Objective To investigate the therapeutic effect of ozone in treating the recurrent herniated lumbar disc after surgery.Methods Thirty-seven lumbar discs in 37 patinets with recurrent lumbar disc herniation after surgery were injected with ozone under CT-guided.The operative approaches were via lateroposterior position of lumbar vertebrae in 30 and via posterior position in 7 cases.Results The process of injection was done successfully in all patients.Followed-up for three months to one year after the treatment,the cases of clinical therapeutic efficacy of excellent results were 9,the cases of good results were 22,no changes in 6 cases.Conclusion Ozone in treatment of recurrent herniated lumbar disc after surgery is a safe and effective method.

Objective To observe the dynamic changes and the effects of Captopril on interstitial fibrosis in lung tissue of neonatal rats with lung fibrosis induced by hyperoxia. Methods Two hundred and forty neonatal Wistar rats were randomly assigned into model group, air control group, normal saline control and Captopril-trcated group (n=60 each).The air control group was exposed to room air (FiO2 = 0.21), and the rest three groups were continuously exposed to hyperoxia (FiO2 = 0.9) for 21 days. During the exposure, the Captopril-treated group received Captopril [ 30 mg/( kg·d) ] by intragastric administration, and the normal saline control group was administrated with normal saline instead, the model group did not receive any treatment. On the 1 st, 3 rd, 7 th, 14 th and 21 st day of exposure, the subjects were sacrificed. And then, the protein levels of collagen Ⅲ (Co-Ⅲ ) were measured by enzyme-linked immunosorbent assay and angiotensin Ⅱ(Ang Ⅱ )by radio-immunity technique, and the mRNA expression of Ang Ⅱ, Co- Ⅲ was measured by RT-polymerase chain reaction. The changes of lung histomorphology were observed. Results On the 14 th day, The Ang Ⅱ, Co- Ⅲ protein levels and their mRNA expression of modal group and normal saline control group increased significantly as compared to the air control group ( P < 0.05 ), except the Ang Ⅱ mRNA expression of normal saline control group. The Ang Ⅱ and Co-Ⅲ protein levels of model group was (838.22 ± 197.75 ) and ( 104.21 ± 43.37) ng/mg respectively, and normal saline control group was ( 759.97 ± 60.81 ) and ( 128.69 ± 54.74) ng/mg respectively on the 21 st day, their mRNA expression of two groups also increased to the peak on the 21 st day(P< 0.05).The AnglI and Co- Ⅲ protein levels of Captopril-treated group was (554.52 ± 59.32) and (39.90 ± 13.45) ng/mg on the 21 st day respectively, their mRNA expression was (1.50 ± 0.84 ) and (1.13 ± 0.55) respectively, and decreased significantly as compared to the model group and normal saline control group respectively (P<0.05), but increased significantly as campared to the air control group (P < 0.05). The histopathological examination demonstrated different degrees of alveolitis, broaden interstitium and reduced alveolar quantity in the model group and normal saline control group compared with air control group. The pathological changes were markedly alleviated in the Captopril-treated group. Conclusion Captopril may have protective effects on lung injury induced by hyperoxia.

Objective To analyze the early clinical efficacy of alendronate sodium on residual pain after vertebral angioplasty for osteoporotic vertebral compression fractures.Methods By drug single treatment method,a total of 30 elderly patients with residual pain after vertebral angioplasty for osteoporotic vertebral compression fractures were included.Patients were randomly divided into 2 groups:the treatment group and the control group.All patients were given calcium carbonate D3 treatment,and the treatment group was given alendronate sodium treatment additionally.6 weeks after the treatment,visual analogy score (VAS) was used for the evaluation of pain relief.Results All patients were followed up for 6 weeks.At the end of follow-up,the rates of pain relief were 86.8％ in treatment group and 13.2％ in control group.There was a significant difference in visual analogy scores between the treatment group and the control group[(0.51±0.32),(1.59±1.21) ; t=3.4,P＜0.001],which showed the degree of pain relief was higher in the treatment group than in control group.Conclusions Alendronate sodium is effective and reliable for the treatment of residual pain after vertebral angioplasty for osteoporotic vertebral compression fractures.This study provides the scientific reference for the treatment and research of residual pain after vertebral angioplasty for osteoporotic vertebral compression fractures.

Objective To investigate the influence of Chinese medicine ( CM) treatment on life span of middle-late primary hepatic carcinoma (PHC) patients. Results A multicenter retrospective cohort study was carried out in 489 PHC patients at the stages of Ⅱb, Ⅲa and Ⅲb collected from 15 domestic hospitals. With CM treatment as the exposure factor, the enrolled patients were divided into CM group, western medicine (WM) group and the CM-WM combination group. The main outcomes included median survival time (MST) and survival rate, and the effects of CM treatment and minimally invasive therapy on MST were observed. Results Half-a-year survival rate, one-year survival rate and two-year survival rate were 50%, 9%, 1% in CM group, 70%, 30%, 6% in CM-WM combination group, and 50%, 10%, 0% in WM group, respectively. The survival rates in CM-WM combination group differed from those in CM group and WM group (P<0.01), but the differences of survival rates between CM group and WM group were insignificant (P>0.05) . MST at the stages of Ⅱb, Ⅲa, Ⅲb in CM-WM group was obviously prolonged as compared with the other two groups (P<0.01), and MST at the stages of Ⅲa, Ⅲb in CM group was also obviously prolonged as compared with WM group (P<0.05) . The difference of MST at the stage of Ⅱb was insignificant between CM group and WM group ( P>0.05) . CM treatment and minimally invasive therapy were effective on prolonging the survival time of PHC patients ( P<0.01) . The results of COX regressionanalysis showed that Karnofsky scores, CM treatment and minimally invasive therapy were the preventive factors for the prognosis. Conclusion CM-WM combination group has the best long -term therapeutic effect. CM -WM combination treatment is effective on increasing MST and long-term survival rate, in particular for PHC patients at the stages ofⅡb, Ⅲa and Ⅲb. CM treatment and minimally invasive therapy are helpful for the prolongation of the survival time of PHC patients.

Objective To evaluate the value of real-time three-dimensional echocardiography(RT-3DE)in diagnosing congenital tricuspid valve anomaly.Methods Eighteen patients with congenital tricuspid valve anomaly were studied by RT-3DE,the spatial framework and neighboring structures of the tricuspid valve were analyzed and compared with result of the operation.Results The anomaly of tricuspid,chorda tendineae,the papillary muscle and their connection with neighboring structures could be displayed clearly from different directions.The diagnose accordance rate of RT-3DE was 83%.Conclusions RT-3DE may provide more information on congenital tricuspid valve anomaly than 2DE.

Objective To observe the clinical curative effect of Ⅲb~Ⅳstage non-small cell lung cancer treated by radiofrequency ablation combined with chemotherapy. Methods Forty-eight Ⅲb~Ⅳstage non-small cell lung cancer patients were divided into the study group (RFA + chemotherapy) and 74 were in control group (chemotherapy alone) by the method of non randomized controlled. Curative effect was evaluated every two cycles during the treatment. A 6 to 36 months follow-up was conducted after the treatment. Results The objective response rate of experiment group and control group was 58.3%and 41.9%respectively (P>0.05) with no significant difference and disease control rates of experiment group and control group were 91.7% and 75.7% respectively (P<0.05). MST were 14.4 months and 8.2 months respectively (P<0.01), with statistically significant differences in experiment group and control group and clinical benefit efficient were 87 . 5% and 66 . 2% respectively ( P < 0.05). Conclusion The treatment of radiofrequency ablation combined with chemotherapy for advanced non-small cell lung cancer can significantly improve the patient′s survival and the clinical curative effect.

Objective To observe the morphological changes of pancreatic tissue of thoracic duct ligated rats in fine and ultrastructural levels, and to determine whether lymph block animal model can affect pancreatic islet amyloid polypeptide(PIAP)deposit in rat pancreas. Methods At the 6th month after the operation, some pancreatic tissue sections of 16-month-old experimental rats were embedded in paraffin wax and stained with HE and Congo red;immunohistochemical staining was performed on some frozen sections, which were then observed with light microscope;transmission electron microscope (TEM) specimen preparation and observation were performed on other samples. Results HE and Congo red stained sections showed that the pancreatic glandular lobule space was widened, with significant connective tissue hyperplasia, and fat accumulation when the islet was stained indistinctly or vermeil and tissue space was broadened. The sections with immunohistochemical staining displayed the pancreatic islet as well as the tissues around it were stained into dark brown being positive with PIAP antigen. TEM observation showed the pancreatic glandular interlobule space was widened, while blood vessels and enlarged lymphatic vessels were visible;within widened pancreatic islet interstitial space, a great quantity of lipid droplets and some collagen fibril structures could be seen.Conclusion The ligation of thoracic duct can contribute to pancreatic lymph draining block, lymphagiectasis, connective tissue space and interstitial space widening, fat accumulation, and PIAP deposit in rat pancreas. These structural changes may affect the function of pancreatic islets.

Objective To evaluate the efficacy of computed tomography ( CT ) and diffusion?weighted magnetic resonance imaging ( DWMRI ) in the diagnosis of regional lymph node metastasis in thoracic carcinoma, and to figure out the methods and thresholds for delineation of lymph nodes with higher reasonability and accuracy. Methods A total of 43 patients with thoracic carcinoma, including 35 patients with esophageal cancer and 8 patients with non?small cell lung cancer, were enrolled as subjects from 2012 to 2013. All patients received abdominal CT scan and DWMRI examination one week before surgery, and regional lymph node metastasis was diagnosed based on the images of CT scan or DWMRI. With the postoperative pathology as the gold standard, the diagnostic efficacy was evaluated and compared between the two methods. The two sets of obtained images were analyzed using the χ2?test. Results The sensitivity, specificity, accuracy, positive predictive value, negative predictive value, and Youden’ s index of CT versus DWMRI in the diagnosis of regional lymph node metastasis were 57?1% vs. 60?0%, 96?3% vs. 98?9%, 93?8% vs. 96?5%, 50?0% vs. 77?8%, 97?2% vs. 97?4%, and 53?4% vs. 58?9%, respectively;the specificity, accuracy, and positive predictive value of DWMRI were significantly superior to those of CT ( P=0?005,0?038,0?022) . Twenty out of forty lymph nodes diagnosed by CT scan were false positive, and 15( 75%) of them could be corrected by DWMRI. Fifteen out of forty lymph nodes diagnosed by CT scan were false negative, and 3 ( 20%) of them could be recognized by DWMRI. In all 35 metastatic lymph nodes, 5 lymph nodes had no apparent swelling on images, and 13(43?3%) out of the other 30 lymph nodes had a short diameter less than 1?0 cm. Conclusions CT scan has apparent limitation in the diagnosis of regional lymph node metastasis. Many metastatic lymph nodes would be missed if a short diameter not less than 1? 0 cm is the only standard for target volume delineation . With superior specificity , accuracy , and positive predictive value to CT in the diagnosis of regional lymph node metastasis, DWMRI can effectively rule out non?cancerous intumescent lymph nodes and recognize some of small metastatic lymph nodes.

OBJECTIVE:To screen the optimal micronization technology of Alitretinoin crude drug. METHODS:Using characteristic value of particle size distribution [d(0.9)] and the content of impurity A of crude drug after crushed as indexes, crushing method(universal pulverizer,ball crusher,airslide disintegrating mill),crushing gas source(compressed air,high pressure nitrogen)and crushing pressure(0.2,0.4,0.6 MPa)of Alitretinoin crude drug were screened,and validation test was also conducted. RESULTS:The optimal technology was as follows as airslide disintegrating mill,high pressure nitrogen as gas source,at 0.4 MPa.In validation test,particle sizes for 3 batches of crude drug after crushed were 8.57,8.55,8.54 μm(<10 μm, RSD=0.15%,n=3). The content of impurity A was not increased compared with before crushed(0.07%). CONCLUSIONS:Screened micronization technology of Alitretinoin crude drug is feasible and stable in quality.

The current recommendation for postoperative radiotherapy for esophageal cancer in China is mainly based on the data of incomplete two-field dissection of open left thoracotomy. At present, the type of surgery for esophageal cancer gradually transitions from open left thoracotomy to open right thoracotomy and from open esophagectomy to minimally invasive esophagectomy (MIE). Patients with early-stage esophageal cancer are selected as candidates for MIE. MIE is less invasive than open esophagectomy, and the right thoracic approach is conducive to more thorough lymph node dissection. However, few data and related studies are available on the patterns of failure after MIE in esophageal cancer, and guiding an adjuvant therapy is difficult. The feasibility of an adjuvant therapy for selective high-risk patients and the optimized treatment after MIE remains to be explored in clinical practice. In this regard, this article aims to review the safety of MIE, long-term survival outcomes, postoperative recurrence patterns, and recurrence rates of patients to discuss the value of postoperative adjuvant therapy and guide clinical treatment.