Objective To analyze the effects of adenohypophysis function after treating with thyrotropin releasing hormone and its clinical significance in patients with brain trauma. Methods There were 22 cases with traumatic brain injuries from July 2010 to September 2012 in Chinese people's Liberation Army nine eight hospital,after injuried within 4 to 12 hours,then 1 1 cases who were given thyrotropin-releasing hormone(TRH)were selected as experimental group,while 1 1 cases who were given the same amount of isotonic saline were selected as control group,then the score of GCS, ICS,RLS85 and the improvement of adenohypophysis function were observed. Results After treatment,the score of glasgow coma scale (GCS ), innsbruck coma scale (ICS),and the reaction level scale (RLS85)between two groups were significantly increased in three days compared with before treatment,and within three days after injury situation,the improvements of ICS and RLS85 in experimental group were better than control group(P<0.05 ). Compared with control group,the levels of each gland pituitary hormone in experimental group were significantly increased(P<0.05 ),and on the third day,the growth hormone (GH)was reduced significantly,finally 50%of that in control group. Conclusion Patients with brain injury treated with thyrotropin releasing hormone,has no significant adverse reactions,with the characteristics of safe and effective.

Objective To design a new type of mouth opening training device.Methods The device had a semicircular structure,and was composed of upper and lower bite blocks,a spring and a regulation mechanism.The bite blocks were made by one-step injection molding,and the spring and regulation mechanisen were manufactured by metal forming.Totally 88 patients with restriction of mouth opening after mandible fracture surgery in the oral surgery department from January to December 2016 were randomly divided into two groups,and each group had 44 patients.The control group used the traditional bite block for mouth opening training,and the experimental group applied the developed training device.Training was started 10 d after surgery,and the training time lasted 3 to 6 months.Results The experiment group behaved significantly better than the control group in maximal mouth opening (P＜0.05) and patient comfort (P＜0.01).Conclusion The training device gains advantages in easy operation,patient comfort,flexibility for regulation,cleaning and maintenance and patient compliance,and thus is worthy promoting clinically.

The present article addressed method, indications, contraindications of 6 min walk test (6MWT), and its correlation with plasma level of brain natriuretic peptide (BNP) and NYHA class. 6MWT can be used for rehabilitation guidance, improve exercise tolerance and assess their cardiac function and prognosis, etc. in patients with heart failure.

Objective To construct a three-dimensional (3D) lumbar spine model to allow real-time complicated interactions in virtual lumbar surgery based on virtual reality technique. Methods The data of high-resolution CT slices were segmented and the contours were extracted. Surface rendering technique was adopted to construct of the lumbar spine model on the basis of serial contours, and the model was optimized according to the need of real-time interaction. Results The lumbar spine model with fewer polygons was characterized by high resolution and smoothness. After being loaded in the virtual surgery system, the model accurately displayed the anatomy of lumbar spine and allowed real-time interaction during the virtual surgery. Conclusion The 3D lumbar spine model constructed based on the CT slices is applicable for complicated interactions in virtual lumbar surgery.

OBJECTIVETo culture dendritic cells (DC) from peripheral blood of patients with laryngeal carcinoma for therapeutic aid.

METHODSAdherent peripheral blood mononuclear cells from peripheral blood were cultured with 15 ng/ml rhGM-CSF and 7 ng/ml rhIL-4 for one or two weeks. The purity of DC was detected by immunocytochemistry method. The mixed leukocyte reactions stimulated by DC loaded with laryngeal carcinoma antigen were tested by measuring 3H-TdR uptake.

RESULTSA considerable number of suspended cells with spicular or dendritic appearance were observed after 1 week of culture, and their mitochondria were rich in cytoplasm. The positivity of DC was about 30%-60%. DC loaded with laryngeal antigen could induce proliferation of syngeneic T lymphocytes.

CONCLUSIONA large number of DC with high purity can be cultured from peripheral blood of patients with laryngeal carcinoma in vitro. It may be used in further experimental studies for clinical applications.

Carcinoma, Squamous Cell ; blood ; Cell Separation ; Cells, Cultured ; Culture Media ; Dendritic Cells ; pathology ; Granulocyte-Macrophage Colony-Stimulating Factor ; pharmacology ; Humans ; Interleukin-4 ; pharmacology ; Laryngeal Neoplasms ; blood ; Recombinant Proteins ; pharmacology

OBJECTIVETo explore the effect of new model for tuberculosis (TB) control and management, and provide a scientific basis and justification for making TB control strategies in rural communities.

METHODSAmong those townships with low TB service accessibility by the county TB control institute in Guangxi Xingye county (population of 679 thousands), four townships with total population of 152 518 and inconvenient transportation, were selected as the experimental group to conduct a new model research project.Based on the accessibility for community services, setting diagnosis and treatment management centers in township hospitals, employing family treatment supporters to supervise the treatment process. The TB cases of the base-line and the project expiration of the experimental group were 44 and 117. Meanwhile, three townships including Dapingshan, Longan and Gaofeng in the county with the similar condition and total population of 133 303 were selected as the control group. The control group conducted the provisions of national TB control program in the county TB clinic management. The TB cases of the base-line and the project expiration of the control group were 56 and 110. By double-direction comparison method, the effect of the new model was evaluated through TB patients detection, treatment outcomes and TB control management data. SPSS 13.0 statistical software was adopted and Chi-square test was used for analyzing technical data.

RESULTSAfter two-year project research implementation, in the experimental group the detection rate of new smear-positive TB patients increased from 16.39/100 000 (25/152 518) to 51.14/100 000 (78/152 518) (χ(2) = 27.281, P < 0.01), the cure rate of new smear-positive cases increased from 71.4% (15/21)to 91.1% (51/56) (χ(2) = 4.812, P < 0.05), and the completing treatment rate in newly diagnosed smear-negative cases improved from 23.5% (4/17)to 71.4% (15/21) (χ(2) = 8.622, P < 0.01); the loss rate of newly diagnosed smear-positive cases dropped from 23.8% (5/21) to 0.0% (0/56) (χ(2) = 10.608, P < 0.01), and the loss rate of newly diagnosed smear-negative cases decreased from 64.7% (11/17) to 4.8% (1/21) (χ(2) = 15.624, P < 0.01). Meanwhile, the cure rate of new smear-positive cases in the experimental group, 91.1% (51/56), was higher than the control group, 72.0% (36/50) (χ(2) = 6.531, P < 0.05). The loss rate of newly diagnosed smear-positive cases in the experimental group (0.0% (0/56)) was lower than the control group (16.0% (8/50)) (χ(2) = 7.534, P < 0.01). During the project implementation, in the experimental group the on time rate of taking medicine, 91.5% (107/117) and receiving medicine, 100.0% (117/117), the reexamining sputum ratio, 83.6% (98/117) were higher than that in the control group: 81.8% (90/110), 92.7% (102/110) and 64.5% (71/110). The differences were statistically significant (χ(2) = 4.589, 8.820 and 11.005, P < 0.05).

CONCLUSIONThe new management model had been proved effective. It can improve TB case detection and cure rates, reduce the loss rate of patients, and improve patient treatment and management conditions as well.

China ; Communicable Disease Control ; methods ; Humans ; Outcome Assessment (Health Care) ; Rural Health ; Tuberculosis ; prevention & control

OBJECTIVETo evaluate the clinical effect of the disk-up sinus reamer (DSR) applied to transcrestal maxillary sinus floor elevation with simultaneous placement of implants.

METHODSThirty-seven patients underwent transcrestal maxillary sinus floor elevation with fifty-one implants placed simultaneously using the DSR. The residual bone height (RBH) was 3 to 8 mm, (5.61 ± 1.61) mm on average. The safety of this technique and the pain index during the operation was evaluated. The final prostheses were restored in 3-6 months postoperatively. The follow-up period was 3 to 24 months. The stability and osseointegration of the implants were clinically evaluated, and the endo-sinus bone gain around the implants were measured.

RESULTSThe elevation height ranged from 2 to 8 mm, with an average of (4.75 ± 1.55) mm. There was no detectable sinus membrane perforation, no serious suffering or uncomfortable subjective sensation in any patients during operation with a pain index of (2.22 ± 0.98). During the follow-up period, no sinus complication was observed. Favorable osseointegration was obtained. There were no implants or prostheses which were loose or lost. The survival rate was 100%. The radiographic results demonstrated that the endo-sinus bone gain tended to reach stabilization after 6 months and the marginal bone loss was (1.20 ± 0.72) mm after 12 months.

CONCLUSIONSTranscrestal maxillary sinus floor elevation with simultaneous implant placement by DSR is a safe, invasive and handy technique, with higher elevation height, fewer clinical complications and less pain. It shows satisfactory clinical results in short term and a long-term observation is still needed.

Adult ; Aged ; Dental Implantation, Endosseous ; Dental Implants ; Female ; Follow-Up Studies ; Humans ; Male ; Maxillary Sinus ; diagnostic imaging ; surgery ; Middle Aged ; Osseointegration ; Pain Measurement ; Radiography, Panoramic ; Sinus Floor Augmentation ; instrumentation ; methods ; Tooth Loss ; diagnostic imaging ; surgery ; Treatment Outcome ; Young Adult

Objective: To know the pre-treatment drug resistance ( PDR ) status of newly reported human immunodeficiency virus type 1 ( HIV-1 ) infected individuals in Wenzhou, so as to provide guidance for antiretroviral therapy ( ART ). Methods: Totally 232 plasma samples of newly reported HIV-1 infected individuals who had not received ART were collected in Wenzhou in 2019. Virus ( HIV-1 ) RNA was extracted, followed by reverse transcription PCR and nested PCR to amplify the pol region and sequence. Resistance mutations and resistance to non-nucleoside reverse transcriptase inhibitors ( NNRTIs ), nucleoside reverse transcriptase inhibitors ( NRTIs ) and protease inhibitors ( PIs ) was analyzed. Results: The pol region sequences from 199 infected patients were obtained and the incidence of PDR was 8.04% ( 16/199 ). Eight genotypes were detected, including circulating recombinant forms ( CRFs ) CRF07_BC ( 47.24%, 94/199 ) and CRF01_AE ( 29.15%, 58/199 ) which were the dominant types. Two unique recombinant forms ( URFs ) were detected, namely URF( CRF01_AE/BC ) and URF( B/C ) . Thirty-one cases ( 15.58% 31/199 ) had drug-resistant mutations. For NNRTIs, NRTIs and PIs, 20 cases ( 64.52% ) , 2 cases ( 6.45% ) and 9 cases ( 29.03% ) with drug resistance mutations were detected, respectively. The resistance mutations to NNRTIs included K101E, K103N/R, V106I, E138K, V179D/E/T, Y181C, G190A and H221Y. Four cases each had two resistance mutations to NNRTIs. The resistance mutations to NRTIs were V75M and M184V. The resistance mutations to PIs were M46I, L33F and Q58E. For the newly released NNRTI drug Doravirine ( DOR ), two cases were found to have mutations of resistance. Conclusions The incidence of PDR among newly reported HIV-1 patients in Wenzhou is 8.04%, mainly caused by NNRTIs drug-resistant mutation. Resistance to the new drug DOR has emerged. The surveillance of drug resistance should continue to be strengthened.

Objective To observe the morphological changes of the peripheral nerves,the expression changes of microtubule-associated protein 1B (MAP1B) and the changes of motor function in rats after chronic spinal cord compression.Methods A total of 50 female Wistar rats were randomly divided into normal control group (n=10),sham-operated group (n=10) and chronic compressive groups (n=30).The rats in the chronic compressive groups were given gradual compression on the posterior spinal cord using blunt plastics screw; compression degree reached 20％ (n=10),40％ (n=10) and 60％ (n=10),respectively,after 2 months.Rats in the normal control group did not receive any treatment and rats in the sham-operated group was only given removal of the L5 spinous process and part of the vertebral plate.Following sacrifice of the rats,cells from sciatic nerves were removed for HE staining;light microscopy and electron microscopy were employed to observe the changes; immunohistochemical staining of MAP1B was performed.Results Hypokinesia,and decreased Tarlov scores,Ramp test scores and BBB-21 scores in the chronic compressive groups were noted as compared with those in the normal control group (P＜0.05).Peripheral nerve degeneration was noted in all the chronic compressive groups; the more severe the compression,the more significant the degeneration.Expression of MAP1B in the peripheral nerves of the chronic compressive groups was significantly down-regulated as compared with that in the normal control group (P＜0.05).Conclusion Spinal cord compressive injury can lead to peripheral nerve degeneration; and neuronal apoptosis and necrosis lead to rare axonal regeneration,which may be one of the important reasons that influences the neural function recovery after chronic spinal cord compression.

OBJECTIVETo assess the feasibility of visual-reality technique for simulating surgical resection of pancreatic tail carcinoma using a 3-dimensional pancreas model reconstructed on the basis of the CT data.

METHODSThe original image data of 64-slice spiral CT was obtained from a patient with pancreatic tail carcinoma. Using adaptive region growing algorithm, the serial CT images were segmented and automatically extracted for 3-dimensional reconstruction of the pancreas and the anatomically related structures with a self-designed program. The model was then processed with Freeform Modeling System for image modification and smoothing. With the assistance of GHST SDK and PHANTOM software systems, preoperative simulation of surgical resection of the carcinoma was performed on the basis of the established pancreatic model.

RESULTSThe reconstructed 3-dimensional pancreatic model with the related structures clearly visualized the 3-dimensional structures of the pancreas, the pancreatic tail compromised by the carcinoma, and the adjacent organs, displaying also the distribution, courses and the anatomical relations of the ductal systems including the main pancreatic duct, abdominal aorta, portal vein system, and the biliary tract. During simulated surgery for pancreatic tail carcinoma resection, the GHOST SDK system allowed effective application of the virtual surgical instruments, and the use of PHANTOM software produced a surgical experience with high resemblance of that from an actual operation.

CONCLUSIONThe serial CT data-based reconstruction of 3-dimensional pancreas model and simulated operation on this model using virtual-reality technique has great potentials for application in individualized surgical planning and surgical risk assessment in cases of pancreatic tail carcinoma, and also facilitates clinical training of the surgeons.

Computer Simulation ; Female ; Humans ; Imaging, Three-Dimensional ; methods ; Middle Aged ; Models, Biological ; Pancreatic Neoplasms ; diagnostic imaging ; surgery ; Tomography, Spiral Computed ; User-Computer Interface