Objective To investigate the clinical manifestation,pathological characteristics,neurological imaging,indications,operative approach and microsurgieal technique of surgery for brain stem tumor.Methods 17 cases of brain stem tumor treated by applying microsurgical skills were retrospectively analyzed from Jan.2002 to Dec.2007.Ten cases were operated via the suboccipito-retromastoid approach,among which 5 situated in pons,3 in medulla oblongata and 2 invoved both pens and medulla oblongata;4 cases were performed via the posteromedian-suboccipital approach,among which 2 located in pens,1 in medulla oblongata and 1 involved both midbrain and pens;3 lesions situated in varying sites of mesencephalon were operated by the suboceipito-supratentorial,infratemporal approach and pterional approach respectively.Results In the series of the patients,lesion was totally excised in 6 cases,subtotally in one,without surgical mortality.All patients were followed up for years ranging from 5 months to 4 years.During the follow-up period,seven patients resumed work and normal life;4 patients could perform physical labor;3 patients obtained self care capability;2 patients needed to be taken care of,1 patient died from pneumonia after discharge.Conclusion Fine therapeutic efficacy and low disability rate could be obtained while applying microsurgical techniques to resect brain stem tumors with correct indication,appropriate approach and elaborate microneurosurgical skills.

Objective To compare the incidence of cardiopulmonary complications between treatment of video assisted thoracoscopic operation and traditional thoracotomy operation in elderly patients with non-small cell lung cancer.Methods 122 cases of elderly patients with non small cell lung cancer were treated in our hospital from Mar 2010 to Jun 2014,and randomly divided into observation group (therapeutic lobectomy by video assisted thoracoscopic operation) and control group (therapeutic lobectomy by traditional thoracotomy operation) (n=61,each).The postoperative cardiopulmonary complications and relevant indexes of cardiopulmonary function were analyzed and compared between the two groups.Results Before operation,there was no significant difference in the relevant indexes of cardiopulmonary function between the two groups (P＞0.05).After operation,the forced expiratory volume in one second (FEV1) and maximal ventilatory volume (MMV) were higher and the heart rate was lower in observation group than in control group (t=3.682,2.243,5.677,all P＜0.05).The incidence of cardiopulmonary complication was lower in observation group than in control group (13.1％ vs.27.9％,x2 =4.075,P=0.044).Conclusions Video assisted thoracoscopic operation is better for the recovery of cardiopulmonary function,and can reduce cardiopulmonary complication in elderly patients with non-small cell lung cancer.

The image guided radio therapy (IGRT) Imaging System based on cone-beam computer tomography (CBCT) can reach the goal of improving the accuracy of the radiotherapy. However, because the clinical registration between CBCT images and Planning CT images is carried out manually, it inevitably reduces radiation positioning accuracy to some extent. To tackle the problem, we proposed a new feature vector selection method for the CBCT image elastic registration in the framework of hierarchical attribute matching mechanism for elastic registration (HAMMER) algorithm. We analyzed the characteristics of HAMMER algorithm and used Canny operator which has a better edge detection and positioning performance to replace the noise-sensitive gradient amplitude. Therefore, we used a new attribute vector, which consisted of the intensity, Laplacian of the Gaussian and Canny operator, to ex tract the image feature points in CBCT and planning CT images. We also presented an adaptive feature-point selection method and the choice criteria of attribute vector weights. Experimental results showed that the new feature vector effectively avoided the noise interference resulted from scattering lines in CBCT images to improve registration accuracy, and it also decreased the required feature point numbers and reduced the computation redundancy, so that it provided a new approach for the clinical elastic registration of CBCT and Planning CT rapidly and accurately.
Algorithms ; Cone-Beam Computed Tomography ; Humans ; Radiotherapy ; methods ; Radiotherapy Planning, Computer-Assisted

To study the expression of transforming growth factor β1 (TGFβ1) and platelet-derived growth factor (PDGF) in alveolar type Ⅱ cells and their significance in the process of pulmonary fibrosis. MethodsCultivation of alveolar type Ⅱ cells were mode from normal adult rat and of silicotic animal model of rat was established. In situ hybridization and irnmunohistochemieal staining were applied to detect the gene expression of TGFβ1 and PDGF-B in the alveolar type Ⅱ cells of primary culture and silicotic tissue. Results(1) In situ hybridization and immunohistochemical staining showed the positive expression of TGFβi, PDGF-B rnRNAs and their relevant proteins in cultured alveolar type Ⅱ cells. (2) The positive expression of TGFβ1, PDGF-B rnRNAs and their proteins were prominent in the proliferative alveolar type Ⅱ cells of experimental group of silicotic models. Weak expression of TGFβ1 mRNA were found only in a part of normal alveolar type Ⅱ cells of control group. ConclusionThe proliferative alveolar type Ⅱ cells express TGFβ1 and PDGF-B, which may play an important role in silicotic fibrcsis.

With the development of the proteomics technology, more and more tumorous labeled substrates have been discovered and applied to clinical practice. This can provide the forepart diagnosis of tumor and prognosis monitoring with the reliable evidence. A summary is given of the study strategy of proteomics and its application in the prostatic carcinoma research.
Animals ; Biomarkers, Tumor ; analysis ; Humans ; Male ; Prostatic Neoplasms ; diagnosis ; Proteomics ; methods ; Sensitivity and Specificity

Objective To evaluate the potential risk of aorta injury by simulating different lateral misplacement patterns of thoracic pedicle screws (TPS) in the treatment of adolescent idiopathic scoliosis (AIS).Methods From December 2010 to August 2011,50 AIS patients were admitted to our hospital,including 7 males and 43 females,aged from 13 to 18 years (average,15.3±2.6 years).All patients underwent axial magnetic resonance imaging (MRI) scans from T5 to T12.The left pedicle-aorta (LtP-Ao) angle and distance were measured on the axial MR images by the software of PACS Client.The lateral misplacement of pedicle screw was simulated with variable direction errors (10°,20°,30°) and different lengths of pedicle screw (30 mm,35 mm,40 mm).A total of nine patterns of lateral pedicle screw misplacement were set up,and a warning misplacement was defined as the mimic pedicle screw crossed the aorta.The percentages of warning misplacement were compared in each pattern of lateral pedicle screw misplacement and each level from T5 to T12.Correlation analysis was made between the percentages of warning misplacement and the direction errors as well as length of pedicle screw.Results The mean LtP-Ao angle increased from 34.3°±8.5° at T5 level to 45.7°±4.1° at T7 level,and then gradually decreased to 9.2°±5.6° at T12 level.The mean LtP-Ao distance increased from 28.2±7.3 mm at T5 level to 37.7±6.5 mm at T12 level.The percentages of warning misplacement were positive correlation with the direction errors and length of pedicle screw.The percentage of warning misplacement was higher at the T11 level.Conclusion The potential risk of aorta injury increases with enlarging of direction error and lengthening of thoracic pedicle screw,particularly at the T11 level.

Objective Based on active monitoring MRSA carriage for hospitalized patients, the relationship between colonization pressure and MRSA cross transmission in wards without rigorous contactisolation measures was analyzed, and the role of colonization pressure in predicting MRSA cross transmission was further evaluated. Methods From March to December 2009, active MRSA colonization screening was performed for 240 hospitalized patients in emergency ward and 94 cases in RICU in our hospital. rep-PCR method was employed to do homology analysis on MRSA strains obtained in this study. MRSA weekly colonization pressure, threshold colonization pressure ,cross transmission rate were calculated respectively. RR of MRSA cross transmission under higher level of colonization pressure and lower level of colonization pressure was analyzed. Results MRSA carriage rates on admission for patients in emergency wards and RICU were 6. 25% (15/2A0) and 13. 83 % (13/94) ,and MRSA cross transmission occurred in 13 weeks and 14 weeks in above two units, respectively. Threshold colonization pressures for above two units were 6. 49%and 17. 66%, respectively. For emergency ward, the MRSA cross transmission rate under higher level of colonization pressure was significantly higher than that under lower level of colonization pressure (x2 = 7. 10,P＜0. 01), the RR of MRSA transmission was 9. 61 (95% CI:1. 25-74.00). For RICU, the MRSA cross transmission rate under higher level of colonization pressure was significantly higher than that under lower level of colonization pressure(x2 = 12. 60, P＜0. 01 ), the RR of MRSA transmission was 15.87 (95% CI:2. 06-122. 10). Conclusions Higher level of colonization pressure is an important risk factor for MRSA transmission, and average colonization pressure can be used as a prediction index for MRSA transmission and strengthening prevention and control measures.

Objective To investigate the correlation between heat-shock protein 70-2 (HSP70-2) gene+1267A/G polymorphism and coronary heart disease (CHD) in Han Chinese population. Methods Using the method of polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) , the polymorphism and genotype and allele distribution of HSP70-2 gene + 1267A/G in 185 CHD patients and 149 controls were analyzed. Results The HSP70-2 gene + 1267A/G polymorphism was found in this study population.The distribution of HSP70-2 genotypes was in Hardy-Weinberg equilibrium. The frequency of G allele in CHD group was significantly higher than that in control (61.89% vs51.68%, P ＜ 0. 01). After multiple logistic regression analysis, HSP70-2 gene (GG + AG) genotype was an independent risk factor of coronary heart disease. Conclusion HSP70-2 gene + 1267A/G polymorphism was associated with CHD risk of Han Chinese population, the G allele might serve as a genetic risk factor of coronary heart disease.

Objective To investigate the expression of connexin (Cx) 43, Cx26 gene in the thyroid tissue in patients with autoimmune thyroid diseases (AITD).Methods The thyroid tissue specimens of 76 cases were selected, including 30 cases of Graves disease (GD group), 30 cases of Hashimoto thyroiditis( HT group ), and 16 cases of normal tissues from thyroid adenoma (control group), which were all confirmed by pathologic diagnosis.The expression of Cx43 and Cx26 mRNA among three groups was determined by reverse transcriptase polymerase chain reaction (RT-PCR), and GAPDH,which was used as the internal control.Results The staining of Cx43 and Cx26 mRNA in all the cases from human thyroid tissue were strongly positive.The expression levels of Cx43,Cx26 mRNA in GD group were significantly higher than those in control group (0.9307 ± 0.0716 vs.0.5938 ± 0.0484 and 0.7371 ± 0.0463 vs.0.3431 ± 0.0399 ) (P ＜ 0.01 ).And the expression levels of Cx43,Cx26 mRNA in HT group were significantly lower than those in control group (0.3581 ±0.0458 vs.0.5938 ±0.0484 and 0.3150 ±0.0218 vs.0.3431 ±0.0399)(P＜0.01 or ＜0.05).Conclusion The Cx43 and Cx26 mRNA expression in the human thyroid tissue and a remarkable deferral expressions of Cx43 and Cx26 mRNA in three groups of AITD suggests that gap junction is associated with AITD.

Objective To investigate the risk factors and revision strategies for rod fracture in patients with severe kyphoscoliosis following posterior vertebral column resection (PVCR).Methods Between June 2003 and June 2011,7 patients (4 males and 3 females) who developed rod fractures following PVCR in our institution were retrospectively reviewed.The average age was 24.4 years (range,12-39 years) at the time of primary surgeries.The occurrence times and locations of the rod fractures were recorded and the risk factors for the fractures were analyzed.Results The occurrence times of the rod fractures ranged from 6 to 53 months.Five cases of fracture occurred within 2 years after the primary surgeries,while the other 2 cases occurred more than 4 years after the primary surgeries.Six cases of fracture occurred at levels of osteotomies and 1 case occurred at 1 level below the osteotomy.The potential reasons for rod fractures were listed as follows:(1)residual kyphosis (1 case); (2) residual kyphosis combined with unsteady gait (1 case); (3) residual kyphosis combined with single rod fixation (1 case); (4) residual kyphosis combined with malposition of titanium mesh cage (1 case); (5) residual kyphosis combined with anterior column defect; (6) injury (2 cases).Six patients underwent revision surgeries,5 patients received one-stage combined anterior-posterior approach surgeries,while 1 patient received single posterior surgery.They were followed up for 12 to 22 months (average,18months).At final follow-up,all patients obtained satisfying corrections and graft fusion,without internal fixationrelated complications.Conclusion Rod fractures mostly occur at levels of osteotomies within 2 years after PVCR.Residual kyphosis is the main risk factor for the rod fracture.Injury,anterior column defects,unsteady gait,single rod fixation and malposition of titanium mesh cage also increase risks of rod fractures.