Using a 3D Navigation Template to Increase the Accuracy of Thoracic Pedicle Screws in Patients with Scoliosis.

This study compares the accuracy and safety of pedicle screw placement using a 3D navigation template with the free-hand fluoroscopy technique in scoliotic patients. Fifteen scoliotic patients were recruited and divided into a template group (eight cases) and a free-hand group (seven cases). All patients received posterior corrective surgeries, and the pedicle screw was placed using a 3D navigation template or a free-hand technique. After surgery, the positions of the pedicle screws were evaluated using CT. A total of 264 pedicle screws were implanted in 15 patients. Both the two techniques were found to achieve satisfactory safety of screw insertion in scoliotic patients (89.9% vs. 90.5%). In the thoracic region, the 3D navigation template was able to achieve a much higher accuracy of screw than the free-hand technique (75.3% vs. 60.4%). In the two groups, the accuracy rates on the convex side were slightly higher than on the concave side, while no significance was seen. In terms of rotational vertebrae, no significant differences were seen in Grades I or II vertebrae between the two groups. In conclusion, the 3D navigation template technique significantly increased the accuracy of thoracic pedicle screw placement, which held great potential for extensively clinical application.

p53 inhibits CTR1-mediated cisplatin absorption by suppressing SP1 nuclear translocation in osteosarcoma.

Background: Osteosarcoma (OS) is a malignant bone tumor mainly affecting children and young adolescents. Cisplatin is a first-line chemotherapy drug for OS, however, drug resistance severely limits the survival of OS. Nevertheless, cellular factors in cisplatin resistance for OS remain obscure. In this study, the function and potential mechanism of p53 in cisplatin absorption were explored in OS cells. Methods: The CRISPR-Cas9 gene editing technology was performed to obtain p53 gene knock-out U2OS cells. The p53 over-expression 143B cell line was established by lentivirus-mediated virus infection. Moreover, the functions of p53 and CTR1 in cisplatin absorption were assessed by inductively coupled plasma mass spectrometry (ICP-MS) through CTR1 over-expression and knock-down. Further, the DNA binding activity of SP1 on CTR1 gene promoter was determined by dual-luciferase assay and chromatin immunoprecipitation (ChIP) assay. The functional regulation of p53 on SP1 was studied by nucleocytoplasmic separation assay and electrophoretic mobility shift assay (EMSA). The interaction between p53 and SP1 was verified by Co-Immunoprecipitation assay. Results: Under cisplatin treatment, p53 knock-out promoted CTR1 expression and cisplatin uptake, while p53 overexpression inhibited CTR1 expression and cisplatin uptake. Moreover, p53 regulated CTR1 level not by binding to CTR1 promoter directly but by suppressing the nuclear translocation of transcription factor specificity protein 1 (SP1). It was verified that SP1 is directly bound with CTR1 promoter. SP1 overexpression stimulated CTR1 expression, and SP1 knock-down attenuated CTR1 expression. Conclusion: The p53 might function as a negative regulator in CTR1 mediated cisplatin absorption, and the p53-SP1-CTR1 axis is a target for cisplatin resistance.

The Treatment of Oesophageal Perforation after Anterior Cervical Spinal Surgery.

Oesophageal perforation is a rare complication occurring during or after cervical spine surgery, and the risk factors are not well understood. This study presents a case of a 25-year-old man with oesophageal perforation after anterior cervical spine surgery. It is suggested that four factors (anatomical structure, mechanism of trauma, implant dislodgment, and the operation) could induce postoperative oesophageal perforation after cervical spine surgery performed using the anterior surgical approach. A comprehensive understanding and early management of this complication are necessary for successful therapy.

Traditional chinese medicine for the treatment of chronic prostatitis in China: a systematic review and meta-analysis.

OBJECTIVE: To systematically evaluate the effectiveness of Chinese herbal medicine for treating chronic prostatitis (CPT) in China. DESIGN: Electronic medical database from China National Knowledge Infrastructure (CNKI) was searched, language is Chinese; date is from January 1, 1994 to December 31, 2003. A total of 108 trials were found, and all studies with words like "randomization" or "quasi-randomization" in their abstracts were included, whether they used blinding or not. Nineteen theses that met the entry criteria were downloaded and fully printed. Four groups were divided: Chinese herbs orally treated group (based on syndrome differentiation), Chinese herbs externally treated group, Chinese herbs orally and externally treated group, and integrated Western with Chinese herbs treated group. RESULTS: All 19 articles that met the entry criteria were clinical trial studies with low quality (Jadad Score <3). The results showed that Traditional Chinese Medicine (TCM) may benefit the patients who had CPT. However, from the results of the funnel plots analysis of all four groups of clinical trials that met the inclusion criteria in this systematic review are distant asymmetrical and irregular plots, which indicate that a positive publication bias may exist. There was no obvious evidence indicating that the efficacy of the therapy in the treated groups using TCM was superior to that of the control group (Western medicine treatment group). CONCLUSIONS: All of the four groups in the clinical trials have not provided evidence of evidence-based medicine (EBM) A class (including 1a, 1b, 1c level), failed to prove that the TCM may have beneficial effects for patients with CPT, because of low quality in all the trials and a positive publication bias. Therefore, in light of some positive outcomes, a good design of multicentered, randomized, parallel-controlled and blinding trials is needed in order to make further studies, and deserve further examination for the treatment of CPT with TCM.

Effects of chai hu (radix burpleuri) containing formulation on plasma beta-endorphin, epinephrine and dopamine on patients.

Chai Hu (Radix Burpleuri), a major ingredient in many traditional Chinese medicine formulas, such as Xiao Yan Wan, is used in the treatment of liver stagnation and spleen deficiency syndrome (LSSDS). The objectives of this study were to examine the effects of Xiao Yao Wan containing Chai Hu on the changes of plasma indices in patients with LSSDS. Fifty-eight cases of LSSDS were randomly divided into two groups: 41 cases in the experimental group were treated with Xiao Yao Wan containing Chai Hu and 17 cases in the control group were treated with Zhi Bai Di Huang Wan for one consecutive month in a single blind design. Before and after treatment, high performance liquid chromatography (HPLC) was applied to determine the changes of plasma norepinephrine (NE), epinephrine (E) and dopamine (DA). Radioimmunoassay was performed to measure the amount of plasma beta-endorphin (beta-EP), adrenocorticotropin hormone (ACTH), estradiol (E2) and testosterone (T), and laser nephelometry was also conducted to measure plasma immunoglobulin A (Ig A) and G (Ig G). Compared to baseline levels, plasma beta-EP was significantly increased (p < 0.01), while E and DA were markedly decreased (p < 0.01) after the administration of Xiao Yao Wan in the experimental group. The other indices did not change. This is the first evidence showing that the effect of Xiao Yao Wan containing Chai Hu on the treatment of patients with LSSDS may be through enhancing plasma beta-EP and decreasing E and DA release. We conclude that Xiao Yao Wan containing Chai Hu regulates nervous and endocrine systems and contributes to the improvement of the clinical status of patients with LSSDS.

A linear matrix inequality (LMI) approach to robust H/sub 2/ sampled-data control for linear uncertain systems.

In this paper, we consider the H/sub 2/ sampled-data control for uncertain linear systems by the impulse response interpretation of the H/sub 2/ norm. Two H/sub 2/ measures for sampled-data systems are considered. The robust optimal control procedures subject to these two H/sub 2/ criteria are proposed. The development is primarily concerned with a multirate treatment in which a periodic time-varying robust optimal control for uncertain linear systems is presented. To facilitate multirate control design, a new result of stability of hybrid system is established. Moreover, the single-rate case is also obtained as a special case. The sampling period is explicitly involved in the result which is superior to traditional methods. The solution procedures proposed in this paper are formulated as an optimization problem subject to linear matrix inequalities. Finally, we present a numerical example to demonstrate the proposed techniques.