Objective:To investigate the effect of anterior cervical discectomy and fusion(ACDF)and cervical spine stability in patients with two-segment cervical spondylosis.Methods:The clinical data of 60 patients with two-level cervical spondylotic myelopathy in Anqing Municipal Hospital were analyzed retrospectively.They were divided into group A(30 cases)and group B(30 cases)according to the communication results between doctors and patients.The control group was given anterior cervical corpectomy and fusion(ACCF),and the observation group was given ACDF.The clinical effects(cervical brace protection time,hospital stay,operation time and intraoperative blood loss),postoperative pain degree[visual analogue score(VAS)],neurological function[Japanese Association of Orthopaedic Surgeons(JOA)],cervical spine function[cervical spine dysfunction index(NDI)],cervical spine stability(C3-6 segment Cobb angle,intervertebral height and cervical spine curvature)and complication rate were compared between the two groups.Results:There were no significant differences in cervical brace protection time,hospital stay and operation time between the two groups(P>0.05).The VAS score in ACDF group was lower than that in ACCF group at 1,3 and 6 months after operation(t=4.312,3.864 and 9.338,P<0.05).The JOA score was higher than that of ACCF group(t=6.482,6.366,5.059,P<0.05).The NDI score was lower than that of ACCF group(t=4.922,6.178,8.859,P<0.05).Six months after operation,the Cobb angle,intervertebral height and cervical curvature of cervical vertebra 3-6(C3-6)in ACDF group were higher than those in ACCF group.The difference was statistically significant(t=5.011,2.171 and 3.386,P<0.05).The incidence of complications between the two groups was not different(P>0.05).Conclusion:ACDF for two-segment cervical spondylosis can effectively improve cervical spine function and nerve function,reduce postoperative pain,and reduce intraoperative blood loss,which is safe and effective.

Objective:To investigate the effect of anterior cervical discectomy and fusion(ACDF)and cervical spine stability in patients with two-segment cervical spondylosis.Methods:The clinical data of 60 patients with two-level cervical spondylotic myelopathy in Anqing Municipal Hospital were analyzed retrospectively.They were divided into group A(30 cases)and group B(30 cases)according to the communication results between doctors and patients.The control group was given anterior cervical corpectomy and fusion(ACCF),and the observation group was given ACDF.The clinical effects(cervical brace protection time,hospital stay,operation time and intraoperative blood loss),postoperative pain degree[visual analogue score(VAS)],neurological function[Japanese Association of Orthopaedic Surgeons(JOA)],cervical spine function[cervical spine dysfunction index(NDI)],cervical spine stability(C3-6 segment Cobb angle,intervertebral height and cervical spine curvature)and complication rate were compared between the two groups.Results:There were no significant differences in cervical brace protection time,hospital stay and operation time between the two groups(P>0.05).The VAS score in ACDF group was lower than that in ACCF group at 1,3 and 6 months after operation(t=4.312,3.864 and 9.338,P<0.05).The JOA score was higher than that of ACCF group(t=6.482,6.366,5.059,P<0.05).The NDI score was lower than that of ACCF group(t=4.922,6.178,8.859,P<0.05).Six months after operation,the Cobb angle,intervertebral height and cervical curvature of cervical vertebra 3-6(C3-6)in ACDF group were higher than those in ACCF group.The difference was statistically significant(t=5.011,2.171 and 3.386,P<0.05).The incidence of complications between the two groups was not different(P>0.05).Conclusion:ACDF for two-segment cervical spondylosis can effectively improve cervical spine function and nerve function,reduce postoperative pain,and reduce intraoperative blood loss,which is safe and effective.

Temporomandibular joint (TMJ) diseases are common clinical conditions. The number of patients with TMJ diseases is large, and the etiology, epidemiology, disease spectrum, and treatment of the disease remain controversial and unknown. To understand and master the current situation of the occurrence, development and prevention of TMJ diseases, as well as to identify the patterns in etiology, incidence, drug sensitivity, and prognosis is crucial for alleviating patients′suffering.This will facilitate in-depth medical research, effective disease prevention measures, and the formulation of corresponding health policies. Cohort construction and research has an irreplaceable role in precise disease prevention and significant improvement in diagnosis and treatment levels. Large-scale cohort studies are needed to explore the relationship between potential risk factors and outcomes of TMJ diseases, and to observe disease prognoses through long-term follw-ups. The consensus aims to establish a standard conceptual frame work for a cohort study on patients with TMJ disease while providing ideas for cohort data standards to this condition. TMJ disease cohort data consists of both common data standards applicable to all specific disease cohorts as well as disease-specific data standards. Common data were available for each specific disease cohort. By integrating different cohort research resources, standard problems or study variables can be unified. Long-term follow-up can be performed using consistent definitions and criteria across different projects for better core data collection. It is hoped that this consensus will be facilitate the development cohort studies of TMJ diseases.

Background: s: Recently, alternative surrogate endpoints such as a 30% or 40% decline in estimated glomerular filtration rate (eGFR) or eGFR slope over 2 to 3 years have been proposed for predicting renal outcomes. However, the impact of GFR estimation methods on the accuracy and effectiveness of surrogate markers is unknown. Methods: We retrospectively enrolled participants in health screening programs at three hospitals from 1995 to 2009. We defined two different participant groups as YR1 and YR3, which had available 1-year or 3-year eGFR values along with their baseline eGFR levels. We compared the effectiveness of eGFR percentage change or slope to estimate end-stage renal disease (ESRD) risk according to two estimating equations (modified Modification of Diet in Renal Disease equation [eGFRm] and Chronic Kidney Disease-Epidemiology Collaboration (CKD-EPI) equation [eGFRc]) for GFR. Results: In the YR1 and YR3 groups, 9,971 and 10,171 candidates were enrolled and ESRD incidence during follow-up was 0.26% and 0.19%, respectively. The eGFR percentage change was more effective than eGFR slope in estimating ESRD risk, regardless of the method of estimation. A 40% of decline in eGFR was better than 30%, and a 3-year baseline period was better than a 1-year period for prediction accuracy. Although some diagnostic indices from the CKD-EPI equation were better, we found no significant differences in the discriminative ability and hazard ratios for incident ESRD between eGFRc and eGFRm in either eGFR percentage change or eGFR slope. Conclusion There were no significant differences in the prediction accuracy of GFR percentage change or eGFR slope between eGFRc and eGFRm in the general population.

Background: s: Recently, alternative surrogate endpoints such as a 30% or 40% decline in estimated glomerular filtration rate (eGFR) or eGFR slope over 2 to 3 years have been proposed for predicting renal outcomes. However, the impact of GFR estimation methods on the accuracy and effectiveness of surrogate markers is unknown. Methods: We retrospectively enrolled participants in health screening programs at three hospitals from 1995 to 2009. We defined two different participant groups as YR1 and YR3, which had available 1-year or 3-year eGFR values along with their baseline eGFR levels. We compared the effectiveness of eGFR percentage change or slope to estimate end-stage renal disease (ESRD) risk according to two estimating equations (modified Modification of Diet in Renal Disease equation [eGFRm] and Chronic Kidney Disease-Epidemiology Collaboration (CKD-EPI) equation [eGFRc]) for GFR. Results: In the YR1 and YR3 groups, 9,971 and 10,171 candidates were enrolled and ESRD incidence during follow-up was 0.26% and 0.19%, respectively. The eGFR percentage change was more effective than eGFR slope in estimating ESRD risk, regardless of the method of estimation. A 40% of decline in eGFR was better than 30%, and a 3-year baseline period was better than a 1-year period for prediction accuracy. Although some diagnostic indices from the CKD-EPI equation were better, we found no significant differences in the discriminative ability and hazard ratios for incident ESRD between eGFRc and eGFRm in either eGFR percentage change or eGFR slope. Conclusion There were no significant differences in the prediction accuracy of GFR percentage change or eGFR slope between eGFRc and eGFRm in the general population.

Objective:To observe and analyze the image characteristics of eyes with choroidal osteoma using swept-source OCT (SS-OCT).Methods:Seventy-three eyes of 61 patients with choroidal osteoma were enrolled in the study, including 17 males (20 eyes) and 44 females (53 eyes) with an average age of 33.5±12.7 years. Single tumor was found in 71 eyes and multiple tumors were found in 2 eyes. All patients received examinations of slit lamp ophthalmoscope, color fundus photography, fundus autofluorescence, fluorescein angiography and/or indocyanine green angiography, B-scan ultrasonography and/or computerized tomography. Tumor features were characterized using SS-OCT.Results:Among 75 tumors of 73 eyes, the osteoma was completely calcified in 7 tumors, completely decalcified in 5 tumors and all the other tumors were composed of calcified and decalcified portions. SS-OCT revealed normal inner retina in all the calcified areas of tumors and abnormal outer retina including external limiting membrane, ellipsoid zone, interdigitation zone and RPE in some cases. Whereas the outer retina and RPE showed abnormality in the decalcified areas of all cases. The choriocapillaris was invisible in all cases and most of the medium and large caliber vessels showed thinning or nonvisibility. Choroidal osteoma revealed a sponge-like appearance ( n=39), loofah sponge appearance ( n=11), lamellar pattern ( n=10), mixed ( n=12) and irregular patterns ( n=5). Other unique features included horizontal lamellar lines ( n=71), hyperreflective horizontal lines ( n=47) and hyporeflective tubules (horizontal: n=39, vertical: n=42, circular: n=41) within choroidal osteoma. Hyperreflective tumor-like tissues were also detected above the disrupted Bruch’s membrane. The sclero-choroidal junction was detectable in all tumors and a posterior ciliary vessel penetrating the sclera was also seen. Conclusions:SS-OCT clearly reveals characteristic appearances of choroidal osteoma as sponge-like, loofah sponge, lamellar pattern, mixed and irregular patterns, with unique features of horizontal lamellar lines, hyperreflective horizontal lines and hyporeflective tubules within osteoma. Hyperreflective tumor-like tissues were detected to grow above the disrupted Bruch’s membrane.

BACKGROUND: An inactivated Hantaan virus vaccine (iHV) has been broadly used as a preventive strategy for hemorrhagic fever with renal syndrome (HFRS) by the South Korean Army. After the vaccination program was initiated, the overall incidence of HFRS cases was reduced in the military population. While there are about 400 HFRS cases annually, few studies have demonstrated the efficacy of the iHV in field settings. Therefore, this study aimed to evaluate the iHV efficacy on HFRS severity. METHODS: From 2009 to 2017, HFRS cases were collected in South Korean Army hospitals along with patients’ vaccination history. HFRS patients were classified retrospectively into two groups according to vaccination records: no history of iHV vaccination and valid vaccination. Vaccine efficacy on the severity of acute kidney injury (AKI) stage and dialysis events were investigated. RESULTS: The effects of the iHV on renal injury severity in between 18 valid vaccinated and 110 non-vaccinated patients were respectively evaluated. In the valid vaccination group, six of the 18 HFRS patients (33.3%) had stage 3 AKI, compared to 60 of the 110 (54.5%) patients in the non-vaccination group. The iHV efficacy against disease progression (VEp) was 58.1% (95% confidence interval, 31.3% to 88.0%). CONCLUSION: The iHV efficacy against the progression of HFRS failed to demonstrate statistically significant protection. However, different severity profiles were observed between the iHV and non-vaccination groups. Additional studies with larger populations are needed to demonstrate the effectiveness of the iHV in patients with HFRS.
Acute Kidney Injury ; Dialysis ; Disease Progression ; Hantaan virus ; Hantavirus* ; Hemorrhagic Fever with Renal Syndrome* ; Hospitals, Military ; Humans ; Incidence ; Military Personnel ; Preventive Medicine ; Retrospective Studies ; Vaccination

No abstract available.
Carcinoma, Renal Cell* ; Humans ; Polycystic Kidney, Autosomal Dominant* ; Translocation, Genetic

OBJECTIVE To investigate whether quinolinic acid(QA)induces autophagy in PC12 cells and its relationship with glycogen synthase kinase-3β(GSK-3β)/β-catenin related signaling path?ways. METHODS PC12 cells were treated with QA 2.5,5.0 and 10.0 mmol·L-1 for 24 h. The cell viability was determined by MTT assay. Autophagy fluorescent spots labelled form of microtubule-associated protein 1 light chain 3(LC3)was examined by LC3 immunostaining. The expressions of GSK-3β,β-catenin,LC3 and Beclin 1 were determined by Western blotting. RESULTS QA inhibited PC12 cell survival in a concentration-dependent manner,and IC50 was 8.7 mmol · L- 1. Compared with normal control group,QA 2.5,5.0 and 10.0 mmol · L-1 increased autophagic intracellular LC3 fluorescence spots,elevated the expression ratio of LC3-Ⅱ/LC3-Ⅰ and expression of Beclin 1 in PC12 cells(P<0.05). In addition,QA enhanced GSK-3βexpression and decreasedβ-catenin expression(P<0.05,P<0.01). CONCLUSION QA induces autophagy in PC12 cells. This mechanism may be associated with the activation of GSK-3β/β-catenin related signaling pathways.

Tumoral calcinosis (TC) is a condition resulting from extensive calcium phosphate precipitation, primarily in the periarticular tissues around major joints. Calciphylaxis is a fatal ischemic vasculopathy mainly affecting dermal blood vessels and subcutaneous fat. This syndrome is rare and predominantly occurs in patients with end-stage renal disease. Here, we report on a rare case involving a patient with TC complicated with calciphylaxis. Our patient was a 31-year-old man undergoing hemodialysis who presented with masses on both shoulders and necrotic cutaneous ulcers, which were associated with secondary hyperparathyroidism, on his lower legs. He underwent subtotal parathyroidectomy, and sodium thiosulfate (STS) was administered for 27 weeks. Twenty months after beginning the STS treatment course, he experienced dramatic relief of his TC and calciphylaxis.
Adult ; Blood Vessels ; Calcinosis* ; Calciphylaxis* ; Calcium ; Humans ; Hyperparathyroidism, Secondary ; Joints ; Kidney Failure, Chronic ; Leg ; Parathyroidectomy* ; Renal Dialysis ; Shoulder ; Sodium* ; Subcutaneous Fat ; Ulcer