BACKGROUND:Spinal canal decompression and fusion combined with pedicle screw fixation has become the main method for the treatment of thoracolumbar fracture and dislocation. OBJECTIVE:To restore the vertebral height of the patients with thoracolumbar fracture and dislocation who underwent subtotal resection and decompression through titanium cage packed with autologous cancel ous bone and pedicle screw fixation. METHODS:Thirty-one patients with thoracolumbar fracture and dislocation treated in the Shanghai 6th People’ s Hospital of Shanghai Jiao Tong University from February 2007 to September 2011 were selected. Al the patients received subtotal resection, spinal canal decompression and titanium cage packed with autologous cancel ous bone and pedicle screw fixation. Imaging examination was performed before and after treatment to observe the recovery of vertebral sequence, vertebral height and Cobb angle, as wel as the recovery of nerve function. RESUTLS AND CONCLUSION:The patients were fol owed-up for 12 months, and al the patients healed wel after treated with titanium cage packed with autologous cancel ous bone and pedicle screw fixation, and there was no loosening, shedding or breakage after pedicle screw fixation. During reexamination, the grafts fusion, good deformity correction, basic recovery of vertebral height and good recovery of Cobb angle were observed. Seven cases had neurological function recovery, and among them, six cases raised for one degree, one case raised for two degrees, and another 22 cases without recovery. Case analysis and relative researches showed that subtotal resection and decompression and titanium cage packed with autologous cancel ous bone and pedicle screw fixation can reduce the loss of correction of the patients with thoracolumbar fracture and dislocation, restore the vertebral height, and enhance the stability of the vertebral body.

Objective To analyse the treatment,clinical features and prognosis of chronic lymphocytic thyroiditis combined with thyroid cancer.Methods Retrospectively analysed 40 cases with chronic lymphocytic thyroiditis combined with thyroid cancer,admitted to the Department of General Surgery of the First Affiliated Hospital of Dalian Medical University from November 2002 to April 2011.All the 40 patients were female.Results Ultrasound diagnosis or suspected diagnosis of chronic lymphocytic thyroiditis was made in 2 patients.Eleven patients underwent CT examination,and 2 patients were found with thyroid adenoma,1 patient found with thyroid cancer and lymph node metastasis,3 patients with chronic lymphocytic thyroiditis.Forty patients underwent surgical treatment,pathological results of 39 patients showed chronic lymphocytic thyroiditis with thyroid papillary carcinoma,1 patient was medullary thyroid carcinoma combined with chronic lymphocytic thyroiditis.Forty patients were administrated levothyroxine tablets.Thirty-six patients were followed up,4 patients were lost,1 relapsed,the others were in stable condition.Conclusions Preoperative diagnosis is difficult for chronic lymphocytic thyoiditis combined with thyroid cancer,which needs through the thyroid antibody tests,imaging examinations and intraoperative,postoperative pathologic examination and other means of comprehensive application.The method of definitive diagnosis for CLT combined with TC is intraoperative,postoperative pathologic diagnosis.The main pathological type is papillary thyroid carcinoma,which small papillary carcinoma occupies a large proportion.Surgery is the main treatment for CLT combined with TC.

Objective To evaluate the value of proton magnetic resonance spectroscopy(~1H-MRS))and diffusion tensor imaging(DTI)in minimal hepatic encephalopathy(MHE).Methods Twenty-nine with cirrhosis(15 cases with MHE diagnosed according to number-connection test A and digital symbol test and 14 age-matched controls underwent ~1H-MRS and DTI examinations.~1H-MRS of left basal ganglia were acquired using STEAM sequences.Peak area of each metabolite,including NAA,Cr,Cho,mIns and Glx and their ratios to Cr were measured,respectively.Fractional anisotropy(FA),mean diffusivity(MD)were calculated in deep gray matter nuclei and mainly white matter regions in both cerebral hemispheres.The MD and FA values from different regions in different groups were compared.Results NAA/Cr and Glx/Cr levels showed no significant difference among the groups(P＞0.05).Ratios of mIns/Cr and Cho/Cr showed no differences in MHE group compared to controls(P＞0.05),whereas were significantly different in MHE and cirrhosis without MHE(P＜0.05).The MD values from different regions had a significant difference among various groups(P＜0.05),and there were no significant changes in FA among the groups(P＞0.05).Significantly increased MD was found in five regions of brain in MHE and only caudate nuclei in cirrhosis without MHE compared to controls.Conclusion Patients with MHE have abnormal metabolite changes in basal ganglia;the increase in MD with no concomitant changes in FA in cirrhosis with MHE that indicates the presence of reversible interstitial brain edema.MRS and DTI may be sensitive tests for detecting MHE.

BACKGROUND:Animal models can be used to study specific scientific problems of intervertebral disc biology.Model of disc degeneration is mainly used to resolve the relevant disease mechanisms and scientific and security issues of the treatment.OBJECTIVE:To summarize currently used experimental animal models of intervertebral disc degeneration study,and to dynamically observe and confirm the pathological process of disc degeneration based on disc imaging,morphology,biomechanics and bi(o)chemicel changes.METHODS:Using "intervertebral disc degeneration,animal models,in vivo,in vitro" in English as the search words,Cochrane Library (No.1 2009),Cochrane Library Database of Controlled Clinical Trials (No.1 2009),MEDLINE from 1990 to March 2009,EMbase from 1990 to March 2009,Current Controlled Trials,and the National Research Register were retrieved.Literature was limited to English language.The disc imaging,morphology,biomechanical end biochemical composition and other indicators,as well as the pathological process of disc degeneration served as the evaluation indices.The articles related to the intervertebral disc cell culture models,the whole disc tissue culture model,mechanical model,injury model,biological model,genetically modified models,spontaneous models were included.The repetitive researches and those unrelated to animal models of intervertebral disc degeneration were excluded.RESULTS AND CONCLUSION:The establishment of a reliable animal model can provide favorable conditions for studying the pathogenesis of intervertebral disc degeneration,at the same time,provides a good experimental vehicle for various researches about the repair treatment of intervertebral disc degeneration.Animal models of intervertebral disc degeneration can be divided into two categories:in vitro models and in vivo models of disc degeneration and repair.The former can be assigned into disc cell culture models and whole disc tissue culture model;the latter is assigned into mechanical models,injury models,biological models,genetically modified models,spontaneous models and so on.The above models are commonly used in the study of the occurring mechanism of disc degeneration,as well as the feasibility and effectiveness of a variety of treatments.However,there is still no generally accepted animal models as an ideal disc degeneration model,various types of models reported have their own advantages and disadvantages.

Mitochondrial aldehyde dehydrogenase(ALDH2),one of the isoforms of aldehyde dehydrogenase,has multiple enzymatic functions including the activity of dehydrogenase and esterase.The metabolisms of ethanol,amino acids,biogenic amine,vitamin or steroid in the body produce various substances of aldehyde.With the help of co-factor NAD(P)+,ALDH2 can convert aldehydes into corresponding carboxylic acid,which plays a key role in reducing toxic effects of aldehydes on the body.It does not need co-factor when ALDH2 works as esterase.It can convert carboxylic ester or other acids into corresponding carboxylic acids or alcohols.Recently,it has been shown that the decrease of ALDH2 activity exacerbates multiple factors(such as ethanol,ischemia)-induced myocardial injury and accelerates the development of nitroglycerin tolerance.Therefore,the development of specific agonists of ALDH2 may provide a novel approach to the therapy and prevention of heart diseases.

Objective To investigate the effect of steroid receptor coactivator family in initiation, development, treatment and prognosis of breast cancer. Methods The literatures in recent years which have related to the effect of steroid receptor coactivators in breast cancer are reviewed. Results Steroid receptor coactivators are essential for several kinds of steroid hormones binding to steroid receptors, so they are important accessory factors that induce the initiation, development and recurrence of breast cancer, and predictive factors that estimate the prognosis of breast cancer. Conclusion Inhibition of the expression and signaling pathway of steroid receptor coactivators may be effective for breast cancer prevention and treatment.

Necrosis is also tightly controlled by signaling path-ways,thus it is called as regulated necrosis,which includes ne-croptosis,ferroptosis,parthanatos and CypD-mediated necrosis. It has been shown that regulated necrosis is closely related to the occurrence,development and prognosis of injury-relevant disea-ses such as myocardial infarction,stroke,neurodegenerative dis-eases.It will be significant for prevention and therapy of injury-relevant diseases to clarify the signal transductions and regulatory mechanisms for the regulated necrosis.

Objective To investigate the clinical efficacy and safety of alteplase thrombolysis in the treatment of patients with acute ischemic stroke.Methods 42 patients with acute ischemic stroke were randomly divided into the control group and the study group.1 8 cases in the control group were treated by urokinase thrombolysis, and 24 cases in the study group were treated by alteplase thrombolysis.The clinical efficacy and safety were compared between the two groups.Results The total effective rate of the study group(91 .7%)was higher than that of the con-trol group(77.8%),and the difference was statistically significant(χ2 =9.7,P <0.01 ).Compared with the control group,the total vascular patency rate was higher,the difference was statistically significant(χ2 =97.6,P <0.01 ).The NIHSS score was lower in the two groups after treatment(t =1 0.1 58,1 5.962,all P <0.05),and that in the study group was more lower,the difference between the two groups was statistically significant(t =1 0.564,P <0.05 ). Conclusion Alteplase thrombolysis in the treatment of acute ischemic stroke patients,thrombolytic therapy for patients,in the use of drugs within the time window patients can get good clinical curative effect,no more than drug use the most extensive restrictions rarely cause patients with intracranial hemorrhage,and being suitable for populari-zation and application.

Objective: To study therapeutic effect of atorvastatin on patients with asymptomatic heart failure (AHF) after myocardial infarction, and its influence on prognosis.Methods: Clinical data of 100 AHF patients after myocardial infarction, who were treated in our hospital from Jul 2014 to Jul 2015, were analyzed.According to random number table, patients were randomly and equally divided into routine treatment group and atorvastatin group (received atorvastatin based on routine treatment).Cardiac function indexes, plasma levels of BNP and N-terminal pro B-type natriuretic peptide (NT-proBNP), 6min walking distance (6MWD) and cardiac function score were measured and compared between two groups before and after treatment.Course of treatment was one year.Results: Compared with before treatment, after treatment, there were significant rise in left ventricular ejection fraction (LVEF) and 6MWD, and significant reductions in left ventricular end-diastolic dimension (LVEDd), left ventricular end-systolic dimension (LVESd), plasma levels of BNP and NT-proBNP, and cardiac function score in both groups(P=0.001 all).Compared with routine treatment group after treatment, there were significant rise in LVEF [(52.48±8.65)% vs.(57.86±9.70)%] and 6MWD [(262.60±12.40)m vs.(282.65±15.50)m], and significant reductions in LVESd [(36.23±2.13)mm vs.(30.08±2.05)mm], LVEDd [(58.61±6.40)mm vs.(51.25±6.18)mm], plasma levels of BNP [(267.48±42.10)pg/ml vs.(149.40±32.30)pg/ml] and NT-proBNP [(524.65±138.60)pg/ml vs.(406.20±112.45)pg/ml], and cardiac function score [(2.30±0.22) scores vs.(1.15±0.10) scores] in atorvastatin group(P<0.01 all).Conclusion: Atorvastatin can alleviate left ventricular remodeling, reduce plasma levels of BNP and NT-proBNP, and improve cardiac function in AHF patients after myocardial infarction, which is worth extending.

Concepts and techniques of spinal fusion as a therapeutic modality may date back to the origins of spinal surgery. Spinal fusion has been considered as the standard treatment of progressive deformities,including instability,scoliosis and trauma. In this study,we shall attempt to define and review the bone graft materials,progress on the operative techniques,postoperative complications and related therapy,the latest dynamic fixation,and minimally invasive technique to lumbar spine fusion.