Influencing of inferior mediastinum and esophageal hiatus lymph node metastasis in Siewert type Ⅱ adenocarcinoma of esophagogastric junction invading submucosal different venous divisions of esophagogastric junction / 中华消化外科杂志

Objective:To investigate the influencing of inferior mediastinum and esophageal hiatus lymph node metastasis by submucosal different venous divisions of esophagogastric junction (EGJ) invaded in Siewert type Ⅱ adenocarcinoma of esophagogastric junction (AEG).Methods:The retrospective case-control study was conducted. The clinicopathological data of 547 patients with Siewert type Ⅱ AEG who were admitted to Shanxi Cancer Hospital from January 2018 to December 2021 were collected. There were 461 males and 86 females, aged 61 (range, 33?75)years. Observa-tion indicators: (1) lymph node metastasis rate in different groups; (2) influencing factors of inferior mediastinum lymph node metastasis in Siewert type Ⅱ AEG; (3) influencing factors of esophageal hiatus lymph node metastasis in Siewert type Ⅱ AEG. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was conducted using the t test. Measurement data with skewed distribution were represented as M(range) or M( Q1, Q3), and com-parison between groups was conducted using the Mann-Whitney U test. Count data were described as percentages or absolute numbers, and comparison between groups was conducted using the chi-square test. The univariate analysis was conducted using the corresponding statistical methods based on data type. The Logistic regression model was used for multivariate analysis. Results:(1) Lymph node metastasis rate in different groups. The lymph node metastasis rate in No. 1, 2, 3, 4sa, 4sb, 7, 8a, 9, 11,20, 108, 110 of the 547 patients was 17.37%(95/547), 6.76%(37/547), 46.44%(254/547), 1.65%(9/547), 1.10%(6/547), 23.22%(127/547), 4.39%(24/547), 3.11%(17/547), 3.47%(19/547), 3.66%(20/547), 0.55%(3/547), 4.20%(23/547), respectively. Of the 547 patients, there were 456 cases with proximal of AEG invading submucosal palisade venous of EGJ including 4 cases with inferior mediastinum lymph node metastasis and no case with media mediastinum or up media-stinum lymph node metastasis. There were 91 cases with proximal of AEG invading submucosal perforator venous of EGJ including 18 cases with inferior mediastinum lymph node metastasis, 3 cases with media mediastinum lymph node metastasis and no case with up mediastinum lymph node metastasis. (2) Influencing factors of inferior mediastinum lymph node metastasis in Siewert type Ⅱ AEG. Results of multivariate analysis showed that age, tumor invading submucosal perforator venous of EGJ and histological classification were independent influencing factors for inferior media-stinum lymph node metastasis of Siewert type Ⅱ AEG ( odds ratio=0.93, 23.33, 0.31, 95% confidence interval as 0.87?0.99, 4.18?130.28, 0.12?0.78, P<0.05). (3) Influencing factors of esophageal hiatus lymph node metastasis in Siewert type Ⅱ AEG. Tumor invading submucosal perforator venous of EGJ was an independent influencing factor for esophageal hiatus lymph node metastasis of Siewert type Ⅱ AEG ( odds ratio=14.95, 95% confidence interval as 2.46?90.76, P<0.05). Conclusion:Age, tumor invading submucosal perforator venous of EGJ and histological classification are independent influencing factors for inferior mediastinum lymph node metastasis of Siewert type Ⅱ AEG, and tumor invading submucosal perforator venous of EGJ is an independent influencing factor for esophageal hiatus lymph node metastasis.

Prenatal diagnosis for a fetus with 5p deletion syndrome / 中华医学遗传学杂志

OBJECTIVE@#To explore the genetic basis for a fetus with club foot detected upon mid-pregnancy ultrasonography.@*METHODS@#Amniotic fluid of the fetus and peripheral blood samples of its parents were collected and subjected to G-banding karyotype analysis and copy number variation sequencing (CNV-seq). The result was verified by fluorescence in situ hybridization (FISH).@*RESULTS@#The fetus and its parents all had a normal karyotype. CNV-seq analysis revealed that the fetus has harbored a 23.12 Mb on chromosome 5 and a 21.46 Mb duplication on chromosome 7. FISH assay has verified that its mother has carried a cryptic t(5;7)(p14.3;q33) translocation.@*CONCLUSION@#CNV-seq combined with FISH can effectively detect cryptic chromosome aberrations, and can help to reduce severe birth defects and provide a basis for prenatal genetic counseling.

Cytogenetic analysis of an amniotic sample with X chromosome abnormality signaled by non-invasive prenatal testing / 中华医学遗传学杂志

OBJECTIVE@#To determine the chromosomal karyotype of a fetus with copy number variation (CNV) of the X chromosome signaled by non-invasive prenatal testing (NIPT).@*METHODS@#NIPT was performed on the peripheral blood sample taken from the pregnant women. Amniotic fluid and cord blood samples were subjected to conventional G banded karyotyping, and were further analyzed by high-throughput sequencing for chromosome microdeletion/microduplication. The results were then verified by fluorescence in situ hybridization (FISH) on metaphase cells.@*RESULTS@#The NIPT test of pregnant women suggested low risk for 21-trisomy, 18-trisomy, and 13-trisomy, whilst indicated the number of chromosome X to be low. The G banded karyotype of the amniotic fluid and cord blood cells was 46,XX. The result of high-throughput sequencing chromosome microdeletion/microduplication detection was seq[hg19](X)× 1, (Y)× 2. FISH showed a clear red signal at each end of a whole chromosome, and a green signal on the other chromosome, with a karyotype of 46,X,ish idic(Y) (q11.23) (SRY++, DXZ1+). C banding showed that there is a dense and a slightly loose centromere at both ends of the Y chromosome, and the parachromatin region was missing. The karyotype of amniotic fluid and cord blood cells was finally determined to be 46,X, pus idic(Y) (q11.23).@*CONCLUSION@#For chromosome anomalies suggested by auxiliary report of NIPT, conventional karyotyping combined with high-throughput sequencing for chromosome microdeletion/microduplication should be adopted for the prevention and reduction of the rate of chromosome microdeletion/microduplication syndromes.

Genetic analysis of a fetus with partial 18p deletion / 中华医学遗传学杂志

OBJECTIVE@#To carry out prenatal diagnosis for a fetus with partial 18p deletion detected by non-invasive prenatal testing (NIPT).@*METHODS@#Peripheral blood and amniotic fluid samples of the pregnant woman and her husband were subjected to G-banded chromosomal karyotyping and more accurate chromosomal microarray analysis (CMA). The deletion sites were verified by fluorescence in situ hybridization (FISH) using centromeric probe Cep11 Aqua and telomeric probes Tel11q SO and Tel18 SG.@*RESULTS@#The karyotype of the fetus was determined as 46,XN,del(18)(p11.3). CMA has detected a 6.66 Mb deletion at 18p11.32-p11.31 (136 226-6 796 178). FISH confirmed the presence of a partial deletion at 18p. The mother was found to harbor the same deletion by chromosomal karyotyping as well as CMA analysis. No abnormality was found with the husband.@*CONCLUSION@#Although the fetus and its mother have both carried the same 18p deletion, no clinical manifestation was detected in the mother, which may be attributed to a low penetrance of the disorder. The fetus had died at 33 weeks of gestation with unknown cause.

Biosynthesis of 2,5-dimethylpyrazine from L-threonine by whole-cell biocatalyst of recombinant Escherichia coli / 生物工程学报

2,5-dimethylpyrazine (2,5-DMP) is of important economic value in food industry and pharmaceutical industry, and is now commonly produced by chemical synthesis. In this study, a recombinant Escherichia coli high-efficiently converting L-threonine to 2,5-DMP was constructed by combination of metabolic engineering and cofactor engineering. To do this, the effect of different threonine dehydrogenase (TDH) on 2,5-DMP production was investigated, and the results indicate that overexpression of EcTDH in E. coli BL21(DE3) was beneficial to construct a 2,5-DMP producer with highest 2,5-DMP production. The recombinant strain E. coli pRSFDuet-tdh(Ec) produced (438.3±23.7) mg/L of 2,5-DMP. Furthermore, the expression mode of NADH oxidase (NoxE) from Lactococcus cremoris was optimized, and fusion expression of EcTDH and LcNoxE led to balance the intracellular NADH/NAD⁺ level and to maintain the high survival rate of cells, thus further increasing 2,5-DMP production. Finally, the accumulation of by-products was significantly decreased because of disruption of shunt metabolic pathway, thereby increasing 2,5-DMP production and the conversion ratio of L-threonine. Combination of these genetic modifications resulted in an engineered E. coli Δkbl ΔtynA ΔtdcB ΔilvA pRSFDuet-tdhEcnoxELc-PsstT (EcΔkΔAΔBΔA/TDH(Ec)NoxE(Lc)-PSstT) capable of producing (1 095.7±81.3) mg/L 2,5-DMP with conversion ratio of L-threonine of 76% and a yield of 2,5-DMP of 28.8% in 50 mL transformation system with 5 g/L L-threonine at 37 °C and 200 r/min for 24 h. Therefore, this study provides a recombinant E. coli with high-efficiently catalyzing L-threonine to biosynthesize 2,5-DMP, which can be potentially used in biosynthesis of 2,5-DMP in industry.

A Comparative Study of Target Reconstruction of Ultra-High-Resolution CT for Patients with Corona-Virus Disease 2019 (COVID-19)

BackgroundThe corona-virus disease 2019 (COVID-19) pandemic has caused a serious public health risk. Compared with conventional high-resolution CT (C-HRCT, matrix 512), ultra-high resolution CT (U-HRCT, matrix 1024) can increase the effective pixel per unit volume by about 4 times. Our study is to evaluate the value of target reconstruction of U-HRCT in the accurate diagnosis of COVID-19. MethodsA total of 13 COVID-19 cases, 44 cases of other pneumonias, and 6 cases of ground-glass nodules were retrospectively analyzed. The data were categorized into groups A (C-HRCT) and B (U-HRCT), following which iDose4-3 and iDose4-5 were used for target reconstruction, respectively. CT value, noise, and signal-to-noise ratio (SNR) in different reconstructed images were measured. Two senior imaging doctors scored the image quality and the structure of the lesions on a 5-point scale. Chi-square test, variance analysis, and binarylogistic regression analysis were used for statistical analysis. ResultsU-HRCT image can reduce noise and improve SNR with an increase of the iterative reconstruction level. The SNR of U-HRCT image was lower than that of the C-HRCT image of the same iDose4level, and the noise of U-HRCT was higher than that of C-HRCT image; the difference was statistically significant (P< 0.05). Logistic regression analysis showed thatperipleural distribution, thickening of blood vessels and interlobular septum, and crazy-paving pattern were independent indictors of the COVID-19 on U-HRCT. U-HRCT was superior to C-HRCT in showing the blood vessels, bronchial wall, and interlobular septum in the ground-glass opacities; the difference was statistically significant (P < 0.05). ConclusionsPeripleural distribution, thickening of blood vessels and interlobular septum, and crazy-paving pattern on U-HRCT are favorable signs for COVID-19. U-HRCT is superior to C-HRCT in displaying the blood vessels, bronchial walls, and interlobular septum for evaluating COVID-19.

Primary desmoplastic small round cell tumor of the tibia: PET/CT and MRI presentation of a rare case and review of the literature.

Desmoplastic small round cell tumor (DSRCT) was a soft tissue sarcoma of mesenchymal cell origin that typically exhibited a multi-phenotypic pattern of immunohistochemical staining. DSRCT mainly presented in the abdomen sites and primary occurrence in bone was exceptional. In this study, we reported a new case of primary DSRCT of the tibia in a 33-year-old man who had intermittent pain in the left tibia. Radiographs showed transparent lesions in the left upper tibial. MRI revealed a lobular, lytic and ill-identified lesion with adjacent soft tissues swelling of the upper left tibia. CT confirmed notable destruction and wormlike osteolysis of the bone cortex. PET/CT showed a mass of high uptakes, indicating the malignance. He accepted surgical resection with followed multi-agent chemotherapy, containing vincristine, doxorubicin, ifosfamide and etoposide. Clinically and radiologically, the patient did not show any evidence of recurrence or metastasis at 30 months after surgical treatment. Primary osteogenic DSRCT was extremely rare and should be considered in differential diagnosis of bone tumors.

Consensus on emergency surgery and infection prevention and control for severe trauma patients with 2019 novel coronavirus pneumonia / 中华创伤杂志

A novel coronavirus pneumonia (NCP) epidemic has occurred in Wuhan, Hubei Province since December 2019, caused by a novel coronavirus (2019-nCoV) never been seen previously in human. China has imposed the strictest quarantine and closed management measures in history to control the spreading of the disease. However, severe trauma can still occur in the NCP patients. In order to standardize the emergency treatment and the infection prevention and control of severe trauma patients with hidden infection, suspected or confirmed infection of 2019-nCoV, Trauma Surgery Branch of Chinese Medical Doctors' Association organized this expert consensus. The consensus illustrated the classification of the NCP patients, severe trauma patients in need of emergency surgery, emergency surgery type, hierarchical protection for medical personnel and treatment places. Meanwhile, the consensus standardized the screening, injury severity evaluation, emergency surgical treatment strategy and postoperative management strategy of severe trauma patients during the epidemic period of NCP, providing a basis for the clinical treatment of such kind of patients.

Research progress in clinical value of multidetector computed tomography in evaluating blunt splenic injury / 中华创伤杂志

The spleen is the most vulnerable abdominal parenchymal organ. Accurate detection, diagnosis and evaluation of the severity of splenic parenchyma and vascular injury by radiologists is crucial for selection of clinical treatment strategies. Multidetector computed tomography (MDCT) is the first choice for hemodynamically stable patients. The American Association for Surgery of Trauma-Organ Injury Scale (AAST-OIS) scale is the most widely used tool to guide clinical treatment based on spleen parenchymal injury. The authors conduct a review from aspects of MDCT diagnosis, AAST-OIS classification and treatment, prognosis evaluation and imaging follow-up of patients with blunt splenic injury, in order to provide more help for radiologists and trauma surgeons.

Consensus on emergency surgery and infection prevention and control for severe trauma patients during epidemic of corona virus disease 2019 / 中华创伤杂志

Epidemic of corona virus disease 2019 (COVID-19) has occurred in Wuhan, Hubei Province since December 2019, caused by a novel coronavirus (2019-nCoV) never been seen previously in human. China has imposed the strictest quarantine and closed management measures in history to control the spreading of the disease. However, severe trauma can still occur in the COVID-19 patients. In order to standardize the emergency treatment and the infection prevention and control of severe trauma patients with hidden infection, suspected or confirmed infection of 2019-nCoV, Trauma Surgery Branch of Chinese Medical Doctors' Association organized this expert consensus. The consensus illustrated the classification of the COVID-19 patients, severe trauma patients in need of emergency surgery, emergency surgery type, hierarchical protection for medical personnel and treatment places. Meanwhile, the consensus standardized the screening, injury severity evaluation, emergency surgical treatment strategy and postoperative management strategy of severe trauma patients during the epidemic period of COVID-19, providing a basis for the clinical treatment of such kind of patients.

Evaluation of the value of neck extension in chest CT scanning / 中华放射医学与防护杂志

Objective@#To explore the possibility that the neck extension in chest CT scanning would make thyroid move upward and reduce thyroid radiation exposure.@*Methods@#The images of 1 994 patients who underwent chest CT examination in Beijing Chaoyang Hospital from March to June in 2017 were compared and analyzed retrospectively. According to different cervical positions, patients were divided into extension group and routine group with 997 cases in each group. In the extension group, the head and neck bended back to the maxillary top position while in the regular group with normal position. The length of thyroid glands exposed to the scanning range and the number of cases of all glands moved out of the scanning range were observed with the first rib head as the baseline counting mark. The differences in exposed length of thyroid gland in primary radiation area between the two groups were compared.@*Results@#The length of exposed thyroid gland by primary radiation in the extension group (4.69±5.68) mm was significantly shorter (U=91 073.5, P<0.05) than that in the routine group (17.16±6.68) mm. In addition, the number of thyroid glands out of scanning range completely in the extension group (n=519, with ratio of 52.1%) was significantly more (U=594.8, P<0.05) than those in the routine group (n=32, with ratio of 3.2%).@*Conclusions@#During chest CT scan, the length of thyroid gland in the scanning field can be shortened with neck backbend position and the radioation protection for thyroid gland can be effectively improved.

Evaluation of the value of neck extension in chest CT scanning / 中华放射医学与防护杂志

Objective To explore the possibility that the neck extension in chest CT scanning would make thyroid move upward and reduce thyroid radiation exposure.Methods The images of 1 994 patients who underwent chest CT examination in Beijing Chaoyang Hospital from March to June in 2017 were compared and analyzed retrospectively.According to different cervical positions,patients were divided into extension group and routine group with 997 cases in each group.In the extension group,the head and neck bended back to the maxillary top position while in the regular group with normal position.The length of thyroid glands exposed to the scanning range and the number of cases of all glands moved out of the scanning range were observed with the first rib head as the baseline counting mark.The differences in exposed length of thyroid gland in primary radiation area between the two groups were compared.Results The length of exposed thyroid gland by primary radiation in the extension group (4.69± 5.68) mm was significantly shorter (U=91 073.5,P＜0.05) than that in the routine group (17.16±6.68) mm.In addition,the number of thyroid glands out of scanning range completely in the extension group (n =519,with ratio of 52.1％) was significantly more (U=594.8,P＜0.05) than those in the routine group (n=32,with ratio of 3.2％).Conclusions During chest CT scan,the length of thyroid gland in the scanning field can be shortened with neck backbend position and the radioation protection for thyroid gland can be effectively improved.

The value of signal intensity of portal vein at hepatobiliary phase on gadoxetic acid liver MRI enhancement for accessing the liver function / 中华放射学杂志

Objective To investigate the value of the signal intensity of portal vein at hepatobiliary phase on gadoxetic acid liver enhancement imaging for accessing the liver function. Methods Ninety five subjects who underwent gadoxetic acid enhanced liver MR imaging due to suspicion of liver diseases between January 2015 and June 2016 at the First Hospital of Soochow University were retrospectively analyzed. Patients were classified into 4 groups based on their liver function: cirrhosis patients with Child-Pugh class A(n=50),B(n=19),C(n=6)and control group(n=20).All the patients had underwent the abdominal non-enhanced and gadoxetic acid enhanced MR imaging. The signal intensity (SI) of the portal vein at non-enhanced phase and hepatobiliary phase(delayed 20min)were recorded.The ratio of the portal vein to spleen were calculated.The nonparametric Kruskal-Wallis test was used to compare the differences in the SI of portal vein at non-enhanced and the ratio of portal vein to spleen at hepatobiliary phase among the four groups.Multiple regression analysis was applied to analyze the correlated predicting factors of the ratio of the portal vein to spleen at hepatobiliary phase. Results At non-enhanced phase, the SI ratio of portal vein had no significant difference(P>0.05).The ratio of the portal vein to spleen at hepatobiliary was significantly different (P<0.05). The ratio of the portal vein to spleen at hepatobiliary constantly and significantly decreased as the severity of liver dysfunction increased. The serum levels of albumin and platelet count were independent predictors of the ratio of the portal vein to spleen at hepatobiliary phase(P=0.002 and 0.007).Conclusions The ratio of the portal vein to spleen at hepatobiliary phase on gadoxetic acid enhanced MR imaging indicates the severity of liver dysfunction.It might be used as a tool to assess the liver function.

Relationship between the mutations in precore/core region of hepatitis B virus gene and the postoperative survival in hepatocellular carcinoma / 中华实验和临床病毒学杂志

Objective@#To investigate the relationship between the mutations in precore/core (preC/C) region of hepatitis B virus (HBV) gene and the postoperative survival in patients with hepatocellular carcinoma.@*Methods@#A total of 81 cases in HBV associated hepatocellular carcinoma (HBV-HCC) patients with cancer tissue genomic DNA were extracted. The preC/C region of HBV was amplified and sequenced, and survival-associated HBV mutations were identified according to the NCBI database. The relationships between the mutations in the preC/C region and HCC survival was analyzed with the Kaplan-Meier method and the Cox proportional hazards model. Eleven mutational sites were identified as statistically significant independent predictors of HBV-HCC postoperative survival.@*Results@#The portal vein thrombosis, tumor TNM classification and size were identified as statistically significant independent predictors of survival in HBV-HCC patients. In the research, we found that seven mutational sites in preC/C region of HBV were associated with independent risk factors for postoperative survival in patients of HBV-HCC. The following five mutational sites were identified as statistically significant independent predictors of HBV-HCC survival: 1915, 2134, 2176, 2221, 2260. The mutational site of 1979 and 2245 were identified for the association with survival at a borderline significance level.@*Conclusions@#The portal vein thrombosis, tumor TNM classification, size and seven mutational sites in the PreC/C region were identified as independent predictors of postoperative survival in HCC patients.

Evaluation of neovascularization patterns in an orthotopic rat glioma model with dynamic contrast-enhanced MRI.

Background Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) has been proved useful in evaluating glioma angiogenesis, but the utility in evaluating neovascularization patterns has not been reported. Purpose To evaluate in vivo real-time glioma neovascularization patterns by measuring glioma perfusion quantitatively using DCE-MRI. Material and Methods Thirty Sprague-Dawley rats were used to establish C6 orthotopic glioma model and underwent MRI and pathology detections. As MRI and pathology were performed at six time points (i.e. 4, 8, 12, 16, 20, and 24 days) post transplantation, neovascularization patterns were evaluated via DCE-MRI. Results Four neovascularization patterns were observed in glioma tissues. Sprout angiogenesis and intussusceptive microvascular growth located inside tumor, while vascular co-option and vascular mimicry were found in the tumor margin and necrotic area, respectively. Sprout angiogenesis and intussusceptive microvascular growth increased with Ktrans, Kep, and Vp inside tumor tissue. In addition, Kep and Vp were positively correlated with sprout angiogenesis and intussusceptive microvascular growth. Vascular co-option was decreased at 12 and 16 days post transplantation and correlated negatively with Ktrans and Kep detected in the glioma margin, respectively. Changes of vascular mimicry showed no significant statistical difference at the six time points. Conclusion Our results indicate that DCE-MRI can evaluate neovascularization patterns in a glioma model. Furthermore, DCE-MRI could be an imaging biomarker for guidance of antiangiogenic treatments in humans in the future.

Research on the Relationship between Hospital Service Culture and Employee Satisfaction / 现代医院

Objective To explore the relationship between hospital service culture model and the satisfaction degree of employees.Methods To build a hospital service culture model through qualitative and quantitative research and make it into the hospital service culture questionnaire and use the satisfaction scale to investigate and analyze the sample.Results The hospital service culture model conforms to the standard modeling, which consists of a sense of belonging, sense of achievement, ability development, self-reconciliation, humanization, effective communication, effective performances and win-win.These eight factors have significant positive correlations with the employee satisfaction (P<0.01).Regression analysis showed that the 8 factors on employee satisfaction prediction coefficient was between 0.062~0.241 (P<0.05 or P<0.01, P<0.001).Conclusion The sense of belonging, sense of achievement, development ability, self-congruity, humanity, effective communication, efficiency and win-win in hospital service culture have become positive predictors in different degree and range of employee satisfaction.

Structural bone grafting combined with locking compression plate for the treatment ofcomminuted femoral calcar intertrochanteric fractures / 重庆医学

Objective To evaluate the clinical effects of proximal femoral locking compression plate(PFLCP) combined with iliac structural bone grafting for the treatment of comminuted femoral calcar intertrochanteric fractures.Methods A total of 45 patients with comminuted femoral calcar intertrochanteric fractures were treated with PFLCP combined with iliac structural bone grafting.The hip function was evaluated by Harris hip score system.Results All patients were followed up from 8 to 34 months(average 16 months) in the outpatient department.All cases healed without complications of non-union,reduction lost,varus deformity of the hip,losening,breakage or cut-out of the internal fixation,femoral head necrosis and shortening of the limbs.According to Harris hip score,there were 29 excellent cases,11 good cases,4 fair cases and 1 poor case,with excellent and good rate of 88.9%.Conclusion Reconstruction of the comminuted or defected femoral calcar with the iliac structural bone grafting can enhance the internal fixation and promote the bone healing.Combined with PFLCP fixation it is an effective method for treatment of comminuted femoral calcar intertrochanteric fractures.

Silk fibroin/nano-hydroxyapatite composite material as a lumbar interbody implant: a study on initial segmental stability / 中国组织工程研究

BACKGROUND: With the development of nanotechnology, silk fibroin/nano-hydroxyapatite composite materials used for tissue repair have been reported; however, there are few reports on its use in spinal stability.OBJECTIVE: To explore the feasibility of silk fibroin/nano-hydroxyapatite composite materials for the initial segmental stability of the reconstructed spine.METHODS: Thirty-six New Zealand rabbits were randomly divided into three groups, and the L4/5 nucleus pulposus was removed in all the animals. Autologous bone group was implanted with autologous bone, experimental group implanted intervertebrally with silk fibroin/nano-hydroxyapatite composite material, and control group implanted with hydroxyapatite.At 12 weeks after implantation, lumbar interbody fusion was observed using X-ray, the spinal stability of the fusion segments was measured by biomechanical test, and histologically, bone graft fusion and material degradation at the surgical site were observed.RESULTS AND CONCLUSION: (1) X-ray observation: In the autologous bone group, the experimental group and the control group, there were respectively 11, 7, 2 rabbits meeting the standard of fusion. (2) Biomechanical test: The spinal activity during flexion-extension was significantly lower in the experimental group than the autogenous bone group and control group (P < 0.05). (3) Histological observation: Bony union was found at the junction between the iliac bone and surrounding tissues in the autologous bone group, and a large number of bone cells and fibroblasts were found around the new bone, while woven bone was found inside. The material was partially degraded in the experimental group,fibrous tissues were visible in the surrounding tissue, new woven bone was found inside, and pit cells and bone cells were scattered. Blood vessel growth around the material was visible in the control group, and a large number of macrophages were found inside the material. To conclude, the silk fibroin/nano-hydroxyapatite composite material has good biocompatibility and mechanical properties, which could rebuild the initial segmental stability in the rabbit spine in the short time.

Efficacy of Lamiophlomisrotata Dripping Pill combined with intra-articular injection of medical ozone in treatment of knee osteoarthritis / 药物评价研究

Objective To discuss the efficacy of Lamiophlomisrotata Dripping Pill combined with intra-articular injection of medical ozone in the treatment of knee osteoarthritis.Methods Eighty patients with knee osteoarthritis were selected,the control group (39 cases) were administered Lamiophlomisrotata Dripping Pill,the observation group (41 cases) were administered Lamiophlomisrotata Dripping Pill combined with intra-articular injection of medical ozone.The efficacy of Lamiophlomisrotata Dripping Pill combined with intra-articular injection of medical ozone in the treatment of knee osteoarthritis were evaluated by efficacy,knee function,and inflammatory factor.Results After treatment,the effective rate of the observation group was higher than that of the control group (P ＜ 0.05).In the observation group,there were 38 cases of patients who felt pain,tenderness,and swelling symptom relief.There were 28 cases in the control group.After treatment,the scores of pain,activity,walking ability,and KSS in the observation group were higher than that of the control group (P ＜ 0.05).There was no statistical significance on the stability between two groups.Before treatment,there were no statistical significance on the IL-6,IL-8,and TNF-α.After treatment,the IL-6,IL-8,and TNF-αt were increased in two groups (P ＜ 0.05).And these indexes in the observation group were higher than that of the control group (P ＜ 0.05).Conclusion In summary,Lamiophlomisrotata Dripping Pill combined with medical ozone had good effect on the knee osteoarthritis.It could release the pain,improve knee function and anti-inflammatory.It was worthy of clinical use.