[Objective]To analyze the clinical and radiographic outcome of surgical treatment for idiopathic scoliosis in patients treated at the age of 20 years or older.[Methods]In this study,62 adult patients with idiopathic scoliosis who underwent surgery using pedicle screw instrumentation were followed up for 2 to 5 years,and the results were analyzed clinically and radiographically.[Results]The prevalence of pain requiring specific treatment decreased from 16% to 4%,and the pain relieve was reliably obtained in the older patients.Radiographically,the mean correction rate of Cobb's angle was 56% for both the thoracic and lumbar curves,whereas it decreased with the age increasing,especially in relation to the thoracic curve.The sagittal plane correction was satisfactory.[Conclusion]This study clarified different specific characteristics and problems in the surgical treatment of adult idiopathic scoliosis in different age groups.Pain is the most important indication for surgery in patients older than 40 years,and it has been improved reliably by surgery in most of these patients.On the other hand,the correction rate of Cobb's angle would be decreased with the increased age,the sagittal plane correction rate is not related to age.

Objective To evaluate methods and effect of the endovascular embolization of intracranial aneurysms. Methods From 2004,3 to 2004,8,14 patients with intracranial aneurysms, underwent intravascular embolization was reviewed. Clinic presentation: 6 cases males, 8 cases females, age range 45-78 years. 1 case ICA aneurysms, 8 cases PCA aneurysms, 5 cases ACA aneurysms . All patients were treated with DCS/MATRIX embolization. Results 11 cases aneurysms were 100% occluded, 2 cases aneurysms were 70-90% occluded,1 case aneurysm was 50% occluded; 6 patients found cerebral vasospasm.Conclusions In the Cerebral vasospasm time, endovascular embolization of intracranial aneurysms is a safe, minimal traumatic and effective method.

BACKGROUND: In the early stage following spinal cord injury, a series of changes in metabolism and secretion take place, such as accelerated bone resorption and decreased bone formation. Determination of the biochemical markers of bone metabolism early after spinal cord injury may help understand the metabolic changes and facilitate risk evaluation for osteoporosis on such occasion.OBJECTIVE: To study the earlychanges of bone mass and bone metabolism indices in guinea pigs with spinal cord injury and evaluate the impact of spinal cord injury on bone metabolism.DESIGN: Randomly controlled animal experiment. SETTING: Department of Rehabilitation Medicine, Zhongshan Hospital of Fudan UniversityMATERIALS: The experiment was conducted in the Institute of Rehabilitation Medicine, Zhongshan Hospital of Fudan University in March 2004. Twenty-three male guinea pigs with body weight of 427-710 g (averaging 570 g) were provided by the Experimental Animal Center,Zhongshan Hospital of Fudan University and divided into experimental group (n=10) and normal control group (n=13). All the guinea pigs were kept under the same environment and fed with standard food for two weeks.METHODS: Small microsurgery scissors was used to induce a 1.5-mm transverse incision of the spinal cord, with the bleeding carefully managed and the wound closed. Thirty minutes after surgery, the guinea pigs recovered consciousness with bilateral lower limb paralysis (hypertonic paraplegia) and loss of superficial and deep sensations, but without urinary and fecal incontinence. The animals in the control group had sham operation. After housing in the same environment with standard food for 2 weeks, urine,serum and shinbone samples were collected from the animals for measurement of serum bone alkaline phosphatase (BALP), urinary pyridinoline (Pyd)/creatinine (Cr) and Ca/Cr. t test and H test were used for comparison of the samples between the two groups.parison of biochemical markers for bone formation between the two groups.RESULTS: Ten animals were analyzed in each group. No significant difference was observed in the BMD and bone dry weight between the two groups (P ＞ 0.05), but the bone ash weight of experimental group was remarkably lower than that of the control group [(0.284±0.050) vs (0.361±0.064) mg, t=3.254, P ＜ 0.05). The experimental group had significantly lower serum BALP than the control group [(0.640±0.240)vs (1.328±0.606) U/L, H=9.499, P ＜ 0.05), but higher urinary Pyd/Cr [(0.206±0.080) vs (0.117±0.037), P ＜ 0.01) and Ca/Cr [(0.003±0.003)vs (0.002±0.002), P ＜ 0.05] than the control group (H=9.676, 4.124,P ＜ 0.05).CONCLUSION: After the spinal cord injury, bone resorption remarkably increases and the function of the osteoblasts is inhibited. Bone metabolic abnormalities can occur in the early stage of spinal cord injury, and the biochemical indices for bone metabolism are sensitive in evaluating the risks for osteoporosis after spinal cord injury.

Acute kidney injury (AKI) is the complex clinical syndrome attributed to multiple causes and risk factors, which is characterized by an abrupt loss of renal function. Metabonomics, recently advances in the field of omics, is the nontargeted measurement of all of the low-molecularweight compounds that appear in a particular cell, tissue, organ or biofluid in a living organism. Compared to genomics, transcriptomics and proteomics,metabonomics has its unique advantages, including fewer metabolites than genes, transcripts and proteins, the most accurate predictors of the signature of the actual processes, easy access to biofluids. Thus, metabonomics makes it possible to find new biomarkers for AKI on early diagnosis, identifying new metabolic pathways, finding new targets for drug therapy and individual medical treatment.

Objective To observe the expression profiles of miR-200b/c and their targets ZEB1/2 in early pulmonary fibrosis caused by acute lung injury induced by lipopolysaccharide in mice.Methods Early pulmonary fibrosis caused by acute lung injury is built via a lipopolysaccharide three-hit regimen.Mice were sacrificed at post-injective day 3,7,14,21 respectively and the lung tissue specimens were collected.The lung tissue sections were stained with HE and Masson staining and pathological changes were observed by optical microscope.The expression profiles of miR-200b,miR-200c,ZEB1 mRNA and ZEB2 mRNA were detected by real-time PCR.Western blot was utilized to detect the levels of ZEB1,ZEB2,E-cadherin,Vimentin,α-SMA proteins.Results (1) pathological findings:compared with the control group,the collagen fibers deposited on on the third day after LPS treatment and pulmonary fibrosis gradually worsened;(2) Real time-PCR results:With the aggravation of pulmonary fibrosis,miR-200b and miR-200c levels were declined and the levels of miR-200b/c at post-injective day 7,14,21 were significantly lower than that of control group (P＜0.01).ZEB1 mRNA and ZEB2 mRNA levels were gradually increased in the process of pulmonary fibrosis and the increased magnitude of ZEB2 mRNA was more significant than that of ZEB1 mRNA;(3) Western blot results:ZEB1 and ZEB2 protein levels were also gradually increased,consistent with their mRNA levels and the expression of E-cadherin protein was decreased while Vimentin and oα-SMA protein levels increased with the evolution of pulmonary fibrosis caused by acute lung injury.Conclusion miR-200b and miR-200c promote epithelial-mesenchymal transition by inhibiting their targets ZEB1/2 in early pulmonary fibrosis caused by acute lung injury induced by LPS.

ObjectiveTo acquire the basic information of trainees and analyze the training results and it' s influence factors in the training of rural health appropriate technology in Jiangsu.MethodsWe used the questionnaire to collect data of the trainees' personal information and training results after training.Results A total of 2284 valid questionnaires were collected. There were 73.6％ trainees came from township hospitals,95.1 ％ of them under 45 years old,62.9％ for females,79.2％ have been working for 8 years,3％ with senior professional titles,only 0.4％ had acquire the master's degree or above.Multiple regression analysis showed that the different level of hospitals,the training needs, suitable degree,knowledge familiarity before the training,expert instruction and learning were the main influence factors for the master of the technology; The influence factors for the wish to be re-training were working age,education,the demand for training technology,ease of learning,expert instruction,grasp of this time,appliance of the technology.Conclusionlong-term mechanism for trainning and continue education should be established,and medical workers in rural areas should be strengthen to take the technical training to further improve the rural medical services.

Objective To investigate the clinical features of VAE and to assess the predictive value of VAE cough. Methods We retrospectively reviewed the medical records of 461 consecutive patients who underwent DBS surgery at Beijing Tiantan Hospital. Patients with VAE manifestation were enrolled in this study. The clinical features, operative courses, post-operative conditions and treatment of these patients were analyzed. The correlation between intraoperative tremor intensity , cough duration and prognosis was also investigated. Results Among 461 patients,10 (2.2%) were found with evidence of VAE, including cough, dyspnea, decreased O2 saturation (SO2). Statistical analyses revealed that severe cough was associated with greater age , a longer coughing time, more intensive tremor, greater influence, and a longer length of stay (P < 0.05, rspectively). Conclusions Early recognition and prompt management of VAE are essential to prevent unfavorable consequences. Cough intensity might be a useful tool for evaluating VAE and its prognosis , which is helpful for neurosurgeons to decide on the subsequent maneuvers.

We retrospectively collected the ultrasound imaging data of 152 patients with cirrhosis, the gallbladder wall thickness (GBWT) and portal hemodynamics parameters (portal vein diameter, portal vein mean flow velocity, portal vein blood flow) were recorded,and SPSS 11.0 software was used to analyze the correlation between them. The results revealed that there was good correlation between portal vein diameter and the degree of gallbladder wall thickening (r 0.944, P < 0.05). Portal vein mean velocity and portal vein blood flow were both negatively correlated with gallbladder wall thickness (r = -0.939 or r = -0.950, respectively; both P < or = 0.005). These indicate that gallbladder wall thickening is closely related to hemodynamic parameters. It is feasible to predict the degree of portal hypertension through the observation of gallbladder wall thickening in patients with liver cirrhosis.
Adult ; Aged ; Aged, 80 and over ; Female ; Gallbladder ; pathology ; Hemodynamics ; Humans ; Liver Cirrhosis ; pathology ; physiopathology ; Male ; Middle Aged ; Portal Vein ; physiopathology

OBJECTIVETo investigate the expression of fragile histidine triad (FHIT) gene protein, FHIT and the possible relationship between FHIT expression and clinicopathological indices in colorectal carcinoma.

METHODSDetecting FHIT protein expression in 60 cases of formalin-fixed, paraffin-embedded colorectal carcinoma by citrate-microwave-SP immunohistochemical method, and analyzing its relationship to histological grade, Dukes' stage and 5-year survival rate.

RESULTS55% of the carcinomas showed a marked loss or absence of FHIT expression compared with their matched normal mucosa. Carcinomas with reduced expression of FHIT correlated with their histological grade, Dukes' stage (P < 0.05) and 5-year survival rate. The distribution of decreased expression of FHIT was 7/16 in grade I carcinoma, 14/30 in grade II, 12/14 in grade III, respectively. The correlation between decreased expression of FHIT and Dukes' staging was 5/11 in stage A, 12/28 in stage B, and 16/21 in stage C. The difference between stage A, B with no lymph nodes metastases and the stage C with lymph nodes metastases was of significance (P < 0.05). The follow-up data of 39 cases showed that in the 5-year survival group, 13/25 were of the low FHIT expression carcinomas, while in 5-year deceased group 12/14 were of the low FHIT expression carcinomas (P < 0.05).

CONCLUSIONSThe reduced expression of FHIT may be associated with decreasing differentiation, metastasis and 5-year survival rate in colorectal carcinoma. It is suggested that decreased FHIT expression plays an important role in the development and progression of the tumor, and thus may become a new prognostic marker in colorectal carcinoma.

Acid Anhydride Hydrolases ; Colorectal Neoplasms ; metabolism ; pathology ; Humans ; Immunohistochemistry ; Lymphatic Metastasis ; Neoplasm Proteins ; biosynthesis ; Neoplasm Staging ; Survival Analysis

OBJECTIVETo compare the expressions of lysyl oxidase (LOX) and matrix metalloproteinases-2 (MMP-2) in gastric cancer and pericancerous tissues, in gastric cancers with and without lymph node metastasis, and to analyze the effects of LOX and MMP-2 on tumor invasion and metastasis.

METHODSGastric cancer and pericancerous tissues were collected from 46 patients who underwent surgery. Levels of LOX and MMP-2 mRNA were detected by RT-PCR. Protein abundance of LOX and MMP-2 was examined using Western blot.

RESULTSExpressions of LOX and MMP-2 mRNA, and protein in 46 gastric cancers were significantly higher than that in 46 pericancerous tissues. In gastric cancer with lymph node metastasis, the levels of LOX and MMP-2 mRNA and protein were higher than those in gastric cancers without lymph node metastasis (P < 0.05). In the groups of gastric cancer with lymph node metastasis, expression of LOX was positively correlated with MMP-2 protein expression (P < 0.01).

CONCLUSIONSExpressions of LOX and MMP-2 in gastric cancer tissues are significantly higher than that in pericancerous tissues. The expressions of LOX and MMP-2 in gastric cancer with lymph node metastasis are higher than that in gastric cancer without lymph node metastasis. Expressions of LOX and MMP-2 are positively correlated. The results suggest that LOX and MMP-2 may promote the growth and metastasis of gastric cancer.

Adenocarcinoma ; metabolism ; pathology ; surgery ; Biomarkers, Tumor ; metabolism ; Female ; Gastrectomy ; Humans ; Lymphatic Metastasis ; Male ; Matrix Metalloproteinase 2 ; genetics ; metabolism ; Middle Aged ; Neoplasm Invasiveness ; Protein-Lysine 6-Oxidase ; genetics ; metabolism ; RNA, Messenger ; metabolism ; Stomach ; metabolism ; surgery ; Stomach Neoplasms ; metabolism ; pathology ; surgery