OBJECTIVETo study the clinical effects of one stage surgical treatment of thoracolumbar spinal tuberculosis by anterior radical debridement with bone graft fusion and posterior pedicle screw-rods system fixation.

METHODSFrom February 2002 to March 2007, 21 patients who were 45.3 years old on average with thoracolumbar spinal tuberculosis, including 13 males and 8 females were underwent surgical treatment of posterior pedicle screw-rods system fixation, correction of deformities, anterior radical debridement, bone graft fusion. Among them, 3 patients had 2 involved vertebras, 17 patients had 3 involved vertebras, and 1 patient had 4 involved vertebras. The patients were all complicated with kyphosis deformity with an average Cobb angle of (28.0+/-9.7) degrees. According to the Frankel neurological function grade system, 3 cases in grade B, 5 in grade C, 1 in grade D, 12 in grade E. All the patients received antiphthisic treatment with isonicotinylhydrazide (INH), rifampicin (RFP), Ethambutol (EMB), pyrazinamide (PZA), and support therapy in preoperation. The chemotherapy was continued 9 to 12 months after operation. Neurological functions of all cases were investigated, and radiography was analyzed pre-operation and post-operation to determine the state of bony fusion and the correction of spinal kyphosis. Statistical analysis was made according to the preoperative and post-operative Cobb angle.

RESULTSThe follow-up period ranged from 1 to 6 years with 2.5 years on average. All the patients had primary healing of the incisions. The Cobb angle was (9.8+/3.3) degrees in post-operation. The kyphosis deformity was corrected 17.2 degrees in thoracolumbar on average (t=-13.48, P<0.01). According to the Frankel neurological functional grade system, 1 case was in grade C, 3 in grade D, and 17 in grade E.

CONCLUSIONIt is effective for patients with thoracolumbar spinal tuberculosis in correction of spinal kyphosis, reconstruction of the spinal stability and bony fusion by anterior radical debridement with bone graft fusion and posterior pedicle screw-rods system fixation.

Adolescent ; Adult ; Bone Transplantation ; methods ; Debridement ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Internal Fixators ; Lumbar Vertebrae ; surgery ; Male ; Middle Aged ; Thoracic Vertebrae ; surgery ; Treatment Outcome ; Tuberculosis, Spinal ; surgery ; Young Adult

AIM:To remark the effect of Qingguang'an Ⅱ on expression of PAX6, Ngn1, and Ngn2 mRNA of rats with chronic high intraocular pressure.METHODS:Totally 40 male SD rats were randomly divided into 6 groups, that was:A:blank group, B:model group, C:Qingguang'an Ⅱ low dose group, D:Qingguang'an Ⅱ moderate dose group, E:Qingguang'an Ⅱ high dose group, F:Yimaikang disket group.B, C, D, E, F groups of experimental rats were established the model of chronic high intraocular pressure (IOP) by cauterizing of superficial scleral vein.Animal model was established successfully by using monitoring IOP consistently keep above 25mmHg for 8wk as cut-off criterion.Tissues of Eyes were obtained after intragastric administration for 2wk and 4wk.The expressions of PAX6, Ngn1, and Ngn2 mRNA were investigated by Real-time PCR.RESULTS:At the time-point of 2wk, PAX6, Ngn1, and Ngn2 mRNA in group B were statistically expressed in lower level comparing with other groups (P<0.05).Moreover, at the time-point of 4wk, PAX6, Ngn1, and Ngn2 mRNA in group C, D and E were statistically expressed in higher level comparing with group F (P<0.05).Besides, PAX6, Ngn1, and Ngn2 mRNA in group C and D were statistically expressed in lower level comparing with group E (P<0.05).PAX6, Ngn1, and Ngn2 mRNA in group C and D were expressed in similar level(P>0.05).CONCLUSION:In summar, Qingguang'an Ⅱ and Yimaikang disket can remarkably increase the expressions of PAX6, Ngn1, and Ngn2, which suggest protecting the optic nerve of rats caused by chronic high IOP.What's more, this study indicated that, in the protection of optic nerve of rats with chronic high IOP, the high dose of Qingguang'an Ⅱ at the time-point of 4wk was the better choice.

In recent years, artificial intelligence (AI) technology has advanced rapidly and has been widely applied in various fields such as medicine and pharmacy, accelerating the drug development process. Focusing on the application of AI in the discovery and optimization of lead compounds, this review provides a detailed introduction to AI-assisted virtual screening and molecular generation methods for discovering lead compounds, while particularly highlighting the cases of AI-drived drugs into clinical trials. Additionally, we briefly outline the application of AI basic algorithm models in quantitative structure-activity relationship (QSAR) and drug repurposing, offering insights for AI-based drug discovery.

The purpose of this study was to investigate the clinical value of plasma thrombomodulin (PTM) in different diseases or in different severity or complications of diseases, PTM in 979 patients and 60 healthy controls was determined by ELISA method. The results showed that the PTM level in the control group was 20.40 +/- 7.72 microg/L, there was no difference in sex and ages. In chronic primary glomerular disease, the PTM level in chronic renal failure (CRF) group was higher than that in non-CRF group (P < 0.01). PTM level > 70 microg/L was defined as its positive criterion. The sensitivity, specificity and positive predictive value in PTM were 85.7%, 82.4% and 77.8% respectively. The PTM level in septemia group was higher than that in non-septemia group (P < 0.01), the sensitivity, specificity and positive predictive value were 86.6%, 89.5% and 76.5% respectively (> 50 microg/L as its positive criterion). With respect of multiple trauma, the PTM level in multiple organ failare (MOF) group was higher than that in non-MOF group (P < 0.01), while the sensitivity, specificity and positive predictive value were 77.8%, 77.3% and 73.7% respectively (> 40 microg/L as its positive criterion). For systemic lupus erythematosus (SLE), the PTM level in the patients with albuminuria was higher than that in the patients without albuminuria (P < 0.01), and the sensitivity, specificity and positive predictive value were 77.8%, 92.3% and 93.3% respectively (> 35.54 microg/L as its positive criterion). For diabetes, the PTM level in complication group was higher than that in group without complications, the sensitivity, specificity and positive predictive value were 53.4%, 97.1% and 98.6% respectively (> 35.54 microg/L as its positive criterion). The PTM level in microangiopathy group was higher than that in macroangiopathy group (P < 0.01). The sensitivity, specificity and positive predictive value were 71.2%, 97.1% and 97.9% respectively. Acute leukemia (AL) and multiple myeloma (MM) had higher PTM level and PTM level was extremely high when renal failure developed (P < 0.01). As compared the acute stage with the restoration stage in stroke, pre-chemotherapeutics with post-chemotherapeutics in AL and MM, and pre-operation with post-operation in cancer, the PTM level was connected with clinical development. The PTM level in the patients with microangiopathy was higher than that in the patients with macroangiopathy (P < 0.01). The defined PTM level was higher than its normal upper limit as PTM positive criterion in microangiopathy diseases, the sensitivity, specificity and positive predictive value were 77.7%, 71.2% and 75.6% respectively. It is concluded that PTM level is a good criterion in evaluating the microangiopathy, and PTM is also a valuable indicator in prediction or assessment of the severity of diseases, or evaluation of therapeutic effectiveness.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Kidney Failure, Chronic ; blood ; Male ; Middle Aged ; Multiple Organ Failure ; blood ; Predictive Value of Tests ; Prognosis ; Sensitivity and Specificity ; Sepsis ; blood ; Severity of Illness Index ; Thrombomodulin ; blood

OBJECTIVETo explore the application of ultrasonography in the diagnosis of deep electric injury.

METHODSHP-IPHX high resolution color and pulse doppler ultrasonography was employed in the study. The hemodynamic indices were determined in the burn wound area and tissues 5 - 15 cm proximal to the wound in 12 patients with deep electric injury. At the same time, injuries to subcutaneous and muscular tissue and blood vessels (fifty-six blood vessels detected) were detected.

RESULTS1. It was found by two-dimentional ultrasonography that the injury degree in different tissue after deep electric injury was different, i.e. blood vessels were most liable to injury followed by muscles and subcutaneous tissue. In the burn wound area, endothelium was not visualized in 7 blood vessels and endothelial swelling was identified in 12 blood vessels. Furthermore, vascular occlusion was found in 4 blood vessels and thrombosis found in 5 vessels. 2. It was also demonstrated by color ultrasonography that change in course of blood vessel and tortuesity were observed in 12 blood vessels, stenosis of lumen in 21 vessels and widened intravascular space in 11 vessels, All these findings were confirmed in the subsequent operations. 3. It was revealed by pulse Doppler that the top blood flow speed increased during vascular contraction period in narrowed blood vessels with decreased blood flow per minute.

CONCLUSIONBeing an non-invasive examination, ultrasonography could directly demonstrate the morphological changes in subcutaneous tissue, muscle and blood vessels after a deep electric injury, which might help determine the injury degree and the hemodynamic changes in the injured site.

Adolescent ; Adult ; Blood Vessels ; diagnostic imaging ; injuries ; Burns, Electric ; diagnosis ; diagnostic imaging ; physiopathology ; Female ; Hemodynamics ; Humans ; Male ; Middle Aged ; Muscles ; diagnostic imaging ; injuries ; Skin ; diagnostic imaging ; injuries ; Ultrasonography, Doppler ; methods

OBJECTIVETo elucidate the necessity of No.14v lymph node dissection in D2 lymphadenectomy for advanced gastric cancer.

METHODSClinicopathological data of 131 cases of advanced gastric cancer receiving D2 or D2+ plus No.14v lymph node dissection were reviewed retrospectively. Clinicopathological factors associated with No.14v lymph node metastasis were analyzed and prognostic value of No.14v lymph node metastasis was evaluated.

RESULTSOf the 131 patients, 24 (18.3%) had positive No.14v lymph node. The incidence of 14v metastasis was associated with tumor location, tumor size, depth of invasion, N staging, TNM staging, No.1, No.6, and No.8a lymph nodes metastasis. Tumor location and N staging were independent risk factors for No.14v metastasis (all P<0.05). The 5-year survival rate was 8.3% and 37.8% in patients with and without No.14v metastasis respectively. The difference was statistically significant (P<0.01). Multivariate analysis revealed that metastasis of No.14v was an independent prognostic factor for advanced gastric cancer after D2 lymphadenectomy (P=0.029, RR=1.807, 95%CI:1.064-3.070).

CONCLUSIONSFor advanced middle and lower gastric cancers, especially those with larger size, serosa invasion and possibility of No.6 lymph node metastasis, it is necessary and feasible to remove the No.14v lymph node.

Adult ; Aged ; Female ; Humans ; Lymph Node Excision ; methods ; Male ; Middle Aged ; Prognosis ; Retrospective Studies ; Stomach Neoplasms ; surgery

OBJECTIVETo describe the brief survey of alcohol intake and the incidence of alcohol liver disease in Zhejiang province.

METHODS18,237 requested persons aged over 18 years were selected by multi-stage stratified cluster sampling in Zhejiang province. Questionnaire about alcohol consumption, hepatic ultrasonic scan and detection of hepatic enzymes and markers of HBV and HCV were carried out. Daily alcohol intake more than 40g (including equal to 40g/d) was essential for the diagnosis of alcoholic liver disease.

RESULTSAmong the 18,237 persons (male 12,042, female 6195), the average daily alcohol intake was (17.7 +/- 27.2) g. The incidence of alcoholic liver disease in Zhejiang province was 4.34% (male 6.36%, female 0.36%) in the whole population. Four subtypes were separated as alcoholic cirrhosis, alcoholic fat liver, alcoholic hepatitis and mild alcoholic injury in liver with the corresponding incidence of 0.68%, 0.94%, 1.51% and 1.21% separately.

CONCLUSIONAlcoholic liver disease is found to be a common disease in Zhejiang province, indicating an urgent need for the public education on alcohol abuse and the treatment on related health problems

Adult ; Age Distribution ; Aged ; China ; epidemiology ; Data Collection ; Female ; Humans ; Incidence ; Liver Diseases, Alcoholic ; epidemiology ; Male ; Middle Aged

OBJECTIVETo evaluate the clinicopathologic characteristics and prognosis of mixed histological type (MHT) gastric cancer.

METHODSClinical and follow-up data of 1108 gastric cancer patients undergoing radical operation in Tianjin Cancer Hospital between 2003 and 2006 were analyzed retrospectively. Clinicopathologic characteristics of MHT gastric cancer were summarized and the prognosis was analyzed by Kaplan-Meier analysis and COX regression.

RESULTSAmong the 1108 patients, 144 (13.0%) had mixed histology type of gastric cancer. Compared to the unitary histological type (UHT), MHT gastric cancer had bigger tumor size, higher proportion of T4 tumor, and was easier for lymph node and distant metastasis (all P<0.05). The 3- and 5-year survival rates of patients with MHT were 26.5% and 10.8% respectively, which were lower than those with UHT (58.8% and 35.0%, P<0.01). Univariate and multivariate analyses showed TNM classification was an independent prognostic factor (P<0.01).

CONCLUSIONSMHT gastric cancer shows worse prognosis than UHT gastric cancer. There is no difference in prognosis among various combination of MHT gastric cancer. TNM classification is an independent prognostic factor of MHT gastric cancer.

Adult ; Aged ; Aged, 80 and over ; Female ; Follow-Up Studies ; Humans ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Multivariate Analysis ; Neoplasms, Complex and Mixed ; diagnosis ; pathology ; surgery ; Prognosis ; Retrospective Studies ; Stomach Neoplasms ; diagnosis ; pathology ; surgery ; Young Adult

OBJECTIVETo evaluate the prognostic value of metastatic lymph node ratio (MLR) for gastric cancer patients with less than 15 lymph nodes dissected.

METHODSClinical data of 610 gastric cancer patients undergoing operation in Tianjin Cancer Hospictal from January 2003 to July 2007 were analyzed retrospectively. Patients were divided into two groups: <15 lymph nodes dissected group (n=320) and ≥ 15 lymph nodes dissected group (n=290). MLR was classified based on the following intervals: rN1 ≤ 10%, rN2 10%-30%, rN3 30%-60% and rN4 >60%. Survival was determined by Kaplan-Meier method and difference was assessed by Log-rank test. Multivariate analysis was performed using Cox proportional hazard regression model. Survival rates were compared between two groups in pN and rN stages respectively.

RESULTSIn <15 nodes group, all the survival differences among various rN stages were not significant (all P>0.05), while in same rN stage, all the survival differences among various pN stages were not significant (all P>0.05). Significant differences of 5-year cumulative survival rates were found between the two groups in pN2 and pN3a stage patients (both P<0.05) while no significant differences were found among different rN stages (all P>0.05). Multivariate analysis demonstrated rN stage was an independent prognostic factor for gastric cancer patients with <15 lymph nodes dissected (P=0.012, RR=1.617, 95%CI:1.111-2.354).

CONCLUSIONThe rN staging system based on MLR can predict the prognosis of gastric cancer patients with less than 15 lymph nodes dissected.

Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Lymph Node Excision ; Lymph Nodes ; pathology ; Lymphatic Metastasis ; pathology ; Male ; Middle Aged ; Prognosis ; Proportional Hazards Models ; Retrospective Studies ; Stomach Neoplasms ; pathology ; surgery ; Young Adult

OBJECTIVETo evaluate the feasibility and necessity of No.13 lymph node dissection in D2 radical gastrectomy for lower-third advanced gastric cancer (AGC).

METHODSData of 379 cases who were diagnosed as TNM II-III stage AGC were collected from January 2001 to June 2007. One hundred cases who undergone No.13 lymph node dissection during D2 gastrectomy for lower-third AGC were selected as study group. Other 279 cases (control group) received only D2 gastrectomy. The differences in clinicopathologic and intraoperative and postoperative parameters and 5-years survival rate were compared using the SPSS 17.0 software.

RESULTSThere were no significant differences between the two groups in patients' gender, age, tumor size, histologic type, Borrmann type, duodenum invasion, tumor depth, lymph node metastasis, TNM classification, operative time, blood loss and the incidence of postoperative complications (P > 0.05). In the study group, there were 9 patients with positive No. 13 lymph node, and its 5-year survival rate (46.0%) was higher than the control group (36.5%, χ² = 4.452, P < 0.05). The Univariate analysis showed that age (χ² = 7.539), No.13 lymph node dissection (χ² = 4.452), tumor size (χ² = 7.100), duodenum invasion (χ² = 9.106), tumor depth (χ² = 7.428), lymph node metastasis (χ² = 45.046), TNM classification (χ² = 57.008) are associated with prognosis of lower-third AGC (P < 0.05). Multivariate analysis identified age (HR = 0.500, 95% CI: 0.343 - 0.730), tumor size (HR = 0.545, 95%CI: 0.339 - 0.876), duodenum invasion (HR = 5.821, 95%CI: 2.326 - 14.572), and tumor depth (T4: HR = 2.087, 95% CI: 1.283 - 3.394) as independent prognostic factors (P < 0.05).

CONCLUSIONNo. 13 lymph node dissection for TNM II-III stage lower-third advanced gastric cancer is feasible and necessary.

Adult ; Aged ; Aged, 80 and over ; Female ; Gastrectomy ; Humans ; Lymph Node Excision ; Male ; Middle Aged ; Multivariate Analysis ; Risk Factors ; Stomach Neoplasms ; mortality ; pathology ; surgery ; Survival Rate ; Young Adult