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2014 Vol. 44, No. 11 Published: 2014-11-26   781 A study on the molecular mechanism of B[a]P induced expression of TNF-α in human bronchial epithelial cells DAI Jia, LV Jianyi, ZHANG Min, CAI Qinzhen, GAO Jimin. Objective: To study B[a]P on TNF-α mRNA expression regulation mechanism in Beas-2B cells through constructing TNF-α promoter luciferase reporter gene vector. Methods: The expression of TNF-α mRNA was detected by Real time-PCR with in 24 hours in Beas-2B cells exposed to B[a]P. We constructed TNF-α promoter luciferase reporter gene vector by molecular cloning technique and detected the promoter activity. Also we detected the change trend of TNF-α promoter activity in Beas-2B cells and 293T cells exposed to B[a]P. Results: Upon B[a]P exposure, the expression of TNF-α mRNA increased gradually with in 24 hours in Beas-2B cells and B[a]P can induce the TNF-α promoter activity. The TNF-α promoter activity also enhanced in 293Tcells exposed to B[a]P environment. Conclusion: We successfully construct the TNF-α promoter luciferase reporter gene plasmids and explained that B[a]P can induce the expression of TNF-α mRNA at transcriptional level without cell specificity. 2014 Vol. 44 (11): 781-786 [Abstract] ( 589 ) HTML (1 KB)  PDF (10295 KB)  ( 818 ) 787 The impact of postoperative complications on 5-year survival after surgery for gastric cancer MA Haiguang, HU Changyuan, PANG Wenyang, JIN Jinji, CHEN Jiaozhen, JIN Cancan, CHEN Wenjing, ZHU Guanbao. Objective: To investigate the potential impact of postoperative complications on 5-year survival after gastrectomy for gastric cancer. Methods: A total of 380 gastric cancer patients with complete follow-up data who underwent gastrectomy between January 2006 and April 2009 in the First Affiliated Hospital of Wenzhou Medical University were enrolled in this study. Patients were devided into 2 groups: with (n=52) or without (n=328) complications after surgery. The types and classifications of postoperative complications were assessed to analyze the risk factors affecting the occurrence of postoperative complications and the impact of postoperative complications on 5-year survival. Results: In the univariate analysis, age, body mass index (BMI), depth of invasion, lymph node metastasis, TMN staging were significant predictors of postoperative complications and age, gender, depth of tumor invasion, lymph node metastasis, distant metastasis, TMN staging, surgical approach, differentiation of tumor and postoperative complications were significantly related to the 5-year survival of patients (P<0.05). Mutivariate analysis based on COX proportional hazard regression model showed that postoperative complications, gender, lymph node metastasis and tumor differentiation were independent prognostic factors on 5-year survival. Conclusion: Postoperative complications after gastric resection is one of the independent factors in patients on 5-year survival, and active prevention and treatment of postoperative complications is of great significance to prolong living time. 2014 Vol. 44 (11): 787-791 [Abstract] ( 627 ) HTML (1 KB)  PDF (5195 KB)  ( 691 ) 792 The expression of neurotransmitters in enterogenous neural stem cells and central nervous system neural stem cells from the same fetal rats XIA Liguang, LI Zhongrong, LIU Senqing, WANG Yongbiao, ZHU Libin, ZHAO Yiming. Objective: To observe the expression of neurotransmitters in enterogenous neural stem cells (ENSCs) and central nervous system neural stem cells (CNS-NSCs) from the same fetal rats, and to explore a suitable stem cell source for neural stem cells transplantation. Methods: Rat ENSCs and CNS-NSCs were extracted from the same 20-day SD rat embryos followed by repeated subculture using improved neural stem cell medium. Two different kinds of nerve bulbs originated from 6-10 days culturing were chosen. The expressions of four transmitters on ENSCs and CNS-NSCs were analyzed by agarose pre-embedded immunocytochemistry assay and flow cytometry. Results: After analyzing data of imunocytochemistry assay, we found the expression of nNOS and ChAT on ENSCs; nNOS, ChAT and DβH on CNS-NSCs. Significant differences of nNOS and ChAT expression were observed between ENSCs and CNS-NSCs respectively (P<0.05). Flow cytometry analysis indicated GABA(+), nNOS(+), ChAT(+), DβH(+) cells averagely accounted for 1.59%, 14.97%, 5.43%, 1.36% in ENSCs respectively,within which nNOS and ChAT expression were significantly different from isotype groups (P<0.05). In CNS-NSCs, the pecentages were 1.68%, 6.14%, 25.42%, 9.30% on average, comparing with isotype groups, the differences of nNOS, ChAT, and DβH expression were all significant (P<0.05). Conclusion: ENSCs express neurotransmitters including NO and Ache, with NO of dominance. While CNS-NSCs express neurotransmitters such as NO, Ache and NE, especially Ache. There is almost no GABA expression in either ENSCs or CNS-NSCs. 2014 Vol. 44 (11): 792-796 [Abstract] ( 563 ) HTML (1 KB)  PDF (12108 KB)  ( 574 ) 797 Application of the modified Nuss procedure for pectus excavatum repair with bilateral chest wall vertical incisions in 240 patients DU Jie, HU Xingti, ZHAO Qifeng, ZHENG Binbin, WU Guowei, XIA Jie. Objective: To explore the surgical skills and efficacy of the modified Nuss procedure on pectus excavatum repair with bilateral chest wall vertical incisions. Methods: Two hundred forty patients (181 male, 59 female, aged 2.5-25 years with an average of 8.0 ±5.1 years) with pectus excavatum undergone the modified Nuss procedure in our hospital between August 2006 and April 2014 were recruited in this study. One hundred and sixty-four out of 240 patients were symmetry and 76 were asymmetry according to the Park’s classification. Preoperative Haller Index (HI) of the patients was determined by computed tomography (CT) and ranged from 3.3 to 16.5 with an average of 5.1±1.9. All patients were anesthetized by combined tracheal in intubation and intravenous anesthesia, underwent the modified Nuss procedure assisted by thoracoscopy, and not used of pleural drainage tubes. Results: The surgery of all patients went smoothly, and the operating time ranged from 30 to 90 minutes with an average of (45.56±13.48) minutes. The plates were changed to diagonal placement because of the ineffective repairs of the lateral placement in 15 cases. Sequential biventricular thoracoscopy for bilateral chest wall were applied in 10 cases due to extremely severe pectus excavatum. Severe complications, such as penetrating injuries on heart, lung and diaphragm, didn’t occurred and the amount of bleeding was little (less than 20 ml) during the operation. 20, 6, and 4 patients showed subcutaneous emphysema, little pneumothorax, and pleural effusion after operation, respectively. All complications relieved after conservative therapy. Post-discharge follow-up time was 1-48 months. During the early 3 months follow-up period, 212 of 240 cases (88.3%) showed excellent molding effects while 28 cases (11.7%) attained good molding effects. And no bad corrective results happened. In the middle to late after operation, 10 incision allergic reactions of the plates occurred. The buttress plates of 136 patients were removed during the period of 24-40 months after operation and 6 showed slightly recurrence. Conclusion: The modified Nuss procedure with vertical incisions on bilateral chest walls simplifies the processes of the classical Nuss procedure, and is worth of being generalized. 2014 Vol. 44 (11): 797- [Abstract] ( 571 ) HTML (1 KB)  PDF (4820 KB)  ( 832 ) 800 Ultrasound study of ventricular synchronicity in patients with ischemic cardiomyopathy accompanied with complete left bundle branch block YANG Licui, WANG Kaihua, HUANG Xumei, ZHANG Mingying Objective: To identify the difference of left ventricular and interventricular synchronicity found on echocardiogram between patients with ischemic cardiomyopathy (ICM) accompanied with complete left bundle branch block (CLBBB) and those with isolated left bundle branch block. Methods: Thirty-two patients with ICM accompanied with CLBBB (the study group) and 30 patients with isolated left bundle branch block (the control group) were enrolled. The standard deviation of systolic peak time (Ts-SD) in 12 segments along the long axis of left ventricular motion, including the left ventricular septal, the lateral wall, the anterior wall, the inferior wall, the posterior wall of basal segment and the middle segment were evaluated by quantitative tissue velocity imaging (QTVI). The septal-to-posterior wall motion delay (SPWMD) in parasternal long axis was assessed by M-mode echocardiogram. The interventricular mechanical delay (IVMD) of left and right ventricle was measured by pulse Doppler. Results: Compared with the control group, Ts-SD, SPWMD and IVMD in the study group were increased significantly (P<0.001). The results of linear correlation analysis indicated that the left ventricular and interventricular synchronicity was positively correlated with the size of ventricle, the width of QRS wave and N terminal pro brain natriuretic peptide (NT-proBNP). Conclusion: Patients with ICM accompanied with CLBBB have obvious left ventricular and interventricular dyssynchrony. Echocardiogram is valuable in the assessment of ventricular dyssynchrony. 2014 Vol. 44 (11): 800-803 [Abstract] ( 549 ) HTML (1 KB)  PDF (4611 KB)  ( 653 ) 804 An epidemiological survey of pediatric asthma in urban area of Wenzhou city HU Xiaoguang, ZHANG Hailin, LI Changchong, ZHANG Weixi, YE Leping, LIN Li, PAN Liping, LI Haiyan, ZHANG Hui, JIANG Handan, CHONG Lei. Objective: To investigate the prevalence, risk factors, attack triggers and management status of pediatric asthma in Wenzhou city, and to provide useful evidence for management of pediatric asthma. Methods: This survey was a randomized cluster sampling survey which was conducted according to a unified protocol, procedure and questionnaire. The eligible candidates were children aged 0 to 14. Results: The accumulative prevalence of asthma in children Wenzhou city was 3.3%, and male to female ratio was 1.3:1. The prevalence rate was 2.7%. The first attack age of asthma was 27 months (13~43), and the first diagnose age was 30 months (18~40). Children aged 3 to 6 years had the highest prevalence (5.5%). Asthma exacerbation most likely occurred in autumn and winter (28%), and early morning (48%). The most common trigger of asthma exacerbation was upper airway infection (87.5%), and the common precursors were running nose (64.8%), sneezing (59.6%) and nasal obstruction (43.3%). Common symptoms were cough (95.6%) and wheezing (69.2%). As for asthma management, the ratio of antibiotics utilization was 49.8%, inhaled steroid 53.6% and leukotriene receptor antagnist 45.1%. The independent risk factors of asthma were the first and second degree relatives’ history of asthma, patient’s history of allergic rhinitis and eczema. Conclusion: The prevalence of pediatric asthma in Wenzhou city is significantly higher than ever. Upper airway infection is the most common trigger of asthma exacerbation. Allergic rhinitis, eczema and family history of asthma are the main risk factors of asthma. 2014 Vol. 44 (11): 804-809 [Abstract] ( 581 ) HTML (1 KB)  PDF (5628 KB)  ( 606 ) 810 Effect of Shenmai injection on inflammatory response of rats with ventilator-induced lung injury JIN Lida, WANG Liangrong, XIONG Xiangqing, SHAN Yuanlu, LIN Lina. Objective: To investigate the effect of Shenmai injection on inflammatory response of rats with ventilator-induced lung injury (VILI). Methods: Thirty healthy adult male SD rats weighting 300~350 g were randomly divided into 3 groups (n=10 in each): group TV (traditional tidal volume, VT=8 mL/kg), group HV (high tidal volume, VT=40 mL/kg), group HS (pretreated with Shenmai injection 10 mL/kg and high tidal volume 40 mL/kg). After 4-hour mechanical ventilation, arterial blood samples were obtained for blood gas analysis before the animals were sacrificed. The lungs were removed for observation under microscopic examination, and bronchoaveolar lavage fluid (BALF) was collected. W/D lung weight ratio and pulmonary permeability index (PPI) were calculated, also TNF-α, IL-1β, IL-10 in BALF and Na+-K+-ATPase activity in lung tissue were measured. Results: After 4-hour ventilation, compared with group TV, PaO2 was significantly decreased, PPI, W/D and TNF-α/IL-10 ratio was increased, the levels of TNF-α, IL-1β, IL-10 in BALF were increased and Na+-K+-ATPase activity in lung tissue were decreased in group HV (P<0.05). PaO2 was significantly higher, PPI, W/D and TNF-α/IL-10 ratio were decreased, TNF-α, IL-1β in BALF were decreased, the level of IL-10 in BALF and Na+-K+-ATPase activity in lung tissue were higher in group HS as compared to group HV (P<0.05). The lung tissues injury was severe in group HV, which could be obviously alleviated in group HS. Conclusion: Shenmai injection can attenuate ventilation-induced lung injury in rats, whose mechanism may be related to alleviate the inflammatory response and improve lung water metabolism in VILI. 2014 Vol. 44 (11): 810- [Abstract] ( 572 ) HTML (1 KB)  PDF (6495 KB)  ( 643 ) 813 Antioxidation of hydrogen-rich water on renal injury induced by type 1 dibetes in mice ZHAO Chenchen1, WANG Qingqing1, QIU Pengcheng1, ZHU Penglei1, SU Zhongqian1, MAO Yuyan2, SONG Zhangjuan3, JIN Keke3. Objective: To study the protective effect of hydrogen on renal injury induced by type 1 dibetes in mice and explore the possible mechanism. Methods: Sixty healthy male ICR mice were randomly divided into control group (A), diabetic group (B) and diabetes hydrogen water intervention group (C). Diabetes were induced by intraperitoneal injection of streptozotocin 150 mg/kg. Group C were injected saturated hydrogen-rich water 5 mL/kg and group B were injected with equal normal saline every day for 8 weeks in mice models of type 1 dibetes. The blood was collected from the tail vein and blood glucose was measured. Renal injury were identified by hematoxylin and eosin (HE) staining. Expression of Nox4 and HO-1 were identified by immunohistochemical staining. Results: Expression of Nox4 in Group C was significantly lower than that in group B, expression of HO-1 in Group C was significantly higher than that in group B. Blood glucose in Group B and C were higher than that in Group A, but there was no difference between the two groups. Kidney HE staining did not show significant lesions. Conclusion: Hydrogen-rich water can reduce oxidative stress in renal tissue of diabetic mice. 2014 Vol. 44 (11): 813-816 [Abstract] ( 609 ) HTML (1 KB)  PDF (16944 KB)  ( 663 ) 817 Clinical relevance of the protein expression of RCL, TAOK1, 14-3-3 zeta, ZNF706 in breast cancer LING Ren1, LING Jin2, NI Xinghao3, XUE Hongyan4, SHI Hongqi5, CHEN Zhonghua1 Objective: To detect the expression of RCL, TAOK1, 14-3-3 zeta and ZNF706 proteins in the breast cancer tissue, and to analyse and discuss the relationship between the expression of each protein and its clinical, as well as pathological relevance. Methods: Immunohistochemistry was used to detect the protein expression of RCL, TAOK1, 14-3-3 zeta and ZNF706 in 60 cases of breast cancer tissues, then the relationship between the expression of each protein in the cancer tissues and the tissues’ pathological grading, tumor size, metastatic status, and prognosis were evaluated by mathematic statistic methods. Results: RCL, TAOK1, 14-3-3 zeta and ZNF706 proteins were expressed in all of the breast cancer tissues, and the expression level were significantly higher than that in para-carcinoma tissues (P<0.05). The elevated expression of RCL was related to the tumor size, pathological grading and Ki67 (P<0.05). The expression of TAOK1 was related to the expression of ER and HER2 (P<0.05). The expression of 14-3-3 zeta was also related to ER (P<0.05). The expression of ZNF706 was related to lymphatic metastasis and ER (P<0.05). Conclusion: RCL, TAOK1, 14-3-3 zeta and ZNF706 proteins are high expressed in breast cancer tissues than that in normal tissues. The elevated expression of RCL is related to the tumor size, pathological grading and Ki67. The expression of TAOK1 is related to the expression of ER and HER2. The expression of 14-3-3 zeta is also related to ER. And the expression of ZNF706 is related to lymphatic metastasis and ER. The protein expression of RCL, TAOK1, 14-3-3 zeta and ZNF706 are detected in breast cancer tissues can help us determine the degree of tumor malignancy and predict the prognosis of the patients. 2014 Vol. 44 (11): 817- [Abstract] ( 597 ) HTML (1 KB)  PDF (12627 KB)  ( 599 ) 822 Comparative study on set-up errors with different registration algorithm for lung cancer undergone image guided radiation therapy WU Zhiqin, ZHANG li, YU Jianyi, YAN Huawei, YANG Guiqiang, LIN Li, HUANG Baoji, WANG Zhiwei, PAN Hanhui, JIN Xiance Objective: To investigate the accuracy of two different image registration algorithms for the setup error study in the treatment of lung cancer with image-guided radiation therapy (IGRT) technique. Methods: Forty-three lung cancer patients were treated with cone beam CT (CBCT) undergone image guided. Elekta Synergy linear accelerator radiation (KV-CBCT) was applied to investigate the setup discrepancy before the treatment, after online correction and the end of delivery. The difference in bone alignment, and grey value alignment were compared between CBCT images obtained by the reconstruction and original plan system CT images. The rotational error of the X, Y, Z-axis in the horizontal direction and the error of X, Y, Z in rotation direction were analyzed. Results: Total of 114 sets of CBCT images were scanned for 43 patients with lung cancer. The setup errors with bone-based registration and grey-based registration in the translational direction of the X, Y, and Z axis were (-0.297±3.137) mm and (0.377±2.958) mm, (-1.415±0.5.313) mm and (0.719±5.451) mm, (0.632±3.033)mm and (-0.679±2.982) mm. The setup in rotational direction of GX, GY, and GZ for bone-based and grey-based registration were (-0.469±1.605) ° and (-0.493±1.461) °, (-0.203±1.4 31) ° and (0.35±1.424) °, (0.134±1.478) ° and (0.196±1.348) °. Except in the rotational X and Z direction, there was significant difference between bone-based and grey-based registration algorithm. Conclusion: The two registrations all can be selected in lung cancer treatment with image guided radiation therapy (IGRT). It is suggested that the bone registration auxiliary after gray alignment is necessary. 2014 Vol. 44 (11): 822- [Abstract] ( 636 ) HTML (1 KB)  PDF (3647 KB)  ( 784 ) 825 The effect of ultrasound-guided popliteal sciatic nerve combined saphenous nerve blocks for surgical of diabetic foot ZHOU Riyong, XU Xuzhong. Objective: To observe the anesthesia effect of popliteal sciatic nerve and saphenous nerve block guided with ultrasound for diabetic foot surgery. Methods: Sixty patients undergoing diabetic foot surgery were randomly assigned to nerve block group (group NB) and Epidural block group (group EA) with 30 cases each group. Group NB: popliteal sciatic nerve block and saphenous nerve block on the adductor canal level guided with ultrasound. Group EA: routine lumbar epidural anesthesia 3-4 gap. Two groups of local anesthetics are lidocaine 2% 5 mL+0.75% ropivacaine 10 mL. Following variables were recorded: the anesthesia efficacy, rating as excellent, effective and failure; onset time of nerve block, duration of perioperative; blood pressure and heart rate during perioperative, Numeric rating scale (NRS) 24 h after operationg was used to assess the intensity of pain. Results: Anesthesia efficacy were no signifcant between two groups; the onset time were no signifcant differences between two groups, but the duration of sensory and motor block in group EA were obviously shorter than those of group NB (P<0.05). The SBP and DBP during perioperative has no significant change in Group NB before and after anesthesia. while in Group EB, SBP and DBP were lower at the time 15, 30 min after anesthesia (P<0.05). The changes of intraoperative blood pressure and heart rate were significantly differences between the two groups (P<0.05). Group NB were significantly lower NRS scores than Group EB (P<0.05). Conclusion: Ultrasound-guided popliteal sciatic nerve combined with saphenous nerve block for diabetic foot surgery has the equivalent analgesia and more stable hemodynamics with superior postoperative analgesia compared with epidural anesthesia. 2014 Vol. 44 (11): 825- [Abstract] ( 711 ) HTML (1 KB)  PDF (4142 KB)  ( 694 ) 829 Plasma interleukin-10 and 25(OH) Vitamin D in patients with lung cancer and its clinical value WANG Maofeng1, YING Jun2, JIANG Xinliang1, CHEN Debao1, JIANG Xiaowei1, LOU Yonggang1, ZHANG Qiaohong1, WAN Rugen1. Objective: To investigate plasma interleukin-10 (IL-10) and 25 (OH) vitamin D in patients with lung cancer and its clinical value. Methods: From March 2012 to January 2013, 78 cases newly admitted patients with lung cancer in our hospital were enrolled, including 40 cases of adenocarcinoma, 28 cases squamous cell carcinoma, 10 cases of small cell carcinoma, select age and sex matched 50 healthy volunteers as a control group. Analysis of 25 (OH) vitamin D and IL-10 in the differences among the groups and their correlation. Results: Lung cancer patients plasma 25 (OH) vitamin D concentration were (24.5±6.8) ng/mL, lower than the healthy control group 35.1±8.7 ng/mL, lung cancer patients plasma IL-10 concentrations were 1 031 (805~1 243) ng/L, higher than the healthy control group, the difference was statistically significant (P<0.05); lung adenocarcinoma patients plasma 25 (OH) vitamin D concentrations was not statistically significant difference in patients with squamous cell carcinoma of lung (P>0.05), lung adenocarcinoma patients plasma concentrations of IL-10 were 1 255 (1 050~1 440) ng/L, higher than that in patients with squamous cell carcinoma of lung, the difference was statistically significant (P<0.05), there is no correlation of plasma IL-10 and 25 (OH) vitamin D in patients with lung cancer (r=-0.011, P>0.05). Conclusion: Plasma 25 (OH) vitamin D and IL-10 concentration anomalies in patients with lung cancer, we suggesting that plasma 25 (OH) vitamin D and IL-10 concentration detection are helpful for monitoring the treatment and prognosis of patients with lung cancer. 2014 Vol. 44 (11): 829- [Abstract] ( 585 ) HTML (1 KB)  PDF (3398 KB)  ( 644 ) 832 Conservative treatment with suture surgery under laparoscope for the cornual or interstitial tubal pregnancy CHEN Yan, ZHANG Hongyang, ZHAI Aiqin Objective: To evaluate the benefit and efficacy of conservative treatment with suture surgery under laparoscope for the cornual or interstitial tubal pregnancy. Methods: Clinical data of 19 cases with cornual or interstitial tubal pregnancy undergoing surgery by laparoscopic treatment were retrospectively analyzed. They were designed to observation group and control group. The patients in observation group received suture surgery and taking embryo by cornual or tube pregnancy incision by laparoscope combined with partly injection on methotrexate (MTX), and those in control group received one horn of uterus wedge resection or one tubal removal by Laparoscope. Results: Comparing the control group, the observation group patients had the advantages of less bleeding, shorter duration of surgery. Between the two groups, the difference was statistically significant (P<0.05). Postoperative levels of serum β-HCG of 19 cases decreased to normal level within 60 days after surgery. All patients recovered to normal menstrual 3 months after the surgery. Conclusion: The method of through suture surgery and taking embryo by cornual or tube pregnancy incision combined with partly injection on methotrexate (MTX) by laparoscopic conservative treatment with the advantages of operation simply, shorter duration of surgery, less trauma, less bleeding, utmost retaining the structure and function of uterine and fallopian tube is worth in wide clinical application. 2014 Vol. 44 (11): 832- [Abstract] ( 693 ) HTML (1 KB)  PDF (3278 KB)  ( 1168 ) 835 Affection of short-term and low-dose glucocorticoid on bone mineral density and bone metabolism in the treatment of male patients with ankylosing spondylitis WEN Li, WANG Guoliang, SHENG Tongliang, CHEN Yu, SHOU Yanyun. Objective: Explore the change of bone mineral density and bone metabolism in male patients with ankylosing spondylitis by short-term and low-dose glucocorticoid. Methods: Randomly divide 46 patients into non-GC treatment group (22) and low-dose GC treatment group (24). Non-GC treatment group receive DMARD and Ca, Low-dose GC treatment group receive low dose glucocorticoid as well as DMARD and Ca. The Serum levels of osteoprotegerin (OPG), macrophage-colony stimulating factors (M-CSF), erythrocyte sedimentation rate (ESR), c-reactive protein (CRP), bath AS disease activity index (BASDAI) and Bone mineral density (BMD) were measured at the baseline and 6 months after therapy. Results: Six months after treatment, the level of OPG increased significantly (P<0.05) and the level of ESR, CRP, BASDAI decreased significantly (P<0.05) in both groups respectively, compared with that at the baseline; the level of M-CSF of two treatment groups decreased, in which the low-dose GC treatment group did more significantly (P<0.05). Six months after treatment, there was no significant difference in the levels of OPG, M-CSF, and BMD (P<0.05) between the two groups. There was  significant difference in the levels of ESR, CRP, BASDAI between the two groups (P>0.05).Conclusion: Short-term treatment of low-dose GC affect bone metabolisms and inflamed index, while with no significant influence on BMD in AS patients. It is safe and benefit for AS patients. 2014 Vol. 44 (11): 835- [Abstract] ( 606 ) HTML (1 KB)  PDF (4405 KB)  ( 657 ) 838 Treatment strategy of the elderly patients with cardiac surgery ZHENG Chunhui, ZHANG Xiangyan. Objective: To summarize the treatment strategy of the elderly patients with cardiac surgery by analyzing the perioperative care. Methods: From September 1 2010 to September 30 2013, 215 patients were undergone cardiac operations in our hospital. They were divided into young group (age≤44 y, 59 cases), middle-aged group (age between 45～59 y, 96 cases) and elderly group (age≥60 y, 60 cases). The postoperative hospital stay, postoperative mechanical ventilation time and intensive care time, drainage tube indwelling time and complication rate of elderly group were compared with the young group and middle-aged group. Results: Two hundred and fourteen cases were cured after operations and the cure rate was 99.5%. One case of elderly group died. The operative mortality in group was 1.7%. The postoperative mechanical ventilation time and intensive care time and drainage tube indwelling time of elderly group, except the postoperative hospital stay, were significantly longer then the young group and middle-aged group. Complication rate of elderly group was 45.0%. Conclusion: The surgical treatment is safe and effective to the elderly patients if the surgical indications, intraoperative and postoperative management are mastered well. 2014 Vol. 44 (11): 838- [Abstract] ( 626 ) HTML (1 KB)  PDF (3521 KB)  ( 772 ) 842 Clinical analysis and electromyogram study of Pancoast syndrome XIA Niange, WANG Xinshi, ZHANG Wanli, SHAO Bei, HUANG Huanjie. Objective: To investigate the clinical feature of pancoast syndrome, summarizing its causes and exploring the significance of electromyography in the early diagnosis. Methods: Two patients of pancoast syndrome were diagnosed in our hospital from June 2012 to April 2014, electromyogram (EMG), chest CT, neck and chest MRI or PET-CT and biopsy were performed and summarized. Results: Chest CT and thoracic MRI of one case revealed a superior sulcus tumour with an invasion of the adjacent vertebral body and appendix, EMG suggested a lower brachial plexopathy. Cervical MRI of the other case revealed a protrusion of C4-7 cervical intervertebral disc, a PET/CT scan showed obvious increased FDG uptake in the apex of the left hemithorax extending into the adjacent chest wall, T1-2 vertebral body and T1-2 ribs, EMG suggested isolated C8-T1 cervical radiculopathy. Both of 2 cases were confirmed by biopsy with a poorly differentiated non-small-cell lung carcinoma, presenting with pancoast syndrome. Conclusion: Main causes of Pancoast syndrome are neoplasms and infectious processes. The special initial clinical manifestation of Pancoast syndrome with shoulder and back pain is responsible for the observed delay in diagnosis. EMG plays a possible ancillary role in directing the course of diagnosis in challenging cases of Pancoast syndrome. 2014 Vol. 44 (11): 842- [Abstract] ( 600 ) HTML (1 KB)  PDF (9004 KB)  ( 609 ) 846 The surgical strategy of vascular malformation hemorrhage of posterior fossa ZHANG Yi, LI Zequn, LONG Yanxiao, ZHONG Ming, LU Xianghe, ZHENG Weiming Objective: To discuss the surgical strategy and curative effect of vascular malformation hemorrhage of posterior fossa. Methods: The clinical data of 24 patients, from January 2008 to October 2013, with vascular malformation hemorrhage of posterior fossa were analyzed retrospectively. All patients received preoperative imaging scaning and/or pathologic diagnosis, 15 with arteriovenous malformation, 1 with telangiectasis, 2 with venous malformation, and 6 with dura arteriovenous fistulas (DAVF). Seven cases suffered with subarachnoid hemorrhage (SAH) and 17 cases had posterior fossa hematoma. Results: Eleven cases of the arteriovenous malformation got arteriovenous malformation resection and hematoma evacuation, 2 were treated with endovascular embolization and another 2 got radiotherapy after part arteriovenous malformation resection. The telangiectasis cases and venous malformation patients were performed hematoma evacuation. Four DAVF patients got embolization and 1 got two-stage embolization after hematoma evacuation, and 1 got DAVF excision. Patients were followed up for a period from 6 months to 54 months. Of these patients, the curative effect was excellent in 22, bad in 2. Conclusion: Individualized comprehensive treatment of vascular malformation hemorrhage of posterior fossa can improve efficacy and prognosis. 2014 Vol. 44 (11): 846- [Abstract] ( 539 ) HTML (1 KB)  PDF (6802 KB)  ( 623 )

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