Treatment of spine metastases by open decompression, microwave ablation combined with open vertebroplasty and pedicle screw rod system / 中国骨伤

OBJECTIVE@#To evaluate the preliminary clinical effective of open decompression, microwave ablation combined with open vertebroplasty and pedicle screw rod system in the treatment of spine metastases.@*METHODS@#The clinical data of 12 patients with spine metastases were retrospectively analyzed, they were treated with open decompression, microwave ablation combined with open vertebroplasty and pedicle screw rod system between January 2014 and January 2016. Six males and 6 females were included, aged from 30 to 75 years old with an average of 55.6 years. There were 5 cases with spine metastases from lung cancer, 2 from breast cancer, 2 from thyroid cancer, 2 from renal cancer and 1 from liver cancer. Sevencases were thoracic metastases and 5 cases were lumbar metastases. Tomita score were mainly arranging from 3 to 6 points. According to ASIA neurologic grading system, 3 patients were grade C, 1 was grade D, 8 were grade E. Preoperative VAS score was 8.3±0.4. VAS was used to evaluate the clinical effect at 1, 3, 6 months after operation and final follow-up.@*RESULTS@#All operations were successful and the amount of blood loss during surgery was 500 to 2 050 ml (average of 850 ml), operation time was 3.5 to 5.5 h (average of 4.5 h). There was no nerve root injury during surgery. Cerebrospinal fluid leakage occurred in 3 cases after surgery, which were healed after conservative treatment. Superficial infection of the incision occurred in 2 cases, which were healed after dressing change. There was one case of pulmonary infection. No deep infection, lower limb thrombosis or other complications were found. All 12 patients were followed up for 9 -40 months with an average of 28.6 months. The clinical symptoms of all patients were significantly improved, and the motor function of the lower limbs was recovered to varying degrees. According to ASIA grade, 2 cases of grade C were improved to grade B;1 case of grade C did not recover significantly;1 case of grade D was improved to grade E. One patient died of primary liver cancer 10 months after surgery. Local tumor recurrence occurred in 1 patient during follow up period. The VAS scores were 2.7±0.6, 2.5±0.4, 2.6±0.5, and 2.5±0.5 at 1, 3, 6 months after surgery and at final follow-up, which were significantly improved compared with the score before surgery(<0.05).@*CONCLUSION@#Open decompression, microwave ablation combined with open vertebroplasty and pedicle screw rod system in the treatment of spine metastases show some effects, with less intraoperative blood loss, shorter operation time, significant postoperative pain relief, and low tumor recurrence rate.

Clinical outcomes of microincision vitrectomy for high myopia patient with macular hole retinal detachment / 国际眼科杂志(Guoji Yanke Zazhi)

·AIM: To observe the clinical effects of microincision vitrectomy combined with internal limiting membrane (ILM) peeling for high myopia patient with macular hole retinal detachment (MHRD). ·METHODS: This was a retrospective non-randomized controlled clinical study. A total of 26 eyes of 26 patients with high myopic MHRD from January 2011 to December 2016 were included. All eyes underwent 23G pars plana microincision vitrectomy combined with ILM peeling. The preoperative and postoperative best corrected visual acuity ( BCVA ), intraocular pressure, ocular anterior segment and fundus examination were observed, and the anatomical closure of macular hole was checked by optical coherence tomography ( OCT). The relationships between final BCVA and these parameters ( age, GASS stage, onset time, OCT pattern of MH closure, initial vision) were examined by regression analysis. ·RESULTS: The postoperative MH closure rate of high myopia MHRD was 58% . OCT images of the repaired MH in high myopia were categorized into 3 patterns: U-type (3 eyes) with relative normal foveal contour; V-type (4 eyes) with steep foveal contour; W-type (8 eyes) with foveal defect od neruosensory retina, but without warped hem of retinal hole or cystic formation. Multivariate Logistic regression analysis showed that postoperative BCVA was correlated with the OCT patternts of closed MH and initial vision ( P< 0. 05 ). The postoperative visual acuity of U-type closed MH was 6. 9 times higher than that of W-type. ·CONCLUSION: Microincision vitrectomy combined with ILM peeling is a safe and effective surgical treatment for high myopia patient with macular hole retinal detachment. The postoperative visual acuity was correlated with the OCT patterns of closed MH and initial vision.

Systemic Reactions to Dust Mite Subcutaneous Immunotherapy: A 3-Year Follow-up Study

PURPOSE: The incidence of allergen specific immunotherapy-related systemic reactions (SRs) varies among different studies, and many factors are likely to contribute to SRs. This study aims to investigate the incidence, characteristics, and risk factors of SRs to standardize dust mite-specific subcutaneous immunotherapy (SCIT) in Central China. METHODS: All patients receiving standardized dust mites (100-100,000 SQ-U/mL; Alutard SQ, Hørsholn, Denmark) immunotherapy were followed up. Recorded data included demographics, diagnosis, patient status, pulmonary function testing results before and after each injection, allergen dosage, and details of SRs. RESULTS: From June 2011 to August 2014, a total of 208 patients received 4,369 injections; 27 (13.0%) patients experienced 48 (1.1%) systemic reactions. Most of the SRs were grade 2 reactions (n=30, 62.5%), followed by grade 1 (n=11, 22.9%), grade 3 (n=7, 14.6%), and no fatal reactions occurred. Forty-six SRs (95.8%) occurred within 30 minutes. Higher SR rates were associated with high concentration extracts (100,000 SQ-U/mL), injections with concomitant local reactions (LRs), children, asthma and high sensitivity (skin prick test 3+/4+ and/or sIgE≥17.5 kUA/L) (P<0.05). The estimated odds of SRs increased in children (OR=6.57; 95% CI: 1.88-22.97, P=0.003), asthmatic patients (OR=4.10; 95% CI: 1.72-9.80, P=0.002), and injections with LRs (OR=2.41; 95% CI: 1.33-4.36, P=0.004). CONCLUSIONS: The incidence of SRs to dust mite SCIT was low, and multiple factors were associated with the increased incidence of SRs. Children, asthmatics and patients with concomitant LR may be prone to develop SRs.

Amiloride slows down calpain-mediated ABCA1 degradation through in-hibition of hypoxia-induced NHE1 expression / 中国病理生理杂志

AIM:To examine the effects of hypoxia on sodium-hydrogen exchange 1 (NHE1) expression, in-tracellular Ca2+concentration ( [ Ca2+] i ) and calpain activity, and to explore the effect of amiloride on adenosine triphos-phate-binding cassette transporter A1 (ABCA1) degradation and its calpain-related mechanism.METHODS:RAW264.7 cells were exposed to hypoxia for 0 h, 12 h, 24 h and 48 h.The cell viability was measured by MTT assay and the expres-sion of NHE1 at mRNA and protein levels was detected by real-time PCR and Western blot.[ Ca2+] i was analyzed by flow cytometry.Calpain activity was assessed by the method of Suc-LLVY-aminoluciferin.Furthermore, the protein levels of ABCA1 in the RAW264.7 cells exposed to hypoxia for 24 h were determined after 6 h or 12 h treatment with NHE1 inhibi-tor amiloride in the presence of cycloheximide.ABCA1 protein levels and calpain activity were detected after 12 h incuba-tion with calpain inhibitor ALLN or intracellular calcium-chelating agent BAPTA.RESULTS: Hypoxia inhibited the cell viability in a time-dependent manner.Hypoxia up-regulated the mRNA and protein expression of NHE1, and increased [ Ca2+] i and calpain activity.Hypoxia increased the degradation of ABCA1 and amiloride slowed down the ABCA1 degra-dation.ALLN or BAPTA increased ABCA1 protein level and decreased calpain activity.CONCLUSION:NHE1 inhibitor amiloride attenuates the calpain-mediated degradation of ABCA1, indicating that hypoxia-induced NHE1 might, at least in part, participate in the ABCA1 degradation.

The stress distribution of the temporomandibular joint under four types of inter-arch elastics--a three dimentional finite element model analysis / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To analyze the influence of four types (class II long elastic, class II short elastic, class III long elastic, class III short elastic) of inter-arch elastics on the stress distribution and displacement of temporomandibular joint (TMJ).</p><p><b>METHODS</b>To reconstruct a three-dimensional element model of left craniofacial bones with TMJ, maxilla, mandible and dentition with MBT straight wire appliance by CT images, Mimics, Ansys software. The influence of four types elastic on the model was analyzed by simulating the clinical conditions.</p><p><b>RESULTS</b>The stress distribution and displacement of TMJ under four types of elastics have been acquired. The stress distributed rule of condition 1 and 2 was similar, compression stress centred on the frontal surface of the condyle, while stretching stress centred on the posterior surface. The stress distributed rule of condition 3 and 4 was similar too, the frontal surface of the condyle was most stretching stress, while posterior surface was most compression stress. The displacement of the condyle of condition 1 and 2 was overall forward and downward with a clockwise rotation, the displacement of the condyle of condition 3 and 4 was overall backward and upward with a anticlockwise rotation.</p><p><b>CONCLUSION</b>Class II long elastic and short elastic, class III long elastic and short elastic, the stress distributed rule was similar, the strength under short elastics was gentle under the same strength value. Overall displacement was downward and forward under class II elastics, the condyloid made a clockwise rotation. Overall displacement was upward and backward under class III elastics, the condyloid made a counterclockwise rotation.</p>

Is albumin administration beneficial in early stage of postoperative hypoalbuminemia after gastrointestinal surgery: a prospective randomized control trial / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate whether albumin administration is beneficial in early stage of postoperative hypoalbuminemia after gastrointestinal surgery.</p><p><b>METHODS</b>A prospective randomized control trial was designed. One hundred and twenty-seven patients suffered from hypoalbuminemia after gastrointestinal surgery were randomly divided into albumin group (64 cases) and saline group (control group, 63 cases) by using random number form. The albumin group was given 100 ml 20% human albumin daily for 3 days; and in control group, saline 100 ml daily was administered for 3 days after the operation. The disease course of postoperative hypoalbuminemia, nutritional status, complications and hospital stay were compared between the two groups.</p><p><b>RESULTS</b>Plasma albumin level in both groups decreased significantly after the operation (P < 0.05). No significant differences was found in the change of postoperative plasma albumin level between the two groups (P > 0.05). Postoperative plasma albumin, total protein and pre-albumin levels were similar in the two groups. Three-day and 5-day plasma albumin recovery ratios were similar in the two groups, and the 7-day recovery ratio was lower in the albumin group (P < 0.05). No significant difference was found in the incidence of postoperative complications between the two groups (23.4% vs. 12.7%, P = 0.116).</p><p><b>CONCLUSION</b>Albumin administration in early stage of postoperative hypoalbuminemia following gastrointestinal surgery is not beneficial either in correcting hypoalbuminemia or in clinical outcomes.</p>

Prevalence and predictors of acute stress disorder after earthquake: findings from Wenchuan earthquake in China / 中华预防医学杂志

<p><b>OBJECTIVE</b>To investigate the prevalence and predictors of acute stress disorder (ASD) in the victims affected by Wenchuan earthquake in China.</p><p><b>METHODS</b>A random clustered sampling method was used. Of 891 victims enrolled in the study, 874 were completely assessed with the ASD constructive questionnaire and diagnosed with DSM-IV criteria. Sociodemographic variables were obtained. Also, the major symptoms of ASD (i.e., general symptoms to a traumatic event; dissociative symptoms; re-experiencing symptoms; hyper-arousal symptoms; avoidance symptoms) were recorded.</p><p><b>RESULTS</b>The incidence rate of ASD was 12.59% (110/874). The incidence rates of ASD for female and male were 15.16% (72/475) and 9.52% (38/399) respectively. There was a significant difference between female and male on the incidence rate of ASD (chi(2) = 6.26, P = 0.01). Logistic regression indicated that the ASD diagnosis was predicted by gender (beta = 0.58, P = 0.01, OR = 1.79), the condition of casualties of family members (beta = 0.60, P = 0.01, OR = 1.82), and the condition of sharp properties loss (beta = 1.02, P = 0.01, OR = 2.76).</p><p><b>CONCLUSION</b>The major earthquake should have great influence on mental health of victims. The efforts to reduce casualties and property loss might help to prevent ASD. Further research is needed on gender difference among traumatic events.</p>

Relationship between carotid artery stenosis severity and 3-vessel coronary artery disease / 中国组织工程研究

BACKGROUND: Previous studies showed that the prevalence and extent of carotid artery stenosis increased with thedevelopment of coronary artery disease. There was a higher incidence of intracranial small-vessel disease, but lower of carotid artery disease in the Chinese stroke patients as compared with the white.OBJ ECTIVE: To observe the distribution of carotid and intracranial artery stenosis in patients with 3-vessel coronary artery disease.DESIGN: An observational study.SETTING: Department of Neurology; Heart Center, Beijing Chaoyang Hospital affiliated to Capital Medical University.PARTICIPANTS: From August 2003 to August 2004, The coronary angiography was performed in the outpatients and inpatients suspected to be coronary arteriosclerotic cardiopathy in the Department of Neurology, Beijing Chaoyang Hospital affiliated to Capital Medical University, and 126 patients of them with 3-vessel diseases were examined with carotid arteriography, including 56 males and 70 females, 47-76 years of age. Informed contents were obtained from all the participants.METHODS: Digital substraction angiography (DSA) was performed immediately after coronary angiography in the 126patients. All catheterizations were performed through a transfemoral approach using the Seldinger technique, and thenan appropriate amount of nonionic Ominipaque was injected. The angiography of bilateral carotid arteries, subclavian artery, or vertebral artery was taken from different angles. The percentage of stenosis was calculated directly from DSAmachine. Evaluative standards: Based on the stenosis degree from carotid angiography results, the patients were divided into 5 categories as normal, mild stenosis, moderate stenosis, severe stenosis and complete occlusion.MAIN OUTCOME MEASURES: Severity of carotid stenosis.RESULTS: All the 126 patients were involved in the final analysis of results. There were 13 (10.32%), 18 (14.29%), 12(9.5%), or 10 (7.9%) patients found to have mild, moderate, severe carotid stenosis, or complete occlusion, and the incidences of these changes were fairly similar. However, the incidence of angiographic carotid stenosis coupled with 3-vessel carotid artery disease was 42.06%.CONCLUSION: The prevalence of carotid stenosis in patients with 3-vessel carotid artery disease was as high in the Chinese population as that in Westem countries. In patients with 3-vessel disease, the prevalence of carotid stenosis was higher than that of intracranial artery stenosis, thus they may require both coronary and carotid interventions.

Ultrastructural features and platelet-derived growth factor receptor A gene mutations in CD117-negative gastrointestinal stromal tumor / 中华病理学杂志

<p><b>OBJECTIVE</b>To explore the ultrastructural features and mutation status of platelet-derived growth factor receptors A (PDGFRA) and c-kit in gastrointestinal stromal tumors that were immunohistochemically negative for CD117 antigen.</p><p><b>METHODS</b>Six cases of gastrointestinal stromal tumors that were CD117 immunostain negative were studied by electron microscopy. Direct PCR sequencing was used to investigate the mutation status of c-kit gene exons 9, 11, 13, 17 and PDGFRA gene exons 12 and 18.</p><p><b>RESULTS</b>The ultrastructural features of all 6 cases were similar to those of the interstitial cell of Cajal (ICC). None of the 6 cases were found to have c-kit gene mutations. However, three tumors were found to harbor PDGFRA exon 18 activating mutations, including two tumors having an Asp-->Val842 missense mutation and one having an Arg-->Ser841 missense mutation.</p><p><b>CONCLUSIONS</b>PDGFRA mutations may provide an important alternative molecular mechanism for the development of gastrointestinal stromal tumor.</p>

The clinical significance of p16 protein non-expression and p16 gene inactivation by deletions and hypermethylation in nasopharyngeal carcinoma / 中华病理学杂志

<p><b>OBJECTIVE</b>To investigate the clinical significance of p16 protein non-expression and p16 gene inactivation by deletions and hypermethylation in nasopharyngeal carcinoma.</p><p><b>METHODS</b>Immunohistochemical study for p16 protein was carried out in 90 cases of non-keratinizing carcinoma (NKC) of nasopharynx. P16 gene deletions and hypermethylation were also analyzed by polymerase chain reaction (PCR) and methylation-specific PCR in 23 randomly selected NKC cases.</p><p><b>RESULTS</b>Among the 90 NKC cases studied, 42 cases (46.7%) were negative for p16 protein. The non-expression rate of p16 protein also correlated with the 5-year survival rate. The non-expression rate was 60.0% in patients who died within 5 years, in contrast to 20.0% in those alive for over 5 years after diagnosis. The non-expression rate of p16 protein in cases with or without distant metastasis was 81.8% and 41.8% respectively (P < 0.05), while that in cases with or without local invasion into skull base was 41.7% and 48.5% respectively (P > 0.05). As for molecular analysis, deletion of p16 gene exon 2 was found in 10 of the 23 cases (43.4%) studied, while deletion of p16 gene exon 1 was not detected in these samples. Hypermethylation of p16 gene exon 1 was also noted in 2 of the 23 cases (8.7%). The overall mutation rate of these cases was 52.1%.</p><p><b>CONCLUSIONS</b>There is a high incidence of p16 protein non-expression, deletion of p16 gene exon 2 and hypermethylation of p16 gene exon 1 in NKC. P16 gene inactivation may thus play an important role in the pathogenesis of NKC, especially in terms of its metastatic potential.</p>

Somatic hybridization between carrot and Bupleurum scorzonerifolium and esteras isoenzyme analysis / 中国中药杂志

<p><b>OBJECTIVE</b>To transfer the effective elements of Bupleurum scorzonerifolium into carrot, and provide theoretical data for the exploitation, improvement and selection of the germplasm of Chinese medicinal plants.</p><p><b>METHOD</b>The protoplasta of Bupleurum scorzonerifolium irradiated by ultraviolet light (UV) at an intensity of 300 microW.(cm2)-1 for 0, 1, 2 min respectively were fused with those of carrot Fisch by PEG method. The regenerated clones, derived form a single fused cell, were examined for their hybrid nature by phenotype and Esterase isoenzyme analysis.</p><p><b>RESULT</b>Nine clones were identified as the somatic hybrids between B. scorzonerifolium and carrot.</p><p><b>CONCLUSION</b>This provides a firm foundation for the further analysis of the main active components saikosaponin of somatic hybrids and the screening out of high-medicine-content hybrid cell lines.</p>

Determination of Strychnine in Jinqianbaihuashe Medicinal Wine by Dual Wavelength Spectrophotometry / 中成药

Objective: To determine strychnine content of Jinqianbaihuashe Medicinal Wine. Methods: The dual wavelength spectrophotometry was adopted. Results: The calibration curve was linear in the range of 1.6～ 14.4?g?mL -1 of strychnine. The average recovery rate was 99.35%. RSD was 0.74%(n=7). Conclusion: The method is reproducible, sensitive and prevent from the interference of other components.