BACKGROUND:Lumbar disc herniation is a clinical syndrome of lumbar pain and radiated pain of the lower limb induced by biochemical changes after intervertebral disc degeneration. Transforaminal endoscopic spine system (TESSYS) and Yeung endoscopic spine system (YESS) are commonly used in the clinic, but their effects are different.
OBJECTIVE:To compare the curative effect of TESSYS and YESS in treatment of lumbar disc herniation. METHODS:Fol ow-up data of 134 cases of lumbar disc herniation were retrospectively analyzed. They were assigned to TESSYS group (n=76) and YESS group (n=58). Intraoperative condition, pain at various time points after repair, and lumbar function changes were compared between the two groups.
RESULTS AND CONCLUSION:(1) No significant difference in Visual Analogue Scale and Oswestry Disability Index scores was detected between the two groups before repair (P>0.05). At 1, 3, and 6 months after repair and during final fol ow-up, above scores were significantly decreased in both groups (P<0.05). Above scores were significantly lower in the TESSYS group than in the YESS group at various time points after repair (P<0.05). (2) No significant difference in Japanese Orthopedic Association score was found between the two groups before repair (P>0.05). Japanese Orthopedic Association score was greater in the TESSYS group than in the YESS group at 1, 3 and 6 months fol owing repair and during final fol ow-up (P<0.05). (3) The excel ent and good rate was significantly greater in the TESSYS group than in the YESS group during final fol ow-up (P<0.05). (4) Operation time and incision length were significantly shorter in the TESSYS group than in the YESS group. No significant difference in the amount of bleeding was detectable between the two groups (P>0.05). Results suggest that TESSYS for lumbar disc herniation was characterized by smal trauma, mild pain and good recovery of function.

The da Vinci robotic surgical system assisted colorectal radical resection has been widely applied in many countries and regions.The advantages of the da Vinci robotic surgical system include stable and distinct stereoscopic vision,short learning curve,convenient operation and feasibility of remote manipulation,while its disadvantages are expensive cost,lack of tremor and prolonged operation time.The advantage of da Vinci robotic surgical system is not distinct when compared with traditional laparoscope in radical resection of colorectal cancer.With the accumulation of clinical data and the update of the system,the prospect of da Vinci robotic surgical system assisted colorectal radical resection is promising.

Pancreaticoduodenectomy (PD) is the procedure for treating adenocarcinoma in periampullary region.This involves resection of multiple organs and complex reconstructions.The modern surgery has witnessed the dramatic improvement in outcomes after PD.Mortality has dropped to less than 4％,however,the complication rate remains high,making this procedure still a big challenge for most surgeons. PD is so complicated that even small mistakes could jeopardize the whole procedure and outcomes.With experiences of over 1000 PDs,we discuss the challenges of this procedure and strategies to deal with them.

Objective To comparatively investigate the characteristics of bone metabolism in forelimb malformation WHBE rabbits based on the OPG/RANK/RANKL system.Methods Healthy male 2-2.5-month old WHBE rabbit ( HWR) , Healthy Japanese rabbit ( HJR) and forelimb malformation WHBE rabbit ( FMWR) were used in this study and divided into 3 groups, HWR, HJR and FMWR groups, with 10 rabbits in each group.The shape of forelimb and mean gray value observed from X-ray film were examined, and the bone tissue micro-morphology was analyzed using HE staining.Re-al-time fluorescence quantitative PCR was used to determine the expression of osteoprotegerin ( OPG) and receptor activator of NF-KB ligand ( RANKL) mRNA.The expressions of OPG, receptor activator of NF-KB ( RANK) and RANKL protein in serum and bone tissue were assayed by enzyme-linked immunoassay ( ELISA) and immunohistochemistry, respectively. Results Compared with the HWR and HJR groups, rabbits in the FMWR group appeared abnormal in toutuous forelimb and thinner bone cortex.The mean gray values of X-ray in the FMWR group were lower than that in the HWR group ( P<0.05).There were significant differences between the FMWR and healthy rabbits (HWR and HJR) in the following pa-rameters:RANKL mRNA expression and RANKL/OPG mRNA ratio in the liver(P<0.05, P<0.01), serum protein expression of RANK and RANKL and RANKL/OPG ratio (P<0.05, P<0.01), and positive index of expression of RANKL protein and RANKL/OPG ratio in the bone tissue(P<0.05, P<0.01).Furthermore, the gene expression lev-els of OPG and RANKL of HWR were significantly higher than that of HJR(P<0.05, P<0.01).Conclusions The FMWR show some abnormal symptoms in bone metabolism as well as decrease of bone quality and histological changes of bone micro-structure, due to the significant increase of RANKL/OPG ratio of FMWR.The breed differences between WHBE and Japanese rabbits in RANKL mRNA expression level may be one of factors inducing limb malformation in the WHBE rabbits.

Objective To investigate the prevalence of gastroeaophageat reflux disease(GERD)in the end stage renal disease patients(ESRD)with maintenance hemodialysis and the pathogenetic factors of GERD.Methods 60 cases who had heart burn and acid regurgitation symptoms were enrolled,31 cases of them were ESRD patients with maintenance hemodialysis,29 patients who were renal diseases free as control group.GERD was diagnosed by three methods:endoscopy,24h esophageal pH monitoring,endoscopic esophageal biopsy.GERD was established if any of these tests was positive.HP infection and serum gastrin were assessed too.Results (1)The prevalences of GERD in two groups were 83.9%,79.3% respectively and had no significant difference(P＞0.05).(2)The prevalence of HP infection in the ESRD group was significantly lower than control group(19 4% vs 51.7%,P＜0.05).(3)The concentration of serum gastrin in the ESRD group and control group was(102.61±30.80)ng/ml and (83.41±20.61)ng/ml,two group had significant difference(P＜0.05).Conclusion The prevalence of GERD inthe ESRD patients was higher than expected,and was correlated with absence of HP infection and hypergastinemia.

Bone is now regarded as an endocrine organ modulating energy metabolism. Osteocalcin, which was a traditional bone remodeling marker, especially in its undercarboxylated form, was believed to be a metabolic active molecule involving in glucose homeostasis. Bone can uptake glucose through glucose transporter 1 expressed on osteoblasts, and this process is crucial for osteoblasts differentiation and bone formation. In addition, the osteoblasts specific insulin resistance may also lead to the dysregulation of whole body glucose metabolism. Clinical investigations generally echo the findings from mice studies. More work, especially prospective clinical studies are needed to prove the clinical utility of osteocalcin and/or other bone turnover parameters as solid predictors of pancreaticβcell function and incident diabetes, as well as the potential use of osteocalcin and/or its undercarboxylated form as an anti-diabetic agent. In the 11th issue of Diabetes in 2016, a review paper entitled asRegulation of glucose handling by the skeleton:Insights from mouse and human studies was published [Diabetes, 2016,65(11):3225-3232]. With the permission of Diabetes and American Diabetes Association, we translated the most important part of this review into Chinese with a new title:The regulatory role of skeleton in maintaining glucose homeostasis.

Objective To explore the immunoregulatory and lethal effects of natural killer T lymphocytes(NKTs) in vitro .Meth‐ods The mixed lymphocyte cultured(MLC) system was established ,in which the B16F10‐luc‐G5 cells were set as target cells ,the total lymphocyte cells were set as effector cells .(1)In the experiment on immunoregulatory effects ,NKT lymphocytes or CD4+CD25+ T lymphocytes were set as regulating cells ,there was three groups ,including the NKT group ,CD4+CD25+ T group and pure target cell control group .Otherewise ,the 1640 blank control group was set by only adding RPMI1640 solution .(2)In the ex‐periment on antitumor effects ,the NKT or natural killer(NK) lymphocytes were set as killer cells ,there was three groups ,inclu‐ding the NKT group ,NK group and pure target cell control group .Mixed culturing 24 ,48 and 72 hours ,the bioluminescence of target cells in MCL system was detected by using the in vivo imaging system .Results (1)In the experiment on immunoregulatory effects ,there were statistically significant differences in measured average photon numbers between NKT group ,CD4+ CD25+ T group and the two control groups(P<0 .05) .The statistically significant differences were also found in the NKT group between 24 hours and 72 hours (P<0 .05) .(2)In the experiment on antitumor effects ,there were statistically significant differences in meas‐ured average photon numbers ,when the NKT group and NK group were compared to the pure target cell control group(P<0 .05) . After culturing 24 and 72 hours ,statistically significant differences were found between NKT group and NK group(P<0 .05) .Con‐clusion The NKT cells could inhibit the lethal effects of lymphocyte cells on target cells ,and the inhibitory effects are changed by the length of culturing .Compared with the CD4+CD25+ T lymphocytes ,NKT lymphocytes have strongger regulatory effects .Addi‐tionally ,the NKT cells have lethal effects on target cells ,which might be weaker than that of NK cells .

[Objective] To investigate the osteogenetic effect of calcium sulfate(CS)combined with bone matrix gelatin(CS)as bone substitute material in a rabbit ulnar defect model.[Method]Twenty one adult New Zealand White rabbits were used.The segmental ulnar defects of 15 mm were created b/laterally and were divided into tbree groups:Group 1,defects were filled with CS/BMG;Group 2,defects were filled with CS;Group 3,untreated control defects.The samples were harvested at 4,8,12 weeks and were examined by radiographic,histomorphological and tetracycline tracing analysis.[Result]No inflammatory or foreign body reaction was observed around all the defects.Both CS/BMG and CS were almost completely resorbed 8 weeks postoperation.At the group 1,nem bone was found throngbout the defects after 4 weeks.All defects were repaired with a well-organized traheeular pattern and a thin neocortex after 12 weeks.At the group 2,mass of new bone tissue formed at the periphery of the defect 4 weeks postoperatlon,but the development of new bone at the central of the defect was latter than that at the group 1.At 12 weeks,all defects were bridged by new bone tissue with little adjacent medullary bone.At the group 3,slight new bone was observed at the periphery of the defect region,and the defects were filled with fibrous tissue.[Conclusion]Calcium sulfate containing bone matrix gelatin is totally bioresorbable and biocompatible.The compound material can enhance the repair bone defects effectively as a bone graft substitute.

Purpose: To study new treatment of leukemia with both bcr-abl and mdrl positive. Methods: We detected the effect of STI571 ( 1 ?mol/L), an inhibitor of tyrosine kinase, in combination respectively with vincristine (VCR), daunorubicin (DNR), homoharringtonin( HHT) ( 10-4,10-5, 10-6, 10-7,10-8 mol/L) and DNR + arabinoside cytosine (Ara-C) of 1 mmol/L on a high tumorigenicity in nude mice multi drug-resistant leukemia cell line ( K562-n/VCR) by MTT method. Results: IC50 of VCR and VCR + STI571 were 127.28 ?mol/L, 1. 37 ?mol/L respectively, and synergistic interaction on K562-n/VCR cells was 93. 04-fold. IC50 of DNR and DNR + STI571 were 6. 96?mol/L, 0. 30?mol/L respectively, synergistic interaction was 23. 35-fold. IC50 of HHT and HHT + STI571 were 156.70?mol/L, 7.916?mol/L respectively, synergistic interaction was 19. 80-fold. IC50 of DNR + Ara-C and DNR + Ara-C + STI571 were 0. 10 ?mol/L, 0. 015 ?mol/L respectively, the synergistic interaction was 464-fold. Chemotheraputic agents have not intensive cytotoxic effect on K562-n/VCR cells, but the cytotoxic effect became greater when combined with STI571. Conclusions: Combination of STI571 with DNR, VCR, HHT and DNR + Ara-C had a greater synergistic inhibiting effect on K562-n/ VCR cells . The combinations of STI571 and these Chemotheraputic agents would display synergistic activity in bcr-abl and mdrl positive leukemia cells.

Objective To evaluate the expression of endothelial Per-ARNT-Sim domain protein-1(EPAS-1)/hypoxia-inducible factor-2?(HIF-2?) and its relationship with vascular endothelial growth factor (VEGF) in bladder transitional cell carcinoma (BTCC). Methods The expression of EPAS-1/HIF-2? and VEGF by immunohistochemical staining was examined in 60 cases of BTCC (Grade Ⅰ in 28 cases,Grade Ⅱ in 12,Grade Ⅲ in 20) and 8 subjects with normal urothelium. Of the 60 cases 29 had superficial (≤pT 1) bladder cancer and 31 had invasive (≥pT 2 bladder cancer).?2 test was used to assess the relationship between EPAS-1/HIF-2? and VEGF expression versus tumor grade and stage. Results The expressions of EPAS-1/HIF-2? and VEGF were negative in all normal bladder tissue but high in BTCC.Of the 60 cases,34 (56.6%) were positive and 26 ( 43.4%) were negative for EPAS1/HIF-2?.Four cases (14.3%) of Grade Ⅰ,11 (91.7%) of Grade Ⅱ and 19 (95.0%) of Grade Ⅲ were positive for EPAS-1/HIF-2?. Positive staining was seen in 5 (17.2%) of the superficial and 29 (93.5%) of the invasive cancer cases.EPAS-1/HIF-2? positivity was correlated with high histological grade (r=0.862,P