Objective To compare the clinical efficacy of minimally invasive percutaneous pedicle screw fixation and posterior paraspinal muscle space approach pedicle screw fixation for the treatment of thoracolumbar fractures.Methods Retrospectively analyzed the clinical data of 29 patients treated via minimally invasive percutaneous pedicle screw fixation(minimally invasive group) and 28 patients treated via posterior paraspinal muscle space approach pedicle screw fixation(paraspinal muscle approach group) from March 2013 to October 2015.The anterior vertebral height ratio,sagittal Cobb angle,surgical incision,operation time,number of fluoroscopy,intraoperative blood loss and ODI and VAS scores were compared between the two groups.Results All patients were followed up for an average period of 12.6 months (ranged from 6 to 18 months).At the end of 3 days,3 months and 12 months after operation,vertebral sagittal index and Cobb angle of the two groups were significantly recovered compared with the preoperative data(P<0.05),and the ODI and VAS scores were significantly lower than those before the operation,but the above indicators had no significant difference between the two groups(P>0.05).The surgical trauma and intraoperative blood loss of patients in the minimally invasive group were significantly lower than those of the paraspinal muscle approach group,while the operation time and fluoroscopy times were significantly higher than those of the paraspinal muscle approach group,and the differences were statistically significant(P<0.05).Conclusion Minimally invasive percutaneous and paraspinal muscle approach pedicle screw fixation are both effective,safe and reliable.Paraspinal muscle approach pedicle screw fixation has shorter operation time and easier operation,while minimally invasive percutaneous pedicle screw fixation has less trauma,less bleeding and faster postoperative recovery.

Objective To discuss the method and surgical technique in treatment of the displaced acetabular fracture.Methods The study involved 66 patients with displaced acetabular fracture treated operatively with reconstruction plates from August 2005 to June 2009.Based on the fracture typing,the surgical techniques including anterior ilioinguinal,posterior Kocher-Langenbeck,combined ilioinguinal and Kocher-Langenbeck and Y shaped approach were performed in 12,30,22 and 2 patients,respectively.Results The operation time was mean 3.4 hours(1.5-6.5 hours),with mean blood loss of 550 ml(range,350-1 200 ml).All patients were followed up for average 29 months(range,12-46 months).According to Matta evaluation standard,the reduction of acetabular fracture was anatomical in 34 patients,imperfect in 25 and unsatisfactory in seven.According to the modified Merled' Aubigne and Postel clinical evaluation standard,the clinical outcome was graded as excellent in 23 patients,good in 29,fair in eight and poor in six.Conclusion The factors key to successful operation include correct fracture classification,good approach anatomy,proficient technique of reduction and fixation,and reasonable perioperation measures.

Objective To investigate the effect of isoflurane anesthesia during early pregnancy on the cognitive function of offspring rats.Methods Thirty SD rats at 5-7 day gestation were randomly divided into 3 groups ( n =10 each):control group (group C) and 2 isoflurane groups (groups Ⅰ1,Ⅰ2).Groups Ⅰ1 and Ⅰ2 inhaled 1.4％ isoflurane in O2 for 4 and 8 h respectively while group C inhaled 95 ％ O2 for 8 h.At 20 and 30 days after birth,offspring rats from 5 pregnant rats were tested for learning and memory abilities using Morris water maze.The offsprings were sacrificed at 7 days after test and their hippocampi were isolated for determination of N-methyl-D-aspartate receptor subunit 2B (NR2B) mRNA and protein expression.Results There were no significant differences in the results of Morris water maze test and NR2B mRNA and protein expression among the three groups.Conclusion Isoflurane anesthesia during early pregnancy has no effect on the cognitive function of the offspring rats.

AIM: To observe the effects of hypoxia on the levels of nitric oxide (NO), endothelin (ET-1) and the expression of inducible nitric oxide synthase (iNOS) mRNA in human umbilical vein endothelial cells (HUVECs), and further investigate the mechanism of hypoxic pulmonary hypertension. METHODS: On the basis of the HUVECs culture model, the methods of nitrate reductase and radioimmunoassay were used to determine the changes of NO and ET-1 in the medium secreted by HUVECs, and the expression of iNOS mRNA was analyzed by semi quantitative RT-PCR after exposure to hypoxia (3% O_2) for 6, 12 or 24 h. RESULTS: The contents of NO_2-/NO_3-and ET-1 in hypoxia group in the medium was significantly higher than that in control group at different time points (P

AIM: To investigate the effect of Salidroside on the proliferation, DNA synthesis, intracellular Ca 2+ content of rabbit PASMC (pulmonary artery smooth muscle cells) under hypoxia. METHODS: Techniques of cell culture, MTT test, -TdR incorporation, fluo-3 and confocal laser scanning microscopy were used. RESULTS: The A value of MTT and -TdR incorporation of PASMC increased significantly by 62% (P

AIM: To study the effects of Rhodiola(Rho), nitric oxid e (NO), hem oglobin (HB) on the multiple organ dysfunction syndrome(MODS) in early stage aft er burn in rabbits. METHODS:The rabbits were divided into the sh am burn group (SB), burn group (B), orally taken Rho group (R), burn and Rho therapy group (BR ). The changes of hemodynamics were monitored. The index of pulmonary permeabili ty was calculated. These data reflected separately the functions of heart, live r, lung, kidney and blood coagulation system were also determined. NO contents i n ser um and bronchoalveolar lavage fluid (BALF) were measured by Griess method. The l e vels of serum HB were measured. RESULTS:① The dysfunctions of hear t, liver and kidney achieved the criterion of MODS in group B at 48 h postburns (B 48 h ). The N O content of group B significantly increased in serum and BALF at B 48 h . ② The cardiac index (CI) and creatine phosphokinase (CK), urea nitrogen (BUN) markedly raised or decreased in group BR at 48 h postburns (BR 48 h ) than B 48 h . The NO cont ents in serum and BALF markedly raised. ③ HB contents in serum markedly raised in group B and BR at 0 h postburns (B 0 h , BR 0 h ) than group SB, B 48 h , R, BR 48 h , but NO was reverse. CONCLUTIONS: ① HB contents in serum markedly raise d at 0 h post burns, but NO was reverse. ② Rho promoted the increases of NO synthesis and the blood perfusion of organs, which might be one of mechanisms to prevent the devel opment of MODS.

Objective To understand the clinical features of candidemia.Methods A retrospective analysis was performed based on the data of 88 candidemia cases treated in Huashan Hospital during the period from 2007 to 2012.The clinical data were re-viewed in terms of species distribution,underlying diseases,clinical manifestations,treatment and outcomes.The prognostic factors were analyzed by chi-square test or Fisher exact probability test.Multivariate analysis was conducted by multiple Logis-tic regression.Results Candida albicans (40/88,45.5%)was the most common pathogen isolated from these candidemia ca-ses,followed by Candida tropicalis (20/88,22.7%),Candida parapsilosis (17/88,19.3%),Candida glabrata (10/88, 11 .4%),and Candida krusei (1/88,1 .1 %).Solid malignancy,diabetes,and surgical procedure were the most frequently identified underlying diseases.Fatal or deteriorative outcome was reported in 28 cases.The attributable mortality was 18.2%. Multivariate prognostic analysis indicated that presence of central venous catheter (OR:6.322,95% CI :1 .055-37.891 ,P =0.044)was independently correlated to increased mortality.Appropriate antifungal therapy was an independent predictor of de-creased overall mortality (OR:0.137,95% CI :0.039-0.480,P =0.002).Conclusions The pathogen distribution of candi-demia has changed slightly.Appropriate antifungal therapy plays a key role in the treatment of candidemia.

Objective To explore the application value of 320-slice spiral CT myocardial perfusion technique in the evaluation of cardiac function in patients with coronary artery disease.Methods 24 patients with known reversible myocardial ischemia with coro-nary heart disease and 13 cases of normal were detected by 320-slice spiral CT myocardial perfusion scan in resting and after dobu-tamine-induced stress,measured the values of cardiac function indexes(ESV、EDV、SV、EF)in resting and after dobutamine-induced stress respectively,the results were analyzed by paired t test and independent sample t test,when the P value is less than 0.05,con-sidered statistically significant or correlation.Results The values of cardiac function indexes (ESV,EDV,SV)between the resting and after dobutamine-induced stress were significantly different except EF value in normal group.But only the EF value was signifi-cantly different in CHD,the rest values of cardiac function indexes(ESV,EDV,SV)no significant difference.Each corresponding value of cardiac function indexes in resting and after dobutamine-induced stress was significantly different between the CHD and the normal.Conclusion The dobutamine-induced stress myocardial perfusion with 320-slice spiral CT can judge the impaired degree of cardiac function in patients with myocardial ischemia,provide the basis for comprehensive evaluation of coronary artery disease and its prognosis.

Purpose:To discuss the relationship between the extent of red pseudocolor of pseudocolor CT image and MVD in lung carcinoma.Materials and Methods: The CT angiography was performed by using 16-slices spiral CT in 25 cases with pulmonary carcinoma,proved by pathology.Pseudocolor VR of tumor lesions of pulmonary carcinoma was performed.The immunohistochemical test of MVD of tumor lesion of pulmonary carcinoma was performed in 25 cases.The relation between the extent of red color on pseudo color VR and MVD of tumor lesion of pulmonary carcinoma were analyzed.Results: The extents of red pseudocolor of tumor lesion on VR pseudocolor Imaging were divided to four types: heavy ( n = 5 ),moderate ( n - 8 ),light (n = 9 ),no color( n = 3 ).The add CT values of tumor lesion after enhanced CT were 26.32 ±9.17Hu in 13 cases with heavy or moderate group,10.87 ±4.257Hu in 12 cases with light or no red color group.The numbers of MVD of tumor lesion of pulmonary carcinoma were 57 ±6.43 in 13 cases with heavy or moderate group,19 ±5.29 in 12 cases with light or no red color group.The numbers of MVD of pulmonary carcinoma had statistical significant between heavy or moderate group and light or no red color group.Conclusion:It has a significantly direct correlation between the extent of red pseudocolor of tumor lesion on pseudocolor image and MVD of tumor lesion in pulmonary carcinoma.

Objective:To investigate the vasodilatative roles and mechanisms of 17 ? estradiol(E 2) on rat thoracic aortas (TA). Methods:Rings cut from thoracic aortas of female rats were used by in vitro perfusion. The endothelium dependent and endothelium independent vasorelaxing effects of E 2 were measured. Furthermore, it was also observed whether the relaxing effects of E 2 were modulated by tamoxifen, N ? nitro L arginine methyl ester(L NAME),TEA, methylene blue(MB) or Methylene Blue(MB).Results:E 2 caused acute concentration dependent relaxation in TA with endothelium, but not significant without endothelium( P