Objective To investigate the effects and feasibility of mini-thoracotomy focus cleaning in the management of cavitary pulmonary tuberculosis or pulmonary tuberculoma. Methods The mini-thoracotomy approach was adopted in patients with cavitary pulmonary tuberculosis or pulmonary tuberculoma who had undergone long-term anti-tuberculosis therapy or needed a re-treatment.Eight patients with chronic fibro-cavitative pulmonary tuberculosis and 10 patients with pulmonary tuberculoma underwent focus cleaning, irrigation, and folding suture. Results All the 18 patients were cured clinically, with their sputum findings turning negative for bacteria and pulmonary shadows subsiding. No operative complications occurred. Follow-up for 1～4 years found no recurrence. Conclusions Focus cleaning is an effective surgical alternative for pulmonary tuberculosis after proper selection of cases. The procedure is minimally invasive and patient's pulmonary function can be protected to the greatest possible advantage.

Objective To investigate the recent studies about the relationship between Chlamydia pneumoniae and abdominal aortic aneurysm. Methods The current literatures about the relationship between Chlamydia pneumoniae and abdominal aortic aneurysm were reviewed. Results Chlamydia pneumoniae is one of the most important factors for the formation of abdominal aortic aneurysm since Chlamydia pneumoniae can cause abdominal aortic aneurysm through the metabolism of matrix metalloproteinases, the apoptosis of smooth muscle cells in the vessels and the chronic infection of the wall of the aneurysm. Conclusion There maybe a distinguishingly close relationship between Chlamydia pneumoniae and abdominal aortic aneurysm, and Chlamydia pneumoiae may take an important role in the development and progress of the abdominal aortic aneurysm.

Objective To explore the mechanism of sulfotanshinone sodium injection in treatment of patients with sudden deafness (SD).Methods Sixty patients with SD admitted to the Department of Otorhinolaryngology of Wuxi Traditional Chinese and Western Medicine Hospital from January to December 2016 were enrolled, and they were randomly divided into a study group and a control group (each 30 cases). The same basic treatment was given in the two groups, the patients in the study group were treated with sulfotanshinone sodium 40 mg intravenous (IV) drip, while the patients in the control group were treated with vinpocetine sodium chloride 20 mg IV drip, once a day for consecutive 14 days to complete a therapeutic course, and two courses were carried out in bothgroups. Before and after treatment, the changes of hearing threshold, indexes of hemorheology and immune function were compared between the patients in the two groups, and the clinical efficacy and adverse reactions in the two groups were observed.Results After treatment, the hearing threshold, hemorheology indexes, immune function index of CD8+ were significantly lower than those before treatment, while the CD3+, CD4+, CD4+/CD8+ ratio were significantly higher than those before treatment in the two groups, and the above changes of indexes were more obvious in the study group than those in the control group hearing [threshold (dB): 16.63±2.04 vs. 17.15±1.88, plasma viscosity (PV, mPa·s): 1.27±0.14 vs. 1.31±0.11, whole blood middle shearing viscosity (mPa·s): 4.77±0.33 vs. 4.95±0.28, whole blood high shearing viscosity (mPa·s): 3.86±0.25 vs. 4.00±0.31, erythrocyte aggregation index (EAI): 1.57±0.29 vs. 1.72±0.34, CD3+: 0.70±0.05 vs. 0.64±0.05, CD4+: 0.43±0.04 vs 0.37±0.03, CD8+: 0.32±0.04 vs. 0.34±0.03, CD4+/CD8+: 1.36±0.32 vs. 1.18±0.27]; the degree of whole blood low shearing viscosity (mPa·s: 6.72±0.80 vs. 7.01±1.13) and hematocrit (HCT: 0.38±0.04 vs. 0.40±0.03) decreasing weremore significant in the control group than those in the study group. The total effective rate was higher in study group than that in the control group [86.67% (26/30) vs. 83.33% (25/30)], but the difference between the two groups was not statistically significant (P > 0.05); the incidence of adverse reactions in the study group was markedly lower than that in the control group [3.33% (1/30) vs. 20.00% (6/30),P < 0.05].Conclusions Sulfot anshinone sodium injection can effectively enhance the SD patients' hearing, and improve their hemorheology indexes and immune function; the therapeutic results of sulfotanshinone sodium injection in safety and improvement in immune function are superior to those of vinpocetine sodium chloride injection.

BACKGROUND: Angiogenesis attracts much attention in tissue engineering field. Previous research has proved that a two-dimensional culture of vascular endothelial growth factor (VEGF) promotes angiogenesis.OBJECTIVE: To evaluate the effect of VEGF on three-dimensional angiogenesis.METHODS: Endothelial progenitor cells were separated from the SD rat bone marrow. At about 70%-80% fusion, rat tail collagen gel was added to establish three-dimensional models. Samples in the experimental group were incubated in complete culture solution containing M199 culture media, fetal bovine serum, VEGF, and double antibody. The samples in the control group were incubated with VEGF-free culture media. In vitro culture and amplification of bone marrow-derived endothelial progenitor cells were determined at 1, 4, 7, and-20 days after incubation. Morphology and quantitative analysis were performed at 3, 6, 9, and 12 days after three-dimensional model establishment.RESULTS AND CONCLUSION: Endothelial progenitor cells grew from three-dimensional matrix into collagen matrix in the experimental group. Budding and infiltration were observed in the collagen within 24 hours, and branching-like structure was then gradually formed. Cells in the control group grew slowly, with slowing budding, small tubiform structure, superficial infiltration into COllagen, sparse network structure, and non-intact. Numbers of newborn vessels in the expedmental group were significantly greater than control group (P<0.01). A detection on gel block showed positive expressions of endothelin-1 and endothelial nitric oxide synthase-3 on the 3~(rd), 6~(th), 9~(th), and 12~(th) days. The results demonstrated that VEGF mobilized and induced endothelial progenitor cells in order to promote angiogenesis. Rat tail collagen gel induced endothelial progenitor cells which behaved migration, proliferation, and pullulation of angiogenesis.

Drug Resistance, Bacterial ; Humans ; Time Factors ; Tuberculosis, Pulmonary ; drug therapy ; epidemiology ; surgery

BACKGROUND: To observe clinical features, clinical stagings, types ofpathology, treatment options and clinical effects of patients suffer from HIV infection combined with lung cancer, and also to provide guidance for individualized comprehensive treatment of HIV combined with lung cancer. METHODS: Through the retrospective analysis of 53 cases of HIV merger of lung cancer patients admitted in our department, 47 cases of non-small cell lung cancer (NSCLC), 6 cases of small cell lung cancer (SCLC), 24 cases accepted surgery combined chemotherapy, 22 patients with simple chemotherapy, 7 cases give up treatment; 28 cases are in stages I-III, 25 cases are in stage IV; 24 patients received combined chemotherapy in 28 patients with stages I-III, 2 cases gave up treatment, 2 cases with severe chronic obstructive pulmonary disease (COPD) could not tolerate chemotherapy plus surgery. According to the situation of patients before highly active anti-retroviral therapy (HAART) treatment, patients who received HAART before treatment were divided into observation group (n=27), patients who did not receive HAART were divided into control group (n=19). The survival and the independent influencing factors between the two groups were analyzed. RESULTS: Among the 53 HIV infected cases a toal of 46 patients received treatment among 53 cases of treatment in patients with lung cancer merger of HIV, there are no differences of 1 year survival rate, 2 years survival rate between observation group and control group; patients in I-III phase 1 year survival rate was 76.0%, 2 years survival rate was 60.0%. Patients in IV phase 1 year survival rate was 13.6%, 2 years survival rate was 0%. 24 patients with surgery combined chemotherapy 1 year survival rate was 83.3%, 2 years survival rate was 62.5%; 22 cases treated with simple chemotherapy 1 year survival rate was 18.0%, 2 years survival rate was 0%. CONCLUSIONS HIV merger in patients with lung cancer can improve the patients survival rate after different individualized comprehensive treatment, early surgery with combined chemotherapy has remarkable effect.
Adult ; Aged ; Anti-HIV Agents ; therapeutic use ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Antiretroviral Therapy, Highly Active ; Female ; HIV Infections ; complications ; drug therapy ; mortality ; Humans ; Lung Neoplasms ; complications ; drug therapy ; mortality ; surgery ; Male ; Middle Aged ; Neoplasm Staging ; Retrospective Studies ; Survival Rate

Objective:To explore the clinical effect of the 3D printing pre-installed screw channel model in assisting screw placement of single complete segmented congenital hemivertebrectomy.Methods:Clinical data of 13 children treated with single complete segmented congenital hemivertebrectomy in the Department of Spine and Spinal Surgery of Henan Provincial People′s Hospital from August 2016 to January 2019 were retrospectively analyzed.Among them, there were 5 males and 8 females with the mean age of 9.9 (5-14) years.Categorized by the lesion location, 3 cases were located at T 9, 2 cases at T 10, 5 cases at T 11, 1 case at T 12, and 2 cases at L 1.During the operation, the 3D printing pre-installed screw channel model was used to assist the placement of pedicle screws.The accuracy of screw placement was assessed by the postoperative CT.All children were routinely examined by full-length anterior and lateral X-ray of spine in the standing position before and after surgery to measure the Cobb angles at the coronal and sagittal view.Furthermore, the correction rate of scoliosis and kyphosis after surgery and during follow-up was also calculated.The One-Way repeated measures ANOVA was used to compare the Cobb angle of scoliosis and kyphosis before surgery, after surgery and during follow-up. Results:A total of 85 pedicle screws were placed in 13 children, with the accuracy rate of screw placement of 95.3%.The mean surgery time and intraoperative blood loss were (216.9±28.3) min, and (478.5±132.6) mL, respectively.Scoliosis Cobb was corrected from (57.1±12.7)° to (12.7±4.7)° with a correction rate of (78.4±5.9)%, which was (14.2±7.0)° at the last follow-up.Kyphosis angle was corrected from (46.2±8.4)° to (13.2±4.4)° with a correction rate of (72.6±7.0)%, which was (14.0±3.4)° at the last follow-up.None of the children had serious complications like vascular and nerve damage.The mean postoperative follow-up was 12.3 (6-18) months.No significant loss of angle was detected during the follow-up period.There were significant differences in the lateral and kyphotic angles after surgery and during follow-up compared with preoperative ones (all P<0.05). No significant difference was detected between the postoperative lateral and kyphotic angles and those at the last follow-up (all P>0.05). Conclusion:The 3D printing pre-installed screw channel model used to assist screw placement of single complete segmented congenital hemivertebrectomy can improve the precision of screw placement and the orthopedic effect on lateral kyphosis.

Objective:To explore the accuracy and repeatability of the smartphone scoliosis screening APP developed by our team in the measurement of the Cobb angle of adolescent idiopathic scoliosis (AIS).Methods:Clinical data of 60 patients with AIS admitted to Department of Spine and Spinal Surgery, Henan Province People′s Hospital from August 2020 to February 2021 were analyzed retrospectively.Three surveyors measured the coronal main curvature Cobb angle, sagittal thoracic kyphosis (TK) angle, thoracolumbar kyphosis (TLK) angle and lumbar kyphosis (LL) angle on whole-spine lateral X-ray films of 60 patients with AIS by means of the protractor, scoliosis screening APP and computerized Picture Archiving and Communication System (PACS). The time and results of each measurement were recorded.The measurement was repeated once after 2 weeks.Paired t-test was used to compare the measurement time of the APP method and the protractor method.Taking the Cobb angle measurement results of the PACS system as the reference standard, the accuracy of Cobb angle measurement by the APP method was analyzed by paired t-test.The repeatability of the surveyor and the consistency between the surveyors was compared by intraclass correlation coefficient (ICC). Results:Among the 60 patients with AIS, there were 17 males and 43 females, aged from 10 to 16 years [(12.2±2.4) years]. The main bends were thoracic curvature (Lenke Ⅰ) in 23 cases, Lenke Ⅱ in 18 cases and thoracolumbar curvature/lumbar curvature (Lenke V) in 19 cases.The APP method took significantly less time to measure the Cobb angle than the protractor method ( P<0.05). There was no significant difference in the Cobb angle measured by the APP method and PACS method ( P>0.05). The results of the coronal main curvature Cobb angle, TK angle, TLK angle and LL angle measured by 3 surveyors through the APP method were all in good agreement (ICC=0.990, 0.988, 0.986, 0.987). The repeatability (ICC 0.973-0.982) of the coronal main curvature Cobb angle, TK, TLK and LL measured twice before and after the APP method were both better that of the protractor method (ICC 0.933-0.954). Conclusions:Compared with the traditional protractor, the smartphone scoliosis screening APP has the advantages of short measurement time, high efficiency, excellent accuracy and good repeatability in measuring the Cobb angle of AIS.

Objective:To analyze the incidence and epidemiological characteristics of traumatic spinal cord injury in China in 2018.Methods:Multi-stage stratified cluster sampling was used to randomly select hospitals capable of treating patients with spinal cord injury from 3 regions，9 provinces and 27 cities in China to retrospectively investigate eligible patients with traumatic spinal cord injury admitted in 2018. National and regional incidence rates were calculated. The data of cause of injury，injury level，severity of injury，segment and type of fracture，complications，death and other data were collected by medical record questionnaire，and analyzed according to geographical region，age and gender.Results:Medical records of 4，134 patients were included in this study，with a male-to-female ratio of 2.99∶1. The incidence of traumatic spinal cord injury in China in 2018 was 50.484 / 1 million （95% CI 50.122-50.846）. The highest incidence in the Eastern region was 53.791 / 1 million （95% CI 53.217-54.365）. In the whole country，the main causes of injury were high falls （29.58%），as well as in the Western region （40.68%），while the main causes of injury in the Eastern and Central regions were traffic injuries （31.22%，30.10%）. The main injury level was cervical spinal cord in the whole country （64.49%），and the proportion of cervical spinal cord injury in the Central region was the highest （74.68%），and the proportion of lumbosacral spinal cord injury in the Western region was the highest （32.30%）. The highest proportion of degree of injury was incomplete quadriplegia （55.20%），and the distribution pattern was the same in each region. A total of 65.87% of the patients were complicated with fracture or dislocation，77.95% in the Western region and only 54.77% in the Central region. In the whole country，the head was the main combined injury （37.87%），as well as in the Eastern and Central regions，while the proportion of chest combined injury in the Western region was the highest （38.57%）. A total of 32.90% of the patients were complicated with respiratory complications. There were 23 patients （0.56%） died in hospital，of which 17（73.91%） died of respiratory dysfunction. Conclusions:The Eastern region of China has a high incidence of traumatic spinal cord injury. Other epidemiological features include high fall as the main cause of injury cervical spinal cord injury as the main injury level，incomplete quadriplegia as the main degree of injury，head as the main combined injury，and respiratory complications as the main complication.

According to the pathological characteristics of symptomatic chronic thoracic and lumbar osteoporotic vertebral fracture (SCOVF), the different clinical treatment methods are selected, including vertebral augmentation, anterior-posterior fixation and fusion, posterior decompression fixation and fusion, and posterior correction osteotomy. However, there is still a lack of a unified understanding on how to choose appropriate treatment method for SCOVF. In order to reflect the new treatment concept and the evidence-based medicine progress of SCOVF in a timely manner and standardize its treatment, the clinical guideline for surgical treatment of SCOVF is formulated in compliance with the principle of scientificity, practicability and advancement and based on the level of evidence-based medicine.