Objective To investigate the characteristics and influencing factors leading to sudden cardiac death (SCD) of incarcerated prisoners. Methods Seventy-five SCD cases of prisoners between 2000 and 2013 in Henan province were collected, and environment, psychological and physical factors were retro-spectively analyzed. Combined with histopathological results, specific factors of SCD were also studied. Results In the 75 cases, 21 cases (28%) had definite chronic past medical histories, and 75 cases (100%) had cardiovascular disease confirmed by autopsy. Conclusion Due to presence of the potential cardiac diseases, special incarcerated environment, psychological stress, and body-restraint might be the precipitat-ing factors in SCD of those prisoners.

Objective To explore the fixed-effects of the treatment using transarticular screw joint lateral mass screw unilateral bi-direction fixation through posterior midline approach.Methods 16 patients,12 patients with traumatic fracture-dislocation and 4 patients with cervical disc herniation with spinal stenosis,were treated with transarticular screw(caudad) joint lateral mass screw (cephalad)unilateral bi-direction fixation in the posterior cervical.Results 32 transarticular screws were implanted,including C4-5 8 pieces,C5-6 12 pieces,C6-7 12 pieces;36 lateral mass screws were implanted,including C2 13 pieces,C3 14 pieces,C4 9 pieces.All screws were successfully implanted in operation,without injuries and other complications in vertebral artery,nerve root and spinal cord.16patients were followed up for averaged 18 months ( 10 - 30 months).Surgical incisions reduced by half than traditional ,fusion time were 2.0 to 4.5 months for an average of 3.1 months.Conclusions When through theposterior fixed cervical spine,used transarticular screw joint lateral mass screw unilateral bi-direction fixation,fixed simply and reliably,reduced internal fixation materials for implantation,reduced operative time,increased bone bed area,the bone fusion rate was high,reduced the length of surgical incision,reduced the blood vessels,nerve root injury risk ,reduced complications such as axial symptoms ,saved medical expenses,achieved good results.

OBJECTIVETo investigate the expression of osteopontin (OPN) splice variant mRNA, including the three isoforms OPN-A, OPN-B, and OPN-C, to explore its correlation with clinicopathologic features in gastric cancer, and to elucidate their role in tumor invasion and distant metastasis of gastric cancer.

METHODSThe expression of OPN-A, OPN-B and OPN-C mRNA were detected by real-time reverse transcriptase-polymerase chain reaction in 66 gastric cancer tissues. The relationship between the expression of OPN-A, OPN-B and OPN-C mRNA and clinicopathologic features of gastric cancer was analyzed.

RESULTSThe expression of OPN-C mRNA in the gastric cancer tissue was 3.21-fold higher than that in peritumoral mucosal tissue, showing a significant difference between them (P < 0.001). OPN-C mRNA expression was correlated with the depth of tumor invasion, tumor diameter, lymph node meatastasis, distant meatastasis and had no correlation with differentiation grades. The low expression of OPN-C mRNA was correlated with long survival benefit (P = 0.03). The expression of OPN-A and OPN-B mRNA had no significant relationship with clinicopathologic features of gastric cancer.

CONCLUSIONSOne of the isoform of osteopontin (OPN) OPN-C mRNA is overexpressed in gastric cancer. The overexpression of OPN-C mRNA may reflect the progression and is associated with the prognosis of gastric cancer. OPN-C mRNA may have value as a prognostic biomarker in gastric cancer. However, the expression of OPN-A and OPN-B are not correlated with the progression and metastasis of gastric cancer.

Disease Progression ; Gastric Mucosa ; metabolism ; Humans ; Lymph Nodes ; Lymphatic Metastasis ; Neoplasm Invasiveness ; Neoplasm Proteins ; genetics ; Osteopontin ; genetics ; Prognosis ; Protein Isoforms ; genetics ; RNA, Messenger ; metabolism ; Real-Time Polymerase Chain Reaction ; Stomach Neoplasms ; genetics ; mortality ; pathology

Objective To investigate the expression of osteopontin ( OPN) splice variant mRNA, including the three isoforms OPN?A, OPN?B, and OPN?C, to explore its correlation with clinicopathologic features in gastric cancer, and to elucidate their role in tumor invasion and distant metastasis of gastric cancer. Methods The expression of OPN?A, OPN?B and OPN?C mRNA were detected by real?time reverse transcriptase?polymerase chain reaction in 66 gastric cancer tissues. The relationship between the expression of OPN?A, OPN?B and OPN?C mRNA and clinicopathologic features of gastric cancer was analyzed. Results The expression of OPN?C mRNA in the gastric cancer tissue was 3. 21?fold higher than that in peritumoral mucosal tissue, showing a significant difference between them (P<0.001). OPN?C mRNA expression was correlated with the depth of tumor invasion, tumor diameter, lymph node meatastasis, distant meatastasis and had no correlation with differentiation grades. The low expression of OPN?C mRNA was correlated with long survival benefit ( P=0.03) . The expression of OPN?A and OPN?B mRNA had no significant relationship with clinicopathologic features of gastric cancer. Conclusions One of the isoform of osteopontin ( OPN) OPN?C mRNA is overexpressed in gastric cancer. The overexpression of OPN?C mRNA may reflect the progression and is associated with the prognosis of gastric cancer. OPN?C mRNA may have value as a prognostic biomarker in gastric cancer. However, the expression of OPN?A and OPN?B are not correlated with the progression and metastasis of gastric cancer.

Objective To investigate the expression of osteopontin ( OPN) splice variant mRNA, including the three isoforms OPN?A, OPN?B, and OPN?C, to explore its correlation with clinicopathologic features in gastric cancer, and to elucidate their role in tumor invasion and distant metastasis of gastric cancer. Methods The expression of OPN?A, OPN?B and OPN?C mRNA were detected by real?time reverse transcriptase?polymerase chain reaction in 66 gastric cancer tissues. The relationship between the expression of OPN?A, OPN?B and OPN?C mRNA and clinicopathologic features of gastric cancer was analyzed. Results The expression of OPN?C mRNA in the gastric cancer tissue was 3. 21?fold higher than that in peritumoral mucosal tissue, showing a significant difference between them (P<0.001). OPN?C mRNA expression was correlated with the depth of tumor invasion, tumor diameter, lymph node meatastasis, distant meatastasis and had no correlation with differentiation grades. The low expression of OPN?C mRNA was correlated with long survival benefit ( P=0.03) . The expression of OPN?A and OPN?B mRNA had no significant relationship with clinicopathologic features of gastric cancer. Conclusions One of the isoform of osteopontin ( OPN) OPN?C mRNA is overexpressed in gastric cancer. The overexpression of OPN?C mRNA may reflect the progression and is associated with the prognosis of gastric cancer. OPN?C mRNA may have value as a prognostic biomarker in gastric cancer. However, the expression of OPN?A and OPN?B are not correlated with the progression and metastasis of gastric cancer.

Objective:To investigate the influencing factors, periprocedural complications, and long-term outcomes of successful recanalization after endovascular treatment in patients with non-acute symptomatic internal carotid artery occlusion.Methods:Patients with non-acute internal carotid artery occlusion received endovascular treatment in the Nanjing Stroke Registration System between January 2010 and December 2021 were retrospectively enrolled. Clinical endpoint events were defined as successful vascular recanalization, periprocedural complications (symptomatic embolism and symptomatic intracranial hemorrhage), neurological function improvement, and recurrence of ipsilateral ischemic events. Multivariate logistic regression analysis was used to investigate the independent influencing factors of successful vascular recanalization. Cox proportional hazards regression analysis was used to investigate the correlation between endovascular treatment outcomes and neurological function improvement, as well as ipsilateral ischemic cerebrovascular events. Results:A total of 296 patients were included, of which 190 (64.2%) were successfully recanalized. Multivariate logistic regression analysis showed that symptoms manifest as ischemic stroke (odds ratio [ OR] 3.353, 95% confidence interval [ CI] 1.399-8.038; P=0.007), the time from the most recent symptom onset to endovascular therapy within 1 to 30 d ( OR 2.327, 95% CI 1.271-4.261; P=0.006), proximal conical residual cavity ( OR 2.853, 95% CI 1.242-6.552; P=0.013) and focal occlusion (C1-C2: OR 3.255, 95% CI 1.296-8.027, P=0.012; C6/C7: OR 5.079, 95% CI 1.334-19.334; P=0.017) were the independent influencing factors for successful vascular recanalization. Successful recanalization did not increase the risk of symptomatic intracranial hemorrhage within 7 d after procedure (3.2% vs. 0.9%; P=0.428). The median follow-up time after procedure was 38 months. Cox proportional hazards regression analysis showed that after adjusting for confounding factors, successful recanalization was significantly associated with postprocedural neurological improvement (hazard ratio 1.608, 95% CI 1.091-2.371; P=0.017), and significantly reduced the risk of recurrence of long-term ischemic events (hazard ratio 0.351, 95% CI 0.162-0.773; P=0.010). Conclusion:In patients with non-acute internal carotid artery occlusion, successful endovascular recanalization can effectively reduce the risk of long-term ischemic events without increasing the risk of symptomatic intracranial hemorrhage.

Objective:To investigate predictive factors for successful endovascular recanalization in patients with non-acute symptomatic internal carotid artery occlusion (SICAO), to develop a decision tree model using the Classification and Regression Tree (CART) algorithm, and to evaluate the predictive performance of the model.Methods:Patients with non-acute SICAO received endovascular therapy at 8 comprehensive stroke centers in China were included retrospectively. They were randomly assigned to a training set and a validation set. In the training set, the least absolute shrinkage and selection operator (LASSO) algorithm was used to screen important variables, and a decision tree prediction model was constructed based on CART algorithm. The model was evaluated using the receiver operating characteristic (ROC) curve, Hosmer-Lemeshow goodness-of-fit test and confusion matrix in the validation set.Results:A total of 511 patients with non-acute SICAO were included. They were randomly divided into a training set ( n=357) and a validation set ( n=154) in a 7:3 ratio. The successful recanalization rates after endovascular therapy were 58.8% and 58.4%, respectively. There was no statistically significant difference ( χ2=0.007, P=0.936). A CART decision tree model consisting of 5 variables, 5 layers and 9 classification rules was constructed using the six non-zero-coefficient variables selected by LASSO regression. The predictive factors for successful recanalization included fewer occluded segments, proximal tapered stump, ASITN/SIR collateral grading of 1-2, ischemic stroke, and a recent event to endovascular therapy time of 1-30 d. ROC analysis showed that the area under curve of the decision tree model in the training set was 0.810 (95% confidence interval 0.764-0.857), and the optimal cut-off value for predicting successful recanalization was 0.71. The area under curve in the validation set was 0.763 (95% confidence interval 0.687-0.839). The accuracy was 70.1%, precision was 81.4%, sensitivity was 63.3%, and specificity was 79.7%. The Hosmer-Lemeshow test in both groups showed P>0.05. Conclusion:Based on the type of ischemic event, the time from the latest event to endovascular therapy, proximal stump morphology, the number of occluded segments, and the ASITN/SIR collateral grading constructed the decision tree model can effectively predict successful recanalization after non-acute SICAO endovascular therapy.

Objective To investigate the value of navigated transcranial magnetic stimulation (nTMS) in preoperative evaluation of epilepsy in functional zones.Methods Retrospective analysis was performed in 12 refractory epilepsy patients had functional cortical lesions and accepted surgery in our hospital from January 2016 to March 2017.The target surgery areas were considered in or near the functional areas by video electroencephalogram and stereotactic electroencephalography or Wada test,nTMS was used to identify the motor or language functional areas before surgery,and direct cortical stimulation (DCS) was performed during the surgery to identify the accuracy of nTMS.Treatment efficacies were evaluated 6-18 months after surgery.Results Hand motor areas were detected in all patients by nTMS,of which 72.7％ patients (8/11,one severe hemispheric atrophy patient was excluded due to functional zone drift to the opposite) were coincided with intraoperative DCS (＜0.5 cm),the deviation distance between 0.5 cm and 1 cm was noted in 27.3％ patients (3/11);motor speech areas were detected in 11 patients with nTMS,72.7％ patients (8/11) were coincided with intraoperative DCS (＜0.5 cm),the deviation distance between 0.5 cm and 1 cm was noted in 27.3％ patients (3/11),18.2％ patients (2/11) were for adjacent relationship,and one was with large difference (＞1.5 cm).And 8 patients had Engel grading Ⅰ outcome (seizure-free),2 had grading Ⅱ outcome (almost seizure-free),and one had grading Ⅲ outcome (worthwhile improvement).No persistent function deficits were noted.Conclusion The nTMS is an accurate,noninvasive and safe functional localization method,which can provide important information for epilepsy patients especially who are not suitable for invasive language evaluation in epilepsy surgery.

Objective:To investigate the clinical outcome of endovascular treatment vs. drug treatment in patients with symptomatic non-acute long-segment occlusion of the internal carotid artery. Methods:Based on prospective cohort registration research data, patients with symptomatic non-acute long-segment occlusion of internal carotid artery were retrospectively included. They were divided into a drug treatment group and an endovascular treatment group according to the actual treatment received. The latter was further divided into a successful recanalization group and an unsuccessful recanalization group. The endpoint events included ipsilateral ischemic stroke, any stroke, and all-cause death. Multivariate logistic regression analysis was used to compare the endpoint events between groups during the perioprocedural period (within 30 days), and multivariate Cox proportional hazards model was use to compare the endpoint events between the groups during the long-term follow-up. Results:A total of 684 patients were included, of which 570 (83.33%) were male, median aged 63 years (interquartile range, 56-70 years). Three hundred and fifty-three patients (51.6%) received drug treatment; 331 (48.4%) received endovascular treatment, of which 161 (48.6%) had successful recanalization. The median follow-up time was 1 223 days (interquartile range, 646.5-2 082 days), with 109 patients (15.9%) experiencing stroke recurrence events (including 87 ipsilateral ischemic stroke) and 78 (11.4%) experiencing all-cause mortality. The risk of any stroke during the perioprocedural period in the successful recanalization group was significantly higher than that in the drug treatment group (odds ratio 3.679, 95% confidence interval 1.038-13.036; P=0.044), but the risk of ipsilateral ischemic stroke recurrence (risk ratio 0.347, 95% confidence interval 0.152-0.791; P=0.012) and all-cause mortality (risk ratio 0.239, 95% confidence interval 0.093-0.618; P=0.003) during the long-term follow-up were significantly lower than those in the drug treatment group. Conclusions:In patients with symptomatic non-acute long-segment occlusion of the internal carotid artery, endovascular treatment can increase the risk of stroke recurrence within 30 days, but successful recanalization can reduce the risks of long-term ipsilateral ischemic stroke recurrence and all-cause mortality.