ObjectiveTo compare the biomechanical differences between the kidney-shaped nano-hydroxyapatite/polyamide 66 (n-HA/PA66) Cage and the bullet-shaped n-HA/PA66 Cage. MethodsL2-L5 spinal specimens were selected from 10 adult male pigs. L2, L3 and L4, L5 served as a motor unit respectively, 20 motor units altogether. They were divided into 4 groups (n=5):no treatment was given as control group (group A); nucleus pulposus resection was performed (group B); bullet-shaped Cage (group C), and kidney-shaped Cage (group D) were used in transforaminal lumbar interbody fusion (TLIF) through left intervertebral foramen and supplemented by posterior pedicle screw fixation. The intervertebral height (IH) and the position of Cages were observed on the X-ray films. The range of motion (ROM) was measured. ResultsThere was no significant difference in the preoperative IH among 4 groups (F=0.166, P=0.917). No significant change was found in IH between at pre- and post-operation in group B (P>0.05); it increased after operation in groups C and D, but difference was not statistically significant (P>0.05). There was no significant difference in the postoperative IH among groups B, C, and D (P>0.05). The distance from Cage to the left margin was (3.06±0.51) mm in group C (close to the left) and (5.68±0.69) mm in group D (close to the middle), showing significant difference (t=6.787, P=0.000). The ROM in all directions were significantly lower in groups C and D than in groups A and B (P<0.05), and in group A than in group B (P<0.05). The right bending and compression ROM of group C were significantly higher than those of group D (P<0.05), but no statistically significant difference was found in the other direction ROM (P>0.05). ConclusionThe bullet-shaped and kidney-shaped Cages have similar results in restoring IH and maintaining the stability of the spine assisted by internal fixation. Kidney-shaped Cage is more stable than bullet-shaped Cage in the axial compression and the bending load opposite implant, it can be placed in the middle and back of the vertebral body more ideally.
ObjectiveTo investigate the effectiveness of distraction therapy assisted by arthroscope in the treatment of ankle traumatic osteoarthritis. MethodsBetween October 2013 and October 2014, 13 patients with ankle traumatic osteoarthritis were treated, including 8 males and 5 females with an age range of 44-63 years (mean, 55.2 years). The left ankle and the right ankle were involved in 4 and 9 cases respectively. The disease duration was 1.5-10.0 years (median, 5 years). The American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hind foot scale score was 51.00±7.09; the short-form 36 health survey scale (SF-36) score was 40.82±4.62. According to Scranton grade system, 9 cases were rated as grade II and 4 cases as grade III. First, ankle hyperplasia osteophytes was removed under arthroscope, then Ilizarov apparatus was used to maintain distraction of 5-10 mm ankle space for 3 months. ResultsOne case had postoperative pin tract infection after removing the external fixation, and infection was controlled by dressing treatment; no related complications occurred in the other patients. All patients got follow-up of 12-18 months (mean, 14.7 months). Patients achieved disappearance of ankle swelling, pain relief, and were able to walk after rehabilitation. The ankle activity was obviously improved. At last follow-up, AOFAS ankel-hind foot scale score and SF-36 score were significantly increased to 85.23±6.41 and 56.29±6.20 respectively (t=20.756, P=0.025; t=11.647, P=0.018). According to AOFAS scores, the results were excellent in 4 cases, good in 8 cases, and fair in 1 case; the excellent and good rate was 92.3%. Postoperative X-ray film showed normal ankle position and alignment, osteophytes at the edges of the tibia and talus, articular surface sclerosis, normal joint space, and no joint swelling. ConclusionDistraction therapy assisted by arthroscope is an effective method for treating ankle traumatic osteoarthritis.
ObjectiveTo summarize the research progress of femoral neck system (FNS) in the treatment of femoral neck fracture in young and middle-aged patients. Methods The literature on FNS at home and abroad in recent years was extensively reviewed, and the results of mechanical and clinical studies on FNS were summarized based on clinical experience. Results FNS has good mechanical stability, which can reduce complications such as femoral neck shortening, internal fixation failure, and varus caused by mechanical instability. At present, FNS is mainly selected for comparison with cannulated compression screws and dynamic hip screws in clinical research. The results show that FNS has the advantages of minimally invasive, short operation time, less intraoperative fluoroscopy, earlier postoperative weight-bearing and fracture healing, and better hip function recovery. Conclusion As a new internal fixator, FNS has achieved satisfactory results in the current research. FNS has good mechanical advantages, which is beneficial to fracture healing and the recovery of hip joint function after operation. However, whether FNS can reduce the incidence of nonunion and osteonecrosis of the femoral head remains to be further clarified.
Transcription factor p63 originates from p53 protein family and is encoded by TP63 gene. TP63 gene contains two different promoters encoding two proteins, TAp63 and ΔNp63, which can be cleaved to produce p63α, p63β, p63δ and some other subtypes. ΔNp63α is one of the promoters of TP63 gene and acts as a core regulatory factor to regulate gene expression at epigenetic and transcriptional levels. Recent research shows that ΔNp63α abnormal expression can lead to the occurrence of various malignant tumors and reduce the sensitivity of malignant tumors to radiotherapy and chemotherapy. Therefore, ΔNp63α can be used as a diagnostic marker and therapeutic target for malignant tumors. This article reviews the latest research progress of ΔNp63α in the mechanism and drug resistance in malignant tumors.
MicroRNA-92a (miR-92a) is an evolutionarily highly conserved pathogenic microRNA that is a member of the microRNA-17-92 gene cluster and is involved in the regulation of biological activities such as cell proliferation, apoptosis and differentiation. Recent studies have revealed that disorders of miR-92a expression are associated with disease development and exert pathogenic effects mainly through the regulation of target genes or target proteins. The current research related to miR-92a is mainly focused on malignant tumors, and its high expression has been found to be associated with cancer cell malignancy and reduced sensitivity of tumors to radiotherapy. miR-92a targeting target genes or target proteins to cause disease and its relationship with radiotherapy has been a hot research topic in recent years. Based on this, This article reviews the latest research on miR-92a target gene or target protein pathogenesis and its impact on chemotherapy in order to provide targets for clinical disease treatment.
Neoadjuvant chemoradiotherapy or chemotherapy combined with surgery for locally advanced esophageal cancer has become the standard treatment, and despite the survival benefit, most patients still experience postoperative recurrence and distant metastasis. Immune checkpoint inhibitors play an anti-tumor role by activating T cells, and immunotherapy has become one of the important strategies for first-line and second-line treatment of advanced esophageal cancer with the continuous evolution of immunotherapy models. Regarding neoadjuvant immunotherapy for esophageal cancer, a large number of studies are being carried out and explored, which are expected to inject new vitality into neoadjuvant therapy for esophageal cancer. This article reviews the current clinical studies on neoadjuvant immunotherapy for esophageal cancer.
The present study is aimed to investigate the early clinical effects of nano-hydroxyapatite/polyamide 66 intervertebral fusion cage (n-HA/PA66 cage) for the treatment of lumbar degenerative diseases. We selected 27 patients with lumbar degenerative diseases who were managed by posterior decompression or reset operation combined with n-HA/PA66 cage intervertebral fusion and internal fixation from August 2010 to January 2012. The oswestry disability index (ODI), low back and leg pain visual analogue score (VAS), and intervertebral height (IH) were evaluated at preoperation, 1 week postoperation and the last follow-up period, respectively. Intervertebral bony fusion was evaluated at the last follow-up time. The patients were followed up for 12-24 months (averaged 19 months). The ODI, VAS and IH were significantly improved at 1 week postoperation and the last follow-up time compared with those at preoperative period (P<0.05). But there was no significant difference between 1 week postoperative and the last follow-up time (P<0.05). Brantigan's standard was used to evaluate fusion at the last follow-up time. There were 19 patients with grade 5 fusion, 8 with grade 4 fusion, with a fusion rate of 100%, and none with grade 1-3 fusions. There was no cage translocation and internal fixation breakage. These results suggested that n-HA/PA66 cage was an ideal biological material in the posterior lumbar interbody fusion and internal fixation operation for treatment of lumbar degenerative diseases. It can effectively maintain the intervertebral height and keep a high rate of bony fusion. The early clinical effect has been satisfactory.
ObjectiveTo observe the pathological changes in heart and lung tissues in rats with pulmonary hypertension induced by monocrotaline. MethodsTwenty-four male Sprague-Dawley rats were randomly and equally divided into an experimental group and a control group. The rats in the experimental group were intraperitoneally injected with monocrotaline to induce pulmonary hypertension, and the rats in the control group were treated with saline. All rats were fed for 3 weeks, and the general situation were observed. Then the rats were sacrificed for measurement of mean pulmonary artery pressure (mPAP), right ventricular hypertrophy index [RV/(LV+S)], changes of myocardial cells and lung vascular, calculated density of middle membrane smooth muscle cells (SMC) in medium/small pulmonary arteries accompanied with bronchi and alveoli, media thickness of pulmonary artery (PAMT), the percentage of wall thickness with outer diameter (WT%), the percentage of wall area with total area (WA%), the average diameter of myocardial cells (AD), and myocardial nuclei density (MND). ResultsCompared with the control group, the condition of rats in the experimental group were getting worse obviously.mPAP and RV/(LV+S) were both increased (both P < 0.05). The observation by light microscope revealed that obvious myocardial hypertrophy and structure disturbances, severe luminal stenosis of medium/small pulmonary arteries, medial thickening, infiltration of inflammatory cell in tissue space, proliferation of unorganized collagen fibers in the experimental group. The observation by electronic microscope showed proliferation of endothelial cell with irregular nuclei, increased organelles and vacuoles in the experimental group. The differences in SMC, PAMT, WT%, WA%, AD, and MND were significant between two groups (all P < 0.05). ConclusionsThe monocrotaline can induced pulmonary hypertension and right ventricular hypertrophy. The mechanism may be related to severe stenosis or occlusion of the vessel lumen caused by plexiform proliferation of endothelial cells, proliferation of smooth muscle cells and collagen fibers, compensatory hypertrophy and hyperplasia of myocardial cells.
ObjectiveTo systematically review the safety and efficacy of greenlight laser photoselective vaporization (PV) for nonmuscle-invasive bladder tumors (NMIBTs). MethodsSuch databases as PubMed, EMbase, The Cochrane Library (Issue 2, 2016), CNKI, CBM, VIP and WanFang Data were systemically searched from inception to February 2016, to collect randomized controlled trials (RCTs) investigating the efficacy and safety of greenlight PV for NMIBTs. Two reviewers independently screened literature, extracted data, assessed the risk of bias of included studies. Then RevMan 5.3 software was used for meta-analysis. ResultsA total of 11 RCTs involving 921 patients met the predefined criteria. The results of meta-analysis showed that: Compared with electrocautery transurethral resection and plasmakinetic resection in treating NMIBTs, greenlight PV could significantly shorten indwelling catheter time and hospital stay, decrease bladder perforation, obturator nerve reflex, blood loss rate and tumor recurrence rate; but the operative time between the greenlight PV group and the routine surgery group was not statistically different. ConclusionCurrent evidence shows that greenlight PV is safe and effective in treating NMIBTs. Due to the limited quality and quantity of the included studies, more large-scale high-quality studies are warranted to further assess these results.
ObjectivesTo investigate the prevalence of respiratory diseases and lung function of school-age children in Chongqing and to compare them with that of children in 25 years ago and to explore the possible causes of this change.MethodsAccording to the air quality data of Chongqing from 1998 to 2016, the annual variation of air quality days and pollutant concentrations were plotted. 2 126 school-age children in two districts of Chongqing were selected by random cluster sampling for questionnaires. 771 children were randomly selected from the children who completed the questionnaire for pulmonary function tests. The results were compared with that of 25 years ago.ResultsFrom 1998 to 2016, the number of days with good air quality in Chongqing increased annually, and the concentration of SO2 decreased significantly. The main air pollution composition changed from SO2 to PM10 and PM2.5. The prevalence of bronchitis (P<0.05) was higher than that of 25 years ago. After adjusting for confounding factors by multivariate logistic regression, the OR value of bronchitis in children was 1.667 (P<0.05) compared with 25 years ago. After adjusting for age, sex, height and weight by multiple linear regression, the results showed that the subjects' lung function indexes (FVC, FEV1, PEF and FEV3) were lower than that of 25 years ago. In this survey, there were differences in lung function indexes between children with different frequency of eating fruits and dairy products (P<0.05), and those with high frequency consumption were higher than low frequency. In terms of exercise time, subjects exercising ≥1 hour/day had greater FVC and FEV3 values than those exercising <1 hour/day (P<0.05).ConclusionsThe overall air quality in Chongqing has improved from 1998 to 2016; The respiratory health of children has decreased when compared with that of 25 years ago. Changes in the composition of air pollutants may endanger children's respiratory health, and fruit and dairy foods and exercise may be protective factors for children's respiratory health.