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Objective:To evaluate the effect of oblique lateral interbody fusion (OLIF) combined with posterior fixation on segmental alignment in the treatment of degenerative spondylolisthesis (DS).Methods:The clinical data of 40 patients with DS who underwent OLIF combined with posterior fixation from July 2017 to December 2019 were retrospectively analyzed. There were 7 males and 33 females, aged 45-81 years, with an average age of 65.7±9.06 years. The total number of slip segments was 43, including 37 levels at L 4, 5, 5 levels at L 3, 4, and 1 level at L 2, 3. According to the decompression methods, the patients were divided into two groups. 22 patients with 23 levels were treated with direct decompression combined with laminectomy, and 18 patients with 20 levels were treated with indirect decompression without laminectomy. All patients underwent preoperative and intraoperative imaging examination. The disc height (DH), slip ratio (SR) and segmental lordosis (SL) were measured by preoperative CT and intraoperative fluoroscopy images. One-way repeated measures ANOVA was used to compare the radiographic parameters of the segmental alignment prior to cage implantation, following cage insertion and posterior fixation. Bonferroni test was used to compare the radiographic parameters between groups. Results:In the OLIF combined with the posterior fixation, there were statistically significant differences in the radiographic parameters of segmental alignment at different stages of operation [DH ( F=147.786, P<0.001) , SR ( F=83.754, P<0.001) , SL ( F=38.296, P<0.001) ]. DH increased from 7.99±1.39 mm to 11.69±1.72 mm ( P<0.001), SR decreased from 10.67%±4.67% to 8.66%±4.50% ( P=0.001) and SL increased from 7.26°±2.73° to 7.85°±2.30° ( P=0.425). After combined posterior fixation, SR further decreased from 8.66%±4.50% to 2.07%±4.00% ( P<0.001), SL further increased from 7.85°±2.30° to 10.72°±3.08° ( P<0.001), and DH had no significant change ( P=1.000). There was no significant difference in radiographic parameters between the direct decompression group and the indirect decompression group when prior to cage implantation, following cage insertion and following posterior fixation, respectively. Conclusion:OLIF combined with posterior fixation in the treatment of DS can further reduce the slip rate of patients with lumbar degenerative spondylolisthesis and increase the lordosis angle of the surgical segment. At the same time, the direct decompression combined with laminectomy has no significant effect on the segmental alignment.
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Objective:To analyze clinical features of aortoesphageal fistula (AEF) patients with massive upper gastrointestinal hemorrhage.Methods:Five AEF patients with massive upper gastrointestinal hemorrhage admitted in Peking Union Medical College Hospital from 2016 January 1st to 2019 December 31st. The clinical data, endoscopic findings, radiological manifestations, treatment and clinical outcomes were retrospectively analyzed.Results:Among 5 patients, 4 were males, 1 was female with an average age of (58±8) years old. The underlying conditions were atherosclerosis ( n=4), hypertension ( n=3), hyperlipidemia ( n=1); 2 cases had aortic aneurysm stent implantation and 1 case of rheumatic heart disease had valve replacement. All 5 patients were complicated with hematemesis and hypovolemic shock, and 4 cases had sentinel hemorrhage. Contrast-enhanced CT or CT angiography of the aorta showed thicken esophageal wall, local esophageal discontinuity, aortic aneurysm, gas around the aortic stent and contrast agent spilling over. The gastroscopy showed esophageal depression lesions, deep ulcers, mucosal erosion with bleeding. Conservative therapy and endoscopic hemostasis failed, 2 patients died without surgical intervention; 3 patients underwent emergency surgeries, 2 survived and 1 died perioperatively. Conclusions:Aortoesophageal fistula is in lack of specific clinical manifestations but is highly in mortality. Therefore CT and gastrocopic examination should be performed for suspected patients, early diagnosis and surgical treatment are the key to save patients′ lives.
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Objective@#To provide the normal value of atlas (C1) inner sagittal diameter in adults thus defining the diagnostic value of developmental canal stenosis at C1 and to establish the Jishuitan (JST) morphological classification for C1 developmental canal stenosis in craniovertebral junction (CVJ) anomalies.@*Methods@#From December 2010 to November 2018, 101 patients with various CVJ anomalies (50 males, 51 females; mean age 48.8±12.9 years, range 15-78 years; the anomaly group) and 857 patients with normal CVJ (461 males, 396 females; mean age 50.2±8.3 years, range 21-79 years; the normal group) were enrolled in a retrospective study. In the anomaly group, 92 cases of atlantoaxial dislocation were furtherly divided into three subgroups according to Wadia classification: atlantoaxial dislocation with os odontoideum (OO subgroup, n=33), atlantoaxial dislocation with occipitalization of the atlas (OA subgroup, n=24), atlantoaxial dislocation without both OO and OA (AAD subgroup, n=35); the rest of the anomaly group was combined with Chiari malformation (CM subgroup, n=9). The range of C1 inner sagittal diameter in each group was measured via CT scan images. The normality of C1 inner sagittal diameter of each group was tested via Shapiro-Wilk method. T test was performed on C1 inner sagittal diameter of each group. The diagnostic value of C1 developmental canal stenosis was defined as the lower bound of 95% confidence interval (CI) for the mean of the normal group. The C1 morphology of developmental canal stenosis cases in anomaly group were analyzed via CT scan images thus establishing the JST morphological classification for C1 developmental canal stenosis in CVJ anomalies.@*Results@#The mean C1 inner sagittal diameter was 29.05±1.60 mm (range, 24.05-33.50, 95%CI: 25.91-32.19). C1 developmental canal stenosis was defined as C1 inner diameter ≤ 25.91 mm. The mean C1 inner sagittal diameter of the whole anomaly group was 26.84±2.04 mm (95%CI: 22.84-30.84), which differed significantly from that in the the normal group (t=10.504, P< 0.01). A total of 33 cases meeting the criteria of C1 inner diameter ≤ 25.91 mm were diagnosed as C1 developmental canal stenosis, including 14 cases of the OO subgroup, 4 cases of the OA subgroup, 15 cases of the AAD subgroup and none of the CM subgroup. Based on the C1 morphological characteristics of 33 cases, the JST classification of C1 developmental canal stenosis in CVJ anomalies was established, which could be divided into type I-III. Type I: little atlas type, 84.9% (28/33), normal C1 posterior arch morphology without C1 occipitalization; Type II: atlas posterior arch incurving type, 3.0%(1/33), C1 posterior arch incurves towards spinal canal, without C1 occipitalization; Type III atlas occipitalization type, 12.1% (4/33), furtherly divided into: type IIIa with normal C1 posterior arch morphology; type IIIb with incurving C1 posterior arch.@*Conclusion@#The normal value of C1 inner sagittal diameter in adults was from 24.05 to 33.50 mm. The criteria of C1 inner sagittal diameter ≤ 25.91 mm can be used as the radiographic diagnostic value of C1 developmental canal stenosis. C1 developmental canal stenosis in CVJ anomalies can be classified according to the JST classification system.
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Objective To provide the normal value of atlas (C1) inner sagittal diameter in adults thus defining the diag?nostic value of developmental canal stenosis at C1 and to establish the Jishuitan (JST) morphological classification for C1 develop?mental canal stenosis in craniovertebral junction (CVJ) anomalies. Methods From December 2010 to November 2018, 101 pa?tients with various CVJ anomalies (50 males, 51 females; mean age 48.8±12.9 years, range 15-78 years; the anomaly group) and 857 patients with normal CVJ (461 males, 396 females; mean age 50.2±8.3 years, range 21-79 years; the normal group) were en?rolled in a retrospective study. In the anomaly group, 92 cases of atlantoaxial dislocation were furtherly divided into three sub?groups according to Wadia classification: atlantoaxial dislocation with os odontoideum (OO subgroup, n=33), atlantoaxial disloca?tion with occipitalization of the atlas (OA subgroup, n=24), atlantoaxial dislocation without both OO and OA (AAD subgroup, n=35); the rest of the anomaly group was combined with Chiari malformation (CM subgroup, n=9). The range of C1 inner sagittal diam?eter in each group was measured via CT scan images. The normality of C1 inner sagittal diameter of each group was tested via Shap?iro?Wilk method. T test was performed on C1 inner sagittal diameter of each group. The diagnostic value of C1 developmental canal stenosis was defined as the lower bound of 95% confidence interval ( CI) for the mean of the normal group. The C1 morphology of de?velopmental canal stenosis cases in anomaly group were analyzed via CT scan images thus establishing the JST morphological clas?sification for C1 developmental canal stenosis in CVJ anomalies. Results The mean C1 inner sagittal diameter was 29.05±1.60 mm (range, 24.05-33.50, 95% CI: 25.91-32.19). C1 developmental canal stenosis was defined as C1 inner diameter≤25.91 mm. The mean C1 inner sagittal diameter of the whole anomaly group was 26.84±2.04 mm (95% CI: 22.84-30.84), which differed signifi?cantly from that in the the normal group (t=10.504, P<0.01). A total of 33 cases meeting the criteria of C1 inner diameter≤25.91 mm were diagnosed as C1 developmental canal stenosis, including 14 cases of the OO subgroup, 4 cases of the OA subgroup, 15 cases of the AAD subgroup and none of the CM subgroup. Based on the C1 morphological characteristics of 33 cases, the JST clas?sification of C1 developmental canal stenosis in CVJ anomalies was established, which could be divided into type I-III. Type I: lit?tle atlas type, 84.9% (28/33), normal C1 posterior arch morphology without C1 occipitalization; Type II: atlas posterior arch incurv?ing type, 3.0% (1/33), C1 posterior arch incurves towards spinal canal, without C1 occipitalization; Type III atlas occipitalization type, 12.1% (4/33), furtherly divided into: type IIIa with normal C1 posterior arch morphology; type IIIb with incurving C1 posterior arch. Conclusion The normal value of C1 inner sagittal diameter in adults was from 24.05 to 33.50 mm. The criteria of C1 inner sagittal diameter≤25.91 mm can be used as the radiographic diagnostic value of C1 developmental canal stenosis. C1 developmen?tal canal stenosis in CVJ anomalies can be classified according to the JST classification system.
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Objective To investigate the characteristics of brain network based on brain electrical activity induced by somatosensory electrical stimulation,and to provide a theoretical basis for further understanding the mechanism of brain neural plasticity induced by somatosensory electrical stimulation.Methods Ten healthy subjects were selected and a somatosensory electrical stimulation experiment was constructed based on the directed transfer function (DTF).In the experiment,the DTF causal connection matrixes of the 32-channel EEG data of Delta,Theta,Alpha and Beta bands were obtained under the somatosensory electrical target and non-target stimulation,and the differences of clustering coefficient and global efficiency between two stimulation states were contrasted based on graph theory.Results Under the target stimulation and non-target stimulation states,the regions with stronger DTA causal connections were mainly concentrated in FCz,Cz,CPz and Pz channels.The causal connection intensity under target stimulation state was greater than that of non-target stimulation.Also,in the Delta,Theta,and Alpha bands,the clustering coefficient under the target stimulation state was significantly higher than that in the non-target stimulation state (P＜0.05).In the Delta and Theta bands,the global efficiency of the target stimulation state was significantly higher than that of the non-target stimulation state (P＜0.05).Conclusions Somatosensory electrical stimulation can activate and induce EEG brain networks.In the target stimulation state,the role of the parietal lobe in the EEG causal network is enhanced,which helps to induce attention to specific brain region plasticity,and thus realizing the nerve rehabilitation in the brain regions of interest.While in the non-target stimulation state,the synergistic interactions between brain regions were enhanced,which helps to activate and induce a wide range of associations in the whole brain network,so as to promote the global neural activity in the brain.
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Objective:To investigate the effects of cerebral ischemic postconditioning (CIP)on the expressions of Cyclin D1 and CDK4 proteins in hippocampal neurons of the rats with global cerebral ischemia and reperfusion (I/R)based on Notch1 signaling pathway,and to explore the mechanisms.Methods:A total of 128 healthy male SD rats were randomly divided into sham operation group,I/R group (modified Pulsinelli four vessel occlusion method), CIP group (repeated 3 times of reperfusion or blocking blood vessel before complete reperfusion)and DAPT group (intraperitoneal injection of 10 mg·kg-1 ·d-1 DAPT 3 h before CIP),and there were 32 rats in each group.HE staining was used to observe the morphology of the neurons at 6, 24, 48 and 72 h after ischemia;immunohistochemical staining was used to observe the expressions of Cyclin D1, CDK4 and Notch1 in the hippocampus of the rats;Western blotting method was used to observe the expression levels of Cyclin D1,CDK4 and Notch1 proteins in the hippocampus of the rats at different time points. Results:The HE staining results showed that compared with sham operation group,the structure of neurons in hippocampus area of the rats in I/R group was damaged and the survival rate of neurons was significantly decreased (P <0.05).Compared with I/R group,the survival rates of neurons in the hippocampus area of the rats in CIP group were significantly increased at the corresponding time (P <0.05).Compared with CIP group,the survival rates of neurons in hippocampus area of the rats in DAPT group at the corresponding time were significantly decreased (P < 0.05 ). The immunohistochemical staining results showed that compared with sham operation group,the number of cells with positive Notch1,Cyclin D1 and CDK4 in I/R group was increased (P < 0.05).Compared with I/R group,the number of Cyclin D1 and CDK4 positive cells in CIP group was decreased (P <0.05),and the number of Notch1 positive cells of was significantly increased (P <0.05).Compared with CIP group,the number of Cyclin D1 and CDK4 positive cells in DAPT group was increased (P < 0.05 ),and the number of Notch1 positive cells was significantly decreased (P < 0.05 ). The Western blotting results showed that compared with sham operation group,the expression levels of Notch1,Cyclin D1 and CDK4 proteins in the hippocampus of the rats in I/R group were increased (P <0.05);compared with I/R group,the expression levels of Cyclin D1 and CDK4 proteins in the hippocampus of the rats in CIP group were significantly decreased (P <0.05),and the expression level of Notch1 protein in the hippocanpus of the rats was significantly increased (P < 0.05 ); compared with CIP group,the expression levels of Cyclin D1 and CDK4 proteins in the hippocampus of the rats in DAPT group were increased (P <0.05),and the expression level of Notch1 protein was significantly decreased (P < 0.05).Conclusion:CIP may play an important role in protecting the neurons by increasing the activity of Notch1 and inhibiting the expressions of Cyclin D1 and CDK4.
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Objective To assess the effect of ischemic postconditioning on the Notch1 signaling pathway,and learning and memory in rats with global cerebral ischemia.Methods A total of 128 healthy male SD rats were randomly divided into the sham operation (sham),whole-brain ischemia(CIR),ischemic treatment(CIP),and inhibitor(DAPT) groups,with 32 rats in each group.A global cerebral ischemia model was generated using the modified Pulsinelli's four-vascular occlusion model,and the inhibitor group was injected intraperitoneally with gamma secretase inhibitors (DAPT) before ischemic treatment.Rats' learning and memory function results from the Morris water maze test were assessed by observing the changes in hippocampal CA1 neurons with HE staining.The expression of Notch1 in the CA1 area of the hippocampus was assessed using immunohistochemical and Western blotting methods in rats.Results Compared with the sham group,the hippocampal cell survival rate in the CIR group decreased significantly (P ＜ 0.05) and the expression level of Notch1 increased significantly (P ＜ 0.05).Compared with the CIR group,the CIP group revealed a significantly higher hippocampal cell survival rate (P ＜ 0.05) and an increase in Notch 1 expression (P ＜ 0.05);compared with the CIP group,the hippocampal cell survival rate significantly decreased after DAPT administration (P ＜ 0.05) and Notch1 expression decreased significantly.Conclusion Ischemic postconditioning can promote the recovery of learning and memory ability,which may relate to the activation of the Notch 1 signaling pathway.
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Objective To explore the correlations of coping styles with self-management practices and fear of recurrence in patients having undergone mastocarcinoma resection.Methods Toally 330 patients having received mastocarcinoma resection participated in the investigation by medical coping modes questionnaire (MCMQ),self management scale(SMS) and cancer worry scale (CWS).Pearson correlation analysis was integrated to analyze the correlations of coping style with self-management practices and fear of recurrence.Results The total scores by MCMQ,SMS and CWS were (79.10t7.62),(45.31±4.52) and (14.86±4.36),respectively.Pearson correlation analysis showed that there was a significant negative correlation of the coping styles with fear of recurrence,and a positive correlation with the self management(P＜0.001).The items of avoidance and yielding were both positively correlated with the fear of recurrence,while negatively correlated with the self management (P＜0.001).Conclusions The coping style and fear of recurrence are closely correlated.The staff in the community should take active measures to improve the coping styles to reduce the fear of recurrence of the patients who have received mastocarcinoma resection.
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Objective:To measure the clivo-axial angle (CAA)and cervicomedullary angle (CMA)in upper cervical deformity patients who underwent computer-assisted posterior upper cervical reduction and fixation surgery,and analyze their correlation.Methods:In the study,25 patients with symptomatic upper cervical deformity were chosen for measurement of preoperative and postoperative CMA and CAA using magnetic resonance imaging (MRI)and intraoperative C-arm.The angle between the clivus plane and the straight line parallel to that of the posterior margin of the C2 vertebral body was defined as CAA;moreover,the angle between the straight line parallel to the ventral side of the cervical spinal cord and the straight line parallel to that of the ventral side of the medulla oblongata was defined as CMA.Two ex-perienced spinal surgeons performed the measurements.The CAA and CMA were measured three times, and the mean value was considered as the result.Results:Analyses of the CAA and CMA were per-formed with Wilcoxon rank test,which showed that there was consistency between the CAAs measured with MRI and intraoperative C-arm.The result showed that the postoperative CAA and CMA increased significantly compared with preoperation (P<0.001).Through Spearman rank correlation analysis,the preoperative CAA was positively correlative with the CMA (r=0.902,P<0.001),and so was the post-operative CAA (r=0.921,P<0.001).Conclusion:Preoperative and postoperative CAA in upper cer-vical deformity patients is significantly correlative with preoperative and postoperative CMA.CAA can be measured during surgery using intraoperative CT or C-arm based three-dimension navigation,and may predict the patient’s CMA,which cannot be measured during operation,but is essential for evaluating the decompression and reduction of the spinal cord.
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Objective To investigate the effect of treadmill running pretreatment on the expression of CyclinA and CyclinE protein in hippocampus of rats after global cerebral ischemia and reperfusion.Meth-ods 60 healthy male wister rats were randomly divided into control group, model group and experiment group.Global cerebral ischemia reperfusion model was generated by improved four-vessel occlusion as de-scribed according to the description of Pulsinelli's method.Rats in the experiment group were performed treadmill running for 2 weeks before injury.The water maze test was performed at 24 h and 48 h respectively after injury to determine the spatial memory ability of rats.Morphological changes of hippocampus were ob-served by HE staining ( hematoxylin-eosin staining) at 3 h,6 h,24 h,48 h after injury and the expression of CyclinA and CyclinE were detected by immunohistochemical staining.Results Compared with control group,the survival rate of neurons in the model group was significantly decreased at each time point.Morris water maze test showed that the escaping latency of rats in the model group was significantly prolonged( 24 h (24.35±3.99)s,48 h(33.08±5.85)s),and the frequency of crossing the platform was decreased(24 h(6.80 ±0.79),48 h(4.00±0.67)).The expression of CyclinA was increased significantly in the model group ((8.40±0.52)/high view,(11.70±1.06)/high view,(15.50±0.53)/high view,(22.40±0.52)/high view) as well as the expression of CyclinE((20.30±0.48)/high view,(15.20±0.63)/high view,(10.00± 0.82)/high view,(7.70±0.68)/high view) (P<0.05).Compared with model group,the survival rate of neurons in the model group was significantly increased at each time point.Morris water maze test showed that the escaping latency of rats in the experiment group was significantly shorten(24 h(13.21±2.73) s,48 h (24.20±4.66)s),and the frequency of crossing the platform was increased(24 h(9.70±0.95),48 h(6.30± 1.16)).The expression of CyclinA was significantly increased in the model group((10.60±0.84)/high view),(16.70± 0.68)/high view),(24.50±0.53)/high view),(36.20±1.40)/high view) as well as the expression of CyclinE((31.60 ±0.70)/high view),(24.50±0.70)/high view),(16.80±0.63)/high view),(9.10±0.74)/high view) (P<0.05).Con-clusion The treadmill running pretreatment improves the function of spatial memory after global cerebral ischemia and reperfusion,potenlially mediated by regulating the expression for cell cycle proteins,which have a protective effect on cerebral brain tissue.
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Objective To evaluate the diagnostic value of 99mTc-EC dynamic renography for renal scars in children with urinary tract infection. Methods The 99mTc-EC and 99mTc-DMSA renographic results of 67 children diagnosed with urinary tract infection were retrospectively studied. In comparison with 99mTc-DMSA cortical images, the value of 99mTc-EC dynamic renogra-phy for the diagnosis of urinary tract infection, hydronephrosis and renal scars was analyzed. Results The sensitivity and speci-ficity of the initial 2 minutes summed images in the 99mTc-EC images for the diagnosis of renal scars was 80.28%and 88.89%re-spectively, and the likelihood ratio was 7.23. Renal scars were more likely to be formed in patients with obstructed upper urinary tracts, as compared with patients with unobstructed upper urinary tracts and unsmooth upper urinary tracts (P0.05). Conclusions For children with urinary tract infection, the diagnostic sensitivity and specificity of the initial summed images of 99mTc-EC dynamic renography are high. Furthermore, the excretion of upper urinary tract showed by 99mTc-EC dynamic renogra-phy is valuable for the diagnosis of renal scars.
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Objective To measure the clivus-axial angle (CAA) of Chinese,provide a normal value,and explore the correlation between CAA with cervico-medullary angle (CMA).Methods The CAA was measured on the CT of cervical spine in 225 Chinese with normal cranio-vertebral junction (CVJ).Both the CAA and the CMA were measured on the MRI of cervical spine in 117 subjects.All measurements were performed under a bone window (window level,300 Hu; window width,1 000 Hu) with an accuracy of 0.01°.A regression analysis was used for analyzing the correlation between CAA and CMA.The angle between the clivus plane and the straight line parallel to that of the posterior margin of the C2 vertebral body was defined as CAA; moreover,the angle between the strajght line parallel to the ventral side of the cervical spinal cord and the straight line parallel to that of the ventral side of the medulla oblongata was defined as CMA.Two experienced spinal surgeons performed the measurements.The CAA and CMA were measured three times,and the mean value was considered as the result.Results The CAA of 225 subjects was 133.52°-172.16° (156.93°±6.53°).The 95％ confidence interval was 145.10°-170.19° in male and 142.67°-168.47° in female.If the patients were divided into five groups according to their age,a comparison of these groups showed that there were no significant differences among the groups with respect to CAA.It showed that there was consistency between the CAAs measured with MRI and CT.The CMA for 117 patients ranged from 130.38° to 168.75° with a mean value of 154.17°±6.54°,and its 95％ confidence interval ranged from 141.35° to 166.99°.If the patients were distributed according to their gender or to their age,there were no significant differences among the groups.The relationship between CAA and CMA was linearity,and the regression coefficient was as high as 0.95 (P=0.007).Conclusion The normal CAA of Chinese is from 133.52° to 172.16°.The 95％ confidence interval goes from 145.10° to 170.19° in male,and 142.67° to 168.47° in female,close to CMA.It is valuable for measuring the compression of spinal cord,which can be accessed easily during the procedure.
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Objective To measure the vitamin B1 levels in plasma,erythrocytes and urine of the patients with type 2 diabetes,and to analyze the correlation of vitamin B1 level with the progression of diabetic nephropathy,and to clarify the metabolism of nutrtion mechanism of type 2 diabetic nephropathy.Methods Total 90 patients with type 2 diabetes and 30 healthy volunteers were recruited.According to the levels of microalbuminuria,the patients with type 2 diabetes were divided into non diabetic nephropathy (NDN)group,early diabetic nephropathy (EDN)group and clinical diabetic nephropathy (CDN)group (n=30);the healthy people was used as normal control (NC) group.The vitamin B1 levels in the plasma,erythrocytes and urine were examined with high performance liquid chromatography (HPLC). The correlation of microalbuminuria with the plasma viamin B1 level was analyzed. Results The level of vitamin B1 in plasma of the patients in NC group was (7.1±3.3)μg·L-1,while it was (4.0±2.3)μg·L-1 in NDN group,(3.1±1.0)μg·L-1 in EDN group and (2.3±0.6)μg·L-1 in CDN group. Compared with NC group,the vitamin B1 levels in the plasma in NDN,EDN and CDN groups dropped 43.7%, 56.3%,and 67.6%,respectively (P<0.05). The excretion of vitamin B1 in urine were (2.9 ± 0.8),(9.0 ± 4.7),(11.7±3.9),and (15.6±5.0)μg·L-1 in NC group,NDN group,EDN group and CDN group, respectively.Compared with NC group,the vitamin B1 levels in the urine in NDN,EDN and CDN groups were increased by 2,3 and 4 times,respectively (P<0.05).A negative correlation was found between the level of microalbuminuria and the level of vitamin B1 in plasma (r=-0.62,P=0.013).Conclusion Vitamin B1 deficiency can be observed in the early stage of diabetic nephropathy,and the level of vitamin B1 is closely correlated with the progression of diabetic nephropathy.
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Objective To study the clinical value of 18F-FDG PET/CT in childhood neuroblastoma (NB). Methods 18F-FDG PET/CT was performed in 31 children diagnosed with NB. According to the treatment conditions, patients were divided into pre-therapy group, radiation and chemotherapy group, postoperative group, respectively. The positive rate, sites, and im-age characteristics of the primary lesion and metastasis lesion were analyzed through qualitative and quantitative analysis of the image. Results Twenty-one (67.7%) and fourteen (45.2%) patients were found positive in primary sites by CT and PET respectively. All cases (9/9, 100%) in pre-therapy group were found positive in primary lesions by PET, 3 positive cases (75.0%) in radiation and chemotherapy group and 2 positive cases (11.1%) in postoperative group. Twenty-one patients showed metas-tases (67.7%). Lymph nodes (16 cases) and bone (bone marrow) (13 cases) were the most common sites of metastasis followed by pleura, meninges, liver and retrobulbar inifltration, all of which showed increased FDG uptake. Two patients were found lesions in lungs by CT, but had no FDG uptake. SUVmax of primary lesions was signiifcantly different among pre-therapy, chemotherapy and postoperative group (H=13.89, P=0.001), and pre-therapy group had the highest value. Metastases (lymph nodes, bone and bone marrow, pleura, liver and meninges) in pre-therapy group had high SUVmax. Conclusions NB primary tumors are characterized by the increased FDG metabolism. PET can fully detect the distribution of NB metastases in whole body. Except the pulmonary metastasis, metastases in other positions show increased FDG uptake. PET has potential role in evaluating the efifcacy of radiation and chemotherapy, and identifying postoperative residual or recurrence.
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Objective To study the clinical manifestations,diagnosis,treatments and prognosis of the pulmonary change in mixed connective tissue disease(MCTD).Methods From January 1996 to June 2008,112 patients with definite MCTD in Second Affiliated Hospital of Harbin Medical University were retrospectively studied,and the clinical feature about pulmanary manifestations,echocardiography feature,radiology features and treatments were reviewed and analyzed.44 patients were followed up.Results 48(5 male)had pulmonary manifestation.The median age of onset of symptoms was 39 years and the median duration of disease was three years.The most common manifestation was pleural effusion and(or)pachynsis pleurae(21 cases,18.8%).16 patients(14.3%) had interstitial lung disease,and 8 cases(7.1%)had pulmonary hypertension.The cardinal symptom was short breath.Thirteen patients(11.6%)had dyspnea,4 cases(3.6%)had chest pain,and 4 cases(3.6%)had cough.Reductions of pulmonary function or abnormalities of ultrasonographic image were noted in 25(52.1%)of 48 patients with pulmonary involvement of MCTD who had not any complaint of respiratory symptoms.Six patients had reductions in diffusing capacity of the lung for carbon monoxide(DLCO),17 patients had pulmonary abnormality on chest X ray or CT,and two patients had pulmonary hypertension on doppler echocardiography.Conclusion Pulmonary involment of MCTD may contribute to prognosis seriously.DLCO was the most sensitive parameter.Pulmonary hypertension was the most common cause of death.
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Objective To explore the relationship between the quality of head nurses and nursing quality. Methods Analyses of data were conducted by means of linear regression analysis and stepwise linear regression analysis. Results In the regression analysis of the overall quality of head nurses and nursing quality, t=2 974,P
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The paper mainly introuduces a kind of advanced portable firstaid kit,which is used in evacuation corridor by doctors,hygeians and nurses.It has such fuctions as hemostasis,bandaging,fixing,ventilation-improved respiration and contershock.With reasonable internal structure,it is very convenient to be quickly opened,closed and supplied.With the optimized allocation of ambulance drugs and materials,it meets the effective and modularization needs of field medical equipment.
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Objective To study a new portable aid bag used to first aid and care in the process of wounded soldiers' delivery so as to meet the need of treatment in the high-technique local war. Methods The function,kinds and amount of outfit are decided on the basis of treating range. The new aid bag with hung sack and capsule outline is designed according to six different modules,which are not only easily-opened but convenient for fast treatment and supply. The field trial was taken after the development. Result A new portable combined aid bag fit for both wartime and peacetime is developed .Conclusion The new portable combined aid bag can meet the need of wounded soldiers' treatment in the modern high-technique local war,and can be used to first aid and care in the process of wounded soldiers' delivery.
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As a kind of standard medical equipment for peacetime round and wartime first aid,the first-aid kit is composed of a special kit and the unitized medicines and equipments in it.The situations and advances of such information of the kit are introduced in this paper as its classification,functions,quality,structure and the articles equipped with it.