BACKGROUND:Percutaneous transforaminal endoscopic discectomy combined with radiofrequency annuloplasty is a minimaly invasive therapy for chronic discogenic low back pain, especialy suitable for lumbar disc herniation. OBJECTIVE:To evaluate the safety and short-term efficacy of percutaneous transforaminal endoscopic discectomy combined with radiofrequency annuloplasty for treatment of lumbar disc herniation. METHODS:Thirty-two patients with lumbar disc herniation were subjected to percutaneous transforaminal endoscopic discectomy combined with radiofrequency annuloplasty. Visual analogue scale and modified Macnab criteria were used to evaluate the relief of low back pain, and the Oswestry Disability Index was used for daily life evaluation of patients. Al the patients were folowed for 1-6 months, with an average of 3.5 months. RESULTS AND CONCLUSION:The operation was successfuly completed in al patients, and no complications such as damage to nerve and vascular systems occurred. Low back pain and living ability of the patients were improved obviously. Visual analog scale score and the Oswestry Disability Index were improved significantly after operation (P < 0.01); according to Macnnab's criteria, the results showed that at 1 week after the operation, the effective rate reached 94%; at 3 months after the operation, the effective rate was up to 97%. These findings indicate that percutaneous transforaminal endoscopic discectomy combined with radiofrequency annuloplasty in the treatment of lumbar disc herniation is confirmed in the short-term efficacy, and characterized as fewer complications and stable functional recovery.

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Objective To improve the resistance exercise apparatus of climbing ladder with load on rats, and to observe the technological, athletic training and biological response to the improved experimental apparatus.Methods Thirty-six healthy SPF male Sprague-Dawley were randomly divided into control and exercise groups.The climbing ladder and weight bearing device were separately improved to develop a new resistance exercise apparatus of climbing ladder with load on rats.The exercise group took an 8-week incremental exercise program using this improved device.To observe the operation effect of this improved exercise apparatus.To observe the dynamic changes of average maximum load on SD rats from the exercise group during 8 weeks.To compare the effect of climbing ladder exercise with load on body weights of SD rats between the two groups.Results The improved climbing ladder was marked by the prioritization technique of architecture stabilization, weight bearing and easy cleaning.The improved bearing device has the advantages of being sturdy and durable, and simplemethod to calculating load.Moreover, the new experimental apparatus can be operated by one person during the exercise program.The average maximum load was successfully increased to 756 g after an 8-week exercise using the improved apparatus.Compared with the control group, the body weights of SD rats from the exercise group after training were significantly reduced (P<0.05).Conclusions The improved resistance exercise apparatus of climbing ladder with load can provide a more endurable and repeatable process in the study of rat strength training and it is recommended to use this new device in future experimental research.

Objective To study the clinical application of laparoscope combined with gastroscope surgery in patients with gastric stromal tumor. Methods The clinical data of 50 patients with gastric stromal tumor were retrospectively analyzed. Among them 20 cases were treated with traditional laparotomy (laparotomy group), and 30 cases were treated with laparoscope combined with gastroscope surgery (combination group). The intraoperative bleeding, operation time, postoperative recovery time, postoperative hospitalization time and complications were compared between 2 groups. Results One case in combination group received open surgery (3.33%, 1/30), mainly because of obesity, and tumor rupture occurred in 1 case during operation. All specimens of the 2 groups had no tumor residue. There were no statistical differences in tumor diameter and operation time between 2 groups (P>0.05); the intraoperative bleeding, postoperative recovery time and postoperative hospitalization time in combination group were significantly lower than those in laparotomy group:(26.33 ± 14.21) ml vs. (42.57 ± 15.67) ml, (37.96 ± 8.80) h vs. (60.14 ± 13.41) h and (6.42 ± 2.80) d vs. (12.04 ± 4.69) d, and there were statistical differences (P<0.05). The 2 groups had no death, stomach bleeding, anastomotic stenosis and anastomotic leakage. The laparotomy group had postoperative incision fat liquefaction in 3 cases and incision infection in 2 cases, and the combination group had pulmonary infection in 1 case. All were cured after symptomatic treatment. Conclusions Laparoscope combined with gastroscope surgery in the treatment of gastric stromal tumors has a short operation time, less blood loss, faster postoperative gastrointestinal function recovery, shorter hospitalization time, and no major complications. It is a more ideal and minimally invasive surgery.

Objective Investigates expression of PTEN(Phosphatase and tensin homology deleted on chromosome ten , PTEN) in bladder transitional cell carcinoma (BTCC) and its clinical significance.Methods Fifty-one cases of bladder transitional carcino -ma, forty-two cases of Cystitis Glandularis(CG) and ten cases of normal bladder tissue 10 cases of normal bladder tissue were collect -ed.All samples were derived from cystoscopic biopsy and were subjected to histopathological examination to confirm the diagnosis .Im-munohistochemistry S-P methods is used to demonstrate the expression of PTEN .Results The positive rate of PTEN expression in BTCC, CG and normal bladder tissue are 58.8%, 81% 100%,and there is statistic significance ( P <0.01) among three groups.51 cases of BTCC are divided into group G Ⅰ ,GⅡ ,GⅢ and Tis -T1 ,T2-T4 ,and there is statistic significance among group G Ⅰ and GⅡ, GⅢ ( P <0.01),between group Tis -T1 and T2-T4 ( P <0.05).Conclusions The reduced expression or loss of PETN might play an important role in carcinogenesis and progression of bladder cancer .The positive rate of PTEN expression was negatively correlated to the clinical and grade staging of tumor .

Objective To investigate the blood perfusion characteristic of acute pancreatitis (AP) using multisection dynamic CT. To detect the changes of the perfusion parameters in patients with AP and assess the value of the perfusion parameters as severity indicators in AP. Methods 120 cases (34 cases of normal pancreas and 86 cases of AP) were examined for pancreatic perfusion from August 2006 to April 2008. The multisection dynamic CT perfusion series was performed by a multisection CT scanner (Siemens somatom Sensation 64) and the perfusion parameters, including BF, BV, TTP, PS, were collected and were compared with APACHE Ⅱ score, Ranson score, CRP, CTSI, time to abdominal pain cessation, length of hospital stay and complication rate for correlation analysis. Results The mean BF, BV, TTP and PS in AP patients were (113.57 ±50.04) ml · 100 mg~(-1) · min~(-1), (146.61 ±45.11) ml/L, (148. 88 ±21. 16) 0.1 s, (119.53± 52.36) 0. 5 ml · 100 ml · min , respectively; when compared with normal control, BF, BV decreased significantly (P<0.05) , while the change of TTP, PS were not statistically significant. Both BF and BV were correlated with APACHE II score, Ranson score, CRP, CTSI (P<0. 05) , as well as the time to abdominal pain cessation, length of hospital stay and complication rate (P < 0. 05). Conclusions Pancreatic vessel perfusion was decreased in AP. Both BF and BV were correlated with APACHE Ⅱ score and Ranson score, CRP, CTSI, and could be used to predict severity of acute pancreatitis.

OBJECTIVE To investigate the status of the management of nosocomial infection in Anhui Province so as to help to improve it.METHODS Twenty-four hospitals were on-the-spot investigated in a way of questioning and sampling using uniform questionnaire by trained investigators.RESULTS 95.83% Of all involved hospitals have built independent department of nosocomial infection management.These departments from 70.83% hospitals play an important role in infection management and 45.83% of them have suitable structure of staff.There are some problems in the key regions of nosocomial infection control such as operating room,blood dialyzing center and sterilization supply department: small work area,old equipment,irrational arrangement,sterilizing inadequately and so on.CONCLUSIONS The work of administration of nosocomial infections needs to be strengthened.

BACKGROUND:When the intervertebral disc is under stress, the hydraulic pressure generated inside the nucleus pulposus makes the annulus fibrosus extend outward and expand, and the annulus colagen fibers are stretched so that the extracelular matrix of annulus fibrosus cels is also under the pressure. In the intervertebral disc, aggrecan is the main component of proteoglycans, matrix metaloproteinase-2 is a major enzyme for extracelular matrix degradation, and tissue inhibitor of metaloproteinase is a multifunctional specific inhibition factor for matrix metaloproteinase activity. There is a mutual regulation between the latter two to keep the homeostasis between them.
OBJECTIVE: To investigate the mechanism of cyclic tensile strain in the metabolism of intervertebral disc annulus matrix.
METHODS:Rat anulus fibrosus cels were subjected to 2% or 10% cyclic tensile strain at 1.0 Hz for 2 and 12 hours using Flexcel4000 tension system. Then cels were colected and cultured in conditioned medium for gene and protein detection. Real-time quantitative PCR was used to detect mRNA expression of aggrecan, matrix metaloproteinases-2 and tissue inhibitor of metaloproteinase-2. Gelatin zymography was used to detect matrix metaloproteinases-2 activity.
RESULTS AND CONCLUSION:The use of 2% cyclic tensile strain had no obvious effect on the stress fiber of actin cytoskeleton, whereas actin cytoskeleton was depolymerized in response to 10% cyclic tensile strain. The 2% cyclic tensile strain raised the expression of Aggrecan at 12 hours; whereas raised the matrix metaloproteinases-2 and tissue inhibitor of metaloproteinase-2 at 2 hours, both of which were in homeostasis; matrix metaloproteinases-2 activity had no significant changes. 10% cyclic tensile strain had no effect on the mRNA expression of Aggrecan. No matter stretching 2 or 12 hours, the matrix metaloproteinases-2 was up-regulated, and the tissue inhibitor of metaloproteinase-2 was down-regulated, both of which were not in balance. Moreover, the matrix metaloproteinases-2 activity was not significantly changed. These findings indicate that the mRNA expressions of Aggrecan, matrix metaloproteinases-2 and tissue inhibitor of metaloproteinase-2 alter in response to cyclic tensile strain in rat anulus fibrosus cels, and the tensile strain induces different mechano-responses in the actin cytoskeleton.

The fovea avascular area (FAZ) is an area of the retina surrounded by a continuous capillary plexus that does not have any capillary structure of its own. FAZ is an important region for the formation of fine vision function. The changes of its morphology and surrounding capillary density reflect the degree of macular ischemia, and are closely related to retinal vascular diseases such as diabetic retinopathy, retinal vein occlusion, Coats disease, idiopathic macular telangiectasia, and retinopathy of prematurity. Early observation of FAZ region changes in patients with retinal vascular disease by optical coherence tomography angiography (OCTA) can evaluate the severity and prognosis of the disease. However, the measurement error of FAZ-related data is still a problem that cannot be ignored. At present, OCTA devices of various manufacturers have different methods and algorithms for measuring and analyzing FAZ, which makes it impossible to compare the measured data between different devices. It is believed that with the continuous progress of OCTA related technology, more accurate data of FAZ regional changes can be obtained, which will bring more help to clinical work.

Objective To evaluate the therapeutic efficacy and safety of endoscopic sphincterotomy (EST) combined with large balloon dilation for bile duct stones.Methods A total of 83 patients with common bile duct stones were randomly divided into 2 groups to receive standard EST (n =41,EST group) or EST plus large balloon dilation (n =42,EPLBD group),respectively.The number of endoscopic session,operation time,rates of successful complete stone retrieval,mechanical lithotripsy,and procedure related complication were compared between the two groups.Results The rate of early procedure-related complications was similar in 2 groups (9/41 vs.7/42,P ＞0.05),including perforation ( 1/41 vs.0/42,P ＞0.05),bleeding (5/41 vs.2/42,P＞0.05) and pancreatitis (3/41 vs.5/42,P＞0.05).The rate of successful complete stone removal was also similar in 2 groups (39/41 vs.41/42,P ＞ 0.05 ).However,EST group needed more procedure time (38.8 ±4.3 min vs.29.2 ±5.3 min,P ＜0.01 ) and use of mechanical lithotripsy to achieve complete stone removal (9/41 vs.2/42,P ＜ 0.05 ).Only one patient in EPLBD group ( 1/42,2.4％ ) needed a second ERCP to clear bile duct stone,while in EST group,8 patients underwent a second procedure ( 19.5％,P ＜ 0.05 ).Conclusion For endoscopic removal of common bile duct stones,EST combined with larg4e balloon dilation is as safe and effective as EST,while easier in manipulation.