The paper reviewed the research cooperation on public health between China and US in 30 years since the establishment of Sino-US diplomatic relation, based on the project database of Peking University, and made out the comments on the benefits, shortages and expectation in future cooperation.

There should be confusion about diagnosis and treatment for multiple segments cervical myelopathy in some respects. The author reviewed the literature and combined with clinical experience, proposed a new classification for cervical myelopathy according to responsibility segment areas, which dividing into single segment,double segments (continues or jumping type), multi-segment (≥ three segments). The responsible segments determination is the premise of diagnosis and also a key to determine surgical decompression segment. Decompression only according to imaging was not desirable, surgical segment should mainly relies on clinical, imaging, electrophysiological and comprehensive analysis to avoid surgery range expansion. Surgical approach and procedures are still the focus and hotspot of cervical myelopathy treatment, and no treatment standards and corresponding guidelines to consult. The author proposes that surgical approach should advocate the individual, and surgical procedure should follow simple instead of complicate, anterior and posterior combined decompression is not necessary in most cases, and anterior and posterior fixation are not need.
Cervical Vertebrae ; surgery ; Decompression, Surgical ; Humans ; Spondylosis ; diagnosis ; surgery ; Treatment Outcome

Objective To study the clinic value of digital three-dimensional shaping titanium mesh in repairing skull defects and reconstructing temporal muscle attachment points. Methods Eighty-two patients with skull defects from December 2013 to January 2016 were enrolled in this study. They were divided into two groups according to patients' will with 41 patients in each group. The patients in control group received traditional hand-shaping titanium mesh repair, the patients in observation group received individual digital forming technology to produce titanium mesh repair and reconstruct the temporal muscle attachment points at the titanium mesh temporal corresponding position. The rate of appearance satisfaction, operation time, the number of titanium nail and the rate of postsurgery adverse reaction was compared between the two groups. Results The rate of appearance satisfaction in observation group was significantly higher than that in control group: 97.56%(40/41) vs. 80.49%(33/41), P<0.05. The operation time and the number of titanium nail and in observation group was significantly lower than that in control group:(8.9 ± 1.6) h vs. (12.4 ± 2.4) h, (10.3 ± 0.9) pieces vs. (11.8 ± 1.8) pieces, P < 0.01. The rate of postsurgery adverse reaction in observation group was significantly lower than that in control group: 0 vs. 9.8%(4/41), χ2 = 4.21, P < 0.05. Conclusions The operation of repairing skull defects and reconstructing temporal muscle attachment points with digital three-dimensional shaping titanium mesh is simple. It can shorten the operation time, decrease the postsurgery adverse reaction, and increase the appearance satisfaction.

Objective To compare the efficacy of pressure-controlled ventilation and volume-controlled ventilation in patients undergoing lumbar surgery in prone position.Methods Sixty ASA physical status Ⅰ or Ⅱ patients of both sexes,aged 40-64 yr,weighing 45-90 kg,scheduled for lumbar surgery in prone position,were randomly divided into 2 groups (n =30 each) using a random number table:pressure-controlled ventilation group (group P) and volume-controlled ventilation group (group V).Anesthesia was induced with dexamethasone 10 mg,etomidate 0.3 mg/kg,sufentanil 0.4 μg/kg,and rocuronium 0.6 mg/kg and maintained with propofol 2-4 mg· kg-1 · h-1,remifentanil 6-10 μg· kg-1 · h-1 and vecuronium 0.08 mg· kg-1 · h-1.The i-gel laryngeal mask airways were inserted after induction and the patients were mechanically ventilated.A gastric tube was inserted through the drain tube of i-gel.The maximum inspiratory pressure was adjusted to reach the tidal volume (VT) of 8 ml/kg in group P and the VT was set at 8 ml/kg in group V.PTrCO2 was maintained at 30-40 mm Hg.The mean airway pressure (Pmean) and peak airway pressure (Peak) were recorded immediately after insertion of i-geal (T0),immediately after the patients were turned to prone position (T1),immediately before skin incision (T2),30 min after the beginning of surgery (T3),immediately after the end of surgery (T4) and immediately after the patients were turned to supine position (T5).While dynamic lung compliance (Cdyn) was calculated.Arterial blood samples were taken at the same time points for blood gas analysis.Oxygenation index (OI) and respiratory index (RI) were calculated.Results Compared with group V,Pmoan and Ppeak were significantly decreased at T0-5,Cdyn and OI were increased,and RI was decreased at T1-4 in group P (P ＜ 0.05).Conclusion Compared with volumecontrolled ventilation,pressure-controlled ventilation can better improve the ventilatory efficacy and reduce prone position-induced effect on respiratory function in patients undergoing lumbar surgery.

Objective:To study the feasibility of 3-D reconstruction model in the observation of tetrachlorodibenzo-p-dioxin(TCDD) effected palatal organ development of fetal mouse.Methods:Kunming mice treated 40 ug/kg TCDD by lavage on day 12.5 of pregnancy were used as in the experimental group,isodose corn oil treated in the control group.On day 13.5,14.5 and 15.5 of pregnancy heads of the fetal mice were taken out and fixed.Conventional paraffin serial sections of palatal organ were preparated and dyed by hematoxylin-eosin,images of the palatal organs were collected and photoshop treated,3-D reconstruction of the palatal organ was performed by 3D-DOCTOR software.Results:3-D reconstruction images showed that palatal organs moved from on both sides above the tongue and gradually closed and merged in the control group.In the experimental group,the palatal organs moved from on both sides above the tongue was later than control group,gradually closed,but not merged,formed cleft palate.Conclusion:3D-DOCTOR software reconstruction can be used for the study of the development process effected by TCDD in the pregnant mouse.

Objective To assess the clinical value of dual-energy intracranial CT angiography (CTA).Methods Forty-one patients suspected of intracranial vascular diseases underwent dual-energy intracranial CT angiography, and 41 patients who underwent conventional subtraction CT were enrolled as the control group.Image quality of intracranial and skull base vessels and radiation dose between dual-energy CTA and conventional subtraction CTA were compared using two independent sample nonparametrie test and independent-samples t test, respectively.Prevalence and size of lesions detected by dual-energy CTA and digital subtraction CTA were compared using paired-samples t test and Spearman correlative analysis. Results The percentage of image quality scored 5 was 70.7% (29/41) for dual-energy CTA and 75.6% (31/41) for conventional subtraction CTA.There was no significant difference between the two groups(Z= -0.455, P=0.650).Image quality of vessels at the skull base in conventional subtraction CTA was superior to that in dual-energy CTA, especially for the petrosal and syphon segment (Z=-4.087, P= 0.000).Radiation exposure of dual energy CTA and conventional CTA were (396.54±17.43) and (1090.95±114.29) mGy · cm respectively.Radiation exposure was decreased by 64% (t=-38.52, P=0.000) by dual energy CTA compared with conventional subtraction CTA.Out of the 41 patients,19 patients were diagnosed as intracranial aneurysm, 2 patients as arteriovenous malformation (AVM), 3 patients with Moya-moya's disease, and the remaining 17 patients with negative results.Nine patients with intracranial aneurysm, 2 patients with AVM, 3 patients with Moya-moya's disease, and 2 patients with negative findings underwent DSA or operation, with concordant findings from both techniques.Diameter of aneurysm neck, long axis and minor axis by dual-energy CTA was (2.90±1.61), (5.23±1.68) and (3.83±1.69) nun, respectively; Diameter of aneurysm neck, long axis and minor axis by DSA was (2.95±1.71), (5.10±1.60) ,(3.83±1.65) nan,respectively.There was no significant difference for the diameters of aneurysm between dual energy CTA and DSA ((t=-0.734,1.936,0.12.5 respectively, P=0.482,0.085,0.903 respectively), and good correlation was found between diameter measurements using the two techniques(r=0.964,0.976,0.973, respectively, all P=0.000) Conclusions Compared with conventional subtraction CTA, dual energy CTA has good image quality for intracranial vessels; however, image quality of the skull base vessels is worse, especially for the petrosal and syphon segment.Dual energy CTA has decreased radiation dose and a high diagnostic accuracy, being a practical imaging madality for diagnosis of intracranial vascular lesions.

ObjectiveTo investigate the clinical significance of transforming growth factor β1 (TGF-β1)and vascular endothelial growth factor (VEGF) expression in tissues of nasal inverted papilloma (NIP).MethodsThe clinical data of patients with NIP underwent surgical resection were retrospectively analyzed.The TGF-β1 and VEGF expression in NIP tissues and nasal polyps tissues were detected by immunohistochemistry method.100 patients with NIP were divided into benign lesions,atypical hyperplasia and malignant group according to result of pathological diagnosis,the nasal polyps was used as the control group.ResultsThe positive expression rate of TGF-β1 and VEGF in the NIP group were 46.0％ and 32.0％,compared with the control group the differences were significant(all P ＜ 0.05 ).In different pathological groups,the results of TGF-β1 and VEGF expression were malignant group ＞ atypical hyperplasia ＞ benign lesions.The positive expression rate of TGF-β1 and VEGF in the NIP group had significantly positive correlation(P ＜ 0.05).ConclusionThe TGF-β1 and VEGF expression were closely related to the the occurrence,development and malignant of NIP.TGF-β1 was highly expressed in the NIP tissues,and could increase the expression of VEGF and promote the formation of neovascularization of NIP.

Objective To investigate the expression of granulocyte macrophage-colony stimulating factor(GM-CSF)in skin lesions and sera of patients with pustular psoriasis and psoriasis vulgaris.Methods Tissue specimens were obtained from the lesions of 15 patients with pustular psoriasis,15 patients with psoriasis vulgaris and 15 normal human controls.Immunohistochemistry and dual antibody sandwich enzyme-linked immunosorbent assay(ELISA)were carried out to detect the levels of GM-CSF in the tissue and serum specimens from the patients and normal human controls,respectively.Results Significantly higher levels of GM-CSF were observed in the tissue and serum specimens from patients with pustular psoriasis and psoriasis vulgaris compared with the normal controls(all P ＜ 0.01),as well as in those from the patients with pustular psoriasis compared with the patients with psoriasis vulgaris(both P ＜ 0.01).Conclusion GM-CSF may be involved in the pathogenesis of psoriasis.

Objective To comparison of the quality of life in children with migraine and quality of life in children with primary epilepsy(EP)or Tourette's syndrome(TS).Methods There were 239 children with moderate migraine,the time of which lasted from 6 to 36(12.14?4.67)months,headache index 4-20(9.98?3.74).There were 250 cases and 424 cases with EP or TS,respectively,both team members were under good control with single drug therapy,the diagnosed according to the international classification of headache disorders-Ⅱ.The pediatric quality of life inventory,version 4.0,age 8-12 years,and child report forms were used to evaluate the quality of life in children with migraine and the other two kinds of samples by Bonferroni and Mann-Whitney tests.Results The scores of quality of life in children with moderate migraine were lower than those in children with EP(total score 69.06?10.48 vs 81.26?13.80;physical function scores 67.43?14.37 vs 83.14?14.70;psychological function scores 69.92?10.56 vs 80.26?14.32;emotional function scores 66.76?14.09 vs 80.90?18.93;social function scores 76.81?14.67 vs 83.36?17.40;school function scores 66.20?13.62 vs 76.52?13.80).The scores of quality of life in children with moderate migraine were lower than those in children with TS(total scores 69.06?10.48 vs 79.18?11.45;physical function scores 67.43?14.37 vs 81.52?12.61;psychological function scores 69.92?10.56 vs 77.90?12.28;emotional function scores 66.76?14.69 vs 74.07?16.34;social function scores 76.81?14.07 vs 89.06?16.23;school function scores 66.20?13.62 vs 70.35?16.96).Two sets of data between children with moderate migraine and those with EP,TS showed statistical significance(Pa

Objective To study the etiology,clinical characteristics,electroencenphalography(EEG),mental degree of Lennox-Gastaut syndrome(LGS). Method Retrospectively analyzed etiology,sex,age,seizure types,EEG,mental degree of 54 children diagnosed as LGS. Results The number of male was 36,female was 18,seizure onset from 1 month to 8 years,diagnosing age from 3 months to 11years. The EEG reveals 1.5-2.5 Hz spike-wave discharges and a slow baseline activity. Conclusions LGS is one of the most difficult epilepsys to treat and need frequently more than 2 antiepilepsy drugs. It is characterized by variable etiology,multiple types of intractable seizures, and has enormous detrimental effects on patient′s developmental health.