Objective: To observe the effect of DSP on three models of memory dysfunction,so as to provide evidence for its potential therapeuticaction for senile dementia.Methods: Three kinds of memory dysfunction are induced by scopolamine,reserpine and ovariectomy respectively,and memory ability is measured through step through and water maze tests.Meanwhile AchE activity in front cortex, hippocampus,striatum and limlic lobe of rats injected scopalamine is determined.Results: DSP can significantly prolong the step through latency,and decrease AchE activity in different parts of rats injeted scopalamine.And DSP can remarkably prolong latency,and increase uterus index of mice after ovariectomy.On the other hand,DSP can shorten water maze latency,enhance the correction percentage of mice injected reserpine.Conclusions:DSP can improve the memory dysfunction possibly through below pathways:(1)enhance the cholinergic system;(2)antagonize the decrease of monoamino transmitter;(3)has the possible estrogen like action.

Objective To investigate indications,technique,prognosis and complications of anterior flap hemipelvectomy (hemipelvectomy using a quadriceps femoris muscle flap with superficial femoral artery)in the treatment of pelvic tumors.Methods From April 2009 to October 2010,10 patients with pelvic tumors underwent anterior flap hemipelvectomy in our department.There were 9 males and 1 female,aged from 30 to 62 years (average,46 years).There were 7 cases of chondrosarcoma,1 case of epithelioid sarcoma,1 case of pleomorphic liposarcoma and 1 case of spindle cell sarcoma.Results Nine patients were followed up for 12 to 30 months (average,21.5 months).Superficial skin necrosis occurred in 1 patient,while there was no wound infection.Local recurrence (33.3％) occurred in 3 patients,including 2 cases of chondrosarcoma and 1 case of epithelioid sarcoma.Three patients died at last,including 2 patients with local recurrence and 1 with pulmonary metastasis from liposarcoma.Two patients survived with pulmonary metastasis,and remaining 3 patients survived without recurrence and metastasis.Conclusion Anterior flap hemipelvectomy is indicated for:(1) patients with extensive soft tissue sarcoma in the buttock,and the tumor or reaction zone involve the subcutaneous tissue; (2) patients with recurrent pelvic tumors,and the conventional posterior flap can't be used due to contamination by the original incision; (3) patients whose posterior flap has poor blood supply due to radiotherapy or other factors.The prerequisite of the surgery is that the blood stream between external iliac artery and femoral artery is unobstructed; moreover the blood vessels are not in the tumor reaction zone.Compared with conventional posterior flap,the anterior flap hemipelvectomy is an easier procedure,which not only can easily cover surgical defect and obtain better surgical margin,but also has less complications.

ObjectiveTo investigate safety and efficacy of one-stage pedicle screw fixation plus 360° spinal canal decompression and reconstruction in treatment of severe thoracolumbar burst fractures.MethodsThe study reviewed 11 patients (8 males and 3 females, at age range of 19-59 years, mean 34.4 years) with severe thoracolumbar burst fracture, who underwent one-stage posterior pedicle screw fixation, 360° spinal canal decompression and reconstruction. The injury location was at T12 in one patient, at L1 in three, at L2 in two, at L3 in three and at L4 in two. According to AO classification, all patients were with type A 3.3 fractures. McCormack load score was 7-9 points ( average 8.2 points). Based on the Frankel' s scale, the spinal cord function was classified as grade A in one patient, grade B in one,grade C in five and grade D in four. ResultsAll the operations accomplished successfully, with operation duration for 3.5-4.5 hours ( mean 4.1 hours) , blood loss for 900-2 800 ml ( mean 1 750 ml) and allogeneic blood transfusion for 400-1 200 ml ( average 760 ml). There was no complication either during or after operation. The loss rate of the anterior vertebrae column height was 48％ -85％ ( average 64.2％ )before operation and recovered to 95％ -100％ (average 98.6％ ) of the normal. The kyphotic Cobb angle was at -12°-35 ° ( average 12.1 ° ) before operation and recovered to - 30°-7 ° ( average - 8.1 ° ) after operation. The spinal canal stenosis rate was improved remarkably. The patients were followed up for 10-18 months (average 14. 5 months), which showed solid bone fusion, with no implant failure. The spinal cord function was improved Ⅰ to Ⅲ degrees in all patients except for one patient at grade A. One patient had mild lower back pain.ConclusionsOne-stage pedicle screw fixation plus 360° spinal canal decompression and reconstruction is a good alternative for severe thoracolumbar burst fracture, but it is essential for choosing strictly the surgical indications.

ObjectiveTo compare the clinical results of pedicle screw fixation via the injured vertebra versus across the injured vertebra for thoracolumbar spine fracture.MethodsThe study reviewed 56 patients (41 males and 15 females,at age range of 21-66 years,mean 41.5 years) with thoracolumbar spine fractures managed with the two fixation methods from June 2005 to December 2008.The fracture segment included T12 in 13 patients,L1 in 27 and L2 in 16.According to the AO classification,there were six patients with type A1.2,29 with type A3.1,nine with type A3.2 and 12 with type A3.3.McCormack load score was 5-8 points (average 6.3 points). The spinal cord injury was classified as grade A in three patients,grade B in four,grade C in eight,grade D in 17 and grade E in 24 according to Frankel scale.The patients were divided into two groups,ie,across vertebral fixation group (27 patients) and via the vertebral fixation group (29 patients).All patients were selectively treated with monosegment bone graft simultaneously.The Cobb' s angle,restoration of the anterior height of the injured vertebra,improvement of spinal canal stenosis rate and Denis scale in local pain and work status were compared between the two groups.The bone graft fusion and spinal cord recovery of both groups were observed during follow-up.ResultsAll patients were followed up for 12-48 months (average 25.8 months).Implantation loosening occurred in one patient 1.5 month after operation in across vertebral fixation group.There were no significant differences in aspects of correction of Cobb' s angle,restoration of the anteriorheight of injured vertebra and improvement of spinal canal stenosis rate postoperatively as well as in aspects of restoration of anterior height of injured vertebra and improvement of spinal canal stenosis rate at the latest follow-up between the two groups ( P ＞ 0.05).The postoperative loss of correction rate of Cobb's angle of both groups existed,with significant difference (P ＜0.05). The differences of the Cobb's angle at the latest follow-up and after operation were significant in the across vertebral fixation group ( P ＜ 0.05) but insignificant in the via vertebral fixation group (P ＞ 0.05 ).Bone graft fusion occurred in 21 patients (78％) in the across vertebral fixation group and in 27 patients (93％) in the via vertebral fixation group ( P ＜ 0.05 ).Denis scale indicated a better recovery in the local pain of via vertebral fixation group compared with the across vertebral fixation group ( P ＜ 0.05 ),but showed no significant differenc e in work status between the two groups ( P ＞ 0.05 ).ConclusionsCompared with across vertebral fixation,the pedicle screw fixation via the vertebra has the advantages of higher fusion rate and better correction rate of Cobb' s angle and is a better choice for thoracolumbar spine fracture with posterior approach.

Objective To evaluate intra-operative radiotherapy after breast conservative surgery in early breast cancer patients in terms of postoperative complications,cosmetic outcome and recurrence events.Methods From June 2007 to Dec 2010,115 early breast cancer patients received breast conserving surgery.Fifty-nine patients (study group) received intra-operative radiotherapy,compared with 56 patients (control group) receiving routine postoperative radiotherapy.Postoperative complications were evaluated 1 month after surgery; cosmetic outcome was evaluated 1 year postoperatively; recurrence and death events were followed up.Results The average wound healing time was 13 -22 days in study group and 9 - 14days in control group.In the study group,2 patients developed fat deliquescence,16 patients showed wound edema while no such side effects were found in control group.No infection or hematoma were found in either group.Overall cosmetic outcome was rated 1 year post operation.In the study group (41 cases),36 patients were graded as excellent or good,5 patients were as fair or poor.Meanwhile in the control group (37 cases),wounds in 25 patients were graded as excellent or good,that in 12 patients were as fair or poor (P =0.031).After a follow-up from 3 to 42 months(median:24 months),two patients (3.39％) in study group developed local cancer relapses,one of them( 1.7％ ) died.In control group,one patient ( 1.8％ )developed local relapse,and no one died.Conclusions Intra-operative radiotherapy is safe and reliable with good cosmetic outcome.

Objective To investigate the effects of a proliferation-inducing ligand(APRIL) on migration and invasion of colorectal cancer (CRC) and matrix metalloproteinases (MMPs) expression in order to observe the role of APRIL in CRC metastasis.Methods The siRNA plasmid vector targeting APRIL gene (siRNA-APRIL) was transfected into SW480 cells and recombinant human APRIL(rhAPRIL) was used to stimulate HCT-116 cells.Tumor cell migration and invasion were measured by Transwell chambers.RT-PCR and ELISA were applied to examine the expression level of MMPs.Results Metastatic and invasive capacities of siRNA-APRIL transfected SW480 were significantly inhibited,and these capacities of APRIL stimulated HCT-116 cells were significantly enhanced compared with their respective controls( all P＜0.05 ),accompanied with the alterations of MMPs mRNA and secreted protein expression( P＜0.05).The number of invading cells of SW480 control and rhAPRIL stimulated HCT-116 was significantly decreased by a MMP inhibitor GM6001 ( P＜0.05 ).Conclusion APRIL facilitates migration and invasion of CRC via regulation of MMPs,which suggests that APRIL might be used as a new target for the intervention and treatment of CRC metastasis.

Objective To investigate the changes of hypoxia-inducible factor(HIF)-1α and hexokinase-Ⅱ(HK-Ⅱ)expression in human esophageal squamous cell carcinoma and its effect in glycolysis.Methods TE13 cells and Eca109 cells were cultured under hypoxic condition(1 ％O2)for different hypoxic time(6,12,24 and 48 hours).Cells cultured under normal oxygen condition(20％O2)were set as control.The changes of HIF-1α and HK-Ⅱ expressions at protein level were detected by Western blot.HIF-1α genes were specifically silenced with RNA interference technology(RNAi),and then the changes of HIF-1α and HK-Ⅱ expression were determined by realtime PCR and Western blot.Under normal oxygen and hypoxic condition,the changes of lactic acid concentration in cell culture medium were detected by spectrophotometric method.Results Under hypoxic condition,the expression of HIF-1α and HK-Ⅱ gradually increased as hypoxic time extended(P＜0.05),reached a peak at 12h and then gradually decreased as time extended.Compared with that under normal oxygen condition,the expression of HK-Ⅱ in TE13 cells and Eca109 cells significantly increased under hypoxic condition(P＜0.05),which was more significant after 12 hours hypoxia.The result of realtime PCR indicated that under normal oxygen condition the expression of HIF-1α at RNA level in TE13/shRNA cells and Eca109/shRNA cells significantly decreased compared with TE13 cells and Eca109 cells without interference(P＜0.05).The expression of HK-Ⅱ at RNA level was consistent with the result of HIF-1α.Under normal and hypoxia condition,the expression of HK-Ⅱ at protein level in TE13/shRNA cells and Eca109/shRNA cells significantly decreased compared with TE13 cells and Eca109 cells without interference,and the difference was statistic significant(P＜0.05).The lactic acid secretion of TE13 cells and Eca109 cells under hypoxia condition(14.707 ± 3.594 and 15.062 ±3.901)was higher than that under normal oxygen condition(6.070±1.839 and 6.891±1.592,P＜0.05).The lactic acid secretion of TE13/shRNA cells and Eca109/shRNA cells significantly decreased compared with TE13 cells and Eca109 cells without interference,and the difference was statistic significant(P＜0.05).Conclusion The expressions of HIF-1α and HK-Ⅱ in human esophageal squamous cell carcinoma significantly increased under hypoxia conditions.The expression of HK-Ⅱ is closely correlated with lactic acid concentration and HIF-1α expression.HIF-1α may affect cell glycolysis through HK-Ⅱ.

Objective To study the clinical effect of posterior lumbar interbody fusion (PLIF) using expandable cage in treatment of lumbar spondylolisthesis.Methods Twenty patients who underwent PLIF using expandable cage for lumbar spondylolisthesis were retrospectively analyzed.The operative time and transoperative bleeding were recorded.Postoperative regularity follow-up X-ray and CT,the olisthy rate,intervertebral height index and intervertebral fusion were observed.The lumbar function improvement was assessed by Oswestry disability index (ODI).Results All the patients were successfully operated,the operative time was 100-160 (123.3 ± 16.4) min,transoperative bleeding was 350-600 (464.0 ± 78.7) ml.The follow-up time was 12-36 (24.3 ± 7.3) months,symptoms were significantly improved.During the follow-up duration,20 patients obtained bony fusion.According to the reforming Macnab grade standard,excellent was in 14 cases,good was in 4 cases,acceptable was in 2 cases,the rate of excellent and good was 90.0％(18/20).The ODI score and olisthy rate postoperative 6 months and last follow-up were significantly lower than preoperative,and ODI score last follow-up was significantly lower than that postoperative 6 months,there were statistical differences (P ＜ 0.05).The intervertebral height index postoperative 6 months and last follow-up were significantly higher than that preoperative,there were statistical differences (P ＜0.05).There was no statistical difference in olisthy reset rate between postoperative 6 months and last followup (P ＞0.05).The last followed-up,There were no expandable cage subsidence or displacement,intervertebral space collapse and intervertebral height loss.Conclusions As a new production,expandable cage is an effective tool on treating lumbar spondylolisthesis,it can effectively restore the intervertebral height and the biological mechanical properties of the lumbar vertebrae.This study indicates that expandable cage is an effective and safe products for lumbar interbody fusion,which maintained a lower complication rate and better results.

Objective To analyze the distribution and drug resistance of pathogens isolated from blood culture specimens in a grade 3A hospital so as to provide a basis for the prevention and control of bloodstream infection ,and rational antibacterial drugs use .Methods A total of 3 241 blood culture results in our center from June 2014 to September 2016 were analyzed retrospectively . The blood samples were cultivated with the BacT/ALERT 3D and VersaTrek instruments .The bacterial identification and antibiotic susceptibility tests were conducted with VITEK‐2 Compact and ARIS 2X instruments .Results Among 3 241 blood culture speci‐mens ,99 strains of pathogenic bateria were isolated with the positive rate of 3 .1% ,including 42(42 .4% ) strains of Gram‐negative bacteria ,54(54 .5% ) strains of Gram‐positive bacteria and 3(3 .0% ) strains of fungus .The top three of Gram‐negative bacteria were in turn Eescherichia coli ,Klebsiella pneumonia and Pseudomonas aeruginosa ;the top three of Gram‐positive bacteria were in turn coagulase‐negative staphylococcus (CNS ) ,Staphylococcus aureus and streptococcus pyogenes .Enterobacteriaceae remained 100 .0% sensitivity to imipenem ,meropenem ,piperacillin/tazobactam and amikacin .The resistance rate of Gram‐positive bacterium to vancomycin ,linezolid ,teicoplanin and gentamycin was 0 .0% ,the rest had different degrees of drug resistance .Conclusion Ee‐scherichia coli ,CNS and Staphylococcus aureus are the most frequent pathogenic bacteria of the blood stream infection in our hospi‐tal .Pathogens show different resistance to different kinds of antibacterial agents .Clinic should rationally select the antibacterial a‐gents according to the drug susceptibility test results so as to slow down the generation of drug resistance bacterial strains .

Objective To compare the advantages and disadvantages of three different fixation methods via muscle-splitting approach for the treatment of single segmental lumbar vertebral diseases.Methods All of 90 patients with the single segmental lumbar vertebral diseases were treated from June 2012 to June 2013,including 34 males and 56 females,at the age of 27-76 years old,averagely (53.37± 15.41) years.Twenty-seven patients were treated with unilateral pedicle screws via unilateral muscle-splitting approach (unilateral fixation group).Thirty-three patients were treated with unilateral pedicle screws and contralateral translaminar facet screw via unilateral muscle-splitting approach (combined fixation group).Thirty patients were treated with unilateral pedicle screws via bilateral muscle-splitting approach (bilateral fixation group).Observe and compare the imaging and clinical results of these three groups.Results There were no significant difference in incision length and postoperative wound drainage between these three groups.The operation time was shortest in unilateral fixation group,while longest in bilateral fixation group.In the intraoperative blood loss,the unilateral fixation group was the same as the combined fixation group,while less than the bilateral fixation group.No infection was found after operations.Seven patients experienced epidermal necrosis of the incision,including 1 patient of unilateral fixation group,4 patients of combined fixation group and 2 patients of bilateral fixation group.Three patients suffered from nerve injury,including 2 patients of combined fixation group and 1 patients of bilateral fixation group.The follow-up time was from 12 to 36 months,averagely 25.5 months.The intervertebral height of lesion segments was apparently recovered after surgery,and maintained during the follow-up in these three groups.No significant changes of area and grade of multifidus muscle were detected at 1 year after surgery compared with preoperative.Seven patients experienced endplate cutting and cage partially embedded into vertebral body,including 3 patients of unilateral fixation group,3 patients of combined fixation group and 1 patient of bilateral fixation group.There was no loosening,displacement,breakage or cage shifting.Except 5 patients (2 patients of unilateral fixation group,2 patients of combined fixation group and 1 patient of bilateral fixation group),the remaining cases had well interbody fusion.At the final follow-up time,the JOA score significantly increased compared with preoperative.Besides,unilateral fixation group and combined fixation group were superior to bilateral fixation group.Conclusion Three different fixation methods via muscle-splitting approach for the treatment of single segmental lumbar vertebral diseases had well clinical results.The unilateral fixation and combined fixation via muscle-splitting approach had more advantages.The combined fixation via muscle-splitting approach is an innovation in approach,exposure and fixation aspects.