[Objective]To assess the clinical outcome of the clinical application of TSRH hook screw fixation after direct repair of lumbar spondylolysis in young patients.[Method]From 2002.7～2003.10,12 young male patients suffered from lumbarspondylolysis were selected to be treated with TSRH hook screw fixation after direct repair of the defect.MacNab criteria was used to assess their pre-and postoperative status.Postoperatively,radiographic finding and clinical results were observed.[Result]All patients were followed-up after surgery,ranging from 6 months to 19 months.Radiographs showed all patients having bilateral union;a11 patients with low back pain or radicular pain experienced significantly relieved.Neither complications nor instrumentation failure were observed.[Conclusion]This technique proves to be well-designed and easy to handle,and is considered useful and recommended for direct repair of the defects found in lumbar spondylolysis in young patients.

Autologous stem cell transplantation (ASCT) is the standard frontline therapy for newly diagnosed multiple myeloma (MM) in patients younger than 65 years in the era of conventional chemotherapy. The use of novel drug-based chemotherapy in the in-duction, consolidation, and maintenance phases of chemotherapy has significantly improved the response rates of patients. Thus, wheth-er or not ASCT is still necessary in the era of new drugs has become controversial. Currently available data supported that ASCT should be the frontline therapy for qualified newly diagnosed MM patients and that new drugs may be applied before and after ASCT to further improve the response rate and prolong the progression-free survival of patients. Further prospective clinical trials should be conducted to clarify the role of ASCT in MM and optimize the treatment strategies involving ASCT in the era of new drugsto cure myeiona.

Purpose To investigate the expression of TAZ and β-catenin in colorectal carcinoma and to analyze their correlation with the clinical pathological features of colorectal carcinoma. Methods The immunohistochemical method was used to detect the expres-sion of TAZ and β-catenin in 168 colorectal carcinoma specimens and 30 normal colorectal mucosal specimens. Results The positive rate of TAZ expression was significantly higher in colorectal carcinoma than that in normal colorectal mucosal (P<0. 01). The ectopic expression ofβ-catenin was significantly higher in colorectal carcinoma than that in normal colorectal mucosa (P<0. 01). The expres-sion of TAZ was correlated with degree of differentiation, lymph node metastasis, invasion depth and TNM stages (P<0. 05), and that of β-catenin was correlated with lymph node metastasis, invasion depth and TNM stages (P<0. 05). The positive expression of TAZ and the ectopic expression of β-catenin were significantly related to the 5-years survival rate ( P<0. 05 ) . The expression of TAZ was significantly positively correlated with the ectopic expression of β-catenin ( P<0. 01 ) . Conclusion Up-regulated expression of TAZ and ectopic expression of β-catenin may be synergistically involved in the occurrence, invasion and metastasis of colorectal carcinoma.

According to the latest classification of International Myeloma Working Group(IMWG),multiple myeloma(MM)is roughly classified into two groups,asymptomatic myeloma(smoldering myeloma)and symptomatic myeloma.The former is equal to the stage Ⅰ of Durie-Salmon(DS),and patients of this type only wait and see,and do not need any therapy.The later is equal to stage Ⅱ and Ⅲ of DS,and patients of this type need therapy immediately.Autologous stem cell transplantation(ASCT)is recommended by National Comprehensive Cancer Network(NCCN)for patients with stage Ⅱ or Ⅲ myeloma with good performance status in 2007.Different therapeutic regiwen should he selected for newly diagnosed MM patients according to whether ASCT is suitable or not.

Humans ; Soft Tissue Neoplasms ; diagnosis

Objective To analyze the causes of misdiagnesis and mistreatment of traumatic abdominal hernia. Methods In this study,11 cases of traumatic abdominal hernia admitted during 1971 to 2004 were retrospectively analyzed.Hernia located subcutaneously in 8 cases including incarcerated hernia in 2 csses.Hernia located intermuscularly in 2 cases with one case being incarcerated.and the other strangulated.One located retroperitoneally.Among the 11 cases,3 were simple hernia,8 were complicated with injuries of other organs. Results Eight cases were misdiagnosed,5 were operated on with wrong incision,and in one case the herniated intestinal loop,mistaken as hematoma,was incised.All these 5 cases underwent a second surgery due to failure in repairing the hernia. Condusion For traumatic abdominal wall hernia,correct diagnosis,the correct timing of operation and an appropriate incision chosen insure good therapeutic results.

Objective This prospective study was performed to evaluate the role of oral glucose toler-ance test(OGTF) in evaluating the preoperative status and postoperative complications of patients with hepa-tocellular carcinoma. Methods One hundred and twenty-eight patients with primary hepatic carcinoma (PHC) were divided into 3 groups according to the resection, in which the resection of no more than 1 seg-ment called group A, the resection of 1-2 segments called group B, the resection of more than 2 segments called group C. OGTT, routine liver function tests and Child-Pugh classification were performed in these pa-tients preoperatively. The postoperative complications were also recorded. Results Blood glucose lever of 60 min and 120 min after glucose loading test in Child B (11.23 mmol/L ± 2. 78 mmol/L, 11.79 mmol/L± 3.48 mmol/L) were significantly higher than that in Child A (8.56 mmol/L±2. 36 mmol/L, 6. 78 mmol/L ±1.60 mmol/L,P <0.01) ,but the blood glucose lever of 0 min and 30 min showed no difference. The rate of diagonis of DM in Child B was 28. 30% ,which was higher than Child A(13.33% ,P =0. 035). The OG-TT results for the L-shaped curve showed that postoperative complications were significantly higher than that of type I and P in group A and B. I-shaped and L-shaped were found ascites in group C. The cases with jaun-dice all showed L-shaped curve. When the patients' OGTT curve was P -shaped, the ascites production rate was no significantly different in these three groups. With the increase of the removal in liver, ascites produc-tion rate increased evidently in I-type and L-type(P < 0. 05). Conclusions OGTT is worthwhile to assess hepatic function reserve and postoperative complications for patients with PHC. Combination of OGTT and Child-Pugh classification has higher predictive value on hepatic function reserve.

Automobile Driving ; psychology ; Burnout, Professional ; prevention & control ; Emotions ; Humans ; Railroads

OBJECTIVETo investigate the effect of 8-aminolevulinic acid (ALA) photodynamic therapy (PDT) on the cell proliferation, apoptosis and collagen secretion in keloid fibroblasts and to provide the theoretical base for ALA-PDT treatment of keloids.

METHODSFibroblasts from keloid patients were cultured to the third generation in vitro and incubated in 0, 1, 3, 6, 9 mmol/L of δ-aminolevulinic acid for 3 h in the darkness. Then they were exposed to 635 nm wavelength red light ( 30 J/cm2 ) and continued incubation 24 h after irradiation. CCK-8 assay was used to detect proliferation inhibition rate of fibroblasts. The content of hydroxyproline was measured by colorimetric method. The expression of p-Akt and programmed cell death 4 ( PDCD4) were detected by Western blot.

RESULTSThe inhibition rate of keloid fibroblasts were respectively 0, (8.30 ± 1.01)%, (29.48 ± 3.27)%, (52.01 ± 5.34)%, (79.99 ± 5.85)% with the presence of difference concentrations (0, 1, 3, 6, 9 mmol/L) of ALA. The content of hydroxyproline were respectively (9.540 0 ± 0.352 42), (6.242 5 ± 0.224 85 ), (5.107 5 ± 0.534 88), (3.490 0 ± 0.623 48), (2.945 0 ± 0.514 10) μg/mg. The relative expression of p-Akt were respectively 1, 0.75 ± 0.12, 0.52 ± 0.14, 0.41 ± 0.18, 0.32 ± 0.09. The relative expression of PDCD4 were respectively 1, 1.18 ± 0.19, 1.51 ± 0.22, 0.15 ± 0.30, 2.44 ± 0.22. The difference was statistically significant when compared the group of 1, 3, 6, 9 mmol/L with 0 mmol/L (P < 0.05).

CONCLUSIONSIn concentration within the range of 1-9 mmol/L, ALA could inhibit the proliferation of fibroblasts significantly, promote fibroblasts apoptosis and reduce the content of hydroxyproline in a dose-dependent manner, indicating that 8-aminolevulinic acid photodynamic therapy may be a potential treatment for keloid.

Aminolevulinic Acid ; pharmacology ; Apoptosis ; drug effects ; Cell Culture Techniques ; Cell Proliferation ; drug effects ; Collagen ; secretion ; Fibroblasts ; cytology ; drug effects ; secretion ; Humans ; Keloid ; drug therapy ; pathology ; Light ; Photochemotherapy ; methods ; Photosensitizing Agents ; pharmacology

Fatty Liver ; Humans