Objective To evaluate the effectiveness of one-stage debridement for cervical tuberculosis at different segments.Methods Clinical data of 54 patients (male 20,female 34) with cervical tuberculosis treated by one-stage debridement from Jan 1998 to Dec 2011 were reviewed retrospectively.The average age of these patients was 45.4 years (range,26-75 years).Among them,12 cases were involved in single level (C2 1 case,C4 2 cases,C5 3 cases,C6 4 cases,C7 2 cases); 36 cases in the adjacent two levels (C1,2 3 cases,C2,3 2 cases,C3,4 5 cases,C4,5 6 cases,C5,6 14 cases,C6,7 5 cases,C7T1 1 case); 5 cases in three levels(C4 6 2 cases,C5-7 2 cases,C3,5,6 1 case)and 1 case in four levels (C4-7).Five cases were involved in other spinal levels (T6 1 case,T 3 cases,L3,4 1 case).Comorbidity of cervical ossification of the posterior longitudinal ligament was found in 1 case.Before surgery,the mean VAS and JOA scores were 5.9 (range,4-9) and 10.5 (range,7-12) respectively and the mean Cobb angle of lesion segment was 26.7°± 9.1°.All cases underwent regular anti-TB treatment preoperatively,and surgical treatment were performed when blood sedimentation (ESR) was lower than 50 mm/1 h.According to the segmental involvement,different surgical approaches were performed including anterior debridement with anterior or anterior-posterior internal fixation and fusion,submandibular approach debridement with posterior occipital cervical fusion or atlantoaxial fusion.Results Mean follow-up duration was 27.3 months (range,13-52 months).Symptoms were improved significantly in all cases.Mean time of union was 3.2 months (range,2-4 months).At the last follow-up,the mean VAS and JOA scores were 5.9 (range,4-9)and 10.5 (range,7-12) respectively,and the mean Cobb angle of lesion segment was 6.8°.Regular anti-TB treatment was performed postoperatively for 18 to 20 months.Intraoperative esophageal injury was found in one case of upper cervical tuberculosis which was cured uneventfully after gastrointestinal tubation for 1 week.No cervical tuberculosis recurrence,graft loosening or pseudarthrosis was found in follow-up.Conclusion With preoperative anti-TB treatment,cervical tuberculosis can be treated by one-stage foci debridement according to the segmental involvement and deformity.Postoperative regular anti-TB treatment is a crucial factor for the final recovery of cervical tuberculosis.

OBJECTIVETo observe the efficacy and safety of modified Shengma Biejia Decoction (MSBD) combined with CAG program in treating elderly acute myeloid leukemia (AML) patients with yin deficiency toxin stasis syndrome (YDTSS).

METHODSTotally 46 elderly AML patients were assigned to the treatment group (24 cases; treated with MSBD + CAG) and the control group (22 cases; treated with CAG + placebos of Chinese medicine) according to random digit table. The therapeutic course of CM placebo or MSBD was 21 days. The clinical efficacy and adverse reactions were observed. Meanwhile, physical state (ECOG Score), transfusion dependency, and TCM syndrome score were compared before and after treatment.

RESULTS(1) The complete remission rate was 54% (13/24) and the objective response rate (ORR) was 71% (17/24) in the treatment group, obviously higher than those of the control group [36% (8/22); 54% (13/24)], with statistical difference (P = 0.036, 0.042). When comparing the efficacy based on risk level, the moderate and poor ORR was 71% (10/14) and 67% (6/9) in the treatment group, and 57% (8/14) and 33% (2/6) in the control group, with statistical difference between the two groups (P = 0.048; P = 0.010). (2) Compared with before treatment in the same group, the ECOG score significantly decreased, the average infusion time of red cells and platelets were markedly prolonged in the treatment group after treatment (P < 0.05). ECOG score, the average infusion time of red cells and platelets were significantly better in the treatment group than in the control group after treatment (P < 0.05). (3) Compared with before treatment in the same group, scores of fever, hemorrhage, and bone pain were markedly reduced in the control group (P < 0.05); scores of fever, fatigue, hemorrhage, dry mouth, and bone pain were markedly reduced in the treatment group (P < 0.05). Better effect in relief of fever, fatigue, hemorrhage, dry mouth, and so on was obtained in the treatment group than in the control group (P < 0.05). (4) In aspect of hematotoxicity, the incidence of neutropenia, anemia, thrombocytopenia was obviously lower in the treatment group than in the control group [29.2% (7/24) vs 54.5% (12/22); 16.7% (4/ 24) vs 45.5% (10/22); 33.3% (8/24) vs 63.6% (14/22); P < 0.05]. The incidence of fatigue and anorexia was obviously lower in the treatment group than in the control group [37.5% (9/24) vs 63.6% (14/22), 37.5% (9/24) vs 81.8% (18/22); P < 0.05].

CONCLUSIONMSBD combined with CAG program in treating elderly AML patients with YDTSS, with efficacy enhancing toxicity reducing effect, had distinct advantages in improving physical condition and clinical symptoms, and reducing transfusion dependency.

Aclarubicin ; therapeutic use ; Aged ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Cytarabine ; therapeutic use ; Drugs, Chinese Herbal ; therapeutic use ; Granulocyte Colony-Stimulating Factor ; therapeutic use ; Humans ; Leukemia, Myeloid, Acute ; drug therapy ; Medicine, Chinese Traditional ; Phytotherapy ; Yin Deficiency ; drug therapy

Objective To evaluate the applications of magnetic resonance cholangiopancreatography (MRCP) after fat meal in the preoperative evaluation of biliary anatomy of living liver donors.Methods Fifty cases of the preoperative donors for living liver transplantation were included and all had the corresponding intraoperative cholangiography (IOC) information. The MRCP of the donors for living liver transplantation was performed before and after fat meal (two fried eggs). The visualization and diameter of the secondary bile duct were analyzed before and after the fat meal. The results of the biliary branching pattern by MRCP after fat meal were compared with the corresponding IOC results. The accuracy, sensitivity,specificity, positive predictive value and negative predictive value of MRCP after the fat meal in distinguishing normal and any type of variant biliary anatomy were calculated. Results In all cases,82% of the 50 cases in MRCP before the fat meal could meet the diagnosis needs of the preoperative evaluation,and 100% of the 50 cases in MRCP after the fat meal could meet the diagnosis needs. There was significant difference in the demonstration quality and diameter of the secondary bile duct in MRCP before and after the fat meal (P＜0. 05). MRCP showed accurate anatomy of the biliary system, using IOC as the reference standard, in 49(98%) subjects. The sensitivity, specificity, positive predictive value and negative predictive value of MRC in distinguishing normal and any type of variant biliary anatomy were 98%,94. 7%, 100%, 10% and 96. 9%,respectively. Conclusion The MRCP after fat meal can clearly demonstrate the secondary bile duct and perfectly meet the needs of the preoperative evaluation of the living liver transplantation. The MRCP after fat meal and routine MRCP should be considered complementary to one another in order to avoid complications in living liver transplantation donors.

Objective To compare the therapeutic effect of preoperative chemoradiotherapy or postoperative adjutant chemoradiotherapy for locally advanced rectal cancer.Methods The clinical data of 76 patients with locally advanced rectal cancer from 2011 to 2016 in Guizhou Provincial People's Hospital were retrospectively analysed.A total of 30 cases received preoperative chemoradiotherapy (group A),5 of them received concurrent chemoradiotherapy combined with bevacizumab target treatment.The other 46 cases (group B) were given post-operative adjutant chemoradiotherapy.Both group A and group B were treated with intensity-modulated radiation therapy (IMRT).The chemoradiotherapy regime was as follows:the median of target volume dose was 50.4 Gy (45.0-55.8 Gy);the median of chemotherapy sessions was 26 times (24-28 times).Capecitabine tablets (825 mg/m2,twice a day) were also given on the date of chemotherapy.The clinical data and follow-up results of all patients were compared between the two groups.Results The five-year disease free survival rates of group A and group B were 66.7％ and 57.7％,respectively;and the five-year overall survival rates of group A and group B were 81.8％ and 73.0％,respectively,no statistically significant difference was found between the two groups (P=0.599,0.489).The anus-preserving rates of patients with tumor below peritoneal reflection in group A and group B were 56.52％ and 25.00％,there was statistically significant difference (P=0.045).In the group A,86.6 ％ patients resulted in down-staging,including 3 cases with complete pathologic response.Conclusion Preoperative chemotherapy could down tumor stage and improve rates of anal preservation and local control without increasing possibility of postoperative complications.Preoperative chemotherapy in combination with bevacizumab target treatment may be more effective in lowering tumor stage.

AIMTo study the structure and crystal forms of chlorobenzylidine.

METHODSKarl Fischer titrimetry, FTIR, thermal analysis, single and powder X-ray diffraction were used for the studies of the structure of chlorobenzylidine and for the identification of two forms of chlorobenzylidine.

RESULTSChlorobenzylidine and its diastereoisomer have been studied in this article. They can be distinguished by their different melting points. Two crystal forms of chlorobenzylidine (form A and form B) have also been detected and studied. Form A was studied by single-crystal X-ray diffraction, it crystallized in the triclinic system, space group P1(-), with two formula units per cell, is monohydrate. Karl Fischer titrimetry, FTIR, thermal analysis and powder X-ray diffraction were used for identification of the two forms.

CONCLUSIONThe studies of structure and crystal forms of chlorobenzylidine are very useful for the clinical research and the selection of recrystallization process.

Benzylidene Compounds ; Crystallization ; Crystallography, X-Ray ; Differential Thermal Analysis ; Molecular Conformation ; Molecular Structure ; Polycyclic Compounds ; chemistry ; Stereoisomerism

OBJECTIVETo construct double gene deletions at the htrA and clpP loci on the chromosome of Streptococcus mutans (Sm) and to remove the antibiotic resistance markers with the Cre-loxP(*) site-specific recombination system.

METHODSThe htrA gene was cloned into the pGEM-T-Easy TA cloning vector and then inactivated via the insertion of a kanamycin resistance cassette (lox71-Km-lox66), yielding pGEM-T-ΔhtrA/Km for deleting the htrA gene. Using the same method, the pGEM-T-ΔclpP/Sp was constructed for deleting the clpP gene. Following the transformation of pGEM-T-ΔhtrA/Km in Sm, the homologous recombination event was selected. One such mutant was transformed with a cre expression plasmid (pCrePA). The kanamycin resistance gene was then excised. The pCrePA was then easily eliminated at nonpermissive temperatures, resulting in a mutant strain (MSΔhtrA) carrying a deletion at the htrA loci without a selectable marker. This mutant was verified by PCR and DNA sequencing. Then, the clpP and spectinomycin resistance gene were deleted from MSΔhtrA, yielding markerless mutant strain lacking clpP and htrA.

RESULTSThe deletion of htrA, clpP and antibiotic resistance markers were confirmed by PCR analysis and DNA sequencing.

CONCLUSIONSA mutant of Sm was constructed successfully which contained a deletion of the htrA and clpP gene without selectable marker. The Cre-loxP(*) system can be applied to Sm, which provides experimental evidence for generating markerless multiple gene deletion mutants.

Drug Resistance, Microbial ; genetics ; Gene Deletion ; Gene Expression Regulation, Bacterial ; Genes, Bacterial ; Genetic Vectors ; Integrases ; genetics ; Plasmids ; Streptococcus mutans ; genetics

PURPOSE: Modafinil is a wake-promoting agent that has been proposed to improve cognitive performance at the preclinical and clinical levels. Since there is insufficient evidence for modafinil to be regarded as a cognitive enhancer, the aim of this study was to investigate the effects of chronic modafinil administration on behavioral learning in healthy adult rats. METHODS: Y-maze training was used to assess learning performance, and the whole-cell patch clamp technique was used to assess synaptic transmission in pyramidal neurons of the hippocampal CA1 region of rats. RESULTS: Intraperitoneal administration of modafinil at 200 mg/kg or 300 mg/kg significantly improved learning performance. Furthermore, perfusion with 1mM modafinil enhanced the frequency and amplitude of spontaneous postsynaptic currents and spontaneous excitatory postsynaptic currents in CA1 pyramidal neurons in hippocampal slices. However, the frequency and amplitude of spontaneous inhibitory postsynaptic currents in CA1 pyramidal neurons were inhibited by treatment with 1mM modafinil. CONCLUSIONS: These results indicate that modafinil improves learning and memory in rats possibly by enhancing glutamatergic excitatory synaptic transmission and inhibiting GABAergic (gamma-aminobutyric acid-ergic) inhibitory synaptic transmission.
Adult ; Animals ; CA1 Region, Hippocampal ; Excitatory Postsynaptic Potentials ; Humans ; Inhibitory Postsynaptic Potentials ; Learning* ; Memory ; Neurons ; Perfusion ; Rats* ; Synaptic Potentials ; Synaptic Transmission*

We reported a technical report of traumatic lower cervical spondylolisthesisca used by bilateral pedicle fracture, without neurological compression. The patient was treated with the minimally invasive technique of percutaneous pedicle screw fixation. Fracture healing and normal cervical motion were confirmed by plain films and physical examinations on the 18-monthpostoperatively. The technique of percutaneous pedicle screw fixation might be an alternative strategy for the treatment of traumatic lower cervical spondylolisthesis with pedicle fracture.
Cervical Vertebrae ; Female ; Fracture Healing ; Humans ; Physical Examination ; Spondylolisthesis*

OBJECTIVETo study the prediction model of O. hupensis in the lake and marshland regions in order to provide methodological basis for quantitative study of O. hupensis.

METHODSThe research sites were randomly selected from the bottomlands along Qiupu River in the Guichi District, Anhui Province. A random and stratified sampling method was administrated according to the type of vegetation; the frame size of snail survey was 0.11 m2. Snail data was collected by crosscheck-random sampling inspection survey. Elevation, soil temperature and air temperature, height of vegetation, soil humidity and types of vegetation were measured through GPS machine, T&D Recorder for Windows, tape measure and attemperator. All the data were doubly inputted into the computer and checked. The final dataset for developing the prediction model was set up after necessary data preprocessing, such as, recoding the variable of elevation. The generalized linear models were used to develop the prediction model, and the statistics of deviance and AIC were used to determine the best model structure. Model diagnostics and model evaluation of efficiency were performed with the determined best model structure.

RESULTSThe sample size was 162, and there were 6 explanatory variable including 2 categorical variables and 4 quantitative variables. A complicated relationship was observed among all the variables. Snail was positively associated with height of vegetation (r = 0.36), while negatively associated with soil humidity (r = - 0.22), and the air temperature had a close positive relations with soil temperature (r = 0.59), and the soil temperature was negatively associated with height of vegetation (r = - 0.36), the soil humidity had negative relations with the soil and air temperature (r = -0.34 and -0.12). The best structure fitting for the liner model selected in gamma distribution was the error distribution, reciprocal as the conjunction function in mathematics, and the mean square as the variance function. The results showed that the elevation, soil humidity, soil temperature, types and the height of vegetation were statistically significant to predict the O. hupensis, while t-values were -3.202, 3.124, -1.989, 2.668 and -2.371, respectively, and P-values were 0.00166, 0.00214, 0.04849, 0.00846 and 0.01897 respectively.

CONCLUSIONThe generalized linear models can be used to develop the predictive model, which could broaden the area of quantitative study for O. hupensis.

Animals ; Environmental Monitoring ; methods ; Geographic Information Systems ; Models, Statistical ; Snails ; Wetlands

Acupuncturists have always paid high attention to deqi (needling sensation) in clinical. However, relationship between deqi and curative effect has not been elucidated yet. In order to have a further understanding on effect of deqi on clinical effect, through study on literature associated with deqi since the establishment of People's Republic of China in 1949, it is held that various factors can influence therapeutic effect of acupuncture treatment, including whether needling sensation appears or not, the speed of deqi, the intensity of deqi, different types of sensations as well as propagated sensation along meridians (PSM). Joint launched multidisciplinary researches should be carried out to reveal the influence principle of deqi on acupuncture effect, and to lay foundations for the further studies on mechanism of deqi.
Acupuncture ; Acupuncture Points ; Acupuncture Therapy ; Humans ; Meridians ; Qi ; Treatment Outcome