Objective To investigate the diagnostic value of electrophysiological examination for tarsal tunnel syndrome (TTS).Methods Motor nerve conduction velocity (MCV),sensory nerve conduction velocity (SCV),F wave and electromyographic measurements were carried out with 26 clinically suspected TTS patients.Results Of the 26,22 patients were unilaterally affected and 4 were bilaterally affected,so 30 tarsal tunnels in total were affected.All received electrophysiological examination.Of the 30 affected tarsal tunnels,abnormal MCV was detected in 28 of the posterior tibial nerves (93.3％),while abnormal SCV was detected in 27 medial plantar nerves (90％) and 24 lateral plantar nerves (80％).Needle electromyography of 156 targeted foot muscles detected abnormal spontaneous potentials in 90 of them (57.7％),giant potential in 12 muscles (7.7％) and decreased recruitment in 76 (48.7％).Conclusions The distal posterior tibial nerve is impaired in TTS,presenting axonal damage in an electrophysiological examination.Such examinations should have an important role in the diagnosis and differential diagnosis of TTS.

Objective To determine the expression spectrum of microRNA(miRNA)in the lung homogenate of rats with chronic obstructive pulmonary disease(COPD)or healthy rats,to look for differentially expressed miRNA, and to explore their potential role in pathogenesis of COPD. Methods Twenty male Sprague-Dawley(SD)rats were randomly divided into normal control group and COPD model group,with 10 rats in each group. COPD rat models were reproduced by smoke inhalation as well as intratracheal instillation of lipopolysaccharide(LPS). The samples of the lung were harvested,and the histopathological examination of the right lung was carried out to evaluate the degree of lung injury. Total RNAs were isolated from the left lung. The miRNA expressions in lung tissue of rats with COPD or normal rats were determined by miRNA chip eichnology to screen the miRNA with differential expression, and hierarchical clustering analysis was made. The data were analyzed to study the expression difference of miRNAs between the two groups,and to construct the miRNA-Target network. Results Compared with normal control group, 20 miRNA with increased expression were found in COPD model group,the top 10 were miR-30c-2,miR-199a-5p, miR-30a, miR-145, miR-151, miR-674-5p, miR-214, miR-423, miR-28 and miR-181b, and only miR-376b-3p showed down-regulation. Hierarchical clustering analysis showed that significant differences in individual miRNA in lung tissue between rats of two groups were found. However,similar samples could not be gathered well,thus it may give rise to inconsistency during the sample preparation. Many miRNAs had multiple target genes in miRNA-Target network, such as miR-30c-2, miR-145, miR-181b, miR-181a, miR-181d, miR-199. Conclusions The study reveals that there is a variance of miRNAs expression profile in lung homogenates between COPD group and the normal control group of rats,and many miRNAs have multiple target genes,such as miR-30c-2,miR-145,miR-181b,miR-181a,miR-181d,and miR-199. Therefore,the results may be valuable to centain extent for the interpretation of COPD pathogenesis.

Objective:To investigate the effects of ultrasound-guided intervention with methotrexate combined with lauromacrogol on uterine wall thickness and menstrual recovery time in patients with uterine scar pregnancy.Methods:Sixty patients with uterine scar pregnancy who received treatment in Jinhua Wenrong Hospital, Jinhua Central Hospital, and Yiwu Maternity and Children Hospital from February 2019 to February 2020 were included in this study. They were randomly assigned to receive either uterine artery embolization treatment ( n = 30, control group) or ultrasound-guided interventions with methotrexate combined with lauromacrogol ( n = 30, study group). The success rate of treatment, uterine wall thickness at the scar, menstrual recovery time, hospitalization time, hospitalization expenses, incidence of adverse reactions, serum levels of beta-human chorionic gonadotropin (β-HCG) and high sensitivity C-reactive protein (hs-CRP) after 7 days of treatment and uterine wall thickness before and after treatment were compared between the study and control groups. Results:After treatment, the success rate of treatment in the study group was significantly higher than that in the control group [96.67% (29/30) vs. 70.00% (21/30), χ 2 = 7.680, P < 0.05]. Before treatment, there were no significant differences in β-HCG and hs-CRP levels between the control and study groups ( t = -0.197, 0.197, both P > 0.05). After treatment, serum level of β-HCG in the control and study groups was significantly decreased ( t = 22.803, 10.233, both P < 0.01), and serum level of hs-CRP in the control and study groups was significantly increased ( t = -16.357, 7.854, both P < 0.001) compared with before treatment. After treatment, there were no significant differences in serum β-HCG and hs-CRP levels between the control and study groups ( t = 20.413, -20.306, both P < 0.05). After treatment, the incidence of adverse reactions in the study group was significantly lower than that in the control group [6.67% (2/30) vs. 30.00% (9/30), χ 2 = 5.455, P < 0.05). After treatment, menstrual recovery time, hospitalization time and hospitalization expenses in the study group were shorter or less than those in the control group ( t = 5.080, 5.398, 7.599, all P < 0.05). There was no significant difference in the thickness of uterine wall at the scar site between the two groups ( t = -1.045, P > 0.05). Conclusion:Ultrasound-guided intervention with methotrexate combined with lauromacrogol for treatment of uterine scar pregnancy can effectively increase the success rate of treatment, promote the restoration of menstruation, shorten the length of hospital stay, and is highly safe.

Objective To evaluate the application value of the micro movement sensitive mattress sleep monitoring system(MSMSMS) in the diagnosis of children with obstructive sleep apnea syndrome (OSAS).Methods One hundred and twenty-nine children aged from 3 to 14 years who visited the sleep center of Beijing Children's Hospital Affiliated to Capital Medical University from June 2013 to June 2015 due to sleep snoring were enrolled.Children with acute respiratory infection,cranial facial abnormalities,chronic lung diseases and neuromuscular diseases were excluded.According to the criteria,36 children were diagnosed as OSAS with average age of (7.3 ± 2.5) years,including 28 males and 8 females.Ninety-three non-OSAS children were recruited with average age of (6.3 ± 2.3) years,including 61 males and 32 females.Subjects were monitored with polysomnography(PSG) and MSMSMS simultaneously.Apnea/hypopnea index (AHI) ＞ 5 or obstructive apnea index (OAI) ＞ 1 were used to define whether OSAS existed.The consistency between MSMSMS and PSG in the diagnosis of OSAS and the determination of sleep efficiency were compared.Results The Kappa consistency coefficient of MSMSMS and PSG in the diagnosis of OSAS was 0.70(95％ CI:0.57-0.84),Z =7.99,P ＜ 0.000 1,which indicated the consistency between PSG and MSMSMS was good.The consistency of sleep efficiency of MSMSMS and PSG were compared.Bland-Altman results showed that there were 3％ (5/129 cases)points out of 95％ consistency bound and the interclass correlation coefficient (ICC) was 0.69 which indicated the consistency of 2 methods was good in determination of sleep efficiency.MSMSMS was able to detect respiratory event that was associated with sub-cortical arousals with no electroencephalogram arousal or blood oxygen reduction.Conclusions There is an adequate consistency between MSMSMS and PSG in the diagnosis of children with OSAS and determination of sleep efficiency.The MSMSMS has an advantage in detection of sub-cortical arousals and respiratory event.

Objective To compare the effectiveness and safety of central venous catheters inserted from the left side and right side during peripheral inserted central catheterizations (PICC). Methods Totally 458 adult patients undergoing PICC between May 2007 and May 2008 were enrolled in this study and divided randomly into right-sided group (n = 228)and left-slded group (n = 230). Chest X-ray was performed immediately after catheterization to identify the initial tip locations. Other parameters were evaluated during follow-up. Results The rate of difficult insertion was significantly lower in right-sided group than in left-sided group (14.9% vs 24. 8% , P =0.003). The rate of tip projection angle ＞40°was also significantly lower in right-sided group (2.2% vs 23.4% ,P = 0. 000). The rate of tips reaching the central veins was not significantly different between two groups (54.4%vs 53.0% , P = 0. 538). Compared with right-sided catheters, the tip positions in the left-sided group was significantly less frequently located in the inferior segment of superior vena cave in the central tip locations (6. 6% vs 21.0% , P =0. 001)and more commonly positioned in the nominate vein in non-central tip locations (66. 7% vs 48.1% , P = 0. 008). In addition, the catheter detaining time (P = 0. 617), incidence of local phlebitis after puncture (P = 0. 561), catheter obstruction rate (P = 0. 774), and catheter-related infection rate (P = 0. 854)showed no significant differences between two groups. The incidence of swollen limb was significantly lower inright-sided group than in left-sided group (4. 4% vs 8.3%, P = 0. 043). Conclusions Right-sided catheters provide better outcomes than left-sided catheters. PICC through the right elbow veins should be preferred in clinical practices.

Objective To compare the effects of different doses of amino acids and fat emulsions in parenteral nutrition on the incidence of complications and prognosis in very low birth weight infants (VLBWI). Methods The clinical data of 328 VLBWI who received nutrition support therapy for at least 5 days starting in 72 h after birth during January 2005 to December 2014 , were retrospectively analyzed. According to the dosage in parenteral nutrition, patients were divided into low-dose group and high-dose group. The incidence of complications and prognosis between two groups were compared. Results There were 204 cases in low-dose group and 124 cases in high-dose group. Compared with the low-dose group, the incidence of complications was lower in high-dose group during hospitalization and the incidence of intracranial hemorrhage was reduced most;the incidence of developmental retardation was lower at discharge;the overall incidence of metabolic complications of parenteral nutrition was higher, among which the incidence of high blood glucose, electrolyte disturbance and cholestasis were increased and the incidence of hypoglycemia was lower, and the differences were all statistically signiifcant (P??0 . 05 ). Conclutsions VLBWI can tolerate early aggressive parenteral nutrition which can reduce the incidence of extrauterine growth retardation and premature complications.

Objective To explore the clinical value of expression of CEA and CK-20 detected by flow cytometry (FCM) in peritoneal washes on predicting peritoneal metastasis and prognosis of gastric carcinama.Methods Clinicopathological characteristics and follow up data of 105 patients with gastric carcinoma who were underwent D2 radical resection (R0) were collected.Peritoneal washes was collected.Peritoneal lavage cytology examination (PLC) was used to find intraperitoneal free cancer cells (IFCC).FCM was used to determine the CEA and CK-20 expressions.Meanwhile,13 patients with benign lesion on the stomach and the gastric carcinama cell line SGC-7901 were served as the negative and positive control,respectively.Results Positive expression of CEA was in 48 (45.7 ％) patients,of CK-20 was found in 67 (63.8 ％) patients,and of CEA and CK-20 was in 85 (81.0 ％) patients by FCM.However,positive expression of IFCCs was found in 31 patients(29.5 ％) by PLC.The expression of CEA and CK-20 were related to serosa invasion,lymphnode metastasis and pTNM stage (P ＜ 0.05).The median survival of patients with negative expression of both CEA and CK-20 (n =20) was significantly longer those with positive expression (n =30)(52 vs 18 months,P ＜ 0.05).Conclusions Combined Detection of CEA and CK-20 in peritoneal washes by FCM can be used to predict peritoneal micrometastasis and may predict the prognosis of gastric carcinoma.

Objective To explore a method of establishing a canine model of intracerebral hemorrhage (ICH) by puncturing the main branch of middle cerebral artery (MCA) under ultrasonic guidance and proceed a pilot study of contrast-enhanced ultrasound (CEUS) of ICH.Methods Twelve adult healthy mongrel dogs were enrolled in the experiment.In the condition of bone window,the main branch of MCA was punctured to bleed under the ultrasonic guidance.CEUS of brain was performed every 30 minutes until hematoma formed and another CEUS was performed at 24 hours.Then brains were collected for pathologic examination after dogs were euthanized.Results Eleven of twelve dogs developed ICH successfully that located in the Out edge of basal ganglia,which was confirmed by CEUS and autopsy.One dog died within 6 hours due to intraventricular hemorrhage which was confirmed by autopsy.The hematoma diameters were measured as (22.4 ± 7.1)mm by CEUS before euthanasia and as (21.6 ± 6.9)mm on autopsy.There was no significant difference between the two methods of measurement (t =1.521,P =0.1565).The characteristics of active bleeding and hematoma on ICH were performed in the CEUS imaging.Conclusions A model of dog ICH by puncturing the main branch of MCA under the guidance of ultrasound was established successfully,and it proved to be simple,effective and repeatable.The imaging characteristics of this model are in good accordance with those of ICH in patients.

OBJECTIVETo explore the effectiveness of absorbable hemostatic fluid gelatin in preventing postoperative cerebrospinal fluid leakage.

METHODSThe clinical data of 17 patients with dura mater tear were retrospectively analyzed from March to September in 2003. There were 16 males and 1 female, aged from 16 to 67 years old with an average of (39.6 ± 15.4) years. The injury site was at cervical vertebrae in 1 case, thoracic vertebrae in 9 cases, thoracolumbar junction in 4 cases, lumbar vertebrae in 3 cases. There were burst fracture in 4 cases and fracture-dislocation in 13 cases. According to ASIA grade, 12 cases were grade A, 2 cases were grade B, 2 cases were grade D, 1 case were grade E. Two cases caused by traffic accident, 10 by high falling, 4 by heavy parts crash, 1 by stairs fell during the earthquake. Absorbable hemostatic fluid gelatins were used to plug the dura mater tear,in order to prevent postoperative cerebrospinal fluid leakage. Postoperative drainage were recorded every day.

RESULTSOf 17 patients, 15 cases did not develop with cerebrospinal fluid leakage. Two cases develop with cerebrospinal fluid leakage after operation and their drainage were removed at 6 to 7 days after operation. In all cases, no complications related with cerebrospinal fluid leakage occurred, such as headache, dizzy, fever,neck resistance, rash, incision disunion, incision infection, hematoma, neurologic symptoms aggravation. No abnormal phenomena was found on incision surrounding at follow-up of 9 months.

CONCLUSIONUsing absorbable hemostatic fluid gelatin to plug the dura mater tear during operation is an effective method in preventing postoperative cerebrospinal fluid leakage.

Adolescent ; Adult ; Aged ; Cerebrospinal Fluid Leak ; prevention & control ; Female ; Gelatin ; administration & dosage ; Hemostatics ; administration & dosage ; Humans ; Male ; Middle Aged ; Postoperative Complications ; prevention & control

OBJECTIVE Gastric cancer is one of the most common malignant tumors,and the inci-dence rate is the highest in all kinds of tumors in China. However,it remains unclear that how signifi-cantly gastric cells are dependent on glycolysis,and which type of gastric cells are sensitive to glycolysis inhibition. In this study, several kind of gastric cancer cell lines were used as the research object, and the metabolic characteristics of different cell lines were systematically analyzed to provide theoretical support for the accurate treatment of gastric cancer. METHODS We examined the energy metabolism of four gastric cancer cell lines(MGC-803,SGC-7901,HGC-27 and BGC-823)by using glycolysis inhibitor, 2-deoxy-D-glucose(2-DG)and inhibitor of oxidative phosphorylation,oligomycin.Oxygen consumption rates(OCR)and L-lactate were also measured with an XF96 Analyzer(Seahorse Biosciences)to deter-mine the significance of metabolism of oxidative phosphorylation and aerobic glycolysisin gastric cells. In addition, western blot was used to detect the contribution of AMP-activated protein kinase (AMPK), and anti-apoptotic proteins(Bcl-2 and survivin)to clarify the mechanism of death or survival of gastric cancer cells treated by 2-DG or oligomycin. RESULTS In this study, it was shown that the growth of gastric cell lines were suppressed by 2-DG.However,the sensitivity to 2-DG was quite different among cell lines:IC 50 of 2-DG was from 3.28 mmol·L-1(MGC-803)to 15.57 mmol·L-1(BGC-823).MGC-803 was relatively sensitive to 2-DG (IC 50:3.28 mmol·L-1), consumed more glucose and produced more lactate (waste product of glycolysis) than the three other cell lines. Consequently, MGC-803 could be more dependent on glycolysis than other cell lines, which was further confirmed by the fact that glucose (+)FCS(-)medium showed more growth and survival than glucose(-)FCS(+)medium.Alternatively, BGC-823, most resistant to 2-DG (IC50: 15.57 mmol·L- 1), was most sensitive to oligomycin, and showed more growth and survival in glucose(-)FCS(+)medium than in glucose(+)FCS(-)medium. Thus,we had reasons to think BGC-823 cells depended on oxidative phosphorylation for energy production. In BGC-823,AMPK,which is activated when ATP becomes limiting,was rapidly phosphorylated by 2-DG, and expression of Bcl-2 was augmented,which might result in resistance to 2-DG.Interestingly,AMPK phosphorylation and augmentation of Bcl-2 expression by 2-DG were not observed in MGC-803,which is 2-DG sensitive. CONCLUSION There is a large metabolic difference between gastric cancer cell lines,which will facilitate the future gastric cancer therapy by targeting metabolic pathways.