Objective To explore the function of stereotactic radiation therapy (SRT) and wholebrain radiation therapy (WBRT) in treatment of multiple brain metastasis tumor.Methods Fifty-two patients with multiple brain metastasis tumor were retrospectively analyzed.The patients were divided into simple stereotactic radiation therapy group (22 cases) and whole-brain radiation therapy + stereotactic radiation therapy group (30 cases) according to the radiation therapy method.The median overall survival time and distant brain tumor recurrence rate in 1 year etc.were compared between 2 groups.Results There were no statistical differences in the median overall survival time and fatality rate between simple stereotactic radiation therapy group and whole-brain radiation therapy + stereotactic radiation therapy group:13.0 months (95％ CI 8.05-27.84) vs.13.4 months (95％ CI 8.57-19.48),86.36％ (19/22) vs.86.67％ (26/30),P＞ 0.05.The distant brain tumor recurrence rate in 1 year in simple stereotactic radiation therapy group was significantly higher than that in whole-brain radiation therapy + stereotactic radiation therapy group:45.45％ (10/22) vs.20.00％ (6/30),and there was statistical difference (x2 =3,861,P =0.049).Conclusion Stereotactic radiation therapy and whole-brain radiotherapy can achieved similar median overall survival time.

Objective To explore the related risk factors of type 2 diabetic nephropathy,and to provide theoretical basis to make the strategy of prevention of diabetic nephropathy.Methods By case-control study method,98 patients with type 2 diabetic nephropathy were selected as the observation group.98 diabetes mellitus patients without kidney disease were selected as control group.Single factor analysis and non-conditional logistic regression analysis were conducted in two groups.Results The results of single factor analysis showed that type 2 diabetic nephropathy was closely related to family history of diabetes,course of diabetes,high blood pressure,diabetic retinopathy,BMI,coronary heart disease,HbAlc,FPG,2hPG,CRP (P ＜ 0.05).The results of multiple factors of logistic regression showed that type 2 diabetic nephropathy was closely related to course of diabetes and diabetic retinopathy,CRP,HbA1c,FPG(P ＜0.05).Conclusion Course of diabetes and diabetic retinopathy,CRP,HbA1c,FPG are independent risk factors for type 2 diabetic nephropathy.

OBJECTIVE TTo evaluate the clinical manifestations of the laryngeal amyloidosis and its laryngoscopic characteristics.METHODS The clinical data of 11 cases with laryngeal amyloidosis confirmed pathologically was studied retrospectively. RESULTS There were 4 males and 7 females in this study.The age of the patients ranged from 16 to 64 years old (average 43.36?4.16).The duration of symptoms was 4 months to 10 years (average 2.85?0.87 years).Hoarseness presented in 10 patients (90.90%) and dyspnea in 4 patients.The false vocal cord was involved in 8 patients,laryngeal ventricle in 6 patients,true vocal cord in 5 patients and subglottic area in 3 patients observed with fibrolaryngoscope. The appearance of the lesions was mainly described as waxy yellow or yellow-gray submucosal plaques and nodules without ulceration of the overlying mucosa.The laryngostroboscopy demonstrated that the wave of the mucosa and vibration of the involved vocal cords were adynamic or disappeared.CONCLUSION The chief complaint of the laryngeal amyloidosis was hoarseness. Laryngeal amyloidosis is a slowly progressive disease. The lesions commonly involve the false vocal cord, laryngeal ventricle,true vocal cord and subglottic area.

OBJECTIVE: To study the anatomic characteristics of recurrent laryngeal nerve during thyroid surgery. METHOD: A retrospective review of surgical data of 307 patients undertook thyroid surgery was conducted. RESULT: Total 342 recurrent laryngeal nerves were identified during the surgery(184 on the right side, left 158). 215 (62.9%) nerves were deep to the inferior thyroid artery, 106(31.0%)were superficial to the artery, 21(7.5%) were between the arterial branches. A nerve bifurcation was found in 203(59.4%). None of nerve bifurcation was found in 136(39.8%). 3(0.9%)were confirmed to hold non-recurrent laryngeal nerves during operations. No patient showed permanent laryngeal recurrent nerve paralysis postoperatively. CONCLUSION The careful dissection and protection of the recurrent laryngeal nerve was an effective method to prevent its injury during thyroid surgery.
Arteries ; Cranial Nerve Diseases ; etiology ; prevention & control ; Dissection ; Humans ; Postoperative Period ; Recurrent Laryngeal Nerve ; Retrospective Studies ; Thyroid Gland ; surgery ; Thyroidectomy ; Vocal Cord Paralysis

Objective To explore the application and analysis of E-PASS scoring system for orthopaedic senile hip surgery risk assessment. Methods Retrospectively analyzed the data of 188 cases of elderly hip fracture patients with anesthesia and surgery, postoperative complications. Useing E-PASS scoring system to evaluate the mortality of patients with surgical risk. Results Postoperative complications mainly was respiratory system diseases, the rate of complication was 25.88%(22/85), accounting for total cases rate was 11.70% (22/188). Secondly for cardiovascular diseased and urinary system diseases. E-PASS scoring system showed that the scores of surgery risk assessment in patients with complication was significantly higher than that without complication:(0.27±0.23) scores vs. (0.17±0.16) scores, t=3.728, P<0.05. Ninety-one patients were evaluated to occur complications by E-PASS grading system, 85 patients occurred practically,the rate of actual value/forecast was 0.93.Six patients were evaluated to die, 2 patients occurred practically, the rate of actual value/forecast was 0.33, there were no significant differences ( P=0.056,0.124). Conclusion E-PASS scoring system for orthopaedic senile hip surgery risk assessment can predict the risk of complication and death effectively,it is value of interventing the preoperative risk factors and has great clinical application value.

BACKGROUND: Our former studies have shown that bone marrow mesenchymal stem cells (BMMSCs) can be induced differentiation to vascular smooth muscle-like cells (VSMLCs) and vascular endothelium-like cells (VELCs), which are compatible with collagen-embedded polyglycolic acid scaffolds. OBJECTIVE: To investigate the possibility of constructing small diameter tissue-engineered blood vessels via subcutaneous implantation. METHODS: The cells-scaffold complex was produced by separately seeding VSMLCs and VELCs derived from BMMSCs on polyglycolic acid collagen scaffolds. The two layers were separated by ECMgel. The cells-scaffold complex was subcutaneous implanted into small diameter tissue-engineered blood vessels.RESULTS AND CONCLUSION: Histological analysis of the small diameter tissue-engineered blood vessel walls revealed a typical artery structure, which was similar to natural vessels. The tissue-engineered blood vessels were not broken down under a force of 26.6 kPa. Eight weeks after implantation, the Brdu-labeled seed cells were found in the three layers of the vessel walls. The results revealed that the subcutaneous tissue was a good bioreactor to construct small diameter tissue-engineered blood vessels.

ObjectiveTo retrospectively analyse the data of patients with suspected primary aldosteronism (PA) during the last five years.The receiver operating characteristic (ROC) curve was used to evaluate the value of aldosterone to renin ratio (ARR) in screening primary aldosteronism.MethodsThe clinical data of ARR in supine and upright positions were collected in 590 patients with suspected during January 2006 to August 2010.There were 357 patients diagnosed as primary aldosteronism and 233 patients as essential hypertension among these patients.100 patients with suspected primary aldosteronism took the upright and random ARR during September 2010 to April 2011 ; Among these patients,29 patients were diagnosed as primary aldosteronism and 71 as cases of essential hypertension.ROC curve was made to retrospectively define the method and the cut-off value of the supine,upright or random ARR.ResultsThe area under the curve(AUC) of the supine ARR in the 590 patients who took the supine and upright ARR during January 2006 to August 2010 was 0.838 (0.805-0.867 ) and the AUC of the upright ARR was 0.873 (0.843-0.899 ).There was significant difference between these two AUC readings (P＜0.01 ).The AUC in the upright ARR of the 100 patients who took the upright and random ARR during Septeuder 2010 to April 2011 was 0.962 (0.928 -0.995 ) and the AUC of the random ARR was 0.944 (0.893-0.994 ).There was no significant difference between these two AUC readings (P＞0.05).The upright ARR cutoff value with 400 ( pg · ml-1 )/( ng· ml-1 · h 1 ) yielded a sensitivity of 91.9％ and a specificity of 64.2％ to diagnosis of PA.ConclusionUpright ARR value was more suitable in the screening test than supine ARR value.Random ARR showed similar effect as the upright ARR.In our research,under strict control of the drug,position and detection time,ARR value with 400 ( pg · ml-1 )/( ng· ml-1 · h-1 ) can be the cutoff point in screening the suspcctcd PA patients.

Objective To discuss the difference of cognitive function in patients of first-episode schizophrenia with and without metabolic syndrome.Methods Event related potential detection and Wechsler Memory Scale (WMS) was determined in 57 patients of first-episode schizophrenia with metabolic syndrome (research group) and 57 patients of first-episode schizophrenia without metabolic syndrome (control group),and the psychiatric symptom in two groups was assessed by the application of the positive and negative symptoms scale (PANSS).Results The memory quotient score was (78.51 ± 12.54) scores in research group,and (92.01 ± 17.49) scores in control group,and there was significant difference between two groups (t =-2.130,P=0.047).The short-term memory,instantaneous memory impairment in research group were lower than those in control group(t =2.151-3.054,P=0.007-0.046).The latency of P300 was (325.10 ±22.46) ms in research group and (284.60 ±22.46) ms in control group,and there was significant difference (t =3.454,P =0.003).The amplitude was (6.56 ± 1.61) μ V in research group and (9.78 ±1.73) μV in control group,and there was significant difference (t =-4.307,P =0.000).Conclusion The patients of first-episode schizophrenia with metabolism syndrome has more severe cognitive impairment than those without metabolism syndrome.

Objective To study the clinical efficacy of percutaneous transluminal angioplasty (PTA) and vacuum sealing drainage technique on patients with diabetic foot and arteriosclerosis obliteration of the lower extremity.Methods Sixty-four patients were divided into two groups.Group A (32 patients) were treated by traditional methods,while 32 patients in Group B treated by vacuum sealing drainage technique in addition to percutaneous transluminal angioplasty.Results One week after surgery,ABI in group A was 0.53 ±0.17 vs 0.85 ±0.27 in group B,P =0.00.Ulcer healing rate increased from 31.25％ in group A to 81.25％ in group B,P ＜0.01.The amputation rate decreased from 56.25％ in group A to 18.75％ in group B,P =0.00.Claudication distance extended and ulcer recurrence rate in group A was 40％,while in group B it was 0,P =0.00.Conclusion The combination of PTA and vacuum sealing drainage significantly improves the prognosis of patients with diabetic foot and arteriosclerosis obliteration of the lower extremity.

Objective To investigate the effects of angiotensin receptor blocker (ARB)losartan on the glomerular protein expression profile of spontaneous type 2 diabetic KKAy mice by two-dimensional differential gel eleetrophoresis and MALDI-TOF mass spectrometry.Methods 8-week-old spontaneous type 2 diabetic KKAy mice were randomly divided into losartan (10 mg·kg-1·d-1 given in drinking water) treatment group and non-treatment group.Eight-week-old C57BL/6 mice were used as normal control.The glomeruli were separated by magnetic bead perfusion through thoracic aorta at age of 20 weeks,then glomerular protein was extracted.The glomerular protein expression profile was investigated by CyDyes minimal fluorescence labelling,two-dimensional differential gel electrophoresis and MALDI-TOF mass spectrometry.Results KKAy mice developed higher body weight and blood glucose,higher urinary microalbumin creatinine ratio at age of 20 weeks than C57BL/6 mice at the same age (all P＜0.05).Losartan treatment markedly reduced urinary microalbumin creatinine ratio [(539.71 ±100.23)mg/g vs (728±177.19) mg/g],attenuated mesangial expansion and the thickening of glomerular basement membrane,but had no effect on the blood glucose.By DeCyder 2-D differential analysis software,62 protein spots of differential expression were found in glomeruli between losartan treatment and non-treatment KKAy mice at age of 20 weeks.Among them,41 proteins were identified by peptide mass fingerprinting.The expressions of 28 proteins were up-regulated by losartan treatment,including glycerokinase,sulfite oxidase,glycine amidinotransferase,adenosylhomocysteinase,etc.The expressions of 13proteins were down-regulaled by losartan treatment,including 3-mercaptopyruvate sulfurtransferase,ATP synthase subunit d,60 000 heat shock protein,stress-70 protein (alternative name 75 000glucose-regulated protein,GRP75),etc.Six differcntially expressed proteins were found in glomeruli between non-treatment KKAy mice and C57BL/6 mice,and the differential expressions were suppressed by losartan treatment,including dihydrolipoyllysine-residue acetyltransferase component of pyruvate dehydrogenase complex,succinyl-CoA ligase (GDP-forming) subunit beta,mitochondrial,ATP synthase subunit d,GRP75,nucleoside diphosphate-linked moiety X motif 19 and seleniumbinding protein 1.Conclusions Losartan significantly reduces the urinary protein excretion rate and renal pathological lesion of spontaneous type 2 diabetic KKAy mice,and suppresses the differential expression of mitochondrial ATP synthase subunit d,GRP75,selenium-binding protein 1,etc in glomeruli.Losartan may play a renoproteetive role by reducing glomerular mitochondrial reactive oxygen species genesis and inhibiting oxidative stress.