[Objective]To investigate the feasibility and merits of the Smith-Peterson osteotomy for the treatment of degenerative lumbar scoliosis. [Methods]Twenty-five patients(11 males,14 females)with degenerative lumbar scoliosis malformations underwent operations from May 2004 to October 2007.The mean average age were 67 years (range,56~77 years).All the patients underwent more than three segments Smith-Peterson osteotomy and lumbar pedicle screw fixation to have the reconstruction of spinal coronal and sagittal plane balance.[Results]The mean duration of surgery were 200 mins(range,150~320 mins),and the average intraoperative blood loss were 1000 ml (range,600~2 000 ml).There were two cases of postoperative cerebrospinal fluid leakage,which were alleviated by pulling drainage tube and oppressing the wound.Postoperative pain and numbness in both lower extremities were aggravated in 2 cases,one of which was recovered completely 3 weeks later,and another 12 weeks later.The mean clinical follow-up were 36 months(range,24~60 months).JOA 29 score was recorded to evaluate the relief of the symptoms.The good-to-excellent rate was 88.2% and the poor rate was 0%.The coronal Cobb's angle was improved from the preoperative average of 23? (range,15?~ 40?) to the postoperative average of 12? (range,8?~ 20?).The sagittal Cobb's angle was improved from the preoperative average of 0 ?(range,-15?~ 15?) to the postoperative average of 33?(range,25?~ 40?).[Conclusion]Smith-Peterson osteotomy is an effective method for the decompression of lumbar spinal stenosis,and is helpful to correct the sagittal deformity of the degenerative lumbar scoliosis.It also has relatively small interference to nerve in the operation.

Objective To evaluate the clinical outcomes of lumbar spinal stenosis treated with three different surgical modalities.Methods One hundred and forty patients were treated with posterior lumbar interbody fusion (PLIF,n =50),transforaminal lumbar interbody fusion (TLIF,n =40) or modified method (n =50).The operation time and intraoperative blood loss were compared.The outcones were evaluated with Japanese Orthopedic Association (JOA) score and visual analogue scale (VAS),and the radiographic findings were also reviewed.Results The operation time was shorter and the intraoperative blood loss was less in modified group than those in other two groups (F =10.02,P ＜0.05).The excellent and good rate was 90％ (45/50) in PLIF group,92％ (37/40) in TLIF group and 90％ (45/50) in modified group.No complication happened in both TLIF group and modified group.Two patients had cerebrospinal fluid leakage in PLIF group.The JOA scores and VAS scores were significantly improved 3 and 6 months after surgery in three groups (F =10.66,9.68,11.03,all P ＜ 0.05).There were no significant differences in JOA scores and VAS scores among three groups before operation (P ＞ 0.05),also in JOA scores after operation among three groups.The VAS scores in TLIF group and modified group 3 and 6 months after operation were significantly lower than those in PLIF group (F =9.46,10.02,all P ＜ 0.05),but there was no significant difference between TLIF group and modified group.Interbody fusion was good in all three groups.Conclusions Three surgical methods have good clinical outcomes for lumbar spinal stenosis.But compared with PLIF and TLIF,the modified method has less blood loss,shorter operation time and less pain after operation.

Objective To investigate the relationship between CYP2J2*7 mutation(G-76T) and coronary heart disease (CHD) in Chinese Hanpopulation and to study the effects of CYP2J2 geneover-expressionon the proliferation and migrationof aortic smooth muscle cells of ApoE-/- mice. Methods CYP2J2*7 genotype was detectedin 500 patients with CHD and 478 controlsubjects by the Polymerase Chain Reaction-Restriction Frag-ment Length Polymorphism (PCR-RFLP). Culturedaortic smooth muscle cells of ApoE-/- mice were divided into control group, sham transfectiongroup and CYP2J2 over-expression group. Cell proliferation and migration were investigated after CYP2J2 over-expressionby MTS and Transwell assay. Results The frequency of CYP2J2*7 in CHD group was significantly higher than that incontrol group (10.00% vs. 6.49%, P = 0.046). Same is the case in female cases(P = 0.026). Compared with these of aortic smooth muscle cells incontrol group and sham trans-fectiongroup, the cell proliferation in 24, 48, 72 h, and the cell migration in 48 h after CYP2J2 over-expression in CYP2J2 group were significantly suppressed. Conclusions CYP2J2*7 mutation might increase the risk of CHD in Chinese Han population. CYP2J2 over-expression can suppress the proliferation and migration of aortic smooth muscle cells and CYP2J2 might have the effect of anti-atherosclerosis.