Objective To analyze the correlation between impact positions on the head and hyperextension severities of cervical spinal cord,as well as their treatment.Methods A retrospective analysis was done for 41 cases of hyperextension of cervical spinal cord without fracture-dislocation who had received management in our department from January 1999 to January 2004.All the patients had no cervical disorders before injuries.They were injured by impact mostly on the forehead,cheek or lower mandible.Their neurological findings at admission and 6-month follow-ups were assessed according to ASIA (American Spinal Injury Association) rating system.Results Of the 20 patients who were injured by impact on the forehead,four were rated in neural function as grade B,11 as grade C,and five as grade D at admission,while one as grade C,11 as grade D,and eight as grade E at 6-month follow-up.Of the 12 patients who were injured by impact on the cheek,one was rated in neural function as grade B, four as grade C,and seven as grade D at admission,while one as grade C,two as grade D,and nine as grade E at 6-mouth follow-up.Of the nine patients who were injured by impact on the lower mandible,five were rated in neural function as grade B,three as grade C,and one as grade D at admission,while two as grade B,five as grade C,and two as grade E at 6-month follow-up.The 6-month follow-ups after treatment showed that the neural function was rated below grade C in nine patients,seven of whom had been injured by impact on mandible.Two patients of grade B who showed little improvement after treatment had been injured also by impact on mandible.Conclusion Impact on the lower mandible causes mote severe hyperextension than impact on tbe cheek or forehead.Both rea- sonable non-operative and operative treatments can lead to satisfactory outcome for patients with hyperextension of cervical spinal cord but without fracture-dislocation.

PurposeTo perform a quality assurance program for Truebeam imaging system using MIMI phantom, and to evaluate the accuracy of the imaging system center with the radiation isocenter and the accuracy of couch shift.Materials and Methods The reference images of MIMI phantom were acquired using CT scanner. The reference images were imported into the treatment planning system and a simple plan was created. The MIMI phantom was placed on the treatment couch. The images were acquired using the MV/KV imaging system, and a match registration was performed with the reference images from the TPS.Results Measured over six months, the precision of the imager and linac's isocenter was <1 mm, and the couch shift accuracy was <1 mm. The measurements over six months demonstrate that isocenters of the MV/KV imaging systems on Truebeam system are stable.Conclusion The accuracy of the Truebeam imaging system center and couch shift is safe and reliable. The error of Truebeam imaging system center and couch shift can be tested on a monthly base.

A total of1415 elderly individuals in Nanchang were included in the study and were divided into normal glucose tolerance group, impaired glucose regulation group, and diabetes mellitus group.The results showed that HbA1C was significantly correlated with fasting plasma glucose (FPG) and 2 h postprandial plasma glucose.When HbA1C 6.3% was applied as the cut point of diabetes, the sensitivity was 85.19% and the specifity was 99.45%.When HbA1C 6.5% was applied, the sensitivity was 75.56% and specifity was 99.61%.It seems that HbA1C 6.3% had higher specifity and sensitivity for diagnosing diabetes than HbA1C 6.5% and FPG 7.0mmol/L in studied population.

OBJECTIVETo study the diagnosis and treatment of lumbar internal disc disruption (IDD).

METHODSThirty-six patients with chronic disabling low back pain proved by discography as IDD were treated with disc excision and lumbar interbody fusion, and 8 cases were treated with PLIF, 28 with ALIF. The clinical results were evaluated by pre- and post-operative VAS, and the fusion results were evaluated by X-ray studies of the lumbosacral spine.

RESULTSThe average period of follow-up was 18 months, ranging from 6 to 26 months. Six patients treated with PLIF basically disappeared low back pain, 2 complained of mild back pain; the VAS after operation was decreased significantly in comparison with that of pre-operation (P < 0.01). Twenty-seven treated with ALIF basically disappeared low back pain; the VAS after operation was decreased significantly in comparison with that of pre-operation (P < 0.01). Fusion rate was 88% in patients who were treated with PLIF, and 97% in patients with ALIF.

CONCLUSIONDisc excision and interbody fusion is an effective method for the treatment of IDD, but the operation indications should be known well.

Adolescent ; Adult ; Female ; Follow-Up Studies ; Humans ; Internal Fixators ; Intervertebral Disc ; diagnostic imaging ; Low Back Pain ; etiology ; Lumbar Vertebrae ; diagnostic imaging ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Spinal Diseases ; complications ; diagnosis ; surgery ; Spinal Fusion ; instrumentation ; methods ; Tomography, X-Ray Computed ; Treatment Outcome ; Young Adult

OBJECTIVETo study the human myxovirus resistant protein A (MxA), a specifically induced peptide by interferon I, and to use its level as a diagnostic criterion for viral infections.

METHODSAnti-MxA antisera from immunized mice were prepared with the expressed MxA protein of pET32a-MxA in E. coli BL-21(DE3). To confirm the antiserum activity and specificity, the expression product of BL21, wild type MxA pEGFP-C1-wMxA and site-directed mutant MxA pEGFP-C1-mMxA(N589S) stably transfected 3T3 cells and induced A549 cells were detected by Western blot with the antisera using non-MxA transfected or non-IFN-beta induced cells, intact A549, NIH 3T3 cells transfected with pEGFP-C1 and pET32a (+)-transformed BL-21 as controls.

RESULTSThe antisera had specific positive immunoreactivity to the NIH3T3 cells transformed with pEGFP-C1-wMxA and pEGFP-C1-mMxA, INF-beta induced A549 cells and BL21 proteins expressed with pET32a (+)-MxA. The hybridization signals from IFN-beta induced A549 cells depended on the IFN-beta inducing concentrations. Meanwhile, immunohistochemical assay showed that NIH 3T3 cells with pEGFP-C1-wMxA and pEGFP-C1-mMxA had > 98% of positive cells at 1:50 dilution of the serum and A549 cells induced by 20 ng/mL IFN-beta for 48 h showed 95% positive cells. pEGFP-C1-transfected NIH 3T3 cells were all negative.

CONCLUSIONAnti-sera are highly specific to diversified MxAs. The antibody is detectable by Western blot, immunocytochemistry and immunofluorescence assay.

Animals ; Antibody Specificity ; Cell Line, Tumor ; GTP-Binding Proteins ; genetics ; immunology ; metabolism ; Gene Expression Regulation ; Humans ; Mice ; Myxovirus Resistance Proteins ; NIH 3T3 Cells ; Species Specificity

Objective To observe the effect of lentiviral vector-mediated basic fibroblast growth factor (bFGF) gene transfection on the biological characteristics of rabbit bone marrow stromal cells(BMSCs)under in vitro culture conditions. Methods BMSCs were obtained by density gradient centrifugation and adherence screening. The bFGF gene was transfected into BMSCs by lentiviral vector and divided into bFGF transfection group,empty virus group and untransfected group according to the transfection conditions.After transfection,the morphology,expressions of bFGF mRNA and protein, cell proliferation,cell cycle and alkaline phosphatase(ALP)activity were observed in three groups of cells. Results High density BMSCs were successfully obtained by density gradient centrifugation and adherence screening.After transfection of BMSCs with bFGF gene, the cell morphology showed no significant changes, while the expressions of bFGF mRNA and protein were significantly increased, the cell proliferation curve shifted upward, the proportion of proliferating cells increased,and the activity of ALP was significantly enhanced.There were significant differences between three groups(P<0.05).Conclusion The rabbit bFGF gene is successfully introduced into the BMSCs cultured in vitro by lentiviral vector, and the target gene is stably expressed.The expression of bFGF can promote the proliferation and osteogenic differentiation of BMSCs.

Objective:To analyze the expression of P-selectin and thrombopoietin (TPO) in patients with glioma, and explore their correlation with severity of disease.Methods:One hundred and six patients with glioma who were treated in the Third People's Hospital of Dalian City from June 2017 to June 2019 were selected as the observation group, and 50 physical examination person in the same period were selected as the healthy control group. The clinic data of patients in two groups were analyzed.Results:The serum P-selectin and TPO levels in the observation group were significantly higher than those in the healthy control group: (62.35 ± 16.71) μg/L vs. (25.42 ± 9.18) μg/L, (12.64 ± 3.26) μg/L vs. (6.93 ± 1.77) μg/L ( P<0.01). In patients with different severity of glioma, serum P-selectin and TPO levels in the high-grade group were significantly higher than those in the low-level group: (65.14 ± 17.19) μg/L vs. (53.71 ± 15.26) μg/L, (14.57 ± 3.38) μg/L vs. (9.04 ± 1.97) μg/L ( P<0.01). Serum P-selectin and TPO levels in patients with glioma after treatment were significantly lower than those before treatment: (57.28 ± 16.22) μg/L vs. (62.35 ± 16.71) μg/L, (10.85 ± 2.97) μg/L vs. (12.64 ± 3.26) μg/L ( P<0.01). Spearman correlation analysis result showed that there was a significant positive correlation between serum P-selectin, TPO levels and WHO classification in patients with glioma ( r = 0.417 and 0.361, P<0.05). The results of receiver operating characteristic (ROC) curve analysis showed that the area under curve (AUC) of serum P-selectin in the diagnosis of glioma was 0.859 (95% CI 0.794 to 0.910, P<0.01), the sensitivity was 90.00%, and the specificity was 74.53%. The ROC curve analysis result showed that the AUC of serum TPO in the diagnosis of glioma was 0.720 (95% CI 0.643 to 0.789, P<0.01), the sensitivity was 69.81%, and the specificity was 72.00%. Conclusions:Serum P-selectin and TPO are abnormally expressed in glioma patients, and their level changes are related to the severity of the disease.

OBJECTIVETo introduce a new kind of grade system for thoracic pedicle screws placement by performing postoperative computerized tomography (CT) scanning and discussion the clinical purpose.

METHODSFour hundred and fifty thoracic pedicle screws were implanted in 64 patients with the assistance of fluoroscopy. Postoperative CT scanning was conducted to determine a grade for each screw: Part A, screw entirely contained within pedicle; Part B(1), violate lateral or upper pedicle but screw tip entirely contained within the vertebral body (VB); Part B(2), violate medial or inferior of pedicle; Part B(3), tip penetrated anterior or lateral VB; Part C, violate pedicle or VB and endangers spinal cord, nerve roots, or great vessels. Based on anatomical morphometry, thoracic vertebral were subdivided into upper (T(1 - 2)), middle (T(3 - 6)), and lower (T(7 - 12)) regions. The mean follow-up period was 25.8 months.

RESULTSThe postoperative CT scanning-documented grade were determined: Part A, 367 screws (81.6%); Part B, 78 (17.3%), B(1) 40 (8.1%); Part B(2), 23 (5.1%); Part B(3), 15 (3.4%); Part C, 5 (1.1%). There were not significant difference between upper and lower thoracic that the placement of pedicle screws in part B or C. In part C, 5 pedicle screws were all in the middle thoracic.

CONCLUSIONPostoperative CT scanning should be considered as a routine examination for evaluating thoracic pedicle screw placement.

Adolescent ; Adult ; Aged ; Bone Screws ; adverse effects ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Postoperative Complications ; prevention & control ; Retrospective Studies ; Spinal Fusion ; instrumentation ; Thoracic Vertebrae ; diagnostic imaging ; surgery ; Tomography, X-Ray Computed ; methods

OBJECTIVETo evaluate the efficacy and clinical outcome of the treatment of thoracolumbar single compression fracture by using in situ rod rotation reduction and short segment pedicle screw at the fracture level.

METHODSFrom December 2008 to May 2010,12 cases of traumatic thoracolumbar single compression fracture (T11-L2) were treated, including 9 males and 3 females, with an average age of 35.8 years old (ranging from 24 to 52). There were 2 case with T11 fracture, 2 cases with T12, 6 cases with L1 and 2 cases with L2, without osteoporosis,pathological fractures or neurologic deficits. Radiographic data were collected preoperatively, 5 days postoperatively and at last follow-up (at least 12 months). Cobb's angle, vetebral compression ratio, internal fixation state were observed.

RESULTSAll patients were followed up from 12 to 30 months postoperatively,with an average of 19 months. There was no pseudoarticulation and solid bone fusion was achieved in all cases. There were no complications such as loosening or rupturing of internal fixation and so on. Sagittal kyphotic Cobb angle was corrected from preoperative (25.8 +/- 9.4) degrees to postoperative (6.7 +/- 2.3) degrees and (6.9 +/- 2.6) degrees at last follow-up. The percentage of vertebral compression was corrected from preoperative (42.5 +/- 10.4)% to postoperative (7.5 +/- 3.9)% and (8.4 +/- 4.5)% at last follow-up.There was significant difference between the postoperative data and preoperative data (P < 0.05), while the difference was not significant between the postoperative data and the last follow-up (P > 0.05).

CONCLUSIONThe thoracolumbar single compression fracture can obtain and maintain a good restoration by using the technic of in situ rod rotation reduction and short segment pedicle screw at the fracture level. The technique should be highly recommended.

Adult ; Female ; Fracture Fixation, Internal ; methods ; Fractures, Compression ; surgery ; Humans ; Lumbar Vertebrae ; injuries ; surgery ; Male ; Middle Aged ; Rotation ; Spinal Fractures ; surgery ; Spinal Fusion ; methods ; Thoracic Vertebrae ; injuries ; surgery

Objective: To clinically validate the feasibility and accuracy of cine images acquired through the multitasking method, with no electrocardiogram gating and free-breathing, in measuring left ventricular (LV) function indices by comparing them with those acquired through the balanced steady-state free precession (bSSFP) method, with multiple breath-holds and electrocardiogram gating. Materials and Methods: Forty-three healthy volunteers (female:male, 30:13; mean age, 23.1 ± 2.3 years) and 36 patients requiring an assessment of LV function for various clinical indications (female:male, 22:14; 57.8 ± 11.3 years) were enrolled in this prospective study. Each participant underwent cardiac magnetic resonance imaging (MRI) using the multiple breath-hold bSSFP method and free-breathing multitasking method. LV function parameters were measured for both MRI methods. Image quality was assessed through subjective image quality scores (1 to 5) and calculation of the contrast-to-noise ratio (CNR) between the myocardium and blood pool. Differences between the two MRI methods were analyzed using the Bland–Altman plot, paired t-test, or Wilcoxon signed-rank test, as appropriate. Results: LV ejection fraction (LVEF) was not significantly different between the two MRI methods (P = 0.222 in healthy volunteers and P = 0.343 in patients). LV end-diastolic mass was slightly overestimated with multitasking in both healthy volunteers (multitasking vs. bSSFP, 60.5 ± 10.7 g vs. 58.0 ± 10.4 g, respectively; P < 0.001) and patients (69.4 ± 18.1 g vs. 66.8 ± 18.0 g, respectively; P = 0.003). Acceptable and comparable image quality was achieved for both MRI methods (multitasking vs. bSSFP, 4.5 ± 0.7 vs. 4.6 ± 0.6, respectively; P = 0.203). The CNR between the myocardium and blood pool showed no significant differences between the two MRI methods (18.89 ± 6.65 vs. 18.19 ± 5.83, respectively; P = 0.480). Conclusion Multitasking-derived cine images obtained without electrocardiogram gating and breath-holding achieved similar image quality and accurate quantification of LVEF in healthy volunteers and patients.