ObjectiveTo detect the differentially expressed circular RNA (circRNA) in rotator cuff tendinopathy and analyze the potential molecular mechanism of these parental genes.MethodsTen supraspinatus tendons donated from patients who underwent tendon repair surgery between June 2018 and June 2019 were used for RNA-sequence. All rotator cuff tendinopathy and normal tendon samples were confirmed by MRI, histological staining, and observation by arthroscopy. All pathological tendons were matched with tendon samples for patients’ age, gender, body mass index, and Bonar score. The bioinformatic analysis was performed based on the differentially expressed circRNA and their parental genes, including gene ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG), and competing endogenous RNA (ceRNA) network construction.ResultsThere were 94 differentially expressed circRNAs, including 31 up-regulated and 63 down-regulated, detected between the rotator cuff tendinopathy and normal tendon samples with |log2 fold change (FC)| >2, P<0.05. GO analysis showed that the genes were mostly enriched in response to cyclic adenosine monophosphate (cAMP). KEGG pathway analysis showed that the most genes were enriched in extracellular matrix-receptor interaction, protein digestion and absorption, cell cycle, and nuclear factor κB signaling pathway. ceRNA networks showed the interactions among circRNAs, mRNAs, and miRNAs. And circRNA.8951-has-miR-6089-DNMT3B was the most sum max energy.ConclusionThis bioinformatic study reveals several potential therapeutic targets for rotator cuff tendinopathy, which paves the way to better treatment and prevention of this disorder.
ObjectiveTo analyze the clinical outcome of anterior cervical discectomy and fusion using a Zero-profile interbody fusion and fixation device (Zero-P) for cervical spondylotic myelopathy.
MethodsBetween April 2011 and September 2013, 26 cases of cervical spondylotic myelopathy underwent anterior cervical discectomy and fusion with the Zero-P. Of 26 cases, 12 were male and 14 were female, aged 43-82 years (mean, 58.3 years). The disease duration was from 3 months to 10 years (mean, 5.9 years). The involved segments included C3,4 in 5 cases, C4,5 in 3 cases, C5,6 in 6 cases, and C6,7 in 12 cases. The clinical outcome was evaluated using visual analogue scale (VAS) score, Japanese Orthopaedic Association (JOA) score, and Neck Disability Index (NDI) score before operation and after operation.
ResultsThe operations were successful and the operation time was 75-140 minutes (mean, 105 minutes); and blood loss was 20-150 mL (mean, 45 mL). There was no complications of infection, neural injury, esophageal fistula, prevertebral hematoma, or leakage of cerebrospinal. Dysphagia occurred in 1 case within 1 week after operation,and disappeared after 1 month. All patients were followed up for an average of 15.3 months (range, 12-18 months). The clinical symptoms were relieved after operation. During follow-up, no implant displacement or subsidence, screw breakage, and cervical instability were observed. At 3 and 12 months after operation, the VAS score and NDI reduced significantly (P<0.05); the JOA score increased significantly (P<0.05); and the intervertebral space height and the cervical Cobb angle improved significantly (P<0.05). But there was no significantly difference between at 3 and 12 months (P>0.05). According to JOA evaluation, the results were excellent in 14 cases, good in 10 cases, and fair in 2 cases, with an excellent and good rate of 92.3% at last follow-up.
ConclusionThe clinical outcome of anterior cervical discectomy and fusion using a Zero-P is satisfactory and reliable in the treatment of cervical spondylotic myelopathy. It can restore the cervical physiological curve and the intervertebral space height and decrease the incidence of postoperative dysphagia.
ObjectiveTo compare the effectiveness between anterior cervical Zero-profile interbody fusion device (Zero-P) and anterior cervical plate device (plate cage benezech, PCB) for cervical disease.
MethodsBetween February 2011 and January 2013, 98 patients with cervical spondylosis who accorded with the inclusion criteria were treated with Zero-P in 49 cases (group A) and with PCB in 49 cases (group B). There was no significant difference in gender, age, disease type, disease duration, and disease segments between 2 groups (P>0.05). The Cobb angle, short-form 36 health survey scale (SF-36 scale), Japanese Orthopedic Association (JOA) score, postoperative dysphagia cases, neck disability index (NDI), and visual analogue scale (VAS) score were compared between 2 groups.
ResultsThe operation time and intraoperative blood loss of group A were significantly less than those of group B (t=4.089, P=0.000;t=3.587, P=0.001). The patients were followed up 3-36 months (mean, 18.5 months). No loosening or breaking of internal fixation and bone absorption or collapse occurred in the other patients except 2 patients who suffered from screw loosening at 3 months after operation. Within 6 months after operation, dysphagia occurred in 8 cases (16.33%) of group A and in 13 cases (26.53%) of group B, showing significant difference (χ2=10.616, P=0.001). At last follow-up, JOA score, VAS score, NDI, SF-36 scale, and Cobb angle were significantly improved when compared with preoperative ones in 2 groups (P<0.05);the other indexes of group A were significantly better than those of group B (P<0.05) except SF-36 scale and Cobb angle (P>0.05). The excellent and good rate of JOA score was 81.63% in group A and 71.43% in group B, showing significant difference (χ2=4.346, P=0.037).
ConclusionZero-P and PCB can get good results in treatment of cervical disease, but the Zero-P is better than PCB in reducing postoperative dysphagia because less wounds and strong stability.
ObjectiveTo investigate the clinical heterogeneity and auto-immunologic state in patients with diabetic ketosis (DK) or diabetic ketoacidosis (DKA).
MethodsDiabetic patients who presented with DK/DKA were recruited from West China Hospital of Sichuan University from January 1, 2000, to December 31, 2008. We analyzed the clinical classification, biochemical profiles, and auto-immunologic state of the patients.
ResultsAmong them, 257 (15.0%) patients had type 1 diabetes, while 883 (51.6%) with type 2 diabetes, and 515 (30.1%) could be typed as "atypical diabetes" or "untying diabetes". The average age of hospitalized patients with type 1 diabetes was (31.1±13.5) years, which was significantly lower than that of the type 2 diabetes patients [(58.1±13.2) years] (P＜0.001). The most common contributing factor for DK/DKA was infection, followed by noncompliance with therapy. Glutamic acid decarboxylase antibody positive rate was 4.37% in patients with "atypical diabetes", which was similar with type 2 diabetes group (2.69%, P=0.79), but lower than that of the patients with type 1 diabetes (13.79%, P＜0.001).
ConclusionsWe conclude that DK or DKA can occur not only in type 1 diabetic patients but also in patients with type 2 diabetes under infection or stress condition. DK/DKA patients have a high clinical heterogeneity. The auto-immunologic state and β-cell function have significant implications for the diagnosis and classification of diabetes.
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)
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.
ObjectiveTo discuss the risk of abortion related to lamotrigine (LTG) and its safety profile during pregnancy.
MethodsRetrospectively studied pregnant women in our epilepsy clinics who took LTG from 2011 to 2015 as monotherapy and experienced embryo damage or abortion. Here, we present an extensive review of related literatures regarding possible mechanisms, clinical features and safty of LTG during pregnancy.
ResultsIn our study, fourty-five pregnancies were administered monotherapy LTG, and three of these patients suffered embryo damage.
ConclusionsAlthough LTG is considered safe for pregnant women and the embryo or fetus,it also has risk of embryo damage or abortion, which should be carefully considered before prescription. Using monotherapy and the lowest effective drug dose, monitoring LTG serum concentrations during pregnancy, supplementing folate administration before and after conception and conducting regular prenatal diagnostic tests might reduce the risk of abortion.
Objective To evaluate the safety and effectiveness of anterior cervical discectomy and fusion (ACDF) by using zero-profile anchored cage (ZAC) in treatment of consecutive three-level cervical spondylosis, by comparing with plate-cage construct (PCC). Methods A clinical data of 65 patients with cervical spondylosis admitted between January 2020 and December 2022 and met the selection criteria was retrospectively analyzed. During consecutive three-level ACDF, 35 patients were fixed with ZAC (ZAC group) and 30 patients with PCC (PCC group). There was no significant difference in baseline data between the two groups (P>0.05), including gender, age, body mass index, surgical segment, preoperative Japanese Orthopaedic Association (JOA) score, Neck Disability Index (NDI), visual analogue scale (VAS) score, prevertebral soft tissue thickness (PSTT), cervical lordosis, and surgical segmental angle. The operation time, intraoperative blood loss, hospital stay, clinical indicators (JOA score, NDI, VAS score), and radiological indicators (cervical lordosis, surgical segmental angle, implant subsidence, surgical segment fusion, and adjacent segment degeneration), and the postoperative complications [swelling of the neck (PSTT), dysphagia] were recorded and compared between the two groups. Results Patients in both groups were followed up 24-39 months. There was no significant difference in follow-up duration between the two groups (P>0.05). The operation time and intraoperative blood loss were lower in ZAC group than in PCC group, and the length of hospital stay was longer, but there was no significant difference (P>0.05). At each time point after operation, both groups showed significant improvements in JOA score, VAS score, and NDI compared with preoperative scores (P<0.05), but there was no significant difference between the two groups at each time point after operation (P>0.05). Both groups showed an increase in PSTT at 3 days and 3, 6 months after operation compared to preoperative levels (P<0.05), but returned to preoperative levels at last follow-up (P>0.05). The PSTT at 3 days and 3 months after operation were significantly lower in ZAC group than in PCC group (P<0.05), and there was no significant difference between the two groups at 6 months and at last follow-up (P>0.05). The incidences of dysphagia at 3 days and 3 months were significantly lower in ZAC group than in PCC group (P<0.05), while no significant difference was observed at 6 months and last follow-up between the two groups (P>0.05). There was no postoperative complication in both groups including hoarseness, esophageal injury, cough, or hematoma. Both groups showed improvement in cervical lordosis and surgical segmental angle compared to preoperative levels, with a trend of loss during follow-up. The cervical lordosis loss and surgical segmental angle loss were significantly more in the ZAC group than in PCC group (P<0.05). The incidence of implante subsidence was significantly higher in ZAC group than in PCC group (P<0.05). There was no significant difference between the ZAC group and PCC group in the incidences of surgical segment fusion and adjacent segment degeneration (P>0.05). ConclusionIn consecutive three-level ACDF, both ZAC and PCC can achieve satisfactory effectiveness. The former can reduce the incidence of postoperative dysphagia, while the latter can better maintain cervical curvature and reduce the incidence of implant subsidence.
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.
