 12 articles were included,and the numbers of Pfirrmann grade Ⅰ-Ⅴ lumbar discs were 316,1 460,769,430 and 98,respectively.T1ρ relaxation time decreased gradually with the increase of the grade of degeneration.The T1ρ values of grade Ⅰlumbar discs were significantly higher than those of grade Ⅱ lumbar discs[weighted mean difference(WMD)=14.55,95%confidence interval(CI)6.35-22.75,P<0.01],and the T1ρ values of grade Ⅱ lumbar discs were significantly higher than those of grade Ⅲlumbar discs(WMD=34.20,95%CI 27.05-41.34,P<0.01).The T1ρ values of grade Ⅲ lumbar discs were significantly higher than that of grade Ⅳ lumbar discs(WMD=22.94,95%CI 17.08-28.80,P<0.01).The T1ρ values of grade Ⅳ lumbar discs were significantly higher than that of grade Ⅴ lumbar discs(WMD=9.35,95%CI 6.81-11.89,P<0.01).Conclusion T1ρ imaging technology can objectively and quantitatively evaluate degeneration at different stages,especially sensitive to IVDD in the early and middle stages,which can provide imaging evidence for clinical diagnosis of early IVDD.

Methods: This retrospective study analyzed patients who underwent chest CT and DXA at our hospital between August 2021 and August 2022. Thoracic thoracolumbar segment HU values, lumbar T-scores, and hip T-scores were computed for comparison, and thoracic thoracolumbar segment HU thresholds suggestive of potential bone density abnormalities were established using receiver operating characteristic curves. Results: In total, 470 patients (72.4% women; mean age, 65.5±12.3 years) were included in this study. DXA revealed that of the 470 patients, 90 (19%) had osteoporosis, 180 (38%) had reduced osteopenia, and 200 (43%) had normal bone mineral density (BMD). To differentiate osteoporosis from osteopenia, the HU threshold was established as 105.1 (sensitivity, 54.4%; specificity, 72.2%) for T11 and 85.7 (sensitivity, 69.4%; specificity, 61.1%) for T12. To differentiate between osteopenia and normal BMD, the HU threshold was 146.7 for T11 (sensitivity, 57.5%; specificity, 84.4%) and 135.7 for T12 (sensitivity, 59.5%; specificity, 80%). Conclusions This study supports the significance of HU values from chest CT for BMD assessment. Chest CT provides a new method for clinical opportunistic screening of osteoporosis. When the T11 HU is >146.7 or the T12 HU is >135.7, additional osteoporosis testing is not needed unless a vertebral fracture is detected. If the T11 HU is <105.1 or the T12 HU is <85.7, further DXA testing is strongly advised. In addition, vertebral HU values that fall faster than those of the T11 and L1 vertebrae may explain the high incidence of T12 vertebral fractures.

ObjectiveTo explore the relationship between Kansui Radix and Glycyrrhizae Radix et Rhizoma in the Gansui Banxiatang based on cytochrome P450 （CYP450） enzyme and ascites rats. MethodA total of 150 Wistar rats were randomized into blank group （distilled water， ig）， model group （distilled water， ig）， Gansui Banxiatang group （5.68 g·kg^-1·d^-1， ig）， Gansui Banxiatang without Kansui Radix group （5.57 g·kg^-1·d^-1， ig）， Gansui Banxiatang without Glycyrrhizae Radix et Rhizoma group （4.01 g·kg^-1·d^-1， ig）， and Gansui Banxiatang without Kansui Radix And Glycyrrhizae Radix et Rhizoma group （3.90 g·kg^-1·d^-1， ig）， with 25 rats in each group. The Gansui Banxiatang was composed of 1.1 g Kansui Radix， 9 g Pinelliae Rhizoma Praeparatum， 15 g Paeoniae Radix Alba， 16.7 g Glycyrrhizae Radix et Rhizoma praeparata cum melle， and 15 g honey. The rats， except for the blank group， were injected （ip） with Walker-256 cells to induce cancerous ascites. The administration lasted 7 days for each group. The concentration of probe drugs was detected by high performance liquid chromatography （HPLC） and based on the metabolic rates of the drugs， the CYP450 enzyme activity was yielded. The CYP450 enzyme gene expression was determined by Real-time PCR， and CYP450 enzyme protein expression by Western blot. ResultCompared with the blank group， the model group showed high activity of CYP1A2 and CYP2C9， low activity of CYP2E1， CYP2C19， and CYP3A4， low mRNA expression of CYP2E1， CYP2C19， CYP2C9， and CYP3A4， and low protein expression of CYP2E1 and CYP3A4 （P<0.05）. Compared with the model group， Gansui Banxiatang group displayed low activity of CYP2C9 and high expression of CYP3A4 mRNA （P<0.01）， and Gansui Banxiatang without Kansui Radix group demonstrated low activity of CYP1A2， high activity of CYP2E1 and CYP3A4， high mRNA expression of CYP1A2， CYP2E1， CYP2C19， and CYP3A4， and high protein expression of CYP2E1 and CYP3A4 （P<0.05）. In comparison with the model group， the Gansui Banxiatang without Glycyrrhizae Radix Et Rhizoma group showed low activity of CYP2C9， high activity of CYP3A4， and high mRNA expression of CYP2E1 and CYP2C19 （P<0.05）， and Gansui Banxiatang without Kansui Radix and Glycyrrhizae Radix Et Rhizoma group had low activity of CYP2C9， high activity of CYP3A4， and high CYP3A4 mRNA expression （P<0.01）. The activity of CYP2E1， CYP2C9， and CYP3A4 was higher， and the mRNA expression of CYP1A2， CYP2C19， and CYP3A4 and CYP3A4 protein expression were higher in the Gansui Banxiatang without Kansui Radix group than in the Gansui Banxiatang group （P<0.05）. The activity of CYP2C9 and CYP3A4， and CYP2C19 mRNA were higher and mRNA expression of CYP3A4 was lower in the Gansui Banxiatang without Glycyrrhizae Radix Et Rhizoma group than in the Gansui Banxiatang group （P<0.05）. The activity of CYP2C9 and CYP3A4 in the Gansui Banxiatang without Kansui Radix and Glycyrrhizae Radix et Rhizoma group was higher than that in the Gansui Banxiatang group （P<0.01）. ConclusionThe four prescriptions all showed certain efficacy in the perspective of CYP450 enzyme， among which Gansui Banxiatang without Kansui Radix had the best effect and was better than Gansui Banxiatang. The Kansui Radix and Glycyrrhizae Radix et Rhizoma did not show antagonism in Gansui Banxiatang， but reduced the effect. Thus， in this study， the medicinal pair may show mutual inhibition.

OBJECTIVE:To investigate the efficacy difference of gypsum in oral and external prescriptions,so as to provide reference for safe and effective drug use in clinic. METHODS:According to Chinese Medical Classics(electronic books)and Selected Dictionary of Chinese Medical Prescriptions,the prescriptions containing gypsum from the Eastern Han Dynasty to the Modern Times (up to 1979)were summarized;the regularity of clinical use of gypsum by physicians in past dynasties were analyzed. RESULTS:A total of 682 prescriptions containing gypsum were collected. According to the time,there were 169 prescriptions of the Song Dynasty (24.8％)and 152 prescriptions of the Qing Dynasty(22.3％);there were 138 prescriptions of the Ming Dynasty(20.2％)and 118 prescriptions of the Modern Times(up to 1979,17.3％);there were 53 prescriptions of the Jin and Yuan Dynasty(7.8％)and 52 prescriptions of the Han Dynasty,the Jin Dynasty,Northern and Southern Dynasties,and Tang Dynasty(7.6％). Gypsum mainly showed the efficacy of clearing heat-fire,relieving restlessness and slaking thirst,promoting wound healing and tissue regeneration, astringing dampness and stopping bleeding,etc. Among them,there were 516 prescriptions of clearing heat-fire (75.7％),69 prescriptions of relieving restlessness and slaking thirst(10.1％),56 prescriptions of promoting wound healing and tissue regeneration (8.2％),20 prescriptions of astringing dampness and stopping bleeding(2.9％),21 prescriptions of other efficacy(tooth fixation, cosmetology,health care and so on,3.1％). This indicated that the effect of gypsum was mainly clearing heat-fire;gypsum could treat heat-induced disease by combining with other drugs. It could be used in following prescriptions,such as yangming heat syndrome, syndrome of flaring heat in Qifen and Xuefen(Ying),Qifen fever complicated with syndrome of deficiency of Qi and Yin,other meridians complicated with excess-heat syndrome,miscellaneous dosease due to internal injury. In addition,gypsum could be cyed erally or externally,and it can be taken orally after being calcined. CONCLUSIONS:By studying the prescriptions of gypsum used by physicians in past dynasties,it can promote the further use of gypsum,and give better play its clinical efficacy.

Objective To explore the brain changes of electroacupuncturing (EA) different acupoints of peripheral facial paralysis (PFP) with functional magnetic resonance imaging (fMRI). Methods Eighteen patients with left PFP were randomly divided into three groups. Six of them received electroacupuncturing left Dicang, 6 received electroacupuncturing left Hegu, and 6 received electroacupuncturing left Houxi. fMRI data were obtained from scanning of the whole brain. Functional data were processed by SPM99 software and functional responses were established with t-test analysis (P<0.05). Results Electroacupuncturing Dicang and Hegu on the left induced decreasing of signal in bilateral middle frontal gyrus, left cingulate gyrus, signal increased of right precentral gyrus, bilateral postcentral gyrus, left superior temporal gyrus and right insular, while electroacupuncturing Houxi on the left induced decrease of signal in bilateral inferior frontal gyrus, left lentiform nucleus, right middle temporal gyrus, right cerebellar tonsil, signal increased of right caudate head, right cingulate gyrus, brainstem, cerebellar vermis and right parahippocampal gyrus. Conclusion Electroacupunctuing Hegu and Dicang can cause corresponding functional activation in cerebrum, while electroacupuncturing Houxi can not, suggesting that there is association between cerebral and acupoint of owned meridian.

To examine the effect of transcatheter arterial embolization (TAE) of liver tumors on hypoxia-inducible factor-1alpha (HIF-1alpha) expression in the residual viable tumor, a total of 30 New Zealand White rabbits implanted with VX2 liver tumor were divided into 2 groups. TAE-treated group animals (n=15) were subjected to TAE with 150-250 mum polyvinyl alcohol particles. Control group animals (n=15) underwent sham embolization with distilled water. Six hours, 3 days or 7 days after TAE, the animals were sacrificed, and samples of tumor and adjacent normal liver tissue were harvested. Expression of HIF-1alpha protein was examined immunohistochemically. Real-time PCR was performed to examine the HIF-1alpha mRNA levels. Our results showed that HIF-1alpha protein was expressed in the VX2 tumors but not in the adjacent normal liver tissue. The HIF-1alpha-positive tumor cells were located predominantly at the periphery of necrotic tumor regions. The mean levels of HIF-1alpha protein were significantly higher in TAE-treated tumors than those in control tumors (P=0.002). Among the three sacrificing time points, the difference in increase in HIF-1alpha protein was significant between the two groups at the sacrificing time point of 6 h and 3 days after TAE (P=0.020, P=0.031, respectively), whereas no significant increase was noted 7 days after TAE (P=0.502). In contrast, although HIF-1alpha mRNA was expressed in TAE-treated and control VX2 tumors, there existed no significant difference in the HIF-1alpha mRNA level between the two groups (P=0.372). It is concluded that TAE of liver tumors increases the expression of HIF-1alpha at protein level in the residual viable tumor, which could be attributed to hypoxia generated by the procedure.

To examine the effect of transcatheter arterial embolization (TAE) of liver tumors on hypoxia-inducible factor-1α (HIF-1α) expression in the residual viable tumor,a total of 30 New Zealand White rabbits implanted with VX2 liver tumor were divided into 2 groups. TAE-treated group animals (n=15) were subjected to TAE with 150-250 μm polyvinyl alcohol particles. Control group animals (n=15) underwent sham embolization with distilled water. Six hours,3 days or 7 days after TAE,the animals were sacrificed,and samples of tumor and adjacent normal liver tissue were harvested. Expression of HIF-1α protein was examined immunohistochemically. Real-time PCR was performed to examine the HIF-1α mRNA levels. Our results showed that HIF-1α protein was expressed in the VX2 tumors but not in the adjacent normal liver tissue. The HIF-1α-positive tumor cells were located predominantly at the periphery of necrotic tumor regions. The mean levels of HIF-1α protein were significantly higher in TAE-treated tumors than those in control tumors (P=0.002). Among the three sacrificing time points,the difference in increase in HIF-1α protein was significant between the two groups at the sacrificing time point of 6 h and 3 days after TAE (P=0.020,P=0.031,respectively),whereas no significant increase was noted 7 days after TAE (P=0.502). In contrast,although HIF-1α mRNA was expressed in TAE-treated and control VX2 tumors,there existed no significant difference in the HIF-1α mRNA level between the two groups (P=0.372). It is concluded that TAE of liver tumors increases the expression of HIF-1α at protein level in the residual viable tumor,which could be attributed to hypoxia generated by the procedure.

Objective To summarize clinical experience in application of nail-bed lengthening operation for fingertip injuries.Methods From September 2003 to May 2007,36 patients (25 men and 11 women) aged 16 -45 years (26 in average) with nail defect by fingertip injuries underwent reconstruction operation using nail-bed lengthening at Orthopaedics and Traumatology Hospital of Taizhou,with the thumb involved in 15 cases,the index finger in 10 cases,the middle finger in eight eases and the ring finger in three case.A skin rectangle with thickness of 2 - 3 mm and width as that of the nail was resected at the skin edge 5 -6 mm distant from the epenychium,without damage to underlying subcutaneous vascular network, and U-shape skin flap was delicately slid proximally with its ends sutured.Results All surgical operations for nail lengthening were uneventful and clinically satisfactory,and the appearance of the thumb or other fingers was good during follow-up for six months to three years (19 months in average).Conclusions Nail lengthening for fingertip injuries with nail defect is a simple and effective surgical operation which could improve the appearance of the thumb and other fingers.

Objective To summarize clinical application of the medial sural artery perforator pedicled flap for the coverage of soft tissue defects around the knee and upper one third of lower leg.Methods From May 2003 tO January 2007,16 patients(11 men,5 women)with soft tissue defects around the knee and upper one third of lower leg underwent reconstruction with the medial sural artery perforator pedicled flap.Of them,4 eases recipient site were located on the prepatellar region,2 cases were located on the anterolateral pateflar,1 case was located on the anteromedial patellar,and 9 cases upper one third oflowerleg.They ranged in age from 23 to 52 years(mean,36 years).The donor leg was ipsilateral in all cages. Results One ca8e sustained superficial infection postoperative and the gradual wound healed by daily wound dressings.All the flaps had survived completely without major complication with satisfactory clinical results. Follow-up period ranged from 3.0 months to 3.5 years(mean, 1.7 years)postoperatively.There was no remarkable donor site morbidity.All cases had good appearance and function in recipient site.There was no remarkable donor site morbidity. Conclusion The medial sural artery perforator flap is nourished by the musculocutaneous perforater of the medial sural artery.The flaps seem to has highly vascularize,a constant vascular anatomy and a long vascular pedicle.The flap is thin and suitable for the coverage of soft tissue defects around the knee and upper one third of lower leg.

In order to observe the feature of age-related marrow conversion and maturation of epiphyseal cartilage and analyze the distribution of red and yellow marrow in the proximal femur at STIR MR imaging, STIR and T(1) weighted MR imaging of the proximal femur in 52 subjects, aged 4 months to 25 years old, were retrospectively analyzed for the distribution and appearance of red and yellow marrow. The subjects with no known bone marrow abnormalities were divided into 6 age groups. The signal intensity of the marrow in the proximal epiphysis, proximal metaphysis, proximal diaphysis, distal diaphysis and greater trochanter was compared with the signal intensity and homogeneity of surrounding muscle and fat and graded by two observers. The results showed that the conversion of hematopoietic marrow in the proximal femur followed a well-defined sequence, occurring first in the proximal epiphysis, followed by the distal diaphysis, and then greater trochanter and metaphysis. STIR in combination with T(1)-weighted imaging could display clearly the origin of ossification center and the course of conversion from red to yellow marrow in proximal epiphysis and greater trochanter. STIR imaging showed that the marrow conversion in proximal metaphysic began below epiphyseal plate and intertrochanter. The site of red yellow was distributed in weight-bearing axis by 20 years of age. The marrow conversion of diaphysis was from distal end to proximal end, and the consequence of conversion was that distal diaphysis contained yellow marrow but proximal diaphysis partly red marrow connected with the red marrow of metaphysic. The epiphyseal cartilage had different characters of signal-intensity with age in STIR sequence. The distribution of red marrow in STIR imaging was more close to that of anatomy than T(1)-weighted imaging. It was concluded that STIR could dynamically display the feature of marrow conversion and the development of epiphyseal cartilage and accurately reveal the age-related distribution of red and yellow marrow on STIR imaging in the proximal femur.
Age Factors ; Bone Marrow/*anatomy & histology ; Bone Marrow/physiology ; Epiphyses/anatomy & histology ; Femur/*anatomy & histology ; Image Enhancement/*methods ; Magnetic Resonance Imaging/*methods ; Retrospective Studies ; Young Adult