[Objective]To evaluate the clinical outcome of lumbar spinal canal stenosis treated by microendoscopic decompressive laminotomy with facet-preserving technique.[Method]Twenty-nine consecutive patients of posterior lumbar spinal canal stenosis were treated by microendoscopic unilateral approach and bilateral decompression with facet-preserving technique using the METRxTM microendoscopic spinal system.Moreover,operation time,blood loss,use of diclofenac suppositories,intra-and postoperative complications and Imaging evaluation were investigated.Clinical outcomes were evaluated by the Japanese Orthopaedic Association scoring system for lumbar disease.[Result]Twenty-four patients were followed up for 7 to 24 months,mean 15.3 months.Mean preoperative JOA scores were(14.5?3.7),and postoperative JOA scores were(22.4?2.3).The mean recovery rate was 54.7%.Operation time was 94.2 minutes for one level decompression,and mean blood loss was 56.4 ml.The use of diclofenac suppositories was average 0.37 times.Intra and postoperative complications were due to one misjudgment of the vertebral level,one dural tears.Intraoperative endoscopic photograph showed satisfactory decompression of dural sac and contralateral nerve root from ipsilateral laminotomy could be performed completely.Postoperative CT and 3DCT showed bilateral decompression from ipisilateral laminotomy and revealed no damage of the facet joints.[Conclusion]Microendoscopic unilateral approach and bilateral decompression with facet-preserving technique using the METRxTM microendoscopic spinal system minimizes resection of the pathologic compression tissues and is a safe,effective and ideal decompressive method for lumbar spinal canal stenosis.

Objective To create new tetraploid resource of Dioscorea zingiberensis in the hope of potential breeding materials with high yield and high level of diosgenin. Methods Callus with tiny green buds were directly soaked in colchicine solution or cultured in medium plus with colchicine to prohibit the isolation of chromosomes and induce tetraploid mutants. Results Tetraploids were achieved successfully. The most efficient treatment for inducing tetraploid was soaking the tiny buds in 1?103 mg/L colchicine solution for 24 h, the inducing rate could be up to 35. 2%. The induced tetraploids exhibited notable difference with common wild type (diploids) in morphology, physiology, and microscopic structure. ConclusionThe tetraploid plants show the advantages of gigantic size and vigorous growth. Thus, the established technique system to induce tetraploid from tissue cultured callus would provide an efficient alternative pathway for medicinal plants of Dioscorea L. breeding.

BACKGROUND:Percutaneous vertebraplasty is a new means for the treatment of vertebral compression fractures and bone metastases. The multiplaner reconstruction with digital substraction angiography (DSA)-Innova 3D plays an important role in guiding the percutaneous vertebraplasty puncture, which can effectively prevent the leakage of bone cement. OBJECTIVE:To explore the value of DSA-Innova 3D in the guidance of puncture of percutaneous vertebroplasty. METHODS:From March 2014 to September 2014, a total of 72 patients with 94 vertebras were selected for percutaneous vertebraplasty, of whom 36 (48 vertebras) with Innova 3D (experimentalgroup) and 36 (46 vertebras) without Innova 3D (control group). Spiral CT scan was performed in al patients to assess the distribution of bone cement. The imaging quality in the two groups was compared by Mann-Whitney U test. RESULTS AND CONCLUSION:CT showed bone cement leakage occurred in 7 of the 36 patients in the control group. Leakages were into the lumber disc in two cases, paravertebral space in two cases, vertebral pedicle in onecase or veins in two cases. However, only one case of bone cement leakage was observed in the experimental group. With the guidance of DSA-Innova 3D, the experimental group had signficantly lower leakage and fluoroscopic time than the control group (P < 0.05). The multiplaner reconstruction with DSA-Innova 3D plays an important role in guiding the percutaneous vertebraplasty puncture, thereby effectively reducing the leakage of bone cement.

ObjectiveTo rapidly detect the mutation frequency of DBC2 gene 7776C ＞ T in breast cancer and breast fibroadenoma by applying the mutation-sensitive molecular switch ( comprised of high-fidelity DNA polymerase and phosphorothioate-modified allele-specific primers) and agarose gel electrophoresis.Methods Allelic specific primers targeting mutation type and wild type were designed with the primers'3'terminal phosphorothioate modification.When the primers matched with the tissue DNA,the primers could be extended with highfidelity polymerase; when they mismatched with the tissue DNA,the primers could not be extended.DNA samples from 85 cases of breast cancer and 10 cases of breast fibroadenoma tissues were chosen and analyzed by PCR amplifications mediated by high-fidelity DNA polymerase.Gel imaging system was employed to make analysis of PCT products.ResultsThe mutation-sensitive molecular switch system showed that the mutation rate of 7776C ＞ T was 2.4％ ( 2/85 ) in the 85 cases of breast cancer,and no mutation was found in the 10 cases of breast fibroadenoma.ConclusionsThe mutation-sensitive molecular switch combined with agarose gel electrophoresis can rapidly detect the mutation of breast cancer DBC2 gene 7776C ＞ T.It is applicable in single nucleotide polymorphisms assay and has enormous application value in detecting gene mutation.

Objective To discuss the feasibility and clinical application of percutaneous internal fixation (PIF) combined with pecutaneous osteoplasty (POP) for the treatment of metastasis of proximal femur with impending pathological fracture. Methods Six consecutive patients with metastases of the proximal femur, who could not be able to tolerate conventional surgery, underwent PIF together with POP. The results were analyzed. Results The procedure was successfully accomplished in all six patients. Neither pulmonary embolism nor death occurred in all patients during and after the operation. No fracture at operated area was observed during follow-up period. Conclusion For stabilization of proximal femoral metastatic lesion with impending pathological fracture, percutaneous internal fixation combined with pecutaneous osteoplasty is a safe and effective technique.

0.01). No serious complications occurred. Conclusion Both PLD+IDET and PLD are very effective in treating lumbar disc herniation. IDET is very helpful in relieving low back pain, although it can hardly improve patient's daily activities.

Objective To analyze the magnetic resonance imaging (MRI)and histologic features of the synchronous bilateral primary breast cancer (sBPBC).Methods MRI findings and pathologic types of sBPBC in 20 patients in our institute were reviewed retrospectively. The MRI features of sBPBC were compared with the pathologic types,respectively.Results 20 sBPBC patients with 41 lesions were found with the most common pathological type of invasive ductal carcinoma in 26 (26/41 ).Bilateral lesions had the same pathological types in 1 1 patients(1 1/20),and different types in 9(9/20).The MRI features of invasive breast cancer were more characteristic than that of early breast cancer.In 20 patients,the first and second primary breast cancers with similar MRI findings were found in 6(6/20).In 10 patients with sBPBC,the first cancer was advanced breast cancer,and the second was early or low grade breast cancer.Conclusion (1)The most common pathological type of sBPBC is invasive ductal carcinoma,and the pathological types of bilateral lesions are not similar. (2)The MRI features of the first and the second lesions in bilateral primary breast cancer showed lower similarity,and the bilateral lesions should be diagnosed independently.(3)In patients with sBPBC,some cancers are advanced breast cancers,and the second ones are early cancers,suggesting the lesion should be followed up if the contralateral one is diagnosed as breast cancer.

Objective To discuss the technical points, safety and clinical effectiveness of DSA-guided percutaneous acetabuloplasty (PA) for the treatment of acetabular metastases. Methods Fifteen patients, including 6 males and 9 females, with acetabular malignant metastases were enrolled in this study.A total of 19 lesions were detected. The lesions were 13 - 25 mm in size (mean 19 ± 4 mm), the dose of PMMA used for per lesion was 5 - 13 ml (mean 8.2 ± 2.3 ml). All patients complained of greater or less degree of pain in their hips, 8 patients had to use walking stick, 4 patients showed limping although they could walk independently and three patients could not walk alone. DSA-guided percutaneous acetabuloplasty was performed in all patients and follow-up after the procedure was conducted for 1 - 12 months. Visual analogue score (VAS), walking state score and analgesic dosage taken by the patients were used for the evaluation of the clinical effectiveness. The complications were analyzed. All the data obtained were statistically analyzed with paired samples t test and analysis of variance by using SPSS12.0 statistical software.Results The procedure was technically successful in all patients. Pain rating evaluated by the VAS decreased from a mean of 7.8 before surgery to a mean of 4.2 in 24 hours after surgery (P < 0.01 ), which further decreased to 2.5 in one month (P < 0.01 ), while walking state score increased from a mean of 1.5before surgery to a mean of 2.5 in 24 hours after surgery (P < 0.01 ). The analgesic dosage taken by the patient was reduced in 14 patients and remained the same in one patient. The bone cement leakage into paraacetabular soft tissues occurred in three cases and peripheral vascular exudation of acetabulum was observed in three cases with no obvious clinical symptoms. Conclusion As a safe, reliable and minimally-invasive technique, DSA-guided percutaneous acetabuloplasty has excellent anti-pain effect in treating acetabular metastases. This therapy can markedlyimprove the patient's walking ability and the quality of life.

BACKGROUND:At present, there are many methods to treat cartilage defects, but none radical y repairs the articular cartilage defects.
OBJECTIVE:To histological y verify the effect of naringin combined with tissue engineering cartilage on the repair of rabbit articular cartilage defects.
METHODS:Rabbit bone marrow mesenchymal stem cells fol owing in vitro proliferation were compounded onto acellular dermal matrix, which was then implanted into rabbit knee cartilage defects. Naringin was also given by lavage. Hematoxylin-eosin staining, Masson trichrome staining, toluidine blue dyeing, type II col agen staining and type X col agen staining were performed in the repaired tissue.
RESULTS AND CONCLUSION:After 8 weeks post-surgery, the defects repaired with the naringin and stem cells composite were turned into milky-white and transparent smooth tissue. The defective tissue which was repaired, was very similar to normal cartilage tissue, with smooth surface. After the histology research, we found that the defect tissue was fil ed with new cartilage tissue. Results indicated that naringin combined with tissue engineering cartilage can promote the repair of articular cartilage defects in rabbits.

To prepare scaffolds for heart valve tissue engineering, porcine heart valves were treated with varied concentrations of trypsin for 32, 56, 80 and 104 h or followed with DNase. And then the structure of acellular valves was observed under light microscope, scanning and transmission electron microscope. Porcine endothelial cells, human endothelial cells, and canine myofibroblasts were reseeded onto the acellularized porcine heart valve scaffolds once a day for 3 days. The valves were analyzed by immunohistochemical staining and electron microscopy. Results show that all endothelial cells and the majority of interstitial cells were removed from the heart valves after digestion with trypsin for 104 h, and the collagen fiber structure remains intact, but the space between collagen fibers increased slightly. Incubation with trypsin for 80 h and then with DNase almost removed all cells, and the collagen fiber structure and the space between the fibers remain intact. After reseeding, human endothelial cells almost fully cover the valve scaffold surface as shown by H-E staining and platelet endothelial cell adhesion molecules (PECAM-1) staining. Xenogeneic porcine endothelial cells also adhered to and grew on the scaffolds. As shown by H-E staining and actin staining, canine myofibroblasts not only adhered to the surface of valve scaffold but also migrated to the inner part of matrix after one week culture. These results suggest that the digestion of porcine heart valves with trypsin combining with DNase is a suitable method to remove cells. The acellular porcine heart valve scaffolds have a quite favorable biocompatibility with human and porcine endothelial cells as well as canine myofibroblasts.
Animals ; Bioprosthesis ; Cells, Cultured ; Endothelium, Vascular ; cytology ; transplantation ; Fibroblasts ; cytology ; Heart Valve Prosthesis ; Heart Valves ; cytology ; Humans ; Muscle Fibers, Skeletal ; cytology ; Swine ; Tissue Engineering