[Objective]To provide microsurgery anatomical data for the surgical operation in treating of extreme lateral lumbar dsic herniation through the observations of the regional anatomic structure about the post-median approach tolateral vetebral lamina(PMALVL).[Method]Thicknesses of intertransverse ligament,the distribution of anterior branches of lumbar nerve and vessel were measured at the adult cadavas specimens.Retrospectively analyzed with 12 cases of extreme lateral lumbar disc herniation from January 2004 to January 2006,including 7 cases were treated by the lateral approach to the vertebral lamina,5 cases treated by PMALVL.[Result]The thickness of intertransverse lingament is 0.6~1.3 mm.More than 90 percent of anterior branches of lumbar segmental arteries and the accompanying veins from L_3 to S_1 were located ventrally in the superior portion of the intertransverse ligament.A branch from Lumbar artery permanently locates in the hfiddle of post-lateral intertransverse ligament.The angle between the anterior branch of Lumbar nerve root and midline sagittal plane is 18.9?~39.2?.The distance from the root of the tranverse to the anterior branch of lumbar nerve root and from the lateral margin of the pars interarticul aris to the anterior branch of lumbar nerve root(5.6~8.0)mm and(1.7~3.6)mm respectively.The period of follow up in 12 cases was from 3 months to 24 months,with an average of 10 months.The resultwas excellentin 8 cases,good in 3 cases,total fine rate according the classification of Nakal was 91.67%.[Conclusion]Intertransvarse ligament is a reliable landmark for PMALVL and treating extreme lateral lumbar disc herniation through PMALVL may get microtraumatic and excellent effect.

Objective To search the effective treatment for the female chronic pelvic pain.Methods The drugs of ?-receptor inhibitor,antianxietic,psychotherapy and proper movement were taken.It was six weeks for a course of treatment.Results Of the study group(48 cases),complete recovery were noted in 36 cases,remarkable improvement in 5 cases,remarkable inefficacy in 4 cases,the total curative rate was 91.66%,which was significantly better than the control group(60.42%).Conclusion It is an effective treatment for the female chronic pain.

Objective To investigate the effect of L-carnitine (LCN) on heart function following myocardial contusion in mongrel dogs.Methods Twenty-four male mongrel dogs were randomly divided into myocardial contusion group,low dose LCN group (LCN1 group),and high dose LCN group (LCN2 group) with 8 dogs per group,according to the random number table.The model of myocardial contusion was established in all groups.LCN1 and LCN2 groups were respectively treated with 100 mg/kg and 200 mg/kg LCN for three consecutive days before the injury and afterward.Left ventricular systolic pressure (LVSP),left ventricular end diastolic pressure (LVEDP),left ventricular ± dp/dt were recorded 30 min before injury,and 30 min,1 h,2 h,4 h as well as 6 h after injury.Blood samples were withdrawn from femoral vein to detect the levels of creatine kinase isozyme (CK-MB),cardiac troponin I (cTnI),and malondialdehyde (MDA).Wall motion score index (WMSI) was observed using the ultrasound examination 1 day before and 5 hours after injury.Myocardial tissue was available at 6 hours after injury for the examination of content of adenosine triphosphate (ATP).Results LVSP and ± dp/dtmax appeared a downward trend after injury,while a gradual increase in LVEDP.And the changes were relatively smaller with LCN intervention,especially in LCN2 group.Levels of CK-MB,cTnI and MDA increased after injury,but the same time point showed lower levels in LCN groups (especially in LCN2 group) as compared to myocardial contusion group (P ＜ 0.05).WMSI increased 5 hours after the injury,but the increase was higher in myocardial contusion group (2.46 ±0.31) than that in LCN1 group (1.91 ± 0.23) and LCN2 group (1.85 ± 0.25) (P ＜ 0.05).There was no significant difference in WMSI between the two LCN groups (P ＞ 0.05).Level of ATP in myocardial contusion group was (11.3 ± 1.6) μg/g,which was improved after LCN intervention (P ＜ 0.05),and the improvement was much higherin LCN2 group than in LCN1 group[(21.3±3.9) ug/g vs (15.7±2.8)ug/g] (P＜0.05).Conclusion LCN can alleviate the adverse effect of myocardial contusion on cardiac function in mongrel dogs,which may be associated with the reduced energy imbalance induced by LCN.

BACKGROUND:Primary dislocation after total hip arthroplasty is a major complication, besides prosthesis loosening. It is controversial whether joint capsule and external rotators should be repaired during total hip arthroplasty through posterolateral approach.
OBJECTIVE:To explore the clinical significance of joint capsule and external rotator repair on preventing hip dislocation after primary total hip arthroplasty through posterolateral approach.
METHODClinical data of patients with primary or secondary hip osteoarthritis after primary total hip arthroplasty through posterolateral approach were retrospectively analyzed. They were assigned to two groups according to different strategies of soft tissue repair. Control group did not receive posterior soft tissue repair. Combined repair group received the repair of joint capsule and short external rotators. Al patients were fol owed up for more than 1 year. Early dislocation was defined as the dislocation occurred within 1 year after operation. The effects of different repair methods on early dislocation rate were compared.
RESULTS AND CONCLUSION:There were 362 patients. Total y 390 case-times of primary total hip arthroplasty were included. Early dislocation occurred in 7 cases, of which 6 case-times in the control group (2.2%, 6/268), and 1 case-time in the repair group (0.8%, 1/122). There were significant differences in the incidence rate of early dislocation between the repair group and control group (P=0.012). These findings confirmed that the combined repair of posterior joint capsule and short external rotators could decrease the rate of early dislocation after primary total hip arthroplasty through posterolateral approach.

Objective To study the clinical significance of systemic lupus erythematosus disease activity index(SLEDAI) in the treatement of SLE. Methods Disease activity of every patient with SLE 10 days before admission and before discharging was assessed using the SLEDAI system. The patients were treated separately with prednisone, pulse methylprednisolone and/or pulse cyclophosphamide according to their conditions. Statistical analysis was carried out using SPSS software. Results ①The difference of SLEDAI between the patients before admission and discharging was significant (P

Objective To evaluate the therapeutic effect and safety of ureteroscopy pneumatic lithotripsy(PL) and extracorporeal shock wave lithotripsy(ESWL) in the treatment of distal ureteral calculi.Methods 368 cases of distal ureteral calculi were divided into the PL treatment group(178 cases) and the ESWL treatment groups(190 cases).The clinical datas were compared between the two groups.Results PL treatment group 97.19% patients became stone free in 4 weeks,and in ESWL treatment group the stone free rate was 73.16%(P

Objective To investigate the role of dynophin and substance P in pruritus with 5/6 subtotal nephrectomy rats (STNx). Methods 5/6 subtotal nephrectomy rots were prepared. After 24 weeks , STNx rats entered in end stage renal disease(ESRD). Sixty male SD rats were divided into 4 groups, STNx+P group(n=15), STNx+dynophin group( n=15), STNx control group(n=15) and sham operation group(n=15). Substance P (SP), dynophin and saline were intradermal injected separately. After injection, scratch reaction of rats in 30 minutes were recorded. And then SP concentration in blood was estimated by ELISA and SP expression in skin was examined by immunohistochemisty. Results SP concentration in blood of STNx rats were (1010.2±103.5)pg/ml, which increased to (2530.0± 236.3) pg/ml in STNx+SP group and decreased to (612.4±72.2)pg/ml in STNx+dynophin group, and it was the lowest in sham opera- tion group (240.2±36.5)pg/ml. SP expression in skin was similar to that of in blood. The scratch times in STNx+SP group were highest (7.3±1.9 times), there was no significant difference between STNx + dynophin group and STNx control group. Conclusion Pruritus in ESRD rats was correlated to the increase of SP in blood and skin. Intradermal injection of dynophin can decrease SP in blood and skin, but can not induce scratch in STNx rats.

Objective To investigate the efficacy and safety of using combined lingual mucosa and buccal mucosa onlay grafts or foreskin flap urethroptasty for the treatment of long or multi-seg-ment urethral strictures. Methods Seven patients with long and 4 cases with multi segment urethral strictures(range 10 to 15 cm,mean 12)underwent substitution urethroplasty using combined lingual mucosa and buccal mucosa onlay grafts or foreskin flap urethroplasty.The patients'age ranged 24 to 56,mean 32 and the course of disease was from 6 to 96 months.Of the 11 patients 7 underwent com-bined lingual mucosa and buccal mucosa grafts urethroptasty,4 patients underwent combined lingual mucosa graft and foreskin flap Urethroplasty. Results The patients were followed up 5-1 2(mean 10)months postoperatively. Meatal stenosis developed 3 months postoperatively in 1 patient who un-derwent combined lingual mucosa and foreskin flap urethroplasty.The patient could void well after re-operation.The other patients could void well and the peak flow rate ranged from 2 1 to 3 6 ml/s(mean 26.8 ml/s). Conclusions Combined lingual mucosa and buccal mucosa onlay grafts or foreskin flap substitution urethroplasty may have the advantage of easier harvest,less trauma.It could be a good U- rethral substitution technique for the treatment of long or multi-segment urethral stricture.

BACKGROUND:Changes in the parameters of lumbar spine bone structure are direct reaction of morphological changes in lower lumbar spine bone structure. These changes possibly result from normal structure strain of the spine affected by long-term external or internal factors. Whether the conditions reflected by different parameters are identical, and whether corresponding clinical symptoms are correlative stil deserves further exploration. OBJECTIVE:To measure and compare the construction parameters of lumbar spine bone structure in lower lumbar disc herniation patients, and to investigate whether abnormalities of lumbar bony structure could lead to lower lumbar disc herniation and to evaluate the significance in degenerative lumbar disc. METHODS:From March 2008 to March 2010, 207 cases of lower lumbar disc herniation were randomly selected from the Department of Orthopedics, First Affiliated Hospital, Fuzhou General Hospital, Nanjing Military Area Command of Chinese PLA. They received CT examination at the Department of Radiology at the same period, and results revealed that 143 cases of lower lumbar disc non-herniation served as control group. According to gender, they were divided into male and female groups. According to ages, they were divided into 25-34 group, 35-44 group, 45-54 group and 55-65 group. They were studied by measuring spinous process deflection angle, facet joint angle, lumbar vertebrae curvature, angle of lumbar vertebrae curvature, lumbosacral angle. RESULTS AND CONCLUSION:Process deflection angle at L 4 and L 5 levels had a significant statistical difference between the lower lumbar disc herniation group and the control group. The date did not show normal distribution. Using Rank sum test, it had a significant statistical difference (Z=-10.609,-12.074, P<0.01). There was not significant statistical difference between the lower lumbar disc herniation group and the control group on the facet asymmetry, lumbar vertebrae curvature, angle of lumbar vertebrae curvature and lumbosacral angle at various ages (P>0.05). There only was significant difference on lumbosacral angle between male group and female group (P=0.007<0.01). There was significant difference on the facet asymmetry, lumbar vertebrae curvature, angle of lumbar vertebrae curvature and lumbosacral angle between 55-65 age group and 25-34 age group or 35-44 age group (P<0.01), and there was significant difference between 45-54 age group and 25-34 age group (P<0.01). These data suggested that the abnormalities of lumbar bony structure could not directly lead to the lumbar disc herniation, but the abnormalities of lumbar bony structure aggravate the lumbar intervertebral disc degeneration.

Objective:To investigate effects of miR-503 on cisplatin sensitivity in BEL-7402 cells by targeting of bcl-2.Methods:MiR-503 and bcl-2 mRNA expression levels in hepatocellular carcinoma cells were measured by real-time quantitative (qRT)-PCR;Bcl-protein level was detected by Western blot;miR-503 mimics were transiently transfected to the BEL-7402 cells by liposome transfection;potential target genes of miR-503 were predicted by Bioinformatics software;miR-503 potential targets were validated by dual luciferase activity;and the cell viability was measured by MTT assay.Results:MiR-503 level was down-regulated and Bcl-2 protein expression level was up-regulated in BEL-7402 cells compared with HL-7702 cells.MiR-503 could interact with bcl-2 and inhibit its expression.Cell vitality with miR-503 transfection was significantly reduced compared to that in the negative control.Conclusion:MiR-503 may enhance the sensitivity of BEL-7402 cells to cisplatin and inhibit the cell proliferation by targeting bcl-2.