Objective To observe morphological character of posterior arch of Atlas and lamina of axis,as well as provide anatomical basis to design special guiding device for the operation of upper cervical posterior fixation with Atlas titanium cable so as to make the operation safe and easy.Methods The posterior arch of Atlas and lami- na of axis were observed and measured in 100 adult dry Atlas and axis specimens,then special guiding devices were designed based on the anatomical data.Results (1)The posterior arch of Atlas was thin with a fan-shape section, whose inner plane descended from back to inside and the lamina of axis was stronger and thicker than posterior arch of Atlas,with a vertical inner plane and a ridge near the lower edge.(2)The special guiding device for posterior arch of Atlas should be designed with a bend head as well that for lamina of axis should be designed with a round head. They were used in 61 operations which became safer and easier.Conclusion The operation of upper cervical posteri- or fixation with Atlas titanium cable would be safer with the help of special guiding devices which were designed based on the anatomical character.

Objective To explore the prevalence of ETS gene fusion in prostate cancer and its correlation with patient's clinicopathologic index.Methods Ninety-one samples from prostate needle biopsy cases with median age 75 (55-90) years and 18 samples from radical prostatectomy cases with median age 72 (63-81) years were collected from Oct.2010 to Feb.2012.TMPRSS2-ERG,TMPRSS2-ETV1 and TMPRSS2-ETV4 fusions were tested by multi-probe fluorescence in situ hybridization (FISH) assay.Fusion positive and negative cases were compared with age,TNM stage,Gleason score (median Gleason score 7 (6-9)),and PSA value (median PSA 33.4 μg/L,mcan PSA 118.8 μg/L).In needle biopsy cases,there were early stage 32 (34％),locally advanced prostate cancer 36 (40％),metastasis 23 (26％) ; in radical prostatectomy cases,there were 9 cases in T2 stage,8 cases in T3 stage,1 cases in T4a stage,respectively.Results TMPRSS2-ERG fusions were present in 14.3％ (13/91,95％ confidence interval,0.071-0.215)biopsy specimens and in 11.1％ (2/18,95％ confidence interval,0-0.256) radical prostatectomy specimens.No TMPRSS2-ETV1 or TMPRSS2-ETV4 fusions were found in any cases.Altogether,13 (86.7％)cases possessed deletion pattern.And 7 (46.6％) hold insertion pattern.5 cases had both deletion and insertion pattern.38.5％ (5/13) deletion pattern had distant metastasis.Except one metastatic case harbored both deletion and insertion pattern,there was no insertion pattern accompanied with metastasis.There were no differences between fusion positive and negative cases in the distribution of age (P =1.000),PSA (P =1.138),primary Gleason score (P=2.186),Gleason score (P=2.107),TNM stage (P=2.052) and Risk Degree (P=2.597).Conclusions The TMPRSS2-ERG fusion positive cases harbor more deletion pattern than insertion pattern.There are no differences between fusion positive and negative cases in the distribution of age,PSA,Gleason score,TNM stage and Risk Degree.

Adolescent ; Adult ; Barium ; poisoning ; Chronic Disease ; Female ; Humans ; Male ; Middle Aged ; Occupational Diseases ; diagnosis ; therapy ; Retrospective Studies ; Young Adult

AIM:Scopolamine blocks cholinergic transmission and impairs learning and memory in mice．The purpose of this study was to evaluate the memory-improving properties of curcumin on scopolamine-induced memory im-pairment in mice．METHODS：The mice of memory impairment were induced by scopolamine．Step down test and Morris water maze test were used to observe the earning and memory ability in curcumin-treated ice．Biochemical assessments of AChE，MDA，and GSH-Px levels in brains were performed．RESULTS：Oral administration of curcumin ignificantly reduced the numbers of step-down rrors(P<0．05)and prolonged the step-down latency induced by scopolamine(P<0．05)．The escape latency time in mice treated with curcumin Was remarkably educed compared to that in scopolamine group by Morris water maze test(P<0．05)．After the platform was removed，the total time that the mice swam in the tar-get quadrant Was also longer in curcumin group than that in model group(P<0．05)．The data also indicated that curcumin significantly inhibited AChE ctivity(P<0．01)and prevented oxidative stress characterized by the significant reduction in MDA content and the significant increase in GSH-Px activities in the brain(P<0．01)．CONCLUSl0N：Curcumin in-duces cognitive improvement by enhancing the function of cholinergic system and its antioxidant activity．

Corneal endothelial cell(CEC)is the most critical part for the cornea, of which activity can influence the postoperative vision.It is very important for the clinical cornea preservation considering the function and its self-purification of donor cornea.There are a variety of classical methods, which can significantly prolong the saving time of donor cornea with its good quality of CEC.We reviewed the published papers about present preservation methods of cornea, which can give us many suggestions for the clinical cornea preservation.

Objective To study the inter-rater reliability of Wisconsin Gait Scale (WGS) and Gait Abnormality Rating Scale (GARS) in patients with stroke. Methods 20 hemiplegic patients were required to walk on their comfortable speed and videotaped from frontal, backward and lateral. The video recordings were scored with WGS and GARS by 2 experienced physical therapists. Intraclass correlation coefficient (ICC) was calculated for the scores in each category and the total score. Results ICC for the WGS were 0.372~1, and were 0~0.875 for the GARS. Conclusion WGS is more appropriater to assess the gait of hemiplegic stroke patients than GARS.

Objective To characterize the spinal motion of 6 degrees of freedom (6DOF) under the fulcrum bending in Lenke type 1 adolescent idiopathic scoliosis (AIS) patients using 3D image volume fusion technique.Methods Ten volunteers with Lenke type 1 AIS were examined by the Gemstone Spectral Imaging to obtain their T1-S1 vertebral morphological data in the supine position and fulcrum bending position.With the computer software,images of 2 different positions were fused with the 3D image to obtain in vivo kinematics data of each vertebral body in the target area.Results In the apical vertebrae (AV) region,the main range of motion in the fulcrum bending position ranged from-2.57°± 0.95° to-1.37°± 0.65°,showing significant differences between segments (P ＜ 0.05);along the vertical axis the coupling rotation ranged from-2.71° ± 0.48° to-1.27° ± 0.49°;along the coronal axis,the coupling flexion and extension ranged from 0.19° ± 0.85° to 1.51° ± 0.42°.In the upper end vertebrae (UEV) area,the main ROM ranged from-2.20° ± 1.13° to-1.91° ± 0.76°,showing no significant differences between the 3 segments (P ＞ 0.05);along the vertical axis,coupling rotation ranged from 0.18°±0.47° to 1.35°±0.52°;along the coronal axis,coupling flexion and extension ranged from 1.62° ± 0.41° to 2.07° ± 0.37°.In the lower end vertebrae (LEV) region,the main movement ranged from-0.79°± 0.63° to 0.73°± 1.09°,showing significant differences between the 3 segments (P ＜ 0.05);along the vertical axis,the coupling rotation ranged from-1.62°± 1.05° to-0.60°± 0.60°;along the coronal axis,the coupling flexion extension ranged from -1.41° ± 0.87° to-0.75° ± 0.66°.Conclusionts In the fulcrum bending position,Lenke type 1 AIS shows a unique motion and coupling mechanism in the spine.The coupling rotational movement in the UEV region is at the same side as the lateral flexion movement.The coupling rotational motion in the AV and LEV regions is opposite the lateral flexion movement.

OBJECTIVETo observe the effect of transcutaneous acupoint electrical stimulation (TAES) on brain tissue oxygen and glucose metabolism of the brain tissue in peri-operative period of the craniocerebral operation.

METHODSFifty patients scheduled for neuro-surgery were randomly assigned to the treatment group and the control group equally. Anesthesia applied after induction on all patients was continuous sevoflurane inhalation and intermittent intravenous injection of sulfenany and vecurnium bromide, but to the treatment group TASE was applied additionally from 30 min before anesthesia to the end of operation. Blood samples were taken from artery and jugular venous bulb at different time points, i. e. before induction (T0) , before skin incision (T1) , at the end of operation (T2) , and 10 min after extubation (T3) , for blood-gas analysis. The difference of oxygen, glucose and lactate contents between blood samples of arterial and jugular bulb (Da-jvO2, Da-jvGlu and Da-jvLac) at respective time point were determined and calculated.

RESULTSDa-jvO2 decreased in both group at T1, T2 and T3, and all lower than that at T0 (P < 0.05 or P < 0.01), but significant difference was shown in comparison of the index at T2 and T3 with the same time points in the control group in the treatment group (P < 0.05 or P < 0.01) , and that between groups at T2 and T3 (P < 0.01). Da-jvGlu in the treatment group decreased at T2 and T3 (P < 0.05), but keep unchanged relatively in the control group before and after anesthesia, inter-group comparison showed it was lower at T2 and T3 in the treatment group than that in the control group respectively (P < 0.05). Da-jvGlu in the treatment group at T1, T2, and T3 were all lower than that at the same time points (P < 0. 01).

CONCLUSIONTAES can significantly decrease the oxygen and glucose metabolism of the brain tissue in the perioperative period of the craniocerebral operation.

Acupuncture Points ; Adult ; Brain ; metabolism ; pathology ; surgery ; Brain Neoplasms ; metabolism ; surgery ; therapy ; Female ; Glucose ; metabolism ; Humans ; Male ; Middle Aged ; Oxygen Consumption ; Perioperative Care ; Transcutaneous Electric Nerve Stimulation ; methods ; Young Adult

Objective To evaluate the efficacy and safety of sunitinib as first line treatment in patients with metastatic renal cell carcinoma (RCC). Methods This study included 46 Chinese patients who were diagnosed with metastatic RCC after radical nephrectomy. The patients received oral sunitinib (50 mg once daily on a 4 weeks on, 2 weeks off) on a 6 weeks cycle dose schedule until disease progression or intolerable toxicities occurred. Results The overall objective response rate was 32.6% (95% confidence interval [CI, 19.1% to 46. 1%]), and the disease control rate was 86.9%,with complete response (CR) 0 (0%), partial responses (PRs) 15 (32.6%), stable disease (SD) 25(54.3 %), and progression disease (PD) 6 ( 13. 1%). The median progression-free survival was 11 months, and the 1-year survival rate was 65.2%, while the median overall survival (mOS) has not been reached. The main adverse events included fatigue 33 (71.7%), skin discoloration 29 (63.0 %),anorexia 28 (60.9%), hand-foot syndrome 26 (56.5%), oral mucositis 25 (54.3%), hypertension 19 (41.3%), facial edema 18 (39.1%), diarrhea 17 (37.0%), hemorrhage 17 (37.0%), nausea 15 (32.6%), and hematological toxicity: leukopenia 32 (69.6%), neutropenia 30 (65.2%), thrombocytopenia 28 (60.9%), anemia 21 (45.7%). Most of grade 3/4 serious adverse events were thrombocytopenia in 15 (32. 6%) patients. Conclusions Sunitinib has a prominent effect in metastatic renal cell cancer in a Chinese population with mostly mild to moderate adverse reactions. More attention should be paid to grade 3/4 adverse reaction of thrombocytopenia.

Objective To identify the relationship between sorafenib's efficacy and its side effects in treatment of advanced renal cell carcinoma patients. Methods Fifty-one patients having measurable diseases were diagnosed with advanced renal cell carcinoma. Of whom, 26 patients were in stage T1Nx,0,1M1, 12 patients in stage T2Nx,0 M1, 8 patients in stage T3NxM1, 5 patients in stage T4NxM1. These 46 patients of T1 -T3 had their primary diseases removed, but the 5 T~ patients didn"t have their primary diseases removed. These 51 patients received oral sorafenib 400 mg Bid continual-ly and they had CT scan every two months to evaluate the progression. The dosage of sorafenib wasmodified according to efficacy and toxicity. Two patients changed the dosage to 200 mg Bid due to se-vere side effects. Sixteen patients increased the dosage to 600 mg Bid or 800 mg Bid. The response ofSorafenib and toxicities as well as their severity were recorded. The toxicity severity was graded ac-cording to National Cancer Institute Common Toxicity Criteria version 3.0. The efficacy was deter-mined by RECIST criteria. The efficacy and progression free survival (PFS) were recorded. The sta-tistics analysis was conducted between sorafenib's side effects and efficacy as well as their severity by multi-faetor Logistic regression. Results The rates of adverse events in the patients receiving oral sorafenib were hand-foot skin reaetion 68. 6% (35/51), diarrhea 39. 2% (20/51), rash 25. 5% (13/ 51), mucositis 23.5% (12/51), hypertension 17.6% (9/51), and myelosuppression 13. 7%(7/51). The response rate in the patients who had toxicity of grade 3-4 was 33.3%(12/36), and that in the patients who had slight toxicity was 12.0%(3/25). The rate of hand-foot skin reaction was higher than that of diarrhea, rash, mucositis, hypertension and bone marrow suppression (P<0.01). Sor-afenib's efficacy was eorrelated to rash and mueositis (P=0.048, 0.045 respectively). More grade 3 4 side effects occurred in the patients who would have better response to sorafenib (P=0.008). The median PFS was 15.0 months and PFS was not related to the toxicity and its severity. Conclusions It may help to predict the response for sorafenib's side effects and efficacy in the treatment of the patients with advaneed renal cell earcinoma.