AIM: To evaluate the clinical outcomes and evaluate the application value of pedicle screw system internal fixation in short segment for the treatment of Hangman's fracture. METHODS: A retrospectively analysis was conducted in 17 cases of Hangman's fracture who were treated in Department of Orthopaedics, Sichuan Provincial People's Hospital since 2004. According to Levine-Edwards classification, 4 of them belonged to type II, 6 type IIA, 7 type III. According to Frankel classification in function of spinal cord, 12 cases of them belonged to Grade E and 5 cases D. All cases were fixed with C2,3 pedicle screw system short segment implantation materials (product of Medtronic Sofamor) after skull traction and reduction. RESULTS: No vertebra artery injury or spinal injury was found during operation. Postoperational photograph and CT detection revealed bilateral fracture had no reduction in 1 case and cerebrospinal fluid leaking occurred in 1 case who was cured after conventional therapy. All cases were followed up for 12-24 months (average 14.5 moths). All fractures healed within 6 months, and activities of cervical vertebra were not obviously limited. As for nerve function, 4 cases of Grade D recovered up to Grade E. Ti-alloy implant materials used in this study were well biocompatible to the human body. There were no blood, immune, histology reactions, or the corrosion and abrasion of Ti-alloy appeared. CONCLUSION: Pedicle screw fixation in short segment for the treatment of Hangman's fracture is satisfactory in fracture reduction, fixation and healing. There are little lose in function of cervical vertebrae and it promotes functional recovery of spinal cord.

To study the chemical constituents of Cymbopogon citratus, isolation and purification of constituents were carried out on silica gel, Sephadex LH-20 and prepatative HPLC. The structures of the compounds were identified by physicchemical properties and spectral data analysis. Eight compounds were isolated and identified as 3beta-methoxy lanosta-9(11)-en-27-ol (1), 3beta-hydroxylanosta-9 (11)-en (2), (24S) -3beta-methoxylanosta-9(11), 25-dien-24-ol (3), 8-hydroxyl-neo-menthol (4), (2E)-3,7-dimethyl-2,7-octadiene-1, 6-diol (5), (+)-citronellol (6), 7-hydroxymenthol (7) and ethyl nonadecanoate(8). Compounds 1 is a new one. Compounds 2-3 are obtained from C. citratus for the first time.
Cymbopogon ; chemistry ; Drugs, Chinese Herbal ; chemistry ; Molecular Structure ; Spectrometry, Mass, Electrospray Ionization ; Triterpenes ; chemistry

Objective To explore the substantial resection limits of CO2 laser surgery for hypopharynx and the course of wound healing in animals,for the purpose of evaluating the clinic usefulness of transoral CO2 laser surgery in the treatment of selected hypopharyngeal carcinomas.Methods Twenty-three dogs were randomly assigned to two groups.Group one(11 dogs)received left piriform sinus resection,group two(12 dogs)received the resection of posterior wall of the hypopharynx.Six dogs in group one were killed immediately or 4,8,12,16,20 d post-operatively.Seven dogs in group two were killed immediately or 7,14,21,28,35,42 d post-operatively.The whole larynx and hypopharynx were taken out and the specimens were examined by naked eyes and under microscope.The other 5 dogs in each group were fed until the wound healed,the duration were observed.Results All the operations were successful and the results were satisfactory.In group one,the dogs could take food the day after operation;two dogs had slight cough during eating and recovered after five days.In group two,the dogs could take food the next day after operation,eight dogs had slight cough during eating and recovered after ten days.The excision dimensionwas satisfactory.In group one(resection of the lateral wall of piriform sinus),the size of raw surface was (7.5±0.8)cm2((-x)±s) and the healing time was(18.4±1.5)d.In group two(resection of the posterior wall of the hypopharynx),the wound surface was(7.0±0.5)cm2 and the healing time was(39.8±1.9)d.The healing time in group two was significantly longer than that in group one(t=19.535,P<0.01).Thepost-operative healing process were observed,including cellulose membrane coverage,granulation filling andepithelization.Conclusions Transoral CO2 laser was suitable for partial hypopharynx resection.Animalscan recuperate well with little complications.Although the course of wound healing was delayed,wound surface can recover with good laryngeal and deglutition functions.

BACKGROUNDAquaporin-1 (AQP1) has involved in fluid transport in diverse pulmonary edema diseases. Our study aimed to explore the dynamic changes of AQP1 in pulmonary water metabolism in rats following traumatic brain injury (TBI) and the protective effect provided by shenmai injection.

METHODSSixty male Sprague Dawley rats weighting 280 - 300 g were randomly divided into three groups: the normal control group, the model group and the shenmai injection (SMI) group. One piece skull was taken away without injuring cerebral tissue in normal control group, while rats in model group and SMI group were subject to free fall injury in the cerebral hemisphere. Rats in model group received intraperitoneal normal sodium (15 ml/kg) at one hour post-injury and the same dose of shenmai injection instead in SMI group, respectively. The expression of AQP1 was detected by immunohistochemical analysis and semi-quantitative RT-PCR at 0 hour, 10 hours, 72 hours and 120 hours after TBI. Arterial blood gas analysis and lung wet to dry were also measured.

RESULTSAQP1 was mainly presented in the capillary endothelium and slightly alveolar epithelial cells in three groups, but the expression of AQP1 in the normal control group was positive and tenuous, weakly positive in the model and SMI groups, respectively. Compared with normal control group, AQP1 mRNA levels were down regulated in the model and SMI groups at 10 hours, 72 hours and 120 hours (P < 0.05). While AQP1 mRNA levels in the SMI group was up-regulated than that in the model group (P < 0.05). Lung wet to dry weight ratio (W/D) in the model and SMI groups at 10 hours were higher than that in normal control group (P < 0.05). Compared with normal control group, PaO2 was markedly lower in the model and SMI groups (P < 0.05), but there were no statistically significant differences between model and SMI groups (P > 0.05).

CONCLUSIONSThe decreased AQP1 expression may be involved in the increased lung water content and dysfunction of pulmonary water metabolism following TBI. The treatment with SMI could improve water metabolism by promoting AQP1 expression.

Animals ; Aquaporin 1 ; genetics ; metabolism ; Brain Injuries ; drug therapy ; metabolism ; Drug Combinations ; Drugs, Chinese Herbal ; administration & dosage ; therapeutic use ; Immunohistochemistry ; Injections ; Lung ; drug effects ; metabolism ; Male ; Random Allocation ; Rats ; Reverse Transcriptase Polymerase Chain Reaction

Objective To compare the treatment outcomes,complications and histopathologic features between conventional parotidectomy and functional regional parotidectomy in the treatment for pleomorphic adenoma of parotid gland and to provide clinical,and pathological evidence for determining the safe surgical margin.Methods Of 109 patients,60 patients received conventional parotidectomy and 49 patients received functional regional parotidectomy.The rates of tumor recurrence and complications were compared between the groups of patients.Results There was no significant difference in the incidence of tumor recurrence,the facial paralysis and sialosyrinx between two groups.The rates of Frey's syndrome,numbness of auricular region,and facial asymmetry were 30.0％,61.7％,and 38.3％ in the patients with conventional parotidectomy respectively,while the rates were 6.1％,30.6％,and 8.2％ in the patients with functional regional parotidectomy,with significant statastically difference,respectively (P ＜ 0.05 ).Of 109 patients,33 with incomplete capsule,29 with capsule penetration,25 with pseudopodia,and 13 with satellite nodules.There was no significant difference in the depth of tumor infiltration between two groups of patients.For the tumor smaller than 2 cm,the depth of infiltration in conventional group was from 0.061 to 1.122 mm,functional group was from 0.442 to 3.127 mm (Z =- 1.093,P =0.057) ; for the tumors between 2 - 4 cm,the depth in conventional group was from 0.081 to 7.908 mm,functional group was from 0.082 to 6.632 mm ( Z =-0.214,P =0.831 ) ;for the tumor larger than 4 cm,the depth of infiltration was from 0.340 to 8.476 mm.Conclusions Compared with conventional parotidectomy,functional regional parotidectomy has good outcomes and less complications.The surgical margins of pleomorphic adenomas of the parotid gland should be determined by the size of tumor.The 1 cm-surgical margins are safe for the tumors less than 4 cm,and the tumors more than 4 cm should be treated with superficial parotidectomy.

OBJECTIVETo detect the mutations of Krit-1 gene that cause familial cerebral cavernous malformation (CCM) in the Han ethnic origin.

METHODSThe subjects were hospitalized in the Department of Neurosurgery, Tiantan Hospital affiliated to Capital University of Medical Sciences. Two families (A and B) and 8 apparently sporadic individuals affected with CCM were screened for mutations of Krit-1 gene. Members of the family CCM have a wide range in age of onset with seizures, headaches and skin lesions. The gene was screened by PCR amplification of 16 exons and mutation was detected by direct sequencing.

RESULTSIn family A samples, analysis of the Krit-1 gene revealed a new point mutation in exon 14 [a heterozygous C to G transition at nucleotide 1 289 (counting from the start codon or nt 2 308 counting from the first nt of the mRNA, aligned according to Gene Bank AF388384)] which predicts the substitution of a premature termination codon for Serine at codon 430 (S430X), belonging a nonsense point mutation. No mutation was identified in one of family A members as well as in any of the sporadic individuals with the exception of a single nucleotide polymorphism.

CONCLUSIONSReport the first family in the Han with CCM having a novel mutation in the CCM1 gene on the continent of Asia. The newly identified mutation creates a premature termination codon and is predicted to produce a truncated Krev1 interaction-trapped 1 protein, KRIT1. This result allows efficient presymptomatic molecular diagnosis.

Adult ; Base Sequence ; Child ; Child, Preschool ; Female ; Hemangioma, Cavernous, Central Nervous System ; genetics ; pathology ; Humans ; KRIT1 Protein ; Male ; Microtubule-Associated Proteins ; genetics ; Middle Aged ; Molecular Sequence Data ; Mutation ; Proto-Oncogene Proteins ; genetics

Objective: To explore the relationship between the ratio of dietary vitamin A (VitA) to body weight and hypertension among children, so as to provide a reference for blood pressure control through dietary nutritional interventions and childhood hypertension prevention. Methods: Utilizing the baseline survey and followup sample data from the Healthy Children Cohort established in urban and rural areas of Chongqing from 2014 to 2019, structured quantitative dietary questionnaire and selfdesigned questionnaire were used to investigate the information of dietary intake and socioeconomic characteristics of 15 279 children, as well as blood pressure, height, weight measurement. The ratio of dietary VitA to body weight was divided into four groups based on quartiles [≤P25(Q1), >P25~P50(Q2), >P50~P75(Q3), >P75(Q4)]. Generalized linear regression models and Logistic regression models were used to analyze the correlation between ratio of dietary VitA to body weight with blood pressure levels and prevalence of hypertension. Results: The results of the 2014 baseline survey indicated that, after adjusting for confounding factors such as demographic indicators and nutritional intake, significant differences were observed in systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP) among different groups categorized by the ratio of dietary VitA to body weight (F=157.57, 44.71, 95.92, P<0.01). The baseline ratio of dietary VitA to body weight in children exhibited a negative correlation with DBP, SBP and MAP at baseline and in 2019[baseline: β(95%CI)=-0.65(-0.89--0.42), -0.22(-0.42--0.01), -0.36(-0.56--0.16); 2019: β(95%CI)=-0.77(-1.34--0.19), -0.62(-1.21--0.02), -0.77(-1.34--0.19), P＜0.05]. Compared to Q1 group, the risk of hypertension decreased among children in Q4 at baseline and followup in 2019 [OR(95%CI)=0.63(0.49-0.81), 0.18(0.08-0.42), P<0.01]. Conclusions The ratio of dietary VitA to body weight is significantly negatively correlated with blood pressure levels among children, and dietary VitA deficiency is an independent risk factor for hypertension among children. Measures should be taken to actively adjust childrens dietary nutrition and reduce the risk of childhood hypertension.

Background: Delivering a poor prognosis to patients and their families is critically challenging in pediatric populations. The application of palliative care (PC) provides a bridge between accepting the occurrence of mortality and offering lifelong support.However, little is known about the specifics of PC. This study aims to explore the unmet need for PC in pediatric populations. Methods: We retrospectively reviewed the medical records of mortality cases in the Department of Pediatric Hematology and Oncology at Chang Gung Memorial Hospital. Statistical tests, including Chi-square and Student’s t-tests, were applied to determine the differences between early and late intervention groups in terms of the timing of PC introduction. Results: During the study period, 41 patients were included. Their median age was 11.8 years (IQR, 7.6-15.9). The majority of the disease statuses were refractory or relapsing (R/R). The incidence of memento application was significantly higher in the early intervention group (47.6% vs. 10%, P=0.0081). Vital signs variations tended to be end-of-life (EoL) indicators in this study. Conclusion The early introduction of PC encourages families to accompany their beloved child. EoL signs in the pediatric population include vital sign variations. With the presence of relevant EoL signs, clinical physicians can apply PC earlier to meet the needs.

Background: Delivering a poor prognosis to patients and their families is critically challenging in pediatric populations. The application of palliative care (PC) provides a bridge between accepting the occurrence of mortality and offering lifelong support.However, little is known about the specifics of PC. This study aims to explore the unmet need for PC in pediatric populations. Methods: We retrospectively reviewed the medical records of mortality cases in the Department of Pediatric Hematology and Oncology at Chang Gung Memorial Hospital. Statistical tests, including Chi-square and Student’s t-tests, were applied to determine the differences between early and late intervention groups in terms of the timing of PC introduction. Results: During the study period, 41 patients were included. Their median age was 11.8 years (IQR, 7.6-15.9). The majority of the disease statuses were refractory or relapsing (R/R). The incidence of memento application was significantly higher in the early intervention group (47.6% vs. 10%, P=0.0081). Vital signs variations tended to be end-of-life (EoL) indicators in this study. Conclusion The early introduction of PC encourages families to accompany their beloved child. EoL signs in the pediatric population include vital sign variations. With the presence of relevant EoL signs, clinical physicians can apply PC earlier to meet the needs.

Background: Delivering a poor prognosis to patients and their families is critically challenging in pediatric populations. The application of palliative care (PC) provides a bridge between accepting the occurrence of mortality and offering lifelong support.However, little is known about the specifics of PC. This study aims to explore the unmet need for PC in pediatric populations. Methods: We retrospectively reviewed the medical records of mortality cases in the Department of Pediatric Hematology and Oncology at Chang Gung Memorial Hospital. Statistical tests, including Chi-square and Student’s t-tests, were applied to determine the differences between early and late intervention groups in terms of the timing of PC introduction. Results: During the study period, 41 patients were included. Their median age was 11.8 years (IQR, 7.6-15.9). The majority of the disease statuses were refractory or relapsing (R/R). The incidence of memento application was significantly higher in the early intervention group (47.6% vs. 10%, P=0.0081). Vital signs variations tended to be end-of-life (EoL) indicators in this study. Conclusion The early introduction of PC encourages families to accompany their beloved child. EoL signs in the pediatric population include vital sign variations. With the presence of relevant EoL signs, clinical physicians can apply PC earlier to meet the needs.