[Analysis of factors associated with proximal junctional kyphosis after surgery for Lenke type 5 adolescent idiopathic scoliosis].

Objective: To investigate the risk factors associated with the development of proximal junctional kyphosis (PJK) after posterior spinal fusion for in children with Lenke type 5 adolescent idiopathic scoliosis (AIS). Methods: It was a retrospective case-control study that included medical records of 98 children with Lenke type 5 AIS who underwent posterior orthopedic surgery under general anesthesia at the Honghui Hospital Affiliated to Xi'an Jiaotong University from January 2013 to December 2018. There were 23 males and 75 females with a mean age of (14.5±2.2) years (10-18 years). Patients were divided into PJK and non-PJK groups according to whether the posterior junctional angle (PJA) was greater than 10° and increased for more than 10° from the preoperative period at the the last follow-up. Univariate analysis was used to analyze the correlation of general data of the children with occurrence of PJK after the operation. Multivariate logistic regression analysis was used to analyze the risk factors of postoperative PJK. Results: There were 35 cases in the PJK group and 63 cases in the non-PJK group. The PJK and non-PJK groups were followed up for (35.6±7.3) months and (36.4±7.5) months, respectively, and the difference was not statistically significant (P=0.637). There was no statistically significant difference between the two groups in general data such as gender, age, and body mass index (all P>0.05), while there were statistically significant differences between the two groups in upper instrumented vertebrea (UIV) location and junctional area posterior ligamentous complex (PLC) injury (all P<0.05). The results of univariate analysis showed that UIV location at T10-T12, junctional area PLC injury, preoperative coronal thoracic curve (TC), preoperative and final follow-up PJA, and preoperative and final follow-up pelvic incidence-lumbarlordosis (PI-LL) were correlated with postoperative PJK (OR=2.50, 5.37, 0.92, 1.12, 1.32, 1.06, 3.35, all P<0.05). Multifactorial logistic regression analysis showed that UIV located at T10-T12 (OR=2.346, 95%CI: 1.582-3.481, P=0.001), junctional area PLC injury (OR=5.112, 95%CI: 1.283-20.418, P=0.023) and last follow-up PI-LL (OR=1.826, 95%CI: 1.558-24.745, P=0.012) were risk factors for the occurrence of postoperative PJK in children with Lenke type 5 AIS. Conclusions: Postoperative UIV fixation to the thoracolumbar segment, PLC injury in the junctional area and excessive postoperative PI-LL in children with Lenke type 5 AIS may be the risk factors for the occurrence of PJK after the operation. It is suggested that avoidance of UIV selection to the thoracolumbar segment, intraoperative protection of the PLC located near the UIV and restoration of a good PI-LL relationship may reduce the incidence of PJK.

[The development of artificial cervical disc replacement from the perspective of orthopedic bionic therapy].

The modern surgical treatment of cervical degenerative disc disease can be traced back to the advent of anterior cervical decompression and fusion.With the emergence of fusion-related complications,different scholars have promoted the gradual transformation of cervical degenerative disc diseases from "fusion fixation" to "non-fusion reconstruction" through in-depth fusion with materials science,engineering mechanics and other disciplines.The innovation of this treatment concept is consistent with the original intention of "structural remodeling,functional reconstruction,maximum repair and reconstruction of the morphology and function of skeletal muscle system" in orthopedic bionic treatment,which is essentially in line with the "bionic alternative therapy" in orthopedic bionic therapy.This paper focuses on the surgical treatment of cervical degenerative disc diseases,reviews the development history of artificial cervical disc replacement,analyzes the evolution from orthopedic biomimetic therapy,and explores a new direction for the design of artificial cervical disc prostheses and the treatment of cervical degenerative disc diseases in the future.

Impact of different regenerative techniques and materials on the healing outcome of endodontic surgery: a systematic review and meta-analysis.

BACKGROUND: Regenerative techniques are increasingly applied in endodontic surgery, but different materials used in regenerative techniques may have varying impacts on wound healing. OBJECTIVES: This study evaluated the effects of different regenerative techniques and materials on the outcome of endodontic surgery. PARTICIPANTS: patients with persistent periapical lesions, treated with root-end surgery. CONTROL: endodontic surgery without the use of regenerative techniques/materials. INTERVENTION: endodontic surgery with the use of regenerative techniques/materials. OUTCOME: combined clinical and radiographic results. METHODS: PubMed, Web of Science, Embase, SinoMed and the CENTRAL Cochrane were searched up to 10th July 2020, followed by a manual search. Detailed eligibility criteria were applied. Cochrane's risk-of-bias tool 2.0 was used to assess the risk of bias of the eligible studies. Meta-analysis was conducted using RevMan software. Subgroup analyses were performed based on the regenerative materials used in endodontic surgery. RESULTS: Eleven eligible randomized controlled trials (RCTs) were included in the meta-analysis: two had a low risk of overall bias, and nine had some concerns of overall bias. Generally, the use of regenerative techniques significantly improved the outcome of endodontic surgery (risk ratio [RR]: 0.42; 95% confidence interval [CI], 0.26-0.68; P < 0.001). On subgroup analysis, the use of expanded polytetrafluoroethylene (e-PTFE) membranes alone had no added benefits (RR: 2.00; 95% CI, 0.22-18.33; P = 0.54). The application of collagen membranes or autologous platelet concentrates (APCs) alone was associated with a trend for better outcomes (RR: 0.51; 95% CI, 0.20-1.25; P = 0.14) (RR: 0.55; 95% CI, 0.18-1.71; P = 0.30). The combined use of collagen membranes and bovine-derived hydroxyapatite significantly improved the outcome (RR: 0.35; 95% CI, 0.17-0.75; P = 0.007). DISCUSSION: This systematic review evaluated the effects of collagen membranes, e-PTFE membranes, APCs and bone grafting materials, providing detailed information about the risks and benefits of using each regenerative technique/material or its combination in endodontic surgery. CONCLUSIONS: Regenerative techniques improve periapical lesion healing after endodontic surgery. The combined use of collagen membranes and bovine-derived hydroxyapatite may be beneficial as an adjunct to endodontic surgery. In contrast, the positive efficacy of e-PTFE membranes or APCs alone remains doubtful.

[Abnormalities of white matter differentiate the Parkinson variant of multiple system atrophy from Parkinson's disease].

Objective: To identify objective markers between the Parkinson variant of multiple system atrophy (MSA-P) and Parkinson's disease (PD). Methods: Retrospective analysis was performed on 10 patients with MSA-P, 15 patients with PD, and 15 healthy control group during the period from August 2016 to February 2019 in Baoshan Branch of Shanghai First People's Hospital.We combined the novel tract based spatial statistics (TBSS) and region of interest (ROI) analyses for the first time to investigate three groups with diffusion tensor imaging. By TBSS, we performed pairwise comparisons of mean diffusivity and fractional anisotropy (FA) maps. The clusters with significant differences between MSA-P and PD were used as ROIs for further analyses. Results: FA values in the left anterior thalamic radiation(ATR) (ROI values were 0.371(0.287-0.535), 0.472(0.390-0.594), 0.473(0.388-0.555); P values were 0.008, 0.008) and left superior longitudinal fasciculus (SLF)(ROI values were 0.397(0.291-0.469), 0.456(0.338-0.560), 0.473(0.427-0.530); P values were 0.013,<0.001) were significantly decreased in MSA-P compared with PD or controls, and significantly correlated with clinical data((r =-0.807, P =0.005),(r =-0.455, P =0.022)). Conclusion: Our findings indicate the abnormalities of left ATR and left SLF as specific biomarkers for differential diagnosis.

[Clinical observation of single-segment cervical adjacent segment disease treated with artificial cervical disc replacement].

Objective: To investigate the clinical outcomes and radiographic results of artificial cervical disc replacement (ACDR) for cervical adjacent segment disease (ASD). Methods: The clinical data of 28 patients with single-segment cervical ASD treated with ACDR in Xi 'an Honghui Hospital from December 2013 to July 2016 were retrospectively analyzed. There were 19 males and 9 females with a mean age of (46±7) years (36-63 years). Preoperative, postoperative 1 month and postoperative 24 months of clinical and radiographic outcomes were recorded and compared. The clinical outcome mainly includes Japanese orthopedic association (JOA), Neck Disability Index (NDI%), Odom score and complications. Imaging assessment mainly included range of motion (ROM) of cervical spine, surgical segment ROM, Cobb angle of surgical segment, degree of adjacent disc degeneration, heterotopic ossification, and prosthesis related image parameters. Results: In terms of clinical outcome, the average JOA score was 12.7±1.5 before surgery, 14.0±1.0 one month after surgery, 15.8±0.9 24 months after surgery, and the improvement rate of JOA was 75%±19%. The mean NDI% was 27.0%±2.8% before surgery, 20.5%±1.6% one month after surgery, and 15.3%±2.8% 24 months after surgery; the difference before and after treatment was statistically significant (F=159.101, P<0.01). Twenty patients were classified with excellent Odom score and 8 patients with good Odom score at the final follow-up. The total ROM of cervical spine, operation segment ROM, operation segment Cobb angle were all improved significantly after the operation (F=4.633, 6.063, 26.952, all P<0.05). There was a statistical difference in Miyazaki classification between adjacent discs above ACDR and below the fusion segment 24 months after surgery (µ(c)=2.12, P=0.034). The incidence of heterotopic ossification was 14.3%. The results of displacement degree of prosthesis were as follow: coronal plane (0.30±0.11) mm, sagittal plane (0.28±0.10) mm; subsidence of the prosthesis: (0.27±0.09) mm. No prosthesis loosening was observed. Conclusions: The clinical outcome of revision of cervical ASD by ACDR is satisfactory. The risk of intervertebral disc degeneration in adjacent segments is significantly lower than that of ACDF due to the presence of certain motor function postoperatively.

shRNA inhibits the expression of chicken telomerase reverse transcriptase in MDCC-MSB1 cells.

Here, we investigated the effects of blocking chicken telomerase reverse transcriptase (chTERT) in MDCC-MSB1 cells, using small-hairpin RNAs (shRNAs) to interfere with gene expression. shRNAs specific to chTERT mRNA were designed, cloned into DNA plasmid vectors, and transfected into MDCC-MSB1 cells. The transfected chTERT RNAs were expressed by the RNA polymerase machinery of the MDCC-MSB1 cells. mRNA expression in transfected MDCC-MSB1 cells was detected using real-time PCR. After transfection, telomerase activity was monitored via a modified telomeric repeat amplification protocol assay, and cell cycle analysis was performed using a flow cytometer. At 72 h after transfection, chTERT expression was considerably reduced in cells transfected with shRNA; the highest inhibition rate was 89%. Compared with the control group, telomerase activity was significantly reduced and the cells failed to progress to S phase. shRNA effectively reduced telomerase activity and prohibited the transition of MDCC-MSB1 cells from G2/M to S phase.

Combination of a novel photosensitizer DTPP with 650 nm laser results in efficient apoptosis, arresting cell cycle and cytoskeleton protein changes in lung cancer A549 cells.

Photodynamic therapy (PDT) using photosensitized reaction to produce cytotoxicity was used for cancer therapy in recent years. To study the effectiveness of PDT mediated by a novel photosensitizer (PS), DTPP 5-(4'-(2″-dicarboxymethylamino)acetamidophenyl)-10, 15, 20-triphenylporphyrin, on lung cancer A549 cell lines in vitro, DTPP was employed in different concentrations (2, 4, 6, 8, 10, 12, 15, 20, 25, and 30 µg/ml) and combined with 650 nm laser of different power densities (0.6, 1.2, 2.4, 4.8, 7.2, and 9.6 J/cm(2)) that resulted in obvious inhibition of cell proliferation and apoptosis. Results showed that cell survival rates have a dependent relationship with time and PS concentrations and no significant cytotoxicity was induced by DTPP itself. Apoptosis and cell cycle S arrest were observed; cytoskeleton morphologic observation revealed collapse, sparkling, and shrunken shapes. Apoptosis-related protein caspase-3 overexpression was detected while caspase-9, bcl-2, and cytoskeleton protein beta-catenin were in low levels of expression than the control. Cleavage of beta-catenin by caspase-3 or other proteases from the lysosome might be the main reason for the cytoskeleton collapse as beta-tubulin and actin were at a stable level 12 h after PDT. This paper gives a better understanding of the effectiveness of DTPP-mediated PDT in lung cancer A549 cells both with regard to dosimetry and apoptosis changes.

Analysis of DNA methylation patterns and levels in maize hybrids and their parents.

Heterosis is the superior performance of heterozygous individuals and has been widely exploited in plant breeding, although the underlying regulatory mechanisms still remain largely elusive. To understand the molecular basis of heterosis in maize, in this study, roots and leaves at the seedling stage and embryos and endosperm tissues 15 days after fertilization of 2 elite hybrids and their parental lines were used to estimate the levels and patterns of cytosine methylation by the methylation-sensitive amplification polymorphism method. The relative total methylation levels were lower in all the tissues of all hybrids than their corresponding mid-parent values, and the number of demethylation events was higher in the hybrids. These results implied that the decreasing trend and demethylation in hybrids relative to their parents may enable the derepression and possibly expression of many genes that were associated with the phenotypic variation in hybrids. To further analyze the observed methylation pattern changes, a total of 63 differentially displayed DNA fragments were successfully sequenced. Basic Local Alignment Search Tool analysis showed that 11 fragments shared similarity with known functional proteins in maize or other plant species, including metabolism, transposon/retrotransposon, development, stress response, and signal transduction, which indicated that these genes might play a significant role in maize hybrid vigor.

Left circumflex coronary-to-pulmonary artery fistula as the exclusive collateral to the occluded left anterior descending artery.

A 64 year-old male presented with a five month history of effort angina. Non-invasive studies demonstrated preserved left ventricular function and a modest stress-induced myocardial perfusion defect at the anterior wall. Coronary angiography revealed occlusion of the proximal left anterior descending coronary artery with its distal segment well supplied by collaterals branching from a left circumflex-to-main pulmonary artery fistula. The occluded left anterior descending coronary artery was recanalised by percutaneous interventions, the collaterals vanished immediately, and the patient lived free of symptoms for the following five months.

Electrostatic tuning of the proximity-induced exchange field in EuS/Al bilayers.

We demonstrate that the proximity-induced exchange field H(ex) in ferromagnetic-paramagnetic bilayers can be modulated with an electric field. An electrostatic gate arrangement is used to tune the magnitude of H(ex) in the Al component of EuS/Al bilayers. In samples with H(ex)~2 T, we were able to produce modulations of ±10 mT with the application of perpendicular electric fields of the order of ±10(6) V/cm. We discuss several possible mechanisms accounting for the electric field's influence on the interfacial coupling between the Al layer and the ferromagnetic insulator EuS, along with the prospects of producing a superconducting field-effect transistor.

Measurement of coherent polarons in the strongly coupled antiferromagnetically ordered iron-chalcogenide Fe1.02Te using angle-resolved photoemission spectroscopy.

The nature of metallicity and the level of electronic correlations in the antiferromagnetically ordered parent compounds are two important open issues for the iron-based superconductivity. We perform a temperature-dependent angle-resolved photoemission spectroscopy study of Fe(1.02)Te, the parent compound for iron chalcogenide superconductors. Deep in the antiferromagnetic state, the spectra exhibit a "peak-dip-hump" line shape associated with two clearly separate branches of dispersion, characteristics of polarons seen in manganites and lightly doped cuprates. As temperature increases towards the Néel temperature (T(N)), we observe a decreasing renormalization of the peak dispersion and a counterintuitive sharpening of the hump linewidth, suggestive of an intimate connection between the weakening electron-phonon (e-ph) coupling and antiferromagnetism. Our finding points to the highly correlated nature of the Fe(1.02)Te ground state featured by strong interactions among the charge, spin, and lattice and a good metallicity plausibly contributed by the coherent polaron motion.

Sam68 expression and cytoplasmic localization is correlated with lymph node metastasis as well as prognosis in patients with early-stage cervical cancer.

BACKGROUND: This study was aimed at investigating the role and molecular mechanism of Sam68 in cervical cancer lymph node metastasis. MATERIALS AND METHODS: Sam68 expression profile was detected by quantitative polymerase chain reaction, western blotting and immunohistochemical staining. Short hairpin RNA interfering approach was employed to suppress endogenous Sam68 expression in cervical cancer cells to determine its role in metastasis and the possible mechanism. RESULTS: Sam68 expression in cervical cancer was significantly up-regulated at both messenger RNA and protein levels compared with that in normal cervical tissues. The high expression level of Sam68 and its cytoplasmic localization were significantly associated with risk factors including pelvic lymph node metastasis (P < 0.001), and served as independent prognostic factors for predicting shortening of the overall survival time and disease-free survival time in patients with early-stage cervical cancer. Moreover, down-regulation of Sam68 in cervical cancer cells remarkably inhibited cellular motility and invasion. In addition, down-regulation of Sam68 reversed epithelial-mesenchymal transition through inhibiting the Akt/ GSK-3ß/Snail pathway. CONCLUSION: This study demonstrated that Sam68 could induce cervical cancer lymph node metastasis through regulating epithelial-mesenchymal transition, and Sam68 expression profile possessed the potential to serve as predictors of pelvic lymph node metastasis in cervical cancer patients.

Exchange field-mediated magnetoresistance in the correlated insulator phase of Be films.

We present a study of the proximity effect between a ferromagnet and a paramagnetic metal of varying disorder. Thin beryllium films are deposited onto a 5 nm thick layer of the ferromagnetic insulator EuS. This bilayer arrangement induces an exchange field, H(ex), of a few tesla in low-resistance Be films with sheet resistance R≪R(Q), where R(Q)=h/e2 is the quantum resistance. We show that H(ex) survives in very high-resistance films and, in fact, appears to be relatively insensitive to the Be disorder. We exploit this fact to produce a giant low-field magnetoresistance in the correlated-insulator phase of Be films with R≫R(Q).

Friedel-like oscillations from interstitial iron in superconducting Fe(1+y)Te0.62Se0.38.

Using polarized and unpolarized neutron scattering, we show that interstitial Fe in superconducting Fe(1+y)Te(1-x)Se(x) induces a magnetic Friedel-like oscillation that diffracts at Q⊥=(1/2 0) and involves >50 neighboring Fe sites. The interstitial >2µ(B) moment is surrounded by compensating ferromagnetic four-spin clusters that may seed double stripe ordering in Fe(1+y)Te. A semimetallic five-band model with (1/2 1/2) Fermi surface nesting and fourfold symmetric superexchange between interstitial Fe and two in-plane nearest neighbors largely accounts for the observed diffraction.

Expression of androgen receptor in breast cancer and its significance as a prognostic factor.

BACKGROUND: Breast cancer is an extraordinarily hormone-dependent tumor. This study was to evaluate androgen receptor (AR) status and its significance in breast cancer in Chinese women. METHODS: Three hundred and thirty-five consecutive cases of invasive ductal breast carcinoma, 34 ductal carcinoma in situ (DCIS), and 82 DCIS adjacent to invasive tissues were involved in this study. The expression of AR was analyzed by immunohistochemistry and compared with patient outcome, and its implications were evaluated in five molecular subgroups of invasive ductal carcinoma (IDC) and in DCIS lesions. RESULTS: AR expression was related to that of estrogen receptor (P < 0.001) and progesterone receptor (P = 0.035) but not correlated with the other conventional parameters. AR retained independent prognostic significance (hazard ratio 0.309, 95% confidence interval, 0.192-0.496; P < 0.001). The majority (61.0%) of basal-like breast cancers showed loss of AR expression (P < 0.001), which had poor prognosis. The percentage of AR-positive cases was significantly higher in DCIS adjacent to IDC group than in pure DCIS and IDC groups (93.9%, 79.4%, and 72.5%; P = 0.046 and P < 0.001, respectively). CONCLUSIONS: Our data suggest that AR may provide another specific definition of breast cancer subtypes and reveal a potential role in DCIS progression. These findings may help develop new therapies.

From (pi,0) magnetic order to superconductivity with (pi,pi) magnetic resonance in Fe(1.02)Te(1-x)Se(x).

The iron chalcogenide Fe(1+y)(Te(1-x)Se(x)) is structurally the simplest of the Fe-based superconductors. Although the Fermi surface is similar to iron pnictides, the parent compound Fe(1+y)Te exhibits antiferromagnetic order with an in-plane magnetic wave vector (pi,0) (ref. 6). This contrasts the pnictide parent compounds where the magnetic order has an in-plane magnetic wave vector (pi,pi) that connects hole and electron parts of the Fermi surface. Despite these differences, both the pnictide and chalcogenide Fe superconductors exhibit a superconducting spin resonance around (pi,pi) (refs 9, 10, 11). A central question in this burgeoning field is therefore how (pi,pi) superconductivity can emerge from a (pi,0) magnetic instability. Here, we report that the magnetic soft mode evolving from the (pi,0)-type magnetic long-range order is associated with weak charge carrier localization. Bulk superconductivity occurs as magnetic correlations at (pi,0) are suppressed and the mode at (pi, pi) becomes dominant for x>0.29. Our results suggest a common magnetic origin for superconductivity in iron chalcogenide and pnictide superconductors.

Propofol ameliorates doxorubicin-induced oxidative stress and cellular apoptosis in rat cardiomyocytes.

BACKGROUND: Propofol is an anesthetic with pluripotent cytoprotective properties against various extrinsic insults. This study was designed to examine whether this agent could also ameliorate the infamous toxicity of doxorubicin, a widely-used chemotherapeutic agent against a variety of cancer diseases, on myocardial cells. METHODS: Cultured neonatal rat cardiomyocytes were administrated with vehicle, doxorubicin (1µM), propofol (1µM), or propofol plus doxorubicin (given 1h post propofol). After 24h, cells were harvested and specific analyses regarding oxidative/nitrative stress and cellular apoptosis were conducted. RESULTS: Trypan blue exclusion and MTT assays disclosed that viability of cardiomyocytes was significantly reduced by doxorubicin. Contents of reactive oxygen and nitrogen species were increased and antioxidant enzymes SOD1, SOD2, and GPx were decreased in these doxorubicin-treated cells. Mitochondrial dehydrogenase activity and membrane potential were also depressed, along with activation of key effectors downstream of mitochondrion-dependent apoptotic signaling. Besides, abundance of p53 was elevated and cleavage of PKC-δ was induced in these myocardial cells. In contrast, all of the above oxidative, nitrative and pro-apoptotic events could be suppressed by propofol pretreatment. CONCLUSIONS: Propofol could extensively counteract oxidative/nitrative and multiple apoptotic effects of doxorubicin in the heart; hence, this anesthetic may serve as an adjuvant agent to assuage the untoward cardiac effects of doxorubicin in clinical application.

Overexpression of E2F-1 in glioma triggers apoptosis and suppresses tumor growth in vitro and in vivo.

The transfer of apoptosis genes to tumors is one of the most promising strategies for cancer gene therapy. We have shown that massive apoptosis occurs when wild-type p53 expression is induced in glioma cells carrying a p53 gene mutation. However, adenovirus-mediated p53 gene transfer is ineffective in causing apoptosis in glioma cells that retain a wild-type p53 genotype. We evaluated the effect of E2F-1 overexpression on the growth of gliomas in vitro and in vivo. In the in vitro study, the adenovirus-mediated transfer of exogenous E2F-1 protein precipitated generalized apoptosis in gliomas. The treatment with Ad5CMV-E2F-1 of nude mice carrying subcutaneous gliomas arrested tumor growth. Our results indicate that E2F-1 has anti-glioma activity in vitro and in vivo.

Accuracy of CT-guided biopsies in 158 patients with thoracic spinal lesions.

BACKGROUND: Inconsistent accuracies of CT-guided thoracic spinal biopsies have been reported in previous studies. PURPOSE: To determine the accuracy of CT-guided thoracic spinal biopsy, to compare the results with those previously reported, and to determine if there are any factors that influence the accuracy of CT-guided thoracic spinal biopsy. MATERIAL AND METHODS: In total, 158 consecutive CT-guided percutaneous thoracic spine procedures (performed at the Department of Spinal Surgery, Xi'an Red Cross Hospital between April 2000 and July 2010) were reviewed. The 158 lesions were categorized by location and radiographic features. Pathological and clinical follow-up were used to determine accuracy. RESULTS: The diagnostic accuracy of CT-guided thoracic spinal biopsy was 90.5% overall. Biopsy of metastatic bone disease (98.2%) was significantly more accurate than biopsies of primary tumors (80.9%) and of hematological malignancies (47.0%) (P < 0.05 and P < 0.005, respectively). The diagnostic accuracy of CT-guided thoracic spinal biopsy was significantly higher for the lower thoracic spine (97.6%) than for the middle (90.0%) or upper thoracic spine (80.4%) (P < 0.05 and P < 0.025, respectively). The diagnostic accuracy was significantly higher for lytic lesions (96.4%) than for sclerotic lesions (81.3%) (P < 0.010). The accuracy of biopsies performed using the transpedicular approach (91.0%) was not significantly different from that of biopsies performed using posterolateral approaches (91.5%) (0.25 < P < 0.5). CONCLUSION: Percutaneous CT-guided thoracic spinal biopsy is a viable alternative to open surgical biopsy. The diagnostic accuracy was not affected by any of the variables except for lesion level, histology, and radiographic features.

Heparin- and basic fibroblast growth factor-incorporated degradable stent: comparison with traditional transmyocardial revascularization.

AIM: We have recently developed a novel method transmyocardial drilling revascularization (TMDR) combined with heparinized bFGF-incorporating degradable tubular stent implantation to revascularize ischemic myocardium. The aim of the present study was to compare the effect of this new method on left ventricular (LV) remodeling and global function to traditional transmyocardial revascularization (TMR) in acute myocardial ischemia. METHODS: Eighteen miniswine underwent ligation of the left anterior descending (LAD) at the mid-third and were divided into three groups (N.=6 in each group): no treatment (control), TMDR (T), and TMDR+stent implantation (TS) groups. Two channels with 3.5 mm in diameter were established (T and TS groups), followed by implantation of two stents (TS group). LV function, myocardial perfusion, expression of von Willebrand factor (vWF), transforming growth factor-ß3 (TGF-ß3), vascular endothelial growth factor (VEGF), interleukin-1beta (IL-1ß), vascular density, and histologic and morphologic analyses were evaluated at different time-points. RESULTS: Six weeks post-treatment, there were no differences between T and control groups. TS group showed significant improvement compared to T group as to: expressions of TGF-ß3, VEGF, vWF and IL-1ß (P<0.001), neovascular density (2.561±391 vs. 6.201±443 pixels/hpf, P<0.001), myocardial viability (18.913±2775 vs. 94.800±14.076 pixels/hpf, P<0.001), and dp/dtmax (1.735±161 vs. 2.242±223 mmHg/s, P<0.001), Further, there were significant decreases in changes of Mass Defect Percent (2.05±0.22% vs. -1.79±0.45%, P<0.001) and LV end diastolic volume (164.83±10.74 vs. 147.00±7.32 mL, P=0.048) in the TS group. CONCLUSION: TMDR and stent implantation is more effective in enhancement of myocardial viability, improvement of global LV function, and attenuation of LV remodeling than TMDR.