Objective To evaluate the safety and effectiveness of one stage surgery of release and bone reduction by posterior approach to treat basilar invagination (BI) with irreducible atlantoaxial dislocation (IAAD),and to explore the indications and crucial techniques of posterior approach.Methods All of 17 Consecutive patients (8 males and 9 females) with BI and IAAD who underwent release and reduction by posterior approach from July 2000 to June 2015 were enrolled in the present study,the mean age was 35.2±13.8 years with a range of 12-56 years.The clinical symptoms and signs was recorded,and preoperative imaging examination,including anteroposterior,lateral,dynamic films,MRI and CT of cervical spine,were performed to identify the series.There were 14 cases with atlanto-occipital fusion,7 cases with C2,3 fusion,6 cases with Chiari malformation,6 cases with Syringomyelia,and 8 cases with myelomalacia.The clinic symptoms include occiput/neck pain in 15 cases,cervical movement limitation in 13 cases,short neck in 9 cases,torticollis in 12 cases,Paresthesia in 14 cases,weakness in 13 cases,tendon reflexes hyperfunction in 16 cases and ataxia in 13 cases.The postoperative X-rays,MRI or CT were used to observed the results of decompression,fixation and fusion.Neurological function was assessed by JOA scale and Ranawat's score before,after surgery and at final follow-up.Pre-and post-operative Chamberlain (CL),Wackenheim (WL),McGae (ML),atlantodental interval (ADI) and cervico-medullary angle (CMA) were analyzed by student t-test.Results The average operation time was 145 mins (90-210 mins) and blood loss was 175 ml (150-350 ml).The average follow-up was 44.47 months (9-94 months).JOA score was increased from 8.06 preoperatively to 15.20 postoperatively,the improvement rate was 77.2％.Preoperative Ranawat's score was Ⅱ in 1 case,Ⅲla in 12 cases,ⅢB in4 cases.Postoperative score was Ⅰ in 13 cases,Ⅱ in 4 cases.The preoperative CL,WL,ML,ADI and CMA were (12.52±5.17) mm,(6.59±3.04) mm,(6.96±4.32) mm,(9.88± 1.93) mm,115.35°± 12.40°,respectively.and the postoperative CL,WL,ML,ADI and CMA were (2.0±3.67) mm,(-3.06±1.85) mm,(-1.76±2.88) mm,(1.17± 1.18) mm,136.76°±11.44°,respectively.The perioperative complications were discovered in 2 cases,including 1 case of infection and1 case of cerebrospinal fluid(CSF) leakage.Conclusion Primary surgery of nerve release and bone reduction by posterior approach may be safe and efficient for the treatment of BI and IAAD.Preoperative evaluation,proper surgical indications and advanced surgical techniques are important for treatment results.

NSP4, as the diarrhea-related protein of rotavirus, is becoming an attractive candidate for vaccine development. To compare the immunogenicity of NSP4 from different genetic groups, we constructed eukaryotic expression plasmids comprising the NSP4 genes from four different genetic types using the pCI vector. The recombinant vectors were designated as pCI-97B6, pCI-97S36, pCI-97S34 and pCI-97SZ8, respectively. Following the conformation of the transient expression of the constructs in 293 cells, the plasmids were respectively subjected to the 5 round i. m. inoculation of BALB/c mice. The specific antibodies against NSP4 as well as the IgG1/IgG2a subclasses of immunoglobulin in mice sera were examined with indirect ELJSA after each immunization. The results showed that the immunization of plasmids expression NSP4s could elicit not only humoral but also cellular immunity, but the humoral immune response is dominant. There is a difference of immunogenecity among the NSP4 of different genetic type. Further studies were needed to focus on the relationship between the immunogenicity and protection effect.

KK-Ay mice with type 2 diabetes were divided into metformin plus high-fat diet,metformin plus low-fat diet,high fat diet alone and low fat diet alone groups.AMP-activated protein kinase(AMPK)activity was measured in skeletal muscle.The results showed that metformin and low-fat diet were able to increase AMPK activity.However,no additive effect on AMPK activity by metformin and low-fat diet was found.

Objective To explore the influence of urbanicity of birth place,upbringing place,gender,childhood neglect,physical abuse and lack of parental accompaniment on the psychological distress and somatic symptom of university students in China.Methods Four thousand six hundred and twenty second-year undergraduates of a comprehensive university in Sichuan Province were surveyed using the 6-item Kessler psychological distress (K6) scale,patient health questionnaire-15 (PHQ-15),a questionnaire adapted from the childhood section of the World Mental Health Composite International Diagnostic Interview(WMH-CIDI) for childhood neglect and physical abuse and a self-designed questionnaire for lack of parental accompany in childhood.Generalized linear model (GLM) with gamma family was used for the multivariate regression analyses.Results Female (β=0.894,P＜0.001),rural upbinging (β=0.378,P＜0.010),childhood neglect (β=0.279,P＜0.001) and childhood physical abuse (β=0.550,P＜0.001) were associated with psychological distress.Female (β=2.638,P＜0.001),rural upbinging (β=0.395,P=0.015),childhood neglect (β=0.487,P＜0.010) and childhood physical abuse (β=0.483,P＜0.001) were associated with somatic symptom.And psychological distress was positively correlated with somatic symptom (r=0.545,P＜0.001).Conclusions Rural living,female,childhood adversities are prone to increase the severity of both psychological distress and somatic symptom of university students in China.Psychological distress and somatic symptom are positively correlated in aspect of severity.

Objective The role of long non-coding RNA Linc00467 in human lung adenocarcinoma is not yet clear.This study was to investigate the expression of long non-coding RNA Linc00467 in human lung adenocarcinoma, its clinical significance, and the effects of Linc00467 on the functions of the tumor and endothelial cells in vitro.Methods Lung adenocarcinoma tissue and normal tissue surrounding the malignance were obtained from 60 patients with pathologically proved stage I-Ⅲa lung adenocarcinoma.Human umbilical vein endothelial cells (HUVECs) were transfected with the over-expressed plasmid pccl-Linc00467 (HUVEC experimental group) or the empty vector pccl (HUVEC control group), A549 cells with Linc00467-siRNA (A549 experimental group) or negative siRNA (A549 control group), and H1299 cells, too, with Linc00467-siRNA (H1299 experimental group) or negative siRNA (H1299 control group).The expression level of Linc00467 in the lung adenocarcinoma tissue was detected by qRT-PCR with an analysis of its correlation with the clinicopathological characteristics of the patients;the influence of Linc00467 on the proliferation of the A549, H1299 and HUVEC cells was assayed with CCK-8;and the role of Linc00467 in the angiogenesis of the HUVECs was assessed by fibrin bead sprouting assay.Results The expression of Linc00467 in the lung adenocarcinoma tissue was 2.72±1.31 times as high as that in the normal lung tissue (P<0.01), and those in the A549 and H1299 cells were 3.45±0.25 and 3.22±0.33 times as high as those in the human bronchial epithelial (HBE) cells (P<0.01).The expression level of Linc00467 was significantly correlated with the tumor size and vascular invasion (P<0.05).After transfection of Linc00467-siRNA, the expressions of Linc00467 in the A549 and H1299 experimental groups were down-regulated by 72% and 68% as compared with those in the A549 and H1299 control groups (P<0.01).The number of living cells was remarkably decreased in the A549 experimental group in comparison with the A549 control at 48 h (1.29±0.07 vs 1.51±0.09), 72 h (1.53±0.15 vs 2.13±0.11), and 96 h after culturing (1.98±0.18 vs 3.02±0.12), and so was it in the H1299 experimental versus the H1299 control group, but markedly increased in the HUVEC experimental versus the HUVEC control group (P<0.05).At 5 days, HUVEC experimental group, as compared with the HUVEC control, showed a significantly increased number of newly formed vascular branches (7.36 vs 4.25/superbead, P<0.01) and relative length of the blood vessels (3.12 vs 1, P<0.01).Conclusion Linc00467 promotes tumor cell proliferation and angiogenesis and is highly expressed in the lung adenocarcinoma tissue, which is correlated with the tumor size and vascular invasion and suggests that Linc00467 could be a potential biomarker and therapeutic target.

OBJECTIVETo improve the understanding of thymic neuroendocrine carcinoma (TNC) by retrospective analysis of the clinical data of 21 cases.

METHODSThe clinical data of 21 patients with TNC treated in the Peking Union Medical College Hospital from 1998 to 2010 were retrospectively analyzed.

RESULTSThere were 12 males and 9 females, with onset age ranging from 13 to 67 years and the mean age of 43 years. The clinical manifestation was diverse, in which the malaise of chest and back accounted for 57.1% (12/21), Cushing's syndrome 33.3% (7/21), multiple endocrine neoplasia type 1 accounted for 4.8% (1/21), pharyngeal malaise 4.8%, superior vena cava syndrome 4.8% (1/21) and asymptomatic patients accounted for 4.8% (1/21). Eighteen of them demonstrated metastasis, in which 13 had metastasis to lymph nodes and local vascular invasion, 9 to lung or pleura, 5 to bone, 1 to liver and 1 was recurred in situ. Twenty of them were treated by surgical resection. Eleven of them received radiotherapy and 9 chemotherapy after surgery. One patient was too severe to endure surgery, and was a treated by chemotherapy only.

CONCLUSIONTNC is rare, and its clinical features are complex, with a high level of malignancy. The first choice of treatment is resection. Adjuvant radiotherapy and/or chemotherapy may be applied in patients with metastasis.

Adolescent ; Adrenocorticotropic Hormone ; metabolism ; Adult ; Aged ; Bone Neoplasms ; secondary ; Carcinoma, Neuroendocrine ; metabolism ; pathology ; secondary ; surgery ; therapy ; Chemotherapy, Adjuvant ; Cushing Syndrome ; metabolism ; pathology ; surgery ; therapy ; Female ; Humans ; Hydrocortisone ; metabolism ; Immunohistochemistry ; Lung Neoplasms ; secondary ; Lymphatic Metastasis ; Male ; Middle Aged ; Multiple Endocrine Neoplasia Type 1 ; metabolism ; pathology ; surgery ; therapy ; Radiotherapy, Adjuvant ; Retrospective Studies ; Thymectomy ; Thymus Neoplasms ; metabolism ; pathology ; surgery ; therapy ; Young Adult

BACKGROUND:Laminar flow operating room used in artificial joint replacement can improve the aseptic conditions and can effectively prevent the infections after joint replacement.
OBJECTIVE:To compare the number of colonies during artificial joint replacement in laminar flow operation room and traditional operation room.
METHODS:300 patients with artificial joint replacement in hundred-level laminar flow operation room and 300 patients with artificial joint replacement in traditional operation room were selected, and al the patients had no infection. Then 100 patients with artificial joint replacement were randomly selected from the hundred-level laminar flow operation room and traditional operation room respectively. The number of colonies in operation room of two groups was compared before and after replacement.
RESULTS AND CONCLUSION:There was no significant difference in the number of colonies between two groups before replacement, and the settling bacteria number of the artificial hip replacement patients in the hundred-level laminar flow operation room was significantly smal er than that in the traditional operation room (P<0.05). The results indicate that compared with the traditional operation room, the hundred-level laminar flow operation room for artificial joint replacement has higher safety and can effectively prevent infections after replacement.

BACKGROUND:Discectomy and pedicle fixation fusion are golden standard to repair lumbar degenerative disease, but the treatment would induce other complications such as degeneration of adjacent segments or severer pre-existing spinal degeneration. For the problem of lumbar fusion and fixation, lumbar elastic fixation has recently been a hot focus. ＜br> OBJECTIVE:To evaluate the short-term effectiveness of dynamic lumbar pedicle fixation in repair of lumbar spinal stenosis and lumbar disc herniation. ＜br> METHODS:From December 2010 to December 2012, 62 cases of lumbar spinal stenosis and lumbar disc herniation treated with lumbar dynamic system were included. The involved segments included:5 cases at L 3/4 , 20 cases at L 4/5 , 20 cases at L 5 S 1 , 6 cases at double segment L 3/4 and L 4/5, 8 cases at double segment L 4/5 , L 5 S 1 , 3 cases at L 3/4 and L 5 S 1 . There were 34 males and 28 females with an average age of 50.8 years (range 32 to 72 years). According to different fixation systems, they were assigned to three groups:general dynamic lumbar fixation system in 17 cases, K-Rod posterior dynamic stabilization system in 28 cases, and Dynesys system in 17 cases. The fol ow-up time was from 24 to 48 months. Evaluation indexes included visual analogue scale, Oswestry disability index, imaging analysis and excellent and good rate of curative effects. ＜br> RESULTS AND CONCLUSION:Compared with before treatment, visual analogue scale score and Oswestry disability index were significantly improved at 6 months after treatment and final fol ow-up (P＜0.01). No apparent changes were detected in the length of inserted segments and adjacent segments before treatment and during final fol ow-up. There were no significant differences in the excellent and good rate in each group after treatment (P>0.05). These data indicated that the lumbar dynamic system was an effective option for lumbar disc herniation and spinal stenosis. Although there are some differences in the structure of three kinds of flexible fixation, no obvious difference in early therapeutic effects was detected. Long-term effects deserve further investigations.

To discover novel fluoroquinolone lead compounds as possible anti-infective or/and antitumor chemotherapies, combination principle of pharmacophore-based drug design, a series of novel tricyclic fluoroquinolone title compounds, [1,2,4]triazino[3,4-h][1,8]naphthyridine-8-one-7-carboxylic acid derivatives ( 5a-5p), were designed and synthesized with a fused [1,2,4]-triazine ring unit. Their structures were characterized by spectral data and elemental analysis and the in vitro antibacterial and anti-cell proliferation activities were also evaluated. The results showed that the titled compounds exhibited more significant inhibitory activities against drug-resistant bacteria (Methicillin-resistant Staphylococcus aureus and multi drug-resistant Escherichia coli strains) and three tested cancer cell lines (human hepatoma SMMC-7721, murine leukemia L1210 and human murine leukemia HL60 cells). Interestingly, SAR showed that compounds with electron-donating groups attached to benzene ring had stronger antibacterial activity than antitumor activity, but electron-withdrawing compounds displayed more potential antitumor activity than antibacterial activity, especially antitumor activity of nitro compounds was comparable to comparison doxorubicin. Thus, novel triazine-fused tricyclic fluoroquinolones as potent anti-infective or/and antitumor lead compounds are valuable to pay attention and for further development.
Animals ; Anti-Bacterial Agents ; chemical synthesis ; chemistry ; Antineoplastic Agents ; chemical synthesis ; chemistry ; Carboxylic Acids ; Carcinoma, Hepatocellular ; Cell Line ; Cell Proliferation ; Drug Design ; Escherichia coli ; drug effects ; Fluoroquinolones ; chemical synthesis ; chemistry ; HL-60 Cells ; Humans ; Leukemia L1210 ; Liver Neoplasms ; Methicillin-Resistant Staphylococcus aureus ; drug effects ; Mice ; Naphthyridines ; Triazines

To explore an efficient strategy for the conversion of antibacterial fluoroquinolones into antitumor fluoroquinolones, an azole heterocyclic ring of oxadiazole instead of the C-3 carboxylic acid group with a functionalized hydrazone group as a modified side-chain, fifteen novel 2-(fluoroquinolon-3-yl)-oxadiazole-5- sulfanylacetylhydrazone derivatives 7a-7o were designed and synthesized on the basis of the pharmacophore hybridization principle from pefloxacin, separately. The structures for fifteen title compounds were characterized by elemental analysis, 1H NMR and MS, and their in vitro antitumor activity against Hep-3B cell line was evaluated by a MTT assay. The results showed that the title compounds exhibited more significantly inhibitory activity than that of the parent pefloxacin, in which compounds with electron-withdrawing group attached on aryl ring had more potency than that of compounds with electron donating group, especially compounds with a carboxylic substituent were comparable to comparison doxorubicin. It suggests that it is favorable for an improvement of antitumor activity to remain a carboxylic acid unit at the aromatic ring.
Antineoplastic Agents ; chemical synthesis ; chemistry ; Cell Line, Tumor ; Fluoroquinolones ; chemistry ; Humans ; Oxadiazoles ; chemistry ; Structure-Activity Relationship