Surgical site infection (SSI)following spinal surgery is the most common complications, which is devastating for both the patient and the surgeon.There is strong evidence in the literature that opti-mizing specific preoperative,intraoperative,and postoperative variables can significantly lower the risk of developing an SSI.Evidence-based approach will allow surgeons to minimize the risk of SSI and,therefore, significantly improve patient care.Here,we review the current evidence.

Objective To explore the feasibility and evaluate its efficacy of transnasal marsupialization of maxillary cyst under nasal endoscope. Methods 15 cases of maxillary cyst were treated by endoscopic marsupialization in nasal. According to the situation of maxillary cysts, the fenestration of bottom nasal was opened in 6 cases, the fenestration of inferior nasal meatus was opened in 7 cases and inferior nasaI meatus was opened through the prelacrimal duct recess in 2 cases under the nasal endoscope. With partial removal of the cyst wall, the cyst and maxillary sinus was fused into a cavity if necessary. This ensured nasal drainage through the cyst cavity and nasal cavity or maxillary sinus. Results The operations of the 15 patients were success without complications. All patients were followed up for 6 to 24 months after operation. Operation cavity to complete epithelization in 2 to 3 months, the cyst cavity drained well with no recurrence. Conclusion Endoscopic marsupialization in nasal is a feasible alternative for management maxillary cyst. It makes the procedure simple, less traumatic, quick recovery, definite curative effect and low recurrence rate.

OBJECTIVE To explore the effect of E-cadherin on the proliferation ability of Hep-2 by method of RNA interference technology to silence the expression of E-cadherin. METHODS The specific siRNA sequences and non-silencing siRNA were designed and synthesized. Hep-2 cells were transfected and then the down expression of E-cadherin gene in vitro cultured Hep-2 cells were got. The silencing effect of E-cadherin gene was explored by Fluorescence Quantitative Polymerase Chain Reaction and the proliferation of the transfected Hep-2 cells were detected in vitro by MTT assay. RESULTS 1.When transfected with the ratio of recombinant plasmid and the quality of liposome volume at 1:1, the transfection efficiency at the siRNA-3 group was the highest and can be up to 65%. 2.The results of Fluorescence Quantitative Polymerase Chain Reaction: recombinant plasmid pRNAT-U6.1/Neo-siRNA1, pRNAT-U6.1/Neo-siRNA2 and pRNAT-U6.1/Neo-siRNA3 can down regulate the expression of E-cadherin mRAN. Set blank control group as a baseline (set to 1), the changes of expression of E-cadherin relative to β-actin in siRNA-1group was 0.00092, siRNA-2 group was 0.00143, siRNA-3 group was 0.00045 and the negative control group was 3.44898. The difference was statistically significant (P<0.05). 3. MTT: The growth rate of Hep-2 cells treated by specific siRNA was faster than that of the control group, and the difference was statistically significant (P<0.05). CONCLUSION Effectively inhibition the expression of E-cadherin's mRAN can enhance the proliferation of Hep-2 cells.

Objective To investigate the efficacy and safety of levofloxacin and rifapentine for elderly initial treatment pulmonary tuberculosis.Methods 120 cases of elderly initial treatment pulmonary tuberculosis patients January 2015 to January 2016 in our hospital were randomly divided into A,B,C three groups,with 40 cases in each group.Treatment regimen of group A: 2HRZE/4HR; treatment regimen of group B: 2Rft(rifapentine capsules)HZE/4HRft; treatment regimen of group C: 2Rft(rifapentine capsules)HELfx/4HRft.The clinical symptoms,signs and adverse drug reactions were compared between the three groups of patients,observation the changes of blood,urine,liver and kidney function,perform imaging and bacteriological examination to determine the treatment effect.Results Five cases in group A and one case in group B abandoned treatment because of liver damage and severe gastrointestinal reaction,but no one in the 40 cases of group C abandoned treatment.There was no statistically significant difference among three groups in sputum negative conversion rate and focus absorption.The number of cases presenting gastrointestinal reaction and liver damage in group C was significantly smaller than that in group A and group B(P<0.05).Rifampicin was replaced by levofloxacin in two cases of group A as a result of allergy,and no allergy occurred in the other two groups.Conclusion Levofloxacin and rifapentine have good efficacy and few side effects for elderly initial treatment pulmonary tuberculosis,initial treatment regimen for elderly pulmonary tuberculosis patients should be individualized,drugs with few side effects can be used to guarantee smooth proceeding of treatment.

Objective To compare the effect of thoracoscopy combined with laparoscopy Mckeown and tradi-tional three incision surgery in radical resection of esophageal carcinoma.Methods 300 patients with esophageal cancer who confirmed diagnosis by gastroscopy and pathology,were randomly divided into the observation group and the control group,150 patients in each group.The observation group was treated by thoracoscopy combined with lapa-roscopy Mckeown esophagectomy,and the control group was treated by traditional three incision surgery.The operation time,intraoperative blood loss,number of lymph node dissection,length of chest tube drainage,postoperative complica-tions,and length of postoperative hospital stay of the two groups were compared.Results There were no significant differences between the two groups in operating time[(282 ±62)min vs.(273 ±64)min,P >0.05],and number of lymph node dissection[(23.2 ±6.6)vs.(21.6 ±6.4),P >0.05],and there were significant differences in intraop-erative blood loss[(262.3 ±44.7)mL vs.(315.2 ±72.6)mL,P <0.05],length of chest tube drainage[(7.6 ± 1.6)d vs.(9.4 ±2.4)d,P <0.05],postoperative complications[16.7% vs.30.0%,P <0.05],and length of hos-pital stay[(10.5 ±2.5)d vs.(14.0 ±2.0)d,P <0.05].Conclusion Thoracoscopy combined with laparoscopy Mckeown esophagectomy can achieve the same efficacy compared with the traditional approach,and it is worth popu-larizing in clinic for reducing intraoperative blood loss,length of chest tube drainage,postoperative complications,and length of hospital stay.

Objective: To explore the mechanism of orindonin induced apoptosis on NB4 (Human acute promylocytic leukeamia cell line) cells. Methods: The variation of both morphology and inhibitory rate of NB4 cells were observed in culture medium with various concentrations of orindonin at different time in vitro. The activity of Caspase3 was detected before and after apoptosis occurred. Results: orindonin could increase the activity of Caspase3, inhibit the growth and cause apoptosis on NB4 cells significantly. The variations were both in time and dose dependent manner. Conclusion: Orindonin can inhibit the growth of NB4 cells and induce apoptosis. Increasing the activity of Caspase3 may be one of the most important mechanism.

Objective To explore the impact of hypoxia/reoxygenation stimulation on phenotype and immune activity of dendritic cells(DCs) cultured from murine bone marrow. Methods Mouse DCs were generated from bone marrow cells and were divided into control group and hypoxia/reoxygenation group. DC in control group was cultured at normal condition, and in hypoxia/reoxygenation group was cultured at hypoxic condition for 4 h followed by cultured at normal condition for 24 h. Flow cytometry and mixed lym-phocyte reaction(MLR) was used to detect the phenotype and functional properties of DCs. ELISA was used to detect the concentration of TNF-α, IFN-γ and IL-12 in the supernalant, Imrounochemistry was used to de-tect the concentration of NF-κB. Results Hypoxia/reoxygen stimulation increased the CD80, CD86, MHC Ⅱ in the cytomembrane of DCs and TNF-α, IFN-γ, IL-12 concentration in the supernalant. Hypoxia/reoxy-gen stimulation also promoted the shift of NF-κB to karyon. Conclusion Under hypoxia/reoxygen stimula-tion, DCs express high level of surface molecules, and possess strong immune activity.

BACKGROUND:Bone marrow stromal stem cel s have multilineage differentiation capacity and can differentiate into transparent chondrocytes under certain conditions, which can provide new thoughts for treatment of osteoarthritis. OBJECTIVE:To investigate the effects of Tougu Xiaotong Granule containing serum on the cartilage differentiation of bone marrow stromal stem cel s. METHODS:Bone marrow stromal stem cel s from Sprague-Dawley rat limbs were cultured in vitro, and those cel s at passage 3 were used in the study. Cel s were divided into six groups:saline serum group, Tougu Xiaotong Granule water extract group, Tougu Xiaotong Granule alcohol extract group, chondroinductive group, Tougu Xiaotong Granule water extract and chondroinductive group, Tougu Xiaotong Granule alcohol extract and chondroinductive group. The Sox9, col agen Ⅱ, and col agen X mRNA and protein expression levels were tested by real-time polymerase chain reaction and western blot analysis. RESULTS AND CONCLUSION:After cel s were intervened with drug-containing serum for 14 days, the Sox9, col agen Ⅱ, and col agen X mRNA and protein expression in Tougu Xiaotong Granule water extract group, Tougu Xiaotong Granule alcohol extract group, chondroinductive group, Tougu Xiaotong Granule water extract and chondroinductive group, Tougu Xiaotong Granule alcohol extract and chondroinductive group were significantly higher than that in saline serum group (P<0.05, P<0.01). In addition, the chondroinductive group, Tougu Xiaotong Granule water extract serum and chondroinductive group, Tougu Xiaotong Granule alcohol extract and chondroinductive group showed significantly higher expression levels than Tougu Xiaotong Granule water extract serum group, Tougu Xiaotong Granule alcohol extract group (P<0.01). Sox9 expression in Tougu Xiaotong Granule water extract serum and chondroinductive group were significantly higher than that in the chondroinductive group. Experimental findings indicate that, Tougu Xiaotong Granule containing serum can accelerate bone marrow stromal stem cel s differentiate into cartilage cel s by up-regulation of Sox9 expression.

Objective To investigate the expression of hypoxia-inducible 1 alpha(HIF-lα)and glucose transporter 1(Glut1)in human breast cancer and its relationship to proliferating cell nuclear antigen (PCNA)protein and clinical pathologic factors.Methods Immunohistochemical staining was used to measure the expression of HIF-lα.Glut1 and PCNA in human breast fibroadenoma,usual hyperplasia and breast carcinoma.Results HIF-1α expression was not found in breast fibroadenoma and hyperplastic Iesions.In contrast.the positive rate of HIF-1α was found in the ductal carcinoma in situ 55%(DCIS,11/20)and the invasive breast carcinoma 85%(51/60).Glut1 positivity in breast carcinoma was 58.8%(47/80).The totsl positive rate of PCNA in breast carcinoma was 75%(60/80),that in DCIS was 65%(13/20)and that in invasive carcinoma was 78.3%(47/60).There was a positive correlation between HIF-lα and Glut 1 level (r=0.653,P＜0.01),a positive correlation between HIF-1α and PCNA level(r=0.693,P＜0.01);and also a positive correlation between Glutl and PCNA level(t=0.742.P＜0.01).conclusion The overexpression of HIF-lα and its target gene Glut1 played important roles in carcinogenesis and progression of breast carcinoma and closely correlated with cell proliferation of breast carcinoma and may become a new target for treatment of breast carcinoma.

Objective To evaluate the clinical efficacy of pingyangmycin (PYM) injection on infantile hemangioma located in the parotid gland region. Methods Twelve patients were treated by intralesional injection of PYM. When necessary, the injections were repeated at an interval of one week, but not more than 3-4 sessions within a therapeutic period. Normally, the secondary therapeutic period was performed 1 month later. The general and local adverse responses were recorded and the clinical outcomes were assessed with a follow-up of 1 to 3 years. Results Complete clinical resolutions were achieved in 10 patients. 2 patients received one injection, 3 patients received 2 injections, 3 patients received 3 injections, and 2 patients received 4 injections. The remaining 2 patients with partial resolution received 6 and 7 injections respectively. No clinical recurrence was observed during the follow-up of 1 to 3 years. No ulcerations or postoperative sears in injection regions were presented. The function of facial nerve was remained normality in all patients. The systematic side effects included transient pyrexia and poor appetite appeared in partial patients. No allergy cases were found. Conclusion Treatment of infantile hemangioma located in parotid gland region with PYM injection reveals a high rate of complete clinical resolution, with fair cosmetic results and short treatment time, and it does not damage the facial nerve or form local scar.The treatment time of PYM injection seems to be positively related to size of the lesions.