Objective To investigate the clinical value of computer-assisted navigation system (CANS) in pedicle screw placement. Methods From August 2002 to June 2006, we carried out 66 cases of pedicle screw placement under the guidance of CANS; 66 cases of traditional pedicle screw placement were set as a control. Results The mean operation time of CANS group was significantly shorter [(142.3?5.3) min vs (173.4?7.1) min; t=-28.301, P=0.000] and the blood loss was significantly fewer [(798.3?10.9)ml vs (912.2?14.3) ml; t=-51.463, P=0.000] than those in the control. X-ray and CT scan respectively showed that the placement of pedicle screw in CANS group was significantly more accurate than that in the control. (?2=29.424, P=0.000; ?2=36.829, P=0.000). Conclusion Pedicle screw placement under the guidance of CANS is more accurate, safe, and micro-invasive than traditional operation.

OBJECTIVE: To investigate the current situation of early diagnosis and intervention in 0-9 months old infants with hearing loss and analysis factors that will affect early diagnosis and intervention. METHOD: One hundred and eighty-six infants referred to the West China hospital from February 2014 to September 2014 were included. All 186 children were referred due to the fact that either they failed infant hearing screening or outer ear malformation. Early diagnosis and/or intervention were performed on those 186 children and their records of early diagnosis and intervention were analyzed. RESULT: Among the 186 infants, 167 (89.8%) were diagnosed with an average age at (4.0 ± 1.4) months. Among the 167 infants with final diagnosis, there were 31 (18.6%) infants diagnosed as conductive hearing loss (CHL), and 99 cases (59.3%) diagnosed as sensorineural hearing loss (SNHL), among whom, there were 75 (44.9%) bilateral SNHL and 24 (14.4%) unilateral SNHL. There were 2 cases (1.20%) with SNHL on one side and atresia on the other side. 5 (2.99%) of all conductive hearing loss cases with unilateral atresia and 2 cases with auditory neuropathy (AN) were found. 33 infants (19.8%) were found to have normal hearing. 30.7% (23/75) infants diagnosed as bilateral SNHL and 8.3% (2/24) infants diagnosed as unilateral SNHL were fitted with hearing aids. The fitting rate in infants with bilateral SNHL with mild, moderate, severe to profound degrees were 0 (0/23), 24.0% (6/25), 66.7% (6/9), 61.1% (11/18) respectively. The average intervention age was (5.0 ± 2.1) months. CONCLUSION Although the early diagnosis and intervention situation in this study are very close to international standard, there are still infants without final diagnosis and infants with hearing loss without hearing aid fitting. Further studies and efforts to promote early diagnosis and intervention in infants with hearing loss are needed.
China ; Deafness ; Early Diagnosis ; Hearing Aids ; Hearing Loss, Bilateral ; Hearing Loss, Central ; Hearing Loss, Conductive ; diagnosis ; Hearing Loss, Sensorineural ; diagnosis ; Hearing Tests ; Humans ; Infant ; Infant, Newborn

Objective To report the clinical and pathological features of the sensory neuropathy caused by a combined therapy of telbivudine and pegylated interferon α-2a in 2 patients with hepatitis B virus infection Methods Two male patients aged 48(case 1)and 20(case 2),who suffered from hepatitis B virus infection.were given telbivudine and pegylated interferon α-2a.After 4 months treatment,both patients developed numbness and pain in the lower limbs.The physical examination showed decreased pain sensation in distal extremities.Hypahidrosis appeared in distal extremities.The nails were pale changed in fingers and toes in cage 1.Case 2 presented mild weakness in the proximal muscle of lower limbs and the tendon reflex was decreased in both lower limbs.His 8erunl creatine kinase level was mild elevated.The electromyography examination and sural nerve biopsies were performed on both patients.Results Electromyography examination showed significant decrease of amplitude of sensory nerve action potentials and mild decrease of sensory nerve conduction velocities in both patients.The amplitude of motor nerve action potentials was also decreased in case 2.Light microscope examination revealed middle reduction of myelinated fibers,wallerian degeneration of myelinated fibers and small clusbers of regenerated fibers in sural nerve.Electro microscopy examination revealed the loss of unmyehnated nerve fibers.After the combined therapy was stopped and vitamin B,CoQ10 and L-camitine were administered,the patients recovered gradually.Conclusions Combined therapy of telbivudine and pegylated interferon α-2a may cause sensory neuropathy with electrophsiological and pathological abnormalities of axonal lesions.The sensory neuropathy induced by the combined therapy may be reversible.

Objective To analyze the prognostic factors of nasopharyngeal carcinoma treated with radiotherapy.Methods 135 preliminary diagnosed patients were selected and treated with radiotherapy to a total dose of 68～80 Gy in 7～8 weeks. In order to analyze the factors affecting prognosis of NPC,SPSS analysis and Cox regression analysis were used to identify the prognostic factors.Results The overall 10-year survival rate was 48 9%; Univariate analysis suggested that 8 out of 13 items were significant factors for prognosis (P

Objective To evaluate the feasibility and efficacy of percutaneous intratumor injection of gene-immunotherapy combined with capacitive radio-frequency hyperthermia treatment for advanced lung carcinoma under CT guided.Methods Thirty-one unresectable peripheric lung carcinomas(29 men and 2 women,10 squamous carcinomas,15 denocarcinoma and 6 alveolus carcinomas) in clinical Ⅲ~Ⅳ stage were undergone percutaneous intrastumor injection of H101 and ⅠL~Ⅱ under CT guided,and repeated at 8,29,35,57 and 64 d respectively as one course.During interventional therapy,radio-frequency hyperthermia carried out twice one week,totally 12 times per-patient.After one course 4 weeks later,the blood TSGF levels and CT changes of the tumors were observed.Results The short period effect included:CR in 0 case,PR in 22 cases,NC in 6 cases and PD in 3 cases,the total short-term efficacy rate was 71 percent(22/31).Significant statistical difference was found in the positive rate and quantitative level of the blood TSGF after on cycle(P

[Objective]To modify posterior lumbar interbody fusion for improvement of convenient manipulation and safety in the operation,and solid fusion. [Methods]After total decompression of the spinal nerve through posterior medline approach,discectomy of the slipping segment was performed with a circular saw with diameter of 1.0 centmeter.Under direct visualization through the hole of the circular saw,the disc tissue including cartilage of upper and lower end plates was removed with a long handle curette.After pedicle screw and rod system was placed,a bone block harvested from the posterosuperior iliac with a circular saw with diameter of 1.2 centmeter was implanted into the intervertebral space.Then compression of the intervertebral space to catch the bone lock firmly was conducted by regulating and fixing the the pedicle screw and rod system.[Results]Forty-eight patients in this report were followed up from 6 to 24 months.Based on JOA low back pain score,there were 36 patients was in excellent result,8 in good and 4 in fair,the satisfactory rate was 91.67% and effective rate was 100%.[Conclusion]Using circular saws in posterior lumbar interbody fusion has advantagas of good visualization profit removing disc tissue,preventing neurovascular injuries,and making good bone grafting bed.Convenient and secure bone harvesting decrease blood loss,time consume during the operation and prevent donor site complication.Futhermore,follow up results of the patients in this report demonstrate that posterior interbody fusion with circular saw for treatment of lumbar spondylolisthesis have satisfactory outcome and high fusion rate.

Objective:To observe the related factors of depression in patients with lacunar cerebral infarction with mild cognitive impairment.Methods:From 2016 to 2019, 114 patients with mild cognitive impairment of lacunar cerebral infarction in Kailuan General Hospital were selected as the research objects.MRI brain scan was completed within 72 hours after admission, and Zung′s self rating Depression Scale (SDS) was used to evaluate emotion within 1 week.According to the results of SDS, 69 patients with mild cognitive impairment and no depression of lacunar infarction were selected as the control group, and 45 patients with mild cognitive impairment and mild depression of lacunar infarction were selected as the case group.The general clinical data, the proportion of patients with lacunar infarction in different brain regions and cognitive function of the two groups were observed.Logistic regression method was used to analyze the risk factors of depression in patients with mild cognitive impairment of lacunar infarction, and the characteristics of clinical somatization symptoms were observed.Results:(1)There were 53 males (76.81%, 53/69) and 16 females (23.19%, 16/69) in the control group, 29 males (64.44%, 29/45) and 16 females (35.55%, 16/45) in the case group, and the difference between the two groups was statistically significant ( P=0.049). Hyperhomocysteinemia in the control group and the case group was 31.88% (22/69) and 53.33%(24/45), respectively, with statistically significant differences between the two groups ( P=0.003). (2) The incidence rates of lacunar infarction in basal ganglia and oval center was 80% (36/45) and 71.11% (32/45) in case group respectively, and 59.42% (41/69) and 18.84% (13/69) in control group respectively.The difference between two groups was statistically significant ( P values were 0.001 and <0.001), and there was no significant difference in infarct size in other regions ( P>0.05). (3) The rate of impaired attention and computing power in the case group was 88.89%(40/45), which was higher than that in the control group 78.26%(54/69), and the difference was statistically significant ( P=0.036). (4) Multivariate Logistic regression analysis showed that hyperhomocysteemia ( OR=2.659, 95% CI 1.041-6.793, P<0.05) and central oval infarction ( OR=10.332, 95% CI 4.069-26.235, P<0.01) were independent risk factors for mild cognitive dysfunction and depression in lacunar cerebral infarction.(5) The proportion of insomnia and tears with somatization symptoms in the case group was 35.56%(16/45) and 37.77%(17/45), respectively, which were higher than that in the control group 8.70%(6/69) and 2.90%(2/69), respectively, with statistically significant differences (all P<0.001). Conclusion:Hyperhomocysteinemia and hemioval central cerebral infarction are independent risk factors for depression in patients with lacunar cerebral infarction with mild cognitive dysfunction, accompanied by somatization symptoms of insomnia and tearing.

Adolescent ; Female ; Humans ; Leukemia ; etiology ; Leukemia, Promyelocytic, Acute ; complications ; Male ; Young Adult

BACKGROUND: Magnesium alloy studies in orthopedic field have been carried out,and good biocompatibility has been reported.However magnesium alloys have not yet been researched in the intestine.OBJECTIVE: The biodegradable magnesium-zinc alloy samples are implanted around the rat cecum to investigate the biocompatibility in rat.METHODS: Sprague Dawley rats were randomly divided into magnesium alloy group,medical titanium group and the sham-operated group.Then magnesium-zinc alloy samples with the dimension of 5 mm × 1 mm× 1 mm were embedded in the cecum incision in the magnesium alloy group.The medical titanium was embedded in the medical titanium group,and just suture in the sham-operated group.Prior to surgery and at 7,14,21 and 28 days after operation,the serum glutamic-oxaloacetic transaminase,creatinine and magnesium ion concentration were examined in each group.X-ray film on implanted region.The pathological changes in liver,kidney and cecum were examined.RESULTS AND CONCLUSION: There were no significant differences in serum glutamic-oxaloacetic transaminase,creatinine and magnesium ion concentrations among each group(P > 0.05).Magnesium-zinc alloy degraded gradually during 28 days.The pathology of liver,kidney and cecum was normal.Results suggested that magnesium-zinc alloy had no obvious effect on the cecum.The degradation time to play a fixed function of time was longer than the intestinal healing time,with good biocompatibility.Magnesium-zinc alloy can be used as anastomotic nail for stomach intestine anastomat.

Objective To study the synergism effect of 131 I-Herceptin and high-energy X-ray on HER2 overexpressed breast cancer SK-BR-3 cells.Methods The protein expression and gene amplification of human epidermal growth factor receptor-2 ( HER2 ) in SK-BR-3 cells were identified by immunohistochemistry and fluorescence in situ hybridization ( FISH ) method, 131 I-Herceptin was prepared by iodogen method, and the IC15 concentration of 131 I-Herceptin on SK-BR-3 cell were selected by MTT method.The cells were divided into control group and drug group according to 131 I-Herceptin used or not, and were delivered five different doses of external irradiation (0,2,4 and 6Gy), and the synergism effect was detected by colonogenic assay.The cells were divided into blank group, drug group(131I-Herceptin), X-ray group(2 Gy external irradiation) and combination group (131I-Herceptin+2 Gy external irradiation), the apoptosis rate and death rate were detected by AO/EB method and cell cycle were detected by flow cytometry.Results The labling rate, radiochemical purity and specific radioactivity of 131 I-Herceptin were 86.8%, 93.9% and 868.3 μci/mg, respectively.The IC15 of 131 I-Herceptin was 15.625μci/mL.131 I-Herceptin and high-energy X-ray significantly reduced surviving fraction ( SF) ( F=628.888,F=964.97,P<0.05) and there were interactions between them (F=113.046,P<0.05).There were significant differences in apoptosis rate and death rate among blank group, drug group, X-ray group and combination group(F=103.324,F=13.33,all P<0.05),and there were significant differences of pairwise comparison (P<0.05).After irradiation and 131I-Herceptin administration, the cell cycle changed obviously from G1-phase to G2-and S-phase.Conclusion 131 I-Herceptin combined with high-energy X-ray has the synergism effect on HER2 overexpressed breast cancer SK-BR-3 cells.