In this paper,based on the latest domestic and foreign literatures,segmental stability in degenera-tive spondylolisthesis,therapeutic principles,indications and new progress of many minimally invasive surgery of this disease are described in detail.Minimally invasive surgical procedures for degenerative lumbar spondylolisthesis is diversity,so we should choose the best treatment for every patient according to the age,basic diseases,the degree of slipped levels,segmental stability of slipped vertebraes,ecnomic factors in patients,combined with operation skills of surgeons.

Objective: To validate the therapeutic value of CT-guided percutaneous ethanol injection (PEI) in the treatment of metastatic adrenal tumors. Methods: Thirty one foci (diameter ranging from 1.5 cm to 7.2 cm) in 25 patients with metastatic adrenal tumors were treated with CT-guided PEI for more than twice. Plain and enhanced CT scans were performed 1-2 months after PEI to observe the size and necrosis of the tumors. Results: Post-PEI enhanced CT scan showed that 18 of the 20 foci with diameters less than 3 cm completely necrotized; 11 foci with diameters between 3 cm and 7.2 cm necrotized partially, and 2 foci completely necrotized after another 2-3 courses of PEI treatment. Conclusion: CT guided PEI is a simple and minimally invasive means for treatment of metastatic adrenal tumors, and the therapeutic effect is satisfactory.

Objective To compare the effect of electroacupuncture at head points and body points on glucose metabolism of the cerebral motor function regions in normal subjects.Methods To observe the change of glucose metabolism of cerebral motor area in normal subjects between before and after acupuncture during the movement by PET.Talairach coordinates(Atlas of brain) and statistical parametric mapping(SPM) software were used to deal with the acquired imaging data.Results ① Acupuncture at Baihui(GV20) and left Qubin(GB7) could increase metabolism of glucose in bilateral Lps and precuneus,the activation of left area in the brain being more significant.②Acupuncture at right Quchi(LI11) and Zusanli(ST36) change metabolism of glucose in left gyrus precentralis,right loblus paracentralis,right gyrus frontalis medialis,both cerebellums and both putarnens.Conclusion All acupoints can change glucose metabolism in cerebral structures related to motor function in the bilateral cerebral hemispheres,different acupoints active different motor areas.The function of acupuncture is a kind of comprehensive regulative process.

Objective To investigate the effect of different noise index (NI) combined with iterative recombination on the image quality and radiation dose of CT scan in patients with different body mass index (BMI). Method One hundred and sixty patients who had a liver CT enhanced scan were divided into group A (18 kg/m2≤BMI<24 kg/m2 ) and group B (24 kg/m2≤BMI<31 kg/m2) according to BMI, and each group had 80 patients. The two groups were randomly divided into 4 subgroups which NI value was 11, 13, 15 and 17 respectively. All images were restructured with 50% adaptive statistical iterative reconstruction. Subjective evaluation, objective evaluation [signal noise ratio (SNR) and contrast noise ratio (CNR)] and the effective dose of each group were recorded and calculated after the scan. ANOVA and Kruskal-Wallis test were used to evaluated the difference of imaging quality and radiation dose. Results In group A, the SNR, CNR and the subjective score of the later arterial phase images showed a statistical difference between NI=17 group and other subgroups (P<0.05), while there was no statistical differences among the other three subgroups during three CT enhanced phase. The average ED of NI=15, 17 group were decreased by 57.56%(2.17/3.77) and 61.54% (2.32/3.77) compared with NI=11 group, respectively. In group B, the SNR, CNR and the subjective image scores of the later arterial phase showed a significant difference between NI=15 and NI=11, 13 group (P<0.05). There was a statistically difference of image quality in group NI=17 compared with the other three subgroups in the later arterial phase, portal venous phase and equilibrium phase (P<0.05). The average ED of NI= 13, 15 group was decreased by 26.41% (1.69/6.40) and 45.31%(2.90/6.40) compared with NI=11 group, respectively. Conclusion Upon maintaining diagnostic imaging quality, setting different NI according to BMI and applying the iterative reconstruction algorithm can effectively reduce the radiation dose of liver CT enhanced scanning.

OBJECTIVE To analyze the effect of advanced glycation end products(AGEs) on apoptosis of cultured mouse spiral ganglion cells(SGCs) and expression of receptor of AGEs(RAGE). To explore the pathway of AGEs in promoting apoptosis of SGCs. And to explore the possible mechanism of neural presbycusis. METHODS The effect of AGEs on apoptosis of SGCs was studied by Tunel technique and fluorescence microscope. The expression of RAGE mRNA was assayed by Real time RT-PCR. RESULTS AGEs induced apoptosis of cultured SGCs. The effects were dose-dependent and time-dependent. Meanwhile RAGE mRNA expression was enhanced in apoptosis cells. CONCLUSION AGEs induced apoptosis in SGCs,which may be mediated by RAGE. And this may be one of the mechanisms of neural presbycusis.

Objective:To investigate the value of magnetic resonance cholangiopancreatography(MRCP)in the diagnosis of pancreas divisum by comparing with endoscopic retrograde cholangiopancreatography(ERCP).Methods:The MRCP and ERCP images of 8 patients with pancreas divisum were retrospectively analyzed.The diagnostic accuracy and findings by MRCP were compared with those by ERCP.Results:MRCP had a diagnostic accuracy of 87.5%(7/8)based on the result of ERCP.ERCP displayed the dominant dorsal pancreatic ducts in all 8 cases and ventral pancreatic ducts in 6 cases;MRCP also displayed the dominant dorsal pancreatic ducts in all 8 cases,but the ventral pancreatic ducts only in 3 cases.Conclusion:As a non-invasive technique,MRCP has important clinical value in the diagnosis of pancreas divisum.

OBJECTIVETo explore therapeutic effects of Modified pinning combined with external tension band for the treatment of Gartland type III humeral supracondylar fractures in children.

METHODSFrom February 2009 to November 2010, 79 children with Gartland type III humeral supracondylar fractures were treated by modified pinning (pinning cross internal and external condyle assisted with lateral condyle) combined with external tension band (crossing needle end and hooking around) through lateral approach of elbow. There were 47 males and 32 females, with an average age of 8.7 years (ranging from 2.5 to 14 years). The time from injury to operation was 2 h to 8 d. The elbow joint function and Carrying angle were observed before and after treatment. The Flynn criteria were used to evaluate therapeutic effects.

RESULTSSixty-one patients were followed up (18 patients' data were lost) for 6-30 months (mean 13.5 months). According to Flynn criteria, 53 patients got excellent result, 7 good and 1 fair.

CONCLUSIONTreatment of child Gartland type III humeral supracondylar fractures with modified pinning combined with external tension band through lateral approach of elbow is believed to be an ideal method, which has advantages of reliable fixation, rapid recovery and less complications.

Adolescent ; Bone Nails ; Child ; Child, Preschool ; Female ; Fracture Fixation ; instrumentation ; methods ; Humans ; Humeral Fractures ; diagnostic imaging ; surgery ; Male ; Mechanical Phenomena ; Radiography ; Treatment Outcome

Tumor is a system-biology illness.Treatment of this intractable disease by any single medicine has not been realistic.In this review, we analyze the anti-tumor network of Tumor Necrosis Factor-related Apoptosis-indu-cing Ligand ( TRAIL ) by a system-biology technology and try to providecin individualized treatment strategy for TRAIL based therapy .

Objective To investigate the best weighting of adaptive statistical iterative reconstruction (ASIR) algorithm and optimized low-dose scanning parameters in thoracic aorta CT angiography(CTA).Methods Totally 120 patients with the body mass index (BMI) of 19-24 were randomly divided into 6 groups.All patients underwent thoracic aorta CTA with a GE Discovery CT 750 HD scanner (ranging from 290-330 mm).The default parameters (100 kV,240 mAs) were applied in Group 1.Reconstructions were performed with different weightings of ASIR (10％-100％ with 10％),and the signal to noise ratio (S/N) and contrast to noise ratio (C/N) of images were calculated.The images of series were evaluated by 2 independent radiologists with 5-point-scale and lastly the best weighting were revealed.Then the mAs in Group 2-6 were defined as 210,180,150,120 and 90 with the kilovoltage 100.The CTDIvoland DLP in every scan series were recorded and the effective dose (E) was calculated.The S/N and C/N were calculated and the image quality was assessed by two radiologists.Results The best weighing of ASIR was 60％ at the 100 kV,240 mAs.Under 60％ of ASIR and 100 kV,the scores of image quality from 240 mAs to 90 mAs were(4.78 ±0.30)-(3.15 ±0.23).The CTDIvol and DLP were 12.64-4.41 mGy and 331.81-128.27 mGy,and the E was 4.98-1.92 mSv.The image qualities among Group 1-5 were nor significantly different (F =5.365,P ＞ 0.05),but the CTDIvol and DLP of Group 5 were reduced by 37.0％ and 36.9％,respectively compared with Group 1.Conclusions In thoracic aorta CT Angiography,the best weighting of ASIR is 60％,and 120 mAs is the best mAs with 100 kV in patients with BMI 19-24.

Adenocarcinoma, Papillary ; blood supply ; metabolism ; pathology ; Adult ; Aged ; Carcinoma, Pancreatic Ductal ; blood supply ; metabolism ; pathology ; Chemokine CXCL12 ; metabolism ; Female ; Gene Expression Regulation, Neoplastic ; Humans ; Lymph Nodes ; metabolism ; Lymphatic Metastasis ; Male ; Microvessels ; pathology ; Middle Aged ; Neoplasm Staging ; Neovascularization, Pathologic ; metabolism ; pathology ; Pancreas ; metabolism ; Pancreatic Neoplasms ; blood supply ; metabolism ; pathology ; Receptors, CXCR4 ; metabolism