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To compare the short-term and long-term results of thoracoscopic and open pneumonectomy for non-small cell lung cancer. The clinical data of patients with non-small cell lung cancer who underwent pneumonectomy in the Department of Thoracic Surgery, Qingdao University Hospital from January 2008 to December 2016 were collected. Totally 142 patients (55 in the thoracoscopic group and 87 in the open group) were included in the study. A total of 29 pairs of patients were successfully matched by propensity score matching (PSM). Perioperative outcomes and overall survival were compared between the two groups using test, χ(2) test, Kaplan-Meier curve and Log-rank test, respectively. Camparion with open group, the thoracoscopic group had longer operative time ((209.7±70.2) minutes . (171.3±43.5) minutes, 2.50, 0.02), more mediastinal lymph node dissection ((): 17(9) . 11(10), =388, 0.02) and shorter postoperative hospital stay (7.0(3.5) . 9.0(3.0), =285, 0.03). There was no significant difference in estimated blood loss, postoperative drainage time, dissected lymph node number, dissected lymph node station and perioperative complications. After PSM, there were no signifificant differences found in 3-year survival (71.4% . 48.1%, 0.10) and 3-year disease-free survival (67.4% . 47.2%, 0.13) between the two groups. Thoracoscopic pneumonectomy is safe and feasible for the treatment of non-small cell lung cancer with more mediastinal lymph node dissection and accelerating recovery, and equivalent long-term prognosis when compared with open approach.
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Objective: To establish a canine model of lumbosacral nerve root compression, so as to search for treatment for radicular pain and numbness caused by nerve root compression. Methods: Eighteen male adult mongrel dogs were evenly randomized into 3 groups: 7 days group, 14 days group and 28 days group. A 5 mm long thick silica tube (diameter 3-4 mm) were implanted under right L6, L7 and S1 nerve root to establish the compression model; the left side served as self controls. Results: Dynamic observation with histopathology and immunohistochemical staining showed that, after the nerve root nerve root compression, the myelinated nerve fibers decreased and there was ultrastructure changes of the nerve fibers, such as Schwann cell cytoplasm swelling and edema, Wallerian degeneration, and demyelinated degeneration of axons. Conclusion: The ultra-structural changes of nerve root are the pathological basis of the function loss of the nerve root. The present model is more closer to the model of lumbar intervertebral disc herniation and stenosis of nerve root compression and it provides a basis for treatment of compression-caused radicular pain and numbness in clinic.
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Objective: To prepare stable, small-sized injectable sustained-release nanoparticles harboring brain-derived neurotrophic factor (BDNF) and to evaluate its drug releasing process. Methods: The nanoparticles were prepared using poly (D,L-lactic-co-glycolic acid) (PLGA) as the carrier by w/o/w double emulsion-solvent evaporation method. The formula and technique were optimized; the shape,size and the distribution of the diameters of the particles were observed; and recovery rate, precision, repeatability, encapsulation efficiency,and drug releasing characteristics were assessed. Results: With the optimized formula, the drug loading rate was 1%,the polymer concentration was 3.3 mg/ml, and the ultrasound time was 40 s; mannitol was used as the supporting agent. BDNF nanoparticles were round, homogenous in size, with a mean diameter of 156.7 nm. The prepared particles had high recovery rate, precision, repeatability, and encapsulation efficiency. The drug release was characterized by slow corrosion and the process lasted for 30 days. Conclusion: We have successfully prepared slow-release nanoparticles harboring BDNF, which are stable and have high encapsulation efficiency.
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<p><b>OBJECTIVE</b>To review the literature on the clinical progress in cauda equina syndrome (CES), including the epidemic history, pathogenesis, diagnosis, treatment policy and prognosis. Data sources All reports on CES in the literature were searched in PubMed, Ovid, Springer, Elsevier, and the Chinese Biomedical Literature Disk using the key terms "cauda equina syndrome", "diagnosis", "treatment", "prognosis" and "evidence-based medicine". Study selection Original milestone articles and critical reviews written by major pioneer investigators about the cauda equina syndrome were selected.</p><p><b>RESULTS</b>CES is rare, both atraumatically and traumatically. Males and females are equally affected. The incidence of CES is variable, depending on the etiology of the syndrome. The most common cause of CES is herniation of a lumbar intervertebral disc. CES symptoms may have sudden onset and evolve rapidly or sometimes chronic ally. Each type of CES has different typical signs and symptoms. Low back pain may be the most significant symptoms, accompanied by sciatica, lower extremities weakness, saddle or perianal hypoesthesia, sexual impotence, and sphincter dysfunction. MRI is usually the preferred investigation approach. Patients who have had CES are difficult to return to a normal status.</p><p><b>CONCLUSIONS</b>The diagnosis of CES is primarily based on a careful history inquiry and clinical examination, assisted by elective radiologic investigations. Early diagnosis and early surgical decompression are crucial for a favorable outcome in most CES cases.</p>
Subject(s)
Female , Humans , Male , Evidence-Based Medicine , Methods , Magnetic Resonance Imaging , Polyradiculopathy , Diagnosis , PathologyABSTRACT
<p><b>OBJECTIVE</b>To discuss Clinic feature and turnover of delayed hyperextension injury concomitance spinal cord injury of cervical spine.</p><p><b>METHODS</b>The clinic data of 30 patients delayed hyperextension injury of cervical spine were reviewed and analyzed. Course of disease was from 3 months to 8 years. Thirty patients were divided into three groups according to course of disease. The first group, 3 - 6 months, 17 cases; the second group, 6 - 12 months, 8 cases; the third group, 12 months-8 years, 5 cases. Neurological function improvement rates were evaluated according to the JOA scores at preoperative, 3 months and 1 year post operation, and complications were observed in three groups. Twenty-six cases were treated with anterior decompression, bone graft and plate fixation. Four cases were treated with posterior decompression, bone graft and plate fixation.</p><p><b>RESULTS</b>The patient number of the three group exist with statistical significance. Thirty patients were followed up for 18 - 39 months, 23 months on average. Neurological function recovery rates were 23.8% in the first group, 53.9% in the second group and 54.3% in the third group at 1 year post operation. JOA scores of the first group and the second group with statistical significance at 3 months and 1 year post operation. JOA scores of the first group and the third group with statistical significance at 3 months and 1 year post operation. JOA scores of the second group and the third group without statistical significance at 3 months and 1 year post operation.</p><p><b>CONCLUSIONS</b>Incidence of hyperextension injury associated with spinal cord injury of cervical spine would degrade along with course of disease prolong. If delayed spinal cord injury occurred earlier, the patient's condition was severer and badly improvement rate.</p>