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1.
Article in Chinese | WPRIM | ID: wpr-928282

ABSTRACT

OBJECTIVE@#To investigate the correlation between the changes of cervical curvature and atlantoaxial instability.@*METHODS@#The correlation between the changes of cervical curvature and atlantoaxial instability was retrospectively studied in 50 outpatients with abnormal cervical curvature (abnormal cervical curvature group) from January 2018 to December 2019. There were 24 males and 26 females in abnormal cervical curvature group, aged from 18 to 42 years old with an average of(30.62±5.83) years. And 53 patients with normal cervical curvature (normal cervical curvature group) during the same period were matched, including 23 males and 30 females, aged from 21 to 44 years with an average of(31.98±6.11) years. Cervical spine X-ray films of 103 patients were taken in lateral position and open mouth position. Cervical curvature and variance of bilateral lateral atlanto-dental space(VBLADS) were measured and recorded, Pearson correlation coefficient analysis was used to study the correlation between the changes of cervical curvature and atlantoaxial instability.@*RESULTS@#Atlantoaxial joint instability accounted for 39.6%(21/53) in normal cervical curvature group and 84.0%(42/50) in abnormal cervical curvature group. There was significant difference between two groups(P<0.01). VBLADS in abnormal cervical curvature group was (1.79±1.01) mm, which was significantly higher than that in normal cervical curvature group(0.55±0.75) mm(P<0.01). Pearson correlation coefficient analysis showed that the size of cervical curvature was negatively correlated with VBLADS.@*CONCLUSION@#Cervical curvature straightening and inverse arch are the cause of atlantoaxial instability, the smaller the cervical curvature, the more serious the atlantoaxial instability.


Subject(s)
Adolescent , Adult , Atlanto-Axial Joint/diagnostic imaging , Cervical Vertebrae/diagnostic imaging , Female , Humans , Joint Instability/diagnostic imaging , Kyphosis , Male , Radiography , Retrospective Studies , Young Adult
2.
Article in Chinese | WPRIM | ID: wpr-927900

ABSTRACT

Objective: To investigate the mechanism that hypoxia promotes the migration of lung adenocarcinoma A549 cells. Methods: A549 cells were cultured and cells that knockdown of acetyl-CoA carboxylase 1 (ACC1) were obtained by transfection with lentivirus, and cells that knockdown of sterol regulatory element-binding proteins-1 (SREBP-1) were obtained by treated with si-RNA. A549 cells were treated with hypoxia combined with hypoxia inducible factor-1α (HIF-1α) inhibitor PX-478 (25 μmol); Hypoxia combined with linoleic acid (LA) (20 μmol) treated A549 cells with ACC1 knockdown, and A549 cells with SREBP-1 knockdown were treated by hypoxia. Transwell migration assay was used to detect cell migration. Western blot was conducted to detect HIF-1α, ACC1 and epithelial mesenchymal transition (EMT) related proteins, Vimentin, E-Cadherin and SREBP-1; Real-time fluorescent quantitative polymerase chain reaction (RT-qPCR) was performed to detect the changes of ACC1 and SREBP-1 mRNA in A549 cells after hypoxia and HIF-1α inhibitor PX-478 (25 μmol) treatment. Each experiment was repeated three times. Results: Compared with the normoxic control group, hypoxia promoted the migration of A549 cells (P<0.01), and up-regulated the expressions of ACC1, HIF-1α (all P<0.01) and SREBP-1 (P<0.05). PX-478 (25 μmol) inhibited the migration of A549 cells induced by hypoxia and down-regulated the expression of SREBP-1 (all P<0.05). ACC1 mRNA and SREBP-1 mRNA levels were increased after hypoxia treatment of A549 cells (all P<0.05). The levels of ACC1 mRNA and SREBP-1 mRNA were decreased after A549 cells treated with hypoxia combined with PX-478 (25 μmol) for 24 h (P<0.05, P<0.01). Knockdown of SREBP-1 in A549 cells was obtained by transfection with si-RNA. Transwell migration assay showed the number of cell migration in si-SREBP-1 group was less than that in normoxia control group (P<0.01). The si-SREBP-1 group and the si-NC group were treated with hypoxia. Compared with the control group, the number of cell migration in the si-SREBP-1 group was decreased (P<0.01), however, the difference was not statistically significant compared with the normoxia si-SREBP-1 group (P>0.05). Western blot showed that the expression of ACC1 in the si-SREBP-1 group was lower than that in the control group (P<0.01). Compared with the control group, the expression of ACC1 was decreased after si-SREBP-1 group treated with hypoxia (P<0.01). Knockdown of ACC1 inhibited the migration of A549 cells (P<0.05). After knockdown of ACC1, the migration number of A549 cells under normoxia and 5% O2 conditions had no significant difference (P>0.05). Application of LA under hypoxia condition rescued ACC1-knockdown induced inhibitory effect on hypoxia-promoted A549 cell migration (P<0.05). Conclusion: Hypoxia promotes migration of lung adenocarcinoma A549 cells by regulating fatty acid metabolism through HIF-1α/SREBP-1/ACC1 pathway.


Subject(s)
A549 Cells , Acetyl-CoA Carboxylase , Adenocarcinoma of Lung , Cell Hypoxia/physiology , Cell Line, Tumor , Humans , Hypoxia , Hypoxia-Inducible Factor 1, alpha Subunit , Lung Neoplasms , RNA/metabolism , RNA, Messenger/metabolism , Sterol Regulatory Element Binding Protein 1/metabolism
3.
Article in Chinese | WPRIM | ID: wpr-927891

ABSTRACT

Objective: To uncover the time-dependent expression pattern of ptk2b gene and ptk2b-encoded protein, protein tyrosine kinase 2 beta(PTK2B), in the brain tissues of transgenic animal models of Alzheimer's disease (AD) and its relationship with the levels of Aβ1-42, phosphorylation of Tau (p-Tau) and low density lipoprotein receptor-related protein-1(LRP-1) in blood and brain tissues. Methods: In this study, 5-, 10- and 15-month-old APPswe/PS1dE9 double-transgenic mice harboring the genotype of AD confirmed by the gene test were divided into the 5-, 10- and 15-month-old experiment groups, and simultaneously, age-matched C57BL/6J mice were placed into the corresponding control groups, with 8 mice in each group. All mice were subjected to the Morris Water Maze for test of cognitive and behavioral ability. Expression profiles of PTK2B, Aβ1-42, p-Tau/Tau and LRP-1 in the hippocampus or blood of mice were quantified by using the immunohistochemistry staining, Western blot or enzyme-linked immunosorbent assay (ELISA), while the mRNA expression of ptk2b in the hippocampus was quantified by using the real-time quantitative polymerase chain reaction (qRT-PCR). Results: Results of experiment groups demonstrated that as mice aged, the expression levels of PTK2B, ptk2b mRNA, Aβ1-42 and p-Tau/Tau in the hippocampus were increased, and the expression of LRP-1 was decreased gradually. While in the blood, the level of Aβ1-42 was decreased, and the cognitive and behavioral ability was decreased in an age-dependent manner (all P< 0.05). However, comparisons among the control groups, only the age-dependent downregulation of LRP-1 were observed in hippocampus(P<0.05), but other indicators had no significant differences (P>0.05). Conclusion: In the hippocampus of APP/PS1 double-transgenic mice, the expressions of PTK2B, Aβ1-42 and p-Tau/Tau are upregulated, LRP-1 is downregulated, while cognitive and behavioral ability is decreased, and such changes are presented in a time-dependent manner.


Subject(s)
Alzheimer Disease/metabolism , Amyloid beta-Peptides , Amyloid beta-Protein Precursor/genetics , Animals , Focal Adhesion Kinase 2/metabolism , Hippocampus/metabolism , Low Density Lipoprotein Receptor-Related Protein-1 , Maze Learning , Mice , Mice, Inbred C57BL , Mice, Transgenic , RNA, Messenger
4.
Chinese Journal of Geriatrics ; (12): 707-711, 2021.
Article in Chinese | WPRIM | ID: wpr-910902

ABSTRACT

Objective:To investigate the effects of different mechanical ventilation methods on respiratory function in elderly patients in the steep Trendelenburg position undergoing general anesthesia.Methods:This was a randomized controlled study.Sixty patients scheduled for elective laparoscopic radical prostatectomy in the steep Trendelenburg position under general anesthesia were randomly divided into the lung protective ventilation strategy group(the P group)and the traditional ventilation strategy group(the T group)(n=30, each group). The setting for the P group included FiO 2 at 50%, tidal volume at 6 ml/kg, respiratory rate at 14-16/min, positive end expiratory pressure(PEEP)at 5 cmH 2O, with sustained lung inflation by pressure control every 30 min and the pressure at 30 cmH 2O for 30 s. The setting for the T group included FiO 2 at 50%, tidal volume at 10 ml/kg, and respiratory rate at 10-12/min.Anesthesia was maintained by sevoflurane, remifentanil and cis-atracurium.Driving pressure(DP), mean airway pressure(P mean)and end-tidal carbon dioxide(EtCO 2)were recorded at T1(5 mins after intubation), T2(after pneumoperitoneum), T3(30 mins after pneumoperitoneum), T4(1h after pneumoperitoneum), T5(2h after pneumoperitoneum), T6(3h after pneumoperitoneum)and T7(end of surgery). Arterial blood partial pressure of carbon dioxide(PaCO 2), alveolar-arterial oxygen partial pressure difference[P(A-a)O 2]and oxygenation index(OI)were recorded at T0(entering the operating room), T1, T3, T4, T5, T6, T8(after extubation)and T9(24h after operation). Arterial-end-tidal carbon dioxide partial pressure difference[P(a-et)CO 2]was recorded at T3, T4, T5 and T6. Results:DP in the P group was lower than in the T group at each time point( P<0.01). The P mean in the P group at each time point was higher than in the T group( P<0.01). EtCO 2 was higher in the P group than in the T group at T1( t=0.751, P<0.01)and T2( t=2.830, P<0.01). PaCO 2 was higher in the P group than in the T group at T1( t=1.435, P<0.01), T3( t=2.469, P<0.01)and T4( t=1.359, P<0.05). There were no statistic differences in P(A-a)O 2, OI and P(a-et)CO 2 between the two groups at any time point( P>0.05). Conclusions:Compared with the traditional ventilation strategy, the lung protective ventilation strategy has lower DP and higher P mean during laparoscopic radical prostatectomy, while it has no advantage in lung oxygenation.The lung protection ventilation strategy can be safely used in laparoscopic radical prostatectomy in the steep Trendelenburg position under general anesthesia.

5.
Article in Chinese | WPRIM | ID: wpr-910835

ABSTRACT

Objective:To investigate the cognition of the diagnosis and management of bronchiectasis among respiratory specialists.Methods:Between May and June 2020, a questionnaire survey based on expert consensus and guidelines was conducted among respiratory specialists from 50 hospitals from Sichuan and Yunnan provinces. Total 691 questionnaires were distributed and 641 were received. 601 valid questionnaires were chosen for further analysis with an effective recovery rate of 87.0%. The respondents were required to finish the e-questionnaires independently in terms of cognition of diagnosing, severity assessment, treatments and Chinese medicines of bronchiectasis. The responses were collected online and the cognitive levels were evaluated by calculating the correct rates of corresponding questions.Results:540 (89.9%) of the respondents agreed that high-resolution computed tomography (HRCT) was the gold standard for diagnosing of bronchiectasis, but 318 (52.9%) had an incomplete understanding of common radiographic manifestations of bronchiectasis, and different cognitive degrees of common radiographic manifestations of bronchiectasis existed among respondents with different qualifications or working in different levels of hospitals ( P<0.05). Only 118 (19.6%) of the respondents were familiar with severity assessments of bronchiectasis, but 65 (55.1%) of the 118 respondents said they won′t apply these severity assessments to patient during their clinical works. For the treatment of patients with stable bronchiectasis, airway clearance techniques were most recommended by specialists surveyed [410 (68.2%)], among which, postural drainage was the most known method [559 (93.0%)]. For patients undergoing an acute exacerbation, most respondents recommended antibiotics [600 (99.8%)] as the primary treatment, and examinations such as sputum culture [544 (90.5%)], inflammatory markers [523 (87.0%)] should be performed as well. 504 (83.9%) thought that pseudomonas aeruginosa was the most common conditioned pathogen for bronchiectasis. For patients with frequent exacerbations (≥3 per year), 385 (64.1%) of the respondents supported the therapeutic effect of long-term antibiotics, however, among the 385 respondents supporting long-term antibiotics, only [113 (29.4%)] were willing to recommend long-term antibiotic treatment actively during their clinical practice. Besides, 304 (50.6%) respondents held a positive attitude to the clinical effect of traditional Chinese medicine therapies. Among 304 respondents holds the point of supporting, only 86 (28.3%) were willing to recommend traditional Chinese medicine to patients actively, differences about the attitude and clinical behaviors were found between respondents working in different levels of hospitals ( P<0.05). Conclusions:Respiratory specialists′ cognition on diagnosis and treatments of bronchiectasis remains inadequate, and cognitive levels differ among respondents working in different levels of hospitals. There is a gap between respondents′ cognition and clinical practice. Further education and trainings are necessary for improving respiratory specialists′ knowledge for timely diagnosis and standard treatment of bronchiectasis.

6.
Chinese Journal of Orthopaedics ; (12): 1785-1794, 2021.
Article in Chinese | WPRIM | ID: wpr-910773

ABSTRACT

Objectives:To investigate the feasibility of second sacral alar-iliac (S 2AI) screw placement and trajectories index in patients with neuromuscular scoliosis with severe pelvic obliquity; and to explore the accuracy of S 2AI screw placement by O-arm three-dimensional (3D) CT navigation (Medtronic, Minneapolis, MN, USA). Methods:All of 28 patients with neuromuscular scoliosis who underwent posterior long fusion with S 2AI between January 2017 and August 2020 were reviewed, with an average age of 22.2 years old (ranged from 10 to 51 years), and the pelvic obliquity angle was 27.54±9.90° (ranged from 16.2° to 53.6°). Based on 3D CT reconstruction of these specimens, virtual S 2AI screw channels were identified and measured. Entry point was determined by 1 mm inferior and 1 mm lateral to the S 1 dorsal foramen, and virtual S 2AI screw trajectories with maximum length and width were explored by rotating 3D pelvis. The parameters of the determined channels were measured including caudal angulation on the sagittal plane (sagittal angle, SA), lateral angulation on the transverse plane (transverse angle, TA) and the maximal length of the channel (maximal length, ML). The accuracy of screw placement was evaluated by postoperative pelvic CT scan. Results:All of the virtual S 2AI screw trajectories can be reconstructed. The screw trajectory parameters were shown as follows: SA was 30.20°±21.94° and 50.94°±16.02° on the high and low sides of pelvis, respectively, and the difference was statistically significant ( t=3.990 , P<0.001). SA was 30.14°±21.93° on the anterior side of the pelvis and 51.00°±15.96° on the posterior side, respectively, with statistical significance ( t=4.027, P<0.001). TA was 43.67°±12.86° on the high side of pelvic tilt and 31.95°±13.80° on the low side, with statistical significance ( t=2.834, P=0.009). TA was 42.56°±12.52° on the anterior side of the pelvis and 33.05°±14.94° on the posterior side, respectively, and the differences were statistically significant ( t=2.192, P=0.037). ML was 97.12±12.44 mm and 92.28±11.04 mm on the high and low side of pelvis, and there was no significant difference ( t=0.963 , P=0.060). ML was 97.72±12.41 mm on the anterior sides of the pelvis and 91.68±10.57 mm on the posterior side, and the difference was statistically significant ( t=2.556 , P=0.017). SA tended to be smaller on the high side of pelvic tilt ( r=0.474, P<0.01) and TA tended to be higher on the anterior side of pelvis ( r=-0.419, P<0.01) . Only 2 screws (3.6%) showed screw breaches after surgery, with no clinically notable neurovascular or visceral complications. Conclusion:In patients of neuromuscular scoliosis with severe pelvic obliquity, the virtual S 2AI screw trajectory can be found in 3D CT reconstruction of the pelvis. But the parameters are very discrete at SA and TA. In these patients, the O-arm 3D CT navigation can be used to make sure the direction and length of the S 2AI screw, greatly improving the accuracy of screw placement and effectively descending the ratio of poor screw.

7.
Chinese Journal of Orthopaedics ; (12): 1673-1682, 2021.
Article in Chinese | WPRIM | ID: wpr-910760

ABSTRACT

Objective:To evaluate the safety and efficacy of one-stage posterior-only jumping hemivertebra (HV) resection combined with respective short fusions in the treatment of congenital scoliosis (CS) caused by multiple HVs.Methods:All of 13 consecutive patients with multiple HVs treated surgically from January 2010 to December 2017 were retrospectively reviewed, including 4 males and 9 females with a mean age of 3.7±1.2 years. One child had 4 HVs, and the rest had 2 HVs. The responsible HVs causing local scoliosis/kyphosis deformity or coronal plane deviation were selected as the target of resection. The distal HV was removed firstly and then the proximal one was resected; both of the fixation vertebraes were horizontalized during surgery. The clinical and imaging data of the children before the initial operation, immediately after the operation and at the latest follow-up were collected, and the short-term and long-term complications related to surgery were recorded. The data were evaluated on the whole-standing spine anteroposterior and lateral films, including the corrections of proximal and distal main curves, coronal balance, local kyphosis, and the improvement of spinal growth height (upper and lower internal fixation length, T 1-S 1 length). At the same time, the re-progression of coronal and sagittal deformities of the spine during growth was recorded (coronal decompensation: emerging postoperative curve progression more than 20°; kyphosis progression: kyphosis aggravation between upper and lower internal fixation more than 40°) and internal-fixation-related complications (screw cutting, screw malposition) were recorded. Results:Dual HVs were resected in each child, of which 8 (61.5%) were located on contralateral side of the spine, and 5 (38.5%) were located on ipsilateral side of the spine. The follow-up time was 6.2±3.3 years (range 2.0-10.5 years) after surgery. The Cobb angles of proximal and distal main curves were 36.7°±11.8° and 35.2°±7.8° respectively before surgery and were corrected to 9.7°±6.6° and 6.1°±4.1° respectively after surgery ( F=31.249, F=93.83, P< 0.001) ( t=6.888, t=10.954, P<0.001), and the correction rates was 73.6%±19.6% and 82.7%±11.7%, respectively. They were maintained at 14.3°±5.4° and 8.0°±4.6° at the latest follow-up, showing the correction rates loss of 15.8%±26.9% and 6.9%±7%, respectively. The coronal balance improved from 17.2±14.8 mm pre-operatively to -0.2±15.7 mm postoperatively ( t=2.703, P=0.008), and it remained at 0±18.4 mm at the final follow-up ( F=4.137, P=0.024). The T 1-S 1 length was corrected to 273.8±27.3 mm postoperatively, slightly increased compared with pre-operation 256.3±24.0 mm, ( t=0.680, P=0.527), and significantly increased to 333.2±33.4 mm at the latest follow-up ( t=2.986, P<0.001; F=6.704, P=0.003). Seven patients had local kyphosis before operation, which was significantly improved from 32.2°±13.6° to 6.1°±9.8° with a correction rate of 93.4%±27.0% after surgery ( t=3.355, P=0.004), which showed no significant loss of correction at the latest follow-up (5.4°±10.4°) ( F=11.187, P=0.002). Six patients (46.2%) developed coronal decompensation (Curve magnitude >20 °), with an average of 21.7°±1.9°. Two cases (15.4%) had progressive kyphosis between the thoracic regional internal fixations at 3 months after surgery, which were 68° and 58° respectively. After bracing, both coronal decompensation and sagittal kyphosis were improved. At the last follow-up, the coronal decompensation was improved to 14.7±8.9° and the kyphosis was alleviated to 55° and 46°, respectively. Conclusion:Posterior-only skipping hemivertebra resection and short fusion is a safe, effective procedure yielding significantly improvement of the growth imbalance and reginal spinal deformities of CS with multiple HVs. The mid-term follow-up results showed that the progress of the scoliosis was common during the growth period, which could be further controlled by supplementary brace treatment.

8.
Chinese Journal of Orthopaedics ; (12): 1598-1606, 2021.
Article in Chinese | WPRIM | ID: wpr-910753

ABSTRACT

Objective:To explore the efficacy and correction mechanism of posterior column osteotomy for treatment of "Lenke 5-like" lumbar congenital scoliosis.Methods:From April 2008 to September 2019, 16 patients with lumbar congenital scoliosis underwent posterior column osteotomy were retrospectively reviewed including 6 males and 10 females, aged 23.9±11.7 years (range, 14-48 years). Among them, 8 cases were unsegmentation, 5 malformation and 3 mixed type. The average segments of PCO were 5.3. Posterior column osteotomy was adapted after the insertion of pedicle screws, then removed spinous process, ligaments, superior and inferior facet and corrected the deformity with the rods. The pre- and post-operative and last follow-up radiographic parameters were measured: Cobb angle of lumbar curve, distance between C 7 plumbline and center sacral vertical line (C7PL-CSVL), deformity angle (DA), disc correction angle (DCA) of instrumented segments, disc angle above upper instrumented vertebra (DAAU), lower instrumented vertebra disc angle (LDA), upper instrumented vertebra slope (US), lower instrumented vertebra slope (LS), lower instrumented vertebra offset (LO) and sagittal parameters such as thoracic kyphosis (TK), lumbar lordosis(LL) and thoracic junctional kyphosis (TJK). The Scoliosis Research Society-22 questionnaire (SRS-22) were conducted at preoperation and the final follow up to evaluate the clinical outcomes. Results:The mean follow-up period was 16.69±7.65 months (range, 12-36 months). The coronal DA was 26.74°±10.59° while the sagittal DA was 14.70°±11.63°. The pre- and post-operative Cobb angle were 51.19°±12.91° and 23.25°±12.86° while the correction rate was 57.17%±16.31% and reached 24.26°±13.19° in the last follow-up. The improvement of DAAU, LDA, US, LS, and LO pre- and post-operative had statistical significance ( P<0.001). The pre- and post-operative and the last follow-up C 7PL-CSVL were 27.13±17.08 mm, 21.81±12.80 mm and 20.24±15.02 mm. The pre-operative, postoperative and last follow-up DAAU were -4.35°±2.12°, 1.36°±2.34° and 1.60°±2.45°. The pre- and post-operative LDA were -7.03°±4.40° and 2.42°±3.39°, and the last follow-up LDA was 2.81°±2.98°. US and LS decreased from pre-operative 12.01°±8.33° and 21.46°±5.79° to 2.84°±7.52° and 11.64°±6.06°. The mean US and LS were 4.22°±6.56° and 11.56°±6.02° in the last follow-up. LO decreased after surgery and keep unchanged in the last follow-up, which were 12.71°±6.43°, 6.31°±5.17° and 7.01°±4.73°, respectively. For the sagittal plane parameters, the changes of TK, LL, and TJK reached statistical significance through the surgery. LL increased from 33.69°±14.01° to 44.28°±10.07° through the surgery and reached 41.97°±6.69° at the last follow-up while TK increased from 13.41°±12.37° to 23.52°±8.10°, TJK decreased from 29.02°±20.74° to 16.20°±12.62° after the surgery and reached 16.07°±13.33° at the last follow-up. The pre-operative, post-operative and last follow-up thoracic kyphosis were 13.41°±12.37°, 23.52°± 8.10°, and 24.21°±7.39°. There was no statistical significance of the change of C 7PL-CSVL, SVA, SSA and PI-LL through the surgery ( P>0.05). At the final follow-up, the self-image and psychologic status scores of SRS-22 were significantly higher than that before surgery ( t=15.457, P<0.001; t=14.726, P<0.001), and there was no significant difference in the rest of the domain ( P>0.05). Conclusion:"Lenke5-like" lumbar congenital scoliosis could obtain satisfactory correction of coronal and sagittal deformities with the treatment of posterior column osteotomy, while there was no significant loss of correction during follow-up. The incidence of surgical complications is low.

9.
Chinese Journal of Orthopaedics ; (12): 1536-1544, 2021.
Article in Chinese | WPRIM | ID: wpr-910745

ABSTRACT

Objective:To evaluate the clinical outcomes and complications of second sacral alar-iliac (S 2AI) technique utilized in adult patients with neuromuscular scoliosis, and to evaluate the impact on patients' quality of life. Methods:All of 11 patients (6 males and 5 females) applying S 2AI technique from January 2014 to December 2016 were retrospectively reviewed. The average age of the patients was 39.6±12.7 years. Among them, 8 cases were poliomyelitis, 2 cases were spinal muscular atrophy and 1 case was muscular dystrophy. All of 11 patients underwent posterior spinal fusion and utilized S 2AI screws for pelvic fixation. All patients were taken anteroposterior and lateral radiographs of the entire spine. Cobb's angle, spinal pelvic obliquity (SPO), regional kyphosis (RK), sagittal vertical axis (SVA) were recorded at pre-operation, post-operation and last follow-up. The Scoliosis Research Society (SRS)-22 questionnaires and Oswestry disability index (ODI) were utilized to evaluate the patient-reported outcomes. All complications were also recorded. Repeated measurement analysis of variance, t-test or non-parametric test was used to analyzed the data, respectively. Results:The average follow-up period was 62.4±10.8 months. The pre-operative Cobb angle was 98.0°±24.0°, and the post-operative Cobb angle was 60.7°±20.8°, of which difference was significant ( Z=3.015, P=0.003). The correction rate of Cobb angles was 57.2%±17.7%. 1-year after operation, the Cobb angle was 62.8°±23.6°, no loss of correction was found ( Z=0.294, P=0.797). And at last follow-up, the Cobb angle was 61.6°±21.7°, the correction maintained well ( Z=0.603, P=0.594). The pre-operative, post-operative, 1-year post-operative and last follow-up spinal pelvic obliquity were 37.0°±11.8°, 21.5°±11.6°, 23.2°±10.1° and 21.1°±8.6°. The significant improvement was obtained ( Z=2.934, P=0.003) and no loss of correction was found ( Z=0.690, P=0.519; Z=0.000, P=1.000). The pre-operative, post-operative, 1-year post-operative and last follow-up regional kyphosis were 46.8°±23.6°, 18.6°±10.6°, 18.9°±11.4° and 19.5°±9.8°. The significant improvement was obtained postoperatively ( Z=4.364, P<0.001) and remained stable at the last follow-up ( Z=0.074, P=0.945; Z=0.271, P=0.838). When compared the pre- and post-operative sagittal vertical axis, no significant difference was detected. In these patients, one patient had rod breakage and underwent revision, one patient suffered deep infection, and recovered by debridement surgery, one patient suffered from severe pain in the lower back and relieved with conservative treatment. Conclusion:The S 2AI technique utilized in patients with neuromuscular scoliosis could obtain satisfying clinical outcomes and provides safe, durable fixation with low rates of complications.

10.
Chinese Journal of Orthopaedics ; (12): 1528-1535, 2021.
Article in Chinese | WPRIM | ID: wpr-910744

ABSTRACT

Objective:To evaluate the outcomes of transforaminal lumbar interbody fusion (TLIF) for patients with lumbar spinal stenosis (LSS) and diffuse idiopathic skeletal hyperostosis (DISH).Methods:This study recruited 33 patients (15 male and 18 female) with LSS and DISH who underwent TLIF surgery from January 2010 to July 2018. The mean age was 65.1±11.2 years old and the instrumented segments averaged 1.45±0.42 levels. Another group of LSS patients without DISH were well matched to the DISH group at a 1∶1 ratio in terms of age, sex, and instrumented levels. Lumbar lordosis, local lordosis as well as lowerlumbarlordosis were measured on X-ray taken before and after surgery. According to Pfirrmann's classification, the degree of preoperative disc degeneration was evaluated on preoperative MRI, and the incidence of postoperative fusion cage subsidence was recorded during follow-up. Oswestry disability index (ODI) was used to evaluate the lumbar function and visual analogue scale(VAS) scores for low back pain and leg pain were used to evaluate the quality of life.Results:There were no significant difference between two groups in terms of age, bone mineral density, operative time, postoperative bleeding volume, fusion levels and postoperative follow-up time. Compared with the non-DISH group (3.20±0.95), the DISH group had higher degeneration disc according to Pfirrmann's classification (3.82±0.64) ( t=3.109, P=0.002), lower lumbar lordosis(37.4°±8.5° vs. 45.2°±12.2°, t=3.013, P=0.003), and lower lower lumbar lordosis (18.3°±3.9° vs. 21.9°±5.4°, t=3.104, P=0.002). After TLIF surgery, lumbar lordosis was significantly improved in both groups. During follow-up, notable correction loss was noted in DISH group in terms of lumbar lordosis (43.6°±9.7° vs. 50.1°±10.2°, t=2.652, P=0.010), lower lumbar lordosis (19.1°±4.7° vs. 22.9°±5.2°, t=2.540, P=0.013) as well as local lumbar lordosis (17.4°±6.5° vs. 22.7°±7.2°, t=3.138, P=0.002). Moreover, these above value in the DISH group were significantly lower than those in the non-DISH group. At the latest follow-up, 12 patients in the DISH group were identified with cage subsidence, which were significantly higher than in the non-DISH group (36.3% vs. 12.1%, χ2=5.280, P=0.022). Till the latest follow-up, both groups had considerable improvement of the ODI score, back pain and leg pain VAS score. However, the back pain VAS scores in the DISH group were significantly higher than that in the non-DISH group ( t=2.862, P=0.005). Conclusion:Compared with LSS patients without DISH, LSS patients with DISH are more likely to have cage subsidence and loss of correction of lumbar lordosis angle after TLIF surgery. Moreover, the VAS score of low back pain in LSS patients with DISH was lower than those without DISH.

11.
Chinese Journal of Orthopaedics ; (12): 881-891, 2021.
Article in Chinese | WPRIM | ID: wpr-910670

ABSTRACT

Objective:The purpose of the study is to investigate how to select lowest instrumented vertebra (LIV) in posterior spinal corrective surgery for Lenke 1A/2A adolescent idiopathic scoliosis (AIS) patients,and to further identify the risk factor for postoperative distal adding-on.Methods:FromJanuary 2008 to January 2014, a total of 85 Lenke 1A/2A AIS patients with one level proximal to last substantially touching vertebra (LSTV-1) selected as LIV were enrolled in the study. There were 45 Lenke 1A and 40 Lenke 2A, and 70 females and 15 males. The average age of surgery was 14.4±2.2 years (10-18 years). They were followed up over 2 years. The upright posteroanterior and lateral radiographs were performed preoperatively, immediately after surgery and at the final follow-up. Several radiographic parameters were measured such as Cobb angle, thoracic curve length, apex location, LIV rotation, deviated distance of LIV from central sacral vertical line, coronal balance and sagittal balance, etc. Distal adding-on was defined as a progressive increase in the number of vertebrae in the distal curve at the last follow-up. Patients were classified into adding-on and non adding-on group. The risk factors associated with the incidence of adding-on were analyzed. Subgroup analysis were further performed according to the curve type.Results:The mean duration of follow-up was 37.8±16.3 months (24-95 months). The average Cobb angle of main thoracic curve was 51.9°±6.8° (42°-85°). At the last follow-up, 36 patients (42.4%) had ideal outcome without distal adding-on. For Lenke 1A patients, the risk factor for adding-on included: low Risser ( t=2.730, P=0.005), long thoracic curve ( t=1.930, P=0.030) with low apex ( t=1.734, P=0.045), preoperative large rotation and deviation of the LSTV-1 ( t=2.319, P=0.013; t=3.288, P=0.001), and preoperative coronal imbalance ( t=1.729, P=0.046). For Lenke 2A patients, the risk factor for adding-on included: low Risser ( t=2.246, P=0.015), preoperative large rotation and deviation of the LSTV-1 ( t=2.534, P=0.008; t=1.972, P=0.028), and preoperative coronal imbalance ( t=1.702, P=0.048). Conclusion:When choosing LSTV-1 as LIV, skeletal immaturity, large rotation and deviation of LSTV-1 and preoperative coronal imbalance are risk factors for distal adding-on in Lenke 1A/2A curves; Also, long thoracic curve with low apex is associated with distal adding-on in Lenke 1A curves. Therefore, for skeletal immature patients with large rotation and deviation of LSTV-1, preoperative coronal imbalance and long thoracic curve with low apex,the 'LSTV’ rule should be followed to decrease the incidence of distal adding-on. While in other case, it could safely distally stop at LSTV-1.

12.
Chinese Journal of Orthopaedics ; (12): 844-855, 2021.
Article in Chinese | WPRIM | ID: wpr-910666

ABSTRACT

Objective:To establish age- and gender-based normative values of sagittal spinal-pelvic alignment in Chinese adult population, and to investigate influence of age, gender and ethnicity on sagittal spinal-pelvic alignment in Chinese normal adults.Methods:A total of 786 asymptomatic Chinese adult volunteers aged between 20 and 89 years were prospectively recruited from different spine centers. The inclusion criteria were: 1) age between 20 to 89 years old; and 2) Oswestry disability index (ODI) scored lower than 20. The exclusion criteria were: 1) previous history of spinal, pelvic or lower limb pathologies that could affect the spine; 2) presence of recent and/or regular back pain; 3) previous surgeries on spine, pelvic and/or lower limb; and 4) pregnancy. Demographic characteristics of these subjects including age, gender, body weight and height were recorded. During the enrollment of volunteers, 16 groups were defined based on the age (20 s, 30 s, 40 s, 50 s, 60 s, 70 s and 80 s) and gender. Whole body biplanar standing EOS X-ray radiographs were acquired to evaluate the sagittal alignment. Spinal-pelvic parameters including pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS), thoracic kyphosis (T 5-T 12, TK), lumbar lordosis (L 1-S 1, LL), lower lumbar lordosis (L 4-S 1, LLL), global tilt (GT), T1 pelvic angle (TPA) and sagittal vertical axis (SVA) were measured. Values of PI-LL and lordosis distribution index (LLL/LL, LDI) were calculated. Radiographic measurements of 100 subjects were randomly selected to determine the intra- and inter-observer reliabilities using inter- and intra-class correlation coefficients (ICC). The spinal-pelvic parameters were compared among volunteers between different age and gender groups. The comparison was also made among various ethnic population. Results:The mean value was 23.7±7.1 kg/m 2 for BMI and 6.9%±2.5% (range, 0-18%) for ODI score. Each sagittal spinal-pelvic parameter was presented with mean value and standard deviationbased on age and gender. The ICCs of radiographic measurements ranged from 0.89 to 0.95, suggesting good to excellent intra- and inter-observer reliabilities. Significant differences were observed between males and females in multiple sagittal parameters (all P values <0.05). Compared to the male subjects, significantly higher values of PI (41.4° for male vs. 45.0° for female, P<0.001), PT (10.7° for male vs. 13.9° for female, P<0.001), PI-LL (-0.5° for male vs. 1.8° for female, P<0.001), and GT (10.9° for male vs. 13.5° for female, P<0.001) were documented in female subjects. Males had significantly higher values of LLL (28.6° for male vs. 26.6° for female, P<0.001) and LDI (0.68 for male vs. 0.63 for female, P<0.001). PI-LL, SVA, GT and TPA increased with aging from Group 40 s to Group 80 s, while LL, LLL and LDI decreased gradually, and TK decreased slowly with aging. Comparison of sagittal spinal-pelvic parameters between different ethnic subjects showed that Chinese adult population presented lower PI, SS, TK and LL as compared with American population; lower PI, SS and LL as compared with Japanese population. But the variation trend with aging tended to be consistent among different ethnic populations. Conclusion:Age- and gender-based normative values of sagittal spinal-pelvic alignment were established in asymptomatic Chinese adult population. Sagittal spinal-pelvic alignment varies with age and gender, and presented different compensation mechanism among different ethnic populations. Therefore, to achieve balanced sagittal alignment, age, gender and ethnicity should be take intoconsideration when planning spine correction surgery.

13.
Chinese Journal of Orthopaedics ; (12): 834-843, 2021.
Article in Chinese | WPRIM | ID: wpr-910665

ABSTRACT

Objective:To investigate the clinical outcomes and complication of posterior surgery for Scheuermann kyphosis fusing to different distal fusion levels.Methods:From January 2012 to December 2017, a consecutive cohort of 34 patients who were treated with posterior spinal instrumented correction and satisfied the inclusion criteria were retrospectively reviewed, including 29 males and 5 females, aged 17.1±4.3 years (range, 12-30 years). All of the patients had a minimum follow-up of 2 years. According to the distal fusion level, patients were divided into 2 groups. Group sagittal stable vertebra (SSV) (22 cases) included patients whose lowest instrumented vertebra (LIV) was SSV; Group SSV-1 (12 cases) included patients who had a LIV one level above the SSV. Radiographic parameters including global kyphosis (GK), lumbar lordosis (LL), sagittal vertical axis (SVA), pelvic incidence (PI), pelvic tilt (PT), and sacral slope (SS) were measured in the standing radiographs before and after operation and at the latest follow up. Intraoperative and postoperative complications were recorded. The Scoliosis Research Society-22 questionnaire (SRS-22) were conducted at pre-operation and the final follow up to evaluate the clinical outcomes. The sagittal radiographic parameters and the incidence of distal junctional kyphosis (DJK) were compared between the two groups.Results:There were no significant differences in terms of age, sex, radiographic measurements and scores of SRS-22 between two groups preoperatively ( P>0.05). The correction rates of GK in the SSV group and the SSV-1 group were 42.8%±7.6% and 43.2%±8.4% ( t=0.151, P=0.881) respectively. While the correction rates loss were 1.2%±5.2% and 3.9%±7.2% ( t=0.767, P=0.449) at the latest follow up. No significant difference was observed in terms of other radiographic parameters ( P>0.05). During the postoperative follow up period, 3 patients (16.7%) in SSV group and 2 patients (13.6%) in SSV-1 group developed DJK. The incidence of DJK did not show any significant difference between two groups ( χ2=0.057, P=0.812). At the final follow-up, the function scores of SRS-22 in SSV-1 group (4.1±0.6) was significantly higher than SSV group (3.7±0.5) ( t=2.300, P=0.028) and there was no significant difference in the rest of the domain ( P>0.05). Conclusion:Compared with stopping at SSV, fusion to SSV-1 could achieve comparable curve correction with the preservation of more lumbar motility. Moreover, it would not increase the risk of DJK. As a result, we recommend selecting SSV-1 as the ideal LIV for SK patients.

14.
Chinese Journal of Orthopaedics ; (12): 815-824, 2021.
Article in Chinese | WPRIM | ID: wpr-910663

ABSTRACT

Objective:To analyze the natural history and outcomes of major neurological complications in spinal deformity correction surgery and to determine the risk factors for no neurological recovery.Methods:All of 7 851 patients with spinal deformity who underwent deformity correction from January 2000 to December 2017 were reviewed. Major neurological complication featured by complete or incomplete paralysis of single or both lower extremities was identified in 59 patients, including 28 males and 31 females with an average age of 25.0±16.3 (range 6 to 71 years old). Among these cases, 6 were adolescent idiopathic scoliosis, 22 were congenital scoliosis, 10 were neuromuscular scoliosis, 5 were neurofibromatosis type 1, and 16 were other types. 5 patients had complete paraplegia of the lower limbs, 17 patients had incomplete paralysis of the lower limbs, and 37 patients had incomplete paraplegia of unilateral lower limb. Treatment included implant removal, debridement of hematoma, loosening the fixation and decompression by laminectomy for mechanical injury, as well as transfusion and press agent for ischemic injury. The neurological function was determined by the American Spinal Injury Association (ASIA) grading system.Fisher exact test and univariate logistics regression were used to determine the association between clinical, surgical parameters and no recovery of neurological function. For the identified factors with P value<0.10, multiple logistics regression was used to determine the independent risk factor for no recovery. Results:The incidence of major neurological complications was 0.75%(59/7851). At final follow-up, 42 patients (71.2%) had complete recovery and 10 patients (16.9%) had partial recovery, and 44 cases (74.6%) had recovery within 6 months. There were 7 cases had no recovery, including 3 with type I neurofibromatosis(ASIA: 1 grade A, 2 grade C), 1 with Scheuermann's disease (ASIA: grade C), 1 with arthrogryposis multiplex congenital (ASIA: grade B), 1 with poliomyelitis related scoliosis (ASIA:grade C), and 1 with idiopathic scoliosis (ASIA: grade A). Fisher test showed the distribution of etiology was statistically different between recovery and no recovery groups. Univariate logistics regression showed diagnosis as NF-1 ( OR=18.750, P=0.005), Cobb angle of the main curve >90° ( OR=4.444, P=0.073), preoperative deficit ( OR=5.750, P=0.046) and complete neurological injury ( OR=6.533, P=0.067) were potential risk factors for no recovery. Multivariate logistics regression showed that diagnosis with NF-I ( OR=35.477, P=0.005) was the risk factor for no recovery. Conclusion:For patients who underwent deformity correction that develops major neurological complications after surgery, 88.1% of patients were able to recover during follow-up, and 71.2% of patients achieved complete recovery. The first 3-6 month is the time window for neurological recovery. Patients with type I neurofibromatosis is the risk factor for no recovery.

15.
Article in Chinese | WPRIM | ID: wpr-910646

ABSTRACT

Objective:To study the results of surgical treatment on post-pancreaticoduodenectomy hemorrhage (PPH).Methods:The clinical data of 47 patients who developed PPH after pancreaticduodenectomy treated with surgery at the First Affiliated Hospital of University of Science and Technology of China from January 2012 to December 2020 were retrospectively analyzed. The operative indications, bleeding site, intraoperative treatment and prognosis were analyzed.Results:There were 33 males and 14 females, aged 42 to 81 (mean 60) years. Early hemorrhage occurred in 17 patients and delayed hemorrhage in 30 patients. A total of 35 patients developed intraperitoneal hemorrhage, 7 gastrointestinal hemorrhage and 5 intraperitoneal combined with gastrointestinal hemorrhage. The indications for surgery were hemodynamic instability ( n=31) and other treatment failure ( n=10). In 17 patients (36.2%), hemorrhage was associated with blood vessels. In 14 patients (29.8%), hemorrhage was associated with anastomotic stoma, while in 6 patients (12.8%) with gastrointestinal hemorrhage, the bleeding was non-anastomotic related. Early hemorrhage was mainly vascular related, and the surgical treatment mainly consisted of suture hemostasis at the bleeding site combined with abdominal irrigation and drainage. Delayed hemorrhage was most commonly anastomotic associated, and its management should consider avoiding anastomotic fistula formation after treatment. The operation time of early hemorrhage was significantly shorter than that of delayed hemorrhage [(136.0±37.5) min vs. (191.1±73.8)min, t=-3.289, P<0.05]. The incidence of re-hemorrhage was 23.4% (11 patients) and 9 patients died with a mortality rate of 19.1%. The re-hemorrhage and mortality rates of early-stage bleeding were significantly lower than those of delayed bleeding [5.9%(1/17) vs. 33.3%(10/30), 0 vs. 30.0%(9/30), P<0.05]. Conclusions:Surgical treatment of early hemorrhage had better results than that of delayed bleeding. Patients with anastomotic related hemorrhage were at high-risks of postoperative death after surgery. Recurrent bleeding was the main cause of death.

16.
Article in Chinese | WPRIM | ID: wpr-921556

ABSTRACT

Objective To observe the patients after transvaginal mesh(TVM)implantation surgery by using transperineal ultrasound(TPUS),compare the diagnosis of pelvic organ prolapse(POP)by TPUS and clinical examination[according to the Pelvic Organ Prolapse Quantification(POP-Q)system published by the International Continence Society],and to explore the role of ultrasound in postoperative evaluation as well as the high-risk factors of post-surgery POP recurrence. Methods This is a retrospective study based on the POP-Q records and TPUS data sets of patients within 6 months after TVM surgery during September 2013 and November 2019.The diagnostic results of TPUS and POP-Q were compared.The incidences of hiatal ballooning and levator avulsion were separately compared between the TPUS group and the control group. Results A total of 147 patients were enrolled.The Kappa values between TPUS and POP-Q in the diagnosis of anterior and posterior compartment POP were 0.268(


Subject(s)
Humans , Pelvic Floor/diagnostic imaging , Pelvic Organ Prolapse/diagnostic imaging , Retrospective Studies , Surgical Mesh/adverse effects , Ultrasonography
17.
Acta Physiologica Sinica ; (6): 845-854, 2021.
Article in Chinese | WPRIM | ID: wpr-921288

ABSTRACT

The aim of the present study was to explore the correlation between ptk2b/PTK2B (protein tyrosine kinase 2 beta, a ptk2b-encoded protein) and the level of low density lipoprotein receptor-related protein-1 (LRP-1), as well as to uncover the relationship between the changes in beta amyloid protein (Aβ) levels in blood and brain and the expression of ptk2b in Aβ-induced cognitive dysfunction mice. A total of 64 3-month-old C57BL/6J mice were divided randomly into the experimental group and control group. All mice underwent the intracerebroventricular (i.c.v.) intubation. Mice in the experimental group received the i.c.v. infusion of oligomeric Aβ


Subject(s)
Alzheimer Disease , Amyloid beta-Peptides/metabolism , Animals , Brain , Cognitive Dysfunction/chemically induced , Disease Models, Animal , Focal Adhesion Kinase 2 , Hippocampus/metabolism , Mice , Mice, Inbred C57BL , Peptide Fragments
18.
Chinese Medical Journal ; (24): 2692-2699, 2021.
Article in English | WPRIM | ID: wpr-921207

ABSTRACT

BACKGROUND@#Breast cancer patients with ipsilateral supraclavicular lymph node metastasis (ISLNM) but without distant metastasis are considered to have a poor prognosis. This study aimed to develop a nomogram to predict the overall survival (OS) of breast cancer patients with ISLNM but without distant metastasis.@*METHODS@#Medical records of breast cancer patients who received surgical treatment at the Affiliated Cancer Hospital of Zhengzhou University, Jiyuan People's Hospital and Huaxian People's Hospital between December 21, 2012 and June 30, 2020 were reviewed retrospectively. Overall, 345 patients with pathologically confirmed ISLNM and without evidence of distant metastasis were identified. They were further randomized 2:1 and divided into training (n = 231) and validation (n = 114) cohorts. A nomogram to predict the probability of OS was constructed based on clinicopathologic variables identified by the univariable and multivariable analyses. The predictive accuracy and discriminative ability were measured by calibration plots, concordance index (C-index), and risk group stratification.@*RESULTS@#Univariable analysis showed that estrogen receptor-positive (ER+), progesterone receptor-positive (PR+), human epidermal growth factor receptor 2-positive (HER2+) with Herceptin treatment, and a low axillary lymph node ratio (ALNR) were prognostic factors for better OS. PR+, HER2+ with Herceptin treatment, and a low ALNR remained independent prognostic factors for better OS on multivariable analysis. These variables were incorporated into a nomogram to predict the 1-, 3-, and 5-year OS of breast cancer patients with ISLNM. The C-indexes of the nomogram were 0.737 (95% confidence interval [CI]: 0.660-0.813) and 0.759 (95% CI: 0.636-0.881) for the training and the validation cohorts, respectively. The calibration plots presented excellent agreement between the nomogram prediction and actual observation for 3 and 5 years, but not 1 year, OS in both the cohorts. The nomogram was also able to stratify patients into different risk groups.@*CONCLUSIONS@#In this study, we established and validated a novel nomogram for predicting survival of patients with ISLNM. This nomogram may, to some extent, allow clinicians to more accurately estimate prognosis and to make personalized therapeutic decisions for individual patients with ISLNM.


Subject(s)
Breast Neoplasms , Female , Humans , Lymph Nodes , Lymphatic Metastasis , Nomograms , Retrospective Studies
19.
Chinese Medical Journal ; (24): 2730-2737, 2021.
Article in English | WPRIM | ID: wpr-921205

ABSTRACT

BACKGROUND@#Shenque (CV8) acupoint is located on the navel and has been therapeutically used for more than 2000 years in Traditional Chinese Medicine (TCM). However, clinical research on the underlying therapeutic molecular mechanisms of the CV8 acupoint lags far behind. This study aimed to study the mechanisms of umbilical acupoint therapy by using stem cells.@*METHODS@#The morphological characteristics of CV8 acupoint were detected under a stereomicroscope using hematoxylin and eosin (H&E) staining. Oil Red, Masson, and immunohistochemical staining on multi-layered slices were used to identify the type of cells at the CV8 acupoint. Cell proliferation was measured by a cell counting kit-8 (CCK-8) method. Flow cytometry and immunohistochemistry were used for cell identification. Induced differentiation was used to compare the differentiation of cells derived from CV8 acupoint and non-acupoint somatic stem cells into other cell types, such as osteogenic, adipogenic, and neural stem cell-like cells.@*RESULTS@#Morphological observations showed that adipose tissues at the linea alba of the CV8 acupoint in mice had a mass-like distribution. Immunohistochemical staining confirmed the distribution of stem cell antigen-1 (Sca-1) positive cells in the multi-layered slices of CV8 acupoint tissues. Cells isolated from adipose tissues at the CV8 acupoint exhibited high expression of Sca-1 and CD44 and low expression of CD31 and CD34, and these cells possessed osteogenic, adipogenic, and neurogenic stem cell-like cell differentiation ability. The cell proliferation (day 4: 0.5138 ± 0.0111 vs. 0.4107 ± 0.0180, t = 8.447, P = 0.0011; day 5: 0.6890 ± 0.0070 vs. 0.5520 ± 0.0118, t = 17.310, P 100 μm: 2.6000 ± 0.5477 vs. 0.8000 ± 0.8367, t = 4.025, P = 0.0038) were significantly enhanced in somatic stem cells derived from the CV8 acupoint compared to somatic stem cells from the groin non-acupoint. However, cells possessed significantly weaker osteogenicity ([2.697 ± 0.627]% vs. [7.254 ± 0.958]%, t = 6.893, P = 0.0023) in the CV8 acupoint group.@*CONCLUSIONS@#Our study showed that CV8 acupoint was rich with adipose tissues that contained abundant somatic stem cells. The biological examination of somatic stem cells derived from the CV8 acupoint provided novel insights for future research on the mechanisms of umbilical therapy.


Subject(s)
Acupuncture Points , Adipose Tissue , Adult Stem Cells , Animals , Cell Differentiation , Cells, Cultured , Mice , Osteogenesis
20.
Article in Chinese | WPRIM | ID: wpr-912437

ABSTRACT

Objective:To establish an interpretive reporting system for urinalysis based on artificial intelligence (AI).Methods:Urine tests were collected from the First Affiliated Hospital, College of Medicine, Zhejiang University from 2008 to 2018, including 2 899 917 patient tests and 710 971 physical check-up tests. Then we set up a large population distribution with the frequency of different results of each item and established a health index of each sample and an abnormal level of each item according to data distribution, importance and degree of abnormality. We collected data of seven diseases, such as diabetes mellitus, urinary tract infection, glomerulonephritis and nephrotic syndrome, and matched them with a same number of healthy control group by gender and age. An integrated learner based on the AdaBoost algorithm was used to establish a diagnostic model and assess its algorithm performance. JAVA was used to develop data presentation software. The accuracy of the AI model for disease judgment was assessed by manual verification using 199 abnormal urine tests.Results:Each report could be graded as four levels: normal, abnormal, ill and critical. Each item could be judged as normal, mild, moderate, severe or extreme and the population distribution was provided with big data. The training accuracy, true positive rate and area under the curve were ≥88.3%, ≥80.0%, and ≥0.954 respectively using the machine learning model based on AdaBoost. The developed JAVA software presented the above results and displayed medical records and results, historical results, personalized advice, patient education and position in large population data. By manual verification, the accuracy rate of the AI model for disease judgment was 82.41% (166/199).Conclusion:This study established an intelligent interpretive reporting system for urine test results. It can distinguish the abnormality of each report, predict the disease of patients, and make personalized clinical decisions.

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