Altitude Sickness ; Chronic Disease ; Humans ; Male ; Middle Aged ; Occupational Diseases

Adult ; Female ; Hearing Loss, Noise-Induced ; diagnosis ; etiology ; Humans ; Male ; Middle Aged ; Noise, Occupational ; adverse effects ; Occupational Diseases ; diagnosis ; etiology

BACKGROUND: With the development of pedicle-screws,pedicle-screw internal fixation system has been widely used in the clinical treatment of thoracolumbar fractures because it can provide rigid internal fixation for injured spine to acquire more dimensional stabilization with little trauma and simple operation.OBJECTIVE: To investigate the long-term therapeutic effects of CD2 pedicle-screw intemal fixation in treatment of thoracclumbar burst fractures.METHODS: A retrospective analysis was made on 72 cases of thoracolumbar burst fractures who received treatment at the Department of Orthopedics and Traumatology of Nantong University of Traditional Chinese Medicine between January 2000 and January 2008.All these patients received CD2 pedicle-screw internal fixation treatment.All of them were checked with radiography prior to and after surgery and at the final follow-up.The anterior and posterior vertebral body height,the situation of bone graft fusion,and the change of cobb angle were observed after surgery and at final follow-up.CT examination was performed in 27 cases prior to surgery and at the final follow-up to evaluate the space occupying in the spinal canal.Frankel classification was performed to evaluate the recovery of nerve system and Oswestry Disability Questionnaire was used to score the back pain at the final follow-up.RESULTS AND CONCLUSION: 72 cases were followed up for an average of 48 months(range 0.5-8 years)after surgery.X-ray results showed that after surgery,the correction of antedor vertebral body height averaged 6.55 mm,posterior vertebral body height 2.69 mm,and cobb angle 25.7°,and at the final follow-up,correction loss averaged 2.29 mm in the anterior vertebral body height,1.74 mm in the posterior vertebral body height,and 2.6° in the cobb angle.Among 27 patients scanned by CT,the space-occupying rate of the vertebral canal was 10%-75% prior to surgery and it was declined to 5%-24% at the final follow-up.In the last survery,eggshell phenomenon was still observed in 20 cases.Neurological status improved at least 1 Frankel grade in the patients who had preoperative incomplete paraplegia,while no improvement was obtained in those who had preoperative complete paraplegia.Clinical curative effects were evaluated according to Oswestry Disability Questionnaire,results showed 0%in 23 cases,2% in 29 cases,3% in 5 cases,6% in 5 cases,8% in 4 cases,10% in 1 case,56% in 1 case,57% in 1 case,80% in1 case,and 87% in 2 cases.Nuts loosened in 2 cases,pedicle screws loosened in 2 cases,and sticks broken in 1 case.All these findings indicate that CD2 pedicle-screw internal fixation in treatment of thoracolumbar burst fractures can well restore vertebral heights,physiologic curves,and neurological functions.

Objective To observe the effect of mild hypothermia on expression of vascular endothelial growth factor (VEGF) and hypox-ia-inducible factor-1α(HIF-1α) in brain tissues in rats with cerebral ischemia-reperfusion. Methods Thirty Sprague-Dawley rats were ran-domly divided into sham group, model group and mild hypothermia group with ten rats in each group. The latter two groups were estab-lished middle cerebral artery occlusion (MCAO) for two hours and reperfusion model. The mild hypothermia group received mild hypother-mia treatment for 24 hours. The neurologic function was evaluated with Longa's score. The brain water content was measured by wet/dry method. The infarction area ratio was assessed by TTC staining. The protein levels of VEGF and HIF-1αwere determined by ELISA, while the mRNA level of VEGF was assessed by qPCR. Results Compared with the sham group, the score of neurologic score, the brain water content ratio and the infarction area ratio, the expression of VEGF protein and HIF-1αprotein, and the mRNA level of VEGF increased in the model group (P<0.05). Compared with the model group, the score of neurologic score significantly decreased (χ2=26.657, P<0.001), the brain water content ratio and the infarction area ratio decreased (P<0.05), and the expression of VEGF protein and HIF-1αprotein, and the mRNA level of VEGF further increased (P<0.05) in the mild hypothermia group. Conclusion Mild hypothermia may protect against isch-emic-induced neurologic injury by up-regulating the expression of VEGF and HIF-1α, and promote the angiogenesis in the rats with cerebral ischemia-reperfusion.

China ; Hearing Loss, Noise-Induced ; prevention & control ; Hearing Tests ; standards ; Humans ; Noise, Occupational ; adverse effects ; legislation & jurisprudence ; prevention & control ; Occupational Diseases ; prevention & control

Coding region instability determinant (CRD) is one of the influence factors of oncogene c-myc.Coding region instability determinant-binding protein (CRD-BP) can connect with CRD in order to protect CRD from nuclease attack,prevent rapid degradation of c-myc mRNA,and increase c-myc protein content.Beta-transducin repeats-containing protein (β-TrCP) can affect cell growth,differentiation,apoptosis and oncogenesis by regulating multiple signaling pathways and cell cycle.The overexpression of CRD-BP can upregulate the expression of β-TrCP and both of them play important roles in the tumorigenesis,progression,metastasis and invasion of colorectal cancer.

Heart ; drug effects ; Heart Failure ; drug therapy ; Humans ; Hydrogen Bonding ; Nitrogen Oxides ; pharmacology ; therapeutic use

The sulfonylureas as insulin secretagogues,have formed a cornerstone of pharmacotherapy for type 2 diabetes over 50 years.Although sulfonylureas are effective antihyperglycemic agents,individual variability exists in drug response (i.e.,pharmacodynamics) and adverse effects which may be related to some genes.This article mainly reviews the advance of recent studies about drug metabolism and pharmacogenomics of sulfonylureas.

Objective To compare the curative effects of different ideas for application of vasoactive drugs in patients of congenital heart disease with SPAH during perioperative period and to choose a method to improve the survival rate of patients with high-risk SPAH.Methods Thirty two patients were separated into two groups randomly,one group was treated by vasodilator to dilate the pulmonary artery and decrease the pulmonary pressure as conventional therapeutic strategy,the other was treated by vasoactive drugs to decrease the right cardiac output,which maintain the normal vessel resistance and cardiac output and reduce right heart failure.Indexes were recorded respectively,including hemodynamic,right cardiac working index(RCWI),the time of using respirator and postoperative complications to compare the differences.Results Indexes were recorded in two groups as following:Aortic/pulmonary artery pressure inversion(6.25％ vs.56.25％),RCWI (1626.87 ±411.23 vs.3808.99 ± 275.52),incidence of right heart failure (6.25％ vs.93.75％),respirator applying time[(68.00 ± 7.17) h vs.(115.00 ± 13.68) h],ICU time[(5.0 ± 0.8) d vs.(8.0 ± 1.5) d],incidence of postoperative pulmonary complications (6.25％ vs.81.25％),mortality(0 vs.12.5％).Conclusion The new therapeutic idea that using vasoactive drugs to reduce RCW1 and to maintain peripheral vessel resistance and appropriate cardiac output is superior for postoperative complications and mortality reduction.

Objective:To study the indications and clinical efficacy of video assisted small incision in treatment of infected pancreatic necrosis.Methods:A retrospective study was conducted on 27 patients with infected pancreatic necrosis treated by video assisted small incision at the Department of Pancreatic and Splenic Surgery, Hunan Provincial People's Hospital, from January 2018 to December 2019. The surgical approach, operation time, intraoperative blood loss, postoperative hospital stay and complications were analysed. Postoperative follow-up was carried out at outpatients’ clinic, and the patient's time to full recovery and long-term complications were studied.Results:The 27 patients successfully underwent the operations. There were 22 males and 5 females, aged (50.6±6.2) years. The treatment results were analyzed according to the different surgical approaches: the retroperitoneal approach group ( n=4); the omental sac approach group (n=14); the intercostal space approach group ( n=2); and the combined approach group ( n=7). The operation time was (85.3±31.6)min. The intraoperative blood loss was 65.0(45.2, 121.4)ml. The postoperative hospital stay was 23.0(12.5, 36.1)days. The incidence of complications (Clavien-Dindo grade Ⅲ and above) was 14.8%(4/27). There were 2 patients in this study who were admitted to the intensive care unit due to postoperative hemorrhage: 1 patient responded well to conservative treatment and the remaining patient required interventional treatment. Another patient because of poor results, underwent debridement by laparotomy 2 weeks after the operation. There was 1 patient who developed grade C pancreatic fistula which was cured by surgical treatment 6 months later. On follow-up, 2 patients developed colonic fistula 2 weeks after surgery and 2 patients gastric fistula 1 week and 3 weeks after surgery. These patients responded to conservative treatment. Conclusion:With proper case selection, video assisted small incision could safely and effectively be used to treat infected pancreatic necrosis.