[Objective]To initially approach the role of lumbar facet joint derived inflammatory factors in degenerative lumbar spinal canal stenosis. [Methods]Totally 75 cases of degenerative lumbar spinal canal stenosis(LSCS)(n=41)and lumbar intervertebral disc herniation(LDH)(n=34) undergoing posterior lumbar spinal surgery in our department were evaluated in terms of the extent of degenerative arthrosis according to the Weishaup grading criteria.The grading of backleg pain,melosalgia and functional impairment were recorded.The excised lumbar facet joints were collected as species.The content of interleukin-1? and tumor necrosis factor-? in the species were determined by ELISA.[Results]There was no TNF-? detected in both of the two groups.More IL-1? was detected in degenerative lumbar spinal canal stenosis group than that in lumbar intervertebral disc herniation group.It was demonstrated that the content of IL-1? in the species increased as the degeneration of lumbar facet joint sharpened.IL-1?-positive cases in degenerative lumbar spinal canal stenosis group showed higher grading of backleg pain,melosalgia and functional impairment.[Conclusion]The cartilage of degenerative lumbar spinal canal produced more IL-1?.Lumbar facet joint derived inflammatory factors might be one of the reasons that cause backleg pain and melosalgia and functional impairment in degenerative lumbar spinal canal stenosis patients.

[Objective]To discuss the diagnosis and surgical management of lumbar degenerative juxtafacet joint cysts. [Methods]From June 2004 to June 2007,seven patients were diagnosed as degenerative juxtafacet joint cysts and were treated by surgery. The authors made a retrospective analysis on the clinical data of these 7 patients. Among these 7 patients,there were one as ligamentum flavum cyst and six as facet joint cysts. Five lesions were located at the L4、5 level and two were located at the L5S1 level. According to the preoperative lateral films and CT scan,segment instability were found in two patients. Fenestration decompression,resection of cyst and 1/3 medial articular process were performed on five patient without preoperative segment instability,while additional posterior fixation and posterolateral fusion were done to two patients with preoperative segment instability.The mean length of follow up were 14 months (range: 9~24 months ). The VAS score and ODI score were used for clinical outcome assessment.[Results]The pathological results confirmed the preoperative radiological diagnosis in all patients. Improvement were found in all patients,including completely recovery in five patients and significant relief of pain in other two patients.[Conclusion]Lumbar degenerative juxtafacet joint cysts has been proved to be a cause of low back pain. Preoperative CT scan and MRI are helpful in the diagnosis and the clinical outcome of surgery is satisfactory.

AIM: To investigate the changes of first order kernel ( FOK ) and second order kernel ( SOK ) of multifocal electroretinogram( mf-ERG) in detecting the early retinal abnormalities in sub-clinical stage of diabetic retinopathy. ·METHODS: Totally 32 patients ( 58 eyes ) with type 2 diabetes mellitus ( DM ) without apparent diabetic retinopathy( DR) were detected by mf-ERG, from June 2014 to May 2015. Thirty cases ( 60 eyes ) of normal control group had also been taken to compare the difference of the amplitude and latency between the two groups. ·RESULTS: Compared with the control group: there was no statistical difference in the FOK b-wave latency of the diabetic group, and the FOK b-wave amplitude was significantly decreased (t=3. 099, P=0. 012). The SOK b-wave latency in diabetes group was statistically delayed (t=2. 643, P=0. 025), and the SOK b-wave amplitude statistically decreased (t=4. 833, P<0. 01). There was no statistically difference in the a-wave latency and amplitude of FOK and SOK. The b-wave amplitude of FOK and SOK was negatively correlated with the course of the disease. However, the b-wave amplitude was not statistically correlated with the duration of diabetes mellitus. ·CONCLUSION: The function of the post-polar outer and inner retina detected by FOK and SOK had been damage even before retinopathy. The anomaly is mainly reflected by the decreasing amplitude of b-wave.

Objective To investigate the feasibility of laparoscopic repair for ingunal hernia after peritoneal dialysis. Methods Laparoscopic repair of inguinal hernia was conducted in 26 patients with chronic renal insufficiency who had received peritoneal dialysis for a long time. For indirect inguinal hernia, a piece of mesh was placed in the abdominal cavity and the internal ring was sutured and ligated under laparoscope. For direct inguinal hernia, the hernia sac was high suspended and then the mesh onlay was placed under laparoscope. Results The laparoscopy was successfully performed in all the 26 patients, without conversions to open surgery. No postoperative hematoma of scrotum or refractory neuralgia was observed. Follow-up examinations for 6~12 months (mean, 9 months) showed no recurrence. Conclusions Laparoscopic herniorrhaphy for inguinal hernia after peritoneal dialysis is feasible, effective, and safe.

Objective To stuey effects of coloprotectomy under colonoscopy combined with laparoscope on exfoliated tumor cells in abdominal cavity.Methods 42 cases of colorectal cancer proved by pathologic histology were devided into two groups randomly: Laparoscope Group(laparoscopic surgery) and Combined Group(colonoscopy combined with laparoscope surgery).Operation time,the positive rate of exfoliated tumor cells in abdominal cavity after and before operation,the positive rate of residual tumor cells in resection of operation specimen and postoperative complications between 2 groups were compared.Results Operation time of the Combined Group was shorter than that of the Laparoscope Group [(160.5?12.6) min vs.(201.2?18.4) min,t=-8.363,P=0.000].The positive rate of exfoliated cells in abdominal cavity before operation had no significant difference between the 2 groups[9.5%(2/21) vs.19.0%(4/21),?2=0.194,P=0.659],but the postoperative positive rate of exfoliated cells in the Combined Group was significantly lower than that in the Laparoscope Group[14.3%(3/21) vs.42.9%(9/21),?2=4.200,P=0.040].There were no residual tumor cells in resection of operation specimen of 2 groups.No infection of incisional wound and lung occurred.A follow-up for 6-24 months in the Laparoscope Group showed abdominal metastasis in 1 case.Conclusions Coloprotectomy for colorectal cancer under colonoscopy combined with laparoscope can decrease exfoliated tumor cells in abdominal cavity and shorten operation time.

Objective To evaluate the value of gemstone spectral imaging (GSI)and multi artifact reduction system(MARs)in re-ducing metallic implants artifacts,and find the best monochromatic images.Methods Twenty-one patients with metal implants in our hospital receievd GSI examination ,MARS reconstruction and polychromatic images(140 kVp).Eleven groups of monochromatic and MARS images were obtained from 40 keV to 140 keV every interval of 10 keV by the special GSI viewer ,respetively.Subjective image quality of two methods were assessed by 3 radiologists in consensus.For every patient one group monochromatic images and blend enery images were selected two heaviest artifacts level and no artifacts level,the CT value and the standard deviations(SD)value of the region of interest(ROI)were meatured of artifacts.Contrast-to-noise ratio(CNR)and artifacts index(AI)were also caculated and were analyzed with paired-t test.Results There was significant statistical differences of CNR between energy spectral images and blend energy images in energy level of 40 to 120 keV(P <0.05),while there was no difference in energy level of 130 to 140 keV (P >0.05),and the optimal CNR was acquired at the energy level of 70 keV(CNR=8.75±3.28).The value of AI for two mehtods has no difference in energy level scope 40 to 60 keV(P >0.05),there was significant statistical differences of AI between energy spectral images and blend energy images in energy level of 70 to 140 keV(P <0.05),and the lowest of AI(AI=26.95±9.64)was ac-quired at 1 10 keV images.Conclusion The energy spectral CT possess superiority in decreasing the artifacts and will provide high image quality in the metal implants.Gemstone spectral CT has great significance for postoperative patients with metal implants in imaging diagnosis.

Objective To study the positions and ways of displaying the panorama of the ossicles in one plane respectively by multi-direction adjusting multi-planar reformation (MPR). Methods Fifty normal middle ears were scanned by using the HRCT isotropic parameters, and multi-direction adjusting MPR was performed to find out the basic positions, the rotating central point of reformation basic line, and the anatomic structure orientated the adjusting directions. The angles between adjusting lines and reformation baselines were measured. The axial, coronal, sagittal and multi-adjusting MPR images were graded according to the display of the ossicles. Then Ridit analyses and X2 test were performed. Results The demonstrating ratios of the panoramas of the malleus, incus, and stapes in one plane in multi-adjusting MPR images were 100% (50 middle ear) . The ratios were higher than those of axial (6 stapes, 0 malleus, 0 incus) , coronal (3 malleus, 0 incus, 0 stapes) , and sagittal images (0 malleus, 0 incus, 0 stapes) (Ridit analysis, P

We reviewed medical data of 22 patients receiving intravenous thrombolysis therapy for acute isehemic stroke and evaluated our efforts of promoting intravenous thrombolysis for acute ischemic stroke.The mean in-hospital delay was 107 minutes.The most common reason was waiting for the results of laboratory tests.Only 6 cases received a standard dose of recombinant tissue plasminogen activator (rtPA) at 0.9 mg/kg.Only one patient had asymptomatic intracranial hemorrhage.No symptomatic hemorrhage occurred.Intravenous thrombolysis for ischemic stroke had excellent safety profile.Intravenous thrombolysis for ischemic stroke should be promoted under the guidance of standardized protocol according to the national guideline.

Objective To investigate the inhibitory effect of RNA interference on the expression of Aurora A in U251 cells, and the influence on proliferation and apoptosis of U251 cells. Methods The siRNA specific for Aurora A was synthesized and transfected into U251 cells in vitro. Aurora A mRNA expression and protein content were detected by RT-PCR and Western blotting respectively. The cell proliferation and apoptosis were observed by methyl thiazolyl tetrazolium(MTT) and flow cytometry(FCM). Transmission electron microscope was used to observe the ultrastructural changes of U251 cells. Results After transfection, the expression level of Aurora A mRNA was significantly decreased(P<0.01), and the protein content of Aurora A was also obviously reduced. The inhibitory rate of cell proliferation reached up to 67.57% 72 hours after transfection, which was significantly higer than that of normal control group(P<0.01). The apoptosis rate of U251 cells was significantly increased from (3.69±0.87)% to (15.34±2.16)% (P<0.01). Under the transmission electron microscope, it was observed that the U251 cells showed typical morphologic changes of apoptosis after transfection, such as karyopyknosis, chromatin condensation and margination, intracytoplasmic vacuoles formed, and apoptotic bodies formed. Conclusion The expression of Aurora A gene can be inhibited by siRNA successfully, and it results in the suppression of cell growth and induce apoptosis of human glioma cells in vitro. Aurora A may become a new target for the gene therapy of gliomas.

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