BACKGROUND:The purpose of lumbar disc protrusion and spondylolysis operation is not only to anterior decompression and fusion,but also to maintain the mechanical stability of vertebrae by holding the normal stress spot range of instantaneous center of rotation (ICR).OBJECTIVE:Using mechanical tenet to explain the pathological relationship between lumbar disc protrusion and spondylolysis,and to summarize the treatments for 68 cases with lumbar disc herniation and spondylolisthesis.METHODS:Totally 68 cases of lumbar disc protrusion and spondylolisthesis suffered lumbago or sciatica simultaneously.All patients were treated by the surgical method containing posterior whole or half laminectomy exploration decompression,discectomy,intervertebral fusion and the short segment posterior pedicle screw reduction and internal fixation.RESULTS AND CONCLUSION:All patients received 1.5 years follow-up.According to Stamffer criterion of therapeutic effectiveness,63 patients were good,and 5 patients were average,with 92.6% good rate.Due to abnormal ICR,the pathological disc and spondylolysis were reciprocal causation.Following implantation,the stress of ICR was kept in a normal range,and the anterior sliding power of vertebrae was reduced,which can maintain the mechanical stability of vertebrae.

Objective To evaluate the clinical value of choledochoscopy combined with electrohydraulic lithotripsy (EHL) for the treatment of pancreatolithiasis. Methods From October 2002 to July 2006, choledochoscopy combined with EHL was used in 11 patients with pancreatolithiasis during a dissection of the pancreatic duct combined with pancreato-jejunum Roux-en-Y anastomosis (EHL group). The data of these patients were compared with the data of 12 patients with pancreatolithiasis, who were treated by routine dissection of the pancreatic duct combined with pancreato-jejunum Roux-en-Y anastomosis from January 1995 to September 2002 (Routine group). Results The intraoperative blood loss and the postoperative rate of residual stones in the EHL group were significantly less than those in the routine group [(145.5?82.0) ml vs (406.7?384.9) ml, t=-2.201, P= 0.039; and 0% vs 41.7%, P= 0.037]. The postoperative rate of pain relief in the EHL group was higher than that in the routine group (90.9% vs 58.3%), however the difference was not significant (P=0.155). In the EHL group, 6 patients had diarrhea before the operation, 4 of them achieved relief after the surgery (4/6), which was not significantly more than that in the routine group (5/9, P=1.000). Before the operation, 7 patients in the EHL group and 9 in the routine group had diabetic mellitus; in each group, the disease was relieved in 2 patients after the operation (2/7 vs 2/9, P=0.665). Conclusions Choledochoscopy combined with EHL is effective for the treatment of pancreatolithiasis. The procedure can increase the rate of stone removal, decrease the intraoperative blood loss, and elevate the postoperative rate of pain relief.

Objective To investigate the changes of laminin(LN) and fibronectin(FN) expressions in atypical hyperplasia and breast cancer. Methods LN and FN expressions in normal breast tissue, tissues from grade Ⅰ, Ⅱ and Ⅲ atypical hyperplasia and breast cancer were detected by means of S P immunohistochemical staining method. Results In normal breast tissue, LN expression was found only in basement membrane, but FN expression in basement membrane and matrix. In gradeⅠ hyperplasia, LN expression was found in basement membrane and epithelium, but FN expression was similar to that in normal tissue. In grade Ⅱhyperplasia, more LN expression was found in epithelium, but FN expression in epithelium and matrix. In grade Ⅲ hyperplasia, LN expression increased significantly in matrix and decreased significantly in epithelium as compared with those in grade Ⅱ( P

Objective:To investigate the pathway of C.albicans-induced murine thymocyte apoptosis.Methods:The chages of TNF-? level in murine plasma and caspase-3 activity were measured by ELISA and flurorescence spectrophoto meter respectively;FCM measurement was adopted for the expression levels of related genes.Results:The level of TNF rise,the caspase-3 activity serengthen significantly and bax,p53 gene expression are upregulated.Conclusion:It is possible that C.albicans elicits apoptosis in murine thymocytes by upregulating bax and p53 gene expression as well as raising the serum TNF-? level to strenghen the activity of caspase-3.

OBJECTIVE To investigate the distribution of serum markers of transfusion-transmitted infections in hospital,and analyze the clinical values in the control of nosocomical infection. METHODS The serum markers of transfusion-transmitted infections from 21 605 hospitalized cases,such as HBsAg,anti-HCV,anti-HIV,and RPR were detected. RESULTS The positive rate of HBsAg and anti-HCV was 9.78% and 1.70%,respectively.The positive anti-HIV was detected in 13 cases by the primary screening test for HIV,and the 13 cases were reconfirmed by the reconfirmation laboratory of CDC in Hunan Province.The positive RPR was in 4 cases,the same as of TPHA.There were 2 582 positive cases of the four indexes(HBsAg,anti-HCV,anti-HIV and RPR),the total positively detectable rate was 11.95%,which was obviously higher than 7.6% of normals(P

Objective To investigate the relationship of T peak-T end (Tp-Te) interval and Tp-Te interval disper-sion (Tp-Ted) in different periods of myocardial ischemia in patients with acute myocardial infarction (AMI), and to assess the clinical significance of Tp-Te and Tp-Ted for prediction of the ventricular arrhythmia (VA). Methods A total of 80 pa-tients with AMI were enrolled in the study. The sizes and changes of Tp-Te and Tp-Ted were observed during the acute phase and recovery phase in patients. The differences of Tp-Te and Tp-Ted were compared between ventricular tachycardia group (A group), ventricular premature beats group (B group) and non- ventricular arrhythmia group (C group). Results The values of Tp-Te and Tp-Ted were obviously longer in acute period [(125.22±17.70) ms and (54.76±13.26) ms] than those in recovery period[ (113.84±17.37) ms and (42.06±13.95)ms] (P<0.01). The values of Tp-Te and Tp-Ted were signifi-cantly longer in A group[ (134.82±19.56) ms and (62.00±15.19) ms] than those in B [(122.94±15.09) ms and (54.09±10.56) ms ]and C group [(110.09±15.21) ms and (45.27±9.85) ms]. The values were higher in B group than those of C group. Con-clusion The Tp-Te interval and Tp-Ted prolongated in acute phase than those of recovery phase in patients with AMI. Tp-Te interval and Tp-Ted can be used as an important index to predict VA in patients with AMI.

Objective To investigate the effect of early low-glucocorticoid on hemodynamics and prognosis in the patients with septic shock.Methods Sixty patients with septic shock failing in active fluid resuscitation and vasoactive drugs in our hospital from June 2013 to August 2015 were selected and divided into the control group,early-hormone group and late-hormone group.MAP,HR,PO2/FIO2 and serum lactic acid levels were monitored in all selected patients before treatment and at 12,24,48 h after treatment.Apache Ⅱ,SOFA scores were assessed before treatment and on 1,3,7 d after treatment.The ventilation time,ICU stay time,hospital stay time and intravenous use time of vasoactive agents(VDNT) were recorded.Results The Apache Ⅱ scores and SOFA scores on 3,7 d after treatment in the early-hormone group were significantly decreased compared with the late-hormone group and control group (P＜0.05).MAP and HR at 24,48 h after treatment in the early-hormone group were significantly improved compared with the late-hormone group and control group (P＜0.05).The level of serum lactic acid at 12,24 h after treatment in the early-hormone group and late-hormone group were obviously lower than that in the control group,the levels of serum lactic acid at 12,24 h after treatment in the early-hormone group were obviously lower than those in the late-hormone group (P＜ 0.05).PO2/FIO2 at 12 h after treatment in the early-hormone group and late-hormone group were obviously better than that in the control group,and PO2/FIO2 at 12 h after treatment in the early-hormone group was obviously better than that in the late-hormone group(P＜0.05).The ventilation time,ICU stay time,hospital stay time and VDUT in the early-hormone group were significantly shortened compared with the late-hormone group and control group.The ventilation times,ICU stay time and VDUT in the latehormone group were significantly shortened compared with the control group (P＜0.05).Conclusion Early using low-dose glucocorticoid may restore hemodynamics more quickly,protects the organ function and improves the prognosis in the patients with septic shock.

OBJECTIVETo study the gene mutation and streptomycin, isoniazid or rifampicin resistance of Mycobacterium isolated from silico-tuberculosis patient's sputum so as to find a more effective therapy for this disease.

METHODSMycobacteria tuberculosis were separated from 96 coal worker with silico-tuberculosis firstly. Then rpsL, KatG and rpoB fragments of genome were copied with PCR and compared their SSCP profiles with standard strains.

RESULTS67 strains of streptomycin, isoniazid or rifampicin resistant Mycobacteria tuberculosis were found in routine drug resistance test, with the percentages of 80.5% (54/67), 58.2% (39/67) respectively. PCR-SSCP showed that out of 67 drug-resistant strains, 66(98.5%) of rpsL, 47(70.1%) of rpoB and 42(62.7%) of KatG appeared abnormal.

CONCLUSIONMost of the resistant strains appeared gene mutation. The mution rates were higher than the results from routine drug resistance test.

Coal ; Drug Resistance, Bacterial ; Humans ; Mutation ; Mycobacterium tuberculosis ; drug effects ; genetics ; Polymerase Chain Reaction ; Polymorphism, Single-Stranded Conformational ; Silicotuberculosis ; microbiology ; Sputum ; microbiology

Objective: To investigate the preparation of bioactive denatured acellular dermal matrix (DADM) from burn mice riched in mice bone marrow mesenchymal stem cells. Methods: Twelve BALB/c mice were collected and 20% total body surface area scalds (hereinafter referred to as burns) with deep partial thickness were inflicted on the back skin of each mouse. After removing epidermis, the burned skin were collected and divided into Triton X-100 group and elhylene diamine tetraacetic acid (EDTA) group according to the random number table, with 15 samples in each group. Samples in Triton X-100 group and EDTA group were respectively placed in mixture of 2.5 g/L Triton X-100 and 2.5 g/L trypsin solution and mixture of 0.2 g/L EDTA and 2.5 g/L trypsin solution for sustained vibration and elution for 24 hours to make mice DADM. The general appearance of DADM was observed. The structure and arrangement of collagen fibers of DADM were observed by scanning electron microscope and tissue structure of DADM were observed by fluorescence microscope. Bone marrow mesenchymal stem cells (BMSCs) from mice were transplanted in mice DADM in the two groups with concentration of 2×105 cells per well to prepare bioactive mice DADM. After cultured for 3 days, tissue structure of bioactive mice DADM was observed by hematoxylin and eosin staining, distribution and number of BMSCs of bioactive mice DADM were observed by immunofluorescence staining. Proliferation of BMSCs of bioactive mice DADM after cultured for 2 h, 1 d, 3 d, and 5 d was detected by cell count kit-8. Data were processed with analysis of variance for repeated measurement and t test. Results: (1) Mice DADM in the two groups were white in appearance with certain tenacity and elasticity. Mice DADM in the two groups maintained good three-dimensional porous network structure. Collagen fibers of mice DADM in EDTA group were with good continuity, and collagen fibers of mice DADM in Triton X-100 group were fractured in varying degrees. Mice DADM in the two groups were decellularized completely, and the collagen fibers were loose and arranged disorderly. The continuity of tissue structure of mice DADM in EDTA group was better than that of mice DADM in Triton X-100 group. (2) After cultured for 3 days, the BMSCs in bioactive mice DADM in the two groups were evenly distributed. The number of bioactive BMSCs in mice DADM in EDTA group was 37±7, which was significantly more than that of mice DADM in Triton X-100 group (25±8, t=0.128, P<0.05). The proliferation of bioactive BMSCs in mice DADM in Triton X-100 group and EDTA group was similar at 2 hours and on day 1 after cultured (t=1.292, 0.656, P>0.05). On 3, 5 days after cultured, the proliferation of bioactive BMSCs in mice DADM in EDTA group was significantly higher than that of mice DADM in Triton X-100 group (t=2.309, 14.128, P<0.05 or P<0.01). Conclusions Mice DADM prepared by decellularization of EDTA has better three-dimensional porous network structure and good continuity of collagen fiber. The BMSCs in bioactive DADM from burn mice prepared by transplanting BMSCs are evenly distributed with large quantity and strong proliferative capacity, which has the potential to be good autologous dermal substitute.

OBJECTIVETo investigate the postoperative adverse events and survival of patients with sustained-released fluorouracil implanted during operation.

METHODSData of 124 patients with advanced gastric cancer undergoing radical operation in Tianjin Medical University Cancer Institute and Hospital from January 2007 to January 2009 were analyzed retrospectively. All the patients were divided into two groups according to whether intra-operative fluorouracil was implanted or not. The treatment group(n=64) was implanted with fluorouracil in abdominal cavity after radical resection. The control group(n=60) did not receive fluorouracil implant in abdominal cavity after radical resection. Abdominal drainage fluid, temperature and adverse events within 15 postoperative days and 3-year survival were observed and compared between the two groups.

RESULTSPathological findings of the two groups were similar. No statistical significances existed in abdominal drainage fluid, temperature and adverse events within 15 postoperative days(P>0.05). The 3-year survival rate was higher in treatment group(64.3% vs. 42.4%, P=0.018).

CONCLUSIONIntra-operative sustained-released fluorouracil implants are safe and tolerable, and can improve the survival rate of patients with advanced gastric cancer.

Abdominal Cavity ; Antimetabolites, Antineoplastic ; administration & dosage ; therapeutic use ; Fluorouracil ; administration & dosage ; therapeutic use ; Humans ; Retrospective Studies ; Stomach Neoplasms ; drug therapy ; surgery ; Survival Rate