OBJECTIVETo explore the effect of clinical application of stand-alone MC+PEEK cage in anterior cervical fusion.

METHODSFrom January 2011 to January 2014,50 patients were treated with the MC+PEEK cage filled with autogenous cancellous illic-bone graft after anterior cervical discectomy. There were 22 patients with cervical spondylosis,26 patients with traumatic cervical disc herniation, 2 patients with cervical instability in these patients. There were 32 males and 18 females, aged from 30 to 79 years old with an average of 53.30 years old. There were 32 patients with single segment, 15 patients with double segments and 3 patients with three segments. Cervical AP and lateral and the flexion-extension X-rays were regularly taken in order to assess the cervical physiological curvature, the graft fusion and internal fixation related complications. Nerve function, clinical effect and bone fusion were respectively evaluated according to Japan Orthopedic Association (JOA), Otani grade and Suk method.

RESULTSAll patients were followed up from 6 to 36 months with an average of 20 months. No correlated surgical complications were found and all patients obtained bony fusion with an average time of 4.30 months. JOA score had significantly improvement after surgery (P < 0.05). The JOA score was 10.60 ± 3.00 before surgery and 16.10 ± 2.20, 16.40 ± 2.35 at one week and six months after surgery respectively. According to Otani grade,40 cases got excellent results, 9 good, 1 fair. No significant dysphagia and internal fixation related complications such as displacement of cages were found during the follow-up period.

CONCLUSIONUsing this cage in anterior cervical fusion can obtain satisfactory clinical effect with less operation injury and reduce the complications. It is a better fusion method in anterior cervical fusion.

Adult ; Aged ; Cervical Vertebrae ; surgery ; Female ; Humans ; Male ; Middle Aged ; Spinal Fusion ; adverse effects ; instrumentation ; methods

Objective To understand the incidence and characteristics of nonfatal drowning among primary and middle school students in rural area and to provide basic information for intervention.Methods A rural town was selected and all students from 3th-8th grades,10th grade and 11th grade were studied.All data were collected,using a self-administrated questionnaires which was guided by investigator.Results The overall incidence rate of nonfatal drowning was 5.65%(549/9732)and were 7.69%,5.80%,2.39%for primary,secondary and high school students,respectively.Male students had a higher rate(7.14%)than that of females(4.03%).The incidence rates of non-treated,treated in emergency and under hospitalization were 4.52%,0.77% and 0.35%.The major reasons of drowning were swimming (46.88%),falling into waters(15.67%),diving(13.79%)and rescuing others(6.24%).The proportion of drowning occurred in the afternoon,evening,at noon or in the morning were 59.94%,15.64%,14.77%and 9.65%respectively.The common sites of drowning were river/lake(42.48%),swimming pool(19.56%),reservoir(11.39%)and pond(4.38%).66.76%of the drowning cases were witnessed by other person,and 17.86%were conscious when being removed from waters.Conclusion The incidence of nonfatal drowning among students in rural areas was high,and the natural body of waters was the most common site causing drowning while swimming was the major reason of drowning.Intervention targeting on primary and middle sehool students in rural should be carried out to reduce the incidence.

OBJECTIVETo compare the performance of full-field digital mammography (FFDM) and digital breast tomosynthesis (DBT) in the assessment of the lesions in dense breast, and to estimate the difference in diagnosis of breast disease by FFDM images alone and FFDM plus DBT images.

METHODSAccording to the breast imaging reporting and data system (BIRADS), 134 patients were selected. The morphology of the lesions shown on FFDM and DBT were evaluated and compared, and the maximum diameter of the lesions was measured. At first, doctors made the diagnosis of a patient by reading FFDM only. Then they made another diagnosis by combining with DBT images of the same patient. The two diagnoses were compared and analyzed according to the pathology results.

RESULTSOne hundred and thirty-four patients were included in this study, and all of them were confirmed by histology (65 benign cases, 69 malignant cases). DBT could show more details about the morphology of the lesions, including the border of the masses, spiculation and vessels. The numbers of those signs detected by DBT were 46, 30 and 3, respectively, while only 33 case with circumscribed masses and 14 cases with spiculation were detected by FFDM. Only the difference of spiculation in heterogeneously dense breast detected by DBT and FFDM was statistically significant (P < 0.05). Of the cases with calcifications, DBT images (reconstructed as a 1-mm-thick slice) showed calcifications superior to FFDM in 2 cases, equal to FFDM in 23 cases, and inferior to FFDM in 11 cases. The difference was statistically significant (P < 0.05). But when thickness was changed into 1 cm, the visibility of calcifications in those cases was equal between FFDM and DBT. The maximum diameter of lesions was 2.46 ± 1.64 cm in DBT image, and 2.58 ± 1.62 cm in FFDM image, with a significant difference (P < 0.05). Comparing with reading FFDM images only, the accuracy of FFDM combining with DBT was increased from 88.8% to 91.8%. For FFDM, the AUC of ROC was 0.887, while for DBT it was increased to 0.912, with a non-significant difference (P > 0.05).

CONCLUSIONSDBT is superior to FFDM in the morphological characterization and small calcification in the lesions in dense breast. Combining FFDM and DBT improves the accuracy of diagnosis, but the difference is not statistically significant.

Adolescent ; Adult ; Breast Diseases ; diagnostic imaging ; Breast Neoplasms ; diagnostic imaging ; Calcinosis ; diagnostic imaging ; Carcinoma in Situ ; diagnostic imaging ; Carcinoma, Ductal, Breast ; diagnostic imaging ; Female ; Fibroadenoma ; diagnostic imaging ; Humans ; Image Processing, Computer-Assisted ; Imaging, Three-Dimensional ; Mammography ; methods ; Middle Aged ; Radiographic Image Enhancement ; Tomography, X-Ray Computed ; Young Adult

OBJECTIVESTo investigate the effect of interlukin-10 (IL-10) on expression and secretion of collagen I, IV in rat's hepatic stellate cells (HSC) of livers injured by CCl4.

METHODThe adenovirus vector encoded IL-10 gene was used to transfect rats with liver injury via the caudal veins. HSC were isolated and purified from the rat livers by collagenase IV perfusion and density gradient centrifugation with Nycodenz. The expression of collagen I, IV mRNA in HSC was detected by semi-quantitative RT-PCR method and the secretion of collagen I, IV in culture serum of HSC by ELISA method. The quantity of collagen was measured in the van Gieson stained histological liver preparations.

RESULTSThe expression and secretion of collagen I, IV in the adenovirus vector encoding IL-10 gene group were significantly lower than those in the adenovirus vector without IL-10 gene group and the control group (P < 0.05). The quantity of collagen in the treatment group was lower than that in the control group.

CONCLUSIONIL-10 can inhibit collagen I, IV expression and secretion in rat HSC.

Animals ; Cells, Cultured ; Collagen Type I ; biosynthesis ; genetics ; Collagen Type IV ; biosynthesis ; genetics ; Hepatocytes ; metabolism ; pathology ; Interleukin-10 ; pharmacology ; Liver Cirrhosis, Experimental ; metabolism ; pathology ; Male ; Rats ; Rats, Sprague-Dawley

Objective To observe the changes of serum S100B and MBP in rats with liquid petroleum gas poisoning. Methods Fifty-four healthy adult male SD rats were randomized into normal control group (n=6), 20% LPG poisoning group (n=24) and 50% LPG poisoning group (n=24). Rat models of liquid petroleum gas poisoning were established in the later 2 groups, and controls were given the same volume of air. The rats of each group(n=6) were scored with neurological severity scale (NSS) and the blood serum was collected on the 1st, 2nd, 3nd and 7th d of poisoning, respectively. The levels of S100B and MBP were detected by euzymelinked immunosorbent assay (ELISA).Results As compared with the scores of NSS in the normal control group, those on the 1st d of poisoning in the 20% LPG poisoning group and those on the 1st and 2nd d of poisoning in the 50% LPG poisoning group were significantly higher (P＜0.05). The levels of Sl00B and MBP in 20% and 50% LPG poisoning groups were higher than those in the control group on the 1st and 2nd d of poisoning (P＜0.05); the levels of S100B and MBP in 50% LPG poisoning group were higher than those in 20% LPG poisoning group on the 1st and 2nd d of poisoning (P＜0.05). The levels of S 100B and MBP in 50% LPG poisoning group were higher than those in 20% LPG poisoning group and normal control group on the 3rd of poisoning (P＜0.05). The NSS scores and the levels of S100B and MBP in rats with LPG poisoning enjoyed the highest scores or levels on the 1st d of poisoning and those decreased after that. Conclusion The levels of S100B and MBP of rats with LPG poisoning increase, indicating that gliocytes participate in the mechanism of nervous system injury in rats with liquid petroleum gas poisoning.

OBJECTIVETo investigate the effect of interleukin-10 (IL-10) on the expression of transforming growth factor-beta(1) (TGFbeta(1)) and platelet-derived growth factor (PDGF) in hepatic stellate cells (HSC) during liver injury.

METHODSThe adenovirus vector (the titer was 1 x 10(7) efu/ml) encoded IL-10 gene was used to transfect the rat via the vein of caudal. At the same time, CCl(4) was injected into rat by a hypodermic injection. These processes went on twice a week. After eight weeks, the liver were perfused with collagenase IV and purified by density gradient centrifugation with Nycodenz for separate HSC. The level of IL-10 was measured by ELISA method; The expression of PDGF and TGFbeta(1) in HSC was detected by semi-quantitative RT-PCR and Western-blot methods.

RESULTSThe level of IL-10 in therapy group (adenovirus vector encoding IL-10 gene group) was higher than that in non-therapy group (adenovirus vector without IL-10 gene and PBS group); The expression of TGFbeta(1) mRNA, TGFbeta(1) protein and PDGF mRNA, PDGF protein in therapy group were significantly lower than that in non-therapy group (P < 0.05).

CONCLUSIONDownregulating the TGFbeta(1) and PDGF expression could be the passageway by which IL-10 alleviate the degree of proliferation and activation in hepatic stellate cells.

Animals ; Down-Regulation ; drug effects ; Genetic Therapy ; Hepatocytes ; drug effects ; physiology ; Interleukin-10 ; pharmacology ; Liver Cirrhosis, Experimental ; metabolism ; pathology ; therapy ; Male ; Platelet-Derived Growth Factor ; biosynthesis ; RNA, Messenger ; biosynthesis ; Rats ; Rats, Sprague-Dawley ; Stromal Cells ; drug effects ; physiology ; Transfection ; Transforming Growth Factor beta ; biosynthesis ; Transforming Growth Factor beta1

OBJECTIVEThis study was to investigate the condom use and its factors on sex workers in Shandong province, and to provide effective suggestions for AIDS prevention strategies and interventions.

METHODSFrom April to July in 2009, 4732 female sex workers were investigated through anonymous questionnaires from 11 cities which were selected based on the AIDS epidemic, geographic location, economic conditions in Shandong province. Serum samples were collected and antibodies were tested by ELISA and TPPA from 4641 people.

RESULTS4732 female sex workers who were 15 - 58 years old were investigated and the majority belonged to the low age group (≤ 24 years old) which accounted for 61.5% (2912/4732). Among the 4732 female sex workers, the unmarried, the divorced, or the widowed females accounted for 72.8% (3441/4725) and 72.0% (3403/4726) of them were poorly educated.42.3% (1994/4719) of them were found from other provinces. The right answers for knowledge of AIDS accounted for 45.7% (2164/4732). 80.6% (3416/4236) of these females were found to used condoms in the most recent commercial sex activity. The rate of consistently using condoms in sex activity during the last month was 58.4% (2467/4221). In this survey, 7.3% (337/4637) of investigated females had been diagnosed with sexually transmitted diseases, 30.7% (1449/4726) of them had received HIV antibody test, 70.4% (3323/4732) of these people had received the AIDS intervention services, and 3.6% (167/4668) of them had ever used drug. Multivariate logistic regression analysis showed that high education level (junior high school or lower vs senior high school or higher, adjusted OR = 0.77, 95%CI: 0.67 - 0.90), having received the HIV intervention (received vs unreceived, adjusted OR = 1.36, 95%CI: 1.17 - 1.58), antibody detection (done vs not done, adjusted OR = 1.33, 95%CI: 1.15 - 1.55), and good knowledge about AIDS (low score group vs high score group, adjusted OR = 0.37, 95%CI: 0.32 - 0.44) were independent factors that increased safe sex behavior; while using drug (drug vs not drug, adjusted OR = 0.22, 95%CI: 0.15 - 0.31) was a negative factor.

CONCLUSIONThe prevalence rate of HIV infection among female sex workers was low in Shandong province. However, the low rate of condom use and the high prevalence of self-reported STD-related symptoms suggested that more attentions should be paid to the factors of risk behaviors, and more targeted interventions are critically needed.

Acquired Immunodeficiency Syndrome ; prevention & control ; Adolescent ; Adult ; China ; Condoms ; utilization ; Female ; Humans ; Middle Aged ; Population Surveillance ; Prevalence ; Safe Sex ; statistics & numerical data ; Sex Workers ; statistics & numerical data ; Sexually Transmitted Diseases ; prevention & control ; Surveys and Questionnaires ; Young Adult

OBJECTIVETo investigate the risk factors for recurrent wheezing in infants and young children suffering from dust mite allergy after their first wheezing.

METHODSA total of 1 236 infants and young children who experienced a first wheezing episode and were hospitalized between August 2014 and February 2015 were enrolled, among whom 387 were allergic to dust mites. These infants and young children were followed up to 1 year after discharge. A total of 67 infants and young children who experienced 3 or more recurrent wheezing episodes within 1 year were enrolled as the recurrent wheezing group, while 84 infants and young children who did not experience recurrent wheezing during follow-up were enrolled as the control group. Univariate analysis and multivariate logistic stepwise regression analysis were performed to investigate the risk factors for recurrent wheezing in these patients.

RESULTSThe univariate analysis showed that the age on admission, wheezing time before admission, Mycoplasma pneumoniae infection rate, and influenza virus infection rate were associated with recurrent wheezing. The multivariate logistic stepwise regression analysis showed that the older age on admission (OR=2.21, P=0.04) and Mycoplasma pneumoniae infection (OR=3.54, P=0.001) were independent risk factors for recurrent wheezing.

CONCLUSIONSInfants and young children who are allergic to dust mites, especially young children, have a significantly increased risk of recurrent wheezing if they are complicated by Mycoplasma pneumoniae infection during the first wheezing episode.

Animals ; Child, Preschool ; Female ; Humans ; Hypersensitivity ; complications ; Infant ; Logistic Models ; Male ; Pyroglyphidae ; immunology ; Recurrence ; Respiratory Sounds ; etiology ; Risk Factors

OBJECTIVETo discuss the value of a simple occlusive technique of the triple vessels, ie, portal vein, superior mesenteric vessels and splenic vein, in complicated pancreaticoduodenectomy.

METHODSThe technique was fulfilled with a No.8 urethral catheter to encycle the portal vein, superior mesenteric vessels and its near tissue plus pancreatic tail and splenic vein than the neck of pancreas was transected and well exposure superior mesenteric vein and complete transaction of uncinate. From November 2005 to November 2006 the technique was applied to 12 cases of pancreatic malignancy which presented very infiltrated and adhesive to the hilar vascular structure.

RESULTSThe 12 cases were accomplished according with this technique. The operating time was (292.4 +/- 36.3) min (270 - 390 min) and the intraoperative blood loss was (833.3 +/- 618.4) ml (300 - 2500 ml). The postoperative complication included one case of lymphatic leakage, two cases of pneumonia, one case of abdominal infection and two cases of wound infection. There was no perioperative mortality. The postoperative hospital stay was 17 d (11 - 29 d).

CONCLUSIONSUse this triple vessels occlusive technique can improve the safety and feasibility in complicated cases of pancreaticoduodenectomy.

Aged ; Anastomosis, Surgical ; methods ; Female ; Humans ; Male ; Mesenteric Artery, Superior ; physiopathology ; Middle Aged ; Neoplasm Invasiveness ; Pancreas ; blood supply ; pathology ; surgery ; Pancreatic Neoplasms ; pathology ; surgery ; Pancreaticoduodenectomy ; methods ; Portal Vein ; physiopathology ; Splenic Vein ; physiopathology ; Treatment Outcome

OBJECTIVETo explore the strategy of isolated complete resection of the caudate lobe of the liver through the anterior liver-splitting approach.

METHODSFrom January 1995 to June 2006, isolated complete caudate resection of the caudate lobe of the liver through the anterior liver-splitting approach in which accessed the caudate lobe by separation the liver parenchyma along the interlobar plane, was performed on 19 patients with tumors originated in caudate lobe. They were included hepatocellular carcinoma in 13 cases, cholangiocarcinoma in 4 cases and hemangioma in 2 cases, the tumor size range from 4 - 12 cm. The approach to hepatic resection involved routine use of Peng's multifunctional operative dissector, inflow and outflow of hepatic vascular control before hepatic parenchyma transection, low central venous pressure and selective use of liver hanging maneuver, as well as retrograde caudate lobectomy.

RESULTSThe operations were successful in 19 patients. Operating time averaged at (296 +/- 55) min. The average amount of blood loss were 1200 ml (ranged from 500 - 3000 ml). Postoperative complications included ascites in 2 cases, pleural effusion in 5 cases and bile leakage in 2 cases. They were cured by drainage. No mortality occurred in the perioperative period.

CONCLUSIONSThe application of anterior approach for isolated caudate lobectomy can converse certain kind of caudate lobe tumor from non-resectable to respectable resulting in widening the indication. The intraoperative routine use of Peng's multifunctional operative dissector, application of inflow and outflow of hepatic vascular control, low central venous pressure and selective use of liver hanging maneuver, as well as retrograde caudate lobectomy make the anterior liver-splitting approach for isolated complete caudate lobectomy safer and easier.

Adult ; Aged ; Carcinoma, Hepatocellular ; surgery ; Cholangiocarcinoma ; surgery ; Female ; Hemangioma ; surgery ; Hepatectomy ; methods ; Humans ; Liver Neoplasms ; surgery ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome