Adenocarcinoma ; metabolism ; pathology ; Adenoma ; metabolism ; pathology ; Colonic Neoplasms ; metabolism ; pathology ; Cytoplasm ; metabolism ; Female ; HSP27 Heat-Shock Proteins ; Heat-Shock Proteins ; analysis ; Humans ; Intestinal Mucosa ; metabolism ; pathology ; Male ; Neoplasm Proteins ; analysis ; Proteome ; analysis ; Proteomics ; methods ; Rectal Neoplasms ; metabolism ; pathology

[Objective]Osteoporotic vertebral compression fractures(OVCFs)are commonly multiple fractures and this study is aimed to explore how to determine the symptomatical fractured vertebrae as well as the pitfalls in treating OVCFs using percutaneous vertebroplasty(PVP).[Method]Forty-eight OVCFs patients(78 vertebrae)undergoing PVP were retrospectively analyzed.All the patients had anteroposterior and lateral plain X-rays as well as T1W1,T2W1 and fat-compressing(STIR)MR images preoperatively.The symptomatical fractured vertebrae were determined with combination of regional pain、X-rays and MR images.Of all the patients,36 were injected unilaterally while 12 were injected bilaterally.The mean injected volume of PMMA were 3-7 ml.[Result]The back pain of all the patients were relieved to different degrees postoperatively.The back pain completely disappeared in 30 patients while the left back pain was not improved though the right back pain disappeared in 2 patients who were injected via right approach.The back pain almost disappeared but the bilateral rib pain was not improved in 1 patient with T8 vertebral fracture.No severe complications including pulmonary emboli occurred.[Conclusion]The symptomatical fractured vertebrae should be determined comprehensively not only based on preoperative X-rays but also on the MR images,especially fat-compressing MR images.Only when the fractured vertebrae demonstrate low intensity on T1W1 MR image and high-intensity on T2W1 or fat-compressing MR image can we consider them new fractures.Otherwhise,the fractured vertebrae are considered old fractures and they see no necessity to be injected.The injection should reach the most severely fractured part and if necessary the bilateral approaches are considered.PMMA should be injected after the bone cements are solid enough so as not to develop complications such as pulmonary emboli.

[Objective]The present study was undertaken to investigate the incidence of symptomatic adjacent segment disease after anterior cervical interbody fusion(ACIF),and to identify the factors which are related to the development of this disease.[Method]From 1981 to 1997,a total of 160 patients underwent anterior cervical in terbody fusion for intervertebral disc herniation and cervical spondylosis.A total of 112 patients were followed up clinically and radiologically for more than two years.Of them,74 were men and 38 were women,the average age at operation was 51 years(ranged,31~70 years).Of the 112 patients,66 had one,44 had two and 2 had three levels of fusion.Follow-up evaluation was primarily viaclinical visited.The post-operative course of any symptoms,the findings of neurological examination and serial follow-up radiographs were performed in all patients.The diagnosis of symptomatic adjacent segment disease was based on the presence of new radiculopathy or myelopathy symptoms referable to an adjacent level,and the presence of a compressive lesion at an adjacent level by magnetic resonance imaging or myelography.We evaluated the correlation between the incidence of symptomatic adjacent segment disease and the following clinical parameters(age at operation sex,number of the levels fused)and radiological parameters(preoperative cervical spine alignment,preoperative range of motion of C_(2~7) cervical spine,antero-posterior spinal canal diameter,preoperative existence of an adjacent segment degeneration on plain radiograph,myelography and magnetic resonance imaging(MRI).[Result]The average length of follow-up was 9.4 years(ranged,2 to 19 years).Symptomatic adjacent segment disease developed in 19 out of 112 patients(19%)followed.A Kaplan-Meier survival analysis was performed in order to follow the disease-free survival of the entire series of patients.The disease free survival rates were 89% at 5 years,84% at 10 years and 67% at 17 years.The incidences of indentation of dura matter on pre-operative myelography or disc protrusion on MRI at the adjacent level were significantly higher in disease cases(P=(0.0 087),(0.0 299),respectively;Chi-square test).Howerer,the other parameters did not show a statistically significant difference.There were 7 cases(37%)who had failure of non-operative treatment and additional operations were performed.[Conclusion]The incidence of symptomatic adjacent segment disease after ACIF was higher when pre-operative myelography or MRI revealed asymptomatic disc degeneration at that level regardless of the number of the level number fused,pre-operative alignment,spinal canal diameter of fusion alignment.

Humans ; Mandible ; surgery ; Osteogenesis, Distraction ; methods ; Reconstructive Surgical Procedures

Female ; Humans ; Infant ; Leishmaniasis, Visceral

Animals ; Beryllium ; toxicity ; Cells, Cultured ; DNA Damage ; drug effects ; Lung ; cytology ; Male ; Rats ; Rats, Sprague-Dawley

Adult ; Aged ; Boronic Acids ; therapeutic use ; Bortezomib ; Female ; Humans ; Male ; Middle Aged ; Multiple Myeloma ; complications ; drug therapy ; Pyrazines ; therapeutic use ; Renal Insufficiency ; complications ; drug therapy

Adult ; Child ; Humans ; Male ; Pain ; etiology ; Pharyngeal Diseases ; etiology ; Rabies ; complications

AlM:To investigate the effect of teaching mode of problem- based learning ( PBL ) in the teaching of medical students' clinical ophthalmology.
METHODS: Five classes ( total 148 students ) were randomly selected as experimental group, using PBL method, at the same time another 5 classes ( total 151 students) were also randomly selected as control group, using lecture-based learning ( LBL) mode in 2010 grade. The scores of the experimental group were compared with control at the end of term. ln addition, students and teachers were respectively interviewed using self -administered questionnaire to obtain their evaluation for PBL practice.
RESULTS:The mean scores of PBL group (78. 35±7. 63) were significantly higher than control group (71. 68±6. 37) (P<0. 001). Most of students thought that their ability of referring, synthesizing and analyzing information was enhanced by PBL, and their skills both in written and oral were also improved. PBL made it easier to understand the contexts of course. lt was the best way to improve the effect of teaching in ophthalmology based on the increase of quality in novitiate that gives more chance to students of contacting with practice, developing the ability of clinical thinking and verifying the theory in clinical novitiate. Lots of teachers considered that the classroom atmosphere was more active, students were becoming more and more proactive on their classes and the relationship between students and teachers were more harmonious when PBL was used.
CONCLUSlON:Using PBL teaching mode can highly improve the teaching effectiveness of clinical epidemiology, which is worth popularizing.

Background Orthokeratology has been proved to temporarily alter the equivalent sphere,but its effects on visual quality deserve attention.Objective The present study was to investigate the visual quality after overnight orthokeratology in pre-adolescent myopes.Methods Written informed consent was obtained form each subject prior to entering into this series.A descriptive study design was used.One hundred and fifty eyes of 76 teenagers aged (14.90± 1.24)years with low and moderate myopia (-2.79 ± 0.82)D were included in the study.Fitted with Ortho-K contact lens,the lens was wore every night for over 8 hours.Subjective refraction,uncorrected visual acuity (UCVA),contrast sensitivity function,corneal-topography,and aberrometry were examined before,1 week and 3 months after the initiation of orthokeratology.Visual quality was generally evaluated by comparing before wearing,1 week and 3 months after wearing using the National Eye Institute refractive error quality of life instrument (NEI-RQL-42TM).All the procedures were performed by the same clinician.Results Spherical equivalent refractions were (-0.33± 1.02) D and (-0.26 ± 0.60) D 1 week and 3 months after orthokeratology,showing significant decline in comparison with (-2.79±0.82) D of before orthokeratology (P =0.001,0.001).However,no considerable difference was seen between 1 week and 3 months after orthokeratology (P=0.161).Contrast sensitivity function was significantly different in all spatial frequencies before wearing,1 week and 3 months after wearing,and those of 1 week and 3 months after wearing were significantly lower than those of before wearing (1 week:3 cpd P =0.001,6 cpd P=0.001,12 cpd P＜0.05,18 epd P＜0.05 ;3 months:3 cpd P=0.001,6 cpd P=0.001,12 cpd P＜0.05,18 cpd P＜0.05).There was no significant change in contrast sensitivity function between 1 week and 3 months of orthokeratology (P＞0.05).Flat K,steep K and corneal eccentricity (e) were significantly reduced (P =0.000),and surface asymmetry index (SAI) and surface regularity index (SRI) were significantly improved after orthokeratology in comparison with before orthokeratology (both P =0.001).Root mean square (RMS) of total higher-order,third-order and fourth-order aberrations were significantly increased (P＜0.05),but RMS of whole aberration and second-order aberrations significantly decreased after orthokeratology (P＜ 0.05).There were no significant changes in the fifth-order,sixth-order and seventh-order aberration among pre-wear,1 week and 3 months after orthokeratology.Scales of dark to bright,nocturnal driving,glare,visual fluctuate and halo were lower than those before orthokeratology (P＜0.05).The scales of visual fluctuate between 1 month and 3 months after orthokeratology had significant differences (P＜0.01),while the rest of the scales had no significant differences (P＞0.05).Conclusions Orthokeratology can reduce myopic diopter 1 week after orthokeratology.The overnight wearing of fitted orthokeratology can decrease contrast sensitivity and increase corneal surface irregularity and RMS of third-order and fourth-order.Compared with spectacles,orthokeratology reduces subjective visual quality,especially nocturnal quality.