Objective To evaluate the value of pedicled fat and capsule-packed nerve root in operation of sacral canal cysts.Methods We collected the information of 14 cases of sacral canal cysts for operation in our department and analyzed the operation indications and skills as well as the prognosis.Results All the operations were performed with the help of the microscope and the electrophysiological monitor.The capsules were removed in 9 cases and wrapped in 6 cases,with the total resection rate of 64.3%.The clinical symptoms were improved markedly after the operation.Conclusion The operation with pedicled fat and the capsule-packed nerve root is valuable in treating sacral canal cysts because it can protect the nerve root and get lower recurrence rate.

Objective To analyze the effect of malaria surveillance and evaluate the surveillance measure in Guangxi Zhuang Autonomous Region from 1995 to 2004 so as to provide scientific basis for formulating control strategy at the late-stage of malaria control. Methods The data on blood smear examination of febrile patients among local residents, focus residents and mobile population in 92 counties from 1995 to 2004 were collected,described and analyzed. Results The totals of 10920395,427600,246159 and 253530 slides in local residents,focus residents, returned population and endemic population were examined. The average positive rates of blood examination were 0.009%,0.079%,1.386% and 0.324%,respectively. The indigenous cases and imported cases accounted for 23.29% (1285/5517) and 76.71% (4232/5517) of the total malaria cases respectively. Conclusions The malaria incidence in Guangxi Zhuang Autonomous Region has been under 1/10000 for 17 years. There is less indigenous malaria in Guangxi. The imported malaria cases are dominated and scattered in whole Region. The secondary cases of imported malaria is very low. The results show that the present surveillance system and control programs are effective for monitoring the epidemic situation of malaria.

Objective To study intraoperative neural electrophysiological monitoring applied in lumbosacral spinal cord tumor resection.Methods We retrospectively reviewed the clinical data of 212 patients undergoing lumbosacral spinal cord tumor resection with or without intraoperative neural electrophysiological monitoring in our hospital.The patients were divided into two groups:124 patients in the monitored group received intraoperative neural electrophysiological monitoring while 88 ones in the control group did not.The monitoring was performed by recording the cortical somatosensory evoked potential (CSEP),dermatomal somatosensory evoked potential (DSEP) and electromyography (EMG).The patients were followed up for 3-6 months and their postoperative outcome was analyzed.Results There were significant differences in the outcome (P <0.05),but no difference was found in the incidence of complications between the monitored group and the control group.The sensitivity of CSEP +DSEP+EMG was 100%,and the specificity was 55.9% in the former group.Conclusion Combined monitoring with CSEP,DSEP and EMG during lumbosacral spinal cord tumor resection is valuable in protecting the spinal nerve roots and ensuring better operation safety.

ABSTRACT:Objective To compare the clinical effects of Zero-P and traditional titanium plate with cage in treating single level cervical spondylosis.Methods We retrospectively analyzed the clinical data of 28 patients with single level cervical spondylosis who underwent anterior cervical discectomy and fusion (ACDF)by traditional titanium plate with cage (group A,n=16)or Zero-P implant (group B,n=16)in our department between January 2012 and January 2014.The intraoperative blood loss,operation time,postoperative JOA scores,JOA recovery rate,NDI scores,and dysphagia incidence in both groups were measured and compared.The changes of the midpoint interbody height (IBH),the cervical Cobb angle of the surgical segment and the cervical Cobb angle of C2 and C7 vertebral body were measured on the standing lateral cervical spine X-ray.Results The operation time was significantly longer in group A than in group B (P < 0 .0 1 ), but there were no significant differences in intraoperative blood loss between the two groups (P>0 .0 5 ).The incidence of dysphagia was lower in group B than in group A.The two groups did not significantly differ in JOA score or JOA improvement rate during the same period after operation (P>0.05).The NDI score in group B was significantly lower than that in group A (P<0 .0 5 )at 1 month and 6 months after operation,but showed no significant difference in preoperative and 1 2 months after operation (P>0 .0 5 ).The midpoint interbody height in group B was significantly greater than that in group A (P<0 .0 5 )1 2 months after operation,but showed no significant difference one month after operation.The cervical Cobb angle of the surgical segment was significantly greater in group B than in group A (P<0 .0 5 )after operation, but there was no significant difference in cervical Cobb angle of C2 and C7 vertebral body between the two groups at various time points (P>0.05).Conclusion Zero-p and traditional titanium plate with cage have similar effects in treating single level cervical spondylotic myelopathy,and Zero-P system has the advantages of lower incidence of dysphagia after operation,shorter operation time and better recovery of postoperative cervical physiological structure.

Objective To compare the modified expanding suspended laminoplasty and posterior pedicle screw fixation applied in lumbar intraspinal tumors and evaluate operation,complications,postoperative neurofunctional improvement and lumbar lumbar stability in the two groups.Methods We made a retrospective analysis of the clinical data of 1 14 cases of lumbar intraspinal tumors, including 66 cases of modified expanding suspended laminoplasty and 48 cases of posterior pedicle screw fixation.We compared the operation time,operation bleeding volume,and incidence of postoperative cerebrospinal fluid leakage in the two groups.We also analyzed the lumbar instability and spinal cord injury score standard by the Japanese Orthopedic Association (JOA)between the two groups at 3,6, 12,and 24 months after operation.Results The results of modified expanding suspended laminoplasty group were significantly better than those of posterior pedicle screw fixation group in operation time, operation bleeding volume and incidence of postoperative cerebrospinal fluid leakage (P < 0.01 ).The lumbar instability did not significantly differ between the two groups (P >0.05).At 3,6 or 12 months after the operation, changes in the increase of JOA score of the two groups had no significant difference (P > 0.05 ).However,24 mouths after the operation,the group of posterior pedicle screw fixation had significantly improved JOA score compared with that in the modified expanding suspended laminoplasty group.Conclusion Both the modified expanding suspended laminoplasty and posterior pedicle screw fixation have a favorable outcome of postoperative lumbar instability and neurofunction.And posterior pedicle screw fixation is superior to modified expanding suspended laminoplasty in improving neurofunction.

Objective To investigate the indications,surgical principles and advantages and disadvantages of microsurgery of intra-spinal tumor via the quadrant pathway.Methods We made a retrospective analysis of the clinical data of patients with spinal canal tumors treated via the quadrant pathway from October 2014 to July 201 5. Results Totally 1 6 patients were included.Their tumors were fully removed by microscopic resection,in which there were three epidural cases,twelve subdural extra-medullar cases,and one intra-medullar case.In terms of stage,there were three cases of cervical segment (C3 - C7 ),four cases of thoracic (T1 - T10 ),nine cases of thoracic and lumbar ones (T1 1 - S2 ). In pathology, there were nine cases of neurilemmoma, two cases of neurofibroma,four cases of meningeal tumor and one case of neuroepithelial cyst.The postoperative symptoms and signs of the patients were significantly improved,and no recurrence or complications occurred in the follow-up 2-10 months.Conclusion Quadrant pathway can be used in removing spinal epidural and subdural tumor,which is shorter than two vertebral segments in length,and the cross-sectional area is less than 2/3 of the spinal cord. However,surgery with extensive adhesion and intra-medullary lesions should be performed carefully,and the surgical techniques are more demanding and a longer learning curve is needed.

OBJECTIVETo investigate the glycolytic phenotype of SHG44 human glioma cells under hypoxic conditions and the association between cell proliferation and apoptosis and the metabolic status.

METHODSAn in vitro hypoxic cell model was established in SHG44 cells using CoCl2. Real-time PCR and Western blotting were used to assess the expressions of hypoxia-inducible factor-1α (HIF-1α) and the enzymes involved in glycolysis including PDK1, PKM2, and LDHA. Intracellular ATP levels were measured by bioluminescence assay to assess the energy metabolic status of SHG44 cells. The viability and apoptosis of the cells were examined using MTT assay and flow cytometry, respectively.

RESULTSThe cells in hypoxic culture showed obviously increased expressions of HIF-1α, LDHA, PDK1, and PKM2 at both the mRNA and protein levels as compared to those in normal cell culture. Hypoxia of the cells also resulted in a lowered cell proliferative activity and an increased apoptosis rate with lowered intracellular ATP concentrations and elevated mitochondrial membrane potential.

CONCLUSIONHypoxia can induce a glycolytic phenotype of tumor cells. The sensitivity of tumor cells to hypoxia-induced cell death is directly correlated with their metabolic status.

Adenosine Triphosphate ; metabolism ; Apoptosis ; Carrier Proteins ; metabolism ; Cell Hypoxia ; Cell Line, Tumor ; Cell Proliferation ; Central Nervous System Neoplasms ; metabolism ; pathology ; Glioma ; metabolism ; pathology ; Glycolysis ; Humans ; Hypoxia-Inducible Factor 1, alpha Subunit ; metabolism ; Membrane Potential, Mitochondrial ; Membrane Proteins ; metabolism ; Protein-Serine-Threonine Kinases ; metabolism ; Thyroid Hormones ; metabolism

Strengthening the supervision over the use of large-scale medical equipment is an effective means to improve the efficiency of equipment use and the quality of medical services, and it is an important part of promoting the construction of the Healthy China and the development of health undertakings. Through four stages of preliminary demand investigation, intelligent collection of data, intelligent analysis and evaluation, and continuous improvement, a large-scale medical equipment intelligent management platform was built in our hospital. Real-time data collection, interconnection, analysis and evaluation were achieved, which could help the use and supervision, improve efficiency and effectiveness, and optimize the evaluation system.

Objective:To explore any effect of pulsed electromagnetic field (PEMF) stimulation on intervertebral disc degeneration (IDD).Methods:Forty Sprague-Dawley rats were randomly divided into a control group, an IDD model group, a PEMF group and an observation group. An IDD model was induced in all except those in the control group. Both the PEMF and observation groups were given PEMF stimulation, while the latter was additionally injected with the A2AR agonist CGS-21680. Eight weeks after the modelling any pathological changes in the morphology of the rats′ intervertebral disc tissues were evaluated using saffron solid green staining. The expression of A2AR, cyclic adenosine phosphate (cAMP), protein kinase A (PKA), cysteine aspartate proteolytic enzyme-3 (Caspase-3), type II collagen (COL-II) and matrix metalloproteinase-3 (MMP3) in the intervertebral discs were evaluated.Results:The nucleus pulposus had shrunk, while fibrous tissues and chondrocytes had increased in the IDD model group. In the observation group the nucleus pulposus was intact and of basically normal shape. A2AR mRNA and protein levels were higher in the intervertebral disc tissue of the model group than among the control group, on average, while the levels in the observation group were significantly higher than in the other groups. In the PEMF and observation groups cAMP and PKA mRNA were significantly higher than in the IDD model group. The p38 MAPK and P-P38 MAPK levels of the IDD model group and its average P-P38 MAPK/p38 MAPK ratio were significantly higher than in the control group. In the PEMF and observation groups those indices had decreased to varying degrees, with those of the observation group significantly lower than among the model and PEMF groups on average, except for the p38 MAPK values. Caspase-3 and its mRNA were significantly higher in the model group than in the control group, on average, and those values were significantly lower in the PEMF and observation groups than in the IDD model group. The average MMP3 contents of the IDD model group had increased significantly compared with the control group, while the Col-Ⅱ level had decreased significantly. Compared with the IDD model group, the MMP3 level had decreased but Col-Ⅱ expression had increased in both the PEMF and observation groups, with significant differences between the IDD model and observation groups.Conclusions:The activation of the p38 MAPK signaling pathway by inflammatory factors to induce apoptosis is one of the important reasons for the aggravation of IDD lesions. PEMF combined with A2AR agonists can activate the A2AR/cAMP/PKA signaling pathway, inhibit p38 MAPK phosphorylation, reduce apoptosis of nucleus pulposus cells, and relieve IDD damage.

【Objective】 To explore the expressions of adipocyte enhancer binding protein 1 （AEBP1） gene and its isoforms in different types of gliomas， and the influence of AEBP1 gene on the prognosis of patients with different types of gliomas. 【Methods】 We used the GEPIA2 visual network analysis tool to analyze AEBP1 gene expression levels in the tumor tissues of glioblastomas （GBM， including classical， mesenchymal， neural， and proneural ones） and low-grade gliomas （LGG， including astrocytoma， oligoastrocytoma， oligodendroglioma） in the TCGA database and normal human tissue samples in the TCGA and GTEx databases by one-way ANOVA. The distribution trend of isoforms of AEBP1 gene in gliomas was analyzed using the violin plot. The Kaplan-Meier survival curve was drawn and the Logrank test was used to analyze the influence of AEBP1 gene expression in GBM and LGG tumor tissues on the prognosis of glioma patients. 【Results】 The expression of AEBP1 in the tumor tissues of overall GBM and the four types of GBM was higher than that in the normal control tissues （P<0.05）. The expression of AEBP1 in astrocytoma and oligodendrocyte astrocytoma tumor tissues was higher than that in normal control tissues （P<0.05）. There were nine isoforms of AEBP1 gene in GBM and LGG， and the expression level in GBM was higher. The overall survival （OS） of the AEBP1 low expression group of GBM patients and the proneuronal GBM patients was better than that of the high expression group （P<0.05）. The OS and progression-free survival of LGG patients and the AEBP1 low-expression group of astroglioma were better than those of the high-expression group （P<0.05）. 【Conclusion】 AEBP1 has an important clinical value in the pathogenesis and development of GBM and LGG， and thus can be used as a diagnostic marker and a candidate gene for targeted therapy.