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BACKGROUND@#Postoperative pneumonia (POP) is one of the most common infections following heart valve surgery (HVS) and is associated with a significant increase in morbidity, mortality, and health care costs. This study aimed to identify the major risk factors associated with the occurrence of POP following HVS and to derive and validate a clinical risk score.@*METHODS@#Adults undergoing open HVS between January 2016 and December 2019 at a single institution were enrolled in this study. Patients were randomly assigned to the derivation and validation sets at 1:1 ratio. A prediction model was developed with multivariable logistic regression analysis in the derivation set. Points were assigned to independent risk factors based on their regression coefficients.@*RESULTS@#POP occurred in 316 of the 3853 patients (8.2%). Multivariable analysis identified ten significant predictors for POP in the derivation set, including older age, smoking history, chronic obstructive pulmonary disease, diabetes mellitus, renal insufficiency, poor cardiac function, heart surgery history, longer cardiopulmonary bypass, blood transfusion, and concomitant coronary and/or aortic surgery. A 22-point risk score based on the multivariable model was then generated, demonstrating good discrimination (C-statistic: 0.81), and calibration (Hosmer-Lemeshow χ2 = 8.234, P = 0.312). The prediction rule also showed adequate discriminative power (C-statistic: 0.83) and calibration (Hosmer-Lemeshow χ2 = 5.606, P = 0.691) in the validation set. Three risk intervals were defined as low-, medium-, and high-risk groups.@*CONCLUSION@#We derived and validated a 22-point risk score for POP following HVS, which may be useful in preventive interventions and risk management.@*TRIAL REGISTRATION@#Chictr.org, ChiCTR1900028127; http://www.chictr.org.cn/showproj.aspx?proj=46932.
Subject(s)
Adult , Aged , Humans , Cardiac Surgical Procedures/adverse effects , Cardiopulmonary Bypass , Heart Valves , Pneumonia , Risk FactorsABSTRACT
BACKGROUND: Whether nighttime surgery will affect the safety and prognosis of patients has been controversial. OBJECTIVE: To compare the safety and prognosis of daytime surgery versus nighttime surgery in patients receiving total knee arthroplasty. METHODS: Data of 712 patients who received unilateral total knee arthroplasty from January 2015 to January 2018 in the Binzhou Medical University Hospital were retrospectively analyzed. Of the patients, 615 cases were treated by total knee arthroplasty during daytime hours (8:00-18:00) and the other 97 patients were treated by total knee arthroplasty during nighttime hours (18:01-7:59). The perioperative and postoperative conditions of the two groups of patients were compared. This study was approved by the Medical Ethics Committee of Binzhou Medical University Hospital, China (approval No. LW2016013). RESULTS AND CONCLUSION: (1) Perioperative period: The operation time in the nighttime surgery group was shorter than that in the daytime surgery group (P 0.05). (2) Prognosis: There was no significant difference in motion range and knee joint function KSS score between the two groups (P > 0.05). (3) The results showed that nighttime surgery did not increase the incidence of adverse reactions after total knee arthroplasty, and did not affect the prognosis of patients.
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Pregnancy has increased susceptibility to H1N1 influenza virus infection. Maternal influenza infection is associated with increased risk of morbidity and mortality. A case of influenza A (H1N1) during late pregnancy (pregnancy 1, birth 0, pregnancy 30+2 weeks) was admitted to the Second Affiliated Hospital of Kunming Medical University on December 16th, 2018. The patient was set on mechanical ventilation with a FiO2 of 1.0, a positive end-expiratory pressure (PEEP) of 15 cmH2O (1 cmH2O = 0.098 kPa), and a tidal volume of 4-6 mL/kg (ideal body weight). However the pulse oxygen saturation (SpO2) could only be maintained at about 0.85. The disease was controlled by the treatments of anti-infection, mechanical ventilation, immune therapy, nutritional support, preventive anticoagulant treatment by heparin sodium, adequate negative fluid balance, and other organ support therapy. This article introduced the treatment process of the patient in detail, and provided experience for clinical treatment.
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Pregnancy has increased susceptibility to H1N1 influenza virus infection. Maternal influenza infection is associated with increased risk of morbidity and mortality. A case of influenza A (H1N1) during late pregnancy (pregnancy 1, birth 0, pregnancy 30+2 weeks) was admitted to the Second Affiliated Hospital of Kunming Medical University on December 16th, 2018. The patient was set on mechanical ventilation with a FiO2 of 1.0, a positive end-expiratory pressure (PEEP) of 15 cmH2O (1 cmH2O = 0.098 kPa), and a tidal volume of 4-6 mL/kg (ideal body weight). However the pulse oxygen saturation (SpO2) could only be maintained at about 0.85. The disease was controlled by the treatments of anti-infection, mechanical ventilation, immune therapy, nutritional support, preventive anticoagulant treatment by heparin sodium, adequate negative fluid balance, and other organ support therapy. This article introduced the treatment process of the patient in detail, and provided experience for clinical treatment.
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Objective To evaluate the effect and cost-effectiveness of three commonly used molluscicides, 4% "Luo-wei" (tea-seed distilled saponins, TDS), 50% niclosamide ethanolamine salt wettable powder (NESWP), and 26% metaldehyde and niclosamide suspension concentrate (MNSC) in large-scale field application, so as to provide the references for formulating the strategy of snail control. Methods The field test and parallel comparison were implemented. A marshland with Oncomelania hupensis snails of the Yangtze River was divided into 4 parts (10 hm2) for the research, and three of them were experimental areas while the last one was a blank control area. The experimental areas were sprayed with 4% "Luo-wei", 50% NESWP and 26% MNSC respectively for 3 times and the interval was 1 week. Seven days after each spraying the effect of snail control was investigated, and the costs of molluscicides, labor, transportation, fuel consumption and mechanical loss were recorded. The cost of each molluscicide, snail mortality, snail density, and the cost of increasing 1% of snail mortality per 100 m2 were analyzed and compared. Results After the first, second and third spraying, the corrected snail mortality rates were 67.34%, 76.55% and 84.60% respectively in the 4% "Luo-wei" group; the corrected snail mortality rates were 64.71%, 75.17% and 83.89% respectively in the 50% NESWP group; the corrected snail mortality rates were 66.55%, 76.27% and 86.67% respectively in the 26% MNSC group. There was no significant difference among the 3 groups in the snail mortality at the same spraying time (χ2 = 1.590, 0.571, 3.238, all P > 0.05) . In addition, along with the increase of the spraying times, the snail mortality of each group was increased significantly compared to that of the control group (χ2 = 79.333, 94.718, 117.020, all P < 0.01) . After the first, second and third spraying, the reduction rates of snail density were 69.82%–86.60% in the 4% "Luo-wei" group, 68.66%–86.55% in the 50% NESWP group, and 71.89%–88.87% in the 26% MNSC group respectively. The decreasing amplitude of the snail density was more than 85% in all the experimental areas after 3 rounds of spraying molluscicide. The snail control costs per 100 hm2 were 19.57, 11.97 Yuan and 10.47 Yuan in the 4% "Luo-wei" group, 50% NESWP group, and 26% MNSC group respectively. After the first, second and third spraying, the costs of increasing 1% of snail mortality per 100 m2 were 0.30, 2.08 Yuan and 2.38 Yuan in the 4% "Luo-wei" group, 0.20, 1.10 Yuan and 1.32 Yuan in the 50% NESWP group, and 0.17, 1.04 Yuan and 0.97 Yuan in the 26% MNSC group respectively, and the cost-effectiveness was the highest at the first spraying in all the three groups. Conclusions The effects of the three molluscicides for snail control are similar, but the efficacy of snail control is reduced as the spraying time increases.
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OBJECTIVE@#To evaluate the safety and efficacy of allogeneic natural killer (NK) cells in the treatment of primary hepatocellular carcinoma (HCC), and to elucidate the mechanism of NK cells therapy.@*METHODS@#Twenty-one patients with primary HCC treated with allogeneic NK cells at the Fifth Medical Center of the PLA General Hospital were followed up for 1 year. Peripheral blood mononuclear cells (PBMCs) were isolated from patient-related donors and cultured in vitro for 15 days and infused to the patients in two consecutive days. Clinical data and laboratory data were collected and analyzed, including survival, clinical features, imaging changes, hematology, immunology, and biochemical indicators to evaluate the safety and efficacy of allogeneic NK cell therapy. The changes of peripheral blood lymphocyte subsets after treatment were also analyzed to explore the possible anti-tumor mechanisms.@*RESULTS@#(1) Of the 21 patients with primary HCC, 11 patients were treated once, 5 patients were treated twice, and 5 patients were treated 3 times. After allogeneic NK cells infusion, 10 patients had fever, 1 patient had slight hepatalgia and 1 patient had slight headache, no other adverse events occurred including acute and chronic graft-versus-host disease (GVHD). They resolved spontaneously within 8 hours without other treatment. (2) The total disease control rate was 76.2% during one-year follow-up. Among them, the patients with Barcelona clinic liver cancer (BCLC) stage A had a disease control rate of 100%, stable disease (SD) in 10 cases; BCLC stage B patients had a disease control rate of 60%, partial response (PR) in 1 case, and SD 2 in cases; BCLC stage C patients had a disease control rate of 50%, complete response (CR) in 1 case, and 2 cases of PR. (3) The frequencies of NK cells and CD8+ T cells in peripheral blood were significantly lower than that before at 24 hours after treatment, and the frequencies of CD4+ T cells and CD4/CD8 were significantly higher than the baseline.@*CONCLUSION@#Allogeneic NK cells have good safety and efficacy in the treatment of primary HCC. The anti-tumor effect of the allogeneic NK cells may play an important role in the activation of the patient's natural immune system and delay disease progression, suggesting that allogeneic NK cells combined with sorafenib may be a very effective treatment for advanced HCC, and further large-sample multicenter randomized controlled clinical trials are needed to validate this result.
Subject(s)
Humans , Carcinoma, Hepatocellular , Graft vs Host Disease , Killer Cells, Natural , Leukocytes, Mononuclear , Liver NeoplasmsABSTRACT
Chaihu Jia Longgu Muli Tang is a classical Chinese formulas treating Shaoyang syndrome complicated with Yangming syndrome according to Treatise on Febrile Diseases. This formula is used in mental disorder, nervous system, gynecologic, andrologic, and cardiovascular disease. However, its therapeutic effect on ischemia stroke and its mechanism is far from clear. In clinical practice, we have found that this formula is effective in treating ischemic stroke, which can shorten the course of the disease and reduce recurrence. The characteristics of this formula include: Shaoyang cardinal disadvantageous syndrome, mental and nervous symptoms, retained fluid punched upward syndrome and accumulation of heat in the stomach and intestines. By combining traditional Chinese medicine (TCM) pathogenesis and efficacy with modern pathology and pharmacology, we proposed that the TCM pathogenesis of stroke, which is characterized by hyperactivity of heat combining with phlegm, stasis and water drink, is consistent with syndromes and corresponding pathology targeted by Chaihu Jia Longgu Muli Tang, including the stress brain edema zone around the ischemic lesion, the increase of intracranial pressure, the excitement of sympathetic nerve, the release of monoamine neurotransmitter, the hypofunction of autonomic nervous system after stroke, and gastrointestinal stress response. Furthermore, the pharmacological mechanism of Chaihu Jia Longgu Muli Tang is concentrated on regulation the neuroendocrinology system centered by hypothalamic-pituitary-adrenal axis (HPA), participating in the process of neuron regeneration and apoptosis, oxidative stress, hyperactivity of sympathetic nerve, and inflammatory reaction. These pathological processes are consistent with the pathological changes after ischemic stroke. Therefore, Chaihu Jia Longgu Muli Tang is a key formula for treating ischemic stroke.
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Objective To evaluate the effect and cost-effectiveness of three commonly used molluscicides, 4% "Luo-wei" (tea-seed distilled saponins, TDS), 50% niclosamide ethanolamine salt wettable powder (NESWP), and 26% metaldehyde and niclosamide suspension concentrate (MNSC) in large-scale field application, so as to provide the references for formulating the strategy of snail control. Methods The field test and parallel comparison were implemented. A marshland with Oncomelania hupensis snails of the Yangtze River was divided into 4 parts (10 hm2) for the research, and three of them were experimental areas while the last one was a blank control area. The experimental areas were sprayed with 4% "Luo-wei", 50% NESWP and 26% MNSC respectively for 3 times and the interval was 1 week. Seven days after each spraying the effect of snail control was investigated, and the costs of molluscicides, labor, transportation, fuel consumption and mechanical loss were recorded. The cost of each molluscicide, snail mortality, snail density, and the cost of increasing 1% of snail mortality per 100 m2 were analyzed and compared. Results After the first, second and third spraying, the corrected snail mortality rates were 67.34%, 76.55% and 84.60% respectively in the 4% "Luo-wei" group; the corrected snail mortality rates were 64.71%, 75.17% and 83.89% respectively in the 50% NESWP group; the corrected snail mortality rates were 66.55%, 76.27% and 86.67% respectively in the 26% MNSC group. There was no significant difference among the 3 groups in the snail mortality at the same spraying time (χ2 = 1.590, 0.571, 3.238, all P > 0.05) . In addition, along with the increase of the spraying times, the snail mortality of each group was increased significantly compared to that of the control group (χ2 = 79.333, 94.718, 117.020, all P < 0.01) . After the first, second and third spraying, the reduction rates of snail density were 69.82%–86.60% in the 4% "Luo-wei" group, 68.66%–86.55% in the 50% NESWP group, and 71.89%–88.87% in the 26% MNSC group respectively. The decreasing amplitude of the snail density was more than 85% in all the experimental areas after 3 rounds of spraying molluscicide. The snail control costs per 100 hm2 were 19.57, 11.97 Yuan and 10.47 Yuan in the 4% "Luo-wei" group, 50% NESWP group, and 26% MNSC group respectively. After the first, second and third spraying, the costs of increasing 1% of snail mortality per 100 m2 were 0.30, 2.08 Yuan and 2.38 Yuan in the 4% "Luo-wei" group, 0.20, 1.10 Yuan and 1.32 Yuan in the 50% NESWP group, and 0.17, 1.04 Yuan and 0.97 Yuan in the 26% MNSC group respectively, and the cost-effectiveness was the highest at the first spraying in all the three groups. Conclusions The effects of the three molluscicides for snail control are similar, but the efficacy of snail control is reduced as the spraying time increases.
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Objective:To explore the effect of nano-carbon in lymph node dissection for thyroid cancer.Methods:46 patients with thyriod cancer were randomly divided into treatment group and control group.The identification rate of lymph nodes,lymph node positivity and parathyroid function were compared after surgery.Results:Compare to the control group,the identification rate of lymph nodes in treatment group was higher (P＜0.05),but there was no significant difference on lymph node positivity (P＞0.05).what's more,patients with low blood calcium and parathyroid hormone in treatment group were less than that in control group after surgery (P＜0.05).The difference of severity of clinical symptoms was not statistically significant (P＞0.05).Conclusion:Nano-carbon increases the lymph node identification rate and reduces the risk of parathyriod injury in patients with thyroidectomy.
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The morbidity and mortality of cardiovascular diseases(CVD)are still high in our country,they severely threaten peopleS health and quality of life.A dysregulated or reduced autophagy is associated with ischemic heart disease,cardiac hypertrophy,heart failure and arrhythmia.Autophagy is a key regulator in CVD development,and is essential for maintenance of heart function and improvement of prognosis.Thus,modulating autophagy represents an attractive future therapeutic target for treating cardiovascular disease.This article reviewed the research progression about effects of autophagy on ischemic heart disease,cardiac hypertrophy,heart failure and arrhythmia.
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Dioscorea nipponica, a famous traditional Chinese medicine, belongs to the Dioscoreaceae family and has been widely distributed in the north, northeast and Qinghai regions of China. With its root and rhizome as an important herb material, it has been applied in China for several thousand years. Traditional Chinese medicine reported that this plant had been used for relieving cough and asthma, eliminating rheumatic aches, alleviating pain and improving blood circulation. Modern pharmacology studies have confirmed that saponins, the major active compounds in this herb, have shown various pharmacological actions including anti-tumor, anti-inflammatory,lipid-lowering, anti-fungal and anti-virus activities. Therefore, the studies on saponins from D. nipponica are valuable and promising. In this present research, the pharmacological actions, therapeutic effects and mechanism of saponins from D. nipponica were summarized in order to provide the theoretical basis for the further research.
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Swelling-activated chloride currents (ICl.swell) are thought to play a role in several physiologic and pathophysiologic processes and thus represent a target for therapeutic approaches. However, the mechanism of ICl.swell regulation remains unclear. In this study, we used the whole-cell patch-clamp technique to examine the role of protein kinase C (PKC) in the regulation of ICl.swell in human atrial myocytes. Atrial myocytes were isolated from the right atrial appendages of patients undergoing coronary artery bypass and enzymatically dissociated. ICl.swell was evoked in hypotonic solution and recorded using the whole-cell patch-clamp technique. The PKC agonist phorbol dibutyrate (PDBu) enhanced ICl.swell in a concentration-dependent manner, which was reversed in isotonic solution and by a chloride current inhibitor, 9-anthracenecarboxylicacid. Furthermore, the PKC inhibitor bis-indolylmaleimide attenuated the effect and 4α-PDBu, an inactive PDBu analog, had no effect on ICl.swell. These results, obtained using the whole-cell patch-clamp technique, demonstrate the ability of PKC to activate ICl,swell in human atrial myocytes. This observation was consistent with a previous study using a single-channel patch-clamp technique, but differed from some findings in other species.
Subject(s)
Humans , Anthracenes , Pharmacology , Chloride Channels , Metabolism , Chlorides , Metabolism , Culture Media , Metabolism , Pharmacology , Dose-Response Relationship, Drug , Evoked Potentials , Physiology , Heart Atria , Cell Biology , Metabolism , Hypotonic Solutions , Metabolism , Pharmacology , Indoles , Pharmacology , Ion Transport , Maleimides , Pharmacology , Myocytes, Cardiac , Cell Biology , Metabolism , Patch-Clamp Techniques , Phorbol 12,13-Dibutyrate , Pharmacology , Primary Cell Culture , Protein Kinase C , MetabolismABSTRACT
Objective To assessed the distribution of two single nucleotide polymorphism (SNP)loci (rs2383206.rs10757278)on chromosome 9p21 in Xinjiang Uygur and Han nationality populations,and to investigate correlation and the incidence of all cases of macrovascular disease (coronary artery disease,carotid atherosclerosis and peripheral arterial disease)and analysis of risk factors.To further study the correlation between the incidence of two single nucleotide polymorphism (SNP)loci (rs2383206.rs10757278)on chromosome 9p21 in type 2 diabetes melli-tus(T2DM)of Han and Uygur ethnic and the incidence of all cases vascular disease,then to analysis the risk factors. Methods 497 adults with T2DM who were treated in the Endocrinology department in hospital from May 2012 to April 2014 were involved in this study,including 298 Uygur patients and 199 Han patients.215 non -T2DMpatients who were treated in the Cardiology department in hospital were also involved in the study,including 93 Uighur patients and 122 Han patients.Then the total 712 patients were detectedby using PCR -SNP Stream technology to analyse rs2383206.rs10757278 loci SNP genotyping.The relevant results were compared with t test,two different genotype distribution and allele frequency were compared with χ2 test,multiple factors analysis were calculated by Logisitic regression.Results The distribution of genotype with two SNP loci had no significant difference between the patients in Uygur group and Han group (rs2383206χ2 =5.570,P =0.062;rs10757278 χ2 =2.721,P =0.257 ),and there's no significant difference between the patients with macrovascular disease and non -macrovascular disease in all patients(rs2383206χ2 =0.120,P =0.950;rs10757278 χ2 =1.027,P =0.598).Logisitic regression analysis showed that the incidence of macrovascular was significantly associated with increasing age(χ2 =28.820,P =0.000)and fatty liver(χ2 =5.210,P =0.020)in Uighur group with type 2 DM.In Han group with type 2 DM,the macrovascular was significantly associated with the increase of age (χ2 =19.980,P =0.000),elevated fasting blood glucose (FPG)(χ2 =4.070,P =0.044)and poor controlled with glycosylated hemoglobin (χ2 =4.280,P =0.040). Conclusion This study found that there's no correlation between two single nucleotide polymorphisms (SNPS)loci (rs2383206.rs10757278)on chromosome 9 p21 large with macrovascular in Uygur group and Han group.Increasing age,higher FPG and poor controlled with glycosylated hemoglobin combined with fatty liver were the risk factors for macrovascular.
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This study was aimed to establish an experimental mouse model of combined transgenic inhibition of both multifunctional Ca(2+)/calmodulin-dependent protein kinase II (CaMKII) and inward rectifier potassium current (Ik1), and to observe whether the specific inhibition of both CaMKII and Ik1 can bring about any effects on cardiac remodeling. Mice were divided into 4 groups: wild type (WT), CaMKII inhibited (AC3-I), Ik1 inhibited (Kir2.1-AAA) and combined inhibition of both CaMKII and Ik1 (AC3-I+Kir2.1-AAA). Mice in each group received electrocardiogram (ECG) and echocardiography examination. ECG in the condition of isoproterenol (ISO) injection was also checked. The whole cell patch clamp technique was used to measure Ik1 and the transient outward potassium current (Ito) from enzymatically isolated myocytes of left ventricle. In the condition of basal status, no significant changes of heart rate, PR interval and QRS interval were observed. No mouse showed ventricular arrhythmias in all of the 4 groups. After ISO injection, each group presented no significant ventricular arrhythmias either. The indexes measured by M-mode (motion-mode) and two-dimensional echocardiography had no significant differences among the four groups. Ik1 in AC3-I group was significantly higher than those in other three groups (P < 0.01) because of the results brought about by CaMKII inhibition. Among the latter three groups, both Kir2.1-AAA group and AC3-I+Kir2.1-AAA group had a significant reduced Ik1 compared with that of WT group, which was due to the Ik1 inhibition (P < 0.01). Ito in AC3-I group was higher than that of the other three groups (P < 0.01), but there were no significant differences in Ito among WT, Kir2.1-AAA and AC3-I+Kir2.1-AAA groups. Thus, combined transgenic myocardial CaMKII and Ik1 inhibition eliminated the up-regulation of Ik1 in CaMKII inhibited mice, and had no effects on cardiac remodeling including heart structure and function as well as arrhythmias at the basic and ISO conditions. The results of this study may provide a basis for the further investigation of combined inhibition of CaMKII and Ik1 in pathogenic cardiac remodeling.
Subject(s)
Animals , Mice , Arrhythmias, Cardiac , Brugada Syndrome , Calcium-Calmodulin-Dependent Protein Kinase Type 2 , Physiology , Cardiac Conduction System Disease , Disease Models, Animal , Electrocardiography , Heart , Physiology , Heart Conduction System , Congenital Abnormalities , Heart Ventricles , Isoproterenol , Mice, Transgenic , Patch-Clamp Techniques , Potassium Channels, Inwardly Rectifying , Physiology , Up-Regulation , Ventricular RemodelingABSTRACT
The management of pulmonary atresia with intact ventricular septum (PA/IVS) remains controversial. The goal of separating systematic and pulmonary circulation can be achieved by biventricular or uni-ventricular (Fontan or one and a half ventricle repair) strategies. Although outcomes have been improved, these surgical procedures are still associated with high mortality and morbidity. An optimal strategy for definitive repair has yet to be defined. We searched databases for genetically randomized controlled trials (RCTs) comparing biventricular with uni-ventricular repair for patient with PA/IVS. Data extraction and quality assessment were performed following the guidelines of the Cochrane Collaboration. Primary outcome measures were overall survival, and secondary criteria included exercise function, arrhythmia-free survival and treatment-related mortality. A total number of 669 primary citations were screened for relevant studies. Detailed analysis revealed that no RCTs were found to adequately address the research question and no systematic meta-analysis would have been carried out. Nevertheless, several retrospective analyses and case series addressed the question of finding right balance between biventricular and uni-ventricular repair for patient with PA/IVS. In this review, we will discuss the currently available data.
Subject(s)
Humans , Arrhythmias, Cardiac , Cardiac Valve Annuloplasty , Methods , Mortality , Fontan Procedure , Methods , Mortality , Heart Defects, Congenital , Mortality , Pathology , General Surgery , Heart Ventricles , Congenital Abnormalities , Pathology , General Surgery , Pulmonary Atresia , Mortality , Pathology , General Surgery , Retrospective Studies , Survival Analysis , Treatment OutcomeABSTRACT
Objective To establish the monosegmental transpedicular fixation model and short segmental fixation model by three-dimensional finite element technique, and evaluate the biomechanical properties of monosegmental transpedicular fixation for thoracolumbar fractures and verify its feasibility for application. Methods T10-L2 motion segment of a young healthy subject was used to establish the normal finite element model. The superior 1/2 cortical bone of the T12 segment was removed and superior 1/2 cancellous bone of the same vertebrae was assigned material property of the injured bone to simulate the thoracolumbar fracture. Transpedicular screw fixation of the T11 and T12 segment was performed in monosegmental fixation model. T11 and L1 segment were instrumented in the short segmental fixation model. All the four finite element models were applied with loading of axial compression, anteflexion, extension, lateroflexion and axial rotation, respectively. Motion difference of each functional unit and the stress of implants were measured to evaluate biomechanical behaviors of monosegmental fixation. Results The motion difference of all the functional units (T10-11, T11-12, T12-L1) in the fractured model was obviously increased under all loading conditions as compared to the normal model, but the motion difference in the fractured models was decreased after monosegmental fixation and short segmental fixation, and no significant differences were found between monosegmental fixation and short segmental fixation. The stress on screws in monosegmental fixation model was significantly lower than that in short segmental fixation under axial compression and anteflexion, but the stress on screws of two fixation models had no significant difference under extension, lateroflexion and axial rotation. The stress on the rods of monosegmental fixation model was apparently higher than that of short segmental fixation under extension and lateroflexion, and lower under axial rotation, but no significant difference was found for two fixation models under axial compression and anteflexion. Conclusions Monosegmental transpedicular screw fixation would give the similar stabilization as short segmental fixtion and could be an effective alternative to treat incomplete fractures in thoracolumbar spine.
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AlM: To evaluate the effectiveness and security of lift and squeeze technique in phacoemulsification of hypermature cataract. METHODS: From June 2010 to June 2013, totally 156 eyes with hypermature cataract, which received phacoemulsification in our hospital, were enrolled. Lift and squeeze technique was used to chop the nucleus, and 1g/L Trypan blue was used for capsulorhexis. Average time of phaco complication, corneal edema and visual outcome were recorded. RESULTS: The best-corrected visual acuity ( BCVA ) was 0. 1-0. 4 in 15 eyes (9. 6%), 0. 5-0. 7 in 82 (52. 6%) eyes, and 0. 8-1. 0 in 59 ( 37. 8%) eyes at 3mo after surgery. The phaco time was 25-56s (average 42±10s), the maximum phaco power was 30%. Posterior capsular rupture and vitreous loss happened in 2 eyes (1. 3%), and the lOLs were implanted in the sulcus. Corneal edema classified at grade Ⅰ were seen in 12 eyes (7. 7%), and 5 eyes (3. 2%) at gradeⅡ, no eye at gradeⅢ and gradeⅣ. The mean endothelial cell loss was 8. 7%at 3mo. CONCLUSlON: Crystalline lens capsule staining with Trypan blue increase the success rate of intact continuous curvilinear capsulorhexis ( CCC ) . The lift and squeeze technique reduces the stress on the zonules and capsule, and decreases the phaco time and phaco power.
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Melanoma is an intractable cancer that is aggressive, lethal, and metastatic. The prognosis of advanced melanoma is very poor because it is insensitive to chemotherapy and radiotherapy. The incidence of melanoma has been ascending stably for years worldwide, accompanied by increasing mortality. New approaches to managing this deadly disease are much anticipated to enhance the cure rate and to extend clinical benefits to patients with metastatic melanoma. Due to its high degree of immunogenicity, melanoma could be a good target for immunotherapy, which has been developed for decades and has achieved certain progress. This article provides an overview of immunotherapy for melanoma.
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Humans , Immunotherapy , Melanoma , TherapeuticsABSTRACT
<p><b>BACKGROUND</b>Traumatic brain injury (TBI) is a major cause of death and disability in children and young adults worldwide. Therefore, we investigated the role of AG490 in regulating brain oedema, expression of CD40 and neurological function after TBI.</p><p><b>METHODS</b>Sprague Dawley rats (n = 240) were randomly divided into a sham operation group, TBI+saline group and TBI+AG490 (JAK/STAT inhibitor) group. Members of each group were euthanized at 6, 12, 24 or 72 hours after injury. Neurological severity score (NSS) was used to evaluate the severity of neurological damage. Brain water was quantitated by wet/dry weight method. The expression of CD40 was assessed by flow cytometry.</p><p><b>RESULTS</b>In both the TBI+saline group and the TBI+AG490 group, the brain water content was elevated after TBI, reached a peak at 24-hour and remained high for the rest of the period investigated; the expression of CD40 reached a peak 24 hours after TBI; the NSS was elevated after TBI and then decreased after 6 hours. Elevations in the level of CD40, degree of brain edema and NSS after TBI were significantly reduced in TBI+AG490 group.</p><p><b>CONCLUSION</b>Inhibition of the JAK/STAT signalling pathway reduces brain oedema, decreases the expression of CD40 and exerts neuroprotective effects after TBI.</p>
Subject(s)
Animals , Male , Rats , Brain Edema , Metabolism , Brain Injuries , Drug Therapy , CD40 Antigens , Flow Cytometry , Janus Kinases , Metabolism , Neuroprotective Agents , Therapeutic Uses , Rats, Sprague-Dawley , STAT Transcription Factors , Metabolism , Tyrphostins , Therapeutic UsesABSTRACT
Objective To investigate the effects of different anteversion angles on stress distributions of the proximal femur after femoral neck fracture fixation by cannulated screw, and to provide biomechanical evidences for the importance of anatomical reduction in internal fixation in clinic. Methods Femoral neck fracture with Pauwells angle 70°was treated with cannulated screw internal fixation, and its three-dimensional finite element models with five different anteversion angles set at 0°，5°，10°，15°and 20°, respectively, were constructed based on normal human anatomical data from multi slice spiral CT as well as reverse engineering and CAD software. Loads were applied on each model to simulate normal walking status. Changes in stress distributions of the proximal femur in each model were observed. Results When the anteversion angle was 10°, the stress, displacement and equivalent strain of the femur was were the minimum, as the maximum stress of the proximal femur was 1.7 MPa, and the displacement was 1.1 mm. With the anteversion angle increasing or decreasing, the effective stress and displacement of the proximal femur was gradually increasing. When the anteversion angle was 20°, the stress of on the proximal femur and on the cannulated screw was became the maximum. When the anteversion angle was 0°, the displacement and equivalent strain of the femur also became the maximum. The stress concentration site of the femoral neck was gradually transferred from the inside rear to the outer top of the head and neck junction. The three cannulated screws there stood the higher stress than the surrounding bone tissues, and with the bottom screw stood the higher stress than the other top two screws. Conclusions Anatomic reduction is essential for femoral neck fracture fixation treated by cannulated screw. Changes in biomechanical factors after femoral neck fracture may play an important role in postoperative femoral head necrosis.