There should be confusion about diagnosis and treatment for multiple segments cervical myelopathy in some respects. The author reviewed the literature and combined with clinical experience, proposed a new classification for cervical myelopathy according to responsibility segment areas, which dividing into single segment,double segments (continues or jumping type), multi-segment (≥ three segments). The responsible segments determination is the premise of diagnosis and also a key to determine surgical decompression segment. Decompression only according to imaging was not desirable, surgical segment should mainly relies on clinical, imaging, electrophysiological and comprehensive analysis to avoid surgery range expansion. Surgical approach and procedures are still the focus and hotspot of cervical myelopathy treatment, and no treatment standards and corresponding guidelines to consult. The author proposes that surgical approach should advocate the individual, and surgical procedure should follow simple instead of complicate, anterior and posterior combined decompression is not necessary in most cases, and anterior and posterior fixation are not need.
Cervical Vertebrae ; surgery ; Decompression, Surgical ; Humans ; Spondylosis ; diagnosis ; surgery ; Treatment Outcome

BackgroundChondroitin sulfate(CS) is a highly viscous and elastic acid mucopolysaccharide extracted from animal soft tissues,with a wide range of biological activity for use in clinical ophthalmology.Interim preservation solution containing CS has a significant protective effect on corneal endothelial cells (CECs).However,the protective effect played by CS in long-term glycerol cryopreservation of CECs remains to be studied.Objective This study is mainly attempted to investigate the protective effect of CS on graft CECs after cryopreservation by glycerin,and to compare the preserving outcome with that of sodium hyaluronate (SH).MethodsOne hundred and four eyes of fifty-two female Wistar rats were divided into four groups randomly.The cornea grafts were evenly anointed on the surface of the endothelium by 3％ CS and 1％ SH,respectively,and then cryopreserved in glycerol in the 3％ CS group and 1％ SH group,and the corneas cryopreserved only in glycerin were assigned to the glycerin only group.The fresh corneas of matched rats were used as the normal control group.Ninety-six female SD rats were appointed as recipients to receive allogeneic penetrating keratoplasty (PKP) 2 months after the graft cryopreservation.The viability of CECs on the corneas cryopreserved for 20 days and grafts of 14 days following surgery was assessed using trypan blue & alizarin red stain.The ultrastructure of cryopreserved corneas was examined under a transmission electron microscope.The rejection index (RI) and graft survival time were evaluated by inflammatory scoring under the slit lamp 1 day after operation,and regular pathological examination was performed after 7,14 or 30 days.The expression of transforming growth factor-β1 ( TGF-β1 ) and intercellular adhesion molecule-1 ( ICAM-1 ) in corneas and grafts were detected by immunochemistry.ResultsCECs morphology was normal in fresh cornea in normal control group,presenting no blue stained cells after trypan blue staining.In the 3％ CS group,few blue-stained cells were seen:however,the number of blue-stained cells noticeably increased in the 1％ SH group and glycerin only group.The viability and density of CECs were significantly lower in the 1％ SH group and glycerin only group,compared with the 3％ CS group (P＜0.05).Edema of the endoplasmic reticulum,inflammatory infiltration and neovascularization were more severe in the 1％ SH group and glycerin only group than the 3％ CS group 14 days after PKP.Compared with the 1％ SH group and glycerin only group,the R1 of the 3％ CS group was significantly reduced and the CECs survival time was delayed after PKP ( P＜0.05 ).Immunochemistry revealed that the expression of TGF-β1 in grafts (A value)was up-regulated and that of ICAM-1 was down-regulated in the 3％ CS group,compared with the 1％ SH group and glycerin only group ( P＜0.05).ConclusionsThe combination of 3％ CS with glycerol to cryopreserve corneal donor can maintain the viability of CECs for a longer duration and improve the effectiveness of PKP.

Objective To investigate the effect of fluvastatin (FLV) on the expression of β1 integrin in puromycin aminonucleoside (PAN)-treated podocytes and its mechanism.Methods Cultured human podocytes were divided into PAN,different concentrations of fluvastatin (1 × 10-8 to 1 × 10-5 mol/L),SOD,H2O21 groups respectively.Expressions of β1 integrin and reactive oxygen species (ROS) in podocytes were detected by Western blotting and DCFHDA (2' 7'-Dichlorofluoresecein 3' 6'-diacetate) respectively.The viability of podocyte was determined by MTT colorimetry.Results PAN and H2O2 significantly decreased the expression of β1 integrin and increased the synthesis of ROS in podocytes (P＜0.05respectively).Lower concentration fluvastatin or SOD treatment up-regulated β1 integrin and downregulated ROS of podocytes induced by PAN (P＜0.05 respectively).MTT revealed that lower podocyte viability was found in higher concentration fluvastatin,PAN and H2O2 groups.Lower concentration fluvastatin and SOD could protect podocytes against PAN.Conclusion Fluvastatin attenuates the injury of podocyte induced by PAN and increases the expression of β1 integrin,whose mechanism may be associated with the inhibition of the ROS activity.

AIM:To study the effect of centromere protein W ( CENP-W) down-regulation on human glioma U87 cells.METHODS:Small interfering RNA ( siRNA) was used to inhibit the expression of CENP-W in the U87 cells. The interference effect of siRNA was evaluated by RT-qPCR and Western blot .The proliferation of the cells was analyzed by MTT assay , BrdU staining and colony formation experiment .Transwell chamber assay was used to detect the invasion a-bility of the cells .The cell migration ability was measured by a scratch test .The changes of the cell cycle distribution and apoptosis were analyzed by flow cytometry .RESULTS:The results of MTT assay , colony formation experiment and BrdU staining showed that the cell proliferation and colony formation abilities in experimental group were significantly lower than those in control group and negative control group .The results of Transwell and scratch experiments showed that the migra-tion and invasion abilities in experimental group were weaker than those in blank control group and negative control group . The results of flow cytometry analysis showed that the cell cycle distribution in experimental group was arrested in G 0/G1 phase .The percentage of apoptotic cells in experimental group was higher than that in control group ( P<0.05 ) .CON-CLUSION:Down-regulation of CENP-W expression inhibits the proliferation , migration and invasion of human glioma cells and promotes the apoptosis of the cells , suggesting that CENP-W may be a potential target of gene therapy for human glioma.

In China, with the restructuring of health care system moving forward, private community health facilities have been playing a complementary but increasingly important role in providing public health and basic medical care services in urban areas. However, only limited evidence is available concerning the service functions of private community health facilities in China. The aim of this study was to explore the functions of private community health stations (PCHSs) to provide evidence-based recommendations for policy-making and practice in the development of urban community health services systems. A total of 818 PCHSs and 4320 government-sponsored community health stations (GCHSs) located in 28 cities of China were investigated in 2008. The percentages of stations that provided health services and the annual workload per community health worker (CHW) were compared between the two types of institutions. The results showed that the percentages of PCHSs providing public health services were significantly higher than those of GCHSs (P<0.05); but no significant differences were found in the percentages of basic medical services providing between PCHSs and GCHSs (P>0.05). The annual workloads of all the public health services and basic medical services per CHW in PCHSs were lighter than those in GCHSs (P<0.05), except for resident health records establishment and health education materials distribution (P>0.05). At present, the GCHSs are still the mainstream in urban China, which will last for a long period in future. However, our findings showed that the annual workloads of CHWs in PCHSs were no heavier than those in GCHSs, and the PCHSs were willing to provide public health services. In view of current inadequacy of health resources in China, it is feasible to further develop PCHSs under the guidance of the government, given that PCHSs can perform the basic functions of community health services, which is useful for the formation of public-private partnerships (PPP) and the improvement of community health services.

Objective To evaluate the efficacy and safety of "outside-in" arthroscopic cam resection in the treatment of femoroacetabular impingement (FAI)syndrome.Methods Nine patients were treated with "outside-in" hip arthroscopy for cam or mixed type FAI syndrome between July 2015 and July 2016.All the 9 patients(11 hips)underwent osseous correction of the femoral neck and labral debridement.Before the surgery and 12 months after it,all patients were evaluated using the Harris Score and their complications were observed.Results The average postoperative Harris Score(92.5,range from 64 to 100)was significantly better compared with the preoperative one(56.4,range from 22 to 70,P＜ 0.001).One patient with blister on dorsal foot and another with fluid leakage were cured.No neurovascular injuries or cartilage injuries were found among all the patients.Conclusion "Outside-in" arthroscopic treatment of FAI with osseous correction and labral debridement is safe and effective.

OBJECTIVE: To study the incidence rate, pattern and affective factors of mental disorder due to brain damage. METHODS: According to CCMD-2-R, 388 subjects with traumatic brain damage in the Psychiatric Hospital of Huainan city within last 5 years were assessed by three psychiatrists 6 months to 1 year after brain injury. RESULTS: (1) 74.2% of the mental disordered due to brain injury have intellectual impairment, most of them is mild; (2) The intracranial hematoma, brain stem injury, brain injury extent, GCS, complicated mental disorder, and education have great effect on intellectual impairment; (3) There is an intimate relationship between the intellectual impairment and the brain stem injury, intracranial hematoma, GCS, brain injury extent, and unconsciousness time. There is an intimate relationship between the mental symptom and the brain injury extent, contusion and laceration of brain, frontal lobe injury, and intracranial hematoma. There is also an intimate relationship between the personality change and the frontal lobe injury, unfolding brain case treatment, and intracranial hematoma. CONCLUSION To assess overall mental disorder should rely on the characteristics of craniocerebral injuries.
Adolescent ; Adult ; Aged ; Brain Injuries/complications* ; Child ; Child, Preschool ; China/epidemiology* ; Female ; Humans ; Intellectual Disability/etiology* ; Intelligence ; Logistic Models ; Male ; Mental Disorders/etiology* ; Middle Aged ; Neuropsychological Tests ; Young Adult

In China,with the restructuring of health care system moving forward,private community health facilities have been playing a complementary but increasingly important role in providing public health and basic medical care services in urban areas.However,only limited evidence is available concerning the service functions of private community health facilities in China.The aim of this study was to explore the functions of private community health stations (PCHSs) to provide evidence-based recommendations for policy-making and practice in the development of urban community health services systems.A total of 818 PCHSs and 4320 government-sponsored community health stations (GCHSs)located in 28 cities of China were investigated in 2008.The percentages of stations that provided health services and the annual workload per community health worker (CHW) were compared between the two types of institutions.The results showed that the percentages of PCHSs providing public health services were significantly higher than those of GCHSs (P＜0.05); but no significant differences were found in the percentages of basic medical services providing between PCHSs and GCHSs (P＞0.05).The annual workloads of all the public health services and basic medical services per CHW in PCHSs were lighter than those in GCHSs (P＜0.05),except for resident health records establishment and health education materials distribution (P＞0.05).At present,the GCHSs are still the mainstream in urban China,which will last for a long period in future.However,our findings showed that the annual workloads of CHWs in PCHSs were no heavier than those in GCHSs,and the PCHSs were willing to provide public health services.In view of current inadequacy of health resources in China,it is feasible to further develop PCHSs under the guidance of the government,given that PCHSs can perform the basic functions of community health services,which is useful for the formation of public-private partnerships (PPP) and the improvement of community health services.

Objective To investigate the diagnostic values of radiomics model based on ADC map in differentiating benign from malignant lesions in suspicious breast findings with MRI breast imaging reporting and data system (BI-RADS) category 4. Methods Eighty eight patients (36 benign and 52 malignant)with diagnosis of MRI BI-RADS 4 in our hospital from December 2014 to December 2015 were retrospectively enrolled in this study.All the patients were proved by pathology and examined by sequence of T1WI,T2WI,DWI and dynamic contrast enhanced magnetic resonance imaging(DCE-MRI),and then were further sub-categorized into BI-RADS 4A, BI-RADS 4B, or BI-RADS 4C based on DCE-MRI sequence. Thus positive predictive value(PPV)of each sub-category were calculated and ROC were used to describe its efficiency in differential diagnosis.Radiomics features based on ADC map were generated automatically from Analysis-Kinetics(GE Healthcare).Sixty three of the 88 cases randomized-selected by computer were used to establish forecasting models and other 25 cases for validation. Kruskal-Wallis test and Spearman were introduced to reduce radiomics features that were highly correlated with others. Logistic linear regression(LLR)model was constructed based on the selected features by'glm'function in R software and then verified by 10-fold cross validation (repeat 10 times). ROC was curved to determine the diagnostic accuracy of the model.Results The PPV of BI-RADS 4A,4B,4C were 16.7%(2/12),59.6%(28/47),75.9% (22/29)respectively.Area under curve(AUC)of ROC was 0.650,sensitivity and specificity were 76.9% and 45.9% respectively. Three hundred and ninety six radiomics features were extracted automatically by software and 5 features (size zone variability, difference entropy, zone percentage, intensity variability and inverse difference moment)were left after redundancy reduction step.Cross-validation showed the accuracy of Logistic regression model was 80.0%(20/25),AUC was 0.790,sensitivity and specificity were 81.3% and 77.8% when cut-off was 0.45. Conclusion The radiomics model could provide important reference for differentiation between benign and malignant lesions in suspicious BI-RADS 4 findings.

Objective To study the effect of SNORD47 over-expression on proliferation and invasion of U87-epidermal growth factor receptor (EGFR)vⅢ glioma cells. Methods U87-EGFRvⅢ glioma cells at logarithmic phase were assigned into lenti-SNORD47 group, lenti-NC group and blank control group. The recombinant lentiviruses containing lenti-SNORD47 or lenti-NC were transfected into U87-EGFRvⅢ glioma cells of the lenti-SNORD47 group and lenti-NC group, respectively. Forty-eight h after transfection, the SNORD47 expression in the three groups was measured by real time quantitative PCR. Western blotting was used to detect the protein expressions of matrix metalloproteinase (MMP) 2 and MMP9. The proliferation of U87-EGFRvⅢ cells 4, 24, 48, 72 and 96 h after transfection was evaluated by CCK-8 assay and colony formation assay. Transwell assay and wound-healing assay were used to examine the invasion and migration of these cells. Results The SNORD47 expression in the lenti-SNORD47 group was significantly higher than that in the lenti-NC group and control group (P<0.05). The protein expressions of MMP2 and MMP9 in the lenti-SNORD47 group were significantly decreased as compared with those in the lenti-NC group and control group (P<0.05). At 48, 72 and 96 h after transfection, the optical density and number of cloned cells in the lenti-SNORD47 group were significantly decreased as with those in the lenti-NC group and control group (P<0.05). The invasion and migration abilities of U87-EGFRvIII cells in the lenti-SNORD47 group were significantly suppressed as compared with those in the lenti-NC group and control group (P<0.05). Conclusion SNORD47 could inhibit the proliferative and invasive abilities of U87-EGFRvⅢ glioma cells.