[Objective]To evaluate the curative effects of the posterior or anterior lumbar interbody fusion for the treatment of superior position intervertebral disc herniation. [Method] Forty-seven patients with superior position intervertebral disc herniation were followed up.There were 29 males and 18 females with mean age of 53.3 years(from 35 to 67 years).Twewty-five patients were treated with posterior lumbar interbody fusion(PLIF)using facet joint autograft and cage additional of pedicle screw internal fixation(posterior way group),and 22 patients were treated with anterior disckectomy,bone graft and plates internal fixation(anterior way group).The mean follow-up time was 53.5?5 months(from 24 to 78 months).The clinical results were compared between two groups.Clinical functional assessment standard was used to evaluate the clinical curative effect.The changes of the therapeutic effects,the radiographic findings and complications were evaluated.[Result]In regard to the operation time and bleeding,the posterior way group was superior to anterior way group.There was no difference between the two groups in clinical recovery rates and nerve root injury rates.Complications included dural tear(n=3),and pedicle screw deviating(n=1) in the posterior way group;and dural tear(n=2),unilateral transient lower extremity paresthesia(n=3),and hard controlled singultation(n=1) in the anterior way group.The rates of bone fusion were 96.00% and 95.45% in the posterior and anterior way groups. [Conclusion] Operation for the superior position intervertebral disc herniation is effective.The posterior lumbar interbody fusion using facet joint autograft and cage additional of pedicle screw internal fixation to shorten the operation time and decrease bleeding is recommend for the treatment of superior position intervertebral disc herniation.

Objective To investigate the molecular mechanisms of glial cell derived neurotrophic factor in promoting proliferation of spermatogonial stem cell.Methods RNAi expression vectors,targeted at GDNF,were constructed and transfected into SSCs from 5 to 7 days old mice.The SSCs with highest effectiveness of GDNF interfere was set as study group.And the SSCs without GDNF interfere was considered as control group.The ELISA method was used to compare the proliferative rate between study group and control group.Flow cytometry,RT-PCR were used to detect the expression of GDNF,RTKs,Fyn and FAK's mRNA,and the apoptosis of SSCs.Results From 1 to 4 days after transinfection,the absorbable A value in study group was 0.45 ± 0.02,0.68 ± 0.03,1.12 ± 0.03,2.24 ± 0.04,respectively.Meanwhile,the same item in control group was 0.46 ± 0.03、0.73 ± 0.02、1.32 ± 0.05、1.15 ± 0.06,respectively (P ＜ 0.05).There were significant different between experiment groups (25.43 ± 1.91) ％ and control group (5.61 ± 0.16)％ in the apoptosis rates of SSCs (P ＜ 0.05).Significant differences were noted between experimental group and control group(P ＜ 0.05).The mRNA expression rates of GDNF was (12.32 ± 1.22) ％ in study group and (54.25 ± 1.34)％ in control group (P ＜0.01).The mRNA expression rates of RTKs and Fyn and FAK in study group and control group were (16.24 ± 1.35)％ vs (45.35 ± 1.37)％,(18.32 ±1.34)％ vs (38.37 ± 1.55)％,(20.04 ± 1.65)％ vs (43.27 ± 1.28)％,respectively (P ＜0.05).Conclusions The glial cell line derived neurotrophic factor was important in course of SSCs' proliferation,which may up-regulating the expression of RTKs,Fyn and FAK.

Background and purpose: The increased of specific expression of prostate cancer antigen 3 (PCA3), as one of long non-coding RNA, has been observed in prostate cancer, indicating that PCA3 may contribute to the development of prostate cancer. To further study its roles in prostate cancer, we construct a lentivirus expression vector carrying the whole PCA3. Methods: PCA3 was amplified from prostate cancer cell line LNCaP by reverse transcriptase polymerase chain reaction (RT-PCR). After the sequence was proved to be correct, we recombined the pCDH-CMV-MCS-EF1-copGFP-PCA3. After transformation into E.coli cells, the candidate clones were identified by PCR amplifying, restricting enzyme digestion analysis and DNA sequencing, and the viral titer was determined. Results: Through the Blast analysis software, we compared the results of PCA3 sequence amplified by PCR with GeneBank sequence, ifnding that the homology is 99.8%. The lentivirus vector was constructed successfully, and the virus in the supernatant reached a titer of 2*108. Conclusion: The successful construction of the lentivirus vector encoding PCA3 not only lays the foundation for the further research into the effect of PCA3 gene on the prostate cancer but also provides a new therapy for advanced prostate cancer.

[ Objective] To observe the therapeutic effect of fetus - soothing and liver - clearing therapy for pregnancy associated with chronic hepatitis B. [Methods] Fifty cases of pregnancy associated with chronic hepatitis B were treated with fetus - soothing and liver - clearing Decoction, which is mainly composed of Semen Cuscutae, Radix Astragali, Radix Scutellariae, Herba Phyllanthus and Herba Taraxaci. After treatment, general state of gravida, indexes of hepatic function, hepatitis B virus (HBV) marker and hepatic fibrosis were detected. [Results] No miscarriage was found in the cases. Serum levels of glutamic - pyruvic transaminase, bilirubin and hyaluronic acid ( HA) were decreased obviously , the difference being significant as compared with those before treatment ( P

The global prevalence of overweight and obesity has increased dramatically over the past decades. It has been verified that overweight and obesity have been associated with heart disease and type 2 diabetes, as well as the development and prognosis of cancer (such as breast cancer, renal cancer, and endometrium cancer). Adipose tissues surrounding tumor contributes to tumor growth and prognosis through their interactions with malignant cells, secretion of associated molecules (e.g. adipocytokines, proinflammatory cytokines, proangiogenic factors and extracellular matrix constituents) and acting as an energy reservoir for cancer cells. This paper reviews the advances in mechanism of excess body weight and obesity contributing to cancer development and its impact on cancer growth and prognosis.

BACKGROUND: Degenerative lumbar spinal stenosis could be treated by laminectomy internal fixation placement,unilateral or bilateral decompression,posterior laminectomy and so on.However,whether laminectomy internal fixation placement can be used remains unclear.OBJECTIVE: To evaluate the efficacy of interbody fusion cage implantation of pedicle screw fixation,in combination with posterior lumbar laminectomy,bilateral resection and decompression of the inferior articular process,autologous facet joint bone transplantation in the treatment of degenerative lumbar spinal stenosis.METHODS: A total of 41 patients of degenerative lumbar spinal stenosis,who failed after 3 months of conservative therapy,including 23 males and 18 females,at a mean of 60.3 years,Received posterior lumbar laminectomy,bilateral inferior articular process resection and decompression,autologous facet joint bone and cage interbody fusion implant pedicle fixation.They were followed up for 24 months,preoperative and postoperative Japanese Orthopedic Association(JOA)score evaluations were performed to assess the therapeutic efficacy of the patients,radiological examination was done to investigate the graft fusion and vertebral stability of surgical segments in patients.RESULTS AND CONCLUSION: During the follow-up,JOA score significantly increased compared with the preoperative score(P＜0.01)and clinical excellence rate was 90%; 40 cases obtained bony fusion,with a fusion rate of 98%,1 patient exhibited signs of lumbar instability.There was no loosening,fracture and other complications after internal fixation,but 2 cases appeared dural tear,1 case pedicle position deviation,1 case pseudoarticulation formation.The results suggest that the posterior lumbar laminectomy,bilateral inferior articular process resection and decompression,autogenous facet joint bone and cage interbody fusion implanted pedicle screw fixation show good clinical effects for the treatment of degenerative lumbar spinal stenosis.

Purpose To investigate the clinicopathological features of multilocular cystic renal cell carcinoma ( MCRCC) , and to im-prove the understanding of this disease. Methods Thirty-two of MCRCC were studied by clinic data, pathological features and immu-nophenotype. All the thirty-two cases were followed up. Results In this study, thirty-two patients were diagnosed as MCRCC with a male-to-female ratio of 2.2 : 1, thirteen of whom had the tumor in the left kidney, eighteen in the right kidney, another in the double kidneys. The mean of tumor diameter was 4.6 cm (1.0~8.0 cm). Eleven patients underwent radical nephrectomy while the other 21 patients received nephron sparing surgery. Microscopically, all the cases were multiocular, lined in the cyst wall by a single layer of tumor cells with the clear or pale cytoplasm and Fuhrman grade 1 nuclei. Occasionally, the lining consisted of several layers of tumor cells or a few small papillae were present. The linings of the cyst wall were rich in thin-wall blood vessels. Immunohistochemically, the tumor cells were positive for CK(32/32), CK7(25/32), EMA(32/32), CD10(23/32) and vimentin(20/32), while negative for CD68. Conclusions MCRCC is characteristic by low grade nuclei, lacking solid nodules, and in the cyst wall, and has a favourable prognosis. The rich in thin-wall blood vessels and the lining cells with the clear or pale cytoplasm are diagnosis clues.

Objective To evaluate the clinical outcomes of modified eggshell technique through posterior approach for the treatment of hard thoracic disc herniation. Methods From January 2006 to June 2009, 22 patients admitted for hard thoracic disc herniation were reviewed, including 13 males and 9 females, with an average age of 49.5 years (range, 33-69). The courses of disease were 11 months on the average (range, 3-18 ). The lesions located in T8-9 for 4 cases, T9-10 for 9, T10-11 for 7, T11-12 for 2. Each of the patients underwent X-ray, CT scanning and MRI examination before surgery. There were 16 cases of central type, and 6 cases of paracentral type. All patients were treated surgically by modified eggshell technique via posterior approach. Results The mean operative time was 210 min (range, 180-300 min), with a mean blood loss of 860 ml (range, 600-1200 ml). All surgeries were performed successfully without neurological symptoms aggravation. Surgical complications included dural laceration in 2 cases, both dural lacerations were repaired intraoperatively, epidural hematoma in 1 case with lower extremity neurological symptoms, full neurologic recovery was observed after surgical removal of the hematoma. All patients were followed up for average 27.5 months (range, 12-54). The mean JOA score increased from 3.36±1.79 before operation to 7.45±2.99 after the operation at 12 months follow up, and the mean improvement rate of neurological status was 58.3%±30.7%. There was significant difference in JOA score before and after surgery(t=10. 12,P＜0.01 ).The results of 14 cases were ranked as good, 6 as fair, 2 as unchanged, and none as worsened. All cases obtained bony fusion without instrument failure. Conclusion Modified eggshell technique enable ventral and dorsal spinal decompression from the posterior approach in cases of hard thoracic disc herniation, with reduction of the rate of postoperative paralysis.

This study was aimed to establish the three-dimensional model of C_(3-7) segment of lower cervical spine after artificial disc implantation, to analyze the movement of lower cervical spine after artificial disc replacement. According to CT films of 1 patient at 6 months after artificial disc implantation, three-dimensional finite element model that included Bryan~(TM) artificial cervical disc prosthesis of the lower cervical spine was established using finite element method, then introduced into Ansys 9.0, the vertebral cortical bone, cancellous bone and intervertebral disc were meshed and analyzed by using under several states such as flexion/extension, lateral bending and rotation, thus understanding their motion characteristics. By comparison with previous research findings, test results nearly accorded with or exhibited identical trend with previous study. The results suggest that, cervical disc replacement can basically guarantee the stability of lower cervical spine movement.

Objective To evaluate the effectiveness of rehabilitative treatment after extended open-doorlaminoplasty of the cervical spine for cervical spondylotic myelopathy.Methods Sixty patients(mean age 61.7 ±12 years)who had undergone extended open-door laminoplasty of the cervical spine for cervical spondylotic myelopa-thy were studied for an average of 40.7 months.They are divided into a rehabilitation group and a control group with 30 patients in each.The patients in the rehabilitation group received systematic rehabilitation therapy pre-and post-operation.In both groups,the neurological recovery rate,the cross-sectional areas of the cervical posterior muscles,and the incidence of axial symptoms and post-operative complications were recorded and compared. Results The wounds of patients in the rehabilitation treatment group healed with no complicating infections,but the wounds of three patients in the control group became infected.There was no statistically significant difference in neurological recovery between the two groups.In the rehabilitation treatment group,the rate of atrophy and the cross-sectional areas of the cervical posterior muscles were significantly lower than in the control group.At the same time,the rate of neck axial symptoms was 23% in the rehabilitation group but 60%in the control group.a difference which was statistically significant. Conclusions Although rehabilitation treatment pre-and post-operation may not speed up neurological recovery,it may prevent postoperative atrophy of the cervical extensors and lower the incidence of neck axial symptoms.