[Objective]To introduce the composion and mechanism of Iliac Bars Lever Reduction and Fixation System(IBRFS),and to evaluate the clinical efficacy of IBRFS.[Method]IBRFS was made of stainless steel composing of pedicle screw,anglar lift,reduction rod,iliac bar and screw nut A,B,C.Eighteen volunteers offered their contribution for this study.There were 6 males and 12 females with mean age of 53 years(range from 43-66 years).The classification was DS 9,IS 8,trauma 1.The slip segments were L4 6,L5 12.The reductive operation was conducted by IBRFS.Clinical efficiency was evaluated by slip ratio,slip angle,sacral slope and the height of intervertebral space.[Result]Eighteen patients were followed up from 8 to 28 months(average 14.9 months).Preoperative JOA scores ranged from-1 to 22(mean 10.7).Postoperative JOA scores ranged from 13 to 29(mean26.9).The overall recovery rate ranged from 42.9% to 98%(mean 88.3%).There was no neurologic complication.Slip ratio was improved from 20.80% to 5.01%,slip angle from 6.67?to 12? and sacral slope from 32.2? to 43.3?.The height ratio of intervertebral space was increased from 0.78 to 0.97.[Conclusion]The reduction efficiency of IBRFS is reliable.The restoration of height of intervertebral space is improved.IBRFS is an effective internal fixation.

Objective:To observe the dynamic change of cystathionine β-synthase during cerebral ischemia-reperfusion and its effect in rats.Methods:The ischemic model was established with line embolism to block the middle cerebral artery .The reverse tran-scription-polymerase chain reaction ( RT-PCR) and Western blot assay were used to assess the expression of cystathionine β-synthase (CBS) in SHAM group,I group,and IR group.ELISA assay was performed to detected the homocysteine (HCY) level in plasma.After treating with the inhibitor of cystathionine β-synthase called hydroxyla mine(HA),the expression of hemeoxygenase 1(HO-1) and the pathologic change of the brain was evaluated .Results:As compared to sham group ,the expression of CBS was significantly up-regulated in ischemia-reperfusion group at 12 h post-reperfusion.Meanwhile,it existed the lowest level of HCY at 12 h post-reperfusion,comparing to sham grouzp ( 5.73 ±1.17 vs 2.88 ±0.93 , F=25.56 , P=0.001 ) .When inhibited the activity of CBS via using HA , the down-regulation of HO-1 protein and further damage in neuron were observed .Conclusion:Cystathionine β-synthase serves as an protective factor during cerebral ischemia-reperfusion.

OBJECTIVE:To investigate the effects of different processed products of Paeonia lactifloria in Shaoyao gancao tang on the content of paeoniflorin in their use.METHODS:The content of paeoniflorin in Shaoyao gancao tang was determined by HPLC in which SHIMA-DCIS ODS C18 was used as chromatographic column with acetonitrile-0.1% phosphoric acid water solution(15∶85) used as a mobile phase at a flow rate of 1.0 mL?min-1.The detective wavelength was set at 230 nm.RESULTS:In Shaoyao gancao tang,the content of paeoniflorin in Radix Paeoniae Rubra was the highest,followed in descending order by Radix Paeoniae Alba Prepara cum Vini,Radix Paeoniae Alba Prepara Flava,Radix Paeoniae Alba sine Cortice and Radix Paeoniae Alba. CONCLUSION:The difference in the content of paeoniflorin appeared when Radix Paeoniae Rubra,Radix Paeoniae Alba Prepara cum Vini and Radix Paeoniae Alba respectively used in combination with Shaoyao gancao tang suggest that Radix Paeoniae Rubra,Radix Paeoniae Alba and its processed products should be used differently based on different syndrome in clinical use of Shaoyao gancao tang.

BACKGROUND:The risk of lower extremity deep venous thrombosis was high in patients with bone metastases. Major surgery is a major risk factor for thrombosis. There was no standard prophylactic regimen available.
OBJECTIVE:To investigate the efficacy and safety of low molecular weight heparins versus rivaroxaban in the postoperative prevention of lower extremity deep venous thrombosis in patients with bone metastases.
METHODS:From January 2010 to December 2013, a total of 73 patients with bone metastasis in spine, pelvis and lower extremities, who underwent open surgery in the Department of Musculoskeletal Tumor, Third Hospital, Hebei Medical University, China, were retrospectively analyzed. The patients were divided into low molecular weight heparins group (n=41) and rivaroxaban group (n=32) according to the prophylactic drugs after surgery.
RESULTS AND CONCLUSION:Nine cases (22%) in the low molecular weight heparins group were found lower extremity deep venous thrombosis, and six cases (19%) in the rivaroxaban group suffered from lower extremity deep venous thrombosis, showing no significant differences (χ2=0.11, P=0.74). The incidences of bleeding events in both groups were respectively 7.32%and 6.25%, showing no significant differences (correctionχ2=0.083, P>0.05). There were no significant differences regarding the levels of platelet, activated partial thromboplastin time and prothrombin time between both groups preoperatively or postoperatively (P>0.05). Therefore, the efficacy and safety of low molecular weight heparins and rivaroxaban in the postoperative prevention of lower extremity deep venous thrombosis were similar. Both could effectively reduce the incidence of deep venous thrombosis, with a relative low risk of bleeding.

In the process of designing genechip probe for detecting pathogenic microorganism, the selection of single nucleotide polymorphism (SNP) combination is of great importance. At present, there is no automatic design method. This work is hard and the result is not always well. A new approach for selecting SNP combination is presented in this paper. Genetic algorithm is used to search optimal solution on the basis of classification ability of SNP combination, which is evaluated by the rough set theory. Other related experimental parameters are also incorporated. Experimental results show that the method can find out the best SNP combination pattern efficiently and accurately, thus demonstrating the reliability of this new method for designing the genechip probe.
Algorithms ; Base Sequence ; Brucella ; isolation & purification ; Humans ; Molecular Sequence Data ; Oligonucleotide Array Sequence Analysis ; methods ; Polymorphism, Single Nucleotide ; Salmonella enterica ; isolation & purification

Objective To retrospectively analyze clinical features,treatment methods and efficacy of giant cell tumor of bone in proximal tibia,and to investigate risk factors affecting tumor recurrence and functional outcomes.Methods A total of 250 patients with giant cell tumor of bone in proximal tibia confirmed by pathology,who had undergone surgical treatment from March 2000 to July 2014,were enrolled in this study.There were 132 males and 118 females,with an average age of (34.59±12.86) years.A total of 140 patients who were followed up for more than 3 years were included in this study,and there were 72 males and 68 females,with an average age of (34.46± 11.96) years.There were 11 cases of Campanacci grade Ⅰ,58 cases of grade Ⅱ,71 cases of grade Ⅲ and pathological fracture of 47 cases.According to surgical methods,they were divided into bone grafting group (49 cases),bone cement filling group (34 cases),prosthesis group (46 cases) and others group (11 cases).The epidemiology,clinical and radiographic features and risk factors affecting tumor recurrence and functional outcomes were analyzed.Results A total of 140 patients were followed up,the follow-up period was 36-324 months,with an average of 95.4 months,and the median follow-up time was 88 months.Recurrence was found in 26 cases,and recurrence rate was 18.57％,with an average recurrence interval of 25.85 months.Recurrence was found in 17 cases in the first 2 years.The 5-year free survival rate was 77.60％.The recurrence rates were 18.37％ in bone grafting group,20.59％ in bone cement filling group,15.22％ in prosthesis group and 27.27％ in the others group,no statistically difference was found on recurrence rate and free survival rate (P=0.805,P=0.558).Recurrence was not related to all kinds of factors.A variety of related factors affecting postoperative recurrence were analyzed,sex,the first diagnosis of the original recurrence,left and right side,whether the eccentricity,fracture,cortical bone destruction,soft tissue mass,surgical methods,high-speed grinding,auxiliary application,and there was no significant correlation between recurrence and these factors.The MSTS 93 score was 25.26±4.31.Function of the primary patients was better than that of recurrence (P=0.044).Function of the patients treated with curettage with or without internal fixation was better than that with segmental resection (P=0.011).Function of the patients treated with grafting or bone cement filling was better than that with prosthesis or allograft-prosthesis reconstruction (P=0.004).There were no significant correlation between MSTS function score and gender,left and right side,whether the eccentricity,whether fractures,cortical bone destruction (Campanacci grade),whether there is soft tissue mass,whether the use of assisted inactivation,whether the use of grinding or internal fixation.Conclusion Various surgical methods had no significant effect on the recurrence of proximal tibial GCT,as for GCT in proximal tibia,there is no relation between recucrrence and related factors.Whether primary tumor and surgical methods are two important factors affecting limb function.

Objective To investigate the factors related to the local recurrence of spine giant cell tumor (GCT) after surgical treatment and provide a reference for the treatment.Methods A retrospective analysis of GCT of the spine from January 2000 to June 2016 was conducted.A total of 73 patients with GCT of the spine who underwent surgical treatment in Giant Cell Tumor Team of China (GTOC) were collected,including 29 males and 44 females.The average age was 33.73±11.34 years (range:13-60 years).Clinical characteristics including gender,age,history of recurrence,tumor position,Ennecking stage,Frankel score,clinical symptoms,surgery procedures,surgical approach,preoperative selective artery embolism (PAE),radiotherapy and bisphosphonate treatment history are collected.The correlation between the factors and tumor recurrence were analyzed by single factor analysis and multiple-factor logistic regression.Results The mean follow-up time was 61.81 ±53.21 months (range:4-210 months).Surgical procedures,bisphosphonate treatment,history of recurrence and radiotherapy were found significant correlation with tumor recurrence by single factor analysis.The result of multiple-factor logistic regression showed that surgical procedures (P=0.026) and bisphosphonate treatment (P=0.017) were independent risk factors for tumor recurrence.Conclusion Total spondylectomy and bisphosphonate treatment could significantly reduce the recurrence rate of GCT of the spine.

Objective To retrospective analysis the onset characteristics and outcome of surgical management in patients with giant cell tumor (GCT) of distal tibia,explore the operation indication and the risk factors for recurrence and limb function.Methods From October 2000 to June 2014,Fifteen patients with GCT in the distal tibia from domestic three bone tumor centers were involved in this study.They included 8 males and 7 females,with an average age of 35.9± 10.4 years.There were 11 cases of Campanacci Ⅱ and 4 cases of Campanacci Ⅲ.Two cases of Campanacci Ⅱ occurred pathologic fracture.Expanded curettage surgery was performed in 11 cases and tumor resection with revascularization was performed in 4 cases.Factors influencing the choice of surgery,recurrence and limb function were analyzed.These included tumor size,ankle condition,Campanacci grade,pathological fracture.Results A1l patients were followed up with a mean duration of 62.3±25.2 months,ranging from 26 to 60 months.One of 11 patients treated with extended curettage underwent local recurrence.One of 4 patients treated with marginal excision underwent local recurrence.The effect of Campanacci classification and pathological fracture on selection of operation scheme was analyzed.The effects of pathological fractures,Campanacci classification,surgical methods and postoperative functional score (MSTS score) on postoperative recurrence rate were analyzed.Single factor analysis showed that the pathological fractures did not affect the selection of GCT surgical treatment plan (P=1.000).Campanacci classification affected the selection of GCT surgical treatment plan (P=0.001).Pathological fractures,Campanacci classification and surgical methods were not related to the local recurrence rate (P ＞ 0.05).Expanded curettage of Campanacci grade Ⅱ patients with better postoperative MSTS score than tumor segment resected Campanacci grade Ⅲ patients (t=3.385,P=0.005).There was no significant relationship between pathological fracture and postoperative MSTS score.Conclusion Distal tibia GCT Campanacci classification and whether combined with pathological fracture or not affects the choice of surgical procedure and postoperative functional recovery.

Objective:To evaluate the clinical value of the New England spinal metastasis score (NESMS) in predicting the prognosis of patients with spinal metastases by retrospectively analyzing the medical records of multicenter spinal metastases in China.Methods:The data of 179 patients with spinal metastases from January 2008 to December 2018 were retrospectively collected. There were 108 males (60.3%) and 71 females (39.7%) with an average age of 59.79±10.88 years old (range 27-84 years). The patient demographic characteristics, primary tumor type, spinal metastases and segments, vertebral pathological fractures, neurological Frankel classification, physical function status, Karnofsky performance scale (KPS), visual analogue score (VAS), the spinal instability neoplastic score (SINS), modified Bauer score, NESMS score, Tomita score and modified Tokuhashi score were collected. The clinical value of NESMS score, Tomita score and modified Tokuhashi score in predicting the survival of patients with spinal metastases were compared. The independent factors affecting survival in these patients were analyzed by Cox proportional hazards regression model.Results:Among the 179 patients, the peak incidence of spinal metastases was in the age group of 61-75 years (45.3%, 81/179) of all patients. Lung cancer was the most common primary tumor (46.9%, 84/179). 40.8% (73/179) of patients had multi-segment metastasisand thoracic spine was the most common site with single-site metastasis (26.3%, 47/179). 28.5% (51/179) of the patients had visceral metastases and 52.0% (93/179) of the patients had extraspinal bone metastases. 31.3% (56/179) of the patients had pathological fractures of the involved vertebral bodies.114 patients received surgical treatment (63.4%). The mortality rates in 3-months, 6-months and 1-year were 22.4% (40/179), 51.4% (92/179) and 77.1% (138/179), respectively. The median survival time of patients with NESMS score of 0-3 was 3, 4, 8, and 10 months respectively with the mean survival time was 3.60±2.10, 6.77±3.39, 9.69±5.71 and 10.53±6.25 months. The 1-year mortality rates were 100% (13/13), 87.5% (42/48), 71.6% (63/88) and 66.7% (20/30) respectively. The consistency of NESMS score, Tomita score and modified Tokuhashi score in predicting survival of all patients was 0.63, 0.58 and 0.55, respectively. For patients with spinal metastases, the NESMS score was better than the Tomita score and modified Tokuhashi score in predicting survival at 3-months (AUC=1.00, 0.63, 0.42) and 6-months (AUC=0.71, 0.63, 0.45). But the accuracy of Tomita score was best in predicting survival at 1-year (AUC=0.66, 0.61, 0.38). Multivariate Cox proportional hazards regression model analysis showed that growth rate of primary tumor, neurological function Frankel score, albumin level and surgical treatment were independent factors affecting the survival time of patients with spinal metastases ( P<0.05). Conclusion:The consistency and accuracy of NESMS score in predicting survival of patients with spinal metastases are better than Tomita score and modified Tokuhashi score, especially in predicting 3- and 6-month survival. The growth rate of primary tumor, Frankel classification, albumin level and surgical treatment were independent factors affecting the survival time of patients with spinal metastases.

Objective:To retrospectively analyze the patients with spinal metastases who received surgical intervention and summarize the evolution of their clinical and pathological characteristics and surgical methods.Methods:The data of 703 patients with spinal metastases from January 2007 to December 2018 were collected retrospectively. There were 395 males (56.19%, 395/703) and 308 females (43.81%, 308/703) with an average age of 58.14±11.46 years (range 13-84 years). According to the degree of invasion and thoroughness of tumor resection, the surgical methods could be divided into minimally invasive surgery, decompression surgery, separation surgery, piecemeal resection and total en-bloc spondylectomy surgery. The operative methods were minimally invasive surgery in 89 cases (12.66%), decompression surgery in 96 cases (13.66%), separation surgery in 303 cases (43.10%), piecemeal resection in 182 cases (25.89%) and total en-bloc spondylectomy in 33 cases (4.69%). To analyze the trend of the clinical, pathological types and surgical treatment of patients with spinal metastases over the years, and determine the relevant factors affecting the decision-making of surgical methods by multivariate logistic regression.Results:The ratio of male to female was 1.28:1. 39.54% (278/703) of patients with single-segment involvement in 703 patients, 24.04% (169/703) of patients with double-segment metastasis and 36.42% (256/703) of patients with multi-segment metastasis. The most common type of primary tumor was lung cancer (34.57%, 243/703), followed by breast cancer (8.25%, 58/703), myeloma (8.11%, 57/703), gastrointestinal tumor (6.82%, 48/703) and renal malignant tumor (6.40%, 45/703). From 2007 to 2018, there was no significant difference in the percentage change of different age, gender and primary tumor source composition (age: χ 2=14.01, P=0.233; gender: χ 2=35.73, P=0.341; primary tumor: χ 2=120.09, P=0.074). The percentage of patients with sacrococcygeal metastasis decreased from 20.00% in 2008 to 1.89% in 2017 and the difference was statistically significant (χ 2=8.09, P=0.005). The percentage of patients with multi-level metastasis increased from 26.67% in 2008 to 52.83% in 2017, and the difference was statistically significant (χ 2=7.23, P=0.007). The percentage of patients with minimally invasive surgery decreased from 25.00% in 2007 to 5.88% in 2018, and the percentage of patients with segmented resection decreased from 53.33% in 2008 to 10.29% in 2018. The proportion of the two surgical methods showed a significant downward trend, and the differences were statistically significant (minimally invasive surgery: χ 2=1.46, P=0.026; segmented resection surgery: χ 2=19.56, P<0.001). The percentage of patients undergoing separation surgery increased from 13.33% in 2008 to 64.71% in 2018, and the proportion of patients undergoing total en-bloc spondylectomy increased from 0 in 2007 to 10.29% in 2018. Both surgical methods showed a significant growth trend and the differences were statistically significant (separation surgery: χ 2=27.09, P<0.001; χ 2=4.16, P=0.042). Multivariate Logistic regression analysis showed that age, metastatic site, number of metastatic segments, pathological vertebral fractures, Frankel grade, SINS score and VAS score were independent factors influencing surgical decision-making ( P<0.05). Conclusion:With different time and age, the invasiveness and thoroughness of surgery are increasing, which shows that the percentage of patients who underwent separation surgery and to-tal en-bloc spondylectomy is significantly increasing. Age, metastatic site, number of metastatic segments, pathological vertebral fractures, Frankel grade, SINS score and VAS score are independent factors affecting surgical decision-making.