Objective To explore the relationship between cervical spondylotic radiculopathy (CSR) and carpal tunnel syndrome (CTS) by investigating their electrophysiological characteristics and the incidence of CSR root injury and root injury complicating with CTS.Methods One hundred and twenty-four cases of CSR diagnosed in Peking Union Medical College Hospital from September 2013 to February 2014 by electromyography (EMG) were recruited.According to the results of EMG,patients were divided into root injury and root injury complicating with CTS groups.The distal motor latency (DML),motor nerve conduction velocity (MCV),sensory nerve conduction velocity (SCV),sensory nerve action potential (SNAP),compound muscle action potential (CMAP) and spontaneous potential (SP) were compared between the two groups.Results There were 81 (65.3％) cases with root injury,11 cases with double sides injury and 29 cases with normal EMG among these 124 patients.The CMAP,DML,MCV,SCV and SNAP were normal in 76 cases,CMAP lowered 5％-12％ in 3 cases,DML extended 3％ and 9％ in 2 cases.There were 14 cases (11.3％) with concomitant CTS (female 10 cases and male 4 cases,double sides CTS 10 cases).Among the 14 cases with concomitant CTS,there were 9 cases with simply sensory nerve conduction abnormality,SCV slowing down 26％-47％,SNAP reducing 58％-86％ or normal,while other 5 cases with motor conduction abnormality as well as sensory nerve conduction abnormality,CMAP reducing 21％-78％,DML extending 27％-39％ in 3 cases,MCV slowing down 32％ and 40％ in 2 cases.Five cases had spontaneous electricity position movement in the abductor pollicis brevis.The incidence of root injury complicating with CTS in C6 (27.4％,9/33),C7 (26.9％,7/26) and C8 (5/7) showed statistically significant difference (x2 =5.96,P ＜ 0.01).Conclusions There is a high incidence of root injury and CTS in CSR patients,indicating a possible double crush between CSR and CTS.

Objective To investigate the feasibility and primary therapeutic effect of inverted Y-shaped self-expandable metal stent for complex airway stenosis.Methods On the standpoint of the peculiar anatomic structure and the pathological changes of complex airway stenosis,we designed the inverted Y-shaped self- expandable metal stent.Under the fluoroscopic guidance,7 stents were implanted in 7 cases of airway complex stenosis.Results The inverted Y-shaped self-expandable metal stents were placed seccussfully,with instantaneous relief of dyspnea and improvement of living quality.Conclusion The placement of inverted Y- shaped self-expandable metal stent is feasible and safe for treating airway complex stenosis.(J Intervent Radiol, 2007,16:92-94)

To have a better understanding on the evolution of Metallosphaera sedula-mediated precipitation and the properties of the precipitate synthesized by this species，a newly identified extremely thermophilic strain (YN23) of Metallosphaera sedula was cultured in the medium containing Fe2+ as energy resouTce under optimal condidons (pH1.5，65℃,0.2g·1-1 yeast extract,30g·1-1 Fe2SO4·7H2O and 170rpm)．XRD，EDS，ETIR and SEM reveal the precipitate obtained from YN23-inoculated flasks to be a mixture of potassium jarosite and ammoniojarosite，with morphological features similar to the latter．Precipitation Was first detected once over 90％ of Fe2+ was oxidized at hour 25 with a peak pH value of 1.92，and was ended when precipitate reached the highest point of 7.9g·1-1 at hour 95 with the lowest pH value of 1.32 in solution．Microbial density underwent a rapid increase along with Fe2+ oxidation and a gradual decrease with precipitate piling up.

OBJECTIVETo evaluate the impact of neoadjuvant chemoradiation on perineal wound healing following abdominoperineal resection(APR) for lower rectal cancer.

METHODSData of 93 patients who underwent APR for low rectal cancer between January 2005 and January 2009 in Peking Union Medical College Hospital were reviewed, including patients who received neoadjuvant chemoradiation (n=29) and those undergoing surgery alone(n=64). Perineal wound healing was the primary outcome measurement. Condition of wound healing was classified as good, moderate, and poor and was compared between the two groups.

RESULTSTwenty nine patients in the neoadjuvant group received preoperative regional radiation(50 Gy, 25 fractions/5 weeks) with synchronous FOLFOX4 chemotherapy(fluorouracil and oxaliplatin). In the neoadjuvant group, wound healing after APR was good in 18 patients(62.1%), moderate in 6(20.7%), and poor in 5(17.2%). In patients who had surgery alone, wound healing after APR was good in 41 patients(64.1%), moderate in 15(23.4%), and poor in 8(12.5%). There was no significant difference in the incidence of wound infection(poor wound healing)between the two groups(P=0.773).

CONCLUSIONNeoadjuvant chemoradiation therapy is not associated with increased perineal wound infection following abdominoperineal resection for low rectal cancer.

Aged ; Combined Modality Therapy ; Female ; Humans ; Male ; Middle Aged ; Neoadjuvant Therapy ; Perineum ; surgery ; Rectal Neoplasms ; surgery ; therapy ; Rectum ; surgery ; Wound Healing

Objective: To investigate the clinical manifestations, imaging features, clinicopathologic features, and differential diagnosis of solitary fibrous tumors/anginoblastomas (SFT/HPCs) originating in the central nervous system. Methods: Sixty cases of SFT/HPCs originating in the central nervous system were collected at Nanjing Jinling Hospital, from January 1, 2008 to December 31, 2016. The clinical data, imaging data, histomorphologic changes and immunohistochemical finding were analyzed in the sixty cases. Results: The 60 cases included 26 males and 34 females, aged 14 to 85 (median 49) years. The main clinical manifestations were headache, dizziness with nausea and vomiting. Radiologically, the tumors were large, enhancing, solid and cystic masses attached to the dura. Histopathologically, the neoplasms were composed of spindle cells with oval nuclei, inconspicuous nucleoli and moderate amount of eosinophilic cytoplasm arranged in fascicles with areas of hyalinized stroma, myxoid changes and a staghorn vascular pattern. Immunohistochemically, tumor cells of all cases were positive for vimentin (100.0%, 60/60), STAT6 (98.3%, 59/60), CD34 (61.7%, 37/60), and the tumor cells were typically positive for CD99, bcl-2, EMA and SSTR2 as well.Negative for S-100 protein, SOX10, E-cadherin, GFAP. Ki-67 index ranged from 1% to 50%. Forty cases were followed up for 6 to 82 months with average of 40 months, 30 patients were alive and 10 patients died. Conclusions Central nervous system SFT/HPCs can be aggressive and relapses may occur several years after diagnosis. STAT6 is highly sensitive and specific for the diagnosis. Complete tumor resection is optional treatment followed by radiotherapy and chemotherapy. There is a correlation between the prognosis and the location of the disease, the histological grade, Ki-67 index, and fusion gene variants.

OBJECTIVETo investigate the relationship between gene polymorphism of CYP2E1, CYP1A1, IL-4 and susceptibility of medicamentosa-like dermatitis induced by trichloroethylene (TCE).

METHODS35 patients with medicamentosa-like dermatitis induced by TCE were chosen as the patient group, and 35 healthy workers as control group. The real-time quantitative polymerase chain reaction (PCR) with TaqMan minor groove binding (MGB) probes was used to test single nucleotide polymorphisms (SNP) of CYP2E1, CYP1A1 and IL-4 in the patients with medicamentosa-like dermatitis as well as in the control. The genotypes and the frequency of genotype or allele were compared between the patients and control with statistical analysis.

RESULTSThe frequency of allele G within CYP1A1 gene (rs1048943) was significantly higher in TCE patients (37.1%) than that in control (P<0.05); the frequency of allele T within CYP2E1-1053 C/T was significantly higher in TCE patients (41.4%) than that in control (P<0.01); the frequency of T/T within IL-4-588 C/T (rs2243250) was significantly higher in TCE patients (75.0%) than that in control (P<0.01), and the frequency of allele T within IL-4-588 C/T (rs2243250) was also significantly higher in TCE patients (87.5%) than that in control (P<0.01).

CONCLUSIONThe gene polymorphism of CYP2E1, CYP1A1, IL-4 is probably associated with hypersensitivity for the TCE patients with medicamentosa-like dermatitis, and could be one of the genetic factors related to the individual susceptibility to TCE exposure.

Cytochrome P-450 CYP1A1 ; genetics ; Cytochrome P-450 CYP2E1 ; genetics ; Dermatitis, Occupational ; genetics ; Genetic Predisposition to Disease ; Humans ; Interleukin-4 ; genetics ; Polymorphism, Single Nucleotide ; Trichloroethylene ; adverse effects

OBJECTIVETo compare the effects of presacral irrigation and simple drainage on the perineal wound healing in patients after abdominoperineal resection (APR).

METHODSFrom October 2004 to August 2009, patients with rectal cancer, ulcerative colitis or rectal gastrointestinal stromal tumor, who underwent APR or proctocolectomy, were randomized into two arms: simple drainage group (n = 37) and continuous irrigation (n = 37). Patients randomized to arm B received simple drainage only to presacral space; while those patients in arm A received continuous irrigation in addition to simple drainage. Perineal wound healing was taken as endpoint of this study. Major complication was defined as wound dehiscence or wound infection that the perineal wound should be reopened for drainage. Minor complication was defined as delayed healing wound with seroma or hematoma.

RESULTSA total of 74 patients were enrolled in present study, with 37 patients in each arm, and there were 12 cases and 10 cases who received preoperative radiation therapy, respectively. In the arm A, 2 patients developed major complications, 3 patients incurred with minor complications and 32 patients got primary healing of the perineal wounds. In arm B, 8 patients suffered major complications, 3 patients incurred with minor complications and 26 patients got primary healing of the perineal wounds. The incidence of major complication was significantly lower in arm A (5.4% vs.21.6%, P = 0.042). Patients received preoperative radiation therapy had significantly higher rate of minor complications than patients underwent surgery only (18.2% vs. 3.9%, P = 0.039).

CONCLUSIONSSimple drainage with continuous irrigation of the presacral space, in patients with abdominoperineal resection or proctocolectomy, could significantly lower the incidence of major complication and improve wound healing for perineal wound when compared with simple drainage only. Preoperative radiation therapy tends to increase the incidence of minor complications.

Abdomen ; surgery ; Aged ; Drainage ; methods ; Female ; Humans ; Male ; Middle Aged ; Perineum ; surgery ; Postoperative Period ; Prospective Studies ; Rectal Neoplasms ; surgery ; Rectum ; surgery ; Surgical Wound Dehiscence ; prevention & control ; Surgical Wound Infection ; prevention & control ; Therapeutic Irrigation ; methods ; Wound Healing

Objective To observe the improving effect in joint function of moderate skeletal fluorosis treated by traditional Chinese medication(main ingredient was Strychnine).MethodsFrom December 2007 to July 2009,120 moderate skeletal fluorosis patients met the inclusion criteria were divided into the treatment group(60 cases)and the control group(60 cases)in the skeletal fluorosis hospital of Xinzhou,the treatment group was given basic treatment and traditional Chinese medication,the control group wa8 given basic treatment and placebo.The treatment lasted 12 weeks,follow up 24 weeks.Before treatment,after treatment 4 weeks,8 weeks,12 weeks,36 weeks,a third party evaluate comprehensive function of both upper and lower limb and joint dysfunction.Results The main effect of both drugs was statistically significance in the scores of the upper forearm in the finger by touching the posterior contralateral ear, upper arm touched by the finger back in the opposite corner subscapularis function, lower limb function and single-joint dysfunction(F values were 4.08,14.32,35.81,13.02, all P<0.05), the main effect of time also was significant (F values were 82.63,72.82,277.33,328.16, all P<0.05),①the upper forearm in the finger by touching the posterior contralateral ear functions:At the time of 8,12 weeks,scores of the treatment group were lower than those of before treatment and control group (all P<0.05);At the time of 36 weeks,scores of the treatment group were lower than that 12 weeks(all P<0.05);At the time of 8,12,36 weeks, scores of the control group were lower than those of before treatment(all P < 0.05);②upper arm function, namely fingers touching the opposite corner subscapularis:At the time of 4,8,12 weeks, scores of the treatment group were lower than those of before treatment(all P<0.05); At the time of 36 weeks, scores of the treatment group were lower than that 12 weeks(all P<0.05); At the time of 8,12,36 weeks, scores of the treatment group were lower than those of the control group (all P<0.05);③Lower extremity functions: At the time of 8,12 weeks,scores of the treatment group were lower than those of before treatment and control group (all P<0.05);At the time of 36 weeks, scores of the treatment group were lower than that 12 weeks(all P<0.05) ; At the time of 8,12,36 weeks, scores of the control group were lower than those of before treatment (all P<0.05);④single joint functions:At the time of 4,8,12 weeks,scores of the treatment group were lower than those of before treatment(all P<0.05); At the time of 36 weeks,scores of the treatment group were lower than that 12 weeks(all P<0.05) ; At the time of 8,12,36 weeks, scores of the control group were lower than those of before treatment(all P<0.05);At the time of 4,8,12,36 weeks, scores of the treatment group were lower than those of control group(all P<0.05);⑤At the end of treatment and follow-up,the improvement rate in joint functions in the treatment group were 88.33% (53/60),93.33% (56/60); the control group were 28.07%(16/57),40.35%(23/57), (Fisher test, P<0.01,X2=56.21, P<0.01). ConclusionTraditional Chinese medication(its main ingredient is Strychnine), an effective drug for improving joint dysfunction in patients suffering from moderate skeletal fluorosis, is simple and effective.

OBJECTIVETo explore the reliability ,validity and reaction degree of patient reported outcome scale for low back and leg pain.

METHODSTwo hundreds inpatients were analyzed between August 2010 and January 2012, including 93 males and 107 females with an average age of 50.3 years old ranging from 22 to 65 years. There were 144 cases of lumbar disc herniation and 56 of lumber spinal stenosis. All patients were tested by the patient reported outcome scale for low back and leg pain, and then analyzed the reliability,validity and reaction degree of the scale.

RESULTSThere was no statistical significence difference (P>0.05) and significant correlation (r>0.9) in scores of two times in patients with no change in illness. Measurement result of the scale had significant correlation (r>0.9) with Oswestry disability index (ODI). The total Cronbach's Alpha of the instrument was 0.931, the total split-half reliability was 0.912. The KMO value was 0.919, Bartlett test value was 1882.975 (P<0.001), factor analysis resulted in 3 factors with eigenvalue >1 which contributed to 64.364%. Scores of two times of 43 cases who felt better were 34.80+/-9.00 and 28.77+/-8.73, respectively,with stasitical significance (P<0.01).

CONCLUSIONThe scale has a good reliability, validity and reaction degree,which can be applied for the therapeutic evaluation of low back and leg pain.

Adult ; Aged ; Female ; Humans ; Intervertebral Disc Displacement ; therapy ; Leg ; Low Back Pain ; therapy ; Lumbar Vertebrae ; Male ; Middle Aged ; Outcome Assessment (Health Care) ; Reproducibility of Results ; Severity of Illness Index ; Spinal Stenosis ; therapy

Objective:To investigate the effect of post pyloric feeding on hospital-acquired pneumonia and mortality in patients with critical respiratory disease.Methods:A retrospective survey of 41 cases of post pylorus feeding (post pylorus feeding group,n =41) in respiratory intensive care unit (RICU) was carried out,and 41 patients who received nasogastric feeding (nasogastric feeding group,n =41) were investigated in the same RICU.The incidence of ventilator-associated pneumonia (VAP),the incidence of hospital-acquired pneumonia (HAP,excluding VAP) and the in-hospital mortality of RICU were observed and compared between the two groups.Vomiting,aspiration,gastric retention,diarrhea,and the times of stopping enteral feeding were observed and compared as well.Results:The incidence of HAP in the post pylorus feeding group was 2.4％,which was significantly lower than that in the nasogastric feeding group (22％,P ＜ 0.05).The incidences of VAP in the post pylorus feeding group and nasogastric tube feeding group were 16.7％ and 8.7％ individually,which was no significant difference between the two groups (P ＞ 0.05).The mortality in RICU in the post pyloric feeding group was 36.6％,which was similar to that in the nasogastric feeding group (41.5％) (P ＞ 0.05).There was no difference in terms of vomiting,aspiration,gastric retention,diarrhea,and the times of stopping enteral nutrition.Conclusion:Compared with nasogastric feeding,post pyloric feeding reduces the incidence of HAP in critical respiratory patients.Nevertheless,post pyloric feeding fails to affect the incidence of VAP and in-hospital mortality in RICU.