Objective:To evaluate the neurologic complications associated with posterior lumbar interbody fusion (PLIF).Method:From March 2003 to May 2008,a total of 178 patients experienced PLIF procedure due to lumbar disease.Of these,forty two had lumbar disc herniation,39 had lumbar spine stenosis,61 had degenerative spondylolisthesis, 22 had isthmic spondylolisthesis and 14 had post-laminectomy/discectomy syndrome. One hundred and thirty patients had single level fused,of these,8 at L3/4.64 at L4/5 and 58 at L5/S1.Forty six cases had two levels fused,of these, 19 at L3/4 and L4/5,27 at L4/5 and L5/Sl.Two patients had three levels fused,all at the L3/4.L4/5 and L5/S1.A11 causes possibly related to the neurologic complications were documented.Result: 13 cases(7.3%) were noted to have neurologic complications,of these,one at L4,7 at L5 and 5 at S1.6 cases had nerve root stretch injury,3 cases had nerve root injury from instrument maneuver, 1 case had nerve root deformity, 1 case had developed epidural hematoma, 1 case had nerve root injury from pedicle fracture and 1 case had secondary lateral recess stenosis.2 cases had complete neurological injury,and 11 cases had incomplete injury.According to American Spinal Injury Association (ASIA) criteria,there was complete recovery of neurologic function in 7 cases, incomplete recovery in 4 cases and no change in 2 cas-es.Conclusion: Many causes may be associated with the neurologic complications due to posterior lumbar interbody fusion,nerve root stretch injury is the most common.

Objective To evaluate the relationship between th e expression of E-cadherin (E-CD) and differentiation, macroscopic features, l ymph node metastasis, and Dukes stages of colorectal carcinoma (CC). Me thods Frozen storage samples of 31 cases of CC and adjacent normal c olon mucous membrane epithelium were examined for E-CD expression by S-P immun ohistochemistry. Results High expression of E-CD was detec ted in normal colorectal mucous membrane epithelium (100%) while E-CD expressio n was lower (77.4%) in the tumor samples. E-CD expression was closely associate d with the differentiations,macroscopic features and lymph node metastasis, resp ectively ( P 0.05). Conclusion The examination of E -CD expression can be used as a valuable index to evaluate the biological behav ior and prognosis of colorectal carcinoma.

0.05). The 5-year survival rate of cyclinD1-posit ive patients was significantly lower than that of cyclinD1-negative patients ( P

Access of safe, effective, convenient and affordable medical and health care services to the people is set as the goal of public hospitals health services as stated in the "Guidelines for Public Hospitals Pilot Reform". Such a goal, however, can hardly be achieved by mechanism changes within the public hospitals. The input and output of public hospitals rely critically on such factors as the input mechanism, regional pattern of healthcare system, the economic and industrial conditions of the region,payment quota and payment approval procedures of medical insurance. This paper set off from the input compensation mechanism of public hospitals in China and analyzed the input and output characteristics of the hospitals. Furthermore, the paper proposed to establish an input compensation mechanism based on public welfare performance for such hospitals. This provided further reference for improving the management of public hospitals and building a public welfare-oriented operation mechanism of public hospitals.

OBJECTIVE:To study the effect of tanshinone on inflammatory response in air-pouch model mice with artificial joint aseptic loosening. METHODS:Mice were randomly divided into blank control group(normal saline),titanium particle group (normal saline),tanshinone low-dose,medium-dose,high-dose groups(50,100,200 mg/kg),10 in each group. Air-pouch mod-els were induced. Except that mice were injected 0.5 mL normal saline into air-pouch in blank control group,other groups were in-jected 0.5 mL Titanium particle suspension(10 mg/mL)into air-pouch,continuously administrated medicines by 0.1 mL/10 g after 24 h,ig,for 14 d. After 24 h of last administration,the air-pouch was collected,air-pouch inflammation was observed by eyes and by microscopy after hematoxylin-eosin staining,and inflammatory cell density was calculated. Real-time quantitative poly-merase chain reaction method was conducted to detect the tumor necrosis factor α(TNF-α),interleukin 1β(IL-1β)mRNA expres-sion;enzyme-linked immunosorbent method was used to detect the TNF-α,IL-1β protein expression. RESULTS:Compared with blank control group,air-pouch swelling was obvious in titanium particle group,much exudation and neovascular were observed,in-flammatory response was severe,inflammatory cell density was increased significantly(P<0.05);TNF-α,IL-1β mRNA and pro-tein expression were obviously enhanced(P<0.05). Compared with titanium particle group,air-pouch swelling was relieved in tan-shinone doses groups,exudation and neovascular were decreased,inflammatory response was relieved,inflammatory cell density was decreased significantly(P<0.05);TNF-α,IL-1β mRNA and protein expression were obviously decreased(P<0.05),with a dose-dependent manner. CONCLUSIONS:Tanshinone can effectively inhibit the aseptic inflammatory response in air-pouch model mice with artificial joint aseptic loosening.

Objective To study clinical application value of sacral and epidural block in treating lumbar intervertehral disc protrusion (LIDP), and explore technical operation methods, indications and con-traindications of sacral block. Methods Sacral block was adopted in 120 patients with LIDP(sacral group), they were injected triamcinolone acetonide 40 mg, vitamin B1 100 mg, vitamin B12 1 mg, 2% lidocaine 100 mg, added physiological saline 20-30 ml, twice a week, three times as a period. Compared therapy effect with epidural block (120 cases, epidural group). Results The achievement ratio of once puncture was 93.3% (112/120) in sacral group and 82.5% (99/120) in epidural group, P < 0.05. After treatment, the excellent and good rate of sacral group and epidural group were 85.0%(102/120) and 93.3%(112/120), there was not obvious difference, P>0.05, but the fair and bad rate were 15.0%(18/120) and 6.7%(8/120), there was ob-vious difference, P<0.05. Conclusions Sacral block and epidural block are effective methods to treat LIDP. They can relieve the stress at nerve root, especially sacral block, which has the advantages of easily operation, less pain, less side effect and safety.

Objective To explore the radiosensitivity ofβ-elemene on Colo320 cells transplanted tumor in nude mice and its molecular mechanisms.Methods Colo320 cells transplanted tumor model was established by cell suspension inoculation in nude mice.Then the transplanted mice with 0.8-1.0 cm3 tumor were randomly divided into 4 groups:control,β-elemene (40 mg/kg),radiation (4 Gy),andβ-elemene (40 mg/kg)+ radiation (4 Gy) groups,with four to five mice in each.Tumor weight and morphology were observed in each group.In addition,the apoptosis of tumor cells was measured by TUNEL and the expression of Fas gene was detected by immunohistochemistry.Results The nude mice transplanted tumor model was successfully established.Compared with that in control and simple radiation groups,tumor weight was significantly decreased inβ-elemene combined with irradiation group (P <0.05).At the same time,the apoptosis rate and the expression of Fas gene in tumor cells were significantly increased (P <0 .0 5 )inβ-elemene combined with irradiation group compared with control and simple radiation groups. Conclusion β-elemene could enhance the radiosensitivity of Colo320 cells transplanted tumor in nude mice probably by inducing Fas-mediated apoptosis of tumor cells.

A comparison of the number of clinicians per 1000 residents in the province,and analysis of their distribution and characteristics identified an imbalance of such resources between regionsand between urban and rural areas.A further analysis of the payment flow of medical insurance fund of the counties and districts probed into the deployment efficiency of clinical in the province,holding that the hck of a human resources deployment and guidance mechanism for clinical resources is key to toor healthcare equity and difficulties in accessibility of healthcare service.

Objective:To investigate the effects of experimental periodontitis on serum C reactive protein(CRP) and insulin resistance in obese rats.Methods:4 week old SD rats (n=35)were fed with high fat diet for 16 weeks to establish the model of obesity.According to the obesity criteria,5 rats were screened out.According to the proportion of 1:2,10 rats were randomly selected as obese control group,20 obese rats were used for the establishment of the obesity with periodontitis model(combination group) by periodontal ligation using silk thread.4 rats died after ligation.Before periodontal ligation,1 and 4 weeks after periodontal ligation,orbital venous blood were collected for the detection of fasting blood glucose and fasting insulin.Homeostasis model assessments of insulin resistance index(HOMA-IR) and beta cell function index(HOMA-β) were calculated.The level of serum CRP was examined by ELISA.Results:The level of CRP in the combination group was increased 1 week after periodontal ligation,and then gradually decreased in the following 4 weeks(F=7.773,P=0.004).HOMA-IR in the combination group were higher than that in the obese group(F=-4.691,P=0.000),and beta cell function index was significantly lower(F=3.672,P=0.002) than that in the control group 4 weeks after periodontal ligation.Conclusion:The experimental periodontitis may affect the serum level of CRP in obese rats,aggravate insulin resistance and decrease the function of beta cells in obese rats.

Objective To explore causes of complications after endovenous laser treatment (EVLT) , for patients with superficial varicosities of the lower extremities. Methods In this study, 207 patients with a total of 268 lower limbs were treated by EVLT combined with surgical procedures. According to CEAP classification, there were C2 in 268 limbs, C3 in 56 limbs, C4 in 101, C5 in 23 and C6 in 18. Simple EVLT was performed for 25 limbs in 21 patients; EVLT combined with external banding valvuloplasty of superficial femoral vein for 23 limbs in 23 patients; EVLT combined with ligation of great saphenous vein (CSV) and denudation of superficial varicosities for 220 limbs in 163 patients. Results An average of 10?5 (3-24) months of follow up was achieved in 175 cases. Early complications (within the first 2-weeks after operation) included bruising or ecchymosis (178 cases, 66.42%) and skin burning (56, 20.90% ). Three month complication included painful induration or trabs (235 cases, 87. 69% ) as well as thrombophlebitis (28, 10. 45% ). Long-term complication (after 3 months) included skin numbness or pain at medial knee or ankle region (15,5. 60% ). Recanalization of CSV occurred in 4( 1. 49% ) treated limbs. Residual or reoccurred varicose veins were found in 13(4. 85% ) cases. Movement related swelling appeared in 6(2. 24% ) lower limbs. Conclusion EVLT is effective for patients with superficial varicosities of the lower extremities. Minor complications most often subsided within 3 months. Strict surgical protocol and high ligation of the GSV could prevent local recurrence of the varicose veins and the recanalization of GSV.