[Objective]To investigate the metaphase result of extensive fusion in treatment of spondylolisthesis combined with intervertebral disc degeneration of adjacent joints.[Methods]Seventy-nine cases of lumbar spondylolisthesis combined with intervertebral disc degeneration of adjacent joints were treated with extensive fusion and internal fixation from September 2002 to September 2007.JOA and VAS scores were assessed and compared pre-and post-operatively.X-ray and CT were performed to observe the stabilization of fusion joints,and satisfaction rate from patients was investigated.[Results]All patients were followed up for 2 to 6.5 years(mean,4.6 years).Post-operative JOA scores increased(P

Objective To observe the effects of Jiuxieling granules on rats with ulcerative colitis and explore its mechanism.Methods Ulcerative colitis models were established by immune method combined with local stimulation of 5% acetic acid.Wistar rats were randomly divided into control,model,positive control and low,middle,high dose Jiuxieling granules group.Rats in positive control group were treated with sulfasalazine,and those in three treatment groups were treated with low,middle and high dosage of Jiuxieling granules respectively for 14 days continuously.24 hours after last administration,the rats were killed to obtain colon mucous membrane to test GSH-Px,SOD,MDA,NO,tNOS and iNOS concentration of the homogenate of colon mucous membrane.Results Jiuxieling granules could markedly improve the levels of GSH-Px and SOD activity,whereas decrease the levels of MDA,NO,TNOS and iNOS.Conclusion Jiuxieling granules exert its marked curative effects on rats of ulcerative colonitis by resisting oxygen free radical lesion,inhibiting the generation of NO and NOS,and enhancing the activity of antioxidase.

Type 2 diabetes mellitus is a metabolic disorder characterized by hyperglycemia caused by multifactors.The incidence of type 2 diabetes is gradually increased.Its prevention and treatment are paid more and more attention.Intestinal flora is one of the hot spots in recent years.A large number of studies have shown that intestinal flora is closely related to the occurrence and treatment of type 2 diabetes mellitus.Intestinal flora is expected to be a new direction for the improvement and treatment of type 2 diabetes mellitus.In this paper,the relationship between type 2 diabetes and intestinal microflora in recent years,pathogenesis and treatment were summarized.

Objective To investigate the surgical technique and clinical effectiveness of retroperitoneal laparoscopic nephroureterectomy with transurethral bladder-cuff excision and open nephroureterectomy in pelvis carcinoma. Methods We retrospectively analysed the records of all 62 patients who underwent retroperitoneal laparoscopic or open nephroureterectomy in Tianjin Dagang Hospital or the Second Affiliated Hospital of Tianjin Medical University from July 2001 to July 2009. Variables analyse were compared including operative time, blood loss, turning to open operation, complications, length of stay, tumor recurrence and metastasis. Groups were compared using Student's t-test, and a probability (P) value of less than 0.05 was taken to indicate statistical significance. Results The respective mean operative duration [(47.34±39.16) vs (118.17±44.65) ml], length of hospital stay [(9.15±2.19) vs (11.64±3.71) d], time to ambulation [(3.58±0.79) vs (5.67±1.24) d]and blood loss [(70.64±27.33) vs (118.17±44.65) ml]in retroperitoneal laparoscopic nephroureterectomy with transurethral bladder-cuff excision group was significantly reduce to open nephroureterectomy group (t = 3.3167, 2.0587, 8.0494, 5.1777, P ＜0.05). There was no significantly difference between two groups in complication of during operation and post operation [4.8 % (2/42) vs 5.0 %(1/20), 0 vs 0, respectively](P ＞0.05). 4 cases were failed and conversed to open surgery in retroperitoneal laparoscopic nephroureterectomy group. During the follow up period range from 8-48 months, there was no significantly difference between two groups in tumor recurrence and metastasis [4.8 % (2/42) vs 5.0 % (1/20),2.4 % (1/42) vs 5.0 % (1/20), respectively](P ＞0.05). Conclusion Retroperitoneal laparoscopy in upper urinary tract transitional carcinoma uses a small incision, incurs less blood loss, and allows for a more rapid recovery, suggesting it is a safe and effective method for treating patients with renal and pelvis cancer.

Objective:To research the relationship of urinary cytology positive rate with the grade and stage of primary ureter uroepithelium cancer.Methods:A total of 104 cases of primary ureter uroepithelium cancer were recruited in this study.The urine of all paitents was collected for preoperative urinary cytology de-tection.The urinary cytology detection rates were compared among different grades and stages of primary ureter uroepithelium cancer.Results:The overall unnary cytology positive rate of primary ureter uroepithelium cancer was 34.26%.The overall urinary cytology positive rate was 43.59%in the advanced stage group and 11.54%in the low stage group,with a significant difference(X2=8.740, P=0.003).The difference in positive rate between the advanced stage group and the low stage group in the high grade with inferior segment group of primary ureter uroepithelium cancer was statistically significant(X2=10.628,P=0.001).The difference in positive rate between the advanced stage group and the low stage group in the high grade group of primary ureter uroepithelium cancer was statistically significant(X2=5.678,P=0.01 7).The difference in positive rate be-tween the high grade group and the low grade group in low stage group of primary ureter uroepithelium can-cer was statistically significant(X2=12.860,P=0.001).Conclusion:The unnary cytology positive rate of primary ureter uroepithelium cancer of high grade and low stage is higher.

Background Dry eye is the most common ocular surface disease.Anterior segment pattern of optical coherent tomography (OCT) is able to be used to assess the tear meniscus directly and accurately.Objective This study was to evaluate the correlation between measuring outcomes of tear meniscus by anterior segment module of OCT with signs and symptoms of dry eye.Methods A retrospective serial cases-observational study was designed.Thirty-six patients who completed Ocular Surface Disease Index (OSDI) and got a score more than 20 were enrolled in the First Hospital of Peking University from September to October,2010 under the informed consent.The upper and lower tear meniscus height (U/LTMH,μm),depth (U/LTMD,μm) and cross sectional area (U/LMA,mm2) were measured with the anterior segment module of OCT (RTVue.pitch).A series of clinical tests were performed,including tear film interferometry,break-up time (BUT),fluorescein corneal staining,lissamine green conjunctival staining and Schirmer Ⅰ test (S Ⅰ t).The correlations of measuring outcomes of tear meniscus by anterior segment module of OCT with dry eye-related examinations were analyzed with Spearman correlation coefficients.Results The values of UTMH,UTMD,UMA were (232±56) μm,(156±53) μm,(0.021 ±0.008) mm2,respectively,and the values of LTMH,LTMD,LMA were (222 ± 72) μm,(163 ± 65) μm,(0.020 ± 0.006) mm2,respectively.No significant differences were found in the measuring values between the upper and the lower tear meniscus (all at P＞0.05).The quantitative values of tear meniscus were not significantly correlated with the OSDI scores or tear film interferometry grade.Significant correlations were seen between UTMH,UTMD,UMA and BUT (r=0.46,P=0.01 ;r=0.40,P=0.02;r=0.43,P=0.01).LTMH,LTMD,LMA were positively correlated with BUT (r=0.61,P=0.00;r=0.64,P=0.00;r=0.64,P=0.00) and S Ⅰ t (r=0.54,P=0.02 ;r=0.46,P=0.01;r=0.55,P=0.01) as well as negatively correlated with fluorescein cornealstaining (r=-0.37,P=0.04;r=-0.37,P=0.04;r=-0.41,P =0.05) and lissamine green conjunctival staining (r =-0.56,P =0.01 ; r =-0.37,P =0.04 ; r =-0.47,P =0.00).Conclusions Anterior segment module of OCT is an effective approach to the measurement of tear meniscus.The measuring outcomes of anterior segment of OCT are associated with dry eye-related signs.

Objective To investigate the expression of TLR2 and HIF-1α in pancreatic cancer and explore the relationship between TLR2 or HIF-1α protein and the clinical or pathological changes in pancreatic cancer. Methods The mRNA of TLR2 and HIF-1α in 30 cases of pancreatic cancer and its adjacent tissues were detected with real-time PCR and with immunohistochemical methods in 65 cases of pancreatic cancer and 38 cases of corresponding adjacent tissues. The relationship between TLR2 or HIF-1α and pathologic features of pancreatic cancer was analyzed. The correlation between TLR2 and HIF-1α in pancreatic cancer was also assessed. Kaplan-Meier method was used to assess the impact of TLR2 or HIF1αexpression on survival. Results The relative quantification of TLR2 mRNA and HIF-1α mRNA in pancreatic cancer tissues was 0.84±0.17 and 0.87±0.11, respectively, which was significantly higher than that in adjacent tissues 0.70±0.13 and 0.68±0.13 respectively,P＜0.05. The protein expression of TLR2 and HIF-1α in pancreatic cancer tissues was 63. 10% and 70.8%, respectively, significantly higher than that in adjacent tissues (34.20% and 36.8%, respectively). There was no significant correlation between the expression of TLR2 or HIF-1α protein and the age, gender, tumor location, the degree of differentiation in patients with pancreatic cancer (P＞0.05). However, there was significant correlation between the expression of TLR2 or HIF-1α protein and tumor size, lymph node metastasis, venous invasion and clinical staging. TLR2 and HIF-1α had a significant impact on survival. Conclusion TLR2 and HIF-1α overexpressed in pancreatic cancer and TLR2 signaling pathway may promote development of the pancreatic cancer with HIF-1α together.

ObjectiveTo explore the diagnosis and surgical treatment techniques for the patients with primary presacral tumor.Methods Data from 31 patients with primary presacral tumor admitted into our Department for Surgery from Jan. 1999 to Jar. 2009 were retrospectively analyzed.All patients underwent surgical treatment,among them,10 received per-sacroiliac or per-perineum approaches to remove the tumors,18 receivedper-abdomentumorectomy, and3receivedcombinedper-peritoneumandper-perineum tumorectomy.Results Patients visited the doctor while exhibiting the compression symptoms by the the tumors.Final diagnosis could be reached with the help of rectal touch,B-mode ultrasound,computerized tomography,or magnetic resonance imaging.Complete resection was performed in 28 patients.Partial resection was performed in 3 patients.Fractionated resection was successfully performed in 2 patients with chronic infection or sinus tract.ConclusionThe primary presacral tumor should be surgically resected once final diagnosised and without surgical contraindications.Pelvic plexus should be preserved and presacral hemorrhage should be prevented.The tumor should be resected as complete as possible.

Objective To evaluate the role of orexin in the sleep disorder after isoflurane anesthesia in rats.Methods Sixty-four male Sprague-Dawley rats,aged 10-12 weeks,weighing 280-320 g,were randomly divided into 2 groups (n =32 each) using a random number table:control group (C) and isoflurane group (Ⅰ).Group Ⅰ inhaled 1.2％ isoflurane from 8:00 to 13:30 to induce anesthesia,followed by 0.5 h of recovery.Group C received no anesthesia and the other procedures were similar to those previously described in group Ⅰ.The induction time and awakening time were recorded.Eight rats were randomly chosen to record the movement condition (locomotor time and activity) from 14:00 to 8:00 the next morning.Before beginning of anesthesia,at 4 h after beginning of anesthesia,and at 4 and 10 h after the end of anesthesia,6 rats were randomly chosen in each group to count the orexin/c-fos double-labeled neurons in hypothalamus.The ratio of activated orexin neurons (orexin/c-fos double-labeled neurons to orexin positive neurons) was calculated and plasma orexin-A concentration was detected.Results The induction time was (2.14 ± 0.17) min,awakening time was (8.7 ± 0.5) min,and EEG showed that there was no typical burst and suppression patterns in group Ⅰ.There was no significant difference in the number of orexin positive neurons between the two groups (P ＞ 0.05).Compared with group C,the time for locomotor activity was significantly prolonged,and the activity was increased during the night (P ＜ 0.01),the number of activated neurons,ratio of activated orexin neurons and plasma orexin-A concentration were decreased at 4 h after beginning of anesthesia in group Ⅰ (P ＜ 0.01).The plasma orexin-A concentration was lower at 4 h after beginning of anesthesia,while higher at 10 h after the end of anesthesia than before beginning of anesthesia in group Ⅰ (P ＜ 0.05).The number of activated neurons was significantly larger and ratio of activated orexin neurons was higher before beginning of anesthesia and at 10 h after the end of anesthesia and the plasma orexin-A concentration was higher at 4 and 10 h after the end of anesthesia than at 4 h after beginning of anesthesia in group Ⅰ (P ＜ 0.05 or 0.01).Conclusion The development of sleep disorder after isoflurane anesthesia during the day time in rats is related to the regulatory role of orexin in it.

Objective To improve the method to establish a rat model of vascular dementia and to better serve the experimental studies on vascular dementia.Methods We used the method of“repeatedly clipping the carotid artery com-bined with injection of sodium nitroprusside and with permanent unilateral carotid artery ligation” to prepare a rat model of vascular dementia.The drug piracetam was used to validate the established rat model in respect of the behavior and histopa-thology.Results Different from the reports of previous research, firstly, the results of this study suggested that injection dose of sodium nitroprusside should be 2.0 mg/kg, room temperature should be controlled at 28℃ during surgical opera-tion, and kept at 25℃postoperatively for 24 hours.Under these experimental conditions, the rats were stable and the death rate was reduced.Secondly,“repeatedly clipping carotid artery combined with permanent unilateral carotid artery ligation”could cut off about a third of cerebral blood supply, and causing chronic cerebral ischemia, which is seemingly more con-sistent with the pathogenesis of vascular dementia.Experimental results showed that compared with the control group, the navigation incubation period was extended and space search ability became worse in the model group, cell number was de-creased, with blurred cell contour and deeply stained cytoplasm, and cell nuclei were not clear in the hippocampal tissue. Conclusions Our findings indicate that the improved methodrepeatedly clipping the carotid artery combined with injec-tion of sodium nitroprusside and with permanent unilateral carotid artery ligationcan be used to efficiently establish a rat model of vascular dementia.The similar results of experiment using piracetam validate that this rat model can be used in vascular dementia-related experimental studies.