Relationship Between Trunk Control Ability and Respiratory Function in Stroke Patients: A Scoping Review and Meta-Analysis

Purpose@#Hemiparesis in stroke survivors has been reported to affect respiratory function. The relationship between trunk control and respiratory function, however, is not well understood. We aimed to map the state of the association between the trunk and respiratory function as well as evaluate the effect of a respiratory function training intervention on trunk control for stroke survivors. @*Methods@#A scoping review and meta-analysis of observational and interventional studies were performed. Cochrane Library, CINAHL with Full Text (EBSCO), Medline (Ovid), and PubMed were searched using the terms stroke, respiratory, and trunk control. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) checklist was used to examine the sections of each report. @*Results@#A total of 102 studies were identified, of which 12, published between 2011 and 2022, were included in the meta-analysis or narrative synthesis. Three studies were included in the meta-analysis of the correlation between trunk control and respiratory function parameters (forced vital capacity [FVC], forced expiratory volume during the first breath [FEV1], maximal inspiratory pressure [MIP], and maximal expiratory pressure [MEP]) with effect sizes (Fisher's z) for all outcomes, which ranged from small to intermediate (between 0.21 and 0.39). Furthermore, five studies were included in the meta-analysis of the effect of respiratory function training intervention on trunk control. An overall effect size (Cohen's d) of 1.47 corresponds to a large effect. We also found significant improvements in MIP and MEP but not in FVC and FEV1 for stroke survivors with the interventions. @*Conclusions@#Respiratory training, use of diaphragmatic resistance exercise or abdominal breathing, use of a pressure threshold-loading device, and the performance of functional strengthening exercises for the trunk muscles were found to increase patients’ trunk control and improve their respiratory muscle strength.

Dignity and Related Factors in Patients with Cancer: A Cross-Sectional Study

Purpose@#Dignity is a basic human right that is related to psychological distress factors in patients with cancer such as depression and demoralization. Hence, the dignity issue is of great importance to healthcare professionals. The present study aimed to advise healthcare professionals regarding the related distress factors of dignity in patients with cancer by investigating its relationship with patients’ demographics, disease characteristics, and psychological distress. @*Methods@#This was a cross-sectional study design. A convenience sample of 267 patients with cancer from a medical center was recruited into this study. Each patient completed demographics and disease characteristics questionnaires, the Patient Dignity Inventory Mandarin Version, the Demoralization Scale Mandarin Version (DS-MV), and the Patient Health Questionnaire-9 (PHQ-9). Data were analyzed with SPSS 22.0 software. @*Results@#Dignity was significantly correlated with age, demoralization, and depression. Cancer patients aged 65 or above were more likely to have a lower sense of dignity. In the present study, the sensitivity and specificity of the Patient Dignity Inventory Mandarin Version for demoralization (DS-MV≥30) were 84.8% and 79.1% and for depression (PHQ-9≥10) were 73.8% and 70.9% in patients with cancer with an aggregate score of 35 or above. @*Conclusions@#Dignity is significantly correlated with personal demographic characteristics and psychological distress in patients with cancer. The results provide reference data for healthcare professionals to understand and enable dignity in patients with cancer and aid in the development of methods that promote their dignity.

The Effectiveness of Dignity Therapy as Applied to End-of-Life Patients with Cancer in Taiwan: A Quasi-Experimental Study

Purpose@#The aim of the study was to determine the effectiveness of dignity therapy for end-of-life patients with cancer. @*Methods@#This study used a quasi-experimental study design with a nonrandomized controlled trial.Dignity therapy was used as an intervention in the experimental group, and general visit was used in the control group. Thirty end-of-life patients with cancer were recruited, with 16 in the experimental group and 14 in the control group. Outcome variables were the participants' dignity, demoralization, and depression. Measurements were taken at the following time points: pre-test (before intervention), posttest 1 (the 7th day), and post-test 2 (the 14th day). The effectiveness of the intervention in the two groups was analyzed using the generalized estimating equation, with the p value set to be less than .05. @*Results@#After dignity therapy, the end-of-life patients with cancer reflected increased dignity signifi-cantly [β= -37.08, standard error (SE) = 7.43, Wald x2= 24.94, p < .001], whereas demoralization (β= -39.55, SE = 6.42, Wald x2= 37.95, p < .001) and depression (β= -12.01, SE = 2.17, x2= 30.71, p< 001) were both reduced significantly. @*Conclusion@#Clinical nurses could be adopting dignity therapy to relieve psychological distress and improve spiritual need in end-of-life patients with cancer. Future studies might be expanded to looking at patients vis-a -vis end-of-life patients without cancer to improve their psychological distress. These results provide reference data for the care of end-of-life patients with cancer for nursing professionals.

The Effectiveness of Dignity Therapy as Applied to End-of-Life Patients with Cancer in Taiwan: A Quasi-Experimental Study

Purpose@#The aim of the study was to determine the effectiveness of dignity therapy for end-of-life patients with cancer. @*Methods@#This study used a quasi-experimental study design with a nonrandomized controlled trial.Dignity therapy was used as an intervention in the experimental group, and general visit was used in the control group. Thirty end-of-life patients with cancer were recruited, with 16 in the experimental group and 14 in the control group. Outcome variables were the participants' dignity, demoralization, and depression. Measurements were taken at the following time points: pre-test (before intervention), posttest 1 (the 7th day), and post-test 2 (the 14th day). The effectiveness of the intervention in the two groups was analyzed using the generalized estimating equation, with the p value set to be less than .05. @*Results@#After dignity therapy, the end-of-life patients with cancer reflected increased dignity signifi-cantly [β= -37.08, standard error (SE) = 7.43, Wald x2= 24.94, p < .001], whereas demoralization (β= -39.55, SE = 6.42, Wald x2= 37.95, p < .001) and depression (β= -12.01, SE = 2.17, x2= 30.71, p< 001) were both reduced significantly. @*Conclusion@#Clinical nurses could be adopting dignity therapy to relieve psychological distress and improve spiritual need in end-of-life patients with cancer. Future studies might be expanded to looking at patients vis-a -vis end-of-life patients without cancer to improve their psychological distress. These results provide reference data for the care of end-of-life patients with cancer for nursing professionals.

Application of percutaneous vertebroplasty with the second injection for poor dispersion bone cement of Kümmel disease / 中国骨伤

OBJECTIVE@#To investigate clinical effect of percutaneous vertebroplasty with second injection for poor dispersion bone cement of Kümmel disease.@*METHODS@#Eighty-eight patients with Kümmel disease were treated with vertebroplasty from February 2014 to December 2017, and 16 patients were found cement dispersion unsatisfactory during initial cement injection and were undertaken second cement injection during operation. Among patients, there were 1 male and 15 females aged from 63 to 82 years old with an average age of 72.7 years old. Distribution of fractured vertebrae were followed: 1 patient was on T₁₀, 1 patient was on T₁₁, 3 patients were on T₁₂, 8 patients were on L₁, 1 patient was on L₂, and 2 patients were on L₃. VAS and ODI score were compared before operation, 2 days after operation and the latest following-up, anterior vertebral height and local kyphosis angle of fractured vertebrae with intravertebral cleft were also observed. Postoperative complication was recorded.@*RESULTS@#All patients were followed up from 5 to 22 months with average of 14.1 months. ODI score before operation, 2 days after operation and the latest following-up were 72.3±12.1, 56.8±5.0 and 12.1±5.3 respectively; VAS score before operation, 2 days after operation and the latest following-up were 7.8±0.6, 3.0±0.4 and 2.4±0.7, respectively; ODI score at 2 days was improved compared with before operation, while ODI and VAS score at the latest following-up was improved than that of 2 days after operation. Vertebral anterior compression rate and Cobb angle of the fractured vertebrae with intravertebral cleft were respectively corrected from (37.8±5.4)% and (15.1±2.0)°preoperative, to (4.7±1.4)% and (4.4±2.2)° at 2 days after operation, (4.9±1.5)% and (4.8±2.4)° at the latest following-up, there was significant difference between before operation and 2 days after operation, while there was no difference between 2 days after operation and the latest following-up. Three patients occurred cement leakage without pulmonary embolism and neurological impairment. Four patients occurred adjacent vertebrae fracture. There was no incidence of recollapsed vertebrae during follow-up period.@*CONCLUSIONS@#Percutaneous vertebroplasty for Kümmel disease could receive satisfactory clinical results when cement dispersion was inadequate during initial cement injection by the second injection, and effectively prevent occurrence of vertebral re-collapse.

Kinesin Family Member 11 Enhances the Self-Renewal Ability of Breast Cancer Cells by Participating in the Wnt/β-Catenin Pathway / 한국유방암학회지

Construction of real-time polymerase chain reaction detection for infection-related cytokines of tree shrew / 生物医学工程学杂志

Tree shrew is a novel and high-quality experimental animal model. In this study, the real-time polymerase chain reaction methods were established to detect infection-related cytokines interleukin-6 (IL-6), IL-8, IL-10, IL-17A, interferon-γ (IFN-γ) and housekeeping gene glyceraldehyde-phosphate dehydrogenase ( ) of tree shrew. The results indicated that the establised methods had good specificity. The high point of the linear range of these reagents reached 1 × 10 copies, and the low points ranged from 10 copies (IL-6, IL-17A), 100 copies (IL-10, ) to 1 000 copies (IL-8, IFN-γ). In this interval, the linear correlation coefficient of each reagent was greater than 0.99. The lowest detectable values of IL-6, IL-8, IL-10, IL-17A, IFN-γ and were 8, 8, 4, 8, 128 and 4 copies, respectively. The results showed that the established detection methods had good specificity, sensitivity and wide linear range. The methods were suitable for detection of multiple concentration range samples, and could be used for the subsequent studies of tree shrew cytokines.

Application of operation bed and C-arm digital metrology adjustment in the percutaneous vertebroplasty for osteoporotic thoracolumbar vertebral fractures / 中国骨伤

OBJECTIVE@#To explore the application effect of operation bed and C-arm digital metrology adjustment in percutaneous vertebroplasty for osteoporotic thoracolumbar vertebral fractures.@*METHODS@#Ninty-four patients with osteoporotic thoracolumbar vertebral fractures admitted to our hospital from February 2015 to February 2017 were divided into control group and observation group according to random number table method, with 47 cases in each group. Control group adjusted C-arm and operating bed based on experience. For observation group surgical bed and C arm were measured and adjusted digitally and metrologically during percutaneous vertebroplasty. The operation time, times of fluoroscopy, hidden blood loss and bone cement volume were recorded in two groups. The clinical efficacy of two groups was observed by visual analogue score (VAS) and Oswestry Disability Index(ODI). Cobb angle and height of injured vertebrae before and after surgery were analyzed by imaging data.@*RESULTS@#The operation time, times of fluoroscopy, and hidden blood loss were significantly lower in observation group than in control group (0.05); VAS and ODI of observation group were significantly lower than that of the control group(<0.05); there was no significant difference in Cobb angle and height of injured vertebrae before and after operation between two groups. There were 3 cases of cement leakage, 1 case of urinary tract infection, 1 case of pulmonary infection, 2 cases of bedsore in observation group with complication rate was 14.89%(7/47); there were 8 cases of cement leakage, 2 cases of spinal nerve injury, 1 case of urinary tract infection, 3 cases of pulmonary infection, 2 cases of bedsore in control group with complication rate was 34.04% (16/47). The incidence of complications in observation group was significantly lower than that of control group (<0.05).@*CONCLUSIONS@#Operation bed and C-arm digital metrology adjustment can improve the surgical effect in percutaneous vertebroplasty for osteoporotic thoracolumbar vertebral fractures and promote rapid recovery.

Pertussis antibody titers in pregnant women's venous blood and cord blood—a survey from three women and children's hospitals in Beijing / 中国新生儿科杂志

Objective To study the levels of antibodies against bordetella pertussis among pregnant women and neonates in Beijing. Method From December 2016 to March 2017, pregnant women and their newborns from three women and children′s hospitals in Beijing were enrolled in this study. 3 ml of venous blood from the mothers and 3 ml of umbilical cord blood from neonates were drawn.Pertussis bacillus IgG antibody (PER-IgG) and pertussis toxin IgG antibody (PT-IgG) were tested using enzyme-linked immunosorbent assay. χ2 test was used to compare the positive rate of pertussis IgG antibodies in maternal and cord blood in the three hospitals. Correlational analyses of the antibodies levels in each hospital were conducted. The demographic characteristics, history of cough during pregnancy and history of DTaP vaccination of the mothers were collected via questionnaires. Result A total of 612 pairs of venous blood and cord blood samples were collected, including 4 mothers delivered twins and 616 cases of cord blood sample were collected. No history of pertussis were found in the 612 mothers. Among the 616 cases of umbilical cord blood, positive rate of PER-IgG was 13.3％ (82/616), positive rate of PT-IgG was 0.5％ (3/616). Among 612 cases of venous blood from the mothers, positive rate of PER-IgG was 7.7％ (47/612), positive rate of PT-IgG was 0.3％ (2/612). Positive rates of PER-IgG and PT-IgG in the mothers′ venous blood were not correlated with their residences (P=0.676 and 0.544). Positive rates of PER-IgG (r=0.842, P<0.001) and PT-IgG (r=0.619, P<0.001) in the mothers′ blood were positively correlated with the positive rate in umbilical cord blood. Conclusion This study shows that the positive rate of PER-IgG is very low in the maternal and umbilical cord blood in Beijing. Positive correlations of PER-IgG and PT-IgG between mother and umbilical cord blood were existed. Most mothers and their newborns do not have enough protection against pertussis.

A family affected by multiple acyl-CoA dehydrogenase deficiency due to compound heterozygous mutations on ETFDH and literature review / 中国新生儿科杂志

Objective To improve the understanding of clinical phenotype and genotype of multiple acyl-CoA dehydrogenase deficiency (MADD) in neonates.Method The clinical data of a neonates with the diagnosis of MADD and treated in the Neonatal Department of Children's Hospital of Capital Institute of Pediatrics in December 2016 were analyzed.The literature collected from Wanfang database,CNKI and PubMed database from 1976 January to 2017 June was retrieved.Using "glutaric acidemia type Ⅱ ","multiple acyl CoA dehydrogenase deficiency","infant" and "neonate" as the key words.The phenotype and genotype characteristics were summarized.Result This boy was a full-term low birth weight infant with abnormal family history.He was admitted to hospital with recurrent episodes of poor response,respiratory distress and hyperlactacidemia.B-mode ultrasound abdominal examination suggested polycystic kidney disease.Laboratory tests revealed non-kenotic hypoglycemia,refractory metabolic acidosis,elevated lactate and muscle enzymes,hyperammonemia,abnormal coagulation function test.Mass spectrometry analysis showed that multiple acyl-carnitine increased.Urine gas chromatography-mass spectrometry showed significantly increased levels of lactic,glutaric,2-hydroxypentanedioic,dicarboxylic,and 4-hydroxybenzene lactic acids.The infant was given high doses of vitamin B2,L-carnitine,and other symptomatic treatments,but the condition did not improve.He died 5 days later.The gene test showed ETFDH gene compound heterozygous mutations,one missense mutations from the father with normal phenotype c.770A ＞ G (p.Y257C),a frameshift mutation from the mother with normal phenotype c.1281-1282 deletion mutation of AA (p.I428Rfs6).The protein structures of the mutations were predicted to be deleterious.Frameshift mutation c.1281-1282 deletion mutation of AA (p.I428Rfs6) were not included in the gene bank.A total of 21 cases with MADD were found from the literature.The clinical characteristics including:male (76.2％),dyspnea (52.4％),poor response (52.4％),hypoglycemia (47.6％),hepatomegaly (47.6％),elevated muscle enzymes (42.9％),immediate onset within 24 hour of birth (42.9％),abnormal family history (38.1％),malformation (38.1％),hyperammonemia (33.3％),metabolic acidosis (28.6％).81.0％of the patients were given vitamin B2 treatment,71.4％ of carnitine,28.6％ of coenzyme Q10,28.6％ of low fat,low protein and high carbohydrate feeding.However,the prognosis of these patients was poor,76.2％ died,and 42.9％ died within 1 week after birth,and 23.8％ survived.But all showed different degrees of mental retardation during follow-up periods.Conclusion Neonatal onset MADD can be characterized by dyspnea,poor response,hypoglycemia,hepatomegaly and elevated muscle enzymes.The disease is more common in early male neonates.It can be treated with vitamin B2 and L-carnitine,but with poor prognosis and high mortality.In this case,there were 2 sites in the ETFDH gene that formed complex heterozygous mutation:c.770A ＞ G (p.Y257C) and c.1281-1282 deletion mutation of AA (p.I428Rfs6),while the latter is a new mutation.

Clinical findings of 16 cases of neonatal influenza / 临床儿科杂志

Objective To investigate the clinical features, laboratory diagnostics, treatments, and prognosis of neonates infected with influenza. Methods The clinical data of 16 neonates diagnosed as influenza admitted to the neonatal ward from January 2015 to May 2017 were retrospectively analyzed. Results Of the 16 neonates, 11 were male and 5 were female. Mean age was 18.5 days. 75% (12/16) of them were reported to be exposed to family members with common cold- like symptoms before hospitalization. Clinical manifestations included nasal obstruction (11/16), fever (10/16), cough (10/16), and rhinorrhea (8/16). Influenza antigen rapid detection (colloidal gold method) was positive in all cases. Influenza immunofluorescence assays were performed in 15 cases, only 6.67% (1/15) was positive. Sputum culture was performed in 13 cases, 8 of which were positive. Of them, 75% (12/16) neonates were diagnosed with pneumonia. Only 12.5% (2/16) neonates were treated with neuraminidase inhibitor. All cases recovered well and were discharged after antibiotic treatment. Conclusions Neonates contacted with family members displaying common cold-like symptoms should be examined for influenza in time. The common clinical manifestations include catarrhal symptoms, fever and cough. The sensitivity of the influenza immunofluorescence assay is lower as compared with the colloidal gold method. Pneumonia may often be developed in neonatal influenza. The prognosis of neonatal influenza is satisfactory if treated.

Effect of the proximal level on post-laminoplasty loss of lordosis / 中国骨伤

<p><b>OBJECTIVE</b>To analyze the effect whether or not retaining muscle ligament complex of C2 attachment on cervical spine kyphotic deformity after single open-door laminoplasty.</p><p><b>METHODS</b>A total 40 patients with cervical spondylotic myelopathy underwent single open-door laminoplasty from February 2011 to June 2014 were retrospectively analyzed. Of them, single open-door for C₃-C₆ was 40 cases (group A), including 28 males and 12 females, with an average age of (68.4±9.3) years old;and single open-door for C₄-C₆ plus C₃ laminectomy decompression (in order to protect the muscle ligament complex of C₂ attachment) was 40 cases (group B), including 26 males and 14 females, with an average age of (66.8±8.4) years old. Japanese Orthopaedic Association (JOA) score, visual analogue scale (VAS), Cobb angle of sagittal plane from C₂-C₇, cervical range of motion were used to evaluate effects before operation and at the latest follow-up.</p><p><b>RESULTS</b>All the patients were followed up from 24 to 31 months with an average of(26.5±3.4) months. There was no significant differences in VAS, JOA scores and cervical range of motion before surgery between two groups (>0.05) and all above items were significantly improved at the latest follow-up (<0.05), but there was no significant difference between two groups(>0.05). There was no significant difference in cervical Cobb angle before surgery between two groups(>0.05), and postoperative Cobb angle had obviously improved in two groups(<0.05), but the improvement of group B was better than that of group A.</p><p><b>CONCLUSIONS</b>Starting the laminoplasy on C₄ level and retainning the muscle ligament complex of C₂ attachment can obviouly decrease cervical spine syphotic deformity.</p>

Unilateral Wiltse intermuscular approach and contralateral decompression for the treatment of thoracolumbar burst fracture / 中国骨伤

<p><b>OBJECTIVE</b>To compare the clinical effects and multifidus muscle injury of different approaches, including unilateral Wiltse intermuscular approach and intramuscular approach combined with contralateral decompression, in treating thoracolumbar burst fracture.</p><p><b>METHODS</b>Forty-three patients with thoracolumbar burst fracture were enrolled in the study from January 2010 to December 2014, including 29 males and 14 females with an average age of 42.3 years old(ranged from 21 to 64 years old). The patients were treated with posterior pedicle screw fixation and unilateral decompression and were divided into Wiltse intermuscular approach group (group A) and intramuscular approach group (group B) according to surgical approach. Operation time and intraoperative bleeding were recorded for all patients; visual analogue scale(VAS) was compared 1 d preoperatively, 1 week, 12 months postoperatively between two groups; preoperation and 12 months postoperatively, the fractured vertebral canal and two-sides multifidus muscle of the same section were observed and compared by CT measure between two groups.</p><p><b>RESULTS</b>All the patients were follow-up for 14 to 21 months with an average of 16.3 months. Partial wound non-healing occurred in 3 patients and the wound ultimately healing after debridgement suture and change dressings. No screw breakage was found. There was significant difference in operation and intraoperative bleeding operation between two groups (<0.05), while there was no significant difference in VAS score of 1 d preoperatively, 1 week, 12 months postoperatively between two groups(>0.05). As for CT measurement results, postoperative vertebral canal narrow ratio was significant decreased in all patients(<0.05), while perioperative changes of the two-sides multifidus muscle cross section area and density were significant in group A (<0.05), but there was no significant difference in group B (>0.05). Neurologic status of all patients got recovery at final follow-up.</p><p><b>CONCLUSIONS</b>The method of unilateral Wiltse intermuscular approach combined with contralateral decompression for the treatment of thoracolumbar burst fracture has good clinical effects, also it is less invasive and less damage to multifidus muscle compared with intramuscular approach.</p>

Analysis of complications of percutaneous endoscopic lumbar discectomy / 中国骨伤

<p><b>OBJECTIVE</b>To analyze the complications of lumbar intervertebral disc herniation treated with percutaneous endoscopic lumbar discectomy(PELD), and discuss how to avoid these complications.</p><p><b>METHODS</b>The data of 132 patients with lumbar intervertebral disc herniation underwent PELD from October 2013 and June 2015 were retrospectively analyzed, including 85 males and 47 females with an average age of 42.9 years old. There were 6 cases of L₃,₄, 68 of L₄,₅ and 58 of L₅S₁. The incidences of intraoperative and postoperative complications were analyzed.</p><p><b>RESULTS</b>There was spinal dura mater injury in 1 patient, but no cerebrospinal fluid leakage and nerve function deficit was found, the muscle strength did not decrease postoperatively and the incision healed well. Two patients converted to open surgery ultimately because of stenosis of the intervertebral foramen and adhesion between nucleus pulposus and spinal dura mater; two patients complicated with early recurrence(in 3 months);nucleus pulposus residue developed in 3 patients; all of them were treated by open surgery and got satisfactory results. One patient with heart disease history complicated with supraventricular tachycardia after surgery and 2 patients with the increased cerebrospinal fluid pressure during surgery.</p><p><b>CONCLUSIONS</b>PELD have a steep learning curve, and the technology is a safe and effective method in treating lumbar disc herniation, but the beginners must have enough open surgery experience, and to grasp indications strictly.</p>

Protective Factors of Demoralization among Cancer Patients in Taiwan: An Age-matched and Gender-matched Study

PURPOSE: This study aimed to explore the protective factors of demoralization in cancer patients via investigation of cancer patients' demographic and disease characteristics. METHODS: This was a cross-sectional descriptive study. We used a structured questionnaire, which contained items on demographic and disease characteristics, as well as the Demoralization Scale Mandarin Version (DS-MV), with a cutoff of 30 or more indicating high demoralization. Data were analyzed with age-matched and gender-matched conditional logistic regression analysis. For the study, 428 questionnaires were delivered and 411 were recovered. After being age-matched and gender-matched, 182 participants of high demoralization (DS-MV > 30) and low demoralization (DS-MV ≤ 30) were obtained respectively, for a total of 364 participants. RESULTS: Cancer patients' demoralization was significantly related to family support (p = .019), education (p = .049), and monthly income (p = .001). Family support [odds ratio = 0.38; p = .028; 95% confidence interval (0.16, 0.91)] and monthly income [odds ratio = 0.49; p = .009; 95% confidence interval (0.29, 0.84)] were protective factors of demoralization in cancer patients. CONCLUSION: Early and appropriate demoralization assessment of cancer patients' demographic and disease characteristics is very important in clinical settings. Healthcare providers might regularly monitor demoralization in cancer patients, and develop related nursing care guidelines or treatment for demoralization in cancer patients. The study results can be a reference for healthcare providers who work with cancer patients.

Predictive value of NGAL and renal injury molecule 1 in 28-day mortality of neonatal sepsis with re-nal injury / 中国医师杂志

Objective To investigate the prognostic value of serum neutrophil gelatinase-associated lipid transport protein (NGAL) and renal injury molecule 1 (KIM-1) in assessing neonatal sepsis with a-cute renal injury. Methods A total of 63 cases of renal injury with neonatal sepsis was collected from De-partment of Pediatrics, Affiliated Children's Hospital of Capital Institute of Pediatrics. The general condition of the patients, and neonatal critical case score ( NCIS) were recorded. The expressions of NGAL and KIM-1 in serum of all children were measured by venous blood and urine. Each case was followed up for 28 days to track the death of newborns. Pearson correlation analysis was used to test the correlation among NGAL, KIM-1, and NCIS;Multivariate regression analysis was used for NGAL, KIM-1, and other risk factors asso-ciated with neonatal sepsis kidney injury 28 days mortality. Receiver operating characteristic ( ROC) curve was used to compare the value of NGAL and KIM-1 in the prognosis of neonatal sepsis renal injury. The val-ues of NGAL and KIM-1 in the prognosis of neonatal sepsis renal injury were analyzed by ROC curve. Re-sults ⑴ After 28 days of follow-up, 63 cases of neonatal sepsis, and 22 died were found, which was ac-counted for 34. 92 percent of the total. ⑵ Compared to the survival group, the expressions of NGAL and KIM-1 in the death group were increased ( P<0. 01 ) . ⑶ Pearson correlation analysis showed that NGAL and KIM-1 expressions in peripheral blood were negatively correlated with NCIS. ⑷Multivariate regression analysis showed that NGAL and KIM-1 were independent risk factors for neonatal sepsis kidney injury ( P<0. 01). ⑸ ROC curve analysis showed that the area under the curve of NGAL and KIM-1 was 0. 79 (95％CI:0. 75-0. 93), and 0. 84 (95％ CI:0. 71-0. 90), NGAL and KIM-1 were better than single detection with NGAL, or KIM-1, area under curve (AUC) was 0. 89 (95％ CI:0. 78-0. 94) (P<0. 01). Sensitiv-ity of KIM-1 was superior to that of NGAL, and specificity of NGAL was superior to KIM-1. The sensitivity and specificity of both were better than single detection with NGAL and KIM-1. Conclusions NGAL and KIM-1 have good predictive value in assessing neonatal sepsis kidney injury mortality.

Cervical single open door laminoplasty with lateral mass screw fixation for the treatment of cervical spondylotic myelopathy with cervical instability / 中国骨伤

<p><b>OBJECTIVE</b>To evaluate the outcomes of single open door laminoplasty with lateral mass screw fixation in treating cervical spondylotic myelopathy (CSM) with cervical instability.</p><p><b>METHODS</b>From March 2010 to October 2012, 25 patients with spondylotic myelopathy and cervical instability underwent single open door laminoplasty with lateral mass screw fixation. There were 18 males and 7 females, aged from 57 to 68 years with the mean of 57 years. Japanese Orthopaedic Association (JOA) scores were used to evaluate clinical effects before operation and final follow up. Radiographical measures were made in change of Cobb angle by sagittal plane from C₂ to C₇, and cervical range of motion.</p><p><b>RESULTS</b>All the patients were followed up from 18 to 36 months with an average of 25.6 months. Cerebrospinal fluid leakage occurred in 1 case, incision fat necrosis in 1 case, C₅ nerve root palsy in 4 cases. JOA scores was improved from preoperative 5.2±2.1 to 11.3±2.4 final follow up. Cobb angle was changed from preoperative (6.5±3.4)° to (13.2±4.9)° final follow up. Cervical range of motion was changed from preoperative (30.4±9.2)° to (26.5±8.4)° final follow up.</p><p><b>CONCLUSIONS</b>As an effective treatment to CSM with cervical instability, single open door laminoplasty with lateral mass screw fixation has the advantage of extensive application scope, safety and steady, but the incidence rate of complication must be reduced.</p>

Outcomes and related factors of C₅ nerve root palsy after cervical posterior single open-door laminoplasty / 中国骨伤

<p><b>OBJECTIVE</b>To analyze the clinical outcomes and related factors of C₅ palsy following cervical laminectomy in treating multi-segments cervical spondylotic myelopathy.</p><p><b>METHODS</b>From January 2010 to June 2014, 80 patients with spondylotic myelopathy underwent C₃-C₆ open-door laminoplasty(group A) and 80 patients C₄-C₆ open-door laminoplasty (group B). The mean age was (68.4±9.2) years (44 males and 36 females) in group A and the mean age was (66.8±8.9) years (48 males and 32 females) in group B. Japanese Orthopaedic Association(JOA) score, Visual Analogue Score, incidence of C₅ palsy, time of onset, grade of muscle weakness, other accompanying cervical nerve root palsies, recovery time were used to evaluate clinical effects before operation and at last follow-up. Radiographically, changes of Cobb angle of sagittal plane from C₂-C₇, cervical range of motion, minimal spinal cord diameter on MRI were analyzed before operation and at last follow-up.</p><p><b>RESULTS</b>All the patients were followed up from 6 to 15 months with an average of (12.4±3.2) months. No obvious differences were observed between change of VAS of cervical and upper limb, JOA, Cobb angle, cervical range of motion, minimal spinal cord diameter on MRI. C₅ nerve root palsy occurred in 7 cases (8.75%) in group A, including 4 cases of upper limb pain, 3 cases of upper limb pain, and 2 cases of residual upper limb pain and sensory loss at the last follow-up. C₅ nerve root palsy occurred in 5 cases (7.5%) in group B, 3 cases of upper limb pain, 2 cases of upper limb sensory loss, and all patients recovered normal radiation pain and sensory loss at the last follow-up. There was no significant difference in the incidence of C₅ nerve root palsy between the two groups. C₅ nerve root palsy, deltoid muscle, accompanied by neurological symptoms, recovery time were(2.3±1.0) N, 30 cases (37.5%), (11.4±1.0) weeks in group A, (2.8±0.8) N, 23 cases (28.8%), (8.2±0.8) weeks in group B, there was no significant difference on deltoid muscle decreased between the two groups, accompanied by neurological symptoms and the recovery time in group A was worse than the group B.</p><p><b>CONCLUSIONS</b>Comparison of the two kinds of operation, the probability of postoperative C₅ nerve root palsy was equal, but the C₅ nerve root palsy in patients with C₄-C₆ open-door laminoplasty showed lighter symptom and faster recovery.</p>

Expression characteristics of the Ccdc70 gene in the mouse testis during spermatogenesis / 中华男科学杂志

<p><b>OBJECTIVE</b>To investigate the expression characteristics of the gene of coiled-coil domain-containing protein 70 (Ccdc70) in the mouse testis and its potential role in spermatogenesis.</p><p><b>METHODS</b>Using expression profile microarray, we screened the mouse testis-specific gene Ccdc70, studied its expression characteristics in the mouse testis by RT-PCR, real-time PCR, Western blot and immunohistochemistry, followed by bioinformatic analysis of the Ccdc70 protein.</p><p><b>RESULTS</b>The Ccdc70 gene was expressed highly in the testis but lowly in the epididymis of the mice. The Ccdc70 protein was expressed mainly in the spermatocytes and round spermatids of the testis and in the epithelial cells of the epididymis. Bioinformatic analysis showed a structural domain in the Ccdc70 protein, which was highly conserved in mammalian evolution.</p><p><b>CONCLUSION</b>The Ccdc70 gene is highly expressed in the mouse testis and mainly in the spermatocytes, round spermatids, and epididymal epithelial cells, which indicates that it is involved in the regulation of spermatogenesis and epididymal sperm maturation.</p>

Correlation among prevertebral hyperintensity signal, canal sagittal diameter on MRI and neurologic function of patients with cervical vertebral hyperextension injury / 中国骨伤

<p><b>OBJECTIVE</b>To explore the correlation among prevertebral hyperintensity (PVH), sagittal canal diameter on MRI and neurologic function of patients after cervical vertebral hyperextension injury without fracture and dislocation.</p><p><b>METHODS</b>The clinical data of 100 patients with cervical vertebral hyperextension injury without fracture and dislocation were retrospectively analyzed from September 2010 to December 2013. The patients were divided into PVH group and non-PVH group according to the presence of PVH on T2-weighted magnetic resonance imaging. There were 39 patients in PVH group, including 31 males and 8 females, aged from 21 to 83 years old with an average of (58.10 ± 14.78) years; and the other 69 patients in non-PVH group, including 49 males and 12 females, aged from 32 to 77 years old with an average of (55.05 ± 10.36) years. The sagittal disc level canal diameters of subaxial cervical spine were measured on mid-sagittal magnetic resonance imaging. The age, sex, cause of injury, and the segments of spinal stenosis were recorded. American Spinal Injury Association (ASIA) impairment scale and motor score were used to evaluate the neurological status.</p><p><b>RESULTS</b>The ASIA motor score of the group with PVH was 52.56 ± 31.97 while the ASIA motor score was 67.70 ± 22.83 in non-PVH group (P = 0.013). More patients with intramedullary hyperintensity signal on MRI were observed in the PVH group than in non-PVH group (P = 0.006). There was a significant positive correlation between ASIA motor score and sagittal disc level canal diameter of injury segment (P = 0.003). The neurological status was worse in patients with multi-level sagittal canal diameters below 8 mm.</p><p><b>CONCLUSION</b>The PVH and the disc-level canal sagittal diameter of the injury segment are associated with neurological status. The patients with multi-level sagittal canal stenosis are vulnerable to severe cervical spinal cord injury.</p>