Objective To investigate the safe directions of screw trajectory in atlas via posterior arch and lateral mass and its clinical significance. Methods Lateral radiographs and CT axial scans of atlases were performed in 30 cases with normal morphology of atlases and axes. The minimal height of posterior arch, the maximum inclination of screw projection relative to sagittal plane, and the maximum medial angle of screw projection relative to axial plane were evaluated radiologically. According to the safe directions obtained radiologically 21 cases of atlantoaxial instability were treated with screw fixation atlas via posterior arch and lateral mass. During operation the influence of screws on surrounding structures was investigated and postoperative neural symptoms were documented also. Preoperative and postoperative radiographs and CT scans of 13 patients were available and some related parameters were measured to evaluate the safety of the screw placements. Results 1) The maximum angle of screw projection to sagittal plane is about 10? cephalad to 6? caudal, with the tendency of increasing maximum angle as the minimal height of posterior arch increases. 2) When the entry point on the posterior arch was switched laterally, the medial angle of screw projection should be adjusted from 0? to 30?, correspondingly. 3) The actual directions of screw trajectory might differ from preoperative ones, but all were in the estimation range. 4) All screws were placed successfully, and the postoperative radiographs and CT scans shows no neural or vascular complications relative to atlantal screws placed in traditional way. Conclusion There is a safe range to insert atlas screw via posterior arch and lateral mass both in sagittal and axial plane.

Objective To investigate the mortality and cause of death in inpatients with cerebral infarction. Methods The clinical data of 515 patients with cerebral infarction as the underlying cause of death from January 2005 to December 2009 were analyzed retrospectively. The hospital mortality, direct cause of death,and constituent ratio of the cause of death were calculated. The clinical features,such as classification of the Trial of Org 10 172 in acute stroke treatment( TOAST),age and duration of hospital-ization were analyzed. Results ( 1 )The hospital mortalities in patients with cerebral infarction from 2005 to 2009 were 2. 0%(91/4 659),2. 1%(110/5 264),1. 9%(95/5 035),1. 2%(100/8 656),and 1. 0%(119/11 640),respectively. The overall mortality rate was 1. 5%(515/35 254),basically had a declining trend year by year(χ2 =42. 39;P<0. 01).(2)The mortalities of the inpatients with cerebral infarction in the young( <45 years),middle-aged(45 to 59 years),elderly(60 to 74 years),and aged ( >74 years)groups were 1. 1%( 22/2 009 ),1. 0%( 112/11 158 ),1. 5%( 221/14 311 ),and 2. 1%(160/7 776),respectively. They increased with increasing age(P<0. 01).(3)The TOAST classification in 515 died patients were as follows:57. 3%(n=295)for large-artery atherosclerosis,19. 4%(n=100) for cardioembolism,14. 4%(n=74)for cryptogenic stroke,7. 0%(n=36)for small-artery occlusion and 1. 9%(n=10)for other reasons. The five leading direct cause of death were cerebral hernia 49. 3%(n=254),primary central respiratory and circulatory failure 25.0%(n=129),pneumonia 8. 9%(n =46), cerebral-cardiac syndrome 5. 8%( n =30 ),and multiple organ failure 5. 6%( n =29 ).( 4 ) The mean age of death was 67 ± 12 years old. The patients who died of cerebral hernia and primary central respiratory and circulatory failure were younger than those who died of pneumonia(65 ± 13,68 ± 11,and 75 ± 10,respectively;all P<0. 01). The median length of hospital stay was 3 days. The length of hospital stay in patients who died of hernia,primary central respiratory and circulatory failure,and cerebral-cardiac syndrome were significantly shorter than those who died of pneumonia and multiple organ failure( the median length of hospital stay was 3. 0,3. 0,3. 0,12. 5,and 9. 0 days,respectively;all P <0. 05). Conclusions The mortality of hospitalized patients with cerebral infarction have a declining trend year by year. Brain disease itself is the most important reason of early death for patients with cerebral infarction, indicating that it is the important point of prevention and treatment in clinical work.

Aged ; Bone and Bones ; pathology ; Carcinoma, Small Cell ; complications ; pathology ; Female ; Humans ; Hyoid Bone ; pathology ; Plasmacytoma ; complications ; Small Cell Lung Carcinoma ; Thyroid Gland ; pathology ; Thyroid Neoplasms ; pathology

Objective To research the effect of poria cocos on the immune function of mice.Methods We filled the stomaches of mice with 100% water extract of poria cocos regularly and tested the ability of antibody-forming cells of mice,specific rosette forming cells(SRFC) and serum immunoglobulin(IgG).Results The immune function of poria cocos group improved remarkably compared with control group(P

Objective: To construct a prediction model of non-alcoholic fatty liver disease (NAFLD) in middle-aged and elderly patients with type 2 diabetes mellitus (T2DM), so as to provide basis for early screening and prevention of T2DM complicated with NAFLD. Methods: Patients aged 45 years and above and diagnosed with T2DM in Karamay Hospital of People's Hospital of Xinjiang Uygur Autonomous Region in 2021 were collected as the study subjects. The data of general demographic characteristics and biochemical test results were collected. The patients were randomly divided into training group (n=3 241) and validation group (n=1 389) according to the ratio of 7∶3. LASSO regression and multivariable logistic regression model were used to select predictive factors. The nomograph model for prediction of NAFLD risk in T2DM patients was established. The predictive value of the model was evaluated using the receiver operating characteristic (ROC), adjusted curve and decision clinical analysis. Results: Totally 4 630 T2DM cases were included, including 1 279 cases (27.62%) complicated with NAFLD. LASSO regression and multivariable logistic regression analysis identified gender, age, diastolic blood pressure, body mass index, alanine transaminase, triglycerides, low density lipoprotein cholesterol and platelet count as risk prediction factors for NAFLD in T2DM patients. The area under the ROC curve was 0.823 (95%CI: 0.814-0.832) for the training group and 0.809 (95%CI: 0.799-0.818) for the validation group, and Hosmer-Lemeshow test showed a good fitting effect (P>0.05). Decision curve analysis showed higher net clinical benefit of using the predictive model to predict NAFLD risk when the risk threshold probability was 0.27 to 0.85. Conclusion The nomogram model established has a good predictive value for the risk of NAFLD in T2DM patients aged 45 years and above.

Introduction of problem-based learning (PBL) teaching is the demand of teaching reform.Teaching and research section of physiology in Chongqing medical university implemented PBL teaching throughout the whole process of clinical medicine undergraduate education.The overall quality of students and the teaching quality were improved by constructing a new mode suitable for physiology teaching,focusing on training students' active learning ability and stimulating students' enthusiasm for learning.

Objectives To explore the change of interleukin-17 (IL-17) in Kawasaki disease (KD). Methods Fourty KD pediatric patients, among them 12 patients with echocardiographic abnormalities in acute phase, 25 age-matched non-KD patients were enrolled. The level of serum IL-17 was measured by enzyme linked immunosorbent assay in acute and convalescent phase of KD patients and non-KD patients. At the same time, C-reactive protein (CRP), globulin, albumin were detected. Results In acute phase of KD patients, the level of serum IL-17 were signiifcantly higher than that in convalescent phase of KD patients and non-KD patients (P<0.05). The level of serum IL-17 was no signiifcant differences in convalescent phase of KD patients and non-KD patients (P>0.05). In acute phase of KD patients with echocardiography abnormalities, the level of serum IL-17 was signiifcantly higher than that with non-echocardiography abnormalities (P<0.05). The level of serum IL-17 in acute phase of KD patients were positively correlated with CRP and globulin (r=0.750, 0.750, P<0.05), and negatively correlated with albumin (r=-0.779, P<0.05). Conclusions IL-17 may be involved in KD immune pathogenesis. Serum IL-17 is one of the activity index of KD, which associ-ated with cardiovascular damages.

Objective To evaluate the effectiveness of TCM combined with western medicine for advanced gastric cancer.Methods We retrieved literatures of randomized controlled clinical trials related (from January 1991 to June 2012) to the use of TCM combined with western medicine treatment for advanced gastric cancer and made meta-analysis including:the effectiveness,Kamofsky scores and publication bias.Results 44 papers (including 3088 AGC patients) were included.Meta analysis suggested a difference between the treatment group and the control group in effectiveness (Z＝ 6.12,P＜ 0.01),and K score (Z＝ 3.31,P＜0.01).The effectiveness of the reatment group and the control group are 97.8％ and 73.4％ respectively.Conclusion The combined treatment resulted in an improved quality of effectiveness and Kamofsky scores.

Objective To evaluate the effects of different ratios of medicine dosage for isoflurane and propofol on postoperative cognitive function of rats with mild cognitive impairment (MCI).Methods Healthy male Wistar rats,aged 16-18 months,were used in the study.MCI model was established by occlusion of bilateral common carotid arteries.One hundred and fifty rats with MCI were divided into 5 groups (n=30 each) using a random number table:sham operation group (group S),isoflurane group (group I),propofol group (group P) and different ratios of medicine dosage for isoflurane and propofol groups (IP1,2 groups).The rats inhaled 1.9％ isoflurane for 3 h in group I.Propofol 40 mg · kg-1 · h-1 was infused intravenously for 3 h in group P.The rats inhaled 1.0％ isoflurane,and propofol 20 mg · kg 1 · h-1 was infused intravenously for 3 h in group IP1.The rats inhaled 1.4％ isoflurane,and propofol 10 mg· kg-1 · h-1 was infused intravenously for 3 h in group IP2.After disappearance of eyelash reflex,open reduction and internal fixation was performed after tibial fracture was induced.On 7 days after operation,contextual fear conditioning test and Y maze test were used to assess the cognitive function,and hippocampal tissues were obtained to count the viable neurons (using Nissl's staining) and CCAAT/enhancer-binding protein homologous protein (CHOP) and caspase-12 positive neurons (by immunofluorescence) in hippocampal CA1 region.Results Compared with group S,the rate of time spent in N arm,the rate of time spent freezing,and the number of viable neurons were significantly decreased,and the number of CHOP and caspase-12 positive neurons were significantly increased in IP2,I and P groups (P＜0.05),and no significant change was found in the parameters mentioned above in group IP1 (P＞0.05).Compared with group IP1,the rate of time spent in N arm,the rate of time spent freezing,and the number of viable neurons were significantly decreased,and the number of CHOP and caspase-12 positive neurons was significantly increased in IP2,I and P groups (P＜0.05).Compared with group IP2,the rate of time spent in N arm,the rate of time spent freezing,and the number of viable neurons were significantly decreased,and the nunber of CHOP and caspase-12 positive neurons was significantly increased in I and P groups (P＜0.05).Conclusion Combination of 1.0％ isoflurane and propofol 20 mg · kg-1 · h-1 does not aggravate the postoperative cognitive dysfunction of the rats with MCI.

Objective To explore the protective effect and mechanism of astaxanthin (AST) on the acute kidney injury induced by iohexol in rats.Method Thirty rats were randomly divided into five groups:control group (Ctrl);iohexol group (CM);astaxanthin group (AST,100 mg/kg),low astaxanthin dose group (LAST+CM,50 mg/kg) and high astaxanthin dose group (HAST+CM,100 mg/kg),6 in each group.The rats in AST,LAST+CM,HAST+CM groups were administrated with AST by oral gavages using an intubation needle for 10 consecutive days.The rats in Ctrl and CM groups rats in Ctrl,CM groups were given with dissolvant instead in equal volume.Except for the Ctrl and AST groups,on day 8,rats were given indomethacin,L-NAME and iohexol in their femoral vein under chloral hydrate anesthesia to build a contrast induced-nephropathy (CIN) model.At the end of the experiment (72 h after CIN induction),all rats were sacrificed.The Scr level,BUN level,renal histology,renal tissue activities in superoxide dismutase (SOD),catalase (CAT),glutathione peroxidase (GPx),Glutathione (GSH) and level of malondialdehyde (MDA) were performed.Apoptosis of renal cells was detected by Bcl-2,Bax and Caspase-3 p17 with Western blot.Results Compared with Ctrl group,the levels of Scr,BUN were significantly increased in CM group (all P ＜ 0.01);while compared with CM group,the indicators were decreased in treatment groups (P ＜ 0.01).Renal tubular structure damage,medulla congestion,loss of brush border,vacuolar degeneration,apoptosis and proteinaceous casts were observed in the CM group,and the renal injury scores were higher compared with Ctrl group (P ＜ 0.05),however,administrated with AST could significantly improve the changes (P ＜ 0.05).Oxidative stress indicators showed that MDA level were increased while SOD,GPx,GSH activities were significantly decreased at CM group (all P ＜ 0.05),and the indicators above were ameliorated in treatment groups (all P ＜ 0.05).Western blot showed that the expression of Bcl-2 was down-regulated while the Bax,Caspase 3 p17 was up-regulated respectively at CM group (P ＜ 0.05),while the HAST+CM group could prevent the changes.Conclusions Iohexol can results in oxidative stress increased in kidney,which activate Caspase-3 p17 signal path,down-regulated Bcl-2 expression,up-regulated Bax expression respectively,and lead to cell apoptosis.AST can ameliorate the changes,especially with high AST dose,which suggest that the possible protection mechanism is by ameliorating oxidative stress and inhibiting apoptosis pathways.