To study the clinical characteristics and surgical treatment of congenital scoliosis with diastematomyelia, four patients were found to have scoliosis with diastematomyelia by CT and MRI.The first step of surgery was to excise the osteal compartion in spinal cord, the second step was the posterior scoliosis correction and fusion after two weeks. All the patients had successful surgery. The body height of the patients increased 4 75cm and the Cobb angle deceased 43? in average. No complication was found in the nervous system. This method is very effective, and is worth popularizing its application.

Antigens, CD ; metabolism ; B7-1 Antigen ; metabolism ; CD28 Antigens ; metabolism ; CTLA-4 Antigen ; Child ; Humans ; Interleukin-2 ; metabolism ; Mucocutaneous Lymph Node Syndrome ; immunology ; metabolism ; RNA, Messenger ; genetics ; Receptors, Immunologic ; metabolism

AIM:To observe the expression of Smad7 and Smad ubiquition regulatory factor-Smurf2 in rat glomerular mesangial cells (GMC) stimulated by the high concentration of glucose,and to investigate the effect of the ubiquition on Smad signaling by adding MG132 as a proteasome differential inhibitor. METHODS:Cultured rat GMC were divided into normal group (the concentration of glucose:5.6 mmol/L),high glucose group (20 mmol/L,30 mmol/L,respectively),therapy group (30 mmol/L glucose with MG132). The expressions of Smurf2 and Smad7 in each group were measured by indirect immunofluorescence and laser scanning confocal microscope. RESULTS:(1) The expression of Smurf2 in GMC in normal group was weak (25.93?3.35) whereas the expression of Smad7 was strong (64.09?7.43). (2) The expression of Smurf2 in high glucose group was stronger than that in normal group (P

Objective To assess the effect of family doctor team care on morbidity of disabled elderly in home care.Methods Eighty six disabled elderly patients with home care in Shanghai Xujiahui community were enrolled from February 2014 to January 2015.The patients were randomly divided into intervention group and control group with 43 cases in each.In intervention group,the family doctor team provided long-term,comprehensive and integrated care,and in control group the conventional home care was provided.The rates of morbidity and readmission to hospital were documented during the 3,6 and 12 monthfollow-up,and compared between two groups.Results The incidence rates of bedsore,pneumonia and deep vein thrombosis in intervention group was significantly lower than those in control group [after 6 months:4.9％ (2/41) vs.28.9％(11/38),x2 =8.311;2.4％ (1/41) vs.21.1％ (8/38),x2 =6.769;2.4％ (1/41) vs.15.8％ (6/38),x2 =4.353,respectively;after 12 months:2.4％ (1/41) vs.42.1％ (16/38),x2 =18.374;4.9％ (2/41)vs.28.9％ (11/38),x2 =8.311;7.3％ (3/41)vs.28.9％ (11/38),x2 =6.328,respectively;all P ＜0.05].The number of cases with bedsore healing(6/7 vs.0,x2 =18.555)and pneumonia recovery[5/6 vs.4.3％ (1/23),x2 =18.092] was significantly more and that with pneumonia deterioration (0 vs.52.2％ (12/23),x2 =5.340)was significantly less in intervention group than those in control group (all P ＜ 0.05).More cases with deep vein thrombosis improved(1/3 vs.0,x2 =3.949) and less cases with deep vein thrombosis deteriorated(0 vs.8/11,x2 =5.091) in intervention group than those in control group (P ＜ 0.05).And both the readmission rate for home care patients [2.4％ (1/41) vs.36.8％ (14/38),x2 =15.175] and for patients with complications [1/12 vs.43.8％ (14/38),x2 =4.872] was much lower in intervention group than that in control group (both P ＜ 0.05).Conclusion The family doctor team care can reduce the risk of complications and readmission to hospital,and also can improve the quality of life of home care disabled elderly,as well as reduce the burden of family and society.

Objective To analyze the MRI imaging feature and the clinical feature of pituicytoma. Methods The clinical data and imaging feature of 10 patients with pituicytoma who were proved histologically were retrospectively studied. Visual disturbances disorder and headache were the main complaints of all patients. One patient had sexual function decline. All patients were given the examination of MRI and showed saddle area were occupied. Results Most of pituicytoma was circular or oval morphologically. Pituicytoma located at suprasellar region in 4 patients, in the sellar in 2 patients and over the sellar region in 4 patients.In them, cystic change occured in 1 patient. In most of the cases, the tumor showed isointensity on T1WI, isointensity or slightly hyperintensity on T2WI. After injection of contrast medium, the tumor showed homogeneous enhancement in early stage. Pathological markers:S-100, and vimenlin indicated 100%positive;glial fibrillary acidic protein(GFAP), synaptophysin (SYN) and epithelial membrane antigen(EMA) indicated 50% positive. Six patients′serum endocrine function test:the levels of serum total triiodothyronine (TT3), total thyroxine (TT4), free triiodothyronine (FT3), free thyroxine (FT4), thyroid stimulating hormone (FSH), luteinizing hormone (LH) had different degrees of reduction in 4 patients, and these index were normal in 2 patients. Conclusions On MRI, pituicytoma has certain characteristics which might help clinical diagnosis combined with the clinical manifestation and endocrine function tests.

OBJECTIVETo evaluate the efficacy and safety of testosterone undecanoate (TU) in the treatment of late-onset hypogonadism (LOH) by meta-analysis.

METHODSWe searched Pubmed (until April 1, 2014), Embase (until March 28, 2014), Cochrane Library (until April 17, 2014), CBM (from January 1, 2001 to February 2, 2014), CNKI (from January 1, 2001 to February 2, 2014), Wanfang Database (from January 1, 2000 to February 2, 2014), and VIP Database (from January 1, 2000 to Febru ary 2, 2014) for randomized controlled trials of TU for the treatment of LOH. We evaluated the quality of the identified literature and performed meta-analysis on the included studies using the Rveman5. 2 software.

RESULTSTotally, 14 studies were included after screening, which involved 1 686 cases. Compared with the placebo and blank control groups, TU treatment significantly increased the levels of serum total testosterone (SMD = 6.22, 95% CI 3.99 to 8.45, P < 0.05) and serum free testosterone (SMD = 4.35, 95% CI 1.86 to 6. 85, P < 0.05) but decreased the contents of luteinizing hormone (WMD = -2.23, 95% CI -4.03 to -0.42, P < 0.05), sex hormone binding globulin (WMD = 2.00, 95% CI 1.38 to 2.63, P < 0.05). TU also remarkably reduced the scores of Partial Androgen Deficiency of the Aging Males (WMD = -9.49, 95% CI -12.96 to -6.03, P < 0.05) and Aging Males Symptoms rating scale (WMD = -2.76, 95% CI -4.85 to -0.66, P <0.05) but increased the hemoglobin level (SMD = 2.35, 95% CI 0.29 to 4.41, P < 0.05) and packed-cell volume (SMD = 4.35, 95% CI 1.36 to 7.33, P < 0.05). However, no significant changes were shown in aspertate aminotransferase, alanine transaminase, prostate-specific antigen, or prostate volume after TU treatment (P > 0.05).

CONCLUSIONTU could significantly increase the serum testosterone level and improve the clinical symptoms of LOH patients without inducing serious adverse reactions. However, due to the limited number and relatively low quality of the included studies, the above conclusion could be cautiously applied to clinical practice.

Androgens ; therapeutic use ; Hemoglobin A ; metabolism ; Humans ; Hypogonadism ; blood ; drug therapy ; Luteinizing Hormone ; blood ; Male ; Prostate-Specific Antigen ; Randomized Controlled Trials as Topic ; Sex Hormone-Binding Globulin ; metabolism ; Testosterone ; adverse effects ; analogs & derivatives ; blood ; pharmacology

Objective To find out the situation of household consumption of iodized salt in Hebei province so as to provide scientific basis for prevention and control of iodine deficiency disorders(IDD). Methods According to the "national iodine deficiency disorders surveillance program (Trial)", the county (city, district) was taken as a unit, township (town) and administrative villages were selected in accordance with the principle of systematic sampling, then households were chosen by random sampling to collect their edible salt in Hebei province from 2007 to 2009. Salt iodine content was detected by direct titration method. Results A total of 48 675, 48 448 and 48 756 salt samples were collected from 2007 to 2009, respectively. The consumption rate of qualified iodized salt from 2007 to 2009 was 91.16%, 91.96% and 96.17%, respectively. There were 24.6%(41/167)and 18.0%(30/167)counties with consumption rate of qualified iodized salt under 90% in 2007 and 2008, respectively. The percentage of counties with consumption rate of qualified iodized salt above 90% was 100.0%(167/167) in 2009. In general there was a significant differences in frequency distribution of consumption rates of qualified iodized salt among the three years(H = 10.778, P ＜ 0.01 ), and the difference was found significant between 2007 and 2009 as well as between 2008 and 2009(all P ＜ 0.05), but was not significant between 2007 and 2008(P ＞ 0.05). Conclusions The consumption rate of qualified iodized salt at household level increases annually from 2007 to 2009. By 2009,the consumption rate of qualified iodized salt in each county is more than 90%, which has reached the national standard stipulated in "the evaluation programs for fulfilling the goal of eliminating IDD at county level".

Objective To investigate the expression of guanylyl eyelasec(GC-C)mRNA in pefipheral blood of colorectal cancer patients and discuss its clinical significance. Methods To detect the GC-C mRNA in peripheral blood of colorectal cancer patients by reverse transcriptase PCR and analysis their clinical and pathological indexes. Results The positive rate of GC-C mRNA in 52 colorectal cancer patients was 50%(26/52),while to patients with extra-intestinal cancer,the positive rate was 0(0/8).There were significant difierences of positive rate of GC-C mRNA associated with tumor infiltration(P＜0.05)and tumor embolus in vessel(P＜0.05).While to CEA level in peripheral blood(P＞0.05),but there were no statistical difference.The positive rate of micrometastasis in coloreetal cancer patients might increase using the GC-C mRNA combined with CEA level in peripheral bood.The positive rate of GC-C mRNA in colorectal cancer patients with Dukes A、B、C and D stages were 0(0/3),47.06%(8/17),52.38%(11/21),63.63%(7/11),The expression of GC-C mRNA increased with the clinical stage chang,there was no statistical difference.Conclusions GC-C expresses selectively in peripheral blood of colorectal cancer patients.Itis a valuable new tumor marker in micrometastasis diagnosis and post-operation follow-up of colorectal cancer,and it can also be used as the location determination of metastasis intestinal tumor.

The basic stress pathway above the acetabular dome is important for the maintenance of implant stability in acetabular reconstruction of total hip arthroplasty (THA). The purpose of this study was to describe the basic stress pathway to provide evidence for clinical acetabular reconstruction guidance of THA. A subject-specific finite element (FE) model was developed from CT data to generate 3 normal hip models and a convergence study was conducted to determine the number of pelvic trabecular bone material properties using 5 material assignment plans. In addition, in the range of 0 to 20 mm above the acetabular dome, the models were sectioned and the stress pathway was defined as two parts, i.e., 3D, trabecular bone stress distribution and quantified cortical bone stress level. The results showed that using 100 materials to define the material property of pelvic trabecular bone could assure both the accuracy and efficiency of the FE model. Under the same body weight condition, the 3D trabecular bone stress distributions above the acetabular dome were consistent, and especially the quantified cortical bone stress levels were all above 20 MPa and showed no statistically significant difference (P>0.05). Therefore, defining the basic stress pathway above the acetabular dome under certain body weight condition contributes to design accurate preoperative plan for acetabular reconstruction, thus helping restore the normal hip biomechanics and preserve the stability of the implants.
Acetabulum ; anatomy & histology ; Arthroplasty, Replacement, Hip ; Biomechanical Phenomena ; Finite Element Analysis ; Hip Prosthesis ; Humans ; Imaging, Three-Dimensional ; Stress, Mechanical ; Tomography, X-Ray Computed

Objective To determine the diagnostic value of double-phase enhancement and virtual endoscopy with multi-slice spiral CT (MSCT) on clinical staging of preoperative bladder cancer.Methods Seventy-five patients with bladder cancer diagnosed by fibercystoscope or operation. All of them were examined by double-phase enhancement and virtual endoscopy with MSCT. The images were analyzed and clinical staging were obtained. The findings of MSCT (71 cases)were compared with the post-operative histopathological results. Results There were 94 lesions to be found. The staging of MSCT: T1 26 cases,T2, 27 cases, T2b 13 cases, T3 12 cases, T4 16 cases. Histopathological results: pT1 28 cases, pT2a 24 cases, pT2b 14 cases, pT3 12 cases, pT4 16 cases. The sensitivity of preoperative staging on bladder cancer was 89.4 % (84/94) by double-phase enhancement of MSCT;the sensitivity of virtual endoscopy was 96.6% (84/87)for polyploidy tumors and 90. 9 % (10/11) for sessile lesions. When double-phase enhancement and virtual images were evaluated together, the sensitivity rate increased to 94.5%. When the tumors were confined within the bladder wall (≤T2b), the diagnostic accuracy of double-phase enhancement and virtual images was 91.2% (51/56). When the tumors had invaded the tissues and organs beyond the bladder wall (≥T3), the accuracy was 100% (28/28). Conclusion Double-phase enhancement and virtual endoscopy of MSCT is of great value in clinical staging of bladder cancer.