Objective To retrospectively review the mortality and morbidity after orthopedic surgery for aged patients with reference to orthopedic version physiological and operative severity score for the enumeration of mortality and morbidity (O-POSSUM) and Portsmouth POSSUM (P-POSSUM) and validate the score' s accuracy in operative risk prediction.Methods O-POSSUM and P-POSSUM for mortality and morbidity were applied to 839 aged patients who had undergone orthopedic surgery between January 2008 and December 2011.Observed mortality and morbidity were compared with the expected values.Results O-POSSUM predicted 230 morbidities,but the observed value was 182 (x2 =2.718,P ＞ 0.05).O-POSSUM predicted 46 deaths,higher than the observed 3 deaths (x2 =38.870,P＜0.01).P-POSSUM predicted 16 deaths,higher than the observed 3 deaths (x2 =8.997,P ＜ 0.01).Conclusions O-POSSUM accurately predicts postoperative morbidity in aged orthopedic patients.However,O-POSSUM and P-POSSUM overpredicts the mortality and should be used with caution.

Objective To evaluate the feasibility, safety, and clinical outcome in patients with cervical spondylotic radiculopathy underwent cervical nerve root decompression using the anterior percutaneous endoscopic surgery.Methods Eleven subjects consisting of 6 men and 5 women treated from July 2012 to December 2013 were enrolled in the study.Mean age was 42.1 years (range, 27 to 63 years).All were diagnosed to be unilateral single-segment injury involving C3/4 in 1 case, C4/5 in 2 cases, C5/6 in 6 cases and C6/7 in 2 cases.Because of unsatisfactory results 6 week following the non-operative treatment, the patients were operated on using the anterior percutaneous endoscopic osteophyte removal and nerve root decompression.Operation time, postoperative complications, visual analogue scale (VAS) and modified Macnab scale were recorded.Results Operation time was (102.5 ± 21.3) min (range, 80-140 min).Nine patients were followed up for 12 months and no complications were noted.VAS improved significantly at postoperative 3 days and 1, 3, 6, as well as 12 months compared to the preoperative value (P ＜ 0.01).Modified Macnab scale presented great improvement at postoperative 3 and 12 months compared to the preoperative value (P ＜ 0.01).Conclusion The technique is reliable and effective in treatment of cervical spondylotic radiculopathy.

OBJECTIVETo verify the existence and significance of calcium/calmodulin dependent serine protein kinase/inhibitors of differentiation 1 (CASK/Id1) pathway in fibroblasts of human keloid.

METHODSImmunofluorescence laser was used to confirm CASK and Id1 protein expression and localization in fibroblasts of the keloid and normal skin. RT-PCR and Western-blot were adopted to analysis the CASK and Id1 expression and differences between keloid and normal skin fibroblasts. The natural combination of CASK and Id1 protein of keloid fibroblasts was tested by immunoprecipitation.

RESULTSCASK and Id1 protein expression were both found in fibroblast cells of keloid and normal skin under normal circumstances. Most of CASK and Id1 were distributed in the cytoplasm and nucleus of fibroblasts. The results of RT-PCR showed that the expression of CASK mRNA in the keloid group was 0.658 +/- 0.024, which was lower than that in the normal control group (1.076 +/- 0.008, t = 11.159, P < 0.05). The expression of Id1 mRNA was 0.497 +/- 0.014, which was higher than that in the normal control group (0.307 +/- 0.017, t = 15.148, P < 0.05). The results of Western-blot showed that the expression level for CASK protein in the keloid group was 0.057 +/- 0.006, which was lower than that in the normal control group (0.168 +/- 0.012, t = 13.524, P < 0.05); the expression of Id1 protein was 0.812 +/- 0.035, which was higher than that in the normal control group (0.368 +/- 0.031, t = 16.356, P < 0.05). The results of immunoprecipitation showed that Id1 could be detected in the CASK precipitate, while CASK also could be detected in the Id1 precipitate. There was a natural binding of CASK and Id1 in keloid fibroblasts.

CONCLUSIONCASK/Id1 signal pathway may be existed and involved in the proliferation of keloid fibroblasts, which is related with the occurrence of keloid.

Cell Proliferation ; genetics ; Cyclin-Dependent Kinase Inhibitor Proteins ; genetics ; metabolism ; Fibroblasts ; metabolism ; Humans ; Inhibitor of Differentiation Protein 1 ; genetics ; metabolism ; Keloid ; metabolism ; pathology ; RNA, Messenger ; metabolism ; Signal Transduction

Objective To explore the value of CT venography in the surgical treatment of falcotentorial junction meningiomas. Methods CT venography was carried out in 25 patients with falcotentorial junction meningiomas. 2-D and 3-D images were reformatted at the workstation. The classification and relationship between the tumors and veins were determined, and the degree of venous stenosis and collateral were assessed. The safe surgical pathway was chosen to avoid the injury of main draining vein. Results Falcotentorial junction meningiomas were divided into 5 types according to the relationship between the tumors and veins and the direction of the tumors. There were 5 cases of forward type, 4 cases of backward type, 3 cases of inferior type, 6 cases of superior type and 7 cases of lateral type in this group. The relationship between tumors and veins was accordant with the findings in surgery. Of all 25 cases, 19 underwent total removal, 6 underwent subtotal removal and all of the main driving veins were reserved. There were 3 cases of quadrantanopsia or hemianopsia after the operation, and all of them recovered after 3 months of follow-up. Conclusion CTV technique can classify the falcotentorial junction meningioma and is helpful for choosing the appropriate surgical approaches.

Objective To explore the reliability and validity of poly ether ether ketone (PEEK) rods and pedicle screw system for lumbar degenerative diseases.Methods Sixty-three patients,including 23 men and 40 women with the mean age of 56.2±5.1 years (range,35-75 years),treated by PEEK rods pedicle screw system from September 2012 to March 2013 were retrospectively recruited.Fusion procedure were performed in 10 patients,with 2 cases at L3,4,5 cases at L4,5,3 cases at L5S1; nonfusion procedure were performed in 17 patients,with 4 cases at L3,4,10 cases at L4,5,3 cases at L5S1; hybrid procedure were performed in 36 patients,with 22 case fusion at L4,5 and nonfusion at L3,4,with 2 cases fusion at L3,4 and nonfusion at L4,5,with 12 cases fusion at L5S1 and nonfusion at L4,5.Clinical effects were evaluated via Japanese Orthopedics Association (JOA) score and Oswestry disfunction index (ODI) at 3 months,6 months and 24 months postoperatively.Disc heights were measured by disc height index on lateral lumbar radiograph.Range of motion (ROM) was measured by extension-flexion lumbar X-ray.Three-dimensional CT reconstruction was achieved to observe the integrity of PEEK rods at the final follow-up.Results The mean follow-up were 23.4±3.3 months.The mean operation time were 110±17 min in the fusion group,98±22 min in the non-fusion group and 121±25 min in the hybrid group.The mean blood loss were 270±85 ml in the fusion group,255±72 ml in the non-fusion group and 316±80 ml in the hybrid group.The JOA score improved from 10.5±2.6 preoperatively to 24.0±3.1 at the final follow-up in the fusion group,from 10.3±2.2 to 24.3±3.4 in the non-fusion group and from 11.1±2.3 to 23.9±3.3 in the hybrid group (P＜0.05).The ODI decreased from 51.8％±10.3％ preoperatively to 14.1％±3.7％ at the final follow-up in the fusion group,from 52.2％±11.1％ to 13.2％±3.2％ in the non-fusion group and from 53.4％±9.2％ to 13.8％±2.5％ in the hybrid group.There was no significantly statistical difference in the disc height index at 3 months,6 months and 24 months postoperatively compared with that at preoperative.The ROM decreased from 8.8°±1.8° preoperatively to 2.2°±0.3° at the final follow-up (P＜0.05).One case demonstrated cage migration at one month follow-up,bony fusion in situ at 3 months follow-up,and the patient had no related symptoms during the follow-up.No screw loosening or breakage and rods breakage was observed during the follow-up.Conclusion PEEK rods and pedicle screw system for lumbar degenerative diseases by fusion,non-fusion and hybrid procedure can achieve considerable clinical outcome with low complication rate.

Objective To explore the cause of and treatment for psychiatric complications developed in the early stage after liver transplantation. Method The clinical data of 125 patients who underwent liver transplantation in our hospital were analyzed retrospectively. Results There was no significant difference in gender,age,liver function and the blood cyclosporine A level between psychiatric complication (PC) patients and those without PC. The anhepatic time and the total operation time of the PC group were longer than that of the non-PC group ( P

Objective To explore the sonographic characteristics and to evaluate its diagnostic value of hepatic lymphoma (HL). Methods The clinical data and abdominal sonographic ifndings of 18 consecutive patients with histological proven diagnosis of lymphoma with liver involvement were reviewed, including contrast-enhanced ultrasound (CEUS) images. Results The liver sonographic features of 18 HL were differentiated as three types including nodular, diffuse and mixed type. Nodular type showed well-deifned hypoecho lesions in 6 cases with penetrating vascular lfow signals in 2 cases and no vascular lfow signals in 6 cases by color Doppler imaging. In 3 cases by CEUS, all the hepatic focal nodulars showed variable arterial enhancement but wash-out in the portal venous and late phases. For diffuse type cases, hepatomegaly without nodule was showed in 11 cases. Vasular in liver showed normal in 8 cases and abnormal in 3 cases. For mixed type cases, hepatomegaly and multiple ill-deifned hypoechoic lesions with normal vascular in liver were showed in 1 case. Hepatosplenomegaly and abdominal lymphoadenopathies were identiifed in 11 cases. Conclusions The characteristics and the types of sonographic ifndings may be helpful in differentiating HL from other liver lesions.

The overexpression of doublecortin-like kinase 1 (DCLK1) is closely related to the occurrence and development of various malignant tumors. Discovery of novel anti-tumor agents targeting DCLK1 represents a hot spot in this field. So far, several DCLK1 small molecule inhibitors with excellent anti-tumor activity in vitro and in vivo have been designed and synthesized, which is expected to provide a new strategy for tumor therapy. This article reviews the research progress in the discovery, structure type, structural optimization, biological activity and mechanism of action of DCLK1 small molecule inhibitors, and provides research basis for the development of new anti-tumor small molecule inhibitors targeting DCLK1.

Background Glaucoma is one of the leading causes of blindness worldwide;while the different types of glaucoma is vary from different region. Objective Present study was to survey the prevalence and types of glaucoma among peasants of Uigur adults in Kuche county and offer the basis for the prevent and treatment of glaucoma in Uigur nationanlity. Methods 4191 Uigur peasants aged 40 years or above were collected in Kuche county for the survey of prevalence and types of glaucoma by randomized cluster sampling in March and April of 2009. The subjects were grouped into 40-,50-,60- and ≥70 years groups according to the distribution of age. The disease history of glaucoma, regular eye examination, funds examination and measurement of the anterior chamber depth, gonioscope were performed in the all subjects. Darkroom prone test and mydriasis test were carried out in suspicious glaucomous patients. The depth of periphery anterior chamber was assessed based on van Herick' s criteria, and the width of chamber angle was graded based on Scheie' s method. The standardized training was performed. This survey approved by Xinjiang Medical Ethics Committee, all subjects signed the informed consent before the examination. Results 4191 of 4873 subjects finished all the examinations with the response rate 86%. All the subjects showed a good compliance. The prevalence of glaucoma was 3. 79% , and the prevalence of primary angle-closed glaucoma(PACG) .primary angle-open glaucoma (PAOG) and secondary glaucoma was 2.22% ,0.26% and 1. 31% respectively, showing a significant difference among the different types of glaucoma( P<0. 05). The prevalence of glaucoma was elevated with aging (χ2 - 116. 69 ,P<0. 05) and presented a high rate in male subjects compared with female ones(χ2 = 7. 34, P<0. 05 ). Bilateral blindness was found in 19.75% glaucoma peasants, in which 25.3% glaucoma peasants received anti-glaucoma surgery. The distribution of visual acuity of patients was of significant difference among different age groups(χ2 = 37. 69 ,P<0. 05 ) . Conclusions The prevalence of the glaucoma among Uigur peasants in Kuche county was higher than most area no matter inland or overseas. PACG still is the common type in those people.

Intra-articular injection of hyaluronic acid for osteoarthritis is an old and useful method. According to recent literatures, the following four problems were reviewed in this article: 1) Mechanisms. Real-time PCR was used to detect the transforming growth factor-beta 1 (TGF-beta1), vascular endothelial growth factor (VEGF) and connective tissue growth factor (CTGF) gene expression, which were significantly increased, as well as promoted secretion and synthesis of the tissue inhibitors of metalloproteinase, thus the reaction and cartilage destruction were decreased. 2) Methods. Because of discovering of new HA derivants, single intra-articular treatment with 6 ml hylan G-F 20 had replaced the routine method of once a week. To improve the therapeutic effectiveness, compound drags were applied, such as NSAIDs. 3) Indication. Knee OA (K-L II-III type) was first elected. But at present, the K-L I type was advocated early application. While the K-L IV type, although joint function can not improve, the symptoms relieved. 4) Therapeutic effectiveness. The double-blind place bo-controlled study showed that it was better than corticoid, and persistent and no side-effect. Therefore, this was a safe, persistent effective method.
Humans ; Hyaluronic Acid ; administration & dosage ; pharmacology ; therapeutic use ; Injections, Intra-Articular ; Osteoarthritis ; drug therapy