OBJECTIVETo investigate the early clinical effects and radiological outcome of dynamic cervical implant (DCI) internal fixation in treating cervical spondylosis, and evaluate its safety and efficiency.

METHODSFrom June 2009 to December 2011, 19 patients with cervical spondylosis correspond to the indication of DCI internal fixation in the study, including 5 cases of cervical spondylotic myelopathy and 14 cases of cervical spondylotic radiculopathy. There were 8 males and 11 females, aged from 35 to 54 years with a mean of 43.2 years. Pathological segments included C3,4 in 1 case, C4,5 in 6, C5,6 in 6, C6,7 in 4, C3,4 and C5,6, C6,7 in 2. All patients were treated with anterior discectomy and decompression and DCI internal fixation, meanwhile, 2 cases of them with anterior cervical corpectomy and fusion plate fixation. Clinical evaluation included Modified Japanese orthopedics association (mJOA), neck disability index (NDI), visual analogue scale (VAS) score and patient satisfaction index (PSI) at pre-operation and final follow-up. Radiographic evaluation included flexion/extension lateral view at operative level and adjacent segment. The adjacent level degeneration was analyzed according to Miyazaki classification on MRI images.

RESULTSAll patients were followed up from 12 to 42 months with an average of 19.8 months. Preoperative mJOA score was 13.6±1.1 and at final follow-up was 16.3±1.2 with improvement rate of 85.0%. Preoperative VAS,NDI was 6.6± 1.4, 17.1±7.4 and at final follow-up was 1.4±0.8, 6.1±3.9, respectively; there was statistical significance in all above-mentioned results between preoperative and final follow-up (P<0.05). Preoperative ROM at operation level was (7.6±1.9)° and final follow-up was (7.8+2.1)°; preoperative ROM at C2-C7 was (38.6±7.2)° and final follow-up was (39.9±6.4)°; there was no statistical significance in all above-mentioned results between preoperative and final follow-up (P>0.05). Preoperative DHI at operation level was (6.3±1.1) mm and final follow-up was (7.1±0.8) mm, there was statistical significance in DHI between preoperative and final follow-up (P<0.05). No heterotopic ossification was found. All patients followed up MRI, degeneration of 3 segments aggravated 1 degree in 38 adjacent segments, without clinical symptom.

CONCLUSIONTreatment of cervical spondylosis with dynamic cervical implant can got satisfactory outcome in early follow-up. Activity of operative segment obtain reservation in some degree. The incidence of adjacent segment degeneration is lower and no adjacent segment disease occur. Nevertheless a longer follow-up time should be needed to assess the long term functionality of the DCI and the influence on adjacent levels.

Adult ; Cervical Vertebrae ; surgery ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Male ; Middle Aged ; Prostheses and Implants ; Range of Motion, Articular ; Spondylosis ; physiopathology ; surgery

In Western countries, more and more people select acupuncture and moxibustion as medical ways, and more and more acupuncture and moxibustion research organizations are set up. Britain TCM foundation is such one center for acupuncture research. This center is aimed at promoting acupuncture research. Since 1991, a series of clinical trials and several big research tasks have been completed. The clinical designs in the center are very careful and scientific, being worth to be learnt. In the paper, clinical studies in the center are introduced for increasing levels of acupuncture and moxibustion research at home.
Acupuncture ; Acupuncture Therapy ; Biomedical Research ; History, 20th Century ; Humans ; Moxibustion ; United Kingdom

Objective To systematically evaluate the effectiveness and safety of Elemene combined with radiotherapy for intervention in brain metastasis from pulmonary neoplasms. Methods Articles of clinical randomized controlled trials about Elemene combined with radiotherapy for intervention in brain metastasis from pulmonary neoplasms from the establishment of the databases to October of 2016 from CNKI, CBM, Chongqing Weipu, Wanfang database, Cochrane Library, PubMed and Embase were retrieved by computers. Bias risk assessment tools in Cochrane systematic evaluation handbook 5.1.0 was used to conduct quality evaluation for included articles. RevMan5.3 software was used to carry out Meta-analysis. Results Totally 12 articles and 839 patients were included. Results of Meta-analysis showed that Elemene combined with radiotherapy had more obvious curative effect on narrowing the neoplasm compared with pure radiotherapy [OR=2.73, 95%CI (1.97, 3.77), P<0.000 01], and improve patients' life quality at the same time [OR=3.85, 95%CI (2.23, 6.65), P<0.000 01], and relieve adverse reactions [OR=4.16, 95%CI (2.40, 7.22), P<0.000 01]. Conclusion Elemene combined with radiotherapy for intervention in brain metastasis from pulmonary neoplasms shows confirmed efficacy, and is relatively safe. But whether the program should be widely used in clinic, more large sample, multi-center, and high-quality clinical randomized controlled trials are still needed.

AIMTo exploit the characteristic digital criterion for the potential information characteristics of traditional Chinese medicine chromatographic fingerprints, the 37 parameters such as F and I were firstly proposed to disclose the potential information characteristics of traditional Chinese medicine fingerprints.

METHODSThe HPLC fingerprints of the Ginkgo biloba extract (GBE) , Ginkgo leaf extract and diphyridamole injection (GLEDI), Ixeris sonchifolia Hance (ISH) and Ixeris sonchifolia Hance injection (ISHI) were compared each other.

RESULTSAs far as the peak signal intensity, the uniform of peak signal, resolution and the fingerprint information were concerned. The GBE fingerprint was better than the GLEDI's, and the ISH fingerprint was also better than the ISHI's, then GBE fingerprint was close to the ISHI' s.

CONCLUSIONThe 37 parameters such as F and I can be used to objectively, authentically and thoroughly display the potential information characteristics of the traditional Chinese medicine chromatographic fingerprints.

Asteraceae ; chemistry ; Chromatography, High Pressure Liquid ; methods ; Drugs, Chinese Herbal ; chemistry ; isolation & purification ; Ginkgo biloba ; chemistry ; Medicine, Chinese Traditional ; Plant Leaves ; chemistry

OBJECTIVE: To investigate the clinical application of percutaneous vertebroplasty (PVP). METHODS PVP was performed in 21 cases of 37 vertebral lesions,including 14 osteoporotic compression fractures, 6 metastases, 1 hemangioma,and 17 lesions in thoracic vertebra and 20 in lumbar. The procedures of PVP were as follows: The needle was inserted via percutaneous transpedicular approach or percutaneous posterolateral vertebral approach; the needle tip was placed at the junction of the anterior located the one third of the vertebral body; intraosseous venography was performed; and last bone cement was injected at 2-10 mL. The technical success rate, clinical efficacy and complications were observed after the procedure. Results The procedure was successful in 18 cases with 31 lesions,and the success rate according to the number of cases and vertebral lesions was 85.7% (18/21) and 83.8% (31/37), respectively. After the procedure, the numbers of complete remission, partial remission, mild remission and no remission were 10, 5, 2 and 1, respectively; and the total effective rate was 94.4% (17/18). Progressive compression did not occur. Three patients had transient neuropathy and recovered after physiotherapy. Other complications were insignificant; no severe complications occurred. Conclusion PVP is an effective and micro-traumatic treatment for patients with benign and malignant lesions in vertebral bodies.
Adult ; Aged ; Female ; Fractures, Compression ; surgery ; Humans ; Lumbar Vertebrae ; surgery ; Male ; Middle Aged ; Orthopedic Procedures ; methods ; Osteoporosis ; complications ; Spinal Fractures ; etiology ; surgery ; Thoracic Vertebrae ; surgery

The combination use of dexamethasone and calcium gluconate can be applied to hypersensitivity. Severe hypokalemia is a usual complication of dexamethasone and calcium gluconate therapy, which occurs frequently with therapeutic use. Fatal cases, accidental and intentional, occur frequently in forensic practice. The current case report presented a 43-year-old man with diabetes mellitus with infection, to whom dexamethasone and calcium gluconate were administered in the private clinic. With the development of such clinical symptoms of severe hypokalemia as quadriplegia, he was confirmed to have severe hypokalemia through a biochemical test before dying of arrhythmia. And also it presented pathophysiologic mechanism underlying severe hypokalemia as well as suggestions for clinical practice regarding combination use of dexamethasone and calcium gluconate.
Adult ; Anti-Inflammatory Agents/adverse effects* ; Calcium Gluconate/adverse effects* ; Dexamethasone/adverse effects* ; Diabetes Mellitus ; Fatal Outcome ; Humans ; Hypokalemia/chemically induced* ; Male

Postmortem chemistry is becoming more and more essential in routine forensic pathology and has made considerable progress over the past years. Biochemical analyses of vitreous humor, blood, urine and cerebrospinal fluid may provide important information in determining the cause of death or in elucidating forensic issues. Postmortem chemistry may be essential for the determination of cause of death when morphological methods (diabetes mellitus, alcoholic ketoacidosis and electrolytic disorders) cannot detect the pathophysiological changes involved in the death process. It can also provide many information in other forensic situations, including myocardial ischemia, sepsis, inflammation, infection, anaphylaxis and hormonal disturbances. The most recent relevant research advances on glucose metabolism, liver function, cardiac function, renal function, sepsis, inflammation, infection, anaphylaxis and hormonal aspect are hereby reviewed.
Anaphylaxis ; Autopsy/trends* ; Biomarkers/analysis* ; Body Fluids/chemistry* ; Death ; Diabetes Mellitus ; Forensic Pathology/methods* ; Humans ; Postmortem Changes ; Sepsis ; Vitreous Body

Objective To investigate the clinical outcomes of patients undergoing microsurgery for cerebellar medulloblastoma. Methods This retrospective analysis of the clinical and follow-up data involves 57 patients who received microsurgery for pathologically confirmed cerebellar medulloblastorna, and the microsurgical techniques for medulloblastoma were discussed. Results Among the 57 patients, 42 had total tumor resection, 13 had subtotal and 2 had partial resection of the tumors. Patency of the midbrain aqueduct was achieved in all the cases after the surgery. Hydrocephalus was found in 43 patients before the operation and only in 16 patients after the operation. Tumor relapse occurred in 19 patients 2 years after the operation, including 8 with implantation metastasis compromising the central nervous system and 1 patient with frontal lobe metastasis who received reoperations. The earliest tumor relapse occurred 20 days after the surgery. The 2- and 5-year postoperative survival rates in these patients were 68.4% and 49.1%, respectively. Conclusion Good therapeutic effects can be achieved with total resection of the tumors and postoperative whole brain and spinal cord radiotherapy in patients with medulloblastomas.

Objective To study the inducement of U251 glioblastoma cell apoptosis in vivo through up-regulating PUMA expresion and knocking down miR-221/222, and explore its mechanism.Methods Nude mouse xenograft models were established in 5-week-old BALB/c nude mice by subcutaneous vaccination of U251 glioblastomas; 1 week later, they were treated with intratumoral injection of lipofcctamine-mediated miRNA-221/222 antisense oligonucleotides (GroupA), nonsense sequences (Group B) and controls (Group C),respectively (n=8).The tumor growth was monitored until the end of observation period (28 d after the treatment) and pathological changes of the glioblastoma tissues were observed by HE staining at the end of observation.Fluorescence in situ hybridization (FISH) and real-time PCR were employed to measure the miR-221 and miR-222 expressions. Terminal deoxynucleotidyl transferase-mediated uridine 5'-triphosphate-biotin nick end labeling (TUNEL) assay was used to detect the apoptosis of glioblastomas.Immunohistochemistry and Westem blotting were used to detect the expressions of PUMA,bax,bcl-2 and p53 in removed tumor specimens. Results The volume in Group A was significantly smaller than that of those in group B and group C 6-28 dater treatment (P=0.006). The miR-221 and miR-222 mRNA expressions in Group A were significantly decreased as compared with those of those in group B and group C.HE staining indicated that decreased heteromorphism and reduced number of new vessels in Group A were noted as compared with those in group B and group C.The cell apoptotic index in Group A was significantly higher than that in group B and group C (P＜0.05).Immunohistochemistry showed that the expression levels of PUMA and bax in Group A was significantly up-regulated as compared with those in group B and group C, while the expression of bcl-2 in Group A was significantly down-regulated as compared with that in group B and group C; and no significant changes were noted in the p53 expression. Conclusion By up-regulating PUMA expresion,knocking down miR-221/222 can induce U251 glioma apoptosis in vivo.

OBJECTIVETo study the prognosis and the factors affecting the prognosis in children with acute respiratory distress syndrome (ARDS).

METHODSSeventy-eight children with ARDS were enrolled. The states of their survival within 30 days were followed-up.

RESULTSOf the 78 children with ARDS, 51 cases demised, 27 cases survived, with a 30-days survival rate of 35%. The average survival time was 14.4 days (median: 8 days). The peak of death appeared within 3 days after ARDS. There were significant differences in aspects of age, primary disease, percentage of neonatal hyaline membrane disease, pediatric critical illness score (PCIS), duration of mechanical ventilation, oxygenation index (PaO(2)/FiO(2)), white blood cell count and number of involved organs between the died and survived children (P<0.05 or 0.01). The Cox multiple factors analysis showed that the age (HR 3.924~3.938), primary disease (HR=1.817) and PCIS (HR=0.469) were the risk factors of death.

CONCLUSIONSThe peak of death usually appears within 3 days after ARDS. Age, primary disease and PCIS are the independent factors of prognosis in children with ARDS.

Adolescent ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Infant, Newborn ; Male ; Multivariate Analysis ; Prognosis ; Respiratory Distress Syndrome, Adult ; mortality ; Survival Rate