Objective To evaluate the clinical efficacy of a self-designed novel n-shaped aiming device in aiding the percutaneous cannulated screwing for treatment of odontoid fractures of Anderson-D' Alonzo type Ⅱ and shallow type Ⅲ.Methods A retrospective analysis was conducted of the 17 patients who had been treated at our department for odontoid fracture of Anderson-D' Alonzo type Ⅱ and shallow type Ⅲ between January 2009 and December 2013.They were 13 males and 4 females,with an average age of 37.5 years (from 16 to 61 years).All received surgical treatment after skull traction or jaw pillow traction preoperatively for reduction.Intraoperatively,percutaneous cannulated screwing via the anterior cervical approach was performed with the help of a self-designed novel n-shaped aiming device to fix the odontoid.Postoperatively,X-ray and CT scan were used to check the screw locations and evaluate the fracture healing.Results The 17 cases were followed up for 6 to 15 months (average,10.5 months).No intraoperative injury to the esophagus,artery,spinal cord or nerve root happened.The operating time ranged from 60 to 125 min.The bleeding was from 10 to 40 mL.Intraoperative observation revealed fine locations of the screws.Bony union was achieved in 16 cases 3 months postoperatively while separation and hardening of the fracture ends was found in one ease.Conclusion Our self-designed novel n-shaped aiming device can facilitate the percutaneous cannulated screwing for treatment of odontoid fractures of Anderson-D'Alonzo type Ⅱ and shallow type Ⅲ,given that it has advantages of simple manipulation,accurate insertion,minimal invasion,quick recovery and reliable efficacy.

Objeetive To assess the study outcomes in a consecutive series of patients with thoracic disc herniation (TDH) who undergone posterior spinal canal decompression and discectomy with segmental instrumentation and fusion.Methods Between January 2005 and June 2012,the data of 17 patients (11 males and 6 females) was retrospectively reviewed and analyzed.Disc herniation was classified as central in 10 cases and paracentral in 7 cases.The average canal encroachment was 71.7％±9.6％ (range,52％ to 90％).Their mean age at surgery was 55.7 years (range,21 to 81 years).All patients underwent a transfacet decompression and segmental instrumentation with interbody fusion.The data of patients included clinical presentation,blood loss,operative time,complications,visual analogue scale (VAS),Japanese Orthopaedic Association (JOA) score,and Frankel grading system.Results The average follow-up period was 37±12 months.The average surgical time was 120±63 min.The mean blood loss was 471±198 ml.Mean preoperative VAS score was 8.01±0.21,which improved to a mean of 1.12±0.07 at final follow-up.Average pre-and post-operative at 12 months JOA scores were 3.17±0.83 and 8.78±0.94 points,respectively.The average recovery rate was 65.1％±23.4％.Overall JOA scores showed a significant postoperative improvement.All patients reported 1 or 2 grade improvement in Frankel grading compared with preoperative status except for 1 patient whose grade had not changed.There were three complications,including one patient developing postoperative wound infection,one experiencing a cerebrospinal fluid leakage,one developing further neurological deterioration.Conclusion The results suggested that the posterior approach using special shaped osteotomy is feasible for central calcified TDH.No major complications occurred for achieving adequate decompression for central calcified TDH.

Objective To evaluate the electrocardiographic(ECG)-gated 4-dimensional computed tomographic angiography (4D-CTA) in the determination of pulsation of unruptured cerebral aneurysms (URCAs).Methods This study included 48 patients with 62 URCAs.Examinations of ECG gated 4D-CTA of dual-source CT were performed.Twenty sets of image data with the time intervals of 5％ in a cardiac cycle were obtained after postprocessing on the workstation.The convex was defined as the point of pulsation if small bubble or small pointed convex could be found in continuous three or more images at the same location.The 62 URCAs were divided into two groups based on whether having a point of pulsation.All the URCAs were scanned at the follow-up by 3D-CTA or ECG gated 4D-CTA more than 120 days later.The diameters of aneurysms and aspect ratio between the two groups were compared with independent t test,while neck of aneurysms and follow-up time were compared with two-independent samples Mann-Whitney U test.The other variables including history of hypertension,type 2 diabetes,smoking et al between the two groups were analyzed by x2 test.The sensitivity and specificity of aspect ratio for diagnosis of pulsation were analyzed by receiver operating characteristic (ROC) curve.Results Pulsation was observed in 28 of the 62 URCAs.Aspect ratios in whose pulsation was or was not detected were 1.5±0.3 and 1.1±0.3,respectivelyThe difference between the two groups was statistically significant (t=-2.274,P＜0.001).The sensitivity and specificity of the aspect ratio were 75.0％ and 70.6％.After follow-up more than 3 months,of the 28 URCAs in which pulsation was observed,11 showed a change in shape,while in 34 URCAs without visible pulsation,5 showed a change in shape.The aneurysms with detectable pulsation were more likely to show a change in shape (x2=4.891,P=0.027),with an odds ratio of 3.753.Conclusions URCAs with a large aspect ratio are easily to show the pulsation by ECG gated 4D-CTA.Besides,the aneurysms with visible pulsation are more likely to show a change in shape after follow-up,which suggests a higher risk of rupture.

Objective To explore the role of the transcriptional factor activator protein (AP)-1 in mediating vascular endothelial growth factor ( VEGF) expression in human bronchial epithelial cells exposed to PM 2.5.Methods Beas-2B cells was treated with PM2.5.Luciferase assay was used to detect the activation status of AP-1 and transcription of VEGF in the Beas-2B cells.The induced activation of c-Jun, ATF2 and VEGF expression was tested by Western blotting assay.Results PM2.5 induced transactivation of the transcriptional factor AP-1, accompanied by phosphorylation of the AP-1 components, c-Jun and ATF2 in Beas-2B cells.Moreover, when AP-1 activation was inhibited by knocking down c-Jun or ATF2 expressions, induction of VEGF expression was partially attenuated in Beas-2B cells.Conclusion AP-1 is a critical transcriptional factor in mediating PM2.5-induced VEGF expression and inflammatory responses in human bronchial epithelial cells.

Objective　To investigate the mechanism affecting on permeability of vascular endothelial cell by nitric oxide (NO). Methods　Series concentration of sin-1（a donor of NO） were added to ECV 304, a cell line of human umbilical vein endothelium. Cell growth and expression of f-actin, a cytoskeleton protein were observed. Results　Cell growth was inhibited with a dose from 6.25 to 100 μmol/L and was caused to death at the concentration of 50 to 100 μmol/L by sin-1. The expression of f-actin was suppressed obviously after cultured with 100 μmol/L sin-1 for 4 hours. Conclusion　It suggests that anomaly increased NO can increase permeability of blood vessels by suppressing the expression of f-actin, inhibiting cell growth or even resulting in cell death.

DNA ; DNA Fingerprinting ; Homicide ; Humans

OBJECTIVETo explore the effects of high altitude on cognitive flexibility.

METHODSSimulated hypoxia at an altitude of 3 600 m was performed in a hypobaric chamber. Twenty-three volunteers without hypoxic experience were selected and the mean age was about 25.1 years. The physiological parameters (heart rate, blood pressure and oxygen saturation) were measured. Task switch paradigm was used to explore the cognitive flexibility in each phase, and the changing anxiety state was evaluated simultaneously.

RESULTSReaction time (RT) switch cost in hypoxia phase showed a significant increase compared with the baseline; anxiety level in hypoxia phase was higher than the adaptation phase; a remarkable negative correlation between anxiety level and RT switch cost was found in adaptation phase, whereas a positive correlation was found in landing phase.

CONCLUSIONHigh altitude (3 600 m) affects cognitive flexibility and anxiety state. Anxiety before the hypoxia exposure improves the cognitive flexibility performance, while anxiety after the hypoxia exposure hampers the performance because of the post-hypoxia effect.

Adult ; Altitude ; Anxiety ; Cognition ; physiology ; Humans ; Hypoxia ; psychology ; Male ; Reaction Time

Objective To evaluate the consistence in the detection of antibodies against HIV-1 between a new rapid test using oral mucosal transudate (OMT) samples and ELISA using serum samples. Methods Two-hundred patients who were positive for anti-HIV-1 antibodies by serum ELISA and confirmed by Western blot to be infected with HIV, and 600 healthy human controls negative for anti-HIV-1 antibodies by serum ELISA, were eligible for this study. OMT samples were collected from these subjects and subjected to a rapid test for anti-HIV-1 antibodies. The factors influencing the performance of the rapid test were analyzed. Results Of the 200 OMT specimens from HIV-infected patients, 198 showed positive reaction, 2 showed negative reaction. Among the 198 positive reactions, 192 (96%) were "clear" and easy to make decisions, 4 (2%) were "faint", 2(1%) were "very faint" and required professionals to make decisions. The rapid test was negative in all the 600 OMT specimens from the control group. Conclusions The consistence in the detection of anti-HIV-1 antibodies between the OMT rapid test and serum ELISA was 99% in HIV-positive specimens, 100% in HIV-negative specimens, and 99.75% in all the specimens.

OBJECTIVETo explore the function and motor pathway of remained cerebral hemisphere by studying motor evoked potential of both upper extremities on patients long term after anatomical hemispherectomy.

METHODSFive patients after anatomical hemispherectomy, who were marked 5 dispersive sites on head to perform transcranial magnetic stimulation. Recording motor evoked potential of target muscles (brachioradialis muscle and abductor pollicis brevis) of both upper extremities respectively when muscle resting and contracting.

RESULTSOnly affected abductor pollicis brevis of case 2 and only affected brachioradialis muscle of case 4 and 5 recorded motor evoked potential when muscle resting. Motor evoked potential of some cases can be recorded simultaneously in homonymous muscles of both sides when muscle resting or contracting.

CONCLUSIONSThere exists motor cortex that controls movement of ipsilateral limbs and also ipsilateral motor pathway of corticospinal connection at patients after anatomical hemispherectomy. It also means that the motor function of affected limbs has potency to recover well after hemispherectomy. The mirror movement after hemispherectomy is possible relate to overlap of both limbs' motor cortex.

Adult ; Evoked Potentials, Motor ; physiology ; Female ; Follow-Up Studies ; Hemispherectomy ; Humans ; Male ; Motor Cortex ; physiopathology ; Postoperative Period ; Transcranial Magnetic Stimulation ; Upper Extremity ; physiopathology