OBJECTIVETo discuss the reasons for the operation performed on 13 patients with upper cervical disease and to explore the management and prevention of upper cervical disease.

METHODSThirteen patients with upper cervical disease were retrospectively reviewed. The reason for of reoperations on these patients were analyzed. The measures to reduce upper cervical operational complication and bad prognosis were discussed to avoid reoperations.

RESULTSThe reasons for reoperations included 9 cases with unstable or re-dislocated atlantoaxial joint, 10 cases with residual spinal cord compression, 1 case with malposition of odontoid screw, 1 case with adjacent cervical spine regression, 1 case with occipital-cervical fusion failure, 1 case with spinal cord injury during operation, 1 case with bone-plant slipped into canales spinalis, and 1 case with demand to take out internal fixation for aggravated symptom.

CONCLUSIONSThe common reasons for upper cervical reoperations were due to instability or redislocation of atlantoaxial joint and residual of spinal cord compression. Some measures such as reducing operate miss, using firm internal fixation and decompressing were advisable to decrease the incidence of reoperations.

Adolescent ; Adult ; Atlanto-Axial Joint ; Cervical Vertebrae ; surgery ; Decompression, Surgical ; Female ; Humans ; Joint Instability ; etiology ; prevention & control ; surgery ; Male ; Middle Aged ; Postoperative Complications ; etiology ; prevention & control ; surgery ; Reoperation ; statistics & numerical data ; Spinal Cord Compression ; etiology ; prevention & control ; surgery ; Spinal Fusion ; Young Adult

Acetylcysteine ; pharmacology ; Animals ; Cell Line ; Gene Expression ; Lipopolysaccharides ; pharmacology ; Macrophages ; drug effects ; Mice ; Toll-Like Receptor 2 ; genetics ; Toll-Like Receptor 4 ; genetics

OBJECTIVETo investigate the effect of niacin on HDL-induced cholesterol efflux and LXRalpha expression in adipocytes from hypercholesterolemic rabbits.

METHODSTwelve rabbits fed with high-cholesterol diet for 8 weeks were randomly divided into two groups: (1) high cholesterol group (n = 6): maintained high cholesterol diet for 6 weeks; (2) niacin group (n = 6): the same cholesterol diet plus niacin (0.2 g . kg(-1). d(-1)) for 6 weeks. Control group (n = 6) was fed with normal diet for 14 weeks. Subcutaneous adipose was collected for adipocyte culture. RT-PCR was used to evaluate adipocytes LXRalpha mRNA expressions. Cholesterol efflux rate was determined through measuring release of radioactivity from 3H-cholesterol prelabeled cells into medium containing HDL. The direct effect of niacin on LXRalpha and PPARgamma mRNA expression in primary rabbit adipocytes was assayed.

RESULTSHigh cholesterol diet resulted in decreased LXRalpha mRNA expressions and reduced cholesterol efflux rate in adipocytes. Six weeks of niacin treatment significantly enhanced the cholesterol efflux from adipocytes, which was related to the increased mRNA expressions of LXRalpha (r = 0.71, P < 0.05). In vitro study, niacin dose-dependently stimulated LXRalpha and PPARgamma mRNA expression in cultured adipocytes and there were positive correlations between various doses of niacin-induced cholesterol efflux and LXRalpha and PPARgamma mRNA expression (r = 0.83 P < 0.01, r = 0.76 P < 0.05, respectively).

CONCLUSIONLXRalpha and PPARgamma might play an important role in cholesterol efflux from adipocytes. Niacin can up-regulate LXRalpha and PPARgamma mRNA expressions and promote the cholesterol efflux in adipocytes from hypercholesterolemic rabbits.

Adipocytes ; drug effects ; metabolism ; Animals ; Cholesterol ; metabolism ; DNA-Binding Proteins ; metabolism ; Disease Models, Animal ; Hypercholesterolemia ; drug therapy ; metabolism ; Hyperlipidemias ; drug therapy ; metabolism ; Liver X Receptors ; Male ; Niacin ; pharmacology ; therapeutic use ; Orphan Nuclear Receptors ; PPAR gamma ; metabolism ; Rabbits ; Receptors, Cytoplasmic and Nuclear ; metabolism

Objective To explore the effect of enriched environmental stimulation on mouse brain cognitive reserve to enhance the sensitivity of brain age gap estimation (BrainAGE).Methods Twenty-one healthy adult C57BL / 6J male mice,15 months old,were divided into a group with a standard environment and two groups with enriched environments.All the groups underwent magnetic resonance microcopy.Scaled subprofile model was used to analyze the features reflecting the changes of brain cognitive reserve.Results There were significant differences between the mean BrainAGE of the two groups with enriched environments and that of the remained standard environment group,then it's proved that some assumption might be reasonable that brain cognitive reserve could be estimated based on BrainAGE.Optim ized BrainAGE model made explanations for 58.9％ differences during stimulus phase in enriched environment.Conclusion Improved BrainAGE model gains high sensitivity when used to measure the redundancy of brain cognitive reserve.

Objective To learn the smoke-free environment and smoking status at or below county-level governments of Zhejiang Province, and to promote a smoke-free government.Methods By multi-stage random sampling method, 4 cities were selected in Zhejiang Province, then 4 counties were selected in 4 cities, finally12 governments were selected in 4 counties.With the methods of field observation,interview and questionnaire survey,smoke-free environment and smoking behavior , tobacco related knowledge of civil servants were investigated.Results A total of 12 governments and 405 civil servants were investigated.The smoke-free environment of 12 governments were relatively well.The total smoking rate of civil servants was 17.78%, and the highest was 26.67% in Jiande City, and the lowest were 9.00% in Zhuji City.For the civil servants ,male(26.62%), aged 50-(40.74%),divorced or widowed(40.00%),graduation of technical secondary school (33.33%),cadre of section rank(57.14%),above 20 years' work(28.81%),smoking anywhere at home(50.00%), smoking in certain areas at work(22.95%)were significantly higher.The rate of cognition on the hazards of smoking was lower among the smokers than that of non-smokers (P<0.05).The rate of agreement on MPOWER tobacco control strategies and smoking bans in public places were lower among the smokers than that of non-smokers (P<0.05).Non-conditional logistic regression analysis showed that age of 30-39(OR=9.87,95%CI:1.45-67.29),50-(OR=9.87,95%CI:1.45-67.29), smoking anywhere at home(OR=12.28,95%CI:2.95-51.18),and smoking in certain areas at home(OR=6.57,95%CI:3.07-14.08) may be the risk factors about smoking behavior.Conclusion The situation of smoking control at or below county-level governments in Zhejiang Province was good, and smoking rates has declined.But tobacco related knowledge and behavior of civil servants were relatively insufficient.Aiming at the problems found in the investigation, it is necessary to strengthen education on smoking control among civil servants, and to promote a smoke-free government.

OBJECTIVE: To investigate the risk factors for recurrence of medulloblastoma (MB) within 2 years and their influence on progression-free survival (PFS). METHODS: A retrospective analysis was performed for the clinical data of 123 children with MB who were admitted from January to December, 2017. According to the presence or absence of recurrence, they were divided into recurrence group with 30 children and non-recurrence group with 93 children. The risk factors for recurrence within 2 years were analyzed, and PFS was compared between the children with different risk factors. RESULTS: Large-cell/anaplastic type and M stage were risk factors for MB recurrence within 2 years. The risk of recurrence in the children with M+ MB was 3.525 times that in those with M0 MB, and the risk of recurrence in the children with large-cell/anaplastic MB was 3.358 times that in those with classic MB (P<0.05). The survival analysis showed that the median PFS time was 20 months in the children with M+ MB, and the 20-month PFS rate was 50% ± 11% in the children with M+ MB and 81% ± 5% in those with M0 MB (P<0.05). The 20-month PFS rate was 80% ± 5% in the children with classic MB, 65% ± 10% in those with desmoplastic/nodular MB, 86% ± 13% in those with MB with extensible nodularity, and 36% ± 20% in those with large-cell/anaplastic MB (P<0.05). CONCLUSIONS Recurrence is an important influencing factor for the prognosis of MB, and M+ stage and large-cell/anaplastic MB are risk factors for recurrence. Children with such risk factors tend to have a low PFS rate.
Cerebellar Neoplasms ; Child ; Humans ; Medulloblastoma ; Neoplasm Recurrence, Local ; Prognosis ; Recurrence ; Retrospective Studies ; Risk Factors

OBJCTIVE: To study the clinical effect of surgery combined with chemotherapy and radiotherapy in children with central primitive neuroectodermal tumor (cPNET), as well as the risks factors for poor prognosis. METHODS: A retrospective analysis was performed for the clinical data of 42 children who were diagnosed with cPNET from June 2012 to September 2018. RESULTS: The 42 children had a median overall survival (OS) time of 2.0 years and a median event-free survival (EFS) time of 1.3 years; the 1-, 3-, and 5-year OS rates were 76.2%±6.6%, 41.4%±8.7%, 37.3%±8.8% respectively, and the 1-, 3-, and 5-year EFS rates were 64.3%±7.4%, 32.7%±8.0%, 28.0%±8.1% respectively. The univariate analysis showed that there were significant differences in the OS and EFS rates among the children with different patterns of surgical resection, chemotherapy cycles, and risk grades (P<0.05), and there was also a significant difference in the OS rate between the children receiving radiotherapy and those not receiving radiotherapy (P<0.05). The multivariate Cox regression analysis showed that chemotherapy cycles and risk grade were independent influencing factors for EFS and OS rates (P<0.05). The EFS and OS rates increased with the increase in chemotherapy cycles and the reduction in risk grade. CONCLUSIONS Multimodality therapy with surgery, chemotherapy, and radiotherapy is an effective method for the treatment of cPNET in children. Early diagnosis and treatment and adherence to chemotherapy for as long as possible may improve EFS and OS rates.
Antineoplastic Combined Chemotherapy Protocols ; Child ; Combined Modality Therapy ; Disease-Free Survival ; Humans ; Neuroectodermal Tumors, Primitive ; Prognosis ; Retrospective Studies

Objective To plan microwave antenna puncture direction effectively and realize personalized preoperative simulation by exploring microwave ablation(MWV)outcomes of lung cancer based on real anatomical model.Methods Firstly,a personalized MWA simulation model consisting of the lung tissue,tumor and vascular system was constructed based on the lung CT data of real patients.Secondly,the MWA effect was simulated by coupling 2 physical fields including an electromagnetic field and a biological heat transfer field,so as to determine the volume of the ablation thermocoagulation zone and the temperature distribution of the lung tissue.Finally,the effects of the vascularized network on the ablation results were quantitatively evaluated in terms of conductivity and blood perfusion,and the ablation results were analyzed with different distances between the large vessels and the antennae(5 and 10 mm from the antennae tips)and puncture angles(large vessels parallelling or intersecting with the antennae tips).Results The vascularized network reduced the volume of the thermocoagulation zone by 0.5％to 3.7％,and blood perfusion made the ablation temperature and the volume of the thermocoagulation zone decreased significantly.The cooling effect gradually diminished with the increase of the distance between the large vessels and the antenna.With the same treatment parameters,the thermocoagulation zone formed when the large vessels paralleled with the antenna was obviously larger than that when the vessles intersected with the antenna.Conclusion Personalized MWA simulation analysis based on real CT data contributes to clarifying the temperature distribution and damage estimation close to the actual situation,which provides guidance and reference for precise treatment of the lung tumor and determination of microwave antenna puncture direction.[Chinese Medical Equipment Journal,2024,45(9):27-34]

OBJECTIVETo compare multiple organ dysfunction score (MODS), the sequential organ failure assessment (SOFA) and the logistic organ dysfunction score (LODS) in predicting hospital mortality in severe sepsis.

METHODSFour hundred and three patients admitted to the ICU from December 2004 to November 2007 with a diagnosis of severe sepsis were enrolled in this study. Their MODS, SOFA, LODS and Acute Physiology and Chronic Health Evaluation (APACHE) II at admission and the highest score during hospitalization were respectively recorded and collected in regard to mortality. The discrimination of three multiple organ dysfunction score systems were assessed by the areas under the receiver operating characteristic curves (AUC).

RESULTSThe AUC of admission scores was 0.811 for LODS, 0.787 for SOFA, 0.725 for MODS, and 0.770 for APACHE II in predicting hospital mortality. All maximum scores had better power of discrimination than the admission scores (P < 0.01). The power of discrimination of LODS and SOFA were better than the MODS, either the admission or the highest, respectively (P < 0.01). However, no significant difference was observed between the LODS and the SOFA regarding mortality prediction (P > 0.05). The AUC value for the APACHE II score was much lower compared to LODS (P < 0.01). However, there was no difference in AUC value among APACHE II, SOFA and MODS (P > 0.05).

CONCLUSIONLODS, SOFA and MODS show a good discrimination power, while maximum LODS is of the highest discrimination power to predict the outcome of patient with severe sepsis.

APACHE ; Adult ; Aged ; Aged, 80 and over ; Female ; Hospital Mortality ; Humans ; Intensive Care Units ; Male ; Middle Aged ; Multiple Organ Failure ; pathology ; Prognosis ; Sepsis ; mortality ; Severity of Illness Index

OBJECTIVETo investigate the expression of integrin beta 1 in hepatic cirrhosis (HC) and hepatocellular carcinoma (HCC).

METHODSThe expression of integrin beta 1 in HCC, HC and normal liver tissues was detected by reverse transcriptase-polymerase chain reaction (RT-PCR) and laser scanning confocal microscopy (LSCM). The association between the integrin beta 1 expression and clinical pathological features were analyzed.

RESULTS(1) The levels of integrin beta 1 mRNA and protein in the HCC (1.30+/-0.24, 90.50+/-33.50) and HC (1.58+/-0.31, 123.10+/-38.90) were much higher than that in the normal hepatic tissue (0.37+/-0.08, 11.90+/-6.00) (P less than 0.05). (2) The expression of integrin beta 1 was associated with HC (r = 0.692), Edmondson pathologic grade (F = 13.618), encapsulation (F = 17.857) and metastasis (F = 38.857) (P less than 0.01).

CONCLUSIONSIntegrin beta 1 may play an important role in the development of hepatic fibrosis, hepatic cirrhosis and hepatocellular carcinoma.

Carcinoma, Hepatocellular ; metabolism ; pathology ; Humans ; Integrin beta1 ; genetics ; metabolism ; Liver ; metabolism ; Liver Cirrhosis ; metabolism ; pathology ; Liver Neoplasms ; metabolism ; pathology ; RNA, Messenger ; genetics