Objective To analyze the ophthalmologic characteristics and examinations which caused by vertebral-basilar insuffi- ciency.Design Retrospective case series.Participants 469 eases of vertebral-basilar insufficiency.Methods Retrospective analysis of 469 cases of vertebral-basilar insufficiency patients with ophthalmologic signs' features,incidence,the main cause,color Doppler flow imaging and(or)digital subtraction angiography clearly stenosis location,the degree of stenosis from July 1st 2005 to July ist 2007 in PLA General Hospital.Main Outcome Measures Ophthalmologic signs' related reasons and supplementary examination.Results 96 cases were with the corresponding eye symptoms(20.4%).Vision decreased in 83 cases,diplopia was in 56 cases,ipsilateral hemiopia quadrant blind in 12 cases and depending on deformation in 10 cases,fundus arteriosclerosis in 72 cases,nystagmus in 39 cases,the eye movement disorder in 16 cases.Among 96 patients with associated ocular symptoms,75 patients with color Doppler flow imaging (CDFI)showed unilateral vertebral artery abnormal in 66 cases(88%),among those blood flow velocity decreased in 26 cases,17 cases with vascular plaque stenosis,thinning in 20 cases,3 cases with complete occlusion;different bilateral vertebral artery abnormal in 9 cases(12%),among those velocity dropped in 4 cases,two cases with vascular plaque stenosis and thinning in 3 cases.Forty-five cases with the digital subtraction angiography(DSA),left vertebral artery was abnormal in 24 cases,18 cases with stenosis,occlusion in 5 cas- es,abnormal bending in 1 case.Right vertebral artery was abnormal in 16 cases,13 cases with stenosis,occlusion in 3 cases.Bilateral vertebral artery stenosis was found in 2 cases;vertebral artery stenosis was in 3 patients.Conclusion Vertebral-basilar insufficiency may cause eye-related symptoms,therefore,vision acuity decrease,fundus 'arteriosclerosis,diplopia and nystagmus symptoms are more likely for patients with vertebral-patients with basilar artery insufficiency performance of the eye.(Ophthalmol CHN,2002,16:406-410)

Diagnosis, Differential ; Female ; Humans ; Middle Aged ; Pancreatic Neoplasms ; diagnosis ; Solitary Fibrous Tumors ; diagnosis

Chronic spinal cord lesions (CSCL) which result in irreversible neurologic deficits remain one of the most devastating clinical problems. Its pathophysiological mechanism has not been fully clarified. As a crucial factor in the outcomes following traumatic spinal cord injury (SCI), the blood-spinal cord barrier (BSCB) disruption is considered as an important pathogenic factor contributing to the neurologic impairment in SCI. Vascular endothelial growth factor (VEGF) is a multirole element in the spinal cord vascular event. On one hand, VEGF administrations can result in rise of BSCB permeability in acute or sub-acute periods and even last for chronic process. On the other hand, VEGF is regarded to be correlated with angiogenesis, neurogenesis and improvement of locomotor ability. Hypoxia inducible factor-1 (HIF-1) is a primary regulator of VEGF during hypoxic conditions. Therefore, hypoxia-mediated up-regulation of VEGF may play multiple roles in the BSCB disruption and react on functional restoration of CSCL. The purpose of this article is to further explore the relationship among HIF-1, hypoxia-mediated VEGF and BSCB dysfunction, and investigate the roles of these elements on CSCL.
Animals ; Chronic Disease ; Humans ; Hypoxia-Inducible Factor 1 ; physiology ; Neovascularization, Physiologic ; Neurogenesis ; Spinal Cord ; physiopathology ; Spinal Cord Injuries ; physiopathology ; Vascular Endothelial Growth Factor A ; physiology

OBJECTIVETo compare the short-term outcomes in patients with esophageal cancer after subtotal esophagectomy via thoracoscopy in prone position and in left lateral position.

METHODSBetween September 2008 and September 2010, thoraco-laparoscopic esophagectomy (TLE) with thoracoscopic mobilization of the esophagus and mediastinal esophagectomy was performed in 41 patients in prone position (group A) and other 41 patients (group B) performed by the same surgeon in left lateral position.

RESULTSPreoperatively, the endoscopic location of the tumor was in the upper third in 5 cases (2 vs. 3), the middle third in 21 cases (12 vs. 9), and the lower third in 56 cases (27 vs. 29). The median operative time was 230 (range 170-310) min in group A and 280 (range 190-380) min in group B (P=0.04). The median intraoperative blood loss was 275 (range 100-320) ml in group A and 360 (range 120-670) ml in group B (P=0.09). The median number of lymph nodes dissected was 8.4 (range 4-23) in group A and 6.9 (range 6-21) in group B (P=0.03). The postoperative complications totaled 6 (14.6%) in group A and 8 (17.1%) in group B (P=0.44). After a median follow-up period of 15.7 (range 2-28) months for group A and 16.3 (range 3-31) months for group B, 19 patients in group A died and 21 patients in group B.

CONCLUSIONSFor esophageal cancer under T3N1M0, surgical outcomes are similar between prone thoracoscopic esophageal mobilization and left lateral position. Prone position may be associated with better lymph node dissection.

Esophageal Neoplasms ; surgery ; Esophagectomy ; methods ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Prone Position ; Retrospective Studies ; Thoracoscopy ; methods ; Treatment Outcome

OBJECTIVETo compare the surgical results of two kinds of posterior approach for osteoporotic thoracolumbar Kvmmell's disease.

METHODSClinical and radiographic results of 1-segmental pedicle screw fixation combined with vertebroplasty (Group A, n equal to 12) or posterior shortening osteotomy (Group B, n equal to 16) for osteoporotic thoracolumbar Kvmmell's disease were analyzed retrospectively. Japanese orthopedic association (JOA) and visual analogue scale (VAS) scores were used for clinical evaluation. Neurological status was judged by Frankel grades. X-ray was used to evaluate the radiographic results. Complications related to operation and devices were also considered.

RESULTSThe follow-up period was 12-54 months (average 29 months). Pre-and post-operative VAS were 9.3 and 3.2 in Group A, 8.9 and 2.5 in Group B, respectively. The mean JOA score at the final follow-up was significantly higher than that of pre-operation (t equal to 5.306, P less than 0.001). There was no significant difference between Groups A and B (t equal to 0.618, P larger than 0.05). The kyphosis were corrected from preoperative 33.9 degree A)/37.3 degree B) to postoperative 10.3 degree A)/6.5 degree B), and 15.3 degree (A)/13.7 degree B) at the final follow-up. There was a significant difference between the two groups at the final follow-up. Frankel grade was improved from grade C preoperatively to postoperatively grade D or E in 7 cases of Group A and 5 cases of Group B, from grade D to E in 5 cases of Group A and 11 cases of Group B. The mean improvement was 1.6 and 1.7 grades for Groups A and B, respectively. There were no serious complications related to internal fixation.

CONCLUSIONSThe similar clinical results can be obtained by the two kinds of posterior surgical methods for osteoporotic Kvmmell's disease. Posterior spinal shortening is a better choice for patients with serious kyphosis combined with neurological deficit than the other.

Aged ; Bone Screws ; Female ; Follow-Up Studies ; Humans ; Kyphosis ; surgery ; Lumbar Vertebrae ; injuries ; surgery ; Male ; Middle Aged ; Osteoporosis ; complications ; Osteotomy ; Retrospective Studies ; Spinal Fractures ; surgery ; Thoracic Vertebrae ; injuries ; surgery ; Vertebroplasty

OBJECTIVETo study the influence of distal tibiofibular synostosis on ankle function.

METHODSFrom October 1998 to October 2004, a total of 281 consecutive patients underwent operations because of ankle fractures or distal fractures of the tibia and fibula. Distal tibiofibular synostosis occurred after operation in 8 patients. The duration of follow-up averaged 20.6 months (14-44 months). The ankle function was assessed on the basis of functional rating system described by Mazur.(1)

RESULTSAccording to Mazur's ankle evaluation system, 4 patients achieved an excellent result, 2 a good result and 2 a fair result. The dorsiflexion of the synostosis ankle reduced by 8.26 degrees as compared with that of the contralateral ankle, and there was little influence on the plantar flexion. All the patients had a normal gait.

CONCLUSIONThe distal tibiofibular synostosis after the operation of ankle fractures or distal fractures of the tibia and fibula usually gives rise to few symptoms and needs no specific treatment.

Adult ; Ankle Injuries ; physiopathology ; Ankle Joint ; physiopathology ; Female ; Fracture Healing ; Humans ; Male ; Middle Aged ; Range of Motion, Articular ; Retrospective Studies ; Young Adult

OBJECTIVETo study changes in T lymphocyte subsets in preterm infants with intrauterine growth retardation (IUGR).

METHODSThe study enrolled 29 IUGR preterm infants, 38 preterm infants born appropriate for gestational age (AGA), and 20 healthy full-term infants. Peripheral blood was sampled during the first 24 hours of life, and again at a corrected age of 38 weeks of the preterm infants. T lymphocyte subsets were analyzed by flow cytometry, and absolute counts of leukocytes, total lymphocytes, and T lymphocytes were determined with an automated hematology analyzer.

RESULTSWithin the first 24 hours of life, percentages of CD3(+) and CD4(+) were lower in IUGR preterm infants than in AGA preterm infants and full-term infants (P<0.05), percentages of CD8(+) and CD4(+)/CD8(+) ratio were lower in IUGR preterm infants than in full-term infants (P<0.05), and percentages of CD3(+), CD4(+) and CD4(+)/CD8(+) ratio were lower in AGA preterm infants than in full-term infants (P<0.05). Moreover, the absolute counts of total lymphocytes were lower in IUGR preterm infants than in full-term infants (P<0.05); the absolute counts of T lymphocytes were lower in preterm infants, regardless of IUGR, than in full-term infants (P<0.05), and lower in IUGR infants than in AGA infants (P<0.05). At the corrected age of 38 weeks, percentages of CD3(+), CD4(+) and CD4(+)/CD8(+) ratio were increased in both IUGR and AGA infants as compared to the measurements within the first 24 hours of life (P<0.05), and percentages of CD3(+), CD4(+), CD8(+) and CD4(+)/CD8(+) ratio were lower in IUGR infants than in AGA infants (P<0.05), whereas there were no significant differences in counts of leukocytes, total lymphocytes and T lymphocytes between IUGR and AGA infants (P>0.05).

CONCLUSIONSThere may be a certain degree of compromise in cell-mediated immunity in preterm infants with IUGR and this compromise may last to 38 weeks after birth.

Female ; Fetal Growth Retardation ; immunology ; Gestational Age ; Humans ; Infant, Newborn ; Infant, Premature ; Male ; T-Lymphocyte Subsets ; immunology

OBJECTIVETo compare efficacy between the modified tension band technique and the parallel titanium cannulated lag screw technique for the transverse patella fracture.

METHODSSeventy-two patients were retrospectively analyzed aged 22 to 79 years (mean, 55.6 years) with transverse patella fractures, among whom 37 patients underwent the modified tension band and 35 patients received the titanium cannulated lag screw. Patients were followed up for 1-3 years. We analyzed the difference of operation time, complications, fracture reduction, fracture healing time, and the Iowa score for knee function between both groups.

RESULTSIn modified tension band group, five patients had skin irritation and seven suffered wire migration, two of whom required a second operation. In comparison, there were no complications in the titanium cannulated lag screw group, which also had a higher fracture reduction rate and less operation time.

CONCLUSIONThe parallel titanium cannulated lag screw technique has superior results and should be considered as an alternative method to treat transverse patella fracture.

Adult ; Aged ; Bone Screws ; Female ; Fracture Fixation, Internal ; instrumentation ; Fractures, Bone ; surgery ; Humans ; Male ; Middle Aged ; Patella ; injuries ; Postoperative Complications ; Retrospective Studies ; Titanium ; Treatment Outcome

BACKGROUNDLow back pain (LBP) is a major medical and social problem among working populations and is associated with high medical expense, loss of productivity, and disability. The aim of this study is to investigate the prevalence of LBP among soldiers and evaluate the possible causative factors in military training. The results may provide an insight into changes needed in military training that will reduce the occurrence of LBP among soldiers.

METHODSA cross-sectional survey was conducted in a group of young soldiers in China to estimate the prevalence of LBP and evaluate possible causative factors in military training.

RESULTSThe survey was distributed to 1659 soldiers, of whom 1624 responded. LBP was reported by 425 of the 1624 (26.2%) soldiers. The prevalence of LBP was higher in the armored force (51.3%) than in the artillery (27.5%) or infantry (11.9%). A multivariate logical regression analysis identified night training, 5 km cross-country race, and grenade-throwing training as military training risk factors for LBP.

CONCLUSIONSThe relatively high incidence of LBP among soldiers was related to night training, 5 km racing, and grenade throwing. Modifications in these training methods should enhance the health of recruits and lower the incidence of LBP.

Adolescent ; Adult ; Cross-Sectional Studies ; Humans ; Low Back Pain ; epidemiology ; Male ; Military Personnel ; Prevalence ; Risk Factors ; Surveys and Questionnaires ; Young Adult

OBJECTIVETo study the effects of carbon disulfide (CS(2)) on the health of workers, and to provide the basis for the further preventive measures.

METHODSThe occupational health examination of 881 workers exposed to CS(2) in a chemical fiber factory was carried out according to the national technical standard of occupational health surveillance. The time weighted average concentrations (TWA) of CS(2) in the workshops of short silk and long silk exceeded the national standard, The workers in these two workshops served as the high exposure group. The workers of the other workshops were classified as low exposure group, in which TWA met the national standard. All exposed workers were also divided into long-term exposure group and short-term exposure group on the basis of average exposure years (16 years). The statistical analysis was used by t test, χ(2), and fisher exact test.

RESULTSThe symptom rates of numbness, fatigue, dizziness, insomnia and headache were 12.5%, 8.5%, 8.2%, 7.5%, and 7.2% respectively. The abnormal rates of superficial sensation, three fibrillation, achilles tendon reflex, patellar reflex, EMG, hypertension, triglycerides, low-density lipoprotein, and apolipoprotein B were 33.0%, 26.1%, 20.8%, 18.6%, 10.8%, 33.4%, 24.5%, 17.0% and 9.3% respectively. Among the high exposure group, the abnormal detectable rates of dizziness, headache, fatigue, insomnia, numbness, achilles tendon reflex, superficial and deep sensation, EMG, hypertension, ECG, total cholesterol, triglyceride and low density lipoprotein in long-term exposure group were significantly higher than those in short-term exposure group (P < 0.05 or P < 0.01). However, among the low exposure group, the abnormal rates of the insomnia achilles tendon reflex and superficial sensation in long term exposure group were significantly higher than those of short term exposure group (P < 0.05 or P < 0.01). The detected rates of hypertension, triglycerides, low-density lipoprotein, creatinine and uric acid were in males significantly greater than those in females (P < 0.05 or P < 0.01).

CONCLUSIONLong-term exposure to high concentrations of CS(2) could lead to the damage of nervous system, elevate blood pressure and promote the development and progression of hyperlipemia and atherosclerosis. Furthermore, CS(2) had greater effects on blood pressure and lipid in males than in females.

Adult ; Carbon Disulfide ; adverse effects ; Cardiovascular System ; Chemical Industry ; Female ; Health Status ; Humans ; Male ; Middle Aged ; Multiphasic Screening ; Nervous System Diseases ; epidemiology ; Occupational Exposure ; Young Adult