Objective To explore the prognostic index for nasopharyngeal carcinoma (NPC). Methods The expression of nm23-H 1 protein in the tissue specimens of 115 NPC patients was detected by immunohistochemical S-P staining before radiotherapy. The 115 patients were treated in 1992～1994, underwent the whole radiotherapy, and were followed up for over 5 years. The association of nm23-H 1 protein expression with the clincal staging of NPC, radiosensitivity of tumor, survival rate of patients, and relapse and metastasis of carcinoma was analyzed. Results The positive rate of nm23-H 1 expression in NPC was 47.8%. The tumor clinical staging, lymph nodes metastasis, and patient survival rate were closely correlated with the low level expression of nm23-H 1 protein in NPC. Conclusion The low level expression of nm23-H 1 protein may be associated with the development and poor prognosis of NPC.

ObjectiveTo investigate the characteristic changes of expression of the genes related to inflammation response after injury of rubrospinal tract（RST）. Methods18 Sprague Dawley（SD）female rats were randomly divided into 2 groups: RST injury group (n=9) and Sham group (n=9). RST injury models were established, and the rats were killed 24 hours after injury. 5 mm length spinal cord was harvested from the epicenter and total RNA was extracted. Affymetrics Gene Chips for rats, representing 28000 genes, were used for mRNA expression profiling.Results153 transcripts were observed to differ (2.0 fold; 136 up-regulated and 17 down-regulated) after injury of RST, compared with sham group. Most of genes related to inflammation response were up-regulated (except Scn9α). 8 genes related to Toll-like receptor signaling pathway were also up-regulated.ConclusionSignificant changes related to inflammation response occur in acute phase after injury of RST.

Objective To investigate the epidemiology of spinal cord injuries (SCI) in hospital. Methods 423 patients with SCI were reviewed. esults The ratio of male to female was 15.3∶ 1, aged (40±11) years. The coal mine-related staff was the most (61.7%), mainly aused from coal blocks dropping (53.26%). 135 cases (31.91%) injured in cervical vertebra, and 187 cases (44.21%) in lumbar. There were 92 (45.39%) cases were complete injury. The most frequent complication of SCI were urinary tract infection, pressure sore and pulmonary nfection. The factors correlated with the complication were the degree of ASIA Impairment Scale, the period of admitted to hospital after injury, nd the surgery (P<0.05). The expenditure of hospitalization was mainly provided by oneself (73%). Conclusion It is important to improve he occupation prevention, enlarge the coverage of medical insurance, and promote pre-hospital care to prevent SCI.

BACKGROUND: Conventional means in treatment of distal tibiofibular syndesmosis disruption include plaster cast or splint immobilization as external fixation and internal fixation using screws, and bone bolts or plates;however, some disadvantages such as unstable fixation and uncertain fixation exist.OBJECTIVE: To observe the primary clinical curative effect of newly self-developed fixation, Hook-plate fixation (HPF), for distal tibiofibular syndesmosis disruption and its biochemical characteristics of HPF.DESIGN: Self-control observation.PARTICIPANTS: We recruited 23 patients with sustaining abruption of lower tibiofibular ligament union with fibular fracture who received treatment in the Department of Orthopedics, Affiliated Hospital of Yangzhou University Medical College, between October 2001 and March 2004. According to the Lauge-Hansen classification system, there were 11 cases of supination-lateral rotations, 7 cases of pronation-lateral rotations and 5cases of pronation-abductions. Among them 14 had bimalleolar fractures and 9 had trimalleolar fractures.METHODS: HPF was used on the 23 patients with distal tibiofibular syndesmosis disruption. Radiographs were taken routinely. Talocrural joint function exercise was recommended at week 1 and partial weight bearing was allowed 2 months later. Functions were evaluated according to modified Mazur's criteria (excellent, good, fair and poor).MAIN OUTCOME MEASURES: ①Healing time and function ev aluation after operation for distal tibiofibular syndesmosis disruption. ② Adverse events and side effectsRESULTS: Totally 23 patients entered the result analysis, with the mean of 11 months' follow-up. ①Results of healing time and function evaluation in the patients after operation for distal tibiofibular syndesmosis disruption: The healing time of fracture ranged from 12 to 18 weeks: 16 cases were excellent, 5 good, and 2 fair. ② Adverse events and side effects:There was no separation of the tibiofibular space, the distance between medial malleolus or lateral malleolus and anklebone was symmetrical.There was no mobilization or rupture of the internal fixation after operation.CONCLUSION: HPF is applied in treating distal tibiofibular syndesmosis disruption. It causes no postoperative complications, and can recover the ankle joint function with stable internal fixation and good biomechanical features.

10.3969/j.issn.1007-3969.2013.05.002

Objective To compare the clinical outcomes of dilator-kyphoplasty (DKP) and balloonkyphoplasty (BKP) in treatment of osteoporotic vertebral compression fractures. Methods From May 2007 to March 2009, 23 cases with 26 vertebrae were treated with DKP, while 29 cases with 29 vertebrae were treated with BKP procedures. The operating time, bleeding volume and injecting volume of cement were recorded during operation. The distribution of cement, the restoration of vertebral height and Cobb angle were observed. The patients' visual analogue scales (VAS) score and Oswestry disability index (ODI) score were evaluated after operation. Results There were no differences in operative time, bleeding volume of every vertebrae and cement injected volume between these two groups (P＞0.05). The vertebral height, Cobb angle, VAS and ODI scores were significantly improved than those of pre-operation in these two groups (P＜0.05). The height of the anterior vertebrae and Cobb angle in DKP groups were restored significantly than those in BKP groups (P＜ 0.05). There were 1 case (1 vertebra, 3.8%) underwent cement leakage in DKP groups and 5 cases (5 vertebrae, 17.2%) in BKP groups. Conclusion DKP and BKP were effective in the treatment of osteoporotic vertebral compression fractures. The height of the anterior vertebrae and Cobb angle in DKP groups were restored significantly than those in BKP groups.

Objective:To investigate the application value of multimodal image three-dimensional reconstruction combined with facial nerve tracking in acoustic neuroma surgery.Methods:Forty-five patients with single acoustic neuroma accepted primary surgical treatment at Department of Neurosurgery, Yibin Hospital, West China Hospital, Sichuan University from November 2018 to June 2022 were chosen. The head, skull, brain tissues, arteriovenous system, tumor and facial nerves were reconstructed preoperatively by multimodal three-dimensional image reconstruction combined with facial nerve tracking. Preoperative planning was carried out according to the relationship between tumor and surrounding structures. The accuracy of facial nerve tracking was evaluated by intraoperative microscopic observation and nerve electrophysiological monitoring. House-Brackmann (H-B) criteria was used to evaluate facial nerve functions 2 weeks after surgery. Three months after surgery, all patients underwent enhanced MRI scanning, and combined with intraoperative findings, the degrees of acoustic neuroma resection were determined.Results:The facial nerves and their relations with acoustic neuroma were successfully tracked in all 45 patients; as confirmed by intraoperative microscopy and nerve electrophysiological monitoring, the results of facial nerves and their relations with acoustic neuroma were consistent in 42 patients and inconsistent in 3 patients. Using intraoperative nerve electrophysiological monitoring as gold standard, the accuracy of multimodal image three-dimensional reconstruction of the facial nerves was 93.3%. Preoperative facial nerve tracking results were highly consistent with intraoperative nerve electrophysiological monitoring results (Kappa=0.903, P<0.001). The facial nerves were intraoperatively preserved in 91.1% patients (41/45), and the facial nerve function was good in 86.7% patients (39/45) at 2 weeks after surgery. The total/subtotal resection rate of acoustic neuroma was 88.9% (40/45). No death, cerebrospinal fluid leakage, hematoma, or cerebral infarction were noted during the perioperative period. Conclusion:Multimodal image three-dimensional reconstruction combined with facial nerve tracking can help to protect blood vessels and nerves, improve total resection rate and facial nerve function retention rate in surgery of acoustic neuroma.

Objective:To explore the effects of hospital-to-community model-based case management on outcomes and life quality of patients with atrial fibrillation.Methods:By convience sampling method, a total of 90 cases of atrial fibrillation patients admitted to Changzhou Second People′s Hospital from January 2019 to May 2020 were randomly divided into control group and experimental group, with 45 cases in each group. The patients in the control group received routine nursing care, the experimental group implemented hospital-to-community model-based case management. The beliefs about medicine, medication compliance, quality of life and readmissions of cardiovascular events were compared between 2 groups before and 6 months after intervention.Results:Finally, 41 cases were included in the experimental group and 38 cases in the control group. Before intervention, there were no significant differences in various indexes between the two groups ( P>0.05). After 6 months of intervention, the scores of specific-necessity in Beliefs about Medicines Questionnaire-Specific (BMQ-Specific) and Morisky Medication Adherence Scale-8 (MMAS-8) were (16.98 ± 4.22) and (7.15 ± 0.69) points in the experimental group, higher than in the control group (14.95 ± 4.33) and (6.32 ± 1.07) points; the scores of specific-concerns in BMQ-Specific were (6.83 ± 1.91)points in the experimental group, lower than in the control group (8.42 ± 2.73) points. The differences were statistically significant ( t = 2.11, 4.07, 2.98, all P<0.05); the scores of physical function, role-physical, pain, general health, mental health dimensions and total scores in SF-36 were (80.37 ± 3.46), (46.63 ± 14.54), (90.37 ± 5.78), (70.07 ± 9.98), (84.20 ± 8.73) and (584.88 ± 25.71) points in the experimental group, higher than in the control group (70.13 ± 11.20), (37.34 ± 10.25), (83.37 ± 6.89), (59.55 ± 7.98), (77.58 ± 9.09) and (533.87 ± 31.62) points, the differences were statistically significant ( t values were 3.30-7.89, all P<0.05). At 6 months after discharge, the re-admission of cardiovascular events were 5 cases (12.2%) in the experimental group and 12 cases (31.6%) in the control group, the difference was statistically significant ( χ2=4.74, P<0.05). Conclusions:Hospital-to-community model-based case management can effectively promote beliefs about medicine and medication compliance, improve quality of life and decrease re-admission of cardiovascular events of patients with atrial fibrillation.