Objective To provide the endoscopic anatomic basis and anatomic parameters for endoscopic surgical therapy on orbital lesions , and to analyze the advantages and key points of this surgical approach .Methods Five fresh adult heads were used in this experiment .Endonasal thanslamina approach and endoscopic technique were applied to observe important anatomic marks while intraoperative medicalization of the medical rectus muscle was applied to observe the exposure and positioning of important structures and trends of the optic canal and intra orbit .Results Uncinate process was at the lower front corner of middle nasal concha; ethmoidalis bulla was behind the uncinate process , and ethmoidei sinus was reachable after an incision was made on ethmoidalis bulla;anterior ethmoidal artery and posterior ethmoidal artery were the important anatomic landmarks of the inner ethmoidei sinus;optic canal prominence , carotid artery prominence and OCR were the important anatomic landmarks of the inner sphenoid sinus; lamina papyracea was at the lateral wall of ethmoidei sinus , and orbital contents were approacchable after lamina papyracea was cut off ;inside orbit , the optic nerve was approachable through the gap between the medial rectus muscle and inferior rectus muscle .The ophthalmic artery of 9 out of 10 sides of the specimens was originated from the supraclinoidal segment of the internal carotid artery while the remaining one was originated from the cavernous segment of internal carotid artery .There were 7 sides in which ophthalmic artery was located at the inferior lateral of the optic nerve;there were 2 sides in which ophthalmic artery was located at the inferior of the optic nerve; the remaining one was located at the inferior medial of the optic nerve .Conclusion The endoscopic endonasal thanslamina approach can sufficiently expose the optic nerve and the structures in the medical space of the orbit.Uncinate process, ethmoid bulla, anterior ethmoidal artery, posterior ethmoidal artery and posterior ethmoid sinus are the important landmarks of the endoscopic endonasal thanslamina approach .Optic canal prominence , internal carotid artery prominence and OCR are the important landmarks for optic canal decompression .Ophthalmic artery , orbital branches , anterior ethmoidal artery , posterior ethmoidal artery , internal carotid artery are the important vessels . Medialization of the medial rectus muscle is effective to approach the orbital anatomical structures .

PURPOSETo explore the possible surgical factors related with nonunion in femoral shaft fracture following intramedullary nailing.

METHODSWe retrospectively analyzed totally 425 patients with femoral shaft fracture in level I urban trauma center, including 254 males and 171 females, with an average age of 37.6 (ranging from 21 to 56) years old. The inclusion criteria included: (1) traumatically closed fracture of femoral shaft, with pre- operative films showing non-comminuted fracture, such as transverse fracture, oblique fracture or spiral fracture; (2) closed reduction and fixation with interlocking intramedullary nail at 3-7 days after trauma; (3) complete follow-up data available. The relationship between the following factors (fracture site, reduction degree, direction of nail insertion and nail size) and nonunion was studied.

RESULTSThe incidence of femoral nonunion was 2.8% in patients with closed simple fracture undergoing interlocking intrameduallary nailing, including 11 cases of hypertrophic nonunion. Nonunion was related significantly to distal fracture, unsatisfactory reduction and unreamed nail (p < 0.05). There was no significant difference between antegrade nail and retrograde nail (p > 0.05).

CONCLUSIONSNonunion in femoral shaft facture following interlocking intramedullary nailing is related to fracture site, fracture reduction and nail diameter. The choice of reamed nails or unreamed nails depends on the fracture site and reduction degree.

Adult ; Age Distribution ; China ; Cohort Studies ; Female ; Femoral Fractures ; diagnostic imaging ; surgery ; Follow-Up Studies ; Fracture Fixation, Intramedullary ; adverse effects ; methods ; Fracture Healing ; physiology ; Fractures, Ununited ; epidemiology ; etiology ; surgery ; Humans ; Incidence ; Injury Severity Score ; Male ; Middle Aged ; Reoperation ; methods ; Retrospective Studies ; Risk Factors ; Sex Distribution ; Time Factors ; Trauma Centers ; Treatment Outcome ; Urban Population ; Young Adult

Objective:To construct the molecular transmission network of human immunodeficiency virus type 1 (HIV-1) epidemic strains in northern Zhejiang Province (Jiaxing City and Huzhou City) and to explore the HIV-1 transmission characteristics in this region.Methods:A total of 371 newly diagnosed human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) patients in Jiaxing City and Huzhou City in 2017 were included as study subjects, and the blood samples were collected and the basic demographic and epidemiological information were obtained. RNA in plasma was extracted, and the pol region gene sequence was amplified by reverse transcriptase polymerase chain reaction (RT-PCR) and nested polymerase chain reaction (PCR) to construct phylogenetic tree for identifying subtypes. The pairwise genetic distances were calculated, and the optimal threshold of genetic distance was selected, and finally the molecular transmission network was constructed. Chi-square test was used for statistical analysis. Results:The pol region gene sequences of 336 samples were successfully obtained, and 11 subtypes were detected, mainly including circulating recombinant form (CRF)07_BC (40.8%, 137/336) and CRF01_AE (31.2%, 105/336). Based on the 1.0% genetic distance threshold, the molecular transmission network of HIV-1 was plotted. A total of 38 transmission clusters (cluster sizes ranging from two to 28) including 119 patients were found, with males predominantly (82.4%, 98/119) and most of the patients aged over 40 (include 40) years old (52.9%, 63/119), mainly infected with CRF07_BC subtype (57.1%, 68/119) and CRF01_AE (24.4%, 29/119). The clustering rate of CRF07_BC (49.6%, 68/137) was significantly higher than that of CRF01_AE (27.6%, 29/105), the difference was statistically significant ( χ2=5.27, P=0.022). Two large clusters C1 (28 cases) and C2 (11 cases) were identified, the majority of which were men who have sex with men (17 cases and seven cases, respectively). High-risk cases generally sought sexual partners in local or nearby cities through mobile phone dating software, of which the infected sequences mostly had high homology with other economic developed regions (Guangdong Province, Beijing City and Hangzhou City, etc.). Conclusions:The HIV-1 subtypes are diverse in Jiaxing City and Huzhou City, mainly CRF07_BC and CRF01_AE. The HIV-1 transmission networks are complex, among which high-risk cases may be the key factor leading to the HIV-1 epidemic in the region. Therefore, it is urgent to deepen the transmission network monitoring and formulate timely precise intervention and prevention strategies.

ABSTRACT:OBJECTIVE To investigate the role of connexin proteins (Cx), which form gap junctions (GJ), in progression and chemotherapeutic sensitivity of cervical cancer (CaCx). METHODS We analyze the expression of Cx26, Cx30, Cx32 and Cx43 in human specimens consisting of: Normal cervix (n=78), CaCx FIGO stage Ⅰ (n=148), CaCx FIGO stage Ⅱ (n=165). InCaCx cell lines, Hela- Cx32 (induced expression by doxycycline), C- 33A (endogenously express Cx32) and siHa (transiently transfected plasmid with Cx32), we detected the role of Cx32 against tostreptonigrin/cisplatin-induced apopotosisin presence or absence of functional GJ through using GJ inhibitors or low density cultural.Furtherly, we observed the relativity of Cx32 and EGFR expression in human specimens. Also, we detected the role of EGFR signaling pathway in the process of Cx32 anti-apoptosis through suppressed EGFR expression by inhibitors or siRNA sequences in cell lines. RESULTS We firstly demonstrated the expression of Cx32 was highly upregulated and accumulated in cytoplasm in the CaCx specimens, and the degree of upregulation correlated with advanced FIGO stages. Thus,in three human cervical cell lines, Cx32 was shown to suppress apoptosis when GJ formation is inhibited. No matter in cases of CaCx or cell lines, Cx32 expression was highly correlated with expression of EGFR and the EGFR pathway is an essential component of the Cx32-induced anti-apoptotic effect. CONCLUSION Cx32, traditionally tumor suppressive protein, was shown to be tumor protective against chemotherapy through EGFR pathway in a GJ-independent way.

Objective To explore the effect of cardiac valve replacement surgery in the medium term on patients with giant left ventricular and its related risk factors.Methods Retrospective analysis the clinical data of 82 cases of valvular heart disease with giant left ventricle underwent heart valve replacement surgery.To compare the size and function of heart between preoperation and postoperation,and explore the relevant risk factors affecting the prognosis.Results The left atrial diameter,left ventricular end diastolic diameter,and left ventricular systolic diameter (LVESD) were decreased after the operation,and the difference was statistically significant (P ＜ 0.05).There was no significant difference between left ventricular ejection fraction and left ventricular shortening rate.But the NYHA classification showed significant difference (P ＜ 0.05).The risk factors related to the prognosis of patients were preoperative LVESD value ＞6.0 cm,heart function NYHA classification in grade Ⅳ,postoperative unuse of ACEI drugs or β-blockers (P ＜ 0.05).Conclusion The perioperative mortality is low in patients with valvular heart disease and giant left ventricle after heart valve replacement surgery.The curative effect is satisfactory,the shape and size of the heart in the medium term have obvious reverse remodeling process,and the cardiac function is also improved.Preoperative LVESD value ＞6.0 cm,heart function NYHA classification in grade Ⅳ,postoperative unuse of ACEI drugs or β-blockers are the major risk factors affecting prognosis of patients.

AIMTo study the protective effect of Quinacrine(QA) on rat striatum neurons from the injury caused by heat environment treatment, to probe the relationship between cell membrane injury and cellular injury protection, and to seek the possibility of QA as a preventive agent to heat injury.

METHODSPrimary cultured striatum neurons from newborn rats were pretreated with QA at different concentration for 1 h, and then heat-treated at 43 degrees C for another 1 h. Cell necrosis was detected by Trypan blue staining, and apoptosis was evaluated through Activated Caspase-3 dye and TdT dye.

RESULTSHeat treatment effected the survival of striatum neurons and resulted in great number of cell death, which was mainly mediated by cell necrosis process. It was shown that treatment of QA itself had little effect on the survival of striatum neurons, while QA pretreatment decreased cellular necrosis caused by following heat treatment.

CONCLUSIONQA protects striatum neurons from heat environment injury at about 20 pmol/L, and the protection may mediated by reduction of necrosis.

Animals ; Apoptosis ; drug effects ; Caspase 3 ; metabolism ; Cell Death ; drug effects ; Cells, Cultured ; Corpus Striatum ; cytology ; Heat-Shock Response ; Neurons ; drug effects ; Quinacrine ; pharmacology ; Rats ; Rats, Wistar

OBJECTIVETo study the variation tendency of hypertension in two rural areas in Gansu, and provide epidemiological evidence to evaluate the hypertension of rural residents.

METHODSUsing equidistant random sampling method and cross-sectional sentinel monitoring, two remote natural villages, Yangzhuang and Xiangming, at Yellow river and Yangtze river valley were selected as hypertension monitoring site. From 1990 to 2012, clinical examination to the resident above 18 years old was carried out continuously for 23 years, 11 164 cases were included.

RESULTSHypertension prevalence of tested cases increased with years, Yangzhuang monitoring site increased from 6.9% (16/232) in 1990 to 36.7% (216/597) in 2012 with an increase of 29.8%, and Xiangming monitoring site increased from 3.4% (16/474) in 1995 to 20.6% (120/582) in 2011 with an increase of 17.2%. Total prevalence of Yangzhuang (24.1%, 1505/6240) was significantly higher than Xiangming (11.4%, 578/4924) (χ(2) = 277.9, P < 0.01). Total hypertension prevalence of 18 - 35 years old group was 9.9% (292/2944) in Yangzhuang and 4.2% (63/1495) in Xiangming, Yangzhuang was higher than Xiangming (χ(2) = 43.7, P < 0.01). Total hypertension prevalence of above 35 years old group was 36.8% (1213/3296) in Yangzhuang and 14.1% (515/3429) in Xiangming, Yangzhuang was higher than Xiangming (χ(2) = 417.7, P < 0.01). The growth rates of hypertension prevalence in 18 - 35 years old group of both areas (Yangzhuang: 823.5%, Xiangming: 614.3%) were higher than 35 years old group (Yangzhuang:310.5%, Xiangming: 368.0%), but the hypertension prevalence of above 35 years old group was higher than 18 - 35 years old group. Hypertension prevalence of male was 25.4% (761/2992) in Yangzhuang and 11.7% (238/2047) in Xiangming, Yangzhuang was higher than Xiangming (χ(2) = 145.8, P < 0.01), hypertension prevalence of female was 22.7% (738/3248) in Yangzhuang and 11.2% (340/2877)in Xiangming, Yangzhuang was higher than Xiangming (χ(2) = 125.1, P < 0.01). While the difference between male and female had no statistical significance in both areas.

CONCLUSIONHypertension of the two monitoring points was in high epidemic trend, but with different epidemic trend. From different region and environment research to discuss the cause of hypertension can provide scientific evidence for prevention and control.

Adolescent ; Adult ; China ; epidemiology ; Female ; Humans ; Hypertension ; epidemiology ; prevention & control ; Male ; Obesity ; epidemiology ; Population Surveillance ; Prevalence ; Risk Factors ; Rural Population ; Young Adult

Objective To design and manufacture a multifunctional cushion for venous thrombosis prevention of lower extremities, which can be also applied to the low extremities needing raising. Methods The cushion was made of anti-rust, low-weight, undeformable and easy-to-clean stainless material, which was composed of a pad and a massage apparatus. The pad had its height regulable from 16 to 30 cm and telescopic inclination from 30 to 70° to adapt the cushion to sizes of patients. There were 6 independent air chambers and tubular circulating pipes around the blanket wrapping the chambers so that extremity massage and temperature-controlled heating could be executed based on setting up pressure, time and temperature of the electromagnetic air and water pumps. Results The cushion simulated the functions of the muscle pump, which formed step-by-step-increasing pressure changes by driving the chambers to be inflated and discharged continuously to execute extremity massage, temperature-controlled heating etc. Conclusion The cushion gains advantages in flexible composition, patient comfort etc, solves the problems in fixing angle and height, constant time for pump inflation and discharge as well as temperature-controlled heating, and thus is worthy promoting clinically.

OBJECTIVETo study the prognostic value of hematogones (HGs) for childhood B-lineage acute lymphoblastic leukemia (B-ALL) during consolidation chemotherapy.

METHODSA retrospective analysis was conducted for 196 children with newly-diagnosed B-ALL. They were divided into high-risk group (n=55), intermediate-risk group (n=69), and low-risk group (n=72) by risk stratification, and into complete remission group (n=165) and relapse group (n=31) by clinical outcome. The European BIOMED-1 standard flow cytometry for minimal residual disease (MRD) was used to determine the number of HGs during consolidation chemotherapy. The Kaplan-Meier survival curve was used to assess event-free survival (EFS).

RESULTSThe high-risk group had a significantly lower number of HGs than the intermediate-risk and low-risk groups (P<0.05). The number of HGs in the complete remission group was significantly higher than in the relapse group (P<0.05). The children with HGs ≤1.0% had a significantly lower EFS than those with HGs <1.0% (P<0.05).

CONCLUSIONSHGs can be used to assess the treatment outcome and prognosis in children with B-ALL, and proliferation of HGs reflects the good effect of chemotherapy in such children.

Adolescent ; Bone Marrow ; pathology ; Child ; Child, Preschool ; Female ; Flow Cytometry ; Humans ; Infant ; Male ; Neoplasm, Residual ; Precursor B-Cell Lymphoblastic Leukemia-Lymphoma ; mortality ; pathology ; Prognosis ; Retrospective Studies

OBJECTIVETo study the impact of abdominal obesity on the production of male reproductive endocrine hormones.

METHODSThis study included 342 male patients at the andrology clinic, aged 19 -47 years and higher than 160 cm. We measured their waistlines, hiplines and waist-hip ratio, detected the levels of serum estradiol (E2), testosterone (T), follicle-stimulating hormone (FSH), luteinizing hormone (LH) and free testosterone (FT) by chemiluminescence and radioimmunoassay, and analyzed the correlation of the waist-hip ratio with the levels of reproductive endocrine hormones. Abdominal obesity was defined as the waist-hip ratio > 0.9.

RESULTSIn the 342 male patients, there were 62 cases of abdominal obesity and 280 cases of the normal somatotype (waist-hip ratio < or = 0.9). The waist-hip ratio was negatively correlated with the T level (r = -0.163, P = 0.003) and the T/LH ratio (r = -0.13, P = 0.02). Both the T level and T/LH ratio were significantly reduced in the abdominal obesity patients ([14.51 +/- 4.53] nmol/L and 2.26 +/- 0.36) as compared with the normal somatotype controls ([17.21 +/- 4.23] nmol/L and 4.61 +/- 0.19) (P < 0.05).

CONCLUSIONThe waist-hip ratio has a significant negative correlation with the T level and T/LH ratio, and the serum T level is significantly lower in men with abdominal obesity than in those of the normal somatotype.

Adult ; Case-Control Studies ; Estradiol ; blood ; Follicle Stimulating Hormone ; blood ; Humans ; Luteinizing Hormone ; blood ; Male ; Middle Aged ; Obesity, Abdominal ; blood ; Somatotypes ; Testosterone ; blood ; Waist-Hip Ratio ; Young Adult