Objective To analyze the treatment and prognosis of lung cancer patients with brain metastases.Methods The clinical data of 352 lung cancer patients with brain metastases were retrospectively reviewed.According to the treatment modalities,patients were divided into palliative therapy group(n=28),simple whole brain radiotherapy(WBRT)or chemotherapy group(n=49)and comprehensive treatment group(n=275).Comprehensive treatment group was subdivided into WBRT plus chemotherapy group(n=192),stereotactic radiosurgery(?knife)plus chemotherapy/WBRT group(n=72,n=16 for?knife plus chemotherapy and n=56 for?knife plus WBRT and chemotherapy)and neurosurgical resection plus chemotherapy/WBRT group(n=11).In comprehensive treatment group,111 patients received chemotherapy≤3 cycles,and the other 164≥4 cycles.Survival curves of each group were drawn respectively,and both survival time and survival rates were compared among groups.Results The median survival time of palliative therapy group,simple WBRT or chemotherapy group,WBRT plus chemotherapy group,?knife plus chemotherapy/WBRT group and neurosurgical resection plus chemotherapy/WBRT group was 1.7,3.2,9.0,11.6 and 17.1 months,respectively.It was revealed by survival analysis that WBRT plus chemotherapy group was better than simple WBRT or chemotherapy group (P=0.0000),?knife plus chemotherapy/WBRT group was better than simple WBRT or chemotherapy group(P=0.0000),and neurosurgical resection plus chemotherapy/WBRT group was better than simple WBRT or chemotherapy group and WBRT plus chemotherapy group(P=0.0001,P=0.0229).There was no significant difference in survival rates between neurosurgical resection plus chemotherapy/WBRT group and?knife plus chemotherapy/WBRT group(P=0.2543),and there was no significant difference in survival rates between those with?knife plus chemotherapy and those with?knife plus WBRT and chemotherapy(P=0.3804).In comprehensive treatment group,the survival rates of those with chemotherapy≥4 cycles was significantly higher than that of those with chemotherapy≤3 cycles(P=0.0000). Conclusion Both WBRT plus chemotherapy and?knife plus chemotherapy and WBRT are effective modalities for the treatment of lung cancer patients with brain metastases,and the latter has the tendency to gain more survival benefit.There is no significant difference in the survival time between patients receiving?knife with WBRT and those without.It is proper for the patients to have no less than 4 cycles of chemotherapy.

ObjectiveTo investigate the concentration of water fluoride and the application of water defluoridation projects in Suizhou,and to provide a basis for water improvement and prevention of the disease.MethodsCross-sectional study was carried out to investigate completely the water defluoridation projects built between 1986 and 2009 in the area under Suizhou's jurisdiction; 3 source water and terminal water samples of the projects in use were collected,respectively; 1 water sample was collected,respectively in the 3 projects with out-ofcommission or discarded water sources that used to be major water supply,for detection of fluoride,chloride,total hardness,heavy metals and other indicators.ResultsA total of 21 projects were investigated,14 projects were in normal use (66.7％),7 projects were out of order and abandoned (33.3％).Of the 14 projects normally used,13projects with water fluoride concentration ≤ 1.0 mg/L(92.9％)and 1 project with water fluoride concentration higher than 1.0 mg/L(7.1％),the concentration of water fluoride in the 7 abandoned projects was higher than 1.0 mg/L(100％).Arsenic and lead levels of all the water samples were normal.There were two water samples with iron content exceeded the standard,and one total hardness of water samples exceeded the standard in the normally used 14 peripheral water sources.One chloride content exceeded the standard,one manganese content exceeded the standard,two iron content exceeded the standard and three total hardness exceeded the standard in the seven abandoned projects.ConclusionsSome defluoridation projects are stopped using and abandoned in Suizhou,and the water fluoride exceeds the standard.

Humans ; Supranuclear Palsy, Progressive ; Acupuncture Therapy

OBJECTIVETo evaluate the clinical effects of posterior spinal transpedicular wedge osteotomy for kyphosis due to delayed osteoporotic vertebral fracture in elderly.

METHODSFrom July 2009 to February 2014,26 patients with kyphosis caused by delayed osteoporotic vertebral fracture were treated with transpedicular wedge osteotomy. There were 10 males and 16 females,aged from 55 to 75 years old with an average of 67 years. There were 1 osteotomy in thoracic vertebra,21 osteotomies in thoracolumbar vertebrae and 4 in lumbar vertebrae. Total 29 vertebrae were involved, 23 cases with single vertebral fracture and 3 cases with double vertebral fractures. Preoperative Cobb angles were 32°~51° with the mean of (42.00 ± 4.75) ° and VAS scores were 6 to 9 points with an average of (8.40 ± 0.75) points. According to the Frankel grade of spinal cord function, 4 cases were grade D and 22 cases were grade E. Intraoperative bleeding, operation time and perioperative complications were recorded, and improvements of Cobb angle were evaluated by X-rays. VAS score and Frankel grade were respectively used to evaluate the pain and nerve function.

RESULTSThe average operation time were 155 min (ranged, 120 to 175) and the mean intraoperative bleeding were 1 100 ml (ranged,800 to 1 500). Postoperative at 2 days, Cobb angle and VAS score were (9.60 ± 2.50) ° and (4.00 ± 1.00) points, respectively, ranged from 5° to 15° and 1 to 5 points. VAS score and Cobb angle improved obviously compared with preoperative (P < 0.05), and the improvement rate of Cobb angle was 76%. Frankel grade of 1 case changed from grade E to C, and the others did not become worse. The follow-up period ranged from 3 to 24 months with an average of 16.4 months. At the final follow-up, Cobb angles and VAS score were (11.00 ± 3.50)° and (4.40 ± 1.25) points, respectively, ranged from 5° to 19° and 1 to 6 points. The patient whose Frankel grade E changed to C at 2 days after surgery and changed to grade D at the latest follow-up. Vertebral body fracture below the fusion level happened in 1 case at 3 months after surgery, vertebral body fracture above the fusion level happened in 1 case at 5 months after surgery, and their chest pain symptoms were relieved after symptomatic treatment and anti osteoporosis treatment. All osteotomy levels obtained fusion which confirmed by X-ray and no internal fixation loosening and breakage were found.

CONCLUSIONThe clinical effect of posterior transpedicular wedge osteotomy for kyphosis due to delayed osteoporotic vertebral fracture was satisfactory, but manipulation during the operation should be cautious and prevent adjacent vertebral body fracture should be pay attention to prevent.

Aged ; Female ; Humans ; Kyphosis ; etiology ; surgery ; Male ; Middle Aged ; Osteoporotic Fractures ; complications ; surgery ; Osteotomy ; methods ; Spinal Fractures ; complications ; surgery ; Visual Analog Scale

Animals ; Lung ; immunology ; pathology ; Male ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Reperfusion Injury ; metabolism ; physiopathology ; Spleen ; immunology ; pathology ; fas Receptor ; analysis

OBJECTIVETo investigate the clinical effects of 360 degree circular decompression and transpedicle screw fixation to treat the ossification of thoracic posterior longitudinal ligament by posterior approach.

METHODSFrom December 2009 to November 2013, 18 patients with ossification of thoracic posterior longitudinal ligament ossification were treated with 360 degree circle decompression and transpedicle screw fixation by posterior approach. There were 8 males and 10 females,ranging in age from 32 to 67 years old, with an average of 51 years old. Four patients were accompanied with ligamentum flavum ossification. Longitudinal ossifications in 5 cases were located in the upper thoracic vertebra and 13 cases in the middle and lower thoracic vertebra. Five cases were typical type, 4 cases were segmental type, 6 cases were continuous type and 3 cases were mixed type. All the patients had the posterior spinal canal decompression combined with longitudinal ligament resection, interbody fusion with bone graft and internal fixation surgeries. The operation time,blood loss and complications were recorded. JOA score were applied to evaluate the neurological function recovery pre-surgery, 2 days post-surgery and the latest follow-up. The surgery effects were evaluated by Epstein-Schwall method.

RESULTSThe operation time ranged from 3 to 6 hours (mean, 4.2 hours). The blood loss ranged from 800 to 4 000 ml (mean, 1 800 ml). All the patients were followed up, and the duration ranged from 6 months to 3 years, with a mean of 1.8 years. The JOA score increased from preoperative 4.30 ± 2.60 to 7.60 ± 2.40 2 days after surgery, and 7.80 ± 1.90 at the latest follow-up (t = 4.61, P < 0.001). The JOA scores between 2 days after surgery and the latest follow-up had no significant differences (t = 0.28,P = 0.78). The neurological recovery rate was 74% 2 days after surgery and 71% at the latest follow-up. There were 4 cases got an excellent result,10 good,3 fair and 1 poor according to Epstein-Schwall evaluation method. Four patients had cerebrospinal fluid leakage, 3 patients had intercostal nerve paralysis or pain, and 1 patient had superficial incision infection. The neurological function in 3 patients became worse in the second day posteratively , and among them, 2 patients were recovered at the latest follow-up and 1 patient had no changes. All the patients got fusion of bone graft and no internal fixation loosening and fractures occurred.

CONCLUSION360 degree circular decompression and transpedicle screw fixation can resect different types of thoracic longitudinal ligament ossification, and can achieve a good clinical effect.

Adult ; Aged ; Decompression, Surgical ; methods ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Male ; Middle Aged ; Ossification of Posterior Longitudinal Ligament ; surgery ; Thoracic Vertebrae ; surgery

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)

Objective To explore the method of clinical application and the final result of the com- pound flap of distally based of saphenous nerve-great saphenous vein nutritional vessels.Methods Basing on the anatomic basis that the nutrient vessels of saphenous nerve-great saphenous vein have the same deriva- tion as the branches of the muscle,bone and skin.Eight cases of the tissue defects of ankles and feet were re- paired by the flap.Results Seven cases were survived completely except the distal partly necrosis in one case.The calcaneal defects of one case were repaired by the iliac graft after two weeks of the operation.Follow up from 3 monthes to one year,the texture,appearance and function of the multiflap were good.Conclusion The compound flap of distally based of saphenous nerve-great saphenous vein nutritional vessels has the ad- vantages as follow:the reliable blood supply,avoidance of sacrificing the major arteries,reconstruction of sen- sation and simply procedure.Besides,the defects of soft tissue and bone can be repaired on one operation.

Objective:To investigate the inhibitory effect of breast cancer-associated antigen 1(BRCAA1)gene silencing on gastric cancer MGC-803 cells and the related mechanism.Methods:Plasmid shRNA-BRCAA1 and shRNA-N were constructed and transfected with FuGene HD into gastric cancer cell line MGC-803.The transfection efficiency was examined using fluorescent microscope 24 h later.The total RNAs was extracted 48 h 'after transfection and the expression of BRCAA1 and GAPDH gene were analyzed by real-time PCR.The cell proliferation was assessed by MTT assay 24 h,48 h,and 72 h after transfection.The cell apoptosis was determined by Annexin V-PE/TAAD.The expression of Rb,Bax, Bcl-2 and BRCAA1 proteins was analyzed by Western blotting 48 h after transfection.Results:We found that the transfection efficiency of shRNA-BRCAA1 was(81.2?2.6)%24 h after transfection.Forty-eight hours after transfection with shRNA-BRCAA1 the expression of BRCAAI mRNA decreased by 61.4%;the inhibition rate of MGC-803 cells growth was 45.0%.The cell apoptosis rate of shRNA-BRCAA1 transfection group was significantly higher than those of untransfected group and mock plasmid transfected group([14.4?1.6]%vs[5.4?2.0]%,[4.4?2.5]%,P

OBJECTIVETo explore the clinical effects of total vertebral column resection combined with anterior mesh cage support in treating severe congenital kyphoscoliosis.

METHODSFrom April 2008 to April 2012,21 patients with severe congenital kyphoscoliosis were treated with total vertebral column resection and internal fixation through posterior approach combined with anterior mesh cage support. There were 8 males and 13 females with an average age of 19.4 years old (ranged from 10 to 35). And 6 cases were thoracic segments deformity,13 cases were thoracolumbar segments and 2 cases were lumbar segments, of them, 2 cases were accompanied with Chairs deformity, 6 cases with diastematomyelia, 4 cases with syringomyelia,and 1 case with neurofibromatosis. According to the Frankel grade system, 3 cases were grade C, 5 cases grade D and 13 cases grade E. Blood loss, operative time, and perioperative complications were recorded. Coronal and sagittal Cobb angle, apical vertebral offset distance, sagittal offset, the relative height of shoulders, razor back deformities were measured and analyzed before and after operation.

RESULTSThe average operative time was 5.2 h (3.5 to 6.5 h) and blood loss was 2,500 ml (1,400 to 4,900 ml). The 2nd day after operation, apical vertebral offset distance, sagittal offset, the relative height of shoulders, razor back deformities had obviously improved than preoperative (P < 0.05). There was no significant difference in above items between postoperative on the 2nd day and final follow-up (P > 0.05). The corrective rate of kyphosis and scoliosis were (60.97 +/- 6.30)% and (62.24 +/- 5.82)%, respectively. On the first day after surgery,2 cases of Frankel grade E aggravated to grade D, and obtained recovery at 2 week after conservative treatment. And 1 case palinesthesia later,grade D aggravated to grade C and obtained recovery after revision surgery in time. One case complicated with permanent blindness of left eye, 1 case occurred injury of pleura and 2 cases had cerebrospinal fluid leak during operation. All patients were followed up from 9 to 31 months with an av- erage of 18.6 months. At final follow-up,all patients obtained bone union, Frankel grade D in 4 cases and grade E in 17 cases, no correction loss and internal fixation loosening was found.

CONCLUSIONTotal vertebral column resection combined with anterior mesh cage support can effectively correct kyphosis and scoliosis in severe congenital kyphoscoliosis and can avoid injury of spine cord by spinal crispation, but intraoperative position and neurologic complications should still be considered.

Adolescent ; Adult ; Child ; Female ; Humans ; Kyphosis ; complications ; congenital ; diagnostic imaging ; surgery ; Male ; Retrospective Studies ; Scoliosis ; complications ; congenital ; diagnostic imaging ; surgery ; Spine ; surgery ; Tomography, X-Ray Computed ; Young Adult