Extradural meningiomas are relatively rare and those arising from spinal root are even rarer. Recently, a case of extradural meningioma arising from a spinal nerve root was surgically treated in our institution. This patient was a 19-year-old female presented with paraparesis and paresthesia. The mass was compressing the spinal cord at the level of fourth thoracic spine, and it was extended to the nerve root. At operation it was found to be originated from the fourth thoracic spinal nerve root. After removal of the tumor, the neurologic symptom and sign were recovered completely. Histoligic examination of tumor revealed as transitional type of meningioma.
Female ; Humans ; Meningioma* ; Neurologic Manifestations ; Paraparesis ; Paresthesia ; Spinal Cord ; Spinal Nerve Roots ; Spine ; Young Adult

This study was purposed to analyse the immunophenotypic characteristics of chronic myelomonocytic leukemia (CMML), myelodysplastic syndromes (MDS) and acute monocytic leukemia (AML-M5b) by using multiparameter flow cytometry, and to explore its significance in diagnosis and differential diagnosis. The immunophenotypic characteristics of bone marrow samples from 14 CMML patients, 48 MDS patients, 46 AML-M5b patients and 18 normal persons were analyzed and compared by multiparametric flow cytometry. The results showed that the ratio of monocytes in CMML patients was obviously higher than that in MDS, AML-M5b patients and normal persons (P < 0.05), but there was no statistically significant difference between bone marrow samples of MDS and AML-M5b patients as well as normal persons. The ratio of blast cells in MDS patients was obviously higher than that in normal persons (P < 0.05), but did not show significant difference as compared with CMML patients. The ratio of mature granulocytes in AML-M5b patients was obviously lower than that in CMML and MDS patients as well as normal person bone marrow (P < 0.05). Certain differences of CD45/SSC characteristics in MDS, AML-M5b and CMML patients were found in comparison with normal persons. The abnormal expression of CD2, CD56, and CD14 tailing phenomenon were observed in CMML patients in comparison with bone marrow samples of MDS, AML-M5b and normal persons (P < 0.05). Lack and decrease of CD15 expression in MDS and CMML patients was significant different from AML-M5b and normal persons marrow, abnormal expression rate of CD15 in CMML patients was higher than that in MDS patients (P < 0.05), the CD13/CD11b/CD16 abnormal expression of granulocytes was seen in both CMML and MDS patients, but there was no statistically significant difference between them. Other antigens showed abnormality of varying degrees, but did not have any statistical significance. It is concluded that MDS, CMML and AML-M5b displayed a certain degree of similarity, and also possess their own immunophenotype characteristics. Comprehensive analysis of immunophenotype by multiparameter flow cytometry may be important for differential diagnosis among CMML, MDS and AML-M5b. High percentage of monocytes, abnormal coexpression of CD2, CD56 and CD14 tailing phenomenon, lack or decrease of CD15 as well as abnormal expression of CD13/CD11b/CD16 in granulocytes may play important roles in diagnosis of CMML.
Case-Control Studies ; Flow Cytometry ; methods ; Humans ; Immunophenotyping ; methods ; Leukemia, Monocytic, Acute ; diagnosis ; immunology ; Leukemia, Myelomonocytic, Chronic ; diagnosis ; immunology ; Myelodysplastic Syndromes ; diagnosis ; immunology

OBJECTIVE: The authors report the microsurgical anterolateral tunnel approach for the treatment of the cervical disc diseases and its postoperative surgical results. METHODS: All surgical procedures followed the method of classical microsurgical anterior discectomy. Small tunnel(7-8mm) was made on the disc space reaching to the posterior longitudinal ligament. The disc materials and bony spurs were removed through this tunnel. Thirty-one patients of cervical disc herniation(24 cases with pure disc herniation, 7 cases with combined cervical spondylosis) were evaluated on the symptoms, conformation in plain X-ray, C-T, and MRI. The follow up time was over 2 years . RESULTS: Postoperatively the result(following the out come scale) was excellent and good in Twenty-nine patients. One with fair result showed remnant disc particle and spur and another one is combined with cord contusion. One patient with lesion in C 3-4 space and two cervicothoracic junction showed excellent result. Two patients with osteoporosis also showed good results. Cervical spine curvature and disc space height were not changed on the plain X-ray and MRI in all patients. Twenty-nine patients were discharged within 3 days after surgery without any postoperative complications. CONCLUSIONS: The microsurgical anterolateral tunnel approach could be indicated for the treatment of patients with cervical disc diseases and with difficulty in achieving interbody fusion(the higher cervical level and cervicothoracic junction, osteoporosis etc.).
Contusions ; Diskectomy ; Follow-Up Studies ; Humans ; Longitudinal Ligaments ; Magnetic Resonance Imaging ; Osteoporosis ; Postoperative Complications ; Spine

BACKGROUNDRecently, due to the rapid development of proteomic techniques, great advance has been made in many scientific fields. We aimed to use magnetic beads (liquid chip) based matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF-MS) technology to screen distinctive biomarkers for lung adenocarcinoma (adCA), and to establish the diagnostic protein profiles.

METHODSUsing weak cation exchange magnetic beads (MB-WCX) to isolate and purify low molecular weight proteins from sera of 35 lung adCA, 46 benign lung diseases (BLDs) and 44 healthy individuals. The resulting spectra gained by anchor chip-MALDI-TOF-MS were analyzed by ClinProTools and a pattern recognition genetic algorithm (GA).

RESULTSIn the working mass range of 800 - 10 000 Da, 99 distinctive peaks were resolved in lung adCA versus BLDs, while 101 peaks were resolved in lung adCA versus healthy persons. The profile gained by GA that could distinguish adCA from BLDs was comprised of 4053.88, 4209.57 and 3883.33 Da with sensitivity of 80%, specificity of 93%, while that could separate adCA from healthy control was comprised of 2951.83 Da and 4209.73 Da with sensitivity of 94%, specificity of 95%. The sensitivity provided by carcinoembryonic antigen (CEA) in this experiment was significantly lower than our discriminatory profiles (P < 0.005). We further identified a eukaryotic peptide chain release factor GTP-binding subunit (eRF3b) (4209 Da) and a complement C3f (1865 Da) that may serve as candidate biomarkers for lung adCA.

CONCLUSIONMagnetic beads based MALDI-TOF-MS technology can rapidly and effectively screen distinctive proteins/polypeptides from sera of lung adCA patients and controls, which has potential value for establishing a new diagnostic method for lung adCA.

Adenocarcinoma ; blood ; diagnosis ; Adult ; Aged ; Female ; Humans ; Lung Neoplasms ; blood ; diagnosis ; Magnetics ; Male ; Microspheres ; Middle Aged ; Sensitivity and Specificity ; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization ; methods

BACKGROUNDIn recent years the proportion of lung adenocarcinoma (adCA) which occurs in lung cancer patients has increased. Using laser capture microdissection (LCM) combined with liquid chip-mass spectrometry technology, we aimed to screen lung cancer biomarkers by studying the proteins in the tissues of adCA.

METHODSWe used LCM and magnetic bead based weak cation exchange (MB-WCX) to separate and purify the homogeneous adCA cells and normal cells from six cases of fresh adCA and matched normal lung tissues. The proteins were analyzed and identified by matrix assisted laser desorption/ionization time-of-fight mass spectrometry (MALDI-OF-MS). We screened for the best pattern using a radial basic function neural network algorithm.

RESULTSAbout 2.895 × 10(6) and 1.584 × 10(6) cells were satisfactorily obtained by LCM from six cases of fresh lung adCA and matched normal lung tissues, respectively. The homogeneities of cell population were estimated to be over 95% as determined by microscopic visualization. Comparing the differentially expressed proteins between the lung adCA and the matched normal lung group, 221 and 239 protein peaks, respectively, were found in the mass-to-charge ration (M/Z) between 800 Da and 10 000 Da. According to t test, the expression of two protein peaks at 7521.5 M/Z and 5079.3 M/Z had the largest difference between tissues. They were more weakly expressed in the lung adCA compared to the matched normal group. The two protein peaks could accurately separate the lung adCA from the matched normal lung group by the sample distribution chart. A discriminatory pattern which can separate the lung adCA from the matched normal lung tissue consisting of three proteins at 3358.1 M/Z, 5079.3 M/Z and 7521.5 M/Z was established by a radial basic function neural network algorithm with a sensitivity of 100% and a specificity of 100%.

CONCLUSIONSDifferential proteins in lung adCA were screened using LCM combined with liquid chip-mass spectrometry technology, and a biomarker model was established. It is possible that this technology is going to become a powerful tool in screening and early diagnosis of lung adCA.

Adenocarcinoma ; metabolism ; Aged ; Female ; Humans ; In Vitro Techniques ; Lung Neoplasms ; metabolism ; Male ; Microdissection ; methods ; Middle Aged ; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization ; methods

Objective The aim of this study was to demonstrate the immunogenicity and safety of diphtheria, tetanus, pertussis (acellular, component) , poliomyelitis (inactivated) vaccine (adsorbed) and Haemophilus influenzae type b conjugate vaccine (DTaP-IPV//PRP-T) combined vaccine compared with commercially available DTaP (diphtheria, tetanus and pertussis), Haemophilus influenzae type b (Hib), tetanus conjugate and IPV monovalent vaccine. Methods Subjects were randomly divided into three groups, Group A and Group B were DTaP-IPV//PRP-T combined vaccine (PENTAXIMTM) vaccinated at 2,3,4 months of age or 3,4, 5 months of age respectively; Group C was commercially available DTaP. Hib tetanus conjugate (Act-HIBTM) and IPV (IMOVAX PolioTM) vaccines vaccinated at 3,4, 5 months of age. All groups received booster dose at 18 to 20 months of age, with antibody titers tested. Non-inferiority analysis was demonstrated in terms of seroprotection / seroconversion rates between Group A, Group B respectively and Group C. Safety information was collected after each vaccination to assess the safety of investigational vaccines. Results The non-inferiority of DTaP-IPV//PRP-T combined vaccine vaccinated at 2,3,4 or 3,4, 5 months of age versus DTaP, Hib tetanus conjugate and IPV vaccine was demonstrated for all vaccine antigens in both primary and booster phases in terms of seroprotection/seroconversion rates. DTaP-IPV//PRP-T combined vaccine was well tolerated. The rate of solicited/unsoliciated severe adverse reactions was very low and similar to the control vaccines. Conclusion DTaP-IPV//PRP-T combined vaccine was highly immunogenic with good safety profile in Chinese infants, which was comparable to the commercially available control vaccines.

Objective:To analyze the results of Grading of Recommendations Assessment, Development and Evaluation (GRADE) for clinical practice guidelines of rehabilitation. Methods:Clinical practice guidelines of rehabilitation were systematically retrieved from PubMed, EMBASE, CNKI, China Biology Medicine disc, Wanfang database and the guideline-related websites until January 11, 2020. Two researchers independently screened guidelines using Grading of Recommendations Assessment, Development and Evaluation (GRADE), and extracted and analyzed the results. Results:A total of 83 clinical practice guidelines of rehabilitation were included, in which 46 (55.4%) applied grading systems. Only four (4.8%) guidelines applied GRADE, including 44 recommendations, in which 39 guidelines (88.6%) had quality of evidence. Among the evidences citied in the recommendations, low quality evidences were the most (34.1%); among the recommendations, weak recommendations were more (56.8%). The quality of strong recommendation supporting evidence was higher than that of weak recommendation (χ² = 8.218,P < 0.05). Conclusion:The application of the GRADE grading system in clinical practice guidelines of rehabilitation remains to be improved. It is proposed for guideline makers to further implement the methodology of guidelines and GRADE to improve the reliability and applicability of the clinical practice guidelines of rehabilitation more effectively.

Objective To evaluate the quality of reporting of clinical practice guidelines of rehabilitation.Methods A comprehensive retrieve was performed in electronic databases of PubMed, EMBASE, CNKI, China Biology Medicine disc, Wanfang data, etc., from January 1, 2017 to January 11, 2020. Supplementary searches had been done on relevant websites. Two researchers reviewed literatures and assessed the reporting quality independently by using Reporting Items for Practice Guidelines in Healthcare (RIGHT), and any disagreements needed to be discussed in a consensus meeting.Results A total of 16 guidelines were included, with an average reporting rate of (44.8±27.9)%. Among the seven domains of RIGHT, basic information was reported the highest (57.3%), and evidence (31.3%) and other information (31.3%) was the lowest. The reporting rate was less as the guidelines published in China than in foreign contries (OR = 0.80, 95%CI 0.56-1.16), in original version than in update version (OR = 0.79, 95%CI 0.54-1.16); and higher as developed by various societies or associations than developed by non-societies or associations (OR = 1.15, 95%CI 0.82-1.61), however, no statistically significant difference was found in above comparisons.Conclusion Current clinical practice guidelines of rehabilitation reported with low quality. It is proposed that future guideline developers should report guidelines after RIGHT statements, including key information and content, in order to improve the quality of reporting guidelines.