Objective To compare the 7th edition of International Union Against Cancer ( UICC) staging system with the Chinese 2008 staging system for nasopharyngeal carcinoma ( NPC) , and to provide evidence for further updating of the staging system. Methods A retrospective analysis was performed among 767 patients who were pathologically and newly diagnosed with non?metastatic NPC and treated with intensity?modulated radiotherapy from 2006 to 2012. Based on the main prognostic indices, overall survival ( OS) , locoregional failure?free survival( LFFS) local relapse?free survival ( LRFS) , and distant metastasis?free survival ( DMFS) rates, the value of T stage, N stage, and clinical stage in prognostic prediction was compared between the two staging systems. The Kaplan?Meier method was used for calculating survival rates. The log?rank test was used for survival difference analysis. The Cox model was used for multivariate prognostic analysis. Results In terms of T stage, the Chinese 2008 staging system was a significantly better predictor of the OS and LRFS rates than the 7th edition of UICC staging system. In terms of N stage, they were comparable in the prediction of the OS and DMFS rates. In terms of clinical stage, the 7th edition of UICC staging system was a significantly better predictor of the OS rate than the Chinese 2008 staging system. For the new staging system proposed based on the statistical results, the T, N, and clinical staging gave significantly better prognostic prediction. Conclusions The 7th edition of UICC staging system and the Chinese 2008 staging system for NPC have their own advantages in prognostic prediction. The new staging system proposed in this study could contribute to the updating of the current staging system for NPC.

Objective:To analysis the effect of two methods of transposition of pectoralis major in different degrees deep sternal wound infection(DSWI) after undergoing cardiac surgery.Methods:128 patients with DSWI after cardiac surgery were treated, 72 were mild, and 56 were severe. 66 cases of pectoralis major muscle flap docking method(medial muscle flap docking group) and 62 cases of lateral pectoralis major muscle flap turnover method(lateral muscle flap turnover group) were implemented respectively. Drainage tube indwelling time, reoperation rate, incidence of lung infection, long-term thoracic stability and other aspects were observed to compared the treatment effect.Results:In the mild patients, the medial muscle flap docking group and the lateral muscle flap turnover group were compared( P<0.05). The postoperative hospital stay [(14.2±4.7)days vs.(17.1±3.9)days], drainage tube retention time[(6.2±1.7)h vs.(9.1±2.9)h], and reoperation rate(2.4% vs. 6.7%), the incidence of lung infection(14.3% vs. 23.3%), long-term thoracic stability[73.8%(31/42)vs.43.3%(13/30)]. In the severe patients, the medial muscle flap docking group and the lateral muscle flap turnover group were compared. The postoperative hospital stay[(24.2±7.2)days vs.(20.1±3.5)days], drainage tube retention time[(20.2±6.6)h vs.(13.2±3.1)h], reoperation rate(20.8% vs.12.5%), incidence of pulmonary infection(41.7% vs. 31.3%), long-term thoracic stability[25.0%(6/24)vs.68.8%(22/32)]. The differences of the indicators in each group were significant , P<0.05. In the mild group, each index of the pectoralis major medial muscle flap docking method was superior to the lateral muscle flap turnover method, but the treatment results of the two methods in the severe group were opposite. Conclusion:Patients with mild deep DSWI treated with medial pectoralis major muscle flap docking and suture have less hospital stay, less reoperation rate, less complications and better treatment effect than reverse lateral pectoralis major muscle flap turnover. But the two treatments in the severe DSWI have the opposite effect.

OBJECTIVE: To explore the treatment and pathophysiology of extra-axil cerebrospinal fluid accumulation aft er skull surgery. METHODS: The treatment of 46 cases of pineal regional tumor was retrospectively studied. RESULTS: The CT showed that all patients had postoperative extra-axil cerebrospinal fluid accumulation in 6 hours after operation. 5 cases displayed symptomatic accumulation of extra-axil cerebrospinal fluid. 1 died 30 days aft er discharge, 4 performed S-P shunt and 3 of them switched to V-P shunt after S-P shunt failed. CONCLUSION Much more attention should be paid to postoperative accumulation of extra-axil cerebrospinal fluid. Both V-P and S-P are the effective strategies of therapy.
Cerebrospinal Fluid Shunts ; Humans ; Pinealoma ; cerebrospinal fluid ; surgery ; Postoperative Period ; Retrospective Studies ; Skull ; surgery

To explore the correlation between the transluminal attenuation gradient with corrected contrast opacification(TAG-CCO)and the severity of atherosclerotic stenosis in the anterior segment of myocrardial bridge(MB). The imaging data of 200 patients diagnosed with left anterior descending branch(LAD)single MB and coronary atherosclerosis in the anterior segment of MB were retrospectively analyzed.According to MB types,the patients were divided into two groups:incomplete and complete.There were some significant differences in TAG-CCO between patients with the same degree of coronary atherosclerosis(mild,moderate,and severe stenosis)in two groups.The relationships among groups with different degrees(mild,moderate,and severe stenosis)of the same type of MB were further compared. Among 84 patients with complete MB,36,30,and 18 patients had mild,moderate,or severe coronary atherosclerosis in the anterior segment of MB;among 116 patients with incomplete MB,45,42,and 29 patients had mild,moderate,or severe coronary atherosclerosis in the anterior segment of MB.In the complete MB group,the TAG-CCO in the anterior segment of MB subgroups were(-0.0086±0.0014)/10 mm,(-0.0170±0.0180)/10 mm,and(-0.0230±0.0026)/10 mm,respectively,in mild,moderate,and severe subgroups( = 404.728, <0.001).In the incomplete MB group,the TAG-CCO of patients with mild,moderate and severe coronary stenosis in the anterior segment of MB were(-0.0039±0.0011)/10 mm,(-0.0100±0.0140)/10 mm,and(-0.0160±0.0020)/10 mm,respectively,and the difference among the different stenosis groups was statistically significant( = 17.756, < 0.001);the TAG-CCO of patients with mild( = 16.519, < 0.001),moderate( = 2.570, = 0.012)and severe anterior segment coronary stenosis( = 10.714, < 0.001)were significantly lower in the complete MB group than in the incomplete MB group. TAG-CCO is correlated with the MB type and the degree of anterior coronary artery stenosis.Thus,TAG-CCO can be used as a predictive indicator for the degree of atheroscleratic stenosis in the anterior segment of MB.
Atherosclerosis ; Coronary Angiography ; Coronary Artery Disease ; Coronary Stenosis ; Coronary Vessels ; Humans ; Retrospective Studies

OBJECTIVE: To evaluate the feature and difference between treadmill exercise test (TET) and myocardial perfusion imaging (MPI) in myocardial bridge patients with symptoms.
 METHODS: The data from 97 patients, who underwent 256-slice CT coronary angiography (CTCA) on TET and MPI, were collected and analyzed retrospectively. The patients were divided into an incomplete MB group (n=41) and a complete MB group (n=56). They were also divided into three groups according to the narrow degree of mural coronary artery (MCA) during the cardiac systolic period (Nobel grade): a Nobel 1 grade group (n=44), a Nobel 2 grade group (n=42), and a Nobel 3 grade group (n=11). Besides, the abnormal TET and MPI patients were divided into a TET abnormal group (n=21) and a MPI abnormal group (n=31). The results of TET and MPI were compared among the total, the different MB type groups and the different Noble grade groups, while the complete MB thickness and length were also compared between the abnormal TET group and the MPI abnormal group.
 RESULTS: The positive rate of MPI (39/97) was higher than that of TET (26/97) in total (χ2=8.048, P<0.01). But there was no significant difference in the positive rate of TET (5/41) and MPI (8/41) in the incomplete group (χ2=1.000, P>0.05). There was a significant difference in the positive rate of TET (21/56) and MPI (31/56) in the complete MB group (χ2=8.333, P<0.01). There were significant difference in the positive rate of TET (6/44) and MPI (12/44) in the Noble 1 grade group (χ2=4.500, P<0.05), or TET (11/42) and MPI (18/42) in the Nobel 2 grade group (χ2=5.444, P<0.05). But there was no difference in Nobel 3 grade group (P>0.05). The complete MB thickness was (3.4±0.6) and (2.9±0.8) mm between the TET abnormal group and the MPI abnormal group, with statistically difference (t=2.229, P<0.05). But the MB length was (16.6±5.5) and (15.7±7.1) mm, with no statistical difference (t=0.489, P>0.05).
 CONCLUSION MPI is more sensitive than TET in myocardial ischemia in patients with MB, especially to complete MB and mild-to-moderate systolic narrowing of MCA. The positive rate is low to incomplete MB, and it is highly sensitive to severe systolic narrowing of MCA. There is difference in the MB thickness between the two methods, but there is no difference in the MB length between the two methods.
Coronary Angiography ; Coronary Artery Disease ; Exercise Test ; Humans ; Myocardial Ischemia ; Myocardial Perfusion Imaging ; Myocardium ; Retrospective Studies ; Stress, Physiological ; Tomography, X-Ray Computed

Objective To investigate the effects of three-dimensional(3D)screws and circular plates on the biomechanical stability of Sanders ABⅢ calcaneal fractures.Methods Calcaneal computed tomography(CT)and magnetic resonance imaging(MRI)data from a 26-year-old volunteer were collected to establish a 3D finite element model of Sanders ⅢAB calcaneal fracture fixed with 3D screws and circular plates.A longitudinal load of 700 N was applied to compare the variations in the stress,displacement of the bone block,and internal fixation in the different models.Results Under 700 N longitudinal loads,the maximum displacement of the bone block and the maximum stress of the bone block and internal fixation were concentrated at the intersection of the posterior talar articular plane internal fixation and fracture line.The overall displacements of the bone blocks in the 3D screw and circular plate models were similar.Compared with the circular plate model,the maximum and average stresses of the bone block and internal fixation in the 3D screw model were lower,and the displacement and stress changes of the 3D screw model were closer to those of the complete calcaneal bone model.Conclusions In the fixation of Sanders ⅢAB calcaneal fractures,both 3D screw and circular plate fixation method can provide good stability.The biomechanical properties of the 3D screws were better than those of the circular plates,which is consistent with the biomechanical characteristics.

OBJECTIVE: To evaluate the time and effect of shunt operation on cryptococcal meningitis.
 METHODS: A total 7 patients received shunt operation for the therapy of cryptococcal meningitis patients and the data was retrospectively analyzed.
 RESULTS: Intracranial hypertension-caused symptoms were resolved immediately. There was no complication, no infection dissemination and no recrudescence of cryptococcal meningitis. 
 CONCLUSION Shunt operation is effective for intracranial hypertension caused by cryptococcal meningitis. It does not affect the antifungal treatment.
Antifungal Agents ; therapeutic use ; Drainage ; Humans ; Intracranial Hypertension ; surgery ; Meningitis, Cryptococcal ; drug therapy ; surgery ; Recurrence ; Retrospective Studies

Since the outbreak of corona virus disease 2019 (COVID-19), viral strains have mutated and evolved. Vaccine research is the most direct and effective way to control COVID-19. According to different production mechanisms, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines included inactivated virus vaccine, live attenuated vaccine, mRNA vaccine, DNA vaccine, viral vector vaccine, virus-like particle vaccine and protein subunit vaccine. Among them, viral protein subunit vaccine has a wide application prospect due to its high safety and effectiveness. Viral nucleocapsid protein has high immunogenicity and low variability which could be a new direction for vaccine production. We summarized the current development of vaccine research by reviewing the current progress, vaccine safety and vaccine immune efficiency. It is hoped that the proposed possible development strategies could provide a reference for epidemic prevention work in future.
Humans ; SARS-CoV-2/genetics* ; COVID-19/prevention & control* ; Protein Subunits ; Vaccines, DNA ; Nucleocapsid Proteins