For more than a century,the treatment of cervical disorders has been greatly improved.The researches for the complications of cervical spine surgery have been enhanced during the same period.The objective of this paper is to summarize the progressive results of researches on the complications of cervical spine surgery through literature review.Common surgical complications include hematoma,dural tear,postoperative infection,C5 nerve root palsy,recurrent/superior laryngeal nerve injury,axial pain,etc.Rare complications such as esophageal injury,Homer's syndrome,vertebral artery injury,dysphagia and dyspnea caused by posterior upper cervical spine surgery have also been reported in recent years.The application of cervical instruments provides great support for the improvement of clinical efficacy.However,reports about the related complications also increases year by year,including implant displacement or broken,and special complications associated with cervical artificial disc replacement.Prevention and treatment of complications is the key in clinical practice.For those complications which already have relatively clear causes,such as soft tissue or spinal cannel hematoma,recurrent/superior laryngeal nerve injury,dural tear,accurate and effective operation is highly suggested.However,there's still no standard of operating process for preventing the complications (C5 nerve root palsy,dysphagia,axial pain,etc.),whose pathogeny are still unclear,and further studies are needed in the future.Instrument related complications caused by mal-operation or abnormal patient condition can be effectively controlled through correct medical procedures.Those instrument shortcomings of material or design aspects need to be improved by the auxiliary of cutting-edge technology for further improvement of the results of clinical application.

BACKGROUND:Current decelularized methods have the certain damage to the extracelular matrix and reduce the biomechanical properties of acelular scaffolds. OBJECTIVE:To explore the biomechanical properties of decelularized scaffold of lyophilized bovine tendon. METHODS:Sixty lyophilized fiber bundles from fresh flexion tendon of calf toes were randomly divided into two groups: control group and experimental group. In the experimental group, serine protease inhibitors were placed asepticaly for 24 hours at room temperature, then the samples were rinsed with PBS and transferred to the low concentration of trypsin+ethanol mixed solution to remove the cel wal without destruction of the extracelular matrix at room temperature for 5 hours; after that, the fiber bundles were cultured in DNA enzyme solution for 5 hours, finaly the acelular scaffold was completed and rinsed with PBS for 48 hours and dried at room temperature in sterile room. No treatment was done in the control group. Modulus of elasticity, durability and maximum stress were determined in the two groups. RESULTS AND CONCLUSION:Similar elastic modulus and durability were found in the two groups, but the maximum stress in the experimental group was significantly lower than that in the control group (P < 0.01). These findings indicate that the lyophilized acelular tendon fibers can mimic the biological function of bovine tendon fibers to a certain extent.

Objective:To summarize the experience of Bacillus Calmette-Guerin(BCG) in the treatment of bladder cancer secondary to renal transplantation.Methods:The clinical data of 5 patients who underwent BCG bladder irrigation after secondary bladder cancer after kidney transplantation in Tianjin First Central Hospital from January 2015 to December 2019 were analyzed. There were 1 male and 4 female cases. During the period of immunosuppression after transplantation, 1 case developed secondary high-level non-muscular invasive bladder cancer (NMIBC), 3 cases developed secondary low-grade NMIBC, and 1 case developed secondary glandular cystitis (4 cases). The mean age of the 5 patients with secondary bladder cancer was 59.7±4.0 years. Case one with high level NMIBC was treated with transurethral resection of bladder tumor (TURBT) and postoperative irrigation of epirubicin. Case 3 and 5 with low-level NMIBC accepted regular postoperative irrigation of gemcitabine. No irrigative therapy was performed in case 2. Bladder cancer recurred in case 1, 2, 3 and 5 after 20.1±9.7 months. TURBT was observed in all the 4 patients, among which 3 were of high grade NMIBC and 1 was of low grade NMIBC. Four patients were irrigated with BCG 2 weeks after operation. Postoperative pathology indicated low-level NMIBC in case 4, and BCG was irrigated 2 weeks after the operation. During perfusion therapy, immunosuppressive agents were continued.Results:During BCG perfusion, 4 of the 5 cases showed BCG related local inflammation, among which 2 cases presented symptoms of bladder irritation, 1 case presented hematuria, and 1 case presented hematuria with low fever. Patients with frequent urination, pain in urine, hematuria and other symptoms improved after drinking plenty of water, taking bed rest and taking levofloxacin (0.5g/ day ×7 days). Patients with low fever were treated with antipyretic treatment. No antituberculous agents were used prophylactically during BCG perfusion. There were no symptoms of tuberculosis infection or sepsis. The function of transplantated kidney was normal and no tendency of rejection. The 5 patients were followed up for 7-24 months, 1 patient was lost to follow-up after 7 months of BCG bladder perfusion, and no tumor recurrence or metastasis was found in 5 patients during the follow-up.Conclusions:The use of immunosuppressive agents does not reduce the biological activity of BCG, and BCG does not increase the risk of systemic toxicity or affect the function of transplanted kidneys in immunocompromised patients. BCG is a treatment option for bladder cancer secondary to renal transplantation.

In this study,70 cows with (34.55 ± 8.44) kg per day milk,(2.24 ± 1.01) years at (60-90)d postpartum were chosen from an intensive dairy farm in Heilongjiang province.Ten plasma parameters including reproductive hormones,energy metabolism,liver function and minerals were measured at(60-90)d postpartum from the estrous and ovarian cyst dairy cows,combined with binary Pearson correlation analysis,Logistic analysis and ROC analysis.The results showed that:the incidence of ovarian cysts in this farm was 9.8％,its main reason is negative energy balance;the plasma concentrations of FSH,LH and P4 in ovarian cysts were lower than those in estrus group,but E2 (6.2 ng/L) was significantly higher than that in estrus group ((91.97± 10.62) ng/L);the plasma concentrations of NEFA,BHBA and AST were significantly increased in ovaries cysts at 14-21 d and 60-90 d,and Glu was significantly lower than that in estrus group.When the plasma concentration of BHBA were more than 0.855 mmol/L,NEFA more than 0.585 mmol/L,AST more than 77.0 U/L at 14-21 d postpartum,the risk of ovarian cyst increased.Negative energy balance can cause disorder of reproductive hormone secretion in early lactation cows,and then provoke cyst of follicle.Plasma NEFA,BHBA and AST of dairy cows postpartum can be used to predict the risk of ovarian cysts.

OBJECTIVETo explore the neuropsychological characteristics of children with attention deficit hyperactivity disorder (ADHD).

METHODSNeuropsychological tests, including visual working memory, Stroop test, digits inverse reciting, vocabulary fluency, Wisconsin card sort test (WCST), and Temporal discounting were used to evaluate the capacity of response inhibition, phonological working memory, visual working memory executive function and delayed satisfying capacity of subjects.

RESULTS1. The ADHD children spent longer time [ADHD-I (84(20), ADHD-C: 98 (31), normal: 70 (28)] to accomplish color naming and made more errors [ADHD-I: 3 (3), ADHD-C: 6 (19), normal: 2 (5)] than the normal control when the color was inconsistent with the word meaning in Stroop test (P < 0.01). 2. The scores of digits reciting [ADHD-I: 3 (3), ADHD-C: 3 (4), normal 4 (4)] inverse was lower in ADHD than in normal control (P < 0.01). 3. The representation of ADHD was poorer than normal control in visual working memory [ADHD-I: 21 (3), ADHD-C: 20 (5), Normal: 20 (3)], and in delayed visual memory [ADHD-I: 19 (5), ADHD-C: 19 (5), Normal: 20 (5)] (P < 0.01). 4. The scores of vocabulary fluency [ADHD-I: 1 (1), ADHD-C: 2 (1), normal: 0 (0)] was lower in ADHD than in normal control (P < 0.01). 5. In WCST, the ADHD children made more errors [ADHD-I :15 (17), ADHD-C: 15 (15), normal: 13 (13)] and less classification [ADHD-I: 5 (4), ADHD-C: 5 (4), normal: 5 (3)] than normal control (P < 0.01). 6. In Temporal discounting, the ADHD children showed significantly more impairments than normal control did (P < 0.01). 7. There was significant difference between the two subtype groups on some tests (P < 0.01).

CONCLUSIONSObvious cognitive impairments were found in children with ADHD, involving poor response inhibition, impaired working memory, dysfunction of planning and set-shifting, and there was no significant difference between the two subtype groups.

Attention Deficit Disorder with Hyperactivity ; classification ; immunology ; physiopathology ; psychology ; Child ; Cognition Disorders ; physiopathology ; psychology ; Humans ; Memory ; Memory Disorders ; immunology ; psychology ; Memory, Short-Term ; physiology ; Neuropsychological Tests

Lymphatic leakage and lymphatic cysts are common complications after radical resection of middle- and high-risk prostate cancer. There are many treatment methods but the effect is not accurate. This article reports two patients who were diagnosed by lipiodol lymphangiography under ultrasound guidance and used a mixture of n-butyl cyanoacrylate and lipiodol to embolize lymphatic leakage. Among them, one patient achieved success after one session of interventional embolization. Another patient achieved success after 3 interventions and embolization. Two patients had no complications related to lymphatic interventional therapy, and no lymphatic leakage recurred during the 3-month follow-up. Ultrasound-guided lymphangiography and lymphatic embolization through the inguinal lymph nodes are a feasible option for the treatment of refractory lymphoma leakage

Objective To investigate the clinical features of recurrent epileptic seizures and perioperative management principles and methods of neurosurgical patients with recurrent epileptic seizures.Methods The clinical data,reasons for aggravated seizures,seizure characteristics,and treatment methods and results of 9 patients with recurrent epileptic seizures were analyzed retrospectively.Results Of all the 9 patients,3 were combined with glioma,1 with arachnoid cyst,1 with cavernous hemangioma and 1 with encephalomalacia; epilepsy history was noted in 7 patients; frontal lobe epilepsy was noted in 7,and temporal lobe epilepsy in 2.The reasons for seizure aggravation included drug-decrement(n=3),recent-diagnosed brain tumor(n=2)and surgical operation during intracranial electrode implantation(n=1); and unknown reason was noted in the other 3.Epileptic seizure types included partial seizure and secondary generalized seizure; the frequency of seizure ranged from 3 minutes of interval to several hours of interval.Patients given multiple antiepileptic drugs,including oral and parenteral administration,received good seizure-control; and levetiracetam showed good curative effect during the treatment.Conclusion Recurrent seizures show drug refractory,and is hard to control.The AEDs having good curative effect in partial seizure should be combined used in these patients with higher dosage than conventional initial dose; intravenous and intramuscular administration can be used; the seizures should be controlled as soon as posible.Levetiracetam has good curative effect on patients with recurrent seizures for its fast oral-absorption,rapid onset of action and good antiepileptic effect.

OBJECTIVETo explore the effect of Osteoking on bone mineral density (BMD) and serum Dickkopf-1 (DKK-1) protein levels in rabbits with osteoporotic fracture (OPF).

METHODSTotally 45 female Japanese big-ear rabbits were randomly divided into the treatment group, the model group, and the blank control group (as the control group), 15 in each group. Bilateral ovaries were ectomized for 24 weeks in the treatment group and the model group. Their left radial factures were induced after confirmed osteoporosis. Rabbits in the treatment group were administered with Osteoking by gastrogavage, once per two days. Equal volume of normal saline was given to rabbits in the model group. The general BMD and serum DKK-1 protein levels were detected before ovariectomy, at week 24 and 48 after ovariectomy.

RESULTSThere was significant difference in the general BMD at week 24 after ovariectomy between the model group and the control group, and it was lower in the model group. Compared with the model group, the general BMD significantly increased and serum DKK-1 protein levels significantly decreased in the treatment group after intervention. Serum DKK-1 protein levels were significantly lower after intervention than before intervention in the treatment group.

CONCLUSIONOsteoking could improve the BMD of OPF rabbits, and reduce their serum DKK-1 protein levels as well.

Animals ; Bone Density ; drug effects ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Female ; Humans ; Intercellular Signaling Peptides and Proteins ; metabolism ; Osteoporosis ; Osteoporotic Fractures ; drug therapy ; metabolism ; Ovariectomy ; Rabbits

Objective To explore the implementation styles on the therapeutic effects on the neurosurgical intensive care unit (NICU) patients. Methods Patients were enrolled during February 3, 2015 to February 3, 2016. The key point time was August 3, 2015 when the treatment in our NICU was fully implemented by NICU professional doctors. Based on this time point, all the enrolled patients were divided into non-NICU professional doctor implementing (NNPDI) group and NICU professional doctor implementing (NPDI) group. Thus non-NICU professional doctors and professional doctors were the leaders of diagnosis and treatment in tow groups. The length of hospital stay, complications, prognosis and other therapeutic outcomes were compared between two groups. Results The length of hospital stay was longer in NPDI group than that in NNPDI group (P<0.05). The incidence of water-electrolyte imbalance was lower in NPDI group than that in NNPDI group (P<0.05). There were no significant differences in the incidence of the ventilator-associated pneumonia (VAP), the hepatic and renal insufficiency, the intracranial infections and stress ulcers between the two groups (P>0.05). The proportion of referral to other wards and fatality rate were both lower in NPDI group than those in NNPDI group (P<0.05). And the discharge rate from NICU was higher in NPDI group than that of NNPDI group (P<0.05). There was no significant difference in the rate of patients left hospital without treatment between the two groups (P>0.05). Conclusion The NICU professional doctor implementing may be contribute to, at least in part, the improving of prognosis of NICU patients without obvious advantages in most complications. The level of professional management remains to be improved.

OBJECTIVE: To study the mRNA level of runt-related transcription factor 3 (RUNX3) in children with bronchiolitis and its clinical significance in bronchiolitis. METHODS: A total of 54 young children with bronchiolitis were enrolled as the bronchiolitis group, among whom 28 with atopic constitution were enrolled in the atopic bronchiolitis group and 26 with non-atopic constitution were enrolled in the non-atopic bronchiolitis group. A total of 48 healthy young children were enrolled as the healthy control group, among whom 24 with atopic constitution were enrolled in the atopic healthy control group and 24 with non-atopic constitution were enrolled in the non-atopic healthy control group. Quantitative real-time PCR was used to measure the mRNA level of RUNX3 in peripheral blood mononuclear cells. ELISA was used to measure the serum levels of interleukin-4 (IL-4) and interferon gamma (IFN-γ). RESULTS: The bronchiolitis group had a significantly lower mRNA level of RUNX3 than the healthy control group, and the atopic bronchiolitis group had a significantly lower mRNA level of RUNX3 than the non-atopic bronchiolitis, atopic healthy control, and non-atopic healthy control groups (P<0.05). The bronchiolitis group had a significantly higher serum level of IL-4 than the healthy control group, and the atopic bronchiolitis group had a significantly higher serum level of IL-4 than the non-atopic healthy control group (P<0.05). The bronchiolitis group had a significantly lower serum level of IFN-γ than the healthy control group, and the atopic bronchiolitis group had a significantly lower serum level of IFN-γ than the non-atopic bronchiolitis, atopic healthy control, and non-atopic healthy control groups (P<0.05). The correlation analysis showed that the mRNA level of RUNX3 was negatively correlated with the serum level of IL-4 and was positively correlated with the serum level of IFN-γ (P<0.05). CONCLUSIONS Measurement of RUNX3 gene expression in peripheral blood mononuclear cells has a certain value in identifying children with atopic constitution at high risk of asthma among children with bronchiolitis.
Asthma ; Bronchiolitis ; Child ; Child, Preschool ; Core Binding Factor Alpha 3 Subunit ; genetics ; Humans ; Interferon-gamma ; Leukocytes, Mononuclear