Whole transcriptome sequencing identifies a competitive endogenous RNA network that regulates the immunity of bladder cancer.

Several types of non-coding RNAs such as circRNAs, lncRNAs, and miRNAs have been identified to regulate mRNAs through the mechanism known as the competitive endogenous RNA (ceRNA) network. To explore the role of the ceRNA regulatory network in the immune microenvironment of bladder cancer, whole-transcriptome sequencing of bladder tumor and its peritumoral tissues from 38 bladder cancer patients, with a total of 63 samples, was performed to screen differentially expressed circ-, lnc-, mi-, and mRNAs to construct a circ/lnc-mi-mRNA regulatory network with pruning algorithms. We excavated a key immune-related gene BDNF to build the final ceRNA network as hsa-miR-107 sponged by hsa-circ-000211, AC108488.1, and LINC00163. Finally, a meta-analysis of 7 public datasets demonstrated that low expression of BDNF and high expression of hsa-miR-107 were associated with longer survival. Our study identified a ceRNA regulatory network as a potentially new prognostic marker and molecular therapeutic target of bladder cancer.

ZnO-decorated SiC@C hybrids with strong electromagnetic absorption.

A novel strategy is provided to improve the absorption of SiC nanomaterials through surface carbonization of SiC nanowires and hydrolysis. SiC@C-ZnO composites were synthesized with different dosages of ZnNO3·6H2O. Composition, microstructure, and electromagnetic properties of the composites were characterized and analyzed. Results from TEM and XRD show that crystalline ZnO particles adhere to the surface of amorphous carbon, and the ZnO content increases as a function of a dosage of ZnNO3·6H2O. The as-prepared SiC@C-ZnO hybrids exhibit effective electromagnetic absorption, which is related to a synergy effect of different dielectric loss processes. The minimum reflection loss reached -65.4 dB at 11 GHz at a sample thickness of 3.1 mm, while the effective absorption bandwidth (EAB) reached 7 GHz at a sample thickness of 2.56 mm. Furthermore, the EAB of the samples can also cover the whole X band and Ku band at small sample thicknesses (2.09-3.47 mm). The excellent properties of the materials suggest great prospect as electromagnetic absorbers.

FOXK1 regulates epithelial-mesenchymal transition and radiation sensitivity in nasopharyngeal carcinoma via the JAK/STAT3 signaling pathway.

BACKGROUND: Nasopharyngeal carcinoma (NPC) is the most common head and neck tumor in China. Forkhead box (FOX) proteins have 19 subfamilies, which can maintain cell metabolism, regulate cell cycle and cell growth, etc. FOXK1 is a member of the FOX family, and studies have found that FOXK1 is closely related to tumors. OBJECTIVE: This experiment aims to study the effects of FOXK1 interference on proliferation, apoptosis, invasion, epithelial-mesenchymal transition (EMT), and radiosensitivity, by regulating the Janus kinas/signal translator and activator of the transfer 3 (JAK/STAT3) pathway. METHODS: The expression of FOXK1 was detected via immunohistochemistry using clinical nasopharyngeal carcinoma tissues and adjacent tissues. The relationship between FOXK1 expression and tumor stage was subsequently evaluated. The colony formation rate was calculated through the colony formation experiment. Cell apoptosis and cell cycle distribution were detected using flow cytometry, while cell invasion was detected using the Transwell method. The number of cells in the nucleus of each group after 30 min, 4 h, and 24 h of radiotherapy with the 2 Gy dose was counted using immunofluorescence under γ-H2AX focal points of a laser confocal microscope. RESULTS: FOXK1 is clearly expressed in the patients' cancer tissues. The expression of FOXK1 was significantly correlated with the patient's sex. FOXK1 interference or Peficitinib can upregulate the apoptosis rate of 5-8 F and CNE-2 cells; increase the G2 phase of cells; and inhibit the invasion, migration, and EMT of cells. At the same time, FOXK1 interference can downregulate the protein expression of p-JAK1, p-JAK2, and p-STAT3 in cells. Interference from FOXK1 or Peficitinib alone can reduce the rate of cell colony formation under different radiation doses, and enhance the green fluorescence intensity of γ-H2AX in the nucleus after 4 and 24 h of the 2 Gy dose of radiotherapy. These results are optimal when FOXK1 interference and Peficitinib are used together. CONCLUSION: FOXK1 interference in NPC cells can regulate EMT through the JAK/STAT3 signal pathway, enhance the radiosensitivity of cells, and thus inhibit tumor cell progression.

Controllable Fabrication of SiC@C-Fe3O4 Hybrids and Their Excellent Electromagnetic Absorption Properties.

In this work, a batch of novel ternary hybrids (SiC@C-Fe3O4), characterized by SiC nanowires core, carbon shell, and adhered Fe3O4 nanoparticles were controllably synthesized via surface carbonization of SiCnw followed by hydrothermal reaction. Carbon, which was derived from SiC with nanometer thickness, possesses an amorphous structure, while Fe3O4 nanoparticles are in a crystalline state. Simultaneously, the inducement of Fe3O4 nanoparticles can provide significant magnetic loss, which is well-tuned by changing the molar content of iron precursors (FeCl3·6H2O and FeCl2·4H2O). SiC@C-Fe3O4 hybrids show great electromagnetic absorption performance owing to the synergy effect of dielectric and magnetic losses. The minimum refection loss can reach to -63.71 dB at 11.20 GHz with a thickness of 3.10 mm, while the broad effective absorption bandwidth (EAB) can reach to 7.48 GHz in range of 10.52-18.00 GHz with a thickness of 2.63 mm. Moreover, the EAB can also cover the whole X band and Ku band. The outstanding performance of the obtained material implys that it is a promising candidate as an electromagnetic absorber.

Primary malignant melanoma of the male urethra: a case report.

We present a rare case of a 69-year-old male patient with serendipitous urethral melanoma. He complained of dysuria and recurrent urinary retention and was initially diagnosed with benign prostatic hyperplasia. Accidentally, a dark-brown pigmented macula was found in the distal urethra at the end of transurethral prostatectomy when we exited the resectoscope, transurethral resection of the nidus and sent to pathological examination showed the characteristics of melanoma. No other lesions were found on further examination and the patient preferred a close follow-up cystoscopy rather than an immediate urethrectomy. Unsurprisingly, he relapsed in the urethra with the local disease three months later and we treated him with partial urethrectomy, followed by watchful waiting for 11 months. However, the patient was readmitted for hematuria, and 18F-FDG PET-CT showed a large number of pelvic and bone metastatic lesions. Therefore, eight cycles of single-agent dacarbazine chemotherapy were administered, and the disease was demonstrated prolonged stabilization. Follow-up was conducted every 3 months, during which time palliative transurethral resection of the melanoma in the bladder was performed to control urinary tract infections. Although the prognosis of the disease is extremely poor, this patient has gained more than 50 months of overall survival and is alive to date.

Initial Experience and Analysis of Outcomes Using the Visualized Percutaneous Endoscopic Lumbar Discectomy Technique for the Treatment of Lumbar Disc Herniation.

AIM: To introduce a visual surgical concept using a retrospective comparison of the outcomes between visualized percutaneous endoscopic lumbar discectomy (V-PELD) and conventional PELD techniques. MATERIAL AND METHODS: Data from 61 patients in the conventional PELD group and 55 in the V-PELD group. Data included the duration of the operation, number of intraoperative radiation exposure events, and follow-up information for 24 months. The Oswestry Disability Index (ODI) and visual analog scale (VAS) scores were collected. RESULTS: The mean (± SD) operating time for the V-PELD group was 57.82 ± 11.25 min, and the mean duration of radiation exposure was 0.74 ± 0.32 min. The mean operating time for the conventional group was 63.16 ± 14.49 min (p < 0.05), and the mean duration of radiation exposure was 2.81 ± 1.12 min (p < 0.001). All patients in both groups demonstrated significant improvement in the ODI and VAS scores after surgery (p < 0.05). CONCLUSION: V-PELD is a minimally invasive surgical technique that involves less radiation exposure and is more efficient for treating lumbar disc herniation.

A novel retractor for reducing operation time and radiation exposure in percutaneous pedicle screw placement.

AIM: Design a novel hand-held retractor to reduce operation time and radiation exposure in percutaneous pedicle screw placement. MATERIAL AND METHODS: 126 patients with single segment thoracolumbar vertebral fracture were surgically treated with percutaneous pedicle screws through our novel hand-held retractor technique（group A） or conventional fluoroscopic method(group B), the operation time and fluoroscopy shot times were compared, and the accuracy of screw placement were assessed. RESULTS: There was no serious complications occurring during our study, such as infection, blood vessel injury, spinal cord or nerve root injury. We did not find any statistically difference between the two groups in corrected rate of regional Cobb's angle or vertebral body height percentage(P 0.05), however, the mean operation time was found to be 75.9±2.37min in the novel hand-held retractor method group and 94.2±2.19min in the conventional method group. The difference was statistically significant (p﹤0.001). Fluoroscopy shot times averaged 9.01±0.41 in the novel hand-held retractor group versus 16.8±0.56 in the conventional group (P 0.001), the novel hand-held retractor group had apparent advantages over the conventional method in postoperative improvement on visual analog scale (VAS) scores and Oswestry Disability Index (ODI) at 2days, 3month after operation and last follow-up (P 0.05). There was no statistical difference between group A and B in the radiographic results and screw position violation grade. CONCLUSION: The novel hand-held method retractors have several advantages, including shorter operation time, less fluoroscopy shot times, and better postoperative improvement on visual analog scale (VAS) scores and Oswestry Disability Index (ODI). It provides a new alternative method for effective management of thoracolumbar fractures.

Percutaneous endoscopic lumbar discectomy and microsurgical laminotomy : A prospective, randomized controlled trial of patients with lumbar disc herniation and lateral recess stenosis.

BACKGROUND: Sufficient decompression of the nerve root canal is still regarded as the method of choice when operating on patients with lumbar disc herniation (LDH) with lumbar lateral recess stenosis; however, tissue-sparing procedures are becoming more popular. Endoscopic techniques offer advantages and the benefits of rehabilitation, which have become the standard in many surgical operations when operating on the spine. A significant issue has been the upgrading of instruments to provide enough bone resection under continuous visual control. MATERIAL AND METHODS: We examined patients who had LDH with lateral recess stenosis and compared the results of nerve root canal decompression using percutaneous endoscopic lumbar discectomy (PELD) with a microsurgical laminotomy (ML) technique. In this study 40 patients with full endoscopic decompression or microsurgery were followed up for 2 years. In addition to general and specific parameters, the following two parameters were also used for the investigation: the Visual Analog Scale (VAS) and the Oswestry Disability Index (ODI). RESULTS: Except for 1 patient in whom repair was done by fusion and 1 who was lost to follow-up, 38 patients remained in the study over the 2 years. The mean operating time in the PELD group was longer (p < 0.05), but intraoperative and postoperative blood loss was less than in the ML group (p < 0.05). The postoperative results were better than before surgery, and the VAS and ODI parameters indicated a clear improvement in leg pain and daily activities in both groups (p > 0.05). Of the patients three suffered increasing back pain (2 ML, 1 PELD). CONCLUSION: The results indicated that the PELD can provide an effective supplement and serve as an alternative for LDH with lateral recess stenosis compared with the ML technique when the indication criteria are fulfilled. The PELD also has the advantage of being a minimally invasive intervention.

Myrtol improves post-traumatic knee osteoarthritis by regulation of reactive oxygen species, transforming growth factor ß1 and apoptosis in a mouse model.

The present study tested whether myrtol improves post-traumatic knee osteoarthritis (PTKO) by regulating the reactive oxygen species (ROS), transforming growth factor ß1 (TGF-ß1) and apoptosis in a mouse model. PTKO model mice were administered with 150, 300 or 450 mg/kg myrtol for 8 weeks. ELISA analysis was used to measure tumor necrosis factor-α, interleukin-6, malondialdehyde, superoxide dismutase, reactive oxygen species and TGF-ß1 levels. Caspase-3 and Bax protein expressions were analyzed using western blot analysis. In the current study, treatment with myrtol improved the tissue damage and osteoarthritis score, while it also reversed the subchondral bone thickness, subchondral bone density, trabecular bone volume/relative trabecular bone volume ratio and trabecular bone spacing in PTKO mice. The activity of tumor necrosis factor α, interleukin-6, TGF-ß1, malondialdehyde, superoxide dismutase and ROS were effectively inhibited, and the protein expression of caspase-3 and Bax were clearly suppressed by treatment with myrtol in a mouse model of PTKO. In conclusion, the results demonstrated that myrtol treatment improved PTKO through the suppression of inflammation, oxidative stress, ROS, TGF-ß1 and Bax/caspase-3 in mice, and myrtol may be a potential agent for clinical therapy.

[EFFECTIVENESS EVALUATION OF PERCUTANEOUS MONOAXIAL SCREW COMBINED WITH INJURED VERTEBRAE POLYAXIAL PEDICAL SCREW FIXATION FOR TREATMENT OF THORACOLUMBAR FRACTURES].

OBJECTIVE: To explore the effectiveness percutaneous monoaxial screw combined with polyaxial pedical screw for treating thoracolumbar fracture by comparing with simple polyaxial pedicle screw fixation. METHODS: Between January 2012 and June 2014, 56 cases of thoracolumbar fractures were treated by percutaneous pedicle screw fixation, the clinical data were retrospectively analyzed. Of 56 cases, 30 were treated with percutaneous monoaxial screw combined with percutaneous polyaxial pedical screw fixation (group A), 26 patients with only percutaneous polyaxial pedicle screw fixation (group B). There was no significant difference in gender, age, body mass index, injury causes, time from injury to admission, involved segments, fracture type, and preoperative American Spinal Injury Association (ASIA) stage, visual analogue scale (VAS), the anterior height of the injured vertebrae, Cobb angle, and sagittal index between 2 groups (P>0.05). The operation time, intraoperative blood loss, and complications were recorded and compared between the 2 groups. The VAS score was used to evaluate the improvement of the pain. The sagittal kyphosis Cobb angle, the anterior height of the injured vertebrae, sagittal index, and the average correction (difference between 3 days after oeration and preoperation) and loss degrees (difference between last follow-up and 3 days after operation) were measured on the X-ray films at preoperation, 3 days after operation, and last follow-up. RESULTS: Incision healing at stage I was obtained, no related complications occurred. The operation time and intraoperative blood loss showed no significant difference between 2 groups (P>0.05). The patients were followed up 20-42 months (mean, 32 months) in group A and 21-44 months (mean, 30 months) in group B. VAS score of group A was significantly lower than that of group B at 3 days after operation (t=-2.277, P=0.027), but no significant difference was found at last follow-up (t=-0.289, P=0.774). X-ray examination showed good position of internal fixation, with no broken nails or exit of nail. There were significant differences in the anterior height of the injured vertebrae, Cobb angle, and sagittal index between at preoperation and at 3 days and last follow-up, and between at 3 days and last follow-up in 2 groups (P<0.05). The anterior height of the injured vertebrae, Cobb angle, and sagittal index of group A were significantly better than those of group B at 3 days and last follow-up (P<0.05), and correction degree were significantly higher than those of group B (P<0.05), but loss degree was not significant between 2 groups (P>0.05). CONCLUSIONS: Percutaneous monoaxial screw combined with polyaxial pedicle screw fixation is better than simply polyaxial pedicle screw in effects of treating thoracolumbar fracture under the premise of strictly holding indications.

Modified minimally invasive transforaminal lumbar interbody fusion using a trans-multifidus approach: a safe and effective alternative to open-TLIF.

BACKGROUND: Application of minimally invasive transforaminal lumbar interbody fusion (MI-TLIF) is limited by long fluoroscopy time and a steep learning curve. Herein, MI-TLIF was modified using a trans-multifidus approach, assisted by microscope, termed MMI-TLIF, and the clinical outcomes of MMI-TLIF and open-TLIF were compared. METHODS: Forty-nine patients treated with MMI-TLIF were matched with 49 subjects who underwent open-TLIF. Patients were assessed using the North American Spine Society Score (NASS), Oswestry Disability Index (ODI), Short Form-36 (SF-36), and Visual Analogue Score (VAS) before surgery and during follow-up (6 months and 2 years). The four-type Bridwell anterior fusion grading system was used to evaluate fusion rates at 2 years. RESULTS: The median fluoroscopic time did not differ significantly between the MMI-TLIF and open-TLIF groups. MMI-TLIF surgery took significantly longer than open-TLIF (91.3 vs. 82.5 min; P < 0.05). Meanwhile, MMI-TLIF patients lost significantly less blood than open-TLIF patients (75.3 vs. 215.2 ml; P < 0.05), and MMI-TLIF patients were hospitalized for less long than open-TLIF patients (3.7 vs. 6.9 days; P < 0.05) and reported less pain, faster ambulation, and lower morphine intake than open-TLIF patients (all P < 0.05). The NASS, ODI, VAS, and SF-36 scores were significantly improved 6 months and 2 years postsurgery in both groups, compared with preoperative values, and similar values were obtained for both groups. Finally, fusion rates were similar in MMI-TLIF and open-TLIF patients. CONCLUSIONS: Overall, these findings strongly suggest the superiority of MMI-TLIF to open-TLIF. Therefore, MMI-TLIF could be a safe and effective alternative to MI-TLIF and open-TLIF.

[Inhibitory effect of ¹³¹I-CD133mAb combined with cisplatin on liver cancer cells in vitro and in a tumor-bearing mouse model].

OBJECTIVE: To study the inhibitory effect of CD133 monoclonal antibody labeled with ¹³¹I (¹³¹I-CD133mAb) on Huh-7 human liver cancer cell line overexpressing CD133 antigen in vitro and in mouse models bearing the tumor cell xenograft. METHODS: ¹³¹I-CD133mAb was prepared by chloramines-T method and evaluated for its stability. Flow cytometry and immunohistochemistry were used to detect the expression of CD133 in Huh-7 cells and in Huh-7 cell-derived tumors, respectively. Huh-7 cells treated with ¹³¹I-CD133mAb plus cisplatin (DDP), ¹³¹I -CD133mAb, DDP, or no treatment (blank control) were examined for cell proliferation suppression by MTT assay with the IC50 calculated. BALB/c mice bearing subcutaneous Huh-7 cell xenograft in the right forelegs were treated with ¹³¹I -CD133mAb, DDP, or both every two days for two weeks. The tumor size and volume were measured twice a week, and pathological examination of the tumor was carried out after the treatments. The tumor inhibition rate was calculated and tumor cell apoptosis observed with HE staining. RESULTS: The labeling ratio of ¹³¹I-CD133mAb was 90.25% and the radiochemical purity was 97.78%. Huh-7 cells showed obviously higher CD133 expression than HepG2 cells. ¹³¹I-CD133mAb combined with DDP group resulted in a significantly higher tumor inhibition rate than other treatments in the tumor-bearing mice. CONCLUSION: ¹³¹I-CD133mAb can inhibit the growth of liver cancer cells with a high CD133 expression both in vivo and in vitro.

[Effectiveness study on minimally invasive transforaminal lumbar interbody fusion assisted with microscope in treatment of lumbar spondylolisthesis].

OBJECTIVE: To investigate the effectiveness of minimally invasive transforaminal lumbar interbody fusion (MI-TLIF) assisted with microscope in treatment of lumbar spondylolisthesis. METHODS: Between January 2011 and June 2012, 52 patients with lumbar spondylolisthesis underwent MI-TLIF assisted with microscope. There were 29 males and 23 females with an average age of 46 years (range, 32-67 years). The median disease duration was 3.2 years (range, 3 months to 6 years). There were 38 cases of lumbar isthmic spondylolisthesis and 14 cases of degenerative spondylolisthesis; 12 cases had stenosis secondary to lumbar spondylolisthesis. The affected segments were L4,5 (29 cases) and L5, S1 (23 cases). According to the Meyerding evaluating system, 24 cases were classified as degree I and 28 cases as degree II. The visual analogue scale (VAS) score and Oswestry disability index (ODI) were used for clinical assessment, and the clinical effects were also analyzed by Macnab criterion at last follow-up. The radiographic data were used to evaluate reduction of spondylolisthesis, including slipping degree, slipping angle, and intervertebral space height. The fusion rate was assessed by Suk criterion. RESULTS: The operations were performed successfully in all patients. No dural tear or cerebrospinal fluid leakage occurred during operation. The average operation time was 105 minutes; the average intraoperative blood loss was 225 mL; the average postoperative drainage volume was 75 mL; and the average hospitalization days were 5.5 days. Superficial infection of incision occurred in 1 case and was cured after change dressing, and primary healing of incision was obtained in the others. All patients were followed up 12-26 months (mean, 18 months). No loosening, breakage, and displacement of pedicle screw and no Cage dislocation occurred by X-ray films after operation. The lumbar spondylolisthesis all got good correction. The three-dimensional CT showed continuous bone trabecula between centrums. The VAS score, ODI, and the slipping degree, slipping angle, and intervertebral space height were significantly improved at last follow-up when compared with preoperative ones (P < 0.05). According to Macnab criterion at last follow-up, the results were excellent in 20 cases, good in 29 cases, and fair in 3 cases; the excellent and good rate was 94.2%. According to Suk criterion for fusion, 49 cases obtained complete fusion and 3 cases got possible fusion. CONCLUSION: As long as indications are seized, MI-TLIF assisted with microscope is safe and reliable for treatment of lumbar spondylolisthesis (Meyerding dergee I or II), and it has the advantage of less injury, less blood loss, less complications, and definite short-term effectiveness.

[Amphotericin B suppresses migration and invasion of esophageal carcinoma Eca109 cells in hypoxic microenvironment by down-regulating hypoxia-inducible factor-1α activity].

OBJECTIVE: To investigate the effect of amphotericinB (AmB) on migration and invasion of esophageal carcinoma Eca109 cells exposed to hypoxia and explore the molecular mechanisms. METHODS: Routinely cultured esophageal carcinoma Eca109 cells were treated with 0, 1.25, 2.5, or 5 µg/ml AmB in hypoxic condition (3% O2, 5% CO2, and 92% N2) for 24 h. The cell migration and invasion were assessed by cell scratch test and Transwell chamber assay, respectively. Real-time quantitative PCR and Western blotting were used to detect the mRNA and protein expressions of hypoxia-inducible factor-1α (HIF-1α), matrix metalloproteinase-2 (MMP-2), and E-cadherin in the cells, respectively. RESULTS: Compared with the control cells, the cells treated with different doses of AmB showed attenuated ability of migration and invasion (P<0.05). AmB treatment resulted in significantly lowered mRNA and protein expressions of MMP-2 (P<0.05) and increased expressions of E-cadherin (P<0.05); the protein expression of HIF-1α decreased significantly in cells after AmB treatment (P<0.05) but its mRNA levels showed no significant changes (P>0.05). CONCLUSION: AmB can suppress the migration and invasion of esophageal carcinoma Eca109 cells in hypoxic microenvironment possibly by regulating the expressions of HIF-1α, MMP-2 and E-cadherin.

All-trans-retinoic acid promotes iodine uptake via up- regulating the sodium iodide symporter in medullary thyroid cancer stem cells.

Recently, the main therapy of medullary thyroid cancer (MTC) is surgical, but by which way there is a poor prognosis with a mean survival of only 5 years. In some cases, some researchers found that it is the medullary thyroid cancer stem cells (MTCSCs) that cause metastasis and recurrence. This study aimed to eradicate MTCSCs through administration of all-trans-retinoic acid (ATRA). Here we demonstrate that MTCSCs possess stem- like properties in serum-free medium. The ABCG2, OCT4 and sodium iodide symporter (NIS) were changed by ATRA. Additionally, we found that ATRA can increase the expression of NIS in vivo. All the data suggested that ATRA could increase the iodine uptake of MTCSCs through NIS.

Gene expression analysis in response to osmotic stimuli in the intervertebral disc with DNA microarray.

BACKGROUND: Intervertebral disc (IVD) cells experience a broad range of physicochemical stimuli under physiologic conditions, including alterations in their osmotic environment. At present, the molecular mechanisms underlying osmotic regulation in IVD cells are poorly understood. This study aims to screen genes affected by changes in osmotic pressure in cells of subjects aged 29 to 63 years old, with top-scoring pair (TSP) method. METHODS: Gene expression data set GSE1648 was downloaded from Gene Expression Omnibus database, including four hyper-osmotic stimuli samples, four iso-osmotic stimuli samples, and three hypo-osmotic stimuli samples. A novel, simple method, referred to as the TSP, was used in this study. Through this method, there was no need to perform data normalization and transformation before data analysis. RESULTS: A total of five pairs of genes ((CYP2A6, FNTB), (PRPF8, TARDBP), (RPS5, OAZ1), (SLC25A3, NPM1) and (CBX3, SRSF9)) were selected based on the TSP method. We inferred that all these genes might play important roles in response to osmotic stimuli and age in IVD cells. Additionally, hyper-osmotic and iso-osmotic stimuli conditions were adverse factors for IVD cells. CONCLUSIONS: We anticipate that our results will provide new thoughts and methods for the study of IVD disease.

[Effectiveness of minimally invasive transforaminal lumbar interbody fusion assisted with microscope in treatment of lumbar degenerative disease].

OBJECTIVE: To investigate the effectiveness of minimally invasive transforaminal lumbar interbody fusion (TLIF) assisted with microscope for lumbar degenerative disease. METHODS: Retrospective analysis was made on the clinical data of 82 patients with lumbar degenerative disease (minimally invasive group) undergoing minimally invasive TLIF assisted with microscope between January 2010 and June 2011, which was compared with those of 76 patients (traditional group) undergoing traditional open TLIF. There was no significant difference in age, gender, disease duration, disease type, lesion level, preoperative visual analogue scale (VAS), and preoperative Oswestry disability index (ODI) between 2 groups (P > 0.05). The perioperative related parameters, radiography index, and effectiveness were documented and compared. RESULTS: There was no significant difference in operation time and intraoperative radiological exposure time between 2 groups (P > 0.05), but intraoperative blood loss and postoperative drainage volume in the minimally invasive group were significantly less than those in the traditional group (P < 0.05). Dural tear occurred in 2 patients of the traditional group. Superficial infection of incision occurred in 1 case in each group, respectively; and primary healing of incision was obtained in the other patients. All patients were followed up 12-28 months (mean, 18 months). No failure of internal fixation occurred. Radiological analysis showed that the bone graft fusion rate was 96.1% (73/76) in the traditional group and 95.1% (78/82) in the minimally invasive group at last follow-up, showing no significant difference (chi2 = 0.012 2, P = 0.912 0). The postoperative ODI and VAS score were significantly improved when compared with preoperative ones in 2 groups (P < 0.05); the ODI of the minimally invasive group were significantly better than those of the traditional group at 3 months (t = -11.941 1, P = 0.000 0), and the VAS score of the minimally invasive group was significantly lower than that of the traditional group at 1 day and 3 months (P < 0.05); but no significant difference was found in ODI and VAS score between 2 groups at 1 year and last follow-up (P > 0.05). CONCLUSION: Minimally invasive TLIF is an effective method to treat lumbar degenerative disease. This procedure is safe and reliable because it has less injury, less blood loss, and milder pain than the traditional open TLIF, and the short-term effectiveness is comparable in 2 procedures.

[Instrumented slip reduction combined with 360 degrees circumferential fusion and restoration of laminae for adult isthmic spondylolisthesis].

OBJECTIVE: To evaluate the mid-term clinical outcome of instrumented slip reduction combined with 360 degrees circumferential fusion and restoration laminae for symptomatic adult isthmic spondylolisthesis. METHODS: Between October 2004 and March 2008, 44 patients with symptomatic isthmic spondylolisthesis underwent instrumented slip reduction combined with 360 degrees circumferential fusion and restoration laminae. There were 15 males and 29 females with an average age of 38.4 years (range, 28-45 years). The disease duration was 14 months to 7 years (38 months on average). The affected vertebrae was L4-5 in 18 patients and L5, S1 in 26 patients. According to Meyerding's grade for spondylolisthesis, 28 cases were rated as grade II and 16 as grade III. The visual analogue scale (VAS), Oswestry disability index (ODI), and the short form 36 health survey (SF-36) scores were evaluated before operation and at last follow-up; the radiographical outcome was evaluated by measuring slipping percentage, heights of intervertebral space and foramen, and fusion rate. RESULTS; All patients were followed up 20-60 months (42 months on average). The VAS, ODI, and SF-36 scores were all significantly improved at last follow-up when compared with those before operation (P < 0.05). According to Morelos criteria, the clinical results were excellent in 32 patients, good in 9, and fair in 3; the excellent and good rate was 93.2%. The preoperative average percentage of slip was 47.5%, which was improved to 2.6% 3 days after operation; the total average reduction rate was 97.4%, and it was maintained at last followup. The heights of intervertebral space and foramen were all improved significantly after operation (P < 0.05), and there was no significant difference between at 3 days after operation and at last follow-up (P > 0.05). X-ray and CT showed bony fusion 1 year after operation in all patients with a fusion rate of 100%. Complications included pain at donor site of iliac bone in 4 cases, superficial infection in 2 cases, dural tear in 1 case, and degeneration of adjacent vertebrae in 2 cases; no nerve root injury, pseudoarthrosis, failure of internal fixation, and acquired spinal canal stenosis occurred. CONCLUSION; Instrumented slip reduction combined with 360 degrees circumferential fusion and restoration laminae is a reliable procedure for adult isthmic spondylolisthesis with satisfactory mid-term results, a high fusion rate and low complication rate. The long-term outcomes should be verified by follow-up in the future.

Distraction osteogenesis technique using an intramedullary nail and a monolateral external fixator in the reconstruction of massive postosteomyelitis skeletal defects of the femur.

BACKGROUND: Large skeletal defects due to postosteomyelitis are uncommon, and they present a challenging reconstructive problem. The aim of our study was to summarize our experience performing a distraction osteogenesis technique using an intramedullary nail and a monolateral external fixator in the reconstruction of massive postosteomyelitis skeletal defects of the femur. METHODS: Between January 1998 and October 2004, 17 patients with massive postosteomyelitis skeletal defects of the femur (11 men and 6 women), underwent the reconstruction procedure. After osteotomy of diaphysis of the femur, we inserted an intramedullary nail into the femur, and we placed a monolateral external fixator with half-pins lateral to the nail. Lengthening was started on the seventh postoperative day at a rate of 1 mm/d. Once we achieved solid bone union, we removed the monolateral external fixator; the intramedullary nail remained for bone consolidation until reconsruction was complete. We assessed the outcomes clinically and radiographically at a mean of 70.3 months postoperatively. RESULTS: At follow-up (mean 70.3, range 14.0-96.0 mo), all the skeletal defects were filled, bone union at docking sites was achieved without bone graft and leg length discrepancies were less than 2.5 cm in all patients. The mean gain in length was 12.9 (range 10.2-18.4) cm. According to Paley and Maar's evaluation criteria, we graded the bone results as excellent for 10 patients, good for 5, fair for 1 and poor for 1. We graded the functional results as excellent for 12 patients, good for 4 and fair for 1. The mean external fixator index was 18.1 d/cm; the consolidation index was 35.7 d/cm. Ten patients experienced pin infection, and 1 patient experienced a recurrence of deep infection. There were no neurologic or vascular injuries. CONCLUSION: Our study demonstrates that a distraction osteogenesis technique using an intramedullary nail and a monolateral external fixator is a reliable method for the reconstruction of massive postosteomyelitis skeletal defects.