[Objective]To investigate the key points of treatment and effect of schmannomas in brachial plexus and peripheral nerves.[Method] Thirty-eight cases of schwannomas in brachial plexus and peripheral nerves were verified with pathology and clinical from 1999 to 2007.There were one case in accessory nerve,2 cases in cervical plexus cutaneous nerve,6 cases in brachial plexus,2 cases in lumbar plexus,17 cases in upper extremity,10 cases in lower extremity.Microsurgical removal of the tumors was done in 37 cases.They were monitored with negro-electro phsiology in operation.The other one case was repaired for nerve grafting after the tumor was cut off.The complexed parts were all examined with MRI before surgery,and all tumors were verified for schwannoma with pathyology.[Result]In 38 cases,there were no function deficit and recurrence over a period of follow up from 6 months to 7 years in 36 cases.The partial intrinsic muscle palsy was present postoperatively in one case of the schwannomas in ulnar nerve with microsurgery of tumor,and recovered after 10 days.After the schwannoma in L4 nerves were cut off and the nerves was grafted,the myodynamia of quadriceps femoris were decreased two degree below,the treatment effect of nerve grafting were being followed up. [Conclusion](1)The technique of microsurgery was used under the microscopic operating,the tumors should be cut off for the most degree to decrease the recurrence possibility,remain the normal neuro-function.(2) The MRI examination should be carried out before the schwannoma operating in the complex pares of the crans,brachial plxus,lumbar plexus and etc.(3) All the schwannoma should be verified by pathyology after surgery.

One imported endemic of schistosomiasis occurred in historical non-endemic area in Shayang County in 2006.Through the comprehensive control measures of surveillance,control of infectious sources and health education,the endemic was controlled effectively.

Objective To analysis the molecular epidemiology characteristics of human Bocavirus1-4 ( HBoV 1-4) in children for diarrhea in Urumqi area.Methods Feces samples were collected from 315 in-patient and out-patient children with diarrhea at People's Hospital of Xinjiang Uygur Autonomous Region,Xinjiang Province,China,all through the year of 2011.Using nested PCR,which amplified NS1(518 bp) fragments.Human Bocavirus1-4 were screened. Results The overall frequency of HBoVs was 8.57％ (27/315),of which 2 were HBoV1,22 were HBoV2,and 3 were HBoV3.HBoV4 was not detected.Except XJ1378,the rest of 26 strains shared 98％-100％ nucleotide sequence identity with different reference strains,but 3 HBoV3 all shared 92％ nucleotide sequence identity with gorilla BGoV12009( HM145750.1 ).Phylogeny showed that NS1 fragments of HBoV3 were closer to that of HBoV1.HBoV infection was distributing throughout the year,there was no significant seasonal.There was no difference in gender,age and ethnic.Conclusion HBoV1-3 were detected throughout the year in Urumqi area,Xinjiang,HBoV2 was dominant.

Objective To evaluate the clinical significance of combined measurement of antiperinuclear neutrophil cytoplasmic antibody(ANCA)and anti-saccharomyees cerevisia antibody(ASCA)for the diagnosis of inflammatory bowel disease(IBD)patients and difierentiation of Crohn's disease(CD)with ulcerative colitis(UC).Methods A total of 159 patients with IBD(97 UC,62 CD),167 patients with other non-IBD gastrointestinal conditions(NIBDC)and 25 healthy controls(HC)were recruited in our research.ASCA and ANCA were detected by enzyme-linked immunosorbent assay(ELISA)and indirect immunofluorescence assay.respectively.Results The prevalence of ASCA-IsA or IgG in CD group,UC group,NIBDC and HC were43.5%,14.4%,29.3%and 0,respectively.The prevalence of ASCA-IgA or IgG in CD group were higher than those in other groups(X2=16.76 or 4.12,P＜0.01 or＜0.05).The prevalence of ANCA in CD group.UC group,NIBDC and HC were 8.1%,56.7%,4.8%and 0,respectively.The prevalence of AMA in UC group were much higher than those in other groups(X2=38.08 or 90.47,P＜0.01).The sensitivity specificity and positive predictive value(PPV)in ASCA+/ANCA-were 40.3%.93.8% and 80.6%,respectively,and in ANCA+/ASCA-were 48.5%,98.4% and 97.9%,respectively.Condusions ASCA or ANCA testing alone are not sensitive enoulgh for diagnosing CD and UC,but their combination asses are specific for differential diagnosis between CD and UC.Combined testing of ASCA-IgA with IgG can improve the sensitivity in screening CD patients.The ASCA positive pattern in Chinese CD group are correlated with surgery.

Objective To evaluate clinical application of thyroid fine-needle aspiration biopsy (FNAB) and its diagnostic value.Methods FNAB was performed for 782 cases during 2005-2009 at China-Japan Friendship Hospital,Beijing and their clinical pathological data were retrospectively analyzed.Cytopathological diagnoses by FNAB were classified as unsatisfactory,benign,atypical cellular lesions,follicular neoplasm,suspicious malignancy and definite malignancy.Results of thyroid cytological and histological examinations of 76 patients with subsequent thyroidectomies were compared to those with FNAB to evaluate its diagnostic accuracy.Results Of 782 FNAB specimens,74.4 % (582/782) were classified as benign,2.6 % (20/782) as malignant,5.6 % (44/782) as follicular neoplasm,3.2 % (25/782) as atypical cellular lesion,2.9% (23/782) as suspicious malignancy and 11.3 % (88/782) as unsatisfactory.Among 76 patients with thyroidectomies,65.8 % of them (50/76) were histologically diagnosed as benign lesion,28.9 % (22/76) as definite malignancy and only 5.3 % (4/76) as benign follicular adenoma.Agreement between FNAB cytological diagnoses and histologically confirmed diagnoses for benign lesion and malignancy was 16/16 and 16/17,respectively.Conclusion FNAB is a reliable diagnostic method for evaluation of thyroid nodules.

Objective To investigate the diagnostic value of fine-needle aspiration(FNA) for thyroid nodules.Methods The cytological and histological results of 74 patients who had undergone FNAs for thyroid nodules,followed by thyroidectomy,were compared to evaluate the accuracy of cytological diagnosis of thyroid FNA and analyze the common causes of missed diagnosis and misdiagnosis in thyroid cytopathology.Results Benign lesions were histologically diagnosed in 48 patients(65%),malignant tumors in 22 cases(30%) and benign tumors in 4 cases(5%).Cytological diagnosis of benign and malignancy was confirmed histolopathologically in 96% and 94%,respectively.Fifteen discrepant cases came mainly from the group of FNA diagnosis of follicular neoplasm,and the discrepancies resulted mainly from cytodiagnostic errors and overlapping cytological features between adenomatoid nodule and follicular neoplasm.Conclusion Despite some limitations,thyroid fine-needle aspiration is a reliable diagnostic method of assessing thyroid nodular disease,especially in differentiation of benign lesion and malignant lesion.

Objective: To establish an optimized path for health management of HBV infections among pregnant and lying-in women based on a Delphi method, so as to provide the evidence for intensifying the interruption of the mother-to-child transmission of HBV. Methods: Based on literature review and previous studies, the preliminary framework and contents of the optimized path for health management of HBV infections were constructed. Experts from epidemiology, clinical medicine and maternal and children healthcare were invited to participate in two-round Delphi consultations, and the preliminarily designed indicators were screened and revised. The score for feasibility of each indicator was calculated, and the weight of each indicator was estimated using a proportional distribution method. Results: Sixteen experts participated in the consultation, including 13 women. The participants had a mean age of (45.69±5.71) years, and a mean employment duration of (23.06±7.05) years. All participants had a degree of bachelor and above, and there were 14 experts with vice senior professional titles. The mean positive coefficient was 96.88% and the mean authority coefficient was 0.790 during the two-round expert consultations. There were significant differences in the coordination coefficient of importance, necessity and feasibility of indicators at all levels (P<0.05), and the coefficient of variation of the feasibility was all less than 0.250. The final optimized path for health management of HBV infections among pregnant and lying-in women included 6 primary indicators, 17 secondary indictors and 73 tertiary indicators. Among the primary indicators, delivery management (0.173 4), screening and evaluation (0.172 8) and pregnancy management (0.172 7) had a high weight. Conclusion A scientific and reliable optimized path is created for health management of HBV infections among pregnant and lying-in women, which has a potential value for improving the interruption of mother-to-child transmission of HBV.

Objectives:To investigate the impact on lumbar spine biomechanical performance of endoscopic lumbar interbody fusion(Endo-LIF)via two approaches,namely endoscopic transforaminal lumbar interbody fu-sion(Endo-TLIF)and endoscopic posterior lumbar interbody fusion(Endo-PLIF)through finite element analysis.Methods:The L3-L5 CT scan data of a 24-year-old healthy male volunteer was collected to establish a three-dimensional finite element model containing conical bone,cancellous bone and posterior structure of L3-L5 vertebrae.The validity of the model was verified by comparing with other previous studies.The clini-cal and radiological data of 40 patients underwent Endo-LIF were analyzed retrospectively,and according to different operational approaches,the patients were divided into Endo-TLIF group(n=19)and Endo-PLIF group(n=21).The cage positions and angles of the patients were measured,and the facet joint preservation ratios were calculated to determine the cage placing positions and angles in constructing finite element surgical models.Finally,four finite element surgical models were constructed as Endo-TLIF+45° cage,Endo-TLIF+60° cage,Endo-PLIF+45° cage,and Endo-PLIF+60° cage.The range of motion(ROM)at the fusion segment and the maximum von Mises stress of endplates,cages,screws,rods,and bone-screw interfaces were calculated.Results:The ROMs of fusion segments in all surgical models reduced significantly compared with the intact model.The maximum von Mises stress of endplates in the surgical segment increased significantly under the flexion conditions in all surgical models.The maximum von Mises stress at the bone-screw interfaces of the Endo-PLIF model was significantly increased compared with the Endo-TLIF model under left and right rota-tion conditions(23％-84％).The maximum von Mises stress of the endplate and cage in the 60° cage models was higher than that in the 45° cage models.In the Endo-PLIF model,the stress of internal fixations and endplates was significantly increased compared with the Endo-TLIF model under left and right rotation condi-tions.Conclusions:Comparing with Endo-TLIF,Endo-PLIF has significantly higher maximum von Mises stress around the internal fixations,especially under rotational conditions,with greater risk of internal fixation failure.

BACKGROUND/AIMS: Myenteric plexus interstitial cells of Cajal (ICC-MY) are involved in the generation of gut pacemaker activity and neuronal communication. We performed patch clamp on ICC-MY in situ to observe the changes of pacemaker activity in response to neural modulations. METHODS: A fresh longitudinal muscle with myenteric plexus (LMMP) from mouse jejunum was prepared. ICC-MY and ganglion neurons embedded in the layer of longitudinal muscles were targeted by patch clamping in whole-cell configuration in a model of current or voltage clamp. Neurogenic modulators were applied to evaluate their effects on ICC pacemaker activity. RESULTS: In situ ICC-MY showed spontaneous and rhythmical voltage oscillations with a frequency of 27.2 ± 3.9 cycles/min, amplitude of 32.6 ± 6.3 mV, and resting membrane potential of −62.2 ± 2.8 mV. In situ neurons showed electrically evocable action potential in single or multiple spikes. Pacemaker activity was modulated by neuronal activators through receiving a neuronal input. Application of tetrodotoxin depolarized pacemaker potentials in a dose dependent manner, and decreased the amplitude at tetrodotoxin 0.3 μM for about 40 ± 10%; capsaicin (1 μM) ameliorated ICC-MY K+ current for about 49 ± 14.8%; and, nitric oxide hyperpolarized pacemaker potential and decreased the amplitude and frequency. CONCLUSIONS: The in situ preparation patch clamp study further demonstrates that the pacemaker activity is an intrinsic property of ICC. The neurogenic activators change and shape pacemaker potential and activity in situ. LMMP preparation in situ patch clamp provides an ideal platform to study the functional innervation of the ICC and the enteric neural system, thereby, for evaluating the neural regulation of pacemaker activity, especially in disorder models.
Action Potentials ; Animals ; Capsaicin ; Constriction ; Enteric Nervous System ; Ganglion Cysts ; Interstitial Cells of Cajal ; Jejunum* ; Membrane Potentials ; Mice* ; Muscles ; Myenteric Plexus* ; Neurons ; Nitric Oxide ; Tetrodotoxin

Objective To explore the application value of modified prophylactic ileostomy in natural orifice specimen extraction surgery(NOSES)for patients with mid-low rectal cancer.Methods We retrospectively analyzed 63 patients who received prophylactic ileostomy in NOSES for mid-low rectal cancer in our hospital from September 2017 to May 2023.The patients were divided into the observation group(those who received modified ileostomy,n=31)and the control group(those who received conventional loop ileostomy,n=32)according to different ostomy methods.The operation time of ostomy,operation time of ostomy reversal surgery,early-stage complications(stoma leakage,peristomal dermatitis,stoma pain,peristomal trocar hole infection,stoma bleeding,stoma ischaemic necrosis,stoma oedema,peristoma skin-mucosal separation and stoma proximal bowel obstruction)and long-stage complications(stoma stenosis,stoma retraction,stoma prolapse,parastomal hernia),tumor recurrence and death of the two groups were compared and analyzed.Results Both prophylactic ileostomy and ostomy reversal surgery were successfully completed in all the 63 cases.The operation time of ostomy in the observation group was 7(6-8)min,which was significantly shorter than that of 23(21-24)min in the control group(Z=-6.853,P=0.000),and the operation time of ostomy reversal surgery in the observation group was(63.2±5.7)min,which was significantly shorter than(93.5±4.7)min in the control group(t=-23.109,P=0.000).Neither stoma bleeding nor stoma ischaemic necrosis were observed in both groups.The incidence of stoma pain in the observation group was lower than that in the control group[6.4％(2/31)vs.65.6％(21/32),x2=21.766,P=0.000].The incidence of peristomal incision infection in the observation group was lower than that in the control group[0％(0/31)vs.53.1％(17/32),P=0.000].There was no stoma stenosis in both groups.There were 3 cases of parastomal hernia,1 case in the observation group and 2 cases in the control group,the difference of the incidence being not statistically significant(P=1.000).There was 1 case of stoma retraction and 1 case of stoma prolapse in the control group.All the 5 cases with complications received prompt treatment in the second ostomy reversal surgery.Follow-up visits for 6-60 months in the 63 cases showed no tumor recurrence or death.Conclusion Modified prophylactic ileostomy in NOSES for patients with mid-low rectal cancer is safe,feasible,and easy to operate,having certain practicality and promotion value.