AIM: To investigate the clinic effect of the femoral neck fracture (FNF) with percutaneous internal fixation of hollow screw Ti-nails. METHODS: A total of 57 patients with closed FNF were recruited from Department of Orthopaedics in the First Mine Hospital of Pingdingshan Coal Group from February 2001 to December 2005. They were treated with 3 hollow screw Ti-nails (produce by Shanghai Qunli Medical Devices Co., Ltd) in 5-mm diameter under C-arm X-ray monitoring after close reduction by hand, punctured with 4-6 bone round nails in 2.5-mm diameter through skin for prefixation. The patients were encouraged to stretch and flex muscles early and perform articular physiological movement. The criteria of outcomes: Excellent: the patients were completely cured in six months after surgery, no pain was found in diseased coxa, the articular movement was normal, and they could walk freely half one year after surgey. Good: The fracture was cured in 9 months lately or no healing, there was a little ache in diseased coxa, the articular movement was limited, and they could walk normally in 10-12 months after surgery and recover slight work. Bad: The fractures were not cured, there were absorption, shifting, and aching in fracture joint early, and they need walk with walking stick. RESULTS: There were 55 cases followed up for 9 months, 51 cases for 18 months, and 57 cases for 42 months.①The curative effect of FNF by internal fixation was excellent in 27 cases, good in 20 cases and bad in 10 cases. ②Host response: 6 patients suffered from fracture shift due to screw-nail displacement, 4 patients got bone un-union, 6 patients experienced femoral head necrosis, and 2 patients got ache at bone fracture and were limited for articulation movement. No infection and rejection happened among 57 patients. CONCLUSION: The treatment of AO cannula Ti-screws internal fixation under closed reduction is effective for FNF, and no abnormal biocompatibility between materials and host appears in the clinical follow-up.

ObjectiveTo analyze the incidence,etiology and clinical treatment of the impacted maxillary central incisors.Methods A retrospective study was conducted on 29 cases of impacted maxillary central incisors that were randomly selected from the 1000 patients.Age of the patient was ranged from 7 to 23 years with median 11.1 years.Numbers of impacted teeth were 32,in which 22teeth were intraosseous impaction and others were extraosseous.The incidence,etiology,sites and direction of impacted teeth and their treatment approaches were explored in this study.Results Impac tion of maxillary central incisors occurred more frequently in females than in males,with a ratio of 1.0 ∶ 1.2.The ratio of intraosseous impaction to extraosseous one was 11 ∶ 5.The insufficient eruption space of maxillary central incisors was present in 65％ patients,but intermediate and severe crowded teeth only accounted for 15％.The incidence of the abnormal site and position of impacted teeth reached 71 ％.The clinical approach and solution were surgical-orthodontic treatment,transplantation or removal of impacted teeth.ConclusionsThe main cause is abnormity of teeth in the shape and position.Most of the impacted maxillary central incisors could be moved to the correct position by effective treatment.

Objective To investigate the risk factors and clinical characteristics,auxiliary examination char-acteristics,treatment and prognosis for acute stroke patients with deep vein thrombosis (DVT),in the hope of provi-ding the detailed clinical data for hospitalized patients with stroke in early prevention,early diagnosis and early treat-ment of DVT.Methods 160 cases of stroke patients were reviewed including 66 cases of patients with hemiplegia after stroke and ultrasound confirmed DVT data analysis,And compared with the same period of 94 cases of DVT in patients with stroke.The purpose of this study was to evaluate the incidence of DVT,possible risk factors,and clinical characteristics.Results Stroke in patients with DVT spent an average of 16d.DVT occurred in elderly patients (65 years or higher) with 44 cases,accounting for 66.67%;Serious paralytic 42 cases (72.72%),long-term bed 52 cases (78.78%);The most commonly comorbid disease was diabetes mellitus,hypertension and hyperlipidemia;The plasma fibrinogen concentration was (5.02 ±1.38) g/L,which was significantly higher than (2.74 ±1.65) g/L of the control group.Compared with control group,the difference was statistically significant (t=4.78,P<0.01). Conclusion Limb paralysis,long-term lie in bed,older age and high condensation state are DVT risk factors,which should be paid to prevent in advance clinically.

Objective To investigate the diagnostic value of CTP-SI in acute stroke less than 9 hours.Methods In present study."one-stop shop"CT examination were performed in 34 patients with symptoms of acute stroke in le88 than 9 hours.We divided patients into two groups according to with and without delayed perfusion on CTP-SI.and compared ASPECTS (Alberta Stroke Program Early CT Score Study)scores on non-contrast CT(NCCT),arterial phase CTP-SI,venous phase CTP-SI with follow-up imaging.The ASPECTS were analyzed on arterial phase CTP-SI and veIlous phase CTP-SI using Wilcoxon rank-sum test.then compared with the follow up imaging ASPECTS using multiple linear regression.Results The median(min-max)scores of ASPECTS on NCCT,arterial phase CTP-SI,venous phase CTP-SI and follow-up imaging were 9.0(6.0-10.0),6.5(1.0-8.0),8.0(3.0-10.0)and 7.0(0-10.0)in group with delayed perfusion,respectively,and 9.0(1.0-10.0),8.5(1.0-10.0),8.5(1.0-10.0)and 8.0 (0～10.0)in group without delayed perfusion respectively.ASPECTs scores measured on arterial phase CTP-SI did not differ from venous phase CTP-SI in group without delayed perfusion ( Z = - 1.00, P =0.317), while there was significant difference in group with delayed perfusion (Z = -3.08, P = 0.002 ).There were significant correlation with ASPECTS scores measured on NCCT, arterial phase CTP-SI and venous phase CTP-SI to follow-up imaging ASPECTS (r =0.899,0.926,0.928,P ＜0.01 ) in group without delayed perfusion; ASPECTS measured in venous phase CTP-SI showed the best correlation to follow-up imaging ASPECTS (r = 0.762, P = 0.004) in group with delayed perfusion.Multiple linear regression showed that the correlation in only venous phase CTP-SI with foUow-up imaging ASPECTS was statistically significant:in group without delayed perfusion, Beta = 0.966, P ＜ 0.001 ; in group with delayed perfusion,Beta = 0.765, P = 0.004. Conclusion Presence of delayed porfusion in CTP-SI is quite important in identifying ischemic penumbra, which plays a critical role in imaging-guided thrombolytie therapy.

Objective:To explore the regional brain activities in healthy adolescent subjects after sleep deprivation (SD) using amplitude of low-frequency fluctuation (ALFF) method.Methods:Total of 16 healthy adolescent subjects (8 males,8 females;aged 13-20 years) were recruited in the community and the campus through the internet and posters.Each of the 16 healthy adolescent subject underwent the attention network test and magnetic resonance imaging (MRI) session twice:once was after rested wakefulness (RW condition),and the other was after SD condition.Amplitude of low frequency fluctuation (ALFF) method was used to assess the local brain features.The mean ALFF signal values of the different brain areas were performed to investigate their relationships with the accuracy rate,reaction time and lapse rate in the attention network test,and were analyzed with a receiver operating characteristic (ROC) curve to investigate their sensitivities and specificities to distinguish the SD condition from the RW condition.Results:Subjects showed a lower response accuracy rate [(83 ± 12) ％ vs.(97 ± 4) ％,P ＜ 0.05],a longer response time [(832 ± 134) ms vs.(715 ± 97) ms,P ＜ 0.05] and a higher lapse rate [(15 ± 11)％ vs.(2.4 ±7.3)％,P ＜0.05] under SD condition than under RW condition.They showed higher ALFF area in the right cuneus (BA 17,BA 18),and lower ALFF areas in the right lentiform nucleus,right claustrum,left dorsolateral prefrontal cortex (BA 46) and left inferior parietal cortex (BA 39) under SD condition than under RW condition.Under SD condition,the mean ALFF signal value of the right claustrum showed a significant positive correlation with the accuracy rate (r =0.69,P ＜0.05),and a negative correlation with the lapse rate (r =-0.71,P ＜0.05).The mean ALFF signal value of the dorsolateral prefrontal cortex showed a significant positive correlation with the reaction time (r =0.68,P ＜ 0.05).The values of area under the curve of the right cuneus,right lentiform nucleus,right claustrum,left dorsolateral prefrontal cortex and left inferior parietal cortice were 0.9,0.8,0.9,0.8 and 0.9,respectively.These different ALFF areas also showed high degree of sensitivities and specificities.Conclusion:Sleep deprivation leads to the dysfunction in the default mode network,anticorrelatedtask-positive network,and advanced cognitive function brain areas,and the functional compensation in the visual network.

OBJECTIVE:To study the improvement effect of geniposide on cognitive dysfunction in model rats with diabetes. METHODS:50 rats were randomly divided into blank control group(distilled water),model group(distilled water)and genipo-side low-dose,medium-dose,high-dose groups(5,10,20 g/kg),10 in each group. Except for blank control group,rats in other 4 groups were fed with high-sugar and high-fat diet and injected streptozotocin to induce diabetes model. After modeling,rats in each group intragastrically administrated relevant medicines,once a day,for 8 weeks. After last administration,fasting blood glu-cose(FPG),glycosylated hemoglobin(HbA1c)levels,escape latency period in Morris water maze test,and correct rate of behav-iors in Y maze test of rats in each group were detected. RESULTS:Compared with blank control group,FPG,HbA1c levels of rats in model group were obviously increased,escape latency period was obviously prolonged,correct rate of behaviors in Y maze test was obviously decreased,with statistical significances(P<0.05). Compared with model group,above-mentioned indexes in genipo-side groups were obviously improved(P<0.05),which were positively correlated with dose(P<0.05). CONCLUSIONS:Genipo-side can effectively reduce blood glucose level of model rats with diabetes and improve their cognitive dysfunction.

OBJECTIVE: To compare the effectiveness of vocal cord cyst excision with electronic laryngoscope (EL) and self-retaining laryngoscope (SRM). METHOD: Nightly-two patients, diagnosed as vocal cord cyst with strobolaryngoscope or electronic laryngoscope, were randomly divided into two groups. One group was 48 cases treated with electronic laryngoscope and another group was 44 cases treated with self-retaining laryngoscope. Electronic laryngoscopy examination and voice function assessments were performed to all patients, preoperatively and postoperatively at one week, three months and six months. RESULT: One failed cases under SRM, difficult exposure of glottic portion, were treated under EL. The recurrence rate of the two groups was of no statistical significance in three months after operation. Voice function assessment of the two groups was of no statistical significance at one week, three months and six months after operation. CONCLUSION The operation under electronic laryngoscope is a minimal invasive procedure to the laryngeal mucosa. Electronic laryngoscope had advantages such as clear view, accurate operation. Furthermore, it can be used for those that could not be treated under self-retaining laryngoscope.
Adult ; Aged ; Cysts ; surgery ; Female ; Humans ; Laryngeal Diseases ; surgery ; Laryngoscopy ; methods ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; Vocal Cords ; surgery

OBJECTIVE: To filtrate and prove the different microRNAs (miRs) profiles in nasopharyngeal carcinoma. METHOD: Screening the different expressions of miRs between nasopharyngeal carcinoma and the inflammatory tissues by the application of expression profiling of chip high-throughput and large-scale microarray analysis. Then we used RT-QPCR technology to prove the accuracy of screening results. RESULT: There were significant expression differences of miRs between nasopharyngeal carcinoma and the control tissues, 144 human miRs had 2 or more fold the difference ratio. Compared with the inflammatory tissues, we have found that miRs-34b, miRs-449b and miRs-7-1 significantly low expressed in nasopharyngeal carcinoma, yet miRs-125b, miRs-184, miRs-196b, miRs-205 and miRs-24-1 expressed high. The results were consistent with the microarray analysis. CONCLUSION The difference expressed miRs might be closely related to the process of nasopharyngeal carcinoma, and the research on miRs profiles maybe provide a powerful target basis for early diagnosis and therapy of nasopharyngeal carcinoma.
Carcinoma ; Gene Expression Profiling ; Humans ; MicroRNAs ; genetics ; Nasopharyngeal Carcinoma ; Nasopharyngeal Neoplasms ; genetics ; Oligonucleotide Array Sequence Analysis

Objective This study compares a dual-freeze protocol with a triple freeze protocol for hepatic cryoablation in the Tibetan pig model.Method Cryoablation with a dual-(10-5-10-5 min)and triple-freeze (5-5-5-5-10-5 min) protocol for the normal livers of 9 Tibet pigs was performed under exposed operation.Temperature changes of cryoprobes and diameter changes of iceballs were measured during the ablation,and seven days later the pathological changes of cryozones were reviewed and the surface and depth cryolesions were measured.Results Compared with cryoablation with two freeze-thaw cycles,there was a greater iceball diameter for cryoablation by three freeze-thaw cycles.Also,seven days after cryosurgery,there were similar surface and deep cryolesions in dual-and triple-freeze protocols.Pathologically,the triple freezing protocol was associated with a longer zone of complete necrosis.Conclusions With the same freezing time (20 min),the triple-freeze protocol may become a more powerful liver-ablation method in cryosurgical application.

Objective To summarize the CT characteristics of tumor deposition adjacent to colorectal cancer (CRC),and provide the evidences for differential diagnosis.Methods The retrospective cross-sectional study was conducted.The clinicopathological data of 26 CRC patients who were admitted to the Wuxi Second People's Hospital of Nanjing Medical University from May 2015 to April 2017 were collected.Patients underwent preoperative multi-slice spiral CT scan and double-phase enhanced scan,and then received open surgery.Observation indicators:(1) characteristics of multi-slice spiral CT scan;(2) differential comparisons;(3) follow-up.Follow-up using telephone interview was performed to detect patients' prognosis once every 3 months up to May 2017.Measurement data with normal distribution were represented as (x)±s.Comparisons between groups and among groups were respectively analyzed using the t test and the one-way ANOVA.Pairwise comparison was done using the SNK method.Results (1) Characteristics of multi-slice spiral CT scan:of 26 patients,17 underwent double contrast enhanced scans of chest,abdomen and pelvic and 9 underwent double contrast scans of abdomen and pelvic.Primary tumors of 18 and 8 patients respectively located in the colon and rectum.Forty-one tumor deposits of 26 patients were collected,with number of tumor deposits of 1.6±0.9 per case,and number of tumor deposits ＜ 3 and ≥3 respectively were found in 20 and 6 patients.Tumor deposits were often isolated in the fat spaces around the rectum or colon and unconnected with the surrounding primary tumor or lymph node.Distance to the center of primary tumor was (2.6±l.0)cm (range,0.2-5.0 cm),the distance ＜2.6 cm and ≥2.6 cm were respectively detected in 22 and 19 patients.Thirty-three tumors showed signs of lobulation,22 showed signs of burr and 7 showed liquefaction necrosis,and there was a combination of multiple imaging characteristics in the same tumor deposit.The maximum width,minimum width,maximum diameter,plain scan value of CT,CT enhancement values in the arterial phase and venous phase in 41 tumor deposits were respectively (1.15 ± 0.60)cm,(1.11±0.44)cm,(1.13±0.49)cm,(27±13)HU,(28±14)HU and (49±19)HU.Of 41 tumor deposits,34 demonstrated homogeneous density in the plain scan,and obviously enhancement in early enhanced scan,with homogeneous enhancement;7 demonstrated heterogeneous density in the plain scan,with internal liquefaction necrosis,and enhanced scans showed no enhancement in the areas of necrosis and obviously early enhancement in the areas of non-necrosis.(2) Differential comparisons:26 patients underwent open surgery,including 8 with right hemectomy,2 with transverse colon resection,4 with left semicolon resection,2 with simple sigmoid resection,2 with abdominoperineal resection of rectal cancer and 8 with low anterior rectal resection,and all patients received postoperatively individualized treatment.Fifty-two lymph nodes with distance to center of primary tumor ＜ 5.0 cm that were confirmed by pathological examination were collected,including 19 metastatic lymph nodes.Of 41 tumor deposits,33 were irregular,and 8 were regular and round-like or oval-like shape.Of 19 metastatic lymph nodes,16 were regularly round-like shape,1 showed irregular shape and edge blur,and 2 were irregular with a mutual integration.The maximum width,minimum width and maximum diameter of 19 metastatic lymph nodes were respectively (1.09± 0.33) cm,(1.01 ± 0.23) cm and (1.05 ± 0.20) cm,with statistically significant differences in the above indicators between metastatic lymph nodes and tumor deposits (t =5.48,4.80,7.75,P＜0.05).The plain scan value of CT,CT enhancement values in the arterial phase and venous phase were respectively (12±7) HU,(18± 12) HU,(42± 15) HU in 19 metastatic lymph nodes and (33±6) HU,(31 ±15) HU,(53± 14)HU in 26 primary tumors,showing statistically significant differences in the plain scan value of CT and CT enhancement values in the arterial phase among tumor deposits,metastatic lymph nodes and primary tumors (F=24.43,4.46,P＜0.05),and no statistically significant difference in CT enhancement value in the venous phase (F=2.41,P＞0.05).There were statistically significant differences in the plain scan value of CT and CT enhancement values in the arterial phase between tumor deposits and metastatic lymph nodes (q =5.48,2.50,P＜0.05) and between metastatic lymph nodes and primary tumors (q =6.82,2.84,P＜0.05),and no statistically significant difference between tumor deposits and primary tumors (q =2.15,0.65,P＞0.05).Of 19 metastatic lymph nodes,11 demonstrated homogeneous density in plain scan,with a lower density compared with tumor deposits and primary tumors,and relatively homogeneous enhancement in the arterial phase of enhanced scan;8 demonstrated heterogeneous density with internal liquefaction necrosis,and ring-shaped enhancement in enhanced scan with no enhancement in the areas of necrosis.The density and enhancement range in the arterial phase and venous phase of tumor deposits were similar to primary tumors.(3) Follow-up:24 patients were followed up for 1-25 months,with a follow-up rate of 92.3％(24/26) and a median time of 17 months.Of 24 patients,2 were dead,and survival time were respectively 9 months and 21 months;22 had good survival.Conclusions Multislice spiral CT examination of tumor deposits demonstrates larger and irregular shape,with the signs of lobulation and burr,and the density in plain scan is similar to the primary tumor,with obviously enhancement in early enhanced scan.The metastatic lymph nodes are mostly round-like shape,diameter is smaller than that of tumor deposits,density in the plain scan and CT enhancement values in the arterial phase are lower than that of tumor deposits.