Service Quality and Residents' Preferences for Facilitated Self-Service Fundus Disease Screening: Cross-Sectional Study.

BACKGROUND: Fundus photography is the most important examination in eye disease screening. A facilitated self-service eye screening pattern based on the fully automatic fundus camera was developed in 2022 in Shanghai, China; it may help solve the problem of insufficient human resources in primary health care institutions. However, the service quality and residents' preference for this new pattern are unclear. OBJECTIVE: This study aimed to compare the service quality and residents' preferences between facilitated self-service eye screening and traditional manual screening and to explore the relationships between the screening service's quality and residents' preferences. METHODS: We conducted a cross-sectional study in Shanghai, China. Residents who underwent facilitated self-service fundus disease screening at one of the screening sites were assigned to the exposure group; those who were screened with a traditional fundus camera operated by an optometrist at an adjacent site comprised the control group. The primary outcome was the screening service quality, including effectiveness (image quality and screening efficiency), physiological discomfort, safety, convenience, and trustworthiness. The secondary outcome was the participants' preferences. Differences in service quality and the participants' preferences between the 2 groups were compared using chi-square tests separately. Subgroup analyses for exploring the relationships between the screening service's quality and residents' preference were conducted using generalized logit models. RESULTS: A total of 358 residents enrolled; among them, 176 (49.16%) were included in the exposure group and the remaining 182 (50.84%) in the control group. Residents' basic characteristics were balanced between the 2 groups. There was no significant difference in service quality between the 2 groups (image quality pass rate: P=.79; average screening time: P=.57; no physiological discomfort rate: P=.92; safety rate: P=.78; convenience rate: P=.95; trustworthiness rate: P=.20). However, the proportion of participants who were willing to use the same technology for their next screening was significantly lower in the exposure group than in the control group (P<.001). Subgroup analyses suggest that distrust in the facilitated self-service eye screening might increase the probability of refusal to undergo screening (P=.02). CONCLUSIONS: This study confirms that the facilitated self-service fundus disease screening pattern could achieve good service quality. However, it was difficult to reverse residents' preferences for manual screening in a short period, especially when the original manual service was already excellent. Therefore, the digital transformation of health care must be cautious. We suggest that attention be paid to the residents' individual needs. More efficient man-machine collaboration and personalized health management solutions based on large language models are both needed.

Efficacy of two opportunistic methods for screening osteoporosis in lumbar spine surgery patients.

PURPOSE: Hounsfield unit (HU) measurements and vertebral bone quality (VBQ) scores are opportunistic screening methods for evaluating bone quality. Since studies comparing the efficacies of the two methods are rare, this retrospective study aimed to examine the efficacy of VBQ scores compared with that of HU measurements for diagnosing osteoporosis in lumbar spine surgery patients. METHODS: We selected patients who had undergone spinal surgery between January 2020 and May 2022 from our database. The VBQ scores based on magnetic resonance imaging (MRI) and HU measurements based on computed tomography (CT) were calculated. Correlation analysis of the dual-energy X-ray absorptiometry (DEXA) T score and study parameters was performed. The Delong test and decision curve analysis (DCA) were used to compare the efficacies of the two methods. RESULTS: We included 118 consecutive patients who underwent selective spinal surgery. The VBQ score and HU measurement were significantly correlated with the DEXA T score. Based on the Delong test, HU measurement predicted osteoporosis more effectively than the VBQ score did. The DCA revealed that the VBQ score performed better than the HU measurement did. CONCLUSIONS: The calculation of VBQ scores is a novel opportunistic screening method for diagnosing osteoporosis; however, CT-based HU measurements outperform MRI-based VBQ scores. HU measurements can be used as a screening method when pre-operative CT scans are available.

Tubular minimally invasive resection of McCormick type II paraspinal schwannoma: preliminary experience.

PURPOSE: Complete removal of paraspinal schwannomas is generally required for full patient recovery. However, traditional open approaches to surgery are often extensive and may lead to more postoperative complications. Herein, we present our preliminary experience with tubular minimally invasive resection of McCormick type II paraspinal schwannomas and describe the technique by specifically reviewing two patient cases. MATERIALS AND METHODS: Type of study: Retrospective: Level of evidence: Level III: A total of 15 patients (six men; nine women; median age, 45 years) who underwent minimally invasive resection of McCormick type II paraspinal schwannomas were retrospectively analysed. Preoperative characteristics, including age, location of tumour, Visual Analog Scale score, Modified McCormick Scale score, and intraoperative findings and complications were analysed. Furthermore, postoperative outcomes using imaging, such as magnetic resonance imaging (MRI) and thin-slice computed tomography, and postoperative neural status using the Modified McCormick and Visual Analog Scales were also assessed. RESULTS: The mean operation time was 134.72 ± 34.21 min. The estimated mean blood loss and mean hospital stay were 25.33 ± 17.27 ml and 7.67 ± 1.88 days, respectively. Regarding complications, one of the patients had a local wound infection, which improved after antibiotic treatment. The total resection in all cases was verified using postoperative MRI. CONCLUSION: The tubular minimally invasive approach is a feasible technique for the total resection of McCormick type II paraspinal schwannomas. Using this technique, surgeons can resect paraspinal schwannomas while maintaining spinal stability.

Radiomics analysis based on lumbar spine CT to detect osteoporosis.

OBJECTIVES: Undiagnosed osteoporosis may lead to severe complications after spinal surgery. This study aimed to construct and validate a radiomic signature based on CT scans to screen for lumbar spine osteoporosis. METHODS: Using a stratified random sample method, 386 vertebral bodies were randomly divided into a training set (n = 270) and a test set (n = 116). A total of 1040 radiomics features were automatically retracted from lumbar spine CT scans using the 3D slicer pyradiomics module, and a radiomic signature was created. The sensitivity, specificity, accuracy, and area under the receiver operating characteristic curve (AUC) of the Hounsfield and radiomics signature models were calculated. The AUCs of the two models were compared using the DeLong test. Their clinical usefulness was assessed using a decision curve analysis. RESULTS: Twelve features were chosen to establish the radiomic signature. The AUCs of the radiomics signature and Hounsfield models were 0.96 and 0.88 in the training set and 0.92 and 0.84 in the test set, respectively. According to the DeLong test, the AUCs of the two models were significantly different (p < 0.05). The radiomics signature model indicated a higher overall net benefit than the Hounsfield model, as determined by decision curve analysis. CONCLUSIONS: The CT-based radiomic signature can differentiate patients with/without osteoporosis prior to lumbar spinal surgery. Without additional medical cost and radiation exposure, the radiomics method may provide valuable information facilitating surgical decision-making. KEY POINTS: • The goal of the study was to evaluate the efficacy of a radiomics signature model based on routine preoperative lumbar spine CT scans in screening osteoporosis. • The radiomics signature model demonstrated excellent prediction performance in both the training and test sets. • This radiomics method may provide valuable information and facilitate surgical decision-making without additional medical costs and radiation exposure.

Efficacy of non-enhanced computer tomography-based radiomics for predicting hematoma expansion: A meta-analysis.

Background: This meta-analysis aimed to assess the efficacy of radiomics using non-enhanced computed tomography (NCCT) for predicting hematoma expansion in patients with spontaneous intracerebral hemorrhage. Methods: Throughout the inception of the project to April 11, 2022, a comprehensive search was conducted on PubMed, Embase, and Cochrane Central Register of Controlled Trials. The methodological quality of studies in this analysis was assessed by the radiomics quality scoring system (RQS). A meta-analysis of radiomic studies based on NCCT for predicting hematoma expansion in patients with intracerebral hemorrhage was performed. The efficacy of the radiomics approach and non-contrast CT markers was compared using network meta-analysis (NMA). Results: Ten articles comprising a total of 1525 patients were quantitatively analyzed for hematoma expansion after cerebral hemorrhage using radiomics. Based on the included studies, the mean RQS was 14.4. The AUC value (95% confidence interval) of the radiomics model was 0.80 (0.76-0.83). Five articles comprising 846 patients were included in the NMA. The results synthesized according to Bayesian NMA revealed that the predictive ability of the radiomics model outperformed most of the NCCT biomarkers. Conclusions: The NCCT-based radiomics approach has the potential to predict hematoma expansion. Compared to NCCT biomarkers, we recommend a radiomics approach. Standardization of the radiomics approach is required for further clinical implementation. Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=324034, identifier [CRD42022324034].

Preoperative Simulation of the Trajectory for L5/S1 Percutaneous Endoscopic Transforaminal Discectomy: A Novel Approach for Decision-Making.

OBJECTIVE: We simulated the trajectory for an L5/S1 percutaneous endoscopic transforaminal discectomy (PETD) to guide decision-making for the surgery approach. METHODS: Twenty-three patients with L5/S1 lumbar disc herniation were included in the study. The patients all underwent thin-section computed tomography scans, after which data were collected for 3-dimensional reconstruction. Simulations of the trajectory for the L5/S1 PETDs were generated and the hindrance of surrounding anatomic structures was evaluated. RESULTS: Preoperative simulation showed that 14 patients were considered suitable for lumbar PETD. Nine patients were not considered suitable for PETD surgery according to the simulation. Factors affecting the trajectory included high iliac crest in 5 patients, L5 transverse process in 3 patients, and hypertrophic L5-S1 facet joint in 1 patient. CONCLUSIONS: Preoperative simulation of the trajectory for L5/S1 PETD was helpful in the decision-making for the surgical approach.

Abnormal spinal curvature and influencing factors in children and adolescents in Hongkou District, Shanghai / 中国学校卫生

Objective@#To investigate the incidence of abnormal spinal curvature and related factors in primary and secondary school students in the Hongkou District of Shanghai, so as to provide evidence for abnormal spinal curvature prevention and treatment.@*Methods@#Using a stratified cluster random sampling method, 1 884 students of grade 4 to grade 12 from seven schools were investigated via questionnaires for abnormal spinal curvature in Hongkou District.@*Results@#The detectable rate of abnormal spinal curvature was 7.2%, The detectable rate of abnormal spinal curvature increased with increasing age(P<0.01): senior high school (15.7%) > vocational high school (8.1%) > junior high school (3.4%) > primary school(1.8%)(χ 2=91.24, P<0.01). The detectable rate of spinal curvature among female students was 8.6%, which was higher than that among male students(5.9%), and the difference was significant(χ 2=5.27, P<0.05). Multivariate Logistic regression analysis showed that the factors influencing abnormal spinal curvature included phase of studying, nutritional status and time spent engaged in outdoor activities every day(P<0.05).@*Conclusion@#Abnormal spinal curvature is one of the common conditions that endangers the health of children and adolescents. The collaboration of the school, students and parents is required to strengthen screening and prevention.

Fractional-order autonomous circuits with order larger than one.

Fractional-order circuit is a kind of circuit which contains fractional-order elements. It has been proved that the fractional-order circuit has some characteristics which are hard to be achieved by integer-order circuits, such as higher degree of freedom in circuit design. For integer-order circuits, there are not only non-autonomous circuits, but also autonomous circuits. Since there are many applications of integral-order autonomous circuits in real world, it is also necessary to explore fractional-order autonomous circuits. However, few research focuses on fractional-order autonomous circuits. Therefore, this paper proposes two kinds of fractional-order autonomous circuits based on fractional-order elements with order larger than one. The corresponding mathematical models are also established based on fractional calculus and their characteristics are analyzed based on circuit theory. Finally, circuit simulation are performed to verify the correctness of theoretical analysis.

Frequency bifurcation in a series-series compensated fractional-order inductive power transfer system.

This paper reveals and analyzes the frequency bifurcation phenomena in the fractional-order inductive power transfer (FOIPT) system with series-series compensation topology. Using fractional calculus theory and electric circuit theory, the circuit model of the series-series compensated FOIPT system is first proposed, then taking the case of a single variable fractional order as an example, three frequency analytical solutions of frequency bifurcation equation are solved by using Taylor expansion method. By analyzing the three bifurcation frequencies solved, it can be found that the frequency bifurcation phenomenon can be effectively eliminated by controlling the fractional order, and the boundary of critical distance and critical load is reduced, thereby expanding the working range of the conventional inductive power transfer (IPT) system. Furthermore, the output power and transfer efficiency at the three bifurcation frequencies are analyzed, it can be observed that the output power and transfer efficiency at the high bifurcation frequency and low bifurcation frequency are close and basically keep constant against the variation of transfer distance, and the output power is obviously higher than that at the intrinsic frequency. In addition, the output power at the three bifurcation frequencies can be significantly improved by adjusting the fractional order. Finally, the experimental prototype of FOIPT is built, and the experimental results verify the validity of theoretical analysis.

Identification and validation of potential novel prognostic biomarkers for patients with glioma based on a gene co-expression network.

BACKGROUND: Glioma is widely regarded as one of most lethal and challenging diseases of the nervous system. The aim of this study was to identify novel biomarkers that offer better prognosis prediction for Chinese patients with glioma. METHODS: By using systematic approaches, the co-expression modules were identified from the Chinese Glioma Genome Atlas (CGGA) database through weighted gene co-expression network analysis and functional enrichment of essential modules of Kyoto Encyclopedia of Genes and Genomes terms. The co-expression modules were validated using The Cancer Genome Atlas database and the protein-protein interaction (PPI) network. RESULTS: For network construction, 5,374 among 21,494 genes were selected, and an increasing genetic variance was associated with the prognosis of glioma. By using functional enrichment analysis, the involvement of multiple vital processes, including metabolism of fatty acids, was correlated with the patient prognosis. Notably, five hub genes (KCNB1, UST, SOX8, KLHL42, and HDAC4) were identified for these processes. Accordingly, using the Kaplan-Meier method, there was enhanced expression of these genes in patients with significantly lower overall survival rates, especially those from the CGGA database. CONCLUSIONS: This study not only revealed the essential co-expression gene modules in patients with glioma, but it also unraveled the potential signaling pathways underlying these functional processes.

Using the information embedded in the mixed profiles to assist in determining the identity of the deceased and the suspect in a deficiency case.

In the present case, due to the lack of database matches and available relatives, the use of single-source DNA profiles from the unidentified deceased and the suspect was not yet able to determine the identity of them, resulting in the inability to continue the investigation. However, by interpreting a simple mixture on the penile swab of the deceased and a complex mixture on the prayer flag wrapped around the ankles of the deceased, the information embedded in these two mixtures provided us with a breakthrough point for addressing the identity determination. Preliminary analysis using the separating method or based on imbalanced peaks at the Amelogenin locus revealed that each of the two DNA mixtures should have a female minor contributor, who were likely to be sex workers according to the investigation results. Consequently, blood samples from fifty-two women were collected for STR genotyping. The analysis results of the two mixtures using LRmix Studio showed that the probability of the simple mixture that if it came from the deceased and the female numbered P0053 is 4.7078 × 1012 times more likely than if it came from the deceased and an unknown female, while the probability of the complex mixture that if it came from P0062, the deceased and the male suspect is 8.1777 × 107 times more likely than if it came from the deceased and two unknowns. Subsequently, based on the clues provided by P0053 and P0062, the identity of the deceased and the suspect was successfully determined and the case was finally resolved. These results suggest the valuable evidence that can be obtained from mixtures and the high priority that should be placed on the analysis of mixtures, especially those that may be considered unlikely to derive complete single-source profiles by interpretation. In addition, the occurrence of a secondary DNA transfer was confirmed.

Influenza-associated outpatient visits among children less than 5 years of age in eastern China, 2011-2014.

BACKGROUND: The disease burden of influenza in China has not been well described, especially among young children. The aim of this study was to estimate the incidence of outpatient visits associated with influenza in young children in Suzhou, a city of more than 11 million residents in Jiangsu Province in eastern China. METHODS: Influenza-like illness (ILI) was defined as the presence of fever (axillary temperature ≥38 °C) and cough or sore throat. We collected throat swabs for children less than 5 years of age with ILI who visited Suzhou University Affiliated Children's Hospital (SCH) outpatient clinic or emergency room between April 2011 and March 2014. Suzhou CDC, a national influenza surveillance network laboratory, tested for influenza viruses by real-time reverse transcription-polymerase chain reaction assay (rRT-PCR). Influenza-associated ILI was defined as ILI with laboratory-confirmed influenza by rRT-PCR. To calculate the incidence of influenza-associated outpatient visits, we conducted community-based healthcare utilization surveys to determine the proportion of hospital catchment area residents who sought care at SCH. RESULTS: The estimated incidence of influenza-associated ILI outpatient visits among children aged <5 years in the catchment area of Suzhou was, per 100 population, 17.4 (95 % CI 11.0-25.3) during April 2011-March 2012, 14.6 (95 % CI 5.2-26.2) during April 2012-March 2013 and 21.4 (95 % CI: 10.9-33.5) during April 2013-March 2014. The age-specific outpatient visit rates of influenza-associated ILI were 4.9, 21.1 and 21.2 per 100 children aged 0- <6 months, 6- <24 months and 24- <60 months, respectively. CONCLUSION: Influenza virus infection causes a substantial burden of outpatient visits among young children in Suzhou, China. Targeted influenza prevention and control strategies for young children in Suzhou are needed to reduce influenza-associated outpatient visits in this age group.

Viral etiology of medically attended influenza-like illnesses in children less than five years old in Suzhou, China, 2011-2014.

Limited information is available on the non-influenza etiology and epidemiology of influenza-like illness (ILI) in China. From April 2011 to March 2014, we collected oropharyngeal swabs from children less than 5 years of age with symptoms of ILI who presented to the outpatient departments of Suzhou University Affiliated Children's Hospital (SCH). We used reverse transcription polymerase chain reaction (rt-PCR) or PCR to detect 11 respiratory viruses. Among 3,662 enrolled ILI patients, 1,292 (35.3%) tested positive for at least one virus. Influenza virus (16.9%) was detected most frequently (influenza A 7.4%, influenza B 9.5%), followed by respiratory syncytial virus (RSV) (5.6%), parainfluenza virus (PIV) types 1-4 (4.8%), human bocavirus (HBoV) (3.8%), human metapneumovirus (HMPV) (3.5%), and adenovirus (ADV) (3.0%). Co-infections were identified in 108 (2.9%) patients. Influenza virus predominantly circulated in January-March and June-July. The 2013-2014 winter peaks of RSV and influenza overlapped. Compared with other virus positive cases, influenza positive cases were more likely to present with febrile seizure, and RSV positive cases were more likely to present with cough and wheezing, and were most frequently diagnosed with pneumonia. These data provide a better understanding of the viral etiology of ILI among children less than 5 years of age in Suzhou, China. Influenza is not only the most frequently identified pathogen but it is also the only vaccine preventable illness among the 11 pathogens tested. Such findings suggest the potential value of exploring value of influenza vaccination among this influenza vaccination target group. J. Med. Virol. 88:1334-1340, 2016. © 2016 Wiley Periodicals, Inc.

Socio-economic burden of influenza among children younger than 5 years in the outpatient setting in Suzhou, China.

BACKGROUND: The disease burden of children with laboratory-confirmed influenza in China has not been well described. The aim of this study was to understand the epidemiology and socio-economic burden of influenza in children younger than 5 years in outpatient and emergency department settings. METHODS: A prospective study of laboratory-confirmed influenza among children presenting to the outpatient settings in Soochow University Affiliated Children's Hospital with symptoms of influenza-like illness (ILI) was performed from March 2011 to February 2012. Throat swabs were collected for detection of influenza virus by reverse transcription polymerase chain reaction assay. Data were collected using a researcher administered questionnaire, concerning demographics, clinical characteristics, direct and indirect costs, day care absence, parental work loss and similar respiratory illness development in the family. RESULTS: Among a total of 6,901 children who sought care at internal outpatient settings, 1,726 (25%) fulfilled the criteria of ILI and 1,537 were enrolled. Influenza was documented in 365 (24%) of enrolled 1,537 ILI cases. Among positive patients, 52 (14%) were type A and 313 (86%) were type B. About 52% of influenza outpatients had over-the-counter medications before physician visit and 41% visited hospitals two or more times. Children who attended daycare missed an average of 1.9 days. For each child with influenza-confirmed disease, the parents missed a mean of 1.8 work days. Similar respiratory symptoms were reported in 43% of family contacts of influenza positive children after onset of the child's illness. The mean direct and indirect costs per episode of influenza were $123.4 for outpatient clinics and $134.6 for emergency departments, and $125.9 for influenza A and $127.5 for influenza B. CONCLUSIONS: Influenza is a common cause of influenza-like illness among children and has substantial socio-economic impact on children and their families regarding healthcare seeking and day care/work absence. The direct and indirect costs of childhood influenza impose a heavy financial burden on families. Prevention measures such as influenza vaccine could reduce the occurrence of influenza in children and the economic burden on families.

Crystallization of cobalt amorphous alloys under field annealing.

Crystallization of Co-rich amorphous ribbons annealed under a 10 Oe external magnetic field at the early 30 minutes from their glassy status to supercooled liquid status is investigated by high-resolution transmission microscope (HR-TEM), Selected Area Fourier Transform (SA-FT), X-ray diffraction (XRD) and differential scanning calorimetry (DSC). Results indicate that the short-rang ordering feature can be refined very well in specimen annealed under temperatures about 87.4 degrees C below their glass transition (Tg), showing refined salt-pepper morphologies with a mean length changing from 1.2 +/- 0.8 nm to 0.8 +/- 0.2 nm and a mean width shifting from 0.5 +/- 0.2 nm to 0.3 +/- 0.1 nm. When the amorphous ribbons are field-annealed at temperature near to Tg (i.e., 450 degrees C), ultra-fine nanocrystalline structures can be formed on the top surface of ribbons with size of 3.5 +/- 0.5 nm and inter-grain spacing of about 0.4 +/- 0.2 nm even though the inner parts of the ribbons are still in amorphous phases. The nanocrystalline areas are featured by the formation of doped hcp cobalt phase orientated along the c-axis, with the inter-plane spacing ranging from 4 A to 6 A. When the annealing temperature is above Tg, the grain sizes are increased dramatically with multi-phased nanocrystals precipitating from the amorphous substrate, and finally reaching almost complete crystallization at 600 degrees C, causing greatly coarsening of the nanocrystal structures.

Magnetic field driving gradient effects on the microstructure in amorphous-nanocrystalline cobalt alloy ribbons.

Field effects on the early crystallization of Co-rich amorphous ribbons (Co(68.15)Fe(4.35)Si(12.5)B(15), atomic%) performed at 450 °C for 30 minutes in an applied 10 Oe longitudinal or transverse external magnetic field are investigated by comparing with the as-spun and annealed samples in zero applied magnetic field. Results indicate that the crystallization on the surface skin of the ribbon differs from that of the middle section due to the combined effects from the field direction and the defects or stress characteristics across the ribbons. In particular, the ribbons annealed under a transverse field exhibit an extremely distinct graded microstructure across the ribbon, which features amorphous-phased skin layers (top and bottom) of about 4-5 µm thickness and a middle amorphous-nanocrystalline composite layer about 10-12 µm thick, with the nanograins of 434 ± 99 nm dispersing in the amorphous matrix.

The complete genome sequence of Mycoplasma bovis strain Hubei-1.

Infection by Mycoplasma bovis (M. bovis) can induce diseases, such as pneumonia and otitis media in young calves and mastitis and arthritis in older animals. Here, we report the finished and annotated genome sequence of M. bovis strain Hubei-1, a strain isolated in 2008 that caused calf pneumonia on a Chinese farm. The genome of M. bovis strain Hubei-1 contains a single circular chromosome of 953,114 bp with a 29.37% GC content. We identified 803 open reading frames (ORFs) that occupy 89.5% of the genome. While 34 ORFs were Hubei-1 specific, 662 ORFs had orthologs in the M. bovis type strain PG45 genome. Genome analysis validated lateral gene transfer between M. bovis and the Mycoplasma mycoides subspecies mycoides, while phylogenetic analysis found that the closest M. bovis neighbor is Mycoplasma agalactiae. Glycerol may be the main carbon and energy source of M. bovis, and most of the biosynthesis pathways were incomplete. We report that 47 lipoproteins, 12 extracellular proteins and 18 transmembrane proteins are phase-variable and may help M. bovis escape the immune response. Besides lipoproteins and phase-variable proteins, genomic analysis found two possible pathogenicity islands, which consist of four genes and 11 genes each, and several other virulence factors including hemolysin, lipoate protein ligase, dihydrolipoamide dehydrogenase, extracellular cysteine protease and 5'-nucleotidase.

Extensive duraplasty with autologous graft in decompressive craniectomy and subsequent early cranioplasty for severe head trauma.

OBJECTIVE: To compare the effect of extensive duraplasty and subsequent early cranioplasty on the recovery of neurological function in management of patients with severe traumatic brain injuries received decompressive craniectomy. METHODS: The computer-aided designation of titanium armor plate was used as a substitute for the repair of skull defect in all the patients. The patients were divided into three groups. Twenty-three patients were in early cranioplasty group who received extensive duraplasty in craniectomy and subsequent cranioplasty within 3 months after previous operation (Group I). Twenty-one patients whose cranioplasty was performed more than 3 months after the first operation were in the group without duraplasty (Group II); while the other 26 patients in the group with duraplasty in previous craniotomy (Group III). Both the Barthel index of activity of daily living (ADL) 3 months after craniotomy for brain injuries and 1 month after cranioplasty and Karnofsky Performance Score (KPS) at least 6 months after cranioplasty were assessed respectively. RESULTS: The occurrence of adverse events commonly seen in cranioplasty, such as incision healing disturbance, fluid collection below skin flap, infection and onset of postoperative epilepsy was not significantly higher than other 2 groups. The ADL scores at 3 months after craniotomy in Groups I-III were 58.9 ± 26.7, 40.8 ± 20.2 and 49.2 ± 18.6. The ADL scores at 1 month after cranioplasty were 70.2 ± 25.2, 50.8 ± 24.8 and 61.2 ± 21.5. The forward KPS scores were 75.4 ± 19.0, 66.5 ± 24.7 and 57.6 ± 24.7 respectively. The ADL and KPS socres were significantly higher in group I than other 2 groups. CONCLUSION: The early cranioplasty in those with extensive duraplasty in previous craniotomy is feasible and helpful to improving ADL and long-term quality of life in patients with severe traumatic brain injuries.

[Changes of RyR2 mRNA expression in rats suffering from acute myocardial ischemia].

OBJECTIVE: To investigate the changes of ryanodine receptor 2 (RyR2) mRNA expression in rats suffering from acute myocardial ischemia. METHODS: SD rats were divided randomly into normal control group, myocardial ischemia group and sudden death group. The models of myocardial ischemia and sudden cardiac death were induced by intraperitoneal injection of hypophysine. The changes of RyR2 mRNA expression in cardiac sarcoplasmic reticulum (SR) of rats suffering from myocardial ischemia were detected by fluorescent RT-PCR technique. RESULTS: The levels of RyR2 mRNA in the myocardial ischemia group and sudden death group were significant lower than those in the control group (P<0.05). CONCLUSION: Myocardial ischemia may induce down-regulation of cardiac SR RyR2 mRNA expression.