Objective To analyze the clinical effect of pedicle screw fixation in the treatment of multi-segmental lumbar fracture and dislocation under the guidance of visualization technique. Methods A total of 21 patients with multi-segmental lumbar fracture and dislocation were selected from November 2012 to November 2013. Before the screw implantation, the structure of bilateral pedicle was observed through Mimics software and the implantation parameters were measured. The position of pedicle screws by postoperative CT scan, operation time, and the satisfaction of the patients were assessed. The percentages of anterior vertebral height and Cobb′s angle were measured before operation, 2 weeks and 8 months after operation. Results All patients were satisfied with informed consent score and the way of pedicle screw and the selection of plant were more reasonable. With better screw position, shorter operative time and less blood loss and adverse reactions, pedicle screw fixation achieved good effect. Conclusion With high security and considerable clinical value, pedicle screw fixation in the treatment of multi-segmental lumbar fracture and dislocation under the guidance of visualization technique has exact and good effecct.

BACKGROUNDThe relationship between inflammatory markers and the characteristics of coronary atherosclerosis plaques is uncertain. The aim of the present study was to evaluate the relationship between the characteristics of coronary atherosclerosis plaques and inflammatory markers such as high sensitivity C-reactive proteins (Hs-CRP) and interleukin-6 (IL-6).

METHODSAll patients suspected of having coronary heart disease (CHD) underwent Siemens 64-slice CT angiography (64-SCTA) to distinguish the quality of plaque of coronary artery lesions. Blood samples were taken to measure levels of serum Hs-CRP and IL-6 in different plaque groups and the control group and compared with the value of 64-SCTA for detection of coronary artery plaque.

RESULTSThe sensitivity of detecting coronary artery plaque by 64-SCTA was 87.4%, the specificity was 87.1%, the positive predictive value was 82.2%, and the negative predictive value was 91.0%. Comparing the levels of serum Hs-CRP and IL-6 among plaque groups, the mean levels of serum Hs-CRP and IL-6 in three plaque groups were significantly higher than those in the control group (P < 0.01). The mean levels of serum Hs-CRP and IL-6 in the soft plaque group and mixed plaque group were significantly higher than those in hard plaque group (P < 0.01). Plaque burden in the soft plaque group and mixed plaque group was significantly higher than in the hard plaque group (P < 0.01), but there was no statistical difference between the soft plaque group and mixed plaque group (P = 0.246). There was a negative correlation between the CT scale and Hs-CRP and IL-6 levels in the soft plaque group (r = -0.621, P < 0.01, and r = -0.593, P < 0.01 respectively). There was a positive correlation between the plaque burden and Hs-CRP and IL-6 levels in the soft plaque group (r = 0.579, P < 0.05 and r = 0.429, P < 0.05 respectively).

CONCLUSIONS64-SCTA is an effective way to distinguish the different quality of coronary atherosclerosis plaque. Serum Hs-CRP and IL-6 levels can be considered as the indexes to judge the degree of CHD and may reflect the activity of plaque in CHD patients. Thus it is important for clinical diagnosis and risk evaluation of acute coronary syndrome (ACS) patients.

Aged ; C-Reactive Protein ; metabolism ; Coronary Artery Disease ; blood ; diagnostic imaging ; metabolism ; Female ; Humans ; Interleukin-6 ; blood ; metabolism ; Male ; Middle Aged ; Tomography, Spiral Computed

OBJECTIVETo study the accumulation of fluoride in rat hippocampus and its effect on cholinesterase activity.

METHODSRats were subchronically exposed to NaF, and fluoride concentration and cholinesterase activity in rat hippocampus were determined.

RESULTSFluoride concentration in rat hippocampus was significantly correlated with the dosage of fluoride, and there were significant differences among high dosage group [(13.03 +/- 1.79) micro g/g], low dosage group [(9.83 +/- 0.92) micro g/g] and control [(8.27 +/- 1.11) micro g/g], P < 0.01. Acetylcholinesterase activities among three groups [(0.111 +/- 0.031) micro mol/mg, (0.143 +/- 0.025) micro mol/mg, (0.183 +/- 0.027) micro mol/mg] were also significantly different (P < 0.01), which was negatively correlated with fluoride concentration in rat hippocampus (r = -0.700, P < 0.01). The activity of butylcholinesterase in high dosage group [(0.041 +/- 0.010) micro mol/mg] was different from that of control [(0.067 +/- 0.025) micro mol/mg, P < 0.05], but the activity was not significantly related with fluoride concentration in rat hippocampus (r = -0.317, P = 0.094).

CONCLUSIONFluoride may go through the blood-brain barrier and accumulate in rat hippocampus, and inhibit the activity of cholinesterase.

Acetylcholinesterase ; metabolism ; Animals ; Blood-Brain Barrier ; Butyrylcholinesterase ; metabolism ; Fluoride Poisoning ; metabolism ; Fluorides ; pharmacokinetics ; Hippocampus ; metabolism ; Male ; Organ Size ; Rats ; Rats, Sprague-Dawley

Objective To investigate the predietors of road traffic accidents(RTAs)in middle school students.a ease-control study WaS designed to seek new clues for prevention and control on RTAs in this population.Methods Cases were 116 students who experienced RTAs from 2005/01/01 to 2005/12/31.116 students were.served as controls who were from the same clams of the cases and matched by age and sex.Information on personal behavior,family conditions,and knowledge,attitude,practice(KAB)on road traffic of these children were collected and compared.Conditionallogistic regressions were conducted to analyze the relationship between these factors and RTAs.Results Compared to the controls.the cases showed more negative attitude and risk-taking-behaviors especially in riding bicycle.However,knowledge on road safety showed less significant differences between eaSe and control groups.The negative attitude and risk-taking-behaviors were independent risk factors for RTAs by logistic regression.In addition.distance from home to school that longer than 1000 m seemed a risk factors for RTAs.while high education levels among mothers WaS a protective factor.Conclusion Road safety attitude and behavior.distance from home to school were the main influenee factors for RTAs among middle school students.It seemed more important in improving the attitude and behavior on road safety than to enhance the knowledge for prevention and eontrol of RTAs among middle school students.

Objective To evaluate the clinical effects and safety of heparin injection on hemiplegia following urokinase thrombolysis for acute ischcmic cerebral infarction. Methods Fifty-six patients with acute cerebral infarction matched the standards which could be treated with urokinase thrombolysis in our department from January 2004 to January 2008. Among the 56 patients, 36 cases with hemiplegia in 2 h after thrombolysis got their muscle force recover over Ⅲ scale. Then 36 cases were divided into the treated group and control group randomly; 18 cases in the treated group were treated by heparin sodium 1000 U/h intravenously for 5 d. They were monitored for their activated partial thromboplastin time (aPTT) and the injected heparin speed was regulated according to their aPTT to keep their aPTT between 1.5 to 2 times of the control value. The 18 cases in the control group were given oral aspirin 0.1 daily, 24 h after thrombolysis. The 2 groups were compared in the case numbers of hemiplegia reoccurrence and cerebral hemorrhage within 7 d and the National Institutes of Health Stroke Scale (NIHSS) scores. Results Though there were 5 cases with asymptomatic hemorrhagic conversion, there was no hemiplegia case again in the treated group. In the control group, 5 cases suffered from hemiplegia again and 2 cases asymptomatic hemorrhagic conversion. There were less cerebral infarction in the treated group than the control group after 14 d by brain CT. The neurological deficit improvement in the treated group was more efficient in the treated group than in the control group in 14 d. Conclusion The application of heparin for the prevention of hemiplegia in the patients with acute cerebral infarction with muscle recovery after urokinase thrombolysis is safe and effective and shows obvious clinical value when their aPTT is remained 1.5-2.0 times of the normal level.

The study investigated the burden of smear-positive pulmonary TB and its infectivity using DALY(disability-adjusted life year) as an indicator. Methods An assumed cohort of 2 000 cases was set up based on the age-specific incidence of 794 newly registered smear-positive cases in Beijing in 1994. Prognostic trees and model diagrams of infectivity under natural history and DOTS(directly observed treatment, short-course) strategy were established according to the epidemiological evidence. Results The results showed that 29.6%of DALYs would be neglected if the burden caused by the infectivity was not considered.Conclusion DOTS strategy may reduce 97.3% of the number of potential cases infected,92.9% of DALYs related to TB-patients themselves. and 99.9% of DALYs caused by TB's infectivity as well.

OBJECTIVETo determine whether there was excessive risk of cancer among workers exposed to chrysotile fiber alone by applying a meta-analysis technique.

METHODSAll data meeting the criteria of cohort studies on cancer mortality among workers exposed only to chrysotile were incorporated into meta-analysis. Pooled standardized mortality ratios (SMRs) and their corresponding 95% confidence intervals (CIs) for main cancer sites were calculated using two approaches of unweighted ratio and random effect model. The heterogeneity and its sources of the results were examined with a Q-statistic and Z-score test. The dose-response effect as reflected in the percentage of all deaths due to mesothelioma served as a proxy measure of chrysotile exposure.

RESULTSA cohort of twenty six workers exposed to chrysotile alone was summarized. The significantly elevated meta-SMRs for all deaths (1.27), all cancers (1.28), cancers of respiratory organs (2.51), cancers of lung (2.35) and cancers of stomach (1.24) were observed. The significantly elevated meta-SMRs for lung cancer within occupational strata were observed among textile workers (3.55), asbestos product manufacturers (3.30), miners and millers (2.24), cement product workers (1.22), and for stomach cancer among asbestos product manufacturers (1.49). Meta-SMRs for cancers at other sites were not significant. Meta-SMR for lung cancer showed an increasing trend with an elevated percentage of all deaths from mesothelioma, but no such trend for stomach cancer.

CONCLUSIONThere are excessive risks of lung cancer and mesothelioma among workers exposed to chrysotile fiber alone, and likely no convincing indication of an etiological association between chrysotile exposure and cancers at other sites.

Asbestos, Serpentine ; adverse effects ; Cohort Studies ; Dose-Response Relationship, Drug ; Humans ; Lung Neoplasms ; etiology ; mortality ; Mesothelioma ; etiology ; mortality ; Neoplasms ; chemically induced ; mortality ; Occupational Exposure ; Occupational Health ; Risk Assessment ; Stomach Neoplasms ; etiology ; mortality

OBJECTIVETo define TB control priorities using cost-effectiveness and burden of disease.

METHODSAn assumed cohort of 2,000 cases was set up based on age-specific incidence of 794 newly registered smear-positive cases in Beijing in 1994. Prognostic trees and model diagrams of infectivity with natural history and DOTS intervention were constructed based on the epidemiological parameters.

RESULTSDOTS reduced 89.19% of YLL, 78.90% of YLD, and 99.98% of infectivity BOD. One DALY could be saved with 45.70 Yuan by DOTS with 3% discount. Sensitivity analysis showed that discount had effect on CER. Weight of age was insensitive to CER. The higher the DOTS cured rate, the more the cost-effectiveness.

CONCLUSIONSDOTS is a good cost-effectiveness TB control strategy. Cost-effectiveness and burden of disease can be used to define TB control priorities.

Adolescent ; Adult ; Child ; Child, Preschool ; China ; epidemiology ; Cohort Studies ; Cost of Illness ; Cost-Benefit Analysis ; Disabled Persons ; Forecasting ; Humans ; Middle Aged ; Models, Biological ; Quality-Adjusted Life Years ; Tuberculosis ; economics ; epidemiology ; prevention & control

Objective The treatment methods for blood blister-like aneurysm remain controversial due to its special patholog-ical structure,the risk of post-operative rebleeding and the high rate of recurrence. The arm of this paper is to access the feasibility and effectiveness of overlapping stent-assisted coiling in the treatment of blood blister-like aneurysms of the internal carotid artery. Methods Form January 2014 to December 2016,we treated 15 patients with blood blister-like aneurysm of the internal carotid artery by stent-assisted coiling in the Department of Neurosurgery,5 with two Enterprise tents,3 with three Enterprise tents,4 with Enter-prise+LVIS tents,and 3 with two LVIS tents. We determined the rate of immediate embolization of aneurysms by Raymond-Roy Occlu-sion Classification(RROC)and analyzed the clinical characteristics,postoperative complications,and follow-up data. Results All the coils and stents were successfully implanted. RROC showed 9 cases of gradeⅠ(60%),4 cases of gradeⅡ(27%),and 2 cases of gradeⅢimmediate occlusion(13%),with the parent arteries unobstructed in all the cases. Thrombosis in the stent was found in 2 cases intraoperatively,slight stent migration in 1 case,and internal carotid artery dissection in the petrous segment in another,but no cer-ebral vasospasm or aneurysm rupture in any case.Delayed cerebral in-farct was observed in 2 cases postoperatively. The patients were fol-lowed up for 2 weeks to 28 months,which showed that 11 of them were cured,2 remained stable and 2 developed further thrombosis,with an MRS score of 0-2 in 12 cases,4 in 1 case,5 in 1 case, and 6 in 1case. Conclusion Overlapping stent-assisted coiling is effective for the treatment of blood blister-like aneurysm by reduc-ing the risks of rebleeding and recurrence.

OBJECTIVETo compare the positive rates and complications of ultrasound-guided transrectal and transperineal prostate biopsies.

METHODSWe retrospectively analyzed 156 cases of ultrasound-guided transrectal (n = 97) and transperineal (n = 59) prostate biopsy, and compared the positive rate and post-biopsy complications between the two approaches.

RESULTSThe positive rates in the transrectal and transperineal groups were 48.4% and 44.1%, respectively, with no significant difference between the two approaches according to different PSA levels (P >0.05). No statistically significant differences were observed between the transrectal and transperineal groups in the post-biopsy incidence rates of such complications as hematuria (54.6% vs 42.4%, P >0.05), lower urinary tract symptoms (17.5% vs 22.0%, P >0.05), dysuria (9.3% vs 6.8%, P >0.05), and acute urinary retention (7.2% vs 6.8%, P >0.05). However, the incidence rates of post-biopsy infection and rectal bleeding were remarkably higher (15.5% vs 3.4%, P<0.05 and 50.5% vs 3.4%, P >0.01) while that of perineal swelling markedly lower in the former than in the latter (3.1% vs 13.6%, P <0.05).

CONCLUSIONTransrectal and transperineal biopsies are both effective for the diagnosis of prostate cancer. Since their complications vary, the choice between the two methods depends on the specific condition of the patient.

Biopsy, Needle ; adverse effects ; methods ; Hematuria ; etiology ; Humans ; Lower Urinary Tract Symptoms ; etiology ; Male ; Prostate ; pathology ; Prostatic Neoplasms ; pathology ; Rectum ; Retrospective Studies ; Ultrasonography, Interventional ; methods ; Urination Disorders ; etiology