To explore the utility of apparent diffusion coefficient(ADC)histogram analysis for differentiating genetic subtypes of diffuse lower-grade gliomas. A total of 55 patients with WHO grade Ⅱ/Ⅲ diffuse lower-grade gliomas who underwent preoperative routine brain magnetic resonance imaging and diffusion weighted imaging in our center were retrospectively evaluated.Among whom there were 14 patients with isocitrate dehydrogenase(IDH)wild-type gliomas(IDH group),19 patients with IDH-mutant 1p19q intact gliomas(IDH 1p19q group),and 22 patients with IDH-mutant 1p19q co-deleted gliomas(IDH 1p19q group).The whole-lesion ADC values derived from histogram analysis(including ADC,ADC,ADC5%,ADC10%,ADC25%,ADC50%,ADC75%,ADC90%,ADC95%,ADC,mode,range,skewness,kurtosis,standard deviation,inhomogeneity,and entrophy)were measured for each patient.All parameters between the different genetic subtypes were compared by using the Student's test or Mann-Whitney test.Receiver operating curve(ROC)analysis was used to assess the diagnostic performance of ADC histogram in distinguishing the different genetic subtypes. Compared with IDH group,the ADC75%(=0.021),ADC90%(=0.015),ADC95%(=0.014),ADC (=0.035),range(=0.009),standard deviation(=0.001)and inhomogeneity(=0.001)were significantly lower in IDH group;in contrast,the ADC (=0.031)and kurtosis(=0.020)of IDH group were significantly higher than those in IDH group.The ADC(=0.010),ADC5%(=0.016),ADC10%(=0.012),ADC25%(=0.007),ADC50%(=0.005),ADC75%(=0.015),and mode(=0.002)were significantly higher in IDH 1p19q group than in IDH 1p19q group.Inhomogeneity achieved the highest area under ROC(AUC)(0.811)in differentiating IDH gliomas and IDH gliomas,with a cutoff value of 0.229;the sensitivity and specificity were 85.7% and 73.2%.The mode achieved the highest AUC(0.744)in differentiating IDH 1p19q gliomas and IDH 1p19q gliomas,with a cutoff value was 1448.75×10 mm /s;the sensitivity and specificity were 57.9% and 90.9%. ADC histograms analysis may be helpful to differentiate genetic subtypes in lower-grade gliomas.
Brain Neoplasms ; Diffusion Magnetic Resonance Imaging ; Glioma ; Humans ; ROC Curve ; Retrospective Studies

OBJECTIVETo analyze the data of angle variation on traction based on a finite element model of complete cervical spine with straight physiological curvature, and try to give experimental reference and suggestion in treating cervical spondylosis.

METHODSA 43-year-old female patient with straight cervical spine was chosen and the CT scan data were collected. By using specially designed modeling system, a high quality finite element model of complete cervical spine with straight physiological curvature is generated,which included ligament and muscle according to anatomy. After the model was confirmed, traction was loaded with angle 0 degree, anterior 5 degrees, 10 degrees, 15 degrees, 20 degrees, 25 degrees, to observe the data of distance change on between adjacent intervertebral foramen, processus articularis, uncovertedral joint, intervertebral discs, and stress of anulus fibrosus and nucleus pulposus.

RESULTSWhen the angle was 0 degrees-15 degrees, the distance between intervertebral foramen, Luschka joint and processus articularis posterioris was enlarged, the tensile stress was adequate and compressive stress was small. It met the clinical requests.

CONCLUSION0 degree-15 degrees anterior position is suggested for the treatment of cervical spondylosis.

Adult ; Biomechanical Phenomena ; Cervical Vertebrae ; anatomy & histology ; surgery ; Female ; Finite Element Analysis ; Humans ; Spondylosis ; surgery ; Traction ; methods

Cell Line ; Epithelial-Mesenchymal Transition ; drug effects ; Humans ; Hydrogen Sulfide ; pharmacology ; Transforming Growth Factor beta1 ; pharmacology ; Wound Healing ; drug effects

Objective To explore the risk factors of nosocomial infections to provide a reference for prevention and control of nosocomial infection.Methods The data of 680 patients with nosocomial infection in this hospital from January 2015 to December 2016 were retrospectively collected.The characteristics of nosocomial infection were analyzed from the aspects of age,hospitalization department,infection site,etc.Results A total of 680 cases of nosocomial infection accounted for 1.67％(680/40 657) of all hospitalization patients,including 316 cases(nosocomial infection rate was 2.47％) of 61-80 years old.The infection rate was the highest in ICU(24.90％),followed by the nephrology department(4.99％).For infection sites,the maximal cases-times in infection site was lower respiratory tract(413 case-times),followed by urinary tract and superficial incision(each 68 case-times).The pathogenic detection rate was 45.03％,and 190 strains of pathogens were detected.The top five places were Escherichia coli(47 strains),Klebsiella pneumoniae(28 strains),Pseudomonas aeruginosa (23 strains),Staphylococcus aureus (22 strains) and Bauman Acinetobacter (16 strains).Logistic regression analysis showed that age larger than 60 years old,hospitalization time longer than 60 d,indwelling urinary catheter,peripherally inserted central catheter(PICC),tracheotomy and enteral nutrition were the risk factors for nosocomial infection occurrence.Conclusion Hospital should put the emphasis on preventing nosocomial infection of lower respiratory tract and strengthen the nosocomial infection management of key departments like ICU.

OBJECTIVEGenetic evolution of VP1 of enterovirus type 71 in Shenzhen were analyzed.

METHODSAll samples were tested by RT-PCR using EV71 specific primer. The VP1 of EV71 were amplified and sequenced. A phylogenetic tree was constructed by comparison of the sequences with subgenotype A, B and C using DNAStar, BioEdit and Mega 3.1 software.

RESULTSAmong 35 strains, the homogeneity of the VP1 nucleotide sequence was between 92.1%-100%. The homogeneity of the VP1 nucleotide sequence with subgenotype A and B was between 81.4% -91.1%. The VP1 nucleotide sequence of 35 strains of Shenzhen shared between 93% -97.4% identity with cluster C4. The prevalence strains of EV71 were cluster C4b from 1998 to 2004, and gradually moved to C4a since 2003. All of EV71 were C4b from 2006 to 2008. Also, the homogeneity of the VP1 nucleotide sequence with Anhui FY23 EV71 strain were 94.5% -94.7%, 95.7% -95.8%, 96.2%, 95.4% -97.5%, 96.3% -99.2% from 2003 to 2008. It shows that the homogeneity was increased year by year. There was a mutation (A --> C) at No. 66 nucleotide of VP1 of EV71 that two strains were isolated in 2003 and 8 strains in 2008, that caused amino acid mutation (Q --> H) at No. 22 of VP1.

CONCLUSIONEV71 C4b was gradually moved to C4a from 1998 to 2008. There was a missense mutation at No. 66 nucleotide of VP1.

Enterovirus ; classification ; genetics ; Humans ; Mutation, Missense ; genetics ; Phylogeny ; Reverse Transcriptase Polymerase Chain Reaction ; Viral Structural Proteins ; classification ; genetics

Objective:To evaluate the efficacy and safety of Yang-Monti tube in the operation of bladder controllable outflow tract, and to compare the efficacy of single and double segments Yang-Monti tube in patients with urethral damage.Methods:The clinical data of 27 patients who underwent Yang-Monti tube surgery in West China Hospital of Sichuan University from January 2009 to February 2018 were retrospectively analyzed, including 14 cases of single segment ileum (single segment group) and 13 cases of double segment ileum (double segment group). The age of single-segment group and double-segment group was (56.5±4.3) years and (50.2±6.8) years, respectively ( P=0.220). There were 2/12 and 3/10 males and females, respectively ( P=0.564). The body mass index (BMI) was (19.6±1.3) kg/m2 and (24.2±2.1) kg/m2, respectively ( P<0.001). The disease duration was 6 (3-24) months and 8 (3-48) months, respectively ( P=0.650). The preoperative quality of life (QOL) score was (46.7±1.7) and (45.5±1.7), respectively ( P=0.061). The number of patients with urinary tract infection before operation was 11 and 13, respectively ( P=0.480). In the single-segment group, a 2 cm ileum with mesangial vessels was cut at a distance of about 15 cm from the ileocecal part, and the intestine was cut longitudinally along the direction of the intestinal canal at the opposite mesangial margin. The intestinal piece was wrapped horizontally around the F12 urinary tube and wound into a Yang-Monti tube by intermittent suture with a 3-0 single thread. The bladder wall was cut anterolateral to the top wall of the bladder, about 1 cm in length, and the Yang-Monti tube was anastomosed end-to-end with the mucosal muscularis of the bladder wall. A circular incision with a diameter of about 1 cm was made at the level of the anterior superior iliac spine at the rectus abdominis muscle, and a tunnel was formed by puncture into the abdomen with curved forceps. The Yang-Monti tube was led out of the abdominal wall along the tunnel, and the tube opening was fixed with subcutaneous suture. At the same time, the tube wall was fixed in the peritoneum with 4-0 silk thread. In the double-segment group, two segments of 2 cm ileum were cut, and the intestinal tube was cut longitudes along the direction of the opposite mesangial margin. The intestinal piece was first sutured end to end, and then the tube was coiled and reconstructed to form a Yang-Monti tube with a diameter of 0.6-0.8 cm and a length of about 12 cm. The proximal end of the Yang-Monti tube was directly anastomosed with the mucosal muscle layer of the bladder. The operation time, intraoperative blood loss, postoperative catheterization interval, postoperative single catheterization volume, postoperative complications (bleeding, intestinal obstruction, anastomotic leakage, anastomotic stenosis, stoma infection, urinary tract infection, urinary tract infection) and QOL score were compared between the two groups. Results:The operation was successfully completed in both groups. The operation time of single-segment group and double-segment group were (165.8±17.8) min and (157.54±12.25) min, respectively ( P=0.302), and the intraoperative blood loss was (60.0±20.0) ml and (50.00±25.00) ml, respectively ( P=0.650). The postoperative recovery time was 3 (2-4) d and 3 (2-9) d, respectively ( P=0.790), and the postoperative hospital stay was 12 (9-40) d and 12 (10-32) d, respectively (P=0.259). The postoperative single catheterization volume was (240.4±42.7) ml and (261.5±36.3) ml ( P=0.186), and the postoperative QOL was (22.4±2.7) and (21.5±2.6), respectively ( P=0.325), and there was no significant difference. There were 2 cases of urinary tract infection in the single-segment group, and 1 case of urinary tract infection, postoperative bleeding, and intestinal obstruction in the double-segment group. There was no significant difference between the two groups ( P=0.222). The time interval of catheterization in single-segment group and double-segment group was (2.5±1.0) h and (3.5±1.3) h, respectively, and the difference was statistically significant ( P=0.029). The quality of life score after operation was statistically significant compared with that before operation ( P<0.001), and the incidence of urinary tract infection after operation was also statistically significant compared with that before operation ( P=0.011). Conclusions:Both single segment and double segment ileum Yang-Monti tube surgery are feasible surgical methods for patients with urethral damage. There was no difference in the effects of the two types of surgery, and both may improve the quality of life of patients.The postoperative QOL score could be greatly improved and the incidence of complications was low.

OBJECTIVETo determine the optimal position of hypoglossal nerve in hypoglossal-facial nerve anastomosis and the eligibility of hypoglossal-facial nerve anastomosis with the cervical loop.

METHODSThe cervical course and adjacent structures of the hypoglossal nerve were observed on 21 adult cadavers. The hypoglossal nerve and facial nerve were taken from 3 fresh specimens, and the number of the fasciculus and the cross-sectional area of the nerve were measured.

RESULTSThe facial nerve trunk were monofascicular with a cross-sectional area of 5.1-/+0.2 (range 4.6-5.7) mm(2). The number of the fasciculus and the cross-sectional areas of the nerve trunk and the fasciculus were 1.6-/+0.8 (range 1-4) mm(2) , 7.5-/+0.7 mm(2) (range 6.8-8.0) mm(2), and 4.7-/+0.6 (4.1-5.5) mm(2), respectively, at the proximal segment of the hypoglossal nerve, 3.6-/+0.5 (1-5) mm(2) , 5.6-/+0.5 (4.9-6.1) mm(2) , and 1.6-/+0.4 (0.9-2.2) mm(2) at the distal segment, and 2.4-/+0.8 (1-3) mm(2), 1.1-/+0.7 (0.6-2.2) mm(2), and 0.5-/+0.3 (0.3-1.2) mm(2) at the cervical loop.

CONCLUSIONThe cervical loop is inadequate for facial nerve anastomosis and the proximal segment is large enough to allow partial harvesting of the hypoglossal nerve for neurotisation of the facial nerve.

Anastomosis, Surgical ; methods ; Cadaver ; Facial Nerve ; anatomy & histology ; surgery ; Humans ; Hypoglossal Nerve ; anatomy & histology ; surgery ; Nerve Transfer ; methods

Patients who suffer severe burns are at increased risk for local and systemic infections. The incidence of fungal infections has increased in recent years, and these infections represent a major issue in burn intensive care units. Herein, we report three cases of fungal infection due to Candida species occurring in patients undergoing supportive therapy and antibiotic treatment during their hospitalization. Two of these patients were infected with Candida parapsilosis, and one was infected with Candida albicans. The risk factors for these patients' Candida infections were multiple and prolonged courses of antimicrobial treatment, steroid treatment, tracheal intubation and smoke inhalation. Susceptibility testing of nine antifungal compounds was performed, and the minimum inhibitory concentration (MIC) values of all isolated strains were lower than the breakpoint MIC value for resistance of the relevant drug. All three patients were cured by treatment with antifungal agents. Candida infection may occur 1 - 3 weeks after thermal injury, and the prompt recognition and treatment of such infections with antifungal therapies may result in decreased morbidity and mortality associated with these infections in burn patients.
Adult ; Antifungal Agents ; therapeutic use ; Burns ; complications ; microbiology ; Candida albicans ; drug effects ; pathogenicity ; Candidiasis ; drug therapy ; etiology ; Female ; Humans ; Male ; Microbial Sensitivity Tests ; Middle Aged

Adolescent ; Adult ; Asian Continental Ancestry Group ; genetics ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Male ; Membrane Transport Proteins ; genetics ; Middle Aged ; Mutation ; genetics ; Polymerase Chain Reaction ; Sequence Analysis, DNA ; Spastic Paraplegia, Hereditary ; genetics ; Young Adult

OBJECTIVETo analyze the relationship between P-glycoprotein function in peripheral blood cells and primary multidrug resistance in breast carcinoma.

METHODSP-gp function was investigated by flow cytometry in NK cells of 16 breast cancer patients treated with anthracyclines and taxanes. Among all the patients, 8 were in chemotherapy-sensitive group and 8 in chemotherapy-resistant group. P-gp function was determined by rhodamine 123 (Rh123)-ejection test. Mathematical model was established by a regression of the fluorescence-time curve. The efflux rate constants of the chemotherapy-sensitive and -resistant groups were compared.

RESULTSThere was no significant difference of Rh123 accumulation, retention or efflux between the two groups. The mathematical model of F(t) = F(0) · e(-kt) was established. K was the efflux rate constant, which was significantly different between the chemotherapy-sensitive and -resistant groups (P = 0.025). When k > 3.9 was used as diagnostic criterium for primary resistance, the sensitivity, specificity and accuracy were 75.0%, 100% and 87.5%, respectively.

CONCLUSIONP-glycoprotein function in peripheral blood cells is associated with primary multidrug resistance in breast carcinoma. The efflux rate constant may be a good predictor for chemotherapy sensitivity.

ATP-Binding Cassette, Sub-Family B, Member 1 ; blood ; Adult ; Aged ; Anthracyclines ; administration & dosage ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Breast Neoplasms ; drug therapy ; metabolism ; pathology ; Drug Resistance, Multiple ; Drug Resistance, Neoplasm ; Female ; Humans ; Killer Cells, Natural ; metabolism ; Middle Aged ; Retrospective Studies ; Rhodamine 123 ; metabolism ; Taxoids ; administration & dosage