Genetic insights into the 'sandwich fusion' subtype of Klippel-Feil syndrome: novel FGFR2 mutations identified by 21 cases of whole-exome sequencing.

BACKGROUND: Klippel-Feil syndrome (KFS) is a rare congenital disorder characterized by the fusion of two or more cervical vertebrae during early prenatal development. This fusion results from a failure of segmentation during the first trimester. Although six genes have previously been associated with KFS, they account for only a small proportion of cases. Among the distinct subtypes of KFS, "sandwich fusion" involving concurrent fusion of C0-1 and C2-3 vertebrae is particularly noteworthy due to its heightened risk for atlantoaxial dislocation. In this study, we aimed to investigate novel candidate mutations in patients with "sandwich fusion." METHODS: We collected and analyzed clinical data from 21 patients diagnosed with "sandwich fusion." Whole-exome sequencing (WES) was performed, followed by rigorous bioinformatics analyses. Our focus was on the six known KFS-related genes (GDF3, GDF6, MEOX1, PAX1, RIPPLY2, and MYO18). Suspicious mutations were subsequently validated through in vitro experiments. RESULTS: Our investigation revealed two novel exonic mutations in the FGFR2 gene, which had not previously been associated with KFS. Notably, the c.1750A > G variant in Exon 13 of FGFR2 was situated within the tyrosine kinase domain of the protein, in close proximity to several established post-translational modification sites. In vitro experiments demonstrated that this certain mutation significantly impacted the function of FGFR2. Furthermore, we identified four heterozygous candidate variants in two genes (PAX1 and MYO18B) in two patients, with three of these variants predicted to have potential clinical significance directly linked to KFS. CONCLUSIONS: This study encompassed the largest cohort of patients with the unique "sandwich fusion" subtype of KFS and employed WES to explore candidate mutations associated with this condition. Our findings unveiled novel variants in PAX1, MYO18B, and FGFR2 as potential risk mutations specific to this subtype of KFS.

Clinical and Surgical Characteristics of Patients with Atlantoaxial Dislocation in the Setting of Sandwich Fusion: A Case-Control Analysis of Over 500 Patients with Mid-Term to Long-Term Follow-up.

BACKGROUND: Patients with "sandwich" fusion (concomitant C1 occipitalization and C2-C3 nonsegmentation), a subtype of Klippel-Feil syndrome, are at particular risk for developing atlantoaxial dislocation (AAD). However, the clinical and surgical characteristics of AAD in patients with sandwich fusion have not been clearly defined. METHODS: A retrospective case-control study with a large sample size and a minimum 2-year follow-up was performed. From 2000 to 2018, 253 patients with sandwich AAD underwent a surgical procedure; these patients constituted the case group, and a matching number of patients with non-sandwich AAD were randomly selected to form the control group. Clinical data from electronic medical records and various imaging studies were analyzed and compared. The Japanese Orthopaedic Association (JOA) scale was used to evaluate neurological function. RESULTS: Patients with sandwich AAD, compared with patients with non-sandwich AAD, had symptom onset at a younger age (34.8 compared with 42.8 years; p < 0.001) and had a higher likelihood for myelopathy (87.4% compared with 74.7%; p < 0.001). Patients with sandwich AAD had a higher incidence of lower cranial nerve palsy (7.9% compared with 0.0%; p < 0.001), a lower preoperative JOA score (13.4 compared with 14.2; p < 0.001), and higher incidences of accompanying Type-I Chiari malformation (20.9% compared with 1.2%; p < 0.001) and syringomyelia (21.3% compared with 1.6%; p < 0.001). Finally, patients with sandwich AAD had higher likelihoods of undergoing transoral release (28.5% compared with 5.1%; p < 0.001) and use of salvage fixation techniques (34.4% compared with 6.3%; p < 0.001), and had lower postoperative results for the JOA score (14.9 compared with 15.9; p < 0.001) and improvement rate (43.8% compared with 58.2%; p < 0.001). CONCLUSIONS: Patients with sandwich AAD demonstrated distinct clinical manifestations. Versatility involving the use of various internal fixation techniques and transoral release procedures was frequently required in the surgical management of these patients, and meticulous and personalized preoperative planning would be of paramount importance. LEVEL OF EVIDENCE: Prognostic Level III . See Instructions for Authors for a complete description of levels of evidence.

Strategies to avoid internal carotid artery injury in "sandwich" atlantoaxial dislocation patients during surgery.

PURPOSE: To elucidate the anatomic relationship between the internal carotid artery (ICA) and the bony structures of the craniovertebral junction among "sandwich" atlantoaxial dislocation (AAD) patients, and to analyze the risks of injury during surgical procedures. METHODS: The distance from the medial wall of ICA to the midsagittal plane (D1), the shortest distance between the ICA wall and the anterior cortex of the lateral mass of atlas (LMA) (D2) on the most caudal and cranial levels of LMA and the angle (A) between the sagittal plane passing through the screw entry point of C1 lateral mass(C1LM) screw and the medial tangent line of the vessel passing through the entry point were measured. Besides, the location of ICA in front of the atlantoaxial vertebra was divided into 4 categories (Z1-Z4). RESULTS: There was a statistically difference between the male and female patients regarding D1, and the difference between D2 at level a and level b as well as angle A between the left and right sides were statistically different (p < 0.05). Ninety-two ICAs (57.5%) were anteriorly located in Z3, 50 (31.3%) were located in Z4, 17 were located in Z2, and only one ICA was located in Z1 in all 80 patients. CONCLUSIONS: In "sandwich" AAD patients, particular attention should be paid to excessively medialized ICA to avoid ICA injury during trans-oral procedures, and the risk of injuring the ICA with more cranially and medially angulated C1LM screw placement was relatively less during posterior fixation procedures. A novel classification of ICA location was used to describe the relationship between ICA and LMA.

Vertebral Artery Variations at the Craniovertebral Junction in "Sandwich" Atlantoaxial Dislocation Patients.

OBJECTIVE: To summarize the vertebral artery (VA) pattern of 96 "sandwich" atlantoaxial dislocation (AAD) patients and to describe the strategies of reducing the injury of VA during surgery. METHODS: From 2009 to 2020, we retrospectively reviewed the 3-dimensional computed tomography angiography data of 96 AAD patients combined with atlas occipitalization and C2-3 fusion, which were diagnosed as "sandwich" AAD and 96 patients as control group patients who were without atlas occipitalization, C2-3 fusion and any other cervical bone deformity at our institution. The variations of each side of VA were described in 3 different parts (C0-1, C1-2, and C2-3) according to the characteristics of the 3-part pathological structures in "sandwich" subgroup. RESULTS: One hundred ninety-two sides of VAs in every group of patients were analyzed and every VA was described separately at 3 different level regions. There were different variations in these 3 different regions: 4 variations in the upper fusion region, 5 variations in the sandwiched region, and 6 variations in the lower fusion region in sandwich AAD patients. And the rate of VA deformity in sandwich AAD patients was much higher and more types of VA variations existed. CONCLUSION: In "sandwich" AAD patients, deformities of vertebral arteries in craniovertebral junction are more common, and the same VA may have deformities at different levels that severely affect surgical procedures. Therefore, preoperative imaging examination of VA for "sandwich" AAD patients is vital of guiding surgeons to avoid injury of VA during surgery.

Identification and evaluation of occupational hazards during construction of a large construction project / 中国职业医学

OBJECTIVE: To analyze the occupational hazard factors and their critical control points in the process of construction of a large-scale construction project.METHODS: The engineering analysis, worksite survey occupational health and occupational hazard factor testing were conducted in a large-scale construction project, and the results were analyzed. RESULTS: During the process of construction of this large-scale construction project, there were many occupational hazard factors such as silicon dust, welding smoke, wood and other dusts, inorganic compounds of manganese, carbon monoxide, carbon dioxide, nitric oxide, ozone, noise, high temperature, hand-transmitted vibration and ultraviolet irradiation, among them, silicon dust and noise were the most common ones. The over standard rates of exposure concentration of short term of total dust and respirable dust in the workplace were 68.2%(15/22) and 40.9%(9/22), and the over standard rates of exposure concentration of time weighted average were 54.5%(12/22) and 13.6%(3/22), respectively. The over standard rates of the noise intensity of area sampling and personal sampling in workplace were 69.2%(45/65) and 61.0%(25/41) respectively. The four hours energy equivalent frequency-weighted acceleration to vibration of three hand-transmitted vibration positions has been detected, and the result has surpassed the occupational exposure limit.The results of other occupational hazard factors such as high temperature, ultraviolet radiation, wood dust, welding smoke, other dust, manganese inorganic compounds, carbon monoxide, carbon dioxide, nitric oxide, nitrogen dioxide, hydrogen sulfide, hydrogen cyanide and ozone all met the occupational exposure limits. CONCLUSION: There are various occupational hazard factors in the process of construction of this large-scale construction project, among them, noise, dust and hand-transmitted vibration are the most prominent hazards.These hazards are the critical control points of this type of construction projects.

Effect of baicalin on renal function in patients with diabetic nephropathy and its therapeutic mechanism.

The present study observed the effect of baicalin on blood glucose and renal function in patients with diabetic nephropathy and explored its mechanism of action. A total of 95 patients diagnosed with diabetic nephropathy by clinical and laboratory examinations were selected and randomly divided into a control and treatment group. The control group included 45 patients who were treated with routine symptomatic treatment. The remaining 50 patients in the treatment group received baicalin, in addition to routine symptomatic treatment. The treatment course was 6 months. Following this, the changes of indicators such as fasting plasma glucose (FPG), glycosylated hemoglobin (HBA1c), aldose reductase (AR) activity, 24-h urinary microalbumin, urinary ß2-microglobulin (ß2-MG) and urinary albumin excretion rate (UAER) were compared before and after treatment; at the same time, the variations of indexes, including superoxide dismutase (SOD), glutathione peroxidase (GSH-px), nuclear factor κ-light-chain-enhancer of activated B cells (NF-κB), transforming growth factor-ß1 (TGF-ß1) and vascular endothelial growth factor (VEGF) were detected. Compared with those in the control group, baicalin had little effect on the treatment group's FPG and HBA1c, but it clearly reduced the AR activity and the difference was significant (P<0.05). Baicalin visibly decreased the 24-h urinary microalbumin, urinary ß2-MG and UAER (P<0.05) and had notable effect on improving renal function. Following treatment, compared with those in the control group, baicalin distinctly increased the levels of SOD and GSH-px (P<0.05) and decreased the content of NF-κB and VEGF (P<0.05), however, its impact on the expression of TGF-ß1 was not statistically significant (P>0.05). The results showed that baicalin may improve the renal function in patients with diabetic nephropathy and delay the progression of diabetic nephropathy through various ways, including anti-inflammation and anti-oxidation.

Rab5, Rab7, and Rab11 Are Required for Caveola-Dependent Endocytosis of Classical Swine Fever Virus in Porcine Alveolar Macrophages.

The members of Flaviviridae utilize several endocytic pathways to enter a variety of host cells. Our previous work showed that classical swine fever virus (CSFV) enters porcine kidney (PK-15) cells through a clathrin-dependent pathway that requires Rab5 and Rab7. The entry mechanism for CSFV into other cell lines remains unclear, for instance, porcine alveolar macrophages (3D4/21 cells). More importantly, the trafficking of CSFV within endosomes controlled by Rab GTPases is unknown in 3D4/21 cells. In this study, entry and postinternalization of CSFV were analyzed using chemical inhibitors, RNA interference, and dominant-negative (DN) mutants. Our data demonstrated that CSFV entry into 3D4/21 cells depends on caveolae, dynamin, and cholesterol but not clathrin or macropinocytosis. The effects of DN mutants and knockdown of four Rab proteins that regulate endosomal trafficking were examined on CSFV infection, respectively. The results showed that Rab5, Rab7, and Rab11, but not Rab9, regulate CSFV endocytosis. Confocal microscopy showed that virus particles colocalize with Rab5, Rab7, or Rab11 within 30 min after virus entry and further with lysosomes, suggesting that after internalization CSFV moves to early, late, and recycling endosomes and then into lysosomes before the release of the viral genome. Our findings provide insights into the life cycle of pestiviruses in macrophages.IMPORTANCE Classical swine fever, is caused by classical swine fever virus (CSFV). The disease is notifiable to World Organisation for Animal Health (OIE) in most countries and causes significant financial losses to the pig industry globally. Understanding the processes of CSFV endocytosis and postinternalization will advance our knowledge of the disease and provide potential novel drug targets against CSFV. With this objective, we used systematic approaches to dissect these processes in CSFV-infected 3D4/21 cells. The data presented here demonstrate for the first time to our knowledge that CSFV is able to enter cells via caveola-mediated endocytosis that requires Rab5, Rab7 and Rab11, in addition to the previously described classical clathrin-dependent pathway that requires Rab5 and Rab7. The characterization of CSFV entry will further promote our current understanding of Pestivirus cellular entry pathways and provide novel targets for antiviral drug development.

Porcine Mx1 Protein Inhibits Classical Swine Fever Virus Replication by Targeting Nonstructural Protein NS5B.

Mx proteins are interferon (IFN)-induced GTPases that have broad antiviral activity against a wide range of RNA and DNA viruses; they belong to the dynamin superfamily of large GTPases. In this study, we confirmed the anti-classical swine fever virus (CSFV) activity of porcine Mx1 in vitro and showed that porcine Mx2 (poMx2), human MxA (huMxA), and mouse Mx1 (mmMx1) also have anti-CSFV activity in vitro Small interfering RNA (siRNA) experiments revealed that depletion of endogenous poMx1 or poMx2 enhanced CSFV replication, suggesting that porcine Mx proteins are responsible for the antiviral activity of interferon alpha (IFN-α) against CSFV infection. Confocal microscopy, immunoprecipitation, glutathione S-transferase (GST) pulldown, and bimolecular fluorescence complementation (BiFC) demonstrated that poMx1 associated with NS5B, the RNA-dependent RNA polymerase (RdRp) of CSFV. We used mutations in the poMx1 protein to elucidate the mechanism of their anti-CSFV activity and found that mutants that disrupted the association with NS5B lost all anti-CSV activity. Moreover, an RdRp activity assay further revealed that poMx1 undermined the RdRp activities of NS5B. Together, these results indicate that porcine Mx proteins exert their antiviral activity against CSFV by interacting with NS5B.IMPORTANCE Our previous studies have shown that porcine Mx1 (poMx1) inhibits classical swine fever virus (CSFV) replication in vitro and in vivo, but the molecular mechanism of action remains largely unknown. In this study, we dissect the molecular mechanism of porcine Mx1 and Mx2 against CSFV in vitro Our results show that poMx1 associates with NS5B, the RNA-dependent RNA polymerase of CSFV, resulting in the reduction of CSFV replication. Moreover, the mutants of poMx1 further elucidate the mechanism of their anti-CSFV activities.

Rab5 and Rab11 Are Required for Clathrin-Dependent Endocytosis of Japanese Encephalitis Virus in BHK-21 Cells.

During infection Japanese encephalitis virus (JEV) generally enters host cells via receptor-mediated clathrin-dependent endocytosis. The trafficking of JEV within endosomes is controlled by Rab GTPases, but which Rab proteins are involved in JEV entry into BHK-21 cells is unknown. In this study, entry and postinternalization of JEV were analyzed using biochemical inhibitors, RNA interference, and dominant negative (DN) mutants. Our data demonstrate that JEV entry into BHK-21 cells depends on clathrin, dynamin, and cholesterol but not on caveolae or macropinocytosis. The effect on JEV infection of dominant negative (DN) mutants of four Rab proteins that regulate endosomal trafficking was examined. Expression of DN Rab5 and DN Rab11, but not DN Rab7 and DN Rab9, significantly inhibited JEV replication. These results were further tested by silencing Rab5 or Rab11 expression before viral infection. Confocal microscopy showed that virus particles colocalized with Rab5 or Rab11 within 15 min after virus entry, suggesting that after internalization JEV moves to early and recycling endosomes before the release of the viral genome. Our findings demonstrate the roles of Rab5 and Rab11 on JEV infection of BHK-21 cells through the endocytic pathway, providing new insights into the life cycle of flaviviruses.IMPORTANCE Although Japanese encephalitis virus (JEV) utilizes different endocytic pathways depending on the cell type being infected, the detailed mechanism of its entry into BHK-21 cells is unknown. Understanding the process of JEV endocytosis and postinternalization will advance our knowledge of JEV infection and pathogenesis as well as provide potential novel drug targets for antiviral intervention. With this objective, we used systematic approaches to dissect this process. The results show that entry of JEV into BHK-21 cells requires a low-pH environment and that the process occurs through dynamin-, actin-, and cholesterol-dependent clathrin-mediated endocytosis that requires Rab5 and Rab11. Our work provides a detailed picture of the entry of JEV into BHK-21 cells and the cellular events that follow.

The Impact of Traditional Health Beliefs on the Health Practices of Women From Southern Taiwan.

PURPOSE: This study investigated the health beliefs of Taiwanese women in Anping, an urban district in Taiwan that was introduced to Western medicine in the 1860s. DESIGN: A qualitative design with content analysis was used. Fourteen Anping women aged 44 to 84 years were interviewed. RESULTS: The women integrated both traditional and Western biomedicine without any dissonance. Three themes were found: cultural beliefs about medicine-diet homology or the lack of a distinction between medicine and food, reliance on both doctor and deity, and a pattern of health practice based on situational decision making about which health practice to employ. IMPLICATIONS: Understanding health-related viewpoints in Chinese culture and its rationale will help health workers provide culturally competent care.

Effect of organic solar cells using various power O2 plasma treatments on the indium tin oxide substrate.

The effect of organic solar cells (OSCs) by using different power O2 plasma treatments on indium tin oxide (ITO) substrate was studied. The power of O2 plasma treatment on ITO substrate was varied from 20W to 80W, and the power conversion efficiency of device was improved from 1.18% to 1.93% at 20W O2 plasma treatment. The function of O2 plasma treatment on ITO substrate was to remove the surface impurity and to improve the work function of ITO, which can reduce the energy offset between the ITO and SubPc layer and depress the leakage current of device, leading to the shunt resistance increased from 897 to 1100Ωcm(2). The surface roughness of ITO decreased from 3.81 to 3.33nm and the work function of ITO increased from 4.75 to 5.2eV after 20W O2 plasma treatment on ITO substrate. As a result, the open circuit voltage and the fill factor were improved from 0.46 to 0.70V and from 0.56 to 0.61, respectively. However, the series resistance of device was dramatically increased as the power of O2 plasma treatment exceeds 40W, leading to the efficiency reduction. The result is attributed to the variation of oxygen vacancies in ITO film after the 60, 80W O2 plasma treatment. As a consequence, the power of O2 plasma treatment on ITO substrate for the OSCs application should be controlled below 40W to avoid affecting the electricity of ITO film.

Testing tetrahydrofuran in the air of workplace by solvent desorption-gas chromatography / 中国职业医学

OBJECTIVE: To establish a method for testing tetrahydrofuran( THF) in workplace air by solvent desorption gas chromatography. METHODS: The air samples were collected by activated carbon tube,desorbed with carbon disulfide solution,then separated by capillary column and detected by flame ionization detector. RESULTS: The linearity range of THF concentration was 1. 78-8 892. 00 mg / L,and the correlation coefficient was 0. 999 9. The minimum detection limit of THF was 0. 09 mg / m3. The minimum quantitative concentration was 0. 27 mg / m3( 3. 00 L air collection). The average desorption efficiency of THF was 94. 29%-96. 46% when placed overnight at the room temperature. The within-run and the between-run relative standard deviation were 0. 30%-0. 91% and 0. 66%-1. 23% respectively. THF sample could be stored at room temperature for at least 8 days. CONCLUSION: The method could be widely applied in sampling and detection of THF in workplace air.

Improved Color Purity of Blue Organic Light-Emitting Diodes with Double Hole-Transporting Structure.

A blue organic light-emitting diode with a double hole-transporting (DHT) structure has been developed. The device, ITO/N,N'-Bis (naphthalene-1-yl)-N,N'-bis(phenyl)-benzidine/4,4'-Bis (N-carbazolyl)-1,1'-biphenyl (CBP)/4,4'-Bis(2,2-diphenylethen-yl) diphenyl/CBP/tris(8-hydroxyquinolate)aluminum/lithium fluoride/aluminum, consists of a hole-transporting layer, a DHT structure layer and an electron-transporting layer. The blue color purity is improved by modulation the thickness of CBP layer. When the thicknesses of left CBP and right CBP are respectively 8 nm and 2 nm, the more pure blue coordinates (0.155, 0.079) are obtained at 9 V, which are very close to the national television system committee standard blue coordinate (0.14, 0.08). Furthermore the current density, brightness and the luminous efficiency of device with the left CBP of 8 nm and the right CBP of 2 nm are respectively 144.7 mA/cm2, 1065 cd/m2 and 0.93 cd/A at voltage of 9 V.

Clinical characterization and treatment of acute spinal cord decompression sickness after repeated dives / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To analyze and summarize the characteristics and treatment of acute spinal cord decompression sickness. To explore the factors that influence the treatment effect.</p><p><b>METHODS</b>77 cases of acute spinal cord decompression sickness patients should be divided into 4 groups according to the pressurized treatment and drug treatment options. They were group I, group II, group III and group IV. At the same time they were get hyperbaric oxygen therapy and other treatment. The evaluation index, were Frankel function classification and paraplegia index. There were 17 factors that affected the treatment effect.</p><p><b>RESULTS</b>The rate of early cure was 57.14% (44/77). The rate of late cure was 74.03% (57/77). Their difference was statistically significant (P<0.05). In 3 months and 1 year the cure rate of group IV and group B were the highest. But there was no difference between them(P>0.05). They were higher than group ii and group I (P<0.05). The Frankel function classification in 3months and 1 year in each group was higher than before treatment (P<0.05). The paraplegia index in 3 months and 1 year in each group was lower than before treatment (P<0.05). In 3 months and 1 year the Frankel function classification was increased gradually and the paraplegia index was decreased gradually in group I , group II, group III (P<0.05). In group IV and group III the Frankel function and the paraplegia index had not significant difference (P>0.05). Among the 17 factors that affect the treatment effect there are 9 factors that affect the proportion of the large.</p><p><b>CONCLUSIONS</b>The first choice of treatment method for the patients with acute spinal cord decompression sickness would be group III. Drug therapy was also imporpant. At the same time the hyperbaric oxygen therapy and other treatments were taken. Although the cure rate was not high in this article. But most of the cure is within 3 months. Within 1 year.the cure rate still could be improved. 9 factors that affect the efficacy of acute spinal cord decompression sickness was more noteworthy.</p>

Interrelationships between romance, life quality, and medical training of female residents.

BACKGROUND: For the past 30 years, there has been a steady increase in the number of female physicians, but the relationship between their romantic lives and their pattern of training has been inadequately reported. This study was designed to investigate the interrelationships between medical training, quality of life, and the attitudes that female residents have toward romance. METHODS: Of the 106 female medical residents at our medical center in 2009, a total of 78 residents (73.6%) were enrolled for the study. Structured questionnaires (Cronbach α = 0.878), which included questions about female resident quality of life, attitude toward spousal choice, and the impact of programmed professional medical training, were self-administered through an anonymous process. RESULTS: Female residents, especially ward-care specialists, were determined to have excessively long working hours (84.6% > 88 work hours/week), insufficient and irregular sleep (44.9%), and inadequate personal time (73.1% < 24 hours/week) on average. Of the 48 residents with ongoing romances, 87.5% (n = 40) of romantic partners were physicians and 58.3% (n = 28) initiated their relationships when they were medical students, but exhibited no preferential dating of senior medical students or physicians. Factors affecting the choice of spouses included time limitations, a limited circle of friends, differences in values, and work-related stress. Those presumptive factors influencing romance between the assumed partner being a doctor or a "nondoctor" were significantly different with regard to lack of time (p = 0.002), values (p < 0.001), work-related stress (p < 0.001), and family background (p = 0.004). CONCLUSION: Romance and quality of life were significantly influenced by the pattern of medical training in female residents. Setting duty-hour limits and initiating a new hobby were determined to be potentially beneficial to their quality of life and attitudes toward romance.

The image of people with intellectual disability in Taiwan newspapers.

BACKGROUND: There is limited research on the development of newspaper analysis about the images of people with ID in Chinese newspapers. The purpose of this study was: (a) to understand the general image of persons with ID presented in printed newspapers in Taiwan, and (b) to classify the various images of persons with ID and to measure the relative proportions among these classifications. METHOD: Articles from 2008 from the media databank UDNDATA were analysed by content analysis. RESULTS: Three main images were portrayed. The greatest number of articles revolved around the "dispirited" image (44.5%), followed by "needy" (32.7%), and "affirmative" (22.8%). Articles focused on families with a member with ID made up 20.8% of the total articles, and 81% of these stories had a negative theme. CONCLUSION: The pessimistic portrayal of people with ID is popular and newspapers may create stigma for people with ID in Taiwan.

Changes of CD11,CD54 in patients with acute cerebral infarction after hyperbaric oxygen intervention and their influence on patients" prognosis / 中华物理医学与康复杂志

Objective To observe the changes of CD11 a, CD11c and CD54 and its' influence on prognosis after the intervention of hyperbaric oxygen(HBO) in patients with acute cerebral infarction (ACI).Methods Sixty-four ACI patients were divided into control group( C group) and HBO therapy group( HBOT group).C group (33 cases) received routine treatment only, HBOT group ( 31 cases) received routine treatment and hyperbaric oxygen therapy.CD 11 a, CD11 c and CD54 were measured in both groups at ≤72h, the 7th d, 10th d, 12th d, 20th d after ACI, and neural functional damage scores(NDS) were evaluated at the same time.CD11a, CDllc and CD54 were also measured in normal control group (25 cases).Results Plasma levels of CD11a, CD11c and CD54 rose significantly both in HBOT group and C group and peaked at≤72 h after ACI, there was no significant difference between two groups (P > 0.05), then declined at the 7th d.Levels of CD11 a, and CD11c maintained at the peak for 7 d in H BOT group and for 10 d in C group.CD54 peak remained for 10 d in HBOT group, and for 12 d in C group.A correlation analysis and linear regression analysis showed that the NDS levels at 20th d (short-term curative effect), 6 months and 12 months (long-term outcome) could be explained by 97.3 % , 96.7% and 96.6% , respectively by the admission levels of CD11 a and/or CD11 c and/or CD54 and other related factors.Conclusion After hyperbaric oxygen therapy peak level duration of CD11a, CD11c and CD54 could be shortened.Hyperbaric oxygen could influence intercellular adhesion molecule changing process, reduce leukocytes adhesion, decrease expressions of CD11a CD11c and CD54, and protect ACI patients.Before treatment, expression of CD11a, CD11c and CD54 may predict the severity, short or long-term outcome and prognosis of ACI patients.

Clinical characterization and treatment of acute decompression sickness after group repeated dives / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To clinically characterize the divers who suffer from decompression sickness in group after diving, optimize therapeutic treatment settings for grouped patients where the conventional individualized treatment cannot be implemented.</p><p><b>METHODS</b>Clinical parameters of patients such as age, professional seniority in dive, labor intensity, diving depth and their symptoms were statistically categorized to identify the factors that correlate with treatment efficacy and recurrence rate. In accordance with the symptoms and the reactions to pressure, 4 treatment programs were applied: Program A, Program B, Program C, Program D.</p><p><b>RESULTS</b>(1) age, professional seniority, diving depth, length of service, dive frequency were positively correlated with the treatment efficacy (P<0.05, P<0.01), and these parameters together with pain intensity were also positively correlated with recurrence risk (P<0.05, P<0.01), while long latency time of the disease often related with poor therapeutic outcome and high recurrence rate (P<0.01), (2) pain intensity were positively affected by age, diving depth and dive frequency (P<0.05, P<0.01), whereas negatively affected by disease latency time (P<0.01), (3) Four elements in this clinic project, selection of treatment program, length of service, diving depth and disease latency time of patient, were responsible for (or: could account for) 48.0% change of treatment efficacy, (4) Among Programs using different therapeutic pressure, Program D, C and B had better outcomes than Program A (P<0.01, P<0.05). Also, less patients in Program D, C and B suffered from recurrence with relative to Program A (P<0.01, P<0.05), (5) Between Programs adopting same hyperbaric pressure and treatment duration time, Program D was more efficient and fewer recurrent cases were found in it if compared to Program B (P<0.05), (6) In programs with same pressure and duration time settings, Program D was remarkably superior to program C in regard of its treatment efficacy.</p><p><b>CONCLUSIONS</b>In condition with only limited clinic supplies, Program D could be the first choice to provide the hyperbaric oxygen as an ideal group treatment, and it is not very necessary for the clinician to provide individualized therapy. An appropriate extension of stay in hyperbaric chamber may apply to some patients but depending on the clinical symptoms, however, no longer time than 120 min is recommended.</p>