Objective To detect the bile acid profile in serum based on liquid chromatography-tandem mass spectrometry, and construct a combined biomarker diagnostic model for differentiating acute myocardial infarction (AMI) from unstable angina (UA). Methods A total of 180 patients with acute coronary syndrome who visited Huludao Central Hospital between August 2023 and February 2024 were randomly selected, and there were 117 patients with UA and 63 patients with AMI. Using liquid chromatography-tandem mass spectrometry, 15 bile acid subtypes in serum were detected. Orthogonal partial least squares discriminant analysis was used to compare the serum bile acid metabolic profiles of the subjects. Differences in metabolites were screened based on a significance level of P<0.05 and variable importance in projection (VIP)>1. Multiple logistic regression analysis was performed to construct a diagnostic model for differentiating AMI from UA, and the diagnostic performance of the model was evaluated using receiver operating characteristic (ROC) curve and other statistical methods. Results The differential bile acid biomarkers in the serum of UA and AMI patients included glycodeoxycholic acid, glycochenodeoxycholic acid (GCDCA), deoxycholic acid (DCA), glycocholic acid, and aurodeoxycholic acid (TDCA) (P<0.05, VIP>1). A binary logistic stepwise regression analysis showed that three bile acid biomarkers (GCDCA, DCA, and TDCA) and three common biochemical indicators (aspartate aminotransferase, creatine kinase, and total bile acid) were factors differentiating AMI from UA (P<0.05). The area under the ROC curve of the model was 0.986 [95% confidence interval (0.973, 0.999), P<0.001], demonstrating a good diagnostic performance. Conclusions GCDCA, DCA, and TDCA can serve as potential biomarkers for distinguishing AMI from UA. The model combining these three bile acids with aspartate aminotransferase, creatine kinase, and total bile acid can effectively identify AMI.
Objective To analyze the changes of gene expression profiles during the process that human bonemarrow mesenchymal stem cells (hBMSCs) are induced to differentiate into cardiomyogenic cells with 5-azacytidine (5-aza). Methods hBMSCs were isolated from marrow of obsolete ribs and induced with 5-aza. Then immunocytochemicalstaining was used to detect the expressions of α-actin, cardiac troponin T (cTnT), and connexin 43, and the percentage ofcTnT positive cells was tested with flow cytometry. In the process of differentiation, variation of gene expression was screenedwith Genechi ps Operating System of human gene expression profiles. And the differentially expressed genes were functionallyanalyzed and hierarchical clustered. Results When BMSCs were induced in vitro with 5-aza, part of the cells turnedinto myogenic cells morphologically. Before induction, immunocytochemical staining for α-actin and cTnT showed sl ightpositive and for connexin 43 showed negative. While after 3 weeks of induction, immunocytochemical staining for α-actin,cTnT, and connexin 43 showed all positive. With flow cytometry, the percentage of cTnT positive cells was 7.43% ± 0.02%before induction, but it was 49.64% ± 0.05% after induction. During differentiation, 1 814 differentially expressed geneswere reported by gene chi ps. Of them, 647 genes were divided into 5 groups with hierarchical clustering. They had variousbiological functions, involving signal transduction, cell metabol ism, prol iferation, differentiation, development, andtopogenesis. Conclusion hBMSCs can differentiate into cardiomyogenic cells with the induction of 5-aza in vitro. Multi plegenes related with signal transduction, transcri ption, and growth factors are involved during this process.
Objective
To study the major factors which affect quality of life of Chinese patients with diabetic retinopathy,and provide basis raising the patients condition of health and quality of life.
Methods
Quality of life of 179 patients with different stages of diabetic retinopathy and 30 healthy persons was measuerd by the medical outcomes study 36-item short form health survey(SF-36)and the brief scale of quality of life of WHO(WHOQOL-BREF),then the affectting factors were analysed by step regression.
Results
The major factors which affect quality of life of patients with diabetic retinopathy included:bilateral visual acuity(BVA),different category of retinopathy,course of disease,economic condition,personality,medical care and age.
Conclusion
The study suggests that bringing about the transformation from the biologic medical model to bio-psycho-social medical model is important to improve quality of life of the patients with diabetic retionpathy.
(Chin J Ocul Fundus Dis,2000,16:141-143)
The dose data produced by treatment plan system (TPS) in intensity-modulated radiation therapy (IMRT) has many gradient edge points. Considering this feature we proposed a new interpolation algorithm called treatment plan dose interpolation algorithm based on gradient feature in intensity-modulated radiation therapy (TDAGI), which improves the Canny algorithm to detect the gradient edge points and non-edge points by using the gradient information in the dose data plane. For each gradient edge point, the corresponding gradient profile was traced and the profile's sharpness was calculated, and for each non-edge point, the dispersion was calculated. With the sharpness or dispersion, the kernel coefficients of bi-cubic interpolation can be obtained and can be used as the central point to complete the bi-cubic interpolation calculation. Compared with bi-cubic interpolation and bilinear interpolation, the TDAGI algorithm is more accurate. Furthermore, the TDAGI algorithm has the advantage of gradient keeping. Therefore, TDAGI can be used as an alternative method in the dose interpolation of TPS in IMRT.
Objective
To evaluate the early outcome of anterior cervical discectomy and fusion (ACDF) using a Zero-profile implant system (Zero-P) for interbody fusion in the treatment of cervical spondylosis.
Methods
Between March 2010 and June 2011, 25 patients with cervical spondylosis underwent ACDF with Zero-P. There were 13 males and 12 females with an average age of 44.2 years (range, 26-67 years), including 14 cases of nerve root cervical spondylosis, 6 cases of spinal cervical spondylosis, and 5 cases of mixed cervical spondylosis. The disease duration was 3-120 months (median, 25 months). Single segment was involved in 20 cases, 2 segments in 4 cases, and 3 segments in 1 case. A total of 31 Zero-P were implanted (3 at C3, 4, 8 at C4, 5, 12 at C5, 6, and 8 at C6, 7). Primary cervical operation was performed in 23 cases and re-operation in 2 cases. Before and after operation, the height of intervertebral space and the cervical Cobb angle were measured; clinical outcome was evaluated using visual analogue scale (VAS) score for pain in the neck and upper limb, and Japanese Orthopaedic Association (JOA) score for myelopathy; and intervertebral fusion and the incidence of dysphagia were also observed.
Results
All incisions healed by first intention. All the patients were followed up 12-16 months (mean, 13.9 months). Interbody bone fusion was obtained, and the fusion time was 2.7-6.0 months (mean, 3.8 months). Three patients had dysphagia after operation; symptom disappeared at 1 week and 3 months after operation in 2 cases and 1 case, respectively. No fixation loosening, subsidence, or breakage occurred. The height of intervertebral space was significantly improved (P lt; 0.05) from (4.5 ± 0.5) mm at preoperation to (6.0 ± 0.7) mm at 1 week and (5.7 ± 0.6) mm at 12 months after operation; the cervical Cobb angle was significantly improved (P lt; 0.05) from (11.9 ± 6.1)° at preoperation to (21.2 ± 4.1)° at 1 week and (20.2 ± 3.7)° at 12 months after operation; and there was no significant difference between at 1 week and 12 months after operation (P gt; 0.05). The VAS score was significantly reduced (P lt; 0.05) from 7.1 ± 0.8 at preoperation to 1.9 ± 0.8 at 3 months and 1.0 ± 0.5 at 12 months after operation; the JOA score was significantly increased (P lt; 0.05) from 9.6 ± 1.3 at preoperation to 13.5 ± 1.0 at 3 months and 14.9 ± 1.0 at 12 months after operation; and there was significant difference between at 3 months and at 12 months after operation (P lt; 0.05).
Conclusion
The early outcome of ACDF using a Zero-P in the treatment of cervical spondylosis is satisfactory and reliable, and it can restore and maintain the cervical alignment and disc height, and disc has low incidence of postoperative dysphagia.
ObjectiveTo evaluate the effectiveness of very low profile/variable angle locking plate (VLP) internal fixation for posterior Pilon fractures extending to the medial malleolus by posteromedial approach.
MethodsA retrospective analysis was made on the clinical data from 13 patients with posterior Pilon fractures extending to the medial malleolus between December 2011 and August 2012. There were 4 males and 9 females with an average age of 48.9 years (range, 23-68 years). Fractures were caused by falling in 9 cases and by traffic accident in 4 cases. The locations were the left ankle in 6 cases and the right ankle in 7 cases. According to the Orthopedic Trauma Association (OTA) classification, 6 cases were rated as type 43B1, 4 cases as type 43B2, and 3 cases as type 43B3. Twelve cases had fibular fractures, including 11 cases of Denis-Weber type B, 1 case of Denis-Weber type C. The interval of injury and operation was 7-14 days (mean, 11.4 days). Open reduction was performed and VLP internal fixation was used for posterior malleolar fracture by posteromedial approach.
ResultsPrimary healing of incision was obtained in all patients. Tibial nerve palsy was observed in 2 cases, and was cured after oral administration of mecobalamin. Twelve cases were followed up 12-18 months (mean, 14.5 months). According to the Burwell-Charnley's radiological evaluation system, 11 cases achieved anatomical reduction, 1 case achieved fair reduction. The fracture union time was 3-6 months (mean, 3.7 months). No loosening or breakage of internal fixation occurred during follow-up. According to the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot scale, the results were excellent in 7 cases, good in 4, and fair in 1; the excellent and good rate was 91.7%.
ConclusionVLP internal fixation for posterior Pilon fractures extending to the medial malleolus by posteromedial approach can achieve good short-term effectiveness. The high quality of reduction is acquired under direct vision with low rate of soft tissue complications.
ObjectiveTo analyze the expression profile changes of osteogenic-related genes during spontaneous calcification of rat bone marrow mesenchymal stem cells (BMSCs).
MethodsBMSCs were isolated from 3-day-old healthy Sprague Dawley rats;cells at the 4th generation were used to establish the spontaneous calcification model in vitro. Spontaneous calcification process was recorded by inverted phase contrast microscope observation and alizarin red staining after 7 and 14 days of culture. For gene microarray analysis, cell samples were collected at 0, 7, and 14 days after culture; the differentially expressed genes were analyzed by bioinformatics methods and validated by real-time quantitative PCR (RT-qPCR) assay.
ResultsRat BMSCs calcified spontaneously in vitro. When cultured for 7 days, the cells began to aggregate and were weakly positive for alizarin red staining. After 14 days of culture, obvious cellular aggregation and typical mineralized nodules were observed, the mineralized nodules were brightly positive for alizarin red staining. A total of 576 gene probe-sets expressed differentially during spontaneous calcification, corresponding 378 rat genes. Among them, 359 gene probe-sets expressed differentially between at 0 and 7 days, while only 13 gene probe-sets expressed differentially between at 7 and 14 days. The 378 differentially expressed genes were divided into 6 modes according to their expression profiles. Moreover, according to their biological functions, differentially expressed genes related to bone cell biology could be classified into 7 major groups:angiogenesis, apoptosis, bone-related genes, cell cycle, development, cell communication, and signal pathways related to osteogenic differentiation. In cell cycle group, 12 down-regulated genes were linked with each other functionally. Matrix metalloproteinase 13 (Mmp13), secreted phosphoprotein 1 (Spp1), Cxcl12, Mmp2, Mmp3, Apoe, and Itga7 had more functional connections with other genes. The results of genes Spp1, Mgp, Mmp13, Wnt inhibitory factor 1, Cxcl12, and cyclin A2 by RT-qPCR were consistent with that of gene microarray.
ConclusionThe first 7 days after rat BMSCs were seeded are a key phase determining the fate of spontaneous calcification. Multiple genes related with cell communication, bone-related genes, cell cycle, transforming growth factor-β signaling pathway, mitogen-activated protein kinase signaling pathway, and Wnt signaling pathway are involved during spontaneous calcification.
ObjectiveTo compare differences in the maintenance of cervical curvature after anterior cervical surgery between zero-profile and self-locking intervertebral cage and plate-cage construct (PCC).MethodsA clinical data of 100 patients with single-segment cervical disc herniation who were treated with anterior cervical discectomy and fusion were retrospectively analyzed between January 2015 and January 2016. Among them, 50 patients were treated with the zero-profile and self-locking intervertebral cage (group A) and 50 patients with the PCC (group B). There was no significant difference between the two groups in age, gender, bone mineral density, disease duration, operative segment, and preoperative visual analogue scale (VAS) score, Japanese Orthopaedic Association (JOA) score, C2-7 cervical curvature, segmental Cobb angle, and adjacent vertebral height (P>0.05). The operation time and intraoperative blood loss were recorded. The postoperative VAS and JOA scores were used to evaluate the clinical efficacy. The C2-7 cervical curvature, segmental Cobb angle, and adjacent vertebral height were measured on lateral X-ray films, and the interbody fusion was evaluated according to Pitzen’s criteria.ResultsThe operation time in group A was significantly shorter than that in group B (t=2.442, P=0.021), but there was no significant difference in the intraoperative blood loss between the two groups (t=0.812, P=0.403). All patients were followed up 24-36 months, with an average of 28.5 months. According to Pitzen’s criteria for cervical interbody fusion, bone fusion achieved in both groups. The VAS score, JOA score, C2-7 cervical curvature, segmental Cobb angle, and adjacent vertebral height of the two groups at 1 and 24 months after operation were significantly improved when compared with those before operation (P<0.05). The C2-7 cervical curvature, segmental Cobb angle, and adjacent vertebral height of group A at 24 months changed significantly compared with those at 1 month (P<0.05). The other indexes of the two groups showed no significant difference between the different time points after operation (P>0.05). There were significant differences in C2-7 cervical curvature, segmental Cobb angle, and adjacent vertebral height between the two groups at 24 months after operation (P<0.05); but there was no significant difference in the clinical indexes at 1 and 24 months and the imaging indexes at 1 month between the two groups (P>0.05).ConclusionCompared with the PCC, the zero-profile and self-locking intervertebral cage can significantly shorten the operation time and obtain the same clinical efficacy, but the intervertebral height loss and secondary cervical curvature change after operation is more serious.
Objective To evaluate the safety and effectiveness of applying self-stabilizing zero-profile three-dimensional (3D) printed artificial vertebral bodies in anterior cervical corpectomy and fusion (ACCF) for cervical spondylotic myelopathy. Methods A retrospective analysis was conducted on 37 patients diagnosed with cervical spondylotic myelopathy who underwent single-level ACCF using either self-stabilizing zero-profile 3D-printed artificial vertebral bodies (n=15, treatment group) or conventional 3D-printed artificial vertebral bodies with titanium plates (n=22, control group) between January 2022 and February 2023. There was no significant difference in age, gender, lesion segment, disease duration, and preoperative Japanese Orthopedic Association (JOA) score between the two groups (P>0.05). Operation time, intraoperative bleeding volume, hospitalization costs, JOA score and improvement rate, incidence of postoperative prosthesis subsidence, and interbody fusion were recorded and compared between the two groups. Results Compared with the control group, the treatment group had significantly shorter operation time and lower hospitalization costs (P<0.05); there was no significant difference in intraoperative bleeding volume between the two groups (P>0.05). All patients were followed up, with a follow-up period of 6-21 months in the treatment group (mean, 13.7 months) and 6-19 months in the control group (mean, 12.7 months). No dysphagia occurred in the treatment group, while 5 cases occurred in the control group, with a significant difference in the incidence of dysphagia between the two groups (P<0.05). At 12 months after operation, both groups showed improvement in JOA scores compared to preoperative scores, with significant differences (P<0.05); however, there was no significant difference in the JOA scores and improvement rate between the two groups (P>0.05). Radiographic examinations showed the interbody fusion in both groups, and the difference in the time of interbody fusion was not significant (P>0.05). At last follow-up, 2 cases in the treatment group and 3 cases in the control group experienced prosthesis subsidence, with no significant difference in the incidence of prosthesis subsidence (P>0.05). There was no implant displacement or plate-screw fracture during follow-up.Conclusion The use of self-stabilizing zero-profile 3D-printed artificial vertebral bodies in the treatment of cervical spondylotic myelopathy not only achieves similar effectiveness to 3D-printed artificial vertebral bodies, but also reduces operation time and the incidence of postoperative dysphagia.
Objective
To investigate the early effectiveness of Zero-profile interbody fusion system (Zero-P) in the treatment of cervical disc protrusion.
Methods
Between October 2010 and June 2012, 25 patients with cervical disc protrusion underwent anterior cervical discectomy and fusion (ACDF) using the Zero-P system. There were 15 males and 10 females, aged from 35 to 68 years (mean, 49 years). The disease duration was 3-26 months (mean, 10.5 months). Single segment was involved in all cases (2 cases in C3, 4, 5 cases in C4, 5, 11 cases in C5, 6, and 7 cases in C6, 7). The operation time and blood loss were recorded and analyzed. The visual analogue scale (VAS) score, Japanese Orthopaedic Association (JOA) score, and neck disability index (NDI) were used to assess pain and nerve function improvement; the cervical Cobb angle was measured on the X-ray films before and after operation; according to Pitzen’s criteria, intervertebral fusion was evaluated.
Results
The operation was successful in 25 patients, with no severe complication. The average blood loss was 42.6 mL (range, 20-120 mL). The average operation time was 63.6 minutes (range, 45-90 minutes). Primary healing of incision was obtained in all cases; no injury of spinal cord and nerve root, cerebrospinal leakage, or deep infection occurred. The patients were followed up 6-23 months (mean, 14.5 months). No Cage subsidence and loosening, breaking, or pulling-out were observed. The symptoms and curvature of the cervical spine were obviously improved in all patients after operation. The VAS score, JOA score, NDI, and the cervical Cobb angle at 3 months and last follow-up showed significant differences when compared with preoperative ones (P lt; 0.05), but no significant difference was found between at 3 months and at last follow-up (P gt; 0.05). The interbody fusion was achieved in each operated segment of all patients according to Pitzen’s criteria.
Conclusion
The early effectiveness of ACDF with Zero-P system is satisfactory in treatment of cervical disc protrusion because it has the advantages of short operation time, less bleeding, good stability and restoration of the cervical alignment.
