OBJECTIVE: To investigate the influence of posterior osteotomy on spinopelvic parameters in lumbar degenerative kyphosis (LDK) patients. METHODS: The clinical data of 21 patients with lumbar degenerative kyphosis who underwent osteotomy from January 2012 to December 2015 were retrospectively analyzed. There were 5 males and 16 females, aged from 55 to 76 years with an average of (66.24±5.13) years. All patients had taken preoperative and postoperative full length spinal X-ray, analyzing the spinopelvic parameters as thoracic kyphosis (TK), lumbar lordosis (LL), sagittal vertical axis (SVA), pelvic incidence (PI), pelvic tilt (PT) and sacral slope (SS). RESULTS: All operations were successful, the average operative time was 190 min (160 to 220 min) and intraoperative blood loss was 1 000 ml (800 to 1900 ml). Parameters of the patients between preoperative and period 1-year follow-up were as follows : preoperative TK increased from (31.67±21.13) ° to (34.67±11.60) °, LL corrected from (4.76±3.17) ° to (37.41±6.28) °, PT reduced from (33.94±5.01) ° to (20.12±5.36) °, and SS improved from (18.47±2.60) ° to (31.71±4.30) °, SVA restored from (13.24±3.60) cm to (2.82±1.33) cm. There were significant differences of spinopelvic parameters between preoperation and postoperation (<0.05). CONCLUSION Posterior osteotomy can effectively reconstruct the sagittal balance of spinopelvis in patients with lumbar degenerative kyphosis. The recovery of lumbar lordosis and sacral slope is closely related to the reconstruction of sagittal balance.

Objective To investigate the feasibility, safety and efficacy of excimer laser coronary atherectomy used in complex lesions, including in-stent restenosis, non-crossable or nonexpandable lesions, heavily calcified lesions without successful wire-exchange and saphenous vein grafts lesions. Methods From Jul 24, 2017 to Aug 24, 2018, 22 cases with 24 lesions were treated with excimer laser coronary atherectomy in Peking University People's Hospital, combined with or without IVUS/OCT, rotational atherectomy or other percutaneous coronary intervention instrument, and with or without stent implantation. Results The procedural success rate was 23/24. There was no complications in all cases. Drug-eluting stents were implanted in 19/24 of lesions. There were no major advent cardiovascular events, including death, acute ST-segment-elevation myocardia and pericardial tamponade recorded. Conclusions Excimer laser coronary atherectomy used in complex lesions is feasible, safe and efficient with satisfactory in-hospital short-term outcome.

Objective To investigate the effect of transcranial direct current stimulation (tDCS) before or during task-oriented training on the upper limb dysfunction of stroke survivors.Methods Ninety stroke survivors were randomly divided into groups A,B and C,each of 30.Those in all the three groups received the same task-oriented training,but those in groups A and B received 20 minutes of tDCS of the M1 area of the cerebrum before and during the task-oriented training respectively.Group C was given placebo stimulation during the task-oriented training.The Fugl-Meyer functional upper limb assessment (FMA-UE),a Hong Kong hemiplegia upper limb function test (FTHUE-HK) and the modified Barthel index (MBI) were used to evaluate the outcomes before and after 4 weeks of treatment.Results After 4 weeks of treatment the average FMA-UE,FTHUE-HK and MBI scores of all three groups were significantly better than those before the treatment.Group B's average scores were significantly better than those of groups A and C.Conclusion tDCS significantly enhances the benefits of task-oriented training after stroke.

PURPOSE: The purpose of this study was to investigate the survival trends and patterns of failure in patients with stage II nasopharyngeal carcinoma (NPC) treated with radiotherapy (RT) and chemotherapy over the last 20 years. MATERIALS AND METHODS: Thirty-eight hundred and eight patients diagnosed with stage II NPC between January 1990 and December 2012 were involved in this retrospective cohort study. All patients were treated with RT. According to the main imaging techniques and RT technology, we categorized these patients into four calendar periods: 1990-1996, 1997-2002, 2003-2007, and 2008-2012. Overall survival (OS), progression-free survival (PFS), locoregional relapse-free survival (LRFS), and distant metastasis–free survival (DMFS) were served as the clinical outcome. RESULTS: After a median follow-up period of 84.7 months, we observed increasing trends in survival and disease control. The 3- and 5-year OS rates increased from 87.1% and 78.7% in the first calendar period to 97.4% and 94.5% in the last calendar period, respectively (p<0.001). Additionally, significant increasing trends could be seen in the PFS and LRFS during the four calendar periods. In the subgroup analysis, the LRFS in patients older than 50 years at diagnosis showed greater improvement than younger patients. However, the rate of distant metastasis was stable and relatively low, as the 5-year DMFS ranged from 90.5% to 94.7% among the four calendar periods. CONCLUSION: The survival rates in patients with stage II NPC showed increasing trends from 1990 to 2012. The advance of RT provided excellent locoregional control and enhanced OS.
Cohort Studies ; Diagnosis ; Disease-Free Survival ; Drug Therapy ; Follow-Up Studies ; Humans ; Neoplasm Metastasis ; Prognosis ; Radiotherapy ; Retrospective Studies ; Survival Rate

Adult ; DNA, Mitochondrial ; genetics ; Electroencephalography ; Humans ; MERRF Syndrome ; genetics ; Male ; Mitochondrial Myopathies ; genetics ; Mutation ; RNA, Transfer, Asn ; genetics

OBJECTIVE: To analyze the current status of diagnosis and management of acute appendicitis (AA) in China. METHODS: Questionnaire survey was used to retrospectively collect data of hospitalized patients with AA from 43 medical centers nationwide in 2017 (Sort by number of cases provided: Jinling Hospital of Medical School of Nanjing University, The First Affiliated Hospital of Xinjiang Medical University, Lu'an People's Hospital, Tengzhou Central People's Hospital, Dalian Central Hospital, The Affiliated Hospital of Xuzhou Medical University, Dongying People's Hospital, Jinjiang Hospital of Traditional Chinese Medicine, Huangshan Shoukang Hospital, Xuyi People's Hospital, Nanjing Jiangbei People's Hospital, Lanzhou 940th Hospital of PLA, Heze Municipal Hospital, The First College of Clinical Medical Science of China Three Gorges University, Affiliated Jiujiang Hospital of Nanchang University, The Second People's Hospital of Hefei, Affiliated Central Hospital of Shandong Zaozhuang Mining Group, The Third People's Hospital of Kunshan City, Xuzhou First People's Hospital, The 81st Group Army Hospital of PLA, Linyi Central Hospital, The General Hospital of Huainan Eastern Hospital Group, The 908th Hospital of PLA, Liyang People's Hospital, The 901th Hospital of Joint Logistic Support Force, The Third Affiliated Hospital of Chongqing Medical University, The Fourth Hospital of Jilin University, Harbin Acheng District People's Hospital, The First Affiliated Hospital of Zhengzhou University, Nanjing Luhe People's Hospital, Taixing Municipal People's Hospital, Baotou Central Hospital, The Affiliated Hospital of Nantong University, Linyi People's Hospital, The 72st Group Army Hospital of PLA, Zaozhuang Municipal Hospital, People's Hospital of Dayu County, Taixing City Hospital of Traditional Chinese Medicine, Suzhou Municipal Hospital, Beijing Guang'anmen Hospital, Langxi County Hospital of Traditional Chinese Medicine, Nanyang Central Hospital, The Affiliated People's Hospital of Inner Mongolia Medical University).The diagnosis and management of AA were analyzed through unified summary. Different centers collected and summarized their data in 2017 and sent back the questionnaires for summary. RESULTS: A total of 8 766 AA patients were enrolled from 43 medical centers, including 4 711 males (53.7%) with median age of 39 years and 958 (10.9%) patients over 65 years old. Of 8 776 patients, 5 677 cases (64.6%) received one or more imaging examinations, and the other 3 099 (35.4%) did not receive any imaging examination. A total of 1 858 (21.2%) cases received medical treatment, mainly a combination of nitroimidazoles (1 107 cases, 59.8%) doublet regimen, followed by a single-agent regimen of non-nitroimidazoles (451 cases, 24.4%), a nitroimidazole-free doublet regimen (134 cases, 7.2%), a triple regimen of combined nitroimidazoles (116 cases, 6.3%), nitroimidazole alone (39 cases, 2.1%) and nitroimidazole-free triple regimen (3 cases, 0.2%). Of the 6 908 patients (78.8%) who underwent surgery, 4 319 (62.5%) underwent laparoscopic appendectomy and 2589 (37.5%) underwent open surgery. Ratio of laparotomy was higher in those patients under 16 years old (392 cases) or over 65 years old (258 cases) [15.1%(392/2 589) and 10.0%(258/2 589), respectively, compared with 8.5%(367/4 316) and 8.0%(347/4 316) in the same age group for laparoscopic surgery, χ²=91.415, P<0.001; χ²=15.915,P<0.001]. Patients with complicated appendicitis had higher ratio of undergoing open surgery as compared to those undergoing laparoscopic surgery [26.7%(692/2 589) vs. 15.6%(672/4 316), χ²=125.726, P<0.001].The cure rates of laparoscopic and open surgery were 100.0% and 99.8%(2 585/2 589) respectively without significant difference (P=0.206). Postoperative complication rates were 4.5%(121/2 589) and 4.7%(196/4 316) respectively, and the difference was not statistically significant (χ²=0.065, P=0.799). The incidence of surgical site infection was lower (0.6% vs. 1.7%, χ²=17.315, P<0.001), and hospital stay was shorter [6(4-7) days vs. 6(5-8) days, U=4 384 348.0, P<0.001] in the laparoscopic surgery group, while hospitalization cost was higher (median 12 527 yuan vs. 9 342 yuan, U=2 586 809.0, P<0.001). CONCLUSIONS The diagnosis of acute appendicitis is still clinically based, supplemented by imaging examination. Appendectomy is still the most effective treatment at present. Laparoscopic appendectomy has become the main treatment strategy, but anti-infective drugs are also very effective.
Acute Disease ; Adolescent ; Adult ; Aged ; Anti-Bacterial Agents ; therapeutic use ; Appendectomy ; Appendicitis ; diagnosis ; therapy ; China ; Female ; Health Care Surveys ; Humans ; Laparoscopy ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome ; Young Adult

OBJECTIVE: To investigate the effects of inhibiting proliferation and inducing apoptosis of low-dose triptolide and sorafenib alone or in combination on FLT3-ITD acute myeloid leukemia cell line MV4-11 and STAT5 pathway. METHODS: The MV4-11 cells were treated with low dose triptolide(IC) and sorafenib(IC) alone or in combination for 48 hours. The cell proliferation and inhibition were detected by using CCK-8 kit, the cell apoptosis was detected by flow cytometry, the expression of FLT3,STAT5 in mRNA and protein levels was detected by RT-PCR and Western blot respectively. RESULTS: The treatment of MV4-11 cells with low dose triptolide and sorafenib alone and in combination for 48 hours could inhibit cell proliferation and induce cell apoptosis, moreover the inhibitory rate and apoptotic rate of MV4-11 cells in drug-combination group both were higher than those in single drug group. The mRNA expression and protein expression of FLT3,STAT5 signaling pathway in drug combination group were significantly lower than those in single drug group. CONCLUSION Low-dose triptolide combined with sorafenib can synergistically inhibit the proliferation and induce the apoptosis of MV4-11 cells, which may be related with the inhibition of FLT3 and STAT5 pathway.
Apoptosis ; Cell Line, Tumor ; Diterpenes ; Epoxy Compounds ; Humans ; Leukemia, Myeloid, Acute ; Phenanthrenes ; STAT5 Transcription Factor ; Sorafenib ; fms-Like Tyrosine Kinase 3

Objective To summarize the experiences of diagnosing and treating acute pancreatitis (AP) after kidney transplantation .Methods From September 2007 to December 2017 , clinical data were retrospectively analyzed for 12 AP patients after kidney transplantation .Results They were diagnosed as AP within 72 h after an onset of abdominal pain .Among 4 recurrent cases within 1 week post-transplantation ,the curative interventions included non-operative therapy (n=2) and peripancreatic puncture & drainage (n=2) .AP occurred at 1 year post-transplantation (n=8) . Three cases were cured non-surgically while another 5 cases underwent surgery . The procedures included laparoscopic cholecystectomy ( n = 1 ) , endoscopic retrograde cholangiopancreatography (ERCP) for cholelithiasis (n=1) and peripancreatic puncture & drainage (n= 2) .One patient died after surgical debridement for adjacent pancreatic tissue .Conclusions After kidney transplantation , the occurrence of AP may be associated with immunosuppressants interfering with triglyceride metabolism and pancreatic microcirculation .For those with cholelithiasis-related pancreatitis ,surgical removal of precipitating factor is required .Mini-invasive puncture and drainage are preferred for severe non-gallstone pancreatitis while surgery is performed whenever necessary .

Objective: To observe the clinical efficacy of the Mulligan technique in treating cervical vertigo (CV) in a hyperbaric oxygen (HPO) environment. Methods: Sixty-eight CV patients were randomly divided into a control group and an observation group, each of 34. Both groups were given routine treatment with ultrashortwave irradiation, but the observation group was additionally provided with 15 minutes of treatment based on the Mulligan technique in an environment with oxygen at 0.2 MPa, five days a week for two weeks. Both groups were assessed using the cervical vertigo symptoms and functional assessment scale (ESCV) and the daily frequency of vertigo was recorded before the treatment and 2, 4, 7, 14 and 60 days after treatment began. Moreover, the mean blood flow velocity in the patients′ vertebral (VA) and basilar arteries (BA) was detected using transcranial Doppler sonography before the treatment and after two weeks and two months. Results: There were no significant differences between the two groups in any of the measurements before the intervention. Afterward, however, significant improvement in all of the measurements was observed compared with before the treatment. After two weeks and two months the average ESCV score, daily occurrence of CV and mean VA and BA blood flows in the observation group were all significantly superior to those of the control group at the same time points. Conclusion Treatment based on the Mulligan technique in an environment with 0.2 MPa partial pressure of oxygen is a more effective way to relieve the symptoms of cervical vertigo and reduce the frequency of its occurrence. Such treatment is worthy of application in the clinic.

AIM:To observe the expression of calreticulin(CRT)in nasopharyngeal carcinoma tissues,ana-lyze the significance of clinical pathology and the influence on epithelial -mesencymal transition(EMT)of CNE2 cells. METHODS:The expression of calreticulin was detected by immunohistochemistry in 52 nasopharyngeal carcinoma and 57 nasopharyngeal benign tissues,and the significance of clinical pathology was evaluated.The calreticulin gene-specific small interfering RNA was constructed,and then was transfected into the NPC cell line CNE 2 using the cationic liposome meth-od.The effect of CRT on the morphological changes of the CNE 2 cells was observed under light microscope.The effect of CRT on the cell migration and invasion abilities of the CNE 2 cells was detected by Transwell migration and invasion assays. The expression of EMT-related proteins E-cadherin,vimentin,transforming growth factor(TGF)-βand matrix metallopro-teinase(MMP)-9 in the CNE2 cells was determined by Western blot.RESULTS:The positive expression rate of CRT in the benign lesion tissues was 19.29%(11/57),which was significantly increased in the nasopharyngeal carcinoma tissues as 82.69%(43/52).The expression rate of CRT was positively correlated with the stage of nasopharyngeal carcinoma and lymph node metastasis(P<0.05).Knockdown of CRT expression made the CNE 2 cells showing a spindle shape to a flat, cobblestone-like epithelial state change,arranged more compact,and the migration and invasion abilities were significantly decreased(P<0.05).Knockdown of CRT expression resulted in significant increase in the protein expression of E -cadhe-rin,and the decreases in the protein expression of vimentin, TGF-βand MMP-9 in the CNE2 cells(P<0.05).CON-CLUSION:Calreticulin expression in nasopharyngeal carcinoma is significantly higher and positively correlated with naso -pharyngeal carcinoma stage and lymph node metastasis.Calreticulin promotes cell migration and invasion of nasopharyngeal carcinoma CNE2 cells by inducing EMT.