BACKGROUND & AIMS: -2

背景与目标： -2

BACKGROUND & AIMS: :Chronic patellofemoral instability can be a disabling condition. Management of patients with this condition has improved owing to our increased knowledge of the functional anatomy of the patellofemoral joint. Accurate assessment of the underlying pathology in the unstable joint enables the formulation of appropriate treatment. The surgical technique employed in patients for whom non-operative management has failed should address the diagnosed abnormality. We have reviewed the literature on the stabilising features of the patellofemoral joint, the recommended investigations and the appropriate forms of treatment.

背景与目标： ：慢性pa股不稳可能是一种残疾状况。由于我们对the股关节功能解剖学的了解增加，对这种情况的患者的管理得到了改善。准确评估不稳定关节中的潜在病理状况可以制定适当的治疗方案。在非手术治疗失败的患者中采用的外科手术技术应解决诊断出的异常情况。我们回顾了有关of股关节稳定特征，推荐的研究方法和适当治疗方式的文献。

BACKGROUND & AIMS: :OBJECTIVE Spinal navigation techniques for surgical fixation of unstable C1-2 pathologies are challenged by complex osseous and neurovascular anatomy, instability of the pathology, and unreliable preoperative registration techniques. An intraoperative CT scanner with autoregistration of C-1 and C-2 promises sufficient accuracy of spinal navigation without the need for further registration procedures. The aim of this study was to analyze the accuracy and reliability of posterior C1-2 fixation using intraoperative mobile CT scanner-guided navigation. METHODS In the period from July 2014 to February 2016, 10 consecutive patients with instability of C1-2 underwent posterior fixation using C-2 pedicle screws and C-1 lateral mass screws, and 2 patients underwent posterior fixation from C-1 to C-3. Spinal navigation was performed using intraoperative mobile CT. Following navigated screw insertion in C-1 and C-2, intraoperative CT was repeated to check for the accuracy of screw placement. In this study, the accuracy of screw positioning was retrospectively analyzed and graded by an independent observer. RESULTS The authors retrospectively analyzed the records of 10 females and 2 males, with a mean age of 80.7 ± 4.95 years (range 42-90 years). Unstable pathologies, which were verified by fracture dislocation or by flexion/extension radiographs, included 8 Anderson Type II fractures, 1 unstable Anderson Type III fracture, 1 hangman fracture Levine Effendi Ia, 1 complex hangman-Anderson Type III fracture, and 1 destructive rheumatoid arthritis of C1-2. In 4 patients, critical anatomy was observed: high-riding vertebral artery (3 patients) and arthritis-induced partial osseous destruction of the C-1 lateral mass (1 patient). A total of 48 navigated screws were placed. Correct screw positioning was observed in 47 screws (97.9%). Minor pedicle breach was observed in 1 screw (2.1%). No screw displacement occurred (accuracy rate 97.9%). CONCLUSION Spinal navigation using intraoperative mobile CT scanning was reliable and safe for posterior fixation in unstable C1-2 pathologies with high accuracy in this patient series.

背景与目标： ：客观的脊柱导航技术用于复杂的骨和神经血管解剖学，病理学的不稳定性以及不可靠的术前配准技术，对不稳定的C1-2病理学的外科手术固定提出了挑战。具有C-1和C-2自动配准的术中CT扫描仪保证了脊柱导航的足够准确性，而无需进一步的配准程序。这项研究的目的是分析术中使用移动CT扫描仪引导的导航技术对C1-2后路固定的准确性和可靠性。方法2014年7月至2016年2月，连续10例C1-2不稳定的患者采用C-2椎弓根螺钉和C-1侧块螺钉进行后路固定，另有2例患者经C-1到C-后路固定3。脊柱导航是使用术中移动CT进行的。在将螺钉固定插入C-1和C-2之后，重复术中CT检查螺钉放置的准确性。在这项研究中，由独立的观察者对螺钉定位的准确性进行了回顾性分析和分级。结果作者回顾性分析了10名女性和2名男性的记录，平均年龄为80.7±4.95岁（范围42-90岁）。通过骨折脱位或屈曲/伸展X线片检查证实的不稳定病理包括8例安德森II型骨折，1例不稳定安德森III型骨折，1例行人骨折Levine Effendi Ia，1例复杂hangman-Anderson III型骨折和1例破坏性类风湿病C1-2的关节炎。在4例患者中，观察到了关键的解剖结构：高位脊椎动脉（3例）和关节炎引起的C-1侧块的部分骨性破坏（1例）。总共放置了48个导航螺钉。在47个螺钉（97.9％）中观察到正确的螺钉定位。在1个螺钉中观察到较小的椎弓根破坏（2.1％）。没有发生螺丝位移（准确率97.9％）。结论在本患者系列中，使用术中移动CT扫描进行脊柱导航在不稳定的C1-2病理中进行后路固定术是可靠且安全的，且具有较高的准确性。

BACKGROUND & AIMS: :Both operative and nonoperative management of the unstable shoulder requires a thorough understanding of the natural history of instability, as well as the normal anatomy and biomechanics of the shoulder joint. Failure of management may occur at any time during the course of treatment, and may be a result of either physician or patient error, or a combination of both. The correct diagnosis allows for selection of the most appropriate treatment, and the success of surgical treatment depends on proper recognition of the pattern of instability and technically adequate anatomic capsulolabral reconstruction. Complications that can occur include making the shoulder too loose or too tight, injury to the neurovascular elements about the shoulder, and articular injury from hardware usage about the shoulder.

背景与目标： ：对不稳定肩部的手术和非手术处理都需要对不稳定性的自然病史以及肩关节的正常解剖结构和生物力学有透彻的了解。治疗失败可能在治疗过程中的任何时候发生，并且可能是由于医生或患者错误，或两者兼而有之。正确的诊断可以选择最合适的治疗方法，而手术治疗的成功取决于对不稳定性模式的正确认识和技术上适当的解剖性cap囊重建。可能发生的并发症包括使肩膀变得太松或太紧，对肩膀周围的神经血管元件造成的伤害以及由于肩膀周围的硬件使用而引起的关节伤害。

BACKGROUND & AIMS: PURPOSE:This project explored the influence of loss of heterozygosity (LOH) and microsatellite instability (MSI) of locus D8S277 to PINX1 expression of gastric cancer in Chinese people. METHODS:LOH and MSI of locus D8S277 in 90 paraffin-embedded gastric carcinoma specimens were detected by polymerase chain reaction-single strand conformation polymorphism (PCR-SSCP). Envision immunohistochemistry was used to assess the expression of PINX1. RESULTS:The frequency of LOH was higher in cases with lymph node metastasis than those without (18.57 vs. 0.00%, P < 0.01), and was higher in the specimens that were at TNM stage III + IV than those at stage I + II (21.43 vs. 2.94%, P < 0.01). In terms of the frequency of MSI, it was lower in cases with lymph node metastasis than those without (10.00 vs. 30.00%,P < 0.05). The positive rate of PINX1 protein was higher in samples without lymph node metastasis than those with lymph node metastasis (80.00 vs. 50.00%, P < 0.01); and was higher in the cases at TNM stage I + II than those at stage III + IV; and was lower in the cases between 40 and 60 years old than those above 60 years old (43.75 vs. 65.52%, P < 0.05). CONCLUSION:LOH and MSI of PINX1 may play major role in tumor development and regulate it through different pathways. Because LOH plays a major role in negative expression of PINX1, it can be regarded as a sign of gastric cancer development and MSI may affect the prognosis and tumor turnover.

背景与目标： 目的：本项目探讨了D8S277基因座杂合性丧失（LOH）和微卫星不稳定性（MSI）对中国人胃癌PINX1表达的影响。
方法：采用聚合酶链反应-单链构象多态性（PCR-SSCP）检测90例石蜡包埋的胃癌D8S277位点的LOH和MSI。使用Envision免疫组化评估PINX1的表达。
结果：淋巴结转移病例的LOH频率高于无淋巴结转移者（18.57 vs.0.00％，P <0.01），TNM III期IV的标本的LOH频率高于I II期的（21.43）比2.94％，P <0.01）。就MSI的发生频率而言，有淋巴结转移的患者的MSI发生率要低于没有淋巴结转移的患者（10.00 vs. 30.00％，P <0.05）。在无淋巴结转移的样本中，PINX1蛋白的阳性率高于有淋巴结转移的样本（80.00 vs. 50.00％，P <0.01）；在TNM第II阶段的病例要高于第III IV阶段的病例；并且在40至60岁之间的情况下比60岁以上的人群要低（43.75对65.52％，P <0.05）。
结论：PINX1的LOH和MSI可能在肿瘤发展中起主要作用，并通过不同途径对其进行调控。由于LOH在PINX1的负表达中起主要作用，因此可以认为它是胃癌发展的征兆，MSI可能会影响预后和肿瘤的发生。

BACKGROUND & AIMS: BACKGROUND:Patients who have pain and dysfunction from glenohumeral arthritis associated with severe rotator cuff deficiency have few treatment options. The goal of this study was to retrospectively evaluate the short-term results of arthroplasty with use of the Reverse Shoulder Prosthesis in the management of this problem. METHODS:We report the results for sixty patients (sixty shoulders) with a rotator cuff deficiency and glenohumeral arthritis who were followed for a minimum of two years. Thirty-five patients had no previous shoulder surgery, whereas twenty-three had had either an open or arthroscopic rotator cuff repair, one had had a subacromial decompression, and one had had a biceps tendon repair. All patients were assessed preoperatively and postoperatively with the American Shoulder and Elbow Surgeons scoring system for pain and function and with visual analog scales for pain and function. They were also asked to rate their satisfaction with the outcome. The shoulder range of motion was measured preoperatively and postoperatively. RESULTS:The average age of the patients was seventy-one years. The average duration of follow-up was thirty-three months. All measures improved significantly (p < 0.0001). The mean total score on the American Shoulder and Elbow Surgeons system improved from 34.3 to 68.2; the mean function score, from 16.1 to 29.4; and the mean pain score, from 18.2 to 38.7. The score for function on the visual analog scale improved from 2.7 to 6.0, and the score for pain on the visual analog scale improved from 6.3 to 2.2. Forward flexion increased from 55.0 degrees to 105.1 degrees , and abduction increased from 41.4 degrees to 101.8 degrees . Forty-one of the sixty patients rated the outcome as good or excellent; sixteen were satisfied, and three were dissatisfied. There were a total of thirteen complications in ten patients (17%). Seven patients (12%) had eight failures, requiring revision surgery to another Reverse Shoulder Prosthesis in five patients (one shoulder had two revisions) and revision to a hemiarthroplasty in two patients because of deep infection. CONCLUSIONS:The data from this study suggest that arthroplasty with the Reverse Shoulder Prosthesis may be a viable treatment for patients with glenohumeral arthritis and a massive rotator cuff tear. However, future studies will be necessary to determine the longevity of the implant and whether it will provide continued improvement in function.

背景与目标： 背景：患有因严重肩袖缺损而引起的盂肱型关节炎引起的疼痛和功能障碍的患者几乎没有治疗选择。这项研究的目的是回顾性评估使用反向肩假体治疗该问题的关节置换术的短期结果。
方法：我们报告了60例肩袖缺损和盂肱型关节炎患者的结果，这些患者至少随访了两年。 35例患者以前没有进行过肩部手术，而23例患者进行了开放式或关节镜下肩袖修复，1例行肩峰下减压，1例进行了二头肌腱修复。所有患者在术前和术后均通过American Shoulder and Elbow Surgeons疼痛和功能评分系统进行评估，并使用视觉模拟量表评估疼痛和功能。他们还被要求对结果表示满意。术前和术后测量肩膀的运动范围。
结果：患者的平均年龄为71岁。平均随访时间为三十三个月。所有措施均显着改善（p <0.0001）。美国肩肘外科医师系统的平均总得分从34.3提高到68.2；平均功能评分从16.1至29.4；平均疼痛评分从18.2至38.7。视觉模拟量表上的功能评分从2.7提高到6.0，视觉模拟量表上的疼痛评分从6.3提高到2.2。前屈从55.0度增加到105.1度，外展从41.4度增加到101.8度。 60例患者中有41例的结局为好或差。十六个人满意，三个人不满意。 10例患者中共有13例并发症（17％）。 7例患者（占12％）有8例失败，由于深部感染，需要对5例患者的另一个反向肩假体进行翻修手术（其中一个肩膀进行了2次翻修），并且对2例患者进行了半髋置换术翻修。
结论：这项研究的数据表明，带肩关节假体的人工关节置换术可能是对盂肱型关节炎和巨大的肩袖撕裂患者的一种可行的治疗方法。但是，未来的研究对于确定植入物的寿命以及是否能够持续改善其功能将是必要的。

BACKGROUND & AIMS: :Varus posteromedial rotatory instability refers to one of the complex elbow fracture-dislocation caused by anteromedial coronoid fracture with disruption of lateral collateral ligament (LCL). Recent clinical and biomechanical studies have demonstrated that this unstable complex injury resulted in incongruence of joint, which could lead to early posttraumatic arthritis. With reports of poor result after conservative treatment, surgical treatment including anteromedial fixation and LCL repair has been strongly recommended to achieve stable joint. This case series describes three patients with anteromedial coronoid fracture who were managed conservatively with excellent outcomes. This report suggests that anteromedial coronoid fracture associated with posteromedial rotatory instability might be treated using conservative treatment in selective cases when anteromedial coronoid fracture is minimally displaced and there is no evidence of elbow subluxation.

背景与目标： ：内翻后内侧旋转不稳是指由冠状动脉前内侧骨折伴侧副韧带（LCL）破坏引起的复杂肘部骨折脱位之一。最近的临床和生物力学研究表明，这种不稳定的复杂损伤导致关节不协调，这可能导致创伤后早期关节炎。有报道称保守治疗后效果不佳，强烈建议进行外科手术治疗，包括前路内固定和LCL修复，以实现稳定的关节。本病例系列描述了三例冠状动脉前内侧骨折患者，保守治疗均取得了良好的效果。该报告表明，在选择性病例中，当前冠状动脉内侧骨折移位最小且没有肘关节半脱位的证据时，可以采用保守治疗来治疗前内侧旋转不稳定性伴有前内侧冠状动脉骨折。

BACKGROUND & AIMS: :Microsatellite instability (MSI) has been reported in 25% to 45% of sporadic endometrial carcinoma. The clinicopathologic and molecular characteristics of MSI-high phenotype in colorectal and gastric carcinomas have been widely investigated; however, the clinicopathologic impact of MSI on endometrial carcinomas remained unclear. This study was performed to determine the clinicopathologic and molecular significance of MSI in endometrial carcinomas. We analyzed the MSI status using National Cancer Institute-recommended 5 microsatellite markers, and the immunohistochemical profiles of various regulatory proteins of cell cycle and apoptosis using tissue microarray in 100 endometrial carcinomas. The results were compared between MSI-high and MSI(-) groups as for the traditional clinicopathologic prognostic parameters and the immunoreactivities of various regulatory proteins. We especially focused on the endometrioid type adenocarcinoma to exclude the bias from nonendometrioid type adenocarcinomas with more aggressiveness and a close association with MSI(-) phenotype. The incidence of MSI-high phenotype was significantly higher in endometrioid type than in nonendometrioid serous type (20% vs. 0%, P<0.001). It showed orderly increase in the frequencies of MSI-high phenotype in higher histologic grade (13% vs. 21% vs. 50% in histologic grade I, II, and III, P=0.039). The MSI-high phenotype was related with the presence of lymphovascular invasion (P=0.008), deep myometrial invasion (P=0.040), and the higher clinical stages (P=0.018) independent of tumor grade. We also found a correlation between MSI-high phenotype and higher cyclin A and skp2 immunoreactivity (P=0.03 and 0.05, respectively), known to be the poor prognostic molecular indicators. According to these results, the MSI may represent the poor prognostic impact on the endometrioid type endometrial adenocarcinoma.

背景与目标： ：已有25％至45％的散发性子宫内膜癌报道了微卫星不稳定性（MSI）。 MSI高表型在大肠癌和胃癌中的临床病理和分子特征已得到广泛研究；然而，MSI对子宫内膜癌的临床病理影响尚不清楚。进行这项研究以确定MSI在子宫内膜癌中的临床病理和分子意义。我们使用美国国家癌症研究所推荐的5种微卫星标记分析了MSI状态，并使用组织芯片分析了100种子宫内膜癌中细胞周期和凋亡的各种调节蛋白的免疫组织化学特征。将MSI高组和MSI（-）组之间的结果进行比较，以了解传统的临床病理预后参数和各种调节蛋白的免疫反应性。我们特别关注子宫内膜样腺癌，以排除具有更强侵略性且与MSI（-）表型密切相关的非子宫内膜样腺癌的偏倚。子宫内膜样类型的MSI-高表型的发生率显着高于非子宫内膜样浆液性（20％vs. 0％，P <0.001）。在较高的组织学等级中，显示MSI-高表型的频率有序增加（在组织学等级I，II和III中，分别为13％对21％和50％，P = 0.039）。 MSI-高表型与淋巴管浸润（P = 0.008），深层子宫肌层浸润（P = 0.040）以及较高的临床分期（P = 0.018）有关，而与肿瘤分级无关。我们还发现了MSI高表型与较高的细胞周期蛋白A和skp2免疫反应性之间的相关性（分别为P = 0.03和0.05），这被认为是不良的预后分子指标。根据这些结果，MSI可能代表对子宫内膜样型子宫内膜腺癌的不良预后影响。

BACKGROUND & AIMS: OBJECTIVE:To evaluate the diagnostic yield of two acquisitions of single-contrast CT arthrography (CTA) of the shoulder in internal, neutral, or external glenohumeral rotation with arthroscopic correlation. MATERIALS AND METHODS:The CT study was obtained using two acquisitions (first the humerus positioned in maximum tolerated external rotation with the arm along the body and the second with the humerus in internal rotation with the palm placed flat on the table). Two independent readers blinded to the arthroscopic results evaluated the CTA images for labral tears, glenoid bone loss/fractures, and cartilage loss. For each CTA acquisition, sensitivity and specificity for detection of the aforementioned pathology were assessed. Inter-reader agreement was quantified by weighted ĸ statistics. RESULTS:Sensitivity and specificity for detecting anteroinferior or posterior labral tears was highest with neutral rotation (sensitivity 91-100%, specificity 61-100%). For glenoid fracture, sensitivity (67%) was highest with external rotation and specificity (100%) was highest with internal rotation. For cartilage loss, sensitivity (64%) and specificity (89%) was highest with external rotation and neutral rotation, respectively. Neutral rotation showed high sensitivity and specificity for glenoid fractures and cartilage loss. Inter-reader agreement ranged from fair to very good. CONCLUSIONS:Neutral glenohumeral position in shoulder CT arthrography was adequately sensitive and specific for the detection of intra-articular pathology, avoiding the use of more than one acquisition.

背景与目标： 目的：通过关节镜相关性评估两次获取的单次CT单次CT造影（CTA）在内部，中性或外部盂肱旋转中的诊断价值。
材料与方法：CT研究是通过两次采集获得的（首先，肱骨在手臂沿身体的最大允许外旋中定位，第二步在肱骨内旋转且手掌平放在桌子上的状态下进行肱骨旋转）。两名不愿接受关节镜检查结果的独立读者评估了CTA图像的唇裂，盂盂骨丢失/骨折和软骨丢失。对于每次CTA采集，评估用于检测上述病理的敏感性和特异性。读者间的一致性通过加权统计来量化。
结果：中性旋转时，检出前下唇或后唇撕裂的敏感性和特异性最高（敏感性为91-100％，特异性为61-100％）。对于关节盂骨折，外旋敏感性最高（67％），内旋特异性最高（100％）。对于软骨损失，外旋和中性旋转分别具有最高的敏感性（64％）和特异性（89％）。中性旋转显示出对关节盂骨折和软骨损失的高敏感性和特异性。读者间的协议范围从公平到非常好。
结论：肩部CT关节造影中的肱骨肱中位对于检测关节内病变具有足够的敏感性和特异性，避免了多次采集。

BACKGROUND & AIMS: :Using x-ray magnetic spectroscopy with in-situ electrical characterizations, we investigated the effects of external voltage on the spin-electronic and transport properties at the interface of a Fe/ZnO device. Layer-, element-, and spin-resolved information of the device was obtained by cross-tuning of the x-ray mode and photon energy, when voltage was applied. At the early stage of the operation, the device exhibited a low-resistance state featuring robust Fe-O bonds. However, the Fe-O bonds were broken with increasing voltage. Breaking of the Fe-O bonds caused the formation of oxygen vacancies and resulted in a high-resistance state. Such interface reconstruction was coupled to a charge-transfer effect via Fe-O hybridization, which suppressed/enhanced the magnetization/coercivity of Fe electronically. Nevertheless, the interface became stabilized with the metallic phase if the device was continuously polarized. During this stage, the spin-polarization of Fe was enhanced whereas the coercivity was lowered by voltage, but changes of both characteristics were reversible. This stage is desirable for spintronic device applications, owing to a different voltage-induced electronic transition compared to the first stage. The study enabled a straightforward detection of the spin-electronic state at the ferromagnet-semiconductor interface in relation to the transport and reversal properties during operation process of the device.

背景与目标： ：使用具有原位电学特征的X射线电磁光谱技术，我们研究了外部电压对Fe / ZnO器件界面处的自旋电子和输运性质的影响。当施加电压时，通过交叉调整X射线模式和光子能量，可以获得设备的层，元素和自旋分辨信息。在操作的早期阶段，该器件表现出具有坚固的Fe-O键的低电阻状态。然而，随着电压的升高，Fe-O键断裂。 Fe-O键的断裂导致氧空位的形成并导致高电阻状态。这种界面重建通过Fe-O杂化作用耦合到电荷转移效应，从而电子地抑制/增强了Fe的磁化/矫顽力。但是，如果器件连续极化，则界面会被金属相稳定。在此阶段，铁的自旋极化增强，而矫顽力由于电压而降低，但两种特性的变化都是可逆的。由于与第一阶段相比，电压感应的电子跃迁不同，因此该阶段对于自旋电子设备应用是理想的。这项研究使得能够在设备操作过程中直接检测铁磁-半导体界面上的自旋电子状态与传输和反转特性之间的关系。

BACKGROUND & AIMS: Cytogenetic study in a case of a human chromophobe renal cell carcinoma revealed a hypodiploid chromosome number of 36 with loss of chromosomes 1, 2, 5, 6, 10, 13, 15, 17, 21, and X. The tumor DNA showed microsatellite instability in dinucleotide repeat microsatellite markers. This is the fourth case that has been fully karyotyped and showed a low chromosome number in a chromophobe renal cell carcinoma. Our data in the present study are consistent with those in the literature. It is suggested that human chromophobe renal cell carcinoma may possibly be characterized by tumor cells with low chromosome number or microsatellite instability.

背景与目标： 在人类发色团肾细胞癌病例中进行的细胞遗传学研究显示，二倍体染色体数为36，缺失了1、2、5、6、10、13、15、17、21和X染色体。肿瘤DNA显示微卫星不稳定性在二核苷酸中重复微卫星标记。这是第四例完全染色体核型，并且在发色肾细胞癌中显示出低染色体数。我们在本研究中的数据与文献中的一致。提示人类发色团肾细胞癌的特征可能在于低染色体数或微卫星不稳定性的肿瘤细胞。

BACKGROUND & AIMS: BACKGROUND:Chronic ankle instability (CAI) induces osteoarthritis (OA) by inflicting abnormal stresses on the medial gutter. It is important to detect early OA change and to explore factors likely to induce the OA. The purpose of this study was to evaluate subchondral bone change in the medial gutter of CAI using computed tomography (CT) scans. METHODS:Thirty-five ankles with CAI (CAI group) and 35 ankles without CAI (control group) were included. The region of interest (ROI) in the subchondral bone of the medial gutter on CT axial images was set on the tibia and talus. The Hounsfield unit (HU) in ROIs was measured and corrected by the HU of the fibula in the same slice. HU ratios were compared between the CAI and control groups. In the CAI group, the relationship between the HU ratio and the talar tilt angle (TTA), OA change, and the anterior talofibular ligament (ATFL) remnant quality were analyzed. RESULTS:The mean HU ratio in the CAI group was significantly higher than that in the control. In the CAI group, HU ratios in ≥10 degrees of TTA were significantly higher than those in <10 degrees. But there was no significant difference in the HU ratios with or without OA change in the medial gutter. A good-quality ATFL remnant showed a low HU ratio compared with that with poor quality. CONCLUSION:CAI patients exhibited subchondral bone change in the medial gutter, which suggests that the elimination of instability may help to prevent or decrease the development and/or progression of osteoarthritis. LEVEL OF EVIDENCE:Level III, comparative series.

背景与目标： 背景：慢性踝关节不稳（CAI）通过对内侧水槽施加异常压力来诱发骨关节炎（OA）。重要的是要发现早期OA的变化并探讨可能诱发OA的因素。这项研究的目的是使用计算机断层扫描（CT）扫描评估CAI内侧沟中软骨下骨的变化。
方法：包括35只CAI踝关节（CAI组）和35只无CAI踝关节（对照组）。在CT轴向图像上，内侧沟槽的软骨下骨中的感兴趣区域（ROI）设置在胫骨和距骨上。通过相同切片中腓骨的HU来测量和校正ROI中的Hounsfield单位（HU）。比较了CAI组和对照组之间的HU比率。在CAI组中，分析了HU比与距骨倾斜角（TTA），OA变化和距前腓韧带（ATFL）残留质量之间的关系。
结果：CAI组的平均HU比值显着高于对照组。在CAI组中，TTA≥10度的HU比明显高于<10度的HU。但是，无论有无内沟OA改变，HU比率均无显着差异。优质的ATFL残余物与低劣的质量相比显示出较低的HU比率。
结论：CAI患者的内侧沟软骨下骨改变，提示不稳定性的消除可能有助于预防或减少骨关节炎的发展和/或发展。
证据水平：III级，比较系列。

BACKGROUND & AIMS: :Microsatellite instability (MSI) in human carcinoma DNA is a characteristic phenotype observed in hereditary non-polyposis colorectal cancer and also in some human sporadic cancers including multiple primary carcinomas. In this study, we analyzed mutations in the hCHK1, E2F4, hMSH3, and hMSH6 genes in MSI+ human cancers arising in colorectum, stomach and endometrium. The E2F4 and hMSH3 genes were mutated in all tumor types. Interestingly, the hMSH6 gene was mutated in colorectal and gastric cancers but not in endometrial cancer; this is similar to the TGFbetaRII gene. It is notable that the mutation status of the secondary mutators, hMSH3 and hMSH6, did not influence slippage-related frameshift mutations in genes harboring simple tandem-repeats, which suggests that the MSI phenotype may be affected mainly by abnormalities in the primary mutator genes, not by the secondary mutator genes. No mutations were observed in the cell cycle checkpoint gene hCHK1; mutations of this gene are thought to have a limited role, if any, in at least the tumor types analyzed in this study.

背景与目标： ：人类癌症DNA中的微卫星不稳定性（MSI）是在遗传性非息肉性结直肠癌以及某些人类散发性癌症（包括多种原发癌）中观察到的特征表型。在这项研究中，我们分析了MSI人类癌症中由结直肠，胃和子宫内膜引起的hCHK1，E2F4，hMSH3和hMSH6基因突变。 E2F4和hMSH3基因在所有肿瘤类型中均发生突变。有趣的是，hMSH6基因在大肠癌和胃癌中发生了突变，而在子宫内膜癌中没有发生突变。这类似于TGFbetaRII基因。值得注意的是，二级突变体hMSH3和hMSH6的突变状态不会影响具有简单串联重复序列的基因中与滑移相关的移码突变，这表明MSI表型可能主要受一级突变体基因的异常影响，而不是由次级突变基因。在细胞周期检查点基因hCHK1中未观察到突变。该基因的突变至少在本研究中分析的肿瘤类型中被认为具有有限的作用（如果有的话）。

BACKGROUND & AIMS: OBJECTIVES:To assess the efficacy and safety of trospium chloride (TCl, 20 mg twice daily) in the treatment of detrusor instability, compared with placebo. PATIENTS AND METHODS:In all, 208 patients were allocated at random to either TCl or placebo in a double-blind clinical study; the patients were treated for 3 weeks. Urodynamic values were measured at the beginning and end of the treatment period. Adverse events were recorded on patient diary cards. A confirmatory adaptive procedure with one planned interim analysis was used to evaluate efficacy. RESULTS:Trospium chloride produced significant improvements in maximum cystometric bladder capacity (median treatment effect 22.0 mL, mean 37.3 mL, one-sided P = 0. 0054) and urinary volume at first unstable contraction (median treatment effect 45.0 mL, mean 63.6 mL, one-sided P = 0.0015). The patients' assessment of efficacy showed significantly greater clinical improvement in the TCl group than in the placebo group (two-sided P = 0.0047). Furthermore, TCl was well tolerated, with similar frequencies of adverse events reported in both groups (68% in the TCl and 62% in the placebo group). CONCLUSION:Trospium chloride (20 mg twice daily) is an effective and safe option for the treatment of detrusor instability.

背景与目标： 目的：与安慰剂相比，评估氯化钾（TC1，每天两次，每次20 mg）在治疗逼尿肌不稳中的疗效和安全性。
病人和方法：在一项双盲临床研究中，共有208名患者被随机分配为TCl或安慰剂。患者接受了3周的治疗。在治疗期的开始和结束时测量尿动力学值。不良事件记录在患者的日记卡上。验证性的适应性程序和一个计划中的中期分析用于评估疗效。
结果：氯化ros的最大膀胱容量（中位治疗效果为22.0 mL，平均37.3 mL，单侧P = 0. 0054）和首次不稳定收缩时的尿量（中位治疗效果为45.0 mL，平均为63.6 mL）产生了显着改善。一侧P = 0.0015）。患者对疗效的评估显示，TC1组的临床改善明显高于安慰剂组（双面P = 0.0047）。此外，TC1的耐受性良好，两组中不良事件的发生频率相似（TCI中为68％，安慰剂组为62％）。
结论：氯化ros（20 mg，每天两次）是治疗逼尿肌不稳定的有效且安全的选择。

BACKGROUND & AIMS: :Expansion of trinucleotide repeats is associated with a growing number of human diseases. The mechanism and timing of expansion of the repeat tract are poorly understood. In humans, trinucleotide repeats show extreme meiotic instability, and expansion of the repeat tract has been suggested to occur in the germ-line mitotic divisions or postmeiotically during early divisions of the embryo. Studies in model organisms have indicated that polymerase slippage plays a major role in the repeat tract instability and meiotic instability is severalfold higher than the mitotic instability. We show here that meiotic instability of the CAG/CTG repeat tract in yeast is associated with double-strand break (DSB) formation within the repeated sequences, and that the DSB formation is dependent on the meiotic recombination machinery. The DSB repair results in both expansions and contractions of the CAG repeat tract.

背景与目标： 三核苷酸重复序列的扩增与越来越多的人类疾病有关。重复管道扩展的机理和时机知之甚少。在人类中，三核苷酸重复序列显示出极度的减数分裂不稳定，并且已暗示在胚系有丝分裂分裂中或在胚胎的早期分裂发生于减数分裂后，重复序列的扩增会发生。在模型生物中的研究表明，聚合酶滑移在重复道不稳定性中起主要作用，减数分裂不稳定性比有丝分裂不稳定性高出几倍。我们在这里显示，CAG / CTG重复序列在酵母中的减数分裂不稳定与重复序列内的双链断裂（DSB）形成有关，并且DSB的形成取决于减数分裂重组机制。 DSB修复导致CAG重复道的扩张和收缩。