BACKGROUND:At present, percutaneous vertebroplasty has been widely used in clinical treatment of osteoporotic vertebral fractures. Considering the limitations of the underlying disease in elderly patients (> 65 years of age) at surgery, the relevant detailed studies have gradualy attracted the attention of clinicians. OBJECTIVE:To compare and analyze the clinical effects of vertebroplasty with bone cement and conventional fracture reduction for elderly osteoporotic thoracolumbar fractures. METHODS:Totaly 24 elderly patients with osteoporotic thoracolumbar fractures were voluntarily divided into bone cement treatment and conservative treatment groups (n=12 per group) and subjected to vertebroplasty with polymethylmethacrylate bone cement and conventional reduction therapy, respectively. RESULTS AND CONCLUSION:Compared with the conservative treatment group, the visual analog scale scores, Oswesty dysfunction index and Cobb angle were significantly reduced in the bone cement treatment group, while the degree of anterior vertebral compression was increased. These results suggest that minimaly invasive spine treatment is conducive to improve the fracture healing and enhance the quality of life in elderly patients with osteoporotic vertebral compression fractures in stable conditions.

BACKGROUND: Growth factor can promote the development of collateral vessels. The synergistic effects of multiple factors are obvious. Many kinds of growth factors are enriched in bone marrow serum. OBJECTIVE: To determine effects of bone marrow serum on angiogenesis in chick chorioallantoic membranes following vascular intimal injury. METHODS: A total of 70 fertilized chick eggs were incubated at (37.5±0.5) ℃ and made a window in every egg at day 7. The survival chick embryos were randomly divided into six groups: normal saline group, normal blood serum group, normal bone marrow serum group, blood serum of rabbit suffered with vascular intimal injury group, bone marrow serum of rabbit suffered with vascular intimal injury group and vascular endothelial growth factor group (n=10), which were respectively treated with 5 μL rabbit normal blood serum, 5 μL rabbit normal bone marrow serum, 5 μL blood serum of rabbit suffered with vascular intimal injury, 5 μL bone marrow serum of rabbit suffered with vascular intimal injury, 5 μL normal saline and 0.3 μg vascular endothelial growth factor in chick chorioallantoic membranes, for 3 consecutive days. Pictures were taken by a digital camera, and the total number of the vessels around the disc was measured. RESULTS AND CONCLUSION: The total numbers of vessels in normal bone marrow serum group and blood serum of rabbit suffered with vascular intimal injury group were obviously higher than that of normal blood serum group. Large and middle vessels were obviously proliferated. Large and middle vessels were more observed in the blood serum of rabbit suffered with vascular intimal injury group. These indicated that normal bone marrow serum can stimulate angiogenesis in models of chick chorioallantoic membranes. Compared with vascular endothelial growth factor, both the normal bone serum and the bone marrow serum of rabbit suffered from vascular intimal injury were more effective in angiogenesis. The blood serum and bone marrow serum from vascular intimal injured rabbit at day 7 can significantly promote angiogenesis in chick chorioallantoic membranes, which was better than the vascular endothelial growth factor group.

Objective To evaluate the efficacy and safety of the improved percutaneous balloon mitral valvuloplasty (PBMV) in elderly patients with mitral stenosis. Methods Elderly patients with severe mitral stenosis received an improved PBMV which included a modified way of atrial septal puncture and technique across the mitral valve. The left atrial pressrue (LAP), mean pulmonary pressure (MPA), mean gradient across the mitral value (MPG) and mitral valve area (MVA) were recorded and compared before and after the operation. Long term follow up were made. Results After operation, the LAP decreased [(25.3±6.7) mm Hg vs.(16.4±5.8) mm Hg,1 mm Hg=0.133 Kpa], MPG decreased [(17.6±6.7) mm Hg vs.(6.8±2.9) mm Hg], MPA decreased [(38.6±12.1) mm Hg vs. (29.2±9.8) mm Hg], MVA increased [(1.05±0.22)cm2 vs.(1.61±0.38)cm2] and the New York heart association heart function classification improved. The follow-up result showed that the effect of PBMV was constant. Conclusions Improved PBMV may be an effective and safe measure for patients with mitral stenosis.

ObjectiveTo investigate the effects of glioma microenvironment and COX-2 inhibitor celecoxib on the phenotypes and function of dendritic cell (DC).MethodsThe expression of cyclooxygenase-2 (COX-2) and prostaglandin E2 (PGE2) production were detected in glioma C6 cells treated with different concentration of celecoxib.Monocytes were isolated from human peripheral blood and cultured with 200 ng/ml rhGM-CSF and 50 ng/ml rhIL-4,either C6 tumor cells supernatant (TSN) or TSN from C6 cells treated with celecoxib to generate DCs.Cell morphology was observed.Cell phenotype including CD1a,CD80,CD83 and D86 were analyzed on a FACScan.Production of IL-12 in DC supernatant and the potential to stmiulate allogeneic T cell proliferation were detected.ResultsThe expression of COX-2 and PGE2 production in C6 cells decreased after treated with celecoxib in a concentration dependant manner.Typical DCs were induced in all groups and the expression of CD1a ((75.56±2.40)％,(75.09±3.67)％,(76.03 ±3.43)％),CD83((72.04±3.45)％,(71.44±3.78)％,( 73.63 ± 3.31 ) ％ ) had no difference (P ＞ 0.05 ).Expression of CD80 ( ( 58.41 ± 3.85 ) ％ ),CD86 ( ( 58.22 ±3.25)％ ) in DC with TSN obviously decreased compared with normal group( (70.36 ± 2.91 )％,(69.31 ±4.29 ) ％,P ＜ 0.01 ) as well as the IL-12 production ( ( 137.88 ± 5.33 ) pg/ml,( 186.04 ± 4.76 ) pg/ml) and the potential to stmiulate allogeneic T cell proliferation ( P ＜ 0.01 ).Celecoxib increased the expression of CD80,CD86 (66.83 ± 2.51,63.51 ± 5.47,P＜ 0.01 ) in DC and the same as IL-12 production( ( 170.31 ± 3.46) pg/ml,P ＜ 0.01 ) and the potential to stmiulate allogeneic T cell proliferation ( P ＜ 0.01 ),which were lower than the normal level.ConclusionGlioma microenvironment may induce the celecoxib can inhibit the expression of COX-2 and PGE2 in gliomas cells and improve the phenotypes and function defect of DCs.

Objective: To compare the efifcacy between emergent and delayed stent implantation in patients with ST-elevation myocardial infarction (STEMI) after thrombus extraction.
Methods: A total of 82 STEMI patients who received thrombus extraction and intracoronary injection of tiroifban, sodium nitroprusside, nitroglycerin via thrombus extraction catheter and with recovered TIMI 3 lfow from 2012-11 to 2014-01 were retrospectively studied. The patients were randomized into 2 groups by SAS software: Emergent group, the patients received stent implantation immediately upon diagnosis and Delayed group, the patients were treated by anti-platelet and anticoagulant medication for 10-14 days, and then received stent implantation. n=41 in each group. The primary and secondary indicators were compared between 2 groups which including ST-segment resolution (STR), the occurrence rate of no-relfow/slow-relfow, myocardial blush grade (MBG) 3, parameters of stent, ventricular remodeling condition, the incidence of major adverse cardiac events (MACE).
Results: ①Delayed group had the post PCI STR at (68.2 ± 9.2)%, TIMI 3 grade at 97.5%, MBG 3 at 69.0%and corrected TIMI frame count (CTFC) at (19.5 ± 5.2), compared with Emergent group, P<0.05. The occurrence rate of no-relfow/slow-relfow in Delayed group and Emergent group were 2.5% and 31.0%, P<0.01. ②The parameters of stents in Delayed group and Emergent group were as the number at (1.21 ± 0.32) vs. (1.76 ± 0.76), the mean length at (28.3 ± 11.7) mm vs. (33.7 ± 12.9) mm, the mean diameter at (3.17 ± 0.76) mm vs. (2.82 ± 0.87) mm, all P<0.01. Delayed group had the higher dilating pressure than that in Emergent group, (18.5 ± 6.2) atm vs (13.6 ± 7.1) atm, P<0.01, and more patients in Delayed group receive high-pressure non-compliant balloon dilation 75% vs 23.8%, P<0.01. ③With 6 months of follow-up study, there were slightly declining trend for LVEF and LVSF in both groups than that at 1 week condition, P>0.05, while LVEDV and LVEDD increased than 1 week, P<0.05, the changes were more obvious in Emergent group, P<0.05. Delayed group had less MACE occurrence, P<0.05.
Conclusion: Delayed stent implantation in STEMI patients after thrombus extraction had reduced incidence of post PCI no-relfow/slow-relfow phenomenon, improved myocardial reperfusion and less MACE occurrence.

Objective To explore the short term efficacy and safety of percutaneous transluminal renal artery stenting in patient with renal artery stenosis.Methods From January 2003 through June 2012,fifty hypertension patients with unilateral or bilateral renal artery stenosis ≥70％ were successfully treated by percutaneous translumminal renal angioplasty with stent (PTRAS).There were 32 males and 18 females with an average age of (51.2 ± 12.3) years ranged from 21 ～78 years.The blood pressure level,dosage of anti-hypertension drugs and serum creatinine (Scr) of patients were documented and analyzed before and after stenting.All patients were clinically followed up for 6 months after stenting.Continuous variables were analyzed by using t-test for comparison among patients.Results The technical success rate was 100％.Of them,16 patients were cured,30 patients improved and 4 patients ineffective.There were significant differences in blood pressure,sCr and dosage of anti-hypertension drugs between post-stenting and prestenting [SBP (145.7 ±11.3) vs.(179.1 ±22.3) mmHg; DBP [(75.1±9.2) vs.(112.5 ±19.2)mmHg],sCr [(138.2 ±20.3) vs.(191.1 ±36.5) μmol/L] (P＜0.01) and the dosage of antihypertension drug was dramatically decreased.And there were no adverse events found during follow-up period.Conclusions The success rate of PTRAS technique was high,and the blood pressure of patients could be effectively controlled by it,being beneficial to renal function.