Diagnostic Performance of Acoustic Radiation Force Impulse Elastography for the Differentiation of Benign and Malignant Superficial Lymph Nodes: A Meta-analysis.

To estimate the diagnostic performance of acoustic radiation force impulse elastography in distinguishing between benign and malignant superficial lymph nodes, relevant articles published before October 31, 2018, in China and other countries were used. Conclusively, a total of 18 articles were analyzed. Sixteen studies used Virtual Touch tissue quantification (Siemens Healthineers, Erlangen, Germany), and 4 studies used Virtual Touch tissue imaging (Siemens Healthineers). After a meta-analysis, it was found that acoustic radiation force impulse elastography is an efficient method for detecting superficial lymph nodes. In addition, if the cutoff value for the shear wave velocity were less than 2.85 m/s, the summary sensitivity would increase, and the heterogeneity would be reduced.

Use of Blood Lipid Indicators as a Screening Tool of Insulin Resistance among Individuals in Low-Income Country Sides of China: A Multiethnic Region Study.

OBJECTIVE: This study is aimed at evaluating the diagnostic value of blood lipid indicators (BLIs) for insulin resistance (IR) among major ethnic groups in Xinjiang, China, to identify the most valuable indicators and appropriate cut-off points for each ethnic group and to lay the foundation for the early detection, diagnosis, and treatment of metabolic diseases in remote rural areas. METHODS: Overall, 418 Uygurs, 331 Kazakhs, and 220 Hans were randomly included in our study. The homeostasis model assessment was the gold standard for identifying IR. The receiver operating characteristic (ROC) curve was used to evaluate the diagnostic value, and the nomogram was utilized to analyze the predictive value. The size of the area under the curve (AUC) reflected the accuracy of screening and prediction. RESULTS: Differences in races were observed in terms of IR and BLIs, and the Kazakhs had the highest IR level at 5.27 mmol/L. The correlation between IR and BLIs differed among the three races. For the Kazakhs and Hans, all BLIs, except total cholesterol (TC), were correlated to IR. However, for the Uygurs, only the triglyceride (TG) level, TG/high-density lipoprotein cholesterol (HDL-C) ratio, and TC/HDL-C ratio were associated with IR. After further adjustment of confounding factors, these indicators were still correlated to IR. BLIs that independently correlated to IR in the three nationalities had a certain diagnostic value for IR. In terms of the AUC size, the TG level was the highest in Uygurs, the TG/HDL-C ratio was the highest for Kazakhs and Hans, and the corresponding best cut-off points for IR were 1.515, 1.230, and 1.495 mmol/L, respectively. In addition, for each race, when the indicators with a certain diagnostic value were combined, the diagnostic value for IR was higher. CONCLUSION: BLIs had a certain diagnostic value for IR and could be used as a screening tool for IR among Uygurs, Kazakhs, and Hans in Xinjiang. These findings are extremely important for the prevention and treatment of IR and metabolic diseases in remote rural areas.

[Trend in the prevalence of prostate cancer in Shihezi, Xinjiang from 2009 to 2017].

OBJECTIVE: To analyze the trend in the prevalence and mortality of prostate cancer in Shihezi, Xinjiang from 2009 to 2017 and provide some evidence for the prevention and control of the malignance. METHODS: We collected the data on the cancer registries in the Shihezi area between 2009 and 2017, calculated the incidence and mortality rates of prostate cancer, and analyzed the annual percent change (APC) and prevalence trend of the disease. RESULTS: The crude incidence rate, age-standardized incidence rate by Chinese standard population (ASIRC), age-standardized incidence rate by world standard population (ASIRW) and cumulative incidence rate of prostate cancer (in 0－74-year-olds) in Shihezi between 2009 and 2017 were 16.94, 10.33, 8.98 and 2.29 per 100 000, respectively. The crude mortality rate, age-standardized mortality rate by Chinese standard population (ASMRC), age-standardized mortality rate by world standard population (ASMRW) and cumulative incidence rate (in 0－74-year-olds) were 9.03, 5.39 and 4.72 and 0.49 per 100 000, respectively. Both the incidence and mortality rates showed an increasing trend from 2009 to 2017, with an APC of 16.69% (P < 0.05) and 19.71% (P < 0.05), respectively. From 2011 to 2017, the increase rates of incidence and mortality of prostate cancer in the >60-year-olds were 86.20% and 89.30%, with the peak values shifted from the 70－74 to the 80－84 years old males. CONCLUSIONS: The incidence and mortality of prostate cancer in Shihezi showed an increasing trend from 2009 to 2017, chiefly in the males aged over 60 years, with the peak value moving towards an older age.

The Bidirectional Effects of Arsenic on miRNA-21: A Systematic Review and Meta-analysis.

OBJECTIVE: Arsenic is a metalloid environmental carcinogen involved in the occurrence and development of many cancers. miRNA-21 plays a crucial role in arsenic-induced carcinogenesis. We aimed to elucidate the mechanism by which miRNA-21 influences arsenic-induced cancer. METHODS: We used meta-analysis of published studies to determine how arsenic induces cancerous cells through miRNA-21. RESULTS: Low-dose arsenic exposure (⪕ 5 µmol/L) can increase miRNA-21 and phosphorylated signal transducter and activator of transcription 3 (pSTAT3) expression, and decrease programmed cell death protein 4 (PDCD4) and protein sprouty homolog 1 (Spry1) expression. High-dose arsenic exposure (> 5 µmol/L), can increase miRNA-21 expression, and decrease Spry1 and E-cadherin expression. Short-term arsenic exposure (⪕ 24 h) can increase miRNA-21 and pSTAT3 expression, and decrease PDCD4 expression. Moreover, long-term arsenic exposure (> 24 h) can increase the miRNA-21, STAT3, and pSTAT3 expression, and decrease PDCD4 expression. We found that activation of miRNA-21 and pSTAT3 were most pronounced following long-term arsenic exposure at low doses, and the effects on PDCD4 expression were most pronounced following short-term arsenic exposure at low doses. miRNA-21 inhibitors increased the expression of tumor suppressor genes PDCD4, PTEN, and Spry1 and miRNA-21-mimics suppressed the expression of these tumor suppressor genes. CONCLUSION: Arsenic can cause cancer by activating miRNA-21 and inhibiting the expression of PDCD4, PTEN, and Spry1.

The increased number of tumor-associated macrophage is associated with overexpression of VEGF-C, plays an important role in Kazakh ESCC invasion and metastasis.

Tumor associated macrophages (TAMs) play an important role in the growth, progression, and metastasis of tumors. The distribution of TAMs in Kazakh esophageal squamous cell carcinoma (ESCC) is not determined. We aimed to investigate the role of TAMs in the occurrence and progression of Kazakh ESCC. CD163 was used as the TAM marker, and immunohistochemistry (IHC) counts were used to quantify the density of TAMs in tumor nest and surrounding stroma. IHC staining was used to evaluate the expression of vascular endothelial growth factor C (VEGF-C) in Kazakh ESCC and cancer adjacent normal (CAN) tissues. The density of TAMs in Kazakh ESCCs tumor nest and stromal was significantly higher than that in CAN tissues. The increased number of CD163-positive TAMs in tumor nest and tumor stromal was positively associated with Kazakh ESCC lymph node metastasis and clinical stage progression. Meanwhile, the expression of VEGF-C in Kazakh ESCCs was significantly higher than that in CAN tissues. Overexpression of VEGF-C in Kazakh ESCCs was significantly associated with gender, depth of tumor invasion, lymph node metastasis and tumor clinical stage. The increased number of TAMs, either in the tumor nests or tumor stroma was positively correlated with the overexpression of VEGF-C, which may promote lymphangiogenesis and play an important role in the invasion and metastasis of Kazakh ESCC.

Grape Seed Procyanidin Extract Reduces Arsenic-Induced Renal Inflammatory Injury in Male Mice.

The aim of the present study is to evaluate the ability and mechanism by which grape seed procyanidin extract (GSPE) relieves arsenic trioxide (As2O3)-induced renal inflammatory injury. Therefore, male Kunming mice were treated with As2O3 and/or GSPE by gavage for 5 weeks. Mice were then sacrificed and inflammatory cytokines of kidneys were examined by ELISA, whereas the expression levels of molecules involved in the nuclear factor (NF)-κB signaling pathway were evaluated by both qRT-PCR and Western blot. Our results indicate that GSPE prevents As2O3-mediated renal inflammatory injury by inhibiting activation of the NF-κB signaling pathway and inflammatory cytokine production, while promoting expression of anti-inflammatory cytokines.

The effect of growing Rod treatment on coronal balance during serial lengthening surgeries in early onset scoliosis.

BACKGROUND: Gaining and maintaining spinal balance after surgery is of great importance for early onset scoliosis (EOS). However, tendency of balance on the coronal plane after growing rod surgery has not been studied before. This study evaluated the effect of growing rod treatment on coronal balance (CB) during serial lengthening surgeries in EOS. METHODS: All EOS patients treated with growing rod technique in our hospital from August 2002 to June 2014 were retrospectively reviewed. Radiographic data before the sixth lengthening surgery were measured on the posteroanterior X-ray images, including global CB (C7 plumbline-central sacral vertical line, C7PL-CSVL), regional CB (apical vertebrae-CSVL), Cobb angle of the main curve and pelvic inlet width (PIW). Global CB index and regional CB index were calculated as dividing global CB and regional CB by PIW, respectively. The changes of these parameters during repeated lengthening surgeries were analyzed. RESULTS: Five hundred seventy Radiographs of 67 patients, including 134 images before and after growing rod insertion surgeries and 436 images pre- and post-lengthening surgeries were measured. Global CB and global CB index did not show significant differences between every two set points during lengthening procedures (P > 0.05). The percentage of patients with C7PL-CSVL distance more than 20 mm roughly ranged from 30 to 45 % during the lengthening process. With regards to regional CB and main curve Cobb angles, there were significant differences between every two adjacent set points during the first five lengthening surgeries (P < 0.05). CONCLUSIONS: Global CB did not significantly change during serial lengthening surgeries and C7PL-CSVL distances of greater than 20 mm comprised of over one third of patients during growing rod treatment. However, worsening regional CB and Cobb angles of the main curve during lengthening intervals were corrected by lengthening manipulation and maintained at a stable level.

SLC39A6: a potential target for diagnosis and therapy of esophageal carcinoma.

BACKGROUND: Esophageal squamous cell carcinoma (ESCC) is a highly lethal cancer, and its underlying molecular mechanisms are poorly understood. Recent large-scale genome-wide association studies in Chinese Han populations have identified an ESCC susceptibility locus within the SLC39A6 gene. Here, we sought to explore the expression and biological function of SLC39A6 in ESCC. METHODS: Multiethnic validation of SLC39A6 protein expression was performed in different cohorts of patients from Chinese Han and Kazakh populations in the Xinjiang region by immunohistochemistry. The associations among SLC39A6 expression, clinicopathological parameters, and prognosis outcomes of ESCC were analyzed. And the effects of SLC39A6 silencing by siRNA on cell proliferation, apoptosis, and invasiveness, as well as the proteins involved in epithelial-to-mesenchymal transition (EMT) of esophageal cancer cells, were studied. RESULTS: SLC39A6 protein expression increased progressively from normal esophageal epithelium (NEE) to low-grade intraepithelial neoplasia to ESCC, and finally reached the highest in high-grade intraepithelial neoplasia from Han ethnic. Similarly, SLC39A6 protein was significantly overexpressed in Kazakh ethnic ESCC compared with that in NEE. Increased expression of SLC39A6 was found to be closely correlated with histological grade and early Tumor-Node-Metastasis stage I/II. High tumorous SLC39A6 expression was significantly correlated with shorter overall survival (OS). Cox regression analysis confirmed that SLC39A6 expression was an independent prognostic factor for poor OS in ESCC. Experimentally, the suppression of SLC39A6 expression promoted ESCC cell apoptosis but abrogated proliferation and invasion, and induced an EMT phenotype that included enhanced expression of E-cadherin, loss of vimentin, and morphological changes in ESCC cells in vitro. CONCLUSIONS: Combined, our findings highlight a tumor-promoting role for SLC39A6 in ESCC, suggesting that SLC39A6 could serve as an early detector of high-risk subjects and prognostic biomarker. The targeting of SLC39A6 might be a potential therapeutic strategy for blocking ESCC.

Association of Metabolic Syndrome with the Adiponectin to Homeostasis Model Assessment of Insulin Resistance Ratio.

This study aimed at determining whether the adiponectin to HOMA-IR (A/H) ratio is associated with MetS and MetS components and comparing the diagnostic efficacy of adiponectin, HOMA-IR, and the A/H ratio in healthy, middle-aged participants. MetS was assessed in 1628 Kazakh participants (men, 768; women, 860). The associations between adiponectin, HOMA-IR, and the A/H ratio with the components of MetS and MetS were examined using logistic regression analysis and receiver operating characteristic (ROC) curves. Our results show that A/H ratio may be a better diagnostic marker for MetS than either HOMA-IR or adiponectin alone, and it may serve as an important biomarker to determine an increased risk for MetS in healthy middle-aged population.

Dual growing rod treatment in early onset scoliosis: the effect of repeated lengthening surgeries on thoracic growth and dimensions.

PURPOSE: To investigate changes in thoracic dimensions (TDs) following repeated lengthening surgeries after dual growing rod treatment of early onset scoliosis and thereby its effect on thoracic growth. METHODS: All EOS patients treated with dual growing rod technique in Peking Union Medical College Hospital from June 2004 to June 2014 were retrospectively reviewed. Thoracic spine height (T1-T12), total spine height (T1-S1), maximal coronal chest width and pelvic inlet width (PIW) were measured on the posteroanterior X-ray images after initial growing rod insertion surgery and after each lengthening surgery. Absolute TDs measurements were normalized by PIW. Changes of absolute and normalized TDs measurements with age and number of lengthening surgeries were analyzed. RESULTS: Radiographs of 229 surgeries of 53 EOS patients were measured, including 49 images after initial growing rod insertion surgery and 180 images of lengthening surgeries. Significant positive correlations between age and all three absolute TDs were found (P < 0.01) whereas significant negative correlations between age and all three normalized TDs (P < 0.01) were identified. Similarly, negative correlations were also identified between number of lengthening surgeries and the three normalized TDs (P < 0.01). Significant differences of normalized TDs were identified between initial surgery and the first lengthening through covariance analysis (P < 0.01). Yet, such differences were seldom seen between every two adjacent lengthening surgeries. CONCLUSIONS: Growing rod technique could maintain TDs growth through repeated lengthening procedures but the growth rate was compromised as the number of lengthening procedures increased.

Grape Seed Proanthocyanidin Extract Alleviates Arsenic-induced Oxidative Reproductive Toxicity in Male Mice.

OBJECTIVE: To determine the ability of grape seed proanthocyanidin extract (GSPE) in alleviating arsenic-induced reproductive toxicity. METHODS: Sixty male Kunming mice received the following treatments by gavage: normal saline solution (control); arsenic trioxide (ATO; 4 mg/kg); GSPE (400 mg/kg); ATO+GSPE (100 mg/kg); ATO+GSPE (200 mg/kg) and ATO+GSPE (400 mg/kg). Thereafter, the mice were sacrificed and weighed, and the testis was examined for pathological changes. Nuclear factor (erythroid-derived 2)-like 2 (Nrf2), heme oxygenase 1 (HO1), glutathione S-transferase (GST), NAD(P)H dehydrogenase, and quinone 1 (NQO1) expression in the testis was detected by real-time PCR. Superoxide dismutase (SOD), glutathione (GSH), total antioxidative capability (T-AOC), malondialdehyde (MDA), 8-hydroxydeoxyguanosine (8-OHdG), and reproductive indexes were analyzed. RESULTS: ATO-treated mice showed a significantly decreased sperm count and testis somatic index and activity levels of SOD, GSH, and T-AOC than control group. Compared to the ATO-treated group, ATO +GSPE group showed recovery of the measured parameters. Mice treated with ATO+high-dose GSPE showed the highest level of mRNA expression of Nrf2, HO, NQO1, and GST. CONCLUSION: GSPE alleviates oxidative stress damage in mouse testis by activating Nrf2 signaling, thus counteracting arsenic-induced reproductive toxicity.

Design and synthesis of new 7-(N-substituted-methyl)-camptothecin derivatives as potent cytotoxic agents.

A series of novel 7-(N-substituted-methyl)-camptothecin derivatives was designed, synthesized, and evaluated for in vitro cytotoxicity against four human tumor cell lines, A-549, MDA-MB-231, KB, and KBvin. All of the derivatives showed promising in vitro cytotoxic activity against the tested tumor cell lines, with IC50 values ranging from 0.0023 to 1.11 µM, and were as or more potent than topotecan. Compounds 9d, 9e, and 9r exhibited the highest antiproliferative activity among all prepared derivatives. Furthermore, all of the compounds were more potent than paclitaxel against the multidrug-resistant (MDR) KBvin subline. With a concise efficient synthesis and potent cytotoxic profiles, especially significant activity towards KBvin, compounds 9d, 9e, and 9r merit further development as a new generation of camptothecin-derived anticancer clinical trial candidates.

[Meta-analysis of lumbar disc herniation in Chinese adolescents].

OBJECTIVE: To provide evidence-based medicine rationales for the diagnosis and treatment of lumbar disc herniation (LDH) in Chinese adolescents. METHODS: The related medical literature of pediatric LDH between January 1990 and December 2012 was collected by retrospective searches of WANGFANG and CNKI databases. The data concerning mechanism, clinical manifestations, diagnosis and treatment were recorded and analyzed. RESULTS: A total of 1208 cases of LDH in adolescents were retrieved from 45 articles. Most of them were males (74.2%). And the primary cause was trauma (65.9%). Their clinical presentations were characterized by mild symptoms and serious physical signs. And 87.0% of them had a positive straight-leg raising test. Single-level intervertebral disk protrusion accounted for 92%. And the levels were at L4-L5 (54.7%) and L5-S1 (37.6%). There was a higher incidence of lumbar scoliosis deformity (38.2%), lumbar spine physiological curvature change (41.4%) and loss of vertebral height (33.6%) in adolescents than adults. There were many different treatments for pediatric LDH. Each method had its own advantages and disadvantages. The success rates of micro endoscopic discectomy (MED) and open discectomy were more than 90%. CONCLUSION: Trauma is a common cause of pediatric LDH. Males are more frequently affected. The single-level protrusion of L4/5 or L5/S1 has a much higher incidence. Positive straight-leg raising test and imaging findings of lumbar scoliosis deformity, lumbar spine physiological curvature change and a loss of vertebral height may aid the diagnosis. Normally conservative treatment is offered. And chemonucleolysis, MED and open discectomy are alternative options.

[Effects of pedicle subtraction osteotomy on spino-pelvic parameters of ankylosing spondylitis].

OBJECTIVE: Pedicle subtraction osteotomy (PSO) is a spinal realignment technique of correcting the sagittal spinal imbalance. Theoretically, the level and degree of resection via a PSO should impact the degree of sagittal correction. However, the quantitative effect of PSO level and focal angular change on postoperative spino-pelvic parameters has not been fully elucidated. The purpose of this study was to analyze the relationship between the level/degree of PSO and changes in global sagittal balance and spino-pelvic parameters. METHODS: Retrospective analysis was conducted for 34 patients undergoing PSO surgery for ankylosing spondylitis. Preoperative and postoperative free-standing sagittal radiographs were obtained and analyzed by regional curves (lumbar lordosis, thoracic kyphosis), pelvic parameters of pelvic tilt (PT), pelvic incidence (PI) and sacral slope (SS) and global balance of sagittal vertical axis (SVA). And the correlations between PSO parameters (level and degree) and spino-pelvic parameters were analyzed. RESULTS: There were significant changes in spino-pelvic parameters including decreased thoracic kyphosis, increased lumbar lordosis, decreased SVA, decreased PT and increased SS. The decreased SVA were 3.94 ± 3.38 and 3.97 ± 1.91 in lumbar/thoracic osteotomy respectively (P > 0.05). The decreased values of PT were 9.71 ± 6.46 and 5.20 ± 2.74 respectively (P < 0.05). Larger degree of osteotomy (≥ 22°) had greater SVA and PT decreases (P < 0.05). CONCLUSION: PSO is a quite useful technique of restoring spinal alignment. Lumbar and larger degrees of osteotomy have greater effects on spino-pelvic parameters.

[Epidemic features of dyslipidemia among Uygur, Kazakh, and Han adults in Xinjiang, China in 2010].

OBJECTIVE: To investigate the prevalence of dyslipidemia among the Uyghur, Kazakh, and Han adults in Xinjiang Region and to analyze the features of distribution. METHODS: 3625 Uygur residents, 1773 males and 1852 females, aged (42.89 ± 15.95) years old, 4148 Kazakh residents, 1649 males and 2499 females, aged (44.14 ± 13.27) years old, and 3733 Han residents, 1563 males and 2170 females, aged (49.66 ± 12.24) years old, were selected by stratified cluster random sampling method in year 2010, 11 506 adults in total. Questionnaire and physical examination were conducted, including fasting venous blood samples to test the levels of triglyceride (TG), total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), and high density lipoprotein cholesterol (HDL-C). RESULTS: The levels of TG, TC, HDL-C and LDL-C were separately (1.31 ± 1.03), (4.44 ± 1.20), (1.41 ± 0.62), and (2.44 ± 0.81) mmol/L in the Uygur adults; separately (1.24 ± 0.99), (4.55 ± 1.31), (1.41 ± 0.62), and (2.40 ± 0.87) mmol/L in the Kazakh adults; and (1.62 ± 1.34), (4.60 ± 1.10), (1.16 ± 0.68), and (2.23 ± 0.93) mmol/L in the Han adults, respectively. The general prevalence of dyslipidemia in the Uygur, Kazakh, and Han adults were 42.4% (1537/3625), 31.6% (1311/4148), and 30.2% (1127/3733) respectively; while the age-standardized prevalence were separately 42.4%, 31.8%, and 28.2%. The prevalence of dyslipidemia in the Uygur adults was significantly higher than it of the Kazakh and Han adults, with statistical significance (χ(2) = 179.87, P < 0.01). The standardized prevalence of dyslipidemia in the Uygur males was 52.6%, significantly higher than it of the Kazakh and Han males (35.4% and 33.2%), with statistical significance (χ(2) = 159.19, P < 0.01). The prevalence of hypertriglyceridemia among the Han adults was 17.3%, which was significantly higher than it among the Uyghur and Kazakh adults (χ(2) = 172.55, P < 0.01). The prevalence of hypercholesterolemia in Kazakh (6.9%) was higher than it in Uygur (5.2%), with statistical significance (χ(2) = 10.20, P < 0.01). The prevalence of low HDL-C hyperlipidemia in the above 3 ethnic were 33.6%, 20.8% and 11.1%, respectively; while Uygur was the highest (χ(2) = 552.82, P < 0.01), followed by Kazakh, which was higher than Han (χ(2) = 138.01, P < 0.01). There was no significant difference in the prevalence of high LDL-C hyperlipidemia among the adults of the 3 ethnics. CONCLUSION: The prevalence of dyslipidemia among the Uygur, Kazakh, and Han adults in Xinjiang were all higher than the national average prevalence, the distribution of dyslipidemia varied with ethnicity, age and sex.

[Epidemiological study on overweight and obesity among rural adult residents in Hazakh and Uygur population in Xinjiang province, 2010].

OBJECTIVE: To investigate the prevalence and distribution features of overweight, obesity and abdominal obesity among rural adult residents in Hazakh and Uygur population in Xinjiang province, 2010. METHODS: Questionnaire-based survey and physical examination were conducted towards the 8611 subjects selected from Hazakh and Uygur residents aged over 18 years old in Yili Xinyuan County and Kashi Jiashi County in Xinjiang province by stratified cluster random sampling method; and thereby the results were analyzed and compared between the two ethnic populations. RESULTS: The prevalence of overweight in Hazakh(male: 29.5% (612/2078) and female: 26.4% (789/2991)) was higher than that in Uygur(male: 25.5% (440/1728) and female: 21.9% (397/1814)). The difference showed statistical significance (male: χ(2) = 7.50, female: χ(2) = 12.27, P < 0.01). The prevalence was higher in males than in females among the same ethic population (Hazakh: χ(2) = 5.79, Uygur: χ(2) = 6.28, P < 0.05). The prevalence of obesity in Hazakh(male:18.2% (379/2078) and female:18.1% (540/2991)) was higher than that in Uygur(male: 9.4% (163/1728) and female: 13.2% (240/1814)). The difference showed statistical significance (male: χ(2) = 59.90, female: χ(2) = 19.32, P < 0.01). The female prevalence was higher than male in Uygur (χ(2) = 12.66, P < 0.01); however, there was no statistically significant difference in the prevalence stratified by gender in Hazakh. The prevalence of abdominal obesity in Hazakh(male: 57.0% (1185/2078) and female: 60.2% (1801/2991)) was higher than that in Uygur(male: 46.9% (811/1728) and female: 59.5% (1080/1814)). The difference showed statistical significance (male: χ(2) = 38.54, P < 0.01; female: χ(2) = 0.216, P > 0.05). And the female prevalence was both higher than male in the two ethic populations (Hazakh: χ(2) = 5.15, P < 0.05; Uygur: χ(2) = 56.50, P < 0.01). CONCLUSION: The prevalence abdominal obesity among rural adult residents in Hazakh and Uygur population was much higher than the average level nationwide in China. Hazakh had a higher prevalence of overweight and obesity than Uygur.

[Analysis of clinical results and complications of growing rod technique for congenital scoliosis].

OBJECTIVE: To evaluate clinical outcomes of growing rod technique in treating young children with congenital scoliosis. METHODS: From August 2002 to October 2009, 34 patients with congenital scoliosis underwent growing rod procedures including 12 male and 22 female patients. Four patients underwent posterior correction surgeries with single growing rod (single growing rod group), 30 patients underwent posterior correction surgeries with dual growing rod(dual growing rod group). The average age at initial surgery was 6.9(2-13) years. Five patients with severe rigid deformity or kyphosis had an osteotomy at apex vertebra with short segmental fusion followed by dual growing rod technique. The analysis included age at initial surgery and final fusion (if applicable), number and frequency of lengthenings, and complications. Radiographic evaluation including scoliosis, trunk translation, length of T1-S1, thoracic kyphosis and lumbar lordosis was conducted. RESULTS: The follow-up was 40.5 (24-110) months. In single growing rod group, the mean scoliosis Cobb angle improved from 80.9°to 59.5°after initial surgery and was 65.3°at the latest follow-up. T1-S1 length increased from average 24.3 cm to 26.0 cm after initial surgery, and to 31.1 cm at latest follow-up with an increase of 1.05 cm per year. The space available for lung ratio(SAL) in patients with thoracic curves improved from 0.81 to 0.92 at the latest follow-up. Three patients reached final fusion. Four complications occurred in 3 of the 4 patients. In dual growing rod group, the mean scoliosis Cobb angle improved from 72° ± 22°to 35 ± 14° after initial surgery and was 35 ± 17°at the last follow-up or post-final fusion. T1-S1 length increased from (25 ± 5) cm to (29 ± 5)cm after initial surgery and to (33 ± 5)cm at latest follow-up with an average T1-S1 length increase of 1.49 cm per year. The SAL in patients with thoracic curves improved from 0.84 ± 0.08 to 0.96 ± 0.06 at the latest follow-up. Three patients reached final fusion. Complications occurred in 7 of the 30 patients, and they had a total of 13 complications. CONCLUSIONS: Growing rod technique is a safe and effective choice for young children of long, complex congenital scoliosis. It maintains correction achieved at initial surgery while allowing spinal growth to continue. Implants-related complications remain the biggest challenge.

[Analysis of ribs and intraspinal anomalies in congenital scoliosis].

OBJECTIVE: To investigate the incidences and characteristics of the ribs and intraspinal abnormalities in surgical patients with congenital scoliosis. METHODS: We conducted a retrospective study of the medical records and spine radiographs of 118 patients underwent surgical treatment between January 2010 and March 2011 with congenital scoliosis. The average age was 14 years (3-50 years).Fifty-two were male and 66 were female patients. The rib and intraspinal abnormalities were compared in different vertebral anomalies. Pearson's χ(2) test were used to analyze the incidence of anomalies of the ribs and vertebrae, as well as intraspinal anomalies. RESULTS: A total of 57 (48.3%) patients were found to have intraspinal abnormalities.Split cord deformities were identified to be the most common intraspinal anomaly (32.2%), followed by syringomyelia (21.2%).Sixty-nine patients (58.5%) had rib anomalies, which occurring on the concavity of the scoliosis was most frequent. The patients with mixed deformity and failure of segment were found to have a higher incidence of rib anomaly than those with failure formation (χ(2) = 14.05, P < 0.01). The patients with multiple level malformations were found to have significantly higher incidence of rib anomaly than those with single level malformation (χ(2) = 27.50, P < 0.01).Intraspinal anomalies occurred in 42 of 69 patients (60.9%) with rib anomalies and 15 of 49 patients (30.6%) without rib anomalies in congenital scoliosis. The occurrence of intraspinal malformation has significant difference with or without rib anomalies in congenital scoliosis (χ(2) = 10.5, P < 0.01). CONCLUSIONS: The intraspinal malformation is common in patients with mixed defects and failures of segmentation. The rib anomalies occurring on the concavity of the scoliosis is most frequent. The incidence of intraspinal anomaly is significant higher in the patients with rib anomalies than those without rib anomalies. Both the occurrence and type of rib anomaly, combined with vertebral deformity are helpful in forecasting the occurrence of intraspinal abnormalis.

[Therapeutic complications of posterior vertebral column resection for spinal tumors].

OBJECTIVE: To summarize and analyze the complications of posterior vertebral column resection in the treatment of spinal tumors. METHODS: The complications of 31 patients were recorded and categorized into primary and secondary complications. Many factors such as segment, bleeding volume and surgical duration were reviewed. The SPSS 12.0 software was used to analyze the relations between the complications and these factors retrospectively. RESULTS: Two primary and 30 secondary complications were identified. A definite relation existed between the delayed removal of endotracheal intubation and bleeding volume. And a definite relation existed also between transient thrombocytopenia and operative duration. There was no relation between prosthetic subsidence and various factors (including follow-up period). CONCLUSION: Most complications are secondary and have basically no effect on the recovery of patients. And prevention are feasible in most cases. So a thorough plan should be devised to prevent the occurrences of potential complications, especially primary ones. For any occurrence, active treatment should be offered to improve the surgical safety.

[Surgical treatment of scoliosis associated with syringomyelia].

OBJECTIVE: To explore the clinical manifestations and surgical strategies of scoliosis associated with syringomyelia. METHODS: A total of 50 cases diagnosed as scoliosis with syringomyelia between January 2003 and November 2010 were recruited. They were divided into 2 groups: Group A, neurosurgery before scoliosis correction, including suboccipital decompression and syrinx shunting; Group B, one-staged posterior correction and instrumentation without previous neurosurgery. The preoperative, postoperative and last follow-ups of Cobb angle of coronal main curve and thoracic kyphosis were measured. Also the preoperative and postoperative apical vertebra translation, apical vertebra rotation and trunk shift were measured by the same person. The surgical efficacies and complications of correction were compared between 2 groups. RESULTS: All patients underwent posterior pedicle screw instrumentation and had a mean follow-up period of 32.1 months. Among them, 42 patients had clinical symptoms or signs preoperatively and 3 patients improved postoperatively. The mean correction of coronal curve was 65.7% and a mean loss of correction 6.4% during the follow-up. The mean correction of apical vertebra translation and apical vertebra rotation were 63.0% and 60.0% respectively. However, the trunk shift increased 0.4 cm. There were no statistically significant differences for the correction efficacies and complications between 2 groups (P > 0.05). CONCLUSION: Scoliosis associated with syringomyelia may be effectively managed if a surgeon manipulates carefully intraoperatively and perioperative spinal monitoring is practiced. Furthermore syrinx will not increase the incidence of postoperative complications without prophylactic neurosurgery.