With the continuously exploration,in recent years,further understanding of anatomical characteristics of the cervical pedicle brings great breakthrough in cervical pedicle screw implantation.In addition,pedicle screw implantation in cervical spine is considered as a technique with high safety and reliability,which can be widely used in cervical trauma fracture,cervical instability,degenerative,inflammatory,benign or malignant tumor,deformity and other neck diseases.Because of the tremendous differences between upper cervical spine (C1,C2) and lower cervical spine (C3-7) in anatomical morphology,cervical pedicle screw implantation in C1 and C2 differs from in lower cervical spine.Due to the similar structure of C3-7,pedicle screw implantation methods are based on the same principle and sharing a few points in common.The pedicle screw technique can be classified in two groups according to the practice methods:navigation technology and manual placement of cervical pedicle screw.Navigation nailing is considered as reliable,easy handing,and with clear operative vision,however,with disadvantages as complex procedures,highly cost operation equipment,and risk in navigation draft.Therefore,manual placement of pedicle screw is more reasonable and practical comparing with the former.In this study,it analyzed anatomical characteristics of lower cervical pedicle and the measurement of pedicle structure,discussed technique of manual placement of pedicle screw in lower cervical spine and biomechanical study of pedicle screw,and summed up the comparison of the advantages and disadvantages of current representative manual placement technology.

OBJECTIVETo evaluate the therapeutic effect of MHSP65-TCL on melanoma and its effect on the activity of the immunocytes.

METHODSMHSP65-TCL was prepared by mixing MHSP65 with TCL derived from B16 melanoma cell lysate by repeated freezing and thawing. The MHSP65-TCL vaccine was administered in mice bearing B16 melanoma, and the changes in melanoma growth was observed. To investigate the influence of TCL in MHSP65-TCL on the activity of the immunocytes, we co-cultured TCL and mouse spleen cells in vitro, and analyzed CD69 expression on the cells, cell apoptosis, and levels of IL-10 and IFN-γ in the cell culture supernatant.

RESULTSThe MHSP65-TCL vaccine showed an anti-melanoma effect in the tumor-bearing mice. In the in vitro experiment, TCL in MHSP65-TCL strongly stimulated the activation of mouse spleen cells while causing apoptosis in some of the immunocytes and promoting cellular IL-10 secretion, but not IFN-γ.

CONCLUSIONSMHSP65-TCL derived from B16 melanoma cells has an anti-melanoma effect mediated by the activation of immunocytes. TCL in MHSP65-TCL also has immunosuppressive effect on immunocytes possibly due to the presence of suppressive components in TCL, and identifying and eliminating these components may potentially improve the anti-tumor actovoty of MSHP65-TCL vaccine.

Animals ; Antigens, CD ; metabolism ; Antigens, Differentiation, T-Lymphocyte ; metabolism ; Apoptosis ; Bacterial Proteins ; administration & dosage ; immunology ; Cancer Vaccines ; Cell Extracts ; administration & dosage ; immunology ; Cell Line, Tumor ; Chaperonin 60 ; administration & dosage ; immunology ; Female ; Interferon-gamma ; metabolism ; Interleukin-10 ; metabolism ; Lectins, C-Type ; metabolism ; Melanoma, Experimental ; immunology ; pathology ; Mice ; Mice, Inbred C57BL ; Random Allocation ; Spleen ; cytology ; immunology ; metabolism ; Tumor Burden ; immunology

OBJECTIVETo access left ventricular global deformation abnormalities during low-dose dobutamine stress test (DSE) by three-dimensional speckle-tracking echocardiography(3D-STE)in patients with non-ST-elevation acute coronary syndrome (NSTE-ACS), and explore the diagnostic value of 3D-STE combined with DES for NSTE-ACS.

METHODSForty-nine patients with suspected NSTE-ACS underwent DSE and coronary angiography with an initial dobutamine dose of 5 µg·kg(-1)·min(-1), which was doubled at 3-min intervals to the peak dose of 20 µg·kg(-1)·min(-1). The global longitudinal strain (GLS), global circumferential strain (GCS), territory longitudinal strain (TLS), and territory circumferential strain (TCS) of the left ventricular subendocardial myocardium were measured with 3D-STE at rest and at the peak-dose stage. Conventional echocardiography and 3D-STE parameters and their changes during DSE were evaluated, and their diagnostic values were analyzed according to the receiver-operating characteristic (ROC) curves.

RESULTSAll the patients completed DSE uneventfully and 3D-STE showed a good reproducibility of the results. Compared with patients with non-NSTE-ACS, NSTE-ACS patients showed obviously reduced resting left ventricular global deformation function especially in terms of circumferential deformation (P<0.05); the ROC curves for the parameters were similar between the two groups (P>0.05). During DSE, the global deformation differences between the two groups further increased (P<0.01), and the diagnostic values of the peak-dose stage parameters were significantly greater than those of the resting parameters. ROC curves analysis showed that TLS and TCS at peak-dose stage had the highest diagnostic value for NSTE-ACS.

CONCLUSION3D-STE combined with low-dose DSE is a safe and effective noninvasive technique for accessing and identifying NSTE-ACS, and DSE can significantly enhance the diagnostic value of 3D-STE.

Acute Coronary Syndrome ; diagnosis ; Coronary Angiography ; Echocardiography, Stress ; Echocardiography, Three-Dimensional ; Heart Ventricles ; pathology ; Humans ; Myocardium ; pathology ; ROC Curve ; Reproducibility of Results

Objective To evaluate the therapeutic effect of MHSP65-TCL on melanoma and its effect on the activity of the immunocytes. Methods MHSP65-TCL was prepared by mixing MHSP65 with TCL derived from B16 melanoma cell lysate by repeated freezing and thawing. The MHSP65-TCL vaccine was administered in mice bearing B16 melanoma, and the changes in melanoma growth was observed. To investigate the influence of TCL in MHSP65-TCL on the activity of the immunocytes, we co-cultured TCL and mouse spleen cells in vitro, and analyzed CD69 expression on the cells, cell apoptosis, and levels of IL-10 and IFN-γin the cell culture supernatant. Results The MHSP65-TCL vaccine showed an anti-melanoma effect in the tumor-bearing mice. In the in vitro experiment, TCL in MHSP65-TCL strongly stimulated the activation of mouse spleen cells while causing apoptosis in some of the immunocytes and promoting cellular IL-10 secretion, but not IFN-γ. Conclusions MHSP65-TCL derived from B16 melanoma cells has an anti-melanoma effect mediated by the activation of immunocytes. TCL in MHSP65-TCL also has immunosuppressive effect on immunocytes possibly due to the presence of suppressive components in TCL, and identifying and eliminating these components may potentially improve the anti-tumor actovoty of MSHP65-TCL vaccine.

s:Objective To access left ventricular global deformation abnormalities during low-dose dobutamine stress test (DSE) by three-dimensional speckle-tracking echocardiography (3D-STE)in patients with non-ST-elevation acute coronary syndrome (NSTE-ACS), and explore the diagnostic value of 3D-STE combined with DES for NSTE-ACS. Methods Forty-nine patients with suspected NSTE-ACS underwent DSE and coronary angiography with an initial dobutamine dose of 5μg·kg-1·min-1, which was doubled at 3-min intervals to the peak dose of 20 μg ·kg-1 ·min-1. The global longitudinal strain (GLS), global circumferential strain (GCS), territory longitudinal strain (TLS), and territory circumferential strain (TCS) of the left ventricular subendocardial myocardium were measured with 3D-STE at rest and at the peak-dose stage. Conventional echocardiography and 3D-STE parameters and their changes during DSE were evaluated, and their diagnostic values were analyzed according to the receiver-operating characteristic (ROC) curves. Results All the patients completed DSE uneventfully and 3D-STE showed a good reproducibility of the results. Compared with patients with non-NSTE-ACS, NSTE-ACS patients showed obviously reduced resting left ventricular global deformation function especially in terms of circumferential deformation (P<0.05);the ROC curves for the parameters were similar between the two groups (P>0.05). During DSE, the global deformation differences between the two groups further increased (P<0.01), and the diagnostic values of the peak-dose stage parameters were significantly greater than those of the resting parameters. ROC curves analysis showed that TLS and TCS at peak-dose stage had the highest diagnostic value for NSTE-ACS. Conclusion 3D-STE combined with low-dose DSE is a safe and effective noninvasive technique for accessing and identifying NSTE-ACS, and DSE can significantly enhance the diagnostic value of 3D-STE.

Parkinson′s disease is a common clinical degenerative disease of the nervous system, and rapid eye movement sleep behavior disorder (RBD) is a common sleep symptom of patients with Parkinson′s disease. This article reviews the pathogenesis, epidemiology, clinical characteristics, imaging manifestations, clinical evaluation and treatment of RBD in patients with Parkinson′s disease, in order to deepen the understanding of RBD in patients with Parkinson′s disease.

Objective To evaluate the therapeutic effect of MHSP65-TCL on melanoma and its effect on the activity of the immunocytes. Methods MHSP65-TCL was prepared by mixing MHSP65 with TCL derived from B16 melanoma cell lysate by repeated freezing and thawing. The MHSP65-TCL vaccine was administered in mice bearing B16 melanoma, and the changes in melanoma growth was observed. To investigate the influence of TCL in MHSP65-TCL on the activity of the immunocytes, we co-cultured TCL and mouse spleen cells in vitro, and analyzed CD69 expression on the cells, cell apoptosis, and levels of IL-10 and IFN-γin the cell culture supernatant. Results The MHSP65-TCL vaccine showed an anti-melanoma effect in the tumor-bearing mice. In the in vitro experiment, TCL in MHSP65-TCL strongly stimulated the activation of mouse spleen cells while causing apoptosis in some of the immunocytes and promoting cellular IL-10 secretion, but not IFN-γ. Conclusions MHSP65-TCL derived from B16 melanoma cells has an anti-melanoma effect mediated by the activation of immunocytes. TCL in MHSP65-TCL also has immunosuppressive effect on immunocytes possibly due to the presence of suppressive components in TCL, and identifying and eliminating these components may potentially improve the anti-tumor actovoty of MSHP65-TCL vaccine.

s:Objective To access left ventricular global deformation abnormalities during low-dose dobutamine stress test (DSE) by three-dimensional speckle-tracking echocardiography (3D-STE)in patients with non-ST-elevation acute coronary syndrome (NSTE-ACS), and explore the diagnostic value of 3D-STE combined with DES for NSTE-ACS. Methods Forty-nine patients with suspected NSTE-ACS underwent DSE and coronary angiography with an initial dobutamine dose of 5μg·kg-1·min-1, which was doubled at 3-min intervals to the peak dose of 20 μg ·kg-1 ·min-1. The global longitudinal strain (GLS), global circumferential strain (GCS), territory longitudinal strain (TLS), and territory circumferential strain (TCS) of the left ventricular subendocardial myocardium were measured with 3D-STE at rest and at the peak-dose stage. Conventional echocardiography and 3D-STE parameters and their changes during DSE were evaluated, and their diagnostic values were analyzed according to the receiver-operating characteristic (ROC) curves. Results All the patients completed DSE uneventfully and 3D-STE showed a good reproducibility of the results. Compared with patients with non-NSTE-ACS, NSTE-ACS patients showed obviously reduced resting left ventricular global deformation function especially in terms of circumferential deformation (P<0.05);the ROC curves for the parameters were similar between the two groups (P>0.05). During DSE, the global deformation differences between the two groups further increased (P<0.01), and the diagnostic values of the peak-dose stage parameters were significantly greater than those of the resting parameters. ROC curves analysis showed that TLS and TCS at peak-dose stage had the highest diagnostic value for NSTE-ACS. Conclusion 3D-STE combined with low-dose DSE is a safe and effective noninvasive technique for accessing and identifying NSTE-ACS, and DSE can significantly enhance the diagnostic value of 3D-STE.

Objective:To summarize the best evidence for prevention and management of aspiration in neurosurgical ICU patients and provide evidence for clinical nursing work.Methods:Relevant evidence on prevention and management of aspiration in neurosurgical ICU patients, including guidelines, consensus, system reviews, and randomized controlled trials (RCTs) which were published from 1st January, 2010 to 30th June, 2019 in any language was retrieved from guideline websites, relevant websites and databases. Two researchers evaluated the quality of the included literature and performed evidence extraction on those literatures that met the quality standards.Results:Totally 9 clinical practice guidelines, 8 expert consensus, 13 Meta analysis / systematic reviews and 10 RCTs were included, which were collected and extracted to form the final version of best evidence for aspiration prevention and management including 10 primary indicators and 29 secondary indicators.Conclusions:Medical staff should take effective measures in early assessment of aspiration risks, artificial airway management, position management, enteral nutrition management, sedation and analgesia management, etc., and reduce the incidence of aspiration in neurosurgical ICU patients by applying the best evidence. In addition, hospitals should provide various forms of education and training to medical staff, form transdisciplinary cooperation teams, and strengthen the prevention and management of aspiration.

Objective:To understand the current situation of robot-assisted patient rehabilitation training in neurological disease-related departments of ClassⅢ medical institutions across the country, so as to provide guidance and basis for promoting the improvement of robot-assisted training.Methods:In September 2021, convenience sampling was used to select neurological disease-related departments in Class Ⅲ hospitals from all provinces and cities across the country to conduct a survey on the status of robot-assisted rehabilitation training. A self-designed Hospital Robot-Assisted Training Questionnaire was used for investigation. The survey was conducted using an electronic questionnaire. A total of 250 questionnaires were distributed, and 236 valid questionnaires were recovered, with a valid recovery rate of 94.4%.Results:Among the 236 neurological disease-related departments, a total of 93 (39.4%) departments used robot-assisted rehabilitation training. The robot type was mainly wearable robot, which was mainly used to train lower limb motor function, upper limb motor function, gait ability and so on. A total of 55.9% (52/93) of departments believed that robot-assisted rehabilitation training was more effective than conventional rehabilitation training. Hospital type, department bed turnover times, and daily training time were the main factors affecting the effectiveness of robot-assisted training, and the differences were statistically significant ( P<0.05) . Among the 93 departments that had used robots, 22.6% (21/93) of the departments had not experienced any negative events in the robot-assisted rehabilitation training. The 143 departments that had not yet used robots had a positive attitude towards robots, and the main reasons for not using robots were that robots were too expensive, lacked the guidance of technicians, and were afraid to use them without professional training. Conclusions:Robot-assisted training has been concerned and tried to use by neurological disease-related departments, but the safety still needs to be further enhanced. Medical institutions should formulate robot-assisted rehabilitation training guidelines as soon as possible to guide the application and development of robot-assisted training.