Carcinoma, Adenosquamous ; pathology ; Carcinoma, Squamous Cell ; metabolism ; pathology ; surgery ; Diagnosis, Differential ; Humans ; Jejunal Neoplasms ; metabolism ; pathology ; surgery ; Jejunum ; surgery ; Keratins ; metabolism ; Male ; Middle Aged

OBJECTIVETo explore the clinical effects of anterior corpectomy decompression and titanium mesh bone graft fusion combined with titanium plate fixation in treatting multilevel cervical spondylotic myelopathy.

METHODSThe clinical data of 48 patients with multilevel cervical spondylotic myelopathy underwent surgical operation were retrospectively analyzed from October 2010 to January 2013. There were 37 males and 11 females, aged from 37 to 76 years old with an average of 54.6 years. Thirty-five cases were two-segment lesion, 7 cases were three-segment lesion, 6 cases were four-segment lesion. All the patients were treated by anterior corpectomy decompression and titanium mesh bone graft fusion combined with titanium plate fixation. ROM, JOA, VAS and SF-36 scores were recorded before and after operation(including 3, 6, 12 months after operation and final follow-up). Fusion degree and spinal canal decompression condition were observed by radiographic data.

RESULTSAll patients were followed up from 14 to 48 months, with an average of 27.3 months. At 12 months after surgery, radiographic data showed that all patients obtained bony fusion, spinal canal decompression were sufficient. Preoperative vertebral canal sagittal diameter of the most serious segment were (5.13 +/- 1.32) mm, 12 months after surgery were (9.94 +/- 1.22) mm, there was statistically significance (t=2.463, P=0.014); the degree of vertebral canal decompression were (92.15 +/- 2.35)%. Postoperative ROM, JOA, VAS and SF-36 scores were obviously improved than that of preoperative (P<0.05); there was no statistically significance of ROM, JOA, VAS and SF-36 scores in each time after operation (P>0.05).

CONCLUSIONAnterior corpectomy decompression and titanium mesh bone graft fusion combined with titanium plate fixation can obtain higher fusion rate, complete thoroughly decompression, improvement of clinical symptoms and well safety in treating multilevel cervical spondylotic myelopathy.

Adult ; Aged ; Bone Plates ; Bone Transplantation ; Cervical Vertebrae ; diagnostic imaging ; surgery ; Decompression, Surgical ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Prostheses and Implants ; Radiography ; Retrospective Studies ; Spinal Cord Diseases ; diagnostic imaging ; surgery ; Spondylosis ; diagnostic imaging ; surgery ; Treatment Outcome

OBJECTIVETo evaluate the influence of naringin on PMMA-induced osteoclastic bone resorption using the mouse air sacs model.

METHODSTotal 48 female Balb/c mices with the age of 8 to 10 weeks were chosen in the study. Air were injected into the back in 32 mices and formed the air sacs, 6 d later, the skulls (originated from other 16 mices) were implanted to the air sacs. Thirty-two animals were divided into naringin treatment group (with 2 concentrations of 150 mg/kg and 30 mg/ kg) , DMSO group and PBS blank group, 8 animals in each group. Polymethylmethacrylate (PMMA) particles were injected into the air sacs in naringin treatment groups and DMSO group so as to irritate inflammatory reaction. Naringin with 2 concentrations of 150 mg/kg and 30 mg/kg were dissolved in DMSO of 0.2 ml, and were injected into air sacs, respectively. In PBS black group, no stimulation with PMMA particles, only injected PBS, and in DMSO group, injected DMSO without naringin. Tartrate resistant acid phosphatase (TRAP), Ca2+ release, modified Masson stain and histological analysis were performed on the 7th day after stimulation.

RESULTSCompared with DMSO group, naringin treatment group's cellular infiltration decreased (P < 0.01); concentration of 150 mg/kg was better than that of concentrations of 30 mg/kg (8.90 ± 1.75 vs 15.23 ± 1.86). Naringin can decrease calcium release in the lavage of the air sacs bone resorption model, especially obvious in naringin with concentration of 150 mg/kg. Naringin can ameliorate the inflammatory reaction and the subsequent bone resorption (including bone collagen loss, TRAP positive cells amount and so on) in air sacs with bone implant and PMMA particles. Naringin with concentration of 150 mg/kg appeared to be an optimal dosage to deliver the therapeutic effects.

CONCLUSIONNaringin inhibits PMMA-induced osteoclastogenesis and ameliorates the PMMA-associated inflammatory reaction and the subsequent bone resorption.

Animals ; Disease Models, Animal ; Female ; Flavanones ; therapeutic use ; Mice ; Mice, Inbred BALB C ; Osteoclasts ; drug effects ; physiology ; Osteolysis ; chemically induced ; prevention & control ; Polymethyl Methacrylate ; toxicity

Objective To explore the clinical value and significance of elastography technique used in the diagnosis of thyroid nodules .Methods The preoperative imaging data of pathologically confirmed 138 patients with thyroid nodules(160 nodules) were retrospectively analyzed .The imaging characteristics of routine preoperative ultra-sound and elastography were compared and the results were compared with the histopathological findings ,thus to eval-uate the clinical value of elastography in the diagnosis of thyroid nodules .Results Of 160 thyroid nodules in 138 pa-tients,129 nodules (80.63%) were histologically confirmed benign ,31 nodules (19.38%) were confirmed malig-nant.According to the elastic graph color grading standards of ultrasound elastography , in 129 benign nodules, 113 nodules (86.82%) were 0~Ⅱ grade,16 nodules(13.18%) wereⅢ~Ⅳ grade.Of 31 malignant nodules,4 nodules (12.90%) were 0~Ⅱgrade,27 nodules (87.10%) wereⅢ~Ⅳgrade.The diagnosis coincidence rate of conventional ultrasound was 66.25%,which was significantly lower than 87.50%of elastosonography (χ2 =20.32, P=0.000).The specificity,sensitivity,positive predictive value and negative predictive value of routine ultrasound were 61.29%,67.44%,87.88%,31.15%,which were significantly lower than those of ultrasound elastography (87.10%,87.60%,96.58%,62.79%)(χ2 =15.04,P=0.000;χ2 =5.39,P=0.022;χ2 =5.92,P=0.019;χ2 =10.24,P=0.001).Conclusion Compared with conventional ultrasound ,ultrasound elastography technique has ob-vious advantages in the differential diagnosis of benign and malignant thyroid nodules ,which has very important clini-cal value and should be popularized and applied in clinical diagnosis .

AIM: To investigate the efficacy of 23G minimally vitrectomy without irrigation in cataract phacoemulsification and trabeculectomy of malignant glaucoma, and to analyze such compound operative procedures for phakic malignant glaucoma.
●METHODS:A total of 21 phakic malignant glaucoma patients (21 eyes) underwent anterior vitrectomy without irrigation by using 23G vitrectomy. During surgical course phacoemulsification with anterior and posterior continuous circular capsulorhexis, trabeculectomy combined with iridectomy would be completed. lntraocular pressure, anterior chamber depth changes and postoperative complications were observed after the operation.
●RESULTS:ln the three-month follow-up, intraocular pressures were reduced from ( 57. 18 ± 6. 18 ) mmHg to (16. 15 ± 2. 43 ) mmHg, there was statistical difference compared with pre - operation ( P < 0. 001 ). The preoperative anterior chamber depth (ACD) was (0. 88± 0. 25) mm, the postoperative ACD was (2. 44±0. 37) mm 3mo later, there were significant difference (P<0. 001). The best corrected visual acuity improved significantly, no serious postoperative complication appeared.
● CONCLUSION: The compound surgical method of anterior vitrectomy combined with phacoemulsifier and trabeculectomy can effectively treat phakic malignant glaucoma. Early diagnosis and early compound surgery may effectively reduce the intraocular pressure of malignant glaucoma.

Objective:Analysis of the clinical characteristics and genetic mutations of ten tuberous sclerosis complex(TSC) families to provide support for clinical diagnosis of TSC.Methods:Retrospective analysis of ten TSC family probands and their members were performed with detailed medical history collection and physical examination. The study consisted of 26 patients in 10 TSC families, including 12 males and 14 females, with male to female ratio of 1∶1.17, and aged 7-65 years. In terms of skin lesions, there were 24 cases of facial angiofibromas, 20 cases of hypomelanotic macules, 16 cases of ungual fibromas, and 9 cases of shagreen patch. There were 12 cases of renal angiomyolipoma, 4 cases of subependymal nodules based on craniocerebral CT, and 1 case of lymphangioleiomyomatosis. Four cases had a history of seizures. Peripheral blood was extracted for next generation DNA sequencing.Results:A total of 23 TSC patients were genetically tested, and a total of 14 patients in 6 families were TSC2 mutations(5 frameshift mutations, 5 heterozygous deletions, and 4 nonsense mutations), a total of 4 patients in 2 families were TSC1 nonsense mutations, and no mutations were seen in the 2 families.Conclusions:A total of 10 TSC families were summarized, and the patients mainly had skin manifestations and kidney lesions.There were 18/23 patients having TSC1/2 mutations, of which TSC2 mutations accounting for 14/18. In the two non-mutant families, patients mainly had facial angiofibroma and/or hypomelanotic macules.

OBJECTIVE:To establish a method for the content determination of cabozantinib in its raw material. METHODS:RP-HPLC method was adopted. The determination was performed on Inertsil ODS-SP C18 column with mobile phase consisted of acetonitrile-0.02 mol/L ammonium acetate buffer (pH 5.2,52:48,V/V) at the flow rate of 1.0 mL/min. Detection wavelength was set at 241 nm,the column temperature was 38 ℃,and sample size was 20 μL. RESULTS:The linear range of cabozantinib were 9.88-49.40 μg/mL(r=0.9999). The limit of quantitation was 11.46 ng,and the limit of detection was 3.36 ng. The RSDs of preci-sion,stability,repeatability tests were all lower than 2.0%;recoveries were 98.5%-101.7%(RSD=1.2%,n=9). CONCLU-SIONS:The method is simple,accurate and suitable for the content determination of cabozantinib in its raw material.

Objective:To compare the drug release of nifedipine sustained-release tablets from four manufacturers to evaluate the intrinsic quality. Methods:The drug release rate was determined by UV respectively with pH 1. 2 HCl solution, pH 4. 0 sodium ace-tate buffer, pH 6. 8 phosphate buffer and water as the dissolution medium. The dissolution curves were compared by f2 factor. Results:The drug release rate of nifedipine sustained-release tablets from the four manufacturers all met quality standard of our country, al-though the dissolution curves in the different dissolution medium was various. Conclusion:There are differences in intrinsic quality a-mong the nifedipine sustained-release tablets from the four manufacturers. The dissolution examination standard should be improved fur-ther.

Objective To explore how Vibrio vulnificus (Vv) invades dendritic cells (DC) and induces acute necrosis of DC via toll-like receptor (TLR) 2 and 4 pathways.Methods Vv 1.1758 strain and DC 2.4 mixed culture model was established,observed the infection rates of DC with optical microscope,the location of Vv and structural changes of DC by transmission electron microscope.The expression levels of TLR2 and TLR4 mRNA were determined by real-time quantitative reverse transcription polymerase chain reaction (RT-qPCR) and tumor necrosis factor-α (TNFα) protein titers were measured by enzyme-linked immunosorbent assay (ELISA).DNA ladder qualitative test was used to detect cell apoptosis,while flow cytometry was used to quantify cell apoptosis and necrosis rates.Statistical analysis was done by chi-square test and one-way ANOVE.Results The infection rates of DC after 0.5,1,2,4 and 6 h of mixed culture were (7.8±0.8) ％,(13.9± 1.1) ％,(34.6±4.9) ％,(77.8± 10.2)％ and (95.8 ± 13.1)％,respectively.Vv was generally located in the internal cell membrane of DC 2.4.After 2 h co-culture,nuclear chromatins of DC became active and intranuclear apoptosis bodies appeared.After 4 h,cytoplasmic vacuoles appeared,chromatin gathered,and cell membranes were seriously damaged.After 6 h,mitochondria was highly swelled and distorted,and cell apoptosis and necrosis occurred.TLR2 and TLR4 mRNA levels reached peak values after co-culture for 0.5 h; TNF-α level began to increase at 1 h (P＜0.05) and reached peak values at 2 h.DNA Ladder electrophoresis presented scouring necrosis after 2 h culture and apoptotic bands appeared between 720 bp and 900 bp after 4 to 5 h culture.Early apoptosis rates of DC after 2,4 and 6 h culture were (3.1±3.8)％,(7.8±4.7)％ and (12.7±8.2)％,and necrosis rates of DC were (16.7±12.5)％,(41.6±25.9)％ and (75.5±33.6)％,higher than that of control group (all P＜0.05).Conclusions Vv infects DC and induce DNA degradation through up-regulated expression of TLR2 and TLR4 and increasing of TNF-α inflammatory mediators.During cell degradation,apoptosis and necrosis coexist,while necrosis is predominant.

Objective To evaluate the correlation between sonographic features of papillary thyroid microcarcinoma(PTMC) and cervical lymph node metastasis.Methods Preoperative sonographic features of 379 papillary thyroid microcarcinoma in 341 patients were retrospectively reviewed,and were divided into two groups,lymph node metastasis and lymph node non-metastasis according to pathology.Univariate and multivariate analyses were performed to analyze the sonographic features relevant to lymph node metastasis.Results Univariate analysis revealed that unclear border,microcalcification and multifocal PTMC were statistically significant(all P ＜0.05).Multivariate analysis revealed that microcalcification and multifocal PTMC were statistically significant (both P ＜0.05).Conclusions Microcalcification and multifocal PTMC are closely relevant to cervical lymph node metastasis.