Search

Kai-Cai Liu,1 Wei-Fu lv,2 Dong Lu,2 Chang-Long Hou,2 Jun Xie,3 Yu-He Lu,4 Qi-Sheng Cao,5 Yu-Lin Tan,6 Ying-Zhan Zhang,7 Jie Liu8 1Infection Hospital, The First Affiliated Hospital of University of Science and Technology of China, Hefei, People’s Republic of China; 2Department of Interventional Radiology, The First Affiliated Hospital of University of Science and Technology of China, Hefei, People’s Republic of China; 3Department of Interventional Radiology, Fuyang People’s Hospital, Fuyang, People’s Republic of China; 4Department of Interventional Radiology, Chuzhou First People’s Hospital, Chuzhou, People’s Republic of China; 5Department of Interventional Radiology, Ma’anshan People’s Hospital, Ma’anshan, People’s Republic of China; 6Department of Interventional Radiology, The First Affiliated Hospital of Bengbu Medical College, Bengbu, People’s Republic of China; 7Department of Interventional Radiology, The Second Affiliated Hospital of Bengbu Medical College, Bengbu, People’s Republic of China; 8Department of Interventional Radiology, Yingshang People’s Hospital, Fuyang, People’s Republic of ChinaCorrespondence: Wei-Fu lv; Dong LuDepartment of Interventional Radiology, The First Affiliated Hospital of University of Science and Technology of China, Hefei, People’s Republic of ChinaEmail weifulv@ustc.edu.cn; ahslludong@163.comPurpose: To investigate the potential safety and efficacy of drug-eluting bead-transcatheter arterial chemoembolization (DEB-TACE) in treating TACE-refractory hepatocellular carcinoma (HCC).Methods: We retrospectively evaluated the treatment outcomes of DEB-TACE for 41 HCC nodules in 30 patients who were refractory to conventional TACE (c-TACE) according to tumor response. The antitumor response was evaluated according to mRECIST criteria, and changes in alpha-fetoprotein (AFP), albumin-bilirubin score, the incidence of adverse events, and the time to disease progression were observed.Results: The objective response rate and disease control rates were 60.98% and 95.12% at 4 weeks after DEB-TACE, 63.41% and 92.68% at 8 weeks, respectively. The median time of disease progression was 4.60 ± 0.23 months. The AFP of patients decreased continuously at 2– 6 weeks after operation, and the AFP at 4 weeks was significantly lower than that at 2 weeks (P = 0.038). Adverse reactions were well tolerated, and no grade 4 adverse reactions were reported. The albumin-bilirubin score did not deteriorate within 6 weeks.Conclusion: DEB-TACE has potential efficacy and safety after failure of c-TACE in patients with advanced liver cancer. Further studies are needed to confirm the efficacy of DEB-TACE treatment after failure of c-TACE.Keywords: transcatheter arterial chemoembolization, refractory disease, drug-eluting bead, hepatocellular carcinoma, efficacy

Hua Yuan,* Yu-Zhao Zhang,* Hong Jie, Shi-Lian Li Department of Ophthalmology, Wuhan Children’s Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science & Technology, Wuhan, 430016, People’s Republic of China*These authors contributed equally to this workCorrespondence: Shi-Lian LiDepartment of Ophthalmology, Wuhan Children’s Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science & Technology, No. 100 Hongkong Road, Wuhan, 430016, People’s Republic of ChinaTel +86 13971212408Fax +8627-82433375Email lisldrli@163.comObjective: To discuss a rapid and effective treatment used for children with eyelid lacerations during the COVID-19 lockdown in Wuhan to limit the risk of cross-infection.Methods: A comparative study was conducted of forty-five patients with eyelid lacerations who attended the Ophthalmology Department of Wuhan Children’s Hospital between January 23, 2020 and March 6, 2020. The tissue glue Histoacryl was used to bond the wounds in 24 cases, while the traditional suture method was used for 21 cases. The wound healing time, complications, treatment satisfaction, and number of visits of the two groups were compared.Results: The two groups had similar baseline characteristics. The wound healing time (from wound disinfection to wound dressing) was shorter in the tissue glue group (4.35 ± 0.47min versus 11.71 ± 1.85 min, P< 0.01). There was 1 case of wound dehiscence in the tissue glue group. Twenty-two cases in the tissue glue group were satisfied, 2 cases were basically satisfied, and 0 were dissatisfied. Eleven cases in the traditional suture group were satisfied, 9 cases were basically satisfied, and 1 case was dissatisfied. The difference was statistically significant (P < 0.05). In terms of the number of visits, the tissue glue group visited (1.54 ± 0.88) times, while the traditional suture group visited (2.38 ± 0.59) times. The difference between the two groups was statistically significant (P < 0.01). The real-time reverse transcriptase polymerase chain tests for severe acute respiratory syndrome coronavirus 2 of all medical staff in the ophthalmology emergency room were negative.Conclusion: Compared with the traditional suture method, tissue glue used in eyelid laceration in children has the advantages of painlessness, shorter operation duration, higher safety and satisfaction, greater ease of care, and fewer hospital visits. Tissue glue can be widely used to reduce the risk of cross-infection.Keywords: coronavirus disease 2019, COVID-19, tissue glue, acrylate cyanide, children, eyelid, laceration

Ming Zhong,1– 3 Yi-Ru Yang,4 Yong-Ze Zhang,1– 3 Sun-Jie Yan1– 3 1Department of Endocrinology, The First Affiliated Hospital, Fujian Medical University, Fuzhou, 350005, Fujian, People’s Republic of China; 2Fujian Diabetes Research Institute, The First Affiliated Hospital, Fujian Medical University, Fuzhou, 350005, Fujian, People’s Republic of China; 3Metabolic Diseases Research Institute, The First Affiliated Hospital, Fujian Medical University, Fuzhou, 350005, Fujian, People’s Republic of China; 4Department of Ultrasound, The Second Affiliated Hospital, Fujian Medical University, Quanzhou, Fujian, 362000, People’s Republic of ChinaCorrespondence: Sun-Jie YanDepartment of Endocrinology, The First Affiliated Hospital, Fujian Medical University, 20 Tea Road, Taijiang District, Fuzhou, 350005, Fujian, People’s Republic of ChinaTel +86-0591-87983333Fax +86-0591-87981685Email fjyansunjie@163.comPurpose: This study aimed to assess association between change in urine albumin-to-creatinine ratio (UACR) and the risk of diabetic peripheral neuropathy (DPN) in type 2 diabetes mellitus.Patients and Methods: A retrospective study was performed, which included 185 individuals with type 2 diabetes. At baseline, and at two-year follow-up, we collected basic data, recorded symptoms and signs of DPN, measured biochemical indicators, composite motor nerve conduction velocity (composite MCV), and composite sensory nerve conduction velocity (composite SCV).Results: Changes of composite SCV, MCV and TCSS among different changes in UACR in patients without DPN and with DPN were not significantly different. An increase in UACR ≥ 30% (OR 3.059, 95%; CI: 1.012– 9.249) suggested a risk for new-onset DPN. Based on ROC curve analysis, the areas under the curve were 0.654 ± 0.066 for change of UACR levels in non-DPN patients.Conclusion: Change in UACR and NCV was not related in patients without DPN and with DPN; change in UACR ≥ 30% suggested a risk for new-onset DPN.Keywords: diabetic peripheral neuropathy, type 2 diabetes, urine albumin-to-creatinine ratio, nerve conduction velocity

You-Zhi Zhang,1 Yu-Lin Zhang,1 Qi Huang,1 Cong Huang,1 Zhi-Long Jiang,1 Fei Cai,1 Jian-Fen Shen2 1School of Pharmacy, Hubei University of Science and Technology, Xianning, Hubei 437100, People’s Republic of China; 2Department of Central Laboratory, The First Affiliated Hospital of Jiaxing University, Jiaxing, Zhejiang 314001, People’s Republic of ChinaCorrespondence: Jian-Fen ShenDepartment of Central Laboratory, The First Affiliated Hospital of Jiaxing University, 1882 Zhonghuan South Road, Jiaxing, Zhejiang 314001, People’s Republic of ChinaTel +86 573 8251 9007Email shenjf2008@163.comBackground: Hypoadiponectinemia is a high risk factor for type 2 diabetes and cardiovascular disease. Although adiponectin is a protective molecule in cardiovascular diseases, it is hampered due to short plasma half-life and high cost of production. This study aimed to investigate whether AdipoRon, a small-molecule adiponectin receptor agonist, alleviated saturated free fatty acids such as palmitic acid (PA)-induced cardiomyocyte injury by suppressing Nlrp3 inflammasome activation.Methods: Cell viability was used with MTT assay. Cell apoptosis and mitochondria membrane potential were detected by flow cytometry. We also detected the ROS production and colocolization of inflammasome protein with fluorescence and immunofluorescence microscopic analysis, respectively. Then, IL-1β was detected by Elisa assay and other protein expression was analyzed by Western blot.Results: Our observations demonstrated PA dose-dependently promoted the cell injury, and such high lipotoxicity induced impairment of cardiomyocytes was significantly attenuated by AdipoRon treatment. Moreover, PA markedly activated the first phase of Nlrp3 inflammasome (NF-ƙb) signaling. Notably, the stimulation of PA enhanced ROS production as regulators of Nlrp3 inflammasome activation. In addition, treatment with PA increased the Nlrp3 inflammasome protein expression and complex formation, while AdipoRon abolished it. Lastly, the suppressive effect of AdipoRon to PA-induced cell injury and Nlrp3 inflammasome activation was significantly reversed by Nlrp3 siRNA and pan-caspase inhibitor (z-vad-fmk).Conclusion: Taken together, these data suggested that AdipoRon suppressed PA-induced myocardial cell injury by suppressing Nlrp3 inflammasome activation. Thus, AdipoRon might possess potent protective effect in lipotoxicity injury such as obesity leading to cardiac disease.Keywords: adiponectin, AdipoRon, PA, inflammasome, cardiomyocytes

Taohua Liu,1 Yuezhong Zhang,1 Qiquan Wan2 1Xiangya School of Medicine, Central South University, Changsha 410083, China; 2Department of Transplant Surgery, The Third Xiangya Hospital, Central South University, Changsha 410013, China Abstract: Pseudomonas aeruginosa bacteremia remains as a life-threatening complication after liver transplantation (LT) and is intractable because of the high rate of drug resistance to commonly used antibiotics. To better understand the characteristics of this postoperative complication, PubMed and Embase searches as well as reference mining was done for relevant literature from the start of the databases through August 2018. Among LT recipients, the incidence of P. aeruginosa bacteremia ranged from 0.5% to 14.4% and mortality rates were up to 40%. Approximately 35% of all episodes of bloodstream infections (BSIs) were P. aeruginosa bacteremia, of which 47% were multidrug resistant and 63% were extensively drug resistant. Several factors are known to affect the mortality of LT recipients with P. aeruginosa bacteremia, including hypotension, mechanical ventilation, and increasing severity of illness. In LT recipients with P. aeruginosa bacteremia, alteration in DNA gyrase A genes and overexpression of proteins involved in efflux systems, namely the expression of KPC-2-type carbapenemase, NDM-1, and VIM-2-type MBL, contribute to the high resistance of P. aeruginosa to a wide variety of antibiotics. Because of complicated mechanisms of drug resistance, P. aeruginosa causes high morbidity and mortality in bacteremic LT patients. Consequently, early detection and treatment with adequate early targeted coverage for P. aeruginosa BSI are of paramount importance in the early posttransplantation period to obtain a better prognosis for LT patients. Keywords: antimicrobial resistance, morbidity and mortality, risk factor, solid organ transplantation, liver transplantation

Jianfen Shen,1 Youzhi Zhang,2 Hui Shen,1 Hua Pan,1 Longsheng Xu,1 Linna Yuan,1 Zhiying Ding1 1Department of Central Laboratory, The First Affiliated Hospital of Jiaxing University, Jiaxing 314000, China; 2School of Pharmacy, Hubei University of Science and Technology, Xianning 437100, China Objective: Breast cancer has been reported to be a serious disease and a threat to women’s health. 2,3,5,4'-Tetrahydroxystilbene-2-O-β-D-glucoside (THSG) is a bioactive natural compound originating from Polygonum multiflorum Thunb., which has been shown to possess anti-inflammatory and antitumor properties. Adriamycin (ADM) is a chemotherapy agent used in tumor therapy that is limited by its side effects. However, little is known about the synergistic effect of THSG combined with ADM on breast cancer. This study seeks to investigate the effects of the combination of THSG plus ADM on MCF-7 breast cancer cells and to test the mechanisms involved.Materials and methods: MTT assay was detected to determine cell viability. Furthermore, cell apoptosis was tested by flow cytometry and TUNEL assay. In addition, protein expression was measured by Western blot analysis.Results: The individual treatment of THSG and ADM induced cell injury. Moreover, cotreatment further increased it, which the effect may be associated with the elevation of the apoptotic-related protein expression such as Bax/Bcl-2 and cleaved caspase-3/caspase-3. Lastly, our results also show the reduction of vascular endothelial growth factor/phosphatidylinositol 3-kinase/Akt protein expression in the individual or synergistic treatment.Conclusion: Taken together, cotreatment of THSG and ADM may exert a synergistic reduction of cell injury via the inhibition of vascular endothelial growth factor/phosphatidylinositol 3-kinase/Akt pathway. Thus, THSG might possess potent anti-breast cancer effect with ADM. Keywords: THSG, ADM, synergistic effect, apoptosis, VEGF/PI3K/Akt, breast cancer

Bi-Lian Chen,1,* Yin-Zhuang Zhang,1,* Jian-Quan Luo,2,3 Wei Zhang2,3 1Department of Geriatrics, Xiangya Hospital, Central South University, Changsha, Hunan, People’s Republic of China; 2Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha, Hunan, People’s Republic of China; 3Institute of Clinical Pharmacology, Central South University, Changsha, Hunan, People’s Republic of China *These authors contributed equally to this work Background: Hypertension is the most common chronic disease and the calcium channel antagonist is the most popularly used antihypertensive drug in Chinese patients. Azelnidipine is a third generation and long-acting dihydropyridine calcium channel antagonist. A series of research has demonstrated that azelnidipine produced an effective antihypertensive effect in patients with essential hypertension. Now it is need to summarize clinical use of azelnidipine in the treatment of hypertension in Chinese patients. Methods: Relevant literature was identified by performing searches in PubMed and CNKI (China National Knowledge Infrastructure), covering the period from January 2003 (the year azelnidipine was launched) to July 2014. We included studies that described pharmacology of azelnidipine, especially the pharmacokinetics, clinical efficacy, and safety and tolerability of azelnidipine in a Chinese population. The full text of each article was strictly reviewed, and data interpretation was performed. Results: In Chinese healthy volunteers, a single-dose oral administration of azelnidipine 8–16 mg had a peak plasma concentration of 1.66–23.06 ng/mL and time to peak plasma concentration was 2.6–4.0 hours and the area under the plasma concentration versus time curve from time 0 hour to 96 hours was 17.9–429 ng/mL·h and elimination half-life was 16.0–28.0 hours. A number of clinical trials have demonstrated that azelnidipine produced a significant reduction in blood pressure in Chinese patients with mild-to-moderate hypertension, which was similar to that of other effective antihypertensive drugs such as amlodipine, zofenopril, and nifedipine. In addition to its antihypertensive effect, azelnidipine had other cardiovascular protective effects as well, like anti-oxidative action, decreasing heart rate, and improving systolic and diastolic function. Azelnidipine was generally well tolerated in Chinese patients and no severe adverse events were observed. Conclusion: Azelnidipine is effective and safe in the treatment of hypertension in Chinese patients. Keywords: azelnidipine, hypertension, Chinese, pharmacology, pharmacokinetics, efficacy

Abstract The semiconducting single-walled carbon nanotube (C-SWNT) has been synthesized by S-doping, and they have extensive potential application in electronic devices. We investigated the electronic structures of S-doped capped (5, 5) C-SWNT with different doping position using first principles calculations. It is found that the electronic structures influence strongly on the workfunction without and with external electric field. It is considered that the extended wave functions at the sidewall of the tube favor for the emission properties. With the S-doping into the C-SWNT, the HOMO and LUMO charges distribution is mainly more localized at the sidewall of the tube and the presence of the unsaturated dangling bond, which are believed to enhance workfunction. When external electric field is applied, the coupled states with mixture of localized and extended states are presented at the cap, which provide the lower workfunction. In addition, the wave functions close to the cap have flowed to the cap as coupled states and to the sidewall of the tube mainly as extended states, which results in the larger workfunction. It is concluded that the S-doped C-SWNT is not incentive to be applied in field emitter fabrication. The results are also helpful to understand and interpret the application in other electronic devices.

The current research on the damage-based strength reduction factor has been completely based on the inelastic single-degree-of-freedom systems that are more suitable for two-dimensional analyses. Therefore, it is necessary to construct damage-based strength reduction factor spectra for systems subjected to bidirectional ground motions. In this study, an inelastic single-mass bi-degree-of-freedom (SMBDOF) system subjected to the orthogonal bidirectional ground motions with the hysteretic property of two-dimensional yield-surface plasticity function is presented, and the x -component of the system is used to construct the damage-based strength reduction factor spectra of the system (R b spectra). The Park-Ang damage model is used to determine the constant damage index of the R b spectra. In addition, 178 ground motion records for site classes C, D, and E are considered as ground excitations of the SMBDOF system to construct the mean R b spectra with the format of R b - D - T for a given ductility capacity and R b - μ u - T for a given damage level. The R b spectra of the SMBDOF system is compared with the corresponding R spectra of the SDOF system. Statistical analysis considering different values of the natural period, ductility capacity, damage index, period ratio, and site condition is conducted. Analysis results show that the coupling of two-component responses of an inelastic system could increase the strength demand of the system in certain cases; the trend of the R b spectra presented in this study is approximately consistent for different site classes, but the spectral values have the characteristic of site conditions. Therefore, the influence of the period ratio should be considered because a large period difference between two components of the SMBDOF system could aggravate seismic damage in certain situations. Based on the statistical analysis, the expression of R b spectra curves with a period ratio γ = 1 is derived using the regression analysis, and the correction expression is obtained considering the influence of the period ratio on the R b spectra. Then, the construction procedure of the R b spectra is introduced. The predicted R b spectra obtained by the proposed procedure is compared with the actual mean spectra, and comparison results indicate a good match. [ABSTRACT FROM AUTHOR]

Objectives: To enhance diagnosis of gastrointestinal neuroendocrine carcinomas using CT and contrast-enhanced CT images. Methods: A total of 44 patients with gastrointestinal neuroendocrine carcinomas, as confirmed by clinical pathology and immunohistochemistry in the Sixth Affiliated People's Hospital of Shanghai Jiao Tong University Shanghai China, were included in the study. CT and enhanced CT scanning were performed, and the resulting images were reviewed and analyzed. Results: Twenty-seven males and 17 females were enrolled. Gastrointestinal involvement included the following: 5 cases located in the middle or inferior segment of the esophagus; 5 in the gastric cardia, 15 in the body of stomach, 6 located in the gastric antrum; 5 located in the Vater papilla of the duodenum; and 8 located in the colon. Among the 44 cases 80%-90% of the lesions had homogeneous density. Totally 81.8% (36/44) cases demonstrated homogeneous enhancement in arterial phases, most of the cases (n = 33) moderately or obviously enhanced. Only 17.2% (8/44) cases appeared as heterogeneous enhancement. And 86.4% cases (n = 38) were further enhanced in the venous phase. The CT images also revealed some of the metastases. Some liver metastasis cases have obvious homogeneous enhancement. Conclusions: CT and enhanced CT provide useful information regarding gastrointestinal neuroendocrine carcinomas' location, density, enhancement pattern, and some metastasis. These features are helpful to increase the diagnostic accuracy. [ABSTRACT FROM AUTHOR]

Context : There are currently few published studies that compare hippocampal volume (HCV) in children with temporal lobe epilepsy (TLE). Aims : T0 o compare HCVs in children with TLE and in relation to normal controls (NC), and to analyze HCV change in the acute phase in pediatric subjects using magnetic resonance imaging (MRI). Setting and Design : T0 he case group (n=24) was matched in gender and age range with NC subjects (n=24). Subjects were divided into three groups according to age: 2-5.9 years, 6-8.9 years and 9-13 years. Materials and Methods : M0 anual measurements were used to obtain HCVs on oblique coronary MRI images obtained by three-dimensional magnetization-prepared rapid gradient-echo (3D-MPRAGE) sequence. Statistical Analyses : T0 he HCV was calculated and normalized. Paired t-tests were used to compare the right and left HCVs within each study group. Analysis of covariance (ANCOVA) was used to consider the impact of age and gender on HCVs. Results : T0 wenty-two patients were diagnosed with definite/probable TLE, and two were non-syndromic focal epilepsy which was distributed in the 2-5.9 years group. The range of left to right mean HCVs of the case and NC group aged 2-13 years was 2014.14 ± 54.32 mm 3 to 2165.31 ± 80.99 mm 3 and 2015.46 ± 26.97 mm 3 to 2100.93 ± 57.33 mm 3 respectively. There were age-related differences in left and right HCV, but no effect of gender. Relative to NC subjects, cases group aged 2-5.9 years had significantly different HCVs, while no significant difference was found in the other two groups. There was significant difference in the right to left HCVs in the case subjects aged 2-5.9 years, but not in the other age groups. Conclusions : T0 he heterogeneity in the 2-5.9 years age cohort may relate to the increased HCVs. The HCV data from NC subjects may be used as a reference to assess hippocampal abnormalities in clinical practice. [ABSTRACT FROM AUTHOR]

Aim : To compare diffusion tensor image (DTI) study in association fiber tracts among normal control (NC), amnestic mild cognitive impairment (aMCI) and Alzheimer's disease (AD) subjects. To assess diagnostic value of DTI in aMCI and differential diagnosis of DTI study between aMCI and AD. Material and Methods : DTI was used to assess changes in cerebral association fiber tracts in NC, aMCI, and AD subjects (n = 20/group). Regions of interest included the inferior fronto-occipital fascicles (IFOF), superior longitudinal fascicles and cingulum tract, genu of corpus callosum (Gcc) was set right, splenium of corpus callosum was set left. Bilateral fractional anisotropy (FA) and apparent diffusion coefficient values were compared in three groups. Results : Relative to NC, aMCI subjects had significantly different FA values for the IFOF and cingulum tract, while AD subjects had significantly different FA values of IFOF, Gcc, and cingulum tract. Relative to aMCI, AD subjects had significantly different FA values of cingulum tract. Conclusion : Based on the results, DTI could be used as a diagnostic method for aMCI with abnormal changes in IFOF and cingulum tract. DTI could also be used for differential diagnosis of aMCI and AD by comparing FA values of the cingulum tract. Abnormal FA values of IFOF, Gcc, and cingulum tract in AD patients may help to elucidate the pathological processes in this disease. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the endothelial cell damage by detecting the circulating Tie2 mRNA level in a rat model of sepsis.Methods: The model of sepsis was established by cecal ligation and puncture (CLP) in 90 rats which were divided into 6 groups: normal, sham, CLP-3 h, CLP-6 h, CLP-12 h and CLP-24 h. Serum biochemical markers were detected by automatic biochemical analyzer. Serum IL-6 was measured with enzyme linked immunosorbent assay. The vascular permeability of liver, kidney, lung and heart was detected with Evans blue. Circulating endothelial cells (CEC) were separated using density gradient separation and counted. Total RNA of whole blood were extracted and the mRNA levels of two endothelial specific genes, Tie2 and vascular endothelial growth factor receptor 2 (VEGFR2), were measured by quantitative real-time PCR.Results: The level of serum biochemical indexes increased after CLP. The amount of serum IL-6 in CLP-6 h, 12 h, and 24 h group was increased 6.5-fold (P <0.05), 8.4-fold (P < 0.01), and 13.3-fold (P < 0.001) compared with normal group (170.68 pg/ml ± 42.46 pg/ml) respectively (F = 14.319, P < 0.001). Significantly increased organ vasopermeability of liver, kidney, lung and heart was observed after CLP respectively. The number of CEC peaked (11.83 ± 1.94) 3 hours after CLP compared with normal control (5.33 ± 1.21, P < 0.05), and then decreased gradually (F = 54.183, P < 0.001). The mRNA level of Tie2 in CLP-3 h group (3.47 ± 1.47) was also markedly higher than that in other groups (F = 10.640, P < 0.001).Conclusion: Using quantitative real-time PCR to measure the level of Tie2 mRNA in peripheral blood is a simple and relatively sensitive method to evaluate the damage of endothelial cells. [ABSTRACT FROM AUTHOR]

Objective: To estimate the heritability of Kashin–Beck disease (KBD) in first-degree relatives and to identify chromosome regions likely to contain susceptibility loci for KBD. Methods: A total of 331 probands with confirmed KBD in their pedigrees were selected from 9331 residents in 17 KBD villages of Linyou county, northwestern China. The heritability (h2) in first-degree relatives was estimated by using Falconer's formula. The segregation ratio was calculated by the Li–Mantel–Gart method. A total of 23 short tandem repeat (STR) loci on chromosomes 2, 11, and 12 were used to identify the susceptibility genes for KBD by linkage analysis using the GENEHUNTER program in 19 KBD pedigrees. Results: The general prevalence rate of KBD was 13.75% in the 17 KBD villages, lower than that of 20.88% in the first-degree relatives of the KBD probands. In the first-degree relatives, the heritability was 0.064 and the segregation ratio 35.10% (p < 0.05). Slight evidence for heritability was detected only in locus D12S1725 with a logarithm of odds (LOD) score of 1.95. However, the nonparametric linkage (NPL) scores showed no linkage between KBD and the 23 loci; the maximum NPL score was 1.59 for locus D12S1725. Conclusions: Our results show that 35.10% of the heritability is attributable to genetic variation for the KBD phenotype among individuals of Linyou county, and the segregation ratio supports a multifactorial inheritance of KBD. There is no significant linkage between KBD and the 23 markers in the Linyou population examined; however, markers near the locus D12S1725 may indicate loci for further study. [ABSTRACT FROM AUTHOR]

The present method of C2 laminar screw placement relies on anatomical landmarks for screw placement. Placement of C2 laminar screws using drill template has not been described in the literature. The authors reported on their experience with placement of C2 laminar screws using a novel computer-assisted drill guide template in nine patients undergoing posterior occipito-cervical fusion. CT scan of C2 vertebrae was performed. 3D model of C2 vertebrae was reconstructed by software MIMICS 10.01. The 3D vertebral model was then exported in STL format, and opened in a workstation running software UG imageware12.0 for determining the optimal laminar screw size and orientation. A virtual navigational template was established according to the laminar anatomic trait. The physical vertebrae and navigational template were manufactured using rapid prototyping. The navigational template was sterilized and used intraoperative to assist the placement of laminar screw. Overall, 19 C2 laminar screws were placed and the accuracy of screw placement was confirmed with postoperative X-ray and CT scanning. There were not complications of related screws insertion. Average follow-up was 9 months (range 4-13 months), 77.8% of the patients exhibited improvement in their myelopathic symptoms; in 22.2% the symptoms were unchanged. Postoperative computed tomographic (CT) scanning was available for allowing the evaluation of placement of thirteen C2 laminar screws, all of which were in good position with no spinal canal violation. This study shows a patient-specific template technique that is easy to use, can simplify the surgical act and generates highly accurate C2 laminar screw placement. Advantages of this technology over traditional techniques include planning of the screw trajectory is done completely in the presurgical period as well as the ability to size the screw to the patient's anatomy. [ABSTRACT FROM AUTHOR]

Objective: To provide a new method in the fixation of sacral fracture by means of three-dimensional reconstruction and reverse engineering technique.Methods: Pelvis image data were obtained from three-dimensional CT scan in patients with sacral fracture. The data were transferred into a computer workstation. The three-dimensional models of pelvis were reconstructed using Amira 3.1 software and saved in STL format. Then the three-dimensional fracture models were imported into Imageware 9.0 software. Different situations of reduction (total reduction, half reduction and non-reduction) were simulated using Imageware 9.0 software. The best direction and location of extract iliosacral lag screws were defined using reverse engineering according to these three situations and navigation templates were designed according to the anatomic features of the postero-iliac part and the channel. The exact navigational template was made by rapid prototyping. Drill guides were sterilized and used intraoperatively to assist in surgical navigation and the placement of iliosacral lag screws.Results: Accurate screw placement was confirmed with postoperative X-ray and CT scanning. The navigation template was found to be highly accurate.Conclusion: The navigation template may be a useful method in minimal-invasive fixation of sacroiliac joint fracture. [ABSTRACT FROM AUTHOR]

Objective: To develop a novel method of spinal pedical stereotaxy by reverse engineering and rapid prototyping techniques, and to validate its accuracy by experimental and clinical studies.Methods: A 3D reconstruction model for the desired lumbar vertebra was generated by using the Mimics 10.11 software, and the optimal screw size and orientation were determined using the reverse engineering software. Afterwards, a drill template was created by reverse engineering principle, whose surface was the antitemplate of the vertebral surface. The drill template and its corresponding vertebra were manufactured using the rapid prototyping technique.Results: The accuracy of the drill template was confirmed by drilling screw trajectory into the vertebral biomodel preoperatively. This method also showed its ability to customize the placement and size of each screw based on the unique morphology of the lumbar vertebra.The drill template fits the postural surface of the vertebra very well in the cadaver experiment. Postoperative CT scans for controlling the pedicle bore showed that the personalized template had a high precision in cadaver experiment and clinical application. No misplacement occurred by using the personalized template. During surgery, no additional computer assistance was needed.Conclusions: The authors have developed a novel drill template for lumbar pedicle screw placement with good applicability and high accuracy. The potential use of drill templates to place lumbar pedicle screws is promising. Our methodology appears to provide an accurate technique and trajectory for pedicle screw placement in the lumbar spine. [ABSTRACT FROM AUTHOR]

We report the imaging findings of a mature thyroid teratoma in a 5-year-old girl. Nuclear imaging showed a decrease in (99)Tcm uptake in the right lobe of the thyroid gland. CT scan showed a slightly lobulated soft-tissue mass without calcification, fat or cystic components. Histological analysis showed that the tumor was composed of mature neural tissue, cartilaginous, and epithelial elements. This case study provides new insights into the CT appearance of mature thyroid teratomas. [ABSTRACT FROM AUTHOR]

STUDY DESIGN: A retrospective imaging study of 73 patients who underwent surgery for cervical spondylotic myelopathy (CSM) between April 2005 and July 2007. OBJECTIVE: To investigate whether magnetic resonance (MR) T2 image signal intensity (SI) ratio and clinical manifestation can assess the prognosis in patients with CSM. SUMMARY OF BACKGROUND DATA: The association between intramedullary high SI on T2-weighted MR images and surgical outcome in CSM remains controversial. The means of quantizing SI ratio for the disease has not been discussed. METHODS: A total of 73 patients with cervical compressive myelopathy were retrospectively enrolled and were treated with anterior, posterior, and posterior-anterior united decompression. A total of 1.5-T magnetic resonance imaging was performed in all patients before surgery. T2-weighted images of sagittal increased SI on the cervical spinal cord were obtained, and the regions of interest (ROIs) are taken by 0.05 cm. T2-weighted MR images of sagittal normal cord SI on the cervical between C7-T1 disc levels were obtained, and the ROIs are taken by 0.3 cm. SI value is measured by computer, and the SI ratio between the regions 0.05 cm and 0.3 cm has been calculated. If no intramedullary high SI was noted on T2-weighted MR images, the ROIs were taken by 0.05 cm of the severe compression cord. All patients had been divided into 3 groups by hierarchical clustering analysis with SI ratio (Group 1: low SI ratio, Group 2: middle SI ratio, and Group 3: high SI ratio). Statistical analyses were performed with SPSS 11.0. RESULTS: There are significant differences between 3 groups by comparing the recovery rate (P < 0.001), age (P = 0.003), duration of disease (P = 0.001), Babinski sign (P < 0.001), preoperative JOA score (P = 0.006), and postoperative JOA score (P < 0.001). There are no significant differences on sex among 3 groups (P = 0.387). By using the multiple comparison analysis, the above results are further shown. CONCLUSION: Patients with low SI ratio who were not too old and had a shorter duration of disease experienced a good surgical outcome. However, with the increase of SI ratio and the occurrence of pyramidal sign, a poor prognosis after surgery will show. SI ratio and clinical manifestation can be a predictor of surgical outcome. [ABSTRACT FROM AUTHOR]

Background: Preserving the C7 spinous process during cervical laminoplasty has been reported to prevent axial symptom. Some patients underwent laminectomy and fixation developed the symptom. The objective of this article was to investigate whether axial symptom can be reduced by preserving the C7 spinous process during cervical laminectomy and fixation with lateral mass screw.Methods: Between 2005 and 2008, data of 53 patients who underwent laminectomy and lateral mass-screw fixation for multilevel cervical myelopathy were reviewed. Analysis consisted of the incidence of axial symptom, Japan Orthopaedic Association (JOA) scores, recovery rate, cervical lordotic angle, and atrophy rate of cervical posterior muscle. Axial symptom severity was quantified by a visual analog scale (VAS). Twenty-five patients were decompressed from C3 to C7 (group A) and 28 from C3 to C6 with dome-shape removal of the C7 superior lamina (group B).Results: Analysis of final follow-up data showed improvement in clinical outcome for both groups. No difference in recovery rate, cervical lordotic angle and atrophy rate was observed between groups. Postoperative axial-neck pain was significantly rarer in group B than in group A. Axial symptom severity was correlated with cervical posterior muscle atrophy rate; correlation coefficient was 0.665.Conclusion: The C7 spinous process might play an important role in preventing axial symptom, but there is a need for randomized, control studies with long-term follow-up to clarify the results. [ABSTRACT FROM AUTHOR]