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Objective@#To understand the current status of the team structure of health personnel in primary and secondary schools, and to provide suggestions and references for strengthening and optimizing school health workforce.@*Methods@#A nationwide stratified random cluster sampling method was adopted to select provinces for investigation in stratification from 2015-2016, a total of 16 provinces, autonomous regions, and municipalities directly under the Central Government, 26 survey sites, 10 027 primary and secondary schools, 9 536 questionnaires of health personnel were collected.@*Results@#Among the 9 536 school health staffs, there were various types of positions, and different types of schools had different position types construction. Elementary schools had the most part time health care teachers, accounting for 77.6%, while full time school doctors only accounting 10.0%; high schools had the most full time school doctors, accounting for 65.7%, and part time health care teachers only accounting for 15.1 %. There were various employment channels, with the most transfer jobs in schools, accounting for 70.7%. The series of professional titles were diverse, with the teaching profession accounting for 67.4%. Most of school health teachers had junior and intermediate professional titles, accounting for 42.6%, respectively. Proportion of medium, medium low, and low level of salary accounted for 39.3%, 27.9% and 21.1% respectively.@*Conclusion@#The educational background and age distribution of school health personnel is reasonable, but the proportions of medical background and full time school doctors are relatively low. School health personnel have various job types, professional titles, salary level, and limited space of career development. Top level design from the policy level, and clearly defined improve the structure of school health personnel to meet the needs of high quality development of school health work in the new era.
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Objective:To explore the surgical techniques and outcomes of closed reduction for geriatric subtrochanteric femoral fractures with certain radiological characteristics.Methods:A retrospective analysis was conducted in the 38 aged patients with subtrochanteric femoral fracture who had been treated at Department of Geriatric Orthopedics, Guangdong Provincial Hospital of Chinese Medicine from January 2015 to December 2019. There were 24 females and 14 males, aged from 62 to 95 years (average, 80.9 years). According to the Seinsheimer classification, there were one case of type ⅡB, 7 cases of type ⅡC, 18 cases of type ⅢA, 9 cases of type Ⅳ, and 3 cases of type Ⅴ. The time from injury to operation averaged 2.3 days (from 0.5 to 8.0 days). The fractures of this cohort were characterized by: ①The starting point of the medial fracture line was at the proximal end and the lesser trochanter separated. ②The fracture end was shortened and overlapped on the medial side and angled outward, showing a varus deformity. ③The alignment returned to normal after traction, with only partial lateral displacement left. Before fixation with proximal femoral nail antirotation (PFNA), all these patients were treated by closed reduction in a supine traction bed. In those whose reduction was unsatisfactory, a main nail was inserted or after the main nail was inserted reduction by leverage was performed through the screw blade incision. Intraoperatively, the quality of fracture reduction was evaluated according to the modified Baumgaertner assessment. Recorded were the patients’ operation time, intraoperative blood loss, fracture healing time, hip function and complications.Results:All the fractures achieved 100% of good to excellent reduction (38/38). The operation time ranged from 25 to 120 min (average, 55.6 min) and the intraoperative blood loss from 10 to 150 mL (average, 42.9 mL). This cohort of 38 patients was followed for 10 to 20 months (average, 15.3 months). All the fractures united after 3 to 8 months (average, 4.8 months). The Harris hip scores at the last follow-up ranged from 70 to 94 (average, 81.5). The follow-ups revealed no such complications as internal fixation failure, fracture re-displacement, malunion or nonunion.Conclusion:Closed reduction and PFNA fixation in a supine traction bed can lead to satisfactory clinical effects for the subtrochanteric femoral fractures with certain radiological characteristics in the aged patients.
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Objective@#To establish a laryngeal squamous cell carcinoma (LSCC) cell line through primary cell culture and observe its biological characteristics.@*Methods@#Tissue block culture method was used for primary cell culture. After LSCC cells passed 25 times in vitro, the morphology of cells was observed, keratin was stained histochemically, cell cycle was tested by PI-FACS, and the specie of cells was detected by PCR and short tandem repeat(STR) typing.@*Results@#This newly established LSCC cell line was named as TR-LCC-1, most of the cancer cells were polygonal shape, like the cobblestone, loss of contact inhibition and with overlapping growth. Cell size was large and cell pleomorphism was very obvious. Cytokeratin staining was positive. After 6 months of continuous culture in vitro, the TR-LCC-1 cells passed more than 30 times, and cell doubling time was 201.2h. Cell cycle assay indicated that G1 phase accounted for 51.71%, S phase was 44.56%, and G2 phase was 2.28%. Mycoplasma test showed no mycoplasma contamination. Cell species identification identified TR-LCC-1 was human-derived cells. STR detection showed P26 and P6 were same, and they were different from the STR typing of disclosed cells.@*Conclusion@#The establish ment of the new laryngeal squamous carcinoma cell line TR-LCC-1 can be helpful to the research for laryngeal squamous cell cancer.
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BACKGROUND:Posterior lumbar fusion using pedicle screw-rod system fixation is the main surgical method for various lumbar diseases, and the accuracy of pedicle screw insertion is the key to success. Spinous processes are superficial in position, which serve as a anatomical landmark providing significant reference. OBJECTIVE: To analyze the anatomical classification of spinous process tilt of adult in northeast China, and to discussthe feasibility of it as the reference of anatomical landmark in pedicle screw fixation.METHODS: The tilt angle of spinous processes of 97 adults in northeast China was measured, and spinous processes of lumbar vertebrae were then classified. All subjects underwent simulative operation to determine the optimal insertion angle,measure the angle between pedicle screw and the spinous process, or standard sagittal plane for comparative analysis.RESULTS AND CONCLUSION: (1) The results were as follows: the distribution of type I was 75.1%, and 20.9% of typeII, 2.3% of type III, 1.7% of type IV. Moreover, there were no significant differences in the angle between pedicle screwand the spinous process, or standard sagittal plane. (3) These findings suggest that lumbar spine angle varies in different individuals, which shouldbe defined through relative examinations. Additionally, spinous process can be a reference inpedicle screw inserting operation.
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BACKGROUND: Pedicle screws are widely used in spinal internal fixation, while complications related to screw mistaken placement can be found occasionally. Conventional imaging examination cannot provide the accurate situation of the nail, and the nail path can be directly revealed on CT.OBJECTIVE: To discuss the application of CT scanning in the preoperative planning of lumbar spine surgery using digital technology.METHODS: 136 patients were enrolled, and digital technology was used to determine the best nailing track on planar CT images. Then the length of the pedicle screws, width of the pedicle, angle between pedicle screws and standard sagittal plane, and angle between pedicle screw and spinous process as well as sagittal plane were measured. The difference in measured values on each side was compared. Also, the difference in angle between pedicle screw and sagittal plane and spinous process was compared.RESULTS AND CONCLUSION: (1) There was no significant difference in the length of pedicle screw in both sides (P > 0.05). (2) There was significant difference in the width of pedicle screw at L1 and L4 of two sides (P 0.05). (4) The angle between pedicle screw and spinous process at each level bilaterally did not differ significantly (P > 0.05). (5) To conclude, pedicle CT scanning can accurately reflect patients' pedicle anatomic situation, which can help surgeons to design an appropriate scheme. Moreover, the anatomical variations of lumbar spine are remarkable, so pedicle screw insertion should be planned individuality.
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OBJECTIVE The purpose of this study was to analyze the screened miRNAs related to tumorigenesis using miRNA array in laryngeal squamous cell carcinoma (LSCC), and provide a set of miRNAs that may be useful for the development of novel diagnostic markers and/or more effective therapeutic strategies from the screened miRNAs in LSCC. METHODS A total number of 5 patients who underwent surgery for primary laryngeal squamous cell carcinoma were recruited for miRNA array analysis. LSCC tissues compared with corresponding adjacent non-neoplastic tissues were analyzed by the Affymetrix GeneChip miRNA Array 3.0 to screen effective miRNAs, and the raw dataset had been submitted to Gene Expression Omnibus. Then mirfocus 3.0 database was adopted to analyze putative regulated miRNAs related to MCM4, a gene related to tumorigenesis we had studied previously in LSCC. Moreover, the selected putative regulated miRNAs were also validated by qRT-PCR in another 21 patients diagnosed as LSCC. RESULTS Analyzed by the miRNAs arrays, there were 127 miRNAs significantly related to tumorigenesis, and 78 showed a higher expression in tumor than in non-tumor tissue while 49 presented the contrasting pattern (P<0.01). Then analyzed by mirfocus 3.0 database, there were 2 putative regulated miRNAs, hsa-miR-24-3p and hsa-miR-183-5p, related to the expression of MCM4. Another miRNA we should focus on was hsa-miR-30a-5p, which was down-expressed obviously analyzed by the miRNA array. The expression of the 3 putative regulated miRNAs were also validated by qRT-PCR in another 21 patients, and the result was the same with that in miRNA array (P<0.05). CONCLUSION The 3 putative miRNAs based on miRNA array analysis, hsa-miR-24-3p, hsa-miR-183-5p and hsa-miR-30a-5p, could be considered as potential diagnostic and therapeutic markers in LSCC. The result will contribute to the understanding of the molecular basis of LSCC and help to improve the treatment.
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[ABSTRACT]OBJECTIVEThe purpose of this study was to analyze the screened miRNAs related to the chemosensitivity for the TPF regimen of hypopharyngeal squamous cell carcinoma by miRNA array, and provide a set of miRNAs that may be useful for the development of novel diagnostic markers and more effective therapeutic strategies from the screened miRNAs.METHODSA total number of 21 patients who underwent TPF induction chemotherapy for primary hypopharyngeal squamous cell carcinoma were recruited for miRNA array analysis. 12 patients are sensitive to chemotherapy, and 9 patients are not. Moreover, the selected putative regulated miRNAs were also validated by RT-PCR in another 24 patients (14 patients are sensitive to chemotherapy, and others are not).RESULTSThere were 24 miRNA significantly differencial to the sensitivity to chemotherapy, and 6 miRNAs were up-regulated in the TPF group while 18 miRNA were down-regulated (P<0.05). To identify typical miRNA, mirfocus 3.0 database selected four miRNAs hsa-miR-211-3p, hsa-miR-4253, hsa-miR-4443, and hsa-miR-193b-3p, which were significant down-regulated in TPF-sensitive group. QRT-PCR further validated that only three miRNA (hsa-miR-4253、hsa-miR-4443、hsa-miR-193b-3p) were under-expressed in TPF-sensitive group of another 24 tissue samples (P<0.05).CONCLUSIONMiRNA hsa-miR-193b-3p, hsa-miR-4253, hsa-miR-4443 were identified in TPF-sensitive tissues by microarrays, and further validated by RT-PCR. These down-regulated miRNAs may act as novel biomarkers to classify TPF sensitivity of hypopharyngeal squamous cell carcinoma patients and will contribute to the understanding of the molecular basis of the chemosensitivity in the disease.
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Objective To compare the clinical effects of proximal femoral nail antirotation (PFNA) and proximal femoral nail antirotation-Ⅱ (PFNA-Ⅱ) in the internal fixation of femoral intertrochanteric fracture.Methods A retrospective study was conducted of the 54 patients with femoral intertrochanteric fracture who had been treated at our department from May 2009 through July 2014.During May 2009 and November 2011,27 of them were treated with PFNA;during December 2011 and July 2014,the other 27 of them were treated with PFNA-Ⅱ.The 2 groups were compared in terms of operation time,intraoperative blood loss volume,hidden blood loss volume,intraoperative and postoperative complications,fracture healing time and Harris hip score at the last follow-up.Results In the PFNA group,27 patients were followed up for an average time of 22.6 ± 4.8 months.In the PFNA-Ⅱ group,27 patients were followed up for an average time of 19.5 ± 4.6 months.The PFNA group had significantly more intraoperative blood loss volume (130.1 ± 74.3 mL),and significantly higher rates of intraoperative lateral wall fracture of the proximal femur (18.5％,5/27),postoperative lateral thigh soft tissue irritation (22.2％,6/27) and postoperative thigh pain (22.2％,6/27) than the PFNA-Ⅱ group [46.3 ± 23.1 mL,0,3.7％ (1/27),3.7％ (1/27),respectively] (P ＜ 0.05).There were no significant differences between the 2 groups in operation time,hidden blood loss,postoperative complications of internal diseases,fracture healing time,or Harris hip score of last follow-up (P ＞ 0.05).Conclusion Compared with PFNA,PFNA-Ⅱ may lead to a smaller volume of intraoperative blood loss and a lower incidence of complications related to internal fixation.
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BACKGROUND:Pedicle screw fixation is the mainstream type of spine operation currently. The key point of the fixation is to make the screw pass through the center of pedicle. The angle of pedicle screw implantation is a key factor for repair quality. In previous literatures, angle of pedicle screw is determined according to the patient body, and is easily disturbed by factors such as position of the body. OBJECTIVE:To determine the inserting angle of pedicle screw of lower lumbar spine taking local anatomic landmark as a reference using digital technology. METHODS:3D-CT data of 100 patients were selected. The fourth and fifth lumbar vertebrae received three-dimensional reconstruction, and the operation was simulated using digital technology to achieve optimal placement. After simulation, the angle of pedicle screw was measured. The angle of the planes of the midline of the screw and the midline of the spine served as coronal angle. The angle of the planes of the midline of the screw and the upper surface of the vertebral body served as sagittal angle. RESULTS AND CONCLUSION:Measure results suggest that each angle was bigger than the angle in previous studies, which might be induced by different reference markers. Standard deviation of each angle was also big. These findings verify that the anatomical differences of pedicles were apparent. Thus, we should insert the pedicle screws individual y. Method of locating reference using anatomic landmarks of a single vertebral body can maximize to avoid interference posture. The combination with preoperative three-dimensional reconstruction is more in line with the requirements of pedicle screw, and can effectively improve the accuracy of pedicle screws.
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Aseptic loosening is mainly mediated by bone resorption cytokines in the surrounding area of orthopaedic implants. Our previous investigation demonstrtated that different-sized titanium particles loading can inbibit the osteoblastic differentiation and mineraliztion. In order to investigate the hypothesis that particulate wear debris derived from prosthetic biomaterials affects the release of bone resorption related cytokines, we studied the influence of different-sized titanium particles loading on the osteoblastic cytokines by assaying the secretion of IL-6, IL-10 with use of ABC-quantitative sandwich enzyme-linked immunosorbent assay, and on the expression of osteoclast differentiation factors (ODF) by RT-PCR. The results showed that the 0.9 microm titanium particles promoted osteoblasts producing bone resorption cytokines (IL-6, ODF), and simultaneously secreted bone absorption restraining factor (IL-10) quickly and transitorily. In comparison, the 2.7 microm and 6.9 microm titanium particles,especially the latter primarily promoted osteoblasts secreting bone absorption promoting factors powerfully and slowly. The results suggested that there was a biphasic response appearing in titanium particles loaded-osteoblastic cultures, the level of which varied according to the different size and the loading time of titanium particles. This in vitro experimental result showed that attentaion to the inhibition of bone resorption cytokines stimulated by wear debris and to the screen potential favourable biomaterials for implants must be taken.