Objective To investigate the expressions of epidermal growth factor receptor (EGFR), cyclooxygenase-2 (COX-2) and P63 protein in non-small cell lung cancer (NSCLC) and their relationship with TNM staging and lymph node metastasis of NSCLC. Methods Seventy-eight paraffin-embedded specimens of NSCLC from 1998-2005 were collected in this study. Inclusion criteria included no chemotherapy or radiotherapy before operation. Pathological diagnosis was made after operation: 43 squamous carcinoma and 35 adenocarcinoma, 45 with lymph node metastasis and 33 without, 13 in stage Ⅰ, 19 in stage Ⅱ, 28 in stage Ⅲ and 18 in stage Ⅳ. The expressions of EGFR, COX-2 and P63 were determined by immunohistochemical staining (S-P). Results The expression rates of EGFR, COX-2 and P63 were 65.4% (51/78), 61.5% (48/78) and 56.4% (44/78) respectively in 78 cases of NSCLC. Significant difference in the expressions of COX-2 and P63 was found between squamous carcinoma and adenocarcinoma (P0.05). The positive rate of EGFR and COX-2 protein expressions in NSCLC of stage Ⅲ-Ⅳ and NSCLC with lymph node metastasis was significantly higher than that in stage Ⅰ-Ⅱ and NSCLC without lymph node metastasis (P0.05). Conclusion Over-expressions of EGFR and COX-2 may play an important role in invasion and metastasis of NSCLC. COX-2 and P63 may be valuable markers in differentiating pulmonary squamous cell carcinoma from pulmonary adenocarcinoma.

Objective To evaluate the effect of percutaneous transforaminal endoscopic discectomy (PTED) using tar?get puncture and 2-stage procedures in treating lumbar disc hernia. Methods Patients present in our clinic from January 2014 to June 2014 with lumbar disc hernia who were treated with PTED were collected (n=36). Lower back and leg pain were evaluated by visual analog scale (VAS) while clinic outcome were assessed by Oswestry disability index (ODI) and modified Macnab criteria. Results All surgeries were carried out successfully. On average, operation time was(125±31)min, blood loss was(8.5±2.9)mL in each operation. The average length in hospital stay was(7.6±3.5)day. Compared with the preoper?ative VAS scores,the postoperative and last follow-up scores for lower back and leg pain decreased significantly (P<0.01). The ODI of pre-operation and last follow-up were (18.90 ± 7.78)%and (73.30 ± 18.21)%respectively with statistic differ?ence. As to the modified Macnab criteria,theexcellent and goodratio was 94.4%. One case present hyperalgesia in L4 der?matome which recovered through conservative treatment. No complications such as permanent nerve root injury ,cerebrospi?nal fluid leakage,or infection were found during or after operations. All patients are in stable conditions during follow-up pe?riod without recurrence. Conclusion PTED using target puncture and 2-stage procedures is an effective method with mini?mal trauma, less bleeding, quick recovery, high security, short hospitalization time. what′s more, it can remove protruded disc and broken nucleus from the intervertebral space. It ensure efficacy and avoid recurrence.

Objective To investigate short?term clinical outcomes of XLIF through small incision approach combined with percutaneous pedicle screw fixation for degenerative lumbar scoliosis. Methods From December 2011 to June 2013, 15 pa?tients with degenerative lumbar scoliosis were treated by XLIF combined with percutaneous pedicle screw fixation (XLIF group). There were 6 males and 9 females, with an average age of 68.27±5.70 (ranging from 58 to 75) years old and Cobb angle of scoliosis 22.20°±6.66° (ranging from 14° to 35°). Meanwhile, 23 patients were treated with posterior lumber inter?body fusion (PLIF) com?bined with pedicle screw fixation (PLIF group). There were 9 males and 14 females, with an average age of 63.26 ± 6.03 (ranging from 49 to 73) years old and Cobb angle of scoliosis 23.17°±6.95° (ranging from 13° to 36°). The efficacy was assessed through cor?rection rate of Cobb angle, VAS and lumbar JOA score at the time of the latest follow?up. Results The operation time was 224.35 ± 51.53 min in the PLIF group and 197.47 ± 31.84 min in the XLIF group. No significant differences were found, but there was significantly difference in the intraoperative blood loss (PLIF group: 576.52 ± 227.89 ml, XLIF group: 181.33 ± 47.37 ml, t=-8.054, P<0.001). No patient accepted blood transfusion in the XLIF group, but in the PLIF group, 11 patients accepted blood transfusion. The Cobb angle, VAS and JOA score in two groups were improved compared with the preoperative. 38 patients were followed up for 12 to 32 months, with an average of 23 months. The correction rate of Cobb angle, VAS and JOA scores were 56.90%±11.51%, 87.97%±12.07%, 84.00%±5.59%in the XLIF group, and 62.88%±8.28%, 83.68%±12.33%, 84.79%±6.76%in the PLIF group. No significant differences were found between the two groups (P>0.05). Conclusion Treatment of degenerative lumbar scoliosis with XLIF through small incision approach combined with percutaneous pedicle screw fixation is a kind of safe and effective minimally invasive spine surgery with small trauma and less bleeding, and the recent surgery efficacy was close to PILF.