Objective The objectives of this study were to analyze the results of lung cancer screening from 9265 urban residents in Urumqi from year 2014 to 2016,and to evaluate the significance of early diagnosis and treatment of cancer for the lung cancer prevention.Methods A total of 31,177 people with high risk of lung cancer were assessed by cancer risk questionnaire surveyed from 40 to 69 years old residents in Urumqi.High-risk groups were assigned to low-dose spiral CT scan in Affiliated Tumor Hospital of Xinjiang Medical University.Results 9,265 people were scanned with low dose spiral CT and overall completion rate was 29.7％.There had 11.9％ detection rate in 1,005 people who were scanned positive pulmonary nodules.The detection rate was 31.9％ for 2,955 people who were scanned solid nodules(＜5 mm) and 2.5％ for 236 people who had the non solid nodules(＜ 8 mm).After screening,14 patients were diagnosed by pathology and the detection rate was 0.2％.The emphysema,pulnonary cysts,pulmonary bullae and other related lung disease were detected in 4,095 people and the detection rate was 44.2％.Conclusion The lung health status of Urumqi residents was found by a wide range of lung cancer screening,and the awareness of lung cancer prevention and control was greatly improved.It provided the basis for the establishment of effective prevention and treatment system,which was helpful to improve the early diagnosis and treatment rate of lung cancer.

Objective To review the influence of 131I therapy on bone mineral density (BMD) in patients with hyperthyroidism.Methods Published articles of prospective randomized controlled study,clinical controlled study or case-control study on BMD change in patients with hyperthyroidism after 131I therapy were selected from PubMed,the Excerpta Media Database (Embase),Cochrane library,Chinese Journal Full-text Database,Wanfang Database,Vip Database and Chinese Biomedical Literature Database.Data from the date of database establishment to October 2015 were all reviewed.The languages were restricted to English and Chinese.Meta-analysis was performed with RevMan 5.3.Results Thirteen trials with a total of 668 hyperthyroidism patients were included.The meta-analysis showed that BMD of the lumbar spine,hip joint,femoral neck and osteocalcin were significantly improved after 131I therapy.The weighted mean difference (WMD) for BMD of the lumbar spine was 0.07 (95％ CI:0.04-0.11),P=0.O00 2;that of the hip joint and the femoral neck was 0.13(95％ CI:0.09-0.16) and 0.05(95％ CI:0.03-0.06),respectively(both P＜0.01).The standardized mean difference (SMD) of osteocalcin was-1.20(95％ CI:-1.43--0.97) with P＜0.01.Furthermore,the improvements were time dependent within the 2 years' follow-up.Conclusions 131I therapy improves the BMD and osteocalcin in patients with hyperthyroidism in a time dependent manner within 2 years' follow-up.

Dystonia is a movement disorder characterized by continuous or intermittent muscle contraction leading to involuntary abnormal movements or postures. The etiology of dystonia can be hereditary,acquired,or idiopathic. Hereditary dystonia has been listed in the first catalog of 121 rare diseases in China. The genetic causes of dystonia are complex,with numerous new genes related to dystonia discovered in recent years,which include HPCA,KCTD17,COL6A3,KMT2B,VPS16,VPS41,VPS11,AOPEP,EIF2AK2,ADCY5,GNAO1,GNB1,TBCD,CACNA1B,DNAJC12,SLC18A2,SQSTM1,IRF2BPL,and YY1. The relationship between clinical phenotypes and genotypes in dystonia is complex and insufficiently understood. This article reviews the genetics of dystonia,aiming to improve clinicians ability to diagnose and treat this disease.

Objective To explore the efficacy of middle and high (mid-high) flow intracranial-external vascular bypass in treatment of complex intracranial aneurysms and selection of grafts. Methods The clinical data of 79 patients with complicated intracranial aneurysms treated by mid-high flow extracranial-intracranial bypass in our hospital from August 2010 to October 2017 were collected retrospectively. The grafts were radial artery (n=21), saphenous vein of the calf segment (n=29) or thigh saphenous vein segment (n=29). The efficacy was determined based on Glasgow outcome scale (GOS) scores at discharge and modified Rankin scale (mRS) scores at follow-up, and the differences of occlusion in different types of grafts were analyzed. Results CTA showed patency of the grafts in all patients one d after surgery. There were 6 patients having vascular occlusion: 2 patients (the grafts at saphenous vein of the calf segment ) were occluded 3 and 4 d after surgery, without symptom; 2 patients (the grafts at the radial artery), with decreased limb muscle strength, were occluded 5 and 25 d after procedure; 2 patients ( the grafts at the saphenous veins of the calf segment) were occluded 6 months after procedure without any symptom. There were 4 patients developed cerebral ischemia after operation: one had cerebral infarction and three had vasospasm. GOS scores at discharge and mRS scores at follow-up showed that 78 patients had improved symptoms and good prognosis; one patient showed no improvement in symptoms and plant survival. Conclusion Mid-high flow extracranial-intracranial bypass for treatment of complex intracranial aneurysms is effective; the graft should be individually selected based on preoperative assessment results.

Objective To compare animal models of chronic heart failure(CHF)prepared by three different protocols,to establish a stable,reliable,and reproducible mouse model of CHF.Methods Twenty-five male C57BL/6J mice were divided randomly into four groups:a blank group,model A group(MA group),model B group(MB group),and model C group(MC group).The model groups adopted different preparation protocols for continuous injection of isoprenaline.The MA group and MB group were dose-decreasing models:MA group:subcutaneous injection of 10 mg/kg on day 1,5 mg/kg on day 2,2.5 mg/(kg·d)on days 3～30,total 30 days;and MB group:subcutaneous injection of 20 mg/kg on day 1,10 mg/kg on day 2,5 mg/(kg·d)on days 3～14,total 14 days.The MC group used a constant dose of intraperitoneal injection of 7.5 mg/(kg·d)for 28 days.The day after the final injection,the survival and model-formation rates for each group of mice were calculated.Cardiac function was measured by cardiac ultrasound and serum levels of N-terminal pro B-type natriuretic peptide,interleukin-6,and tumor necrosis factor-α were measured.Results CHF was successfully induced in all the model groups after all injections at the end of the fourth week.However,comprehensive test result showed that the MC model was the most stable.Conclusions An isoprenaline-induced mouse model of CHF using constant intraperitoneal injection of 7.5 mg/(kg·d)for 28 days may be the most suitable model for subsequent research on traditional Chinese medicine.

Objective:To explore the clinical features and risk factors of in-hospital mortality in idiopathic inflammatory myopathies (IIM) patients.Results:We retrospectively analyzed clinical records of polymyositis (PM), classic dermatomyositis (CDM) and clinically amyopathic dermatomyositis (CADM) patients admitted to the First Affiliated Hospital of Zhejiang University from February 2011 to February 2019. The deceased group was defined as the patients who died in hospital or within 2 weeks after hospital discharge, while the survival group was defined as the survival patients. The clinical features were described. Risk factors for deceased patients were identified by logistic regression analysis.Results:The in-hospital mortality rate of IIM patients ( n=424) was 9.4%. The hospitalization time was longer in deceased group ( n=40) [0.9(0.5, 1.0) m vs 0.6(0.4, 1.0) m, Z=-2.159, P<0.05]. Ferritin [1170.8(757.6, 3 759.9) μg/L vs 374.9(182.1, 993.4) μg/L, Z=-4.665], red blood cell distribution width (RDW) [15.2(14.5, 16.3)% vs 14.4(13.5, 15.2)%, Z=-3.066], CRP con-centrations [11.3(4.4, 36.9) mg/L vs 5.1(1.8, 17.2) mg/L, Z=-2.667] and neutrophil-to-lymphocyte ratio (NLR) [10.1(5.5, 18.9) vs 4.2(2.6, 6.5), Z=-5.108] were higher in deceased group ( P<0.05). Proportion of patients with high levels of CEA (45.0% vs 12.5%, χ2=15.745), glutamyl transpeptidase (γ-GT) (55.0% vs 23.8%, χ2=11.578), fucosidase (AFU) (35.0% vs 10.0%, χ2=10.902) and with complications [including pro-gressive in-terstitial lung disease (ILD) (60.0% vs 16.3%, χ2=23.934), pulmonary infection (72.5% vs 20.0%, χ2=31.360), hemophagocytic lymphohistiocytosis (35.0% vs 1.3%, χ2=27.771) and low T3 syndrome (50.0% vs 17.5%, χ2=16.644) were higher in deceased group ( P<0.05). Steroid pulse therapy and intravenous immuno-globulin therapy were more common in deceased group. Higher on-admission disease activity [ OR=1.593, 95% CI(1.255, 2.022), P<0.001], progressive ILD [ OR=5.600, 95% CI(1.510, 20.772), P=0.010] and pulmonary infection [ OR=6.771, 95% CI(2.031, 22.574), P=0.002] were independent risk factors for death in IIM patients. In su-bsection analysis, pulmonary infection and respiratory failure were short-term adverse prognostic factors for IIM patients with progressive ILD, while heliotrope rash, progressive ILD and increased steroid dose therapy were short-term adverse prognostic factors for IIM patients with pulmonary infection. Conclusion:High disease activity at admission, progressive ILD and pulmonary infection are the independent risk factors for death in IIM patients. Therefore, it is necessary to closely monitor above indicators during hospitalization.

Objective:To evaluate the feasibility of the screw and plate for clival fixation using a transoral expanded approaches.Methods:The transoral expanded approaches were performed on craniocervical segment specimens obtained from 7 subjects, including transoral approach (TO), transoral with soft (TOP) or hard (TOHP) palate split, mandibulotomy (MO) and mandibuloglossotomy (MLO). The distribution and thickness of soft tissue, the configuration of the vertebral arteries, the distance between the midline and the vertebral arteries, the exposed area of the clivus and cervical spine, and the range of screw angle (the angle between the line from the lower incisor or the central base of the mandible to the exposed area of the clivus and the tangent line of the clivus) were evaluated.Results:The thickness of the soft tissue on the posterior pharyngeal wall above the clival pharyngeal nodules was 3.5±0.6 mm. That on the anterior C 1-C 5 vertebrae was 5.0±0.5 mm. The distances from the bilateral vertebral arteries to the midline was 19.5±1.2 mm at C 1, 2, 14.6±2.7 mm at C 2, 3, 14.0±2.7 mm at C 3, 4, and 13.9±2.7 mm at C 4, 5. For the TO approach, the longitudinal diameter of the exposed clivus was 8.3±3.0 mm. The distance from the lower incisor to the superior margin of the exposed clivus, the lower margin of the exposed clivus, the anterior arch of C 1, the vertebral body of C 2 and C 3 were 104.7±4.3 mm, 99.2±6.8 mm, 81.4±4.3 mm, 75.1±4.0 mm and 68.7±6.5 mm, respectively. Six specimens were exposed to the C 3, while one was exposed to the C 2. For the TOP approach, the longitudinal diameter of the exposed clivus was 18.5±4.8 mm. The distance from the lower incisor to the superior margin of the exposed clivus and the pharyngeal nodules were 107.9±6.7 mm and 104.8±6.7 mm, respectively. For the TOHP approach, the longitudinal diameter of the exposed clivus was 26.3±1.8 mm (the clival length) with distance from the lower incisor to the superior margin of the clivus 112.4±12.6 mm. For the MO/MLO approach, the entire clivus was exposed. The distance from the central base of the mandible to the superior and inferior margin of the exposed clivus and the pharyngeal nodules were 141.8±15.7 mm, 131.0±9.9 mm and 120.5±8.2 mm, respectively. The inferior margin of the exposed cervical vertebra was C 5, 6. The rate of the clival screw placement through anterior occipitocervical fixation using TO, TOP, TOHP, MO and MLO was 0%, 71% (5/7), 86% (6/7), and 100%, respectively. The screw angle was 99.0°±1.8°, 92.6°±7.7°, 92.6°±7.7°, 75.1°±7.7°, and 75.1°±7.7°, respectively. Conclusion:Occipitocervical fixation with clival screw and plate could be conducted in most cases via TOP and TOHP approaches. However, in some cases with small split-mouth or mouth opening limited, smaller clival screw angle caused by basilar impression or basilar invagination, requiring fixation and reconstruction of the lower cervical spine, and the MO/MLO approaches could be still required to achieve the fixation.

Objective:To investigate the relationship between antibacterial treatment scheme and prognosis, and to analyze the mortality risk factors of bloodstream infection with carbapenem-resistant Klebsiella pneumoniae(CRKP).Methods:A retrospective case-control study was conducted. The CRKP isolated from clinical venous blood samples in the First Medical Center, Chinese PLA General Hospital between January 1, 2013 and December 31, 2018(not included from January 1, 2016 to December 31, 2017) was collected. According to relevant standards, a total of 50 patients with bloodstream infection with CRKP were included. The patients were divided into death (19 cases) or survival (31 cases) group according to their hospitalization outcomes, and clinical data and antibacterial treatment scheme after infection were collected. The clinical features of the two groups and the correlation between different antibacterial treatment regimens and prognosis were compared. Logistics regression model was used to analyze the risk factors for death in CRKP-infected patients.Results:The all-cause mortality rate of patients with CRKP bloodstream infection during hospitalization was 38%(19/50). The age ((66.89±18.13) vs. (55.06±14.39) years old, t=2.555, P=0.014), charlson's comorbidity index ((6.11±2.87) vs. (3.19±1.97), t=4.256, P<0.001) of the death group was higher than that of the survival group. The proportion of patients with chronic obstructive pulmonary disease (42.1%(8/19) vs. 3.2%(1/31), χ2=9.574, P=0.002), Charlson's comorbidity index ≥5 (68.4%(13/19) vs. 22.6%(7/31), χ2=10.314, P=0.001), septic shock (36.8%(7/19) vs. 6.5%(2/31), χ2=5.456, P=0.020), source of lung infection (36.8%(7/19) vs. 9.7%(3/31), χ2=3.868, P=0.049) was higher in death group than those in survival group. Kaplan-meier survival curve showed that the 30-day mortality of appropriate targeted treatment was lower than that of inappropriate targeted treatment ( χ2=8.138, P=0.004). Multivariate analysis showed that septic shock ( OR=56.363, 95% CI: 4.309-737.273, P=0.002) and charlson's comorbidity index ≥5 ( OR=18.605,95% CI: 1.813-190.896, P=0.014) were independent risk factors for mortality in patients with bloodstream CRKP infection. Conclusion:Appropriate targeted therapy can reduce 30-day mortality in patients with CRKP bloodstream infection. In order to reduce the risk of mortality, we should prevent the occurrence of septic shock and strengthen the diagnosis and treatment of patients with Chalson's comorbidity index ≥5.

Schizophrenia is a serious mental disease. The diagnosis of schizophrenia so far relies heavily on subjective evidence, including self-reported experiences by patients, manifestations described by relatives, and abnormal behaviors assessed by psychiatrists. The diagnosis, monitoring of the disease progression and therapy efficacy assessment are challenging due to the lack of established laboratory biomarkers. Based on the current literature, clinical consensus, guidelines, and expert recommendations, this review highlighted evidence-based potential laboratory biomarkers for the diagnosis of schizophrenia, including genetic biomarkers, neurotransmitters, neurodevelopmental-related proteins, and intestinal flora, and discussed the potential future directions for the application of these biomarkers in this field, aiming to provide an objective basis for the use of these biomarkers in the early and accurate diagnosis, treatment, and prognosis and rehabilitation assessment of schizophrenia.

Neuroligins (NLs) are postsynaptic cell-adhesion proteins that play important roles in synapse formation and the excitatory-inhibitory balance. They have been associated with autism in both human genetic and animal model studies, and affect synaptic connections and synaptic plasticity in several brain regions. Yet current research mainly focuses on pyramidal neurons, while the function of NLs in interneurons remains to be understood. To explore the functional difference among NLs in the subtype-specific synapse formation of both pyramidal neurons and interneurons, we performed viral-mediated shRNA knockdown of NLs in cultured rat cortical neurons and examined the synapses in the two major types of neurons. Our results showed that in both types of neurons, NL1 and NL3 were involved in excitatory synapse formation, and NL2 in GABAergic synapse formation. Interestingly, NL1 affected GABAergic synapse formation more specifically than NL3, and NL2 affected excitatory synapse density preferentially in pyramidal neurons. In summary, our results demonstrated that different NLs play distinct roles in regulating the development and balance of excitatory and inhibitory synapses in pyramidal neurons and interneurons.
Animals ; Cell Adhesion Molecules, Neuronal ; physiology ; Cells, Cultured ; Cerebral Cortex ; embryology ; physiology ; GABAergic Neurons ; physiology ; Interneurons ; physiology ; Membrane Proteins ; physiology ; Nerve Tissue Proteins ; physiology ; Protein Isoforms ; physiology ; Pyramidal Cells ; physiology ; Rats, Sprague-Dawley ; Synapses ; physiology