Objective:To investigate the microsurgical anatomy of the far lateral suboccipital approach and to evaluate its application to surgical approach. Methods:Fourteen cadaveric heads(28 sides) were dissected through far lateral suboccipital approach to obtain the anatomical data of this approach.A retrospective analysis of microsurgical treatment in 12 cases of tumors situated at lower clivus and foramen magnum was performed. Results:Transverse process of C_1 and inferior occipital trangle were important anatomical marks in the far lateral occipital approach.Drilling the condyle and jugular tubercle was benefit to expand the surgical space.Total removal of the turmors was achieved in 9 patients,subtotal removal in 3 patients,and without any surgical morbidity. Conclusion:Study on the microsurgical anatomy of the far lateral suboccipital approach was helpful in resecting tumors situated at lower clivus and foramen magnum.

Objective To investigate the effect of dexmedetomidine ( Dex) combined with ropivacaine in brachial plexus block ( BPB) on serum basic fibroblast growth factor ( bFGF) levels of upper limb fracture patients in the perioperative period. Methods 80 patients ( ASA gradeⅠ~Ⅱ) scheduled for selective upper extremity surgery were randomly divided into the dexmedetomidine combined with ropiva-caine group ( RD group) and the ropivacaine group ( R group) with 40 patients in each group. BPB was performed at the point of 2 cm below coracoid directed by nerve stimulator. Ropivacaine (200 mg) was diluted into 40 mL in group R and ropivacaine (200 mg) +1 μg/kg dexmedetomidine were diluted into 40 mL in group RD. Drew 5 mL blood at T0~T4 points respectively,and serum bFGF concentration were determined. Results Compared with group R,MAP and HR at T1~T3 points were significantly lower in group RD (P<0. 05). SpO2 in the two groups at each point had no statistical significance (P>0. 05). Compared with T0 points,bFGF concentration were increased in two groups at T1~T4 points (P<0. 05),and it was higher in group RD compared with group R (P<0. 05). Conclusion Dex combined bra-chial plexus block promote the secretion of bFGF more than simple brachial plexus block,which is conducive to fracture healing after opera-tion,but it should be cautious to apply for patients with bradyarrhythmia.

Objective To understand the study habits of medical postgraduates in basic cours-es so as to provide references for the reformation of teaching methods. Methods Totally 250 postgra-duates of grade 2010 in our university were investigated with self-made questionnaire. The contents of the questionnaire included basic condition of postgraduates, study methods and suggestions for teaching methods. Rate, percentage and Chi-square test were applied to do statistical analysis. Results Accor-ding to the results of the collected 246 copies of questionnaire, 91.5%(225/246) did not preview lessons before class, 93.5%(230/246) took notes in class, 78.9%(194/246) simply took notes in the book, 60.6%(149/246) preferred more detailed courseware and 27.2%(67/246) reviewed lessons after class. The percentage of simply taking notes in the book of local students (86.5%) was significantly higher than that of army ones (73.2%) (P=0.030), but the percentages of preferring more detailed courseware and reviewing lessons after class of local students were significantly lower than those of army ones (P=0.008, P=0.016). Conclusions The proportion of previewing before class is low among postgrauates. Postgraduates depend heavily on teachers and do not review after class in time. There are differences between local students and army students in taking notes and review habits. It is important to cultivate postgraduates’good study habits.

Objective To investigate the efficacy and toxicity of conventional fractionated three-dimensional conformal radiotherapy (3D-CRT) on unresectable hepatocelluar carcinoma(HCC).Methods Fifty two patients with unresectable HCC,all without extrahepatic metastases,were treated by 3D-CRT conducted 5 times a week with the total radiation dose of 36-66 Gy and a daily dose of 2 Gy.The curative effect was evaluated by CT scan to observe the maximum tumor size.Survival rates,survival time,and adverse responses were recorded.Results The total effective rate of the 52 patients was 69.2％ with complete response (CR) in 2 patients and partial response (PR) in 34 patients.The incidence rate of radioactive hepatitis was 1.92％.The 1-,2-,3-,and 4-year survival rates were 57.7％,34.6％,23.1％,and 9.61％ respectively,and the median survival time was 10.5 months.The 1-,2-,3-,and 4-year local control rates were 67％,51.5％,32.3％,and 2.24％,and the 1-,2-,3-,and 4-year distant metastasis rate were 17.2％,23.5％,36.7％,and 76.9％ respectively.The intrahepatic metastases rate was 62.5％ and 37.5％ of the patients suffered from extrahepatic metastasis,including metastases of lung,bone,and retroperitoneal lymph nodes.The remission rate of the≥50 Gy group was 76.9％,significantly higher than that of the ≤50 Gy group (46.2％,x2 =10.72,P ＜ 0.05 ).There was no grade 3 or 4 acute toxicity,and two patients (3.84％) developed gastric or duodenal ulcer.Conclusions Conventional fractionaled 3D-CRT evokes a rather effective response for unresectable HCC with acceptable toxicity.Radiation dose seems to be a significant prognostic factor in RT response for HCC.

Osteosarcoma is suggested to be caused by genetic and molecular alterations that disrupt osteoblast differentiation. Recent studies have reported that transmembrane protein 119 (TMEM119) contributes to osteoblast differentiation and bone development. However, the level of TMEM119 expression and its roles in osteosarcoma have not yet been elucidated. In the present study, TMEM119 mRNA and protein expression was found to be up-regulated in osteosarcoma compared with normal bone cyst tissues. The level of TMEM119 protein expression was strongly associated with tumor size, clinical stage, distant metastasis and overall survival time. Moreover, gene set enrichment analysis (GSEA) of the Gene Expression Omnibus (GEO) GSE42352 dataset revealed TMEM119 expression in osteosarcoma tissues to be positively correlated with cell cycle, apoptosis, metastasis and TGF-β signaling. We then knocked down TMEM119 expression in U2OS and MG63 cells using small interfering RNA, which revealed that downregulation of TMEM119 could inhibit the proliferation of osteosarcoma cells by inducing cell cycle arrest in G0/G1 phase and apoptosis. We also found that TMEM119 knockdown significantly inhibited cell migration and invasion, and decreased the expression of TGF-β pathway-related factors (BMP2, BMP7 and TGF-β). TGF-β application rescued the inhibitory effects of TMEM119 knockdown on osteosarcoma cell migration and invasion. Further in vitro experiments with a TGF-β inhibitor (SB431542) or BMP inhibitor (dorsomorphin) suggested that TMEM119 significantly promotes cell migration and invasion, partly through TGF-β/BMP signaling. In conclusion, our data support the notion that TMEM119 contributes to the proliferation, migration and invasion of osteosarcoma cells, and functions as an oncogene in osteosarcoma.
Apoptosis ; Bone Cysts ; Bone Development ; Cell Cycle ; Cell Cycle Checkpoints ; Cell Movement ; Dataset ; Down-Regulation ; Gene Expression ; In Vitro Techniques ; Neoplasm Metastasis ; Oncogenes ; Osteoblasts ; Osteosarcoma* ; RNA, Messenger ; RNA, Small Interfering ; Up-Regulation*

OBJECTIVE: To investigate the expression of costimulatory molecule Tim3 and its subsets on NK cells in patients with acute myeloid leukemia. METHODS: 30 patients with acute myeloid leukemia treated in our hospital from August 2016 to August 2018 were randomly selected as the AML group, and 30 healthy persons in our hospital during the same period were randomly selected as the control group. The expression levels of CD56 RESULTS: The expression levels of CD56 CONCLUSION The expression of costimulatory molecule Tim3 in NK cells and its subsets of patients with acute myeloid leukemia is down-regulated.
CD56 Antigen ; Flow Cytometry ; Hepatitis A Virus Cellular Receptor 2 ; Humans ; Killer Cells, Natural ; Leukemia, Myeloid, Acute ; Patients

OBJECTIVETo study the effect of endoscopic-assisted keyhole operation (EAKO) on treating hypertensive intracranial hematomas and the value of our patent dissector applied during the operation.

METHODSA total of 25 patients with hypertensive intracranial hematomas underwent endoscopic-assisted keyhole evacuation, during which, the viewing dissector, which had recently achieved national patent, was connected to the tip of endoscope and used to help dissect hematomas. The outcome of this procedure were compared with those of 22 comparable cases undergone conventional surgical treatment (large or smaller craniotomy). The items for comparison included the volume of remaining hematoma, the duration of operation, postsurgical Glasgow Coma Scale (GCS) and Glasgow Outcome Scale (GOS).

RESULTSRemaining hematoma was ascertained 48 h after operation with the use of computerized tomography (CT) scans. In the case of EAKO, nearly complete evacuation (> 84%) was achieved in 21 cases; GCS was evaluated at 7 d postsurgery resulting in GCS > 12 in 9 patients, GCS 9 - 12 in 12 patients and GCS < 9 in 4 patients. The follow-up period ranged from 6 to 21 mon. GOS was estimated at half a year and good recovery rate as defined by GOS was assigned to 76% of the EAKO patients. There are significant differences in the volumes of remaining hematomas and the duration of operation between the EAKO and craniotomy group (P < 0.05). In addition, better clinical outcomes were obtained in EAKO.

CONCLUSIONEAKO has the advantage of being minimally invasive, improving surgical results and the prognosis of hypertensive intracranial hematoma patients. We conclude that keyhole operation is a safe, effective alternative for removal of hypertensive intracranial hematoma, particularly during acute stages.

Aged ; Cerebral Hemorrhage ; surgery ; Dissection ; Endoscopy ; Female ; Hematoma ; surgery ; Humans ; Hypertension ; complications ; Male ; Middle Aged ; Neurosurgical Procedures ; methods

Objective To evaluate the efficacy of acupoint catgut embedding combined with abdominal massage in the treatment of female abdominal obesity with spleen deficiency and dampness. Methods A total of 300 female abdominal obesity patients who met the inclusion criteria were divided into observation group (200 cases) and control group (100 cases) according to the ratio of 2:1 by random number table. The control group was treated with abdominal massage, while the observation group was treated with acupoint catgut embedding on the basis of the control group. The changes of body weight, waist circumference, waist-hip ratio, BMI, FPG, TC and TG levels before and after treatment were compared between the two groups, and the clinical efficacy was evaluated. Results After treatment, the body weight, waist circumference, waist-hip ratio and BMI of the observation group were significantly lower than those of the control group (t values were 10.869, 6.058, 2.941, 21.267, P<0.01 or P<0.05), and the serum levels of FPG, TC and TG were significantly lower than those of the control group (t values were 21.147, 18.325, 19.931, P<0.01). The total effective rate was 91.5％ (183/200) in the observation group and 65.0％ (65/100) in the control group. There was significant difference between the two groups (χ2=32.671, P<0.001). Conclusions Acupoint catgut embedding combined with abdominal massage can improve the obesity index and blood lipid level of women with abdominal obesity, and the curative effect is better than that of abdominal massage alone.

Background Diseases severely affect the efficiency of workers. Comorbidity refers to the coexistence of two or more chronic diseases or health problems in the same individual. Previous studies have primarily focused on occupational injuries caused by environmental exposures, while the analysis of the epidemiological characteristics of self-reported diseases and occupational injuries among manufacturing workers has been insufficient. Objective To analyze the distribution of self-reported diseases and occupational injuries among manufacturing workers, the strength of correlation between different diseases, and common disease combinations, and to preliminarily explore the relationship between self-reported diseases and occupational injuries. Methods A cross-sectional survey was conducted to investigate the occupational injuries of 2382 workers in 2 manufacturing enterprises over the past year, and 2355 questionnaires were valid after cleaning. The questionnaire included three parts: basic information, occupational injury occurrence, and disease prevalence. The self-reported diseases diagnosed by physicians included musculoskeletal diseases, cardiovascular diseases, respiratory diseases, mental health problems, neurological and sensory organ diseases, digestive organ diseases, reproductive and urinary organ diseases, skin diseases, tumors, endocrine and metabolic system diseases, blood diseases and birth defects, a total of 11 types. Log-binomial model was used to calculate the prevalence ratio (PR) value of the association between different diseases, and UpSet diagram was used to present the disease combination pattern. Results In total, 40.2% (946/2355) of the study participants reported at least one disease, while 8.6% (203/2355), 5.2% (122/2355), and 5.9% (140/2355) reported having two, three, and four or more diseases, respectively. A higher prevalence was observed for musculoskeletal diseases, neurological and sensory organ diseases, digestive organ diseases, and skin diseases, which accounted for 18.0% (423/2355), 13.8% (324/2355), 9.3% (218/2355), and 9.1% (214/2355), respectively. Workers with musculoskeletal disorders, cardiovascular diseases, or neurological and sensory organ diseases reported significantly higher incidence of occupational injuries compared with workers without the corresponding diseases (P<0.001, P=0.041, and P=0.006, respectively). Musculoskeletal diseases were strongly associated with comorbidities of neurological and sensory organ diseases (PR values were 1.86 and 1.98, respectively), and the other patters were musculoskeletal diseases and digestive organ diseases (PR and OR values were 1.57 and 2.35, respectively), and musculoskeletal diseases and cardiovascular diseases (PR and OR values were 1.46 and 2.22, respectively). The largest binomial comorbidity group involved musculoskeletal diseases and neurological and sensory organ diseases, accounting for 5.4% (25/465) of the comorbid workers. Conclusion Among the self-reported diseases of manufacturing workers, musculoskeletal diseases, neurological and sensory organ diseases, digestive organ diseases, and skin diseases are more common. Musculoskeletal diseases and neurological and sensory organ diseases are the most common in all comorbidities. Musculoskeletal diseases, cardiovascular diseases, and neurological and sensory organ diseases are associated with occupational injuries. In the prevention and control of occupational injuries, joint prevention strategies targeting multiple diseases should be strengthened.

Construction of smart hospitals is of great significance to the substantial development of medical institutions and the reform of medical and health systems and meanwhile it serves as a crucial support for the high-quality development of pub-lic hospitals.Guangdong Second Provincial General Hospital actively responds to national policies,constantly exploring standard-ized application of new smart medical technology.It has successfully built itself into a first full-scene smart hospital.Through gradually deepening the intelligent construction of hospitals,the hospital has achieved obvious achievements in hospital manage-ment such as medical services,medical resources,medical data,hospital operation logistics,and medical environment improve-ment.Their practical experience can provide references for the intelligent construction of hospitals domestically.