ObjectiveTo observe the effect of early-stage intervention with acupuncture on gastrointestinal dysfunction in critically ill patients.MethodTotally 112 critically ill patients were randomized into two groups. Based on the treatment for primary disease, the conventional group additionally received Lived Combined B. Subtilis and E. Faecium Enteric-coated Capsules, plus Alanyl Glutamine injection when parenteral alimentation was required; in addition to the treatments given to the conventional group, the acupuncture group received electroacupuncture, once a day. Before treatment, and on treatment day 7 and day14, the gastrointestinal function and nutritional state (hemoglobin, albumin), nutrition type, APACHEⅡscore, incidence rate of gastrointestinal function failure, and mortality rate were evaluated and compared.ResultAfter 7-day treatment, the gastrointestinal function scores were significantly improved in both groups (P<0.05), and there was a significant difference between the acupuncture group and conventional group (P<0.05); after 14-day treatment, the gastrointestinal function scores were significantly improved in both groups compared to that before treatment (P<0.01), and there was a significant difference between the acupuncture group and conventional group (P<0.05). Respectively after 7-day and 14-day treatment, the APACHEⅡscores were significantly improved in both groups (P<0.01), and there was a significant difference between the acupuncture group and conventional group (P<0.05); after 14-day treatment, there was a significant difference between the two groups (P<0.05). After 7-day treatment, the hemoglobin levels were insignificantly changed in the two groups (P>0.05), and the difference was insignificant between the two groups (P>0.05); after 14-day treatment, the hemoglobin levels were significantly changed in both groups compared to that before treatment (P<0.05), and there was a significant difference between the two groups (P<0.05). After 7-day treatment, the albumin levels were insignificantly changed in the two groups (P>0.05), and the between-group difference was statistically insignificant (P>0.05); after 14-day treatment, the albumin levels were significantly changed in both groups compared to that before treatment (P<0.05), and there was a significant difference between the two groups (P<0.05). In the acupuncture group, 10 patients were dead, and there were 13 dead in the conventional group, and the between-group difference in death rate was statistically insignificant (P>0.05), though the death rate was comparatively lower in the acupuncture group; in the acupuncture group, 3 patients turned from complete parenteral nutrition to mixed nutrition, while 4 patients turned to mixednutrition because of intolerance to enteral nutrition and 2 cases turned to complete parenteral nutrition in the conventional group.Conclusion The two groups of treatments both can effectively improve the gastrointestinal function, decrease the incidence rate of gastrointestinal function failure, and the efficacy in the acupuncture group was more significant than that in the conventional group;the two groups of treatments both can sustain the gastrointestinal function and nutrition supply, and improve the nutrition state of the patients, and the acupuncture group was superior to the conventional group; the two methods both can effectively reduce APACHEⅡ score and improve the prognosis, while the acupuncture group was superior to the conventional group. Regardingthe death rate and enteral nutrition, the acupuncture group produced a higher comprehensive efficacy than the conventional group.

Objectives To investigate the relationship between angiogenesis and vascular endothelial growth factor (VEGF) and its receptor in patients with psoriasis. Methods The expression of VEGF and its receptor KDR, and micro-vascular density (MVD) were measured in 42 patients with psoriasis vulgaris and 15 normal controls by in situ hybridization and immunohistochemistry technique, respectively. The concentration of VEGF in sera was measured by double antibody sandwich enzyme-linked immunosorbent assay (ELISA) in patients with psoriasis vulgaris and normal controls. Results ①The expression of VEGF mRNA and its protein, KDR, and MVD in psoriatic lesions were significantly higher than those in the normal controls (P

Objective To evaluate the advantages of plasma cell enrichment combined with fluorescence in situ hybridization (FISH) based on a panel of probes by the conventional cytogenetic (CC) analysis.Methods Fresh heparinized bone marrow samples were collected by bone marrow biopsy.Plasma cells were enriched in BM samples using a magnetic cell-sorting procedure to select CD138+ cells.The common chromosome abnormalities of MM were detected by FISH based on a panel of probes and CC analysis after short-term culture of the BM cells,in order to compare the differences between these two methods for the frequency of common cytogenetic abnormalities.Results 72 of 95 (75.8％) MM patients were found to carry clonal chromosome abnormalities by FISH.And RB 1 deletion was the highest at 44.2％ (42/95) followed by CKS1B (1q21) amplification (42.1％).The frequencies of CDKN2C (1p32) deletion,TP53 deletion,IGH/CCND1 and IGH/FGFR3 were 8.4％ (8/95),12.6％ (12/95),14.7％ (14/ 95) and 14.7％ (14/95),respectively.IGH/MAF was negative.Thirty-two of 95 (33.7％) patients were found to carry clonal aberrations by CC analysis.The frequency of chromosome abnormalities detected by FISH was significantly higher than CC analysis (75.8％ vs 33.7％,P =0.000).Conclusion Plasma cell enrichment combined with FISH based on a panel of probes can greatly increase the frequency of chromosome abnormalities,which provides cytogenetic basis for risk stratification and prognosis of MM patients.

Objective To discuss the complication risk factors for early death after cervical injuries and explore the indication for treatment. Methods A retrospective study was carried out on early death and complications in 419 patients with cervical injuries admitted into our hospital. We observed the relationship of all kinds of complications with cervical cord injury severity and the incidence rate of complications in all patients. Results The respiratory complication was the main cause of early death, accounting for 79.11%. There found complications including hypoalbuminemia ( 85.29% ), hypotension(50%) and hyponatremia ( 35.29% ) in the death patients. Conclusions The existence of complications, especially hypoalbuminemia, can aggravate the original dysfunction and is the risk factor for early death. The early treatment of the dangerous complications could prevent multiple organ failure and early death and provide sound condition for functional recovery.

ObjectiveTo identify the anatomical feasibility of cross screw fixation in the atlas via posterior arch,provide a reference for clinical applications.MethodsA total of 10 dry atlas specimens were used to measure anatomic data and three dimension(3D) CT data.The data included height of the posterior tubercle,width of the posterior arch,distance from the ideal point to the interior of the vertebral artery sulcus,from nail point to central line,and the ideal direction of the screws.Statistical analysis was done to compare the two methods.Then 100 3D CT data were measured.The parameters included height of the posterior tubercle (mid-sagittal plane),width of the posterior arch (the inner side where arch transformed to the vertebral artery sulcus),distance from the ideal point to the interior of the vertebral artery sulcus (where screws completely located in the medullary cavity),distance between the nail point to central line,and angle of the ideal screws (between screws and horizontal line).The anatomy of the atlas was analyzed for whether height of the posterior tubercle is more than 7 mm,width of the posterior arch is more than 3.5 mm,and whether or not cross screws can be planted.ResultsThere was no statistical difference between anatomic and 3D-CT measures.Thickness of the C1 laminar was (4.7±0.9) mm in the left side,(4.6±0.8) mm in the right side,and 93.5％ of specimens were thicker than 3.5 mm.Distance of the ideal screw was(15.9±3.0) mm in the left side,(15.9±3.0) mm in the right side.Height of the C1 posterior tuber was (7.8±1.2) mm,with 91％ of the data higher than 7.0 mm.Angle between the axial of C1 laminar and frontal plane was 26.8°±6.8° (8°-44°) in the left side,26.8°±6.3°(13°-44°) in the right side,and about 11％ of them can not cross plant.ConclusionIt is feasible and safe to place cross screws in the posterior arch of the C1 in anatomy.

Objective To study the effect of different rod curvature on the postoperative stability and stress of thoracolumbar junction fracture using the finite element simulation.Methods (1) Thoracolumbar finite element model of T11 to L1 from three-dimensional CT data of a 30-year-old healthy male volunteer was established,including the assignment of cortical bone,cancellous bone,disc,ligaments and facet joints.On this basis,the T12fracture model was also established.T11 to L1 bilateral pedicle screw fixation was loaded,and the rod connection was divided into straight rod group and pre-bended rod group (lordotic 15°-25°) according to angle of the rod.A 400 N stress was loaded on the top of the upper endplate of T11 to simulate the upper part body gravity,while applying a 10 N · m torque to generate flexion and extension,lateral flexion and rotation.Stress distribution of different methods of pre-bending for thoracolumbar fractures after reduction was compared.(2) A retrospective cohort analysis was made on 56 cases of thoracolumbar fractures surgically treated from July 2012 to July 2016,including 31 cases in straight rod group and 25 cases in pre-bended rod group.Two groups were compared in angle between adjacent level before operation,after operation and at final follow-up.Results (1) In flexion,extension,lateral bending and rotation,both rod bending methods effectively controlled the thoracolumbar junction displacement.The peak stress of connecting rod (151,315,369,377 MPa respectively) in pre-bended rod group was lower than that in straight rod group (110,239,281,189 MPa respectively) (P ＜ 0.05),and straight rod group appeared relatively obvious stress concentration.(2) Mean follow-up time was 21.4 months (range,4-33 months).Preoperative kyphosis angle was (21.7 ± 7.4)°in straight rod group and (20.3 ± 6.8)° in pre-bended rod group (P ＞ 0.05).Postoperative lordosis angle in straight rod group was (3.3 ± 1.2) °versus (8.3 ± 2.8) ° in pre-bended rod group (P ＜ 0.05).At the final follow-up,the lordosis angle in straight rod group was reduced by (8.7 ± 2.3) ° versus (3.9 ± 1.7)°in pre-bended rod group (P ＜0.05).Implant failure was seen in 3 cases in straight rod group,but there was no implant failure in pre-bended rod group.Conclusion Pre-bended (lordotic 15°-25°) and pre-loaded rods used in internal fixation of thoracolumbar fractures may reduce the stress of rods,decrease the incidence of implant failure and facilitate the recovery of spine stability.

Objective To compare the feasibility and efficacy of intervertebral wedge osteotomy and pedicle subtraction osteotomy (PSO),vertebral column resection (VCR),Smith-Petersen osteotomy (SPO) for the treatment of severe kyphosis and scoliosis.Methods The data of 38 cases of severe kyphosis and kyphoscoliosis were retrospectively analyzed from January 2010 to February 2016,including 22 males and 16 females.According to the osteotomy mode,PSO,SPO,VCR and intervertebral disc wedge osteotomy were used to collect the average number of fixed phases,volume of bleeding,length of stay,length of hospital stay,improvement of main cobb angle,improvement of ODI score,and Frankel classification to evaluate the efficacy.Results There were no significant differences in the overall operative time between the four groups.The average number of fixation in 18 patients with SPO was (9.4±3.9) segments,the blood loss was (3 000±410) ml,the average Cobb angle was improved by 55.3％± 9.5％,the average postoperative hospitalization was (14.6±4.9) days,the improvement rate of ODI was 42.1％±7.4％,all the patients were improved to Frankel E;The average number of fixation in 5 patients with PSO was (7.6± 1.5) segments,the blood loss was (4 360± 1 161) ml,the average Cobb angle was improved by 58.9％ ± 15.1％,the average postoperative hospitalization was (18.2±7.0) days,the improvement rate of ODI was 41.3％±9.6％.One Frankel C patient was improved to Frankel D,others remained to be Frankel E as the same as pre-operation;The average number of fixation in 4 patients with VCR was (6.2±2.6) segments,the blood loss was (3 750+ 1 848) ml,the average Cobb angle was improved by 83.9％± 10.9％,the average postoperative hospitalization was (21±7.2) days,the improvement rate of ODI was 39.6％± 18.1％.Three Frankel D patients were improved to Frankel E and one Frankel C patient was improved to Frankel D;The average number of fixation in 11 patients with IWO was (7.1 ± 2.7) segments,the blood loss was (2855±1046) ml,the average Cobb angle was improved by 59.6％±22.05％,the average postoperative hospitalization was (13.5±2.7) days,the improvement rate of ODI was 51.3％±8.3％.One Frankel C patient was improved to Frankel D,eight Frankel D patients were improved to Frankel E,other patients remained to be Frankel E;The mean follow-up time was 25.2 months in 11 patients underwent intervertebral wedge osteotomy.All the patients had successful spinal fusion and no failure of internal fixation.Conclusion Intervertebral wedge osteotomy for the treatment of scoliosis and kyphosis could reduce surgical injury to obtain good biomechanics and surgical result.

Objective:To explore the difference and clinical significance of paraspinal muscle degeneration between single-segment degenerative lumbar spondylolisthesis and degenerative lumbar spinal stenosis.Methods:From January 2014 to October 2020, a retrospective analysis of 30 patientswere diagnosed with L 4,5 degenerative lumbar spondylolisthesis, aged 61.63±8.42 years old (range 44 to 82 years old), body mass index 24.07±3.17 kg/m 2 and 30 patientswere diagnosed with L 4,5 degenerative lumbar spinal stenosis, aged 59.67±12.89 years old (range 31 to 80 years old), body mass index 25.29±3.48kg/m 2, both of them went on surgery in department of spine surgery, shengjing hospital, China Medical University.30 healthy people were selected from outpatient physical examination in the control group, aged 58.33±7.36 years old (range 52 to 83 years old), body mass index 25.72±2.58 kg/m 2. These three groups were all male. Select all patients with L 3,4, L 4,5 and L 5S 1 disc level axial MRI images, and use the deep learning automatic segmentation measurement system developed by our hospital and Shenyang Institute of Automation Chinese Academy of Sciences to measure multifidus muscle cross sectional area (MMCSA), erector spinae cross sectional area (ESCSA), multifidus muscle fatty infiltration rate (MMFIR) and erector spinae fatty infiltration rate (ESFIR). One-way ANOVA was used to test the imaging parameters of multifidus and erector spinae of the three groups, and LSD- t test was used to compare the imaging parameters in each segment of paraspinal muscles. Results:The gender of three groups were male, there was no significant difference in age ( H=5.303, P>0.05), and there was no significant difference in body mass index ( F=2.267, P>0.05). Multifidus muscle cross-sectional area in L 3,4: degenerative lumbar spondylolisthesis groupincreased 189.11 mm 2 compared with degenerative lumbar spinal stenosis group ( P=0.010). Multifidus muscle cross-sectional area in L 4,5: compared with healthy people group, degenerative lumbar spondylolisthesis group decreased 205.52 mm 2 ( P=0.002), while degenerative lumbar spinal stenosis group decreased 184.14 mm 2 ( P=0.006). Multifidus muscle cross-sectional area in L 5S 1: compared with degenerative lumbar spinal stenosis group, degenerative lumbar spondylolisthesis group decreased 174.93 mm 2 ( P=0.018); compared with healthy people group, degenerative lumbar spondylolisthesis group decreased 406.06 mm 2 ( P<0.001), while degenerative lumbar spinal stenosis group decreased 231.13 mm 2 ( P=0.002). Erector spinae cross sectional area in L 4,5: compared with healthy people group, degenerative lumbar spinal stenosis group decreased 398.70 mm 2 ( P=0.006). Erector spinae cross sectional area in L 5S 1: compared with degenerative lumbar spinal stenosis group, degenerative lumbar spondylolisthesis group decreased 500.02 mm 2 ( P<0.001); compared with healthy people group, degenerative lumbar spinal stenosis group decreased 455.37 mm 2 ( P<0.001). Compared with healthy group, the multifidus muscle fatty infiltration rate of degenerative lumbar spondylolisthesis group in L 3,4 increased 4.96% ( P=0.001). Compared with degenerative lumbar spinal stenosis group, the erector spinae fatty infiltration rate of degenerative lumbar spondylolisthesis group in L 5S 1 decreased 5.41% ( P=0.004). Compared with healthy group, the erector spinae fatty infiltration rate of degenerative lumbarspinal stenosis group in L 5S 1 increased 5.02% ( P=0.008) . Conclusion:Paraspinal muscle cross sectional area of each segment in degenerative lumbar spondylolisthesis group and degenerative lumbar spinal stenosis group decreased in different degrees. In degenerative lumbar spondylolisthesis group, the degree of multifidus muscle fat infiltration was more significant, while indegenerative lumbar spinal stenosis group,the degree of erector spinal fat infiltration was higher.

The technology of electronic chromoendoscopy consists of narrow band imaging (NBI) and fuji intelligent chromo endoscopy (FICE). The two skills help distinguish between normal mucous membrane and focal zone and raise the detecting rate between the abnormal proliferation and early cancer. Therefore, the exploring research for type selection index of the two technologies and systems will be beneficial to the choice of the highest cost-effective endoscopy system and to the avoidance of wasting resources. By comparing all the indexes, and with purpose of clinical usage, NBI system has advantage over the FICE system. But with purpose for scientific research, the FICE system will be the better choice.
Capsule Endoscopy ; instrumentation ; Color ; Equipment Design ; Gastric Mucosa ; pathology ; Humans ; Image Enhancement ; methods ; Intestinal Mucosa ; pathology ; Intestinal Neoplasms ; diagnosis ; pathology ; Stomach Neoplasms ; diagnosis ; pathology

As an emerging non-invasive brain stimulation technique, transcranial direct current stimulation (tDCS) has received increasing attention in the field of stroke disease rehabilitation. However, its efficacy needs to be further studied. The tDCS has three stimulation modes: bipolar-stimulation mode, anode-stimulation mode and cathode-stimulation mode. Nineteen stroke patients were included in this research (10 with left-hemisphere lesion and 9 with right). Resting electroencephalogram (EEG) signals were collected from subjects before and after bipolar-stimulation, anodal-stimulation, cathodal-stimulation, and pseudo-stimulation, with pseudo-stimulation serving as the control group. The changes of multi-scale intrinsic fuzzy entropy (MIFE) of EEG signals before and after stimulation were compared. The results revealed that MIFE was significantly greater in the frontal and central regions after bipolar-stimulation ( P< 0.05), in the left central region after anodal-stimulation ( P< 0.05), and in the frontal and right central regions after cathodal-stimulation ( P< 0.05) in patients with left-hemisphere lesions. MIFE was significantly greater in the frontal, central and parieto-occipital joint regions after bipolar-stimulation ( P< 0.05), in the left frontal and right central regions after anodal- stimulation ( P< 0.05), and in the central and right occipital regions after cathodal-stimulation ( P< 0.05) in patients with right-hemisphere lesions. However, the difference before and after pseudo-stimulation was not statistically significant ( P> 0.05). The results of this paper showed that the bipolar stimulation pattern affected the largest range of brain areas, and it might provide a reference for the clinical study of rehabilitation after stroke.
Humans ; Transcranial Direct Current Stimulation/methods* ; Electroencephalography ; Stroke Rehabilitation ; Stroke/therapy* ; Electrodes