Objective To evaluate the value of serum granulocyte colony-stimulating factor(G-CSF),interlukin-8(IL-8)and white blood cell count(WBC)in detecting acute surgical bacterial infections.Methods A total of 36 patients with infections and 32 with traumatic diseases admitted in Beijing Tongren Hospital without use of antibiotics before admission were recruited,as well as 30 normal healthy controls.Three milliliters of peripheral blood were collected from each of them.Serum G-CSF and IL-8 were measured by enzyme-linked immunosorbent assay(ELISA).Results Of all the 68 patients,serum G-CSF Was(82±71)ng/L in average in those with infections,significantly higher than that in those with trauma(15±7)ng/L(P＜0.01)and controls(7±4)ng/L(P＜0.01).Conclusions Serum G-CSF may be used as a sensitive indicator for acute surgical bacterial infections.

Objective To observe the effect of acupoint-injection on vascular dementia. Methods 1 ml of cytidine diphosphocholine was injected into Baihui ( GV 20) and Fengchi (GB 20, bilateral) respectively. 234 patients were treated. Results and conclusion: 49 cases were cured, 150 cases got improve, 35 cases had ineffectiveness, the total utility rate was 85.0%, so acupoint-injecting cytidine diphosphocholine is a utility method healing vascular dementia.

BACKGROUND: Stellate ganglion block (SGB) has become a technique frequently used in the field of pain management for its wide indication spectrum. Its ameliorative effect on cephal-facial pain may be achieved by regulating the cerebrovascular diastolic and systolic functions and intensifying cerebral perfusion.OBJECTIVE: To observe the influence of SGB on the blood velocity of anterior cerebral artery (ACA), middle cerebral artery (MCA), posterior cerebral artery (PCA) and vertebral artery with three-dimensional transcranial Doppler (TCD) in patients with caphal-facial diseases caused by is chemia or vascular spasm.DESIGN: A before-after control observation.SETTINGS: Department of Pain Management, Guizhou Provincial Orthopaedic Hospital; Department of Anesthesiology, the First Affiliated Hospital of Guangzhou Medical College; Department of Anesthesiology, the Second Affiliated Hospital of Sun Yat-sen University.PARTICIPANTS: Twenty patients of 18-50 years old were selected from the Department of Pain Management of Guizhou Provincial Orthopaedic Hospital from March 2004 to December 2005, including 6 cases of migraine,3 of cluster headache, 4 of muscle tension-type headache, 2 of nervous tinnitus and earache, and 5 of derangement of temporomandibular joint.METHODS: Unilateral SGB was performed by means of paratracheal anterior technique, with the following compound prescription: lidocaine (20 g/L)2.5 mL and dexamethasone 1 mg in normal saline with a total volume of 10 mL. SGB was performed once a day for 7 consecutive days as one course.MAIN OUTCOME MEASURES: The changes of blood velocity of ACA,MCA, PCA and vertebral artery were observed with three-dimensional TCD before SGB and at 30 minutes after SGB.RESULTS: All the 20 patients finished the treatment and entered the analysis of results. After treatment, the blood velocities of ACA, MCA and PCA of the blocked side were increased remarkably as compared with those before treatment [(76.20±3.83), (61.95±2.50) cm/s; (83.65±2.36),(77.55±2.69) em/s; (65.20±2.99), (58.70±2.2.35) cm/s; P ＜ 0.01], but that of vertebral artery had no significant change before and after treatment [(47.20±2.04), (45.55±2.23) cm/s, P ＞ 0.05]. CONCLUSION: The blood velocities of the blocked side are obviously increased after treatmeut, the increased blood velocities of ACA, MCA and PCA have important clinical significance for the blood supply of cerebral hemisphere, especially the anterior 2/3 part, but had little great influence on vertebral artery, indicating that SGB has great pertinence to the caphalfacial diseases caused by ischemia or vascular spasm, and can ameliorate the cerebral blood perfusion.

BACKGROUND: Endothelial cell structural and functional integrity is importnat decisive fatcor for ischemic time-window and hemorragic transformation follwing brain ischemic injury.OBJECTIVE: To investiagte the endotheliocyt endurance to various course of ischemic injury basing on dynamical observation of morphological and ultrastructural changes of endotheliocyte during IR injury.DESIGN: Randomized controlled experiment.SETTING:Neurological Internal Department of the Second Affiliated Hospital of Jinan University.MATERIALS: This experiment was carried out in the Animal Experimental Laboratory of the Second Affiliated Hospital of Jinan University from March 1998 to March 1999. Totally 53 SD rats were randomly dihours of 6 rats.METHODS: Thread-bolt occlusion method was used to establish focal brain ischemia model on rats. Brain tissue was evenly cut into five coronary segments: namely A, B, C, D and E, segments C underwent TTC staining for marginal region location. segments D was taken for routine dehydration, transparency, envelop, slice and HE staining,optical microscopic observation. Ischemic surrounding area and central brain tissues was obtained from slice B, fixed and enveloped before cutting into ultrathin slices that was observed under transmission electron microscope.the occurring time of hemorrhagic infarction at different ischemic time cell vacuolization degree in foot process layer at different ischemic time points.RESULTS: Totally 53 rats were enrolled in this experiment and all data was entered into results analysis. Under optical microscope: Neuropil loose and small vascular surrounding edema was observed at ischemia 3 hours.Small arterial broken and hemorrhage occurred at ischemia 12 hours reperfusion 3 hours. Under electron microscope: Capillary endothelial nuclear swelling was observed at ischemia 3 hours, with cytoplasmic pinocytosi increasing and vacuolization in foot process layer appearing+; At ischemia 3 hours reperfusion 3 hours, the foot process layer vacuolization in center area was (++) and (+++) in marginal area; while at ischemia 6 hours reperfusion 3 hours, endothelia tight junction opened and vacuolization in foot process layer was (+++); pinocytosis was found obviously reduced after ischemia 12 hours reperfusion 3 hours, mitochondrial swelling was seldom observed, but tight junction increasingly opened and vacuolization in foot process layer appeared (+++) - (++++).CONCLUSION: Obvious structural changes of endotheliocyte appeared in post-ischemia 3 hours, endotheliocyte tight junction openning was observed at ischemia 6 hours, and hemorrage transformation occurred after ischemia 12 hours, mainly at the post-reperfusional ischemia center.

Objective To discuss the clinical and radiological features of congenital absence of the internal carotid artery.Methods Four patients of the congenital absence of the internal carotid artery were reported and the clinical and radiological features were summarized by a review of the literature.Results Four patients were shown subarachnoid hemorrhage ( SAH) , transient ischemic attack ( TIA) , epilepsy and headache, respectively.All of the four patients presented the absence of unilateral or bilateral carotid arteries in cervical computed tomography angiography ( CTA) or magnetic resonance angiography ( MRA).Carotid canal was absent in all the patients in CT base of skull and multiple intracranial vascular dysplasia was shown in all the patients.Basilar or posterior communicating artery was presented as dolichoectasia in 3 patients.There were 2 patients who suffered aneurysm.Conclusions The onset of the congenital absence of the internal carotid artery can be presented in any age.Sudden severe headache as initial symptom caused by SAH is showed more common in children and adolescents.TIA is commonly seen in the elderly.CT shows carotid canals are absent in the base of skull.Unilateral or bilateral carotid arteries are shown absent in CTA or MRA.Multiple intracranial vascular dysplasia is shown in CTA or MRA.Carotid artery CTA has been considered as the optimal imaging method of showing the congenital absence of the internal carotid artery.

BACKGROUND:Due to the importance of pedicle adjacent structures, once the screw replacement appears a deviation, adjacent structures may be damaged, leading to extremely serious consequences. Although the security of screw placement in thoracic vertebral pedicle-rib complex is significantly greater than that of pedicle screws, the mechanics of the pedicle-rib complex at different cross-sectional areas of the screw are rarely reported.
OBJECTIVE:To observe mechanical property of different cross-sectional area screws in the middle and upper thoracic vertebral pedicle-rib complex.
METHODS:Five specimens of adult cadaveric thoracic spine (T 1-T 10 ) and adjacent rib segment (50-60 mm long) were used. The bone density of specimens was measured using difunctional bone density testing machine, and osteoporotic vertebral body was excluded. The position of the screws was detected with CT images. The maximal withdrawal force of the pedicle screw was measured with biomechanical force test machine.
RESULTS AND CONCLUSION:Thirty-eight specimens at normal bone density were implanted with 25 screws (5.5 mm), 25 screws (6.0 mm) and 26 screws (6.5 mm). Because the pedicle screws destroyed the pedicle-rib complex and perforated the vertebral body, we final y obtained the withdrawal force of 68 screws. The axial withdrawal force of pedicle screws at different diameters was (812.36±147.22) N, (868.64±160.48) N and (946.48±157.58) N, respectively. There were significant differences between the 5.5 mm screws and the 6.5 mm screws (P<0.05). Experimental findings indicate that, the pedicle screws (diameter>5.5 mm) are suitable in the middle and upper thoracic vertebral pedicle-rib complex due to strong internal fixation and clinical requirement.

Objective To explore the clinical efficacy of motor imagery therapy in treating neurogenic bladder dysfunction after traumatic spinal cord injury (SCI).Methods Seventy patients with neurogenic bladder control problems after SCI were randomly divided into an experimental group and a control group using a random number table.All patients of the two groups were given general bladder function intervention,including intermittent catheterization,inducing voiding by reflex detrusor contraction,Credé's maneuver urination,etc.Additionally,the patients in the experimental group were given supplemental motor imagery therapy.The times of urinary incontinence,average bladder capacity,maximum voided volume and residual urine volume of the two groups were measured before treatment and at 2 months after treatment.The two groups' outcomes were quantified using a quality of life (QOL) score.Results Incidents of urinary incontinence,average bladder capacity,residual urine volume,voided volume and the QOL score showed significant improvements in both groups,but the experimental group showed better improvements than the control group.The differences were statistically significant.Conclusion The combination of general bladder function intervention with motor imagery therapy can improve the voiding function of patients with neurogenic bladder disorders after SCI more significantly and enhance their QOL.

[Objective] To investigate the effect of mitogen-activated protein kinases (MAPK) on cerebral ischemia induced by photothrombosis in Swedish amyloid precursor protein (APP/SWE) transgenic mice.[Methods] In APP/SWE transgenic mice and non-transgenic mice (n ＝ 12,respectively),photothrombotic stroke was induced,on 7 d after cerebral ischemia,the amount of the survival neuron in the penumbra was counted using Nissl staining (n ＝ 6),and the activities of p38MAPK and JNK were measured by Western blot (n ＝ 6).[Results] On 7 d after cerebral ischemia,ratio of amount of survival neuron over the penumbra in hippocampus in the ischemic side to that in the non-ischemic side in the non-transgenic mice group (78.3 ± 1.3)% was significantly higher than that in the APP/SWE transgenic mice group (70.5 ± 1.4)% (P ＜ 0.05);compared with the non-ischemic hemisphere,the activities of p38 MAPK and JNK increased significantly in the ischemic hemisphere in the APP/SWE transgenic mice group (P ＜ 0.05),whereas,there was no significant difference between ischemic and non-ischemic hemisphere in the non-transgenic mice group (P ＞ 0.05).[Conclusion] Photothrombosis causes more severe damage in the APP/SWE transgenic mice group than that in the non-transgenic mice group.The possible mechanism includes the increased activities of MAPK which enhance the process of neuronal cell apoptosis.

Objective:This study aimed to establish an eXtreme Gradient Boosting(XGBoost) model that can predict the recurrence of hepatocellular carcinoma(HCC)patients after laparoscopic hepatectomy (LH) surgery.Methods:A total of 440 patients with primary HCC who received LH treatment for the first time from January 2013 to September 2016 in Affiliated Hospital of Chengde Medical University were selected as the research objects. The diagnosis method was pathological diagnosis. Research objects were divided into training group ( n=88) and verification group ( n=352) at a ratio of 2∶8 by random number table method. The Kaplan-Meier method was used to draw the recurrence-free survival curve, and the Log-rank test was used to compare the survival of the two groups; the training group was used to establish the COX regression model and the XGBoost model to screen independent predictors of recurrence after LH; receiver operating characteristic(ROC) curve was used to analyze the predictive abilities of the two models, and conducted internal verification in the verification group; Hosmer and Lemeshow Test was used to evaluate the calibration of the two models, and P>0.05 was used as a good fit between the model and the actual situation. Results:Both the COX regression model and the XGBoost model screened out tumor thrombus, low degree of differentiation, tumor microvascular infiltration (MVI), number of tumors, large tumors, and positive hepatitis B surface antigen were independent predictors of tumor recurrence( HR=2.477, 0.769, 1.786, 1.905, 1.544, 1.805; 95% CI: 1.465-4.251, 0.619-0.819, 1.263-2.546, 1.354-2.704, 1.272-1.816, 1.055-2.555). The XGboost model scores were 32 points, 29 points, 24 points, 18 points, 16 points, 11 points, respectively. In the training group, the area under the curve (AUC) of the COX regression model and XGBoost model for predicting recurrence were 0.746 (0.730-0.762) and 0.802 (0.785-0.818), respectively. The XGBoost model had strong predictive ability and was confirmed in the validation cohort. Conclusions:This study had established and verified the XGBoost model that can predict the recurrence of HCC patients after receiving LH for the first time. It can be used in clinics to assist doctors in formulating personalized postoperative monitoring programs for patients. Early detection, early diagnosis and early treatment of tumors and strengthening of postoperative follow-up are important measures to improve the prognosis of patients.

ObjectiveTo investigate the predisposing factors and pathogenic fungal species of Malassezia folliculitis in different geographical areas and body sites.MethodsTotally,241 patients diagnosed with Malassezia folliculitis were asked to complete a questionnaire.The content of hair follicles was obtained and subjected to fungal smear and culture examination.Fungal species were identified according to morphological,physiological and biochemical features.Results Of the 241 patients with Malassezia folliculitis,204 (84.65％) were positive for smear examination.A total of 259 specimens were collected from these patients,and fungal culture grew 213(82.24％) strains,of which,209 belonged to Malassezia species,4(1.54％) to Candida species.Among the 209 Malassezia strains,186 were activated and subjected to species identification which resulted in 6 species,including M.furfur (111 strains,59.68％ ),M.sloofiae (43 strains,23.12％ ),M.sympodialis (17 strains,9.14％),M.globosa (9 strains,4.84％),M.pachydermatis (4 strains,2.15％),and M.obtuse(2 strains,1.08％ ).Of the pathogenic fungi of Malassezia folliculitis,M.furfur predominated in the chest,back,abdomen,face and neck,M.sloofiae in the upper limbs,shoulders and vertex,M.globosa in the lower limbs.There were obvious differences in the distribution of pathogenic fungal species at different body sites in a same host,and M.furfur with M.sloofiae or M.sympodialis appeared to be the most common pathogens.ConclusionsIn this study,6 Malassezia species are identified in patients with Malassezia folliculitis in Nantong and Nanjing area,M.furfur and M.sloofiae appear to be the dominant pathogens.