[Efficacy of polyetheretherketone rod hybrid surgery in preventing proximal junctional failure after adult spinal deformity surgery].

Objective: To investigate the clinical outcome and preventive effect of polyetheretherketone(PEEK) rod hybrid surgery on proximal junction failure(PJF) after long-segment fusion of adult spinal deformity. Methods: A retrospective study was conducted to analyze patients with degenerative scoliosis/kyphosis who underwent long-segment decompression and fusion surgery at Department of Orthopedics, Peking University First Hospital from January 2017 to December 2021. A total of 75 patients were included in the study, including 14 males and 61 females, aged (67.2±6.8)years (range:55 to 84 years). According to the operation method chosen by the patients, the patients were divided into PEEK rod hybrid group (20 cases) and traditional titanium rod group (55 cases). The general information of the patients was collected, and the coronal and sagittal parameters of the spine were measured before operation, at 1 month after operation, and at the last follow-up. The clinical effect of surgery was judged by the visual analogue scale (VAS) and Oswestry disability index (ODI). Whether proximal junctional kyphosis (PJK) and PJF occurred during the follow-up and the time of occurrence were recorded. Comparisons between groups were performed using independent sample t test, Mann-Whitney U test, χ2 test and Fisher's exact probability method. The data before and after surgery in the same group were compared using the paired sample t test and the Wilcoxon test. Results: There were no significant differences in age, gender, body mass index, bone mineral density, distal instrumented vertebrae, surgical segments, osteotomy method, operation time, and intraoperative bleeding between the two groups (all P>0.05). The follow-up time of the PEEK rod group was shorter(M(IQR)16.5(4.8) vs. 25.0(12.0),Z=-4.230,P<0.01). There were no significant differences in coronal, sagittal parameters, VAS and ODI between the two groups before operation (all P>0.05). Postoperative coronal Cobb angle, pelvic incidence, pelvic tilt, sacral slope, lumbar lordosis, thoracic kyphosis, sagittal vertical axis (SVA), VAS and ODI were significantly improved in both groups(all P<0.05). At the last follow-up, the SVA of the PEEK rod hybrid group was(3.74±2.40)cm, which was significantly lower than that of the titanium rod group (6.28±4.06)cm (t'=-3.318, P=0.002). At the last follow-up, the ODI of the PEEK rod hybrid group was 30.7±6.1, significantly better than the titanium rod group 39.3±17.2(t=-3.203, P=0.046). PJK occurred in 2 patients (10.0%) in the PEEK rod hybrid group, and no PJF phenomenon was observed. In the titanium rod group, 18 patients (32.7%) developed PJK, and 11 patients (20.0%) developed PJF. There was a statistically significant difference in the incidence of PJF between the PEEK rod hybrid group and the titanium rod group (P=0.031). Conclusions: PEEK rod hybrid surgery can achieve good clinical results in the treatment of adult spinal deformities. Compared with traditional titanium rod surgery, it can significantly reduce the incidence of postoperative PJF and improve the clinical function of patients.

[Analysis of surgical strategy of percutaneous endoscopic lumbar discectomy in young and middle-aged double-segment patients with lumbar disc herniation].

OBJECTIVE: To investigate clinical efficacy and safety of single and double segmental percutaneous lumbar discectomy for young and middle-aged patients with double-segment disc herniation. METHODS: Retrospective analysis was undertaken for 32 young and middle-aged patients with percutaneous endoscopic lumbar discectomy (PELD) in the treatment of double-segment lumbar disc herniation from January 2015 to October 2018 in Peking University First Hospital. In the study, 18 cases were treated with single-segment treatment and 14 cases with double-segment treatment. Visual analogue score (VAS) and oswestry disability index (ODI) assessment were used to compare clinical symptom outcomes before surgery, 3 months after surgery and at the last follow-up. Macnab criteria were used to assess the patients' overall satisfaction after surgery. Imaging parameters included lumbar lordosis, intervertebral height at each segment and endplate angle of lesion segment on the X-ray. And Michigan State University(MSU) rating and Pfirrmann scoring system were used to evaluate the grade of disc herniation and disc degeneration respectively on magnetic resonance imaging (MRI). The perioperative parameters included the surgeon, anesthesia method, operation time, postoperative hospital stay, postoperative bracing time and perioperative complications. RESULTS: The mean follow-up time was (26.78±10.64) months. There was no significant difference in the follow-up time and baseline information between the two groups(P > 0.05). ODI scores 3 months post-operatively and at the last follow-up were lower in the double segment (P < 0.05). The ODI improvement was also more significant in the double-segment group at the last follow-up (P < 0.05). There was no significant difference in radiographic parameters at baseline (P>0.05). MSU scale for the primary segment was significantly lowered after both operations (P < 0.05). MSU scale for secondary segment was significantly lowered in double segment group but not in single segment group. Other imaging parameters were similar between the two groups (P > 0.05). The operation time of the single-segment group was significantly shorter than that of the double-segment group(P < 0.001). No perioperative complications were found in either group, but three patients underwent secondary lumbar surgery during the postoperative follow-up period in the single-segment group. CONCLUSION: For young and middle-aged patients with double-segment disc herniation, this study suggests double-segment PELD may be more advantageous than single-segment PELD in terms of asuring clinical efficacy without increasing perioperative risks.

[Clinical efficacy of short-term halo-pelvic traction combined with surgery in the treatment of severe spinal deformities].

OBJECTIVE: To evaluate the clinical efficacy of short-term halo-pelvic traction (HPT) combined with surgery in the treatment of severe spinal deformities. METHODS: In the study, 24 patients diagnosed as severe spinal deformity accepted the treatment of one-stage short-term HPT and two-stage surgery from January 2015 to May 2018 in our orthopedics department. 24 cases (9 males and 15 females) were retrospectively reviewed. The average age of the cohort was (28.8±10.0) years (12－48 years). The height, scoliosis angle, kyphosis angle, the height difference of shoulders, the height difference of crista iliaca, C7PL-CSVL and the perpendicular distance of S1 and the convex point of the patients were assessed at pre-traction, post-traction and post-surgery. The paired t test was used to analyze the difference among pre-traction, post-traction and post-surgery. RESULTS: The average traction time of 24 cases was (2.5±1.1) weeks (1－5 weeks). The height of pre-traction and post-traction were (141.7±11.2) cm (116-167 cm) and (154.1±9.5) cm (136－176 cm) respectively, showing significant difference (P < 0.05), and the increased height was (12.4±4.6) cm (4－20 cm). The average scoliosis angle before traction was 104.9°±35.0°(25°ï¼158°), and it was significantly decreased in post-traction[64.8°±21.0°(19°ï¼92°)] and post-surgery[39.3°±17.0° (10°-70°)] (P < 0.05). The traction's coronal correction rate was 37.2%±10.9% (11.9%－51.2%) and the total coronal correction rate was 61.9%±12.6%(26.9%-79.0%). The average kyphosis angle before traction was 106.9°±29.2°(54°ï¼163°), and it was significantly decreased in post-traction [63.1°±17.1°(32°ï¼92°)] and post-surgery [39.0°±16.8°(10°ï¼68°)](P < 0.05). The traction's sagittal correction rate was 40.0%±10.7%(16.7%－55.5%) and the total sagittal correction rate was 64.3%±10.7%(49.0%－87.5%). The average C7PL-CSVL before traction was (3.2±2.8) cm, and it was significantly decreased in post-traction [(2.5±2.5) cm] (P < 0.05). The perpendicular distance of S1 and the convex point before traction was (10.5±4.8) cm, and it was significantly decreased in post-traction[(8.4±3.5) cm] (P < 0.05). CONCLUSION: The one-stage short-term HPT combined with two-stage surgery is a safe and effective procedure for severe spinal deformities. The clinical efficacy is satisfactory and the complication is relatively less.

[Expression of heterogeneous nuclear ribonucleo-protein A2B1 in mouse cerebellar development and human medulloblastoma].

Objective: To investigate the expression and potential role of heterogeneous nuclear ribonucleo-protein A2B1 (HNRNPA2B1) in mouse cerebellar development and the significance of HNRNPA2B1 in human medulloblastoma. Methods: The data of HNRNPA2B1 RNA expression in mouse and human cerebella were obtained from databases. Western blot and immunohistochemical staining were performed to detect the protein level of HNRNPA2B1 in mouse cerebella at different ages. The expression level of HNRNPA2B1 in control human cerebellum and medulloblastoma was detected by immunohistochemical staining. m6A-IP-qPCR method was applied to confirm whether HNRNPA2B1 RNA in Daoy cells was modified with m6A.Western blot was used to detect the effect of MG132 treatment on the HNRNPA2B1 protein level in Daoy cells. Results: The level of HNRNPA2B1 protein in postnatal mouse cerebella was higher than that in adult mouse cerebella, with weak HNRNPA2B1 staining in external granular cells while strong staining in mature Purkinje cells and molecular layer. Compared with control normal human cerebella, the RNA expression level of HNRNPA2B1 increased in medulloblastoma, while immunohistochemical staining showed that the mean intensity of HNRNPA2B1 decreased in medulloblastoma. HNRNPA2B1 RNA in medulloblastoma and Daoy cells was modified by m6A. The HNRNPA2B1 protein level in Daoy cells increased upon MG132 treatment. Conclusions: HNRNPA2B1 is dynamically expressed during mouse cerebellar development. Compared with normal human cerebella, HNRNPA2B1 is significantly up-regulated at transcriptional level but obviously down-regulated at translational level in medulloblastoma. These results indicate that HNRNPA2B1 may be involved in cerebellar development process and medulloblastoma tumorigenesis. The m6A methylation in HNRNPA2B1 transcript and protein ubiquitin-proteasome pathway may account for the down-regulation of HNRNPA2B1 at protein level.

[Anterior cervical discectomy and fusion to treat cervical spondylosis with sympathetic symptoms].

OBJECTIVE: To investigate the clinical effectiveness of polytheretherketone (PEEK) cages assisted anterior cervical discetomy and fusion (ACDF) to treat cervical spondylosis with sympathetic symptoms. METHODS: Retrospective analysis was undertaken for 39 patients who were diagnosed as cervical spondylosis with sympathetic symptoms and underwent ACDF with PEEK cages. Radiographs obtained before surgery, after surgery, and at the final follow-up were assessed for quality of fusion. The following criteria were used for assessing radiographic success of fusion: (1) endplate obliterated with no lucent lines; (2) obliteration of disc space by bony trabeculae; (3) less than 2°of intervertebral motion or 2 mm of motion between the spinous processes at the operated segment on flexion-extension lateral radiographs. The sympathetic symptoms including vertigo, headache, tinnitus, nausea and vomiting, heart throb, hypomnesia and gastroenterological discomfort were scored by 20-point system preoperatively, 2 months postoperatively and at the final follow-up. The recovery rate and clinical satisfaction rate were also evaluated. Surgical complications were also assessed. RESULTS: They were followed up for at least one year. The mean follow-up was 15.6 months. Radiographs of the cervical spine at the last follow-up revealed a solid fusion with no signs of a pseudoarthrosis in 36 cases. In two patients delayed union and bony fusion were achieved at the end of 9 and 11 months. Pseudoarthosis was found in 1 case but the patient had no symptoms. The score of sympathetic symptoms before surgery, 2 months after surgery and at the final follow-up were 8.4±1.0,2.2±0.3,and 2.4±0.3, respectively. There were 22 excellent cases, 15 good cases, 1 fair case and 1 bad case in terms of RR. Good to excellent results were attained in 95% of theses patients. The sympathetic symptoms improved in all the patients and the score was significantly improved after surgery. There was one patient who had cerebral spinal fluid leakage but he recovered one week after surgery. Two patients felt a mild swallowing discomfort, but it disappeared within one month after surgery. Subcutaneous hematoma occurred in one patient due to obstructed drainage. It was cleared two days after surgery. CONCLUSION: Cervical spondylosis patients with sympathetic symptoms may be managed successfully with ACDF using PEEK cages. Successful clinical results regarding symptom improvement and general satisfaction with the surgical procedure depend not only on obtaining successful decompression and radiographic fusion but also on patient selection.

[How to restore the proper lumbar lordosis in spine surgery].

Sagittal alignment of the spine significantly affects the physical function. In this article, we review the clinical application of several spinal-pelvic parameters, analyze the impact factors of sagittal alignment and provide calculating methods to value the correcting degrees. Spine surgeons should get a deep understanding of the spinal-pelvic parameters, differentiate the functional and structural imbalance. Every patient needs thorough preoperative evaluation to restore the proper alignment during surgery and avoid overcorrection.

[Efficacy of transforaminal endoscopic nerve root decompression in the treatment of degenerative lumbar spinal stenosis].

OBJECTIVE: To evaluate the feasibility of transforaminal endoscopic nerve root decompression for degenerative lumbar spinal stenosis (DLSS). METHODS: From July 2011 to April 2016, 96 cases of single segment DLSS were involved. All the patients had unilateral lower extremity neurological symptoms, signs, neurogenic intermittent claudication of less than 500 m. Imaging examinations (CT or MRI) or diagnostic nerve root block confirmed single segment degeneration. The mean age was (71.6±5.4) years, male: 55 cases, female: 41 cases. Their intraoperative blood loss, operation time, complications, ambulation time and discharge time were recorded. Leg pain VAS, ODI were used to evaluate the pain and lumbar function of the patients. The clinical efficacy was evaluated by Nakai evaluation. RESULTS: All the patients were performed endoscopic decompression of the lateral recess and nerve root by removing the ventral part of the superior facet joint, the ligamentum flavum and the intervertebral disc. The decompression range was from the inferior edge of the upper pedicle to the superior edge of the lower pedicle. The nerve root was detected to have no compression and the pulse of nerve root returned to normal. The patient got ambulant on the operation day and discharged if he had no discomfort symptom. In the study, 68 cases got follow up. The mean follow-up time was 12.1 months (6-63 months). The VAS at different follow-up time points was improved relative to the baseline, and the difference was statistically significant (F=491.60, P<0.001). The ODI at different follow-up time points was improved relative to the baseline, and the difference was statistically significant (F=189.91, P<0.001). The excellent and good rates of Nakai evaluation were 79.4% (excellent in 42 cases, good in 12 cases, fair in 10 cases and poor in 4 cases). The mean intraoperative blood loss was (49.29±11.86) mL. The mean operation time was (92.46±21.34) min. The mean ambulation time was 1.8 h. The mean discharge time was 2.3 days. Postoperative epidural hematoma was found in 1 case. Foot drop was found in 1 case. Second stage open surgery was performed in 6 cases. CONCLUSION: We can apply transforaminal endoscopic decompression for the patients of lumbar spinal stenosis who have unilateral nerve root irritation. Patients with transforaminal endoscopic decompression can get less surgical trauma, quick recovery and obtain good short-term outcome.

[Polymethylmethacrylate augmentation of bone cement injectable cannulated pedicle screws was used to treat degenerative lumbar scoliosis with osteoporosis].

OBJECTIVE: To describe the application of polymethylmethacrylate (PMMA) augmentation of cement-injectable cannulated pedicle screws for the treatment of degenerative lumbar scoliosis with osteoporosis. METHODS: Retrospective cohort study was used to compare cement injectable cannulated pedicle screws (CICPs) group with PMMA augmentation and control group with traditional method in the correction surgery for Lenke-silva level III and level IV degenerative scoliosis cases with osteoporosis. Both groups were followed up for 1 year. The clinical results were assessed by visual analog scale (VAS) of pain on lumbar and lower limbers, Oswestry disability index (ODI) score and EuroQol-5 dimensions (EQ-5D) score. The coronal major curve Cobb angel in coronal plane and thoracic kyphosis Cobb angle, lumbar lordosis Cobb angle and sagittal vertical axis (SVA) in sagittal plane were tested in whole long spine X ray. The fusion rates were evaluated by lumbar X ray and dynamic X ray. RESULTS: In this study 34 cases were enrolled, 15 cases in CICPs group and 19 cases in control group. The general characteristics including age, gender, weight, height, BMI and BMD were without statistical difference between the two groups. There were (5.7±2.2)PMMA augmentation screws in CICPs group. The operation time, blood loss and blood transfusion were higher in CICPs group than in control group, but without statistical difference. Lumbar VAS, lower limbers VAS, ODI score and EQ-5D were all better in 1 month postoperation, 6 months postoperation and 1 year postoperation than in preoperation in both groups. lumbar VAS scores of CICPs group in 6 months postoperation (CICPs group 3.1±1.3 vs. control group 4.4±1.4, P<0.01) together with lumbar VAS scores (CICPs group 3.3±1.0 vs. control group 5.2±1.4, P<0.01), ODI scores (CICPs group 22.7±17.2 vs. control group 31.4±18.5, P<0.01) and EQ-5D in 1 year postoperation (CICPs group 2.9±2.0 vs. control group 3.5±2.5, P<0.01)were lower than those of control group. The coronal major curve Cobb angels were all lower in 1 month postoperation, 6 months postoperation and 1 year postoperation than in preoperation in both groups; thoracic kyphosis Cobb angle and lumbar lordosis Cobb angle were all higher in 1 month postoperation, 6 months postoperation and 1 year postoperation than in preoperation in both groups. The coronal major curve Cobb angel was lower in CICPs group than that in control group in 1 year postoperation (CICPs group 17.6°±6.9° vs. control group 21.2°±7.2°, P<0.01)and thoracic kyphosis Cobb angle was higher in CICPs group than that in control group in 6 months postoperation (CICPs group -33.5°±8.8 ° vs. control group -28.9°±8.3°, P<0.01) and 1 year postoperation (CICPs group -33.0°±8.1° vs. control group -26.3°±7.4°, P<0.01) together with lumbar lordosis Cobb angle were higher in CICPs group than that in control group in 1 year postoperation (CICPs group 26.4°±8.1° vs. control group 22.1°±7.3°, P<0.01). CONCLUSION: Polymethylmethacrylate augmentation of bone cement-injectable cannulated pedicle screws for the treatment of degenerative lumbar scoliosis with osteoporosis was effective and safe, the short-term clinical result was good.

The effects of bortezomib alone or in combination with 5-fluorouracil on proliferation and apoptosis of choriocarcinoma cells.

PURPOSE: To investigate the effects of bortezomib alone and in combination with 5-fluorouracil (5-FU) on proliferation and apoptosis in the human choriocarcinoma cell line JEG-3. MATERIALS AND METHODS: Cells were treated with bortezomib, 5-FU or with a combination. Proliferation and apoptosis were measured. NF-iB protein expression was examined using immunofluorescence. RESULTS: Following treatment with ten nM bortezomib, rates of apoptosis were significantly higher than controls (p < 0.05) and NF-kB expression increased. 5-FU at 0.025 µg/ml or 0.25 µg/ml resulted in 60.1 ± 0.4% and 67.0 ± 0.2% growth inhibition, respectively, an increase compared to individual treatment (p < 0.05). Apoptosis in cells treated with bortezomib +5-FU was significantly higher than either treatment alone (p < 0.05). Inhibition of proliferation by the combination treatment was synergistic. CONCLUSION: Bortezomib alone or in combination with 5-FU inhibited JEG-3 cell proliferation and induced apoptosis by increasing NF-kB expression. Combination treatment exerted synergistic effects on growth inhibition.

[Analysis of the clinical outcomes of the over 5-year follow-up study of degenerative lumbar scoliosis treated with posterior decompression and instrumented fusion].

OBJECTIVE: To evaluate the over 5-year follow-up clinical outcomes of degenerative lumbar scoliosis treated with operation of decompression and fusion, and the effectiveness and risks factors about revision surgery cases. METHODS: A total of 47 cases of diagnosis of degenerative lumbar scoliosis treated with posterior decompression and instrument fusion recorded from Jun. 2003 to Jun. 2008 were analyzed. Lumbar Japanese Orthopedic Association (JOA) score and visual analogue score (VAS) were applied to evaluate the improvement of the clinical effect after surgery treatment, and the clinical effect and reasons of revising operation were recorded and analyzed. RESULTS: All the 47 patients had finished the over 5-year followed-up time with an average time of (8.2±3.6) years (range from 5.2 years to 12.5 years). The patient's mean age was (67.0±9.6) years and the age of patient range from 56 years to 81 years. There were 10 patients who underwent revision surgery since primary operation, in whom 8 cases because of proximal failure of internal fixation and the other 2 cases because of distal failure of fusion segment. The average clinical improvement excellent rate was 83.3% after 5 years since primary operation of 37 cases while the average fine rate of revision operation was 67.6%. CONCLUSION: In the over 5-year follow-up, there was a better clinical outcome of degenerative lumbar scoliosis treated with posterior decompression and instrumented fusion, which had a certain rate of revision operation and had a worse effect of clinical results compared with primary operation. The risks of revision surgery included the poor bone quality of patients, with fusion to L1 at proximal terminal and the fusion end to S1 at distal terminal.

[Polymethylmethacrylate augmentation of bone cement-injectable cannulated pedicle screws for the treatment of degenerative lumbar diseases with osteoporosis].

OBJECTIVE: To describe the application of polymethylmethacrylate augmentation of bone cement-injectable cannulated pedicle screws for the treatment of degenerative lumbar diseases with osteoporosis. METHODS: Observation group included 14 cases of degenerative lumbar diseases with osteoporosis received polymethylmethacrylate augmentation of bone cement-injectable cannulated pedicle screws from November 2014 to July 2015, control group included 12 cases of degenerative lumbar diseases with osteoporosis received polymethylmethacrylate augmentation with traditional pedicle screws.The operation time, blood loss, number of pedicle screws and number of augmented pedicle screws in the two groups were compared. The bone cement leakage and pulmonary bone cement embolism in the two groups were also compared. The fusion rate and pedicle screws loosening by lumbar X ray and dynamic X ray were evaluated. The clinical results were assessed by visual analog scale (VAS) of pain on lumbar and lower limbers, lumbar Japanese Orthopaedic Association scores (JOA), Prolo functional scores and Oswestry disability (ODI) scores. RESULTS: Differences of operation time and blood loss in the two groups were not statistically significant. The average number of pedicle screws was 9.9±4.7 and the average number of augmented pedicle screws was 5.9±2.6 in observation group while the average number of pedicle screws was 7.1±2.8 and the average number of augmented pedicle screws was 3.0±1.9 in control group. The ratio of augmented pedicle screws was higher in observation group than in control group (0.69±0.30 vs.0.47±0.30,P<0.05). The bone cement leakage rate was lower in observation group than in control group (5/83 vs. 12/42, P<0.01). All the cases in observation group were without leakage to the interspinal canal while one case in control group suffered from bone cement leakage to the interspinal canal with augmentation of 3 pedicle screws. The follow up period was (10.6±2.3) months in observation group and (36.5±7.2) months in control group. In final follow up, no case with non-fusion or pedicle screws loosening was found in both groups. Lumbar VAS, lower limbers VAS, lumbar JOA scores, Prolo functional scores and ODI scores were all better than pre-operation (P<0.01). CONCLUSION: Polymethylmethacrylate augmentation of bone cement-injectable cannulated pedicle screws for the treatment of degenerative lumbar diseases with osteoporosis was effective, with simple working processes and lower risk of bone cement leakage. The short-term clinical result was good.

[Research on the trend of the decrease of human chorionic gonadotropin in the treatment of cesarean scar pregnancy by different surgical treatments].

OBJECTIVE: To explore the clinical effect of different surgical methods in the treatment of cesarean scar pregnancy, the decline trend of human chorionic gonadotropin (hCG) and the indications of different treatment methods. METHODS: This study was a prospective cohort study. The clinical data of 120 patients with cesarean scar pregnancy who were treated with four different surgical methods in the Beijing Obstetrics and Gynecology Hospital from June 2013 to December 2014 were collected. Seven cases ultrasonic curettage, 63 cases uterine arterial embolization (UAE) with hysteroscopic pregnancy embryo removal surgery, 41 cases UAE + B-ultrasound or laparoscopic monitoring hysteroscopic pregnancy embryo clearance surgery and 9 cases UAE + hysteroscopic and laparoscopic removal of pregnancy scar and uterine repair. The clinical efficacy of different surgical methods and the decrease trend of serum HCG in postoperative period were analyzed. RESULTS: (1)The levels of serum beta hCG in patients with cesarean scar pregnancy after different surgical treatments decreased (84.5±9.7)%, (97.7±3.2)% and (99.6±1.2)% after the 2 days, 7 days and 14 days respectively. The average time of blood beta hCG level dropped to normal was (22.4±6.7) d. (2)There was a significant difference in the amount of bleeding and the time of hospitalization among the patients treated with different surgical methods. (3)There was a significant difference in the analysis of the decline percentage rate of serum beta hCG under the interactive effect between different surgical methods and postoperative recovery time (P<0.01). CONCLUSION: The level of serum beta hCG in patients with cesarean scar pregnancy were reduced to normal range after 3 weeks of operation. The choice of surgical approach should be based on the degree of implantation of embryo sac scar, the thinnest muscle thickness, local blood flow, serum beta hCG levels, gestational sac size, process to the bladder and fertility desire to determine.

[Clinical research of percutaneous vertebroplasty or percutaneous kyphoplasty for treating osteoporotic vertebral compression fractures induced by glucocorticosteroid].

OBJECTIVE: To investigate the clinical characteristics of vertebral compression fracture (VCF) in glucocorticosteroid-induced osteoporosis (GIOP) and risk of vertebral refracture after percutaneous vertebroplasty (PVP) or percutaneous kyphoplasty (PKP). METHODS: In the study, 570 cases who received PVP or PKP as treatments of VCF from January 2010 to December 2013 were retrospective reviewed, of which 42 were GIOP and 21 were followed up as GIOP group, and the other 528 were primary osteoporosis and 391 were followed up, of which 84 were selected as Control group based on age and gender. The fracture location, ratio of single segment fracture and multiple segments fracture in the two groups were compared. In the final follow up, the reoperation rates for vertebral refractures by the Kaplan-Meier method in the two groups were compared. RESULTS: The follow up periods were (24.0± 13.1) months in GIOP group and (25.8±14.4) months in control group(P>0.05). In GIOP group, there were 11 cases with one-segment fracture, 2 with two-segments fracture, 3 with three-segments fracture, 2 with four-segments fracture, 2 with five-segments fracture and 1 with eight-segments fracture. In Control group, there were 67 cases with one-segment fracture, 12 with two-segments fracture, 3 with three-segment fracture, and 2 with four-segments fracture. The ratio of single segment fracture in GIOP group was significantly lower than that in Control group(52.4% vs. 79.8%,P=0.01). There were 50 fracture segments in GIOP group and 109 fracture segments in Control group. The ratios of fracture segments located in thoracic segments(T1-T10), thoracolumbar segments(T11-L1)and lumbar segments(L2-L5)were 18%, 46% and 36% in GIOP group and 11.9%, 58.7% and 29.4% in Control group (P>0.05). The refracture rate in GIOP group was higher than that in control group (23.8% vs. 6.0%). The survival rate was lower in GIOP group than that in control group (P<0.01). CONCLUSION: The predilection site of VCF was similar in GIOP and primary osteoporosis (thoracolumbar segments> thoracic segments> lumbar segments). The risk of multiple segments VCF was higher in GIOP than in primary osteoporosis. The risk of vertebral refractures after PVP or PKP was higher in GIOP than in primary osteoporosis.

Classification of hypothalamic hamartoma and prognostic factors for surgical outcome.

OBJECTIVES: The main aims of this study were to classify patients with hypothalamic hamartoma (HH) based on neuroimaging features and describe the clinical manifestations of HH. MATERIALS AND METHODS: A retrospective review of 214 consecutive patients with HH treated in Beijing Tiantan Hospital was performed. RESULTS: HH were diagnosed and divided into Types I-IV based on MRI. Types I and II were defined as the HH attached to the floor of the third ventricle with narrow (Type I) or broad (Type II) interfaces. Type III ('straddling') was defined by the HH extending into the third ventricle and interpeduncular cistern. Type IV was defined as the HH located totally within the third ventricle. The percent distribution of patients was 35.9% Type I, 12.1% Type II, 40.7% Type III, and 11.2% Type IV. The percentage of patients with precocious puberty was highest in Type I (81.8%). The percentage of patients with gelastic seizures was highest in Type IV (91.7%). After surgery, 20% (1/5) of patients with Type II HH, 48.8% (20/42) with Type III, and 91.7% (11/12) with Type IV were free of epileptic seizures. Significant prognostic factors for surgical outcome were HH size, surgical approach, and resection level. CONCLUSIONS: The clinical manifestations of HH are correlated with the topology of the HH in relation to the hypothalamus. Our results suggest that patients with Type IV HH have the best outcome from surgery and neurosurgeons should be cautious about performing surgery on patients with Type II and Type III HH.

Molecular detection of QTL controlling plant height components in a doubled haploid barley population.

Yield losses caused by lodging in barley can be partially controlled by reducing plant height. In order to understand dwarfing mechanisms and efficiently use new dwarf germplasms for a breeding program, it is important to identify QTL of plant height components. QTL analysis was performed for seven plant height component traits using a DH population of 122 lines derived from the cross of Huaai 11 x Huadamai 6. Composite interval mapping procedures detected 20 QTL, which were mapped onto chromosomes 2H, 3H, 5H, 6H, and 7H. Eleven QTL were detected in 3 years and four QTL were detected in 2 years. QTL controlling all seven plant height component traits were found near the dwarfing gene btwd1 on chromosome 7H. These QTL accounted for 27.19 to 59.73% of phenotypic variation in seven plant height component traits. Positive transgressive segregation was found for all traits. Some of the QTL identified in this study will be useful for understanding the dwarfing mechanism and for developing new dwarf varieties using marker-assisted selection.

Promotion of LncRNA HOXA11-AS on the proliferation of hepatocellular carcinoma by regulating the expression of LATS1.

OBJECTIVE: To investigate the expression levels of lncRNA HOXA11-AS in HCC tissues and cells, and to explore its biological role in the development and progression of HCC. PATIENTS AND METHODS: We detected the relative expression level of HOXA11-AS in 72 HCC tissues and cells by the real-time quantitative PCR (qRT-PCR) assay. After interference with HOXA11-AS expression in HCC cells, 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT), clone formation, flow cytometry and an established nude mice transplanted tumor model were used to detect the biological behavior of HCC cells. qRT-PCR and Western blotting assays were used to detect the expression level of large tumor suppressor kinases 1 (LATS1). The subcellular localization of HOXA11-AS in HCC was detected by separating nuclei from the cytoplasm. The molecular mechanism of HOXA11-AS was regulated by ribonucleoprotein immunoprecipitation-microarray (RIP-Chip) experiments. RESULTS: qRT-PCR assays showed that HOXA11-AS was relatively highly expressed in HCC tissues and cells. In vivo and in vitro experiments showed that HOXA11-AS could inhibit the proliferation of HCC cells, promote their apoptosis and retard the cell cycle progression from G1 to G0 phase. qRT-PCR and Western blotting assays results showed that LATS1 genes were the downstream target genes of HOXA11-AS. RIP and CHIP experiments showed that HOXA11-AS inhibited the expression of LATS1 genes by binding enhancer of zeste homolog 2 (EZH2) proteins. CONCLUSIONS: HOXA11-AS inhibited the malignant transcription of the LATS1 genes and promoted the malignant proliferation of HCC cells. Interactions among HOXA11-AS, PRC2, and LATS1 may provide a new target for the treatment of HCC.

Antitumor Effect of Docetaxel in Osteosarcoma by the Inhibition of Wnt Signal Channel.

Osteosarcoma (OS) is the most common type of malignant bone tumor in adults and children. Despite the great strides in biology and medicine, the survival rate of patients with metastatic disease remains very poor. This rate has been staggering with recurrence and metastasis. In the present study, we proposed Wnt/ß-catenin pathway as a key biological target for the effective treatment in OS. Wnt signaling has been reported to play important roles in osteoblastogenesis. We hypothesized that docetaxel (DTX) will effectively arrest the osteosarcoma progression by suppressing the Wnt/ß-catenin pathway in OS cells. Our results show that DTX significantly inhibited the cell proliferation of U2OS and SaOS-2 cancer cells in a time-dependent and dose-dependent manner. DTX inhibited the intrinsic transcriptional activity of ß-catenin/Tcf in U2OS cancer cells and SaOS-2 cancer cells. GSK-3ßinhibitor (SB216763) treatment remarkably increased the ß-catenin/Tcf transcriptional activities. The transcriptional activities have been increased by around ~200% due to the decrease in the degradation of ß-catenin mediated through GSK-3ß. Summarizing, present study clearly showed that DTX inhibited Wnt/ß-catenin signalling pathways and significantly reduced the matrix metallopeptodase 9 (MMP-9) protein expressions and its activity. Taken together, our findings provide novel insight on the effect of anticancer small molecules to improve the outcomes in osteosarcoma.

Spinal cord substance P mediates carbachol-induced cardiovascular responses from the rostral ventrolateral medulla.

Intrathecal (i.t.) infusion of substance P (SP) antagonist, (D-Pro2, D-Trp7,9)-substance P (20 micrograms), lowered blood pressure profoundly without any significant change of heart rate. The hypertensive and tachycardic responses elicited by microinjection of carbachol (25 ng/site) into the bilateral rostral ventrolateral medulla (rVLM) were blocked by i.t. infusion of SP antagonist. These data provided evidence that an excitatory cardiovascular effect induced by cholinergic system in rVLM may be mediated mainly by the SP receptors in spinal cord.

Solubilization of murine melanoma xylosyltransferase and galactosyltransferase activities and their inactivation by dialdehyde nucleosides.

The enzymes involved in the initial steps in the biosynthesis of glycosaminoglycans were examined in the murine B16 melanoma. Approximately 60% of the melanoma xylosyltransferase activity and nearly all of the galactosyltransferase activity were membrane-bound; these enzymatic activities were solubilized by treatment with Nonidet P-40 and potassium chloride, and the Michaelis constants for the substrates and acceptor molecules were determined and found to be comparable to those reported for these enzymes from the chick embryo and a rat chondrosarcoma. Dialdehyde nucleosides, which have been reported to alter the activity of several enzymes involved in nucleic acid synthesis, inhibited both xylosyltransferase and galactosyltransferase activities, with galactosyltransferase being considerably less sensitive than xylosyltransferase. The inhibition of xylosyltransferase by dialdehyde nucleosides was irreversible, with no apparent specificity for the base moiety of the dialdehyde nucleosides.

NH-S hydrogen bonding in zinc enzyme model complex with S2N2 binding set studied by normal coordinate analysis of vibrational spectra.

In order to provide theoretical evidence for the existence and effect of NH-S hydrogen bonding in the zinc enzyme model complex [Zn(S-2-C6H4NHCOC6H5)2(1-MeIm)2] (1-MeIm = 1-methylimidazole) in addition to the spectroscopic and crystallographic investigations, normal coordinate analysis (NCA) was carried out using a modified Urey-Bradley force field. The vibrational frequencies of the complex with and without the NH-S hydrogen bonding as well as the corresponding internal coordinates were obtained. The good agreement found between the calculated and observed frequencies in the presence of the NH-S hydrogen bond, supports the reliability of the analysis. The stretching force constant of the NH-S hydrogen bond obtained from the calculation is 0.18 mdyne per A. The calculation shows that the N-H bond is weakened by formation of the NH-S hydrogen bond. The results are indicative of the existence of the NH-S hydrogen bond in the complex.