Resumen Objetivo. Investigar la seguridad y la eficacia de la discectomía endoscópica percutánea (DEP) y de la discectomía fenestrada (DF) en el tratamiento de la hernia de disco lumbar. Método. Se analizaron retrospectivamente los datos clínicos completos de 87 pacientes con hernia de disco lumbar. De acuerdo con el tratamiento prescrito, los pacientes fueron divididos en grupo control (DF, n = 39) y grupo de estudio (DEP, n = 48). Se compararon las condiciones básicas de funcionamiento de los dos grupos y se evaluaron los resultados de la cirugía, la incidencia de complicaciones y la calidad de vida al año de la operación. Resultados. Ambos grupos completaron la operación. En el grupo de estudio, las puntuaciones en la escala visual análoga y ODI disminuyeron significativamente, mientras que las puntuaciones JOA aumentaron significativamente. La tasa de éxito de la operación en el grupo de estudio fue significativamente mayor que en el grupo control, y la incidencia de complicaciones fue significativamente menor que en el grupo control. No hubo diferencia significativa en la calidad de vida entre los dos grupos (p > 0.05). Conclusiones. La tasa de éxito del tratamiento con DEP fue mayor, y el tiempo de recuperación fue más rápido y más seguro que con la DF.

Abstract Background. The aim of the study was to explore the safety and efficacy of percutaneous transforaminal endoscopic discectomy (PTED) and fenestration discectomy (FD) in the treatment of lumbar disc herniation (LDH). Material and methods. The complete clinical data from 87 patients with LDH from our hospital were retrospectively analyzed. Patients were divided into a control group (n = 39, treated with FD) and a research group (n = 48, treated with PTED) according to the prescribed treatments. The basic operation conditions were compared across the two groups. Surgical outcomes were assessed. The incidences of complications and the life quality of patients were evaluated 1 year after surgery. Results. The patients in both groups completed the operation. The visual analog scale and Oswestry Disability Index score of patients in the research group was significantly lower while the Orthopaedic Association Score was significantly higher after surgery. The success rate of the operation in the research group which was significantly higher and the rate of complications was significantly lower. No statistical differences in the quality of life were observed between the patients (p > 0.05). Conclusions. PTED and FD are effective in the treatment of LDH. However, our study showed that PTED has a higher rate of treatment success, faster recovery times and is safer than FD.

Abstract Aplastic anemia (AA), a rare disorder, is associated with bone marrow microenvironment (BMM). Presently, AA treatment is of great difficulty. This study aimed to explore the mechanism of action of Rehmannia glutinosa polysaccharide (RGP) in AA. Busulfan was used to induce AA in BALB/c mice; blood cell count and Ray’s Giemsa staining were used to assess the severity of hematopoietic failure; HE was performed to assess the pathological state of the marrow cavity; ELISA was performed to assess IL-4, IL-10, IL-6, IL-12, IL-1β, TNF-α, MCP-1, VEGF, and EPO; and WB was performed to evaluate the effects of RGP on the HIF-1α/NF-κB signaling. Significant downregulation of hemocyte levels in the blood and nucleated cells in the bone marrow was reversed by RGP and Cyclosporine A (CA). Compared with the AA group, dilating blood sinusoids, inflammation, hematopoiesis, decreased bone marrow cells and megakaryocytes were alleviated by RGP and CA, and the HIF-1α/NF-κB signaling was inhibited too. Notably, RGP was more effective when used in combination with CA. In this study, we established a relationship between BMM and the HIF-1α/NF-κB signaling pathway and found that RGP regulates BMM by suppressing the activation of the HIF-1α/NF-κB signaling. Thus, RGP exerts a pharmacological effect on AA.

ABSTRACT Objective: Interstitial cystitis (IC)/bladder pain syndrome (BPS) is a chronic inflammatory disease that can cause bladder pain and accompanying symptoms, such as long-term urinary frequency and urgency. IC/BPS can be ulcerative or non-ulcerative. The aim of this study was to explore the core genes involved in the pathogenesis of ulcerative IC, and thus the potential biomarkers for clinical treatment. Materials and Methods: First, the gene expression dataset GSE11783 was downloaded using the Gene Expression Omnibus (GEO) database and analyzed using the limma package in R to identify differentially expressed genes (DEGs). Then, the Database for Annotation, Visualization and Integrated Discovery (DAVID) was used for Gene Ontology (GO) functional analysis, and the Kyoto Encyclopedia of Genes and Genomes (KEGG) was used for pathway enrichment analysis. Finally, the protein-protein interaction (PPI) network was constructed, and key modules and hub genes were determined using the STRING and Cytoscape software. The resulting key modules were then analyzed for tissue-specific gene expression using BioGPS. Results: A total of 216 up-regulated DEGs and 267 down-regulated genes were identified, and three key modules and nine hub genes were obtained. Conclusion: The core genes (CXCL8, CXCL1, IL6) obtained in this study may be potential biomarkers of interstitial cystitis with guiding significance for clinical treatment.

ABSTRACT Objective: Describe the visual results of correction of high myopia with ACR-128 phakic lens implantation. Methods: An observational descriptive longitudinal prospective study was conducted of 60 eyes of 32 patients with myopia corrected with the ACR-128 phakic lens. Determination was made of the expected and observed spherical component, the keratometric cylinder, uncorrected and best corrected visual acuity in the pre- and postoperative periods, and induced astigmatism. Statistical analysis was based on the paired T-test with a significance level of 95 %. Results: Mean age was 27.41 ± 5.91 years, preoperative spherical equivalent was -11.54 ± 3.20 diopters, and 68.75 % of the patients were female. Spherical component in diopters expected (-0.53 ± 0.37) and observed (-0.42 ± 0.47) without differences (p= 0.0742). Between ± 1.00 diopters 91.67 % and between ± 0.50 diopter 70 %. No eye was above +0.50D. Keratometric cylinder in diopters, preoperative (1.44 ± 0.76) and postoperative (1.49 ± 0.84) without induced astigmatism (p=0.6377). In 100 % visual acuity without correction ≤ 0.1 preoperative and ≥ 0.3 postoperative. After surgery 10 % reached 1.0 and 71.6% ≥ 0.5. Only 28.33% had the unit corrected in the preoperative period and 70 % in the postoperative period (98.33 % ≥ 0.7). Conclusions: ACR-128 phakic lens implantation provides patients with favorable refractive correction and predictability. This is achieved by reducing the spherical component to desired values, not inducing astigmatism and improving visual acuity, all of which leads to an adequate visual result.

RESUMEN Objetivo: Describir los resultados visuales en la corrección de la alta miopía con implante de lente fáquica ACR-128. Métodos: Se realizó un estudio descriptivo, observacional longitudinal y prospectivo en 60 ojos de 32 pacientes con miopía corregida con lente fáquica ACR-128. Se determinó el componente esférico esperado y observado, el cilindro queratométrico, las agudezas visuales sin corrección y mejor corregidas en el pre y en el posoperatorio y el astigmatismo inducido. El análisis estadístico se realizó con la Prueba T para datos pareados, con una significación del 95 %. Resultados: La edad media fue 27,41 ± 5,91 años, el equivalente esférico preoperatorio -11,54 ± 3,20 dioptrías y el 68,75 % eran femeninas. El componente esférico en dioptrías esperado (-0,53 ± 0,37) y observado (-0,42 ± 0,47) sin diferencias (p= 0,0742). Entre ± 1,00 el 91,67 % y entre ± 0,50 el 70 %. Ningún ojo quedó por encima de +0,50 dioptrías. El cilindro queratométrico en dioptrías, pre (1,44 ± 0,76) y posoperatorio (1,49 ± 0,84) sin astigmatismo inducido (p= 0,6377). El 100 % tenía agudeza visual sin corrección preoperatoria ≤ 0,1 y posoperatoria ≥ 0,3. Después de la cirugía el 10 % alcanzaba 1,0 y 71,6 % ≥ 0,5. Solo el 28,33 % tenía la unidad en el preoperatorio, y el 70 % en el posoperatorio (98,33 % ≥ 0,7). Conclusiones: El implante de lente fáquica ACR-128 proporciona corrección refractiva y predictibilidad favorables para el paciente, al reducir el componente esférico al deseado, no inducir astigmatismo y mejorar la agudeza visual, todo lo que se traduce en un adecuado resultado visual.

ABSTRACT Objective: Describe the effects of ACR-128 phakic lens implantation for high myopia correction on ocular tension and the corneal endothelium. Methods: An observational descriptive longitudinal prospective study was conducted of 60 eyes of 32 patients with myopia corrected with the ACR-128 phakic lens. Determination was made of intra- and postoperative complications, intraocular pressure, endothelial cell density, variability and hexagonality quotient, and lens position. Statistical analysis was based on the paired T-test with a significance level of 95 %. Results: Mean age was 27.41 ± 5.91 years and 68.75 % of the patients were female. Mean preoperative spherical equivalent was -11.54 ± 3.20 diopters. Complications were none in the intraoperative period, 93.33 % in the immediate postoperative period and 95.00 % mid- or long-term. No significant differences were found between the pre- and postoperative periods concerning ocular tension (p= 0.2570). Endothelial cell density was p= 0.0928, the variability quotient p= 0.889 and hexagonality p= 0.0957. Conclusions: ACR-128 phakic lens implantation for correction of high myopia is a safe procedure causing few complications and minimal effects on ocular tension and the corneal endothelium.

RESUMEN Objetivo: Describir los efectos sobre la tensión ocular y el endotelio corneal con el implante de la lente fáquica ACR-128 para la corrección de la alta miopía. Métodos: Se realizó un estudio descriptivo, observacional, longitudinal y prospectivo en 60 ojos de 32 pacientes con miopía corregida con lente fáquica ACR-128. Se determinaron las complicaciones trans y posoperatorias, la presión intraocular, la densidad de las células endoteliales, el coeficiente de variabilidad y la hexagonalidad, así como la posición de la lente. El análisis estadístico se realizó con la Prueba T para datos pareados, con una significación del 95 %. Resultados: La edad media fue de 27,41 ± 5,91 años y el 68,75 % correspondió al sexo femenino. El equivalente esférico preoperatorio promedio fue de -11,54 ± 3,20 dioptrías. Resultó sin complicaciones transoperatorias el 100 %; las posoperatorias inmediatas fueron de 93,33 % y las mediatas y tardías del 95,00 %. No hubo diferencias significativas entre el pre y el posoperatorio en la tensión ocular (p=0,2570); la densidad endotelial fue p= 0,0928; el coeficiente de variación p= 0,889 y la hexagonalidad (p= 0,0957). Conclusiones: El implante de la lente fáquica ACR-128 para la corrección de las altas miopías es un procedimiento seguro, al ofrecer escasas complicaciones y mínimos efectos en la tensión ocular y en el endotelio corneal.

ABSTRACT The objective of this study was to evaluate the effects of maternal dietary intake on the amino acid and fatty acid contents in eggs during the laying period. An experiment with a 2×2 factorial design was conducted with two maternal dietary intake levels (100 and 75% of dietary intake recommended by the Chinese Ministry of Agriculture) and two broiler lines (fat and lean line). A total of 384 hens of fat line and 384 hens of lean line at 23 weeks of age were included in the experiment. Each line was randomly divided into two treatments (n = 192 in each treatment, with 12 replications), and each replication included 16 birds. The treatments were LN (lean line and normal maternal dietary intake, n = 192), LL (lean line and low maternal dietary intake, n = 192), FN (fat line and normal maternal dietary intake, n = 192), and FL (fat line and low maternal dietary intake, n = 192). The amino acid and fatty acid contents in eggs were tested (50 weeks of age). The fat line had higher levels of arginine, aspartic acid, glycine, histidine, leucine, methionine, and threonine in the egg albumen than the lean line. Low maternal dietary intake increased the cystine deposition in egg yolks. There were interactions between maternal dietary intake and line on the deposition of trans-oleic acid, docosanoic acid, and total fatty acid in egg yolks. Low maternal dietary intake increased the deposition of tetradecenoic and linolenic acids and the ratio of total polyunsaturated fatty acids to total saturated fatty acid in egg yolks but decreased the deposition of docosanoic acid. Maternal dietary intake and line affect the amino acid and fatty acid profiles in eggs.

ABSTRACT Objective: To report our experience of retroperitoneoscopic technique in semi-lateral decubitus position for the retroperitoneal nonadrenal ganglioneuromas in 18 patients, and to evaluate its clinical outcomes. Materials and Methods: From January 2012 to May 2016, 18 patients with retroperitoneal nonadrenal ganglioneuromas underwent retroperitoneoscopic resection. With the patients in semi-lateral decubitus position, a 4-port retroperitoneal approach was used. Data were collected on the tumor size, tumor location, perioperative outcomes, pathology, and last-known disease status. We reviewed the operative videos to identify surgical tips and tricks. Results: All procedures were carried out successfully without converting to open surgery. The tumors had an average size of 5.2cm. The mean operative time was 86.5 min, with a mean estimated blood loss of 85.4mL. There were three patients suffering from intraoperative complications. Postoperatively, all patients achieved an uneventful recovery; the mean postoperative hospital stay was 5.5 days. The postoperative pathology revealed to be retroperitoneal ganglioneuromas. With a mean follow-up of 39.5 months, all patients were recurrence free. The review of the operative videos revealed several tips and tricks, including keeping peritoneum and posterior Gerota fascia intact to provide a favorable operative exposure of tumors, and placing the harmonic scalpel through different ports during tumor dissection. Conclusions: With the patient in semi-lateral decubitus position and a 4-port retroperitoneal approach, retroperitoneoscopic resection of retroperitoneal nonadrenal ganglioneuroma is a feasible, effective, and safe procedure. This approach has distinct advantages including direct access to the tumor, optimal exposure of tumor and less intraperitoneal interference.

RESUMO Objetivo: Analisar se a associação entre fragilidade óssea e risco de fratura depende do nível de trauma. Método: Todos os participantes, juntamente com suas mães, foram submetidos à DEXA e medições corporais. Os participantes responderam um questionário de autorrelato sobre atividades físicas e descrição de como o trauma ocorreu. Os resultados do questionário foram associados à DEXA realizada na primeira visita do estudo. Resultados: Um total de 374 crianças com DEXA disponível e acompanhamento completo de 5 anos foi incluído na análise final. Das 374 crianças, 53 (14,2%) tiveram uma fratura e 11 (20,7%) tiveram mais de uma fratura. Com base na classificação de Landin modificada, foi determinado o nível de trauma. Das 53 (14,2%) crianças que tiveram uma fratura, 39 (73,6%) foram classificadas, sendo 19 (48,7%) com trauma leve, 16 (41%) com trauma moderado e quatro (10,2%) com trauma grave. O nível de trauma não pôde ser atribuído a 14 (26,4%) crianças, devido a informações limitadas. As crianças sem fraturas apresentaram valores significantemente mais altos em todos os parâmetros ósseos, em comparação com os que tinham fraturas causadas por trauma leve. Conclusão: Os indivíduos com fraturas por trauma leve apresentaram relação inversamente proporcional entre os parâmetros fragilidade óssea e o risco de fratura em comparação com indivíduos sem fratura. Nível de Evidência IV, Série de Casos .

ABSTRACT Objective: To analyze whether association between bone fragility and risk of fracture depends on the trauma level. Method: All participants along with their mothers underwent DXA scan and body measurements. The subjects answered a self-report questionnaire about their physical activities and the precipitating causes. The questionnaire results were associated with DXA performed at the baseline visit. Results: A total 374 children with available DXA scan and complete follow-up of 5 years were included in the final analysis. Of the 374 children, 53 (14.2%) had one fracture, and 11 (20.7%) had more than one fracture. Based on the modified Landin classification, the trauma level was determined. Of the 53 (14.2%) children who had one fracture, 39 (73.6%) were classified, namely 19 (48.7%) with mild trauma, 16 (41%) with moderate trauma and four (10.2%) with severe trauma. Trauma level could not be assigned to 14 (26.4%) children due to limited information. Children without fractures had significantly higher values in all bone parameters compared to those with fractures caused by mild trauma. Conclusion: Subjects with mild trauma fractures had an inversely proportional ratio between bone fragility parameters and fracture risk compared with subjects without fractures. Level of Evidence IV, Case Series.

ABSTRACT: An optimization strategy is constructed to solve the aerodynamic and structural optimization problems in the conceptual design of double-swept flying wing aircraft. Aircraft preliminary aerodynamic and structural design optimization is typically based on the application of a deterministic approach of optimizing aerodynamic performance and structural weight. In aerodynamic optimization, the objective is to minimize induced drag coefficient, and the structural optimization aims to find the minimization of the structural weight. In order to deal with the multiple objective optimization problems, an optimization strategy based on collaborative optimization is adopted. Based on the optimization strategy, the optimization process is divided into system level optimization and subsystem level optimization. The system level optimization aims to obtain the optimized design which meets the constraints of all disciplines. In subsystem optimization, the optimization process for different disciplines can be executed simultaneously to search for the consistent schemes. A double-swept configuration of flying wing aircraft is optimized through the suggested optimization strategy, and the optimization results demonstrate the effectiveness of the method.

Powdery mildew (Oidium heveae Steinm.) is one of the most important leaf diseases in rubber tree (Hevea brasiliensis). However, physiological and molecular processes associated with the Hevea-powdery mildew interaction are still unclear. In this study, effects of powdery mildew infection on the mitochondrial and chloroplast functions in rubber tree were comprehensively investigated. Powdery mildew damaged the structure and function of mitochondria prior to chloroplasts, causing inner and outer membranes disruption. The intact rate of mitochondria membrane was reduced from 70% in control leaves to 23.1% in the leaves at 5 days after inoculation (dai). Significant decreases in the activities of cytochrome c oxidase, NADH oxidation and malate dehydrogenase (MDH) were observed in the powdery mildew-infected leaves. Tricarboxylic acid cycle (TCA) and electron transfer capacity were seriously impaired after powdery mildew invasion. Chlorophyll (Chl) contents, maximal photochemical efficiency (Fv/Fm), actual photochemical efficiency of photosystem II (ΦPSII), and electron transport rate (ETR) were dramatically decreased in the infected leaves from 10 dai. Our results provided new insights into understanding the mechanism of Hevea-powdery mildew interaction in rubber tree.

PURPOSE: To compare orthopedics publications from USA, Japan and China. METHODS: Scientific papers belong to ''Orthopedics'' category of Science Citation Index Expanded subject categories were retrieved from the "PubMed'' and ''Web of Knowledge'' online databases. RESULTS: In the field of orthopedics, the annual number increased significantly from 2000 to 2012 in the three countries (p<0.001). The share of articles increased significantly in China, but decreased significantly in Japan and USA (p<0.05). In 2012, USA contributed 35.3% of the total world output in orthopedics field and ranked 1st; Japan contributed 5.9% and ranked 4th; China contributed 5.2% and ranked 5th. Publications from USA had the highest accumulated IFs and the highest total citations of articles (USA > Japan > China, p<0.001). Average IF from USA was much higher than Japan and China (p<0.001). USA published the most articles in the top ten orthopedics journals (USA (14355) > Japan (1702) > China (487), p<0.01). CONCLUSION: Although China has undergone significant increase in annual number and percentage of scientific publication in orthopedics journals, it still lags far behind USA and Japan in the field of orthopedics in terms of quantity and quality.

FUNDAMENTO: O Imatinib é um inibidor do receptor tirosina-quinase que foi confirmada como exercendo um efeito inibidor sobre a atividade do receptor do PDGF, fator de crescimento plaquetário (PDGFRα e PDGFRβ). OBJETIVO: Investigar o efeito protetor do Imatinib na fibrose miocárdica em acetato de deoxicorticosterona (DOCA)/ratos com hipertensão induzida por sal. MÉTODOS: Sessenta ratos Sprague-Dawley machos, uninefrectomizados foram distribuídos em três grupos: ratos controles (grupo CON): grupo deoxicorticosterona (grupo DOCA); grupo deoxicorticosterona e Imatinib (grupo DOCA IMA). A Pressão Arterial Sistólica (PAS) foi medida quinzenalmente. Foi estudada a porção apical do ventrículo esquerdo. Foram empregados: coloração vermelho sirius, coloração de hematoxilina-eosina, imuno-histoquímica e ensaio de western blot. RESULTADOS: A PAS nos grupos DOCA e IMA+DOCA foi maior que no grupo CON nos dias 14 e 28. Os animais do grupo DOCA apresentaram fibrose intersticial e perivascular grave no dia 28, e as expressões de PI, PIII, tenascina-C e fibronectina foram significativamente maiores que nos grupos DOCA+IMA e CON. Quando comparados com o grupo CON, os grupos DOCA e DOCA+IMA apresentaram resposta inflamatória de tecido miocárdico e infiltração de monócitos/macrófagos de diferentes graus. As expressões proteicas do PDGF-A, PDGF-C e PDGFRα foram significativamente maiores nos grupos DOCA e DOCA+IMA que no grupo CON, mas a expressão proteica do p-PDGFRα no grupo DOCA+IMA foi menor que no DOCA. CONCLUSÃO: O Imatinib pode exercer efeitos inibitórios sobre a fibrose miocárdica em ratos com hipertensão induzida por DOCA/sal, os quais podem ser atribuídos à inibição da atividade do PDGFR-α.

BACKGROUND: Imatinib is a tyrosine kinase receptor inhibitor that has been confirmed to exert inhibitory effect on the platelet derived growth factor PDGF receptor (PDGFRα and PDGFRβ) activity. OBJECTIVE: To investigate the protective effect of imatinib on the myocardial fibrosis in deoxycorticosterone-acetate (DOCA)/salt induced hypertensive rats. METHODS: Sixty male uninephrectomized Sprague-Dawley rats were assigned to three groups: control rats (CON group); deoxycorticosterone group (DOCA group); deoxycorticosterone and imatinib group (DOCA+IMA group). Systolic blood pressure (SBP) was measured biweekly. The apical portion of the left ventricle was studied. Sirius-Red staining, Hematoxylin-Eosin staining, immunohistochemistry and Western blot assay were employed. RESULTS: SBP in the DOCA group and DOCA+IMA group was higher than that in the CON group on day 14 and 28. Animals in the DOCA group showed severe interstitial and perivascular fibrosis on day 28, and the expressions of PI, PIII, tenascin-C and fibronectin were significantly higher than those in the DOCA+IMA group and CON group. When compared with the CON group, myocardial tissue inflammatory response and monocyte/macrophage infiltration of different degrees were observed in the DOCA group and DOCA+IMA group. Protein expressions of PDGF-A, PDGF-C and PDGFRα were signiflcantly higher in the DOCA and DOCA+IMA groups than those in the CON group, but the p-PDGFRα protein expression in the DOCA+IMA group was lower than that in the DOCA group. CONCLUSION: Imatinib can exert inhibitory effects on myocardial fibrosis in DOCA/salt induced hypertensive rats, which may be attributed to the inhibition of PDGFR-α activity.

OBJECTIVES: The aim of this study was to evaluate the diagnostic performance of serum HA and LN as serum markers for predicting significant fibrosis in CHB patients. METHODS: Serum HA and LN levels of 87 patients with chronic hepatitis B and 19 blood donors were assayed by RIA. Liver fibrosis stages were determined according to the Metavir scoring-system. The diagnostic performances of all indexes were evaluated by the receiver operating characteristic (ROC) curves. RESULTS: Serum HA and LN concentrations increased significantly with the stage of hepatic fibrosis, which showed positive correlation with the stages of liver fibrosis (HA: r = 0.875, p < 0.001; LN: r = 0.610, p < 0.001). There were significant differences of serum HA and LN levels between F2-4 group in comparison with those in F0-F1 group (p < 0.001) and controls (p < 0.001), respectively. From ROC curves, 185.3 ng/mL as the optimal cut-off value of serum HA for diagnosis of significant fibrosis, giving its sensitivity, specificity, PPV, NPV, LR+, LR- and AC of 84.2%, 83.3%, 90.6%, 73.5%, 5.04, 0.19 and 83.9, respectively. While 132.7 ng/mL was the optimal cut-off value of serum LN, the sensitivity, specificity, PPV, NPV, LR+, LR- and AC were 71.9%, 80.0%, 87.2%, 60.0%, 3.59%, 0.35% and 74.7, respectively. Combinations of HA and LN by serial tests showed a perfect specificity and PPV of 100%, at the same time sensitivity declined to 63.2% and LR+ increased to 18.9, while parallel tests revealed a good sensitivity of 94.7%, NPV to 86.4%, and LR- declined to 0.08. CONCLUSIONS: Serum HA and LN concentrations showed positive correlation with the stages of liver fibrosis. Detection of serum HA and LN in predicting significant fibrosis showed good diagnostic performance, which would be further optimized by combination of the two indices. HA and LN would be clinically useful serum markers for predicting significant fibrosis in patients with chronic hepatitis B, when liver biopsy is contraindicated.