AIM: To evaluate the clinical outcomes and evaluate the application value of pedicle screw system internal fixation in short segment for the treatment of Hangman's fracture. METHODS: A retrospectively analysis was conducted in 17 cases of Hangman's fracture who were treated in Department of Orthopaedics, Sichuan Provincial People's Hospital since 2004. According to Levine-Edwards classification, 4 of them belonged to type II, 6 type IIA, 7 type III. According to Frankel classification in function of spinal cord, 12 cases of them belonged to Grade E and 5 cases D. All cases were fixed with C2,3 pedicle screw system short segment implantation materials (product of Medtronic Sofamor) after skull traction and reduction. RESULTS: No vertebra artery injury or spinal injury was found during operation. Postoperational photograph and CT detection revealed bilateral fracture had no reduction in 1 case and cerebrospinal fluid leaking occurred in 1 case who was cured after conventional therapy. All cases were followed up for 12-24 months (average 14.5 moths). All fractures healed within 6 months, and activities of cervical vertebra were not obviously limited. As for nerve function, 4 cases of Grade D recovered up to Grade E. Ti-alloy implant materials used in this study were well biocompatible to the human body. There were no blood, immune, histology reactions, or the corrosion and abrasion of Ti-alloy appeared. CONCLUSION: Pedicle screw fixation in short segment for the treatment of Hangman's fracture is satisfactory in fracture reduction, fixation and healing. There are little lose in function of cervical vertebrae and it promotes functional recovery of spinal cord.

Purpose To exp1ore the expression and c1inica1 significance of epiderma1 growth factor receptor( EGFR)and human epi-derma1 receptor-2(HER-2)in co1orecta1 carcinoma. Methods Immunohistochemistry(IHC)PV-9000 was used to detect the expres-sion of EGFR and HER-2 in 78 cases of co1orecta1 carcinoma. Si1ver in situ hybridization( SISH)was used to detect HER-2 amp1ifica-tion in co1orecta1 carcinoma. Results The positive rates of EGFR in 78 co1orecta1 carcinomas were 69. 23%( 54/78 ). The differ-ences of the expression of EGFR between different depth of invasion group and 1ymph node metastasis group were statistica11y signifi-cant. The differences of the expression of EGFR between different aging group,gender group,tumor size,different histo1ogica1 grading group and Dukes stage were insignificant. The positive rates of HER-2 in 78 cases of co1orecta1 carcinoma were 25. 64%(20/78). The differences of the expression of HER-2 between different depth of invasion group and 1ymph node metastasis group were statistica11y sig-nificant. The differences of the expression of HER-2 between different aging group,gender group,tumor size,histo1ogica1 grading group and Dukes stage were insignificant. The expression of EGFR and HER-2 was positive1y corre1ated. Among the 20 cases of HER-2 protein overexpression,10 cases showed HER-2 gene amp1ification,15 cases showed HER-2 protein overexpression(~)by IHC and 10 cases showed HER-2 gene amp1ification by SISH. The rate of HER-2 gene amp1ification was 66. 67%. 5 cases with 1ow HER-2 protein overexpression( +)and no case showed HER-2 gene amp1ification. Conclusions EGFR and HER-2 are high1y ex-pressed in co1orecta1 carcinoma. EGFR and HER-2 expression is connected to invasion and metastasis process of co1orecta1 carcinoma. The both may be synergy. The corre1ation between HER-2 protein overexpression(~)and HER-2 gene amp1ification is statisti-ca11y significant. Therefore,immunohistochemistry can be regarded as an initia1 screening method for HER-2 gene amp1ification,and then SISH testing shou1d be done as we11 to confirm the resu1t. It is usefu1 for mo1ecu1ar target therapy to detect HER-2 status in co1or-ecta1 carcinoma.

BACKGROUND: Posterior transarticular screw fixation (Magerl’s) is recommended for atlantoaxial instability. However,some patients do not suit for Magerl’s fixation. OBJECTIVE: To evaluate the clinical outcomes of atlantoaxial pedicle screw system in the treatment of atlantoaxial instability from odontoid fracture. DESIGN,TIME AND SETTING: The retrospective case analysis was performed at the Department of Orthopedics,Sichuan People’s Hospital between July 2004 and June 2007. PARTICIPANTS: Twenty-one cases of atlantoaxial instability from odontoid fracture were selected. According to Anderson and D’Alonzo classification,9 of them belonged to type II odontoid fracture with atlantoaxial instability and 12 to type Ⅲ with severe atlantoaxial dislocation. All cases suffered pain at occipitocervical part and limited activities of cervical spine. According to Frankel classification in function of spinal cord,16 cases of them belonged to Grade E and 5 cases to D. METHODS: All cases were fixed with C1 and C2 pedicle screws system following skull traction and reduction. MAIN OUTCOME MEASURES: Biocompatibility between materials and host; bone graft fusion and functional improvement. RESULTS: No vertebral artery injury or spinal injury was found during operation,neither incision infection was. All cases were followed up for at least 8 months. Postoperative radiograph and CT detection revealed good positions of all screws with no loosening or breakage. All fractures healed within 5 months,and activities of cervical vertebra were not obviously limited except slightly limited rotation function. As for nerve function,5 cases of Grade D recovered up to Grade E. CONCLUSION: Posterior pedicle screw fixation system exhibits no specific biocompatibility responses. It greatly improves atlantoaxial stability and promotes functional recovery of spinal cord but has little influence on cervical function.

BACKGROUND:Photoelectric navigation-aided percutaneous pedicle screw placement has been developed extensively,but its accuracy,safety and effectiveness have not yet been confirmed by evidence-based medicine.OBJECTIVE:To compare the curative efficacy of photoelectric navigation-aided percutaneous pedicle screw placement and traditional open posterior pedicle screw fixation for thoracolumbar fractures.METHODS:Sixty patients with thoracolumbar fractures were equivalently randomized to treatment and control groups and then underwent photoelectric navigation-aided percutaneous pedicle screw placement and traditional open posterior pedicle screw fixation,respectively.The perioperative indexes,imaging indexes,function recovery and incidence of complications were compared between two groups.RESULTS AND CONCLUSION:(1) The Visual Analogue Scale scores,intraoperative blood loss,radiant times,and hospitalization time in the treatment group were significantly less than those in the control group (P ＜ 0.05).(2) The operation time did not differ significantly between two groups (P ＞ 0.05).(3) The postoperative sagittal Cobb angle,and percentage of anterior height in the vertebral body in the two groups were significantly improved compared with those before surgery (P ＜ 0.05),but all above imaging indexes showed no significant differences between two groups (P ＞ 0.05).The endplate-screw angle in the treatment group was significantly less than that in the control group (P ＜ 0.05).(5) The excellent and good rate of placement in the treatment group was significantly higher than that in the control group (P ＜ 0.05).(6) These results suggest that compared with the traditional open posterior pedicle screw fixation,the photoelectric navigation-aided percutaneous pedicle screw placement exhibits high placement accuracy,less radiant times,less trauma,less blood loss and rapid functional recovery.

Objective To optimize the processing condition of the extraction of Baphicacanthis cusiae ( Nees) Bremek. roots polysaccharides ( BCP) by ultrasound technology, and to provide the basis for the further development and study of BCP. Methods The extraction temperature, extraction time, liquid-solid ratio were used as the influence factors, and the yield of polysaccharides from Baphicacanthis cusiae roots was used as the evaluation index. On the basis of single-factor test, 3-factor and 3-level Box-Behnken test was designed for quadratic polynomial regression equation of the yield of polysaccharides. And then the response surface methodology was used for the optimization of process condition. Results The optimum extraction condition was as follows: extraction temperature was 60℃, extraction time was 35 min, and liquid-solid ratio was 24.5∶1 (V∶m, mL·g-1). Under the optimal condition, the yield of polysaccharides was 83.7 mg·g-1. Conclusion The method is simple, rapid and highly efficient, which will provide experimental basis for the development and application of Baphicacanthis cusiae roots polysaccharides.

Abstract: Objective　To evaluate the completion and final effect of key parasitic disease prevention and control planning tasks in Hubei Province from 2016 to 2019, summarize the experience, find out the problems, and provide the basis for the next stage of prevention and control. Methods　According to the requirements of the Final Evaluation Plan of the National Plan for the Prevention and Control of Hydatid Disease and Other Major Parasitic Diseases (2016-2020), a retrospective survey method was adopted to collect relevant data on the implementation and safeguard measures of the prevention and control of major parasitic diseases, and population infection status in Hubei Province in 2016-2019. Results From 2016 to 2019, We carried out 2 920 992 person times of publicity and education, 209 times of prevention and control technology training, 7 680 person times of business training, with an average of 52 sessions and 1 920 person times per year. We have allocated 3.445 2 million yuan for the prevention and control of parasitic diseases, including 1.722 2 million Yuan froom provincial government, to achieved full coverage of safe drinking water in rural areas under the current national standards, and 7.687 9 million harmless toilets have been built in rural areas. From 2016 to 2019, we carried out 39 658 person times of monitoring and disease investigation, the infection rate of human liver fluke was 0, and the infection rate of soil transmitted nematode was 0.42%. While the annual infection rates varied, there was no statistically significant difference in infection rate between years (χ2＝2.276, P>0.05), but there were statistically significant differences in the infection rates between various soil nematodes (χ2=112.807, P<0.01). From 2016 to 2019, a total of 5 393 people were detected at 17 monitoring points, with the serum positive rate of 3.93% for paragonimiasis, there was a statistically significant difference in serological positive rate between years (χ2=146.011, P<0.01); a total of 738 stream crabs were collected, and the infection rate of intermediate host was 16.26%, wtih a statistically significant difference in the infection rate of stream crabs between years (χ2=49.731, P<0.01). Conclusions　From 2016 to 2019, we adhered to the prevention and control strategy of "prevention first, prevention and control combined", implemented comprehensively various prevention and control measures, and achieved remarkable results in Hubei Province. The key parasitic diseases have been in a low epidemic situation, meeting the requirements of the prevention and control objectives. But the transmission risk still exists, the next step is to continue to strengthen security and monitoring and consolidate the achievements of prevention and control.

Abstract: Objective　To collect and organize malaria case data in Hubei Province from 2017 to 2021, compare and analyze the malaria epidemic characteristics on the before and after malaria elimination, and provide scientific support for Hubei Province to further optimize the comprehensive strategies to prevent re-transmission after the elimination of malaria. Methods The study was conducted by collecting the data of reported malaria cases of Hubei during 2017-2021 from the Infectious Disease Surveillance Reporting and Management System, and conducting the epidemiological characteristics of malaria on pre-elimination (2017-2019) and post-elimination (2020-2021). Results A total of 429 cases of imported malaria were reported in Hubei Province from 2017 to 2021, and the malaria epidemic showed an obvious trend of rising first and then falling. On the pre-malaria elimination, 374 malaria cases were reported, including 262 cases of P.falciparum (70.05%); on the post-malaria elimination, 55 malaria cases were reported, including 25 cases of P.falciparum (45.45%). There was a statistically significant difference in the proportion of infections caused by the four types of malaria parasites before and after the elimination of malaria (χ2=14.248, P<0.05). On the pre-malaria elimination, the peak of disease onset mainly occurred in January, July, and November; on the post-malaria elimination, the peak of disease onset mainly occurred in January to February, and December. Both before and after malaria elimination, the reported cases were mainly concentrated in Wuhan, Yichang, Huangshi, Xiangyang, Shiyan and Huanggang, but the range of cases showed a clear trend of narrowing. Before and after malaria elimination, malaria cases in Hubei Province were mainly among young and middle-aged males aged 30-49. The proportions of workers and migrant workers increased from 37.70% and 9.09% before the elimination to 50.91% and 18.18% after the elimination, respectively, with a statistically significant difference (χ2=17.839, P<0.05). The percentage of interval from onset of illness to initial diagnosis ≥ 5d decreased from 21.66% before the elimination to 10.91% after the elimination (χ2=6.448, P<0.05). The percentage of definitive diagnosis of malaria at initial diagnosis in town clinic increased from 18.18% before the elimination to 50.00% after the elimination. The proportion of malaria cases diagnosed by county-level medical institutions increased from 22.73% before the elimination to 34.55% after elimination. There was no statistically significant difference in the proportion of malaria cases diagnosed by medical institutions at all levels before and after the elimination of malaria (χ2=5.630, P>0.05). The proportion of cases with the interval between initial diagnosis and diagnosis within 24h increased from 43.85% before the elimination to 70.91% after the elimination. There was a statistically significant difference in the proportion of cases with the interval between initial diagnosis and diagnosis before and after the elimination of malaria (χ2=14.006, P<0.05). Before and after malaria elimination, all reported cases were mainly imported from African countries. Conclusions There are imported malaria cases reported every year in Hubei Province before and after the elimination of malaria, which poses a great challenge to the prevention of re-transmission. Therefore, it is necessary to strengthen the surveillance system, detect and standardize the treatment of imported malaria cases in a timely manner, conduct targeted retransmission risk surveys and assessments, and consolidate the achievements of malaria elimination.

OBJECTIVETo observe the effect of immediate topical application of chitosan on preventing anterior glottic stenosis (AGS) after microsurgical resection of both vocal fold with CO2 laser, including the anterior commissure, in a canine model.

METHODSSixteen canine larynges were injured by microresecting procedure of both vocal folds with CO2 laser. The dogs were randomly divided into two groups, chitosan group and control group. The chitosan and isotonic sodium chloride solution (control) were used for 5 minutes immediately after surgery. One week after the initial surgery, three dogs in each group were randomly selected , ultrastructure of fibroblast were examined with transmission electronic microscope and expression of basic fibroblast growth factor (bFGF) and transforming growth factor beta1 (TGF-beta1) were evaluated by enzyme-linked immunosorbent assay (ELISA). Three weeks after surgery, the rest dogs' glottic web were lysed and repeatedly treated with chitosan and isotonic sodium chloride solution respectively. The glottic wound healing and AGS formation were examined every week, and all larynges were harvested and examined histologically six weeks after the initial surgery.

RESULTSTransmission electronic microscope examination of the ultrastructure of fibroblast indicated that chitosan inhibited the proliferation of fibroblast. Chitosan increased the expression of bFGF and TGF-beta1, and bFGF and TGF-beta1 in chitosan group, which was significantly higher than that in control group (z=-2.887 and -2.005, P=0.002 and 0.041). Chitosan decreased the extent of AGS formation. Three weeks after the surgery, the AGS lesion in the control group affected mean 49% of the length of the vocal folds from the anterior commissure to the vocal process, while chitosan group affected mean 7%, which was significantly less than the extent of web formation in the control group, (z=-2.619, P=0.008). The grade of collagen content in chitosan group was significantly lower than that in control group (P=0.003).

CONCLUSIONChitosan is effective in preventing AGS after CO2 laser cordectomy.

Animals ; Cell Proliferation ; Chitosan ; pharmacology ; therapeutic use ; Constriction, Pathologic ; prevention & control ; Dogs ; Fibroblast Growth Factor 2 ; metabolism ; Fibroblasts ; ultrastructure ; Lasers, Gas ; adverse effects ; Male ; Postoperative Complications ; prevention & control ; Transforming Growth Factor beta1 ; metabolism ; Vocal Cords ; drug effects ; pathology

OBJECTIVETo investigate the correlation between nonalcoholic fatty liver disease (NAFLD) and three anthropometric indices, namely waist to hip ratio (WHR), body mass index (BMI) and waist to height ratio (WHtR).

METHODSThis retrospective case-control study involved 77 NAFLD patients and 50 patients without such disease, and their data of the 3 anthropometric indices were collected. Risk correlation analysis and Mantel-Haenszel chi-square test were used for correlation analysis.

RESULTSNAFLD was significantly correlated to WHR (chi(2)(MH)=59.609, P<0.001; odds ratio=30.522, 95% CI 12.815-72.695), WHtR (chi(2)(MH)=45.316, P<0.001; odds ratio=21.037, 95% CI 8.665-51.072) and showed a dose-response relationship with BMI (chi(2)=25.017, P<0.001).

CONCLUSIONThese results support a close correlation between NAFLD and the 3 anthropometric indices, indicating that BMI, WHR and WHtR can be significant predictors of NAFLD and have potential value for evaluating and predicting NAFLD.

Adolescent ; Adult ; Anthropometry ; Body Constitution ; Body Height ; Body Mass Index ; Case-Control Studies ; Fatty Liver ; diagnosis ; Female ; Humans ; Male ; Middle Aged ; Non-alcoholic Fatty Liver Disease ; Retrospective Studies ; Waist Circumference ; Waist-Hip Ratio ; Young Adult

This paper was designed to observe the colocalization of 11beta-HSD1 and GR, and its significance in the rat hippocampus. Immunocytochemical dual-staining showed that not only 11beta-HSD1 but also GR immunoreactive substances were present in the cultured rat hippocampal neurons. Moreover, they were colocalized in the same hippocampal neuron. Synthetic glucocorticoid dexamethasone (DEX) up-regulated the protein expression and activity of 11beta-HSD1 in the cultured hippocampal neurons, as determined by Western blot and thin layer chromatography (TLC) respectively. The transfection of PC12 cells with the plasmid containing promoter sequence of 11beta-HSD1 gene and the reporter gene of CAT enzyme was conducted. DEX up-regulated the reporter gene expression in the system described above. The up-regulation of 11beta-HSD1 and reporter gene expression induced by DEX were both blocked by GR antagonist RU38486. Our study suggests that the colocalization of 11beta-HSD1 and GR in the hippocampus may be implicated in the up-regulation of 11beta-HSD1 expression by glucocorticoids combining to its promoter region, which in turn produces more biologically active glucocorticoids necessary for the binding of low affinity of GR.
11-beta-Hydroxysteroid Dehydrogenases ; genetics ; metabolism ; Animals ; Animals, Newborn ; Dexamethasone ; pharmacology ; Gene Expression Regulation ; Hippocampus ; cytology ; metabolism ; Mifepristone ; pharmacology ; Neurons ; chemistry ; metabolism ; PC12 Cells ; Promoter Regions, Genetic ; Rats ; Receptors, Glucocorticoid ; genetics ; metabolism ; Transfection