OBJECTIVE: To investigate the correlation between the clinical diagnostic criteria of sleep bruxism and the frequency of mandibular movements during sleep. METHODS: Video polysomnography was used to record 20 healthy adults with at least one of the following clinical symptoms and signs: 1) report of frequent tooth grinding; 2) tooth wear and dentin exposure with at least three occlusal surfaces; 3) masticatory muscle symptoms in the morning; 4) masseter muscle hypertrophy. The rhythmic masticatory muscle activity (RMMA) and isolated tonic activity were scored to compare the correlations with clinical symptoms and signs. Finally, the incidence of temporomandibular disorders (TMD) was investigated in patients with isolated tonic and RMMA subjects. RESULTS: Among the 20 subjects, RMMA events were observed (5.8±3.1) times·h⁻¹ and isolated tonic episodes were observed (2.1±0.9) times·h⁻¹. The frequency of RMMA events was significantly greater in the patients with acoustic molars than in those without (P<0.05). Similarly, the frequency of RMMA events was significantly greater in the patients with tooth attrition than in those without (P<0.05). However, no difference was observed between the occurrence of RMMA and the symptoms of masticatory muscles or masseter hypertrophy in the morning. The incidence of TMD was significantly higher in the patients with RMMA than in the isolated tonic patients. CONCLUSIONS The clinical symptoms and signs often used to diagnose sleep bruxism are different clinical and physiological mandibular movements during sleep. RMMA during sleep can reflect the occurrence of tooth attrition and the high risk of TMD.
Adult ; Electromyography ; Humans ; Masticatory Muscles ; Polysomnography ; Sleep ; Sleep Bruxism ; Tooth Attrition

OBJECTIVE: People in Western Africa suffer greatly from febrile jaundice, which is caused by a variety of pathogens. However, yellow fever virus (YFV) is the only pathogen under surveillance in Sierra Leone owing to the undeveloped medical and public health system there. Most of the results of YFV identification are negative. Elucidation of the pathogen spectrum is required to reduce the prevalence of febrile jaundice. METHODS: In the present study, we used Ion Torrent semiconductor sequencing to profile the pathogen spectrum in archived YFV-negative sera from 96 patients in Sierra Leone who presented with unexplained febrile jaundice. RESULTS: The most frequently identified sequencing reads belonged to the following pathogens: cytomegalovirus (89.58%), Epstein-Barr virus (55.21%), hepatitis C virus (34.38%), rhinovirus (28.13%), hepatitis A virus (20.83%), coxsackievirus (10.42%), Ebola virus (8.33%), hepatitis E virus (8.33%), lyssavirus (4.17%), leptospirosis (4.17%), chikungunya virus (2.08%), Crimean-Congo hemorrhagic fever virus (1.04%), and hepatitis B virus (1.04%). CONCLUSION The distribution of sequencing reads suggests a broader spectrum of pathogens for consideration in clinical diagnostics and epidemiological surveillance in Sierra Leone.
Adolescent ; Adult ; Case-Control Studies ; Female ; Fever ; epidemiology ; virology ; Humans ; Jaundice ; epidemiology ; virology ; Male ; Sequence Analysis ; Sierra Leone ; epidemiology ; Young Adult

Objective: To investigate the correlation between CXC chemokine receptor 6 (CXCR6) and prognosis of renal clear cell carcinoma. Methods: A total of 100 patients with renal clear cell carcinoma who underwent surgery in the First People's Hospital of Ziyang from January 2013 to October 2014 were selected. Immunohistochemistry was used to detect the expression of CXCR6 in 100 cases of renal clear cell carcinoma and adjacent normal tissues. The patients were followed up to observe the positive rate of CXCR6 expression and the factors affecting overall survival (OS) and progression-free survival (PFS) of renal clear cell carcinoma and adjacent normal tissues. Results: The positive rate of CXCR6 expression in renal clear cell carcinoma tissues was higher than that in adjacent tissues, and the difference was statistically significant [46.0% (46/100) vs. 20.0% (20/100), χ² = 15.287, P < 0.01]. The positive expression rate of CXCR6 in patients with clinical stage Ⅲ-Ⅳ, lymph node metastasis and pathological grade Ⅲ-Ⅳ was higher than that in patients with clinical stage Ⅰ- Ⅱ, pathological grade Ⅰ- Ⅱ and without lymph node metastasis, and the difference was statistically significant (all P < 0.05). A total of 92 patients were followed up and 40 died. The follow-up time reached to (35-60) months and the median follow-up time was 48.9 months. Kaplan-Meier and log-rank test showed that patients with positive CXCR6 expression had lower 3-year OS and PFS rate compared with patients with negative CXCR6 expression, and the difference was statistically significant (3-year OS rate: 52.1% vs. 78.6%, χ² = 10.027, P = 0.001; 3-year PFS rate: 48.3% vs. 67.8%, χ² = 4.344, P = 0.037). Cox regression multivariate analysis showed pathological grade (OS: OR = 2.154, 95% CI 1.547-9.517, P = 0.023; PFS: OR = 1.235, 95% CI 1.109-5.917, P = 0.042), lymph node metastasis (OS: OR = 1.412, 95% CI 1.109-5.917, P = 0.041; PFS: OR = 1.841, 95% CI 1.354-8.994, P = 0.010), CXCR6 expression (OS: OR = 1.864, 95% CI 1.358-6.813, P = 0.031; PFS: OR = 1.457, 95% CI 1.127-6.884,P = 0.025) were independent risk factors of OS and PFS for renal clear cell carcinoma patients treated by the surgery. Conclusions The positive expression of CXCR6 is an independent risk factor for OS and PFS of renal clear cell carcinoma. The prognosis of patients with positive CXCR6 expression is poor.

Background: In our previous paper, we demonstrated that Connexin 43 (CX43) was highly expressed in bladder cancer (BC) tissues. But the molecular mechanism about microRNAs (miRNAs) regulation upstream of CX43 in BC has not been well elucidated and remains to be further studied. MicroRNA-139-5p (miR-139-5p) is a tumor suppressor in progression of multifarious cancers including BC. Nevertheless, the underlying mechanisms of CX43/miR-139-5p in tumorigenesis of BC are still not well illustrated. The specific objective of our study was to inquiry the effect of CX43/miR-139-5p on BC progression and its underlying mechanism. Methods: The bioinformatics analysis softwares were applied to predict the miRNAs in the upstream of CX43. First, the expression levels of miR-139-5p in BC tissues (tumor) and paracancer tissues (normal) were investigated using the data from The Cancer Genome Atlas database. Quantitative reverse transcription-polymerase chain reaction (qRT-PCR) was used to detect the mRNA expression level of miR-139-5p in three human BC cell lines 5637, T24, ECV-304 and a human bladder epithelial immortalized cell line SV-HUC-1 (normal control). Then si-CX43, si-control, miR-139-5p mimic, and its negative control (NC) were transfected into BC cell line ECV-304. The relationship of miR-139-5p and CX43 was analyzed by dual-luciferase reporter assay. The qRT-PCR and Western blotting were used to test the mRNA and protein expression level of CX43. The proliferation of ECV-304 and T24 cells were examined by cell counting kit-8. The migration and invasion of ECV-304 cells were tested by transwell assay. To determine whether miR-139-5p would affect cell proliferation, migration and invasion by targeting CX43, we executed the rescue assay. The comparison between two groups was analyzed by Student’s t test, and comparisons among multiple samples were performed by oneway analysis of variance and a Bonferroni post hoc test. Results: The expression of miR-139-5p was remarkably down-regulated in BC tissues (tumor vs. normal, 2.286 ± 0.017 vs. 3.211 ± 0.034, t= 11.540, P < 0.0001) and cell lines (P < 0.01 in all BC cell lines). Besides, we also indicated that over-expression of miR-139-5p reduced the proliferation of ECV-304 (P = 0.001) and T24 cells (P = 0.005). Moreover, miR-139-5p over-expression weakened the invasion (P = 0.001) and migration (P = 0.001) of ECV-304 cells. Furthermore, the relative luciferase activity of CX43-wild type construct was distinctly lessened by up-regulation of miR-139-5p (miR-139-5p mimic NC vs. miR-139-5p mimic, 0.916 ± 0.063 vs. 0.356 ± 0.048, t = 7.085, P = 0.002), nevertheless the activity of CX43-mutant type construct was untouched (miR-139-5p mimic NC vs. miR-139-5p mimic, 0.918 ± 0.057 vs. 0.878 ± 0.039, t= 0.577, P = 0.595). Finally, the rescue assay revealed that CX43 deletion enhanced the depressor effect of miR-139-5p on ECV-304 cell proliferation (P < 0.01), invasion (P = 0.028), and migration (P = 0.014). Conclusion MiR-139-5p, as a tumor-suppressor, repressed cell proliferation, invasion, and migration in BC, which might be achieved by regulating CX43.

BACKGROUND: Acetabulum anterior column shape is complex, and closed to femoral artery, and femoral nerve. Fixed screws easily went into the acetabulum. Currently, there was less data on quantitative anatomy data of pelvic acetabulum fracture with anterior column plate internal fixation. OBJECTIVE: To compare the pelvis gender differences by analyzing digital anatomical features of normal adult acetabulum anterior column section through digital three-dimensional reconstruction and measurement. METHODS: Totally 30 normal adults (half male and half female) received pelvic CT scans, and data were obtained. Using Materialise Mimics Innovation Suite 16.0 software, the boundary of the pelvis was used as reference line for sectioning. The obturator groove, iliopubic eminence, anterior inferior iliac spine, and the anterior superior iliac spine were used as a reference mark. In 15 males and 15 females (30 sides), the corresponding boundary line from obturator groove to the anterior superior iliac spine of acetabular anterior column was sliced into 5 mm-thick sections. The tangent line was vertical to the boundary line. The tangent plane was vertical to the upper plane of the anterior column. The angle and length of each section 5, 10, 15 mm points from the boundary line to the acetabulum, and the perpendicular distance from anterior and posterior edges of the acetabulum to anterior inferior iliac spine, iliopubic eminence and the pubic tubercle. RESULTS AND CONCLUSION: (1) Acetabular anterior column from the obturator groove to the anterior superior iliac spine section was not significantly different (P > 0.05). (2) No matter in males or females, the tangent angle of the fifth layer section was minimum, and the tangent length of the sixth layer section was longest. The length and angle of the second slice at 5 mm point were not significantly different between males and females. However, above indexes in others were significantly larger in females than in males (P < 0.05). (3) Results indicated that in different fracture ranges and different fixation plate positions, the angle and length of pedicle screws are dynamic, so we only selected in accordance with above range, but cannot fix in a certain value. The design of the most accurate and effective placement angle and length should be aimed at nailing design parameters for each individual patient. The use of Mimics software can be used for three-dimensional reconstruction of CT data of adult acetabular anterior column fracture, and can measure the number of indexes, and provide a theoretical reference for the clinical diagnosis and treatment of acetabular anterior column fracture.

Object To design a casualty sorting unit with chest integrated with table in the tent-form field medical system.Methods The unit was designed with virtual prototype simulation and CAD, which took considerations on the service orientation, the types and quantity of equipment and devices as well as the requirements for packaging box's size and dimensions of the tent-form field medical system.Results The unit had a size of 1795 mm ×600 mm ×600 mm when deployed, and could be used as the field diagnostic and treatment table; the size was 800 mm ×600 mm ×600 mm when withdrawn, when the module met the requirements of the tent-form field medical system for the packaging box and could be used to hold valuable devices such as color Doppler ultrasound and ECG machine. Finite element simulation and check verified that the module had shape and stress changes due to austere force satisfy the desired requirements.Conclusion The unit gains advantages in deployment and withdrawal, materials, mechanical structure and ergonomics-based operation, accords with the requirements for modularity and multi function integrated into one decice, and enhances the efficiency of casualty sorting in the tent-form field medical system.

Objective To analyze and summarize the clinical manifestations,diagnosis and treatment of pure spinal epidural cavernous hemangiomas.Methods We presented a case series of 6 patients with pure spinal epidural cavernous hemangiomas in our hospital from April 2012 to November 2016 with previous articles discussing their clinical presentation,radiological characteristics,surgical technique,pathological features,and functional outcome.Results All patients were diagnosed as pure spinal epidural cavernous hemangiomas by pathology.The cavernous hemangiomas were totally cut and patients recovered well after operations.All patients gradually improved neurologically and achieved a good outcome with no recurrence during the follow-up for 13 to 68 months.Conclusion Pure spinal epidural cavernous hemangioma is rare.It is easily confused with other spinal diseases.MRI is an important imaging examination method.Pathology is the method of diagnosis.Surgical resection is the main method of treatment,and the prognosis is good.

Objective To investigate the variation of renal pelvic pressure during percutaneous nephrolithotomy (PCNL) via standard nephrostomy tract and explore its influence on renal function. Methods 156 patients with renal calculi were selected for PCNL in standard-tract. The patients were divided into normal, mild hydronephrosis, moderate hydronephrosis groups according to the image by color Doppler ultrasonograph. A transurethral 6F ureteral catheter was inserted into renal pelvis and connected to the pressure monitering system before PCNL. During the operations, all the nephrostomy tracts were dilated to F24 size after successful puncture. Energy used was pneumatic and ultrasound lithotripsy. Renal function of the patients was evaluated with glomerular filtration rate (GFR) determined by 99mTc-DTPA dynamic renal imaging before and one week after PCNL. Data were analyzed by SPSS 19.0 software. Results The stone clearance rate was 75.0％ in one-session procedure. Severe complications did not occur during the operation, such as hemorrhage needing nephrectomy and abdominal organ injury or pneumothorax. There were no statistically significant differences between normal and mild hydronephrosis groups for the variation of renal pelvic pressure during preoperative versus intraoperative PCNL (P > 0.05). The renal pelvic pressure was significantly higher during operation than those of preoperation in moderate hydronephrosis group (P < 0.05), and it was greater than those of normal and mild hydronephrosis groups during operation (P < 0.05). Renal pelvic pressure generally remained lower than a level to 30.00 mmHg. There were no significant differences of preoperative and postoperative glomerular filtration rate in all the groups (P > 0.05). Conclusions There were no significant differences on the renal pelvic pressure in normal group and mild hydronephrosis group during operation via standard nephrostomy tract. It should be careful to maintain the lower intrapelvic pressure in order to avoid reflux and infection in moderate hydronephrosis group. Percutaneous nephrolithotomy via standard- tract does not cause significant effects on glomerular filtration rate during the perioperative period of PCNL .

OBJECTIVETo explore the clinical effects of protecting the internal structure of the knee and internal fixation through two different directions for the treatment of tibial plateau fractures with medial large block split.

METHODSFrom January 2010 to January 2016, data of 21 patients of tibial plateau with medial large block split fractures who were treated with protecting the internal structure of the knee and internal fixation through two different directions were retrospectively analyzed, including 17 males and 4 females, with an average age of (39.2±3.2) years old ranging from 27 to 63 years. Anteroposterior and lateral radiographs as well as computed tomography(CT) images were obtained in the course of preoperative. It was made in the operation to protect medial knee structure, combining with internal fixation via two different directions plates(medial and posteromedial). If the posterolateral condyle fracture was involved, a plate was applied through posterolateral approach. Rasmussen score was used for radiological assessment, and HSS knee score was used for efficacy assessment at 1 year after operation. The fracture healing time was judged by X-ray and clinical examinations, additionally, the complications and corresponding outcomes were also recorded.

RESULTSAll patients were followed up for 10 to 24 months with an average of(17.2±1.7) months. All fractures were healed, the healing time was 9 to 16 weeks with an average of(11.1±3.2) weeks. The Rasmussen score after surgery was 1 to 18 points with an average of(16.7±1.5) points. Sixteen cases got excellent, 3 good and 2 fair. At the final follow-up, HSS functional scores ranged from 60 to 100 points with an average of (87.3±6.7) points, the result was excellent in 18 cases, good in 2 cases and fair in 1 case.

CONCLUSIONSFor a split fracture of the medial tibial plateau, the medial incision, full protection of the medial knee structure, and two different directions of supporting plate fixation are feasible, and the short-term effect is satisfactory.

OBJECTIVETo evaluate the clinical effects of percutaneous coblation nucleoplasty in treating cervical spondylotic radiculopathy and investigate its mechanism of action.

METHODSForm January 2015 to January 2017, 21 patients with cervical spondylotic radiculopathy were treated by percutaneous coblation nucleoplasty, including 8 males and 13 females with an average age of 49.6 years old ranging from 43 to 61 years old. The course of disease was for 1 to 6 months with a median age of 4 months. Three cases were single segment, 9 cases were double segments, 7 cases were three-segment, 2 cases were four-segment. Intervertebral disc pressure, VAS were compared before and after operation. Angular displacement(AD) and horizontal displacement(HD) were measured by image data and in order to evaluate the cervical stability. Modified MacNab criteria was used to assess clinical effects.

RESULTSAll the patients were followed up from 1 to 12 months with an average of 8.6 months. Preoperative intervertebral disc pressure was (32.0±5.26) cmH2O and immediately after operation was (21.0±7.18) cmH2O, there was statistical significance between before and after operation(=0.003). Preoperative angular displacement and horizontal displacement was (3.85±1.26) ° and (1.23±0.58) mm, six months after operation was (4.18±1.31) ° and (1.69±0.46) mm, respectively. There was no statistical significance before and after operation(>0.05). Preoperative VAS scores were 7.49±0.53, postoperative at 3 days, 3, 6 months were 3.51±0.49, 2.63±0.61, 2.56±0.71, respectively, and postoperative obtained obvious improvement(<0.05). According to modified MacNab criteria, 6 cases obtained excellent results, 7 good, 4 fair 3 poor at 3 days;10 cases obtained excellent results, 5 good, 3 fair, 2 poor at 3 months; 12 cases obtained excellent results, 6 good, 1 fair, 1 poor at 6 months after operation. Postoperative clinical effect at 6 months was better than 3 d, and 3 months(<0.05), and postoperative at 3 months was better than 3 d(<0.05).

CONCLUSIONSPercutaneous coblation nucleoplasty in treating cervical spondylotic radiculopathy can effectively relieve the pain of neck, shoulder and upper limb and can also relieve some associated symptoms such as headache and dizziness.