ObjectiveTo explore the clinical outcomes of posterior lumbar interbody fusion using BTwin expandable spinal spacer with microendoscopic discectomy (MED) for lumbar disc herniation accompanying degenerative instability.MethodsFrom March 2006 to May 2010,87 patients with lumbar disc heniation (only one level) accompanying degenerative instability were managed with posterior lumbar interbody fusion using B-Twin with MED,includeing 49 males and 38 females with an average of 47.6 years(range,37-65).Objective level located in L3,4 in 2 cases,L4,5 in 43,and L5S1 in 41.The patients were treated with single BTwin(Single group,n=51) and double B-Twin(Double group,n=36).Clinical outcomes were evaluated with surgical time,blood loss,visual analogue scale (VAS) scores,Oswestry disability questionnaire (ODI),and the pre- and post-operative disk space heights.ResultsThe patients were followed up for an average of 35.8months (range,12-46).All the patients felt the low back pain and radiation pain disappeared or relieved apparently.The mean preoperative ODI and VAS scores decreased from 78％±3％ to 18％±3％,and (8.70±11.3)to (0.65±10.48) at the final follow-up respectively.Disc space increased from a pre-operative height of (8.76±1.3) mm to a post-operative of (11.8±0.6) mm.ODI,VAS and the disk space heights in all patient showed statistical significance,which revealed no statistical significance between the two groups.However,the operation time,blood loss were statistical difference between the two groups.All the patients achieved solid union or probable union at a mean time of 5.6 months (range,3.9-8.6).ConclusionPosterior lumbar interbody fusion using B-Twin with MED can obtain satisfactory outcomes in the treatment of lumbar disc herniation accompanying degenerative instability.Single B-Twin can get similar clinical outcomes,but shorter surgical time,less blood loss,and less medical costs.

BACKGROUND: Most of the patients suffered from degenerative lumbar instability are treated by exposure both sides and bilateral pedicle screw fixation,which bring highly operative risk,large blood loss and great medical expenditure to patients.OBJECTIVE: To explore the clinical efficacy of single cage plus unilateral pedicle screw placement for treating lumbar degenerative instability.METHODS: Totally 51 cases with lumbar degenerative instability underwent single cage plus unilateral pedicle screw placement were selected,including 32 males and 19 females,aged ranging from 41 to 72 years.47 cases had single segment involved and 4cases had two segments involved.All cases experienced unilateral laminectomy and transforamenal lumbar interbody fusion.The therapeutic effect was assessed by Japanese Orthopaedic Association(JOA)score system.RESULTS AND CONCLUSION: The blood loss was 90-430 mL.The surgical time was 100 minutes(85-120 minutes)for single segment and 150 minutes(120-170 minutes)for double segments.The patients were allowed to early ambulation at 2-3 days after operation.Two cases did not get improvement on back-leg pain,but there was no abnormality from CT and MRI recheck,one case felt pain relieved after anti-symptom treatment for 3 months while the other did not relieve.The average JOA scores at pre-operation and 1 year follow-up was 11(7-13 scores)and 25(18-27 scores),respectively.The total improvement rate of JOA was larger than 50%.44 cases were evaluated as fusion and 7 cases as possible fusion.The average fusion time was 5.4 months(4.3-7.1 months).Postoperative X-ray showed no evidence of pedicle screw loosening,broken,or cage displacement.Single cage plus unilateral pedicle screw placement is characterized by simple operation,small blood loss,short operation and few interference to spine,which is a better method for treating lumbar degenerative instability.

Objective To study the clinical efficacy of intra-operative implantation of I125 seeds to treat advanced pancreatic cancer.Methods We retrospectively analyzed the clinical data of 28 patients who underwent intra-operative implantation of I125 between January 2009 and June 2010 to treat advanced pancreatic cancer.Patients who received conservative treatment (n =136) at the same period were used as the control group.Results The mean tumor diameter was (5.7 ± 1.7) cm.The average number of implanted seeds were 50.There were no patients who suffered from pancreatic fistula or post-operative bleeding,and no patient died from the treatment.Twenty-five patients were regularly followed up,and the follow-up rate was 85.7％.The survival rates at one month,half a year and one year were 100％,70.8％ and 26.9％,respectively.The average survival time was (9.9 ± 1.4) months.The survival data were significantly higher than that in the control group.Conclusion Intra-operative implantation of I125 seeds was an efficacious treatment for patients with advanced pancreatic cancer.

To evaluate the efficacy of a variety of lacrimal duct obstruction diseases treated by Nd: YAG laser lacrimal duct forming surgery using Meta analysis.
●METHODS: Relevant database in 1995 - 2012 and other network resources were retrieved by computer and manual, using MetaAnalyst software on the Meta analysis. Analysis of indicators: disease prevalence between men and women, the prevalence of various lacrimal duct diseases and the effective rate of Nd: YAG laser lacrimal duct forming surgery to treat a variety of lacrimal duct obstruction diseases.
●RESULTS: According to the inclusion and exclusion criteria, 38 subjects were selected, the cumulative number of patients included 4638 cases, the men combined prevalence was 23%; the women combined prevalence was 77%; lacrimal punctum occlusion combined prevalence was 6. 0%, combined treatment efficiency was 88. 1%; lacrimal canaliculus obstruction combined prevalence of 17. 9%, combined efficiency was 85. 6%;lacrimal common canaliculus obstruction combined prevalence was 14. 0%, 92. 7% of the combined effective rate; nasolacrimal duct obstruction combined prevalence of was 43. 6%, 93. 3% of the combined effective rate;chronic dacryocystitis combined prevalence was 18. 4%, 76. 6% of the combined efficiency. All study has heterogeneity. Selection of random effects model combined effect size. Model was statistically significant (P<0. 001).
●CONCLUSlON: The prevalence of lacrimal duct obstruction diseases of women are higher than men, lacrimal canaliculus obstruction in the lacrimal duct obstruction is in the lowest prevalence, nasolacrimal duct obstruction is the main type of lacrimal duct obstruction disease, Nd: YAG laser lacrimal forming surgery has slightly efficacy different in various lacrimal duct obstruction diseases.

Objective To evaluate the diagnostic value and clinical significance of 1.5T MR multiple sequence for atrial septal defect (ASD) and ventricular septal defect (VSD).Methods To collect the data of MRI and transthoracic echocardiography(TTE)of 46 patients with ASD/VSD,Among them,12 patients had surgical treatment,27 patientsDSA treatment and 7 patients no surgery or DSA treatment. The biggest defect diameter was recorded which measured by TSE,GRE,PC-MR and TTE,and the main deformity,valvular regurgitation, atrioventricular enlargement,cardiac function,maximum aperture of ASD/VSD were recorded which were confirmed by surgery.Al-so,myocardial delayed reinforcement was recorded.Results Multiple sequence check of MRI found different number of defects in 39 patients(7 patients without surgery or treatment removed );the largest defect aperture of ASD/VSD measured by TSE、GRE、PC-MR had no statistically significant(P >0.05)with TTE measurements,they had good correlation with TTE (r=0.86,0.94,0.99) (P >0.05),and PC-MR had the highest consistency with TTE.The measured results of GRE,TTE,surgical in 14 ventricular sep-tal defects of 12 cases had no statistically significant(P >0.05).the largest defect aperture between myocardial delayed reinforce-ment and not delayed reinforcement had statistically significant in 41 cases of ASD(P <0.05).MRI had more advantage in the right heart enlargement and right heart function than TTE,the differences between the two had statistically significant(P <0.05).And MRI could find intracardiac deformity and outside the heart malformation in ASD/VSD,especially outside the heart malformation. Conclusion 1.5T MR multiple sequence inspection have high diagnostic value for ASD/VSD,which can display ASD/VSD clearly, measure the defect aperture accurately,find merged deformity accurately,and can also show myocardial delayed reinforcement and judge heart function.

Objective To assess the efficacy and safety of tacrolimus (TAC) combined with methotrexate (MTX) for the treatment of refractory rheumatoid arthritis (RA),and to compare it with cyclophosphamide (CTX) added to MTX for the treatment of refractory RA.Methods Thirty-six cases of refractory RA patients were divided into the observation group and the control group.TAC+MTX were used in the observation group,and CTX+MTX were used in the control group.We used repeated measures to analyze the variance and Fisher exact probability method to analyze the efficacy at 8 weeks and 24 weeks.Results The effective rate of the observation group in 8 weeks,24 weeks were 77.8％(14 cases) and 100％(18 cases) respectively,while those of the control group were 11.1％ (2 cases) and 44.4％(8 cases),it showed that both TAC+MTX and CTX+MTX in the treatment of refractory RA were effective,but the efficacy of TAC+MTX was better than CTX+MTX,the difference of C reactive protein (CRP) and disease activity score (DAS)28 was statistically significant (P＜0.05),and it could significantly improve the clinical symptoms and laboratory indexes.Conclusion TAC+MTX is effective and safe in treating refractory RA,and is worth of spreading.

Abdominal Injuries ; complications ; Adenosarcoma ; etiology ; Adult ; Cicatrix ; complications ; Endometriosis ; complications ; Female ; Humans

With the advance of drug development and research techniques, the drug metabolic processes and mechanism can be more deeply achieved. As the drug metabolism and pharmacokinetics process are mediated by drug metabolizing enzymes and transporters, study of drug metabolizing enzymes and transporters has become an important part for drug development. The traditional immunoassays with low sensitivity and poor specificity can not reflect the accurate expression level of drug metabolizing enzymes and transporters. We now give a brief review on the quantitative study of drug metabolizing enzymes and transporters by mass spectrometry-based proteomic approach.
Enzymes ; chemistry ; Humans ; Inactivation, Metabolic ; Mass Spectrometry ; Membrane Transport Proteins ; chemistry ; Pharmacokinetics ; Proteomics

Objective To review the experience with mini-percutaneous nephrolithotomy (MPC NL) in early children and discuss its safety and indications. Methods Between Dec 2005 and Apr 2009, 34 boys and 22 girls aged 7 months to 36 months underwent MPCNL for upper urinary tract calculi. Clinical data were analyzed retrospectively. Results The mini-percutaneous renal access of 12 - 16 F was successfully established in 56 patients under realtime colour ultrasound guidance and immediate lithotripsy was performed. Average accessing time was 2. 9±0. 6 min, and stone management time was 13. 9±3. 2 min. No severe complication occurred. Stone free rate was 92. 5%. Conclusions MPCNL was highly effective to treat stone disease in this population. The indications for MPCNL in early children include large upper tract stone burden ( greater than 1. 5 cm ) , multiple renal calculi, staghorn calculi, stones with high-grade obstruction, and those could not be cleared by EWSL or other treatment conservatively.

OBJECTIVETo explore therapeutic effects of modified femoral prosthesis applied in the initial posterior stabilized total knee arthroplasty.

METHODSFrom April 1, 2012 to January 1, 2013, 156 patients with knee osteoarthritis underwent posterior stabilized total knee arthroplasty by the same director of orthopedic surgeon. Sixty-one patients were treated with modified femoral prosthesis, including 7 males and 54 females, with an average age of (68.34 +/- 5.41) years old; and 95 patients were treated with conventional designed femoral prosthesis, including 14 males and 81 females, with an average age of (69.92 +/- 5.11) years old. Indexes including age, body mass index, Insall-Salvati index, type of prosthesis, occurrence rate of patella click syndrome, postoperative line of force of lower extremity and postoperative function of the knee joint were observed and recorded. And American Knee Society (AKS) score was used to evaluate the clinical results.

RESULTSAll the patients were followed up, and the duration ranged from 36 to 56 weeks, with a mean of 45.31 weeks. Among patients in the conventional designed femoral prosthesis group, 7 patients had patella click syndrome, but there was no patient having patellar click syndrome in the modified femoral prosthesis group. Postoperative knee activity of patients in the modified femoral prosthesis group was (110.98 +/- 10.32) degrees, which was better than (107.05 +/- 8.61) degrees in the conventional designed femoral prosthesis group. The AKS score in the modified femoral prosthesis group was 129.79 +/- 9.63 during 21 to 28 days after operation, which was higher than 126.85 +/- 7.79 in the conventional designed femoral prosthesis group.

CONCLUSIONNew designed femoral components are effective to reduce the occurrence rate of postoperative patellar click syndrome and obtain better early functional recovery from knee surgery.

Aged ; Arthroplasty, Replacement, Knee ; adverse effects ; instrumentation ; Case-Control Studies ; Female ; Femur ; surgery ; Follow-Up Studies ; Humans ; Incidence ; Knee Joint ; surgery ; Knee Prosthesis ; Male ; Middle Aged ; Postoperative Complications ; epidemiology ; etiology ; Retrospective Studies