Objective To detect the spatial point pattern distribution rules of neural tube defects.Methods The kernel density estimation and Ripley's K-function were used to analyze the spatial point pattern of the neural tube birth defects in Heshun county in 1998-2001.Results The kernel density estimation result showed that there was two clusters' distribution in central area and southeastern area respectively.In addition,the result by the Ripley's K-function presented that the location of neural tube birth defects had a significant cluster tendency in the spatial distance from 3.17 to 10.41 kilometers in the investigated area.Conclusion These results can provide an important clue for identifying the relations between environment risk factors and birth defects in this area in the future.

Objective To explore the application value of self-made directional arcuate bone drill during vertebroplasty by observing its operative effects for osteoporosis in vitro . Methods EDTA-Na2 was used to soak the prepared vituline osteoporotic vertebral bodies in vitro .A total of 40 osteoporotic vertebral bodies were randomly divided into Group A and B , with each group having 20 vertebral bodies for vertebroplasty .The Group A underwent a puncture by routine straight bone drill , while the Group B received a puncture by self-made directional arcuate bone drill with the arc directing toward the contralateral , which terminated when the drill reached the first 1/3 of vertebral body .Finally, statistical analysis was conducted on the distance between the bone drill bit and exterior margin of contralateral vertebral body , as well as whether bone cement reached or went over the vertebral sagittal midline . Results The osteoporotic vertebral bodies were successfully prepared in vitro by using EDTA-Na2 immersion decalcifying for 9 days. In the Group A, the drill bit was (2.50 ±0.32) cm away from contralateral exterior margin of vertebral bodies , which was significantly different from that in the Group B (0.90 ±0.26) cm (t=17.354, P=0.000).The bone cement reached or went over the vertebral sagittal midline in 11 vertebral bodies in the Group A and in 19 vertebral bodies in the Group B , with statistical difference ( Fisher’ s test,P=0.004).The intraspinal bone cement leakage occurred in 9 vertebral bodies in the Group A and 4 in the Group B, without significant difference between the two groups (Fisher’s test,P=0.176). Conclusion The self-made directional arcuate bone drill can build an osseous channel that reach or go over the vertebral sagittal midline and guide bone cement distributed to contralateral puncture , which avoids the disadvantages of bilateral vertebral pedicular puncture .The result shows that the self-made directional arcuate bone drill has more adventages in vertebroplasty than that of traditional straight bone drill but doesn ’ t have significant advantages in preventing bone cement leakage .

Objective To evaluate the technical points and security of CT-guided in percutaneous gold seed fiducials implantation for 132 solid tumors before cyberknife radiosurgery treatment. Methods 132 solid tumors were implanted with gold seed fiducials guided by CT before cyberknife radiosurgery treatment.The complications were analyzed. The methods for the prevention and treatment of the complications were suggested. Results Of 132 cases, the achievement rate of puncture was 99.2%(131/132), including 16 (12.1%) cases of pain in the location of puncture, 10(7.6%) cases of tachycardia, and 6 (4.5%) cases of hypertension. Among the 68 cases of lung cancer, there were 3(4.4%) cases of slight pneumothorax, 3(4.4%)cases of generous pneumothorax. Among the 50 cases of liver cancer, there were 1 (2.0%) case of gold seed fiducials transmigration, 2 (4.0%) cases of small amount bleeding from needle channel. Conclusion Percutaneous gold seed fiducials implantation in CT-guided for solid tumors before cyberknife radiosurgery treatment is a slight trauma and safe method.

Objective To evaluate the survival and adverse effects of adjuvant concurrent temozolomid (TMZ) combined with radiochemotherapy in postoperative patients with high grade intracranial glioma.Methods 84 postoperative patients with high grade intracranial glioma were randomly divided into the observation group (42 cases including 25 grade Ⅲ cases and 17 grade Ⅳ cases) and the control group (42 cases including 23 grade Ⅲ cases and 19 grade Ⅳ cases).All patients were treated with concurrent radiochemotherapy after surgical operations,the total radiation dose was 60-66 Gy.The patients in observation group were given daily oral TMZ 75 mg/m2 during radiotherapy.4 weeks after radiotherapy,all of the patients received 6 cycles of TMZ,each cycle lasted 5 days with 28 days interval between each cycles.150 mg/m2 of TMZ was given for the first cycle for 5 days,followed by 200 mg/m2 of drug for the rest of the cycles if no significant drug related toxicities were observed.Results The overall response rates (CR+ PR) were 71.7 ％ (33/46) in the observation group,and 32.6 ％ (15/46) in the control group,and with significant difference between the two groups (P ＜ 0.001).The 1,2 and 3 year survival rates of patients in the observation group were 71.7 ％,47.8 ％,36.9 ％,and 56.5 ％,26.1％,15.2 ％ in the control group.The significant differences were found in 2-year and 3-year survival rates between the two groups (P =0.031,0.018).The median recurrent period in the observation group were 22 and 12 months in the control group,and with singnificant difference (P =0.015).The main side effects were limited to grade Ⅰ or Ⅱ.Conclusions Concurrent TMZ combined with radiotherapy in the treatment of high grade gliomas has better clinical efficacy,and can improve the 2-year and 3-year survival rates.Patients tolerate the strategy well and no severe toxicities are observed.

Objective To observe the effect of EGFR mutation on radiation induced DNA repair in pulmonary adenocarcinoma ceils.Methods A549 cells with wild-type EGFR and H1975 cells with mutated-type of EGFR were irradiated by 4 Gy of 6 MV X-rays.After irradiation,the formation of nuclear γ-H2AX foci was assayed with immunostaining method,the level of DNA-PKcs-EGFR interaction was detected with coimmunoprecipitation,and nuclear RAD51 expression and EGFR nuclear translocation were detected using Western blot.Results DNA repair in the H1975 cells was significantly lower than that in A549 cells.In the irradiated H1975 cells,there was no EGFR translocation with further nuclear DNA-PKcs binding,and the expression of nucleus RAD51 was not altered.But in the irradiated A549 cells,EGFRDNA-PKcs interaction and nucleus RAD51 were increased.Conclusions Lung adenocarcinoma cell line with mutations in the tyrosine kinase domain (TKD) of EGFR exhibits a high radiosensitivity due to the reduction of the non-homologous end-joining (NHEJ) and homologous recombination (HR) DNA DSB repair kinetics.

ObjectiveTo investigate the efficacy of raltitrexed combined with transcatheter arterial chemoembolization (TACE) in the treatment of advanced colorectal cancer with liver metastasis. MethodsA total of 80 patients with liver metastasis of advanced colorectal cancer who were admitted to Central Hospital of China National Petroleum Corporation and underwent surgery from January 2012 to June 2015 were enrolled and randomly divided into study group and control group, with 40 patients in each group. The patients in the study group underwent hepatic arterial infusion chemotherapy with raltitrexed combined with TACE, and those in the control group were treated with intravenous infusion of raltitrexed alone. The above treatment was performed once every 4 weeks for 3-6 cycles. The response rate (RR), disease control rate (DCR), median time to disease progression, survival rate, and reductions in carcinoembryonic antigen (CEA), CA19-9, aminotransferases, and bilirubin were observed in the two groups. The chi-square test was used for comparison of categorical data between groups. ResultsRR, DCR, and the median time to disease progression showed significant differences between the study group and the control group (45.0% vs 22.5%, χ2=4.528, P=0.033; 70.0% vs 47.5%, χ2=4.178, P=0.041; 17.9 months vs 10.5 months, χ2=2408, P＜0.001). The study group had significantly higher 1- and 2-year survival rates than the control group (80.0% vs 57.5%, χ2=4.713, P=0.030; 55.0% vs 32.5%, χ2=4.114, P=0.043). The study group had a significantly higher number of patients with more than 50% reductions in CA19-9, CEA, aminotransferases, and bilirubin at 2 months after TACE than the control group (χ2=5333, 4528, 5051, and 5.013, P=0.021, 0.033, 0.025, and 0.025). ConclusionRaltitrexed combined with TACE is of good value in the treatment of advanced colorectal cancer with liver metastasis and holds promise for clinical application.

Objective:To evaluate the effect of exercise on the sleep quality of elderly persons experiencing a sleep disorder so as to provide an evidentiary basis for future studies.Methods:Reports of randomized and controlled trials of the effects of exercise on sleep quality among elderly persons with sleep disorders were extracted from the Cochrane library, PubMed, EMbase, the Web of Science, CNKI and other databases. Reports from the database′s inception to August 28, 2019 were retrieved. All were screened applying inclusion and exclusion criteria, and their methodological quality was evaluated using the Cochrane bias risk tool. The combined effect was analyzed using version 5.0 of the ReMan software.Results:Nine reports covering 928 patients were identified. Meta-analysis showed that compared with the control group, exercise could significantly improve the overall sleep quality of elderly patients with sleep disorders in terms of sleep score, subjective sleep quality, sleep latency, sleep duration, sleep efficiency, degree of sleep disturbance, sleep medication use, and daytime functioning.Conclusion:Exercise can improve the overall sleep quality of patients with a sleep disorder, shortening the sleep latency, improving sleep efficiency, reducing the use of sleep drugs, and improving their daytime functioning. However, it has less effect on subjective evaluations of sleep quality and sleep disorder.

Objective To investigate the correlation between type H hypertension and the development of coronary atherosclerosis.Methods From January 2015 to December 2016,three hundred and sixty patients with essential hypertension complicated with coronary atherosclerosis were treated in First Hospital of Shijiazhuang were selected,according to the level of serum homocysteine (Hcy),the patients were divided into the observation group (n =197 cases,Hcy ≥ 10 μ mol/L) and the control group (n =163 cases,Hcy＜10 μmol/L),all patients underwent coronary angiography and intravascular ultrasound.Results The cross-sectional area of extravascular elastic membrane (EEMCSA),plaque area (PA) and plaque burden(PB) of the observed group were (15.10±0.91) mm2,(8.80±0.99) mm2 and (62.03±3.20)％,wrere obviously higher than thoseat of the control group((13.72±0.96) mm2、(7.92±0.89) mm2、(56.87 ±3.37) ％),and the difference was statistically significant (t =14.079,、8.864,and 14.983,P＜0.05),and the minimum lumen cross section area (MLA) was (5.40 ±0.64) mm2,were obviously lower than that of the control group ((5.89 ± 0.52) mm2),and the difference was statistically significant (t =-7.937,P＜0.05);The Gensini score of the coronary artery in the observation group was (67.64± 13.19) points,which was significantly higher than that in the control group ((55.34± 12.20) points),and the difference was statistically significant (t =9.190,P＜0.05);the Serum Hcy were positively correlated with PA,PB and Gensini scores in the observation group (r =0.873,0.732and 0.856,P ＜ 0.05),which was negatively correlated with MLA (r =-0.773,P＜0.05).Conclusion There is a certain correlation between the severity of coronary atherosclerosis and the level of serum Hcy in patients with type H hypertension,which is worthy of further study.

OBJECTIVE: To examine the expression and clinical significance of the Stat3 and Cyclin D1 in laryngeal squamous cell carcinoma (LSCC). METHOD: The expression of Stat3 and Cyclin D1 in LSCC tissue were detected by the RT-PCR and Western blot method respectively, and then the relationship between Stat3 and Cyclin D1 protein expression level and relevant clinical factors of LSCC was explored. RESULT: Compared to the normal larynx mucosa group, the expression level of Stat3 and Cyclin D1 was significantly higher in LSCC (P < 0.01). The high expression level of Stat3 and Cyclin D1 protein in LSCC was correlated with the clinical stage, tumor differentiation and lymph node metastases (P < 0.01). The expression level of Stat3 was positively correlated with that of Cyclin D1, The correlation coefficient(r) was 0.564 (P < 0.01) for the protein expression and 0.552 (P < 0.01) for the mRNA expression. CONCLUSION Stat3 signaling pathway may play an important role in the tumorigenesis and progression of LSCC. The expression level of Stat3 and its target gene Cyclin D1 can reflect the malignancy degree of LSCC.
Adult ; Aged ; Aged, 80 and over ; Carcinoma, Squamous Cell ; genetics ; metabolism ; pathology ; Cyclin D1 ; genetics ; metabolism ; Female ; Humans ; Laryngeal Neoplasms ; genetics ; metabolism ; pathology ; Male ; Middle Aged ; Neoplasm Staging ; STAT3 Transcription Factor ; genetics ; metabolism

【Objective】 To compare the clinical efficacy of percutaneous transforaminal endoscopic decompression （PEID） and percutaneous interlaminar endoscopic decompression （PETD） in the treatment of L5-S1 lateral recess stenosis. 【Methods】 We selected the patients in our center diagnosed with L5-S1 lateral recess stenosis from March 2018 to October 2019 and divided them into Group A and Group B according to the principle of prospective， single-blind， and randomized control （A： PETD； B： PEID）. The operation was performed by the same senior surgeon with mature spinal endoscopy technology. We recorded the basic information， operation duration， usage count of C-arm， hospital stay， VAS score and ODI index of lower back and lower limbs before operation and 3 days， 1 month， 1 year and the last follow-up after the operation， and the operative excellent and good rates （the last follow-up）. The angle of bony lateral recess was measured during pre- and postoperative CT. 【Results】 A total of 95 patients （A： n=48； B： n=47） successfully completed the operation and were followed up for at least 1 year. The two groups did not significantly differ in age， gender， hospital stay， or complication by lumbar intervertebral disc herniation， but PEID group had significantly shorter operation duration and fewer usage counts of C-arm （P<0.001）. VAS score of lower back and lower limbs， and ODI index were significantly reduced at 3 days，1 month， 1 year and the last follow-up after the operation， with no significant difference between the two groups at the same time； no statistical difference was found between the two groups in operative excellent and good rates at the last follow-up （P>0.05）. The postoperative bony side recess angle was significantly improved （P<0.05）， while there was no significant difference in either pre- or postoperative bony side recess angle between the two groups （P>0.05）. 【Conclusion】 Both PEID and PETD are effective strategies in the treatment of L5-S1 lateral recess stenosis and can achieve good clinical outcomes.