ObjectiveTo investigate the clinical value of ATP bioluminescence tumor chemosensitivity assay (ATP-TCA) for recurrent and refractory non-Hodgkin lymphoma (NHL) specimens in vitro.Methods Thirty-four freshlytaken recurrent andrefractoryNHL specimens weretestedin vitro for cancer chemosensitivity by ATP-TCA.ResultsDrug sensitivity of NHL specimens had heterogeneity.Different drugs had different tumor growth inhibition ratio in vitro.Response rate (RR) of the patients receiving chemotherapy according to in vitro assay was 82.4 ％ (28/34),complete response rate (CR) was 52.9 ％ (18/34).In DICE group RR was 60.0 ％ (18/30),CR rate was 33.3 ％ (10/30).In GDP group RR was 62.3 ％ (33/53),CR rate was 26.4 ％ (14/53).In ATP-TCA group RR was significantly higher than those in DICE and GDP groups (x2 =3.93,P =0.047; x2 =3.98,P =0.046).ConclusionThe results of ATP-TCA assay are correlated well with clinical treatment responses.The assay may be an important and useful method for individual-based chemotherapy of cancers.

INTRODUCTIONMajor workplace related accidents pose a significant healthcare resource challenge in Singapore.

MATERIALS AND METHODSOur study looks at the epidemiology of patients who were admitted for workplace related accidents, in a single institution, with an Injury Severity Score of >9.

RESULTSThere were 196 cases of major workplace related accidents admitted between January 2006 and December 2007. The median age of patients admitted was 37 years with a large percentage being males (95.4%) and non-residents (57.1%). The most common ethnic group was Chinese (53.1%) followed by Indians (23.5%). The most common mechanism of injury was fall from height (66.3%) followed by injuries as a result of falling objects at work (21.9%). The percentage of patients who required surgical intervention was 69.9%. Patients admitted for major workplace related accidents had a median length of stay of 5 days in the hospital, a median length of 24 days of medical leave (ML), certifying them unfit for duty and the average cost of stay for each patient was S$11,000.

CONCLUSIONSWe have a better understanding of the epidemiology and socio-economic impact of workplace related accidents through this study. Workplace related accidents result in significant number of man-days lost from work and monetary cost to employers, medical insurance and the hospital. With an improved understanding, we propose methods to prevent and reduce such accidents in future. A direct consequence of which will be the possible reduction of hospitalisation costs and better allocation of healthcare resources in the future.

Accidents, Occupational ; trends ; Adult ; Female ; Humans ; Male ; Middle Aged ; Registries ; Singapore ; epidemiology ; Trauma Centers ; Trauma Severity Indices ; Wounds and Injuries ; epidemiology ; surgery ; Young Adult

ObjectiveTo observe the distribution of vitamin D receptor(VDR) gene polymorphisms in coal-burning borne fluorosis in Guizhou province and investigate the relationship between VDR gene polymorphisms and the susceptibility to coal-burning borne fluorosis.MethodsOne hundred and fifty villagers from non-improving cooking stove villages were selected as a non-intervention group in Bijie area,Guizhou province where coal-burning borne fluorosis was prevailing; 150 villagers were chosen from cooking stove improved villages as a intervention group; 150 villagers were selected from non-endemic area Changshun county as a control group.DNA was extracted from peripheral blood samples of these people.Genotype of VDR gene Bsm Ⅰ and Fok Ⅰ loci were detected using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP).ResultsDistribution of Bsm Ⅰ polymorphism site of VDR gene of control group [AA:19.3％ (29/150),AG:39.3％ (59/150),GG:41.3％(62/150)],was compared with that[AA:4.7％(7/150),AG:14.0％(21/150),GG:81.3％(122/150)] of the non-intervention group and that[AA:7.3％(11/150),AG:23.3％(35/150),GG:69.3％(104/150)] of intervention group,and the difference was statistically significant(X2 =56.6,P ＜ 0.05).The frequency of VDR-Fok Ⅰ loci in non-intervention group [TT:29.3％(44/150),TC:55.3％(83/150),CC:15.3％(23/150)] and intervention group [TT:32.7％(49/150),TC:55.3％(83/150),CC:12.0％(18/150)] was compared with that [TT:45.3％(68/150),TC:48.7％(73/150),CC:6.0％(9/150)] of control group,and the difference was statistically significant(X2 =11.9,P ＜ 0.05).Univariate analysis showed that individuals carrying the GG genotype had increased risk of suffering fluorosis than individuals carrying the AA and AG genotypes(OR values were 6.2,3.2,all P ＜ 0.05),while carrying the TC and CC genotype had increased risk of suffering fluorosis than individuals carrying the TT genotype (OR values were 1.3,2.8,1.3,2.1,all P ＜ 0.05).ConclusionVDR gene polymorphisms may be one of the predisposing factors of coal-burning borne fluorosis.

Objective To observe the time course of changes in synaptophysin (P38) expression in the cortex and hippocampus of rats with posttraumatic epilepsy (PTE), and explore the role of synaptic plasticity in the epileptogenesis of PTE. Methods Thirty-seven male Sprague-Dawley rats were randomized into normal control group (n=5), sham-operated group (n=12) with intracortical saline injection, and PTE model group (n=20) with stereotactic FeCl<,2> injection (0.1 mol/L, 10 μ1) into the motor cortex. The expression of P38 in the brain cortex and hippocampus of the rats was detected immunohistochemically at 1 h and 7, 14 and 30 days after the injections. Results Most of the rats with FeCl<,2> injection developed isolated epileptiform discharges soon alter the injection. Compared with the sham-operated groups, the rats in PTE group showed significantly decreased P38 expression in the right frontal cortex at all the time points of measurement (P<0.05). At 1 h after FeCl<,2> injection, P38 expression in the polymorphic layer, stratum lacunosum and stratum radiatum of the right hippocampai CA3 area and DG molecular layer underwent no significant changes (P>05), but at 7 days, the expression increased significantly in all the stratum regions of the right hippocampal CA3 area, and this high expression level was maintained till 30 days after the injection. Conclusion Synaptic plasticity alterations in relation to P38 expression changes in the cortex and hippocampus may play an important role in the epileptogenesis of PTE in this rat model.

INTRODUCTIONThis study aimed to evaluate the clinical and radiological outcomes, and safety and efficacy of percutaneous pedicle screw fixation (PPSF) in the treatment of thoracolumbar burst fractures.

METHODSThis was a retrospective review of patients with thoracolumbar burst fractures treated with PPSF in a single hospital from 2010 to 2011. Baseline data included patient demographics, mechanism of injuries, fracture level, neurologic status and the number of percutaneous screws inserted. Kyphotic angle correction, vertebral body height restoration and mid-sagittal canal diameter improvement were used to assess radiological outcome. Screw misplacement, operative complications, functional improvement (ASIA score) and pain score on visual analogue scale were used to assess safety and clinical outcomes.

RESULTS21 patients with 25 thoracolumbar burst fractures were treated with 134 percutaneous screws. There was significant improvement in kyphotic angle correction (mean difference 6.1 degrees, p = 0.006), restoration of anterior and posterior vertebral height (mean difference 19.7%, p < 0.01 and mean difference 6.6%, p = 0.007, respectively) and mid-sagittal canal diameter (mean difference 15.6%, p = 0.007) on discharge. These improvements remained statistically significant at six months post operation for restoration of anterior vertebral body height (mean difference 9.8%, p = 0.05) and mid-sagittal diameter (mean difference 30.0%, p < 0.01).

CONCLUSIONIn this first local review, we have shown that PPSF is a relatively safe and effective technique for treating selected thoracolumbar burst fractures, and that it yields satisfactory results. However, its long-term outcome and efficacy need to be further evaluated.

Adult ; Aged ; Bone Screws ; Female ; Fracture Fixation, Internal ; adverse effects ; instrumentation ; methods ; Humans ; Lumbar Vertebrae ; injuries ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; Radiography ; Retrospective Studies ; Safety ; Singapore ; Spinal Fractures ; diagnostic imaging ; surgery ; Thoracic Vertebrae ; injuries ; Treatment Outcome

Objective To study the anatomical features of medial wall of the glomus jugulare to provide the theoretical direction for surgery of the glomus jugulare. Methods Fifteen (30 sides)formalin-fixed adult cadaveric specimens were dissected under the operating microscope, and their structural features of the medial wall of the glomus jugulare and their anastomosis of nerves were observed; and 5 dry skull specimen were also employed to observe the bone landmark of medial wall of the glomus jugulare. Results The medial wall of the glomus jugulare is composed of endocranial opening of the jugular foramen, jugular process of the temporal bone and occipital bone, cerebral dura mater and the Ⅸ, Ⅹ and Ⅺ cranial nerves. A curve line was marked on medial wall of the glomus jugulare, finding that the cranial nerves and the cerebral dura mater are at the anteroinferior position and the posterior-up part is composed of the well of the jugular vein adhered to the petrous bone and cerebral dura mater. Cranial nerve Ⅸ travels at the anterosuperior part of its own fibrous sheath and the inferior petrosal sinus ostium separates it from cranial nerves Ⅹ and Ⅺ; cerebral dura mater separates the cranial nerves Ⅸ and Ⅹ. The cranial nerve Ⅹ and the accessory nerve are closely related. Interval of cerebral dura mater between cranial nerve Ⅸ and Ⅹ is clearly seen in 86.67％ (26/30) patients and illegible in 13.33％ (4/30). Hypoglossal canal travels of the bottom of the medial wall of the glomus jugulare. Conclusion The medial wall of the glomus jugulare is composed of endocranial opening of the jugular foramen,jugular process of the temporal bone and occipital bone, cerebral dura mater and the Ⅸ, Ⅹ and Ⅺ cranial nerves, and this information can help the clinicians during the operations of the jugulare foramen, so that the operation complications can be reduced.