Objective:To analyze the clinical efficacy of treatment of cement dislodgement after vertebral augmentation for osteoporotic vertebral fractures.Methods:A retrospective study was conducted to analyze the data of 13 patients who had been treated at Department of Orthopaedics, The First Affiliated Hospital of Soochow University for cement dislodgement after vertebral augmentation for osteoporotic vertebral fractures from July 2013 to July 2022. There were 4 males and 9 females, with an average age of (76.5±8.6) years and a T value of bone mineral density of -3.3±0.6. By the CT and MRI features of cement dislodgement, their conditions fell in 4 types: cement loosening in situ (4 cases), anterior cement moving (6 cases), anterior cement moving with posterior bone mass moving (2 cases), and posterior cement moving (1 case). They were treated by percutaneous vertebroplasty (3 cases), pedicle screw fixation combined with bone graft fusion and decompression (7 cases), and conservative therapy (3 cases). The curative effects for surgical patients were evaluated by comparing their visual analogue scale (VAS), Oswestry dysfunction index (ODI) and cobb angle of kyphosis at preoperation, 1 week and 1 month postoperation, and the last follow-up, and Frankel grading for nerve injury as well. The curative effects for patients undergoing conservative treatment were evaluated by observing their symptoms.Results:This cohort was followed up for 7 (5, 12) months after treatment. The VAS scores [5.0 (4.0, 5.0) points, 3.0 (2.0, 3.0) points, and 3.0 (2.0, 3.0) points] in the 10 surgical patients at 1 week and 1 month postoperation and the last follow-up were significantly improved compared with the preoperative value [8.5 (8.0, 9.0) points] ( P<0.05); the VAS scores at 1 month postoperation and the last follow-up were also significantly improved compared with that at 1 week postoperation ( P < 0.05), but there was no significant difference between the last follow-up and 1 month postoperation ( P > 0.05). The ODIs (50.6%±4.2%, 37.8%±4.5%, and 29.3%±5.6%) in the 10 surgical patients at 1 week and 1 month postoperation and the last follow-up were significantly improved compared with the preoperative value (93.2%±3.6%), showing significant differences in pairwise comparisons ( P<0.05). The cobb angles [10.0 (9.0, 11.0)°, 9.0 (9.0, 11.0)°, and 10.0 (9.0, 12.0)°] in the 10 surgical patients at 1 week and 1 month postoperation and the last follow-up were significantly improved compared with the preoperative value [12.5 (11.0, 14.0)°] ( P<0.05) , but there was no statistically significant difference between the time points after operation ( P>0.05). The Frankel grading was significantly improved in the 6 patients with nerve injury after operation. Of the 3 patients undergoing conservative treatment, the symptoms were cured in one, showed no change during follow-up in one, and aggravated in one. Conclusion:Surgical treatment can significantly relieve pain, improve spinal dysfunction and repair nerve injury in patients with bone cement dislodgement after vertebral augmentation.

Objective: To evaluate the clinical efficacy and safety of nimodipine combine with butylphthalide in the treatment of patients with mild to moderate vascular cognitive impairment(VCI). Methods: From January 2012 to December 2016, 100 patients with mild to moderate VCI in Jinhua Municipal Central Hospital were randomly divided into control group(n=50) and treatment group(n=50) according to the random number table method.The control group received butylphthalide capsule, 200 mg po tid.The treatment group received nimodipine tablets, 40mg po tid, on the basis of the control group.The two groups of patients were treated for 24 weeks.Montreal cognitive assessment(MoCA), activities of daily living(ADL), serum hs-CRP, IL-6, TNF-α, clinical efficacy and adverse drug reactions were compared after treatment. Results: After treatment, the scores of MoCA and ADL in the treatment group were (24.32±2.87)points, (59.22±6.17)points, respectively, which were significantly higher than those in the control group[(22.76±2.67)points, (55.63±6.3)points, t=2.814, 2.870, all P<0.05]. The effective rates in the treatment group and control group were 74.00%(37/50), 52.00%(26/50), respectively, and there was statistically significant difference between the two groups(χ²=5.191, P<0.05). After treatment, the levels of hs-CRP[(189.51±23.27)mg/L vs.(211.51±25.51)mg/L], IL-6[(76.42±9.86)ng/L vs.(95.85±10.23)ng/L], TNF-α[(0.24±0.08)ng/L vs.(0.32±0.10)ng/L] between the treatment group and the control group had statistically significant differences(t=4.505, 9.670, 4.417, all P<0.05). The adverse drug reactions were nausea and vomiting in 3 cases in the control group(6.00%), nausea and vomiting in 3 cases and hypotension in 1 case in the treatment group(8.00%), and there was no statistically significant difference between the two groups(P>0.05). Conclusion Nimodipine combined with butylphthalide in the treatment of mild to moderate VCI is effective and has high safety.

Objective: To evaluate the anthracyclines-induced cardiotoxicity in patients with early-stage breast cancer. Methods: This retrospective study analyzed data of 64 patients (aged from 36 to 59 years old) with early-stage breast cancer after surgery. Patients were divided into ACT group (n=21), FAC group (n=19) and EC group (n=24). The NCI CTC 4.0 scores was used to evaluate the side effects at the time of 2 weeks, 4 weeks and 6 weeks after chemotherapy. Meanwhile, the level of cTnT, the incidence of abnormal electrocardiogram (ECG) and left ventricular ejection fraction (LVEF) were used to evaluate the anthracyclines-induced cardiotoxicity, the follow-up observation points were as follows: at the acute cardiotoxicity (time A), subacute cardiotoxicity (time B), 24 months after chemotherapy (time C), 36 months after chemotherapy (time D), 48 months after chemotherapy (time E), 60 months after chemotherapy (time F). The 3-years and 5-years overall survival and progress free disease survival among three groups were compared. Results: The ages, clinical stage, the size of tumor, axillary lymph node positivity and Eastern Cooperative Oncology Group Scores were similar among three groups (P>0.05); the incidence of side effects level 4 was 0. The levels of cTnT in the three groups were significantly lower than those at the baseline and time points C, D, E and F (all P<0.05), and the levels of cTnT were significantly higher in EC group than in FAC and ACT group at the time points B, C, D, E and F (P<0.05); however, the incidence of abnormal ECG and LVEF was similar among the 3 groups (P>0.05). The 5-year overall survival was 95.2% (20/21) ,100% (19/19) and 95.8% (23/24) in ACT group, FAC group and EC group, respectively; 5-year progress free disease survival was 95.2% (20/21) ,94.7% (18/19) and 91.7% (22/24) in ACT group, FAC group and EC group, respectively (P>0.05) . Conclusions Patients with early-stage breast cancer after surgery could tolerate the anthracyclines-induced cardiotoxicity. Three chemotherapy schemes of ACT, FAC and EC, especially the EC protocol, could affect the myocardial damage. However, outcome is comparable among patients treated with above chemotherapy schemes in this patient cohort.

Aim To research the protective effects of specnuezhenide, an active compound of traditional Chinese medicine, against CCl4-induced hepatic dam-age in mice. Methods The model of acute hepatic damage caused by CCl4 intraperitoneal injection on mice was obtained. The levels of ALT, AST, TNF-α, IL-1β, and IL-6 in serum, the activities of MDA, SOD, and GSH-Px in liver homogenates, and the his-topathological organization of liver sections were also examined to observe the protective effects of specnu-ezhenide. Results Specnuezhenide markedly de-creased the CCl4-induced elevation of serum ALT and AST activities, and improved hepatic histopathology changes. Specnuezhenide also significantly decreased the content of MDA in liver tissues, meanwhile in-creased the activities of antioxidant enzymes SOD and GSH-Px. In addition, specnuezhenide reduced the lev-els of TNF-α, IL-1β and IL-6 . Conclusions Specnu-ezhenide has significant protective effects against CCl4-induced hepatic damage in mice, and the possible un-derlying mechanisms of the activity could be due to its antioxidant and anti-inflammatory effects.

Erzhiwan includes two components of Chinese herbal medicines - Ligustri Lucidi Fructus and Herba Eclip-tae .Ligustri Lucidi Fructus ,Herba Ecliptae and their formulation have various hepatoprotective effects .There are many ac-tive ingredients in the formulation ,such as triterpenes ,iridoids ,phenethyl alcohol-glucosides ,coumarin ethers ,etc .They can resist various chemistry-induced hepatic injury ,ischemia reperfusion induced hepatic injury ,and hepatic fibrosis .The mecha-nisms of hepatoprotective effect include anti-oxidative stress ,anti-inflammatory ,inhibition of hyperplasia and activation of liver stellate cell ,motivating the apoptosis of liver stellate cell ,influencing the metabolic processes of liver cell ,ect .We reviewed and summarized the hepatoprotective effects of Erzhiwan and its components Ligustri Lucidi Fructus and Herba Ecliptae and explore the mechanisms of hepatoprotective effect in order to provide information for further research of pharmacodynamic ma-terial base .

OBJECTIVETo modify the level set method for precise and fast segmentation of B-type ultrasound image lesions.

METHODSBased on the best of region level set method, entropy in the information theory was introduced into image processing to define a dynamic weighting factor that responded to the gradient change of the local gray levels to evaluate the dynamic degree of driven force on each pixel on the contour to the target and background areas. The dynamic weighting factors were reconciled into the regional level set model and led the contour to deform and move during the iterations. As lesion segmentation was classified as local segmentation of a specific area, the calculation was restrained to the local sphere abide by the contour, which greatly reduced the calculation complex.

RESULTSExperiments on B-type ultrasound images showed improved results of the proposed method with a better accuracy and less time consumption compared with several current level set methods.

CONCLUSIONLevel set method reconciled with dynamic weighting factor allows a better evaluation of the lesion contour pixels, and the local calculation strategy results in an enhanced segmentation efficiency.

Algorithms ; Image Processing, Computer-Assisted ; Models, Theoretical ; Ultrasonography

OBJECTIVETo investigate the effect of mTOR signal transduction pathway and down-regulating anti-oncogene PTEN on the growth of breast cancer MCF-7 cells.

METHODSMCF-7 cells were transfected with the eukaryotic expression plasmid pcDNA3.1-mTOR and non-loaded plasmid, and the expression of mTOR in the cells was detected using Western blotting. Flow cytometry was used to analyze apoptosis and cell cycle of the transfected cells, and the expression of PTEN was detected after transfection.

RESULTSThe cells transfected with pcDNA3.1-mTOR showed a increased growth rate than those transfected with the non-loaded plasmid and those without transfection. The expression of the protein PTEN decreased obviously in the cells after mTOR trasnfection.

CONCLUSIONmTOR can regulate the expression of PTEN via PI3K/AKT/PTEN pathways through a negative feedback mechanism. Increased mTOR expression promotes MCF-7 cell growth, suggesting the potential value of mTOR specific inhibitor in the treatment of breast cancer.

Apoptosis ; Breast Neoplasms ; pathology ; Cell Cycle ; Down-Regulation ; Gene Expression Regulation, Neoplastic ; Humans ; MCF-7 Cells ; PTEN Phosphohydrolase ; metabolism ; Plasmids ; Signal Transduction ; TOR Serine-Threonine Kinases ; genetics ; Transfection

Objective To study the relationship between vitamin D deficiency and severe bronchial pneumonia in children. Methods A total of 58 children with severe pneumonia complicated by a lack of vi-tamin D from January 2011 to December 2013 were enrolled in this study,the serum 25-( OH) D3 was detec-ted by the high performance liquid chromatography-tandem mass spectrometry. All the children were random-ly divided into two groups,the vitamin D treatment group( observation group) and without vitamin D treat-ment group(control group),control group received conventional treatment,and the observation group re-ceived vitamin D based on the same treatment with the control group. Results The serum 25-( OH) D3 of the observation group increased significantly( P<0. 01 ) . ( 2 ) The symptoms such as cough, asthma, fever and pulmonary rales in the observation group disappeared more quickly than that of the control group,and the av-erage cure days of heart failure,respiratory failure and encephalopathy as well as the average length of stay in the observation group were less than those of control group,and there were significant differences between two groups(P<0. 01). (3) The total efficiency of the observation group and control group was 96. 42% and 73. 33% respectively,and there was significant difference between two groups(χ2 =6. 693,P<0. 01). (4) Blood oxygen pressure and oxygen saturation of the observer group were significantly improved,CO2 partial pressure decreased obviously, the differences were statistically significant between two groups ( P <0. 01 ) . Conclusion During the treatment periods in children with severe pneumonia,vitamin D supplements could relieve symptoms promptly,shorten the duration,improve the 25-( OH) D3 levels,and vitamin D deficiency may also be the underlying cause of severe pneumonia in children.

Objective To investigate the effect of mTOR signal transduction pathway and down-regulating anti-oncogene PTEN on the growth of breast cancer MCF-7 cells. Methods MCF-7 cells were transfected with the eukaryotic expression plasmid pcDNA3.1-mTOR and non-loaded plasmid, and the expression of mTOR in the cells was detected using Western blotting. Flow cytometry was used to analyze apoptosis and cell cycle of the transfected cells, and the expression of PTEN was detected after transfection. Results The cells transfected with pcDNA3.1-mTOR showed a increased growth rate than those transfected with the non-loaded plasmid and those without transfection. The expression of the protein PTEN decreased obviously in the cells after mTOR trasnfection. Conclusion mTOR can regulate the expression of PTEN via PI3K/AKT/PTEN pathways through a negative feedback mechanism. Increased mTOR expression promotes MCF-7 cell growth, suggesting the potential value of mTOR specific inhibitor in the treatment of breast cancer.

Objective To modify the level set method for precise and fast segmentation of B-type ultrasound image lesions. Methods Based on the best of region level set method, entropy in the information theory was introduced into image processing to define a dynamic weighting factor that responded to the gradient change of the local gray levels to evaluate the dynamic degree of driven force on each pixel on the contour to the target and background areas. The dynamic weighting factors were reconciled into the regional level set model and led the contour to deform and move during the iterations. As lesion segmentation was classified as local segmentation of a specific area, the calculation was restrained to the local sphere abide by the contour, which greatly reduced the calculation complex. Results Experiments on B-type ultrasound images showed improved results of the proposed method with a better accuracy and less time consumption compared with several current level set methods. Conclusion Level set method reconciled with dynamic weighting factor allows a better evaluation of the lesion contour pixels, and the local calculation strategy results in an enhanced segmentation efficiency.