[Clinical studies of pedicle screw-rod fixation of thoracolumbar burst fractures through posterior unilateral approach after vertebrae corpectomy fusion].

OBJECTIVE: To compare the clinical curative effect of thoracolumbar burst fracture treated by the posterior unilateral approach corpectomy fusion screw-rod fixation and anterior corpectomy bone fusion screw plate fixation. METHODS: From January 2008 to May 2014,36 cases of thoracolumbar burst fracture underwent operation of decompression, fusion, and internal fixation was retrospective analyzed. Among them, 16 patients were treated through posterior approach as posterior group, including 13 males and 3 females aged from 37 to 62 years old; 9 cases caused by falling injury, 3 cases by traffic accident injury,4 cases by heavy aboved;the injury segment was on T12 in 2 cases, L1 in 5 cases, L2 in 7 cases, L3 in 2 cases; according ASIA grade, 3 cases were grade A, 2 cases were grade B, 2 cases were grade C, 5 cases were grade D, 4 cases were grade E; the time between injury and operation ranged from 5 to 15 days. Other 20 patients were treated through anterior-lateral approach as anterior-lateral group, including 15 males and 5 females with age from 27 to 62 years old; 12 cases caused by falling injury, 4 cases by traffic accident injury, 4 cases by heavy aboved; the injury segment was on T12 in 2 cases, L1, in 7 cases, L2 in 9 cases, L3 in 2 cases; for ASIA grade: 4 cases were grade A, 2 cases were grade B, 4 cases were grade C, 6 cases were grade D, 4 cases were grade E; the time between injury and operation ranged from 4 to 12 days. The operation time, bleeding during operation and postoperative drainage volume were observed in two groups,and the changes of nerve function of ASIA grade, clinical efficacy,improved degree of thoracic and lumbar lordosis,and bony fusion were compared between two groups. RESULTS: All patients were followed up from 12 to 24 months with an average of (15.8 ± 3.3) months. The operation time, bleeding during operation, and postoperative drainage volume had no significant different between two groups (P > 0.05). As compared with preoperative, ASIA grade of two groups at last follow-up had statistically significantly different (P < 0.01), the neural function of two groups after operation was recovered for different extent. The JOA score of two groups was compared between last follow-up and preoperative, the difference had statistically significant (P < 0.01), the two groups showed good clinical effect. The clinical results of ASIA grade, JOA score and RIS had no significant differences between two groups. All patients of two groups were obtained fusion. Thoracic and lumbar lordosis angle improvement degree had no significant difference between two groups ,it bad significant difference had statistical significance compared with preoperative, the two approaches could effectively restore the spinal sequence. CONCLUSION: For patients with thoracolumbar burst fracture just treated by anterior decompression and reconstruction of anterior column, according to the degree of operation performer' skill proficiency and the patient' condition to choose, but for patients must performed the spinal canal decompression anterior and posterior, the three column-reconstruction to required anterior-posterior approach, the posterior unilateral approach corpectomy fusion screw-rod fixation obviously shorten operation time, reduce the operation wound, it is worth the clinical promotion.

SSRs transferability and genetic diversity of three allogamous ryegrass species.

Simple sequence repeat (SSR) markers are widely applied in studies of plant molecular genetics due to their abundance in the genome, codominant nature, and high repeatability. However, microsatellites are not always available for the species to be studied and their isolation could be time- and cost-consuming. To investigate transferability in cross-species applications, 102 primer pairs previously developed in ryegrass and tall fescue were amplified across three allogamous ryegrass species including Lolium rigidum, Lolium perenne and Lolium multiflorum. Their highly transferability (100%) were evidenced. While, most of these markers were multiple loci, only 17 loci were selected for a robust, single-locus pattern, which may be due to the recentness of the genome duplication or duplicated genomic regions, as well as speciation. A total of 87 alleles were generated with an average of 5.1 per locus. The mean polymorphism information content (PIC) and observed heterozygosity (Ho) values at genus was 0.5532 and 0.5423, respectively. Besides, analysis of molecular variance (AMOVA) revealed that all three levels contributed significantly to the overall genetic variation, with the species level contributing the least (P<0.001). Also, the unweighted pair group method with arithmetic averaging dendrogram (UPGMA), Bayesian model-based STRUCTURE analysis and the principal coordinate analysis (PCoA) showed that accessions within species always tended to the same cluster firstly and then to related species. The results showed that these markers developed in related species are transferable efficiently across species, and likely to be useful in analyzing genetic diversity.

Fully human HER2/cluster of differentiation 3 bispecific antibody triggers potent and specific cytotoxicity of T lymphocytes against breast cancer.

The use of a bispecific antibody (BsAb) is a promising and highly specific approach to cancer therapy. In the present study, a fully human recombinant single chain variable fragment BsAb against human epidermal growth factor receptor (HER)2 and cluster of differentiation (CD)3 was constructed with the aim of developing an effective treatment for breast cancer. HER2/CD3 BsAb was expressed in Chinese hamster ovary cells and purified via nickel column chromatography. Flow cytometry revealed that the HER2/CD3 BsAb was able to specifically bind to HER2 and CD3­positive cells. HER2/CD3 BsAb was able to stimulate T-cell activation and induce the lysis of cultured SKBR­3 and BT474 cells in the presence of unstimulated T lymphocytes. HER2/CD3 BsAb efficiently inhibited the growth of breast cancer tissue by activating and inducing the proliferation of tumor tissue infiltrating lymphocytes. Therefore, HER2/CD3 BsAb is a potent tool which may be a suitable candidate for the treatment of breast cancer.

Molecular insights into the genetic diversity of Hemarthria compressa germplasm collections native to southwest China.

Start codon targeted polymorphism (SCoT) analysis was employed to distinguish 37 whipgrass (Hemarthria compressa L.) clones and assess the genetic diversity and population structure among these genotypes. The informativeness of markers was also estimated using various parameters. Using 25 highly reproducible primer sets, 368 discernible fragments were generated. Of these, 282 (77.21%) were polymorphic. The number of alleles per locus ranged from five to 21, and the genetic variation indices varied. The polymorphism information content (PIC) was 0.358, the Shannon diversity index (H) was 0.534, the marker index (MI) was 4.040, the resolving power (RP) was 6.108, and the genotype index (GI) was 0.782. Genetic similarity coefficients (GS) between the accessions ranged from 0.563 to 0.872, with a mean of 0.685. Their patterns observed in a dendrogram constructed using the unweighted pair group method with arithmetic mean analysis (UPGMA) based on GS largely confirmed the results of principal coordinate analysis (PCoA). PCoA was further confirmed by Bayesian model-based STRUCTURE analysis, which revealed no direct association between genetic relationship and geographical origins as validated by Mantel's test (r = 0.2268, p = 0.9999). In addition, high-level genetic variation within geographical groups was significantly greater than that between groups, as determined by Shannon diversity analysis, analysis of molecular variance (AMOVA) and Bayesian analysis. Overall, SCoT analysis is a simple, effective and reliable technique for characterizing and maintaining germplasm collections of whipgrass and related species.

[Treatment of lumbar instability with transforaminal lumbar interbody fusion (with single cage) combined with unilateral pedicle screw fixation].

OBJECTIVE: To explore the clinical effect of transforaminal lumbar interbody fusion (with single cage) combined with unilateral pedicle screw fixation in treating lumbar instability. METHODS: The clinical data of 50 patients with lumbar instability were retrospectively analyzed. They underwent treatment and obtained following up more than 8 months from 2009 to 2012. All patients complicated with refractory or recurrent lower back pain, and unilateral primarily or unilateral lower limb radiation pain, X-ray and CT films showed lumbar instability. The patients were respectively treated with transforaminal lumbar interbody fusion (with single cage) combined with unilateral or bilateral pedicle screw fixation. According to different fixation methods, they divided into unilateral fixation group and bilateral fixation group. There were 20 patients with 22 intervertebral spaces in unilateral fixation group, 8 males and 12 females, aged from 26 to 66 years old, 2 cases with isthmic spondylolisthesis of degree I, 8 cases with degenerative spondylolisthesis, 10 cases with lumbar disc herniation; fusion location with L3,4 was in 1 case, L4,5 was in 12 cases, L5S1 was in 9 cases. There were 30 patients with 30 intervertebral spaces in bilateral fixation group, 14 males and 16 females, aged from 41 to 62 years old, 4 cases with isthmic spondylolisthesis of degree I,14 cases with degenerative spondylolisthesis, 12 cases with lumbar disc herniation; fusion location with L3,4 was in 3 cases, L4,5 was in 15 case, L5S1 was in 12 cases. Operation time, intraoperative blood loss, postoperative drainage, complications were analyzed and intervertebral height, lordosis angle changes, fusion rate and clinical effect were compared between two groups. RESULTS: All incisions obtained primary healing,lower limb radiation pain and low back pain disappeared basically, no infection, endorachis injury was found. Foot drop occurred in one case of bilateral fixation group and no iatrogenic neurological symptom was found in unilateral fixation group. All patients were followed up from 8 to 18 months with an average of (10.8?4.3)months. Ac- cording to JOA score improvement rate (RIS) to assess clinical effect, all patients got excellent and good results, there was no statistically significant difference between two groups. Two methods can both effectively increase the pathological intervertebral height. Unilateral fixation group was better than bilateral fixation group in aspect of operation time, intraoperative blood loss and postoperative drainage. CONCLUSION: With strict indication and good skills, transforaminal lumbar interbody fusion (with single cage) combined with unilateral pedicle screw fixation in treating lumbar instability has advantages of smaller traumatic, less blood loss, faster recovery for the patient and can reduce the economic cost.

[Transposition of orbital fat and orbicularis muscle flap over the orbital rim for correction of lower eyelid pouches complicated with lacrimal groove deformity].

OBJECTIVE: To introduce the experience in the treatment of lower eyelid pouches orbital rim. METHODS: An incision was made along the margin of lower eyelid and dissection was performed under the orbicularis muscle to expose the orbital septum and periosteum of lower orbital rim. The fat released from orbital septum was transposed just below the lower orbital rim and fixed on the periosteum. If lacrimal groove deformity was not corrected completely, the musculocutaneous flap, which may be excised beside the incision, was kept to correct the deformities further with only the muscle portion. RESULTS: 72 cases with lower eyelid pouches complicated with lacrimal groove deformities were treated with transposition of orbital fat and orbicularis muscular flaps. Satisfactory results were achieved in all the patients after a follow-up period of 3-6 months. CONCLUSION: It is an effective and feasible technique to correct lacrimal groove deformities with transposition of orbital fat and orbicularis muscular flaps.

[Submucosal tunneling endoscopic resection for submucosal tumor originating from the muscularis propria layer of the esophagus].

OBJECTIVE: Tumors originating from the muscularis propria layer of esophagus are usually removed by thoracoscopic resection. With the introduction of new endoscopic therapeutic techniques, some of these tumors could be treated by endoscopic submucosal dissection (ESD). However, the above endoscopic methods are associated with a high risk of perforation and it is hard to close the perforation through the endoscopy. Recently we successfully resected a tumor originating from the muscularis propria layer of the esophagus by submucosal tunneling endoscopic resection (STER), which was based on peroral endoscopic myotomy (POEM) and ESD. Compared with ESD, STER is a safe, economic and less invasive treatment. Even when perforation happens, it is easier to close the tunnel with the endoscopic clips which can help stopping the leak of air and digestive fluids. In this case, we found STER wss an effective and safe endoscopic procedure to remove tumors originating from the muscularis propria layer in the esophagus.

[Preliminary clinical study on the treatment of severe infantile hemangioma with high-dose propranolol in China].

OBJECTIVE: To investigate the clinical results of the treatment of severe infantile hemangioma with high-dose propranolol in Chinese. METHODS: 56 cases with severe infantile hemangioma were treated with propranolol. Clinical evaluation, electrocardiography, and experimental examination of liver function and heart function were performed before treatment. The daily dose of propranolol was increased from 1 mg/kg at the first day to 1.5 mg/kg at the second day, and to 2 mg/kg at the third day. The propranolol was given twice a day. The treatment was lasted for six months. The patients were visited every month. RESULTS: The lesion color was changed after 2-4 days of treatment in all the cases. All the lesions were dramatically improved after one month of treatment. The ulceration were healed, except one case. Until now, complete regression was achieved in 10 cases and marked improvement in 46 cases. Side effects were happened in 3 cases, including one case of abnormal liver function, one case of CK-MB increase and one case of continuous increase of CK-MB, LDH, ALT, GGT. CONCLUSIONS: High-dose Propranolol is very effective in the treatment of infantile hemangioma with minor side effects and short disease period. It might he used as the first-line treatment for infantile hemangioma.

Whether drainage should be used after surgery for breast cancer? A systematic review of randomized controlled trials.

A systematic review of randomized controlled trials (RCTs) was conducted to evaluate whether patients benefit from the suction drainage after axillary lymph node dissection (ALND) in breast cancer surgery. RCTs of drainage versus no drainage after ALND in women with breast cancer were retrieved from PubMed, EMBASE, Cochrane Library and Chinese Biomedical database. Two authors independently assessed the quality of included trials and extracted data. Odds ratio (OR) for dichotomous outcomes and mean difference (MD) for continuous outcomes were presented with 95% confidence intervals (CI). A total of 1115 titles were indentified from the databases; 1109 obvious irrelevant studies were excluded by examining the titles, abstracts, full texts because of duplicates, no RCT, different modality of drainage, drain for lymphedema, application of fibrin sealant and so on. And then, only 6 RCTs to compare drainage with no drainage after ALND in breast cancer surgery were included in the systematic review and a total of 585 patients were included in the pathological diagnosis of breast cancer in women before surgery, management by ALND with or without addition surgical procedures. The study demonstrated that insertion of a drain in the axilla after breast cancer surgery resulted in a statistically significant reduction in the rate of seroma (OR = 0.36, 95% CI, 0.16 to 0.81, P = 0.01), the volume of aspiration (MD = -100.10, 95% CI, -174.36 to -25.85, P = 0.008), or the frequency of seroma aspiration (MD = -1.03, 95% CI, -1.35 to -0.71, P < 0.00001), but prolonged the length of hospital stay (MD = 1.52, 95% CI, 0.36 to 2.68, P = 0.01). There was no statistically significant difference in the incidence of wound infection (OR = 0.67, 95% CI, 0.34 to 1.32, P = 0.25) between drainage group and no drainage group. Based on the current evidence, insertion of a drain in the axilla following ALND in breast cancer surgery effectively decreased seroma formation, volume of aspiration as well as the frequency of seroma aspiration without increasing the incidence of wound infection, but extending their stay in hospital.

[Application of single interbody fusion cage with pedicle screws by transforaminal approach in treating lumbar instability].

OBJECTIVE: To evaluate the value of transforaminal approach single interbody fusion cage combining with fixation with pedicle screws in treating lumbar instability. METHODS: From 2006 to 2009, 36 patients (39 interspaces) with lumbar instability were retrospectively analyzed, included 14 males and 22 females; aged from 45 to 68 years with an average of 54 years; course of disease was from 6 months to 12 years with an average of 4 years. Of them, instability in lumbar disc herniation had 8 cases, lumbar spinal stenosis 5 cases, postoperative instability in lumbar disc herniation 3 cases, lumbar spondylolysis 20 cases; unstable segment in L3,4 had 2 cases, L4,5 18 cases, L5S1 13 cases, and double segment 3 cases (both L4,5 and L5S1). All patients underwent decompression, reduction, interbody fusion with single cage from transforaminal approach with pedicle screws and posterolateral fusion. The clinical effects were evaluated according to imaging results and JOA scoring system. RESULTS: All the patients were followed up from 8 to 32 months with an average of 18 months. The results of 38 intervertebral fusion, suspicious fusion of a vertebral space, fusion rate was 97.4% (38/39). Segmental lordosis angle after operation was increased (4.09 +/- 0.13) degrees than before operation (P < 0.01), and final follow-up was reduced (3.83 +/- 0.17) degrees than after operation (P > 0.05). JOA scoring before operation and final follow-up were respectively 8.14 +/- 1.09 and 13.54 +/- 1.19, there was statistically significant between the two periods (P < 0.01); the JOA score improvement rate (RIS): 28 cases got excellent result, 6 good and 2 fair, the rate of excellent and good was 94.4%. CONCLUSION: The path through the transforaminal approach single-fusion cage, implantation of pedicle screw fixation fusion surgery can simplify operations, reduce complications, and can obtain satisfactory clinical efficacy, which is an effective method for the treatment of lumbar instability.

[Estrogen on stimulating the angiogenesis of children's hemangioma in vitro].

OBJECTIVE: To demonstrate that estrogen stimulates the angiogenesis of children' s hemangioma. METHODS: A piece of hemangioma biopsy was embedded in fibrin gel, and a model in vitro of angiogenesis of human hemangioma was then established. The angiogenesis of hemangioma in each group was interfered by the estrogen and tamoxifen. There were four groups divided into the followings: the group with estrogen, the group with tamoxifen, the group with estrogen + tamoxifen and the control. The dimension of newborn tubule area in the 3rd, 6th, 9th day after the culture was calculated to compare statistically differences among the groups. RESULTS: In the model of angiogenesis of hemangioma, microvessels grew out from the tissue sample in 2 to 3 days after the culture, and in 8 to 9 days a complex network of microvessels had been shown, the tending to inactivity. On the 3rd,6th and 9th day after the culture the dimension of newborn tubule area of the group of estrogen [(2.84 +/- 0.20) mm2 (12.93 +/- 0.85) mm2 (22.47 +/- 1.40) mm2] were larger than those of the control [(1.98 +/- 0.17) mm2, (7.51 +/- 0.48) mm2, (11.26 +/- 0.73) mm2]. Those of the group of estrogen + tamoxifen [(1.08 +/- 0.11) mm2, (3.54 +/- 0.31) mm2, (5.72 +/- 0.40 mm2] and the group of tamoxifen [(1.13 +/- 0.14) mm2 (4.26 +/- 0.29) mm2, (6.08 +/- 0.42) mm2] were smaller than those of the groups of the estrogen and the control (P < 0.05). CONCLUSIONS: The estrogen may stimulate the angiogenesis of children's hemangioma, and the tamoxifen may reverse the process.

[A three-dimension in vitro model for angiogenesis of hemangioma].

OBJECTIVE: To create a three dimension (3D) in vitro model for angiogenesis of hemangioma. METHOD: The fragment of hemangioma specimen was embedded in fibrin gel to set up the three-dimension (3D) in vitro model for angiogenesis of hemangioma. RESULT: In the model, microvessels grew out from the tissue fragments at the 2nd to 3rd day after culture, and at the 8th to 9th day a compact network of microvessels come into being, then tending to be stationary. The compact network around the tissue fragment was confirmed to be blood vessels by immunohistochemistry and electron microscopy. CONCLUSION: This model helps to study the mechanism of hemangioma angiogenesis and investigate the drugs of anti-angiogenesis.