Objective To evaluate the effect of remote controlled injection manipulator system (RCIM) assisted percutaneous kyphoplasty (PKP) for the treatment of rupture of posterior vertebral osteoporotic vertebral fracture by comparing with intermittent hand bolus injection of bone cement during operation. Methods Between September 2010 and January 2016, a retrospective analysis was made on the clinical data of 48 senile patients with single segment rupture of the posterior vertebral osteoporotic thoracolumbar fracture undergoing PKP who accorded with the inclusion criteria. Of 48 patients, 22 received intermittent hand bolus injection of bone cement in the control group, and 26 received RCIM assisted bone cement perfusion in the trial group. There was no significant difference in age, gender, duration of disease, causes of injury, implicated vertebral bodies, bone mineral density T value, pain duration, preoperative visual analogue scale (VAS), relative vertebral body height in the anterior part, and posterior convex Cobb angle between groups (P>0.05). The bone cement perfusion time, the radiation dose of both doctors and patients, and the amount of bone cement injection were recorded; treatment effects were evaluated based on VAS score, posterior convex Cobb angle, relative ver-tebral body height in the anterior part, ratios of bone cement diffusion area and bone cement leakage rate. Results The patients were followed up for 6 months; no complications of toxic effect of bone cement, spinal cord or nerve root injuries, infection and vascular embolization occurred during follow-up period. There was no significant difference in bone cement injection amount and radiation dose of doctors between groups (P>0.05), but bone cement perfusion time, ratios of bone cement diffusion area, and radiation dose of patients were significantly lower in the trial group than the control group (P<0.05). Bone cement leakage was observed in 6 cases of the control group (27.27%) and 2 cases of the trial group (7.69%), showing significant difference between groups (χ2=4.850,P=0.029); no cement leakage into the spinal canal was found in both groups. VAS score, relative vertebral body height in the anterior part, and posterior convex Cobb angle were significantly improved at 3 days and 6 months after operation when compared with preoperative ones (P<0.05), but no significant difference was observed in the above indexes between groups at 3 days and 6 months after operation (P>0.05). Conclusion Satisfactory effectiveness can be achieved by applying RCIM assisted PKP for the treatment of rupture of posterior vertebral osteoporotic vertebral fracture. RCIM can shorten perfusion time, reduce radiation dose, and decrease incidence of bone cement leakage.
Objective
To explore the effect of pulmonary arterial hypertension on the children with functional single ventricle in the early period after Fontan operation.
Methods
Forty-three children with pulmonary arterial hypertension after Fontan operation were enrolled in our department between January 2015 and December 2016. There were 24 males and 19 females at a median age of 4.3 years ranging from 2.5 to 4.8 years. The pulmonary arterial pressure was evaluated by cardiac catheterization. There were 23 children diagnosed without pulmonary hypertension (a non-PAH group) including 16 males and 7 females, while 20 patients were diagnosed with pulmonary hypertension (a PAH group) including 8 males and 12 females. Postoperative parameters related to outcomes were compared between the two groups.
Results
There was no death in the non-PAH group, but the mortality of children in the PAH group was 20.0% (4/20, χ2=5.34, P=0.02). The central venous pressure (t=–2.50, P=0.02), N-terminal prohormone of brain natriuretic peptide (NT-proBNP, Z=–3.50, P<0.01), peritoneal dialysis rate (χ2=5.40, P=0.02), incidence of arrhythmia (χ2=4.40, P=0.03) in the PAH group were significantly higher than those of the non-PAH group. The early postoperative utilization rate of pulmonary vascular targeting agents in the PAH group was significantly higher than that in the non-PAH group (χ2=6.30, P=0.04).
Conclusion
Pulmonary arterial hypertension is one of the most important factors which influence the early postoperative prognosis of children with functional single ventricle after Fontan operation.
【摘要】 目的 研究不同亞型多系統萎縮（multiple system atrophy，MSA）患者的臨床特點。 方法 回顧分析2009年1月—2011年1月收治的105例“很可能的”MSA患者的臨床資料，包括發病年齡、首發癥狀、臨床表現、治療反應性等。 結果 105例MSA患者中，男57例，女48例，發病年齡58歲。以小腦性共濟失調為主要特點的MSA（MSA with predominant cerebellar ataxia，MSA-C）患者76例，以帕金森綜合征為主要特點的多系統萎縮（MSA with predominant parkinsonism，MSA-P）患者29例。39例患者僅以小腦功能障礙為首發癥狀；29例患者僅以帕金森綜合征為首發癥狀，23例患者僅以自主神經功能障礙為首發癥狀，其余14例患者的首發表現至少包括2種癥狀組合。至最后一次隨訪時，54例患者同時存在小腦功能障礙、帕金森綜合征、自主神經功能障礙和錐體束征，51例患者表現為自主神經功能障礙與小腦功能障礙和（或）帕金森綜合征的不同形式的組合。 結論 MSA患者以MSA-C為主。由于在病程早期，MSA與其他帕金森綜合征或小腦性共濟失調疾病的鑒別較為困難，因此，仔細動態觀察患者臨床特點的演變情況，對MSA的診斷至關重要。【Abstract】 Objective To investigate subtypes and clinical features of multiple system atrophy (MSA). Methods The clinical data of 105 probable MSA patients treated in our hospital from January 2009 to January 2011 were analyzed, including the age at onset, initial symptoms, clinical manifestations and responsivity to levodopa. Results The 105 probable MSA patients consisted of 57 males and 48 females, including 76 patients (72.4%) of MSA with predominant cerebellar ataxia (MSA-C) and 29 patients (27.6%) of MSA with predominant parkinsonism (MSA-P). The mean age at onset was 58 years. The initial symptom of 39 patients was pure cerebellar dysfunction. Twenty-nine patients presented pure parkinsonism as the initial symptom. The initial symptom of 23 patients was pure dysautonomia. By the last clinical visit, 54 patients had cerebellar dysfunction, parkinsonism, autonomic failure and pyramidal signs. Conclusion The study revealed a predominance of MSA-C patients. The differentiation of MSA and other forms of parkinsonism or cerebellar ataxia may be difficult at the early stage. For more accurate diagnosis, it is important to carefully observe the clinical progression.
Objective
Hepatitis B virus X (HBx) protein is involved in the initiation and progression of hepatocellular carcinoma (HCC) by regulating the host protein-coding genes. Herein, we want to explore whether HBx protein can alter the expression of microRNAs (miRNAs) to promote proliferation and transformation in malignant hepatocytesin vitro.
Methods
MiRNA microarray and quantitative reverse-transcription polymerase chain reactions (qRT-PCRs) were performed to identify miRNAs that were differentially regulated by HBx protein in HCC cells. Protein and mRNA expression analyses, cell cycle and apoptosis analyses, and luciferase reporter assays were performed to delineate the consequences of miR-16 family repression in HepG2 cells.
Results
HBx protein induced widespread deregulation of miRNAs in HepG2 cells, and the downregulation of the miR-16 family was reproducible in HepG2, SK-HEP-1, and Huh7 cells. CCND1, a target gene of the miR-16 family, was derepressed by HBx protein in HepG2 cells. C-myc mediated the HBx-induced repression of miR-15a/16 in HepG2 cells. Ectopically expressed miR-15a/16 suppressed the proliferation, clonogenicity, and anchorage-independent growth of HBx-expressing HepG2 cells by arresting them in the G1 phase and inducing apoptosis, whereas reduced expression of miR-16 accelerated the growth and cell-cycle progression of HepG2 cells.
Conclusions
HBx protein altered thein vitro expression of miRNAs in host malignant hepatocytes, particularly downregulating the miR-16 family. Repression of miR-15a/16 is c-myc mediated and is required for the HBx-induced transformation of HepG2 cellsin vitro. Therefore, miR-16 family may serve as a therapeutic target for hepatitis B virus (HBV)-associated HCC.
【摘要】 目的 探討佛波酯激活的蛋白激酶C與扭轉蛋白A在亞細胞成分中的表達之間的關系。 方法 采用免疫熒光法觀察扭轉蛋白A在原代培養的神經元和小鼠胚胎成纖維細胞（NIH 3T3細胞）中的分布。運用蛋白質印跡法分析蛋白激酶C和扭轉蛋白A在細亞細胞成分中的表達。 結果 扭轉蛋白A在NIH 3T3細胞中的表達類似于神經元。扭轉蛋白A在細胞質溶質、膜成分中均有分布。佛波酯活化蛋白激酶C后并不引起扭轉蛋白A在細胞質成分和膜成分中表達含量的變化。 結論 扭轉蛋白A可能是膜相關蛋白，細胞氧化應激中扭轉蛋白A表達上調和重分布變化不是由佛波酯誘導的蛋白激酶C活化途徑來實現的。鑒于扭轉蛋白A表達上調具有潛在的治療原發性早發扭轉性肌張力障礙的前景，影響其分布和表達的分子機制需要進一步研究。【Abstract】 Objective To investigate the relationship between the phorbol 12-myristate 13-acetate (PMA) activated protein kinase C (PKC) and the subcellular expression of TorsinA protein. Methods The expression of TorsinA in the primary cultured neurons and the NIH 3T3 cells was detected by immunofluorescence. The expression of PKC and TorsinA in subcellular fraction was analyzed by the western blotting. Results The expression pattern of TorsinA in NIH 3T3 cells was similar to neuron. PMA, an activator of PKC, did not promote the up-expression of TorsinA or redistribution in the subcellular fraction of NIH 3T3 cells. Conclusions TorsinA may be a membrane-associated protein. The up-regulation and redistribution of TorsinA is not caused by the pathway of the PMA activating PKC after cells insulted by oxidative stress. We should pay more attention on the mechanisms of the expression of TorsinA protein for the potential therapies to early-onset primary torsion dystonia (DYT1).
Objective To learn the current situation of traditional Chinese medicine (TCM) systematic reviews/meta-analyses published in Chinese journals. Methods All TCM systematic reviews/meta-analyses published from 1978 to July 31, 2009 were searched in the Chinese Biomedical Database (CBM). According to the inclusion and exclusion criteria, relevant information was extracted on the basis of research purpose. Meanwhile, publication year, journal name, author’s district, number of authors and their articles, types of diseases and interventions were took as the indexes, and then descriptive analysis was performed using SPSS 15.0 software. Results A total of 245 articles including 238 in Chinese and 7 in English were included. All of them were published in 117 different journals from 1998 to 2008, showing an accelerating growth trend of article number. In addition to only one article with first author from Germany, the first author of other 244 were from 24 domestic provinces (autonomous regions and municipalities); the number of authors ranged from 1 to 11; a total of 186 people had published articles as first author, and the number of their published articles ranged from 1 to 29. There were 16 types of diseases according to the International Classification of Diseases 10th Edition (ICD-10). Totally, 218 articles took drugs as interventions (including 106 listed drugs, 25 self-made prescriptions, 70 related to both listed drugs and self-made prescriptions, and 17 without reporting detailed interventions), accounting for 89%; and 27 articles were about non-drug interventions (including 26 about acupuncture and 1 about massage), accounting for 11%. Most (95.8%) of the articles about self-made prescriptions and listed drugs/self-made prescriptions adopted inappropriate pooled analyses. Conclusion Evidence-based medicine has been spread into the field of TCM, the number of TCM systematic reviews/meta-analyses shows an accelerated growth trend. The types of diseases discussed in the literature were almost the same as the diseases those could be effectively treated by TCM, but there existed imbalance in districts. In the future, systematic review/meta-analysis on drug intervention should aim at Chinese patent medicines and single medicines rather than self-made prescriptions, and should pay more attention to advantageous drugs and advantageous treatments of diseases. Moreover, importance should be also attached to clinical heterogeneity controlling when using acupuncture as a non-drug intervention.
ObjectiveTo evaluate the usefulness of estimation of physiologic ability and surgical stress (E-PASS) for predicting postoperative complications in patients undergoing elective colorectal cancer surgery. MethodsPatients underwent colorectal cancer surgery between August 2009 and October 2010 were analyzed retrospectively. E-PASS equations were applied to those patients for estimation of operative risk. The preoperative risk score (PRS), surgical stress score (SSS), and comprehensive risk score (CRS) of the E-PASS were compared with actual postoperative complications. The relationship between E-PASS variables and morbidity after colorectal cancer surgery was identified. ResultsOf the 313 patients, 22 (7.0%) had postoperative complications. Of all the E-PASS variables between complicative group and noncomplicative group, the morbidity was significantly correlated to age (P=0.003), weight (P=0.019), tumor histologic types (P=0.033), Dukes stage (P=0.001), severe heart disease (P=0.019), severe pulmonary disease (P=0.000), performance status (P=0.000), loss of blood volume/body weight (P=0.007), loss of blood volume (P=0.001) and operation time (P=0.001). Differentiation degree of tumor (P=0.503), diabetes (P=0.745), ASA grade (P=0.085), and size of surgical incision (P=0.726) were not significantly associated with postoperative complications. The PRS and CRS were higher in complicative group than those in noncomplicative group (Plt;0.001). But the difference of SSS between the two groups was not statistically significant (P=0.059). ConclusionThe E-PASS scoring system is a relatively simple, fast, and operable tool that can be used to predict short-term postoperative morbidity accurately for clinical decision-making in colorectal cancer surgery.
ObjectiveTo compare the citations of Chinese literature in the 2015 and 2025 editions of the American Thyroid Association (ATA) guidelines, aiming to evaluate the progress in the field of differentiated thyroid cancer (DTC) research in China. MethodsChinese literature cited in the 2015 and 2025 ATA guidelines was collected and cataloged. A comparison was conducted between the two editions regarding the number of publications, source journals, affiliated institutions and their regional distribution, research types, and research foci of the cited literature. Results ① Changes in the quantity and regional distribution of Chinese citations: in the 2025 ATA guideline, the proportion of Chinese literature cited increased by nearly two times compared to the 2015 ATA guideline [8.8% (128/1 458) vs. 3.3% (36/1 078), P＜0.001]. The number of source journals increased by nearly three times (74 vs. 21), the number of contributing cities nearly doubled (29 vs. 13), and the number of involved healthcare institutions increased by nearly three times (65 vs. 18). In terms of regional distribution, compared to the 2015 ATA guideline, where institutions producing cited literature were mainly located in the Taiwan region (11 publications), the Hong Kong region (11 publications), and coastal and Beijing-Tianjin-Hebei rigions of the Chinese mainland (12 publications), the 2025 ATA guideline showed a expansion of distribution to medical centers in regions such as Beijing-Tianjin-Hebei, Yangtze River Delta, Pearl River Delta, Chengdu, and Changchun. Among these, West China Hospital of Sichuan University had the highest number of cited publications nationwide (20 publications). The proportion of cited literature from institutions in the Chinese mainland increased significantly compared to that from the Taiwan and Hong Kong regions [69.2% (45/65) vs. 16.9% (11/65) and 13.8% (9/65)]. ② Changes in research types of cited literature: clinical research constituted the majority [100% (36/36) and 97.7% (125/128), respectively] of the cited Chinese literature in both the 2015 and 2025 ATA guidelines. However, three basic research studies appeared in the 2025 ATA guideline. Cited literature in both editions was predominantly single-center studies [86.7% (26/30) and 93.8% (90/96), respectively]. ③ Changes in research foci of cited literature: the number of research foci involved in the 2025 ATA guideline (19 foci) increased by nearly doubled compared to the 2015 ATA guideline (11 foci). Among them, iodine-131 therapy was the most cited research focus in both editions. Among research foci with ≥5 citations, besides traditional areas such as tumor staging and prognosis, and surgical methods and extent which remained top-ranked, the ranking of recurrent laryngeal nerve protection rose. The ranking of some traditional research foci, such as molecular markers, imaging, preoperative diagnosis, declined. Notable newly prominent or significantly changed foci included ablation therapy (12 publications, ranked 2nd), comprehensive treatment (11 publications), lymph node metastasis (10 publications), parathyroid protection (7 publications), thyroid cancer and pregnancy risks (5 publications), and active surveillance (5 publications). ConclusionsCompared to the 2015 ATA guideline, the 2025 ATA guideline cites a higher proportion of Chinese literature, demonstrates a wider geographical distribution of publication origins (expanding from Taiwan region, Hong Kong region, and coastal developed area to major regional centers across China), and covered broader and more in-depth research foci. This suggests that the field of DTC in China has undergone robust development in recent years, with a gradual shift from traditional focuses such as cure rate and recurrence rate towards improving long-term quality of life, developing individualized, and precise comprehensive management models. China is playing an increasingly important role in establishing global DTC diagnostic and treatment standards. However, high-quality prospective, multicenter, randomized controlled trials remain to be strengthened.
