Objective To review our experiences in portaazygous disconnection for the treatment of portal hypertension and to analyze the causes of postoperative complications. Methods We reviewed the results of 236 patients with portal hypertension who were treated with disconnection from April 1994 to July 2002. Results Postoperative complications occurred in 65 of all the patients(the incidence rate was 27.5%). Twenty-four patients experienced postoperative infection(10.2%),12 patients suffered from intraabdominal massive bleeding(5.1%),12 from massive ascites (5.1%),8 patients suffered from recurrent upper gastrointestinal bleeding (3.4%),7 patients experienced acute thrombosis of portal venous system(3.0%). Two patients suffered from multiple organ dysfunction syndrome (1.0%). The operative mortality was 3.4%(8/236). The main causes of death included intraabdominal massive bleeding and severe infection with MODS. Conclusions The occurrence of postoperative complications was related with the selection of patients,thorough portaazygous disconnection and perioperative management.

Objective:To explore the calvarial critical size defect (CSD)in rats with type 2 diabetes mellitus(T2DM).Methods:T2DM model of SD rats(weighted 300-320 g)was induced by high fat and high sugar diet and low dose intraperitoneal streptozotocin (STZ)injection.The rats with T2DMand the normal controls were divided into 4 groups(n=3)respectively.Defects with the diame-ter(mm)of 2,3,4 and 5 were made on the central calvaria of each rat.General observation,X-ray examination and histological study were performed 8 weeks postoperatively.Results:In the T2DM group,only the defects of 2 mm diameter were healed completely,X-ray resistance and new bone formation were observed;the defects of 3,4 and 5 mm diameter were unhealed,X-ray transmission was observed and newly formed bone was insufficient.In the control group,the defects of 2,3 and 4 mm diameter were healed completely, X-ray resistance and new bone formation were observed;the defects of 5 mm diameter were unhealed,X-ray transmission was ob-served,newly formed bone was insufficient.Conclusion:The calvarial CSD of T2DM rat model can be defined as the defect with the diameter of 3 mm.

Objective To investigate the influence of fusion to upper end vertebra(UEV)or not on the correction outcomes of Lenke type 5 idiopathic scoliosis with anterior selective fusion.Methods From January 2002 to December 2006,36 AIS patients with a Lenke type 5 curve received anterior single-rod selective fusion and had a minimum 2-year follow-up.According to the level of upper instrumented vertebra,the patients were divided into two groups:Group A(n=21),fused to UEV,and Group B(n=15),fused to the vertebra below UEV.Patients of Group A and B had a mean age of 15.3 and 15.5 years,a mean thoracolumbar/lumbar curve of 46.2° and 46.7°,and a mean proximal thoracic curve of 26.3° and 29.6°,respectively.During the surgery,average 5.3 and 4.8 levels of vertebrae were fused in Group A and B,respectively.Results Group A and B had a mean follow-up of 31 and 33 months,respectively.The correction rate of major curves in Group A was marginally higher than in Group B(79％ versus 70％,P=0.062),and the spontaneous correction rate of proximal curves in Group A was higher than in Group B(46％ versus 29％,P=0.044).Regarding the pre-operative sagittal profile,similar lumbar lordosis and sacral slope were observed between both groups,and a slight negative balance was maintained.Thoracic kyphosis showed a mild increment in both groups.Thoracolumbar junctional kyphosis resulted in a trivial kyphotic trend.Proximal junctional measurement showed a slight increment in kyphosis,and instrumented segment angle displayed a decreasing lordotic trend.Conclusion Fusion to UEV in anterior selective fusion of Lenke type 5 curve might lead to a better correction of the thoracolumbar/lumbar curve and the unfused proximal thoracic curve,while have no significant influence on the sagittal reconstruction.

Objective To analyze the outcomes of bracing treatment for girls with adolescent idiopathic scoliosis (AIS), and to investigate the predictive factors of the protocol. Methods This study included 142 girls with AIS who finished standardized bracing treatment from July 2003 to July 2009. These patients had a mean age of 13.1±1.5 years, a mean main curve of 29.6°±5.4°, and a mean Risser grade of 2.0±1.5 before bracing treatment. Curve progression was defined that Cobb angle was greater than 6° compared to bracing initiation or was aggravated to more than 45° (indicative for surgery). The outcomes of bracing treatment were assessed based on the ratio of curves of progression or indicative for surgery. Chi-square and Logistic regression Analyses were performed to investigate the predictive factors of bracing treatment. Results The duration of bracing treatment averaged 2.5±1.0 years. Twenty-seven girls with curve progression (19%)and 115 girls (81%) with non-progression were found. Final curve which was greater than 45° was found in 18 girls (13%) who need a correction surgery, the remaining 124 girls (87%) had completed bracing treatment and avoided surgery. Chi-square analyses revealed that curve progression were more common in younger girls with lower Risser grade, with initial larger Cobb angle and with a main thoracic curve pattern.Logistic regression analyses found that premenarchal status and a main thoracic curve pattern were the independent risk factors of curve progression despite bracing. While initial Cobb angle which was greater than 30° was the additional independent risk factor of progression requiring surgery. Conclusion Bracing treatment could effectively prevent curve progression in most girls with AIS. The degree of growth maturity, the pattern and grade of curve are the influencing factor for bracing treatment.

OBJECTIVETo determine the effects of dihydroartemisinin (DHA) on the proliferation and apoptosis of rat glioma C6 cells.

METHODSDHA (1~ 125 micromol/L) was added into the cultured C6 cells and incubated for 24, 48 and 72 h. The cell proliferation and viability were determined by trypan blue exclusion assay and 3-(4, 5-dimethylthiazol-2yl)-2, 5 diphenyl tetrazolium bromide (MTT) reduction assay. The apoptosis was detected by Hoechst 33342 staining. The intracellular reactive oxygen species (ROS) was measured by H(2)DCFDA oxidative reaction.

RESULTSDHA 5 ~ 125 micromol/L inhibited the proliferation of C6 cells in concentration- and time-dependent manners, the IC50 at 48 h was 23.4 micromol/L. DHA 5 ~ 25 micromol/L induced C6 cell apoptosis (P<0.05), and 5 ~ 125 micromol/L increased the intracellular ROS (P<0.01).

CONCLUSIONDHA inhibits the proliferation and induces the apoptosis of C6 cells; its cytotoxic effect may result from the increase of intercellular ROS.

Animals ; Antineoplastic Agents, Phytogenic ; pharmacology ; Apoptosis ; drug effects ; Artemisinins ; pharmacology ; Brain Neoplasms ; metabolism ; pathology ; Cell Line, Tumor ; Cell Proliferation ; drug effects ; Glioma ; metabolism ; pathology ; Inhibitory Concentration 50 ; Rats ; Reactive Oxygen Species ; metabolism ; Sesquiterpenes ; pharmacology ; Time Factors

Adenoma ; metabolism ; pathology ; Adult ; Carcinoma, Renal Cell ; metabolism ; pathology ; Diagnosis, Differential ; Ear Neoplasms ; complications ; genetics ; metabolism ; pathology ; surgery ; Endolymphatic Sac ; Female ; Follow-Up Studies ; Humans ; Kidney Neoplasms ; metabolism ; pathology ; Middle Aged ; Paraganglioma ; metabolism ; pathology ; Point Mutation ; Von Hippel-Lindau Tumor Suppressor Protein ; genetics ; von Hippel-Lindau Disease ; complications ; genetics ; metabolism

OBJECTIVETo establish an adolescent violence crime prediction model, and to assess the value of serotonin transporter (5-HTT) gene polymorphism for the assessment and prediction of violent crime.

METHODSInvestigative tools were used to analyze the difference in personality dimensions, social support, coping styles, aggressiveness, impulsivity, and family condition scale between 223 adolescents with violence behavior and 148 adolescents without violence behavior. The distribution of 5-HTT gene polymorphisms (5-HTTLPR and 5-HTTVNTR) was compared between the two groups. The role of 5-HTT gene polymorphism on adolescent personality, impulsion and aggression scale also was also analyzed. Stepwise logistic regression was used to establish a predictive model for adolescent violent crime.

RESULTSSignificant difference was found between the violence group and the control group on multiple dimensions of psychology and environment scales. However, no statistical difference was found with regard to the 5-HTT genotypes and alleles between adolescents with violent behaviors and normal controls. The rate of prediction accuracy was not significantly improved when 5-HTT gene polymorphism was taken into the model.

CONCLUSIONThe violent crime of adolescents was closely related with social and environmental factors. No association was found between 5-HTT polymorphisms and adolescent violence criminal behavior.

Adolescent ; Adolescent Behavior ; psychology ; Crime ; psychology ; Humans ; Male ; Polymorphism, Genetic ; Serotonin Plasma Membrane Transport Proteins ; genetics ; Violence ; psychology

OBJECTIVETo summarize the clinical characteristics, diagnosis and treatment of gastric neurogenic tumors.

METHODSClinical data of 11 patients with gastric neurogenic tumors confirmed by pathology, operation and immunohistochemistry were analysed retrospectively.

RESULTSThere were 7 males and 4 females with a median age of 55.5 years. The main manifestations were gastrointestinal hemorrhage, abdominal pain, upper abdominal discomfort and anaemia. Nine patients underwent gastroscopy and only one case was confirmed by the examination. Two patients were diagnosed during operation. Eight patients were submitted to subtotal gastrectomy, three were partial gastrectomy. All patients were followed up, and perioperative death occurred in one patient because of respiratory failure, recurrence occurred in two patients. Other patients with long- term follow- up had a good prognosis.

CONCLUSIONSGastric neurogenic tumors have no specific clinical characteristics preoperatively, and the misdiagnosis rate is high. Once the diagnosis of gastric neurogenic tumors is made, an operation should be performed as early as possible.

Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Neoplasm Staging ; Prognosis ; Retrospective Studies ; Stomach Neoplasms ; diagnosis ; pathology ; surgery

The risk factors of high trait anger of juvenile offenders were explored through question naire study in a youth correctional facility of Hubei province,China.A total of 1090 juvenile offenders in Hubei province were investigated by self-compiled social-demographic questionnaire,Childhood Trauma Questionnaire (CTQ),and State-Trait Anger Expression Inventory-Ⅱ (STAXI-Ⅱ).The risk factors were analyzed by chi-square tests,correlation analysis,and binary logistic regression analysis with SPSS 19.0.A total of 1082 copies of valid questionnaires were collected.High trait anger group (n=316) was defined as those who scored in the upper 27th percentile of STAXI-Ⅱ trait anger scale (TAS),and the rest were defined as low trait anger group (n=766).The risk factors associated with high level of trait anger included:childhood emotional abuse,childhood sexual abuse,step family,frequent drug abuse,and frequent internet using (P＜0.05 or P＜0.01).Birth sequence,number of sibling,ranking in the family,identity of the main care-taker,the education level of care-taker,educational style of care-taker,family income,relationship between parents,social atmosphere of local area,frequent drinking,and frequent smoking did not predict to high level of trait anger (P＞0.05).It was suggested that traumatic experience in childhood and unhealthy life style may significantly increase the level of trait anger in adulthood.The risk factors of high trait anger and their effects should be taken into consideration seriously.

Objective:To modify the global alignment and proportion (GAP) score according to the spinopelvic alignment of healthy volunteers and to validate the reliability of the GAP score and the modified GAP (M-GAP) score in the prediction of mechanical failure after corrective surgeries in adult degenerative scoliosis (ADS).Methods:Clinical and radiographical data of 66 ADS patients undergoing correction surgeries in our center between January 2014 and January 2017 were retrospectively reviewed. The average age of the cohort was 60.2±7.1 years, including 13 male patients and 53 female patients. The predictive ability of GAP score to the mechanical failure was validated with Fisher's exact test and Linear-by-linear association test. Sagittal spinopelvic parameters were measured on lateral full-spine X-rays of 67 healthy volunteers aged between 50 and 70. The average age of these subjects was 58.2±5.4 years. Values of spinal and pelvic parameters including pelvic incidence (PI), sacral slope (SS), lumbar lordosis (LL), global tilt (GT) and sagittal vertical axis (SVA) were measured. Simple linear regression analysis was conducted between PI and SS, LL and GT, respectively. The equations of regression analysis were used to calculate patients' ideal SS, LL and GT, and to establish the modified GAP (M-GAP) score. The predictive ability of M-GAP score to the mechanical failure was also validated.Results:Sagittal spinal and pelvic parameters of healthy subjects were measured and illustrated. The correlations between SS, LL and PI were SS=0.40×PI+12, LL=0.46×PI+22 and GT=0.46×PI-5. According to the GAP score, the postoperative sagittal spinopelvic alignment was proportioned in 16 (24.2%) cases, moderately disproportioned in 32 (48.5%) cases and severely disproportioned in 18 (27.3%) cases according to the original GAP score, and the occurrence of mechanical complication was 18.8% (3/16), 12.5% (4/32) and 22.2%(4/18) respectively. The GAP categories were not significantly correlated with the prevalence of mechanical failure ( P=0.633), and no significant linear correlation was found (χ 2=5.022, P=0.822). After re-evaluation of M-GAP score, the postoperative sagittal spinopelvic alignment was proportioned in 32 (48.5%) cases, moderately disproportioned in 25 (37.9%) cases and severely disproportioned in 9 (13.6%) cases, and the occurrence of mechanical failure was 6.3% (2/32), 24.0% (6/25) and 30%(3/9), respectively. The prevalence of mechanical failure was statistically different between proportioned, moderately disproportioned and severely disproportioned spinopelvic alignment patients classified by M-GAP score ( P=0.048), and there was a statistically significant linear association between the M-GAP categories and the occurrence of mechanical complications (χ 2=0.093, P=0.034). Conclusion:Poor predictive ability of the original GAP score to the mechanical failure was detected in ADS patients. However, the modified GAP score seemed to be a reliable predictor for mechanical failure in ADS patients.