Assessing gray matter volume in patients with idiopathic rapid eye movement sleep behavior disorder

Idiopathic rapid eye movement sleep behavior disorder(iRBD) is often a precursor to neurodegenerative disease. However, voxel-based morphological studies evaluating structural abnormalities in the brains of iRBD patients are relatively rare. This study aimed to explore cerebral structural alterations using magnetic resonance imaging and to determine their association with clinical parameters in iRBD patients. Brain structural T1-weighted MRI scans were acquired from 19 polysomnogram-confirmed iRBD patients(male:female 16:3; mean age 66.6 ± 7.0 years) and 20 age-matched healthy controls(male:female 5:15; mean age 63.7 ± 5.9 years). Gray matter volume(GMV) data were analyzed based on Statistical Parametric Mapping 8, using a voxel-based morphometry method and two-sample t-test and multiple regression analysis. Compared with controls, iRBD patients had increased GMV in the middle temporal gyrus and cerebellar posterior lobe, but decreased GMV in the Rolandic operculum, postcentral gyrus, insular lobe, cingulate gyrus, precuneus, rectus gyrus, and superior frontal gyrus. iRBD duration was positively correlated with GMV in the precuneus, cuneus, superior parietal gyrus, postcentral gyrus, posterior cingulate gyrus, hippocampus, lingual gyrus, middle occipital gyrus, middle temporal gyrus, and cerebellum posterior lobe. Furthermore, phasic chin electromyographic activity was positively correlated with GMV in the hippocampus, precuneus, fusiform gyrus, precentral gyrus, superior frontal gyrus, cuneus, inferior parietal lobule, angular gyrus, superior parietal gyrus, paracentral lobule, and cerebellar posterior lobe. There were no significant negative correlations of brain GMV with disease duration or electromyographic activity in iRBD patients. These findings expand the spectrum of known gray matter modifications in iRBD patients and provide evidence of a correlation between brain dysfunction and clinical manifestations in such patients. The protocol was approved by the Ethics Committee of Huashan Hospital(approval No. KY2013-336) on January 6, 2014. This trial was registered in the ISRCTN registry(ISRCTN18238599).     

Tumor-associated Macrophage-derived Interleukin-23 Interlinks Kidney Cancer Glutamine Addiction with Immune Evasion

Background

Glutamine addiction is a hallmark of clear cell renal cell carcinoma (ccRCC); yet whether glutamine metabolism impacts local immune surveillance is unclear. This knowledge may yield novel immunotherapeutic opportunities.

Medial sustainable nail versus proximal femoral nail antirotation in treating AO/OTA 31-A2.3 fractures: Finite element analysis and biomechanical evaluation

Objectives

Using finite element analysis and biomechanical tests, the biomechanical behaviors of Medial Sustainable Nail (MSN) and Proximal Femoral Nail Antirotation (PFNA) were compared for the fixation of fracture type of AO/OTA 31-A2.3.

血清标本溶血对自动生化仪检验指标的影响的研究观察

目的研究分析血液样本溶血对临床生化检验的影响。方法对2013~2014年我院78例健康检验患者来进行探讨分析,要求患者在晨时空腹状态接受血液采集,将这些血液样本分成两份,进行常规生化检验以及诱导溶血生化检验,对检验结果进行比较分析。结果经过检验后,两份血液样本中的ALT、AST、LDH以及K+含量等均是在经过诱导溶血后的样本中比较高,ALP含量在诱导溶血后的样本中比较低。结论临床进行血液检验的时候,如果样本发生了溶血情况,那么检验结果就会受到影响,导致检验结果不准确,所以应该要积极的避免血液样本发生溶血的情况。     

髋臼横韧带定位髋臼假体前倾校正骨盆旋转

目的通过观察后外侧入路全髋关节置换术中骨盆的旋转变化，探讨术中骨盆旋转对髋臼假体前倾角植入的影响，评估使用髋臼横韧带作髋臼假体前倾定位的准确性以及对骨盆旋转角度变化的校正作用。 方法2015年1月至2016年1月河池市第三人民医院关节外科收治的行初次THA的40例44髋的髋关节疾病患者纳入本研究。纳入标准为：初次THA术的患者，术前、术后CT扫描质量符合标准、能确定髋臼解剖前倾角、髋臼假体前倾角的患者。排除标准：髋臼发育不良、强直性脊柱炎、既往有髋关节严重创伤手术史以及翻修术等，术前、术后双髋关节CT扫描，CT横断面上骨盆明显倾斜、两侧髋关节的中心显示明显不在同一层面、难以确定水平线测量前倾角的患者，予以排除。手术均采用侧卧位后外侧入路，切皮前将1枚施氏针以垂直于地面方向打入髂骨嵴，术中髋臼假体的前倾角，以髋臼横韧带为参照标志，通过直接参照或间接参照髋臼横韧带进行髋臼挫磨及安装臼杯，使髋臼假体开口平行韧带进行安放，在此过程中用摄像机记录施氏针相对于地面的角度变化，确定手术过程中骨盆旋转度数，同时测量并记录挫磨髋臼及安放假体时，相对于身体长轴髋臼手术前倾角的数值。术后通过CT测量髋臼假体前倾角，对术中手术前倾角和术后髋臼假体的前倾角、术前髋臼解剖前倾角数据进行t检验分析。 结果术中骨盆旋转发生在本研究中的平均度数为(18±4)°。44个髋关节中，所有的病例都能对髋臼横韧带进行辨认，术中手术前倾角平均为(33±5)°，有93%(41髋)的病例大于Lewinnek提出的"安全区"的前倾角上限25°，余下的7%(3个髋)也全部大于24°。术后CT测量髋臼假体的解剖前倾角为(21±10)°，与术前髋臼解剖前倾角度(19±7)°比较，差异无统计学意义(t＝1.264，P >0.05)。 结论在后外侧入路THA术中，体位改变骨盆前旋转会影响髋臼假体植入的准确性，使用髋臼横韧带作为解剖标志指导髋臼假体前倾角度的植入，可以排除患者体位改变骨盆旋转对前倾角的影响，提高髋臼假体放置的准确性。     

Percutaneous endoscopic laser annuloplasty for discogenic low back pain

BackgroundLaser-assisted spinal endoscopy (LASE) kit has been used for percutaneous intradiscal decompression to evaporate and shrink the posterior and central nucleus for improvement of leg and radicular pain due to contained disc herniation. Percutaneous endoscopic laser annuloplasty (PELA), a new minimally invasive technique, uses LASE to directly coagulate the inflamed disc granulation tissue associated with annular tears. The small diameter of the endoscope including Ho:YAG laser, irrigation, and light, plus the extreme posterolateral approach into the posterior annulus, enables one to minimize damage to normal nuclear tissue. The authors sought to demonstrate the safety and efficacy of PELA for controlling discogenic low back pain (DLBP) due to abnormal disc tissues, new vessels, and nerves in the central torn posterior annulus.MethodsClinical outcomes of PELA were investigated in patients having DLBP with an annulus-torn degenerative disc or contained disc herniation. Thirty patients treated at a single level and achieving a mean follow-up of 9.7 months were analyzed. Outcomes were assessed using the visual analog scale (VAS) for back pain, the Korean Oswestry Disability Index (KODI), and the modified Macnab's criteria.ResultsThe mean back pain VAS score improved from 8.0 to 2.4, and the mean KODI score improved from 79.0 to 22.4 (P < .001). Results by the modified Macnab's criteria also showed a good outcome, with a success rate of 90.0%. There were no serious complications observed during follow-up.ConclusionsPercutaneous endoscopic laser annuloplasty using the Ho:YAG laser provides favorable outcomes for carefully selected groups of patients with DLBP.     

Transurethral injection of bulking agent for treatment of failed mid-urethral sling procedures

Introduction and hypothesis  

We evaluated the efficacy of transurethral injection (TUI) for the treatment of recurrent or persistent stress urinary incontinence after mid-urethral sling (MUS) procedures.     

人脂肪间充质干细胞的分离培养及其遗传稳定性

背景:研究发现脂肪间充质干细胞核型具有不稳定性,且干细胞移植后长期安全评价等问题尚未从根本上得到解决.目的:观察体外分离培养的人脂肪间充质干细胞传代培养的遗传稳定性.设计、时间及地点:细胞学体外观察,于2008-03/11在解放军兰州军区兰州总医院骨科研究中心完成.材料:成人腹部大网膜脂肪组织来源于单纯性阑尾炎患者,由解放军兰州军区兰州总医院普通外科提供.方法:胶原酶消化法体外分离培养人脂肪间充质干细胞,加入含体积分数为10%胎牛血清的HG-DMEM培养基吹打细胞沉淀,过滤后于37℃、体积分数为5%的CO2饱和湿度条件下培养,待细胞生长至70%～80%融合时消化传代.分别取第3,25,30代脂肪间充质干细胞进行相关指标检测.主要观察指标:脂肪间充质干细胞表面标志表达、细胞增殖、核型分析、超微结构电镜观察、恶性肿瘤特异性生长因子的表达.结果:第3代脂肪间充质干细胞CD13,CD44,CD59均呈阳性表达,而造血干细胞表面标志CD34及成纤维细胞表面标志HLA-DR均呈阴性表达:染色体的形态、结构和数目均未见异常,呈二倍体结构;镜下可见完整的高尔基复合体,数量较多的粗面内质网,部分糖元颗粒分布在胞浆中.第25代脂肪间充质干细胞分裂增殖作用强于第3代脂肪间充质干细胞;多条染色体出现断裂畸变,并且染色体数目出现异常,呈亚二倍体或超二倍体核型;核仁增大,异染色质及线粒体数量增多,内质网数量少,细胞较为幼稚.第3,25,30代脂肪间充质干细胞恶性肿瘤特异性生长因子的表达吸光度值无明显差异(P>0.05).结论:分离获得的人脂肪间充质干细胞长期体外培养具有遗传不稳定性,有向肿瘤细胞突变的倾向.