A growing number of children and adolescents are being diagnosed as Chiari malformation type Ⅰ (CM-Ⅰ) for behavioral disorders,developmental delay,seizures,or abnormal orpharyngeal function.The aim of this study was to compare the clinical characteristics,imaging findings and surgical outcomes of CM-Ⅰ in pediatric and adult patients.Between January 2014 and June 2017,84 patients with CM-Ⅰ underwent surgical treatment in our department.We divided the patients into two groups:pediatric group (n=1 1,age ＜18 years)and adult group (n=73,age ≥18 years).Data on clinical characteristics,imaging findings,surgical outcomes,and prognosis were retrospectively reviewed and compared between these two groups.For clinical presentation,scoliosis (36.4％) and developmental delay (36.4％) were more common in pediatric patients,whereas,sensory disturbance (58.9％) and motor weakness (41.1％) were more common in adult patients.Imaging findings showed that the incidence of hydrocephalus and craniovertebral junctional abnormalities was significantly higher in pediatric group than in adult group (P＜0.05).Compared to adult group,pediatric group showed a better improvement or resolution of syrinx and tonsillar herniation after surgical treatments (P＜0.05).The total Chicago Chiari Outcome Scale (CCOS) score in pediatric patients at the last follow-up was significantly higher than that in adult patients (P=0.002).In conclusion,the clinical characteristics and imaging findings appeared to be different in pediatric and adult patients with CM-Ⅰ.The surgical outcomes of pediatric patients were shown to be significantly better than those of adult patients.

Objective To observe the effect of liver disease special-purpose enteral nutrition preparation on protein metabolism and liver function in children with liver injury.Methods Sixty cases of severe ill with liver injury in hospital,with mean age of (7.8?6.3) years old.All patients were randomly divided into experimental group (n=30) and control group(n=30).The experimental group was treated by adding the liver disease special-purpose enteral nutrition preparation homogenized diet and control group was treated by adding entire protein entire nutrition type enteral nutrition preparation.All patients in both 2 groups were nasally fed with intestinal nutrition,which contained 418-628 kJ/(kg?d).One day before nutritional support and 14 days after nutritional support,the liver function,total serum protein,albumin,hemoglobin were recorded.SPSS 11.5 software was used to analyze the data.Results The baseline indicators were similar before nutritional supports.Fourteen days after nutritional support,alanine aminotransferase(ALT) and aspartate aminotransferase(AST) were all significantly lower in experimental group than in control group(Pa

Objective To observe he effects of new Tangshenkang on α-SMA and E-cadherin of human renal tubular epithelial cell HK-2 in high concentrations of glucose; To explore the mechanism of new Tangshenkang on the prevention and treatment of diabetic renal fibrosis. Methods The HK-2 cells were cultured and divided into control group, high glucose group, animal serum control group, new Tangshenkang low-, medium-, and high-dosage group. After medicine intervention, cell proliferation was tested by MTT assay, and contents of α-SMA and E-cadherin were observed by ELISA assay. Results Compared with control group, α-SMA of HK-2 cultured with high glucose was much notable, but the content of E-cadherin significantly decreased, with statistical significance (P<0.05). The content of α-SMA of HK-2 cultured with new Tangshenkang decreased, and the content of E-cadherin increased; cell proliferation was markedly inhibited in culture medium supernatant of HK-2 cells cultured with high glucose plus new Tangshenkang compared with only high glucose, with statistical significance. Conclusion New Tangshenkang can inhibit cell proliferation and epithelial-myofibroblast transdifferentiation of HK-2 cell induced by high glucose, and prevent the development of diabetic renal fibrosis to a certain extent.

Objective:Using lasso regression analysis to screen out the blood lipid indexes closely related to coronary heart diseaseMethods:The clinical data of 3 062 patients with coronary heart disease who were hospitalized in the Department of Cardiology, Affiliated Hospital of Jining Medical College from May 2013 to November 2015 were retrospectively analyzed.They were divided into control group ( n=2 427) and coronary angiography group ( n=635). R language was used for statistical analysis.Multiple logistic regression models were established for indicators of blood lipid related to CAD, and their multicollinearity severity was assessed.LASSO regression was used to screen out the representative lipid parameters in the CAD prediction model. Results:A total of 3 062 patients were enrolled, including 2 427 patients in coronary heart disease group and 635 patients in control group.The inclusion of lipid parameters into multiple logistic regression model leads to serious multicollinearity.Stepwise regression can only partially reduce multicollinearity severity, while LASSO regression model significantly reduces multicollinearity severity.Low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C) and non-high density lipoprotein cholesterol (non-HDL-C) were found to be the representative lipid indexes for predicting coronary heart disease by LASSO regression analysis.Conclusion:LASSO regression has advantages in processing multicollinearity data.LASSO regression showed that LDL-C, HDL-C and non-HDL-C were representative lipid indicators for predicting coronary heart disease..

Objective To further investigated the effect of minocycline on the inhibition of microglial activation and subsequent protection of nigral DA neuron.Methods 20 rats injected with LPS in the substantia nigra (SN) were randomly divided into two groups (LPS group and LPS+Minocycline group).The behavior was observed on the 7~(th) d and 14~(th) d.The immunohistoehemistry,in situ hybridization and Western-blot were used to detect the levels of positive neuron,mRNA,protein of TH and OX-42. Results The slightly rotational behavior was observed in LPS+Minoeyeline group.The majority of mieroglias were activated in the two groups.Some microglia in the SNpc remained ramified in LPS+ Minocycline group.The numbers of hypertophie microglia in LPS+Minoeyeline group were less than that in LPS group.Western-blot showed that the protein of OX-42 in two LPS groups was higher than in normal group(P

Objective To study the characteristics of work disability and its influencing factors in patients with ankylosing spondylitis (AS). Methods The demographic data, work conditons and disease related characteristics of 277 patients with AS were recorded, and randomly selected from the Department of Rheumatology, Chinese PLA General Hospital from November 2014 to January 2016. Work and productivity activity impair-ment questionnaire (WPAI) was used to survey the work disability and productivity loss, then explore its in-fluencing factors and the relationships between patient-reported outcomes and WPAI scores. Logistic regression was used to analyze the associated factors of work disability. Multivariate linear regression was used to analyze the predictive factors of lose of work productivity. Results The prevalence of work disability was 30.3%. Twenty patients were unemployed because of working disability. Two hudreds patients were employed, with average 36.5 (24.0, 50.0) hours workingtime in the past week. Average AS related absenteeism was 4.4 (0, 10) hour. Average workproductivity loss was 26.4%(2.5%, 40.0%). Logistic multiple regression analysis showed that Bath AS disease activity index (BASDAI), SF-36 physical component summary (PCS) scores might be the important influencing factors among those clinical measures ( OR=1.270, 0.959). Presenteeism and overall work impairment were moderately correlated with patients' global assessment of disease activity (VAS), BASDAI, bath AS functional index (BASFI), SF-36 physical Functioning (PF), SF-36 body pain (BP) and SF-36 Physical Component Summary (PCS) (|r|=0.539-0.648). Linear multivariate analyses indicated that work presente-eismand absenteeismwere significantly associated with BASDAI (P<0.01). Conclusion High prevalence of work disability in patients with AS is noted, which is closely related with disease activity and body function;High attention should be paid to AS patients with work disability.

Objective:To compare the effectiveness of fire needle versus Western medicine in the treatment of herpes zoster. Methods:Randomized controlled trials comparing fire needle with Western medicine in the treatment of herpes zoster were identified using 8 databases. A meta-analysis was performed using RevMan 5.3 software. Results:Eight trials involving 569 patients were included in this meta-analysis, and the results showed that fire needle was superior to Western medicine comparing the effective rate [risk ratio (RR)=1.13, 95％ confidence interval (CI): 1.06 to 1.20;P=0.0002], the visual analog scale (VAS) score [mean difference(MD)=–7.95, 95％ CI: –10.71 to –5.20;P<0.00001], time of pain disappearance (MD=–7.61, 95％CI: –9.38 to –5.84;P<0.00001), time of blister-stop (MD=–1.34, 95％CI: –1.51 to –1.18;P<0.00001), time of crusted scab (MD=–2.92, 95％CI: –3.62 to –2.23;P<0.00001), and time of scab off (MD=–4.64, 95％CI: –5.83 to –3.46;P<0.00001). In addition, a significantly lower incidence of postherpetic neuralgia was found in the fire needle group in 30 d (RR=0.23, 95％CI: 0.11 to 0.51;P=0.0002) and 60 d (RR=0.33, 95％CI: 0.12 to 0.91; P=0.03) after treatment. Conclusion:Fire needle has a favorable effect in increasing the effective rate, relieving pain, recovering skin lesions and decreasing incidence of postherpetic neuralgia in the treatment of herpes zoster. However, considering the limitations in this study, the findings should be interpreted cautiously.

OBJECTIVE To investigate the clinical significance of human papillomavirus in paraffin-embedded cervical cancer and precancerous lesion tissue by gene clip technology.METHODS 153 Patients with paraffin-embedded examples.DNA was extracted from paraffin-embedded tissues and amplified by polymerase chain reaction(PCR).RESULTS The positive rate of high-risk HPV of inflammation was 8.33%,CINⅠ45.83%,CINⅡ/CINⅢ 87.50% and invasive cancer 92.21%.The HPV infection rate of squamous cell carcinoma was 94.12%.The HPV infection rate of adenocarcinoma was 88.46%.Among all the patients with cervical cancer and CIN,the infection rate of HPV16,the most genotype,was 88.98%.The infection rate of HPV18,the second most subtype,was 33.06%.In addition,the minority were infected HPV52、33、59、68.Among 48 cases of cervical squamous cell carcinoma,the infection rate of HPV16,HPV18 was 93.73% and 27.08% respectively.Among 23 cases of cervical adenocarcinoma,the infection rate of HPV16,HPV18 was 82.61% and 52.17% respectively.On the other hand,all the patients with cervicitis were HPV single infection.The HPV multiple infection rate of CINⅠ,CINⅡ/CINⅢ,cervical cancer was 20.00%,28.57%,36.62% respectively.CONCLUSIONS Gene chip technology can detect multiple HPV genotypes in paraffin-embedded tissues with high sensitivity and specificity,which is useful in the pathogenesis and prevention of cervical cancer.

Objective Explore an approach with which stem cell can be used to cure traumatic spinal cord. Methods To better repair spinal cord injury, adult Sprague-Dawley (SD) rat MSCs was isolated and induced to differentiate into neuron-like cells with a Chinese medicine, Musk's polypeptide named Musk-1 in vitro and be seeded into microsurgical transectional model of adult rat spinal cord with cell differentiation and transplantation techniques. Results After cell transplantation, animals seeded with the rMSCs-derived neuron-like cells promoted significant improvement in function after spinal cord (P＜0.05,effective observation for 90 days ) when compared to the lesion-control group. Histology and immunocytochemical analysis confirmed a large number of rMSCs-derived neuron-like cells survived well in the transplantation zoon and numerous cells migrated within the host adjacent tissues as far as 6millimeters above and below the border of the lesion. Fluorescence gold retrograde tract tracing analysis revealed the positive motor neuron of fluorescence gold mark was found in the head side of rat spinal marrow ,corpus rubrum ofmesencephalic and corticospinal tract fibers. This suggested that corticospinal tract fibers of spinal cord area got regeneration and passed through the lession to reach the tail of spinal marrow.Conclusion These findings demonstrated that "pre-programmed" rMSCs can survive, migrate, integrate as well as restore spinal function and behavior in the microsurgical transectional model of rat spinal cord, and may serve as a suitable approach to traumatic spinal cord injury.

OBJECTIVETo design and manufacture a reliable spine phantom used in the cross calibration and quality control of dual X-ray absorptiometry (DXA).

METHODSA hydroxyapatite quality control phantom was designed and made through three steps: solid water, bone phantom material and integration, then evaluated the phantom on four different types of DXA machines made by LUNAR company.

RESULTSAmong the four DXA densitometers, the Expert fan beam densitometer had the biggest accuracy errors of bone mineral density (BMD), bone mineral content(BMC) and area values while the other three one narrow fan beam (Prodigy) and two pencil beam densitometers-had small errors. Of the three indexes measured by all the machines, BMD error was the smallest (-15.4%-11.5%), with the Prodigy's BMD was most outstanding. BMD errors at the higher density ends were small, tend to be positive values while the errors at the lower ends were big, tend to be negative. In cross calibration, giving consideration to the differences between the both ends, it is better to use the regression equation to correct. The base line of precision error derived by scanning the phantom once a day for consecutive 25 days was better than that derived by scanning the phantom 25 times consecutively on the same day. As to precision error, the coefficient of variation (CV) of scanning-25 times-a day was the smallest (0.0043) while the CV of 12 adults measurements was the biggest (0.0078).

CONCLUSIONSThis phantom can be used in the quality control and cross-calibration of different types of DXA machines.

Absorptiometry, Photon ; Adolescent ; Adult ; Biocompatible Materials ; Bone Density ; Calibration ; Durapatite ; Female ; Humans ; Male ; Middle Aged ; Models, Anatomic ; Spine