T-tube implantation combined with cricoid cartilage reconstruction in the treatment of congenital laryngeal webs with subglottic stenosis.

OBJECTIVE: To discuss the presentation, evaluation, and management of congenital laryngeal webs with subglottic stenosis. METHODS: The clinical data of six children were retrospectively analyzed. RESULTS: The median age of these children who came to our hospital was 14 months (range 1-26 months). A tracheotomy was performed in all these six children. The median age of the patients who underwent tracheotomy was 4 months (range 1-11 months). The surgical method was T-tube implantation combined with cricoid cartilage reconstruction. The median age of these patients at the time of operation was 22 months (range 13-35 months). The T-tube remained in place for 3-8 months, with a median time of 6 months. The tracheal tubes in all these children were successfully removed. All patients were followed up for more than 2 years without recurrence. CONCLUSIONS: Children who have congenital laryngeal webs with subglottic stenosis required early tracheotomy. Open laryngoplasty combined with T-tube implantation and cricoid cartilage reconstruction may play a crucial role in the treatment of these children.

The radiologic assessment of posterior ligamentous complex injury in patients with thoracolumbar fracture.

PURPOSES: To discuss whether radiologic parameters are closely related to posterior ligamentous complex (PLC) injury identified by magnetic resonance imaging (MRI). METHODS: One hundred and five thoracolumbar fracture (T11-L2) patients were retrospectively analyzed in the study. The patients were divided into different groups by the status of the PLC on MRI: intact, incompletely ruptured and ruptured. The radiographic parameters included the anterior edge-inferior endplate angle (AEIEA), the anterior edge displacement (AED), the Cobb angle (CA), the region angle (RA), the sagittal index (SI), local kyphosis (LK), the anterior/posterior vertebral height ratio (A/P ratio), the anterior vertebral height ratio (AVH ratio), and bony fragment in front of the fractured vertebra (BFOFV). T test, Pearson's Chi-square and multivariate logistic regression were calculated for the variables. RESULTS: Supraspinous ligament (SSL) rupture versus intact was not only associated with the occurrence of AEIEA <70°, LK >25° and BFOFV, but also with increased AED (9.89 ± 3.12 mm and 9.34 ± 3.36 mm, P = 0.034), RA (9.52 ± 3.93° versus 7.91 ± 3.99°, P = 0.042), and LK (23.98 ± 5.88° versus 15.55 ± 5.28°, P = 0.021). The indications for interspinous ligament (ISL) injury included AEIEA <75°, AEIEA <70° (P = 0.004 and P < 0.001, respectively), increased AED (P = 0.010), LK >25° (P = 0.024), AVH (P < 0.001), and BFOFV (P < 0.001). Multivariate logistic regression analysis revealed that AEIEA <70° and BFOFV were high risk factors for SSL rupture [standard partial regression coefficients (betas) were 0.439 and 0.408, P = 0.003 and 0.001, respectively] and ISL rupture (betas were 0.548 and 0.494, P = 0.028 and 0.001, respectively). Increased AED and LK >25° were also related to either ISL rupture (P = 0.035 and 0.001, respectively) or SSL rupture (P = 0.014 and 0.008, respectively). CONCLUSION: Our data may prove useful in a preliminary assessment of the PLC integrity based on plain radiographic imaging. We show that radiologic indications, such as AEIEA <70°, BFOFV, LK >25°, and increased AED, are correlated with ISL or SSL rupture, while RA, CA, SI, A/P ratio, and AVH ratio are not.

A novel micro-CT-based method to monitor the morphology of blood vessels in the rabbit endplate.

PURPOSE: The aim of this study was to develop a novel method for observing the morphology of the blood vessels in the rabbit endplate. METHODS: Twenty 6-month-old rabbits were used in this study. The blood vessels in the L5 endplate in Group A were injected with iohexol and Group B with barium sulfate. Group C was the control group with saline. To optimize the study, Group B was divided into two subgroups: Group B-1 was injected with 100% (w/v) barium sulfate and Group B-2 with 50% (w/v). After injection, the L4-L5 vertebral body was excised and the cranial endplate of L5 was scanned using a micro-CT scanner. Models of the vertebral endplate and vessels were reconstructed using the 3D reconstruction software (Mimics 16.0) by calculating a bone threshold value, and then merged these two models to create a superimposed model. RESULTS: The 3D vessel models could not be created in Groups A and C, but they were clearly visualized in Group B. In the 3D model, the blood vessels extended from the subchondral bone to the endplate, and the density of the blood vessels in the area of the nucleus pulposus (NP) was higher than in the annulus fibrosus. CONCLUSIONS: The results of this study suggest that the blood vessels in the rabbit endplate can be clearly observed by the method described using barium sulfate [the 50% (w/v) gave better results compared with the 100% (w/v)]. The information from the 3D vessel structure could provide essential data to help us understand the nutrient pathways within the vertebral endplate.

Modified translaminar screw fixation in the cervicothoracic junction (C7-T2): a technical note.

PURPOSE: To describe and illustrate a modified technique for using translaminar screw in the cervicothoracic junction (C7-T2). METHODS: 12 patients (8 males and 4 females, average age was 52 years) underwent insertion of unilateral or bilateral translaminar screws by using our modified technique. With this modified technique, a tiny unicortical "hole" was made at the middle of the contralateral lamina, and the screw can be directly visualized through the unicortical "hole" to prevent violating the spinal canal. RESULTS: With this modified technique, the mean operation time was 205 min (range 145-360) and mean estimated blood loss was 445 ml (range 260-1250). The mean length of the laminar screws was 27 (range 24-30) mm. The results of the 12 patients with an average follow-up of 17 (6-33) months demonstrated this modified technique to be safe and effective in the fixation of cervicothoracic junction. CONCLUSION: In this modified technique, a tiny unicortical "hole" which was made at the middle of the dorsal lamina of cervicothoracic junction (C7-T2). By directly visualizing the screw inserting against the dorsal cortices of the lamina, this modified technique can reduce the risk of violation of the spinal canal and shorten the operation time.

Minimally invasive cortical bone trajectory screws placement via pedicle or pedicle rib unit in the lower thoracic spine: a cadaveric and radiographic study.

PURPOSE: To evaluate the feasibility of cortical bone trajectory (CBT) screws fixation via pedicle or pedicle rib unit in the cadaveric thoracic spine (T9-T12). METHODS: Computed tomography (CT) images of 100 patients are analyzed by multiplanar reconstruction. Ten cadaveric thoracic spines are used to insert 4.5 × 35.0 mm CBT screws at all levels from T9 to T12. RESULTS: Maximal screw length obtained by CT has a tendency to gradually increase from T9 (29.64 mm) to T12 (32.84 mm), and the difference reaches significant level at all levels except T9 versus T10 (P < 0.01). Maximal screw diameter increases from T9 (4.92 mm) to T12 (7.47 mm) and the difference reaches significant level among all levels (P < 0.01). Lateral angle increases from T9 (7.37°) to T12 (10.47°), and the difference reaches significant level among all levels except T11 versus T12. Cephalad angle from T9 to T12 are 19.03°, 22.10°, 25.62° and 27.50° (P < 0.01), respectively. The percentage of the inner and outer pedicle breakage are 2.5 and 22.5 %, respectively. The violation of lateral pedicle wall occurs at T9 and T10, especially for women at T9. CONCLUSIONS: Both radiographic and cadaveric studies establish the feasibility of CBT screws placement via pedicle or pedicle rib unit in the lower thoracic spine (T9-T12). Furthermore, our measurements are also useful for application of this technique.

Effects of shear force on intervertebral disc: an in vivo rabbit study.

PURPOSE: A new in vivo rabbit model was developed to investigate the effects of shear force on intervertebral disc (IVD). METHODS: Japanese white rabbits (n = 38) were used for this study. The L4/5 discs in Group A (n = 10) were subjected to a constant shear force (50 N) using a custom-made external loading device for 1 month; in Group B (n = 10) for 2 months; whereas in Group C (n = 10), loading device was attached to the spine but the discs remained unloaded. Group D (n = 8) was a non-operated intact control group. After loading, the loading devices were taken out and the animals were given X-ray and MRI examination. After X-ray and MRI examination, the animals were euthanized for histological analysis. RESULTS: After 1 and 2 months of loading, radiographic findings showed significant disc height narrowing in L4/5 discs of the animals in loading groups, and slight lumbar spondylolisthesis in some animals of Group B. MRI showed a significant decrease in nucleus pulposus (NP) area and signal intensity from T2-weighted images. Histologically, loss of normal NP cells and disorganization of the architecture of the annulus occurred, and proteoglycan stain decreased. CONCLUSIONS: The results of this study suggest that disc degeneration can be induced by hyper-physiological shear loading in the rabbit IVD. Long-term shear loading may result in structural disc failure inducing lumbar spondylolisthesis and progressive disc degeneration, which, however, has to be proven by further studies.

Analysis of differential transcriptional profiling in wheat infected by Blumeria graminis f. sp. tritici using GeneChip.

Powdery mildew, caused by Blumeria graminis f. sp. tritici (Bgt), is a devastating disease of wheat. The use of wheat cultivars resistant to powdery mildew provides an effective, economical, and environmentally friendly method to control the disease. Previously, we identified a dominant resistance gene, temporarily named Pmhym, from the wheat cultivar Hongyoumai. In order to screen differential transcripts related to Pmhym-mediated resistance, four F3 homozygous resistant and four susceptible progenies derived from the Hongyoumai/Yumai13 cross were selected to construct two different pools, respectively, representing an incompatible and compatible interaction with Bgt. Pre-inoculated control and the pathogen-inoculated treatments at 24 h post inoculation (hpi) were used. Three groups of differential genes were categorized from three comparisons as pre- and post-induced, respectively, in two interactions, and post-induced between incompatible and compatible interaction. It was found that salicylic acid (SA), jasmonate (JA), and ethylene (ET) signaling-related genes were differentially expressed, thus suggesting that they are involved in the defensive response against Bgt infection. In compatible interactions, the genes involved in the abscisic acid (ABA) signaling pathway might be inhibitory to the above-mentioned three pathways, resulting in a susceptible reaction. Genes involved in disease/defense, signal transduction, and reactive oxygen species (ROS) metabolism were up-regulated in incompatible interactions, implying a role in resistant response. The results of qRT-PCR analysis on several candidate genes were consistent in their expression patterns as revealed by microarray analysis. The differential expression analyses in the present study are good candidates for further elucidation of wheat defensive response to powdery mildew.

The role of autophagy and mitophagy in cancers.

Autophagy is an important life phenomenon in eukaryotic cells. Its main role is to remove and degrade its damaged organelles and excess biological macromolecules, and use degradation products to provide energy and rebuild the cell structure, playing an important role in maintaining cell homeostasis and cell life activities. Mitophagy is a form of macroautophagy. It has the beneficial effect of eliminating damaged mitochondria, thereby maintaining the integrity of the mitochondrial pool. Autophagy and mitophagy have a dual role in the development of cancer. On one hand, autophagy and mitophagy can maintain the normal physiological function of cells. On the other hand, excessive autophagy and mitophagy can lead to diseases. The present review introduces the mechanisms of autophagy and mitophagy, and the main related proteins, and introduce the correlation with cancers, providing a basis for the treatment of cancers through the understanding of these proteins.

An unsupervised image segmentation algorithm for coronary angiography.

Computer visual systems can rapidly obtain a large amount of data and automatically process them with ease. These characteristics constitute advantages for the application of such systems in the automatic analysis of medical images, as well as in processing technology. The precision of image segmentation, which plays a critical role in computer visual systems, directly affects the quality of processing results. Coronary angiographs feature various background colors, complex patterns, and blurry edges. The image areas containing blood vessels cannot be precisely segmented through regular methods. Therefore, this study proposed an unsupervised learning algorithm that uses regional parameter expansion (RPE). This method was derived from the flood fill algorithm, which can effectively segment image areas containing blood vessels despite a complex background or uneven light and shadow. An optimal cover tree (OCT) algorithm was proposed for the establishment of coronary arteries and the estimation of vessel diameter. Through the region growing method, spanning trees were used to record the cover length of adjacent connections, thereby establishing vessel paths, and the length can be used to track changes in vessel diameter.

Pediatric temporal fistula: Report of three cases.

BACKGROUND: Pediatric temporal fistulae are rarely reported in the literature. Dissemination of these cases can help inform future diagnosis and effective treatment. CASE SUMMARY: Three pediatric patients came to the clinic due to repeated infections of the skin and soft tissue of the temporal area. One patient presented with a temporal fistula that penetrated the temporal bone and reached the dura mater. Another patient presented with a temporal fistula that penetrated into the temporal muscle fascia. The third patient presented with a fistula that penetrated the lateral wall of the orbit and entered the orbit. All patients underwent surgical fistula resection informed by preoperative computed tomography (CT) evaluation. Histopathological evaluation was also performed. All three patients were surgically treated successfully. Histopathological evaluations confirmed the fistula diagnoses in all three cases. CONCLUSION: For patients who have temporal fistulae with repeated infections, surgical treatment should be performed as soon as possible to prevent serious complications. CT can be very useful for preoperative evaluation. B-mode ultrasound examination and evaluation also have a certain auxiliary role.

Association of Overlapped and Un-overlapped Comorbidities with COVID-19 Severity and Treatment Outcomes: A Retrospective Cohort Study from Nine Provinces in China.

OBJECTIVE: Several COVID-19 patients have overlapping comorbidities. The independent role of each component contributing to the risk of COVID-19 is unknown, and how some non-cardiometabolic comorbidities affect the risk of COVID-19 remains unclear. METHODS: A retrospective follow-up design was adopted. A total of 1,160 laboratory-confirmed patients were enrolled from nine provinces in China. Data on comorbidities were obtained from the patients' medical records. Multivariable logistic regression models were used to estimate the odds ratio ( OR) and 95% confidence interval (95% CI) of the associations between comorbidities (cardiometabolic or non-cardiometabolic diseases), clinical severity, and treatment outcomes of COVID-19. RESULTS: Overall, 158 (13.6%) patients were diagnosed with severe illness and 32 (2.7%) had unfavorable outcomes. Hypertension (2.87, 1.30-6.32), type 2 diabetes (T2DM) (3.57, 2.32-5.49), cardiovascular disease (CVD) (3.78, 1.81-7.89), fatty liver disease (7.53, 1.96-28.96), hyperlipidemia (2.15, 1.26-3.67), other lung diseases (6.00, 3.01-11.96), and electrolyte imbalance (10.40, 3.00-26.10) were independently linked to increased odds of being severely ill. T2DM (6.07, 2.89-12.75), CVD (8.47, 6.03-11.89), and electrolyte imbalance (19.44, 11.47-32.96) were also strong predictors of unfavorable outcomes. Women with comorbidities were more likely to have severe disease on admission (5.46, 3.25-9.19), while men with comorbidities were more likely to have unfavorable treatment outcomes (6.58, 1.46-29.64) within two weeks. CONCLUSION: Besides hypertension, diabetes, and CVD, fatty liver disease, hyperlipidemia, other lung diseases, and electrolyte imbalance were independent risk factors for COVID-19 severity and poor treatment outcome. Women with comorbidities were more likely to have severe disease, while men with comorbidities were more likely to have unfavorable treatment outcomes.

Relationship Between Apoptosis of Endplate Microvasculature and Degeneration of the Intervertebral Disk.

OBJECTIVE: To explore the relationship between intervertebral disk degeneration and endplate microvasculature, and to determine the role of apoptosis in the pathophysiology underlying end plate microvasculature. METHODS: Twelve 6-month-old rabbits were randomly divided into group A (control group where animals underwent a sham operation, in which the loading device was implanted but without loading) and group B (degeneration group, where a calibrated spring within the loading device would immediately create static shear force of 50 N to the disk of L4-5). Paraffin-embedded midsagittal sections of the L4-5 disk were obtained 4 weeks after surgery in the both groups. Sections were stained with cluster of differentiation (CD) 31 immunohistochemistry to measure the blood vessel density in the endplate, with CD31 immunofluorescence and terminal dUTP nick-end labeling (TUNEL) to detect the apoptosis of vascular endothelial cells in the endplate. RESULTS: After 4 weeks, the microvasculature density was 91 ± 8 vessels/mm2 in group A and 47 ± 2 vessels/mm2 (P < 0.001) in group B, demonstrating that vessels were reduced in the endplate of intervertebral disk degeneration. CD31 immunofluorescence and TUNEL showed that apoptosis of vascular endothelial cells exists in the endplate of intervertebral disk degeneration. CONCLUSIONS: The results of this study suggest that apoptosis of vascular endothelial cells results in a decrease in endplate microvasculature density, further affecting the pathologic process of intervertebral disk degeneration.

Magnetic Resonance-Based Morphological Features of the Manubrium and the Surgeons' View Line: When to Use Manubriotomy?

OBJECTIVE: We sought to identify the morphological features of the relationship between the manubrium and vertebrae of the cervicothoracic junction for use in guidelines for the selection of the appropriate surgical approach. METHODS: We performed a review of 222 midsagittal section magnetic resonance imaging scans. The surgeons' view line was parallel to the inferior caudal vertebral endplate. Morphometric measurement of the manubrium and the cervicothoracic junction's vertebral body included the distance from the highest point of the manubrium to the surgeons' view line and the angle between that line to the horizontal line. RESULTS: A significant difference was found with regard to the distance between the groups (P < 0.001). A significant difference between males and females was also identified. The lowest level above the manubrium was the T1. Between the groups, the angles were significantly different (P ≤ 0.01). Males had a larger angle than females with respect to groups C6, C7, T1 (P < 0.001), and T2 (P = 0.007). In terms of both the distance and the angle, no significant difference was found according to age (P > 0.05). CONCLUSION: Our results have provided insight into the anatomy of the manubrium and vertebrae of the cervicothoracic junction. Furthermore, our results have shown that, for most people, the T1 forms the boundary of the manubriotomy. We found that both the distance and angle differed significantly according to sex. A better understanding of the radiological anatomy of the surgeons' view line will help in the preoperative assessment of patients and in indicating an appropriate surgical approach.

[Establishment of pharyngeal 3-dimensional finite element model of patients with isolated cleft palate].

PURPOSE: The aim of this study was to provide basis for future design and selection of cleft palate surgery through establishing finite element model of pharyngeal cavity which was suitable for biomechanical analysis. METHODS: One patient with isolated cleft palate and 1 normal child underwent multilayer head CT examination. The scanned data of pharyngeal cavity were imported into Mimics software for a 3-D geometric model reconstruction. The model was divided into a grid, so it can be further processed for subsequent finite element analysis. RESULTS: After applying 5cm water column pressure load of 0.0005 MPa at the back edge of the soft palate in the two models respectively, the results showed that the maximum stress of the abnormal nasopharyngeal cavity model was 0.025 MPa, greater than the normal model (0.017 MPa). The same pressure loading was applied to different parts of the two models, the stress change area in the posterior margin of the soft palate and the middle of the palate was the same, and the stress in the front of the hard palate was smaller. CONCLUSIONS: Finite element model has good biomechanical characteristics and geometric similarity. It can be used in isolated cleft palate with preoperative biomechanical analysis, for repairing and functional reconstructive surgery to provide ideal biomechanical model predicts.

Combined treatment with parathyroid hormone (1-34) and beta-tricalcium phosphate had an additive effect on local bone formation in a rat defect model.

The objective of this study was to evaluate the effect of following combined treatment with parathyroid hormone (1-34) (PTH) and beta-tricalcium phosphate (ß-TCP) on local bone formation in a rat 3-mm critical-size defect at distal femur. Twelve weeks after bilateral ovariectomy (OVX) and sham operation (sham), all animals were randomly divided into four groups: group OVX, group OVX + ß-TCP, group sham, and group sham + ß-TCP, then all rats underwent bone defect in the bilateral distal femurs, and ß-TCP were implanted into critical-sized defects for group OVX + ß-TCP and group sham + ß-TCP. After defect operation, all animals were received following subcutaneous injections with PTH (60 µg/kg, three times a week) until death at 4 and 8 weeks. The defected area in distal femurs of rats was harvested for evaluation by histology, micro-CT, and biomechanics. The results of our study show that systemic usage of PTH or local usage of ß-TCP can increase the healing of defects in OVX or sham rats. Furthermore, treatments with PTH and ß-TCP showed a stronger effect on accelerating the local bone formation than used alone. Osteoporosis can limit the function of PTH and/or ß-TCP. The results from our study demonstrate that combination of PTH and ß-TCP had an additive effect on local bone formation in non-osteoporosis and/or osteoporosis rats.

Intermittent administration of human parathyroid hormone (1-34) increases fixation of strontium-doped hydroxyapatite coating titanium implants via electrochemical deposition in ovariectomized rat femur.

Previous studies have demonstrated the effect of human parathyroid hormone (1-34) (PTH) or strontium-doped hydroxyapatite coating (Sr-HA) on osteoporotic bone implantation. However, reports about effects of PTH plus Sr-HA on bone osseointegration of titanium implants in a state of osteoporosis were limited. This study was designed to investigate the effects of intermittent administration of human parathyroid hormone (1-34) on strontium-doped hydroxyapatite coating (Sr-HA) implant fixation in ovariectomized (OVX) rats. Twelve weeks after bilateral ovariectomy, all animals were randomly divided into four groups including control group, Sr group, PTH group and PTH+Sr group. Forty OVX rats accepted implant insertion in the distal femurs, control group, and PTH group with HA implants and the Sr group and PTH+Sr group with Sr-HA implants. Animals from PTH group and PTH+Sr group then randomly received PTH (60 µg/kg, 3 times a week) until death at 12 weeks. After 12-week healing period, implants from group PTH+Sr revealed improved osseointegration compared with other treatment groups, which is manifested by the exceeding increase of bone area ratio and bone-to-implant contact, the trabecular microarchitecture and the maximal push-out force displayed by tests like histomorphometry, micro-CT, and biomechanics evaluation. These results demonstrated that PTH+ Sr-HA coatings could enhance implant osseointegration in OVX rats, and suggested the feasibility of using this method to improve implant fixation in osteoporotic bone.

Oxymatrine downregulates HPV16E7 expression and inhibits cell proliferation in laryngeal squamous cell carcinoma Hep-2 cells in vitro.

OBJECTIVE: To investigate the possible mechanisms of oxymatrine's role in anti laryngeal squamous cell carcinoma. METHODS: We examined the effects of oxymatrine on the proliferation, cell cycle phase distribution, apoptosis, and the protein and mRNA expression levels of HPV16E7 gene in laryngeal carcinoma Hep-2 cells in vitro. The HPV16E7 siRNA inhibition was also done to confirm the effect of downregulating HPV16E7 on the proliferation in Hep-2 cells. RESULTS: Oxymatrine significantly inhibited the growth and proliferation of Hep-2 cells in a dose-dependence and time-dependence manner. Oxymatrine blocked Hep-2 cells in G0/G1 phase, resulting in an obvious accumulation of G0/G1 phase cells while decreasing S phase cells. Oxymatrine induced apoptosis of Hep-2 cells, whose apoptotic rate amounted to about 42% after treatment with 7 mg/mL oxymatrine for 72 h. Oxymatrine also downregulated the expression of HPV16E7 gene, as determined by the western blotting and reverse transcription-polymerase chain reaction analysis. Knockdown of HPV16E7 effectively inhibited the proliferation of Hep-2 cells. CONCLUSIONS: Oxymatrine inhibits the proliferation and induces apoptosis of laryngeal carcinoma Hep-2 cells, which might be mediated by a significant cell cycle arrest in G0/G1 phase and downregulation of HPV16E7 gene. Oxymatrine is considered to be a likely preventive and curative candidate for laryngeal cancer.

Treatment study of distal femur for parathyroid hormone (1-34) and ß-tricalcium phosphate on bone formation in critical size defects in rats.

The objective of this study was to evaluate local bone formation following systemic administration of parathyroid hormone (1-34), a surgically implanted synthetic ß-tricalcium phosphate bone biomaterial serving as a matrix to support new bone formation. Twelve weeks after bilateral ovariectomy, all rats underwent bone defect in the distal femurs, and ß-tricalcium phosphate was implanted into critical sized defects. After defect operation, all animals were randomly divided into four groups and received following subcutaneous injections until death at four and eight weeks: sham rats (group ST); sham rats + parathyroid hormone, 30 µg/kg, three times a week (group SPT); OVX rats (group OT); and OVX rats + parathyroid hormone (group OPT). The distal femurs of rats were harvested for evaluation. The treatment group demonstrating the highest levels of new bone formation was the defects treated with parathyroid hormone as assessed by micro-computed tomography, biomechanical strength, and histological analysis for sham rats. Furthermore, parathyroid hormone showed a stronger effect on accelerating the degradation of ß-tricalcium phosphate. Osteoporosis can limit the function of parathyroid hormone and/or ß-tricalcium phosphate. The results from our study demonstrate that combination of parathyroid hormone and ß-tricalcium phosphate brings better effect to bone tissue repair in non-osteoporosis and/or osteoporosis status.

A Computed Tomographic Morphometric Study of the Pediatric Occipital Bone Thickness: Implications for Pediatric Occipitocervical Fusion.

STUDY DESIGN: This study is a computed tomographic-based morphometric analysis of the pediatric occipital bones as related to pediatric occipitocervical fusion. OBJECTIVE: To quantify reference data concerning the thicknesses of the immature occipital bones to guide the pediatric occipitocervical fusion. SUMMARY OF BACKGROUND DATA: To the best of our knowledge, no published study has provided insight into the thicknesses of pediatric occiputs with different age groups. METHODS: 80 pediatric patients were divided into 4 age groups, and their occiputs were studied on Philips Brilliance 256 iCT scan. RESULTS: The mean thickness ± standard deviations of the pediatric occipital bones with different age groups is shown. The median and the paramedian regions are always thicker than the more lateral regions at each age group and the thickest point in the occiputs is mostly at the external occipital protuberance. The mean thickness of occiputs showed an obvious significant difference between each 2 age groups and no significant difference between male and female in different age groups except the group 4. CONCLUSION: Our investigation provides insight into the anatomy of occiputs in pediatric population and preoperative CT evaluation must be required to further decrease the risk of occipitocervical fusion.

Association of interleukin-13 SNP rs20541 with allergic rhinitis risk: a meta-analysis.

Studies investigating the association between interleukin-13 (IL-13) single nucleotide polymorphism (SNP) rs20541 and allergic rhinitis (AR) risk have reported conflicting results. The aim of the present study was to conduct a meta-analysis assessing the possible association of IL-13 SNP rs20541 with AR risk. Eight studies were included in the present meta-analysis (2153 cases and 3931 controls). The combined results based on all studies showed that IL-13 SNP rs20541 was associated with increased AR risk (Gln versus Arg: odds ratio (OR)=1.18, 95% confidence interval (CI)=1.08-1.30; Gln/Gln versus Arg/Arg: OR=1.52, 95% CI=1.20-1.92; Arg/Gln+Gln/Gln versus Arg/Arg: OR=1.19, 95% CI=1.06-1.33; Gln/Gln versus Arg/Gln+Arg/Arg: OR=1.42, 95% CI=1.13-1.79). When stratifying for race, IL-13 SNP rs20541 exhibited increased AR risk in Asians (Gln versus Arg: OR=1.20, 95% CI=1.06-1.36; Gln/Gln versus Arg/Arg: OR=1.57, 95% CI=1.17-2.12; Arg/Gln+Gln/Gln versus Arg/Arg: OR=1.22, 95% CI=1.04-1.44; Gln/Gln versus Arg/Gln+Arg/Arg: OR=1.45, 95% CI=1.09-1.93), while no significant association was detected in Caucasians (Gln versus Arg: OR=1.28, 95% CI=0.93~1.78; Gln/Gln versus Arg/Arg: OR=1.42, 95% CI=0.96-2.11; Arg/Gln+Gln/Gln versus Arg/Arg: OR=1.35, 95% CI=0.89-2.05; Gln/Gln versus Arg/Gln+Arg/Arg: OR=1.37, 95% CI=0.93-2.02). This meta-analysis supported that IL-13 SNP rs20541 was associated with AR, particularly in Asians.